Monday, September 25, 2017

Comments by Eric Coates

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  • You’re describing something that all of us who are willing to be right out there about what we have experienced have to go through. Even I, a noted author on the subject of voicehearing and schizophrenia, have to go through this. Fortunately, I decided a few years ago to simply stand right up and say fuck you and just be who I am, and it hasn’t really hurt me a whole lot in society. Yet, I have been taken to psych hospitals and confined, and when I was there it didn’t really help me to say fuck you and fight back, saying that I am who I am.

    It doesn’t help me now that I say fuck you and fight back against the local community mental health center.

    But you know what? In the end, all we can live with is ourselves. Yes, it makes life harder to fight back the way that we do. And yet that is what God demands of us. I’m not trying to be delusional here. It’s simply that what God demands of us — that we truly obey our own consciences — is what we do. We have to do it, whether we like it or not. It’s just how it is, even if it hurts us most of the time.

    I’m sorry that the churches don’t understand, but they aren’t the spiritually informed that people like you and me are. They see Jesus up on the wall, on his cross, but they don’t see that Jesus is sitting in the aisle next to them, suffering on a cross that is called society. You have to forgive them. That doesn’t mean you have to hang out with them. Just forgive them, and then go do your own thing. A real saint isn’t worried about what people in a church say anyway. A real saint is doing whatever God tells them to do, and you’re probably out there in the world, working for people. Like in a soup kitchen. A soup kitchen is worth 10,000 times what a church service is worth, believe me. And in a soup kitchen, you will be appreciated. Not judged for what you are, but appreciated for who you are and how hard you are willing to work and what you are willing to give. That’s how it really works. I’m sorry that your churches are full of people who don’t understand that. But you know what? The people who created the churches were creating a space for the weak and the lost and the confused to gather together in safety. The real warriors are the ones who create the churches to protect the weak and the unimaginative. Don’t be one of the weak ones. Be one of the ones who creates something new. You can do it. I believe in you.

    Best, Eric

  • Too true, too true. The scary thing is that most of them probably don’t even realize it. I call it “The Ever-Expanding Mental Health System.” Everyone bitches about how “the system is broken.” Yet all that they do is add yet another professional, at yet another salary, to the system as it already exists. There is never any fundamental questioning of the system as it exists. “The system is broken.” You hear this every day. Yet the very people who say this, from inside the system itself, never actually do anything to change it all radically, from the ground up. It’s the same thing, over and over.

    Thanks for your comments. Be well.

  • I believe that God created a physical universe. And in a physical universe, there are many things that can happen that affect our spiritual universe, which is also physical. And I do believe, quite sincerely, that it is possible that mercury fillings, or even a bad tooth, can cause you to have interactions with a so-called “spiritual universe” that might have been giving you trouble. I hope that you are truly feeling better now, and that you sleep the sleep of the blessed. I’m sorry that it took me so long to reply to your post, but I haven’t been paying close attention to this one for a while. My best to you.

  • I have read the comments by Elaha, Sa, Stephen, and AnotherAccount, and I would like to say right now that you are the most important people on our side of this discussion. There are those who understand the social dynamics, etc: those are the others in this conversation. I wrote this article with those people in mind. Yet I, myself, am one of you. And I believe that this is all a spiritual question, and I am on YOUR side when it comes to all of this as a larger question. God bless you all. I can tell by your comments that you are all God’s people, and that you are all on the right side of things. God bless. Thank you for bringing our side into this conversation — even if no one realizes what you are doing. I hope to see you all again, especially after my next article is posted.

  • Thank you, sir. With my only primitive Spanish (at best, believe me!), I can see that you got the idea. What a wonderful thing that this has crossed the language barrier! My best to you, sir, as you move ahead. A friend once told me that they say: Muerte o suerte! Maybe that’s how it works for us. Bon chance!

