Antidepressants might stop people from rebelling against intolerable conditions, but only because the drugs are disabling. They are not efficacious in any positive way. More important, however, is the effect on people of believing that they are ill. This is what prevents them from understanding the genesis of their predicament and taking effective action to deal with it.
No, not really a good article at all. This kind of piece is just a limited hangout that actually helps to solidify the system. Unless and until people like Moncrieff are willing to get off the fence and question the entire drugging/electrocution/diagnosis enterprise – which of course they will never do – they won’t make the smallest dent in this.
What to make of it? Maybe abandon your apparent assumption that all good judgment and virtue lie on one side of the ideological aisle. I suspect you’re a so-called progressive.
In other words your manifesto is to insert mental healthism into as many domains of human existence as possible. Let’s hope the citizens of Europe see through the progressive jargon in which this is couched and vote decisively no.
They won’t necessarily drug the population; they might instead “prescribe” various “psychosocial interventions”. There are already reports of doctors doing this in the UK, and it’s just as sinister in my opinion.
I heard about this study on a podcast. The idea is that the younger children are more likely to get the diagnosis because they’re less mature, less developmentally equipped for the challenges of school. It’s black magic voodoo like all psych research, but I guess that hypothesis is more acceptable than some pseudoscience about the kids’ brains being defective.
Certain groups, such as those with a diagnosis of schizophrenia and homeless people, are almost certainly underrepresented in this survey. Imagine how much worse the picture would be if those groups were adequately included.
Psychiatric wards and institutions are a special kind of hell.
Yes of course I do, although I don’t visit this site much now. I do think it has sold out: the only anti-psych consciousness propounded (except by commenters) is very, very limited, and the sovereignty of professionals over people in distress is essentially unchallenged. It has always pretty much been that way, but it has moved further along the spectrum.
Junk science is too generous a description of rubbish like this, and I wish MIA would stop promoting it. In fact MIA could helpfully debunk this stuff in the same way that it takes a stand on mainstream mental health “treatments”.
Where are you getting your information on psychiatry and eating disorders? We must be in parallel universes.
I don’t think warnings about tolerance and dependence are likely to make much difference. That’s my experience at least, based on everyone I know who’s got into trouble with these drugs. Just stop prescribing them at all, as you say. We can’t reliably identify risk factors for addiction, and the potential damage is too great.
It’s my impression that the use of benzodiazepines in epilepsy is increasing. Often they’re actually prescribed not for controlling seizures but for anxiety, which many people with epilepsy experience. Whenever I encounter someone with epilepsy asking about these drugs I warn them of the dangers, but these drugs have a strong allure.
I also appreciate your comments about epilepsy “for life”. Many neurologists have a poor knowledge of the natural history of epilepsy, which does indeed spontaneously remit in many cases, and tell their patients that they’ll need to take medication for the rest of their lives. This is unfair and inaccurate. Each patient should be assessed individually rather than subject to a blanket conservative approach. Moreover, even people with active epilepsy should be allowed to decline or discontinue medication if that’s their preference.
Not only that, we now have more and more penetration of psychologizing, psychotherapy and general psychobabble into physical medicine. In every field from irritable bowel syndrome to end-stage kidney disease (yes, I saw a psychosocial treatment program for the fatigue caused by the latter) physical medicine doctors are now herding patients off for psychotherapy of some form or another, under the banner of the biopsychosocial model.
Making a distinction between the system and the powerful individuals who carry out its vile mandates is a pathetic apology for those people. I am surprised that you would make such a statement.
Ah yes, let’s medicalise loneliness and devise cute programs with acronyms like LISTEN. Better still, get the “mental health” profession in on the act. That will do lonely people a world of good.
“I accept that I may fit the DSMâs criteria for Borderline Personality Disorder. I am not trying to say that this does not come with challenges and obstacles. I acknowledge that I have things to work on. While I may not feel completely comfortable or fulfilled while I am single, there are times when I may need to accept being single temporarily. While I may feel intense amounts of pain after a break-up, I will need to learn how to deal with that pain in a way that does not make romantic partners feel pressured to stay with me in order to prevent my self-harm.”
These are not the statements of someone who doesn’t think that they have anything more to work on than anyone else. I think you have internalised the psychiatric narrative to such a degree that you cannot see it. As Julie said, step off this stage. Step right away from all of this; carrying that label around will not help you.
I see you as still allowing yourself to be defined by it, for example in your kind of concession that you need to work on yourself. I think it’s still taking a toll on your self-respect, and that’s a terrible thing.
I was the same way for many years, after horrible experiences with psychiatrists and psychologists who essentially told me that I was defective. Eventually I drew the line and decided that I wouldn’t allow it to shape the way I see myself. I still find talk about psychiatry deeply upsetting and I generally stay away from related discussions, because these professions and their derogatory views permeate society in so many ways. However I’m much, much better for the strides I’ve made in putting it all in a big metaphorical trashcan.
Best wishes to you in your journey of liberation.
Emily, you’re still all tangled up in the system – it permeates the way you think about yourself. Just reject the whole thing, or it will always define you and distress you. There is no other way.
You’re right. The suffering inflicted by psychiatry is profound, and unless one rejects it fundamentally its poisonous traces linger and lurk.
No one expects you to pander to the audience, but you might have expected some strong reactions if you were familiar with your audience.
News and views about the issues you discuss (interventions and screening for young people) have been extensively debated on this site. You too were given an opportunity to express your views and some of us did likewise. I don’t think it’s very complicated.
“Counselors need to be awarded enough power to make serious decisions about students whom they see are using poor emotional coping skills … Why arenât we preventive in our approach and engaging all young adults by testing their emotional health?”
