Wednesday, April 25, 2018

Comments by Steve McCrea

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  • Thanks for your thorough answer. I agree that, in essence, most of us are projecting our rage/powerlessness either on those who appear to have the most social power (left) or those who have the least (right). Dealing with our own disappointment/rage/grief regarding our own upbringing and the adults who were supposed to care with us but failed is the first job of anyone trying to be helpful to others or to society at large. Unfortunately, few people do this, and once a person has ripped open this veil, other people’s motivations seem all to obvious and yet often impossible to discuss. It is, indeed, a lonely experience. Thanks for sharing it with me!

  • Which proves that the real problem is NOT the drugs themselves, it is the ATTITUDE that allows the idea of prescribing drugs for behavior problems to be accepted. The essential purpose of the DSM III and beyond was to provide cover and justification for drugging normal human beings for profit. Until we address that approach and eliminate it completely from anyone’s idea of “care,” stopping “overprescription” of one drug will simply lead to a new drug to replace it. It is the idea of labeling and drugging people whose behavior is inconvenient that has to go!

  • Thank you for the clarification. I agree that children in general are the least powerful and most oppressed group on the planet, and that their oppression is often ignored or minimized by all folks across the political spectrum. It’s kind of sad, because it is the one kind of oppression that most of us can deeply share and relate to, regardless of what race, religion, sexual orientation, gender, or national origin label may apply to us. I think it’s crucial that we come together on the point of the oppression of children, because that’s where all the other forms of oppression have their birth, IMHO. But sadly, children don’t vote and have no real social power at all, so it falls to us who used to be children to speak for them, and for the most part, we have failed them miserably.

    I’m interested in your views on what I said above, namely, the difficulty or unwillingness of those leaning left on the political spectrum to find a way to see the oppression of the psychiatric system and work it into their “intersectionality” analysis.

  • The term “meds” evolved to get away from calling them “drugs”. It’s been apparent from the first that these drugs were in a different category than normal medicine, and the fear of people creating an analogy (essentially correct) that these drugs are not dissimilar to street drugs. So we call them “meds” to make it seem like it’s somehow different.

  • Wow, great blog, Chaya! I particularly liked the analogy of candy bars for emergencies vs. long term health. I also appreciated your elucidation of how mainstream views are always presented as “the other side of the story” while the mainstream speakers are never required to be balanced by other points of view. This is stuff I’ll be able to use in talking with others about the strange anti-critical bubble that seems to surround the psychiatric worldview. Thanks!

  • Danke!

    Personally, I find the very process of “diagnosing” people with these largely arbitrary labels like “OCD” and “mental retardation” and “schizophrenia” to be problematic in itself. I have rarely used them except as a means of getting insurance companies to pay for their client’s needs. I find them dehumanizing.

    I agree about assessing each individual as an individual, but even the term “assessing” suggests that I’m somehow above them and able to tell the client “what is wrong” or “what to do.” My approach is more humble: I try to help the client clarify what s/he needs and what is happening to him/her without me trying to evaluate or direct them beyond simply helping them gain some perspective on what is happening. I figure that the only one who knows what’s really going on is the client. It seems your approach supports that idea, but still uses diagnostic labels. I wonder, is it possible to accomplish the same or better results with no labels or “assessment” whatsoever?

  • I think the missing first step here is recognizing that our so-called “objective medicine” IS a culture in itself, and is a reflection of the larger culture. Pretending that it is objective in the first place is the starting point for allowing medicine to avoid dealing with the truth shown by its own research. There IS no separation of culture and medicine, so it’s impossible to “rejoin” these, since one is embedded in the other. Pretending to be objective is what gives this cultural phenomenon its unearned power.

    “Zen and the Art of Motorcycle Maintenance” is a fantastic book that takes about an ECT survivor whose personality is erased by the process. It is a true story that shows his slow recovery of himself, but meanwhile completely and effectively takes down the idea that science is somehow separate from and superior to “subjective” areas of study. (Though he places fault not with the Romans, but with the Greeks, and specifically with Aristotle). It’s an amazing read!

  • Yeah, some people benefit from Jack Daniels, too. Alcohol is a great anti-anxiety agent. Doesn’t mean getting drunk is “treating” a “mental illness.”

    What do you think about the DSM/ICD classification of “mental illnesses” based on behavioral checklists?

    Ich habe einmal in Deutschland gewohnt (Freiberg i. Br.) und verstehe die Einschrankungen des Deutschen Sinn fuer Humor! (Ungluecklicherweise habe ich kein Umlaut auf mein Computer!)

  • Thanks for your reply. I was not referring to individuals who have distortions, but somewhat sardonically referring to the DSM diagnostic system and the mainstream’s religious adherence to it in contradiction to actual data. The idea that all or most “mental illness” is due to physiological malfunctions of the brain is completely unsupported by the data (the “low serotonin” theory of depression was debunked back in the 1980s, before Prozac even came to market), and yet is still held to be undeniably true by many in the field. It is a shared delusion, given more power by the agreement of powerful people, despite a complete lack of evidence that this belief has any connection to reality.

