Saturday, March 25, 2023

Comments by Theinarticulatepoet

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  • You are welcome. I enjoyed the article.

    Yes, squeezing the life out of people with the blood spread so thin it doesn’t appear to be on any ones hands in particular is how the system functions. Consequently despite preventing suicide being a stated aim of the mental health system… the system is perfectly happy for people to kill themselves as long as they do it slowly enough. Try and kill yourself quickly and the system steps in. So the societal sanction against suicide appears not be against suicide as such just how quickly you do it. Conversely the system will only be investigated, if at all, if they accidently harm people quickly. Quirky.

  • I agree. If one wants to go and live on a farm go and live on a farm. If you are working for free or willing to pay for the privilage I’m sure it wouldn’t be hard to find a place. I don’t think going to one where some people are supposedly mad and some people are accidently not designated mad is a great idea.

    A lot of the big institutions were self sufficient by dint of having a thriving agricultural beating heart with all the inmates doing the heaving lifting. I guess that how they got to be called “funny farms”.

  • I’ve go sympathy with the idea of looking back at Moral Treatment. On the otherhand my suspicion is that in practice they might have been quite miserable places for a lot of the inmates. Always living up to someone elses standard. It’s just a surmise but I doubt it was as rosey as is sometimes presented…

    It’s interesting that mad people are presumed not only to benefit from being in the company of other mad people but that they all uniformly welcome gardening / farming in one form or another. Being artistic is another Trope…

    That said I expect a lot people do like theses farm type therapy outfits. I’d hate it. I like the feel of the pavement under my feet.


    Since mental illness is a lifelong condition with no known cure, the successful psychopharmacological management of disorders such as depression and anxiety can be challenging. Treatment with medication almost inevitably results in side effects requiring additional medications leading to additional side effects necessitating still more medications in a self-perpetuating cycle which continues until the patient dies or the insurance runs out.

    This report discusses two cases in which complete symptomatic relief was achieved following the administration of large sums of money to the patients. The comparative safety, efficacy, and tolerability of cash is assessed. Based on our findings, the clinical utility of monetary incentives in the form of cash deposits or lump sum payments directly to patients should be reappraised as viable alternative therapeutic modalities for the treatment of mild, moderate and severe cases of anxiety with or without co-occurring depression. Cash payment should also be considered the treatment of choice for all major depressive disorders including mild, moderate and severe clinical or sub-clinical depression, depressed moods and dysthymic, cyclothymic or depressive symptoms appearing with or without comorbid anxiety disorders.

    Case report 1:

    The patient is a 52-year old male with a history of depression. He reported feeling sad at various times throughout his life but did not seek treatment until age 51, when the factory where he had worked for 23 years was permanently shut down, costing him his pension and health insurance the same year his wife was diagnosed with terminal cancer. The patient was initially prescribed Paxil 20 mg, but after complaining of sleeplessness and expressing suicidal ideation, the dosage was increased to Paxil 40mg with Ambien 10mg prescribed for insomnia. Depressive symptoms improved somewhat, but constant diarrhea, headache and nausea grew intolerable, so a switch from Paxil to Zoloft 50mg was tried. Within 5 weeks the therapeutic effects of Zoloft became readily apparent: the patient stopped worrying about the future and no longer seemed concerned about his wife’s failing health. Numerous treatment-emergent side effects were observed but the patient was reassured by his physician that chest pain, skin rash, constipation, tremor, dry mouth, hypertension and palpitations were not life threatening. One month later, pharmacotherapy was discontinued because the patient refused further treatment, claiming to be cured after winning $20 million in the Illinois State Lottery. A computed tomographic brain scan confirmed the patient had indeed fully recovered (see images below).

  • The original experiments were done on prisoners of war.

    I think a lot of people probably died but they don’t make it into the official history.

    His 1949 article here

    Basically he used his own urine “sane piss” and urine from people he thought were mad and started injecting guinea pigs. Some dies more slowly than others. Later on he started injecting people with more or less the same results. The names of these human sacrifices are lost to history.

  • An assumption made by all these researchers, is that behavior originates in the brain.

    The trouble is that however convenient it is for these researchers to make that assumption it is not one that stands up. The assumption that the mind body problem is solved is one of the biggest mistakes in psychiatry. And even they know its not true.

    It leads straight back to “what is the mind?” and therefore “what does it mean to be a person, a human”.

    The mind could just as easily be leading the brain. They ignore this because its just to difficult to contemplate even though it could just as easily be true. And just as likely is. Uncomfortable as it sounds all this “research” while potentially interesting is ultimately dehumanising for precisely this reason. Understandably they won’t want to hear this. But its the truth, even if its an uncomfortable one for them.

  • Yes… I am just exploring as well. I don’t have fixed views in the final analysis.

    Taking as a starting point that a mental health law regulates detention first, including the powers of arrest that police officers have…. (this may or may not be desirable in that it could be time limited or it may just open the door to the whole shooting match of mental health law.) I would like to see that done away with but Im not sure if its possible.

    My thinking is that having no mental health law is probably desirable because once someone has been detained they enter into a state of being where they are classified and treated differently to other people. Dehumanised or second class citizens. This is just undesirable and an inevitable consequence of having mental health laws.

    My own feeling is that MH laws are anti democratic and don’t fit well in a post modern world where their is a plurality of views about what are deemed acceptable forms of knowledge. ie psychiatric knowledge is not the only legitimate form of knowledge and hence its power derived from mental health laws is illegitimate.

    However it is not just MH law that needs to change be abolished. Their would be a requirement that the issues dealt with using MH law would be dealt with using civil and criminal law. It wouldn’t just be a case of repealing MH laws.

    MH law is only necessary becasue they allow difficult situations that have inherent philosophical and ethical questions to be addressed by reinterpreting those situations as medical situations…. thus avoiding philosophical and ethical questions. And of course by shutting down the conversation actions that follow like forced treatment are not brought under scrutiny.

    All this is meat and drink to you I am sure.

