Monday, September 24, 2018

Comments by kindredspirit

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

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

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

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

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

  • Mike,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    Precisely.

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

  • I have a different explanation.

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

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

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

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

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

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

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

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

    And

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

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

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

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

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

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

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

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

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

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

  • Here’s a helpful start:

    Old headline:

    Unsafe use of zolpidem sleep drug common.

    New headline:

    Unsafe prescribing of zolpidem sleep drug common.

    Old byline:

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

    New byline:

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

    Fixed it. You’re welcome.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • “Nobody was ever labeled “mentally ill” for committing suicide.”

    Sorry, I have to call bullshit on this. People are labeled mentally ill posthumously as a matter of course these days. It is one of the points the author makes. It is one of the most common ways to dismiss any collective responsibility for the deaths of those who take their own lives. On a societal scale, from the government to media, to the mental ill health profession, to our families and friends and community structures, we cry boohoo about the tragedy of mental illness rather than do anything constructive to change the power imbalances that our “civilization” is built upon. Honestly, having followed your commentary for quite some time now, it seems that (most of the time, at least) you do fully grok the power structures that keep the masses in misery. And yet, you present this totally dismissive, damn near sociopathic response to those who ultimately succumb to these unrelenting pressures. Your inconsistency is utterly bewildering to me.

  • It has come to my attention privately that this comment has caused some concern. Please forgive me for speaking too frankly about my own experience of late. Please don’t send help – I’m not jumping off anything. I’ll try to be more clear about that in any future comments. I was simply commiserating with the idea that (what I call) positivity bullying is harmful. Again, sorry for any confusion.

  • Well, no, I don’t think you’re quite presenting my viewpoint correctly for a simple reason: I completely agree with you that we should be free to choose our associates and that if people don’t want to be around me because I often have a negative attitude, I’m fine with that. I have a negative attitude because we live in an upside down world with clear winners and losers and a ridiculous amount of competition in a society that values individualism and an economic system that promotes the idea of false scarcity of resources rather than acting together for the common good. But, besides that, I honestly can’t stand being around incessantly cheerful people and I think that should be my prerogative. I don’t like spin doctors and would prefer to make space for those in deep pain and grief than to listen to someone talking about what they learned from x or y painful experience. I’m absolutely sick to death of the “inspiration porn” genre and I’m nearly always tempted to deck people who reduce my suffering by calling my survival story ‘inspirational’. (In just the last week, I saw someone use Viktor Frankl’s seminal work Man’s Search for Meaning used as a weapon to shame someone to stop talking about their suffering.) So to reiterate, I don’t think it’s about tolerating any and all behavior (short of abuse) or personalities that you find grating but more about stopping the shaming and blaming of those who dare express their suffering. And for goodness sake we’ve got to stop telling people to reach out and then turning around and shaming them when they do.

    Your meditation instructor has clearly got a chauvinist streak. What a pathetic way to dismiss you in the moment. I’m sorry that happened to you. I hope you were able to either express how inappropriate that kind of commentary is to the instructor or else find an instructor with an actual understanding of how meditation can effect survivors of abuse. In my class, we were told in the first intro session to expect that we could have overwhelming feelings come up or cry and not to be embarrassed or ashamed if that happened.

  • Thanks for your reply however, I think we are talking past each other here.

    No one would suggest that abuse be tolerated. Or that someone actively being abused should humanize their abuser. The context of the article isn’t about abuse and that’s what I was attempting to point out. The context was the tendency for negative people to be labeled as toxic and dumped. When in fact, those negative people are usually the victims of abuse or otherwise tragic circumstances and that labeling and dumping is tantamount to abuse. And it’s done on a very wide scale.

    “Don’t be a negative Nancy.” “Look on the bright side.” “Find the silver lining.” We are conditioned from birth to suppress negative feelings and this is especially harmful when the negativity is the direct product of abuse. This was the point of my post and my comment about humanizing people was specifically about the labels we put on people. Again, not to dismiss or make excuses for people who are actively being abusive because abusiveness and a negative attitude are two very different things. I hope that clears up any confusion you may have had about where I was coming from.

