Wednesday, February 21, 2018

Comments by Steve McCrea

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  • A great perspective. Goes to show that people with the exact same “diagnosis” need totally different things. What works for one won’t work for the next. Which makes me wonder what the meaning of the “diagnosis” is, if diagnosis doesn’t tell you what you should do to help. But well done to you for finding your way, Pat, because of or in spite of outside efforts to help. It is a very personal journey.

  • I am kind of amazed that the media has avoided the obvious major causal factor in this mass murder: racism and hatred, promoted and supported by a white supremacist militia this young shooter belonged to. Why do we need to go to the “mental health” argument when white supremacy appears to be the clear motivation? If the guy were Latino, we’d be shouting about illegal immigration. If he were Muslim, we’d be shouting “terrorism” from the highest buildings. But he’s a white supremacist, so he must be “mentally ill?” Help me understand this!

    I am also wondering if he was being “treated” with benzos or SSRIs, but we’ll have to wait for more data on that point.

  • Maybe “changing their minds” isn’t really the right phrase here. Perhaps “helping them remember their purpose” or “helping them process their pain” are what really make the difference. I agree that we can’t “change people’s minds,” but I’ve intervened in the lives of hundreds of people who were considering suicide, and helped almost all of them by helping them take a good look at what problem they were trying to solve by dying, and helping them come up with other ways that might solve the problem in a less final fashion. Most of the people I encountered did not WANT to die, they wanted to stop suffering and saw death as a certain means to do that. Of course, I worked at a crisis line, so those calling were almost all ambivalent about their intentions. I know there are people who genuinely want to end their lives and have their reasons, and I agree it’s not society’s job to “stop them” or “make them change their minds.” But that doesn’t mean we can’t help people who are suffering through compassionate listening and support.

  • I still don’t understand how anyone can claim “overdiagnosis” or “misdiagnosis” of something that has no objective diagnostic criteria. It’s good they recognize that “Adult ADHD” is a marketing scheme, but how is it any different than “childhood ADHD,” which they still claim to be able to diagnose accurately?

  • I don’t agree that it’s oppressive to have rules and expectations for civil behavior. Oppression comes from the rule of one “in” group over another “out” group. There are many examples in Western democracies, but the most encompassing is the oppression of the poor and the working laborer by the rich and the propertied classes. This oppression is chronic in Western societies, but societies have been observed where such oppression does not exist at all.

    Laws in a democracy are supposed to be made by general agreement, with all having either direct or indirect input through representation. If such is the case, problematic laws can be changed by communication, and any oppressiveness is temporary, accidental, and remediable. Looking at psychiatry, we see the opposite. “Patients” or “clients” are clearly considered less valuable than “professionals,” leading to the latter feeling justified in making decisions for the former, including forcing “treatment” on them “for their own good.” The main thing a Soteria-type model provides is freedom from this kind of oppression. If people are allowed to be themselves, yet still expected to maintain some kind of respect for other people’s rights, it is possible to create a society where oppression is not a major force. Unfortunately, psychiatry is clearly and violently opposed to any such creation, and will stamp it out wherever such creations begin to blossom, as Mosher learned to his dismay.

    Oppression starts with a significant imbalance in power, and the person in power can and often does use that power to do harm. It has nothing to do with creating laws for a just and smooth-functioning society. It’s not oppressive to expect societies’ members to treat each other with respect. It IS oppressive to expect some to accept disrespectful treatment while not holding those treating them poorly accountable for their violations.

  • US healthcare is WAY more expensive than most other countries, mostly due to the profit motive and to perverse incentives, such as paying $200/hr for 10-minute “med checks” vs. $75/hr for therapy vs. next to nothing for “peer support.” So we have plenty of money to afford this kind of system. It’s just not profitable enough for the powers that be.

  • Thanks for the excellent article. I notice at a few places that you say that the professional staff “doesn’t understand” true peer support principles. I don’t agree with this. My observation is that they don’t BELIEVE IN peer support principles, and the more they understood them, the less they’d believe in them. Peer support presents a THREAT to the status quo, including threatening many professionals’ deeply held belief that they are inherently superior to “the mentally ill” and therefore have a right to condescend to and feel superior to them. Accepting a true peer support concept would be tantamount to admitting that they (the professionals) are not substantially different from the clients they are supposed to help. While such an admission would, of course, be tremendously helpful in allowing professionals to actually understand what works and what doesn’t work, the vast majority of professionals don’t have the courage to face the uncomfortable feelings that come up when they step down from their place of power and face the truth of their own oppressive behavior and their own prior experiences of oppression.