    So I do think that having a situation with no MH law is desirable. I also believe it would be possible as long as a lot else changed. I also believe that people would die as a result. My answer to that is that people are already dying. Its not a very palatable message as society likes its deaths to be out of site out of mind. Rather than ostensibly appearing to have been potentially preventable.

    As you know as you have read Faucoult they system we have has taken 300+ years to build and coming to a new consensus if ever won’t happen overnight.

    Just my thoughts…

  • My feeling is that stating a vision is the best first step. It is by far the best starting point for a clear conversation.

    While I am not certain if it is possible to have no mental health laws at all I do feel that it is certainly worth exploring it as an aspiration. Aspirations being just that they don’t demand an immediate answer although they do usefully beg questions.

  • I did attend. If I could sum it up it would be that their is a lot that needs to change in wider society. Its not simply a case of only changing the mental health system. In short their are a lot of issues that need to be addressed.

    I think that would be a fair summary but the good thing is that a more official document is going to be put together and circulated that will do a far better job than me of describing the outcome.

    When I get it I will post the document.

    It was a wonderfully run event with a lot of outstanding survivor speakers and space was made for representatives from other organisations like Speak out Against Psychiatry, Mad Pride and others to present themselves. It was a very bottom up event if I can put it like that.

    I think the plan is to have another event in a few months or so to carry on the conversation. I expect that as people coalesce around some central themes more will emerge in terms of doing things. I will say that there were a lot of people who attended were already doing a lot of doing and sharing around that was a theme for me if not for the event. I don’t want to speak for anyone else but I thought it was a really great event and a very safe space was created. I’m certainly looking forward to the document that comes out and next event.

  • Their is very little to be gained from having an argument with people who have what amounts to an ideological position….. no evidence will ever convince them of anything…… you can’t argue someone out of a position with reason if they never reasoned themselves into that position in the first place….

    It’s better to just posit an alternate point of view and leave it at that for the most part when dealing with ideologically driven zealots….

  • As medicine becomes increasingly demedicalised psychiatry is going to find itself marooned ….. even if no one critiqued psychiatry….. psychiatrists would and will sound increasingly anachronistic…… they will start to sound increasingly crazy to the general public all on their own……

    Its a slow process that the internet will only speed up…..

  • We have bodies…. time for psychiatrists to get over it. Calling someone mentally ill is just to say you disapprove of them….. same as calling someone fat is to disapprove of them if thats whats current in your culture… its all just cultural…..

    All bodies are different…. all people are different…. not better, not worse…. we are all just different….

    Attempting to reframe the social denunciation that is “mental illness” in to a denunciation of some ones endocrine system or cytokines is a neat trick but it won’t alter the truth of the matter….

    But then psychiatry isn’t about truth….. its about control…. so nice try but no cigar.

  • I believe that the future of psychiatry is a feature in history textbooks. Children will learn about it as a historical aberration, an oddity, along with human sacrifice, witch hunting, slavery and women not having the right to vote.

    Eventually people will have to have the concept of mental illness explained to them as a concept that primitive people used for a social purpose. Eventually it might even be forgotten about completely. Christianity only survives or survived in tact for 2000 years because the bible was written in a language people couldn’t understand for 1400 yrs. Ideas that are junk are going to be discarded by society at large much much faster from now on.

    Critical psychiatry is really just part of the death rattle of psychiatry…. a rattle that will only get louder…. the edifice is weaker than it looks.

  • Thanks… thats interesting, I didn’t know Szasz had ever refered to Postel…

    Stretching the point a little I feel this is also might interest people along the lines of the Dr. Fox effect.

    The Seductive Allure of Neuroscience Explanations

    Explanations of psychological phenomena seem to generate more public interest when they contain neuroscientific information. Even irrelevant neuroscience information in an explanation of a psychological phenomenon may interfere with people’s abilities to critically consider the underlying logic of this explanation…..Crucially, the neuroscience information was irrelevant to the logic of the explanation, as confirmed by the expert subjects. Subjects in all three groups judged good explanations as more satisfying than bad ones. But subjects in the two nonexpert groups additionally judged that explanations with logically irrelevant neuroscience information were more satisfying than explanations without.

    You couldn’t make it up… or actually it seems you can make it up… and get away with it…

  • The other side of the coin is represented by Gurt Postel, a postman who decided to pretend to be a psychiatrist in Germany. Hugely successful he reduced the compulsory admission rate by 86% as the medical director of his hospital. He made up and lectured to psychiatrists on “Bi polar of the third degree”….. his audience of psychiatrists lapped this nonsense up without batting an eyelid.

    Caught out when he was recognised…. not because of anything he did. Hero. Champion imposter of imposters.

  • @oldhead Wouldn’t want to rain on the parade of someone who found another humans presence helpful but I agree with you….

    If anything I find the soul snatchers who try to be empathic even more creepy and weird than the bio b.s.ters…

  • @Fiachra

    I feel that you are pointing towards a real difficulty…. most people who enter the MH system never come into contact with people who have a message that doesn’t conform to the traditional message…

    If I am right we are both in the UK…. I’m sure you know a version of Recovery has been taken up thats more or less congruent with medical model thinking within NHS services…. spaces where Recovery conversations take place are forums where people can hear about alternatives so thats something….. but it all a matter of luck and just meeting someone who themselves has been exposed to other ways of thinking…. its a bit of a problem…..

    Totally agree about schizophrenia…… its objectifying, degrading and dehumanising… all labels are of course…. one hopeful thing is their is a back lash of sorts going on against all the labels not just schizophrenia……

  • It is a curious fact that people seen as “psychotic” or “schizophrenic” may show sometimes more creativity, and sometimes less creativity, than “normals.”

    Are you certain this is a fact? No offense but this is just a trope….. mad people are creative and all that…. my fear that this a way of saying people who get caught up in the dragnet of the mental health system are somehow different to people who manage not to come to the attention of the system and avoid their turn sitting at the bottom of pile…..

    I’m not keen on othering people in this way…….

    Just saying…..

