Sunday, November 27, 2022

Comments by cabrogal

Showing 171 of 171 comments.

  • The term placebo effect is generally used to include a variety of things, including expectation effects, and usually it also helps control for things like regression to the mean which, obviously, is not an “effect” of the placebo. In its strictest sense there is no such thing as a placebo “effect” because by definition, placebos are substances without an effect. But that usage strikes me as pedantic. The term placebo effect, when used to encompass all of the aspects of the difference between a drug group and a control group, is helpful and, I think, operationalized well enough to be clear.

    Obviously not.

    If ‘placebo effect’ exclusively meant “the aspects of the difference between a drug group and a control group” it would be impossible to do placebo controlled trials of non-drug therapies. That clearly isn’t the case.

    The trial you are reviewing was not of the traditional ayahuasca healing ceremonies of the people of the Amazon. To introduce them by claiming they rely on the placebo effect is just as gratuitous as if a pill doctor reviewing a placebo controlled neuroleptic trial claimed that therapeutic communities such as Soteria rely on the placebo effect because the patients (by and large) don’t take neuroleptics.

    To know whether the ceremonies you mentioned rely on the placebo effect you’d have to run a trial in which one arm used the actual ceremony and another arm used a sham ceremony which resembled it but lacked the aspects practitioners claimed were what brought about healing (e.g. by having the shaman take a sugar pill). The trial you review does no such thing, so to suggest it says anything about whether traditional ceremonies rely on the placebo effect is false. To suggest you know anything about whether such ceremonies rely on the placebo effect is also false because no such trials have been done (at least to my knowledge – please correct me if I’m wrong).

    “Yes, the researchers in this paper CALLED it a limitation. However, while the researchers called this a lower dose, there’s really nothing to compare it to. It’s not as if there is an established dose of ayahuasca for clinical work. So, the researchers note that their dose was just somewhat lower than in two other studies.”

    So if they gave a microdose – or even a zero dose – it wouldn’t have been a limitation because there’s no established benchmark to compare it to? Perhaps. If so it’s equally true to say there’s no dosage that would be relevant to the study because we don’t know which ones might be therapeutic. So it’s a non-study that shows nothing.

    But there is something to compare it to. The placebo controlled trials which had neither the limitation of subjects with no clinical symptoms to alleviate nor a lower dose than has been found to have therapeutic effects. And they found “significant antidepressant effects of ayahuasca when compared with placebo at all-time points”.

    Obviously if you lower the dose sufficiently from there you will eventually reach a point at which it doesn’t have significant effects, so if this trial hadn’t had the additional limitation of lacking depression symptoms to treat it would be reasonable to say it shows a sub-clinical dose of ayahuasca, not that it shows the placebo effect in action (or at least not any more than any placebo controlled trial of anything does).

  • “The study had one massive limitation: the participants did not meet the criteria for psychiatric disorders. But this is also true of other naturalistic studies on the drug, which appeared more promising because they did not control for the placebo effect.”

    The study had another massive limitation – which it explicitly acknowledges in the discussion section.

    “In previous placebo-controlled studies, oral doses containing 0.36mg/kg DMT were administered to depressed patients (Palhano-Fontes et al. 2019) and freeze-dried oral doses containing 0.75mg/kg DMT (Dos Santos et al. 2012; Valle et al. 2016) and 1 mg/kg DMT (Dos Santos et al. 2011) to experienced users of ayahuasca. In the present study, doses were not adjusted for body weight. However, for an average individual of 70 kg, the equivalent dose would be between 0.20 (7 capsules) and 0.29 mg/kg (10 capsules). Therefore DMT doses in the present study were lower than a therapeutic dose of DMT as administered in a clinical setting. “

    In other words they were using sub-therapeutic doses, so it would have been quite surprising to see a strong drug-mediated response, especially as the subjects weren’t even suffering from the disorders used as response measures.

    So I guess the title of this article ‘New Study of Ayahuasca Users Shows Placebo Effect in Action‘ is less misleading than the text. But a similar study using sugar pills instead of sub-clinical doses of ayahuasca could have been expected to show the same thing and resulted in an even less misleading title and article.

    That said, it’s important to remember that it’s not the drug that effects healing in psychedelic therapy. The drug (in sufficiently high doses) merely temporarily knocks down the ego so the sufferer can gain insights into her condition that were obscured by her own self-image and notions of how she relates to her suffering and the aspects of her self/experience/environment that give rise to it. It’s up to the sufferer herself to decide what to do with those insights.

  • “In fact, both groups experienced about the same level of psychedelic effects, too. The researchers write that “participants in both groups experienced altered states of consciousness during the ceremony.”

    That’s not at all what it says either. ‘Contact highs’ are a thing, so you’d expect both groups to experience altered states. But unless the dose is quite small they would definitely not experience the same level of psychedelic effects. And sure enough, according to Fig 2 the ayahuasca group experienced significantly greater psychedelic effects than the placebo group in all categories except ‘Ego Dissolution Inventory’ and ‘reduction of vigilance’.

    “This study also demonstrates how indigenous ritual beliefs are co-opted and misunderstood by the medical model of psychiatry. In psychiatry, it is assumed that the drug’s biological aspect causes the improvement; however, in indigenous cultures, the ritual itself is entirely or primarily responsible for the improvement.”

    That’s only partially true too.

    It’s true that only the shaman takes ayahuasca in traditional healing ceremonies and true that Western ayahuasca ceremonies co-opt and misrepresent indigenous ones. But it’s completely false to claim the ritual itself is primarily responsible for the improvement.

    In fact the shaman uses the ayahuasca to ‘get behind’ the objective physiological symptoms of the problem so she can address the entire disorder – which has physiological, emotional, social and spiritual components (not that non-Enlightenment cultures would make such distinctions). Without the drug the shaman would be unable to fully grasp the disorder and exercise her healing art upon it.

    It’s also misleading to imply ‘ritual effect’=’placebo effect’. In fact the ritual has important socio-spiritual components that serve to reintegrate the sufferer with his community and environment, thereby addressing aspects of disorders typically neglected by Western medicine.

    I really think Peter should consider rewriting or withdrawing this article. Some of his errors are attributable to misunderstanding but others are harder to find innocent explanations for. At the very least it seems he didn’t closely read the research he’s reviewing.

  • A study on the mental health effects of the psychedelic drug ayahuasca found that the drug was no better than a placebo

    Err, no it didn’t.

    What it actually found was …

    There was a main treatment × time interaction on implicit emotional empathy, indicating that ayahuasca increased emotional empathy to negative stimuli. The current findings suggest that improvements in mental health of participants of ayahuasca ceremonies can be driven by non-pharmacological factors that constitute a placebo response but also by pharmacological factors that are related to the use of ayahuasca.

    And the moral of the story is; when reading analyses by commentators with an agenda always check primary sources.

    But you’re probably right about ketamine/esketamine.

  • I also think this article starts from universalist assumptions about individualism that would have been quite alien to many cultures prior to European contact.

    If you don’t start from a position of ‘me’ and ‘mine’ in relation to possessions, power and status then it’s not really egalitarian to fail to competitively seek to enhance those aspects of your social identity rather than trying to live in accordance with tried and true social relationships that have been handed down in tradition, myth and lore for centuries or millennia.

    Probably few could even have imagined more individualist ways of life, much less felt the need to ‘maintain their egalitarian ways’. Propagating Abrahamic notions of a personal relationship with a judgemental creator God, rather than a more holistic view of People, Land and Divinity as inextricably interwoven, sure seems an effective way of undermining such societies.

  • I think there’s a lot of Rosseauism in this article.

    My Aboriginal ancestors were perhaps the nearest thing to ‘pure’ nomadic hunter-gatherers on the planet when first encountered by Europeans. But reports of their pacifism are seriously exaggerated, not least by those who think their subsequent dispossession, oppression and slaughter were the regrettable but inevitable consequences of social Darwinism. “If we didn’t do it, someone even nastier would have”.

    My forbears didn’t make lil-lils, shields and war boomerangs for decoration you know. And unlike New Agers and corporate motivators their warrior culture wasn’t an affectation.

  • Even more scary is the whole vision contemplates therapy without the human touch, without caring, compassion, and empathy.

    How’s that different to the psychiatry we already have?
    We just feed the DSM punch cards into the psyche-bot and it spits out a diagnosis and prescription.

  • sophisticated artificial intelligence (AI) are hoped to somehow eliminate clinical bias in the assessment of mental illness, but how this is achieved remains unexamined”

    Isn’t it obvious?

    Clinical bias will be replaced with algorithmic bias. Not Facebook, but Mindbook. And naturally all these new technologies will be controlled and directed by the corporations that develop them. So ‘normal’ will be the ideal of passive worker-consumers regimented to think and behave in exactly the way corporations want them to.

    I’m sure it will be necessary to adopt this system well before 2500 so that corporate capitalist states in the West can continue to compete with the emerging corporate socialist powers of the East. Democracy can only survive if we all agree about everything all the time and the pathology of dissent is therapeutically regulated out of existence.

    There is no alternative!

  • It’s even more Kafkaesque than that.

    When the Hawaii Innocence Project first tried to clear Spriestersbach and get him released they applied to the state Attorney General’s office for documents pertinent to his case. They were refused.


    According to AG officials he wasn’t entitled to them because Joshua Spriestersbach wasn’t the listed defendant. Thomas Castleberry was.

  • When I was lecturing in criminology about 20 years ago there was a huge debate among academics as to why the violent crime rate had risen remorselessly since the late 60s across most of the developed world, only to start dropping steeply from the mid-90s onward.

