Wednesday, December 7, 2022

Comments by Steve McCrea

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  • Judith Rappoport et al proved this back in the late 1970s. She and her colleagues gave stimulants in therapeutic dosages to teens who were not diagnosed with “ADHD”. They measured things like movement levels and activity levels and ability to concentrate. All were improved in a similar manner to those who were diagnosed with “ADHD” (or whatever they called it back then – hyperkinetic reaction of early childhood or MBD or the equivalent). She called the “paradoxical effect” a myth which was “an artifact of observation,” meaning that people noticed that the “ADHD” kid concentrated better because they were LOOKING for that, but did not notice the same effect in non-diagnosed people because they weren’t looking for that result.

    Note that Rapoport has been a supporter of stimulant treatment for “ADHD” for her entire career. This study has been considered conclusive (in 1978) and the idea of the “paradoxical effect” was dropped afterwards by researchers, though the popular myth of the “paradoxical effect” survives in some communities to this day.

    More recent scientific commentary on the subject:

    The idea that “ADHD” kids react differently to stimulants has long since been discredited.

    As to WHY they increase concentration, we’d have to get into talking about the role of dopamine in concentration, an area where I have not studied extensively at all. But it is VERY clear that all kids (and by extension adults) taking stimulants will react in a very similar manner.

  • The idea of “using one’s voice” as a means to combat insensitive or bullying people is that it doesn’t work very well if you don’t have the power to make your own voice heard. Speaking up when involuntarily committed to a psych ward or living with an abusive partner or abusive parents can be extremely dangerous! Certain bosses specialize in firing anyone who “uses their voice” in any way that challenges the boss’s power and control. I do think we should trust our intuition, but we need to be selective where we “use our voices” if we don’t want to get injured!

  • Clearly, being “highly sensitive” is caused by a chemical imbalance in the brain. Research has proven that insensitive and thoughtless people fare better in society, experiencing less anxiety and depression and being more successful in certain professions like sales, law, or politics. There are special drugs now to help people care less, the most popular being “Fuckidall,” promoted by famous comedian, Robin Williams. Our next efforts will be to create psychoeducational presentations in schools and other places teaching people the importance of insensitivity and teaching them specific “Fuckidall” skills that can be practiced even without medical intervention.

    Stop worrying! Stop caring! Buy some “Fuckidall” today!

  • There is certainly no denying that physiological damage CAN cause psychological phenomena. The problem, as you intimate, is the assumption that physiological damage is the ONLY thing that can cause psychological phenomena, or worse, that physiological DAMAGE (and let’s be honest, that’s what every drug intervention AND so-called ECT does to the brain, and usually to other parts of the body as well: physiological damage) is the only way to address psychological phenomena. It’s like saying insufficient memory can cause a computer to slow down, so the answer to any computer slowing down is adding more memory chips. Illogical. Except adding memory chips at least enhances the machine’s capacity, while psychiatric drugs without exception decrease the body’s capacity to do something, whether the reuptake of serotonin (SSRIs), the reuptake of dopamine (stimulants), or whatever process these drugs disrupt.

    So if some observable physical defect can be detected, it should be addressed as best we can. But ASSUMING that we’re addressing a physiological deficit that no one can actually identify is a very dangerous pathway.

  • I have to disagree with you that “we” (meaning all ADHD-type personalities) “function at a level so far below our potential.” This is only true to the extent that you accept the normal capitalistic go-to-work-and-do-what-your-boss-says-for-a-paycheck kind of standards as one’s “potential.”

    A fascinating study was done not too long ago where they took kids and put them into groups of three. The study groups had two “normal” kids and one diagnosed with “ADHD.” The control groups had three “normal” (non-ADHD) kids in each group. They gave them a set of three problems to figure out the solution to. I can’t remember the age level, but I think they were elementary, something like 8-10 years old.

    They measured “on-task” behavior, and the non-ADHD groups did far better. The groups with the “ADHD” kid in them screwed around more, focused less on the problems and more on just hanging out together. But when it came to solving the problems, NONE of the so-called “normal” groups solved ANY of the problems, while each of the ADHD-inclusive groups solved at least one, and if I am recalling correctly, a couple solved all three.

    Now if you’d run groups where ALL THREE kids had an “ADHD” diagnosis, it’s quite possible nothing would have been accomplished at all in terms of the problems at hand. But it’s clear from the results that the off-task, goofy, creative, “what about this” kind of behavior from the supposedly “mentally ill” child played a very important role in getting the task at hand done, even if less time was spent at the task itself.

