Tuesday, November 13, 2018

Comments by kindredspirit

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  • Stephen, Ohwhatisthatlight didn’t say anything about correct beliefs. It’s hard to read these replies taken so very out of context. No one ever has to share a belief you have. Not sharing a belief does not mean the person thinks your belief is stupid or crazy. Doesn’t mean they don’t think you should have the right to have such a belief. Where is all this demand for conformity in thinking coming from suddenly? People can disagree on things without shaming.

    Am I supposed to tell my Christian friend that I believe in god so she doesn’t feel I am shaming her for her belief? Well then what happens to my belief that there are no deities? Is my belief less real or valid?

  • Whoa! Ekaterina, your reply was entirely uncalled for!

    Ohwhatisthatlight just expressed your absolute right to believe such things and you said he stigmatized you because he said he doesn’t share your belief but supports your right to believe it. I feel exactly the same way. As an atheist, I don’t believe in anything supernatural. I don’t believe you were Anne Frank or Buddha, then now or ever.

    I completely support your right to believe in such things without being psychiatrized and medicated but no one has to share your beliefs and not sharing them is not the same as stigmatizing you.

  • Again for those in the back: Correlation does not equal causation.

    I am heartily tired of being held responsible for the traumas that happened to me, including having a loaded gun put to my head in front of my toddler. As a prohibited purchaser, thanks to psychiatric treatment, I cannot purchase a weapon to defend myself, however I have to read constantly about how I’m such a danger because I have a DSM label and a trauma background. Any scientist worth his salt knows that the correlation disappears when you factor in gender. This is sloppy science that is not properly controlled, reporting inaccurate sensational findings about trauma and violence, which doesn’t hold up when you control for gender. It’s time to stop holding women accountable for gun violence we are not committing!

  • I would write LOL if the data were believable. Having been victim of medical error and treated in a drug unit unceccarily for two weeks in 2008, I no longer trust any of the numbers. They claimed I had PCP in my drug screen and then accused me of stealing ketamine from a veterinary run clinic when they found out I rescued cats. The whole situation was made even more ludicrous by the woman screaming like a banshee and beating on the door of the next psych ER cell while I was sitting there talking calmly and reasonably with the staff simply trying to get a medical clearance for the trauma unit. Instead I was diverted to the drug unit in another city and held against my will for two weeks.

    Considering the amount of deaths attributable to medical error, and the number of discrepancies in data sets, I say shrug, who cares.

    Of course, lots of people are taking all sorts of drugs these days – legally prescribed or otherwise. Until you close the revolving door between pharma and fda, nothing will change. Proof in the pudding is the new opioid just got approved under the guise of battlefield treatment when there are cheap effective options already available. And this one was sponsored by the defense department in case you wondered how your tax dollars are being wasted for more war.

  • I don’t know where this physician got his expertise in hate or the underpinnings of such. What I can say that the research is missing is women. How many bombers and mass shooters are women? Almost none. (Less than three percent is the correct answer) Lots of people are stressed beyond the breaking point but with women it comes out in videos of them yelling at people. We make them internet sensations for yelling hateful words but otherwise doing little actual harm. But with men we get bombers and mass shooters. What’s missing from this article, and from the conversation in general, is the topic of toxic masculinity. I and a lot of other survivors would really appreciate it if MIA would stop promoting the idea that traumatized people as a whole are some scary group of angry potential domestic terrorists. It may be correct that men with trauma in their pasts are more likely to become violent themselves, but where are the women? If trauma were the culprit, you’d expect women to be equally violent and antisocial and it simply isn’t the case any more than mentally ill people are responsible for large amounts of violence. So once again, correlation does not equal causation. And if it doesn’t apply to the whole group of traumatized people, it is simply another correlation in the puzzle of factors influencing violence.

  • I’m amused by your reference to crazy Betty and her cats cats. I’ve discovered the trick to blending in when it comes to cats. The trick is: you can’t only own cats. You must own a dog as well. As long as you have at least one dog, you can own up to four cats as well without being a crazy cat lady. If you want to have more cats, you will need additional dogs to prove your normalcy. And under no circumstances should you ever reveal the true pecking order of the household, which anyone owned by cats knows is Cats -> Humans -> Dogs.

  • Frank, this is the first time in the 24 years since I was pregnant with my eldest child and received that book as a gift that I have ever heard anyone reference it. Thank you. That book and Neil’s philosophy on child development and education had an enormous impact on my parenting for the few short years I had my daughters. I have given it to a number of expecting parents over the years. It could have been a game changer but for the reality that our government does NOT, in fact, want a thinking populous.

  • OH, I think hope that flies in the face of evidence is little different from faith, and as an atheist, I don’t peddle in fantasies that make reality easier to swallow.

    For the record, my cynicism is not directly related to psychiatry or social justice issues and has far more to do with global issues such as the ongoing rapid climate collapse that humans are gleefully racing into while raping the planet of every last resource in the search for money and power. And war, which Americans can never get enough of, is the tool used most heavily to leverage that power – both in terms of population control at home (via fear of foreign attack) and global population control (via fear of American attack or sanctions). So, money and military power are basically two sides of the same evil.

    Psychiatry is one way that hope is continually killed, but it’s just one of many ways in which the powerful hold onto power. Hope is what our leaders sell us to keep the populous calm and compliant. It’s a drug, AKA Hopium. And it’s effects are powerful – for the powerful.

    Cynicism would be a much more effective arbiter of change than hope if enough people would take the blinders off long enough to realize the shit show we are all living and participating in. It’s not enough to fight back against psychiatry anymore.

    As they say, hope for the best, expect the worst. You can fill in the rest.

  • I want to feel some hope that trauma-informed care might make some difference, but my personal experience of several admissions to a medium-term trauma disorders unit suggests otherwise. I have found little difference between regular psychiatric units and the prestigious trauma unit I went to – more art therapy, same blaming the victim tactics. I put in 12 72-hour notices in 7 weeks, begged them to let me go home. Finally they let me go a few days after I attempted suicide on the unit, but only after the director of the unit personally screamed at me for several minutes in his office. I recently came across the Medicare Lifetime Reserve Days Waiver form I had to sign to get in and the $55,000 bill for the stay. Trauma-informed or not, it’s still the Hotel California until either your insurance runs out or you become a liability.

  • I’m so amused by this because I recall how the nurses never actually took an accurate pressure from me anyway because my blood pressure is usually low enough to scare the bejeezes out of them. Totally normal for someone who’s had very low bp my whole life, it runs in the family. But they’d never accept the first pressure, always saying I had to walk around for a few minutes and drink some juice or soda to increase my pressure. One nurse flat out said she’d be fired for not calling a medical emergency if she reported a pressure that low in my chart. To be fair, it was like 55/42. But with a normal pressure of 80/60, it can dip quite low when I’m resting. But there is no rest after they get a reading like that… And the funniest part about it is the higher pressure they then get as a result of completely stressing me out are not in the slightest bit accurate. And they know that. But it’s far more important to them to cover their ass than report accurate readings. And of course, it made me look like an idiot when I finally ended up needing a regular cardiologist – he looked back through my hospital records and assumed the low readings they got in his office were a new issue because what has been recorded in my charts has routinely been a second or third reading. Actually, having typed this all out, I’m convinced this is malpractice but experience tells me no one cares.

  • I have a blanket practice of refusing to watch or listen to the news. I have been in ‘read-only’ mode since 2004. I have considered carrying one of those devices that turns public TVs off (waiting rooms and such) but so far I’ve had success simply asking if anyone minds if I change the channel. About 3/4s of the time, whoever else is there is more than happy to watch something else. It boggles me why so many doctor’s offices and other health facilities routinely have a news channel playing – it’s so stressful, it cant possibly be good for their patient’s overall wellbeing.

