Saturday, December 3, 2022

Comments by Truth in Psychiatry

Showing 340 of 340 comments.

  • Thank you for this! As a person with my own and also familial experience who has worked as a “professional” for decades in non-profits, I could not agree more about the deep and neglected value of personal truths, perspectives, lived experiences and shared power.

    This quote is one of many that hits home,

    “They suggest that “academic programs include and recognize persons with patient experiences—who could also be students—as official members of the pedagogical team and include them in all levels of the educational continuum (from admissions to curriculum design, teaching, assessment, and program evaluation).”

    You and the authors of this study are speaking to a deep and neglected truth and problem of epistemic power and oppression.

  • Yes, agree that the economics of for-profit health”care” including the medicalizing of mental health”care” has led to the co-optation (and colonization) of the wisdom of lived experiences. Big Pharma and the Big Healthcare Industry profit from the status quo. This is a huge problem, driving so many other oppressive forces including robbing us in the U.S. of the last bits of our democracy with Citizen’s United in 2010 and now the loss of RBG:-( Systems of power are all related. Thank you for speaking to this one, perhaps the biggest and most inequitable of all!

  • I hear you and would want a peer partnered dialogic approach such as Intentional Peer Support combined with a humanistic and systems oriented therapeutic dialogic approach (not biomedical type of practice) which I have found helped our family keep my young adult son out of the hospital completely many years ago and as a result he never landed in the horrible system you describe. I also have experience with the medical models‘ dominating and closed minded and sometimes horrible practices… I think all types of systemic power and compensation need to be equitable between peers and other professionals. Thank you for your thoughts.

  • I hear you about the slippery slope. We used a dialogic approach (based on Open Dialogue) successfully with my 19 year old son to avoid hospitalization and the biomedical model approach to altered states…and 6 years later he has moved beyond these (for him) largely existential and growing up in this crazy world difficulties. I know what you are referring to in terms of the abuse potential. And I agree environmental interventions and supports can also help tremendously.

    Still, unless you have been in someone else’s specific shoes, as a spouse for example caring for a spouse with behavioral variant FTD, a young dementia, who is threatening and assaulting your six year old son – or you as his spouse (true situations) and even nursing homes will not take someone this violent, it is not always possible to manage things and keep everyone’s interests and needs met.

    I don’t believe it is just about the person with dementia’s needs, although obviously important, but also everyone around them too. Unless you’ve been in these situations I hope you don’t make sweeping statements that feel very judgmental and unhelpful to real world situations. We don’t help caregivers in these situations, especially spousal caregivers much at all on top of it as a society. They are expected to spend all of their spouse’s and their retirement savings too before there is much of any help at all with what becomes 24/7 care.

    I know for a fact that some of these tranquilizing neuroleptics have helped some otherwise unmanageable situations. Being too rigid really can hurt our message in my opinion.

    With sincerity, C

  • They can be life savers though for families trying to manage violent or unmanageable behaviors brought on by brain deterioration from dementia. Some people don’t have these symptoms. Some do.

    I agree that Big Pharma is ruthless and making profits by pushing and lying about drugs. That said, sometimes these drugs have desired effects that allow for families to cope with loved ones with dementia. I know they can be easily overused, but unless you have experienced losing a spouse or close family member to dementia, please don’t assume one argument addresses all situations.

    Please know that I agree with 95% of what most of you have shared. There can be a time though that these drugs, on balance, improve the overall situation when caring for a person with dementia.

  • My husband has been diagnosed with advanced Early Onset Alzheimer’s and FTD. Many with this form of dementia, especially behavioral variant FTD (a younger onset dementia) can become extremely upset and anxious, aggressive and behave violently toward others, sometimes their own children. This is a result of organic brain changes.

    While I agree that psych meds are extremely misrepresented by profit driven drug companies and they should be used only with full informed consent and for minimum amounts of time if ever, I have been humbled as a spouse of someone with dementia. This condition is not related to something that can be addressed with therapy or other means, beyond a point.

    Medications to calm and tranquilize a person with dementia can be overused and abused no doubt. Neuroleptic drugs used in those with Lewy Body Dementia in particular can have some of the worst side effects so should be used minimally. But I would also say that these drugs do often lessen some of the most hard to manage behaviors and can be lifesavers for families and caregivers. The last caregiving family members need is judgement for managing a terribly difficult, lonely, financially and emotionally draining, sad, and sometimes dangerous situation.

    Hoping there can be an appreciation of the complexities in these situations.

  • Thanks for your response Sera. I am familiar with the differences of opinion about including peers in anything ‘clinical,’ including Peer Supported Open Dialogue. That word itself is a huge problem and assumes a medical, individual pathology understanding before there is any conversation about what’s happening. The invitation for polyphony and disagreement is one of the things I value most about POD and the dialogic approach.

    I share many of the concerns I’ve heard about ‘peers’ on treatment teams, especially with the ongoing power imbalances that keep people with lived experience in token or junior clinician type roles. Systemic power is a real and pervasive concern and has led me to push for an approach where peers are at least equal in power and number to any other role on the team.

    As someone with survivor, therapist and parent experiences with emotional struggles, I have noticed that we often still turn to or end up in the current medical model system when things get really tough or when we don’t know of or can’t find the much better alternatives out there like Alternatives to Suicide, peer run respites and HVN. POD is the best thing I’ve found so far, but always welcome the dialogue about better ideas.

    With respect always

  • Yes, risk assessments for professionals! I love it

    Life takes courage and sitting with someone in the most difficult spaces takes more than most ‘professional services’ support, allow or encourage.

    I fear professional responses and ‘care‘ more than almost all human experiences of emotional and existential distress.

    The best “alternative” I’ve found when one may want a bit of what professionals offer is Peer Supported Open Dialogue, (POD) with at least equal numbers of peer and clinical 50:50 staff facilitators.

    Thank you Sera

  • Thank you for this Stephen. I agree with your thoughts about for profit Pharma and other market driven medical research. I worry that our systems are very corrupted by the influence of money and other systems of power, and no longer are what they claim to be.

    My personal story is one of many millions of examples of the harm perpetuated by the misrepresentations and blatant lies of Big Pharma.

    I was prescribed a medication for prolonged and serious morning sickness during my first pregnancy. The drug I used, (only half the dose prescribed, but for 5 months) was Phenergan. My child, now a young adult was born with developmental delays and labeled on the “spectrum.” I have come to strongly suspect that much of what gets called autism is probably a form of neurological damage – and that the rising levels of this damage (also known as the incidence of “autism”) are most likely related to the fact that people, including pregnant women and their children are not protected from the harms caused by for profit Pharma.

    I find your ending quote powerful,

    “To ask, as Albert Einstein did in 1949, ‘Why Socialism?,’ we might, if we answer without reflex, be tempted to respond as he did, that ‘the economic anarchy of capitalist society as it exists today is, in my opinion, the real source of the evil.'”

    Your work is much appreciated.

  • Thank you for sharing your thoughts about how therapists can best be with the people that they support. Your description of being a humble presence reminds me of the practice of Peer Supported Open Dialogue, POD, or Open Dialogue, both ways of being with others in dialogue rather than offering goal directed, advice giving interventions. I also remember an article about avoiding becoming a colonizer when offering any type of counseling or support for individuals or families in which we assume that we know best or better than the individuals we work with. Thank you for the “dialogue,”

  • My son was diagnosed with a developmental disability (“high functioning autism”) as a young child after I used Phenergan (Promethazine, an antihistamine) for severe morning sickness (Hyperemesis Gravidarum – HG) from month 2 through month 7 of my pregnancy. Although I was reassured that it was safe and the benefit outweighed the risk to my baby, I only used half the prescribed dose.

    I have come to believe that individuals diagnosed with developmental challenges such as ADHD and autism include a group of people who have had some type of brain/neurological damage that could have resulted from multiple causes including but not limited to drugs the mother took in pregnancy such as SSRIs or Valproate (or before pregnancy) and other neuro-toxins that she had in her body. I think that there is more than enough evidence that this is true, but our FDA and drug industry does not properly do the research, share the information and protect us from what should be known and forbidden. There were other options to treat the HG (that were not offered to me with my first son), that I used with my two subsequent children, such as home rest and an IV to stay hydrated through the HG.

  • Great article. I agree that we need to address the underlying cause, unrestrained capitalism which is now running our so-called democracy. I would hesitate to criticize teacher’s unions, although I agree that any human institution, even the PTA can be corrupted, but this does not mean that unions don’t add some counter-balance for workers to our out of control corporate power. (None of us will benefit from the weakening of unions).

    So, where do we start? Overturn the 2010 Citizens’ United Supreme Court ruling giving money the same rights as free speech. (The more money you have the more influence you have over elections.) I would also do what you’ve done here, bring up the elephant in the room, unrestricted capitalism. I need help figuring out the actual next steps, but voting, running for office, joining together to support each other in these efforts and NOT becoming a professional complainer within the system are all important. Thanks for a very good article!

  • Thank you Sarah. We all should be very worried about the direction of our world, including in ‘mental health services’ – specifically the fact that Big Pharma, psychiatry and other trade and big business interests benefit by funding biased “scientific research,” defining “Evidenced Based Practices” and then using that “expert” authority to label and force “treatment” on us for their own benefits and profits. Thank you for repeating and amplifying the words and concerns of Matt about what needs to change. This will take all of us.

  • Oh No, this is so very sad and tragic. I met Matt in person last year at ISPS after reading his MIA posts for a very long time. He was deeply kind and insightful. He was fearless in his work to expose truth. This is a reminder to me that we are our brothers’ and sisters’ keepers. Please reach out for connection and do not give up my friends. Life can be unbelievably painful at times. Matt, RIP and know that we will carry your message and spirit into tomorrow. Wishing your family peace and healing.

  • Thank you Frank. I could not agree more. Thanks also Corinna for your work and for reminding us once again about the deeply upsetting health disparities among those people who are labelled with a psychiatric diagnoses and given neuroleptics. I hope we can continue to help educate people about all the things that help people move through emotional distress, how medical model treatments cause/add to the problems and how individuals can take control of their lives beyond the medical model system.

  • Hi, I really like your ideas about accepting a winding, personally chosen and individually paced path toward adulthood. I agree that our culture creates expectations that contribute toward great pressure on young adults which can then lead to an emotional crisis. My belief is that unrestrained capitalism, which creates economic pressure and great inequity is behind this competitive, one size fits all system. Thank you for sharing your thoughtful perspective.

  • Hi Sera,
    Thank you for this much need summary about NAMI and other big mental health organizations’ ties to Big Pharma. As a peer, a parent (who helped to successfully keep her young adult son out of the system 3 years ago when he had what he called an existential crisis at the age of 19) and as a person working as a peer-professional leader in the system that you describe, you have again given me much to think about. I keep hoping we can make change from within, but it reminds me of trying to make change within our political structures that are so controlled by Big Money and lobbyists. My eyes are open and I hope to either find real value in my work to create true alternatives in the system or find other work. Thank you for all you do to light the way.

  • Thank you for this article exposing more of the untested and/or hidden harms of prescribed drugs. I blame my son’s autism on Phenergan which I was prescribed for 5 months while pregnant with him for severe morning sickness. Do you know how to insist on more research and information on the risks of this or any prescribed drugs during pregnancy? My sense is that part of the rise in autism is directly related to the surge in the use of many medications by women of childbearing age. I also consider both the lack of research and the lack of full disclosure of the known risks of prescribed drugs, especially in pregnancy a crime against humanity.

  • I was impressed that my young adult son came through a two week experience of what gets called psychosis almost three years ago with the help of an Open Dialogue trained psychiatrist, a supportive family therapist and our family network who was very committed to keeping him both safe and out of the hospital. He has since shared that there was a questioning part of him that gained strength as we connected and shared our thoughts and feelings while also deeply listening to his non-consensual experiences. I have come to believe that the respect for all voices in the dialogic process empowered his agency and self understanding while also helping each of us hear each other and ourselves. He came through the ‘psychosis’ with only 3 nights of Klonopin to help him get back on a sleep schedule and has not experienced psychosis again. The respect and curiosity we offer each other, especially at moments of great intensity or vulnerability can be very empowering and healing – quite the opposite of the diagnose and drug medical model! Thank you for all of your very insightful work Joanna.

  • Rufus, thank you for sharing Chris’ story.

    Chris, I deeply appreciate hearing about your resilience through your experience of medical model psychiatry. I am very saddened to hear of your horrible mistreatment, repeated disrespect and psychiatric oppression. My heart goes out to you. Wishing you strength and healing in the years ahead.

  • This type of resource for parents is badly needed as an alternative to drug company sponsored propaganda and so called ‘grassroots’ groups such as NAMI that reportedly receive about 75% of their funding from Big Pharma. (see NY 2009 Times article about this). Thank you

  • Still there are times of great pain and crisis when I have found professional help critically important. I’m not referring to ER’s and the medical model, but humanistic therapists, peers, mindfulness teachers etc. Some moments of crisis are beyond everyday (yes, often missing) community support. What can we do to help create these humanistic, non-medicalizing responses? I think there is a place for paid professionals during these trauma related, existential and/or spiritual crises.

  • Interesting discussion. As a person who was locked up as a young person and rejected/escaped the medical model but found help in therapy and mindfulness teachings, a parent of a young person who in the summer of 2014 went through a two week extreme experience (with an Open Dialogue informed approach) without heavy drugs (just some very minimal drugs for sleep for a very short time) and is now living a full life without these difficulties and as a mental health counselor and “professional” who has struggled for 34 years to find my way to meaningful “help” for those in need, what should I (we) do? I agree that our society is the reason so many of us struggle, but people do struggle with real pain, extreme experiences and life threatening situations. How can we support or respond to them in our current neoliberal, capitalistic world? Where do we start? I ask these questions with humility. I am still trying to find my way to change things for the better. So far, the dialogic, relational and peer approach are the most democratic and non-violating ways I have found to respond. Thank you for all of your shared thoughts.

  • Glad to see his honest self reflection. However, I know that his assertion that, “There is no doubt that antipsychotics are necessary in acute active psychosis.” is not true. I have known several family, friends and others who have fully recovered from psychosis without neuroleptics and with alternative support including dialogic connection. Unfortunately, we don’t give most people experiencing psychosis this option.