  • Context is important and I don’t think the author is referring to abusers when she says it’s wrong to label people with negative attitudes as toxic. But even in such instances as an abusive person, we have a tendency to stick labels on people and condemn their entire being “abusive”, “crazy”, “bipolar”, “moron”, “lazy”, and it would behoove us to relearn how to see the whole person. Yes, there are people who will be nasty and abusive and overwhelmingly harmful but we can often see the rest of the human being behind those labels with a little effort. And even among those people who have committed atrocious acts, we understand the human ability to grow and learn. If we didn’t, what would be the point of prison for murderers (or those guilty of other unthinkable crimes?) If we adopt the position that humans are incapable of repentance and change, we might as well simply execute violent felons immediately upon conviction. In my own path to healing, I’ve learned to find ways of humanizing those who have hurt me. I think that’s something most of us need to make a harder effort to do.

    Your link, by the way, references Michelle Carter, whom many of us understand to have been a victim herself – of psychiatry, of the boyfriend she was accused of driving to suicide, and of an overzealous prosecutor who tried her in the court of public opinion with much vitriol (and through distorting the evidence) long before she had even had her day in court.

  • In my experience recently it doesn’t matter whom one reaches out to – a family member who pretends the phone line is staticky and hangs up as soon as anything distressing is mentioned, the friend who only responds to good news, the fellow psychiatric survivor who says “it sounds like you need someone to talk to” with the implicit (just not me), or the acquaintance who responds to your distress with “when will you just be happy?” This isolation is what drives suicide. You don’t have to be actively suicidal or even depressed to contemplate what the point is in continuing a life that is completely meaningless and bereft of anything approaching personal significance and belonging.

    I think the most shocking statement I hear when someone successfully takes their life is “if only they had reached out for help”. I don’t think my experience is particularly unique and so I’ve come to believe that for the majority of those who suicide, they did reach out and the rejection was so profound that they were actually driven to suicide by the collective responses to their pain.

  • Hey Julie, that’s exactly how I lost my friend group – Facebook posts about my struggles. My friend group even ostracized my boyfriend (now husband) for dating the crazy girl. Luckily he dropped them and kept me. He helped me get off the meds and away from psychiatry. They would have let me rot in an institution. I’ve since decided with friends like that I don’t need friends.

  • I had this experience after having a naproxen script filled last year while on vacation. Prescribed by an urgent care doctor, only ever took two of them, for a temporary injury, but I got calls for months reminding me to fill them. I got around it by blocking CVS 800 number on my phone.

    Further, this is quoted verbatim from my mother:

    “I knew this from personal experience, though it wasn’t connected to psychotropic drugs. When I was released from the hospital in January after surgery, I was given multiple prescriptions. (Nephew) arrived so late to pick me up that the only place I could get them filled was at the all-night CVS near the hospital. I started getting almost daily telephone reminders that I needed to renew my prescriptions. I finally got fed up with it and called the pharmacy to tell them to stop already. They said that the calls didn’t come from them but from ‘headquarters,’ and gave me a long distance number to call. That took care of the calls, but at my next doctor’s visit, the nurse commented that I had not had my prescriptions refilled, even though she must have known these things were only for temporary post operative use. It has taken me all of the five visits I’ve had to this practice to remove from my records the multiple drugs that were prescribed either for temporary use (10 days) post surgery, or to use as needed. One of them is available OTC and so I never had the prescription filled at all. But CVS kept yammering at me to get it ‘refilled’ and notified the doctor’s office when I didn’t. Your sister asks why I put up with the local pharmacy’s inconvenient hours. Because they don’t share my prescription information with anyone, for one reason.”

  • I was with you until you trotted out the drug war propaganda. Thank you for actually using the word poison to describe psychiatric drugs. Few people, especially doctors, possess the cajones to call psych drugs poison, so kudos.