    The arguments generally split across the usual left/right divide. One side saying the 60s rejection of authority and emphasis on individual rights had pushed crime up and increasing imprisonment and zero-tolerance policing was bringing it down. The other pointed to reduction in social safety nets and widening gaps between rich and poor as the cause and more data informed, evidence based criminal justice and rehabilitation programs as the cure. Both sides tried to fit patterns of illegal drug consumption (e.g. the ‘crack’ epidemic) and media portrayals of criminality into their arguments. There were also some outliers, like the authors of ‘Freakonomics’, who claimed changes in the availability of abortions among the impoverished (especially non-whites) explained it all.

    Turns out they were all wrong.

    It was only when people started comparing levels of environmental lead pollution to violent crime rates in the relevant regions about 15-20 years later that a clear pattern began to emerge. Turns out if you want to turn someone into a violent criminal the best way to do it is expose them to lead in their early childhood. The most effective crime reduction programs of the 20th century were the elimination of lead additives to petrol and paint.

    Though there’s been a lot of follow-up studies all around the world replicating and confirming those findings, you pretty much never hear it mentioned in the mainstream media and even criminology textbooks barely touch on it.
    I wonder why.

  • Hi Nicole.

    We’re expecting a parliamentary inquiry into the NSW mental health system to be announced in November and are hoping to get the sort of results we saw in the recent Victorian Royal Commission into the Mental Health System. If we do, that’s a good platform for root and branch reform of how the NSW system operates; starting with a human rights based rewrite of the Mental Health Act, continuing with a curtailing of the power of psychiatrists in the Health Department bureaucracy and hopefully going all the way to an effective, enforceable plan to eliminate seclusion, restraint and involuntary treatment within a decade or so.

    Personal testimony from those who have been abused under the current system will be key to getting the results we need. There’s a few ways you can assist with that.

    One would be to make a personal submission to the inquiry when it opens. If you do you might also be asked to give testimony before the committee of inquiry, but you won’t be pressured if you decline. The submission can be marked as not for publication if you like, but that will reduce its effectiveness.

    If you want to be heard without giving identifying information to parliament the best way would be through a sympathetic third party. I’d suggest contacting either the NSW Greens spokesperson on mental health, Cate Faehrmann or the activist group Justice Action. In this way your testimony can be quoted in someone else’s submission without the need for you to self-identify to the committee.

    I hope you’ll seriously consider contributing. It’s going to be years before we start seeing real results but the momentum from the Victorian Royal Commission, along with the strong human rights stances recently adopted by the UN and WHO, probably offer the best chance for lasting change we’re gonna get for a generation.

    Australia is particularly poor at respecting the rights of those designated mentally ill and NSW is probably the worst jurisdiction in the country. There’s nowhere to go but up.

    (P.S. I’m amazed you found a humane forensic psychiatrist in NSW. If you contact Justice Action I hope you can give them details. We’re always looking for sympathetic mental health professionals for our casework, both for personal support and for expert testimony to the MHRT and Supreme Court.)

  • Well, I don’t have a TV or radio. Not that it insulates me from the effects of the media. That permeates our whole society.

    But somehow I think my opinion of law enforcement is informed more by life experience than what the journos try to tell me.

    My earliest degree from the college of hard knocks came 40 years ago, when I was both a heroin addict and a dealer and the Australian media never questioned police narratives about anything.

    Twice I was caught by police. Both times I was bashed and had my money and drugs stolen. But I was never charged. That’s because I was listed as a police informant by a senior detective I’d never met or spoken to. So why was I down as his informant? Because he was on the payroll of the drug importer I worked for.

    I also attended numerous court cases involving my friends – including a murder trial. In every case the police gave false evidence and in every case the outcome was fixed. Usually, but not always, in favour of the defendant. Because the police and/or prosecutor and/or defence attorney and/or judge had been bribed. One time I accidentally fixed a case myself. Under cross examination I revealed the name of my employer in the IT industry (Not my other employer of course. I’m still alive.) The judge had attended the same exclusive school at the same time as my boss. You should have seen the prosecutor’s face when he realised his mistake.

    I lived near the then ‘sex capital’ of Australia – Kings Cross – and many of my friends – including all my flatmates – worked in the sex industry, which was then illegal in NSW. So I got to see close up how the dynamics of police corruption and the sex industry played out. Sex work has since been decriminalised in NSW and the element of police corruption in it has been vastly reduced, but not eliminated.

    Twenty years ago I was working for Justice Action and the Indigenous Social Justice Association on deaths in custody cases, wrongful convictions and sex offence resolution, restoration and rehabilitation. I often acted as a consultant on cases involving forensic DNA – which I lectured on and wrote cited papers and articles about. Though the NSW police had supposedly cleaned up their act following the Wood Royal Commission into police corruption concocting false evidence was (and remains) the rule rather than the exception. I was in close contact with several US Innocence Projects, so I know the US police follow similar ‘rules of evidence’ – including in capital cases.

    The OJ Simpson murder case was one in point. He was almost certainly guilty but the police still planted DNA evidence and gave false testimony. They were caught and OJ was acquitted. The whole world was watching so the judiciary couldn’t just sweep the corruption under the carpet.

    But the hardest lessons were the ones I learned supporting the families of those killed by police through the inquest and (occasionally) the trial.

    Mostly they were conservative, church-going folk who had no previous reason to think the police, coroners and judiciary were thoroughly bent. They then had to face police media blitzes that dishonestly defamed their dead loved one in an attempt to justify his/her death. Often that included retrospectively having them diagnosed with a psychotic illness, so their lives were worth less and they were ‘a danger to others’. This isn’t a case of police working with corrupt psychiatrists. It’s psychiatrists working with corrupt police. They then saw the coroner bend over backwards to exclude evidence of the obvious – that their loved one had been murdered by police for no lawful reason. If that was impossible (usually because of witnesses and media coverage) it was passed to a prosecutor who no-billed the case or to a judge who instructed the jury to return an innocent verdict.

    My job wasn’t to help families find justice. That’s impossible under the system we have. It was to plug them into what support services were available and try to manage their expectations so their irresolvable grief doesn’t tip over into the sort of hopeless despair that kills.

    I can’t do that sort of work any more, rebel. I burned out. As I write this the tears are pouring down my face with the memories it brings. But plenty of other people do that work day-in, day-out for decades on end. Please don’t tell them their views on police corruption come from the media.

  • “If seems to me, that if the dosage is just a little off, it could put a person’s life in danger.”

    Psychedelics can put people’s lives in danger, not least because of the response law enforcement often has towards those who take them. But the dosage has very little to do with it.

    As I’ve pointed out repeatedly, the difference between an effective and a lethal dose of conventional psychedelics is huge. At least an order of magnitude more than the difference between slaking your thirst and dying of water toxicity.

    And there’s never been any evidence found for what could reasonably be described as ‘brain damage’ attributable to them, despite a lot of government funded research attempting to prove exactly that.

    If you have any references to the contrary I’d appreciate a link. I do advocate for legalisation and wider use of these drugs. I take my responsibility to inform myself of their potential dangers seriously.

  • “There is good evidence from reputable historians that the Prohibition at least contributed to the Depression and then the Depression contributed to WWII”

    Well, I guess everything ultimately contributes to everything else. The butterfly wing-beat that contributes to a cyclone half the world away. Indra’s Net. That sort of thing.

    But if you can give me a reference as to how the US experiment with alcohol prohibition was a proximate cause of the worldwide Great Depression I’ll certainly take a look. I’ve heard the Depression attributed to many factors, mostly economic though not exclusively, and that one’s new to me.

    I do not know if the Prohibition era led to corrupt law enforcement. Personally, I do not think law enforcement is corrupt

    Well we definitely disagree there. But I’m non-white. I’ve also been involved in many court cases including several deaths in custody. It gives you a different perspective. I’d have thought you’d at least see the collusion between law enforcement and forced psychiatry as corrupt.

  • I agree in principle with your critique of psychiatry from a spiritual perspective. As a pseudoscience psychiatry is very defensive of its bogus credentials and so will always seek to deny or explain away anything that can’t be objectified in accordance with its simplistic facsimile of the scientific method. And yes, there is much in Jungianism that’s guilty of that, though I’d argue less so than in most branches of psychiatry or in many non-psychiatric post-Enlightenment cults of objectivity. ‘Scientific’ parapsychology for example.

    What I disagree with is that there could be some kind of objective, one-size-fits all spiritual path that would enable us to judge which ones are ‘deeper’ or ‘more advanced’. IMHO you have to find your path from where you are and imagining all start and end in the same place or pass the same milestones is hubristic at the very least. Often it’s using spiritual ‘authority’ as a tool of authoritarianism.

    TBH, paranormal phenomena such as miracle healing, ESP, OOBEs, NDEs, witchcraft, meditative levitation, past life regression, etc, etc, are irrelevant to my own spiritual path. To me they’re just performative means people use to try to objectify their spirituality and give it social value, meaning and authority.

    I have neither subjective nor objective measures of the worth of my spirituality. It’s completely contained in and of itself. It doesn’t promise me salvation, certainty, redemption, psychic powers, understanding, personal growth, wealth, health, happiness, arcane knowledge, a better rebirth, the end of suffering or eternal life. There’s no gauge or exchange rate I could use to weigh it against anything else. And it’s not a matter of preference or personal choice any more than the fact of my own existence is. It simply is. As am I. That’s good enough for me.

