“…the psychology of the Global North can be challenged by the academics the Global South, advancing the cause of liberation.”
Let’s hope this happens, otherwise all talk of “diversity” is meaningless (real diversity is diversity of perspectives and values not appearance).
Makes sense, it seems like PTSD takes for granted that the trauma is over, what about ongoing situations?
Yeah pretty much
Sounds about right but asking mainstream America to take culture seriously (without fetishizing it) in my experience is like getting a dog to walk on its hind legs.
Guess it shows how almost anything can be twisted into something oppressive (TMS, microdosing, and other things coming your way).
I’ve even heard it’s started to happen with trauma-informed therapies, which is unfortunate.
Thats probably true, although they’re masters at tweaking a molecule or two and claiming it deserves a new patent (think extended release versions).
Ironically there was also a recent article stating that the basis for Alzheimer’s research is incorrect (amyloids).
It’s neuroscience, transmagnetic stimulation, microdosing, etc.
“Please stop blaming patients for the way that Psychiatry is viewed. The way Psychiatry is viewed is completely psychiatry’s responsibility. Patients have been scapegoated enough!”
He’s not blaming patients, he’s saying that stigma that gets attached to people with psychiatric diagnoses (by the general public) also “infects” those who treat them. The patients aren’t doing anything whatsoever in this process, but you’re right that psychiatry’s image is psychiatry’s responsibility.
That’s true (they’re more dirty than desperate now) but the desperation refers to their historic attempts at cures, not their desire to be successful financially.
Many people develop substance abuse disorders as responses to trauma though, and recovery from trauma necessitates reclaiming power, so telling people to accept powerlessness may be counterproductive.
AA has very low rates of long-term success from what I’ve read (I don’t have any peer-reviewed references on hand, but they’re probably easily found at Google Scholar). The emphasis on total abstinence, public confession, implicit religiosity and potentially re-traumatizing approach (not to mention a reputation for predatory males) don’t make it a great choice for many, although it’s the only thing many people (including judges) have heard of.
No, that’s just more fearmongering (the mind is probably more capable of healing itself than the brain if anything).
Don’t you think you just needed a therapist who was allied with your views on society’s expectations then?
I’m not a huge fan of behaviorism but it’s great to see voices from within the profession demanding accountability.
At this point do we really need any more critiques about how psychiatric studies are bogus? The medicalization of mental illness has been a hoax from day one and anyone with a brain, heart and scientific education should know it.
(But of course it’s necessary to continue debunking the new myths that pop up daily like heads from the hydra.)
I wouldn’t say there is no difference between (in general) between white and black Americans but they do have more in common than either of them tend to think.
Also I would agree that African-Americans see themselves more through whites’ eyes than the latter realize, but it is not always the case.
Teaching people to stand up for themselves would also involve some form of expertise and therefore not be legitimate according to your logic (it’s impossible to teach anything without any kind of interpersonal engagement, otherwise it’s just brainwashing).
Interesting that the article’s title refers to cultural differences but that the issue is then defined solely in terms of race as if race and culture are the same thing (i.e., everything else being equal, there cannot be any meaningful differences between a white American and a white French person, or an African-American and someone from Kenya?)
There’s no trick they won’t turn to
Yup!
She makes a lot of good points but it should also be noted that Alice Miller’s own son made a film about how abusive she was towards him:
Interesting article, everything has a cultural component to it I would think.
Yup pretty much (for those interested in the question of states and municipalities struggling with funding I encourage you to explore the idea of public banks–movements exist in Philadelphia, New York, Oakland, Santa Fee, etc.–instead of paying high fees to out-of-state private banks they are able to essentially borrow from themselves and give out low-interest loans to small businesses which keeps the money circulating in the community (loans which aren’t worth the time of big private banks to make). They are vetted through a public-private partnership to ensure economic viability and transparency.
North Dakota has had one for a hundred years and it works fantastically–we have to get past the old dichotomy of capitalism vs. socialism and create something which is profitable for the masses (USPS used to offer postal banking, this is a smaller version of this).
(If people feel empowered in their communities they will be less likely to die deaths of despair.)
Yeah pretty much.
Sounds like concepts around individualism and “toughness” have been over-extended into child psychology.
What a surprise (not)
Yup pretty much.
Interesting article (and hypotheses) but I think it’s very one-sided in its treatment of evolutionary psychology (it makes it sound as if it’s all just a justification for inequality and brutality, it’s not).
And shame on Harvard for not just letting this guy operate there but essentially continue unpunished after his outrages were exposed.
“The Diagnostic and Statistical Manual, the so-called “Bible of Psychiatry,” is approaching its 70th year. It should be its last.”
Amen to that!
Interesting article, yes culture permeates everything in psychiatry including personality disorders and needs to be accounted for.
Agree, that’s why I’m not totally unsympathetic to anti-vaxxers although I disagree with their stance on this particular issue (the medical-health complex is massive and mostly interested in making money, your health is a secondary concern).
At the same time this is somewhat of a false either-or, it is not simply that people need not try but only wait for “the system” to supply them with good jobs, a better lifestyle, etc.