  • Thank you again for all the discussion,

    I like Paris’s suggestion to use “both…and” to describe how a combination of adversity, developmental issues and many other factors may contribute to extreme experiences or other emotional/mental distress. More than anything, I hope we hold our theories lightly and remain open to the dialogue as it unfolds with the person experiencing distress and his/her network.

  • Matt,

    Yes, I am familiar with object relations theory. I agree with the central tenets of this theoretical understanding of human development in relationship to others (initially parents). People must overcome both the fear of abandonment and engulfment in all relationships. The safer we feel with our first caregivers the more we build a strong sense of self. Yet, having worked through many, many crises with many people, including my own, it’s not always this straightforward, not at all.

    The most hopeful response(s) to crisis I have found is Open Dialogue and Need Adapted Tx. and peer support. The worst response is the hospital and the medical model. Hope we can move toward person-centered dialogue without preconceived ideas about the cause of crisis. Humility sometimes is more important than the most well conceived theories. Thanks again Paris and Matt. All the best…

  • I would like to comment on some of the research you referenced above. I hope to continue to challenge some assumptions that tend to blame parents, usually the mother, for difficulties with development. I am a therapist, parent and a peer and I’ve spent my entire adult life coming to this perspective. Humility is the best approach when we offer support to those in crisis and their families.

    The studies that look at how mental health crises relate to adversity and difficulties with attachment show correlations between the two. It’s very clear that adversity and later mental health conditions are correlated. However, when children fail to feel safe and secure in their attachments and lives, the reasons (causes) are less clear. Many other factors beyond maternal personality and the elements mentioned in the ACE study may be involved.

    I have 4 children, one on the spectrum. As someone who has had many years of psychodynamic therapy, including much reflection on the problems with my relationships with my parents growing up, self help, education etc etc, I don’t believe that I caused my son’s developmental/spectrum issues anymore than I caused his siblings’ personalities. (Perhaps the medication I was prescribed for severe morning sickness for 5 months caused his autism though!)

    Secure attachment is critically important for all children. Nurturing and safety are vital. But not all kids who have mental health crises have parental caused attachment problems. Kids who are vulnerable can be born with sensitivities that are magnified as they struggle in a difficult world. Parents may have done everything in their power to help (often have) and still have young adult children who find growing up and living in the world overwhelming.

    Just because mother and child had difficulties when these kids were infants does not mean that the problems were “caused” by mothers…these children may have been born with very different nervous systems and developmental challenges. In addition, poverty, racism, health crises, bullying and other complex forms of adversity may exist. To later blame individual mental health crises on attachment to mothers is presumptuous and even harmful. In any case, as a parent (and a peer and professional) I have come to believe that it’s not helpful to hold to one theory.

    People (parents) know when they are being judged and I feel it a bit here. Studies that show correlational relationships do not explain the complex dance of life. Furthermore, even though there is truth in some of these theories – that parental difficulties can cause trauma and developmental problems in children – jumping to these assumptions is probably neither fully accurate nor that helpful for individuals and families in crisis.

    Again, I could not agree more that early relationships and family experiences are a part of what leads people to have emotional problems and/or more well adjusted lives. BUT, there are many, many other factors affecting people beyond maternal attachment and the 10 challenges listed in the ACE study. My question is how to keep an open, humble perspective as a therapist, support individuals in crisis with humanistic, non-medical model approaches and bring people together in dialogue. This is what I have found most helpful.

  • I appreciate all of the discussion here. My primary perspective is that “dialogue,” (as in Open Dialogue or Need Adapted Treatment) between family members and the person experiencing distress can help tremendously. “Polyphony” and not necessarily full agreement on everything can help people hear each other and work things through. My hope is that professional supports join this process humbly and not with preconceived (or prematurely conceived) formulations and theories about what causes what in the family.

    Having been a part of these dialogues in my own family has been eye opening. People (parents, kids, siblings etc) in the same family can understand and experience the same things very differently. Yes, no doubt, attachment issues, unhealthy communication patterns, unresolved parental pain and issues, overt abuse and unhealed trauma as well as personality differences may all cause harm to children in the family.

    However, I would again caution us not to fall back on our professional theories and preconceived ideas. Yes, early attachment is critical and usually happens between mother (as opposed to father) and child. Developmental (neurological) problems such as autism are on the rise and can negatively affect these early developmental experiences having nothing to do with mothering. Research is showing that these developmental issues are often biological in nature, although with warm environments, targeted behavioral interventions and neuroplasticity, they too can be overcome.

    We must be very careful not to fall back on blaming mothers. Mothers in particular often carry (much) more of the parental responsibility and are also the first to be blamed for complex problems, sometimes having to do with absent or abusive fathers, school systems that don’t work, employers that are not flexible etc. I much prefer dialogue in which professionals come in to the family meetings as humble listeners and try to understand and facilitate communication between others and ultimately healing.

    I realize that both of you, Paris and Matt, appreciate the complex causes of family issues and what may lead to “psychosis” or other extreme experiences and are not intending to blame anyone, especially fathers or mothers. However, some of the theories themselves jump to conclusions such as the concept of “disorganized attachment” which may have some value, but also may be entirely wrong as an explanation. These concepts are at best theories and may not be anymore helpful to the family than diagnoses are. In fact, I find some of these ideas presumptuous and harmful. Non-judgmental and humble dialogue can instead be immensely helpful in the process of crisis response and longer term transformation.

  • Thank you for this insightful interview with Paris Williams, one of my mentors. Paris actually was there for our family as a kind support 2 1/2 years ago when our 19 year old son went through a 2 week extreme state with 24/7 home respite, a dialogic, family approach and minimal meds (just for sleep for a few nights). Our son has not had another extreme experience and is thriving.

    I want to suggest that we, as a community, remain open and humble about all the possible and unknown causes of ‘psychosis.’ Trauma and developmental problems certainly are big factors in later emotional pain and upheaval. I would also argue that living in this stressful world, the experience of being bullied, PTSD of all kinds, not fitting in socially, maybe being on the “Spectrum” (which I believe is probably related to more and more expectant mothers taking pharmaceuticals or being exposed to other toxins), economic or health related adversity etc. also impact children and can lead to mental health crises. Humility is something mental health professionals have often lacked. I hope we don’t make this same mistake by assuming parenting problems are the prime cause of emotional difficulties. Parents almost always are doing the best that they can. In some cases, they may not have contributed at all to their child’s emotional difficulties. In most situations, parents are trying to help when their kids have emotional struggles and need our support.

    Pain and existential mysteries are also part of living so intense emotional transformations are a natural part of healing and growing. So much contributes to each person’s path and challenges. Thus, even though this interview with Paris shows how parental trauma and pain can contribute to mental health difficulties in children, we should not simply assume that this is the primary cause of emotional pain in children.

    Thank you Matt and Paris for this great interview. More than anything, I value that you have reminded us that emotional suffering has meaning and is related to life experience.

  • Thank you David. I was once like your daughter and can assure you that support, time, therapy and maybe yoga would be much better choices than an SSRI drug for her teenage anxiety and struggle. I hope her mother realizes that these meds have unpredictable and unknown effects on a teenager’s brain and can make things much worse. Best Wishes to your daughter, you and your ex-wife as you negotiate the challenges and joys that come with adolescence. Hang in there.

  • Thank you once again Robert Whitaker for speaking the truth about psychiatric drugs. My son went through a 2 week psychosis over two years ago with very minimal meds (benzos) for a few days just for sleep. Using an Open Dialogue informed approach, he came through the experience using a home respite with family with him and trying to connect 24/7. Since then, he has not experienced a recurrence. He continues to work through some issues, pain and existential challenges related to growing up with his therapist who is also a mindfulness teacher. I cannot say enough positive things about the power of simple meditation and living in the present. He and several of us have started meditating and found it very helpful with anxiety, worry and mood regulation.

    All of this together has kept us moving forward individually and as a family with minimal use of meds. Long term meds are NOT necessary for recovery from all experiences of psychoses and other extreme experiences and overuse may actually interfere with the insights that may be gained with dialogue and mindfulness practices. I say this as a parent, a peer and as a clinician. Each of our expertise counts and we all have the right and the duty to examine the research and weigh in on the use and overuse of medications in psychiatry.

  • Thank you for sharing your story. My heart goes out to you. I too found my way forward beyond the mental health system. Friends, exercise, mindfulness meditation, the Serenity Poem/Prayer and taking one day, sometimes one breath at a time has helped. Know that you are not alone. Your story is touching and inspiring. Wishing you all the best…

  • Matthew,
    Your essay really touched me and I can relate to what you describe. Many of us working in the “system” are complicit and yet also victims to secondary trauma as a result of what we witness. I wish I could say, after over 30 years working in this field that I no longer have this type of experience, but I cannot. Almost every day that I go to work and witness heavily medicated people who have given up their autonomy and self definition and are , “in recovery” I wonder what we are doing. There must be a better way.

    Thank you for putting words to this trauma and reminding me that we should not “comfort those in power at the expense of those without.”

  • Reid,
    I am sorry for your and your family’s extremely difficult experience. It sounds like coming off the psych meds suddenly and then being refused immediate help when you went to the ER several nights before this tragedy played a big part in your loss of control. As human beings we are vulnerable to many things, and do have to take responsibility for our behavior, but it does sound like the sudden psych med withdrawal was a BIG factor here, that would cause most of us to “lose it.” Regardless, you and every person deserve to be treated with respect and kindness. The type of treatment you describe here only further hurts people and must stop. It’s not easy, but I will never give up trying to make this society and world a more humane, sane and peaceful place. One last thing – Mindfulness has been very helpful to me and many people I know…it may be worth a try, now or in the future.

  • I appreciate your sharing your powerful story with us. Your persistence is inspiring. We need more people like you to tell the full story of meds, the (sometimes) short term benefits and long term consequences. I am also someone who was hospitalized and diagnosed at a young age, but I got away from the medical model approach to my problems soon after. It’s so sad that we must protect ourselves not only from our inner struggles, but even more so from the system that claims to help us. Best Wishes Naas!

  • Ken,

    Thank you for another insightful article! I agree with you that diagnoses often cause great damage. Labels take away from our curiosity and openness toward each others’ stories. Dialogue and connection are vital for people to move forward through emotional and mental health crises; diagnoses often derail this process.

    Thanks again,


  • Great article! I’ve spent my life, first as a peer in the late 70s (before we were ‘peers) then 30 plus years working in our field and in recent years a Mom of teenage and young adult children who have had some bumps in the road. One of these ‘bumps’ was a 2 week period of psychosis, 2 years ago that we successfully got through at home using an Open Dialogue approach as a family. Mindfulness has also helped us, including me. There are better ways. You really get it and I so appreciate your perspective!

  • I appreciate your wisdom. Thank you for sharing your story. You sound clear and strong and are making a huge difference. I also struggled with very difficult eating disorder issues earlier in my life and found that they were my way of trying to protect and comfort myself. Trusting our wisdom and the meaning of our struggles is critical…wishing you healing and strength. Thanks again!

  • Noel,

    Thank you for this article. I love your questions regarding what a trauma informed community would be like. Your essay shows how far we have to go to create such an alternative. Speaking from firsthand experience, these approaches work.

    However, I worry that we are creating growing numbers of traumatized individuals in our corporately controlled world where human life is disregarded. The presidential election in the US highlights the level to which our so-called democracy has been bought and sold, including the ongoing damage done by the mental health industry and Big Pharma. My hope is that we will consider the overlap between big money, oligarchy and trauma. We need leaders who represent us, not corporate interests which create wars (trauma), poverty (trauma), iatrogenic illnesses (trauma), mental health conditions (trauma), climate change caused by fossil fuels and coal (trauma) and for profit jails (trauma), among many other traumas.

    Noel, trauma is related to most forms of human suffering. I hope we work to heal existing trauma and stop creating new ones.

  • Thank you for sharing your powerful and personal story. Your courageous honesty is an example of what we need in my opinion to help re-create services, supports and respites for people working through altered and extreme experiences.

  • Thank you for is article Dr. Gold. In addition to the generational effects of SSRI treatment, could you comment on any known damage to the developing fetus when mothers are given other psychoactive drugs such as Phenergan? I was given this drug for 5 months during my first pregnancy for severe morning sickness. I worried, resisted it, was reassured and took half the dose. My son, now a young adult, was diagnosed with “high functioning autism” as a young child and has had learning and social difficulties throughout his life. Could my use of Phenergan in pregnancy be related to his developmental challenges in your opinion?

    I worry that the rising rates of diagnoses of autism are related to the rising exposure of pregnant women to pharmaceuticals and other toxins. Please let me know if you have any thoughts on this. I know much more research needs to be done, but I worry that this won’t happen and that our FDA is not properly protecting us from Big Pharma’s focus on profits and their corrupting influence of psychiatric and other medical research.

    Thanks again!

  • Thank you for this Steve. We need to tolerate the uncertainty of those moments and take them one step at a time, listen, talk, create respite and see where they may lead. There is no need to rush or bury them under loads of drugs. So sorry this happened to you 15 years ago.

    Best Wishes as you continue on your journey. I have seen the protein powder, BCAA, which has been studied, help some with reducing a speeded up limbic system (whatever the cause). See the article below:

    Mindfulness meditation has also helped several in my family as well. There is a book called Mindsight that first introduced me to the benefits of mindfulness for regulating our emotions when we’re going through intense times.

    None of this is to minimize the meaning and value of those moments for us, only to offer a couple alternative supports to help come through the intensity…Best Wishes

  • Hi Ron,

    Thank you for this article, My hope is that psychiatry can transform itself and live up to this vision. Yet, I doubt it can given the current, profit before people economy that we seem to worship in this country.

    Question: Speaking of alternatives, has anyone tried BCAAs as a nutritional approach for help with what gets labelled “mania?” I have seen it work wonders within 6 hours of beginning the supplement, as described in the study below. Yet, (no surprise here given the relative lack of big profit potential), little follow up research has been conducted on this very promising nutritional “treatment.”

    Here is a study of BCAAs for mania:

    Also, meditation is really effective with almost all mental health problems. We need more research on this approach as well!

    Thanks again for this article and to all for the rich discussion!

