Wednesday, October 27, 2021

Comments by evan1

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  • Ruined and pissed,

    I relate to or have related to much of what you say. I’m so sorry it hurts so bad. I feel it, and these are what got me through. I’m not saying it will get anyone else through, but it’s all I can do. Maybe with special emphasis on my clinical nutrition part, which isn’t restricted to nutrients. My email is there if you have any questions. Much love to you, if that’s ok.

  • Maria,

    Very interesting on many levels, thank you.

    I want to say that I generally think it’s not an ideal form to make a grandiose ‘You’ or ‘population’ of citizens as patients-clients, especially given the fluctuation and diversity. I understand it’s part of professional identity, and I feel your goodwill and struggle. The message certainly seems great to me in many ways, the attention on these issues being important.

    Part of the difficulty is not just in the ‘politics of professionalism’, but professionalism, the service-business itself, and ‘service-provider’. I admit I’m still trying to reckon with this. In a sense, there needs to be more politics FOR or ABOUT professionalism.

    I personally reject the word ‘patient’ except in rare circumstances or usually for the convenience of providers/staff in a service-business, insurance, etc. I find many people understand why, like my psychologist who has moved from the habit of ‘patient’ to ‘client’ or the county mental health services director who moved from ‘consumer’ to ‘client’, each based off my comments. Then there’s the insurance customer service, receptionist, or billing manager who asks ‘what is the patient’s name’ (I’m pretty sure I already said ‘I’ wanted ‘my’ medical records, so it is my name, not ‘the’; or ‘are you the patient’: I say, ‘yes, I am the client’, haha, but underneath I know that the client-ification and systems-language should really be transcended whenever possible, too. Not always, but whenever possible. In this way, one may relinquish some ‘power’, but another may gain it. This is what you have been doing in many ways, and I like that.

    I spoke with a Bradford agent yesterday. We didn’t know if a person I was calling about had entered their ‘system’, and she almost said ‘what is the patient’s name?’, but she hesitated. I said, ‘oh my friend? The person’s name is…..’. Apparently it didn’t even matter unless I gave her my friend’s birthdate anyways.

    I have found both positives and negatives in Dr. Humphrey’s Osmond’s book on Models of Madness, Models of Medicine about the physician’s or doctor’s Aesculapian authority and designation of the sick-role (and patient-role). Ivan Illich in Medical Nemesis has important supplementary and counter arguments to Osmond’s preferences and purposes (which have spread far beyond the classic physician). All terribly complicated.

  • Paula followed-through or followed-up with me and showed support and compassion, while pointing to the many doors and galleries of substance she created or hoped to create. I wish I could have interacted with her more. Hopefully, her website will stay up, along with all the YouTube content, etc.

    Thank you for the article.

  • Astra,

    Thank you for your comment, I liked reading it. I think and feel that last question is very important for many people, including me, although I find I can make a difference within and without as I go along, if possible.

    These are some of my contributions to life/suffering, art/science, and wellness/struggle:

    I’m still trying to find completion (and more income), although I find Ivan Illich’s notion of ‘useful unemployment’ to be relevant and inspiring. I am not always unemployed, but even with part-time work, this idea is meaningful to me. I actually find his works extremely relevant to the ongoing crises the world and many, perhaps most, individuals are facing.

  • Ruyi,

    I’m very sorry you have been dealing with all that. I don’t normally offer my website here, but I do talk about my experiences with olanzapine and many other related issues (see below). I am not pressing you to read it, but I was on olanzapine off and on many years, with many similar issues that you’ve mentioned. It often seems like ‘THEY’ prefer that you ‘jump through hoops and turn around in circles’ to stay on the ‘antipsychotic’.

    I discuss why I ‘preferred’ Saphris when I switched from olanzapine, and what it was like, etc. I am now off Saphris (no major tranquilizer whatsoever for 2.5 months), and there are quite specific reasons for this (both ‘being able’ and self-chosen), and I discuss a few reasons how I’ve done this although there are newer developments as well. My email is there if you’d like to discuss more. I am carefully yet optimistically determined to move forward without any major tranquilizers in my life ever again, as well as other people’s attitudes and pressure that I need to and must use them. However, there are layers, levels, and spectrums of things to do even when life seems to ‘require’ them.

    We do what we can do, if/when/how we can. Peace out:

  • Ruyi,

    The same thing happened to me in California but with seroquel. I think I said/complained that it ‘didn’t work/help’ so they gave me another. Pretty sure they were horse pills (meaning large tablets). I didn’t sleep that night, for many a ‘good’ reason.

    After a nurse in the presence of a second took off my shoes without asking and essentially tried to ‘put me to bed’ virtually without a word spoken. I realized the mattress was deeply dipping down like it hadn’t been replaced in 2 decades. I requested another room, and they put me in one with what seemed to be a raised hard wood structure with the equivalent of an adult-sized child’s nap time ‘mat’ on it. Or maybe two of those, but no more. It didn’t help that there was a camera in the top ceiling corner, whether functioning or not. What a racket.

  • Lametamor,

    I’d probably reword/analyze my comment on victims not being the only ones working on this. Your emphasis was on the publicity and solidarity of certain social groups (previously marginalized but gaining political power and recognition). Reminds me of how homosexuals and non-‘traditional’ sexual orientation and gender identity have quite an oppressive history in psychiatry. Much progress, much more needed.

    It is interesting to me when different marginalized, minority, or otherwise civil rights/liberties groups could team up to strengthen political change and social realization. Sometimes our identities and niches both empower and divide agendas, including within single individuals.

  • Lametamor,

    Largely agreed. This is one reason, as you hint at, why political and legal solutions will be (have been) needed as well, in all their breadth and depth. Unfortunately, many politicians are often last to either know or do something, especially since ‘they’ so often must act as a group or sub-groups. But to the extent that participatory democracy is real, the attitudes and acts of citizens should ‘trickle up’ or be installed in political positions. As always, individual acts and attitudes are still required. I believe there are more than the ‘victims’ working on this, and there are also ‘friends in high places’, all not necessarily mutually exclusive. Often, even those that are not hardcore victims are victimized or at least good listeners and connect a few dots. One thing about criminal injustice systems and mental hell systems (and politics!): overall, they must abide by ‘the law’ — not only the laws they are accustomed to manipulating, but the laws which could make ‘them’ imprisoned, unemployed, or bankrupt….new laws, stricken old laws, or simply understanding and enforcement of existing laws — especially when citizens know how, and do, use their rights and liberties. Or something like this.

    BTW: (Gentlemen?)

  • Dear Martin,

    We ‘all’ need to lift our game.

    Not every pill is a synthetic ‘psychiatric’ drug prescription, nor is every drug from a laboratory that directly or indirectly affects the mind inherently corrupt and valueless, including for the long-term and including for some who are not ‘severely ill [mental] patients’ (and therefore occasionally justified in using them, from what you’ve said).

    The production, advertising, and prescription of pharmaceuticals do not exclusively define, make completely irrelevant, nor corner the market on ‘biological’ psychiatry.

    Please, as I’ve said to another MiA author, stop reinforcing the cliche or stereotype of ‘madness’ by using the tired definition of ‘doing the same thing over and over again expecting different results’, just to describe/diagnose AND ridicule another person/system as ‘gone barking mad’. Not only is this not necessarily logically accurate, but it repeats a probably faulty prejudice while maintaining the faulty premise. Plus, it gives madness, in this case, that style of ol’ moon-howling madness (as luna-tic), a bad name, which isn’t a given and may depend on the context and the one who is perceiving and/or
    interpreting it.

    There is much I agree and resonate with in this article, but I don’t need to flesh out nor reiterate those relevant points here.

  • On a separate tack:

    You say ‘self-analysis’ is a form of ‘tele-analysis’? Is this because Freud used media to ‘treat himself (as a ‘patient’)’, the self-analysis occurring as interior/exterior and over space/time? Such as through writing (documenting dreams, noting repressions, etc. that are then interpreted/made conscious….or treating himself today from yesterday’s traumas and for tomorrow’s empowerment?). Otherwise it is a pretty bold leap, although my interpretation is certainly convoluted. If teletherapy is simply a ‘therapeutic’ professional-client relationship at a distance through some form of media (here as writing), I would think this type of thing occurred longer than a hundred years ago. Although ‘professionalism’ was perhaps yet to be named in modern terms, and psychology-therapy as a field and certification only began mostly in the late 19th century. Regardless, the Freud-Jung requirement that psychoanalysts/analysts must undergo their own ‘psychoanalysis/analysis’ simultaneous to their additional education and training is not only completely understandable, but should be obvious and universal.  Actually, it often should be done well before the path to certification.  In the privileged ‘analyst’s’ scenario, they usually become an ‘analysand’ rather than a clean-cut ‘patient’. Despite this tradition, which has often applied to laypeople and training analysts, Jung called almost all of his clients, ‘patients’. I love Jung to death, but he helped teach us how to find our blind spots, including his.


    You claim ‘distance is not the opposite of presence; absence is’. I quite like this. I don’t find it absolute and without a need for qualification. Distance, though mediated by media, is a kind of disembodied presence, especially non-internet and visual forms, where those who can see still can’t even see the body/head/eyes, etc. This whole discussion does push us to experiment, learn, and refine how to use our media and relationships mindfully and effectively, and realize there may be benefit/risk, pro/con, give/take, blessing/curse, and receiving/sacrifice. I started using the internet in middle school (mid-90s), but there was never a class or ‘field trip’ to learn the etiquette of chat room discussions; the healthy-exploratory-yet-careful-and-critical use of online (or any!) pornography; the ergonomics of environment, hardware, and software; nor how to prevent and ameliorate information-overload.  Most of that was yet to be known, let alone by the teachers mostly 2 or 3 generations older than me. Although there were many pioneers and groups already attending to those things in previous decades, just not in the earlier schooling systems I was in.

