Sunday, July 25, 2021

Comments by cabrogal

Showing 100 of 142 comments. Show all.

  • If you’re talking enthusiasm for killing rather than just drugging and imprisoning I’d say the Republicans have the edge when it comes to judicial executions and citizens shooting each other, it’s pretty much neck and neck with regard to police killings and the Dems pull ahead again in the bombing foreigners department.

    But the distinction is pretty moot to us non-Americans. From here you all look like cold eyed killers, regardless of ethnicity, religion or political leanings.

  • Gotta agree with you there.

    The Clinton administration oversaw the biggest increase in US imprisonment rates in my lifetime. As Californian AG Kamala Harris implemented ‘three strikes’ laws that sent the imprisonment rates there through the roof then blocked several Supreme Court initiatives that would have reduced it. And even if Joe Biden starts honouring his election promise to reduce US imprisonment he’s unlikely to fully reverse the damage his own mass incarceration initiatives of the 80s and 90s caused.

    Locking people up for a long time for minor offences has a long history of bipartisan support in the US. Especially if they’re not white.

  • Not only that, if you diagnose someone before locking them away you can restrain them chemically as well as physically and suspend more of their legal & civil rights. You don’t even have to give them a release date to look forward to.

    Why just imprison someone’s body when you can also imprison their spirit and mind?

    I’m sure glad I don’t live in the Land of the Free (and they say you Yanks don’t do irony).

  • To see this done on a client provoked empathy in me, since the client seemed a bit tortured by the therapist’s insistence that they needed to get to zero.”

    I think you’ll find making things difficult for the client has been key to EMDR’s “success”.

    As proponents of weight loss, D&A rehab and criminal anti-recidivism programs discovered long ago, by making the treatment particularly onerous you filter out those with less resilience and determination (i.e. the ones most likely to fail). Then you eliminate the drop-outs from your final results and, viola, a high success rate.

    That’s the main thing that distinguishes studies showing high efficacy for EMDR from the ones that show about the same success rates as with regular exposure and desensitisation therapies. The latter include the drop-outs in the reported figures. The former don’t.

    Clinical anecdotes presented as evidence employ a similar filter. You’re seeing ‘profound healing’ from trauma because they’re the clients that come back. The ones who see little benefit or find it too difficult to continue simply stop showing up with their money.

    There’s the added effect that the more someone can be persuaded to invest into a product – personally or financially – the more likely they are to be enthusiastic about it. Most people don’t like to admit to themselves or others that they’ve wasted time, money or effort on something important to them.

  • “Not sure what you’re saying here. What is there “more” than the fact that the therapist is listening non-judgmentally and interestedly?”

    The fact that it has about the same reported efficacy with or without a therapist.

    I think you’ve missed the distinction I’m making between exposure and desensitisation therapies – which have been around since before Freud was in short pants – and EMDR, which Francine Shapiro patented in the 1980s. EMDR incorporates the former and properly designed and reported studies into it suggest it has about the same success rate (i.e. 50-60%. Nothing like the better than 90% rates claimed by EMDR proponents.) So the ‘EM’ and ‘BLS’ aspects of EMDR seem to be pure window dressing without even an enhanced placebo effect to recommend them.

    If you’re scared of spiders and you try to deal with it by starting off in the same room with a small spider and progressively exposing yourself to closer contact with bigger and hairier arachnids you’re practicing exposure and desensistisation therapy, with no therapist and no BLS. If you pay for sessions with a therapist to do the same thing you can have a similar expectation of success – even if they add an attentive, sympathetic ear to the mix.

    So whatever makes exposure and desensitisation therapy work for some people doesn’t seem to be dependent on having someone listening to them.

    And yeah, I’ve had personal experience of success with exposure and desensitisation following traumatising events in a car wreck (paralysing flashbacks when I smelled petrol) and with a pack of sharks (fear of entering deep water), all without the assistance of a therapist. But hey, that’s just anecdote. It’s no more evidence than is David Busch’s experiences of EMDR with his clients.

  • I think there’s probably more to trauma exposure and desensitisation than telling your story to someone you have rapport with Steve. It seems to work at least as well when self-administered as it does with a therapist. It was also a staple of folk-wisdom for getting over trauma and phobia long before professionals started jargonising it with words like ‘trauma’ and ‘phobia’.

  • “A lot of folks really twist themselves into pretzels trying to come up with a “biological” explanation.”

    e.g. “Sleep’s primary evolutionary function is to clean out the brain quite literally of accumulating debris. It is like a dishwasher that keeps flushing through to wash the dirt away. Without that nightly wash cycle, dangerous toxins can damage healthy cells and interfere with their ability to coherently compose our thoughts and regulate our emotions.”

    Might be worth noting that not all sleep is dream-state, not all dream-state is REM and not all REM is bilateral.

    And to indulge in a little neurobabble of my own, the visual cortex is in the occipital lobe, almost the opposite end of the brain to the auditory cortex which is in the superior temporal gyrus. So to theorise that BLSsing either will have similar effects on the connections between the amygdala and the prefrontal cortex is a pretty big stretch. But hey, it also offers bio-materialist evidence as to why listening to early Pink Floyd through headphones makes me feel good. I knew I wasn’t just imagining it.

    As the author points out, “[EMDR] has developed into a multi-million-dollar enterprise, and there are many thousands of EMDR therapists worldwide. So, what’s to be unhappy about?”. Especially if you’re getting a slice of the cake.

    I just don’t understand why we’re not hearing neurological explanations as to how reality TV like Queer Eye improves mental health. After all, it generates millions of dollars as well. Surely they can afford a shiny biopsychiatric paint-job too.

  • I can see you’ve been thinking a lot about the practical and moral dilemmas that come with offering therapy, not just those posed by EMDR. I think some of the ones you raise are best addressed by approaches that connect the person seeking help to the support offered by their own community and loved ones, rather than ones that seeks to make the problem a technical, neurobabbled one for trained professionals. Whether they’re always applicable and appropriate or get the best results is another big set of questions though.

  • Yeah, I’ve gotta admit I’m not really too concerned about whether EMDR’s any better than regular exposure and desensitisation therapy. And if the mumbo-jumbo enhances rapport or the placebo effect then it’s probably gonna help people. It was the dodgy study design & reporting and cultish enthusiasm of some of its proponents 20 years ago that put me off.

    If you think there’s important differences between EMDR without BLS and regular E&D therapies – other than marketing – I’d appreciate anything you’d care to offer.

  • I’m with you and your wife on this Sam.

    My earliest experiences of dissociation were interesting in the short term but became increasingly intolerable as they dragged on, often to the point where I’d self-harm to try to break out of them. But a couple of decades down the track I’d learned to accept them and even see them as a kind of refuge from more difficult mental states. In the lowest period of my life from 2003 to 2012 they acted as a kind of circuit-breaker that offered me the only waking relief I had from suicidality.

    I had a big turnaround in 2012 and have learned to accept all my mental states – though unlike you I don’t owe it to hard work. It was more like an unearned epiphany. If I was Christian I’d probably call it grace. Since then I’ve had no suicidality and no dissociation. I think coming to accept dissociation was a key part of the learning experience that led to that.

  • My knowledge of EMDR is a couple of decades out of date now. It stems from the research I did during an unethical and abusive trial of EMDR upon inmates of Sydney’s Mulawa Women’s Prison (scroll down about a dozen paras to see the EMDR bit).

    What I found from the literature available at the time was that PTSD trials carried out by Shapiro and her colleagues consistently made hyperbolic claims of success rates in excess of 90% while those carried out by independent researchers found no significant difference between EMDR and regular trauma exposure and desensitisation therapies (i.e. the BLS is BS). Sure enough, when the head of the Mulawa trial (one of Shapiro’s acolytes) reported his results a year or so later he too made claims that over 90% of those treated showed reductions in trauma symptoms and made no mention of the numerous adverse responses that had alerted the NGO I work with to the trial in the first place (via complaints by the trial subjects and their families).