Ugh. Unless I’m misunderstanding something, this is completely contrary to the message encapsulated in your title. And I don’t think you are likely to find any support on this site for interventions like this, particularly giving professionals “power to make serious decisions about students”. Do you have any idea what this site is all about?
Hallelujah! The author wakes up to the notion, amongst other things, that adverse childhood experiences can lead to psychological suffering (“mental illness”). Give them an award for reinventing the wheel.
All the recovery BS doesn’t help. You never see realistic stories about people coping as best they can with emotional suffering, just a slew of propaganda about people climbing out of the dark depths and making a “success” of themselves. “Recovery” is compulsory.
The right that’s being sought is the right for someone ELSE to end your life, which is completely different from the right to end it yourself.
Yes it was, and it increasingly permeates other fields of medicine. There’s nothing to be gained by a false contrast between psychiatry and the rest of medicine.
From the article:
“Gabapentin can enhance the euphoria caused by an opioid and stave off drug withdrawals. In addition, it can bypass the blocking effects of medications used for addiction treatment, enabling patients to get high while in recovery.”
Oh please. CFS/SEID has about as much validity as a diagnosis as psychiatric labels, i.e. none.
I don’t know how sound their data is. I’m just saying that if their conclusion is correct it’s surely not unwelcome.
I didn’t infer anything about complete withdrawal from this item or the headline. If you did, if was an inference of your own creation. The post clearly refers to switching medications. There was no need to read the actual article to establish that (although I did read it before commenting).
Click on the link to get these details. It’s all there.
It was a meta-analysis, BTW, not an original study.
I’m not sure why people find this conclusion so threatening. I would think it’s good news for people getting of these drugs.
Why? It’s what they found.
I don’t support any psychological “interventions”. But if they’re pinning their hopes on “brief psychological interventions that require minimal expertise to deliver” they ain’t going nowhere.
“Doctors in other medical specialties must keep up with whatâs going on in their area of medicine so why are psychiatrists so lacking in knowledge about whatâs going on in theirs?”
Stephen, I can assure you that that is not the case, at least not across the board. I have encountered shocking instances of ignorance in other medical specialties. There are big problems in medicine as a whole. Admittedly they are particularly, excruciatingly, bad in psychiatry.
When I said “booming” I merely meant that it has no shortage of takers; it wasn’t a positive statement about psychiatry. I agree that it’s only flourishing for want of an alternative, and I personally don’t see therapy as a good alternative, at least not as it’s currently offered.
I also agree that most of us are not well equipped to argue with our peers about the merits and underpinnings of psychiatry. Myths about “chemical imbalance”, genes and the like have been too successfully propagated and cemented. I’m very much with FeelinDiscouraged on this.
“Every day a growing chorus of voices proclaims the naked truth about the disease model of psychiatry. Itâs not a matter of if it will collapse, but when.”
I think this viewpoint comes from spending too much time around critics and victims of psychiatry – such as on this website. In the real world psychiatry is booming; its willing customers are everywhere. However please keep up the good fight.
Hardly surprising. Equally unsurprising was the implication that people need longer treatment with this garbage in order to fully “recover”.
You could have made your points without bagging Trump and Trump supporters. In fact it would have been a stronger, more principled piece if you’d done so. Please consider that. I completely understand why Jerry feels attacked and alienated.
I agree. The human connection is indeed the healing part, and it’s the luck of the draw whether you get that from a professional. What’s more you don’t need to be a professional to provide it.
I think you were responding to me, oldhead? Yes, we’re on the same page, for sure. Putting an end to drugging is just part of the problem, and probably not the biggest part. As you say it’s the entire context, the framework.
This article is a healthy reminder of why I rarely visit this site now: the casual embrace of anything non-drug as benign, evidence-free endorsement of many of these “therapies”, and the continuing pathologization of human experience in new clothing. And yet another person trying to make a buck out of all of this.
Stephen Fry is pushing nonsense and pseudoscience about “mental illness” for all he’s worth. I don’t know how much money he’s making out of it.
Would you feel any better if you believed it? She just wants to roll out psychiatry on a bigger and broader scale, with plenty of “early intervention” of course.
It doesn’t sound like opposition based on individual liberty or related concerns.
“Their first action after the hearing was to cancel GDâs leave privileges so that he could not attend the first class of a long-awaited photography course today.”
To repeat uprising’s comment: classic psychiatry.
Thank you for writing about this case. I am following it but only have access to what is in the media and the Free Garth blog. The latter mentioned the issue of guardianship; perhaps you could comment on that in one of your pieces.
There’s plenty of evidence about the long-term risks of antipsychotics in adults, both the older drugs and the atypicals. If the APA doesn’t talk about it, that’s probably the reason.
I agree!
One other thing I wonder about is the “new information” on which the proposed reclassification is based. The proposed rule refers to this several times. Is there really some new information or is this just a formality/form of words?
My understanding is that the proposed reclassification would mean that for the specified indications ECT would not have to undergo premarket approval, i.e. the manufacturers would not have to demonstrate safety and efficacy as required for class III medical devices. So the very questions that you say are âup for grabsâ (I suspect that Dr Breggin and others would dispute this) would never have to be systematically investigated. Technically speaking, this is different from approval or âendorsementâ, but its practical effect is the same.
ECT has been defended for years and years by the ritual parading of success stories, people who say that their lives were saved by this treatment. Why is this standard acceptable for ECT but not for other medical treatments? Vioxx would still be on the market if we applied this approach across the board.
You make a good point about maintenance ECT. I know someone who is having monthly maintenance ECT, which Iâd previously never heard of. This development alone is one very good reason why the proposed reclassification should be strongly opposed.
On the positive side it shows that there are a few voices, like Dr Breggin, speaking out against this.
