Art may be more for the artist than the observer. I recently wrote a very emotional poem, not something I usually do. But it was quite cathartic for me. Others found it beautiful, but it didn’t have the same meaning for them. I wrote it for me more than anyone else.
Thank you. I have found peace in the wake of this sadness, with a very special new friend and some very good old ones. It comes and goes, but I feel like I’m doing about as well as could be hoped. This week is her birthday and also the anniversary of our first meeting (4th and 5th respectively) and it’s been a little rough. But I’m doing OK.
Absolutely. They go into withdrawals, which means they are MORE hyperactive than they were to start with often. But like I said, “professionals” often use this to convince parents that “see, when he stops using it, he gets so much worse!” without bothering to mention that they might get a whole lot BETTER once they actually got through the withdrawal period.
Or perhaps they ought to simply change the environment. Good research shows that so-called “ADHD” kids do way better in open classroom settings. Why aren’t we creating settings that work for these kids? Maybe they are a warning sign that the adults are not meeting the children’s need!!!
It may be worse to electrocute a developing brain than a fully developed one. But electrocution as a “treatment” for “mental illness” is rank insanity in any case! We generally do anything we can to avoid people having seizures. Why we’d want to induce one and imagine it is helpful is baffling beyond words!
Thank you, Kermit! It is an observable fact that we would not be here if not for you (and Bob, of course!) So right back at you – thanks for making MIA a functioning reality, and I am happy you will be rejoining us here on earth for a while longer!!!
I found this very touching, Kermit, after having dealt with my own brush with death and of course the loss of my wife. It is sometimes hard to remember the good fortune we have had in life, but love really IS the answer!!!
No, it doesn’t. It means stopping those with power (whatever color their skin) from taking over a culture and dictating what is supposed to be believed and acted upon. An example would be forcing other countries or cultures to adopt the DSM or ICD as a way of describing “mental illness” rather than using the ways they already have to describe such phenomena. The fact that white people have a lot of the power positions is merely a fact of life. Most white people are harmed by “colonization of mental health,” only a very small number have the power to actually create this effect, and they’re not all white, either.
This is a good reminder that AI is not actually “intelligent,” it does exactly and only what it is programmed to do. I’m sure that providing reassurance and common reality is a good thing in MOST conversations, but when AI starts agreeing with someone that killing themselves is understandable and helping them make a plan, we’ve gone way around the bend!
I do appreciate the honest response. I should have acknowledged you for both being willing to come here and for challenging standard practice yourself. I’ve been in the position of working with the system and I know it takes a lot courage to speak up and question the status quo.
Actually, I DO think we’d have a lot to talk about and if we were going to revise the system, you’d definitely be the kind of person I’d want to be planning it with.
And for the record, I don’t have any expectation that ALL psychiatrists act in any particular way. I had any number I used to work with who were open to feedback and a couple who worked with me and others on implementing a law to protect foster youth from over-drugging for behavioral reasons. My comments were mostly motivated by the seeming dismissal of the POSSIBILITY that there are, in fact, some in the field who DO engender ill intent or at best neglect, and that many of them have been quite powerful in influencing our cultural views of emotional and behavioral challenges without much respect for the actual science involved. I don’t think we make any progress without dealing with the “bad apples” in the barrel, especially if they are people with lots of influence in the field.
Looking forward to your next blog and thanks for being willing to engage with us despite having to face some pretty intense feedback!
I am NOT expressing contempt and condemnation. I am observing factual reality. It seems you are the one attempting to show contempt for the logic I have presented. For instance, you claim that “new drugs” means that doctors don’t know the information regarding withdrawal effects. I showed you that Prozac (marketed since 1987, almost 30 years ago) had been shown to have withdrawal effects as early as 1992. That is factual, not contemptuous or condemning. Yet your comment condemns me as “uncharitable” for not allowing psychiatry off the hook for this clear, observable and measurable failure.
Being reasonable and charitable can be helpful to a point, but we have to start with being honest with ourselves. It does not scan that psychiatrists didn’t notice for 20+ years that SSRIs had serious adverse effects. The only logical conclusions are that 1) they chose to ignore that information, or 2) they actively suppressed that information because it didn’t fit with their philosophical and/or economic model of reality. Making excuses for this failure does not lead to improving things for people in need. Honestly confronting the facts of inherent conflicts of interest and the actual PRACTICE of psychiatry in the field (vs. what you say the training is or should be) is essential to improving things for people in need. Nothing will change if we professionals make excuses for ourselves or blame clients for the behavior that our model has encouraged them to adopt. It’s a not a matter of contempt, it’s a matter of RESPONSIBILITY. Professionals are responsible for the results they obtain. If folks suffered adverse effects or withdrawal effects for decades and mainstream psychiatry failed to notice or intervene, the fault lies with the profession/system, not the clients/patients. I think that is a VERY reasonable proposal, that we start by relying on the actual known DATA rather than pursuing what is most economically or socially rewarding for the industry. No contempt, simply an insistence on holding ourselves responsible for our own results.
Patients’ resistance to stopping psych drugs has to be seen in context – if they have been told they will “relapse” and that their “brains are broken” and they have “diagnoses” that are vague but purportedly permanent, of course, they will be reluctant to reduce or stop drugs, ESPECIALLY when most have not been really given the opportunity to explore alternatives.
I used to work at a crisis line. Got a call one time from a person diagnosed with “major depression.” She was in a panic. She’d been trying different antidepressants for over a year, done 5 or more as I recall, and had no benefits. She felt like there was no hope, that she’d be depressed FOREVER!
I stopped her and asked, “Has anyone told you that there are other things you can do besides antidepressants for depression?” She paused for a moment. “No,” she said very calmly. “Well, there are,” I said. “Oh,” she said. “Well, THAT’S good!” And we talked about other options and she already felt a lot better. This discussion must happen, of course, BEFORE antidepressants are ever prescribed. It did not, and in my experience, if one sees a psychiatrist, it almost never does. If one thinks their only hope is antidepressants, of course, they will resist coming off of them. And yes, that IS blaming the clients!
Additionally, how do you know that the failure to discuss withdrawal problems was not done with malice or ignoring of information? Peter Breggin reported convincingly on antidepressant withdrawal, with good research references, way back in 1992. It is only in the last few years that withdrawal effects finally appear to be STARTING to be taken seriously. I still talk to plenty of people who are never informed of any possible withdrawal effects.
Again, it appears you are making excuses for professional failures. Are you suggesting that between 1987 and 2025 there hasn’t been PLENTY of time to research withdrawal effects, or that most psychiatrists ought to have been well aware of this problem (internet withdrawal groups have been around for decades)? Why is it so important to you that we “be reasonable” about the obvious failures of the profession? At what point do we stop assuming there is no ill intent and begin to face the fact that financial conflicts of interest have colored and distorted the psychiatric worldview so that drugs are, in fact, hugely favored without strong data supporting their efficacy?
Or to put it another less charitable way: It’s a lot easier to dehumanize clients who are involuntary and don’t have advocates there to stand up for them.
It seems you are willing to give other practitioners the benefit of a doubt in most cases. Years of experience disabused me of such notions. And the docs “not having other tools” is clearly a validation of my assertion that they only see biology as the cause. I’ve also had many a conversation with psychiatrists about these questions (I’m pretty assertive), and have gotten very bio-based responses. For instance, I talked to one guy (whom I actually liked quite a bit) about PTSD. He’d made it clear he thought biological brain differences were the main issue for psychiatrists to address. I asked him, “Well, in PTSD, there has to be a traumatic event to trigger the reaction. Doesn’t it seem like the traumatic event should be considered the primary cause?” His response was, “Not everyone gets PTSD from the same level of trauma. There MUST be something different in the brains of those who have that reaction.” See what I mean? No consideration of cultural context, of personality features, of social support networks or the lack thereof, of prior trauma, of resilience factors – no psychosocial analysis at all. Just, “They react differently. Brains must be different.” And this was one of the more educated and rational psychiatrists who was mostly in a research role, not overwhelmed by clients.
I do agree that lack of staff training in observing and intervening is a big issue. But isn’t that the psychiatrist’s job, to train them or make sure they have training? For example, the kid I mentioned with the extreme hand tremor was on four drugs, two antipsychotics and two mood stabilizers. All four had involuntary movements as potential side effects, and two specifically mention hand tremors in the product information. Yet the psychiatrist, when I told him we were concerned about side effects, said, “We haven’t noticed any side effects!” The hand tremors were obvious and the girl was spending a huge amount of energy trying to stop or disguise them, and she found it embarrassing that it was occurring to her. But the staff told her it was because she was “nervous”. The CASA spoke to the line staff, and they said they were NEVER told about potential side effects to watch out for when a kid started a new drug.
So at a certain point, we’re no longer talking about being overwhelmed. In the above case, we are talking about overt neglect and violation of the child’s right to informed consent (she was 14 and that right was posted on the “clients’ rights” posters all around the facility). Of course, once we convinced the psychiatrist to reduce the risperdal and lithium, the hand tremors decreased markedly. But they still told her it was nervousness, despite the clear scientific evidence it was not. This goes beyond being biologically oriented and moves into dehumanization of the client, as I mentioned above. No one should be treated that way, no matter how overwhelmed the staff is. Frankly, I think saying the doctors don’t have tools or enough time is pretty much an excuse. They ought to have other tools if they receive the training you assert is standard. It seems they are simply not applying them, and blaming the clients’ brains when their approach fails or creates other problems.
You also failed to address the overt claims that were frequently made to foster youth that despite massive trauma, they had “brain problems” that needed drugs to resolve. This is both a philosophical failure and further evidence of a lack of application of the supposed tools these psychiatrists were trained with. It doesn’t take a rocket scientist or a lot of extra time to recognize that the foster youth needs an acknowledgment that his/her distress is very real and is NOT the result of bad brain chemistry. It’s not an inability to do so that is the problem. It is either an unwillingness or a lack of empathy, and I truly believe and observe that the DSM diagnose-and-drug paradigm both allows for and increases the likelihood of such dismissive behavior on the part of ostensible professionals.