    My conclusion at the time was that EMDR was mostly a mumbo-jumbo driven cult. It’s my understanding that its popularity among therapists has grown in leaps and bounds since then and it’s now being used in a wide range of non-trauma related applications (e.g. relationship counseling).

    Although there’s nothing in the article above that would cause me to revisit my opinion I’m always willing to adopt new conclusions in response to new data. So if any of the EMDR proponents posting here can point me to, say, some independent randomised studies carried out by researchers without skin in the game (i.e. who don’t make a living from EMDR) that have more than a dozen or so subjects and either have low dropout rates or incorporate the dropouts into their statistical analysis that demonstrate EMDR is any more effective than other exposure and desensitisation therapies for trauma or that it’s effective at all for non-trauma based treatments I’d be much obliged. Surely after more than three decades there would have to be some good quality evidence for it. If it works.

    (BTW, as is the case with a lot of D&A treatments I found the EMDR trials carried out by proponents routinely ignored the relatively large number of dropouts rather than classifying them as failures. I never got access to the raw data from the Mulawa trial, but given the number of inmates who refused to continue in the face of distressing flashbacks I can’t see how they could have reported such a high ‘success’ rate without discarding the failures.)

  • I agree with all the points l_e_cox makes.

    I’d add that the most meaningful, fulfilling and useful work done to support those facing emotional, behavioural and psychological difficulties is very rarely well paid. You’re probably going to have to find a balance between monetary and less tangible rewards and think hard about how much you’re prepared to compromise one for the other.

    If you’re doing this right – with empathy, compassion and rapport with those you’re trying to help – it’s likely to result in considerable acute and chronic stress upon you. This field has the tendency to either burn-out or dehumanise those working in it. When committing to a career – or just short term voluntary work – be sure to check out what support is offered to workers, especially in terms of time off, relief and transfer of casework, leave entitlements and peer counseling. Also look into how much overtime and on-call work is expected – both official and unpaid. Martyrdom can have romantic appeal but it rarely helps anyone.

  • I’ve had many friends, colleagues and relatives who’ve gone into the system to reform it from within. The ‘system’ has variously been politics, academia, journalism, the police, the military, school teaching, various medical fields including psychology and prison health, among others.

    Those like yourself who were abused and bullied by the system were the lucky ones. Mostly they were driven out, scarred and traumatised but capable of carrying on in other fields, sometimes criticising the system from the outside. A very few butted their heads against the wall over careers spanning decades, eventually retiring with the conviction their professional lives were largely wasted. Far more were worn down by the system sooner or later, becoming well fitted cogs in its smoothly whirring machinery of abuse.

    The system is the people trying to reform it from within. Even E Fuller Torrey was a dissident once.

  • Psychiatry can sharpen this framework by defining and measuring the construct of despair, sorting out causal chains surrounding it, and infusing deaths of despair’s limited causal view with biological perspectives. In turn, psychiatry would benefit from increasing its focus on societal trends to identify risk groups and macro-level causes that could be targeted for intervention

    Ah yes, what we need to address despair is for psychiatry to ‘sharpen’ our understanding of its causes with biological perspectives that dispense with all those messy, blunt notions that it could be caused by factors other than defects in the sufferer. But we should still look at societal correlates of despair to better target people with non-societal interventions grounded in psychiatry’s biological perspectives (i.e. drug the despair out of them).

    Nothing beats psychiatry when it comes to despair, eh?

  • and why trying to “reform” the profession is destined to complete and utter failure.

    Yeah. There are decent psychiatrists out there trying to put the profession onto a humane and scientific basis but there’s too much cultural baggage to overcome in my opinion. The guilds crucify criticalists and reformists and there’s too many external vested interests who like the illegitimate authority of psychiatry just the way it is (drug companies, courts, authoritarian governments, oppressive families, etc).

    Reformers think that if psychiatry can legitimise its own authority with treatments and professional ethics that actually help people it won’t have to maintain symbiosis with external authorities who need a pliant pseudo-scientific priesthood to leverage their own power. But I can’t see how to overcome the inertia of all those dysfunctional interlocking institutions.

    Better to start from scratch with a new caring profession that salvages what it can from benevolent psychiatric initiatives like Soteria and Open Dialogue without climbing into bed with those who prefer a white-coated political police force. Then, hopefully, psychiatry will lose its mystique to the real carers, become useless to its totalitarian sponsors and just wither on the vine.

    Problem is it’s been tried before. We call it psychology. And the US version of that has a long and sordid history of torture and brainwashing for the military and CIA. Is it wishful thinking to believe we might learn from those mistakes and try again?

  • It was more a case of the Nazis being foursquare behind the psychiatrists.

    When Dr Alfred Hoche laid down the utilitarian principles of ‘life unworthy of life’ in 1920 the newly named NDSAP (Nazi Party) had less than 200 members and was almost unknown outside Munich.

    When Germany invaded Poland the shrinks took it upon themselves to start exterminating the institutionalised ‘mentally deficient’ to free up hospital space for wounded soldiers. Hitler only found out later and signed backdated orders authorising it.

    When Hitler was forced to close down the official program exterminating the ‘mentally ill’, psychiatrists took it underground and increased the rate of killings.

    When the ‘Final Solution’ was implemented the Nazis turned to psychiatrists to bring their expertise in mass extermination to the death camps, with Dr Irmfried Eberl designing Treblinka and becoming its first commandant. He was soon dismissed for the casual way he left piles of rotting corpses around the railway lines, making it impossible for ‘good Germans’ to pretend they didn’t know what was going on there.

    And after the Germans surrendered and the camps were liberated psychiatrists continued to kill hospital and asylum inmates for weeks until occupying authorities found out what was going on and put a stop to it.

    So when it came to genocide the shrinks were both ahead of the Nazis and still kept going after the Nazis had been stopped.

  • We have flu shots to protect us against the underlying problem; influenza virus. Flu-like symptoms aren’t caused by the virus, they’re caused by the body’s response to it. And because those symptoms are triggered in response to lots of things – viruses, bacteria, some toxins – looking only at the symptoms and saying you’ve got ‘Flu like symptom syndrome’ then applying the same treatments to all the cases would be medically irresponsible. It would be like psychiatry.

    That said, sometimes the symptoms themselves can be dangerous. Normally a fever would help fight off the pathogens but if it gets too high it can kill, so sometimes it is appropriate to treat the symptoms.

  • Given how well the symptom constellations psychiatry identifies as mental illness correlate with historic trauma I’ve long wondered if they’re sort of flu-like symptoms of the mind; i.e. not specific to any ‘disease’ but signs of the mind trying to protect and heal itself.

    According to a 2015 study led by Andrew Holmes traumatic memories are reprocessed and integrated via the coordinated actions of the amygdala and prefrontal cortex; so a good connection between them is needed to enable the resolution of trauma. That connection is the dopamine D2 pathway through the ventral tegmental area. So if you have a lot of particularly traumatic memories to process you might expect that link to become quite active.

    The neurobabble that justifies neuroleptics as treatment for psychotic illness would have it that psychosis is caused by over-activity in precisely that pathway, so the drugs try to block it.

    Now, if rather than being an illness psychosis is a side effect of the mind’s attempts to self heal – in the same way flu like symptoms are signs of the body’s attempts to heal – then we’d expect blocking that response to prolong the ‘psychotic illness’ by preventing resolution of the underlying trauma. And whaddya know? Giving psychosis patients long term neuroleptic therapy increases the duration of the ‘disease’ the drugs purport to treat.

    On the face of it, it’s hard to see how depression, schizophrenia, etc, would increase an individual’s evolutionary fitness. Yet the conditions remain common in the human race; they haven’t been eliminated by selection pressure. Likewise it’s hard to see how flu-like symptoms help anyone survive and produce offspring, but we know that by and large they’re signs of the immune system doing just that.

