Wednesday, September 18, 2019

Comments by kindredspirit

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  • Alex, the new research implicating osteocalcin in the fight or flight response doesn’t negate previously discovered hormonal responses to stress, it’s just saying that the physical reaction to adrenalin and cortisol doesn’t happen as quickly as they once thought and so they went off looking for other hormones that would explain that rapid response. The adrenals and cortisol depletion are *definitely* still involved and adrenal fatigue is known to be a big factor in all sorts of things but especially ME/CFS type symptoms that so many survivors have to deal with during/after withdrawal.

    I think what Steve meant by “real” science was comparing it to psychiatric pseudoscience. 🙂

  • Respectfully, there is an entire organization made up of family, friends, and concerned others speaking for and over those labeled as “mentally ill”. It’s called NAMI.

    I don’t want families brought in so they can be supported in fixing their broken loved ones. I want systems change to address family dysfunction that is one source of perpetual distress to so many.

  • There is a significant percentage of of people who privately dismiss western medicine as dangerously hubristic and often harmful. When they speak up about other ways of healing, they are summarily dismisses by the masses as anti-science. The propaganda is deep and pervasive. Your doctor is not god.

    Ask a doctor how to stay well. They will often say to stay away from doctors. That is very telling all by itself!

  • Psychiatry is an illegitimate and pseudoscientific branch of medicine. But it is still a branch of medicine. Also, much of medicine is still not understood and a series of trial and error, which is why promoting any belief that western medicine is actually evidenced based and doctors are authority figures or healers is truly the definition of delusional.

  • I agree with this. It’s telling that psychiatrists want nothing to do with legitimate brain-effecting illnesses, referring those to neurologists, rheumatologists and infectious disease specialists. The domain of psychiatry is psychiatric drugging of behavior, not curing physical illnesses.

  • Lymedisease.org is THE authority on Lyme Disease. The membership is worth it to have access to the Lyme Times newsletter. There is also MyLymeData, run by the same org, which is providing the first of its kind, patient-centered data repository for Lyme symptoms and treatments.

    Mary Beth Pfeiffer is the Robert Whitaker equivalent in investigative Lyme journalism. Her book is from 2012 but still full of relevant info.

    Avril Lavigne released just this year what have quickly become known as the Lyme anthems – Head Above Water and Warrior.

    Finally, Steven Jarrod Buhner is an herbalist who came up with what’s known as the “Buhner Protocol”, which many chronic (late diagnosed) Lyme patients find helpful. He has a stack of books on herbal antibiotics and antivirals.

    NatCapLyme and Bay Area Lyme are the two largest and best known patient advocacy groups in the US, with lots of free good info, too.

    *** Sadly, the Lyme community often pushes traditional psychiatric treatments under the delusion that they’re real medicine. With suicide the number one cause of death for Lyme Disease, desperation drives many of us into the hands of witch doctors; both psychiatrists and a good portion of those claiming to be “Lyme literate” and offering treatments such as IV peroxide infusions. So it’s really a massive mine field to navigate, especially for those without a significant pre-existing medical knowledge base to draw on.

  • The truly sad part is that the medical/psychiatric community is completely ignoring real illnesses like Lyme Disease that have known neuropsychiatric effects, among them dissociative states, psychosis, and mood lability.

    https://www.lymedisease.org/psychiatric-lyme-marke/

    There is an epidemic of neuro-Lyme mimicking psychiatric disturbances, and the Infectious Diseases Society of America recommends against testing psychiatric patients for Lyme Disease.

    https://www.lymedisease.org/ignoring-psychiatric-lyme/

    Additionally, Moderator Steve commented the other day that the medical community generally harms an enormous number of patients. This is true. If medical error were properly accounted for on death certificates and were a reportable condition, it would amount to the third leading cause of death.

    https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

    While this blog was generally well-received, I think you err in your position that it is Psychiatry alone (or primarily) that is doing active (known) harm to its patients while other disciplines are ‘real’ or ‘good’ medicine. There are guild interests going on in virtually all of medicine.

    The American Heart Association for example, accepts meat industry funding and has close ties with pharmaceutical companies promoting statins for almost everyone.

    https://www.huffpost.com/entry/health-news_b_4398304

    The IDSA has close ties to the health insurance industry with enough evidence that a RICO case has been allowed to proceed.

    https://www.lymedisease.org/lyme-patients-sue-idsa-insurers

    Women are routinely harmed by the entire medical industry.

    https://www.harpercollins.com/9780062470805/doing-harm/

    The US is the most dangerous developed country in which to give birth.

    https://www.propublica.org/article/severe-complications-for-women-during-childbirth-are-skyrocketing-and-could-often-be-prevented

    This is just what immediately comes to mind. So I think it’s wise to recognize that medicine does harm, full stop. It is always a gamble when you receive medical care. The privileged get to seek multiple opinions and choose what care they receive. But most don’t have that option with our current capitalist, profit-based and profit-seeking, health care delivery system. Emergency medicine is always a crapshoot. Always. Both in delivery and cost.

    Psychiatry does enormous and largely still untold harm. But western medicine is not to be praised at this moment in time. On the whole, the lot of us are sicker and more dependent on chronic pharmaceuticals than ever before. This is not a win and it’s not progress and it’s not limited to psychiatry.

    Otherwise, right on!

  • I suppose this reminds me that August 2015 was when I quit Lexapro – four years seems odd, as if it hasn’t really been that long. I was so heavily drugged that the SSRI was the easiest to withdraw from and marked the beginning of my withdrawal journey. Gabapentin and Lamictal were the difficult ones for me. I’m still approaching three years off them all which feels like a real accomplishment.

    I developed tinnitus only about a year ago but I sympathize. I believe it’s not withdrawal related but symptomatic of Lyme Disease. It is maddening at times though. Loud music in headphones is the only relief I get from it.

    Anyway, congrats on your sustained recovery from psych drugs. Likewise, I find all of my moods much easier to cope with – and spring back from – now than when I was popping pills.

  • I would really love to see the Open dialogue approach adapted to suit the response to children and families in crisis. So many children end up in psychiatric care and/or protective custody due to trauma/poverty/family dynamics, and yet the focus is almost always on treating the child in isolation from its distressing environment as if the child were the problem and not the environment. This damages children, it damages families when siblings and parents resent the distressed child’s needs, and it costs so much over the child’s lifetime in terms of recovering from such treatments and targeting. I don’t believe the current approaches to “trauma-informed” care in schools and community settings are adequate or correctly oriented toward helping families.

    “In Open Dialogue, Valtanen explains, “supporting the individual and family’s agency from the beginning of the work is prioritized above the professional assessment of the situation or the diagnosis of the individual.” When professionals are too quick to make conclusions or interpretations of a client’s situation or decisions, it may lead to a reduction in the client, family, and network involvement.””

    This is precisely the direction that CPS, schools and community settings need to be moving in. Help families and you’ll help kids.

  • What a refreshing read, Lauren, thank you! Some of the most disturbing material published on this site has been in the calls for tighter background checks in response to indiscriminate acts of public gun violence, which is a white, MALE, driven scourge. Given that women are responsible for roughly 3% of these crimes and yet women make up a majority of those in psychiatric care, it doesn’t follow that “mental illness” is strongly correlated with such acts. But we do not yet have the cultural will to address toxic masculinity and systemic racism, which often combine to fuel these mostly well planned heinous acts.

    I do see some value in red flag laws as applied to those with a demonstrated history of domestic violence since that is so strongly correlated with those who go on to commit public acts of gun violence. Studies have shown that women remain at risk of being murdered by their abusers for decades after they escape abusive situations. So again, I think that what is largely missing from these discussions is the risk of MALE violence. I do find some amusement in the fact that my abuser (the one who put a loaded gun to my head while drunk) can purchase a gun while I can’t. It’s a sad testament to who really runs the show.

    Can we really expect Trump and Cuomo – white men – to target their own demographic?

  • I don’t have any problems with your explanations of the science but I do think you speak in overly praising terms about psychotherapists and therapy itself. Much of what passed as therapy for me was further traumatizing – especially the childhood intervention you promote so strongly. This tends to lead advocates to push for more family separation in order to protect the child, but the foster care statistics are abysmal and troubled children especially are often further abused by non-familial foster caregivers, increasing, not decreasing that child’s trauma load.

    Twenty-five years of therapy made it possible for me to speak of horrific traumas without really feeling the pain. That doesn’t mean the pain isn’t there, it means I learned to perform for therapists. Acting okay isn’t the same as being okay.

    The current licensing guidelines in maryland for psychotherapists requires multiple courses each on DSM diagnosing and psychopharmacology. This directly promotes psychiatry, not healing from personal connection and safe emotional exploration.

    Additionally, I do not think that even excellent psychotherapy is a panacea for the very clear and alarming science about chronic disease and early death among those of us with high ACEs. My understanding of epigenetic changes is that deletions of genetic code are permanent. I have accepted that despite the long telomeres I inherited which have meant my female family members routinely live into their 90s, I will probably die young.

    I think this topic deserves a lot more discussion but I am extremely leery of simple solutions such as therapy, especially when promoted with such glowing prose. I can only imagine you aren’t personally familiar with how much damage this system doles out to those already deeply harmed.

  • Effrat, I have spoken on all of these topics here in the comments; it is clear to me that you have a solid understanding of the issues people are facing and the environmental factors driving psychic distress in western (US) culture.