    I think the implications of this study are quite huge. Perhaps instead of trying to FORCE the “ADHD” kids into becoming more willing to do as they are told and focus rotely on the “task at hand,” we ought to be looking at figuring out how to make the most of this skill set that clearly our society needs to survive! I think that’s why the “ADHD” kids in the open classroom settings were almost impossible to detect – they weren’t being expected to be rigidly “on task” doing something they found dull or pointless, so they had far fewer problems than their counterparts in “regular” classrooms.

    Another interesting study looked at employer satisfaction with their “ADHD” – diagnosed employees. One might expect they’d be less satisfied because these employees would come late, be disorganized, say offensive things to other workers, etc. But as it turned out, their satisfaction levels were quite similar to “normal” employees. The experimenter observed that the “ADHD” employees tended to CHOOSE jobs where promptness and adherence to assigned tasks were not as important. They became ski instructors, computer programmers, entrepreneurs, salespeople, whatever suited their personality best.

    Which goes back to my original thesis: “ADHD” is a real phenomenon, but it is mostly a problem only because we expect these kids to do things that they are not ready or able to do, and then punish them for failing to do so. When they have more control of their environment, deciding what to do and when to do it and when to shift to the next task, as in an open classroom, on the whole, they do MUCH better than if they are being constantly directed by authority figures on what to do next and when to start and stop their activities. So much better that they look “normal” to professional observers who are looking to pick them out.

    This does not even take into account the HUGE percentage of kids “diagnosed with ADHD” when something else is really the problem. 20 years working in the foster care system showed me how frequently kids with horrible home lives and super high anxiety levels or even frank PTSD symptoms are labeled “ADHD” because they “have trouble concentrating on their work!” Well, if YOU were removed from everyone you ever knew after years of being abused and neglected and were forced to live with a family who had to be PAID to take care of you and could dump you at a moment’s notice, you might find concentrating on schoolwork a bit difficult, too!

  • No one can be totally “nonjudgmental.” The best we can do is be AWARE of our judgments and decide not to act on them, but take them into account when evaluating what is the best thing to do. A person who pretends to be “nonjudgmental” is usually not being honest with him/herself and will have to rationalize any decisions as being “for the good of the client.” I always knew there was a danger I was acting to meet my own needs rather than the clients,’ making it a lot more likely I could avoid that danger. At least, that’s how I saw it.

  • Oh, absolutely, for me, any therapist who thinks s/he can be “above” countertransferrence (aka an emotional reaction to a relationship with another human being!) is highly dangerous!

    In my relatively brief stint as a counselor, I viewed my reaction to the client as a) my responsibility completely, b) something that told me about how I might potentially make this situation worse by making it about me instead of them, and c) information about how the client is affecting me that may give me some insight into what’s going on with them. It is completely NORMAL to have an emotional reaction to an interaction with a client or any other person for that matter. The only thing that SHOULD distinguish the counselor from anyone else is that they understand how to use that information to get their own issues out of the way and make sure they are responding to the person asking for help. Anyone pretending they DON’T have an emotional reaction to their client is just plain lying to him/herself.

    The only way I see to be able to be successful as a “counselor” or “therapist” is to have your own shit together enough that you don’t end up acting it out on the client. That means that far from being “above” your emotional reactions, you are 100% aware of those reactions AT ALL TIMES and are humble enough to know they are there and respect them, both as an expression of your own needs and as a conduit to information that might be of help to the client. There is no training for this ability. It means you have to have done your own “work” on yourself by whatever means you can. I found clients respected me because I was genuine and in touch with my emotions and was honest with them about what was going on for me without putting responsibility on them for my reactions. They liked it that I was human and real with them, and that I think was what worked when it did work – nothing to do with any training or “method,” just being one human honestly there with another and willing to share their pain without trying to “fix” it to make myself feel better.

  • It should be noted that EVERY person can experience “psychosis” if they go long enough without REM sleep. It is not an “abnormal condition,” it’s something everyone can experience under the right (or wrong) circumstances.

  • A few good studies back in the 1970s showed that “ADHD” diagnosed kids placed in open classroom environments were indistinguishable from “normal” children. Additionally, a bunch of studies in very different places ALL showed that if you wait a year to enroll kids in Kindergarten, the rate of “ADHD” diagnosis goes down by 30%! A very odd “disease” indeed that is reduced by 1/3 if you just let kids develop for another year before enforcing your expectations on them, and pretty much disappears completely when you stop enforcing those expectations entirely!

  • It sounds like literal torture! I have also noticed that whatever “treatment” is being provided, there is no requirement that it actually improve the client’s condition, either by the client’s report or any of their subjective “screenings” that are supposed to be objective. If things get worse, it’s raise the dosage or try a new “treatment.” And then they say you are “treatment resistant” if their shit doesn’t work, rather than saying, “Well, I guess our shit didn’t work this time.” And if you somehow get better in some way despite all of this nonsense, they are the first to step up and give their wonderful drugs all the credit. No, logical reasoning doesn’t seem to be in much supply.