  • You certainly seem to have a real grasp of what was going on for these people. Are you German, or of German descent? You are describing the kind of thing that normally only someone inside the situation would know — much as one can tell immediately from a written account if someone has actually spent time on a psych ward. There are certain things about an experience that are almost impossible to imagine unless you’ve actually had the experience.

  • After your inquiry yesterday, I did ask Mr. Whitaker to put one of them back up. He immediately CCed his associate to have it put back up. However, I hesitate to burden Mr. Whitaker or his staff on the basis of my own requests, which might seem needless. If you find the material valuable and would like to ask him to put them back up yourself, please do so. I have no problem with the material being available again. In fact, I would like it if it was. But I wouldn’t want to ask him to put himself or his staff out just to satisfy my own vain, personal desires, especially after I made such an ass of myself when I was psychotic a couple years ago.

  • There is certainly a lot of information here, and I won’t pretend that I can comprehend all of it. However, there are certain things that I would like to state in going forward, and to which I hope both of you can reply.

    1.) there is the sincere acknowledgment that both of you are very sincere in your efforts, and that I hope everyone realizes that.

    2.) although I am not aware of the origin of your disagreement, I will have to state, going from what I have read, that I am completely opposed to any sort of institutionalization of peer support, whether paid or not.

    One of the simplest ways that any professional organization (like psychiatry) can destroy the opposition of a grass roots organization is to buy it. Yes, that’s right: by deciding to “certify” (according to exactly whose expertise?) and then to pay for the work of peer specialists (who chooses them? to what authority, like an institutionalized psychiatrist, or another mental health agency, do they answer?), we turn over our authority to an outside agency. And the psychiatric profession can buy our peers, take control of their training, then control who manages them and what they are allowed to say. And what this means is: certification by ANYONE as some kind of authority is a way to take over and control and then destroy our movement.

    If you want to work in peer support, good for you. But if you want to work for an agency, or a department of something-something-something (the bullshit department), you are not working in peer support. You are working in a system that is about psychiatry and you are supporting psychiatry’s control, because that is who is at the top of your food chain. And if you tell yourself anything different, you are lying to yourself.

    And once they get you on their payroll? Once they have silenced you, as you answer to their managers and their system? Then they cut your funding, and you are back out on the street again. This is how social movements too numerous to mention have been coopted and destroyed: by accepting a paycheck, and being silenced by it, and then not seeing what was really coming.

    Please don’t sell us out. That’s what the whole alliance between the deadly mental-illness system and the mentally ill is really all about. Don’t let this happen.

    And I hope that you two have a lovely debate.

  • All I can say is: Trust God, and let yourself go through it. You will come out on the other side eventually, and even if you don’t, it is because that is the way that God wants you to serve Him. You can never know what purpose He is using you for. Just have faith. He will take care of you in the hereafter. I don’t say that in any glib way. I am one who has reason to know that He is there. Trust me.

  • You are opening up a whole field of discussion here, and I would love to respond sufficiently. However, there simply isn’t time or space right now. But I will at least suggest the outline of my own views to you.

    What if God had decided that there were certain people who were so good that He would make them suffer even more than they otherwise would have, just so as to teach them even more about the world and what it means to sacrifice ourselves for others and for Him? What if trauma is not a biological factor in the situation, but one that comes from God Himself? That it is not a causation in terms of brain development, but a sign that God is testing you and preparing you to become one of His Chosen?

    I realize that this point of view is outside the boundaries that everyone believes in right now, but this is what I believe. And if you are a true schizophrenic, with a split mind — two forms of consciousness at once: the human being’s, and the consciousness that God has given you — then you will understand what it means. This is why I do not use quotes around the word schizophrenia. Schizophrenia is real, real, real — a split mind. Maybe people haven’t encountered it, and maybe most people wouldn’t know what it is when they see it, and maybe a whole lot of people who aren’t schizophrenic at all are mislabeled by people who don’t know better. But we do exist, and I have no doubt at all about what that means. God is here.

