Wednesday, July 8, 2020

Comments by Steve McCrea

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  • Appalling! Very much like Kindergarten, except we didn’t have to take drugs and weren’t labeled as malfunctioning. They at least recognized that we were children, not robots.

    It seems particularly ironic when they tell you on the one hand that you have no control over your symptoms, only the drugs can help, and yet they punish you for failing to participate or to control your behavior in the way they want you do. Which is it people?

  • You really think that any drug that has an effect is somehow neuroprotective???? Improvement is not a sign of neuroprotection. Look it up. Alcohol is very effective at reducing anxiety. Does that mean drinking alcohol is “neuroprotective?”

    I’m not doing your research for you. You obviously don’t have any research to hand and have simply swallowed up what someone wrote or said in your training classes. I’m not interested in hearing quotations from your “abnormal psych” professor. Come up with some real data or drop it.

  • Once again, your views are equated with scientific truth. Just saying things don’t make them true. If we want to have dueling personal experiences, I have helped people who have “severe suicidal ideations” to huge turnarounds in their lives with no assistance from any drugs whatsoever. I’ve also talked to many people who have taken drugs and become MORE suicidal, or suicidal for the first time ever in their lives, and it went away when they stopped.

    The scientific evidence is strong that antidepressants DO NOT prevent or reduce suicides, and they likely increase the probability on the average. Perhaps you simply lack the skills to help these people, which is not a black mark for you, just a fact. But claiming that the fact you can’t help them means that nobody else can is very much an arrogant and self-centered viewpoint. A little humility might be a good starting point, rather than simply stating your opinions louder and louder when actual scientific data goes against your viewpoint.

  • That is an interesting statement. You understand that scientific analysis of the data from multiple studies has shown that there is an increase in suicide for those on antidepressants over placebo. Perhaps you don’t understand that the people in these studies are screened for suicidality before the studies begin. So these are people who were NOT suicidal who BECAME suicidal during the study. This was so clear that the US FDA demanded that a black box warning be put onto the label. And yet you state your BELIEF that suicidality is not caused by antidepressants? How do you expect to have the slightest credibility when making such statements of faith that directly contradict scientific data? Because of your personal observations, you get to invalidate actual scientific studies?

    Don’t bother responding if you’re going to continue just telling us you’re right because you say so.

  • They are also frequentely accused of assault and sometimes charged criminally, especially in institutional settings, when they react defensively to what is actually an assault by the staff. Any time a staff person lays hands on a person, any defensive reactions should be considered expected and understandable efforts to defend one’s person from attack. It is a manifestation of the power imbalance between patient and staff that the staff can assault patients with impunity and yet any attempt by a patient/resident to defend him/herself is automatically considered an assault.

  • Your point is very well taken! There is no such thing as “rights for the mentally ill,” they are the same rights everyone else has. The question is why they are not regualrlly afforded to those labeled as “mentally ill,” and why the failure to enforce them doesn’t seem to bother people too much. It is an issue of prejudice and discriination, not of a lack of “rights” under the law.

  • There is really nothing “scientific” about the idea that the mind is synonymous with the brain. It’s a philosophical position posing as a scientific one. A real scientific approach would be to postulate what would predictably result if the mind WERE inside the brain and what would predictably result if it were NOT insde the brain, and then start reasoning from your observations. But since no one can truly define WHAT the mind is, let alone WHERE it resides, the proper scientific knowledge in the sphere is simply, “We don’t know.”

  • From the article you link:

    “These results suggested a differential effect of antipsychotic agents on BDNF levels inpatients with schizophrenia. Peripheral BDNF may play a role in the disease process of a subset ofpatients, related to the use of antipsychotic agents”

    The authors are talking about a “differential effect” with SOME patients, and it says it “MAY play a role,” so not clearly established. There is nothing about protection from harm to the brain in this link, so claims of “neuroprotectiveness” are not shown by this link.

    Additionally, we’d need to know what kind of ostensible damage naturally happens in cases of “schizophrenia,” which is, of course, extremely problematic in that there is no objective way to diagnose who “has schizophrenia” and who does not, so any study on “schizophenia” may be and is most likely being done on heterogeneous populations, making any claims of neurological damage due to “schizophrenia” moot, let alone claims of “neuroprotectiveness.”

    Such a well educated person as you must certainly be aware that even mainstream psychiatry has questioned the validity of schizophrenia as a concept: https://theconversation.com/the-concept-of-schizophrenia-is-coming-to-an-end-heres-why-82775

    Of course, we DO know for certain at this point that “antipsychotic” drugs, formerly known as “major tranquilizers” and “neuroleptics,” do actually CAUSE brain damage, in that they create a loss of grey matter over time (on the average): “Viewed together with data from animal studies, our study suggests that antipsychotics have a subtle but measurable influence on brain tissue loss over time, suggesting the importance of careful risk-benefit review of dosage and duration of treatment as well as their off-label use.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476840/

    I find it a bit hard to see the argument that something which reduces grey matter volume in the brain (the actual NEURONS are less dense!) is somehow “neuroprotective.” In fact, the mechanism of “synaptic pruning” is well known in studies of long-term street drug users, and there is plenty of evidence to suggest that the exact same process occurs when other psychiatric drugs that mess with neurotransmitter levels are used. Hardly an indication of protection of the brain from damage.

    Sorry, you’ll have to do a lot better than that to have any credibility in this quarter.

    As for your suggestion regarding antidepressants, I can only refer to the best insult in the history of film, from the Wizard of Oz:

    Auntie Em (To Miss Gulch): “Elmira Gulch! Just because you own half the county doesn’t mean you can run the rest of us! For twenty-five years, I’ve been DYING to tell you what I really think of you. And now… well… being a Christian woman, I can’t say it!”

    Hope that’s not too subtle for you to parse out.

    Enjoy your evening!

  • Yeah, gotta love that concept of “treatment resistant.” If our “treatment” doesn’t work, it’s not our fault, you are “treatment resistant.” Which justifies us doing MORE of the “treatment” that didn’t work or forcing a worse “treatment” on you against your will. “I KNOW this will work, if only she’d stop RESISTING…” Why do people believe this kind of obviously illogical nonsense? Hammering harder on a screw will not screw it in!

  • It sounds like you are here to promote a viewpoint. It’s my expectation that a person claiming research needs to provide their own links rather than saying “do a search on Google.” Do you have anything specific? I’m pretty familiar with the literature and any study I’ve seen on “neuroprotective effects” of psychotropics has been refuted or is not replicable. Please correct me if I’m wrong, but I’m not going to search for studies that you claim exist. Please provide some links and we can talk.

    As for “side effects,” sure, all drugs have side effects. The question is always whether the risks outweigh the benefits, remembering the Hippocratic Oath to “first, do no harm.” When people diagnosed with “serious mental illnesses” are dying 25 years earlier than the general population, when studies show that people NOT taking antipsychotic drugs do BETTER than those who take them in the long term, even if they had a worse prognosis to start with, when people in “developing” countries do far better in terms of recovery than those who have the “benefits” of modern psychiatry, arguments about “neuroprotectiveness” start to sound pretty foolish.

  • Your assumption that a “suicidal patient” will die or kill is, of course, a ridiculous one. I have talked to hundreds of suicidal people in my role as a crisis line supervisor and doing involuntary “hospitalization” evaluations and advocating for foster youth and just being a human being encountering other human beings in our crazy culture today. I would suggest that 98% of the people I talked to felt better JUST BECAUSE THEY FOUND SOMEONE WHO WAS INTERESTED IN THEIR STORY. Not once did I ever recommend or require psychiatric drugs to “prevent suicide.” But you might be interested to know that I did encounter a significant number who were suicidal ONLY AFTER they took one of psychiatry’s magic “antidepressant” pills. I met many, many more who found the drugs marginally helpful, utterly useless, or making things worse.

    The message that we are somehow taking a huge risk by NOT drugging a suicidal person flies in the face of massive evidence that a) “antidepressants” do nothing to prevent suicide, b) “antidepressants” actually CAUSE suicidal feelings or actions in a small but significant proportion of those who take them, and c) there are many ways to help a person considering suicide that have nothing to do with giving them drugs of questionable value and unquestionable risk.

    I think you have come to the wrong place if you want to sell the idea that we only have a choice between drugging people and letting them die. We know better. I hope you’ll read some of the stories here and you can learn that there is another viewpoint.

  • I know what you mean. I was just being flippant, as I have a tendency to do. Naturally, if a person has experienced lots of rejection over his/her life, rejection by psychiatry will at least initially feel like other rejections. It is to be hoped that over time and with education, a person might come to understand that s/he may have “dodged a bullet,” but it is hardly reasonable to expect a client to see this up front.

  • I agree. It is the psychiatrist who should make certain that any such interactions happen in a non-threatening manner for the PATIENT! Te psychiatrist has all the power, and expecting the client to protect the psychiatrist’s ego is very much like expecting the victim of an assault not to upset his assailant too much for fear of “provoking” further attacks. The person with the most power is the most responsible for creating a safe atmosphere for discussion. If the psychiatrist’s ego is so weak that s/he can’t accept feedback, s/he should not be in the business of “helping” people at all.

  • I went to a counselor one time. I told him I would feel angry sometimes when I got home from work. He said, “So you get angry when you come home from work?” I said, “Yes, I just said that!” He was like a freakin’ parrot! Just repeated back what I said to him, and then invited us to join his church. At least he didn’t “diagnose” me. I’d have had to tell him what my “diagnosis” was and no doubt he’d have repeated it back to me. How can people feel OK taking money and not providing a service of any value? I mean, they have to know that they aren’t helping, don’t they?

  • Perhaps instead of saying, “Opposing corruption in psychiatric science,” we could just call it “opposing psychatric corruption posing as science.” As I commented in another post, it’s a pretty big stretch to even use the term “psychiatric science.” It’s kind of an oxymoron, because if psychiatry were at all interested in science, it would have to tear down the entire structure and start over again.

    Unless they mean the “science” of making lots of money through clever marketing of destructive ideas…

  • It seems to me that the conclusions, as usual, were dramatically soft-pedaled compared to the actual conclusions one ought to draw from this. If the most experienced professionals in the field can’t draw a common conclusion from the same data, there are only two possible conclusions: SPECT scans or PET scans actually tell us nothing significant or meaningful about the brain or its functioning, or that the people analyzing the data are either so incompetent or so utterly biased as to remove any possibility of gaining any reliable intepretation of ANY data from these scans, at least as far as “mental health” is concerned. Or both may be equally true.

    These people are taking in millions of dollars, including our tax dollars, doing worthless research and making claims that are not substantiated, otherwise known as LIES. This is a dire situation and calls for a complete reconsideration of the value of spending significant money on what is either a fraudulent field or one in such a stage of infancy that nothing of value can be expected for decades to come. Particularly given that such studies are granted such high value and yet are almost worthless, these studies are contributing confusion rather than knowledge, and should be discontinued or else relegated to a very cool back burner while somebody figures out if there is anything of scientific value that will ever come out of this kind of study.

  • I see no alcohol wipes, no blood drawing equipment, no stethoscopes, not even a blood pressure cuff or thermometer or a scale. Usually just a desk, books and a filing cabinet. Pens, papers, coffee, whatever, but no sign of a medical exam being even a possibility. And clients I’ve spoken to almost never report any kind of medical workup, and most that do are sent to someone or someplace else to do it. Psychiatrists don’t do medical exams in the vast majority of cases, based on my observations and data.

  • Having an open mind includes being open to the possibility that other people have experiences you have not yourself had or imagined. Remember that we’re not only dealing with withdrawal here, we’re dealing with brain changes that happen over time and take a lot longer to heal than simply removing the drug from the system. Meth, for instance, should be out of the system within a couple days at the most, but the consequences of bathing one’s brain in dopamine for years are evident in a range of difficulties that can last months or years after the last dose.

  • Power dynamics really are the ultimate problem, which Mirandizing the potential victims does not resolve in any way. It might just let a few more people escape from knowing what they’re up against. But I’m sure it would only stop a very small proportion of the current batch of forcibly “hospitalized” people (inmates). At the least, giving such a warning would be an acknowledgement to the larger society that we are not talking about “treatment” when we lock someone up.

  • I think it is very possible to have therapy of many kinds without a doctor/psychiatrist’s involvement. And I don’t think it’s a problem of “inadequate training.” It’s more a problem of following a completely false and destructive model, which they are very adequately trained to apply. The model they are applying is the problem, as it is based on the ideas that 1) behavior outside of the “social norm” indicates a “disorder” just because it isn’t “normal,” and 2) that any such manifestation must indicate a physiological problem with the person acting that way, since apparently everyone should be moderately satisfied to moderately dissatisfied with the current status quo, and anyone who has more extreme reactions is defacto “ill.”

    I don’t think ANY positive change can be possible when operating on such a nihilistic and destructive model of the human mind and behavior. As long as no agency or decision-making capacity is assigned to the client, there is nothing that psychiatry can do but destroy lives, and it does that very well, indeed.

    And “insufficient numbers of psychiatrists” would not be on my list of things to be fixed. We have far too many, and they appear for the most part to wreak destruction wherever they go. The average 12 year old has a better grip on how to help a person in distress than the average “DSM-trained” psychiatrist. At least the 12 year old would have the sense to ask a person WHY they are sad, instead of blaming it on his/her brain!

  • I would say any time the “professional” is considering the possibility of “hospitalization,” it becomes an assessment. If someone asks questions that lead them to decide you need to be “hospitalized,” and they haven’t warned you they were “assessing,” none of that data is useable for petitioning the court. It’s thrown out, just like an illegal search. And no one gets to “prep” the official “assessor” with any lead-ins, like “He’s my patient and I’m really worried about him,” or anything like that. Just facts, with any self-disclosures eliminated that have not been “Mirandized.” That’s my thinking.

  • Those who are pretending but don’t have an actual grasp of their subject are always threatened by any person with real knowledge and understanding, as they know they are always vulnerable to being “outed” as the charlatans they are.

  • I think what you just said agrees wholeheartedly with the concept that “mental illness” is a metaphor (“Thus a mental “illness” might be called an “illness” just because there might be certain behaviors connected with it that mimic physical illness, like expressions of pain.”) With which I agree, but my reasons for not using the term “mental illness” still stand. It adds confusion and makes it easy for the psychiatric industry to continue to convince people that they need to see a DOCTOR, rather than a friend or spiritual guide or wise elder or another person who understands what it’s like to be in your circumstances.

  • How about “dangerously irrational?”

    But of course, his “illness” lies to a large extent in the society in which he practices. His behavior is sanctioned by the social mores of the time he lives in, so he is considered “sane” while his victims are considered “ill,” simply because he pronounces it is so. This “illness” would not be possible without the huge power imbalance he enjoys. So again, if the psychiatrist is “mentally ill,” what is actually ill? Him? His theories? His group (psychiatrists)? Society at large?

  • Let me ask you this. From a purely personal viewpoint, what do you think a “mind” is? Is it a part of the body, a section of the brain? Is it an outgrowth of the brain, like a computer program creates images on a screen that are not understandable in terms of the structure of the computer? Is it something external that resides in the brain, a spiritual entity? Or an interface or control mechanism for running the body?

    If the mind is NOT a part of the body, what would it mean for the mind to be “ill?” Can the concept of “illness” extend to a spiritual entity? Certainly, distress is obvious, as is happiness or confidence. But is lack of confidence an “illness?” Or is it a lack of an ability to believe in oneself? If we’re talking about beliefs, it’s hard for me to see beliefs or ideas or even spiritual entities as having “illnesses” in the same sense that a body has infections, cancer, broken bones, etc. How can a mind be ill if it is not a part of the physical universe? And who would decide what “ill” would mean?

    The other point I made already is that the term “mental illness” has been utterly claimed at this point by the psychiatric profession and their allies, and is fully associated in the public mind with “brain disorders” or “chemical imbalances” and such. To me, it makes no sense to use a term that feeds into the hierarchy of psychiatric dogma, as it is way too easily misunderstood or misappropriated. I much prefer to speak of “mental/emotional distress” or “suffering” or “confusion” or “altered perceptions” or “sadness” or “worry.” You may think it is splitting hairs, but in terms of reclaiming power from the “mental health professions,” I believe discarding this very confusing and coopted term is essential, regardless of what other considerations exist.

  • I agree that “mental illness” at this point is such a tainted term, it can’t even be referred to in the metaphorical sense without instant connection to the DSM and all the stupidities inherent in assuming a “real disease” is present and exists in the brain. It is a term that needs to be tossed and never used. For certain, people experience confusion, illogical urges, emotional distress, even experience seemingly unavoidable sensations, voices, etc. that other people don’t perceive. None of this implies “illness.” It might very well imply some sort of causation, which in SOME cases COULD be physiological, but the idea that we lump all “depressed” people together as having an “illness” that needs to be “treated” is reductionistic and scientifically invalid.

    I very much favor the idea of simply describing what the person is experiencing and going from there. “I feel hopeless and am not sure why my life is worth living” is something I can related to. “I feel like killing myself because I’m mentally ill” is not something that I can find any shared reality with. It doesn’t really mean anything. The first one allows that a person is doing something and can potentially take action to remedy the situation by answering some of these difficult questions or refocusing his/her attention on meaningful activities. The second implies powerlessness and lack of agency, and that for me is enough reason to bag the idea of “mental illness” altogether, bad “science” notwithstanding.

  • New title: “The use of induction of grand mal seizures by electrocution should no longer be allowed or justified through pretending it is some sort of ‘treamtent’ when it is actually electrically-induced brain damage.”

    Or “Induction of seizures is not ‘treatment.’ It is intentional brain damage.”

    There are many other options, but you get the idea.

  • I love this – when we use proper mathematical analysis, the findings are “no longer valid.” Meaning they were NEVER VALID in the first place! Isn’t the real conclusion, “The findings were fraudulent, as the researchers used inappropriate methods to draw the conclusion they wanted to find?” Why not call a spade a spade?

  • Well, by all accounts, sneaking in wouldn’t be very difficult. “Empty, hollow, thud.” (The Rosenhahn Experiment.) The challenge would be getting the phone in. Perhaps one might find a staff person who is concerned about abuse who is willing to assist. Inmates get phones and drugs and other contraband inside jails, and it’s usually with the help of the guards.

  • Yeah, the placebo effect kind of refutes the “brain disease” concept all by itself. But most psychiatric researchers view it as an annoying impediment instead of real and meaningful data. If a third of your cases can resolve based on BELIEVING that they’re going to resolve, it sounds like there is something pretty powerful about believing things that affects the entire body and all its systems! But it’s hard to make money off of that kind of data, and it keeps making their drug trials look bad!

  • Hi, Furies,

    Not sure I said what you think I said. I have no problem with the term PC. It was objecting to it being turned into a term of hostility because it undermines what was a very legitimate effort to look at the purpose and effect of certain terms from a perspective of power in relationships. But that’s what the term has come to mean, and it is used that way, and everyone understands that. So I wasn’t criticizing you or anyone else for using the term. I was only observing that the real purpose of looking at “correcting” language wasn’t to make people wrong, it was to address issues of inequality, and it’s been coopted to another purpose by those in power who don’t want the power dynamics to change.

    I’m sorry if you got the impression I was criticizing you. I was not, not at all.

    Steve

  • Wow, who would have GUESSED that feeling like killing oneself could be related to unmet needs? Such radical thinking! Just when we were all convinced it was a brain disorder that had nothing whatsoever to do with the person’s place in the world and experiences!

    It is sad that such research is even needed. Seems to me kind of like discovering that “based on interpersonal theories of infant communication, crying in babies is often caused by unmet needs for food and nurturance.”

  • I agree. It appears to me to be a term that has been appropriated and turned into a negative. It is unfortunately true that a lot of shaming has gone on in the name of “political correctness,” but in reality, words have great power and choice of language generally frames both what people see as the problem and what solutions are to be considered.

  • MIA is a news magazine. It operates on a skeleton staff and accomplishes an amazing amount with a tiny budget and a lot of volunteer work hours. There is no bandwidth to start creating other organizations, but of course, if readers see such a need, they are encouraged to come up with ways to make it better. We put the information out there for others to use in whatever way seems productive to them.

  • I agree, most people go to NAMI because they need support, just like most people go to psychiatrists because they feel desperate and are looking for answers. But the organizations themselves have to answer for being corrupt and misleading people intentionally, because that’s what they do.

    NAMI is a very interesting phenomenon. There are plenty of people who go to NAMI genuinely looking for support, and some even find it to some extent. There are also a good segment, by my observation, who go to NAMI to be absolved of responsibility for any contribution they may have made to their child’s distress, and these are the ones who really grab onto the “bioligical brain disorder” terminology and ideology. The people in the second group, I have found almost impossible to talk to, because their identity is very much tied up in blaming their child’s brain for everything, which means toeing the party line on the “liftime brain disorder” and “drugs for life” concepts.

    I truly wish there were other places for families to go for support. I mean, there ARE, but NAMI pretty much has taken all the air out of the room so any such effort is generally small, local, and relatively unknown (sorry, bad pun there!) And it becomes a real problem when families really do need genuine support and they get a choice between NAMI and nothing. But the needs of family members are very different than those of the survivors of psychiatry, and in all too many cases, those needs conflict too strongly for both to get support in the same venue. Open Dialog appears to make an effort to bridge that gap, which I’m sure can be very helpful in many cases, but it’s also generally not available, and depending on the family members’ attitudes, might or might not provide what they needed.

    It’s a problem, for real.

  • I don’t disagree. It is amazing how many normal activities are coopted into “therapy” so that someone can charge you for it and still maintain the fiction that they are “treating” some “disease state.” I get apoplectic when they start talking about “mindfulness” or “exercise as therapy” and that kind of nonsense. “Therapy” appears to be anything that can be marketed to convince people that someone else has an answer to their problems.

    My point in that comment is that people in the “biz” try to come up with some magical “therapeutic school” such that if everyone does this, their clients will all get happy. And of course, whenever the client does not, they are “treatment resistant,” because our “treatment” is “evidence based,” so any “failures” are the fault of the client, or the “disease.” It’s 99.9% hogwash. Deep breathing isn’t therapy. It’s breathing. Available to anyone for free.

    When I was a “counselor,” I had the great advantage of having no training whatsoever to be a counselor. So I basically just listened to people and tried to understand their issues, and occasionally came up with an idea or suggestion for them to consider at their own determinism. There was no need for a “school of therapy,” I considered myself just another human being who had somehow earned the privilege of their trusting me with their thoughts and feelings, and I acted accordingly. If that’s “therapy,” then “therapy” is pretty much anything that someone finds helpful in confronting life. The idea that telling everyone to “change their thoughts” is somehow going to produce uniform results is stupid. Just be human. That’s what people need.

  • I always thought of CBT as a technique, not a “therapy” by itself. It works great in some situations, and is awful in others. Works really well for some people, others find it intrustive and invalidative. Any therapist worthy of his/her fee would adjust his/her approach to the person in front of him/her. The best therapy is what gets the person you’re working with to where they want to go. Rigidly applying one technique as the be-all and end-all is a sure sign of incompetence.

  • Sam, I really DO think the way you describe your approach is an exception. Most family members are neither committed nor skilled enough to find a way to either elude the “helpers” who “know better” or find people who actually CAN help or develop his/her own approach. Family members most defintely CAN be incredibly helpful, but as often as not, they can also be incredibly harmful, and are sometimes the very reason the person was traumatized and overwhelmed in the first place. So it is possible, even likely, that there is some bias toward distrusting family members who claim to be “here to help.” Personally, I think each person is different and should be considered individually. But I’m in general agreement that the voice of the person ostensibly being “helped” has to be raised above that of any family member, however well intended, because in the end, that is the person who has to live with the results of any “helping” that is going on.

  • I’m not saying at all that he didn’t say that, just that I am not sure it means what you think it means. I don’t think you are casting aspersions, either. I just see the logic in the decisions he’s made, and the effect it has had.

    I did check the mission statement, and it is a “reimagining” statement. So it may be you are right. But I’ll leave it to Bob to say.

  • This is NOT me as moderator. I will let Bob answer for himself on this, but my view is that this is a misperception of what he has said. For sure, he wants to be seen as scientific and objective, and I think the pursuit of disseminating information and letting people draw their own conclusions from it is the most effective way to make that happen. And I certainly see that his work AND MIA has had a huge impact on causing people to question the dominant paradigm, more than any other person I can think of. I think his impact speaks for itself and I have certainly not accomplished 1/100th of what he has, so whatever approach he is taking, my hat is off to him.

  • Posting as moderator: I do want to point out here that MIA is not taking any specific point of view regarding reform vs. abolition. MIA was created as an alternative news source to put out any and all information that questions the validity of the current paradigm of care. It is not intended to take a political position on an antipsychiatry vs. critical psychiatry viewpoint. It is intended to encourage discussion of a range of viewpoints that are not normally made visible, and to allow voices that are normally silenced to be heard. As such, MIA is not taking any particular viewpoint supporting or opposing the abolition of psychiatry. That is up to the readers to determine for themselves.