  • The amount of lithium used as “treatment” for “bipolar disorder” is many, many times the daily required dosage for nutrition. One estimate I just read suggests that one mg of Lithium a day is sufficient. Another measured the amount in micrograms (thousandths of a gram). A “therapeutic dose” is defined as 300-600 mg three times daily, or 900-1800 mg, one to two THOUSAND times the needed amounts. No one will specify what actual daily dosage of Lithium will kill you, but it is recognized that the “therapeutic” dosage and the toxic dosage of lithium are so close together that regular blood tests (once a week or so to start with) have to be done to ensure you are not receiving a toxic dosage.

    Lithium at high dosages is most definitely a drug. And a potentially deadly one. For those who don’t happen to die as a result of overt toxicity, Lithium at “therapeutic dosages” is known to be very hard on the kidneys, and can lead to kidney failure.,you%20have%20been%20taking%20lithium.

  • There is more than a “dearth of long-term data on impact and safety.” There is PLENTY of long-term data saying that the impact and safety profile of these drugs is questionable at the VERY most optimistic. I’m not OK buying into this “more long-term studies are needed.” The studies we have are more than sufficient to call the use of these agents into question, particularly the blithe way they are prescribed so broadly with little to no standards of care. It is the job of the doctors and the medical community to prove they ARE safe, and they have failed to do so. No one should have to prove “beyond a reasonable doubt” that they are dangerous!

  • In other words, you know of no such stories you can share. Your are unwilling to support your claim with data, yet expect others to accept your claim or else they are “not hearing your voice?”

    This is not a matter of viewpoint. Either the media is slanted toward success stories or it is not. I’ve given a long list of examples of that slant. You claim I am wrong. Where’s your data?

  • Consensus is not science. Scientists have had “consensus” on all sorts of things that were stupid or dangerous in the very recent past. Thalidomide was safe, bottle feeding was as good as or better than nursing, Benzedrine was not addictive, Valium was not addictive, Prozac had a only few mild side effects, Viiox was safe and effective, schizophrenia was caused by overproduction of dopamine, depression was caused by low serotonin, Tardive Dyskinesia was a consequence of being schizophrenic and was NOT caused by antipsychotic drugs… all of these things were agreed upon by “consensus” and turned out to be totally wrong. So scientific consensus is not worth wasting our time on. People agree to false ideas all the time and swear by them, even in the world of science.

    You seem to have spent a great deal of time reading research on these genetic factors, which is great! I’m interested to know what PERCENTAGE of those “diagnosed” with ADHD have the specific CDH2 mutation you mention, and how many have that mutation who do not have an “ADHD” diagnosis? This information is essential if one is going to assume causality of a particular gene. Most of the genetic studies I have seen have found only probability correlations, and I seem to remember someone talking about this one and it was also a correlation – more people diagnosed with “ADHD” had this variation, but most did not, and a lot of folks having the variation did NOT get diagnosed with “ADHD.” Which suggests it could be A causal factor in SOME subset of those diagnosed with “ADHD”, but does not explain the phenomenon overall. Which might be good if that subset is in some way able to be identified and “treated” in some specific way. But it would not be proof that “ADHD is genetic.”

    But I could be wrong. Please share.

  • Lovely hypotheses. No actual facts presented. Who cares who yawns, seriously?

    These presentations are 100% relying on emotional arguments. It is factual that people have been told for decades and still are told by some practitioners that they have a “chemical imbalance” that is “corrected” by psychiatric drugs. What you share is a bunch of professionals using plausible deniability to say, “Oh, we never really SAID that. Or at least none of us actually BELIEVED that, even if we did say it. So who cares if everyone still believes it’s true?”

    The “black bile” comment is particularly egregious. No one has every told anyone in recent times that their depression was caused by “black bile.” While fully 80% of Americans in a semi-recent survey said they believed that depression was caused by a “chemical imbalance.” The latter circumstance did not occur in a vacuum. Whether they themselves believed it or not, psychiatrists sold this idea of “chemical imbalances” hard, along with the pharmaceutical companies, because it was good for business. They only backed away from it when forced to by hard scientific research, and many still promote it in their literature or their practices. These after-the-fact disclaimers are in no way convincing. If they thought this such a silly, simplistic theory, why have they not spoken to discredit it publicly until Moncrieff’s study finally shone some public attention on the subject?