    As in any movement, cooptation is an effort to disempower a threatening group. No amount of education, training, or regulation will make peer support acceptable to the mainstream. They won’t give their power away voluntarily, with a few exceptions, and those exceptions will be hounded and driven out (as I was) by the violence and corruption of the system.

    What we need is not “peers” in the current system, but a new system not based on power differentials.

    — Steve

  • Most of the psychiatric armamentum would qualify as “unnecessary care.” But if you pay people to prescribe drugs, they’ll prescribe drugs. If you pay people to do tests, they’ll do tests. For profit healthcare is problematic, because as soon as the need for profit drives care, then we receive what is profitable, not what is actually helpful to us. Something’s got to change!

  • You’re right – it should be Job #1, as the threat of involuntary “treatment” (aka torture) contaminates any system that tolerates it. Job #2 should be to eliminate psychiatric “diagnosis.” I don’t hold my breath that either of these things will be a part of ANY “Integrated Care” initiative, which is why I doubt there is any value in the concept.

  • Like I said, it’s a viable strategy. It’s not a panacea, and it can be and often is used in an authoritarian manner. The enemy isn’t CBT, it’s AUTHORITARIANISM. An authoritarian thinks s/he is better than “the mentally ill” and so believes clients need to be “fixed” by having something done TO them. Quality therapy (and I admit it is rare) involves empowering the individual to take action in the service of improving the conditions of his/her own life. It should never be driven by the needs of the therapist, but it too often is, and the DSM lends tremendous credence to authoritarian views and encourages this kind of abusive, controlling behavior in the name of “therapy.” I can completely understand that even one visit with one of these charlatans would turn one off of therapy forever. I was fortunate to have run into a capable therapist early in my life, and I learned what good therapy can do, but I don’t think most people in therapy get therapy at all. They get authoritarianism and/or ineffectual sympathy, neither of which helps anyone get anywhere good.

  • CBT is often used in an authoritarian manner – instead of the client deciding what thoughts or beliefs s/he wants to change, if any, the therapist decides what beliefs THEY think the client should change and tries to force the client to change them. When approached that way, it can be extremely oppressive.

    Also, CBT is just one strategic approach that could be used, doesn’t work for everyone. A therapist who is committed to being a “CBT therapist” will continue to force the issue even when it isn’t working or is harming the client.

    A really good therapist will have a range of options available to apply, and will adjust his/her approach to the needs of the client. But I’d estimate that 80% of therapists are not fully capable of doing this kind of work, and as such, they become dangerous.

  • The list is very thorough, though incomplete in one regard: to put an end to “ADHD” diagnoses, we need to revise the oppressive nature of our educational system and take an approach that respects the individuality and internal motivations of our students. The industrial educational model is responsible for probably 90% of “ADHD” diagnoses. Consider alone the fact that 30% of the “ADHD” cases go away if kids go to school one year later. Clearly, schools (and now even preschools!) are expecting things from kids that are not appropriate, and alternative models already exist. Time to start doing what works instead of what’s politically expedient!

  • “Standard Protocol” – Jeez! This is why it is really, really dangerous to have these things viewed as “medical diseases.” They start acting like they have some scientific handle on how to “treat” it and your opinions stop meaning anything at all. This is horrific – they almost killed you! I hope you are someday in a position to sue their asses!

  • I agree. Ultimately, real community is the answer. So how to go about rebuilding communities in a system that is designed to destroy them? How to dismantle that system in a way that allows communities to be reborn and to flourish? That’s the truly big question at hand. “Therapy” almost by definition assumes a society that fails to meet the needs of a large percentage of its members.

  • Finally, someone who knows how to design and honestly report on a social science study! Notice that he reports on both his original hypotheses and outcome measures, and whether nor not the measures support his original hypotheses in full or in part. And he honestly reports the results when his hypotheses are not supported or only partly supported. If only psychiatric research were supported this way, psych drugs would be rarely used.

  • Rate of prescription is not the same as rate of “depression.” If the definition of depression is arbitrary, the rate of prescriptions written will be, too. The question is, given the subjective and frankly arbitrary definition of “Major Depression” in the DSM, how can any rate calculation be anything but subjective and arbitrary? We already know that rates of concordance on diagnosis for any of the DSM “mental disorders” are mediocre to poor. So talking about “rates of depression” is just not meaningful.

  • I think it’s simple to explain. “Mental illnesses” as defined in the DSM are not scientifically true. What is called “mental illness” is very real. It’s the names they put on them, or the way psychiatrists group people together that have little to nothing in common that is the trouble.

    OK, it’s not simple to explain, but it isn’t that hard, and NOT explaining it means allowing the mythology of the DSM to continue unchallenged.

