Sunday, April 18, 2021

Comments by Whatuser

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  • We all may have learnt much that is more or less gratifying or useful and maybe can learn much that is needed or unnecessary. This is welcome for those reasons alone. Every activist needs to undergo a process of development.
    However the phrase ‘problems with living’ rather expands the ‘market’ in treatment to include everyone doesn’t it? It has probably done more harm thuswise than any other blurb besides ‘chemical imbalance’. And what if you are somebody else’s ‘problem of living’ , someone with the power to insist on treatment. Yes more trust for the mill of expanding the market in treatment. And isn’t Popper one of the original neo Liberal ideologs? About time we concentrated on the problems inadequate resources confront people afflicted with severe deprivation experience and stop trying to brainwash us into thinking we can overcome inadequacies by the mere power in thought alone!

  • Actually Sera you are writing words that I recall myself as saying. So we probably agree on much of the same thoughts about how psycho-socially disabled folk like myself are mistreated, discounted, discriminated against, deprived of resources – it would be of enormous worth for those resources which are set aside to be more properly deployed to help us directly or ensure that people are employed to work with us to develop more meaningful lives for ourselves. Still don’t see the harm in according the title Dr. To those who’ve earned the accolade any more than according the accolade plumber, electrician, nurse, mechanic, dentist to those who’ve earned their skills with hard study and effort. Actually alot of people’s identity is very tied up with their work.
    Maybe I’m missing something (I’ve had long conversations with people about the misuse of the concept of ‘helping’ people in distress wherein the people failed utterly to comprehend the point(help can be welcome but a helping attitude can be cloaking the sense of superiority, one that feels no obligation to understand ie. its more akn to colonial attitudes) ) but consider the possibility that you are barking up the wrong tree with this. Better to focus on the major fact that psychiatry ignores – People aren’t disordered, we are distressed. We have no known etiology of disease, disorder, illness but suffer mental distress because of what has happened us, because of what hasn’t happened, because of what is happening here and now more often than not. These events can colour our psychology, our attitudes and make it difficult to get by until our attitudes change but the events, how we interpret them, our powerlessness over them are the key ingredients to understanding our distress. And appropriate resources the key to solving what seem intractable problems.

  • Fabulous blog Dana, it shows you as a confident capable person assured in their identity. Personally we ought to get support because we ask for it (most people are in that situation) or in extremis after a needs assessment. Supportive relationships and resources should not depend on adopting a pejorative label. All my diagnosis have been unnecessary, even in their own terms, usually very stigmatising and excuses to prescribe. Like many people in the psychiatric system the labeling has been the occasion for the denial of support not its introduction. But having said this you are quite right to show how we can work with the system the way it is and sometimes gain strength even from a woefully inadequate system of care.

  • Indeed the fact that somebodies expertise is earned is no reason to assume they always abide by it. Most people presumably are happy with the service they receive from plumbers, mechanics, physicians etc.
    The problem with psychiatry might be brought further into light by realising they have trained as experts but the expertise they possess, such as it is, does not equip them usually to work with people to develop a meaningful life. It’s aimed at containing the troubled and/or troubling person. Pharma have been exploiting this fact at enormous profit for decades now. And it’s got to the point that many of its victims are not particularly troubled!

  • “listening’ should clearly have been in quotes! But truly most patients say too much to their doctors, most doctors would agree here busy as they are with heavy patient loads, but then again you can’t afford to say nothing either! – Talking to a shrink usually merely gives them ammunition to use to justify otherwise unjustifiable practices.

  • Oldhead, how about – nationalising the commanding heights of the economy, promoting the common ownership of the means of production, housing for all, equal access to healthcare, education, the law and other professional services, welfare provision, pensions, leisure amenities. Sounds hopelessly ideal until you realise it has already happened. And oh right maybe UBI and certainly vigorous environmental protections.

  • Sara, congratulations on this effort to promote fairness and equality. However maybe your missing the point and overgeneralising from your experience of psychiatry. Question, would you ask Joe the plumber to diagnosis your aches and pains? I feel confident you’d go to a suitably qualified physician.
    Has anyone here actually studied for a doctorate, it’s hard going, and the honour, and it is an honour, is a testament to intellectual effort and rigour- we’d still be living in caves without people like this. People who’ve gone through a rigorous process of research and education to earn a Phd have every right to have it recognised. And have their expertise recognised, in their area of expertise. My but theres an awful lot of distracting nonsense going around these days.
    However Sara, please do keep honouring the struggle for fairness, equality and respect but also maybe we need to respect professional expertise and maybe be especially respectful when they get it so spectacularly wrong as they do in psychiatry. I’m not entirely convinced they know what their at despite being presented with daily evidence that they know what their doing!

  • Actually, thinking about it, their not even peering at our brains (all the brain scans have resulted in absolutely zero ‘psychiatric knowledge’) unlike neurologists. What exactly is it they do? A lot of listening and encouraging patients to talk, which their unfazed by and doesn’t exactly have them imparting much wisdom, prescriptions and a sense eventually that they haven’t heard a word you’ve said. But they usually do all this with an air of concern and decency, go figure.

  • The point being “what is the point of having a brain if it doesn’t respond to its environment?”.
    In science reductionism, reduces our attention to focus on a small number of crucial assumptions and has produced wonders as a result. Without this idea we could not communicate on the Internet, like here, for instance.
    But the charges against psychiatry and psychology is that they have taken this idea to a perverse extreme by excluding, almost in its entirety, consideration of the environment, merely peering inside peoples minds!