    So my post was intended as dark humor, as in my view, the entire psychiatric worldview is based on a mass delusion, namely that the DSM diagnostic categories represent some as yet undefined physiological malfunction, despite years of research failing to find any such malfunction for any such diagnosis. In fact, the very idea that all people meet the criteria for a particular disorder have the same problem, or even have anything wrong with them at all, is another shared delusion. Unfortunately, those who have power can safely maintain their delusions, while persecuting those whose beliefs don’t comport with the official version of what people are supposed to believe.

  • Saying something over and over again doesn’t make it true. Where is your evidence? Your Edgar Cayce link on Depression is simply a stating of opinion with no facts, and his opinion conflicts with even mainstream psychiatrists these days who have admitted several years ago that the “chemical imbalance” theory is completely unsupported by evidence and has no validity.

  • “…attributional distortions (especially one-sided attributions; module 1), a jumping to conclusions bias (modules 2 and 7), a bias against disconfirmatory evidence (module 3), problems in theory of mind (modules 4 and 6), overconfidence in memory errors (module 5), and depressive cognitive patterns (module 8).”

    Well, this looks like it might be an EXCELLENT therapy for the PROVIDERS of “mental health care,” especially the psychiatric community. All of these except perhaps Module 8 are regularly evidenced by mainstream practitioners. “Attributional distortions” are, of course, built into the DSM diagnostic system, including the infamous “chemical imbalance” trope. “Jumping to conclusions” is facilitated by the DSM, as fitting the checklist allows one the luxury of pretending you know what’s happening in the absence of evidence. “Bias against disconfirmatory evidence” – well, that one’s kind of obvious. “Problems in theory of the mind” – again, completely obvious. “Overconfidence in memory errors” – such as Dr. Ron Pies’ confident statement that no well-informed psychiatrist would ever put the “chemical imbalance theory” forward, despite evidence he’d done so himself in the past. As for “depressive cognitive patterns,” if you changed that to “depressing cognitive patterns,” psychiatry would be 100%!

    Let’s require them to go through this before they’re allowed to talk to a client. I bet 80% would drop out of psychiatry rather than face up to the delusion on which their profession is built.

  • I had a similar experience, despite telling the guy that I never took drugs for anything if I could help it, and was only there for antibiotics. I think they get kickbacks. Why else would they push so hard for us to get a prescription we’re making clear we won’t use?

  • Lots of other sources of abuse, too. School was a huge one for me. Just for one example, I got hit in the head in 2nd grade BY THE TEACHER when I had the temerity to object when she tossed a book over our heads in a rage while spitting venomous words at the whole class. Of course, nothing happened to hear at all, while me and another kid had to go to the principal’s office. That was the worst, but stuff like this happened all the time, with kids getting intimidated, punished and humiliated just for acting like kids. Churches and businesses and many other institutions are similarly abusive. To limit trauma to family of origin stuff (though that is VERY important!) will miss a lot of the harms that our society perpetrates on those not in power positions.

  • You’re not making sense, Pat. What does a critique of psychiatry have to do with “white privilege?” And why would the fact that some people scam the system mean that the system is working fine? People scam ANY system. The question is whether or not people on the average are getting better with the current model, and the answer appears to be no. Have you even READ “Anatomy of an Epidemic,” the basis for this website? Please answer this question – failure to do so will terminally undermine what credibility you currently maintain.

  • Almost every TV show or movie with psychiatrists shows them as therapists who talk and listen to patients. It is very different from reality. I recently saw an episode of Chicago Med where the psychiatrist was claiming that a man’s “scan” (of his brain) could show that he is a sociopath. So it’s weird – they support the “medical model” but still portray the psychiatrists as being interested in the patient’s experiences. Best of both worlds, I guess, but it’s pretty much all BS.

  • “Rather, trauma exposure is posited to create an initial level of heightened vulnerability for later psychopathology, including but not limited to psychosis…”

    Wow, way to make it sound as complex as possible! Why not say, “Being traumatized makes it very likely you’ll get a later DSM diagnosis.” Or better yet, “Trauma is bad for you.”

    With Someone Else’s great contribution, we see that over 80% of “psychotic” adults have been traumatized. Compare this with the fact that the most optimistic genetic studies have showed less than 15% of “mentally ill” adults have any correlation with even a wide range of genetic markers (over 100, as I recall). Seems like we’re wasting a lot of time looking at genetics, when the most obvious “contributing factor” is childhood trauma.

  • Not sure I like “negative” behavior pattern, because it still leaves room for others to decide what is “negative”. Struggling to come up with something better, though. Maybe it’s better not to call them anything except “what the client wants to work on.” Categorization of behavior patterns into “good” and “bad” may just inevitably feed into authoritarianism rather than empowerment.

  • The flaw is that they created the categories first and then tried to make the neurology fit. The should be testing for neurological problems on a case by case basis until they see some pattern, and then group people together based on their actual, observable neurological issues (assuming they are not simply a common variant and not a real biological problem at all), and create and apply treatments ONLY to those circumstances where actual neurological problems have been identified, and ONLY if they are shown to improve the problem. Examples include Parkinson’s, epilepsy, Multiple Sclerosis, etc.

    No psychiatric disorder comes close to meeting these criteria, because they are manufactured from the completely errant assumption that all people who are depressed (or anxious or highly active or whatever) ALL have something wrong with their brains, and ALL have the SAME thing wrong with their brains. There is NO evidence that these assumptions are true, and as long as psychiatry operates on these assumptions, it will never find any neurological evidence for any of its “disorders.”