  • veg. Patients have to pander to psychiatrists for obvious reasons when they have ultimate power over them….. the suspension of ones critical faculties when your being held hostage is certainly a survival strategy…. I can appreciate that. So to some people win the mentalhealth lottery and have a good experience of the system.

    Lots of patients consider thier psychiatrist in the absence of a belief in god consider them to be thier lord and saviour. Psychiatrists love love love that sort of patient. It feels good for both parties.

    Some psychiatrists actually think of them selves as priests and reckon that just being around them has a sort of magic fairy dust effect…. this they believe…… no study needed. Perhaps you believe that as well.

    I believe that people should be allowed to believe what they want…..good luck to you with your beliefs and if what you read makes your faith grow stronger so be it….. faith based medicine needs faith based mantras….. stories of people cured with miracle wonder drugs that no one can quite explain… that sort of thing….

  • Veg. You are coming off as a bit patronising here….. my knowledge of neuroscience, pharmacology and epigenetics are quite up to date…. but thanks anyway.

    Genes code for structure, thats why they hold some but only a bit of promise for physical medicine.

    Genes code for structure not behaviour. End of story. These associations are mere sample size effects. Beliefs no matter how odd they might seem are the result of culture and environment…. no more no less….. psychiatry itself is merely an ideology….. an unprovable belief system….

    Anytime a direct genetic link is found that disorder disappears from the orbit of psychiatry, similarly if something is found that is really neurological it becomes neurology.

    Psychiatry is pure social control. I appreciate you might have some catching up to do but you are coming over a bit green….. no offence intended.

  • Science can illuminate but it can also blind…….while the technological approach born in the enlightenment has brought benefits to society in places it also brought us industrial killing in two world wars. The technological approach has worked out quite well in physical medicine…. in the affairs of humans subject to psychiatry not so much….. any realistic assessment is that its been nothing short of a disaster….. the science is suspect and psychiatrists know it….. its a profession in crisis….

    Human problems need human solutions….. not technical ones…..

  • @Ron, trouble is the sort of logic you are using here is straight out of the psychiatric play book….. if you “get better” you were never really “ill” in the first place….

    It won’t wash….. the whole system functions as a sort of dragnet….. pretending you can chunk up who gets caught in a meaningful way is a doomed enterprise…. imo

    Appreciate your comments though….just saying….

  • @ Ted , this doesn’t address the fact that the labels now being applied to people have almost no validity at all.

    The traditional argument is that reduced validity is worth it because the labels have some sort of utility value, but as the majority of the posting on this site demonstrate the utility value claim is very flimsy indeed…. of course thats something you and a lot of people here know already…. the trouble is getting to the attention of the public. One way is holding a placard in public another way is to get academics and journalists writing about the issues…. its all to the good and I believe will lead to the same end…..

  • Thank you for this article because it chips away at the edifice of psychiatry although I share Ted’s dismay that we need this level of scrutiny to expose the obvious….

    As one boring old man points out, “patients” don’t believe in this rubbish, physical doctors certainly don’t, psychiatrists hold their noses when they write these things down and increasingly the general public understands that these labels are essentially meaningless.

    It’s all to the good that people outside the mental health bubble are taking an interest in these issues….

  • The concerns listed in the article above just serve to demonstrate how mentalist all the concerned employees are….. all the so called concerns have to do with peers not meeting thier conditions of employment…. peers are no more likely to fail to meet the terms of thier employment contracts than anyone else. Its pure mentalism on the part of the “concerned” staff…..

    The concern about confidentiality is hilarious….. social workers and MH nurses are notorious blabber mouths…..

  • This article shows that peers working in places where they also get “huelp”…….expose the mentalism inherent in a system that can’t or struggles to cope with the idea that someone could need help and at the same could have something to offer as a helper.

    I do feel that people should work in places that deem themselves suitable providers…. to deny them work doesn’t make any sense because otherwise you would have to sack/fire current workers who “get ill” and need help. Anyone can need help one day. MH services need to get used to this and peer workers can be part of cultural change inside the system.

    Obviously working as a peer comes at a personal cost as peer working is ultimately incompatible with working inside the system….. ironically exposing the reasons why this is true is part of the power of the role…. its a paradox and comes at a cost….. pure abolitionists will feel uneasy with the idea of peers working inside the system at all…… my own feeling is that change will come faster with survivors working inside the system as well as outside….

    Each to their own…. thier is no point trying to occupy the existential moral high ground as no such place exists…

  • On the topic of Christianity I would claim Jesus for the home team as he would today meet all the criterion for the schizophrenia label….. pontious pilate was the first psychiatrist, if largtil had been available in the Galilee things might have worked out differently….. as it was it was death by cop….imo

  • Its an irony that moderation comes up in a discussion about someone who spoke about social control.

    For all the ways that unique people with unique circumatances could be helped if our current system, that grew out of the asylum system was proposed today……. ie lets build mini prisons in every town in the land and lets pass some antidemocratic legislation to lock up and drug people into a stupor even though they have committed no crime and that this system would be at the core of the system of help… would be treated with howls of derision. In todays world you couldn’t begin to get the system off the ground. No one would go along with it.

  • The right of freedom from fear. From the irren offensive.

    We call on all members of the community of people who recognize our basic right to self-determination as a people who suffer from psychiatric persecution, psychiatric incarceration and psychiatric torture.
    We hereby declare that:

    1 Preamble

    Whereas recognition of the inherent dignity and of the equal and inalienable rights of all the human family is the foundation of freedom, justice and peace in the world,
    Whereas disregard and contempt for human rights have resulted in barbarous acts which satisfy the conscience of mankind with indignation, and
    has been proclaimed as that of a world in which human speech and belief and freedom from fear (consisting of the freedom from arbitrary detention, torture and killing) and enjoy freedom from want, the highest aspiration of man is true,
    since it is necessary to protect human rights through the rule of law, that the man is not compelled to have recourse, as a last resort, to rebellion against tyranny and oppression,
    we accept the atrocities of the systematic psychiatric mass murders in the gas chambers of the “Action T4”, which started in 1939 as a medical biologistic campaign in Germany, and was followed by the extermination camps in Poland, as a starting point for our following Declaration of Human Rights.
    We emphasize that the defeat of such barbaric acts, the worst case in the history of dehumanization and violations of basic social norms, 1948 after the Nuremberg trials was also the basis of the Universal Declaration of Human Rights of the United Nations.