    Ok then. Again, I’ll consider this. Thank you.

  • (To the interviewee): Very interesting framing, research, and analyses, thank you.

    I’d suggest as continuing considerations/questions:

    You say you are more than worried at seeing the ‘patient’ as a ‘user’ or ‘consumer’, although you immediately reinforce that most therapy (‘under capital’) is consumed. We probably agree that ‘ideal therapy’ (I say ideal) is not ‘consumed’ except that there is a payment for a service. Is this what you mean by ‘under capital’? However, chronically using the word ‘patient’, as you’ve been doing, reinforces some of the similar problems-issues. So often (why not always?), ‘patient’ intrinsically implies a use, a consumption, as well as a role, assumption of position, and is always in relation to a ‘provider’ who is in a privileged position and is often assumed to have power and knowledge that the ‘patient’ is given, does not know, or is not allowed to do on his/her own. Unfortunately, the insistence on the words ‘therapy’ and ‘care’ (whether given or managed) causes some of the same issues that could often be applied more accurately, and as empowerment, if the professional masks and descriptions were at least reduced to a minimum.  It seems to me that this minimization is at least implied when the medical doctor gets back surgery, goes to the dentist, or gets a vaccine, or when the psychologist sees his own psychologist, even if it’s once a year as maintenance consultation.

    With ‘care’, you raise this potential issue when you say: ‘Behind teletherapy, but within it, care can function as a cover for capture and control.’ Unfortunately, this capture and control can also be subtle yet profound and ubiquitous in professionalism of, in this case, mental health services. Service-providers are inherently self-interested and often disabling and disempowering even with the best of intentions. Even replacing the word patient with client doesn’t completely solve the power discrepancy and sometimes arbitrary but convenient freezing of the masks/roles. The doctor and the ‘Aesculapian authority’ that traditionally has the power to define and assign the ‘sick-role’ (inherent in the word ‘patient’) has moved beyond physicians, so that psychologists (and most therapists?), chiropractors, naturopaths, etc. have taken it, by tradition and choice, to designate their ‘client’ as ‘patient’. We live in a society where so many can proclaim themselves therapists who obtain clients-patients with perceived needs which can be serviced and problem-solved for a fee.  Here, I expand the type of ‘therapist’ to anyone with a therapeutic technique.  Still, most massage therapists don’t consider their clients as patients, whereas most physical therapists do, it seems to me.  I’m not suggesting that professional service-providers are of NO VALUE, but we shouldn’t always assume that they are within an easily understandable system, free and clear of major problems just because they sometimes produce a positive result, are somewhat regulated, or appear to have perfected any relevant information/misinformation storm in the field.  Actually, I’m not saying that you just assume that either.

    You sort of reckon with this here: ‘As employees or students, we might be told to use an app to achieve wellness, whatever that might be, and to mind our own wellness. This is an unfortunate defending of the political notions of self-care, turned into a hashtag, and that language itself skirts therapy on purpose…the intervention might do something good or bad, but it is not therapy, and it is not regulated as such.’ You say it may be a good thing or a bad thing, yet you lead up to that by seemingly making politics of self-care as ‘unfortunate’ and ‘skirting therapy on purpose’ also implying something unfortunate.  My impression is you are using ‘therapy’ of a specific sort, but I wouldn’t mind knowing if you are incorporating psychologists, social workers, counselors, and any other variations of mostly ‘talk therapy’ that I am not thinking of right now.  I’ll point out that many doctors and nurse practitioners use a kind of medical reference app, where they can access information they need to verify, or don’t know or remember. After all, no therapist or doctor with ‘proper credentials’ can or should know all there is to know, all the time. People may have been able to hold the prestige of ‘all-knowing’ or even ‘knows-enough’, but anyone who claims this in the ‘information-knowledge era’ would eventually be exposed as excessive, if not by themselves, then by others who at least claim to expose it.  In some ways, the internet is the App of the World that to some extent is available to everyone, regardless of background, demographic, and certification.  The ‘disrupting’ of mental health care (professions, systems, markets) is not in principle an unwanted thing, unless the ground you stand on is being removed.  This applies to app company CEOs who are carving up the pie, as well as more traditional power holders.

    Right now, I feel that everyone requires others for maintenance, counter-check, and support, and it’s not clear that any one ‘wellness app’ used to ‘solve/soothe’ depression should replace people or political restructuring. But certainly the preferred if not ultimate goal of any ‘therapy’ (in the way you are referencing it) is to free oneself from patient-hood, client-hood. And that ‘self-care’/education/action/autonomy are clear and important means to achieve this. Being ‘not regulated’ is probably another example of a blessing/curse; yet hasn’t this blessing/curse already been proven time and again to be true in the ‘regulated’, certified, and licensed professions of psychology and psychiatry, and the markets which they themselves are attached?

    Some may think or feel a client ‘needs’ the professional, whereas the ‘professional’ does not need the client. It may appear this way since the professional can obtain other clients as replacements, not be emotionally bound, or not believe his/her overall income doesn’t rely on any one client. But the fact is, beyond these being true or false, service-providers (or givers of ‘care’) and service-organizations NEED clients, among other needs that, it is assumed, must be satisfied. Otherwise, they become part-time (which could mean their profession is so effective and efficient that client-customers are being substantially reduced relative to population) or leave the playing field all together.

    Ok then. I’ll consider this. Thank you.

  • Other terms defined by examples of doing the same thing over and over again while expecting a different result could also be stupidity or foolishness, or more kindly, to ignorance or unconsciousness….not madness (or insanity). Then again, rare (but many!) individuals have won lotteries or the $100,000 slot machines. This definition (or cliche) has been used to sum-up and describe ‘madness’, but there’s no need to use this convention to reinforce the stereotype just to simply return the label onto ‘psychiatry’, regardless of the ultimate point….and with ‘delusional’ as a cherry on top. The ad hoc diagnostic (of a professor with an MD?) flipping the muddled diagnoses and leaving no sign of irony, self-doubt, or self-criticism. It’s not clear to me that this benefits ‘patients’ any more than ‘psychiatrists’.

    Someday I expect the author to mention something about nutrient supplements. Whether or not it’s in any way positive, I’m not sure.

  • Ricky,

    Very interesting.

    I don’t mean to nitpick, but it’s not clear to me that ‘pharmakeia’ and related words don’t include ‘drugs’, whether for poison or healing, and could be involved in the etymology. There’s also a history or ‘traditional’ view in some cultures, whether ‘legitimate’ or not, or valuable or debunked ‘magic’, that what would be considered a poison in larger doses, would in small doses be used for healing. I’m familiar with some of the corruption of this idea, like the ingestion of arsenic or gold for ‘healing’, and certainly the historical and current mental-management systems/individuals have been and are full of ostensible justifications for ‘treatments’ of the most heinous sort. Some reference may clear this up for me, especially one that isn’t from a strictly Christian website. Christianity has a long history of negating and framing as evil/heresy, things such as magical arts, sorcery, ‘paganism’, polytheism, etc. I get a mix of details from dictionary sites.

    Having said that, I relate to a great deal of your experiences and situation, and I am certainly impressed with your perseverance and attention to detail. Best of luck.

  • Bananas,

    This may be; I never heard a response. Maybe a play on words. Adverse leans to the effects themselves rather than the feeling toward them.

    Averse and adverse are similar, but my impression is that averse tacks on her concern that people taking the drug could be seen as having an aversion to it, which would naturally be the case with any unwanted effects. I’m not sure if adverse carries that assumption so directly. Of course, often the prescriber’s desired effect is the client’s adverse effect, some effort at a trade-off. Doctors aren’t always less averse to adverse effects than the person that swallows the drug, but often this is nullified by degree and the times they are complacent or in denial.

    Anyway, I think I get the drift.

  • A friend recently described 3 of her friends who ‘passed themselves away’. I found this interesting and useful. Long ago, I stopped using the phrases ‘suicidal ideation’ or ‘committed suicide’, and now I use the word ‘suicide’ only when absolutely necessary or typically convenient for public consumption. I used ‘self-murder’ with myself, but I don’t need to use that anymore, thankfully.

    Can you imagine someone listening to someone struggling with this kind of thing, and they put a check mark by ‘suicidal ideation’? Or after the person has passed, putting a check mark by ‘committed suicide’? Such a profound and personal thing being so quickly and easily turned into a notation or a statistic.

    I have learned that if you are asked ‘do you have thoughts of hurting yourself or others?’, the reaction and help usually won’t make much of a difference either way (although the conventional ones will think so). But then when they ask ‘and do you have any plans?’ (which is really what they are after), that’s when something will happen: not help or love or amelioration of pain. But rather legal mandate and compulsion.

  • Brice,

    Very interesting. I have slowly influenced my clinical psychologist to use the word ‘client’ rather than ‘patient’. He knows why, but he was in the years of habit. Same for a local state mental health program director and his meetings, except he used ‘consumer’ (most staff still does). I’d prefer they, at least behind their self-interested masks of love and care, largely de-professionalize their customary roles and their needs for ‘clients’ who directly or indirectly pay the ‘clinician’s-provider’s’/administrator’s bills, and use ‘person’ when possible, even ‘citizen’, but it’s a start. Maybe you could consider this on your adventure of counselor-mental health/sickness transformation.

  • Miranda,

    Thank you. I can readily see how the ancient uses of food-as-medicine would naturally be recognized. My main point is that nutritional psychiatry is not new, as scientific research nor as a branch of psychiatry. Perhaps you are emphasizing the size, popularity, and amount and types of research that have been growing over the last decade or so? More integration into schooling, more practitioners, more well-funded and longer research projects, perhaps with more sophisticated testing technologies, etc.?