    Turning off the idiot box entirely is what we all really need of course, and I didn’t own one by choice for 12 years, but my husband wanted a screen to stream to and we had free cable with our internet so we got a fancy smart TV and programmed it to skip right over the 24 hour dedicated news stations entirely. 🙂

  • By the way, whether or not you’re a parent, you’ll find some friends in the “Free Range”, “Wild and Free”, and “Unschooling” communities. These people really get how harmful our modern social structures have become to children’s development and many also reject formal government schooling as well. And you can see how they are targeted by CPS and police for that. But if you talk to those children, most of the time, you will find kids who have been taught how to think, not what to think (reference to Sydney Sugarman). Someone here mentioned Summerhill recently too. I would have done very well in that kind of environment and it’s certainly how I’d have parented if I’d had a real chance at that. I don’t see any chance of most kids having an opportunity at that kind of environment. I also wonder sometimes if the reason average people are so easily controlled is that they are average, and if it’s as you said, the curse of intelligence that breeds the need to question everything – authority first and foremost.

  • I can’t agree more with your comment here. As an antiauthoritarian child, I took a lot of abuse for my questioning illegitimate authority. When told to respect my elders, I always replied that I’d respect them if they earned it. Many people in charge of my care responded by describing the abuses they’d employ if I were their child in order to bend my will. Talk about being under a constant state of threat. I was also constantly told what a disappointment I was for not living up to my potential. Of course, rather than being put into advanced placement with children my own age, I was skipped three grades, placed with the sixth graders, and then told it was my fault I couldn’t stay because I wasn’t emotionally ready for that environment. So I sat bored AF with the average kids my age. It was basically a perfect storm of abuse at home, gaslighting by authorities, and then shock that my life turned to shit. When I think back on my child therapy, I think now that it was specifically designed to break my will and make me a compliant child, not necessarily a happy one. (And I think this aim is what has led to so many children being targeted for medicating.) So, anyway, my personal experience has always made me think exactly what you’ve posted here. The system is designed to dumb down the populous and make them easy to control. I’ve actually tried very hard to blend in with the crowd, just as a survival attempt at this point, but it makes me miserable.

  • As for “risk assessment”, well, I’ve long since learned how to turn off emotion in an instant for my own safety. So, thanks, Psychiatry, for teaching me how to be a sociopath for my own protection.

    The most disturbing thing I take away from the “suicide hotlines call the police” stories though (which I totally believe) is that it seems to me that someone who was truly looking for a way to end their own life, rather than simply reaching out for a human connection, might call a suicide hotline actually hoping to cause the police to show up and shoot them. And thus we’ve given suicidal people the means to suicide by cop under the pretense of suicide prevention. Hopefully most people’s moral compasses would stop them from doing that, but since suicide by cop is a thing, I can totally envision the suicide by calling a suicide hotline. That’s pretty ironic.

  • This is handily among the best articles on this site. Thank you, Megan. It’s clear, concise, deadly accurate, and has just enough snark to take the edge off how depressing the material is.

    Chronic suicidality is indeed a special kind of hell. As for me, I’m pretty certain I died during my first big attempt in 2002 and have been in Hell ever since. I don’t believe in God or religion, but I can’t shake the feeling I’m dead and in the bad place. I’m also pretty certain this is a common delusion due to our slow and steady decent into a dystopian nightmare beyond the scope of anything Orwell ever dreamt up.

    And for those not yet sufficiently depressed, the 24 hour negative news cycle is always there to give you a nudge over the edge…

  • I have mostly escaped. I have “self-harm” scars from the Effexor-induced manic psychosis that will always give me away even though I was never a cutter. Trying to explain to a medical professional about the one time you were manic and tried to cut yourself out of your own body doesn’t really help to convince them you aren’t a danger to yourself and others. Sad. It’s been almost twenty years since. My body will always bear the scars. But I applaud you in your efforts to escape the system.

  • I shouldn’t need to build resilience against stigma. Black and brown people shouldn’t need resilience against racism. Immigrants shouldn’t need resilience against white nationalists. Poor people shouldn’t need resilience against cold and hunger. Abused people shouldn’t need resilience.

    WHEN ARE WE ACTUALLY GOING TO HOLD THOSE WHO HARM TO ACCOUNT FOR THEIR ACTIONS INSTEAD OF CONSTANTLY DEMANDING THE HARMED TO BE RESILIENT!!!!???? Ffs

  • Marie, thanks! This is something I’ve been sounding the alarm about ever since my father’s reaction to Lipitor. It’s not just psych meds, it’s western medicine’s almost exclusive focus on matching symptoms to drugs rather than matching symptoms to diseases, and pharma making sure there’s a pill for everyone and everything.

  • No, not equating psychiatric survivors with the oppressors. I mean “we” in the sense that humans are basically complex lemmings and we follow one another right off the cliff. So, in the societal sense, “we” have allowed this because too few are willing to question authority. Yes, absolutely, blame the owners, but they couldn’t have done it without the willing cooperation of the masses.

  • Where are those mothers? They’re at work. Few women (or in some cases men) are privileged enough to stay home and raise their children with another parent singlehandedly earning enough to support a family with today’s lifestyle and expectations. American’s have placed such a massive value on productivity that we’ve forgotten the art of child raising. Our kids are being raised by institutions – daycare from infancy, twelve years of public schooling. And the children being raised the way we were fifty years ago? So-called “free-range” kids? That’ll get the cops called and social services investigating. Wasn’t it just yesterday’s headline here at MIA something about how more mental health services in schools would help kids? So the short answer is, parents don’t do a whole lot of child raising these days – haven’t since well before I was a child.

  • You’re barking up the right tree, However, It’s not just the psychiatric drugs at this point. Some pharmacies will tattle on you if you fail to refill any type of medication. Patient non-compliance to medications or prescribed therapy is really a sin in the God/Doctor’s opinion, regardless of the medical specialty, it’s only those they can label as crazy that they can force to take medication. And now the God/Doctor is omniscient when your pharmacy tells your doctor you didn’t follow his orders. It’s all about compliance. The fact that psych patients are the easiest to target doesn’t change much.

  • I appreciate this defense of Dr Gotzsche. However I just want to point out that it’s really not just psychiatry. Western medicine is inexorably intertwined with the capitalist pursuits of pharma. Going to a doctor for any reason other than life-threatening illness or injury is pretty dumb at this point. I find it rather remarkable that when many extraordinarily old people are asked the secret to their longevity, they will routinely say they avoid doctors. I suspect that a dig into the literature and history will find that it’s rather routine for doctors and researchers whom challenge the status quo to be hushed, ridiculed, and booted from their professional societies or positions. The doc who discovered the importance of gut bacteria first made that finding in the seventies and was literally poopooed for nearly 50 years – wasn’t even able to begin quietly researching it until the 90s. Just imagine the direction psychiatry could have taken if we had treated the whole person instead of just the “mind” via psychiatric drugging. And in all of medicine, it is the case that doctors are looking for symptoms to match to drugs. And frankly, I think a lot of doctors have given up trying to get their patients to maintain a healthy lifestyle. They know their patients likely can’t afford to eat nutritiously, manage their stress levels, get enough exercise, or even just get enough downtime in our current slave wage economy. So in come Prozac, Lipitor, Xanax, Ambien, propanolol, metformin/insulin, etc, etc, etc. Of everyone I know (in terra form), I am the only one not taking any daily maintenance medications. I also don’t know a single female in my larger social group not taking a psychiatric drug of some sort. No one seems to remember that just 30 years ago, widespread chronic illness and poly-drugging was not the norm. And I for one am at a complete loss as to how to convince people that their lifestyle and drugs are literally killing them. Frankly, if the big wigs like Dr Gotzsche find themselves targets for calling out bad research (and wrong conclusions) in medicine, how are any of the rest of us Earth walkers going to avoid becoming targets for this heresy other than keeping our heads down? So, props to the good doctor and hopefully he will survive this eventually, as you say, but it sure feels like this widespread polydrugging across all fields of medicine is a case of Pandora’s Box being opened and the powerful forces that be are going to target everyone trying to shut it.