Fair enough, leave out the word ‘blame’ if you like and talk about personal responsibility instead. However I doubt that will make much difference to the NAMI mummies (and daddies). An entire industry has flourished because of these parents’ desire/need to attribute their children’s problems to faulty brain chemistry rather than anything remotely to do with them.
I’m not suggesting that a single person is to blame, and of course family issues are usually multigenerational. What I am saying is that people need to reflect on and take responsibility for the part – and it may be a limited part – they have played in the suffering experienced by others. In other words they do need to take part of the blame. Why is that so hard to say?
I’m not talking about the gossipy finger pointing that is rampant in our society; I’m talking about something responsible and constructive.
People in this thread are working overtime to distance themselves from the word ‘blame’. It looks to me like the taboo is still very much in place.
“There are no valid, reliable separable mental illness categories… So why keep using this illusory term?”
Excellent observation. Why is it that in the realm of âalternativeâ treatments itâs always suddenly OK to use the medical language of illness and disease again?
Iâve looked at this legislation and find nothing whatsoever to object to. The aim is to ensure that consumers get what is on the label and to protect them against shonky claims. To that end there is a regime of registration/licensing fees and a requirement that all therapeutic claims be substantiated. I fully support this.
I said that alternative approaches might be less harmful (they’re not always harmless). They still involve diagnosing and ‘treating’ children, however.
There is a huge market in alternative ‘natural’ approaches for children, for autism spectrum disorder for example, and I don’t see any evidence that they’re doing anyone any good (except those selling them).
Thank you for this excellent response to Dr Middletonâs paper. It was very disappointing to read the paper, and it made me question once again how critical âCritical Psychiatryâ really is.
The problems raised here are not unique to psychiatry. Medical practitioners have been complaining for years that they are forced to prescribe antibiotics because patients demand them. Recent data indicates that this practice is still continuing on a large scale, but at least a sizeable minority of doctors seem to have absorbed the message about antibiotic resistance and are not writing prescriptions just because patients ask for them. Psychiatrists who have any integrity have to do the same.
Of course the other issue is how the demand is generated in the first place, as you point out, and it is least said exceedingly rich for a profession that has created the demand to criticize patients who respond to the marketing and come asking for medication.
You want to replace psychiatric medications with ‘strategic nutrition’, ‘better physiologic assessments’, ‘smart supplementation’, yoga, homeopathy, and ‘energy medicine’. These may (or may not) be safer than psychiatric drugs, but you’re still labelling and treating kids. So-called functional medicine wants a piece of the pie, too. NO: Just leave kids alone, or help families and communities to support them in loving, human ways!
I basically agree. It seems that whenever someone who’s committed a major act of violence is found to have been taking psych drugs the violence is immediately attributed to the medication. While I agree that psychiatric drugs are ineffective and very harmful I don’t believe in jumping to conclusions. This reaction also has the potential to make critics of psychiatry look like a bunch of ratbags. Finally and importantly, it diverts attention from the critical psychosocial issues that lead to psychological and interpersonal suffering.
If the doctor has truly exhausted all avenues of discussion with the patient they should decline to write the prescription and offer them a referral to another practitioner.
So long as professionals handball the responsibility to someone else – the insistent patient, their employer or ‘society’ – the problem will continue.
Yes – this is a sage observation that bears repeating!
Nice sentiments, but it seems like you are already half way to a pragmatic decision to fall in with the system in order to build and preserve a career. Doing something in full and open acknowledgment of the fact that it is wrong doesn’t make it OK. Think about looking for a role that doesnât require you to act contrary to your values.
You state that another commenter is âvery wrongâ. What, then, was the outcome for Mary? Do you know? Did you, having incarcerated her, follow her through the system to check on her welfare?
Yes, very creepy. The rhetoric about ‘vulnerable families’ and the like sounds well-intentioned, but the program itself seems like a worry – ‘Just look at the brain scan of this troubled kiddy!’.
Sorry, meant ‘underserved’ of course.
This is very moving, and the best deconstruction of stigma that I’ve ever read. Thank you – I will re-read this many times.
I agree entirely. He seems to be respectful and compassionate, but I have a horrible suspicion that he would want more of the mainstream medical model. The prevailing progressive view is that people with mental health problems are drastically undeserved and that we need more services and more ‘interventions’. This is reflected in the view that mental health should be accorded parity with physical health.
Peter Breggin, who is a lifelong libertarian, now believes that we should be working towards a ban on psychiatric drugs for children. Enough said.
I believe that fish oil/omega-3 and other alternative ‘treatments’ will prove to be useless and a distraction from the real issues – the quality of children’s lives.
You could say the same thing about alcohol. Tell it to my friend whose young son just died of alcohol-induced liver disease.
The anti-pot crowd are blinkered, but the other side also have fixed opinions and closed minds. It probably does harm some people.
Hi Sera,
I’m late to this discussion but I want to say how much I appreciate your comments on parents who publicly talk about their children, whether itâs to do with âmental illnessâ, a substance use issue, crime or some other unfortunate plight. I see it all the time and always, always the parentâs account is taken at face value – the old adage that there are two sides to every story doesnât even get a look-in.
I love your articles and always look out for them.
Itâs a great idea to get away from culture-centric notions of âmental healthâ, especially those that focus on positive psychology. Unfortunately the proposed new definition imports much of the same faulty thinking as the one it criticizes â amazingly enough â and has the same potential to sweep large numbers of people into the category of âmental illnessâ.
Yes, unfortunately this is true. Many progressives advocate expanded mental health services, including involuntary treatment. Some of them are authoritarians in drag, and some of them are misguided humanitarians thinking they are upholding human rights. In any event they’re not reliable allies.
I very much agree!