  • I think that’s by and large true. I contradict myself, they do know what their doing. They think you’ve got to be cruel to be kind maybe or that it’s the lesser of two evils. And often it’s through less cruelties. But I’ve met a lot of these people and their rarely out and out nasty. I think they genuinely feel they are doing the right thing.
    But also in some key respects I think they actually don’t know what they are doing. The numbers of people registered with psychiatric difficulties keeps rising and I don’t think the system has stopped to consider its role in this scandal.
    As for us patients, sometimes thankfully, they usually don’t care they are just fulfilling their duties.

  • Isn’t it sad the way the mental health service Almost automatically assume you don’t fit in because there’s something, whatever, endemically wrong with you and exclude the possibility that you might fit in better elsewhere. In fact by informing people you are psychiatrically disabling they deepen any difficulties, add stigma etc, etc,…

  • Hey Sam Science has come along way by leaps and bounds, we witness that all the time, but psychiatry like politics and economics has been rapidly headed in the opposite direction. Humanities social discourse seems to be regressing in this respect!

  • Excellent analogy oldhead.

    @KEPLER902 – How can you sustain the belief that ‘autism’ is a genetic condition which ‘runs’ in families? It’s incidence has skyrocketed in recent decades – your chance of earning a diagnosis of autism has climbed a hundred if not a thousand fold in that time, a hundred years ago you had zero chance of such a diagnosis. Our DNA has not changed in that time and our environment, not withstanding the immanent threat of climate catastrophe has got more benign, relatively, for people living in the west. And even if family members share behavioural traits they are more easily learnt than inherited.

  • The drugs work real well if you happen to own stock in the pharmaceutical enterprise concerned.
    They don’t work to cure any ‘psychiatric condition’ but they do work on the brain sometimes by making you feel like a duvet has been stuffed in your head or otherwise disabling you.
    Mostly though the seem to work to support the idea that you are undergoing a legitimate medical procedure.

  • @Sam, I don’t neccessarily like fishing even if its less unwelcome than some other activities. Indeed their might be some tasty morsels at the end of such a trip.
    @Steve, haven’t you noticed, well no doubt you have, that the mere act of attaching the word therapy can make almost any worthwhile activity a drudgery and ten times as expensive.! Indeed it may see previously free acts incurring a cost – but I suppose such is the cost of financialisation. Don’t encourage the bastards, people need an exit strategy out of psychiatry wherein they can make, cement and sustain genuine relationships.

    Do you all recall the scene in one flew over the cuckoo’s nest wherein a group of ‘patients’ visit the local ice cream parlour. Many such potentially interesting, amusing, worthwhile events take place during psychiatric care but are sometimes stripped of meaning by the deadening effect of drugs and the artifical nature of the relationships. They can be quite welcome nonetheless. These sort of events are often the nearest to genuine socialising many victims of psychiatry have in their lives.

  • Dana, as recently as several decades ago a dictionary running to over two and a half thousand pages had no entry for ‘autism’ in its main text, only in an addenda. Its was so rare to be so described. Why do you think huge numbers of people are now described as “morbidly self obsessed and out of touch with reality” when, like with yourself, there is ample evidence that this description is simply untrue?

  • I think you care because you comment several times a week. You might comment on the basic nature of what you think societies response to profound psychological turmoil might be. Even post revolutionary societies are going to have many persons so affected.

  • Neuro divergent will probably be used similar to bipolar – ie. address concerns about stigmatising language by invalidating those concerns. Claiming that replacing one word with another while simultaneously loosing the ‘diagnistic’ criteria and thus expanding your market. Its a bit frightening actually as the word neuro-divergence is a fact of all brains (there is no ‘typical’ neurological configuration) , it applies to all of us!

  • Neuro divergent will probably be used similar to bipolar – ie. address concerns about stigmatising language by invalidating those concerns. Claiming that replacing one word with another while simultaneously loosing the ‘diagnistic’ criteria and thus expanding your market. Its a bit frightening actually as the word neuro-divergence is a fact of all brains (there is no ‘typical’ neurological configuration) , it applies to all of us!

  • Sam, that’s often precisely the point.
    Except these days you don’t even have to express your distress. All you need is to fall for that marketing slogan “it’s good to talk” and you might find yourself in therapy – talking-and slowly being turned into a self absorbed solipsistic bore. Or maybe just fill in tic box form… Aaaaaahhhh!
    In the past many probably escaped the grasp of psychiatry by not expressing their feelings to the wrong person in the wrong way at the wrong time. Of course they still didn’t escape whatever traumas, adversities or deprivation they suffered. Oh the injustice!
    Take care.

  • I’m a case in point, the psychiatric intervention(s) have/had become a veritable vicious circle of decline which I am and have fought against valiantly rescuing somewhat my humanity but not escaping the trap. And that despite being educated, somewhat articulate and coming late to treatment equipped with a healthy scepticism of what might be in store. In fact initially I was pleasently surprised that it wasn’t nearly as bad as feared. Even my inital decision to refuse drugs was respected up to a point (still is) before I succumbed to denial of service threats. They rather disengenuously told me ‘you have a chemical imbalance’ and stated ‘its best for you to go along with the treatment or things will go worse for you otherwise’.
    Maybe its best to view psychiatrists in a political light. Certainly the power dynamics separating patients from family, friends, colleagues and psychiatric staff, those relationships are the key to success or more often failure. The work done in places like Trieste are done humbly and have proved more humane than the tic box diagnoses and prescriptions we are usually greeted with. But as yet the critical psychiatry professionals are merely slowing the push towards more ‘clinically’ driven bio- bio – bio psychiatry. Which is still usually delivered by humane even decent ‘professionals’ who maybe don’t know what their doing.

  • Isn’t that regarded as a relatively successful outcome (of psychiatric training)?
    Although falling toward obsequious rotund obtundency might be seen as the somewhat lesser evil sometimes.
    Whatever, regardless of these considerations, as I sit at the kitchen table, with two dictionaries open before me and another on my phone while they discuss the nature of language on the radio, these considerations lead me to believe these are two skills I need to develop.