  • “In recent research with LSD, the maximum dose is generally 200 micrograms, given the high intensity of subjective effects at this dose range and an increased likelihood of adverse events if exceeded. Moreover, giving people high dose psychedelics on consecutive days could be mentally destabilizing, especially for patients with schizophrenia.”

    Well, any form of abuse can be mentally destabilising, but there’s a few problems with this statement.

    While it might be fair to say recent research is generally at less than 200mcg, the types of treatment currently being researched can be classified into three broad categories, “psycholytic therapy”, “psychedelic chemotherapy” and “psychedelic peak therapy”.

    Psycholytic therapy is the most common. It includes micro-dosing at as low as 10mcg and rarely exceeds 200mcg per session. But the other two categories routinely dose at higher levels, up to and sometimes exceeding 500mcg.

    In the 1970s a standard recreational street dose contained 100-150mcg of LSD. These days 40-80mcg is more common. Using 500mcg or more of LSD without a high pre-existing tolerance is described by the subculture as ‘heroic’, but I’d call using it on someone with no prior psychedelic experience ‘utterly irresponsible’.

    But a bigger issue is that the statement doesn’t address the extraordinary tolerance curve of psychedelics.

    If you take 100mcg on day one then you’ll need more than 200mcg 24 hours later to get a similar effect, then 400mcg the next day, 800mcg the day after that, etc. If you stop using it takes 6 to 8 weeks to return to naive tolerance levels.

    So taking 100mcg daily for two weeks would have little detectable effect after the first few days. Suddenly increasing it to 500mcg would presumably have an effect, but it would still be unlikely to be as effective as a 200mcg dose to a psychedelic naive subject.

    The abusive form the research described here took is of much greater concern. It’s hard to imagine anything more hellish than being physically and psychologically abused while under the influence of psychedelics.

  • Here’s an interesting article in which a Jungian therapist gives her interpretation of how psychedelics can benefit mental health and personal development.

    Quote: “Research indicates that an essential healing mechanism of psychedelic use is the ‘mystical experience’: an encounter with the ineffable, with that-which-is-nothing-and-all, or that which you, as a discrete entity, are most certainly not. That is, psychedelics seem to heal by expanding people into something larger than they previously thought themselves to be.”

    I disagree somewhat with her article. Firstly I don’t think recalled dreams are particularly useful means of self-analysis whether or not psychedelics are involved. I think only fragments of dreams are recalled after waking – even if you immediately copy all you can remember into a dream diary – and a lot of the narrative gaps are filled in post-facto in an attempt to make a linear story from them. That’s why I think we can so easily follow movies with cuts and gaps in the story – because we already do that all the time to make sense of our dreams and incomplete memories.

    So basically, recalled dreams aren’t as ‘primal’ as the Jungians would have it. They’re already edited/processed/contaminated by our preconceptions, preferences and prejudices into something we can make sense of.

    Secondly, she assumes that because the language of symbolic representation is ‘older’ than the spoken word it’s somehow more suitable for capturing the ineffable nature of mystical experiences. I disagree.

    What makes transcendent, ego-dissolving mystical experiences unique, ineffable and impossible to imagine is their non-dual nature. All languages, including symbolic ones, communicate by dividing the universe into binaries.

    So the word “cat” also implies all that is not a cat, in the same way left implies right, up implies down, light implies darkness and right implies wrong. All languages, including symbolic ones, work the same way. Mystical experiences don’t.

    In a nondual state all such distinctions disappear. There is no separation between things, not even subject and object or self and other. So there is nothing separating you from anything in the universe, including God. It’s a sort of ephemeral return to a state before eating from the tree of knowledge brought about the Fall.

    The problems arise when you try to hang onto your mystical experience by fitting it into your narrative memory with language. Throwing words or symbols at it contaminates it. On the one hand, this may allow certain insights it offers to be preserved within your conceptual frameworks – as when you ‘fit it’ into your religious belief system – but on the other, it allows charismatic or powerful people to superimpose their own symbols and beliefs over your experience, as did Charles Manson and other ‘gurus’.

    If you already buy into Jungian symbology it’s probably not going to do any harm to use it to interpret your own mystical experiences. But if you’re allowing a Jungian to do that for you you’re running the risk of being brainwashed into their doctrine.

    In my experience, the trickiest and most important thing about guiding someone through a powerful psychedelic experience is to avoid doing it at all unless it’s absolutely necessary to avoid harm and, if you do, to be very aware of the temptations and dangers of imposing your own world view on someone else when they’re trying to find a way to make sense of something completely out of the realms of their prior experiences.

    But if we’re gonna turn this stuff over to shrinks I’d prefer it was the Jungians.

  • I respect most of your views and the main thrust of your points.

    There is indeed a major problem with the way everyone thinks there is a technical solution (often drugs) for every problem facing individuals, society, mankind and the planet and the trick is to find the right expert and make sure they have the power and resources to fix everything.

    Regarding Prohibition, I’d disagree it was a major factor in the Depression or WWII, but it certainly gave us the sort of organised crime and corrupt police forces we have today, which was perpetuated after alcohol prohibition was lifted and replaced with prohibition of other drugs. This was due largely to the efforts of law enforcement authorities (especially Harry Anslinger) to maintain the power and funding they gained from alcohol prohibition.

    The Prohibition also led to an increase in alcohol related deaths in the US due to unsafe bootleg liquor (often laced with methanol) and the inability of people to seek medical help for alcohol overdose for fear of criminal penalties. We still see exactly the same problem with black-market drugs and that’s a big reason the opioid epidemic has killed so many Americans (nearly twice as many as Covid).

    I am against current psychiatric drugs. Not because they’re drugs but because their risk:benefit ratio skews so heavily in the wrong direction. I would allow both that they can benefit some people if used in certain ways and that everyone should have the right to make an informed choice as to whether to use them. But I’d still like to see them banned from being prescribed as therapies because I think the business model of the pharmaceutical and psychiatric industries ensures most people will make a misinformed choice.

    I’d also like to see free clinics authorised to dispense them while helping people to withdraw and allow that complete withdrawal may be impossible for some and they should be permitted to keep receiving them indefinitely (at the minimum feasible dose). This would be similar to a program in the UK which was originally set up to help morphine addicted ex-servicemen following WWII.

    But I think that even though the benefits of most legal drugs are overestimated and the harms underestimated (with the reverse usually true for illegal drugs) there really are a lot of vital drugs out there that are needed. Antibiotics, vaccines, insulin, etc, etc. In fact if it wasn’t for antibiotics, antivirals, bronchodilators and anesthetics I’m quite sure I wouldn’t be alive now. If it wasn’t for cortico-steroids I’d be blind.

    I also think – on the balance of probabilities – that my life would have been more spiritually impoverished and my mental health worse were it not for psychedelics.

  • I’ve been in and out of several addictions over my life – including heroin, though never nicotine or alcohol fortunately – but I think it would be very hard to get addicted to conventional psychedelics and the research backs me up on that.

    Firstly you don’t get cravings. Psychedelics don’t start working until around 30 minutes after you take them and if they cause euphoria (which is context dependent) it’s generally not until they’ve peaked at least an hour after that. So you’re not getting the Pavlovian association between dose and pleasure that causes cravings in quicker acting drugs.

    The tolerance curve for psychedelics is unique and amazing. After a trip it will be weeks until you can take another one and expect an effect. So you can’t use them frequently enough to develop habituation and you will always have completed physical withdrawal (which is mild and lasts only a day or so) by the time you use them again.

    If you use them socially as a party drug (which I never have) there’s always the risk you’ll become socially addicted to them (i.e. you won’t know what to do with yourself at gatherings unless you’re tripping). I’ve run across a handful of people like that at tourist places with a rave scene (Goa in India and Koh Phangan in Thailand) but I’m told it’s fairly common with non-conventional psychedelics such as ketamine, GHB and MDMA on the club circuit (which I’ve never been involved with).

    As I said, I’ve been using conventional psychedelics regularly for about 40 years now and in all that time I’ve never been tempted to use them more than 3-4 times a year, despite feeling more positively about them than I do any other mind altering substance or activity. I’ve sometimes gone for several years without them without feeling the need to seek them out. I figure when the time is right they’ll find me.

    The other advantage psychedelics have over all other drugs is the huge difference between an effective dose and a toxic one. People have accidentally taken many hundreds of times the normal dose of LSD and once it wore off about 24 hours later suffered no ill effects. That means LSD is less toxic than water (which can cause permanent brain damage in overdose).

    However I’d emphasise again that even normal doses of LSD can induce seizures in epileptics and increase blood pressure by up to 30 points (though about 10 is more usual) and these things are potentially fatal. But coffee, sex or vigorous exercise can do that too. It’s also been linked to sustained psychotic breaks in people with histories of psychosis – though the stories of people thinking they can fly and leaping from buildings seem to be apocryphal.

    The biggest danger of taking psychedelics is that you’ll become so disoriented you’ll walk into traffic or behave so aberrantly that someone will call the cops and you’ll get shot (a particular danger if you’re young, male and non-white). That can be minimised with careful attention to set and setting.

    There’s also a case in which an elephant was killed with a deliberate megadose of LSD. No prizes for guessing the profession of the people who did it.

    Also in 1953 a bioweapons researcher named Frank Olsen fell from a hotel window and died nine days after being unknowingly given a huge LSD as part of MKULTRA research. But the LSD would have worn off long before then. Some people speculate he committed suicide because he didn’t know he’d been drugged and thought he was going mad. Others claim he was murdered by the CIA because he’d threatened to blow the whistle on MKULTRA and/or the illegal chemical warfare research he was involved in.

