Friday, July 21, 2017

Comments by Steve McCrea

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  • Thanks for telling a great story so effectively! It sounds like the last therapist you saw was the only one who got what was going on. It kind of sounds like your need to go along with what others were suggesting was a big part of your struggle, but “the system” saw that compliance as the ultimate in good patient behavior. Does that sound right? I say this as a person who worked years to overcome my need to keep everyone but me happy. I was very fortunate to strike gold on my first therapist, but this was back in the 80s before the DSM was in place. It was particularly disheartening to hear how much time they spent trying to figure out which DSM box you should be fit into and so little time actually listening to your view of things. It seems they actually did the exact OPPOSITE of what you really needed, and it predictably made things worse.

    Thanks again for sharing your story. It’s very important for people in similar situations to see that there really IS a way out, but that finding the right label is not part of the path to a better life.

    —- Steve

  • Too true. I am familiar with some of Connors’ work and can attest that the “objective” screening tools he developed are totally based on teacher and parent ratings of children’s behavior as it affected them or their classrooms, and zero consideration was given to family stress or personal trauma history. You do the checklist, the kid gets a score, and no one ever even talks to the kid to find out why they might be acting the way they are. It’s a joke.

    I’m glad he came to the conclusions he did toward the end of his life, but it’s telling that neither he nor many like Allen Frances who decry the “over-diagnosis” of this or that “disorder” appear to understand that the “diagnostic” process itself leads to this result inevitably. As soon as you have a subjective element in diagnosis, especially when it involves people in a relationship with a significant power differential, the victims of abuse and neglect will be subjected to ever-increasing criticism in the form of “diagnosis” of anything they do that is inconvenient or uncomfortable. Allowing subjective “diagnosis” based on the opinions of parents or professionals opens the door wide to blaming the powerless victims of their irresponsible behavior, and given the opportunity, I’d say the majority of adults in the power-up situation are only to happy to open that door the moment a crack of light shows a possibility of passing through.

  • I agree. I can only speculate that mania may be harder for the person him/herself to notice, as it doesn’t necessarily feel bad to the person experiencing it at the time it’s occurring. I also wonder what kind of questions they asked – if they were very open ended, a person might report, say, agitation and feelings of restlessness and loss of sleep and suicidal thoughts, but not put them all together and call it “mania.” We know mania is a reasonably common reaction, and it is puzzling that it doesn’t appear in the manuscript.

  • There is no drug war against the recipients of ANY of these drugs. The war (if that is the right term) is against the PURVEYORS OF LIES who pretend that these drugs aren’t addictive or that they have no adverse effects or that anxiety is “treated” by giving these drugs over the long term. Informed consent merely gives people like you the information needed to decide if you want to or don’t want to use them. There is no hostility intended toward the users of these substances.

  • The basic problem starts from treating “symptoms” as “disorders.” Giving up on the idea that we can “treat” an emotional condition without figuring out what’s behind it, whether mental, physical, or spiritual, would be a great first step toward a rational approach. I guess this is better in that it at least doesn’t denigrate the person with the “symptoms,” but you’d think the lack of results for “causes” would lead an intelligent person to abandon the labeling process that gave us “disorders” that don’t have unitary or even similar causes.

  • Missing the #1 reason these evaluations are unreliable – they are relying on subjective “diagnoses” and sketchy “objective” tests that aren’t the least bit objective, because they’re “measuring” things like risk of violence that are not actually measurable in any real sense. Admitting this will help us realize that the courtroom is a place of moral judgment, not medical, except as far as medical expertise can objectively shed light on guilt or innocence. As such, psychological/psychiatric pseudo-experts should not be considered to provide valid testimony, and the judge should consider the case on more objective facts. For instance, instead of testimony on whether someone is “mentally ill,” why not hear testimony from people who know the person in question as to his/her volatility/violence potential in their direct observation? A person’s actions are a much better predictor of their future actions than some “expert” who barely knows the person and tosses a few Mickey-Mouse “tests” at them.

  • No one is suggesting that people don’t act the way BPD and others are described in the DSM. We’re only saying that it’s a DESCRIPTION, not a DIAGNOSIS. The “diagnosis” (though I don’t think that’s the right word at all) for most BPD people should really be childhood abuse and neglect, because it’s present in almost all cases. This way, we’re looking at actual causes instead of blaming victims. Saying someone “has BPD” places the problem within the person who was abused, and lets the parents and/or cultural institutions and/or other perpetrators off the hook for their destructive behavior.

    You say that people with these “disorders” come for help. So I guess there are two questions: one, is it really OK to “diagnose” a person with a “disorder” that is simply an observation of how someone acts and has no connection to any kind of objective physical cause or measurement, just because it allows them to get insurance reimbursement? And two, is “diagnosing” someone with BPD actually helpful TO THE PERSON who is diagnosed?

    I think on the latter, the concerns are pretty obvious. As a person who has worked in the field, I can tell you that people with a BPD diagnosis are commonly feared and even reviled by mental health “professionals” in the system. People find their behavior frustrating, and the label BPD allows them to blame the client for his/her frustrating behavior and allows clinicians to act out their anger punitively with the support of their fellow professionals while denying any kind of real connection or empathy with the client. It also often disqualifies a person for therapeutic support, since “BPD” is considered by some to be “untreatable.” So I think the answer to the second question is a resounding NO in most cases.

    As to the first, I again ask you if it makes sense to “diagnose” someone with a description? To get more concrete, would it make sense to diagnose someone with “a rash” and leave it at that? A rash is an indication that something might be wrong and that further investigation into causes is needed. If we diagnosed a rash like we do BPD, we’d give everyone topical steroids. It would work for some cases, would do nothing in others, and make it worse in yet other cases. Some cases would really be caused by poison ivy, others by measles, others by syphilis. The ones with poison ivy would resolve better with the steroids, the measles would be unaffected. The syphilis rash would go away, too, but the person would later die an excruciating death as the bacteria ate up his/her brain. We’d say that the syphilitic person was “treatment resistant,” and no one would ever suspect that the problem was with the diagnosis itself, or rather the pretension of diagnosis that prevents actual diagnosis from ever happening.