  • I had the same thought. Industrialization forces us all to comply with many arbitrary schedules and rules, often starting as infants. This is highly stressful and screws not only with our sleep schedules but any other part of our circadian rhythms. Not to mention disruptions in nutrition, toxic chemicals in the environment, noise and light pollution, and on and on. Psychiatry is the handmaiden of industry, helping blame individuals for the costs of industrialization.

  • I think it is perhaps a mistake to say that “EDs” are caused by any one thing in particular. Every person is different, and the big error (if it is an error and not a tactic) made by psychiatry is to assume or pretend that all people who behave, feel or think in a particular way have something wrong with them, and in fact have the SAME thing wrong with them and need the SAME “treatment.” This sells drugs well, but does not serve their patients. I am certain that every case of “binge eating disorder” is different, having different causes, different needs, and different things to be done to help.

    That said, your comment about reconnecting with the passions of one’s life is a good recommendation for almost any condition one may have, regardless of the cause. While medical intervention may be temporarily needed or helpful, living a full life and engaging with the world on one’s own terms is what life is always about. I know that not everyone has the means or the capacity to do that, but I think that should be a primary target, if not THE primary target, of any psychological therapy/help that is offered.

  • How can you “overestimate” the prevalence of “depression” when there is no way to identify the “actual rate of depression,” since there is not an even close to reasonably accurate way to measure what “depression” really is? It’s like estimating the “accurate rate of anger” or “accurate rate of itchiness.” There is no such thing as an accurate rate of “depression.”

  • What you say seems so clear and obvious to me. It’s baffling that so many “mental health professionals” don’t see it this way. If someone’s angry, you can bet they’re angry at something or someone. Why not find out who or what is involved instead of snuffing out the anger to make yourself feel more comfortable?

    Thanks for sharing this – I am sure many readers will relate.

    — Steve

  • Pretty good article. The writer speculates a whole lot about purported biological causes near the beginning without research basis, but toward the end, the discussion of holistic care is quite interesting and probably very useful to many who are looking beyond the narrow-minded “modern” bio-bio-bio lens. Thanks for sharing!

  • A “myth” in this sense means a belief system that is not necessary ENTIRELY false, but is based on assumptions that are not factual and verifiable. It is a “story” told not for the truth of it, but for the symbolic content. In other words, for psychiatry, these “disorders” are “disorders” not because there is proof of it, but because believing that makes their job seem more meaningful or confers more power to them. A myth is a way of structuring the world through a system of beliefs which are not verifiable, but are held so strongly to be true that questioning them often feels like some sort of attack on reality.

    In my personal observation, it appears you have been both exposed to and indoctrinated into these myths to a heavy degree, as many people here have been initially. It appears you have become aware that the truth varies from what you have been told, but it seems like it’s hard for you to conceive that this mythology is both intentional and known to be less than truthful. It’s very hard to emerge from this mythology, because it means accepting you’ve been deceived and that the general field of psychiatry has not had your best interests at heart.

    Remember that something mythological doesn’t have to be entirely false. It can be true, for instance, that some people feel better when they take psychiatric drugs, or that biology plays a role in at least some people’s “mental illness” as identified by the DSM. The fact that there is some truth in the myth doesn’t make it any less of a myth, because the point of the myth is not truth or falsity, but control over the belief system of those who are exposed to it.

  • I think it needs to be worked together. In other words, eliminating psychiatry goes along with making other changes. I don’t think either psychiatry or capitalism is going down without a fight, and both are going to be undermined step by step. But just as we can’t eliminate capitalism without another means of people having a medium of exchange, people will have to have some way of dealing with challenges in operating in our weird society.

    I was thinking about this last night: here is a short list of “needs” psychiatry fills: 1) gives people an explanation (however poor) for why some people act or think or feel in ways that are outside the “status quo.” This is a real need for people and it will have to be filled in some other way. For instance, trauma, nutrition, social stress are all potential explanations that can be substituted for psychiatry’s “chemical imbalance.” But people need a way of thinking about psychological/spiritual issues.

    2) Psychiatry provides an excuse/justification for avoiding revising or examining current institutions. Naturally, avoiding these things is not healthy for a society, so in order to eliminate psychiatry, we need to create some ways to deal with institutional problems that require accountability and responsible change. Eliminating psychiatry won’t handle this need, because our social system will come up with new ways to justify the continuation of the status quo and the blaming of the victims of their shortcomings.

    3) Psychiatry provides an “authoritative” view on what’s “wrong with people,” allowing rank and file proletarians like you and me to avoid having to think about the issue. Clearly, this is also not healthy, but authoritarianism is rampant in our culture and we need to start addressing this and encouraging people to think independently. This would involve revising schools, at the minimum, as well as many other authoritarian institutions.