  • Yeah, I know many Christians think anything outside their own belief system is demonic, often even other Christians who don’t think, believe or worship the same way they do. A lot of Protestants think the Pope is the Antichrist and Catholics have a history of killing other Catholics over such arcane theological disputes as the ‘true’ nature of the Trinity.

    That sort of thinking has led Christians to do a lot of demonic things over the centuries. What they did to Native Americans and my own Australian Aboriginal forbears in the name of ‘driving the devil out’ are just two cases in point. The ‘One True God’ has always been a bit like that. He’d no sooner told the Children of Israel ‘thou shalt not kill’ than He had them off slaughtering the Midianites, down to women, children and farm animals. All except for the young virgins, who were enslaved with God taking a share of that booty for Himself.

    On the face of it, if there really is a Satan the Deceiver, maybe Christians should stop pointing their fingers at other people’s gods and start looking a lot closer to home.

    It’s that sort of thing that ensured I’d never be a Christian. So if failing to toe the ‘damn the disbelievers’ line is a ticket to hell then my berth is already booked.

  • Of course it’s better if you can induce such experiences without drugs and some people do. My earliest experiences of that sort were spontaneous, years before I took any ‘recreational’ drugs (unless you count the passive nicotine intake from my early 60s parents) and I’ve since learned to (unreliably) induce them with various meditation techniques and breathwork, though it’s hard to sustain them that way.

    But basically if you’re OK with religious mysticism – especially modern Catholic mystics like Teilhard de Chardin and Thomas Merton – then chances are you’d be OK with psychedelic use in a religious context. If you’re more of a biblical literalist who rejects the mystical aspects of spirituality then you’d probably either hate it or have your religious perspective profoundly changed by it.

    When used in a religious context psychedelics are called ‘entheogenic’, which means ‘to induce the divine’.

  • From what I have gathered from online information and experiencers, psychedelics are particularly effective at promoting an “out of body experience”

    Well, after about four decades of psychedelic use involving dozens of individual and group trips plus dozens more where I’ve acted as a non-using ‘sitter’ while others used them I can’t say I’ve ever experienced an out-of-body experience as a result or spoken to anyone who says they have.

    There’s loads of effects of psychedelics and they’re highly dependent on what’s called ‘set and setting’ (expectations and environment) but the most profoundly spiritual ones closely resemble the mystical experiences that seem common to many different religions, including Christianity.

    Religiously observant Christians who’ve tried them (including clerics) routinely describe it as the most profoundly spiritual experience of their lives and the deepest connection to God they’ve ever felt. People who start a trip as atheists often finish it believing in God and take up a spiritual practice – sometimes Christian, sometimes not.

  • So is caffeine neurotoxic because it affects your brain?

    The good thing about the drug war is that it’s prompted loads of research into street drug toxicity to try to justify the hefty legal penalties against them. After decades of research there’s still no evidence LSD, mescaline or psilocybin (from magic mushrooms) kill brain cells and some (unverified) evidence they promote neuron growth.

    However there are newer synthetic psychedelics (such as 25I-NBOMe) that are quite toxic and they’re sometimes sold as LSD. That’s another reason to legalise them so people can be reasonably sure they’re taking what the label on the pack says they’re taking.

    There’s also certain magic mushrooms (such as fly agaric) that contain toxic chemicals as well as psilocybin. The traditional users have ways to neutralise them (the Sami people in Lapland feed fly agaric to their reindeers then drink the reindeer urine, which still contains lots of unmetabolised psilocybin) but a lot of people are pretty clueless when it comes to taking appropriate precautions when collecting and consuming mushrooms.

  • which seems to be from a loving concern for your mother

    Actually my mother was never sucked in by A Course in Miracles, probably because by the time she saw it she’d been through several similar belief systems and could see how derivative it is.

    Her brother, OTOH, was a lifelong atheist going through a major life crisis when his new partner introduced him to ACIM. He’d never seen anything like it before and thought it was revolutionary. He’s also a perfect fit for the educational, socioeconomic and personality profile ACIM is aimed at.

    I’d always been close to my uncle and feel I owe him a lot for help he’s given me at crucial points of my own life but I saw through ACIM right from the start. I researched it so thoroughly so I could discuss it with him at his own level of expertise. But I sure wasn’t expecting it to be an MKULTRA subproject.

    As with most ACIM followers, my uncle knows one of its founders worked for the CIA, but ACIM has a well rehearsed apologia for both Thetford’s career in brainwashing and the criminal immorality of MKULTRA, so he’s not terribly disturbed by it. Thetford started his career in military intelligence psychology working for G2 screening Manhattan Project researchers and staff, BTW.

    We’ll have to agree to disagree about psychedelics. Many religious and healing traditions the world over have incorporated them since prehistoric times and I think they’re onto something. I’ve never been a Christian so I don’t feel compelled to condemn non-Christian belief systems as Satanic. Nor do I buy into Nixon’s war on drugs propaganda that started all the nonsense about psychedelics being addictive and neurotoxic, though as I said, they do have the potential to be quite harmful if you don’t know what you’re doing or don’t care. As with most illegal drugs, a lot of the harm is caused or aggravated by their legal status.

  • I was wondering, did any of this money find its way into “new thought churches” like unity or the new thought alliance?

    Not that I know of specifically.

    I don’t think MKULTRA was about funding existing movements (it preferred to found its own) but a lot of knowing and unknowing MKULTRA researchers would have been linked to groups and belief systems rooted in New Thought; not because it’s particularly sinister but because it’s so ubiquitous in America, especially among psychologists. That’s probably because the famous US psychologist, philosopher and religious scholar, William James, gave New Thought such a good rap in his classic 1902 work The Varieties of Religious Experience.

    New Thought is generally considered to have been founded by Phineas Quimby and Mary Baker Eddy, the latter being the founder of the first New Thought church, Christian Science.

    The MKULTRA psychologist who co-founded A Course in Miracles, William Thetford, was a lapsed Christian Scientist.

    The other co-founder. Helen Schucman, who probably didn’t know who funded her work, was a non-practicing Jew and child psychologist who had once worked in her father’s esoteric bookshop.

    So as you can imagine ACIM shows strong New Thought influences. But so too do most US religions, cults and self-help movements developed since the late 19th century, so it’s hardly surprising MKULTRA was so tangled up in it.

    Schucman had a life-long obsession with Catholicism and she returned to it after renouncing ACIM. She was buried by the celebrity Franciscan priest, Father Benedict Groeschel, who had promoted ACIM in its early days but later condemned it as ‘demonic’.

    Helen thought the ACIM texts had been dictated to her by ‘Jesus’ – though ACIM is ambiguous about whether it’s the biblical Jesus, despite referring to him throughout as The Son.

    I don’t know how a trained priest could ever have gone for a ‘Jesus’ who sounded like a mixture of Theosophy, New Thought and 60s pop psychology and spoke in iambic pentameter, but there you go. Groeschel had studied psychology under Thetford so perhaps he got sucked in by his sophisticated manipulation techniques.

  • I don’t think I have a religious agenda here.

    My mother has always been one of those fad-driven New Age fans, uncritically adopting whatever’s trendy and dropping it when it goes out of fashion, but I’ve always had a skeptical bent and her ever-changing pseudo-scientific belief systems have never held much appeal for me. The crass commercialism of some of them also turned me off, but there’s plenty of that in mainstream religions too. I still can’t work out why God needs so much money.

    When I started learning about other beliefs and cultures I got increasingly disenchanted with the way the New Age has appropriated and distorted them, especially the traditions of my own Australian Aboriginal forbears.

    I’d long known of the claims made by some social justice activists that much of the New Age was contrived by authorities as a way to fragment and individualise the mass movements of the 60s and turn them away from political engagement and inwards towards pseudo-spiritual development, but I hadn’t given them much credence until I started researching A Course in Miracles.

    But I do think psychedelic drugs have great potential, both as means of healing and as a way for some to gain true spiritual insights. I don’t subscribe to the Christian notion that any spirituality not spelled out in the Bible is the work of Satan. But like any other powerful tool psychedelics can be misused and abused, both through ignorance and ill-will, and I’m becoming increasingly worried that excessive enthusiasm for them is gonna produce a backlash that will spoil things for responsible users, just like it did in the 60s.

    I definitely think psychedelics should be kept out of the hands of psychiatrists. Unless they want to use them on themselves of course. Perhaps for some they can even ‘cure’ psychiatry.

  • Well, the first thing to say is that the official records of MKULTRA were mostly destroyed by the CIA when the Church Committee investigation into it was announced. They missed the financial records, so we know who was paid, how much and the names and directors of the MKULTRA subprojects that received the money, but other than that, some supplementary documents FOIed by investigative journalists, the unreliable testimony MKULTRA operatives gave to the Church Committee and the claims of CIA whistleblowers there’s little in the way of direct evidence for anything.

    If you’re not familiar with the details of MKULTRA your first stop should be The Search for the Manchurian Candidate by the former intelligence analyst and State Department employee John Marks.