    It would be a lot easier for people to be “diagnosed” with “Badly mistreated by parents and learned coping measures that are ineffective in current life” than “BPD.” They could still get help without someone blaming and denigrating them for having what is a very common reaction to very poor conditions in early life.

    Hope that clears things up a bit!

    —- Steve

  • What a great treatise on the realities of privilege! Privileged people DO get abused and otherwise traumatized, but they have many more opportunities to have alternative outcomes, because they have funds, more connections to other privileged people, more sympathy, better educations, and so on. I have compassion for all folks who have been traumatized, but it is very important for privileged folks (like me) to recognize that trauma for those less privileged are more constant, more systematic, less avoidable, and less recoverable. Reducing poverty is probably the #1 way to reduce what is so laughably called “mental disorders” by our cold and unforgiving system.

  • True enough. And it happened under Democrats and under Republicans. When push comes to shove, they all hang together to support corporate power over human rights, and the further from US soil you get, the less we give a crap about the human rights of the citizens involved.

    As to Sanders, one of the great things about him is that he IS open to being educated about things he is not fully informed of. If there is one politician who might be able to be influenced to take a stand contrary to Big Pharma, Bernie is that guy.

  • I wish I did! We could perhaps start by supporting efforts to end corporate contributions to political campaigns, shorten those campaigns, and massively reduce the cost of running for office. Physician groups have already come out against DTC advertising – perhaps that’s a good place to start? I suppose another goal might be to make it so that lobbying expenses can’t be taken off on a corporation’s taxes, but I’m guessing we’d get ENORMOUS resistance to that kind of idea!

  • I like the focus on finding points of agreement, Gary, and I found the points you mentioned excellent. I believe you are, however, missing one of the most, if not THE most important one. Financial corruption! I think we can get strong agreement that pharmaceutical companies purchasing influence in various ways, including sponsoring “educational” seminars promoting their products, ghostwriting articles, and engaging in DTC advertising and promotion to doctors which massively impacts prescribing habits and research priorities, is an evil that needs to be eliminated in the service of accomplishing any of the other goals you mention. Corporate malfeasance is also an area where many who occupy different ends of the left-right political spectrum can find solid agreement.

    Thanks for a timely article!

    — Steve

  • It is truly a religious system. The doctors are the holy priests, and people go to them for magical cures. They even have holy vestments. Nurses could be considered “vestal virgins” of a sort. The Holy Scriptures, in psychiatrists’ case, are the pages of the DSM, which ironically enough is often called the “psychiatrists’ Bible.” Doctors are the priests of Scientism, the belief that Science will provide us with Ultimate Truth. Hence, doctors are believed regardless of the sense of anything they say, and those who speak ill of them are considered apostate or heathen. Real science often inconveniently undercuts many Scientist dogma, but that doesn’t seem to bother the True Believers. Hence, we have electronic fetal monitoring as a standard of care (increases Caesarian rates massively with actual reduction in outcomes), cholesterol drugs massively prescribed with little to no improvement in outcomes, and of course, the entire field of psychiatry, whose clients are sicker and die younger than those who manage to escape their notice.

    It is very hard to undercut basic mythology in any society.

    — Steve

  • Once again, the intervention is wrong-headed – it is focused on trying to stop self-harming behaviors instead of trying to figure out why they’re happening and addressing the underlying causes. The first thing I learned as a counselor about self-harming behaviors (and I learned this from the clients, not any training I had) was that self-harming behaviors served a purpose, and understanding the purpose was the key to moving forward, regardless of whether the person continued to self-harm or not. The very concept of hospitalizing someone for self-harming (non-suicidal) behavior is stupid in the extreme. Most self-harming behavior is not intended to be lethal or anything close to it, but “professionals” end up punishing the coping measure instead of looking for what the client is coping with. When I worked a crisis line for 3 1/2 years, we had many cutters call us instead of their therapists, because they knew telling their therapists meant either shaming of them (you know you’re not supposed to do that) or being sent to the hospital. As long as we’re studying how to “stop self-harming behaviors,” we will continue to create “interventions” that do more harm than good.

    —- Steve

  • Well, your fear seems rational to me. I’m sorry no form of therapy has seemed helpful, either. It sounds from your story that your early life experiences lie at the core of your distress most likely. There is no drug for that.

    Two things you didn’t mention that some people have found helpful: 1) support groups of people who have had similar past experiences, and 2) mindfulness/meditation. Now I know the latter has been commodified and mutated so as to remove any spiritual significance, and I know that some support groups have been coopted by the authorities and are no longer worth going. But if you find something through a YWCA or a women’s program, you can probably find a support group for survivors of childhood abuse, and there are plenty of genuine meditation practitioners out there who have no association with the so-called “mental health” system. I’ve personally used meditation practices to handle high-anxiety situations with lots of success. Of course, nothing works for everyone, and you have to find your own path, but both of those I’ve seen work for many people.

    I’m so sorry you’ve gone through such horrors! It sounds like almost every authority figure you’ve ever known has betrayed you. I hope you are able to find some comfort and support from others like you, because your suffering is by no means unusual, though your particular experiences may be unique. It’s a crappy world sometimes, and we have to be careful whom we trust, but there ARE trustable people out there. Just not a lot in the places we’re told to look.

    —- Steve

  • I agree. However, these syndromes should be called syndromes, not “disorders.” And the explanations given for them claim that they are something a lot more than syndromes. Clients are frequently told that they “have a chemical imbalance” or “their brain doesn’t work quite right” or “I know you want to pay attention, but your brain won’t let you” or “mental illness is a neurobiological disorder of the brain.” I could riff off half a dozen more “explanations” that are simply lies, given out of ignorance or malfeasance, it doesn’t matter. I have no objection to people using shortcut terms to communicate, but syndromes are syndromes, and when they’re treated as if they are something else, you get idiocy and destruction as a result.

