Saturday, January 19, 2019

Comments by shaun f

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  • 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.

  • I agree Oldhead that both parties maintain the status quo in most ways. Neither one is particularly radical. They do stand for different values, such as gay marriage vs. marriage for heterosexuals only, environmental protections vs. most things go to make a buck, abortion vs. banning abortion, etc. We do elect our officials, so on some level we are still a democracy. We aren’t Russia after all, where there is only president (I mean, dictator, who will have his opponents murdered) indefinitely. The fact is that in America regular people can and do run for and win political office. Obama wasn’t particularly economically privileged, but he is smart, intelligent, goal oriented, and has clear leadership abilities. In the US his presidency was possible, but in most other places around the globe he would never had a chance to get to that level of politics. I miss him everyday. He is a good man, much like McCain, and now we have a man child running the free world. God help us all. Obama was truly inspirational. Trump only inspires me to throw up into my toilet.

  • Oldhead, this is false. Corporate news isn’t necessarily “fake” news. It’s only inconvenient for people like Trump who can’t admit their fallibility. Most news reported on CNN, MSNBC, and Fox is factual. But some people can’t handle the truth. Fake implies completely made up, which is hogwash when it comes to mainstream news. Of course it’s biased, but that doesn’t mean it’s not true, at least to some reasonable degree.

  • Oldhead,

    Chiropractors are potentially dangerous. I know one person who had a stroke after receiving subluxation on her neck. It’s a pseudo-science that is mainly a business venture to make lots of money (many similar comparisons to psychiatry if you ask me).

    I went to a chiro once who told me that diabetes and other chronic conditions are the result of spinal misalignment. I walked out of the door after I heard his trash. Granted some people like you do report benefit, and that’s excellent. If you believe it is helpful, that is good for you. But I do think the public is misinformed about this “medical specialty”.

  • How many journalists and political opponents has Putin have murdered?

    Sure Putin is smarter and more strategic than Trump, but that doesn’t make him a moral leader. He’s sure good at getting positive attention for Russia through the Olympics and World Cup in order to try and legitimize his corrupt ways.

    For the record you have bashed Democrats, calling them the greatest threat to democracy. So pot, kettle.

  • Stephen,
    It’s a real head scratcher. The Reagan supporters in the 1980s would be very confused by what is happening today. Seems to me that until Trump came along, Russia was not viewed positively by the American public. Certainly, one would think that Russia’s meddling in our election would concern most American people. The fact that Putin murder’s his political opponents and journalists should be reason enough to be weary of Russia. I would say that Trump’s base is highly emotional and rarely has much logic for their support of the man. I mean, how did anyone think a billionaire who has always cared about himself first would somehow change his ways and prioritize the middle class and poor? Not gonna happen. His base will not be economically better off in the next decade, and somehow they’ll blame the democrats. Certainly Trump has made that case anytime anything hasn’t gone his way. “It was the Democrats fault!!!!!”

  • Well said, Richard. I do think it’s important to also distinguish from social and economic conservatives. The former is concerned with things such as abortion and gay marriage, whereas the latter group is most interested in lower taxes, increased profit margins, deregulation, and reducing the size of the government (but usually still support military spending). At the end of the day most conservatives believe in the capitalist system, and thus it would be difficult for them to support abolishing psychiatry and limiting big pharma from attaining their profits.

  • Let’s be clear, I doubt many folks are coming to therapy primarily because of their anxieties about Trump. I have yet to see it. In the first six months of his presidency, many of my clients expressed concern and worry that Trump will harm them in some way. But they had other anxieties which were more pressing, like basic survival of paying their rent or being homeless.

  • Nobody in the mental health world is seriously treating TAD as a real thing (It’s not in the DSM yet!). People get anxious about a number of things which are scary, and no surprise that marginalized people in particular are worried how Trump will make their lives more difficult given his rhetoric and unpredictable behavior. Trump is scary and dangerous, so we have all the reasons to feel concerned for our future. People willingly seek out counseling to talk about any number of reasonable anxieties they face in life. Trump is just one of many reasons to worry about the state of the world.