    What we do know is that MKULTRA ran from the early 50s to 1978 and researched interrogation, brainwashing and mind-control techniques – both individual and social – and was a direct successor to similar CIA programs dating back to the start of the Korean War. We know it had a huge budget which was used both directly by the CIA on often illegal projects using its own employees and other US citizens as guinea pigs and was also farmed out through various front organisations such as the Esalen Institute (where it often funded ‘New Age’ research) and the Center for Human Ecology at Cornell University (which focused on more mainstream psychological research),

    We know Gregory Bateson at Esalen knew he was getting CIA funds but many of the researchers he paid probably didn’t know who they were working for. We also know the co-founder of A Course in Miracles, William Thetford at Cornell, had been doing such work for the CIA since 1954 but the other co-founder, Helen Schucman, was probably an unwitting dupe.

    The MKULTRA funded groups and individuals who may or may not have known who their bosses were included the founders of NLP and the Findhorn Foundation, the Merry Pranksters (who followed The Grateful Dead around distributing LSD), Ken Kesey who wrote One Flew Over the Cuckoo’s Nest and a very large proportion of 1960-70s ‘respectable’ psychologists in the US, UK and Canada (as well as less respectable ones like Harold Wolff and Ewen Cameron).

    The encounter therapy sessions run by Carl Rogers, Abraham Maslow and William Coulson that led to the break between the nuns of LA’s Sacred Heart of Mary convent and the Catholic hierarchy was MKULTRA funded, but it’s far from clear that anyone involved knew that.

    Most of my research has been into A Course in Miracles (ACIM) because I have relatives who have been sucked into it. I can provide references to the information I used and explain how I pulled it all together if you like, but there’s no single, simple summary. I’m quite satisfied that Thetford started ACIM as a ‘proof of concept’ that the Gittinger Personality Assessment System (PAS) could be ‘weaponised’ as a tool of mass ideological manipulation (Gittinger was the head psychologist for MKULTRA) but since the mid-80s when Thetford died ACIM has continued on with a life of its own without evidence of direct CIA involvement. Nonetheless its founding text and workbooks, which are still used by ACIM practitioners, were rooted firmly in the ideological manipulation methods pioneered by Thetford and his fellow MKULTRA subproject director David Saunders. Also the biographical details of Thetford and Schucman strongly suggest he manipulated her to the point of insanity using techniques developed by the CIA for breaking interrogation subjects and prompting enemy agents to defect (Thetford very likely worked on Projects Bluebird and/or Artichoke in the early-50s that pioneered what would eventually be the CIA’s KUBARK ‘enhanced interrogation’ techniques and were later folded into MKULTRA).

    If you want more references you should be a bit more specific about what you’re interested in and I’ll try to help. There’s a heck of a lot of material out there but other than Marks’ work it’s almost never collated into a coherent narrative. I spent years pulling together the ACIM stuff, some of which involved personal correspondence between myself and some of the earliest ACIM acolytes at the Foundation for Inner Peace.

  • They “work” best in the hands of shamans and trained facilitators. Psychiatrists are about the furthest from that existing on this planet (except for a very few).

    Charlie Manson and the CIA’s MKULTRA researchers come to mind (some of whom were psychiatrists, but not many). The Esalen Institute under Gregory Bateson and Margaret Mead was a major hub for MKULTRA’s psychedelic-assisted brainwashing research and several California-based New Age cults were MKULTRA spin-offs (e.g. NLP, A Course in Miracles).

    Unfortunately there’s already some clueless opportunists in California (where else?) who are using the religious exemption loophole to offer psychedelic therapy without proper training, or medical support and with only the sham New Age ritualism you’d expect in the Eureka state in the place of centuries old shamanistic traditions.

    They’ve already killed a couple of people with convulsion and blood pressure related side-effects. Participants are expected to sign a long, complex form saying they don’t have any of a list of pre-extant conditions and waiving their right to civil redress if things go wrong, but last I heard they were presenting it as a technical formality and encouraging people to sign without thinking about it. The on-site guides have no formal medical training that would qualify them to recognise a medical emergency and in at least one fatal case they delayed calling an ambulance for fear of ‘bumming out’ the other paying participants.

    OTOH, the Synthesis Institute in the Netherlands, while a bit hippy-drippy, take the medical side of it very seriously, both in carefully screening participants and having properly trained emergency medics to hand.

    I suspect groups like the one in California will be used to justify the sort of expensive and mostly ineffective regulatory hurdles that will ensure only large, greedy corporations will be offering legal psychedelic therapy to the worried well (and well-off) in the US while an illegal underground scene will meet the excess demand without having proper access to medically trained backup.

    It’s not just shrinks who are the problem. It’s the entire top-down, profit-driven health system you have over there.

  • 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.

  • I’m not suggesting you’re not committed to journalistic ‘balance’. Just that if MIA readers want to check out this sort of stuff there’s sites like the NYT, NAMI or the Treatment Advocacy Center that can keep them filled in. When I click on an MIA link I’ve come to expect a viewpoint that isn’t already being flogged by the mainstream media and corporate funded lobby groups so I guess I’m expressing my discomfort at having to adjust my expectations of late. It seems like a trend to me.

    Should we expect to soon see a blog reflecting E Fuller Torrey’s lived experience?

  • Definitely agree with that assessment.

    Maybe psychiatry reformers would like to consider abolition of forced psychiatry as a necessary step to avoid capture of its institutional ethics by authorities in the way the ethics of US psychology was captured by its association with CIA torture and mind control programs.

    I’m an abolitionist because I think enforcement of authoritarian norms is intrinsic to psychiatry, with patient care and community protection used to justify the primary function. I can imagine a caring profession that would fill the role of psychiatry without also having a social enforcement function, but it would look so different to psychiatry as we know it that calling it by the same name would be misleading.

  • The thrust of your argument assumes there are ‘appropriate’ forced treatments for those designated mentally ill. I don’t think you’ll have to go too deeply into this website to find strong arguments against that notion.

    I think it may be possible to identify groups of people who are statistically more likely to commit violent offences. For example, it seems irrefutable that men aged 18-35 who play contact sports and binge drink are at seriously increased risk of committing assaults and rapes. But before we round up the NFL and Largactil their asses it might be good to have a discussion as to whether there are less harmful and abusive ways to reduce that risk.

    As to the idea that having your body locked up indefinitely in a psychiatric hospital and your mind locked up indefinitely with drugs because of something you might do is preferable to serving a fixed sentence of incarceration for something you did do, perhaps you should ask the people who’ve been through it.

  • Yeah, I can see the ontological conflict here too. Thanks for opening my eyes to it l_e_cox.

    Not having an eternal, incorruptible self interwoven with my narrative memory leaves me free to see it as inherently fallible and subject to corruption and decay. If my memory was part of my soul that would be a grim and terrifying prospect.

    So that’s another reason someone might react quite badly to suggestions her memory is faulty and send death threats to academics who say so (I’m not suggesting anyone here would do that).

    So, to clarify my understanding. Would you see something like Alzheimer’s symptoms as part of a transient process that might be temporarily impairing your memory, but once you were free from your body all the lost memory would be restored? Or would it be more a matter of the decay of the brain and body preventing the pure incorruptible energy structure from communicating properly with our plane of existence?

    And what about the fidelity of the recording? If I’m experiencing hallucinations I perceive as real are they recorded onto the energy structure as reality?

  • So, I’m not entirely content with the thought that “if something bad happened to you, you would *always* remember it very vividly.

    I don’t think anyone is trying to deny that amnesia is real or that it can be induced by traumatic experience. The question is how reliable the memories ‘recovered’ after extended amnesia are.

    False memories are definitely real and can be induced in a reliable and replicable way. When ‘recovered’ memories have been put to the test they’ve often failed to match independently verifiable facts. But so too have ‘regular’ memories.

  • “Can you explain how you understand memory?”

    Probably not short of writing a book.

    It’s been a preoccupation of mine for a while and I don’t think there’s a simple answer. There’s narrative memory and body memory and emotional memory and Pavlovian reflexes and … There’s short term memory and long term memory and the memories of accidents you hold in your bones. And I don’t think using the sorts of metaphors that see brain cells as computer chips used to store data is very helpful. In fact I don’t think ‘memory’ – the noun – is anywhere near as useful as ‘remembering’ – the verb – and I don’t think trying to divide human memory up into ‘record’ and ‘playback’ functions works either. Data is no more memory than it is knowledge or wisdom.

    For the sake of this discussion I’m talking about narrative memory and while I’m confident there’s aspects of it that rely on neurological functions I think it also exists in our environment and our societies. We may need ‘data’ which may or may not be encoded in neural ‘engrams’ but to create the story of part of our life we construct it from many other inputs and cues as well. Then we contextualise it according to our current beliefs and values. So the memory of the monster under your bed when you were four becomes a memory of being frightened by noises and shadows and may come to include the memory of your mother coming to comfort you when that never happened, though perhaps she did on a different night for a different reason.

    And maybe the shot wasn’t fired within sight of the bank customer, but the peculiar vividness of the memory of his “mind’s eye” when he was shocked by the sound is what caused him to confidently misidentify the shooter.

    Speaking personally, as someone who often has cause to revisit something I read or wrote long ago, I frequently discover that what seemed solid memories to me were completely wrong. Often my ‘clear memories’ of papers I wrote include things I didn’t learn about until after I wrote them.

    We’re constantly dredging up fragments of old narrative memories and rewriting them. This seems to be part of the function of dreaming and may be necessary to preserve them in the face of inevitable decay. You’re only going to remember so much, so your mind rehashes the ‘important’ bits.