    At first your use of the word obtuse was in question but then, well it seems to me that intentionality might be seen to be out of place in an environment like this. One of the chief errors in our thinking it seems to me is to assume intentionality where none exists. Whatever about the misdirected rage and emotional obduracy of the average trumpesta it would be wrong to assume that they are forever thinking of doing anybody any harm, although obviously some do.
    It seems likewise that the systemic troubles with psychiatric care getting worse with time can’t be analysed by assuming intentionality on behalf of staff, let alone patients for the most part. This might explain why expressing individual agency and having agency respected proves so impossible. Of course being free is remarkably far from doing what you damn well please.

    Mostly though I realise how much this damage has contributed to dulling my own senses while being trapped in this process. At least I’ve discovered a word, ‘obtundent’, that perfectly describes the treatment so frequently recommended.

  • Sam Plover
    We might benefit in our thinking by placing psychiatry in its proper social context. It is as you know not the sole author of misfortune in this world of ours. In fact it sees itself and sometimes is the author of solutions to intractable conundrums. The mental health services are not always damaging. I have found its interventions useful on occasion, making friends therein and finding some events to interest me. When life got spectacularly harsh on a few occasions its service even came as a relief. But the stigmatising, unnecessary and completely unjustified stigmatising diagnoses with the accompanying neurotoxins contributed to this harshness. In fact initially there was no obvious mental distress just a sort of social dislocation. You could say that as a person ‘lost’ in life the main requirements where socio-economic resources which in part the services strove to provide or connect me with.
    But the people most responsible for directing me to psychiatry (thus denying me opportunity, making me vulnerable to harm and losing me years of my life) had access to contacts and resources which they could have used to help me work my way out of my loss and even provided these tokenistically. They cannot or will not attempt to justify their choices.
    Two things may be or may not be relevant here, they disrespected my beliefs and sought to get me to abandon the philosophical stance that sustained and continues to sustain me, particularly my ecosocialist political choices. Also they themselves might have needed someone to scapegoat. So for that of other reasons they failed in often even considering useful interventions that they are resources to provide. Indeed at one stage when I hadn’t had any meaningful contact with them for years they decided to intervene in a fashion that rendered me homeless.

  • Dana, please attempt to give a reasonable explanation for the massive increase in ‘diagnosis’ of ‘autism’ in recent decades? And what precisely, in your view is ‘autism’? What ‘things’ do all or most as autists have in common, do you mean to say they have little interest in others?

  • I’m neurodivergent. We’re all neurodivergent now. Our minds can imagine things that never where while responding to the actualitie of what is. We are all different – neurodivergent- having different environmental stimuli to interpret but we’re all the same, what’s the point in having a brain if it doesn’t respond to its environment. We cant just imagine any old thing and make it happen any old way.
    We operate basically subjectively in a world whose déirce objective reality is near impossible to know with any certainty. And what does a ‘diagnosis’ do – it to ignores this reality and maps the real (psychological attitudes, disjunctures in relationships, society in turmoil, real tangible material deprivation (homelessness, unemployment, lack of training and education, unavailability of healthcare and welfare)) by pathologising, individualising and personalising with the illusory objectivity of a psychiatric/psychological diagnosis. Placing all responsibility in the hands of the most vulnerable – scapegoating.
    I respect diversity but when as a child I had a problem reading I wasn’t ‘diagnosed’ with a developmental disorder, neither was my ‘neurodiversity’ celebrated – I was placed in a class appropriate to my reading age! Thus I learned to read(as it turned out chronologically I was the youngest in class).
    It’s true that we are all subjects with our own subjective experience and understanding. We experienced depression, anxiety, psychosis in individual ways but if all we have to go on to understand what ‘autism’ means is to ask the person ‘identifying’ as such i’m none the wiser as to what it means. I must catch up and read a few more chapters of Sami Tamimis book.

  • @Diger. There is much sense in what you have to say but I can’t concur with everything you say. There are understandable reasons people reach out to psychiatry for ‘help’ with their problems, usually a troubled and/ or troubling significant other. Am I correct in assuming you have no direct experience of a psychiatric intervention (ie. as someone who is the recipient of so called ‘care’)?
    Doctors in my experience are skilled members of a helping profession motivated to solve problems. It is strange that the branch of medicine called psychiatry has chosen to take the strategy adopted by substance abusers to help people with whichever conundrums beset them these days.
    And they are rather insistent on it. Can I ask if you feel that anybody can truly volunteer to take their drugs (much different and inferior to drugs of choice ie alcohol) while denied their rights, deprived of resources and possibly threatened with detention (rightly or wrongly) based on the assumed quality of their thinking?
    A simple Internet search or a search of MIA will inform you of PTMF a unique distillation of many views critical of current practise and a structured understanding of how to make sense of the predicament and what to do about it. It’s a work in progress but seems to be a way of developing understandings that might lead us out of the current impasse wherein genuine recovery is proving near impossible for more and more people than previously! Here’s one page from MIA

  • @Diger, in short the best way to veiw my position is as stated, I’m an admirer of the PTMF understanding and always keen to respect the environmental, cultural, social context and origins of mental distress. Unlike some here I do believe (as it seems self evident) that some sorts of professional intervention are necessary sometimes even as we currently stand they are at best woefully inadequate if not downright damaging! Even excellent therapeutic interventions dont have the resources available for people in need and indeed don’t even often think of this need so focused on the inner mind are they (not that this is unimportant.) Often these days (how often I don’t know) no intervention is mandated by anything other than resources such as housing, education, training and welfare provision (and not even that sometimes.)
    Drugs: people gave always taken various subsatances to get by which can be a useful or even enjoyable distraction but that’s all it is. Often relying on substances to deal with a difficult existence can ultimately just add to the troubles afflicting you. I feel psyche drugs are mostly prescribed because they are so profitable but there are other reasons which motivate doctors to prescribe them. But do they solve anything or merely act to over up the problem? I’ve certainly rarely benefitted from these drugs and I’ve been forced to take them for nearly 30 years by now. My own struggle has meant that usually I’m on a fraction of an effective dose – I’d be on a least 10 times as much otherwise. But still I’ve lost tears of my life to unnecessary treatments that haven’t worked for me. I’ve asked people why they reached out for a psyche intervention instead of more meaningful resourced support and have received no satisfactory answer. Just insults in fact!