    So if ‘mental illness’ symptom clusters are manifestations of the mind’s ‘immune’ responses and self-healing functions, suppressing them may entrench the underlying problems that give rise to them. Which is what we see when we look at long term psychiatric drug use.

  • Let’s say we’re talking a historic sex offence (as ‘recovered memory’ cases generally are) in which the accused initially made a statement that he couldn’t remember where he was on the night or gave an alibi which failed to establish his innocence. He may very well want to present a different alibi defence that would strengthen his case, but simply coming up with a new alibi after the old one has fallen through would typically be frowned upon by a court. However if the prosecution is relying on therapy-recovered memories that have been accepted as probative he would be in a good position to argue that his own therapy-recovered memories should be given equal weight, no?

    Would you give them weight equal to those of the alleged victim, or would you privilege a victim’s therapy-recovered memory evidence over that of the defendant?
    Would you go so far as to say that the victim’s t-r memories should be allowed as evidence while the defendant’s should be rejected?

  • Whether you choose to believe anyone’s uncorroborated claims of what they remember, repressed or not, is up to you.

    But I think going back to the days in which uncorroborated memories ‘recovered’ during a therapy session was accepted as probative in criminal trials would be a very bad idea.
    Would you accept it as alibi evidence in defence of an accused sex offender? (“Thanks to my therapist I now recall I was in a different city that night.”)

  • Gotta agree with most of that KS.

    The first sentence notes the well established correlation between parental support and a reduction in youth ‘delinquency’ and the final conclusion would seem to be that kid’s perception of parental support correlates with reduced delinquency. The only ‘new’ finding would seem to be that if you support your kids they’ll probably come to believe you support them.

    Walters’ contribution is to insert his wonky definition of empathy into the equation as a mediating factor because he thinks it belongs there, then to conclude it might belong there. The notion that empathy is the capacity to experience the feelings of others rather than to emotionally respond to imagining them would imply some kind of PSI power. Does this guy believe in the New Age concept of ’empaths’ or something?

    He admits his scope for measuring what he calls empathy is limited then, so far as I can tell, establishes correlation between those dubious measures, parental support and decreased delinquency. How he then concludes empathy is therefore the mediating factor between the other two variables escapes me. Chronological sequence?

  • Are you sure it’s in the court documents?

    Without the need to use that sort of evidence I don’t see why it would have been introduced. It wouldn’t have aided the prosecution (due to the confession) and its controversial nature could have offered grounds for appeal against the sentence on the grounds of prejudicial untested evidence unless she was cross-examined about it. Dropping that aspect of the case seemed a wise tactic to me.

    I assumed it was dropped after the early media reports in order to keep the focus away from her and on him.

  • It seems though our experiences in these matters are quite different our conclusions are remarkably similar Steve. I don’t know whether to be reassured or disturbed by that.

    If you’ve worked with victims and perpetrators of trauma and seen how therapists deal with them this stuff seems like a no-brainer to me. Yet the huge amount of collective experience our societies have accumulated doesn’t seem to be doing much to change how we respond to the problems.

    Part of it’s gotta be institutional. Our legal systems, media outlets, commercial entities and professional guilds may be made of human beings but they ain’t human and have very different survival imperatives. So to expect them to develop in a way that optimises their responses to human needs would be naive.

    But can that really be the whole explanation?
    Or is there something about the way we think that’s stopping us from using what we learn to change how we behave?
    Or am I just too burned out to see positive developments even when they’re staring me in the face?

  • 1000 psychiatrists that want to shock “it” into becoming an actual repression and resulting disability that one then REALLY needs therapy for.

    I agree. There’s been strong evidence for about 30 years now that critical incident trauma debriefing increases the likelihood of the sort of long term harm that will get you a PTSD diagnosis. Yet the practice continues to grow in leaps and bounds. I can’t help thinking it might be to do with the fact that the same people who do the debriefing generally have a financial stake in treating the PTSD. That plus the sentiment “these people are suffering so we can’t stand by and do nothing”, so we’ll do something that doesn’t help and may make things worse.

    I think there are openings for post therapy therapists.

    Yeah, but I shudder to think what form that might take if such a thing became a professional discipline.

  • And while I’m on the topic of fads in psychology it might be worth recalling that not all the scandals of the childcare centre abuse moral panic arose from ‘recovered’ false memories.

    In at least one instance the problem was a couple of therapists who were very enthusiastic about a method of diagnosing child sex abuse that involved rubbing or inserting something into the child’s anus and measuring its dilation. Not only did they get many positive responses to their tests, those children also showed other signs consistent with having been sexually abused. I can’t imagine why.

    Therapist? The rapist? Hmm.

  • The latter is NOT caused by the concept of repression, it is caused by unethical therapists who are either greedy or unable to deal with their own issues and act them out on their clients.

    I think that’s a little harsh Steve.

    I’d definitely allow the possibility that many such therapists sincerely believe in the integrity of their methods and that they are helping their patients. Unfortunately psychiatric and psychological training doesn’t encourage critical thinking and groupthink is rife in the industry, especially during therapeutic fads.

    I think not knowing how easily memories can be manipulated is likely a bigger problem among therapists than knowing about it. I also think the need of some patients to receive validation of identifiable, external reasons for their distress plays a part.

  • I’ve gotta say abuse memories recovered during EMDR therapy would raise a huge red flag to me.

    I don’t pretend to be up to date on EMDR research these days, but when I was, about two decades ago, the only studies that found any superiority to standard desensitisation therapy were the ones carried out by Francine Shapiro and her colleagues. Independent researchers found about the same efficacy as systemic exposure and desensitisation therapy, which EMDR largely incorporates.

    OTOH, the ‘EM’ of EMDR is remarkably similar to the techniques used by stage hypnotists, no? So even if the therapist is scrupulous about avoiding suggestion – no mean feat in the context of exposure – she may well be putting the patients into a hypersuggestive state in which even the most innocuous things could mess with their self-narrative.

    Why was I studying EMDR 20 years ago?

    Because the NGO I work with received a sudden stream of complaints from Mulawa women’s prison where an EMDR trial was underway (women prisoners are a captive population with very high levels of historic trauma and abuse). Consent for the trial was a long way short of informed and women were encouraged to dredge up memories of abuse during the day then locked back in their cells at night where they sometimes acted out their newly refreshed memories and received the usual prison system response to problematic behaviour. One woman complained she was encouraged to ‘recall’ abuse by her ex-partner she insisted had never happened and deny the abuse by police officers she insisted had happened (she’d presented at her committal hearing covered in bruises).

    A year or so later I attended a conference at which the trial director presented his findings. No mention whatsoever was made of the adverse outcomes suffered by subjects nor of the dubious practices of those running the trial. It was known I was with the organisation that had lodged complaints on behalf of the trial subjects and I was studiously ignored during the Q&A that followed.

    I’m not suggesting anyone posting here is as unethical as those who carried out that EMDR trial, but you’re gonna have a hard time convincing me EMDR is a reliable way of recovering repressed memories. And it’s not just because ‘reprogramming’ is such a sinister term to use in the context.

    Again, I’m not up to date on how EMDR is currently promoted and practiced, but 20 years ago I saw something akin to a therapeutic fad in the process of becoming a cult.

  • Yeah, from what I’m reading the case is as close as you get to a ‘good news story’ about a sexual assault investigation and trial.

    The young lady wasn’t disbelieved even before copies of the films were found. With the video evidence the investigators and prosecutors had plenty to run with without subjecting her to bruising interrogation and cross examination. The offender discovered that neither his status as a former cop nor seeking refuge in an overseas jurisdiction could protect him. Faced with the evidence he made a comprehensive confession that spared a jury from having to listen to disturbing details day after day. And he got a sentence only a torture or death penalty enthusiast could decry as inadequate. His daughter need never fear he will be released to seek reprisals nor that she’ll be expected to make submissions to a parole board while the case is dragged through the media spotlight again.

    It’s not often I see a sex offence case that fails to revictimise the survivor.