And I’ll end by saying that it’s not the client’s job to “be fair” or “understand the limitations” of their caretakers. Harm is harm, no matter why it happens. As an old friend of mine used to say, “It doesn’t matter why the milk truck doesn’t make it to the refrigeration center, the milk still spoils.” Clients who have been harmed, in particular, should not be expected to “be reasonable” about the professionals who failed them. We as professionals need to absorb their anger and critiques and reexamine our practices, not make excuses for bad service.
I appreciate you taking the time to write a considered response.
As to #3 and #4, it may not matter a lot what is taught, the choice to rely on “medications” as the first line and often ONLY intervention for “mental illnesses” makes any other non-medical-model considerations moot. I have known a large number of psychiatrists from my work in the child welfare system, and can count on one hand the number who actually prioritized non-drug analysis or interventions for foster youth, ALL of whom were certainly victims of childhood trauma of the most serious kind, both by their birth families and by the process of removing them to foster care. I’ve also spoken to dozens, maybe hundreds of foster youth, and have not met one yet who felt their problems or issues were mainly addressed by psychiatric diagnosis and “medication.” They were addressed by changing foster homes, by being adopted, by being empowered by attorneys or CASA volunteers to be their own advocates, by being particularly cared for by an excellent caseworker or social worker, according to the kids themselves. I’ve also encountered many kids being damaged by the “medical model” assumptions inherent in the label-and-drug process: kids becoming diabetic, becoming psychotic, relapsing into eating disordered behavior thanks to stimulants, becoming suicidal, having constant hand tremors and akathesia, among others. NONE of the situations I just mentioned were addressed by the MD psychiatrists whose drugs were creating the problems. ALL were resolved by advocacy by the CASA volunteer or by the child’s own decision to stop following the MD’s instructions.
So whatever the training, my experience is that in practice, most psychiatrists (at least the ones treating foster youth) are in fact quite committed to the “medical model,” but don’t even attempt to provide informed consent, let alone analysis of social factors contributing to the youth’s difficulties. Multiple foster youth have reported to me being told they were depressed “because you have a brain chemistry problem.” They were often incredulous, saying, “So they are telling me that my BRAIN is the problem, that if my BRAIN were working properly, despite being abused at home, removed from my family, moved to multiple foster homes, separated from my siblings, grandparents, relatives, forced to change schools multiple times… despite all of that, I’d NOT be depressed if my brain were working properly???!!”
It appears to me from my experience and the stories I hear that, notwithstanding the “bio-psycho-social model” claimed to be in use, most mainstream psychiatrists use the “bio-bio-bio” model and view ALL “mental illness” as problems with the brain. It is hard to see how any kind of change can happen in the field when the majority of practitioners fail to address or even consider the kind of psychosocial issues that are often behind or exacerbating the “symptoms” they are trying to suppress with their biological interventions.
And the only way to stop it is to stop taking that particular drug. The drug is the cause. I have never seen any kind of side effect “medication” be truly effective in stopping this, though such medications do exist.
I am familiar with Invega. It is an antipsychotic and most definitely could and often does cause akathesia and movement disorders.
You found the right way to respond. When there’s no button, just go back to the last one that HAS a respond button and use it, and your comment ends up at the end of the queue.
I have always thought we needed safe spaces for people to go to when they are feeling or acting out of control, but to unlink that from “diagnosis” and “treatment” unless that’s something the person wants or relates to. Folks can write “advance directives” for times they are unable to decide. But it’s certain we need safe spaces for people to destimulate from whatever is upsetting them. The idea that being held in such a place necessitates drug “treatment” is where I object to the process.
“This suggests a treatment culture that diverges from guideline recommendations, where symptom-targeted prescribing prevails despite the risks of side effects and overmedication”
Doesn’t this prescribe mainstream psychiatric practice? What are they doing other than “symptom-targeted prescribing?” Seems like the only tool they have in their “toolbox” for the most part.
You are a truth speaker. Those afraid of the truth will find you threatening and often be hostile toward you. I’ve found the same myself. I’m a perfectly kind and cooperative person in general, but I speak up when something is wrong. And some people (especially doctors) seem to have difficulty with this concept.
Quite so. It is a typical “blame the victim” scenario, and blaming fat people for being fat due to some character flaw is very much accepted in our culture.
I don’t either. Knowingly creating harm through fraudulent representations and blaming of the victim. Particularly egregious when the clients are young and involuntary, not in a position to defend themselves or often even understand they are under assault.
I worked with kids in foster care taking Zyprexa or other fat-inducing antipsychotics, and saw psychiatrists frequently put them on diets and exercise regimes, never telling them that their weight gain was caused or exacerbated by the drugs. I saw one case where a kid in recovery from an eating disorder was given stimulants. When she stopped eating, they treated her like her ‘eating disorder’ came back, rather than recognizing (as my CASA volunteer observed and informed them) that her loss of appetite was due to the foolish decision to give her stimulants! Another kid became psychotic on stimulants (which happens in close to 7% of the cases, per a Canadian J Psychiatry study), yet she was given a psychotic disorder NOS diagnosis and prescribed antipsychotics. She only stopped being psychotic after SHE decided to stop all the drugs! Another got diagnosed with diabetes, which disappeared when she stopped taking Seroquel at the CASA volunteer’s behest.
The ability and willingness to ignore the obvious connections between drug administration and behavioral/physiological adverse reactions seems endemic to psychiatry. If the person gets better, it’s always attributed to the drugs, but if they get worse, it’s “the disease” rearing its ugly head, even if the drugs are the obvious cause.
There is a difference in my mind between “authoritative” (able to take charge as needed and help keep things in order) vs. “authoritarian,” which to me means attached to power and willing to use it to keep “subordinates” in their place in the hierarchy. Doctors who believe patients should just “do as they are told” are the ones I think are most dangerous. I don’t mind my doctor having a strong opinion and expressing it, but I have the right to do the same, and if s/he can’t acknowledge that, s/he will quickly become my former doctor!
I don’t know how many, but it’s not a trivial number. And of course many should never have been approved in the first place but are still in use today. That’s why truly informed consent matters so much these days. Even the doctors don’t seem to know all the adverse effects that are acknowledged, and of course the drug companies only publish the ones they are forced to by the FDA. We are really on our own when it comes to protecting ourselves against dangerous drugs, but most people don’t realize that until something bad happens, and sometimes it’s too late!
I still think medical doctors need to be much more flexible and honest about side effects and options and alternatives. They also often exercise the option to be defensive when getting something wrong. Remember that most stimulants and antidepressants are prescribed by non-psychiatric doctors.
Plus my experience with cancer treatment tells me that most doctors don’t really know about the drugs they prescribe. I recently experienced a sudden and dramatic recovery from significant anemia after discontinuing one blood pressure drug (Losartan) at my own behest. Sure enough, looking up that drug immediately showed red blood cell production to be suppressed in rare cases, but particularly if one is over 60 (which I am) and takes it for an extended period (which I had been). When I confronted the doctor about it, he said, “I’ve never seen that.” Well, now he has. But he didn’t even record the dramatic recovery in the chart notes. Just said I’d potentially lost some kind of protection against sudden heart attacks, “But I did not take up this issue with the patient.”
Doctors should advise. Patients should decide. Doctors should be honest and accept patient feedback. Even if they are “right,” authoritarian doctors prevent feedback and disempower clients. And empowered clients have better outcomes.
Yeah, remember Vioxx? Caused strokes and heart disease, literally killed people, but the drug company buried the data until they’d made billions of dollars on this blockbuster drug. No one went to prison for this, either. Not even sure they were fined. It’s not a rare thing.
It is true that many are driven to become therapists by a feeling of their own incompleteness or inadequacy. This in itself should not disqualify them, but they must have already dealt with these feelings effectively themselves and be relatively emotionally healthy in order NOT to take advantage of the noted power imbalance. I have found such people rare, either in or out of the therapeutic professions. Among psychiatrists, I’ve found them almost nonexistent. Doctors in general tend toward the authoritarian, I’d say, but the number of truly self-aware and non-authoritarian psychiatrists I’ve met over many years of working both within and on the edges of the system can be counted on one hand.
The CLIENT should be the one who “balances the risks with the benefits.” Too many doctors, and especially psychiatrists, seem to think THEY get to make this assessment. It’s their job to outline the risks and benefits for the client. The client then gets to decide what the balance is. This is too often forgotten!
Thank you, Rosalee. It has been quite a process so far, and still only 4 months in. But I have learned a lot about myself and finding my way. It’s a big change!
Niko, I previously sent you an email about your prior comment explaining why I could not publish it. Please check your emails and respond via email so we can resolve the issues.
Ah, but I DID often confide in my clients. I found self-disclosure to be a very powerful way to connect on a real level, even if there are some who would have criticized my “poor boundaries.” But I get where you’re coming from. I’ve always been a big fan of support groups NOT “facilitated by a professional.” Those who have been there and done that are usually the safest people to talk and share with. And again, finding a capable therapist is a challenging proposition. I was quite aggressive in my screening and prepared to drop the grief counselor at a moment’s notice if the process did not meet my needs. Most potential clients are not in a position to take such an assertive stance, nor are most aware that they need to. Only years of experiencing seeing how crappy the average therapy experience was led me to be able to take such steps. I certainly would never trust or assume that the therapist in question was competent or safe without thoroughly testing them out in ways that most people would not realize are necessary or have the skills to accomplish.
I have had the same experience. It is next to impossible to find a doctor who truly supports withdrawal. Some will “allow” it but generally convey suspicion and condescension toward clients attempting this kind of effort. And if things deteriorate, most are very quickly told, “See, there is proof that you are relapsing and you need the ‘medication.'”
I think we’re all irrational to some degree. Which is why it’s silly to call some people “mentally ill” because they act in certain ways, since almost anyone could be so labeled in the right (or wrong) circumstances. I am sure I could get such a label slapped on me since my wife died, if I let anyone with the power close enough to do so. And yes, I do behave irrationally sometimes. It’s part of being human.
