Monday, March 27, 2023

Comments by shaun f

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  • Excellent article. More and more of my clients are looking to get off pills, because I think they understand that it’s not helping them achieve their goals and in some cases doing much harm to them physically and mentally. Hopefully, society can find a way through all this toxicity, but to be honest I don’t see that happening until capitalism as we know it ceases to exist. Capitalists seek to exploit “opportunities” to make a profit, damned the consequences. Exponential growth is harmful and unsustainable in most cases, like in your cancer example. The system is broken but I’m unsure humans have found a system which doesn’t exploit the land, animals, or people to sustain itself.

  • Ramesh,

    How do you explain an overall reduction in violent crime in the last quarter century at the same time there has been on ongoing increase in psych drugs prescriptions? Furthermore, there has been a significant decrease in the amount of impatient hospital beds during this time. I agree with you that psychiatric abuse occurs, and should be stopped; however, it’s a stretch to say that hospitals and doctors are “deliberately” harming and torturing people. They actually believe they are doing good on the whole. This issue is of course very debatable. Modern-day treatment is a mixed bag of results. Most people who come through the MH system are content with their care, otherwise I have to imagine so many of them wouldn’t voluntarily stay coming to group/individual counseling or seeing their doctors. It’s not exactly like there is a large movement against psychiatry. Actually, it’s a small number of people who have spoken out. The vast majority of folks are content with the system as it currently stands. So until the people who voluntarily choose to participate in the system stop and demand reform/changes, the status quo will remain.

  • “DT” is Donald Trump, our womanizing, misogynistic POTUS. I’m sorry but Cosby, R. Kelly, Weinstein, et al. deserve every bit of criticism and judgement for raping and sexually assaulting/harassing women. We can’t blame the system for people acting like giant turds. At some people are responsible for their actions. Certainly, men in power have ample opportunity to abuse their status, and unfortunately many do. Trump is a rich ahole who thinks he should be able to do whatever he wants regardless of how it impacts others. This is a personal attitude of his, and all the men I mentioned above fall into this category as well. There are hundreds of female actresses who have been assaulted, abused, or harassed by male producers, actors, agents, and directors. We see sports stars like Woods do similar things. Did the system make Matt Laurer harass co-workers and cheat on his wife? No.

    The truth is that men can and are violent, no matter what system they are in. We abuse both men and women. We men need to learn to control our violent and sexual impulses and respect others. We can never justify rape or other sexual violence. We too often act like animals and don’t use our prefrontal cortex nearly enough.

  • Steve,

    “It is also important to keep in mind that while women can be abusive, emotionally and sometimes even physically, men are supported and protected by social structures and gender role expectations in ways women are not.”

    Not necessarily the case these days. I’ve seen women have their parental rights taken away and given to men for what seemed to be gender bias in the opposite direction. Also, now when the cops are called for a DV situation, it is often the case that men are at higher risk of being arrested, even when they are innocent. There is a belief by many that “women are always the victim” in such situations, which is clearly not the case. Yes, men do have social advantages, but they are shrinking by the year (for the better). 50 years ago DV against women was basically enabled by the system (much like drunk driving), but thankfully today that has changed. Any abuser should be held accountable.

    Typically, in the MH system, however, it is the survivor who is “treated” and “diagnosed”/pathologized for their distress from the abuse. The abuser is the one that needs to change, but usually they don’t see their role as being problematic (which is why they don’t seek treatment unless forced to by the courts). It is the trauma survivor who has to find a way to cope with all the madness.

  • “Some men thrive on abusing their partner and manipulating the effect of that abuse to further disempower her by crazifying her reaction in what becomes a vicious cycle of abuse and often an inability to leave because of credible threats to the woman or her children.”

    Some women do this to men as well. It isn’t common but does occur for sure. I have an aunt in my family who emotionally abuses my uncle. It’s a mess and my uncle feels pretty trapped in the dysfunctional situation.

  • Screen time, like all the other factors mentioned in the article, clearly plays a role in human development and well-being. I do agree anecdotally that bullying and early drug use are very detrimental to children and teenagers. It seems that everything in our environment plays a role in our health and development. I’d suggest that if a kid is on the computer, smart phone, or TV most of the day, then they will likely develop some problems from it, such as social anxiety, low self-esteem, etc. Much of this depend on how the caregivers respond to the child; I know of many parents who use this technology as a de factor babysitter. From an attachment perspective, children are more likely to develop anxious and avoidant styles of bonding later in life if they don’t get regular, consistent, and predictable responses from their caregivers/parents. This is probably one of the top factors in healthy development. Screen time may just play a role in all of this but likely isn’t the most significant factor.