  • I completely disagree with you. My experience is that the “success stories” are the only thing you ever hear in the media, and that those who have problems with this approach are silenced. Sure, there is the odd “horror story” that is sensational enough to make the news, but the idea that “ADHD” is a “neurodevelopmental disorder” that affects millions of children and can be specifically diagnosed (usually implied that “brain scans” or a response to stimulants are diagnostic) is almost never, ever questioned in the mainstream media. There are plenty of “celebrity stories” (Ty Pennington, Simone Biles, Michael Phelps, Justin Timberlake, Jim Carey, Howie Mandel) where the message is “Stimulant treatment saved my life.” I can’t think of one celebrity who has come out saying, “I tried this stuff but it really didn’t work for me” or “They tried to say my kid had ADHD but he moved to a new school and things went much better.” You’re welcome to prove me wrong by getting me some of these stories about how stimulants don’t work or made things worse or weren’t needed because X was really the problem, but that’s not what I see in the media at all. Seriously, I can’t think of a single story off the top of my head where such a story is told. I’m open to hearing evidence to the contrary.

    But my point was not about Big Media, it is about each of us being willing to accept it when other people have different experiences and don’t agree with our own viewpoint. My initial impression left me wondering if you’d be open to hearing things that don’t fit with your own narrative experience. But I could be wrong. Everyone’s entitled to their opinion here, and we all have to respect each others’ views, even when they disagree with us, as long as it is done civilly and with respect for the diversity of experience that exists in the field.

  • You are absolutely welcome to tell your story here. We value all voices of anyone who has been through the system and want to hear how things look to you. At the same time, it’s very important to remember that others have had different experiences than you have had, and that you owe them the same level of respect that you are asking. Different people have different experiences, and hearing that one or two or ten or a hundred people feel their lives are turned around by by stimulants doesn’t alter that one or two or ten, or a hundred people share having experienced harm or confusion with the same approach. It also doesn’t alter the statistics and scientific studies about the overall results of stimulant treatment on the whole group of people diagnosed with “ADHD.” You may learn a thing or three from them as well, and it might help you not take it personally when other people’s description of their experience is quite divergent from your own.

    I hope that makes sense to you.

    BTW, I HAVE seen objective interviews of people diagnosed with ADHD and treated with stimulants or some other approach, and have spoken personally to a large number of such kids. I can assure you that there is a very wide range of responses, some of which reflect your own, some of which are more lukewarm, and some of which reflect feelings of resentment and betrayal. For instance, I worked with a ten-year-old foster kid who was put on stimulants while in foster care, and I asked her how she felt about it a year and a half or so after she was put on the drugs. She said, “Well, I guess it did help me focus better… but on the other hand, maybe I was just going through a lot of stuff at that time.” I would ask you to reflect on why she might not have been as enthusiastic about stimulants as you are. Food for thought.

  • I agree. Folks who are looking for help don’t need another person whose ego they need to protect. Most of the time, that’s what got them into the trouble they are in, having to take care of people who were supposed to be taking care of them. It is ridiculous for a professional to create this kind of expectation, consciously or not. It’s not the client’s job to make them feel good about their work.

  • If you would actually read Whitaker’s work, he was originally fully supportive of the status quo system. He only reduced his support as he observed SCIENTIFIC STUDIES showing that people AS A WHOLE were getting worse, not better. As far as I know, Bob Whitaker has never said that psychiatric drugs are worthless, that all psychiatrists are evil, or that no one has benefitted from psychiatric drugs. In fact, he has spoken out in favor of a targeted use protocol for psychiatric drugs, to use them for what scientific study says they are useful for, primarily for short-term symptom reduction, while seeking to look at other approaches which COULD be used by psychiatrists or anyone else to try to get past “symptom management” and create some viable long-term change. He even gives a couple of examples of how this mixed-use protocol would work, including real world examples of where it has been effective. Given the disastrous “recidivism” rate among users of psychiatric drugs and repeated studies showing that long-term use can make things worse for many users, indeed perhaps the majority, this seems a VERY rational viewpoint to take.

    You seem to be making this a personal thing, as if critiquing psychiatry as a SYSTEM is the same as saying psychiatrists AS INDIVIDUALS are no good. This is simply not the case. You are arguing for a chance to have a civil exchange about these questions. It seems to me that would start with you as an individual dropping the assumption that people at MIA are out to destroy people’s “mental health,” which VERY clearly seemed to be your assumption from the first words you put down in your first comment. If you come into a web community and start off insulting everyone here, it should hardly be surprising if you don’t get a warm welcome. If, perhaps, you REALLY want to have a meaningful discussion as you claim, it would seem to me the most sensible thing would be to start by saying, “Wow, I have a really different experience of psychiatry from y’all. Can you help me understand how you came to these conclusions, and maybe I can tell you how I reached mine?” But I don’t hear you expressing any interest whatsoever in the people who have experienced psychiatry as something unhelpful, insulting, demeaning, or downright dangerous in a very physiological way. I am hearing in you a desire to tell such people their experiences are wrong, or their conclusions are wrong, but wanting them to listen to YOUR viewpoint “nonjudgmentally.” I don’t think that is a realistic plan.