  • Sorry Steve as I was saying by and large we probably agree here on this. My question was for those here who are articulating an entirely untenable stance, defending the indefensible by attacking everyone who suggests a response to life’s most extreme tragic consequences. You cannot wish away these troubling circumstances, situations and mental states by abolishing psychiatry. It would immediately reemerge anyhow as these extreme states aren’t going to go away anytime soon. So please try answering the question I’ve actually asked and tell me how you (@Oldhead,@sam plover etc.) suggest society should respond to these varied troubles without resource to psychiatry.

  • Extraordinary report. Thank you Mr. Robert Whitaker for exposing another example of rapacious avarice occluding common decency and the sensible assessment of evidence. The pile of evidence is clearly pointing at greed as the primary motive for the prescription of psychiatric drugs (and usually of those not in a position where they are obliged often to meet the victims of their prescriptions).

  • @Steve MaCrea, @Diger. These are by and large fair comments. I think we probably agree a lot about psychiatry as it’s currently practised. Here’s the main motives for prescribing psyche drugs in my opinion –
    1. Greed. 2. Wrath 3.Credulity 4.Laziness. 5.Vanity 6.Greed (did I mention greed) 7. Risk aversion. 8.Desperation.
    You will note that none of this much relates to the Dr/patient relationship – The Dr. is motivated by intellectual curiosity to provide solutions and the ‘patient’ usually needs solutions to sometimes quite complex psycho-social difficulties that maybe quite resistant to any obvious course of possible action – So drugs are prescribed.
    Having said that, it seems here that some people seeking the abolition of psychiatry have no viable response to these situations. ie, your responses while welcome do not in fact answer the question asked.

  • Any of you AP people want to tell me something else I don’t know, maybe by answering the question! I’ve suffered extensive misery as a consequence of psychiatric interventions, I could write the book on abolition but I won’t – something resembling psychiatry would quickly reinstitute itself and anyhow my experience suggests most if not all people arrive in psychiatric services already burdened with trouble. So I’ll ask again for those people suffering profound misery how do you suggest society ought to respond to our difficulties?
    If you don’t respond with some kind of answer I’ll assume you mean to respond by abandoning us all together.

  • So when people are at the end of their tether, at their wits end, overwhelmed with their own or others mental distress what sort of system of care do you think should be available for people to turn to? Your not denying the very existence of psychiatric problems now are you? (granted that many (possibly the majority(particularly children)) are treated for problems they don’t have and treatments are heavily bio – bio – bio, lacking adequate psycho social supports and resources) but huge problems which are currently refered to as “psychiatric” exist and individuals can’t cope, what do you suggest we do about them?
    I think that a lot of people’s time might be saved if psyches included the phrase ‘your in the wrong place my dear’ and were able to direct people to appropriate supports/resources and could avoid the pressure to prescribe the latest patented wonder drug but many peoples minds are already quite addled by the time they first meet a mental health worker.

  • Sam plover? Is that an insult or something? Psychiatry has been and is being reformed constantly – encapsulating more mere ‘problems of living’ and more beholden to corporate interests and the influence of rapacious greed.
    Do you honestly think that abolition will in any way improve the lot of people overwhelmed by psycho social traumas and any associated impoverishment and deprivation?
    Psychiatry needs to be transformed. How exactly do you suggest society respond to people trapped in impossible circumstances?

  • Gender, race, ethnicity, class, sexualutt, poverty, status, credentials and disability – All the usual suspects, with stigmatising diagnosis can be and are employed to double down on prejudice, discrimination, discounting, denying or ignoring a person’s own subjective reality and the manifest denial of adversity, trauma and deprivation.

  • No, doctors are the experts in solving problems – they are not motivated by greed, wrath, credulity or all the other problems by and large. Don’t you think that mostly people encounter psychiatry already overwhelmed by difficulties? Many find a system that works with them to arrive at solutions to their problems. However for many, like me, the efforts to help become part of their problems, stigmatising diagnosis and pressures to collude with false labels, ineffective treatments and discounting your own needs in addition to what might include objectifying othering leads me to think that psychiatry is often part of the problem. However, still the primary offences are external to the system but exert their influence on it nonetheless.
    Philip Hickey is quite correct to suggest psychiatrists should show more courage in resisting such pressures.

  • Have you noticed how so called anti stigma campaigns while well meaning attempts mostly attempt to mostly destigmatise psychiatric interventions. And then compound the error in priorities by promoting beliefs that are known to compound the stigma, ie biological causality.
    You say we shouldn’t be ashamed to be called ‘schizoprenic’ for instance, well don’t use that diagnosis then, refer instead to our multiple adversities, deprivation and traumas! And try fighting for the provision of resources that are actually shown to promote recovery.

  • Philip, well you left them out this time, which is a bit of an oversight! But my criticism is not of you, merely to highlight the many pressures psychiatric services are under. I usually appreciate the work you and colleagues are engaged in aimed at securing interventions that work and avoiding interventions that don’t work or are unnecessary. Thanks.

