Monday, March 27, 2017

Comments by Matt Stevenson

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  • I do want to support what another commenter said about the lack of validity for the label “bipolar disorder” – let alone generational or hereditary bipolar. The human genome did not evolve to reify or transmit invalid DSM diagnoses.

    MIA author Jay Joseph has some excellent essays about why twin studies and other gene investigations do NOT support a genetic basis for schizophrenia, bipolar, or other related “illnesses”/severe behavioral-emotional problems.

  • Emily,
    Great job! This is a fantastic story. I have read your story in more detail on the Jewish Currents site and was impressed with how you spoke out from the first time I read.
    I totally agree that speaking out and being an example that people who’ve been traumatized by the system can come to to tell their story, privately at first… is so valuable and needed. Well done.

  • Ok, again you made an assertion, “The bodily system of the central nervous system is CASUAL, but the endocrine system can be contributing component to schizophrenia as well.” – but you give no data, no links to studies, no evidence or explanation for these opinions.

    Why should people believe you if you cannot back up your assertions?

    And perhaps you meant “causal”, not casual.

  • pathayes,

    If you have actual data beyond opinion which explains how misfiring nerves cause schizophrenia, please present it here. I think most readers know that that data doesn’t exist, which is one reason why the diagnosis of schizophrenia lacks validity – being a label under which two people can have no symptoms in common, but still receive the same “diagnosis.”

  • pathayes, you haven’t made any actual arguments nor presented any evidence with your comment.

    Of course we all have a nervous system.

    And yes, our brain chemistry changes constantly in relation to the environment.

    You said the nervous system is “a reason” – for what? Perhaps for your idea that “mental illness” has a biological component? If so you need to clarify that and explain how the nervous system can cause mental illness. You didn’t do that.

    What you haven’t presented is any evidence that changes in brain chemistry are the cause of distress, rather than the expression or correlation of interaction between organism and environment.

    Meanwhile, I presented admissions from leading American psychiatrists that DSM disorders lack validity, have no established biomarkers, and that there is not clear evidence of biogenetic causation for these problems. But you didn’t seem to acknowledge or respond to that… isn’t it more powerful when the leading people within the profession admit that lack of evidence?

  • Or rather than a fool disagreeing, perhaps former NIMH directors Steven Hyman:

    “The underlying science remains immature…The molecular and cellular underpinnings of psychiatric disorders remain unknown… psychiatric diagnoses seem arbitrary and lack objective tests; and there are no validated biomarkers with which to judge the success of clinical trials.”

    and Thomas Insel:

    “The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”

    … offer a different view on the biological side of mental health challenges.

    The fact remains that while all of our experiences are expressed in biology and epigenetics, there are no biomarkers for any DSM disorder, nor any evidence that changes in brain chemistry or epigenetics are causal for – rather than correlated with – behavioral and emotional problems that get labeled as mental illnesses.

    Perhaps you can define more clearly what you mean by “a biological component”…

  • The level of deception and misleading intra-group reassurance within the psychiatric establishment is startling and stunning… or perhaps not so much when we think back to how staunchly tobacco execs resisted acknowledging the harms of their immensely profitable product decades ago. Profit over people.

  • Hi Oldhead,
    Thanks for your comment. While it may not correlate with my being right, I have felt from my reading about people experiencing delusions / hallucinations / withdrawal etc (experiences that get these severe labels) that there are commonalities (at the group level) in terms of the people having experiencing a lot of neglect and/or abuse, when I read their stories either in the first-person or from the third-person view of someone relating to them. And then there are some commonalities in how seriously distressed people react – they have trouble with making trusting relationships, trouble with functioning independently in a confident manner, trouble dealing with high levels of terror/rage, etc. It would be strange to me if there weren’t some commonalities, since people do have common tasks to deal with in growing up and navigating the world and relationships, and since as human beings we tend to react to threatening things by, perhaps obviously, becoming afraid and upset.

    Do you think that’s incorrect?

    I see your view too. People are very variable and applying any of these labels to an individual doesn’t mean much at all.

  • Noel,
    The Soteria project ( is quite similar in how it was run to the 388 Project which still runs in Quebec, Canada:

    I did not realize this link before for some reason prior to read your article. 388 has had, and still has, results similar to Soteria for French-speaking Canadian people experiencing psychosis.

  • Noel,
    Good to see more deep thinking from you… it had been a while.
    I’m always impressed by how you cite a range of interesting sources, and keep finding new ones. It reminds me of someone I know 🙂

    Now, being a bit more humble, I do really like this essay.
    I’m becoming a bit more open to the idea that the suffering aspect of psychosis itself could be transformative, which is difficult for me to see because it was not my experience. However, the fact that things are rarely all-bad suggest that it’s quite possible that some adaptive or possibly useful results may come from a psychotic crisis. It’s like the Chinese word for crisis, meaning opportunity.

    I still remain of the opinion that the most important thing for healing is genuinely supportive, close relationships which support the psychological self and gradually allow it to be freed from the negative thinking/feeling/behaving it is caught up in. But such a statement can only be made very generally, because psychosis or schizophrenia are very vague words and the nature of people’s problems varies a lot from person to person. Still, I like to think about the developmental continuum in which all-bad internalized experience (partially based on neglect – almost always some neglect or lack of needs met – and then sometimes also based on added trauma or abuse) is key to understanding the disturbing thoughts/feelings and behaviors that get labeled psychosis.

    Of course as you rightly point out, psychiatry mostly does not understand, or will not acknowledge the factors pointed out in the sentence above. Thus it is important to keep pointing it out – and to point out a range of ways of looking at the problem, as you do in this case by exploring other cultures and how they understand unusual experiences differently, as well as psychedelic drug use.

    Thanks for this great article.

  • Calling it “involuntary psychiatric care” is a misnomer, due to the use of the word “care”.

    What bothers me the most is that psychiatrists not only forcibly give drugs, but also mislead families and clients that these drugs are “medications” treating specific “illnesses” (e.g. schizophrenia / bipolar), even when no biomarkers exist for these supposedly discrete pathologies, and there is no clear evidence that severe distress caused by biology/genes primarily. So forced treatment can become a pathway along which people get led into becoming a chronic patient / a believer in the brain disease model.

    Psychiatrists should present their pills honestly as tranquilizers / numbing agents, which are exerting generalized effects without specifically treating any “illness”. They should admit how little is known about psychiatric diagnosis and that diagnosis lacks validity and has poor reliability.

    And of course they should not force people to take drugs, let alone misleadingly frame these drugs as medications treating a brain disease.

    Seclusions / restraint is another issue. I remain open to the idea that if someone is violent and about to harm another person, they should be forcibly restrained or secluded for at least a limited time. But as Oldhead wrote, this is a matter of violence and a legal response to it, not the province of psychiatry and its invalid diagnoses and questionable treatments, the latter of which should always involve choice as to whether a person wants to accept them or not.

  • Sandra,
    You said at the end what I was thinking from the very beginning of your article:

    So much more could be offered.

    Psychiatric involuntary commitment is a relatively minor issue when set against the backdrop of so little resources being available to help seriously distressed people in the USA outside of drugs. In terms of job training, affordable housing, individual therapy, family therapy, etc, the availability of these psychosocial resources – which in many cases could prevent the need to even consider committing someone – is sorely deficient by an order of magnitude (10x) or maybe even two orders of magnitude (100x).

    Involuntary commitment also makes only a small difference because it typically means locking someone up for only a few days or weeks. Not everyone is harmed, but many are harmed by being started on too many drugs and being traumatized by the force used. For those who are not harmed, like the woman who appreciated her experience, they might be kept safe, but a few days or weeks are usually not enough to address all the life circumstances that may be contributing to serious distress.

    And lastly, this part was also important,

    “When one is raised, so to speak, in a world in which these problems (paranoia, heightened disorganization of thought and behavior, marked elevations of mood and energy) are known to be illnesses, then the examination of the problem starts, in my view, midway down a road. The questions asked have to do with how to best treat the illness over the person’s objection. If, however, one starts from a premise of uncertainty — accepting that these are complex situations whose cause and etiology are unknown — then one might be more cautious about jumping into framing the problem as one of access to treatment.”

    I continue to be amazed to see psychiatrists writing about serious distress as if it were a brain disease, even in the lack of any objective evidence/biomarkers of biogenetic causation. It seems like this is the hallmark of thinking for most in the field: Assume your conclusions.

    I guess when you need to frame problems as illnesses to make your living and feel justified in prescribing drugs, that is what you do. But to me it is unethical and an example of living an unexamined professional life.

  • Oldhead,
    Let’s be straight here: calling someone’s words “egotistical” and “machismo” is making it personal, rather than discussing the issues. Again, let’s discuss the issues at hand rather than making assumptions about each other.

    And I said, “it would be powerful” if more people spoke out publicly… and that … “In some cases it is indeed too risky, due to threats like job loss, repercussions from the system or from family, and so on.”

    So at the beginning I explicitly acknowledged that there are some situations where it’s not possible or desirable to speak publicly; that dosen’t sound like pressuring people to me.

  • AntiP, I agree. Relative to your points about journalists, if I lived in certain countries or settings I would not write online publicly or under a real name. But living where I do, being in the US and not currently involved with the psychiatric system, I feel it’s a calculated, worthwhile risk.

  • Oldhead, there’s no need to respond in such a negative way.

    Many authors on this forum with experience of grave harm from psychiatric treatment have decided to publish and comment under their real names, such as myself, Tina Minkowitz, Rai Waddingham, Sera Davidow, Caleb Chafe, Laura Delano, Chaya Grossberg, Corinna West, Rufus May, and others.

    I’ve been free of psychiatric treatments for a long time, fortunately.

    Absolutely, people’s opinions are just as valid if they are made under a pseudonym or under their real name.

    You don’t know what I experienced or did not experience in the system, so should not assume what I know or don’t know. Hint: it was pretty vicious. You also don’t know the specifics of my personal or financial situation.

    The part where I spoke about courage was intended to say that sometimes, people choose to make difficult decisions that feel risky at the time, such as the choice to speak out publicly against psychiatric treatment. To do that takes some guts, but it may also have benefits such as showing that it’s possible to talk about difficult experiences in the psychiatric system with less fear and/or less shame. And it may inspire others.