Interesting article, curious why rates of recovery weren’t better and alcohol use was higher? Perhaps just giving them their own space gave them time/space to “use” but is a part of the road back and there’s no way around it. (Otoh lower inpatient days is a plus as that’s how legislators are motivated [reduced costs]).
This is why I’m leery of NAMI; there are many well-intentioned people in it but they can’t bring themselves to question the disease narrative (for multiple reasons IMO).
Sounds about right–when economics is the basis for all existence those who are not economically productive (for whatever reason) need to be shunted aside.
I think it would be great if someone could fund translations of certain books (Moncrieff, Whitaker, etc.) into many different languages.
Excellent article, thanks for the author (and MIA for reprinting).
Just another way in which psychology is implicitly classist, also it’s interesting how the “free mindset” mirrors so-called “free markets” (which in Western countries are often government-protected oligopolies, but we’re required to believe otherwise).
It reminds me of the famous quotation by Eleanor Roosevelt (who was in the 1% of the 1% of her day) about not letting other people make you feel bad about yourself–easy for her to say.
Will psychology ever get out of the lab and become self-aware?
There are Susan Inmans everywhere
Big corporations will literally drive their customers into the grave if it makes them money; there needs to be pushback against their domination of society’s rules and Big Pharma in particular (take your pick).
Western civilization has arguably replaced religion with scientism.
That’s why I don’t even like the term “neurodiversity”; it’s a way of smuggling in a physicalist paradigm in the sheep’s clothing of a social justice expression.
Well I don’t think CBT (when done well) is about convincing the person to simply think of something else, rather it’s coming up with alternative explanations which relieve suffering while also being plausible enough to be intellectually satisfying (i.e., not “oh they just did out of love”, etc.)
Yes I think CBT has value insofar as questioning one’s thoughts and assumptions is valuable, the problem is when treatment providers decide what is rational or not based on their norms.
Do you have a link to sign up for it? Yours is just the talk itself once it starts and I didn’t see anything at his homepage.
Yes this is what I meant roughly, don’t use the methods of the natural sciences to answer questions of the human sciences (“how” cannot answer “why”).
Not so sure about this–yes empiricism and rationality have limitations but the answer to bad science is not throw out science altogether, it’s to respond with better science.
(Maybe in practice that’s what the author meant, challenging conventional epistemological narratives that privilege certain ways of defining truth).
I couldn’t tell from looking at the article which psychotherapies they looked at, however. (It said: “All types of pharmacotherapy or psychotherapy were eligible for inclusion” and mentions CBT in passing but that was it.)
I agree, the moneyed interests will try to destroy this (the media will do their work by not even reporting it for starters).
At the same time not reforming the current system has tremendous human costs as well.
I think efficacy also plays a role–therapists like anyone else wants to feel that they are good at their job, so people who are extremely difficult to help (in the sense of not responding to conventional treatment) may frustrate them after time.
Not surprising but it’s good to have some empirical data showing it to be the case.
Good article but I wish it had been fleshed out a little more, for example are there other forms of therapy beyond psychodynamic and CBT and how do they fare with varying SES-based demographics? (Especially things like family and/or group therapy.)
Also I think sociologists usually use four different variables to calculate SES (iirc it’s level of education, income, wealth and occupation [e.g., blue- vs. white-collar]).
They might be talking more about social workers, or people who go to low-cost clinics or those who have to see graduate students doing their hours for licensure under supervision.
I think one of the points is that the way talk therapy is designed is inherently poorly-fitting with “lower” class norms/ways of being/doing/relating/etc.
I’m not reading Daniel Kahneman, I don’t even know who that is (or was).
Another problem to me it seems is the pity response–what is needed/desired is empathy, but what is given (or not) is sympathy.
In the current system, yes.
Very good interview, I hope her program succeeds and thrives (and is replicated elsewhere).
Good article, I think a lot of people falls through the therapeutic cracks because they feel traumatized but their situation doesn’t fit the textbook definition of PTSD.
Yup!
Everyone has a culture but not everyone’s culture is being dominated by others.
Also not all North Americans are descended from immigrants (slaves, colonists, etc.)
And it’s entirely possible to be unaware of certain issues, it’s the normative same as the way your brain blocks out 99% of your sensory input at any given time.
(And how can you be aware without looking at why people are they way they are? It’s like saying I want to understand someone but don’t care about their name, age, ethnicity, gender, etc.)
Excellent interview, we need more like this.
Sounds about right–the line between legal and illegal drugs *is* arbitrary (cocaine and opium used to be legal for example, while marijuana is mindlessly classified as Schedule One).
Also I like the concept of epistemic violence–it happens all the time.
(At some point psychotropic drugs as per Joanne Moncrieff should be seen as simply providing relief rather than fixing some underlying brain pathology.)
Every illegal drug is surrounded by hysteria–reefer madness, opium dens, crack babies, bad LSD trips, etc.; the current form exists vis-a-vis fentanyl (some members of law enforcement go into convulsions when they think they’ve touched it even though it can’t affect you at that level that way).
Reminds me of the saying about something being so stupid only an intellectual would believe it.
