Oldhead, I am coming to the conclusion that I have very poor writing skills because some of these countering responses aren’t countering anything I (meant to) say.
You write: “Is anger a disease caused by adrenalin?”
No, but adrenalin is required to have the sensation of anger. If the neighbour’s music is making me angry, knowing that there’s an intermediate step (adrenalin) in no way changes the basic relationship of that noise = anger relationship. But here’s where we differ: The structure and function of adrenalin is still worthy of study even after the neighbour turns off his stereo.
And earlier in the same post you write: “So the answer lies in changing the “environment,” not screwing around with the chemicals and the brain.”
But you’re assuming that the culprit MUST be the environment and that’s not always the case. And even when it is the case, sometimes the environment can’t be immediately changed and sometimes changing the environment doesn’t immediately affect the brain state.
Psych drugs remain and always will remain a valuable tool. Unfortunately, in rare and extraordinary circumstances, using them is completely justified even over someone’s objections.
Clearly, involuntary treatment happens way too often and outpatient commitment is generally a bad approach. However, in a crisis intervention, there may be no alternative. Arguing otherwise is a lost cause.
PS to CS2013, I concede that my “intellectual ability” (your words) precludes my agreeing with your position.
And, with that, I will be leaving this thread and Mad in America. I wish everybody well but I prefer not to participate here anymore.
Abolitionists would forbid such practices even when completely warranted as in the situation you describe here. Their rule seems to be that the only grounds for intervention are AFTER a criminal act has been committed. It’s an untenable position and will never be taken seriously.
Here in BC, one could certainly be paid a visit from the police for a “wellness check” on the say so of a 3rd party but that by itself wouldn’t be grounds for a mental health apprehension. I’ve never heard of any such 3rd party being either sued or charged for a bad faith report. I’d be interested to see how that would play out.
And I do agree with you that critical thinking does not equate to bickering. Bickering, however, is mostly what’s prominent here.
Hi, Oldhead. Anon had already suggested to me that it wasn’t an appropriate post and I responded in agreement. The notion of assessing who’s doing more to help does not strike me as an absurd approach, however. What was inappropriate about the post was my suggesting that CS2013 hadn’t helped which of course I have no way of knowing. That’s why I agreed with Anon.
You’re right, Anon. I retract.
Destroyed her metabolism, I’m guessing. Sorry to hear about your friend.
When I became stable, my doctor wanted to maintain me on Risperdal on the grounds that “if it ain’t broke, we needn’t fix it.” But it was broke! I was taking harmful and unnecessary medication.
Perhaps my biggest objection was that I was not willing to have my mental health attributed to pills. In any event, I got off that crap in April 2013 and have never looked back.
Jonah, you’re quite right. My tone was unnecessary and I apologize, sincerely.
My frustration is driven by your comments such as:
“Even if/when on can clearly establish, that “Without the neurochemical state XYZ, one wouldn’t have the sensations/perceptions” that are suggestive of ‘fear,’ that proof will not, in and of itself, be convincing evidence, that XYZ has created those sensations/perceptions.”
I KNOW THAT AND SAID AS MUCH! You take such a professorial tone to state such obvious truths. My point was simply that the research Jill is talking about is still valuable and worthwhile REGARDLESS OF HOW ANY PARTICULAR NEUROCHEMICAL STATE CAME TO BE.
And what if this hypothetical person adamantly refuses support? Are you prepared to ignore him or her? If your answer is “yes,” you’ve solved the riddle of why anti-psychiatrists aren’t taken seriously.
I’m sorry you went through such trauma at the hands of the psychiatric system. I must say though that you seem to be leaving out a few details here. There must have been some context to the police coming to your home. I’m not saying that the context necessarily justified the actions, just that the police do not generally show up at peaceful, law-abiding citizens’ houses and Tazer them.
BTW, the comparisons to slavery and Sharia law are very offensive and add nothing to the discussion.
I think Boans might counter that children aren’t entitled to their full rights yet but your example certainly also applies to removing an adult out of harm’s way. You’re quite right that the notion of abolition involves morally indefensible positions. That’s why it’s going nowhere.
Thanks for contributing to the discussion, Jonathan. I so wish that some could understand that their position actually undermines the cause.
CS2013, let me rephrase. Please give one example of any impact you have had on the lives of those suffering from mental disorders. For instance, one report of somebody reading your wisdom and improving his or her life as a result.
Actually, no, CS2013, it doesn’t nearly answer my question which was: What have YOU done to improve the situation?
CS2013, there are myriad reports of forced medical interventions. The fact that you’re not aware of them doesn’t make them cease to exist.
Jonah, this is really getting tedious. Without the neurochemical state XYZ, one wouldn’t have the sensations/perceptions. If you want to argue mind vs. brain, I’m too bored to continue.
Your assumption that if I don’t agree with you then I don’t understand you is both amusing and reminiscent of the psychiatric approach. Have you considered the possibility that you’re just not that interesting?
Boans, I do agree with you that forced psychiatry necessarily involves human rights violations. The question is when is it justifiable? We might agree that a 14 year old should be prevented from cutting herself in response to bullying at school.
This gets back to the arguments I have had with other posters: What do you suggest instead? On a different thread on a different topic, I was describing a situation I was in several years ago. Long story short, I was in agony and was incapable of either consenting to or refusing treatment. Anyway, when I described my circumstances as a counter-example to the “all force is evil” camp, one poster in particular gave a smiley face and talked about my responsibility for my own distress. It actually chilled me to the bone that someone could read what I had described and say the equivalent “Oh, well ….” In fact, every time I think of it, I ‘m thinking antisocial personality disorder.
Your logic is breathtaking.
CS2013, you’re right that statins are never court ordered but you’re wrong that physical medicine is never done over a patient’s objections. There are several exceptions where public safety trumps an individual’s freedom. I know that’s likely a scenario that sickens you politically but it exists and it exists for good reason.
Jonah, can you understand that if neurochemical state Y is found to be responsible for what we term mental state Z, that does not preclude a causal relationship between environmental factor X and mental state Z via neurochemical state Y?
The scientific fact that the brain creates our sensations and perceptions seems to threaten an awful lot of people.
Actually, I believe migraine is the disease and migraine headache is one symptom of that disease. I therefore correct and resubmit my analogy accordingly.
The point is that migraine headaches exist and respond to treatment, even without objective diagnostics.
I think it’s a mistake to tar all psychiatrists with the same brush. If Dr. Steingard just wanted to maintain her “livelihood,” I’m guessing she wouldn’t spend much time writing for MiA.
Can’t remember what all NIMH had to say about this beyond that they are no longer funding research based on symptomology. I assume that means more resources than ever will be sunk into the genetics/neurology end of things.
Cannotsay2013, at the risk of provoking you, may I ask how your “thinking big” has translated into improving the lives of those who suffer from mental disorders/emotional distress/fill in your favourite term here?
I believe that Dr. Lawhern is encouraging us to actually get something done rather than just keep bickering.
Steve, you make an excellent point about migraine headaches. Would you allow me to try again with fibromyalgia? I believe that’s considered a disease, rather than just a cluster of symptoms.
Anyway, my point is that lacking an objective test isn’t what kills the endeavour. It’s far more useful to argue that outcomes are generally worse with treatment or that the diagnostic criteria are too fluid to be meaningful.
I would argue that mental disorders certainly exist but they are rarely diseases. Many go much further and claim mental disorders are never diseases and some go further still and claim there’s no such thing as a mental disorder.
At present, the term “anti psychiatry” is taken about as seriously as the term “anti vaxxer.”
You needn’t have bothered. Dr. Steingard has always been completely open about her position but nice detective work, all the same.
Absolutely. Psychiatry is way, way too quick to medicalize human emotion. At the same time, we do need to acknowledge that in rare and extraordinary circumstances some people require support, up to and including treatment they may not want. The issue for me is short vs. long term treatment. There is far more justification for emergency intervention than outpatient commitment. In my view, reform should focus on the latter. Abolition, however, is a non-starter.
I completely agree with you as far as losing sympathy with the “anti psychiatry” position. Listening to some of these “activists” exactly proves psychiatry’s point.