    To not do it, is equally an option and sometimes a wise and necessary one, as you wrote. You interpreted my comment as criticizing other people generally, but I did not intend that, as can be seen in how I answered other people.

    I hope you will appreciate that I responded to your comment without making negative assumptions about your own motivations or impugning you personally.

  • Kindredspirit, thanks for sharing this story… sorry to hear about the incredibly irresponsible therapist and what that put you through.

    Again, I think people should do whatever they feel necessary to stay safe.

    Having said this, many people, including many authors of MIA articles here like Olga Runciman, Eleanor Longden, Caleb Chafe, myself etc, eventually reach a point where they feel free enough emotionally and financially to speak up publicly about their experiences. I think this is a positive thing, because there should be no shame in having receive invalid psychiatric diagnoses, having taken drugs (however one thinks about drugs), having been harmed by treatments which one didn’t want, etc. And so I hope more people will do this.

  • Cat, it is difficult to admit these things publicly, but I think there is nothing wrong with making mistakes and having been hurt when we didn’t know better. It’s nothing to be ashamed of. I also took psych drugs, was afraid of the idea of incurable mental illnesses, etc, at one time in the past. It’s ok… sometimes we make mistakes, and now we know better.

    Having said this you should do whatever you think is best. I like your posts and think your online consciousness-raising is very valuable. I also like the humor in some of your posts as that is very therapeutic when people are seeking relief from a system as oppressive as mainstream psychiatric treatment… so well done.

  • Rachel, I hope you will become freer soon and more able to speak up as you wish.

    I only considered speaking up publicly once I had moved away from my family to live independently, stopped taking all psych drugs, became established and secure financially. There is a certain base level of resources and self-sufficiency that is needed to limit that risk that comes with speaking out publicly about such difficult issues as psychiatric diagnoses and treatments one has been through.

  • I think if more people here would speak up about injustice using their real names with actual photos, it would be powerful… as do people like myself and Frank Blankenship and Tina Minkowitz. If so many people are commenting under pseudonyms, it speaks about how afraid many of us are to be seen and say what we have to say publicly.

    In some cases it is indeed too risky, due to threats like job loss, repercussions from the system or from family, and so on. In other cases, the fear is mostly a perception, and if a person starts speaking up under their real name, nothing that bad will happen. The latter has been my experience. So, let this be a challenge to others to come out from the shadows if they feel they can, and if they have the guts to do so.

  • What is dishonest is that no mention of the Big Pharma funding is to be found on the site… or maybe I didn’t look hard enough to find it. But sites need to be honest and list where they are getting their money from:

    Nothing there about pharma funding. Maybe the money spigot hasn’t been turned on yet, but if and when it does (is it already on?) there should be full disclosures.

    And the CEO’s response totally ignores the content of what was said to him about the reasons for leaving. It’s not very genuine, to me.

  • Great article, Danny. Thanks for coming in here. I have gone through similar experiences to you in questioning and moving away from mainstream views.

    I have done a lot of questioning of the “illness like any other” model myself. I find people are often threatened by it being questioned, and also cannot imagine that what they have been told about the causes of their distress might be so mistaken (i.e. it’s embarrassing and disturbing to even consider how far off the mark the explanations many people are given about, for example, schizophrenia, are).

    Please check out a few resources that are not drug-company funded and which question mainstream diagnoses:

    Drop the Disorder –

    ISPS and its forum – and

    ISEPP and its forum – and

    Questioning the disease model and talking about difficult experiences is the norm on these forums… as it is here.

    Occasionally I try to talk to mainstream online psych forums in a way that questions the medical model, and often it has very mixed results; for example here –

    But I was encouraged because when I shared these views around the internet recently, only one forum out of many banned me, and that is a forum that is committed to telling people they have a brain disease and have to take drugs.

    I think people are hungry to hear other more hopeful views than the brain disease and have to take drugs one.

  • Oldhead,
    There is a way of thinking about serious distress that goes from, roughly…

    – a “younger”, more developmentally early, less mature way of thinking and feeling, sometimes called presymbiotic phase, and which involves seeing things as all-good or all-bad, and confusing what is oneself and what is other people

    – through various phases up to an older, more mature, more integrated/ambivalent way of processing relationships and situations (called individuation / separate sense of oneself and other)

    I think there is some reality to these continua in how people experience their relationships and lives, very generally speaking. Mahler, Stern, Schore, and others who’ve seriously studied mothers and children and what helps children grow up to be fulfilled adults, have done good studies of these ways of relating and not pathologized the problems as much.

    The question is what to call these experiences, and how talking about it can not be destructive to label or discuss common experiences.

  • Craig,

    This is a great post – nice to see a broad 30,000 foot view of options that can help with emotional distress. The key point I took away from this is that drugs are just one option among many, not the centerpiece of treatment necessarily – and this should include experiences that get labeled “schizophrenia” and “bipolar”, in my view. From reading most mainstream material, you would think drugs should be 70-80% of the treatment for serious distress… whereas really, they should probably at most be 10-20% (or sometimes 0%) of an integrative approach that addresses what can help a person in many spheres and on many levels.

    One criticism – DBT may have more short-term research due to its branding, but it’s not necessarily better in any way over the long term for people labeled “borderline” (a meaningless, vague label anyway) than other approaches. A lot of survivors hate DBT because of its concretization of labels and its directive, simplistic approach. So I don’t think you should put it out there as the primary approach for a vague label like this. Here are a couple of ways to rethink this issue:

    – Intensive Long-Term Therapy can have really good results for trauma that gets labeled “borderline” – – no DBT study has these kind of long-term results over years, that I’m aware of.

    – BPD should be abolished as a label and replaced by a more continuum-based, non-stigmatizing way of describing serious distress:

    These links above are from my personal site about part of my traumatic experience.

    Borderline Personality is not a thing people have, just a flawed label for experience people may have at one time and become free from later. These labels are a conundrum and most of the studies on them are, admittedly, biased in various ways by the observer’s input.

  • The problem is that that the word “merit” makes it sounds as if the word “schizophrenia” is something that people deserve or earn… almost as if the label schizophrenia were valid or accurate, and as if such a label was worthwhile. In reality, two people can “merit” this label while having no experiences in common. It is largely arbitrary and subjective. Not to mention extremely harmful given the assumptions attached to this outdated word.

    These labels are just so problematic.

  • “I wonder what leads Robin Murray to acknowledge his mistakes when others seem to hunker down.”

    Well Sandra, as Upton Sinclair said in the early 20th century, “It is difficult to get a man to understand that ‘schizophrenia’ is not an illness and that antipsychotic tranquilizers are not ‘medications’, when his salary depends upon his not understanding these facts.”

    Or is that a misquote? I’m joking… but perhaps once they come to the end of their career, it becomes a bit easier to acknowledge mistakes.

    From an outsider perspective like mine, it seems obvious that it would be much easier to admit one’s mistakes once one’s living has been made and one’s retirement has been funded, as in Murray’s case (given that he’s in his mid 70s). It’s still good of him to admit to mistakes, but less impressive – and perhaps from another perspective less foolish and risky – than for a younger man. In his case, speaking out involves primarily humility, which is a good thing, but not risk. But for younger psychiatrists, speaking out could involve being unable to pay their mortgage, not being able to send their kids to school, not being able to fund their retirement, etc… who would take those risks?

    Regarding this, “The idea that antipsychotic drugs treat a specific pathological process inherent to all who merit the diagnosis of schizophrenia simply makes no sense. And yet these compounds seem fairly consistently to reduce the intensity of voices and lessen the intrusiveness of unusual thoughts.”

    This is where I think it would be helpful to simply name most of these compounds as tranquilizers or deadeners. People will not do that, perhaps because they don’t want to face the reality that we are silencing our fellow humans en masse by loading them up with numbing agents that block their ability to think and feel… treating them, in some cases, almost like non-human animals or cattle. It’s not a very attractive picture. The euphemism that we are giving them “medications for schizophrenia” protects the self-esteem of professionals and prevents us from facing how inadequately such people are really being treated.

    More broadly, the need to frame antipsychotic drugs as “medications” treating an specific disease process, and the need to overfocus on biology, must be traced directly back to the profit motive for both psychiatrists and their benefactors, the drug companies. I discussed these factors in my essay last year:

    “This bio-genetic focus is understandable when one considers that primarily bio-genetic explanations of psychosis have numerous “advantages” for the psychiatric profession, in that they:

    1) Support the illusion that psychiatrists are treating well-defined brain diseases in their privileged role as medical doctors;
    2) Justify the use of tranquilizers, euphemistically named “medications,” to treat the supposed illness;
    3) Protect psychiatrists and allied mental health workers from having to get to know psychotic people intimately as individuals, a process which often involves encountering uncomfortably large amounts of confusion, terror, rage, and despair;
    4) Allow for shorter sessions and more profit per hour worked – it is much easier and more lucrative to give someone a pill after a 15-minute evaluation, than to sit and talk to them for an hour;
    5) Allegedly protect parents from being “blamed” for contributing to their child’s psychosis despite the fact that biological models actually encourage prognostic pessimism, and obscure the obviously uncomfortable fact that not all, but many parents of psychotic individuals have abused and neglected their children, as pointed to by the studies connecting trauma and psychosis”

    Lastly, Sandra, you might be interested to check out how George Soros picked stocks in his early career. He studied the thinking processes you describe and tried to interrupt his own processes of easily assuming which stocks were best by reading many contrary views – i.e. constantly challenging himself by reading both the supporters and critics of ideas about different companies. In this way he stopped himself from becoming too enchanted with any one view. I read about this in an interview, but I don’t have the link.

    Another good book on a related subject is Future Babble, in which cautious thinkers who think along ranges or continuums are more accurate in making predictions than more certain thinkers who try to make precise prognostications.

  • Hi Fiachra, thank you, I do not have personal experience of this phenomenon but don’t doubt it is possible from reading the experiences of others who were withdrawn abruptly from drugs and then experienced sudden recurrence of their distress. Disturbingly, leading American psychiatrists during the 1980s and 1990s actually proved that such experiences are possible, via conducting unethical experiments in which they suddenly withdrew patients from their drugs cold turkey.