Will concludes: âJust follow the money.â
Money is important but itâs not the central issue. The ill-treatment of troubled souls is an issue that cuts across economic systems, cultures, and historical epochs. Itâs about how society treats the Other and should be regarded as a liberation issue like the aspirations of the feminist and LGBT movements. Corruption and industrial-scale medicalization are important but theyâre not the heart of the issue.
âOr still reject usâ: your language continues to betray you. When all is said and done, people are not free to ârejectâ you.
Itâs encouraging that you respect Willâs model of engagement. The real question, however, is this: Are you willing to abandon your professionâs appalling model of engagement with people in extreme states? That is the burning issue for people whose lives are damaged by involuntary âtreatmentâ.
The belief that there is a hard-core group of persons for whom nothing works but coercion and chemical numbing is very prevalent. For example, in a recent article Sandra Steingard said that âthere will still be individuals who decline every option or are too agitated to be in a community settingâ. But as Will says we havenât tried everything we can, by a long shot. Letâs get some decent alternatives in place and really give them a go before we continue to write people off and consign them to the social dustbin.
Thank you for this wonderful contribution.
Iâm glad that someone else said this â and very nicely!
Practising gratitude goes along with forgiveness and âgetting out of yourselfâ/helping others as one of those injunctions that can be very hurtful to someone experiencing emotional trauma, for the reasons that fluffybunny outlines. None of them is inherently wrong; to the contrary, genuine forgiveness is liberating, and gratitude is something that I try to practise in my own life. It does seem to me, however, that people experiencing distress are too often called upon to exhibit saintly virtues in a world that is far from saintly.
I agree. At its best, this program is merely teaching students what ordinary folk have known for millennia, namely, that people can change and that people arenât black and white. At its worst, it conveys a popular version of neurobabble, the equation of personhood with brain, that is not only not contrary to the propaganda of the psychoactive drug industry but in fact is quite consistent with it.
This is indeed the nature of the objection. I also object to the notion that people can or should be âtrainedâ to be forgiving. Are there not some aspects of existence that can be kept outside of the ever-encroaching domains of technique and (pseudo)science?
Ah, good old forgiveness again. Itâs just another burden foisted on the suffering. If only there was as much emphasis on change and remorse on the part of those needing to be forgiven.
As for forgiveness (or âforgivingnessâ!) training, I find the very notion Orwellian and scary.
An excellent analysis as always, Steve. Add to your three things the fact that denigration and humiliation seem to be part and parcel of psychiatric treatment. Yes, it ain’t necessarily so, but it’s the sad reality for many, many people.
I agree that this data should be more widely known. It is so contrary to the universally accepted paradigm of both suicide prevention specifically and care for those with wounded souls generally.
I agree, Ted. I would like to see more articles of the sort you describe.
If you get some activism going, please report back on the site! My own efforts are currently limited to trying to put an alternative view to family, friends and acquaintances, but this is pretty fruitless because of the pervasive voice of so-called experts and of patients who have bought into the whole box and dice.
Hi Laura,
Wouldnât it be even nicer if we didnât need âsafe spacesâ as a refuge from the toxic values that engender perfectionism and fear? That value system seems more entrenched than ever, however, so a few safe spaces would be a great start.
Congratulations on emerging from the maelstrom and finding authenticity. Itâs a tough struggle that requires honesty and courage.
Agreed – thank you for this comment oldhead.
Presumably you believe that the non-biological, âREST of psychiatryâ is a force for good or at least salvageable. The truth is that psychiatry was an oppressive force long before the DSM and the rise of big pharma. Older, psychodynamic orientations, for example, also pathologised normal aspects of human experience, and psychiatrists have engaged in coercive practices ever since the emergence of the specialty. Weâre misconceiving and missing large parts of the problem if we focus only on the current biological approach. Indeed weâre misguided if we focus only on psychiatry; clinical psychology and social work, in all their flavours, are major contributors to the problem too.
This piece in no way shuts down dialogue; that is a ludicrous claim. Don’t allow yourself to be silenced, Daniel.
Thank you for this wonderful article. For precisely the reasons you outline, the biological model of psychological suffering is highly seductive: it enables us to feel that in fact weâre not failures, not defective, but instead experiencing the effects of a broken biology that lies outside our control. As you say, we need an approach that looks beyond these binary scenarios and sees the individual in a context and a life course. Without this we remain stuck in shame and self-loathing.
The only thing I would add is that, unlike you, I donât see such a sharp distinction between physical and psychological care. Iâve heard a palliative care specialist say that he is sometimes moved to tears in discussions with families of dying patients. Sharing and showing humanity in the physical care of people is just as nourishing as in the psychological arena.
If I can jump in here, Steve, your point of view really resonates with me! I find that this knowledge does provide some comfort.
And thanks to Doug and Alex. My family situation is very similar, so your stories are very encouraging.
Thank you for this excellent article. Off-label prescribing is a huge issue in medicine generally, but the problem is particularly acute in psychiatry. I cannot understand the various regulators’ casual stance.
Thank you also for drawing attention to the role of doctors in this whole mess. As you point out, Pharma is very powerful but it can only succeed if it has willing agents.
Hi Donna,
Just my attempt at wit – glad it made you smile. This topic so horrifies me that I occasionally need to indulge in sarcasm or ridicule to stay on the level.
Same reaction – excitement followed by horror.
It’s interesting that this book is by a neurologist. They must want part of the action.
It’s also alarming that this article appeared in The New Republic. Maybe Eugenics Monthly isn’t taking articles at the moment.
Antidepressants might stop people from rebelling against intolerable conditions, but only because the drugs are disabling. They are not efficacious in any positive way. More important, however, is the effect on people of believing that they are ill. This is what prevents them from understanding the genesis of their predicament and taking effective action to deal with it.