  • I do hope that the anti-psychiatry message is more widely heard and understood. Unfortunately, MIA and other such groups in America are on the fringe. The vast majority of people still believe “mental illness” is a valid construct and thus that diagnosing and “treatment” are logical conclusions. I don’t see this changing anytime soon, especially with powerful interests involved to maintain the status quo, like Big Pharma and the APA. It sure seems that for radical reform/abolishment to take place we need more than 2,500 views of articles like this one. Millions of people need to be exposed to the downsides of traditional “treatment”. Honestly, I’ve tried to educate my clients about such problems like diagnosis not being scientific and pills being potentially dangerous, and most of them say, “Well, I still want to see the doctor”. If the people coming to my clinic don’t seem to mind the status quo, it’s very doubtful there will be any significant revolt anytime soon. We can debate these issues online all we want, but it doesn’t change the system. We do need a large camp of people to come together for any substantial change to occur given the pervasiveness of diagnosis and “treatment” with pills. While it isn’t hopeless, I give us a better chance to land on Mars by 2025 than I see psychiatry removed from the system. I guess anything is possible since we did (maybe?) land on the moon.

  • Sam,
    Thanks for your kind words. You clearly understand my process, and your effort at empathy is greatly appreciated! If you read my posts from 1-2 years ago I think I’ve come a long way in understanding how “treatment” is problematic and why some people see abolishing the MH system is the only reasonable answer (as a side note, I prefer reform where we would reduce prescribing by 95% or more and provide a lot more therapy instead–without diagnosing or (mis)labeling people).

    My sense is that I get flak from some on MIA because I still work in the system which has harmed many of the posters here (and because I don’t support abolishment). While traditional outpatient treatment clinics can and are helpful sometimes, they can create devastation in peoples’ lives. Our doctors don’t have to personally face the consequences of their prescribing practices. Therapists don’t have the feel the negative emotions they evoke in sessions. It is our clients who face these realities in lives. I’ve been personally very frustrated at our doctors when they minimize the harm which we are clearly doing with “side effects” from pills. I think many counselors are oblivious to the reality that therapy can do more harm than good as well. In my therapy I aim to be like Carl Rogers–warm, compassionate, good listener, shows care and concern, and try to leave my ego at the door. It’s amazing how people feel better just knowing that someone cares about them and tries to really understand them without judgement.

    Of final note, I’ll add that I don’t believe I was contradicting myself in the post Oldhead commented on. I was saying that while on the one hand conceptualizing “mental illness” as a metaphor makes sense to me, we still cannot say without certainty that “mental illness” doesn’t exist (kind of like arguing if God exists or not). We do know that the brain develops illnesses, but we don’t know why or if issues like depression or mania have genetic/biological causes. I suspect that some people are genetically vulnerable to certain distressed states like depression; however, what seems to unlock most peoples’ “symptoms” is the environment–namely, trauma of various sorts. Humans are mysterious and probably always will be to some degree. I do think there are genetic/biological differences which may account for why some people experience problematic behaviors or emotional states. I mean, the Ted Bundy’s of the world sure seem different on a fundamental level than the Dali Lama’s (or the rest of humanity).

    Thanks again.

  • Kindred,

    You are right, and I appreciate the nudge! I have altered how I talk with clients about their distress already. I normalize their experiences and point out that it would be crazy not to feel distress after dealing with traumatic events. I do encourage them to seriously consider alternatives to pills. I educate them that we require a diagnosis which is not scientific. I do a lot of things that other clinicians don’t do. But I could do more, including the way I conceptualize “symptoms”. I do what I can to not make the situation worse for my clients.

  • Thank you for you for writing this important article. As a LPC I’ve heard usually good things about NAMI from others in various MH systems. Most professionals I’ve heard talk about NAMI don’t say anything critical. They assume that speakers bureaus, education, and outreach are all worthy activities because it can decrease stigma and increase engagement in treatment. Not until reading MIA did I realize the harm done by groups like NAMI. I have assumed that they do good work, but of course that is the convenient narrative for paid helpers to believe (especially when we’ve been indoctrinated by the culture of “mental health treatment”). I was a victim to being “educated” about only one point of view, the disease model. Every place I have worked uses DSM codes to bill, and even that was never presented as a potential problem for the people we supposedly care about, our clients. There’s a lack of critical thinking in medicine and MH systems. We all go after the money and disregard the harm which is being perpetrated by the system, such as forced hospitalizations and drugging. NAMI has no issue with continuing the status quo because it works for them. This is the same with psychiatry, APA, DSM, MH centers, and Big Pharma. Nearly everyone is getting wealthy (well, NAMI employees don’t get paid much or are volunteers) off the suffering of others, but they convince themselves they are compassionate and doing good work. Cognitive dissonance is strong amongst these groups.

  • Kindred, I get your point. Using the term “symptoms” refers to a “pathology”. Because most people who do experience terrible “symptoms”/distressed states, however, they aren’t particularly bothered with the term “symptom.” Certainly, I understand that getting away from any medical language is preferable. It’s semantics, and definitely people on MIA pay close attention to these words, which are too often used as weapons by family and so-called professionals.

    I am so accustomed to using medical terminology because that is the system I work in and have been in when I worked at a hospital.

  • Oldhead,

    Our interactions have generally felt difficult and unproductive. So yes it is probably best we stop commenting on what each other has to say. We come from different points of view, and like I have said before, both have valid points to offer. It is frustrating that we can’t focus more attention on what we agree upon (like forced “treatment” and the DSM). But so be it. This is the internet, where communication is often challenging.