  • Exactly. Mainstream schools are a positive for a small minority of kids, I think. Most are bored to death, feel resentful of the many restrictions on their activities, feel restless and anxious to do something of their own choosing. Bullying and shaming are generally epidemic, often due to institutionally approved bullying by school staff.

    I remember very well being in 6th grade on the last day of school. The last 5 minutes, no one said a word. We had a clock on the wall that had no second hand, but which gave a buzz 4-5 seconds before moving to the next minute. As we went through the last minute, the tension was palpable. The clock buzzed, the minute hand ticked, and the bell rang. Suddenly, pretty much every kid in the room stood up cheering in joy and picked up their stuff and ran out of the school as fast as they could go! If school was such an appropriate and helpful place for kids to learn, why was everyone so elated and relieved to be allowed to escape?

  • In “mainstreaming,” there is an unspoken assumption that adaptation to the “mainstream” is good, and that the “mainstream” way of “educating” kids is the ideal, and that kids who can’t manage that are “special education.” I disagree with all three of these assumptions. I think that “Mainstream” schools are actually quite damaging, both educationally and emotionally, to a majority of kids who attend. The lack of creative alternatives condemns all of our kids to this unproductive and at times destructive “mainstream.” When kids can’t manage it and fall out for one reason or another, it should be a sign that this “mainstream” is not working for these kids and that there is a need to approach them differently. But instead, we assume that the child is flawed for finally letting us know that our system doesn’t meet their needs. How many kids are in the “mainstream,” suffering every day (as I did) and yet swallowing their needs and “fitting in” to avoid punishment and humiliation?

    Assuming “mainstream” schooling is healthy or appropriate allows schools the luxury of not confronting or improving on their failures. They can blame the child and keep on doing what they are doing. It is very much analogous to the assumptions of the psychiatric worldview.

  • You make an excellent point!

    Plus, people probably DO feel better when they take Ketamine. Until they stop taking it. Or until they become addicted and tolerance builds up. That is not a solution, even if the study WERE really double blinded, and really were positive for Ketamine.

    I could do a double blind study for alcohol, and I guarantee that alcohol would show significant anti-anxiety properties. There is no doubt about it. But does that make it a “treatment” for anxiety? It is ancient history that taking substances can alter one’s mental state temporarily. Is this really all that has to be proven for a drug to become a “treatment?”

  • People come out worse from psychiatric interventions all the time, and it is almost always blamed on “the disease”, aka blamed on the “patient.” Take a look at “treatment resistant depression.” All it means is “our approach failed.” But rather than take responsibility for failing and looking for another approach, they blame “depression” for “resisting” their “treatment.” It is a pervasive tactic that absolves the psychiatric “professionals” of any responsibility no matter how much worse the “patient” is upon release that at admission. It remains baffling to me that this is not obvious to more people who watch the process.

  • I think it means that they have given up on testing on drug-naive patients because 99% of the patients they deal with are or have been drugged, usually with multiple drugs. A pretty weak argument scientifically. Reminds me of how they used to say they can’t ethically have “control groups” with “schizophrenia”-diagnosed patients because it would be unethical to deprive half the group of their wonderful “treatments.” Even though their odds of recovery would improve as a result. Go figure!

  • When I worked at a crisis line, we used to get calls all the time from people who used cutting to cope. They said they could not tell their doctors or therapists because they’d be hospitalized. They were uniformly NOT interested in killing themselves, they used it as you describe, as a way to reduce tension or frustration or pain. It was clear to me that it met a need and was not specifically dangerous, so enforced “hospitalization” even by their own “danger to self and others” standards didn’t apply. I found it quite ironic that they were doing “therapy” with people who could not handle talking to a person who used cutting as a a means of coping with a difficult reality. How could any therapist be helpful if they aren’t actually safe to talk with?

  • Posting as moderator: Just a reminder that most MIA articles are either already on the internet or are submitted by folks who are telling their own stories or summarizing their own research. MIA doesn’t decide whether the author uses quotations around certain “mental health” related terms except when it is an article published by MIA itself.

  • They do. I used to work with foster kids and I always attended foster youth panels where the kids presented on what THEY thought should be different in the system to make it work for them. At one such meeting, I asked them what was good or not good about their “mental health” support. They talked a bunch about therapy but not a word about “medication.” When the topic came up later in the discussion, it became clear that they did not see “medication” as a “mental health treatment” but as a means for adults to manage “bad” behavior. They understood it as something that happened if you acted out and the intention was to stop you from acting that way. They knew intuitively that it had nothing to do with their health, “mental” or otherwise.

  • “Moving cars are a “risk factor” for broken legs, but clearly, there is a biological vulnerability for people whose legs break when hit by moving cars, because after all, not ALL people who get hit by cars break their legs, so there MUST be something different about those “weak-legged people” who just can’t take the hit and keep on walking!”

  • Of course, that begs the question of how any person could be determined to “have a mental illness” when these “illnesses” are clearly subjective judgments about a person’s behavior or character, without any objective way to determine who does and doesn’t “have” these spurious “disorders.”

  • Most people would allow that electrocution and grand mal seizures would be things that anyone would want to avoid at any cost. It shows how utterly distorted the world of psychiatry is that opponents of “ECT” have to do anything at all to debunk the obvious harms that inducing a grand mal seizure would create. People who have near-death experiences often recover an appreciation for the fragility of life and make big changes to make their lives more meaningful. Does this suggest we should push people in front of cars as a form of “therapy?”

    I also doubt the patient ratings are reliable. After 3-4 “treatments,” I’m guessing most of the “patients” are very much inclined to say, “I am feeling SO much better! I feel COMPLETELY cured! Now, can you please open that door and let me the hell out of this place?”

  • I think we would have to create a bank of lawyers who were serious about enforcing the laws, not the “reasonable” lawyers generally employed in these roles today. Of course, some of these lawyers would be excited to actually be able to defend their clients and would be happy to step into the new role. But it would mean hiring lawyers who would actually be willing to challenge the system. It would also mean collecting stories and data to change the laws so that they are enforced and effective. It would be a big change from the status quo.

  • Are psychiatrists really challenged by this question? It seems likely there will be no actual research into what happens or why. Perhaps the challenge they don’t want to face is why more people will suddenly qualify as “mentally ill” when it’s all supposed to be a “biological brain disease.” But we know that no one will really challenge them on that point except their “patients,” whom no one will listen to, because, after all, they are “crazy.”

  • I would add that the “overreach” is driven by intentional bias in the direction of making genetic explanations stick even when there is no or only circumstantial evidence for them being true. This, in turh, is driven by both professional and financial conflicts of interest, as there is more profit to be made and more responsibility to be evaded by those in powerful positions if the “biological explanation” can be propped up enough for people to buy into it.

  • On the other hand, some people won’t make it to the doctor to get “evaluated for depression” and hence will not start on SSRIs or other such drugs, which may bring the suicide rate down. I know a person who has gotten off of antipsychotics because the doctors were unwilling to come to his/her home to administer it. This person is doing quite well in the aftermath, despite trying many times to stop in the past without success. I’m using s/he construction to obscure any guesses at the person’s identity.

  • I guess it seems like a sneaky way to suggest that somehow Covid19 and “harm to self and others” are connected. I guess as I read it again, the implication is that people with “serious mental illnesses” could be incarcerated because they are judged as too stupid or incompetent to take proper protective measure against Covid19. Which is, of course, is ridiculous, because COVID19 isn’t necessarily dangerous to everyone, and because the fact of someone “having a mental illness” is probably completely unrelated to their ability to protect themselves in the first place. Hey, people with “OCD” characteristics or who are afraid to go out of their homes would actually be at an advantage! But naturally, they can’t just come out and say what they mean, they have to raise fears by vague generalizations. That guy is a dangerous person! He is a “danger to others” with his whacky ideas!

  • There used to be a crisis line whose name was “Let’s talk.” It seems like such an obvious thing. What do you do when you see a car wreck? First thing you do is tell someone, go over what happened and how you felt, they ask you questions, etc. It’s what you do when something scary happens. It is only massive propaganda that has moved people away from this basic, intuitive understanding of what people need from each other. Any “therapy” that isn’t primarily based on listening should be immediately shitcanned!

  • A sad comparison!

    “Hospitalizing” someone for suicidal thoughts or plans is one of the most counterintuitive things I can think of. And someone PRETENDING you are suicidal is far worse!!!! I can’t imagine my rage – but of course, my rage would be “evidence of my disorder” and be held against me, too.

  • In fairness, there are some rational helpers scattered about in the “mental health” system, and if you’re needing someone to listen and they have the capacity and skills and proper attitude to do so, it would be a shame to blot them out by generalization. On the other hand, Muhammad Ali used the analogy that if you’ve got a hundred snakes outside you’re room and 90% of them are nice snakes and only 10% are planning to bite and kill you, are you going to go out and check and see which ones you can trust, or are you going to just keep your damned door shut?

  • I LOVED the graphic! I am envisioning a potential client approaching a “professional” with this in hand. “Before I agree to share my feelings and experiences with you, I have a few questions I’d like to ask. First off, do you feel you are in a better position to know what to do that some of your client? Please elaborate…”

  • Milton Erickson used to say that therapy has to be reinvented anew for each client. I believe he was absolutely correct. Labels only distract from the fact that all people have unique needs and strengths and that nothing is going to work for everyone based on some external characteristics.

    There are some educational techniques we can use with kids who have difficulty communicating, just like there are approaches that work better or worse for kids who are seeking lots of stimulation or don’t like to sit still. But these are adaptations to personalities and personal needs, not “diagnoses” of “disease states.” Any kind of “treatment” requires creativity and a willingness to communicate with the person you’re trying to help, verbally or non-verbally. The rest is all window dressing, or more often, marketing.

  • In the real world of science, “spectrum” always denontes a continuous range from one extreme to another. As much as people are defined as “on the (autism) spectrum,” a real spectrum has no defined point of differentiation except at the extreme ends. If there is a spectrum involving people, then EVERYONE is on the spectrum somewhere. I know that’s not how the word is used by most people in this context, but scientifically/mathematically speaking, that’s the nature of a spectrum. It doesn’t suddenly stop at a certain arbitrary distance from “normal.” The recognition that there ARE spectra of human behavior and emotion that exist around any definable “norm” is a very good thing, but deleting the idea that there are people “ON” the spectrum and those “OFF” the spectrum is really not a sustainable concept.

  • I tend to agree. We don’t know in any case even whether it’s “neuro”, that the person is somehow neurologically different, nor do we know if that difference in a particular case is a result of any kind of abnormal disease process. There are probably some people “on the spectrum” who actually do have something physiologically wrong with them, but we don’t know what it is or how to differentiate those who really do have a physiological problem from those who simply act in ways that are unusual or that make some “normal” people unconfortable for some reason.

  • Excellent analogy with “sex offenders.” A sex offender has committed a CRIMINAL ACT, and his/her label is based on that act(s). This is defined by law and enforcable with known penalties. A person who “has a personality disorder” is so labeled based on a general opinion of what some people have decided is a “problem personality.” Such a label does not require ANY specific act, it is NOT defined by law, or actually by even any objective meausrement at all, and the penalty can be whatever the people in charge want to assess, including incarceration on a more or less permanent basis, enforced drug-taking, public shaming, discouragement, being discriminated against in employment or education, and on and on. It is not in any way a legitimate analogy.

  • I would add that asking people questions, per the Socratic method or something like it, is a better way to lead people into making observations that conflict with their own assumptions than telling them they are wrong. Most people hate being wrong. As Albus Dumbledore wisely stated, “Most people find it much easier to forgive you for being wrong than they do for being right.” Or something like that.

  • My concern is not with fairness or unfairness to Donald Trump per se. My concern is that allowing “professionals” of any stripe to “diagnose” public figures reinforces the idea that “mental illnesses” CAN be objectively “diagnosed” and that these professionals have some inside knowledge that makes them more capable of validly assessing the capacity of a particular person to continue in the office of President. It empowers the DSM and its adherents in a way I find unacceptable, regardless of the reasons given. Since the author acknowledges early in the piece that the DSM “diagnoses” lack any sort of validity, the labeling process he is describing is no more nor less meaningful than any lay person getting together with another lay person and saying, “I think Trump is crazy!” Or “I think people opposed to him have ‘Trump Derangement Syndrome.'” Sure, any psychiatrist or psychologist has the right to come up with a descriptive label of Trump’s or any other President’s behavior or conduct, just as any other citizen has that right. We still have freedom of speech in the USA, last I heard. The question is, why should their label carry any more weight than the guy in the machine shop or the woman serving her country in the armed forces or the teenager trying to figure out what politics is all about? Why should a Ph.D. or M.D after someone’s name privilege them to provide a “professional” opinion regarding labels which the author himself admits are essentially fraudulent?

  • It shows an incredible degree of defensiveness and insecurity. What’s the big deal about admitting that you don’t know what’s going on and are trying to figure it out? Or that you’re disappointed that the drug didn’t live up to its advertising? If a doctor cares more about patients than ego or income, we wouldn’t see this kind of behavior.

  • Hear, hear! It is the responsibility of the researchers to prove their intervention is safe and effective, not the responsibility of detractors to prove them wrong. If there is no proof that “depression,” let alone “treatmeant-resistant depresssion,” actually even exists as an entity, it’s pretty rich to accuse people of being “treatment resistant” just because you don’t know how to help them or are making them worse.

  • The concept of “treatment resistance” is utterly ridiculous. If I am being paid to fix a car, I don’t get to say the car is “repair resistant” when I can’t figure out how to fix it. It irks the crap out of me that they get away with this kind of nonsense. If they need a label, why not just say, “People who are not helped by our interventions?” Or why not just admit that their whole “treatment regimen” is guesswork and there is no actual expectation that any drug will necessarily be helpful?

    Fava does some really important work. We need more researchers willing to challenge the status quo. But I wish they’d been a little more blunt about calling out the nonsensical and defensive nature of this entire concept.

  • I was talking more about perpetuating and supporting habits, ideas and institutions through our training, mostly on an unconscious level. I contrast this to the idea that somehow it’s always “those other people” who are racists, sexist, violent, abusive, etc. Naturally, there are people who are more or less aware of these tendencies and are more or less active in combatting both the internalized and external forms of oppression, such as not allowing ourselves or others to blame “the mentally ill” or black people or even gun owners as the “cause” of violence, but instead reminding everyone that violence is possible in any of us, and its more frequent emergence in our society is not caused by some external force or group of “other people,” but is actually a function of the society in which we are all participating (however voluntarily or involuntarily).

  • Yeah, apparently you’re supposed to be HAPPY that you’re physically ill or that your life may be in danger. God help us we should find it discouraging or overwhleming to have an actual phsyical disease process going on! Apparently we’re supposed to face pain and death cheerfully (but not TOO cheerfully – that would be manic!)

  • We are also encouraged to group people into “those oppressive bad people” vs. “the rest of us,” rather than recognizing that all of us participate in some ways in maintaining oppressive systems. It’s easier to maintain the status quo if we can blame “those other people” for being the cause of the “bad stuff,” so we can pretend that if only we get rid of the “bad people,” the rest of us “good people” can get on with doing good. And of course, “the mentally ill” (as conveniently defined by the status quo) are often put into that scapegoat role of the “bad people” who are causing all the problems and need to be “controlled” for “their own good” or the good of society.

  • I do like a spectrum approach to these discussions – it allows for variation without discrimination, and also includes the possibility that people who aren’t near the center of the graph can still have a lot to contribute that those closer to the “average” would not be able to provide. Ironically, every population biologist knows that diversity of phenotypes is the core of species survival – adaptation is only possible if there is a range of potential responses available within the species, and those who are too adapted to a particular niche are wiped out when change becomes necessary. As long as the concept doesn’t lump people into those who ARE and ARE NOT “neurodiverse,” I think it works, but we both know there are forces who can take any reframing and smash it back into two-valued “logic” for their own nefarious purposes!

    Thanks for your thougts on this!

  • The only problem I have with the concept of “neurodiverse” is that it seems to imply or could be thought to imply that there is a “neuro-normal” that describes most people. I don’t think that is the case. I think we’re all “neurodiverse” to a large extent. Unfortunately, our society picks on certain “neurodiversities” and condemns them, which is pretty sad. But I do get that normalizing “different” presentations is a very sane thing to do, and I totally support that idea!

  • I think the biggest problem with even quality therapy is that it is not really the proper mode to deal with current or ongoing abuse or oppression. It can be valuable for a person to discuss the pain of living with a dead-end job, and may even help motivate a person to seek a better one, but it can’t take care of the question of why so many jobs are dull and lifeless and why so many people are forced to work in them for inadequate pay in order to merely survive to face another day. Therapy can be valuable, but it is limited and can’t really handle the bigger social issues with which our current Western society is riddled.

  • Yeah, I think I’d volunteer for that one. Except if you’re a kid, they might lock you in a “residential treatment home” until you learn to knuckle under.

    The best diagnosis is “don’t know what happened to that guy – he seems to have disappeared.”

  • Lack of long-term outcome data means you have no idea if your “treatment” is actually effective. Which means from a purely scientific viewpoint, your “treatment” is not legitimate. We assume something doesn’t work until proven that it does, not the other way around. That’s how science is supposed to work. Anything else is marketing.

  • Well, of course, the algorithm is only as good as the programmer. I’m sure someone could program a discriminatory app. But at least they won’t have to manage their emotional reactions to our statements, appearance, etc. I’m sure they’d totally suck, because they’d be made by people who have no comprehension of what is helpful, otherwise, they’d realize that a computer can’t provide what is needed.

  • Hey, people do it all the time. I was just making it clear that there is a difference between people calling someone names because they don’t like their behavior vs. calling someone official names with the power of a medical degree behind it. It’s still name calling, and I am generally opposed to name calling, as it is usually very unproductive and avoids planning to overcome the problem. But there is a very important difference in quality between being called a name by someone who is no more or less powerful than you are vs. being officially sanctioned by the medical profession to call people names as “medical diagnoses.” The second is far more insidious and destructive.

    Hope that makes my point clearer. At least in the colloquial situation, we KNOW it’s a matter of name calling or generalizations with no scientific basis. No one is pretending that the other person “has” some brain problem or whatever. They’re just saying the othe person is a jerk.

  • Nah, they just liked high school for some inexplicable reason. I guess maybe they would miss their friends, but I didn’t have that many, and in any case, I could still be friends with them absent the authoritarian regime. And that was in the days when we had MORE freedom in high schools, right at the end of the 60s “student rights” movements. Student rights have massively deteriorated since that time, in my observation, other than that physical abuse has been MOSTLY outlawed.

    My high school was in suburban Philadelphia. Supposedly one of the top 10 public high schools in the country. And there were a lot of good teachers. But it was still school.

    And there were still a few, like Mr. Mims, who probably belonged in jail. Even as naive as I was back then, I suspected he was sleeping with at least one of the students.

    I guess I’m impatient with injustice and authoritarianism. Probably a “mental illness” of some sort. Otherwise, I would have loved being pushed around and bored and bullied and neglected and prevented from exploring anything not on the curriculum. What was wrong with me?

  • “Narcissistic” is a colloquial description of a certain kind of behavior, kind of like “cowardly” or “noble” or “conscientious.” “Narcissistic Personality Disorder” is an alleged “mental disorder” that can purportedly be “diagnosed” by people with a “professional background.” What would you think if they diagnosed someone with “Cowardly Personality Disorder?” Wouldn’t that seem pretty far out there, to take a set of personality characteristics and call it a name and then claim it is somehow a “diagnosis?”

    You could replace “narcissistic” with “childish” or “selfish” or “ill tempered” or “thoughtless” or “mean-spirited” and it would still just be a description of a person’s behavior. A description of a person’s behavior can not logically be a medical “diagnosis.” That’s the difference.

  • I remember they had an overnight party the day of graduation, with a hypnotist and dancing and punch and the usual entertainments. I saw different clutches of kids hugging each other, some with tears in their eyes, talking about how sad they were it was all over. I was thinking, “What high school did YOU go to?” I am sure that their experiences were very real to them and I admire them for being able to emote about them publicly, but it was TOTALLY unreal to me. I felt a huge weight off of me, along with the thought, “Wow, I’m free! Now what am I going to do with my life?”

  • I think you’re making total sense. My point is only that there are, in fact, any number of imponderables, and it is possible, even likely, that some measures in place are not particularly helpful while there are others we will later learn we ought to be doing. We’re flying blind to a large extent, as there is not much prior experience to draw on, and we don’t have time to do controlled experiments. So “playing it safe” and reducing risk is probably the best we can do. But I do think it’s important to acknowledge (not saying that you aren’t) that our knowledge is limited and to some extent we’re making educated guesses as to what will be most helpful, which explains at least in part why at first we were told no masks, then we were told to mask up. New information is coming in and best practices will change as we learn more.

  • Because traditional meditation approaches are grounded in Hindu and Buddhist spirituality, I see meditation as being utterly incompatible with psychiatry. “Mindfulness” is something appropriated from Buddhism without the nasty entanglements of silly questions like “What is a person?” and “How should I conduct myself on Earth?” and “What happens when I die?” Buddhism is based on the assumption that we are spiritual beings who suffer because of our own attitudes toward life, and offers a means of attaining greater peace and satisfaction through expanded use and understanding of our minds. Psychiatry teaches us that we are bodies, that there is no spiritual existence, that the mind is just a function of the brain, and that the mind is incapable of having more than a marginal influence on a person’s “mental health.” Meditation in every way contradicts the basic tenets of psychiatry, unless you go for “McMindfulness” that says you can sit there and breathe and it can calm you down. Which can be true, but it certainly misses the point, especially when people are told they HAVE to meditate or are shamed for failing to “succeed” at it.

  • Do we know that reduction of droplets extruded reduces the likelihood of infection when distancing and surface sanatiziation and hand washing are all in effect? A recent study showed that outdoor transmission almost never has been shown to occur. So maybe we should only wear masks indoors? There are lots of imponderables, which is my point.

  • It seems that only a certain number of comments in a thread can “nest” as replies, after which they are just listed one after the other, with no “reply” button. You have to go back up the chain to the last one that had a “reply” button on it if you want to continue on this thread.

    I agree that there are things which are concretely known and some which are purely speculative, but there are also partly-knowns which have to be evaluated, and that’s where a lot of conflict occurs. For instance, it is known that COVID19 virus can be found in droplets in the air 2-3 hours after they have been deposited. But what does that mean? Are they still infectious at that point? Do ACTUAL cases get passed that way or don’t they? Is this important for people who are infected to prevent spread, or people who are trying to prevent infection in themselves? These are all questions that people are willing to weigh in on heavily, either shaming people for not wearing masks or dismissing the possible risks as nothing but hype. The truth is, we don’t know if masks help or not, or how much, or on whom. A lot of this stuff is guessing.

    As to how Trump is handling all this, again, I think this subject is pretty well pooped out, and I’m going to ask more directly that the two of you move on from this subject, as it is now deteriorating into a more personal “thing” that is not productive.

  • Posting as moderator:

    I agree that this exchange has been interesting, but has perhaps reached as far as it can go. I think we’ve seen both perspectives fleshed out pretty thoroughly, and I doubt very much if either of you will sway the other. Part of the challenge of this set of events is the inability to know what information is reliable or not. I think this exchange makes that point very clear.

  • “The problem is that common approaches to deploying AI tools are not improving outcomes.”

    No, the problem is that common approaches to “helping” with mental/emotional/spiritual distress don’t improve outcomes, and no amount of AI is going to change the fact that the basic model of distress and helping is fatally flawed. Well, flawed unless your “outcome” is increased profits. Maybe that’s what they mean – AI isn’t improving income, therefore, it isn’t working?

  • I wasn’t so much bullied by peers as by teachers (we had some mean ones!), plus very lonely and bored out of my mind. I hated taking arbitrary orders from anyone, and still do. Particularly when I was smarter than most of the teachers and was always way ahead in almost every subject, which instead of counting as a positive made me a problem for them. The kids who liked school were the ones who had lots of friends, mostly, or the ones whose home lives were so bad that school seemed like a big step up. I was neither, and I hated every minute of elementary school. Junior high was only better because they had sports and I was a good athlete, and so finally got a few friends, too. When I graduated high school, I felt like the allied troops had freed us from the POW camp!

  • Well, we wouldn’t want to get in the way of commerce, now, would we? What about the danger to the individual of a poorly-programmed driverless truck? Oh, but I guess actual PEOPLE would be expendable in this futuristic world.

  • That’s been my experience, both as a helper and as a “helpee.” These “disorders” are just a way of experiencing the world, and we have to be the ones to decide what is and isn’t the best way to approach it. Most of the time, people have adapted to difficult circumstances by developing a way of thinking about the world or interacting with the world that seemed to work at the time. So accepting that these thoughts/behaviors/emotions have served a purpose, and then asking oneself what purpose they continue to serve, has been a successful path for me. Others would frame that differently. But in any case, what is helpful is NORMALIZING the experience as part of your own process, rather than externalizing it and making it seem like “OCD” or “ED” is some external agent that is attacking you! It reminds me a lot of demon possession. Not saying some people might not find it helpful, but it sure seems counterproductive to me.