No, not really a good article at all. This kind of piece is just a limited hangout that actually helps to solidify the system. Unless and until people like Moncrieff are willing to get off the fence and question the entire drugging/electrocution/diagnosis enterprise – which of course they will never do – they won’t make the smallest dent in this.
What to make of it? Maybe abandon your apparent assumption that all good judgment and virtue lie on one side of the ideological aisle. I suspect you’re a so-called progressive.
In other words your manifesto is to insert mental healthism into as many domains of human existence as possible. Let’s hope the citizens of Europe see through the progressive jargon in which this is couched and vote decisively no.
They won’t necessarily drug the population; they might instead “prescribe” various “psychosocial interventions”. There are already reports of doctors doing this in the UK, and it’s just as sinister in my opinion.
I heard about this study on a podcast. The idea is that the younger children are more likely to get the diagnosis because they’re less mature, less developmentally equipped for the challenges of school. It’s black magic voodoo like all psych research, but I guess that hypothesis is more acceptable than some pseudoscience about the kids’ brains being defective.
Certain groups, such as those with a diagnosis of schizophrenia and homeless people, are almost certainly underrepresented in this survey. Imagine how much worse the picture would be if those groups were adequately included.
Psychiatric wards and institutions are a special kind of hell.
Yes of course I do, although I don’t visit this site much now. I do think it has sold out: the only anti-psych consciousness propounded (except by commenters) is very, very limited, and the sovereignty of professionals over people in distress is essentially unchallenged. It has always pretty much been that way, but it has moved further along the spectrum.
Junk science is too generous a description of rubbish like this, and I wish MIA would stop promoting it. In fact MIA could helpfully debunk this stuff in the same way that it takes a stand on mainstream mental health “treatments”.
Where are you getting your information on psychiatry and eating disorders? We must be in parallel universes.
I don’t think warnings about tolerance and dependence are likely to make much difference. That’s my experience at least, based on everyone I know who’s got into trouble with these drugs. Just stop prescribing them at all, as you say. We can’t reliably identify risk factors for addiction, and the potential damage is too great.
It’s my impression that the use of benzodiazepines in epilepsy is increasing. Often they’re actually prescribed not for controlling seizures but for anxiety, which many people with epilepsy experience. Whenever I encounter someone with epilepsy asking about these drugs I warn them of the dangers, but these drugs have a strong allure.
I also appreciate your comments about epilepsy “for life”. Many neurologists have a poor knowledge of the natural history of epilepsy, which does indeed spontaneously remit in many cases, and tell their patients that they’ll need to take medication for the rest of their lives. This is unfair and inaccurate. Each patient should be assessed individually rather than subject to a blanket conservative approach. Moreover, even people with active epilepsy should be allowed to decline or discontinue medication if that’s their preference.
Not only that, we now have more and more penetration of psychologizing, psychotherapy and general psychobabble into physical medicine. In every field from irritable bowel syndrome to end-stage kidney disease (yes, I saw a psychosocial treatment program for the fatigue caused by the latter) physical medicine doctors are now herding patients off for psychotherapy of some form or another, under the banner of the biopsychosocial model.
Making a distinction between the system and the powerful individuals who carry out its vile mandates is a pathetic apology for those people. I am surprised that you would make such a statement.
Ah yes, let’s medicalise loneliness and devise cute programs with acronyms like LISTEN. Better still, get the “mental health” profession in on the act. That will do lonely people a world of good.
“I accept that I may fit the DSMâs criteria for Borderline Personality Disorder. I am not trying to say that this does not come with challenges and obstacles. I acknowledge that I have things to work on. While I may not feel completely comfortable or fulfilled while I am single, there are times when I may need to accept being single temporarily. While I may feel intense amounts of pain after a break-up, I will need to learn how to deal with that pain in a way that does not make romantic partners feel pressured to stay with me in order to prevent my self-harm.”
These are not the statements of someone who doesn’t think that they have anything more to work on than anyone else. I think you have internalised the psychiatric narrative to such a degree that you cannot see it. As Julie said, step off this stage. Step right away from all of this; carrying that label around will not help you.
I see you as still allowing yourself to be defined by it, for example in your kind of concession that you need to work on yourself. I think it’s still taking a toll on your self-respect, and that’s a terrible thing.
I was the same way for many years, after horrible experiences with psychiatrists and psychologists who essentially told me that I was defective. Eventually I drew the line and decided that I wouldn’t allow it to shape the way I see myself. I still find talk about psychiatry deeply upsetting and I generally stay away from related discussions, because these professions and their derogatory views permeate society in so many ways. However I’m much, much better for the strides I’ve made in putting it all in a big metaphorical trashcan.
Best wishes to you in your journey of liberation.
Emily, you’re still all tangled up in the system – it permeates the way you think about yourself. Just reject the whole thing, or it will always define you and distress you. There is no other way.
You’re right. The suffering inflicted by psychiatry is profound, and unless one rejects it fundamentally its poisonous traces linger and lurk.
No one expects you to pander to the audience, but you might have expected some strong reactions if you were familiar with your audience.
News and views about the issues you discuss (interventions and screening for young people) have been extensively debated on this site. You too were given an opportunity to express your views and some of us did likewise. I don’t think it’s very complicated.
“Counselors need to be awarded enough power to make serious decisions about students whom they see are using poor emotional coping skills … Why arenât we preventive in our approach and engaging all young adults by testing their emotional health?”
Ugh. Unless I’m misunderstanding something, this is completely contrary to the message encapsulated in your title. And I don’t think you are likely to find any support on this site for interventions like this, particularly giving professionals “power to make serious decisions about students”. Do you have any idea what this site is all about?
Hallelujah! The author wakes up to the notion, amongst other things, that adverse childhood experiences can lead to psychological suffering (“mental illness”). Give them an award for reinventing the wheel.