  • The big question is whether memories can exist of which a person is not consciously aware, but which can come to awareness at a later time. If you call this “spontaneous recollection,” that’s your right, I suppose, but I fail to see any distinction between a memory a person files away to the “unconscious” file that can later be retrieved and the basic assumptions behind “repression.”

    Just last week I was sent a class photo taken when I was five years old and was very surprised at being able to remember the names of nearly all my 1A classmates from an image over half a century old. So I have no problems with spontaneous (or triggered) recollection of apparently lost memories.

    Repression is trickier, though I have no reason to doubt its existence.

    On the one hand it seems likely to involve unconscious prevention of a partially recalled memory reaching conscious awareness as a protection against retraumatisation, so we might expect it to be preserved for long periods by frequent re-accessing. On the other that process might promote contamination of the memory itself.

    So, for example, viewing pornography might cause incomplete, unconsious recall of memories of sexual abuse but also ‘contaminate’ those memories with elements from the pornography.

    All of this is purely speculative and should in no way be used to try to invalidate the traumatic accounts of those seeking help, sympathy or understanding. But in a courtroom where serious legal penalties are at stake I think strict rules of evidence need to be applied to testimony based on such memories and without corroboration they should be viewed with caution.

    Whatever we might think of repression and later retrieval of traumatic memories I think we should acknowledge there is little known about their mechanisms of action and little we can say about their reliability or otherwise. I wonder if examining the fidelity of post trauma ‘flashbacks’ would offer any insights.

  • Hey Steve,

    I’ve just noticed a stack of old comments ‘removed for moderation’ (none of mine as far as I can tell, though I reckon I’ve tacked close to the wind more than once).

    Does this reflect a change in MIA comment policy?
    (I’ve read the guidelines and haven’t seen a recent update.)

    If so I’d appreciate a heads up on what those changes are. I tend to get moderated out of a lot of forums and I’d like to have a clear idea of the boundaries in this one, otherwise I’ll probably just follow the lead of other commenters.

  • Six years ago I was a beneficiary of an AbbVie ‘compassionate treatment program’ that got me access to the over A$100,000 worth of pills needed to cure my hep C. The drugs were yet to be listed on Australia’s Pharmaceutical Benefit Scheme (PBS) and there was no way I could afford them. My liver was in the process of turning to wood and it’s unlikely I would have survived until they were listed.

    So do you think I’m grateful to AbbVie?
    No fucking way!.

    The so called ‘compassionate’ program was really a marketing exercise akin to a seeding trial, designed to turn doctors, nurses and patients into partisans for the drug. Several drug companies had hit the market with 2nd generation treatments for hep C at the same time and based on precedent it seemed unlikely more than one of them would receive PBS listing. The idea was that medicos who’d gained experience on the ‘compassionate’ programs would lobby the government to ensure AbbVie’s was the treatment that won. Their pills would then monopolise the Australian market with the taxpayer footing the ridiculous bill.

    In the end the PBS listed all the new treatments, but with the proviso that after a certain number of full price prescriptions the Australian government would receive a substantial discount on subsequent ones (around an 80% reduction I’m told).

    The lesson for US readers is that government funded health programs are in a much better position to negotiate deals with extortionate drug manufacturers than consumers or private health funds.

    The lesson for everyone is that we should stop fining drug companies a fraction of the profits they make from illegal and unethical marketing practices and nationalise the lot of them. Or better yet, internationalise them.

  • Gotta agree with you there. I think most psychiatric ‘patients’ captured by psychiatry are trying to live according to standards set by others and think they can obliterate their ‘bad’ bits with the drugs.

    But yeah, your main point is the only person we need to be is ourselves. Ain’t no-one else gonna do it.

  • Don’t take what I said to heart rebel. Mostly I was responding to KS’s admonition that anyone who is true to themselves – even to the point of being labeled ‘bad’ by those with different moral standards – should suffer penalties justified by the old ‘protecting others’ rubric used by all authoritarians.

    I’ve never been a Christian but I have nothing but respect for those who want to live their lives in Christ, so long as that doesn’t mean punishing or persecuting others who don’t live the same kind of life. As a Christian you’d be familiar with those who are criminalised, persecuted, even executed for living according to their beliefs regardless of what society thinks about them.

  • Those of you who say “This is just how I am because of my ‘madness’” show no ability or willingness to be accountable for the effects of your actions on others.

    I don’t say that at all. My madness is just as much a part of me as my gender, my bass playing skills or my love of surfing. It’s not an excuse or ‘contributing factor’ for what I do, it’s part of what I am.

    I’m sorry if the nuance is lost on you.

    I’m also bemused as to why acknowledging the roles an allegedly abusive partner or a loved one ‘making my life stressful’ play in your acting out would need to be offered to others as an explanation/excuse. My attitudes and responses to those things might make my life stressful, not their actions. I have no need to pass the buck to them. If they had drugged me or otherwise compromised my agency it might be a different matter.

  • BTW, if I do something I regret that harms or upsets others I might very well say “Sorry. I’ll try not to do anything like that again”. Being me doesn’t mean I can’t or don’t change.

    What I won’t do is blame my brain chemicals, lack of sleep, my frequent bouts of inflammatory pain (HLA-B27), my intimate partner or other loved ones.

    And if I don’t regret it I won’t apologise at all.

  • I’ve certainly encountered adults who’ve dismissed their own non-consensual sexual encounters as non-harmful, including women who’ve gone on to have a consensual sexual/romantic relationship with their rapist and others who’ve dismissed their unwanted childhood sexual contacts as harmless. I wouldn’t presume to disagree with them but I sure wouldn’t presume to dismiss such encounters in that way if the subject of them didn’t.

    I’ve also worked with (adult) rape/sexual assault victims who’ve been deeply traumatised, even when no physical force or violence was involved, particularly in regards to trust and feelings of security. I find it hard to believe some children wouldn’t feel similar, even if they’re unable to articulate it.

    I guess a lot of it depends on what you think of yourself and how you think you got there. If you’re proud of who you are and consider such an experience to be formative you probably won’t see it as harmful, even if others think you’ve been badly damaged by it. I suspect that’s a rationale some child sex offenders who were themselves victims of childhood sex abuse use to justify their own actions.

    BTW, if your summaries are accurate I find a lot of those viewpoints pretty hard to credit, but I think Gold makes an important point. Gardner’s reminds me of Father Benedict Groeschel’s condemnation of all the predatory children who took advantage of vulnerable clerics.

  • Campbell’s quote seems rather similar to me.

    I don’t see it that way. IMHO the experience of madness is a boundary smasher, including the boundary between sacred and profane. It’s not inherently divine or not divine, but if you don’t fight it and let go of your fears it opens the potential of apprehension of the divine.

    The qualities of the extreme states that happen when I’m in a safe place such as my own room and those that overcome me when I’m in public space some distance from home (thankfully rare) seem largely the same, but in the latter case the need to ‘pass’ (i.e. not prompt a police response) and find my way home means I have to fight it and that can result in a nightmarish experience with nothing divine about it.

    We should never generalize too easily from one person’s bliss or one person’s pit.

    Absolutely. I’ve been dealing with extreme states since childhood – often deliberately induced – and they’re pretty familiar turf to me. The voices I hear have never seemed malevolent to me either, though their comments can be cutting (I appreciate their honesty). My family culture prepared me somewhat for it (similar to Jung I have scientists and clerics on my English father’s side and mystics and artists on my Aboriginal mother’s, some of whom died in asylums). Almost five years in India probably helped too.

    But I think my own approach to extreme states has helped others struggling with their own, both when I’ve tried to assist people suffering a ‘psychotic break’ and when I’ve acted as a psychedelic guide, so I do think it’s reasonable for me to generalise a bit from my own experiences.

    I’m sure you’ve noticed the Goddess Kali is mentioned once or twice (briefly) in The Red Book. Bloodthirsty.