  • Vlado,
    Thank you for this. I’m glad you got out of there, but so many do not. It’s really difficult to find alternative spaces and enough support at the most wrenching
    times, so people fall into the hands of the medical model. Wishing you well.

  • This is an area in which I know quite a lot since I was deeply affected by this condition as a teenager, over 35 years ago. My experience was quite severe and I could have died given the degree to which I was systematically starving myself by over-exercising and under-eating for several years.

    My thoughts, now that I have had a full and lasting (over 3 decades) recovery from this difficult period in my life are that starving oneself is a meaningful response to a life of pain in which one feels that he/she has little power to respond to his/her life situation. Working with a therapist who helped me see the lack of safe boundaries in my family of origin, my tendency to be a perfectionist as a way to gain approval from a family system that ignored me, our society’s tendency to idealize thinness and objectify women and my lack of maturity due to my lack of consistent and sufficient parental nurturing were all very related to my restrictive eating behaviors and obsession with my weight.

    After several years working with an insightful, person-centered and trauma informed therapist, I moved past my obsession with weight and have remained free of eating and or weight concerns for over 30 years. I can assure you that DNA research would have had little benefit or meaning for me, then or now. When it comes to most emotional and mental health concerns we must ask, “What happened to you?” not “What’s wrong with your DNA?”

  • Sure, providing humanistic understanding and support, person-centered, trauma informed therapy, lessons in mindfulness and CBT, social and academic support could help teenagers going through difficult emotions as they face young adulthood. Medications and diagnoses will not improve outcomes and are much more likely to cause harm. I wish I trusted our mental health services, but I don’t. Any services built on research sponsored by Big Pharma is likely very biased and has helped create our misguided, medical model paradigm in this country…sad and frightening

  • Deena,
    Thank you for the reminder to focus on little things when this big ole world is too much. I agree that life can be so hard. I’m glad that you and your turtle came together and helped each other keep going. This is a beautiful and touching story and I will carry it with me.

  • This is one more clear reason why we need to overturn Citizen’s United. Our government (and our science) has been undermined by the very corporate interests it must oversee. Bernie Sanders speaks about this frequently. We must insist in resuming control of our democracy and keep full integrity in public safety and science…we obviously no longer have real “science” or oversight we can trust!

  • Philip,

    You clearly sum up an example of what should be obvious to all of us and is now backed by numerous medical studies. Our environment affects our biology. Stressful and traumatizing experiences cause harm and contribute to mental suffering and distress. This is not about “blaming” parents, but realizing that human beings are both nurtured and/or damaged by their environment and relationships. Racism, poverty, sexism and personal experiences of abuse all leave their mark on our psyche.

    You rightly point out that the word ‘trigger’ is misleading. Environmental harm can ’cause’ the problem. In addition to behavioral experiences, I would include environmental toxins such as the iatrogenic harm caused by prescribed meds to adults, children and developing babies in pregnancy (related to skyrocketing rates of autism).

    Thank you for your work.

  • Thank you for sharing your difficult story cat. Glad you survived through that psychiatric nightmare. I couldn’t agree more about the value of Rob Whitaker’s work for us and others as they search for ways to ease their’s and others’ mental anguish. We all have come together in search of truth on this website. You are so wrong Dr Frances. Please ask us before you make these unfair and baseless judgements about Mr. Whitaker’s books, lectures and work.

  • Dr. Frances,

    I am a mother of a young adult who experienced “florid psychosis” according to his therapist, yet came through the experience after 2 weeks, with minimal meds (Benzos used for a few nights to help him get back to sleeping at night) using a dialogic home and family based approach with a psychiatrist trained in Open Dialogue. This was 18 months ago. The psychosis has not recurred, he is not using any meds and he is in his third year of college. This would not have happened this way if we had taken him to an ER.

    Robert Whitaker has raised very valid and important issues about the dishonest and problematic ways psychiatry is practiced in this country. As a licensed therapist, a “peer” who experienced my own full recovery 38 years ago and as a family member, I am so thankful for Robert Whitaker’s work. I am not alone.

  • Thank you for the reminder that our brains are both biological and a result of environmental nurturing and/or trauma. As I’ve shared on this site, I am convinced that one of my sons suffered neurological damage, later labelled autism and learning disabilities, as a result of the Phenergan I took for 5 months during my pregnancy with him for severe morning sickness. We need to remember the neurological harm from prescribed drugs and environmental toxins that may be a big cause of autism and many other problems in developing babies. We need to study environmental toxins as well as the deprivation, trauma and abuse that can also cause mental anguish and mental health conditions. Our biology and our experiences interact from day one throughout our lives.

  • Yes, unregulated capitalism is at the root of this. Corporations designed to make a profit above all else, willing and able to compromise public safety, honesty and all integrity to increase their bottom line for stockholders. Unfortunately, until we get corporate money and political action committees out of our electoral and governing process, we will see more (and even more) of the same. We have a rare opportunity to take a position on this very topic in the current presidential election.

  • In addition to the misinformation and propaganda promulgated by these Big Pharma screening tools, one of my biggest concerns is the issue of “medical neglect.” In my state as in many others, parents who refuse to follow their child’s school’s advice and have their child evaluated for a “suspected” mental health problem can lose custody of their child due to “medical neglect.” I have seen this happen several times and it is beyond wrong and extremely heartbreaking.

    It’s also important to realize that any time one of these screening tools or a “professional” evaluator determines that your child needs ‘treatment’ (ie: drugs) for an emotional difficulty that parents who do not follow this ‘professional advice’ are also at risk of being charged with medical neglect. Parents should be really careful when either agreeing to these pharmaceutically pushed screenings and/or to agreeing to any professional evaluation for your child. It’s critically important to find a professional, (if you ever feel you need one to advocate for services for your child or for any other reason) that supports a non-medicalized response to childhood difficulties.

    This whole situation is extremely concerning. Thank you Sera for a comprehensive discussion of a critically important topic!

  • I think you raise some important questions regarding the differences that get labeled ADHD and those that get labeled as autism spectrum disorders. Some people conceptualize some of the difficulties with learning and attention that get labeled ADHD as being one end of a long and varied “spectrum” of conditions that includes what gets called autism. The use of alcohol, crack cocaine, thalidomide and many other neurotoxins have been shown to cause neurological damage to fetuses in pregnancy. This research is solid. These neurotoxins have also been shown to cause attention difficulties and autistic like behaviors in experimental animals as well. While a warm and caring environment and capable, loving, attached parenting helps any child reach his/her potential and have a more fulfilled and well adjusted life, some developmental problems are clearly caused by physical harm.

    I don’t think this negates all the great points made on this blog about the harm of the medical model and the biased science sponsored by Big Pharma or other powerful and corrupting influences. The fact that physical harm may cause certain traits or challenges, such as behaviors that get labeled autism also does not deny how important a loving attachment to caring parents is for children or how much peer support, hearing voices groups, respites, good quality humanistic therapy etc etc can help us grow through and heal psychic pain. Beyond this, physical causes of certain developmental difficulties does not minimize the harm that trauma and neglect can also inflict on people. We are both nature and nurture and a complex interaction of the two.

  • Thank you again Sandy for this thought provoking article. I agree with your conclusion that all of us could benefit by respecting and listening to what each of us struggle with as we try to understand and support people in working through/living with psychoses and other extreme, complex, emotional/human experiences.

    I have my own lived experience of recovery dating back 38 years and have also tried to find my place working as a clinician/professional in the mental health field. I have been very humbled over time, especially in recent years when two of my four teenage/young adult children struggled through various emotional difficulties, one with an experience of what could be called psychosis. We were able to use a combination of individual and family therapy, time without labeling (tolerating uncertainty), meditation /mindfulness, minimal PRN meds and other supports to work through these difficulties together. Both of my adult children are moving forward and enjoying their lives at this point for which I am grateful.

    All of this has taught me to be more humble and to respect the complex and the known, theorized and as yet unknown things that may contribute to extreme emotional experiences. I also see how the medical model’s focus on diagnosing and medicating symptoms is very simplistic and often makes what is often both a painful and a mysterious mental health/existential crisis much worse. My questions, as yet unanswered by the field are:

    Do we know that (most) mental health diagnoses are valid?

    While medication addresses immediate symptoms, given it’s severe side effects, is it worth the risk?

    Might it be possible (yes, in my son’s experience) to come through psychosis or other extreme states with intense support and very little medication and may this have better long term outcomes?

    Once someone is on psychiatric medications when and how should they come off these drugs?

    My hope is that we continue to develop alternative supports that help with extreme states and work to answer the above questions. Too many times we may see our piece of the struggle, but miss others’ valid concerns. Thank you Sandy for once again reminding us that there is some truth in most of our questions and perspectives. Our work is not easy and I deeply respect the sincerity of all that post here at MIA. Thank you for the dialogue.

  • Thank you again Sera! Tolerating uncertainty is part of Open Dialogue and part of any humble, person-centered approach to partnering with/supporting people through/with various intense personal experiences. My hope is that we honor the time and space it takes for people to find meaning in their experiences, including voice hearing rather than asking the wrong questions and jumping to unsupported conclusions. Thank you for presenting this in such a concise and helpful way.

  • My heart goes out to you. I share your rage. One of my sons has a form of autism and learning difficulties that I attribute to my use of Phenergan for morning sickness for 5 months during my pregnancy. Pregnant women and all of us need to beware of using all of these pharmaceuticals. We are regularly misled and lied to by Big Pharma and other corporations.

  • Hi Paris,

    I appreciate how clearly you explain how psychosis can develop in people as a result of deep intra-psychic conflicts between an urge to be safe and connected and a competing urge to be free and independent. You describe how this may arise when parents are unable to provide authoritative parenting which is warm and loving and also encourages autonomy and individuation in children. Ideally parents provide both solid roots and strong wings to their children.

    I continue to wonder about other factors that may negatively impact families (parents and children) such as economic systems, (e.g. unregulated capitalism that puts profits before people), war, technology that is changing our connections to others in unforeseen ways, government spying and war which makes a certain amount of ‘paranoia’ almost expected, environmental collapse, unhealthy food, too many prescribed drugs, (especially when given to pregnant women or developing children) and religious or political fascism. While I highly respect and agree with your perspective, I have come to humbly appreciate the many complex forces that impact all of us as human beings. Existential stress is pervasive and can also contribute to psychotic crises for deeply feeling people. My hope is that we wonder together, create non-judgmental dialogue, tolerate uncertainty and give people experiencing psychoses and their families support and safe spaces to come through these challenging experiences. I think we, as professionals should hold our theories lightly and realize that there is great mystery in the human condition.

    That said, your theoretical perspective is such a rich, humane alternative to the disease model which reduces human pain, especially psychosis to a biological illness. Thank you for all of your time, sharing and research.

  • Sera,

    My heart goes out to you. Your experience with your son sounds a bit like my experience with my youngest son. He found that meditation really helped him with a school system (and world) that valued test results and did not usually, as we would hope, appreciate and nourish his gifts. He did not ‘fit in’ easily in middle school or most of high school. This was not an overnight success, but has really been helpful over the years. He is now in his first year of college and doing well.

    Best Wishes

  • I am not a doctor. I hear you and am sorry that things sound so difficult. I realize that if someone is on prescribed medications when they become pregnant that coming off the medications also presents a difficult process, so there are no easy answers. Having a doctor you trust, doing your own research and using as many alternatives to meds is my best understanding of what can help. Best Wishes…we all should be respected and believed.

  • I am in complete agreement with you that better parenting of all children should be high on any research agenda. I just don’t know of any research that shows that what we call autism is caused by (problematic) parenting. However, I agree that the label of autism may be imprecise or invalid and include more than one condition. My understanding is that what is meant by the label autism is something that probably includes neurological differences and damage. Given the skyrocketing use of medications during pregnancy and increasing environmental toxins and the growing number of studies that support these toxins as a cause of neurological harm to fetuses, we cannot ignore these results.

    I agree that no matter who a child is biologically, better parenting can only help. We are both biology and experience, not just one or the other. Do you have experience parenting a child with a diagnosis of autism? As someone who has long valued (and still does) looking at the environment (including parenting) as a possible cause for emotional suffering, I have found it quite humbling.

  • Other toxins as well have been correlated with the development of autism. I share these in response to my concern that some here are still suggesting that inadequate parenting causes autism.

    I fully agree that parenting and attachment issues are related to many mental health conditions including some of the emotional problems of children born with autism. However, to suggest that the developmental delays and extreme difficulties associated with a diagnosis of autism are caused by bad parenting is damaging and not backed by research.

  • Taking chemicals during pregnancy should be a last resort. Multiple studies associate the use of anti-emetics, anti-depressants and other medications for other concerns with autism and other fetal damage. Suggesting that autism could instead be related to parenting or other factors is denying the obvious and is both misguided and very damaging and unfair for these parents as they work to help their children overcome the obstacles posed by neurological damage. These chemicals very likely damage developing fetuses and are rarely worth the risk.

  • Hi Paris,

    Thanks for your response. I agree with your theory about how early attachment and later individuation probably plays a pivotal role in the development of psychosis for some people.

    However, I encourage you to be careful about making comparisons or overgeneralizing about what I believe are both very broad and very different types of difficulties – “schizophrenia” and “autism.” I see these two labels as similar in that they are both labels that may reflect conditions that are diverse with varying causes and treatments. I also share your concern about the reductionism associated with the disease model of mental health conditions and think that trauma and attachment difficulties are often a big cause of emotional suffering.

    I also shared in a previous post that my son, who has what has been called mild autism experienced psychosis and came through it with no neuroleptics or hospitalizations. Instead, our family used an Open Dialogue informed approach and advice and support from all of our trusted friends, including you to move through this difficult time. Your advice about honoring my son’s existential questions and his need to individuate were very helpful. You reminded us, his parents to support his individuation. Through Open Dialogue many family dynamics were put on the table and addressed.

    Yet, I believe that his emotional pain and psychosis also related to his trauma and extra challenges in life which relate to what has been called his “autism.” As a child, he frequently misunderstood social situations, retreated into his own world to cope, experienced bullying and overwhelming feelings of inadequacy in a world that often rejected his differences. He continues to work to individuate and have all the things his brothers have, a girlfriend, a full social life, meaning and independence. None of these things come easy for him.