    One famous example is Dr. Linus Pauling and his Linus Pauling Institute that started in the ’70s under a different name. He not only coined the term orthomolecular (the ‘field’ of which has had a pioneering and profound influence on all these areas today), but he first learned about the science, clinical use, and basic ideas from Drs. Hoffer and Osmond’s book called How to Live with Schizophrenia, which included clinical research, and the first few randomized double-blind placebo-controlled studies in psychiatry involving vitamin B3. (Hoffer later criticized the trend of these ‘gold-standard’ methods for justifiable reasons I won’t go into here.)

    I can understand that much of the early ‘pioneering’ work was based on practical clinical experience and, to some extent, research that would be lacking in the complexities of technologies and accumulated (sometimes only apparent) knowledge that modern research would prefer. However, research and the development of the nutritional and nutritional psychiatry fields have taken many forms and turns over the decades. So my impression is that you are either requiring a certain threshold of ‘formality’ to be made to consider it formal scientific research and a new field, or you are disregarding the work and research of the last 70 years and more. Thank you. I am certainly glad you found benefit with this stuff in your own history.

  • bcharris,

    Here is the original Bill W. AA pamphlet. I actually haven’t read it yet, but I notice it does mention niacinamide, as well.

    Hoffer often used niacinamide for children and elders especially, and many women, due to the feeling or cosmetics of the flush. I’ve been using inositol hexaniacinate (no-flush) B3 (7 grams a day!) with great satisfaction. I was on niacin for 4 years, niacinamide for probably 3. I had issues with the those after awhile that I won’t go into here. I do wonder if the niacin caused my rosacea/face acne after 3-4 years of flushing very deeply every morning. My dermatologist doesn’t think so, but I’m not convinced. The orthomolecular literature usually says alternatives to niacin will have to be used if: 1) the flush becomes intolerable or 2) if the flush doesn’t stop or isn’t reduced. Curious. The flush stops or dramatically stops for many who use large doses consistently. Do you still flush at all? Hoffer only had a slight tingle in the forehead.

    Hoffer usually mentioned niacin (his favorite) and niacinamide, but he occasionally mentions inositol hexaniacinate, and even more rarely the NAD supplements from research of decades ago, etc. He says things like inositol hexaniacinate is good for ‘schizophrenia’, but not quite as effective (same for modulating cholesterol/triglycerides). I believe the even larger doses of this form compensates for both. I feel he didn’t mention it as much because it has always been more expensive, and he knew that many people he recommended for would not have the budget. It feels very ‘smooth’.

  • rebel,

    Thank you for your input. I can sympathize with your views on this. You mentioned in an above-comment that you appreciated our biochemical (etc.) individuality, so this may apply to some degree with this area. Psychedelics have been used (under some conditions, often carefully and attentively) as single experiences, as well as multiple or even daily micro-dosing, which is basically what I do with ketamine (low-dose). I quit using cannabis immediately when starting to use ketamine and radically lowered my dose of major tranquilizer. I’ve actually been off the ‘antipsychotic’/major tranquilizer for going on 2 months now. (I’ve been on ketamine for 14 months, but it has been a process). It’s interesting how the (perceived?) need to take an antipsychotic is diminished when one is not suicidal and depressed. I’m still working on the benzodiazepine, but my main focus right now is to never take an antipsychotic again for the rest of my life. I’m sure you can understand why.

    The ‘psychotic-like’ aspects are certainly a complex topic with all this, both from pharmaceutical withdrawal and use of any psychedelic. Ketamine itself has been used for (what I consider dubious) research to ‘understand’ schizophrenia and psychosis. As someone who not only has had labels of schizophrenia and psychosis, but who has been researching what these could or could not be and how they can be viewed and experienced, I am always sensitive when these subjects come up. Perhaps there will be another time for a deeper dive into that, but it should definitely be attended to.

    There is research and experience going back at least to the ’50s and ’60s on the use of psychedelics like LSD and mescaline to help alcoholism/alcohol-abuse, and other substance use/misuse, and more recently there is research on psilocybin (magic mushroom active ingredient) for cocaine addiction, ibogaine for heroin addiction, and again, ketamine for certain ‘addictions’. You mention the ‘life-threatening’ situation where drugs may be necessary; given that I was almost as suicidal as one can get before using ketamine (and other wellness modes), I’m sure you could understand why it may have been initiated for me as a ‘life-saving treatment’. But my continued use is an ongoing thing. My impression is that you are more amenable to nutrients as ‘chemical/drug tools’, or simply don’t see them as chemicals, but you mentioned above that you are quite conservative there, too. It’s all so damn complicated, isn’t it?

  • rebel,

    That makes sense. You at one point mentioned the ‘fillers’ of pills and such. Some capsules either do not have as many or any fillers at all, although the common ones are so often there like magnesium stearate. But other ‘supplements’ have none, like liquids, powders, etc. Then there are herbal methods, like teas or capsules.

    I’m all for using dietary strategies and being mindful there. It is especially good for preventing deficiencies or boosting certain nutrients to modest levels. Too many Brazil nuts may lead to too much selenium and what not, but 20 oranges will only give you so much vitamin C, and olive oil only so much vitamin E. I’d be glad to hear from someone who even gets the RDA of magnesium, vitamin E, vitamin A, and iodine, as well as omega-3 fatty acids (which don’t have a formal RDA), in their diet alone. You really have to practice the most radical of diets like the paleo with 9 cups of fruits and vegetables, organ meat, fish, and seaweed, etc. to get either the RDA or the more optimal levels. As someone who has had a lot of jaw popping while chewing (painful if I over did it), then I can appreciate any way to bypass a crunching and masticating festival to get the amounts of nutrients that I would like.

    Each person is individually different and unique, however luckily not so much as a whole that we never share commonalities. Basic nutrient deficiency disorders seem to be examples of this.

  • bcharris,

    The other forms of B3 have been used too, but not always in the exact same way. Bill W. of Alcoholic’s Anonymous and his use of B3 has an interesting history. (Perhaps you knew that Dr. Abram Hoffer ‘prescribed’ it to him for his depression and anxiety, after he had long stopped drinking? I think you are familiar with Hoffer.) Bill W. advocated its use and spread pamphlets, but that part of the AA history unfortunately did not stick around like many of the other principles. Interestingly, Bill W. (and many AA members) continued to smoke cigarettes for the rest of his life. I believe he died of smoking-related lung disease.

    Large dose vitamin C is useful in many ways, including neutralizing and removing toxins, and even assisting with opiate overdoses if you can get the stuff in the person. Vitamin C IV’s have profound power in terms of toxin exposure. But other nutrients can assist with withdrawal, not the least of which is because of rebalancing and strengthening various parts of the body and their interactions. Magnesium chloride was one thing that helped me get of tobacco. It relaxed and rebooted my muscles, which were in a way verging on catatonia.

  • I’d note that, sticking with the chemical and biochemical, the Hoffer/Saul book highlights the use psychedelics for addiction, such as as when an orthomolecular approach doesn’t work (as a last resort). Much research went on (while it was legal) going back to the ’50s and ’60s. But there is a great deal over the last couple decades, too. I have benefited from low-dose generic affordable ketamine.

    Even though this may seem like replacing one hat for another, it connects to discussion on the differences between ‘addiction’, ‘habit’, and ‘management’. And ‘substance use-abuse’ vs ‘medicine’. Since nutrients are technically chemicals, whether natural or synthetic, I don’t find the use of certain substances to overcome other chemical challenges as innately wrong.

  • Rebel & Julia,

    I see discussion on nutrients and withdrawal. There is actually a great deal not only on nutrients through diet and supplements on drug withdrawal, like from tobacco, illegal opiates, and alcohol, but also on prescriptions like benzodiazepines and major tranquilizers. Julia, you reference your group’s study, as well as anecdotal reports, but there is more than meets the eye. Many references can be found in Hoffer/Saul’s The Vitamin Cure for Alcoholism, treatment alcoholism&qid=1619491639&sr=8-3, and material in The Journal of Orthomolecular Medicine,, although there are many others. Is it not good enough, only anecdotal, or should it be forgotten and left behind? Rebel, your difficulty with diet and any type of supplements (at least pills/pill-like) is certainly a difficult challenge in terms of some of this.

    Julia, you said you (‘we’) did research on quitting nicotine, and associated withdrawal, yet you said you yourself can’t do tapering studies on drugs, as you are not a prescriber. I assume you refer there to prescription drugs and not legal drugs like nicotine? The references I made above, and many more, have been run, used, consulted, reviewed, and affirmed by and with many prescribers, psychiatric and as physicians.

  • I’ve been using and studying clinical nutrition and nutritional psychiatry for years. I dedicate part of my website to it. I only read the discussion points and didn’t listen to the audio. However, some points:

    This piece invokes ‘The emerging field of Nutritional Psychiatry’: I’m sorry, but nutritional psychiatry and health has been going on for almost a century. (Actually longer than decades, since citrus was used for what was not yet known as scurvy and Ayurvedic and other herbal/dietary medicines were used for centuries/millennia.) Here, I am primarily referring to orthomolecular psychiatry first, then functional and integrative psychiatry/medicine. This includes reliable research, clinical use, and ‘anecdotal reports’. Julia’s interest ‘grew out of her own research showing poor outcomes for children with psych. outcomes for children with psych. illness despite conventional treatments…..In the last decade, the MHNRG has been running clinical trials….’. Well, I beg your pardon, but there is a very rich history that should have been attended to before her ‘practice’, and there should have been recognition of many types of research for many decades. If my points are irrelevant, I would be curious to know how many references from the last 70 years are used in Julia’s new book. Not scientific enough, not rigorous enough, not enough ‘patients’ studied? Hm, I wonder, and I certainly hope I’m wrong. Otherwise, this is putting a new lock on an old door. Maybe the old key was never found.