    I suspect Jung’s knowledge of Kali comes second-hand from the British colonisers and their mythologising of the Thuggee.

    There’s folk stories of Kali that seem bloodthirsty and Her iconography certainly supports that view. Also there’s no denying She’s the Goddess of Creation, Destruction, Time, Death and Madness. But the violence and thirst for blood is symbolic (as are the folk stories and iconography). Kali worshippers such as Vivekananda and Ramakrishna (and myself?) tend to be gentle people, albeit prone to ungentle states of mind.

    I consider myself agnostic (or rather, an epistemological and ontological anti-realist) but I can’t deny my direct experiences of Kali, in which She lacks form yet is infinitely beautiful and immanent in all things. Despite having spent years in India I didn’t initially identify Her as Kali, mostly because I’d never looked far beyond the iconography and folk stories. It was both Vivekananda’s poem, which I only read after encountering Her, and my reading of the Mahakali of Kashmir Shaivism that led me to recognise Her as Kali.

  • As you might imagine, KS, I’ve been running up against the sort of mindset that believes those who think and behave different to them need to be ‘fixed’ for my whole life.

    Some wear white, use words like ‘schizoaffective disorder’ and ‘bipolar’ and think the answer is pills and locked wards. Some wear blue, use words like ‘offender’ and ‘criminal’ and think the solution is handcuffs and prisons. Some wear Doc Martens and crewcuts, use words like ‘c**t’ and ‘f***ing nutjob’ and think the answer is fists and boots. Some are faceless, use words like ‘jerk’ and ‘sociopath’ and think the answer is rights restrictions.

    Same old crap. Different wrappers.

    As for me, I just want to be me and live my life as me.

    Careful rebel. An attitude like that can get you labeled ‘jerk’ or ‘sociopath’. I’m told we’ve gotta take measures to protect others from people like that.

  • Keep in mind, Jung distinguished between ‘divine madness’ and ‘madness’ in his Red Book.

    Yes, but I don’t. I agree more with Joseph Campbell on that.

    It’s not about individuation to me. It’s a matter of letting go of your self. It’s not the madness that hurts. That’s a storm of bliss. It’s trying to hold onto what you think you are in the midst of it that brings pain and terror. Differentiation might be necessary for a social animal to survive, but death comes, meaning evaporates, chaos reasserts, subject/object dissolves. Oneness abides. When you sacrifice yourself to the storm you are the storm.

    It probably helps to have a Goddess who is Madness and Death ;).

    So if you paid $120 you must have got the covered hardback with illustrations. I’m told it’s awesome. I’ve just got a text-only e-book.

  • From the article:
    “I know it’s super controversial sometimes. But I’ve been medicated for a long time, and I can’t function without taking it,” McLaughlin said. “If I don’t take my medication, I see an immediate difference in my ability to manage complex tasks, clean the house, get up and cook dinner. So I’m hoping it will have the same effect on her.”

    Yes, you can use amphetamines to help you get up, clean the house, maintain focus, study, do long-haul truck driving, etc. For a while. Then you become acclimatised/addicted and need it to do those tasks. If you stop taking it your capacities fall apart. That doesn’t mean you have ADHD though. It means you’re an addict. Please don’t send your daughter down the same road.

    She’ll probably come good by herself when she and her remote learning program better adapt to each other or when face-to-face teaching recommences. In the meantime offer her compassion and support, not diagnoses and drugs.

  • I thank you too Sami. We hear a lot about the problems with psychiatry-as-she-is-spoke but rarely do we hear such incisive analysis of how those problems are rooted in our political and economic systems.

    I think your portmanteau could be improved with an extra character though.

  • “Be silent and listen: have you recognized your madness and do you admit it? Have you noticed that all your foundations are completely mired in madness? Do you not want to recognize your madness and welcome it in a friendly manner? You wanted to accept everything. So accept madness too. Let the light of your madness shine, and it will suddenly dawn on you. Madness is not to be despised and not to be feared, but instead you should give it life.”
    – Carl Jung, The Red Book

    “An individual has the right to express himself or herself even if he or she behaves irrationally; to demonstrate his or her insanity.”
    – Muammer Gaddafi, The Green Book

  • rarely (I won’t say never) does anyone consider themselves “mad” before a shrink has labeled them “mentally ill.”

    That’s only because the shrinks get in early these days.

    I started school in the 60s and I sure considered myself mad decades before I saw my first shrink. And it was my permanent social identity from a young age. My teachers, classmates and family saw to that.

    There’s a body of opinion on this site that the labels get you ‘othered’. That’s not my experience and I doubt it was the experience of my out-group school friends who were othered because of their weight or looks or speech impediment or learning difficulties.

    You don’t get othered because you’ve been labeled. You get labeled because you’ve been othered.

  • “Mad Pride” sounds about as mature as saying “I can’t help it, I’m bipolar”.

    I think most people use it in the same way I do. “Mad Pride” means that you accept the aspects of yourself that society condemns as ‘madness’ and stand in solidarity with those who are marginalised for their ‘madness’. It’s certainly not another way to say “I can’t help it”.

    The list of reasons you offer for acting out seems more like “I can’t help it” to me.

    Speaking personally, my cyclic mood swings, extreme states, acting out, etc are no more ‘because’ of external social circumstances than they are ‘because’ of internal brain chemistry. Nor are my flashes of inspiration, sustained bursts of energy and capacity to stand up to illegitimate authority. They’re because I’m me.

    I don’t have madness. I don’t suffer from madness. I am mad. And I’m not interested in curing myself of me.

  • I use chemical in the broadest definition and not just pharmacology. Nutrient supplements, and especially food, are clear examples.

    That sounds a little like the apologia offered by supporters of the oil, pesticide, pharmaceutical, etc industries use when they say “Chemicals in your food and air? Everything you eat and breathe is chemicals! And so are you! Hah!”.

    We know what ‘chemicals’ means in common parlance; as do corporations that call themselves ‘chemical companies’ and retailers who call themselves ‘chemists’.

  • Well, I can’t help thinking that if I was enslaved and was told that I’d be set free just as soon as alternate work and accommodation was arranged for me that I might say “Fuck that. Just let me go and I’ll try to find my own solutions as a free man.”

    As far as energy sources go, we need energy of some kind so it wouldn’t make sense to just shut off the CO2 belchers and freeze while we wait for replacements. Do we need slavery? Do we need psychiatry?

    As for things like prisons, it’s the current PIC – especially in its for-profit form – that’s holding back the alternatives that are already in place on a small scale, just as the fossil fuel companies try to hold back sustainable alternatives. Many alternatives to prison have already proved more effective at meeting the stated goals of prisons than prisons themselves.

    There’s anarchists who’d agree with your last paragraph. A group of platformist internationalists once tried to recruit me. I’m not buying. I can’t see how you can call it anarchy if everyone has to think the same.

    Anarchism has thrown up several ideas for keeping hierarchies flat to non-existent within a large scale industrial society. Probably the best known one is anarcho-syndicalism, which seemed to worked well in both agrarian and urban industrial settings during the Spanish revolution. However it didn’t work so well in alliance with the non-anarchist groups of the Spanish Republic so a more hierarchical system of appointing delegates to represent anarchists within the Republican government was tried, with unfortunate results.

    A similar thing was tried by some Sydney anarchist groups in order to gain representation within the NSW Greens party. As in 1930s Spain the delegates were eventually captured by parliamentary party politics and ceased representing those who’d put them there.

    A (formerly?) anarchist friend of mine who is now a Greens member of parliament even entered into a strategic alliance with what was then a particularly authoritarian pro-psychiatry group in the name of political pragmatism, though to be fair the group is now focused on maintaining the green space around a former asylum rather than reviving the asylum and flogging forced psychiatry, so perhaps the alliance had merit.

  • In 2001 I attended a conference at which a couple of research psychiatrists presented one of the early studies showing that antidepressants caused suicidality in children.