In practice (no pun intended) I think most physicians are too busy and/or disinclined to look for evidence themselves–they’re trained to accept whatever the most recent medical journals tell them is the truth. Also with the decline of personalized medicine it may feel gratifying to them to be able to address their patients’ misery–often that is part of why they become doctors in the first place. (It’s also very difficult to swim against the mainstream as Mr. Hickey points out in his response.)
Makes sense, but who has the courage to be a parent who refuses psychiatric drugs for *their* child?
“Most of my colleagues haven’t read Bowlby. In psychiatry, people don’t talk a lot about attachment.”
For psycho-political reasons Anglos tend to be suspicious of attachment.
Having said that, Bonding Therapy does have a number of practitioners in the U.S. who all seem to be in the Baltimore/Washington, D.C. area.
Psychiatry is so corrupt at so many levels it’s mind-boggling.
Very good article; thank you for writing it.
They’re so deep in they can’t bear the thought of looking at themselves and what they’ve done to get where they are.
So basically all goes back to the centuries-old point that the methods of the natural sciences cannot and should not be applied to human beings (i.e. within the social sciences)?
(It’s called anti-positivism or interpretivism.)
Very good article and interview, we need more like her.
I understand what you say about the parallels between Catholic confession and psychotherapy but the institution of confidentiality to me has much more to do with Protestant ideas about privacy and private property (i.e. legal constraints on personal experience); also the one-on-one parallels the Protestant emphasis on an individual relationship with Jesus more than Catholic practice(s).
And the over-emphasis on childhood and childhood experiences originates with Freud who was not Christian.
You mean they would have done it if asked nicely? (Also keep in mind much of the time it’s Europeans and their descendants who do this themselves, not outsiders.)
Why not? Once it scales up and *if* medical costs in this society come down it can become more affordable (perhaps if states realize they’re actually saving money this way they would offer grants, also other parts of the country except for the West Coast and Florida aren’t as expensive as the Northeast).
At the same time neglectful social conditions do not cause disease in and of themselves, rather they allow for the spread of disease(s). (My fear is that the equation of politics with medicine will lead to a tyranny by doctors [rather than big business or demagogues] something that we already arguably see by psychiatrists and Big Pharma and may be a part of what anti-vaxxers sense and are pushing back against.) (The greatest form of patronizing power plays can be sometimes be doing things unilaterally because it’s “good” [for the other person]).
Yes as well but my point was that the name the facility goes by is not “Grace Brook” as the op seemed to suggest. (I don’t think they were implying that only programs run in that building have value.)
“In recent years, Birch says, she’s been approached about starting potential new Inner Fires in Texas, Northern California, Detroit, elsewhere — but right now, all she can do is focus on the one in Brookline.”
It would be great if there were some way to coordinate the people looking to start these kinds of places in other parts of the country!
fyi Grace Brook is the name of the stream and the farm where the facility is located but it goes by the name “Inner Fire”
I think it depends on how you define adaptive, yes a broken arm is not functional but the reaction of the body (swelling, bruising, sending white blood cells to kill off potential infections are adaptive even if they don’t feel or look good [in the context of so-called mental illnesses these are the things which get called symptoms and medicated away, in the same way in which anti-pyretics reduce fever whereas fever arguably restores health by increasing the body’s temperature to the point where certain bacteria can’t survive {so that by cooling the body you might make yourself feel better but it allows the illness to continue longer than it would have}]).
I don’t know which is worse, the fact that researchers fabricate data or the fact that the field doesn’t go back and refute them after it’s discovered (this kind of thing also gives credence to those who say that the research behind vaccines is bogus of course).
Well the cure I was referring to in this case was getting rid of all drugs (presumably apart from those with a clear medical purpose), not using psychotropic drugs to “treat” human misery.
I am no fan of the expansive long-term use of psychotropics but the decades-long radical failure of the so-called war on (recreational) drugs has created far more problems than it has solved in my opinion. Perhaps prescribing of legalized drugs needs to be made much more restrictive, but (for now) trying to simply ban them runs the risk of creating resistance and kickback (not to mention accusations of Scientology).
If you feel that the culture is the problem, as you indicate, I think you need to offer something more nuanced than simply an outright ban–such approaches throughout history have generally failed and/or created problems of their own (e.g., the rise of organized crime during Prohibition).
Again it’s just a word (“sociologically”) and doesn’t need to be read into too much (the very basis of sociology as a discipline, by the way, is *not* looking at issues through an individualized lens).
I agree that Western society is over-medicated but saying that the flow of all drugs needs to be stopped absolutely to me sounds like when people say that religion is the scourge of humanity and needs to be eliminated which in practice means imprisoning, torturing and/or killing believers (so that the cure becomes worse than the disease).
Removed for moderation.
Just use the word “sociologically” or something else than, it’s really not that important.
And why do you still think the drugs themselves are still the problem? It’s people’s relationship to them, and what drives them to use in the first place, that counts no matter how much you demonize the external object.