  • Not to mention doctors doing a RIDICULOUS number of Caesarian sections in the first place – over 30% of babies in the USA are delivered by Caesarian. WHO recommendations say no more than 15%, which I think is very high. Midwifes often sport figures like 2-5%. US Obstetrics is almost as irrational as US psychiatry.

  • The video is an anecdote. It’s one story about one person. We should never make decisions based solely on personal anecdotes. We should look at hard data gathered from many people over time. And the data says that people exposed to electric shocks to their brains have brain damage, lose important memories, sometimes feel despairing and hopeless, and lose whatever “benefits” they gain within days or weeks of the “treatment.” I would never use ECT even if I thought I had no other options.

    What else have you tried before?

    — Steve

  • I have no problem with diagnosis as a means of getting insurance reimbursement. When I had to do psych diagnosis, I told the clients exactly what the diagnosis meant – essentially a description of what seemed to be happening on the outside, chosen for the purpose of getting the insurance company to pay for the needed services. I assured them that I was not in the least concerned with this label, which had to do with payment, and was very much more interested in what the client has to say about what’s going on, when it started, when it stops, what THEY thought it was related to, what has helped in the past, what has made it worse, etc.

    As for psychometrics, sure, you can give someone the HAM-D and count up points and some will have higher scores than others, but what does it mean? I never, ever bothered with such silly nonsense, but instead simply asked the person the kind of questions that might be on such a questionnaire in the context of a normal conversation. As to whether they improved or not, well, they were of course the best and in many ways the only way to make that determination. I feel the same way about IQ tests (somewhat more reliable, but still, what the heck are you really measuring?) and any other psychometric tests. They are mostly very unscientific, because they measure undefined and undefinable entities. To compare a HAM-D scale score to a blood sugar measurement is absurd. One measures a physically determinable quantity. The other “measures” a concept. Measuring depression is as ridiculous as measuring courage or shyness or integrity. They are not measurable entities – they are social constructs that have meaning that varies widely based on both the reporter and the “measurer,” and can’t ever be standardized. They can be “normed,” but of course, “norming” makes the assumption that the average of scores on a questionnaire establish how things ought to be. There is no objective norm possible.

    Diabetes is of course BASED on signs and symptoms, but it is not itself a SIGN or SYMPTOM – it is a concept or model that EXPLAINS why low blood sugar and other signs and symptoms are happening, and PREDICTS with some accuracy what kind of intervention will help. As I outlined very clearly above, an “ADHD” diagnosis does neither of these things – it provides no explanation as to cause, nor does it accurately predict what will help, because of course the same thing will not help all members of an utterly heterogeneous group. So what’s the point of saying someone “has ADHD” when it tells you neither the cause nor the treatment for the “disorder?”

    As for psychiatrists, I defy you to name where I said they were all evil bastards. I believe there ARE some evil bastards at the higher levels of the hierarchy, and a smattering of evil bastards lower in the ranks, but most are simply grossly misinformed, and are committed (as you appear to be) to believing in these subjective and misleading categories of “disorders” which don’t serve them or their clients well.

    I could go on all night, but I’ll stop here. You’re simply stating things without addressing my clearly expressed concerns with the system. You admit that psych diagnosis creates heterogeneous categories, and yet still feel the diabetes-insulin analogy is appropriate? It’s very hard to fathom how an obviously bright person as you appear to be can’t see how very different answering a questionnaire is from having one’s blood sugar measured. I’ll leave it at that.

  • The difference between your diabetes example and psych diagnosis is that at least for diabetes, there is a MEASUREMENT of something that is out of range, even if the range is arbitrary, and treatment can be gauged by whether the measurement moves in the right direction. The “measurements” for psych diagnoses are completely invented based solely on social/behavioral criteria. There is no actual measurement of something “out of balance,” nor is there any way to determine if the situation has been corrected, as there is zero attempt to discover or differentiate cause. Hence, totally heterogeneous groups are lumped together. To take ADHD as an example, a kid could meet the criteria due to low iron, sleep apnea, poor parenting at home, poor classroom structure or a rigid teacher, understandable boredom, prior or ongoing trauma, or lack of sleep, to name only a few. The range of potential solutions for diabetes is pretty narrow – improve diet and exercise, or alter insulin levels in some way. The range of potential solutions for ADHD is huge and totally variable depending on the situation. If you alter the diet of a kid whose mom is being beaten up, it will have little to no impact. If you assign parenting instruction for a kid whose teacher is a poor classroom manager or who bores the kids to tears, it’s not going to help. So calling “ADHD” a diagnosis isn’t just unhelpful, it’s destructive. It is like saying that a “rash” is a diagnosis. A rash can be caused by poison ivy, measles, or syphilis. You MIGHT want to know which is which before you start treatment, eh? A rash is not a diagnosis, it’s a sign. ADHD is not a diagnosis. It’s a sign that needs to be interpreted.

    — Steve

  • The prevalence of ODD is estimated between 2 and 16%? Any scientist would be filled with shame at such a massive range for a prevalence estimate! It’s like saying your IQ is between 100 and 110 with 45% accuracy. An 8x variance in prevalence might as well be admitting that you don’t know what you’re talking about or are just plain making it up from whole cloth. Which pretty much describes the DSM.