  • Oldhead,

    It’s pretty interesting that you accuse me of lecturing others while you do the same to me. I’d suggest we work on finding common ground rather than trying ways to one up the other person. It would be more productive.

    Most people who experience distressing states take no issue calling their experiences “symptoms.” It is a small minority who do. Calling hypervigilence a “symptom” of trauma doesn’t necessarily have to be pathologizing. It’s a real experience which causes real suffering.

  • Well said, kindred. I don’t disagree with any of this. You are right that the scientific method needs to be utilized in determining actual diseases. Western medicine has a lot of faults, one being that assumptions are too often made by so-called experts without knowing the root cause of the symptoms. We often look at the surface level stuff rather than digging in to find the real answers, and in some cases I’d posit it’s likely impossible to know what is the actual cause of someone’s symptoms.

  • Steve,

    I have never said that mental illness, as defined by the DSM, can be scientifically delineated. We simply don’t know if distressed states, like hallucinations or mania, can be attributed to parts of the brain which have gone haywire. This is why you are right that the term “mental illness” is more a metaphor than a reality (that science has been able to prove, anyway). We cannot say with certainty, however, that “mental illness” doesn’t exist either.

    We do have enough data to know that the brain, like all organs, can develop various illnesses, such is the case with dementia, MS, Parkinson’s, Huntington’s, epilepsy, and ALS. . It stands to reason that the brain is vulnerable to various kinds of diseases (and foreign bodies, like tumors), which can and do impact human behavior, thought, and emotion. Someone who has suffered with depression their entire lives will tell you that it sure feels like a curse (e.g., disease) that they cannot shake.

  • Hi Sam,

    Thanks for your empathy! I do take lots of flak but it’s ok.

    I agree with you that dissociation is on a spectrum, like every other human experience. I call your wife’s situation “extreme” because she meets DSM criteria for DID, which is very rare. While all of us disassociate to some degree, the vast majority of us, including trauma survivors, never develop alters. And you are right that there are very severe cases where people never are able to do real healing.

    I’m glad to hear that your wife had you to support her. When people are going through difficult experiences, one thing I know for sure is that they need huge amounts of support and love.

    Have a great weekend!

  • Hi Sam,
    I think there are many valid ways of conceptualizing these complex issues. I see disassociation as a natural response to trauma. What you say makes a lot of sense from how you experienced your wife’s disassociation. I think disassociation becomes very unmanageable when people don’t have the tools to ground themselves to their core self/the moment. When people are regularly “not here” in the present, life can become quite difficult. The trauma is the reason people go there but it can and does happen in everyday life without one trying to.

    I myself do it more than I would like. I recall starting to disassociate in school a lot. It was probably because my father was an alcoholic and my parents weren’t showing much happiness. I sometimes disassociate in the worst times, like when I’m co-facilitating a group at work! I also disassociate frequently when doing mundane actives or even while driving!

    I couldn’t imagine how difficult it would be to support someone with severe disassociation.

  • Steve,

    Your definition of the mind are basically boiled down to the choices we make, like being courageous, and feelings, like regret. All of these experiences/thoughts/beliefs/feelings can be tied to various parts of the brain which we do understand to some degree. Again, your distinction between the brain and mind seems completely arbitrary and lacking any real differentiation.

    I do believe in science, which is why I’m more and more skeptical of psychiatry which lacks hard data. Psychiatry is about treating symptoms with pills which they have no way of knowing are helping or hurting anyone, and certainly know that they aren’t treating the root cause (usually, trauma, or some form of brain trauma like a TBI).

    Regarding the DSM, I have said repeatedly that we’d be better off burning the document and not using it. It is arbitrary in it’s distinguishing various “disorders” without ever having to prove that they actually exist (within the person). I hate having to use the DSM, and look forward to the day in the future where we don’t have to label people in order to support them.

    The concept of “mental illness” has been around for thousands of years, long before people where shoved full of pills. Clearly, people do experience distressing states, some of which never improve (with and without any form of help), and we can call it “mental illness” or “distressed states” but basically we are talking about the same experience/problem, e.g., hearing distressing command hallucinations. We can focus on semantics all we want but it doesn’t change that fact that millions of people around the world experience various distressing symptoms that they desperately want relief from.

  • Rachel,

    It totally sucks to be victimized by “medicine”. It’s unacceptable that thousands are harmed by doctors ever year in the name of “helping”. This is also why I want to stay as far away from hospitals as possible, since there are 100,000 deaths a year due to mistakes by doctors and nurses. And nearly everyone is better off not being on pills.

    I would agree with you that studying the brain should be left up to neurology and not psychiatry, because clearly the latter isn’t doing much when it comes to brain scans and the like. They treat symptoms and that’s about it.

  • Steve,

    All information ultimately goes back to the brain to be processed. Our CNS connects to nerves, and the spine, which all lead back to to the brain.

    The distinction between the mind and brain seems arbitrary and can’t be distinguished by science (yet, anyway).

    As far as I can tell therapy is focused on helping the brain to learn new things, process trauma memories, develop new neural connections, and so forth. When people learn over time that they do have some control I think it changes the brain. But I have no way of verifying this. Like I said earlier, we have a long way to go to understand what is going on in the human brain when change (or trauma) does occur. And why some people are seemingly more resilient than others. So many questions and few answers.