    — Steve

  • And if there WERE some actual physiological problem in some small proportion of people with a DSM “diagnosis,” it would be completely obscured by the vast majority of people in the category being completely healthy. The DSM is a huge deterrent to any real research, and I don’t think that’s by accident.

  • I think the important question is whether the RESEARCHERS had an open mind doing their research. It appears pretty clear that they WANTED to find a correlation and worked hard to find one. If they had found that 80% of people with, say, and “ADHD” diagnosis had a particular variant, vs. 20% of the general population, it might get my attention. But they had to combine 5 DIFFERENT “disorders” together to get a less than .5% correlation! It literally means nothing when the VAST majority of those with these “disorders” did NOT have the gene pattern in question and a good portion of the “control group” did have the pattern. I’m open to any real data that challenges my observations to date, but this one certainly doesn’t challenge anything except for any shred of remaining confidence that the “scientists” doing this kind of research actually care about the truth.

  • Perhaps you may need to read more over time. Many people (including myself) have written about the damage done by social institutions, including and perhaps especially the nuclear family, to people’s ability to thrive. Child abuse, neglect, and even thoughtless parenting have lasting impacts on people’s view of themselves. Kelly Brogan just put out an article today that directly addresses both REAL physiological problems (like nutritional deficiencies, lack of sleep, etc.) as well as exploring traumatic origins of habitual coping measures in one’s family of origin.

    I, for one, believe that nurture makes the most sense to focus on, not only because the VAST majority of those diagnosed with “mental illnesses” have experienced family and social trauma to high degrees, but also because even if there are genetic contributors to our “mental illnesses,” it’s the one area we can’t do a damned thing about! And with the new research on brain plasticity and epigenetics, the idea that “biology is destiny” should be dead in the water. Unfortunately, financial incentives and political ambitions as well as guild interests don’t support applying this concept, which I think is why we see so much energy focused on these perverse incentives and evil intentions. The question of “what replaces it” is a much more challenging one, and in the end, perhaps is only answerable by the person needing assistance.

  • Of course, I agree with you. I guess my two objections to the term being applied to people by professionals are 1) lumping all people with a certain set of behavioral characteristics together prevents any real analysis of whether it is a meaningful grouping of people with real similarities, or simply a social prejudice masquerading as a “diagnosis,” and 2) labeling a group is in and of itself a means to differentiate and “stigmatize” (aka be prejudiced against) the members of this group, which I find inherently dehumanizing. There may be, and perhaps likely is, a certain subset of such folks who actually DO have something physiologically malfunctioning, but we can never identify such situations if we lump all people together who act in similar ways without any understanding of the underlying mechanisms. So if it’s just a means of communicating about and between people who share some behavioral characteristics in common, no problem. But when applied by one person to another, I really have a problem with labels of this sort, as they make it way too easy to dehumanize them as a group instead of trying to understand.

    As for “neurodiversity,” as one of my old foster kid friends put it, “Maybe people should be allowed to have different chemical balances.” Viva la difference!

    — Steve

  • Well, as I said in my definition, I would see “scientism” as a complete repudiation of science, the opposite, in fact, because science involves the absolute unwillingness to have faith in anything that is not supported by evidence. So clearly, believing scientific authorities without or even contrary to existing evidence is not scientific in the least. However, given the cooptation of this term to mean something different, I’m going to have to agree with you that the term is confusing and unclear (partly because most people don’t really understand what science is). I have to say, though, that none of your terms actually identifies a dogmatic belief in or blind faith in science as a specific term. It is really a lot more than reductionism – it is a religious faith based on the belief that there are some smart people called Scientists and these people are Smart and Know Things that the rest of us can’t know, and that if we simply follow them, then the world will be a good and happy place. It is a form of “blind faith,” but specifically blind faith in purported “SCIENTIFIC” AUTHORITIES rather than SCIENCE. Perhaps “authoritarian pseudoscience true believers” describes it, but really doesn’t provide a very catchy meme, does it?

  • Personally, I think “causal agnosticism” is a BS cover for the true intentions of the DSM III+ series. It appears clear in hindsight that this approach was taken to specifically AVOID looking at cause so that the biological causation theories could be safely inferred. Grouping “disorders” without regard for cause, including things like high cholesterol and obesity, makes it easy to avoid bothering to look for one, which plays right into the hands of Big Pharma and professional guilds who want to create a “helping” industry and get paid for it. Because let’s be honest, if we start curing people, or providing free or low-cost home interventions, then we need to find more clients, which is a lot of work.

    So in my view, the DSM is a far more nefarious enterprise than you appear to give it credit for. If there were no “ADHD,” for instance, then we’d have to look at each individual kid and figure out what was going on. We might discover that some DO have something physiologically wrong (like low iron, heavy metal poisoning, sleep apnea, or just plain lack of sleep), or psychologically challenging (very anxious, angry, hopeless), or social oppression (child abuse, racism, bullying), OR, we may eventually conclude that our schools are not meeting the needs of a lot of kids and we might have to re-think how we run our classrooms (“ADHD” labeled kids do WAY better in open classrooms than in standard classrooms!)

    So in the end, creating the cause-free label undermines scientific inquiry and rewards lazy professionals for failure to look deeper into the real conditions behind the behavior they see.

