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Good point. I also note that most apologists for the System will say, “The reason this person committed suicide is because mental health services are underfunded and unavailable.” But most of the time, they’ve had years of “services” before the event. So how is a lack of services the problem? It sounds like the services FAILED TO HELP!
I think you are missing the point. The first mistake is seeing individual humans as “patients” who need “treatment” simply because they are experiencing intense emotions. You seem to be having difficulty accepting that framing of the issue is 90% of the problem. “Medical treatment” is not the answer we are looking for.
As for time and patience, again, we don’t choose our cancer or heart treatments based on whether people find them difficult to implement. We choose them based on whether they work. Taking drugs is easy and quick but it doesn’t work in most cases. In fact, it generally makes things worse and prevents people from choosing the more effective path for them, even if it is harder. I could give you an example or two if it would help you.
We are all responsible for finding our own pathway. All we can do to “help” is to help the person decide. Encouraging them to do the wrong thing because it is easier is foolish in the extreme!
It makes no sense to simply “reframe mental health treatment” in terms the Zulu can accept. We are barking up the wrong tree. We need to shut up and ask THEM what they think would be helpful, and change our model accordingly. But of course, that would mean scrapping our top-down, we-know-best, do-as-we-say approach, which would mean scrapping “mental health treatment” as we know it and starting over.
No, I have plenty of ideas of what is helpful in many situations. However, those situations are NOT defined by “diagnoses” nor subjectable to any kind of “double blind studies” as if humans are some kind of machines who all will respond to a certain approach if they have certain “conditions.” Generally, what is helpful is someone who will take the time to listen and be comfortable with another person as that PERSON figures out what if anything is “wrong” and what needs to change for him/herself. The biggest problem (of many) with the current system is that it attempts to take something like “depression,” a common experience to all humans, and come up with some kind of “cure” that works in all cases, as if feeling depressed (sometimes deeply and sometimes for long periods of time) were not a normal part of the human experience, or that all people experiencing “depression” have something mechanically wrong with their brains or minds that needs to be “fixed” by a doctor.
I’ve found many ways to be helpful to hundreds of people over the years. But every one of them is unique and required me to go into the situation completely open to hearing whatever is being communicated and working to respond appropriately to that particular person. Trying to treat everyone the same and expecting the same result is never going to work. Milton Erickson said that “Therapy has to be re-invented for every client.” I think he was pretty much correct.
I will add that there are plenty of things that are helpful to some but not all which fall outside the realm of “therapy” per se. Buddhism or other spiritual practices are a good example. Also such simple things as walking in the woods, breathing properly, getting good exercise, simply talking to another caring layperson (shown to be generally as effective as “therapy”), and most crucially, having a sense of purpose or intent for one’s life can make all the difference. In addition, altering one’s environment to avoid abusive people or situations is sometimes essential, but no “treatment” will enable someone to do that. It requires a genuine connection with another person or set of ideas that help a person realize they deserve better, and sometimes some very practical help like an affordable attorney or a place to live they can afford or the ability to get away from a negative “treatment” being forced on them.
So no, that’s not at all what I’m saying. I’m saying that medical “treatment” for mental/emotional issues and difficulties is generally harmful, but it takes an individual approach to each person’s situation to find what is helpful, which may or may not look ANYTHING like “treatment” as you imagine it.
There doesn’t need to be an “alternative” if the current paradigm is wrong. Sometimes we don’t know the right thing to do, but we do know that what IS happening is wrong. Should we continue to systematically do something damaging because we don’t have an “alternative?”
So it sounds like a pattern of behavior for you, not a “diagnosis.” That being the case, how can people be accused of not “diagnosing BPD correctly?”
I’d really prefer we dump the label and simply rely on accurate descriptions of people who are dangerous for one reason or another. What a psychiatrist thinks, or frankly what anyone thinks their “diagnosis” is, is of little to no value.
Why do you assume that all or even most medical professionals follow “science?” If you have not read Anatomy of an Epidemic, you have missed the primary explanation for why this website exists, which is specifically because psychiatry has REFUSED over time to use or rationally respond to the “algorithm” known as science. You seem to believe that it does without evidence and attack anyone who disagrees with your assumption. Why not do some listening and exploration toward the very scientific double-blind studies and long-term reviews of the literature on which Mr. Whitaker’s concerns are rationally founded?
I agree 100% that putting down religious beliefs and practices is out of bounds, and I apologize for missing any posts which did so. Please report to me at my email if any other posts of that nature come through and I will re-moderate them for appropriateness.
It is interesting to note how experimenters get mice or whatever into the proper “mental” state to test their drugs. They seem to always STRESS the poor little creatures until they are anxious or depressed or whatever.
See the Rat Park experiment or Harlow’s Monkeys. Environment completely alters animal behavior, for the better or the worse. Clearly should apply to humans…
But there ARE wrong answers! Forcing people capable of reasoning to go against their own wishes IS wrong, whatever might be “right.” The choice of “justice” as a focus implies without question that stopping unjust or “wrong” actions is the main thrust of the effort!
All of these are probabalistic statements. There is no clear connection between a particular genetic pattern and all or even most “cases” of “ADHD”. None of these genetic indicators have ever been used to “diagnose” ADHD, mainly because many people with a particular mutation do NOT “have ADHD,” while many who are diagnosed with “ADHD” don’t have the mutation in question.
Perhaps this begs the larger question: Even if there are genetic associations with SOME cases of “ADHD” that are predictable, why have we decided that these variations in human behavior are a “disorder” or disease condition? Why is there no “Attention excess hypoactivity disorder?” Why is only HYPERactivity considered a problem?
I think we know the answer. “Hyperactive” children are more difficult for adults to manage, as they don’t (by definition) tend to go along with the program, so we decide that the child is the problem rather than examining our own models of education and other societal expectations. This despite reliable research that so-called “ADHD” children are virtually indistinguishable from “normal” children in open classroom settings, and that “treated” children do not in general have any better outcomes than those who are left to their own devices. This doesn’t even begin to touch the other big issue, namely that abused/neglected children tend to have a much higher rate of “ADHD” diagnoses than the general populace. If it’s all genetic, why is it so much more common in the foster care population?
I have no doubt that some kids are genetically “programmed” to be more active than others (though this does NOT come close to explaining “cause” for the range of kids so diagnosed). Maybe a range of such people is necessary for success as a species. After all, species survival depends on sufficient genetic diversity. Or as one wise foster kid put it, “Maybe it’s OK for different people to have different brain chemistries.”
OK, I think we have sufficiently fleshed out this argument. Everyone made their positions clear, and it’s not going to be productive to continue along these lines. Let’s move on!
I’m not sure the system is “broken” so much as that it doesn’t really have the same objectives as it claims to have. Keeping folks under control is a big part of the agenda, and “healing” is something they gave up on a long time ago, if they ever really had that as a goal at all. Someone who thinks electrocuting people into having a grand mal seizure is good “treatment” for anything is not really interested in helping you get better!
The duty to inform is very often disregarded, especially in the “mental health” fields.
When did I advise a person who is depressed to study holy scriptures? I’m afraid you have literally no idea what I’m talking about. I understand you are a “physicalist” as you put it, and I believe that blinds you to the ability to understand that the CAUSES of any “mental disorder” are actually unknown, no matter how many scans you want to do. You are ASSUMING the cause is in the brain, and therefor the consequence is diddling with the brain. The results of such reasoning have so far been fairly disastrous, if you believe the literature (including Anatomy of an Epidemic). A true “duty of disclosure” would mean admitting “we are treating an entity we don’t really understand.” I doubt very much anyone hears this from their doctor.
You are, of course, welcome to express your own philosophy, however, scientific proof of such ideas remains a long way off, if we go by the literature on success rates and damage rates and even diagnostic consistency and so on. (If these scans are so great, why aren’t they being used for “diagnosis?”) You’re not going to convince me by repeating your beliefs over and over again without bothering to try and understand where I am coming from. Probably not worth further discussion, as you seem quite certain of your ‘rightness’ and I doubt will hear me, and I am certainly not going to be convinced by your kind of arguments.
You again conflate function with structure here: “This doesn’t change the fact that a depression is not a mental state you can invoke within a blink of an eye but structural or functional deficits of your brain and such malfunctioning parts of your brain can be exposed by imaging methods.” The fact that SPECT images of “depressed” brains are similar in some respects does not imply structural differences, nor does it imply malfunction. I certainly never would suggest that depression can be overcome by thinking of different events, but that’s not what I said. Depression is a very complicated condition. The brain is clearly involved but to imagine people only get depressed because of “bad brains” is not consistent with observation, otherwise, why would it be so much more common in people with abuse histories?