  • A lot of science is also rooted in what is known NOT to be true. It’s a lot easier to disprove a hypothesis than it is to prove one unequivocally. The most certain data in science are which theories are absolutley wrong. Unfortunately, these days such vital information is often buried or at least not published. Especially when conflicts of interest are involved. Peer review’s job ought to be to poke holes in the methods or conclusions of the researcher based on the data. Unfortunately, that role is not always played fully by the reviewers these days.

  • I think calling it a “disorder” IS shaming! THe non-shaming approach is to assume that it is a normal reaction to circumstances, or else a manifestation of a legitimate and observable physiological problem (lack of sleep, thyroid problems, etc.) It is hard to think of a much more shaming approach than to say your emotions mean nothing, your brain is broken, but there’s nothing anyone can do to actually fix the problem, it’s just you have an inherently bad brain. Tough luck!

  • A point I have always shared and agreed with. Corporations are a force of their own and are often subject to no government at all, yet can do as much ore more damage than any government, and many of the problems with government (though certainly not all) are due to their being in bed with Corporations and/or Crime. And I do see an increasing crossover between Corporate and Crime that also needs to be addressed.

  • I stand by what I said. And it does appear that you misinterpreted my comment. While it does come across as rather flippant, nothing in that comment says that JWR or beer or “antipsychotics” have no effect. All I am saying in this comment is that just because something DOES have an effect that someone likes does not make that something a “treatment” for a “disorder.” Alcohol reduces anxiety significantly. It’s a fact. Why isn’t it considered a “treatment” for “anxiety disorders?” I certainly used it as a teen and young adult to reduce my anxiety in social groups, and so do lots of other people. How is this different from taking Xanax?

    You say “APs” saved your life. I have no desire or data to disagree with or refute your reality on that point. Other people say “APs” ruined their lives, including ruining their health. Neither you nor I have any data to disagree with or refute their reality, either.

    The only real point here is not to confuse a drug’s effects, which may be perceived as positive, negative or neutral, as evidence of any particular “mental health” issue being present or absent. We don’t diagnose cancer based on whether people feel like cancer treatment worked. We don’t diagnose a skin rash based on whether steroid cream makes it go away or not. We look for the CAUSE.

    We should not diagnose “mental disorders” based on people’s reaction to drugs. I don’t want to prevent people from using substances they find helpful. I just want to keep doctors away from “diagnosing” people with speculative “diseases” that no one can objectively observe to exist.

    OK, I broke my vow. That’s really it, Martin. No more.

  • I absolutely agree, Trump is NOT the problem. Which is why simply removing him is NOT the answer. He’s a symptom of a much larger, more difficult problem that besets our whole society. But it’s easier to blame Trump and imagine that somehow if Biden gets elected things will magically improve. I hope people aren’t holding their breath for that one.

  • Sometimes we believe we can change things, or the pile of data doesn’t reach critical mass until a certain point. There are many of us here who had “epiphanies” at one time or another in our lives/careers. At a certain point, I think a person comes to see that it’s not just a matter of confusion or needing training, it is the intention of the SYSTEM that is wrong headed. I’d guess a DSM IV conference would make that point pretty clear to anyone who was participating.

  • So you can’t see the difference between, “The majority (defined as more than half) of scientific studies can’t be replicated” and “Scientific data is not replicable?” Even when I stated clearly that TRUE scientific data IS replicable (around half of the studies I’m talking about), and that this is the only way we can tell if it is true? To put it another way, half of what is put forward in journals as “scientific data” later turns out to be false. Does that state it more clearly? Data that can be replicated are true, those which cannot are false, scientifically speaking. So SOME scientific studies can be validated, but according to the article, more than half cannot be replicated. Which leaves us with plenty of valid scientific data, it’s just a lot less than we’ve been led to believe by leaders in the medical/psychiatric industries. I refer you again to the Viiox scandal. We were told that it was safe, when there were plenty of studies saying that it wasn’t. But those studies were hidden and not published. The studies used to promote its safety could not be replicated, and the drug company promoting Viiox knew this but chose not to share. The studies they used were false. They were put forward as if they were true by people who knew they were false, but who had an interest in profiting off of Viiox’s sale and use. That seems pretty simple to me.

    You never did read the article, did you? It would really help if you did.

    We really need to end this. It seems we are unable to listen to or understand each other’s viewpoints. For you to suggest that I have ever said that antipsychotic medication has no effect on people shows how far we are from being able to communicate.

    I am not going to respond to further comments from you on this topic. I would suggest that if you find the comments here offensive, you might do better to seek another community that is more comfortable for you and aligns more closely with your values. I certainly have no intent to frustrate you, but it is apparent from our conversation that you are not getting what I’m saying, and I’m sure you feel the same way. So let’s just stop, OK?

  • There is nothing in the first statement that contradicts the second. Both say that the majority of today’s scientific research is not replicable. Majority means more than half. If you read the article, you’d perhaps understand why I’m saying that. Scientific analysis of the data says that over half of scientific studies are not replicable. I suppose that study could be wrong as well. But that’s why I read them, so I can make up my own mind. I wouldn’t believe the article unless I read and analyzed it myself. Which is the real point here.

  • Again, I did not say that scientific data is not replicable – you are putting words in my mouth. You either did not read the article, or did not get the main points it makes. The point is that TRUE scientific data IS replicable. But data that is NOT replicable is, BY DEFINITION, not scientifically true. Just because one study shows that X drug has Y effect, that doesn’t make it scientifically factual. Other studies would have to be done testing this hypothesis, and actually working hard to look for other explanations (like the placebo effect, selection bias, statistical manipulations, etc.) to undermine the result that the original researchers may WANT to be true. Only when a theory can withstand the rigors of repeated testing with intent to DISPROVE it or provide an alternate explanation, and yet continue provide the same result, is it regarded to be scientifically “true,” and then only as long as conflicting data don’t come in to create more questions. Unfortunately, this re-testing seldom happens today, largely because it is rarely funded. And even when it does occur, such retesting results are rarely published. This is especially true when these studies clash with the preliminary results that have been shared worldwide as if they were a new and amazing breakthrough rather than just a promising lead, or when some person or corporation stands to reel in healthy profits from the preferred “truth” reported in the initial study.

    So the point of the article is not that scientific studies can’t be replicated. It’s that people often have preexisting biases that make them WANT a certain result, and that they regard studies that don’t provide that result as “failure” and therefore unworthy of pubication, or in need of overt suppression. It is also a problem that many “positive” studies are only positive because of intentional design changes (like “placebo washouts” or not counting dropouts as failures or changing the primary outcome measure when a secondary measure gives you the answer you want) or sometimes outright dishonesty in reporting the data. THOSE are the studies that are not replicable, the biased studies that DON’T follow true scientific method, and they are not replicable because their underlying hypothesis IS NOT TRUE, and for no other reason.

    So those area my views on the finer points of the scientific method, and I ask that you respect what I am saying as what I really mean and not try to “interpret” some other meaning that is not contained in these words.

    Suffice it to say, I think we’ve had our talk, and it’s starting to deteriorate into a more negative exchange. I think we should leave it at this point, and agree to disagree. It seems unlikely that further discussion will be productive.

  • Well, you were very fortunate. Bullying was common in the schools I attended. There were plenty of good teachers, but also some totally crazy ones. My second grade teacher was screaming and yelling at us one day and tossed a book over our heads against the back wall of the classroom. When I stood up to object (and I NEVER talked back or did ANYTHING to get in trouble, but this was just too much even for me), she came down the aisle and smacked me in the back of the head and took me and another kid who was crying and tossed us out in the hallway. I never even told my mom, it was so NOT surprising that such things happened. A friend of mine was shoved down onto the gravel track by Miss Cooper at the end of recess in front of 100 kids and some staff. Yelling at kids and forcing them to stand at attention for a half hour, flicking them in the head with fingers – all of these were totally normal and accepted by the school staff.

    I think it is pretty biased to say that homeschooling automatically deprives kids of anything. It obviously depends on how it is done.

  • Wow, you REALLY need to stop projecting your assumptions onto me, dude! I AM a scientist (chemist) by training and I would be DEAD at the age of 8 from a ruptured appendix and peritonitis without modern medicine. I am ABSOLUTELY a full supporter of modern medical science, and I fully understand what good and bad research looks like. Where we appear to disagree is that you believe psychiatrists are scientists. I think there is massive SCIENTIFIC evidence that the vast majority are not, and that the entire edifice of psychiatry is built on a foundation of sand and wishes. This does extend to medicine as a whole to some extent, but psychiatry is entirely based on unscientific or antiscientific premises. Look into how those DSM categories are determined, and if you have any degree of intellectual honesty, you will agree with me.

    And in case you think my skepticism re: modern medical research is misplaced or based on emotion, try reading the following, which outlines why the majority of scientific research done today is not replicable, which from a REAL scientific perspective, means it is scientifically untrue:

    https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124

    Again, I am NOT saying that the drugs prescribed for “psychiatric conditions” can’t be perceived as helpful by those taking them, even life-saving by some. But you and I both know that anecdotes don’t make science, and there is a lot of good science out there that is buried because monied interests don’t want it to come to light. This is covered in the article. Please read it before you come back and try to imply that I am antiscientific again.

  • Yeah, I would have felt the same way! I’d have been SOOOO happy to be at home and able to pursue what made sense to me instead of being bossed around by bullies and teacher/bullies and forced to be together with people I didn’t choose doing activities I had mostly no interest in at all. Homeschooling must be a Godsend for a good percentage of kids, at least the ones who don’t need to escape from their parents/siblings.

  • Maybe they should just get the drug companies to buy them coats, and they can wear the “colors” of their sponsors, kind of like race car drivers. “And now, in the southeast corner, in the bright red coat, representing Eli Lilly, Dr. JO-seph… LIEEEEBERMAAAAAN!”

  • Given the widespread agreement amongst professionals and informed laypeople that “scientific” studies are massively affected by economic and professional conflicts of interest, I’d rather trust my own ability to judge amongst the many stories that told, both by journalists and by professionals, and by those who have experienced the effects of the drugs directly. If we start with the rather obvious and undeniable facts that these drugs cause huge weight gain, diabetes, and heart problems, and knowing that any number of studies have shown extremely shortened lifespans in those diagnosed with “serious mental illnesses” since the pre-drug era, and actually KNOWING people who have died early directly as a result of taking these drugs, the prospect that they shorten lives seems by far the more believable story. Scientists who are schooled in analysis and methodology are also those most capable of abusing their abilities, and recent history is replete with examples of their having done so (Bidedermann’s “juvenile bipolar disorder,” the Viiox scandal, the lies about antidepressants and suicide, the lies about Benzedrine, then Valium, then Xanax being “non-habit forming,” the denial that Tardive Dyskinesia is caused by neruoleptic drugs – shall I go on?) So someone being a scientist does not convince me of their superior reasoning ability OR superior ethics. Maybe that’s where you and I differ here. You trust psychiatrists to be legitimate scientists. I don’t. You believe you have very good reasons for trusting them. And I have very good reasons for not doing so.

  • Fair enough, but still there is no actual way yet established to measure that difference, let alone studies that have actually done so. How many become suicidal coming off their “meds” and becoming psychotic? How many become suicidal going ONTO antipsychotics? How many because sucidal because they are WITHDRAWING FROM antipsychotics? How many would never have been suicidal in the first place if they’d taken another path? These are things we do not know the answers to, so claiming that “lives are saved” when we also know that lives are lost is very, very premature at this point. We don’t know the cost/benefit analysis and will never really find out what it is when so-called “scientists” are dishonest and manipulate data to serve their own interests instead of the interests of the public.

  • Nothing is more stunningly idiotic in recent years than the idea of giving stimulants for “Binge Eating Disorder.” The disorder itself is laughable, clearly invented solely to sell more drugs (not saying that people don’t binge eat, but the “disorder” is defined in the usual superficial, blameful manner). But to “treat” it with stimulants is ridiculous. As if the problem is appetite. And of course, there is no effort to actually look at WHY the person may be eating in this way, only an attempt to bludgeon the body into submission. I find stomach stapling more rational.

  • I would submit that the moment when we are “two people talking” is when real therapy can take place. As for “countertransference,” it is totally and completely normal for therapist and client to form a bond, and for them each to have feelings about the other. The difference SHOULD be that the therapist uses his/her feelings in the service of therapy, and does not take advantage of the client’s vulnerability in even the slightest way. I often found it helpful to share my feelings of the moment with the client when it seemed likely to increase trust or open up a new perspective. After all, they’re sharing their feelings with me, shouldn’t they get to know that they are having an impact, that I’m not a block of wood trained to say, “Go on” every three sentences? People want to talk to another PERSON, a REAL PERSON who interacts with them in a meaningful way. Nobody wants to talk to a “blank slate.”

    That’s my experience, anyway, but I was not a DSM-trained standard therapist. I pretty much made it up as I went along, depending on the client. Kind of Milton Ericson style. I’d probably be fired in a second from most places nowadays.

  • It sounds like you agree that antipsychotics do play a role in shortening lifespan, but that poverty’s role is greater. This is possible but certainly we don’t have data to prove or disprove this hypothesis. But saying “studies show you live longer if you stay on your medication” is a misstatement of fact, and actually contradicts your earlier statements that antipsychotics do, in fact, contribute to the undeniably shortened lifespans that have been reported. The truth is, there are studies claiming one and the other, and the question as to why lifespans for the so-called “SMI” and the role that antipsychotics play is at this point is very complex and can not definitively be answered as you claim.

    The point of this article is that the claims that people live longer on “APs” put forward in THIS set of studies are based on manipulation of data. I think you should be able to admit that there is a major conflict of interest when people who make their money selling drugs and drug prescriptions do such research, and that intentional manipulation of data has been shown to be extremely common in all branches of medicine. The studies in question clearly don’t prove anything, especially given the basis of “person-years” on medication, which even a layperson can see is a pretty poor substitute for the actual lifspans of actual human beings who are on/off antipsychotic drugs.

  • I think there is a big difference between saying, “Corporal punishment won’t destroy kids’ psyches in and of itself” and “It’s really no problem for parents to use corporal punishment.” It’s one of those things where the truth sometimes hurts, and it feels like a criticism of the person who has used spanking, but it’s still the truth. I think it’s fine to say, “You don’t have to worry that you’ve destroyed your kids’ lives just because you spanked them now and then,” and certainly removing kids to foster care for spanking is massive overkill (given the incredible damage done by the very act of foster care placement), but I think it is important to be honest and say that spanking has been shown to be ineffective and potentially damaging, and that there are more child-friendly ways that work better in accomplishing the same goals.

  • Poverty is, of course, a factor in the lifespan differential. But even between the most rich and the most poor, the differential does not even begin to approach 20 years.

    “More precisely, the study shows that in the U.S., the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.”

    http://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411

    Why is it difficult to believe that drugs which cause obesity, diabetes, and heart disease would be responsible for shortening the lifespan of those who take them? I should think it would be almost impossible to believe they would NOT shorten lifespans, as heart disease and diabetes are very high on the list of killing diseases in the USA and around the world. I find it difficult to take anyone seriously who doesn’t see the almost certain impact of these drugs on lifespan.

    Of course, we should also be asking why our “mental health” system is leaving the huge majority of its “seriously mentally ill” in lifetime poverty. Does that not convey a responsibility for decreasing lifespans, when our “treatment” fails to take into account the quality of life of those being “helped?”

  • Well, of course. I was responding with the idea of “psychiatry” as “carers for the spirit,” psychiatry as it COULD be if they started off by actually believing that such a thing as a human spirit exists.

    Psychiatry is worse than nonsense, or it would already be interested in all the above things I mentioned. The “ADHD” example alone proves that they will bury useful evidence that would reduce the number of diagnosed/drugged kids and promote things that will sell more stimulants. They are a bankrupt profession.

  • For example, looking at indigenous healing practices and indigenous cultures and seeing what they do for “mental health problems.”
    -Looking into why people diagnosed who hear voices have more positive content in countries where culture supports voice healing as a normative experience, and exploring how altering our cultural attitude toward voices might help those suffering right now.
    – Looking at different classroom settings and observing that “ADHD”-diagnosed children do so much better in “open classrooms” than those who are in standard classrooms that they are indistinguishable from “normal” children, and then advocating for revisions in classroom settings instead of drugging the kids who don’t “fit in.”
    – Looking at why it is that certain cultures have almost ZERO incidence of “postpartum depression” while in our culture, it is almost epidemic. Helping move our culture in a direction that emulates those who support new moms in a way that they don’t suffer, based on the evidence of the absence of this suffering in their culture.
    – Studying the interesting phenomenon whereby immigrants develop Western maladies, both “mental” and “physical,” by three generations living in a Western culture. See what it is about Western culture that makes them ill and see if we can stop it.
    – Look at the impact of racism on group experience in terms of emotional experience and behavior.
    – Examine the connection of job satisfaction/”stuckness” to other life indicators, such as mood, marriage success, etc.

    The list is endless. These are things that could be studied using social science methods and might lead to improvements in our social welfare. None of them require labeling anyone as “ill” or “bad” for diverging from what the society considers “normal.” In fact, a real “doctor of the spirit” would dbe working to redefine “normal” toward what works for people instead of what works for the institutions of society. Psychiatry appears to be doing the opposite. If you don’t “fit in,” you’re abnormal and need to be “fixed.” Those who don’t create any problems for the status quo are “normal” and don’t need fixing. “Fixed” is defined as being happy with the status quo (but not TOO happy – then you’d be manic!) It is not working in the interests of improving people’s lives, unless you count the people who are making big bucks out of the enterprise. Sure, there are a number of people who feel better taking their drugs. But people also feel better smoking dope or drinking beer every day. Drinking beer to feel better can be helpful for some, but it’s not a medical treatment.

    So there’s lots to do, but drugging people unhappy with their lives is not particularly productive, IMHO. Especially if you label them as “abnormal” for feeling, thinking or behaving the way they do.

  • Once we allow for subjective “diagnosis” based on observer opinions, there is no end to who and what may get “diagnosed.” I think that’s the clear and obvious conclusion from this observation – when there is no objectively definable line of “normal,” sooner or later, everyone is diagnosable. Which, as you say, makes “abnormal” the new normal!

  • Thanks for your passionate reply.

    There are a couple of things you say that I have to take issue with. First, there is plenty of evidence of significant brain changes due to trauma. This was the primary finding of the “Decade of the Brain” research, which was actually quite different than what was anticipated. More importantly, and less well known, are the findings that the brain can continue to change in a POSITIVE direction when a traumatized person is supported by a healthy adult caretaker or support system. Dr. Bruce Perry is one of the best resources for this. Easy internet searches for these items. Here is one just to get you started: https://www.psychologytoday.com/us/blog/the-mindful-self-express/201809/how-ptsd-and-trauma-affect-your-brain-functioning

    You also seem to conflate “cognitive disability” with “mental illness.” You suggest that most of those severely affected by the syndrome called “schizophrenia” are affected by brain damage. I know of no evidence that this would be true in most cases – there has been a long, intense and frankly biased search for brain damage associations with “schizophrenia” and many other “mental disorders” with little to no results. There is evidence of brain matter loss in people diagnosed with “schizophrenia” over the long term, but Nancy Andreasen’s own research, which she really didn’t WANT to believe at first, showed that antipsychotic drugs cause loss of brain matter when used over the long term, so such studies are meaningless unless controlling for AP use, which is almost never done.

    Finally, you also assume that the “schizophrenia syndrome” is due to different types of “brain malfunction.” As I’m sure you are aware, science proceeds from hypothesis to proof, and it doesn’t work to assume the conclusion that brain malfunction is the cause when that has not been shown to be the case. And your suggestion that the fact that certain drugs “work” to decrease these loosely defined groups of “symptoms” proves an underlying disorder is similarly flawed. Under that reasoning, alcohol must be addressing an underlying “brain malfunction” because anxious people feel better when they get mildly intoxicated. Correlation can’t be used to diagnose anything.

    I very much respect your reframing of “schizophrenia” as a syndrome, something which would really help if we all operated from that assumption. Unfortunately, the current reality in “mental health” research is that these syndromes are being treated as unitary entities for investigation, and that leads to a lot of misleading, trivial and/or meaningless results. I also agree that it is easy to “throw the baby out with the bathwater” if one is too committed to dogma on either side of these questions. I’m a scientist in the end, and at this point, I see no science that really proves that “schizophrenia” is caused by any kind of a brain malfunction, and I am doubtful that continued research will prove any such thing. Partly because, as you say, it is a syndrome, and there may be (probably are) some subgroups that DO have biological causation, but these will never be discovered as long as research is done on “schizophrenia” with the assumption that all cases have the same cause and that this cause is necessarily biological in nature. It is clear from research that trauma has a very high correlation with the syndrome in question, as does urbanization and migration to a foreign culture. It’s also very clear that the manifestations of this “disorder” vary widely depending on the culture in which they occur and how the culture in question responds to such issues. It is, as you suggest, a much more nuanced picture, and until proven otherwise, I think it makes a lot of sense to assume that both nature AND nurture are involved.

  • No, I don’t disagree that we can make factual observations about what people believe. My only point is that science can’t determine “what is right” by the scientific method, and it appears we agree on that point. Sorry if my post sounded dismissive – I was kind of in a hurry last night! And I do think qualitative research is a valid means of studying ethics, though it gets more into sociology/anthropology and is a far distance from medicine. I guess that’s what I’m really getting at here – we can study history and use scientific means to determine certain things about history, but using those methods to make claims about medical treatment of one’s body would be ludicrous. Medicine can be studied from an anthropological/sociological viewpoint, and it has been (“Medicine and Culture” was a great read, comparing medical practices in France, England, Germany and the USA and demonstrating how much of even non-psychiatric medical decisions are made based on cultural beliefs), but this is not a way to determine what is actually wrong with someone or what kind of treatments are effective. Psychiatry would be FAR better off if it viewed itself as a sociological/anthropological soft science and proceeded accordingly, but there’s a lot less drug company money in such an approach.

  • I love your last paragraph! I think it gets to the core of why very few within the ranks question the basic assumptions of psychiatry. I was a dissident voice in the “mental health” field and I can tell you, it is not a comfortable position!

    I do take issue, though, with your assertion that “there is absolutely no possibility that eventually a psychiatrist could not come to the conclusion that it is all a lie.” There are certainly psychiatrists and other “mental health” workers who have come to this conclusion from observing the fact, though admittedly, it is a small minority by my observation. I would suggest that it is very difficult to work in this field at all after having drawing such a conclusion, and most who do so will be unable to live with themselves if they continue to practice as they have done in the past. So they mostly leave an do private work or find another profession. Very few remain in the public “mental health” system once they see what it is actually doing, and those that do, I admire for their courage.

  • It is pretty common for people recovering from a traumatic experience to want to help others do the same. I’d say you’re on the right track in contacting people who have experienced similar things. I wouldn’t waste a lot of time on the “true believers” who can’t consider anything but their own rigid beliefs for fear of their world collapsing, but there are plenty of people who are “on the fence” or who haven’t been helped as promised or who have deteriorated in “psychiatric care” who need people like you to help them out. It’s just a matter of connecting with such people, which isn’t always easy. I also think it’s very important to stay connected with others who agree with your view of things so you don’t start feeling like you’re the “only one.” MIA is really good for that.

    I hope someone who has been exactly where you are can chime in and share how they managed to move forward after this kind of trauma.

  • Ethics is a branch of philosophy. Philosophy is senior to science. Science depends upon a certain philosophy of what is true vs. not true. Ethics has to do with what is GOOD or NOT GOOD. Science can’t answer those questions, except in a mechanical way of measuring X outcome when ethic Y is agreed upon by a society. The decision of what is good or bad is both an individual and a social one and is not really subject to scientific analysis, as it does not provide measurable inputs or outcomes.

    Read Zen and the Art of Motorcycle Maintenance for an incredible exploration of this very subject. It is one of my favorite books of all time.

  • Consensus is completely unrelated to scientific truth. Scientific truth requires proof, usually in the form of vigorous efforts to DISPROVE a particular hypothesis repeatedly failing. The fact that “scientists agree” to something does not make it true or untrue – opinion is not science. And while “beyond a reasonable doubt” certainty is not always attainable, it should be the goal. Instead, what we see is so-called ‘scientists’ collecting evidence to support their own views and hiding things that would cause doubt. That is not science. That is marketing.

  • Hi, William,

    Doctors can prescribe drugs for any indication. It is not a requirement that they have a DSM “diagnosis.” Lots of people get antipsychotic drugs prescribed with no DSM “diagnosis” at all. They prescribe them for sleep problems, for “behavioral disorders,” to “augment antidepressants,” etc.