    Cannabis on the other hand is not only neuroprotective, it’s extremely useful in easing the withdrawal symptoms caused by a range of neurotoxic legal pharmaceuticals such as psychiatric drugs, opioid painkillers and Zdrugs. http://norml.org/component/zoo/category/cannabis-and-the-brain-a-user-s-guide

  • Excellent analysis and rebuttal of the book. The last paragraph which mentions questioning his voters’ mental health requires addressing. Repeated surveys from Gallop report that Republicans have higher rates of mental wellness than Democrats. Even when demographic factors like race, income, and educational level are controlled for, right-wingers report being happier than lefties and utilize psychiatric services at lower rates. So which side is crazier? Can’t we just admit that different folks have different values and that doesn’t make them crazy? Selfish perhaps but not crazy. Trump’s voters voted for the guy who said he’d bring jobs back, bring God back, and make America great again. They looked beyond his behavior and voted in what they believed were their best interests. FWIW, a lot of Clinton voters overlooked all the flaws Bernie Sanders illuminated about her/establishment Democrats during his campaign and they voted for her in their own self interests. It’d be nice if we could focus on the fact that Trump is a bad man instead of maligning him as a mad man. It’d be nice if this means to an end crap would stop. Anyone could be psychiatry’s next target. It’s up to all of us to stop the stigmatization of those with altered experiences and instead focus on holding individuals accountable for bad behavior.

  • Somehow this topic (risperdal-induced male breast growth) is new to me and I’d thought I’d heard it all. The images are shocking. What’s even more shocking is that the effects of the drugs are called ‘side’ effects. Can we just call this one of the actual effects of intentional poisoning once and for all? If J&J knew this was an effect, why do doctors and parents need to be warned about the risk? Why hasn’t the drug simply been withdrawn and acknowledged as a dangerous substance with no value except to those whose only goal is a zombified “compliant” child? When are the doctors and researchers going to acknowledge that in many cases, changing the parents behaviors would have more desirable long term effects than pathologizing the child’s reaction to trauma and dysfunction?

  • No, not medicating, and not drugging. Let’s call a spade a spade – these substances are nothing short of poisons. The antipsychotics originated from the pesticide industry with phenothiazine – in fact, it is this antiparasitic action which made it effective against malaria. It’s derivatives include Thorazine and Mellaril among others. Phenothiazine’s discovery as an antipsychotic came during human toxicity testing by the pesticide industry, and is what led to the development of Thorazine. So let’s be very clear that these substances we call “drugs” were originally intended to be poisons and the neurotoxic effects are to be entirely expected.

    Thorazine never treated a medical illness, and it took decades of research to discover how it “worked” to disturb the sensitivity of D2 dopamine receptors. All it has ever truly done is tranquilize people and therefore produce acceptable behavior on psychiatric wards. These drugs – all of them – have never increased any objectively measurable outcome of success in people’s lives – stable employment, independent living, good social connections – they simply made them more compliant patients – at one time making them more manageable in institutions but now making them more manageable by families, most of whom are the source of the traumas that caused the initial distress. This is much to the chagrin of the NAMI Mommies who want to claim they aren’t responsible for their children’s “illness” because it let’s them off the hook. Fake families pretending to be concerned about their family member, often said person turns out to be the Identified Patient whom the family dysfunction is blamed on.

    The whole industry is sickening when you break it down, but to call these poisons medicines or even legitimate drugs really takes the cake and is sadly what keeps the whole carnival show running. The researchers, doctors, and treatment providers handing out the magic pills don’t want you to see what’s behind the curtain. Don’t be fooled by what is essentially modern day sorcery masquerading as medicine. They’d have better results with laying on of hands or speaking magic incantations over us than they have by drugging us.

  • Cat there are times when I agree with you, and I’m certainly alarmed by Public Citizen advocating for more forced treatment. But I don’t want to live in a world without regulations making sure that large corporations don’t harm me and others. I am sympathetic to the libertarian position up to a point, but regulations exist for a really good reason. I don’t ascribe to your viewpoint that leftists are responsible for this. If libertarians got their way, we’d have no protection at all from corporations (and individuals) who do serious harm.

  • Hi FD, I hope you will take a look at some of the research regarding the brain-gut connection and bacterial imbalances in the gut. 80% or so of our neurotransmitters are actually produced in the intestines, not in the brain. This is the enteric nervous system. I have found enormous benefit from months of probiotic and prebiotic loading – both in the form of daily supplements and lactofermented foods, which are expensive to buy but can be cheaply and easily made at home. I believe it would go a long way toward helping you prepare for your next taper. Let me know if you’d like more info.

  • These stories are incredibly sad and in some ways mirror how the drugs often made me feel. I’ve tried to warn others. I don’t know how better to do that than to be a shining example of recovery after ditching the drugs. I get told so often “you are a totally different person and doing so amazing”, I’ve been called “unrecognizable” from just a few years ago, and then they tell me what new psych med they’re on or offer me some of their xanax. One woman I know recently started a sentence with “all the researchers and psychiatrists agree that…” I’m at a loss as to how to get through to these dear friends how dangerous these drugs are. I’m afraid most of the people I am in close contact with worship at the alter of science and medicine and see me as some sort of statistical outlier or miracle case rather than having been injured by the drugs, and the drugs being harmful. I’m sure a few of them are still waiting for my inevitable fall, as it was so kindly described before I began tapering, in order to welcome me back into the fold. The warnings seem to go in one ear and out the other. Rather than steeling my resolve to keep speaking out against these drugs, it just makes me so very sad.

  • I took gabapentin for well over a decade for supposed fibromyalgia. While it does cause physical dependence and I became very ill trying to withdraw – several attempts resulted in gabapentin withdrawal syndrome -, I *never* got high. I can’t even imagine it making someone high. I’m trying to but drawing a blank. In fact, my doctor bent over backward telling me how benign it was when he first prescribed it. What are they doing, snorting it? I’m still struggling to see how it could make someone high.

  • Agreed. I too had a very easy time getting off benzos and pretty easy time compared to others getting off the rest of the drugs. But the horror stories I’ve read of people experiencing withdrawal for years on end have shown me how lucky I was.

  • “It seems wrong to abstractly judge who has more of a right to suffer emotionally”

    That certainly wasn’t what I said so I’m confused by your comment. Everyone has a right to suffer when they experience trauma. My comment wasn’t about people suffering, but about the statistical outcome of cumulative traumas, and poverty compounds traumas by keeping kids in a daily struggle for survival that more affluent kids don’t have to deal with.

    To say that a child victim of physical and sexual abuse who starts out with educated parents, healthy food, and a good education, and exposure to healthy parent child interactions will have the same outcome of a child victim of abuse who lives with food insecurity, inconsistent housing, poor education, exposure to violence and little to no nurturing is naive.

    The statistics on poverty bear this out. Childhood poverty affects all domains of lifetime outcomes including long term health, educational attainment, wealth accumulation, and even life expectancy.

  • Take two kids and two toys that come unassembled. For the first kid, give him most of the pieces, tell him where to find the rest of the pieces and demonstrate how to assemble the toy. For the second kid, give him half the pieces, smash the rest, and give him no instructions. Then make a grand announcement about how smart the first kid is and put the second kid in jail.

    This is about how screwed our current culture is, and how we set some children up for a lifetime of failure.

  • This is a subject that’s obviously near and dear to my heart so I have a little more to add. There are other ways, if people cared, to help these kids besides the educational setting. Quality childcare and after school care. Subsidized summer camps for respite outside of adverse living environments. Parenting classes that teach nurturing skills and age appropriate interaction and expectations for behavior. Access to neighborhood gardens and nutrition courses. Instituting a minimum income so parents have the resources to care for them. Expanding USDA school lunch programs to include free breakfast and lunch during the summer. Rooting out and harshly prosecuting the adults who harm them. Vastly expanding mentoring programs like Big Brothers/Big Sisters. While I think the concept of playing to their strengths is good for the kids who have already been exposed to adversity, it seems equally, if not more important to me, to do something concrete and constructive to prevent the child ever encountering these situations to begin with.