    So narrative memory isn’t like a computer drive or videotape or novel. Your story of you is a constantly revised work in progress that uses loads of heuristic tricks to compensate for its gaps and errors. It’s ‘stored’ in your brain and your body and your community and your environment, whether or not you consciously use memory cues such as diaries or photo albums. And it only really exists in the act of remembering. Everything leaves traces, from the decay of a carbon atom to a footprint on a beach to the genes copied (imperfectly) from your ancestors. Only remembering can turn those traces into memories.

  • Memory is delicate. It can be damaged by trauma, drugs, alcohol, disease, stress, malnutrition, injury, bias, propaganda …

    There are various mechanisms whereby damaged memory is ‘repaired’. Some are individual, others are social (e.g. the accounts your family members give about events you’ve forgotten or what your friends tell you about your behaviour at the party) and that can become interwoven with narrative memory and indistinguishable from it. That’s why it’s so easy to mess with memory formation and why sworn eyewitness testimony of shocking events is so often unreliable and contradictory, especially if you subject witnesses to leading questions or police ‘help’ them to ‘clarify’ their statements.

    The abuse hysterias and DNA exonerations of the wrongfully convicted since the 80s have forced legal systems to confront that (a bit) and so the courts have become battlegrounds between conflicting notions of what memory is. Loftus has been caught up in that and so has become the target of vilification, death threats and defamatory imputations in articles such as this. I find that regrettable.

    The problem is that we’re encouraged to see narrative memories as at least partial records of events rather than constructions we use to tell our stories to ourselves and others. And we’re encouraged to identify with those stories to demonstrate that we’re ‘honest’ and ‘authentic’. So to question the accuracy of someone’s memory is to attack their social and individual identity. It’s likely to generate more heat than light.

  • The false memory syndrome stands in direct scientific opposition to the wealth of evidence supporting dissociative amnesia—a psychological defense mechanism which, according to trauma therapists, enables people to split off painful events from conscious awareness for years. Are these empirical studies, which date back to the late 19th century, in fact flimsy, as the proponents of the false memory syndrome maintain?

    I think it would be good to make clear that whatever the studies dating back to the 19th century might say, plenty of studies since the 1940s have demonstrated that narrative memory isn’t some kind of static storage mechanism like books in a library. It’s something that’s recalled, recontextualised, edited and replaced. You do not have memories of yourself as a young child. You have memories of you ‘remembering’ yourself as a young child, which actually refer to earlier memories of you ‘remembering’ yourself, etc. Memories are constructed and reconstructed. The potential for Chinese whisper effects is obvious.

    We also know it’s more than possible to plant false memories with therapy. It’s quite easy in fact, as Pickrell and Loftus famously demonstrated with their ‘Bugs Bunny in Disneyland’ study. It’s so easy it could probably be done by accident. Unlike many famous and widely accepted psychological studies, the work of Pickrell and Loftus has been well replicated, so the implicit suggestion in this article that Loftus is some kind of crackpot outlier when it comes to memory studies doesn’t stand up.

    And we know that the Satanic ritual abuse hysteria and daycare abuse hysteria of the 80s and 90s saw many ‘recovered memories’ in both children and adults of impossible things, such as demonic manifestations and events in ‘hidden cellars’ that could never have existed.

    Whether or not dissociative amnesia is real has no bearing on whether false memories are real. Just because people forget things due to trauma doesn’t make the ‘recovered’ memories of the trauma real. The missing piece of narrative memory might provide an ideal blank slate onto which a false memory can be projected.

    That’s not to say I think all recovered memory is false. But I think it takes a huge leap of faith, unsupported by any evidence cited in the article, to assume that all or most of it is true either. And we can be confident that with a bit of suggestion people can easily form false memories that they experience as real. We all probably do it.

  • BTW, there’s an element of circularity in this. Sort of psychiatry eating its own tail.

    Bipolar II was posited largely in response to the fact that ‘depressed’ people prescribed ‘antidepressants’ often developed manic or psychotic symptoms. Of course it couldn’t be that the medicines were causing a disease, so the shrinks explained that these weren’t real depression patients at all. They were in fact bipolar patients who were quite happy with their upswings but seeking treatment for their downswings. In treating the depressive symptoms the pills were unmasking the untreated manic symptoms. They weren’t causing bipolar, they were revealing it. Any initial misdiagnosis was the patient’s fault for not speaking up about their hypomania.

    But even with the new diagnosis psychiatrists just couldn’t resist prescribing antidepressants to their bipolar II patients. The drug reps and key opinion leaders say such nice things about them …

    So people like Ghaemi, who take the diagnoses seriously and believe in ‘evidence based’ therapies for them, find themselves in opposition to the mainstream practices of their profession.

    Oh what a tangled web we weave …

  • I think we’re in furious agreement about the root of the problem. As with so many issues of dignity and survival, the corruption and inhuman rapaciousness of our own institutions are what we’re really fighting here.

    I guess my point was mainly against letting ideological purity stop us from finding allies and ammo where we can. There’ll be a lot more battles before the end of the war is in sight.

    Ghaemi has long fought to end some of the most harmful prescribing practices those with bipolar diagnoses are subjected to. I don’t have to agree with him about the validity of the diagnosis to know I’m on his side.

  • Yeah, sure, the whole notion of mental illness and diagnosis is f*ed up, abusive and oppressive. I think we all get that. And it’s something that needs addressing. But we’re not going to see it fixed tomorrow.

    In the meantime there is research like this being published from within the f*ed up paradigm of mental illness that can be used to argue against coercive and abusive drugging of people today, if we don’t just hold up our “no such thing as mental illness” crucifix and try to banish it. The organisation I work for is always looking for stuff like this to use in the cases we take before the NSW Mental Health Review Tribunal and the courts in attempting to get forced medication Community Treatment Orders lifted and get people released from psychiatric detention. We’re doing that here and now. Not in some future utopia where everyone understands mental illness is a myth and always uses the ‘correct’ terms when referring to abuse and suffering.

    Sure it would give me a smug sense of righteousness in speaking truth to power to stand before the MHRT panel and say “This person shouldn’t be forced to take drugs for her mental illness because there is no such thing as mental illness.”, but I don’t think that’s going to help anyone.

    If you want to argue against medical authorities about coerced psychiatric treatment – either on your own behalf or on behalf of someone else – you’d best adapt your communication to their epistemological framework, because you can be pretty damned sure they aren’t going to adjust theirs to engage with you.

  • I think we’ve all drawn attention to it plenty of times, including me.

    Maybe we should stop obsessing over the branding and pay more attention to the product. As history tells us, when the labels get dirty the shrinks just make new ones.

    When the idea was to pack more distressed people into loony bins neuroleptics were ‘major tranquilisers’ to keep things calm. When the bins had to be emptied and their contents dumped onto the streets they became ‘antipsychotics’ to ‘cure’ those we still designate as human trash, regardless of the currently fashionable pseudo-scientific euphemism we’re papering over the attitude with.

    Abolish ‘depression’ and ‘antidepressants’ will get a new label to be inflicted onto the same people as something else. And we’re back to square one.

    What Ghaemi is telling us here is that even within the epistemological and procedural framework of mainstream psychiatric research there is no justification for current clinical practice. We can use that. If it means less people are having the pills inflicted upon them then I don’t really care what the labels on the bottle or the person say.

  • Why is it their label?
    Because they coined it?
    Why would I accept their authority as language enforcers when I don’t accept it as scientists or medical practitioners?

    English doesn’t have an Academy. It’s defined by its usage. If enough people use ‘bipolar’ outside any pretensions of medical diagnosis it will cease to be seen as such a term.

    It’s not a disease or disorder. It’s arguably not an impairment; at least for some. But it is a disability because of society’s (particularly the medical profession’s) insistence that it should be. And by leaving the label with professionals who’ll pretend it’s objective and scientific you’re denying everyone else the right to engage with it on their own terms.

    I’m not disabled with bipolar because of mood swings or psychotic breaks or any of the other symptoms on the checklist. I’m disabled because our society no longer tolerates how I present as being within acceptable variation. In the 80s and 90s I was enabled by my bipolar and Asperger’s because the IT industry thought some of my ‘symptoms’ valuable enough to put up with the others and hand me big pay cheques for them.

    It’s not labels like ‘bipolar’ or ‘autistic’ or ‘hysterical’ that are the problem. It’s the attitude people have towards what they think they represent. By leaving the labels as professional jargon you’re not only denying people with lived experience under the label the right to define it as they see it, you’re giving everyone else an out when it comes to their own attitudes towards it.

  • That said, I kind of do have a problem with psychiatric labels, truth be told.

    But so do shrinks. They need to keep changing their meanings, making up new ones and ditching the old ones they’ve worn out.

    It’s not hard to reclaim a term like ‘nerves’ (neurasthenia) from them and give it to the community to use to reconnect with us crazies instead of leaving it to ‘experts’ to sew psychobabble straight jackets for us.

    And let’s face it oldhead, if consumer culture is allowed to control our language it’s gonna be inherently abusive no matter what words are being used. Same if we let it control our social interactions or eco-systems. But those are separate (huge) battles. I don’t see why we shouldn’t go for tactical victories while we gird ourselves for the strategic ones. Good for community building and morale I reckon.

    If I’m gonna get abused I’d rather get it straight from my neighbours than by proxy via a pseudo-scientific ‘objectification’ of someone’s subjective judgement.

  • I dunno if I consider myself reclaiming rather than just claiming it, so the question of prior usage doesn’t come up.