    I would be very careful about comparing the label of autism to the label of schizophrenia, although I think both may be invalid. Schizophrenia may represent a large group of experiences related to adjustment and finding one’s place in the world as you suggest. However, from all of my heartfelt reading and research on “autism,” I have come to believe that it may be explained on one end with individual differences and eccentricities and on the rest of the continuum as neurological damage, often dating back to prenatal exposure to toxins. I am pasting an article from MIA which shows one such possibility. There are many more. The medication I took for 5 months for severe morning sickness with my son, Phenergan, is a type of neuroleptic known to cause neurological damage in fetuses. Had I known this at the time, I would have done anything to avoid this risk, something I was able to do with my later two pregnancies. Thus, research is showing more and more how toxins, including the skyrocketing use of pharmaceuticals during pregnancy probably account for much neurological damage and the dramatic increase in autism rates.

    While we explore the psychodynamic roots of mental health conditions and extreme experiences, I think we should remain humble to the very real differences in possible causes of various conditions. We must be very careful not to suggest that parenting causes conditions that likely have a basis in exposure to toxins, such as autism. Antidepressants, neuroleptics and other drugs, including Thalidomide, used during pregnancy (see article below) have all been implicated in the development of autism.

    Yes, each person must grow and does face the same challenges to individuate and build a life. Yet, having a condition similar to what we now label autism makes things much harder for individuals and their families and is not necessarily related to attachment issues.

    Thanks again for your work Paris

  • Hi Paris,

    Thanks again Paris for sharing your thorough and compelling conceptualization of family dynamics and the development of psychosis.

    I am wondering how you would predict young people who have difficulties associated with (mild) “autism” would vary from others without this challenge, according to your theory? It seems that having developmental challenges could add tremendous stress for young adults and that for them the world may be confusing, unwelcoming and unsafe in many ways, not only because of family dynamics and other factors, but because living in society, individuating and connecting to others is much more difficult for them.

    My guess is that developmental difficulties would make the tasks of individuation and autonomy more complex and may increase the chances for the development of psychosis or a related experience. Feeling safe and having a sense of belonging are much more challenging for young people who find connecting to others so arduous.

    Thanks for your work.

  • Paris,

    Thank you for this history and analysis of the family’s role in extreme experiences. One of my sons went through a 2 week extreme experience 18 months ago using an Open Dialogue approach. He has not returned to this difficult state which seemed to have been related to extreme worry and stress, a history of bullying, parental divorce, difficulties related to some developmental challenges and severe existential concerns. You helped me with some suggestions at the time and I will be forever grateful for your support.

    I agree with you that family experiences and dynamics are a big factor in the development of psychosis and that they need to be included in our understanding and response to these experiences. Furthermore, trauma is pervasive and come in many forms, often beyond the nuclear family. I am convinced that trauma in all it’s forms must also be considered as a cause. Beyond these, development, growing up and life itself are difficult. Psychosis may be an attempt to cope with and make sense of something beyond comprehension.

    Your work is so important. Thank you

  • Therefore, CBT or other types of psychotherapy are clearly far superior to drug treatment which comes with cumulative and damaging side effects. In many cases, therapy is even a less costly treatment. Regardless, the harm inflicted by the neurological side effects of antidepressants should pretty much rule them out as a viable treatment option at this point, given that psychotherapy works just as well with no side effects.

  • Sera,

    Thank you for writing this article. After over 30 years working in this field and as a person with lived experience of recovery, I have come to two big questions and I tend to agree with your assessment here. One, “Are psychiatric diagnoses valid (at all?)?” And two, ” Does labeling someone with these diagnoses cause harm?” My answers have left me looking for ways to practice what I know in the small cracks and alternative spaces in our current mental health system. Your article validates my experience, helps me feel less alone and gives me hope.

    All the best to you.

  • Thank you for this thoughtful article. My hope is that we always assume that there is meaning in our own or others’ existential and emotional suffering. Then, as individuals or as supporters of others we can seek to help understand or ease the pain. Calling something an illness or a disease without evidence of such is invalid, damaging and irrelevant.

  • Thank you for your comments.

    I took Phenergan, (only 1/2 the dose) for severe morning sickness (kept ending up in the hospital) for 5 months during my first pregnancy. I questioned this treatment but was reassured that it was safe although I have now learned that it was a Class C drug. I was not offered the non-drug alternatives that I found for my second and third pregnancies. My oldest child was diagnosed on the “Spectrum,” when he was very young. I am convinced his difficulties are the result of this drug but I am so frustrated that so little research exists. I also wonder if what we call the Autism Spectrum includes a wide range of conditions including natural personality differences to severe neurological harm. We know that the babies who’s mothers took Thalidomide (and who had their limbs), ended up with a much higher rate of autism.

    Thank you for your interest in this. I hope we gain attention and support to draw awareness to the risks of prescribed meds during pregnancy.

  • Open Dialogue worked well for my son. 16 months later he is in college, in therapy, took minimal meds for a few days during the crisis for sleep and is now doing well. Dialogue works! My hope is that there will be funding for research on Open Dialogue and Need Adapted Treatment. Open Dialogue does not support the interests of the profit driven, medical model approach for early episode mental health services. Thus, industry money will not be supporting research on these approaches. But, they work.

  • One out of forty five children now have autism. I strongly predict that this increasing rate of autism is partially caused by increased pharmaceutical use by pregnant women. I doubt there is much research funded to test for harm caused by drugs given to pregnant women. Even Thalidomide given to expectant women was exposed for its harm with great resistance from the drug and medical industry. We are letting corporations have more and more (and more) power over our medical research, which is no longer based on sound science. We are harming babies and the entire population with profit driven healthcare.

  • Nick,

    I am not trying to point the finger at you. Sorry if it felt that way.

    I should have used the term “traditional” religions. Do you know of any world religions founded and led primarily by women?

    Regarding medical research, if we are devoting more funding to one rather than the other, this should be corrected. I actually have heard the opposite about research funding being more directed toward men’s health concerns, but I have not researched this and if there are inequities that favor women, they should be corrected.

    I have privilege in some areas, but I don’t agree that being female has been a privilege from a systems point of view. Overall, my understanding and experience is that I have been denied opportunities and respect in areas because of my sex.

    My understanding is that men own most of the world’s wealth, and retain dominant power in most governments. Are you saying that these structures are shared 50:50?

    To be clear, I don’t blame individuals, you or me, for systemic prejudice. However, the systemic differences exist and should be corrected.

    I hope for a fair and equitable world for all,


  • Nick,
    The things you mention do not undo the systemic misogyny that exists across all religions and cultures. I agree though that there are ways that boys and men suffer systemically (and war and circumcision are two examples). Men also have pain. Life is not easy. The other things you mention though suggest that you may be coming from the expectation that men should be dominant and anything less shows that men have no privilege. I would not agree that these examples show a lack of systemic sexism, but only that women are making progress toward equality in some spheres. Beyond this, commenting about women’s healthcare completely ignores the fact that your mother and mine gave birth which explains the healthcare cost differences between men and women and certainly is not something for men to use against women. My hope is that you can acknowledge what Sera has mentioned about systemic misogyny and not see it as a position that denies male suffering. Both can be true.

  • Hi,

    I think asking the question is an important first step and still more than many men ask who may not see the problem or their place in making things better. I think Sera outlined many steps that men can take including giving credit for work done by individual women, not interrupting when a woman is speaking, not taking advantage of your hidden privileges at the expense of women and calling other men out when they do.

    Many of these privileges are built right into our structures, so listening to women and educating yourself about what needs to change. For example, when I married my children’s father, we both talked about our family’s surname, and we actually decided to add a new name which had meaning for us, which then would become our children’s surnames. We did not just fall back on patriarchal tradition. I have found this sort of openness to systemic change very lacking and quite refreshing.

    Challenging religious structures, for example calling out the recently popular Pope for what continues to be deeply imbedded structural patriarchy, rather than idealizing him for some of his more progressive statements that actually contradict the misogyny he perpetuates (calling for human rights and an end to climate change, while denying women power in his church and the rights to birth control…a human rights issue and an important element in family planning which is directly related to population control and human caused climate change).

    Thank you for the question. Men have largely been missing from the women’s movement and my belief is that those with systemic power must work even harder to right what is wrong. We all have work to do 😉

  • This is how I understand the distinction between abuse vs. systemic inequities. The abuse of power can happen in a moment or over time between two individuals or in a family or other group, especially when some have more power than others. Systemic oppression happens in an entire civilization over centuries. We have all been victims of the abuse of power at times. Depending on our race, sex, gender, class etc, we have also been the victim of systemic discrimination and/or the beneficiary of invisible privilege. Alex, I don’t think any of us think abuse or systemic oppression are ever ok. They are different though in structure and magnitude. Sera has reminded us of the pervasiveness of systemic misogyny in this blog.

  • While I agree that the use of the word emasculating is itself based on sexist reactions to women’s power and assertiveness, I would agree with Alex that human beings can oppress others. Mothers can abuse or oppress sons who can grow up and use systemic sexism to subconsciously get back at the females in his life who may have abused him. I think any justifiably angry group (as Sera pointed out) can scapegoat a person of the dominant group instead of addressing the deep systemic oppressions. Individuals can be hurt unfairly for the wrongs of the group. For example, a man with a female boss may be mistreated due to her deep anger at men. However, systemic sexism favors men; patriarchy is alive and well. I hope we stand collectively against all forms of oppression and unfairness, including misogyny.

  • Richard,

    Thank you for pointing out the importance of choice over one’s body and reproductive decisions. This continues to be left out of so many human rights discussions but is a critical foundation for women’s rights. Traditional (misogynistic) religions continue to perpetuate these reproductive restrictions on women. Thanks again!

  • There is so much that can be said here about male privilege. I know that many men who are part of our community try hard to be free of bias. Yet, just as I, a white woman, carry white privilege and many blind spots toward racism, well meaning men do the same. Through honest and respectful dialogue, we all have much to learn about each other’s experience.

    We have been socialized from childhood to unconsciously accept women’s subordination. Women are still expected to give up their surnames upon marriage to men or come up with another plan agreeable to their husbands. Men rarely share this dilemma or the difficult decision about what surnames to give any children they have together. Most major religions treat women as second class members. The Catholic Church will not allow women to have leadership positions, nuns cannot own property while priests can and birth control and a woman’s right to choose are opposed. Traditional Judaism and Islam both keep women in subordinate positions. Religions enforce misogyny while still being allowed tax-free status in this country. “Sports Illustrated” devotes an entire issue each February to showing women in skimpy swim suits as if it’s a sport to objectify women. I could go on, but my point is that these misogynistic structures exist all around us. Both men and women are taught that women are objects for men’s enjoyment and that women are not worth as much as men. So it is not a surprise to me, that our movement is also affected by misogyny.

    My understanding of Sera’s article is that we, as a human rights movement still have our own internal issues to address. I agree with all of her points and hope that we can all work toward a community free of sexism, racism, gender stereotypes, classicism, homophobia etc. Thank you for this rich discussion.

  • Hi Tina,

    I agree that addressing misogyny must involve the whole picture and is not a woman’s issue. As a feminist and a woman, I don’t feel comfortable creating an us and them. If people from any sub-group including women want to gather and support each other, that should always be fine, but in the end, my hope is that we will see that we are all made of the same stuff, female, male, black, white, LBGTQ, religious, spiritual but not religious, atheist…we are all capable of love, hate, kindness, causing grave harm and bringing people together. Power must be shared for all of our voices to count equally. For that, those with more power and privilege carry more responsibility to step up and change systems. Men have a lot of work to do to stop misogyny.

  • Thank you for your time and wisdom. Misogyny is so built into our society, families, religions and history that we may not remember to be vigilant. I agree with you 100%. My hope is that we all remain humble as we move forward and realize that we all have blind spots based on our life experience, sex, race, culture and privilege. By listening respectfully to each other and truly valuing lived experience we can overcome anything. Thank you Sera for this powerful reminder!

  • Thank you for this analysis and your call for both humility and more research. As someone who is familiar with RAISE and with OnTrack NY and as a mother of an adult son who came through what could be considered a psychotic episode about 16 months ago using an Open Dialogue informed approach, I can attest to the fact that these two models are quite different. Open Dialogue does not presume to know what we do not. I am concerned that the acceptance of the medical model by most first episode initiatives is driven by politics and industry sponsored science and will limit what is possible. I am thankful that my son had the opportunity to be treated by a psychiatrist trained in Open Dialogue and that he was able to move through his experience with very minimal and temporary use of medications, in his case just to help him re-establish his sleep cycle. Sandy, as always, thank you for your clear analysis and courage.

  • “Science” is not science when it is paid for by those who stand to benefit financially from certain results. This problem goes way beyond mental health issues to healthcare itself and beyond that to our corrupt economy and political system. Our government and regulatory agencies are dominated by corporate influence. I think we need to overturn Citizens United and take personhood status away from corporations. Then and only then will our voices have political power and our government be a democracy.

  • While I agree that “mothering” is vitally important, I wonder how much more secure and well adjusted children would be in a society that gave both parents the status and support, paid family leave, free healthcare and other resources necessary to devote the time and energy needed to raise the next generation. Our world is still a patriarchy with women left to do the lion’s share of the unpaid, low status work of childrearing without adequate resources, including shared parenting from fathers who are also stressed by work and other societal demands. Patriarchal society is oppressive and traumatizing by definition and may be a big cause of the pain suffered by our children.

  • Hello,
    Thank you for your moving account of your family’s commitment to avoid unnecessary medications for your daughter. I have had a similar struggle in my family and worry about all those families who may not have the resources, knowledge or determination that you have. This article will help many others understand what’s possible. Best Wishes to you, your daughter and family.

  • Thank you Elizabeth for sharing your brave journey. Your story and those of others need to be shared to challenge the state of psychiatry. Force is always traumatic. Passages, such as yours and many others I have known are varied and powerful and deserve more reverence and humility. I am not romanticizing the pain, fear and mystery that comes with what is called psychosis. But, the way our mental health system responds causes much trauma and pain of its own and must be exposed, challenged and changed. Thank you for sharing your story. I look forward to your book.