  • I see no harm in critiquing psychiatric practice, it has after all played havoc with many lives including mine but maybe helps many too or so they claim. But why spare they powerful interest of pharma or the supporting role of advertising, marketing, insurance practices, media promotions, political decisions enabling paying for what is characterised as the bio-bí-bio model – somewhat disengenuously but not entirely – Or indeed a wider societal failure to support the provision of resources (housing, education, healthcare, welfare) sufficient for sustained recovery. Or indeed spare patients (whom you call customers! Customers of what exactly? ) from their responsibility for believing credulous bullshit, if that’s what it is, you seem to believe so.

  • I see no harm in critiquing psychiatric practice, it has after all played havoc with many lives including mine but maybe helps many too or so they claim. But why spare the powerful interest of pharma or the supporting role of advertising, marketing, insurance practices, media promotions, political decisions enabling paying for what is characterised as the bio-bí-bio model – somewhat disengenuously but not entirely – Or indeed a wider societal failure to support the provision of resources (housing, education, healthcare, welfare) sufficient for sustained recovery. Or indeed spare patients (whom you call customers! Customers of what exactly? ) from their responsibility for believing credulous bullshit, if that’s what it is, you seem to be left I’ve so.

  • Thanks Iva, I’ve always believed that the social context of distress (past events, current adversity, deprivation etc and fears for our future) is vital, indeed central to understanding (shit happens leading to disturbance and the absence of available psychological, social or economic resources has a primary role in the resolution of such) distress. It is indeed crazy to believe otherwise but what to do about it?
    As a personal example immediately upon a coercive detention a few years ago the distress incumbent upon being trapped in a shit storm disappeared overnight. The relief felt was not as profound as felt by those escaping a war zone but welcome nonetheless. Unfortunately the system was unable to provide the resources needed for a relocation but toying with a highly stigmatising diagnosis which I may or may not have fought of f and a continued dependency on psych meds.
    I hope the work here can encourage a change in the mentality that currently struggles to imaginebetterfutures to us victims of life’s travails, adversity and the deprivation that prevents us tackling difficulties.
    Thank you.

  • Intellectually dishonest, emotionally laden misdirected hyberbole fails suffering humanity. Never one shy to critique our collective failure to provide adequate responses for mental distress I note that this article fails itself by sparing utterly the most egregious offenders in this ongoing scandel while attacking those with some insightful commentary that may in time prove fruitful.

  • The numbers are certainly staggering, incredulous in fact. And very frightening indeed. Even reading Bob’s extraordinary report leaves me with a sense of disbelief and I almost want to insist it’s been fact checked(footnotes please), and I’ve been aware of these problems for decades. How can this scandal be happening?
    I asked a professor of psychiatry for research evidence that the drugs ‘worked’ as she insisted over twenty years ago. She responded ‘Read a textbook’. To which I said I have. She couldn’t provide any proper rational for standard medical care. It’s over ten years since Irving Kirschs research showing that the tablets work no better than placebo more or less. I’m sorry but saying its ‘standard medical care’ doesn’t cut it. Professionals must be held to a higher standard than that, they are expected to have learnt something useful in order to qualify, to learn from an experience we can respect them for. I don’t know about you but were I come from we’re taught that ignorance is no excuse! If the evidence of the harms done by these do called ‘treatments’ is so readily ignored you have to wonder how this comes to be and why it’s not only allowed to continue but continues to get worse.

  • Politicians want first and foremost to keep their seats. For now they are ensuring as many people as possible are getting the ‘mental health care’ we so richly deserve. A British new Labour spin doctor frequently confesses to his battles with depression on public radio shows. For some reason he insists on calling it an ‘illness’ despite never being challenged on this point. As such despite being a man of considerable privelege and status he is simultaineously denied the insight he needs and acts in effect as an (unpaid) shill for psychiatry. He was in part the architect of the destruction of a party committed for all its faults to ‘the nationalisation of the commanding heights of the economy’ to one with unquestioned deference to neoliberalism and unqualified support for those ‘compassionate conservatives’ war. If this scandal is ever tackled properly it will maybe because of its impact on healthcare in the round and not bacause of its particular impact on psychiatry were people can be depended on not to care. I’m not holding my breathe but as the Poet Seamus Heany says –
    History says, don’t hope on this side of the grave. But then once in a lifetime the longed for tidal wave of justice can rise up and hope and history ryhme.
    Here’s hoping enough folk can struggle to escape the bludgeoning fog of capitalisms current blindness. We all depend on that, not just those of us afflicted by psychiatric adversity.

  • The profit motive is bad for healthcare! This extraordinary report illustrates how. Healthcare provision freed of greed is available at much lower cost, more efficiently and effectively. For this reason most healthcare facilities until recently have operated on a professional non-profit basis.
    It is possible and does happen that by and large trustworthy medical care is offered free at the point of care (paid for through taxes or other mechanisms). And it seems that still now most of the basic research and development of medicine (and technology generally) is conducted free of greed by reasonably honest scientists whose work is rigoursly examined and critiqued by colleagues. It’s only when something looks profitable that it’s hived off into the private for profit business sector. I was alerted to this fact by Noam Chomsky and confirmed it by research(sorry I’ve no links readily available). Pharma do have its own labs and research but their claim to need profits is pure poppycock, even in their own labs the scientist are not motivated by greed (who’d study science on the basis that it would make you rich) but nonetheless are under pressure to pander to the corporate bottom line. So they do do research and development but it’s hard to know how exactly how much as their ‘research’ budget includes do much of what is basically marketing! This doesn’t just apply to psychiatric drugs we’re it’s worst but to the other scandal of opiate dependence but to overprescription generally of anti biotic (fueling resistance) , statins, benzos, sleeping tablets, excessive unnecessary screening and testing.
    Even in Europe our relatively effective health care systems (psychiatry not withstanding, although most people still believe mental distress arises from experience not biology this veiw hasn’t entirely infected the clinic for some strange reason although it has some effect) have not escaped the notice of business. A company previously best known for selling records and tourism has contracts worth billions to provide ‘mental health’ care and they havent being using it to enable people to dance around listening to their favourite or take us on holiday. Have you hoticed how you can walk into a therapists office with a love of music, hobbies and interests and walk out with ‘coping strategies’?