  • Hi BCharris, thanks for commenting. I think Lloyd is actually open to the idea that other causes of severe distress exist and that in some cases they could be directly physical or caused by adverse substances one ingests, as you felt yours to be. Severe distress can be caused in a variety of ways… among the ways that come to mind that are known to be heavily associated with the “symptoms of schizophrenia” (i.e. delusions, hallucinations, voice-hearing, paranoia, withdrawal) are…

    – prolonged torture
    – prolonged isolation
    – taking various illegal drugs
    – heavy use of cannabis
    – unbearably painful surgical procedures
    – other hallucinogenic substances like you describe
    – various adverse social experiences like sexual abuse, extreme neglect, physical abuse, bullying, severe poverty and hunger

    I think Lloyd is just focused on trauma because that is primarily what he worked with. It doesn’t he excludes other possible etiologies. Also, I would have to support Lloyd and say that the research seems to suggest that traumas of various kinds are some of the most common experiences raising the risk of getting one of these diagnoses… this does not mean, however ,that traumas are present in every case or are causal in a given case.

  • Hi Liz, thanks. When I reviewed the text of Lloyd’s talk I sensed some of it would be controversial. But I’m glad some people like it despite the somewhat blunt parts. In knowing him a bit personally, I like how Lloyd is reallyhonest and will always tell you what he thinks in a very straightforward way. He says that’s how people from New Jersey are in general. I don’t know whether that is true or not 🙂

    I would imagine that people who work with or stay with Lloyd tend to be those who are more willing to talk about traumas and discuss troubling feelings around their experience in the world. So it’s possible that Lloyd’s views could partly reflect the type of work he does best, and the people that tend to gravitate toward and stay with him as clients. That would only be natural – all of us have preconceived ideas / schemas / internal object relations based on our unique experiences… these affect how how we represent the external world, and inevitably affect our worldviews by causing us to attract some things and repel or be unaware of other things.

  • Hi Rossa,

    Thank you for commenting.

    In hearing from various parents and family members I have been forced to reconsider what I thought before about trauma and psychosis… I once thought some form of trauma was the cause of severe distress in almost all cases. Now I see that it’s more complicated. It’s by no means primarily the parent that causes what gets labeled as “schizophrenia”, of course (although in some cases, abusive parents are a large negative influence, unfortunately, although they should not be blamed since the parents themselves are often subject to secondary adverse psychosocial factors).

    But more than this, in some cases we simply do not know why someone becomes delusional, withdrawn, paranoid, or hallucinates. It may be partly due to some fragility in their personality which makes them susceptible to stress – although I would say that this is never the ultimate cause… it’s always some interaction between the environment and the organism that leads to the expression of severe distress. However we always divine what that interaction is or how it works. It is hard to follow the causal chain from proximate causes to ultimate causes. Perhaps biology, the way the mind and the brain it depends on interact with the environment, and the way a distressed person conceptualizes the world, are simply too complex to untangle precisely in some circumstances.

    Happily, I think what you say is quite true – healing human relationships can help even if we do not understand the ultimate or even proximate causes in toto of serious distress. Luckily, human beings are primed to respond well – although it may take some time – to things like safe environments, having enough money, genuine interest on the part of another, a non-intrusive other who listens and waits, being in nature, exercise, and so on. So even with a severely distressed person where causes of distress are not apparent, there are many ways to help.

    I am glad to hear your son is doing better.

  • Hi Oldhead,
    I do not think psychosis is a disease. It’s just a vague label for severe distress which can have any number of disparate causes. I only use it reluctantly… because I want outsiders, who do not know other ways of thinking about problems in feeling / functioning, to find such a piece in the first place. The terms I use in my own mind are things like “serious distress”, “soul emergency”, “pre-symbiotic ways of relating”, “regressed mental states”, “being in terror” and so on. More relational, experiential and soul-focused.

    When it comes to Lloyd and his uses of these words, I obviously did not tell him what to say. I believe that when Lloyd was trained in the 60s/70s, that “schizophrenia” was commonly used in training psychologists how to think about and communicate about severe distress. That is probably still the case, so Lloyd is simply using the words that he was originally taught by his teachers to think about delusions and hallucinations. But, you can see in how he speaks about it that Lloyd doesn’t really believe in any underlying illness in a person who is diagnosed as being supposedly schizophrenic.

    I am glad you enjoyed reading some of Lloyd’s thoughts. I like how Lloyd is very direct in what he says. Since he was always someone with a private practice, he doesn’t have a boss or company controlling him and so can be forthright with his opinions.

  • Hi CatNight, thanks for checking in. I don’t know this Aeuspcalian authority concept and would be interested to read more if you have references.

    I agree, it can be easy for things to go wrong when attempting to help a severely distressed person… for example, if the therapist is inexperienced, or if they have serious doubt about whether successful therapy is possible, or if they are poorly trained… or, if the family of the client is unsupportive or abusive, or if there is not enough money to do therapy long enough or frequently enough for what an individual wants or needs. Any one of these things alone could negatively influence or derail a psychotherapy relationship. On the other hand, many good treatments do happen, and few of them are reported or ever known due to confidentiality. What we hear about in terms of good (and perhaps bad) treatment must be the tip of a huge iceberg. Although, good and bad experiences in therapy are also relative, and therapies can (and I would argue almost always do) contain both aspects.

    When you say “giving power” to a professional, I would refer to this as being dependent upon someone who is in a more powerful, quasi-parental role. I think this can be helpful or harmful. In a positive sense, being dependent on a person who is genuinely committed to your best interest, and is loving, can be very helpful. This is what happens in normal childhood development – the young child depends on the parent emotionally for support. In a successful therapy of severe distress / psychosis, this process is crucial (it’s called a “therapeutic symbiosis” in the Mahlerian, or Searlesian terminology). On the other hand, if such dependence goes on too long it can be harmful. Or if the client becomes trusting but then the therapist makes serious mistakes and betrays that trust, that can be very harmful.

    These possibilities for better or worse do not say anything inevitably or essentially negative about psychotherapy, in my view. Psychotherapies are a variety of human relationship. And human relationships have innumerable variations and no two are alike.

  • Thanks for commenting, Fiachra. What exactly were you referring to with what Robin Murray say about dopamine sensitivity? I remember this as the general idea that severely distressed people would get used to being on a certain dose of antipsychotic drugs, but then once withdrawn their brain chemistry would react badly to the sudden change in levels of dopamine and be unable to function “normally” again. Not sure if that is correct. I read about this in Whitaker’s books.

    Meanwhile, yes I agree that a diagnosis of “schizophrenia” (which could mean a wide range of things) is not such a big problem necessarily. Although it depends… extreme states of mind vary along a continuum and some instances can be quite severe and long-lasting. But it all depends on how bad the precipitating conditions have been, and as you said on what quality and quantity resources are available to help… I remember Ira Steinman saying, at the Boston ISPS conference, that “It’s not THAT hard.” (referring to understanding and helping delusional people). What I think he meant to say was that the strong pessimism commonly seen in our society about being able to meaningfully talk to and understand people who seem out of touch with reality is not warranted.

  • Hi Fiachra, thank you… I think it is not helpful to romanticize severe suffering. When a person cannot function, is in chronic terror, is full of rage most of the day, can’t have any degree of close relationship, and is full of anxiety to the point that their mind starts inventing imaginary relationships (often expressed in delusions or hallucinations)… there’s not really value in that to the community. The value is in getting help and getting out of that state, and back into relationships. I find people who have not been heavily involved in the mental health system, not on antipsychotic drugs and thus not aware of their effects, and never delusional or hallucinatory at all, tend to misunderstand the severity of some of these states. Or perhaps not be able to imagine them, since as you know it can just be so difficult.

    I would put mystical awareness / shamanism / communion with the universe into a different spectrum of experience. In this realm, ego boundaries and separation between self and other are weakened – and this is a commonality with extreme states of regression that are labeled “schizophrenia” and “psychosis.” But the difference is that in the mystical experience, the person has enough ego strength to maintain some level of functioning and effective relating or to return to it quickly once the experience is concluded. However, when you are talking about severe psychotic states that impair the ability to take even basic care of yourself, or to have any sort of meaningful relationship, that is a different animal.

  • What a great story with such insight – thank you.

    I also recovered from being in the mental health system, and now work in two great jobs completely divorced from the mental health field. I have recently made a decision to never try to work in mental health – a hope I once had – and I am relieved to have chosen to stay away from mental health.

    I believe that in America the field is so fundamentally corrupted by the biogenetic model and by misconceptions about the nature of suffering, and about the fundamental differences between “normals” and people given labels, that there is no point to such an endeavor. To me, the predominant US approach to the seriously mentally ill resembles a covertly-run slave-plantation (where patients produce funds for the drug companies, with the psychiatrists doing the go-between work). Another good metaphor for this system is T.S. Eliot’s Wasteland:

    I think we are in rats’ alley
    Where the dead men lost their bones.

    The dead man’s alley is that metaphorical place where the unforgiving rats have chewed and gnawed away the bones of a person’s few remaining internalized good relationships, leaving no hope for rapprochement or redemption. That’s what happens when you tell someone they have an incurable brain disease and have to be on drugs, far too often. And when there is not sufficient community or loving support to help a person believe they can become well – something far too infrequently available to those labeled “borderline”, “bipolar”, or “schizophrenic”, making the gap between how they actually do and how they could do (with skilled psychosocial support) a massive chasm.

    Fortunately, they are some glimmerings of hope in more recovery-oriented work, but I want no part of such a system… given how much work would have to be done to bring about significant change, and how unrewarding it would likely be along the way. Narratives like yours simply reinforce my conviction.

  • Hi Noel,
    Although it might sound strange to say given the subject matter, I enjoyed reading this article. I admire when people can write bluntly and honestly about their shortcomings and about difficult, visceral topics. I try to do this myself in terms of speaking openly about “bad” things I have done, recounting when I did not act in accord with societal expectations, when I did not feel guilty for what I did, etc.

    I like your description of the DSM as “the greatest piece of trash”. I’ll have to use that line at some point. It reminds me of my last cartoon with the midnight reading of the DSM by four of my favorite people 🙂 If I continued that cartoon I would have them using the DSM as kindling to warm their cold souls.