And you are right, avoiding psychiatry seems like the smart path to me. I don’t think being a “physicalist” is necessarily a more rational position, though you seem to imply those who aren’t are being foolish. Being a “physicalist” is a belief system or philosophy. You are welcome to your own philosophy, of course, but that doesn’t make it any less a belief system than any other philosophy. I would prefer working with people who recognize my agency as a human being rather than seeing me as some sort of chemical machine.
It sounds like we generally agree on all that. My only objection is that I don’t believe that “mental illness” as currently understood (or misunderstood and labeled) generally requires “treatment” of the brain per se. A person who is suffering can have a perfectly sound and functioning brain. Spiritual/emotional pain is something that I believe extends well beyond the brain, and “treating the brain” to handle most of it is like replacing memory chips to fix a computer programming error. Until we get away from seeing the brain as the problem, and start looking at social conditions, we aren’t going to get far with even the best technology, because I think we’re barking up the wrong tree!
Brain ACTIVITY is not the same as brain STRUCTURE. A brain may be DOING certain things while depressed and those ACTIONS may be reflected in measurements of activity (PET and SPECT scans, for instance). However, a) these scans say ABSOLUTELY NOTHING about the reason the brain is behaving in a certain way, only that it is and b) it has been shown that changing what one is thinking can change the PET scan, hence, thinking of a depressing topic creates a certain pattern, while the same person thinking of something cheerful changes the pattern instantly to something else.
All that being said, there is NO CONSISTENT PATTERN that is associated with all cases of depression, or even most. Same with ADHD or other “disorders.” This is why these are never used in diagnosis, except by charlatans who take advantage of people’s vulnerability. They simply fail completely in being able to understand or predict the CAUSE of any psychiatric “condition,” and this will not change, as they measure ACTIVITY alone.
Of course, these “disorders” are defined by social expectations and judgments in the first place, not scientific criteria, so why anyone would expect any brain measurement to “diagnose” them is puzzling. Clearly, we have the cart before the horse here – we are supposed to find the proximal cause of a condition before assuming we can “diagnose” it concretely. For all we know, there could be 25 different reasons people become depressed, all of which result in similar brain scans. As long as that’s the case, the idea of diagnosing by scans will remain a pipe dream, IMHO.
Please try to keep the condescension out of any response, it is not appropriate.
You are assuming that all “depression” comes from some biological failure of the brain. There is, of course, absolutely no evidence to show that claim to have any validity.
I’m going to let one more post stand on this topic. Larry, if you have any validated links or literature to share that Mark can read, please help us out and do so. If not, it sounds like you’ve answered Mark’s questions and I’d like to leave off with one more post. The discussion is really quite far off the original topic.
Any therapist who thinks it his/her job to “keep the conversation going” is an idiot. Silence is really important in a good, supportive conversation. It allows important things to surface!
Does knowledge of the brain even have a primary place in this discussion? Are we really talking about “illnesses” if these “illnesses” are socially defined?
They seem to mean that they expect people to get better but they get worse instead. A paradox only if there is a rational expectation that the initial “treatment” should work. That seems to be a large part of the “trick” of selling psych drugs. Make an open claim that they “work” and then call failures “resistance” or “paradoxical” instead of just admitting they were wrong!
Walter, if you read carefully, you will see I am not generalizing, merely pointing out that the Deaf community IN MY EXPERIENCE is not monolithic in its views on “normalcy.” I am advocating for listening TO the Deaf community and its individual members to understand, rather than using “ableist assumptions” (including assuming that a member does or does not view him/herself as disabled) to characterize its members. Some do and some don’t view themselves as disabled. I’m not even disagreeing with the prior poster. This is true whether or not the prior poster identifies as part of the Deaf community.
How can the author state there have been “advances in treatment options” when it is clear that the “treatment options” are not resolving the problem? Wouldn’t an “advance” in treatment mean a DECREASE in the number of sufferers??? I think the authors miss the point. As Robert’s research demonstrates, the ADs tend to be COUNTERPRODUCTIVE, a form of ANTI-TREATMENT for many people. When the best estimates of “success” show rates of 30%, and even then with very small improvements that may not even be clinically significant, it’s hardly appropriate to call “treatment failures” a “paradox.” They are evidence that the treatment doesn’t work!
It’s not a “paradox” unless there is reason to expect the “treatments” to be effective. In this case, it’s simply evidence of either treatment failure, or a hidden agenda to create more customers!
Please email me at [email protected] and let me know the details. A delay of one day is normal, as there is only one of me and I don’t always get to this more than once a day. If I said something was duplication, it means you made another comment saying something the same or very similar. If that’s not the case, I can fix it, but I need to know the thread, preferably the date, and the first sentence or so, so I can make sure I identify the correct comments.
Unfortunately for your theory, it appears that these drugs “sculpt” the brain in most unfortunate ways that are not always repairable. We also know from experiment that activities we engage in, such as meditation, do literally alter the structure of the brain, possibly in just the ways needed. Buddhist monks, for instance, have been shown to have certain parts of the brain associated with calmness and focus are more active than the average person.
Neuroplasticity has been shown throughout the brain, namely that brains are altered by experience, both in the negative AND in the positive. And as I recall, the most healing thing for a child damaged by abuse/neglect is not a drug, but a healthy relationship with caring adults. It literally heals the brain.
So the idea that those damaged in their brain region by abuse/neglect are not capable of healing and need drugs to survive is not supported by science. Whitaker’s work demonstrates that in the long run, psych drug use does more damage than good. Have you read Anatomy of an Epidemic?
I have worked with foster kids, and many of them are remarkably calm in a crisis. I think it’s something you learn if you live in a chaotic environment as a survival technique. But of course, not everyone has that skill. It amazes me how clinical people with experience still believe you can predict someone’s behavior reliably based solely on their “diagnosis.” There are LOTS of differing reaction to stressful events, and no one should get to tell another person, “Your event isn’t stressful enough to be called a trauma.” The client is the one who knows what is bothering him/her and ultimately holds any solutions to problems that exist.
BTW, I was also a social worker, very calm in a crisis, but I sort of thrive when crisis comes compared to regular life. Used to manage a crisis line – go figure!
After reading over the article in full, my sense is that the author puts a lot of time into “differential diagnosis” despite recognizing that it is objectively not possible with the subjective DSM criteria. For me, the key to success is adapting therapy to the person in front of me, and “diagnosis” per se had very little to do with that. If someone works well with a CBT (change your thinking to change your emotions and behavior) kind of approach, I’d use that approach, whether they had a “PTSD” or “BPD” or “ADHD” or no diagnosis at all. If it didn’t work, I’d use something else. I certainly wouldn’t waste my time convincing my client we needed a new “diagnosis.” I’d simply say, “Let’s try something different. Sometimes practicing skills can be more effective than going over past events. Are you OK giving that a try?” Or, God help us, I might ask the client what they’ve found to be helpful or not. After all, they are the ones who are defining “helpful” for us! If we think we’re helping and they don’t, we’re not.
So maybe the cultural references have some validity, though I see little to no scientific data to indicate that one way or the other, just anecdotes, really. But when it comes to providing therapy to a specific client, I think we do well not to call their recollections into question (particularly by asking their parents right in front of them!) but instead to apply the widest range of skills based on what actually works for the client, regardless of their ‘diagnosis.’ After all, even if CBT worked on 90% of depressed clients, there are still 10% who will fail unless you do something different. Forget “differential diagnosis” and do what works.
Milton Erickson reportedly said we have to re-invent therapy for every client. I think he got it right!
I can’t imagine a more incompetent attempt to verify developmental trauma than asking the parents! They OF COURSE will almost always deny or minimize any harm done, and are happy to blame the child if they HAVE done some damage, as it lets them off the hook. Moreover, parents can be perfectly well intended and still do a lot of harm, of which they will not be consciously aware. They are the last people in the world to ask, “Was your child traumatized in your care?” Very often, the parents have contributed or facilitated the trauma themselves.
Beyond this, “Borderline Personality” diagnosis is HIGHLY associated with developmental trauma. I don’t think I ever encountered a person diagnosed with “BPD”(which I consider to be a diagnosis of little use except as a means of distancing oneself as a clinician from his/her client) who did NOT experience significant trauma as a child, especially when intermittent EMOTIONAL abuse is included. To diagnose BPD as an EXCLUSION for people whose parents deny they were traumatized is truly a bizarre choice, even within the confines of accepted psychiatric “differential diagnosis.”
Very odd thinking behind this kind of analysis, IMHO.
I agree 100%. Techniques are secondary, handy “tricks” that can help smooth the path sometimes. But what is really healing is having someone care enough to be open to hearing and listening deeply to what is happening for another person. It requires courage, empathy, and an ability to hold others’ pain without reaction or withdrawing or advising. These things can be learned but not “trained” in the sense of classroom instruction. And a person can spend decades “studying” human psychology and yet be completely clueless as a therapist.
I used to work managing a volunteer crisis line. Some of my best counselors were computer programmers. Some of the worst had doctorates in psychology. I can find literally no correlation between “training” and competence as a therapist.
I recall reading a study of kids in a residential program. Over 80% reported overt trauma. Less than 20% had it noted in their charts. So either the clinicians didn’t bother asking about trauma, or they didn’t consider it important enough to write down! This in a residential program for teens with behavior problems. How they can be sooo off base is beyond my comprehension.
It’s hard for me to imagine how they can see case after case, like yours, where the person remains “ill” despite or even because of their “treatments,” never really gets “better” or actually gets worse, and yet somehow continue to believe their approach works! It is somehow always the patient/client’s fault when THEIR “treatment” fails, always their own doing if they get better somehow despite their “treatment.” How can they believe this themselves, let alone perpetrate it on their victims aka “patients?”
As I suspected, your references are only talking about probabilities and associations. There is no inkling of a biological CAUSE that would apply to all situations. Valuable information, to be sure, but nothing to do with validating “depression” as a legitimate diagnosis with a unitary cause. So for sure, Vitamin D and folate should be considered viable interventions for people experiencing mood problems, but this certainly allows for a HUGE range of possible causes, and also doesn’t eliminate the possibility of low folate or low Vitamin D cases NOT being depressed or suicidal, which would also kill off any fantasies about a causal role for any one biological condition in depression or suicidality.
I have no specific objection to therapy at a distance. I used to be very successful with phone counseling at a crisis line many years back. There are some advantages to NOT being able to see one’s client – visual biases are virtually eliminated, for instance – I have no idea if I’m counseling a fat person or a black person or an old or young person.
The real question is, of course, effectiveness. I’m betting that has a lot more to do with WHO is the counselor and HOW they relate to their clients than it does with WHERE the counselor or client are during the process. In-person therapy certainly hasn’t got a fantastic record to beat!
I’m not sure we can talk about “misdiagnosis” when there is no actual way to determine objectively who does or doesn’t have a given “diagnosis.” How would anyone know they were “misdiagnosed?” More proper to say you were misunderstood and mistreated!
What exactly does that mean – a “neurometabolic condition?” Sounds like something he CONCLUDED rather than proved scientifically. I’d be willing to bet that he is talking about averages rather than finding a cause of all or most “depression.” He no doubt found that changes in neurons and metabolism are involved when people are depressed, and that certain changes are more common. Not a big revelation. But I’m willing to be enlightened. What does he imagine CAUSES most or all cases of depression, regardless of experience? What do all or most “depressed” people have in common that almost no one not “depressed” experiences? I am interested in this research. Let me know what you’ve got.
Labels certainly meet a lot of societal needs, especially related to avoidance of discomfort. Of course, those who are “loyal” to parents despite abuse are presenting a competent therapist with the very thing they need to start working on, rather than promoting avoiding it by blaming one’s brain. Additionally, while the CLIENT may initially “feel better” because they’ve been blaming themselves, the studies I referred to show that OTHERS actually are more likely to stigmatize the client, including their own therapists and “mental health professionals.” Finally, it’s not the job of a diagnosis to make the person feel better, it’s to get them on the road to healing. What if we didn’t tell people they have cancer or heart disease because it made them uncomfortable? This is what happens when “diagnoses” are tossed about without regard to scientific validity. No one should be told they have a “brain dysfunction” unless the doctor KNOWS they have one, regardless of how it “feels” to get diagnosed. It is this kind of shady “reasoning” that proves psychiatry to be based on a fraudulent premise. For REAL diseases, no one gets to pick out the diagnosis that makes them feel best!
Perhaps surprisingly, research has shown that people judge others MORE HARSHLY when their problems are attributed to “brain chemistry.” Talking about trauma and life difficulties creates empathy. If someone’s brain is blamed, it appears it’s easier for others to distance themselves, to say, “Oh, he’s ‘mentally ill,’ he’s got a brain problem, he’s not like me!”
“Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.”
I guess my sense is that anyone who was genuinely focused on making their clients’ lives better would notice if their interventions made them worse. Sure they WANT their clients to “get better,” but most seem to not deeply believe that is possible, and view “better” as meaning “less” x or y or z. Reducing one’s depressed feelings is not the same to me as improving quality or life, and even less the same as actually improving their sense of control of their lives. And if evidence came in that my approach didn’t work or was based on false premises, I would chance my approach rather than blaming my clients or insisting I was right regardless of the evidence.
But incompetent or ill-intended, it doesn’t much matter to the clients. There needs to be a real intent to find the best path. Some exceptional practitioners do have that, and get results. But I find them very much in the minority, especially in the psychiatric industry. The proof is in the pudding. And some really crappy pudding is being handed out!
Wow, that person hasn’t got a clue if he thinks his job in therapy is to come up with things to talk about! Shocking that any insurance company would pay good money for such crappy treatment!
Excellent summary about what therapists do to protect themselves at their clients’ expense. C) is particularly damaging – to state or imply that you should NOT feel depressed/anxious/etc. and that YOU are the one with the problem for feeling that way. And I agree, therapists being uncomfortable with their clients’ feelings and experiences provide the OPPOSITE of therapy, and are very hurtful!
So you are not engaged in the practice of medical science, you’re involved in the practice of perpetuating your and your colleagues’ psychiatric belief system. That’s my point. Psychiatry depends heavily on the belief systems of the mental health professionals involved, and what kind of treatment one receives is very dependent on their “philosophy.”
Of course, most people have no clue that is what is going on. They don’t think psychiatry (or alternative medicine or whatever) is something you BELIEVE IN, they think it’s some kind of scientific study that can specifically identify what is “wrong” with their brains and fix it with drugs. This despite recent reviews showing that serotonin deficits are not associated with depression, nor is excess dopamine a causal agent in “schizophrenia.” You should also keep in mind that some “clients” of psychiatry have no choice about it, whether they believe in it or not.
To compare Whitaker’s well-researched reporting to Samuel Butler or Shostakovich is an extremely weak analogy to say the least. But you don’t appear to be interested in expanding your viewpoint based on such research, so there is probably no point.
However, that still does not excuse blaming your patients for responding in predictable ways to the propaganda they’ve been exposed to. They are patients. If you don’t want to treat them, I’d say you need to get yourself a new profession. I don’t believe “psychiatrists are brainwashed,” and of course, I never said any such thing, so such strawman arguments are merely distractions. I’m not hostile toward psychiatrists, I simply don’t respect professionals who blame their clients for annoying them. They’re clients. They’re not there to make you feel good or to validate your belief systems. They are looking for help. If they don’t find your “help” helpful, it’s not their fault. You’re the professional and it’s your job to care for them. Why would you take on clients if they annoy you so much? I’ve worked with plenty of psychiatrists whom I respect, even when we disagreed about how to approach most of our clientele. I only ask for basic respect for and compassion for the client. That is what seems absent in your case. And that’s an observation, not an attack.
Why not do what one psychiatrist I respected greatly did: Say, “I know you are hearing voices that you are not happy about. I have a drug that can help you not hear them as much. They don’t work for everyone, and they can have really intense side effects, but many of my clients find it’s well worth the exchange. If the first effort doesn’t work for you, we have several options available to try. Does this sound like something you would like to try?” Or words to that effect. Of course, he did get some interesting responses. One Native American guy said, “You white folk are all the same. You hear voices, you try to make them go away. We hear voices, we go someplace quiet and listen and see if they have anything interesting to say!”
I’m sure you’d have found that client quite annoying. I find him amusingly insightful.
Do you want us to feel sorry for you that you have to deal with actual patients? You do understand that these “diagnoses” are all “clinical opinions,” that there is no way to say for sure that someone “has schizophrenia” in the same sense that they “Have a broken leg?” Is it any surprise given the sketchy marketing techniques out there (selling “disorders” rather than treatments) that people self-diagnose in massive numbers? How do you let the pharmaceutical industry and the psychiatric industry itself off the hook for convincing people they “have” diagnoses that don’t have any concrete or objective definitions?
Have you ever read “Anatomy of an Epidemic?” I very much doubt you have. If you did, you’d have a much better understanding why people behave the way they do regarding “diagnoses.” I will simply end by saying its hard to respect someone who bears such hostility and disrespect for his own clients. You are laying in a bed that your profession has made for you, and blaming the patient is not a mature reaction, IMHO. The phenomenon is the natural outgrowth of the basic (IMHO faulty) assumptions of your system combined with an essential disrespect for the experiences of your clients, which your comments very much demonstrate to me.
How and why would psychiatrists do any of the recommended things in the essay? There is no financial or professional incentives to do any of them, and in fact involves massive incentives to maintain the status quo, which meets most of the needs of most of the psychiatric workers with no change whatsoever. Those who DO challenge the status quo are generally attacked and humiliated and threatened with loss of status or income or both if they continue their sacrilegious ways.
Psychiatry will continue to oppose any sane efforts at reform. I don’t believe it is reformable, as it is at its core based on faulty assumptions that are self-serving and self-perpetuating, and no one will be able to change its basic purpose, which is NOT to help its clients have better lives!
Remember that these “diagnoses” are almost entirely invented and mean next to nothing. They are mostly just descriptions of annoying behavior and difficult emotion that tend to occur together. Saying he “has bipolar disorder” is not a scientific fact – it’s just someone’s “clinical impression,” AKA someone’s opinion based on their own biases and social values. There is no science to it whatsoever. So don’t let them convince you they know what they are talking about. Do what makes sense and what seems to work, even if they don’t agree with you. Your husband and you know far better what is going on than any psychiatrist!
Stimulants can also induce OCD behavior. It often leads to other diagnoses when folks have adverse reactions to stimulants. Especially Bipolar Disorder. It can be dead obvious what happened, but try to get them to quit giving the kid Ritalin and they freak out. Once had a kid I advocated for who had an eating disorder diagnosis. They gave her stimulants, and lo and behold, her appetite was reduced! They of course attributed it to a “relapse” in her “eating disorder” rather than realizing that stimulants were a bad idea for someone with that condition!
Actually, Irving Kirsch’s work fully supports Peter’s statements. There is more, and I do agree he would do well to include such proof.
But that doesn’t change what I said. The manufacturers can’t claim that ADs reduce suicide rates unless they have evidence that they do. No one has to “disprove” an unsupported claim. The “null hypothesis” is assumed to be true unless proven otherwise!
Just for the record, it is the job of those claiming an effect to prove it. No one has to “disprove” that ADs decrease suicide. If that claim is not supported by evidence, it is considered FALSE regardless of counter-evidence. In other words, I don’t have to prove that something doesn’t happen just because someone claims it does. The burden of proof is on the person claiming it works.
Yes, but we also have to consider that the response of the clients is the only valid measure of success. But remember, it is the quality of the relationship with the therapist/counselor which appears to be the most important variable. How can we measure that, other than by how they are perceived by the client?
While DBT has some useful skills that can be learned by anyone who wants to use them, to suggest it is a “treatment for BPD” is problematic, as there is absolutely no objective way to say who “has BPD” or “doesn’t have BPD.” As such, all we can really say is that some people find it useful and some do not, just like any other set of “therapy skills.” Until it is possible to actually define these “disorders” objectively, there is no way that “clinical research” can prove anything relating to a “disorder” that is defined by social biases rather than scientific measures.
I can’t really agree with you here. It seems to me that providing therapy is more of an art, though it should be informed by science. There is no way to train someone reliably to be a “good therapist,” and I have seen many competent counselors who have little to no formal training. There is an element of having “Done one’s own work” to be emotionally available to a client which is simply not a factor of hours of training or scientific findings. The proof is in the pudding, and many therapists with advanced degrees are mediocre to poor therapists, and many of the best therapists have come to it via alternative routes (I had an undergrad in Chemistry and a MS in Education, as an example). It is not such a black and white “scientific” question!
Thank you for taking such time giving me feedback and sharing your perception of my comments. All I can say is that you’ve given me a lot to think about. Or FEEL about?
You may be taking my comments re: euthanasia a bit too far, though. I was really just trying to get an agreed-upon definition. Whether it SEEMS like suicide or not must certainly be an individual decision!
You may be missing the point here. If there IS science to be debated, it ought to be respected. Using name calling (like “climate change deniers”) does not mean that’s true, but is a great way to distract from the fact they are avoiding talking about the real issues. The fact that antidepressants do NOT decrease suicide attempts or thinking is very well established by mainstream scientific studies. There is no evidence that any drug decreases suicide attempts except for a very thin support for Lithium which has been called into doubt. If the reviewers can’t provide any science demonstrating a reduction in suicidal thinking or attempts, it is they who have more in common with “climate change deniers.”
Yup! You can always get some tramadol paid for, but a massage comes out of your own pocket! How much in Tramadol sales could be saved by prescribing a lot more massages?
I found the idea of intentionally inducing anxiety, depression, etc. to be somewhat disturbing. Is there no sense of possible long-term damage from this process? Doesn’t life already teach us that difficult situations bring on difficult feelings? Why does that need to be “proven” by potentially harming people?
That being said, I agree completely that normalizing anxiety, depression, even delusions and hallucinations is the best path forward, along with some REAL medical care for real, objectively observable conditions (like drug adverse effects). There is no benefit to lying to people to stop them from blaming themselves. In fact, normalizing blaming yourself may be the very first step to moving beyond it!
This is a HUGE problem, for psychologists/therapists as well as psychiatrists and psych nurses. They may often feel uncomfortable and want their own discomfort to go away, so they project it onto the client and either try to drug the feelings into submission or talk the person out of it, sometimes resulting in involuntary holds (aka incarceration) in hospital wards. I can’t tell you how many times I saw foster kids or others sent to the hospital for cutting on themselves (not suicidal) or for talking about suicide. One person said she called the suicide hotline because it was not safe to talk to her therapist when she felt like cutting, because she would always send her to the hospital. The are many smaller cases where the therapist wants the client to do something in order to reduce their own discomfort.
One of my basic principles of “therapy” such as I did was that when I felt uncomfortable, I assumed the client was probably getting to something really important, and the most important thing for me was to sit with that discomfort as they had to and see what was behind it. It requires a lot of courage and willingness to experience the pain of others to be of any use to another person in distress. You have to have “done your own work,” and the vast majority of “mental health professionals” have not done that, and are therefore useless or dangerous to their own clients, IMHO. It really isn’t something you can train for – it’s an attitude one has to adopt, and most don’t even realize they need to let alone have the capability of sitting with another’s pain.
There are also plenty of untrained “amateurs” who DO have that skill, as I found out running a volunteer crisis line shift. You are often better off with a well-supervised computer programmer than a trained “mental health professional!”
Ah, but they rarely do fund this sort of study! The heavily moneyed biopsych advocates have a lot of sayso about what is studied, and protest when their pet drugs and companies get short shrift. Besides which, most studies theses days are funded by drug companies, not government entities. There’s little chance non-drug interventions will ever establish a sufficient “evidence base” to match those the drug companies can muster up!
And of course the “evidence base” depends on what gets researched, and drug company money determines what gets researched. So there is never an “evidence base” for anything but drugs!!
I read Pies and Ruffalo’s response. It is as nonsensical as I expected. They compare “schizophrenia” causing hallucinations to a volcano destroying Pompeii. Well hey, guys, a volcano is obviously THERE and concrete and erupts lava that can level a town. How is that in any way like “schizophrenia,” which cannot be seen, felt, or otherwise observed except by its purported effects? The analogy would be more like Pompeii was destroyed by a “City destroyer.” The proof is that the city was destroyed.
That trained academics engage in such childish arguments to defend an indefensible concept is beyond my comprehension!
Here is the Mirriam-Webster dictionary definition of “euthanasia:”
“the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy”
I’d say that whether it constitutes murder or not depends on the desires of the subject and the intentions of the one helping them die. To put it another way, is the person truly helping the subject accomplish his/her goals or simply helping themselves at the subject’s expense. In the latter case, I’d call it murder.
There is, of course, no possible way to objectively establish “the truth” in “mental health” diagnoses, as there is no way to determine ANY diagnosis beyond simply describing it. If there is ever even ONE test to determine ANY “mental health” diagnosis, I will be shocked.
“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 nothi
The Rat Park experiment shows the truth of what you are saying!
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Their answer will be “more funding for mental health services,” even though it sounds like she was receiving such services for years!
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That makes a lot of sense.
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I think Robin Williams did an ad for that stuff!
https://www.youtube.com/watch?v=XBb5v1sJhuU
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Good point. I also note that most apologists for the System will say, “The reason this person committed suicide is because mental health services are underfunded and unavailable.” But most of the time, they’ve had years of “services” before the event. So how is a lack of services the problem? It sounds like the services FAILED TO HELP!
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Then there are those who go into the field just so they can have power over others. I diagnose them with “BAD” – Basic A**hole Disorder!
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What an awful story!!! Sounds like they were trying to kill you!
You are correct IMHO – Humility is the basic building block of being a helpful person. Without it, practitioners (medical, too) are lost.
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Neither necessary nor sufficient!
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Excellent point!
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I think you are missing the point. The first mistake is seeing individual humans as “patients” who need “treatment” simply because they are experiencing intense emotions. You seem to be having difficulty accepting that framing of the issue is 90% of the problem. “Medical treatment” is not the answer we are looking for.
As for time and patience, again, we don’t choose our cancer or heart treatments based on whether people find them difficult to implement. We choose them based on whether they work. Taking drugs is easy and quick but it doesn’t work in most cases. In fact, it generally makes things worse and prevents people from choosing the more effective path for them, even if it is harder. I could give you an example or two if it would help you.
We are all responsible for finding our own pathway. All we can do to “help” is to help the person decide. Encouraging them to do the wrong thing because it is easier is foolish in the extreme!
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It makes no sense to simply “reframe mental health treatment” in terms the Zulu can accept. We are barking up the wrong tree. We need to shut up and ask THEM what they think would be helpful, and change our model accordingly. But of course, that would mean scrapping our top-down, we-know-best, do-as-we-say approach, which would mean scrapping “mental health treatment” as we know it and starting over.
Don’t hold your breath!
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I am SOOOO sorry! What a sad story. I only wish it were the only time I’ve heard that. We’re here to listen if you want to share!
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I agree 100%!
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No, I have plenty of ideas of what is helpful in many situations. However, those situations are NOT defined by “diagnoses” nor subjectable to any kind of “double blind studies” as if humans are some kind of machines who all will respond to a certain approach if they have certain “conditions.” Generally, what is helpful is someone who will take the time to listen and be comfortable with another person as that PERSON figures out what if anything is “wrong” and what needs to change for him/herself. The biggest problem (of many) with the current system is that it attempts to take something like “depression,” a common experience to all humans, and come up with some kind of “cure” that works in all cases, as if feeling depressed (sometimes deeply and sometimes for long periods of time) were not a normal part of the human experience, or that all people experiencing “depression” have something mechanically wrong with their brains or minds that needs to be “fixed” by a doctor.
I’ve found many ways to be helpful to hundreds of people over the years. But every one of them is unique and required me to go into the situation completely open to hearing whatever is being communicated and working to respond appropriately to that particular person. Trying to treat everyone the same and expecting the same result is never going to work. Milton Erickson said that “Therapy has to be re-invented for every client.” I think he was pretty much correct.
I will add that there are plenty of things that are helpful to some but not all which fall outside the realm of “therapy” per se. Buddhism or other spiritual practices are a good example. Also such simple things as walking in the woods, breathing properly, getting good exercise, simply talking to another caring layperson (shown to be generally as effective as “therapy”), and most crucially, having a sense of purpose or intent for one’s life can make all the difference. In addition, altering one’s environment to avoid abusive people or situations is sometimes essential, but no “treatment” will enable someone to do that. It requires a genuine connection with another person or set of ideas that help a person realize they deserve better, and sometimes some very practical help like an affordable attorney or a place to live they can afford or the ability to get away from a negative “treatment” being forced on them.
So no, that’s not at all what I’m saying. I’m saying that medical “treatment” for mental/emotional issues and difficulties is generally harmful, but it takes an individual approach to each person’s situation to find what is helpful, which may or may not look ANYTHING like “treatment” as you imagine it.
Does that clarify my position?
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There doesn’t need to be an “alternative” if the current paradigm is wrong. Sometimes we don’t know the right thing to do, but we do know that what IS happening is wrong. Should we continue to systematically do something damaging because we don’t have an “alternative?”
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“Behavioral health” always seemed like a bizarre term to me. Behavior doesn’t have health. Beings have health, not actions!
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So it sounds like a pattern of behavior for you, not a “diagnosis.” That being the case, how can people be accused of not “diagnosing BPD correctly?”
I’d really prefer we dump the label and simply rely on accurate descriptions of people who are dangerous for one reason or another. What a psychiatrist thinks, or frankly what anyone thinks their “diagnosis” is, is of little to no value.
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Why do you assume that all or even most medical professionals follow “science?” If you have not read Anatomy of an Epidemic, you have missed the primary explanation for why this website exists, which is specifically because psychiatry has REFUSED over time to use or rationally respond to the “algorithm” known as science. You seem to believe that it does without evidence and attack anyone who disagrees with your assumption. Why not do some listening and exploration toward the very scientific double-blind studies and long-term reviews of the literature on which Mr. Whitaker’s concerns are rationally founded?
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I agree 100% that putting down religious beliefs and practices is out of bounds, and I apologize for missing any posts which did so. Please report to me at my email if any other posts of that nature come through and I will re-moderate them for appropriateness.
[email protected].
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It is interesting to note how experimenters get mice or whatever into the proper “mental” state to test their drugs. They seem to always STRESS the poor little creatures until they are anxious or depressed or whatever.
See the Rat Park experiment or Harlow’s Monkeys. Environment completely alters animal behavior, for the better or the worse. Clearly should apply to humans…
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But there ARE wrong answers! Forcing people capable of reasoning to go against their own wishes IS wrong, whatever might be “right.” The choice of “justice” as a focus implies without question that stopping unjust or “wrong” actions is the main thrust of the effort!
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Dang, how can a guy make money selling cures when people keep getting better on their own?
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“High rate,” “associated,” “potentially,” “often linked,” “may impact…”
All of these are probabalistic statements. There is no clear connection between a particular genetic pattern and all or even most “cases” of “ADHD”. None of these genetic indicators have ever been used to “diagnose” ADHD, mainly because many people with a particular mutation do NOT “have ADHD,” while many who are diagnosed with “ADHD” don’t have the mutation in question.
Perhaps this begs the larger question: Even if there are genetic associations with SOME cases of “ADHD” that are predictable, why have we decided that these variations in human behavior are a “disorder” or disease condition? Why is there no “Attention excess hypoactivity disorder?” Why is only HYPERactivity considered a problem?
I think we know the answer. “Hyperactive” children are more difficult for adults to manage, as they don’t (by definition) tend to go along with the program, so we decide that the child is the problem rather than examining our own models of education and other societal expectations. This despite reliable research that so-called “ADHD” children are virtually indistinguishable from “normal” children in open classroom settings, and that “treated” children do not in general have any better outcomes than those who are left to their own devices. This doesn’t even begin to touch the other big issue, namely that abused/neglected children tend to have a much higher rate of “ADHD” diagnoses than the general populace. If it’s all genetic, why is it so much more common in the foster care population?
I have no doubt that some kids are genetically “programmed” to be more active than others (though this does NOT come close to explaining “cause” for the range of kids so diagnosed). Maybe a range of such people is necessary for success as a species. After all, species survival depends on sufficient genetic diversity. Or as one wise foster kid put it, “Maybe it’s OK for different people to have different brain chemistries.”
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OK, I think we have sufficiently fleshed out this argument. Everyone made their positions clear, and it’s not going to be productive to continue along these lines. Let’s move on!
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I’m not sure the system is “broken” so much as that it doesn’t really have the same objectives as it claims to have. Keeping folks under control is a big part of the agenda, and “healing” is something they gave up on a long time ago, if they ever really had that as a goal at all. Someone who thinks electrocuting people into having a grand mal seizure is good “treatment” for anything is not really interested in helping you get better!
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🙂
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I guess I was correct.
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The duty to inform is very often disregarded, especially in the “mental health” fields.
When did I advise a person who is depressed to study holy scriptures? I’m afraid you have literally no idea what I’m talking about. I understand you are a “physicalist” as you put it, and I believe that blinds you to the ability to understand that the CAUSES of any “mental disorder” are actually unknown, no matter how many scans you want to do. You are ASSUMING the cause is in the brain, and therefor the consequence is diddling with the brain. The results of such reasoning have so far been fairly disastrous, if you believe the literature (including Anatomy of an Epidemic). A true “duty of disclosure” would mean admitting “we are treating an entity we don’t really understand.” I doubt very much anyone hears this from their doctor.
You are, of course, welcome to express your own philosophy, however, scientific proof of such ideas remains a long way off, if we go by the literature on success rates and damage rates and even diagnostic consistency and so on. (If these scans are so great, why aren’t they being used for “diagnosis?”) You’re not going to convince me by repeating your beliefs over and over again without bothering to try and understand where I am coming from. Probably not worth further discussion, as you seem quite certain of your ‘rightness’ and I doubt will hear me, and I am certainly not going to be convinced by your kind of arguments.
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You again conflate function with structure here: “This doesn’t change the fact that a depression is not a mental state you can invoke within a blink of an eye but structural or functional deficits of your brain and such malfunctioning parts of your brain can be exposed by imaging methods.” The fact that SPECT images of “depressed” brains are similar in some respects does not imply structural differences, nor does it imply malfunction. I certainly never would suggest that depression can be overcome by thinking of different events, but that’s not what I said. Depression is a very complicated condition. The brain is clearly involved but to imagine people only get depressed because of “bad brains” is not consistent with observation, otherwise, why would it be so much more common in people with abuse histories?
And you are right, avoiding psychiatry seems like the smart path to me. I don’t think being a “physicalist” is necessarily a more rational position, though you seem to imply those who aren’t are being foolish. Being a “physicalist” is a belief system or philosophy. You are welcome to your own philosophy, of course, but that doesn’t make it any less a belief system than any other philosophy. I would prefer working with people who recognize my agency as a human being rather than seeing me as some sort of chemical machine.
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It sounds like we generally agree on all that. My only objection is that I don’t believe that “mental illness” as currently understood (or misunderstood and labeled) generally requires “treatment” of the brain per se. A person who is suffering can have a perfectly sound and functioning brain. Spiritual/emotional pain is something that I believe extends well beyond the brain, and “treating the brain” to handle most of it is like replacing memory chips to fix a computer programming error. Until we get away from seeing the brain as the problem, and start looking at social conditions, we aren’t going to get far with even the best technology, because I think we’re barking up the wrong tree!
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Brain ACTIVITY is not the same as brain STRUCTURE. A brain may be DOING certain things while depressed and those ACTIONS may be reflected in measurements of activity (PET and SPECT scans, for instance). However, a) these scans say ABSOLUTELY NOTHING about the reason the brain is behaving in a certain way, only that it is and b) it has been shown that changing what one is thinking can change the PET scan, hence, thinking of a depressing topic creates a certain pattern, while the same person thinking of something cheerful changes the pattern instantly to something else.
All that being said, there is NO CONSISTENT PATTERN that is associated with all cases of depression, or even most. Same with ADHD or other “disorders.” This is why these are never used in diagnosis, except by charlatans who take advantage of people’s vulnerability. They simply fail completely in being able to understand or predict the CAUSE of any psychiatric “condition,” and this will not change, as they measure ACTIVITY alone.
Of course, these “disorders” are defined by social expectations and judgments in the first place, not scientific criteria, so why anyone would expect any brain measurement to “diagnose” them is puzzling. Clearly, we have the cart before the horse here – we are supposed to find the proximal cause of a condition before assuming we can “diagnose” it concretely. For all we know, there could be 25 different reasons people become depressed, all of which result in similar brain scans. As long as that’s the case, the idea of diagnosing by scans will remain a pipe dream, IMHO.
Please try to keep the condescension out of any response, it is not appropriate.
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You are assuming that all “depression” comes from some biological failure of the brain. There is, of course, absolutely no evidence to show that claim to have any validity.
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I’m going to let one more post stand on this topic. Larry, if you have any validated links or literature to share that Mark can read, please help us out and do so. If not, it sounds like you’ve answered Mark’s questions and I’d like to leave off with one more post. The discussion is really quite far off the original topic.
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Any therapist who thinks it his/her job to “keep the conversation going” is an idiot. Silence is really important in a good, supportive conversation. It allows important things to surface!
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Does knowledge of the brain even have a primary place in this discussion? Are we really talking about “illnesses” if these “illnesses” are socially defined?
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They seem to mean that they expect people to get better but they get worse instead. A paradox only if there is a rational expectation that the initial “treatment” should work. That seems to be a large part of the “trick” of selling psych drugs. Make an open claim that they “work” and then call failures “resistance” or “paradoxical” instead of just admitting they were wrong!
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Walter, if you read carefully, you will see I am not generalizing, merely pointing out that the Deaf community IN MY EXPERIENCE is not monolithic in its views on “normalcy.” I am advocating for listening TO the Deaf community and its individual members to understand, rather than using “ableist assumptions” (including assuming that a member does or does not view him/herself as disabled) to characterize its members. Some do and some don’t view themselves as disabled. I’m not even disagreeing with the prior poster. This is true whether or not the prior poster identifies as part of the Deaf community.
Not sure what your point is.
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Agreed!
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How can the author state there have been “advances in treatment options” when it is clear that the “treatment options” are not resolving the problem? Wouldn’t an “advance” in treatment mean a DECREASE in the number of sufferers??? I think the authors miss the point. As Robert’s research demonstrates, the ADs tend to be COUNTERPRODUCTIVE, a form of ANTI-TREATMENT for many people. When the best estimates of “success” show rates of 30%, and even then with very small improvements that may not even be clinically significant, it’s hardly appropriate to call “treatment failures” a “paradox.” They are evidence that the treatment doesn’t work!
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It’s not a “paradox” unless there is reason to expect the “treatments” to be effective. In this case, it’s simply evidence of either treatment failure, or a hidden agenda to create more customers!
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That was intended to be a humorous remark! But the engineering team (if there was one) still missed the boat on that one.
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Any deity who came up with the human childbirth process can hardly be accused of “intelligent” design!!!
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I actually just found this comment, I think. I published an identical comment one minute later.
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Please email me at [email protected] and let me know the details. A delay of one day is normal, as there is only one of me and I don’t always get to this more than once a day. If I said something was duplication, it means you made another comment saying something the same or very similar. If that’s not the case, I can fix it, but I need to know the thread, preferably the date, and the first sentence or so, so I can make sure I identify the correct comments.
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Completely agree.
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Unfortunately for your theory, it appears that these drugs “sculpt” the brain in most unfortunate ways that are not always repairable. We also know from experiment that activities we engage in, such as meditation, do literally alter the structure of the brain, possibly in just the ways needed. Buddhist monks, for instance, have been shown to have certain parts of the brain associated with calmness and focus are more active than the average person.
https://www.reddit.com/r/Buddhism/comments/11105s/scans_of_monks_brains_show_meditation_alters/
Neuroplasticity has been shown throughout the brain, namely that brains are altered by experience, both in the negative AND in the positive. And as I recall, the most healing thing for a child damaged by abuse/neglect is not a drug, but a healthy relationship with caring adults. It literally heals the brain.
So the idea that those damaged in their brain region by abuse/neglect are not capable of healing and need drugs to survive is not supported by science. Whitaker’s work demonstrates that in the long run, psych drug use does more damage than good. Have you read Anatomy of an Epidemic?
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I have worked with foster kids, and many of them are remarkably calm in a crisis. I think it’s something you learn if you live in a chaotic environment as a survival technique. But of course, not everyone has that skill. It amazes me how clinical people with experience still believe you can predict someone’s behavior reliably based solely on their “diagnosis.” There are LOTS of differing reaction to stressful events, and no one should get to tell another person, “Your event isn’t stressful enough to be called a trauma.” The client is the one who knows what is bothering him/her and ultimately holds any solutions to problems that exist.
BTW, I was also a social worker, very calm in a crisis, but I sort of thrive when crisis comes compared to regular life. Used to manage a crisis line – go figure!
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After reading over the article in full, my sense is that the author puts a lot of time into “differential diagnosis” despite recognizing that it is objectively not possible with the subjective DSM criteria. For me, the key to success is adapting therapy to the person in front of me, and “diagnosis” per se had very little to do with that. If someone works well with a CBT (change your thinking to change your emotions and behavior) kind of approach, I’d use that approach, whether they had a “PTSD” or “BPD” or “ADHD” or no diagnosis at all. If it didn’t work, I’d use something else. I certainly wouldn’t waste my time convincing my client we needed a new “diagnosis.” I’d simply say, “Let’s try something different. Sometimes practicing skills can be more effective than going over past events. Are you OK giving that a try?” Or, God help us, I might ask the client what they’ve found to be helpful or not. After all, they are the ones who are defining “helpful” for us! If we think we’re helping and they don’t, we’re not.
So maybe the cultural references have some validity, though I see little to no scientific data to indicate that one way or the other, just anecdotes, really. But when it comes to providing therapy to a specific client, I think we do well not to call their recollections into question (particularly by asking their parents right in front of them!) but instead to apply the widest range of skills based on what actually works for the client, regardless of their ‘diagnosis.’ After all, even if CBT worked on 90% of depressed clients, there are still 10% who will fail unless you do something different. Forget “differential diagnosis” and do what works.
Milton Erickson reportedly said we have to re-invent therapy for every client. I think he got it right!
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“May cause?” How much evidence is needed to move to “DO cause!?!”
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I can’t imagine a more incompetent attempt to verify developmental trauma than asking the parents! They OF COURSE will almost always deny or minimize any harm done, and are happy to blame the child if they HAVE done some damage, as it lets them off the hook. Moreover, parents can be perfectly well intended and still do a lot of harm, of which they will not be consciously aware. They are the last people in the world to ask, “Was your child traumatized in your care?” Very often, the parents have contributed or facilitated the trauma themselves.
Beyond this, “Borderline Personality” diagnosis is HIGHLY associated with developmental trauma. I don’t think I ever encountered a person diagnosed with “BPD”(which I consider to be a diagnosis of little use except as a means of distancing oneself as a clinician from his/her client) who did NOT experience significant trauma as a child, especially when intermittent EMOTIONAL abuse is included. To diagnose BPD as an EXCLUSION for people whose parents deny they were traumatized is truly a bizarre choice, even within the confines of accepted psychiatric “differential diagnosis.”
Very odd thinking behind this kind of analysis, IMHO.
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I agree 100%. Techniques are secondary, handy “tricks” that can help smooth the path sometimes. But what is really healing is having someone care enough to be open to hearing and listening deeply to what is happening for another person. It requires courage, empathy, and an ability to hold others’ pain without reaction or withdrawing or advising. These things can be learned but not “trained” in the sense of classroom instruction. And a person can spend decades “studying” human psychology and yet be completely clueless as a therapist.
I used to work managing a volunteer crisis line. Some of my best counselors were computer programmers. Some of the worst had doctorates in psychology. I can find literally no correlation between “training” and competence as a therapist.
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I recall reading a study of kids in a residential program. Over 80% reported overt trauma. Less than 20% had it noted in their charts. So either the clinicians didn’t bother asking about trauma, or they didn’t consider it important enough to write down! This in a residential program for teens with behavior problems. How they can be sooo off base is beyond my comprehension.
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It’s hard for me to imagine how they can see case after case, like yours, where the person remains “ill” despite or even because of their “treatments,” never really gets “better” or actually gets worse, and yet somehow continue to believe their approach works! It is somehow always the patient/client’s fault when THEIR “treatment” fails, always their own doing if they get better somehow despite their “treatment.” How can they believe this themselves, let alone perpetrate it on their victims aka “patients?”
Well done to you for finding your way out!
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As I suspected, your references are only talking about probabilities and associations. There is no inkling of a biological CAUSE that would apply to all situations. Valuable information, to be sure, but nothing to do with validating “depression” as a legitimate diagnosis with a unitary cause. So for sure, Vitamin D and folate should be considered viable interventions for people experiencing mood problems, but this certainly allows for a HUGE range of possible causes, and also doesn’t eliminate the possibility of low folate or low Vitamin D cases NOT being depressed or suicidal, which would also kill off any fantasies about a causal role for any one biological condition in depression or suicidality.
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Makes sense to me!
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I have no specific objection to therapy at a distance. I used to be very successful with phone counseling at a crisis line many years back. There are some advantages to NOT being able to see one’s client – visual biases are virtually eliminated, for instance – I have no idea if I’m counseling a fat person or a black person or an old or young person.
The real question is, of course, effectiveness. I’m betting that has a lot more to do with WHO is the counselor and HOW they relate to their clients than it does with WHERE the counselor or client are during the process. In-person therapy certainly hasn’t got a fantastic record to beat!
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I’m not sure we can talk about “misdiagnosis” when there is no actual way to determine objectively who does or doesn’t have a given “diagnosis.” How would anyone know they were “misdiagnosed?” More proper to say you were misunderstood and mistreated!
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What exactly does that mean – a “neurometabolic condition?” Sounds like something he CONCLUDED rather than proved scientifically. I’d be willing to bet that he is talking about averages rather than finding a cause of all or most “depression.” He no doubt found that changes in neurons and metabolism are involved when people are depressed, and that certain changes are more common. Not a big revelation. But I’m willing to be enlightened. What does he imagine CAUSES most or all cases of depression, regardless of experience? What do all or most “depressed” people have in common that almost no one not “depressed” experiences? I am interested in this research. Let me know what you’ve got.
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Labels certainly meet a lot of societal needs, especially related to avoidance of discomfort. Of course, those who are “loyal” to parents despite abuse are presenting a competent therapist with the very thing they need to start working on, rather than promoting avoiding it by blaming one’s brain. Additionally, while the CLIENT may initially “feel better” because they’ve been blaming themselves, the studies I referred to show that OTHERS actually are more likely to stigmatize the client, including their own therapists and “mental health professionals.” Finally, it’s not the job of a diagnosis to make the person feel better, it’s to get them on the road to healing. What if we didn’t tell people they have cancer or heart disease because it made them uncomfortable? This is what happens when “diagnoses” are tossed about without regard to scientific validity. No one should be told they have a “brain dysfunction” unless the doctor KNOWS they have one, regardless of how it “feels” to get diagnosed. It is this kind of shady “reasoning” that proves psychiatry to be based on a fraudulent premise. For REAL diseases, no one gets to pick out the diagnosis that makes them feel best!
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Perhaps surprisingly, research has shown that people judge others MORE HARSHLY when their problems are attributed to “brain chemistry.” Talking about trauma and life difficulties creates empathy. If someone’s brain is blamed, it appears it’s easier for others to distance themselves, to say, “Oh, he’s ‘mentally ill,’ he’s got a brain problem, he’s not like me!”
“Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.”
https://pmc.ncbi.nlm.nih.gov/articles/PMC4273344/
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I guess my sense is that anyone who was genuinely focused on making their clients’ lives better would notice if their interventions made them worse. Sure they WANT their clients to “get better,” but most seem to not deeply believe that is possible, and view “better” as meaning “less” x or y or z. Reducing one’s depressed feelings is not the same to me as improving quality or life, and even less the same as actually improving their sense of control of their lives. And if evidence came in that my approach didn’t work or was based on false premises, I would chance my approach rather than blaming my clients or insisting I was right regardless of the evidence.
But incompetent or ill-intended, it doesn’t much matter to the clients. There needs to be a real intent to find the best path. Some exceptional practitioners do have that, and get results. But I find them very much in the minority, especially in the psychiatric industry. The proof is in the pudding. And some really crappy pudding is being handed out!
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Wow, that person hasn’t got a clue if he thinks his job in therapy is to come up with things to talk about! Shocking that any insurance company would pay good money for such crappy treatment!
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Nothing wrong with an emotional response in my mind. Besides, you’ve got plenty of factual backup for your points!
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Very well said!
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I always wonder how the “brain dysfunction” advocates account for that.
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Excellent summary about what therapists do to protect themselves at their clients’ expense. C) is particularly damaging – to state or imply that you should NOT feel depressed/anxious/etc. and that YOU are the one with the problem for feeling that way. And I agree, therapists being uncomfortable with their clients’ feelings and experiences provide the OPPOSITE of therapy, and are very hurtful!
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So you are not engaged in the practice of medical science, you’re involved in the practice of perpetuating your and your colleagues’ psychiatric belief system. That’s my point. Psychiatry depends heavily on the belief systems of the mental health professionals involved, and what kind of treatment one receives is very dependent on their “philosophy.”
Of course, most people have no clue that is what is going on. They don’t think psychiatry (or alternative medicine or whatever) is something you BELIEVE IN, they think it’s some kind of scientific study that can specifically identify what is “wrong” with their brains and fix it with drugs. This despite recent reviews showing that serotonin deficits are not associated with depression, nor is excess dopamine a causal agent in “schizophrenia.” You should also keep in mind that some “clients” of psychiatry have no choice about it, whether they believe in it or not.
To compare Whitaker’s well-researched reporting to Samuel Butler or Shostakovich is an extremely weak analogy to say the least. But you don’t appear to be interested in expanding your viewpoint based on such research, so there is probably no point.
However, that still does not excuse blaming your patients for responding in predictable ways to the propaganda they’ve been exposed to. They are patients. If you don’t want to treat them, I’d say you need to get yourself a new profession. I don’t believe “psychiatrists are brainwashed,” and of course, I never said any such thing, so such strawman arguments are merely distractions. I’m not hostile toward psychiatrists, I simply don’t respect professionals who blame their clients for annoying them. They’re clients. They’re not there to make you feel good or to validate your belief systems. They are looking for help. If they don’t find your “help” helpful, it’s not their fault. You’re the professional and it’s your job to care for them. Why would you take on clients if they annoy you so much? I’ve worked with plenty of psychiatrists whom I respect, even when we disagreed about how to approach most of our clientele. I only ask for basic respect for and compassion for the client. That is what seems absent in your case. And that’s an observation, not an attack.
Why not do what one psychiatrist I respected greatly did: Say, “I know you are hearing voices that you are not happy about. I have a drug that can help you not hear them as much. They don’t work for everyone, and they can have really intense side effects, but many of my clients find it’s well worth the exchange. If the first effort doesn’t work for you, we have several options available to try. Does this sound like something you would like to try?” Or words to that effect. Of course, he did get some interesting responses. One Native American guy said, “You white folk are all the same. You hear voices, you try to make them go away. We hear voices, we go someplace quiet and listen and see if they have anything interesting to say!”
I’m sure you’d have found that client quite annoying. I find him amusingly insightful.
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Do you want us to feel sorry for you that you have to deal with actual patients? You do understand that these “diagnoses” are all “clinical opinions,” that there is no way to say for sure that someone “has schizophrenia” in the same sense that they “Have a broken leg?” Is it any surprise given the sketchy marketing techniques out there (selling “disorders” rather than treatments) that people self-diagnose in massive numbers? How do you let the pharmaceutical industry and the psychiatric industry itself off the hook for convincing people they “have” diagnoses that don’t have any concrete or objective definitions?
Have you ever read “Anatomy of an Epidemic?” I very much doubt you have. If you did, you’d have a much better understanding why people behave the way they do regarding “diagnoses.” I will simply end by saying its hard to respect someone who bears such hostility and disrespect for his own clients. You are laying in a bed that your profession has made for you, and blaming the patient is not a mature reaction, IMHO. The phenomenon is the natural outgrowth of the basic (IMHO faulty) assumptions of your system combined with an essential disrespect for the experiences of your clients, which your comments very much demonstrate to me.