    (P.S. it’s not just medicine we’re fighting. It’s the entertainment industry pumping cable TV into your living room. It’s the substance industry advertising to you how easy it is to drown your fears in some crown royal. It’s all the various products we’re supposed to go into debt to buy (at great expense to our natural resources) to keep the economy going (so the rich keep getting richer). It’s the soda industry kicking and screaming in court every time a politician grows a backbone and tries to lower sugar in drinks. It’s the fast easy lifestyle that means in some places like NYC homes are being built without dedicated kitchens because so few people have time or inclination to cook real food anymore. Yeah, we’re all screwed.)

    Sorry, Bob. I know you have to have a focus and it’s psychiatry in this case. But the real issues are entirely systemic and are going to take a systemic approach to a healthy society to be fixed, if they can be fixed at all. As long as money is king and what’s left of community and social connections continue to erode, I have little hope.

  • Well one problem is there actually is something fundamentally wrong with many survivors of early/chronic or violent sexual trauma and it is that precisely which society does not wish to face because the apologists have successfully turned the effects of sexual trauma into a chicken and egg problem via the biomedical model of mental illness.

    Our current “evidenced-based” thinking says the egg was to blame all along and any environmental traumas merely exacerbated what was already there genetically, waiting to erupt. Trauma experts, mad pride/psychiatric survivors (and farmers everywhere) know the meat will be bad if you abuse the chicken. But even if the egg *were* flawed, why do we excuse the effects of abuse and blame bad genes when theoretically, our most sensitive and delicate children (whom are supposedly genetically susceptible to what is termed mental illness) are literally the most vulnerable members of our society and yet also somehow the easiest to blame? Bad genetics. Poof. Uncle Fester is off the hook for buggering little Johnny. And when he shoots up his school in ten years, somehow conveniently, he’ll have schizophrenia. Bad genes. Poof. All better.

    But hey, don’t worry. It’s all going to work out to get those bad genes out of the gene pool. Yesterday’s headline news said low sperm count has increased seven-fold in men over the last 15 years. Soon our environments will be so toxic that few will be able to reproduce naturally anyway. And when those who are deserving (rich) go to the fertility clinic, their embryos will be screened for all these bad genes. Problem solved.

    I’ve probably been reading too much dystopian reality (news) lately. Hope has long since been eviscerated.

  • Michael, I started reading a book last year along these lines that you might be interested in. It’s called Against Empathy: The Case For Rational Compassion. I haven’t finished reading it but the main points seem to be that empathy fails to extend to compassion because (according to the research) humans are apparently somewhat racist and exclusive in offering empathy to those they readily identify with in their racial and socioeconomic class. And that if we want a truly equitable and just society, we’ll need to ditch empathy and practice compassion instead.

  • I think the main problem here is semantics. You’re getting bent because Ruckledge uses psych industry terms in presenting her research findings that nutrition effects emotions. Frankly I think the reason antipsych people aren’t more up in arms about her research is because it makes common sense that malnutrition or nutritional deficiencies effect ones ability to regulate ones emotions and it makes little difference whether you call that someone’s mental health or simply their emotions. Yes, it’s physical. We get it. But you start more fights over terminology than you do over substance.

    Now since we’ve had this discussion privately and I know you don’t believe that nutrition has no impact on emotional functioning, I don’t understand why you’re digging in over the terminology. I for one think there are more important avenues to explore such as why our government subsidizes nutritionally deficient foods to the extent that junk food is far cheaper and more easily available than whole foods that haven’t been heavily processed. And then after subsidizing junk foods, we get told not to eat them because they’re so unhealthy. Our federal government makes junk foods incredibly cheap and then the FDA tells us to limit our intake of such unhealthy, nutritionally deficient, ADDICTIVE, cheap foods.

    It’s not hard to understand that the standard American diet is killing us, and, in my mind, it makes little difference whether we talk about it in terms of “mental health” or we say our emotional state is being effected by physical nutritional deficiencies and inflammation caused by a poor diet.

    We can’t fight Mental Health, Inc effectively by beating everyone over the head until they agree with us on our exact preferred terminology. Getting lost in the weeds of terminology doesn’t advance the message that the bio-medical-psycho model is missing the mark. And I certainly don’t think fighting those who are advancing such basic concepts as ‘we are what we eat’ is going to gain more support.

  • Mike,

    I’m so sorry, I was not as concise as I would have liked to be when I said that. I was responding not to you, but to those who would make a causative connection between his creativity and any supposed “mental illness” as it relates to his suicide. I did not express that clearly enough.

    As for my grandfather, my grandmother took care of him for decades before he died but did finally put him in an institution when she was no longer physically capable of providing his care. He died three years later in conditions exactly as you describe. As many, many other people do.

    I’m sure as Robin Williams was experiencing early symptoms of PD and LBD, he knew he didn’t want to experience a natural death under those conditions. He was not just a creative, he was an expressive. He was larger than life and he risked losing his ability to express himself. That would have been torturous to him. And to shift the focus away from that onto some supposed mental illness in the name of suicide prevention and stigma awareness is disgusting. And I know you understand that. Thank you for your writing this.

  • Sera, what I’m responding to is your objection the use of the term ‘psychiatric slavery’, specifically on behalf of black folk, who appear to be so afraid of the group of white commenters that they aren’t speaking on their own behalf here. If you don’t want to be thought of as policing that term, why are you doing it so vociferously?

    There is a big difference between benefitting from systemic oppression and promoting systemic oppression. And bashing people over the head because they may benefit (in known and unknown ways) from the oppression of others accomplishes nothing. Literally nothing. What’s even funnier is a group of white people arguing about who is woke enough to have a seat at the table in these discussions.

    Cornell West has written and spoken extensively about what he terms the “niggerization of America”. American imperialism (war), free market laissez faire capitalism (money), are the tools used to keep us divided and arguing over issues like race, gender, and sexuality, while a handful run away with the spoils.

    And I don’t really care anymore what offense people take to the position that socioeconomic class is equal to or more important than race in the 21st century. In fact, the whole basis of intersectionality is the idea that lots of factors play into a person’s experience of the world and whether or not they are oppressed. A rich, straight, cisgendered black man is on far better footing than a poor, white transwoman. And just because a poor black transwoman is in a worse position than the white person doesn’t mean the poor white transwoman’s position is somehow magically better than the rich cis black man. And so maybe we can stop beating the race horse and look instead to the rider atop pulling the reigns, to combine analogies…

  • I think this is really great – with a caveat. The only piece I see missing from this is direct support for those who are intent on ending their own lives. I think the supports listed, although some of them sound amazing in terms of emotional support for those who are contemplating suicide, it still sounds like it comes from a place of suicide prevention rather than a right to individual determinism and agency. I am all for helping people to choose to live if that’s what they want to do, and for sitting with them in their distress while they find a path forward. But I am also in support of a Belgian-type system which allows those who want to die to do so in comfort and peace. As we’ve seen from the backlash at allowing children and those labeled with mental illness the same right to end their lives as “emotionally stable” adults with terminal illnesses, it will be messy and contentious at first, but it is a necessary next step in allowing humans to have individual agency over their lives, which is the ultimate freedom. There’s a big difference between encouraging a suicidal person to just finish it already, and offering to sit with that person and comfort them during their final exit. The latter offers them the ultimate freedom to decide, and I’d bet that once presented with that as an actual choice and not one taken out of desperation, that fewer people would choose it than are currently doing so.

    Still, I applaud MIA and the author for taking this bold of a stand on the side of those suicidally distressed.

  • The whole idea of systemic oppression needs to move beyond race in order for us to unite against the Owner Class. As long as we continue to use race as the sole or major theme to describe who is oppressed and who isn’t, or who is appropriating what, we lose sight of those pulling the strings at the top.