It is true that help of any sort is hampered by power dynamics, not just in therapy, of course, but with doctors, teachers, lawyers, social workers, and so on. Some people choose to take advantage of their one-up power situation, some don’t. To be useful, therapists would have to be trusted to step down from their one-up position. But of course, no one can guarantee that, which makes seeking a therapist fraught with potential harm. As I’ve said many times, the fact of being a therapist or having a degree is no guarantee of being helpful. It doesn’t even improve the odds.
However, I have seen some remarkable work done by therapists from time to time. I can’t dismiss it altogether as always being a bad thing, since I benefitted from a good therapist myself. But that was my good fortune. It was also back in the 80s, when therapists had not yet been trained to be DSM-compliant as most have today. I have, in fact, recently found a grief counselor who has been very helpful to me, and I appreciate her. But believe you me, I screened heavily before engaging with her, and told her what I expected and that I would only continue if those expectations were met. She wasn’t perfect (who is), but she accepted and acted on my feedback, and did provide some excellent support when I needed it. So have any number of friends I have relied on since the loss of my wife, including a local pastor with whom I am now good friends. Help comes from wherever it comes from, and just because power dynamics can be exercised by a provider doesn’t mean they will. It’s not quite that black and white to me.
I agree wholeheartedly with your proposed approach. Boundaries means saying “no” politely but firmly, not humiliating the client! And you are also correct to say that the power imbalance makes it too easy to be defensive and take out feelings on the client. It’s up to the therapist not to abuse the power imbalance, but I find few who really are capable of doing so.
I absolutely support that he has the right to ask her not to record the sessions, and refusing the gift was the right thing to do. What I’m trying to say is that her decision to do so says something about HER and what her ideas, needs and motivations are. One can set expectations without engaging in power dynamics. Whatever the client does, whether it’s allowed to continue or not, provides an opportunity to understand her motivations and intentions and provides a pathway to understanding what is behind them. Which is, after all, what therapy is supposed to be about. Again, let’s say she’s agreed to a no-recording policy. The conversation can easily go to, “Do you remember signing the agreement not to record the sessions? So if you knew that, what made you feel that recording them was necessary?” Or words to that effect. Something is going on with her. You don’t have to allow her to keep recording sessions without humiliating her or making her feel small. After all, she IS the client – if she were entirely rational, why would she be needing therapy? Why not use the opportunity to explore what is underneath her behavior, rather than shaming her? That’s what I’m suggesting.
“Boundaries” can be used as tools or weapons by the person with more power, hence the therapists. It can be a way to avoid the therapist’s own feelings and blame the client. That seems to me like what happened to the author.
You are laboring under the illusion that those training therapists are doing so in accordance with what science shows to be most essential!
I’m also not too sure such training can be effective with just anyone. I think it requires a good bit of self-awareness that would require the therapist to deal with his/her own issues before assuming such a role. A lot of people are not interested in or are not capable of that level of self-awareness, and as such should probably be disallowed from ever becoming therapists. But of course, that assumes the TRAINERS and LICENSERS have that degree of self-awareness as well…
Bottom line, it’s kind of a long shot to find someone who really knows how to help. And I don’t know how to screen them except for personal experience. It’s a conundrum, especially when folks are often getting paid for providing little or for making things worse!
I don’t agree. Catherine is not responsible to gain Eugene’s trust. It’s the other way around. If she were recording me, I’d be saying, “That’s an interesting decision you made there. Why did you think it was important to record our conversations?” It would not be at all threatening – just another opportunity to develop the relationship with the client.
Because when comparing results of different “styles” or “schools” of therapy, none of them were consistently superior. The ONLY variable that consistently predicted better outcomes was the quality of relationship with the therapist. If people felt safe and heard and believed, they did better. If they saw the therapist as aloof or distant or dismissive or invalidative, they did worse. It is kind of that simple.
Of course, as we have said multiple times before, therapists are not especially more likely than the general public to have these skills. Science has supported that, too. You’re just as likely to feel helped by a friend or neighbor or colleague as a therapist. It all comes down to good listening and being there for the person, wherever they are at. IMHO.
That is just awful! Criminal, really. They know this can happen but don’t even bother telling their patients or their relatives/carers that it’s possible, and then when it happens, they blame the patient or “his disease!” I’m so, so sorry you have had to deal with this. I agree, fines are not sufficient. Jail time is appropriate!
It is extremely disingenuous for psychiatrists to blame patients’ misconceptions about drugs and “diagnoses” on the pharmaceutical industry. They’ve been foursquare walking together the entire time since the DSM III in 1980. As for Risperdal, the “off-label” use of these drugs is rampant, for kids, the elderly, and even as an (PLEASE!) adjunct for “antidepressants!” Off label use is legal but needs to be reined in, as far as I’m concerned. It’s dangerous!
You sound like “one of the good ones,” Hoda. You are right, it’s all about the relationship. Science has shown that to be the case, yet we continue to train people to “have boundaries” by denying the basic humanity of one person communicating honestly with another. Techniques can be handy, but truly caring and being deeply curious about the client are essential for any kind of success. Plus being humble and flexible, to do what works FOR THIS CLIENT instead of what someone says you’re supposed to do!
Wow, what an amazing story, Janet! Excellent work by your community! More proof that one doesn’t need a degree to be helpful – just empathy and some courage!
“Alexithymia?” Seriously? Talk about making things sound more complex so you’ll sound more erudite! I have a great idea – let’s call it “inability to recognize and describe emotions!” Just a thought…
Using Open Dialog, Finnish researchers found 80% of “schizophrenics” could function without psychiatric drugs, only 20% needed them on an ongoing basis. So to say “a few can manage” is not quite borne out by research. That’s not to invalidate your finding value in them. I’m just trying to undermine the myth that recovering with minimal or temporary drug use is not an unrealistic goal, even if one is “diagnosed with schizophrenia.”
I was trying to be amusing. But unfortunately, the obvious DOES have to be proven by studies and yet is still ignored by the system despite the results. That’s the real problem. I’m glad this kind of research is being done, but it is sad that this is a novel concept that is often considered threatening by the supporters of the status quo.
Your answer sounded like you were saying what I proposed was impossible. I think you’re over interpreting – what I was saying was, your suggesting that this would be DIFFICULT TO FUND was essentially giving in to the idea that the current paradigm is unassailable, not that you were defending it. Sorry if it came across that way. My point is that we should FUND WHAT WORKS and stop PAYING for things that don’t work or make things worse. I hope you would agree with me there!
They made a choice back in 1980 to go down the medical pathway. It has not worked out, but now they are so financially and professionally overcommitted (sorry, bad pun!) that they can’t afford to back away from their belief system, no matter what evidence contradicts it. The financial incentives are all on their side, and they’ll continue to pass off this DSM/biological BS as long as it pays well. THAT is cynical, I suppose. But it seems to be the truth!
The fact that “the system” uses DSM codes for billing is no excuse for giving them more validity than they merit. You’re saying we shouldn’t train people to do quality therapy because the system won’t pay for it???? Isn’t that a pretty damned good reason for scrapping the current system and starting over? You’re sunk in the trap of thinking of “mental illnesses” as medical problems. For the most part, they are not. When they are, the DSM system actually discourages looking for the REAL biological reasons by providing a pseudo-biological “treatment” for a pseudo-biological “disease” which they have no understanding of how to cure or often even treat! But we can’t get funding for actual effective treatment? Something is pretty rotten in Denmark, Richard. I don’t think you’re really facing what we’re up against here. The fact that we’ve all been brainwashed into DSM-style thinking and are forced to employ it to get paid by insurance companies is CENTRAL to why the numbers of “mentally ill” are rising despite (or because of?) the increase in “treatment” rates. It’s like the Sufi parable about the guy who lost his key in the house but is looking outside because the light is better there. We won’t find any answers until we stop pretending we have them, and we won’t improve the situation until actual successful interventions are funded with the money retrieved from the current massive waste of billions on stuff that simply isn’t effective!
It is very cynical to claim “knowledge” you don’t have just so you can sell services or drugs, and to attack those who point out reality as somehow “insane” for not going along with your propaganda.
It is blameful and creates distance between the subject and the objectifying “professional.” It is the kind of judgementalness that prevents any real connection with a client. It is the ultimate in “othering.”
I would add 5) Diverts attention from significant social issues and interpersonal issues that can and should be addressed if we really care about “mental health,” whatever that means.
Heartbreaking! But well done for you to see what was what and get yourself out of the insanity! That psychologist was an idiot who should have his license removed! It astounds me that these DSM “diagnoses” can be made without any consideration of context, even when he KNEW the context and simply denied it had any effect!!!!
In my view, you weren’t MISDIAGNOSED. You were ABUSED. You should not have been “diagnosed” at all. Those abusing you were the ones who needed to be “diagnosed” with something! But it always seems the victim is the one ending up being labeled as “disordered” while the abusive adults continue to abuse with impunity. I’m SO glad you escaped and didn’t let that define your life! Again, VERY WELL DONE!
Defy the “categorical logic of modern psychiatric diagnosis?” Where did you get the idea there was “categorial logic” or logic of any kind involved in psychiatric diagnosis? It is as subjective as saying someone has courage or is shy or has been successful in life. There is no real logic in grouping heterogeneous collections of people based on external symptoms, any more than there is logic in saying someone experiencing pain in their knee has “Knee pain disorder.”
I would have to say it is the psychiatric “thought leaders” who are the shape shifters here, never allowing themselves to be pinned down to actual logical thought but instead assuming various rhetorical positions that seemed more focused on preserving their illusions than in establishing a viable categorical logic that is actually logical!
I mostly agree with the author, but wish she would get away from words like “psychopathology,” which by its very essence reinforces the very dynamic she is critiquing. Perhaps the term “emotional struggles” or “mental/emotional suffering” would be more empowering?