By that standard, migraine headaches don’t exist.
Well, we can argue all day about who the “average person” is. Let’s just say our experiences differ and leave it at that.
I certainly never said that psychiatrists are going to be the driver of psychiatric reform.
And, again with the slavery analogy!
Again, a very poor analogy. Psychiatry has little in common with either slavery or the death penalty.
So? Why should a person have the facts before entering a discussion? 🙂
I really like this post and agree with everything you’ve written. I think you might find, though, that abolitionists will either attack you or write you off. Many “activists” are only interested in the black and white: “Psychiatry is pure evil. Nobody has ever been helped by treatment. Intervening in a crisis is a human rights violation. We will stand for nothing less than complete abolition.” Such an extreme stance will never be taken seriously by either psychiatrists or the general public and it’s a mystery to me why they bother. I see that the first commenter here has already trotted out the chattel slavery comparison.
This wasn’t meant as a suggestion for any particular guest author. I was referring to the general idea of welcoming the “other side.”
It would be truly wonderful to have Biederman or Torrey or Jaffe or someone like that post here and it would be a shot in the arm to MiA that such prominent figures in the establishment wished to engage with us. I can imagine what would happen, though. Some commenters would choose to shriek “Nazi brain rapists, all of you!” or equivalent phrasing. I can certainly understand what drives the anger but the issue is how we’re going to make change. Blindly raging at them just gives them more fodder.
Believe it or not, I make a genuine effort to just read the comments and not engage in the dialogue because I completely agree with your criticism. Too much of the conversation after these articles becomes irrelevant and distracting. This is a thought-provoking article that merits serious consideration. If it’s to be criticized, it ought to be on the basis of specific offending points made in it (which I didn’t find), not general backlash on the basis that the author isn’t 100% in agreement with the MiA audience.
In my neck of the woods, Psychology 101 is pretty damn close to Psychiatry 101. I’ve lost interest and am switching majors.
There is no basis to claim that the choice to undergo ECT cannot be free and informed. A patient can be provided with all information available, be entirely aware of the risks, and choose nonetheless to proceed.
ECT cannot reasonably be compared to cutting one’s self. But if you choose to “advocate that this is everyone’s right,” then your assertion that ECT ought to be abolished outright is even more untenable.
I read your work carefully, Bonnie, and agree with much of it. However, all I’m getting from you on this subject is that you don’t like ECT so nobody should be able to have it. As I said before, your position on this is parallel to the top down “we know best” attitude that psychiatry exhibits.
From a pragmatic standpoint, ECT is not going to go away. Why don’t we work instead on promoting full disclosure and abolishing forced ECT? Those are achievable goals.
I agree with you, Darby. With respect to certain specific circumstances, it is not the least bit “irrational” (author’s word) to believe that things will never improve. Do you remember the movie Sophie’s Choice? I’m sure the protagonist would have considered the description “permanent solution to a temporary problem” a mere platitude, which it often is.
I wrote this letter to our local rag last month but it wasn’t printed:
“I was surprised to read in your June 24th editorial that mental health outreach teams help ‘steer people away from drugs.’ In fact, standard psychiatric care promotes drug use, albeit of ones that profit pharmaceutical manufacturers rather than street dealers. The chemical distinction between prescription and illegal drugs can be murky ….”
Didn’t realize he was in the biz or are you just referring to promoting and/or selling vitamins?
Unfortunately, being yoked with a psychiatric label is pretty much the end of a person’s civil rights. As a Canadian, I can be stripped of my Constitutional right to security of the person and my Constitutional right not to be arbitrarily detained.
That is brilliant. Thanks for posting the link.
Took the words right out of my mouth (typing fingers), Wayne. Judging by the quality of the critical thinking I see at my university, I would suggest that mere credentials don’t equal knowledge, intelligence and understanding. In fact, more education can just lead to more confidence in one’s incorrect assumptions. Seriously, I doubt I will continue my studies for exactly this reason. Regurgitating what one’s told doesn’t seem a likely route to intellectual enlightenment.
Agreed. Many patients are obese and compliant but not necessarily any better off. That’s the problem with trying to measure such a hugely complex issue as well-being with mere statistical tools.
Hi, Monica. I don’t know what the situation is in your state but here in BC there are far more people on “assisted” community treatment orders than could possibly fit in our psych wards. If such patients were to organize (a “Mad Union,” if you will), they would have considerable power. The spectre of hundreds of clients denying medication providers access to their homes at the same time would, I believe, make the establishment sit up and take notice of such demands as assisted tapering programs.
Because involuntary treatment is happening in people’s homes rather than hospitals now, otherwise concerned people are turning a blind eye. The legal standard for forced treatment should be the same, no matter where the treatment occurs. Community “care” is just a cost-saving measure for the government. There is no fundamental difference between psychiatric incarceration and outpatient commitment except the veneer of civility.
Hi, Bonnie. Informed consent entails two separate concepts, of course. “Freely given” is implied in the second.
Clearly, psychiatry is not going to be voluntarily forthcoming with information about the risk/benefit ratio of ECT and there is a huge need to get further information out to the public. Beyond that, we could lobby for legislation that insists individual doctors provide such information.
Consent, however, is far more problematic. Not just for ECT, but for all psychiatric treatments, I would like to see an advocate made available to all patients facing forced treatment or the more insidious, grey area of coerced treatment. Can’t stress enough that such an advocate would be chosen by the patient and be immediately available, free of charge.
Of course, it’s not just the routine lack of informed consent, though, that you and others object to. It’s the notion of someone choosing a course of action that you would not. I would suggest that this is similar oppression to what psychiatry practices: “We know better than you do what’s good for you so what you think really doesn’t matter.”
There are many medical procedures that carry little or no benefit yet substantial risk so ECT isn’t unique. Unfortunately, what works against Breggin’s position is that ECT does often give short-term improvement measured subjectively. Now, for most of us, that very brief relief is not nearly worth the brain damage that accompanies it. For others, though, it is and that’s a choice that needs to be respected. The only issue is whether that choice is truly informed and truly free.
It’s really a shame that so much legitimate criticism of psychiatry is ignored or minimized because this one slice, albeit very well-funded and famous slice, of the psych reform movement is so vocal.
The irony is that Scientology has actually ended up promoting psychiatry because any serious critical writing gets tarred with the same brush. The esteemed E. Fuller Torrey wrote off Peter Breggin’s work largely on the basis that Breggin’s wife was a former Scientologist. Even respectable magazines like The New Yorker point to Scientologists as though they were representative of the movement against psychiatry.
Note to public: Terrorists are not representative of Islam and Scientologists are not representative of psych reform.
Well then, boans, you must be very happy much of the time. 🙂
I know next to nothing about criminal law but I would have hoped that every defendant is given ample opportunity to explain his or her actions. To me, that’s implied in the notion of defence.
I agree. Withdrawal of cigarettes used to be a powerful tool in attaining patient compliance. I would have thought staff would want to encourage smoking on this basis.
How does the author being a psychologist suggest bias?
I have no doubt you’ve seen antipsychotics have an effect on your patients. They are, after all, psychoactive drugs. It’s slightly troubling, though, that you talk about families of patients benefiting. That pretty much aligns with what the article is complaining of – drugging for ease of management.
Hi, Russerford. Your doctor is quite correct that serotonin levels likely vary across the blood-brain barrier and thus merely measuring blood levels is of limited use. However, I’d like to point out that in science theory is derived from strengthening and confirmation of a hypothesis. In other words, the onus is on psychiatry to PROVE the serotonin theory of depression, not on skeptics to DISPROVE it.
You may well be right.
One could make a case that every time a man takes a woman out to dinner with the expectation of sleeping with her and if the woman feels obliged to sleep with him, that the arrangement nears prostitution. Ditto very rich men and their trophy wives. What appalls us about more obvious prostitution is just that – that it’s too obvious. We will never be able to get away from the fact that sex is often used as a commodity.
Well, I really can’t comment on that because I don’t know how you envision a better legal and criminal justice system.
I have been subjected to forced ECT too, Fred. Your assumption and “guarantee” are completely unwarranted.