  • Well, Trump lies like his job depends on it. He doesn’t like it when anything critical is said about him. That is why he falsely proclaims this information is “fake’. This is dangerous behavior.

    “The Democratic Party is the biggest enemy of democracy…”

    Next you’ll tell me that Trump is the second coming of Jesus! Frankly, there are many enemies of democracy, none of which you listed. It really has little to do with party affiliation. The real enemies are super pacs, big business, Russia, and people like Trump who reduce peoples’ faith in our government and system in general. When people stop believing in our government, they will stop voting and participating, which will allow very powerful, wealthy interests to further take hold of our system.

    Sure seems like the Trump administration is following a certain Putin-esk playbook:

    Just remember what Trump said about the election if it doesn’t go the Republican’s way. What a lovely guy.

  • Sam,
    You are correct that all sides of this feel some level of distress. There is a reason that both Bernie and Donald had large audiences and support, because the middle class and poor are hurting in this country and have been for quite some time. Part of the problem, however, is that all criticisms of Trump are basically ignored by his base. It doesn’t matter what Trump says or does, and they look the other way. So the truth doesn’t really matter to them. They believe what they want to believe and ignore the realities which should be smacking them in the face. Trump is dangerous because he’s an authoritarian and a bully. There is no convincing his supporters that this is true. There is very little which is redeemable about Trump, and until people on the Right acknowledge this, we aren’t getting anywhere as a country. The man panders to his audience and lies with reckless abandon. Stephen is right, Trump is a malignant narcissist. Trump will turn on anyone, except maybe his closest family members, if he perceives they’ve wronged him. If people have wonderful things to say about Trump, he’s their buddy. Just look at how Trump treated McCain.

    The author probably should have left out the name calling. But when the shoe fits. By the way, most centrists these days don’t support Trump, either. They don’t need to be convinced that he’s unfit to be president. There is ample evidence which the middle of this country actually pays attention to.

  • Richard,
    I’m just not sure what the viable alternative to capitalism is? I mean, most of the industrialized world is capitalist to one degree or another. Humans have yet to perfect any system which avoids exploitation of land and people.

    Regulation doesn’t have to be a sham if the regulators are righteous, but far too often politicians are corrupted by the system. In America, for instance, we now treat corporations as people. We have super pacs which wield immense power. The rich run things. The rest of us fight for the scraps. The current system is unsustainable, but I just don’t see what we could realistically replace it with.

  • Richard,
    Conservatives value deregulation because it helps them make more profits. I think there are many examples of regulation which has protected the environment and people. The creation of the EPA helped to eventually clean up the polluted waters in America. Regulation also helps prevent consumers from being exploited by creditors. The concept of regulation isn’t a sham, but when industries are deregulated, everyday citizens usually suffer in the long rung.

  • Sam,
    He’s right in his characterization of Trump. Some people will not like this reality, but the facts certainly indicate that Trump is a narcissistic egomanic who makes too many (dangerous) impulsive decisions. If someone needs to defend the size of their manhood in a national debate, we should immediately disqualify the person from political office! Of course there is no DSM category for TAD, so it’s not really being patholigized. But it is a real phenomenon. Many of my clients over the last 18 months have expressed significant levels of distress with this man being in office. He does impact all of our lives, after all!

  • Lawrence,

    I was talking about regulation in general. There are many good examples of how regulation has protected consumers; for instance, requiring that cigarette packages have a warning label has probably helped to reduce tobacco use over time (as well as rising the costs through taxation). When it comes to MH treatment, regulation has done very little to protect consumers. The FDA has failed, as well as state boards.