    The most interesting point you made was our fear of a world that is random, unpredictable, senseless, and potentially meaningless. I have often felt viscerally in touch with this aspect of existence. It is part of why I have my doubts about religion – I see religion as partly a clinging to the notion of an organized, logical, just world in which one can be “saved” for being “good”, and is in control of one’s destiny. Beneath this belief is often a fear of the randomness, emptiness, and uncaring nature of the universe. We only have each other… just off the Earth’s surface, and for millions of light years in any direction, there is no evidence of continued involvement of God, of an afterlife, or of any caring father figure that will protect us from an asteroid strike, gamma ray burst, or any smaller unpredictable and potentially deadly event in our personal lives. Sometimes, I spend my mornings debating with myself whether I am more severe danger from a potential car accident caused by an out-of-control Mack truck, or from an assassin hired by Big Pharma to bring a permanent stop to my online postings. However, I am probably grossly overestimating my influence in the latter scenario (no doubt the result of a DSM disorder!) so the greater danger is probably the truck.

    I believe it is adaptive to believe in religion because it reduces these fears and promotes peer bonding (I must sound like the Terminator here, if you remember the scenes where Arnold Schwarzenegger analyzed the function of human beliefs and relationships). But it is something I find it difficult to believe in with my knowledge of science and my experience of the dark sides of human nature.

  • Stephen – tragic, and well said. Expectations are so important. I suspect these negative prognoses are a big reason why outcomes for severely distressed people are worse in “developed” America than in poor countries. It’s such a tragic loss because with sufficient intensive psychosocial support, severely distressed people can do quite well over time and can have intimate relationships, careers, etc. It’s also a big negative economically to have people on disability for decades, which is ironic for a country that spends so much money researching the biological causes of “schizophrenia” to so little effect.

  • Bruce, America generally has a very individualistic ethos, where being vulnerable, needing help, being gentle and soft, are seen as weakness. It is a shame because many American individuals are not like this privately, but a collective sort of societal psychosis operates where we feel that talking about trauma, vulnerability, fear etc is forbidden as it is a sign of failure or weakness. In fact nothing could be further from the truth – being open, vulnerable, and dependent are signs of strength – and time-limited dependence (on others for emotional help) can be a crucial thing in recovery from many extreme states.

  • Madmom, I agree with this. In large part NAMI functions as a mechanism of group denial of adverse psychosocial factors, and a promoting factor for drug company sales. Their biogenetically-focused ideas tend to soothe feelings of guilt/blame and assist denial in non-diagnosed family members, while resulting in emotional alienation and reinforcement of inability to function for “mentally ill” family members.

    I am going to come out with an interview with Lloyd Ross, a therapist with some strong opinions on NAMI, hopefully later next week on MIA.

  • Hi Bruce,
    Great article. The current treatment of people labeled schizophrenic in America today could be seen as a slow-motion euthanizing of this population in a silent emotional sense – they are chronically tranquilized with heavy, long-term use of drugs, which is one factor resulting in a massive group of terrified people living at home in relatives’ basements unable to work or study. The less fortunate of these – the ones supposedly “missing out” on antipsychotic drug treatment – are those on the streets, in prison, in halfway houses etc. They are also unable to function for the most part. Most of these people are quite deadened emotionally, and of course they are also dying much younger in physical years of life.

    One critique Bruce, of this:

    “The key to a community truly assisting people experiencing altered and extreme emotional states is for that community to believe that these states have meaning and value for the community.”

    Firstly yes, it may have meaning that people are in extreme states – in the sense of revealing what is deficient or harmful in the social sphere that has caused harm to a suffering individual. On the other hand, those states in themselves many times do not really have much value – many such people are simply in an emotional hell of terror, rage, and despair. Far from being valuable, this sort of emotional state is something to escape from as quickly as possible. I am speaking from experience here, and also from talking to many others and reading hundreds of treatment accounts of people in extreme states. There are also more mystical and religious type-psychotic experiences, but those are not the majority from what I can discern. Truly debilitating extreme states that result in a person being unable to function at all are not really that valuable or positive in and of themselves. I find that certain professional authors who may not have direct lived experience tend to generalize and romanticize about these states of mind.

  • Ok, we will have to differ on whether race is always a relevant issue. In some situations, it is not. Few things are always or never.

    Also, poverty is extremely important and may be a large part of the cause of how minorities are portrayed – relative income inequality and poverty are actually the top two factors correlating with receiving serious mental health diagnoses, according to the John Read research. I would argue it is a root factor that accounts for much, perhaps most of the discrimination and social problems that minority people face more frequently than white people. Money and what comes with it – security, housing, jobs, etc – are like oxygen in our capitalist society, unfortunately.

  • Good blog, Sera…. I particularly agreed with this part:

    “Because it’s precisely these out of whack ratios that lead the general public to believe they know what these diagnoses mean, and to assume that all people with such labels are some sort of monolith. Because even though they know they’re watching fiction, those fictionalized representations are basically all they’ve ever seen.”

    There is the persistent myth that labels like “DID” or “bipolar” are explanations in themselves for behavior or thoughts/feelings, not merely descriptions. To me it is a most damaging delusion… or perhaps, what is most damaging is the underlying ideas attached to the label, which tend to include otherness, strangeness, inscrutability, incurability, chronicity, biogenetic causes, etc.

    Only one point of disagreement, about this:

    “However, until the ratio of people labeled with a psychiatric diagnosis who are represented as ‘good’ verses those represented as inherently bad or broken matches the ratio of ‘good’ verses ‘bad’ for… say, undiagnosed, heterosexual, white males … then it’s just flatly unacceptable.”

    Not sure why there’s the need to bring race into this piece, which was quite good without it. Obviously, people with a psychiatric diagnosis are never going to be represented exactly the same as a dominant social group, at least as long as diagnosis persists. And since there is more poverty and trauma experienced by many, not all black or Hispanic people, there’s going to be more emotional problems on average among them and thus more representations of social struggle (correlated with psychiatric diagnoses). But that’s not innately a value judgment nor is there any causal connection between someone’s literal skin color and a psychiatric label (although those connections are inappropriately made)… things are never going to be exactly equal or just, so if we expect that they will then we’re going to be chronically disappointed.

    But yes, having said this it would definitely be great if experiences of suffering related to trauma were presented with much more insight, sensitivity and compassion.

  • David,

    Thanks for this review.

    For me the most important part was this,

    “Most of the beneficial effects Kramer describes can be reframed in terms of an emotional blunting, or the numbing of all emotions, not simply the bad ones. Just like people on an SSRI will nearly universally report genital numbing within 30 minutes of taking their first SSRI—if they’re asked—people will also report some degree of emotional numbing—if asked. They don’t necessarily feel better; they simply feel less.”

    It does sound decidedly less romantic when you unmask “antidepressants” as what they really are – crude emotional numbing agents, not medications treating an illness. And it exposes that psychiatrists are not functioning as doctors treating a well-defined illness.

    In that regard David, the only thing I could have suggested to add to your well-written review was a note about how “depression” is not a unitary illness, but a vaguely described syndrome – people feel depressed to greater or lesser degrees for loads of different reasons. The language used around treating this “illness” is completely misleading.

    And lastly David, if you can have the insight that psychiatric drugs are blunt instruments that often do harm, perhaps at some point you can discuss the same for ECT.

  • Yes Richard.

    Another interesting factor is that the exponential rise of connectivity via the internet in the past 10-15 years has enabled critics of the existing system to spread their ideas more.

    Before 2000, almost all discussion about “schizophrenia” was dominated by academics writing in journals and books, with critics unable to spread their ideas as counters or alternatives widely or effectively. Critics are still fragmented but now they are more visible and can find each other more easily. Whereas before most of the connectivity and organizing belonged to those who held the traditional reins of power, i.e. ability to publish and speak in journals and university settings.

  • Terry, Great response and critique of Murray’s “bonafides” thank you.

    This is the exact same arguments I make against people like Murray within the ISPS group. I argue that their work should not be respected or taken seriously since for the most part they do not know or work with real people, in the sense of getting to know them intimately and helping them recover. What they do is much easier – sit in the halls of academia making up poorly-evidenced biological and genetic theories about “schizophrenia”.

  • Kermit,
    It is important that Murray said what he did. And I like your comment.
    On the other hand, skepticism of his intent is warranted too. He only came out like this once he was near the end of his career and the reputational / financial risk was presumably less due to having already had his career and made his money. That takes far less guts than it would have to do it much earlier.
    In this way, it’s similar to Allen Frances, who made loads of cash by promoting pills for antipsychotic drug companies and profiting from DSM 4, and then turned around and became a critic once he had his wagons loaded down with bags of cash. You have to wonder how genuine it is. Although I think Frances is a worse, more clearly hypocritical case than Robin Murray. Robin Murray’s admission is also important because it will affect current mid- and early- career psychiatrists and associated workers.

    The person with the most guts would leave thei field during their career, or speak out from within the field at professional risk to themselves during their career. But I haven’t seen anyone do that yet, except for perhaps one or two professional MIA writers who left the field to practice differently or work elsewhere. These latter deserve more credit than Murray, IMO, who via his biological reductionism over 30 plus years did great harm in my judgment.

  • Yeah that is just BS from Robin Murray. You have to wonder if this guy is aware of the Open Dialogue’s 3 studies in which about 75% of the people never used antipsychotics even initially, and most recovered to become functional. And the WHO studies where many, many people in lower income places who couldn’t even access the drugs still were able to improve and become quite functional with prolonged communtiy/social support. What kind of echo chamber must Murray be in to not be aware of or to deny these things and cling to drugs being necessary for all.

  • Shook,

    IN your part 5 you made an argument for short-term use of tranquilizers.

    However, it’s important to point out that strong evidence supporting use of long-term drugging for improving outcomes beyond 1 year is lacking. This was discussed in Sohler’s study here:

    So the scale might or might not be weighted against tranquilizing over the short-term (if one defines “effectiveness” as making a person more compliant and less able to feel rage and terror), but long term there is much more doubt.

    Importantly, we want to clarify that antipsychotics drugs are basically tranquilizers that limit the ability to sense and feel disturbing thoughts/feelings. They are not medications treating a specific disease. With this in mind, it’s more clear why their long-term use does not promote a return to functioning and relating well in many very severely distressed people, since drugging cannot address the environmental and psychological factors underlying chronic long-lasting terror, rage, and distrust.

    It’s also important to note that intensive psychotherapy has had a lot of success with people labeled “schizophrenic” that is underreported, and that this can be achieved in many cases without the use of drugs.