    2 Therefore:

    A) A person is born from another man

    B) It is impossible to distinguish between the human rights of any person from those of another, no matter how extraordinary he look and think, or whatever he may express his thoughts.

    C) We emphasize that the articles of the Universal Declaration of Human Rights of the United Nations are the basis to determine the fundamental human rights

    D) We hereby declare that we the use of psychiatric terms as medical slander, as biologistically – consider racial discrimination, particularly when it comes to determine a person’s behavior as a genetic or mental “illness”

    E) We hereby declare as a kind of torture: psychiatric persecution, arbitrary psychiatric incarceration and physical psychiatric coercion to penetrate the body – treatment with drugs, electroshock, psychosurgery, fixation, etc. These measures have been since the inception of coercive psychiatry over and over again by people everywhere referred to the world as torture, regardless of whether someone was referred by medical staff as “incompetent” and the place of these measures a “medical device” called “hospital” should be.

    F) Based on the previous arguments, we hereby declare psychiatric coercion as “fear” (“Fear”), as defined in the Universal Declaration of Human Rights of the United Nations. Everyone has the right to freedom from fear.

    G) We recognize a psychiatry that is based on coercion and violence, as a crime against humanity because it deprives individuals the status of a man with his inalienable human rights by making known their soul to a bio-medical way as “sick” and of a bio-medical “mental illness” speaks, and thus legally justify all kinds of violence against them.

    H) We deny that the General Assembly of the UN has the right to exclude some of the members of the human community from being recognized as a human, by this psychiatric biologically – supports racist doctrine. Therefore we appeal to all peoples of the world to abolish the UN Resolution. 46/119 of 17 December 1991. This resolution violates the basic principles of the Universal Declaration of Human Rights of the United Nations 1948 This resolution is an attack on the human dignity of all members own the human community and their equal and inalienable rights, the basis for freedom and justice.

  • I was at a meeting the other day, a cosmopolitan gathering….. a black man said that bio psychiatry was institutionally racist….. everyone just nodded. An apostate psychiatrist added that it was a racist ideology and would remain so even if it was practiced by a black person. Nods all round.

    Every idea has its time….. its not looking good for bio-psychiatry.

  • @oldhead Thanks! I always enjoy your thoughtful posts!

    @Rossa I agree…. their are many ways to conceptualise what it is to be a person…. its a pity that the wonky bag of chemicals model bio bio bio dominates the western initiated gulag system…… the good news is that no one other than a small band of psychiatrists actually conceive of themselves like that…..

    Ill just add that imo the bio/psycho/social/spiritual(extra-terrestrial?) model isn’t a model that explains anything….. its just some prefixes and punctuation that serves to cover up the fact that none of the professional groups agree with each other about anything….. long run that is a good thing because it indicates that anyone exercising power in a “mental health” context does so illegitimately… imo

  • medicine has a long and venerable tradition that stretches back to the time of the Greek philosophers…..psychiatry was born in the asylum….. it has no such tradition.

    The asylums have largely closed…. society has changed. What has not changed is psychiatry. The truth is that psychiatry as Szasz is scientifically worthless and socially harmful. This is why long term society will do away with it. It might be hard to see that sometimes as the institution still has a lot of power but the institution itself is in crisis as a recent lancet article reviewed here on MIA attests to.

    When psychiatry was born women didn’t even have the vote. Mainly psychiatry preyed on the weak and vulnerable. Now anyone…. even people with social capital can get caught up in its dragnet…… this more than anything mitigates against it.

    What does society harm human society gets rid of …… eventually. The internet is changing everything….. ideas spread faster than ever….. the internet will play its part….. psychiatry is divisive at its root. Humans don’t like that…… modern humans hate it infact. divisive psychiatry has no future. There will be no coup de gra for psychiatry …… humanity will simply smudge it out….eventually and szasz will have played his part.

    Btw critical psychiatrists like MonCrief quote Szasz all the time. His ideas live on.

  • Oldhead

    Spot on. It is frustrating…..


    With regard to self harm…. their are only two kinds, socially acceptable and socially unacceptable….. what is acceptable is culturally defined.

    Most people who cut themselves do so very safely and for them the best thing you can give them is clean razor blades. This accepting approach usually has the effect of people not cutting so much…. even if thats not the point or the most important thing….

  • One thing that is not addressed here is the issue of social control….

    cut and paste from the above….

    A society could not be called free that is governed by laws which are so vague and broad as to regulate ordinary speech and behavior. The medical model developed as an ideology to disguise and justify covert forms of social control. Without invoking the medical model, could we call a society free where people can be deprived of their freedom and forcibly drugged because they are homeless and disturbing to the public? For hearing or speaking to their gods? For going on spending sprees? For believing the government is after them or that they are being monitored by electronic devices? For not being able to face the difficulties of life? It happens in this country and we pretend to the world to stand for the ideal of individual freedom. The problem is that society demands a greater degree of social control than law allows. The public wants to be protected from unconventional, threatening, and dangerous behavior. There is, thus, a public mandate for a covert form of social control which supplements rule of law. Medical-coercive psychiatry, in alliance with the state, performs this function disguised as medical diagnosis and treatment.

  • Thanks for the article….

    This might interest some people here….

    Alastair Morgan on ‘Is psychiatry dying? The contemporary “legitimation crisis” in psychiatry’, Joint Special Interest Group in Psychosis, 26 March 2014, 5.30 pm – 7 pm

    Durham University and Tees, Esk and Wear Valleys NHS Foundation Trust Joint Special Interest Group for Psychosis (JSIGP)

    Abstract: This talk explores the contemporary “legitimation crisis” in psychiatry. Does psychiatry know what it is for, does it have a role in the future and does it have a clear idea of its conceptual foundations ? Should we care if psychiatry withers away, and dissolves into a range of new disciplines, such as neuroscience, the science of wellbeing, or the pragmatic management of life issues in the name of mental health recovery ? The talk will examine a proliferation of new and competing “paradigms” for the ontological status of psychiatry and critical psychiatry, and tries to map a direction for the future of psychiatry in the 21st century.