    People of color do not own the term slavery and slavery as a general term refers to much more than the enslavement of African and Caribbean people of color by early Americans. As such, psychiatric slavery, economic slavery, prison slavery and other types of oppression which removes the freedom of an individual and renders them into a type of bondage then counts as a form of slavery. We don’t need more gatekeeping. We need a broader understanding that oppression (and resulting bondage) shows up in many forms, and just because you benefit from some types of systemic oppression certainly doesn’t mean you benefit from ALL systemic oppression or that you are not oppressed in significant ways unique to your own circumstances and history.

    As a targeted white woman, I cannot go to a doctor without fear. I cannot speak to a police officer as a victim without fear. My lifetime earnings were decimated by being told that I was too ill to work and being forced into poverty by SSI, while simultaneously having most people question if I was gaming the system because I am smart and resourceful and can “hide my crazy”. The resulting physical damage to my body from years of polydrugging and ECT mean I may not ever work in a substantially gainful fashion.

    But when we get into the weeds over who is oppressed and who isn’t, I’m supposed to be greatful it isn’t worse. When individual suffering is nullified on the basis that it isn’t as bad as someone else’s simply because I’m not a person of color, then who is being racist? And beyond that, who does that serve? From my perspective, it can only serve those at the top who are raking in the dough from all of these oppressive systems and they, I’m sure, are more than happy for us to be arguing amongst ourselves about who is oppressed enough to deserve the most sympathy.

    It’s the money, people. If we want to save the world, we’re going to have to get over the bad taste and eat the rich.

  • Having watched my grandfather slowly deteriorate and die from Parkinson’s over the course of my childhood, I am glad that Robin Williams did not have to endure that slow and degrading end to his life. Having said that, the nature of his death made me very very angry. I think it is the definition of tragedy that someone who brought so much joy to so many people died alone, hanging from a rafter, likely overwhelmed with grief and sadness. He should have been surrounded by the ones he loved, comforted, given ample opportunity to say his goodbyes, and allowed to pass away in peace. Further, he should have had the ability to choose, with his loved ones and medical team, a pre-agreed upon time when he could choose to take his own life, painlessly, in the location of his choosing, with the support of those closest to him.

    I have made many people angry – especially on inpatient units – by standing up for the right to die. We should all have it. Our culture is obsessed with lifesaving at any cost which is more than a bit ridiculous considering we all will die eventually. It’s time to end the stigma of suicide and establish a new paradigm of end of life care.

    Robin Williams suicide had nothing to do with his being a creative. It was due to being given a slow and torturous death sentence and living in a culture that refuses to acknowledge that all living things die.

    It’s time for death with dignity for all who so choose.

  • The “like” and similar buttons are one of the ways that Facebook has made its platform so addictive. They’re attached to software algorithms that control what you see. They are emotionally manipulative, giving the content creator a boost of dopamine when they get a notification that their comment or post has been interacted with and creates an addictive feedback loop to keep people coming back to interact with the platform. Now I’m not saying this is exactly what MIA is doing – at least not to start with – but given how other platforms have evolved, I’m expecting a slippery slope, and not necessarily one that we’re informed of in advance.

  • Steve my comment wasn’t addressed toward you or any of the points you make. Of course I’m not advocating for personal attacks, though twice I have been moderated unfairly (once for making a comparison to a literary allegory and once for saying a specific position was ridiculous) and it has deeply effected what and how often I write. Neither was a personal attack against the person writing.

    I don’t have a problem with you, in fact I’ve had nothing but good things to say about you to others. But the job of moderator has changed the people who take it on so it will be interesting to see how it changes you and your writing.

    Surely you all at MIA know that many of us commenting are connected outside of MIA and so it won’t surprise you that I have received multiple emails in the last 24 hours from folks thanking me for speaking up on this thread. People who have the same concerns I have brought up.

    Has it ever occurred to the editorial staff the effect it might have on someone who takes the time and drums up the courage to share something deeply personal to then have to worry about whether or not anyone likes it? The topics discussed here aren’t like regular news. This isn’t the NYT or Gaurdian or WaPo. A lot of stuff that gets shared shouldn’t be up for debate or subject to being liked, it’s descriptions of everyday torture in homes and institutions and people are taking huge personal risks to their own mental integrity to speak up. There is a large contingent of us who feel that MIA is increasingly courting professionals and pushing a standard medical narrative and silencing or at least discouraging survivors from sharing or participating in the debate.

    You have to have a really thick skin to keep coming back here and it’s not the survivors who are causing this atmosphere for the most part.

  • Totally agree here Julie. Comments. The algorithms that online communities use to manipulate what people see is a slippery slope.

    I’m a little shocked and dismayed by the desire to emulate NYT. Their comments section sucks, and marginalized views aren’t published. And they’ve implemented their policies for their own protection and growth, not to provide a forum for robust discussion. So not only is MIA punching way above their weight, they will effectively kill discussion if they copy NYT’s format.

  • Irit, this was my take on that as well. I certainly don’t read “rethinking psychiatry” in light of reform.

    In the same light, abolishing psychiatry, to me, has only to do with doing away with the recognized medical discipline of psychiatry and has no bearing on other forms of socioemotional support – therapy or soteria house type places or social workers to help people in distress stay on their feet and connected to reality.

  • James, it would have behooved you to make that distinction in your post rather than present your conclusions as a logical following from the limited survey answers provided.

    It will be interesting to see how this evolves and whether making it more difficult for the louder more insistent voices to be heard will truly advance your aims. My takeaway ultimately is that MIA would like people like Oldhead, Myself, Frank, Dragon, Julie and others to be less vocal and that calling for more civility is a convenient way to do that. I wonder how civility works for other marginalized groups…

  • There are many factors that go into whether someone comments or not. A lot of people are reluctant to pile on, or “me too”, if someone has already said what they were going to say. Some people start many comments but only hit submit on a few. Some people have very agreeable personality types and would rather say nothing than assert their own beliefs or experiences. Some barely have time to read the articles much less formulate a cohesive response. Some of us are reading on mobile devices and would comment more often if it weren’t so difficult on a tiny screen. Some may be wary of jumping into an active discussion among the more regular commenters.

    The biggest problem I see between the survey questions and the action taken based on the answers is that the folks in charge made absolutely zero effort to understand why people weren’t commenting more, instead making wild assumptions about the reasons people don’t comment more. They also didn’t attempt to understand what people meant by the very subjective answers allowed. What do people mean by rarely or frequently commenting? This is subjective!

    The answers to the comments question are also not very cohesive. The four answers ranged from “I read and observe but don’t join in.”, “I don’t read the comments.”, “I would like to comment but don’t.”, and “I enjoy the lively discussion.”

    These four answers aren’t mutually exclusive. For example, a person could very well have had a hard time choosing one if they fall into two categories. They might enjoy the lively discussions but never personally comment because they don’t have anything to add. They might enjoy the discussions but not comment because they don’t have additional time to write and edit a cohesive response. They might comment frequently but not actually enjoy the lively discussions. They might not read comments at all, have no interest in the comments, and nothing will change that. Some built-in assumptions are that 1) only frequent commenters enjoy the discussions, 2) frequent commenters actually DO enjoy the discussions, 3) those not participating are not doing so solely because it’s an unfriendly place, 4) making the comments section less lively (or less controversial and passionate) means more people will comment. These assumptions don’t logically follow from the limited information collected in the survey and it doesn’t take a PhD in English comprehension to grasp that logical disconnect.

    The survey itself should have been given more thought and worded in a much less ambiguous way so as to get a more accurate picture of who is commenting and why. The only logical conclusion to why those in charge came to this conclusion could be that in the feedback section of the survey, lots of people said they found the comments section to be problematic. In that case, the authors of the survey would have done better to share some of that feedback in this post rather than use the limited survey answers to justify the changes to the comments section.

  • My disdain for likes has nothing to do with my abolitionist stance and everything to do with the dopamine feedback addiction loop that’s pretty well known part of social media and is why I don’t participate in that kind of environment. If I wanted to use a Facebook-like platform to interact with MIA, I’d join Facebook and comment on MIAs Facebook group.