    Reviewing 37 studies of psychotherapy for people diagnosed as “schizophrenic”, William Gottdiener said,

    “There is a long-standing controversy about the use of conjoint medication in the psychotherapy of people with schizophrenia. For many years psychotherapists were reluctant to employ antipsychotic medication as an adjunct to psychotherapy because they thought it would disturb the therapeutic process. However, since at least the 1960s most therapists that treat people with schizophrenia have used antipsychotic medication in conjunction with psychotherapy. Most therapists think it is indispensable. However, between 40% and 75% of patients do not take their medication (Perkins, 1999) and there are many for whom medications fail to work (see above Hegarty et al., 1994). For these patients and for therapists who choose to offer treatment with little or no adjunctive medication, it would be important to know if such treatments work…

    It is surprising that the proportion of patients that were likely to improve without conjoint medication, is similar to the proportion of patients that were likely to improve with a combination of individual psychotherapy and antipsychotic medication. This finding is contrary to most therapists’ clinical expectations. The finding that individual psychotherapy can be effective without medication is not new (see Karon & VandenBos, 1981). However, it is important because it suggests that individual psychotherapy alone might be a viable treatment option for some patients who do not improve from treatment with antipsychotic medications, for some patients who refuse to take medications, or for patients who are treated by therapists that choose to use little or no adjunctive medication.”

    To me, as someone who once took these drugs and discontinued them against my psychiatrist’s advice, this finding that improvement can occur without the drugs is not at all surprising. And given that up to three-quarters of people choose to stop taking their drugs, it certainly merits more research into non-drug treatments for those psychotic people who do not want to use the drugs long-term, which is probably most.

  • It’s a bit strange to hear Robin Murray say this,

    “Murray states that he expects the concept of ‘schizophrenia’ as a discrete disorder to become obsolete, just like “dropsy.”

    And then for him to speak the whole rest of the article as if schizophrenia were still a bonafide, carved at the joints, separable “disorder”. The severe end of the spectrum of extreme distressed (traditionally labeled “schizophrenia”) should not be called a singular term at all. There is one “it” there. For some people severely distressing experience is temporal and short-lived, for others medium and for others much more severe and long-term. Much depends on how the environment responds to the distress.

    On another listserv, I wrote about this issue of “Murray’s mea culpa” in this way:

    I thought some people might like to see British psychiatrist Robin Murray’s reflections on his regrets from a career in psychiatry, especially the part quoted below:

    “I Ignored Social Factors for 20 Years” – Robin Murray

    Quote: “So almost by accident, I got into epidemiology, and then was confronted by the evidence that one of the most con-sistent epidemiological findings in the United Kingdom is the high incidence of schizophrenia in the African-Caribbean population. Having excluded genetic and other biological causes, we were forced to look at the role of social factors such as migration, social isolation, and discrimination.19

    It is odd that it took me until the mid-1990s to take social factors seriously as component causes of schizophrenia because when I trained in the 1970s, social psychiatry was predominant at the Institute. Indeed, one of the first researchers that I worked for was Jim Birley who, together with George Brown, had demonstrated the importance of adverse life events in schizophrenia.20

    However, by 1990 the predominant view, including my own, posited that schizo-phrenia was a brain disease influenced by aberrations in developmental genes20 and early environmental insults.21,22Social psychiatrists, including our local experts such as Paul Bebbington and Julian Leff, confined themselves to say-ing that social factors contributed to relapse. Indeed even as late as 1998, we took a sociologist, Rosemary Mallet, to the winter workshop on schizophrenia in Switzerland. Unfortunately, she was miserable because she didn’t ski, and apart from her own poster, there was no mention of social factors in the whole conference!

    In the last 2 decades, it has become obvious that child abuse, urbanization, migration, and adverse life events con-tribute to the etiology of schizophrenia and other psycho-ses. This has been a big shift for me! Indeed about 5 years ago, after I had given a lecture on the subject of social factors in schizophrenia, one listener stood up and said “Professor Murray, I last heard you talk abut social factors in schizophrenia in 1982. Then you were against them, now you are for them.” The audience fell about laughing! I splut-tered that one must change one’s mind if the data change. However, the truth was that my preconceptions had made me blind to the influence of the social environment.

    I never had a proper epidemiology training—but a suc-cession of younger fellows in my group spent a year at the London School of Hygiene and Tropical Medicine. There theylearnt how to use epidemiological techniques to exam-ine risk factors for psychosis, whether they were social or biological. So, for example, Peter Jones and Mary Cannon were interested childhood hazards be they infection or abuse, David Castle and Nori Takei studied effects of urbanization, Jane Boydell and Craig Morgan researched migration and ethnic minority status, while later Marta Di Forti examined the effects of cannabis.

    Jim Van Os in particular taught me, and then European psychiatrists as a whole, that it’s oversimplistic to regard schizophrenia as just a brain disease. Asthma may be a lung disease but it is one which can be precipitated by environmental toxins (eg, pollution) and allergens. Just as the lungs process air, so the brain processes external stimuli; consequently, its healthy function can be harmed by noxious factors in the social environment such as childhood abuse or adverse life events.”


    Haha what a concept that last sentence is! Too bad it took decades to realize this idea, which seems not to have crossed the Atlantic yet. Apparently, leading American psychiatrists still don’t understand this concept.

    To me people like Sir Robin still sound like aliens studying humans a if they were another species, failing to appreciate the subjective, lived experience of those they write about. The people they write about sound like automatons or machines, without agency or volition.

    Lastly one has to wonder if Murray has ever done intensive psychotherapy with real clients, or if he is just sitting in a university classroom “studying” people from afar.

  • I highly doubt that reliable brain activation patterns will ever be found for any fabricated DSM disorder.

    If brain reliable differences are found associated with particular labels, in my view they should be primarily differences of degree or intensity corresponding to the way multiple linked brain structures respond to greater or lesser amounts of stress.

    They would not likely be differences of kind (as opposed to degree) – i.e. not differences of kind or differences in location of brain-part activation correlating to one “disorder” over another. In this vein, one would expect those labeled “schizophrenic” to have more severe expressions of certain brain responses associated with stress than those labeled “anxious” or “obsessive” for example. But the brain regions activated in people given more “severe” labels would probably be many of the same parts to varying degrees as those observed in less severe labels, and simply be more severe expressions of the same phenomena. And the labels themselves would explain nothing, just like knowing which brain regions activate would explain nothing at all about how to talk to, understand and help a person at an interpersonal level.

    Within the next 10-15 years, it can be predicted that the NIMH’s current RDOC (Research Domain Criteria) search for brain activation patterns correlating to DSM disorders will fail to produce reliable results. The question then is what will happen. Probably some new doomed scheme of biological categorization will be invented, with more requests for ongoing funding. The goal, as always, will be to “Extend and Pretend” – to maintain the status quo in terms of funneling money to biological researchers and to Big Pharma companies. The other goal will be continuing to sell as many drugs as possible via misleading psychiatrists and clients into believing that the drugs are highly effective, and to keep enough people believing that psychiatric drugs are “medications” targeting specific “illnesses”.

    Here is a link to an Allan Schore piece on trauma and brain activation, which explains how stress early in life produces common brain responses across a range of supposed psychiatric diagnoses. Reading this, it’s obvious that brain studies will never produce reliable results for individual illusory psychiatric disorders. People are too individual to fit a label and, paraxodically there are too many commonalities in the ways in which people’s brains respond to stress both less and more severe for distressing experience to fit neatly into different supposed disorders. The current biological research is about profit and social control, not about understanding or helping.

  • This is a fascinating article, thanks.

    Although, I think the ideal solution for many people is to never take psychiatric drugs, or to stop taking psychiatric drugs entirely if possible. Working out difficult feelings and thoughts interpersonally and in terms of what resources in the environment help was always better, in my experience.

    Regarding this,

    “The argument that violence is caused by an underlying psychiatric disorder has been proven wrong…”

    This is misleading because there are no discrete psychiatric disorders that are the cause of anything (as Insel, Frances et al admitted, these categorizations of distress lack validity and are mere descriptions of clusters of behaviors, not well-defined illnesses). Distress and decisions to take action based on distress arises from complicated interactions between a person and their environment over time. No one “gets” or “has” a “psychiatric disorder” called things like “schizophrenia” or “bipolar” that then “causes” them to be violent. This whole way of thinking is so hard to understand; one might assume it comes from doctors who do relatively little intensive psychotherapeutic work with clients and thus do not understand that saying that “psychiatric disorders cause things” makes no sense.

  • Phil,

    I liked the following poetic, image-filled section,

    “And so the tentacles of psychiatric destruction, disempowerment, and, ultimately, despair, are spread to all parts and segments of our society, and people of all ages and all walks of life are shoveled indiscriminately into the insatiable maw of psychiatric dependency and premature death.”

    This sounds like something I would write.

    And no, psychiatric practitioners will never voluntarily curtail a scheme that is so profitable – and so easy, when many of one’s victims are so vulnerable and do not know any better.

    In the movie The Dark Knight, there’s a scene where Batman and his advisor Alfred Pennyworth discuss the nature of the villainous Joker:

    Alfred says: “Alfred: With respect, Master Wayne, perhaps this is a man that you don’t fully understand, either. A long time ago, I was in Burma. My friends and I were working for the local government. They were trying to buy the loyalty of tribal leaders by bribing them with precious stones. But their caravans were being raided in a forest north of Rangoon by a bandit. So we went looking for the stones. But in six months, we never met anyone who traded with him. One day, I saw a child playing with a ruby the size of a tangerine. The bandit had been throwing them away.

    Bruce: So why steal them?

    Alfred: Well, because he thought it was good sport. Because some men aren’t looking for anything logical, like money. They can’t be bought, bullied, reasoned, or negotiated with. Some men just want to watch the world burn.”

    Most psychiatric practitioners are not truly evil or demented like this. But they are absolutely addicted to the drug-like experience of getting large amounts of money, status, power and prestige that comes with giving psychiatric “treatments” to supposedly “vulnerable” patients.

    Those who think that psychiatrists will voluntarily change and stop harming people fail to understand their motivations, in a similar way to how the Dark Knight initially misread the Joker.

  • Hi Margaret,

    It is good to see more people speaking up about having undergone very difficult extreme states and overcoming them in a variety of ways. I assume you have seen some of the many other accounts of such experience on this site, perhaps including my own.