I would like to hear more specifically how you see the DSM being helpful in such situations. I acknowledge that folks acting within the insurance system need to use the codes to get paid, but for my money, that’s about what they are good for. “Diagnoses” never entered into any therapy I engaged in except to tell them I was billing the insurance company or to explain to them what someone else had labeled them so they’d understand the descriptive and subjective nature of the labels.
I’d also love to hear a response to my answer to your question about how to train therapists. Jane also made a fantastic reply which said what I meant even better, and I think it is deserving of a reply, even if it’s “Well, I don’t know how to do that.”
Thank you, Jane, you said it better than I could have. Experience leads to generalized knowledge that is useful, but there’s no one way to approach everyone that will ‘work,’ and “the therapist’s interpersonal approach” really is the key to success! And I also like the emphasis on “curiosity” – one can’t learn if one thinks s/he knows all about the area before s/he starts!
I don’t mean that at all. Not sure where you are getting that. What I mean is that there is no FORMULA we can follow that will help everyone.
As to how we could teach people to be therapists, I agree that this is a difficult, almost impossible task. What the training would need to do is to teach the therapist how to recognize and set aside their own preconceived notions and biases and truly be there to hear what the client has to say. There are certainly situations where past experience helped me know what to do in a current circumstance, but absent the ability to truly connect with the client in their own space, any such experience is pretty much useless. This is why some folks have advanced training (Ph.D. or Masters) in counseling/psychology and are terrible therapists, whereas volunteers at the crisis line I worked at with backgrounds in engineering and/or computer science seemed to be extremely competent in helping out. It is to me an illusion that one can be trained in a particular “school of thought” and apply this thinking universally to all clients with any level of success. My experience is that starting with a “beginner’s mind” and knowing that we DON’T know what to do just yet is the key to success. But this requires a humility and a level of personal security that can’t be trained into someone. Maybe making sure therapists get good therapy before they start is the best chance of creating this. But of course, they’d have to have therapy with a person capable of doing all of the above or their “therapy” won’t make a difference.
It’s a conundrum. But it’s best we acknowledge the observable truth that training people to “do therapy” doesn’t really work very well.
We can’t. As Milton Erickson said wisely, we need to reinvent therapy for every client! The idea that there is one “scientific way” to help people who are having emotional difficulties is actually a ridiculous concept! That’s why the DSM categories are a waste of time. What good is a “diagnosis” that tells you neither why the condition arises nor what can reliably be done to resolve it? It’s a farce!
BTW, I do consider schools inherently dangerous, whether “standard” or “alternatives.” The biggest problem is the kids have zero power and have to put up with whatever is thrown at them. Very similar to “mental health clients” on the whole. Adults for the most part think they know best, just like the “professionals” in the psych system. In both cases, the key is to recognize the needs of the person being served and empowering them to get those needs met, rather than forcing them to adapt to whatever the “professionals” think is right. True professionals recognize this. Unfortunately, there aren’t that many out there, in teaching or in “mental health!”
My kids all were either homeschooled or attended child-centered schools in elementary school, and the youngest did all the way through high school. They’re all very competent at reading and math, two of them obviously gifted in the math/science area. The adults do have to have a focus on making sure they are learning the basics, but having kids pursue their own interests gives PLENTY of opportunities to teach reading, math and science, history, or whatever. It just requires the ADULTS to alter their approach to the needs of the kids rather than the other way around!
Clearly, it is much greater. And I think largely because of the drive by the pharmaceutical companies and psychiatry to see
ll the idea that drugs are the answer to mental/emotional suffering. Many don’t even know there are other options!
I think this article overlooks the most important point: psychiatric protocols and decisions are NOT made based on scientific results! Or to put it another way: there are certain very strong assumptions operating in the psychiatric worldview (the DSM categories are scientifically valid, “mental illnesses” as so described are biological in origin, reduction of “symptoms” as identified in the DSM is the most valid measure of “success,” etc.) and the research, even if it’s otherwise done in a clean and legitimate manner, is automatically biased by these assumptions and therefore leads to wrong conclusions. As an example, if “ADHD” is a “neurological disorder” in all cases, then stimulant “medication” can be shown to “reduce the symptoms” of this “disorder.” However, long-term studies have shown repeatedly that the “treatment” of such children with stimulants does not lead to substantial improvements in any long-term outcomes that most people would value (completion of school, enrollment in college, reduction in delinquency, higher self-esteem) despite the “symptoms” being “reduced” by the drug substantially. I’ll leave the reader to imagine and enumerate the many possible reasons why a child may be seeking attention and stimulation, but I think it’s fair to say in this case that “symptom reduction” serves primarily the needs of the institution (usually schools) who recommend it, and leaves the actual client in no better shape for being exposed to a fairly dangerous brain-altering substance for many years.
So by choosing to measure “symptom reduction” as the main outcome, research favors legitimizing the DSM categories and validating drug “effectiveness.” If different “outcomes” were chosen the results would vary dramatically. But these assumptions are not challenged by the article, and are rarely if ever challenged by mainstream researchers. Those who do challenge them are attacked or ostracized, as Whitaker was from Day One, despite the excellent scientific basis of his theses.
Oh, and there’s also the fact that legit research is intentionally ignored by the establishment. Hard to pretend you are being scientific when you dismiss inconvenient data in order to justify continuing your current practices. I will ask how many psychiatric drugs were said to have “minimal side effects” and “no dependency” only to be later shown to be addictive or cause Tardive Dyskinesia or otherwise do known damage that was denied.
I could go on, but I think y’all get the gist. There’s no point in doing “science” if you start with heterogeneous non-scientific groupings, limit your findings to the things you want to find, and deny the reality of research that doesn’t validate your reality. Psychiatry is the farthest thing from scientific, and no amount of double-blind studies can alter that fact.
Of course, some people want “symptom reduction.” Others don’t. The point is that the client is the one who should be able to decide what “success” looks like for them.
They didn’t “hate math,” they hated having to do math the way the teachers taught it! I was very good at math but found the math instruction to be dull and inapplicable. I only did well because I already understood number concepts before they started “teaching” me about it. This is true for lots of kids. How we teach math is sure to make it seem dull and irrelevant to our daily lives. But it doesn’t have to be that way, as your Mom proved!
I have done so, and your conclusions are without scientific merit. If you can’t defend them, you shouldn’t make the claim. There is plenty of evidence that the DSM-III was part of an intentional effort to “medicalize” mental health care due to competition from therapists and support groups cutting into psychiatry’s margins. They did not even pretend that this was not true. Moreover, the “criteria” you value so much are VOTED ON by committees and their inclusion/exclusion is highly affected by political lobbying. What other scientific realities are decided by vote? See “homosexuality” as a perfect example. It was a mental disorder, then they voted, and it wasn’t. Or Asperger’s Syndrome. It was a disorder, but then it was voted out. Child bipolar disorder was not an allowable “diagnosis” until the DSM-IV (I think), at which point it became acceptable by voting it in, and suddenly millions of children were diagnosed with it, when no one “had it” before. And fascinatingly, the majority of those so “diagnosed” never developed ADULT “bipolar disorder” according to the existing “criteria.”
I will add Moncrieff’s recent review of the literature showing NO convincing evidence that “depression” has anything at all to do with low serotonin, though of course, this theory had already been convincingly disproven prior to Prozac even coming to market in the late 80s. The believe in the “serotonin theory” is 90% pharmaceutical company marketing. There is no known “chemical imbalance” that is associated with depression diagnoses.
That’s just me getting warmed up. The DSM is a book of fiction. There is NO evidence that any of these “disorders” are even legitimately considered illness categories, let alone have a proven biological cause. The head of the NIMH said as much out loud, though he was attacked politically for saying so and quickly backpedaled under pressure from the psychiatric “thought leaders,” who continued to need a justification for their pseudoscientific bullshit. And I use the term “thought” very loosely here.
Again, it’s your job to provide evidence of your claims, otherwise, they are your opinion, and as you know, everyone has an opinion, as well as certain biological organs… well, you know what I’m talking about.
Please present it. Choose any “diagnosis” and prove to me there is a reliably biological cause. I am quite certain you cannot, because these “disorders” were not chosen because of anything except a superficial similarity of “symptoms.”
Sorry, but the “diagnostic criteria” are mere descriptions of unpleasant behavior or emotions which tend to occur together. It is certain that mental distress is real, and that mental aberrations do occur, but to call these DSM categories “illnesses” gives them a scientific legitimacy that they certainly do not deserve. I’ve already proven in an earlier post that two people having a particular “diagnosis” can have as little as one or zero “symptoms” in common with someone else with the same “diagnosis.” Such subjective categorization is anything but scientific.
Not sure I see it. A large portion of the article was aimed at criticizing Gavin Newsome, the Democratic governor of California, and his pro-incarceration approach to “mental health.” He’s seen by some as the next Democratic candidate for President. Hardly a target for a pro-liberal, anti-Trump rant?
Kindergarten also requires things these days (like learning to read) that were not requirements when I went to school. Some even report kindergarteners being given HOMEWORK. There are a lot of inappropriate expectations built into schooling, and I see the so-called “ADHD” kids as the “canaries in the coal mine,” telling us with their behavior that you are asking too much of kids their age.
I think I just said that.
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I suppose any time folks think that being in a particular category makes them more worthwhile than others, we have problems. We’re all just humans!
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Art may be more for the artist than the observer. I recently wrote a very emotional poem, not something I usually do. But it was quite cathartic for me. Others found it beautiful, but it didn’t have the same meaning for them. I wrote it for me more than anyone else.
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Thank you. I have found peace in the wake of this sadness, with a very special new friend and some very good old ones. It comes and goes, but I feel like I’m doing about as well as could be hoped. This week is her birthday and also the anniversary of our first meeting (4th and 5th respectively) and it’s been a little rough. But I’m doing OK.
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Absolutely. They go into withdrawals, which means they are MORE hyperactive than they were to start with often. But like I said, “professionals” often use this to convince parents that “see, when he stops using it, he gets so much worse!” without bothering to mention that they might get a whole lot BETTER once they actually got through the withdrawal period.