    Others have adequately explained how the best comments can easily end up buried simply due to them being newer than ones who’ve been around longer to receive more likes.

    This strikes me as an effort to get more people participating regardless of the quality of the conversation. Perhaps to appear more mainstream to add legitimacy?

    I’m not sure of their reasoning but as one of the people who answered that I rarely comment (because I don’t comment on most articles I read even though I do get caught up in some discussions) I feel like I’ve taken a test without knowing what the outcome of my answers would be. I wish I hadn’t participated in the survey and I won’t be participating here in the future.

    I’ve absolutely had it with this joke of a site that feeds survivors drive and drabs of quality content to string us along all while propping up the status quo among practitioners. It’s been in the comment section where survivors have been able to push back on this two faced behavior from MIA and dissent on articles from professionals that practice and promote mainstream psychiatry.

    Centrism is BS in politics and it doesn’t work when it comes to human rights either.

  • Also I want to point out that the “mania” seen in those who are success seeking is often very different from the “mania” experienced by those in desperate circumstances.

    When my phone goes off with an amber alert, I’m reminded of the time I fled the state with my year old daughter attempting to escape an abusive alcoholic husband. When I ran out of resources and returned, I had to give my daughter over to my husband who had portrayed me as a mental case who had disappeared with his beloved child – a man that was so dangerously dysfunctional (shooting up heroin at that point) that I had to take her back from him before the custody hearing. So at that point I’m living in a women’s shelter with a child I don’t have custody of. Of course this happened long before amber alerts were a thing but I wonder now what it would be like to see my and my child’s face on the tv and on my phone screen as her abductor when I was so desperately trying to protect her. And yet, there really aren’t many resources for extremely traumatized middle school dropout teen mothers with zero familial support married off to men decades their senior.

    Yes, context literally is everything. I can’t speak for people who haven’t come from deprivation and abuse who are simply emotionally exhausted from attempting to stand out in the world. We live in a meritocracy for sure, but success seeking has never been an issue of mine when people like me are lucky to be fed, clothed and sheltered outside of a prison or mental institution.

  • Richard, I agree with all that you have said here. One big thing I’d like to point out though is that I’ve never met someone who was manic before being medicated. The other way around seems to be the norm. I am convinced that behaviors often labeled as manic are desperate attempts to survive made by people who have very little in the way of resources or education.

    I can only speak from my own perspective, which I have seen in many others who come from backgrounds like mine. Trauma coupled with inconsistent rules and expectations, followed by a complete lack of nonpathologizing social and economic support outside of the family unit. Children can’t form stable emotional patterns when the rules change from week to week, and when failure to anticipate constantly changing norms results in physical abuse, when their basic needs aren’t being met, and when they’re being used as sexual playthings by adults. Combine all of those things along with a social structure outside the home that is constantly condemning the child, and you have a perfect recipe for an extremely dysfunctional adult that ends up in the psych system. And if they weren’t dysfunctional enough before to be labeled manic (or borderline or antisocial) then they surely will be once psychiatry is done with them.

    Of course, if we could provide food and housing and basic needs for those in need without first demanding that they become completely disabled via psychiatric drugging, that’d be super nice.

  • I don’t deny that very rare instances of true mania exist and that someone who is floridly psychotic should receive supportive care. But what you keep attesting to is paternalism at its finest. “You don’t know what’s best for you and instead of providing social and economic support, I’m going to medicate and shrink the heck out of you until your illness is cured.”

    Much of what you detail is not psychosis but rather bad behavior that should come with consequences but instead is met by the medicine man with reassurances that the patient’s brain is defective and in need of medicating.

    Poor financial decisions are usually the result of poor financial education. STDs (and pregnancy) are often the result of inadequate sex education. And news flash, we are hardwired to seek comfort in sex, so if shit is hitting the fan, expect babies in about nine months. We can clearly see that in instances of war and famine but when it’s on the individual level, we call it promiscuity.

    Homelessness could easily be solved with the amount of vacant housing we have and yet we continue to treat the homeless as if they’ve got some personal moral failing for not making it in a dog eat dog laissez-faire capitalist world. And many many homeless are previously successful people who have fallen on hard financial times as a result of the heavy burden of student loans and medical bills. Wages haven’t even attempted to keep up with inflation and almost no one has job security anymore, ie a full time career with benefits and retirement.

    Starvation? Why should anyone starve with the amount of food waste we have?

    We have destroyed the social contract and set up our social structure to blame and shame those who fail. We’ve transformed from moralizing failure to medicalizing it.

    And all that is in addition to the punishment we heap on those who start out at the very bottom to begin with. I mean, if only as an embryo we had had the wisdom to choose emotionally healthy parents from a large, tight knit and socioeconomically secure family to raise us…

  • Kids eat what their parents provide. Nutrition counseling for parents and financial support to purchase wholesome foods would be great. And mental health for kids? That’s far too broad to have any meaning. If you want to help kids, address the parents emotional functioning and communication skills, address any financial shortfalls preventing proper care, address any issues with social functioning. You’ve heard of the poem ‘Children Learn What They Live’? It’s one of the most accurate and poignant descriptions of the children’s outcomes every written in so few words and yet people still don’t seem to get it. Kids are products of their environments, plain and simple. They aren’t machines that come precoded for certain outcomes. Kids require a massive amount of input and behavior shaping. It’s almost ridiculous that this is completely accepted in animal training and yet we act like kids can simply raise themselves and any failure on the part of the child to do that is a sign of illness.

  • I don’t think I agree that all societies teach avoidance of failure. And as a Buddhist, that certainly isn’t in line with the teachings I embrace. Jobs was a Buddhist as well, and my interpretation of his words were to not let the fear of failure hold you back. And to not get stuck because your initial attempts are unsuccessful.

    I didn’t know the man otherwise, but I doubt that he wasn’t at least somewhat cognizant of the incredible amount of luck and privilege he started out with. Even the privileged fall prey to diagnosis and pathology, unless you have so much money from the beginning that common sense never has to enter your worldview, like some people we all know with tiny hands…

  • The female is not only pathologised, she has no name, her story is given much less graphic detail, and her timing of “one week” is described as sudden whereas the boy’s timing “For several days” is just as abrupt but is described as planning.

    As a woman in the 21st century, in the age of #metoo, you’re damn straight I’m going to point out every instance of sexism I see, especially as it occurs in the arena of psychiatric diagnosis, and especially when the same behavior in a boy could very well be described differently. And unless someone has a lot of experience being a woman, preferably currently possessing a vagina, they probably shouldn’t present an argument for what is considered to be a lifelong brain disease (bipolar mania) in such a flimsy and sexist manner.

    As for mania, it is still a judgement of a collection of behaviors that society has deemed unacceptable. And historically, many traditionally masculine behaviors have been pathologized in women, and doubly so if she fails.

    Where were the parents in this situation? What amount of prep did they give the child about what to expect from her plans? What if the second child had been a boy and one day he saw the captain of the baseball team with the pretty girls fawning all over him. He went home and told his parents he wanted to join the school baseball team and become the captain – because he associates that with something he wants (the girls, the attention). They spend hundreds of dollars on equipment and a sign a six month deal with a practice coach for him. He is super excited and skips class and doesn’t eat well, and he’s too excited to sleep (all normal kid behaviors). Then after a few weeks having his butt slapped by the other boys and called faggot (jokingly) by his teammates and being belittled by the coach, he realizes what organized sports are like. He’s a sensitive boy so he says he wants to quit the team, and his parents, if they are very lucky and have done a very good job bonding and building trust over this boy’s lifetime, they will get the truth out of him. But if not, like with most kids and parents that age, he’ll say something to save face. Or he’ll quickly pick up a new hobby just as quickly as the girl did as a distraction from his failure. None of this is pathological except for the judgement.