    I think there is nothing to be ashamed of in revealing that one was once paranoid or delusional – it can happen to anyone under enough stress – nor anything to be ashamed of in revealing that a psychiatrist once labeled one “schizophrenic”. As Rosenhan once demonstrated, the darkly funny thing is that almost anyone who goes to a psych hospital and reports hearing critical voices can get a diagnosis of “schizophrenia”. That doesn’t mean that all such people are unable to function and handle their feelings – as is someone experiencing a genuinely incapacitating extreme states of mind – but it does illustrate what I am going to discuss below.

    Reading your piece, I was reminded several times how arbitrary and invalid the label of “schizophrenia” is – how there is not a valid illness called schizophrenia delineated by any biomarkers outside of a psychiatrist’s subjective judgment. From the psychoanalytic viewpoint that I use to look at these problems, extreme states represent an early emotional development state in which terror, rage, and despair result in regression to a childlike state of mind. Usually such a transition can be correlated to specific stressors such as abuse, divorce, job loss, neglect, financial stressors, etc. The terror usually results in a regression to a state of self and other fusion, in which a person cannot really tell emotionally what thoughts/feelings are their own and which thoughts/feeling belong to other people. Thus their own fear and suspicion gets projected into other people having malevolent intentions, as for example in the paranoid fears you once had about your coworkers.

    But the notion that such a regression can be concretized as “schizophrenia” and pegged at “6 months’ duration of psychotic ‘symptoms’” (in a psychiatrist’s subjective judgment) is just bullshit. These experiences vary greatly from individual to individual, plus there’s no sharp cut-off point along the continuum at which one becomes “schizophrenic” or “non-schizophrenic”. Richard Bentall explained this well in his book “Madnes Explained”, in which he discussed how the paranoia, terror, and suspicion that people who get labeled “schizophrenic” experience is not different only in degree, not kind, from lesser experiences of the same things that any of us can and do experience under stress.

    There is not one distinct class of people that “have schizophrenia” and another majority group that don’t carry the “schizophrenia genes”. The mistaken assumptions around all of these issues – which relate to the non-validity and poor reliability of almost all psychiatric diagnosis – explains how psychiatrists deluded themselves over the last several decades into believing that a discrete “schizophrenia” existed (as opposed to a continuum of extreme states varying in severity and without a clear division from less severe distress). Psychiatrists also made the mistake of believing that extreme states are primarily caused by faulty genes, rather than being caused primarily by environmental stress interacting with the brain/epigenome in a dynamic interpenetrating fashion.

    And of course, the notion that “schizophrenia is a lifelong, incurable disease”, is one of the most pathetic, stupid, harmful, and blatantly false (in multiple ways) things research psychiatrists have ever said, an outmoded delusion on psychiatrists’ part that needs to be consigned to the trash heap of history.

    Regarding this, “I was now coping with the fact that I had been diagnosed schizophrenic — and that proved to be more difficult to recover from.”

    Yes, this is one of the most insidious, harmful things that psychiatrists do – tell people that they have a lifelong brain disease and will not be able to fully recover. The terror and pessimism created by such false prophecies can be devastating and even lead to suicide. And many people do not dare believe at first that the psychiatrist is simply spouting bullshit and that the notion that there is a lifelong incurable illness called schizophrenia is, quite simply, an untruth.

    Regarding this, “Well, I believe any schizophrenic on medication is a walking time bomb, because any day they could stop taking their medication — secretly, out of desperation — and all those repressed emotions and thoughts could come exploding out in uncontrollable fury with unpredictable timing.”

    I couldn’t have said it better – the ugly truth is that antipsychotic “medications” are not bonafide medications treating any well-defined illness entity in any way – a far cry from insulin for diabetes. They are nothing more than heavy, numbing tranquilizers that dull down the ability to feel the terror, rage, and confusion that are so overwhelming when one is in an extreme state of mind. This numbing and quieting of the person is what is called “effectiveness” and “response” in reviews of the drugs, pathetic and short-sighted as that conceptualization is. Meanwhile, absolutely nothing is done by the drugs to enable the person to develop more ability to handle their emotions and to face and work on the life problems and stressors that may have led them to break down. On the contrary, the ability to think clearly and to process emotions is progressively eroded by the neuroleptics with long term use.

    Not being on antipsychotic drugs after a diagnosis of schizophrenia to me is something to be proud of. It is a sign of insight, willingness to take an intelligent risk, ability to think for oneself, and often-times the ability to realize that one’s psychiatrist does not know what they are talking about. More than once on this forum I have recounted how tapering off antipsychotics against my psychiatrist’s wishes was a decision I am proud of and never regretted, and would do again.

    Well done again for sharing your story Margaret.

  • Nice list, Susan. I always appreciate the passion you bring to these articles.

    I assume you may have also noticed come studies have coming out recently that show that peers are very effective in helping with emotional problems in other, poorer countries, such as with feelings of depression in India. Countries like India could be a place for peers to gain a stronger, quicker foothold than in the USA, given that psychiatric treatments are fewer and less entrenched at the start in developing nations.

  • Phil,

    Did you know that new neuro-imaging breakthroughs have been made that allow the diagnosis of ADHD to be precisely made via having children wear brain-wave measuring helmets that track the intensity and degree of inattention down to the millisecond?

    Gotcha… they haven’t!

    You’re right; these arbitrary criteria show why what I usually say is true: Every psychiatric diagnosis is a misdiagnosis. Because no psychiatric diagnosis has explanatory power, and psychiatric diagnosis is always lacking in validity.

    Diagnosis is indeed the Achilles heel of psychiatry, and thus should be a target for critics to hammer away at indefinitely for years to come, just as soldiers would attack the weakest part of a castle wall repeatedly in order to bring the structure to the point at which the whole edifice collapses.

    The current RDOC (Research Domain Criteria I think?) of the NIMH is another diversion tactic by mainstream psychiatry: having failed to establish the validity of current DSM disorders, they have made an empty promise that future brain circuits will be identified that are causal to “mental disorders” and which will uncover a valid biological basis for the DSM disorders. This attempt is almost certainly doomed to fail.

    Perhaps this might be a good subject for a future article, Phil – getting out ahead of NIMH and their Research Domain Criteria, and predicting how future neuro-imaging research will inevitably fail to identify replicable biomarkers for “mental disorders”. It will look all the more convincing if critics can predict the failures ahead.

  • Ok. You might consider having a brief “further reading” or “references” section at the end, citing authors such as Whitaker, Breggin, Moncrieff, Kirk, Bentall, Watters, etc, and sites such as MadinAmerica. That would only need to be on screen for a very short time. Many among the public will not know these resources exist.

  • Hi Steve,

    Here are my “live-blogged” notes made in a Word file as I was watching your excellent video:

    provide clickable links during the relevant section for references to the NIMH leaders’ statements and the British Psychological Society’s critique. Or provide brief on-screen references to books / articles / talks. I was thinking where is the backup for this claim? Many people may not wait to see references if they are coming at end of video.

    “cultural acceptance of medical model?” – questionable that most of the public accept this unquestioningly. John Read’s research shows it is not widely accepted by the public. In most countries the public favors the social welfare model, not the medical model, already. See his Youtube videos.

    May want to give more references / links on screen showing how biological / medical model framings lead to more pessimism, fear, and distancing. See my article, “Rejecting the Medications for Schizophrenia Narrative.”

    Not sure if it’s accurate to say that Freud considered psychoses a medical problem. I thought he didn’t know how to effectively treat psychoses and didn’t spend much time writing about this area. Could be mistaken. But no references for your statement given.

    You could expand on the notion “Validity is about truth of DSM” by clarifying that the question is whether DSM labels refer to discrete, “carved at the joints” entities which exist in the external world.

    “two different diagnoses from two different clinicians” – references for this? True but would be good to see data, if only brief links to articles / books. See Noel Hunter’s articles for good examples of how this can be done.

    “Manual with terrible reliability” – true but where is reference for this? Can you show the charts of how reliability has even decreased over time? See 1BoringOldMan blog for these pics.
    “Increase criticism of DSM” – can you give a few quotes from prominent critics? Both recently and in 80s/90s.

    I like Brian Koehler’s (of ISPS) quote, “The human genome did not evolve to reify DSM diagnoses.”
    – Where does it say that only clinicians can understand DSM diagnoses? I didn’t know this was in the DSM. On the other hand I haven’t read it nor would I waste my time doing so.
    “The DSM 5 totally lacks validity” – gives the quotes from Insel, Hyman, Kupfer, Frances right here. Best attacks come from the other side’s own words.

    “erroneously implies discrete boundaries” – yes, crucial criticism, and it is a deal breaker. Cannot have reliable valid categories given relativistic continua of distress which actually don’t break up into discrete concrete entities.

    Ignores harmful effect of stigmatizing – again where is reference or source for this? What studies suggest this is the case? True but give people link to read or research…
    EuroAmerican focus? Yes. Maybe mention Ethan Watters here.

    Strong vested interests – yes. I wrote about this provocatively in my article, noting how the disease model underlies psychiatrists’ supposed superiority and greater knowledge to other mental health professionals.
    18 billion in neuroleptic sales? Yes, but would be good to provide a link here in my opinion evidencing this stat.
    Perhaps give examples of how much some psychiatrists and researchers were paid to promote drugs and diagnoses. Perhaps link to website DocsforDollars etc.

    Parents being defensive about abuse. Yes, but provide support for this contention as it is contentious. Perhaps reference ACE study or John Read’s research on trauma and psychosis.

    Harmful to treat emotional suffering as a medical problem. Yes!!! But where is link to this evidence.
    Worsens outcomes? Yes, at least you mentioned Whitaker here. Also mention many references given by Sami Timimi and John Read in their online talks on Youtube.

    Agree with you not to criticize or try to write off psychiatric drugs but to promote informed consent and respect people’s right to choose to use these drugs if they think they help.

    Allen Frances was a major taker of money from drug companies, then turned around to criticize the newer DSM editors once he’d made millions of dollars from the older DSM and from drug companies. Maybe note this?

    – “flagrant coercive practices” banned by Human Rights – can you give a quote from the UN writing about this?

    Question – what type of cameria / recording software did you use?
    what type of editing program did you use to do the on-screen text and images?
    Wondering because I’m interested in producing videos myself about other mental health issues.

    Hope this is useful Steve. Take what you like and leave the rest.