    Besides which, billing codes are not the same as actual medical diagnoses. If they need to invent a billing code, let them invent a billing code, but let’s not get confused and pretend that a billing code means anything more than that you get paid by the insurance company. The original DSM was, in fact, invented so they could bill insurance companies for “therapy.” The idea that these codes represented actual disease states is quite a distortion of their original purpose, and is utterly unscientific, as there is little to no evidence to suggest that any of these arbitrary groupings by symptom create groups who actually have anything physiologically relevant in common. It would be like billing for “stomach pain.” Sure, you can bill the insurance company for that, but is it indigestion? An ulcer? A gall stone? An intestinal blockage? Appendicitis? Bowel cancer? Each of the things I listed could cause “stomach pain.” So doctors neither diagnose nor treat “stomach pain,” not if they are in any way competent. They’d look for the CAUSE of the stomach pain and treat THAT.” Psychiatry as a profession makes no effort to differentiate between depression due to a loss vs. depression due to a bad boss vs. depression due to insomnia vs. depression due to a low thyroid condition vs. depression due to a long struggle in a dead-end, meaningless job vs. depression due to my husband beating me randomly and controlling everything I do and trying to drive me nuts on purpose. So saying someone “has depression” is pretty close to meaningless.

    I believe the same is true for “schizophrenia.” Many people in the psychiatric field even agree with me on this, and there have been proposals to scrap it as a concept altogether. The fact that professionals in the field disagree as to whether it exists should be reason enough to see that it is not a real scientific concept. Nobody argues about whether cancer or broken legs or syphilis actually exist.

    So if you need a “diagnosis” to get the drug that you feel is necessary, by all means, get a “diagnosis.” I just ask that you not confuse this with an actual, scientific analysis of what is happening that is causing this phenomenon, nor even what to do about it. Antipsychotics can diminish hallucinations, and to a lesser degree, delusions, at least temporarily and at least in some people. That’s about all you can say about it. It is not “treating” a known disease, because no one knows what causes “schizophrenia” or if it’s even a “thing” that has a cause, vs. a phenomenon that is associated with many different causes and possible interventions.

    I hope that clarifies my position on this.

  • I’ve seen kids put on a diet and told they need to exercise more as a response to “antipsychotic” weight gain. Of course, they almost never told the kids there was any relationship with the drugs. I saw one girl’s diabetes disappear within a week or two of discontinuing Seroquel. Crickets from the psychiatrists, of course. I saw one kind graduate from a year-plus long eating disorder program, only to be put on Adderall for “ADHD”. Strangely enough, she stopped eating again. If my CASA volunteer hadn’t intervened, no one would have noticed that the “treatment” for “ADHD” was eliminating her appetite, and would have said her “eating disorder” is “coming out of remission.”

    Not much real medicine being practiced by psychiatrists, at least for the kids in the foster care system.

  • I would even go so far as to say for some people, figuring out how to know what they want is the core job of therapy! So of course, such people won’t be certain what they want to start with, and a good therapist would know this. Sadly, there aren’t very many therapists out there whom I’d describe as good.

  • Exactly. It is abuse, yet if you have the nerve to call it out, then you are “treatment resistant.” There is no way to win that game except not to play.

    And it is totally “Caveat empor” (buyer beware) when it comes to counseling. If you don’t already know what you want, you get pot luck, and pot luck usually isn’t very lucky.

  • This is a great point, too. I was a “dissident mental health professional” in my day. It was obvious how quickly marginalized I would become if I just came right out and said “I don’t believe in all this DSM/drugging nonsense.” I had to learn to couch it all in proper “scientific language” and refer to studies and make it all into a big academic discussion. And mostly keep what I did in my own sessions pretty quiet. There is a lot of force brought onto any professional who won’t toe the party line, or at least that was my experience.

  • It is not always possible for people to choose to walk away from psychiatry – many are forced either by forced treatment orders, threats of hospitalization, threats of loss of children, decisions made by parents or relatives of people in nursing homes, and on and on. Additionally, the propaganda that has been spread regarding these DSM “diagnoses” has had other destructive effects, to the point that people are so confused they don’t even know they have another option.

    I had a caller on the crisis line I worked for one time who had been trying antidepressants for over a year with no success. She was frantic and thought that she’d never get any kind of relief and was condemned for life to suffer this kind of emotional distress. Then I asked her, “Did you know there are other things you can do besides drugs?” She was suddenly calm and said, “No.” I said, “Well, there are.” And she said, “Oh. Well. That’s good!” She had been asking for help for over a year and had NO IDEA there was any other option besides drugs. Nobody had even discussed that with her. THAT is what is wrong with the system. If people want to take a drug because it makes them feel better, I’m totally OK with that. I am opposed to a system that lies to people and pretend to know things they don’t know. I’m opposed to a system that profits from hurting people. Yes, people do have a level of responsibility for their own decisions, but the issue with psychiatry extends far, far beyond individual choices to participate or not.

    Hope that clarifies things from my viewpoint.

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  • I don’t disagree with your analysis. I just don’t see the path forward. Perhaps I’m just more cynical about humans changing how they are trained to behave. It does appear that our economic situation is going to be in the toilet for months at least, maybe longer, so people’s tolerance of the “status quo” may indeed reach a breaking point. It is also true that the need for socialist-oriented interventions has never been clearer. But I’ve already heard people in positions of power saying in effect that socialism is OK in a crisis but not for day to day living.

    I’m ready to act, but I still don’t see the path!

  • I think you are assuming a context for my comments that was not in evidence. I’m not talking about political revolution, I’m talking about whether or not someone should use his/her “professional expertise” to decide if a particular president is doing his/her job. The efforts to “diagnose” Trump do, in fact, contribute to the idea that if somehow he were removed, things would be “back to normal.” Aside from the very relevant question of whether “back to normal” is a legitimate or sane goal, focusing on Trump as the problem avoids the more salient question of how our system created a situation where such a person could even be considered as our “elected leader.” I think your analysis is a lot more relevant when we get to that more nuanced point, but it is certainly obvious that our populace is so far away from even asking that question that, in order to meet people where they are at, we have to answer less overarching questions and start with ones like, “Who gives these people the right to decide whether a particular president is fit too serve?” My bet would be that the majority of people would have a great deal of difficulty coming up with a rational answer to THAT question, let alone have the capacity to even think about the larger issue of what to do about a system that produces “column A/column B” type choices where both options lead to continued deterioration in the average person’s ability to survive with some measure of dignity.

  • I think “Microaggression” is meant to refer to acts which are not obvious to a person who is not receiving them, but are significant and harmful to the person who does. For example, saying to a person who is in a violent relationship, “Why don’t you just leave?” might not seem like a big deal, but it comes across to the recipient as something like, “If you were any good as a human being, you would have left by now.” The person saying it might not even intend it as harmful, but it is invalidating and distressing for the person on the receiving end.

    So I think “microaggression” is a pretty legitimate term that I find useful. Others are free to disagree.

  • I don’t disagree with your last statement entirely. The problem is that psychiatry has coopted such definitions of “illness” and tried to intentionally warp them into the realm of physiological disease states, with little to no scientific evidence that this framing is in any way legitimate.

    I don’t dispute that social sciences can be approached in a scientific manner, but I don’t see much point in trying to define a “personality disorder” as some kind of entity that can be identified, because scientifically speaking, it isn’t really possible to do that. We could theoretically choose a particular kind of behavior, like selfishness, and attempt to measure aspects of this behavior in a reliable fashion. But there is absolutely no reason to assume that the constellation of behavior that psychiatric leaders have agreed upon by committee consensus have any kind of legitimate standing as a viable object for study. A study group needs to have sufficient homogeneousness in a particular aspect in order to yield any relevant data. I’d argue that “personality disorders” do, in fact, describe behavior that people find annoying and clumps them together in a somewhat random fashion. I’ll note, for instance, that selfishness is an aspect of “narcissistic,” “Borderline,” and “sociopathic” personality disorders at a minimum. The overlap between these pseudo-entities is so great that they are essentially useless for any kind of social science research.

    Hence, it really is no different than calling someone a “jerk” in my mind. And btw, I do define “jerk” in my book, but I would make no claim (and in fact, I clearly state the contrary) that there are “jerks” and “non-jerks” that can be clearly distinguished from each other. It is a spectrum of behavior which, at one end, people find offensive and unacceptable. That this distaste is related to social evolution seems likely, yet the idea that such disapproval of behavioral traits can be considered a scientific definition is belied by the wide range of what is considered acceptable behavior depending on the culture one grows up in. We are most definitely in the area of sociology and anthropology rather than psychology at this point, and certainly a long, long way from the pretense of medical precision that the psychiatric community would like us to adopt.

  • I am trying to distinguish between scientific answers, which need to be proven beyond reasonable doubt with actual facts, and social answers, which are massively influenced by culture and social conditions in ways that transcend scientific analysis. For instance, I wrote a book called “Jerk Radar” that characterizes certain behavior as “Jerky,” and even ends with a quasi-mathematical “quiz” to see how your date measures up to the principles introduced in the text. These principles are not in the least scientific – they are based first off on certain social agreements on morality, such as that it’s not OK to promise you love someone and want to marry them when all you really want to do is get them to sleep with you. There is no scientific reason that a person should not do that – in fact, from a pure “evolutionary” (scientific) standpoint, one might say that the man (in most cases) is ensuring that his seed will be spread more widely and thus increasing his chances of his DNA’s survival to the next generation. But from a social/moral standpoint, this kind of behavior is condemned as dishonest, manipulative, and self-serving. There is no scientific test for selfishness or dishonesty – it is entirely a social judgment. It is not possible to objectively measure who is and is not a “jerk,” though it is possible to define a certain behavioral spectrum and to look for behavior that tends toward one end of that spectrum as something to avoid. But what you or I or a different person would view as “jerky” behavior is totally a matter of our personal opinions, values, and priorities. It’s not scientific.

    By contrast, someone who has cancer has a very specific growth that can be identified on an x-ray or MRI, can be biopsied to test the cells for certain tendencies, can be viewed under a microscope, etc. This is science, this is medicine – the identification and treatment of observable conditions of the body. There is no moral argument about cancer – you have it or you don’t. Yes, there are boundary conditions, pre-cancerous cells, but there are still observable conditions being discussed.

    As far as Trump is concerned, there is nothing in his behavior that suggests he is “ill” in the sense of having a physiological problem that could be observed, diagnosed or treated. The definition of “personality disorders,” as Lieberman himself proclaims in the article, is vague and subjective and “lacks validity,” meaning that it has no concrete meaning or value as a scientific/medical concept. It is a list of behaviors that most people don’t like very much. To say someone “has a personality disorder” is about as meaningful as saying, “He’s rude” or “He’s got a temper” or “I don’t like his attitude” or “He’s such a jerk!” It puts a pseudoscientific sound on something that is very much a moral judgment, and in this case, there really is no overlap with medical conditions at all. Unless you can show me how to distinguish “personality disordered” people from the “normal” population by some reliable, objective means, it remains a moral judgment, and in essence, a slam or put down in most cases.

    I want to be clear I am not arguing against making moral judgments – I hope it is clear from my comments that I do believe in people being held to minimum moral/ethical standards by their social group, and that there ought to be significant consequences for failing to fulfill one’s social agreements, including possibly removal from one’s job. This applies even more to a President than other people, because the sweep of his responsibilities is so large. But those judgments have NOTHING to do with medicine, unless a doctor is able to come in and say, “Yes, he has a brain tumor,” or “Yes, his heart attack has left him unable to engage in the stressful duties of being President, and resuming his office will probably lead to his death,” the medical profession has no business poking their noses in and pretending to be able to evaluate his “fitness for office” based on some vague and subjective label that they are applying to a person they have not even met. It gives a veneer of ‘scientific authority’ while lacking any of the necessary conditions for any kind of scientific conclusion to be drawn.

    I hope that clarifies my point.

  • Wow, Brett, I missed that point entirely! This should be copied and reprinted over and over and brought before judges and legislators all over the world. I find it a bit awkward to be in agreement with Lieberman, but I guess it goes to prove that these guys are pretty much all aware of the lack of scientific credibility in their “treatment model,” but chose to “forget” these inconvenient facts as long as they are being sufficiently reimbursed for their troubles.

  • Finding “schizophrenia” in the genome is such a joke at this point. They have to go to lists of hundreds of “markers” to get even 1-2% correlations, when the correlations between what they call “schizophrenia” and environmental stress are in the 80+% range consistently. It is such an obviously self-serving process that assumes the conclusion before doing the work, it is laughable to even consider it in the realm of science. It is more of a religious faith, and as we all know, you can’t use logic to counter religious faith. They operate on completely different rules. Which would’t bother me quite as much if they weren’t pretending to be scientists!

  • Exactly! That’s why I don’t use “stigma” and just call it “discrimination.” Stigma refers more to an internalized oppression – I feel bad because other people don’t accept me. Discrimination puts the responsibility where it belongs – on the person mistreating you based on their perception of your “otherness.”

  • You provide an excellent example of a SOCIAL label. I have no problem with social labels as a shorthand way of referring to a set of characteristics, as long as one understands that it’s shorthand and doesn’t come close to fully describing the person behind the behaviors. Trying to take a SOCIAL label and turn it into a MEDICAL label is not something I support, and it is especially pernicious when the pseudo-medical label is used to “other” the person involved and enforce a worldview and possibly a “treatment plan” on him/her. I have no problem someone saying, “My ex was such a narcissist!” I have a big problem with a professional saying, “Your ex has ‘narcissistic personality disorder,’ and his bad behavior is the result of a malfunctioning brain.”

  • I certainly agree that at some point in any process, a person wanting to be effective has to take a moment to ask what part of this s/he controls. Otherwise, we can waste a lot of time banging our heads against big walls rather than looking for doors or digging tunnels or climbing trees or perhaps choosing another direction to travel. In particular, we can’t directly control how other people choose to view us, and I have spent decades learning slowly how to let go of that urge. But again, to have this kind of discussion presupposes a level of trust that isn’t always present. I also get the idea that saying to “focus on what you control” out of context can very much come across as, “Don’t worry about those people with the rifles over there. You can’t decide whether they shoot you or not, so let’s look for something positive in the situation.” True, there isn’t much we can do about “the people with the rifles over there,” but it is essential to acknowledge their presence and the effect they are having on us before moving to “focusing on what we can control.”

    I hope that makes sense. I most definitely ask that question frequently when I’m working with someone, but certainly not to start out with and always with a sensitivity to when the client/friend/person I’m helping is in a place where that question can be taken on board without feeling shamed or invalidated in their fears or frustrations.

  • I think that is a very fair point. I’d like to pass the “McCrea Rule” that says they can’t diagnose anyone, but not sure that will get too far. The whole discussion seems rooted in the idea that they have this capacity to “diagnose,” which of course I don’t support, but at least if they have to see the person first, they will be limited to applying their social biases to those whom they have at least spoken to.

  • Ron, I think the objection here may be more to the idea that if you “focus on what you can control,” you will somehow magically feel better and solve whatever problems beset you. Naturally, focusing on what you can control does help a person feel more able to make decisions instead of feeling stuck, but just as naturally, advice to “focus on what you can control” when one of the things you CAN’T control is eating or having a place to live or dealing with an abusive partner can come off as just a TAD insensitive. I think it has a lot to do with the relationship between the parties and the timing of such a question. If you haven’t take the time to really understand and empathize with the difficulties of the situation to the satisfaction of the other person involved, suggesting to “stay positive” or “focus on what you can control” is going to come across as condescending or pollyanna-ish, as it feels more like a brushoff than an attempt to understand and be supportive.

  • I like your analysis. I had not seen those last few stories from his childhood, but they don’t surprise me. The best predictor of future behavior is past behavior. Most people don’t change unless they are forced to by external circumstances. Someone born with a silver spoon in his mouth has very little external motivation to change anything. If Donald solved problems as a kid by throwing rocks or hitting kids with a bat or pushing people out of windows, there is no reason to think he’d be much different today, other than finding different means to bully people whom he finds threatening.

  • I appreciate both your viewpoint and the civil tone of the discussion. I think the challenge that professionals (and I qualify as one) face here is that concern for safety of the nation can be very legitimate without invoking any kind of “mental illness” as a causal factor. There are plenty of people who are willing to kill other people who have no “mental illness” at all, even by DSM standards. They just think killing people is a good way to solve certain problems. They may even have their own internal “ethics” of when it is and isn’t OK to kill. In some cultures, it may even be required to kill someone if one’s honor is sufficiently undermined.

    It is in my view utterly impossible to disentangle “personality disorders” from problems of ethics, morality, and social values. Until and unless there is an objective way to “diagnose” someone with a verifiable “mental illness,” we’re building castles in the air. I’d rather go back to philosophy and ethics to handle this kind of situation. Bringing in “mental illnesses” just adds confusion and controversy.

  • I guess we’ll have to disagree on this point. Saying he is a “malignant narcissist” or combines “traits of three or more personality disorders” is to me simply a rarified way of saying he lacks ethics and empathy and is willing to hurt others to get what he wants. I’d rather call him “A person who lacks ethics and empathy and is willing to hurt others to get what he wants.” It describes him in more precise terms that are understood by most laymen and doesn’t assume any special knowledge due to my advanced degree (yes, I do have one) or my position in society. I’m actually more comfortable with “evil” than “malignant narcissist.” For one thing, the latter seems to imply that he is suffering from some sort of “health problem” when what he is really suffering from is a moral/ethical problem. There is no evidence that can identify a “personality disorder” besides a set of descriptions. Why not just be honest and give the descriptions instead of pretending we’re dealing with a medical problem? It doesn’t require any special knowledge to observe and conclude his lack of integrity. It only requires an honest and sufficiently mature person observing his dishonesty and corrupt behavior.

    One of the major confusions introduced into our society by the DSM III and psychiatry’s marketing of the “chemical imbalance” concept is a confusion regarding what are medical issues vs. what are social/ethical issues. There is no scientific way to determine if someone is maintaining their oath, is dealing honestly with those whom he encounters, is playing by the rules, or any of the things that come into assessing a “personality disorder.” All these things are matters of opinion and of social expectation. The likelihood is that he is NOT suffering from any “disorder,” he is simply acting out HIS morality in a world where the majority find that morality unacceptable. Again, this is a matter for social judgment, not quasi-medical analysis or treatment.

  • The problem I have with your commentary here is that “malignant narcissist” isn’t an objective medical decision, but a moral/philosophical one. I think rather than “diagnosing” Trump, what is needed is a coordinated effort to honestly evaluate his behavior in terms of whether he’s doing his job and adhering to his oath of office. It is more akin to a boss firing his/her subordinate than a psych evaluation. People are hired and fired every day without the assistance of the psychiatric profession. We have a means for removing incompetent or corrupt presidents from office. The unfortunate reality is that at this point, those responsible for making that decision are too corrupt to execute their duties of office as well. But corruption and meanness are not “mental disorders.” They are corruption and meanness. If Congress doesn’t act to remove him, the voters have a responsibility to do so. If they do not, well, as they say, people get the government they deserve.

  • I’m not sure anyone is arguing in favor of the APA setting standards for anyone. I certainly am not. And I also agree that the APA should not be weighing in on such things, nor do I think the media should be giving it any kind of weight in their coverage. But these are the times we live in.

  • I think this is an excellent clarification, Bob. It demonstrates how political psychiatry is as well as their lack of coherent philosophical or scientific structure to be able to answer a basic question that is supposed to be central to their own “expertise.”

    But I still think the Goldwater Rule makes a lot of sense!

  • I tend to agree with Kindred here. This is NOT a time for psychiatrists to start weighing in on whether a given President is “sane” or “insane.” We should expect our presidents to follow the rule of law, and remove them when they show they are unable or unwilling to do that. Whether or not a president is fit to continue in office is an assessment that needs to be made by the people working with him/her at the time, and is ultimately a decision Congress needs to make. I think the Goldwater Rule was put in place for a good reason and should remain.

    The article also tiptoes around the giant elephant in the lecture hall. The fact that people within the profession can so vehemently disagree in a public forum without any objective way to determine who or what is “right” speaks volumes about the profession itself. That lack of any objective standards alone should preclude them from weighing in on whether or not a president (or anyone else, for that matter) is “sane.” If there is no means to come to an objective answer, it begs the question of why they feel qualified to give a “professional opinion” in the first place.

  • Any “diagnosis” that boasts a 75% “false positive” rate is worse than a waste of paper – it’s overtly destructive. Besides which, what does psychiatry have to offer for these “psychotic risk” patients BESIDES drugs? Is there some intervention they are touting that will lead to fewer of these people developing more serious “symptoms” and hence reduce the total number ultimately smacked with the “schizophrenia” or “bipolar” diagnoses? Or, and I think this FAR more likely, will this simply bring people to the attention of the system whose only tool is a hammer, leading such people to become another set of “nails” to be hit with psychiatry’s biological sledge hammer? (Not to mention ongoing “customers” to help pay for their yachts or their kids’ college educations?)

  • I hear what you’re saying – you were in distress and you found the diagnosis and the drugs very helpful. I don’t want to invalidate that. But I have to disagree that the DSM helped you. The DSM did nothing except provide a billing code so they could charge the insurance company for neuroleptic drugs. The drugs seemed to be very helpful to you and worth whatever side effects you have to tolerate. Reading here, I hope you understand that your experience is not shared by everyone who takes these drugs.

    You might want to read some of Joanna Moncrieff’s work. She talks about the drug-centered (instead of disease-centered) approach to drugs. Drugs have effects. Some people find these effects helpful, some do not. There is no need for any “diagnosis” for them to seem helpful. And the diagnosis does not contribute to understanding why these things are happening to you or how to solve whatever problem is going on, or even to predicting which people will find them helpful or harmful. . The drug simply suppresses the manifestations you wanted to have suppressed. And that works for you, and well done. But your one personal experience does not necessarily apply to everyone who is involved. Not to mention that the DSM “diagnoses” a lot of other things besides “schizophrenia” that can be extremely damaging or can justify extremely damaging actions taken against a client, including discrimination and involuntary detention by the police, which understandably is highly traumatic to people who are forced to live through it.

    I would strongly suggest you read “Anatomy of an Epidemic” and also do some research into other peoples’ experiences so you can really see both sides of the situation. I’ve seen lots of people who feel like you do. I’ve also seen lots of people who feel their lives were destroyed by psychiatry. I think it would help a whole lot if you can try to understand why so very many people find psychiatry dangerous or unhelpful rather than just dismissing their stories and their observations as misguided without really trying to hear where they’re coming from and why.

  • I think that’s the point here. Some people may find it helpful, some may find it harmful, some may find it does nothing. But the practitioners don’t know what, if anything, is being “treated” nor what “improvement” means. If you don’t know what the problem is, you’re just shooting craps claiming to have a “solution.”

  • It goes right back to “beating the Devil out of them.” It is assumed you must DO something to people who are suffering, to toss out the “evil entity” that is possessing them. We have changed from “The Devil” to “Your Disorder” but the rest of the game is exactly the same. And as in the past, all kinds of barbaric activities are justifiable to eliminate the “forces of evil” from the patient/victim.

  • One of the problems I see with the concept of “recovery” is that it is a co-opted term that presumes that “mental illnesses” are real, scientific entities which can be “treated.” The truth is, “depression” and “anxiety” and “psychosis” are just descriptive terms that don’t reflect any known pathology. What this means is that the “solution” may be totally different for each person, even if they have the same “diagnosis.” So when these “disorders” are studied, no “treatment” will be shown to be generally effective, because we’re not “treating” any kind of unified condition or illness. So it is that some people who “have depression” thrive in therapy, others find it useless or damaging. Some people benefit from nutritional approaches, some need thyroid treatment, some just need to get a new job. Some have to escape from violent relationships, some need time to grieve, some need to move away from their parents, some need to learn how to manage their children’s behavior more effectively. Some need more money or healthcare, some are old and their bodies are deteriorating and they need to move on to the next life. ALL of the above people could be classified as having “Major Depressive Disorder!” Do we REALLY expect each and every “depressed” person to respond to the same “treatment,” when I have just listed over a dozen possible causes/approaches that are completely unrelated to each other? Of course, lumping them all together does meet the interests of one particular group: pharmaceutical companies. Because if you only look at “symptoms,” and measure all “treatments” of these issues, pharmaceuticals will have an advantage, since they are focused only on making the symptoms go away rather than detecting fixing anything that’s actually amiss.

    So I’d say, don’t wait around for the “mental health” industry to come up with answers. There are too many conflicts of interest involved. I think each of us has to find our own path, except that we ALL need to work together to reduce poverty, racism, sexism, and other social ills, and to challenge the institutions of this society to become more humane and just. Beyond that, I think what “helps” is only going to be determined by the person seeking help, and anyone claiming to be able to “fix” our problems is immediately to be distrusted.

  • I would add to this that the main reason unprocessed foods are so unavailable or un-affordable to so many of us is that our government has been corrupted by big food industries and that damaging things like high fructose corn syrup, sugar, and highly processed grains are massively subsidized. We now have to pay premium prices to get food that used to be normal fare before food industrialization. I hope we can go beyond saying, “Hey, it’s OK for poor people to eat crappy food if that’s all they can afford” and toward saying, “Hey, why is it that we are subsidizing the production of crappy food at all, and why don’t we create a system so that healthier foods are available and affordable to all of our population?” And that doesn’t even get started on why there is such widespread poverty in what is held to be the richest nation on earth!

  • There is no evidence that antidepressants reduce suicide, yet these claims are still made wholesale. As for Prozac, it is the ONLY “antidepressant” that has ANY support for its use in those under 18, and the one study that supports it has been harshly criticized as flawed. But there is NO study suggesting it is “safer.” Where do they get these claims????