All the recovery BS doesn’t help. You never see realistic stories about people coping as best they can with emotional suffering, just a slew of propaganda about people climbing out of the dark depths and making a “success” of themselves. “Recovery” is compulsory.
The right that’s being sought is the right for someone ELSE to end your life, which is completely different from the right to end it yourself.
Yes it was, and it increasingly permeates other fields of medicine. There’s nothing to be gained by a false contrast between psychiatry and the rest of medicine.
From the article:
“Gabapentin can enhance the euphoria caused by an opioid and stave off drug withdrawals. In addition, it can bypass the blocking effects of medications used for addiction treatment, enabling patients to get high while in recovery.”
See also: http://www.pulsetoday.co.uk/views/blogs/gabapentinoids-the-new-diazepam/20032721.blog
Oh please. CFS/SEID has about as much validity as a diagnosis as psychiatric labels, i.e. none.
I don’t know how sound their data is. I’m just saying that if their conclusion is correct it’s surely not unwelcome.
I didn’t infer anything about complete withdrawal from this item or the headline. If you did, if was an inference of your own creation. The post clearly refers to switching medications. There was no need to read the actual article to establish that (although I did read it before commenting).
Click on the link to get these details. It’s all there.
It was a meta-analysis, BTW, not an original study.
I’m not sure why people find this conclusion so threatening. I would think it’s good news for people getting of these drugs.
Why? It’s what they found.
I don’t support any psychological “interventions”. But if they’re pinning their hopes on “brief psychological interventions that require minimal expertise to deliver” they ain’t going nowhere.
“Doctors in other medical specialties must keep up with whatâs going on in their area of medicine so why are psychiatrists so lacking in knowledge about whatâs going on in theirs?”
Stephen, I can assure you that that is not the case, at least not across the board. I have encountered shocking instances of ignorance in other medical specialties. There are big problems in medicine as a whole. Admittedly they are particularly, excruciatingly, bad in psychiatry.
When I said “booming” I merely meant that it has no shortage of takers; it wasn’t a positive statement about psychiatry. I agree that it’s only flourishing for want of an alternative, and I personally don’t see therapy as a good alternative, at least not as it’s currently offered.
I also agree that most of us are not well equipped to argue with our peers about the merits and underpinnings of psychiatry. Myths about “chemical imbalance”, genes and the like have been too successfully propagated and cemented. I’m very much with FeelinDiscouraged on this.
“Every day a growing chorus of voices proclaims the naked truth about the disease model of psychiatry. Itâs not a matter of if it will collapse, but when.”
I think this viewpoint comes from spending too much time around critics and victims of psychiatry – such as on this website. In the real world psychiatry is booming; its willing customers are everywhere. However please keep up the good fight.
Hardly surprising. Equally unsurprising was the implication that people need longer treatment with this garbage in order to fully “recover”.
You could have made your points without bagging Trump and Trump supporters. In fact it would have been a stronger, more principled piece if you’d done so. Please consider that. I completely understand why Jerry feels attacked and alienated.
I agree. The human connection is indeed the healing part, and it’s the luck of the draw whether you get that from a professional. What’s more you don’t need to be a professional to provide it.
I think you were responding to me, oldhead? Yes, we’re on the same page, for sure. Putting an end to drugging is just part of the problem, and probably not the biggest part. As you say it’s the entire context, the framework.
This article is a healthy reminder of why I rarely visit this site now: the casual embrace of anything non-drug as benign, evidence-free endorsement of many of these “therapies”, and the continuing pathologization of human experience in new clothing. And yet another person trying to make a buck out of all of this.
Stephen Fry is pushing nonsense and pseudoscience about “mental illness” for all he’s worth. I don’t know how much money he’s making out of it.
Would you feel any better if you believed it? She just wants to roll out psychiatry on a bigger and broader scale, with plenty of “early intervention” of course.
They apparently opposed it because they are opposed to increasing the role of the federal government in health care in general: “Republicans campaigned on reducing the federal governmentâs role in healthcare, so why would Republicans vote to expand the federal governmentâs role in healthcare?â
Source: http://www.nkytribune.com/2016/07/bill-straub-the-hits-just-keep-coming-for-massie-as-he-continues-to-add-to-his-legend/
It doesn’t sound like opposition based on individual liberty or related concerns.
“Their first action after the hearing was to cancel GDâs leave privileges so that he could not attend the first class of a long-awaited photography course today.”
To repeat uprising’s comment: classic psychiatry.
Thank you for writing about this case. I am following it but only have access to what is in the media and the Free Garth blog. The latter mentioned the issue of guardianship; perhaps you could comment on that in one of your pieces.
There’s plenty of evidence about the long-term risks of antipsychotics in adults, both the older drugs and the atypicals. If the APA doesn’t talk about it, that’s probably the reason.
I agree!
One other thing I wonder about is the “new information” on which the proposed reclassification is based. The proposed rule refers to this several times. Is there really some new information or is this just a formality/form of words?
My understanding is that the proposed reclassification would mean that for the specified indications ECT would not have to undergo premarket approval, i.e. the manufacturers would not have to demonstrate safety and efficacy as required for class III medical devices. So the very questions that you say are âup for grabsâ (I suspect that Dr Breggin and others would dispute this) would never have to be systematically investigated. Technically speaking, this is different from approval or âendorsementâ, but its practical effect is the same.
ECT has been defended for years and years by the ritual parading of success stories, people who say that their lives were saved by this treatment. Why is this standard acceptable for ECT but not for other medical treatments? Vioxx would still be on the market if we applied this approach across the board.
You make a good point about maintenance ECT. I know someone who is having monthly maintenance ECT, which Iâd previously never heard of. This development alone is one very good reason why the proposed reclassification should be strongly opposed.