    I really liked your video and think it’s a great first step. Basically I recommend to give more references, links, and further reading to defend the talk against assertions that it’s unevidenced, unsupported or nonspecific.

    Steve if you didn’t yet please join this group –

    I posted a link to your article there.

  • Very well-written paper, Paul.

    I had not even heard of Ruby Wax before. To my knowledge her popularity has not reached America. However I don’t watch TV, so my ignorance could be my own disconnection from popular media.

    I don’t think it’s difficult to disagree with biological reductionism. I regularly do so in all sorts of public settings. For instance, at a meetup event recently, I directed refuted the idea that “schizophrenics” always have to take drugs. People were shocked; I didn’t care.

    I am not sure why you stooped to this part:

    “Opponents of the social determinants school would argue that such treatment would only be triggering peoples’ underlying susceptibility to mental disorders. To which I would reply: someone, or something, still needs to pull the trigger.”

    It appeared that you agreed that there is a “trigger” to supposed vulnerability; I think this is problematic. The human genome did not evolve to reify DSM or ICD diagnoses. The most we can speculate is that some people might be genetically more or less resistant to stress, with the way they react to it being highly individualized, not more or less resistant to to invalid creations of the white-coat people. The research on genetics and mental labels has produced nothing of note. Besides, once a person is born, their epigenome and biology is constantly being modified by interaction with the environment in an interpenetrating process. Genetic vulnerability to stress is not some static thing that stays the same throughout life.

    Paul, You might consider Mary Boyle’s thinking on “vulnerability-stress” theory:

    Quote: “Who or what is protected from scrutiny by vulnerability?
    In the case of vulnerability-stress theory, thefocus of scrutiny has been the ‘vulnerable’ indi- vidual – whatever else they’re protected from,it’s not our scrutiny. This focus is made to seemreasonable partly through word order: the the-ory is stated as ‘vulnerability-stress’ with the im-plication that vulnerability comes first, is morebasic, so that it seems reasonable to focus on theperson to identify the nature of this vulnerability and perhaps to put it right. Even when vulnera-bility is used more generally, the focus is stillmainly on the vulnerable person, a focus whichseems reasonable at least partly because of psy-chology’s and psychiatry’s claims to have discov-ered many negative individual attributes –low-self-esteem, cognitive deficits, mental disor-ders etc, which not only seem to explain the vul-nerability but make it easy for us to accept vulnerability as yet another attribute – a state-ment about a person – rather than a relationalstatement about what happens between people. Vulnerability exposes only one side of this rela-tionship, while protecting the other fromscrutiny. We can see this relational aspect clearly if we take statements about individual vulnera-bility and ‘translate’ them into statements aboutrelationships. On the left side of Table 1 are state-ments of a sort easily found in the media and pro-fessional literature, apparently about individuals,or social groups, and which suggest that our focusshould be on these people or groups – how toprotect them, make them more resilient, and soon. But if these statements are translated intorelational statements (with the two referencedexceptions, not found in the media or literature)

    then a very different picture emerges in which twopoints are worth noting. First, that the reasonable-seeming focus of our scrutiny and potential actionis changed from the vulnerable individual to those who seem to be damaging them. Second, in every case, the people or groups who do not appear inthe statements about vulnerability, are in various ways more powerful than their counterparts whodo. The disturbing conclusion is that the idea of vulnerability runs the risk of systematically pro-tecting from scrutiny the potentially damagingactivities of relatively more powerful socialgroups. Since vulnerability is usually named inothers by those in positions of relative power, itis perhaps not surprising that they should wishto protect their privacy. But we should not un-derestimate how helpful psychology and psychi-atry have been to this process, with their persistent focus on the individual and their pro- vision of an extensive range of negative charac-teristics both to explain vulnerability and tofoster its acceptance as an individual attribute.”

    Source: page 27 of this download –

    Lastly, it is amazing that people continue to believe the trope about 25% of the population “having mental disorders”. As I like to say, according to psychiatrists here in America 80 million people have clearly diagnosable psychiatric diseases and 240 million are completely normal. When you frame it like that, it’s obviously bullshit. No one is immune from the problems of living, and those problems are matters of degree without clear cutoff points along a continuum.

  • Eve,

    I’m curious why your mentor, Andrew Weil, has the following on his website in reference to “schizophrenia”:

    “What are the causes of schizophrenia? The cause of schizophrenia is unknown. However, scientists focus on the interrelationship between a genetic predisposition for the disease working with environmental pressures to ultimately manifest symptoms in susceptible individuals. Knowing that medications work on the neurochemical level to treat schizophrenia, it is certain that problems with brain chemistry, including the neurotransmitters dopamine and glutamate, contribute a key role. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia as compared to those who don’t have the disease. While researchers aren’t certain about the significance of these changes or the interaction with these particular neurotransmitters, it still supports the theory that schizophrenia is indeed an abnormal condition of the brain.”

    Is he really that ignorant, or simply intellectually lazy, or is it something else?

    For one thing, it is not at all certain that dopamine plays a key role in causing, rather than correlating, with severe distress labeled “schizophrenia”. To spread this misinformation as Weil does is harmful and unethical. The “diagnosis” itself is subjective and uncertain – two people can “have” the condition who have nothing in common. But no one would ever know that from reading Weil’s site.

    It’s important for people to know that contrary to Weil’s assetion that “the cause is unknown”, we know a great deal about what causes extreme states – including that trauma and isolation are often central contributors… we also know that there are no “medications” to directly treat what is a vague non-medical syndrome, and that distress labeled schizophrenia can be alternately understood as a normal reaction to abnormal circumstances. Here’s more:

    John Read of ISPS speaking about “Who is Right about the Causes of Psychosis – Psychiatrists or their Patients?” –

    Noel Hunter from ISEPP writing about misleading research (as presented by Weil and others) on “schizophrenia”:

    My discussion of the history of “schizophrenia” and the relevance of trauma –

    Really annoys me to see these untruths put out there as fact, over and over.

    At least there’s a difference between an online forum like this where one can speak out freely, and a university environment or psychiatric conference, the latter being places where questioning the validity of schizophrenia would be sacrilege. Not here.

    I will also contact Dr. Weil myself directly.

    From looking at Weil’s website, it looks like he’s a guy who makes a major effort to promote and make money out of his name/brand. Too bad he didn’t put nearly as much effort into checking the validity of the information he puts on his website about “schizophrenia”.

  • Thanks Eve.

    Looking forward to hearing much more from you.

    Of course agree with everything you are sharing in this article. Would like to hear about everything written above in more detail, including case examples of the people one sees in such a shortened way, and more information about how seeing someone for such short timeframes works on a month to month basis.

  • Yay Bob! Thanks for the update.

    Good to see that Olga Runciman and Eric Maisel will be involved in getting content.

    If you need additional fundraising support / funds (similar to last year’s fundraiser) don’t hesitate to reach out to people here.

  • Amazing:

    “Dr. Gordon’s research has also analyzed neural activity in mice who supposedly carry mutations “of relevance to psychiatric disease… the lab studied genetic models of “these diseases from an integrative neuroscience perspective, focused on understanding how a given disease mutation leads to a behavioral phenotype across multiple levels of analysis… A gigantic leap is then made: that his research “has direct relevance to schizophrenia, anxiety disorders, and depression.”

    What a joke! It’s the tried-and-true NIMH formula: You assume the existence of a valid illness called schizophrenia, and then you look at cute white mice and speculate what they might tell you about the disease in humans. What bullshit!!!

    Even when leading NIMH officials and past DSM heads said that these categories (“generalized anxiety disorder, major depression, schizophrenia”) lack validity and usefulness for research, they just go back to doing the same thing. It’s the definition of insanity: doing the same thing over and over again and hoping for a different outcome. That is what research psychiatrists do.

    I have to wonder how research psychiatrists keep coming up with this stuff. You would think they were trying to be funny on purpose. But the amazing thing is they don’t even do it on purpose. That is the biggest incongruity: research psychiatrists are dead serious about their diagnostic labels and really want to be looked up to as prestigious researchers, and they don’t even realize what ineffective and out of touch they appear to people looking at severe distress from other perspectives outside the field.

  • Hi Martin,

    You obviously think deeply about these things – that must help you in figuring out ways to understand and help your clients. It might also make you a good MIA author – consider that!

    Regarding New Zealand, perhaps you saw Paris Williams’ critique of the psychiatric system there (he lives there too as you may know):

    I agree there are a lot of good insights and ways to understand and help people that have come out of, and still come out of the field of psychology. I differ from some other MIA commenters in having that position in agreements with yours.

    My favorite field-area of psychology is the developmental object-relations psychoanalytic area. You may know the authors like Freud, Jung, Klein, Fairbairn, Sullivan, Kernberg, Rinsley, Masterson, Adler, Searles, Volkan, Boyer, Grotstein, etc. There’s a rich tradition there of doing really good work to help people with all kinds of trauma. And the conceptual models they have of early developmental states (a psychological alternative to the disease model of “schizophrenia” etc) is really good in my opinion.

    The British Psychological Society is doing good stuff. If you like the critiques of these authors, you might also like the critiques of the system of American psychiatrists Jonathan Shedler and Barry Duncan. You can find a lot of their papers on Google. Duncan wrote a good book called “The Heroic Client”. And Shedler has some great criticism of CBT and the flaws in “evidence based” therapy on his website –

    Also see re: Duncan –

    I agree with you – if a treatment works to help someone in their experience, it doesn’t matter that much what method arrived at it.

    I would say that psychological research is not as reliable as people think. I encourage you to check out the whole of Smedslund’s essay “Why Psychology Cannot Be An Empirical Science.” If you cannot find it email me and I have a copy (bpdtransformation (at) gmail (dot) com). I also think Brian Nosek’s work about how psychology has not replicated a high proportion of experiements is instructive.

    Martin one more thing you really might like – Paris Williams has a 25 page paper he hasn’t published yet about the positivistic (mechanistic/Newtonian) approach to psychology versus the relational / subjective-qualitative approach to psychology. He would probably share it with you if you emailed him. He is at pariswilliamsphd (at) gmail (dot) com.

    Martin if you like discussing these things also consider joining – a lot of these discussions are going on there on the listserv – Maybe you are already a member.

  • Hi amnesia,
    I also read your comments – and thank you for coming in. I just didn’t get back right away because your comments came after the article was first posted.