(Responding to rebel above, no reply box for some reason):
I’m not saying that anecdotes have no values, but they’re not the best way to understand issues collectively. Yes if thousands of people come out of the woodwork with personal stories that challenge the conventional narrative then it needs to be reexamined but by and large the epidemic of people deranged by psychedelics never took place (and it’s not done by experiments, no one gave LSD to participants and then calculated how many of them went crazy; it’s done by analyzing data on emergency room admissions correlated with the drug that caused the crisis; yes it’s imperfect like all statistics are but that’s how it’s done to get the bigger picture and not just listen to personal stories–people can have just as strong biases on their own, for example after completed suicides where the physical evidence is incontrovertible those around the deceased will insist they had not been suicidal, generally to assuage their own potential guilt).
(The story about returning Vietnam vets is well-known; any modern textbook on drug abuse will describe how branches of the American government were terrified of armies of heroin-addicted vets roaming the streets of American cities but it never happened, something that the disease model of addiction cannot explain.)
And *everything* affects the brain, including all positive (and negative) life experiences. Caffeine is the most widely-used drug in the world (half of all adults on the planet use it daily iirc) and is addictive, do you propose banning that as well because it changes the brain? (The brain is much more “plastic” than previously thought in any case).
The damage done by the so-called war on drugs is just as real, probably more so (especially for communities of color which have been systematically targeted by law enforcement despite having lower rates of drug use than the white majority) than the problems wrought by addiction/dependence (many of which are the by-product of criminalization and/or social/economic factors, not the substances themselves).
Your friend hurting himself is not a myth but it is anecdote (meaning not generalizable).
And addiction is not even the paradigm that should be discussed as it is not the physical properties of the drugs themselves that matters most contrary to popular belief (e.g., the many thousands of American soldiers who returned from Vietnam hooked on opiates who simply stopped when they returned; the issue is dependence which is slightly different). Another example is that the studies on crack babies did not disaggregate other factors which had greater explanatory power, for example the fact that pregnant women who smoked also had poor nutrition, didn’t go to prenatal counseling, etc.
Marijuana may indeed be damaging but it’s *how* someone uses drugs that determines their harmfulness, same as eating white bread or overexercising.
(I agree that the media has downplayed the dangerousness of certain drugs but those tend to be the legal ones, not the criminalized ones such as psychedelics [whose danger is usually exaggerated]. Plus when you talk about “ridding the world of drugs” in practice that can mean getting rid of the people who use or sell them, in which the cure can be worse than the disease [in the Phillipines nowadays for example people sometimes kill people they don’t like and then claim they were a drug dealer]. For the record I don’t even drink caffeinated coffee.)
Interesting article; I think there’s a lot of hidden depression and trauma among athletes (especially former athletes).
I wonder, have you ever tried Feldenkrais?
She doesn’t delve into over-reifying PTSD and specifically addresses the split our culture often induces between the body and mind…and you have no idea what she did before or how she made time for her (compulsive) exercising…sounds like you need to do a little trauma work yourself before going after people under the pretense of asking provocative but valuable questions.
(Maybe you just didn’t actually read the whole article?)
Perhaps (although if we believe in neuroplasticity it’s important to clarify whether we’re talking about permanent non-reversible changes or not) I was just addressing the perception that things like LSD (which I thought the OP was implying) are so dangerous that often lead to psychotic breaks in their users (they don’t, like probably all illegal drugs their image has been crafted deliberately with heavy doses [no pun intended] of fear-based hysteria).
I’m not sure that psychedelics actually do cause brain damage; stories about people going on a bad acid trip and never “coming back” from what I’ve read turned out to be largely myths created by the media, similar to things like “reefer madness” and the putative crack baby epidemic (which never actually occurred).
P.S. I don’t use any mood-altering drugs myself, so I’m not trying to defend their recreational use for personal reasons.
What was the lower limit of the confidence interval for the NNT? Is there a rule of thumb about what kind of figures are considered acceptable?
“I am a psychiatrist and I have been watching my profession deteriorate for many decades.”
At the same time I am not sure that when Dr. Breggin started practicing psychiatry wasn’t grossly paternalistic, implicitly pathologizing and culturally oblivious (which isn’t much better).
I think it’s an exaggeration to say they are “in lockstep”; most psychologists in my limited experience dislike psychiatrists and are partially locked into the biopsychiatric model because of how health insurance reimbursement works.
Who do you think is doing the telling, and what is their method of getting so many others to do their bidding?
Or it’s something like groupthink or simple convenience (many print journalists simply paraphrase articles from other sources out of sheer laziness for example).
People on the left tend to support biopsychiatry because they think it’s the humane, enlightened thing to do (as opposed to condemning people with problems and telling them to figure it out on their own, similar to telling poor people to get a job and stop asking for handouts).
Rosalynn Carter because interested in mental health because her only child Amy developed a mental illness while in college back when her husband last held political power forty years ago.
Ironically some of them will accuse you of being a Scientologist as well.
I’m not sure if it makes me feel better or worse that northern Europe (land of Bernie Sanders’ democratic socialist utopia) has similar institutional forces pushing the biopsychiatric model onto the population (as opposed to just the U.S.).
Another danger is I think that many people in the media even without a personal connection think they are being “good liberals” by pushing the medical narrative because it removes blame and stigma as opposed to more explicitly moralistic conservatives narratives (although at what cost, and does it really even do the latter or does it merely shift the “problem” to something intractable?)