    — Steve

  • While I agree that attributing all early deaths to psychiatry is factually incorrect, still, psychiatry is the profession who has chosen to group clients in this way and the comparison between the labeled and unlabeled is their comparison. We would expect those labeled with heart disease and treated to do better than those with heart problems who receive no treatment. The opposite appears to be the case. I believe THAT is the point we need to hammer away at. I don’t want to spend a lot of time talking about the “other reasons” that this cohort dies earlier, because, as I have said, it is impossible to sort out that complex of a causal structure. HOWEVER, when we compare those receiving to not receiving “treatment” who have been so grouped by psychiatrists themselves, the “treated” group dies earlier, among a host of other problems that ensue. That point is factual and undeniable, and is more important than trying to figure out what percentage of people who took “atypicals” and developed diabetes would have developed diabetes anyway without the drug. I hope that makes sense to you and others on this thread. The idea that “not all of these deaths are caused by psychiatry” is a distracting straw-man argument. Obviously, they are not ALL caused by psychiatry, but the statistics tell us clearly that psychiatrists are killing a large number of their own patients.

    Perhaps you can propose some language that takes the admitted uncertainty into account, and yet doesn’t give psychiatry an “out” for their failures?

    — Steve

  • Actually, that would not be sufficient to diagnose a brain disease. It would diagnose a brain INJURY, but the “disease model” suggests that addicts are somehow different from “normal” people and that their addiction is a result of these biological differences. So in order to demonstrate a “brain disease,” they’d have to show that “normal” people can somehow be distinguished from “potential addicts” BEFORE exposure to the drugs, and that “normal” people do not develop the same brain injuries upon use. My guess is that most anyone using these drugs would accumulate the same incremental brain damage, and that addicts and non-addicts are not distinguishable before this damage occurs. I would surmise that the main difference between addicts and non-addicts is that the addicts gain something from the drug use that seems important to them, whether physiological, psychological or social, and that non-addicts are not seeking that same kind of relief or experience.

  • So, Ron, how would we distinguish between the lives they are responsible for ending early that those they are not? I agree it’s unwise to overstate the case, but I find no reasonable way to determine what percentage of the 25 year earlier death rate is caused by psychiatrists. For instance, if someone on Risperdal dies of heart disease, would they have died on their own without Risperdal? If so, would they have died later without it? Did Risperdal contribute to the person’s decision to smoke, as smoking is often reported as being a means of reducing the side effects of antipsychotics? Is the person’s decision to smoke their decision, or is it a consequence of antipsychotics? If the person dies earlier due to smoking, is psychiatry in any way responsible?

    I find it much simpler to frame it this way: receiving treatment should improve the quality of life for the person receiving the treatment. If the person’s quality of life is reduced instead, including increasing health issues which create impairments and sometimes even death, it doesn’t really matter what percentage is whose responsibility – the “treatment” is making the patients worse on the average, and killing some of them early. I suppose it is possible to acknowledge that other factors are also involved, but this, of course, provides an “out” for psychiatry – they can claim that this death was caused by smoking and that one by suicide and the other by diabetes, without ever taking the slightest responsibility.

    I’d be very interested in hearing how you would approach this dilemma.

    I would also submit that whatever we say, the psychiatric “thought leaders” will ALWAYS paint anyone who doesn’t 100% agree with their dogma as an irrational extremist. It is an unavoidable side effect of trying to pull the pigs’ snouts out of the trough.

    Sorry, that was probably insulting to pigs…

    — Steve

  • One of the fundamental core principles of science is skepticism. You’re always supposed to look for evidence to DISPROVE your hypothesis, and only when vigorous efforts to disprove it fail is it considered true. You aren’t supposed to try and skew the data to prove the hypothesis you want to be true! Something is scientifically true only if it is THE BEST hypothesis among all possible hypotheses. You don’t get to pick your favorite!

    — Steve

  • Pat, I actually agree with your post. My only complaint about you is when you create conflict for no reason. Sharing your own experiences is great, as is making suggestions as to how people can come together, which you did above. I happen to agree that a synthesis would be the best solution. The only problem is that some folks are making so much money that coming together to build consensus will most likely never happen.

  • WE means those of us who are committed to the truth rather than dominance of the current elite.

    Another example: US outcomes for “ADHD”-diagnosed kids vs. Finland, where drugs are rarely used. No difference in outcomes. Stimulants do nothing to affect outcomes, and this study provides more proof that is the case.

    The real question is how to get this actual DATA through the screen of BS that those wishing to dominate the world are able to put out there as propaganda. When you figure that one out, let me know!

  • You may be mistaking political multiculturalism for attending to scientific variables. The latter has no agenda except for truth, otherwise, it’s politics, not research. The WHO study was actually very important in this whole movement we’re involved in. They were hoping it would show that those poor, underprivileged countries would benefit from our benevolent drugging paradigm, but in fact, the opposite was proven to be true. They were so incredulous they forced the WHO to repeat the experiment, which had exactly the same results. It was one of Bob Whitaker’s “aha” studies that prompted him to write “Mad in America” in the first place.

    The problem isn’t honest multicultural scientific studies. The problem is when fake science becomes the mute handmaid of politics. Real science is our friend, and showing that psychiatry’s cultish practices don’t work is easier, I think, the further away from Western society we look.

  • I don’t know, Cat, I think it’s totally legit to question research that doesn’t include cultural variables. What about those WHO studies showing that third-world countries had much better “schizophrenia” recovery rates than in the US/UK? I am against globalization as a manifestation of corporate dominance but in the context of science, I think it makes sense to realize that what “works” from a Western viewpoint won’t necessarily be seen as “working” by people from a different culture.

  • Arrogance and stupidity are certainly dangerous partners. A stupid person who is humble enough to know he is ignorant and seeks enlightenment can get better. An arrogant person who knows his or her business and gets good results is perhaps worth tolerating. But to be both arrogant and ignorant or stupid together is unforgivable, and that’s unfortunately a good description of the average psychiatrist, in my experience.

    Of course, there is also the arrogance of knowing you’re doing evil and profiting from it, and continuing because you just don’t give a crap, and that’s the worst of the three.