    Another big factor in how much flitting about from one thing to the next a parent will stand is their socioeconomic status, which was not mentioned in either of the original stories. So we’re told the girl spends hundreds of dollars on different swimsuits, but I wonder if the author knows that the average woman (who swims) owns multiple suits )partly because we’ve grown up in a toxic culture that values perfect bodies over all else?) Does he know that swimsuits can cost a small fortune? Are we talking about dozens of suits from Walmart or are these mid-level designer brand and she bought maybe two or three? A more well off family is going to have a higher threshold for spending, first of all. But secondly, is she spending her own money that she earned? Then that is a chance for the parents to remind her perhaps of other things she was saving up for. If she is spending her parents money, either they sent her off shopping alone with a wad of cash or a credit card, and they didn’t give her a budget to start out with. This is a communication issue and the parents should have set firm limits. If it was her own money that she earned, then this is a teaching moment for the parents. There’s no need to pathologize the girl, she will learn that if she blows her spending money, it isn’t there for other things she wants. Unless her parents are very permissive and don’t set spending limits or guide her in what the consequences will be. Unfortunately, there is nowhere near enough information about the family dynamics or financial status to make any kind of informed decision about whether she is spending wrecklessly, or just spending upfront on equipment. Most sports and hobbies these days can cost a few hundred to just get the basics of what you need. I’ve spend a small fortune on my hobbies without regret.

    I’ll point out Shaun, that your very last sentence, reinforces exactly what I’ve said about pathologizing failure. “If someone can pull off such an event, they aren’t manic. They are a passionate enthusiast.” Do you know how many athletes have been diagnosed after a series of injuries because being accident prone is considered a sign of mania? The only difference between them and the Olympic winner is that we collectively agree that someone with extraordinary talent is worthy and someone who has a dream but isn’t as successful isn’t a true athlete.

    They are all judgements. Every last one. And I, for one, wish there had been some kind of primer beforehand to tell me what was diagnosable and what wasn’t because I hate going to a test without studying. And that’s essentially what psychiatric diagnosis is. It’s a pop quiz and a dirty trick on the part of those in power in order to describe, categorize, label, and pathologize unacceptable or inconvenient behavior.

  • “I think the very title of this article also reinforces the position of the “expert” as the one who decides what is moral and immoral, OK and forbidden…using terms such as “healthy” and “sick,” of course.”

    Precisely.

  • Mania is associated with depression because it is so closely associated with failure. And we are taught above else in western society to never be a failure. Steve Jobs advice to the graduates he spoke to was “Fail fast. Fail often.” We need to learn to embrace failure as teaching moments.

  • I have a different explanation.

    Billy grew up in a supportive loving home with consistent rules and discipline and parents who showed him plenty of examples of following projects through from idea to completion. Even though his family are tired of hearing about his plans, they don’t belittle him or get in his way. He has the material possessions he needs to make his props in the garage and doesn’t need to buy anything but snacks for the after party.

    The swimmer is from a dysfunctional home. Her father has been molesting her since she was three and she has severe body image issues, so she can’t get comfortable in any of the swimsuits she has purchased. The other girls in swim practice immediately pick up on her vulnerability and begin bullying her. She trips one day beside the pool and the other girls laughing is the last thing she can take. She swears she’s never going to swim again as that is seen in her juvenile mind as a way of protecting herself. She stops on the way home from swim practice and buys art supplies. When her parents ask what happened, she says she can have lots of dreams. That way she doesn’t have to tell anything about why she can’t get comfortable in a swim suit or about the other girls bullying her. Her secret is safe even if she is taken to a doctor and put on drugs for her “mania”.

    Oh, and in all fairness, when describing scenarios like this in order to pathologize one persons behavior and not the other, how about a little less sexism. In your stories, not only is the female the real manic patient, whereas the male’s behavior is normal, she also has no name.

    I know what you’re trying to do here but I’d call this one a flop. A better article, one that is supportive of natural human behavior and one that refuted the standard narratives of failure = diagnosis, would have dug deeper into the whys of the behaviors.

    Lots of child and adolescent therapists could have made a difference in my life growing up if they’d looked past the behavior to try to figure out what was causing it or what kind of environment would lead to each child’s behavior patterns.

  • Thank you so much Bruce and Noel for this. Two of my favorite voices on MIA – consistently empowering of psychiatric survivors and dissidents.

    This really resonated with me as well, but for reasons somewhat different than Noel’s point:

    ““The dynamics between me and several of the mental health professionals I encountered eerily mirrored those with my abusers.””

    And

    “People who enter services are frequently society’s most vulnerable—people who have experienced extensive trauma, adversity, abuse, and oppression throughout their lives. At the same time, I struggle with the word “trauma” because it signifies some huge, overt event that needs to pass some arbitrary line of “bad enough” to count. I prefer the terms “stress” and “adversity.””

    In my case, the professionals response mirrored a different type of abuse from my childhood, not the direct abuse – the types of things measured when talking about childhood adversity, such as physical, sexual and psychological abuse, or neglect. Instead, the professionals response mirrored the response of the people who defended my abusers.

    Direct abuse is not the most traumatic thing that can happen to a child. Instead, the pain of not being believed or helped by adults you tell is what causes (or at least extenuates) the trauma – at least in my case. I can very vividly remember sexual abuse by adults as young as 9 years old, in a level of graphic detail that would have this comment moderated. But those memories are NOT NEARLY AS TRAUMATIC as the memories of sitting in the principle’s office at school with my dad listening to the principle detail how he could abuse (read: discipline) me by whipping me below the knees for my misdeeds. According to him, parents could not be charged for bruises below the knees. Or the many times my brother’s wife suggested that I was a horrible child that my parents should beat in order to teach me to respect them, while refusing to believe that they HAD beaten me. She also refused to believe the accusations against my brother of sexual abuse that he had actually served prison time for. My first mother-in-law one day turned to me and said that she didn’t believe a word of what I’d told her about my upbringing because “parents don’t do things like that to their kids”.

    Then there were school counselors, the local department of social services, and my own treatment providers who compounded the trauma by alternately trying to teach me proper behavior or proper coping mechanisms, and who ignored nearly every incidence of abuse I told them. The two occasions that they investigated accusations of physical abuse, they were both dismissed as “parent-child conflict”.

    But to really put a stick in my craw, it takes being charged with, and then convicted of, simple assault when my mother called the police at 14 and told them I’d hit her. Jesus, you’d have thought I had murdered a kitten in front of a class of preschoolers! Handcuffs, charges, courts, detention, a diagnosis of Conduct Disorder, and 60 days in juvenile prison upstate to teach me a lesson.

    So yeah, I’ve got a score of 8 on the ACE study scale, but the abuse I endured was child’s play compared to how the rest of society punishes those who dare to speak up.

    Mental health providers then convinced me I was mentally defective, had a chemical imbalance, needed drugs for life for my illness. And I alternate between disbelief that I fell for it and self-condemnation that by 23 I just had no fight left in me. It really made no difference at that point whether I was a victim or not. I just needed a break and I feel lucky that break came from Mental Illness, Inc and not prison because at least I can say that I do not harm others.

    One other thing they did with the mental illness narrative was create an excuse for my father’s abuse. He was bipolar. He couldn’t help it. He was ill like me. Let me tell you, that took a long time to realize he was not ill, he was a sexual sadist. I am not ill, I was injured. And I have an injury I may be coping with for the rest of my shortened lifespan.

    So thank you for pointing out that this dynamic in mental health is similar to abuse. I argue that abuse alone is insufficient to cause this level of harm and that it really requires the retraumatization of being blamed for it to become this fabulously mental. It is the disbelief and redirection of blame the victim that creates the real adversity that causes lasting damage.

    But hey, I make interesting art so I guess everything happens for a reason… (Barf)

  • Here’s a helpful start:

    Old headline:

    Unsafe use of zolpidem sleep drug common.

    New headline:

    Unsafe prescribing of zolpidem sleep drug common.

    Old byline:

    Three out of four users of the sedative, zolpidem (brand name Ambien), do not follow FDA recommendations to reduce risk.