    During the meal break that followed I spoke to several psychiatrists about it and eavesdropped on others. Though only a couple were at all skeptical of the study all the ones I heard insisted they would continue to prescribe to children as before, justifying it with the belief that though there were risks they believed themselves capable of judging whether a patient was at risk of suicidality despite the evidence they’d just heard that most prescribers were not. I guess it was the same sort of thing that makes around 90% of car drivers believe they’re better than average drivers.

    One shrink I knew well from other conferences and who I respected for his intelligence and modesty told me he too would continue to prescribe as usual, despite not believing himself able to reliably judge whether the patient would become suicidal on the pills. His reason?

    “These kids and their families are desperate for help. We can’t just stand by and do nothing.”

    So doing something that makes the situation worse is better than doing nothing when your mystique as a ‘healer’ is at stake.

  • I suppose being an anarchist group, though small like a bookstore, is as autonomous as you’d get still being a citizen of a country, paying taxes, using public services, using currency to buy groceries, and so on.

    The bookstores are small, the anarchist communities centred on them aren’t.

    Obviously you can’t be fully autonomous within a self-declared sovereign nation. The rulers don’t like that. It’s also pretty hard to be autonomous outside of one as your neighbours see it as a threat to their own authority and act accordingly. We saw that with the anarchist parts of the Ukraine in the 1920s, Spain in the 1930s and the Rojava parts of Syria now. If there’s one thing governments of all stripes can agree on it’s that anything demonstrating that anarchism might be a viable option must be crushed.

  • Those who are ‘tearing down dysfunctional and oppressive institutions’ need to do so in a way that remembers that the people composing them have to go somewhere and do something, and shouldn’t be told ‘too bad’, ‘get a life’, or ‘get used to it’.

    That was pretty much the proto-liberal argument against practical action towards the abolition of slavery.

  • The problem with the term “mental illness” at this point is that it is used intentionally as a means of denying that suffering has any kind of meaning beyond messed up brain chemicals.

    And I think that comes from the incoherent way the mind sciences approach the mind-body problem(s).

    On the one hand they insist the mind is the brain (or an entirely emergent property thereof), so it follows that any problems with the mind are manifestations of problems in the brain. OTOH, they see the individual as the locus of suffering caused by the mind-brain, as if the individual is something separate from her mind. It’s Abrahamic/Cartesian dualism glossed over with Enlightenment physiology. It don’t work.

    That’s how you get counterfactual claims that locating a person’s suffering and aberrant behaviour in his brain defects rather than his character will somehow reduces stigma while at the same time insisting that mind, and therefore character, is simply a manifestation of the same defective brain. That don’t work neither.

    So we see articles like this one in which a musician’s ‘intensity’ is pathologised as borderline personality disorder and her music is therefore a symptom of “a young woman struggling with a neurological condition she didn’t yet understand”.

    Art too is now an illness. I’m sure there’s a pill for that; though it took ECT to cure Hemingway of his art.

    “Birds born in a cage think flying is an illness.” – Alejandro Jodorowsky

  • Statin therapy is the target of unusually strong skepticism that the study’s authors believe to be caused by baseless claims for the sake of market manipulation on behalf of drug companies.

    Drug companies manipulating the market by overstating side-effects?
    Is there a newer, more expensive cholesterol lowering treatment they’re trying to push?

    Or are you saying the skepticism is being dismissed as baseless by drug companies in an attempt to manipulate the market? If so, this study could be an example of that.

  • I’d guess so. But don’t forget that sexual assault survivors of all ages often have responses that are a long way from the social stereotypes of how rape victims should behave. It would be easy to interpret acting out trauma as something else entirely, especially if you don’t want to think of yourself as an abuser who is doing lasting damage. Again it’s down to the limits of imagination upon empathy.

  • There’s loads of philosophies within anarchism about the best ways to promote change.

    Some lean to building communities based on anarchist principles (usually communes) as examples for change, some prefer to start anarchist activist groups that attempt to address current social problems without necessarily overturning the existing order (e.g. Food not Bombs), others go for promoting anarchist principles and outlooks within existing groups and communities (I lean more to that). Some, like the IWW, promote workplace organisation along anarcho-syndicalist lines, and some are into tearing down dysfunctional and oppressive institutions, with or without proposing replacements. Bertrand Russell held that anarchism was a probably unachievable ideal which nonetheless should inform the goals of any revolutionary or reformist political ideology (Marxism was supposed to lead to anarchism, but as Bakunin pointed out from the start it’s centralisation of authority doomed it to failure).

    I don’t know if your summary of oldhead’s position is correct (I suspect not) but I consider it entirely respectable. You don’t have to propose replacements when you advocate tearing down dysfunctional, oppressive institutions. Many don’t need replacing because they serve no worthwhile function. In other cases the object is to remove the institution so communities can find their own replacements free of control and coercion. Having a revolutionary vanguard trying to impose its own idea of the best replacement would likely lead to the same old oppression under a different flag.

    If you want to know about the history and various philosophies informing anarchism I’d recommend Peter Marshall’s book Demanding the Impossible.

    If you have a link to examples of anarchic ‘politics’ or ‘society/groups’ (especially completely autonomous) that didn’t implode/explode or splinter into ever smaller pieces, then please link it here.

    There’s heaps of examples. Try googling it. I’m personally familiar with the two Sydney groups centred on bookshops, Black Rose and Jura, as well as anarchist activist groups like Squatspace and the now defunct Catalyst anarchist computer collective.

    The longest standing anarchist group I know of are the IWW (the Wobblies), but I’ve never been a member.

    Oh, and if you want the Sex Pistols’ take on anarchy, try here.

  • What about a class action?

    It might be worth a try in the US if you could get enough people to sign on. Class actions are notoriously difficult in Australia and lawyers are reluctant to take them on. They’re usually only worth trying when a product has proved harmful to consumers, especially if it’s a financial product. (There’s currently a class action against Facebook underway. If Facebook keeps poking Australian elites like they’ve been doing it might succeed.)

    The difficulty would be finding enough people who’d suffered similar harms because the courts had accepted psychiatric evidence as scientific. It would probably be easier to pull off if they were all harmed by the same shrink, but that would also make it harder to generalise the ruling to all psychiatric evidence.

  • I’d imagine they’d express their compassion by doing their best to support and help the victim. Of course that’s gonna be warped by the abuse but the abuse doesn’t necessarily stop them from caring about the child’s welfare.

    Extrafamilial child abuse includes the phenomenon of older (usually single) men adopting an underage boy (usually past puberty) who they sexually abuse but also care for and seemingly love. There was a senior South Australian judge who adopted and abused an impoverished boy whom he also educated and connected with the upper strata of Adelaide society. That boy grew up to become a very prominent journalist. The judge was never charged with an offence (because he was influential, not because it was legal). If you ask me there’s a similar subtext in the Batman and Robin stories, especially as it was played in the 1960s TV series.

    Don’t think I’m trying to offer apologia for any of this. I’m certainly not. Just answering your question as to how a child molester can express compassion for his victim.

  • My impression is that you want a ‘revolutionary society’ and use an anarchist stance, but I’m not sure how these translate into your ideal community standards and practical political realities, or fit into existing politics without playing only a role of destruction. Then again, I know almost nothing about you.

    I can’t speak for oldhead, but I’d suggest that if you think anarchist politics is only destructive then you’ve got some more homework to do. The Sex Pistols aren’t the final word on the topic you know.

    “What is an anarchist? One who, choosing, accepts the responsibility of choice.” – Ursula Le Guin

  • even though what we have is imperfect, it’s better than doing nothing.

    It might make us feel better than doing nothing (and perhaps improve the look of street corners) but whether it helps the people who are suffering is another question.

    “It’s better than doing nothing” has been used to justify all sorts of abuses, up to and including wars.

  • Well, time for a test case, I say!

    At Justice Action we’ve been trying to get one for some time (there’s a hopeful case heading for the Supreme Court right now).