    I could go on. You see where I’m going with this? There are reasons why psychiatry has been able to be so successful in today’s society. It fulfills certain niches that our current system demands, and unless that system changes, removing psychiatry will simply open the door for some other charlatans to move into that role.

    Hope that’s a little more articulate.

    — Steve

  • Thanks, Julia and Frank. I agree, moving beyond writing information and comments is needed, some form of political action. I really think we need to get the “left” activated around this as a human rights issue. I also agree with Julia that simply saying how bad it is doesn’t accomplish much. It has been seen over and over again that revolutions that don’t address the underlying social issues end up replacing one oppressor with a new one. “Meet the new boss – same as the old boss…”

  • It may not be a “system” per se. As I said in another comment, it may simply mean rebuilding communities along collaborative lines. It may mean creating sub-communities and support networks of folks who are interested in and capable of supporting each other, much as has happened in the domestic abuse survivor movement. My point is only that being against psychiatry will not be effective if people ask, “Well, what do we do to help people with these difficulties if we don’t lock them up and drug them?” We do need an answer to that question, or panic will ensue.

    Perhaps I might reframe this to say that psychiatry meets a SOCIETAL need in our modern neoliberal corporate capitalist society. Some big changes need to happen in the system or there will continue to be people rebelling against or collapsing under the pressure of this system. That has to be part of our approach. Just screaming “lock up the psychiatrists” doesn’t get us there.

  • Perhaps it’s more correct to say that psychiatry proposes to meet a need that is real, but does it in a very destructive way. People are LOOKING for something, and psychiatry purports to provide it, just as drugs purport to meet a need and end up being destructive. I’m making no argument that psychiatry actually does anything helpful, but that folks are genuinely attempting to get help with real problems, and that’s what leads them to psychiatry’s doorstep. Failing to provide or create some way for those needs to be met will allow psychiatry to be “replaced” with something just as destructive or worse (if that is even possible).

  • This is a great example. It’s quite possible that the professionalization of therapy has prevented other more natural means of resolving conflicts and traumatic events. Perhaps at the core it’s about the loss of community and the psychiatric profession is an attempt to redirect the sense of loss and disconnection that the loss of community entails. Perhaps the answer is creating more intimate communities where people actually care about each other. But there’s definitely something needed that our society is not providing.

  • I am only saying that such needs will have to be addressed, in essence, that the presence of psychiatry in its current form is a consequence of the disturbed and disturbing society we inhabit, and that some means to address these needs has to be developed. It seems we agree on that point. The disagreement is whether psychiatry meets a need. I contend that it does, or no one would voluntarily get involved. Of course, drugs and alcohol, prostitution, and other heinous things meet a need as well. They do need to be addressed, but to eliminate drug abuse without addressing why people crave these drugs in the first place would not work. Same thing with psychiatry, IMHO. So yes, it needs to go, but just saying “get rid of it” I don’t think is enough. There needs to be another path, or preferably MANY other paths, for people to follow to get those needs met along with the drive to eliminate the coercive, corrupt and evil practice of “modern psychiatry.”

  • I’m with Oldhead. The average street psychiatrist might not be “evil” per se, but those in charge KNOW they are using marketing and KNOW the DSM is invented and KNOW the drugs do long-term damage and don’t work very well, and that they make people die young, and intentionally hide these facts so they can make more money. That’s pretty evil in my book!

  • Why would people seek out psychiatric “treatment” if they didn’t have a need to meet? Most psychiatric “patients” are voluntary, and most psych drugs are handed out by regular doctors, not psychiatrists. There is a need there, and it’s being manipulated, but if we banned all psychiatric drugs tomorrow and the DSM the day after, there would still be people saying, “I hate myself, I don’t have any friends, I have no idea what to do, why don’t I just kill myself because my life is meaningless.” Our society is abusive in many ways, and people need some pathway to figure out what to do about it. I don’t know what that pathway is, and I know it’s not taking drugs to numb out your feelings, nor is it categorizing different kinds of difficulties into “diagnoses” and blaming the victims. But there IS a need there and it will still exist even if there is no psychiatry.

  • The idea that “depression” is somehow a unique and different state than feeling sad/hopeless/despondent is a myth. There is no evidence that one can make such a distinction based on how bad someone feels or how long it lasts, as the DSM pretends we can. I suffered for a long time from chronic anxiety and depression, including suicidal thoughts and feelings. A psychiatrist would have certainly diagnosed me with a depressive disorder. I don’t feel that way any more. I like myself, I like my life, and I am very comfortable interacting with people I don’t know at all. How did that happen if my brain was not functioning properly and it was genetic and out of my control?