There is an Australian situation at the moment that really shows the atrocity of this. You can watch a report on it at:
http://www.abc.net.au/news/2015-12-17/mental-health-patient-sues-hospital-over-shock-therapy/7038740
Warning: I found it is very distressing.
On the positive side it shows that there are a few voices, like Dr Breggin, speaking out against this.
Fair enough, leave out the word ‘blame’ if you like and talk about personal responsibility instead. However I doubt that will make much difference to the NAMI mummies (and daddies). An entire industry has flourished because of these parents’ desire/need to attribute their children’s problems to faulty brain chemistry rather than anything remotely to do with them.
I’m not suggesting that a single person is to blame, and of course family issues are usually multigenerational. What I am saying is that people need to reflect on and take responsibility for the part – and it may be a limited part – they have played in the suffering experienced by others. In other words they do need to take part of the blame. Why is that so hard to say?
I’m not talking about the gossipy finger pointing that is rampant in our society; I’m talking about something responsible and constructive.
People in this thread are working overtime to distance themselves from the word ‘blame’. It looks to me like the taboo is still very much in place.
“There are no valid, reliable separable mental illness categories… So why keep using this illusory term?”
Excellent observation. Why is it that in the realm of âalternativeâ treatments itâs always suddenly OK to use the medical language of illness and disease again?
Iâve looked at this legislation and find nothing whatsoever to object to. The aim is to ensure that consumers get what is on the label and to protect them against shonky claims. To that end there is a regime of registration/licensing fees and a requirement that all therapeutic claims be substantiated. I fully support this.
I said that alternative approaches might be less harmful (they’re not always harmless). They still involve diagnosing and ‘treating’ children, however.
There is a huge market in alternative ‘natural’ approaches for children, for autism spectrum disorder for example, and I don’t see any evidence that they’re doing anyone any good (except those selling them).
Thank you for this excellent response to Dr Middletonâs paper. It was very disappointing to read the paper, and it made me question once again how critical âCritical Psychiatryâ really is.
The problems raised here are not unique to psychiatry. Medical practitioners have been complaining for years that they are forced to prescribe antibiotics because patients demand them. Recent data indicates that this practice is still continuing on a large scale, but at least a sizeable minority of doctors seem to have absorbed the message about antibiotic resistance and are not writing prescriptions just because patients ask for them. Psychiatrists who have any integrity have to do the same.
Of course the other issue is how the demand is generated in the first place, as you point out, and it is least said exceedingly rich for a profession that has created the demand to criticize patients who respond to the marketing and come asking for medication.
You want to replace psychiatric medications with ‘strategic nutrition’, ‘better physiologic assessments’, ‘smart supplementation’, yoga, homeopathy, and ‘energy medicine’. These may (or may not) be safer than psychiatric drugs, but you’re still labelling and treating kids. So-called functional medicine wants a piece of the pie, too. NO: Just leave kids alone, or help families and communities to support them in loving, human ways!
I basically agree. It seems that whenever someone who’s committed a major act of violence is found to have been taking psych drugs the violence is immediately attributed to the medication. While I agree that psychiatric drugs are ineffective and very harmful I don’t believe in jumping to conclusions. This reaction also has the potential to make critics of psychiatry look like a bunch of ratbags. Finally and importantly, it diverts attention from the critical psychosocial issues that lead to psychological and interpersonal suffering.
If the doctor has truly exhausted all avenues of discussion with the patient they should decline to write the prescription and offer them a referral to another practitioner.
So long as professionals handball the responsibility to someone else – the insistent patient, their employer or ‘society’ – the problem will continue.
Yes – this is a sage observation that bears repeating!
Nice sentiments, but it seems like you are already half way to a pragmatic decision to fall in with the system in order to build and preserve a career. Doing something in full and open acknowledgment of the fact that it is wrong doesn’t make it OK. Think about looking for a role that doesnât require you to act contrary to your values.
You state that another commenter is âvery wrongâ. What, then, was the outcome for Mary? Do you know? Did you, having incarcerated her, follow her through the system to check on her welfare?
Yes, very creepy. The rhetoric about ‘vulnerable families’ and the like sounds well-intentioned, but the program itself seems like a worry – ‘Just look at the brain scan of this troubled kiddy!’.
Sorry, meant ‘underserved’ of course.
This is very moving, and the best deconstruction of stigma that I’ve ever read. Thank you – I will re-read this many times.
I agree entirely. He seems to be respectful and compassionate, but I have a horrible suspicion that he would want more of the mainstream medical model. The prevailing progressive view is that people with mental health problems are drastically undeserved and that we need more services and more ‘interventions’. This is reflected in the view that mental health should be accorded parity with physical health.
Peter Breggin, who is a lifelong libertarian, now believes that we should be working towards a ban on psychiatric drugs for children. Enough said.
I believe that fish oil/omega-3 and other alternative ‘treatments’ will prove to be useless and a distraction from the real issues – the quality of children’s lives.
You could say the same thing about alcohol. Tell it to my friend whose young son just died of alcohol-induced liver disease.
The anti-pot crowd are blinkered, but the other side also have fixed opinions and closed minds. It probably does harm some people.
Hi Sera,
I’m late to this discussion but I want to say how much I appreciate your comments on parents who publicly talk about their children, whether itâs to do with âmental illnessâ, a substance use issue, crime or some other unfortunate plight. I see it all the time and always, always the parentâs account is taken at face value – the old adage that there are two sides to every story doesnât even get a look-in.
I love your articles and always look out for them.
Itâs a great idea to get away from culture-centric notions of âmental healthâ, especially those that focus on positive psychology. Unfortunately the proposed new definition imports much of the same faulty thinking as the one it criticizes â amazingly enough â and has the same potential to sweep large numbers of people into the category of âmental illnessâ.