  • The main “outcome measure” used by most “mental health services” these days are whether people “have symptoms” or are “on their meds.” I have rarely seen employment used as an outcome measure by any such agency, in fact, they often seem to discourage efforts of clients to find employment, encouraging them instead to get on disability for life. As for quality of life, it doesn’t even enter into the discussion in most situations.

  • An excellent and important distinction! All of us can engage in negative or destructive behavior from time to time. What I think we’re talking about here is people who are COMMITTED to negative and destructive behavior, people who genuinely believe that the best way to live is to be selfish and disingenuous and to mess with other people’s success and even their very sanity. To be raised by such a person is a nightmare and has lasting adverse consequences. But even accidental or unconscious role assignments can be extremely damaging. I also appreciate the observation that our larger society creates and exacerbates such negative flows, as they benefit capitalistic ventures. Insecure people buy deodorant, more makeup, and more insurance. Not to mention more “mental health” services!

  • “If so, then even the DSM-5 needs to be examined as to whether it’s more of a cultural document of social moral values, reflecting the subjective moral socio-cultural opinions of those who voted the DSM-5 into existence – rather than a list of objectively tested medical diagnoses?”

    I think you have described EXACTLY what the DSM manuals are, and I don’t know how anyone examining the DSM-5 honestly can’t see this obvious truth.

  • I don’t call them “narcissists.” I just call them “jerks.” Or “assholes.” Less clinical, more accurate, no free justifications offered. It’s a way of acting, not caused by anything in particular except deciding to be a jerk. I can have compassion for such people, but only after they decide not to pass their pain on to others.

  • I suggest you re-read what I stated in my earlier comments. I have never been accused of inconsistency.

    I think you’re right, we’ve aired this out as much as we can air it. We may just need to agree to disagree on the extent to which genes vs. environment are responsible for these phenomena. Since the scientists can’t prove what is going on one way or the other, I think we’re on solid ground saying that no one can say for certain at this point what causes these phenomena to occur.

  • I never said that genes play no role in schizophrenia. I said that it is not a “genetic disorder” like Down Syndrome or Cystic Fibrosis. And I said that there are small correlations with certain genetic patterns, but that the correlation with childhood adversity is much higher than any genetic correlation. It sounds like we are in essential agreement that genes and environment play a role. I ask that you be more cautious not to read things into what I’m saying that I didn’t actually say.

    Similarly, I didn’t say that psychiatrists shouldn’t be trusted in the present or future because they were dishonest or misinformed in the past, though I think it would be a very reasonable thing to say. (How do YOU decide if someone can be trusted? Don’t you decide based on how they acted in the past?) What I said was that psychiatrists agreeing about something is irrelevant scientifically. I pointed out that psychiatrists have agreed almost to a man/woman about some “facts” in the past and right on up into the present which are now known to be false. This simply confirms that agreement among psychiatrists does not equate to scientific reality. I am certain the same observation can be made in almost any field of study we could mention. Science does not operate by expert consensus. It operates by experimentation and study and the ruthless questioning and retesting of any theory proposed to be true. It is also important to remember that scientifically speaking, any claim is assumed to be false until proven true, so the lack of evidence for something like a genetic basis for schizophrenia means that from a scientific viewpoint, it is not a valid theory.

    Bottom line, we both agree that both genes and environment are most likely involved in what is called “schizophrenia.” So what are we arguing about?

  • From your article: “Rather, researchers discovered that risk for psychiatric illnesses tends to be “highly polygenic.” This means that many combinations of DNA variations— cumulatively occurring in as many as 1,000 of our 21,000 genes—contribute to risk, when viewed at the level of the entire human population.

    In light of this discovery, the question for an individual becomes: Which of these many variations, if any, do I carry in my own genome? And how, if at all, might the variations that I have in my genome affect my mental health and that of my children and grandchildren? Answers to these questions involve understanding what “risk” means in the genomic context.”

    Note that this research is a) in the earliest phases and b) involves “risk variations.” This does NOT represent the genetics of a “genetic disease.” A genetic disease is something like Down Syndrome or Cystic Fibrosis or Huntington’s. These diseases involve a clearly identifiable gene which leads unerringly to the same result in every single case.

    So far, as have already mentioned, such research has led to groups of often hundreds of genes which are estimated to contribute very small proportions of the “risk.” How that risk is assessed remains unclear to me, but even the most optimistic efforts have never shown even a 10% contribution, meaning that even if we take all this at face value, 90% of “schizophrenia” is environmentally mediated. In fact, the very use of the concept of “risk genes” acknowledges that environmental insult is REQUIRED to create the syndrome in question.”

    Your own first comment, suggesting that immigrants have higher rates of “schizophrenia” due to having harder lives due to poverty, is an acknowledgement that “schizophrenia” is NOT a “gene disorder” and is highly affected by environmental situations. If it were purely genetic in origin, it would not matter what kind of environment was involved. Poor kids with the Down Syndrome genes don’t suffer more from Down Syndrome than rich kids with the genes. Every kid who has it, gets it. No kid who doesn’t have it gets Down Syndrome, no matter how s/he is treated.

    And for the record, poverty is not the risk factor for “schizophrenia.” It is being an IMMIGRANT that specifically confers the risk. And there is no gene for immigration.

    As for the genome, I believe the analogy to an “operating system” that I offer is a much more appropriate one. The most superficial observation of human beings makes it very clear that most of our “programming” comes not from our genes, but from the decisions and priorities and education and training and experiences we have after birth. Ants’ “programming” is all in their genes. We have the obvious ability to reprogram ourselves (or to be reprogrammed) based on experience. Which would include adapting to childhood adversity by various means. Not suggesting that such adaptations are not INFLUENCED by our genes, but we are not pre-programmed in our responses in the way an ant or even a mouse might be.

    Of course, the fact that a bunch of psychiatrists agree on something adds not one iota of confidence that it is true. Psychiatrists agreed that Benzedrine (and later Valium) was not addictive, that Thalidomide was safe, that Haldol and Thorazine did NOT cause Tardive Dyskinesia, that antidepressants did NOT increase suicidality (some are still denying this), that antidepressants do NOT create withdrawal symptoms, and on and on. Psychiatrists still deny the decades of research that show stimulants do not lead to any improvement in long-term outcomes, nor that “unmedicated” people with “psychosis” more often than not do BETTER when they are not on long-term antipsychotic drugs. Again, this is NOT to say that some people don’t find these drugs helpful in their observation, just that the idea that EVERYONE who has any kind of psychotic episode MUST be put on antipsychotics for life. You yourself acknowledged earlier that this is true, yet the majority of psychiatrists still insist that every psychotic patient be immediately and permanently put onto antipsychotics. So the agreement of psychiatrists as a group means very little in terms of what is and is not true. Science should be our guide, not “resort to authority” arguments that “most psychiatrists say it’s true, so we should believe it.”

    I really am sorry that you feel you were misled and it sounds like you had an awful outcome! I also want to acknowledge and validate your experience. I certainly agree that all people should vet any and all concepts claiming to “help” people with “mental illnesses.” The fact of the matter is, nobody really knows what a human mind IS let alone how it works and what helps when it doesn’t seem to be working well. It is the arrogance of psychiatrists insisting that they KNOW things when they really don’t that rankles. I have no answers, either, but trusting psychiatrists is a risky business as well, as you should be able to observe by reading the stories on this site. You have your reality, but other people have different experiences, as I’m sure you can see if you have any empathy at all for the many people on this site who have experienced harm at the hands of the “mental health” system.

  • Two viable explanations: 1) the researchers are less able to get away with hiding “negative” results with new laws/regulations regarding availability of unpublished research. 2) Placebo response is a large part of the recorded “benefits,” and as is common among drugs of any sort, decreased confidence by the public in a particular drug over time leads to an increase in placebo effects.

  • I do find it amusing how they say that “traditional” mental health interventions don’t work with “indigenous people.” For whom DO they work?

    I was at a training regarding systemic bias against African Americans in the child welfare system some years back. Someone said that the “mental health” system didn’t work well for black people. I stated, “It doesn’t work that great for white people, either!” Got a big laugh from the crowd. I think people know this deep down.

  • Well, individuals certainly report perceiving them as beneficial. But then, many people perceive a snort of Johnny Walker Red or a couple of beers after work as beneficial, too. Doesn’t make beer a “treatment” for “Work-Related Stress Disorder.”

    Apparently, hospitals are reporting a dramatic decrease in admissions for heart problems and other acute incidents. Is it possible that staying home from work and not having to commute in insane traffic to keep a ridiculous schedule may be beneficial to one’s health? Or perhaps fewer visits to the local MD may result in fewer incidents of iatrogenic heart attacks?

  • No one is saying that medication/drugs can’t be beneficial. But the fact that you find them beneficial does not imply that you are being “treated” for a “disorder.” It just means that you find them beneficial. Lots of people do, but lots of other people don’t. Is that not a fact you have to consider in your analysis? What about the “schizophrenics” (who are many) whose lives are not improved or are made worse by these same drugs?

  • I don’t agree at all. From Wikipedia:

    “In the fields of molecular biology and genetics, a genome is the genetic material of an organism. It consists of DNA (or RNA in RNA viruses). The genome includes both the genes (the coding regions) and the noncoding DNA, as well as mitochondrial DNA and chloroplast DNA.”

    Your statement is the same as saying that a computer program is the same as the computer hardware. The genes are hardware. They contain instructions, which is programming of a sort, sort of like the “operating system,” but the incredible complexity of human behavior is no more explainable by the genome than a computer’s behavior is explainable by the operating system.

    Not to mention, the computer has an OPERATOR as well as a program and hardware. I challenge you to provide a genetic explanation for who/what is operating the brain?

  • You make my point for me. If we don’t know how the brain works, then we can’t say that “genes cause schizophrenia,” at least not if we are being scientific. All we can say is that “genes create the brain.” We’re on safe ground there. See my other post for the requirements of a real “genetic disorder.” Being related to the brain that is created by genes doesn’t qualify as proof. Makes as much sense to say that running is genetically caused, since the leg muscles are created by genes. It is, indeed, a nonsensical argument.

    I am guessing that you are what is called a “reductive materialist.” Do you believe that everything that happens must be directly explainable or measurable in terms of physical reality? And therefore that the mind must be created and run by the brain, and therefore every manifestation of the mind must be caused by the brain?

  • I read the entire article. All it says is that gene expression is altered over time and that these alterations can be tracked. It does NOT place responsibility for “schizophrenia” or any other “mental disorder” in the genes. It talks about an identified “risk group” of genes, providing no information as to what level of risk is entailed by these genes, nor any correlations to a particular “disorder”. The total effect of these genes is not calculated or estimated. The article clearly mentions methylation, the core of “epigenetics,” as a big factor that they will be looking at. All indications I’ve read are that epigentics is primarily and deeply affected by the environment.

    So the article you provide provides no evidence of a genetic origin of any “mental disorder,” and allows for a huge possibility of variation of outcome due to environment. The presence of “risk genes” is mentioned in passing, but risk is not causation, as I’m sure you are aware. I’d be really interested in hearing a comparison of the level of risk attributed to “risk genes” as compared to the level of risk attributable to childhood adverse events. I feel quite certain that the “risk” from environmental abuse is much higher than that from any set of “risk genes.” But your article doesn’t bother to do that comparison. It is an interesting and telling fact that the article makes no mention of non-genetic risk factors, and seems bent on finding a genetic explanation, even when such an explanation is not really viable under the huge variation of environmental factors impacting these “risk genes” that are postulated to contribute to these “disorders.”

    It is also worth noting that the “risk gene” group is correlated with more than one “disorder”. A truly causal gene would be associated ALWAYS with the disorder in question. For instance, children with the Down Syndrome genes will ALL have Down Syndrome. That’s a genetic disorder. Having correlations with “risk genes” does not make any kind of argument for a “genetic disorder.” The “risk genes” could be associated with other survival traits that are essential to the species. To use the obvious example, even if they found a gene which made kids more active and intense than average, and even if that gene did so 100% of the time (which by the way has never been shown to be the case, nor have even “risk genes” been identified), it would not prove that “ADHD” is a “gene disorder,” because the genes convey a general personality tendency that could be positive or negative or neutral depending on the environment.

    You are entitled to believe what you want, but I’m pretty well versed in the research and am quite certain that there is no proof that “schizophrenia” is even a distinct an definable entity, let alone a “genetic disorder.” If you claim it is such, you’ll have to come up with a lot more convincing article than that one to sway my opinion. Mind you, I can be swayed with adequate research, but this doesn’t do it for me. I certainly don’t deny that genes can be involved in mental/emotional states, but “can be” is a pretty broad statement, while claiming that a specific “disorder” IS genetic requires a lot of proof to establish.

  • I would suggest that any “therapy” that is not “trauma-informed, is based on shared-decision making and promotes personal choice in charting the direction of one’s life” does not qualify as therapy. The essence of quality therapy is enhancing one’s self-determinism and ability to exercise one’s options with confidence. “Therapy” that promotes dependence, that blames the client, or that enforces another’s worldview (especially if it is a chemically based worldview!) should instead be called by another name: ABUSE.

  • You miss my point, in a couple of ways. First off, there is no “genetic variant” that “causes” schizophrenia. I ask you for evidence of this and you have not presented any, so it is just as right to say “there’s a correlation but no causation” when referring to genetic claims as well. Which leads to the second point, that the correlation (which I called a correlation, not a causation, if you will review my post) is about 10 or more times higher for childhood adversity than it is for genetic markers of any type. And the relationship is dose dependent. And even the research for markers has to use something like 100 potential markers to get anything like 5-10% correlations. There is no one gene that contributes more than a tiny fraction of that, even in the most optimistic assessments that have been done. So yes, it’s ALL correlations, Martin, including the overblown claims of “heritability.” Here is just one link, found in seconds on google:

    “Those that were severely traumatised as children were at a greater risk, in some cases up to 50 times increased risk, than those who experienced trauma to a lesser extent.”

    https://www.sciencedaily.com/releases/2012/04/120419102440.htm

    RE: multiple casues of “schizophrenia”

    https://www.medicinenet.com/is_schizophrenia_a_genetic_disorder/ask.htm

    The real problem, of course, is that “schizophrenia” itself is just a name given to a certain set of behaviors or experiences, and these “criteria” may exist in people who have little to nothing in common, genetically OR environmentally. The idea that behaving in a similar way means that people have the same problem and need the same “treatment” is scientifically nonsensical. It’s quite possible that SOME people who meet the criteria for “schizophrenia” have something genetically wrong with them, but to suggest that “schizophrenia” is caused by genes or by any one specific thing is absolutely not supported by science, whatever your personal feelings may be on the matter.

  • One might easily feel overwhelmed and overworked if one’s efforts were constantly unsuccessful or damaging to one’s clients. I am sure many psychiatrists recognize on some level that they are not being helpful or are being destructive, and the weight of that must indeed be heavy. The denial of contradictory data is needed to maintain some semblance of being a “good person,” and few seem to have the moral courage or integrity to simply admit what is going on. Instead most seem to be avoiding their own pain and guilt by focusing on convincing others of the “rightness” of their approach or the supposed lack of any “alternatives” and blame insurance companies or short sessions or “the disease” or the client or anyone else except for the processes they are engaging in that are so obviously failing. I MIGHT feel sorry for those who recognize this, but only once they decide they can’t live with themselves doing it any longer and stop.

  • Sometimes recently I’ve been thinking that individual people can be forgiven and healed, but organizations and institutions don’t have their own independent “souls” and so can’t be “forgiven” in the same way. They can only be reformed or eliminated. And as someone wisely noted, the first goal of every organization is to perpetuate itself, so efforts to reform are often doomed, as the internal need to continue doing what has been accepted as “right” is very powerful, especially if rewarded with funds and/or prestige. It is only the most enlightened of organizations that is able to evolve when new data or ideas are brought forward. The “mental health” professions, at least at this time in our history, are seeming to be pretty much the opposite of enlightened. It is almost certain that they will continue to perpetuate the nonsense that their industry is built around unless they are met by some massive force that prevents them from getting rich or powerful by doing so. It has become clear that facts and research are no impediment to the continued psychiatric delusion.

  • The irony is that “clients” of the “mental health system” are exposed to the same kind of treatment that created their distress in the first place. Being forced to pretend to agree with an enforced reality is very familiar to children growing up in unloving or emotionally distorted home situations, where they have to “manage” those who are supposed to care for them in order to survive and avoid further harm. How is dealing with a rigid, authoritarian bureaucracy bent on labeling and blaming its victims any different?

  • Excellent points! I often wondered why so many people identified as “SMI” smoked cigarettes, a factor many in the industry blamed for their early deaths. It was only in the last 10 years or so that I became aware that people on “antipsychotics” often use cigarettes to offset the assault on their dopamine systems, to try and slightly lift the severely depleted levels of dopamine caused by the drugs. And I always found it particularly offensive when clients, often children or teens, were told to go on a diet and to exercise more because of the huge weight gain they experienced on Zyprexa or other “antipsychotics.” Their doctors didn’t even bother to tell them that the weight gain was directly related to the drugs. How is that not malpractice? But as usual, the individual or “the disease” is responsible for anything bad that happens, while any positives are attributed to the drugs.

  • Originally, psychotherapists were expected to go through their own therapy before taking any clients, for this very reason. I think the real difference between helpful and unhelpful therapists is their ability NOT to project their issues onto their clients. But since this is no longer a focus in training, I am afraid very few therapists these days meet this standard.

  • I agree. Victim is in reference to an EVENT. It does not define a PERSON, it defines the action of one person or group against another that causes harm. I can be a victim of a crime without victim defining my identity as a human being. In fact, it is the confusion of events with identity that is what most characterizes the stupidity of the psychiatric worldview.

  • I would say from experience that condescension is the most common attitude. The “professionals” feel like they’re being helpful and want appreciation no matter what they do or how bad it is for the client. Unappreciative or difficult clients are most definitely made fun of by some, and it is difficult for those who are uncomfortable with it to speak up. (Though I used to do so a lot of the time.) The truly successful professionals were the ones who saw the clients as just other humans not very different than anyone else, except as to the particulars of their personal circumstances. But they were in the minority. Not saying that a lot of professionals didn’t care at all, it’s just that so many viewed the clients through a lens of inferiority or failure. They often viewed the clients with pity rather than true compassion. There were plenty who did not, but again, they appeared to me to be in the minority.

  • Thank you for this, Miranda! It has really bothered me how the normal anxiety to the Coronavirus situation has been framed as “triggering mental health issues” for those with a label. You did a great job of showing the disparate and confusing coverage of this, and the intense but unspoken struggle to define what a “normal” reaction to such a situation must be. I’d only add that the fears of a sudden wave of “mental illness” sweeping the country completely puts the lie to the idea that these “mental illnesses” are somehow biologically determined. I also appreciate very much the observation late in the article that many of those already labeled “mentally ill” may actually have a lot to teach the so-called “normal” person about living in isolation or being extra safe or managing anxiety about situations we don’t control.

    Glad someone is finally talking about this!

  • I personally think that’s a distortion of Buddhist thinking. They don’t teach that we should just suffer or that those who accept the Buddhist path won’t suffer. They teach that suffering is primarily caused by wishing/desiring that things be other than as they are, as well as clinging onto and trying to keep things the same that will inevitably have to change. But they also teach that compassion is central and that the easing of suffering is very realistic and something to be valued for all, whether Buddhists or not.

  • In particular, “Pospartum Depression” has been massively promoted as a “disease state” when the vast majority of cases consist of very understandable reactions to difficult life circumstances and the incredible lack of support available for new moms in our culture. My wife did some research on this and found that there are cultures where there is practically zero incidence of “postpartum depression.” Not surprisingly, these cultures put a big emphasis on supporting new moms in doing their job as parents so they don’t have to do much of anything besides spending all their time and energy learning how to care for themselves and their new babies.

  • “Feminism” by my definition (and I think most dictionary definitions) would assume the analysis that domination of women (and the rest of society) by men in positions of power needs to be challenged at every turn. It’s hard, nay I’d say impossible, to reconcile this with believing that it’s OK for someone to look at some surface aspects of your behavior and decide “what is wrong with you” and enforce “treatment” that you don’t want or harms you, etc. It seems the very opposite of what feminist analysis would conclude.

  • Lucy gets it 100% correct here. I have never seen a clearer example of the ludicrousness of claiming “mental illness” to be the cause of anxiety/depression/anger/fear relating to this huge, worldwide concern. I wince every time I hear someone say, “Mental health issue can be TRIGGERED” by the Coronavirus fears. Totally “normal” and undiagnosed people are losing sleep, hoarding toilet paper, worrying about finances and the economy, etc. It is NORMAL to be worried about something like a potentially deadly virus and the social disruption it is causing! In fact, people who are NOT worried are the ones making the problem worse!

    This is proof that the MH paradigm is completely bankrupt and needs to be scrapped!

  • Sometimes what you have to do is do anything you can to convince them you agree 100% and are now happy and healthy due to their wonderful interventions, and then escape once they open the door and don’t ever come back! You clearly have sufficient “insight” to understand what they are about and that convincing them is impossible. So the next best thing is to escape their influence in any way you can! Easier said than done, though. WAY easier.

  • Of course, a lot of the “treatments” adversely affect their “patients'” physical health, making them more vulnerable. Not to mention the impact of being given the idea that your brain is permanently broken. It has been shown that having hope and purpose improves health and resistance, too, though this is pretty much common sense. Though it appears not so common in the world of “mental health treatment.”

  • I think that is a legitimate distinction. I was talking about moving from a strong core protest to a larger mass movement. I agree we are not really at a point where that can happen yet, and building a strong intellectually/scientifically viable base is essential to any movement succeeding. It’s just that a lot of people aren’t able to process on the level that is needed to understand the viable base and need their memes and leaders in order to get with the program. It will happen one day, but again, we’re not there yet.

  • There is a difference between pandering and taking the facts of human behavior into full account when planning a strategy. I would challenge you to show big changes happening against the status quo that were not created with emotional appeals to the masses. Of course, there need to be solid, real, honest ideas that have strong logical backing, because otherwise they don’t WORK. But I can’t think of a major change movement that didn’t employ emotional appeals as a big part of their strategy. I could be wrong, of course, but I’m not seeing examples of “intellectual revolution” being successful. I’m open to hearing examples if you have some. Like I said, it’s not my specialty, just going by what I’ve observed.

  • One can be right all day long and get nothing done. That’s how I’ve experienced attempts to change the system from within. I have no interest in denying reality or polling anyone on what they want to hear about psychiatry, and frankly, given my history, I find that suggestion a little disrespectful. I absolutely agree that calling psychiatrists “doctors” or psychiatry “medicine” is a fraud and needs to be called out as such. The question is how you get masses of people on board with that idea. Most people don’t think with ideas, they react with emotions. That’s why a story in the paper about a poor kid living on the streets with his parents gets tons of donations, while a request for an increase in the welfare budget is met with disinterest or scorn. People have to be grabbed emotionally. Facts don’t convince most people of anything much. Most people are driven by emotional “reasoning,” which is one reason psychiatry has been as successful as it has – it appeals to people’s desire to feel like someone understands something that they don’t, and to people’s desire to blame someone/something in a way that keeps them from having to make any significant changes. It’s how people in groups tend to act. You have to get them excited or angry or worried about something or they will roll with the status quo. At least that’s my experience. Maybe I’m just too cynical!

  • You say you learned schizophrenia is genetic? Who told you that, and what proof did they offer? A full review of massive research has shown a complete failure to demonstrate any specific cause for “schizophrenia,” or even significant evidence that “schizophrenia” is even a valid entity for research. Mainstream psychiatrists (including the head of the NIMH, Tom Insel) have recognized that these diagnoses “lack validity,” and some have even proposed dispensing with “schizophrenia” as a diagnosis, or saying that there are “schizphrenias” which have no necessary relationship with each other in terms of cause.

    I’m sorry that OD did not work for you. The folks who invented and developed it have made it clear that 20% of clients don’t respond to OD. You may have been one of them. That doesn’t make the data wrong.

    I’d also be the last to deny that biology COULD cause a person to have hallucinations and aggressive behavior. But calling all such cases “schizophrenia” and asserting that they all have genetic causes is absolutely contrary to actual science.

    If anyone had an agenda, it was the person telling you this stuff.

  • We are appealing to anyone who is uninformed and who needs to become educated. The world isn’t broken up into those who agree with eliminating psychiatry and those who sing its praises. Most people don’t really HAVE opinions, they make their opinions based on rhetoric they hear from those whom they assume know more than they do. There is no reason not to reframe psychiatry as a human rights abuse because it will garner more support than trying to convince everyone that psychiatry is a fraud (which it is), because we need the general public opinion to turn against psychiatry. That seems to me the most effective, practical way to do it. Any mass movement requires a mass of people to participate, by definition. It seems to me that the way to get a mass movement going is to have memes that people can get behind in large numbers. Take “MADD” for instance. They didn’t argue that no one should drink, they argued that people should not DRIVE drunk. And they came up with the meme of the “designated driver,” which resonated with big numbers of people.