  • My definition of “scientism” is accepting the pronouncements of credentialed “scientists” as infallible and having a religious commitment to following their dictates, whether they make sense or not. It suggests a dogmatic approach to “science,” and an unwillingness or inability to take personal responsibility to separate truth from propaganda. It also involves so-called “scientists” claiming such authority and attacking anyone who disagrees with them as “unqualified” or “hostile to science.” Within that definition, psychiatry fits quite securely. “Pseudoscience” covers some of that, but for me it doesn’t cover the religious commitment aspect as well. Not that I completely disagree with your concerns, because I do see “scientism” used to mean believing that science is a valid way to determine truth, as opposed to having faith in a spiritual reality. But I most definitely do see people who view anything with the trappings of “science” as an article of faith, and who accuse anyone who does their own thinking about it as “anti-science.” Most mainstream psychiatrists fit into the latter category, and they train their subordinates and “patients” to think (or not think) in the same way. Perhaps there is another term you can suggest that covers this unquestioning faith in the Scientific Authorities having special knowledge that we mere mortals are unable to attain?

  • I don’t really think that’s what the article says at all. I think it says that autism is not a scientific term because it’s not definable, and that we should not be prescribing “treatment” for entities that are not definable as different from “normal.” I think a lot of folks who identify as autistic would agree with this, based on my own experience. To say that autism was “discovered by science” is not really true, and that is the main point of the article. Autism was defined by agreement between professionals, but that’s not the same as being scientific, not at all.

    My experience of the author is that he is, in fact, deeply committed to the principles of science, and in fact he is stressing in this article is the need to be scientific in defining “mental disorders.” Sammi has been a stalwart defender of the basic principles of science despite being castigated by his own profession for his integrity. You may or may not agree with his conclusions, but to accuse him of “hating science” is an extreme misunderstanding of his viewpoint and principles.

  • Well said. I’d point out that “obesity” itself is now a medical diagnostic category. The tendency to look at symptoms or outcomes as “diseases” is most definitely not confined to psychiatry. There are profits to be made and power to be established by denying social determinants of health, all across the board. It’s just easier with psychiatry, as there has never been any slight requirement that the categories have anything to do with physical reality, and as the social benefits of being able to categorize people’s behavior as “diseased” far outweigh the related but far less powerful benefits of categorizing people’s cholesterol levels or BMI as unhealthy.

    — Steve

  • I think you frame the issue well – it is a social/political issue rather than a scientific one. That being said, I do see the author’s legitimate critique of the term “autism” being used, as it is both a pseudo-scientific label and a means of putting down a heterogeneous group of people based on their inconvenience to the status quo. It’s a difficult conflict to resolve – I don’t want to be disrespectful to those who choose to view themselves as “autistic” nor to disrespect the fact that this group does have different experiences based on how they are viewed and treated by society. At the same time, I definitely don’t want to do anything to reinforce the idea that diversity of behavior necessarily associates with diversity of neurology, because in the vast majority of cases, it does not. I’m interested in your views on how to resolve this conflict – any thoughts?

    Thanks so much for your thoughtful response!

    — Steve

  • I’ll just note that if only a tiny percentage of depressed people commit violent acts, then it should be obvious that being depressed doesn’t cause violence, nor is it even associated with violence, so giving drugs to prevent depressed people from committing violent acts is nonsense. A more intelligent approach would involved looking at VIOLENT people as a group and see if they have anything in common. When folks have done this, they’ve found a few commonalities: most violent people are males, most violent people are younger in age, many are taking drugs (legal or illegal) at the time of their violent acts. Many are perpetrators of domestic violence, child abuse and/or pet abuse. A certain subset are involved in or supported by violent philosophies that support their violent beliefs. Having or not having a “mental health issue” of any kind has not been correlated with violent acts, except for a very small subset of those suffering from “delusions” of some sort. We should NOT be trying to stop violent acts through “mental health treatment,” we should be working to figure out how to intervene with young men who have shown violent tendencies and who gravitate to drug/alcohol abuse, or better yet, figure out who these people are when they’re kids and find out how to intervene when they first start to show signs of violence.

    I’d also add that even if there is a very small subset of people who become less violent on psych drugs, this and many other stories, not to mention the product label information, suggest that such small numbers are more than negated by the number of less violent people who become violent as a result of taking these drugs. In other words, as a violence prevention measure, the data suggest that psychiatric drugs are at best useless, and probably make violence more likely, just like intoxication with other mind-altering drugs will do.

  • I heard him speak. He acts as if these brain scans are diagnostic of something. Sounds very convincing when he talks, until you look into the data and find out he’s completely talking through his hat. Mostly suggests bio-bio-bio solutions, but to give him credit, he does outline other options for altering brain activity besides taking drugs. Charlatan about sums it up.

  • This should be obvious to us all. Genetic diversity is the key to species survival. Being all the same spells death to a species, as recent disasters resulting from mono-cropping have demonstrated. Also, a “negative” trait can have unexpected positive correlations. I recently read that the “killer bees” that were released way back around 1990 or so have bred into the general honeybee population, and have conferred greater resistance to the mites that are killing off so many bees. Nobody could have been expected to know this would happen but it did.

    It’s time to start appreciating that people are not supposed to all be the same, and that being different is not a disease state.