  • Pat, there’s a difference between your psychiatrist and psychiatry as a profession. The conflicts that you keep bringing up and even creating seem to be related to this confusion. You have had your own experience and no one is entitled to invalidate that experience, and no one is trying to. However, you can’t extrapolate from your experience to all experiences, because then you are invalidating others who have had very different experiences than you. When someone has a different experience, it’s your job to listen, just like it’s my job to listen to your experience. That’s how this works. If you have a comment on the article that comes from your own experience, that’s totally your right. It’s just not your right to say that those who want to abolish psychiatry because of their own crappy experiences or their own research are not entitled to their own conclusions. Please feel free to communicate any DATA that you have that might refute the article, or please feel free to give your own personal ANALYSIS of the data that is presented, but it’s just not OK to keep accusing people of being horrible because they don’t agree with you. This is a free country. People are entitled to draw their own conclusions about psychiatry. If you want to have that freedom yourself, you need to grant it to others. Otherwise, you will get into endless arguments and accomplish nothing but annoying yourself and others.

  • The other thing is, even if a dietary change helps only a little, it starts the person down the path of realizing that THEY THEMSELVES CAN CHANGE THEIR CONDITION! The very worst thing about the current psychiatric model is not the drugs – it is the nihilistic message that you have no control over your own brain, mood, thoughts, and behavior. It is the exact opposite of what actually helps people. So if they find that reducing copper improves their behavior, even if it’s still not great, the psychiatric message is broken – they realize they CAN do something about it, and perhaps even realize that the psychiatrist they were trusting has no idea what s/he is talking about.

  • Angry is up the scale from depressed. I had to go through a very angry period before I came out the other side and started feeling rational. I think anger means you’re getting in touch with how YOU have been mistreated, instead of blaming yourself. Because depressed people mind their own business and don’t bother anyone, but angry people DO things – they FIGHT! I’d say respect that anger and see if you can use that energy to take action, as we talked about before. And too bad for them if they don’t like the “new you.” They have contributed to that anger and it’s about time they saw the real results of their behavior. That’s my take, anyway.

    — Steve

  • I’d be desperate, too! What amazes me is that someone with an obvious historical and ongoing trauma background is drugged because of “brain chemistry problems.” WTF – did they think you’re supposed to be HAPPY about all this? It’s total victim blaming to me, and I’ve seen it a LOT.

    I think waiting to taper the Effexor makes a lot of sense. That’s another principle I try to apply – one thing at a time. Depression is also a reaction to being overwhelmed – kind of like “playing dead” when you can’t fight off an attack. It seems like getting clear from your parents’ influence has to be the priority. You’re like a Viet Nam vet with an apartment under the helicopter pad across from the gun range!

  • OK, so it sounds like you’d like to get away from your parents, but feel you can’t afford it. Is that the basic problem? It sounds like they are the ones making you nuts or reinforcing your upsetness.

    What would you like things to look like if you were moved away? See if you can visualize what it would look like if things were better.

    $733 a month isn’t much to start with. Where do you live? Are there housing agencies near you? Would you qualify under some other category for extra assistance – for instance, if you’re a domestic abuse survivor, there are funds that are specifically available to help AND specific housing resources reserved for that kind of problem.

    To really help, I’d need to know the resources in your area. I am sure there are many others who have suffered similar problems and found a way – I’m sure you can find something. But I know it’s really tough moving forward with all of the withdrawal effects, too! So maybe the first step is accepting that you’ll be there a while, and that your parents will be kind of jerky, and to make a plan of how you can respond that will minimally sap your energy? My wife came up with a plan to simply acknowledge the possibility that her mom was right about things – “That’s a good point.” “I can see how you might be worried about that.” “You’re right, life can certainly be dangerous at times.” Never actually agreed to DO anything her mom suggested, but it stopped the arguments when she seemed to agree. That’s just one approach. Sometimes you have to be creative, but that in itself can start to be almost fun if you take the right attitude – namely, this is a problem and I’m going to try different approaches and see what works, meanwhile not bothering to explain how I feel or try to alter their behavior one iota.

    The other thought for immediate improvement is instead of hiding in your room, to get outside, preferably to a wooded or grassy area where there aren’t too many people around. I find walking to be very rehabilitating, and sometimes I walk around and touch the trees and plants and say hello to the insects and birds and just get in touch with present-time reality. The further away you are from your parents, the easier it will be to relax and think straight, at least that’s what I’m guessing from what you shared so far. My guess is that they have been a big part of how you ended up being drugged in the first place. My parents were both really nice people, but they still contributed big time to me being fucked up as an adult. In some ways, I understand they did the best they could, but it was NOT good enough and they caused a lot of pain for us. Dealing with that was the MOST important thing I did to regain my emotional balance, but I had to not be living with them to do it. You can’t move away now, but you don’t have to spend all your time in that house.

    Don’t know if any of that is helpful at all – just kind of sharing what’s worked for me. Another path that can be helpful for some is to find a support group of adults dealing with childhood issues. It can help to tell your story and sometimes you can make friends or at least have colleagues who share your pain. Doesn’t work for everyone, but just thought I’d toss it out there.

    Bottom line, you can’t change how other people act. The only thing you completely control is your attitude toward their behavior. Not saying it’s easy, because it isn’t, but any small step you can take away from being under their control and observation will be a step toward becoming healthier and more capable and less depressed and hopeless.

    Hope that helps a little!

    —- Steve

  • I think job one is realizing that depression is a normal reaction of the body/mind to being in a place and time that isn’t working for you. It sounds like you recognize this yourself. What is it that you would like to be different about your life? What seems to be in the way of making that happen, internal or external? That’s pretty much how I worked with most of the clients I had, and I was very successful in helping them. Another aspect of depression is that it is generally engaged when we feel there is nothing we can do to alter the situation. It’s a self-defense mechanism so we don’t waste energy in a hopeless situation. But there are almost always things we CAN control that we often take for granted or fail to recognize as options. If you can start finding where you want to go, and find things you DO control that can lead you even slightly in the direction you’ve identified, you’ll start feeling a little better. It’s a lot harder than taking drugs and it takes longer and sometimes it’s scary because we have to do things we don’t want to do, but the solution ultimately takes us to a new place and we learn things that help us solve future problems.