    But it seems personally empowering to me and it’s hard to see how it wouldn’t be to strategic advantage to have a lot more people not feeling disabled by the names people call them, no matter how quickly they adapt them to acceptable euphemisms. (There’s a scene in The Curious Incident of the Dog in the Night-time in which the ‘autistic’ child protagonist is followed down the street by bullies chanting “Special needs! Special needs!” It works because kids know what insults are and don’t need to pretend.)

    If you want to call me bipolar, fine. I’ll accept that. You’ve just made me the expert. You theorise about bipolar. I live it. Now I’m going to tell you a fucking thing or two about it.

    Why accept their authority to define the labels you wear with pride?

  • Well I am a black person with mental illness labels, so I figure I’m allowed to call myself that. Though as an Australian black person I’m more likely to call myself (and my Aboriginal friends and family members) ‘boong’ than ‘nigger’.

    And I have no problems at all with people calling me ‘autie’ or ‘bipolar’ – which I also call myself. I get far more pissed off with real haters who thinly veil their contempt with PC euphemisms than with normal people applying the words they’ve been taught to use but which have been deemed inappropriate by some.

    A lot of today’s ‘hate speech’ was yesterday’s ‘correct’ terminology and frankly I can’t be bothered keeping up with the fashions.

    If someone is trying to beat me about the head with a word I just take it off them and use it as I see fit.

  • “a girl from Cabramatta??”

    Nah. But I get that a lot. Here’s the explanation.

    “If ego death is a “curative” factor for some using psilocybin (and other entheogens) might there be a non-drug way of achieving this? ”

    Yes there is, but in my experience the states that bring it about are difficult to predict and maintain. They’re generally very beautiful and rewarding in their own right, but I can’t see how they’d be applied ‘therapeutically’ to a specific task. Nor do I feel it would be appropriate to attempt to do so.

    The drugs take care of the altered state for me, freeing me to explore it in a semi-volitional manner. (I’m using language here, which is inherently dualistic and egoistic. I hope you can get around words like ‘I’, ‘me’, ‘attempt’ and ‘volitional’ to what I’m trying to say.)

    I’m kinda down on Descartes too, though in my ignorance of Latin I often wonder if ‘cogito ergo sum’ begs the question a little less than ‘I think therefore I am’. But while I agree that linguistic and social conventions reinforce the ego construct I don’t think they cause it, but rather it causes them. IMHO the ego is implied within the fundamental dualism of subject-object and that precedes both language and society.

    Schopenhauer was influenced by the anatta of Buddhism and Hinduism’s Tat tvam asi. (I reckon the no-self of Buddhism and the Self=Brahman of Hinduism are the same non-dual thing, though a well known Buddhist scholar has tried hard to disavow me of that notion.) Western philosophers are johnny-come-latelies when it comes to egolessness. And it’s not like you can say much about it. Neti neti …

  • Incisive yet again oldhead.

    But the alternative path is to seize the labels from the quacks and wear them with pride, as other communities suffering bigotry have done with words like ‘queer’ and ‘nigger’. Of course you’ve got to start by owning them. As in “I am not a person afflicted with bipolar disorder. I’m bipolar. It’s part of me.”

    And the fact is, no serious deviance from the accepted consumerist mean is ever accepted in production line capitalist culture. Unless you toe the line and drink the Kool Aid they’ll just find a new label to beat you about with. That’s why you should always gush over reality TV shows that promote consumerism as mental health therapy.

  • You’re right that the cops are the big danger. Just laughing at them can be ‘threatening behaviour’ and things can go downhill fast from there.

    And you’re spot on with setting too. I won’t go into the details online but the participant is expected to have a big input into co-developing a safe space, both physically and in terms of personal boundaries. That’s especially the case after the low dose ‘test run’. If we don’t feel relaxed and safe in each other’s presence in a co-designed safe space then we don’t go ahead unless/until we both feel that way. ‘Safe space’ has always been an important part of how I deal with my own extreme states so I try to be sensitive to the need in others and the various concepts of how it’s ‘constructed’.

    And I dunno about you oldhead, but my impression of apparent ego death in both myself and people I think I’ve been with in such states is that it’s usually existentially terrifying the first time (or few times), regardless of the space. The difference with a truly safe space it that it’s easier to push through that without it spiraling out of control from negative sensory and emotional feedback.

    Yeah, I’d allow that certain prior experiences – whether spontaneous or the result of some kind of practice – would prepare some people for it. But the fact ego death isn’t physical death is irrelevant at the time. Your ego is where your existential fear of death lives. It’s what you think ‘you’ are until the concept of ‘you’ goes away. And yeah, loads of people think they’ve overcome that but speaking from personal experience, not all of them are right. Not the first time at least.

    So unless I’m with some kind of spiritual adept or experienced psychonaut or someone with a long history of learning to deal with extreme states then I’m gonna assume that coming to the peak of an ego-trashing trip is gonna scare the bejesus out of them at first – especially if you use a substance or dosing method that brings it on fast. I don’t *think* my own expectations and prejudices pre-configure those observations; but I wouldn’t, would I?

    And that’s the bit where the rubber hits the road. The most important part of my function in this is to get them through that without something happening that imperils either of us physically, psychologically or legally. It’s not necessarily to calm them down or reduce their distress. Depending on prior arrangement and my own gut I might even be encouraging them to go deeper into their fears. But if there’s behavior (or volumes) that are going to breach our agreements regarding mutually safe space then I have to be ready to deal with that. And I need to be mindful of safety, ethics and trust when I do.

    It’s generally only the first hour or so that you need to worry about that sort of thing, but some people get flashes of paranoia through most of the trip too. If that happens at low dose it contraindicates a high one, IMHO, though I wouldn’t rule out being convinced that someone had learned to deal with it.

    And yeah, it occurs to me that the experience of traumatic entry into the boundless could be a mythic one, configured by our stories of death followed by purified rebirth. And that maybe if we could find something else to viscerally believe in – or not – we could change our myths into something less traumatic or somehow let go of them entirely. But I think that’s beyond my pay grade.

  • “It is not necessary to have a guide once one is familiar with the new psychic dimensions opened up by the psychedelic agent.”

    Agreed. But most of the people I work with have never experienced high dose psychedelics before and, as I’m sure you’re aware, the first time your ego shrivels and dies can be very traumatic. You need someone you trust and have developed rapport with to help you through that.

    The biggest single danger with this is that someone will lose it on the way up to the peak and trigger a police response.

    And I’m quick to dissuade anyone who starts treating me as a guru, in psychedelics or any other arena. I leave that sort of thing to Charlie and the shrinks.

  • “The data indicated that 54% of those receiving the treatment remitted (no longer met the criteria for depression after four weeks). Still, there was no placebo-controlled group to which the results could be compared. The placebo response rate for depression is usually estimated as falling between 40% and 50%, but some studies have found placebo responses as high as 70%.”

    Yeah, but check out the change in HAM-D scores for those who’ve had psychedelic treatment for depression compared to those for antidepressants or placebos. It’s chalk and cheese.

  • I agree psychedelic ‘therapy’ isn’t a medical intervention. But neither is psychiatry, though it purports to be. And yeah, testimony is anecdote, not data. I’m speaking of my own experience here, not making universalised claims about efficacy. Maybe I’ve just been lucky.

    But I’d also assert that few of the problems people receive psychiatric treatment for are medical. They’re mostly social but often have a large spiritual dimension too, so ritual interventions are probably more appropriate than medical ones in many cases.

    The Synthesis Institute in the Netherlands calls its psychedelic interventions ‘ceremonies’. I call mine ‘sessions’, not therapy. I definitely *don’t* call myself a therapist, counselor, coach or shaman. I’m just someone with extensive experience of being with people who are tripping.

    And I’m sorry to hear about your son. I take as much medical, family and personal history as possible before agreeing to a session – particularly legal and illegal drug use – and reserve the right to refuse if I see any red flags or if it just feels wrong. I start with a low dose test session to see how someone will react but also to give them a better idea of what it’s about before deciding on a high dose session. I also check BP prior to a session because of the hypertensive risks. And because I’m not a professional and don’t see what I’m doing as a commercial service I don’t accept payment. But I’m still not entirely comfortable with the risks of what I do, especially the legal ones. NSW police regularly kill people who are under the influence of psychedelics.

    I think there’s ethical questions about representing this as therapy but, as Sami Timimi recently pointed out, psychiatry is more closely aligned with the pseudo-religious ideology of scientism than with medical science and that’s resulted in a society that thinks misnamed ‘therapy’ is the only legitimate way to address many kinds of life crises.

    I sincerely think the risk:benefit equations of guided psychedelic sessions are significantly better than those of psychiatric ‘therapies’ for many of those problems, even in jurisdictions that haven’t legalised or decriminalised them.

  • Firstly it’s dose related. The ‘therapeutic’ dose is meant to bring about mystical experiences and/or ego death and is much higher than a usual recreational dose. Due to emetic chemicals in mushrooms a lot of people will have trouble holding down enough of them to get that sort of dose. In clinical trials the psilocybin is purified or synthesised so you don’t get that problem. You can also moderate the problem by thoroughly drying the shrooms before use; at least if you’re using psilocybe cubensis (gold top) shrooms.

    Secondly there’s quite a few things that can moderate the effect due to competition with the 5HT-2A receptors the psychedelic chemicals act upon. These include cannabis and, ironically, antidepressants. So unless they withdraw from their pills first a lot of the people going for these therapies are going to get a reduced effect.

    Also, psychedelics produce instant tolerance. If you take a mind bending quantity of shrooms or acid then take a similar dose the next day you will get very little effect. It takes 2-3 weeks for tolerance to get back to normal levels.