    Have you actually read “Anatomy of an Epidemic?” That might be a really good starting point before you start forming conclusions about Bob Whitaker and the entire community simply because they see things differently from you.

    And I absolutely respect your right to have your opinion, and you are welcome to post it here. But others are also welcome to theirs, and I kinda want to see you find the same respect for them you are asking for yourself.

  • I think it’s a scientific fallacy for them to suggest that success of “pharmacological treatment” with a particular drug equates to some “pathology” of a “disorder.” They made that assumption for “ADHD” (that insufficient dopamine was indicated because increasing dopamine “helped”) and this was found to be false. They assumed low serotonin caused depression based on response to SSRIS/trycyclics affecting serotonin. Recent publications have finally put this idea to bed. They assumed that psychosis is caused by TOO MUCH dopamine, because of the response to dopamine inhibitors. Again, they have been proven completely wrong on this. I’m sure the same would be true of OCD. It’s undoubtedly FAR more complex than such simplistic answers want us to believe.

  • Why is it a criticism of “antipsychiatry?” Sounded like a fantastic critique of psychiatry itself! And I agree with you, which is why I argue that the only person qualified to tell if something “works” is the client comparing what they got to what they wanted to get out of the deal.

    No one has to tell you if your shoes fit or if you liked the meal you were served.

    Thanks for sharing!

  • The challenge comes when someone is walking behind you, undermining the incremental changes you have gotten implemented before. That’s what drove me out of the profession eventually. I realized there are some people whose idea of “positive change” was very different than mine, and in fact, MY ideas of “positive change” were threatening and destabilizing to their safe (if utterly ineffective) worldview. And a lot of those people seemed to be the ones running the show.

  • I agree if you’re going to do therapy, the client has to be the one to decide on what a “good outcome” looks like! No one else can do it but them and have them feel self-determined about their successes. “Therapy” or any other intervention done “for the client’s own good” is almost always the opposite of “therapeutic.”

    The biggest problem with THAT idea is that at the beginning, many of the clients I had did not know what they thought a “good outcome” would be for them. The first part of my approach for such people is to help them get to the point where they could make a decision as to what they wanted their life to look like, or what they wanted to change about their lives. Sometimes that’s 90% of the problem – the client has had so many people telling them what to do, think, or feel that they have lost any sense of their own purpose and intentions in life. They do NOT need a therapist or psychiatrist or anyone else piling on more “shoulds” and “should nots” to their already burgeoning heap of them!

    But of course, every client is different. Those who already know what they’re trying to achieve have been the easiest to work with, as a few questions helps them identify such barriers as they are encountering (or putting up themselves) and they’re off to the races! But such folks are rare in my experience.

  • I do agree that social indicators are a legitimate way to measure success – is the person working or involved in activities of some sort, do they have any kind of social interactions, are they sleeping better, are they off of disability payments, are they exercising, etc. But even there, we can’t assume one set of outcomes for everyone. For some, disability is an unavoidable reality. For some, working in a capitalistic 9-5 job is not going to be realistic, regardless of “therapy.” So again, there does need to be some sense of what “success” looks like, but I think we agree it needs to be very much individualized to the person in question, even if some kind of generalized guidelines are agreed to. And it seems we both agree that “symptom reduction” is not a very useful “outcome measure!”

  • Lithium has the closest range between “therapeutic” dosage and toxic dosage of any drug in use today. My belief has always been that the basic action of Lithium is to poison you, JUST A LITTLE, but not too much. The long-term kidney damage alone belies their claim that lithium will do no harm at “therapeutic” levels.

  • The brain imaging stuff is almost all smoke and mirrors anyway. They find that on the AVERAGE, people who “have major depression” have lower activity in X area. They DON’T tell you that not all people labeled with “MDD” have lower activity in the area, some have HIGHER activity, some “normal” people have lower activity and are NOT depressed. So their findings are meaningless.

    Add to that the fact that the brain is constantly changing and that PET scans and SPECT scans measure activity levels, and the whole thing really comes apart. I recall an experiment where they had people think about something sad that happened. Their brain scans changed. Then they had them think about something happy that happened. Their brain scans changed back. So thinking a THOUGHT changes your brain activity levels, and the whole idea that higher or lower activity in a certain area means something chemically or structurally wrong is completely debunked.

  • You are making generalizations about therapists. Some of them very much DO tell you what to do. There are also plenty of inadequately trained therapists out there, or therapists whose own issues make them dangerous no matter how much training you provide. Since there is no agree-upon means of helping clients in the first place, it’s pretty presumptuous to assume all have “adequate training” and know what they are doing. There are competent and incompetent people in every profession. Why would therapists be an exception?