    New byline:

    Three out of four patients prescribed the sedative sleep drug zolpidem (brand name Ambien) in a manner inconsistent with FDA guidelines.

    Fixed it. You’re welcome.

  • In fact, I think this is a really huge issue. Why is this being framed in such a way that the patient is blamed for incorrect usage? Is there evidence that the patient is using zolpidem (ambien) long term without their provider’s knowledge or prescription? If not, why do the subject and byline not more accurately reflect that providers are prescribing zolpidem in a manner inconsistent with the research and FDA recommendation?

    Seriously, MIA, please stop being complicit with the blame the patient model and change the byline to reflect the reality that doctors are inappropriately prescribing these drugs for long term continuous use and that patients following doctors orders are inadvertently harmed by such. You might even send a letter to JAMA asking them to do the same.

  • I was about to point out the same thing! Those damn users following doctors orders! How dare they!

    It was far easier for my psych doctor to prescribe ambien for 9 years than to refer me for treatment of my sleep apnea. After 9 years of continuous use, I haven’t taken a single ambien since the first night I received my cpap machine in 2011. Amazing what happens when you get actual medical care instead of psychiatric fraud. Amazingly, my sleep study showed I was at risk of sudden cardiac death in my sleep because my blood O2 level was dipping below 80% during my apneas. Being on ambien (and Xanax and klonopin and a half dozen or more other drugs at night – including opioids and flexeril) increased my risk of death substantially. My psychiatrist literally could have killed me with the cocktail of meds I was on combined with the effects of untreated sleep apnea. You think my doctor ever acknowledged her mistake? Ha!

  • I thought this was very well articulated. I think some of the angry comments come from a place of incredulity that such validation of grieved parties even needs to be made so explicitly. But if the gaslighting of survivors wasn’t such a regular occurance maybe you wouldn’t have to explain why survivors are justifiably angry.

    I’m so bitterly tired of being told to lower my voice.

  • I believe I may always be in recovery from psychiatric abuse. I’ve long since put the things that happened to me when I was young into a trauma-informed perspective and learned how to be okay but I’m still bitter from losing 15 years to psychiatry and extremely disturbed that I will have to defend my sanity for the rest of my life due to the legal implications of having been found to be a mental defective and the perpetual nature of electronic medical records.

  • I can only recall with bemusement in early January 2006, staying with a friend the night before flying out of Dulles when, just before bed, I pulled out a two gallon ziploc bag full of prescription bottles and starting making a pile of my nightly pills. I can still vividly see in my minds eye the expression of horror on his face. Looking back, the bigger surprise was how I was even able to function at all on all those poisons. You have to laugh at these kinds of memories because otherwise the anger and despondency at a wasted life can become overwhelming. With medical error being the third leading cause of death, I can only hope the western world wakes up to the dangers of modern medicine before it’s too late.

  • I’m absolutely astounded that there isn’t more public outrage about this aspect of the juvenile immigrant detention scandal. First traumatize the kids then drug ‘em – that’s sure starting to seem like the American way. Why isn’t this drugging on the mainstream news? Is it perhaps because we’ve been so brainwashed as to believe these drugs are medicines? And why aren’t more citizens and journalists pointing out that these private contractors have no reason to want the kids out of their care when they have lucrative government contracts hinged on full beds? (Eerily similar to our private prison problem…)

    Welcome to America, kids. Deepest apologies from this very ashamed American. *smdh*

  • It’s no surprise that parents with high ACE scores struggle to raise their own children. When the children do not remain in their natural home, that adds more trauma to the already traumatized parents. And I have yet to see an example where the removed children were substantially better off. Mine weren’t. Their adoptive home ended up in multiple years long child abuse investigations and both girls have documented their horrors in writing and verbally. As a result, instead of celebrating their happy adoptive lives, my husband and I have spent thousands upon thousands of dollars since reunion unsussccefully attempting to help them get their lives back on track as chaotic young adults. A little investment in their natural mother would have gone a lot further but we don’t actually help young impoverished and often traumatized mothers in this country, we shame them.

    And it isn’t just parenting skills at stake here. There’s evidence of epigenetic changes after trauma that are passed to the offspring affecting their future health as well.

  • “At any given time, about 30% of my practice is actively suicidal. They know that I am comfortable with this. They know that I never have called 911. Never put them on a patronizing suicide watch. Never have drawn up some promissory note-type contract. I have never implied for one second that they don’t have what it takes to move through this.”

    Some of your other points resonated as well, but this is the most important piece of this article that every mental health treatment provider (and concerned family member) needs to grasp. I was so used to being instantly (and reactively) locked up for ever bringing up suicidal thoughts, that it was shocking when my therapist allowed me to talk about this subject in therapy and be honest about how much I was struggling with the desire to die (and active urges and thoughts of how to do so). Ultimately, his decision to allow me to be the one in control of whether or not I kept living gave me the strength to keep living even when I could hardly see through the pain and fog of drug withdrawal.

    Nearly a year after I was off all meds, when I said I’m moving in a few months so I’d like to set an end date for therapy, he said you don’t need to keep coming anymore. But I said I wanted to come for three more months, he agreed to let me set a specific end date to work up to. He also agreed to let me see him long distance if things went south for me after my move. About 8 months after I moved, I called up and asked to see him and he said I hear you say you’re struggling but you sound pretty good and I don’t think you really need to see me. He was right. I liken this to a parent telling a kid to get back on the bike after they’ve fallen off. They may have a banged up their knees and bruised their ego but they aren’t injured. This gentle encouragement to get back on track was such a refreshing change to the normal psycho-go-round that is so ordinary in mental health treatment. No control on his part, just a simple willingness to sit with me in my pain, acknowledge that pain without taking the privilege of action away, and then gently encourage me to take the next step, and the next and so on until I realized I truly didn’t need him anymore. I wish everyone who was in crisis could experience this kind of assistance. I would not have moved beyond that chronic suicidality that I felt for so many years with the heavy hand that ordinary psychiatry and psychotherapy wield.

    Of course, I have still the existential angst that seems typical of these times. When there are so many things to worry about: constant threat of war, political division, social media madness, 24 negative news cycle, climate change, it can all feel pretty pointless. We’re all going to die after all. But that is different from active suicidality.

    Thank you for being one of the “good guys”, for being willing to take this risk professionally, for your clients and not just covering your a**. I always thought those ridiculous safety contracts were the biggest waste of my time and served mostly to absolve the treatment provider of any responsibility to actually help.

  • I don’t know if you have personal experience with chronic childhood trauma, but I certainly would not argue with someone who said I’d been traumatically injured because that would at least acknowledge that I was not genetically inferior or brain diseased and that reacting poorly to abuse is expected. It’d be pretty heartless to tell someone who scored a 9+ on the ACES scale like I have that they hadn’t been traumatically injured.

  • Well I’m not talking about biochemistry but rather the extinction of species of gut bacteria due to modern influences (antibiotics, chlorinated water, more calories but less nutrition) that have for a relatively short period of time expanded human lifespans (roughly the last hundred years) but which are beginning to catch up with us.

    I’m sure you wouldn’t argue that the animals of the earth are going extinct at a relatively rapid pace, as are insects, plants, etc. And so it turns out the same is happening in our guts. And processes that were previously thought to be taking place in the brain, for example neurotransmitter production, appear to actually be happening on a far far greater scale in the gut. This is why it’s somewhat laughable when I see so much pushback against nutritional therapies here on MIA. It’s hard to believe people don’t think they have to nourish themselves to be healthy, both in body and in “mind”. But for those of us even remotely educated on the microbiome, it’s unthinkable that we wouldn’t actually have to nourish the ecosystem living within us.

    There haven’t been a lot of articles on the gut-brain-axis here on MIA but I believe it is something we will see more of as the field becomes better known. And it is going to turn psychiatry and the “mental health” field on its head because it’s the first hard science to show any promise in helping people recover from the distressing “mental” symptoms that have been so long attributed to the “mind”.