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Or perhaps they ought to simply change the environment. Good research shows that so-called “ADHD” kids do way better in open classroom settings. Why aren’t we creating settings that work for these kids? Maybe they are a warning sign that the adults are not meeting the children’s need!!!
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Both lovely songs, Richard! Thanks for sharing them – it’s given me a good start to my day!
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Often the selection criteria create a situation where no real information can be gained from the research, because the group is heterogeneous.
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It may be worse to electrocute a developing brain than a fully developed one. But electrocution as a “treatment” for “mental illness” is rank insanity in any case! We generally do anything we can to avoid people having seizures. Why we’d want to induce one and imagine it is helpful is baffling beyond words!
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Thank you, Kermit! It is an observable fact that we would not be here if not for you (and Bob, of course!) So right back at you – thanks for making MIA a functioning reality, and I am happy you will be rejoining us here on earth for a while longer!!!
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Thank you!
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I found this very touching, Kermit, after having dealt with my own brush with death and of course the loss of my wife. It is sometimes hard to remember the good fortune we have had in life, but love really IS the answer!!!
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No, it doesn’t. It means stopping those with power (whatever color their skin) from taking over a culture and dictating what is supposed to be believed and acted upon. An example would be forcing other countries or cultures to adopt the DSM or ICD as a way of describing “mental illness” rather than using the ways they already have to describe such phenomena. The fact that white people have a lot of the power positions is merely a fact of life. Most white people are harmed by “colonization of mental health,” only a very small number have the power to actually create this effect, and they’re not all white, either.
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Wow. That sounds pretty mechanical!
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This is a good reminder that AI is not actually “intelligent,” it does exactly and only what it is programmed to do. I’m sure that providing reassurance and common reality is a good thing in MOST conversations, but when AI starts agreeing with someone that killing themselves is understandable and helping them make a plan, we’ve gone way around the bend!
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I do appreciate the honest response. I should have acknowledged you for both being willing to come here and for challenging standard practice yourself. I’ve been in the position of working with the system and I know it takes a lot courage to speak up and question the status quo.
Actually, I DO think we’d have a lot to talk about and if we were going to revise the system, you’d definitely be the kind of person I’d want to be planning it with.
And for the record, I don’t have any expectation that ALL psychiatrists act in any particular way. I had any number I used to work with who were open to feedback and a couple who worked with me and others on implementing a law to protect foster youth from over-drugging for behavioral reasons. My comments were mostly motivated by the seeming dismissal of the POSSIBILITY that there are, in fact, some in the field who DO engender ill intent or at best neglect, and that many of them have been quite powerful in influencing our cultural views of emotional and behavioral challenges without much respect for the actual science involved. I don’t think we make any progress without dealing with the “bad apples” in the barrel, especially if they are people with lots of influence in the field.
Looking forward to your next blog and thanks for being willing to engage with us despite having to face some pretty intense feedback!
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I am NOT expressing contempt and condemnation. I am observing factual reality. It seems you are the one attempting to show contempt for the logic I have presented. For instance, you claim that “new drugs” means that doctors don’t know the information regarding withdrawal effects. I showed you that Prozac (marketed since 1987, almost 30 years ago) had been shown to have withdrawal effects as early as 1992. That is factual, not contemptuous or condemning. Yet your comment condemns me as “uncharitable” for not allowing psychiatry off the hook for this clear, observable and measurable failure.
Being reasonable and charitable can be helpful to a point, but we have to start with being honest with ourselves. It does not scan that psychiatrists didn’t notice for 20+ years that SSRIs had serious adverse effects. The only logical conclusions are that 1) they chose to ignore that information, or 2) they actively suppressed that information because it didn’t fit with their philosophical and/or economic model of reality. Making excuses for this failure does not lead to improving things for people in need. Honestly confronting the facts of inherent conflicts of interest and the actual PRACTICE of psychiatry in the field (vs. what you say the training is or should be) is essential to improving things for people in need. Nothing will change if we professionals make excuses for ourselves or blame clients for the behavior that our model has encouraged them to adopt. It’s a not a matter of contempt, it’s a matter of RESPONSIBILITY. Professionals are responsible for the results they obtain. If folks suffered adverse effects or withdrawal effects for decades and mainstream psychiatry failed to notice or intervene, the fault lies with the profession/system, not the clients/patients. I think that is a VERY reasonable proposal, that we start by relying on the actual known DATA rather than pursuing what is most economically or socially rewarding for the industry. No contempt, simply an insistence on holding ourselves responsible for our own results.
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Patients’ resistance to stopping psych drugs has to be seen in context – if they have been told they will “relapse” and that their “brains are broken” and they have “diagnoses” that are vague but purportedly permanent, of course, they will be reluctant to reduce or stop drugs, ESPECIALLY when most have not been really given the opportunity to explore alternatives.
I used to work at a crisis line. Got a call one time from a person diagnosed with “major depression.” She was in a panic. She’d been trying different antidepressants for over a year, done 5 or more as I recall, and had no benefits. She felt like there was no hope, that she’d be depressed FOREVER!
I stopped her and asked, “Has anyone told you that there are other things you can do besides antidepressants for depression?” She paused for a moment. “No,” she said very calmly. “Well, there are,” I said. “Oh,” she said. “Well, THAT’S good!” And we talked about other options and she already felt a lot better. This discussion must happen, of course, BEFORE antidepressants are ever prescribed. It did not, and in my experience, if one sees a psychiatrist, it almost never does. If one thinks their only hope is antidepressants, of course, they will resist coming off of them. And yes, that IS blaming the clients!
Additionally, how do you know that the failure to discuss withdrawal problems was not done with malice or ignoring of information? Peter Breggin reported convincingly on antidepressant withdrawal, with good research references, way back in 1992. It is only in the last few years that withdrawal effects finally appear to be STARTING to be taken seriously. I still talk to plenty of people who are never informed of any possible withdrawal effects.
Again, it appears you are making excuses for professional failures. Are you suggesting that between 1987 and 2025 there hasn’t been PLENTY of time to research withdrawal effects, or that most psychiatrists ought to have been well aware of this problem (internet withdrawal groups have been around for decades)? Why is it so important to you that we “be reasonable” about the obvious failures of the profession? At what point do we stop assuming there is no ill intent and begin to face the fact that financial conflicts of interest have colored and distorted the psychiatric worldview so that drugs are, in fact, hugely favored without strong data supporting their efficacy?
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Very well said!
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Or to put it another less charitable way: It’s a lot easier to dehumanize clients who are involuntary and don’t have advocates there to stand up for them.
It seems you are willing to give other practitioners the benefit of a doubt in most cases. Years of experience disabused me of such notions. And the docs “not having other tools” is clearly a validation of my assertion that they only see biology as the cause. I’ve also had many a conversation with psychiatrists about these questions (I’m pretty assertive), and have gotten very bio-based responses. For instance, I talked to one guy (whom I actually liked quite a bit) about PTSD. He’d made it clear he thought biological brain differences were the main issue for psychiatrists to address. I asked him, “Well, in PTSD, there has to be a traumatic event to trigger the reaction. Doesn’t it seem like the traumatic event should be considered the primary cause?” His response was, “Not everyone gets PTSD from the same level of trauma. There MUST be something different in the brains of those who have that reaction.” See what I mean? No consideration of cultural context, of personality features, of social support networks or the lack thereof, of prior trauma, of resilience factors – no psychosocial analysis at all. Just, “They react differently. Brains must be different.” And this was one of the more educated and rational psychiatrists who was mostly in a research role, not overwhelmed by clients.
I do agree that lack of staff training in observing and intervening is a big issue. But isn’t that the psychiatrist’s job, to train them or make sure they have training? For example, the kid I mentioned with the extreme hand tremor was on four drugs, two antipsychotics and two mood stabilizers. All four had involuntary movements as potential side effects, and two specifically mention hand tremors in the product information. Yet the psychiatrist, when I told him we were concerned about side effects, said, “We haven’t noticed any side effects!” The hand tremors were obvious and the girl was spending a huge amount of energy trying to stop or disguise them, and she found it embarrassing that it was occurring to her. But the staff told her it was because she was “nervous”. The CASA spoke to the line staff, and they said they were NEVER told about potential side effects to watch out for when a kid started a new drug.
So at a certain point, we’re no longer talking about being overwhelmed. In the above case, we are talking about overt neglect and violation of the child’s right to informed consent (she was 14 and that right was posted on the “clients’ rights” posters all around the facility). Of course, once we convinced the psychiatrist to reduce the risperdal and lithium, the hand tremors decreased markedly. But they still told her it was nervousness, despite the clear scientific evidence it was not. This goes beyond being biologically oriented and moves into dehumanization of the client, as I mentioned above. No one should be treated that way, no matter how overwhelmed the staff is. Frankly, I think saying the doctors don’t have tools or enough time is pretty much an excuse. They ought to have other tools if they receive the training you assert is standard. It seems they are simply not applying them, and blaming the clients’ brains when their approach fails or creates other problems.
You also failed to address the overt claims that were frequently made to foster youth that despite massive trauma, they had “brain problems” that needed drugs to resolve. This is both a philosophical failure and further evidence of a lack of application of the supposed tools these psychiatrists were trained with. It doesn’t take a rocket scientist or a lot of extra time to recognize that the foster youth needs an acknowledgment that his/her distress is very real and is NOT the result of bad brain chemistry. It’s not an inability to do so that is the problem. It is either an unwillingness or a lack of empathy, and I truly believe and observe that the DSM diagnose-and-drug paradigm both allows for and increases the likelihood of such dismissive behavior on the part of ostensible professionals.
And I’ll end by saying that it’s not the client’s job to “be fair” or “understand the limitations” of their caretakers. Harm is harm, no matter why it happens. As an old friend of mine used to say, “It doesn’t matter why the milk truck doesn’t make it to the refrigeration center, the milk still spoils.” Clients who have been harmed, in particular, should not be expected to “be reasonable” about the professionals who failed them. We as professionals need to absorb their anger and critiques and reexamine our practices, not make excuses for bad service.
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Richard,
I appreciate you taking the time to write a considered response.
As to #3 and #4, it may not matter a lot what is taught, the choice to rely on “medications” as the first line and often ONLY intervention for “mental illnesses” makes any other non-medical-model considerations moot. I have known a large number of psychiatrists from my work in the child welfare system, and can count on one hand the number who actually prioritized non-drug analysis or interventions for foster youth, ALL of whom were certainly victims of childhood trauma of the most serious kind, both by their birth families and by the process of removing them to foster care. I’ve also spoken to dozens, maybe hundreds of foster youth, and have not met one yet who felt their problems or issues were mainly addressed by psychiatric diagnosis and “medication.” They were addressed by changing foster homes, by being adopted, by being empowered by attorneys or CASA volunteers to be their own advocates, by being particularly cared for by an excellent caseworker or social worker, according to the kids themselves. I’ve also encountered many kids being damaged by the “medical model” assumptions inherent in the label-and-drug process: kids becoming diabetic, becoming psychotic, relapsing into eating disordered behavior thanks to stimulants, becoming suicidal, having constant hand tremors and akathesia, among others. NONE of the situations I just mentioned were addressed by the MD psychiatrists whose drugs were creating the problems. ALL were resolved by advocacy by the CASA volunteer or by the child’s own decision to stop following the MD’s instructions.
So whatever the training, my experience is that in practice, most psychiatrists (at least the ones treating foster youth) are in fact quite committed to the “medical model,” but don’t even attempt to provide informed consent, let alone analysis of social factors contributing to the youth’s difficulties. Multiple foster youth have reported to me being told they were depressed “because you have a brain chemistry problem.” They were often incredulous, saying, “So they are telling me that my BRAIN is the problem, that if my BRAIN were working properly, despite being abused at home, removed from my family, moved to multiple foster homes, separated from my siblings, grandparents, relatives, forced to change schools multiple times… despite all of that, I’d NOT be depressed if my brain were working properly???!!”
It appears to me from my experience and the stories I hear that, notwithstanding the “bio-psycho-social model” claimed to be in use, most mainstream psychiatrists use the “bio-bio-bio” model and view ALL “mental illness” as problems with the brain. It is hard to see how any kind of change can happen in the field when the majority of practitioners fail to address or even consider the kind of psychosocial issues that are often behind or exacerbating the “symptoms” they are trying to suppress with their biological interventions.
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“Treatment resistant” is code for “I don’t know what the f*&k I’m doing!” Run from anyone using that term!
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And the only way to stop it is to stop taking that particular drug. The drug is the cause. I have never seen any kind of side effect “medication” be truly effective in stopping this, though such medications do exist.
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I am familiar with Invega. It is an antipsychotic and most definitely could and often does cause akathesia and movement disorders.
You found the right way to respond. When there’s no button, just go back to the last one that HAS a respond button and use it, and your comment ends up at the end of the queue.
If you still want to write, I’m at [email protected]
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I have always thought we needed safe spaces for people to go to when they are feeling or acting out of control, but to unlink that from “diagnosis” and “treatment” unless that’s something the person wants or relates to. Folks can write “advance directives” for times they are unable to decide. But it’s certain we need safe spaces for people to destimulate from whatever is upsetting them. The idea that being held in such a place necessitates drug “treatment” is where I object to the process.
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What drug is causing the akathesia?
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“What About Bob” is priceless! One of my all-time favorites!
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“This suggests a treatment culture that diverges from guideline recommendations, where symptom-targeted prescribing prevails despite the risks of side effects and overmedication”
Doesn’t this prescribe mainstream psychiatric practice? What are they doing other than “symptom-targeted prescribing?” Seems like the only tool they have in their “toolbox” for the most part.
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I am so sorry you had to go through that!
But don’t imagine that “having depression” would have meant any different result. Brain damage is brain damage, regardless of one’s “diagnosis.”
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Not to mention, those receiving neuroleptics die decades before the average person. They are actually killing people slowly with their “treatments.”
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You are a truth speaker. Those afraid of the truth will find you threatening and often be hostile toward you. I’ve found the same myself. I’m a perfectly kind and cooperative person in general, but I speak up when something is wrong. And some people (especially doctors) seem to have difficulty with this concept.
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Quite so. It is a typical “blame the victim” scenario, and blaming fat people for being fat due to some character flaw is very much accepted in our culture.
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I don’t either. Knowingly creating harm through fraudulent representations and blaming of the victim. Particularly egregious when the clients are young and involuntary, not in a position to defend themselves or often even understand they are under assault.
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How anyone imagines that inducing a seizure through electrocution can be anything but harmful to the brain is truly beyond comprehension!
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I worked with kids in foster care taking Zyprexa or other fat-inducing antipsychotics, and saw psychiatrists frequently put them on diets and exercise regimes, never telling them that their weight gain was caused or exacerbated by the drugs. I saw one case where a kid in recovery from an eating disorder was given stimulants. When she stopped eating, they treated her like her ‘eating disorder’ came back, rather than recognizing (as my CASA volunteer observed and informed them) that her loss of appetite was due to the foolish decision to give her stimulants! Another kid became psychotic on stimulants (which happens in close to 7% of the cases, per a Canadian J Psychiatry study), yet she was given a psychotic disorder NOS diagnosis and prescribed antipsychotics. She only stopped being psychotic after SHE decided to stop all the drugs! Another got diagnosed with diabetes, which disappeared when she stopped taking Seroquel at the CASA volunteer’s behest.
The ability and willingness to ignore the obvious connections between drug administration and behavioral/physiological adverse reactions seems endemic to psychiatry. If the person gets better, it’s always attributed to the drugs, but if they get worse, it’s “the disease” rearing its ugly head, even if the drugs are the obvious cause.
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There is a difference in my mind between “authoritative” (able to take charge as needed and help keep things in order) vs. “authoritarian,” which to me means attached to power and willing to use it to keep “subordinates” in their place in the hierarchy. Doctors who believe patients should just “do as they are told” are the ones I think are most dangerous. I don’t mind my doctor having a strong opinion and expressing it, but I have the right to do the same, and if s/he can’t acknowledge that, s/he will quickly become my former doctor!
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I don’t know how many, but it’s not a trivial number. And of course many should never have been approved in the first place but are still in use today. That’s why truly informed consent matters so much these days. Even the doctors don’t seem to know all the adverse effects that are acknowledged, and of course the drug companies only publish the ones they are forced to by the FDA. We are really on our own when it comes to protecting ourselves against dangerous drugs, but most people don’t realize that until something bad happens, and sometimes it’s too late!
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I still think medical doctors need to be much more flexible and honest about side effects and options and alternatives. They also often exercise the option to be defensive when getting something wrong. Remember that most stimulants and antidepressants are prescribed by non-psychiatric doctors.
Plus my experience with cancer treatment tells me that most doctors don’t really know about the drugs they prescribe. I recently experienced a sudden and dramatic recovery from significant anemia after discontinuing one blood pressure drug (Losartan) at my own behest. Sure enough, looking up that drug immediately showed red blood cell production to be suppressed in rare cases, but particularly if one is over 60 (which I am) and takes it for an extended period (which I had been). When I confronted the doctor about it, he said, “I’ve never seen that.” Well, now he has. But he didn’t even record the dramatic recovery in the chart notes. Just said I’d potentially lost some kind of protection against sudden heart attacks, “But I did not take up this issue with the patient.”
Doctors should advise. Patients should decide. Doctors should be honest and accept patient feedback. Even if they are “right,” authoritarian doctors prevent feedback and disempower clients. And empowered clients have better outcomes.
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Yeah, remember Vioxx? Caused strokes and heart disease, literally killed people, but the drug company buried the data until they’d made billions of dollars on this blockbuster drug. No one went to prison for this, either. Not even sure they were fined. It’s not a rare thing.
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It is true that many are driven to become therapists by a feeling of their own incompleteness or inadequacy. This in itself should not disqualify them, but they must have already dealt with these feelings effectively themselves and be relatively emotionally healthy in order NOT to take advantage of the noted power imbalance. I have found such people rare, either in or out of the therapeutic professions. Among psychiatrists, I’ve found them almost nonexistent. Doctors in general tend toward the authoritarian, I’d say, but the number of truly self-aware and non-authoritarian psychiatrists I’ve met over many years of working both within and on the edges of the system can be counted on one hand.
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The CLIENT should be the one who “balances the risks with the benefits.” Too many doctors, and especially psychiatrists, seem to think THEY get to make this assessment. It’s their job to outline the risks and benefits for the client. The client then gets to decide what the balance is. This is too often forgotten!
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Absolutely. But framed as “science”.
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Some researchers believe…
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I just resent it to “[email protected].” Maybe it’s gone in a junk/spam folder?
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Thank you, Rosalee. It has been quite a process so far, and still only 4 months in. But I have learned a lot about myself and finding my way. It’s a big change!
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Ah, but I DID often confide in my clients. I found self-disclosure to be a very powerful way to connect on a real level, even if there are some who would have criticized my “poor boundaries.” But I get where you’re coming from. I’ve always been a big fan of support groups NOT “facilitated by a professional.” Those who have been there and done that are usually the safest people to talk and share with. And again, finding a capable therapist is a challenging proposition. I was quite aggressive in my screening and prepared to drop the grief counselor at a moment’s notice if the process did not meet my needs. Most potential clients are not in a position to take such an assertive stance, nor are most aware that they need to. Only years of experiencing seeing how crappy the average therapy experience was led me to be able to take such steps. I certainly would never trust or assume that the therapist in question was competent or safe without thoroughly testing them out in ways that most people would not realize are necessary or have the skills to accomplish.
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I have had the same experience. It is next to impossible to find a doctor who truly supports withdrawal. Some will “allow” it but generally convey suspicion and condescension toward clients attempting this kind of effort. And if things deteriorate, most are very quickly told, “See, there is proof that you are relapsing and you need the ‘medication.'”
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Fava is brilliant.