  • Yes, everything you mention should be tried…for months in most cases…before any meds are recommended…and then they should only be prn’s or used with the lowest doses for as little time as necessary for the most serious difficulties when there are no other options…for example, to help someone get to sleep when all natural alternatives have not worked…Staying calm and trusting the process of development is most important! I have seen my kids shift and change through stormy times, including what could be labelled ADHD, psychosis or depression in three different instances…Heavy diagnoses and drugging would have prevented their development…all four of them are all doing well as older teens and young adults and have moved through these times of turmoil with good (individual and family) therapy, learning to meditate, reading books on self-help and the meaning of life and with time and good friends…and the process continues…

  • Thank you for another powerful challenge to the dishonesty of modern psychiatry. I wonder if this is not only related to psychiatry as a field, but to the way medicine and science have come to be practiced in our capitalistic economy? As much as I agree with your summary and rebuttal of Pies claims, I see him as an example of a system that rewards dishonesty as long as it brings in research funds, status and career advancement. This must be related to our economy which rewards those who help big business bring in profits and shuts the rest of us out. Thank you again Bob!

  • David,

    Thank you for this article and these five reasons to say ‘No.’! I will take your advice…I think that each of us has many opportunities each day to make enlightened decisions that make a difference…I am amazed at your energy…(some day I hope to find the time and energy to write an article for MIA!) You point out the elephant in the room…So called “normal” is NOT working and nothing for us to aspire to…we need “out of the box” transformation!

    Thank you again,


  • Corinna,
    Thank you for sharing what you are going through…As with many other friends and peers, I am in your corner. I have always believed that meds can be a helpful tool, as long as we are given accurate information about their benefits and drawbacks. The system is a big part of the reason people don’t ask for support when they need it…as you said, One act of coercion can keep a person from ever seeking services again…My belief is we need an approach similar to Needs Adapted Treatment or Open Dialogue that respects the process, tolerates uncertainty and keeps the person of concern in the driver’s seat of his/her life and decisions…Your sharing is so brave and so helpful to all of us…rest and be well…we will be thinking of you

  • Thank you Philip for this thoughtful and clear analysis of Dr. Lieberman’s shared experience with his son. I am always searching for “common ground” and your points suggest that he actually agrees with much that we post about the problems with psychiatry as it is practiced today. Too bad he said such a horrible thing about Robert Whitaker…just so unfair…

  • This sounds like a great meeting. I agree that using dialogical practices and values can begin a meaningful and powerful process, even when we are not adhering to a specific model. I have found this to be true for our family as we worked through a 2 week period of what could be called “psychosis” with one of my adult children 14 months ago. He has continued to stay on track in his life with no further periods of extreme states, although we have continued to communicate and evolve as a family. In addition, I have found dialogue to be very helpful in my professional work with young adults having their first episode of difficulties and with adults who have become very stuck after decades in the system. Concepts such as tolerating uncertainty, listening to each and every perspective and continuing to work day to day through immediate needs without making assumptions about the future have helped in all of these situations. I have come to believe that we have done much harm as a field by assuming we, as helping professionals know more than we do about the causes, course or treatment of mental health difficulties. By remaining humble, supportive and open, we have much to learn from each other, especially the person at the center of concern.

    Please let us know how more of us can become involved in any future meetings.

    Thank you for sharing and for all of your contributions toward a more hopeful way of responding to extreme emotional distress.

  • By concluding that “committing a crime that is sufficiently horrific one deserves to forfeit one’s life” aren’t you putting us in the very same position that a person does when he/she takes another’s life? We are deciding that killing someone is justified…something I find by definition violent, insane, uncivilized and horribly flawed as a response, especially by a rational government. Murder, whether carried out by a desperate individual or the state is an act of insanity and always a result of individual and/or societal illness…

  • I have shared my feeling that the Phenergan I was prescribed for 5 months during my son’s pregnancy for severe morning sickness ( that landed me in the hospital with dehydration ) caused his developmental/neurological/spectrum issues…This study confirms what I already feared….it makes me sick that any woman of childbearing age does not know the effects of these drugs on her baby…I found out later that there were non-drug alternative treatments that I was not offered…that I used successfully in my second and third pregnancies…This sickens me…thank you for getting the word out to people.

  • I am a Licensed Mental Health Counselor, a person with lived experience of my own recovery as a young adult and more recently the mother of a young adult who came through some difficult, existential experiences last year without the medical model. I share a similar lonely path and also find refuge here at Mad In America. I think we need to continue to come together and build humanistic supports that ask, “What is happening?” and “What has happened to you?” rather than “What’s wrong with you?” Thank you for your perspective and for taking the lonely path…you are not alone…

  • I am glad that you are not blaming yourself for your pain…Life is hard and I believe that healing and growth take as long as they take and happen in many different ways…mental health providers should be humble…life is a mystery and mental anguish always deserves respect and patience. No one can claim to have another’s answers…we can only accompany others on their paths so they are not alone…wishing you peace and healing…

  • Humility, tolerating uncertainty, remembering all the ways researchers and all of us have lost our way in the past…these are all critically important as we move forward. Thank you for reminding us that we all have blind spots and can easily fall toward selective attention and interpretation. I think honest, critical, scientific research and dialogue will keep us on track…thank you for your reflections…I believe that we all have blind spots and “it takes a (scientific and courageous) village.”

  • Ron,

    I completely agree. When we define normal within a culture that is destroying its own planet, we have a big problem. The canary in the coal mine is the first to pick up on problems there just as those of us with a history of mental anguish are this first to notice that something is amiss in our lives, our families and our societies…it would be great to value this feedback rather than dismiss it as an illness!

  • Paris,

    Thank you for sharing this powerful and inspiring perspective about the human experience of ‘psychosis.’ My young adult son went through this experience about one year ago. He experienced an altered, extreme state for about 2 weeks, but came through it with 24/7 home respite. He has successfully continued in college this past year. We used an Open Dialogue informed approach, very short term meds for sleep and ongoing dialogic therapy. Your words of wisdom then and now helped us find the strength to trust the process. He has continued to grow and change this past year and I agree that there is deep transformative meaning in what gets called psychosis. In particular, he has been very focused on the concepts of connectedness, finding existential meaning and on developing a way to understand and ease the suffering that is a part of our world.

    Thank you for your wisdom.


  • Evidenced Based Care would be great. Will this be the evidence found by Harding, Wunderink and Harrow about how the long term use of psychotropics is associated with less recovery? Will this evidence base include the fantastic results obtained by Healing Homes in Sweden and Open Dialogue in Finland? Will this evidence base be based on research free of the corrupting influence of Big Pharma sponsored research? Will this include the evidence base for the value of peer support and respites? Finally, will this evidence base include the evidence about how important self determination, shared decision making and having a voice is in recovering from emotional suffering, suffering that frequently has it’s roots in histories of trauma, neglect and other adverse life experiences?

  • Thank you for this response to what I found a very disturbing article in the New York Times implicitly encouraging the use of meds. while pregnant in my opinion.

    I have mentioned many times that I feel that my young adult son’s difficulties dating back to his early childhood, which have been diagnosed as autism, are related to the Phenergan (used to ‘treat’ my severe morning sickness) I took while expecting him. I cannot tell you how much I regret that I followed my doctor’s advice about this. I found out – with my other two subsequent pregnancies – that there were many options that were not mentioned or tried with my oldest son’s pregnancy. These alternative approaches prevented me from using meds for these two following pregnancies. Medications always come with side effects and they often do not treat the underlying conditions very well, especially with anti-depressants. Discontinuation syndromes are real and often account for the effects of reducing or coming off prescribed drugs. Any and all alternatives should be used before meds, especially for pregnant women.

    Thanks for this article.

  • Kermit,
    Thanks for bringing up his history of trauma, bullying and other interpersonal pain. The medical model causes harm in many ways…first by labeling people with a disease and disregarding the complex, meaningful story of their lives…this happened to me when I was hospitalized as a 17 year old…it was confusing, unhelpful and harmful to me and my eventual recovery…I agree with your point that John Nash may have been up against some powerful oppressive cultural forces that would have only added more pain to his life, in addition to a mental health system that probably further harmed him…so sorry we have lost him in such a tragic way…

  • Thank you for this article. As I’ve re-read much of what was published about John Nash in the 90s and since, it is amazing how often the truth has been twisted to support the medical model perspective of his life. This, even though his recovery actually supports another more humanistic and hopeful perspective, one of moments of extremely difficult life experience followed by full recovery without a lifelong dependence on meds. I wonder how much the hospitalizations, meds and ECT actually delayed and interrupted his eventual full recovery.

  • Thank you for your post! I agree with your points, especially the idea that providers underestimate and just don’t know how many people labelled with psychosis go on to have robust recoveries…

  • Thank you for participating in this research and sharing your APA experiences here…I feel that the tide is turning, ever so slowly, but in all my years in the field, I feel that a shift is finally gaining momentum. I give tremendous thanks and credit to people like you, Rob Whitaker, Dr. Moncrieff, Dr Middleton and hundreds of others here on this site…

  • Thank you for posting this study. I was prescribed Phenergan for 5 months during my pregnancy – from month 2 to month 7 – with my first child who was diagnosed with “high functioning autism.” I believe that this drug hurt his developing brain and nervous system. I hope someday our FDA really protects us as it should from known and unknown dangers. Drug companies literally cause unbelievable harm and suffering in my opinion in their pursuit of profits.

  • I have found great healing and support from several therapists over the years…those who were humble and willing to share a bit of their lived experience with me at the right moments helped me most…and that includes therapists who shared their joys and struggles raising their children…as a parent, I have found it my greatest honor and challenge to support my children in growing up and having the best foundation possible…the therapists I have had who were also parents helped me the most with my commitment to be my best as a parent and as a person…I think that there are many different perspectives that all have merit…best wishes Daniel…I admire your contributions which have exposed trauma and hypocrisy in psychiatry , your work sharing what actually helps people, your honesty and your integrity…

  • Thank you Sera. I could not agree more! I have heard many in the advocacy world speak about how we will be less effective as a movement if we spend all our time arguing over “semantics” rather than finding our common ground…Well, my ground starts with who we are and what has happened to us. We are people living our lives and reacting to trauma, stress and a sometimes very difficult world. The term “mental illness” and the “disease model” are front and center when it comes to systemic oppression and untruth. I stand with you in your quest to be heard and fully respected. Language is extremely important in our movement. Thank you once again!

  • I am concerned that this is just the tip of a very huge iceberg. Our science and governmental regulatory agencies are so corrupted by the involvement of corporate money in scientific research, the drug approval process and the practice of psychiatry and other branches of medicine that we must all be on guard. I have learned the hard way that we cannot trust what we are told is safe.

    We need to get corporate PAC money out of our democratic process if we hope to begin to correct this huge problem in our democracy, our regulatory systems and our science.

  • Thank you for this Daniel. We have been able as a family to move through two difficult periods with my son, eight months apart, following all of your guidelines…The second experience was less intense and we have all learned together how to navigate through these existential rough times…it was not easy though and resources are very hard to find in the US. We have been lucky to have the support of an Open Dialogue trained psychiatrist and an open minded therapist…we need much more though to really provide support to people when and where they want it…

  • Yes, medicine is another big business…I worry that the practice of medicine, including psychiatry in the US is extremely biased by special interests…”scientific” medical research sponsored (in any way) by private interests is by definition compromised…

  • Although I am not a proponent of the medical model and feel that many non-medical approaches work best when it comes to mental health concerns, I am struck by the difference in payment to a psychiatrist vs the payment to a medical doctor in another field of medicine. Psychiatry and alternative mental health services seem to be devalued across the board. Interestingly, psychiatric medications are right up there in cost with other meds. and are industry leaders in terms of profit for Big Pharma…I have to wonder if this whole thing is rigged…our culture creates mental dis “ease” and then we support big profits for those who provide a quick fix and a way to muffle our suffering…

  • I am a peer-clinician and agree that it is critically important for peer staff not to be controlled or disrespected by clinical staff; power must be shared always and people being served should lead the way…my hope is to have something like you describe…a range of services and supports for people so they would never end up in an ER or a traditional psych hospital..but have alternative, humanistic, peer-professional support in whatever setting they want and need…

  • I appreciate this article and peer respites!

    I wonder if the effects, both physically and psychologically of being in the system, medicated, given labels etc don’t create very complicated pictures for the people who may choose to use peer respites…I wonder if we should add services to the respite, perhaps a medically supervised detox unit for people who are reducing meds. , including PRN meds, Open Dialogue and trauma informed professional and peer support to give people all that they need to move through their crises? I am in no way advocating for forced treatment or coercive services…I wonder if more people could benefit from a wider array of non-hospital alternatives…14 days of peer support is not enough time for those guests who are in recovery from decades of unaddressed trauma, meds, forced hospitalizations and labels…

    Thank you for your work and for sharing it with us…

  • Carol Munter and Jane Hirschmann wrote a great book years ago called “Overcoming Overeating” that helped me with my difficult binging and dieting patterns at the time. I have also found Geneen Roth’s books very helpful…I am glad that I stayed away from meds.

    Thank you for your sincere, honest reflections Sandra. I wish we had more psychiatrists like you:)

  • Hi,

    I have mentioned our experience with my son last summer before…after he went 5 nights without sleep, we spent two weeks supporting him through what he now feels was an existential crisis that could also be called ‘psychosis.’ I am happy to report that he continues to do fine…he now wants me to mention our experience in my work so people “know that it is not a brain disease.” Although we did not have access to a full Open Dialogue model, I am familiar with the model and have studied alternatives for years…Keeping him out of the hospital and the system was my biggest motivator…we found an Open Dialogue trained psychiatrist and got through the two weeks he spent feeling very distressed.

    It works…People can and do go through extreme experiences without neuroleptics…he used a few nights of Benzos to get back on track with his sleep and that was it…eight months later, he is fine, doing well in college and I am so relieved that he stayed out of our psychiatric system…

    Thank you for your article!