  • Frank,
    NO, I never said any abuse is “ok.” Wwhen it comes to psych drugs, the FDA and state licensing boards are there to help “regulate” the industry, and many would argue they are doing a poor job of it. Many people do get excessively drugged by their doctors. I see it all too often. I understand why people think psychiatry is a sham; PCPs, however, are also largely responsible for their prescribing practices. They are the ones who often start people into the world of benzos, SSRI’s, opioids, etc.

  • Regulation isn’t a sham. We need regulation to prevent excessive abuses within the system, like monopolies and sub-prime loans. Of course regulation will be controlled by those in power; this is the case all around the globe. We need regulation that protects the poor and middle class, but unfortunately this isn’t a priority for the 1%.

  • Oldhead,
    Conservatives want to reduce government spending in general (although clearly they don’t practice this belief when it comes to benefiting themselves), which is why they don’t support spending for “mental health treatment.” Many of them, do, however, believe that mental illness is a legitimate concern. They just don’t love the idea of universal healthcare. There are plenty of conservative veterans who believe in PTSD.

  • Oldhead,

    “The primary clash in the AP movement is between anti-psychiatry survivors and “mental health” professionals, regardless of ideology. And currently the so-called “left” is probably more supportive of psychiatry than the “right.””

    What evidence supports that the left is more supportive of psychiatry?

  • Medicare expansion has been a godsend in my state, which has benefited the working poor the most. That is what my clients tell me anyway. They say they went years without getting therapy because they didn’t have coverage. They tell me they are grateful for the ability to see a therapist. I think when it comes to psych drugs, yes clearly this is increasing healthcare costs in the US. I would love to see national healthcare in the US, because people could then, in theory, get preventative medical care which would reduce suffering and long-term costs (and thus could treat real medical issues). That would be lovely.

  • Capitalism is exploitive in practice. This is why regulation is necessary. Humans have yet to find a balance where everyone wins. There always seems to be “losers” (in any system) in reality. I think income disparities will only grow as the human populace increases. About 1 billion of the world’s population still doesn’t have access to clean drinking water!

  • I’d say that psychiatry is currently problematic because it assumes there is a biological component to mental suffering and “symptoms” without any proof. We simply don’t know if there will be any real science to back up psychiatric belief systems. “Belief” is the operative word here. I am still open to the idea that there are possibly differences in the brain or DNA which lead some people to experience excessive distress, BUT until the day comes that science has proven this, we should continue to challenge psychiatry’s continued assumptions about “mental illness” as a valid concept. If psychiatry would go back to it’s roots of psychotherapy, I think more people would benefit. Maybe we should leave concerns with the brain to neurology?

  • Slaying,
    I think you inserted “socialist” with “capitalist” by mistake. Remember it is capitalists who put their aim at making the most amount of money they can, often without thinking or caring about the long terms risks. Just ask all the rich investors who buy drugs and then jack up the prices. Remember Martin Shkreli? Lovely capitalist human right there. Or the 2008 housing bubble which was driven by greedy lenders and deregulation.

  • Thank you Nancy for adding your thoughts to the conversation. You articulately pointed out why I think mindfulness can be useful.

    Steve, the clients who volunteer for the DBT programs at my clinic are never told “you need to do your mindfulness.” While I’m sure this message gets conveyed elsewhere, it is ridiculous to demand anyone do anything. It is certainly counter-therapeutic and doesn’t actually increase the likelihood that the “skill” will be practiced more regularly. The truth is that for mindfulness to be effective for anyone, they probably need to practice this for years if not decades. DBT superficially addresses mindfulness in the sense that coming to a group once a week isn’t likely going to lead to substantial change for the individual in this regard.

  • Steve, CAN is the operative word here. Doctors CAN be held liable, too, but it rarely happens.

    Streetphotobeing, there are some similarities between drug pushing docs and beer pushing bartenders. The difference, however, is that doctors study, take an oath to do no harm, and they state that pills are “medicine”. While bartenders may joke that their liquor is medicine, we all know this isn’t true.