“…the psychology of the Global North can be challenged by the academics the Global South, advancing the cause of liberation.”
Let’s hope this happens, otherwise all talk of “diversity” is meaningless (real diversity is diversity of perspectives and values not appearance).
Makes sense, it seems like PTSD takes for granted that the trauma is over, what about ongoing situations?
Yeah pretty much
Sounds about right but asking mainstream America to take culture seriously (without fetishizing it) in my experience is like getting a dog to walk on its hind legs.
Guess it shows how almost anything can be twisted into something oppressive (TMS, microdosing, and other things coming your way).
I’ve even heard it’s started to happen with trauma-informed therapies, which is unfortunate.
Thats probably true, although they’re masters at tweaking a molecule or two and claiming it deserves a new patent (think extended release versions).
Ironically there was also a recent article stating that the basis for Alzheimer’s research is incorrect (amyloids).
It’s neuroscience, transmagnetic stimulation, microdosing, etc.
“Please stop blaming patients for the way that Psychiatry is viewed. The way Psychiatry is viewed is completely psychiatry’s responsibility. Patients have been scapegoated enough!”
He’s not blaming patients, he’s saying that stigma that gets attached to people with psychiatric diagnoses (by the general public) also “infects” those who treat them. The patients aren’t doing anything whatsoever in this process, but you’re right that psychiatry’s image is psychiatry’s responsibility.
That’s true (they’re more dirty than desperate now) but the desperation refers to their historic attempts at cures, not their desire to be successful financially.
Many people develop substance abuse disorders as responses to trauma though, and recovery from trauma necessitates reclaiming power, so telling people to accept powerlessness may be counterproductive.
AA has very low rates of long-term success from what I’ve read (I don’t have any peer-reviewed references on hand, but they’re probably easily found at Google Scholar). The emphasis on total abstinence, public confession, implicit religiosity and potentially re-traumatizing approach (not to mention a reputation for predatory males) don’t make it a great choice for many, although it’s the only thing many people (including judges) have heard of.
No, that’s just more fearmongering (the mind is probably more capable of healing itself than the brain if anything).
Don’t you think you just needed a therapist who was allied with your views on society’s expectations then?
I’m not a huge fan of behaviorism but it’s great to see voices from within the profession demanding accountability.
At this point do we really need any more critiques about how psychiatric studies are bogus? The medicalization of mental illness has been a hoax from day one and anyone with a brain, heart and scientific education should know it.
(But of course it’s necessary to continue debunking the new myths that pop up daily like heads from the hydra.)
I wouldn’t say there is no difference between (in general) between white and black Americans but they do have more in common than either of them tend to think.
Also I would agree that African-Americans see themselves more through whites’ eyes than the latter realize, but it is not always the case.
Teaching people to stand up for themselves would also involve some form of expertise and therefore not be legitimate according to your logic (it’s impossible to teach anything without any kind of interpersonal engagement, otherwise it’s just brainwashing).
Interesting that the article’s title refers to cultural differences but that the issue is then defined solely in terms of race as if race and culture are the same thing (i.e., everything else being equal, there cannot be any meaningful differences between a white American and a white French person, or an African-American and someone from Kenya?)
There’s no trick they won’t turn to
Yup!
She makes a lot of good points but it should also be noted that Alice Miller’s own son made a film about how abusive she was towards him:
https://whosafraidofalicemiller.com/en
Interesting article, everything has a cultural component to it I would think.
Yup pretty much (for those interested in the question of states and municipalities struggling with funding I encourage you to explore the idea of public banks–movements exist in Philadelphia, New York, Oakland, Santa Fee, etc.–instead of paying high fees to out-of-state private banks they are able to essentially borrow from themselves and give out low-interest loans to small businesses which keeps the money circulating in the community (loans which aren’t worth the time of big private banks to make). They are vetted through a public-private partnership to ensure economic viability and transparency.
North Dakota has had one for a hundred years and it works fantastically–we have to get past the old dichotomy of capitalism vs. socialism and create something which is profitable for the masses (USPS used to offer postal banking, this is a smaller version of this).
(If people feel empowered in their communities they will be less likely to die deaths of despair.)
Yeah pretty much.
Sounds like concepts around individualism and “toughness” have been over-extended into child psychology.
What a surprise (not)
Yup pretty much.
Interesting article (and hypotheses) but I think it’s very one-sided in its treatment of evolutionary psychology (it makes it sound as if it’s all just a justification for inequality and brutality, it’s not).
And shame on Harvard for not just letting this guy operate there but essentially continue unpunished after his outrages were exposed.
“The Diagnostic and Statistical Manual, the so-called “Bible of Psychiatry,” is approaching its 70th year. It should be its last.”
Amen to that!
Interesting article, yes culture permeates everything in psychiatry including personality disorders and needs to be accounted for.
Agree, that’s why I’m not totally unsympathetic to anti-vaxxers although I disagree with their stance on this particular issue (the medical-health complex is massive and mostly interested in making money, your health is a secondary concern).
At the same time this is somewhat of a false either-or, it is not simply that people need not try but only wait for “the system” to supply them with good jobs, a better lifestyle, etc.