  • Yes, I have seen firsthand what you refer to…What gets labelled psychosis and becomes a disease is a human experience that means many things but is often part of person’s journey…the medical model locks people into labels and diagnoses when they are most vulnerable….this is wrong and often has tragic consequences…We need to rethink psychosis…and at least be honest with what we do and do not know….the human experience is complex and extreme experiences are to be expected especially in light of today’s world…

  • I just watched the evening news, first of which I consider hopelessly biased by corporate sponsors…most commercials are for drugs. The news presented is horrifying with little real analysis and even less to feel hopeful about in our world…We hear a one sided explanation with the conclusion that we need “a more aggressive response to the threat”…meaning we need to bomb our “enemies” so they quit killing us….I am feeling very hopeless about this whole picture, you could describe me as having any number of psychiatric symptoms…anxiety, depression, insomnia…yet, I refuse to believe that I have anything close to a brain disease…we have a world full of pain, confusion and what I consider delusional thinking and I am having a rather normal human reaction…

    Thank you for your article Robert! We need to inject some sanity into psychiatry…and hopefully our world. Instead of taking our “soma” let’s talk, listen and deal with the world’s pain and quit making it worse…

  • Drug companies are always looking to expand their sales…I recovered from a very serious eating and sadness “disorder” as a young adult by learning how my behaviors were a way to manage the pain of my life…I used Geneen Roth’s self help book, “Breaking Free from Compulsive Eating,” and overcame my binge eating problem over 30 years ago…I shudder at the thought of taking a medication to solve what, at least for me, was such a complex, human problem…drugs cannot fix most things…they can speed us up, slow us down and cover our pain…but they can never help us heal or transform or grow…living, finding support and the right kind of ‘help’ and hard work are required for those things…

  • Thank you for your thoughtful comments. I have also known many people who have felt harmed by religious dogma and its impact on cultures and legal systems. As a non-religious, but spiritual and kind (I try anyway) person, I have felt unfairly judged by people who claim that they are following God’s laws when I am just operating on the human level. I find it very difficult to have a rational discussion that keeps us all on the same playing field. This is why I feel we need to keep a separation between religion and a secular state (Church and State). I know that we are all sincere people here, but we are speaking from different paradigms. I feel as spiritual as the next person but I do not claim to know what God would believe, because I do not see things in this way…my hope is that we create a safe space to disagree, but laws that protect everyone’s civil rights and equality…and that brings us back to MIA and our shared quest for human rights and dignity for all..

    Wishing us a peaceful meeting place,
    Thanks again for the discussion.

  • Ron,

    Thank you for this. Thank you for honoring Leonard Frank and his struggle and what he gave to us. I agree that life, the search for meaning, psychological pain and angst are not predictable, tidy pursuits. We need flexibility, respect for the person and the process, patience and humility…you speak so eloquently about this and I love reading your work.

    As I have shared several times on MIA, (with my son’s permission…he wants people to know that “it is not a disease”) my 19 year old son went through a 2 week extreme experience/state last summer…Although there is no Open Dialogue program here in the NYC area, we worked with Nazlim Hagman, a psychiatrist in the City, trained in Open Dialogue. She helped us create an Open Dialogue informed approach. More than anything she stressed that we needed to respect that my son was in the driver’s seat, that he could find his way through this and she encouraged us to tolerate uncertainty, while also staying close, connecting in simple and sincere ways and keeping him safe…and for me, a psychiatric survivor myself, keeping him out of the hospital and out of the system was a big part of keeping him safe. I could not bear the thought of having him forcibly medicated or worse in the hospital. He came through and feels that he grew from the experience. He is fully living his life and doing well 7 months later.

    I have read your book…you are one of many pioneers and survivors, like Leonard Frank who suffered greatly, told the world about what happened to you and have paved the way for something different, something like Open Dialogue for others. Your brave sharing helped me find other ways to understand and support my son through his experience. For that, I am eternally grateful to you.

    Thank you for sharing your deep respect and memories of Leonard Frank with us. You have given more than you know.


  • Thank you once again for taking the time to write back. I appreciate your well written and kind response. I read the article that you attached as well.

    For me, I cannot accept any doctrine that denies women access to birth control and formal power equal to men. I also cannot accept gay people being denied equal rights…(regarding the spread of HIV/AIDS mentioned in the article as associated with gay behavior, I would note that lesbians actually have the lowest rate of HIV/AIDS of any group of sexually active adults). Just because something has been practiced one way for a long time does not provide reason enough to continue the practice if it hurts people. For me, secular humanism is a good fit.

    Best Wishes to you and your family. I too deeply value our community and opportunity to dialogue at MIA.

    Thanks again

  • James,
    Thank you for your sincere and thoughtful reply.

    I am glad you find benefit from your Catholic faith. But, as an example of religious oppression, how do you reconcile your religion’s attitudes toward gay marriage, birth control and the full equality of women? These are examples of what I find oppressive about organized religion…and I wonder how you would think I might be “unfairly propagating” negative attitudes by bringing these things up…

    My daughter’s friend recently asked her priest, during first communion classes, why women were not allowed equal rights in the Catholic Church and why they could not become priests. She was sent to the back of the sanctuary for asking such a question. No answer was given other than she should know not to ask “a question like that.”

    I cannot feel good about these things, but feel good about human community and groups of people coming together to create a spiritual sharing…

    Thanks again and all the best to you…

  • Hi,

    I like your article, but take exception to some of your comments about declines in faith based organizations as one cause of the increase in mental health difficulties….I think it’s important to separate the benefits of connection and community from the problems of organized religion and many of the harms it can cause. I have always felt alienated from the idea that a group of people must all share the same religious beliefs, the same beliefs as their parents and their religious community…this feels oppressive and leaves little or no room for free thought. In addition, religious dogma often leads to conflicted and guilt ridden people who struggle to accept aspects of themselves forbidden by their religion’s “God.” Most religions are very judgmental and separate the good from the bad, the holy from the sinners. This type of thinking prevents the type of honest, reflective soul searching that humanity needs to understand our impulses for love, for hate, for peace or for war…Writing someone off as ‘evil’ or a ‘terrorist’ asks little of us and sets us up for continuing cycles of pain as a world community.

    However, the benefits of feeling connected to a community and something beyond oneself is powerful and the part of organized religion that may explain the positives you refer to as associated with religious communities…I think it is very important to distinguish between the oppressive and “us vs them” elements of religion and the benefits of community and connection to the mystery and wonder of our existence.


    A spiritual person and “non-believer”

  • Bob,

    Thank you for this update. I have had many conversations with colleagues about the validity of the term mental illness…what it means and whether it is valid or helpful…this information will help me explain my concern about illness labels and how our medical model, corporately owned system actually creates much of what is perceived as a medical (mental) illness…

    Your work has given us a firm foundation upon which to stand as we speak truth to power. This community is where I turn for both information and support.

    Thank you,


  • Bob,

    Wow, I completely agree. Psychiatric drug use should be looked at through a similar lens to illicit drug use and/or alcohol abuse…providers often give these drugs out as a first line treatment with little discussion of side effects or the exit plan…and the field of psychiatry has not even adequately studied the withdrawal process from psychiatric drugs…often the rebound psychosis or discontinuation syndrome is interpreted as underlying symptoms of “mental illness”and a reason to keep people on these drugs…sometimes for life…

    Great article!


  • Hi,

    Thank you for sharing your story as a mom…I am so glad to hear that your daughter is doing much better. I am curious if you ever tried an Open Dialogue approach with your her during her extreme experiences? This worked with my son last summer and he came through his extreme state after a few weeks…It was one of the most humbling, difficult times for me as a mom…. I am thankful that he is back on track and continues to be fine and seems to enjoy college. I understand how hard these experiences can be and my heart goes out to you as a mother.

    I also wonder if the traumatic hospitalizations and medical model treatments don’t worsen and create many of the problems that people experience. My hope is that we build more true, non medical model alternatives…such as
    Open Dialogue in the US.

    Best Wishes to you, your daughter and your family

  • What is the best way to reach you? I (with his enthusiastic permission) am actually sharing his story at the ISPS Conference in March. Will you be there? I would welcome the opportunity to talk about his experience anytime. I have long felt that the “Clinician’s Illusion” is keeping the real ‘data’ from full view…people who have had robust recoveries often do not talk about it and/or are discounted as not ‘really sick’ by the establishment. But, we do count..

    Thanks for your work

  • Thank you for this. I also am a person who got through an intense difficult time as a young adult and who went on to become a therapist and for the last 23 years a ‘peer-professional.” I have found that sharing a bit of our common struggle and lived experience with the people I work with to be an important foundation of trust and respect…

    My 19 y.o. son also came through a two week period last summer in which he experienced deep fear and mistrust…something that could be called an extreme experience. We used an Open Dialogue informed approach to work through this as a family and he is now back in college and feeling and doing great. BTW he wants me to share his story to make sure others know that people can get through what some may call ‘psychosis.’

    Thanks for becoming who you are…glad you’re on MIA

  • Noel,

    Thank you for presenting this clear link between trauma and what gets labelled ‘illness’ or psychosis. I also completely agree with you that we are all ‘delusional’ to varying degrees at various times in our lives…for many reasons. My wish is that we could always assume that when a person is distressed or acting in a way we do not understand, that he/she is making sense of his/her experience the best he/she can, as you suggest…and to work to connect with each person going through whatever he/she is going through…This is why I have hope for Open Dialogue and hope that it becomes an available alternative in the US.

    Thanks again!

  • Please share our work for truth and honesty in psychiatry…anything less is unethical…Please don’t trade integrity for income…we need honest psychiatrists…speak the truth and help expose Big Pharma, and trauma, often the real source of pain and struggle in people’s lives, especially children’s lives…don’t push meds, especially on young children…

    Best Wishes and I appreciate how difficult it is to work as a psychiatrist in our current system…This website can be a source of support…

  • I have always disliked the concept and term “mental illness”…I will carry Leonard Frank’s dislike of this label and remember that he too rejected the disease model…we are a human rights movement first and foremost…

  • Thank you Leonard Frank…while I met you and heard you speak only a few times over the years…your name was always a reminder of what psychiatric survivors were fighting for…where we had been and where we must go…thank you…rest in peace and know that we will carry your spirit into tomorrow…

  • I agree with all of your points here… I think one point, that psychiatrists should not earn less for using psychotherapy rather than just prescribing drugs to people sums up one of the big underlying problems with this picture.

    As a society, we have given doctors of medicine much power and control and this is mixed in with Big Pharma and the underlying capitalism that fuels inequality. I am concerned that 99.9% of psychiatrists will not voluntarily give up their power or their money. Thus, psychiatrists, who often are not trained psychotherapists anyway, will not choose to offer this treatment, since it takes more time for less money. This whole picture seems so sad to me…and such a huge crime for the people who receive these mental health “services.” I know that there are some psychiatrists out there, many on this site, that do not fall into this category…and they are trying to do something much different. Perhaps, similar to what Sandra Steingard MD has said, psychiatry should actually have a smaller role in treatment since medications should also have a much smaller role …

  • Hi,

    Thank you for sharing your heart wrenching experience(s) and acquired wisdom with us. I am so sorry for your pain and for the hurt that your children have been through. I love your quote, “Light is the only cure for darkness; living is the only cure for death.”

    I applaud your courage and strength…one step at a time, we move forward beyond and through our pain…and find joy along the way… wishing you peace and joy.

  • Thanks for your reply Sandra. This sounds very interesting…I am not surprised to hear that the person going through the experience has so much to do with the outcome…Sounds like we need to be humble as supporters and do our best to listen and connect…thanks again

  • Michael,

    Thank you for sharing your story. As humble human beings on a planet going around the sun…there is so much we do not know…fear, humility, terror and joy are all a part of this existence, yet we act as if people who deeply feel and question are the problem…Your existential and heartfelt questions at the time of your experience ring true for me…so glad that you got through this in 1970 and shared it with us today.

  • Thanks for another very insightful essay…I agree with all of your points…my hope is that we can keep the human in human services…instead of focusing on the ‘product.’ I have heard this word many times a day lately in my work in the mental health field (industry)…not sure where to start to be a part of something much different…but I so appreciate your article Sandra and all of my friends in the MIA community.

  • I am wondering what theories you feel have credit? My son’s ‘psychosis’ responded well to an Open Dialogue approach and he came through the experience after 2 weeks, with only a few benzos to help him relax and get back on his sleep schedule. His ‘psychotic’ experiences did seem related to his life and stressors, although I realize not everyone with stress become ‘psychotic.’ I have worked in the mental health field for years and realize that the use of neuroleptics, while they do control psychotic experiences rather quickly, come with serious short term, medium term and long term side effects…including brain shrinkage…Whatever psychosis is, shouldn’t we at least agree to look for less damaging treatments? I have known so many people, in addition to my son more recently, who have had full and continuing recoveries from psychosis and are not on meds..but, they also have not talked much about it either because of the stigma…

    I agree however that prisons are usually horrible places to be and the death penalty is barbaric and uncivilized…

  • Autism is likely caused by many things including air pollutants and other toxins….and the fact that women now take an average of 3-5 prescribed meds during pregnancy…I attribute my son’s autism to the Phenergan I was prescribed for severe morning sickness during my pregnancy with him…alternatives were not offered and I did not realize the risk…I will be forever heartbroken about this and my son pays the real price for Big Pharma’s profits over concern for people…

  • Bob,

    Thanks for stating so clearly what would save money, respect scientific knowledge and promote healing and recovery. I am so troubled by the influence of Big Pharma in our mental health system…it is robbing people of their lives…children too…thank you for stating what should be clearly apparent to a system apparently blinded by the influence of Big
    Pharma’s deep pockets…

  • Kerstin,

    Thank you for sharing your terrifying experiences with us…all done in the name of “psychiatric treatment” in hospitals. At this point, I have decided that staying out of a psychiatric hospital is perhaps the most important ‘treatment’ intervention we can provide….so often I have heard those of us in the field say that a person was sent to the hospital “to keep him/her safe”… how tragically ironic…

    So glad that you came through this trauma and are on your journey of healing and living…thanks again for sharing…

  • …more evidence about how human beings and their institutions can go so completely off course…in this case professional “psychologists.” My hope is that we learn from our grave mistakes and never assume that any human institution (religious, governmental, economic etc) is immune from horrible acts of oppression and cruelty…including our current mental health system…

  • Sleep deprivation (5 nights due to anxiety over multiple stressors) seemed to bring on my 19 year old son’s ‘psychosis’ last summer…and when we helped him through it, partly by helping him get back on his sleep schedule, he recovered and has been fine for 5 months now…no hospitalizations and other than a few nights of benzos…no more meds…psychiatry does not allow for this kind of “recovery” according to Allen Frances’ approach…he indicates that acute psychosis must be treated with meds….this is certainly not always the case!