  • The problem I’ve seen over the years is that reform efforts are only funded initially, but once the “testing” period is over, they are either discontinued or left to scrabble for grant money every year, because the system “can’t afford them.” The reason we “can’t afford” the reform efforts is because all the MONEY is going toward paying for overpaid psychiatrists and overpriced drugs for overhyped ‘conditions,’ and no one is willing to get their snoots out of the trough so the money can go to something workable.

    That’s my experience, anyway.

  • I’d also submit that if they have the same “outcome measures,” whatever that means, then mindfulness is MUCH more “effective” because no one has to tolerate the potentially horrific and even dangerous “side effects” of the drug. Any non-drug alternative that is judges to have similar effects should be considered a HUGE improvement over any drug option for that reason, even within their own strained structure of “reasoning.”

  • The importance of self-determination in any kind of “therapeutic” intervention cannot be overstated. I can see how the “home version” might have some real advantages in that the variable of whether the therapist feels safe to talk to is removed, as are the therapist’s own emotional reactions which so often interfere with that sense of safety.

    I’d be interested to know if there is any data on the experiences of people who did this in the office, particularly as to whether certain therapists worked or didn’t work for people.

    But anything that gives people more ability to chart their own course seems very much worth exploring. Not to mention the price!

  • Well, I don’t know if this is true for her, but I associate the term “stigma” with sleazy psychiatric propaganda efforts to make it OK for everyone to be on psych drugs. So I don’t like to use it, either. Maybe that’s her take on it, too. I think we should not say “stigma,” I think we should say “discrimination,” and NO, that does not apply to the poor psychiatrists! They are the “discriminators!”

  • The idea that “all behaviors are purposeful” has been central to all of my work as a counselor and/or social worker, but it seems an utterly foreign concept to those steeped in the DSM/psychiatric worldview. If all “mental illness” is a result of “brain dysfunction,” then NO behavior has any meaning or purpose at all. Could not be a more opposite approach to what I know to work!

  • I know I’m not Dr. Murphy, but I think you have put your finger on a most important issue: how CAN one measure success when the “diagnoses” themselves aren’t even based on any kind of objective test, let alone the outcomes! But insurance companies have become accustomed to accepting DSM “diagnoses” for purposes of reimbursement. In fact, that is what the DSM was invented for and the only actual legitimate use for the manual. It is psychiatry itself that has tried to parlay a very subjective billing document into some kind of pseudo-scientific diagnostic tool for “disorders” that can’t be objectively defined, let alone tested for.

    What, indeed, is success in such a scenario? And who gets to decide?

  • They probably wouldn’t phrase it quite that way, but I have certainly known psychiatrists, mainstream and considered competent, who had exactly this attitude. They express seeing the mind as some sort of mechanical device, and that they are simply tinkering with the parts like a mechanic with a car, to get it “running smoothly.” There seems from some to be no recognition that there is a person in there taking in information and making decisions and having emotional reactions to what’s happening to them, including what the psychiatrists themselves are doing. They seem to view people as bodies, and to discount any sense of agency that an individual may have. It’s not hard for me to see them discussing whether or not treating the “patient” as a human being is a good idea.

  • OCD is a description of a way of behaving. No one has ever said that such behavior doesn’t exist, only that it is not a valid medical “diagnosis” of a “disease state” or “disorder,” as labeling a set of behavior “OCD” does nothing to identify either cause or appropriate “treatment,” as any good diagnosis must do, of course. You seem like a bright fellow and that difference should be VERY easy for a bright fellow like you to understand. And the idea that drugs can induce or exacerbate a particular kind of behavior should also not be surprising to anyone with the slightest education in the area. I’m sure you can think of some examples.

    I get the distinct impression that you are not really interested in understanding the answers to your questions. It seems you are trying to provoke people or prove “us” or Whitaker wrong. Am I wrong?

  • You are missing nothing. There is no objective means to assess “success” in any “mental health treatment” modality. This is why psychiatry/psychology are not actually scientific endeavors. There is no way to even select out a legitimate group for experimentation, let alone obtain an objective measure of pathology or success, for ANY DSM “diagnosis.” Perhaps it’s the last point you are missing after all!

  • Those are all assumptions on your part, which could be true or not be true. It does reflect where folks choose to spend their time, but I have no idea why someone chooses not to respond to comments. I am sure there are lots of reasons, and for some, your assumptions are probably true. But I’m not really in a position to know that. That’s my take on it, anyway.