  • The reason all these studies contradict each other isn’t like giving away the secret formula to Kelloggs Frosties or anything…..

    Why olanzapine beats risperidone, risperidone beats quetiapine, and quetiapine beats olanzapine: an exploratory analysis of head-to-head comparison studies of second-generation antipsychotics.

    Of the 42 reports identified by the authors, 33 were sponsored by a pharmaceutical company. In 90.0% of the studies, the reported overall outcome was in favor of the sponsor’s drug. This pattern resulted in contradictory conclusions across studies when the findings of studies of the same drugs but with different sponsors were compared.

    Well isn’t this shocking….who would have thought it…..

  • Thank you for this….

    For junkies the work of the 7th Earl of Shaftsbury is relevant for his work on the Lunacy Commission…,_7th_Earl_of_Shaftesbury

    Anyone visiting Piccadilly Circus in central London can see the monument erected in his honour….

    Funnily enough he was a tory….a funny sort of tory….also responsible for the Factory Act…

    Thats enough…

  • @Sandra

    My above comment was edited but I expect you saw it anyway…. I did mean the post to be offensive…. I should have contextualized and fleshed it out a bit more…

    Anyway here is the ~Foucault Tribunal if you (you may already be familiar) or anyone else is interested….

    As for Philip Thomas – I’m not sure if Heidegger or Frank Zappa is the bigger influence on his writing….fluent as it is….I fear that “Hermeneutical Phenomenology” has limited sound bite potential…. but I appreciate his efforts….and yours…

  • @Sandra

    Why you are here is one thing….why your colleagues are not is another. Most of the psychiatry chat here is about the science, the blind mans buff and receptor tetris combination game. That can go on anywhere…. and it does.

    The community bit goes largely undressed……but thats the whole point….because if psychiatry wasn’t just a handy way of rooting problems that are the result of problems in society inside individuals…..then society would have to do something about that….politicians would have to do something about that…. something would have to change. But no. Psychiatry serves to prop up the whole crumby shooting match… an institution its deeply deeply repressive…..

    So by all means carry on…. carry on talking about brains and how its possible to interfere with them to oh so interesting an effect….. all this chatter does is obscure where the real problems lie….. like I say, I can’t see your colleagues wanting to discuss that either….

    Psychiatry isn’t just scientifically worthless….its socially harmful into the bargain….

  • “We know that lesions to the brain can cause, for instance, various types of hallucinations. It is not a stretch to think there is some abnormal brain functioning associated with any one who has a hallucination.”

    Not a stretch….?? If jumping to conclusions was an Olympic event psychiatrists would win all the medals…

    A thought…is a thought…is a thought…

    Some thoughts psychiatrists like….these come from “good” brains… therefore thoughts they don’t like must come from “bad” brains…

    It’s daft…but the graduates of medical madrassa can’t see it…won’t see it… when someone has been so thoroughly trained to see the world in one way….it becomes almost impossible to see it any other way….everything that doesn’t fit seems counter intuitive….

    It’s almost as if being indoctrinated into the brain blaming cult of psychiatry leads in the end to a sort of neurological condition…. its the only plausible explanation….

    Sorry Sandra…not a personal dig…just using your words to make a point…

  • @discover and recover

    Duane…I believe that many of the professionals that visit this site and others are so used to encountering people in the professional context they just fall apart when they meet them “in the wild” so to speak 🙂

    What they want is not so much respect but a sort of reverence….and when they don’t get it….they spit the dummy…toys get thrown out of the pramm…melt down…

    Contrast with the hospital environment where its ok to be as degrading as you like about “patients”… as long as they couch it with what they think are the right words…. they can be as nasty as they like and the “patient” just has to soak it up….quite a contrast…

  • @Jonathan

    I understand the points you are making and I can see the merit in what you are saying. However while I agree that psychosis is potentially as you say a generic word it is also redolent of the medical model where its use is very prevalent. So to me it is a question of priorities. When I suggest not using it I am prioritizing using language that puts the maximum amount of distance between what you are saying and what, typically, psychiatrists say.

    When the language changes it changes the way things are thought about. In the final analysis by way of illustration, if psychiatrists used a different language to engage the matters at hand on this site all the papers in their journals, that they currently read, would become unintelligible to them as they would also see them as irrelevant to the matters at hand.

    Knit picking at language is a habit of mine….

    Generally I agree with what you are saying….

  • I appreciate this article although I would like it better if it managed its subject matter without the word psychosis, which is really just a code word for schizophrenia….

    I’m not really keen on the idea that some people have “psychotic tendencies” either…its well demonstrated that sensory deprivation leads to altered states of mind anyone who experiences sensory deprivation…

    The idea of psychotic tendencies is to close to the idea of stress vulnerability thinking which in turn leads to the idea that some people are just inherently mentally weaker than others….this hypothesis… I just personally reject.

    I appreciate finding new words is a struggle and its often easier to just try and reuse medical words….that said I think its worth the struggle….to try…

  • Reminded.

    The Partnership Model
    “…professionals and non-professionals work together to provide services. The recipients of services are told that they, too, are partners in the service. However, the distinction between those who give help and those who receive it remains clearly defined. I consider services based on this model to be alternatives in name only. The overwhelming majority of alternative services […] fit into the partnership model.”


    “‘Alternatives’ based on the partnership model continue many of the same abuses.”

    The Supportive Model
    “…membership is open to all people who want to use the service for mutual support. Nonpatients and ex-patients are seen as equals, since everyone has problems at some time or other, and are capable of helping one another. Professionals are excluded from this model […] because they use a different model of helping, which separates those who give from those who receive help.”

    The Separatist Model
    “…ex-patients provide support for one another and run the service. All nonpatients and professionals ae excluded because they interfere with consciousness raising and because they usually have mentalist attitudes.”