    There are almost certainly people who are feeling depressed for biological reasons alone. If that’s the case, those reasons should be found and addressed. But to suggest that somehow we can distinguish these cases of “biological depression” from a list of “symptoms” that are created by committees is ludicrous. I would submit that MOST depressed people got that way because of how they were treated by other people. Pretending there is a biological explanation prevents us from actually looking at the psychological/spiritual causes that underlie most “depression,” hence the desire of many of us here to use a different term that reminds us that there is no special “depression” that can be “diagnosed,” but rather than sadness and despair, even the most extreme forms, are part of the human condition and require a human response.

  • I believe eliminating involuntary “treatment” is the first step toward a more rational approach. The second is to eliminate the DSM, or to return it to it’s original role as an insurance billing document. The drugs will eventually sink under their own weight if the DSM/psychiatric mythology supporting their use is eliminated.

    The challenge inherent in Bob’s post here, though he does spin it in a very negative (dare I say nihilistic) way, is that in order to eliminate the entire “mental health” system, we’d have to create a world where folks could get their physical, mental, emotional and spiritual needs met in a more consistent and safe and rewarding fashion.

    It’s worth pointing out that mental/emotional struggles appear to be a part of human life, and that every culture in history has had both formal and informal ways of dealing with these challenges. So while abolition of coercive “treatment” and the DSM are very realistic goals, it does appear that something needs to be in place to assist people who are having difficulty figuring out how to respond to the stresses of ANY society, especially our bizarre Western post-industrial culture. I’m all for eliminating psychiatry, but there is a need to be met, and something needs to be in place to meet that need or our efforts will ultimately be fruitless.

    — Steve

  • I always find these articles both amusing and disturbing. How can you “overestimate” the number of people who have a “condition” that is entirely based on social assumptions and subjective lists of “symptoms” that have been agreed on by consensus but have no objective, measurable quality whatsoever? You can rate how many hours people sleep, what percentage try to kill themselves, what they eat for breakfast, whether they meditate or not, but you can’t accurately measure “depression,” any more than you can measure “courage” or “hostility” or “tiredness.” It’s idiotic!

  • I have found mindfulness-based meditation very helpful. Also talking about traumatic experiences to someone who cared. I had a great therapist for a while back in the 80s who actually LISTENED to me and asked good questions and helped me sort out what had happened to me and what it meant. I have read a LOT of self-help books and tried to apply them.

    I have also done work to help other people, including advocacy work to try and change the system. It required me to face my own fears, because I was working for someone else rather than just myself, and I was willing to do for them what I was afraid to do for me.

    Those are just some things that worked for me. The biggest problem with psychiatry isn’t the drugs, it’s lumping everyone who feels similarly into the same group and expecting the same thing will work for all of them. Everyone is different, and different things work for different people.

    — steve

  • The USA has objectively become less socialist since the Carter administration or before. Even the ACA, which everyone accuses of being socialistic, is a market-based attempt to address unaffordable healthcare while assuring no interruption in insurance industry profitability. I suppose you could call it socialism for the insurance companies, but it’s nothing like what exists in Europe, Japan or other truly socialist countries.

    You seem to have a knee-jerk opposition to socialism. I don’t see it as a cure-all by any means, but neither is the “free market”, at least when you get larger than a small community. Almost every Western government today mixes capitalistic and socialistic policies, for very good reason: unfettered capitalism leads to sweatshops and crime and rampant poverty, and unfettered socialism leads to the Soviet Union or something of the sort. People need incentives to work, but corporations can’t be trusted to work in the interests of anyone but themselves, as the recent developments in psychiatry should assure anyone.

    Given that this is what has developed almost anywhere you can think of as a first world country, it appears to be what works. Why the emotional rejection of “socialism” when it’s part and parcel of every country’s success, including ours?

  • Right, Steve. The DSM is the biggest hoax, and it allows us to dehumanize those who are suffering. It also allows our social institutions like families, doctors, schools, etc. to get off the hook for having done harmful things. I’m never against helping people figure out their path in life, but I’m VERY much against categorizing and dismissing people with arbitrary labels and using drugs to suppress their reactions to living in our crazy society!

  • I am glad you are recognizing that you are getting triggered, Pat. I’d be interested in knowing what kinds of things you find triggering. I think it’s important to be aware of our triggers and take responsibility for having them, even if they are often the result of other people doing stuff to us that was harmful. That way, it’s more possible to have a rational discussion instead of going off on attack/defense mode. It sounds like you had some traumatic experiences both in the “mental health” system AND in the recovery movement, which is not uncommon for folks. I’m glad you’ve found your own path.

  • The problem is the system will continue to abuse people as it has always done regardless of “ACE screening.” Any well-informed and sensitive person will ask questions that lead to information about “ACEs” in the course of a normal conversation intended to help. In fact, even calling them “ACEs” diminishes the power both of the experiences themselves and the survivors’ ability to create their own narrative of the meaning of such experiences.