  • Well said, Sam. A point of clarification. Disassociation is a normal reaction to unhealthy and scary events. The problem arises, like with nearly all coping reactions, is that the helpful reaction becomes burdensome and gets in the way of living a full life. Disassociation keeps someone mentally protected when experiencing harm. But in adulthood that same person who continues to subconsciously disassociate will not feel so protected from this defense mechanism that was helpful in childhood. Substance use is another example. Initially, people often find illegal drugs and alcohol to be a relief, but in the long-term, they usually experience bad consequences to their health, finances, and relationships.

    Dissassociation isn’t the real damage to the brain…it is trauma and will always be trauma. The interesting thing is that we all react differently to trauma.

  • Richard,

    I don’t really disagree with anything you are saying. I think there are many causes of human suffering. I can tell you, however, that we do know brain development is directly linked to early childhood experiences. We know that if an infant is locked in a dark room for a period of time they will lose the ability to see. We know that if children aren’t provided a reliable and supportive home environment, that they will likely struggle with boundary setting and relationships, as well as a host of other issues. We know that children disassociate when they are regularly exposed to trauma, and frequently these people as adults will involuntarily disassociate. I could go on and on. The point is that the brain (e.g., self-esteem, self-image, decision making, problem solving) is damaged in some people, to no fault of their own, and they do want some form of resolution/healing. I would venture to say that the brain does need healing under such circumstances.

    For those who say other organs are involved, I would point out that none of our other organs are designed to think or feel. They are there for a specific purpose, like clearing out toxins or moving blood around our bodies.

    “Have you forgotten that we live in a society filled with injustice, trauma, discrimination, and multiple forms of violence, including poverty?”

    Our brains no doubt are damaged by these social and human problems.

  • Rachel,

    You bring up a good point. The system can induce symptoms in people, which is why drug treatment is like throwing darts and can be very dangerous. Iatrogenic consequences are all too common because we don’t really understand how individuals will respond to various pills.

    There are many people who come to my clinic, however, who experienced manic states prior to ever getting on any pills.

    I don’t hear any of our doctors saying that their pills “cure” anyone. They are quit open to the fact they are trying to treat the symptoms and not the root cause of anything. There are no cures provided in psychiatry or most other forms of Western medicine, unfortunately.

  • Steve,

    Can you say you know what is going on in the brain when someone is experiencing distressing voices or can’t sleep for days on end? Or dementia? The simple answer is no. My own theory is that the structure of the brain is damaged or altered when individuals experience trauma. Also, clearly genes play a large role.

    Do I think that pills will likely ever cure the symptoms mentioned in the DSM? No. What will likely lead to lasting healing is when we provide support and care for everyone, make sure their basic needs are met, help people heal through creating meaning and purpose in their lives, and so on. Chronic poverty is one top reasons people suffer with various symptoms; however, for some people they just can’t shut off their symptoms, even after they have attained all the things I’ve mentioned. We simply don’t have all the answers. So I think anyone who says definitively that “Mental illness doesn’t exist” is just as wrong as those who say there is a chemical imbalance in the brain which leads to symptoms. We don’t have enough information one way or another yet (although many on this site would disagree). What we do know is that people suffer from a variety of states and they seek answers and solutions from so-called experts who too often create more harm than good.

  • Stephen, I agree with your analysis. Our current system does not support the needs of all of its individuals. We have an inept system.

    Steve, I would slightly disagree. I think with severe, distressing symptoms, a cure of sorts is necessary to alleviate suffering. Severe mania, for instance, can be life threatening. We don’t understand all the mechanisms of the brain, as it’s the most complicated organ in the body. It drives all human behavior and emotions. The problem is that the medical model is throwing darts without really knowing what they are doing to people in the long run (they should have a good idea by now, but people do respond differently to “treatment”). This is the travesty to me. We shouldn’t experiment on people. That is inhumane. It’s amazing to me how many people, however, willingly/wantingly participate. I strongly suggest to people all the time to reconsider getting on pills, but they say to me that they are wanting any chance to feel better and are willing to take the risks.

    Richard, my point is that we simply don’t know what is going on with the brain, so we can’t cure the distress that people are coming into MH clinics want treated. Medicine can rarely cure anything. It does treat symptoms, like cancer, pretty well, but it hasn’t been able to cure cancer, diabetes, or hearing voices. By the way, regarding voices, most people I talk with who are voice hearers would much rather have this symptom eliminated, or cured. They don’t love hearing, “You should kill yourself”, “You are a loser”, etc. It’s upsetting.

  • Steve,
    Very true. “Professionals”, including myself, are invested in continuing to get a paycheck, and most of us are afraid to rock the boat because we have bills to pay. We’ve spent years in college attaining graduate degrees and student loan debt and feel compelled to stay in jobs which are possibly doing significant harm. We tell ourselves that the harm which the system creates is small compared to all the good we do. The cognitive dissonance is very uncomfortable, particularly in fields which are supposed to be helping others. We don’t want to believe that our interventions are hurting people. We think we are good people doing good things in the world. Of course, metabolic syndrome, TD, stigma, forced hospitalization, and coercion don’t fit into that narrative of being “good, helpful” clinicians.