    Open Dialogue is a Partnership Model and is thus not a true alternative. Soteria, as defined above, is a hybrid Supportive/Partnership Model and is also thus not a true alternative.

    As Chamberlin underlines: “Totally nonprofessional (ie. Separatist) alternatives for people in crisis are truly separated from the mental health system.”

    In “On Our Own” Chamberlin consistently and convincingly argues that orthodox models of care for the mentally distressed and distressing are harmful. Alternatives that spring up are most often, under closer examination, alternative in name only.

  • @markps2

    I covered this point. Its brainwashing but brainwashing entered into voluntarily. If a person doesn’t want it they are not suitable candidates for it anyway.

    And for what its worth DBT is just being your own thought police officer.

    Mindlessness training is just the final frontier of psychiatric imperialism where thought itself becomes a crime…its taking yourself hostage in your own head.

    Whatever floats your boat….some people find these things helpful…

    As to the last question their is so much wrong with it I don’t know where to start…so I won’t or I might never finish..

  • @Sandra

    By logical extension as you suggest in your example we can convince ourselves of anything if we try hard enough. Given the short time we each have on the planet that is probably for the best…not a bad thing…no… not at all…

  • @Brett

    I’ve read again and stand by my view.

    As to the claim that any therapist can eliminate all their personal bias from the encounter is a myth. Even an attempt at neutrality is to introduce a bias in itself.

    The idea of the object neutral observer is a conceit usually ascribed to psychiatrists but psychologists often make the same claim.

    I’m sure their is such a thing as a bad therapist…I also think that every therapist would agree with that statement. I doubt however if you surveyed every therapist you would find any who said that they were such an example.

  • @Brett

    I have never heard of anyone being involuntarily detained because they fear driving. But then the U.S. is a car obsessed society so I suppose its not beyond the realms of possibility. But we will go with this trivial example as its the one you have chosen even though the article is about “psychosis”.

    That driving is acceptably safe is just an opinion of yours. It is a socially acceptable opinion, after all its a belief most people hold. However in 2012 34,080 people died on the road. 1.14 percent, if we looked at injuries we would get an even bigger number.

    It’s perfectly rational to be concerned about driving and perfectly rational to decide getting in a car is not worth the risk. It’s not the view of the majority of people….but thats not the point.

    The point is that your job is persuade your client by what ever magic talking therapy device to hold the “socially acceptable” view.

    The only way to fail an assessment for CBT is to say you don’t want to do it. It’s brainwashing but it’s brainwashing that people go into voluntarily. Your clients have to want to do it…submit to the process…

    Brainwashing is a harsh word but it is an accurate word.

    As an aside I see that you presume to be the final arbiter of what counts as reality and what might count as a “useful” perspective as well…. all of which I am sure you will claim are perspectives you are careful not to impose on your clients….hmmmm

  • CBT is just another technology….just what people don’t need. More technology.

    CBT is a process where by socially unacceptable truth is replaced with more socially acceptable lies. Lies it may be easier to live with…but still lies.

    Its brain washing….pure and simple. Brain washing usually entered into voluntarily but still brain washing.

    Buyer bewares.

  • The Rise of Neuro B.S.

    An intellectual pestilence is upon us.

    Shop shelves groan with books purporting to explain, through snazzy brain-imaging studies, not only how thoughts and emotions function, but how politics and religion work, and what the correct answers are to age-old philosophical controversies. The dazzling real achievements of brain research are routinely pressed into service for questions they were never designed to answer. This is the plague of neuroscientism – aka neurobabble, neurobollocks, or neurotrash – and it’s everywhere.

    In my book-strewn lodgings, one literally trips over volumes promising that “the deepest mysteries of what makes us who we are are gradually being unravelled” by neuroscience and cognitive psychology. (Even practising scientists sometimes make such grandiose claims for a general audience, perhaps urged on by their editors: that quotation is from the psychologist Elaine Fox’s interesting book on “the new science of optimism”, Rainy Brain, Sunny Brain, published this summer.) In general, the “neural” explanation has become a gold standard of non-fiction exegesis, adding its own brand of computer-assisted lab-coat bling to a whole new industry of intellectual quackery that affects to elucidate even complex sociocultural phenomena. Chris Mooney’s The Republican Brain: the Science of Why They Deny Science – and Reality disavows “reductionism” yet encourages readers to treat people with whom they disagree more as pathological specimens of brain biology than as rational interlocutors.

    The New Atheist polemicist Sam Harris, in The Moral Landscape, interprets brain and other research as showing that there are objective moral truths, enthusiastically inferring – almost as though this were the point all along – that science proves “conservative Islam” is bad.

    Happily, a new branch of the neuroscienceexplains everything genre may be created at any time by the simple expedient of adding the prefix “neuro” to whatever you are talking about. Thus, “neuroeconomics” is the latest in a long line of rhetorical attempts to sell the dismal science as a hard one; “molecular gastronomy” has now been trumped in the scientised gluttony stakes by “neurogastronomy”; students of Republican and Democratic brains are doing “neuropolitics”; literature academics practise “neurocriticism”. There is “neurotheology”, “neuromagic” (according to Sleights of Mind, an amusing book about how conjurors exploit perceptual bias) and even “neuromarketing”. Hoping it’s not too late to jump on the bandwagon, I have decided to announce that I, too, am skilled in the newly minted fields of neuroprocrastination and neuroflâneurship.

    Illumination is promised on a personal as well as a political level by the junk enlightenment of the popular brain industry. How can I become more creative? How can I make better decisions? How can I be happier? Or thinner? Never fear: brain research has the answers. It is self-help armoured in hard science. Life advice is the hook for nearly all such books. (Some cram the hard sell right into the title – such as John B Arden’s Rewire Your Brain: Think Your Way to a Better Life.) Quite consistently, heir recommendations boil down to a kind of neo- Stoicism, drizzled with brain-juice. In a selfcongratulatory egalitarian age, you can no longer tell people to improve themselves morally. So self-improvement is couched in instrumental, scientifically approved terms.