  • Your comments are very interesting. To someone outside our movement, they might seem paranoid. Yet to someone who knows about the high incidence of childhood sexual abuse among those who later hear voices, or how common abuse is with “borderlines”, what you have to say makes very good sense. It’s interesting that a doctor actually told you what you say — that doctors would cover up the sexual abuses of the establishment in return for having their own harmful acts ignored. This is not even remotely as crazy as some people might think. These kinds of unspoken — or even spoken — backroom deals used to be very, very common, and in some circles (I’m thinking of governmental power interests here) they probably still are. Thanks for your post.

  • I was very, very psychotic a couple years ago (I won’t pretend otherwise: it was that period that you need to go through before you re-integrate, if you’re a schizophrenic) and I took down those blogs myself in a pique of psychotic rage. I won’t try to explain what I was going through at the time. If you would like a copy of any of that material, I would be happy to supply it. There was one about hearing music as a voicehearer, one about beginning to hear voices again, one about time spent as a prisoner in a mental hospital, and one about what it is like to become awakened, both politically and socially, against the practice of psychiatry. My email is [email protected], and if you would like to write to me and tell me which articles you’re interested in, I can send them to you.


  • Thank you so much! It’s always nice when people actually remember you and what you wrote. And I would LOVE IT if Torrey responded. He won’t, of course — he’s much too highly placed to ever respond to us mere victims of what he’s propounding — but if he did then I would absolutely love to cross swords with him. He would go down in seconds, you can be sure.

    As far as being fair and like Mr. Whitaker himself, I can only say this: that we who are not on the side of big corporations, making money from them for being paid shills, we who are standing for the truth know that our only reward is in being honest, and if that means that we represent the arguments of our opponents in order to show how wrong they are, that is what we have to do. It is an obligation of conscience, and you really can’t fake it. If you believe in the truth — the real truth, which will help everyone when it is recognized as the truth of our situation so that we can effectively deal with it — well, that’s what you have to do. And thank you so much for recognizing that! It is a great compliment to be compared favorably with Mr. Whitaker, who is my own hero and teacher in so many ways.

  • Thank you. I’m doing my best. We don’t have the sheer mass of paid professional writers and trained “experts” on our side, which is what gives them such an advantage even though it’s obvious that they’re wrong. They control the airwaves and the propaganda and the advertising through simple economic power. We do have to fight, even if we are a David against a Goliath. In the end we will win. It’s only a question of how long it will take. Mr. Whitaker’s success in bringing this webzine together, and the newly emerging conferences and consensus among formerly “radical” thinkers is a very good sign. Let’s hope for the best.

  • I take it that you are referring to the experience of schizophrenia or psychosis itself.

    Yes, you can eventually come through it all, and you will not be the person you were before the experience. It can be a terrible period of suffering, doubt and fear, but in the end it does resolve into a new kind of awareness and a sense of possibility. I say this as someone who has endured the most terrible kind of experience that can be imagined (short of actually being physically tortured myself, except by God) and I do not take it lightly at all.

    I hope that your own journey is at a point where it is calm, peaceful and satisfying. If it isn’t yet, then I hope that it will be soon. As Eleanor Longden said (to paraphrase): “Sometimes, you know, it snows as late as May, but the summer always comes eventually.”

  • All the things you mention are very important concerns for me also, especially since I am a schizophrenic myself (I’m sorry, but there is no other term for it at this time, and it is a very, very real experience that needs a word to describe it in some way, even if the old term has come to have a taint of medicalization that shouldn’t be there; perhaps we should simply reclaim the term in the same way that people have reclaimed “gay” or “queer” or anything else that was considered offensive for a while). In any case, I agree with you on all the points you made and this is the focus of almost all my writing these days. Good luck to you, sir.

