Showing 109 of 109 comments.
Do you know about ISEPP? Maybe you don’t need to be hidden in the shadows as much as you think.
The phrase “necessary but not sufficient” comes to mind.
Give them some credit, those aren’t the arguments they use, rather it’s that high prices and patenting “me too” drugs are necessary to fund further research (even though most if not all of them spend more on advertising than they do on R&D–so why not undo the legalization of DTC [direct to consumer advertising]; they would save all that money and suffer no comparative disadvantage because it would still be a level playing field for all of them).
Sounds good to me–schizophrenia is the biggest label bomb out there methinks–Japan dropped the terms years ago iirc.
Which ones would you choose?
That seems too high though, the author’s figure seems impossible (3 out of 10 Australians take antipsychotics?)
Yes I don’t think these myths have been debunked in the public’s mind at all.
To me it sounds like you’re just covering up your own pain by denying its personal component and focusing exclusively on social justice issues.
In Fighter’s defense there is an irreducible quality to the interpersonal nature of reality, as well as power being at the heart of all relations (in my opinion), so that public/political actions can be an incredibly powerful (and healing) response to injustice, however dismissing everything else as simply “reactionary” or “part of the problem” goes too far (to me s/he sounds like a undergraduate Marxian who has discovered [and fallen in love with] a metaphorical hammer with which to diagnose all human ills.)
You sound like you can’t tell the difference between sympathy and empathy.
So not coercing others is a form of denial, as you complain about being coerced by others. Got it.
That’s not his point at all, you’re just twisting everything people say into an affirmation of your oversimplified “insight”.
Interesting that you didn’t say you respect other people’s right to pursue change as they see fit, just that you can’t change them (all?).
In any case I can’t help shake the feeling that you’re (deliberately?) defining the concept of recovery as unnaturally narrow in order to posit it as a kind of strawman-lightning rod that enables you to call for revolution (which is your real agenda, not to help those diagnosed with psychiatric labels).
(Increasing political awareness is itself part of recovery, for me.)
So interestingly (and predictably) you didn’t even address the single point of my post: Do you or do you not grant others the right to decide what they think needs to be done and/or the means (and pace) by which it is to be achieved?
Lol of course “following Foucault” as if a single postmodern French thinker has the final word on reality itself…you still haven’t said a single thing that doesn’t make me suspect your definition of recovery is overly narrow.
I said what I said, that in my experience lefties (by which I meant more people who say that politics is the answer to every question, in my experience this assertion tends to come from the left much more often than the right) often have no sense of history (in fact I’ve had many discussions with such people who argue that studying history is simply a valueless distraction from political engagement).
But you’re right there’s also a deep kind of historical ignorance often found on the right as well.
So two wrongs make a right?
At the same time individuals have the right to pursue and seek change at their own pace, in a way that feels right to them, or do you not agree with that?
Anyone who knows history however (which tends to be not too many leftists in my experience) knows that mental health movements predate eugenics and aren’t simply continuations of it (no matter how “provocative” [and therefore politically useful for certain objectives] such an assertion may sound to some).
Yes I have spent time in various 12 step programs and I have no idea why you would limit your definition of the recovery to them (I find the programs to be self-blaming/shaming, moralistic, and trauma-UNinformed).
My experience has been that people who tell us the “true nature” of all our problems and what we *must* do about them always have their own (self-serving) agenda.
I guess we’re defining recovery differently, I would categorize recognizing the truths you speak as part of recovery as well.
(I agree there’s a simple formula of defining extreme distress biomedically and then turning it into a “project” as you say of personal development, but it can be broader than that.)
I’m with you on psychiatry and some of psychotherapy and recovery but can you be more specific? There’s a lot of good in the last two (in fact one could argue this site, and your comment at it, are two examples.)
Yes it does the raise the question of whether psychiatry as a discipline should even continue to exist, in my opinion.
After a hundred years of looking at it primarily from a biological and/or neuroscientific viewpoint don’t you think it’s time to try a different approach?
Good article, I’d heard of this before but was interesting how the author described the researchers’ inability and/or unwillingness to consider the implications of their own findings.
Know what it is? They can’t even define it.
That’s the Catch-22–how do you become aware of something of which you’re not aware? (metacognition, perhaps facilitated by meditation and/or metacognitive therapy [done only by a couple guys in Manchester UK afaik?])
Agreed, in part it’s because of our Calvinist-Puritan heritage that we can’t admit that people take drugs simply to feel better*, and/or that feeling good is a *necessary* part of the human experience.