    Unfortunately there’s no specific code of admissibility for scientific evidence comparable to Daubert here, just generalised ones for expert witnesses that aren’t applicable to this purpose. However there are legal precedents for borrowing from Daubert in civil cases that we hope to extend and consolidate in criminal trials and tribunal reviews.

    So far every time we’ve got a case to the Supreme Court the Mental Health Review Tribunal has declined to contest it. Good for the client, bad for the precedent.

  • Having psychiatrists in this role makes it way too easy for judges and juries to pass the buck and accept their judgments, rather than those parties having to personally wrestle with the difficult questions of capacity and safety.

    Right again Steve.

    About 15 years back I attended a forum on the insanity defence held by senior members of the NSW judiciary with input from psychiatrists and (sigh) a UNSW philosopher of science of my acquaintance. Hearing the judges basically begging the shrinks to tell them what to think was quite unedifying.

    When comments were invited from the audience I started by reminding the philosopher that questions of the limits of free will vs determinism were notoriously intractable and unlikely to be solved in a NSW courtroom. I then had a go at the judges for abrogating the responsibility society had given them to judge in favour of the testimony of ‘experts’ hubristic enough to make claims way beyond their capabilities while under oath (expert witnesses are immune from perjury in NSW). I got some murmurs of approval from the audience, but pure ice from the podium. I bet some of those judges wished ‘contempt of forum’ was a criminal charge.

  • Mostly with rationalisation and denial. It’s not hard. You also see loads of non-sexual abuse in families that’s self-justified that way. “You’ve gotta be cruel to be kind”, “A good whacking never did me any harm”, “Tough love made me the woman I am today”, “I wish someone had given me a good shake-up when I was your age”, “I’m saving you from a life of sin” …

    Empathy is a very limited way to look at how your actions affect others. It depends on imagination and tends to fail if there are large cultural or emotional differences between the people involved (e.g. a child and an adult). Personally I prefer compassion.

  • I don’t believe any revolutionary societies (none exist today, except maybe Cuba still to an extent) have yet found a way to dispense with police and prisons.

    Cuba has an appalling prison system, comparable to the US albeit with a much lower incarceration rate. (I’m sure you know ‘The Land of the Free’ has by far the highest imprisonment rate in the world.)

    Nonetheless there has been loads of progress all over the world in finding replacements for prison systems for the same reason asylums were largely abolished. They’re becoming harder to sustain economically. So capitalism may yet kill the PIC, though we have to try to avoid simply shifting it to the other wing of the P/PIC.

    Most of the alternatives implemented so far have been about diverting offenders from the system with non-custodial sentencing. The most promising ones are based on restorative justice principles.

  • Has this ever been tried?

    Not to my knowledge.

    For about five years I was on a mailing list that kept track of admissibility challenges to junk science in US courts. Psychiatry never came up, though challenges to junk psychology and neuroscience did (mostly in the context of lie detection).

  • Absolutely right.

    Unfortunately there are loads of ‘sciencey’ sounding concepts in law that aren’t really science at all but have enabled expert witnesses to muscle in on the territory. The judiciary is notoriously ignorant of scientific matters and laps it up.

    There’s a US Federal standard of admissibility for scientific evidence called the Daubert standard that would exclude psychiatric evidence if applied rigorously. Unfortunately it’s rarely applied to shrinks at all (in fact I’ve never seen such a case). If any admissibility standard is used it’s usually the older Frye standard or one of the state specific ones that have let all sorts of pseudoscience into the courtroom.

  • I agree with you there Exit.

    There may be a place for some psychiatric drugs as short term emergency measures but it’s a kind of percussive maintenance for the psyche. Whack ’em hard with chemicals, electroshock, alcohol, a near death experience, whatever. If you’re in a bad enough place then maybe that will put you somewhere not quite so bad. But if they’re going to be a standard part of the emergency arsenal they first need to be evaluated as such against potentially less harmful alternatives.

  • I doubt there would be a lot of difference between Australian and Canadian child molesters but there is a big difference between intrafamilial and extrafamilial child molesters in that extrafamilial ones include the groups that are most predatory, most likely to objectify their victims and most likely to reoffend. That suggests they would also be less empathetic.

    The study you cite only examines extrafamilial molesters, so the data is likely heavily skewed towards non-empathetic ones.

  • there is no patented way to profit from these older drugs—yet.

    Sure there is. J&J showed the way with esketamine.

    All you have to do is isomerise the off-patent molecule into something new that shares many properties with the original. Then you patent it and you can charge many times the street price of the original version.

    Of course by isomerising you’re potentially adding new, unknown properties that can cause adverse events and side-effects never seen in the original, so all of the safety knowledge about the old drug accumulated over decades goes out the window. But hey, you’ll be raking in the $$$!

    We’ve already seen something like that with synthetic cannabinoids. The regulators outlaw one molecule so the syndicates tweak it into something else with worse side-effects to evade the regs. I’m sure drug companies will be quick to learn from the other criminals.

  • At least the degree of criminal responsibility. But this is where the concept of “extenuating circumstances” comes in.

    No. It’s where the legal concept of ‘diminished responsibility’ (or ‘insanity’ or ‘irresistible impulse’) comes in.

    I agree with evanhaar that for this dialogue to make any sense you’re really going to have to specify exactly what kind of responsibility you’re talking about. In your initial comment you specified legal responsibility but are now retreating from that without saying where you’re retreating to. So I have no idea whether you’re talking about moral responsibility, social responsibility, duty, obligation, accountability … They’re quite different and if you keep jumping from one to the other you will continue to be incoherent.

    Also like evanhaar I suspect you’re talking about responsibility as if it’s some kind of natural law that applies to all people at all times independent of what the individual or society thinks. I’ve struck several US libertarians who seem to believe in such a thing. If you’re one, maybe you should lay your cards on the table and say so.

  • someone unjustly charged who can get off using a psychiatric defense should go for it.

    I sure wouldn’t recommend it.

    You’ll not only end up physically incarcerated (probably in a prison hospital) but mentally incarcerated with drugs. You won’t have a release date to look forward to and will probably spend longer locked up than if you’d been convicted. And you will have more of your rights (e.g. visits, possessions) taken away. And when you do get out, instead of having ‘paid your debt to society’ many people (like you and Szasz) will see you as having exploited a loophole to ‘get off’.

    The only people who ‘win’ using a psychiatric defence are lawyers, who have one less convicted client on their record. Families can be keen on that outcome too. Having a ‘sick’ family member is less stigmatising than having a criminal one.

  • You got a better solution for protecting people from violent motherfuckers than keeping them out of reach? I’m all ears.

    Not sure if you mean guns or prisons here, but if you’re a typical American you’re over 1.4 times more likely to use that gun on yourself than be murdered by someone else using any means (2019 figures).

    Sometimes the violent motherfucker is closer than you think.

  • Yes, I’m aware that the culture of prison officers is hostile to the notion of rehabilitation. “Once a crim, always a crim”. But the stated intent of prison systems in the West always includes rehabilitation as one of its primary aims, as the euphemism ‘corrections’ suggests. Nonetheless prisons are inherently criminogenic – they cause crime – so the attitude of officers is arguably more realistic.

    The principles of the modern prison system were first laid down by the Quakers who instigated it in the early 19th century (in Pennsylvania I believe) and strongly emphasised rehabilitation. They thought solitary confinement was particularly efficacious.

    These days Quakers know better and many groups (particularly in Canada) are now campaigners for prison abolition.

    (BTW, psychiatric drugs – particularly neuroleptics – are valued recreationally by many prisoners resulting in prison black markets for diverted drugs. Doesn’t sound like much fun to me but as they say “A day off your face is a day off your sentence”.)

  • Yes, but note that study looked specifically at non-familiar child molesters, which incorporates the groups least likely to show empathy for their victims. About half of detected child sexual abuse occurs within families and is associated with greater long term harm for the victim.

    Yes, they do express horror after they’re arrested.