  • While this is an extremely watered down version of the things that happened to me, it’s important to realize that its hard to ask people to put things into perspective if their perspective had always been from the bottom looking up. And it’s hard to ask them to have sympathy for people who’ve also had trauma but grew up in more privileged environments when they have experienced being downtrodden in every aspect of their existence. And while I realize that there is less sympathy for those who are traumatized but considered privileged, it may help those who have been privileged to understand how much of a leg up on others they actually have.

  • Actually, I’m in a pretty good position to address this point as I did come from a mixed background. My parents started off middle class. Both well educated, both descendants of college educated folks. We didn’t start out poor. My dad was an employee of the federal government with an extremely good income. Mom was a business owner. Both were abusive in different ways. But the things I dealt with before their divorce (physical and sexual abuse inside the family) were very different from the things I dealt with after they separated and my dad moved to a very poor, high minority neighborhood. For one thing, the school system I went to was a much higher quality in the upper middle neighborhood I started in. Until third grade, I was in a much more rigorous educational setting. The other city’s schools were more than a year behind what I had been learning when I switched schools. Additionally, the adverse experiences I had were all inside the home. My friends mothers were stay at home middle class ladies who had snacks ready for their children when they got off the school bus. My friends had toys (some of them had entire playrooms!) and sleepovers and hugs! They had clothing that fit and food on the table and got regular baths and bedtime stories. So even though I was growing up in a hellish situation in my own home, I knew what other homes could be like. I knew what parental nurturing looked like.

    On the other hand, when my dad moved out, and I moved with him shortly after, I was exposed to things that no child should ever see. There were drunken fights in the street All. The. Time. Routine and severe domestic violence. Hungry children who were lucky if they had cold cereal for supper. Regular police presence. The trashy women my dad brought home would beat me for any perceived slight. Child molestors were rampant and everyone knew they had a taste for little girls. A sister’s boyfriend attempted suicide in front of us.

    My parents eventually remarried when I was 13 and we moved back to a lower middle class suburb and that was the end of being exposed to that stuff. I’ve kept track of some of the kids in that neighborhood though and except for one, their lives have not followed the same, relatively positive, trajectory mine did. If you can call being psychiatrized positive – I at least did not end up in jail or dead. Only one person I knew from that place went to college. Similar to me, her family got out a couple of years after I did and she has spent the rest of her life in relatively better circumstances. One person I know from that time has been in solitary confinement in a maximum security prison for the last decade for committing murder. Several are dead. One has been gang affiliated for years. One has had several children that she’s passed down her family’s dysfunction to.

    On the other hand, while I was psychiatrized, and that had some pretty devastating effects in itself, I also had access – once back in good schools – to advanced placement classes, good teachers and mentors. I always had health insurance and healthcare. I had a mother, who for all her faults, which are legend, taught me good nutrition and exposed me to things that broadened my horizons. We hiked the Appalachian Trail, went sailing and camping. I always had books and because my parents owned a computer business and had an engineering background, access to the internet from literally before the internet as we know it existed. I had an email address before the majority of homes had computers.

    There is literally no comparison between me and the kids in that poor neighborhood because they never had the opportunities that I did. It’s unfortunate the things I grew up with. It’s unfortunate that really bad things happen in “rich” families. But there is no comparison when you add in the horrors of poverty and the things kids are exposed to in poverty-stricken neighborhoods. None whatsoever.