  • It’s funny, I read the article that Torrey and Yolken had written and I was just sort of puzzled for a while, because it is a very dense piece of material and it takes a while to get your head around terms like “incidence rate” and “prevalence rate” and so forth . . . in other words, to think like an epidemiologist rather than like a normal person. It’s hard to penetrate. But I could immediately sense that there was something wrong with it all, and by the time I got to the end that first time, I had started to spot what was wrong with it all, and their explanations at the end struck me as a lot of smoke and mirrors — that they were essentially lying to themselves and to their public. So this idea sat in the back of my head for the last couple years, and I finally decided to write it down, just to sort of scratch an itch because it bugged me so much, and it is certainly a surprise and a pleasure to think that someone might use it as a resource. That’s really the point of writing for me in the end — sharing ideas, etc. — so I’m glad you consider it so, even if all I meant to be doing was getting a bugbear off my back.

  • Yes, I think that starvation is often one of the roots of the origins of schizophrenia and psychosis. That’s what everything I have read indicates. Anything that puts survival stress on an individual, even if they are still in the womb and are simply being part of a mother’s experience indirectly, it seems to affect things. Even when there is stress a couple generations back, it can affect a person in terms of health and their mental welfare. Thanks for your comments.

  • Thank you. The cat poop theory of schizophrenia, which I believe was Torrey’s pet idea, was certainly one of the more absurd ideas in retrospect that has ever been produced. Yet, you have to sort of admire the doggedness of the psychiatric profession. If they actually had a clue about anything — if they could get over their bias that schizophrenia is physiological or psychological in origin and start to actually examine the evidence of what their own patients are telling them about their experience — they probably would have solved the problem for us long ago. Thanks again.

  • The question of how we all talk about experiences like that we now call “schizophrenia” is something that a friend and myself have been talking about how to address. We are considering how to organize what we are calling a “virtual conference” that takes place over two or three weekends so that people can talk about what we as a community want as a common language to describe things. The biopsych and psychopharm people move in lockstep, with a common vocabulary and rhetoric. We, on the other hand, are divided, and our lack of progress in penetrating the public discourse is one of the results of that. Thanks for your comments.

  • So, once again Sera hits it out of the park. The thing about Sera is that she writes in a popular form about what only professionals usually write about, i.e., how calling someone (like the president) “crazy” is not stigmatizing to that person but stigmatizing to the actual crazy people. In other words, don’t blame me for your violent racist bullshit; the problem isn’t being crazy, like me, the problem is being an asshole like you, and I’m tired of taking the blame for your bullshit, motherfucker. If you really want to read the ultimate on this, you have to read a book about voicehearing called “Voices of Reason, Voices of Insanity: Studies of Verbal Hallucinations” that has an article about how every time a schizo kills someone, he is identified in the newspapers immediately as a schizo (“Howard Johnson, a schizophrenic, killed his father last night” is the lead, immediately associating schizophrenia with violence), when everyone knows that schizos are no more violent than anyone else, whereas no one who kills someone is immediately identified as a diabetic, which is also a condition that has no history of violence. It’s a brilliant chapter in the book, probably the best one. Maybe if we all start walking around and saying, yeah, he was a real fucking asshole, and he drove a taxi and he lived on that side of town and he had cancer and he killed people, maybe the public would start to believe that driving a taxi while living on that side of town while fighting with cancer is a serious, serious danger sign.

    Sera, one day you and I are going to start our own magazine. Some day it will happen. If I have to slave in New York 8 days a week to pay for it, it will happen. Bank on it.

  • I am glad to see that someone beside this author and myself also recognizes that:

    1.) Raising awareness is a vital first step in the process of societal change.

    2.) That after raising awareness, we need to begin to push for actual change. It is not enough merely to speak out. We have to actually push for REAL change, and this does not mean attending conferences all the time or merely publishing our views. Those are vital, yes, in spreading the word; but they are not the end goal. The end goal is completely changing the system to a new one. We need to remember that.