    Supplements can be beneficial not only because ‘quality foods aren’t available, or if the child has a higher need for certain nutrients due to genetic factors and/or environmental stressors.’ But additionally, they may be useful for optimizing health, prevention, and treatment, regardless of these factors that are mentioned. Also, there is at least one exception to the comment on no ‘vitamin’ being a ‘magic bullet’, although I believe there are others. And that is micro-nutrient deficiencies, whether essential vitamin, mineral, fatty acid, or amino acid. D3 IS a magic bullet for preventing and treating Rickets, B3 for pellagra, B12 for beri beri, and C for scurvy. No? Sure, there may be additional needs if someone already has rickets or scurvy, but I don’t think that is my point. Although, obtaining the ‘consortium’ of nutrients does have a synergistic and holistic effect.

    ‘Nutrient psychiatry’ or nutrients for mental/(and physical) health can save system costs like insurance companies and hospitals, but only in the big picture. They should cover the costs some way, and incorporate this into the entire field, but right now, mostly the customers, the citizens that already choose these methods, pay out-of-pocket for the food, supplements, educational materials, time learning, etc. My insurance company covers a bit of supplements, but only 1 or 2 brands/products, usually of cheap quality with unnecessary ingredients. Some nutrient products are even patented and used in normal prescribing practices like vitamin B9 (as folic acid) used for MTHFR gene variants. They are more expensive with unnecessary ingredients like red dye #5 (or whatever it’s called). The psychiatrist I had would use THAT (since I tested positive for heterozygous MTHFR), yet she warned me against using most of other supplements. Being FDA-approved seems to be a magic halo for many prescribers. My psych. nurse practitioner asked his consulting doctor if I could use nutrient supplements in the psych. hospital (because I asked in case I needed to go), and they said ‘no, because they are not FDA-approved’. I don’t need to say here what I really think about that response.

    I mention these things because I care. 🙂 By all means, continue the many decades long (and longer) movement of using nutrition in psychiatry, overall health care, and healthcare systems. Prove more, network more, educate more. Just don’t make it seem like you are starting from the beginning, or middle for that matter.

  • A psych nurse practitioner (who had a knack for his checklist routine) told me ‘hearing voices’ isn’t illegal. He must have assumed I wasn’t aware of that. He showed how little he thought of (all) of them, and how low a bar he put on (all) of them.

    I told a physician that I heard my dead grandmother tell me she ‘was here to help’, after I asked her why she was there. The prescriber upped my major tranquilizer/’antipsychotic’, with my apparent submission to go along to get along. At some point then or later, he said he’d ‘rather see a fat Evan than a psychotic Evan’.

    If doctors/nurses in psych hospitals know you have used psychedelics recently, they can infer that your ‘hallucinations’ are likely connected to the drug use, and feel they have folded a letter and put it in an envelope. Even if there was relevancy, they don’t know they possibly dismiss, blot out, destroy, and prevent a religious birthright.

    The interviewee should remember this when she advocates for programs/treatments for ‘1st episode psychosis’ in young people, and perhaps she does, and I haven’t fully recognized it. How does ‘set and setting’ influence a ‘psychosis’? If my voice tells me ‘I love you’ rather than ‘you should kill yourself’, if my voice describes the evils and sufferings of humanity to make me conscious of them, etc. should I submit to a ‘treatment team of clinicians and service-providers’, pay for them directly or indirectly, and walk ‘their’ labyrinth?

    I know this topic spans all diversity and variability, and people should have a choice and negotiate these things, including smashing it with a drug-hammer by a doctor’s root-tearing. But keep convention away from me. Not only do I not want to touch them, or have them touch me, with a 10-foot pole, but I don’t want them swimming in my pool or feeding my chickens.

    Perhaps you can see some reasons I am attracted to the title and theme of this interview.

  • Megan,

    I get the feeling that you are blurring individualism with individuality, while bringing up many relevant points. There is no collectivity without individuals, individuals that are as important as any conglomeration or interconnected web. You’ve pointed out many discrepancies of the diagnoses, alienation, etc. of individualism, but I fear you either reversed into the opposite of your previous positioning or never had a full view of the importance of individuality. The 1 is required for any larger number. I guess in some ways you are not denying that, you are just highlighting that 1 cannot or should not do it alone, especially in the long run.

    I like Jung’s differentiation of individuation vs. individualism.

  • kindredspirit,

    For some reason I wasn’t notified that you responded, and I found your comment after sort of randomly checking my original post; sorry about the delay. I’m glad I rechecked!

    That is all very, very interesting what you say. I resonate with so much of it. I certainly wish you good luck and strength with your complex nexus.

    I want to clarify two things though. I really referenced ‘chronic’ pellagra and vitamin B3 ‘dependency’, both of which are related to but technically different from standard pellagra and vitamin B3 deficiency. The Hoffer, et al, literature on all these differences are really interesting, and the work is virtually never mentioned in ‘conventional’ circles and outlets.

    Thanks for your response.

  • 2 comments, one more psychological, one more physical:

    This article would have greatly benefitted from analyzing Freud’s work through Dr. Carl Jung’s work & his relationship, interpretation, & understanding of Freud’s life/work. For example, Jung’s notions of the personal (largely via Freud) & collective (via Jung) unconscious, relationship of both the psychogenesis & neurology of schizophrenia, neuroses & psychoses, the movement away from Freud’s ‘psychoanalysis’ to Jung’s ‘analytical/complex’ psychology in the broader field of ‘depth’ psychology. As well as comparing & contrasting the notions, research, & experience of psychosis vs ‘individuation’, spiritual experience, archetypes, & dreams.

    The fact that there was NO mention of Jung borders on ignorance, certainly unfortunate. I suggest his book The Psychogenesis of Mental Illness and his specific essays & letters on Freud’s work and Jung’s relationship/ex-relationship with Freud.

    Here, I would prefer not to have an extended discussion on the ‘reality’ of ‘mental illness’, although I will try to briefly qualify my statements below.

    The authors suggest there are no scientific ‘findings’ on specific brain abnormalities in schizophrenia, but they emphasize ‘exclusively’, while they give credence to some people that have/are labeled with schizophrenia do show certain ‘neuropathological abnormalities’, just not in ‘most’ and are not ‘exclusive’ to schizophrenia (which they still accept IS a DISORDER, usefully subsumed under one term). Here I would refer to Dr. Hoffer’s & Dr. Osmond’s work on schizophrenia, which generally considered schizophrenia as a ‘syndrome’, not always a single ‘disorder’. Rather a syndrome that has many etiologies, but a possible common end-pathway, though most are connected with chronic pellagra & vitamin B3 dependency. On the authors statement that a ‘majority of those diagnosed with schizophrenia show no neuropathological abnormalities at all’: the ‘majority’ of people ‘diagnosed’ aren’t ‘studied’ (let alone completely & competently) so they can’t ‘show’ anything. Nor does this postulated ‘population’ consist of those who ARE’NT diagnosed.

    One reason neurologists haven’t understood why the same ‘disease’ shows such heterogeneity of symptoms is partly a false pretense, assuming there is one disease, ‘schizophrenia’. My impression is neurologists aren’t equipped to study the psycho-social-environmental-political contexts of their ‘disease’ inquiries, so no wonder they are often stumped, & the authors do a fair job of realizing this, without following up on ANY neurological leads, which granted, are so much of a jungle, with so many false trails in an already infinite matrix of the nature of the human body. The authors feel comfortable using the phrase and judgment of a ‘significant percentage of schizophrenic patients recover…..’, reinforcing that ‘it’ is a ‘population’. This comment is made in regards to using psychotherapy ‘only’ as a means to ‘recover’, recovery here being assumed to be easily understood and measured/evaluated; although the reference that the article links does put ‘patients’, ‘schizophrenia’, ‘mental health’ professionals, & ‘recovery’ in quotation marks, so this suggests a great sensitivity to these areas. The MiA authors say ‘a significant percentage of schizophrenic patients recover with the sole aid of psychotherapy’, and it’s not clear to me what ‘significant’ could mean here. The notion of psychotherapy being ineffective as a ‘sole treatment’ of schizophrenia has long been used as a sign that it IS schizophrenia, in that psychotherapy ISN’T properly effective for schizophrenia. However, psychiatrists like Hoffer suggested that ‘schizophrenia’ has a 50% ‘natural recovery’ given good food, good shelter, & dignity/respect. This, while not explicitly including psychotherapy, no matter what type of ‘psychotherapy’ we are actually talking about. Jung felt the same to a degree, yet both were not convinced nor optimistic that many ‘cases’ of schizophrenia could be dealt with so easily. They each used the word & diagnosed ‘schizophrenia’, studied ‘it’ in hospital, in-office, historically, and in the larger society. Unfortunately, they readily used the descriptor ‘schizophrenic patient’. (Note, so do the authors of this MiA article). Yet upon close analysis, Hoffer & Jung had a remarkably complex & nuanced view on all this, helped—really helped—many people, & largely transcended stereotypes while questioning their own many assumptions.

    Having said all this, I am fully aware that I have skipped over & not qualified many of my statements, suggestions, and references, although I have tried. Any reality, social construct, conventional & unconventional ‘treatments’, & total contexts of schizophrenia & psychosis are EXTREMELY complex, any one angle being enough to fill a lifetime of either lived experience or research, or BOTH. So much is open-ended if not apparently closed. I haven’t had to arrest or imprison people like the Unibomber (was he diagnosed simply with ‘schizophrenia’?), nor have I had to involuntarily commit a ‘gravely disabled psychotic patient’ in a hospital. I hope to do my work on these issues in other roles and by different means. Sometimes I’m glad I can think & reflect on all this at all, rather than deliver pain & control as a means AND an end to this issue.

    I hope someone gets my drift here.

  • oldhead,

    Generally, I don’t disagree. However, in a sense, it takes ‘just one’ other, or a ‘leading minority’. It certainly need not be ‘the masses’ or ‘the people’.