    I’m not a master of group dynamics or mass movements, but it seems to me that people can wrap their brains around the idea that people deserve to have their rights respected more easily than they can that their doctors are a bunch of charlatans, even if the latter is observably true.

    Hope that makes some sense.

  • I personally think the human rights approach is the broadest and would have the most general appeal, especially if combined with honest rhetoric regarding oppression of particular subgroups within the general abuse of rights that psychiatry represents. People want to believe in doctors, but they also want to believe they ave rights which can’t be violated willy-nilly. How we can connect the abuse of rights of the psychiatrized with the rights of people who haven’t yet had that experience is a bigger challenge, but one that I think eventually can be overcome.

  • It’s a classic tautology. Since it’s not “normal” to do antisocial things, anyone doing something antisocial is “abnormal.” But since we’re not allowed to say things like “evil,” we say such people are “crazy” because “only a crazy person would do something like that.” So they did it because they’re crazy, and they’re crazy because they did it. Then, by analogy, anyone who is “crazy” (aka “Mentally ill) is dangerous, because by definition “crazy” things are done by “crazy” people. QED.

  • I do want to distinguish somewhat between you as a layperson saying this vs. a medical professional saying this. You are not purporting to be representing the latest scientific knowledge in the field, so it’s more understandable and less damaging to use analogies to explain things. That being said, I still consider it a damaging framing of the reality of “mental illness.” What you said at the end is much more relevant to understanding most people’s situations – that we have trauma, neglect, and other harm from how we grew up, whether from parents, siblings, school, church, or other institutions. Finding someone to talk to who really understands these experiences is what I’ve found helps people the most. Most folks don’t “need medication,” they need UNDERSTANDING. This is not to say that some people (like you) don’t find these drugs USEFUL. It is to say that the idea that you are “treating a brain malfunction” is simply wrong, both scientifically and sociologically. It is not a “disease” or “disorder” to feel bad, act in antisocial ways, or think unusual thoughts. Some disease states DO cause emotional distress, weird thoughts, or antisocial behavior, but those disease states have specific causes and usually specific remedies. To say that someone “has clinical depression” is totally subjective, and it is highly misleading to create an analogy with diabetes, as diabetes is objectively measurable and has a specific treatment that is effective almost 100% of the time. This is simply not true of “antidepressants” or any of these psychiatric drugs. They are very simply efforts to make someone feel better or act better temporarily. There is nothing observably wrong with the person, and there is nothing specifically being “fixed.”

    I think you’d be far better off telling people that “I’ve taken these pills and they have helped me feel better. That apparently doesn’t happen for everyone. Nobody really knows if there is something biologically wrong with you, but I can tell you that I understand your plight and am very happy to listen. I find that listening and caring for each other is the best ‘medicine.'”

  • This really is the key question. “Medications” are measured intentionally only against “symptom reduction,” mainly, that a person feels LESS of the “negative” feeling or engages in less of the “undesirable behavior.” Quality of life is almost NEVER the overt measure of success. If it were, “medications” would be relegated to last-resort status or banned altogether. One of the great things Bob has done in Anatomy is to demonstrate the massive REDUCTIONS in quality of life with the current paradigm. And to me, what is the point of any “mental health” intervention if the recipient isn’t more satisfied with his/her quality of life as a result? What other measure of “mental health” (if such a thing can even be defined, let alone measured) could be identified?

  • I hear that you’ve had a good personal experience. It concerns me that you seem not to want to hear that not everyone experiences things the same way you do. You write a number of philosophical assumptions regarding the brain, but provide no scientific proof that the brain is the cause of “mental disorders.” If you read the article, you’ll see that the primary difference is that we KNOW that insulin is the singular causal factor in high blood sugar – it can be measured, blood sugar can be measured, and adding insulin or coming up with a way to increase insulin reduces or eliminates the problem in almost 100% of the cases. Add insulin, reduce blood sugar – it is that simple.

    With psychiatric “diagnoses,” there is no known missing substance that needs to be replaced. There is no substance that can reliably replace the mystery “missing substance” and create beneficial results 90% of the time, or even 50% of the time. Compared to placebo, Kirsch’s work showed that ADs are barely better than taking a sugar pill. Compare that to the almost universal success of insulin in reducing blood sugar. Heck, we don’t even know if there IS any chemical causing ANY of these conditions, let alone are we able to MEASURE those chemicals.

    SO the analogy fails completely. There is no SCIENCE saying that “depression is caused by low serotonin,” and lots of evidence saying that it is not. Doctors are GUESSING as to what drugs may or may not be perceived to “help” by reducing the experience of depressed emotions. The analogy with drinking a controlled amount of Jim Beam whiskey daily is a much more accurate one. People DO feel better when they drink alcohol, but there is no “condition” being addressed by the alcohol – it has a general numbing and elating effect on everyone. All psych drugs work similarly – they create effects that some find agreeable, and some don’t. The “diagnosis” itself is made by listening to a list of feelings and behaviors, not by measuring something concrete like blood sugar levels.

    So in essence, the “insulin for diabetes” analogy is a complete deception. Vague philosophical assertions about the nature of the brain (unproven, except that the brain is of course nervous tissue 100%, not a muscle) do not count as hard science. If there is nothing to measure and no reliable approach to improving such a measurement, we’re talking about something VERY different than diabetes.

    Your clients are relying on you for honest information. I don’t believe it is ethical to provide them with unscientific ideas based on your personal belief system. I believe you are responsible for telling them the facts, including the fact that we don’t know WHAT causes “mental illnesses,” or indeed whether they are “illnesses” at all.

  • The irony of the “Decade of the Brain” is that they discovered that the idea of specific “mental illnesses” due to “brain disorders” was wrong. The real results were that the brain is FAR more flexible and malleable than anyone believed, and that experience can change the brain through adulthood. And the most significant brain-healing action we could take for kids is a positive relationship with a mature adult. TOTAL contradiction to what they wanted to find, and of course, these results were largely ignored, except to emphasize that early abuse/neglect “damages the brain,” which serves their narrative if looked at in isolation. If they REALLY applied the lessons from the Decade of the Brain, the DSM would be ditched and we’d be spending a lot of time would be spent improving people’s relationships with each other and creating positive environments that promoted grain health for kids and adults. Who would have guessed?

  • I’d love to have a link to that article posted! I’ll have to look it up, but it is amazing (and yet not surprising) how hard proof of damage is provided and yet to claim that it is “safe” to use something that induced a person to kill his child and almost kill himself! How is that “safe?”

  • Beautiful writing, as usual, Noel! This is the kind of talk I recall back when I initially broke into the field of therapy. I don’t know that this kind of discussion even happens in most peoples’ training these days.

    I do want to point out that one of the many reasons trauma survivors die 20 years earlier than the general population is the drugs they are given/forced to take by the “mental health” system itself. Further physiological and psychological traumatization does not appear to be particularly helpful in “treating” the effects of chronic trauma!

    Thanks for all you do to bring sanity to the crazed world of “mental health treatment.” I wish that all “mental health” workers took their cues from your philosophy.

  • I like the article, great history there. However, I would argue that these efforts at transformation were ultimately coopted and that the basic fundamental beliefs of the system have not changed much at all. Women are still told that their anxiety/depression the the face of childhood sexual abuse, rape, domestic violence, and general oppression by the mainstream of our society are personal problems. They are still proffered new versions of “mother’s little helpers” in the form of benzos and SSRIs. They are still blamed for not “adapting to their roles” properly, and still diagnosed for being “too emotional.” These seminal writers’ critiques are just as valid today as they were in the 70s. We are still waiting for the ensuing “transformation,” and will most likely wait forever for this utterly patriarchal and oppressive system of thought to actually become responsive to the actual needs of clients and society at large.

  • Yes. It was a known concern before it was approved.

    “Those who developed akathisia or who had any suicidal tendencies were excluded from the trial data on the basis that they would otherwise obscure the results of the drug’s success in treating depression. Yet the German licensing authority, the Bundes Gesundheit Amt (BGA), on scrutinising the results, expressed concerns about the drug’s safety. On May 25, 1984, according to Lilly’s internal documents, a letter from the BGA stated: “During the treatment with the preparation [Prozac], 16 suicide attempts were made, two of these with success. As patients with a risk of suicide were excluded from the studies, it is probable that this high proportion can be attributed to an action of the preparation [Prozac].”

    https://www.theguardian.com/theguardian/1999/oct/30/weekend7.weekend1

  • I agree. It is not absolute poverty, but the power differential from income disparity that causes the greatest distress. The sense that you are somehow unable to succeed at life because the rules are rigged against you separates you from others, while working together with others struggling toward the same goals brings people together in a sense of community that is what really helps people feel good about their lives.

  • So being unable to provide sufficient resources to survive, being worried about losing electrical power or heat or even housing, being unable to eat sufficient food and having no recourse, all of these things could make a person more “depressed?” Golly, jeepers! These poor people must have chemical imbalances, mustn’t they? Or they need to sit and have someone understand the difficult feelings associated with having your family lose their home or slowly starve to death?

    I’m glad this research has been done and is published, but how many times to we have to study the obvious? Anyone with half a brain could figure out that poverty feels like crap and will lead to more suicides. Time to DO something about it instead of continuing to blame the victims of our heartless economic system!

  • I have known plenty of people who were on “maintenance antipsychotic treatement,” in fact, almost anyone who had been to an ER for “psychotic symptoms” got on one. Many were forced to take them and had no choice. A lot of foster kids are put on them daily for behavioral problems that have nothing to do with psychosis. Old folks in nursing homes are put on them to manage difficult behavior, again without any “psychotic disorder” diagnosis or even symptoms. It is no myth. It is true that many people (like mathematician John Nash) go off antipsychotics as soon as they are safely away from the authorities. But the standard recommendation I’ve seen for ‘psychosis’ or ‘bipolar disorder’ is “maintenance antipsychotic treatment.” And those who refuse to “comply” are pressured, manipulated, or incarcerated for it. There is no myth involved here.

  • The main valuable expertise I’d be looking for is the ability to convey interest and compassion while I told my story. And from psychiatrists, I can count the ones I’ve see do this on one hand and still have a couple of fingers left over. Most counselors/therapists these days are also bought into the DSM and have stopped talking about unconscious motivations and life goals and sense of purpose and spend their time on “symptom reduction.” It’s a sad situation, and I would value the clients’ expertise over the “mental health professionals” at least 9 times out of 10. Most of what I learned about therapy, I learned from clients letting me know what they felt helped and did not help. There is no other standard for success. It should be the #1 most valued information there is, not relegated to third place after “research” and “clinical expertise.”

  • It is interesting that they refer to “clinical expertise” but to “patient preferences.” What about “patient expertise?” or “Patient knowledge?” It seems that framing a patient’s/client’s decisions as “preferences” is disempowering, in that it implies that the patient’s information is irrational or emotionally-driven, rather than being rationally-derived information based on the patent’s own experiences and knowledge base. A normal power distribution would require the patient and the therapist to negotiate an agreement on the actual facts of the situation, assuming each one had an expertise of their own that legitimately informs the mutual understanding of both the problem and the possible solutions. “Preferences” is a very weak term for what is being expressed by the clients in these situations.

    Additionally, the author neglects to observe that the “evidence base” for “EBPs” is based on the categories in the DSM, which psychiatry’s own leaders (like Tom Insel at the NIMH) and the DSM introduction itself acknowledge to be invalid, heterogeneous categories of behavior that do not necessarily indicate any commonalities between those who “qualify” for a particular diagnosis. So saying that “X treatment is more effective for major depression than Y treatment” becomes a nonsensical statement, since depending on which client with that diagnosis presents to you, the required “treatment” may vary wildly.

    If you really want to do “evidence-based treatment,” you have to start with a legitimate grouping of candidates for study. Absent that, the “scientific evidence base” for these therapies is worse than useless – it is actually deceptive.

  • Don’t know that I was always “eager” to see my therapist, but what was clear is that my therapist, who was wonderful, was focusing on doing whatever she could to help ME meet MY goals. She never told me what to think or believe, never told me what I should or should not do, never criticized me for making a particular decision. She was genuinely INTERESTED in finding out more about me, and even when there were some hard times going through material I would most certainly have avoided without her being there, I always knew she was on my side and would make it safe for me to say whatever was on my mind.

    This was way back in 1982-3 before the DSM took over and when therapists actually listened to their patients. I know there are a lot less such people out there these days. If I were screening a therapist, my first question would be their opinion on the DSM diagnostic approach. If they showed any respect for the DSM, that would be it for me. And if they started talking about “mental illness is a disease, like any other” or “insulin for diabetes,” I’d run from the room!

  • Did I not read fairly recently that receiving “more intensive psychiatric care” actually leads to an INCREASE in suicide attempts? It seems to me that psychiatric care encourages a belief that one’s situation his hopeless and intractable and that one can personally do nothing about it. At least blaming it on bad toilet training meant you had a chance to get over it. Now it’s all in your warped brain and the only “hope” is that the drugs might make you feel a little better, if they don’t kill you in the process.

  • Absolutely! Even within their own framing of things, which of course, lacks any real scientific basis, there ought to still be the expectation that TREATMENT WILL IMPROVE THE SITUATION! It’s probably the first and easiest place to attack psychiatry, without even getting into the DSM idiocy. If I have a skin rash and take a drug for it, the skin rash NEEDS TO IMPROVE! If it doesn’t improve, WE NEED TO DO SOMETHING DIFFERENT. Why does this reasoning not apply to psychiatry?

  • Great point! When working with foster youth, I often found the kids accused of “assault” by staff in institutions when a very short investigation proved that the child was fighting back against the staff assaulting THEM! But that part never got recorded in the logs, did it? “History is written by the victors.” Certainly, the residents of any kind of institution are not the “victors” and their version of history is never recorded by the institution’s staff.

  • After reading the article, the answer is clearly “nothing,” unless by “adding” you mean “providing yet further distractions and justifications for avoiding looking at environmental/social/spiritual causes.” It also appears to avoid looking at ACTUAL physiological causes of emotional distress, such as poor diet, thyroid issues, anemia, sleep problems, etc.

    They mention early on something about “issues of the relationship between mind and brain,” and yet the actual research seems to be all brain, all the time. Not one more word about “mind” in the entire article.

    In other words, “Meet the new boss, same as the old boss.” Nothing new to see here.

  • It seems important to distinguish between medical ERRORS (doing the wrong thing or overlooking something) vs. medical HARM (patient has a worse outcome despite following standard medical practice) vs. MALPRACTICE (doing something that the doctor knows or should have known is harmful, or failing to inform patients of risks of medical harm prior to treatment, etc.) Most medical harm is NOT due to errors, it’s due to adverse drug effects. And of course, those drug effects are MALPRACTICE if they result from neglecting to do proper differential diagnosis, or failing to provide proper informed consent to the patient. The medical profession has tried to reframe medical HARM as medical ERROR, even though most of the harm is done by standard medical practice. This appears to be an intentional effort to downplay the dangers and inadequacies of standard medical practice and to make it seem that failures and harm are due to a few “bad apples” rather than the standards of care being inadequate and frequently dangerous and corrupt.

  • Why should you automatically trust them? Isn’t trust earned by trustworthy behavior? Isn’t one of the “deficits” of “borderline personality disorder” (as they frame it) a difficulty deciding who can and can not be trusted?

    It is clear that these people don’t really know what they’re doing, and they get very insecure when anyone starts making it clear that they don’t, they get defensive and start blaming the person telling them the truth. It’s like The Emperor’s New Clothes! Lord help anyone who points out that the King is naked!

  • I think you start by pointing out the power differential overtly, acknowledging your power advantage and the general advantage of the other staff people and asking how they think it will affect the conversation. I would then humbly ask what YOU can do to make it more comfortable or easier for people to say what they are thinking without feeling like they might get into trouble. But I think the first discussion would be a huge one, if it gets going, and will pull you in the direction you need to go. I think the main thing is to bring it out in the open as an unavoidable fact of life, and get them talking about how it affects their experience. It will be a lot more interesting than Nietzsche, I’m thinking!

  • Another psychiatric success story! How can these people not see when their “treatment” fails utterly? In what other profession are the professionals allowed to blame their failure on the person/machine/process they are supposed to be fixing? “The bridge collapsed because it was a span-resistant river.” “We couldn’t fix your breaks because they are repair-resistant.” “You were poisoned because our chef had the misfortune of serving health-resistant food.” Come on, who the hell else would ever get away with it?

  • Somehow, I found the entire article alienating from the start. The language is very “clinical,” and there is a confusion between social conditions and “mental health diagnoses” that the authors never begin to address. If loneliness is caused by social conditions, then how does it even become a “mental illness?” If “mental illnesses” as defined by the DSM can be caused by loneliness, which is itself caused by adverse social conditions clearly identified in the research, how are they “illnesses” at all? Should they not instead inform the need for changes in the social structure that is increasing the difficulty people are having creating meaningful relationships?

    A lot of fancy words that seem to obscure more than they illuminate.

  • It seems likely that such a group would not be fully successful unless it started with a full discussion of the power dynamics entailed in you being the “professional” and organizing the group. It is apparent from your description that they patients viewed you as the “expert” regardless of any provisos you may have put out there. In fact, your ability to frame the conversation in terms of your role is already an exercise of power over the participants. Unless this set of assumptions, which may have largely been unconscious or subconscious, are fully deconstructed, the group as you envisioned it was unlikely to develop.

    Of course, if you HAD conducted such a discussion, your hierarchical peers would have felt their power threatened and almost certainly would have shut you down, just as they did with the “du” vs. “Sie” issue. Why would it bother them for you to use informal pronouns, except to the extent that it threatened their role as the “experts” speaking down to the “patients?”

    I have to wonder what Nietzsche himself might have said about the process.

  • This is why I’ve said again and again that psychiatry itself is not the enemy, it is only one manifestation of the enemy. The real enemy is AUTHORITARIANISM, the belief that people have the right to order about and take advantage of those below them in the power structure, and the belief and experience of those below that they must acquiesce to such behavior or be punished or ostracized from the group. Regardless of the name and stated purpose of a group, the ability of the group’s membership to hold the group’s leadership accountable is essential to any movement toward justice and equal rights to be successful. In other words, we have to have our own house in order before we’ll succeed at changing the external circumstances. And that is not an easy task!

  • It is also very important to note that these “differences” are AVERAGED over large numbers and are generally quite small. There is a huge overlap between the “disordered” and the “normal” population on any such measure. In other words, even if the average brain size of an “ADHD” diagnosed child is smaller, there are many “ADHD” diagnosed children who have larger brains than the average “normal,” and many “normal” kids who have brain sizes smaller than the average “ADHD” diagnosed kid. When you then take into account that the “ADHD” diagnosed population contains large numbers of kids on stimulants, which we know decreases brain size in the area of the basal ganglia, even these average differences reflect nothing at all.

    SO in other words, it’s all smoke and mirrors. There is no “difference in the brains” of “ADHD”-diagnosed kids. It’s all PR.

  • But there IS a point in telling parents that their kids have a “brain disorder,” even though this has been disproven decades ago: they will be more willing to accept and administer a drug to their child. That is the ONLY purpose for this deception to have continued this long, and the fact that it does continue makes the intentions of the profession eminently clear.

  • Where did they ever come up with that 51% suffering from trauma statistic? The real answer is in the 80-90% range from everything I’ve ever read. Did he provide a reference or was he just spewing hot gasses from his mouth?

    The “It’s not all about medication” meme is just a cover for the fact that “medication” prescriptions are 99% of a psychiatrist’s business these days. My experience (and I have a lot from advocating with foster youth) is that the vast majority of psychiatrists exist solely to prescribe and “monitor” drugs, though the term “monitor” must in most cases be used very, very loosely.

  • They need to believe in their doctors and in “Science.” It violates basic mythology for most people to question that doctors are knowledgeable scientists with their patients’ best interests at heart. We have to undermine this mythology before any real change will happen. I do feel bad that kids have to deal with parents who are deceived, but most parents are trying to do the right thing and need to be educated. Of course, there is a minority of parents who are more interested in controlling and subduing their children than in helping them live well, and such parents get very little sympathy from me.

  • The 6% (I actually think it was more like 6.7%) was from a file review, and only included those reactions noted in the kids’ files. Naturally, there would be doctors who would not notice these symptoms or would not write them down, and also kids/parents who did not report them or did so in a way that the doctor did not make the connection. So if 6% of doctors both knew and recorded these reactions, clearly the actual number so reacting would be considerably larger.

    That being said, even a 6% rate is large enough that it ought to be discussed at every “informed consent” conference with parents and children considering this “treatment.” Of course, many doctors don’t really do an informed consent consult in the first place, but even those who do rarely if ever mention to watch for psychotic symptoms as an adverse effect. In 20 years of experience as an advocate for foster youth, I never once heard or saw it mentioned to any of the 20% of kids in care who were diagnosed with “ADHD.”

  • Few parents indeed are ever told that psychotic experiences are a possible adverse effect of stimulants, even though one study indicated over 6% of kids on stimulants had psychotic symptoms noted in their files. Most kids who start showing these signs are diagnoses with “bipolar disorder” or a “psychotic disorder” and put on antipsychotics. I saw this many, many times in the foster kids I advocated for.

  • I think what it does is help create and sustain an alternate narrative of what is going on. It helps people see that an attitude critical of psychiatry is not “nuts” and is based on actual data and research as well as lots and lots of people’s experience. This in itself doesn’t change the status quo, but it helps bring people together that are opposed and provides tools and information that will help them do so. That’s my take on it, anyway.

    It also provides a space where survivors of the psychiatric system can speak their truth and not be brushed off or attacked for doing so.

  • I wouldn’t really classify him as “right wing.” He’s kind of “wingless,” says what he thinks with no real allegiance to any political viewpoint and offends both ends of the political spectrum. Though some right wing folks have attached themselves to some of the things he has said, because they can be made to fit the right-wing narrative. But in my view, he’s an equal opportunity offender.

  • In what other situations can these diagnoses be given out? They are ALWAYS given on in a subjective situation, because they are all utterly subjective by their very nature. A lay person is just as qualified as a psychiatrist to give a subjective opinion on someone’s “mental health condition,” which is why so many feel like the can do so.

  • It is clear from the focus of the “studies” that the definition of effectiveness is “reduction in symptoms.” This may or may not be of interest to the client specifically, but it certainly makes it obvious that resolving the actual issues that created the “symptoms” is never the goal. It’s like spending a ton of money on topical rash treatments without bothering to figure out if you have poison ivy, the measles, prickly heat, or syphilis. But it certainly is “effective” for creating lifetime patients and blockbuster drug sales!

  • I’d prefer to have “regular people” running for office rather than letting the ignorant and uninformed do the voting. There was an influx of new candidates in 2018, mostly women, who were NOT career politicians but just seemed tired of “business as usual.” But of course, we have to get rid of corporate money donations as point zero in any change plan, which is one thing Bernie has been very strong about.

  • Such euphemisms! What we REALLY should say is, “Schools as designed are extremely stressful for a large percentage of children. We need to rethink how schools are run so we don’t keep traumatizing our young citizens.” You don’t have to be “vulnerable” for school to stress you out. In fact, schools appear to MAKE a lot of kids “vulnerable” in ways they would not be if they participated in a more child-centered, respectful institution.

  • From my observation, antidepressants essentially induce a manic-like state, where a person is more spontaneous and less concerned about consequences. A friend of mine called it “Zolofting.” It’s kind of a “who gives a f*&k” attitude that can feel really good, especially for someone who has always been worried a lot about what other people think or feel about them. But as with all drugs, messing with the neurotransmitter system, however good it might feel, has long-term consequences that are often quite destructive. Some people seem to be able to tolerate them long term, but it’s a very risk way to “feel good,” and of course, does nothing to address why you might have been feeling bad in the first place.

  • The problem is, nobody has a clue what to test for. What’s SUPPOSED to happen is that a cause is postulated, and things that would be present when that cause exists would be extrapolated, and then we develop a test for those events/conditions. We haven’t even gotten to first base (identifying a cause), mostly because “schizophrenia,” like pretty much all the DSM “diagnoses,” is a very vague concept that could not possibly represent one specific malady, and may not represent any malady at all. So how to you test for something that is defined socially instead of physiologically?

  • There is nothing in my statements that conflicts with the idea that certain people’s conditions might have a physiological/medical genesis. All I’m saying is that calling these “mental illnesses” obscures the fact that there are multiple possible causes and multiple possible solutions, and that in many cases, there need not be anything physiologically wrong at all. Once we say someone “has depression,” any attempt to understand the real causes, be they physical, psychological, spiritual or social in nature, come to a rapid end. This is particularly true when the system automatically assumes that every single possible divergence from complete satisfaction with the status quo is caused by a “chemical imbalance” or other physiological problem.

    There are most definitely physical illnesses that manifest with psychological “symptoms.” It just doesn’t work the other way. As Socrates pointed out, if all men have facial hair, and Bob has facial hair, it doesn’t follow that Bob is a man. The logic flows from known physiological conditions to psychological effects, but not the other way.