*So we call them “medications”.
adverb & adjective
(of an argument or reaction) directed against a person rather than the position they are maintaining.
“vicious ad hominem attacks”
relating to or associated with a particular person.
“the office was created ad hominem for Fenton”
There’s enough injustice to go around, we need not turn it into a competition methinks.
Having said that Democrats are also sometimes too quick to embrace a biomedical version of mental illness because it fits their self-image of being compassionate and humanitarian.
What a surprise–drug people nonstop to avoid their emotional states and then wonder why there are negative consequences.
Psychodynamic psychotherapy is not delivered by a medical provider.
Mental health (itself a misnomer) shouldn’t be defined as a biomedical speciality in the first place, ergo psychiatry *should* be in trouble and in need of redefining itself.
(At most psychiatrists should be neuropharmacological consultants to a team of other professionals like caseworkers, psychologists, nutritional advisors, job coaches, and others; they should have no more standing than anyone else).
(While we’re at it why are dental students (along with psychiatry majors) forced to learn everything medical students are, unless it’s related to the mouth they rarely if ever use it once in their careers.)
Great article, it reminds of the time when Carl Whitaker was supposedly asked the secret of his ability to reach certain schizophrenic patients and he replied “My lack of professional training” (he was 0b-gyn before going into psychiatry).
I agree completely, that was a little bit of the flip side of my saying it can feed into people’s manias or delusions (feeling like you have to become famous in order to be an “ok” mentally ill person, if you know what I mean).
Good point, never thought of that.
Great point about the possible downside of citing famous individuals purported to have mental illness…while I understand the goal of decreasing stigma, I’ve often wondered if it might not also feed into some people’s delusions of grandeur and/or (hypo)mania?
Restorative Justice can be a part of recovery.
But eugenics-based sterilization wasn’t just for those who “cannot care for themselves”, it was for people for example who were convicted of multiple crimes (in order to “weed out” the criminal genes from the next generation, not even the people at the time claimed it was for their own benefit themselves.)
Exercise helps but (in my opinion) mental disorders are rooted in dysfunctional psychosocial patterns, especially in the family of origin.
Her first point was that correlation does not mean causation.
Sounds excellent, virtually all therapies (except Positive Psychology which is fairly new) are mired in a highly negative mindset in my opinion, starting with Freud (in other words since the beginning).
Issues like these need to be studied but it’s also important to keep in mind that the larger issue is that mainstream treatment of schizophrenia tends to be iatrogenic (i.e. makes things worse)…it’s not implicitly racist to diagnose African-Americans with higher rates of a mental disorder, every “demographic” lives under somewhat different conditions in general and therefore can be expected to respond and cope differently with their lives…if psychiatric care were truly enlightened, the subtext of this headline would be that blacks are *privileged* compared to other ethnoracial groups when they meet with a psychiatrist.
Don’t worry, the genetic connection is spurious.
In both cases, ideological and public-political factors played a major role in the diagnosis.
Thanks for writing and posting the article, I’ve thought for a long time that so-called mental illnesses were just maladaptive coping strategies but it’s since to see it broken down in more detail…would love to see more examples of your paradigm, for example in terms of OCD, various personality disorders, and so on.
(Also good to see that some of these perspectives are making their way into the system insofar as they count for Continuing Education credits, is there a light at the end of the tunnel?)
A lot of people in 12-Step meetings are anti-drug not because of any enlightenment around the problematic nature of psychotropics but because from the beginning the “program” has looked askance at any kind of controlled substance as a crutch and/or sign of moral weakness (including, from what I understand, things even like methadone in Narcotics Anonymous).
(I’m not a huge fan in case you haven’t noticed.)
Yup. (Thanks for writing and posting.)
Your post detracts from your credibility if you think the author is simply defending the medical model of mental illness.
It’s more about becoming aware of the emotions and sitting with them, which is what allows them to pass in the first place.
Other countries don’t necessarily have a better understanding of mental illness simply because they attribute it to a broader range of psychosocial factors, it depends on what kind of factors they’re talking about.
In any case where are these great societies you’re talking about? It’s easy to generalize, or cite studies, but where do you know of better practices? Apart from the Open Dialogue in Finland, some placement programs in Sweden and family therapy interventions in Italy I’ve never heard anything that sounds truly enlightened to me.
Not only that but so many people will call you antiscience when you point out how *all* studies “proving” genes and/or chemical imbalances causing mental illnesses are deeply methodologically flawed (as if taking scientific pronouncements on faith isn’t itself actually a form of scientism).
S/he was trying to be clever.