    As an adult, when I moved to Maryland, I lived for years in a pretty run-down neighborhood in Baltimore and once again was living in a high conflict, majority-minority neighborhood. The four year old down the street sat with his mother’s dead body for several days before he sought help. She had died over a heroin overdose a decade before the “epidemic”. There were several shootings on my block. Constant gang and drug activity. In the decade I lived there, I watched one sweet innocent child after another turn hard and become hardened by the streets. I watched them drop out of school, join the gangs, start wearing their colors, and some of them died.

    I am incredibly lucky and I will never not acknowledge that fact. You may bristle at the idea of privilege, perhaps some liberal dogooder beat you over the head with the concept, but I am acutely aware of how privileged I am despite all that I’ve survived. I don’t know if this personal account will make any difference to your feelings that we focus too much on poverty, but in my experience – anecdotal, I understand – poverty and class are major determiners of life outcomes. I can only be a witness to how powerful they are.

  • Evolution is grand until it’s interpreted in the greater cultural context as disordered. The social order of the day favors compliance and punishes what it sees as being ‘maladaptive’. In other words, kids who grew up in chronic adversity, like me and so many I know, struggle to find their way in a world that prioritizes getting along for the sake of getting along and punishes those who call BS when they see it. ‘Keep calm and carry on’, practice gratitude and be greatful you don’t have it worse, etc. It’s how revolutionaries are kept in line…

    I think another way to harness the strengths of those who’ve grown up in chronic adversity is to emphasize their innate capacity for compassion for others. Evidence has repeatedly shown that poor folks routinely give a greater percentage of their income to charity than the most well off. That’s because those who grew up in hardship are able to empathize with others who are struggling moreso than those who’ve never experienced things like food scarcity, homelessness, or witnessing violence. Kids who have experienced these things have an enormous capacity to be part of social change and rather than emphasize their lack of complex reasoning or academic skills, we could be tapping them to be the next generation’s helpers, to come up with innovative ways to help others.

  • These adaptive strengths have long been referred to colloquially as “street smarts”. Kids exposed to repeated dangers learn survival skills in order to have their needs met – it just comes with a big dose of fight or flight reactivity. They are less trusting but are also more discerning. They understand body language and vocal tone/inflection in ways different but valuable to them as it is adapted to their situation. Not mentioned by these researchers, but a skill that I’ve witnessed is the ability to barter and negotiate. Those who grow up in poverty have to find alternative means to acquire resources and, believe it or not, stealing is not the first method of most. The sharing economy, barter and trade was around and being employed successfully by the poor and those living in adversity long before the middle class started its downward slide.

    It’s nice to see researchers looking at these kids in a new light and not simply as being broken. Those who have experienced chronic adversity have unique survival skills that can serve them very well in life if, either through luck or hard work, they manage to find their way into better circumstances. Some will continue to struggle even if their circumstances change. I’d suggest research explore ways they can be helped to hone these skills to better serve in more diverse environments.

    One specific deficit that many I’ve known run into when they grow up is not knowing how to behave in different social environments, resulting in increased interpersonal conflicts. Social skills could be integrated into the learning environment in subtle and overt ways to prepare them for survival outside of their primary home and school environments. These don’t take complex reasoning as much as learning how to interpret others behaviors and motivations outside of the harm context and skilled observation of environmental cues.

  • That was a shockingly good performance, lovely tune, and surprisingly well produced video. I’ve often heard that the difference between the protests of the 60s/70s and my generation’s protest movements has been the current lack of quality protest music. Music and art remain uniting forces even after dialogue breaks down. We need more of this. Thank you.

  • Oldhead, I believe we’re pretty simpatico on this issue. When I speak of some total abolitionists, I mean those who believe that all forms of therapy/counseling are always harmful and just as tainted as psychiatric “medicine”. And that genuine help should only come in the form of freely offered friendship support. I’m not going to call anyone out, but taking a look back at Bonnie Burstow’s recent post on anti psychiatry should make it clear. Totally agreed that “therapy” being couched in terms of medicine needs to go. I also think some of the people portraying themselves as “life coaches” are scam artists as well. I don’t think a good counselor necessarily comes from a trained program. Oddly enough, a priest I saw for a while for marital counseling years ago comes to mind.

  • Cultists? Despite his shortcomings, Bernie Sanders remains the most well-liked and respected politician in America. He won Vermont by such a high margin that Clinton wasn’t even viable – she got no delegates. Clinton on the other hand supported the giant corporate giveaway to insurance and pharma, she called black children super predators, she supported the expansion of the drug war and mass incarceration, she supported welfare reform which thrust many more children in deep poverty, she supported the ban on gay marriage, taking until 2011 to “evolve” once it was politically expedient to support it, she supported Don’t Ask Don’t Tell, she pushed the ouster of Libyan President Gaddaffi – a dictator for sure but one that had pretty darn good socialist policies in place, she hasn’t met a war she didn’t support, she has a “public” position and a “private” position on everything so you can never tell what she really believes and supports. I’m honestly sick of the Hillary cultists making excuses for her absolutely undemocratic platform. She is a Barry Goldwater Republican masquerading as a Democrat and has personally worked toward the destruction of everything the Democratic Party used to hold sacrosanct! She should go back to the woods and never come out. And she can take Debbie Wasserman Shultz, Nancy Pelosi, Madeline Albright, and the rest of the pretend lefties so-called feminists with her. Her only goal is to suck up to Wall Street and the ruling class who have paid her so far over 22 million dollars in public speaking fees. Oh yeah, there’s also that pesky issue of her using slave prison labor while First Lady of Arkansas… For all I can’t stand Trump I was RELIEVED she lost the election because after all the cheating involved in her campaign and the collusion between her campaign and the DNC, I don’t want my daughters to get the idea that cheating is how women win.

  • I’m done addressing this in terms of genetic drug testing. And in terms of psychiatric drugs. Did you know you can have a psychotic response to statin drugs like Lipitor and Crestor? These are among the most prescribed and most profitable drugs in the world. There has been a push in the last several years to dramatically increase the number of people taking them. Have you heard of antibiotic-related delirium common to drugs like Cipro, Levaquin and Flagyl? The deadly rash you speak of is Stevens-Johnson Syndrome – a known reaction to drugs as wide ranging as Lamictal (an anticonvulsant) to Tylenol/Paracetamol.

    To my knowledge, simply being able to metabolize a drug won’t tell you definitively whether you will have an allergic reaction or severe side effect. However, knowing whether you’re able to metabolize a drug will give you valuable information *before* risking taking a drug that you definitely shouldn’t take. It would absolutely prevent a number of severe drug reactions. Would it prevent them all? No. And no one here arguing for the merit of such testing has made any claim whatsoever that knowing your CYP status would prevent all reactions. Again, baby meet bath water.

  • But I’m not advocating for psychiatric med tests as I’ve said several times. I’m advocating for knowing your CYP status. Regardless of whether the doctors know the mechanism of action, if the doctor doesn’t know your genetic status and ability to metabolize the drugs they prescribe, they are still taking chances with your health. In fact, a large majority of people do not possess the enzyme function to metabolize the majority of drugs on the market. Additionally, a lot of medications designed for medical issues are prescribed off label for psychiatric use. Think of the anticonvulsants and blood pressure medications. The medication my psychiatrist made me sick with (one of many actually) was not a psychiatric medication and knowing my CYP status would have been useful. I get that you’ve read that psychiatric genetic tests are worthless. I don’t get why you’re throwing the baby out with the bath water on knowing whether or not you can metabolize the vast majority of other drugs you might be prescribed based on that small amount of information.

  • We are certainly in agreement against the use of force. My perspective on coercion seems similar to yours in that it goes beyond the use of legal force to include public attitudes toward the need for medical treatment whenever one admits to any degree of psychological distress whether it be garden variety anxiety and situational depression or the extremes of paranoid psychosis-induced violence.