  • The problem resides in trying to come up for a “solution” to something that can not be identified or defined as a single entity. “Mental illness” is a concept, not a disease state with a defined cause. Why would we imagine for a moment that something so nebulous and subjective as “mental illness” could possibly have a unitary cause or solution?

  • I’m glad this is coming up, and it looks very interesting! I have only one suggestion: let’s see if we can find a way to talk about “people who are suicidal” without lumping them all together and implying there is some “treatment” that is going to “help” all such people. There is a subtle but powerful subtext through most of the titles of the presentations that buys into this idea.

    How about “people who are feeling despair” or “people who are wondering if their life continues to be worth living” or something like that? Or “helping people find hope when their lives seem hopeless to them?” Something that makes it feel like “feeling suicidal” is actually a pretty common experience that doesn’t necessarily reflect anything “wrong” with the person having that experience?

    I think Leah’s title gets to this best: “The Way Forward: Pathways to Hope, Recovery, and Wellness with Insights From Lived Experience.” Hope, wellness, insights… no mention of ‘suicidal people’ at all.

  • It is also important to remember that the “differences on brain scans” are AVERAGES, not diagnostic indicators. And you’re right, of course, they could mean anything. But even if some so-called “ADHD” kids do have a different genetic presentation, SO WHAT? Tall people have different genes than short people, red haired people have different genes than blondes or brunettes, men have VASTLY different genetics in the XY chromosome area… genetic differences are the key to species survival!

    As for the heart events, this was being discussed way back in the mid 90s in antipsychiatry circles (see the “Ritalin Death” website), though it was massively denied by the mainstream. Now, once again, we find that the protesters were correct and the “professionals” were lying. Anyone see a pattern emerging here?

  • I personally thought this was quite enlightening for anyone looking at the gap between what supporters of the DSM approach say and what is really true. I don’t expect an interview with the APA head to get into Marxist analysis, I expect it to report accurately what the APA head has to say. This can be VERY important in laying out a counterattack, as once a person is on record making specific statements, it is a lot easier to counter their position with factual research and descriptions of real events. I don’t see it as supporting the idea of “mental illness” just because MIA interviews someone who believes in it. But maybe that’s just me.

  • I read the quotes from the pamphlet in the article. It seems to be pretty straightforward, and the criticisms forwarded are generalizations and don’t appear to address any of the specific claims in the pamphlet at all. Saying something is “misleading and inaccurate” without saying what is inaccurate or misleading about it is a pretty lame criticism!

  • I’m not entirely certain that people are looking for relief from suffering, at least not all or most. I think a lot are looking for UNDERSTANDING and CONNECTION, but they are offered “escape from suffering” as a weak alternative by the psychiatric industry, and told that’s all they can hope for. Understanding is more nebulous, requires more work, and can be scarier, but those who have genuinely experienced understanding from another person after working through some pain know it is far superior to merely escaping. Because the escape offered by the psychiatric industry is not very different than getting drunk to forget one’s pain – once one “sobers up,” the pain remains in place and needs to be avoided yet again. To reconsider that pain from a new perspective can not only ease the pain, it can provide meaning for one’s suffering and pathways to create a better life going forward, something no drug can ever begin to deliver.

  • I don’t disagree with you on that point. There are certainly diseases and medical situations that cause what has come to be known as “mental illness.” My objection is only the idea that they are “mimicking a mental illness,” because there is no such thing as a “mental illness” to mimic, at least not as defined in the DSM. It is an absolute certainty that anything which is called a “mental illness” COULD be caused by real physiological problems (there are literally hundreds of examples), and one of the greatest harms done by psychiatry is to stop doctors and patients looking for actual causes and allowing the “mental illness diagnosis” stand in place of actual research into causes.

    SO in essence, it seems we agree with each other, terminology notwithstanding. I appreciate the feedback.

  • I agree they have no idea of the cause, but I highly doubt further study of the brain per se is going to yield any more information. It is their primary error to believe that the brain is the causal factor in these “disorders,” in the same sense that solving a software bug or issue can not be resolved by studying the hardware. The mind runs the brain, not the other way around.

  • Lawrence, can you please address the issue of long-term neurological damage that extends beyond the technical withdrawal period from the drug itself? This is not really a controversial issue, at least in the world of substance abuse – it can take a long time for the brain to recover from years of drug-induced altered functioning, and in some cases, there is evidence of permanent damage. Why would this not apply to psychiatric drugs?

  • I would add that “withdrawal” may not be the proper term for this experience. It is more like “recovery from brain damage.” Most people know that the specific withdrawal period for cocaine, for instance, is pretty short – a matter of hours. But for someone taking cocaine long-term, the recovery period can literally take years. I find it pretty easy to believe that the exact same kind of mechanism would be at play for any psychoactive drug, in fact, I’d be stunned if it were not at play. There is plenty of research regarding neurological up- or down-regulation in the brain when the brain is flooded with/deprived of normal brain chemicals. Recovery from this kind of damage is going to take a hell of a lot longer than it takes the drug to exit the body, and I think it is pretty disingenuous to suggest that people suffering months or a year later are automatically suffering from some psychological problem when it is very possible they are continuing to suffer from brain damage induced by neurochemicals provided by their friendly “medical professionals.”

  • Speaking Chinese also runs in families. Do you think there may be genetic roots?

    They can’t even find genetic vulnerabilities for heart disease or most cancers. There are a few clearly genetic diseases, but even physiological diseases are influenced heavily by environmental impacts. To suggest that “mental health” is analogous is pretty ridiculous.

  • This is the fourth loss of a significant MIA contributor and antipsychiatry activist in the last month or so, and it is hitting me and others very hard. Bonnie in particular always seemed so immutable, so inexorable and so powerfully present, it is hard to imagine her succumbing even to death. Her spirit will continue to be with us as we fight on, but this is a huge loss to us and to the world. RIP, Bonnie, and keep fighting on, wherever you are!

  • Maybe you can select options: “If you’d just like a prescription, press 1. If you’d like a spurious but scientific-sounding ‘diagnosis,’ press 2. If you’d like to have the context of your ‘symptoms’ specifically invalidated, press 3. If you’d like a psychobabble explanation of why you need to keep taking your drugs forever, press 4. If you’d like someone to actually listen and understand your struggles, hang up and call somewhere else!”

  • Well said! It is the responsibility of those claiming to “treat the mind” to come up with a coherent definition of the “mind” they are supposedly treating. Those criticizing the approach don’t need to define “mind,” they just need to point out that those claiming to be “treating” it can’t define their terms.

    You can’t treat a metaphor!

  • I don’t disagree with anything you said. I was making the point that I do support individual people in making their own decisions and try not to make generalizations about “psychiatrists” as individual practitioners. There are many subtle points on “effectiveness” of drugs – as I’ve often pointed out, alcohol is a great “antianxiety” agent, but no one would prescribe it as a MEDICAL TREATMENT. It’s just something that makes you feel better temporarily. There are always dangers of ANY psychoactive drug, and I would certainly not recommend Ritalin as a way to make oneself fit into the capitalist mold. My point is only that individual decision making is one issue, but group-wide intentional corruption is something completely different. The first is complex, the second is not really all that complex at all. People do things that bring them money, unless they are motivated by caring first. It’s clear that psychiatry as a profession is motivated by greed and power over individual results.

  • I would suggest that there are, in fact, many caring individual psychiatrists out there, and I have certainly met some of them. I think there is a distinction to be made between psychiatrists (who vary widely as individuals) and “psychiatry,” which is an institution that has its own objectives and strategies and fears and blind spots. It is the institution that I am criticizing, the APA and its group objectives to promote a biologically-centered viewpoint and a drug-centered approach and the DSM strategy of de-contextualizing people’s suffering and blaming them for their “wrong” reactions to trauma and stress in their lives, and the constant hostility and dismissiveness toward even their own research when it conflicts with their agenda. I also feel it is very appropriate to criticize the corruption coming from the pharmaceutical industry that has informed the above goals and strategies.

    I also would never criticize an individual for doing whatever works for them or their families. I have stood by and watched while a friend’s husband got ECT (which didn’t work) and eventually came up with moving to another part of the country as a solution. I’ve known domestic abuse victims who used antidepressants as a means of becoming less worried about their abusers’ feelings and it helped them get away. I know people who feel that they can’t live without Prozac or who feel they’ve benefited from stimulants helping them concentrate better. I have no problem with people doing what works for them. And I have no problem with individuals, professional or not, helping other people. But I do have a big, big problem with an entire profession intentionally lying and manipulating data so that they and their drug company counterparts can increase their income and power, and I make no apologies for doing so.

    I hope that makes things more clear.

  • I like this post. The distinction between trying to “make the bad behaviors go away” and understanding their origins so that a person’s needs can be met in another way is huge! Once we understand the emotions driving behavior, CBT can be a useful technique to practice doing something different. But CBT alone often comes across as minimizing or invalidating the emotional components of behavior. People choose a particular action for a REASON, and without understanding the motivation, changing the behavior in isolation doesn’t work very well, in my experience.

  • I don’t know, maybe it would be fun to interrupt someone’s tirade and say, “You know I was considered one of ‘those people’ once. Do I seem crazy, dangerous or hopeless to you?” Might toss a monkey wrench in their works.

    BUt I also get why you wouldn’t want to go there. People who are on that kind of trip really NEED to believe what they are saying, and even a big dose of “cognitive dissonance” rarely has any effect.

  • Having spent half my career advocating for foster youth, this article resonates with me. Foster youth are the most disempowered group of citizens in the country, and they need all of our help. The rates of drugging tend to be around 20%, but increase by adolescence to over 50% in most states. Claims of “genetic inheritance” and “chemical imbalance” are particularly offensive and egregious in these cases, as we KNOW the main reason why these youth are suffering, yet somehow they continue to be blamed and “treated” for not being happy with their second- or third-class citizen status in life. Many are groomed for the adult “mental health” system and are told they have no chance of surviving without public assistance/disability payments for life. Yet many also rebel when they are able to escape the system and ditch their “mental patient” identities, acting on impulses and beliefs that have been subdued since they were very young in many cases.

    These youth need and deserve all the support we can give them. They are the ultimate “market” for the psych industry and are almost helpless to resist.

    Consider supporting your local CASA (Court Appointed Special Advocate) program, or volunteer to become a CASA in your jurisdiction, and you’ll have some direct and substantial influence upon this most undesirable course of events!

  • Most of them don’t even know the adverse effects of the drugs they personally prescribed. I’d bet that 90% don’t even know there ARE withdrawal effects from Cymbalta. I just figure I have to educate them every time, but avoiding MDs whenever possible is much more effective. I only see them when I have no other choice or need something specific that only they can provide, like antibiotics. Don’t trust them as far as I can toss them.

  • I’ll go with Oldhead on this one, and say that a MIND is an idea, or a set of ideas and processes, and ideas can’t be “ill.” There are neurological illnesses, which should all be detectable by some physiological means. But it is a mistake to equate neurology with “mind.” No one really knows what “mind” is, and until we do, it is going to do nothing but add confusion to call a mind “ill.”

  • It is not lack of training, it is the ability to dehumanize the victims that leads to this kind of mass unethical behavior. It works very much similar to a gang rape. What is the likelihood that ALL members of a certain sports team are rapists? Simply not possible. So how does an entire team participate in such an atrocity, as has been documented numerous times? It happens when the victim is sufficiently dehumanized that other group members can treat the victim is a non-human so that normal rules of ethics don’t apply in this situation. Same thing with group torture like Abu Ghraib. And it is psychiatry’s own DSM labeling process that makes this mass dehumanization possible. Those people providing “treatment” have been “trained” to see the “patients” as a subgroup who don’t deserve the same rights as other humans. So, in fact, it is not a lack of training, but a training in the use of dehumanizing terms and beliefs that leads to this result.

  • Right you are, Sam! Genetic diversity is the core of species survival. Even if it’s proven that genetics, for instance, affect activity levels and that some “ADHD” people have a genetic difference means NOTHING about whether or not “ADHD” is a disease state! Men and women have VASTLY different genetics in the X/Y genes, heck, men are MISSING a whole bunch of DNA that women have, and men certainly act differently overall than women. Are we prepared to call having male sex genes a “disease” based on that fact alone? (Testosterone poisoning, anyone?)

  • The large associations with individual violence are drug use/abuse and domestic/family/pet violence. “Mental illness” and especially “Schizophrenia” are tiny blips in comparison. But it’s easier to blame than it is to deal with big societal problems like why so many people are using and abusing drugs and why so many feel it is OK to beat up their wives and children and dogs.

  • I think the larger question, Daniel, is how do you feel about the use of psychedelics IN THE HANDS OF PSYCHIATRISTS as you know they currently practice their brand of “medicine?” Hell, we know that alcohol can be a great antianxiety agent, and has a better “side effect” profile than benzos. But it’s not a MEDICAL INTERVENTION, it’s a way of holding anxiety at bay. That’s the level psychiatry is working at right now: Anxiety BAD. Benzo make anxiety go away. GOOD. Benzo patentable. GOOD. Alcohol not patentable. BAD. WE USE BENZO! There is no sense of mission or analysis deeper than that going on at the practice level, and for those operating on the “theoretical” level, the situation is even worse! “This research disproves our theory. WE MUST BURY IT! This person speaks uncomfortable truths. WE MUST ATTACK THEM! This group opposes us. WE MUST DEMONIZE THEM!” Do you really want people in such positions promoting psychedelic drugs for traumatized people? A profession that systematically denies that traumatic events are even causal factors in their lists of “disorders?” And who can then force psychedelics against their will on anyone they decide is unable to make informed decisions for him/herself?

    It is much more than a question of whether there are positive research results. It’s a question of putting trust into an utterly corrupt system of decision making and control.

    Steve

  • That’s what I was thinking. What psychiatrist would possibly be remotely qualified to engage in guiding someone through this kind of experience? It seems beyond ludicrous, having known some folks rather intimately who have used this drug. It is shocking that even psychiatry would be so arrogant as to think just giving someone a dose of this and “objectively” watching what happens would be anything but an invitation to disaster.

  • Wow, you are suing? Let us know how this goes. I think the only real success in undermining the psychiatric worldview and control is to hit them in the pockedbooks and in the public realm of discussion. I am sorry all this crap happened to you, but t would truly be awesome to have national news about the psych professions getting their butts sued for hurting people they are claiming to help.

  • Psychiatry and big pharma have ALWAYS claimed miracle cures. Remember when Benzedrine was all the rage, safe, effective and non-habit forming? When that disaster was finally admitted, we had Valium, which was, wait for it, safe, effective and non-habit forming. Except that it’s one of the most addictive drugs known to man. Later on, we have claims that Prozac and the SSRIs are effective and have virtually no side effects. Well, except for increasing the rate of suicide and the occasional outburst of homicidal rage. Oops! So forgive me if I’m a tad skeptical when a party drug/tranquilizer is suddenly claimed as the miracle cure for everything. As for “rewiring the brain,” that’s a pretty tired analogy that doesn’t really correspond to any reality at all. There are no wires in the brain, and nerve channels are not in any way remotely similar to wires other than the ability to conduct and electrical signal.

    It’s important to sift through the rhetoric. EVERY drug is “safe and effective with no side effects” until the patent runs out.

  • I just did a little research on Britney Spears’ life. It sounds like she had a very traumatic upbringing, exposed to domestic abuse by her dad, dad was an alcoholic, and of course, her mom most likely meeting her needs through having Britney perform as a kid. There is evidence she most likely experienced domestic abuse herself. Seems she grew up very insecure, for rather obvious reasons, and was easily taken advantage of by others because she was constantly seeking approval. Of course, NONE of this is discussed in the explanation of her “disorders.” It is all blamed on her “condition,” but it is easy to see that the controlling behavior of her family members continues to the present day. Instead of acknowledging the abusive behavior by her parents, they talk about her being the victim of “very bad genetics.”

    This shows the destructive nature of the DSM labeling process, even for the rich and famous.

  • Waste of time. The only measure of whether or not any “therapy” is effective is whether the person receiving it thinks it’s effective. To think that one “therapeutic school” will magically be proven more effective, regardless of the therapist or the client, is simply a fantasy. Therapy is a HUMAN INTERACTION, not a mechanical undertaking that can be quantified and measured out like some weight of ground meat!

  • Amazing how long they can claim that they “haven’t found the right combination” as if that is an inevitable outcome given enough time, instead of admitting that “our drugs have not been helpful to her, and stopping them makes a whole lot of sense under the circumstances.” How many times can you take your car to the mechanic and hear, “We haven’t found just the right ‘treatment’ yet for your engine…” before you fire them?

  • That’s a great way to put it, Al. We have to be willing to not know and to sit with the person we’re helping and feel their discomfort and pain and despair and not run away from it. Even if we don’t know how to help, knowing that we’re willing to confront the situation with them and NOT try to “make them better” in and of itself is the core of actual helpfulness. And if a possible solution then DOES emerge, both know that it’s a real possibility rather than something you cooked up to make yourself feel better.

  • If you haven’t read about the “Rat Park” experiment, you should. It kind of says all that needs to be said about addiction. Classic experiments have been done where rats in a cage are given a choice between pushing a button for water/food and one for cocaine, and the rats eventually choose the cocaine so often that they die, which is held up as proof that cocaine is “physically addictive” and that the rats have no choice once they’re addicted.

    But the Rat Park people put the rats in a healthy rat environment, with dirt to dig in and tubes and wheels and stuff to play with and other rats for company and so on, everything a rat would need to live a happy rat life. And they were given the same choices, and guess what? These rats picked the food and water and left the cocaine alone.

    To me, it is total proof that the “physically addicting” theory of drugs is hogwash. People, just like rats, take drugs because they’re in pain and they’re trying to alleviate it. Some of these drugs are legal, some are not, but it doesn’t matter, because if they can’t fix up their environment to meet their needs, they will instead continue to use the substance to numb out their feelings of anxiety and depression. The answer is not more drugs, but an approach to modifying the environment so it is easier for folks to meet their basic needs. We need to set up “human parks” and see how many humans choose drugs over life!

  • “Remember, there is no shame in being labeled a worthless, helpless, permanently brain-damaged drain on society of whom other people are taught to be irrationally afraid and who will remain on disability for the rest of his/her medically forshortened life, no matter WHAT those other people say!”

  • Great strategy! This actually comports with my theory on how “ECT” gets people rating it as improving their conditions. After several “treatments”, the patients/victims become more and more likely to say, “Wow, doc, that was GREAT! I feel SO much better, not a HINT of depression any more! What a miracle! Now, can you please unlock that door and get me the hell out of this place?”

  • Unfortunately, recreational drugs and psychiatric drugs are very similar in action, and attempts to convert street drugs into psych drugs are a natural progression from the “bad brain” viewpoint. After all, taking cocaine makes you feel better, doesn’t it? So it’s an antidepressant! Maybe a tad addictive, but hey, you have to deal with the side effect, right? They’ve already converted amphetamine sulfate into a “medical drug,” and tried to do so with meth, with a lot less success, luckily. Why not esketamine, or heroin? The difference between taking Xanax and drinking a prescribed amount of alcohol three times a day is essentially zero. The line between drug dealers and the average psychiatrist is a thin one, indeed.

  • “If you were Jello,” seriously??? That is majorly warped.

    I’m glad you brought this up, especially regarding the obvious financial advantages the “mental health professionals” display. It seems like quite the slap in the face. I mean, I get someone wanting to have a nice office that doesn’t have paint peeling or sticky spills on the floor or broken blinds, but these opulent offices just scream “I’m making a boatload of money off people like you, and when push comes to shove, that’s what really matters to me.” I think it’s inherently offensive. But I guess if the “professional” really believes their clients deserve less because they are that much less important or valuable, maybe they don’t notice how insensitive and greedy they’re being.

  • Of course, they don’t really even do laboratory science, either. They do experiments on heterogeneous groups, don’t identify proper outcomes half the time, if they do identify outcomes and they come out negative, they shop around for positive outcomes instead of reporting, and when their own research condemns their process, they ignore it or “explain” it away and keep on doing whatever they already decided they wanted to do. Not very scientific.

  • It really shows the intense differentiation made by many or perhaps even most “professionals” between themselves (sane people) and their clients (insane people). It is this differentiation that makes it next to impossible for such professionals to be genuinely helpful to their own clients.

  • What I find fascinating is that in the entire article, getting feedback or information from the actual clients is never mentioned once. Perhaps that’s the real reason clinicians can’t get together – they’re aiming as usual at the wrong target.

    Maybe we start with asking clients what or whom they find helpful, then find out what those people do that the clients find of value. Nah, too simple and effective…

  • That is a beautiful post! I can absolutely relate to having to learn that my rage is essential to my survival! And you truly show how destructive idea that you are “disordered” for having your feelings can be. It destroys people’s idea of themselves and keeps them from learning how to direct their righteous indignation for the purpose it is intended.

  • I apologize if I seemed to minimize the incredible damage these drugs can do. I find them abominable and the lies about them and the pretense that they are so wonderful and that the “side effects” are someone’s “disorder” reasserting itself incredibly offensive. The point I am making is that the presence or absence of the drugs doesn’t address the bigger issue. I totally agree the drugs are bad news, and it’s my belief that anyone who gets TRUE informed consent about them would be VERY reluctant to use them at all. It is the framing of the problem as “biological” and the promise of FIXING the “imbalance of brain chemicals,” as well as the societal propaganda pushing all the blame for any behavioral or emotional issues that make the ‘status quo’ uncomfortable on the person with the emotions, or worse yet, on their brains, that allows these drugs to be marketed and sold. If that structure is removed, psychiatry is left with, “This might make you feel better temporarily or it might not. It has a bunch of risks and no long-term positive effects. It won’t solve any problem you have, the only thing it might do is temporarily make you feel better, and even that is not a guarantee.” If that is the marketing pitch, they’ll be right down there with the corner drug pusher, which frankly is where the bulk of psychiatrists belong.

  • The question I ask is this: is psychiatry really a “school of thought?” It purports to be a MEDICAL SCIENCE, with no actual support for that claim. It ignores its own research when it conflicts with the basic dogma of the belief system. People who don’t support those dogma are attacked and/or purged from the group. It seems a lot more like a RELIGION than a school of thought. A school of thought implies a philosophical viewpoint that is open to argumentation and new data. Psychiatry is unwilling to admit that it is promoting a philosophical viewpoint with which others may honestly disagree, and relies instead on having social power to enforce its dogma regardless of the truth. Which really prevents any kind of civil discourse with those who are unwilling to recognize the speculative and frankly dishonest nature of psychiatry as a “medical” field. For that reason, having a discussion about it feels like a big waste of time.

  • I think perhaps you are confusing these drugs, which people may find useful on occasion, and psychiatry, which comes up with socially-biased “labels” in committees of entitled old (mostly) men and lies consistently to people about the “biological origins” of their “disorders,” despite masses of evidence showing that 1) there are no identifiable physical indications of ANY of their so-called “disorders,” and 2) the “treatments” for these “disorders” are essentially an uncontrolled “experiment” where the experimenters declare success whenever anything good happens and blame any unexpected or undesired result on the client or the “disorder,” and 3) any and all evidence invalidating their “theories” is dismissed with unfounded “explanations” or ad hominem attacks on anyone who dares to challenge their dogmatic “reality.” I’d be happy to make drugs available (with GENUINE informed consent) to those who want them once the lies and excuses and pressures and marketing bullcrap area taken out of the equation.

    The problem isn’t the drugs – it’s the lies and the abuse of power that are the real core of psychiatry. And that core is, in fact, totally rotten.

  • “Therapists should have innate understandings of themselves, life, and the possibility of themselves being completely wrong.”

    You said a mouthful there! Success of “therapy” of any type has a lot more to do with the qualities and attitudes of the therapist than what “school” they subscribe to. In my experience, the very best counselors have no commitment to any particular approach, and do instead whatever works for their client. But such therapists are rarer than hen’s teeth!

  • I suppose if we define a “real leftist” as someone committed to actual empowerment of the masses, then I would agree with you. But there might not be a lot of “real leftists” around. There could certainly be people who are sincere but confused, or who have difficulty overcoming their authoritarian programming. The folks at the school I refer to for the most part really did believe in the model, at least to start with. They just got nervous and started panicking. It takes a lot of courage to really stick to one’s mission in the face of the training and pressure to the contrary. And there are a few people around pretty much any group who are mainly interested in gaining control of the group, and are only faking commitment. One school I helped create was destroyed by such a person.

    As to legitimate authority, of course, I’d agree with you 100%. When I talk about authoritarianism, I’m talking about the acceptance of certain people as authorities regardless of legitimacy, and authorities expecting compliance with their demands without question, as well as both authorities and members attacking on those who are willing to question the dogma of the authoritarian group.

    Again, I’m not trying to say this is hopeless or that we should give up. I am merely saying that one needs to be constantly vigilant about authoritarian types making their way into such an organization, as well as being vigilant that one’s own subconscious needs for control and safety don’t overshadow the goal of empowerment of the populace.

  • By all means, we should never stop working toward that goal. We simply need to do it in awareness that AUTHORITARIANISM is a deadly foe that is larger than capitalism itself. Freedom and mutual respect and support are the goals we need to pursue, not a different system with different bosses and different people in powerful and oppressed roles. But I think you agree with me on that point.