“So I would say that the defendant should be offered the opportunity to describe any extenuating circumstances including anything that impacted on their decision-making at the time – and that the defendant’s lawyer could put on information and evidence, it does not have to be the defendant testifying if they don’t want to.”
Isn’t this already true, though?
Still wondering about this. Why should a defendant be entitled to only the benefits of an insanity defence? It’s a bit like saying the mentally ill should get a free pass from their responsibilities. Now, I do understand (but don’t agree with) Thomas Szasz’s position but this article seems like a new twist.
Jonathan, I would prefer more points of view on this blog, too. However, it seems that whenever somebody comes along who doesn’t partake in the groupthink, they are savagely disparaged. That’s not an environment that fosters healthy dialogue. It’s fine to disagree, of course, but if we want to change the status quo, we have to engage with the “other side.”
By “pile on,” I was referring to the general tone of the thread not any particular post of yours. Sorry for the misunderstanding.
I feel it’s just being assumed here that as Dr. Hassman is a psychiatrist that he must promote overmedication and I think if people are going to make that kind of leap, they should at least make a cursory enquiry before publically misstating his position. Believe it or not, there actually are good psychiatrists.
I do find some of the discussions here at MiA incredibly frustrating. I support widespread psychiatric reform but I’m often discouraged by some of the things written here and I wonder what on Earth a random member of the public (who may not have yet formed an opinion on these matters) is going to think when they read some of these discussions.
Richard, your “so called” before the word feminist is pretty offensive.
I don’t think that’s a good argument. Many treatments “do not exist in nature” but that’s not to say they’re medical fraud.
Richard, I’ve never heard prostitution being referred to as “liberating.” And from a legal standpoint, I support harm reduction. By way of analogy, I don’t think street drug use is either desirable or “liberating,” either but I don’t think the answer to it is shaming users.
Rather than the personal attack, Richard, could you tell me specifically what logic of mine you find “almost beyond credibility” if you wish to discuss it? And, yes, I often change my mind about things as I learn more about them. It’s just that I haven’t learned anything here.
Jonah, my comment about “bullying” was a general one directed at some sectors of the psych rights movement, not any particular individuals here. I’m sorry that you chose once again to select the very least generous interpretation of your opponent’s words.
I’ve read Peter Breggin and find his position hard to reconcile with the facts. I agree that forced and/or coerced ECT has to be abolished but, as far as voluntary ECT goes, I’ve frequently seen people decline further treatments. Given that the USA’s mental health laws are much more user friendly than Canada’s, I assume that it happens in the USA too. Bottom line is that some people choose ECT and some in the psych rights movement choose not to respect other people’s choices, much as psychiatrists deny choice to their patients.
Our legal systems may be vastly different, of course. Here, you plead NCR (not criminally responsible) instead of going to trial so it’s really not accurate to call it an insanity acquittal. It’s more like an insanity bypass. As many have already noted, it’s a difficult decision to make.
Agreed. I don’t know how or why the discussion morphed into who wins the Victim Olympics.
As Anon pointed out above, Dr. Hassman has been more than clear that he’s vehemently opposed to overmedicating patients. But, by all means everybody, just ignore that inconvenient fact so that you can continue with the pile on!
Anon, we have somebody here at MiA (not on this thread, but on this site) who went to Dr. Hassman’s blog which is called “Can’t medicate life” and has a header which reads “If you want to get better, take a pill, but if you want to get it right, face the truth” and publicly summed up his position jeeringly as “If you want to get better, take a pill.”
I called her on this virtual libel and she retorted that the missing critical phrase “but if you want to get it right, face the truth” was merely a “non sequitur.” Not only did the commenter not apologize to Dr. Hassman but I was criticized by another commenter for bringing this dishonesty to light. Okay, folks, this is why we’re not taking seriously.
Unfortunately, this kind of crap is what passes for debate in some sectors of the psych rights movement and the hell of it is that it harms us, all of us. The other side could (and perhaps does) quote many of the comments here at MiA and reasonably conclude that some of us are both illiterate and irrational and not to be taken seriously.
None of us holds the monopoly on pain and suffering. It is appalling that some of us are so ready to lash out that we don’t even take the time to consider the target. If you take the time to actually read and think about what he says, you’ll see that Dr. Hassman is actually an ally or would have been before he was subjected to this.
If you don’t like the “psychiatric” descriptor, we don’t need to use it. The term intervention (or crisis intervention or emergency intervention) can stand by itself. My point is just that there are situations where it’s ethical and appropriate to intervene, even though a person may have broken no law.
I agree that there are often a range of services that can be offered beyond involuntary hospitalization in a crisis and, of course, we should encourage use of those services first. However, if a person is declining such help, then, yes, the choice is between forced intervention or nothing. You can’t force a person to be talked down.
If a police officer comes across a suicidal woman standing on a bridge railing, it is only mental health legislation that allows him to physically prevent her from jumping. Without such laws, he would actually be committing assault if he grabbed her. That’s an untenable scenario and just one reason why we’re never going to get rid of involuntary psychiatric treatment. The real issue is in its application and how civil liberties are balanced with public safety.
Actually, doctors do all kinds of horrible and unnecessary surgery on informed, consenting adults.
Tina, could you please tell me who makes the decision? Is it solely up to the defendant or does the prosecutor and/or Judge have input into the decision? What happens if a defendant declines the insanity defence but then clearly displays symptoms of a mental disorder during Court proceedings?
Also, when you say you would want leniency for someone who is “in a state of altered reality or extreme distress when committing a crime,” I am wondering what “leniency” means here. Do you want lesser punishment without specifying that the defendant has a disorder? I’m not sure how that would work. What would be the basis for the leniency, then?
I had never thought about comparing insanity acquittals with regular acquittals in terms of discrimination. If the insanity defence were removed, regular acquittals likely wouldn’t increase. In other words, I don’t think it’s usually a choice between two kinds of acquittals but rather between a guilty verdict and an insanity acquittal.
I’m also aware that involuntary psychiatric treatment happens in prison, too, so it’s not like declining an insanity defence guarantees a person won’t be medicated against his will.
TSIB, I sort of wonder if the drive to force drug more and more of us is ever present but just becomes more public when a shooting tragedy comes to light. In other words, I don’t think it’s as simple as “Hey, crazy person with a gun killed people so let’s force drug ’em,” but rather “Hey, this is a great opportunity to further our agenda of force drugging ’em!”
Well, ECT is a medical treatment if we’re going to call depression an illness. ECT often provides short-term relief. For some, that small gain is worth the substantial risks.
The problem is forced or coerced ECT because it’s way too invasive and dangerous a procedure to use on this basis. I completely, 100% support an absolute abolition on forced/coerced ECT.
Jonah and Richard, it seems you’re having trouble wrapping your mind around the fact that someone may want to make a decision that you would not want to.
Even with memory loss, brain damage, spontaneous seizures and a raft of other problems, some patients want ECT when they can’t see another way out of their depression.
If you really want to reduce ECT, please stop alienating those who voluntarily choose it and concentrate instead on public awareness of the risks and promotion of alternatives for people who suffer from crippling depression.
I’m quite serious about what I said before. It is actually disturbing to me to see psychiatric survivors being bullies. The major complaint most of us have against the psychiatric system is being denied choices and not being listened to. Yet here we are doing exactly the same thing to some of our comrades.
I look forward to seeing your writing on consent, Bonnie. I admire your work.
Sorry. Obviously, I meant to say ” … does NOT make a cogent argument …. “
I’m a Canadian, Richard. Prostitution is legal here. And many feminists are of the view that prostitution is not oppressive to women. In fact, there’s an entire movement to legitimize the sex trade with a goal to keeping prostitutes safe. Merely saying “Eew, it’s blecchy!” does make a cogent argument for abolition.
As for my idea of government in society, in a nutshell, I think needs to be there to gather taxes and to provide services for all in exchange.
Like it or not, many people find that psych meds help them. People voluntarily choose them and there is no reason to deny them their choice. It’s offensive that survivors of psychiatry are so willing to inflict their ideology on others just as psychiatrists did to them.
Now what we do need to do is work towards greater public awareness of the dangers of psych meds so that people know what they’re getting into. But many are already fully aware of the dangers of these drugs and still choose to take them.