    People who are sexually attracted to children also express horror when they haven’t offended at all (see the Virtuous Pedophiles website for examples). So it follows many would feel even greater horror if they offended, whether they’re arrested or not.

    However imprisoned child sex offenders know that failure to express remorse will impact their chances of parole. So taking expressions of horror at face value would be naive in specific cases even if it’s often true overall.

  • I’ve worked a fair bit with convicted pedophiles in the NSW prison system and post-release. I’ve also lectured on child sex offending at the Sydney Institute of Criminology.

    As far as I can tell you can’t generalise about child sex offenders. Some are extremely predatory and objectify their victims, particularly the ones who target prepubescent boys who were previously unknown to them. Others are convinced they’re in love with their victims and offer them support in many ways. This is more typical of those who target family members, the children of people in their social circle or those under their care. Some I’ve spoken to have even rationalised the abuse empathetically, telling themselves they would have wanted an adult to do the same for them at that age (an experience many child sex offenders have had). They’re the ones most likely to believe the child enjoys the experience.

    The biggest single group of convicted child sex offenders in Australian prisons are those who’ve committed only one detected offence, usually against a family member while under the influence of alcohol. They’re likely to express horror at what they’ve done and regret for the impact on the victim.

  • I definitely see us as allies oldhead. Despite our differences on peripheral issues our stated objectives and analysis of the problems align quite closely I think.

    The stated aims of Western prison systems are retribution, incapacitation, deterrence and rehabilitation, with the latter supposedly for the benefit of the prisoner.

    The initiative being pushed by forensic psychiatrists in NSW is interesting in that it abandons all semblance that it’s for the benefit of the subjects. It’s couched entirely in terms of reducing recidivism. I guess they deserve credit for honesty.

  • Anyway the quote you cite doesn’t mention any penal system

    That’s disingenuous. You (and Szasz) are talking legal responsibility, so you’re talking legal penalties. Szasz was more explicit. He railed specifically against psychiatric defences in court and his examples were cases that would have resulted in a prison sentence if the defendants were found guilty and fully responsible for their acts. So you’re talking the penal system.

    If not, perhaps you’d like to specify what sort of responsibility enforced by our legal systems you think might keep us ‘free from fear of violent assault and other predatory acts’.

    everyone is responsible for their own behavior, and that psychiatry cannot absolve them of that. You disagree?”

    Of course I disagree with a statement as simplistic as that.

    We’re not responsible for our behaviour, we’re responsible for our decisions. We don’t hold people responsible for behaviour that wasn’t intentional. OTOH, we do hold people responsible for intending to carry out acts even if they fail to do so. And our decisions are circumscribed by all sorts of circumstances. So we don’t hold children or dementia patients as responsible for their decisions as others. We shouldn’t hold someone as responsible for a violent act if they were acting under the delusion that they were defending themselves or loved ones from demonic attack either.

    Whether psychiatry or courts are adequate or appropriate tools for adjudicating responsibility is very debatable, but at least they acknowledge that degree of responsibility depends on many circumstances, not just the behaviour of the defendant.

    And that gun under your pillow?
    Statistically the person most likely to be shot with it is you. Next most likely is another member of your household.
    How does that keep you free from violent assaults?
    (I’m speaking as a gun owner who doesn’t kid himself with Hollywood cowboy fantasies).

  • Equally destructive, Szasz said, was the power of psychiatry to absolve people of legal responsibility for violent crimes and socially destructive behavior. The first right of a citizen in any society (including socialist ones) is to be free from fear of violent assault and other predatory acts.

    I reckon this is another example of Szasz’s libertarian ideology overruling his common sense. Anyone who thinks the penal system is any better than psychiatry at keeping citizens free from fear of violence hasn’t been paying attention. Both have a vested interest in maximising fear of violence so as to increase their own power and wealth, so they do. It’s also how they justify the fear of violence they themselves inflict upon disempowered people.

  • Yeah. Gotta wonder what ran him down on the road to Damascus. Was it just drug company and Stanley Foundation money? Did he get cat parasites in his head?

    I once read a transcript of a radio interview in which he attacked the concepts of presumption of innocence and legal representation for defendants. Then there’s the NAMI pamphlet he co-wrote that suggested family members turn over furniture and break crockery before calling the cops on a ‘mentally ill’ member.

    He’s a strange one alright.

  • The group I’m with started out as The Prisoners’ Action Group, made up of current and former prisoners with a focus on the prison and criminal justice systems. As Justice Action we’ve come to the perspective that transinstitutionalisation and stigmatisation pretty much erase the boundaries between psychiatric and regular prisoners (as does the proliferation of forensic mental health expert witnesses in the courts and compulsory psychological programs in prisons). So the P/PIC is a natural way to look at it for us.

    One difference is that you don’t get anything like Psychiatric Stockholm Syndrome with criminal justice prisoners. You won’t find many ex-prisoners saying the prison system works and more people should have access to it. And like MIA, we have a policy of respecting the voices of experience. As you might imagine, that can lead to policy disputes. But we’re yet to run across any psychiatric survivors who endorse forced treatment without an advance directive to that effect.

  • Nah. This is a bit of a jobs for the boys project. Loads of new positions for forensic psychiatrists, from doing the initial assessments to heading up the community teams to sitting on the panels to decide whether they’ve reoffended and, if so, to recommend either tossing them back into prison, scheduling them to a locked ward or changing their treatment orders.

    That’s what’s most likely to scupper this. They’ve gotten too greedy. Too many ex-prisoners in the net and too many expensive educated professionals in the various assessment and intervention arms. And no exit strategy. Once an ex-prisoner is in there’s nothing s/he can do to get out. The concept of recovery doesn’t exist.

    There will also be teams who mediate relationships between the subjects and their families, care-givers, employers, etc. Nothing says ‘rehabilitation’ like having a mob of suits explaining to everyone you’re a psychotic ex-prisoner assessed as being at risk of reoffending and that’s why you have to stay drugged.

    So when they start coming up with funding proposals we’ll be talking to fiscal conservatives in parliament. I think we can win this, but as I said, it’s likely to be an ambit claim aimed at getting a lite version that can be grown via bureaucratic creep.

  • BTW, in case anyone is interested in that sort of stuff I’ve uploaded the latest iteration of the vision of NSW prison forensic psychiatrists.

    Defining optimal post-prison care in New South Wales for those with psychosis. (1.36MB PDF)

    As you can see, it’s about having your mens rea cake and eating it too. Making the convicted ‘pay their debt to society’ with a prison sentence, then declaring them unable to control their criminal impulses and putting them under psychiatric coercion and surveillance for life. It applies to even relatively minor offenders and is predicated on an anti-recovery model that can be summed up as “once a psychotic, always a psychotic”.

    It’s not up and running yet but there’s steadily increasing support for it from politicians and non-psychiatric medical professionals. If they can overcome the substantial resourcing hurdles it will probably be implemented here and you can soon expect to see something like it in a Prison/Psychiatric Industrial Complex near you. Otherwise it will be used as an ambit claim to negotiate increased intrusion into the lives of ‘mentally ill’ people who come into contact with the criminal justice system.

  • Gotta admit I’m tetchy on this topic right now though.

    I’m in the middle of fighting a campaign by forensic psychiatrists in the NSW prison system to extend forced medication and compulsory intrusive ‘community care teams’ to all recently released NSW prisoners who have ever had a diagnosis of ‘psychosis’ (very broadly defined to include drug or medically induced psychosis as well as the usual ‘psychotic illnesses’).

    It’s entirely justified in terms of ‘reducing recidivism’ – even for relatively minor non-violent crimes. Not a touch of concern for other outcomes for the subjects. And the arguments deployed for it are the same old non-sequiturs we see on the TAC website and in the article above.

    I wouldn’t want MIA to become a ‘bubble’, with an Overton window excluding pro-psychiatry views, but given how the media currently covers mental health issues it might be nice to see some ‘balance’ away from that sort of propaganda.