    Also, ‘a vision’ can be made real in one’s own life, and not be reduced to a ‘pleasant dream’. In this way, it requires one, who pioneers, so to speak. A hard as granite act. Actually, the vision/dream IS a real act, experienced through the individual. In this sense, it’s the spark of change. So here the ‘change’ isn’t first ‘made by an individual’, but ‘happened to or with an individual’. The individual brings it through. Is how I’m framing it here.

  • kindredspirit,

    Sorry to wedge in:

    I’m not sure if you imply this, but I would add that your comment ‘change is, in fact, created by how we relate’ includes how one relates to oneself, both as a conscious part and as a whole, relating to dream information for example.

    Also, you say you know logic and facts have their place in creating change, yet you say we are feeling creatures, not logical creatures.

    The George Floyd court case will be an example of prosecutors using logic and facts that are often not inherently devoid of feelings and vice versa. In an effort to create justice and change.

    We should remember that personality traits and functions can vary, and certain tactics may work differently depending on the person, theme, or context.

    Although I ‘feel’…and ‘think’….that you dealt with some of my points here.

  • oldhead,

    You said change isn’t made by individuals, although it sometimes appears that way. I find this so absurd, that I’ll just say, oh good grief. Then again, I don’t equate the individual/individuality with the common definition of individualism that permanently lives in spite of or against all community/collectivity and doesn’t see the context. Put another way, 10 is meaningless without 1.

  • bcharris,

    I enjoy Abram Hoffer before he ‘retired’ as a consultant and what not, and I’m pretty sure you do too based on many of your orthomolecular comments. Can you reference your statement on his assistant/secretary? Might I have seen that on their website? Maybe the personal ‘touch’ she used. I wonder what she did differently in terms of the bio/chemicals side.

    Even though I don’t always agree with his work, he’s given me much. I would never simply want to ‘abolish’ his entire psychiatric practice. Though at times, I do supplement (no pun intended) and contradict his thinking on matters, for example, psychosis. I find putting his work with medical psychologist Carl Jung, is a profound synergy.

  • Peter G.,

    I disagree with one area mainly.

    Medical treatment-induced sickness, iatrogenesis, is not at all limited to psychiatry. Not in drug-induced and hospital-induced sickness and death, not in poly-pharmacy to treat the treatment, not in some arrogance and disrespect and bureaucracy, not in malpractice lawsuits, and not in price-gouging. I don’t know why you would say that there are no ‘survivors’ of other specialities, medical fields, or healthcare systems.

  • Let’s try not to freeze the role of ‘patient’ so freely by using the word so often, no matter how progressive the mode. Doctors get vaccines and go to the dentist and become the professional’s client, their patient. I sure am sick of the word patient. Then again, I’ve had it daily in my back pocket and glove compartment for a long, long time. I’ve perhaps ‘doctored’ myself for even longer, so I pay myself, although any patient status doesn’t mean I’m a bad doctor. Wait, what? Goodness.

  • (Note to moderator) Steve,

    Could you please delete some of these repeats above and below? I had issues with my original post being marked as spam so I tried again and also tried a part 1 and 2.

    The above comment from ‘Thanks for the respectful article and response.’ ending with ‘Thanks again.’ will be the only one to keep posted. There are 5 posts that can be deleted as basically repeats plus this one about spam above.

    Thank you.

  • Sandra,

    Thanks for the respectful article and comment. Please forgive this somewhat long-winded comment. I understand if you don’t give a thorough response:

    I suppose I raised the issue because I’ve often heard things like OD is ‘more successful’ at ‘treating psychosis’ than the conventional paradigm (an abomination), which on the surface, I agree with. I do need to know more, but I did watch a documentary on the subject, and my impression is that the spot-lit individual is called a ‘patient’, therefore necessarily designated sick (to be healed), and that the goal is, like you say, some form of ‘recovery’ (which also implies overall inherent dysfunction). The usual ‘reduction of symptoms’ is still used from what I can tell, especially when the model is compared to other models. Even Mr. Whitaker works within similar frameworks and assumptions, using terms like ‘psychotic patients’, symptom elimination, etc. Even if the experience involves ‘symptoms’, it may also have another side that in no way should be reduced and negated. It may be profound and vital. I do appreciate OD’s apparent lack of need to place the ‘patient’ at the bottom of a hierarchy, but I do wish it goes further.

    Through examples like Carl Jung’s complex psychology, ‘individuation’, and himself, we see how visual/audial hallucinations of the ‘personal and collective unconscious’ can be considered natural phenomena albeit non-conventional and often difficult. (Here I’m not directly speaking of delusions that are dragged into the community, extreme dissociation, suicidal depression, etc.) In many ways, Jungian psychology and the associated medical psychologists were OD 100 years ago to the present. The nature and interpretation of dreams is a more common way to understand this. But he showed that one can speak and listen to the ‘soul’ and still continue the day work of paid work, professional obligations, family life, etc. He was never called a ‘patient’ (although according to him it did involve ‘sickness’), not force-drugged and forced-secluded, swarmed by medical professionals (which he himself was), forced into ‘group therapy’, and told when to get up, eat, and sleep, etc. But even if his mind-bending interfered with the day work, he should have been given similar allowances. I might add that Jung used the terms ‘patient’ and ‘psychosis’, as he was a doctor who tended to designate people into sick roles. On the other hand, he did not consider his ‘individuation process’ as psychotic. In any case, we see how ‘set and setting’ can influence the extreme/states, just as they can make the difference in a psychedelic ‘good or bad trip’, and OD seems to recognize much of this. Here, I’ll leave out the ambiguity and ambivalence inherent in psychology and nature. Some statistics show the natural recovery rate of ‘schizophrenia’ is 50% (given good food, shelter, respect), with normal drugs 10%. I won’t go into the definitions of schizophrenia or recovery right now, but I find the statistics relevant in the OD context and to what extent OD is needed for that ‘50%’.

    Also, ‘bringing in the family’ can be a hindrance on some levels, especially when it is they who need to change, and therefore the ‘therapy’ wouldn’t need to revolve around those identified with psychosis and would require a separate line of education and therapy to even the playing field.

    I also suppose if the ‘psychotic patient’ wasn’t perceived as bugging anyone else, a harm to himself or others, and also paid the bills or fulfilled school duties, then there’s less chance of being medicalized, even without conventional pathologizing. I made the mistake once of telling a prescriber I heard my dead grandmother’s voice (who told me she was here to help), and he increased my ‘med’. He later told me he’d ‘rather see a fat Evan than a psychotic Evan’. Had I experienced OD, I surely would have been better respected, even though I believe I needed and continue to need clinical nutrition and other chemical/biochemical methods. My impression is that OD doesn’t go out of its way to deal with clinical nutrition although I’m sure ‘diet’ is highlighted.

    Thanks again.

  • Sandra,

    Thanks for the respectful article and comment. Please forgive this somewhat long-winded comment. I understand if you don’t give a thorough response:

    I suppose I raised the issue because I’ve often heard things like OD is ‘more successful’ at ‘treating psychosis’ than the conventional paradigm (an abomination), which on the surface, I agree with. I do need to know more, but I did watch a documentary on the subject, and my impression is that the spot-lit individual is called a ‘patient’, therefore necessarily designated sick (to be healed), and that the goal is, like you say, some form of ‘recovery’ (which also implies overall inherent dysfunction). The usual ‘reduction of symptoms’ is still used from what I can tell, especially when the model is compared to other models. Even Mr. Whitaker works within similar frameworks and assumptions, using terms like ‘psychotic patients’, symptom elimination, etc. Even if the experience involves ‘symptoms’, it may also have another side that in no way should be reduced and negated. It may be profound and vital. I do appreciate OD’s apparent lack of need to place the ‘patient’ at the bottom of a hierarchy, but I do wish it goes further.

    Through examples like Carl Jung’s complex psychology, ‘individuation’, and himself, we see how visual/audial hallucinations of the ‘personal and collective unconscious’ can be considered natural phenomena albeit non-conventional and often difficult. (Here I’m not directly speaking of delusions that are dragged into the community, extreme dissociation, suicidal depression, etc.) In many ways, Jungian psychology and the associated medical psychologists were OD 100 years ago to the present. The nature and interpretation of dreams is a more common way to understand this. But he showed that one can speak and listen to the ‘soul’ and still continue the day work of paid work, professional obligations, family life, etc. He was never called a ‘patient’ (although according to him it did involve ‘sickness’), not force-drugged and forced-secluded, swarmed by medical professionals (which he himself was), forced into ‘group therapy’, and told when to get up, eat, and sleep, etc. But even if his mind-bending interfered with the day work, he should have been given similar allowances. I might add that Jung used the terms ‘patient’ and ‘psychosis’, as he was a doctor who tended to designate people into sick roles. On the other hand, he did not consider his ‘individuation process’ as psychotic. In any case, we see how ‘set and setting’ can influence the extreme/states, just as they can make the difference in a psychedelic ‘good or bad trip’, and OD seems to recognize much of this. Here, I’ll leave out the ambiguity and ambivalence inherent in psychology and nature. Some statistics show the natural recovery rate of ‘schizophrenia’ is 50% (given good food, shelter, respect), with normal drugs 10%. I won’t go into the definitions of schizophrenia or recovery right now, but I find the statistics relevant in the OD context and to what extent OD is needed for that ‘50%’.

    Also, ‘bringing in the family’ can be a hindrance on some levels, especially when it is they who need to change, and therefore the ‘therapy’ wouldn’t need to revolve around those identified with psychosis and would require a separate line of education and therapy to even the playing field.