Interesting article, curious why rates of recovery weren’t better and alcohol use was higher? Perhaps just giving them their own space gave them time/space to “use” but is a part of the road back and there’s no way around it. (Otoh lower inpatient days is a plus as that’s how legislators are motivated [reduced costs]).
This is why I’m leery of NAMI; there are many well-intentioned people in it but they can’t bring themselves to question the disease narrative (for multiple reasons IMO).
Sounds about right–when economics is the basis for all existence those who are not economically productive (for whatever reason) need to be shunted aside.
I think it would be great if someone could fund translations of certain books (Moncrieff, Whitaker, etc.) into many different languages.
Excellent article, thanks for the author (and MIA for reprinting).
Just another way in which psychology is implicitly classist, also it’s interesting how the “free mindset” mirrors so-called “free markets” (which in Western countries are often government-protected oligopolies, but we’re required to believe otherwise).
It reminds me of the famous quotation by Eleanor Roosevelt (who was in the 1% of the 1% of her day) about not letting other people make you feel bad about yourself–easy for her to say.
Will psychology ever get out of the lab and become self-aware?
There are Susan Inmans everywhere
Big corporations will literally drive their customers into the grave if it makes them money; there needs to be pushback against their domination of society’s rules and Big Pharma in particular (take your pick).
Western civilization has arguably replaced religion with scientism.
That’s why I don’t even like the term “neurodiversity”; it’s a way of smuggling in a physicalist paradigm in the sheep’s clothing of a social justice expression.
Well I don’t think CBT (when done well) is about convincing the person to simply think of something else, rather it’s coming up with alternative explanations which relieve suffering while also being plausible enough to be intellectually satisfying (i.e., not “oh they just did out of love”, etc.)
Yes I think CBT has value insofar as questioning one’s thoughts and assumptions is valuable, the problem is when treatment providers decide what is rational or not based on their norms.
Do you have a link to sign up for it? Yours is just the talk itself once it starts and I didn’t see anything at his homepage.
Yes this is what I meant roughly, don’t use the methods of the natural sciences to answer questions of the human sciences (“how” cannot answer “why”).
Not so sure about this–yes empiricism and rationality have limitations but the answer to bad science is not throw out science altogether, it’s to respond with better science.
(Maybe in practice that’s what the author meant, challenging conventional epistemological narratives that privilege certain ways of defining truth).
I couldn’t tell from looking at the article which psychotherapies they looked at, however. (It said: “All types of pharmacotherapy or psychotherapy were eligible for inclusion” and mentions CBT in passing but that was it.)
I agree, the moneyed interests will try to destroy this (the media will do their work by not even reporting it for starters).
At the same time not reforming the current system has tremendous human costs as well.
I think efficacy also plays a role–therapists like anyone else wants to feel that they are good at their job, so people who are extremely difficult to help (in the sense of not responding to conventional treatment) may frustrate them after time.
Not surprising but it’s good to have some empirical data showing it to be the case.
Good article but I wish it had been fleshed out a little more, for example are there other forms of therapy beyond psychodynamic and CBT and how do they fare with varying SES-based demographics? (Especially things like family and/or group therapy.)
Also I think sociologists usually use four different variables to calculate SES (iirc it’s level of education, income, wealth and occupation [e.g., blue- vs. white-collar]).
They might be talking more about social workers, or people who go to low-cost clinics or those who have to see graduate students doing their hours for licensure under supervision.
I think one of the points is that the way talk therapy is designed is inherently poorly-fitting with “lower” class norms/ways of being/doing/relating/etc.
I’m not reading Daniel Kahneman, I don’t even know who that is (or was).
Another problem to me it seems is the pity response–what is needed/desired is empathy, but what is given (or not) is sympathy.
In the current system, yes.
Very good interview, I hope her program succeeds and thrives (and is replicated elsewhere).
Good article, I think a lot of people falls through the therapeutic cracks because they feel traumatized but their situation doesn’t fit the textbook definition of PTSD.
Yup!
Everyone has a culture but not everyone’s culture is being dominated by others.
Also not all North Americans are descended from immigrants (slaves, colonists, etc.)
And it’s entirely possible to be unaware of certain issues, it’s the normative same as the way your brain blocks out 99% of your sensory input at any given time.
(And how can you be aware without looking at why people are they way they are? It’s like saying I want to understand someone but don’t care about their name, age, ethnicity, gender, etc.)
Excellent interview, we need more like this.
Sounds about right–the line between legal and illegal drugs *is* arbitrary (cocaine and opium used to be legal for example, while marijuana is mindlessly classified as Schedule One).
Also I like the concept of epistemic violence–it happens all the time.
(At some point psychotropic drugs as per Joanne Moncrieff should be seen as simply providing relief rather than fixing some underlying brain pathology.)
Every illegal drug is surrounded by hysteria–reefer madness, opium dens, crack babies, bad LSD trips, etc.; the current form exists vis-a-vis fentanyl (some members of law enforcement go into convulsions when they think they’ve touched it even though it can’t affect you at that level that way).
Reminds me of the saying about something being so stupid only an intellectual would believe it.