    I’ve suffered a lot of depression in my life, but rarely do today. It’s been a long, long road but I’ve stayed on it and it’s led to a better place.

    Hang in there!

    — Steve

  • I think this is a very wise post. Us vs. Them is the oldest meme in human history. We have to find ways to let the person who disagrees know it’s OK to disagree, and to listen to WHY they believe what they do. It is also almost axiomatic that a person being defensive about something is ambivalent, or they wouldn’t have to be so emotional – they’d just be kind of incredulous or scoff but they don’t get upset about it if there isn’t some uncertainty there, usually a LOT of uncertainty. Helping the person locate the pro vs. con in him/herself can enable them not to project the con onto you as the “enemy.”

    Thanks for your wisdom!

  • And the DSM admits it’s not powered up to designate causes, but it’s used as if it is. Most of the folks I know who went to psychiatrists (and I worked 20 years with foster kids, so I have known A LOT!) say that the psychiatrist told them they have an imbalance of brain chemicals that causes their difficulties. It is not the beginning of an investigation – it is THE END.

    Again, there is no point to “diagnosing” someone with something where those with multiple causes are lumped together based on external observation alone. It only adds confusion. Syphilis is a diagnosis. A rash is a sign. If ADHD is the start of investigation, it’s a sign, not a diagnosis, just like a rash.

    —- Steve

  • I know of at least three different studies from different locations – one in Kentucky, one in Canada, and I can’t recall the third. All found the same result. I think there were even a couple more that someone else talked about, but I didn’t read them. They looked at kids just before the age cutoff for admission and those who were just after the age cutoff, and so started almost a year later. All three reported something around 30-33% reductions in diagnosis rate.

    Some related links from a one-time google:

    Looks like Australia is the third:

  • Too true. Good experiments in the 70s showed that “ADHD” kids are indistinguishable from “normal” kids in an open classroom setting. Too bad we don’t care enough to create them. We actually helped create a charter school for our kids that allowed for lots of free movement, interage classrooms, signing up for desired classes instead of just assigning kids to teachers, democratic classroom rules, etc. Our youngest, who would TOTALLY have qualified as “ADHD” in Kindergarten (his nickname was “Wild Boy!”), had no behavioral difficulties whatsoever and graduated with honors. I’m just sorry that most kids never get that chance.

  • I think the problem is that while the behaviors so labeled do exist, there is no reason at all to believe that all people so labeled have anything wrong with them at all, or have the same problem if they do have something wrong. The DSM itself admits this in its introduction, saying that, it is not assumed “that all people having the same diagnosis are alike in all important ways.” So what’s the point of labeling something based solely on external observations when the group so labeled is completely heterogeneous? It’s like saying that everyone with a skin rash has the same problem. Some of them have poison ivy, some have prickly heat, some have the measles, some have syphilis. Might be a good idea to figure out which one the person has before you start treatment, eh?

    Not to mention, a lot of kids labeled “ADHD” have nothing wrong with them at all. A number of studies have replicated the finding that admitting a child to school one year later reduces the “ADHD” diagnosis rate by 30% or more! So while there may be a small number of “ADHD”-diagnosed kids and adults who actually have something biologically wrong with them, there is no way to distinguish these from those kids who are simply bored or who have a naturally active personality and don’t like to sit still or who don’t get enough sleep at night or who have low iron or whose parents are violent or whose parents are neglectful or lack parenting skills. Calling all such cases “ADHD” simply creates confusion and prevents us looking into what might really be causing these subjective “symptoms.”

    — Steve

  • We don’t really disagree, except on the point that calling this an entity “ADHD” to me really just confuses things. Why not say “Hyperactive behavior” or “inability to pay attention” and study the underlying various reasons for it. Since the people grouped together as having “ADHD” may have nothing in common as to the cause, calling it a disorder is nothing but misleading. Of course, the REAL reason that ADHD was constructed was not to figure out the cause but to sell the “cure,” and many other “disorders” were constructed for the same purpose. Rational people like you and me without conflicting interests could certainly study “ADHD” as to underlying cause with little confusion, but sadly, there is a huge financial and social incentive to call these things “disorders” so that drugs and patented therapeutic interventions can be sold for a profit.

  • The only way psychiatry will change is if the financial incentives that reinforce it are altered. It is very clear that psychiatry chose its current direction out of a desire to maintain control of the field and to assure that psychiatrists could make lots of money with less work. It is also supported by the “permanent disability” concept that keeps their biggest funders, the drug companies, making billions. No amount of data can overcome the greed and power drive that is behind the current psychiatric paradigm. It will only stop when it stops paying off.

    — Steve

  • Actually, the article is kind of disturbing. First, they blame “fear of stigma” for African-Americans not seeking out counseling, overlooking the more obvious explanation that on the balance, they are less likely to trust any institution and that the “mental health system” doesn’t feel at all helpful to them. It also avoids the rather obvious question of why more “treated” kids have more problems with anxiety and depression by claiming that “treatment has allowed more kids with mental health issues” to enroll in college. They really don’t seem to have a clue, but they’re going to keep operating on their misguided beliefs.

  • I believe it was the other way around. Dianetics was wildly popular in the 50s and the psychiatric field saw it as a big threat to their hegemony. The AMA and the APA attacked Scientology viciously and consistently all through the 50s and 60s and the IRS continued to pursue them even into the 80s, until George HW Bush decided to change the tenor of the IRS and told them to accept that Scientology was a religion. I think it’s fair to say that Hubbard decided that the answer to being attacked was to attack back. I suppose you could say a vendetta developed, but from what I understand, psychiatry threw the first punches. Scientology also very strongly believes that drug use is damaging to the human spirit in severe ways, and so as psychiatry has relied more and more on drugs, the antipathy has become greater in both directions.