    I also suppose if the ‘psychotic patient’ wasn’t perceived as bugging anyone else, a harm to himself or others, and also paid the bills or fulfilled school duties, then there’s less chance of being medicalized, even without conventional pathologizing. I made the mistake once of telling a prescriber I heard my dead grandmother’s voice (who told me she was here to help), and he increased my ‘med’. He later told me he’d ‘rather see a fat Evan than a psychotic Evan’. Had I experienced OD, I surely would have been better respected, even though I believe I needed and continue to need clinical nutrition and other chemical/biochemical methods. My impression is that OD doesn’t go out of its way to deal with clinical nutrition although I’m sure ‘diet’ is highlighted.

    Thanks again.

  • I like Open Dialogue. However, I’d like to point out that hallucinations can sometimes be the epitome of meaning (which Open D. generally allows for), part of personality development, and that individuals sometime benefit from ‘talking to/with themselves’ (or experience with gods or infinite other figures, ideas, sensations, etc.). Therefore, the goal to pathologize unusual states as ‘psychoses’ that need ‘treating’ (in this case usually without drugs & by a sizable team that constellates/swarms around, yes with, the individual), should be considered in light of psychospiritual transformation. This, even if physical transformation is desirable as well. And that sometimes rather than pouring resources to a multi-pronged care team or family, resources should go to the individual, including privacy and techniques of working with imaginative states, even if these ‘states’ are restricted to an active/over-active dream life, and whether or not they bleed into waking life. Note throughout this I say ‘sometimes’, and of course the individual’s wishes should be considered, including wanting to escape the ‘psychosis’.

    So we shouldn’t simply consider the goal of Open Dialogue to be removing psychosis, and that this is what defines success. Either that, or broadening the very definition of psychosis to include very normal instinctual experiences that may be useful to oneself and others. Or could be if given the opportunity. Even if the ultimate goal is to pass through the threshold to the other side and exit the ‘liminal’ space into a future personality which the ‘psychosis’ tried to anticipate and provoke, or could re-occur under certain conditions. Open Dialogue deals with much of this, but I’m not convinced it has fully reckoned with the implications. I hope I’m wrong.

  • cabrogal,

    Campbell’s quote seems rather similar to me. The question becomes, is the water — or location and creatures in the water — the same? Is the shaman with scuba gear swimming in the same ocean as a person labeled schizophrenia/psychotic without proper gear & training? In any case, Campbell’s ‘swimming’ seems preferable to ‘drowning’. We should never generalize too easily from one person’s bliss or one person’s pit. ‘Madness’, like dreams, can take ANY form. No matter what form, conventional psychiatry and society have a drug for you, a place for you to go, & a conversation they won’t have. And easily replaces one madness with another. Swimmer beware, but try it naked under moonlight at least once! And bring a towel.

    It’s interesting you mention $120, which is what it cost 10 years ago. (*Oh wait, I guess you saw that number from my essay). I see it’s now ~$200 (roughly what it’s been for a long time), but after The Black Books were published last October, The Red was going for ~$280. The Black Books are equally heady & important as well, & long awaited. My illustrated Red Book is literally falling apart from how many times I’ve read it and referenced it. The cover is torn from the binding. Poor thing, bless it’s heart. Yes, the images are astonishing, & there were many more created but not in the book. Most during that period can be found online if you haven’t seen them already. I actually tore to pieces a couple of the images in my own fits of ‘madness’ & odyssey; that, along with my endless underlining, notes, & scribbles, is how I digested it. I ate it up. I was more tame with The Black Books.

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

  • cabrogal,

    Also, there’s a section with the cabiri (gnomes) where Jung is relating madness (I don’t necessarily believe here it’s only ‘divine madness’) and the ‘knotted entanglement of the brain’, which he spiritually cuts through with an alchemical sword that the gnomes give him. The gnomes had played a role in creating the very entanglement that they wanted him to cut.

  • rebel,

    *I should have made clearer my point on evil and dysfunction. I don’t simply support these things. But we cannot finally get rid of them, and I believe the art is to replace a greater evil with a lesser evil in many cases. It’s built in, but if you always understand it and can cast it forever into chains, or always purge it outside of you, all the more power to you. The Biblical wrath and vengeance of God, not simply the Devil, should make us mindful of evil.

    Dysfunction is another thing and has always been there, but we should try our best.

  • kindredspirit, etc.:

    I disagree in two ways, and I sympathize and relate overall. This should probably be my last comment on this thread.

    I use and support chemical strategies for mental health and overall health, and I use chemical in the broadest definition and not just pharmacology. Nutrient supplements, and especially food, are clear examples. The face of conventional pharmacology and the consideration of ‘brain chemicals’ and prescribing has been so appalling that it’s easy to throw the baby out with the bathwater.

    Part of the reason people have these discussions is not only because it is NOT clear what the common parlance means exactly, but also as a means to evolve and change the dynamics of what we’re dealing with. The people who identify or don’t identify with terms like neurodiversity or schizophrenia also have the most complicated time fleshing it all out, and it’s not always about REJECTION. Of course we can’t always hash it out like this, but that’s why people do homework, go to workshops, and then bring it into the world. Anyone is welcome to use a term how they want it, especially if they clearly define how they use it, recognize the context they are in, and that there are expectations people have, sometimes with repercussions. Part of my mentioning Jung is that he used the term ‘mental illness’ in a way that I relate to, but he didn’t necessarily use it in a way that the DSM-eras have come to use it. You do seem unconcerned if and how there could be more than one definition within ‘psychiatry’ rather than the ‘common’ one. Even though there can be overlaps, if words were always frozen into a single meaning and context, we’d be all the more poor. I certainly would hate to have to not use a word, phrase, or symbol just because some norm has cornered the market, although that has occurred, such as the rejection of the rigid Nazi swastika vs. the centuries-old multi-cultural use of it, whereas the circular rounded 4-winds symbol is still used. Having said all that, I now know that you, Steve, and oldhead would prefer ‘mental illness’ not be used, so if I were to continue speaking with ya’ll, I would be more sensitive to that. In that way, it’s not just about commonly acceptable forms but commonly unacceptable forms.

    But I see your thrust, and I’ll easily admit I understand where you’re coming from with your comments on mental illness, neurodiversity, and madness. Also, if I say ‘blue’, a person wants to know that I mean ‘blue’, and you don’t necessarily want to inspect its etymology, distinguish between sky vs. indigo, go into the nature of the perceiving eye vs. inherent object, or how a painter might use it vs. a physicist. I personally don’t think of ‘psychiatry’ as a monolith, and I find much value in the history of psychiatry. So I’m thankful that I don’t have to think within the bounds of what I’ll call a common psychiatry even though its full of loaded and controversial terminology. If I want to free myself from a common psychiatry, I will use my language in a way that allows me to do that, as you seem to be doing too. I feel free to pull from alternative, complementary, and critical psychiatries as well in order to do that.

    Anyways, this kind of forum allows people to ping-pong all this out, and hopefully there’s value in sharing and disagreeing along the way. Much of Steve’s comment had me thinking a lot. I first brought this as a question because I wanted to know how someone could consider ‘it’ non-existent, unreal, metaphysical, and/or metaphorical. I’ve learned a lot. Thank you.

  • cabrogal,

    I get your point about the enslaved, and that is ideal of course. Although I wasn’t really suggesting that freedom SHOULD be postponed UNTIL the most efficient way could be implemented. But can you imagine what would happen not just to the mental health industrial complex, but to the point here, to existing or new customers/clients/patients, if ‘psychiatry’ were to be made illegal overnight or over 3 years even? I completely see that the ‘system’ holds back alternatives, and that there are already numerous alternatives that prove more effective (each in their own way) in the mental health spaces. I have no issues with all that, and I fight daily to play my part in this type of awareness and transformation. But perhaps you see my point about anyone who is or could be a ‘patient’ if the ‘systems’ were to be disrupted abruptly? I’m sure the history of slavery does have much to teach us in this respect, which is of course still being reckoned with. My guess is it that some important work will change ‘from within’ as well as from without, but legal and financial pressures will have to continue.

    Thank you for all your nuanced anarchy histories. I’m glad someone is keeping track. I’ll probably have to make this my last comment.

  • oldhead,

    I’d clarify that many of my comments such as this one are not addressed to the public, but to you, a specific individual. If you want me to take you seriously, you should not provoke me, or whatever lesson you were wishing to give, indirectly in the third person. Say it to ME, not the public, if also addressing my comment specifically. Just as you did on your previous comments to me. You knew very well that I would read it. Ego and insecurity are beside the point.

  • cabrogal,

    Slavery & Anarchy:

    Slavery is a good but extreme example, but my argument still applies. The ideal goal was never to simply kill off or abolish slave owners as people nor leave slaves in the lurch. To take a less heady example than slavery, the need to end coal mines and fossil fuel industries should be respectfully yet firmly transitioned toward renewables simultaneous to a reduction of energy consumption. People want jobs, and they see that in what they’re accustomed to. It takes a comprehensive plan. Banning fossil fuels while saying you are on your own to figure the rest out is not the way and builds resentment and a feeling of resistance and revolution against the proposed alternatives. As I don’t align myself with a destruction of the entirety of psychiatry or government per se, I don’t require each to be simply abolished. There have been some fairly smart innovations over the last 100 years, and certainly lesser evils, which may be as good as we can expect. Evil and dysfunction are intrinsic to human nature, so we will have to learn to live with them. However, conventional and industry of psychiatry is not my friend, and they should be ashamed and forced to look behind the mask in the process of transition and atonement. But I’ve learned that conventional psychiatry at large doesn’t change and political and financial pressure is necessary just as slavery and its after-effects.

    Given the diversity of anarchists you mentioned, it still seems that individual communities would be small unless they all gathered under the Great Anarchy Banner at the anarchy convention. If anarchy unification could really meaningfully stick given the different styles, that’d be interesting. I still feel certain anarchist goals are inimical to group development, especially large groups where it gets ever harder to limit hierarchy and conflicting leadership and agreement.