In practice (no pun intended) I think most physicians are too busy and/or disinclined to look for evidence themselves–they’re trained to accept whatever the most recent medical journals tell them is the truth. Also with the decline of personalized medicine it may feel gratifying to them to be able to address their patients’ misery–often that is part of why they become doctors in the first place. (It’s also very difficult to swim against the mainstream as Mr. Hickey points out in his response.)
Makes sense, but who has the courage to be a parent who refuses psychiatric drugs for *their* child?
“Most of my colleagues haven’t read Bowlby. In psychiatry, people don’t talk a lot about attachment.”
For psycho-political reasons Anglos tend to be suspicious of attachment.
Having said that, Bonding Therapy does have a number of practitioners in the U.S. who all seem to be in the Baltimore/Washington, D.C. area.
Psychiatry is so corrupt at so many levels it’s mind-boggling.
Very good article; thank you for writing it.
They’re so deep in they can’t bear the thought of looking at themselves and what they’ve done to get where they are.
So basically all goes back to the centuries-old point that the methods of the natural sciences cannot and should not be applied to human beings (i.e. within the social sciences)?
(It’s called anti-positivism or interpretivism.)
Very good article and interview, we need more like her.
I understand what you say about the parallels between Catholic confession and psychotherapy but the institution of confidentiality to me has much more to do with Protestant ideas about privacy and private property (i.e. legal constraints on personal experience); also the one-on-one parallels the Protestant emphasis on an individual relationship with Jesus more than Catholic practice(s).
And the over-emphasis on childhood and childhood experiences originates with Freud who was not Christian.
You mean they would have done it if asked nicely? (Also keep in mind much of the time it’s Europeans and their descendants who do this themselves, not outsiders.)
Why not? Once it scales up and *if* medical costs in this society come down it can become more affordable (perhaps if states realize they’re actually saving money this way they would offer grants, also other parts of the country except for the West Coast and Florida aren’t as expensive as the Northeast).
At the same time neglectful social conditions do not cause disease in and of themselves, rather they allow for the spread of disease(s). (My fear is that the equation of politics with medicine will lead to a tyranny by doctors [rather than big business or demagogues] something that we already arguably see by psychiatrists and Big Pharma and may be a part of what anti-vaxxers sense and are pushing back against.) (The greatest form of patronizing power plays can be sometimes be doing things unilaterally because it’s “good” [for the other person]).
Yes as well but my point was that the name the facility goes by is not “Grace Brook” as the op seemed to suggest. (I don’t think they were implying that only programs run in that building have value.)
“In recent years, Birch says, she’s been approached about starting potential new Inner Fires in Texas, Northern California, Detroit, elsewhere — but right now, all she can do is focus on the one in Brookline.”
It would be great if there were some way to coordinate the people looking to start these kinds of places in other parts of the country!
fyi Grace Brook is the name of the stream and the farm where the facility is located but it goes by the name “Inner Fire”
I think it depends on how you define adaptive, yes a broken arm is not functional but the reaction of the body (swelling, bruising, sending white blood cells to kill off potential infections are adaptive even if they don’t feel or look good [in the context of so-called mental illnesses these are the things which get called symptoms and medicated away, in the same way in which anti-pyretics reduce fever whereas fever arguably restores health by increasing the body’s temperature to the point where certain bacteria can’t survive {so that by cooling the body you might make yourself feel better but it allows the illness to continue longer than it would have}]).
I don’t know which is worse, the fact that researchers fabricate data or the fact that the field doesn’t go back and refute them after it’s discovered (this kind of thing also gives credence to those who say that the research behind vaccines is bogus of course).
Well the cure I was referring to in this case was getting rid of all drugs (presumably apart from those with a clear medical purpose), not using psychotropic drugs to “treat” human misery.
I am no fan of the expansive long-term use of psychotropics but the decades-long radical failure of the so-called war on (recreational) drugs has created far more problems than it has solved in my opinion. Perhaps prescribing of legalized drugs needs to be made much more restrictive, but (for now) trying to simply ban them runs the risk of creating resistance and kickback (not to mention accusations of Scientology).
If you feel that the culture is the problem, as you indicate, I think you need to offer something more nuanced than simply an outright ban–such approaches throughout history have generally failed and/or created problems of their own (e.g., the rise of organized crime during Prohibition).
Again it’s just a word (“sociologically”) and doesn’t need to be read into too much (the very basis of sociology as a discipline, by the way, is *not* looking at issues through an individualized lens).
I agree that Western society is over-medicated but saying that the flow of all drugs needs to be stopped absolutely to me sounds like when people say that religion is the scourge of humanity and needs to be eliminated which in practice means imprisoning, torturing and/or killing believers (so that the cure becomes worse than the disease).
Removed for moderation.
Just use the word “sociologically” or something else than, it’s really not that important.
And why do you still think the drugs themselves are still the problem? It’s people’s relationship to them, and what drives them to use in the first place, that counts no matter how much you demonize the external object.