  • Yes Richard I agree it’s all rather complex. (I read the other thread which proved enlightening.) I have to admire the idealism of people seeking the abolition of psychiatry in toto, along with capitalism. But I’m not sure but that psychiatry will outlive capitalism. After all some people will still be driven to distraction by their experience of life. This I have little doubt will be true even if and when capitalism has outlived its usefulness if it ever had any. I’ve only recently come to this view in the light of climate crisis, another reality our ‘mental health’ brigades have identified for concern. In the meantime I won’t be holding my breath waiting for psychiatrys demise. I think there’s always going to be a need for an organised professional response to some people’s states of mind. But here’s still hoping your good selves or others efforts will at least inspire enough restraints to be put in place to limit the damage. Asking psychiatry to reform itself is obviously having no impact. You can throw all the ‘scientifically’ evidenced rebuttals at it you like it will have and has had no effect. They seem utterly oblivious to evidence of any kind while still managing to give every evidence of being decent professionals who sincerely believe in what they do. But maybe they will continue to and maybe more so lose some court cases. But so far they’ve managed to take these on the chin.
    Personally I find no harm in simultaneously respecting the clear thinking (which I continue to admire despite my own muddled thoughts these days, my mind being addled by circumstance, experience and drugs) of some academics who have concern for how society responds to psycho-social distress, while still noticing that they all to often appear to pull their punches when called on to reject the basic functioning of psychiatry, and individualise responses. That and their own experience and understanding may explain what appear to some as cynical rejections of some stances articulated here.
    Anyway I think the analyses of the problems being discussed here and the activism might bear some fruit eventually. It won’t be before time. Good luck and take care.

  • This is actually part of a series of interviews with academics/clinicians with a critical perspective on psychiatry. It’s quite interesting to read and provides some intellectual armoury against the nostrums of psychiatry. I rejected psychiatry from the get go and have always understood my difficulties in a social context but have nonetheless been ground down by the the psychiatric process. Obvious benefit could have produced less adversity from being better informed. These are interesting interviews but I wonder if like always the arguments are being presented merely to give the psychiatric establishment occasion to refute them. The PTMF is grounded in an understanding that our problems start in our experience of the world and what we make of it. Psychiatry has no time for real life experience. However psychology is often no better, engaging in tick box exercises to confirm a diagnosis for psychiatry or counselling coping strategies that while sometimes effective up to a point also place the locus of responsibility in the individual.
    I have considerable admiration for a long line of psychologists who in their work acknowledge actual adversity but I’m doubtful that they’ve had much impact on clinical practice very often in Britain as elsewhere. So often critiques of psychiatric practice pull their punches at the point of acknowledging adversity and often merely at the adversity people sometimes experience in psychiatry. After that they just continue with the process of tinkering about inside our heads. It’ll be a massive job of work to undo the damage done by this mindset.

  • Hey Fiachra ever heard of the ‘schizophrenia challenge” it goes like this -‘ patient’ ( client/consumer/victim/inmate) “Hey doc if you think this poison is so great why don’t you take it then, it might help relieve you of a few of the fixed false ideas you’ve been hawking around about me and improve your social skills, maybe even your occupational functioning, why not have a go then it just might help? ”
    Doc thinking to self – I can see this is not going to go well.
    Well normally this approach is fraught with danger and rarely goes as intended. Sometimes the doc actually takes up the challenge though and within hours of taking just one tablet finds their mind in an awful mess, their occupational and social functioning falling apart and occasional start getting suicidal and wanting to die.
    So called ‘Schizophrenia’ the world’s worst insult mascarading as a legitimate disease is as far as I know the only condition where the treatment causes the majority of its (alleged) ‘symptoms’.
    Good luck with getting your MP interested, however insisting your afraid to walk onto a building site may not prove very helpful (just saying).

  • “Human suffering arises from our embodied interaction with a world, that though it cannot be known cannot be wished away.”
    This is a very thoughtful interview with a very thoughtful, sensitive and erudite man. Thanks. But despite this well reasoned stance which often seems beyond argument, despite the considerable evidence which is easily accessible, despite the fact that psychiatry usually employs educated, cultured and seemingly decent individuals to do its business it carries on oblivious to the evidence. Its failures, mistakes, sometimes downright horrors continue. Why?
    It’s not because their monstrous people – It does us no favours to dehumanised psychiatrists as we have been dehumanised. But still psychiatry exists with, despite many changes, the same basic mindset that Denys the harm that adversity, oppression, abuse and neglect cause people. Not only that but it has expanded its enterprise, sees more people treated than ever before (by a long shot) and despite the recognised proven failure of its treatments seeks ever more confidently to expand further into society. Why? How can it get away with this blind indifference to people suffering to reason even as it claims to be reasons best protector?

  • “Human suffering arises because of an embodied interaction with a world whose nature we cannot know but which we cannot escape.” I don’t know why we need to keep debating this. The DSM mindset outlived it’s usefulness long ago if it ever had anything to commend it. But it seems to proliferate like an out of control epidemic capturing more and more in its poisonous grasp – poisionous words followed by poisonous drugs. Not all are harmed or recognise the harm, maybe even some are helped to heal as they claim – who am I to argue with them. But many are left dissapointed if not destroyed by these treatments which profit the few at the expense of the many. Resting as it does on no firm intellectual basis but more so on a profound denial of the dangers inherent in life, the damage done by adverse experiences, events or circumstances how does it survive and continue to thrive?