    This was an extraordinarily well-written and organized article that I was very pleased to read. I think there is a desperate need for people with your knowledge set in psych academia. You have clearly studied well and were a perfect choice for the first antipsychiatry scholarship award. I’m sure you’ve made Dr. Burstow very proud!

  • I don’t think this is true. The Christian conservatism of my childhood taught that Jesus eschewed the moneylenders and stood up for the poor, for sex workers and otherwise marginalized populations. The church has traditionally provided the services that now fall upon the (supposedly, but not really) secular state. As Rachel has pointed out repeatedly, the church has been corrupted over the last 30 years into accepting psychiatry (specifically, psychiatric drugs).

    I am not religious (I am Buddhist-oriented but do not embrace the idea of anthropomorphic gods) and I am further Left politically than just about anyone I know, but I have been Left Libertarian since the early aughts – long before I embraced antipsychiatry. I still think that salvation has more to offer people in terms of hope and community support than psychiatry does. The trick would be finding a church family willing to tolerate the discomfort of being labeled anti-science. How convoluted it has all become, eh?

  • Yes, graduate doctors with hundreds of thousands in student loan debt and then be surprised that they’re corruptible with cash payments, vacations, and gifts! There’s a reason that extreme debt is a disqualification for a government security clearance. It’s too easy to bribe people with large debts.

    Propublica’s Dollars for Docs is still one of the best resources for checking out physicians conflicts of interest. I remember finding out my gastroenterologist was an industry “thought leader” and had made over half a million dollars from giving speeches at conferences. I never went back. How can you trust someone like that?

  • But how can this kind of research hold any validity if the “personality disorders” are as invalid as the rest of the DSM labels? This is where the neuropsych field continues to run into replication issues. The DSM labels are unscientific to start with, so any correlations between adverse events and specific diagnoses needs to be taken with a grain of salt. Much better to simply assert that adverse prenatal environments have adverse effects on child development. This would be inclusive of other research that attempts to correlate prenatal infection, stress, drug exposure, etc on “autism”, “adhd”, “schizophrenia”, “psychopathy” etc.

  • My problem with “mad pride”, “neurodiversity”, and similar labels is that they serve only to continue “othering” folks experiencing the normal range of human emotion and reaction.

    Trauma did not make me “mad”, “crazy”, or “mentally ill”. Extreme states resulting from adverse experiences should be viewed as part of the spectrum of normal response. I resent the idea that being distressed in response to adversity is something to celebrate. It’s not special, it’s evidence of harm.

    Likewise, the altered mental functioning (neuropsychiatric effects) that result from infection and inflammation in the central nervous system from serious physical illnesses like Lyme Disease, syphilis, HIV (even Alzheimer’s is increasingly looking like it has an infectious etiology), is NOT something to be celebrated as “madness”.

    Unlike being gay, I wasn’t “born this way” and I certainly won’t give any credence to the debunked biological/genetic theories of “mental illness” etiology by embracing such a position. I refuse to glorify the effects of environmental harm when what is needed is systems change – both in medicine and culturally.

    I understand that the labeled population wants better treatment from society in general, but arguing that we’re fundamentally different is a good way to remain targeted for eradication, not inclusion.

    Frankly, I think “Pharma Bro”, Jamie Dimon, The Sackler family, Bernie Madoff, The Trumps, etc, are far more dangerous to us societally than the odd “crazy” who does something sensational. How much press does one person being pushed in front of a subway train deserve when despotic wealth hoarders are screwing us all while smiling and gladhanding? I’m going to guess that far more deaths and misery are associated with the names above than with the one off stories that hog media attention and cause distressed folks to remain targeted as some kind of massive danger to society.

    No, I won’t fight for “mad pride” and I don’t see it as being particularly compatible with antipsychiatry. Given my own circumstances, I’m a shining beacon of normality and goodness, so I will not participate in my own othering and beg for acceptance of my supposed “madness”. Fighting for systems change is my only focus.

  • Hi Alex, I tend to view conflict as a normal part of all relationships, not just something that happens once or twice and then you get on swimmingly from then on. I don’t think I’d say I can judge someone from a single conflict, though a BIG conflict early on would certainly make me hesitate to invest deeper trust in the other person. I think trust is gained in stages, therefore, after one has learned that the other person can communicate and behave in validating and nonabusive ways. I also believe that this requires any potential therapist to have the capacity to absorb some client issues early on while building that trust and while the client is learning that the enrvionment is a safe one where issues and feelings can be expressed honestly.

    The problem with the mh industry and notions of conflict with a treatment provider is that most of mental health is delivered in an authoritarian manner (FYOG, as some say) rather than with truly shared and guided decision making. With the former, it’s not ever really possible for the client/provider team to build authentic trust and navigate conflict because the provider will always win any power struggle. The latter requires building trust between strangers and I think the normal rules of learning how to interact with different kinds of people applies. My comment about learning to navigate conflict was made under the assumption that the provider is acting as a helper/guide/assistant rather than as an authority but from my own experience I know that is rare, so your point is taken. The fact remains that the system of help is pretty broke.

  • There’s nothing wrong with learning new ways of being in the world as one matures and heals, alongside receiving the assistance one needs to survive.

    My disdain for the manualized therapies is precisely that they rely upon learning coping skills but don’t help the individual make the changes necessary – changes that often entail long-term support and financial assistance. I didn’t need a psychotherapist or medication. I needed help escaping from an extremely abusive spouse, a proper education, and antibiotics to treat the symptoms of what I now know was Lyme disease. No one should ever be forced to “cope” with abuse or a treatable illness.

    Coping skills have their place, but almost all of what the helping professions offer is medications combined with coping skills, when what most people need the most is a restoration of the social contract. This boils down to a lack of public will to help poor people. Welfare assistance and paid college/daycare would have been a much cheaper investment for the taxpayer than the fifteen year long disability path I ended up being forced into.

    I have no problem with learning how to cope with life’s natural sadnesses and difficulties – they are fodder for building one’s inner fortitude and grit. Much of modern life stressors are very far removed from anything natural, and are imposed by a sociopathic capitalist class system in which there are few winners and many losers.

  • Connecting “severe mental illness” with “monstrous crimes” is not only stigmatizing but factually incorrect. And you wonder why nobody wants to “adopt” us.

    The biggest barrier to these kinds of projects is funding, not lack of desire to help people. When the majority of Americans cannot afford a $400 emergency, how are you expecting people to do much more than cheerlead? The majority are suffering – by design of a system that prioritizes self sufficiency over cooperation.

    I have had a desire for some time to establish an intentional community for psych survivors, but doing anything outside of the system takes funds that most survivors don’t have, including me, since of course, household wealth is not the same as personal wealth.

  • Point of contention: showering daily is not healthy for anyone who is not being exposed to healthcare pathogens. For one thing, it washes off the vitamin d that your skin oils produce in response to exposure to UVB light and which takes time to absorb back into the skin and blood stream. It’s also not particularly good for your surface microbiome, and the skin is our first line of defense against illness. Also, literally none of the most financially successful people I know showers on a daily basis.

    Secondly, CBT (actually ALL of the manualized therapies) places the onus on an individual to adapt to their situation and develop better coping skills and internal regulation rather than acknowledging and assisting the client to change the circumstances leading to the distress.

    It’s no wonder that treating people as if they’re to blame for their problems and calling it “therapy” doesn’t make them feel better. Most of the time I was in “therapy”, I was high achieving, an honors student, traveling, involved in my community and being gaslighted by treatment providers as not really being invested in my own wellbeing or simply being “seriously mentally ill”. Too bad it took so long and I took so much abuse before my Lyme diagnosis. Even with my trauma history, I was kicking ass and taking names while being tremendously physically ill.

    I certainly hope the providers of these “services” will take the feedback from service users to heart.

  • This is an interesting finding. One of my favorite people, who happens to be a former therapist, has expressed very similar thoughts about what makes an effective therapist.

    “Interestingly, the findings suggested that it may take an interpersonally challenging situation to arise in therapy for these therapist effects to emerge. In other words, how therapists respond when faced with challenging moments differentiate the effective therapists, who respond with empathy, self-control, and emotional containment, from the less effective ones.”

    This concept of navigating conflict is especially one we’ve explored as friends, with us both believing that real trust isn’t built until you’ve successfully navigated a conflict (or several).

    My personal view on the manualized therapies is that they are basically useless in helping the client create permanent improvements in their living situation – they focus on coping skills and changing the patient, who may very well be having a totally normal and expected response to adverse circumstances. An effective therapist, in my view, will help the client create change in their circumstances that are leading to distress. That doesn’t always come quickly. Of course, if the client is nothing more than a source of income for the therapist, marginal (or short-lived) results can be expected. There must be some level of real attachment and caring for the client.

    Timely piece!

  • Nice, well sourced blog, Corinna! I’m so sorry to hear about your friend.

    “The reality of being an advocate is also this: We are trying (with no resources) to heal from medical harm while trying to defend our methods of healing from constant criticism, while trying to help other patients heal, while trying (with no resources) to change a system that isn’t rewarded for creating healing.”

    I hear you. The system isn’t designed for healing and/or recovery, it’s designed for profit. Even nonprofits have to compete in ways that were optimized to benefit a for-profit system. It’s designed for quick, cheap solutions that make nice political sound bites, not to address expensive, long-term root issues.

    I don’t think you should frame the changes you’re making as ‘quitting’, with all the negative connotations that are attached to that word. You’re shifting gears into a different, equally valuable and needed role. Suicidal thoughts thrive on these notions of ‘quitting’ and ‘failure’ but you and your work are necessary. You should be very proud of what you’ve built and really try to internalize that handing off of roles to new fresh players has always been part of progress.

  • These are the same agencies who were perfectly fine with adding SSI recipients to the NICS database under Obama. Remember the Murphy Bill that every democrat voted for? It’s not even been three years since Democrats we’re losing their minds over Trump blocking the implementation of that rule and writing in the Post about how awful it was the “dangerously mentally ill” might retain their 2nd amendment rights.

    This is why knowing political history matters. This is politicking. It has nothing to do with being able to speak about science and everything to do with being pissed about not being able to oppose the policies of the current administration.

  • Oh dear, I never even looked at the comments. “Sick grammar” 😀

    Personally, if I’m going to be completely disabled by drugs, I’m gonna have some fun in the process. Why anyone who isn’t propagandized about “mental illness” would choose Seroquel over cannabis is beyond me. Both give you the munchies and couch lock but at least cannabis makes you happy! And there’s evidence that CBD in cannabis helps regulate blood sugar whereas Seroquel and other neuroleptics can cause diabetes. It’s a no-brainer to me!

  • Yesterday, my apartment building sent out a reminder to parents that there are no play areas on site and that children under the age of 16 may not be unattended at any time on any area of the property. If parents cannot meet them at the bus and they are old enough to legally stay home alone, they must go directly to their apartment alone until a parent arrives home.

    I am eternally glad to have grown up before screens, the internet, and constant contact with helicopter parents and communities more concerned with legal liability than providing spaces for kids to be kids.

  • Recovery is real and need not be from “mental illness”. For some of us, recovery is from the traumatic harm of the medical system misdiagnosing our physical ailments as “mental illnesses”. I also recover from bouts of inflammation – when my joints swell up and the night sweats are in full swing again, the depression hits me like a brick wall. This is an inadequately treated systemic infection, not “mental illness”. It doesn’t mean I’m not sick and don’t have to recover over and over again. For all I know the OP has something similarly *physical* happening in his body that precipitates his psychosis in a cyclical nature. Embracing notions of recovery does not equate to embracing modern notions of “mental illness”, but physical ailments can and DO have mental effects.

  • Speaking from my own experience of treatment for “bipolar disorder”, the psychiatric practitioners themselves are extremely inconsistent in their own approach, taking neither a strictly biomedical nor a psychosocial approach to patients behaviors and affect. In this way, it is possible to both blame the patient for their behavior and keep the patient believing they have an illness outside their control that requires pharmaceutical treatment.

    It’s also easy to see why the “just like insulin for diabetes” metaphor is so useful to them in keeping patients compliant with pharmaceutical treatment. With diabetes, especially with type 2 diabetes, there is a measure of patient control over diet and exercise that will mitigate the illness, but some patients will still need insulin therapy or blood sugar regulating medications – especially when there is a hybrid type disease. Not all patients can fully control their diabetes (an actual progressive disease) with lifestyle factors, in other words.

    In using this metaphor with the “severe mental illnesses”, it is possible for the practitioners to push both the recovery and biomedical models at the same time. My experience was that my reactions to external circumstances beyond my control (social and family situations) were often met with medication changes at the same time as I was being “educated” about recovery methods such as good diet, exercise, reducing stress and conscious behavior alterations. Unfortunately, the medication changes have their own strong effects on the behavior of the drug consumer in terms of inducing hypomania with the antidepressants and stimulants, or conversely inducing stupor-like states with the neuroleptics.

    I have come to see this hybrid response as a type of psychiatric/medical gaslighting. In contrast to using insulin judiciously to lower blood sugar – something that can be instantly measured and that an educated and experienced patient can and should themselves learn to adjust the amount of insulin they inject – there are no direct measurements or patient control over the psychoactive effects of psychiatric drugs. And in fact, it would be dangerous to allow the patient in an altered state induced by the drugs to make such decisions.

    The problem therefore with these notions that there is either a biomedical or a recovery focus – either psychiatric or psychosocial – and notions of external vs internal loci of control, is that you cannot separate the effects of the drugs from the psychosocial conditions the patient is living in and any amount of personal growth or maturity the patient might be capable of gaining. Psychiatry, in my experience, is very adept at claiming the patient is ill while blaming them for behaviors directly induced by the psychiatric drugs. It becomes a hamster wheel of trying to learn new ways of being while also chasing drug effects.

    I have a binder of handouts leftover from my days as a patient that perfectly illustrates both the “you are sick and need drugs/interventions” and the “you can recognize the warning signs and/or alter your behavior”. Again, this is gaslighting. There is no either/or once the patient is medicated and targeted as being “mentally ill”, which the statistic show usually happens in that order, with most patients being given antidepressants by general practitioners without psychiatric diagnoses, and only then progressing on to psychiatric care after they’ve been exposed to the psychoactive effects of the drugs.

    The question then becomes, how do we stop the introduction of psychoactive drugs by general practitioners to those in mild distress or to those who are indeed ill with physical illnesses inducing altered mental states? How do we change the approach to those in distress to be both more humane and to include sound social and medical understandings of the effects of physical illness and psychodynamics?

    In my own case, recovery has included eliminating contact with my traumatic family of origin; antibiotic and herbal treatment for Lyme Disease and coinfections (TBD); CPAP treatment for sleep apnea; dating/marrying my way out of poverty so that I had access to the things that financial security provides in this culture such as a healthy diet (gut *and* brain health), a safe neighborhood to live in, alternative supports like massage/yoga/etc; and completely eliminating psychiatric drugs so that (now two years and ten months later) my intellect and emotions are stable enough such that I can invest in others to a degree that I am developing that elusive support system I was always told I needed but could not obtain while my behaviors and affect were so unstable. The only remaining effects of my time in psychiatric care are my electronic health records and the scars on my arms from my psychiatric-drug-induced suicide attempt (17 years ago) which remain a visible and readily identifiable way to target me despite all the progress I have made.

    In a culture that systematically refuses to actually address the underlying issues that lead to extreme mental states, and that continues to demand more “mental health care” – which, for most of us translates into pharmaceutical management – I do not foresee the majority of (extraordinarily oppressed) people being able to access the kinds of lifestyle and environmental changes that will lead them out of their distress, regardless of whether they personally believe they have an internal vs external locus of control. And surely not for those who do not possess the amount of privilege I have as a white, decently educated, and relatively non-targeted woman passing as straight and aligned with a high-earning white male spouse. I did not personally earn most of the privilege I enjoy, and my method of “recovery” is not widely available. I will never have to worry about being stopped and frisked, driving while black, having my immigration status questioned, or even having my socioeconomic status questioned as long as I continue to play the social games this totally upside-down rich white dominating society requires.

    External vs internal locus of control? Biomedical vs recovery orientation? It is SOOOO much more complicated than that and reducing people’s personal difficulties or extreme states to such trivial factors for tidy research papers is a way to continue to ignore how complicated and interwoven both psychosocial *and* biomedical factors are in creating (and perpetuating) emotional distress and extreme mental states. This is essentially the real crux of living in a capitalist bootstrap culture – the continued elusive search for easy answers.

  • Oldhead, bandaids do not, in and of themselves, stop bleeding. Sometimes a wound continues to bleed and seeps out around the edges of the bandaid, sometimes the wound is too large for a bandaid and must be sutured, sometimes a coagulant must be administered.

    I do not want to put a bandaid over the problems the western world is facing for the same reason that antidepressants are a poor choice for treating psychic pain. It doesn’t treat the underlying issues causing the disfunction, it merely distracts and politicians who promote such false cures pat themselves on the back for doing “something”.

    See my pain. See the collective pain that is driving misery. Don’t promote false treatments. Demand real change. A UBI is a financial antidepressant. It allows those in power, those who are actively doing harm, to continue to do so with impunity.

    A bandaid would be great if, collectively, we could actually figure out how to stop the bleeding first.

  • Rachel, I hear you. I’m hoping to encourage you to write because it’s a talent you possess. It needn’t be here at MIA, it needn’t be your psych story specifically. But it’s a talent that you can harness even though your physical issues make finding and working a traditional job difficult. I believe there is a market calling for your experience – your experience as the preacher’s daughter, your fall from Grace, the years lost – feeling alienated and separated from the flock, eventual, if albeit slow and scary, redemption. It needn’t be autobiographical or even published under your name. But you have a talent for writing and a perspective of both harm and recovery in a unique setting. Maybe I am seeing something that you’re not ready for, but I can imagine having your book on my shelf. I hope that you will give it some thought and consider what I’m suggesting. The fact that your faith remains strong even through all of your struggles is remarkable, and I think you have the linguistic ability and psychic fortitude to pull such a feat off.

  • “It’s not paranoia if they really are after you.” – Harold Finch

    In the current sociopolitical climate, there are many people who have very legitimate reasons to be afraid and to know (not believe, but know) they are part of a targeted group. Forget claims of surveillance, metadata collection, or targeting by any of the alphabet soup agencies; one merely need to be visually identifiable as different from the dominant group to rapidly become a target. This is not paranoia, it’s common sense based on a massive and rapidly growing evidence base.

    Why are researchers wasting time and money on continued “studies” when we all sort of know in our hearts that it’s long past time for a cultural paradigm shift? You really don’t have to be very “woke” at all to see the exploitation, oppression, and widespread misery right in front of us all the time.

  • Well, psych drugs certainly don’t help people make wise, kind or caring choices. And the self-shame that comes with diagnosis can make people give up on being good, make them believe they are fundamentally flawed, actually encourages fatalistic thinking, a la biological determinism.

    In recovering from the effects of psychiatry, there may well be a place for twelve step type thinking and action in terms of setting to rights the ill effects of behaviors displayed while drugged, even if they were unintentional – the concept of taking a fearless moral inventory, admitting wrongs done, making amends. One needn’t embrace any of the religious aspects to become accountable once one feels recovered from the damage enough to face such. It seems like a better approach than claiming one is diseased and unable to control oneself, which surely would only beg for more control over the supposedly “sick” individual.

  • Little turtle, I call my distress exactly what it is – distress. Fear and panic, feeling discouraged, guilty or ashamed, I am so familiar with these. (Aren’t we all, really?) I have a few special people in my life who swarm me with LOVE and validation and reassurance when I need it. Psychiatry made me worse, made me feel damaged, broken, diseased, unlovable. Indeed, my family discarded me as such. If your family doesn’t love you in your darkest moments, who will?

    As the Beatles once sang, I get by with a little help from my friends. There are no drugs that can deliver the healing balm that a few caring words or a warm embrace do for the psyche in moments of distress. Doctors and drugs are no substitute for community and human connection.

  • Thank you very much for sharing Jean’s story. So many of us here can empathize and have our own first-hand experience with prescribed drug harm.

    “Jean’s story may sound extreme, but it illustrates the many barriers to care and justice that patients with benzodiazepine injury endure. Her story is like those of thousands of others who have shared their stories all over the internet. They follow a similar trajectory: First, a symptom brings a patient to a doctor’s office, where they are given a seemingly innocent prescription without informed consent. Next, their physical and mental health deteriorates, without medical personnel ever connecting the dots to the prescribed benzodiazepine. What often follows are a misdiagnosis, polypharmacy, thousands of dollars in unnecessary medical testing, psychiatric holds, severe withdrawal syndromes with no medical validation, barriers to justice for medical negligence, and no support during the healing process.”

    If I could change one word in this paragraph, from “benzodiazepines” to broadly include prescribed drugs such as benzodiazepines, antidepressants, antipsychotics, sleeping pills, muscle relaxers, and narcotic pain medication, it would perfectly describe the many more of us who have suffered similarly devastating effects from prescribed medication when our “symptoms” were not psychiatric in nature before we were treated for such.

  • Rachel, the eloquence with which you share the harm you’ve experienced is exceptional. I hope you will eventually write about your psychiatric career, and the events precipitating it, on a wider scale than just here in the peanut gallery of MIA. Your ability to describe the harms without transmitting the underlying current of rage some of us struggle with, is unique.

  • I don’t think that you’re intending to imply that people in distress are evil, but that seems to be the connotation here, nonetheless. Notions of good and evil are largely based in religion and superstition and are generally harmful. The Bible considers suicide to be a major sin because it deprives “God” of the right to give and take life, so therefore it is “evil”. But this is just another way to target those who are legitimately distressed by intolerable circumstances.

    A different cohort believes that mindfulness is the correct path out of distress, with notions of radical acceptance and non-judgment. Your pain is not driven by external circumstances beyond your control but instead by your refusal to accept things as they are. A suicidal domestic violence victim is therefore expected to radically accept the situation and remain calm and solution-focused despite ongoing gaslighting, violence, control, and isolation. Victims of other traumas and problems of modern living are treated as similarly lacking this ability to radically accept hostile environments.

    A third cohort believes these distress signals and behaviors are a result of biological and genetic diseases only “triggered” by environmental conditions but that were otherwise lurking, waiting to strike the afflicted. Biological determinism, in other words.

    All of these belief systems fail to address the root causes of distress.

    I prefer not to dehumanize my abusers with terms like “evil” as well. My parents are/were deeply damaged people and also worthy of love. The intimate partners who have harmed me do not exist in the bucket of evil but rather had their own struggles that they, for various reasons, were not able to address. I do not need to accept my ex-husband’s violent alcoholism, nor do I need to think of him as an evil person unworthy of his own care and help out of his distress.

    The inability to see the nuance under all of the issues afflicting humans is one reason why people choose easy answers such as taking (or prescribing) psychiatric drugs in response to distress that would be better addressed in more humanistic ways.

  • They not only make you lethargic, they make you HUNGRY, so that you eat nonstop, pile on the pounds and then moving often starts to hurt when the excess weight starts to damage your joints. It’s a horrific self-perpetuating cycle. And then my doctors wanted me to do low impact exercises like swimming. I never quite understood whose swimming pool they wanted me to break into…

  • Dr K, I apologize for giving you such a hard time previously. This was fantastic! Made me literally laugh out loud. You knocked it out of the ballpark. We need more satirical pieces like this to really drive home the utter lunacy of treating environmental problems as illnesses.

    Maybe someone can do a piece on how domestic violence victims are similarly genetically defective. After all, if your parents were perpetrators or victims of domestic violence, your chances of being a victim or perpetrator are also greatly increased. Clearly it’s a hardwired biological defect.

  • Oldhead is right. We have one political party in the US and they keep us in line by passing the ball back and forth every 4-12 years.

    As for immigrant detention centers, Trump’s latest attempt to get around the limits on child detention was first accomplished by Obama in 2014. https://www.thedailybeast.com/thank-obama-for-trumps-child-detentions-immigrant-advocates-say

    NoDramaObama did not walk on water. NaftaSuperpredatorClinton did not walk on water. In my lifetime, we’ve had 16 years of Third Way neoliberalism and 22 years of Third Reich conservatism. At no point have we had a president or congress fighting for the people.

    The faux outrage when a president from the “opposing” party does something your own party previously practiced is vomit inducing. Only when the sheeple wake up and are willing to stop worshipping their “side” will this change. Most millennials are independents for a reason. Both parties are screwing the lowly citizenry, so bought by the corporations they’ve become.

    But if you think there are significant differences in policy between them, I’ve got oceanfront property in Nevada to sell you.

  • Why should you “go after” anyone? These policies are being implemented in lieu of taking measures to reduce the underlying systemic causes of despair, which The WHO has been pointing out for years to little effect.

    The system is founded on chaos, violence and coercion and sustained with massive inequality forcing ever increasing competition for resources driving people to their breaking points and fueled by hateful rhetoric emanating seemingly from all sides.

    And it’s not like the removal of “assault” weapons is going to give those with psychiatric histories their gun rights back since we still have to be “protected” from ourselves, lest we decide not to continue playing along with the capitalist shit show both major political parties insist we must participate in.

    Additionally, with an increasingly militarized police presence in the US, I am of the opinion that we DO need stockpiles of these weapons precisely to defend ourselves from an increasingly tyrannical state. Bonus: when we’re invaded by the coming robot armies being developed by our enemies, our allies, and by our own DoD, we’ll be well prepared to be armed and ready with those “military style” weapons.

  • Yes, exactly! Unrelenting depression after long-term “AD” use is known as tardive dysphoria. It’s surprising to see research presented in a way that doesn’t incorporate this known condition since this outcome supports prior research on the “pro-depressant” nature of so-called “anti-depressants”.

    https://www.sciencedirect.com/science/article/abs/pii/S0306987711000223

  • Oldhead, in my attempt at a balanced appeal to all sides, I think it wise to insert here the difference between presenting news (just the facts, ma’am) and analyzing the larger sociopolitical implications of new information and current events. I am perfectly capable of doing the latter and don’t need someone whose sociopolitical views do not align with mine attempting to incorporate their own political opinions into the delivery of new information.

    I appreciated his answer to a direct question to determine what his opinion was on prioritizing disarmament over societal change, and I will personally value his journalistic contribution more if he keeps his personal opinions (which I feel are bourgie-elitist) out of his delivery of factual information. This is what news delivery was before it became entertainment and outright propaganda, and it is what any researcher should aspire to.

    I am grateful for the space to analyze and discuss in the comments section, censored though it remains. I can always read Truthout, Counterpunch, or watch The Jimmy Dore Show for hard-hitting analysis that agrees with my world view. 🙂

  • A fundamental problem is that a universal basic income is a replacement for a progressive welfare system and is at its core incredibly inequitable in its application. My husband and I DO NOT NEED any financial help, thank you. And people like Rachel (who is in the exact same financial situation I was in on SSI) will get very little additional benefit from another $220 dollars a month. (To be clear, the most frequently discussed number is a UBI of $1000/mo) This has the same shortcomings as a flat income tax, which would take the same percentage from those who have next to nothing as it would from millionaires. That’s not equitable.

    My position is not that people should starve, which is exactly what would continue to happen to those at the bottom of the income scale with those receiving the UBI as their only source of income, such as the disabled. My point is that if a UBI can be legislated by congress or state governments, then better, more equitable distribution of resources can also be legislated by those governments. I am FOR canceling all mortgage debt and nationalizing the housing stock because housing is a human right. We’ve removed people from the natural world and concentrated them in cities where they can’t make their own homes, then we make them participate in debt bondage to meet their needs.

    I am FOR nationalizing food production and distribution as we still produce enough food in the US to feed the world but the government provides economic incentives to allow food to rot in the fields, and for corporations to intentionally spoil good food they throw away and the write the loss off their taxes.

    I am FOR an NHS that entirely removes the profit motive from healthcare, that returns health research to the universities with government funding, and that promotes health in communities through access to healthy environments and healthy foods rather than making people sick and then profiting off their needs for insulin and Lipitor.

    “We”, in terms of the corporate-controlled US govt, behave in completely sociopathic ways toward the citizenry and then we’re surprised that people are cracking up? Please, start getting your heads out of the sand.

    And yes, we do need to be moving back toward more primitive ways. We are already well past the 350 ppm of carbon in the atmosphere that scientists have been warning for over 40 years as being the point at which a 2 degree Celsius plus warming becomes irreversible. We’re already well past the 400+ ppm carbon that we were warned would trigger feedback loops that we’re already seeing as far as melting permafrost and flooding the atmosphere with much more damaging methane. I know you continue to think our technological overlords will pull a Hail Mary and save us, and I’m convinced you don’t really understand climate science, the colonialist nature of resource domination primarily practiced on the North American continent, and what needs to change in order to create a ecologically sustainable and just society. But considering the level of misery that modern lifestyles cause, why wouldn’t we want to return to a more primitive, collectivist approach?

    A UBI is a bandaid, once again, not a fix. We’re all better off when we’re all better off, and a UBI doesn’t make us all better off.

  • The US legal system considers accused parties to be innocent until proven guilty. To speak of someone whose house has been invaded as a “panicking criminal” participates in the othering of those who become police targets. They are not “criminals” until they have been convicted in a court of law.

    Another way that drugs could be addressed is not by invading people’s homes, but by taking a multi-pronged approach of treating drug addiction as a public health issues, ending the carceral state that uses violence and subversion to target specific groups, making it illegal to discriminate against people who have served time for crimes – in housing, jobs, education, etc – and by ending the economic isolation of rural and urban communities. Legalizing all drugs would be a great first step toward all of this.

    I’ll remind everyone that the FBI was roundly criticized for the tactics used in Waco, Tx against the Branch Dividian compound 26 years ago that resulted in the fire that killed so many, are increasingly in use by militarized police departments against people in their homes and against protestors in the streets.

    “I think police raids on drug dealers should be done differently.”?

    I don’t think police raids should be done on suspected drug dealers. Again, it’s using force to get around having to address the actual problems people and communities are facing as a result of…wait for it…capitalism. I’m starting to think we need to call this for what it is – state sponsored terrorism. The same tactics that the US government uses against foreign powers – economic sanctions followed by increasingly violent force are being duplicated on the Homefront in the name of public safety, which is anything but safe or for the public good.

  • The Dayton guy was on cocaine as well per a report I read. His well known misogynistic attitudes, combined with the fact that his trans sister and her boyfriend appeared to be his primary target, make that one seem more like a substance and hate-fueled domestic violence incident. That he also mowed down a whole lot of others may be incidental to his targeting of his sister.

  • Oldhead, I didn’t see a problem with RW’s report of Trump’s rhetoric. I was adding-on for the purposes of illustration of the intentional divisions, not countering it. The fact is that Trump does this with everyone. He even turns on his supporters.

    Your point about the neoliberal (Clintonista) attacks on “deplorables” is well taken. And in fact, Clinton and her army of white affluent women attacked Sanders supporters as well with the “basement dwellers” and “Bernie Bros” messaging. For all of 2016, I was fearful I was going to wake up in a basement magically possessing a penis. The erasure of the female Left is also intentional in the Democratic messaging, and then they shamed us for not “voting blue no matter who”. Sanders doesn’t even represent my values, I’m so far to the left of Democratic Socialism, but he’s the only mainstream candidate attempting to unite and not divide which is why he has my support. #NotMeUs

  • Yes, propose that muslims are terrorists and you create space for a muslim ban. Propose that Latino folks are invading and you create space for walls along the border. Propose that the “mentally ill” are dangerous and you create space for calls to lock them up. Here’s another one: propose that white men are the root of all evil due to unearned privilege and you create space for the vilification of an entire group of folks who didn’t ask for the privilege to begin with – because most white men are not gun toting sociopaths shooting up public spaces but are being harmed by an increasingly pervasive cultural narrative that they are responsible for the state of the world.

    The bottom line is that we are all being pitted against each other and that these narratives serve a narrow group of people who control most of the world – through both financial and violent means.

  • Thank you Megan for this excellent and timely blog. Considering the amount of anger that permeates our culture – and rightfully so – it is always a good time to remind that anger is healthy and that we choose how to respond to it. Are there times when screaming at the top of our lungs that everything is not bloody well alright and shit needs to change? Absolutely! Thanks for this lovely and pointed push back against the pathologization of legitimate outrage.

  • There was a time in my recovery where I put a sign on the wall that read “Anger does not equal violence.” I appeal to others to stick such reminders up for their own benefit. Anger is a tool. It can be used to understand and grow or it can be used to harm. That is a choice.

  • I am against a universal basic income as at its core, it promotes continued production and consumption, which is precisely what is driving climate change. Humanity is on a collision course toward extinction and the only way to even remotely begin to address this is by removing all profit, discouraging consumption (the opposite of current economic theory), and returning to what we in “civilization” think of as “primitive” ways.

    I personally am pretty tired of crapping into the decreasing supply of fresh water, of industrial agriculture that pollutes, and of technology that serves the owners and the surveillance state rather than serving the people.

    I am fully onboard with your criticisms of the nuclear family and climbing the class ladder. I would like to see people benefit directly from the fruits of their labor (socialism), while reducing or eliminating all forms of state control, including policing and incarceration, and warfare – in other words collectivist anarchism.

  • This is basically what I have been trying to say.

    The US is a violent culture. We use force and coersion at every opportunity and couch it in terms of public safety. Then we wonder why people outwardly express the violence they’ve internalized. It makes me want to beat my own head into a brick wall to demonstrate “headache prevention”. I’m still not sure folks would make the connection.

  • Oldhead, it’s been shown that repeal of permit-to-purchase laws increase suicide completion by firearm. But don’t mistake me for a gun control advocate based on such. I am fully committed to protecting the individual’s right to end their own life at the time of their choosing, and I object to gun control on the basis of suicide prevention as, once again, it goes around the actual problem of “why do people want to kill themselves”. I find it a disingenuous “fix”.

    https://www.sciencedirect.com/science/article/pii/S0091743515002297

    I wasn’t suggesting the problem could be addressed by end-stage capitalism. I’m saying end-stage capitalism (capitalism itself) is the problem that needs fixing.

  • I appreciate this article but there are some parts I disagree with vehemently.

    First off, PTSD is itself a label applied to differentiate me from others, suggesting that the source of my distress is internal rather than environmentally caused and perpetuated.

    Individualism is harmful. To all of us. There are no benefits to living in a meritocratic society where individual failures are seen as coming from characteristics of the individual. The Democratic socialist concept that competition is good and healthy but we all need to start from the same position reinforces this horrific bootstrap culture we live in where we leave many behind under the notion that they’re less deserving for whatever reason and that the deficiencies are rooted within the individual, therefore others have no personal responsibility to help the person who “won’t help themselves.”

    Additionally, while systemic racism is indeed the primary environmental factor for the continued disparities between the Black and white communities, the notion that this trauma is environmental while other traumas are appropriately understood and addressed medically, almost makes me wonder if the author thinks Black people and immigrants are different species and have different physiological effects from trauma. At best, I can see these communities having worse physiological effects from trauma, not that the effects of their trauma have no physiological underpinnings, or that other traumas aren’t best understood as also environmentally based.

    These communities are not the only ones isolated in terms of just their blackness or their immigration status. There are other ways in which people are instantly visually “othered”, whether that be obvious disability, disfigurement, morbid obesity, ambiguous gender, or simply personal quirks that make their presentation seem “weird” and “different”. In fact, it seems in this culture (and by that I mean the overall American exceptionalism that permeates the US) that we are literally programmed from birth to find ways to exclude rather than include. My white husband, who is a naturalized US citizen was told by a white female liberal who identifies as an SJW that he should go back to his country. As best as I’ve been able to understand it, the effects of racial trauma are directly associated with how “black” ones features appear, not ones actual ethnicity. This was explained very well in my American Pluralism class in college when my professor brought into class another professor who was ethnically of African descent but looked whiter than the “white” professor teaching the class (and, no, she wasn’t a European from South Africa), and so I was introduced to the notion of “passing”. I’d go so far as to say that my obviously “white” Jewish professor experienced more systemic discrimination than the other professor who was ethnically African but looks as white as me.

    I’ll take it back to my criticism of differentiating oneself on the notion of being “wired differently” in the “autistic” community. We all suffer under ableist attitudes. We all suffer under meritocratic attitudes. We all suffer under classist attitudes. And we all suffer under racist attitudes. People aren’t born this way. We’re socialized into ways of behaving and thinking. Or we’re shunned when that socialization fails, as I have been with my politically mixed but generally neoliberal-Trumpian family. The system needs to change. The culture needs to change so that we understand that we’re all better off when we’re all better off. We can’t keep going with this notion that things just need to become fairer for some marginalized groups so that the competitive nature of our culture isn’t called out for what it is. I don’t need to understand what your Blackness means to you culturally to understand how horrific it is to be an outsider and how physical features can derail attempts to merely survive, much less get ahead in this world.

    When women are the CEOs of the top five defense contractors happily blowing up other countries, when LGBTQ cops enforce racist and patriarchal laws, when a Black justice is one of the most right-wing oppressive voices on the Supreme Court, we need to get back to basics and look at who these narratives serve. It isn’t serving humanity to promote “fairness” in an otherwise oppressive system. Lifting one group up at a time isn’t working. Class and race intersect in ways that foster continued oppression among us all. Joe Biden’s recent gaffe that “poor kids are just as talented as White kids” aught to tell us what the actual owners in this country think of us all. Dismantle the system, don’t just put a veneer of fairness on oppression and call it ‘just’ or good. Abolish the owner class. I don’t need to celebrate “differences”. The fact is we are more alike than different and it serves a very narrow group of folks (some of whom are Black or part of otherwise marginalized groups) to keep us divided. Keep punching up!

  • Sera, it has been my experience that survivors are perfectly capable of sitting with each other in very dark spaces. It is the providers who don’t like us talking, who insist we not share “war stories”. It is very much to both protect themselves from having to acknowledge our pain as well as to keep us from connecting with each other so that we rely on them for treatment and remain within the boundaries of their illness narratives. I’ve never once had a survivor that I personally knew suggest that sharing these details with each other was anything other than validating of eachothers experiences. Others experiences may vary but in general trauma survivors are much stronger and much more resilient than were given credit for.

  • Whether or not one supports a candidate (and I do indeed like Marianne Williamson), I think it’s very important that this message not be lost in the political vitriol. I was a tad disappointed that she backtracked some due to the enormous public pressure of acknowledging “mental illness”, but just like with the gun control debate, Williamson is bringing to the fore the need to change the conditions that are leading to such high levels of misery, speaking about societal trauma and the specific communities effected. I hope that those who don’t support her candidacy will be able to hear through the noise to the important message she brings about the harms of medicating away distress.

  • Sera, thank you so much for this. I was overcome with emotion reading this, not because of the level of graphic detail you shared, but from the sheer power of you speaking and owning your truth and not shrinking from the horrors of it. I do regularly find myself self-censoring, reminded of the many many times when I’ve been admonished for being graphic and “painting a picture”. It is so inauthentic and robs me of being able to express the enormity of the horrors I experienced so others may remain insulated in comfort (often people who weren’t themselves traumatized, but merely don’t wish to confront the horrors others experience.) Thank you, again.

  • If anyone wants to know what is really going on that is driving the xenophobic and racist public attacks we’re seeing more and more of, let me tell you a story.

    My parents retired to a small town in Appalachia the year after NAFTA went into effect – 1995. At the time, manufacturing was already beginning to suffer, but there was still a robust manufacturing sector. But over the next few years, one by one the textile mills shuttered, then the furniture factories, then eventually a few years ago even the local pressboard plant finally layed off its last workers. Meanwhile, the migrant labor that had settled into the area to work the tobacco farms, also found itself with fewer jobs as the tobacco industry waned with fewer people smoking.

    NAFTA was supposed to provide job retraining, but the jobs that replaced manufacturing jobs were not of the same quality, weren’t unionized, didn’t provide benefits, paid only just above minimum wage. And then ironically, as they were mostly call center jobs, these jobs have also started to go away – some offshored to India, but also to the much more exploitable prison labor industry. So you started to see this really extreme economic hardship enveloping the area, which coincided with welfare reform going into effect in 1998. First take people’s jobs, then starve them. What could go wrong?

    In the small town my parents lived in, the local migrant population pooled their funds and opened a Mexican restaurant. A local white man, whose daughter had married a Guatemalan, opened the Guatemalan Coffee Shop. This in a town which already boasted a yearly KKK parade. So the stage begins to be set for someone like Donald Trump to come in, and despite people’s actual knowledge of the sequence of events, they now have a scapegoat and a boogeyman – Central Americans. Then candidate Trump campaigned on reversing NAFTA and bringing back the jobs that had made the area, if not quite prosperous, at least not destitute. He wanted to make America great again, and the way to do that was to drive out these “invaders” – immigrants, but specifically Muslims and those being driven north from Central America (also ironically due to US policies of interventionism and destabilization).

    If you look around the country to the other rural areas experiencing similar economic hardship, you see a similar pattern. Michigan is a very good example because of the Muslim population, and again, the closing or downsizing of the auto industry. Drive an hour from the coast in California and you arrive in Trump country as well, with whites feeling “invaded” by the gang violence in the cities that they see driven by people coming from south of the border. Everywhere you go, there is economic hardship from the drying up of jobs, and that provides the fuel for the hatred and othering of people who don’t look you. It has also driven suicides, divorce, families losing children. And it has come from a mix of economic policies enacted by people on both “sides” of the aisle who won’t feel their effects, and now by a president who has spent years inciting racist, mysogenistic, but especially xenophobic violence at every turn. Trump thrives on this.

    And then what do we add to this toxic mix of class warfare and fomenting hatred? Guns with the ability to mow down large numbers of people. It is true that these incidents increased after the FAWB was lifted in 2004. It’s also true that they increased again substantially when Donald Trump’s rhetoric ramped up to a fever pitch in 2015. What has changed is that “mental illness” is beginning to be known for the boogeyman it is, and with Donald Trump being an easier target politically, the elite liberals who had been pushing that narrative for two decades have begun to change their tune. And so with the advent of the Trump presidency and Muslim bans and calls to stop the invasion by building a wall, the rhetoric has been exposed for what it is. But you cannot fully understand how it has reached such a fever pitch without also understanding the class warfare that was started under Clinton with NAFTA and other trade agreements, that has put so much of America’s heartland into abject misery and destitution financially, and at complete odds with the coasts and it’s educated liberal elites. This is a toxic mix that will not be fixed merely with another assault weapons ban – especially not with the AR-15 being the most popular gun in America, and with this country having more guns than people.

    We have gone about addressing gun violence as if it were the guns that were the issue. And gun reforms did significantly lower the number of suicides completed with a firearm among those with a history of treatment for “mental illness”. But the suicide rate itself continues to increase – with euphemistic names like “deaths of despair” so nobody has to call out the actual cause – this is especially true among middle aged white men who have lost jobs, lost ability to provide for their families, lost face. Now we see headlines about the increases of successful self-poisonings, and we must surely know that eliminating guns won’t eliminate the misery that drives violence – toward self or others. If we cannot or will not attempt to address the underlying causes of mass violence, we are simply, as I said above, putting bandaid on a hemorrhaging wound. This is an effect of end-stage capitalism that creates massive inequality, of austerity policies that punish the poor, and of intentionally divisive hate-filled politics that we are only unable to ignore under Trump because he’s brought it out into the daylight. Ban the guns, but I’m warning you that hunger, joblessness, homelessness, and shrinking net worths are going to have to be targeted to make a real difference in stemming the rates of violence. Incidentally, we’d do a lot of good for the nation’s “mental health” by addressing these underlying factors as well.

  • Rachel, this is especially true among highly educated affluent suburban liberals, which have made up my social circle for most of two decades. A classic response to requests for support are “That sounds like a topic to discuss with your therapist.” Often delivered quite derisively because you’re supposed to pretend everything’s ok, and you’re not welcome at gatherings if you can’t play along. There’s no crying in your mimosa at the country club, got it? (I’ve only been to a country club once, so a slight exaggeration, but still. :))

    The biggest loss I have sustained in terms of supportive community though was leaving the church. So many times I’ve considered pretending to believe just so I could access that support network I lost. But the last church I went to was in rural Appalachia (read: poor people who stick together) and I’ve never gotten the impression that the same kind of solidarity exists among folk who can afford to pay others to fix their problems.

    I have recently begun exploring the topic of Intentional Community, which I’m beginning to believe may be the best path toward a more sustainable and cohesive future. Rachel, as hard and painful as it’s been for you, I do sometimes envy the support you’ve expressed that you’ve received from your parents.

  • “they can’t even get inside people’s heads and find out if the problem you have with noisy neighbors is real.”

    It’s interesting you mention this. My mother-in-law is currently dealing with a similar situation with an extremely noisy neighbor who began targeting her with loud music in the middle of the night after she made noise complaints to her council rep. After almost a year of this, a couple of council reps visited her house a few weeks back during the heatwave that hit England and Europe. In northern England, air conditioning is rare, and my MIL had the curtains drawn during the day to try to keep out the 90 degree heat. What did they ask her? “How long have you been depressed?” They assumed she was depressed because she wasn’t running heat generating lights and she had the curtains drawn trying to survive the heat. Thankfully, she’s a firecracker and read them the riot act about how they were young and better able to tolerate the heat, and also how they had just exited their air conditioned car. But, we’ve seriously considered whether my husband will have to make an international flight home to England to straighten this out before she completely cracks up under the abuse she’s taking. It never fails to surprise me how people who are targeted by malicious actors end up being accused of being crazy. The elderly especially seem to get no empathy and find themselves diagnosed as depressed or demented and put in nursing care instead of receiving the legal assistance and advocacy they need and that is their legal right.

  • Bob, how would you address the 3D printing technology that allows people to simply make their own guns, including assault weapons, bump stocks, etc? One can outlaw this but it would be extremely difficult to enforce. I personally think gun control does not really address the root causes of mass violence, and merely puts a feel-good bandaid on a hemorrhaging wound. (Not that I want guns myself, having been a victim of gun violence.)

  • I would strongly caution against confusing anger and hatred. The pathologization of anger leads to silencing of victims whose anger is legitimate and anger can lead to emotional growth once one reaches the other side if one has safe and appropriate outlets for its expression. Anger can be momentarily threatening, but it also tends to be emotionally and physically exhausting, whereas hatred is energizing, leading to intense feelings of needing to act. While racism, xenophobia, mysogeny, etc can produce intense feelings of anger, it is the ‘othering’ and FEAR that leads to what amount to cold, calculating attacks on generally very specific targeted groups. I found a good article that explains the difference between hate and anger that you might find informative. In that article, he links to another article about hatred in politics, which I think does a good job of explaining how “both sides” participate, though the hatred coming from liberals tends to be disguised more in shaming terms, but is just as vitriolic.

    http://www.afterpsychotherapy.com/anger-vs-hatred/

    I would also suggest that hatred, fear and “othering” are what are driving the political/media/public ‘attacks’ on the so-called “mentally ill”, and so we need to guard against joining in such when we’re in a position to educate people on just why we aren’t the dangerous boogeyman we’re being portrayed as. It is precisely living in a fear-based society that is driving more and more violence, and we need to all be working to dial down the rhetoric and create dialogue and understanding between groups. Our leaders won’t do that because they thrive off of dividing us and fomenting hatred to begin with. It’s going to be up to us The People to do this work. One way we might begin to accomplish this is by refusing to participate in the Us vs Them that occurs in antipsychiatry activism, by remembering that many practitioners are themselves current or former patients who have been taught to believe the things they do about “mental illness”. Things that have been learned can be unlearned. We can extend compassion toward those who have harmed us. I believe this is the only way we will bridge these divides.

  • Suicide is absolutely not a senseless tragedy. It’s the last act of rebellion some can manage. The surviving “family” and “friends” who tut tut and wonder what they could have done are covering for their own complicity.

  • Thank you, Bob. These are frightening times. It’s so hard to get past all the emotion-fueled rhetoric and remember that innocent lives hang in the balance. With concentration camps once again occupied inside American borders, I’m not sure any of the labeled can feel safe. And lest anyone blame Trump and republicans, please see NY Gov Cuomo’s call for “mental health databases”.

    Obama’s targeting of psychiatrically disabled was specific to those who benefits are managed by a representative payee. There are no cognitive tests for such placements and indeed many of us who have received disability for a psychiatric diagnosis have started out with a representative payer for the first year. Trump, for all his problems are legend, was right to repeal this regulation and we need to remember not to get caught up in Right vs Left ideology when politicking tragedy and making reactionary laws based on fear. The calls for new antiterrorism laws are just as flawed and will mean more surveillance, more police force, and more restrictions on liberties cast in drag nets.

    If we really want to address the deep psychological scars blanketing this country, we must address austerity and capitalist oppression along with hateful ideologies that are fueled by fear and class oppression. And we mustn’t forget that our leaders are actively dividing us.

    We must rise in solidarity ready for fight for freedom against tyranny regardless of whether the oppressed looks like us.

  • The headline is misleading. The cohort studied were patients that had been psychiatrically hospitalized, and then were followed up at specific intervals. But they could just as easily have been patients in the community taking psychiatric drugs and followed up at the same intervals *if those records were available*. There is not even a correlation established between hospitalization and cardiac death because in order to do that there would have to have been a control group of non-hospitalized psychiatrically drugged patients followed up at the same intervals, and an increase in cardiac deaths seen *only in the hospitalized group*.

    In addition, the researcher bias is extremely strong with this statement:

    “The reasons for elevated rates of natural deaths among the seriously mentally ill are thought to include the side effects of psychotropic medication, self-neglect, lack of self-awareness regarding lifestyle behaviours influencing physical health, addictions such as smoking and alcohol, poor diet, diagnostic overshadowing of psychiatric conditions over physical conditions and under-treatment by medical care providers.”

    Pt complaints about side-effects are routinely dismissed, even as the patients balloon in weight, develop metabolic and cardiovascular diseases. Self-neglect is often a direct result of receiving neuroleptic drugs which are known to be neurotoxins that adversely effect cognition. Self-neglect is also perceived on the part of treatment staff who misinterpret the presentation of extreme poverty as poor self care. I can assure you that even people with so-called “SMI” are aware of the benefits of a good diet, of exercise, and of meditation/yoga/mindfulness/stress reduction etc. My favorite was when I was told I needed low impact exercise like swimming and tai chi. 😀 Where, dear doctor, do you suggest I obtain the magical funds to pay for all of this when my rent is more than my monthly disability check and I’m shopping the empty shelves at the food bank – hoping for ramen but coming away only with Easter candy this week. Nicotine addictions are known to be exacerbated by neuroleptic drugs so how fucking dare you. Alcohol and other drugs are used to cover up the pain of trauma – both the childhood variety and the adult “if you can’t slave for capitalism, you can rot in the streets” variety. And diagnostic shadowing of psychiatric conditions over physical conditions and poor medical care? You mean like undiagnosed Lyme Disease and wholesale dismissal of physical complaints as somatic?

    This is one of the most glaringly unscientific and victim blaming tropes I have seen on this site in a while. Please stop promoting pseudoscience as legitimate research,. You’re torturing the data!!! The only serious takeaway from this study is that psychiatric treatment has serious adverse long-term effects and the research, medical and political establishments are entirely blinkered on their participation in the continued mistreatment of those labeled as “seriously mentally ill”.

  • I have found that the language and concepts of indigenous cultures come closest to aligning with my values as a child of the Earth, of my Mother that created and nourishes what is left of my root system.

    I had an ugly cry this week when I read about the “zombie” kauri trees of New Zealand, who are connected through their root systems such that trees that are cut down act as living reservoirs for the remaining trees. My spirit died many years ago when I was cut out of the forest by medical doctors and my stump was placed on life support. I’d like to think that I was turned into a table or maybe a beautiful carved object, but in reality I am still essentially dead. My culture’s only intent with treatment was to cut me off from my roots and make an object of me – a tool to be used as the colonist does with all natural objects he doesn’t understand, such as himself.

    All of our attempts to defeat nature, to remove ourselves from our origins, from our connection to spirit and soil and the forces that sustain us, they are only digging our grave as a species.

    I am kauri.

  • The real problem here has been identified and that is that medical diagnoses are not the same as identities. No one can argue with how you identify. Identities are personal and generally not up for debate. What is up for debate is whether a discreet diagnosis called autism spectrum disorder exists. As much as you identify as autistic, that is not in any way proof that your symptoms are any more neurologically distinct from anyone else with autistic-like symptoms. I can easily see myself as a young child being labeled with aspergers or PDD were I raised in anything approaching a normal family with people who cared about each other. I was instead labeled as emotionally deficient. My doctor instructed my parents to not allow me to cry, which resulted in meltdowns because my siblings would tease me when the parents weren’t looking or around. My meltdowns were attributed not to neurological dysfunction but to being spoiled. And I was punished with cruelty, as many kids who don’t express themselves in culturally appropriate ways are. It makes no difference whether you call this marginalization autism or bipolar or cultural deprivation. All label the individual as pathologized and all the neurodiversity movement accomplishes is taking a single diagnosis out of the bucket and leaving everyone else to continue being punished by a cruel society that does not tolerate differences. I think that’s a special kind of cruelty perpetrated from within when a harmed population differentiates themselves as different from the other crazies. That not solidarity, that’s abandonment.

    From my perspective, the neurodiversity movement is a shameful differentiation from and othering of people with “mental disorders” on the same scale as the sleight of hand the LGBT community (which I consider myself a part of) pulled first with the gay population and then transgender identity ideology. There’s nothing noble about saving yourselves at the expense of others with overlapping symptoms but a different label.

    I have three family members labeled on the spectrum. I have “symptoms” of autism. I have genes supposedly associated with autism. But it’s a meaningless diagnosis that overlaps with most of the other mental disorders, as they all do. My daughter was labeled with RAD solely because it’s popular within the adoption community to blame a child’s lack of attachment to the adoptive parents on the first parents. What is a differential diagnosis for RAD? Autism. She would make four family members so labeled on the spectrum but it’s easier to blame me. Aren’t labels fun? The context of the application of these labels matters!!

    Identities aside, we must be able to debate the existence of specific labels in an educated and reasoned manner without having the conversation shut down because it’s threatening to those so labeled who find their specific label helpful. I’d ditch the trauma label if I didn’t live in a society hellbent on piling more traumas onto the already traumatized. Acceptance of personal differences in how we perceive and interact with our environments should come as a matter of course in a polite society, and not only to those whom we believe to be wired differently.

  • I just want to point out that the RDoC is not something to be celebrated just because it rejects the DSM. A fundamental fatal flaw of the RDoC is that “mental disorders” exist as discreet entities and have a biological basis. Otherwise, it is little more than a pissing match over which disorders are legitimate and which are due to mission creep. The emerging data implicates the gut far more than the brain, but you wouldn’t know that by reading the RDoC’s agreed upon terms and calls for a “new nosology”.

    “A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,

    Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,

    Each level of analysis needs to be understood across a dimension of function,

    Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.”

  • It seems to me that the diagnostic system hangs on largely due to payment systems that require labels to justify a level of severity of illness and need for more extensive intervention because we have a profit-driven healthcare system (something current Medicare for All campaigns fail to address). Not only that, we have a disability system that is strongly tied to diagnostic labels to determine severity of “illness”, and ability to earn taxable money. And a media that reinforces cultural notions of a special class of “mentally diseased” people that is really a veiled effort to justify increased policing, mass surveillance, and targeting of people for special lists because the NRA wants us to believe gun violence is solely caused by “crazy” people.

    We have a constitutional right to an education to prepare workers for our profit-driven economy, but there are no core rights to housing, healthcare and food, and our culture is so completely blinkered by notions of merit that not dying homeless and diseased in the streets is considered a right only of the able bodied and strong minded.

    Psychiatry currently serves to reinforce these notions (meritocracy) and until it’s willing to reconcile with its position as an enforcer of the profit-driven version of normality – and the (re)normalizing of debt bondage and serfdom – by pathologizing the normal response to trauma/adversity (at any age), there’s going to be little progress.

    We all do suffer under this system. Most of those of us who get labeled as SMI however have a history of trauma and have been punished by the system for our natural responses to it. My personal experience was that my traumas were blamed as the environmental influence that “triggered” the so-called genetic disease of “Bipolar” that conveniently manifested only after I’d been drugged with an SSRI for the somatic illness of “fibromyalgia” – the symptoms of which I now know to have been caused by Lyme disease. Talk about getting screwed at every step!

    Psychiatry as practiced in the West is a behavior control system with payment based on how sick the doctor can make the patient appear. This will not change until it is no longer profitable to disease the patient. The Finnish healthcare system is ranked among the best and most egalitarian in the world and the American system among the worst of developed countries. We need to look beyond psychiatry to understand why our American healthcare system is failing and the role psychiatry plays in maintaining the status quo for profit if we want to understand why the (zombified, in my opinion) disease model of “mental illness” refuses to die, even in the face of decades of evidence of its failure.

  • Prosecuting parents actually makes things worse for most kids. Foster care is almost universally traumatizing to kids. It further breaks delicate and damaged familial bonds. Kids are equally likely (if not moreso) to be physically and sexually abused in foster care. Group homes that so many teens end up in are not a better solution, as kids can experience violence from both other kids and (universally low paid/low educated) staff.

    Have you personally experienced foster care or a group home? I’ve experienced foster care, group homes, child psychiatric units and the juvenile justice system. The biggest risk factor for being justice involved is time spent in foster care. The universal condition for those on death row is foster care.

    We need to be responding to harm to kids in ways that reinforce and strengthen familial bonds. We should not be delivering children into the hands of child abusing foster carers and congratulating ourselves for getting them out of harm’s way.

  • Precisely. Like suggesting ECT for intractable depression that later turned out to be caused by Lyme Disease. They have such extreme tunnel vision treating symptoms that they have no concept of considering etiology. I’m still waiting for an explanation of how jolts of electricity to the brain are supposed to cure an infection… They’re playing Dr freaking Frankenstein and passing it off as evidence based medicine.

  • What I find incredibly sad is how many people object to the separation of refugee parents and children but are always so ready to separate parents and children for perceived mistreatment or neglect rather than respond in ways that strengthen family bonds and teach skills or otherwise provide opportunities for success for parents. The devastation of separation happens to kids in foster care who are often removed for incredibly dubious reasons from parents who often need little more than economic help and education. We need to respond as a loving supportive community, but we’ve been blinded by a system that marginalizes struggling populations.

    The refugees that are arriving on our borders are victims of the same systems of oppression that citizens continue to suffer under – mass surveillance, a chronic state of war and interference in other countries affairs, wages for capitalist labor only, and a value system that rewards those who trample others on their way to the top. This isn’t sustainable and breeds the criminality and dysfunction it purports to attempt to stem.

  • Humans are animals. Only cultural forces – driven by religious and patriarchal oppression – teach us that our naked bodies are shameful and should be covered for reasons other than warmth. Men can expose their breasts regardless of how much breast tissue they are endowed with but women are barred by law from doing so in most places in America, and are even still being thrown out of public places for breastfeeding. There is no basis for this other than cultural mandates that bodies be commoditized for the sale of products and the control of the population. This commoditization of our bodies actually feeds the shame and secrecy that child sexual abuse thrives on.

    Any trauma that might occur to a child from seeing a naked man howling at the moon is going to be augmented by the response of the adults around. If the adults respond nonchalantly, calmly removing the kid from the scene and then allowing a safe dialogue about what the child witnessed, the kid does not learn to fear such aberrant behavior. But if the adult responds with shock, incredulity and horror, the child learns that such behavior is to be feared and controlled. In any case, absent other harmful behaviors in the environment, there’s nothing especially traumatizing to children about seeing nonsexualized naked bodies. As with everything else, these responses are cultural and socialized into us.

  • Capitalism did not exist as a word in 1776 nor did the key tenets of western socialism or communism which were ideas borne of later philosophers, but most of the founding fathers were definitely pro-commerce and profit. Alexander Hamilton was a successful wealthy businessman. All were for the protection of private property (land capital) which is essential to the core of capitalism. Many did advocate for man being able to keep the fruits of their labor, while at the same time being slave owners. It’s pretty difficult to make an apples to apples comparison with end-stage capitalism as currently exists but the core concepts certainly were promoted and practiced by the founders.

  • “I don’t think that people always know what’s best for them.”

    We totally agree. I don’t think that people always know what’s best for them. As Steve said, not by a long shot.

    In terms of which treatments a particular patient finds therapeutic however, I think the individual is absolutely the first and best authority of what they think helps and what they think does not.

    I’ve witnessed anosognosia caused by a stroke. Very very few people in the depths of a crisis fit the medical definition for such. Patients complaining of severe side effects, or saying their medications don’t seem to help them, or would prefer “psychosis” over total numbing should be trusted as the first and best authority on themselves. Knowing what works for you in terms of “mental health” “treatments” is not the same as knowing what’s best in any broad or general sense. Driving people to suicide because we don’t listen to them is kind of counter productive, no?

    As for myself, I was also similarly prolific art-wise while on a similar combination of meds. For me it was Seroquel and Concerta. Most of my paintings are dated from 2008-2010. I miss it surely. But my creative side is now expressed in writing. And I can math and science and logic again, which I just couldn’t do on the medications.

    It presents an interesting dillema. Do I acknowledge deeply depressive tendencies and console myself with a deep dive into quantum physics or do I drug myself into a creative stupor. Clearly the author can still express herself well even while drugged to a state she prefers. But for me, language and logical expression were the trade off for my creative abilities and fewer depressive symptoms.

    But just as she is free to make that choice for herself, so am I to say it’s not for me but good for her. I’ll still lobby for new prescriptions of these meds to be banned even while I support the decision of people currently taking them to continue.

    There is a lot more nuance to consider than just whether someone knows what’s best for them. Because unless they’re having a stroke or so disconnected from our plane that they’re harming others, we should generally trust people to know what works for them and stop worrying about whether or not they do what we think is “best” for them.

  • She wasn’t “sent” to learn from them. She is Maori and became a psychiatrist so she could exercise the power to change the system from within. This is exactly what feminism was supposed to achieve – dismantling systems of power rather than simply joining the powerful men in their ranks. Dr Kopua is extraordinary no matter how you deconstruct this. The work of indigenous women standing up not just to patriarchy but to colonization should be widely celebrated.

    That it’s still called psychiatry should matter to no one. If the prescribing ends and the systems of control and harm are transformed into life-affirming, humanistic ways of being with those in distress, I will support it no matter what it’s called. This is not critical or reform but true revolutionary change from the inside.

  • I have wondered for some time of the true reason insurers are reluctant to pay for “mental health” services is because they know the dismal facts about the “medications” as well as knowing that there is no real legal definition of what psychotherapy entails. The quality of services provided from one practitioner to another is not in any way similar. I’ve personally gone months at a time – several days a week – and talked about current events, the weather, politics. Medicare and Medicaid will pay the practitioner regardless of whether they actually help you get better. But private insurance expects medical care to actually do something to make you better and to follow some kind of evidence base.

    It will be very interesting to see how this plays out if Medicare For All is enacted. I know that the time and quality of therapy that Stern got will still not be available to all of us. There is nowhere in the world that I know of where the government controlled single payer healthcare system pays for this kind of care.

    There is also the underlying assumption that the ways the person is behaving are dysfunctional. Howard Stern made an awful lot of money being a professional a$$hole. Would he have been such a colossal Jerk if that hadn’t been so lucrative? I’m sure he can make money just off of his fame now so the old Jerk routine wasn’t needed. Did he really need thousands of hours of therapy to learn how to be nice? I think we should be very careful not to conflate the seriously traumatized who could benefit from intensive contact with a caring listener with sociopathic people who profit off of harmful personalities and then play mea culpa while advertising on talk shows for their professional guru. If Alex Jones suddenly started touting the benefits of therapy, I’d be similarly skeptical of what he was receiving and why he was promoting it. These people are essentially actors after all. And famous. I don’t think anything they say is applicable to the average person.

  • ADHD does not exist, just like all of the other slurs in the DSM. A better use of research time and dollars would be spent. Research and reporting like this reinforces the idea that ADHD is a thing that teachers need to be educated about.

    The right to a childhood is not guaranteed in the modern pursuit of wage slaves for capitalism. Children are in forced education camps and made to earn funding for their respective schools, whether it be voluntary or after they are medicated into compliance with the dominant paradigm. If that doesn’t work, they can be declared disabled and put in special ed where they no longer have to perform for dollars because the expectations are lowered. Kids who can’t comply with this system are screwed.

    This breaks my heart. Why aren’t more people standing up against this relentless assault on American childhood? Please read Last Child in the Woods by Richard Louv. Almost all of us are suffering from Nature Deficit Disorder as we pave paradise and forget we are animals.

    RIP humanity.