    But a major roadblock to that ever being possible is the current runaway socioeconomic inequality and the rapidly approaching and irreversible climate change and the resulting actual resource scarcity.

    We all loved it here when the article was published about the UN’s resolution on the treatment of people with “mental illness”, but I wonder how many of the authors and readers here pay attention to the U.N. climate change warnings, and the repeated calls for the entire planet to immediately shift to a plant based diet void of meat and dairy in order to curb methane emissions severely enough to actually save the planet and the humans and nonhuman animals that inhabit it. I suspect very few, because like anything that first requires a change in behavior and attitude, it’s not going to happen willingly.

    As I said on Bob’s article, humans are notoriously bad at gambling. We have a pervasive, won’t happen to me attitude. Despite the dire warnings from all corners, from climate scientists, from nutritionists, from agriscience, from sociologists, maybe it’s just that we’re all so stressed and there are too many warnings now but by and large people make very little in the way of concrete changes. Most of the ills in the world can be traced back to humans doing what is easy instead of what is smart.

    So to go back to your assertion that science shouldn’t be used to assert that people can’t restore their physical integrity, well that’s exactly what I’m doing. There’s a lot of junk science out there; industry funding, researcher bias, publication bias, and institutional pressures, but that doesn’t mean that science is useless in guiding and informing our lives and that we should sit around singing kumbaya in our little feel good sessions wringing our hands because we don’t know whom to trust anymore and don’t know what to believe. There probably is very little that can be done on the small scale at this point, on the individual level, and that’s part of why it’s so damn depressing.

  • There is very little evidence that mental suffering is due to a brain disease. And, in fact, quite strong evidence that it isn’t. There is strong evidence that our gut microbiome effects our mental state and that modern medicine, modern agriculture, and modern living styles have destroyed a great deal of the diversity of our guts – some scientists say permanently. Three cheers then for “civilization”!!

    Calling mental suffering a brain disease and drugging people has been shown to be very ineffective. A doctor’s sympathy does not mean he knows how to make you better. A doctor could be sympathetic to diabetes but unless he offers the diabetic person insulin or blood sugar regulating drugs, he won’t be helping the diabetic. Offering a mentally suffering person neuroleptics or anticonvulsants in the name of treating ”mental illness” is akin to offering a diabetic an antitensive or cholesterol drug. Maybe it’ll make you feel better at first because your doctor has “done something” to help. But when you die from low cholesterol or blood pressure, how will you feel then? (Don’t answer that!)

    So let’s be clear, a doctors sympathy is NOT REQUIRED. Unless that doctor can offer the patient a medication or lifestyle changes that will actually fix the problem, why do you insist on sympathy for your suffering from him?

    Furthermore, it’s been well established that the method of diagnosis in the DSM for hundreds of so called separate afflictions is essentially picking a handful of symptoms out of larger groups of symptoms. Any five out of nine will do. This is so sloppy that you can have a room full of patients all with the same “disease” and no two are alike in their suffering. This is absurd! We would have never found the causes of actual diseases if doctors had all acted this way toward the physical body.

    I understand that we live in a culture that cannot make space for those in pain and those experiencing realities differently. But attacking the people who are attempting to change that makes you no better than the oppressor. And you may scream to the hills for your right to be considered diseased, but all that has brought the mental disability community is agreement from the wider community and hence talk of bringing back institutions to lock up the crazies, and other violations of individual rights like the Murphy Bill and state and federal databases of the crazy. How has that helped anyone in distress?

  • Should patients receive informed consent about the potential harms of medications? Yes. Should the decision be left up to the patient in distress? No. Why? Well, here’s the rub: Humans are notoriously bad at playing the odds. Humans in distress are worse. Even when something has a high chance of harm, people in distress are willing to try it in case they might be one of the few people who benefit.

    Take the lottery as one easy example. Poor people buy the overwhelming amount of lottery tickets. Even if they understand the millions to one odds that they will lose. Even when they’re hungry and spending their last dollar that they should spend on food. Even with all the warnings about the odds they will be broke again (or in jail or dead) within a short period of time (one to several years). We as humans are just really really bad at gambling.

    Now you’re talking to someone who’s super depressed or experiencing psychosis and suggesting that they’ll have a 1 in 6 or 1 in 8 chance they’ll receive some benefit from the medication. In the mind of the person in distress, those are fantastic odds! Even in the face of almost certain odds of experiencing adverse effects, I think most people experiencing severe distress would take that in a heartbeat. Especially since we have a pervasive societal attitude now that we can eat whatever we want, not exercise, not make any personal effort at maintaining our health because there is a pill for everything and anything goes.

    Given this massive cognitive dissonance on the part of the average citizen then, I think this needs to be a regulatory issue rather than a case by case issue. Guidelines need to change so that no one ever is given these medications on a first episode basis. And for those who experience episodic distress, there needs to be a cost benefit analysis done not between the doctor and patient but by a medical board to decide what other therapies would be likely to help more. Those therapies need to be low cost or free to the patient and easily accessible. Then only in the cases of absolutely intractable suffering does the medical board decide that the patient be allowed to choose to risk these dangerous drugs.

    As we’ve seen with some cancer therapies, people will try absolutely anything even when the odds they will die from the treatment are greater than receiving any benefit. Psych drugs cause a living death for so many people that they need to be treated as an absolute last resort and should not simply be a matter of allowing a patient to gamble at will under the pretense of informed consent.

    As an aside, I know the tortilla chips I’m eating aren’t healthy. I know they’re high in fat and calories and I need to only eat a few and then add in more activity to counter the additional calories. I know I’ll probably eat the bag while sitting in front of my TV or computer. When I gain weight and go to the doctor with my weight related ailments, he’ll advise me I need to eat healthy and exercise more. I know I can then take to the internet and accuse him of fat shaming and a legion of angry obese people (and their thinner defenders) will mob the doctor via nasty online reviews, messages, phone calls, and social media posts. All while the cost of medical care is skyrocketing and fewer and fewer people can afford it.

    How do we get back to the understanding of personal responsibility and taking care of ourselves? Humans are terrible at playing the odds and doctors aren’t allowed to dispense common sense anymore, which is one of the things that led to them just writing scripts for everything. This goes way beyond the need for informed consent to really the need to relearn societally how to make wise decisions for ourselves and those around us. (Sorry for the tangent, but I feel like it’s a necessary part of the conversation.)

  • Ok, we can agree on that much. Although I have no doubt that if posthumous psychiatric “treatment” were possible, it would be attempted. And since it is the labels that lead to the “treatments”, I can live with neither, but I’m quibbling at this point.

    I have a problem with the labeling of “celebrats” as well. Though I know you hate victim language and identities, it is clearly a crushing and reductive existence to live constantly in the public eye. I can hardly think of anything worse in modern times than to become a celebrity or internet sensation. The luxuries we are instructed to envy are really the only upside to that lifestyle. And it’s no wonder celebrities so often fall victim to drink, drugs, and excess in an attempt to cope with living in a fish bowl. I would never ever wish to exist in such a way and not because I am humble or possess excess humility but because it must be truly awful. What we are taught to envy comes at a very extreme cost to individual liberty – something I know you value to an extreme. I understand your point of view but I think some empathy is in order. They live differently but they are still human with very real human needs for love, affection, empathy, community, and privacy, and I suspect they get precious little of any of that, at least not authentically.

  • Steven, sorry but I have a point of contention with your suggestion that we should search for contentment rather than happiness. It is a mark of privilege for anyone to be content with their own lives while holding the knowledge of what it looks like to live at the bottom. And considering how rapidly the middle has been shifting into the bottom, and how more and more of us are losing status, while fewer and fewer hold the vast majority of wealth and prosperity in the world, I cannot imagine how one would become content without at the same time having to completely ignore the vast suffering of the majority of those you’re surrounded by. ( I could probably word this better but I’m in a hurry. I hope you get my gist.)