  • One difficulty with OD is that many families (in the US) aren’t in (healthy) contact with people experiencing extreme states. In many cases the family is the cause of the distress in the first place. Lapland is a very small and homogeneous place, and I would also imagine that there is a greater sense of community and connection there than in places like the US. Clearly more research is needed. I think the OC perspective makes a lot of practical sense because it’s systemic and holistic.

  • John,
    What would you hope to attain by having regular dialogue with Dr. Breggin (or anyone else online)? Most of us are strangers online. I’m not sure this is the best option to attain support to be honest. I think he would agree with you that the system is messed up (e.g., the DSM) and that people like yourself have been harmed by the “treatment” you received. Do you have a therapist, church, or another avenue to attain support?

  • Well said, Sam. Crisis can be an opportunity to bring about growth and change. Belief systems we hold are very powerful and can get in our way of being more effective. Ego defense mechanism, such as cognitive dissonance, are natural ways for humans to cope with distress. Unfortunately, they can get in our way of moving forward!

  • Steve,
    True. Certainly something to consider. I think many of my colleagues are scared to push back because it feels like David v. Goliath. The entire system is structured around the idea that SPMI is a valid concept and “should be treated.” We clearly need a revolution, but the powers that be won’t go away easily. I feel daunted fighting against Big Pharma, APA, and psychiatry in general. The power differential is huge.

  • Madmom, I sure hope you are wrong but clearly the medical model still dominates “treatment” in hospitals and clinics. Any system where psychiatry is at the top of the chain the DSM labeling will be used because of billing. The truth is that many professionals would rather not use the labeling but the system requires it. I do agree that if we don’t fall in line we will get fired. Big pharma and the APA have gone to great lengths to develop a system which is focused on diagnosing and prescribing. Private practice therapists do have more liberty and rarely espouse the SPMI perspective or agenda. I do work in community mental health but plan to make my way out in the next year. I am tired of the overdrugging and pathologizing we do. Many of my colleagues feel similarly. I think we too often follow the status quo because it’s easier than making our own path. Maybe some of my ideas about clinicians being progressive like myself is wishful thinking? I sure hope not but you are probably right. I think all doctors and other “helpers” should be required to read the articles on MIA to better understand the perspective of people who have been harmed by this dysfunctional system. Thanks for sharing your thoughts.

  • “Who is this “we,” guy? Speak for yourself please. (Are you also part of the “we” that’s occupying Iraq, Afghanistan and Syria?) And if you’ve adopted a crazy lifestyle why are you counseling others? Do you consider being a “middle class” American (I think you left out white) “normal”? So many questions…”

    Our world is mad because of problems like the military industrial complex, rampant consumerism, corporate welfare, overprescription of all forms of drugs, plastics in our oceans, conspicuous consumption, and corrupt governments. Humans are certainly the cause of the most recent spike in global warming, and yet we’ve done very little about it. We are slowly killing our planet (eroding the conditions were we can thrive), which is quite stupid. So yes there is quite a lot that is mad about the world at large and America in particular.

    Certainly psychiatry contributes to this “madness”, but so do a host of other powerful players in the world. We probably need a massive revolution around the world if we have any hope to stop this madness. I just don’t see it happening because most people are either comfortable enough or feel powerless to change these powerful institutions. Oh, and humans are inherently imperfect, so we screw things up all the time. As we have seen in the Middle East in the last decade, revolution doesn’t guarantee a better system. Maybe you just a new dictator or a wolf in sheep’s clothing.

  • A lack of love–e.g., physical, emotional, and sexual abuse–is why most people seek “mental health treatment” in the first place. Love (healthy attachment) is what all humans need to feel “ok” with themselves. Without love, we have nothing.

  • I and most of my colleagues (people trained after 2000) have been taught to focus on the emotion behind the voices. Of course, there are some clinicians who will poorly handle this area. Former clients who post on MIA have had horrid experiences with doctors and therapists, which is why there are here to begin with. For all the thousands of people who are generally content with their “treatment”, they have no need to go to MIA.

    I’ll also add that groups like HVN are a wonderful resource for people to go talk about their voices without influence from the medical model. I wish there were more chapters in the US.

  • Most therapists and social workers would never “argue” with their clients who experience hallucinations or delusions. We are taught to be empathetic and work to understand our client’s experiences from their unique point of view. I do think psychiatry more often than not assumes there is a biological basis for these “symptoms” that the medical model “should” address; however, it’s important to separate out the other fields who were not indoctrinated in the medical model. I can’t recall once in the last decade that I told a client that their delusions are flatly wrong and need meds to correct them. That would be contrary to my values and training as a therapist. If I don’t respect my client’s perspectives and value them as equal human beings, I have no business being in my field.

  • Frank, good points. The reality is that our world is mad. From a middle class (“normal”) American perspective, we are crazy for adopting the lifestyle of materialism and hedonism. We suffer greatly as a result. We live isolated from our communities, and we spend our free time too often numbing out on screens. We over consume food and alcohol, which is why over half the country is overweight or obese. We are unhappy as a whole because material goods will never fill our souls. What is deemed “normal” isn’t always healthy. It was once “normal” to consider slavery acceptable. It’s now “normal” that we as a western society see nothing wrong with drugging up trauma survivors (or just regular “normal” people who have jobs). Madness is such a subjective subject because it’s socially constructed.