  • Well said. In France wearing a mask is mandatory whereas last year they banned the wearing of masks to stifle public protest whatever you think of it.
    In fact one of the things I know about masks is that as anew thing when introduced first they were heavily and no doubt articulately criticised even by respected members of the medical profession in the C19th. It took a long time for them to be widely accepted even in medical circles. But earlier this year at the start of thr pandemic there was widespread hoarding going on, the price of masks sky rocketed and even medical services were sometimes finding it impossible to source supplies – that’s what initially motivated public health officials to put out the message not to wear masks – the law of unintended consequences maybe?

  • Absolutely nothing in particular Oldhead. Things go in opposite directions simultaneously sometimes. The master strategists with their tentacles infiltrating every avenue of human endeavour are no doubt rubbing their hands with glee. Covid is really serious even as they are delighted to have a really serious replacement for the distraction of the Trump show, who’d have thought that was ever going to fly. In politics both sides now the centre right as well as the right have seizes on to the new distraction, even if its distasteful to a say so as Covid is not just taking and ruining lives it is laying waste to whole communities. What are called the disaster capitalists and their strategists and propagandists are indeed rubbing their hands with glee carrying on with their program unnoticed, unaccountable. They couldn’t give a shit about you or me but have come to dominate the agenda determing what is legitimit to articulate. To a ‘commie without a home’ I find a lot to agree with in what you say. Its validating and occasionally enlightening, much here I’ve heard before or figured out myself but occasionally like now I need reminding and sometimes you and others give me pause for thought. But there is as yet no law that says we have to agree on anything let alone everything. I wish I could say the same about the psychiatrists who I seem to fascinate. Yes I’d Stay away from them but that’s easier said than done in the circumstances.
    For now I am well and truly pissed off with hearing about Covid. From a homeless utterly isolated person living with and caring for an elderly couple obsessed with worry about the virus I dropped in on Mia to find relief from that particular news feed. Thank you.

  • Oldhead, can I just say that I really really don’t want to have an argument with you about vaccinations! But can we both agree that the forces of rapacious corporate greed are indeed winning, hands down, and without any properly organised opposition the sort of which we used to have in the Labour movement and elsewhere. If I recall it may have been your good self who alerted me to what Warren Buffet, one of the world’s luckiest men, said that there is indeed a class war ongoing and the rich are winning – hands down and no dispute.
    As of today one of my sources of news tells me that the loneliness and anxiety of the many during lockdown is distress to be interpreted as a doubling of the number of people showing signs of depression. So that’s another potentially huge expansion in the market, after the already near doubling during the austerity years, the expansion into schools prisons etc. This from a leading mental health charity that once upon a time used to actively harbour and fund the activities of critically inclined survivour activists.
    So that’s all cause for despondency. Not to mention the almost trillion dollar handout the world’s 1000 richest people and corporations got in the bailout earlier this year.
    And maybe we can agree that the profit motive is bad for your health. US healthcare costs are over twice per head as Britain’s NHS and yet people live longer in the UK despite its climate etc. This in spite of large swathes of the American population being uninsured or under insured. You can go bankrupt or end up destitute and homeless for becoming ill, that can’t happen in Europe.
    A large part of the motivation however for over prescribing, over valuing, overselling meds, for disease mongering, unneccesary screening etc. is the profit motive. A good number of people below the line here are prepared to criticise the profession or the government but not tackle one of the key motivating factors in the problem – greed. We need in our solution to recognise this fact. Not for profit healthcare systems have better outcomes and are run at lower cost. I personally credit the scientists who developed life saving treatments obviously. Most of the research and all the basic research is done in non profit institutions, philanthropically or government funded labs or university labs. Failing to nationalise pharma when national free at point of use health care was established seems to have been a serious oversight.

  • No Oldhead I have no expertise as a virologist or epidemiologist or anything else for that matter. But that doesn’t make me automatically distrust everything that goes on in the world. Virology is not psychiatry. Vaccinations have been responsible for very significant improvements in mortality along with other public health measures including the elimination of some diseases and the massive containment of others. Anti vax messages have been responsible for outbreaks and resurgenses of some otherwise well contained viruses. And recall that the original anti vax message was tied up with a false label which exposed it to my mind as false immediately and later this claim was comprehensively rebutted.
    As far as masks are concerned it doesn’t seem to be a big ask to cooperate with seemingly sensible public health measures and easy to do to. I defer to kindred spirits comments above.
    But yea we are as you say being ‘sold a bill of goods’, if nothing else covid has removed alot of otherwise significant stories from the news agenda. We should as always be deeply skeptical about any claims made in areas were alot of money is at stake. The motivation to make false claims overprescribe, oversell or overprice an otherwise acceptable treatment are of course maximised by concerns for profit over peoples health.
    As far as anti psychiatry being removed from social media, well so called anti psychiatry or even critical psychology messaging is a rather marginal thing and increasingly so in my experience. For instance this feed highlighting the adverse effects of psych drugs has been flagged.

  • Indeed, I’m just nitpicking, we have no need for false labels – can I have my chocolate egg now. Do I really have to take those tablets? Seriously I’m struggling with some people who take these concepts very seriously indeed. You know what that’s like so until I can succeed in both putting more distance from them and get closer to more amenable folk I’ll be struggling with the thought of letting them have a piece of my mind or playing dumb.