Yes, unfortunately this is true. Many progressives advocate expanded mental health services, including involuntary treatment. Some of them are authoritarians in drag, and some of them are misguided humanitarians thinking they are upholding human rights. In any event they’re not reliable allies.
I very much agree!
Will concludes: âJust follow the money.â
Money is important but itâs not the central issue. The ill-treatment of troubled souls is an issue that cuts across economic systems, cultures, and historical epochs. Itâs about how society treats the Other and should be regarded as a liberation issue like the aspirations of the feminist and LGBT movements. Corruption and industrial-scale medicalization are important but theyâre not the heart of the issue.
âOr still reject usâ: your language continues to betray you. When all is said and done, people are not free to ârejectâ you.
Itâs encouraging that you respect Willâs model of engagement. The real question, however, is this: Are you willing to abandon your professionâs appalling model of engagement with people in extreme states? That is the burning issue for people whose lives are damaged by involuntary âtreatmentâ.
The belief that there is a hard-core group of persons for whom nothing works but coercion and chemical numbing is very prevalent. For example, in a recent article Sandra Steingard said that âthere will still be individuals who decline every option or are too agitated to be in a community settingâ. But as Will says we havenât tried everything we can, by a long shot. Letâs get some decent alternatives in place and really give them a go before we continue to write people off and consign them to the social dustbin.
Thank you for this wonderful contribution.
Iâm glad that someone else said this â and very nicely!
Practising gratitude goes along with forgiveness and âgetting out of yourselfâ/helping others as one of those injunctions that can be very hurtful to someone experiencing emotional trauma, for the reasons that fluffybunny outlines. None of them is inherently wrong; to the contrary, genuine forgiveness is liberating, and gratitude is something that I try to practise in my own life. It does seem to me, however, that people experiencing distress are too often called upon to exhibit saintly virtues in a world that is far from saintly.
I agree. At its best, this program is merely teaching students what ordinary folk have known for millennia, namely, that people can change and that people arenât black and white. At its worst, it conveys a popular version of neurobabble, the equation of personhood with brain, that is not only not contrary to the propaganda of the psychoactive drug industry but in fact is quite consistent with it.
This is indeed the nature of the objection. I also object to the notion that people can or should be âtrainedâ to be forgiving. Are there not some aspects of existence that can be kept outside of the ever-encroaching domains of technique and (pseudo)science?
Ah, good old forgiveness again. Itâs just another burden foisted on the suffering. If only there was as much emphasis on change and remorse on the part of those needing to be forgiven.
As for forgiveness (or âforgivingnessâ!) training, I find the very notion Orwellian and scary.
An excellent analysis as always, Steve. Add to your three things the fact that denigration and humiliation seem to be part and parcel of psychiatric treatment. Yes, it ain’t necessarily so, but it’s the sad reality for many, many people.
I agree that this data should be more widely known. It is so contrary to the universally accepted paradigm of both suicide prevention specifically and care for those with wounded souls generally.
I agree, Ted. I would like to see more articles of the sort you describe.
If you get some activism going, please report back on the site! My own efforts are currently limited to trying to put an alternative view to family, friends and acquaintances, but this is pretty fruitless because of the pervasive voice of so-called experts and of patients who have bought into the whole box and dice.
Hi Laura,
Wouldnât it be even nicer if we didnât need âsafe spacesâ as a refuge from the toxic values that engender perfectionism and fear? That value system seems more entrenched than ever, however, so a few safe spaces would be a great start.
Congratulations on emerging from the maelstrom and finding authenticity. Itâs a tough struggle that requires honesty and courage.
Agreed – thank you for this comment oldhead.
Presumably you believe that the non-biological, âREST of psychiatryâ is a force for good or at least salvageable. The truth is that psychiatry was an oppressive force long before the DSM and the rise of big pharma. Older, psychodynamic orientations, for example, also pathologised normal aspects of human experience, and psychiatrists have engaged in coercive practices ever since the emergence of the specialty. Weâre misconceiving and missing large parts of the problem if we focus only on the current biological approach. Indeed weâre misguided if we focus only on psychiatry; clinical psychology and social work, in all their flavours, are major contributors to the problem too.
This piece in no way shuts down dialogue; that is a ludicrous claim. Don’t allow yourself to be silenced, Daniel.
Thank you for this wonderful article. For precisely the reasons you outline, the biological model of psychological suffering is highly seductive: it enables us to feel that in fact weâre not failures, not defective, but instead experiencing the effects of a broken biology that lies outside our control. As you say, we need an approach that looks beyond these binary scenarios and sees the individual in a context and a life course. Without this we remain stuck in shame and self-loathing.
The only thing I would add is that, unlike you, I donât see such a sharp distinction between physical and psychological care. Iâve heard a palliative care specialist say that he is sometimes moved to tears in discussions with families of dying patients. Sharing and showing humanity in the physical care of people is just as nourishing as in the psychological arena.
If I can jump in here, Steve, your point of view really resonates with me! I find that this knowledge does provide some comfort.
And thanks to Doug and Alex. My family situation is very similar, so your stories are very encouraging.
Thank you for this excellent article. Off-label prescribing is a huge issue in medicine generally, but the problem is particularly acute in psychiatry. I cannot understand the various regulators’ casual stance.
Thank you also for drawing attention to the role of doctors in this whole mess. As you point out, Pharma is very powerful but it can only succeed if it has willing agents.
Hi Donna,
Just my attempt at wit – glad it made you smile. This topic so horrifies me that I occasionally need to indulge in sarcasm or ridicule to stay on the level.
Same reaction – excitement followed by horror.
It’s interesting that this book is by a neurologist. They must want part of the action.
It’s also alarming that this article appeared in The New Republic. Maybe Eugenics Monthly isn’t taking articles at the moment.