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They seem to be suggesting that “mental illness” creates itself somehow. It’s totally illogical.
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How and why would psychiatrists do any of the recommended things in the essay? There is no financial or professional incentives to do any of them, and in fact involves massive incentives to maintain the status quo, which meets most of the needs of most of the psychiatric workers with no change whatsoever. Those who DO challenge the status quo are generally attacked and humiliated and threatened with loss of status or income or both if they continue their sacrilegious ways.
Psychiatry will continue to oppose any sane efforts at reform. I don’t believe it is reformable, as it is at its core based on faulty assumptions that are self-serving and self-perpetuating, and no one will be able to change its basic purpose, which is NOT to help its clients have better lives!
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Remember that these “diagnoses” are almost entirely invented and mean next to nothing. They are mostly just descriptions of annoying behavior and difficult emotion that tend to occur together. Saying he “has bipolar disorder” is not a scientific fact – it’s just someone’s “clinical impression,” AKA someone’s opinion based on their own biases and social values. There is no science to it whatsoever. So don’t let them convince you they know what they are talking about. Do what makes sense and what seems to work, even if they don’t agree with you. Your husband and you know far better what is going on than any psychiatrist!
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Stimulants can also induce OCD behavior. It often leads to other diagnoses when folks have adverse reactions to stimulants. Especially Bipolar Disorder. It can be dead obvious what happened, but try to get them to quit giving the kid Ritalin and they freak out. Once had a kid I advocated for who had an eating disorder diagnosis. They gave her stimulants, and lo and behold, her appetite was reduced! They of course attributed it to a “relapse” in her “eating disorder” rather than realizing that stimulants were a bad idea for someone with that condition!
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I think Plato nailed THAT one!
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Actually, Irving Kirsch’s work fully supports Peter’s statements. There is more, and I do agree he would do well to include such proof.
But that doesn’t change what I said. The manufacturers can’t claim that ADs reduce suicide rates unless they have evidence that they do. No one has to “disprove” an unsupported claim. The “null hypothesis” is assumed to be true unless proven otherwise!
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Just for the record, it is the job of those claiming an effect to prove it. No one has to “disprove” that ADs decrease suicide. If that claim is not supported by evidence, it is considered FALSE regardless of counter-evidence. In other words, I don’t have to prove that something doesn’t happen just because someone claims it does. The burden of proof is on the person claiming it works.
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Yes, but we also have to consider that the response of the clients is the only valid measure of success. But remember, it is the quality of the relationship with the therapist/counselor which appears to be the most important variable. How can we measure that, other than by how they are perceived by the client?
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While DBT has some useful skills that can be learned by anyone who wants to use them, to suggest it is a “treatment for BPD” is problematic, as there is absolutely no objective way to say who “has BPD” or “doesn’t have BPD.” As such, all we can really say is that some people find it useful and some do not, just like any other set of “therapy skills.” Until it is possible to actually define these “disorders” objectively, there is no way that “clinical research” can prove anything relating to a “disorder” that is defined by social biases rather than scientific measures.
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I can’t really agree with you here. It seems to me that providing therapy is more of an art, though it should be informed by science. There is no way to train someone reliably to be a “good therapist,” and I have seen many competent counselors who have little to no formal training. There is an element of having “Done one’s own work” to be emotionally available to a client which is simply not a factor of hours of training or scientific findings. The proof is in the pudding, and many therapists with advanced degrees are mediocre to poor therapists, and many of the best therapists have come to it via alternative routes (I had an undergrad in Chemistry and a MS in Education, as an example). It is not such a black and white “scientific” question!
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Thank you for taking such time giving me feedback and sharing your perception of my comments. All I can say is that you’ve given me a lot to think about. Or FEEL about?
You may be taking my comments re: euthanasia a bit too far, though. I was really just trying to get an agreed-upon definition. Whether it SEEMS like suicide or not must certainly be an individual decision!
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Sounds like a much safe option than SSRIs!
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You may be missing the point here. If there IS science to be debated, it ought to be respected. Using name calling (like “climate change deniers”) does not mean that’s true, but is a great way to distract from the fact they are avoiding talking about the real issues. The fact that antidepressants do NOT decrease suicide attempts or thinking is very well established by mainstream scientific studies. There is no evidence that any drug decreases suicide attempts except for a very thin support for Lithium which has been called into doubt. If the reviewers can’t provide any science demonstrating a reduction in suicidal thinking or attempts, it is they who have more in common with “climate change deniers.”
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Yup! You can always get some tramadol paid for, but a massage comes out of your own pocket! How much in Tramadol sales could be saved by prescribing a lot more massages?
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I found the idea of intentionally inducing anxiety, depression, etc. to be somewhat disturbing. Is there no sense of possible long-term damage from this process? Doesn’t life already teach us that difficult situations bring on difficult feelings? Why does that need to be “proven” by potentially harming people?
That being said, I agree completely that normalizing anxiety, depression, even delusions and hallucinations is the best path forward, along with some REAL medical care for real, objectively observable conditions (like drug adverse effects). There is no benefit to lying to people to stop them from blaming themselves. In fact, normalizing blaming yourself may be the very first step to moving beyond it!
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This is a HUGE problem, for psychologists/therapists as well as psychiatrists and psych nurses. They may often feel uncomfortable and want their own discomfort to go away, so they project it onto the client and either try to drug the feelings into submission or talk the person out of it, sometimes resulting in involuntary holds (aka incarceration) in hospital wards. I can’t tell you how many times I saw foster kids or others sent to the hospital for cutting on themselves (not suicidal) or for talking about suicide. One person said she called the suicide hotline because it was not safe to talk to her therapist when she felt like cutting, because she would always send her to the hospital. The are many smaller cases where the therapist wants the client to do something in order to reduce their own discomfort.
One of my basic principles of “therapy” such as I did was that when I felt uncomfortable, I assumed the client was probably getting to something really important, and the most important thing for me was to sit with that discomfort as they had to and see what was behind it. It requires a lot of courage and willingness to experience the pain of others to be of any use to another person in distress. You have to have “done your own work,” and the vast majority of “mental health professionals” have not done that, and are therefore useless or dangerous to their own clients, IMHO. It really isn’t something you can train for – it’s an attitude one has to adopt, and most don’t even realize they need to let alone have the capability of sitting with another’s pain.
There are also plenty of untrained “amateurs” who DO have that skill, as I found out running a volunteer crisis line shift. You are often better off with a well-supervised computer programmer than a trained “mental health professional!”
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Ah, but they rarely do fund this sort of study! The heavily moneyed biopsych advocates have a lot of sayso about what is studied, and protest when their pet drugs and companies get short shrift. Besides which, most studies theses days are funded by drug companies, not government entities. There’s little chance non-drug interventions will ever establish a sufficient “evidence base” to match those the drug companies can muster up!
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And of course the “evidence base” depends on what gets researched, and drug company money determines what gets researched. So there is never an “evidence base” for anything but drugs!!
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Research into what? How to create “diseases” from social bias and behavioral checklists?
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How could anyone ever tell if someone “legitimately has BiPolar Disorder” when the only criteria are a list of behaviors and emotions?
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Hey, Laura, great to hear your voice and know you’re still around and doing your thing! Hope all is well with you!
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Shhhh! You’re going to hurt sales with such research!
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I read Pies and Ruffalo’s response. It is as nonsensical as I expected. They compare “schizophrenia” causing hallucinations to a volcano destroying Pompeii. Well hey, guys, a volcano is obviously THERE and concrete and erupts lava that can level a town. How is that in any way like “schizophrenia,” which cannot be seen, felt, or otherwise observed except by its purported effects? The analogy would be more like Pompeii was destroyed by a “City destroyer.” The proof is that the city was destroyed.
That trained academics engage in such childish arguments to defend an indefensible concept is beyond my comprehension!
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Here is the Mirriam-Webster dictionary definition of “euthanasia:”
“the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy”
I’d say that whether it constitutes murder or not depends on the desires of the subject and the intentions of the one helping them die. To put it another way, is the person truly helping the subject accomplish his/her goals or simply helping themselves at the subject’s expense. In the latter case, I’d call it murder.
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Makes total sense. I was not disagreeing with you, I was trying to emphasize your point!
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Well done cK!
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There is, of course, no possible way to objectively establish “the truth” in “mental health” diagnoses, as there is no way to determine ANY diagnosis beyond simply describing it. If there is ever even ONE test to determine ANY “mental health” diagnosis, I will be shocked.
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Wow, they really do talk like that, don’t they? “Should we consider” is already a tacit admission that they don’t know what they are talking about!
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A slight increase in probability of some event or condition on average is no way to “diagnose” anything.
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“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 nothi