    3.) That actual change takes place, whatever it takes to get there. I am not personally comfortable with allying ourselves with other transectional movements, because a) we will always be put last, when confronted with other, much bigger racial and/or sexual and or/gender movements, so we need to stand on our own, and b) because we are not actually concerned with anything that resembles the same issues. We are not concerned about the color of our skin, or the language we speak, or about what genitalia we possess or don’t possess. We are concerned about the content of our mental experience, and that means that we are not actually the same kind of movement as other transectional movements are. We are mental; they are physical. We are all social, but their form of social is not the same as ours. A black schizophrenic is still treated in the same outcast way by black society as he/she is by white society, here in America, which shows that it is not a problem of skin color but a problem of how others perceive and label our behavior and our mental experiences. We should not confuse the issue. A schizophrenic is dealing with a mentally based societal problem, which is social, but not what a black person or a woman or anyone else is dealing with, which is also social but not at all the same thing. And we should NOT ally ourselves with any groups that would take our support to help themselves and then ignore us when we need theirs. This is simple politics. Don’t waste your time on a fake ally. Work for your own cause. Don’t lose sight of what you want. And never forget what you are really about. And allying ourselves with others is one of the worst mistakes we could make. We would lose all our own time working for others, and get nothing ourselves. Let’s be sensible.

    Eric Coates

  • I will freely admit that I have not read all the comments, as it looked like a small book unto itself. But I am sure, having read your post, that you stimulated a lot of intelligent discussion. Certainly some of the names that I saw would suggest that.

    I am going to instead make a comment in solidarity with you. I began to believe, a couple years ago, that MIA (and the conferences, most likely) was basically preaching to the choir and that no one, at least not in this movement, was actually getting anything real done in terms of changing things. I began to believe that if anything was really, really going to change, that we would have to go out on our own and do things independently. That is why I left for a while. And while I am not yet certain that anything is very different from that, I am now focusing my own articles and my own efforts on how to change things for real.

    I will be writing very soon about the actual cost of the “mental health” system, in the hopes that by taking people’s attention away from “efficacy” and instead focusing it on their bottom dollar as well as efficacy (“Why isn’t anything getting done when we’re paying this much?”) I might spread the conversation out beyond our own little group and maybe reach a wider public. That’s just one thing I’m doing. Public information is still a consideration. But I’m doing more than that.

    In addition, myself and a friend of mine are thinking of hosting a virtual conference in which we can begin to address the language of it all. As the Sapir-Whorf Hypothesis states, the shape of your language is the shape of the world. In other words, the words you think in control how you think. And if we want to change things, we need to adopt a revolutionary new language which actually represents our own experience if we want it to ever be honestly represented and then to change how things are done.

    I hope to see you there. You are obviously a very brightly shining light, and I can only imagine that you will contribute much to our cause if you continue to be honest enough to make the kind of statement that you did. We don’t need cowards. We need mavericks. You might be one of them.

  • Thanks for your article.

    As a young man, who was bullied and abused and generally made to feel like I was an odd individual (I was simply more verbal and a little smarter than the people around me: a geek, in other words), I came to the conclusion as an angry young adolescent that it was more important to be yourself than it was to fit in with everyone else. In other words, I came to believe what Emerson talked about in his essay “Self-Reliance”: “whoso would be a man, must be a nonconformist.” And this applies to what this research talks about. It is not important to feel happy so much as it is important to be who you genuinely are, whether that involves some anger or not (and I would point out that some social conditions of the countries that are described as
    “less developed” might involve some social conditions, like poverty and blatant oppression, that might produce very, very natural feelings of resentment, anger, and sadness) and that it is actually MORE adaptive to feel those feelings than to simply feel bliss as you make lots of money and eat at fancy restaurants in America, where you might actually start to feel kind of inauthentic. It is, after all, more natural to be an angry black woman in the United States, who is fighting to change things and who has respect for herself, than to be a white man who goes to his office job every day in resignation to the white, privileged, capitalist system that gives him his big paycheck and his worthless existence. Thank you again. Good article. Being you and in tune with your actual surroundings, I believe, makes you happier. Dr. Martin Luther King was surrounded with some pretty horrible stuff, I imagine, but I also imagine that he was very happy in how he responded to it.