  • Oh, “Trickle down” worked just fine. The problem is that people didn’t realize what it was designed to do. The PLAN was to redistribute wealth upward, and it was very effective in doing that. What needs to change is that regular folk need to become aware of what is going on and insist that it come to an end. We need to start with “percolate up” economics, where regular folk prosper and those at the top can reap the benefits of the general prosperity, as sort of happened in the 60s. But I’m not holding my breath…

  • Sounds like what any sexual abuser would say about his/her victim(s). “They really wanted it.” “I did it for their benefit.” “It wasn’t a big deal.” “They’ll get over it.”

    What I don’t get is how they don’t get in serious legal trouble for failing to report these crimes, especially when their own staff is involved. It’s as disturbing as the Catholic priest scandal, but no one seems to be scandalized.

  • Psychiatry has developed as one face of capitalism, especially corporate capitalism. It both provides cover for and protects the elite from the masses by dividing people into categories so that one can look down on another, and also allows those too “out there” to follow the rules like good drones to be singled out and punished, oops, I mean HELPED to “adjust” to the status quo.

    And I agree, socialism is neither good nor bad, but works as well as the people running it. Which is why I say the enemy is authoritarianism, and unless we deal with that, any revolution ends up with “meet the new boss, same as the old boss.”

  • I think it is also true that therapy was constructed by well-off white men, and so it tends to pathologize things relating to poverty, sexism, and racial oppression, as a lot of well-off white men really want to believe that such things are either trivial or don’t exist. While there are exceptions, the majority of therapy is focused on adjusting to the status quo, rather than questioning the roles we’ve been assigned and/or working to change the oppressive structures that dominate our experiences. Naturally, black people are likely find this a lot less appealing, both as a profession and as a means to improve one’s life condition. Therapy’s got to get a lot more “real” if it is going to be helpful or even relevant to those who experience daily oppression in our society.

  • Very well said. Economics drives oppression in almost every case, and general opposition to psychiatry necessitates general opposition to oppression which necessitates economic reform. While the comments regarding psychiatry under communism are points very well taken, it illustrates my biggest stress, namely, that the enemy is not liberals or conservatives but AUTHORITARIANISM under any name. The idea that there are people “at the top” who deserve to run things and decide what’s OK for the rest of us is the core of oppression, and both capitalism and soviet-style communism are built upon that same bedrock oppressive assumption. Real democracy/equity is not possible when the power is hoarded by a few individuals who dictate to the rest of us. But it starts with economic power needing to be more evenly distributed. Lots of folks will say, “Oh, but wealth redistribution is bad!” Unfortunately, wealth redistribution is occurring every single day, but it’s not from the rich to the poor, it’s from the working people to the rich! If we want to ditch psychiatry and the victim-blaming philosophy that goes with it, we have to attack the problem of wealth redistribution to the wealthy, too.

    Thanks, Richard!

  • Psychiatry is driven by the concept that all “depressed” or “psychotic” people have the same problem and need the same intervention. Real medical care is not the enemy, but psych diagnoses often have the effect of obscuring any physiological problems that actually ARE going on, by lumping everyone into a category and not looking further. So yes, I agree absolutely, real medical care is sometimes essential, and there are real physiological conditions that can cause “mental health” symptoms. But you’d have to actually LOOK in order to find them, and 99 out of 100 psychiatrists don’t even bother to ask those questions.

  • I would ask you to consider this: are depressed people generally know for violent acts when they are NOT taking antidepressants? Depressed people in general are known for NOT taking action, for withdrawing and feeling like there is no point in doing anything. This does not describe a person who is contemplating violence in general (though of course, there are exceptions).

    I’d also ask you to consider the poster’s story. Does this sound like a person who would be violent if not intoxicated with a psychoactive drug?

    Remember that the fact that some or even many people feel better with antidepressants does NOT mean that a small or even fairly large number don’t feel awful or do awful things. The idea that all “depressed” people are the same and need the same thing is the central fallacy of the psychiatric system. Different people are different and respond differently to the same intervention. True in general medicine, why would it not be true for psychiatry?

  • I should mention that the author of “Zen and the Art…”, Robert Pirsig, is an ECT survivor whose personality and historical memory was completely erased by the process, and he unravels his amazing philosophical discoveries during a motorcycle trip with his son during which he gradually rediscovers reclaims his true self that was taken from him by the psychiatrists. It’s one of the best books I’ve ever read and would be very meaningful to anyone recovering from the grasp of psychiatric abuse.

  • A good observation. Science can only go so far. At a certain point, we’re really talking about philosophy. What becomes important is what we VALUE rather than what is objectively true, or rather, objective truth only becomes available in the context of what we value and prioritize. If you’ve never read “Zen and the Art of Motorcycle Maintenance,” you should. He goes right at this question of “What is Best?” and comes up with some valuable conclusions. Among them, he very effectively debunks the idea that science is or can be “value free” – what we consider a “good hypothesis” or a “true result” is determined in part by what we think is “good.” It’s a great read.

  • Well, perhaps I should qualify that it is BAD for those incarcerated. It provides income and status and power for those who run the asylum. The reasons it continue include 1) people make money out of it , 2) people get to feel superior, 3) people get to take out their aggressive feelings on those less powerful and feel OK about it, 4) society gets to scapegoat the “mentally ill” and avoid having to deal with the real challenges of our society. There are probably more reasons, but they all kind of fit into that mold, I think. There is no patient-centered reason why mental hospitals should be the way they are. Even if one could justify arresting and incarcerating someone on the speculative ground of “danger to self or others,” the conditions in the average psych ward, as you describe, are anything but healing. If the people in charge really cared, these institutions would look very different.