    A more honest approach would be that “crappy things that happen to you often lead to you feeling crappy and getting sick.” And to allow the person to share such experiences if they like, without giving them a “score” and labeling them as a victim of “ACEs” as if these were some disembodied entities that need to be “assessed.” Same with depression or any other “screening tool.” Sure, doctors and others should be aware of these issues and be willing to talk about them as needed, but “scoring” people on their past difficulties will only serve to dehumanize them even further.

  • In my observation, the best answers come from others who have panic attacks. They DO happen, but they don’t get better (as you have no doubt observed) by being labeled and blamed and having things done TO us! I don’t suffer from long-term repeated attacks, but I have had a few, and have also helped a lot of other people get through them and eventually reduce their frequency, mostly by listening to them and understanding what was going on behind the attacks. There is also an immediate intervention path involving things like meditation, food health, breathing, exercise, supplementation, etc. that many find helpful but that you will almost NEVER find any doctor (and especially any psychiatrist) telling you about. And of course, there is also the need to look at the big-scale SOCIAL issues that create so much of the anxiety that many if not most members of Western society feel – the need for employment, lack of healthcare, corruption in government, institutionalized violence, racism, sexism, and so on.

    One thing I HAVE found helpful in reducing years of chronic anxiety is to start recognizing that beneath my anxiety is ANGER and RAGE at how I have been treated. As I have learned to stop and SPEAK UP when I feel wronged or dismissed, I have had less and less experience of generalized anxiety about my life. Of course, I feel anxiety big time in the moment I take on my antagonist, but I feel SO much better when I just handle it in the moment it occurs – I feel self-respect and a sense of power, things I never felt much as a kid when I learned anxiety as a way of dealing with a world where I was small and my voice counted for little to nothing. That’s just my path, I’m sure there are many other paths, but the answer for me lay in identifying and feeling OK about my own RAGE regarding how I’d been treated as a kid, and feeling more and more OK about expressing my CURRENT rage (usually very respectfully, but not always) when I was feeling mistreated in the here and now.

    Hope that provides some useful perspective!

  • Hi, Sera,

    SO good to read another blog from you – I was thinking recently it had been a while, and I always find your blogs energizing and affirming!

    You really struck a chord with me this time. I was one of those “insider” dissidents in the “mental health” system for a decade or so, and I ran into the very same kind of dismissive attitudes once my views were known. In particular, I relied a lot on knowing the latest research on a topic as a means of balancing the power for clients, but I encountered exactly the same resentment from folks, as if I’d somehow “outfoxed” them by presenting actual DATA that they were unfamiliar or uncomfortable with. It was, indeed, VERY tiring, and I got out of the field and into advocacy as a result. Advocacy pays like crap but at least I could go home feeling OK at the end of the day. Still, most advocacy is for individuals, and system advocacy is much harder and much slower.

    Bottom line, we’re working against CORRUPTION, and corruption is not changed by data or even by good working relationships. It’s changed by deleting the financial incentives toward corrupt behavior, and it’s rampant in our society today. I truly believe that’s where we have got to put more of our energy, yet the thought of taking on THAT juggernaut is even more exhausting!

    Thanks for putting so much of my experience into words. Sometimes helping individuals who are brutalized by the system doesn’t feel like much, but it DOES make a huge difference for those individuals, and in the end, the country IS made up of individuals and maybe we need to help wake up a lot more before the big-scale changes we need to see become possible.

    —- Steve

  • It’s not just a matter of identity or ideology – it’s also a matter of power and financial remuneration. Social determinants require large-scale social ACTION, and this threatens the bottom line of big corporations (and the politicians who depend on their donations) as well as threatening the hold of dominant groups on power over those they deem below them in social value.

  • If you read about and look at most people’s experiences with psychiatrists these days, you will see that many if not most propose that the MAIN cause of “mental illness” is biological. They need to do this in order to justify using drugs as their first line treatment.

    Clearly, there are situations where a person is very easily injured from almost no impact. However, the psychiatric field is taking NORMAL reactions to traumatic situations and blaming the brain of the patient for their “wrong” reaction. I had this conversation with a very mainstream psychiatrist, smart guy, generally rational. He argued that people who react with flashbacks to a traumatic event are “disordered,” simply because not everyone reacts that way, so there “must be something wrong with their brains.”