  • rebel,

    Once again, I resonate with and appreciate your insights. I responded more thoroughly about grief and illness above. I would find it easier right now if the word ‘ill’ was dropped and replaced by suffering and pain. Both of which should not necessarily be suppressed, but also should not go on indefinitely or constantly interfere with the necessities of life.

  • oldhead,

    As no one else elicited my name to you, once you begin speaking of me indirectly in the third person while still responding to my comment knowing I am a reader, I see there’s little use in continuing. Although I do see it as a clever way to try to ridicule me and distance yourself while trying to align with others.

  • Steve,

    Part 2:

    You seem to necessarily define illness based on the nature of the body or the ideal physical sciences, so your argument that being depressed is not an illness makes sense on that level. But I, and medical psychologists like Carl Jung, do not require this restriction. I personally use ill as including distress, (relative) disfunction, and suffering in general. So I could replace mental illness with mental suffering or mental injury, with no need to call it a metaphor. It would partly be a matter of from what direction the perspective is coming from. I realized I also don’t want to use ‘mental disorder’ as I would use psychic sickness. I normally wouldn’t consider grief of a dead loved one to be a disorder how it’s typically used in the DSM, although some people’s anguish lasts an exceedingly long time and requires continual care — self, communal, or professional.

    It’s part of the nature of mind/psychology not to be easily located or proved, and to remain subjective no matter how objective we aim to be (or actually are). I do believe even the mind can incorporate objective psychological facts, since otherwise we wouldn’t ever understand each other, and dreams can portray accurate qualities of other people and things, not just the subject. Jung showed us that the mind has a nature just as the body does; with functions/disfunction, problems, pathologies, etc. I admit I harken back to Jung’s use of ‘medical psychology’ and don’t like to restrict the term ‘medical’ to a physical definition. I also respect his work in the psychogenesis of mental illness (elaborated in the book by that name). My impression is that we’d be able better sit at the same table if the definitions of ‘ill’ were expanded or replaced, including those beyond ‘emotionally upset or reaction’, which you seem to reject anyway. Mental illness can affect all psychic functions. Certainly beyond the DSM models, and no one should ever assume I abide by the DSM or most of conventional psychiatry. I don’t feel a need to see psychic suffering — systematic, categorical, conceptual — as a metaphor, unless I’m only defining it based on physical premises and assumptions, which you seem to be doing and take for granted. Not to go too far afield, but Hitler was pathological, and there’s obviously no immediate need to tie it into the body. Should we really need to sever the terms ‘mental pathology’ and ‘mental illness’?

  • Steve,

    Not sure if this is a re-post, I had trouble with my first posting. I apologize if this is redundant.

    Part 1:

    Should I assume your recent comment is directed toward me? I try to put the name of those I’m talking to in order to clarify this. I hope I’m right, and I will respond as if this is true, and it seems clearly to be directed to me, given some of your specifics. However, I want to be clear that none my recent comments on this particular thread were directed toward you nor responding to your own commentary. This would immediately explain why you ‘still don’t get why (I) don’t get what (you’re) saying here.’ I don’t even see where you’ve addressed this on this thread, but please forgive me if I have overlooked it.

    I try not to use cheap simplistic definitions of mental illness, and it seems that much could be overcome if I simply replace ‘mental illness’ with ‘mental suffering’ or ‘sickness’. And yes, I would say that if a person’s low thyroid was the (only) cause of their depression, they would have symptoms of mental illness. But it would primarily be seen as a physical illness including mental symptoms. Incidentally, there are many physical ailments that can’t be tested, directly proved, understood, diagnosed, or specifically located, yet they exist and cause suffering. If I use psychic pain and disequilibrium as being mental illness, I don’t necessarily mean A or THE mental illness, per the DSM. Certainly not necessarily a ‘disorder’.

    When I talk about depression, it should never be assumed that I personally would use it in such a cookie-cutter way as ‘major depression disorder’. I’m perfectly aware of many of the issues you raise, and in that vein, I support your views. However, I don’t need any condescension implying that I don’t appreciate the nuance of your lists of influences of depression. But it appears that you yourself don’t deny that there really are depressions, and they can be caused by both physical and psychological influences. I’d note that even though an emotional or mental quality is not caused by physiology, it in no way implies that there aren’t immediate and complicated physiological reactions, some of which can also feedback as further causes and correlations of mental anguish or problems. This seems obvious, but this puts your comment ‘There is a clear and distinct difference between a physical illness that has emotional effects, and an emotional situation that has no physiological cause’ in a particular light, as the mind and body are so intertwined that it is NOT always clear and distinct. Even if ‘depression’ was not the ‘illness proper’, it still would be part of the state of suffering and seen as a symptom and therefore an element of sickness, of illness. The side-reference implying I’m beyond stupid because I consider devastating grief of the death of a parent (or dog) as psychic illness is interesting. I would not belittle my heartbreak as generic by using the term illness, in this case psychic illness. I’m sick, I’m ill, I’m suffering. Here it’s probably worth pointing out that I see ‘ill’ as encompassing an entire spectrum, not simply a state or even a quality that should define the person, such as when the term ‘patient’ is used. If the comment about nervousness when asking a girl out or school boredom was used to counter my example of grief of a dead mother as being sickness, being ill, then there’s an unfortunate disconnect, although those qualities may be included on the spectrum of psychic discomfort and
    ‘dis-ease’. And when I say ill, I also wouldn’t want to imply that it’s chronic. Whether we call the grieving person ill, we still give them all the concessions of someone who is physically ill and in a sick role. We give them leave of absence, send them get well cards and phone calls, and know that there suffering’s primary cause was psychological/experiential but has enormous physiological reactions, some of which can be managed with rest, Tylenol, good food, yoga, etc.

  • cabrogal,

    That’s very thorough, thank you.

    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.

    My immediate feeling is that I resonate more with the ‘attempt to address current social problems without (necessarily) overturning the existing social order’ or ‘promoting anarchist principles and outlooks within existing groups and communities’. 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’. A hard question would be how the transitions could occur with dignity and understanding, even if it is legal and financial compulsion that forces change. Anarchy brings up many important issues within very difficult and complex circumstances.

  • cabrogal,

    I knew I was treading incompletely with my anarchist comment. I was referring to the themes of negation and deconstruction of government and authority (anti-capitalist, anti-psychiatry, anti-etc.). Sometimes I get the impression that oldhead wants to replace these into a void (completely get rid of rather than radically reform), but others I sense that oldhead wants to replace them with complete alternatives, though unnamed and unknown to me now. I feel that to the degree that anarchists have freed themselves from the structures and institutions they oppose, it is an ideal, but that to the degree that they still interact with the institutions, it will inevitably be deconstructive and dissolving (or destructive), unless they compromise their own will and principles. But I admit, I’m not a wiz at the history of anarchy, including anything related to The Sex Pistols. 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. A favorite writer of mine held anarchists IDEALS, and I sympathize with some of this, such as limiting hierarchy and realizing personal responsibility and liberty.

  • Steve,

    Are you suggesting that the legal historical use of ‘insanity’ in courts is somehow more reliable and that a judge would know better than a psychiatrist? That legal authorities are any less biased and non-scientific? As we’ve seen over the last few years at least, we certainly wouldn’t want a police officer to make any final decision, or act as judge, jury, and executioner. What ‘outside party’ would be used to make a decision, if not a ‘mental health professional’? I admit, I’m not saying that they would fit the bill either. I’d like to know more about the concept of insanity in the justice system, some day at least. I know Carl Jung had occasion to be summoned to court in Switzerland as a psychiatrist for very difficult cases involving the psychology of the charged, and that was around 100 years ago, certainly absent any DSM Manual. He sometimes used his ‘word association experiments’ to give insight into guilt or innocence, as well.

  • oldhead,

    I sense that the very real ‘mental symptoms’ I described, from the standpoint of experience and psychology, are given their due as long as we don’t call them ‘mental illness’. This reminds me of the ‘chemical imbalance theory’ although here, brain damage can be structural/functional, and not limited to primarily or simple disfunction of neurotransmitters. But of course we know that psycho-social and environmental influences can also create the very symptoms I listed, in which case the physical causation would not have been the primary cause. I’m trying to see how someone can call mental illness metaphorical, or rather non-existent, yet be so open to both physical illness and apparently mental illness as long as its cause is physical. Even if the disease proper is physical, there’s ultimately no reason to see the psychological correlates as any less ‘ill’. But you should probably know that if my mother dies, and I go into deep depression, crying spells, non-constructive rumination, chronic anxiety, etc., that I consider this illness and not simply understandable grief of a lost love.

    But I get it, conventional psychiatry is so full of itself that these highways and byways are inevitable. And I wouldn’t just accept that my grief over my dead mother would require an SSRI antidepressant, cognitive-behavioral therapy, or a support group for those whose family member has died.

  • oldhead,

    I suppose I’ll be glad you didn’t try rake me over your coals, but the intimation is enough.

    I realized that ‘legal’ and ‘political’ may be synonymous, but there are subtle differences that I would have to do more homework on.

    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.

  • oldhead,

    Let’s say model of human behavior and deviance. You’ve accepted that criminal physical violence, unjustified violence not for self or other-protection, can me sanctioned and controlled legally on a basic level, but not put in a context of mental illness or a medical model. Model of deviance. Violence would be defined legally since you denounce criminal (only physical?) violence, but it could be defined and explained in other terms such as a moral wrong or sin, or a physical/mental medical sickness or even criminal insanity, and this kind of thing. You, yourself, used ‘bad behavior’ as a basic premise, and above you use ‘basic principle’ and ‘basic responsibility’ as if these are common sense or come from a higher authority perhaps. Part of my concern is that restricting it to a legal one, which if you notice has an ostensible moral one as a background, is insufficient and often ends up reducing and limiting the captive just as much as a narrow-minded medical one. Legal and moral concerns can be filled with just as much illusion and projection as a medical, so my impression is that each of these areas, including medical and mental, have something to offer as well as hinder.