Why do you harp so much on “Americans”? (other than the steady diet of cultural elitism which no doubt fed you at your “Ivy League” school)
Name me one other country which has “enlightened” attitudes about mental illness, if anything most of them are increasing their degree of mainstream American understanding of psychiatry as a sign of “progress”.
Btw, 50% of Americans are also above average in intelligence.
If involuntary treatment is justified on the basis that the person is delusional because they don’t recognize the need for “help”, does that mean they don’t need it if they *do* recognize it?
I think you’re right.
Well yes I’m using the phrase “mental illness” for lack of something better, I don’t believe in the medicalization of extreme states of being either.
While living simply and in touch with nature (and using one’s body through physical effort) can be beneficial to many people if you’re implying that mental illnesses don’t exist among rural populations, or are simply a feature of the modern industrialized world, I think you’re very wrong.
@jackdaniels It’s not simply a question of apportioning blame, all three levels have to be addressed (micro-, meso- and macro-), each in their own way.
Try going to Google Books and doing a search there (or the original publisher’s website).
I don’t think the other poster at any point stated or implied that mental illness comes “out of the blue” at the individual level (the “micro-level”), just that the answer may not lie completely at the family or meso-level (there’s also often causative elements at the societal or “macro” level).
It’s not as simple as saying that family members are responsible for someone else’s mental illness (although it is better conceptualized as a disorder of the family as a unit).
Dealing holistically with depression has nothing to do with willing or meditating it “away” (in fact much of the practice of meditation is grounded in the acceptance of negative mood states [rather than running away from them]).
Also, some researchers now think that bipolar is actually a subset of depression (since it *never* exists independently of depressive symptoms [i.e. unipolar mania]).
Duh–that’s obviously not how it was meant.
(Of course he was a pilot but the psychiatrist clearly thought he wasn’t in condition to actually be flying, particularly with other people–no different from a soldier with severe PTSD who should be excused from active duty but goes off-base to purchase a firearm perhaps).
Great article, thanks for writing (I think the whole paradigm of “eliminating” symptoms is tragically short-sighted).
Sorry I meant to post that to the article in general, however I do think anxiety often a big role in schizophrenia (often hidden).
Create a financial incentive large enough and it would happen!
Good post (although a little long 😉
I do find it perpetually amazing how many otherwise scientifically-literate people regularly regurgitate perceived wisdoms about genetic determinism…perhaps any kind of determinism can be psychointellectually seductive because it offers the promise of predictability (and therefore controllability) to life?
There *was* a much better bill sponsored by Ron Barber (D-Arizona) but he lost his reelection campaign…maybe someone else could take up his ideas?
A lot of Western culture is propagated by those who are neither old, male nor white…
Just realized Barber lost his reelection campaign in 2014 (by 167 votes) 🙁
What about Ron Barber (D-AZ)’s Strengthening Mental Health in Our Communities Act of 2014? It was designed to be an alternative to Murphy’s proposal:
I think what he was saying was that their systems were isolated not in the sense of being geographically small but being encircled by hostile (capitalist) systems (under the rubric of “containment”). Yes, both countries were huge and had large populations but were unimaginably poor and trying to survive in world dominated by moneyed interests.
What else is new? Psychological disorders are….psychological in nature.
It also seems like the field precludes the possibility that someone may have “insight” into their problems (not simply their “illness” per se) along non-biomedical paradigms.
They didn’t say for whom the good intentions were directed
Big fan of alternatives and would go to the conference if it didn’t sound like very similar to the Mad in America film festival in Arlington, MA which I attended last year, but to be that guy…Lapland is not a “city in Finland” it is a region (basically the northern third of the country).
The article is making the point that another lesson of the experiment could be that people who are uncomfortable in resisting authority could perhaps take comfort in the possibility that others would be supportive of noncompliance responses, making such resistance potentially more likely (people are incredibly swayed by what they think others are doing, generally).
Well it might be of small comfort if the so-called torture was administered in lower doses, or delayed, or so on.
In any case the phenomenon being studied was uncritical obedience, which does make it relevant that many participants expressed at least passive noncompliance strategies (because it teaches us that efforts to resist more explicitly might not be as unpopular as we imagine).
(Condemning humans as bad does *not* always lead to better moral behavior.)
The point is not the “torture” itself but the phenomenon of mindless obedience.
Yes it’s highly subjective, it’s like saying your depression is serious because it’s “clinical”.