  • I may be getting to be like a broken record on this topic…I apologize…I think these increased birth defects and the increases in autism are partly due to the dramatic increase in prescribed drug use by pregnant women…the New York Times just had an article about the plan to better identify drugs used by pregnant women because the average pregnant woman uses 3-5 prescribed drugs during her pregnancy…

    My son is on the Spectrum…and I took (half of the prescription) Phenergan for 5 months for severe morning sickness during my pregnancy with him…I feel that I was misinformed that this drug was the only course of action (when I found non-drug ways to get through the same morning sickness with my second and third pregnancies) . Morning sickness can be so severe that you end up in the hospital…which is what happened to me…but the drug should not have been so readily prescribed when there were many other options out there (IVs to keep one hydrated, full bed rest etc.) We must change our economic system to rein in the power of big business including Big Pharma…

    Thanks for sharing this study…alarming, but not surprising ….

  • Sandra,

    This is great info. about working with individuals in a more transparent way, using shared decision making with meds…I really appreciate your results and your ongoing attempt to explore how to reduce/discontinue neuroleptics in the best way possible.

    Your suggestion that we also need to continue to explore how to keep people off these drugs in the first place is so important. My son has continued to do well 4 1/2 months after a two week extreme experience (which could also be called ‘psychosis’ ) last summer and he only used benzos very briefly to get back on his sleep/wake cycle. I believe that dialogue and individual and family support can really work…avoiding the hospital and heavy meds may be both possible and the best of all alternatives. I can’t imagine that he would be doing as well as he is right now…getting all A’s in his second year in college…if he had been hospitalized and put on neuroleptics last summer. I look forward to your courses!

    With much gratitude,


  • I have an adult child “on the spectrum.” While his difficulties are not as bad as some, his issues are real and the diagnosis has given a name for something that he and our family have struggled with for two decades. I wonder if the number of diagnoses are going up in part because more women are using more meds and are exposed to more toxins during pregnancy??? I was given Phenergan for severe morning sickness for months during my pregnancy with him and I worry that this caused his extra difficulties…that said, there may be more diagnoses of autism as well…Big Pharma is always looking for a new market!

    BTW, we have found many very helpful environmental supports and have avoided meds for his struggles and ‘sensitivities’ for all these years…things are good, but I cannot deny that his difficulties are real…

  • Monica,

    Thank you for sharing your thoughtful perspective about human feelings, pain and our reactions to painful feelings…I completely agree with you and overcame my impulsive eating and dieting years ago using an approach similar to what you describe here. I will share your perspective with others…I think it is very encouraging, non-judgemental…and that it will truly help people move beyond some difficult reactions…

    Thanks again

  • Adam Lanza and his mother were extremely isolated for many years before the Newtown tragedy. These years of isolation must have deepened and twisted whatever difficulties Adam had to begin with…and yet his mother and Adam did not find help that felt helpful to them…As a mother of four teenagers, I can say that schools are often not helpful, nor is our mental health system when children need extra supports. There is a part of me that wonders how this situation may have been different had Adam and his mother been engaged in services in a person centered, respectful way, using shared decision making, respecting what may have been their valid fears about just medicating problems that needed much more…Adam had many challenges and the systems, the school, mental health and community systems failed to provide an approach that worked…let us not just blame his mother for not following through on professional recommendations…so often a parent is justified in protecting her child from our systems that just want to drug away difficult behaviors rather than provide high quality behavioral therapy and supports…his mom may have felt that she had no where to turn…and maybe she didn’t have anywhere to go to get real help for Adam…Newtown was a terrible tragedy, but we cannot let our horribly flawed mental health and school systems off the hook here, by just blaming mom…

  • Yes, I agree that some of us react to the hypocrisies and fears of modern society and go through extreme experiences. Even ‘loving’ homes can also include confusing inconsistencies and abuses…having a break can be one’s response to overwhelming stress and/or trauma. I have seen people come through these difficult experiences with renewed clarity and strength…the meds have mind altering side effects that should be carefully considered before taking them…if possible, going through extreme experiences with as many supports as possible and minimal meds (or no meds) is best….thanks for your post!

  • Noel,

    Thank you for sharing this confusing experience with us. It has been clear to me that most if not all extreme experiences (‘psychiatric symptoms’) are related to one’s life. For some reason psychosis is left out of the conversation when it comes to environmental stress, especially severe stress and trauma. I wonder if the extreme nature of some of these ‘symptoms’ are hard for people to understand and are held out by psychiatry as examples of ‘real’ ‘illness’ and thus a justification for the field and all of its biological treatments. Your work and voice are helping to break this silence…glad you shared with them…and with us.

    Maybe we could plan a conference on this topic…trauma as a cause for psychosis…

  • Dr. Breggin,

    You are my hero. Thank you for all that you have given us over the years. Glad that you are posting on MIA.

    I found your book, “Psychiatric Drugs: Hazards to the Brain,,” back in 1986 when I was a young mental health professional…and a closeted peer. You brought me hope in my darkest hours in this ‘toxic’ field….and you laid the groundwork for sooo many of us to push back and fight for the truth. I have met you numerous times over the years. I hope you know how critically important your work has been for many of us and how many of us may not be here today, organizing and speaking out for truth in psychiatry if it was not for your courage and willingness to speak truth to power.

    Thank you

  • Malaika,

    I like many of the points you make here. We need to try and find as much common ground as we can to have dialogue with others and hopefully help move our society in a positive direction…more human rights, less oppression, more trauma informed, humanistic support for those going through emotional struggles…

    I am also acutely aware of the corporate control of medical research and the profit driven industry that defends the status quo in the medical model, mental health industry. This industry, which pays the salaries of those of us working for this system, including paid peer specialists, demands our loyalty to the dominant, disease based paradigm. C/S/X formed groups to recover from or escape this oppressive system and form alternatives. In my mind, we are at very high risk of selling out or being bought out as a group…this is what I fear we stand to lose…our history as a group fighting for our dignity and our rights to self determine. While I agree that working toward common ground by being less reactive and striving toward open-mindedness is laudable, I think we must also stand our ground and continue to push forward. I think we have an uphill battle and that we are in a one down position against huge corporate influences. While we should not be ideological, I also think that our revolution is not being paid for by the corporate elite, but by our ingenuity and our blood, sweat and tears…we should expect a tough road ahead…

    Thanks again for your article. Glad to have such a thoughtful discussion on this process.

  • So sad…I have come to believe that we are living in a corportocracy

    Modern medicine seems beholden to monied interests…corporations are ‘people’ and real people are losing their rights and their voice…

    I had someone try and talk me into putting my son on ADHD meds years ago…so glad I resisted…environmental supports and a respect for different learning styles worked without the side effects..

  • My son has been diagnosed with Aspergers since he was young…he is now close to 20. I was prescribed meds for severe morning sickness during my pregnancy…Phenergan…which I too for 5 months out of desperation and a lack of alternatives. Now I have heard that kids born to mothers who took Thalidomide back in the 50s …known to cause severe physical birth defects…have a much higher rate of autism in their offspring as well. Recently the research is also implicating SSRI use in mothers as a cause…so I lean toward pre natal exposure to drugs and other toxins as a likely cause.

    BTW we have kept him off meds even though they were often recommended for some of his behaviors as a child…he is doing well in his second year in college…

  • Thank you Andrew. I completely agree that the field needs to rethink the use or place of medications. There are so many other supports and treatments that work as well or better for many people in emotional distress without the side effects …and choice is both a human right and essential for any real recovery or growth. You have summarized the difficult state of affairs with our current industry driven medical model and a call for dramatic change is the only reasonable conclusion…thank you for this article!

  • Hi,

    Sandra, this was your best talk yet!!! I am so deeply appreciative of your courage, persistence and professional honesty.

    My teenage son continues to do well in college three months after he came through a 2 week period of what could be called – from a medical model perspective – a ‘psychotic’ experience. We worked to keep him away from traditional providers and the hospital…we were so lucky to find an Open Dialogue trained psychiatrist in the NYC area that helped us offer 24/7 support and connection to him as he worked through his extreme experience. We all agreed that his experiences were related to his life, both past and present.

    I found my fear of losing him to the medical model, mental health system worse than my motherly concern over what he was going through…this speaks so loudly to the need for true alternatives in the US. Thank you Sandra, Bob, Laura and all of my MIA community.


  • Douglas,

    I am so sorry that you are in such a painful and difficult place right now…I too have been there and back to a more hopeful space…a few times…I guess I see despair and depression, not as a recurring illness but as one place many of us go when overwhelmed by pain…one thing that helped me is to remember that I was not alone, even with my aloneness…most of us go to very hard emotional places at times in this life…I am one more person who has been there and trusts that you can and will come through this dark time…please let us know how we can help…hang in there…take good care of yourself as you would a dear friend…

  • Lauren,

    I am so deeply sorry for your ancestral trauma and for all people who have been victims of abuse, violence and torture. I only hope that we do not perpetuate these tragedies by thinking that ‘our’ group (whether it be our country, our religion, our profession or our political party) is not capable of doing the same if put in the right circumstances…we humans can create wonderful societies when fairness and equality are shared by all…and we can also horribly traumatize others when we have systems, economies, policies or belief systems that systematically oppress others or when we deny our capacity to be both the victim and the victimizer…

    Of course, this oppression happens in our current medical model of mental health services and in all forced treatment! Perhaps we should start with a commitment to do no harm…in my mind violence and force will always do harm…war will never bring lasting peace…

  • Deron,

    Thank you for sharing this. I often find myself wishing I could express myself more meaningfully in the moments and with the people that mean the most to me. I also have found renewed hope and connection in Bob’s work and in the MIA community. Thank you again for sharing your experience with us.

  • Thank you for this article reminding psychiatrists that each of us has a story. Although we are made of cells, we are complex beings, each with a rich history of relationships and life experiences, which often include sadness, trauma and joy. Compassionate, supportive relationships can help heal both our neurochemistry and our souls, without the neurotoxic side effects of psychiatric medications.

  • Hi again,

    I wanted to check if you knew about the conference this week at Hutchings Psych Center on Oct 2nd in Syracuse, NY about the long term effects of the use of neuroleptics…sounds like an interesting one day conference…hope to see you and many others there:)

  • Hi,

    My son has given me permission to share that he continues to feel well after we supported and connected with him through a very difficult (his words) 2 week period in early July ’14 with a modified Open Dialogue approach (since we did not have the capacity to do it the way they do in Finland). (I actually spoke with you about him during dinner at the Mind Freedom conference last July, Sandra). He considers what he went through to be what could be called ‘psychosis’ by medical model psychiatrists, yet he experienced it more like an existential crisis that led to overwhelming anxiety, insomnia and then to feeling very unsafe. We stayed with him 24/7, avoided hospitalization, all went to therapy together to look at family related stressors and used very few meds…mostly some benzos to help him get back on track with his sleeping…he came out of this period and is now back in college and doing well.

    I raise this example because I wonder, in fact I think I know, that had he been with a family that did not know about Open Dialogue and have access to a psychiatrist who was trained in Open Dialogue, he would have ended up in the hospital, diagnosed and put on neuroleptics. I don’t believe he would have worked his way through his extreme experience the way he did and have come out with the clarity he seems to have gained.

    We are humble about the future…life is hard, his extreme experience was very hard and took all of us working together to connect with him and each other through the 2 weeks it continued. Yet, the medical model’s reductionistic, one size fits all mentality …that also forces this paradigm on people …is always worse in my opinion. I think we need a continuum of support for people going through extreme experiences, with an understanding that these human experiences usually have deep personal meaning, may be related to past traumas or family issues (my son’s were) and that people do so much better when we do not further traumatize them with medical model labels or forced treatments.

    I value this site and the Mad In America community and hope to raise awareness and build Open Dialogue or similar approaches in this country for those of us who may go through extreme experiences…thank you for all of your work and honest struggle to find the best way to support people Sandra.

  • Thank you Noel. My “symptoms” all make sense given my story…

    Instead of diagnoses, my hope is that we support people in finding/understanding their stories…my belief is that we each have a story, filled with joy and pain, whether we have been given a label or not….though some of us have endured overwhelming trauma…and then the trauma of being diagnosed, etc etc….your words make so much sense and are healing…thank you

  • As someone who has struggled and overcome many of the problems you describe, without meds, I must thank you for writing this brilliant article…Meds do not allow us to get through things…While they may be a temporary tool, the side effects are often worse than the original problems…thank you

  • I really like the quote…, “be the change you wish to see in the world.” I also try to follow the thought that, “means equals ends.” The way we do things equals what we do…if we achieve something through war or any kind of violence, we have created oppression and trauma…not peace…violence sows the seeds of pain and the next war…peace is our challenge each and every moment…

    Thanks for this article and for your invitation for us to share our thoughts about creating peace…

  • Thank you for this Leah. I too am struggling with the loss of Robin Williams to suicide … I have many conflicting feelings…from disbelief to ‘not him too,’ to deep sadness at what I now assume must have been his years of deep pain and personal struggle while giving us so much …to anger at how his action has now hurt so many others…

    Your words are so comforting and hopeful…I agree that we must be there for each other and reach out when we can…even a small kindness can make a difference. Your article has helped me…thank you.


  • Noel,

    Thank you for this excellent article about trauma and its relation to emotional and ‘psychiatric’ suffering. Trauma Informed Peer Support (TIPS) is one model that works (as Darby referred to above) and my hope is that we will offer this to anyone in distress. I especially like the way you mentioned that trauma can mean many things beyond the obvious life threatening trauma such as being verbally bullied, growing up in a difficult family or many other difficult and painful emotional experiences. I am so glad you put the time and effort into this article -thank you

  • Thank you for such a concise summary of the extreme overuse of psychoactive drugs in today’s society. Hopefully, people will listen and begin to realize that our current corporately controlled (profit driven) medicine, science and media are not to be trusted. Even our governmental institutions such as the FDA and Congress which are supposed to represent us and protect us from harmful self interests have let these profit driven entities compromise our democracy which is designed to be by and for the people. We must hold our elected officials accountable and demand a change in corporate law so that these amoral corporations no longer have the rights of people. Overturning Citizen’s United is a place to begin…

    In the meantime, we should take your advice and look for the simple truths about negotiating life’s ups and downs such as good self care and supportive connections to others rather than looking to pills for every discomfort.