  • Steve,
    Thoughtful post. I would disagree that the system is “rotten to it’s core.” I think it’s very flawed but can be reformed. If we stopped pathologizing and drugging, and instead focused more attention on providing emotional support, the system would be much more effective. The problem as I see it is the medical model dominates the conversation and practitioners just comply with the demands from such a system.

    About half the clients I work with have full time jobs, and most who don’t either have serious medical issues or are caregivers. While some clients are harmed by our services, I’d have to think that if we were that bad, people on the whole would get worse and not better. But that is not what I’ve seen over the last decade. Obviously the harm done by pills is unacceptable and wrong, but that doesn’t mean that other aspects of the “care” people receive isn’t helpful to them in their daily lives. I’d have to think if the system was really rotten to it’s core, none of our clients would be able to work because we’d be harming them so much that this would be impossible. The system is messed up and needs changing, that is for sure.

  • Well said. I totally see how toxic individualism damages all of us. It’s very tempting to blame the individual for “all their problems”. This is one of the reasons why the DSM is very flawed, because it essentially says that the person is what is “dysfunctional” when in reality they are responding normally to very difficult and traumatic circumstances, e.g., depression.

  • Rachel,
    It is also possible that your friend’s son had other reasons for refusing to let her see the grandchildren. While it’s tempting to blame MH centers for all kinds of social and familial problems, there are many other variables which affect peoples’ choices. It’s possible your friend appeared unstable to her son, or unpredictable. Who knows?

  • Oldhead, many people do like coming to MH centers. I have clients who take three bus rides and two hours just to come see me for a 30 minute appointment. While you clearly don’t want any part of this system, there are others who feel that their “treatment” is in their best interest.

    I also try to encourage my clients to look at ways to reduce their meds or get off them completely, but guess what, most of them are reluctant to do so because they find some benefit from it. Also, most of them seem to care very little what DSM diagnosis they’ve been given. I tell them the possible negative effects of the diagnosis, such as stigma and being denied life insurance, but I usually get nothing more than a yawn from them on this front.

    I believe in reform and you believe in abolishment. We both have valid points.

  • Good point, Rachel. Sunk cost fallacy is relevant in many areas of life–jobs, relationships, and psychiatry. I would tend to agree that when people invest a lot of time and effort into their “treatment”, it is hard for them to accept that it has been a waste, harmful to their health, and so on. Also, often people seen in MH centers don’t attribute any positive changes to themselves but rather to their “treatment”. They think that without this “lovely” treatment things would fall apart. I think that many people do see benefit in coming to the MH centers, however, because of social connection. They make friends in groups, connect with therapists, and so on. One problem in America is that we are isolated, lonely, and disconnected. This is a natural consequence of our individualistic culture and the way we live (e.g., living far away from family), and thus MH centers fill a void to help support people who are suffering. While MH centers do some good in this regard, we do badly by our clients when we drug them up with neurotoxins and pathologize them with the DSM.

  • Well, the problem is we don’t have a viable system which would not somehow get manipulated by the powerful monied interests. Socialism in European countries is the best system currently that tries to consider everyone’s needs, but it has yet to be duplicated in large, heterogeneous countries like the US.

  • Well, said, Kindredspirit. Humans have yet to find the ideal social, political, and economic system which supports the needs of the common people and to protect vulnerable individuals from actual harm. In modern life people are treated as disposable commodities who only matter when the 1% can profit off them (employees) or use them for some other benefit (e.g, our troops). Once we are no longer considered useful (e.g., the elderly), we are discarded and devalued. “Mental health clients” will be used by the system until the system is radically changed or clients walk out. The rub here is that many clients come to mental health centers to seek other resources, such as housing or help attaining public assistance benefits. So many basic needs for the poor are now requiring a doctor’s attestation that the person is “disabled” and thus eligible for affordable housing, transportation, student loan dismissal, and the like. The system is founded on the idea that a doctor can verify that someone is “disabled” and thus determine that the person cannot work. This is very flawed for so many reasons. So while some people are truly distressed by their symptoms, many are also distressed by poverty– the lack of access to basic needs and not feeling safe. We need to get away from linking the two. If someone is poor, they SHOULD have all their basic needs covered, especially in such as relatively wealthy country like America. Unfortunately, we know that many wealthy people hoard their resources and don’t want to pay more taxes to support everyone’s needs. Until everyone pays their fair share, we will continue to find ways to limit “entitlements” to basic needs. The poor will then be forced into finding “treatment” providers who will say they have a disability which makes them eligible for various resources. Additionally, psychiatrists typically will not meet with their clients on an ongoing basis unless pills are prescribed, so this set up coerces people to take neurotoxins when they really don’t want to be on pills in the first place. Screwed up system.