    That’s what I know about it.

  • That is very true. It’s important to keep the statistics very simple, and to have stories available as illustrations of what the stats mean for normal folks who don’t have advanced degrees. That’s why I tell the stories first before getting into the data. But for some people, data is irrelevant, at which point, I would stop using it as an argument.

  • There is a lot of “secondary gain” from going along with the system. For people who have little, it can provide an identity, sympathy from others, an excuse for failure, and protection from dealing with emotional pain from the past, just to name a few items. It can also be scary to try and escape, as one faces isolation, anger from friends and family members, condescension and/or outright hostility from providers, and serious but unacknowledged side effects of withdrawal, just to name a few. It’s kind of like an abusive relationship – it requires a lot of courage to leave and it’s a lot easier to stay, despite the intermittent or even constant pain and disrespect you receive.

  • As a dad who helped raise two classic “ADHD” boys, I can empathize with your statements. It sometimes feels like others expect us to “control” our children when it is very clear that these kids make their own decisions and HATE being controlled in any way that feels arbitrary to them. And I would say I also resented anyone who felt they “knew” how I should parent my kids without any actual knowledge of what it’s like to be in my shoes.

    That being said, I am a scientist and a mental health professional as well as a parent. I appreciate Timimi’s work because he’s always been objective and not afraid to disagree with the establishment if the data tell him they’re wrong. If you look at the long-term DATA regarding “ADHD” interventions, it is VERY clear that long-term outcomes are NOT improved by the long-term use of stimulants. That being the case, it seems pretty shortsighted as a society for us to insist on stimulants as a primary intervention and to disregard or minimize the potential benefits of psychosocial interventions which have a greater chance of making these kids’ lives better in the long run.

    Additionally, you and I may not be interested in controlling our children, but there are most definitely parents and especially teachers and other professions who have control as their main objectives. There were a number of studies done back in the 70s showing that the optimum dosage for academic attention was much, much lower than the average dosage, and that most doctors increased the dosage to the optimum for behavioral control, which dosages actually diminished the child’s ability to attend to schoolwork.

    So I urge you not to throw out the baby with the bathwater. You seem an intelligent and committed parent with the best of intentions for your children and all children. I strongly suggest you re-read the article and pay attention to the actual DATA that is presented, and forget what it means about you or me or your particular situation. If we think about the welfare of all kids, the data is pretty clearly telling us that we need to look at stimulants as at best a short-term intervention, and we need to look at a whole range of other options as a means of really helping these kids become functioning adults. Some examples are: alternative schooling (child-centered classrooms), meditation, exercise, nutritional interventions (low iron is particularly common), addressing sleep apnea, teaching parenting skills specific to intense or oppositional children, teaching self-management skills, and many others. If we really care about helping these kids, we have to get past our own personal fears and ego and look objectively at what has proven to help. At least with regards to the kind of long-term outcomes that matter to most of us, like delinquency rates, college attendance, high school dropout rates, social skills, and self-esteem, stimulants fail the test.

    You might want to read Corrina’s MIA post on anecdote vs. aggregate that was posted just today. It is very much applicable to this discussion.

    —- Steve

  • The main reason anecdotal information is preferred is because of the financial incentives. Unless those change, it’s hard to imagine the industry actually respecting the real data. There is no money in honesty.

    As for those who are themselves convinced by the propaganda, it’s very important to start by acknowledging the reality of their personal experience. I think the next question would be to ask, “Do you think that everyone has the same experience as you do, or do you imagine that some people have different experiences?” If they can’t handle that possibility, I would not bother with further discussion. Some people are like that. If they can, I’d ask, “Would you like to hear some more about that?” and then share some anecdotes (after all, this person is basing their assessment only on anecdote, right?) where things didn’t work out so well. At that point, you can introduce the concept of aggregate data, maybe starting with, “So let me ask you to imagine this: imagine that some people (like you) feel like they do better taking these, some people feel like they do worse, and a lot of people don’t feel very different. Can you imagine that happening?” If they can, you’re in a place to start educating about aggregate data. But you have to get the person to allow that aggregate data is relevant or important before it will be a viable argument.

  • It is also VERY important to recall that they screen out actual suicidal people before starting these trials. So ALL suicidal participants developed suicidal thinking and/or behavior AFTER they started the trials (outside of the possibility of dishonesty in an odd participant here and there). The actual suicide rate in community practice would be considerably higher.

  • I also think it is very possible to be civil regardless of whether the articles are big or small. We can be honest and still be respectful. That goes double for authors who post here, as it should be clear that reactions are expected and normal, and that not all posters will necessarily communicate as diplomatically as could be wished.

  • I agree 100%. There is no training for the kind of ability to be present and non-judgmental and patient yet firm that is needed to be a true helper. I started out in the field by the back door, and had only a three-hour group processing class under my belt. I think this worked hugely to my advantage, because I knew I didn’t know anything and I also knew the only source of the information I needed to figure out what to do was the clients themselves. So I asked them questions and learned from them and I developed my own “theories” based on what actually seemed to work.

    I had one other advantage: I had already had some very good therapy and worked through a lot of my childhood issues, so I knew what good therapy looked like, and I also knew how to separate what was my emotional reaction from what was the client’s need. This is the real “training” for therapy, the only training that will really help – learning to understand and respect how your own life was shaped by your childhood and adult experiences and how to change your perspective on your own life. Absent that, 20 years of “clinical training” will do little besides make you feel like you should know something that you really don’t.

    — Steve

  • I agree with you, when we’re talking about a lay person being a caregiver. When it is a paid staff person, however, the client should be the focal point and the caregiver’s goal should be to be as helpful as they can to the client without letting their own immediate feelings drive their decisions. Not saying that having and sharing feelings in a therapeutic setting is always a bad thing (I do it a lot) but it needs to be done because it’s good for the client, not because it makes the professional feel better. And I’m speaking from very direct experience here. Happy to share an example or two if need be.