  • Replying as me, this time: I don’t think we know whether or not she’s read the comments. I hope she has and that it informs her further work. I am glad she is challenging some of the psychiatric shibboleths with her work, but I also hear a someone apologetic tone in her critique, which I find inappropriate when critiquing those with great power vis a vis their “patients.” The fact that her colleagues are even having a discussion as to whether or not “patients” ought to be treated as human beings suggests that there is a lot worse going on here than a few people being misguided or not quite understanding the experience of their “patient” cohort. It seems there is a built-in dehumanization process going on which can’t be explained by individuals being “misguided” nor altered by a bit of “sensitivity training.” This is ingrained, systematic behavior that is encouraged and enforced by those in charge of the system, and needs to be recognized as being intentional and enforced, such that any (such as her) who challenge the dominant narrative will be punished. Given her own experiences and sensitivities, I’m betting the author will gradually come to that conclusion (as I did), but in the meanwhile, I see no reason not to point out this inconsistency, as long as we do it as respectfully as we can. I value her work and have hope for her in the future, but I do see a need for a more blunt assessment as to why her colleagues are not receptive to her observations.

  • I agree completely. Except that I also believe oncologists and other doctors of actual medical conditions damage their patients’ care by treating them as objects rather than people. It is well established that assertive, empowered patients actually live longer and have fewer ongoing issues than those who simply passively accept whatever “care” is doled out for them. So even oncologists ought to be engaging with their patients as human beings, for their own health and the success of their interventions.

    If PHYSICAL health outcomes are significantly affected, how much MORE would mental/emotional outcomes be impacted by how the “patient” is treated? This is one more reason why the idea of providing “medical treatment” to those with mental/emotional/spiritual issues is so destructive – the transfer of the “patient as object” attitude so common (yet still ineffective) in medical care is transferred to an area where it does a tremendous amount of damage, being essentially the exact OPPOSITE of what is required for actual improvements in “mental health,” though that term itself reinforces the idea of illness that is not appropriate to the situation 99% of the time. It boggles the mind that anyone who actually has the vaguest comprehension of what people are suffering from and what they need would have to have a discussion, let alone an argument, about whether treating their patients “like a human being” was a good idea!!!!

    It is bizarre that the world of physical healthcare is making more effort to alter this attitude while our “mental health professionals” seem to be arguing to continue it!

  • It is just an unsupportable claim, the sort the industry makes all the time. There are plenty of people who have no history of “bipolar” diagnosis who get manic on ADs, and it’s even worse for SSRIs or SNRIs. Aside from which, there is no way to actually determine if someone does or doesn’t “have” “bipolar disorder.” So they can (and often do) claim after the fact that the REASON the person became manic on their drugs is because they WERE ‘bipolar’ but didn’t know it. I recall specifically the rhetoric that “the drugs uncovered a latent underlying ‘bipolar disorder!'”

    The fact is, these drugs can make ANYONE act in a manic manner, it’s simply an adverse effect, and no one has EVER drawn a connection between such a reaction and “bipolar disorder,” except anecdotally and after the fact. In other words, it’s bullshit!


    Why would you think “this comment won’t survive long?” You haven’t violated any of the posting guidelines, have you? We don’t moderate for content here. You can say whatever you want, as long as you are civil and respectful about it. I hope the continuing presence of your comment makes this very clear.

  • We eventually had to invent an alternative school that was child centered. Our youngest went through this school from K-12 and was very successful in college and is now a very powerful, intelligent, and capable adult, despite his “ADHD” tendencies that might well have gotten him “diagnosed” if we weren’t well enough educated to avoid it. The school didn’t last long after we left, but a lot of kids did have a different kind of school experience, one where the kids actually had RECOURSE if they were being abused or mistreated by the adults or other kids. It was a beautiful thing while it lasted, but eventually it knuckled under to the forces of “human nature.”


    It occurs to me that posters in the MIA community are ALSO a group, and I have unintentionally allowed slanderous generalizations about that group, as Nijinsky so powerfully reminds me. In the future, any comments about the MIA community of commenters will be moderated as generalizations about a group based on their membership in the group.

    Nijinsky is also correct that any allegation of an inappropriate comment should be specific, and actually needs to be referred to me as moderator, rather than to the community as a whole. In an effort to be fair, I have allowed violations of the Guidelines, and will be correcting that mistake in the future.

    Any criticisms need to be of specific ideas, not of the MIA community as a whole. It is acceptable to critique MIA as an organization, but not groups of individuals who contribute to it, especially in such a generalized manner.

    Thanks to Nijinsky for reminding me of this requirement.

  • I thought about this very point last night. The Posting Guidelines forbid attacking a person or making attacking generalizations about a group. But there is nothing saying we can’t attack IDEAS. Perhaps some folks find that confusing. You are all welcome to visit and share your ideas, but your ideas are going to be vulnerable to attack and may need to be defended with logic and data. There is nothing mean about letting someone know you disagree with them, especially if you provide legitimate data, either research data or personal experiences or both. It’s part of the price of coming here. If a person wants to challenge the ideas of others, they should expect that they may be challenged in the same manner. That’s how this community works.