    And the people doing this ‘therapeutically’ are aware of the importance of setting. It’s not done in a normal lab or office but something set up more like a chill room at a rave. Often the subject is lying down in an eye-mask and headphones listening to music meant to help set the atmosphere.

    The ‘therapy’ consists of preparation, which helps the subject approach the trip in a constructive, open manner (often involves learning meditation/relaxation techniques and how to ’embody’ emotional experiences), guiding/sitting during the trip to help them through difficult parts (ego death is often existentially terrifying), and post-trip integration. A strong trip brings about experiences so far outside most people’s prior experience it’s generally impossible to express in words (ineffable) and can’t be incorporated into narrative memory, so it slips away like a dream. Integration is meant to ‘fix’ the insights gained during a trip so they can inform later work the subject does on their issue, whether emotional, psychological, social or spiritual.

    It’s not the chemical that does the job. What it does is temporarily knock down your ego defences that can be keeping you locked in a self-defeating mindset. Having hopefully seen through whatever thought patterns are sabotaging her the subject can then, hopefully, ‘cure’ herself. That’s why you don’t need to keep taking it as with psychiatric drugs. One or two experiences will generally be enough for years or a lifetime. Nor do you generally need long term follow-up therapy. A few post-trip integration sessions suffice.

    And as oldhead points out, people are hyper-suggestive when their ego defences are down and subject to manipulation, though as the CIA discovered during MKULTRA research, it can be difficult to manipulate them in a predictable way. So unethical or ignorant practitioners can do a lot of harm with this sort of stuff.

    And no, what I know about this isn’t just theoretical. I can testify to its effectiveness personally and from the feedback of those I’ve guided. Mostly I’ve used it in addiction work (nicotine and alcohol) but I’ve also seen excellent results in people suffering trauma related anxiety. I also use it with people experiencing spiritual crises or blockages, with more mixed results. The insights gained during a trip can be incompatible with some spiritual outlooks and bring about a crisis of faith, though many people consider their first high-dose trip to be the most spiritually significant event of their lives (even if they’re atheists).

  • If your spiritual journey ever takes you past Buddhism maybe you should check out anatta.

    I’ve found letting go of concepts like the “real me” or ‘being myself’ has made me far more accepting of my emotional swings. It’s all just life. Grist for the mill. Dukkha, as the Buddha put it.

    Ditching the value judgements of my own emotions has meant I don’t get the existential despair and suicidality that came with the down swings anymore. Or the grandiosity of the ups.

    Of course letting go of the ‘self’ also means letting go of notions like “I am an empath”. But hey, who needs labels, right?

    And if you want to get an intellectual handle on anatta it’s probably better to skip Tibetan Buddhism and try Theravada or Zen. The Tibetans don’t really do anatta. Lamaism and all that.

    But intellectual grasping of anatta barely scratches the surface. It’s no more helpful than having an intellectual understanding of how to play the piano. Actually getting it takes practice, practice, practice; though very large doses of psychedelics can give you a peek at how it looks (not recommended for people prone to psychosis who aren’t accepting of that state).

    BTW, I don’t consider myself a Buddhist but I’ve found many of its ideas and practices quite helpful.

  • So there’s at least two levels of selection going on here.

    One is that you only had access to (or even knew about) the participants who went to air. Presumably the ones who had less patience than Mr Reddy with any abuse they suffered would have refused to co-operate with the crew and the episode wouldn’t have been completed. I’d be surprised if the producers would have aired any completed programs that hinted at negative outcomes either.

    The second was the self-selection of those who responded. I’d imagine that those who resented their treatment might have been less willing to speak to someone they thought might be writing a puff piece on the program. And, to take one example, how you quote Ms Castellucci’s homage to Karamo as some kind of saviour figure immediately after Mr Mixon’s statement that he thought the show was specifically (and misleadingly?) edited to create that impression (i.e. tending to invalidate his critique) makes it pretty clear this is a puff piece. You even titled your article from Ms Castellucci’s panegyric.

    I have no doubt you’re correct when you say this is ‘good TV’ (albeit the oxymoronic nature of that term). But I don’t think you’re in a position to say it’s good therapy. Or good ethics.

  • “This is why I addressed up front my own skeptical questioning of tidy narratives”

    I can see in the article where you question whether the format is cliched, but I see no questioning as to whether it’s abusive.

    I’ll tell you what is cliche about it. A reality TV program gaining ‘consent’ from vulnerable people then subjecting them to televised abuse in the quest for ratings and advertising dollars while pretending to be motivated by a desire to help them. Many exhibits in these human zoos have later told of how their lives were ruined by the experience. Some have committed suicide.

    I can see how Bob may be right when he says your article honours the experience of *some* of the people who were on the show. But I’d sure like to know how those particular participants were selected.

  • “So what the story does is this: It asks people who consented to being on the show what it was like for them (and they could have said it was horrible, but they did not,)”

    My first question would be how did you get the contact details for these people? Were they selected for you by the show’s producers? Did you ask what happens if someone withdraws consent when they realise what they’re up for? Did you ask if you could interview some of the latter?

    Imagine this. Someone is walking down the street when they’re suddenly accosted by a group of strange men. They try to run away but to no avail. They’re caught by the gang and repeatedly touched despite their protests. The laughing group responds with statements like “You don’t like being touched?” and “I can tell you don’t take a compliment well”, while continuing to touch them. The whole thing is recorded by the group and later publicised for the entertainment of others.

    Now imagine that person is your daughter. Does it still sound alright to you?

    We’re told the targets give their consent.
    We’re told nothing is staged.
    We’re told Mr Reddy tries to escape and voices clear objections to how he is being treated.
    Is it just me who can’t make that add up?
    There’s people serving long prison sentences for refusing to honour withdrawal of consent.

  • So an exploitative, commercial reality TV program barges into your life at the behest of your ‘friends’ and/or family an starts inflicting its ‘therapy’ on you regardless of your objections until, under the glare of camera lights, you finally ‘consent’. I wonder how much tape doesn’t get to air because the ‘hero’ maintains righteous outrage at the media invasion of his/her privacy and refuses to be ‘fixed’. I wonder how many respond with justified hostility and aggression, prompting the crew to call cops or mental health teams on them. I wonder what a 12 month follow up of the ‘successes’ would show as they try to maintain the expensive inner city hipster lifestyles prescribed for them.

    There’s a possible viewer response other than “Cue happy tears”, Amy.
    Utter disgust.

  • “That the relationship between self-concealment and suicidality is ‘partially explained by unmet personal needs in a non-clinical sample of young adults'” sounds reasonable to me, especially if you consider the links between bullying and youth suicidality and how that might effect capacity to reveal inner turmoil and seek support. But I’d guess there’s causal relationships in both directions.

    Revealing suicidality is stigmatising and likely to result in disempowerment and unwanted (and potentially harmful) medical attention. You can make a lot of rights disappear with the magic words “danger to oneself”. School children are under increasing surveillance for ‘signs’ of suicidality and mental illness (Hogge and Blankenship may have some experience of this). By and large they aren’t stupid. It would be a bit surprising if a lot of them aren’t concealing needs and feelings that might be interpreted as symptoms of something.

  • I find this review encouraging.

    I suspect we’re seeing a response to the steadily increasing outcry against gamed RCTs in which trials aren’t pre-registered and drug companies farm out a large number of small trials; relying on publication bias to ensure the ones that find their way into journals are the ones that are ‘successful’ purely by chance. Then a meta-analysis comes along, only finds the ‘successful’ ones, lumps them all together and viola, p<0.05; a significant positive result.

    These days meta-analysts are doing more checking for publication bias (e.g. scattergram the effect size on X, the sample size on Y and if your Bell curve is truncated on the left you've got biased data) and the old tricks are fooling fewer people. So now we're seeing larger studies with weaker results.

    We've still got a long way to go before the reputation of RCTs is rehabilitated but it's a start.

  • From what I have read it’s psycho-state is far worse than ours.

    There’s swings and roundabouts.

    On one hand we don’t have insurance plan driven hospitalisation that provides incentives to keep someone locked up until their coverage expires, so by and large, forced hospital stays tend to be shorter if you haven’t been accused of a criminal offence.

    On the other hand, here in NSW (where Woy Woy is) the usual mantra for tossing you into a loony bin – “danger to oneself or others” – is deliberately left undefined in legislation, with guidelines suggesting it includes danger to your finances, reputation or relationships.

    For a colleague with a bipolar diagnosis what this meant is that when he was feeling energetic, buoyant and chatty and wanted to go out and talk to people, but his mother was afraid he’d embarrass himself and the family unless he stayed home until he was mordant, fatigued and almost mute again, she called his former psychiatrist. As a result he was handcuffed and bundled into the back of a police wagon on the main street of his small town right out front of the store where he bought his groceries in full view of friends, neighbours and acquaintances. He spent the following weeks in a locked ward many miles from home without his closest friends knowing where he was.

    That’s how the NSW Mental Health Act protects the reputation and relationships of those with a mental illness label.

  • Hi Anthony.

    Like you I’m a voice hearer from Woy Woy (are you related to my WWH class of ’79 classmate Neil Murray?).
    Like you I’m interested in Buddhism and am very skeptical of Scientology.
    I’m also a member of a Sydney based social justice activist group that specialises in trying to address the human rights abuses perpetrated under the Australian mental health system.

    If you want to contact me to open a dialogue leave a comment on my blog (about anything you like – ‘Hi’ will do). That will give me your email address and I’ll be in touch.