(Responding to rebel above, no reply box for some reason):
I’m not saying that anecdotes have no values, but they’re not the best way to understand issues collectively. Yes if thousands of people come out of the woodwork with personal stories that challenge the conventional narrative then it needs to be reexamined but by and large the epidemic of people deranged by psychedelics never took place (and it’s not done by experiments, no one gave LSD to participants and then calculated how many of them went crazy; it’s done by analyzing data on emergency room admissions correlated with the drug that caused the crisis; yes it’s imperfect like all statistics are but that’s how it’s done to get the bigger picture and not just listen to personal stories–people can have just as strong biases on their own, for example after completed suicides where the physical evidence is incontrovertible those around the deceased will insist they had not been suicidal, generally to assuage their own potential guilt).
(The story about returning Vietnam vets is well-known; any modern textbook on drug abuse will describe how branches of the American government were terrified of armies of heroin-addicted vets roaming the streets of American cities but it never happened, something that the disease model of addiction cannot explain.)
And *everything* affects the brain, including all positive (and negative) life experiences. Caffeine is the most widely-used drug in the world (half of all adults on the planet use it daily iirc) and is addictive, do you propose banning that as well because it changes the brain? (The brain is much more “plastic” than previously thought in any case).
The damage done by the so-called war on drugs is just as real, probably more so (especially for communities of color which have been systematically targeted by law enforcement despite having lower rates of drug use than the white majority) than the problems wrought by addiction/dependence (many of which are the by-product of criminalization and/or social/economic factors, not the substances themselves).
Your friend hurting himself is not a myth but it is anecdote (meaning not generalizable).
And addiction is not even the paradigm that should be discussed as it is not the physical properties of the drugs themselves that matters most contrary to popular belief (e.g., the many thousands of American soldiers who returned from Vietnam hooked on opiates who simply stopped when they returned; the issue is dependence which is slightly different). Another example is that the studies on crack babies did not disaggregate other factors which had greater explanatory power, for example the fact that pregnant women who smoked also had poor nutrition, didn’t go to prenatal counseling, etc.
Marijuana may indeed be damaging but it’s *how* someone uses drugs that determines their harmfulness, same as eating white bread or overexercising.
(I agree that the media has downplayed the dangerousness of certain drugs but those tend to be the legal ones, not the criminalized ones such as psychedelics [whose danger is usually exaggerated]. Plus when you talk about “ridding the world of drugs” in practice that can mean getting rid of the people who use or sell them, in which the cure can be worse than the disease [in the Phillipines nowadays for example people sometimes kill people they don’t like and then claim they were a drug dealer]. For the record I don’t even drink caffeinated coffee.)
Interesting article; I think there’s a lot of hidden depression and trauma among athletes (especially former athletes).
I wonder, have you ever tried Feldenkrais?
She doesn’t delve into over-reifying PTSD and specifically addresses the split our culture often induces between the body and mind…and you have no idea what she did before or how she made time for her (compulsive) exercising…sounds like you need to do a little trauma work yourself before going after people under the pretense of asking provocative but valuable questions.
(Maybe you just didn’t actually read the whole article?)
Perhaps (although if we believe in neuroplasticity it’s important to clarify whether we’re talking about permanent non-reversible changes or not) I was just addressing the perception that things like LSD (which I thought the OP was implying) are so dangerous that often lead to psychotic breaks in their users (they don’t, like probably all illegal drugs their image has been crafted deliberately with heavy doses [no pun intended] of fear-based hysteria).
I’m not sure that psychedelics actually do cause brain damage; stories about people going on a bad acid trip and never “coming back” from what I’ve read turned out to be largely myths created by the media, similar to things like “reefer madness” and the putative crack baby epidemic (which never actually occurred).
P.S. I don’t use any mood-altering drugs myself, so I’m not trying to defend their recreational use for personal reasons.
What was the lower limit of the confidence interval for the NNT? Is there a rule of thumb about what kind of figures are considered acceptable?
“I am a psychiatrist and I have been watching my profession deteriorate for many decades.”
At the same time I am not sure that when Dr. Breggin started practicing psychiatry wasn’t grossly paternalistic, implicitly pathologizing and culturally oblivious (which isn’t much better).
I think it’s an exaggeration to say they are “in lockstep”; most psychologists in my limited experience dislike psychiatrists and are partially locked into the biopsychiatric model because of how health insurance reimbursement works.
Who do you think is doing the telling, and what is their method of getting so many others to do their bidding?
Or it’s something like groupthink or simple convenience (many print journalists simply paraphrase articles from other sources out of sheer laziness for example).
People on the left tend to support biopsychiatry because they think it’s the humane, enlightened thing to do (as opposed to condemning people with problems and telling them to figure it out on their own, similar to telling poor people to get a job and stop asking for handouts).
Rosalynn Carter because interested in mental health because her only child Amy developed a mental illness while in college back when her husband last held political power forty years ago.
Ironically some of them will accuse you of being a Scientologist as well.
I’m not sure if it makes me feel better or worse that northern Europe (land of Bernie Sanders’ democratic socialist utopia) has similar institutional forces pushing the biopsychiatric model onto the population (as opposed to just the U.S.).
Another danger is I think that many people in the media even without a personal connection think they are being “good liberals” by pushing the medical narrative because it removes blame and stigma as opposed to more explicitly moralistic conservatives narratives (although at what cost, and does it really even do the latter or does it merely shift the “problem” to something intractable?)