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I think we’re all irrational to some degree. Which is why it’s silly to call some people “mentally ill” because they act in certain ways, since almost anyone could be so labeled in the right (or wrong) circumstances. I am sure I could get such a label slapped on me since my wife died, if I let anyone with the power close enough to do so. And yes, I do behave irrationally sometimes. It’s part of being human.
It is true that help of any sort is hampered by power dynamics, not just in therapy, of course, but with doctors, teachers, lawyers, social workers, and so on. Some people choose to take advantage of their one-up power situation, some don’t. To be useful, therapists would have to be trusted to step down from their one-up position. But of course, no one can guarantee that, which makes seeking a therapist fraught with potential harm. As I’ve said many times, the fact of being a therapist or having a degree is no guarantee of being helpful. It doesn’t even improve the odds.
However, I have seen some remarkable work done by therapists from time to time. I can’t dismiss it altogether as always being a bad thing, since I benefitted from a good therapist myself. But that was my good fortune. It was also back in the 80s, when therapists had not yet been trained to be DSM-compliant as most have today. I have, in fact, recently found a grief counselor who has been very helpful to me, and I appreciate her. But believe you me, I screened heavily before engaging with her, and told her what I expected and that I would only continue if those expectations were met. She wasn’t perfect (who is), but she accepted and acted on my feedback, and did provide some excellent support when I needed it. So have any number of friends I have relied on since the loss of my wife, including a local pastor with whom I am now good friends. Help comes from wherever it comes from, and just because power dynamics can be exercised by a provider doesn’t mean they will. It’s not quite that black and white to me.
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Yup. It’s not rocket science!
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I agree wholeheartedly with your proposed approach. Boundaries means saying “no” politely but firmly, not humiliating the client! And you are also correct to say that the power imbalance makes it too easy to be defensive and take out feelings on the client. It’s up to the therapist not to abuse the power imbalance, but I find few who really are capable of doing so.
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What about weaning off and replacing it with nothing? Is that real to you?
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Good for you. I’ve worked “behind enemy lines” myself and eventually felt I had to give it up. So little real care is happening!
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I absolutely support that he has the right to ask her not to record the sessions, and refusing the gift was the right thing to do. What I’m trying to say is that her decision to do so says something about HER and what her ideas, needs and motivations are. One can set expectations without engaging in power dynamics. Whatever the client does, whether it’s allowed to continue or not, provides an opportunity to understand her motivations and intentions and provides a pathway to understanding what is behind them. Which is, after all, what therapy is supposed to be about. Again, let’s say she’s agreed to a no-recording policy. The conversation can easily go to, “Do you remember signing the agreement not to record the sessions? So if you knew that, what made you feel that recording them was necessary?” Or words to that effect. Something is going on with her. You don’t have to allow her to keep recording sessions without humiliating her or making her feel small. After all, she IS the client – if she were entirely rational, why would she be needing therapy? Why not use the opportunity to explore what is underneath her behavior, rather than shaming her? That’s what I’m suggesting.
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“Boundaries” can be used as tools or weapons by the person with more power, hence the therapists. It can be a way to avoid the therapist’s own feelings and blame the client. That seems to me like what happened to the author.
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You are laboring under the illusion that those training therapists are doing so in accordance with what science shows to be most essential!
I’m also not too sure such training can be effective with just anyone. I think it requires a good bit of self-awareness that would require the therapist to deal with his/her own issues before assuming such a role. A lot of people are not interested in or are not capable of that level of self-awareness, and as such should probably be disallowed from ever becoming therapists. But of course, that assumes the TRAINERS and LICENSERS have that degree of self-awareness as well…
Bottom line, it’s kind of a long shot to find someone who really knows how to help. And I don’t know how to screen them except for personal experience. It’s a conundrum, especially when folks are often getting paid for providing little or for making things worse!
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I don’t agree. Catherine is not responsible to gain Eugene’s trust. It’s the other way around. If she were recording me, I’d be saying, “That’s an interesting decision you made there. Why did you think it was important to record our conversations?” It would not be at all threatening – just another opportunity to develop the relationship with the client.
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Because when comparing results of different “styles” or “schools” of therapy, none of them were consistently superior. The ONLY variable that consistently predicted better outcomes was the quality of relationship with the therapist. If people felt safe and heard and believed, they did better. If they saw the therapist as aloof or distant or dismissive or invalidative, they did worse. It is kind of that simple.
Of course, as we have said multiple times before, therapists are not especially more likely than the general public to have these skills. Science has supported that, too. You’re just as likely to feel helped by a friend or neighbor or colleague as a therapist. It all comes down to good listening and being there for the person, wherever they are at. IMHO.
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That is just awful! Criminal, really. They know this can happen but don’t even bother telling their patients or their relatives/carers that it’s possible, and then when it happens, they blame the patient or “his disease!” I’m so, so sorry you have had to deal with this. I agree, fines are not sufficient. Jail time is appropriate!
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It is extremely disingenuous for psychiatrists to blame patients’ misconceptions about drugs and “diagnoses” on the pharmaceutical industry. They’ve been foursquare walking together the entire time since the DSM III in 1980. As for Risperdal, the “off-label” use of these drugs is rampant, for kids, the elderly, and even as an (PLEASE!) adjunct for “antidepressants!” Off label use is legal but needs to be reined in, as far as I’m concerned. It’s dangerous!
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You sound like “one of the good ones,” Hoda. You are right, it’s all about the relationship. Science has shown that to be the case, yet we continue to train people to “have boundaries” by denying the basic humanity of one person communicating honestly with another. Techniques can be handy, but truly caring and being deeply curious about the client are essential for any kind of success. Plus being humble and flexible, to do what works FOR THIS CLIENT instead of what someone says you’re supposed to do!
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Every study has limitations. Honestly acknowledging them is good science.
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Wow, what an amazing story, Janet! Excellent work by your community! More proof that one doesn’t need a degree to be helpful – just empathy and some courage!
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Agreed!
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“Alexithymia?” Seriously? Talk about making things sound more complex so you’ll sound more erudite! I have a great idea – let’s call it “inability to recognize and describe emotions!” Just a thought…
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Using Open Dialog, Finnish researchers found 80% of “schizophrenics” could function without psychiatric drugs, only 20% needed them on an ongoing basis. So to say “a few can manage” is not quite borne out by research. That’s not to invalidate your finding value in them. I’m just trying to undermine the myth that recovering with minimal or temporary drug use is not an unrealistic goal, even if one is “diagnosed with schizophrenia.”
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I can’t agree more with the comment on “resistant clients!” What other profession can you blame the client when your approach fails them?
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I was trying to be amusing. But unfortunately, the obvious DOES have to be proven by studies and yet is still ignored by the system despite the results. That’s the real problem. I’m glad this kind of research is being done, but it is sad that this is a novel concept that is often considered threatening by the supporters of the status quo.
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Your answer sounded like you were saying what I proposed was impossible. I think you’re over interpreting – what I was saying was, your suggesting that this would be DIFFICULT TO FUND was essentially giving in to the idea that the current paradigm is unassailable, not that you were defending it. Sorry if it came across that way. My point is that we should FUND WHAT WORKS and stop PAYING for things that don’t work or make things worse. I hope you would agree with me there!
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They made a choice back in 1980 to go down the medical pathway. It has not worked out, but now they are so financially and professionally overcommitted (sorry, bad pun!) that they can’t afford to back away from their belief system, no matter what evidence contradicts it. The financial incentives are all on their side, and they’ll continue to pass off this DSM/biological BS as long as it pays well. THAT is cynical, I suppose. But it seems to be the truth!
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The fact that “the system” uses DSM codes for billing is no excuse for giving them more validity than they merit. You’re saying we shouldn’t train people to do quality therapy because the system won’t pay for it???? Isn’t that a pretty damned good reason for scrapping the current system and starting over? You’re sunk in the trap of thinking of “mental illnesses” as medical problems. For the most part, they are not. When they are, the DSM system actually discourages looking for the REAL biological reasons by providing a pseudo-biological “treatment” for a pseudo-biological “disease” which they have no understanding of how to cure or often even treat! But we can’t get funding for actual effective treatment? Something is pretty rotten in Denmark, Richard. I don’t think you’re really facing what we’re up against here. The fact that we’ve all been brainwashed into DSM-style thinking and are forced to employ it to get paid by insurance companies is CENTRAL to why the numbers of “mentally ill” are rising despite (or because of?) the increase in “treatment” rates. It’s like the Sufi parable about the guy who lost his key in the house but is looking outside because the light is better there. We won’t find any answers until we stop pretending we have them, and we won’t improve the situation until actual successful interventions are funded with the money retrieved from the current massive waste of billions on stuff that simply isn’t effective!
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It is very cynical to claim “knowledge” you don’t have just so you can sell services or drugs, and to attack those who point out reality as somehow “insane” for not going along with your propaganda.
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It is blameful and creates distance between the subject and the objectifying “professional.” It is the kind of judgementalness that prevents any real connection with a client. It is the ultimate in “othering.”
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Psychiatry as an industry has proven quite cynical!
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I would add 5) Diverts attention from significant social issues and interpersonal issues that can and should be addressed if we really care about “mental health,” whatever that means.
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Very well put!
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Heartbreaking! But well done for you to see what was what and get yourself out of the insanity! That psychologist was an idiot who should have his license removed! It astounds me that these DSM “diagnoses” can be made without any consideration of context, even when he KNEW the context and simply denied it had any effect!!!!
In my view, you weren’t MISDIAGNOSED. You were ABUSED. You should not have been “diagnosed” at all. Those abusing you were the ones who needed to be “diagnosed” with something! But it always seems the victim is the one ending up being labeled as “disordered” while the abusive adults continue to abuse with impunity. I’m SO glad you escaped and didn’t let that define your life! Again, VERY WELL DONE!
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Defy the “categorical logic of modern psychiatric diagnosis?” Where did you get the idea there was “categorial logic” or logic of any kind involved in psychiatric diagnosis? It is as subjective as saying someone has courage or is shy or has been successful in life. There is no real logic in grouping heterogeneous collections of people based on external symptoms, any more than there is logic in saying someone experiencing pain in their knee has “Knee pain disorder.”