  • Rachel, I have not read that book on evil. I do find it to be a useful concept to help describe certain adult behavior. I would venture to guess that nobody would call a baby evil, because it has yet to develop a conscience. What scares me is that some people seem to lack empathy or a conscience (I believe due to neurological conditions we don’t understand, probably often the result of childhood trauma). These people sometimes become serial killers and dictators. They also become doctors, CEOs, lawyers, and politicians! No doubt evil behaviors exist, such as the case during the Holocaust and Hitler.

    Basically evil is “Antisocial Personality Disorder in the DSM; people diagnosed with APD usually have done some horrid stuff to others in their lifetimes and don’t show remorse. They seem to lack the basic understanding of why what they do is wrong in the first place. I have met a small number of people who present like this, and they give me the chills!

  • From what I’ve seen anecdotally, trauma seems highly linked to fibromyalgia diagnosed individuals. It is my belief that the body will show various signs of distress anywhere from 10-25 years after childhood trauma. It appears that people who have experienced ongoing trauma in childhood are particularly prone to experiencing various physical pain and discomfort that cannot be accounted for elsewhere. Trauma also seems linked to autoimmune disorders.

    I believe most doctors don’t like diagnosing fibromyalgia because it gives patients few answers. Personally, I think it’s just the body’s way of processing traumatic material.

    I agree with you that the entire system is problematic. When capitalistic forces drive a system, we know that it will rarely benefit all of us.

  • Kindredspirit,
    Yes, it is absolutely terrible. Modern medicine should not be doing more harm than good, but clearly they are falling way short of their supposed ethos. I think that treating mental distress really needs to be out of the realm of psychiatry. So many medical problems are caused by “treatment”. Also, many medical problems are missed by doctors and falsely labeled as “mental illness.” It is very angering. Thank you for sharing your story which is very worth telling.

  • I agree Oldhead that it can go both ways. I see it here at my center where others (usually family or the court system) are pushing my clients to “get help”. Often the real distressing problem is in the family system or larger society, with issues like poverty, intergenerational trauma, and the justice system.

  • Kindredspirit,

    Your story is all too common in the medical model of “care”. Doctors in my experience are lacking emotional intelligence. They are also in denial that they do harm to people they supposedly are trying to help. I think that medical school needs to do a better job encouraging non-empathetic doctors into parts of medicine that don’t require a good bedside manner to be effective. Doctors, in my experience, are also an arrogant lot. They rarely admit serious mistakes. They place blame onto their patients when things don’t improve or worsen. They create addicts with their prescription practices. While there are some very thoughtful doctors out there, the norm is still to over-pathologize, under-empathize, judge, and to over-prescribe.

  • “This is important, because a non-diagnostic, non-pathologising, scientific alternative is not only already available, it is actually part of the World Health Organisation’s existing system… we can make the change today!”

    It would be wonderful to move in this direction. In my work it’s clear that socio-economic conditions and intergenerational trauma are key elements in individuals mental health picture. It’s likely that most human suffering (in the form of symptoms described in the DSM) are a direct result of living in acute and chronic states of stress, which includes social isolation, poverty, living in unsafe neighborhoods, facing discrimination by the police, and the like.

  • I totally agree, Bradford. The system is backwards. Clients aren’t brought into the process of how “treatment” is provided in any meaningful way. There are superficial committees that “consumers” can join, but they have no power and limited influence over how the larger system works in these roles. I did intern at a small MH center where they have a 50/50 client/professional board leadership setup. This is rare in the US, however.

  • Anyone who has been paying attention knows that Trump scapegoats immigrants for our social problems.

    We also know that he doesn’t care about the well being of marginalized groups (or really anybody else not named Trump). DACA is a perfect target for him. Many white Americans (PS, I’m a white privileged male) are fearful that their power and reign over American society is waning, so marginalizing this minority group is a way to take back their feelings of being in control over society. It’s just a matter of time before we can’t stop the inevitable, when white people are the minority. Building a wall also won’t prevent this from happening. Fear mongering never goes out of style with authoritarian leaders.

  • Steve,
    It’s becoming a running joke with my coworkers that I’m the “anti-pills and anti-diagnosing” therapist here. They often roll their eyes at me when I say something about the systemic BS that is happening to our clients.

    I am talking to my clients about getting off pills, and I expect that I won’t be liked by the doctors or managers real soon. It’s interesting how much people believe in the medical model without much evidence for it’s support, yet we delude ourselves with “evidenced-based practices”. We think we are being rational and sane in our “treatment” of clients, but who ever thinks that they are doing harm to other people for a profit? The more I question the systems I work in, the more uncomfortable I’ve become with the status quo. Clearly our “treatment” works well for some clients, BUT do the benefits weigh out the risks? I know of people who have gained 50 pounds in six months on mood stabilizers. I know of people who have developed diabetes, became zombies, developed addictions because of the pills they were prescribed, and so forth. There appears to lack critical thinking about what harm is being done by these so-called “medications” and other things we subject clients to.

  • The prison system can certainly be improved. Just look at other parts of the world inmates are treated with more respect and dignity.

    One could argue the MH system would be signficantly improved if we removed drugging and forced “treatment.” I know you want the MH system to be abolished (for understandable reasons), but many of us think there are better alternatives which wouldn’t require such drastic measures. Everyday as a therapist I hear from clients who say they are grateful for “the system”. The system works for some and not for others.