    Anyway, I wish you the best with your husband and particularly liked this part of what you said:

    “Drugs don’t heal people. People heal people. I hope soon to be able to support people having exceptional experiences and extreme states.”

    I agree with this idea and hope you will be able to help other people heal soon.

    Thank you for coming in.

  • Nomadic, I think many people would agree that severe distress and suffering is something to be healed and get better from – maybe not “recovery”, which is somewhat of a medicalized colonized word, but certainly healing or wellbeing after suffering.

    Indeed, the way through ordeals is forwards. I think Buhner talked about a lot of ways to achieve that in the article. Your statements about “healing” being attempts to avoid and deny by moving backwards are rather vague and nonspecific, and without knowing what you had in mind it’s hard to say more.

  • Martin,

    This is an excellent comment and some of the most deeply thoughtful musings I have seen in an MIA comment; well done.

    Let me respond to a few things you said that I found interesting.

    I think you are correct that, “This suggests that increased emotional or sensory sensitivity, particularly in relation to human interaction, develops mainly as a result of experience.

    I would suggest this increased sensitivity to negative stimuli is paired with a decreased sensitivity or receptiveness to positive / “good” stimuli, or toward trustworthy relationships. You might like my article here that explains the Fairbairnian approach as to why traumatized people tend to not notice or internalize good stimuli, but to have a heightened attunement to anything “bad”:

    You are probably correct that this strategy is evolutionarily adaptive, at least at first. However, it then becomes a problem in later life as we know.

    I agree that that invented categories of neuro-atypical and neurotypical do not represent divisions in reality, being more like symbolic ideas. I also saw a conflict between that idea and Stephen’s insistence on the other hand that there is no such thing as “normal”. It shows how sometimes we can think in different compartments in our minds in conflicting ways that wouldn’t make sense if we compared them directly.

    The trauma does matter, of course. The trauma is important on its own and its severity and nature directly affects how we think about it. I agree, the actual events – and whatever resilience we have beforehand to help us process the actual events – are more important than whatever we may tell ourselves later.

    Also agree that Western culture is not all bad. I have been reading some contrarian books recently which are relevant to this issue, by Matt Ridley (the Rational Optimist) and Peter Diamandis (Abundance) which talk about the benefits of technological development in capitalistic democracies. I read these as a counterbalance to the constant pessimism about development and technology which seems to permeate our society. I think these optimistic books have good points. Life now is much easier and less filled with suffering in many ways than for people who lived to an average 35 years old at most and had no medical care or leisure time centuries ago.

    The US is a particularly bad example of mismanagement of healthcare dollars and faulty narratives about the nature of emotional suffering. It has a bizarre inversion where many of the most distressed people are subject to the worst treatments (far too many drugs, no therapy), whereas in poorer cultures such people are given more social-emotional support, are less stigmatized, and are not overdrugged. The harms of unrestrained capitalism and economic inequality show up clearly in how American corporations and wealthy people exploit and mistreat “the mentally ill”.

    I like Jordan Peterson’s work and how honest and forthright he is. I watched his Youtube videos. I hope Canada doesn’t start legislating what people have to say about other’s first names. I would never do that.

    I think this statement, “the entire therapeutic process, in nearly every instance, is to make them fit in whether through use of drugs or not’ by Buhner is pretty accurate. At least in America. There is really no interest in listening to people labeled bipolar or schizophrenic here, and every interest in shutting them up as quickly as possible with drugs. Your point about the family though is correct – many families want something different and better. And they are starting to become aware that the “brain disease having to be drugged” narrative is unscientific and limited.

    Regarding a critique of the scientific method you might like this:

    The problem with Western science as applied to psychology it that it has run into the ground in its failure to establish valid diagnoses and its failure to realize that its categories are subjective, not objective. As Holzman discusses.

    The scientific method when it comes to psychiatry and psychology is a sham. They are not real sciences. I’m going to repeat here a quote you may have seen me make elsewhere, from Jan Smedslund, about why “Psychology Cannot Be An Empirical Science”:

    ““The main conclusion to be drawn from irreversibility is that empirical research in psychology… can only be seen as mapping temporarily stable statistical tendencies at the aggregate level. These mappings must be evaluated on pragmatic grounds, i.e. as yielding possibly useful knowledge in limited domains for a limited time…The regularity that is nevertheless observed cannot be taken to reflect permanent laws, but only temporarily stable feedback-loops. These are like whirls in a stream which are stable only as long as the total flow of water does not vary and the stones on the bottom maintain their positions… The findings in psychological journals may superficially appear to be of the same order as those reported in physics or chemistry and, hence, psychology may superficially look like an empirical and accumulative science. The conditional and transient nature of psychological findings is rarely acknowledged, perhaps because the publication and preservation of empirical findings will then appear unjustified since they cannot be taken to be useful in the future. The scarcity of attempted replications also allows psychologists to avoid thinking about this problem.” (from “Why Psychology Cannot be an Empirical Science”)

    I think this is so important to appreciate; the difference between real experiments and a lot of the quasi-experimental trash based on invented diagnoses that research psychiatrists put out. As John Read said, any real field of medicine would dismiss such disjunctive diagnoses in a heartbeat. As the NIMH already has. Only problem is, no real diagnoses are coming to psychiatry anytime soon – or probably ever.

    Ok, I see now you think the same as me – psychiatry is not a real science but a perversion of science. Indeed.

    And I agree, appearing humble is not everything. If one is good at what one does, why be inhibited about that, say it with a touch of confidence or even playful swagger. That’s how I am with what I do and say. As Conor McGregor said, “It’s hard to be humble when you’re the best.”

    Thanks again for your careful thoughts.

  • Lisa, the logical problem in your statement:

    “(they have) scans that show abnormalities in the brain with disorders and these are real…”

    is that the existence of the “disorders” is presumed a priori, and how to define “abnormal” depends entirely on the opinion of the doctor. Different feelings, thoughts, and behaviors always correlate to changed brain chemistry. Indeed our brain is constantly changing its chemistry as we respond to the environment for better or worse. But that does not make our brain’s responses to adverse psychosocial factors an illness caused by biogenetic factors.

    By psychiatric logic, if you took a brain scan of a person taking a piano lesson that they did not enjoy and felt upset about, and their brain chemistry changed (which it inevitably would), that would be evidence of Piano Playing Disorder. The problem is that the notion of Piano Playing Disorder would be an invention or projection from the mind of the psychiatrist, not something real in the (admittedly) altered biochemistry of the person taking the piano lesson.

    As to this: “these fMRIs can show certain abnormalities of brain function and there are certain characteristics with each different illness.”

    The problem with this is that the “illnesses” and judgments of “abnormality” are creations of men sitting around a table, not anything reliably identified by blood or brain scans. The doctors view the brain scans first, then decide arbitrarily what is “normal” or “abnormal”. There’s nothing scientific about it.

    And Lisa, consider what the leading American psychiatrists say about the validity of these “disorders”:

    In 2013, discussing psychiatric diagnosis, the psychiatrist and former National Institute of Mental Health director Steven Hyman stated:

    “The underlying science remains immature…The molecular and cellular underpinnings of psychiatric disorders remain unknown… psychiatric diagnoses seem arbitrary and lack objective tests; and there are no validated biomarkers with which to judge the success of clinical trials.” (emphasis mine)

    Hyman went on to call the DSM model of diagnosis, which includes labels like “schizophrenia,” “Totally wrong… an absolute scientific nightmare.”

    Hyman’s successor at NIMH, psychiatrist Thomas Insel, followed up this criticism by saying:

    “At best, [the DSM is] a dictionary, creating a set of labels and defining each. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.” (emphasis mine)

    David Kupfer, the DSM 5 chair, while trying to defend the new DSM, admitted that the discovery of biomarkers for supposed illnesses like schizophrenia remains “(D)isappointingly distant… unable to serve us in the here and now.”

    And former DSM-IV head Allen Frances went so far as saying, “There is no definition of a mental disorder. It’s bullshit… these concepts are virtually impossible to define precisely.”

    What other field of medicine talks like this about its own labels?

  • Frank, of course I did not mean disappear literally or stop doing business. I meant stop engaging Phil in arguments within that they are bound to eventually be exposed as lacking evidence and data.

    And their arguments were indeed weak and unevidenced – they did not even cite specific studies to support their claims, counter to what you say – but nevertheless Phil broke them down comprehensively above. Nonsubstantial arguments are indeed a “problem” for psychiatry in terms of making sense and having logical, well-thought out models of human suffering and what to do about it, just not a problem in terms of continuing to deny criticism and keep doing what they do.

  • Phil,
    Thanks for taking time to break this down.

    We can assume now that Carolina healthcare partners will disappear, since they will presumably not have any real counterarguments to your breakdown of the myths that “schizophrenia” is a valid illness caused by biogenetic malfunctions, etc. And they won’t want to embarrass themselves further.

  • Sandy,
    Well-written article; your heart and compassion comes through in this. These are some of the most important things to heal people, regardless of our orientation.

    I was just reading an online book you might like, that gave me some new insights into why the brain disease model did not pan out and lead to cures:

    It looks like the faulty unscientific assumptions made early on in the process of researching the diagnoses doomed the research effort.

    Regarding hospitalization as an “answer”, I find it puzzling when people say these things too. To me, the only “answer” found in confining someone for a few days or weeks is that they might be physically safe for at least that long (but maybe less safe after). From my experience, little therapeutic engagement occurs in hospital settings, although your hospital could be different. And there is no “disease” being medicated, just severe terror, confusion, rage, and despair being tranquilized to a temporarily tolerable level – a process which cannot address the developmental/identity issues and lack of social supports which often underlie the distress. And then the social factors and emotional issues causing problems are obscured by the imposition of the unsupported brain disease narrative, leaving the person and their network less able to innovate, think for themselves, and have hope. This is just speaking generally about American psychiatric hospitals by the way, not about you in particular.

    You might also share with your cohorts the apparent results of gradually increasing medicalization and drugging of severe distress (“schizophrenia”) over the last few decades: gradually decreasing rates of functional recovery, as discussed in Jaaskelainen’s meta-analysis where it was admitted “We are not getting better at getting our patients better” –

    The bad news, from the biological/genetic perspective, is that no genetic breakthroughs, nor any new breakthrough drugs, are likely coming to change this dismal picture.