I would have to say it is the psychiatric “thought leaders” who are the shape shifters here, never allowing themselves to be pinned down to actual logical thought but instead assuming various rhetorical positions that seemed more focused on preserving their illusions than in establishing a viable categorical logic that is actually logical!
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I mostly agree with the author, but wish she would get away from words like “psychopathology,” which by its very essence reinforces the very dynamic she is critiquing. Perhaps the term “emotional struggles” or “mental/emotional suffering” would be more empowering?
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I would like to hear more specifically how you see the DSM being helpful in such situations. I acknowledge that folks acting within the insurance system need to use the codes to get paid, but for my money, that’s about what they are good for. “Diagnoses” never entered into any therapy I engaged in except to tell them I was billing the insurance company or to explain to them what someone else had labeled them so they’d understand the descriptive and subjective nature of the labels.
I’d also love to hear a response to my answer to your question about how to train therapists. Jane also made a fantastic reply which said what I meant even better, and I think it is deserving of a reply, even if it’s “Well, I don’t know how to do that.”
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Thank you, Jane, you said it better than I could have. Experience leads to generalized knowledge that is useful, but there’s no one way to approach everyone that will ‘work,’ and “the therapist’s interpersonal approach” really is the key to success! And I also like the emphasis on “curiosity” – one can’t learn if one thinks s/he knows all about the area before s/he starts!
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And under what circumstances do you see the DSM as being useful?
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I don’t mean that at all. Not sure where you are getting that. What I mean is that there is no FORMULA we can follow that will help everyone.
As to how we could teach people to be therapists, I agree that this is a difficult, almost impossible task. What the training would need to do is to teach the therapist how to recognize and set aside their own preconceived notions and biases and truly be there to hear what the client has to say. There are certainly situations where past experience helped me know what to do in a current circumstance, but absent the ability to truly connect with the client in their own space, any such experience is pretty much useless. This is why some folks have advanced training (Ph.D. or Masters) in counseling/psychology and are terrible therapists, whereas volunteers at the crisis line I worked at with backgrounds in engineering and/or computer science seemed to be extremely competent in helping out. It is to me an illusion that one can be trained in a particular “school of thought” and apply this thinking universally to all clients with any level of success. My experience is that starting with a “beginner’s mind” and knowing that we DON’T know what to do just yet is the key to success. But this requires a humility and a level of personal security that can’t be trained into someone. Maybe making sure therapists get good therapy before they start is the best chance of creating this. But of course, they’d have to have therapy with a person capable of doing all of the above or their “therapy” won’t make a difference.
It’s a conundrum. But it’s best we acknowledge the observable truth that training people to “do therapy” doesn’t really work very well.
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My thoughts exactly!
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We can’t. As Milton Erickson said wisely, we need to reinvent therapy for every client! The idea that there is one “scientific way” to help people who are having emotional difficulties is actually a ridiculous concept! That’s why the DSM categories are a waste of time. What good is a “diagnosis” that tells you neither why the condition arises nor what can reliably be done to resolve it? It’s a farce!
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BTW, I do consider schools inherently dangerous, whether “standard” or “alternatives.” The biggest problem is the kids have zero power and have to put up with whatever is thrown at them. Very similar to “mental health clients” on the whole. Adults for the most part think they know best, just like the “professionals” in the psych system. In both cases, the key is to recognize the needs of the person being served and empowering them to get those needs met, rather than forcing them to adapt to whatever the “professionals” think is right. True professionals recognize this. Unfortunately, there aren’t that many out there, in teaching or in “mental health!”
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Sounds pretty messed up. They obviously didn’t know what they were doing!
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My kids all were either homeschooled or attended child-centered schools in elementary school, and the youngest did all the way through high school. They’re all very competent at reading and math, two of them obviously gifted in the math/science area. The adults do have to have a focus on making sure they are learning the basics, but having kids pursue their own interests gives PLENTY of opportunities to teach reading, math and science, history, or whatever. It just requires the ADULTS to alter their approach to the needs of the kids rather than the other way around!
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Clearly, it is much greater. And I think largely because of the drive by the pharmaceutical companies and psychiatry to see
ll the idea that drugs are the answer to mental/emotional suffering. Many don’t even know there are other options!
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I think this article overlooks the most important point: psychiatric protocols and decisions are NOT made based on scientific results! Or to put it another way: there are certain very strong assumptions operating in the psychiatric worldview (the DSM categories are scientifically valid, “mental illnesses” as so described are biological in origin, reduction of “symptoms” as identified in the DSM is the most valid measure of “success,” etc.) and the research, even if it’s otherwise done in a clean and legitimate manner, is automatically biased by these assumptions and therefore leads to wrong conclusions. As an example, if “ADHD” is a “neurological disorder” in all cases, then stimulant “medication” can be shown to “reduce the symptoms” of this “disorder.” However, long-term studies have shown repeatedly that the “treatment” of such children with stimulants does not lead to substantial improvements in any long-term outcomes that most people would value (completion of school, enrollment in college, reduction in delinquency, higher self-esteem) despite the “symptoms” being “reduced” by the drug substantially. I’ll leave the reader to imagine and enumerate the many possible reasons why a child may be seeking attention and stimulation, but I think it’s fair to say in this case that “symptom reduction” serves primarily the needs of the institution (usually schools) who recommend it, and leaves the actual client in no better shape for being exposed to a fairly dangerous brain-altering substance for many years.
So by choosing to measure “symptom reduction” as the main outcome, research favors legitimizing the DSM categories and validating drug “effectiveness.” If different “outcomes” were chosen the results would vary dramatically. But these assumptions are not challenged by the article, and are rarely if ever challenged by mainstream researchers. Those who do challenge them are attacked or ostracized, as Whitaker was from Day One, despite the excellent scientific basis of his theses.
Oh, and there’s also the fact that legit research is intentionally ignored by the establishment. Hard to pretend you are being scientific when you dismiss inconvenient data in order to justify continuing your current practices. I will ask how many psychiatric drugs were said to have “minimal side effects” and “no dependency” only to be later shown to be addictive or cause Tardive Dyskinesia or otherwise do known damage that was denied.
I could go on, but I think y’all get the gist. There’s no point in doing “science” if you start with heterogeneous non-scientific groupings, limit your findings to the things you want to find, and deny the reality of research that doesn’t validate your reality. Psychiatry is the farthest thing from scientific, and no amount of double-blind studies can alter that fact.
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Of course, some people want “symptom reduction.” Others don’t. The point is that the client is the one who should be able to decide what “success” looks like for them.
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Again, do we really need a scientific study to elucidate the obvious?
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They didn’t “hate math,” they hated having to do math the way the teachers taught it! I was very good at math but found the math instruction to be dull and inapplicable. I only did well because I already understood number concepts before they started “teaching” me about it. This is true for lots of kids. How we teach math is sure to make it seem dull and irrelevant to our daily lives. But it doesn’t have to be that way, as your Mom proved!
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I have done so, and your conclusions are without scientific merit. If you can’t defend them, you shouldn’t make the claim. There is plenty of evidence that the DSM-III was part of an intentional effort to “medicalize” mental health care due to competition from therapists and support groups cutting into psychiatry’s margins. They did not even pretend that this was not true. Moreover, the “criteria” you value so much are VOTED ON by committees and their inclusion/exclusion is highly affected by political lobbying. What other scientific realities are decided by vote? See “homosexuality” as a perfect example. It was a mental disorder, then they voted, and it wasn’t. Or Asperger’s Syndrome. It was a disorder, but then it was voted out. Child bipolar disorder was not an allowable “diagnosis” until the DSM-IV (I think), at which point it became acceptable by voting it in, and suddenly millions of children were diagnosed with it, when no one “had it” before. And fascinatingly, the majority of those so “diagnosed” never developed ADULT “bipolar disorder” according to the existing “criteria.”
I will add Moncrieff’s recent review of the literature showing NO convincing evidence that “depression” has anything at all to do with low serotonin, though of course, this theory had already been convincingly disproven prior to Prozac even coming to market in the late 80s. The believe in the “serotonin theory” is 90% pharmaceutical company marketing. There is no known “chemical imbalance” that is associated with depression diagnoses.
That’s just me getting warmed up. The DSM is a book of fiction. There is NO evidence that any of these “disorders” are even legitimately considered illness categories, let alone have a proven biological cause. The head of the NIMH said as much out loud, though he was attacked politically for saying so and quickly backpedaled under pressure from the psychiatric “thought leaders,” who continued to need a justification for their pseudoscientific bullshit. And I use the term “thought” very loosely here.
Again, it’s your job to provide evidence of your claims, otherwise, they are your opinion, and as you know, everyone has an opinion, as well as certain biological organs… well, you know what I’m talking about.
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Please present it. Choose any “diagnosis” and prove to me there is a reliably biological cause. I am quite certain you cannot, because these “disorders” were not chosen because of anything except a superficial similarity of “symptoms.”
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Sorry, but the “diagnostic criteria” are mere descriptions of unpleasant behavior or emotions which tend to occur together. It is certain that mental distress is real, and that mental aberrations do occur, but to call these DSM categories “illnesses” gives them a scientific legitimacy that they certainly do not deserve. I’ve already proven in an earlier post that two people having a particular “diagnosis” can have as little as one or zero “symptoms” in common with someone else with the same “diagnosis.” Such subjective categorization is anything but scientific.
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Not sure I see it. A large portion of the article was aimed at criticizing Gavin Newsome, the Democratic governor of California, and his pro-incarceration approach to “mental health.” He’s seen by some as the next Democratic candidate for President. Hardly a target for a pro-liberal, anti-Trump rant?
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Kindergarten also requires things these days (like learning to read) that were not requirements when I went to school. Some even report kindergarteners being given HOMEWORK. There are a lot of inappropriate expectations built into schooling, and I see the so-called “ADHD” kids as the “canaries in the coal mine,” telling us with their behavior that you are asking too much of kids their age.
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