    Beyond that, there has been a cultural shift away from “we’re all better off when we’re all better off” to “screw you, I’ve got mine, fend for yourself buddy”. People who reach out for support are not comforted, but rather asked if they’ve seen a doctor, or told to call their therapist. We’ve got more connection now than we’ve ever had before in terms of the internet. And yet we are so disconnected from our own responsibility to truly help one another. The idea of community has been eroded. Neighbors turn on neighbors, families are divided, and we have a generation of young adults who’ve grown up in the “if you see something, say something” culture of suspiciousness. We have more connection and treatment than we’ve ever had, and yet we’re, on the whole, isolated, lonely, and suffering. At least from where I sit and observe.

    And so we also need a cultural shift away from the idea that needy folks are burdens, and back toward the idea that we are each our brother’s keeper, in the very fundamental sense of shared burdens being lifted for the benefit of all. I think that talk about coercion without discussion of the underlying cultural attitudes that push people into psychiatry’s open arms is somewhat hollow and lacking.

  • I find I have common ground with the reformists in the arena of psychology. I do not believe in burning the entire mental health system to the ground. I don’t think all the helpers are doing harm. I have a therapist I’ve seen intermittently since 2008. I like him. I trust him. When I’ve felt like I wasn’t getting what I needed, he referred me elsewhere, always offering that I could come back and that he wasn’t offended I was looking for another kind of help. So I believe in the power of having a good counselor. And unlike some of the complete abolitionists, I don’t see any issue with counseling being their paid vocation if they are truly good at relating with others and building respectful collaborative relationships for the benefit of the person seeking help and change. Where I clash with treatment providers, and where I am an abolitionist, is in the medicalization of human struggles in the face of adversity. If I were to try to work with reformists, it would have to be in the arena of ending the biomedical model of mental illness -abolishing psychiatry as a medical field – and returning to a structured compassionate caring supportive framework for helping those experiencing psychological distress.

  • Additionally, I have no vested interest in calling my senators and begging of them to vote for a better different version of the mental health czar they both voted to install in the first place. My senators – Ben Cardin and “Pay to Play” Chris Van Hollen, are directly responsible for this mess. The vote was held *after* the election. They knew Trump would be making the nomination. Do you think they, or any other senator who voted for the Cures Act thought Trump was going to nominate someone who would advocate for psychiatric survivors or individual rights? What makes anyone think that another choice would be better? As far as I can tell, we might actually be lucky in this case that all of Trump’s appointments want to defund their own agencies. At least whatever horrific policies they try to install won’t go anywhere because they won’t have the funding – unlike if the Democrats had been in power. No, I have no intention of calling my senators because I don’t see that anyone who would be nominated by either side as having my rights at heart.

  • ” but I think it’s two things to talk about ideology on one hand and strategy on the other. ”

    This is a fair point, Hildegard. I only want to add that talking about strategy without understanding the ideology that has led us to this point is somewhat short-sighted. In discussing strategy, there needs to be a place for debating the ideological perspectives that allow the disease model and pharma/medical to remain in control.

    Otherwise, I agree with your comment completely.

  • With all due respect, as my comment was not meant as a criticism of your entire blog post, but merely the parts I pointed out, I see little point in arguing semantics. In real world parlance, calling someone “crazy” is synonymous with other harmful adjectives such as “mentally ill”, “unhinged”, “nuts”, “cuckoo”, etc. Further, your assertion was that it was “pretty clear” Trump has “severe and dangerous mental problems”. Your exact words, not mine. It is you who is furthering the belief that mental problems equals dangerous. So I stand by my comment. Nothing about it was a straw man, thanks I’m aware of logical fallacies.

    What I think equates with dangerousness is unchecked power. What keeps people with spoiled, entitled behavior – like Trump – in power, is that other unscrupulous people ignore his bad behaviors, or make excuses for them, so as to continue to curry favor with someone who will help them achieve their agenda.

    Yes, Freedom Lovers comes from all political persuasions, but ignoring the rightward political shift this country has taken in favor of not “arguing politics” is frankly sticking your head in the sand.