  • And just for the record, I don’t equate efforts to maintain the status quo at all costs, which tends to be the ‘right’ leaning form of authoritarianism, with efforts to force one person or group’s vision of change on society by force, which tends to be the ‘left’ leaning form, in my view. Fascism is fascism, it’s authoritarian for sure, but not all authoritarians lean toward fascism. As you well know, there have been plenty of ‘socialist’ dictatorships and lots of human rights abuses done in the name of “socialism.” My only real point is that ONLY looking to the “right” for authoritarianism fails to take into account the internalized oppression we’ve all experienced which leaves every one of us vulnerable to either kowtow to or engage in authoritarian tactics in the service of what seems to us to be a worthy goal. It is something that must be consciously identified and resisted if we’re going to create a different kind of society.

  • I think I understand you better at this point. I was simply stating that SOME authoritarianism can be found everywhere, because it is endemic to our society. By no means do I mean to suggest (or did I suggest) that it simply “human nature” – I believe, as I stated, that it is TRAINED into us from birth onwards, both explicitly by parents and churches and educational institutions and so forth, and implicitly by being the only game clearly on display, and by the hostility expressed toward those who refuse to go along with the status quo. It is a challenge to overcome that kind of training for anyone. For instance, in the “dictatorship of the proletariat” concept, the idea is that there is a temporary period during which the new ideas will become held by a majority of the people in the society, allowing this dictatorship to melt away. But during that period, there is an authority in charge of what should be taught and how it should be taught, and those doing the “teaching” ALL grew up with these authoritarian models of education. So it requires real care and attention not to replicate the same forms that we’re comfortable with, as my example of the “democratic school” shows so clearly. It is not enough to just believe in a revolution, we have to pay attention to how it will happen and what will happen afterwards. I don’t think it’s doomed to failure, but I do think these challenges are great, because a lot of the ideas and models we carry are not conscious (kind of like implicit racism or other unconscious biases). I have always found it of the greatest importance to address the dilemma of being a person of privilege and authority trying to help others to find their own freedom. How easy it is to fall into saying, “Do it my way, it works for me.” It is a challenge we must all keep at the top of our awareness any time we’re working for real empowerment of ourselves and others. That’s my experience anyway.

  • I didn’t say a lot of what you think I said, Richard. I think it’s important to be careful not to read into posts things that are your assumptions. I’d prefer if you’d simply ask for clarification if what I said is confusing.

    I believe that a lot of the current population is authoritarian, at both ends of the political spectrum, based solely on my own observation of people’s behavior. I believe this is mostly because of our authoritarian means of educating people and our ubiquitous authoritarian structures which seem to be “the only way” because people don’t SEE another way ever demonstrated to work. I certainly know people who are not authoritarian and believe that non-authoritarian structures can be found and/or created, and have spent a good proportion of my time on Earth working to create that possibility. However, it’s not as easy as it sounds, because we have all had this stuff hammered into us from birth, and people who are NOT authoritarian are punished for following their path. Naturally, authoritarianism occurs on a spectrum, and people are pushed back and forth based on how their efforts are perceived and reacted to by those around them. So encouraging anti-authoritarian thinking is possible and will push people in the direction of seeing things that way. But just as obviously, those who are running the current society are very invested in maintaining the current power dynamics and use authoritarian tactics to maintain them and push people to a more authoritarian view of the world. Revolutions have historically not always led to real change, because the internalized authoritarian underpinnings of the social system were not addressed, and the new rulers step into the authoritarian roles that they and the society they are part of feel comfortable with. This is a big part of why the current “liberals” in the USA have such a hard time supporting antipsychiatry as a movement – they are unable or unwilling to challenge the idea that doctors generally have their best interests at heart and should be trusted to make up rules that the rest of us should follow. That’s authoritarianism, and you see how strong it is when you try to talk to some (not all) “liberals” about the human rights concerns of those labeled “mentally ill,” with whom their stated philosophies should have great solidarity. But they don’t, because it’s not in their own structure of what is “right” and “good” and “wrong” and “bad.” They accept the authority of the doctor without questioning it. I saw a lot of this when working on creating democratic schools, where kids are mainly responsible for making up their own school rules and enforcing them. Parents and teachers SAID they believed in these principles, but when the kids’ standardized test scores started to come into play, or the District started complaining about the vagueness of the curriculum, they started getting unconsciously very nervous and bit by bit re-instituted authoritarian structures that were opposed to the mission, because they really weren’t quite comfortable themselves trusting kids to wield all that power themselves, much as they wanted to believe that they backed the mission 100%.

    The world is not a black and white place. I can certainly go into examples from our current world where people on the “left” engage in authoritarian behavior and don’t recognize it as such. Examples on the “right” are perhaps more obvious and easy to identify, but the idea that all authoritarians are right-leaning politically is just plain not borne out by the facts. There are also people who identify as “conservative” who are actually quite anti-authoritarian. We need to become more aware of this if we really want to change the way we’re doing business. Because in the end, “society” exists within the people who create and participate in it, and if we want to create a new society, we have to understand our internalized oppression and deal with it, or else we will perpetrate it in our new society as well. As the Who sagely suggested, we want to avoid a “Meet the new boss, same as the old boss” situation. It is not enough to change the external structures of society. We have to change our own internalized structures, too. And that’s a lot of hard work that few are ready to take on, in my experience. That may seem jaded, and maybe it is, but it doesn’t mean I don’t think it can be done. I am saying that, as discouraging as it sounds, this reality MUST be dealt with, and pretending that it doesn’t exist will doom further revolutionary efforts to failure or limited success. We do ourselves no favors by ignoring this particular set of facts about human behavior.

    I hope that clarifies things.

  • The trick is, they portray anyone who actually gets caught as a “bad apple” and an outlier and assure everyone that they are HORRIFIED that any doctor would act this way, and THEY certainly don’t ever do anything like that! It is a great way to distract attention from any deeper investigation or analysis.

  • NA might not be a bad idea, I don’t know. It seems that familiarity with dealing with withdrawal might be valuable. I knew a former heroin addict who took SSRIs for a time, and she had bad withdrawals. She said she felt lucky she’d had to withdraw from heroin, because otherwise, she would not have understood what was happening or how to deal with it. Of course, the doctors never bothered to tell her that she might experience withdrawal.

  • A message from Sharon Crestinger, who has been an MIA poster in the past:

    I am thinking of Julie Greene today and am very sad for her transition from this dimension. I have many comrades and friends, but few contemporaries in the world of survivor and abolitionist essayists. Julie was usually the first one I could name. This was the context of our relationship.

    Writing was never a problem for Julie. She wrote and wrote, every day. It’s beyond an outrage that she was murdered by psychiatry at 62 with so much left to say. And, I am glad she said so much while she was here. Julie got discouraged and frustrated sometimes that her work didn’t find a wider audience, but she never gave up. I greatly admired how she kept going through the discrimination, marginalization, health problems, and everything else she faced as a survivor. She believed her writing and her activism made a difference and that if she and others just kept going, abolition would be a real possibility one day. Julie believed the work of abolition would eventually succeed in a very real and material way I greatly wish I could share.

    Julie was my best editor. The way she lived her life inspired me.

    I see a lot a grief for the end of Julie’s life. I’m trying hard to be outraged, but I am so sad and tired.

    I wish more people were outraged. I wish more people used the words murder and genocide to mark our passings.

    Safe travels, comrade. I’m so sorry you won’t see your writings elevated to the place of importance they will eventually occupy in our history.

    Sharon Jean Cretsinger
    Tijuana, December 7 2019

  • Your point about the “hostile takeover” is very well taken. There appeared to be little in the way of hostility – it was more of a merger made in the interests of monopolizing the market. Both sides agreed from the start, and both sides benefited massively from the collaboration. The only hostility was toward any whistle-blower who tried to point out what was really going on.

  • You seem to be coming from the assumption that all people with the “ADHD” label have the same problem or need the same kind of help. “ADHD” is just a name for a certain set of behaviors that have been identified as problematic. There are all kinds of reasons why people act that way, and hence all kinds of different things that might help different people. It makes total sense that some “ADHD” labeled people would do better with meditation and some would not, because they’re all different. Acting in a certain way doesn’t make people actually similar – it’s just a surface manifestation. Unless you know why it’s happening, you can’t say they are similar at all.

    Besides which, some people who act in ways that are called “ADHD” don’t believe they have any problem, just because other people have a problem with their behavior. And I tend to agree with them.

  • I’m so glad you said that! Science is MUCH better at disproving things than proving them. Scientific proof really consists of vigorous attempts at DISPROVING a hypothesis failing over an extended period of time. A scientific finding that can’t be replicated isn’t scientifically true any longer, but of course, psychiatry does not hold itself to such standards.

  • Ditching the DSM should be on the list. The DSM a highly trauma-misinformed or trauma-denying or trauma-delegitimizing document, and to attempt to provide “trauma-informed care” while working in a DSM framework is utterly impossible to accomplish. Those who really do effective trauma work either ignore the DSM entirely or use it for insurance billing. It has no place in actual therapeutic intervention for trauma survivors.

  • I think what bugs me about this is that it begs the very important question of why there would be debate in the first place. I bet you can’t find 8 or even 4 different audience critiques over clinical practice guidelines for heart attacks or broken limbs. Sure, there will be different opinions on particular approaches taken, and on the possible conflicts of interest with drug companies and others which plague the entire medical profession, but no one will be arguing that heart attacks don’t really happen or that it is a medicalization of a normal human variation. The main reason there are debates of this nature is specifically BECAUSE there is no scientific basis on which these “diagnoses” are formed. So yes, it is a social document, for sure, but one that has little to nothing to do with science and a lot to do with economics and sociology.

  • The problem with the label “PPD” is that it implies something you HAVE rather than something that is happening to you as the result of complex circumstances. Anyone who has had a child knows there are 50 reasons why you might be feeling depressed after the birth of a child. To mention one that never gets mentioned, domestic abuse often starts or escalates immediately after childbirth, and DV is hardly a rare occurrence. How many cases of emerging domestic abuse are papered over by the term “PPD?”

    I know I’m preaching to the choir here, and we are not in disagreement, but I wanted to make it clear from my viewpoint why the term PPD is particularly offensive to me.

  • Anecdotal evidence can be useful, but these studies are controlled and more intentionally screen out “false positives” and “false negatives.” The placebo effect is a HUGE part of why some people find their antidepressants effective. There are also many who find them effective to start with and then the effectiveness fades over time. There are also many who start on ADs and then have trouble coming off due to withdrawal effects, and many of these are told that this is their “depression coming back” and proof that the ADs are “working.” And of course, there are some who derive actual benefit from them in terms of feeling better, however that may be defined.

    Talking about understanding the “nuances of psychiatric care” is likely to be considered pretty insulting in this particular community, as most of the posters have been exposed to those “nuances” personally and can tell you a thing or two about just how “nuanced” the approach was in their particular case. I get that you have found ADs helpful for you or your clients, but it should be clear very quickly from reading these posts that this is NOT the case for everyone, and I think it would be wise to listen a little more to what people have to say about their own experiences before leaping to the conclusions that they “don’t understand” what psychiatric care is all about.

    BTW, have you read Anatomy of an Epidemic yet? You really should read it. It is the basis for this entire site and community, and might open your eyes a bit to what people here are protesting. Hint: the use of medication is not the main issue.

  • I guess some kids must not be “tough enough” to deal with the abuse and need to be diagnosed because their brains just aren’t up to the task of being forcibly separated from their families and kept in overcrowded little rooms or cages without knowing if or when they’ll ever be released. I guess the “mentally healthy” ones either lapse into total apathy or “look on the bright side” because “they control their own narrative.”

  • The idea of common sense suggests that a person with little to no education should be able to see the truth in it intuitively. I truly believe this is the case when it comes to understanding human beings and what we need from each other. Too much training, as you say, creates more and more confusion, because they’re making things more complicated than they really are. And then we get weird studies showing that “racism and oppression increase mental illness symptoms.” Gosh, who knew? It really isn’t that complicated, though it requires courage and willingness to experience intense feelings to fully understand, and that’s where a lot of “professionals” fail.

  • Though Oldhead may disagree with you, I do not. While psychiatry as a “profession” may not be a legitimate “service” that actually intends to meet anyone’s needs but their own need for money and power, most people who seek out psychiatry DO have a need of some sort that our society is not meeting. While there is no real hope for reforming psychiatry, as its intentions are not actually to help (though individuals within the system may have that intention), there are people who need real support and caring which our society fails to provide (or at times actively opposes). We need a plan to help such folks (which let’s be honest has included most of us at one time or another), and I do think that having such a plan will make it easier to get rid of psychiatry, as it will remove one excuse/justification for psychiatry’s existence. Naturally, the psychiatric hierarchy will attack any such attempt with vigor, but that is to be expected, as they will see their gravy train being derailed. So we’re not talking of an “alternative to psychiatry,” but a viable way to help folks who are suffering from the oppression of our patriarchal, authoritarian and capitalistic greed-and-power based system of social control.

  • Do you know of any evidence that any of these “disorders” are physical problems? I don’t. For sure, physiology can be involved, including things like sleep, diet, exercise, drug intake, physical pain, etc. And there ARE physiological conditions that can cause mental/emotional effects (like Lyme Disease). But so far as I know, there is no proof that any “mental illness” is consistently CAUSED by a physiological problem. Remember that these entities are defined by committees voting, not by any kind of scientific process. How would they even know the cause if they are defined by a list of behaviors and feelings?

  • I have found the same. You can’t fully trust someone until they’ve seen you let loose with your most difficult feelings and behavior and find they still want to be around you. There is no intimacy without vulnerability, but we’re taught all the time (which actually starts making it true) that sharing our true selves is foolish and dangerous and we’d better keep those masks on, or else!

    I personally found school particularly awful in this way. Keeping one’s own integrity in place in a standard school environment is next to impossible for most kids.

  • And our society as a whole makes it even harder, as even those women with no trauma history are taught that their value lies in sexual attractiveness and acceptability of appearance to others. But naturally, this kind of issue does not appear to carry any weight with the paternalistic psychiatric profession, which seems myopically committed to blaming the victim and letting social institutions off the hook.

  • I heard an almost exact replica of your description from a coworker who was taking Zoloft for migraine headaches, not “depression.” She was shocked with how “reasonable” the idea of suicide seemed to her, just a casual thought, like, “I could go to the store. I could kill myself.” I do think the “positive effect” of SSRIs is a lessening of empathic connection to others. For some people, this will feel like a relief. For others, it will make things seem reasonable that would have seemed outrageous before. Including suicide or murder in some cases.

  • Commenting as moderator: Just so you know, I will never moderate you for including accurate descriptions of your experience, no matter how ugly it was. Moderation is only for things that attack or distract, not for things that are true but uncomfortable. Sharing the true but uncomfortable is a lot of what this site is all about!

  • I think you hit it on the head. “Mentally healthy” in these circles seems to mean not experiencing any strong emotion of any type. Like Stepford Wives or Invasion of the Body Snatchers. “Once you do the transformation, you’ll understand.” If those pea pods from Invasion of the Body Snatchers really existed, the psychiatric profession would be very excited about them.

  • Wish they’d be a little more definitive in their conclusions: “The use of ADM for adolescent depressive symptoms is not supported, as the risks far outweigh the ostensible benefits.” Or “Doctors should not use ADM as a treatment modality for children or adolescents having depressive symptoms.”

    Of course, the idea of “treating” depression is problematic in itself.

  • ““Partnership-based relationships seem to promote personal recovery more than traditional expert–patient relationships. Our findings also indicate that mental health services need to be organized, more individually tailored, and “bottom-up,” starting with the needs, preferences, and goals of service users.”

    This is a very euphemistic way of saying that seeing a doctor is not likely to be helpful, and that services that ARE actually helpful are ones that start from the client’s needs and preferences. Is this news to anyone? But good for them for making it explicit.

  • That was my experience as well. I remember being a safety patrol and having to keep the kids outside the building when it was 20 degrees out while the teachers walked around inside drinking coffee in their comfy sweaters. I think that was the first time it really struck me clearly just how systematically abusive the system was.

  • Well, ugh! But in addition, what does he think the chemicals in the brain are made from? Food, obviously. Even if one fully embraces the “chemical imbalance” myth (which even psychiatrists are now finally backing away from), it would still make sense that nutrition would be a viable intervention.

    I wonder how much money he gets from Big Pharma every year? Sounds more like a drug salesman than a doctor.

  • And I’d probably be much more interested in talking to one who did than one who simply believed in the “status quo” mythology.

    It is my understanding that traditional healers are part and parcel of psychiatric care in Brazil, and they do, in fact, come in and deal with spirits. I also know of a case in Texas, I believe, where a spiritual healer came over from Mexico and cured a person deemed “severely treatment resistant” by the doctors.

    Compared to “standard treatment,” I’d take spirit dispossession any day of the week.

  • The authors’ experience is not in the least bit surprising, and they properly identify the privilege and power of the academic elite who don’t want their authority challenged. I would have liked to hear more of a connection made between that power and the money flowing to institutions from psychiatry, from equipment makers, and from the pharmaceutical industry. Academia has been largely corrupted when the door was opened to big corporations essentially buying research that promotes their product, including the right to not publish research which is critical. This ethos permeates the entire academic world (not just in psychiatry) to the extent that it is almost invisible to those who swim in that particular water. We don’t bite the hand that feeds us, especially when the owner of the hand can now bite back so painfully. We have to get big corporations disconnected from academic research!

  • The term “social psychiatry” appears to me to be an oxymoron. It fails to recognize the corrupt nature of the current biomedical model and suggests that it is feasible to “integrate” this model with more social/psychological views of emotional distress. This is in my view impossible, because the biomedical model is driven by profits and the interests of the APA to control the narrative, and is not in any way directed toward “health,” even in the metaphorical sense. It is directed toward profit and control, and as such, can’t be integrated into anything rationally focused on improving people’s lives. If you want a socially responsible and flexible approach to people’s emotional well being, don’t bother with the current model. You’d need to start over from scratch.

  • If someone were NOT a therapist, just a friend or colleague, do you believe that that person might listen to someone else’s experience in a non-exploitative way? And that such listening could be helpful to the person telling their story? Is it possible that those “on the barricades” might tell each other stories during lulls in the fighting, and that they might benefit from sharing their stories with each other?

  • If I really wanted to reform schools to improve what they metaphorically and euphemistically refer to as the children’s “mental health,” they could start by reforming the authoritarian nature of the student-teacher relationship and give the students more control and some genuine recourse when they have been wronged by the staff or other students. There are any number of “democratic schools” around the country and the world, starting with Summerhill way back in the early 1900s. At Summerhill, students got to choose what classes they attended, including not attending any class at all. And yet the students chose to attend classes most of the time and would ask kids who were not serious about studying to leave. They made their own rules and had their own justice system for kids AND adults who might have transgressed the school’s agreed laws. The students and staff all got one vote at the meetings, and staff were frequently overruled in their suggestions. This is the kind of approach that is needed if we want our students to be “mentally healthy” – an environment where they are trusted, where they have responsibility and control, where they are able to protect themselves from abusive or coercive behavior of others, where adults are there to help the students pursue their own goals instead of forcing the students to pursue the adults’ goals. Most adults are horrified by such an arrangement and believe that students will never learn anything unless they are forced and coerced and punished into compliance. This is because our culture hates and disrespects children, and most of adult “mental illness” starts from the disrespect and mistreatment of children as they grow up.

    It is laughable in my view for schools to talk about improving students’ “mental health” when the reality is that schools do a huge amount of mental/emotional damage to our kids that many never recover from.

  • I agree with you. The idea that any one intervention will help in ALL cases of “depression” or “ADHD” or whatever label psychiatry wants to toss out is the central problem. There are real, physiological problems that can affect mood and behavior, and they ought to be identified and dealt with through testing and smart interventions. I only protest when someone suggests that ALL such issues can be handled by nutrition or any other specific intervention. Everyone is different, and how they feel is a very sketchy guide for intervention. Good research and exploration is the key to finding out what is actually needed, instead of assuming that someone feeling depressed or anxious is enough information to know what to do.

  • I can’t say that, and I didn’t say that. I’m saying that no doctor can tell you that your depressed moods and experiences are due to genetics, nor can they say in general (and this is more important) that depression is always or usually due to such genetics, because they don’t know that. They’d be lying to you if they claimed that they did. YOU can make your own observations and believe as you see fit, and I totally support your right to do that for your own situation. It’s when one person starts telling another what THEY should believe that things become dangerous, especially when the person (like a doctor) has a special societal role of translating what is known scientifically for lay people. For a doctor to claim that you or anyone else is suffering from a “genetic predisposition” to depression when they have no way to know if this is true or not is not only dishonest, it should be considered malpractice. Whereas your own assessment of your own situation harms no one and hopefully helps you get a better grasp on how to help yourself to move to a better place. That’s the big difference.

  • Hey, I have never said that I “rule out” biology! I’ve always agreed that there are real biological problems that cause problems with moods and behavior. (One such problem is the adverse effects of drugs one is taking, for instance). What I have said and continue to say is that the fact that one FEELS a certain way or ACTS a certain way does not say ANYTHING about why they feel or act that way, and to suggest that simply because someone feels depressed it means they have a problem with their brains is absolutely ridiculous. It’s very much like a person having a pain in their leg and being diagnosed with “leg pain disorder” and to “treat” it by giving drugs to dull the sensation of pain. There could be 50 reasons why a person’s leg is hurting. Let’s suppose they were hit by a car, or stung by a bee, or have a piece of shrapnel in their leg. Is the pain in the leg the problem? Or is it information that leads us to investigate what is going on?

    I don’t know why it seems to be so hard for you to see this distinction. No one is denying that physical conditions can cause changes in mood or behavior. What we’re objecting to is the idea that ALL changes in mood are behavior are ALL caused by physical conditions, especially when there is absolutely NO physiological finding to support such a ridiculous assertion.

    If you want to believe that you have a genetic condition, you’re welcome to believe that. But there is no scientific evidence showing that there is any genetic basis for depression, and assuming or implying that everyone else who is depressed has a genetic or biological problem is going to be viewed as a problem by most of the people who post here.

  • I actually do think that words define our reality. For instance, if a person is kidnapped and threatened with death, and as a result has moments of intense anxiety that this might happen again, do they have an “anxiety disorder?” Or are they responding pretty normally to a violent and terrifying experience?

    I’d say it matters a lot to the victim whether you tell them that their response is a normal reaction or a “disorder” that needs to be “treated.” Having worked with a lot of traumatized people in my career, I’d say that it makes a HUGE difference to have a person think of their reaction as an understandable response to a difficult or impossible situation. The more I was able to have the person understand why they reacted the way they did, the easier it was for them to recognize that the present moment was different and that perhaps a different response in the present is a possible option. Whereas telling someone that they “have a disorder” tells them they SHOULD have reacted differently to the situation and that the fact they are upset about it is a personal failing that needs to be fixed.

    Words do matter. A lot. Especially words about who you are and what your behavior and feelings mean.

  • Dang, these guys are really making things complex!

    What’s wrong with mind-body dualism, anyway? Why would that philosophical position be outdated? I’d say the majority of the world’s cultures see the spirit and the body as being separate entities that interact with each other. This viewpoint could also have explanatory value if it is not dismissed out of hand. Without knowing what “the mind” really is, how can it be considered “disproven”?

    What needs to change is demonstrated in the article – the masquerading of philosophy (such as ethics, epistemology, etc.) as scientific inquiry. Asserting materialistic philosophy as established “truth” does not do science any favors. It’s best to acknowledge when the unknown is unknown, instead of calling a viewpoint “outdated” because it isn’t currently fashionable.

  • This is true, of course. Medical care is the third leading cause of death in the USA. But I consider it even more egregious when the “conditions” being “treated” aren’t even objectively definable, and actually represent social assumptions and biases rather than medical conditions. It’s bad enough we have to trust doctors to treat actual illnesses. I sure don’t want them “treating” my emotions and thoughts!

  • Let’s get rid of the “mental health” language here!

    How about: “Survivors’ reality is badly messed with when people don’t believe them.”

    Or: “Survivors of sexual abuse find it invalidating, infuriating, and depressing when people pretend that what happened to them wasn’t real.”

    Or: “Denying the reality of sexual abuse survivors is another form of abuse.”

    It doesn’t “affect the mental health” of abuse survivors. It attacks them directly and undermines their safety and sense of reality, and it does so intentionally. It is normal to be pissed and confused and self-blaming after someone abuses you, and even more so when those entrusted to protect you protect your abusers instead.

  • How would we react if our doctor told us, “Well, I can’t say for certain what’s wrong, but we think you have a little tiredness disorder, plus a rashy skin disorder and an insomnia disorder plus a headache disorder and a right leg numbness disorder. We have a drug for each of those conditions, but it won’t cure them. It might keep the symptoms under control, but the drugs will make you gain weight and possibly raise your risk of early death through heart disease and/or diabetes. And we still don’t really know what’s causing all of this.”

    I think we’d all realize we were visiting a charlatan.