  • Hi again,

    Just wanted to say that I consider the government our government. As a democracy, we each have a vote and a voice…at least in theory. My concern is with the influence of any big money from industries who want to sway our democracy in their direction and take our collective voice away. I think we tend to value the same things here, maybe just have different perspectives about how to protect our rights and move forward.

    I feel that getting all PAC money out of our democracy is critical, whether it be BigPharma or mental health industry money…or the gun industry money. I have come to believe that we need to overturn Citizen’s United and re-take our democracy from the hands of all corporate interests. Someone from this site told me about Wolfpac which is trying to do just that…

    Wishing all of us civil rights, a voice and full informed consent to all “treatments.”

  • Hi,

    I agree with all of your points and sincerely thank you for your article.

    However, I find your line which describes the CtPost as ‘an excuse to attack the gun lobby’ disturbing. The gun lobby spends millions to keep our Congress from fairly representing the interests of the American people. Instead, this money (like all corporate PAC money, including BigPharma) is used to buy votes to keep a ridiculous number of guns with a ridiculous number of rounds in the hands of the public….just not sure why you want to defend this.

    Thanks for everything else you mention…I believe that we need to know what leads to these shooting sprees..and whether meds. may have contributed to these horrific events.

  • Yes, we need the media to do their job and accurately report the growing body of literature linking SSRIs, pesticides, other meds and toxins during pregnancy to autism in children. My son has autism and I took Phenergan for 5 months for severe morning sickness 19 years ago during my pregnancy. I am convinced it caused his autism, although this has never been rigorously tested. Where is the FDA? Where is the media?

  • Laura,

    Thank you for sharing your story of struggle and your search for peace and meaning…yes, we need something much different than what we have. My thought is that we need to overturn Citizen’s United and keep private monied interests…ie drug companies…out of our government, science and democracy. Otherwise we will not have a democracy…only a big marketing machine in place of a democratically elected government.

    Thank you for your vision…

  • Did anyone go to jail? Perhaps Pfizer, this corporate ‘person’ could do some time.

    On a related note…A constitutional amendment was just introduced in the Senate to overhaul our campaign financing system…essentially overturning Citizen’s United. Does anyone have more info on this? I think this is one of the most important issues of our time.

  • Our economic system allows money to corrupt our democracy, our medical and behavioral health services and the very systems that are there to protect the public interests. We need to focus on getting private money out of our government in my opinion if we hope to get truth in psychiatry. Overturning Citizen’s United is an essential step #1 to begin the process.

    Thanks for your enlightening, well written article!

  • “Sluggish Cognitive Tempo” could also exist in some situations as a result of a person’s mother being on SSRIs or other meds. during pregnancy which are known to produce learning and ‘processing’ issues in her children…This is so infuriating and sad…pharmaceuticals cause the problem only to be given another opportunity to market drugs to the next generation of victims!

  • …and once again drug companies have not done research on how to taper off these drugs successfully…why would they when they want people on them for life! Our FDA and CDC are in bed with the drug companies so we as American and World citizens are not protected from this completely out of control profit motive! We must set limits on Big Business.

    One thing I have noticed also is how mental health providers often really don’t know about these discontinuation effects and will create a new diagnosis for the withdrawal symptoms that can take months (even years) to overcome in my experience.

  • I would like our movement to honestly create alternatives to help people going through very difficult times…I agree with most of what’s written here, but are we able to respond to our community members when they are most distressed? I have seen people who “hate” psychiatry take others to the ER. for an apparent lack of any alternatives.

  • Thank you for updating your article. My adult child has both learning disabilities and was diagnosed with autism at a young age. I took another type of medication, but now believe that not only SSRIs, but also many other drugs routinely given to pregnant women probably also cause autism and learning disabilities. As many other readers have commented on this site, where is the FDA and science and medicine on this huge concern? The silence is very telling. There is frankly a lot of money at stake for pharmaceutical companies. Profit comes before people in our current economy and government.

  • Hello,

    These findings are both deeply painful and validating at the same time. My son has a form of autism and learning disabilities which I have long felt were caused by the Phenergan (Category C) I took ( for 5 months) while expecting him. Although I was repeatedly reassured that these meds were “very safe and necessary,” given my severe morning sickness, I feel now that they probably contributed to or completely caused his difficulties. The problem is that Phenergan, like the SSRIs and numerous other drugs given to pregnant women have never been adequately tested, so drug companies keep selling them and women keep using them. I consider this lack of testing of drugs given to pregnant women a crime; I wonder when we will wake up and rein in our out of control capitalistic economy that allows this sort of thing to happen to children and their families. My son and thousands upon thousands of others are paying the price for the lack of objective oversight by our FDA.

    Breaks my heart,


  • If our system, the FDA and our government was protecting us, pharmaceutical companies would be required to fully test their drugs for the time periods that people actually use them (years and years). These companies would be required to research and post warnings about the effects of their drugs on pregnant women and their developing babies. Finally, pharmaceutical companies would be required to study each drug’s withdrawal process and share it with potential recipients before these individuals started using any meds.

    Then, we would have informed consent. My concern is that we don’t have anything close to this when it comes to many psychiatric treatments in our country.

  • Hi,

    My son has a form of autism. While I was not on SSRIs during my pregnancy with him 19 years ago, I was prescribed Phenergan for severe morning sickness for 5 months of my pregnancy. I was assured that it was not going to affect my pregnancy or child and was used “all the time.” Looking back, I am so sorry that I believed this, since 90% of the drugs women are prescribed during pregnancy are not even tested for safety. This is an outrage.

    Where is the FDA? …is there anything we can do to get this message out to people?

    How can drug companies sell drugs to pregnant women when they have not even gathered data on the meds’ effects on the developing fetus. I would be glad to share the effects that Phenergan seemed to have on my son with anyone wanting to study this.


  • Hi Gina,

    Great article!

    I agree that people will turn away from forced and coercive services. We need to feel safe and understood to connect with others. We also need hope and a sense that we can get what we need.

    So many difficulties arise in life, especially when our parents, schools and communities have their own problems and don’t understand our perspective. Connection, unconditional positive regard, trauma informed services and safety must replace coercive, medical model and forced services if we hope to help others heal.

    Thanks for the article.


  • I am worried about many things in our country today…one big one is the impact of corporations, in this case, pharmaceutical companies, on our political and scientific systems. These drug companies feed the public propaganda and seriously corrupt both our (no longer democratic)political process and our (un)scientific research, as described in this article. I am convinced that we need strong laws that prevent these obvious conflicts of interest. Otherwise, we must admit that what ‘scientists’ claim to be research results are actually drug company promotional materials. These ‘researchers’ are actually functioning as drug company sales representatives not independent, unbiased scientists.

  • Rossa,

    Thank you for sharing this very interesting post. I agree with you…the mental health field has not focused on alternative ways to support, appreciate, cope with, understand, get through etc. altered experiences…aka psychosis. Perhaps we can continue to lead the way on the site…thanks everyone, thanks Kermit, Rob W and Mad In America!


  • Wow, this is a very significant summary of recent research about how trauma impacts one’s biology and can contribute to altered experiences! Many of us have long thought that trauma is one of the most significant causes of mental health pain and difficulties. I think now more than ever, we need to address trauma, in all it’s forms, when we provide treatment and peer support for individuals in recovery. Trauma informed peer support is one of the best models out there. I have also found that having a caring, person-centered therapist who helped me make sense of my suffering and work my way through emotional pain helped tremendously.
    Thank you for posting this important study!

  • I am concerned about the recent study that showed that women who were prescribed SSRIs and became pregnant had a much higher rate of autism in their children…shouldn’t the drug companies have to thoroughly test any medications given to women of childbearing age for these types of problems? I hope the FDA tightens up it’s oversight of meds. I also wonder if a for-profit pharmaceutical and medical system is always going to have a conflict of interest with the provision of optimal and unbiased research and services.

  • I hear and agree with your points Tom. It’s so frustrating for me to see all these health initiatives (healthy eating, smoking cessation, wellness tools etc..) for people in recovery, but often a failure to recognize the horrible side effects that people live with as a result of psychiatric medications. If/when people have full, informed consent and choose to take medications, that is their right in my opinion. However, how many people have full, informed consent about meds and the risks of these meds as well as access to alternatives when they are going though difficult times?…So glad we have this community to support each other, raise awareness and work together for positive alternatives..Thanks Kermit and Rob W 🙂

  • Thank you for sharing your compelling story Monica. My concern about the mental health field is that so many of us go under the radar and unnoticed when we don’t follow prescribed medication and treatment, but instead reject medication and find our healing in other ways, friends, therapy, meditation, exercise, spirituality etc. etc.. Because of the “Clinician’s Illusion” we are not included in research and not seen in psychiatric clinics…therefore our stories get lost. Even when we do tell them, they’re often not believed, minimized or ignored. Thank you again for your courage and for sharing…it means a lot to many of us.

  • Hi Dr. Mark,

    I’m curious what you think about Open Dialogue in Finland. I believe close to 85% of young adults who use this program fully recover from psychotic difficulties. I also wonder if you address trauma in your services. I have read that over 90% of people with more serious psychiatric diagnoses have been victims of physical, sexual or verbal abuse.

    In addition to this, I’m aware that many people can and do have robust recoveries from diagnoses like schizophrenia and bipolar disorder, but when they return to their lives they usually don’t share their stories, probably because stigma is so pervasive in our society. Therefore, providers only see and study those people who are still having more difficult experiences and/or have become stuck in services that have created hopelessness and dependency. This creates what has been called the “Clinician’s Illusion,” which is the sense among providers that these diagnoses have a negative prognosis when in fact, this is not true, but may become a self-fulfilling prophecy.

    Thank you for your work and for sharing what you do.

  • Thank you for all of your work. We need to keep working to get the whole story out about treatment and recovery. I would like to see more research about the discontinuation syndrome…how medications impact people as they work to try and reduce or come off them. In my experience, many people who wish to reduce/come off their meds. try, often with their doctors’ advice, to reduce them too fast which backfires and then causes their doctors to decide that they will not be able to reduce or discontinue their meds. …I feel that this process needs much more research and practice protocols.

  • Thank you Susan. Thank you to everyone else here who has let our voices be heard. Force and a lot of so-called treatment does more harm than good. People need connections (relationships) with supportive others and a commitment of no forced treatment if they are to benefit from any recovery services.

  • Thank you Wayne! Great article. My hope is that we are finally getting enough professionals to listen and the research will soon be even stronger that low and slow (or no) meds with trauma informed therapy is the best approach.

  • Hi Sandy,

    I did not mean to imply that any of us are immune to conflicts of interest. That said, we also know that our field is dominated by certain corporate interests that far outweigh the influence of others with less financial influence over research and treatment. We need government regulation of corporations so that the FDA can do a proper job informing us of the risks and benefits of any given treatment and science that has no ties to those hoping to profit from research outcomes. Perhaps overturning Citizen’s United would be a place to start with this.

    Thanks again for the great discussion!


  • Dear Dr. Steingard,

    Thank you for this thoughtful article. We already know much of what hurts and what helps people in emotional distress. I think that we need to be honest about what we know and what we don’t know as we continue to search for answers.

    One of my concerns is that psychiatric research (the medical model) is often very biased by moneyed interests and corporate influence, so we lose scientific objectivity and credibility. In addition, scientific inquiry is based on the assumption that we can derive answers using the scientific method and our senses with the help of technology to examine data and find answers. In the case of psychology and psychiatry we are studying the brain (with all it’s emotions, existential and spiritual dilemmas, pain and biological structures) with our brains…something unique when compared to all other fields of study. Perhaps it’s difficult to be ‘objective’ about something so ‘subjective,’ and close to home.

    When dealing with mental and emotional phenomena, it’s hard to separate the observed from the observer. The way we define and understand psychic experiences and emotional pain depends very much on our varying world views and then leads to what we then prescribe to ease others’ mental anguish. Thus, given the enormous complexity and challenges of our field, I think it’s important that mental health professionals be very careful not to impose their (scientific, spiritual or otherwise) answers on others, but instead keep open and humble minds as they continue to search for what causes and what helps people in distress. I also think we absolutely need to protect the human rights, (including the right to choose what helps and reject what hurts) of those who receive any kind of mental health services.

    Again, I am thankful for your article and perspective.


  • Hi Michael,

    I also work within the system and struggle with trying to truly support people within services dominated by the medical model. I understand what you are saying and appreciate your courage. Thank you for sharing your story. It’s only by speaking our truth, sometimes to power, that things will change. In the meantime, I am so very thankful for Rob Whitaker’s books and other work, this site and for people such as yourself. thank you

  • Paris,

    Once again, I’m struck by the combination of your down to earth analysis of the problems with the medical model and your deep wisdom and understanding about what people need to get through profound emotional and existential pain. One way I look at all of this is to see each of us as a small part of a much larger system, that is way off course. Some of us are suffering, for good reason as we see corporate power corrupting governments and destroying our environment; as we witness various systems of power hurting ourselves and other people, whether it be family relationships between parents and vulnerable young children or governments, misusing power and dropping bombs on people. Sanity requires a response from us as we witness such pain and sadness. Yet, those of us who suffer are labelled the problem, diagnosed with brain diseases and even put on medications against our will shutting us up and adding insult to injury. We have much to learn from our own and others’ suffering: both about ourselves and about what’s wrong in the world.

  • Paris Williams has written an excellent book, well researched and clearly presented. In my personal and professional experience, I have known many people who have lived through ‘psychosis’ and who then go on to live rich, meaningful lives. However, because of stigma, they often do not disclose their experiences of full recovery. When recovery is researched, these people are not included which just further perpetuates the idea that people cannot fully recover from psychosis.