    Always a pleasure to hear from you!

    —- Steve

  • I am afraid I can’t agree with the idea of a genetic basis for “mental illness.” So far, the best correlation that has been found explains about 15% of cases of a range of “mental disorders” as described in the DSM, and this was a set of over a hundred genetic markers and was the most optimistic interpretation possible from the data. On the other hand, well over 80% of those diagnosed with “schizophrenia,” the most “genetically linked” of “disorders,” report histories of abuse and trauma. So it’s pretty clear that environment is MUCH more important than genetics in explaining “mental illness.”

    Beyond this, there may be genetic patterns that leave one more vulnerable to stress, but such patterns might also make one more sensitive to others’ feelings or more capable of bringing people together socially. Genetic diversity is the key to species survival, and we need people with a wide range of genetic presentations in order to succeed as a society. Arbitrarily defining certain emotional or behavioral responses as “disorders” denies both the importance of genetic variety and the fact that such responses are almost always related to unresolved stress, much of which comes from the bizarre expectations put on us by this bizarre society we live in and for which we have not had time to evolutionarily adapt.

  • When a helper takes on the experience of the “helpee,” they generally set up a situation where the “helpee” feels like they have to take care of the helper because of their distress. I’ve always felt the best approach is to put oneself into the helpee’s shoes long enough to get a sense of what is going on, but then backing away and looking at the situation from a more removed perspective. That way, I can ask relevant questions and suggest options without being invested in whether the person I’m helping agrees with me or not about my assessment. This is critical to the person feeling empowered, and empowerment is at the core of any kind of healing, IMHO.

  • Well, I certainly can’t argue that all of that abuse and disrespect and injustice isn’t a big contributor to suicide rates and serious health problems! And I very much appreciate your attending to these very important issues that almost never get mentioned by any writers.

    That being said, it seems very hard to deny that drugs which induce diabetes and heart disease, and as many report, create a stronger urge to smoke cigarettes as a means to minimize side effects, are not HUGELY contributing to a 25-year earlier death rate. And in truth, I regard it as the responsibility of the pharmaceutical industry or mental health industry to show that these are NOT causally related, as safety should be the primary concern with any form of “treatment.”

    In any case, whether the drugs or the surrounding environment of disrespect and injustice are more important factors, it seems very clear that spending time in the hands of the “mental health” industry is currently hazardous to one’s health.

  • Can you elaborate on the correlation/causation comment? It appears to me that Whitaker’s summation of the evidence pretty clearly shows more than correlation, though I think it’s fair to say that further study is needed. I agree 100% that incentives drive what care is provided, but a pretty radical rethinking of the current model (beyond mere capitation) would have to happen for psychiatry to get itself back under control. It is a highly corrupt field, as you yourself have experienced.

  • Your comments don’t make sense to me. I never compared you to anyone, I simply gave examples of people who had worked through delusions and hallucinations without drugs. You also evaded the main point of my comments, namely that you are making gross generalizations about “people at MIA” without reference to specifics, and your comments are not relevant to the article above. I think you’ll be happier at another website, but blaming folks here for not approving of your hostile comments seems out of line.

  • Pat, please find a forum that meets your needs better. It is not helpful to have you constantly looking for a reason to lash out. I’ve reported both of your last two comments, as they are hostile and have nothing to do with the topic at hand. I’m not sure why it’s so important for you to be right about MIA being wrong, but I would really like you to take a look at your motivations.

  • It seems that anything you, Ron, are suggesting could be prescribed by a GP or family practitioner. There is nothing medical that is really helpful that is specific to psychiatry, except perhaps for the few who know how to wean people off of their wonderful psychiatric drugs. There are real physiological things that could cause “psychiatric symptoms,” but again, these could be provided by the appropriate medical specialist. There is really nothing “medical” that psychiatry brings to the table that isn’t based on their subjective and deceptive DSM diagnostic scheme. And we know exactly how scientific that scheme really is. So I guess I’d ask what psychiatry as a medical specialty can bring to the table that can’t be addressed by another doctor?

  • Hi, Lauren,

    It’s important to remember, I believe, that it’s not just a matter of creating dependency – psychiatric treatment can and often does make clients WORSE and psychiatrists deny this, and it also creates massive health issues that kill clients 25 years sooner (in the case of those taking antipsychotics) than the general population. Further, it creates a lack of trust in ANY helping person, which creates further isolation from potential help from any source.

    I assume you have read Anatomy of an Epidemic? If so, you will realize that these “treatments” on the average make a bad situation worse in the long run, even if they may temporarily provide a respite in the short run. I believe the evidence is pretty clear that the only real utility of these drugs is for the short-term reduction of undesired feelings or difficult behavior (and I am talking from the CLIENT’S viewpoint, not difficult or undesired by others, which is the usual standard), and the long-term use of these drugs should be avoided in any way possible.

    Would be interested in your take on these issues. Thanks for being so available to talk about your views and experiences!

    — Steve

  • I think the difficulty in this conversation is the association of the word “psychiatry” with “anything that can be done to help a person suffering from mental/emotional distress.” If psychiatry is defined as the latter, than antipsychiatry doesn’t make sense. If psychiatry is defined as “the medical ‘treatment’ of any form of emotional distress, regardless of the cause,” I think antipsychiatry makes a whole lot of sense.

  • The huge problem is that there is no way to guard against “overmedication” because there is NO OBJECTIVE STANDARD for when “medication” is needed.

    Hey, I just thought of a new word: “mendication.” It combines “medication” with “mendacity” (the intentional telling of lies to deceive or mislead). What do y’all think?

  • It is true that Freud originally believed his patients and attributed their difficulties to having been abused as children. It was only after the Viennese aristocracy excoriated him for saying such horrible things about them that he developed his “drive theory” to explain away his observations. He chickened out, for which I can’t forgive him, but we do need to give him credit where credit is due.