    The idea that a neurological explanation could exhaust the meaning of experience was already being mocked as “medical materialism” by the psychologist William James a century ago. And today’s ubiquitous rhetorical confidence about how the brain works papers over a still-enormous scientific uncertainty. Paul Fletcher, professor of health neuroscience at the University of Cambridge, says that he gets “exasperated” by much popular coverage of neuroimaging research, which assumes that “activity in a brain region is the answer to some profound question about psychological processes. This is very hard to justify given how little we currently know about what different regions of the brain actually do.” Too often, he tells me in an email correspondence, a popular writer will “opt for some sort of neuro-flapdoodle in which a highly simplistic and questionable point is accompanied by a suitably grand-sounding neural term and thus acquires a weightiness that it really doesn’t deserve. In my view, this is no different to some mountebank selling quacksalve by talking about the physics of water molecules’ memories, or a beautician talking about action liposomes.”

    Shades of grey
    The human brain, it is said, is the most complex object in the known universe. That a part of it “lights up” on an fMRI scan does not mean the rest is inactive; nor is it obvious what any such lighting-up indicates; nor is it straightforward to infer general lessons about life from experiments conducted under highly artificial conditions. Nor do we have the faintest clue about the biggest mystery of all – how does a lump of wet grey matter produce the conscious experience you are having right now, reading this paragraph? How come the brain gives rise to the mind? No one knows.

    So, instead, here is a recipe for writing a hit popular brain book. You start each chapter with a pat anecdote about an individual’s professional or entrepreneurial success, or narrow escape from peril. You then mine the neuroscientific research for an apparently relevant specific result and narrate the experiment, perhaps interviewing the scientist involved and describing his hair. You then climax in a fit of premature extrapolation, inferring from the scientific result a calming bromide about what it is to function optimally as a modern human being. Voilà, a laboratory-sanctioned Big Idea in digestible narrative form. This is what the psychologist Christopher Chabris has named the “story-study-lesson” model, perhaps first perfected by one Malcolm Gladwell. A series of these threesomes may be packaged into a book, and then resold again and again as a stand-up act on the wonderfully lucrative corporate lecture circuit.

    Such is the rigid formula of Imagine: How Creativity Works, published in March this year by the American writer Jonah Lehrer. The book is a shatteringly glib mishmash of magazine yarn, bizarrely incompetent literary criticism, inspiring business stories about mops and dolls and zany overinterpretation of research findings in neuroscience and psychology. Lehrer responded to my hostile review of the book by claiming that I thought the science he was writing about was “useless”, but such garbage needs to be denounced precisely in defence of the achievements of science. (In a sense, as Paul Fletcher points out, such books are “anti science, given that science is supposed to be our protection against believing whatever we find most convenient, comforting or compelling”.) More recently, Lehrer admitted fabricating quotes by Bob Dylan in Imagine, which was hastily withdrawn from sale, and he resigned from his post at the New Yorker. To invent things supposedly said by the most obsessively studied popular artist of our age is a surprising gambit. Perhaps Lehrer misunderstood his own advice about creativity.

    Mastering one’s own brain is also the key to survival in a dog-eat-dog corporate world, as promised by the cognitive scientist Art Markman’s Smart Thinking: How to Think Big, Innovate and Outperform Your Rivals. Meanwhile, the field (or cult) of “neurolinguistic programming” (NLP) sells techniques not only of self-overcoming but of domination over others. (According to a recent NLP handbook, you can “create virtually any and all states” in other people by using “embedded commands”.) The employee using such arcane neurowisdom will get promoted over the heads of his colleagues; the executive will discover expert-sanctioned ways to render his underlings more docile and productive, harnessing “creativity” for profit.

    Waterstones now even has a display section labelled “Smart Thinking”, stocked with pop brain tracts. The true function of such books, of course, is to free readers from the responsibility of thinking for themselves. This is made eerily explicit in the psychologist Jonathan Haidt’s The Righteous Mind, published last March, which claims to show that “moral knowledge” is best obtained through “intuition” (arising from unconscious brain processing) rather than by explicit reasoning. “Anyone who values truth should stop worshipping reason,” Haidt enthuses, in a perverse manifesto for autolobotomy. I made an Olympian effort to take his advice seriously, and found myself rejecting the reasoning of his entire book.

    Modern neuro-self-help pictures the brain as a kind of recalcitrant Windows PC. You know there is obscure stuff going on under the hood, so you tinker delicately with what you can see to try to coax it into working the way you want. In an earlier age, thinkers pictured the brain as a marvellously subtle clockwork mechanism, that being the cutting-edge high technology of the day. Our own brain-as-computer metaphor has been around for decades: there is the “hardware”, made up of different physical parts (the brain), and the “software”, processing routines that use different neuronal “circuits”. Updating things a bit for the kids, the evolutionary psychologist Robert Kurzban, in Why Everyone (Else) Is a Hypocrite, explains that the brain is like an iPhone running a bunch of different apps.

    Such metaphors are apt to a degree, as long as you remember to get them the right way round. (Gladwell, in Blink – whose motivational selfhelp slogan is that “we can control rapid cognition” – burblingly describes the fusiform gyrus as “an incredibly sophisticated piece of brain software”, though the fusiform gyrus is a physical area of the brain, and so analogous to “hardware” not “software”.) But these writers tend to reach for just one functional story about a brain subsystem – the story that fits with their Big Idea – while ignoring other roles the same system might play. This can lead to a comical inconsistency across different books, and even within the oeuvre of a single author.

    Is dopamine “the molecule of intuition”, as Jonah Lehrer risibly suggested in The Decisive Moment (2009), or is it the basis of “the neural highway that’s responsible for generating the pleasurable emotions”, as he wrote in Imagine? (Meanwhile, Susan Cain’s Quiet: the Power of Introverts in a World That Can’t Stop Talking calls dopamine the “reward chemical” and postulates that extroverts are more responsive to it.) Other recurring stars of the pop literature are the hormone oxytocin (the “love chemical”) and mirror neurons, which allegedly explain empathy. Jonathan Haidt tells the weirdly unexplanatory micro-story that, in one experiment, “The subjects used their mirror neurons, empathised, and felt the other’s pain.” If I tell you to use your mirror neurons, do you know what to do? Alternatively, can you do as Lehrer advises and “listen to” your prefrontal cortex? Self-help can be a tricky business.