  • “Humans are not machines whose software needs an occasional chemical adjustment. The roots of human suffering are often located in traumatic personal histories of abandonment and neglect, larger social forces such as poverty, racism and misogyny, and thwarted existential needs. With their wildly disproportionate access to and flagrant manipulation of the media (as illustrated by the recent Facebook debacle), corporations have ushered in a global culture which concentrates wealth and power in a handful of individuals, leaving the rest of us struggling to secure basic amenities such as affordable health care and housing. Significantly, the corporations enjoying the greatest success today are those that alienate us from our own human nature; tech companies that seduce us to replace lived experiences with virtual ones, and pharmaceutical giants whose drugs alter our personalities and blunt our emotions. Increasingly, deep human experiences are replaced by shallow commodified ones; Facebook ‘friends’ replace realtime relationships, and the curated selfie is more valued than authentic self-expression.”

    Well said. Couldn’t agree more. Thanks for the article!

  • In my experience most psychologists aren’t interest much in “social justice”. The only helping profession within the mental health realm I know of who have emphasized “social justice” are social workers. The rest of us rarely deal with the macro issues that social workers tackle. The psychologists who I’ve interacted with over the years are heavily trained in the medical model dogma of diagnosing and patghologizng. They typically don’t address the systemic problems in society in any meaningful way. But hey they can interpret ink blot tests for you! So there’s something I guess.

  • Steve,
    Going old school with your BF Skinner reference!

    PS your posts are showing up out of order on MIA. I get an email notification but then it shows up before other posts have been made on MIA. It’s a little confusing in the order of posts. Let me know if that doesn’t make sense! Maybe it’s based on time zone? See the times on these few last posts.

  • Oh, boy. This must explain why people were so scared of Hillary being president!

    If we really lived in a nanny state I assume we wouldn’t have millions of people who are homeless and tens of millions who are very poor. We clearly don’t provide “care” to those who need housing, basic healthcare, and substance abuse treatment.

  • You are right that our modern computer/phone technology is highly addictive. My point is that it’s designed this way for profit not social control. People make lots of money off of this technology, and frankly many of it’s users are happy to spend our money on it. Certainly many people become addicted to anything which increases dopamine. I think that we do have a choice as adults as to how we use it. My phone doesn’t control me! I do have trepidation when it comes to children using it, because their brains are still developing. It’s a huge industry which is why Apple, Microsoft, et all, are worth so much. We as consumers do have a choice. We can’t blame companies for all of our problems. We do need to take some personal responsibility in this situation. If there wasn’t a demand, there would be no supply!

  • JanCarol,
    Yes, it is a slippery slope. We have a POTUS who is an authoritarian and attacks anyone who he perceives is against him. Not good.

    Regarding social media use, cell phones are ultimately a choice in terms of how we use them. The government certainly isn’t forcing anyone to use “smart phones” if we don’t want to. Frankly, most of what goes on with social media and smart phones is just about advertising and selling products. It’s not about controlling us but maybe keeping us numbed out to some degree. The truth is that if we woke up we would see that the economic system is heavily benefiting a relatively small group of people at the expense of the rest of us. That is what we should be concerned with IMO.

    I’d suggest using a different word to describe the situation than “totalitarianism”. If we describe the current state of affairs as the same as true totalitarian regimes, then we watering down the real thing, like North Korea. That place is nothing like Australia or the US.

  • ““The Russians” had ZERO affect on the election.”

    Did you complete an investigation into the matter? How many Russians have been indicted by Mueller? 12. They did hack the DNC at the very least, which was an attempt to discredit her.

    I was a Bernie supporter and see no evidence that the DNC “screwed him over”. They clearly favored Hillary, but that is how politics goes. Bernie was a long shot to get the nomination because of his leftist views.

    We need to look no further than the Kavenaugh hearings to see which party is still much worse. The Republicans didn’t give the Democrats time to read over the thousands of pages on K before the hearings began. It’s a sham. The Republicans in Congress just want their guy in no matter how corrupt the process is. Sad.

  • I think this article make some important points on this subject:

    The truth is that the military industrial complex is driving American politicians to go to war. Money is made when we are at war after all! The Halliburtons and Lockeed Martins of the world make bank while everyday people suffer and die in these conflicts. Our system has been corrupted, and probably always will be corrupted, by monied interests. This is why all forms of big business thrive and have amazing balance sheets while the average worker is not much better off, or worse than, they were 30 years ago. The fact that our laws now consider corporations to be “persons” is just one example of how far we’ve devolved. I agree that both dems and repubs are to blame for this mess. We can’t expect the decision makers to hold themselves accountable. It’s human nature to be self-interested. I do see dems as the lesser of two evils, but frankly both sides are corrupt. We need to have publicly financed elections so politicians can no longer be bought off by corporate interests. We also need to get rid of super pacs.

    Regarding Vietnam, we had no business being there, just as we have no business in Afghanistan. And for the record Trump has pushed for continued military activity around the world and increasing the military budget, so if you think he’s not pro-war, you are kidding yourself.