  • It’s important to preserve some distinction between madness and badness. People of course can be bought. I’m not sure if all people are as scared of the allegedly ‘mentally ill’, ‘nutters’ crazy people in their midst, sometimes now they just seem concerned that people take their drugs. They call this ‘care’. After that they usually don’t want to know. The violence argument ignores the institutional violence of coercive manipulative psychiatry. They call this ‘care’. The victims of which are more often the victims of violence than the perpetrators of it. In fact it seems that people being treated such are less likely to commit violent crime than the normals.

  • No the easter bunny does not exist but the concept is real. I have to disagree with you here Oldhead, we do need labels and not for nothing. We need to call out the ‘medicalisng’ of distress and the ‘individualising’ of experience, of trauma, abuse, neglect, poverty, oppression, discrimination. Adversity in all its forms is increasingly responded to as ‘mental health’ problems. And this very individualising narrative approach is neutralising our collective Capacity to even discuss the adversity at the root of our troubles.

  • The drugs don’t work they just make you worse.
    The coronavirus pandemic is real.
    Wear a mask for crys sake. Vaccinations are safe, anyone who says otherwise is responsible for spreading diseases the consequences of which are….. Disease.
    Nobody serious is seriously suggesting mandatory vaccinations.
    The label your searching for is disaster capitalism OH.

  • And it’s not just the exceptional overcoming of difficulties that this applies to. No doubt many homeless people have been encouraged to strive to overcome our loss by the power of belief alone (although probably not by their carers who may fear losing a client) but mere thought cannot manifest bricks and mortar…
    Even as one homeless person is housed by their own efforts or with support in the current dispensation corporate landlord ism ensures another is rendered homeless. No society has ever housed all its people adequately without collective resources being deployed and few enough at that rate.

  • Thanks, I hear ya. Their hardly quaking in their boots at the likes of me in this suffocating bourgeoise culture. But the corpus of ideas and the movements I support are frowned upon even if they have a respectable heritage but have been and increasingly neutralised. How has psychiatry gone from something your mother threatened you with to something your encouraged to actively seek help from voluntarily and not necessarily in desperation?

  • While ’empowerment’ is also a term used and abused to hoodwink us into thinking we can surmount impossible odds if we merely adopt the right attitude I won’t quibble. Let’s reclaim the language – It is indeed empowering to see things as they are even as that is the corrupting of our consciousness by this manipulation of our conscious awareness of power. It is empowering, humbling and not a little frightening to acknowledge the pervasiveness of the individualising of suffering even as it rears its remorseless indifference to our fate. We realise the immensity of the challenge and at least free ourselves of blame and loathing for the acts of power. Take care.

  • Exactly so Oldhead and I’m no marxist. What we are witnessing is precisely the commodification of ‘care’ with ‘care’ presumed to be the pretense of concern for a persons feelings and indifference to their circumstances. “Get your head straight and your life will work out fine” I’m advised. This ignoring in its enteirity the exercise of power in the world, the exercise of such power largely denied to the likes of me, niave enough to be sharing my thoughts with mental health professionals.
    But this kind of discourse seems to be seaping into everyday discourse, percolating everyday life, trickling down into the commons poisoning relationships and increasing our sense of alienation.
    Maybe it’s just my becoming further and further socially excluded that I experience this kind of miserably interaction so often. I’d be delighted to see some research on it because it seems likely to be a consequence of the proliferation of ‘mental health awareness/literacy’ marketing campaigns. It’s not just therapists that engages in this kind of thing. Often people do it voluntarily in circumstances where its not their duty to expand the market for mental health treatments. As listening ear counsellors, in self help groups, as teachers these days overly concerned with their charges ‘mental health’ while in effect operating to open up a huge market for the psy complex. I’m not entirely convinced these people are overly happy about this state of affairs but usually seemly strangle reluctant to discuss it. That is discuss why after they’ve offered their help and concern (professionally or otherwise) they insist on distracting you from the reality of your actual problems to affecting sincerely or otherwise concern for the state of mind your expressing. I mean maybe that’s a problem but if should somebody be consulting a therapists when their house is on fire is it beyond the therapists responsibility to insist your on to the wrong person you should call the fire department to put the flames out.
    Many a life has been lost this way. Many have found themselves often with sincere concern to resolve a temporary difficulty turned into a lifelong career patienthood. With all the drugs and therapy sessions, peer counselling, recovery programs etc. And all the while the actual difficulties that beset you are ignored and actually added to in effect.
    How does it help if someone is unemployed and isolated, out of the loop so to speak, to be given a diagnosis of mental illness and drugged into a soporific submission to occupy a place barely on the margins of society with no hope of support or concern that addresses their circumstances.

  • I don’t think it’s a lack of sincerity so much as a lack of thought or a lack of responsibility. What Megan seems to be driving at is power or the abuse of power. What are often sincerely held beliefs are often used to deny the felt trauma. A man brought up with an inate sense of superiority may not ipso facto be accused of insincerity by saying there is no racism/sexism nowadays although best thought of as looking for a rise. Similarly a psychiatrist might express sorrow for our feelings of a sadness or anxiety and give us little chance to avoid ‘treatments’ which more often than not add to our traumas. And they can and do argue for coercive interventions (even the more progressive ones) by presenting case studies it seems impolite to argue with. So what I think Megan is arguing ng is against the power of language to invalidate experience (notwithstanding that some people are being overly sensitive, misattribuing responsibility, maybe in denial etc.)

  • Thanks, best as you say just to walk away if people persist with that kind of attitude. But, and I’m should be careful how I say this, sometimes it’s a lot easier to walk away than shake off somebody’s influence.
    I mean 20 years after making the conscious change to survivor status I’m back using the system. Not by choice so much as lack of choice. But a sorry state of affairs really!