What we should be focusing on is strategies against coercion and unwarranted involuntary treatment. Those are goals that I can see being reached in my lifetime. Abolition of forced psychiatry and/or psychiatry in general, on the other hand, has no possibility of succeeding, ever.
How is it a contradiction in terms? A patient can be given the facts (informed) and genuinely choose the treatment (consent). I think what trips anti-psychiatrists up is their disagreement with other people’s choices. The irony is that limiting choice is the primary complaint they have against psychiatry! We do, indeed, bear responsibility for what we offer but we also bear responsibility for denying choice.
Informed consent is still possible even if forced treatment exists in other situations. What’s critical is to guard against the insidious grey area of coercion where people are “consenting” under threat of force when they don’t actually meet the criteria for involuntary treatment. In BC, the threshold for involuntary treatment is far too low and is so vaguely worded it could pretty much apply to anybody. “Imminent danger,” on the other hand, does seem a reasonable standard. I’d be happy with that in BC, provided a patient was entitled to a court hearing.
There are, unfortunately, rare and extraordinary circumstances where intervention is justified. Intervention need not necessarily mean medication but it may mean a 72 hour hold. The need for such a legal mechanism has to be acknowledged because it’s never going to go away.
I am adamantly opposed to psychiatry but I would never support absolute abolition of emergency psychiatric intervention. If somebody is writing down their fantasies about killing schoolchildren, they are not breaking any law, merely exercising free speech. If they don’t want counselling or other services, are we really going to ignore them? The public is never going to get behind a movement that answers “yes” to that question.
This is how I envision the revolution — making psychiatry obsolete rather than illegal.
Hi, Bonnie. Thank you for not being offended (or not expressing offence). I agree that whatever gains we make will definitely be over the long haul. I must disagree, though, with your assertion that if people knew the biomedical model was a fraud, they wouldn’t pursue psychiatric treatment. I’m fully aware that mental disorders aren’t biological illnesses yet I’m grateful to have meds available, if and when I choose to use them.
And, as with Frank’s comment above re: lobotomy, if a patient really exercises informed consent in choosing a 2 x 4-ectomy, then there’s no ethical reason to deny same. Empowerment means giving people choices, not restricting choices to those we happen to agree with. In this respect, I find certain aspects of the anti-psychiatry movement to be as oppressive as psychiatry.
No, my criticism stands. The issue for such irreversible and invasive procedures (ECT, lobotomy, electrode implantation, etc.) is still informed consent. Who is one person to tell another what treatment they choose?
I think the abolition of psychiatry is a non starter. In fact, I think the abolition of forced psychiatry is a non starter. I wish our considerable efforts were going instead into informed consent (which rests on public awareness), raising the criteria for forced treatment to where it belongs, providing effective voluntary care and (especially) fighting outpatient commitment.
With respect to ECT, abolition is the wrong goal. In response to an email, I wrote back to one of the organizers of an abolitionist outfit to say that some people choose ECT and the real issue is whether their consent is true consent (as in no coercion) and informed (as to risks).
Lack of choice is exactly what we complain about when we criticize psychiatry. Why are we doing the very same thing to others? If somebody finds that ECT works for her, why shouldn’t she have that option? It’s paternalistic to declare that she can’t reasonably make that decision.
Anyway, the organizer said there is no such thing as informed consent to ECT because it always causes brain damage. That doesn’t logically follow. A person can be aware that a procedure causes harm and still choose to go that route.
Anyway, the concept of abolition of psychiatry or even abolition of forced psychiatry turns off an awful lot of influential people who would otherwise be our allies.
Is there any evidence that AbleChild is a Scientology front group?
I think much (if not most) of the bipolar boom can be attributed to harmful, ineffective treatment for depression. Every psychiatrist I’ve ever consulted has declared that antidepressants merely “triggered” my underlying disorder. This rather bold conclusion is made in the face of no evidence: there were no prior mood swings nor any family history of same. Seems a very convoluted way to explain away a pretty obvious cause and effect relationship.
Because a true believer will just look at this situation and conclude the problem was that he didn’t have ENOUGH treatment. If someone’s doing well on meds, it’s proof that they work, but if someone’s doing poorly, it’s proof that we need more. They pretty much have the situation covered.
” … identified that about one to three percent of women in clinical trials experienced depression …. ”
I thought the prevalence of depressive disorders in the general population was more like 6%?
Not really understanding why this “amazed” researchers. It’s a well-known phenomenon.
Am wondering if there are separated twin studies yet on ADHD or whether it’s too new a diagnosis for that. I really have to wonder about these parents! If your doctor is telling you that your child is defective and needs stimulants, GET A NEW DOCTOR!
Seth, it is my consciousness that allows me to look at an apple and recognize it as such. Obviously, when I’m asleep, I lose that awareness. That doesn’t mean that the apple only exists when I’m awake!!!
We don’t require consciousness to have neurochemistry. We have neurochemical states even when we’re in a coma. And, yes, in accordance with science, I know that consciousness cannot exist in the absence of physicality.
I really have no idea why you are trying to compare your theory to quantum physics or, indeed, to any scientific field whatsoever. What you are describing belongs, along with all other perfectly unfalsifiable theories, under religion’s umbrella.
You’re saying that in the absence of involuntary treatment laws nobody would consult a psychiatrist for, say, depression?
Well, we can’t say they have NOTHING to do with mental health. In some cases, the criminal act was clearly the result of psychosis. I agree, though, that safety is the primary justification for incarceration.
Thanks for the info. In some circumstances, there is still involuntary psychiatric treatment in prison, though, right? So declining NGRI (or NCRMD as well call it up here) isn’t a no-treatment guarantee.
Jonah, the fact that Szasz was one of the founders of CCHR has never been in dispute. We’re talking about the religion of Scientology as a whole, not the organization called CCHR. Szasz was a devout atheist.
You are of course correct that Szasz is no longer “still alive and kicking,” however I doubt he changed his mind about Scientology after he died 🙂
(As an aside, it is not unusual to use the present tense in such instances, e.g. “Freud says ….” or “Shakespeare says ….”)
And what on Earth does telepathy have to do with quantum physics or any other science?
“Francesca writes ‘neurochemistry… leads to individual thoughts, feelings and experiences, regardless of the origin of any particular neurochemical state.’ That’s backwards. It is thoughts and feelings that most often lead to neurochemical changes.”
Seth, you have utterly misunderstood my point. I do not have this “backwards.” Ask yourself this: Can one have thoughts and feelings without neurochemicals? No, one cannot. As I said, REGARDLESS OF THE ORIGIN of any particular neurochemical state, it is in fact one’s neurochemicals that provide our consciousness.
Vet, this statement of yours amazed me: “The trouble is, where can an attorney or law firm be found with the stones to take such a case? The Bars of most states have considered a person with a psychiatric label to be unfit for admission to the Bar based upon its “Character and Fitness”portion of its exam.”
Are you referring to the disqualification of someone who is actively suffering from a mental disorder? Or do you mean someone who merely has been so diagnosed at some point in his/her past? If it’s the latter, I can’t imagine that human rights legislation allows such discrimination.
Hi, Sharon. I was just wondering how the “not criminally responsible” system works in your country. Is it by choice of the defendant or is that designation from the prosecutor?
Yes, Steve, I am well aware of the structure, function and location of neurotransmitters. My point was simply that SSRIs (or any other psychoactive drug, for that matter) can mess with a person’s neurochemistry and cause distress as a result.
I think if you’re willing to agree that meds can cause brain chemical changes that can lead to mental distress, then you are logically forced to at least consider the possibility that in some cases brain chemical changes can do the same without the triggering psychoactive drug.
I have never claimed that the answer to emotional distress is better living through chemistry. It’s still important to recognize, though, that it is in fact neurochemistry that leads to individual thoughts, feelings and experiences, regardless of the origin of any particular neurochemical state.
I guess I’m not antipsychiatry because I do see a place for psychiatry, albeit with massive improvements over current practice.
Oldhead, I am coming to the conclusion that I have very poor writing skills because some of these countering responses aren’t countering anything I (meant to) say.