“Genetic determinism is the fool’s gold of the modern era.”–me 🙂
How come no one ever mentions that there is a better alternative to Tim Murphy’s bill (H.R. 4574, the Strengthening Mental Health in Our Communities Act of 2014 by Ron Barber, D-AZ).
Perhaps what is needed is some kind of modern-day psychopharmaceutical equivalent to Upton Sinclair’s “The Jungle”–a story about one or more people harmed from being on more than six or eight different psychiatric drugs simultaneously (fictional or otherwise).
(Appealing to people’s intellectual sensibilities is not a valueless approach but it takes much longer and tends to reach fewer people than more sensationalistic narratives.)
Point taken but also be aware that this argument is used to advance the notion that psychiatry really is “scientific” in some meaningful kind of way.
Interesting how the “article” makes it seems that it’s people who think that psychosis is “nothing more” than life circumstances are the ones who are holding the field back…
I tend to agree–not because I think the speaker was trying to “divide the movement” or anything like that as another poster insinuated, but because there’s a difference between seeing the bigger picture and losing focus (I’m a registered Green btw).
Problems with the mental health system are huge and systemic enough on their own–yes there are linkages to unhealthy living, excessive stress caused by corporate capitalism’s need to expand at any cost, and so on, but there’s also an element of practicality which needs to be addressed–the movement for alternatives has very limited resources compared to its adversary (in a sense, in another sense it has greater resources–the wisdom and desire of people everywhere to be healthy)–to spend it on debating climate change seems like somewhat of a fool’s errand to me.
This is a very good point and I don’t think it’s just limited to those who treat dissociative disorders…for whatever reason schizophrenia is the bogeyman of the whole DSM sometimes it seems (along with BPD maybe)…it’s also the diagnosis which people always seem to bring up in the context of a psychiatric disorder which is “clearly” biological in nature (as if)…
If those responsible realized what kind of effect(s) their treatment(s) were having (in fairness a small number do) they would have to change what they were doing (and/or perhaps leave the profession?).
Would be interesting to see how this would dovetail with a drug-based model of treatment as opposed by Joanna Moncrieff (as opposed to a disease-based model).
Some are worse than others.
wiley witch–it’s possible that islanders have higher rates of suspectability to psychosis are more likely to seek out housing in whiter neighborhoods (whether because they have more stressful jobs and make more money and thus live in a wealthier area, or they are marginalized by their own community for some reason, and so on).
There may not be anyone “behind” them; Murphy is a psychologist (Ph.D. from Pitt) and may just think he’s doing something positive which various trade associations also believe to be in their interest.
There was an alternative proposed several weeks after this article came out: H.R.4574 – Strengthening Mental Health in Our Communities Act of 2014 by Ron Barber (D-Ariz.).
Not only medical training but the self-selected demographic which applies to medical school in the first place—often very idealistic, hard-working and intelligent but also overly given to concretist, physicalist, and/or reductionistic ways of thinking at a personal level (because it’s what they’re most comfortable with?).
Supposedly they’ve also hit somewhat of a brick wall in terms of development; many recent drugs are actually “me too” types (minor variations on preexisting substances, usually targeted at serotonin and/or norepinephrine).
There does seem to be a more enlightened alternative:
Murphy’s bill is problematic at best but there is a (better) alternative: “Strengthening Mental Health in Our Communities” by Ron Barber (D-AZ):
I wonder if the study took into account the fact that *parents* who change locales more frequently than average may themselves exhibit a higher than normal rate of psychopathology?
Any word on what films will be playing in the filmfest in Massachusetts? (and which days?)
I think some background on the question of stigma and mental illness as a biomedical disease needs to be broadened somewhat, specifically in the following ways:
1) in which ways is the biomedical model borrowed from AA (for many people the subconscious model for recovery in my opinion) and its definition of alcoholism as a disease? Does this model also need redefining to eliminate its drawbacks, without losing the benefit of reducing blame and shame by leaving behind the solely moralistic perspective?
2) even if the biomedical model *were* highly successful in reducing stigma, is it worth the collateral damage in popularizing a powerful misconception about mental illness in general? (my answer is obviously no)
3) why not reduce stigma by working with those who are primarily responsible for creating it, i.e. the media? (news as well as Hollywood/TV, both in depicting clients and how therapy works) this seems more direct and potentially effective
Any psychiatrist that believes in expanded levels of institutionalization should leave the profession, I wonder where he did his training.
This is a good letter and I hope it makes *some* impact on raising people’s awareness.
Very true—not only should the focus *not* be solely on the person (“child”) with the diagnosis, it should be prioritized for the parents (although it has to be done in such a way as not to make them overly defensive).