  • I sometimes thing “neurodiversity” cedes way too much to the psychiatric model, and in doing so makes things more complex than they need to be. If we keep it as “The human species is made up of a wide range of different people, all of whom are potential contributors to our survival,” it gets a lot simpler. I don’t think we need to give extra credence to the idea that we are how we are because of our “wiring”. Some difference is sure to be due to genetics, and some due to education/programming, but who cares? People survive as best they can with the tools they’ve been given. Why not just focus on finding the gifts that each of us brings to the table and helping each other expand on what we have to offer? No “neuro” explanations are required!

  • I certainly would. And honestly, I don’t think we need scientific proof that institutionalization is bad! It is BAD! So let’s get on with fighting it and stop bickering about whether psych drugs cause “cell death” or “temporary brain damage” or “sedation leading to atrophy.” They are also BAD for your brain and your spirit! Science can assist us in the battle, but truth transcends science, and we all know the truth: labeling, drugging and incarcerating people for feeling or acting in inconvenient ways is BAD!

  • Great blog, Chaya! I appreciate your weaving in of social context in all of the sections of your blog. People should have to pay when they harm others, even if they’re not intending to. Psychiatrists and Big Pharma as well as the medical profession as a whole have a lot to answer for, and it’s sad that they make billions while people like you get criticized for charging too much for cleaning up their messes!

  • I would add the general and increasing ripoff of wage earners in order to flow maximum wealth to those already ridiculously wealthy. Since the Reagan Administration, productivity has massively increased while real wages have remained stagnant. The middle class shrinks, the super wealthy own more and more, and no one wants to do anything except admire those who manage to survive the deteriorating conditions that pass for “normal.”

  • “Simple logic” is not science. Science is built on evidence. You present no evidence whatsoever. For instance, saying “chemically impaired brains can’t learn or remember anything.” You provide zero evidence for this assertion. Logic would suggest that what can or can’t be learned would differ depending on who is drugged, how drugged they are, what they are drugged with, how long they are on the drugs, what they are taught, etc, etc. There are far too many variables to even make such a statement, let alone evidence to support it. It’s kind of ironic that you’re criticizing my evidence as potentially circumstantial, and yet running solely on your own “logic” without any evidence whatsoever.

    In summary, your assertion that cognitive decline MUST BE due to disuse and atrophy, and CANNOT BE due to the drugs, is completely unsupported speculation. It COULD be due to disuse and atrophy, but it COULD also be due to drug use, and only an experiment controlling other variables and testing this question could say for sure. As a result, your assertion that people supporting the idea that drugs COULD cause cognitive decline are somehow unwitting supporters of biological psychiatry is ridiculous. There is evidence to support the possible link between cognitive decline and long-term drug use. There is NO evidence supporting the idea that DSM diagnoses are due to brain diseases, and plenty of evidence (and logic) that they are not. There is and can be absolutely no comparison.

    Here is just one example of many where evidence of a connection between long-term drug use and cognitive decline is presented:

  • Thanks for your reply. While I can’t refute your assertion that cognitive decline is directly caused by brain damage, you also can’t refute that it is caused by the drugs. Studies that have been done have specifically correlated the use of benzos and antipsychotics with cognitive decline. I am not aware of any studies that correlate cognitive decline with institutionalization. I also know of nothing that compares institutionalization to psych drug use as relates to cognitive decline.

    So given the data to date, the hypothesis that cognitive decline is associated with psych drug use IS supported by evidence, if not conclusively. There is also ancillary evidence from drug abuse studies showing long-term cognitive decline with alcohol and other drugs, and alcohol is particularly similar to benzos in its effects and mechanism of aciton.

    Your hypothesis is not supported by any evidence at all that I am aware of. So it seems very rational to me, and not brain-blaming in the least, to say that damage from psych drugs is or at least is likely to contribute to difficulties in recovering from psychiatric “treatment.” This is VERY different from saying that someone’s brain is damaged at birth due to some theoretical “chemical imbalance” that is unsupported by even the slightest degree of evidence, or that diagnoses like “major depressive disorder” and “ADHD” are real disorders despite no evidence that people in such subjective groupings have anything in common with each other. It’s hard to understand why the difference is not as obvious to you as it is to me. One case involves an actual, physical substance being put into the body and measurable differences in cognitive ability being associated with using that specific drug. The other case involves using subjective social constructs to create groupings of people having no known connection besides their behavior, and postulating brain damage in the complete absence of any evidence whatsoever. Do those sound the same to you, Lawrence? Is it so hard to see why it would be insulting and infuriating to be accused of the latter type of assertion, when actually working from real evidence measured from real events that happen to someone’s body in the real world?

    I would be very interested to know if there is any actual data to support your hypothesis. Until I hear such data, I’d say “Occam’s Razor” applies here. The most likely explanation is the simplest one: the drugs cause the decline in cognitive ability. The drugs directly impact the brain, brain damage from other drugs has already been shown to occur (Tardive Dyskinesia is only one example of many), there is a correlation directly between these drugs and cognitive decline. Any alternative explanation needs some kind of evidence beyond that you think it’s probably true.

  • So Lawrence, can you please answer the oft-placed question: is Tardive Dyskinesia a result of institutionalization? Or is it evidence of old-style brain damage? What about the demonstrated cognitive decline in long-term antipsychotic or benzo users? Or the development of Tourette’s Syndrome in a subset of stimulant users?

    Your definition of brain damage is pretty narrow here. I’d suggest that brain damage should be defined as something that makes the brain unable to effectively function as it is supposed to on a long-term basis. But however you define “brain damage,” the adverse effects of long-term psychiatric drug use are well documented above and beyond the effects of institutionalization. At a minimum, you are speculating without evidence. It might be an interesting area to explore, but as a scientist, you can’t assume your hypothesis to be true, you have to test it.

    Your lack of response to this question continues to concern me greatly. Are you unwilling to deal with data that don’t fit with your hypothesis?

    — Steve

  • Sorry, but saying that suicidal feelings can result from taking or withdrawing from drugs is not a “pro-psychiatry” position. If it were so, psychiatrists would be promoting this idea instead of going into apoplexy every time it’s brought up. It is not necessary to deny that substances can change feelings. I used to get drunk as a kid to overcome my shyness. And it worked! I was a lot less shy when drunk. I felt different and acted different. This is not news. Psychiatry is not based on the idea that substances change mood and behavior, which long predates it. Psychiatry is based on the idea that people can be “diagnosed” with a “brain disease” based on how they act and behave, absent any biochemical intervention, and that such “diagnoses” are caused by unproven brain malfunctions.

    Denying that substances affect mood and behavior is just plain denying reality.

  • People heal from damage all the time. People break their bones in car accidents, have heart attacks and strokes, have their appendix removed and then recover. There is absolutely no assumption that brain damage is not recoverable, as many people with TBIs can tell you. But the brain is no less damaged just because recovery is possible. Talk to someone with Tardive Dyskinesia and ask them if they think it is a result of institutionalization or drugs.

    I want people to have hope, too, but it’s not helpful to give dishonest or unreliable information to people. The first step toward recovering from harm is admitting the harm has happened, and the second is understanding what that harm is and what can be done about it. I consider it frankly insulting to those who have struggled to overcome the known, direct adverse effects of these drugs to suggest that their problem is “institutionalization.” Institutionalization DOES occur and is a legitimate phenomenon to explore, but suggesting that these powerful drugs have no damaging effect on the brain, in the face of strong evidence to the contrary, is just plain dishonest. It makes about as much sense as saying a heroin addict who is chronically impaired from long-term use is suffering from being a part of the drug culture, and if he’d stop, he’d just recover his prior functioning.

    Drugs do damage our bodies. 120,000 people a year die from properly prescribed and administered medications. A lot of these are psych drugs. Is it really your position that these drugs can kill your body but have no deleterious effects on your brain?

  • I’d be very interested in hearing where your psychiatrist is coming from. What big changes does he foresee or recommend?

    Unfortunately, most psychiatrists I have known and/or heard about are not interested in “big changes” and are unable to even accept hard scientific data from their own researchers. It is hard for me to imagine any kind of reform when the majority of practitioners appear allergic to any kind of factual analysis and are instead religiously committed to their “bio-bio-bio” views.

  • How can you say this? Tardive Dyskinesia is an acknowledged outcome of long-term neuroleptic use, even among the most mainstream psychiatrists, and it is understood as damage to the dopamine system. Brain shrinkage from neuroleptic usage has been proven by psychiatry’s own minions in research labs. How can you say that there is no evidence of long-term neurological damage?

  • I agree, Julie. It’s easy to attack people who don’t support psychiatry as being “anti-science” or “not believing in biological causes.” These are handy ways to discredit people, but that argument assumes that psychiatry is scientific and deals in biological causes. Nothing could be further from the truth. There is not one psychiatric diagnosis that any psychiatrist could tell you the cause of in even a small percentage of cases. And the psychiatric profession ignores the actual science that should inform its practice. There are plenty of real biological conditions that can cause hallucinations, agitation, anxiety, or depressed feelings (including, of course, reactions to the drugs they give you to “treat” such feelings), and we’d be a lot better off if we tried to actually look at real biological causes and peel off those cases of “major depression” or “psychosis” that really DID have a biological cause, and admit that the rest are not “treatable” in the medical sense. The big mistake psychiatry makes is creating a set of labels for conditions they don’t understand, and then assuming biological causation for everyone who fits their subjective criteria. Any real scientist would never put up with that kind of shabby pretense.

  • I am so very, very sad to hear your tragic story! I appreciate you sharing it so the public can keep hearing that people can and do develop suicidal and homicidal feelings from taking SSRI antidepressants, sometimes even people who have zero such feelings beforehand. I can’t imagine how you would feel about this, but it is clear that the action of promoting these drugs without sharing these rare but incredibly serious side effects is criminal.

  • What about the increased autism rates for kids of moms taking antidepressants? What about the brain shrinkage/expansion studies for people on antipsychotics/stimulants over time? What about the measurable cognitive decline in folks taking antipsychotics and/or benzos over time? What about the induction of Tourette’s Syndrome in kids taking stimulants? And those are just the ones that come to mind right off the top. What about those, Lawrence? Do these issues (especially brain shrinkage!) not speak to physiological harm done by these drugs?

    I would also submit that admitting these things happen does not minimize or deny the impact of institutionalization as you describe. However, acknowledging these known facts is very, very different than the harebrained and totally unscientific proposals that things like “major depression” and “ADHD” are biological “diseases” resulting from “broken brains.”

    It really IS possible to break someone’s brain. A crowbar to the head will do the trick, but electric shocks to the brain and mass screwing with neurochemicals will do it, too.

    — Steve

  • I must say, I didn’t really notice that section of the blog. I agree 100% that psychiatric practitioners take advantage of social power to deceive and manipulate people into believing they are able to help, and that blaming their “patients” is blaming the victim. I agree also with your later comments that assigning responsibility is different than assigning blame. It is true that the vast majority of those engaged with psychiatry do so “willingly” and have the agency to make another choice, but the combination of our deification of doctors as “scientists” that near godhead, as well as the intentional misinformation provided by doctors, drug companies, and the psychiatric profession as a whole makes such agency extremely difficult to exercise. Not only are trusted doctors providing bad information and pressuring their patients to “take their meds,” our entire society has embraced this “solution” and there is now mounting social pressure from friends and family and even acquaintances to get with the program. We have seen the lengths to which psychiatry and the drug companies go do attack reputable physicians and clinicians and to deny people with personal experience who critique the psychiatric model with hard data from psychiatry’s own research arm. It is difficult to get one’s head around the full pressure that is put on untrained individuals without our level of knowledge and advocacy skills to simply knuckle under and accept the doctors’ advice uncritically, or the attacks they receive if they decide not to take such advice.

    So you are absolutely right, Richard, and I apologize for not supporting you fully. Clients can NEVER be responsible for the decisions of the profession to manipulate and pressure them into complying with their misguided or downright nefarious “advice.” Thanks for clarifying the issue for us all!

  • I didn’t hear anyone denying this. I heard people objecting to being told they supported the “medical model” by insisting that brain damage from psych drug use is very real, above and beyond the institutionalization that Dr. K rightly identifies. He appears to be saying that damage from drug use is NOT a key factor and anyone that says it is would be supporting the “chemical imbalance theory.” This assertion is just plain wrong and needs to be challenged. It’s too bad, because the bulk of his essay makes a whole lot of sense. Breeding dependency is psychiatry’s stock in trade.

  • How do you explain tardive dyskinesia if not toxicity? How do you explain the cognitive decline evidenced by people who take “antipsychotics” or benzodiazepines over extended periods of time, or the increase in autism diagnoses for children born to mothers taking antidepressants, or the neurological up- or down-regulation that has been shown for antipsychotics (up) and stimulants (down) and appears to also be happening for SSRIs? (Not to mention ECT, which clearly causes irreversible brain damage.) While we may not yet have demonstrated significant levels of cell death (but who is researching that question, I ask you?), we certainly have plenty of evidence of brain damage on a broad scale. How can you suggest that this kind of damage does not impede the recovery of even the most hard-working and dedicated citizens working their way out of psychiatry?

    It is certain that dependency on the psychiatric system is encouraged at every turn and that institutionalization contributes significantly to challenges in recovery. But the question of brain damaging substances is 100% a different question. It is very possible to have both/and in this situation, and that’s what I think is happening.

  • Well, that is the most basic thing. I think what people got upset about was being accused of being biological determinists simply because they believe that drugs can alter one’s mood and behavior in negative ways. Other than that, I think it’s a fine blog, but I think that sentiment has been properly taken as an insult.

    That being said, I believe the #1 issue we should pursue is the elimination of the psychiatric hold. Arresting people and locking them up is not “treatment” and should not be allowed to be called that. If people need to be arrested for threatening or harming people or otherwise violating their rights, it should be called arrest and jail, not “treatment.” If we can accomplish that, antipsychiatry will be so far ahead of the game as to almost have won.

  • Drugs purport to present an easy path, and any kind of quality therapeutic process requires hard work and a willingness to experience pain and discomfort. Naturally, the promise of an easy fix is appealing to a lot of people by comparison. Drug pushers know this. So do doctors and especially psychiatrists. Of course, it’s easier for the doctors, too, in the short run. Of course, only one of these approaches actually helps a person improve over time, and we know which one that is.

  • The problem is, the drugs DO have adverse effects on the brain. I think it’s a combination: the adults have distanced themselves from the kids partly due to the DSM/bad brain theories, and the drugs make it easier to do that, but the drugs themselves make it easier for the kids (or others) to distance themselves from their feelings and their oppressors. They are not mutually exclusive, and there is plenty of evidence to support that certain drugs in and of themselves make violence more likely. It’s not blaming the brain to note the evidence supporting the drugs’ adverse effects.

  • I agree. It is very possible that both have an effect on deterioration, given that suicides INCREASE after hospitalization. However, the evidence Whitaker presents shows a DIRECT relationship between increasing use of drugs and dramatic increases in disability. He also presents a clear mechanism by which this occurs. It is not possible to dismiss his hypothesis without refuting the data, and the author fails to do so.

    I would also add that the REMOVAL of genuine supportive services over time contributes to the deterioration of clients over time, but that still does not invalidate the data showing strong correlation with the use of psychiatric drugs and the vast increase in disability.