    Distortion of what and how much we know is bound to occur, Paul Fletcher points out, if the literature is cherry-picked.

    “Having outlined your theory,” he says, “you can then cite a finding from a neuroimaging study identifying, for example, activity in a brain region such as the insula . . . You then select from among the many theories of insula function, choosing the one that best fits with your overall hypothesis, but neglecting to mention that nobody really knows what the insula does or that there are many ideas about its possible function.”

    But the great movie-monster of nearly all the pop brain literature is another region: the amygdala. It is routinely described as the “ancient” or “primitive” brain, scarily atavistic. There is strong evidence for the amygdala’s role in fear, but then fear is one of the most heavily studied emotions; popularisers downplay or ignore the amygdala’s associations with the cuddlier emotions and memory. The implicit picture is of our uneasy coexistence with a beast inside the head, which needs to be controlled if we are to be happy, or at least liberal. (In The Republican Brain, Mooney suggests that “conservatives and authoritarians” might be the nasty way they are because they have a “more active amygdala”.) René Descartes located the soul in the pineal gland; the moral of modern pop neuroscience is that original sin is physical – a bestial, demonic proto-brain lurking at the heart of darkness within our own skulls. It’s an angry ghost in the machine.

    Indeed, despite their technical paraphernalia of neurotransmitters and anterior temporal gyruses, modern pop brain books are offering a spiritual topography. Such is the seductive appeal of fMRI brain scans, their splashes of red, yellow and green lighting up what looks like a black intracranial vacuum. In mass culture, the fMRI scan (usually merged from several individuals) has become a secular icon, the converse of a Hubble Space Telescope image. The latter shows us awe-inspiring vistas of distant nebulae, as though painstakingly airbrushed by a sci-fi book-jacket artist; the former peers the other way, into psychedelic inner space. And the pictures, like religious icons, inspire uncritical devotion: a 2008 study, Fletcher notes, showed that “people – even neuroscience undergrads – are more likely to believe a brain scan than a bar graph”.

    In The Invisible Gorilla, Christopher Chabris and his collaborator Daniel Simons advise readers to be wary of such “brain porn”, but popular magazines, science websites and books are frenzied consumers and hypers of these scans. “This is your brain on music”, announces a caption to a set of fMRI images, and we are invited to conclude that we now understand more about the experience of listening to music. The “This is your brain on” meme, it seems, is indefinitely extensible: Google results offer “This is your brain on poker”, “This is your brain on metaphor”, “This is your brain on diet soda”, “This is your brain on God” and so on, ad nauseam. I hereby volunteer to submit to a functional magnetic-resonance imaging scan while reading a stack of pop neuroscience volumes, for an illuminating series of pictures entitled This Is Your Brain on Stupid Books About Your Brain.

    None of the foregoing should be taken to imply that fMRI and other brain-investigation techniques are useless: there is beautiful and amazing science in how they work and what well-designed experiments can teach us. “One of my favourites,” Fletcher says, “is the observation that one can take measures of brain activity (either using fMRI or EEG) while someone is learning . . . a list of words, and that activity can actually predict whether particular words will be remembered when the person is tested later (even the next day). This to me demonstrates something important – that observing activity in the brain can tell us something about how somebody is processing stimuli in ways that the person themselves is unable to report. With measures like that, we can begin to see how valuable it is to measure brain activity – it is giving us information that would otherwise be hidden from us.”

    In this light, one might humbly venture a preliminary diagnosis of the pop brain hacks’ chronic intellectual error. It is that they misleadingly assume we always know how to interpret such “hidden” information, and that it is always more reliably meaningful than what lies in plain view. The hucksters of neuroscientism are the conspiracy theorists of the human animal, the 9/11 Truthers of the life of the mind.

  • Thanks for this…nice to see Franz Fanon getting an outing as well…

    Reading this review reminded me of a News Night segment screen not that long ago… a Muslim woman was swaddled in towels and was being read the Koran by an Imam…as a response to her mental distress…

    Interestingly this approach to her distress was presented as problematic for UK mental health professionals and obviously shocking for “right thinking” civilized News Night viewers…

    What they didn’t show was how western mental health professionals would prefer her to have been treated, instead of being read to out of the book of her own religion…obviously what you are supposed to do is get five or six men to hold her down, strip off her clothes and inject her with mind altering drugs….so modern…so so terribly modern…so terribly nice and civilized…

  • “similarities between brain abnormalities found both in people who have been abused and those who are diagnosed with schizophrenia”

    The focus on the brain hear is misplaced and the whole problem with the approach.

    If a steam roller rolls over a pea and flatens it. Exploring the properties of pea skin, its properties and how it evolved and came to be be skin, how it is transformed by being steamrollered is to totally miss the point that it is the steam roller that is the problem….it is the steamroller that should be the subject of investigation….not pea skin.

  • From anger to action.

    We’re not mad we are angry
    C4 screened Eleventh Hour’s “We’re not mad we’re angry” in 1986. This was a unique docu-drama which took two years to make with a group of current and former psychiatric patients who held full editorial control. Many of the actors in the drama sequences had been service users, others were involved in the editing and production process. Many of the survivors interviewed were activists such as; Jan Wallcraft who became Mindlink’s first co-ordinator, David Crepaz-Keay, who went onto managing Mental Health Media, then Head of Empowerment and Social Inclusion at Mental Health Foundation, Peter Campbell the founder of Survivor’s Speak Out’, Mike Lawson the first survivor vice-chair of National Mind (who got elected in favour of a psychiatrist who was so angry at not being elected he demanded a recount). Mike also designed one of the first Crisis Cards. It’s a seminal piece of work which you would never see now as criticism of services is more stifled and radical activism has been dumbed down by policy and recovery approaches.