  • Thank you, very important.

    Clinical nutrition or orthomolecular medicine should always be part of the puzzle here as a possible partial answer. (High dose vitamin C, B vitamins, vitamin E, lecithin, manganese, etc.) Also, based off my recent experience and research of oral and IV ketamine, there may be a role there as well in combatting and relieving akathesia and suicidal considerations. I mention these here since they weren’t mentioned in the article.

    I voluntarily went to the ER (then overnight psych hospital) due to extreme akathesia-like symptoms from a newly used neuroleptic. But I’ve experienced various gradations of neurological and psychological severity which the nutrients and ketamine have greatly helped.

  • oldhead,

    I see you are comfortable with highlighting physical illness such as brain damage. Why such a reluctance for mental illness? Does this mean, in reference to a comment above, you would reject ‘violent mentally ill offenders’ but accept ‘violent brain damaged offenders’? Would the brain damage influence your reckoning of the violent offense and any legal punishment, or would it once again simply be a matter of personal responsibility? Surely you would agree that brain damage has psychological correlates even though it may not directly imply a straight forward conventional mental illness. Just trying to feel this out.

  • oldhead,

    Are you using a ‘model’? You don’t seem to be explicitly using a moral model and definitely not a medical model. Are you using a legal model, but an unconventional one? Or are you using a moral model, that is, using notions of good and bad, with according redemption and punishment? I see you use violent, criminal, and irresponsibility similarly. I’m not being especially clear myself, but since you reject psychological pathology as deviance in a medical model, I thought I would ask. Can you elaborate?

  • oldhead,

    A fireside chat would be useful, wouldn’t it?

    Yes, I chose ‘see’ to emphasize my point of view, stay away from ‘believe’ or ‘feel’, and to add a level of familiarity, concreteness, and even a common aspect of the mind itself. I didn’t mean to use a material example as simply code for ‘real’, but I assumed there would be no question of the reality of the hand. There doesn’t seem to be a need to describe the hand as metaphysical or metaphorical. When I see color, see a dream image —or someone’s description of their own — or see someone crying, I’ll maybe consider your suggestion that I can’t see the mind. Perhaps I can see my own but not someone else’s? Or only indirectly or by inference? But I won’t linger next time I see and hear a baby cry, whether it be from hunger, sheer loneliness, or fear. Either way, I’d prefer if the mother, or father, ‘treat’ the baby accordingly.

    In many ways for people, mind and body are two sides of a coin and infused throughout rather a ‘real’ dichotomy.

    But again, what I’ll call ‘conventional psychiatry’s worldview’ is not my friend nor colleague, so I sympathize with you.

  • Steve,

    That’s one reason why I qualified my statement as including the ‘hardcore’ definition. I’ve found that metaphysical can be used as non-empirical, non-experiencable, unprovable, or as flights of abstraction. In this case, I meant none of these uses. My impression is that the response was using it in a way that was reducing or limiting my original comment, and also associating my phrase with metaphor. I wasn’t trying to be metaphorical.

  • oldhead,

    Under usual circumstances, I see the mind as being real as my hand. So I have no need to fritter it away, cheapen, or desubstantiate it — consider it an ‘only just’ or ‘as if’ — by calling it metaphysical or metaphorical. I’m talking about real healing, real mind. Maybe metaphysical in the most hardcore sense.

    The etymology of ‘psychiatry’ is simply healing of the soul or psyche, so I also don’t feel a need to deconstruct the word because of how it’s been misused. However, no one feels the weight of conventional psychiatry’s fraud and malpractice more than I do.

  • Carl Jung knew that often it is the parents of the ‘problem child’ who need to be ‘taken by the ear’, and by extension, ‘society’. But often we get the child a ‘team’ and ‘do’ something ‘to’ them. It sucks when parents would only admit guilt (REAL guilt, not the ‘common’ guilt of ‘good parents’) because they ‘failed’ their child because of how they act, in other words, diverting the true object of guilt. We should remember that life itself is guilt, and no one is completely free. And not once did they have to pay for their own couple’s or individual therapy or drug prescription….and guess who never changed? No ‘service-provider’ or ‘clinician’ ever looked close enough and recommended it, for in a sense, the provider would then have to take their own therapy, their own drug, because they so often unconsciously identify with the parents. It only changed when the child (who is a parent’s child no matter what the age) becomes the parents’ ‘therapist’ at the moments when he doesn’t have to leave the room during their arguments, making sure he can’t hear it in the background, all those ‘contagious emotions’. They were always there. But it was the child who got the label, the infinite ‘services’. In this way, one source of the ‘infection’ was never pulled from the roots. It began only to return again.

    And also no one ever mentioned nutrient supplements (even diet?), not even the most ‘enlightened’ ones like this author. Not once.

    Man, I certainly ‘quoted’ this comment up.

  • oldhead,

    I wouldn’t dare speak for the author, but I’d note that she didn’t simply abolish psychiatry as a convention or system, but gained insight using the words ‘symptom’, ‘syndrome’, and ‘condition’, while maintaining an openness to ethical research and healing of her psyche.

    Psychiatry as slavery should be banished, but healing of the soul should not. My immediate impression is that you would agree.

  • Till Bruckner,

    I see that you only point out negatives to using ketamine, as one would given only its misuse and risky complications. But are you aware that there are positive and constructive uses and applications, as well? Here I’m referring to psychiatric or other off-label uses and not anesthesia in war or veterinarian medicine, for example, which have long been accepted and valued. There are many examples of safe chronic use for pain conditions and not just acute use in battle or for dogs.

    I’d point out that disassociation occurs at middle to higher levels of ketamine, not lower. It’s clear that you are unfamiliar with the spectrum of ketamine since you think that disassociation is simply something it’s supposed to do. The dissociation is probably one area that benefits its anesthetic uses, but my guess is there’s potentially some therapeutic use of mild disassociation for psychiatric reasons too, such as is found in carefully run IV clinics.

    Illegal use helps show that people are desperate (sometimes due to the failing of the ‘system’) and that legal and regulated markets of some sort or another, even if only medical, could reduce crime and risk. These are in addition to the pleasurable/party element that gets mixed in. Decriminalizing drugs while providing a strong social safety net and reliable education would, in the long-term, save both individuals and society money, pain, and stigma. Low to mid-dose use through a prescriber has not shown to lead to unusual levels of addiction-seeking behavior, often quite the opposite, and especially compared to benzodiazepines, opiates, and those sorts of things.

  • There are many good/useful things about this article, but here I will not dwell on those.

    The words ‘medication’ and ‘patient’ are conveniences for those providing a paid service. I see that ‘medication’ is at times replaced by the more accurate ‘drug’ or ‘substance’, ‘chemical effects’ being used, too. Rather than use ‘medication’ when the author uses it in his ideal way, we should just bypass it, as it betrays the neutral, harmful, or mediocre elements, even when used as wisely as possible. Even if one word is preferred, it would be useful to always use it consistently rather than bounce back and forth. Also, why not use ‘client’ instead of ‘patient’? It’s partly due to the doctor’s ‘Aesculapian authority’ and its designation of the ‘Parsons sick role’ that doctors so easily dole out despite not being absolute, and despite creating a disempowering framework upfront in many cases. Apparently, in order to pay for a doctor’s service, accepted or not, you have to be put in a patient/sick role. Patients too often are put in the lowest position in the medical hierarchy, almost making it seem like they always start from the beginning and don’t at times know more than the professional they are paying. The author knows very well the negative conventional tendency toward ‘patienthood’, while he still creates and keeps it during the entire relationship with his service. When the usual doctor breaks his or her leg or gets a vaccine, is when the role-blurring and mask-swapping become more apparent.

    I see that once again nutrients are not mentioned once. Nutrients CAN modify a ‘chemical imbalance’. Nutrient deficiencies are obviously ‘incorrect’, but if I don’t produce enough NAD/NADH from tryptophan or the RDA of vitamin B3 from the diet, higher levels of supplemental B3 will assist with this. Additionally, if I smoke a pack of cigarettes per day, supplementing with vitamin C will help compensate for the large quantity of vitamin C that is destroyed by each cigarette. This is not including how to generally ‘optimize health’ with diet and supplements.

    While drugs don’t ‘have agency’, they can moderately or radically alter the person’s agency, just as foods can. My ability to think smoothly or creatively, for example. The phrase ‘you are what you eat’ (put in your mouth) is both true and untrue.

    Ketamine is an example of a drug that, for many people, does not build a tolerance when used in low doses for certain forms of depression.

  • Low dose generic affordable oral ketamine helped save my life. I don’t mind if people are turned off by bio/chemical strategies for health, and I don’t mind if ketamine is seen as a street drug. I’ve been around the block a few times, and I recommend ketamine for some people (along with nutrient supplements). This method transcends the expensive, time-consuming, and clinical over-control of the nasal spray and IV. Generic ketamine not only can’t be re-patented and studied in the same ways that patents promise, but its long history in anesthesia and pain control tell us much. Many studies of additional ‘off-label’ uses for depression, etc. have been done over the last 2 decades, between prescribers and ‘patients’.

    Don’t be fooled, we need not pursue this research solely through the lens of esketamine, it’s marketing, and corporate shape-shifting and rose-tinted glasses with $-signs in them. There’s already been much research, experimentation, and anecdotal and clinical experience, if only the authors dig deeper, well outside the esketamine black hole.

    Remember: so far, ketamine (with my other modes) has saved my life, and I am not a white crow in a flock or ‘murder’ of black crows. I am simply a crow that did not pluck his feathers out and break his beak since generic affordable oral ketamine was prescribed by an innovative and exploratory prescriber.

    I recommend the book Ketamine for Depression, which, though imperfect, is highly revealing and trail-blazing: