Monday, September 20, 2021

Comments by evan1

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  • 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: http://www.evanhaarbauer.com/

    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:
    http://www.evanhaarbauer.com/orthomolecular/
    http://www.evanhaarbauer.com/

  • 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.

    Lastly:

    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.

    https://aaagnostica.org/wp-content/uploads/2016/05/The-Vitamin-B-3-Therapy.pdf

    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, https://www.amazon.com/Vitamin-Cure-Alcoholism-Orthomolecular-Addictions/dp/159120254X/ref=mp_s_a_1_3?dchild=1&keywords=vitamin treatment alcoholism&qid=1619491639&sr=8-3, and material in The Journal of Orthomolecular Medicine, https://isom.ca/jom/, 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 http://www.orthomolecularvitamincentre.com/links.php 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: http://01greekmythology.blogspot.com/2013/10/brimo.html?m=1

  • 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:

    https://www.amazon.com/Ketamine-Depression-Dr-Stephen-Hyde/dp/1503509559/ref=nodl_

  • Open Dialogue still needs work, too. And while the effort is made to put quotes around ‘mental illness’ and ‘disorder’, let’s not throw around ‘patient’ so easily, as well.

    While I, of course, like Open Dialogue compared to the conventional monstrosity, and link it on my website, I wonder if while the ‘team’ constellated around the ‘patient’ and apparently with an intent to rid them of ‘psychosis’ no matter what, what happens when we find that the individuals of the family or, yes, staff, need to make a change, learn something fundamentally new, or ‘fix’ themselves? It seems to me the onus is solely on the ‘psychotic’ to change, via a humane lens of non-compulsory story and freedom.

    Are we to only see ‘psychosis’ as something to be removed in order to judge treatment as successful? Has Open Dialogue gone far enough in forming a nuanced understanding of psychosis? If I have 4 long lucid dreams per night that make me spooked during the day and unfit to work, is that considered psychotic, or only if the ‘dreams’ break through while I’m awake? It’s not so much neo-Freudian psychoanalytical ideas that bring us a nuanced notion of psychosis, but rather Jungian depth psychological approaches and Jungian therapies, which bring in the psychoanalytical but go beyond them. Psychoanalysis and Jungian psychology DO have special access to the inner workings of the mind; that is, they point to the potential: the keyholes of dreams and active imagination, a.k.a. the unconscious. Look, experience, write down, paint, interpret, pay attention, have it ‘click’. We need not call our preference ‘philosophy’, but we can use ‘psychology’. Also, saying cognitive behavioral therapy is no ‘better or worse’ than other therapies seems to imply that any therapy is no better or worse than any others. No?

    And what about alternative/complementary therapeutics like nutrients? Is there any direction and guidance on these, or are only minor and short-term pharmaceuticals/neuroleptics used as a last-resort biochemical method? Clinical nutrition and micro/macro-dosing psychedelics ARE technical breakthroughs that have improved outcomes, unless I misunderstand the use of ‘technical’ breakthroughs or innovations.

    A Buddhist dis-attachment of a false sense of self is not the same as ‘dissolving the individualist ego’, at least not really. Unless you keep in mind the importance of the ego in the individual-community relationship instead of criticizing and negating the ‘individualist ego’.

  • Jennav,

    I talk about my positive and negative experiences with B3 under ‘B3’ under ‘Vitamins’:

    http://www.evanhaarbauer.com/orthomolecular

    I realized I need to update it with my inositol hexaniacinate experiences, which is what I take now, seemingly without problem. I will continue with occasional blood tests.

    Right now, I take 1.5 grams of the no-flush inositol hexaniacinate, 4 times a day, spaced out about 4 hours each. After 3 meals and before sleep. This form is very ‘smooth’, kind of calms me, yet I keep good focus. (I use other prescriptions and nutrients, too.) I’ve been on one form of B3 most of the time for 9 years now. It has been very interesting.

  • Dunwithpsychslavery:

    I recently learned the concept of the ‘nocebo effect’ from Ivan Illich’s 1970’s book, Limits to Medicine, Medical Nemesis: Expropriation of Health. If only I had all the terms and resources in the early thick of it all, when I was mostly flying on instinct, intuition, feeling, and sensation.

    I dedicate part of my website to orthomolecular medicine:
    http://www.evanhaarbauer.com/orthomolecular

  • Caroline and Joanna,

    My two cents: My U.S. social security disability income does not consider what drugs I am on. They may have when I first applied, but not simply in order to receive benefits. However, I don’t know how a ‘review’ would affect this; it probably depends largely on the doctor(s) opinion rather than any particular drug. I personally have not had a review in probably 6 years for some reason. Often it’s every 3 years, which is what happened on my 3rd year, I believe. Good luck everybody.

  • Hi Joel,

    Thx for sharing. This is an old post, but I relate to your story. I wanted to offer a certain part of my website on my experiences with all this. Most of this section deals with clinical nutrition, but there’s plenty of others intermixed. It may not be your cup of tea, but as you expressed ongoing concern, I wanted to offer it. I hope you have found more peace over the last 4 years: http://www.evanhaarbauer.com/orthomolecular

  • Nijinsky,

    I must admit, hard to follow, but rather poetical with a flow and drive of spirited ongoings, in which I catch things. Are you breaking chains very carefully? Either way, in one of my songs, Psychic Straitjackets, I rap ‘Worldwide word expansive. Systematic random hogtied spontaneous passion….May be montage, death and laughter, hodgepodge coinage too rare too cash in. Runaway train of meaning’s all that I’m asking.’

  • SPHancock,

    Well done, all around. Very interesting. I followed on Twitter, and good-looking website.

    I noticed one of your ‘signatories’ says ‘life transforming in a very good way’.

    I do wonder how a ‘placebo-controlled’ ECT study would work. I have a feeling I’d be wary of being a test-subject, either way. And how ‘confounding variables’ would be confidently handled, without preventing all those ‘complex’ people from entering in the first place, as so often happens.

    Abram Hoffer, orthomolecular psychiatrist, used ECT early in his career. He used high-dose nutrients along with it and didn’t recommend it without that approach. From what I can tell, he abandoned the technique.

    An overall lovely book, Ketamine and Depression, is written by Dr. Hyde. I have gained immensely from ketamine and this work. However, he says that ECT has been the ‘quickest and most effective treatment for treatment-resistant depression in (X) years’. And that ketamine is the most exciting breakthrough in depression in multiple decades. Then briefly mentions ECT’s quick relapse rates and (usually) short-term memory loss. (Apparently unconscious of most of your citations, activist groups, and testimonies; as well as clinical nutrition and, hell, any ‘effective’ psychosocial methods, although he deals with them some as part of a ‘comprehensive plan’). He notes ECT series given (by his prescription or others) that go up to over 100 sessions, as I believe I saw happened to you. It is interesting how they are often pushed onwards, ever hoping for the switch to be turned, so to speak. I find this similar to ‘antipsychotic’ use and other conventional pharmaceuticals. Press the same buttons over and over, maybe a slight tweak here and there, or a different ‘class’, and surely the answer is just around the corner.

    Anyways, I hope I see the further fruits of your extensive and devoted labors.

  • Marie,

    I am curious what your elderly relative thought about his situation? Is the situation such that he is more stable, to himself and others? Or is it that everyone else must speak for him due to his predicament? It is interesting that a person with dementia had to additionally be transferred to a ‘memory care clinic’.

    It is interesting, and frankly tragic, how we all have to needle our way through the great ‘risk/benefit ratio’. I support freedom of speech for the ‘benefit’ just as I do the ‘risk’, just as I do for the amalgamations and the none of the aboves. It’s all very tricky.

  • Magdalene,

    I suppose I won’t really try right now. But it made me think that maybe it’s ‘Sunday’, and that Friday(night) and Saturday(dawn) come before Sun-day. But while nature has days and seasons, the 4 winds, it has no weeks. I don’t often drink my kool-aid though, but I do dip into my organic juice pouches. I also find (non-sarcastic) humor and an ability to smile and laugh are ‘symptoms’ of an (ideal?) mental health, even if it is roped to pain, grief, and incapacity. Perhaps like a blues musician. If we can laugh, we should at every opportunity. Same with getting goosebumps from experience of art, beauty, and meaning. Laughter and goosebumps are signposts to mental health. Know what I mean? But the ability to cry can also be a sign of health in its own way.

    Lol, I have a feeling this doesn’t fit a ‘universally agreed definition’. Take care.

  • Jeffrey & Caroline,

    I relate to most of this in some way. (I am on social security disability income for ‘schizophrenia’, and get family assistance. Able to live alone after unbearable living with parents or others (and ‘self-medicating’, some legit, some not), dating apps, etc. My ear (eye) has listened (read). I breathe it in and exhale confirmation and some kind of energy directed toward new ways, synergism, and something I cannot describe. I was suicidal for a long time. Aside from my skin cancer and stomach inflammation, the Virus Epoch has been a transformative positive year for me, as odd as that may seem. Is it useful for others, I do not know except in my immediate circle.

    My website is my Way. My email is there. I am an orange leaf falling, drying, and seeping into the soil when it rains. I am sap that moves upward, sticky with leaf nutrients. I don’t mean to seem egg-head, but rather trying, trying. Ok then: http://www.evanhaarbauer.com

  • Rebel,

    I’m a very spiritual person and think on this a lot, especially through Carl Jung’s work on these ideas. I would just like to say that God had placed the snake in the garden (evil existed before creation of humanity), Yahweh radically and unjustly punished Job, God forsook Jesus on his cross (a cross that doesn’t seem to be simply the Roman Empire’s doing), seemed fully comfortable debasing homosexuals to Hell—on earth and in the hereafter, and that it was God who unleashed the Seven Plagues. All this tends to highlight God’s wrathful and vengeful side, a side which perhaps Jesus tried to reform, or provide as an incarnation where God tried to offer ‘His’ right hand. I’m very wary of God’s ‘discipline’, as I’ve been abused in its name by certain ‘Christians’ and see the ‘punishment’ (often unjust) throughout history, society, and biology. The degree to which something is deemed ‘God’s doing’ vs a person/society, is notably difficult.

  • Ron,

    I see what you mean in response to the earlier comment (and saying ‘up to a point’). However, bc you agree that the diagnostic labels are ‘not real’ and ‘somewhat or sometimes very misleading’ is where one could point to fraud, and systemic misappropriation of the ‘real complex problems’. The fact that the potentially unreal diagnostic labels, partly or always, are used for professional and coordinated financial gain and efficiency, and isn’t entirely justified and based on truth and accuracy, this is fraud, right? A soft deception, one rooted in the momentum of the past, gigantic social movements and habit? But a partial/potential untruth for accruing money (even sometimes taking away rights), isn’t this a type of fraud, no matter how well-intentioned? No matter how cordial and invisible? I see a kind of quasi-doublespeak that therapists/doctors are often stuck with.

  • Sam,

    I would just like to add, and I know it may be off-putting, but I know a psychiatrist/author who has decided not to retire (as planned) due to people and him who think they need his ketamine prescribing practices, which most doctors would not use. At my next appointment, I’m going to ask my psychiatrist what I should do if I can’t see him. There are a couple or a few other people who would prescribe ketamine in town. My guess is most doctors will eventually use the FDA nasal spray rather than off-label cheap generic ketamine, but they’ll have to get the pens and writing pads with the Spravato name on them, the free seminars, and the drug reps’ smiles and samples first, perhaps. It would take time for the insurances to decide to cover a nasal spray that costs perhaps $1500 or more per month. My doctor doesn’t allow drug reps. He’s only very briefly hurt me, indirectly, twice. Terrible drug reaction (without an apology or much said at all), and a postponement of further action when extremely suicidal and uncomfortable (which ketamine helped greatly).

  • Sam,

    That is interesting that a 24 year relationship with your doc ended. But I guess that given 40-50% of marriages end in divorce, and people/circumstances change, perhaps it is not surprising.

    I didn’t think we were talking about ‘averse effects’. You and my previous reference was ‘adverse effects’. But I understand your ‘aversion’ comment.

    Given that what psychiatrists did with/for/without me for 16 years, I find that they never changed, always doing the same things. The fact that most of them thought they were good enough is more than disappointing. Were they even good, let alone good enough? One trouble is that although they have an ‘arsenal’ of endless things to try, they often do the same things, and ‘trial and error’ becomes a waste of time, energy, and money…and hope. A person in a perpetual fog is less questioning, less of a ‘bother’, and a way to kick the can down the road without ever changing, learning, or finding a new way.

    I agree that there should be more ‘non-hospitals’. I have found some are better designed than others. But the psychiatric drug use and ‘group therapy’ programs, etc. are still the same, regardless of the better design. Then they stick you with a bill of thousands of dollars. California did pay for my 2 week psyche hospital stay (voluntary turned involuntary) because I applied due to low-income. It’s not clear who profited the most, but it wasn’t me. Soteria House and the Finnish Model are alternatives, but hardly the norm.

    I found that even though I sought ‘help’, one of the primary responses was pushing ‘antipsychotics’, as if that was progress and sufficient. It’s very clear to me that psychiatrists have never taken antipsychotics or most of the drugs they’re so fond of and profit from. In medical school, they should take each class of drug as experiential education. 🙂 So should drug company CEO’s and drug reps. A cook tastes his/her food while cooking, and knows what it’s like to eat it. A week of antipsychotics, Haldol to Zyprexa, would be sufficient perhaps. And go ahead and try the higher doses….hell, take the injections. Most likely they would have to take the week off of their work, normal classes, and homework.

  • Eric C.,

    Wonderful article, I’ve read multiple times. Had my parents read it and referenced/linked in a comment recently. I also bought one of your books, Hearing Voices: A Memoir of Madness, an older one that was written before a great deal of your later journey and insights and probably shorter than what you would write now.

    Do you mind me asking if you still take Saphris or a neuroleptic, that doesn’t affect your creativity and mind as you’ve mentioned on this comment?

    I also went from Zyprexa to Saphris. I continue to describe it as a ‘revelation’ although there were other factors going on too. Early this year, I decreased my Saphris by 75% when using ketamine and was no longer suicidal or brutally depressed (with my other modes of health), and not that the 20mg Saphris really helped. Tried to sedate me into ‘health’. I’ve always only taken Saphris before bed (limiting daytime unwanted effects), unlike it’s recommended twice daily. This is one reason I prefer it to all others, which I have hated and resented due to effects and prescribing rationale. Oddly previously, Zyprexa seemed to be the least worst and quasi-modestly-tolerable. I always gained/lost 30(plus!!)lbs every time starting or stopping, never being overweight in my life. This occurred multiple times over about a 10 year period with various interludes of nothing or others. They used dissolving Zyprexa at times in the psyche hospital (I wonder why?!). But I can’t sleep without Saphris. Nor can I sleep without eating a lot.

    I found out that my insurance retail cost of Saphris is ~$1500 no matter dose or times a day! I’ve recently got a years worth from their patient assistance program (having ordered the highest amount despite my 25% dose, which means I’ll have 4 years worth if I disregard the expiration date). This was after my doctor had been ordering free ‘samples’ every so often. Of course I hope to get off some day, but I have no qualms that they are giving me the equivalent of $18,000 for free given their clever history of profit-making and price-gauging. It’s off patent this year, but no generic is available yet.

    Thank you.

  • So ‘do no harm’ is in the oath, just not ‘first’. The sentence you quoted doesn’t seem to require a ‘first’, it is simply a fundamental. It is odd to me that ‘do no harm or injustice to them’ is added to the previous statement on dietary regimens, rather than standing on its own. Also that it disallows abortion and puts the surgical responsibility away from the physician, if that’s the word they used back then.

    The ‘modern oath’ that is linked on the page does not have anything explicit about doing no harm, although it gives a general sense of love, care, and respect.

    “I will apply, for the benefit of the sick, all measures [that] are required….”

  • I require other’s perspectives, and I need to revise everyday. I resonate with a great deal of what he says, and he certainly fills a void in many ways. I agree we have to stay out of the worst of psychiatry, but that’s easier said than done, isn’t it? Especially for children, as the author rightly emphasizes, and as you have pointed out many times. Here are some further thoughts on how I thought I differed or amended the author.

    In terms of ‘professionals’, psychiatry works in conjunction with psychologists, social workers, and counselors, the one’s who are the main people who allow the story and meaning of pain to be given space and unfold. I don’t believe all psychiatry frames pain as meaningless, or something to be simply axed by synthetic chemicals. Especially not the psychiatrists and medical psychologists I read, who I don’t associate with 95% of psychiatry, and who started work before pharmacology overflowed into and dominated practice. Even for my favorite author’s, I find I have to find their blind spots and supplement what one doesn’t have with what the other one does.

    Although pain may not be ‘valueless’ or that it has something to ‘teach us’, I think it should be prevented or ameliorated swiftly or effectively, I just don’t think it should only be done through physio-therapy, whether that’s falsely professed or actually effective. But psychiatry does not usually play the role of the psychologist, social worker, or counselor, even though they should. The author has an unusual combination of psychiatrist/psychotherapist, but I don’t know how he combines them, uses them as separate hats in different appointments, or if insurance pays him. It would be great if we could all just move to a cash-pay system and afford it, but I find that many people would fall through the cracks, despite that sometimes being seen as a good thing. I also don’t get the impression that he uses ANY prescriptions, supplements, or general chemistry in these ways. I was trying to say that the ‘simple easy-to-consume soothents’ have never been limited to psychiatry and its diagnoses or corporate industry. It’s not so much the idea of soothents, but the masquerade, the form, the how, and the why. But I agree that psychiatry, or medicine at large, has played their substantial part. If any substance or soothent was ethically used, not-for-profit, effective, safe, and appreciated, this criticism wouldn’t even have to be made. It’s just that the realities that we are talking about are so often unethical, greedy, non-effective, harmful, and not appreciated that we have to cast it in such a negative light. It is interesting to me HOW MANY people who use psychiatry and take prescriptions DO NOT bother dwelling on the negative sides of theirs or others. I’ve dipped into NAMI quite a bit, both their ‘recovery support group’ and their affiliate meetings. Needless to say, I’ve had to mostly dip out after my research project. It was not the recovery group or doctors who taught me what ‘iatrogenesis’ meant and how common it was.

    The author claimed childhood depression was considered rare, as a ‘condition’, before the past 3-4 decades, that it’s grown through pharmaceutical company marketing, prescribers and exaggerated diagnostics, simplistic chemical imbalance theories, and a gullible public. I understand that further back pharmacology was not used as much, especially given that it largely didn’t exist, except for things like ‘narcotics’ or barbiturates. Some doctors were using nutrients, others were using more psycho-social-environmental methods and who did not find it primary or necessary to inject a child or give them a daily cocktail of drug tablets and capsules. But childhood depression was not rare, and it didn’t NOT require intervention. Unfortunately, it is often difficult if not impossible to change parents, the environment, the culture, the workplace, and the doctors themselves. These are some reasons why the easy use of chemicals are seen as a short-cut or the only remedy that people have control over.

  • Sam,

    I also always consider your words, and they often feed my hunger.

    I should clarify that my ‘getting a beer’ doctor reference was a family physician and not a psychiatrist.

    I’m not sure it is a positive thing that regular docs have no time in the sense you said. Psychiatrists often have even less time with people it seems to me. My ‘beer’ doctor never rushed me though, it’s just that he mainly did what the psychiatrists do with regard to mental health, and failed me, even though he was much more amenable and accommodating, except for his bad attitude toward nutrient supplements.

    But you didn’t give me an alternative to ‘adverse effects’. I understand you want to just call these psyche drugs ‘poisons’, but I guess I was wanting something else. It took me a long time to replace the common usage of ‘side-effects’ by sheer common momentum, so I changed to adverse effects, while always noting the ambiguity of all this. It was actually an MIA article, https://www.madinamerica.com/2019/10/there-is-no-such-thing-as-a-side-effect/, that pushed me further in that direction. I related to his experiences, including his use of both Zyprexa and Saphris.

  • Steve,

    I found this Harvard Medical School article on this oath taking. Apparently some schools mandate the oath, others a different oath, and others none at all. It says the ‘first do no harm’ is not from the technical Hippocratic Oath, but from another of his works, Of the Epidemics. It also goes into how this plays into medical practice. I by no means accept all this article says, but it is interesting to see how this doctor explains and rationalizes it. It is short.

    “But it is a reminder that we need high-quality research to help us better understand the balance of risk and benefit for the tests and treatments we recommend. Ultimately, it is also a reminder that doctors should neither overestimate their capacity to heal, nor underestimate their capacity to cause harm.”

    He could learn a lot from Mad in America’s website, much of which needs no further research, scientifically, journalistically, or from lived experience.

    https://www.health.harvard.edu/blog/first-do-no-harm-201510138421

  • Thx. 3 feathers I’ll slightly ruffle as a supplement:

    I’m not convinced that childhood depression would have been considered rare before more than 3 or 4 decades ago. Although it sometimes went under other guises, like neuroses, anxiety, not to mention child labor and child abuse. ‘Environmental’ causes included parental influences, who had their own problems bleed into children, although they were also collective problems. I’m sure a lot of this is implicit in ‘environmental’.

    It’s not just psychiatry or the medicalization of society that thirsts or itches for ‘soothents’. Human beings have always sought them out. I’m very familiar with things such as pharmaceutical company and prescribing practices on opiate use/abuse/overdose, and criminalization of opiate or illegal drug use, but people seek out changing consciousness, whether that be for reducing pain, making a cocktail party more slippery and fun, or religious trance. Right or wrong or mixed, human beings and human nature itself push toward the use of ‘soothents’, even if framed as a good meal (and hopefully not McDonald’s).

    Illich’s book Medical Nemesis is one of my favorite books of all time….all MIA readers should read it. He had much to offer on the art of suffering and the pain-causing nature of healthcare systems. His colleague Nils Christie was a moral imperialist and simply advocated for the reduction of pain. His book Limits to Pain: The Role of Punishment in Penal Policy discusses much about pain and pain-alternatives. I agree with the notion of ‘storied’ pain, giving meaning to it, but I don’t think it should be required or be reduced to just a part of life. Illich btw treated his (non-chemo-treated) face cancer pain with substantial amounts of raw opium in his later life, with yoga and acupuncture. Illegal opium which he found more effective than what could have been prescribed and which gave him a sense of control rather than institutionalized pain-management. (He also got tax write-offs for large amounts of wine as ‘professional expenses’ for his teaching/student relations.) He preferred staying out of the traditional healthcare system, but we should remember that he eventually hurt beyond his usual art of suffering and sought medicaments and techniques in his own way….always alongside his persistent lit candle among friends that represented Christ, his Messiah.

  • Sam, what do you propose as an alternative to ‘adverse effects’? Preferably a word, phrase, or a couple phrases that encompass the undesirable or unwanted, from the minor to the major. ‘Harmful effects’, I rather like. What if the effect is simultaneously helpful and harmful? I know that often it’s the harmful effects that are even seen as desirable, completely tolerated.

    I recently heard a rephrasing of the Hippocrates Oath (although apparently this oath is misattributed): not ‘first do no harm’, but rather ‘do the potential benefits exceed the potential harm?’. Some replace ‘exceed’ with ‘outweigh’.

    I am well aware that for most psychiatry (and other healthcare systems), this second form is what is preferred, and so often rises to ignorant and abusive levels of what constitutes ‘benefit’, ‘exceeds’, & ‘harm’. Very often with me you’ll be speaking to the choir. But not always.

    I don’t remember the exact context, but I had a doctor suggest an interaction of ours would not need to be in his office, but rather getting a beer someplace. I thought that was good, a way to even the playing field. But it never had a chance to take place. I’ve never had one who offered to pay ME for something they learned from me, let alone a series of things. Often they’ve given the appearance that they can’t or shouldn’t learn from me. They would be bad biographers.

  • Steve,

    Thanks for the reply. Yes, the concern about oppressive environments, for example in schools, is definitely an important issue in all this. Institutional, social, physical, psychological, even architectural oppression, stress, compulsion, and fitting in can all influence this subject. The consensus on what constitutes oppression is not only not simple, but in many schools is not even a question that is raised. Everything runs along according to schedule. I find this very relevant in psychiatric hospitals, where the staff and institutional rules are like a machine. When one is in the patient role, it is a position where a resistance to or even simply questioning of an authority is least likely to succeed. They prefer you to submit at every stage, even if that means remaining silent. The same applies when one is a student. Over-accommodation disorder is a way to prevent punishment and going against any grain that is the norm, even if it’s a norm that really should be modified.

  • Paula,

    I have enjoyed your articles. Keep up the good fight in whatever ways you can.

    I will send you my email address. I tried to donate a very modest amount to your Execution by Numbers doc, but it required $5, and I was only willing to do under that. Please keep me updated if you can.

    In line with your doc, I recently read Limits to Pain: The Role of Punishment in Penal Policy by Nils Christie. It is an oldie, but a goodie, if you haven’t read it:

    https://www.amazon.com/Limits-Pain-Punishment-Penal-Policy/dp/1556355971

  • * I need to add for my above comment that the ncbi article above does not recommend routine clinical application of ketamine until further research is made (published 2015). But the book linked above (also 2015) disagrees, as well as do I and a great many other professionals and people who know extreme suffering. Hesitation/prevention due to the perceived lack of research is mostly transcended by many mindful doctors such as Dr. Hyde and my psychiatrist in Birmingham, AL. Like I said, we can’t simply postpone (push into the future) the suicide issue. It often doesn’t wait for those who abide by their preferred schedule and routine.

  • * I need to add that the ncbi article above does not recommend routine clinical application of ketamine until further research is made (published 2015). But the book linked above (also 2015) disagrees, as well as do I and a great many other professionals and people who know extreme suffering. Hesitation/prevention due to the perceived lack of research is mostly transcended by many mindful doctors such as Dr. Hyde and my psychiatrist in Birmingham, AL. Like I said, we can’t simply postpone (push into the future) the suicide issue. It often doesn’t wait for those who abide by their preferred schedule and routine.

  • Thank you, Jennifer and Samantha:

    Leaving aside the multiplicity of forms of help, including nutrient supplements, here is one newer area I find fascinating and have personally found as a life-saving grace. It could be a game changer for certain people, at certain times, including in emergency room admissions for suicide, of which there are many, of which there is specific research. It is the use of low-dose to higher-dose ketamine. There are many ways to use it, some cheap, some ridiculously expensive. (Perhaps you can guess my preference.) The author and interviewer should at the very least acquaint themselves with this work, if they haven’t already:

    Ketamine & Depression Book by Dr. Stephen Hyde:

    https://www.amazon.com/Ketamine-Depression-Dr-Stephen-Hyde/dp/1503509540/ref=mp_s_a_1_2?dchild=1&keywords=ketamine depression&qid=1608078108&sprefix=ketamine dep&sr=8-2

    PubMed Research (having problems with direct link: search ‘ketamine suicide’ or ‘ketamine depression’):

    https://pubmed.ncbi.nlm.nih.gov/

    Plus:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382138/

    I think the 9 states and D.C. that have medically-assisted suicide for terminal patients with 6 months or less to live is interesting and should be discussed more.

    I think palliative care for many illnesses and the ‘living deaths’ should be better handled. Obviously many things are not working and have always been that way. The ~22 veterans a day have known this. What exactly has changed, I mean really changed? The situation is an apocalyptic emergency that, for so many people, needs radical change, right now. There is often no room for ‘pacing’ ourselves or taking it ‘one step at a time’. Don’t get me wrong, there is as much diversity with suicide as there are plants in the Amazon jungle….or people on the earth.

  • Please see the summary of this book, Death by Calcium by Dr. Thomas Levy. He seems to agree with you that calcium should be obtained through diet, but lower than RDA, especially for the elderly. No milk, cheese, or supplements (and not bc they aren’t absorbed), but bc they are TOO MUCH, especially when combined with vitamin D3. The public often has too much calcium even though it is necessary:

    https://www.medfoxpub.com/medicalnews/product/S-DBC/Death-by-Calcium/Death-by-Calcium/

  • Steve, et al:

    I feel that the comment that some of this is strictly ‘philosophy’ may not be entirely complete. It can be ‘psychology/psychological’, which may be considered a social science and can incorporate many disciplines. In this case, ‘medical psychology’ might be appropriate. Some of the effort here is to put the studies in a psychiatric context that generally tries to bridge the physical and the mental/social. Psychology can be a subjective confession and deals with opinions and assumptions. If psychologists are honest, they immediately take the subjective nature of their judgments into consideration and try to balance them with what is considered general ‘knowledge’, as well as a healthy amount of doubt and uncertainty. The diversity of subjective perspectives, and what constitutes a consensus of knowledge, are what are so difficult. Knowledge need not be restricted to the physical/natural sciences. However, I agree that it is a slippery slope. The more social, humanistic, and artistic, the more difficult this becomes, as opposed to math and physics. I see biology and physiology/neurology as intermediaries, and research inevitably brings in the biases of subjectivity and methods.

    These are my immediate thoughts. Thank you.

  • I use clinical arrogance, too.

    Carl Jung puts it slightly differently here, and he wasn’t completely without clinical arrogance, but was very mindful about it.

    ‘There is a modern rational arrogance that tears our consciousness from its transcendental roots and places before it impending goals.’ (Paraphrased)

  • Hi Joanna,

    I see that your second recent response was made before (but posted after) my brief response saying I looked forward to your email. Should I still expect an email? I would really prefer that. I would like to fully respond and engage there, as you have given me a great deal to consider. Rather than make certain points here, I will await your email. Thank you.

  • Steve,

    The difference between a legal mandate and a warning/guideline is well taken. You pointing out that certain benzo’s were in the top tier of common prescriptions is also notable, and despite that number being from 2016. I believe the benzo advisory warning from the FDA is newer, but I’m sure they are still virtually as common. I would be curious to see if the updated advisories have or are making an impact, not so much for the ‘most severe cases of anxiety’ but rather the more run-of-the-mill and common ones. Also, whether the guideline are affecting if prescribers minimize the time-frame rather than never start the regimen at all. The time-frames for acid reflux prescriptions hardly make a difference, even though the clinical trials and the prescription info. emphasized the very short-term use.

    Perhaps not only the reluctance but firm denial of my prescriber was due in part by his being very young…..someone who did not have the background of commonly prescribing it like many of the old-timers. It is also notable that benzo’s are not prescribed as much if people use illegal drugs like cannabis. I don’t know if this same practice applies in states where it is legal for medical or recreational, although I would like to know.

    I was not questioning the efforts at warnings, advisory guidelines, or COMPLETE informed consent for these things. The idea of informed consent, let alone with ‘newer’ warnings, black box or otherwise, is virtually non-existent it seems to me. The point has been made from commenters, quite rightly, that if people were completely informed before hand, it’s not clear that anybody would choose to take these things. But my guess is that absent apparent alternative or supplementary options, many people will feel so desperate, so at-wits-end, or so fragile, unconscious, or timid, that they would still sign the consent form. Not to mention in the face of family or legal pressure, waving their finger at them, or threatening them with punitive or restrictive measures.

  • I won’t go into the complexity of the Amazon jungle. But I would like to say that rather than prescribe me a benzo, I was prescribed hydroxezine pamoate (due to the points of hesitation and FDA warnings). I found it almost worthless, yet he stuck with it and apparently had no other alternative. (I’m saying that only within the psychiatric context). I was given gabapentin, I can’t remember if that was partly for anxiety, I think so. It made me slower and stupider, it seemed to me, and I refused to continue. I’ve also been prescribed very small benzo doses that were questionable in terms of their ‘effect’ (not just perceived benefit).

    When I was involuntarily committed for 2 weeks, I learned that I could request a benzo every 6 hours. I was so anxious and uncomfortable (partly bc of commitment) that I requested it on the dot. I often still paced the halls constantly, but I felt it at least was a placebo, if not a crutch, if not a relief. But when I was released, it was the lithium that made my hands, head, and MIND shake (as tremors). And it was the Zyprexa that made me fat, tired, and slower.

    I’ve experienced benzo withdrawal when I had no prescriber anymore and was running out. It was extended-release Xanax so cutting the pills wasn’t exactly right. Probably or definitely wrong. I also now take Xanax before bed. My sleep was so bad, I had to do something more. I can’t sleep without my nightly low-dose neuroleptic, and I take melatonin.

    I know I still need a lot of work! I can relate to 4 freedom’s comment, just as I support the article’s message and activism on this issue.

  • 4freedom, I reinforced your original comment above and below, and I stick to them. However, I do disagree with you that there are no other techniques or complementary/supporting/alternative help available. I won’t give all the examples here, unless you press me harder. And I say this despite using xanax before sleep and not wanting/able to get off right now. I hope to try in the future according to my individual needs and the slow tapering method that is advocated. See below for my comment on prescribing hydroxezine pamoate instead of a benzo.

  • Not to belabor the point, but he did refer to the FDA policies forced on the medical community, and concurrent reluctance of many doctors to prescribe them. This is mostly a separate issue from the role of advocates/activism, although it seems to align with much of what they want such as the reduction, if not banning, of use. The move IS taking it away from long term users and forcing stopping, despite the will of those who feel it helps them and feel the risks are acceptable. It’s understandable that if he has used them such a long time with no perceived harm, that he would prefer to continue using them, despite other factors and methods that might be helpful.

  • Joanna, great feedback. If you do respond again, I might prefer you use the email on my website. However, whether brief or long, here is fine, it’s just a bit detailed and personal. No response is fine with me, too. I find everything you say to be very interesting and relatable, and I could go on and on. I wish that I could hear more. I will look at your author references. On a side note, do you know the Polish sculptor/artist Szulkalski? I’m sure you do. Has a bit of a controversial past, but overall truly amazing. Here’s a Netflix documentary link:
    https://www.youtube.com/watch?v=sPkoW4cmqT8

    It is interesting that you’ve had once a year appointments. That suggests to me that you don’t take ANY prescriptions. I’m finding that unlike when I was constantly SEEKING, SEEKING, I saw psychiatrists far more than I wanted, or technically needed, as they were a dead-end in many ways. Now I’m finding that I will probably postpone my next appointment bc I am coasting and don’t require the standard monthly check-up, which was already longer than my previous prescribers’ appointments. I couldn’t go into the void, and even though I knew the routine of the mainstream, I felt desperate enough to repeat the same thing again and again. I feared I would have to go into the hospital, and not only did I know they wouldn’t help me, they would have hurt me. You seem to do your once-a-year thing for a technicality to receive your pension, rather than any need whatsoever. I find that it often is easy to trigger doctors’ emotions, even though I might be emotional at various levels. And that sometimes, what should become a debate and negotiation, with time and references, easily either becomes an argument or a stunted/ended conversation. Especially with hospital doctor’s, who barely plug you in and very quickly move on. I really like my psychologist, and that is a separate issue.

    I find the confluence of childhood sensitivity/depression/anxiety/trauma/family-conflict, use/overuse of legal and illegal ‘substances’ including psychedelics, spiritual seeking and FINDING, getting A/B honor role at two honors schools, confrontation with mental ‘healthcare’ and its assumptions and attitudes, outcomes of forced or accepted pharmaceuticals and involuntary commitment, the big questions of life, and then the context of being labeled with schizophrenia….to be some of the most complicated and difficult things it is possible to imagine. So on my website, I try to do many things. I try to thread the needle, contain contradictory and complementary viewpoints, compare and contrast, and highlight benefits and risks while showing what I favor. One reason I built my website homepage as it is, is to hold 2 or 4 sides very close together.

    I do find it interesting that you don’t embrace ‘schizophrenia’, but you do seem to embrace ‘psychosis/psychotic’, and that there can be drug-induced outcomes, for one. I didn’t accept ANY definitions of schizophrenia that convention gave to me…and prior I had years of studying schizophrenia mainly in the context of psychedelics, shamanism, madness in artists/writers, etc. Then I happened upon Abram Hoffer’s work and literature. I found it so provocative and mostly unusual, that while simultaneously trying his nutritional techniques, I gradually gained a great deal. Part of his notion was that, as you hinted at but don’t really accept as the norm, ‘schizophrenia’ could be considered a ‘syndrome’ with multiple causes, although he favored his ‘chronic pellagra’ hypothesis as a majority of cases. The final clinical outcome was the hypothesized aminochrome pathway, especially the oxidized by-products of adrenaline (epinephrine). It is him that I took the definition of a ‘disorder of perception and thinking’, but I immediately try to cushion it with possible doubt and recognition of the social construction/labeling theory. It is notable that Hoffer also wanted to discard the label ‘schizophrenia’, but on the other hand wanted to use the term ‘chronic pellagra’ in the majority, along with the other causative factors (substance-induced, metal toxicity, cerebral allergy, etc). Oddly, I can’t think of him mentioning trauma/abuse as triggering the ‘psychotic spectrum’, although we know that this can lead to this type of thing. This notion (of chronic pellagra) would offend the deconstructionists and anti-psychiatry folks as much as conventional theorists. A couple remarks: I am critical of many of his attitudes toward this, some internal contradictions in his own history (such as his work on psychedelics, psychotomimetic vs. psychedelic, yet his consistent use of voices/visions as symptoms to both diagnose and to be removed to ‘recover’), and I try to always make this clear in my website. Hoffer thought all ‘psychoanalysis’ was Freud, and didn’t seem to be familiar with Carl Jung’s work. I also try my best to emphasize that very little of the subject is proved as is wished, that standard treatment can lead to the very symptoms that are associated with it, etc. I define positive/negative and hot/cool symptoms partly to paint the orthodox picture of what is being dealt with, but I try to go beyond it, contextualize it, reject it, and relativise it, all at once. This is what I do in my ‘Red Book’ website section on Carl Jung. Of course, I probably have further work to do and may not have succeeded. I’m running a fine line, and I do say at points that, unlike many of the subjects on my site, I will not link standard websites dealing with schizophrenia and psychosis (or pharmaceuticals) bc of the vast misunderstanding and deception as it is usually seen. The exception is links to PubMed, so that some insight can be gained into what standard and nonstandard research avenues have/are taking place. If some day, I feel the need to remove something or change it, I will. This has already occurred over and over again. The Virus Epoch has allowed me to fine-tune my site, which makes the previous forms seem unfortunate in ways.

    One detail I want to mention, is that by taking large and regular doses of vitamin B3, a certain outcome came that I’ve only ever heard mentioned and possibly explained in the Hoffer literature on schizophrenia. It is the collection of freckle-like pigments in certain parts of the skin that eventually can be rubbed off. It is ‘part of the healing process’, is said to happen mostly with schizophrenia (although more rare), but can happen with other people too (but far more rarely). This happened to me. Even if this pigment is not specific to schizophrenia, researchers/scientists still need to notice it and explain it. It seems to be apparent with the B3 therapy. A less clear picture is the occasional mention of a ‘schizophrenic smell’. I believe I had this, and that it went away as I got healthier. Having said all this above, I make no claims at absolute certainty or wish to force onto anyone any of this. Life is a mystery, and will never be fully understood, but these are some areas that are part of my puzzle. It’s possible that my long term heavy cigarette use increased adrenaline and its by-products.

    My website is my work, and it has always required immense editing/revising/rethinking. So my writing is not entirely a representation of the history of my thinking. My thinking has taken on many forms in my life, sometimes its different-ness, sometimes excelling, and then during my suicidal despair, as morbid, compromised, etc. In high school and college, I was a great writer if I cared about the subject (with editing/revising), but my speech in seminars and public speaking was often profoundly difficult. I recognize that much of this is not to be pathologized and labeled, and can be seen as unique to my individuality, and something to be given space and understanding. There have been certain aspects, not just the suicidal period, that were ‘not right’ or ‘not as right as it should be’. Here I don’t wish to overlay my experience as generalizable to others, or people with ‘schizophrenia’, just to emphasize that the thinking/speech function can be cursed or uncomfortable, minor to major.

    I absolutely agree with you, and so would Hoffer and Jung, that both symptoms and outcomes of ‘patients’, can be aggravated or caused, directly and indirectly from treatment and medical environment.

    I generally agree with you about negative symptoms. But I dealt with fatigue, certain difficulty with reading, some difficulty with quality/quantity of relationships, depression, sudden need to leave classrooms, and so on, before ever being on pharmaceuticals. I suppose I should point out that I used cannabis and tobacco. I am aware of and support the nuanced perspective on these things….difficulty with reading due to TOO MUCH READING AND WRITING/information overload, fatigue due to lungs full of tar, paucity of speaking due to being super-reflective and a need to choose words carefully, and because I was still learning and had many Big Questions. But your description of stigma, rejection/misunderstanding, isolation, and being poor couldn’t have been said better. I decided to stop Prozac when, after normally taking it before sleep, I took it after dinner, and I could then not even read. I thought ‘this can’t be good’, so I can relate to your point on this in a thousand ways. My use of micro-dosing ketamine this year profoundly changed my thinking quality and quantity, and I once again began, and still do, read A LOT.

    On your comments on coming off neuroleptics, high-functioning, and occasional hallucinations. Very insightful of you. I wonder, if I had been treated with dignity, given nutrient supplements, perhaps allowed micro/macro dosing of psychedelics, and allowed a psycho-spiritual transformation, would I not have fallen into the levels of despair and sickness I did. The voice-hearing thing is very personal to me, and I’m aware that it runs the spectrum from suicidal command voices to divine revelations, from people who want nothing to do with them, people who learn to live with them, or kind of like my case — who once experiencing the ‘inner voice’ and dreams, though ambiguous, do not need to experience them again, generally speaking. I know how difficult yet meaningful it can be, and I still pay attention to my dreams. That was part of my spiritual experience, the very experience that mainstream psychiatry and normal society try to prevent by any means. The experience that I was never willing to let them take away from me, although they succeeded for a long time. It is my opinion that if you hear a voice, any voice, and especially if you simultaneously use cannabis or psychedelics, that you will be isolated, drugged, labeled, and put through the meat grinder. It might not be as permanent a label such as after your ‘psychotic break’, but may be like mine, ‘psychosis not otherwise specified’, only long after becoming ‘I think you may have schizophrenia, what do you think about that?’, or ‘we’ll use ‘schizophrenia’, that will help with the disability pension application’. !!!!!

    I find your ending comment on what has helped you stay healthy to be not only great advice for everybody, but EXTREMELY resonant with me. Aside from the feminist group. I support feminism FULLY, but I haven’t felt a need to join an activist group for it.

    Thank you for participating. And check out that Polish sculptor/artist if you haven’t already!

  • Joanna, thank you much for sharing. Based off what you said, we have a lot in common, but I won’t assume we are the same by any means.

    I like how you used ‘mainstream psychiatry’. It is interesting that you live in Poland, although I am very uninformed about its history and state of play. I do hope you get your private psychiatrist as soon as you reasonably can. If you are like me, not only seeing the ‘same doctor that diagnosed you’, but even just other doctors who are very similar to the previous ones, is like having to still deal with an abusive parent. The memories and emotional triggers, the attitudes, the putting their drugs in you, the dismissal, the rushed appointments, the lack of help if not consistent harm (even if that comes through the rollercoaster of constant ‘trial and error’). I had one last year who chalked it all up to my the ‘paranoia’ of my paranoid schizophrenia, if she even ever knew what I was referring to in the first place.

    Unfortunately (the epitome), is that all in all, it was, in fact, too much. I was saying I would rather ‘say my goodbyes and tell myself I love you, and quickly pass away’, then deal with conventional/mainstream psychiatry any longer. My new psychiatrist and psychologist, on top of my other modes, came ‘out of the blue’, and I don’t have to think like that any more, for now. I’ve been able to decrease my neuroleptic dose by 75-85%, the only one I’ve been more ‘ok’ with, normally dosed twice a day, but I take it only before bed. I can’t sleep without it, but it reduces daytime adverse effects, once I finally get up. I’m just at my 5 year mark for getting off tobacco. What you say about people who live with/labelled with schizophrenia is tragic. This is why I told a provider/prescriber the other day on facebook: business-as-usual or ‘it is what it is’ is NOT acceptable. People with/labelled schizophrenia have one of the highest suicide rates of any demographic (or die earlier like you said). They were describing it all in the usual ways. I told them what might help more.

    I’ve lived with the diagnosis schizophrenia for 10-15 years depending on how you slice it. I am on social security disability income. I’ve dealt with everything you’ve mentioned here, except for I haven’t been able to escape the neuroleptics as easily. I was off and on them for years (always gaining and losing over 35lbs, tired/slow, etc.). I find most of my psychiatrists/prescribers except for 1 roughly as you describe (1 out of 12), a couple a little more amenable until I inspected closer. Obeying, non-compliant, rebellious, nuisance: these are all like Pee-Wee’s Play House in psychiatry, the ‘secret word of the day’, although the exact opposite of fun and surprise.

    What you describe, and what I have experienced, happen every single day all over the world, as you know. In the main, what exactly has changed over the last decades? Until this year, when I was able to solve my suicidal brutality, I say ‘what the ‘doctors’ did from the beginning (2003) to the end (2019) was exactly the same D&%N thing: firstly neuroleptics, antidepressants, benzos (often if they didn’t think you used illegal drugs). Most of these were placebo if not trivial, mediocre and insufficient, and/or harmful (minor to major). No deep conversation, no imagination. They have such expensive clothes and long vacations for how incompetent they are.

    http://www.evanhaarbauer.com
    In the orthomolecular section, I talk a lot about my experiences with ‘schizophrenia’, etc.

  • JB: I apologize. I see that I misread part of your original comment. Not only do you not consider the hurtful and stigmatizing psychiatric patient or person with mental illness proper descriptions, you may consider them worse since you called the others ‘polite’ euphemisms.

    I completely agree with most of your points, many of which are why I brought up the question. I also agree that client can be misused too. I get the impression that you don’t think psychic/mental health problems exist, or even if they did, should have no relationship to professional or ‘medical help’?

    Might I ask: Do you have any non-professional ‘relation’ to the psychiatric system? If so, do you request that these terms not be used in your presence, or do you just remain silent? Short of retiring, what should a psychiatrist or social worker use, given that you easily accept the patient identity/role for physical illness?

    I actually disagree about the ease of patient being used at the dermatologist, family physician, or dentist. I think some of the same problems exist there too, just not AS stigmatized and burdened by the baggage that a more strict mental health approach has. When a person is being treated for cancer for months, ‘patient’ can become chronic and be taken home with a self-identity, with family, etc. Leaving aside the mental side, client or ‘person who has a physical illness’ have benefits over patient. Diabetes II is an example of a physical illness that ordinarily WILL need care/treatment for the rest of their lives, obviously not stigmatized, but people don’t judge your credibility or overall capacity for having it. In this way, they could be a lifetime patient (person with illness or in a sick role), but who when relating directly with the service/professional, is a client. With client, there’s not as much a need for its use, to be seen as, or to identify as a chronic client in that way, even though that’s essentially what it is.

    I’m not trying to suck you into anything, so I understand if I seem to be getting into the weeds. These kind of things do not change or re-stabilize without an active dialogue of relevant parties.

  • Thx Sam. I know your dead serious. I can relate to that, especially my experiences in hospitals. But really most of my ‘outpatient treatment’ has been a watered-down and extended version of being a guinea pig in the ‘ward’.

    If you went to an emergency room bc you sliced off the tip of your finger, would you submit to a label? Or do you just reject them as much as possible? If you had the full power, what might you prefer? If we use self-care, we don’t say we are both doctor and patient, ‘treating’ ourselves, at least not normally.

  • Thx Johanna. You prefer ‘patient’ over ‘client’? Client, to me, tends to relegate it to the formal relationship and doesn’t necessarily extend outside in the larger world so people carry it around with them all the time. It is more neutral or dignified and doesn’t imply ‘sickness’ or as much of a power difference.

    If we use self-care, we don’t say we are both doctor and patient, ‘treating’ ourselves, at least not normally.

  • Perhaps 95% of my use of in-person psychiatry has been a waste and harmful, flipping through to go along to get along.

    Seeking and experiencing the personal and collective unconscious, nutrient therapy, and psychedelic therapy have all been useful to me, but not without thorns in the side. It was psychiatry and psychology that brought these to me, either locally or through the ether of the internet. It’s possible that once entangled in chemical chaos that chemical tools may have to be used to gain a degree of freedom (I am not referring to the tardive diskenisia drugs).

    Saphris is the only major tranquilizer I’ve been somewhat ok with. I can’t sleep without it. It can be taken once a night unlike its usual twice daily prescription (limiting daytime adverse effects). It’s ridiculously expensive, but there are ways around this. I almost got off with an effective but unusual antidepressant and nutrients.

    Now, only if the ‘doctors’ didn’t use that drug class to abort my spiritual seeking and finding. And put themselves inside me, poke and prod me, and make it appear that the goal was achievable if I obeyed them.

  • I’ve only liked 1 out of 12 psychiatrists (and prescribing physician) I’ve had (and I’m keeping my eyes peeled). Pessimistically, I’d tell the others to [email protected] off; neutrally, I’d tell them ‘I’m sorry, did you say something?’; optimistically, I’d just ‘turn the page over and gladly leave their chapter’. Other than my two favorite psychiatrists whose books I’ve read, I like the one because he virtually prevented me from self-murdering. He has my favorite book (Jung’s The Red Book) on his shelf, but hasn’t read or know what it’s about (a gift). He harmed me two days with a drug (that tried to counter another drug’s adverse effect), and he didn’t apologize. But he’s far cooler than most.

    As it’s unfair to lump ‘patients’ together, it’s ultimately unfair to lump psychiatrists together, despite the majority or how this majority insinuates itself even in the better ones. We can’t go into a void, but we can whittle while changing direction. I long for the day when I can say I no longer require their office/service, only a conversation and debate in a coffee shop, a discussion group, or an activist rally.

  • Similar post to a commenter above, but directed to the author and group:

    I am curious, what are the best labels, if any, for people in the ‘client’ role? Client, service-user, consumer (the worst), patient, customer, person in the sick role….PERSON? Do they pigeonhole, push a sense of permanence, and create an imbalance in the ‘provider-client’ relationship? I use various terms if ‘person’ can’t be used, but as rarely as possibly, and certainly wouldn’t use with people directly: as in, ‘since you are a service-user of mine or this organization’, ‘you are his consumer’, etc. Don’t most or all of these terms create a similar issue as the use of labels like ‘schizophrenic’ and ‘psychotic’? Professionals feel in control. People self-identify: ‘I am a service-user, I am a consumer, a patient’, INSIDE and OUTSIDE the context. Are ‘service-users’ only released from such a role when they are ‘recovered’ and completely without need of being a client to a professional? Are they assumed to be more or less chronic clients? Lastly, do ‘providers’ or ‘clinicians’ become service-users when they get a vaccine or go the dentist? Are they so freely comfortable in the patient role, and does it drop as soon as they leave the office it was used in?

    Words are needed, but not simply for convenience or efficiency or status reinforcement. I don’t ask these to knit pick. I am genuinely interested in what the best terms are and how they affect all parties. ‘Inmates’ and ‘cells’ create a similar problem in prisons.

  • I respect that.

    But I am curious, do you think the term ‘service-user’ is pigeonholing, pushing a sense of permanence, and creating an imbalance in the ‘provider-client’ relationship? I use the term but as rarely as possibly, and certainly wouldn’t use with people directly: as in, ‘since you are a service-user of mine or this organization’. I have difficulty with other terms: patient, consumer (probably the worst), sometimes even client. Customer is relevant but never used. Don’t most or all of these terms create a similar issue as the use of labels like ‘schizophrenic’ and ‘psychotic’? Professionals feel in control. People self identify: ‘I am a service-user, I am a consumer, a patient’, INSIDE and OUTSIDE the context. Are your ‘service-users’ only released from such a role when they are ‘recovered’ and completely without need of being a client to a professional? Or are they assumed to be more or less chronic clients? Lastly, do YOU become a service-user when you get a vaccine or go to the dentist? Are you so freely comfortable in the patient role, and does it drop as soon as you leave the office it was used in?

    I know your work is probably very stressful and requires a lot. Words are needed, but not simply for convenience or efficiency or status reinforcement. I don’t ask these to knit pick. I am genuinely interested in what the best terms are and how they affect all parties. ‘Inmates’ and ‘cells’ create a similar problem in prisons.

  • bcharris

    Sometimes I forget, or am less clear than I’d like, that Hoffer learned most psychiatry on the job so to speak. He did have a medical degree and a degree in biochemistry first. I have seen that one of Hoffer’s first cancer patients he treated was 1977, around the time when Linus Pauling was starting to research it. Hoffer developed it more over time. I see that he had treated 1000 clients with cancer by 1998, with much study in the late 80’s.

    I didn’t think Hoffer had tried other psychedelics other than ‘adrenochrome’, which he said would never become a ‘darling’ street drug. The movie psychedelic pioneers is remarkable, showing Osmond and Hoffer’s history, but doesn’t mention nutrients except for maybe briefly once. https://www.cultureunplugged.com/documentary/watch-online/play/50658/The-Psychedelic-Pioneers
    Hoffer’s memoirs are like $180 on Amazon. Even Osmond was somewhat tight lipped about his and Hoffer’s nutrient research later in his career. Osmond wrote about hospital design and models later in his career more than nutrients, which were Hoffer’s special focus. I get the impression Osmond didn’t practice full orthomolecular therapy at the hospital in Alabama, very near me. Aldous Huxley and osmond’s letters are fascinating. Osmond elaborates extensively on his mescaline, lsd, and peyote experiences, which were a lot. I believe his diagnostic methods for schizophrenia were, at times, unfair, always considering schizophrenia as psychotic rather than psychedelic, despite his research on how mescaline led to hypotheses of the schizotoxin he sought for. His book Models of Madness is flawed but very useful. The fact that he uses the word ‘madness’ throughout, and as basically a synonym for schizophrenia, is unfortunate. He barely even attempts to define ‘madness’ and says it basically has always been understood as a concept throughout history.

  • Interesting point I don’t always consider.

    I have mixed feelings when Hoffer said that many of these referred people already had a schizophrenia diagnosis, and he usually agreed with the diagnosis.

    I live by most of his principles everyday. However, he did not know about the personal and collective unconscious (mythopoetic imagination). It is ironic that he differentiated between ‘psychotomimetic’ and ‘psychedelic’, used psychedelic therapy before they were made illegal, was colleagues with Humphrey Osmond who created the word and who had a great many psychedelic experiences, but yet they both, it (usually) seems to me, saw hallucinated voices and visions only as ‘symptoms’. I guess often constellated with other symptoms. All very complex, but sometimes I wish Hoffer and Osmond were more nuanced in this area, even if ‘treatment’ is necessary. I will still devote part of my website to Hoffer’s field of orthomolecular psychiatry and medicine.

  • I also find your points to partially apply to old generics too. My affordable generic ketamine cannot be patented unless big pharma makes a subtle tweak or two and patents that, like they did with the nasal spray. In this case, the generic ketamine is fda approved but is used ‘off-label’. I cut down my tranquilizer by 75-85% simply by using ketamine. This tranquilizer is $1500 retail no matter what dose or how many times a day.

  • I personally am aware of these very relevant and unfortunate points. Thanks for pointing them out. None of these areas will change anytime soon. In a sense, it is two separate worlds living simultaneously.

    I still would like the same kind of financial assistance I get from insurance to be used for nutrients supplements. Out of pocket supplement expenses can get quite pricy if you are hardcore. If it was either seen or ‘proved’ (and FDA ‘approved’) that nutrient supplements could prevent the need for more expensive treatments or illnesses, the doctors and insurers may have a change of heart. But this gets to the crux of the matter. Apparently there has been a recent clinical phased trial of diet/supplements/electric current stimulation for multiple sclerosis. I don’t know if such results could be ‘FDA approved’ and ‘prescribed/covered’.

    My insurance gives some money to supplement, to gyms, and I think to dietary aspects in some way. But it’s a roundabout way, and the supplements are a drop in the bucket relatively speaking.

    Most psychiatrists don’t care or warn against them. But there are a few….if only one of my first dozen prescribers had helped me in this regard.

  • Cool. I saw in a book yesterday that B6 has been used like you said, and I’m sure the other ones. Although Dr. Thomas Levy says iron should almost never be supplemented unless a proven low blood count…and same for copper and calcium.

    I do wish insurance covered nutrients. My quality fish oil is $75 for 120 high dose capsules. My insurance gives me $240 a year for ‘over the counter’ products, including a number of nutrients, but they are lower quality and with few brands. Not ideal, but I guess it’s a start. I don’t think any other insurance policies I’ve had attempted to do that.

  • Here is a Kunin article and an orthomolecular journal search engine. Abram Hoffer also wrote and used manganese and vitamin B3. He thought if low dose manganese was added to the drugs, TD wouldn’t occur. Never starting major tranquilizers, going to as low dose as possible, or stopping completely, is of course preferable.

    http://orthomolecular.org/library/jom/1976/pdf/1976-v05n01-p004.pdf

    http://orthomolecular.org/library/jom/

  • Abram Hoffer used vitamin B3 and mineral manganese to prevent and treat TD. He claimed that if a little manganese were put in with the drugs, TD wouldn’t occur. Of course, never taking major tranquilizers, going to as low a dose as possible, or stopping are better than the roundabout way of preventing or treating. Here’s a Kunin article, and an orthomolecular journal search engine:

    http://orthomolecular.org/library/jom/1976/pdf/1976-v05n01-p004.pdf

    http://orthomolecular.org/library/jom/

  • Interesting points about the Complexes and the history. I didn’t find it too abstract, but an intellectual effort unsure of some of the finer details. I found ‘cookie-cutter, pea-in-the-pod mirror images’ rather poetic.

    It may be that Jung just suggested the word ‘Electra’ rather than the idea itself. That’s probably the case.

    I personally don’t see these things as just the heights or abstractions of metaphysics, philosophy, or archetypes, but psychological, which has its own substance/nature. This does deal with medicine in its broadest definition and certainly therapy. I’m not sure why you put therapy in quotations, other than showing how the psychological concepts don’t have value for health, or that therapy is a ‘so-called’. Some of these things were integral to these historical figures’ effort at healing. I know medicine has usually meant physical illness/treatment. Even Jung sometimes used it in that way despite having a medical degree and describing himself as a doctor. The term ‘medicalization’ certainly refers to medicine in its broadest definition, and I like the term in medical philosophy/sociology.

    But as you say, hopefully your abstracting will not be required or fertilized until next year at the earliest. And by all means, don’t let me try to call it forth.

  • Steve & oldhead: I think you may be right, Steve. I guess I was thinking about adverse experiences and traumas generally. Off the top of my head, I can’t think of an account or ‘case study’ of molestation, but only of various shades of the incestual ideas between mother/son or father/daughter (which aren’t always so stark as physical abuse), but which in his own way, Jung dealt with. I think it was Jung who suggested the ‘Electra Complex’ to match Freud’s Oedipal. He was always very sensitive to childhood experience and the proper education of parents. I don’t know about the history of sexual abuse, but I would like to.

    I’ve read 1.5 books of Freud’s but mostly know him through Jung. Freud’s writing is less appealing to me than Jung, more 19th century literary and sober, very dense but in a relentless way. I feel that Jung took the ‘best’ of Freud to the next level, but was keen on constructive criticism of him. The Netflix series ‘Freud’ is worth the watch, but of course it fluffs it up with drama and fiction.

  • Steve, yes, although Carl Jung took up some of the ideas of early childhood experiences/traumas, repressed memories, and the formation of complexes, and their impact on later life. Partly through Jung, this influence DID carry on for generations. Freud’s ‘unconscious’ in a way became Jung’s ‘personal unconscious’. He also carried on things like dream analysis, transference, and abreaction from Freud’s psychoanalysis. Jung was radically different than Freud as well, for example his ‘collective unconscious’ and importance on the religious instinct, which Freud reduced to other instincts and considered all religion as illusion. Jung, unlike Freud, almost never used hypnosis.

    We also shouldn’t forget that Freud heavily focused on neurology early on in school, practice, and library, had important roles in its development, and also in psychosomatic and what he called nervous disorders. He often used cocaine for physical and mental problems, his own and clients. And tobacco for that matter.

  • JeffreyC, I enjoyed your article.

    In general, I agree with you, but I’d like to point out that Carl Jung was considered a psychotherapist/psychologist AND psychiatrist. And ‘counseling’ takes away a certain sophistication out of those other approaches. Jung was a ‘psychological’ psychiatrist. He worked in a psych hospital as an ‘assistant psychiatric physician’. He had a private therapy practice, but he still maintained a role of diagnostician and had a medical degree in psychiatry, I believe. But those were the days when boundaries and specialties were different. For many decades, psychiatry is as you state. Jung and Humphrey Osmond met and spoke, and Jung suggested a role for physiotherapies as well as one of the first to hypothesize a ‘metabolic toxin X’ in schizophrenia, which Osmond was so concerned with. Osmond dealt with nutrients, as well as psychedelics before made illegal, and he also used pharmaceuticals more conservatively. He also wrote a lot on hospital design and ‘models’ of health care. I take from him certain things and leave others.

  • Steve,

    Well said. I almost totally agree. Becoming an ‘extra-environmental’ is courageous and needed, as long as there is something there and there is no illusion that one has completely transcended the evils (or ills, forgive me), that are part of human nature.

    I hope one day I won’t need therapy (although I think it can be good mental hygiene), or drugs, or nutrients (although I feel they optimize health), and all these tentacles or nodules in my/the system. My favorite people are those who have risen to their individuality in creative ways while giving back to the collectivity. I try that and fulfill it to some degree, but then again, I am on social security disability income, get family support, and I am technically mostly unemployed. I’m glad you’ve found a niche that allows more freedom without compromising security.

  • Steve,

    Just curious, do you think that any staff, worker, parent, teacher, pharmacist, hospital cleric, or even client who submits to or goes along with psychiatry should admit guilt and do penance? (Not to put too much of a religious custom to it). Or should the blame be restricted to the direct apostles of the pseudoscience, the psychiatrists?

    I like certain aspects of ‘psychiatry’, including the old pioneering psychological psychiatrists like Carl Jung, and nutritional psychiatrists like Abram Hoffer. So in the final analysis, I don’t see ‘it’ as a monolithic entity. But I do take from each what I want and remain critical of their shortcomings.

    I’ve had psychiatrists that did some blood work on basic nutrients, thyroid, etc., but they didn’t earn my respect and trust. The only one I’ve liked has not done blood work, and I don’t know if he knows I have an integrative medicine physician who has. But he did ask me about any abuse in childhood, traumatic brain injuries, and has been open to my suggestions and criticism, and has almost never ‘rushed’ me, allowing me to speak my mind. He says he doesn’t like hospitals, is not as rigid about diagnoses, and doesn’t try to shove his ‘stuff’ down my throat. Is he an exception to the rule, or is he an example of being a ‘lesser evil’? I tend to think so, and I’ve had a dozen.

    My psychologist, who I really like, works in the same office. Is he complicit? He is very intelligent and swims through the system adeptly without holding fast to an always clear cut attitude. He knows diagnoses are questionable, but he still interviews veterans to see if they qualify for ‘PTSD’ in order to receive extra benefits. He’s also seen the disturbing use of Ritalin in institutions for ‘disturbed’ childhood. He’s interviewed people going into the police force to see if they disqualify (mentally) for becoming an officer. I think he utilized a type of ‘diagnostic’ modeling process to make that decision. Based off my respect for him, I would trust him to make a proper judgment in that context, although it may have been restricted to the more obvious cases rather than the professional paranoia and sadism that we find hidden in certain officers.

  • Steve,

    I think I generally agree. I would just point out that mind, body, the social, & the environmental are so tightly linked that there are easily feedback loops that are difficult to disentangle and see where one begins and one ends, at least for a practical perspective or where action is required/preferred. And that the individual in the center of a mandala plays a role in deciding which elements are emphasized, not just the arbiter of a psychiatry, as you know. There may be a critical threshold where the need for identity as ‘illness’ may be appropriate, and I believe the judgement of that threshold should be negotiated with the individual, even if they end up rejecting any need for intercession. I’m not sure if you are suggesting psychiatry does not see ‘stress and trauma’ as real symptoms or just capable of causing physiological changes, where the real illness is perceived to be, but psychologists and social workers certainly do. Yet you point out the importance of noting any physiological relations/causes to mental function. Or something like that. Not to get in a knot about all this. Not sure if that contradicts your points, but I would like it to supplement them.

  • Steve,

    (I posted above, but realized I should’ve posted here. My previous comment of this same comment can be deleted).

    I’m sorry, but was it me who prodded you to make these distinctions? Or are you speaking generally for us all to think about? I don’t think I made any comment to really require these explicit differentiations.

  • Steve, I suppose that rings true. I assume it was referencing my comment of ‘I did need help’….maybe not.

    I’ve thrown up in my life more than anyone I’ve ever met or heard of. I hope we can agree that I not only needed help, but that I was ill. Are you just talking ‘mental illness’, I assume?

  • I support this article and can relate to it.

    But what if after all the childhood trauma, bullying, school punishment, and parental interpersonal and intrapersonal conflict, countless night terrors and repetitive nightmares, and hit in the head with a metal baseball bat; what if after the over use of nonrefined legal and black market drugs; what if after the slamming with major tranquilizers and eternal prescriptions and attitudes that abort your spirit and journey and turn you around in circles and make you jump through hoops; after countless misjudgments and mistakes; after progressively being suicidal after years of oppression of the al(most) heinous sort; what if then you feel like your brain-damaged and missing something? And that there is no light in the darkness anymore, even if it’s not the autonomous incarnation of the Holy Ghost that blessed your life in an earlier iteration of the Apocalypse? What then of saying ‘you (I) am not ill’? How can I reject and escape?

    Having said all that, I have had a very productive year despite the Virus Epoch. I look forward to each day and know that I should be proud of what I’ve done in the face of the nightmare, which I had experienced first in childhood—was it just nature or was it the family milieu? But, make no mistake….it was only ‘yesterday’ that death’s skeletal hand was touching me, and only a few ‘hours’ ago that I could feel that it’s hand was now receding from behind me. Physical AND mental illness can not only steal the smile off your face but also the skin off your skull. I know I don’t have to remind many readers of this. For now, mine is not ‘permanent’, but it appeared that way in various forms and at various times. Many did not or have not escaped. May they find relief in the ways they prefer. Preferably standing up and facing forward rather than slipping backward with their face caved in.

    Again, an inspiring article that was well-written and from lived experience. I salute you.

  • Circle10,

    I have seen 12 psychiatrists/one prescribing physician, and I’ve only, in the final analysis, trusted one, but even he did not apologize for one brief drug-induced adverse effect. Calling them ‘modern shamans’ is misleading, but I assume you are considering shamans like snake oil salesman and with an irrational belief in the supernatural or spirit world.

    I don’t believe calling medicine as using the 4 humour theory until 1900 is accurate. I guess you’re applying that comment to physicians AND psychiatrists/psychologists.

    It is indeed odd that you say people don’t deserve quality medical/health care even in the few times that it is found.

    I do believe that even if someone were to outright reject the ‘mental health system’, they would have to find a path less traveled, whether they follow a path already trailblazed or build their own d$&@ boat. Most psychiatry is not my friend, especially as I have been labeled with schizophrenia and have used some of the worst class of drugs, major tranquilizers, under dubious pretenses. But I did need help, even though I had to go into the unknown wilderness and slip and fall. Although I did find something in that process. Carl Jung said mistakes are the foundation of truth, and if a person does not know what a thing is, it is at least an increase in knowledge if he or she knows what it is not.

  • I use low dose ketamine as part of my modes of operation, and it has helped take me out of suicidal plotting. It is generic, affordable, and easy to use. It transcends the time consuming, expensive, and clinical over control of the nasal spray, IV, etc. It is not a psychedelic trip, which there is a place for, but I won’t go into these nuances here. I’ve been on over half a dozen other ‘antidepressants’. They’ve been placebo if not trivial, mediocre/insufficient, and often with adverse effects on them and coming off of them. Just wanted to mention this; ketamine used in this way is somewhat of an outlier. It also resonates with my interest in psychedelics, in this case, microdosing. Peace out.

  • Dear Mr. Timimi,

    Perhaps I missed it, but will you be discussing ANY chemical use as a psychiatrist or as a person in society? Like nutrient deficiencies at the minimum? RDA’s for omega 3’s, magnesium, iodine, & vitamin A are hard to come by. Or any prescribed chemicals/drugs at all? If not, you are really going to the roots of a ‘psychological psychiatry’ of the 19th and early 20th centuries which of course isn’t necessarily a bad thing, but odd to me. May be a great thing, as long as the physicians or other professionals pay attention to deficiencies and other nutritional-related matters rather than you. If citizens can order their own blood tests and interpret that, I’m open to that too. But those are usually radically expensive, if possible at all. Thx

  • Sam thank you,

    In any case, I thought your comment was relevant. Sorry for this long-winded response.

    I understand your concerns, and no, we very often can’t trust data. I read a book in high school on the philosophy of statistics so I have been concerned with these ideas. I should have used the words ‘facts’ or better, ‘opinions’. Are you comfortable with those? Because even by saying that, I don’t pretend that facts or ‘truths’ are just boxes to be opened. I could have also said observations or interpretations. Do you have the same attitude toward this article and ‘inefficacy’ and danger of Saphris (asenapine)? I actually do, but I wouldn’t swipe left on the whole thing, which follows the trail and often takes for granted the ‘data’ of clinal trials, patient reporting and various data points, and the apparent accuracy of diagnostic scales, at least within their own definitions. There is obviously much to be desired throughout the whole thing, both the original sources and Whitaker’s and whistleblower’s whittling of the accrued ‘information’.

    I’d be glad to hear a series of interviews/accounts with ex-violent-felons who completed their ‘penance’ as defined by law and their experience with or without psychiatry in and outside of prison. And I’d be glad to hear interviews/accounts with court-ordered, but not outright illegal or violent, people mandated to be in the psychiatric hospital or out-patient management. And I would consider some of this type of information ‘data’. Someone or a collaboration of people may choose to compare and contrast those interviews/accounts, trying to form insights and judgements.

    Anyway, I get it. It’s all imperfect and nothing has the greatest history of valid or appropriate information for programs involving people. Still, I took statistics in college, and there is often — not always — a method to the madness of statistics; as well as explicit questions of assumptions and efforts to recognize misleading results. And I wouldn’t ever take that class again. When you put people into the picture as input, rather than classical physics or chemistry, it opens another can of worms.

  • Thank you for responding, sam. I consider a vengeful god quite a bit, & how it insinuates itself through people & into society; & how mercy, in a common sense, always has the guilt-tripping & threat of punishment behind it. I must admit, I have to check my dark side quite a bit.

    I find your last comment “but not for ‘mental health’. Nor for ‘mental wealth’ ” interesting. I’m not sure I want to throw out the term ‘mental health’ completely, but I think I see what you mean.

    lol, if you want or need any extra, I will be sure to send you some saneberry pie next time I find some…or make some.

  • Interesting comments. I thank the author and MiA for publishing although I don’t completely understand the publishing/republishing issue. (lack of informing myself).

    I want to say a few things. I speak for a slice of the pie, perhaps having fingers in multiple slices. If it is not your slice, then I accept that, & I am almost always open to listening, dialogue, & reflection.

    I take legally prescribed, relatively small doses of generic ketamine (liquid), virtually the only legal psychedelic in the U.S. right now. It has assisted me in my complex lifestyle of techniques for health and wellness. I was brutally suicidal for too long, & even before that, surprised I didn’t die or self-murder years before. Concurrently, I found a therapist I love to death. Both methods are on top of many others…clinical nutrition, moderate traditional pharmaceuticals, family-interaction dynamics, long-term integration of the unconscious, art, & so forth.

    This particular niche, psychedelic therapy, is incredibly complex. I’ve always been interested in psychedelics (first LSD trip in middle school—be kind!), but when I got sucked in to conventional psychiatry, my legitimate interests of research and experience were pathologized, disregarded, and made like childish ignorance. In my opinion, that is still commonly the norm throughout the U.S. mainstream medical system—& in much of the general public. I advocate for psychedelic research—medical, spiritual, creative—& always have. As some have noted, it is being wrapped into traditional formats: big pharma, treatment/‘treatment’, advertising, hype, etc. There are positives, negatives, & amalgamations of both. What I will say here is this: I am thankful everyday for my bold and experimental prescriber & my use of ketamine. I am thankful it is not expensive, time-consuming, and under what I call ‘clinical over-control’ like the nasal spray, IV, & even the lozenge & intramuscular. My experiences are not full-blown trips, which I support for some people under some circumstances, & hope to have before I die. One thing it has done is stimulated my thinking function & voice, more like the gift—though eccentric—that I used to have. I no longer pray into the darkness alone, for example, for The God of the Universe to kill me. I hope the out-right critics can agree with me that this is a good thing. & make no mistake, I’ve been at this game for…well…ever.

    Having said that, I hope people realize that this type of approach, milder rather than full-blown, can be gotten at without waiting for MDMA or psilocybin approval, medical or recreational, to be used legally and with some degree of safety & oversight. The more major psychedelic experiences are going on too, in clinics or by experimental psychiatrists. Some cities in America are decriminalizing psychedelics, and there are movements for using legal cannabis for medical, spiritual, creative, & recreational purposes. I’m glad I don’t have to go to Colorado (I live in Alabama—one of the most Red states), nor go to The Netherlands, nor wait for MDMA approval, with its specialist clinics, minimal prescribers, & limited diagnostic uses, so on & so forth. It’s all very tricky, isn’t it?

    I’ve tried to briefly tease some of this out without idealizing or denouncing the whole pie. I’ve stated already, I speak for a certain slice, even if it’s only my own; but more likely, I have my fingers dipped into multiple slices. I feel free to go on a sugar fast at any time.

    Thank you for your attention.

  • This is EXACTLY why ART (and its review/critique) exist. Thank you both.

    If Phoebe reads this, do you allow your images to be posted on other websites if your work is referenced/linked? There may be philosophical differences here and there, but I would love to include them somehow.

    My website http://www.evanhaarbauer.com deals with a number of related/semi-related issues, informational and musical/poetic. I’m still updating, editing, and remixing.

  • Caroline,
    Just wanted to mention that I’ve been on a number ‘antidepressants’. Most were trivial, mediocre, and/or harmful. In terms of legally prescribed pharmaceuticals, microdosing a generic, affordable, liquid solution of ketamine has been the only one I have found much benefit from. Of course, it, like all of this, is controversial and fiercely debated. Will my use of it decompensate me and cause long-term health problems, its efficacy vanish, and lead to withdrawal, etc? I guess I’m going to find out…..because I was on the BRINK despite my other modes of operations, which all now synergize with my ketamine use, creating a more robust system.
    I too find tapering strips needed and would like to try them with my major tranquilizer. Cutting pills or (wafers in my case) is more than imperfect, although it saves money.

  • Sam, good point. I always wonder how to form a judgment that relates to ‘well, 5-15% of people will benefit in some form, but (let’s say) 50-75% will be harmed, and the rest nothing.” In many cases, it seems a potential disability or adverse effect is being chosen over the originally perceived disfunction, in a kind of ‘risk/benefit’ scenario. A great deal would happen if the mental health system became EFFECTIVE, in whatever ways that really means. Holism is relevant in that regard.

  • I agree. Although, I wonder if ‘chemical’ is even better than ‘drug’. But that’s another shift into the unaccustomed. In the mean time, drug is more important than medicine in many contexts. In a college Drugs & Society class, we learned that ‘drug’ is anything that could enter the body and change it physiologically. So foods & beverages could be drugs. This complicates the picture. So we get into complexes, or something, of drug(s) or chemical(s). What do we call a drug that consists of dozens or hundreds of compounds together?
    I’m trying to think how this relates to psychiatry other than drug ‘cocktail’ or ‘combination’.

  • Hi Larry, one last thing. I couldn’t edit my last post. I wanted to leave you with this:
    Having said all that, I believe this will be my last comment in this section. I welcome your response, and I will consider it seriously. If you do respond, please help us both end our discussion with some reconciliation and peace. This is all taxing, and I’ve tried to make my points clear. Take care.

  • Larry, I agree and resonate with much that you say. I’m sorry I didn’t make it clear that I too feel there are systemic human right’s abuses throughout the mental health system, and that all immoral, incorrect, and misleading parts should be redressed–politically, legally, socially, financially, etc. I don’t like to group the entire profession together, and I have tried to point out that there are examples that I trust and respect. Even if the ongoing approaches of ECT, antipsychotics, forced commitment and drugging, etc. are similar to models of 50 to a hundred years ago, I don’t believe it is accurate to simply equate eugenics, sterilization, and lobotomy to how all things are done today, even if they sometimes share similar outcomes. And I don’t believe that all ongoing approaches are always immoral. We can’t claim that these are criminal in the sense that they are against the Law, even though we both recognize that very often they should be considered so and held criminally liable. These things are shared across communities, professional and societal (who are just as under the spell), and in order to change it, education and political pressure will have to be remedied, one step at a time. When you have a hospital of doctors, nurses, social workers, administrators, chaplains, etc. that all are interconnected along what is standard treatment in the in-patient clinic, then this education and change is certainly extremely difficult. We seem to agree on most of this.
    There’s simply no way to convey to you my entire position and ongoing relationship with these things in a short format as this. It is easy to make many assumptions in this context.
    I personally don’t reject the entirety of using chemicals–substances, drugs, macro and micro nutrients, and other physiological techniques–to influence the mind and spirit. I believe we are made of drugs (bio/chemicals), and that it is often an appropriate avenue to navigate psychology. But society is so used to a broken, corrupt, misguided, etc. use of drugs (so often called medicines) that many people reject them outright and conclude that they should be completely abandoned and have not done a spot of good for anyone at anytime. I support all withdrawal support groups, real informed consent and freedom of choice, a complete reimagining of how drugs are FDA approved, researched, and given as treatment. I also support the alternatives you mentioned such as Open Dialogue, nutrition, leaving people alone, religious freedom, as well as personality development through active imagination, mind-body work like yoga and exercise, and many of the other diverse approaches to getting right with ourselves and others. I personally think that, in general, a kind of all of the above approach is fully appropriate. In terms of being immortal beings, I will mostly leave that to you. As someone who has experienced a deterioration of personality/voice/etc., it becomes questionable and luxurious to me to assume that we are immortal, at least on this side of the transcendental fence. I advocate for quality of life at every level, including people with dementia, Parkinson’s, and Down’s syndrome. If immortality is part of that, then that’s fine with me.
    I believe we have many areas where we overlap here, although obviously we have differences. I would point out that Mad in America does not appear to me to be all-encompassing group-identity that forms an ‘us vs them’. The ‘remaking’ of psychiatry posits not only not deconstructing it into a void, but also not only focusing on the abuse of conventional forms, but as you say allowing a furthering of health from all aspects. Your note that mysticism, the paranormal, and traditional’ practices are a minor focus is a little surprising given your previous emphasis on your ‘spiritual’ approach and your comment on being ‘immortal’. Perhaps I have misunderstood something. I have read articles on this website that have dealt with all 3, even though it may not have been the main focus. For example, how traditional Jewish worldviews influence present-day medicine, the commonly associated psychotic symptoms of telepathy, astral travel, speaking with entities, or more normalized subjects like dreams and voices. I do agree that overall the focus is on problems with mainstream psychiatry of the past and present and a collective effort and dialogue on how to proceed. These are many of the reason I have recently given $5 as a donation to this organization and have bought 2 books by Whitaker. I am glad you have tried to clarify your orientation. I’m not exactly sure why you think I’m focusing on psyche and personal experience, or that I have strayed from the themes of this website (other than unfortunately not referencing this article enough), except for the fact that your responses are based on only 3 of my comments. Frankly, focusing on psychiatric abuse and what can be done about (in all those components you mentioned) would be meaningless without dipping into psyche and personal experience. I mean, this entire site is chalk-full of expressing personal experiences and dealing with the ‘psych’ of psychiatry and the structures constellated around it. Surely you didn’t quite mean that. Or perhaps I expressed some things that were not strictly about the abuses and had something positive or neutral to say about psychiatry. I am sorry if I offended you, and if I could edit my long previous post, I probably would, as I was at first offended at some of your accusations and provocative questions.
    I would appreciate you not trying to delineate what I can and can not say, and how it does or does not relate to your particular program. If the mediators would like to critically examine my posts and recommend that I tighten them up somehow, then I will definitely take that into consideration, as I ultimately don’t want to go against the grain unnecessarily of such a fine organization. I do hope to remain relevant and part of the process.

  • I_e_cox and sam plover: Not sure why I couldn’t directly respond to your comments, but I will try this and leave it at that. To both of you: If I could edit my previous comment, I would delete my statement about duct tape etc. I think this website, overall, is so bada&%, and is such a great resource. It allows people from all over the world to transcend their locality if necessary and find avenues of expression that are often delegitimized, overlooked, and forgotten by ‘standard’ care and ‘standard’ society. Sam’s comment that one doesn’t need to agree with my every word is so true for everything. I edit my website a lot, for awhile there constantly, and am so glad because life needs a constant EDIT. I read the Commentary Guidelines for this website, and I was so impressed by the mindfulness and thoroughness of it. Anyways….

    sam plover: Thank you for your response. I’m glad you found value in my comments. See you around on the forum. I’ve noticed you post a lot, and I appreciate that.

    I_e_cox: It is easy to talk past each other. I will try not to. I don’t know about ASPD, and that’s one reason I didn’t respond. I will try to google it sometime. There are so many nooks and crannies in diagnostic/labeling. I tend to speak more for schizophrenia, depression, and anxiety because they’re what I’m most familiar with, although I try to keep up to date on everything. I’m a little confused on your position on ASPD. Do you want it to be removed from the DSM? Do you think it is a legitimate label or will you be glad to have it removed?
    I relate to your caution of leniency of many of these things. I have not familiarized with the 3 historical areas you mentioned. I know a tad about MK-ULTRA, and its experiments with LSD for mind control by the CIA. But really beyond that sentence, I know nothing. I’m very interested in psychedelic history and research, but admittedly, I have focused more on other areas that aren’t as explicitly evil as MK-ULTRA. I am prescribed microdoses of affordable generic ketamine, and it has been a blessing. It also resonates with my original interests with psychedelics, which conventional psychiatry always and only pathologized, etc. I don’t want to go into my particular use of this, so let’s set that aside, although I’d say my generic version transcends the expensive, time-consuming, and clinical over-control of the patented nasal spray and the IV routes, which though interesting, are impractical, nowhere nearby, and rub close against many of the typical ‘Big Pharma’ problems. I hope to have another full psychedelic and spiritual experience before I die. Your spiritual bent is so necessary even though I don’t know your particulars.
    I’ve been reading Robert Whitaker’s books, Mad in America and Anatomy of an Epidemic, and I find them quite good. He doesn’t go over much of Jung’s personal and collective unconscious nor Hoffer’s psychedelic and nutritional work, but there’s so much density in his writings that he can’t possibly review everything. I’ll be looking out for your comments, I’ve noticed you post a lot, and I appreciate that.

  • I prefer the terms neuroleptic or (major) tranquilizer over antipsychotic even though neuroleptic is somewhat masking unless you know what it means, and tranquilizer betrays a sense of tranquility which is often not the case. But psychotic in ‘antipsychotic’ should not be casually used by doctor or service-user. It becomes habitual and a casual term thrown around. Affects identity and constantly puts it in a never ending, not only negative, but as you say one of the worst description that can be placed on someone. Only the simple minded and imitators agree on an easy definition of psychosis and schizophrenia. Both words that can be devastating when applied, and both words that society casually uses as if they know exactly what they are.
    Carl Jung experienced psychosis, but maintained his daily life, created a book about his reactions (voices and visions) insured for $50 million and read by over a million people. The editor claims it wasn’t a psychosis, but most definitions would identify it at that. In no way was he unable to communicate. His ‘psychosis’ was full of magnified communication; but with his soul and in private. Just thought I would mention this.

  • Nice digression. I hope to have another full psychedelic experience before I die. I rather like acid, but it’s liquid draino for the nervous system and is so damn taxing.
    I relate to this. When I got what I consider an effective antidepressant, generic cheap ketamine, along with my other modes of operation, I reduced over time my Saphris from 20mg to 2.5-5mg. (I only take it once a night, usually prescribed twice daily). I am unable to sleep without it or feel very comfortable with even lower doses. I have to cut the wafer too which is difficult and imprecise but seems to save me money too. Unfortunately I also take a xanax and large dose melatonin. These things are much better than what I was dealing with before. I hope to get off everything including Saphris, but I have to find the trail that leads to freedom but still allows me to sleep. Without it, I stay up all night and morning. Even with a fairly slow taper. It would help if I could get precise amounts of the lower doses. I don’t think a compounding pharmacy could do that for Saphris. Admittedly, it would have been far better to never start. But I’m so far from that. Coming off Zyprexa to Saphris was like a revelation. My microdosing ketamine and nutrient therapy were also revelations.

  • I_e_cox: Let me see if I can thoughtfully respond to your comment without you criticizing me to death. Hopefully, it is relevant to this article because I tend to not like straying too far. I have a feeling like I have here.

    First of all, I’ve had the habit of saying about most psychiatrists I’ve seen, about 12 and especially the hospital ones, that “they are dead to me”, “they are not the brightest apples in the basket”, that “I regret having to be at their mercy”, and that “they should be ripped a new a$%hole”. That it’d be a joke if it wasn’t so serious. That I’d simply be disappointed and embarrassed if it weren’t so dangerous. I don’t consider them my colleagues and definitely not my friends. Does that give you sense of my opinion on most psychiatrists? Does that resonate with your agenda and allow you to see me as an ally and not an enemy? By the way, I believe the enemy is intrinsic to human nature and the universe. If we, what?–kill?, all our enemies, we will still have to look into our own void and the great dying and betrayal of nature. My goal is to replace a greater evil with a lesser evil. Are you suggesting that we DO dehumanize people, or more particularly, monstrous people? Even murderers who have spent 30 years in prison can act sanely and with repentance, if not morally and purely good. Even they are more likely to become that way with a certain amount of dignity and as humane a treatment as possible. Are you suggesting we lock ALL of psychiatry in prison for life or inflict the death sentence? I know you mean ending their career and holding them accountable, but…..Perhaps we agree that some of the most mentally ill people run the mental health system, and some of the most criminal people run the criminal justice system.

    I have spent over 20 years studying many of these issues, as a person labeled and as a researcher, and I learn things every day. I do think these things are worth discussing, and while I won’t spend a weekend workshop with you on this, I will try to be open to dialogue. When you say you are comfortable labeling an entire body of thought as criminal, I find that very familiar, as I’ve spent a great deal of time in the mental ‘health’ system and some in the criminal ‘justice’ system, and I saw first-hand how that tendency goes both directions in a tragic way. My drug court judge was one of the most angry, controlling, sadistic people I’ve ever come across. (I can’t say I really MET him). He doesn’t feel what he’s doing. He always finds the enemy outside, so very easily found, and only knows how to put his weapon in other people, doing so by the thousands. Do I think he, and psychiatrists, need to get a dose or 500 of their own medicine? Yes, I do.

    I also don’t wish to mince words, and I try my best to be clear and concise in such a limited format as this. Now here’s where you and I seem to radically disagree. Two of my favorite authors were psychiatrists. Abram Hoffer, and Carl Jung who was a psychiatrist before psychiatry became more physical. Neither one is well integrated into the monolithic profession you are tying all together into a bow. They both had major blind spots, frank mistakes, and probably hurt some people along the way. I don’t intend to blur those distinctions. There is a place for physiological and psychospiritual shamanism and healers of the tribe. These doctors tried not to abuse civil rights, tried to work with people, whether patient or otherwise, and were both pioneers. When they died, thousands and thousands of people gave their condolences. Millions have bought their books. Hoffer did use ECT early in his career–always using high dose nutrients and not recommending it without them–but abandoned it later, and in my opinion, had too limited notion of the psychology and the medicalization of schizophrenia. Jung believed schizophrenia was a valuable term, but tended to be unsuccessful, according to him, of treating what he labeled. Each doctor found what the other lacked in some ways.

    So do I think psychiatry needs to be ripped a new a$%hole and be forced to look behind its own mask? Yes, I do. Do I think there’s no room for soul-healing, psychic and neurological leadership, that enhances life and diminishes pain and lostness? Of course not. Destroying seems to be easier than reconstruction. And criticism should be as constructive as possible. I love Jung and Hoffer, and I don’t usually equate them with Nazis. Even if 20th century psychiatrists are ALL not your thing, perhaps tribal shamanism is? The guide, the healer, and the myth-maker that tries his damnedest to connect the dots, inspire his tribe with song, dance, and plant medicine, and listen to what the dreams are saying? I’m trying my best d$mnit. Please don’t make me feel like you want duct tape on MY mouth and cut the ground from beneath MY feet; and that I am not wise enough to be welcomed in a forum such as Mad in America. Perhaps these are not your intents. I am not a Nazi, nor do I have sympathy for them. I have no intention of becoming the chronic angry and sadistic control-freak like my drug court judge, or the more subtle tight-lipped psychiatrists that think they’ve seen my true nature within 5-15 minutes and hang me out to dry. I’ve had to fight very hard to not become my own worst enemy.

    I welcome your response, but like I said, I won’t get into the thick of it beyond a certain point. Have I made it clear to you that I want the abuses of human rights to stop too? And that I work every f*$&ing day to find freedom and health for myself and for others? If I have not, then I, you, or both of us have failed. I will wake up tomorrow and try again. Grateful for the fact that I am not suicidal, that I don’t have to deal with most conventional psychiatry anymore, that I have food and a roof over my head. And that I can use my voice in a way that I choose, rather than pray into the darkness for The God to kill me. Or with a voice that IS no voice, a voice that knows very well what dying is like. Take care.

  • @Whatuser: I agree. I’ve been chewing over this a lot: ‘Society‘ doesn’t know, doesn’t want to know, and will do whatever it takes to prevent from knowing, even if that means fighting, abandoning, or incarcerating.” I agree that people should be careful not to blatantly dehumanize psychiatrists and the culture constellated around them. But it’s so difficult not to outright reject it, or to tame a response when properly assessing or changing the culture, without being loud, angry, and demanding various forms of justice or dismantling.

  • @streetphotobeing: Although I don’t believe in a monolithic ‘psychiatry’, that is, there are many levels and boundaries, I appreciate all these points. I call it ‘conventional’ psychiatry, and ‘it’ dominates the field. But I know THAT is also not fully satisfying. You shimmied through many of the interviewee’s cracks; many of which I didn’t catch at first glance.

  • kateL,
    P.S.: with me, with my nutrients I was getting better & worse simultaneously, which is odd. I still ended up brutally suicidal until my cheap generic ketamine, and this had more to do with my brain & soul. The nutrients, though, helped heal my nerves & muscles, including brain just not enough, and I believe prevented me from going into a catatonic-like condition of painful rigid muscles & non-fluid painful nerves. It was very slow, painfully slow, but built up over time by micro-changes cascading into macro-changes. This was through the simultaneous slowly stopping of cigarettes and refining nutritional supplements usually 3xday, after meals. Programs can be tailor-made to be either cheaper or more practical—such as a modified program of cheaper or less supplements taken less often, but you can’t go too low or less often if following some of the usual standards. BTW, I talk on my website about how I believe B3 (as niacin) may have caused permanent Rosacea on my face from flushing beet red every morning for 4 years. For many, the flushing stops/lessons with large dose, continual use, but for me didn’t. Sometimes in the literature you get: ‘if flushing becomes intolerable, the person will have to switch to a non-flushing form of niacinimide or inositol hexaniacinate’, or ‘if flushing doesn’t stop, they will have to switch’. In my opinion, they don’t highlight these enough. For me I ‘tolerated’ it fine. But I wish I had switched a lot earlier bc it seemed to lead to permanently dilated capillaries in the face and cystic painful relentless acne. I now have to take daily antibiotics until I can feel comfortable risking side effects of Accutane. I’ve also had to lower my doses due to headache, but took non-flushing forms for years without a problem. Too high doses of niacinimide for example can cause liver damage. I also experienced that and overcame it. So….some things to consider with B3! Also, manganese is a tricky one and doses are small; I don’t have a lot of experience with it. In terms of working with a ‘practitioner’, I completely understand your perspectives on that. ‘don’t get it, talking down to me, ripping me off, like psychiatrist triggering PTSD’….I’ve felt each of those things over the years!!!! F&@$. To leave on a positive note: ;)….

  • KateL,
    Thx for responding. I wanted to try to assist one more time—quickly before breakfast. First, large amounts of vitamin C (I take sodium ascorbate from Nutribiotic, & some ascorbic acid, which is acidic) right before diarrhea occurs (through trial and error), can be enormously helpful for detox from all kind of things. There’s debate on dose & cheap synthetic C vs the C-complex that I talk about on my website, under the clinical nutrition section: http://www.evanhaarbauer.com; designed to make things more accessible. I take standard cheap synthetic but high quality from reputable brands. Whether or not my website interests you, I went ahead and searched ‘akathesia’ & ‘tardive diskenesia’(sp?) on the Journal of Orthomolecular Medicine website:
    https://isom.ca/jom/. Unfortunately it wouldn’t link to the results, but you can scroll down a bit and enter the proper search term you’re interested in, from years of publications, including highlights of the B3 & manganese. There seem to be many items that come up. I really like that website. Hope this helps.

  • Dr Abram Hoffer used both moderate (still small) doses of manganese and high vitamin b3 to prevent and treat TD. Not sure about akathesia, I hope I’m not confusing the two. He thought if the drugs had a small amount of manganese combined in them, the TD would not occur. Actually recommended to a drug company, but of course nothing happened. I can see that as being a complicated thing even if it was legitimate. Hard to get data, but he was convincing.

  • Yes. And yes, rock on. While I don’t pretend to know the ultimate answers, I would like to highlight one of Hoffer’s notions that I find appealing, even though it is materialistic etc. I should add that another favorite psychiatrist of mine, Carl Jung, also used the label schizophrenia and had an enormous amount to say about ‘it’ and had a psychogenic theory that is well worth examining. He also theorized a metabolic toxin ‘X’. He himself had ‘psychotic’-like symptoms which played a role in his self development. Hoffer considered schizophrenia a syndrome whose common final pathway is the by-products of oxidized adrenaline. He said many different causes can lead to the final pathway, but perhaps a majority had to do with chronic pellagra and vitamin b3 dependency; dealing with too little NAD/NADH from normal amounts of vitamin B3 in the diet and a high turnover rate to oxidized adrenaline and it’s by products. He named a whole consortium of psychological AND physical symptoms that can come from this. Having simply summarized his hypothesis, he had a very limited perspective on the function and meaning of hallucinations (and dreams?) and tended to medicalize people who experienced these, and I completely understand if this type of thinking is a turn off; I’m labeled, have used nutrients, & find it all rather maddening. It is not proven and would be hard to get the funding, consensus, etc. But I find it stimulating. His hypothesis was developed in the psychedelic pre-illegal era and before the use of vitamins, which came as a response, not a cause. It is the first oxidative stress disease theory and led to treatment with antioxidants etc. If you’ve bothered reading this, thank you for your patience. I try to make psychology & the body complimentary, and these types of ideas help me with that. Now to the….Peace.

  • I agree and disagree and suspend judgment on much in the article and in comments to it. I’ll just say a couple things:
    To rehash what other commenters have highlighted or framed, speaking from my own experience, I find it odd they both didn’t include schizophrenia as a disorder of adversity (& iatrogenesis) and emphasized it’s genetic & developmental aspect after appearing to negate those earlier in the article. Did I misunderstand something? I tend to believe there can be aspects of all of the above & sometimes none, including schiz as a social construct and loose, if not completely misapplied, label, with its stigma, illusions, etc.
    Unlike many, I am interested in the biogenesis of schizophrenia a la Hoffer & Osmond’s aminochrome hypothesis (which apparently accounts for the dopamine & trans-methylation hypotheses). Also, their urine ‘mauve’, kryptopyrrole, or pyrrole disorder test for some, but not all, people labeled with schiz. Also it’s relevance for other ailments like cancer. It was said to be a marker for oxidative stress. It is an example, and there are others in their work, that there can be biological markers for mental illness though they may not always be only specific to the diagnosis, and also may not be proven. Because we have been so over-immersed in pharmaceutics and their related research & diagnosis standards, we tend to overlook the biochemistry of nutrients and how they directly or indirectly provide insight into health & sickness. Though I’ve made many mistakes, especially doing it mostly all on my own, I‘ve noticed how nutrients—diet & supplements—can have profound effects on mental & physical status and their interrelationships.
    Other commenters, please don’t make this a long debate on what I say. While I welcome comments, & will try to respond to some, I don’t want to get into the thicket and go down the rabbit hole. Of course, I’m still exploring and fleshing all this out, and I think we all know how damn complicated all this is. Thank you.

  • Thnx. I’ll say both positive shades & negative shades about this & asenapine. I’ve read Mad in America & The Zyprexa Papers, thoroughly appreciated them, & will add a couple comments about them at the end.
    I wish the author would have elaborated more on the use of the PANSS scale. For example, obliteration of voices & visions (example of positive symptoms) as a test for efficacy is of course questionable, even if they are painful, interfere with work, etc. They are not illegal. In this sense, the fact that asenapine is not ‘effective’ for schiz might be a good thing. An example of what I mean is Dr. Carl Jung’s ‘psychotic break’ that amounted to authentic religious experiences and production of a book, The Red Book, that insures for $50 million dollars, bought & read by millions of people. Though somewhat unique, this shows how crippling & wiping away voices/visions & the mythopoetic imagination can be counterproductive. I’m fully aware of the complexities here, like homicidal command voices and running in the street naked, but I’ll set that aside for another time.
    I’ve taken asenapine (as Saphris) for 5 years and was mostly unfamiliar with these details though not at all surprised. It’s the only ‘major tranquilizer‘ I’ve ever ‘liked’ or trusted, and moving to it from olanzapine (Zyprexa) was like a revelelation. One reason I am more friendly to it is I can take it once a night, instead of twice a day, which reduces ‘side effects’ like sedation during the day (after I can finally get up). Very unusual for this class of drug. Since starting (what I believe to be) an effective antidepressant, cheap generic ketamine, and along with nutrient supplements, I’ve been able to come down to 1.75mg-2.5mg from 20mg per day of asenapine since I was not brutally suicidal and ‘needed’ far less sedation. (I won’t highlight the psycho-social-environmental context right now). I cut the wafers to get these doses which is imperfect and tricky. I hope to get off completely, but right now, I can’t sleep without it. It’s hard to tease out these issues, as I’m basically addicted (habituated) to it. I’ve had various measures to get either free or lesser expensive supplies. Rarely my parents paid the $300 per month (at highest dose without coverage, it is $1500 per month). It is just now going generic, and they won’t be able to make as many billions of dollars off it. I’ve used their assistance program, Medicaid/Medicare coverage, and doctor’s request for free samples from their website. Of course, I would have preferred not taking it at all, but was long sucked into the rigmarole of conventional psychiatry.
    Having said all that, I hope the authors of Mad in America (Whitaker) @ The Zyprexa Papers (Gottstein) take some time to analyze & highlight clinical nutrition & psychedelic therapy, though I’m very aware that we find many of the same issues as Big Pharma. Also to elaborate more on the notions of the personal & collective unconscious in ‘psychotic’ symptoms a la Carl Jung. I have found great benefit from these areas, and I believe can constitute ‘less-intrusive’ physical & psychological methods for mental health.
    I’ve said a lot already, & I’ll leave it at that to very complicated topics. Thx again.

  • sam, this will be my last response as I don’t want to get into the thick of it. I welcome another response from you.
    If there’s anybody who sympathizes with your general feeling, it would be me. I don’t consider most psychiatrists my colleagues, and definitely not my friends. However, two of my favorite authors were psychiatrists, Abram Hoffer and Carl Jung. They agreed mental illness, or dis-ease, exists, and that something should and could be done. They of course had many blind spots, inconsistencies, and problematic outlooks. I also think there’s an honest role for shamanisn in tribal societies, and that there is a place for modern shamanism, including both physical and psycho—spiritual methods. I think you’re right that most psychiatry and related industry services are not and will not reform/change. That’s one thing I’ve learned: they Don’t change. To the degree that this is true, I am referring to new management that have new ideals and different ways of doing things. I don’t believe psychiatry, in principle, needs to be bombed into oblivion like they do to so many patients. Like police and courts, I believe we need both, but a radical reallocation of funds and purposes should take place. Right now all of the above far too often, make a mockery of justice, guardianship, and medicine. We can’t change it into a void. But I support a radical re-visioning and re-orientation. I believe there are doctors of the past that play a role in the soul-doctoring of the future. Maybe I’m wrong, but I don’t think so. I’ll leave it at that. Take care.

  • Thanks for highlighting that. Yes, I agree, although I’m not sure bending it toward rarely is correct or that taking the time is not worth it. But when dealing with so many variables/positions, and millions of people, it’s inevitable. I tried to suggest your point by putting ‘resolve’ in quotations and leaving it open-ended, where they go their separate ways but without a war breaking out (at the table). Each position tries to make a stab at it, and because each model can have a very real affect on people—the labeled, provider, researcher, and public—it is desirable to clarify and formulate reliable answers. We don’t want a jumble of competing illusions, although maybe that’s what we get. I know that sitting with the unknown and uncertainty is sometimes preferable, but not ideal. I’ll chew on this some more. I do think it would be a good and challenging class experiment to take varying positions and negotiate a plan of action that a ‘society’ could take. Maybe they will argue til they’re blue in the face and lead to civil war, or maybe it would lead to the kind of brain-storming, creativity, and negotiation that are so needed in the reformation of psychiatry. It would at least give students the multiplicity of views before they entered the field and crystallized into a specific decision. I assume as people in the field, they would have to take Some position, even if they differed from colleagues or even if it’s the formal position of abstaining completely.

  • One of your concerns seems to be your lack of the human connection, socializing, etc. I made a comment earlier that didn’t even address that, and I’m sorry. I tend to be an introverted and private loner so I bone-headily over-looked that I guess. I walk with family, masked, although a lot less with the Heat in Alabama rising. I zoom with family or organizations that I am either a member or curious observer/participator. I text and talk occasionally with friends. I still see my psychologist in person, and now we both wear masks (he wasn’t). I actually like him a lot, which is somewhat unusual and shouldn’t be taken for granted. Anyway. Ok. Thanks.

  • I was brutally suicidal for a long time for many reasons. For what it’s worth, if anything to another person in dire straights, the most profound change, ironically just at the very beginning of the virus epoch, was my new generic liquid ketamine treatment prescribed by my psychiatrist. It transformed me; of course with all my other modes of operation: nutrient supplements, privacy of funded apartment (by government and parents—I know, I know), art and website building, minor amounts of other pharmaceuticals, mainly to assist my sleeping, and there are others. But my ketamine really made an important difference. It is generic, $45 a month, 15mg per day, and transcends the expensive, time consuming, and clinical over-control of the nasal spray and IV.
    Maybe you didn’t/don’t want my input, and I can understand that. But I too have lived with the apocalypse, and only hold tight–now–what I can, and proceed from there. Take care.
    (p.s. I think this is not the place for criticizing my use of prescribed drugs, especially from other commentators. I’m fully aware of the complexities. That conversation can be had at another time.)

  • Both of your points of view are important and an intriguing re-framing of the issue. Each question, scientific or philosophical, both put the article’s conclusion in a different light. Combining all three is so damn complicated. Does each play a role or should ‘one’ be given precedent? I guess this is why we need a multi disciplinary approach. How do we resolve the irreconcilable if we Have to sit at the same table? Or do we Have to sit at different tables in order to comfortably ‘resolve‘ it? Anyways.

  • One last comment for me:
    I do agree that b vitamins can give energy and sometimes too much or in a jittery way. B-complex is often given to boost energy and mood…sometimes uncomfortably so. It is important to recognize the differences between what are at least 8 different B vitamins. B6, B12, & B3 are known for boosting energy in one way or another. But B3 also has anti anxiety effects, and I know a person who took 500mg niacin(B3) before bed that helped her sleep. B6 for autism is often prescribed with magnesium to help counter its activating effects. B1, B3, B6, B9, & B12 all have antidepressant potentials. I think B3 can give ‘energy’ but also calming effects. I believe it activates receptors in a similar way to benzos, but it’s been awhile since I’ve looked into it.

  • furies-

    I’ve yet to hear of a method that works for everybody: b vitamins, yoga, pharma, ect, neo-Freudian psych, retreats, et cetera. I’m glad you are mindful of your sensitivities, and we perhaps both agree/hope that your new trial B9 for MTFHR will be beneficial. Apparently it has not triggered & jacked upped your nervous system? I think it’s possible taking niacin and flushing for years gave me rosacae, too high dose niacinimide gave me liver damage, then eventually headaches though I took it for years at lower doses without a problem. But I continue to take inositol hexaniacinate, in high doses, and wouldn’t go without it. Even the niacin did a number of profound things for me. B vitamins can have undesirable effects too, but personalizing it and adapting is part of it. I’m trying to be comprehensive and honest while not throwing the baby out with the bathwater. I maintain there is a place for all b vitamins—all nutrients—including methylfolate. Some rare individuals with a genetic disorder or sensitivities can’t take vitamin c even though it’s generally one of the safest substance known. And, yes, I’m keeping the diarrhea in mind.

  • I had a zoom call with a mental health group yesterday. A psychiatrist said we all need to learn from our mistakes and do a better job going forward. This is admittedly difficult. Suicide is no joke and could be a bold exclamation point or question mark to a very long sentence. It appears that everyone has a role to learn more, do better, and find a new way. The person most in need of education is the educator. I support Steve and Caroline’s responses and value their work. I’ve had enough of this. I won’t respond to any more.

  • You have reasoning there, and I wish I could do an email exchange with you. However, I have a feeling I’d feel like I was dealing with a psychiatrist (psychologist? hence your user name?) as a patient (client?) in a psyche hospital, and I have no interest in that. I should probably protect my email as well. But you seem to me like being someone who either needs a good long term debate, or someone who needs love and communication from someone who can competently communicate from lived experience-in this case from a person with a formal diagnosis. If I was treated by you-again as a psychologist?-neither one of those objectives appear possible from what you say. If you ARE a psychologist, I would have no immediate need for the prescriptions that you find so necessary. My guess is you’re so fond of them due to 1: having the appearance of nothing better and 2: from not ever having taken the drugs, I mean medicine—or your ‘treatment’—-yourself. Or are you including your special form of psychotherapy since your a psychologist? It’s hard to tell, and frankly, I don’t care to know. I must admit, human nature is terribly complicated.

  • Interesting article. I just want to comment on the author saying there’s too much emphasis on new therapies such as psychedelics. Though I partially agree, it should be noted that psychedelics are not new and go back decades in a medical context. They’ve had a resurgence especially over the last couple decades, and especially the last few years. They tend to be publicly seen as either sexy or a scourge. The sexiness is partly why they are getting attention, and their compensating conventional treatments is another. I personally have had revelatory benefit from generic classic ketamine for ‘treatment resistant’ depression and brutal chronic suicidal considerations. Not the fancy and expensive nasal spray that’s being marketed and been trialed I might add. Its use for depression, with psychotherapy, is nothing particularly new either, research dating back to the 90’s and really before. It’s a very old drug being cast in a new light, and I recommend it in some cases. Having said that, there’s a lowlier set of substances that often don’t get a new hearing of an old approach, by mainstream or ‘cutting edge’ and well-funded universities or non-profits, such as more diverse psychedelic therapy. And these lowly substances are micro and macro nutrients: diet & supplements. They don’t seem to be sexy enough or a scourge, although there’s plenty of dismissal and certainty of irrelevance to go around. Now I speak more for supplements than a ‘balanced diet’, but complex, specialized diets are hardly prescribed by psychiatrists, although they can be a pain in the ass to maintain, I must admit. Psychedelics and nutrients are not ‘new’ treatments. Their reappraisal and deepening research are emerging from past pioneers, coming ‘back to the future’, this time hopefully with a more durable, more aware, and broader appeal.
    Sorry I’ve not mentioned race. The topic of racial equality and justice is also revitalizing from past pioneers and is as necessary as it is complex. The author makes a good case for this.

  • My comments address both interviewees: I actually believe people are designed for drugs, namely chemicals or biochemicals. The usual suspects are of course micro and macro nutrients, which are typically viewed as obtained through food and beverage, particularly a ‘balanced diet’. I would broaden the chemical need/want to other non-nutritional substances. However, I find it interesting that Baylissa mentions she’s had a number of clients come in for magnesium withdrawal. This is interesting, and I won’t say much, but what I will say is this: Does she believe that the RDA (recommended daily allowance) for nutrients is a reliable guidepost for society? If so, does she believe people eat and, even with a so-called balanced diet, obtain the RDA for magnesium? Do people Really eat enough leafy greens to get 350-450mg of magnesium per day? The same applies to most nutrients, but especially vitamin e, iodine, and omega 3’s. Are people Really eating enough fish 2-3x a week, iodized salt and seaweed, olive oil and avocados, or leafy greens? If so, I solute them. But let’s be real. Therefore, if someone chooses to take a supplement, they are not stretching the envelope based on this consideration. And this is for the RDA, let alone optimal amounts for preventing/treating illness and increasing well being. Jim says there’s no supplements that can help withdrawal. I completely disagree, but I won’t elaborate, other than to agree with bcharris’, another commentator’s view on vitamin b3, in this case niacinimide. Taking higher doses of supplemental nutrients, and suddenly stopping, Can create rebound/withdrawal effects, for example high dose vitamin c when taken in large daily doses should not be suddenly stopped in the hospital, for example. But I guarantee you the hospital staff will not offer, let alone taper, vitamin c through controlled supplementation. Also, nutritional withdrawal is usually relatively mild—and also begs the question of removing effects that really can be useful. I didn’t hear her describe the undesirable effects of magnesium, just its removal, although of course nutrients can have undesirable, even harmful, ‘side effects’ too. Anyways, other than these remarks, I rather appreciate the interviewees’ work. It’s a complicated issue, and conventional medicine hardly bothers, so they are compensating a neglected area. For this, I also solute them.