“Reduce the core symptoms” is code for “doesn’t make any difference in long-term outcomes.” In “ADHD”, “reducing the core symptoms” simply means making the person less fidgety and more willing to sit through dull or unmotivating exercises. Stimulants, of course, will do this for anyone who takes them. While this might be viewed as helpful for some who take the stimulants, the idea that this is somehow a “treatment” for a “disorder” is delusional.
There is some evidence that accidents may be reduced, but crime involvement is not reduced by stimulants according to my research. They CERTAINLY do not die 5 years earlier on the average!!!
I will no longer be approving any comments on this article. The topic has been well aired and the comments are repetitive and not moving forward as a conversation. Please don’t add any further comments to this thread!
I’m not sure where you got the idea I disagree with you. I used to be a therapist myself, and 99% of what I did was to have people describe their experiences and what those experiences mean to them. I’m simply disagreeing with you on the definition of “taking responsibility”. I don’t think you are understanding it the same way I am. The more we know about ourselves and our emotional history, the more we understand the REASONS for our “irrational behavior” (as others choose to see it, or as we choose to see it), the more we can take responsibility for deciding whether or not we are going to continue to react/respond in the same way we did before or try something new. Mostly we develop habits of thought and behavior based on what happened to us, and I saw counseling as primarily the opportunity to question whether or not those habits continued to serve us, and if not, find out what needs they are serving and find another, better way to meet those needs. So there is no blaming oneself for what happened – only responsibility for deciding how to act NOW and in the future.
That’s MY lived experience, both as a client and as a therapist. I don’t think I’m really disagreeing with you about much here. Let me know if that raises more questions/issues.
And no, I did not read the blog. I did read your comments. I’m speaking from my own direct experiences.
I’m with Bill on this one – taking responsibility means recognizing that one’s own behavior is a choice despite past traumatic events. It’s not the same as taking the blame, which is very damaging. One can take responsibility AND be aware of and process emotion, in fact, one almost HAS to be aware to really take full responsibility.
There are also group cultural insults that are traumatic, such as the generation of Jews whose parents were in concentration camps. There are also lots of ways that parents and other adults can hurt their kids without realizing they are doing so. School was a great example for me – daily torture, but no one seemed to notice or care, I kept having to go back every day for 13 years. There are lots of ways people get hurt and traumatized as children.
We know at least that the AI does not dislike or judge us for our name, gender, sex, race, beliefs, etc. AI doesn’t have a subconscious, as far as I can tell!
I remember a study where they let students log into an AI program, this was decades ago, and it was programmed to listen and ask pertinent open-ended questions. Students reported feeling better after talking to the AI!
I think it goes back to “male privilege,” the broad teaching that men deserve more than women and that women’s job is to keep men happy. We are taught this all the time in our media and other parts of society. It seems it’s women’s job to make sure everything works out for men, and when it doesn’t, women are to blame!
Sorry, I wasn’t suggesting YOU believe those things, I was just pointing out the failure of those arguments you alluded to made by others. I understand you are NOT a supporter of the DSM or the Medical Model. Sorry if there was some confusion there!
I mean this idea that telling people “it’s a chemical imbalance” is somehow good for clients, which you refer to in your comment. Many say, “people like their diagnoses” or “the biological explanation reduces stigma.” Very tiring arguments, indeed!
I agree. Blaming women for being unwilling to be your partner is childish and unproductive. Blaming feminism for women being unwilling to be your partner is childish, unproductive AND bigoted!
There are scientific studies showing that blaming a “chemical imbalance” or brain problem leads to LESS empathy for the “mentally ill.” People relate better and are more compassionate when their issues are framed as a result of trauma or difficult life circumstances. This is science, not my opinion. I’d also suggest that lying to patients for some social reason is not the doctor’s job. You should not try and alter attitudes by lying about the science behind a “disorder.”
I think the author would be wise to avoid the word “incel.” It has taken on some other connotations than an inability to engage in sexual activities, and is associated with misogyny and violence.
I’m amazed anyone gets away with making that argument. They systematically RULE OUT suicidal people before doing these studies. Anyone who is suicidal during the study period became that way AFTER starting the study. If more on antidepressants are suicidal, it’s caused by antidepressants. That’s what double blind studies are for!
Which suggests we should be looking at nutritional/macronutritional solutions, which should help SOME people, but certainly not ALL people. Depression is a VERY complicated experience that is generally more than just physiology, at least in many, many cases.
No, I didn’t miss that part. I’m pointing out that if 55% of females have lipid abnormalities, it means 45% of them do not and are yet still depressed. Depression has multiple causes, and to try and establish ONE cause, biological or otherwise, is a fool’s errands. It’s like trying to say, “What causes a rash?” A LOT of things can cause a rash, and they require different responses. Treating all rashes with one treatment will never work. Same with depression. There will never be one “treatment” because there is never one cause. If addressing lipid abnormalities helps a good percentage, that’s wonderful, but don’t expect it to work for everyone.
1) What do you mean “a real illness like any other?” How do you define “illness?”
2) If you are “ill” both on and off “meds,” and experienced “no success,” why are you so sure that “without meds patients are worse off?”
3) Is it possible in your mind for some people to be better “on meds” and others to be better “off meds?”
You hit the nail on the head. Unfortunately, there is ABSOLUTELY NO WAY to distinguish “real ADHD” from any of these other conditions or no condition at all, and the DSM itself admits this quite bluntly in its introduction. That you feel you BENEFITTED from stimulants is not a reflection that you have “real ADHD,” it’s a reflection that stimulants work for YOU personally. While I never want to take this away from you, it’s a very large leap from saying that “stimulants makes it so I can complete tasks, etc.” and “I have a diagnosable neurological condition that is objectively distinguishable from normal or other such conditions in me and any other person.” Unless you can reflect an objective way to do that, all you’re really saying is that stimulants have worked well for you. And more power to you for that. Just don’t assume others who act or feel similarly will have the same results, because experience and science says that most kids who take stimulants do no better in the long run than those that don’t.
“They work for me” is about all we can say for sure.
Remember when tey say that these receptors were “chronically decreased,” they are talking about AVERAGES. I am sure you will find many who are suicidal that do not have this condition, and many who have it who never become suicidal. If there were a way to isolate this SUBGROUP of people who happen to have this issue AND are “depressed”, by all means, we should do so, but to suggest that ALL cases of suicidal ideation or action are attributable to this is not even vaguely supported by the data presented.
A) Szaz was not a Scientologist. He just worked with them.
B) If he is, why does that matter to you, Marcus? Why not judge a person by their evidence rather than bringing in irrelevant points like religion? A person’s argument for or against abortion, for instance, should be considered independently of whether they are Catholic, don’t you think?
With all due respect, there is not one single “mental disorder” that has a recognized “underlying brain pathology.” You should read Anatomy of an Epidemic so you will better understand why people feel they have been fooled. And people are STILL deemed “abnormal” for any negative or strong emotion they may experience. I don’t see the current system as any improvement from the viewpoint of pathologization. They are still calling you “crazy” but now have broken it down into brands of “crazy.”
There is also now evidence that making the BRAIN the focus of the “disorder” actually increases stigma and decreases empathy for the so-called “mentally ill.” Especially when you consider that the DSM “disorders” are all entirely invented in committees and have no scientific basis in brain pathology, they can keep their labels and stuff them someplace dark and stinky!
It is true that antipsychotics can be useful in the short run to help people get under control. I’m just saying that calling it a “treatment” is a lot like saying morphine is a “treatment” for a broken bone. Might make you feel better and be helpful, but it’s not going to help to simply prescribe morphine without finding out what’s really going on.
I can’t consider electrocuting someone into a seizure a “treatment,” last resort or not. And who gave the doctors the right to “see fit” when electrocuting someone is “therapeutic?”
Actually, that’s NOT the question, with all due respect. It makes the assumption that A. these drugs are “medicines” for “diseases,” and B. that it’s always better to do something than nothing. If doing something wastes money and has no positive benefit, we are better off doing nothing than pretending we are “treating” a “disease” that we clearly do not understand!
You are so right! The “Depression” can’t “resist treatment.” It just means their treatment didn’t work or made things worse. No other profession gets this kind of latitude! What if your mechanic said that you had “repair-resistant fuel injectors?” Would you bring your car back for another “treatment?” No, you’d know it did not work and your car was better off in the care of someone who knows what the f*&k they’re doing!
“Subconscious” is not synonymous with “unintentional.” It just means you’re not willing to acknowledge those intentions. Most “professionals” ARE covering up intentionally, even if it is not something they are consciously aware of doing. Any time someone gets defensive when presented with contrary evidence, they are intending to cover up.
Exactly! As long as the status quo is an easy way to financial success, as long as big corporations are making buckets of money, any “reform” will be considered threatening to those piggies with their snoots in the trough. Stop feeding the piggies and you may have a chance at real change. We need to stop rewarding failure with more money!
I am sorry if I misinterpreted your comments. I have seen OD trainings and participated in one myself. It seems like a great approach. I’m also not opposed to the availability of drugs to assist anyone who finds them helpful. My point would be more that Dr. Jureidini should not expect to be congratulated for his success. As has been clearly demonstrated with many examples, successful healing of patients is threatening to the status quo, and anyone who is successful can expect to be attacked as a quack, a religious nut, or an irrationally hostile force. Initial reactions to Bob’s book are more proof. No one can really undermine his basic premises, yet he’s seen as a kook or an antipsychiatry nut or a “Scientologist,” as if any of those are scientific analyses of his work. And such tactics are generally successful, and will be until the public catches on that the mainstream of psychiatry does NOT have our best interests at heart.
David didn’t “reform” Goliath and convince him not to attack. He beat him physically and defeated him. Peer workers are a great option, but they need to understand that their efforts will be OPPOSED by the mainstream system, and that system must be DEFEATED in terms of losing its power before any peer “reforms” can become mainstream and the label-and-drug model dies a well-deserved death.
That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!
Hey, that’s what ECT is all about – inducing seizures! Why could a spontaneous seizure not cause improvement? Of course, both cause brain damage, at least potentially, but if the docs are INDUCING seizures, I suppose brain damage is potentially therapeutic!
I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.
I LOVE the “Stop it!” skit! But you are right. The problem is opposing goals. The peer movement’s intentions were contrary to those of the main MH system, and so they had to be coopted or snuffed out. And the MH system was very effective in doing so. You can’t change the basic purpose of the MH system. It’s built in.
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Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.
Mark, you have not contacted me by email or responded to my emails. I’m not sure you even received them at this point. I will no longer be able to post your comments until you contact me and we can have a conversation. Again, my email is [email protected] or [email protected]. It’s also listed in the “About” section of your home screen. Meanwhile, all of your posts will simply stay as “pending” until I hear from you. I’m not sure what else to do to get a response from you.
So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.
POSTING AS MODERATOR: I honestly don’t have any idea how to unsubscribe you. Perhaps one of our tech staff can help? You can find them in the “About” section under “Staff.”
Motivational Interviewing has a lot of useful techniques and is or should be very much client directed. The coach or “therapist” finds out what motivates the CLIENT from their own viewpoint and then helps examine which current behavior gets them closer to that goal FROM THE CLIENT’S POINT OF VIEW.
How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”
And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!
Mark, I am giving you until the end of today to respond to my emails or give me a working email address. If this does not occur, I will be forced to remove your right to post here, as having a working email is part of the posting guidelines.
Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?
You do realize that many women are unable to establish positive sexual relationships as well, don’t you? I would love to see you address this issue as part of your presentation.
Posting as moderator: MARK, PLEASE CHECK YOUR EMAIL. I have sent several messages. If you are unable/unwilling to respond to emails, you are not allowed to post at MIA. Please write me back so we can discuss your prior posts. It’s not OK to keep saying you are waiting for them to be posted when I’ve told you my concerns and you have failed to respond.
Please write me back or I will have to stop posting your comments. If that email doesn’t work, please get me one that does ASAP.
Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.
You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.
Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.
They should not be “involved,” they should be the central architects of any such effort. Who knows better than those with “lived experience” what actually does and does not help???
Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
When advocating for foster youth for 20 years, I saw many who became aggressive on stimulants and were then re-diagnosed with “bipolar disorder” instead of stopping the stimulants. It was extremely common but very hard to get anyone to discuss seriously, even though a good number of the psychiatrists I worked with admitted it occurred.
Something is seriously wrong with a system in which we can talk about “”moving toward shared ownership and dialog.” What kind of help can be going on where shared ownership and dialog is not already THE central concept we are operating on? How can a therapist know what is helpful if they aren’t having shared dialog with their client????
How can you say it “works for everyone” when so many people report no benefits or harm from DBT? I see a bunch of useful skills which could be helpful in the hands of a competent therapist but how many therapists are that competent? And why can’t others not trained in DBT employ or teach the same skills? Mindfulness, for example, is swiped from Buddhism, and there are many who understand mindfulness well who have zero connection with DBT. There are plenty of other examples.
The research I’m familiar with suggests that it is not “ineffective methods” but rather lack of emotional preparation and appropriateness that undermines success. Therapy success appears to be associated more with therapist characteristics than by method or school of therapy employed.
I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
Again, please remember that NNT and other stats are based on the assumption that symptom reduction is the goal. This is a false outcome, as symptom reduction does not translate automatically into better outcomes.
It is not the job of others to demonstrate that Ritalin’s benefits do not outweigh the risks overall, it’s the job of those promoting the “treatment” that they do by a significant margin. If there is no major improvement in outcomes, then by definition, the treatment risk outweighs the benefit, unless you are claiming absolute zero risk. Even in the latter case, you’re still advocating for wasting money on something that doesn’t really work.
The burden of proof is on those claiming a treatment effect.
There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.
I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.
BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.
These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.
I think you nailed it here! It’s not that I object to anyone “identifying” with a particular “diagnosis” as an identity. It’s the effect of legitimizing these “disorders” as valid entities rather than social constructions that some people like to use as “explanations” for their uniqueness. The idea that diversity is “neuro,” aka CAUSED by neurological differences, plays completely into the hands of those who want to blame the brain for everything wrong with human beings’ behavior while letting our social structures off the hook. I know that a lot of people WITHIN these movements don’t believe that, but those running the show don’t care, they are still getting support for their label-and-drug approach that’s keeping them rich and protecting those in charge from having to examine the society they are creating and promoting.
How about “unconventional?” Or “unique communicators?” I think it is the idea that neurology and only neurology creates and defines these differences, along with the idea that “neurotypicals” can somehow be defined and dismissed as “normal,” that causes offense.
I can’t agree with that definition. Stigma implies an unfair negative bias based on a label or category. Prejudice implies specific actions taken as a result of believing in the superiority of one group over another. Discrimination is specific acts to harm someone in a category against which one is prejudiced. There are frequently no legal consequences to prejudice and discrimination, and in fact, they are often rewarded. I remember in 6th grade or so standing up for a kid labeled as “mentally retarded.” He was being harassed, so most definitely acts of prejudice. I’m sure he was also not included in people’s social groups, which is a form of discrimination. You know who got punished when I stood up for him? ME! I was “accused” of being a “retard lover” or some such thing. This went far beyond “stigma.” Where are the legal consequences for such acts?
It is a technique, not a “therapy.” The drive to create a manualized “therapy” is very strong, as it emphasizes making long-term clients and avoiding insight-driven healing. But no one can do therapy based on one technique or a manualized set of techniques that avoid connection with the client. CBT is only useful in the context of a larger “therapeutic relationship” where there is trust and sharing and humility between “patient” and “therapist.” This situation rarely happens, so most experience CBT as rather disconnected and intellectualized, and invalidative of the legitimacy of their actual issues and needs.
I was referring to calling other people “autistics” not claiming that label for yourself. Generalization is the problem.
Why not simply point out that some people are prone to violence and need to be dealt with for the safety of society? No one would argue with that premise. But the idea that “medication” is the best answer or is consistently effective is not supported by the number of “medicated” kids who remain violent, or even become violent on the drugs. I’ve worked in the foster system and kids mental health so I know what I am saying.
I see the thought behind your questions. However, by referring to a group of people as “Autistics,” you are making demeaning generalizations as if a person getting this label is somehow described and defined by it. This is a large part of why folks here object to the DSM mentality – labels such as “autistics” are inherently dehumanizing and don’t allow for discussion of either causes or options.
Are you aware that many of these kids your mom worked with, probably 90% or more, are already “medicated?” And yet are still violent?
Things are not as simple as you attempt to portray. Have you read “Anatomy of an Epidemic?” I am betting the answer is “no.” Maybe you should read the book and you will start to understand why people get upset about what you seem to accept as reality.
It sounds like they are training sociopathic traits into people!
The only thing that made me effective as a therapist was my willingness to let down my barriers and feel what the client/”helpee” was feeling. That is completely what guided how I would intervene. If a person can’t do that and still “maintain boundaries,” they have no business trying to help anyone emotionally. They need to get their own help first!
I respect your views on this. But I can tell you from past experience that this line of discussion is not productive and travels far from the realm of the “mental health” system. You will have to respect my judgement on this one. I am speaking from hard experience attempting to moderate such a discussion. So I’m not going to defend my decision. It’s already been made many months ago.
I don’t disagree with you. But COVID is off topic and has not led to productive conversations as a topic. You actually posted the first one on the topic and I should have disallowed it. Some of the more far-fetched comments that DO have to do with psychiatry are allowable as long as they are on topic and not insulting to individuals or groups. I don’t judge by the content except to the degree that it is not on the topic at hand, and I even let a lot of THAT go if it’s productive conversation. But COVID is not a topic that is either on topic or leads to productive exchanges, so that’s why it has been stopped.
POSTING AS MODERATOR: We are not going to go down the COVID path again here. It leads nowhere but to off-topic arguments. Both sides got one “hit” in. That is all I will allow.
Please write me at [email protected] with Amy such concerns. It can take up to a day for something to post, but things do inexplicably disappear from time to time. I don’t recall moderating any of your posts.
The problem is, the assumption that all of these “disorders,” created by committees and literally voted on, are “brain disorders.” There is not one of these “disorders” which is proven to be caused entirely or primarily by biological causes, let alone a single cause for a single “disorder.” The most optimistic data suggests a 10% biological contribution, while environmental causes account for 80% or more of “mental illness.” So be careful not to simply repeat beliefs you have heard. Read Robert Whitaker’s books and then take another look.
Oh, I agree absolutely! ANY potential causal agent with REAL evidence should be explored. Even if only 10% of sufferers have low folate, we can heal 10% of the population with a simple, cheap and safe intervention! We just have to stop expecting that EVERYONE will get better if their folate and betaine are increased. Let’s find the real cause in each case instead of assuming one solution will fix everything.
Just for the record, John Nash recovered without or despite his psychiatric “help,” and spent many years avoiding the psych system before his spontaneous recovery. The movie played it differently because they didn’t want to discourage current patients from using their “meds.” Nash complained about this to the producers but was not listened to.
Good information, but it clearly suggests that “schizophrenia” is not caused by a particular genotype, but is a very complex phenomenon that includes many possible causal factors.
You are denying reality. The point of the articles is that the Star-D has falsified outcomes. If you choose not to believe that (belief is not science) that is up to you, but don’t try to claim that later science is responsible for updating fraud. When the authors have been confronted with their false conclusions they have doubled down, not reconsidered. It was a handy conclusion that people like you want to believe, so they believe it.
Did you read about the Star-D study? It wasn’t wrong or incomplete data. They ALTERED the outcomes. They LIED about the results. That’s different from being overridden by new and more accurate data. Do you just not want to accept that fact?
The fact that there is newer research has no bearing on the clear attempt to falsify the data in the study. Doesn’t that concern you? That the studies aren’t reporting the truth?
I don’t think he’s trying to prove his points are not opinions. He’s trying to show that the entire subject is based on opinion. I don’t think he is in a position or needs to do so. I think it’s OK to identify however you like, and it’s OK for him or you to have an opinion about it. It’s just not science.
You are sharing the “general consensus” that we’ve all been taught to believe. I suggest you read some of these stories from real people who totally believed what you say and had not so great or horrible experiences.
I’m puzzled also hoe “the right medications” are going to help with anything but #1. And of course, research has never really shown “chemical imbalances” to be real, measurable things. So you actually make a great argument that medication is at best a very small part of any treatment approach, yet you seem to be arguing it’s the whole thing.
“Depression” is not caused by one thing. That’s the first error of psychiatry – lumping all “depressed” or “manic” people together as if their behavior or emotions tell us what is wrong with them or what they need. Saying someone “has depression” tells us very little about why or what to do about it. “Treating” something makes no sense if that “thing” isn’t really a thing at all, but a phenomenon with many possible causes and solutions.
It is not about Clozapine per se. It’s about doctors playing fast and loose with the facts and the system being based on incorrect assumptions and guidance. I’d say it’s one more example of how patients are assured that doctors have all the know-how to use these drugs responsibly when they really do not, no matter how responsible they are. By the way, I consider it a pretty cheap shot to toss out that doctors have to be “lazy and negligent” to make Clozapine use a risk not worth the benefits. There are very good reasons it fell into disuse, as you very well know, and they had nothing to do with negligence.
If I can’t discuss concerns about a comment or thread, then I can’t work with you. It’s part of the rules of posting. Otherwise, you can post whatever you want and I have nothing I can do except not publish your posts. Obviously, I have a concern to discuss. If you can’t do it, I’m sorry, but that means you won’t be allowed to post.
I need to talk to you but your email does not function, in fact, appears to be a fake email. I will have to block your submissions until you post with a functioning email address. It is a requirement under the posting guidelines.
Depression is about a lot of things. The first mistake of psychiatry is assuming that depression or anxiety or any emotional phenomenon is always caused by the same thing.
15% certainly does not suggest CAUSALITY. It suggests vulnerability of certain genetic subgroups, who may have many other things in common, not a ‘schizophrenia gene.’ Causality figures would need to be in the 85-90% range. 15% says that at least 85% is NOT caused by genetics. So genetics is a secondary factor.
Abilify is an antipsychotic, most definitely prescribed frequently for “bipolar disorder.” It is only used as an adjunct for depression if regular “antidepressants” are judged not to work. Not sure where you’re getting this false information.
The “low serotinin” theory of depression has long since been debunked. Additionally antidepressants are notoriously ineffective with youth and especially children. You are operating on faulty assumptions and criticizing others for not sharing them with you. Try reading some of the stories before you judge.
You say a lot of things here you have repeated because you heard them somewhere, but most of the people on this site have a lot of direct experience with the system themselves and understand it’s not so simple. Clearly, Brittney’s life didn’t suddenly get all better when she got treatment, did it? Additionally, the issue of the guardianship was fraught with all kinds of conflicts of interest and personal agendas above and beyond any “mental health” concerns. You might want to read Anatomy of an Epidemic and get an idea why people have concerns about the “mental health” system instead of assuming everything you’ve heard is automatically true and people who don’t agree are irresponsible or ignorant.
POSTING AS MODERATOR: We are drifting over into areas of politics that transcend “mental illness,” largely because of the nature of this article. But we need to keep focused on the “mental health” themes and whether “mental illness” focus obscures structural violence. There are many other contexts besides Gaza to draw on.
The use of the term “resistance” these days doesn’t mean the same as Freud’s concept. It just means “didn’t get better with our ‘treatment.'” It’s basically a way to blame the client for the failure of the “treatment.” That’s how I read it.
Electrocuting someone into a grand mal seizure sounds like malpractice to me. How can you “do it incorrectly?” What the heck is the correct way to induce a seizure that might potentially cause brain damage?
Whether or not someone receives treatment is not an “outcome.” An outcome is a result of the treatment approach. The study does not state or claim or suggest or imply that no one has a good outcome using antipsychotic drugs. It suggests that ON THE AVERAGE, those who receive light or no intervention are more likely to have a better outcome at two years onward. A better outcome ON THE AVERAGE. There can be plenty who got a better outcome with drugs or a worse one with drugs as well. Your story is one story of millions. Yours can be 100% true and yet the average person can still be worse off in the long run on antipsychotics. You are one data point. A scientific study is made up of hundreds or thousands of data points. It’s not the same.
Most of these people have HAD ECT themselves or know someone who does. Many also know the ECT research literature better than the average clinician.
It’s insulting to suggest that anyone here is making up their minds on fictional accounts. I’m glad you had a positive experience to report, but don’t assume others experienced the same or similar things!
Traumatizing experiences are also normalized and kids are expected to not complain about it. How many kids say things like, “Oh, that’s not abuse, I totally had it coming!”
Gotta love it. THEIR “treatment” doesn’t work, but it’s because YOU are resistant. Or your “schizophrenia” is. Apparently resists without consulting you. Insanity!!!!
Please explain how any one DSM “diagnosis” is derived from scientific observation and research. Specifically, please describe how exactly one can distinguish who “has” the “disorder” from who does not ‘have it.’
This is not to say that people don’t like or benefit from biological interventions. But that’s nothing new – folks have taken substances to alter their mental/spiritual reality since the beginning of human history. That’s very, very different from claiming that something as vague and amorphous and subjective as “major depressive disorder” or “adjustment disorder” or “ADHD” is derived from the scientific method. In fact, the DSM admits they are not in its introduction, in no uncertain terms. You ought to read it some time.
The fact that you feel you can “diagnose” that based on an internet comment proves how completely subjective and unscientific these “diagnoses” really are.
Your comments reflect not having read the many testimonies of people here who were diagnosed with “major depression” or “bipolar disorder” or even “schizophrenia” and were treated with drugs for years or decades with really poor outcomes, including a significant number who did far better after they came off the drugs and did other things.
There are most definitely big medication success stories. There are also disaster stories. Same drugs, same “diagnoses,” very different outcomes. If you really want to understand a site like this, that has to be your starting point. You can’t decide people are ignorant simply because they had different experiences than you. Maybe you should stop and read some of the stories before you assume that no one here has suffered any “mental illnesses” just because they had very different outcomes than you expected to hear?
Confirmation bias is generally rooted in anecdotal evidence, aka testimonies of those helped/not helped by an intervention. Citing testimonies as proof of confirmation bias seems a bit ironic.
Here are the references I quoted. Barkley and Cunningham 1978. Swanson et al 2003. Oregon Medication Effectiveness Study 2002. Montreal ADHD Study. Raine study from Australia. Finnish comparison study to USA cohort. Not to mention Whitaker himself, who summarizes the extant literature.
How are these not citations of clinical studies? Barkley in particular is a super pro-ADHD researcher. It seems you didn’t read my earlier posts yourself. My comments are firmly rooted in years of long-term research, which you’d know if you’d bothered to read Whitaker’s work before deciding you already know all about the subject. It’s not too late to educate yourself, but I get tired of repeating the same lessons for folks who don’t seem interested in seeing another viewpoint.
And the author mentioned his “clinical experience” including a specific case, as I recall, which is 100% anecdotal. I am very clear what anecdotal evidence looks like.
I think it would be nice if you would learn to respond without putting down the person you are disagreeing with.
Is it an illness if the responses are reasonable and understandable to the conditions bringing them about? Why aren’t the people COMMITTING the traumatic acts against their loved ones or employees or patients considered the ones who have an “illness?”
ADHD being “more recognized” would in no way make it more likely that people taking stimulants being more likely to develop heart problems. It’s not a new suggestion. Probably not a common event but it sounds like more common if you take stimulants. Knowing what we know about stimulants, the increased risk of heart disease associated with them should not be surprising.
None of the studies I referred to were funded by pharmaceutical companies. Government studies, especially when longitudinal, are generally more reliable.
The average “seriously mentally ill” person, most of whom have received years of drug “treatment”, die 15-20 years younger than the general population. There are, of course, multiple reasons, but psychiatric drugs and ECT are high on the list.
The antipsychotics are known to induce diabetes and other metabolic issues, and to increase heart disease. If you think inducing diabetes doesn’t kill people, you are confused.
Anecdotes are not scientific evidence except in the crudest sense. I’m not saying the drugs have no effects or that “ADHD” is trivial or that people so diagnosed don’t do worse than the general population in a number of significant ways. I’m saying that, for instance, the claim that “untreated ADHD leads to delinquency” is false, because “treated” ADHD kid aren’t less likely to become delinquent. BOTH groups are more likely to commit criminal acts, though interestingly, I recall reading a study where those identified early on as non-aggressive “ADHD” types did not commit more criminal acts later. But it makes sense, impulsive people are more likely to do impulsive things, and committing crimes is often impulsive. The point is, IN THE COLLECTIVE, we do not reduce the delinquency rates by “medicating” the subjects. This does not mean a particular individual wouldn’t, say, feel better about school, improve their grades, or even say, “This stuff saved my life!” But those are anecdotes. Scientifically, we have to look at the overall effect, and overall, the effect of widespread stimulant use on the population is not large, if we look at the data rather than stories.
I would submit to you that there are plenty of people whom you don’t know whose situations might have gotten worse to the same degree your client base got better. I don’t know what kind of selection bias you have in your population, but I worked with foster youth and saw plenty whose lives deteriorated after starting stimulants, particularly due to aggression toward others. Many ended up with more drugs and worse “diagnoses,” one ended up psychotic until she herself stopped the drugs and went back to her old “normal.” So anecdotes can tell many stories. Collective data is more reliable.
Multiple long-term studies show no significant advantages to those taking stimulants vs. those who don’t when diagnosed with “ADHD” in childhood, other than the accidents you mention, and I believe clearly overstate in your comments. Delinquency rates, HS graduation, college enrollment, social skills, not even self-esteem scores were better for those taking stimulants. This has been confirmed since Barkley and Cunningham’s first review in 1978, confirmed by Swanson’s “Review of Reviews” in 1993, and in the OSU medication effectiveness study back in 2002 or so. Also confirmed by the Raine study in Australia, the Quebec study, a comparison study between Finnish and US kids who had very different medication rates but similar outcomes, and more.
Read Whitaker’s works if you want to fully understand what’s going on at MIA. Not everything is the way the professionals have told you it is.
It’s not really a legitimate approach to say, “What else should they have done?” It assumes that doing SOMETHING is essential and that NOT doing what they propose is foolish unless you have something “better” to replace it. It is possible that antidepressants were destructive AND there was not a “better treatment” available. We should not assume “antidepressants” as some sort of minimum standard of treatment that is the default unless we have something “better” to propose. Sometimes nothing is better than doing things that are destructive.
If it were so safe, they would not have to do toxicity tests every two weeks. Lithium can do serious kidney damage among other things. It’s therapeutic dose is as close to the toxic dose as almost any other drug you can name.
I think you are missing the larger point, Donna. You say our “knowledge” of these things is in its infancy. But the “diagnoses” themselves are not explanatory of anything, regardless of the education and experience of the person involved. How is saying, “Joe feels really hopeless and sees no point in his life” any different than saying “Joe has major depression?” Is there some way to distinguish Joe’s “Major Depression” from Mary’s “Anxiety disorder with depressive features?” They are simply descriptions of what is observed, and clinicians will make a lot of noise about “clinical depression” vs. “reactive depression” but look in the DSM, there is simply NOTHING there to make a distinction. You meet 5 out of 8 criteria, you “have major depression.” Only meet 4, you don’t. Nothing about cause, nothing about ongoing stressors, nothing about culture – just a description. That’s not a “knowledge in its infancy.” That’s just making stuff up, plain and simple. There is no way any “knowledge” can advance from that kind of basis. The DSM is not knowledge. It’s a fantasy that makes people believe “knowledge” is behind it.
Not sure what the answer is, but calling people names based on arbitrary checklists isn’t it.
I really don’t want to get into debating COVID or the WHO response. It is off topic (not about the article or about the “mental health” system) and has become highly divisive. We’ve now heard both sides well expounded. Let’s get back to our mission!
Science is not created by consensus, and does not have any consideration for a “middle ground.” Are we going to start saying that gravity is inconvenient for some people, so we’re entertaining some small modifications to help people adapt?????
The hummingbird house was a new experiment at the time with an open environment rather than cages. It felt like they were pretty good with the environment or it would not have felt good to be there. I felt like I was in their world.
I used to go to the hummingbird house at the Philadelphia Zoo during the week when nobody was there. I would sit for 10 minutes making no noise, and soon I was surrounded by birds doing their thing. It was very soothing, and I didn’t need someone to tell me it “worked!”
We know this. He can’t answer my challenge and will probably ignore my response. Otherwise, he’ll say it’s “well known” and present no evidence or else attack my credibility. That’s how it seems to be done.
Easy to say that. Please provide us with the definitive proof of shared biological pathology for all forms of “schizophrenia.” Not correlations, not candidate genes – let’s hear the exact “pathology”(to use your own words) that distinguishes these conditions. I will assume failure to answer means you have no answer.
I know, it’s like when they “discover” that hiking in the woods makes people feel calmer, and instead of saying, “hey, try hiking!” they decide to call it “Nature Therapy!”
For the record, I can’t find any moderated posts from you. Next time, I’d ask that you email me and check before publishing the assumption you’ve been moderated. I almost always leave a note.
Superstition comes into play in all forms of medical treatment. Placebo effect is acknowledged to deliver half the benefits of any treatment. Drugs become less effective the longer they’re around because people start to hear issues and concerns that were not talked about before. What people believe has a lot to do with what works.
You sound very committed to the idea that “there is only one reality” that is unaffected by any of our personal narratives. Can you submit some scientific studies that prove your contention to be true? Or is it simply a matter of faith, based on… your personal narrative?
I think the real lesson is: Kids are not all nails, even if you only have a hammer. Use the hammer when the job calls for it, otherwise, quit hammering our kids!
The fact that you worked through it yourself and found out what worked and did not work for you has to be a big plus for you. Additionally, I hope you learned that not everyone responds to the same things and that a therapist has to be creative and responsive to the individual needs of their client. It’s been proven again and again that these therapist characteristics are far more important than the modality used, in fact, in many studies the modality was not a contributing factor to positive outcomes.
Bottom line, it seems you learned empathy for your clients and haven’t forgotten that lesson.
Yeah, it’s sort of rude when patients don’t comply with the doctors’ preexisting biases and expectations, isn’t it? Maybe the doctors just need to work on robots, then you get almost total predictability!
Individuals don’t need to prove the effectiveness of anything they sense is working for them. It is those claiming someone ELSE will benefit from an intervention they are offering/forcing on that person who need to show the proof.
I think it showed that administering group DBT training doesn’t lead to improved outcomes. If I’m a school administrator, that should be enough for me to think, “Well, we’ve got only so much time in the day, why waste time on something that doesn’t have a significantly positive effect?” An intervention doesn’t have to be proven harmful to be avoided. It just needs to be shown not to be significantly helpful.
These “differences” are AVERAGES – They can never be used to determine if person A “has schizophrenia” or person B does not. There are tons of “schizophrenic”-diagnosed people who do NOT have frontal cortex atrophy. It’s also well known that frontal cortex atrophy and other brain shrinkage can be caused by the antipsychotics themselves. PET and f-MRI studies are absolutely useless in “diagnosis.” And of course, this must be the case, because there is no reason to believe any 5 people with the same “diagnosis” have the same kind of problem or need the same kind of help.
I would add that psych ward staff also need to learn and practice these things. Some do this well, but some don’t. The real problem is POWER. The people with power are telling the kids how to “manage their emotions” and whatnot, but they are still free to be as abusive, neglectful, and thoughtless as they wish and suffer no consequences. Whether its parents, teachers, staff, doctors, pastoral leaders, or even just adults who are comfortable exercising power over those they feel are beneath them, as long as the person in the one-up power position is unwilling to step down, no amount of “emotional management” will make things any better.
I would add that the teachers need to learn and practice any skills they want the kids to have.
I had a neighbor kid who was in middle school. He explained to me they spent a one-hour assembly working on Carl Rogers’ reflective listening skills, including “I statements.”
He was sitting on the stage after the session and a teacher came up and said, “You, get off the stage!” in a very loud and aggressive manner. He said, “I don’t like it when you yell at me. I’d prefer we speak in calmer tones.”
He got sent to the Principal’s office immediately. What was the real lesson here?
I would add that being told over and over that their emotional struggles are a “mental disorder” has contributed to younger peoples’ lack of ability to cope. Used to be parents, teachers, and the kids themselves got the message, “Hey, you’re good at x, but not so great at y. Let’s work on your Y skills.” No excuses, you just were how you were and everyone dealt with it, admittedly poorly much of the time, but at least the message was, “Don’t feel sorry for yourself – you can figure this out.
I also remember the crazed maniacs who sometimes passed for school teachers back in my day. I’d hardly say the school environment has gotten more stressful!
When I was a counselor and sometimes had to do these “diagnoses,” I viewed them the same way, and told my clients as much. I said they’re just descriptions of behavior/emotion/thoughts that are used to bill insurance companies. I told them I’d select the one most likely to get them the kind of help they needed. I always favored PTSD or Adjustment Disorder because they would incline toward talking solutions rather than drugs.
Unfortunately, there are an unfortunately large number of terrible or mediocre counselors. I don’t think they “need to keep you sick” as much as not really understand what “better” means to the client and how to get there.
Are you saying anything is better than telling someone they have an incurable brain disease and there’s nothing they can do about it except hope that the doctors have a magic pill that never seems to develop?
A sensitive 8 year old can do better than a standard psychiatric intervention. On the average, listening to someone is going to help, but who needs to be a therapist to listen? And what guarantee is there that a therapist can and will listen anyway?
It is also possible that some are NOT there to make you feel better.
On the other hand, the bartender and the heroin peddle are there to make you feel better, too.
Making someone “feel better” is generally only effective as a short-term objective. People who set their long-term goals at “making myself feel better” generally don’t have very livable lives.
That does seem to be the message. At least from the incompetents. Just “think different thoughts” and your emotions will change! A bit of magical thinking, there. I mean, in the LONG RUN, it’s probably true, but to make out that a person can just “change thoughts” on command, especially after years of trauma or living in current danger, chronic or acute, is patently ridiculous. There’s a lot of trust building and examining patterns and detecting the purpose of certain behavior/thinking from the client’s viewpoint and a lot of “what ifs” and “Let’s imagines” before anyone gets around to saying something as monumental as “I’ve changed my viewpoint. I don’t need my mother’s constant involvement to survive.” People believe what they believe for a reason. It doesn’t work for a therapist to say, “That’s a bad belief, you need to change it!”
Hard to argue with you there. There are probably a few rare exceptions here and there, most of whom will probably quit early or be driven out by their colleagues.
Nobody is saying the medications are not valid. We’re saying PSYCHIATRY is not valid! The idea of taking a substance to make yourself feel better is as ancient as human history, maybe even older. It’s not an amazing 21st century discovery of the psychiatric profession. The biggest problem is these damned DIAGNOSES, which have no scientific reality but are used to promote certain products and discourage people from exploring their own solutions.
If the drugs work for you, more power to you! This website is not about that. It’s about bringing some kind of sanity back to the world of “mental health treatment,” including stopping psychiatrists from involuntarily forcing people to take these drugs when they do NOT work for the recipient!
CBT as practiced by many often does encourage clients to ignore or minimize or intellectualize social causes of distress. I find it useful in certain contexts, but see it as a tool, not a therapeutic school. It works fantastic for some people in some situations (I use it all the time myself), but there are times when “empowering oneself” has to take a back seat to taking an honest look at what’s going on or has happened in the past. For instance, a domestic abuse victim might learn to “think different thoughts” so they find their abuser’s comments less upsetting. This might be a useful skill, but it does not BEGIN to address the needs of the client. If all we gave our DV victims was CBT, we’d be doing them a gross disservice. Same with folks with big tramua histories. Telling them to “think different thoughts” is a short step from “get over it, you wimp!” And lest you think I’m exaggerating or making this up, several people have reported on MIA that they are told by their therapists that they should “not think of the past” and that processing historical emotions is a waste of time and they need to “Be mindful” and “focus on the present.”
A good therapist can use CBT to get good results when it is appropriate. A bad therapist can use CBT to create an emotionally unsafe environment for their clients and effectively make their “mental health” status worse.
I certainly have no intention of attacking psychiatrists. But you are saying things that are said by psychiatrists but not scientifically accurate. Antipsychotic drugs HAVE been shown to do brain damage, including reduction in grey matter volume, altering the size of the Corpus Collosum, and inducing neurological problems like Parkinsonism and Tardive Dyskinesia. No psychiatrist worth talking to will deny these things are known facts. There are now ads on TV to fight off TD, which is directly stated in the ads to be caused by their “mental health meds.” The idea that antipsychotics offer some protection from brain damage caused by schizophrenia or other “mental illnesses” is a nice concept, but again, I know of no evidence that this is actually true. Can you attach a link to a study or two to show where you’re getting this information?
It is hard sometimes for people who have used the MH system and feel they have benefitted from it to hear from others who feel it has harmed them. I don’t think anyone here wants to upset you about this stuff, but they’re mostly just telling their stories, and I believe they have a right to do that, even if these stories don’t jibe with what you’ve read or heard or been told. And if it causes others to be a little more careful how they engage with the system, I think that’s all to the good. An informed patient has the best outcomes, but our practitioners mostly have conflicts of interest that prevent them from giving out the honest information that everyone needs. A lot of that information is available here, albeit often in anecdotal form, but still, don’t you think folks have a right to tell their stories? If you came on and told YOUR story and someone told you it was “wrong” or was damaging people, how do you think you would feel about it?
It’s worse than that, Molly. They don’t know what they should be aiming at. The drugs hit parts of the brain they ARE intended to hit as well, and THOSE parts of the brain get broken down and stop working properly, too. They’re not quite shooting at random, but the targeted parts of the brain do not heal under their attack. And destroying them isn’t good for the brain, either. It is a poor solution.
I don’t consider this obvious. A person may need PROTECTION, yes, and others may need protection from THEM, but why does “treatment” in the form of enforced drugging necessarily emerge from feeling angry or confused or despairing? How about giving folks a safe place to calm down and some sane people to talk with if they want, plus some food and sleep and the like? Why start with forced drugging as the only “answer,” especially when we see how poor the outcomes are for those experiencing such “treatment” in the long term?
I learned early on that “intellectualization” is just one more coping measure, having its value and its drawbacks, just like every other coping measure. We all need coping measures, including denial, splitting, minimization, and intellectualization, in order to survive. There is nothing wrong with using any of them if they are working for you. The times we have problems is when we learn these measures early in life and come to believe they are our only options in certain situations. Becoming aware of the coping measures we choose and getting a broader range of options in any given situation is a valuable set of lessons. A lot of times, using intellectualization to “block childhood trauma” is the smartest thing to do. There are also times it can get in the way of moving forward. Just like any other coping measure. It is not good or bad in itself, it’s about how/when these coping measures are used that matters. And who is really in a position to judge that other than the person deciding how to “cope?”
The answer is simpler and more grim – they prescribe it to keep them quiet. “Antipsychotics” reduce aggression, so any sign of violence or aggression from an “autistic” kid and out comes the Risperdal or Abilify prescription. Also often used to calm down aggression that’s actually CAUSED by stimulants for “ADHD”. Doesn’t even require a “psychosis diagnosis.” If they’re annoying enough and have a label, they are fair game for antipsychotics.
Not to mention the possible damage to the fetus of continuing SSRIs. There are fairly consistent correlations with birth defects, as well as with “ADHD” behavior later in life, if I remember my research correctly.
Exactly. You see it all the time – an article proves that antidepressants are completely useless for kids and meanwhile increase the suicide rates, but the conclusion is, “We should be careful to make sure that antidepressants are only prescribed when indicated in children.” And they get away with it, because they’re saying what those in power want to hear!
Labeling terms is a very human practice. People come up with words to describe what they observe, and I have no problem with that. It’s the fetishizing of these words into “diagnoses” and “disorders” that upsets me, when the “diagnoses” have no more meaning or validity that saying someone who picks his nose has “excessive digital-nasal insertion disorder.”
I think the interesting question that never gets asked is, why do the “standard mental health” programs continue to get funded despite mountains of evidence that they not only don’t work in the long run, but in many cases cause damage? Kind of a double standard, isn’t there?
There is a difference between using a term to describe something (My husband is an ABUSER) and being DIAGNOSED with something (My husband beats me up because he has “Bipolar Disorder”). One is simply a linguistic means of describing people who have certain traits in common, the other implies some kind of deeper “causal” relationship between these people such that some sort of “treatment” will generally be helpful to all of them. Psychiatry blurs these lines badly, and I believe intentionally, such that people are confused between a description (These children all have trouble paying attention in school and get into trouble) and a diagnosis (all children who have trouble paying attention are suffering from a ‘disorder’ called ‘ADHD’ and there is a ‘treatment’ for this condition). Of course, this sells a lot of drugs, but the confusion does a great deal of damage to our society, as it prevents any real attempts to identify the actual causes in individuals, as well as taking perfectly normal behavior (being distracted when bored to death by the school curriculum or process) and making it into a disease state. But when we get as silly as calling something “Oppositional Defiant Disorder” because a person is oppositional and defiant, it should be obvious to any rational person that these “disorders” are absolute irrational nonsense! Might as well say someone picks their nose because they have “Nose Picking Disorder.” It wouldn’t be any less ridiculous.
What they mean by “stigma” is “any comment suggesting people shouldn’t take all the drugs they are prescribed without question.” The industry creates and exacerbates stigma as a marketing tool. The furthest thing from their minds is to “reduce stigma!”
As long as the peer respite concept is dependent on the larger “mental health system” for approval and monitoring, we will see power being used by those uncomfortable with the idea of peer empowerment to undermine this kind of effort or kill it off. I wish I knew the answer.
It also always seems hypocritical when they expect someone ELSE to prove their drugs cause dependency, assuming safety, while normally we expect drug trials to assume non-safety until proven otherwise. How many drugs have we been told are “not habit forming” and yet later turned out to have horrible addiction profiles? Benzedrine, Valium, Xanax, Oxy, Ativan, SSRIs… the list is pretty long at this point. Why aren’t we making the drug companies prove their drugs are NOT addictive/dependence-forming before they’re allowed to market?
It did seem odd to me that after dismissing the claim that science understands the mind, the IFS approach still “diagnoses” people with “conditions” based on their “understanding” of the mind. Better to just admit it’s a mystery and work with the person in front of us and stop trying to “understand” them separately from their own conceptualization of their own situation.
I would not just say that “patient voices” should be reported on, they should be CENTRAL to any analysis, while doctors’ opinions should be considered secondary. As long as “patient experiences” are of secondary concern, we will continue to have a system that oppresses those it’s supposed to help!
A really fun exercise is to pick a diagnosis and see how many different ways you can “diagnose” someone with the same “disorder” despite having no “symptoms” in common with each other. It’s not very hard, but it’s kind of amusing. Except when you realize people take this nonsense seriously!
From what I understand of recent studies, the scientific consensus is about 30% of people taking antidepressants express finding improvement. When you take the placebo effect into account, that number drops even lower, and if you talk about an ACTIVE placebo, Kirsch puts the effectiveness rating near zero, at least in terms of any kind of significant clinical benefit.
The drugs do DO something (mostly a stimulation effect, with a dampening of emotional reactivity), and some people find that SOMETHING positive for them. And more power to them. But we should remember that some people find marijuana or controlled doses of alcohol or taking DSMO or St. John’s Wort helpful, too. The problem isn’t that some people don’t report benefitting, it’s selling the idea that there are NO harms and that EVERYONE who is feeling depressed needs some, and even worse, that people who have adverse reactions or simply don’t improve are “treatment resistant” or are being dishonest!!!! Just because a person or persons report they like this and it helps them feel better is no reason to create a false narrative and make people who don’t feel such a benefit into some kind of monsters for “preventing effective treatment”!
I’ll just remind everyone here that “bad science” isn’t really science at all. It is mostly attempts to use a scientific veneer to justify things that REAL science doesn’t support. The way to tell the difference is what happens when real science comes out with data that contradict the “opinion leaders.” If they attack the data or those who promote or share it, they’re not involved with “bad science.” They’re involved in marketing!
But you ARE right, we do have to engage with anyone who is a real ally and not expect total agreement, except on the point that psychiatry as currently imagined needs to GO!
To be clear, I as moderator am not in the business of deciding what content or claims are accurate or inaccurate, thank the Lord! All I do is make sure that the comments fit the Posting Guidelines. There is no censorship on any kind of content-based grounds, and people are welcome to say more or less whatever they want, with very few exceptions regarding taking over the site with off-topic conversations that don’t advance the purpose of the website. It is the job of the Community at large to add their feedback and “correct” anything that seems exaggerated or unproven, just as you are attempting to do.
MIA needs to be judged on the articles. No website anywhere I know of is judged by the comments people make on the articles. I assume “professional” people understand this and act accordingly.
While I agree with your sentiments, having been “behind enemy lines” for a number of years, the problem is that the workers, while some struggle with the ethics of their situation, also have the power to easily pass on their frustrations and “moral injuries” to the very people they’re supposed to be caring for. The “consumers” or recipients or victims of their care have no such luxury. It is imperative that those working in the system who DO recognize what’s happening fight to change it, even if it means losing their jobs. Saying, “I had to harm them, I would have lost my job otherwise” is very similar to saying “I was only following orders.” Not a valid ethical “out” for someone who really understands the harm being done.
I always found “Behavioral Health” to be a bizarre term. How does behavior have “health?” Though I guess it provides a somewhat more honest glimpse into where these industries are really coming from. If we were healing “brain disorders,” wouldn’t it be “brain health?” No, it’s about controlling BEHAVIOR based on what Those In Charge think is “appropriate!” Not much science involved, but a lot of force and lies and manipulation!
Absolutely. No kid would voluntarily agree to do what is expected of kids in school. Or very few. It is absolutely bizarre to expect them to do so. The ones who act out just have more courage than I did!
Makes perfect sense, actually. Want objectivity? Talk to a robot! Healing comes from real interactions with real humans who are being honest and straight and care about each other.
I think he’s saying that the people RUNNING the system exhibit “psychopathic” tendencies, which include lack of empathy, willingness to commit crimes to accomplish desired goals, willingness to lie, cheat or steal to get what they want, sometimes even a certain perverse enjoyment in watching others suffer. Overall, it speaks to a massive need to control others’ lives at their expense, and a lack of any concern for the welfare of anyone but themselves. This is a very rough and incomplete description, but such people are only rarely ever “diagnosed” with any kind of “Mental illness,” but rather tend to skate through life making trouble for others and getting others blamed for things they themselves have arranged. Those who are “caught” are more likely to be in jail than the “mental health” system, but plenty such people get into positions of power in businesses or government agencies where they have enough control to harm people while being protected from any kind of consequences. Of course, the world of psychiatry provides many such opportunities, and it would hardly be surprising if that field attracted a disproportionate number of psychopathic individuals, some of whom may be actually directing the course of the organization/profession.
I was agonizingly bored in school! Wanted to poke my eyes out with a fork! I understand why kids act out, just to have SOMETHING interesting going on! Unfortunately, I was too scared to take those risks, but I sure thought about it!
I agree. The only therapists of any value are the ones who recognize that there is no such thing as “professional objectivity.” In order to be truly helpful, we have to understand that everything we do is at all times influenced by our own desires and motivations, and that we are only aware of a small percentage of them. It requires “constant vigilance,” not some fantasy belief that professional training somehow cancels out subjectivity!
I think you hit on something EXTREMELY important! It is those wounded by the abusers in society who are “diagnosed” and sent to “therapy,” while the perpetrators walk around harming others. Therapy at its best is about helping those harmed cope with the damage and the horrible awareness that abusers are running the show. I was fortunate to have a caring and competent therapist, so it’s very hard for me to even imagine what would happen to me if my therapist had joined forces with those authority figures responsible for the damage!!!!
Quite so. Trust is earned, it is given entirely at the discretion of the “truster.” Expecting someone to trust you because of your position is pretty massive authoritarianism.
I will suggest here that per the scientific method, we assume something is NOT effective until it is proven to be effective. The “null hypothesis” in this case is that antidepressants do not reduce suicidal thoughts or behavior. If such controversy and conflicting studies continue to exist 30-40 years after ADs were introduced, I think we can conclude at this point that they DO NOT reduce suicidal thoughts and behavior.
Of course, in the “antidepressants cause suicidal thoughts and behaviors,” the “null hypothesis is that they don’t. However, the fact there is a Black Box warning on all drugs impacting serotonin suggests there is enough evidence to concern people about their safety, especially in the young. Since there is almost zero evidence of any AD effectiveness in youth, and literally none in young children, even a chance of increasing suicide rates ought to be enough to eliminate these completely from the psychiatrist’s toolbox, at least for children.
At a minimum, the evidence to date is more than sufficient to conclude that antidepressants do not decrease the suicide rate for any subgroup of identified “depressed” people. The fact that certain “researchers” and “thought leaders” choose to cherrypick the studies they like should not divert us from this conclusion. Any decent review of the literature shows no positive effect, and many show possible increases in suicide rates, even in studies involving people who were screened for suicidality before starting. It’s not really that much in dispute, except for people who want to believe otherwise.
It has always infuriated me when therapists expect their clients to automatically trust them! Don’t they get that this is Step One of any decent helping process? I used to work with foster kids, and I’d often say to them, “I suspect you don’t trust me. That’s pretty smart. I wouldn’t trust me, either – you have no idea who I am or what my agenda is! And I don’t automatically trust you, either. I’m hoping as we get to know each other, we could develop some trust.” Or words to that effect. Oddly enough, I managed to earn the trust of many of them. I wonder why?
I agree with you for the most part. I would never have gotten where I am from psychotherapy. I did have a very good therapist and it was important in getting me started in seeing the limitations of my upbringing. But without Buddhism, meditation, exercise, a job that challenged me to overcome some of my anxieties, the support of important people (including my wife), an exploration of a wide range of spiritual practices, self-help books, and some good old fashioned hard work, I’d have never gotten anywhere. And from what I understand, the training for therapists these days has deteriorated, and they spend time studying the DSM diagnoses but don’t bother with little things like unconscious motivations or the long-term impact of trauma or domestic abuse dynamics. So I don’t want to deny that psychotherapy can play a role for some folks, but it needs to be one who really GETS what s/he is doing, and is empowering of the client to pursue his/her goals. My therapist told me her goal was for ME to become my own therapist and not need her any more. Not every therapist has such goals!
Anyway, I think you’re right, the best even the best therapist can offer (and as I see it, most of them aren’t very good!) is to help you set your feet on a different path. Where you end up going is TOTALLY up to you, and there are as many ways to find the path as there are humans on the Earth!
Forget about “borderline personality disorder” or any other of their anti-scientific labels. What does she really need? What behavior or issues does SHE think are creating problems for her? What does SHE want to be different? What does SHE think would be a good approach?
Usually, people who get branded with the “Borderline” label are those who have difficulty trusting others in relationships. See if you can talk to her about trust. Most are also people who have had traumatic experiences early in their lives. What kind of historical trauma is she still dealing with?
She needs support and understanding, not more labels. Psychotherapy CAN be helpful but only if you find the right person who can create a safe place for her to explore her life and what she wants to do with it. Another person bullying her around and telling her “what’s wrong with you” and what she needs to do will not be helpful. I don’t know what the best way to go about it is, but it starts with NOT accepting the labeling process and find some other people, professionals or not, who agree with you and are willing to help.
Nah. Psychiatry is a religion of greed selectively cherrypicking science to further its own economic ends. Science doesn’t enter into it, except as a red herring to distract from what’s actually happening. Proof is, any science contradicting their narrative is attacked and/or buried. There’s exactly nothing scientific about psychiatry.
Sorry, but psychiatry does NOT rely on “common sense.” Common sense dictates that people who have been emotionally distraught need to talk to someone. Anyone who has witnessed a car accident or experienced an upsetting incident has an immediate urge to tell their story to another human being, who helps best by listening. There is nothing common sensical about the idea that “mental disorders are caused by faulty brains.” That is a very non-intuitive idea that has been sold and sold HARD to the public through massive PR campaigns and through TV and movies and other media methods.
Common sense says that psychiatry is BS. It is only the pretense of “science” coming from the mouths of pseudo-“doctors” claiming “special knowledge” that allows people to actually invalidate their common sense and believe this unscientific and intuitively offensive nonsense!
I would also say that the training for “talk therapy” has deteriorated massively while classes on “diagnosing” with the DSM are hugely on the rise. I often wonder from talking to them whether today’s clinicians have ever even been introduced to the idea of subconscious motivation? They get trained that PTSD exists but to they get any kind of training on what to DO that might be helpful to a traumatized person (or what NOT to do?) Once one’s had “therapy” with a person who doesn’t know what they’re doing and makes things worse, the idea that “therapy” could work is canceled pretty much forever. Which leaves people with very few options!
Quite so. When the experimenters have no objective means to separate those “in” the group from those “not in” the group, the experiment is DOA. Which applies to pretty much all “mental health” studies, except perhaps those measuring adverse effects of the “treatments!”
You are confusing an observable problem and a workable solution.
Of course, no one here denies that people live on the street and talk to themselves. Believe it or not, A LOT of those people are “taking their meds” and still doing that, or have tried the “psychiatric treatment” path and it has failed miserably for them. Did you realize that the likelihood of recovering from “schizophrenia” is now a LOT WORSE than it was in the 1950s, before the “drug era” began? Did you realize that the likelihood of recovering is MUCH HIGHER in countries like Nigeria, Columbia, and other “developing countries” where “medication” is used far less frequently? Were you aware of the fact that a lot of people having first episode psychosis don’t have another, but that the likelihood of spontaneous improvement has REDUCED since psychiatric drugs are in regular use? Have you learned yet that the average “seriously mentally ill” person dies an average of 20-25 years YOUNGER than the rest of the population, and that the drugs used to “treat” these “illnesses” are largely responsible for many of these early deaths?
The social myth is that there are magic drugs that make everyone all better, and if only the “homeless” and the “mentally ill” would follow their doctors’ instructions, they’d be “normal” people working jobs and going to college and raising families, just like on the ads on TV or the movies and TV shows where someone goes “off their meds” and crashes and burns, but as soon as they’re back “on their meds,” they’re totally fine again. The industries have worked hard to create this impression, but if you can put this myth aside for a moment and actually READ some of the stories presented below, you might start to realize that it’s not such a pretty picture.
Psych drugs do seem to be helpful to a certain percentage of the population without serious damage to their quality of life, and more power to them. But the idea that doctors have some great “treatments” that make MOST people “normal” again if only they do as they’re told is completely false. The bulk of “seriously mentally ill” people who are in “compliance” with their treatment plans are poor, unemployed (on disability), and living lives that most of us would consider extremely low in quality. Those who do better often do so despite their “treatment plans” and “providers” rather than because of them, or at least have little to no support for improving their life quality from those supposedly “treating” them besides the drugs they are prescribed. Considering the massive adverse effects most experience, ranging from involuntary movements to severely blunted emotions and motivation to loss of sexual function to enormous weight gain to diabetes and heart disease, it might seem that living on the streets is hardly any worse to some recipients. And that’s not even mentioning the tremendous loss of autonomy most experience, being constantly monitored and told what to do and threatened with incarceration, framed as “hospitalization,” if they step out of line or their “symptoms” increase.
It is very easy to judge if you’re not someone who has had these experiences yourself. Why don’t you suspend the judgment for a while and try reading some of the many stories here about what has happened to people here who “complied” with their “treatment plans” and ended up devastated? There’s a LOT more to the story than you seem to have heard to this point!
The key question would be whether one could distinguish in some objective way between “biological” and “situational depression.” Of course, no one has come close to doing that, and they don’t even bother trying any longer. It’s just “let’s try these drugs out and see what happens.” No pretension in reality of any kind of scientific diagnostic process. But as long as the big money keeps coming in, no one has an incentive to look deeper.
You are assuming that treatment plans mandated by “healthcare professionals” are going to be helpful. Read some of the stories below and you may begin to question that assumption. Saying something “must be dealt with one way or another” does not mean that the one way currently being used is the best approach.
It’s hard to see why anyone needs to do a study to “prove” this. Shouldn’t it be the job of those claiming this “disorder” has validity to prove it does, rather than the other way around???
Maybe just start with the person where they are at, and stop worrying about whether they “fit” the PTSD “diagnosis,” and instead start asking questions and getting to know them on a real level and finding out where they’re at and what they really need?
But many Deaf people in my observation also DON’T view themselves as disabled. In my experience, there is a wide range of ways people view their Deafness, and it would be wise for those not a part of that community not to speak for “them.”
Where can you have come up with such statistics? As far as I know, there is no objective description or measurement of a “neurotypical” brain that is possible. So a “neurodivergent” brain, while I think can be a legitimate identity to choose, is not a scientifically observable phenomenon, and as a result, its frequency of occurrence is not something we can claim to know.
I personally find the term “neurotypical” to be to some extent demeaning, as it seems to imply that I have somehow gotten a “normal” brain and that therefore any struggles I may have are of less significance than the “neurodiverse” brain. I can tell you with absolute certainty there is nothing “typical” about how I have experienced life and I had plenty of struggles in school and elsewhere, even though my particular “brain” (if that is indeed the variable in question) allowed me to be quite successful in the educational environment and to scrape by socially, “it” has provided plenty of challenges in non-academic arenas. Of course, you could now decide (or I could) that I really am NOT neurotypical, that I’m “neurodiverse,” but again, that would be a decision of identity that I (or someone else) made, and not one that can be verified in any scientific manner.
I don’t believe there are “neurotypical” brains out there – my observation is that everyone’s brain is different and everyone has certain things in common, and our society is highly intolerant of certain personality characteristics or behavior, which leads to bigotry and discrimination against certain people who don’t BEHAVIORALLY fit what is expected, whether because of their brains or some other reason. Does neurology factor into that? No doubt. But until there is a means of drawing some kind of objective line between the “neurotypical” and the “neurodiverse,” I’m afraid these terms remain social constructs without any objective meanings. Like I said, everyone should feel free to identify themselves as they wish, but I’d appreciate you and others not choosing MY identity for me!
Quite so. It is never the fault of the practitioners – the client or the “disorder” is resisting! So how is success ever to be defined, if you can’t fail except as a result of something they have no control over!
There are most likely some in Turkey who know the truth. But it may be hard to find each other. Most countries are dominated by people who are “true believers” in psychiatry and tend to attack and humiliate those who don’t agree with them.
It may be that you are the one who will have to educate others about what you’ve learned. We are all in the minority!
My point is that having a goal over which you have no direct control is a setup for failure, in my experience. Empathy in particular is VERY difficult to teach, especially to an adult. Not saying it could not happen, but I’d be more likely to look at something more along the lines of not engaging when negative stuff is coming from her, drilling how to convey the necessary message most effectively, and how to set good boundaries when she becomes abusive. All things the person himself can control. I’ve seen way too many people spend way too much time trying to “get their viewpoint across” or “help him see how he’s hurting me,” etc., with absolutely no success and enormous frustration. I recommend setting goals that a person can accomplish, regardless of whether someone else chooses to “understand” or not!
That DOES make a lot of sense. My only caution is that “depression” is not caused by any one thing. But testing for THIS particular thing could save a LOT of trouble and suffering for a certain identifiable subset of the population!
A goal of making one’s WIFE more compassionate is a pretty inappropriate therapy goal! You can’t make other people compassionate! That seems like his first problem!
I believe the link goes both ways – psychological trauma is associated with increasing inflammation and immune response. Autoimmune diseases are more common with people who have been abused, in a dose-dependent manner, as I recall.
The question is, how can anyone POSSIBLY determine where such a “line” lies, or if it even exists? And if we DON’T objectively define what it is, then we get arbitrary and subjective rules, leading to “diagnostic drift” toward whatever makes more money for the providers and less trouble for those in control of society’s institutions.
And why do we need to define such a line anyway? Why can’t we simply say that “those who suffer need and deserve support” and provide it without pretending there is something physiological going on? Now, if there IS something physical that is off, like low thyroid, anemia, sleep problems leading to depression or hyperactivity, or whatever, then THAT is what should be treated, not “depression” or “anxiety.”
I’d really be interested in knowing why you think such a line can be and/or needs to be drawn to be able to provide full support to those who are suffering?
Somebody decided to go after Kratom and started making it into a “story.” That’s how a lot of news happens, someone with a lot of money and/or power decides to make it a “story” and then tells the papers what to write!
I hope that you found people with this label were a lot more different than they were similar to each other. That was my experience. The main thing they mostly had in common is that their early lives were shitty. Other than that, I saw a huge range of human interests, abilities, and personalities carelessly lumped together simply because traumatization had made it more challenging for the poor professionals to figure out what was going on.
I actually have no patience for this “diagnosis.” Why not just say, “Mary was abused as a kid and has trouble trusting people” or whatever else is going on? Why talk about this group as if they had anything in common besides being labeled and discriminated against by the “system” personnel?
Well, there are no profits to be made from fixing society! Far better to blame and drug the patient and protect the status quo, which provides so many “customers!”
Actually, the “comorbidity” is, in my view, not because these “conditions” share things, but because they are not actual medical “conditions” at all. What should be diagnosed is neuroinflammation, histamine intolerance, vitamin D deficiency, etc, rather than wasting time on these meaningless DSM “diagnoses” that don’t tell us anything about the actual problem at hand.
That’s one of the most insidious dangers of the “label and drug” approach. It gives the impression that your environment is harmless and YOU have the problem. If only your brain worked better, you wouldn’t MIND being worked 60 hours a week at a mindless job that challenges your personal ethics on a daily basis! It’s all about Bad Brains, never about fixing the environment and expectations that lead to burnout!
There has never been any literature supporting the use of antidepressants in children, except one study on prozac and adolescents, and that one was critiqued heavily for many flaws. It amazes me that psychiatrists are allowed to prescribe it. It’s malpractice.
When there is no objective way to determine who has a particular “diagnosis,” the concept of “comorbidity” completely loses any meaning it may have had.
And we can see exactly how helpful the psych drugs were in preventing further violence!
I agree with you, people should be judged on the danger and disrespect of their behavior, not some label affixed to them or some lenience based on “compliance with medication” or whatever else. We can see that compliance and safety don’t necessarily bear any relationship to each other.
I am not surprised to hear any of that. The system is set up so that narcissism is rewarded. Back when I got my own therapy (1982), there were requirements that therapists go through their own therapy before being allowed into the office, and there was strong recognition that the therapist could do a lot of damage if s/he had not dealt with his/her own issues and instead acted them out on the client. Nowadays, I’m not sure they even train counselors on the fact of unconscious motivations they might have. I’d say one takes one’s life in his/her hands applying to a random “therapist” for help today. Odds are better that you’ll get screwed over than helped. I think that was already true in 1982, but it’s far worse today.
“Treatment resistant depression” is a euphemistic way to say, “Our drugs didn’t work and we want to blame the client and/or the disease instead of admitting we failed. Plus it lets us keep ‘treating’ even though we’ve totally screwed it up!”
I think we see here that chatGPT is simply regurgitating what the most common or popular responses are to this kind of question on the internet as a whole. It is not the act of “artificial intelligence,” it’s the act of a very fast collector of other people’s ideas and statements, collating these into some “safe” statements that fit into the mainstream of what’s already been said. It’s INCREDIBLY unlikely that any AI program will look at the situation and conclude, “Well, a lot of people say that antidepressants improve imbalances in chemicals, but research by X, Y, and Z have proven this trope completely false. Evidence is that it originated in propaganda from pharmaceutical company marketing schemes.” ChatGPT is going to amplify the most commonly held beliefs. It will never be able to challenge them, because it can’t really think.
I didn’t meant to be critical, just to make that very point. I’d say the odds of finding what I call a “good therapist” these days are probably in the single digits.
Exactly! A theory with no concrete means of measurement is of next to no scientific value. It’s not wrong, it doesn’t even get to the point of being testable as being wrong! It’s just USELESS!
I will only take this moment to state that not ALL therapists see their role as to identify and/or correct defects in their clients. I think you are acknowledging that in your choice of words, but I want to make that explicit. My view has always been that the only ones who can tell us if therapy “works” are the ones receiving the therapy. They’re also the only ones knowing if something is “wrong” with them and/or what if anything they need to do about it. A good therapist works to help the client discover their own truths about themselves. Anyone who thinks they can “fix” or “improve” the client should be avoided like the plague!
The science does not support your assertions. No medication has been found to reduce suicide rates, and most antidepressants increase rates. Recovery rates have been shown to be LOWER when taking antipsychotics over the long term. Only 30% of users report significant benefits from antidepressants, which is barely more than benefit from placeboes. This is what the science says. Repeating mythology doesn’t make it true. How do you KNOW these things you have claimed to be true?
“Supposed to” is an interesting way to frame it. We know factually that a LOT of adults don’t act like responsible adults. Does that mean we just leave them to machinations of the pharmaceutical industry?
I don’t hear anyone saying the drugs don’t work. I hear someone saying that the data saying they DO work is biased. We already know that they work for less than half of the population at clinically significant levels – the most objective evidence says 30%. Don’t you think it’s fair to the other 70% to let them know they may not see the purported benefits? Do you think it wrong to let people know the actual adverse effect, including withdrawal, oops, I mean DISCONTINUATION effects, that plague many if not the majority of users? Do you deny that these drugs CAN cause harm to a significant subset of the population, based on the scientific data we now have available?
I’m pretty sure in the USA you can hire an attorney, it’s just that most victims of psychiatric incarceration can’t afford one or find one who does such work competently.
It is odd that “patients” are found to “lack insight” as proof of their “illness,” when the profession itself completely lacks ANY insight into what if anything is actually “wrong” with any one of their charges!
ChatGPT gives back from what it’s read, that’s all. It can assemble a ton of information from multiple sources, and maybe even modify its approach if you find it offensive and say so, but it’s not going to provide much outside of the accepted mainstream views. It might outline alternative views, but will identify them as potentially controversial. It’s just a distillation of the “conventional wisdom,” with some acknowledgement given to less popular viewpoints.
It is true that most psychiatric prescribing is done in a very robotic fashion, and would probably be BETTER done by robots, because at least personal prejudice and emotional reactions would be removed from the equation, and the robots wouldn’t hunt you down just because you didn’t follow their advice.
That’s what chatGPT and other AI seems to do – it gathers a huge amount of data and then mimics human responses using “information” it has gleaned from other sources. It does not have any kind of individual thinking or critical analysis, and it works based on what it is programmed to do. It would be easy as heck to program such an entity to simply not publish anything negative about psychiatry or drugs. The only thing that surprised me about Bob’s response is that it has not already been programmed to a pro-psychiatry bent.
Grey matter volume is decreased by antipsychotics. This has been proven in multiple studies. They like to blame it on “schizophrenia,” but pro-drug researchers found this was not the case.
That’s a great idea, actually! I’m guessing it would hem and haw about it, saying it’s “controversial” without really addressing the complete lack of scientific foundations. But who knows? The Chat app bases it’s “comments” on data gathered from billions of sources, and depending on the programming, it could come up with something critical.
My point is only that psychiatric “theories” are mostly mythology. This is only one more example. EVERYBODY said that back in the 70s, even though there was no actual research supporting this idea. When the research debunked the concept, it had some effect, but the myth, much like the “chemical imbalance,” was already so ingrained that few gave it a second thought, despite the research. This seems to me to be the core of psychiatric “theory” – come up with an idea that supports their desired narrative, put out lots of propaganda to promote this idea and pretend it’s all very “scientific,” and don’t research or ignore research in any area that might threaten the narrative. Not much science actually going on!
It is deeply disappointing to hear that professionals still toss around that idiotic trope that “ADHD kids react differently to stimulants.” That notion was debunked way back in 1978 by Judith Rapoport, et. al. It’s worth noting that Rapoport has been a big supporter of stimulants. She gave stimulants in low doses to non-ADHD diagnosed teens and found exactly the same response – less movement, better concentration on dull or repetitive tasks, etc. The only reason she said that people assume the “ADHD” kids react differently is because people are looking for that reaction. She called it “an artifact of observation.”
The fact that such nonsense is still spewed about by “professionals” proves to me how little actual basis any of these “diagnoses” and “treatment” are founded upon. They have to lie to themselves and others to even justify their interventions. It’s such bull!
I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.
This was my experience as well, working “behind enemy lines.” I wasn’t even a psychologist, just a “mental health professional.” We had very little power to alter what the psychiatrists decided to say or do. It was a constant battle, but had to be conducted as a “reasonable conversation” or you were quickly branded as an “anti-meds” worker. I eventually gave up on trying to change the system from the inside. I don’t think it’s possible. I’ve become more of an “abolitionist” the longer I work with this crazed system.
I would estimate that 9 out of 10 therapists are either sold out to the system or don’t really know how to be helpful. I was, indeed, very lucky. And this was in the 80s before the DSM III had taken hold. The odds are a lot worse today!
Can’t disagree with a word of that. The current system makes it as easy as possible to dismiss a client/patent’s concerns, ideas, plans, motivations, etc. and to blame the client for “having the disorder,” and blame “the disorder” for any failure or damage to the client. I think it is much, MUCH harder to find someone today working for the system who is worth seeing than it was back in the 80s when I went. And I was still lucky!
I meant the therapist. I have no problem with the client using his/her own power to his/her own benefit.
It matters because it applies to everyone, whether a therapist or not. What you’re saying is most therapists TAKE ADVANTAGE of their one-up power situation. But not all do so, even if it’s tempting. Same is true of humans you meet on the street, though they have less of a natural advantage in the power department, so it’s probably safer. But lots of “regular humans” take every advantage of their power over others and seek to maximize their influence at the expense of the person they are engaged with. It’s not fair to paint ALL therapists with that brush, any more than all humans. There are even psychiatrists here and there who have a heart and understand their power advantage and don’t use it to hurt their clients. Admittedly, not a common experience, but it happens. I had a fantastic therapist who REFUSED to “diagnose” me or interpret anything I said or did, but always put the question back to me. I kind of hated her for it, but it was the right approach, and I was much the better for my 15 months of weekly meetings with her. Worth every penny I spent. So it’s important not to overgeneralize about people we don’t know, just because they have a certain assigned “role” in “the system.” There are and have always been mavericks who do it their own way. I like to think I was one such.
In the case of the DSM, the very nature of the “diagnoses” makes them diminishing and insulting automatically, as they presume the doctor is able to decide what is wrong with you lacking any concrete testing or evidence of anything being wrong at all. It’s hard to see how a label ever improves anyone’s psychological well-being, unless it’s a label they themselves choose to apply. I see nothing helpful about doctors or psychologists or counselors buying into the DSM fiction campaign.
When people have seizures, our medical system intervenes to stop them because they are known to be dangerous. Yet psychiatrists are allowed to induce seizures for weeks on end and somehow that’s NOT going to create brain damage????
Exactly. The frontal lobes are the center of planning and organization, and hence motivation. It would be almost impossible to execute any kind of complex plan with the dopamine flow to your frontal lobes being so dramatically curtailed. And of course, there is permanent damage from which a person may or may not recover. All to “treat” a “disorder” that no one has any clue if it exists or what is wrong or what is being “fixed.”
Such rages are often caused by the very drugs meant to “treat” them. Stimulants for “ADHD” are the most common offenders, but SSRIs/SNRIs and antipsychotics can do it, too, plus benzo withdrawal is most definitely associated with violence for some users.
Nor for “major depression.” I can’t see how becoming more apathetic and unmotivated plus fatter plus experiencing “involuntary movements” can possibly make a person feel LESS depressed!
Wow, that sounds AWFUL! It sounds like you also had a bad case of akathesia! If you wanted to torture someone, it’s hard to imagine something more effective!
I can well imagine! These ads for the new “anti-TD” drugs always annoy the shit out of me – they make it look like these people have totally normal lives, are working full time and happy, and are just a bit embarrassed that they drop things or their face gets screwed up and looks funny. It’s very trivializing of the reality of TD!
I still don’t get why it’s BETTER for him to call himself “BPD” rather than just identifying what he wants to change and exploring the possible roots and motivations for that behavior? What’s the benefit of calling himself “Borderline,” even if he selects that label for himself?
I agree with this. In my own practice, I never “diagnosed” anyone except to make sure they got a kind of help we agreed they needed. And I told the client from the start that the “diagnoses” are just descriptions of what they already told someone and had no meaning beyond getting insurance reimbursement. Lacking a “diagnosis” never prevented any client I had from making progress. I’m guessing it made it easier for them to make progress, as I “normalized” their experiences and never gave the idea that there was something “wrong” with them that they couldn’t fix, which is the opposite of what these “diagnoses” do.
What’s wrong with saying, “You get scared when you go outside” instead of “You have agoraphobia?” How does the latter help in any way?
That’s why it’s called “Tardive” = “Delayed.” Some show no signs of it until they stop. For some, the only way to get it to go away is to maintain on neuroleptics/antipsychotics, which of course makes the problem slowly worse over time. It’s an awful price to pay!
And why don’t they look at the CAUSE of the TD, instead of “treating your TD movements,” as if this is just some minor thing that happens when you get “good treatment.”
You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!
I don’t think we should redefine our understanding of science. We need to establish a barrier between science and research vs. business and profits. Used to be professors were not allowed to profit from their college-funded or government-funded research. We should go back to those days!
It sounds like you’ve been through hell and are still kinda there!
With all due respect, it appears to me you’ve figured out these “doctors” don’t know the first thing about what they’re doing and their “diagnoses” are fantasies. Are you still looking to them for help? Or are you simply trapped in “the system” and having a hard time getting out of there? What do you see as your path forward?
I am sure there are such people. What’s unfortunate is that they do not appear to be the “thought leaders” in the field, and are in my observation frequently set upon by those with a different agenda. The problems with psychiatry are not those of individual psychiatrists being good or bad people or even good or bad clinicians. It is a matter of the profession itself being committed to misguided values and priorities, including the priority of making money as a profession and maintaining status, and the actual needs of the patients/clients in such a scenario too often take a back seat, if they get a seat at all.
I am always encouraged to find psychiatrists who take a saner approach, but in my experience (and I have more than a bit), they tend to be the minority, and with few exceptions, have little influence on how the profession as a whole considers the problem of “mental illness,” which they seem to have somehow obtained the right to define for the rest of us.
Quite so. It is my experience that telling another person what to think/believe, even if you’re 100% correct, robs them of the ability to realize it for themselves, so they have to either agree or disagree with you instead of realizing their own path. I think exploring possibilities/brainstorming can be fine, but as soon as we start telling the other person what to think of their life and what to do about it, we start doing damage.
Even the girl with “diabetes” can be talked to about how best to frame it from her viewpoint. Perhaps she comes up with, “I have to eat a special diet/take a drug to help” or “My body has trouble handling sugar and I have to take special precautions” or even “Sugar and I have a love-hate relationship.” Why not help her come up with what she feels comfortable instead of deciding what to call it and taking her options away?
Interesting story – I used to work for a crisis line. A woman I had talked to many times called in and said angrily, “Those doctors told me I have Borderline Personality Disorder! I don’t have Borderline Personality Disorder! How DARE they say that about me!” I asked her, “What did they say that meant?” She says, “Well, they didn’t exactly explain it, but they said I have it and I don’t!”
I said, “Let me get out the DSM and read off what they say defines this ‘personality disorder.'” So I read them off to her. “Emotionally volatile?” “Well, yeah, definitely.” “Sometimes feigns suicide for attention?” “Yes, I do that.” “Difficulty with trust in intimate relationships?” “Oh, yeah, for sure.” After I read a few more, she very calmly said, “Well, I guess I DO have it!”
How different would this have gone if they simply started with saying, “It seems to me like you get pretty emotional about things compared to most people. Does that seem true to you?” Or better yet, “What kind of things do you tend to do that you wish you didn’t?” And just describe the behavior instead of the label. She clearly had no trouble acknowledging the behavior she engaged in, was quite aware of it, in fact. But the act of labeling pissed her off big time! So why bother with the label? Why not start with the client’s framing of the problem and go from there?
Sorry, Jukia, but there is exactly zero evidence that the drugs increase suicidality by giving suicidal people the energy to commit suicide they were already planning. For one thing, almost all of these studies ELIMINATE anyone having any hint of suicidal ideation, so even if a few are being deceptive, the majority of these new cases of suicidality come from people who were NOT feeling suicidal before taking the drugs. The explanation you provide is a convenient one for drug companies and doctors who want to convince people that increased suicidality is not a concern, but Prozac in particular was kept off the market in Germany and I think also Italy initially back in the 80s because of increases in suicidal and aggressive behavior in those taking the drugs, so the claim has long been known to be false.
I’m not disputing that some people report getting great benefits from taking these drugs. But it’s not ALL people, and a lot of folks report having little to no effect or becoming worse on the drugs. To claim that being off psychotropic drugs is “FAR more dangerous” than being on them for “most profoundly mentally ill people” is an opinion which is not based on scientific study. In fact, read up on the Wunderlink and Harrow studies, among others, which show that those diagnosed with “psychotic disorders” who don’t take psychotropics actually do better on the average than those who do. Again, not saying some don’t benefit, but generalizing from anecdotes to broad sweeping statements of “truth” is not how science works.
That does kind of sum it up. That kind of thinking is even more destructive in psychiatry, because blaming the victim is the most overtly damaging thing you can do to a traumatized person.
If this guy hates and resents his own patients so badly, he needs to find another profession!
This is NOT new information, but I’m glad it’s being published and brought to people’s attention again. Is it creating depressive feelings really worth a 70% chance of turning in more homework and being less annoying to the adults around a child?
Not surprising to me, but this is important research! The industry relies heavily on claims that “accepting you have an illness” and that “treatment” is just like “insulin for diabetes” reduces “stigma” and makes it easier for people to feel OK about their “mental illness.” Those in charge know these claims are not actually TRUE, but justify using them as PR because “people are more likely to seek help.”
Like other stigma-based research on labels, these findings fly right in the face of these claims. There is no excuse or justification for lying to your clients in the first place, but this kind of research takes away the justification and exposes their “theories” for exactly what they are – propaganda to get more people onto psychiatric drug regimes!
But of course, this kind of thinking will either be ignored, or if it becomes popular enough, will be viciously attacked by the powers that be. We can’t have people HEALING THEMSELVES!!! Or even deciding they DON’T NEED TO BE HEALED!
Sounds brilliant, honestly! I will say from my own experience as a counselor that my goal was always to help the person study their own decisions and experiences and make new decisions (if need be) based on their own observations and conclusions. This seems like it cuts out the middle man and just takes people right there! Perhaps the most important point is that it communicates to the person that s/he CAN figure out what’s going on and what is needed through study and sharing, essentially the opposite of what they hear from the mainstream “mental health” system!
Wait, now the PSYCHIATRISTS are claiming “moral injury?” I suppose it DOES inflict “moral injury” of some sort if you’re constantly claiming to help people and yet so often make no improvements or make their lives agonizingly worse? Perhaps it’s time for a “Truth and reconciliation” circle as they ran in South Africa to help heal the “moral injuries” of the Apartheid regime? Do they expect us to feel sorry for them that their failures don’t feel very good to them???
I agree 100%! I always counted on my clients alone to provide whatever useful information was in play. THEY are the only ones who really know what’s going on or what might help! But that’s the opposite of the mainstream view. The DSM itself admits it doesn’t even bother to attempt to evaluate cause. What’s the point of a “diagnosis” that doesn’t try to identify what the actual problem is!
Ah, the irony! The main reason “professionals” hate “borderlines” so much is that it reminds them of their own failings! I’ve always believed that to be true – EVERYONE can behave in a “borderline” fashion! We just like to pretend it’s someone else and not us!
Well, I worked first for the Long Term Care Ombudsman program, which provides advocacy for seniors in nursing homes, assisted living facilities and adult foster homes/care homes. This is a US program that exists in every state, and while I was a paid employee, most of the Ombudsmen are volunteers. There are plenty of issues with psych drugs in nursing homes, I can tell you!
Then I worked for 20 years for the Court Appointed Special Advocates program (CASA), sometimes known as the Guardian Ad Litem program. This provides volunteers for kids in foster care who advocate to get them to a safe, permanent home as quickly as possible, and for them to be safe in the meanwhile. The number of kids on psych drugs is beyond comprehension, and the longer they are in the worse it gets! So I found plenty of opportunities there to get into the grill of the psych profession, in an effective way.
Mind Freedom, Inc. is also a more or less worldwide association of advocates for those in the “mental health” system, so the advocacy there is more direct.
There are no doubt other organizations I have not mentioned who do advocacy for those in psych “hospitals” or other “mental health” facilities. You’d have to look around where you live and see what’s happening there.
I’m glad to hear you are ready to take that step! It sounds like you certainly KNOW enough to do a great job – the trick is getting through the insane levels of resistance from the people who should know better, especially the psychiatrists themselves! But it’s worth it when you get a victory. I encourage you to go in that direction!
I always came from the belief that any advice or evaluation of what the client ought to do or ought to have done is counter to any effort to help. It’s nobody else’s job to tell the client what to think about their situation or what to do about it. Of course, I understand that most therapists these days don’t seem to hold that view. More’s the pity.
I really wish I could refer you to someone! Have you considered support groups for people traumatized in childhood? It hurts my heart to hear that such therapy, which used to be considered at least one of the main approaches, is virtually unavailable to you now.
I have found people associated with the domestic abuse or sexual abuse worlds to be much more likely to understand about trauma and approach it differently, in an empowering way. Perhaps a local women’s or domestic abuse helpline has a referral for a therapist who understands how to be helpful in these situations? They may also be a source for peer support groups, where you would at least meet others who have been through what you have (including the incredible rigidity and blindness of the so-called “mental health” services) and might have some support and/or ideas for healing? And maybe make a friend or two and feel a bit less lonely?
I’m much more inclined to recommend peer support these days than therapy, as so many therapists (as you report) have become handmaidens of the psych industry. Anyone starting off with diagnosing and recommending drugs should be immediately eliminated from consideration, and in your case, that sounds like everyone!
It is true, those clinicians who speak up are either dismissed as kooks or attacked. That’s what drove me out of the field, I couldn’t deal with being “behind enemy lines” all the time! Advocacy ended up being much more up my alley. Could use my skills without helping sustain a system that did so much harm!
Well, that’s certainly true, and that’s why I’m very distrustful of anyone coming out of current “psychology” or “mental health” training. I believe they focus a huge amount of time on DSM diagnoses and very little on actual ways to improve one’s own awareness and emotional availability to the clients, or actually helping to discover and evaluate what the CLIENT thinks is helpful and desirable. It’s very arrogant and disempowering, the opposite of what is actually helpful!
There is also a big difference between those who use scientific EVIDENCE as proof of their position and those who use scientific CONSENSUS (what ‘scientists’ tend to agree on) as proof of their positions. As has become very clear, many of the so-called “scientists” in the psychiatric field not only don’t rely on science for their conclusions, they actively attack any real science that contradicts their desired narrative. Corrupt “scientists” who benefit from their position of power should not be accorded any kind of special status. Only the science itself is worthy of discussion if we’re really interested in facts and knowledge!
I don’t disagree with anything you said. Except that “diagnoses” are not PART of the “therapy process,” they are the justification for assuming authority over the “clients,” and as such are the opposite of therapeutic. The “diagnoses” are an evil that extends FAR beyond the “treatments” it is used to justify. It starts the process of “othering” and allows people to discriminate and downgrade the “mentally ill” (as they call them) with impunity. If there were no “therapy” at all, the DSM would still be incredibly destructive!
I’m not ‘favoring the therapist’s position,” just describing what has to happen for it to work for the client. I fully acknowledge most “therapy relationships” don’t occur in this way and are mostly destructive or at best do nothing helpful.
And “borderline personality disorder” is a DSM diagnosis and has literally nothing to do with therapy, except as providing an excuse for certain kinds of “therapeutic interventions” that ignore the needs of the “client.”
I engaged in therapy that worked very well for me, and I wouldn’t be who I am without having done so. But I was lucky, very lucky. I’d have to be much MORE lucky today to find such a person, as I see most of those claiming to be “therapists” being guided down the wrong path. You yourself have acknowledged in the past that there are exceptions where people do benefit from a therapist, but we both agree it’s rare and in many cases not even possible. I’m not promoting therapy as a profession. I’m just describing what I see as necessary for it to work. Again, I’ve already agreed and acknowledged that most therapists are incapable of this level of awareness, and that one is just as likely to benefit from talking to someone they know who has some good listening skills. Therapy is a setup for most people, because of the inherent power imbalance and most “therapists'” inability to recognize let alone manage their own needs to heal their own power relationships. Alice Miller had it right.
I hope that clarifies where I’m coming from. Definitely not of the “everybody needs therapy” school of thought!
It CAN happen and DOES happen in some cases, but the incentive is to use one’s power for one’s own benefit. And you are right, this motivation is almost always unconscious and therefore very difficult to recognize for the therapist, even if it becomes obvious to their “clients.” Which is why I say you can’t really train someone to be a good therapist. They have to develop an acute awareness of power relationships and their own issues with power and be aware of these at all times when interacting with someone they are trying to assist. I’d say very few therapists ever meet this goal, and in fact, unless I’m wrong about what happens today in “training,” most of them aren’t even aware of it as a problem. So going to a random therapist is, indeed, a very dangerous undertaking. As research shows, your odds are just as good choosing a friend or colleague as someone with a degree.
My view is that a person can’t really be trained to be a good therapist. I agree, it has to do with the essence of the relationship between two people, and techniques or schools of therapy are borderline irrelevant. “Diagnosis” via the DSM is completely irrelevant. It’s not a “cookbook” procedure, it has to do with creating a safe space and respecting the right of the client to decide what is “right” or not and how to define and pursue “improvement” in their own worlds. I’m not sure what they train “therapists” to know these days, but I know they spend a lot of time on the DSM and “brain scans” and neurology, and it seems not very much on what actually helps people grow and develop in their own way.
That is the huge glitch. And I don’t even think they bother training new therapists/counselors about this any more. It’s all about the DSM. The odds of getting a helpful counselor have dropped dramatically from when I was in counseling back in 1983. Very few are really up to the job, and an incapable therapist can do a HELL of a lot of damage!!!
One approach I sometimes used with traumatized clients is to say, “I am guessing you don’t trust me at this point. I wouldn’t trust me either if I were you. You have no idea who I am or whether I’m a safe person, and distrust is very appropriate in such a situation. I’m hoping I can earn your trust over time.” Or something like that. Acknowledging the “rightness” of them being skeptical seemed to give the clients some sense of getting some power back. It always used to bother me when clients were dinged for “not trusting their therapy team.” I always said, “How do you know they can trust the therapy team?”
I wasn’t very popular with a certain kind of therapist…
Absolutely true. All depends on the therapist backing away from their one-up power relationship, but that still leaves them in the one-up position, because they get to decide if they want to abuse their power or not.
Not to mention, they are based almost 100% on bigotry and social assumptions and have zero foundation in any kind of scientific process. It’s basically rarified name calling.
I’m assuming the intent of a good and respectful therapist is to help the person before them to free up energy used to protect themselves from past traumatic experiences so they can use it to create a better life in the future, by their own definition, not the therapist’s. It is true that not everyone is prepared at a given time to go there, and such resistance should be respected as a behavior that meets a need for the client, something DBT seems not to recognize at all.
In any case, what I’m pointing out is that “resistance” (which is a word I would never use) has historically been viewed as an indicator of exactly what you said, that the person is feeling it is necessary to protect him/herself from danger. These mechanisms are developed for very real reasons to protect from very real dangers at the time, and one HOPES that therapy becomes a safe place to identify what these mechanisms are (help the person be conscious of them rather than having them be automatic), and for the CLIENT to re-evaluate for him/herself whether and when such approaches remain necessary. This should leave the client with all necessary defense mechanisms intact and usable, but cut down on the times they are used on a knee-jerk reactive basis when not really needed, such as becoming hostile to the butcher because he wears the same had your dad wore all the time and his voice sounds similar so he must be dangerous like your dad, etc. Gaining personal awareness and decision-making power over such responses should leave a person feeling more in control of his/her life in general. That’s the theory anyway, and it appears to have been very successful for the clients whom I worked with.
So the idea that the CLIENT is supposed to somehow abandon any “resistance” and just go along with what the “therapist” says is very, very damaging to the client. It is reinforcing the idea that they were WRONG for judging the past situation as dangerous, that the “authority figure’s” feelings are more important than the client’s, and that the big problem is not that the authority figure was abusive, but that the client wasn’t “understanding” enough of the needs of the authority figure and should try HARDER to repress and undermine any actions they took to feel safer. This is exactly the OPPOSITE of what I’ve found to be truly helpful, which is validating the client for taking necessary actions for self-protection and admiring their courage in doing so.
One of the very first things I did as a counselor/therapist was to help the client validate that the “crazy” things they tended to do were not crazy at all, but made perfect sense to them at some time in the past. I would share that I’ve found it helpful to look at what DOES make sense about the behavior (AKA to what extend DOES it act to protect them) and validate them for coming up with effective “coping mechanisms” for a difficult situation. Only after getting very clear on that point would I propose to the client the possibility that such mechanisms are often used by all of us humans in situations where they aren’t as helpful as their original intended purpose, and that becoming more aware and intentional about them, or even developing some new ones with our adult intelligence and recognition that in many cases the danger is not current, might be a good path to follow.
That gives maybe just a little feeling of how important it is for me to respect whatever behavior the client has come up with to survive in their world. I always assume that ALL their actions have purpose, and the question is only whether these actions continue to serve the purpose they were intended for in the present. I have never intentionally tried to force a person to drop or dismiss any behavior they feel is important to their safety and survival. I have tried to run only based on their own stated desire to change a certain pattern of behavior, and “resistance” is important in recognizing when the actual reason for the behavior is coming to light. Naturally, a person is entitled to hang onto whatever “resistance” they feel they still need. Therapy should only be in service of meeting their own goals, not mine!
It’s not the client’s responsibility to avoid “distracting and annoying” the clinician. “Resistance” is supposed to be part of the treatment, at least it used to be back when therapists knew what they were doing. If a person is “resisting,” it was supposed to indicate that you’re getting to an issue that needs to be addressed. It’s not a reason to punish the client!
If clients have to act in certain ways to keep the clinician happy, there is no therapy going on. That’s usually what got the client into their problems in the first place!
That’s exactly what my therapist said to me at the beginning. She said the goal was to develop my own internal “therapist” which I could consult directly and for her to become unnecessary for me as quickly as possible. She did a lot of good for me, but only because she was focused on helping ME become more independent, not in dragging out therapy so she’d get more fees and feel superior!
And this is how genetic testing COULD be helpful. Instead of testing for ONE GENE that creates ALL cases of “depression,” we should be testing for genes that explain a SMALL PART of the cohort which can actually be “treated” at its cause! Such discoveries will remove a certain number of sufferers, while not raising the belief or expectation that some magical one-gene solution will mean EVERYONE suddenly gets better!
Thanks for your thoughtful reply! I agree that these things are complicated, and I appreciate the acknowledgement that “fitting in” to the so-called “social norms” is NOT a sign of “neurotypicality” but of ability to adapt to what are generally unreasonable expectations. The “ADHD” kid in class can’t adapt, and so is identified as “divergent.” Of course, it’s better for him than being identified as “mentally ill,” but that classroom is FULL of kids who are just as miserable as he is and yet don’t act that out for whatever reason, whether better suppression skills or more fear of punishment or whatever. Those kids are not any more “typical” than anyone else, they just don’t make trouble for the adults and are therefore identified as “normal.”
Maybe the term “neuro” is what gives the word its “bioessentialist” undertone. Maybe if we simply identified ourselves as “divergent,” as in “diverging from expected social norms,” then everyone can get on board with “diverging” and maybe even find some new and better “social norms” that are easier for more people to live with!
Frank, while I agree that paying for a quality therapist (if one is fortunate enough to find one) is hardly a form of oppression, I have to say that I’ve seen PLENTY of garden variety straight-up intentional oppression of psychiatric “patients” in the name of “helping” them that most definitely would meet any definition of oppression you can come up with. Dishonesty, use of force, holding people against their will without cause, forcing “treatment” that causes brain damage and early death while claiming that all of these issues are the patients’ problem and were not caused by the “treatment. All of these things are offensive to any sense of justice, freedom, equality of rights and basic respect due to any human being. It seems to me you are singling out the relatively rare case of a free and relatively well off adult engaging in a more or less fair exchange of money for services, and assuming the purchaser has both the information and the wherewithal to resist efforts to indoctrinate or mistreat them at the hands of the therapist. That’s a lot of assuming!
If you slow down a minute and read some of the experiences shared here on MIA, you will see that the vast majority of commenters do not have the kind of experience you are describing. Many are forced against their will to do things they object to with neither information nor consent. Many more are lied to and emotionally manipulated into accepting a very unhealthy framing of their situation and into accepting “treatments” whose benefits are overblown and whose dangerous consequences are minimized or denied completely. This is the oppressive situation we’re dealing with. And it CAN happen in a paid therapy relationship, too.
I’m sure you are a caring person who probably does a good job helping your clients. What I don’t think you get is that you are an outlier in the world most of the posters live in. It’s very understandable that most are extremely skeptical of therapy in any form. It’s been used to hurt them!
My biggest problem with the term “neurodivergent” is that it implies there is a “normal” kind of neurology that “most people” have, and that one has to be “autistic” or “ADHD” or fit some label to be considered “neurodivergent.” I object very much to the idea that there is such a thing as “normal” vs. “divergent” neurology, in fact, genetic diversity is critical to species survival, and one of the great joys of humanity is the amazing degree of divergence that exists within the “normal” range of human behavior. Ultimately, I see us all as “neurodivergent” which means the term really has no meaning. It seems to me that the term “neurodivergent” reinforces the idea that “mental illnesses” are somehow neurological and are discernible by “divergence” from some kind of theoretical “norm.”
I have no problems with individuals identifying themselves as “neurodivergent,” but I can’t agree with such people deciding that I or others are “normies” and that one has to have special qualities to qualify as “neurodivergent.”
That’s my view of it. I’m sure others have their reasons that will diverge from mine!
As I intimated, I don’t think most psychiatrists understand or care about fast- vs. slow-metabolizers and so forth. I do appreciate your research, and that was specifically what I was recalling and referring to.
The difficulty with this approach is that it totally begs the question of what we are supposedly “treating” with these drugs. What we’re doing is manipulating brain chemicals and hoping we get lucky and find a drug that a person can live with that helps reduce his/her “symptoms” without saddling him/her with intolerable adverse effects. But of course, we have no idea if brain chemicals are in fact a causal agent in any of these cases, or how to distinguish the ones that are (if they exist) by any kind of objective means. It’s not really very different from observing that some people can take opioids or drink alcohol and be fine, while some are quickly overwhelmed by the drug’s effects and others seem to take a lot to have any effect at all. All fine information to have, but it hardly substitutes for figuring out and addressing WHY this person is distressed enough to be heading down to the bar every night to imbibe, and what we might do to alter that reality!
I don’t believe that is completely true. They can apparently test for people who are “slow metabolizers” of different drugs and so perhaps avoid creating homicidal/suicidal ideation by SOME people taking SSRIs, but these tests appear to be far from foolproof, and just as importantly, almost no physicians regularly use such testing in their practice, despite your assertion that “ANY WISE PHYSICIAN” will do so. I’d be happy to be proven wrong about this, but that’s my understanding of the current situation. I have yet to meet a person currently engaged in the MH system who was offered such testing by their doctor, though I’ve heard of a few who demanded it themselves. Do you have any links to recent studies showing anything more promising than what I’ve identified above?
Unfortunately, a great deal of what passes for “psychotherapy” these days does not incorporate any of the important philosophical underpinnings you mention above. A lot seems to now be focused on “neurobiology,” on DSM “diagnoses,” and on compliance with “medication” and other “treatment plans” like DBT or CBT. I did therapy for a number of years in various settings, some formal and some informal, and saw and heard what others were exposed to by their “therapists,” who in my view did not deserve the name. I’m not sure they are even taught about unconscious motivations or ideas of consciousness or striving or attachment or awareness of one’s own process, let alone touching on the existential issues of the bizarre expectations and abuses of modern society. The focus seems to be on making “symptoms” go away, as if “depression” or “anxiety” were the problem rather than the observable manifestation of the actual issues causing distress. This is the inevitable result of “DSM” thinking – reducing the complexity and spiritual richness of human experience to “desirable” and “undesirable” emotions or behavior, which the therapist and/or psychiatrist is tasked to change, by force or manipulation if needed. It is small wonder that folks faith in psychotherapy as you describe it is very low – very few people seem to ever experience it these days!
I’m glad Ketamine therapy works so well for you! But I do want to remind you that this doesn’t mean it works for everyone. The idea that all people who are depressed have the same problem or need the same solution is not scientifically valid. I rejoice that people find Ketamine or any other approach workable for them. I just want to be cautious about using anecdotal data to extrapolate for others who may have very different circumstances and very different results than you had.
Clearly, the most fundamental fallacy with the entire psychiatric edifice is the assumption that all people who “have depression” or whatever “mental illness” is under discussion are all ILL and have the SAME PROBLEM and need the SAME INTERVENTION. The DSM itself invalidates this assumption in its introduction, but this apparently has no impact on people’s viewing these “diagnoses” as some kind of valid scientific entity that can somehow be “researched” as such, even though the people in the study group often have little to nothing in common with each other. In fact, it’s been shown that multiple people can “qualify” for the same “diagnosis” and have not a single “symptom” in common! How it’s not obvious to anyone of a slightly scientific bent that this whole system is a house of cards built on nothing but opinion and bias is beyond my comprehension.
Which once again reinforces the idea that the person one is interacting with, their maturity, skills, openness to experience, ability to create a safe environment, ability to help a client focus on their own goals and purposes, is what really matters in any kind of “therapy” or healing practice. I find calling MDMA “medicine” in itself to be an absurdity. It is not a “medical” process you are describing, it is a spiritual/emotional/intellectual journey that is very personal to each individual, and there is no way to create a repetitive “treatment” that can obtain any kind of consistent and predictable results for all people. The key is who is helping “guide” you and what kind of “guidance” they tend to provide (empowering vs authoritarian) rather than the particular drug or other method used. This is not to say that MDMA or any other drug may not be able to contribute to increased spiritual awareness or skills in life, but it’s not “medicine,” any more than alcohol or marijuana are “medicine” because they have certain effects that a person may or may not desire or benefit from.
I do think it is of great concern that the number of contacts appears to have a direct relationship to the number of detentions. This would imply that the increase in contacts would have the same demographic distribution of seriousness as the ones already contacting crisis lines previously. Unless this is simply a redistribution of people who would have contacted another crisis line if 988 did not exist (which of course means there is NOT really an increase in contacts at all), one would expect that the new callers would have a LESS serious distribution of issues, because we should be courting new contacts who otherwise might not have called (the purpose of the 988 easier access).
So there are two likely conclusions: first, that these callers are the same people who already used local crisis lines, and we have spent millions and millions of dollars to accomplish essentially nothing at all, or second, that calling a crisis line gives a particular probability of having the police dispatched, regardless of the average severity of the call. Neither one is a happy conclusion!
We shouldn’t have to prove they are dangerous. The standard is that the doctors/pharma need to prove they are safe. I think the biggest problem is we have hired a lot of foxes guarding the henhouse of drug safety. If we had a REAL set of standards with honest, non-corrupt people applying them, we’d all be a lot safer and it would be a lot easier to get complaints heard and acted upon!
Why is it sad? Science is about facts, not feelings. It is GOOD that Ketamine’s rah-rah propaganda has been served a well-deserved challenge. We need to know the truth.
It is easy to confuse “These categories are not scientifically valid diagnoses” with “debilitating anxiety doesn’t exist.” They are VERY different statements. I doubt anyone here would state that debilitating social fear and apprehension don’t exist or are not painful and difficult. The argument would be that just because you feel anxious in social situations, no matter how severe, it doesn’t mean you are “ill” in a medical sense.
I say this as a person who suffered debilitating anxiety and depression in my youth, and now at 65 rarely experience anything similar. I did get therapy for a while and do a lot of self-help stuff but never was “diagnosed” with anything at all by my therapist. It is not necessary to validate these “diagnoses” in order to agree that someone needs help and support and to assist them in getting to a better place. I’m also not invalidating the potential usefulness of psychiatric drugs, just saying that the “diagnoses” themselves are not valid medical/scientific entities, and that saying so doesn’t invalidate ANYONE’S suffering!
I wouldn’t call it easy, but it’s definitely do-able. I have a little preamble I give to any new doctor I see about how I’m going to be the one making the final decisions, and if that’s a problem for them, let me know now so I can find another provider. And I have had to do that on occasion, but it almost always puts them in their place.
That is exactly my point. How is “standardization” even possible when there are no objective standards possible regarding what diagnosis to give, how to do a danger assessment, optimum “treatment,” what “good outcomes” are, how to measure them, etc.? It’s all so completely arbitrary! How can “imminent risk” ever be anything but haphazard and varied?
I am sure this is an accurate summary of what is happening today. One of the main reasons I left the crisis line was the “professionalization,” which meant more fear of lawsuits, more rules and expectations and rigidity, and a greater likelihood of sending the police out on calls that did not really pose any danger at all. And the lack of any kind of objective standards for police dispatching or diagnosing or anything at all in the “mental health” world makes “quality control” almost impossible.
But it does encourage me to know that crisis lines do still exist where dispatching is not an option, and I wanted to make sure I shared that fact. Of course, it’s a volunteer crisis line, not a “professional” one!
My experience (and I have a lot) is that crisis lines I’ve worked at or volunteered at had a wide range of different views on what to do about suicidal callers. I was a supervisor for a volunteer crisis line in Portland, OR, and we tried only to talk unless a person had a specific plan and intent to carry it out. The line contract was taken over by a “professional” service and the likelihood of a dispatch went up quite significantly, though they did eventually develop a “crisis team” who would see some of the people without police being involved. I later volunteered at a crisis line that never traced or dispatched under any circumstances. So it’s not legitimate to overgeneralize – different crisis lines have different philosophies, and it may also depend very much on whom you reach when you call. I can see people being VERY cautious about sharing that they are suicidal with such a crisis line, without knowing what their general philosophy about such calls is and how frequently they tend to dispatch the police!
I’m not sure I’d say the act of a stimulant improving concentration temporarily represents “healing” per se. Smoking marijuana or drinking alcohol reduces anxiety for many, but I’d not suggest they are “healed” by the process. There are no doubt some healing processes that are mediated by drugs, but I consider this to be more or less incidental to psychiatry’s intent. For instance, I know of a guy who took stimulants for a little while and said he discovered a mental state he could get to that way, then he STOPPED taking the stimulants and found other ways to achieve that same kind of mental state. I’d call that a kind of healing, and the stimulants were a part of it, but no psychiatrist would recommend or approve of the real healing part of that action.
Anyway, that’s just my personal view on it. Some people find psychiatric drugs beneficial for whatever reason, and more power to them, but I don’t think it’s a form of “healing” to take a drug that makes you feel better temporarily. It might be the first step in healing, but psychiatry as a rule discourages any attempt at any further “steps,” in my experience. Healing tends to happen despite their interventions, not because of them.
“Pre-dying!” I love it! It’s a condition we can ALL claim!
The same happened with cholesterol, BTW. At one point, you had to be 160 or so before anyone got worried. Then for no real reason, they changed it to 120. Actually, there was a reason – to sell more cholesterol-lowering drugs!
It is not “demonizing medications” to observe what the research really shows and to share people’s individual experiences. It’s called sharing reality. If “medications” need to be protected from the actual facts about them, it says a lot about who is demonizing whom.
And is in fact contrary to research showing that long-term use of antipsychotics REDUCES the average lifespan of the recipient! The odds are that she’d have lived longer if she’s avoided psychiatry altogether!
It does feel more than a little ironic to hear that she was attacked for questioning the efficacy of antidepressants, and yet failure to take antidepressants is assumed to be the cause of her suicide. As I said earlier, wherever you come down on the “cause” of her suicide, which of course, we will never really know, it is VERY clear to me that psychiatry did NOT get her to a place where she achieved “good mental health.” She clearly eventually gave up on psychiatry because it failed her. It is more than a little disingenuous to imply that her abandoning a practice that never really worked for her is somehow responsible for her despair.
My reality is that therapists who can create a kind and secure environment for a client to share and to some extent be challenged to seek new perspectives have success, regardless of the model they use. “DBT” will work well in the hands of a highly competent therapist, and will be a disaster in the hands of an incompetent one. CBT will similarly be successful to the degree the therapist can create a safe and connected environment where a person can share their fears and explore new options without feeling judged or threatened by the therapist. Whereas an insensitive or self-involved or “rote” therapist will have no success with CBT or any other approach.
There is no way any person can become a “good therapist” by studying a manual and following instructions without truly understanding the nature of the delicate and emotionally sensitive interactions they need to become a part of. There is solid research supporting this viewpoint. I don’t think DBT is good or bad in and of itself, I just think it’s a bunch of possible tools that a competent therapist can use to build up their client’s feelings of success and control, or a bunch of possible tools an incompetent therapist can use to make their clients feel worse and then blame the clients for the therapists’ own failure.
Considering there is absolutely NO evidence that any of the DSM “mental disorders” are fully or primarily caused by biological problems or issues, it’s mystifying why “anti-stigma” campaigns focus so much on convincing people that “mental disorders” are “illnesses like any other.” Unless the intent is not, in fact, to fight stigma, but to fight resistance to accepting drug therapy as the first line intervention for these ostensible “disorders.” Then and only then does this focus make any kind of sense. But then calling these “anti-stigma campaigns” isn’t very honest, is it?
A wise person once said, “All that is not love, is fear!” Fearing our emotions prevents us from feeling the love and connection that for most of us makes life feel like it’s worth living.
They also screen out suicidal people from the vast majority of these clinical trials, so these are not “suicidal people getting the energy to do it.” These are people who, for the most part, were not suicidal until they took the drugs. They most definitely can and do cause suicidal thinking. Hence, the black box warning. That warning ought to be enough for anyone to acknowledge the possibility.
My favorite analogy is “You have pain in your knee because you suffer from knee pain disorder. You know you have knee pain disorder when your knees hurt, but knee pain disorder also CAUSES your knees to hurt.” Very informative!
As extreme and simplistic as the idea that “schizophrenia” is in all cases caused by genetic or biological malfunctions which no one has ever been able to detect but we KNOW must be there?
I’m always the enemy of extreme and simplistic. I just want to make sure that everyone is fully aware of the extreme simplistic basis for these ridiculous psychiatric “diagnoses” and the insistence on “treatments” being determined by such laughably unscientific claims. The proper attitude toward any case of “schizophrenia” is that we have a NAME but very little knowledge of what is going on IN THIS CASE and need to explore what’s happening IN THIS CASE and what might work IN THIS CASE. Trying to generalize based on these laughable “syndromes” where two people can both be “diagnosed” and literally have no symptoms in common (try it some time, it’s quite possible in at least schizophrenia and major depression by my direct observation) is almost as far away from scientific as one can get.
I don’t know about the “subscription” button. I’ll look into that for you.
Dismissing trauma as a causal factor in “mental illness” displays either ignorance or a willful attempt to redirect people away from exploring this very real issue.
I always find it odd that defenders of the current psychiatric paradigm so frequently conflate criticisms of that paradigm with ‘stigma concerning mental health.’ The two have literally nothing to do with each other. There is, in fact, HUGE “stigma” for people suffering emotional pain who DON’T use psychiatric drugs as part of their treatment, and those who choose to discontinue such treatment are often attacked relentlessly by the very people who are supposed to be helping them.
There is certainly general discrimination in the public sphere against people who qualify for or identify with a “mental health diagnosis.” On that point, I’m sure you will find no disagreement on this site whatsoever. However, it is actually shown by scientific research that teaching people to view “mental illness” as a brain disorder of some sort INCREASES “stigma” and discrimination by making it easier for people to emotionally distance themselves from those who are suffering, while a “trauma-based” framing increases empathy and DECREASES stigma.
So please don’t blame “stigma” on those who question the accepted psychiatric paradigm. It is the accepted paradigm itself which is responsible for most of the stigma, according to their own research. There is nothing wrong with questioning the scientific validity of psychiatry’s unproven assumptions, nor does questioning those assumptions mean or imply that those finding psychiatric drugs helpful are wrong or need to be forbidden from using them. Again, the two issues have literally not a thing in common.
It is not at all far fetched to suppose that childhood abuse can contribute to the eventual development of psychotic states. There is also strong correlation with being an immigrant and living in an urban environment.
As in all of the so-called “mental disorders,” the situation is FAR more complex than the “mental health” world would like us to believe. There is “no proof” (to use your words) that ANY “mental illness” as defined by the DSM is caused by any measurable biological/genetic factor either. I’d agree that current drug use and current trauma are often overlooked as contributing factors in psychosis. Maybe the problem is regarding “psychosis” as if it must always be caused by the same things or “treated” in the same fashion. Maybe there are many “causes” that work differently in many different people, and we ought to scrap the idea that “schizophrenia” is a “thing” that has a specific cause.
Additionally, a very significant percentage of studies use a “placebo washout” design, where they screen people who DO respond to the placebo out of the trials! This is obviously designed to minimize the placebo response and make it more likely that the drug will meet “statistical significance” vs. placebo. So far from using active placeboes, most studies actually try to weed out those who will respond to an INACTIVE placebo in order to bias the study in the direction of their drug. And somehow, this is not considered a violation of the scientific method!
Here is a published article in a solid, scientific journal for the original poster to read. It goes over why the author concludes that more than half of all published scientific studies can’t be replicated, and hence are not valid. It ought to make him/her more cautious in assuming that anything published in a scientific journal is de facto proven truth!
One article in an online publication has “done society a disservice!” Why refer back to Freud or Szasz to try and discredit the arguments of the author through the reverse “argument by authority” approach? Don’t you have your own arguments to make?
It would appear to me you might want to re-read Szasz again, as he never claimed that the phenomena describes as “mental illness” did not exist, but that the idea that these were discrete and identifiable “disease states” of the body was mythological, as this concept is not supported by scientific facts.
There is nothing “unqualified” about the argument that traumatic events alter people’s concept of who they are and how the world operates and what relationships are about. In fact, the entire movement toward “trauma informed care” is based on scientific proof that not only their behavior, but that people’s actual brain structures and activities can be dramatically altered both by early life trauma AND improved by healthy relationships later on in life. It is pretty regressive at this point for anyone to claim that traumatic events do NOT impact all of the so-called “mental illnesses” as defined by the DSM, however fuzzy and arbitrary those definitions may be. Even the most medicalized psychiatric supporters at this point know that the idea of a “chemical imbalance” or other purely physiological problem creating any “mental illness” being detectable by tests and repairable by drugs is completely unsupportable by scientific studies.
Ironically, there is far MORE support for the remnants of Freud’s “trauma theory” through the “trauma informed care” movement than for the idea that any discrete “mental illness” described by the DSM is a scientifically valid description of reality. Even more ironically, the DSM itself admits these things in its introduction, where it says that:
“In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi).”
And even more tellingly: “There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.” (APA, 2000, p. xxxi).”
So not only can the DSM criteria NOT distinguish between having one “disorder” or another “disorder,” or between having a “disorder” or having “no disorder.” Worse, two people who both CLEARLY QUALIFY for a given disorder may not have the same problems, needs, or possible solutions! What is the point of having “diagnoses” where the people who are so diagnosed are NOT “alike in all important ways?” Isn’t the point of a “diagnosis” to group together people who have similar needs and issues and distinguish people who have similar presentations but different underlying causes? These two clauses admit outright that these “diagnoses” are scientifically and practically meaningless!
So before you go about accusing others of “unqualified arguments,” it might be wise to spend some time to qualify your own arguments. No one arguing in favor of the DSM “diagnoses” being taken seriously in any scientific manner is in a position to criticize anyone else for being “unscientific!”
It is easy to move from “she wasn’t taking her meds” or “she engaged in recreational drug use” to “she killed herself because she stopped her meds” and/or “she killed herself because she’s an addict.” Neither of those premises has any more evidence backing them up than the “psychiatry killed her” idea. Any of those are possible, none are provable. But one thing we DO know for sure – this person had the best of available psychiatric care for decades, did not “resist” or “rebel” but in fact embraced the system for most of that time, and all of that “help” did not prevent her eventual suicide. It is certainly NOT valid to suggest that everything was going just fine before she “quit her meds!” It sounds from her blogs like she struggled the entire time she was “in treatment” and went another direction for whatever reason she chose. It would be EXTREMELY naïve to look at her situation and say, “if only she’d stayed on her meds…” Whether her suicide was caused by her engagement or disengagement with “the system” is not something we can determine, but I think it is more than fair to say that psychiatry failed her in many ways, and it’s never appropriate in my mind to blame the client for quitting services when the services have not been successful. If psychiatry were the answer for her, 20 or more years of committed engagement with the psychiatric system would have led to a different outcome. I think it’s more than fair to suggest that psychiatry AT BEST did not help the situation, despite her being fully committed to following their instructions for many years. Let’s not blame “not taking her meds” so easily, since we’re hearing we’re not supposed to be so “black and white” in our thinking as the author supposedly is.
It is true that we don’t ever know what prompted a particular person’s suicide. What we DO know in this case is that decades of psychiatric treatment did not prevent it. Whether it contributed substantially to the event or not will always be speculative, but it’s equally speculative to say, “Antidepressants save lives,” when we don’t know how people would have acted under differing circumstances.
It sounds like you might need some help getting away from an abusive partner! Are there any domestic abuse hotlines or programs in your area? There is hope, but you will have to figure out a way of putting at least some emotional distance between you and your husband. No one should be forced to live with someone who hates them so much they intentionally make an addict out of her!
I would add that the presence of psychiatric drugs not only can do damage itself, but it also diverts young people (and older people) from other approaches that have been successful over time, both formally and informally. It may be the lack of developing support networks as much as drug side effects that are helping cause the deterioration of youth “mental health” today.
Please recall that there is also a POWERFUL stigma AGAINST those who choose NOT to accept the standard “treatment” offered by psychiatry, even when it is demonstrably doing serious harm.
There are actually plenty of hard scientific studies showing that psychotropic medications IN GENERAL tend to create worse clinical outcomes. Harrow et al for instance showed that people with poorer prognoses that took antipsychotics only briefly or not at all did BETTER than those who had better prognoses and took antipsychotics long term. So on the average, they were worse off taking psychotropic drugs.
Studies on antidepressants and “ADHD” also show no average benefit or worse outcomes for those taking drugs over the long term.
Multiple studies show an increase in suicidal thinking and acts in those taking antidepressants, especially when younger.
Many studies show the “severely mentally ill” have shorter life spans than the average person, much of it due to heart and metabolic problems that are known to be caused by antipsychotic drugs (clearly, there are other contributing factors as well, but treatment is associated with reduced life span).
Your analogies are completely inappropriate. Taking diabetic treatment does not INCREASE the number of amputations, it decreases them. The same can’t be said for psychosis and antipsychotics or suicide and antidepressants. Not to mention, diabetes is known to be caused by a lack of insulin in all cases. No one suffers from psychosis for a lack of antipsychotics.
Perhaps a more open mind and some honest research will help you see that the situation is not as black and white as you currently believe. You might start by reading Whitaker’s book, “Anatomy of an Epidemic.” It could be quite enlightening.
MIA is mostly interested in looking at alternatives to the “medical model.” It is unlikely we will want to promote any “antipsychotic” drugs given the history of failure and worsening of “symptoms” and in fact the shortening of lives resulting from the “antipsychotics” currently in use. It seems very unlikely that the “new” drugs will be doing anything beyond trying to suppress dopamine and maybe suppress the uptake of Serotonin like Risperdal and Seroquel and the other current drugs.
It is truly a problem to be unable to continue. I’m betting no one warned you this could be an outcome of taking them in the first place! Have you talked to anyone who specializes in getting off drugs? There are such people around, but most psychiatrists either don’t know or actively try to prevent any effort for people to get off.
The use of the term “inclusion” already marginalizes the peer support workers. Who gets to decide if they are “included” or not? Obviously the REAL workers, who are by definition more important than the “peer workers” because they can “include” them or not at their whim.
Reminds me of the concept of “shared decision making,” where clinicians are “encouraged” to “take the views of their clients into account” before making decisions. Obviously, the people being asked to “allow” their clients to have a “voice” are already trampling the rights of clients to true informed consent, and asking them nicely to please ask my opinion before you decide what to do to me is hardly a viable solution.
It is very odd that in most cases, we assume that the device provider is responsible for proving the safety of its products, but in this case, it appears that the “clients” (including forced, involuntary victims) have to prove that it’s NOT safe!
To be clear, I am not against systematic interventions to help people who are struggling, as you seem to suggest. I just want to focus on things that actually work FROM THE POINT OF VIEW OF THE CLIENT. There are some people I know who have used the drugs as a means to help themselves, and have suffered minimal adverse effects. I’ve also known others whose lives were destroyed following that path. I used to be a counselor/therapist and I believe helped lots of people find their way to a new path or direction for their lives. My approach helped a lot of folks, but I know it didn’t help everyone I came in contact with. I had a philosophy that allowed me to connect more directly with people about what their concerns and needs were, and I’ve taken people who had all kinds of different labels and been successful when they experienced failure in “the system.” I could share some pretty impressive stories of monumental changes in people who the “Mental health professionals” had decided were intractable.
Others needed things I couldn’t provide. I tried to help them find some other pathway. I have never had or expressed the viewpoint that there is no such thing as suffering that requires some sort of advanced intervention. I am not sure where you ever got that idea, but I would appreciate it if you drop that as it applies to me. As you are against “bullying” as you so aptly put it, I’d really appreciate you not deciding for me what I believe and drawing conclusions on the basis of those assumptions.
I don’t think mapping the brain will create an understanding of “mental health.” But I do think that real brain research shows and will continue to show that the idea of “mental illness” is a “brain disease” is, scientifically speaking, complete nonsense.
The problem is not that people don’t fully use the criteria (even though they almost never do), it’s that the criteria themselves are subjective, speculative, and completely unscientific in nature. You can’t judge “overdiagnosis” if there is no objective way to tell who “has” or “does not have” a particular “disorder.” The DSM itself admits in its introduction that 1) you can’t really tell who has which “disorder,” or where the line between “disorder” and “no disorder” can be drawn, and 2) any two people who COMPLETELY FIT the criteria at a given moment may not have the same problem or need the same kind of help. Of course, almost no one ever READS the introduction, and it’s couched in very squirmy language that requires interpretation, but it’s a pretty damning admission, don’t you think? We have no way of objectively determining which diagnosis you have, and even if you and another person are right in the center of the target, your diagnosis means nothing about the cause or your needs or what treatment to recommend. What is the value of such a “diagnosis?”
When I did clinical work in the past, I simply talked to the client about his/her own conception of the problem and what they thought might have helped. While of course I asked good questions and made observations and brainstormed options with the client, in the end, the client was responsible for defining the problem and whether or not a particular intervention was “working.” It is arrogant in the extreme in my view for a clinician to enforce his/her views on what is “wrong” or what “should be done” on a client, as the main reason people suffer from “mental health issues” in the first place, ESPECIALLY when we’re talking about depression and/or anxiety, is because OTHER PEOPLE have taken over their lives and told them what to think, say or do and what was “right” in opposition to allowing the to follow their own personal “voice.” I consider it more abuse for a “professional” to boss a client around and disempower them the way they were disempowered by others in their pasts. Empowerment is the answer, not more powerful people exerting their control over the clients’ lives.
Which is how research ought to be done! The actual data should be reported and acted upon, even if the knee surgeons might lose some money in the process!
Exactly. If the current model were working, people who USED TO BE disabled would now be OFF disability and working again! If someone’s disabled with, say, a bad knee, and gets knee surgery, we would expect that the corhort of such people would be LESS disabled than before the surgery! There may be a few for whom it did not work and they didn’t get better or got worse, but overall, the average disability level would have to go DOWN for this intervention to be considered effective! If people are MORE likely to be unable to work and participate in society AFTER receiving psychiatric “treatment” than before – well, there isn’t a much better definition of “ineffective” or indeed “counterproductive” available than having a “treatment” actually INCREASE the disability rate of its recipients!
Again, I think you are confusing efforts to help with effectiveness. Stating things like “ECT is effective and safe” is just as dangerous or moreso than saying, “ECT can have serious adverse effects which should be considered before undertaking such a course of action.” Are you seriously claiming that there are NO or MINIMAL adverse reactions to “ECT” despite all of the hard and soft data showing that the results for some people are devastating? You do realize that “ECT” is the intentional induction of a convulsive seizure (hence the name) and that under normal circumstances, such seizures are considered dangerous and people take drugs to avoid them because of potential brain damage? Why would an intentionally induced seizure NOT be likely to produce brain damage when a spontaneous one IS likely to produce such damage?
My beef with psychiatry is mostly the blithe dismissal of very real concerns that exist, as you demonstrate in your comment. It is not HATEFUL toward psychiatry to report on actual events and studies that challenge the conventional wisdom. “Trust me” is a dangerous comment for ANY physician to make, but more particularly those working in psychiatry, where knowledge is scarce and speculative on the ground and no one really understands the exact cause of ANY “disorder,” or even if such a “disorder” syndrome is a legitimate entity for study rather than a broad collection of phenomena which have been cast together into a syndrome because we don’t understand them, purporting to “know all about it” is just a blatant deception.
Psychiatry would be a lot better off as a medical specialty if it took a big dose of humility and started to understand that these bad results are very often NOT random or made up or the result of “lifestyle issues,” but are very real and potentially dangerous side effects of the “treatments” they are handing out. That way, at least some measure of “informed consent” can be practiced, rather than providing bland and scientifically empty reassurances such as “ECT is safe and effective.”
I worked for 20 years in the foster care system and the stories are all too familiar. I helped get a law passed to require such evaluations of kids before they were ever put on psych drugs, and with the help of a state-level nurse, we also managed to implement a triggered review of any case involving certain polypharmacy criteria. The drugging rate HAS dropped since then in Oregon, but it’s still way too high. It is the inevitable result of inventing “diseases” that can’t be objectively determined and giving people drugs for them. There will always be “diagnostic creep” if there is no hard line to decide when intervention is needed, as is the case with essentially every psychiatric “disorder.”
Another interesting fact was that those kids cared for by relatives had a MUCH lower rate of psych drugging than those being fostered by strangers. I have the greatest respect for the many excellent foster parents out there, but think it really helps to have someone in the room with the doctor who feels a familial obligation to care for the child’s needs. It’s way too easy in the current system to believe we are acting in the child’s interests when we’re actually acting to make the adults’ lives easier. That won’t change until we get rid of these bullshit subjective “diagnoses” as excuses to drug kids into compliance or docility.
It depends on how frequent the adverse effects are and how seriously they damage people. There are plenty of banned therapies for various physiological problems that are considered too risky, even if they work for some people. I agree some people seem to report positive results, and I don’t particularly want to take that away from them, but it’s a cost/benefit analysis that transcends the needs of individuals.
I also think we should remember that Vioxx, for instance, did provide pain relief for a lot of people. It also killed a certain small percentage of them, far from a majority, actually a very small minority. It was taken off the market. Because it killed people. But some people found it very helpful. The FDA decided it wasn’t OK to risk people dying, even a small percentage, in exchange for pain relief.
It isn’t always OK to allow a potentially unsafe intervention even if some people do fine on it, especially when you have no way to determine a head of time whom you might accidentally kill or whose life you may accidentally ruin.
Can you please provide evidence for your claims? It’s easy to say things without providing the actual backup. I’ve heard and read statistics that are WILDLY different from what you are claiming, so I need to see where you’re getting this info to put it into any kind of perspective.
Saying that these folks need help does NOT translate into we should assume and accept that what the psychiatric profession has to offer is the kind of “help” that they need. It is absolutely wrong to postulate that needing attention means needing the kind of abusive and destructive behavior that is often accepted and even encouraged in the name of “psychiatric care.”
Those “helped” by psychiatry with psychotic disorders die on the average 20-25 years YOUNGER than those who don’t receive such treatment. While it’s obvious that there are many variables involved, I challenge you to name another profession where receiving treatment REDUCES average lifespan. Something is not right here. The problem is not that these individuals need attention, it’s that the kind of attention they receive is not the kind of attention then need in a large proportion of cases.
I’m so sorry you had to go through all of this. It sounds like a total nightmare. How people get PAID to do this kind of damage is beyond comprehension.
They never want to admit the significance of the placebo effect. BELIEF can be more powerful than actual physical phenomena in the body! How much MORE causative can belief be over mental phenomena?
You’re right, they can’t really study it honestly. They can’t afford to let the results get out!
Sadly, I can validate all of your observations in the people I’ve seen have to go through the system. Professionals who are prepared to be vulnerable and really care are rare and are themselves often attacked for doing so. I apparently had “bad boundaries,” according to those who wanted me to toe the line and stop giving my time and energy to actually trying to help people get OUT of the system and manage their own affairs. Eventually, I had to give it up because it was clear that the intention of “the system” was VERY different than my intention!
“Reduce the core symptoms” is code for “doesn’t make any difference in long-term outcomes.” In “ADHD”, “reducing the core symptoms” simply means making the person less fidgety and more willing to sit through dull or unmotivating exercises. Stimulants, of course, will do this for anyone who takes them. While this might be viewed as helpful for some who take the stimulants, the idea that this is somehow a “treatment” for a “disorder” is delusional.
There is some evidence that accidents may be reduced, but crime involvement is not reduced by stimulants according to my research. They CERTAINLY do not die 5 years earlier on the average!!!
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Good article! Nice work, Bob!!!
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Commenting as moderator:
I will no longer be approving any comments on this article. The topic has been well aired and the comments are repetitive and not moving forward as a conversation. Please don’t add any further comments to this thread!
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What’s really awful is that none of those things that “untreated ADHD” supposedly leads to are changed by stimulant “treatment!”
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I agree that we agree!
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All very well said!
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I’m not sure where you got the idea I disagree with you. I used to be a therapist myself, and 99% of what I did was to have people describe their experiences and what those experiences mean to them. I’m simply disagreeing with you on the definition of “taking responsibility”. I don’t think you are understanding it the same way I am. The more we know about ourselves and our emotional history, the more we understand the REASONS for our “irrational behavior” (as others choose to see it, or as we choose to see it), the more we can take responsibility for deciding whether or not we are going to continue to react/respond in the same way we did before or try something new. Mostly we develop habits of thought and behavior based on what happened to us, and I saw counseling as primarily the opportunity to question whether or not those habits continued to serve us, and if not, find out what needs they are serving and find another, better way to meet those needs. So there is no blaming oneself for what happened – only responsibility for deciding how to act NOW and in the future.
That’s MY lived experience, both as a client and as a therapist. I don’t think I’m really disagreeing with you about much here. Let me know if that raises more questions/issues.
And no, I did not read the blog. I did read your comments. I’m speaking from my own direct experiences.
Steve
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I’m with Bill on this one – taking responsibility means recognizing that one’s own behavior is a choice despite past traumatic events. It’s not the same as taking the blame, which is very damaging. One can take responsibility AND be aware of and process emotion, in fact, one almost HAS to be aware to really take full responsibility.
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There are also group cultural insults that are traumatic, such as the generation of Jews whose parents were in concentration camps. There are also lots of ways that parents and other adults can hurt their kids without realizing they are doing so. School was a great example for me – daily torture, but no one seemed to notice or care, I kept having to go back every day for 13 years. There are lots of ways people get hurt and traumatized as children.
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Not surprising!
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We know at least that the AI does not dislike or judge us for our name, gender, sex, race, beliefs, etc. AI doesn’t have a subconscious, as far as I can tell!
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I remember a study where they let students log into an AI program, this was decades ago, and it was programmed to listen and ask pertinent open-ended questions. Students reported feeling better after talking to the AI!
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I would not call it “tenuous.” I would call it completely speculative!
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Thx!
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I think it goes back to “male privilege,” the broad teaching that men deserve more than women and that women’s job is to keep men happy. We are taught this all the time in our media and other parts of society. It seems it’s women’s job to make sure everything works out for men, and when it doesn’t, women are to blame!
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Well done!
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Sorry, I wasn’t suggesting YOU believe those things, I was just pointing out the failure of those arguments you alluded to made by others. I understand you are NOT a supporter of the DSM or the Medical Model. Sorry if there was some confusion there!
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I mean this idea that telling people “it’s a chemical imbalance” is somehow good for clients, which you refer to in your comment. Many say, “people like their diagnoses” or “the biological explanation reduces stigma.” Very tiring arguments, indeed!
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I agree. Blaming women for being unwilling to be your partner is childish and unproductive. Blaming feminism for women being unwilling to be your partner is childish, unproductive AND bigoted!
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There are scientific studies showing that blaming a “chemical imbalance” or brain problem leads to LESS empathy for the “mentally ill.” People relate better and are more compassionate when their issues are framed as a result of trauma or difficult life circumstances. This is science, not my opinion. I’d also suggest that lying to patients for some social reason is not the doctor’s job. You should not try and alter attitudes by lying about the science behind a “disorder.”
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I think the author would be wise to avoid the word “incel.” It has taken on some other connotations than an inability to engage in sexual activities, and is associated with misogyny and violence.
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I’m amazed anyone gets away with making that argument. They systematically RULE OUT suicidal people before doing these studies. Anyone who is suicidal during the study period became that way AFTER starting the study. If more on antidepressants are suicidal, it’s caused by antidepressants. That’s what double blind studies are for!
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Which suggests we should be looking at nutritional/macronutritional solutions, which should help SOME people, but certainly not ALL people. Depression is a VERY complicated experience that is generally more than just physiology, at least in many, many cases.
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I’m not sure I got it. What would I be looking for?
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No, I didn’t miss that part. I’m pointing out that if 55% of females have lipid abnormalities, it means 45% of them do not and are yet still depressed. Depression has multiple causes, and to try and establish ONE cause, biological or otherwise, is a fool’s errands. It’s like trying to say, “What causes a rash?” A LOT of things can cause a rash, and they require different responses. Treating all rashes with one treatment will never work. Same with depression. There will never be one “treatment” because there is never one cause. If addressing lipid abnormalities helps a good percentage, that’s wonderful, but don’t expect it to work for everyone.
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A couple of questions:
1) What do you mean “a real illness like any other?” How do you define “illness?”
2) If you are “ill” both on and off “meds,” and experienced “no success,” why are you so sure that “without meds patients are worse off?”
3) Is it possible in your mind for some people to be better “on meds” and others to be better “off meds?”
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You hit the nail on the head. Unfortunately, there is ABSOLUTELY NO WAY to distinguish “real ADHD” from any of these other conditions or no condition at all, and the DSM itself admits this quite bluntly in its introduction. That you feel you BENEFITTED from stimulants is not a reflection that you have “real ADHD,” it’s a reflection that stimulants work for YOU personally. While I never want to take this away from you, it’s a very large leap from saying that “stimulants makes it so I can complete tasks, etc.” and “I have a diagnosable neurological condition that is objectively distinguishable from normal or other such conditions in me and any other person.” Unless you can reflect an objective way to do that, all you’re really saying is that stimulants have worked well for you. And more power to you for that. Just don’t assume others who act or feel similarly will have the same results, because experience and science says that most kids who take stimulants do no better in the long run than those that don’t.
“They work for me” is about all we can say for sure.
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Remember when tey say that these receptors were “chronically decreased,” they are talking about AVERAGES. I am sure you will find many who are suicidal that do not have this condition, and many who have it who never become suicidal. If there were a way to isolate this SUBGROUP of people who happen to have this issue AND are “depressed”, by all means, we should do so, but to suggest that ALL cases of suicidal ideation or action are attributable to this is not even vaguely supported by the data presented.
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Clients are the only really valid source of feedback re: therapy. There is no “clinical measure” of how you’re feeling or what your life means to you!
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A) Szaz was not a Scientologist. He just worked with them.
B) If he is, why does that matter to you, Marcus? Why not judge a person by their evidence rather than bringing in irrelevant points like religion? A person’s argument for or against abortion, for instance, should be considered independently of whether they are Catholic, don’t you think?
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So who gets to decide what emotions are “maladaptive and pathological,” Mich? And based on what?
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With all due respect, there is not one single “mental disorder” that has a recognized “underlying brain pathology.” You should read Anatomy of an Epidemic so you will better understand why people feel they have been fooled. And people are STILL deemed “abnormal” for any negative or strong emotion they may experience. I don’t see the current system as any improvement from the viewpoint of pathologization. They are still calling you “crazy” but now have broken it down into brands of “crazy.”
There is also now evidence that making the BRAIN the focus of the “disorder” actually increases stigma and decreases empathy for the so-called “mentally ill.” Especially when you consider that the DSM “disorders” are all entirely invented in committees and have no scientific basis in brain pathology, they can keep their labels and stuff them someplace dark and stinky!
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That seems to be how they work – by down-regulating serotonin!
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It is true that antipsychotics can be useful in the short run to help people get under control. I’m just saying that calling it a “treatment” is a lot like saying morphine is a “treatment” for a broken bone. Might make you feel better and be helpful, but it’s not going to help to simply prescribe morphine without finding out what’s really going on.
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I can’t consider electrocuting someone into a seizure a “treatment,” last resort or not. And who gave the doctors the right to “see fit” when electrocuting someone is “therapeutic?”
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Actually, that’s NOT the question, with all due respect. It makes the assumption that A. these drugs are “medicines” for “diseases,” and B. that it’s always better to do something than nothing. If doing something wastes money and has no positive benefit, we are better off doing nothing than pretending we are “treating” a “disease” that we clearly do not understand!
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You should put “medicines” in quotes! The idea there is such a “medicine” is a deception!
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I know! That’s why it’s not really funny! How can these people take each other seriously?
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You are so right! The “Depression” can’t “resist treatment.” It just means their treatment didn’t work or made things worse. No other profession gets this kind of latitude! What if your mechanic said that you had “repair-resistant fuel injectors?” Would you bring your car back for another “treatment?” No, you’d know it did not work and your car was better off in the care of someone who knows what the f*&k they’re doing!
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Of course, I was being totally facetious. There is no benefit from electrocuting someone into a seizure!
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“Subconscious” is not synonymous with “unintentional.” It just means you’re not willing to acknowledge those intentions. Most “professionals” ARE covering up intentionally, even if it is not something they are consciously aware of doing. Any time someone gets defensive when presented with contrary evidence, they are intending to cover up.
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I wish I had a plan!
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Exactly! As long as the status quo is an easy way to financial success, as long as big corporations are making buckets of money, any “reform” will be considered threatening to those piggies with their snoots in the trough. Stop feeding the piggies and you may have a chance at real change. We need to stop rewarding failure with more money!
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And GO, ALEW!!!!
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I am sorry if I misinterpreted your comments. I have seen OD trainings and participated in one myself. It seems like a great approach. I’m also not opposed to the availability of drugs to assist anyone who finds them helpful. My point would be more that Dr. Jureidini should not expect to be congratulated for his success. As has been clearly demonstrated with many examples, successful healing of patients is threatening to the status quo, and anyone who is successful can expect to be attacked as a quack, a religious nut, or an irrationally hostile force. Initial reactions to Bob’s book are more proof. No one can really undermine his basic premises, yet he’s seen as a kook or an antipsychiatry nut or a “Scientologist,” as if any of those are scientific analyses of his work. And such tactics are generally successful, and will be until the public catches on that the mainstream of psychiatry does NOT have our best interests at heart.
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David didn’t “reform” Goliath and convince him not to attack. He beat him physically and defeated him. Peer workers are a great option, but they need to understand that their efforts will be OPPOSED by the mainstream system, and that system must be DEFEATED in terms of losing its power before any peer “reforms” can become mainstream and the label-and-drug model dies a well-deserved death.
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Exactly!
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That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!
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Hey, that’s what ECT is all about – inducing seizures! Why could a spontaneous seizure not cause improvement? Of course, both cause brain damage, at least potentially, but if the docs are INDUCING seizures, I suppose brain damage is potentially therapeutic!
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I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.
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Nice!
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I LOVE the “Stop it!” skit! But you are right. The problem is opposing goals. The peer movement’s intentions were contrary to those of the main MH system, and so they had to be coopted or snuffed out. And the MH system was very effective in doing so. You can’t change the basic purpose of the MH system. It’s built in.
‘
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They were actually initially banned in Germany for these very reasons. It’s a very real problem.
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Sure thing!
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Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.
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It sounds like you’ve had a lot who are that way. No therapist should believe they know more than the patient about their own situation!
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POSTING AS MODERATOR:
Mark, you have not contacted me by email or responded to my emails. I’m not sure you even received them at this point. I will no longer be able to post your comments until you contact me and we can have a conversation. Again, my email is [email protected] or [email protected]. It’s also listed in the “About” section of your home screen. Meanwhile, all of your posts will simply stay as “pending” until I hear from you. I’m not sure what else to do to get a response from you.
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So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.
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Motivational Interviewing has a lot of useful techniques and is or should be very much client directed. The coach or “therapist” finds out what motivates the CLIENT from their own viewpoint and then helps examine which current behavior gets them closer to that goal FROM THE CLIENT’S POINT OF VIEW.
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How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”
And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!
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Posting as Moderator:
Mark, I am giving you until the end of today to respond to my emails or give me a working email address. If this does not occur, I will be forced to remove your right to post here, as having a working email is part of the posting guidelines.
My email is [email protected] or [email protected]. Please contact me TODAY.
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— Steve
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I think you mean the one I wrote to Mark about his email not functioning?
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Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?
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You do realize that many women are unable to establish positive sexual relationships as well, don’t you? I would love to see you address this issue as part of your presentation.
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Posting as moderator: MARK, PLEASE CHECK YOUR EMAIL. I have sent several messages. If you are unable/unwilling to respond to emails, you are not allowed to post at MIA. Please write me back so we can discuss your prior posts. It’s not OK to keep saying you are waiting for them to be posted when I’ve told you my concerns and you have failed to respond.
Please write me back or I will have to stop posting your comments. If that email doesn’t work, please get me one that does ASAP.
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Posting as moderator:
Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.
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You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.
Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.
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They should not be “involved,” they should be the central architects of any such effort. Who knows better than those with “lived experience” what actually does and does not help???
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Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
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But that would require a level of honesty the industry does not appear willing to exercise.
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When advocating for foster youth for 20 years, I saw many who became aggressive on stimulants and were then re-diagnosed with “bipolar disorder” instead of stopping the stimulants. It was extremely common but very hard to get anyone to discuss seriously, even though a good number of the psychiatrists I worked with admitted it occurred.
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Something is seriously wrong with a system in which we can talk about “”moving toward shared ownership and dialog.” What kind of help can be going on where shared ownership and dialog is not already THE central concept we are operating on? How can a therapist know what is helpful if they aren’t having shared dialog with their client????
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How can you say it “works for everyone” when so many people report no benefits or harm from DBT? I see a bunch of useful skills which could be helpful in the hands of a competent therapist but how many therapists are that competent? And why can’t others not trained in DBT employ or teach the same skills? Mindfulness, for example, is swiped from Buddhism, and there are many who understand mindfulness well who have zero connection with DBT. There are plenty of other examples.
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The research I’m familiar with suggests that it is not “ineffective methods” but rather lack of emotional preparation and appropriateness that undermines success. Therapy success appears to be associated more with therapist characteristics than by method or school of therapy employed.
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I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
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Again, please remember that NNT and other stats are based on the assumption that symptom reduction is the goal. This is a false outcome, as symptom reduction does not translate automatically into better outcomes.
It is not the job of others to demonstrate that Ritalin’s benefits do not outweigh the risks overall, it’s the job of those promoting the “treatment” that they do by a significant margin. If there is no major improvement in outcomes, then by definition, the treatment risk outweighs the benefit, unless you are claiming absolute zero risk. Even in the latter case, you’re still advocating for wasting money on something that doesn’t really work.
The burden of proof is on those claiming a treatment effect.
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Excellent advice!
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There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.
I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.
BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.
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These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.
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I think you nailed it here! It’s not that I object to anyone “identifying” with a particular “diagnosis” as an identity. It’s the effect of legitimizing these “disorders” as valid entities rather than social constructions that some people like to use as “explanations” for their uniqueness. The idea that diversity is “neuro,” aka CAUSED by neurological differences, plays completely into the hands of those who want to blame the brain for everything wrong with human beings’ behavior while letting our social structures off the hook. I know that a lot of people WITHIN these movements don’t believe that, but those running the show don’t care, they are still getting support for their label-and-drug approach that’s keeping them rich and protecting those in charge from having to examine the society they are creating and promoting.
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How about “unconventional?” Or “unique communicators?” I think it is the idea that neurology and only neurology creates and defines these differences, along with the idea that “neurotypicals” can somehow be defined and dismissed as “normal,” that causes offense.
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I can’t agree with that definition. Stigma implies an unfair negative bias based on a label or category. Prejudice implies specific actions taken as a result of believing in the superiority of one group over another. Discrimination is specific acts to harm someone in a category against which one is prejudiced. There are frequently no legal consequences to prejudice and discrimination, and in fact, they are often rewarded. I remember in 6th grade or so standing up for a kid labeled as “mentally retarded.” He was being harassed, so most definitely acts of prejudice. I’m sure he was also not included in people’s social groups, which is a form of discrimination. You know who got punished when I stood up for him? ME! I was “accused” of being a “retard lover” or some such thing. This went far beyond “stigma.” Where are the legal consequences for such acts?
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What is “scientific” about the DSM? Perhaps the author needs to look up what “scientific” really means.
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I agree 100%!
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Actually, they provide a LOT of “education,” even at official institutions. It’s kind of sick!
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I had a lot of clients blaming their parents for their issues. Often, they were at least largely correct.
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It is a technique, not a “therapy.” The drive to create a manualized “therapy” is very strong, as it emphasizes making long-term clients and avoiding insight-driven healing. But no one can do therapy based on one technique or a manualized set of techniques that avoid connection with the client. CBT is only useful in the context of a larger “therapeutic relationship” where there is trust and sharing and humility between “patient” and “therapist.” This situation rarely happens, so most experience CBT as rather disconnected and intellectualized, and invalidative of the legitimacy of their actual issues and needs.
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I was referring to calling other people “autistics” not claiming that label for yourself. Generalization is the problem.
Why not simply point out that some people are prone to violence and need to be dealt with for the safety of society? No one would argue with that premise. But the idea that “medication” is the best answer or is consistently effective is not supported by the number of “medicated” kids who remain violent, or even become violent on the drugs. I’ve worked in the foster system and kids mental health so I know what I am saying.
And am I wrong that you never read the book?
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I see the thought behind your questions. However, by referring to a group of people as “Autistics,” you are making demeaning generalizations as if a person getting this label is somehow described and defined by it. This is a large part of why folks here object to the DSM mentality – labels such as “autistics” are inherently dehumanizing and don’t allow for discussion of either causes or options.
Are you aware that many of these kids your mom worked with, probably 90% or more, are already “medicated?” And yet are still violent?
Things are not as simple as you attempt to portray. Have you read “Anatomy of an Epidemic?” I am betting the answer is “no.” Maybe you should read the book and you will start to understand why people get upset about what you seem to accept as reality.
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I agree 100%.
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🙂
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It sounds like they are training sociopathic traits into people!
The only thing that made me effective as a therapist was my willingness to let down my barriers and feel what the client/”helpee” was feeling. That is completely what guided how I would intervene. If a person can’t do that and still “maintain boundaries,” they have no business trying to help anyone emotionally. They need to get their own help first!
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I respect your views on this. But I can tell you from past experience that this line of discussion is not productive and travels far from the realm of the “mental health” system. You will have to respect my judgement on this one. I am speaking from hard experience attempting to moderate such a discussion. So I’m not going to defend my decision. It’s already been made many months ago.
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Posting as moderator:
I don’t disagree with you. But COVID is off topic and has not led to productive conversations as a topic. You actually posted the first one on the topic and I should have disallowed it. Some of the more far-fetched comments that DO have to do with psychiatry are allowable as long as they are on topic and not insulting to individuals or groups. I don’t judge by the content except to the degree that it is not on the topic at hand, and I even let a lot of THAT go if it’s productive conversation. But COVID is not a topic that is either on topic or leads to productive exchanges, so that’s why it has been stopped.
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POSTING AS MODERATOR: We are not going to go down the COVID path again here. It leads nowhere but to off-topic arguments. Both sides got one “hit” in. That is all I will allow.
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I think I just approved your post earlier this morning. It was just waiting for moderation.
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Posting as moderator
Please write me at [email protected] with Amy such concerns. It can take up to a day for something to post, but things do inexplicably disappear from time to time. I don’t recall moderating any of your posts.
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Actually, very few even bother with brain scans.
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The problem is, the assumption that all of these “disorders,” created by committees and literally voted on, are “brain disorders.” There is not one of these “disorders” which is proven to be caused entirely or primarily by biological causes, let alone a single cause for a single “disorder.” The most optimistic data suggests a 10% biological contribution, while environmental causes account for 80% or more of “mental illness.” So be careful not to simply repeat beliefs you have heard. Read Robert Whitaker’s books and then take another look.
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Oh, I agree absolutely! ANY potential causal agent with REAL evidence should be explored. Even if only 10% of sufferers have low folate, we can heal 10% of the population with a simple, cheap and safe intervention! We just have to stop expecting that EVERYONE will get better if their folate and betaine are increased. Let’s find the real cause in each case instead of assuming one solution will fix everything.
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Just for the record, John Nash recovered without or despite his psychiatric “help,” and spent many years avoiding the psych system before his spontaneous recovery. The movie played it differently because they didn’t want to discourage current patients from using their “meds.” Nash complained about this to the producers but was not listened to.
https://www.mentalhealthforum.net/forum/threads/john-nash-healing-from-schizophrenia-the-real-story.34784/
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That all makes sense. There will never be one “cause” because it’s not one thing that is happening for the same reason. People need to think!
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Good information, but it clearly suggests that “schizophrenia” is not caused by a particular genotype, but is a very complex phenomenon that includes many possible causal factors.
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Can you identify the comment by the first line of text? I don’t want to remove the wrong comment!
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You are denying reality. The point of the articles is that the Star-D has falsified outcomes. If you choose not to believe that (belief is not science) that is up to you, but don’t try to claim that later science is responsible for updating fraud. When the authors have been confronted with their false conclusions they have doubled down, not reconsidered. It was a handy conclusion that people like you want to believe, so they believe it.
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It may not be damaging, but it is certainly not scientific.
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Did you read about the Star-D study? It wasn’t wrong or incomplete data. They ALTERED the outcomes. They LIED about the results. That’s different from being overridden by new and more accurate data. Do you just not want to accept that fact?
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The fact that there is newer research has no bearing on the clear attempt to falsify the data in the study. Doesn’t that concern you? That the studies aren’t reporting the truth?
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The fact that sharing decision making is even a point of discussion says a lot. Why would you NOT share decisions with the person making them?
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Posting as moderator:
There’s no function to edit approved posts. The only solution I can propose is to submit your new post as a new post.
Hope that helps!
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See my emails to you.
I don’t think he’s trying to prove his points are not opinions. He’s trying to show that the entire subject is based on opinion. I don’t think he is in a position or needs to do so. I think it’s OK to identify however you like, and it’s OK for him or you to have an opinion about it. It’s just not science.
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Not a problem. All part of my day.
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Please let me know if I did this wrong, Tom.
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Well said!
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You are sharing the “general consensus” that we’ve all been taught to believe. I suggest you read some of these stories from real people who totally believed what you say and had not so great or horrible experiences.
I’m puzzled also hoe “the right medications” are going to help with anything but #1. And of course, research has never really shown “chemical imbalances” to be real, measurable things. So you actually make a great argument that medication is at best a very small part of any treatment approach, yet you seem to be arguing it’s the whole thing.
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“Depression” is not caused by one thing. That’s the first error of psychiatry – lumping all “depressed” or “manic” people together as if their behavior or emotions tell us what is wrong with them or what they need. Saying someone “has depression” tells us very little about why or what to do about it. “Treating” something makes no sense if that “thing” isn’t really a thing at all, but a phenomenon with many possible causes and solutions.
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It is not about Clozapine per se. It’s about doctors playing fast and loose with the facts and the system being based on incorrect assumptions and guidance. I’d say it’s one more example of how patients are assured that doctors have all the know-how to use these drugs responsibly when they really do not, no matter how responsible they are. By the way, I consider it a pretty cheap shot to toss out that doctors have to be “lazy and negligent” to make Clozapine use a risk not worth the benefits. There are very good reasons it fell into disuse, as you very well know, and they had nothing to do with negligence.
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Depression most often involves having a shitty life. What is used to measure that, Scott?
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There is not “line blurring” going on. The lines ARE BLURRY and what most object to is trying to make them seem like they are not.
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I think you are missing the point.
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If I can’t discuss concerns about a comment or thread, then I can’t work with you. It’s part of the rules of posting. Otherwise, you can post whatever you want and I have nothing I can do except not publish your posts. Obviously, I have a concern to discuss. If you can’t do it, I’m sorry, but that means you won’t be allowed to post.
Steve
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As in we have to talk.
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POSTING AS MODERATOR:
Hi, 27/2017,
I need to talk to you but your email does not function, in fact, appears to be a fake email. I will have to block your submissions until you post with a functioning email address. It is a requirement under the posting guidelines.
Steve
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Depression is about a lot of things. The first mistake of psychiatry is assuming that depression or anxiety or any emotional phenomenon is always caused by the same thing.
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15% certainly does not suggest CAUSALITY. It suggests vulnerability of certain genetic subgroups, who may have many other things in common, not a ‘schizophrenia gene.’ Causality figures would need to be in the 85-90% range. 15% says that at least 85% is NOT caused by genetics. So genetics is a secondary factor.
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Wow, you can make up a lot of stuff in one paragraph. Do you have even one citation for any of your claims?
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Abilify is an antipsychotic, most definitely prescribed frequently for “bipolar disorder.” It is only used as an adjunct for depression if regular “antidepressants” are judged not to work. Not sure where you’re getting this false information.
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At best, results are mixed. Read Irving Kirsch some time if you want to know the truth.
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The “low serotinin” theory of depression has long since been debunked. Additionally antidepressants are notoriously ineffective with youth and especially children. You are operating on faulty assumptions and criticizing others for not sharing them with you. Try reading some of the stories before you judge.
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Nobody is trying to take your medication away.
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You say a lot of things here you have repeated because you heard them somewhere, but most of the people on this site have a lot of direct experience with the system themselves and understand it’s not so simple. Clearly, Brittney’s life didn’t suddenly get all better when she got treatment, did it? Additionally, the issue of the guardianship was fraught with all kinds of conflicts of interest and personal agendas above and beyond any “mental health” concerns. You might want to read Anatomy of an Epidemic and get an idea why people have concerns about the “mental health” system instead of assuming everything you’ve heard is automatically true and people who don’t agree are irresponsible or ignorant.
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111 days – WELL DONE!
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POSTING AS MODERATOR: We are drifting over into areas of politics that transcend “mental illness,” largely because of the nature of this article. But we need to keep focused on the “mental health” themes and whether “mental illness” focus obscures structural violence. There are many other contexts besides Gaza to draw on.
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Way to go!!!!
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That sounds like your brother being put in danger by prejudice, not his own dangerous behavior.
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How would you know who genuinely “has” BPD?
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I “unapproved” the first one I could find. Is that the one you wanted?
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Posting as moderator: Which post, Beth? How does it start? I can delete it if you can help me identify it.
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The use of the term “resistance” these days doesn’t mean the same as Freud’s concept. It just means “didn’t get better with our ‘treatment.'” It’s basically a way to blame the client for the failure of the “treatment.” That’s how I read it.
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Electrocuting someone into a grand mal seizure sounds like malpractice to me. How can you “do it incorrectly?” What the heck is the correct way to induce a seizure that might potentially cause brain damage?
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I thought similarly – AI at least can’t work out its childhood issues in your sessions!
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Whether or not someone receives treatment is not an “outcome.” An outcome is a result of the treatment approach. The study does not state or claim or suggest or imply that no one has a good outcome using antipsychotic drugs. It suggests that ON THE AVERAGE, those who receive light or no intervention are more likely to have a better outcome at two years onward. A better outcome ON THE AVERAGE. There can be plenty who got a better outcome with drugs or a worse one with drugs as well. Your story is one story of millions. Yours can be 100% true and yet the average person can still be worse off in the long run on antipsychotics. You are one data point. A scientific study is made up of hundreds or thousands of data points. It’s not the same.
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Stick to the facts and the scientific studies as much as you can. No one can sue you for reporting your own experiences honestly.
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Most of these people have HAD ECT themselves or know someone who does. Many also know the ECT research literature better than the average clinician.
It’s insulting to suggest that anyone here is making up their minds on fictional accounts. I’m glad you had a positive experience to report, but don’t assume others experienced the same or similar things!
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Traumatizing experiences are also normalized and kids are expected to not complain about it. How many kids say things like, “Oh, that’s not abuse, I totally had it coming!”
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Gotta love it. THEIR “treatment” doesn’t work, but it’s because YOU are resistant. Or your “schizophrenia” is. Apparently resists without consulting you. Insanity!!!!
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Please explain how any one DSM “diagnosis” is derived from scientific observation and research. Specifically, please describe how exactly one can distinguish who “has” the “disorder” from who does not ‘have it.’
This is not to say that people don’t like or benefit from biological interventions. But that’s nothing new – folks have taken substances to alter their mental/spiritual reality since the beginning of human history. That’s very, very different from claiming that something as vague and amorphous and subjective as “major depressive disorder” or “adjustment disorder” or “ADHD” is derived from the scientific method. In fact, the DSM admits they are not in its introduction, in no uncertain terms. You ought to read it some time.
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The fact that you feel you can “diagnose” that based on an internet comment proves how completely subjective and unscientific these “diagnoses” really are.
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Always wondered why fathers got off the hook, just for starters.
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Your comments reflect not having read the many testimonies of people here who were diagnosed with “major depression” or “bipolar disorder” or even “schizophrenia” and were treated with drugs for years or decades with really poor outcomes, including a significant number who did far better after they came off the drugs and did other things.
There are most definitely big medication success stories. There are also disaster stories. Same drugs, same “diagnoses,” very different outcomes. If you really want to understand a site like this, that has to be your starting point. You can’t decide people are ignorant simply because they had different experiences than you. Maybe you should stop and read some of the stories before you assume that no one here has suffered any “mental illnesses” just because they had very different outcomes than you expected to hear?
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Confirmation bias is generally rooted in anecdotal evidence, aka testimonies of those helped/not helped by an intervention. Citing testimonies as proof of confirmation bias seems a bit ironic.
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It might be interesting to hear a specific objection you have to a specific claim or study.
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Here are the references I quoted. Barkley and Cunningham 1978. Swanson et al 2003. Oregon Medication Effectiveness Study 2002. Montreal ADHD Study. Raine study from Australia. Finnish comparison study to USA cohort. Not to mention Whitaker himself, who summarizes the extant literature.
How are these not citations of clinical studies? Barkley in particular is a super pro-ADHD researcher. It seems you didn’t read my earlier posts yourself. My comments are firmly rooted in years of long-term research, which you’d know if you’d bothered to read Whitaker’s work before deciding you already know all about the subject. It’s not too late to educate yourself, but I get tired of repeating the same lessons for folks who don’t seem interested in seeing another viewpoint.
And the author mentioned his “clinical experience” including a specific case, as I recall, which is 100% anecdotal. I am very clear what anecdotal evidence looks like.
I think it would be nice if you would learn to respond without putting down the person you are disagreeing with.
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Is it an illness if the responses are reasonable and understandable to the conditions bringing them about? Why aren’t the people COMMITTING the traumatic acts against their loved ones or employees or patients considered the ones who have an “illness?”
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ADHD being “more recognized” would in no way make it more likely that people taking stimulants being more likely to develop heart problems. It’s not a new suggestion. Probably not a common event but it sounds like more common if you take stimulants. Knowing what we know about stimulants, the increased risk of heart disease associated with them should not be surprising.
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Hearing about “numerous studies” but no names or links. Might be interesting to get out of the realm of “rhetoric” and into actual science.
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None of the studies I referred to were funded by pharmaceutical companies. Government studies, especially when longitudinal, are generally more reliable.
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The average “seriously mentally ill” person, most of whom have received years of drug “treatment”, die 15-20 years younger than the general population. There are, of course, multiple reasons, but psychiatric drugs and ECT are high on the list.
The antipsychotics are known to induce diabetes and other metabolic issues, and to increase heart disease. If you think inducing diabetes doesn’t kill people, you are confused.
Sometimes, psychiatry does kill.
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Anecdotes are not scientific evidence except in the crudest sense. I’m not saying the drugs have no effects or that “ADHD” is trivial or that people so diagnosed don’t do worse than the general population in a number of significant ways. I’m saying that, for instance, the claim that “untreated ADHD leads to delinquency” is false, because “treated” ADHD kid aren’t less likely to become delinquent. BOTH groups are more likely to commit criminal acts, though interestingly, I recall reading a study where those identified early on as non-aggressive “ADHD” types did not commit more criminal acts later. But it makes sense, impulsive people are more likely to do impulsive things, and committing crimes is often impulsive. The point is, IN THE COLLECTIVE, we do not reduce the delinquency rates by “medicating” the subjects. This does not mean a particular individual wouldn’t, say, feel better about school, improve their grades, or even say, “This stuff saved my life!” But those are anecdotes. Scientifically, we have to look at the overall effect, and overall, the effect of widespread stimulant use on the population is not large, if we look at the data rather than stories.
I would submit to you that there are plenty of people whom you don’t know whose situations might have gotten worse to the same degree your client base got better. I don’t know what kind of selection bias you have in your population, but I worked with foster youth and saw plenty whose lives deteriorated after starting stimulants, particularly due to aggression toward others. Many ended up with more drugs and worse “diagnoses,” one ended up psychotic until she herself stopped the drugs and went back to her old “normal.” So anecdotes can tell many stories. Collective data is more reliable.
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Multiple long-term studies show no significant advantages to those taking stimulants vs. those who don’t when diagnosed with “ADHD” in childhood, other than the accidents you mention, and I believe clearly overstate in your comments. Delinquency rates, HS graduation, college enrollment, social skills, not even self-esteem scores were better for those taking stimulants. This has been confirmed since Barkley and Cunningham’s first review in 1978, confirmed by Swanson’s “Review of Reviews” in 1993, and in the OSU medication effectiveness study back in 2002 or so. Also confirmed by the Raine study in Australia, the Quebec study, a comparison study between Finnish and US kids who had very different medication rates but similar outcomes, and more.
Read Whitaker’s works if you want to fully understand what’s going on at MIA. Not everything is the way the professionals have told you it is.
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You speak wisely. Unfortunately, the privileged are generally protected sufficiently to prevent them from hearing you!
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It’s not really a legitimate approach to say, “What else should they have done?” It assumes that doing SOMETHING is essential and that NOT doing what they propose is foolish unless you have something “better” to replace it. It is possible that antidepressants were destructive AND there was not a “better treatment” available. We should not assume “antidepressants” as some sort of minimum standard of treatment that is the default unless we have something “better” to propose. Sometimes nothing is better than doing things that are destructive.
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You’ll have to ask Justin about this. If you send me an email at [email protected] I’ll see if I can forward it to him.
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Please hit the “report” link/button for anything that shows evidence of being spam/automatically generated.
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If it were so safe, they would not have to do toxicity tests every two weeks. Lithium can do serious kidney damage among other things. It’s therapeutic dose is as close to the toxic dose as almost any other drug you can name.
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Not necessarily:
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2786428
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I think you are missing the larger point, Donna. You say our “knowledge” of these things is in its infancy. But the “diagnoses” themselves are not explanatory of anything, regardless of the education and experience of the person involved. How is saying, “Joe feels really hopeless and sees no point in his life” any different than saying “Joe has major depression?” Is there some way to distinguish Joe’s “Major Depression” from Mary’s “Anxiety disorder with depressive features?” They are simply descriptions of what is observed, and clinicians will make a lot of noise about “clinical depression” vs. “reactive depression” but look in the DSM, there is simply NOTHING there to make a distinction. You meet 5 out of 8 criteria, you “have major depression.” Only meet 4, you don’t. Nothing about cause, nothing about ongoing stressors, nothing about culture – just a description. That’s not a “knowledge in its infancy.” That’s just making stuff up, plain and simple. There is no way any “knowledge” can advance from that kind of basis. The DSM is not knowledge. It’s a fantasy that makes people believe “knowledge” is behind it.
Not sure what the answer is, but calling people names based on arbitrary checklists isn’t it.
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I agree 100%. But everyone still insists he’s wearing beautiful robes!
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Invasion of the Body Snatchers. Or The Stepford Wives.
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Replying as moderator:
I really don’t want to get into debating COVID or the WHO response. It is off topic (not about the article or about the “mental health” system) and has become highly divisive. We’ve now heard both sides well expounded. Let’s get back to our mission!
—-Steve
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The DSM makes a good doorstop! Maybe in the bathroom, so it can double as backup toilet paper!
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It’s my understanding that suicide rates have always fluctuated along with unemployment.
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I think the answer is no. No one is paid a fee for writing for MIA, as far as I am aware.
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Science is not created by consensus, and does not have any consideration for a “middle ground.” Are we going to start saying that gravity is inconvenient for some people, so we’re entertaining some small modifications to help people adapt?????
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You mean we should consult long-term outcome measures to see if something works? Wow, radical concept!
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I think you can just comment on the article and if the author is reading comments, they will consider your comment as intended for the author.
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He won’t even try. He’ll just go somewhere else and keep repeating the lie.
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The hummingbird house was a new experiment at the time with an open environment rather than cages. It felt like they were pretty good with the environment or it would not have felt good to be there. I felt like I was in their world.
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True! You should get funding for a study!
I used to go to the hummingbird house at the Philadelphia Zoo during the week when nobody was there. I would sit for 10 minutes making no noise, and soon I was surrounded by birds doing their thing. It was very soothing, and I didn’t need someone to tell me it “worked!”
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Exactly! They hire “nature therapists” and pay them to go hiking with you!
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We know this. He can’t answer my challenge and will probably ignore my response. Otherwise, he’ll say it’s “well known” and present no evidence or else attack my credibility. That’s how it seems to be done.
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Easy to say that. Please provide us with the definitive proof of shared biological pathology for all forms of “schizophrenia.” Not correlations, not candidate genes – let’s hear the exact “pathology”(to use your own words) that distinguishes these conditions. I will assume failure to answer means you have no answer.
Here’s your chance to prove us all wrong!
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I know, it’s like when they “discover” that hiking in the woods makes people feel calmer, and instead of saying, “hey, try hiking!” they decide to call it “Nature Therapy!”
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Posting as moderator:
If you want to connect via email, please let me know.
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Thanks!
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Strange things happen in Cyberworld! Including whole posts disappearing on occasion. Just check in with me next time.
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POSTING AS MODERATOR:
For the record, I can’t find any moderated posts from you. Next time, I’d ask that you email me and check before publishing the assumption you’ve been moderated. I almost always leave a note.
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Superstition comes into play in all forms of medical treatment. Placebo effect is acknowledged to deliver half the benefits of any treatment. Drugs become less effective the longer they’re around because people start to hear issues and concerns that were not talked about before. What people believe has a lot to do with what works.
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“Maybe you’re not DEPRESSED… maybe you are being OPPRESSED!”
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Very well done, Amber!!!! Take a bow!
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You sound very committed to the idea that “there is only one reality” that is unaffected by any of our personal narratives. Can you submit some scientific studies that prove your contention to be true? Or is it simply a matter of faith, based on… your personal narrative?
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I think the real lesson is: Kids are not all nails, even if you only have a hammer. Use the hammer when the job calls for it, otherwise, quit hammering our kids!
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The fact that you worked through it yourself and found out what worked and did not work for you has to be a big plus for you. Additionally, I hope you learned that not everyone responds to the same things and that a therapist has to be creative and responsive to the individual needs of their client. It’s been proven again and again that these therapist characteristics are far more important than the modality used, in fact, in many studies the modality was not a contributing factor to positive outcomes.
Bottom line, it seems you learned empathy for your clients and haven’t forgotten that lesson.
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Can’t argue with you there! Of course, if all psych studies were held to standard, there’s be a LOT less papers being published on all subjects!
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Yeah, it’s sort of rude when patients don’t comply with the doctors’ preexisting biases and expectations, isn’t it? Maybe the doctors just need to work on robots, then you get almost total predictability!
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Wow, that’s kind of stunning! Do you have a link to the articles?
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Individuals don’t need to prove the effectiveness of anything they sense is working for them. It is those claiming someone ELSE will benefit from an intervention they are offering/forcing on that person who need to show the proof.
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Or NEEDED too believe…
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One size NEVER fits all in the world of mental/emotional challenges.
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I think it showed that administering group DBT training doesn’t lead to improved outcomes. If I’m a school administrator, that should be enough for me to think, “Well, we’ve got only so much time in the day, why waste time on something that doesn’t have a significantly positive effect?” An intervention doesn’t have to be proven harmful to be avoided. It just needs to be shown not to be significantly helpful.
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These “differences” are AVERAGES – They can never be used to determine if person A “has schizophrenia” or person B does not. There are tons of “schizophrenic”-diagnosed people who do NOT have frontal cortex atrophy. It’s also well known that frontal cortex atrophy and other brain shrinkage can be caused by the antipsychotics themselves. PET and f-MRI studies are absolutely useless in “diagnosis.” And of course, this must be the case, because there is no reason to believe any 5 people with the same “diagnosis” have the same kind of problem or need the same kind of help.
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I would add that psych ward staff also need to learn and practice these things. Some do this well, but some don’t. The real problem is POWER. The people with power are telling the kids how to “manage their emotions” and whatnot, but they are still free to be as abusive, neglectful, and thoughtless as they wish and suffer no consequences. Whether its parents, teachers, staff, doctors, pastoral leaders, or even just adults who are comfortable exercising power over those they feel are beneath them, as long as the person in the one-up power position is unwilling to step down, no amount of “emotional management” will make things any better.
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I would add that the teachers need to learn and practice any skills they want the kids to have.
I had a neighbor kid who was in middle school. He explained to me they spent a one-hour assembly working on Carl Rogers’ reflective listening skills, including “I statements.”
He was sitting on the stage after the session and a teacher came up and said, “You, get off the stage!” in a very loud and aggressive manner. He said, “I don’t like it when you yell at me. I’d prefer we speak in calmer tones.”
He got sent to the Principal’s office immediately. What was the real lesson here?
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But we want him to feel OK about being in debt! Don’t want them WORRIED about it!
The goal seems to be Stepford Wives!
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I would add that being told over and over that their emotional struggles are a “mental disorder” has contributed to younger peoples’ lack of ability to cope. Used to be parents, teachers, and the kids themselves got the message, “Hey, you’re good at x, but not so great at y. Let’s work on your Y skills.” No excuses, you just were how you were and everyone dealt with it, admittedly poorly much of the time, but at least the message was, “Don’t feel sorry for yourself – you can figure this out.
I also remember the crazed maniacs who sometimes passed for school teachers back in my day. I’d hardly say the school environment has gotten more stressful!
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I must have a well-developed hippocampus, then! Spent a lot of hours with Mario when I was younger! I still play Tetris to this day!
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Fear and outrage are not scientific arguments!
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When I was a counselor and sometimes had to do these “diagnoses,” I viewed them the same way, and told my clients as much. I said they’re just descriptions of behavior/emotion/thoughts that are used to bill insurance companies. I told them I’d select the one most likely to get them the kind of help they needed. I always favored PTSD or Adjustment Disorder because they would incline toward talking solutions rather than drugs.
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Unfortunately, there are an unfortunately large number of terrible or mediocre counselors. I don’t think they “need to keep you sick” as much as not really understand what “better” means to the client and how to get there.
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Are you saying anything is better than telling someone they have an incurable brain disease and there’s nothing they can do about it except hope that the doctors have a magic pill that never seems to develop?
A sensitive 8 year old can do better than a standard psychiatric intervention. On the average, listening to someone is going to help, but who needs to be a therapist to listen? And what guarantee is there that a therapist can and will listen anyway?
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That is a GREAT reframe!
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Not to mention profits!
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It is also possible that some are NOT there to make you feel better.
On the other hand, the bartender and the heroin peddle are there to make you feel better, too.
Making someone “feel better” is generally only effective as a short-term objective. People who set their long-term goals at “making myself feel better” generally don’t have very livable lives.
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Wow, that is an incredibly sad story! It makes me angry just to read about it!
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That does seem to be the message. At least from the incompetents. Just “think different thoughts” and your emotions will change! A bit of magical thinking, there. I mean, in the LONG RUN, it’s probably true, but to make out that a person can just “change thoughts” on command, especially after years of trauma or living in current danger, chronic or acute, is patently ridiculous. There’s a lot of trust building and examining patterns and detecting the purpose of certain behavior/thinking from the client’s viewpoint and a lot of “what ifs” and “Let’s imagines” before anyone gets around to saying something as monumental as “I’ve changed my viewpoint. I don’t need my mother’s constant involvement to survive.” People believe what they believe for a reason. It doesn’t work for a therapist to say, “That’s a bad belief, you need to change it!”
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Hard to argue with you there. There are probably a few rare exceptions here and there, most of whom will probably quit early or be driven out by their colleagues.
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Nobody is saying the medications are not valid. We’re saying PSYCHIATRY is not valid! The idea of taking a substance to make yourself feel better is as ancient as human history, maybe even older. It’s not an amazing 21st century discovery of the psychiatric profession. The biggest problem is these damned DIAGNOSES, which have no scientific reality but are used to promote certain products and discourage people from exploring their own solutions.
If the drugs work for you, more power to you! This website is not about that. It’s about bringing some kind of sanity back to the world of “mental health treatment,” including stopping psychiatrists from involuntarily forcing people to take these drugs when they do NOT work for the recipient!
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CBT as practiced by many often does encourage clients to ignore or minimize or intellectualize social causes of distress. I find it useful in certain contexts, but see it as a tool, not a therapeutic school. It works fantastic for some people in some situations (I use it all the time myself), but there are times when “empowering oneself” has to take a back seat to taking an honest look at what’s going on or has happened in the past. For instance, a domestic abuse victim might learn to “think different thoughts” so they find their abuser’s comments less upsetting. This might be a useful skill, but it does not BEGIN to address the needs of the client. If all we gave our DV victims was CBT, we’d be doing them a gross disservice. Same with folks with big tramua histories. Telling them to “think different thoughts” is a short step from “get over it, you wimp!” And lest you think I’m exaggerating or making this up, several people have reported on MIA that they are told by their therapists that they should “not think of the past” and that processing historical emotions is a waste of time and they need to “Be mindful” and “focus on the present.”
A good therapist can use CBT to get good results when it is appropriate. A bad therapist can use CBT to create an emotionally unsafe environment for their clients and effectively make their “mental health” status worse.
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Hi, Molly,
I certainly have no intention of attacking psychiatrists. But you are saying things that are said by psychiatrists but not scientifically accurate. Antipsychotic drugs HAVE been shown to do brain damage, including reduction in grey matter volume, altering the size of the Corpus Collosum, and inducing neurological problems like Parkinsonism and Tardive Dyskinesia. No psychiatrist worth talking to will deny these things are known facts. There are now ads on TV to fight off TD, which is directly stated in the ads to be caused by their “mental health meds.” The idea that antipsychotics offer some protection from brain damage caused by schizophrenia or other “mental illnesses” is a nice concept, but again, I know of no evidence that this is actually true. Can you attach a link to a study or two to show where you’re getting this information?
It is hard sometimes for people who have used the MH system and feel they have benefitted from it to hear from others who feel it has harmed them. I don’t think anyone here wants to upset you about this stuff, but they’re mostly just telling their stories, and I believe they have a right to do that, even if these stories don’t jibe with what you’ve read or heard or been told. And if it causes others to be a little more careful how they engage with the system, I think that’s all to the good. An informed patient has the best outcomes, but our practitioners mostly have conflicts of interest that prevent them from giving out the honest information that everyone needs. A lot of that information is available here, albeit often in anecdotal form, but still, don’t you think folks have a right to tell their stories? If you came on and told YOUR story and someone told you it was “wrong” or was damaging people, how do you think you would feel about it?
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It’s worse than that, Molly. They don’t know what they should be aiming at. The drugs hit parts of the brain they ARE intended to hit as well, and THOSE parts of the brain get broken down and stop working properly, too. They’re not quite shooting at random, but the targeted parts of the brain do not heal under their attack. And destroying them isn’t good for the brain, either. It is a poor solution.
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I don’t consider this obvious. A person may need PROTECTION, yes, and others may need protection from THEM, but why does “treatment” in the form of enforced drugging necessarily emerge from feeling angry or confused or despairing? How about giving folks a safe place to calm down and some sane people to talk with if they want, plus some food and sleep and the like? Why start with forced drugging as the only “answer,” especially when we see how poor the outcomes are for those experiencing such “treatment” in the long term?
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I learned early on that “intellectualization” is just one more coping measure, having its value and its drawbacks, just like every other coping measure. We all need coping measures, including denial, splitting, minimization, and intellectualization, in order to survive. There is nothing wrong with using any of them if they are working for you. The times we have problems is when we learn these measures early in life and come to believe they are our only options in certain situations. Becoming aware of the coping measures we choose and getting a broader range of options in any given situation is a valuable set of lessons. A lot of times, using intellectualization to “block childhood trauma” is the smartest thing to do. There are also times it can get in the way of moving forward. Just like any other coping measure. It is not good or bad in itself, it’s about how/when these coping measures are used that matters. And who is really in a position to judge that other than the person deciding how to “cope?”
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Thank you for a beautiful post!
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The answer is simpler and more grim – they prescribe it to keep them quiet. “Antipsychotics” reduce aggression, so any sign of violence or aggression from an “autistic” kid and out comes the Risperdal or Abilify prescription. Also often used to calm down aggression that’s actually CAUSED by stimulants for “ADHD”. Doesn’t even require a “psychosis diagnosis.” If they’re annoying enough and have a label, they are fair game for antipsychotics.
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One can survive on a bit less than half a liver. The liver is the one organ of the body that regrows itself. Thank the Lord in our case!
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Yeah, but who would want them if they actually told the truth about the drugs?
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There is always an excuse, no matter how much damage they manage to do. Zero responsibility!
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Well, but the liver GROWS BACK! So really, no harm no foul!
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But don’t worry, you don’t need both kidneys to live…
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Not to mention the possible damage to the fetus of continuing SSRIs. There are fairly consistent correlations with birth defects, as well as with “ADHD” behavior later in life, if I remember my research correctly.
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Exactly. You see it all the time – an article proves that antidepressants are completely useless for kids and meanwhile increase the suicide rates, but the conclusion is, “We should be careful to make sure that antidepressants are only prescribed when indicated in children.” And they get away with it, because they’re saying what those in power want to hear!
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Labeling terms is a very human practice. People come up with words to describe what they observe, and I have no problem with that. It’s the fetishizing of these words into “diagnoses” and “disorders” that upsets me, when the “diagnoses” have no more meaning or validity that saying someone who picks his nose has “excessive digital-nasal insertion disorder.”
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I think the interesting question that never gets asked is, why do the “standard mental health” programs continue to get funded despite mountains of evidence that they not only don’t work in the long run, but in many cases cause damage? Kind of a double standard, isn’t there?
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Even the Zen Masters sometimes have to resort to a slap in the face!
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There is a difference between using a term to describe something (My husband is an ABUSER) and being DIAGNOSED with something (My husband beats me up because he has “Bipolar Disorder”). One is simply a linguistic means of describing people who have certain traits in common, the other implies some kind of deeper “causal” relationship between these people such that some sort of “treatment” will generally be helpful to all of them. Psychiatry blurs these lines badly, and I believe intentionally, such that people are confused between a description (These children all have trouble paying attention in school and get into trouble) and a diagnosis (all children who have trouble paying attention are suffering from a ‘disorder’ called ‘ADHD’ and there is a ‘treatment’ for this condition). Of course, this sells a lot of drugs, but the confusion does a great deal of damage to our society, as it prevents any real attempts to identify the actual causes in individuals, as well as taking perfectly normal behavior (being distracted when bored to death by the school curriculum or process) and making it into a disease state. But when we get as silly as calling something “Oppositional Defiant Disorder” because a person is oppositional and defiant, it should be obvious to any rational person that these “disorders” are absolute irrational nonsense! Might as well say someone picks their nose because they have “Nose Picking Disorder.” It wouldn’t be any less ridiculous.
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What they mean by “stigma” is “any comment suggesting people shouldn’t take all the drugs they are prescribed without question.” The industry creates and exacerbates stigma as a marketing tool. The furthest thing from their minds is to “reduce stigma!”
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As long as the peer respite concept is dependent on the larger “mental health system” for approval and monitoring, we will see power being used by those uncomfortable with the idea of peer empowerment to undermine this kind of effort or kill it off. I wish I knew the answer.
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I do agree with you there!
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What, you’re arguing to be objective and scientifically honest about these things? Radical concept!
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It also always seems hypocritical when they expect someone ELSE to prove their drugs cause dependency, assuming safety, while normally we expect drug trials to assume non-safety until proven otherwise. How many drugs have we been told are “not habit forming” and yet later turned out to have horrible addiction profiles? Benzedrine, Valium, Xanax, Oxy, Ativan, SSRIs… the list is pretty long at this point. Why aren’t we making the drug companies prove their drugs are NOT addictive/dependence-forming before they’re allowed to market?
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It did seem odd to me that after dismissing the claim that science understands the mind, the IFS approach still “diagnoses” people with “conditions” based on their “understanding” of the mind. Better to just admit it’s a mystery and work with the person in front of us and stop trying to “understand” them separately from their own conceptualization of their own situation.
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Despite there being scant evidence that antidepressants are of any use in the teen population, and ZERO evidence they are helpful to younger children.
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I would not just say that “patient voices” should be reported on, they should be CENTRAL to any analysis, while doctors’ opinions should be considered secondary. As long as “patient experiences” are of secondary concern, we will continue to have a system that oppresses those it’s supposed to help!
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An excellent and concise argument against the very concept of “mental illness,” let alone a “professional” approach to “treating it!”
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A really fun exercise is to pick a diagnosis and see how many different ways you can “diagnose” someone with the same “disorder” despite having no “symptoms” in common with each other. It’s not very hard, but it’s kind of amusing. Except when you realize people take this nonsense seriously!
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Of course, the fact that “treated” people die one to two decades earlier than expected IS a bit of a clue…
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There is literally almost no accountability for psychiatric or “mental health” professionals.
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If media was giving out wrong information, where was psychiatry telling everyone they got the wrong idea? Can you say “Collusion,” kids?
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ABSOLUTELY!!!!
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OMG, that TRULY sounds like torture! How can anyone see that as “treatment” or the outcome as “positive!”
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Translation: “Quit annoying us!”
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From what I understand of recent studies, the scientific consensus is about 30% of people taking antidepressants express finding improvement. When you take the placebo effect into account, that number drops even lower, and if you talk about an ACTIVE placebo, Kirsch puts the effectiveness rating near zero, at least in terms of any kind of significant clinical benefit.
The drugs do DO something (mostly a stimulation effect, with a dampening of emotional reactivity), and some people find that SOMETHING positive for them. And more power to them. But we should remember that some people find marijuana or controlled doses of alcohol or taking DSMO or St. John’s Wort helpful, too. The problem isn’t that some people don’t report benefitting, it’s selling the idea that there are NO harms and that EVERYONE who is feeling depressed needs some, and even worse, that people who have adverse reactions or simply don’t improve are “treatment resistant” or are being dishonest!!!! Just because a person or persons report they like this and it helps them feel better is no reason to create a false narrative and make people who don’t feel such a benefit into some kind of monsters for “preventing effective treatment”!
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I’ll just remind everyone here that “bad science” isn’t really science at all. It is mostly attempts to use a scientific veneer to justify things that REAL science doesn’t support. The way to tell the difference is what happens when real science comes out with data that contradict the “opinion leaders.” If they attack the data or those who promote or share it, they’re not involved with “bad science.” They’re involved in marketing!
But you ARE right, we do have to engage with anyone who is a real ally and not expect total agreement, except on the point that psychiatry as currently imagined needs to GO!
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Don’t sweat it! I get what you’re saying!
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To be clear, I as moderator am not in the business of deciding what content or claims are accurate or inaccurate, thank the Lord! All I do is make sure that the comments fit the Posting Guidelines. There is no censorship on any kind of content-based grounds, and people are welcome to say more or less whatever they want, with very few exceptions regarding taking over the site with off-topic conversations that don’t advance the purpose of the website. It is the job of the Community at large to add their feedback and “correct” anything that seems exaggerated or unproven, just as you are attempting to do.
MIA needs to be judged on the articles. No website anywhere I know of is judged by the comments people make on the articles. I assume “professional” people understand this and act accordingly.
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While I agree with your sentiments, having been “behind enemy lines” for a number of years, the problem is that the workers, while some struggle with the ethics of their situation, also have the power to easily pass on their frustrations and “moral injuries” to the very people they’re supposed to be caring for. The “consumers” or recipients or victims of their care have no such luxury. It is imperative that those working in the system who DO recognize what’s happening fight to change it, even if it means losing their jobs. Saying, “I had to harm them, I would have lost my job otherwise” is very similar to saying “I was only following orders.” Not a valid ethical “out” for someone who really understands the harm being done.
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I always found “Behavioral Health” to be a bizarre term. How does behavior have “health?” Though I guess it provides a somewhat more honest glimpse into where these industries are really coming from. If we were healing “brain disorders,” wouldn’t it be “brain health?” No, it’s about controlling BEHAVIOR based on what Those In Charge think is “appropriate!” Not much science involved, but a lot of force and lies and manipulation!
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Absolutely. No kid would voluntarily agree to do what is expected of kids in school. Or very few. It is absolutely bizarre to expect them to do so. The ones who act out just have more courage than I did!
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Makes perfect sense, actually. Want objectivity? Talk to a robot! Healing comes from real interactions with real humans who are being honest and straight and care about each other.
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I think he’s saying that the people RUNNING the system exhibit “psychopathic” tendencies, which include lack of empathy, willingness to commit crimes to accomplish desired goals, willingness to lie, cheat or steal to get what they want, sometimes even a certain perverse enjoyment in watching others suffer. Overall, it speaks to a massive need to control others’ lives at their expense, and a lack of any concern for the welfare of anyone but themselves. This is a very rough and incomplete description, but such people are only rarely ever “diagnosed” with any kind of “Mental illness,” but rather tend to skate through life making trouble for others and getting others blamed for things they themselves have arranged. Those who are “caught” are more likely to be in jail than the “mental health” system, but plenty such people get into positions of power in businesses or government agencies where they have enough control to harm people while being protected from any kind of consequences. Of course, the world of psychiatry provides many such opportunities, and it would hardly be surprising if that field attracted a disproportionate number of psychopathic individuals, some of whom may be actually directing the course of the organization/profession.
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I was agonizingly bored in school! Wanted to poke my eyes out with a fork! I understand why kids act out, just to have SOMETHING interesting going on! Unfortunately, I was too scared to take those risks, but I sure thought about it!
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And yet so not surprising!
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I agree. The only therapists of any value are the ones who recognize that there is no such thing as “professional objectivity.” In order to be truly helpful, we have to understand that everything we do is at all times influenced by our own desires and motivations, and that we are only aware of a small percentage of them. It requires “constant vigilance,” not some fantasy belief that professional training somehow cancels out subjectivity!
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I think you hit on something EXTREMELY important! It is those wounded by the abusers in society who are “diagnosed” and sent to “therapy,” while the perpetrators walk around harming others. Therapy at its best is about helping those harmed cope with the damage and the horrible awareness that abusers are running the show. I was fortunate to have a caring and competent therapist, so it’s very hard for me to even imagine what would happen to me if my therapist had joined forces with those authority figures responsible for the damage!!!!
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Disgusting!!!! I wish I were surprised!
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Any measure that could help the CAREGIVERS, in most cases. Most of it does not help the clients/patients.
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And GOOD FOR YOU for standing up for yourself! Your last sentence it to me the true key to sanity!
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Apparently, it’s OK with the prescriber that you die, as long as you are “compliant” with your regimen!
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Thanks!
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Quite so. Trust is earned, it is given entirely at the discretion of the “truster.” Expecting someone to trust you because of your position is pretty massive authoritarianism.
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I will suggest here that per the scientific method, we assume something is NOT effective until it is proven to be effective. The “null hypothesis” in this case is that antidepressants do not reduce suicidal thoughts or behavior. If such controversy and conflicting studies continue to exist 30-40 years after ADs were introduced, I think we can conclude at this point that they DO NOT reduce suicidal thoughts and behavior.
Of course, in the “antidepressants cause suicidal thoughts and behaviors,” the “null hypothesis is that they don’t. However, the fact there is a Black Box warning on all drugs impacting serotonin suggests there is enough evidence to concern people about their safety, especially in the young. Since there is almost zero evidence of any AD effectiveness in youth, and literally none in young children, even a chance of increasing suicide rates ought to be enough to eliminate these completely from the psychiatrist’s toolbox, at least for children.
At a minimum, the evidence to date is more than sufficient to conclude that antidepressants do not decrease the suicide rate for any subgroup of identified “depressed” people. The fact that certain “researchers” and “thought leaders” choose to cherrypick the studies they like should not divert us from this conclusion. Any decent review of the literature shows no positive effect, and many show possible increases in suicide rates, even in studies involving people who were screened for suicidality before starting. It’s not really that much in dispute, except for people who want to believe otherwise.
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It has always infuriated me when therapists expect their clients to automatically trust them! Don’t they get that this is Step One of any decent helping process? I used to work with foster kids, and I’d often say to them, “I suspect you don’t trust me. That’s pretty smart. I wouldn’t trust me, either – you have no idea who I am or what my agenda is! And I don’t automatically trust you, either. I’m hoping as we get to know each other, we could develop some trust.” Or words to that effect. Oddly enough, I managed to earn the trust of many of them. I wonder why?
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I agree with you for the most part. I would never have gotten where I am from psychotherapy. I did have a very good therapist and it was important in getting me started in seeing the limitations of my upbringing. But without Buddhism, meditation, exercise, a job that challenged me to overcome some of my anxieties, the support of important people (including my wife), an exploration of a wide range of spiritual practices, self-help books, and some good old fashioned hard work, I’d have never gotten anywhere. And from what I understand, the training for therapists these days has deteriorated, and they spend time studying the DSM diagnoses but don’t bother with little things like unconscious motivations or the long-term impact of trauma or domestic abuse dynamics. So I don’t want to deny that psychotherapy can play a role for some folks, but it needs to be one who really GETS what s/he is doing, and is empowering of the client to pursue his/her goals. My therapist told me her goal was for ME to become my own therapist and not need her any more. Not every therapist has such goals!
Anyway, I think you’re right, the best even the best therapist can offer (and as I see it, most of them aren’t very good!) is to help you set your feet on a different path. Where you end up going is TOTALLY up to you, and there are as many ways to find the path as there are humans on the Earth!
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Good thing for him you were around!
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Forget about “borderline personality disorder” or any other of their anti-scientific labels. What does she really need? What behavior or issues does SHE think are creating problems for her? What does SHE want to be different? What does SHE think would be a good approach?
Usually, people who get branded with the “Borderline” label are those who have difficulty trusting others in relationships. See if you can talk to her about trust. Most are also people who have had traumatic experiences early in their lives. What kind of historical trauma is she still dealing with?
She needs support and understanding, not more labels. Psychotherapy CAN be helpful but only if you find the right person who can create a safe place for her to explore her life and what she wants to do with it. Another person bullying her around and telling her “what’s wrong with you” and what she needs to do will not be helpful. I don’t know what the best way to go about it is, but it starts with NOT accepting the labeling process and find some other people, professionals or not, who agree with you and are willing to help.
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🙂
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Nah. Psychiatry is a religion of greed selectively cherrypicking science to further its own economic ends. Science doesn’t enter into it, except as a red herring to distract from what’s actually happening. Proof is, any science contradicting their narrative is attacked and/or buried. There’s exactly nothing scientific about psychiatry.
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Is the veiled reference to Big Pharma intentional or accidental? “Patently!” It’s the patents that have made it so absurd!
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Sorry, but psychiatry does NOT rely on “common sense.” Common sense dictates that people who have been emotionally distraught need to talk to someone. Anyone who has witnessed a car accident or experienced an upsetting incident has an immediate urge to tell their story to another human being, who helps best by listening. There is nothing common sensical about the idea that “mental disorders are caused by faulty brains.” That is a very non-intuitive idea that has been sold and sold HARD to the public through massive PR campaigns and through TV and movies and other media methods.
Common sense says that psychiatry is BS. It is only the pretense of “science” coming from the mouths of pseudo-“doctors” claiming “special knowledge” that allows people to actually invalidate their common sense and believe this unscientific and intuitively offensive nonsense!
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Say “ADHD” and EVERYONE is off the hook! Except the poor child’s body…
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Yeah, but there’s not a lot of money in spiritual enlightenment!
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And if you disagree, it’s more proof of their “diagnosis!”
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I would also say that the training for “talk therapy” has deteriorated massively while classes on “diagnosing” with the DSM are hugely on the rise. I often wonder from talking to them whether today’s clinicians have ever even been introduced to the idea of subconscious motivation? They get trained that PTSD exists but to they get any kind of training on what to DO that might be helpful to a traumatized person (or what NOT to do?) Once one’s had “therapy” with a person who doesn’t know what they’re doing and makes things worse, the idea that “therapy” could work is canceled pretty much forever. Which leaves people with very few options!
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Only as long as the “data” in question supports the dominant narrative. Plenty of data is ignored when it is inconvenient or might cost profits!
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Actually, there are increasing numbers of shelters for men abused by their partners, both male and female. They are rare, but a growing phenomenon.
https://nypost.com/2017/10/29/these-shelters-help-male-victims-of-domestic-violence/
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Quite so. When the experimenters have no objective means to separate those “in” the group from those “not in” the group, the experiment is DOA. Which applies to pretty much all “mental health” studies, except perhaps those measuring adverse effects of the “treatments!”
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You are confusing an observable problem and a workable solution.
Of course, no one here denies that people live on the street and talk to themselves. Believe it or not, A LOT of those people are “taking their meds” and still doing that, or have tried the “psychiatric treatment” path and it has failed miserably for them. Did you realize that the likelihood of recovering from “schizophrenia” is now a LOT WORSE than it was in the 1950s, before the “drug era” began? Did you realize that the likelihood of recovering is MUCH HIGHER in countries like Nigeria, Columbia, and other “developing countries” where “medication” is used far less frequently? Were you aware of the fact that a lot of people having first episode psychosis don’t have another, but that the likelihood of spontaneous improvement has REDUCED since psychiatric drugs are in regular use? Have you learned yet that the average “seriously mentally ill” person dies an average of 20-25 years YOUNGER than the rest of the population, and that the drugs used to “treat” these “illnesses” are largely responsible for many of these early deaths?
The social myth is that there are magic drugs that make everyone all better, and if only the “homeless” and the “mentally ill” would follow their doctors’ instructions, they’d be “normal” people working jobs and going to college and raising families, just like on the ads on TV or the movies and TV shows where someone goes “off their meds” and crashes and burns, but as soon as they’re back “on their meds,” they’re totally fine again. The industries have worked hard to create this impression, but if you can put this myth aside for a moment and actually READ some of the stories presented below, you might start to realize that it’s not such a pretty picture.
Psych drugs do seem to be helpful to a certain percentage of the population without serious damage to their quality of life, and more power to them. But the idea that doctors have some great “treatments” that make MOST people “normal” again if only they do as they’re told is completely false. The bulk of “seriously mentally ill” people who are in “compliance” with their treatment plans are poor, unemployed (on disability), and living lives that most of us would consider extremely low in quality. Those who do better often do so despite their “treatment plans” and “providers” rather than because of them, or at least have little to no support for improving their life quality from those supposedly “treating” them besides the drugs they are prescribed. Considering the massive adverse effects most experience, ranging from involuntary movements to severely blunted emotions and motivation to loss of sexual function to enormous weight gain to diabetes and heart disease, it might seem that living on the streets is hardly any worse to some recipients. And that’s not even mentioning the tremendous loss of autonomy most experience, being constantly monitored and told what to do and threatened with incarceration, framed as “hospitalization,” if they step out of line or their “symptoms” increase.
It is very easy to judge if you’re not someone who has had these experiences yourself. Why don’t you suspend the judgment for a while and try reading some of the many stories here about what has happened to people here who “complied” with their “treatment plans” and ended up devastated? There’s a LOT more to the story than you seem to have heard to this point!
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The key question would be whether one could distinguish in some objective way between “biological” and “situational depression.” Of course, no one has come close to doing that, and they don’t even bother trying any longer. It’s just “let’s try these drugs out and see what happens.” No pretension in reality of any kind of scientific diagnostic process. But as long as the big money keeps coming in, no one has an incentive to look deeper.
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You are assuming that treatment plans mandated by “healthcare professionals” are going to be helpful. Read some of the stories below and you may begin to question that assumption. Saying something “must be dealt with one way or another” does not mean that the one way currently being used is the best approach.
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It’s hard to see why anyone needs to do a study to “prove” this. Shouldn’t it be the job of those claiming this “disorder” has validity to prove it does, rather than the other way around???
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So apparently, there are a lot of “professional” participants in the “system” who are not in their right minds!!!!
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Maybe just start with the person where they are at, and stop worrying about whether they “fit” the PTSD “diagnosis,” and instead start asking questions and getting to know them on a real level and finding out where they’re at and what they really need?
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They are only “curative” when someone can make a profit on them!
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Then there is the “placebo washout,” to remove placebo responders and make the drugs look better than they are.
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Picky, picky, picky!
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But many Deaf people in my observation also DON’T view themselves as disabled. In my experience, there is a wide range of ways people view their Deafness, and it would be wise for those not a part of that community not to speak for “them.”
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Where can you have come up with such statistics? As far as I know, there is no objective description or measurement of a “neurotypical” brain that is possible. So a “neurodivergent” brain, while I think can be a legitimate identity to choose, is not a scientifically observable phenomenon, and as a result, its frequency of occurrence is not something we can claim to know.
I personally find the term “neurotypical” to be to some extent demeaning, as it seems to imply that I have somehow gotten a “normal” brain and that therefore any struggles I may have are of less significance than the “neurodiverse” brain. I can tell you with absolute certainty there is nothing “typical” about how I have experienced life and I had plenty of struggles in school and elsewhere, even though my particular “brain” (if that is indeed the variable in question) allowed me to be quite successful in the educational environment and to scrape by socially, “it” has provided plenty of challenges in non-academic arenas. Of course, you could now decide (or I could) that I really am NOT neurotypical, that I’m “neurodiverse,” but again, that would be a decision of identity that I (or someone else) made, and not one that can be verified in any scientific manner.
I don’t believe there are “neurotypical” brains out there – my observation is that everyone’s brain is different and everyone has certain things in common, and our society is highly intolerant of certain personality characteristics or behavior, which leads to bigotry and discrimination against certain people who don’t BEHAVIORALLY fit what is expected, whether because of their brains or some other reason. Does neurology factor into that? No doubt. But until there is a means of drawing some kind of objective line between the “neurotypical” and the “neurodiverse,” I’m afraid these terms remain social constructs without any objective meanings. Like I said, everyone should feel free to identify themselves as they wish, but I’d appreciate you and others not choosing MY identity for me!
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The most optimistic I’ve ever heard is 30% EFFECTIVENESS, not 30% REMISSION. It’s bull if anyone tells you there’s a 50% remission rate.
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Quite so. It is never the fault of the practitioners – the client or the “disorder” is resisting! So how is success ever to be defined, if you can’t fail except as a result of something they have no control over!
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Yeah, you don’t want to start upsetting people by speaking the truth!!! Very rude of you! /s
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Posting as moderator: Just to be clear, the above is indicated to be sarcasm.
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There are most likely some in Turkey who know the truth. But it may be hard to find each other. Most countries are dominated by people who are “true believers” in psychiatry and tend to attack and humiliate those who don’t agree with them.
It may be that you are the one who will have to educate others about what you’ve learned. We are all in the minority!
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Exactly! Besides, he’s threatening their client base!
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Quite so.
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It would indeed be interesting!
My point is that having a goal over which you have no direct control is a setup for failure, in my experience. Empathy in particular is VERY difficult to teach, especially to an adult. Not saying it could not happen, but I’d be more likely to look at something more along the lines of not engaging when negative stuff is coming from her, drilling how to convey the necessary message most effectively, and how to set good boundaries when she becomes abusive. All things the person himself can control. I’ve seen way too many people spend way too much time trying to “get their viewpoint across” or “help him see how he’s hurting me,” etc., with absolutely no success and enormous frustration. I recommend setting goals that a person can accomplish, regardless of whether someone else chooses to “understand” or not!
Hope that makes some sense.
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That DOES make a lot of sense. My only caution is that “depression” is not caused by any one thing. But testing for THIS particular thing could save a LOT of trouble and suffering for a certain identifiable subset of the population!
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If the patients got along but the staff shunned you, you must have been doing something right!
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I agree with you completely. I’m not sure I didn’t know you agreed with me already!
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A goal of making one’s WIFE more compassionate is a pretty inappropriate therapy goal! You can’t make other people compassionate! That seems like his first problem!
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I believe the link goes both ways – psychological trauma is associated with increasing inflammation and immune response. Autoimmune diseases are more common with people who have been abused, in a dose-dependent manner, as I recall.
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The question is, how can anyone POSSIBLY determine where such a “line” lies, or if it even exists? And if we DON’T objectively define what it is, then we get arbitrary and subjective rules, leading to “diagnostic drift” toward whatever makes more money for the providers and less trouble for those in control of society’s institutions.
And why do we need to define such a line anyway? Why can’t we simply say that “those who suffer need and deserve support” and provide it without pretending there is something physiological going on? Now, if there IS something physical that is off, like low thyroid, anemia, sleep problems leading to depression or hyperactivity, or whatever, then THAT is what should be treated, not “depression” or “anxiety.”
I’d really be interested in knowing why you think such a line can be and/or needs to be drawn to be able to provide full support to those who are suffering?
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That sounds very intentional and very oppressive!
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Somebody decided to go after Kratom and started making it into a “story.” That’s how a lot of news happens, someone with a lot of money and/or power decides to make it a “story” and then tells the papers what to write!
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I hope that you found people with this label were a lot more different than they were similar to each other. That was my experience. The main thing they mostly had in common is that their early lives were shitty. Other than that, I saw a huge range of human interests, abilities, and personalities carelessly lumped together simply because traumatization had made it more challenging for the poor professionals to figure out what was going on.
I actually have no patience for this “diagnosis.” Why not just say, “Mary was abused as a kid and has trouble trusting people” or whatever else is going on? Why talk about this group as if they had anything in common besides being labeled and discriminated against by the “system” personnel?
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Which is a pretty low bar, I have to point out!
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Well, there are no profits to be made from fixing society! Far better to blame and drug the patient and protect the status quo, which provides so many “customers!”
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Actually, the “comorbidity” is, in my view, not because these “conditions” share things, but because they are not actual medical “conditions” at all. What should be diagnosed is neuroinflammation, histamine intolerance, vitamin D deficiency, etc, rather than wasting time on these meaningless DSM “diagnoses” that don’t tell us anything about the actual problem at hand.
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That’s one of the most insidious dangers of the “label and drug” approach. It gives the impression that your environment is harmless and YOU have the problem. If only your brain worked better, you wouldn’t MIND being worked 60 hours a week at a mindless job that challenges your personal ethics on a daily basis! It’s all about Bad Brains, never about fixing the environment and expectations that lead to burnout!
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There has never been any literature supporting the use of antidepressants in children, except one study on prozac and adolescents, and that one was critiqued heavily for many flaws. It amazes me that psychiatrists are allowed to prescribe it. It’s malpractice.
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When there is no objective way to determine who has a particular “diagnosis,” the concept of “comorbidity” completely loses any meaning it may have had.
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And we can see exactly how helpful the psych drugs were in preventing further violence!
I agree with you, people should be judged on the danger and disrespect of their behavior, not some label affixed to them or some lenience based on “compliance with medication” or whatever else. We can see that compliance and safety don’t necessarily bear any relationship to each other.
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I am not surprised to hear any of that. The system is set up so that narcissism is rewarded. Back when I got my own therapy (1982), there were requirements that therapists go through their own therapy before being allowed into the office, and there was strong recognition that the therapist could do a lot of damage if s/he had not dealt with his/her own issues and instead acted them out on the client. Nowadays, I’m not sure they even train counselors on the fact of unconscious motivations they might have. I’d say one takes one’s life in his/her hands applying to a random “therapist” for help today. Odds are better that you’ll get screwed over than helped. I think that was already true in 1982, but it’s far worse today.
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I wish I were surprised.
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“Treatment resistant depression” is a euphemistic way to say, “Our drugs didn’t work and we want to blame the client and/or the disease instead of admitting we failed. Plus it lets us keep ‘treating’ even though we’ve totally screwed it up!”
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I think we see here that chatGPT is simply regurgitating what the most common or popular responses are to this kind of question on the internet as a whole. It is not the act of “artificial intelligence,” it’s the act of a very fast collector of other people’s ideas and statements, collating these into some “safe” statements that fit into the mainstream of what’s already been said. It’s INCREDIBLY unlikely that any AI program will look at the situation and conclude, “Well, a lot of people say that antidepressants improve imbalances in chemicals, but research by X, Y, and Z have proven this trope completely false. Evidence is that it originated in propaganda from pharmaceutical company marketing schemes.” ChatGPT is going to amplify the most commonly held beliefs. It will never be able to challenge them, because it can’t really think.
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I didn’t meant to be critical, just to make that very point. I’d say the odds of finding what I call a “good therapist” these days are probably in the single digits.
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Exactly! A theory with no concrete means of measurement is of next to no scientific value. It’s not wrong, it doesn’t even get to the point of being testable as being wrong! It’s just USELESS!
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I will only take this moment to state that not ALL therapists see their role as to identify and/or correct defects in their clients. I think you are acknowledging that in your choice of words, but I want to make that explicit. My view has always been that the only ones who can tell us if therapy “works” are the ones receiving the therapy. They’re also the only ones knowing if something is “wrong” with them and/or what if anything they need to do about it. A good therapist works to help the client discover their own truths about themselves. Anyone who thinks they can “fix” or “improve” the client should be avoided like the plague!
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The science does not support your assertions. No medication has been found to reduce suicide rates, and most antidepressants increase rates. Recovery rates have been shown to be LOWER when taking antipsychotics over the long term. Only 30% of users report significant benefits from antidepressants, which is barely more than benefit from placeboes. This is what the science says. Repeating mythology doesn’t make it true. How do you KNOW these things you have claimed to be true?
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“Supposed to” is an interesting way to frame it. We know factually that a LOT of adults don’t act like responsible adults. Does that mean we just leave them to machinations of the pharmaceutical industry?
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I don’t hear anyone saying the drugs don’t work. I hear someone saying that the data saying they DO work is biased. We already know that they work for less than half of the population at clinically significant levels – the most objective evidence says 30%. Don’t you think it’s fair to the other 70% to let them know they may not see the purported benefits? Do you think it wrong to let people know the actual adverse effect, including withdrawal, oops, I mean DISCONTINUATION effects, that plague many if not the majority of users? Do you deny that these drugs CAN cause harm to a significant subset of the population, based on the scientific data we now have available?
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I’m pretty sure in the USA you can hire an attorney, it’s just that most victims of psychiatric incarceration can’t afford one or find one who does such work competently.
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It is odd that “patients” are found to “lack insight” as proof of their “illness,” when the profession itself completely lacks ANY insight into what if anything is actually “wrong” with any one of their charges!
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Love the name! You’re all “in cahoots” with each other!
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ChatGPT gives back from what it’s read, that’s all. It can assemble a ton of information from multiple sources, and maybe even modify its approach if you find it offensive and say so, but it’s not going to provide much outside of the accepted mainstream views. It might outline alternative views, but will identify them as potentially controversial. It’s just a distillation of the “conventional wisdom,” with some acknowledgement given to less popular viewpoints.
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It is true that most psychiatric prescribing is done in a very robotic fashion, and would probably be BETTER done by robots, because at least personal prejudice and emotional reactions would be removed from the equation, and the robots wouldn’t hunt you down just because you didn’t follow their advice.
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Yup!
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You should give it a try! I bet the results would be quite telling.
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That’s what chatGPT and other AI seems to do – it gathers a huge amount of data and then mimics human responses using “information” it has gleaned from other sources. It does not have any kind of individual thinking or critical analysis, and it works based on what it is programmed to do. It would be easy as heck to program such an entity to simply not publish anything negative about psychiatry or drugs. The only thing that surprised me about Bob’s response is that it has not already been programmed to a pro-psychiatry bent.
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Grey matter volume is decreased by antipsychotics. This has been proven in multiple studies. They like to blame it on “schizophrenia,” but pro-drug researchers found this was not the case.
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I really don’t know. I’ve never done it. I don’t have much interest in chatGBT myself.
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Brilliant post!
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Who’da guessed it?
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I like that one, too!
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That’s a great idea, actually! I’m guessing it would hem and haw about it, saying it’s “controversial” without really addressing the complete lack of scientific foundations. But who knows? The Chat app bases it’s “comments” on data gathered from billions of sources, and depending on the programming, it could come up with something critical.
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My point is only that psychiatric “theories” are mostly mythology. This is only one more example. EVERYBODY said that back in the 70s, even though there was no actual research supporting this idea. When the research debunked the concept, it had some effect, but the myth, much like the “chemical imbalance,” was already so ingrained that few gave it a second thought, despite the research. This seems to me to be the core of psychiatric “theory” – come up with an idea that supports their desired narrative, put out lots of propaganda to promote this idea and pretend it’s all very “scientific,” and don’t research or ignore research in any area that might threaten the narrative. Not much science actually going on!
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It is deeply disappointing to hear that professionals still toss around that idiotic trope that “ADHD kids react differently to stimulants.” That notion was debunked way back in 1978 by Judith Rapoport, et. al. It’s worth noting that Rapoport has been a big supporter of stimulants. She gave stimulants in low doses to non-ADHD diagnosed teens and found exactly the same response – less movement, better concentration on dull or repetitive tasks, etc. The only reason she said that people assume the “ADHD” kids react differently is because people are looking for that reaction. She called it “an artifact of observation.”
The fact that such nonsense is still spewed about by “professionals” proves to me how little actual basis any of these “diagnoses” and “treatment” are founded upon. They have to lie to themselves and others to even justify their interventions. It’s such bull!
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I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.
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This was my experience as well, working “behind enemy lines.” I wasn’t even a psychologist, just a “mental health professional.” We had very little power to alter what the psychiatrists decided to say or do. It was a constant battle, but had to be conducted as a “reasonable conversation” or you were quickly branded as an “anti-meds” worker. I eventually gave up on trying to change the system from the inside. I don’t think it’s possible. I’ve become more of an “abolitionist” the longer I work with this crazed system.
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I loved “a la carte menu” as a description of the DSM. Kinda sums it up!
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Maybe this article can inspire you to do so?
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I would estimate that 9 out of 10 therapists are either sold out to the system or don’t really know how to be helpful. I was, indeed, very lucky. And this was in the 80s before the DSM III had taken hold. The odds are a lot worse today!
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Can’t disagree with a word of that. The current system makes it as easy as possible to dismiss a client/patent’s concerns, ideas, plans, motivations, etc. and to blame the client for “having the disorder,” and blame “the disorder” for any failure or damage to the client. I think it is much, MUCH harder to find someone today working for the system who is worth seeing than it was back in the 80s when I went. And I was still lucky!
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I meant the therapist. I have no problem with the client using his/her own power to his/her own benefit.
It matters because it applies to everyone, whether a therapist or not. What you’re saying is most therapists TAKE ADVANTAGE of their one-up power situation. But not all do so, even if it’s tempting. Same is true of humans you meet on the street, though they have less of a natural advantage in the power department, so it’s probably safer. But lots of “regular humans” take every advantage of their power over others and seek to maximize their influence at the expense of the person they are engaged with. It’s not fair to paint ALL therapists with that brush, any more than all humans. There are even psychiatrists here and there who have a heart and understand their power advantage and don’t use it to hurt their clients. Admittedly, not a common experience, but it happens. I had a fantastic therapist who REFUSED to “diagnose” me or interpret anything I said or did, but always put the question back to me. I kind of hated her for it, but it was the right approach, and I was much the better for my 15 months of weekly meetings with her. Worth every penny I spent. So it’s important not to overgeneralize about people we don’t know, just because they have a certain assigned “role” in “the system.” There are and have always been mavericks who do it their own way. I like to think I was one such.
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In the case of the DSM, the very nature of the “diagnoses” makes them diminishing and insulting automatically, as they presume the doctor is able to decide what is wrong with you lacking any concrete testing or evidence of anything being wrong at all. It’s hard to see how a label ever improves anyone’s psychological well-being, unless it’s a label they themselves choose to apply. I see nothing helpful about doctors or psychologists or counselors buying into the DSM fiction campaign.
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When people have seizures, our medical system intervenes to stop them because they are known to be dangerous. Yet psychiatrists are allowed to induce seizures for weeks on end and somehow that’s NOT going to create brain damage????
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Exactly. The frontal lobes are the center of planning and organization, and hence motivation. It would be almost impossible to execute any kind of complex plan with the dopamine flow to your frontal lobes being so dramatically curtailed. And of course, there is permanent damage from which a person may or may not recover. All to “treat” a “disorder” that no one has any clue if it exists or what is wrong or what is being “fixed.”
Chemical stun gun is a great description!
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Such rages are often caused by the very drugs meant to “treat” them. Stimulants for “ADHD” are the most common offenders, but SSRIs/SNRIs and antipsychotics can do it, too, plus benzo withdrawal is most definitely associated with violence for some users.
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Nor for “major depression.” I can’t see how becoming more apathetic and unmotivated plus fatter plus experiencing “involuntary movements” can possibly make a person feel LESS depressed!
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Wow, that sounds AWFUL! It sounds like you also had a bad case of akathesia! If you wanted to torture someone, it’s hard to imagine something more effective!
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I can well imagine! These ads for the new “anti-TD” drugs always annoy the shit out of me – they make it look like these people have totally normal lives, are working full time and happy, and are just a bit embarrassed that they drop things or their face gets screwed up and looks funny. It’s very trivializing of the reality of TD!
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I still don’t get why it’s BETTER for him to call himself “BPD” rather than just identifying what he wants to change and exploring the possible roots and motivations for that behavior? What’s the benefit of calling himself “Borderline,” even if he selects that label for himself?
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I agree with this. In my own practice, I never “diagnosed” anyone except to make sure they got a kind of help we agreed they needed. And I told the client from the start that the “diagnoses” are just descriptions of what they already told someone and had no meaning beyond getting insurance reimbursement. Lacking a “diagnosis” never prevented any client I had from making progress. I’m guessing it made it easier for them to make progress, as I “normalized” their experiences and never gave the idea that there was something “wrong” with them that they couldn’t fix, which is the opposite of what these “diagnoses” do.
What’s wrong with saying, “You get scared when you go outside” instead of “You have agoraphobia?” How does the latter help in any way?
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That’s why it’s called “Tardive” = “Delayed.” Some show no signs of it until they stop. For some, the only way to get it to go away is to maintain on neuroleptics/antipsychotics, which of course makes the problem slowly worse over time. It’s an awful price to pay!
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And why don’t they look at the CAUSE of the TD, instead of “treating your TD movements,” as if this is just some minor thing that happens when you get “good treatment.”
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🙂
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Much like “ECT” aka shock therapy. If you kill off the RIGHT brain cells, things just get better and better!
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You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!
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I don’t think we should redefine our understanding of science. We need to establish a barrier between science and research vs. business and profits. Used to be professors were not allowed to profit from their college-funded or government-funded research. We should go back to those days!
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Hi, Donna!
It sounds like you’ve been through hell and are still kinda there!
With all due respect, it appears to me you’ve figured out these “doctors” don’t know the first thing about what they’re doing and their “diagnoses” are fantasies. Are you still looking to them for help? Or are you simply trapped in “the system” and having a hard time getting out of there? What do you see as your path forward?
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I love the astrology analogy! If it helps to believe you have Taurus traits, go for it, but let’s not pretend we’re practicing medicine!
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Well, they always accuse “BPD”-labeled clients of “splitting.”
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I particularly like the term “splitting” in the title. Nice touch!
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I am sure there are such people. What’s unfortunate is that they do not appear to be the “thought leaders” in the field, and are in my observation frequently set upon by those with a different agenda. The problems with psychiatry are not those of individual psychiatrists being good or bad people or even good or bad clinicians. It is a matter of the profession itself being committed to misguided values and priorities, including the priority of making money as a profession and maintaining status, and the actual needs of the patients/clients in such a scenario too often take a back seat, if they get a seat at all.
I am always encouraged to find psychiatrists who take a saner approach, but in my experience (and I have more than a bit), they tend to be the minority, and with few exceptions, have little influence on how the profession as a whole considers the problem of “mental illness,” which they seem to have somehow obtained the right to define for the rest of us.
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Excellent questions! I wish I had the answer!
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Quite so. It is my experience that telling another person what to think/believe, even if you’re 100% correct, robs them of the ability to realize it for themselves, so they have to either agree or disagree with you instead of realizing their own path. I think exploring possibilities/brainstorming can be fine, but as soon as we start telling the other person what to think of their life and what to do about it, we start doing damage.
Even the girl with “diabetes” can be talked to about how best to frame it from her viewpoint. Perhaps she comes up with, “I have to eat a special diet/take a drug to help” or “My body has trouble handling sugar and I have to take special precautions” or even “Sugar and I have a love-hate relationship.” Why not help her come up with what she feels comfortable instead of deciding what to call it and taking her options away?
Interesting story – I used to work for a crisis line. A woman I had talked to many times called in and said angrily, “Those doctors told me I have Borderline Personality Disorder! I don’t have Borderline Personality Disorder! How DARE they say that about me!” I asked her, “What did they say that meant?” She says, “Well, they didn’t exactly explain it, but they said I have it and I don’t!”
I said, “Let me get out the DSM and read off what they say defines this ‘personality disorder.'” So I read them off to her. “Emotionally volatile?” “Well, yeah, definitely.” “Sometimes feigns suicide for attention?” “Yes, I do that.” “Difficulty with trust in intimate relationships?” “Oh, yeah, for sure.” After I read a few more, she very calmly said, “Well, I guess I DO have it!”
How different would this have gone if they simply started with saying, “It seems to me like you get pretty emotional about things compared to most people. Does that seem true to you?” Or better yet, “What kind of things do you tend to do that you wish you didn’t?” And just describe the behavior instead of the label. She clearly had no trouble acknowledging the behavior she engaged in, was quite aware of it, in fact. But the act of labeling pissed her off big time! So why bother with the label? Why not start with the client’s framing of the problem and go from there?
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Sorry, Jukia, but there is exactly zero evidence that the drugs increase suicidality by giving suicidal people the energy to commit suicide they were already planning. For one thing, almost all of these studies ELIMINATE anyone having any hint of suicidal ideation, so even if a few are being deceptive, the majority of these new cases of suicidality come from people who were NOT feeling suicidal before taking the drugs. The explanation you provide is a convenient one for drug companies and doctors who want to convince people that increased suicidality is not a concern, but Prozac in particular was kept off the market in Germany and I think also Italy initially back in the 80s because of increases in suicidal and aggressive behavior in those taking the drugs, so the claim has long been known to be false.
I’m not disputing that some people report getting great benefits from taking these drugs. But it’s not ALL people, and a lot of folks report having little to no effect or becoming worse on the drugs. To claim that being off psychotropic drugs is “FAR more dangerous” than being on them for “most profoundly mentally ill people” is an opinion which is not based on scientific study. In fact, read up on the Wunderlink and Harrow studies, among others, which show that those diagnosed with “psychotic disorders” who don’t take psychotropics actually do better on the average than those who do. Again, not saying some don’t benefit, but generalizing from anecdotes to broad sweeping statements of “truth” is not how science works.
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That does kind of sum it up. That kind of thinking is even more destructive in psychiatry, because blaming the victim is the most overtly damaging thing you can do to a traumatized person.
If this guy hates and resents his own patients so badly, he needs to find another profession!
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Gotta wonder what the “objections” were that were raised by “other professionals?” “This might work and we’d have to give up our absolute power?”
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This is NOT new information, but I’m glad it’s being published and brought to people’s attention again. Is it creating depressive feelings really worth a 70% chance of turning in more homework and being less annoying to the adults around a child?
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Not surprising to me, but this is important research! The industry relies heavily on claims that “accepting you have an illness” and that “treatment” is just like “insulin for diabetes” reduces “stigma” and makes it easier for people to feel OK about their “mental illness.” Those in charge know these claims are not actually TRUE, but justify using them as PR because “people are more likely to seek help.”
Like other stigma-based research on labels, these findings fly right in the face of these claims. There is no excuse or justification for lying to your clients in the first place, but this kind of research takes away the justification and exposes their “theories” for exactly what they are – propaganda to get more people onto psychiatric drug regimes!
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But of course, this kind of thinking will either be ignored, or if it becomes popular enough, will be viciously attacked by the powers that be. We can’t have people HEALING THEMSELVES!!! Or even deciding they DON’T NEED TO BE HEALED!
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Sounds brilliant, honestly! I will say from my own experience as a counselor that my goal was always to help the person study their own decisions and experiences and make new decisions (if need be) based on their own observations and conclusions. This seems like it cuts out the middle man and just takes people right there! Perhaps the most important point is that it communicates to the person that s/he CAN figure out what’s going on and what is needed through study and sharing, essentially the opposite of what they hear from the mainstream “mental health” system!
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Wait, now the PSYCHIATRISTS are claiming “moral injury?” I suppose it DOES inflict “moral injury” of some sort if you’re constantly claiming to help people and yet so often make no improvements or make their lives agonizingly worse? Perhaps it’s time for a “Truth and reconciliation” circle as they ran in South Africa to help heal the “moral injuries” of the Apartheid regime? Do they expect us to feel sorry for them that their failures don’t feel very good to them???
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Sounds safer and more reliable than any of the drugs on offer!
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I agree 100%! I always counted on my clients alone to provide whatever useful information was in play. THEY are the only ones who really know what’s going on or what might help! But that’s the opposite of the mainstream view. The DSM itself admits it doesn’t even bother to attempt to evaluate cause. What’s the point of a “diagnosis” that doesn’t try to identify what the actual problem is!
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Their constant failure to provide true informed consent ought to make almost all of them vulnerable to malpractice charges!
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Ah, the irony! The main reason “professionals” hate “borderlines” so much is that it reminds them of their own failings! I’ve always believed that to be true – EVERYONE can behave in a “borderline” fashion! We just like to pretend it’s someone else and not us!
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Well, I worked first for the Long Term Care Ombudsman program, which provides advocacy for seniors in nursing homes, assisted living facilities and adult foster homes/care homes. This is a US program that exists in every state, and while I was a paid employee, most of the Ombudsmen are volunteers. There are plenty of issues with psych drugs in nursing homes, I can tell you!
Then I worked for 20 years for the Court Appointed Special Advocates program (CASA), sometimes known as the Guardian Ad Litem program. This provides volunteers for kids in foster care who advocate to get them to a safe, permanent home as quickly as possible, and for them to be safe in the meanwhile. The number of kids on psych drugs is beyond comprehension, and the longer they are in the worse it gets! So I found plenty of opportunities there to get into the grill of the psych profession, in an effective way.
Mind Freedom, Inc. is also a more or less worldwide association of advocates for those in the “mental health” system, so the advocacy there is more direct.
There are no doubt other organizations I have not mentioned who do advocacy for those in psych “hospitals” or other “mental health” facilities. You’d have to look around where you live and see what’s happening there.
I’m glad to hear you are ready to take that step! It sounds like you certainly KNOW enough to do a great job – the trick is getting through the insane levels of resistance from the people who should know better, especially the psychiatrists themselves! But it’s worth it when you get a victory. I encourage you to go in that direction!
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This is what Alice Miller talks about in her books. You might be interested in reading some of her works!
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I always came from the belief that any advice or evaluation of what the client ought to do or ought to have done is counter to any effort to help. It’s nobody else’s job to tell the client what to think about their situation or what to do about it. Of course, I understand that most therapists these days don’t seem to hold that view. More’s the pity.
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Exactly!!!!
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I really wish I could refer you to someone! Have you considered support groups for people traumatized in childhood? It hurts my heart to hear that such therapy, which used to be considered at least one of the main approaches, is virtually unavailable to you now.
I have found people associated with the domestic abuse or sexual abuse worlds to be much more likely to understand about trauma and approach it differently, in an empowering way. Perhaps a local women’s or domestic abuse helpline has a referral for a therapist who understands how to be helpful in these situations? They may also be a source for peer support groups, where you would at least meet others who have been through what you have (including the incredible rigidity and blindness of the so-called “mental health” services) and might have some support and/or ideas for healing? And maybe make a friend or two and feel a bit less lonely?
I’m much more inclined to recommend peer support these days than therapy, as so many therapists (as you report) have become handmaidens of the psych industry. Anyone starting off with diagnosing and recommending drugs should be immediately eliminated from consideration, and in your case, that sounds like everyone!
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Being a good person in a destructive system still contributes to supporting the destructive system. That’s why I’m not a counselor any more!
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It is true, those clinicians who speak up are either dismissed as kooks or attacked. That’s what drove me out of the field, I couldn’t deal with being “behind enemy lines” all the time! Advocacy ended up being much more up my alley. Could use my skills without helping sustain a system that did so much harm!
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Well, that’s certainly true, and that’s why I’m very distrustful of anyone coming out of current “psychology” or “mental health” training. I believe they focus a huge amount of time on DSM diagnoses and very little on actual ways to improve one’s own awareness and emotional availability to the clients, or actually helping to discover and evaluate what the CLIENT thinks is helpful and desirable. It’s very arrogant and disempowering, the opposite of what is actually helpful!
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There is also a big difference between those who use scientific EVIDENCE as proof of their position and those who use scientific CONSENSUS (what ‘scientists’ tend to agree on) as proof of their positions. As has become very clear, many of the so-called “scientists” in the psychiatric field not only don’t rely on science for their conclusions, they actively attack any real science that contradicts their desired narrative. Corrupt “scientists” who benefit from their position of power should not be accorded any kind of special status. Only the science itself is worthy of discussion if we’re really interested in facts and knowledge!
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I don’t disagree with anything you said. Except that “diagnoses” are not PART of the “therapy process,” they are the justification for assuming authority over the “clients,” and as such are the opposite of therapeutic. The “diagnoses” are an evil that extends FAR beyond the “treatments” it is used to justify. It starts the process of “othering” and allows people to discriminate and downgrade the “mentally ill” (as they call them) with impunity. If there were no “therapy” at all, the DSM would still be incredibly destructive!
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I’m not ‘favoring the therapist’s position,” just describing what has to happen for it to work for the client. I fully acknowledge most “therapy relationships” don’t occur in this way and are mostly destructive or at best do nothing helpful.
And “borderline personality disorder” is a DSM diagnosis and has literally nothing to do with therapy, except as providing an excuse for certain kinds of “therapeutic interventions” that ignore the needs of the “client.”
I engaged in therapy that worked very well for me, and I wouldn’t be who I am without having done so. But I was lucky, very lucky. I’d have to be much MORE lucky today to find such a person, as I see most of those claiming to be “therapists” being guided down the wrong path. You yourself have acknowledged in the past that there are exceptions where people do benefit from a therapist, but we both agree it’s rare and in many cases not even possible. I’m not promoting therapy as a profession. I’m just describing what I see as necessary for it to work. Again, I’ve already agreed and acknowledged that most therapists are incapable of this level of awareness, and that one is just as likely to benefit from talking to someone they know who has some good listening skills. Therapy is a setup for most people, because of the inherent power imbalance and most “therapists'” inability to recognize let alone manage their own needs to heal their own power relationships. Alice Miller had it right.
I hope that clarifies where I’m coming from. Definitely not of the “everybody needs therapy” school of thought!
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It CAN happen and DOES happen in some cases, but the incentive is to use one’s power for one’s own benefit. And you are right, this motivation is almost always unconscious and therefore very difficult to recognize for the therapist, even if it becomes obvious to their “clients.” Which is why I say you can’t really train someone to be a good therapist. They have to develop an acute awareness of power relationships and their own issues with power and be aware of these at all times when interacting with someone they are trying to assist. I’d say very few therapists ever meet this goal, and in fact, unless I’m wrong about what happens today in “training,” most of them aren’t even aware of it as a problem. So going to a random therapist is, indeed, a very dangerous undertaking. As research shows, your odds are just as good choosing a friend or colleague as someone with a degree.
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My view is that a person can’t really be trained to be a good therapist. I agree, it has to do with the essence of the relationship between two people, and techniques or schools of therapy are borderline irrelevant. “Diagnosis” via the DSM is completely irrelevant. It’s not a “cookbook” procedure, it has to do with creating a safe space and respecting the right of the client to decide what is “right” or not and how to define and pursue “improvement” in their own worlds. I’m not sure what they train “therapists” to know these days, but I know they spend a lot of time on the DSM and “brain scans” and neurology, and it seems not very much on what actually helps people grow and develop in their own way.
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“I find them really annoying, so they must be ‘mentally ill.’ Otherwise, it might mean I’m just impatient and judgmental!”
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That is the huge glitch. And I don’t even think they bother training new therapists/counselors about this any more. It’s all about the DSM. The odds of getting a helpful counselor have dropped dramatically from when I was in counseling back in 1983. Very few are really up to the job, and an incapable therapist can do a HELL of a lot of damage!!!
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This is all very well said!
One approach I sometimes used with traumatized clients is to say, “I am guessing you don’t trust me at this point. I wouldn’t trust me either if I were you. You have no idea who I am or whether I’m a safe person, and distrust is very appropriate in such a situation. I’m hoping I can earn your trust over time.” Or something like that. Acknowledging the “rightness” of them being skeptical seemed to give the clients some sense of getting some power back. It always used to bother me when clients were dinged for “not trusting their therapy team.” I always said, “How do you know they can trust the therapy team?”
I wasn’t very popular with a certain kind of therapist…
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Absolutely true. All depends on the therapist backing away from their one-up power relationship, but that still leaves them in the one-up position, because they get to decide if they want to abuse their power or not.
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Not to mention, they are based almost 100% on bigotry and social assumptions and have zero foundation in any kind of scientific process. It’s basically rarified name calling.
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I’m assuming the intent of a good and respectful therapist is to help the person before them to free up energy used to protect themselves from past traumatic experiences so they can use it to create a better life in the future, by their own definition, not the therapist’s. It is true that not everyone is prepared at a given time to go there, and such resistance should be respected as a behavior that meets a need for the client, something DBT seems not to recognize at all.
In any case, what I’m pointing out is that “resistance” (which is a word I would never use) has historically been viewed as an indicator of exactly what you said, that the person is feeling it is necessary to protect him/herself from danger. These mechanisms are developed for very real reasons to protect from very real dangers at the time, and one HOPES that therapy becomes a safe place to identify what these mechanisms are (help the person be conscious of them rather than having them be automatic), and for the CLIENT to re-evaluate for him/herself whether and when such approaches remain necessary. This should leave the client with all necessary defense mechanisms intact and usable, but cut down on the times they are used on a knee-jerk reactive basis when not really needed, such as becoming hostile to the butcher because he wears the same had your dad wore all the time and his voice sounds similar so he must be dangerous like your dad, etc. Gaining personal awareness and decision-making power over such responses should leave a person feeling more in control of his/her life in general. That’s the theory anyway, and it appears to have been very successful for the clients whom I worked with.
So the idea that the CLIENT is supposed to somehow abandon any “resistance” and just go along with what the “therapist” says is very, very damaging to the client. It is reinforcing the idea that they were WRONG for judging the past situation as dangerous, that the “authority figure’s” feelings are more important than the client’s, and that the big problem is not that the authority figure was abusive, but that the client wasn’t “understanding” enough of the needs of the authority figure and should try HARDER to repress and undermine any actions they took to feel safer. This is exactly the OPPOSITE of what I’ve found to be truly helpful, which is validating the client for taking necessary actions for self-protection and admiring their courage in doing so.
One of the very first things I did as a counselor/therapist was to help the client validate that the “crazy” things they tended to do were not crazy at all, but made perfect sense to them at some time in the past. I would share that I’ve found it helpful to look at what DOES make sense about the behavior (AKA to what extend DOES it act to protect them) and validate them for coming up with effective “coping mechanisms” for a difficult situation. Only after getting very clear on that point would I propose to the client the possibility that such mechanisms are often used by all of us humans in situations where they aren’t as helpful as their original intended purpose, and that becoming more aware and intentional about them, or even developing some new ones with our adult intelligence and recognition that in many cases the danger is not current, might be a good path to follow.
That gives maybe just a little feeling of how important it is for me to respect whatever behavior the client has come up with to survive in their world. I always assume that ALL their actions have purpose, and the question is only whether these actions continue to serve the purpose they were intended for in the present. I have never intentionally tried to force a person to drop or dismiss any behavior they feel is important to their safety and survival. I have tried to run only based on their own stated desire to change a certain pattern of behavior, and “resistance” is important in recognizing when the actual reason for the behavior is coming to light. Naturally, a person is entitled to hang onto whatever “resistance” they feel they still need. Therapy should only be in service of meeting their own goals, not mine!
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The whole sham depends on the DSM for its foundation.
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It’s not the client’s responsibility to avoid “distracting and annoying” the clinician. “Resistance” is supposed to be part of the treatment, at least it used to be back when therapists knew what they were doing. If a person is “resisting,” it was supposed to indicate that you’re getting to an issue that needs to be addressed. It’s not a reason to punish the client!
If clients have to act in certain ways to keep the clinician happy, there is no therapy going on. That’s usually what got the client into their problems in the first place!
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So do I! It was decades later before I realized how fortunate I had been to draw the good therapy hand I did!
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That’s exactly what my therapist said to me at the beginning. She said the goal was to develop my own internal “therapist” which I could consult directly and for her to become unnecessary for me as quickly as possible. She did a lot of good for me, but only because she was focused on helping ME become more independent, not in dragging out therapy so she’d get more fees and feel superior!
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Apparently, regular trips to the gym or outdoor walks already meet that standard!
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And this is how genetic testing COULD be helpful. Instead of testing for ONE GENE that creates ALL cases of “depression,” we should be testing for genes that explain a SMALL PART of the cohort which can actually be “treated” at its cause! Such discoveries will remove a certain number of sufferers, while not raising the belief or expectation that some magical one-gene solution will mean EVERYONE suddenly gets better!
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Thanks for your thoughtful reply! I agree that these things are complicated, and I appreciate the acknowledgement that “fitting in” to the so-called “social norms” is NOT a sign of “neurotypicality” but of ability to adapt to what are generally unreasonable expectations. The “ADHD” kid in class can’t adapt, and so is identified as “divergent.” Of course, it’s better for him than being identified as “mentally ill,” but that classroom is FULL of kids who are just as miserable as he is and yet don’t act that out for whatever reason, whether better suppression skills or more fear of punishment or whatever. Those kids are not any more “typical” than anyone else, they just don’t make trouble for the adults and are therefore identified as “normal.”
Maybe the term “neuro” is what gives the word its “bioessentialist” undertone. Maybe if we simply identified ourselves as “divergent,” as in “diverging from expected social norms,” then everyone can get on board with “diverging” and maybe even find some new and better “social norms” that are easier for more people to live with!
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Frank, while I agree that paying for a quality therapist (if one is fortunate enough to find one) is hardly a form of oppression, I have to say that I’ve seen PLENTY of garden variety straight-up intentional oppression of psychiatric “patients” in the name of “helping” them that most definitely would meet any definition of oppression you can come up with. Dishonesty, use of force, holding people against their will without cause, forcing “treatment” that causes brain damage and early death while claiming that all of these issues are the patients’ problem and were not caused by the “treatment. All of these things are offensive to any sense of justice, freedom, equality of rights and basic respect due to any human being. It seems to me you are singling out the relatively rare case of a free and relatively well off adult engaging in a more or less fair exchange of money for services, and assuming the purchaser has both the information and the wherewithal to resist efforts to indoctrinate or mistreat them at the hands of the therapist. That’s a lot of assuming!
If you slow down a minute and read some of the experiences shared here on MIA, you will see that the vast majority of commenters do not have the kind of experience you are describing. Many are forced against their will to do things they object to with neither information nor consent. Many more are lied to and emotionally manipulated into accepting a very unhealthy framing of their situation and into accepting “treatments” whose benefits are overblown and whose dangerous consequences are minimized or denied completely. This is the oppressive situation we’re dealing with. And it CAN happen in a paid therapy relationship, too.
I’m sure you are a caring person who probably does a good job helping your clients. What I don’t think you get is that you are an outlier in the world most of the posters live in. It’s very understandable that most are extremely skeptical of therapy in any form. It’s been used to hurt them!
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My biggest problem with the term “neurodivergent” is that it implies there is a “normal” kind of neurology that “most people” have, and that one has to be “autistic” or “ADHD” or fit some label to be considered “neurodivergent.” I object very much to the idea that there is such a thing as “normal” vs. “divergent” neurology, in fact, genetic diversity is critical to species survival, and one of the great joys of humanity is the amazing degree of divergence that exists within the “normal” range of human behavior. Ultimately, I see us all as “neurodivergent” which means the term really has no meaning. It seems to me that the term “neurodivergent” reinforces the idea that “mental illnesses” are somehow neurological and are discernible by “divergence” from some kind of theoretical “norm.”
I have no problems with individuals identifying themselves as “neurodivergent,” but I can’t agree with such people deciding that I or others are “normies” and that one has to have special qualities to qualify as “neurodivergent.”
That’s my view of it. I’m sure others have their reasons that will diverge from mine!
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I am shocked, SHOCKED to find that GAMBLING has been going on in this establishment!
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As I intimated, I don’t think most psychiatrists understand or care about fast- vs. slow-metabolizers and so forth. I do appreciate your research, and that was specifically what I was recalling and referring to.
The difficulty with this approach is that it totally begs the question of what we are supposedly “treating” with these drugs. What we’re doing is manipulating brain chemicals and hoping we get lucky and find a drug that a person can live with that helps reduce his/her “symptoms” without saddling him/her with intolerable adverse effects. But of course, we have no idea if brain chemicals are in fact a causal agent in any of these cases, or how to distinguish the ones that are (if they exist) by any kind of objective means. It’s not really very different from observing that some people can take opioids or drink alcohol and be fine, while some are quickly overwhelmed by the drug’s effects and others seem to take a lot to have any effect at all. All fine information to have, but it hardly substitutes for figuring out and addressing WHY this person is distressed enough to be heading down to the bar every night to imbibe, and what we might do to alter that reality!
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I don’t believe that is completely true. They can apparently test for people who are “slow metabolizers” of different drugs and so perhaps avoid creating homicidal/suicidal ideation by SOME people taking SSRIs, but these tests appear to be far from foolproof, and just as importantly, almost no physicians regularly use such testing in their practice, despite your assertion that “ANY WISE PHYSICIAN” will do so. I’d be happy to be proven wrong about this, but that’s my understanding of the current situation. I have yet to meet a person currently engaged in the MH system who was offered such testing by their doctor, though I’ve heard of a few who demanded it themselves. Do you have any links to recent studies showing anything more promising than what I’ve identified above?
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Unfortunately, a great deal of what passes for “psychotherapy” these days does not incorporate any of the important philosophical underpinnings you mention above. A lot seems to now be focused on “neurobiology,” on DSM “diagnoses,” and on compliance with “medication” and other “treatment plans” like DBT or CBT. I did therapy for a number of years in various settings, some formal and some informal, and saw and heard what others were exposed to by their “therapists,” who in my view did not deserve the name. I’m not sure they are even taught about unconscious motivations or ideas of consciousness or striving or attachment or awareness of one’s own process, let alone touching on the existential issues of the bizarre expectations and abuses of modern society. The focus seems to be on making “symptoms” go away, as if “depression” or “anxiety” were the problem rather than the observable manifestation of the actual issues causing distress. This is the inevitable result of “DSM” thinking – reducing the complexity and spiritual richness of human experience to “desirable” and “undesirable” emotions or behavior, which the therapist and/or psychiatrist is tasked to change, by force or manipulation if needed. It is small wonder that folks faith in psychotherapy as you describe it is very low – very few people seem to ever experience it these days!
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I’m glad Ketamine therapy works so well for you! But I do want to remind you that this doesn’t mean it works for everyone. The idea that all people who are depressed have the same problem or need the same solution is not scientifically valid. I rejoice that people find Ketamine or any other approach workable for them. I just want to be cautious about using anecdotal data to extrapolate for others who may have very different circumstances and very different results than you had.
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Clearly, the most fundamental fallacy with the entire psychiatric edifice is the assumption that all people who “have depression” or whatever “mental illness” is under discussion are all ILL and have the SAME PROBLEM and need the SAME INTERVENTION. The DSM itself invalidates this assumption in its introduction, but this apparently has no impact on people’s viewing these “diagnoses” as some kind of valid scientific entity that can somehow be “researched” as such, even though the people in the study group often have little to nothing in common with each other. In fact, it’s been shown that multiple people can “qualify” for the same “diagnosis” and have not a single “symptom” in common! How it’s not obvious to anyone of a slightly scientific bent that this whole system is a house of cards built on nothing but opinion and bias is beyond my comprehension.
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Which once again reinforces the idea that the person one is interacting with, their maturity, skills, openness to experience, ability to create a safe environment, ability to help a client focus on their own goals and purposes, is what really matters in any kind of “therapy” or healing practice. I find calling MDMA “medicine” in itself to be an absurdity. It is not a “medical” process you are describing, it is a spiritual/emotional/intellectual journey that is very personal to each individual, and there is no way to create a repetitive “treatment” that can obtain any kind of consistent and predictable results for all people. The key is who is helping “guide” you and what kind of “guidance” they tend to provide (empowering vs authoritarian) rather than the particular drug or other method used. This is not to say that MDMA or any other drug may not be able to contribute to increased spiritual awareness or skills in life, but it’s not “medicine,” any more than alcohol or marijuana are “medicine” because they have certain effects that a person may or may not desire or benefit from.
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I do think it is of great concern that the number of contacts appears to have a direct relationship to the number of detentions. This would imply that the increase in contacts would have the same demographic distribution of seriousness as the ones already contacting crisis lines previously. Unless this is simply a redistribution of people who would have contacted another crisis line if 988 did not exist (which of course means there is NOT really an increase in contacts at all), one would expect that the new callers would have a LESS serious distribution of issues, because we should be courting new contacts who otherwise might not have called (the purpose of the 988 easier access).
So there are two likely conclusions: first, that these callers are the same people who already used local crisis lines, and we have spent millions and millions of dollars to accomplish essentially nothing at all, or second, that calling a crisis line gives a particular probability of having the police dispatched, regardless of the average severity of the call. Neither one is a happy conclusion!
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We shouldn’t have to prove they are dangerous. The standard is that the doctors/pharma need to prove they are safe. I think the biggest problem is we have hired a lot of foxes guarding the henhouse of drug safety. If we had a REAL set of standards with honest, non-corrupt people applying them, we’d all be a lot safer and it would be a lot easier to get complaints heard and acted upon!
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Why is it sad? Science is about facts, not feelings. It is GOOD that Ketamine’s rah-rah propaganda has been served a well-deserved challenge. We need to know the truth.
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It is easy to confuse “These categories are not scientifically valid diagnoses” with “debilitating anxiety doesn’t exist.” They are VERY different statements. I doubt anyone here would state that debilitating social fear and apprehension don’t exist or are not painful and difficult. The argument would be that just because you feel anxious in social situations, no matter how severe, it doesn’t mean you are “ill” in a medical sense.
I say this as a person who suffered debilitating anxiety and depression in my youth, and now at 65 rarely experience anything similar. I did get therapy for a while and do a lot of self-help stuff but never was “diagnosed” with anything at all by my therapist. It is not necessary to validate these “diagnoses” in order to agree that someone needs help and support and to assist them in getting to a better place. I’m also not invalidating the potential usefulness of psychiatric drugs, just saying that the “diagnoses” themselves are not valid medical/scientific entities, and that saying so doesn’t invalidate ANYONE’S suffering!
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The only legitimate “outcome measure” in something so subjective as “therapy” is whether the client feels they’ve gotten something out of it!
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I wouldn’t call it easy, but it’s definitely do-able. I have a little preamble I give to any new doctor I see about how I’m going to be the one making the final decisions, and if that’s a problem for them, let me know now so I can find another provider. And I have had to do that on occasion, but it almost always puts them in their place.
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POSTING AS MODERATOR:
So noted.
In the future, could you please report any comments you feel don’t pass the moderation standards? Or write me an email? Thanks!
Steve
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That’s the sad part about these labels. Folks can dismiss what are most likely very valid complaints by blaming the victim.
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Wow, now THAT’S therapeutic! “You’d best get better or I’ll have you locked up!” Reminds me of “Don’t cry or I’ll give you something to cry about!”
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I am agreeing with you.
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Right. So it increased to 220% of previous values.
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That is exactly my point. How is “standardization” even possible when there are no objective standards possible regarding what diagnosis to give, how to do a danger assessment, optimum “treatment,” what “good outcomes” are, how to measure them, etc.? It’s all so completely arbitrary! How can “imminent risk” ever be anything but haphazard and varied?
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I am sure this is an accurate summary of what is happening today. One of the main reasons I left the crisis line was the “professionalization,” which meant more fear of lawsuits, more rules and expectations and rigidity, and a greater likelihood of sending the police out on calls that did not really pose any danger at all. And the lack of any kind of objective standards for police dispatching or diagnosing or anything at all in the “mental health” world makes “quality control” almost impossible.
But it does encourage me to know that crisis lines do still exist where dispatching is not an option, and I wanted to make sure I shared that fact. Of course, it’s a volunteer crisis line, not a “professional” one!
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My experience (and I have a lot) is that crisis lines I’ve worked at or volunteered at had a wide range of different views on what to do about suicidal callers. I was a supervisor for a volunteer crisis line in Portland, OR, and we tried only to talk unless a person had a specific plan and intent to carry it out. The line contract was taken over by a “professional” service and the likelihood of a dispatch went up quite significantly, though they did eventually develop a “crisis team” who would see some of the people without police being involved. I later volunteered at a crisis line that never traced or dispatched under any circumstances. So it’s not legitimate to overgeneralize – different crisis lines have different philosophies, and it may also depend very much on whom you reach when you call. I can see people being VERY cautious about sharing that they are suicidal with such a crisis line, without knowing what their general philosophy about such calls is and how frequently they tend to dispatch the police!
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I’m not sure I’d say the act of a stimulant improving concentration temporarily represents “healing” per se. Smoking marijuana or drinking alcohol reduces anxiety for many, but I’d not suggest they are “healed” by the process. There are no doubt some healing processes that are mediated by drugs, but I consider this to be more or less incidental to psychiatry’s intent. For instance, I know of a guy who took stimulants for a little while and said he discovered a mental state he could get to that way, then he STOPPED taking the stimulants and found other ways to achieve that same kind of mental state. I’d call that a kind of healing, and the stimulants were a part of it, but no psychiatrist would recommend or approve of the real healing part of that action.
Anyway, that’s just my personal view on it. Some people find psychiatric drugs beneficial for whatever reason, and more power to them, but I don’t think it’s a form of “healing” to take a drug that makes you feel better temporarily. It might be the first step in healing, but psychiatry as a rule discourages any attempt at any further “steps,” in my experience. Healing tends to happen despite their interventions, not because of them.
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“Pre-dying!” I love it! It’s a condition we can ALL claim!
The same happened with cholesterol, BTW. At one point, you had to be 160 or so before anyone got worried. Then for no real reason, they changed it to 120. Actually, there was a reason – to sell more cholesterol-lowering drugs!
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It is not “demonizing medications” to observe what the research really shows and to share people’s individual experiences. It’s called sharing reality. If “medications” need to be protected from the actual facts about them, it says a lot about who is demonizing whom.
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And is in fact contrary to research showing that long-term use of antipsychotics REDUCES the average lifespan of the recipient! The odds are that she’d have lived longer if she’s avoided psychiatry altogether!
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It does feel more than a little ironic to hear that she was attacked for questioning the efficacy of antidepressants, and yet failure to take antidepressants is assumed to be the cause of her suicide. As I said earlier, wherever you come down on the “cause” of her suicide, which of course, we will never really know, it is VERY clear to me that psychiatry did NOT get her to a place where she achieved “good mental health.” She clearly eventually gave up on psychiatry because it failed her. It is more than a little disingenuous to imply that her abandoning a practice that never really worked for her is somehow responsible for her despair.
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My reality is that therapists who can create a kind and secure environment for a client to share and to some extent be challenged to seek new perspectives have success, regardless of the model they use. “DBT” will work well in the hands of a highly competent therapist, and will be a disaster in the hands of an incompetent one. CBT will similarly be successful to the degree the therapist can create a safe and connected environment where a person can share their fears and explore new options without feeling judged or threatened by the therapist. Whereas an insensitive or self-involved or “rote” therapist will have no success with CBT or any other approach.
There is no way any person can become a “good therapist” by studying a manual and following instructions without truly understanding the nature of the delicate and emotionally sensitive interactions they need to become a part of. There is solid research supporting this viewpoint. I don’t think DBT is good or bad in and of itself, I just think it’s a bunch of possible tools that a competent therapist can use to build up their client’s feelings of success and control, or a bunch of possible tools an incompetent therapist can use to make their clients feel worse and then blame the clients for the therapists’ own failure.
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Here is one study showing how stigma is INCREASED by explaining “mental disorders” as biological problems.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842491/
Here is another:
https://www.goodtherapy.org/blog/biological-explanations-may-not-reduce-mental-health-stigma-0124181
Considering there is absolutely NO evidence that any of the DSM “mental disorders” are fully or primarily caused by biological problems or issues, it’s mystifying why “anti-stigma” campaigns focus so much on convincing people that “mental disorders” are “illnesses like any other.” Unless the intent is not, in fact, to fight stigma, but to fight resistance to accepting drug therapy as the first line intervention for these ostensible “disorders.” Then and only then does this focus make any kind of sense. But then calling these “anti-stigma campaigns” isn’t very honest, is it?
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A wise person once said, “All that is not love, is fear!” Fearing our emotions prevents us from feeling the love and connection that for most of us makes life feel like it’s worth living.
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“CLD” – let’s propose it for the DSM 6!
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They also screen out suicidal people from the vast majority of these clinical trials, so these are not “suicidal people getting the energy to do it.” These are people who, for the most part, were not suicidal until they took the drugs. They most definitely can and do cause suicidal thinking. Hence, the black box warning. That warning ought to be enough for anyone to acknowledge the possibility.
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You clearly suffer from “Disliking Steve’s Analogy Disorder!”
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My favorite analogy is “You have pain in your knee because you suffer from knee pain disorder. You know you have knee pain disorder when your knees hurt, but knee pain disorder also CAUSES your knees to hurt.” Very informative!
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As extreme and simplistic as the idea that “schizophrenia” is in all cases caused by genetic or biological malfunctions which no one has ever been able to detect but we KNOW must be there?
I’m always the enemy of extreme and simplistic. I just want to make sure that everyone is fully aware of the extreme simplistic basis for these ridiculous psychiatric “diagnoses” and the insistence on “treatments” being determined by such laughably unscientific claims. The proper attitude toward any case of “schizophrenia” is that we have a NAME but very little knowledge of what is going on IN THIS CASE and need to explore what’s happening IN THIS CASE and what might work IN THIS CASE. Trying to generalize based on these laughable “syndromes” where two people can both be “diagnosed” and literally have no symptoms in common (try it some time, it’s quite possible in at least schizophrenia and major depression by my direct observation) is almost as far away from scientific as one can get.
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I don’t know about the “subscription” button. I’ll look into that for you.
Dismissing trauma as a causal factor in “mental illness” displays either ignorance or a willful attempt to redirect people away from exploring this very real issue.
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Part of “informed consent” is also presenting alternatives. This almost never happens in my experience.
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I always find it odd that defenders of the current psychiatric paradigm so frequently conflate criticisms of that paradigm with ‘stigma concerning mental health.’ The two have literally nothing to do with each other. There is, in fact, HUGE “stigma” for people suffering emotional pain who DON’T use psychiatric drugs as part of their treatment, and those who choose to discontinue such treatment are often attacked relentlessly by the very people who are supposed to be helping them.
There is certainly general discrimination in the public sphere against people who qualify for or identify with a “mental health diagnosis.” On that point, I’m sure you will find no disagreement on this site whatsoever. However, it is actually shown by scientific research that teaching people to view “mental illness” as a brain disorder of some sort INCREASES “stigma” and discrimination by making it easier for people to emotionally distance themselves from those who are suffering, while a “trauma-based” framing increases empathy and DECREASES stigma.
So please don’t blame “stigma” on those who question the accepted psychiatric paradigm. It is the accepted paradigm itself which is responsible for most of the stigma, according to their own research. There is nothing wrong with questioning the scientific validity of psychiatry’s unproven assumptions, nor does questioning those assumptions mean or imply that those finding psychiatric drugs helpful are wrong or need to be forbidden from using them. Again, the two issues have literally not a thing in common.
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There is a VERY high correlation between childhood sexual trauma and psychosis.
https://www.medpagetoday.com/psychiatry/schizophrenia/23087
It is not at all far fetched to suppose that childhood abuse can contribute to the eventual development of psychotic states. There is also strong correlation with being an immigrant and living in an urban environment.
As in all of the so-called “mental disorders,” the situation is FAR more complex than the “mental health” world would like us to believe. There is “no proof” (to use your words) that ANY “mental illness” as defined by the DSM is caused by any measurable biological/genetic factor either. I’d agree that current drug use and current trauma are often overlooked as contributing factors in psychosis. Maybe the problem is regarding “psychosis” as if it must always be caused by the same things or “treated” in the same fashion. Maybe there are many “causes” that work differently in many different people, and we ought to scrap the idea that “schizophrenia” is a “thing” that has a specific cause.
Steve
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Additionally, a very significant percentage of studies use a “placebo washout” design, where they screen people who DO respond to the placebo out of the trials! This is obviously designed to minimize the placebo response and make it more likely that the drug will meet “statistical significance” vs. placebo. So far from using active placeboes, most studies actually try to weed out those who will respond to an INACTIVE placebo in order to bias the study in the direction of their drug. And somehow, this is not considered a violation of the scientific method!
Here is a published article in a solid, scientific journal for the original poster to read. It goes over why the author concludes that more than half of all published scientific studies can’t be replicated, and hence are not valid. It ought to make him/her more cautious in assuming that anything published in a scientific journal is de facto proven truth!
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124
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One article in an online publication has “done society a disservice!” Why refer back to Freud or Szasz to try and discredit the arguments of the author through the reverse “argument by authority” approach? Don’t you have your own arguments to make?
It would appear to me you might want to re-read Szasz again, as he never claimed that the phenomena describes as “mental illness” did not exist, but that the idea that these were discrete and identifiable “disease states” of the body was mythological, as this concept is not supported by scientific facts.
There is nothing “unqualified” about the argument that traumatic events alter people’s concept of who they are and how the world operates and what relationships are about. In fact, the entire movement toward “trauma informed care” is based on scientific proof that not only their behavior, but that people’s actual brain structures and activities can be dramatically altered both by early life trauma AND improved by healthy relationships later on in life. It is pretty regressive at this point for anyone to claim that traumatic events do NOT impact all of the so-called “mental illnesses” as defined by the DSM, however fuzzy and arbitrary those definitions may be. Even the most medicalized psychiatric supporters at this point know that the idea of a “chemical imbalance” or other purely physiological problem creating any “mental illness” being detectable by tests and repairable by drugs is completely unsupportable by scientific studies.
Ironically, there is far MORE support for the remnants of Freud’s “trauma theory” through the “trauma informed care” movement than for the idea that any discrete “mental illness” described by the DSM is a scientifically valid description of reality. Even more ironically, the DSM itself admits these things in its introduction, where it says that:
“In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” (APA, 2000, p. xxxi).”
And even more tellingly: “There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.” (APA, 2000, p. xxxi).”
So not only can the DSM criteria NOT distinguish between having one “disorder” or another “disorder,” or between having a “disorder” or having “no disorder.” Worse, two people who both CLEARLY QUALIFY for a given disorder may not have the same problems, needs, or possible solutions! What is the point of having “diagnoses” where the people who are so diagnosed are NOT “alike in all important ways?” Isn’t the point of a “diagnosis” to group together people who have similar needs and issues and distinguish people who have similar presentations but different underlying causes? These two clauses admit outright that these “diagnoses” are scientifically and practically meaningless!
So before you go about accusing others of “unqualified arguments,” it might be wise to spend some time to qualify your own arguments. No one arguing in favor of the DSM “diagnoses” being taken seriously in any scientific manner is in a position to criticize anyone else for being “unscientific!”
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It is easy to move from “she wasn’t taking her meds” or “she engaged in recreational drug use” to “she killed herself because she stopped her meds” and/or “she killed herself because she’s an addict.” Neither of those premises has any more evidence backing them up than the “psychiatry killed her” idea. Any of those are possible, none are provable. But one thing we DO know for sure – this person had the best of available psychiatric care for decades, did not “resist” or “rebel” but in fact embraced the system for most of that time, and all of that “help” did not prevent her eventual suicide. It is certainly NOT valid to suggest that everything was going just fine before she “quit her meds!” It sounds from her blogs like she struggled the entire time she was “in treatment” and went another direction for whatever reason she chose. It would be EXTREMELY naïve to look at her situation and say, “if only she’d stayed on her meds…” Whether her suicide was caused by her engagement or disengagement with “the system” is not something we can determine, but I think it is more than fair to say that psychiatry failed her in many ways, and it’s never appropriate in my mind to blame the client for quitting services when the services have not been successful. If psychiatry were the answer for her, 20 or more years of committed engagement with the psychiatric system would have led to a different outcome. I think it’s more than fair to suggest that psychiatry AT BEST did not help the situation, despite her being fully committed to following their instructions for many years. Let’s not blame “not taking her meds” so easily, since we’re hearing we’re not supposed to be so “black and white” in our thinking as the author supposedly is.
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It is true that we don’t ever know what prompted a particular person’s suicide. What we DO know in this case is that decades of psychiatric treatment did not prevent it. Whether it contributed substantially to the event or not will always be speculative, but it’s equally speculative to say, “Antidepressants save lives,” when we don’t know how people would have acted under differing circumstances.
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It sounds like you might need some help getting away from an abusive partner! Are there any domestic abuse hotlines or programs in your area? There is hope, but you will have to figure out a way of putting at least some emotional distance between you and your husband. No one should be forced to live with someone who hates them so much they intentionally make an addict out of her!
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I would add that the presence of psychiatric drugs not only can do damage itself, but it also diverts young people (and older people) from other approaches that have been successful over time, both formally and informally. It may be the lack of developing support networks as much as drug side effects that are helping cause the deterioration of youth “mental health” today.
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Please recall that there is also a POWERFUL stigma AGAINST those who choose NOT to accept the standard “treatment” offered by psychiatry, even when it is demonstrably doing serious harm.
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There are actually plenty of hard scientific studies showing that psychotropic medications IN GENERAL tend to create worse clinical outcomes. Harrow et al for instance showed that people with poorer prognoses that took antipsychotics only briefly or not at all did BETTER than those who had better prognoses and took antipsychotics long term. So on the average, they were worse off taking psychotropic drugs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661946/
Studies on antidepressants and “ADHD” also show no average benefit or worse outcomes for those taking drugs over the long term.
Multiple studies show an increase in suicidal thinking and acts in those taking antidepressants, especially when younger.
Many studies show the “severely mentally ill” have shorter life spans than the average person, much of it due to heart and metabolic problems that are known to be caused by antipsychotic drugs (clearly, there are other contributing factors as well, but treatment is associated with reduced life span).
Your analogies are completely inappropriate. Taking diabetic treatment does not INCREASE the number of amputations, it decreases them. The same can’t be said for psychosis and antipsychotics or suicide and antidepressants. Not to mention, diabetes is known to be caused by a lack of insulin in all cases. No one suffers from psychosis for a lack of antipsychotics.
Perhaps a more open mind and some honest research will help you see that the situation is not as black and white as you currently believe. You might start by reading Whitaker’s book, “Anatomy of an Epidemic.” It could be quite enlightening.
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…..
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MIA is mostly interested in looking at alternatives to the “medical model.” It is unlikely we will want to promote any “antipsychotic” drugs given the history of failure and worsening of “symptoms” and in fact the shortening of lives resulting from the “antipsychotics” currently in use. It seems very unlikely that the “new” drugs will be doing anything beyond trying to suppress dopamine and maybe suppress the uptake of Serotonin like Risperdal and Seroquel and the other current drugs.
It is truly a problem to be unable to continue. I’m betting no one warned you this could be an outcome of taking them in the first place! Have you talked to anyone who specializes in getting off drugs? There are such people around, but most psychiatrists either don’t know or actively try to prevent any effort for people to get off.
Anyone else have thoughts?
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The use of the term “inclusion” already marginalizes the peer support workers. Who gets to decide if they are “included” or not? Obviously the REAL workers, who are by definition more important than the “peer workers” because they can “include” them or not at their whim.
Reminds me of the concept of “shared decision making,” where clinicians are “encouraged” to “take the views of their clients into account” before making decisions. Obviously, the people being asked to “allow” their clients to have a “voice” are already trampling the rights of clients to true informed consent, and asking them nicely to please ask my opinion before you decide what to do to me is hardly a viable solution.
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It is very odd that in most cases, we assume that the device provider is responsible for proving the safety of its products, but in this case, it appears that the “clients” (including forced, involuntary victims) have to prove that it’s NOT safe!
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Thanks, Ted! Good to know you’re still out there fighting the good fight!
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To be clear, I am not against systematic interventions to help people who are struggling, as you seem to suggest. I just want to focus on things that actually work FROM THE POINT OF VIEW OF THE CLIENT. There are some people I know who have used the drugs as a means to help themselves, and have suffered minimal adverse effects. I’ve also known others whose lives were destroyed following that path. I used to be a counselor/therapist and I believe helped lots of people find their way to a new path or direction for their lives. My approach helped a lot of folks, but I know it didn’t help everyone I came in contact with. I had a philosophy that allowed me to connect more directly with people about what their concerns and needs were, and I’ve taken people who had all kinds of different labels and been successful when they experienced failure in “the system.” I could share some pretty impressive stories of monumental changes in people who the “Mental health professionals” had decided were intractable.
Others needed things I couldn’t provide. I tried to help them find some other pathway. I have never had or expressed the viewpoint that there is no such thing as suffering that requires some sort of advanced intervention. I am not sure where you ever got that idea, but I would appreciate it if you drop that as it applies to me. As you are against “bullying” as you so aptly put it, I’d really appreciate you not deciding for me what I believe and drawing conclusions on the basis of those assumptions.
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I agree 100%!
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I don’t think mapping the brain will create an understanding of “mental health.” But I do think that real brain research shows and will continue to show that the idea of “mental illness” is a “brain disease” is, scientifically speaking, complete nonsense.
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The problem is not that people don’t fully use the criteria (even though they almost never do), it’s that the criteria themselves are subjective, speculative, and completely unscientific in nature. You can’t judge “overdiagnosis” if there is no objective way to tell who “has” or “does not have” a particular “disorder.” The DSM itself admits in its introduction that 1) you can’t really tell who has which “disorder,” or where the line between “disorder” and “no disorder” can be drawn, and 2) any two people who COMPLETELY FIT the criteria at a given moment may not have the same problem or need the same kind of help. Of course, almost no one ever READS the introduction, and it’s couched in very squirmy language that requires interpretation, but it’s a pretty damning admission, don’t you think? We have no way of objectively determining which diagnosis you have, and even if you and another person are right in the center of the target, your diagnosis means nothing about the cause or your needs or what treatment to recommend. What is the value of such a “diagnosis?”
When I did clinical work in the past, I simply talked to the client about his/her own conception of the problem and what they thought might have helped. While of course I asked good questions and made observations and brainstormed options with the client, in the end, the client was responsible for defining the problem and whether or not a particular intervention was “working.” It is arrogant in the extreme in my view for a clinician to enforce his/her views on what is “wrong” or what “should be done” on a client, as the main reason people suffer from “mental health issues” in the first place, ESPECIALLY when we’re talking about depression and/or anxiety, is because OTHER PEOPLE have taken over their lives and told them what to think, say or do and what was “right” in opposition to allowing the to follow their own personal “voice.” I consider it more abuse for a “professional” to boss a client around and disempower them the way they were disempowered by others in their pasts. Empowerment is the answer, not more powerful people exerting their control over the clients’ lives.
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Which is how research ought to be done! The actual data should be reported and acted upon, even if the knee surgeons might lose some money in the process!
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Exactly. If the current model were working, people who USED TO BE disabled would now be OFF disability and working again! If someone’s disabled with, say, a bad knee, and gets knee surgery, we would expect that the corhort of such people would be LESS disabled than before the surgery! There may be a few for whom it did not work and they didn’t get better or got worse, but overall, the average disability level would have to go DOWN for this intervention to be considered effective! If people are MORE likely to be unable to work and participate in society AFTER receiving psychiatric “treatment” than before – well, there isn’t a much better definition of “ineffective” or indeed “counterproductive” available than having a “treatment” actually INCREASE the disability rate of its recipients!
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They say that 78.54% of internet statistics are made up on the spot!
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Another excellent example!
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Unless you’re TRYING to disable people, in which case, they are pretty effective.
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Again, I think you are confusing efforts to help with effectiveness. Stating things like “ECT is effective and safe” is just as dangerous or moreso than saying, “ECT can have serious adverse effects which should be considered before undertaking such a course of action.” Are you seriously claiming that there are NO or MINIMAL adverse reactions to “ECT” despite all of the hard and soft data showing that the results for some people are devastating? You do realize that “ECT” is the intentional induction of a convulsive seizure (hence the name) and that under normal circumstances, such seizures are considered dangerous and people take drugs to avoid them because of potential brain damage? Why would an intentionally induced seizure NOT be likely to produce brain damage when a spontaneous one IS likely to produce such damage?
My beef with psychiatry is mostly the blithe dismissal of very real concerns that exist, as you demonstrate in your comment. It is not HATEFUL toward psychiatry to report on actual events and studies that challenge the conventional wisdom. “Trust me” is a dangerous comment for ANY physician to make, but more particularly those working in psychiatry, where knowledge is scarce and speculative on the ground and no one really understands the exact cause of ANY “disorder,” or even if such a “disorder” syndrome is a legitimate entity for study rather than a broad collection of phenomena which have been cast together into a syndrome because we don’t understand them, purporting to “know all about it” is just a blatant deception.
Psychiatry would be a lot better off as a medical specialty if it took a big dose of humility and started to understand that these bad results are very often NOT random or made up or the result of “lifestyle issues,” but are very real and potentially dangerous side effects of the “treatments” they are handing out. That way, at least some measure of “informed consent” can be practiced, rather than providing bland and scientifically empty reassurances such as “ECT is safe and effective.”
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I worked for 20 years in the foster care system and the stories are all too familiar. I helped get a law passed to require such evaluations of kids before they were ever put on psych drugs, and with the help of a state-level nurse, we also managed to implement a triggered review of any case involving certain polypharmacy criteria. The drugging rate HAS dropped since then in Oregon, but it’s still way too high. It is the inevitable result of inventing “diseases” that can’t be objectively determined and giving people drugs for them. There will always be “diagnostic creep” if there is no hard line to decide when intervention is needed, as is the case with essentially every psychiatric “disorder.”
Another interesting fact was that those kids cared for by relatives had a MUCH lower rate of psych drugging than those being fostered by strangers. I have the greatest respect for the many excellent foster parents out there, but think it really helps to have someone in the room with the doctor who feels a familial obligation to care for the child’s needs. It’s way too easy in the current system to believe we are acting in the child’s interests when we’re actually acting to make the adults’ lives easier. That won’t change until we get rid of these bullshit subjective “diagnoses” as excuses to drug kids into compliance or docility.
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It depends on how frequent the adverse effects are and how seriously they damage people. There are plenty of banned therapies for various physiological problems that are considered too risky, even if they work for some people. I agree some people seem to report positive results, and I don’t particularly want to take that away from them, but it’s a cost/benefit analysis that transcends the needs of individuals.
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I also think we should remember that Vioxx, for instance, did provide pain relief for a lot of people. It also killed a certain small percentage of them, far from a majority, actually a very small minority. It was taken off the market. Because it killed people. But some people found it very helpful. The FDA decided it wasn’t OK to risk people dying, even a small percentage, in exchange for pain relief.
It isn’t always OK to allow a potentially unsafe intervention even if some people do fine on it, especially when you have no way to determine a head of time whom you might accidentally kill or whose life you may accidentally ruin.
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Seriously, what is that supposed to mean?
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Can you please provide evidence for your claims? It’s easy to say things without providing the actual backup. I’ve heard and read statistics that are WILDLY different from what you are claiming, so I need to see where you’re getting this info to put it into any kind of perspective.
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Saying that these folks need help does NOT translate into we should assume and accept that what the psychiatric profession has to offer is the kind of “help” that they need. It is absolutely wrong to postulate that needing attention means needing the kind of abusive and destructive behavior that is often accepted and even encouraged in the name of “psychiatric care.”
Those “helped” by psychiatry with psychotic disorders die on the average 20-25 years YOUNGER than those who don’t receive such treatment. While it’s obvious that there are many variables involved, I challenge you to name another profession where receiving treatment REDUCES average lifespan. Something is not right here. The problem is not that these individuals need attention, it’s that the kind of attention they receive is not the kind of attention then need in a large proportion of cases.
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Another psychiatric success story!
I’m so sorry you had to go through all of this. It sounds like a total nightmare. How people get PAID to do this kind of damage is beyond comprehension.
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They never want to admit the significance of the placebo effect. BELIEF can be more powerful than actual physical phenomena in the body! How much MORE causative can belief be over mental phenomena?
You’re right, they can’t really study it honestly. They can’t afford to let the results get out!
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Sadly, I can validate all of your observations in the people I’ve seen have to go through the system. Professionals who are prepared to be vulnerable and really care are rare and are themselves often attacked for doing so. I apparently had “bad boundaries,” according to those who wanted me to toe the line and stop giving my time and energy to actually trying to help people get OUT of the system and manage their own affairs. Eventually, I had to give it up because it was clear that the intention of “the system” was VERY different than my intention!
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