    As for people claiming no genetic impact, I think you have to be careful not to confuse the idea that genes may influence people’s reaction to trauma and stress, which most people would agree with, with the concept that any of the DSM “disorders” are caused by genetic defects, which is nonsense. The real problem is in the diagnoses, which are made up by committees based on things that are uncomfortable or difficult for society, rather than being based on any common biological problem causing these “diagnostic” categories. If you think about it, why would they? Why would all “depressed” people have the same thing wrong with them? Why would they all need the same kind of help? They have nothing in common except for feeling a certain way. Diagnoses should flow from biological findings, not the other way around.

  • No one would deny that genes are INVOLVED in how people react to stress and trauma. What I object to is two ideas: one, that genes are the ONLY thing (or even the MAIN thing) that causes what is called “mental illness.” The other is the idea that what the psychiatric profession calls “mental illness” is anything but a collection of biases and social constructions that are most likely caused by a bunch of different things, and sometimes aren’t even “disorders” at all.

    For the first idea, I would ask you this: not everyone who gets hit by a car breaks bones. I would guess there is some variation in genetic bone strength that makes some able to withstand a greater impact. Does it make sense to diagnose people whose bones break from impact with “weak bone syndrome?” Should we research the genetics of bone weakness so we can provide extra protection to the weak boned?
    Or should we try to reduce the number of cars hitting people?

    As for the diagnoses themselves, let’s take a look at “ADHD,” the one I’m most familiar with the research on. Possible causes of “ADHD” symptoms include anxiety, trauma, low iron, low or high thyroid activity, nutritional deficiencies, sensory issues, sleep apnea, poor parenting, inappropriate classroom structure, kids being admitted to school too young (a one-year wait reduces “ADHD” diagnoses by 30%), boredom, foster care placement, and many other reasons. Of course, every one of those casual factors would require a different approach. So what’s the meaning of a “diagnosis” that doesn’t tell you the cause and doesn’t tell you what you should do about it?

    The final point I’ll raise is that even if we discover some genetic cause of any of these “disorders” (and 50+years of research have failed to find ONE “mental illness” that has a consistent, identifiable genetic cause), genes are the one thing in the scenario that CAN’T be altered. Why would we spend all of our money and time researching about the one thing that we can’t do anything about? If we know that both genes and environmental impacts combine to create “mental illnesses,” why wouldn’t we want to focus our energy on the environmental issues that can actually be modified?

    Hope that helps answer your question.

    — Steve

  • A horrific story! Thanks for having the courage to share it. It continues to astound me that a person under their care can deteriorate SO horribly over SUCH a long time, and yet at no time do they ever question that their “treatment” is necessary and effective, and that any “failure” that occurs is the fault of “the disease,” never their treatment at fault.

    As I like to say, “Another psychiatric success story!” So glad you’ve figured out how to escape.

  • This is all politics. The Trump Administration decided that “Evidence based” is a dirty word, so they’re not allowed to do it any more. I’ve always had mixed feelings about “evidence based practices.” It’s often used as a way to promote the status quo over anything else, as status quo “treatments” are the ones that get research funded, and hence are the only ones that have any “evidence base” to draw on.

  • Wow, that sounds like just like what you need! It’s really incredible, isn’t it, how they just talk about what they’re going to DO to you right in front of you, as if you don’t even exist? Stunning that they’d even admit Zoloft is screwing you up, but of course, the solution is another drug or another. Glad you’re getting away from them!

  • It is hard to find a holistic doctor. Most would not call themselves “psychiatrists.” PTSD is one label that can be addressed by talking therapies along with good diet, exercise, meditation, and many other approaches that don’t involve drugs. The Zoloft and Klonapin are both potentially going to make things worse in the long run. The lack of sleep may very well be related to Zoloft.

    I wish I had a great idea, but it comes down to searching and searching and interviewing people and seeing who is available and sane in your area who might be able to help. Perhaps finding peer support groups that are not psychiatrically oriented and talking to the other members can be helpful?

    Wish I had more to offer. You can see how how completely incompetent and delusional these psychiatrists and their allies really are. They have NO idea what they’re doing and you’re just a “brain experiment” to them. Get as far away from them as you can! Best of luck to you!

    — Steve

  • A good friend of mine was prescribed Zoloft for migraines. She had never been suicidal in her life, but suddenly had these odd thoughts when struggling with a problem: “I could kill myself.” She was stunned and disturbed! It took her over a year to get off of it due to withdrawal reactions, had to cut the pills down into tiny fragments to wean off. So yes, this does happen, and it’s a horrible idea!

  • Does credentialing actually provide any assurance that the practitioner is competent or ethical? Studies seem to indicate that para-professionals or untrained peer counselors do at least as well as professionals with advanced degrees. What does licensure provide, other than job protection for those so licensed?