You write: “Is anger a disease caused by adrenalin?”
No, but adrenalin is required to have the sensation of anger. If the neighbour’s music is making me angry, knowing that there’s an intermediate step (adrenalin) in no way changes the basic relationship of that noise = anger relationship. But here’s where we differ: The structure and function of adrenalin is still worthy of study even after the neighbour turns off his stereo.
And earlier in the same post you write: “So the answer lies in changing the “environment,” not screwing around with the chemicals and the brain.”
But you’re assuming that the culprit MUST be the environment and that’s not always the case. And even when it is the case, sometimes the environment can’t be immediately changed and sometimes changing the environment doesn’t immediately affect the brain state.
Psych drugs remain and always will remain a valuable tool. Unfortunately, in rare and extraordinary circumstances, using them is completely justified even over someone’s objections.
Clearly, involuntary treatment happens way too often and outpatient commitment is generally a bad approach. However, in a crisis intervention, there may be no alternative. Arguing otherwise is a lost cause.
PS to CS2013, I concede that my “intellectual ability” (your words) precludes my agreeing with your position.
And, with that, I will be leaving this thread and Mad in America. I wish everybody well but I prefer not to participate here anymore.
Abolitionists would forbid such practices even when completely warranted as in the situation you describe here. Their rule seems to be that the only grounds for intervention are AFTER a criminal act has been committed. It’s an untenable position and will never be taken seriously.
Here in BC, one could certainly be paid a visit from the police for a “wellness check” on the say so of a 3rd party but that by itself wouldn’t be grounds for a mental health apprehension. I’ve never heard of any such 3rd party being either sued or charged for a bad faith report. I’d be interested to see how that would play out.
And I do agree with you that critical thinking does not equate to bickering. Bickering, however, is mostly what’s prominent here.
Hi, Oldhead. Anon had already suggested to me that it wasn’t an appropriate post and I responded in agreement. The notion of assessing who’s doing more to help does not strike me as an absurd approach, however. What was inappropriate about the post was my suggesting that CS2013 hadn’t helped which of course I have no way of knowing. That’s why I agreed with Anon.
You’re right, Anon. I retract.
Destroyed her metabolism, I’m guessing. Sorry to hear about your friend.
When I became stable, my doctor wanted to maintain me on Risperdal on the grounds that “if it ain’t broke, we needn’t fix it.” But it was broke! I was taking harmful and unnecessary medication.
Perhaps my biggest objection was that I was not willing to have my mental health attributed to pills. In any event, I got off that crap in April 2013 and have never looked back.
Jonah, you’re quite right. My tone was unnecessary and I apologize, sincerely.
My frustration is driven by your comments such as:
“Even if/when on can clearly establish, that “Without the neurochemical state XYZ, one wouldn’t have the sensations/perceptions” that are suggestive of ‘fear,’ that proof will not, in and of itself, be convincing evidence, that XYZ has created those sensations/perceptions.”
I KNOW THAT AND SAID AS MUCH! You take such a professorial tone to state such obvious truths. My point was simply that the research Jill is talking about is still valuable and worthwhile REGARDLESS OF HOW ANY PARTICULAR NEUROCHEMICAL STATE CAME TO BE.
And what if this hypothetical person adamantly refuses support? Are you prepared to ignore him or her? If your answer is “yes,” you’ve solved the riddle of why anti-psychiatrists aren’t taken seriously.
I’m sorry you went through such trauma at the hands of the psychiatric system. I must say though that you seem to be leaving out a few details here. There must have been some context to the police coming to your home. I’m not saying that the context necessarily justified the actions, just that the police do not generally show up at peaceful, law-abiding citizens’ houses and Tazer them.
BTW, the comparisons to slavery and Sharia law are very offensive and add nothing to the discussion.
I think Boans might counter that children aren’t entitled to their full rights yet but your example certainly also applies to removing an adult out of harm’s way. You’re quite right that the notion of abolition involves morally indefensible positions. That’s why it’s going nowhere.
Thanks for contributing to the discussion, Jonathan. I so wish that some could understand that their position actually undermines the cause.
CS2013, let me rephrase. Please give one example of any impact you have had on the lives of those suffering from mental disorders. For instance, one report of somebody reading your wisdom and improving his or her life as a result.
Actually, no, CS2013, it doesn’t nearly answer my question which was: What have YOU done to improve the situation?
Here you go, CS 2013: http://en.wikipedia.org/wiki/Dax_Cowart
15 seconds on Google saved.
CS2013, there are myriad reports of forced medical interventions. The fact that you’re not aware of them doesn’t make them cease to exist.
Jonah, this is really getting tedious. Without the neurochemical state XYZ, one wouldn’t have the sensations/perceptions. If you want to argue mind vs. brain, I’m too bored to continue.
Your assumption that if I don’t agree with you then I don’t understand you is both amusing and reminiscent of the psychiatric approach. Have you considered the possibility that you’re just not that interesting?
Boans, I do agree with you that forced psychiatry necessarily involves human rights violations. The question is when is it justifiable? We might agree that a 14 year old should be prevented from cutting herself in response to bullying at school.
This gets back to the arguments I have had with other posters: What do you suggest instead? On a different thread on a different topic, I was describing a situation I was in several years ago. Long story short, I was in agony and was incapable of either consenting to or refusing treatment. Anyway, when I described my circumstances as a counter-example to the “all force is evil” camp, one poster in particular gave a smiley face and talked about my responsibility for my own distress. It actually chilled me to the bone that someone could read what I had described and say the equivalent “Oh, well ….” In fact, every time I think of it, I ‘m thinking antisocial personality disorder.
Your logic is breathtaking.
CS2013, you’re right that statins are never court ordered but you’re wrong that physical medicine is never done over a patient’s objections. There are several exceptions where public safety trumps an individual’s freedom. I know that’s likely a scenario that sickens you politically but it exists and it exists for good reason.
Jonah, can you understand that if neurochemical state Y is found to be responsible for what we term mental state Z, that does not preclude a causal relationship between environmental factor X and mental state Z via neurochemical state Y?
The scientific fact that the brain creates our sensations and perceptions seems to threaten an awful lot of people.
Actually, I believe migraine is the disease and migraine headache is one symptom of that disease. I therefore correct and resubmit my analogy accordingly.
The point is that migraine headaches exist and respond to treatment, even without objective diagnostics.
I think it’s a mistake to tar all psychiatrists with the same brush. If Dr. Steingard just wanted to maintain her “livelihood,” I’m guessing she wouldn’t spend much time writing for MiA.
Can’t remember what all NIMH had to say about this beyond that they are no longer funding research based on symptomology. I assume that means more resources than ever will be sunk into the genetics/neurology end of things.
Cannotsay2013, at the risk of provoking you, may I ask how your “thinking big” has translated into improving the lives of those who suffer from mental disorders/emotional distress/fill in your favourite term here?
I believe that Dr. Lawhern is encouraging us to actually get something done rather than just keep bickering.
Steve, you make an excellent point about migraine headaches. Would you allow me to try again with fibromyalgia? I believe that’s considered a disease, rather than just a cluster of symptoms.
Anyway, my point is that lacking an objective test isn’t what kills the endeavour. It’s far more useful to argue that outcomes are generally worse with treatment or that the diagnostic criteria are too fluid to be meaningful.
I would argue that mental disorders certainly exist but they are rarely diseases. Many go much further and claim mental disorders are never diseases and some go further still and claim there’s no such thing as a mental disorder.
At present, the term “anti psychiatry” is taken about as seriously as the term “anti vaxxer.”
You needn’t have bothered. Dr. Steingard has always been completely open about her position but nice detective work, all the same.
Absolutely. Psychiatry is way, way too quick to medicalize human emotion. At the same time, we do need to acknowledge that in rare and extraordinary circumstances some people require support, up to and including treatment they may not want. The issue for me is short vs. long term treatment. There is far more justification for emergency intervention than outpatient commitment. In my view, reform should focus on the latter. Abolition, however, is a non-starter.
I completely agree with you as far as losing sympathy with the “anti psychiatry” position. Listening to some of these “activists” exactly proves psychiatry’s point.
By that standard, migraine headaches don’t exist.
Well, we can argue all day about who the “average person” is. Let’s just say our experiences differ and leave it at that.
I certainly never said that psychiatrists are going to be the driver of psychiatric reform.
And, again with the slavery analogy!
Again, a very poor analogy. Psychiatry has little in common with either slavery or the death penalty.
So? Why should a person have the facts before entering a discussion? 🙂
I really like this post and agree with everything you’ve written. I think you might find, though, that abolitionists will either attack you or write you off. Many “activists” are only interested in the black and white: “Psychiatry is pure evil. Nobody has ever been helped by treatment. Intervening in a crisis is a human rights violation. We will stand for nothing less than complete abolition.” Such an extreme stance will never be taken seriously by either psychiatrists or the general public and it’s a mystery to me why they bother. I see that the first commenter here has already trotted out the chattel slavery comparison.
This wasn’t meant as a suggestion for any particular guest author. I was referring to the general idea of welcoming the “other side.”
It would be truly wonderful to have Biederman or Torrey or Jaffe or someone like that post here and it would be a shot in the arm to MiA that such prominent figures in the establishment wished to engage with us. I can imagine what would happen, though. Some commenters would choose to shriek “Nazi brain rapists, all of you!” or equivalent phrasing. I can certainly understand what drives the anger but the issue is how we’re going to make change. Blindly raging at them just gives them more fodder.
Believe it or not, I make a genuine effort to just read the comments and not engage in the dialogue because I completely agree with your criticism. Too much of the conversation after these articles becomes irrelevant and distracting. This is a thought-provoking article that merits serious consideration. If it’s to be criticized, it ought to be on the basis of specific offending points made in it (which I didn’t find), not general backlash on the basis that the author isn’t 100% in agreement with the MiA audience.
In my neck of the woods, Psychology 101 is pretty damn close to Psychiatry 101. I’ve lost interest and am switching majors.
There is no basis to claim that the choice to undergo ECT cannot be free and informed. A patient can be provided with all information available, be entirely aware of the risks, and choose nonetheless to proceed.
ECT cannot reasonably be compared to cutting one’s self. But if you choose to “advocate that this is everyone’s right,” then your assertion that ECT ought to be abolished outright is even more untenable.
I read your work carefully, Bonnie, and agree with much of it. However, all I’m getting from you on this subject is that you don’t like ECT so nobody should be able to have it. As I said before, your position on this is parallel to the top down “we know best” attitude that psychiatry exhibits.
From a pragmatic standpoint, ECT is not going to go away. Why don’t we work instead on promoting full disclosure and abolishing forced ECT? Those are achievable goals.
I agree with you, Darby. With respect to certain specific circumstances, it is not the least bit “irrational” (author’s word) to believe that things will never improve. Do you remember the movie Sophie’s Choice? I’m sure the protagonist would have considered the description “permanent solution to a temporary problem” a mere platitude, which it often is.
I wrote this letter to our local rag last month but it wasn’t printed:
“I was surprised to read in your June 24th editorial that mental health outreach teams help ‘steer people away from drugs.’ In fact, standard psychiatric care promotes drug use, albeit of ones that profit pharmaceutical manufacturers rather than street dealers. The chemical distinction between prescription and illegal drugs can be murky ….”
Didn’t realize he was in the biz or are you just referring to promoting and/or selling vitamins?
Unfortunately, being yoked with a psychiatric label is pretty much the end of a person’s civil rights. As a Canadian, I can be stripped of my Constitutional right to security of the person and my Constitutional right not to be arbitrarily detained.
That is brilliant. Thanks for posting the link.
Took the words right out of my mouth (typing fingers), Wayne. Judging by the quality of the critical thinking I see at my university, I would suggest that mere credentials don’t equal knowledge, intelligence and understanding. In fact, more education can just lead to more confidence in one’s incorrect assumptions. Seriously, I doubt I will continue my studies for exactly this reason. Regurgitating what one’s told doesn’t seem a likely route to intellectual enlightenment.
Agreed. Many patients are obese and compliant but not necessarily any better off. That’s the problem with trying to measure such a hugely complex issue as well-being with mere statistical tools.
Hi, Monica. I don’t know what the situation is in your state but here in BC there are far more people on “assisted” community treatment orders than could possibly fit in our psych wards. If such patients were to organize (a “Mad Union,” if you will), they would have considerable power. The spectre of hundreds of clients denying medication providers access to their homes at the same time would, I believe, make the establishment sit up and take notice of such demands as assisted tapering programs.
Because involuntary treatment is happening in people’s homes rather than hospitals now, otherwise concerned people are turning a blind eye. The legal standard for forced treatment should be the same, no matter where the treatment occurs. Community “care” is just a cost-saving measure for the government. There is no fundamental difference between psychiatric incarceration and outpatient commitment except the veneer of civility.
Hi, Bonnie. Informed consent entails two separate concepts, of course. “Freely given” is implied in the second.
Clearly, psychiatry is not going to be voluntarily forthcoming with information about the risk/benefit ratio of ECT and there is a huge need to get further information out to the public. Beyond that, we could lobby for legislation that insists individual doctors provide such information.
Consent, however, is far more problematic. Not just for ECT, but for all psychiatric treatments, I would like to see an advocate made available to all patients facing forced treatment or the more insidious, grey area of coerced treatment. Can’t stress enough that such an advocate would be chosen by the patient and be immediately available, free of charge.
Of course, it’s not just the routine lack of informed consent, though, that you and others object to. It’s the notion of someone choosing a course of action that you would not. I would suggest that this is similar oppression to what psychiatry practices: “We know better than you do what’s good for you so what you think really doesn’t matter.”
There are many medical procedures that carry little or no benefit yet substantial risk so ECT isn’t unique. Unfortunately, what works against Breggin’s position is that ECT does often give short-term improvement measured subjectively. Now, for most of us, that very brief relief is not nearly worth the brain damage that accompanies it. For others, though, it is and that’s a choice that needs to be respected. The only issue is whether that choice is truly informed and truly free.
It’s really a shame that so much legitimate criticism of psychiatry is ignored or minimized because this one slice, albeit very well-funded and famous slice, of the psych reform movement is so vocal.
The irony is that Scientology has actually ended up promoting psychiatry because any serious critical writing gets tarred with the same brush. The esteemed E. Fuller Torrey wrote off Peter Breggin’s work largely on the basis that Breggin’s wife was a former Scientologist. Even respectable magazines like The New Yorker point to Scientologists as though they were representative of the movement against psychiatry.
Note to public: Terrorists are not representative of Islam and Scientologists are not representative of psych reform.
Well then, boans, you must be very happy much of the time. 🙂
I know next to nothing about criminal law but I would have hoped that every defendant is given ample opportunity to explain his or her actions. To me, that’s implied in the notion of defence.
I agree. Withdrawal of cigarettes used to be a powerful tool in attaining patient compliance. I would have thought staff would want to encourage smoking on this basis.
How does the author being a psychologist suggest bias?
I have no doubt you’ve seen antipsychotics have an effect on your patients. They are, after all, psychoactive drugs. It’s slightly troubling, though, that you talk about families of patients benefiting. That pretty much aligns with what the article is complaining of – drugging for ease of management.
Hi, Russerford. Your doctor is quite correct that serotonin levels likely vary across the blood-brain barrier and thus merely measuring blood levels is of limited use. However, I’d like to point out that in science theory is derived from strengthening and confirmation of a hypothesis. In other words, the onus is on psychiatry to PROVE the serotonin theory of depression, not on skeptics to DISPROVE it.
You may well be right.
One could make a case that every time a man takes a woman out to dinner with the expectation of sleeping with her and if the woman feels obliged to sleep with him, that the arrangement nears prostitution. Ditto very rich men and their trophy wives. What appalls us about more obvious prostitution is just that – that it’s too obvious. We will never be able to get away from the fact that sex is often used as a commodity.
Well, I really can’t comment on that because I don’t know how you envision a better legal and criminal justice system.
I have been subjected to forced ECT too, Fred. Your assumption and “guarantee” are completely unwarranted.
“So I would say that the defendant should be offered the opportunity to describe any extenuating circumstances including anything that impacted on their decision-making at the time – and that the defendant’s lawyer could put on information and evidence, it does not have to be the defendant testifying if they don’t want to.”
Isn’t this already true, though?
Still wondering about this. Why should a defendant be entitled to only the benefits of an insanity defence? It’s a bit like saying the mentally ill should get a free pass from their responsibilities. Now, I do understand (but don’t agree with) Thomas Szasz’s position but this article seems like a new twist.
Jonathan, I would prefer more points of view on this blog, too. However, it seems that whenever somebody comes along who doesn’t partake in the groupthink, they are savagely disparaged. That’s not an environment that fosters healthy dialogue. It’s fine to disagree, of course, but if we want to change the status quo, we have to engage with the “other side.”
By “pile on,” I was referring to the general tone of the thread not any particular post of yours. Sorry for the misunderstanding.
I feel it’s just being assumed here that as Dr. Hassman is a psychiatrist that he must promote overmedication and I think if people are going to make that kind of leap, they should at least make a cursory enquiry before publically misstating his position. Believe it or not, there actually are good psychiatrists.
I do find some of the discussions here at MiA incredibly frustrating. I support widespread psychiatric reform but I’m often discouraged by some of the things written here and I wonder what on Earth a random member of the public (who may not have yet formed an opinion on these matters) is going to think when they read some of these discussions.
Richard, your “so called” before the word feminist is pretty offensive.
I don’t think that’s a good argument. Many treatments “do not exist in nature” but that’s not to say they’re medical fraud.
Richard, I’ve never heard prostitution being referred to as “liberating.” And from a legal standpoint, I support harm reduction. By way of analogy, I don’t think street drug use is either desirable or “liberating,” either but I don’t think the answer to it is shaming users.
Rather than the personal attack, Richard, could you tell me specifically what logic of mine you find “almost beyond credibility” if you wish to discuss it? And, yes, I often change my mind about things as I learn more about them. It’s just that I haven’t learned anything here.
Jonah, my comment about “bullying” was a general one directed at some sectors of the psych rights movement, not any particular individuals here. I’m sorry that you chose once again to select the very least generous interpretation of your opponent’s words.
I’ve read Peter Breggin and find his position hard to reconcile with the facts. I agree that forced and/or coerced ECT has to be abolished but, as far as voluntary ECT goes, I’ve frequently seen people decline further treatments. Given that the USA’s mental health laws are much more user friendly than Canada’s, I assume that it happens in the USA too. Bottom line is that some people choose ECT and some in the psych rights movement choose not to respect other people’s choices, much as psychiatrists deny choice to their patients.
Our legal systems may be vastly different, of course. Here, you plead NCR (not criminally responsible) instead of going to trial so it’s really not accurate to call it an insanity acquittal. It’s more like an insanity bypass. As many have already noted, it’s a difficult decision to make.
Agreed. I don’t know how or why the discussion morphed into who wins the Victim Olympics.
As Anon pointed out above, Dr. Hassman has been more than clear that he’s vehemently opposed to overmedicating patients. But, by all means everybody, just ignore that inconvenient fact so that you can continue with the pile on!
Anon, we have somebody here at MiA (not on this thread, but on this site) who went to Dr. Hassman’s blog which is called “Can’t medicate life” and has a header which reads “If you want to get better, take a pill, but if you want to get it right, face the truth” and publicly summed up his position jeeringly as “If you want to get better, take a pill.”
I called her on this virtual libel and she retorted that the missing critical phrase “but if you want to get it right, face the truth” was merely a “non sequitur.” Not only did the commenter not apologize to Dr. Hassman but I was criticized by another commenter for bringing this dishonesty to light. Okay, folks, this is why we’re not taking seriously.
Unfortunately, this kind of crap is what passes for debate in some sectors of the psych rights movement and the hell of it is that it harms us, all of us. The other side could (and perhaps does) quote many of the comments here at MiA and reasonably conclude that some of us are both illiterate and irrational and not to be taken seriously.
None of us holds the monopoly on pain and suffering. It is appalling that some of us are so ready to lash out that we don’t even take the time to consider the target. If you take the time to actually read and think about what he says, you’ll see that Dr. Hassman is actually an ally or would have been before he was subjected to this.
If you don’t like the “psychiatric” descriptor, we don’t need to use it. The term intervention (or crisis intervention or emergency intervention) can stand by itself. My point is just that there are situations where it’s ethical and appropriate to intervene, even though a person may have broken no law.
I agree that there are often a range of services that can be offered beyond involuntary hospitalization in a crisis and, of course, we should encourage use of those services first. However, if a person is declining such help, then, yes, the choice is between forced intervention or nothing. You can’t force a person to be talked down.
If a police officer comes across a suicidal woman standing on a bridge railing, it is only mental health legislation that allows him to physically prevent her from jumping. Without such laws, he would actually be committing assault if he grabbed her. That’s an untenable scenario and just one reason why we’re never going to get rid of involuntary psychiatric treatment. The real issue is in its application and how civil liberties are balanced with public safety.
Actually, doctors do all kinds of horrible and unnecessary surgery on informed, consenting adults.
Tina, could you please tell me who makes the decision? Is it solely up to the defendant or does the prosecutor and/or Judge have input into the decision? What happens if a defendant declines the insanity defence but then clearly displays symptoms of a mental disorder during Court proceedings?
Also, when you say you would want leniency for someone who is “in a state of altered reality or extreme distress when committing a crime,” I am wondering what “leniency” means here. Do you want lesser punishment without specifying that the defendant has a disorder? I’m not sure how that would work. What would be the basis for the leniency, then?
I had never thought about comparing insanity acquittals with regular acquittals in terms of discrimination. If the insanity defence were removed, regular acquittals likely wouldn’t increase. In other words, I don’t think it’s usually a choice between two kinds of acquittals but rather between a guilty verdict and an insanity acquittal.
I’m also aware that involuntary psychiatric treatment happens in prison, too, so it’s not like declining an insanity defence guarantees a person won’t be medicated against his will.
TSIB, I sort of wonder if the drive to force drug more and more of us is ever present but just becomes more public when a shooting tragedy comes to light. In other words, I don’t think it’s as simple as “Hey, crazy person with a gun killed people so let’s force drug ’em,” but rather “Hey, this is a great opportunity to further our agenda of force drugging ’em!”
Well, ECT is a medical treatment if we’re going to call depression an illness. ECT often provides short-term relief. For some, that small gain is worth the substantial risks.
The problem is forced or coerced ECT because it’s way too invasive and dangerous a procedure to use on this basis. I completely, 100% support an absolute abolition on forced/coerced ECT.
Jonah and Richard, it seems you’re having trouble wrapping your mind around the fact that someone may want to make a decision that you would not want to.
Even with memory loss, brain damage, spontaneous seizures and a raft of other problems, some patients want ECT when they can’t see another way out of their depression.
If you really want to reduce ECT, please stop alienating those who voluntarily choose it and concentrate instead on public awareness of the risks and promotion of alternatives for people who suffer from crippling depression.
I’m quite serious about what I said before. It is actually disturbing to me to see psychiatric survivors being bullies. The major complaint most of us have against the psychiatric system is being denied choices and not being listened to. Yet here we are doing exactly the same thing to some of our comrades.
I look forward to seeing your writing on consent, Bonnie. I admire your work.
Sorry. Obviously, I meant to say ” … does NOT make a cogent argument …. “
I’m a Canadian, Richard. Prostitution is legal here. And many feminists are of the view that prostitution is not oppressive to women. In fact, there’s an entire movement to legitimize the sex trade with a goal to keeping prostitutes safe. Merely saying “Eew, it’s blecchy!” does make a cogent argument for abolition.
As for my idea of government in society, in a nutshell, I think needs to be there to gather taxes and to provide services for all in exchange.
Like it or not, many people find that psych meds help them. People voluntarily choose them and there is no reason to deny them their choice. It’s offensive that survivors of psychiatry are so willing to inflict their ideology on others just as psychiatrists did to them.
Now what we do need to do is work towards greater public awareness of the dangers of psych meds so that people know what they’re getting into. But many are already fully aware of the dangers of these drugs and still choose to take them.
What we should be focusing on is strategies against coercion and unwarranted involuntary treatment. Those are goals that I can see being reached in my lifetime. Abolition of forced psychiatry and/or psychiatry in general, on the other hand, has no possibility of succeeding, ever.
How is it a contradiction in terms? A patient can be given the facts (informed) and genuinely choose the treatment (consent). I think what trips anti-psychiatrists up is their disagreement with other people’s choices. The irony is that limiting choice is the primary complaint they have against psychiatry! We do, indeed, bear responsibility for what we offer but we also bear responsibility for denying choice.
Informed consent is still possible even if forced treatment exists in other situations. What’s critical is to guard against the insidious grey area of coercion where people are “consenting” under threat of force when they don’t actually meet the criteria for involuntary treatment. In BC, the threshold for involuntary treatment is far too low and is so vaguely worded it could pretty much apply to anybody. “Imminent danger,” on the other hand, does seem a reasonable standard. I’d be happy with that in BC, provided a patient was entitled to a court hearing.
There are, unfortunately, rare and extraordinary circumstances where intervention is justified. Intervention need not necessarily mean medication but it may mean a 72 hour hold. The need for such a legal mechanism has to be acknowledged because it’s never going to go away.
I am adamantly opposed to psychiatry but I would never support absolute abolition of emergency psychiatric intervention. If somebody is writing down their fantasies about killing schoolchildren, they are not breaking any law, merely exercising free speech. If they don’t want counselling or other services, are we really going to ignore them? The public is never going to get behind a movement that answers “yes” to that question.
This is how I envision the revolution — making psychiatry obsolete rather than illegal.
Hi, Bonnie. Thank you for not being offended (or not expressing offence). I agree that whatever gains we make will definitely be over the long haul. I must disagree, though, with your assertion that if people knew the biomedical model was a fraud, they wouldn’t pursue psychiatric treatment. I’m fully aware that mental disorders aren’t biological illnesses yet I’m grateful to have meds available, if and when I choose to use them.
And, as with Frank’s comment above re: lobotomy, if a patient really exercises informed consent in choosing a 2 x 4-ectomy, then there’s no ethical reason to deny same. Empowerment means giving people choices, not restricting choices to those we happen to agree with. In this respect, I find certain aspects of the anti-psychiatry movement to be as oppressive as psychiatry.
No, my criticism stands. The issue for such irreversible and invasive procedures (ECT, lobotomy, electrode implantation, etc.) is still informed consent. Who is one person to tell another what treatment they choose?
I think the abolition of psychiatry is a non starter. In fact, I think the abolition of forced psychiatry is a non starter. I wish our considerable efforts were going instead into informed consent (which rests on public awareness), raising the criteria for forced treatment to where it belongs, providing effective voluntary care and (especially) fighting outpatient commitment.
With respect to ECT, abolition is the wrong goal. In response to an email, I wrote back to one of the organizers of an abolitionist outfit to say that some people choose ECT and the real issue is whether their consent is true consent (as in no coercion) and informed (as to risks).
Lack of choice is exactly what we complain about when we criticize psychiatry. Why are we doing the very same thing to others? If somebody finds that ECT works for her, why shouldn’t she have that option? It’s paternalistic to declare that she can’t reasonably make that decision.
Anyway, the organizer said there is no such thing as informed consent to ECT because it always causes brain damage. That doesn’t logically follow. A person can be aware that a procedure causes harm and still choose to go that route.
Anyway, the concept of abolition of psychiatry or even abolition of forced psychiatry turns off an awful lot of influential people who would otherwise be our allies.
Is there any evidence that AbleChild is a Scientology front group?
I think much (if not most) of the bipolar boom can be attributed to harmful, ineffective treatment for depression. Every psychiatrist I’ve ever consulted has declared that antidepressants merely “triggered” my underlying disorder. This rather bold conclusion is made in the face of no evidence: there were no prior mood swings nor any family history of same. Seems a very convoluted way to explain away a pretty obvious cause and effect relationship.
Because a true believer will just look at this situation and conclude the problem was that he didn’t have ENOUGH treatment. If someone’s doing well on meds, it’s proof that they work, but if someone’s doing poorly, it’s proof that we need more. They pretty much have the situation covered.
” … identified that about one to three percent of women in clinical trials experienced depression …. ”
I thought the prevalence of depressive disorders in the general population was more like 6%?
Not really understanding why this “amazed” researchers. It’s a well-known phenomenon.
Am wondering if there are separated twin studies yet on ADHD or whether it’s too new a diagnosis for that. I really have to wonder about these parents! If your doctor is telling you that your child is defective and needs stimulants, GET A NEW DOCTOR!
Seth, it is my consciousness that allows me to look at an apple and recognize it as such. Obviously, when I’m asleep, I lose that awareness. That doesn’t mean that the apple only exists when I’m awake!!!
We don’t require consciousness to have neurochemistry. We have neurochemical states even when we’re in a coma. And, yes, in accordance with science, I know that consciousness cannot exist in the absence of physicality.
I really have no idea why you are trying to compare your theory to quantum physics or, indeed, to any scientific field whatsoever. What you are describing belongs, along with all other perfectly unfalsifiable theories, under religion’s umbrella.
You’re saying that in the absence of involuntary treatment laws nobody would consult a psychiatrist for, say, depression?
Well, we can’t say they have NOTHING to do with mental health. In some cases, the criminal act was clearly the result of psychosis. I agree, though, that safety is the primary justification for incarceration.
Thanks for the info. In some circumstances, there is still involuntary psychiatric treatment in prison, though, right? So declining NGRI (or NCRMD as well call it up here) isn’t a no-treatment guarantee.
Jonah, the fact that Szasz was one of the founders of CCHR has never been in dispute. We’re talking about the religion of Scientology as a whole, not the organization called CCHR. Szasz was a devout atheist.
You are of course correct that Szasz is no longer “still alive and kicking,” however I doubt he changed his mind about Scientology after he died 🙂
(As an aside, it is not unusual to use the present tense in such instances, e.g. “Freud says ….” or “Shakespeare says ….”)
Thomas Szasz most definitely objected to antipsychiatry: http://societyforhumanisticpsychology.blogspot.ca/2009/02/szasz-hates-laing.html
And what on Earth does telepathy have to do with quantum physics or any other science?
“Francesca writes ‘neurochemistry… leads to individual thoughts, feelings and experiences, regardless of the origin of any particular neurochemical state.’ That’s backwards. It is thoughts and feelings that most often lead to neurochemical changes.”
Seth, you have utterly misunderstood my point. I do not have this “backwards.” Ask yourself this: Can one have thoughts and feelings without neurochemicals? No, one cannot. As I said, REGARDLESS OF THE ORIGIN of any particular neurochemical state, it is in fact one’s neurochemicals that provide our consciousness.
Vet, this statement of yours amazed me: “The trouble is, where can an attorney or law firm be found with the stones to take such a case? The Bars of most states have considered a person with a psychiatric label to be unfit for admission to the Bar based upon its “Character and Fitness”portion of its exam.”
Are you referring to the disqualification of someone who is actively suffering from a mental disorder? Or do you mean someone who merely has been so diagnosed at some point in his/her past? If it’s the latter, I can’t imagine that human rights legislation allows such discrimination.
Hi, Sharon. I was just wondering how the “not criminally responsible” system works in your country. Is it by choice of the defendant or is that designation from the prosecutor?
Yes, Steve, I am well aware of the structure, function and location of neurotransmitters. My point was simply that SSRIs (or any other psychoactive drug, for that matter) can mess with a person’s neurochemistry and cause distress as a result.
I think if you’re willing to agree that meds can cause brain chemical changes that can lead to mental distress, then you are logically forced to at least consider the possibility that in some cases brain chemical changes can do the same without the triggering psychoactive drug.
I have never claimed that the answer to emotional distress is better living through chemistry. It’s still important to recognize, though, that it is in fact neurochemistry that leads to individual thoughts, feelings and experiences, regardless of the origin of any particular neurochemical state.
I guess I’m not antipsychiatry because I do see a place for psychiatry, albeit with massive improvements over current practice.