  • Have you ever read John Taylor Gatto? He was an award-winning elementary school teacher who wrote “The Seven Lesson Schoolroom.” He gets down to the actual meta-lessons that lie behind all of the supposed educational activities, and breaks them down into specific “lessons,” including “Never trust your own observations” and “Always ask permission from the authorities.” It is quite on the point of what you’re talking about. And sadly, though individual teachers challenge this thinking “under the table,” I would posit that it is essentially impossible NOT to reinforce these “lessons” when you participate in the system. I was a teacher for three years, and approached it with a growth and reform concept, and found it quite impossible to make more than a tiny scratch on the bigger system. It is a very unhealthy place!

  • I accused you of nothing. I simply disclosed my intentions. It appeared to me that you came her with a pre-existing viewpoint and have “attacked” others who don’t agree with you in exactly the way you are claiming others are “attacking” you. I consider it valid for people to express an opinion and to have an intention, and it is not an “attack” to me if someone expresses an opinion I don’t automatically agree with. Of course, you don’t need to justify being here. But in my experience, if one wants to actually relate to people, rather than merely irritating them, it might work better to spend more time listening and less time telling others what you think of their ideas. But of course, that’s just my viewpoint. If you want to disagree with people, you’re going to get a lot of arguments, that’s just how people are. If that’s how you want to conduct yourself, you have every right to do so. But you don’t have a right to have everyone respond supportively, especially when you don’t show them the same courtesy, IMHO. I prefer to have honest but civil exchanges of viewpoints, with each side presenting the evidence to support their views. It doesn’t have to be viewed as a “win/lose” “right/wrong” kind of thing. Maybe people just have different experiences and are sharing them with each other? Maybe no one means to “attack” you at all, but just want you to understand what has happened to them without you judging them for sharing it? Maybe you can share YOUR experience and let others know how you came to the beliefs you have? And they can do the same, and each of you will be a bit wiser for understanding the universe isn’t always the way we ourselves experience it?

  • Posting as moderator:

    If you are feeling abused by a specific post, please inform the moderator by emailing me or hitting the “report” button. It is unfair to community members to make blanket assertions that you are being “discounted, insulted or abused” without citing specific instances, not in the comments, but to the moderator to be handled, edited or removed. Everyone is welcome to their own viewpoint, and passionate disagreements to occur and are welcome, but only as long as they remain civil, which means no personal attacks and no generalizations about groups of people based on their belonging to a particular group.

    Please contact me at my email address if you need further clarification. Respectful disagreement is not the same as insults or abuse, and I am here to make sure that we allow the former but not the latter.

  • “Rethinking” does not mean what you said here at all. It means having an open mind. I personally would appreciate you not intentionally interpreting what is going on here. If you want others to welcome your viewpoint, you need to allow that others’ viewpoints might also have validity. Otherwise you are asking of others something you are not willing to grant.

  • POSTING AS MODERATOR: Brenda, I want to clarify that EVERY viewpoint is welcome here, and we NEVER moderate anything based on the content. Clearly, anyone claiming that the medical model is “correct” is going to have to deal with a range of varying opinions, some expressed with more passion than others. But that is hardly different than what you have offered above. So everyone is always welcome to offer differing points of view, but everyone else is also entitled to respond with theirs, and there is no rule against disagreeing or challenging folks to come up with data to support their viewpoints. As long as those disagreeing with you are civil in their replies, they have the same rights as you do to express whatever opinions or viewpoints they have.

    I hope that makes things clearer.

  • I’m afraid there is no science behind the medical model, either. Not one of the DSM “diagnoses” has a legitimate, objective way to differentiate it from a “normal” person, let alone differentiate those WITHIN the “diagnosed” group on the basis of what is CAUSING the problems.

    The DSM itself says this: “In DSM, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” It also says that, “There is also no assumption that all individuals described as having the same. mental disorder are alike in all important ways.”

    What do these two admissions mean? First, they are saying that they can’t tell which category a person fits into, they could fit into more than one category, and there is also no way to tell with any certainty if a person even has a disorder or not.

    Second, and perhaps more important, the second comment says that even if two people fit the same diagnosis, center of the target, same symptoms etc., it doesn’t mean they necessarily have anything of significance in common with each other.

    So in other words, any person “diagnosed” with a “mental disorder” is so diagnosed subjectively, with vague and undefinable boundaries deciding whether they do or don’t “fit the criteria.” AND any person diagnosed with a particular “disorder” may have nothing in common with another person having the same “disorder” diagnosed, meaning the “diagnosis” doesn’t even tell you what kind of “treatment” they would need.

    Of course, everyone ignores this and pretends we somehow “know” that all “mental disorders” are caused by “biochemical/neurobiological” problems with the brain. Does that sound scientific to you?