  • I can easily explain that. The globe is warming, of that there is no denial. Average annual temperatures continue to climb. However, many who don’t understand climate issues complain that “Hey, it’s been super cold this winter, so that proves there is no ‘global warming.'” I think that in order to address this misunderstanding, the term “climate change” began to be used, because a warming earth doesn’t mean it’s warmer everywhere all the time, but it does mean that the expected climate for different regions becomes less predictable, including significantly more or less rainfall than average, extremes in temperature, more extreme storms, longer dry spells leading to a longer fire season (as happened in the US West this year), and rising sea levels.

    The degree to which this is caused by human activity is debatable. The question of whether or not it’s actually happening is not debatable. This, I think, distinguishes global warming from psychiatry in a pretty dramatic way. Psychiatry simply makes up categories and counts them based on arbitrary checklists that don’t measure anything at all. Global warming is measurable by averaging the temperature around the globe, and can be verified to occur. Climate changes relating to warming temperatures are also predicted by mathematical models, though as we all know, climate prediction is a much more imprecise activity than measuring the average temperature. Temperatures rise, glaciers melt, sea levels rise – all completely predictable and measurable. Psychiatry has nothing remotely similar to measure or report on.

  • I like this. I have also approached it from the other direction – “What were you hoping to accomplish when you did this – what was your goal?” Or “What need were you trying to meet with this behavior?” Not always an easy question to answer, but I found it digs down very quickly to the key issues that are hanging the person up. Whether or not it worked, or continues to work, I come from the point of view that all behavior is intended to meet a need, to accomplish something, and once we find the goal, we can talk about other options that might meet the same need at a lower cost.

  • Oh, and I CERTAINLY didn’t discourage any impulse to strike back at the perpetrators of harm – to the contrary, I always felt that anger and intent to act against oppression was a sign of progress, as the person was moving AWAY from being a victim and toward taking ACTION, which seemed in most cases to be the best antidote to feeling bad about him/herself.

  • You keep saying that, but it’s not necessarily the case. I provided therapy from the point of view that the person came in needing/wanting some change in his/her life, and that my job was to catalyze whatever change that was, as they conceived of it. Part of the job was to help them figure out what it was, but that’s not the same as me having an agenda. I agree that most therapists these days lack the skill to do that, but that doesn’t mean EVERY therapist has an agenda for the client. I had a therapist who was very helpful to me in accomplishing MY goals, and actually refused to tell me what she thought about anything I said or did, instead insisting that what I thought of it was what mattered. I can’t see that she had an agenda, other than to help me make sense of my world and decide what I wanted to do differently.

  • Right, I’m agreeing with you. Any real scientist, would, of course, be 100% opposed to “scientism,” as it undermines the most basic tenets of science, namely, that we need to be humble and skeptical about our own assumptions and that any theory or assumption can be disproven by data. To use “scientism” as an ad hominem attack on real science is only possible when used on the ignorant. Unfortunately, as stated above, the ranks of the scientifically ignorant are legion.

  • Pseudoscience is pretending to be scientific when you’re not. I think “Scientism” is more of a religious belief system where there are “smart” people who “know science” and we can be “smart” too if we just agree with them and do what they say, and we don’t have to think about it too hard. The second is a much more encompassing concept, but also more complex, as it involves the development of religious/philosophical dedication to a set of dogma, whereas pseudoscience is just straight up deception. I think Scientism certainly applies to psychiatry, but Richard’s point is well taken – it is too complex for people to understand fully and is too easily used by demagogues to promote an anti-intellectual agenda.

    The truth is, very few Americans actually understand science and most are unable to differentiate it from pseudoscience. Most are ultimately either proponents of “scientism” or are knee-jerk opponents of “those left-wing intellectual communists” without any real comprehension of what science is about and what it can do when unadulterated by corruption and politics.

  • I think you’re right, we don’t know very much. It’ OK for scientists not to know very much as long as they ADMIT they don’t know very much.

    The problem Dr. Timimi is outlining here is that psychiatry as a profession PRETENDS to know things that it doesn’t know, and uses its authority to convince people that it knows what it’s talking about when really their ‘science’ is mostly just made up.

  • It’s just that you’re mostly a one-trick pony, Pat. People don’t want to debate you because there’s no point, since you’re not open to new data, so once we’ve heard your presentation, there isn’t much else to be said. It might be different if you actually were willing to incorporate others’ views and data into your worldview. But I won’t hold my breath on that.

  • No one slams anyone for choosing to use medication, Pat. You’re projecting your own fears out there. You should know by now that the critique is of lying and intentionally misleading people with false data. You and anyone else is welcome to use whatever medications/drugs they choose to use. You’re even welcome to find your psychiatrist useful, helpful, or wise. We’re not talking about individuals. We’re talking about a system that’s intended to create customers instead of promoting health and truth.