  • Was it too expensive? Or was it just a hassle?

    I know that I have been put on drugs that cost, most of the time, about $2,000 a month. I am at present given a shot every month (against my will) that costs about that. So my question is: is it really that it’s too expensive to pay for therapy? I don’t think it is, when you consider what they pay now for me to be drugged. What I think is that the money simply isn’t supplied for THAT specific form of “treatment.” The drug companies get every penny they want. People who actually help other people are, on the other hand, starved of any funds. What do you think?

  • This is an incredible piece of work, sir. Thank you so much. I’m sure that SAMHSA is going to sit up and pay very close attention to this. We who write for MIA may feel at times that we’re screaming in a vacuum. We are, however, the heart of the loyal opposition itself, and in reality, I’m sure that whatever appears on this site is very closely attended to by all of the powers that be, from Big Pharma to Washington, and you just fired the shot that starts the Civil War. Congratulations on your fine work.

  • I am not in any way a fan of antipsychotics, and I am fully aware that the bias of this webzine is against them. I am myself a writer for this webzine, and the last thing I would want to do is to support the use of drugs. However, in the spirit of fairness and science, it must be admitted that you have said that antipsychotic use is associated with better functioning, and this cannot be ignored.

    I have myself been on psych wards, and I have myself seen how various individuals who were psychotic and/or dangerous (I have been both threatened and assaulted by such individuals on psych wards) have actually improved, and improved greatly, with the use of antipsychotics. I have myself also benefited from them at various times. Now, I don’t actually like their use, or approve of it over the long term, but it is simply an undeniable fact that sometimes — SOMETIMES — the use of antipsychotics is helpful. Not always, but sometimes. And I think that this is worth thinking about. We are not here to condemn Big Pharma. That is what I usually do, but that is not our purpose in being here. It is to find out what helps, not what gets in the way.

    Thank you for your article. I find, when reading your work, that you are succinct, pithy, and very informative. Thank you.

  • Thank you for your article, which is clearly and succinctly written.

    I would like to make two suggestions for two anomalies that you point out in your article for which the authors of the study apparently have no answer. They are both social explanations.

    First, you point out that children exposed to antidepressants need fewer special needs classes but miss more of their final exams. Well, I hate to have to put it this way (I’m trying to keep it brief), but perhaps the children of depressed mothers are as intelligent as their mothers were (they may be impaired in some areas but fully functional in others, since not all forms of intelligence are the same), and yet they are also disillusioned. Depression, after all, seems to come out of life circumstances, and if your parents were smart enough to notice the problems of the world and of their own circumstances and perhaps become depressed, then you too might be 1) pretty smart also, and 2) disillusioned enough to blow off your final exams, since none of it really matters anyway. Why bother? This points to a social cause, not a biological one, for depression.

    Second, you point out the increased rate of poverty among those who have parents who used antidepressants. You might need to have actually been in a psych ward at some point yourself, or have been caught in a probation system or a prison system or any other kind of social system that we currently have, but you do not, in general, ever see rich people in psych wards. Rich people get to go somewhere else. Rich people do not end up in the social systems like probation or prison, and if they do, they get the very nice form of it all. And so, once again, you have a social determinant for who ends up on psych drugs: poor people, who don’t have a fancy lawyer to show up and bail them out when they get in trouble, and who get steamrolled into a cut-and-dried form of “treatment” by a stressed-out, overworked psychiatrist whom you might, if you’re lucky, see for five minutes a couple times a week, if that.

    Thanks again for your article. Very informative.

  • Thank you, sir. I realize that many people have very strong feelings about all of this, but I do also feel that there are, believe it or not, legitimate questions on both sides of every debate among us here on MIA. Is there one everywhere in the outside world? No, because people are only too willing to manipulate discussions to serve their own purposes. But here on MIA, I believe that most people are sincere, even though we have some Big Pharma lurkers out there, and so I really do see both sides of it.

    I hope and pray that you and your wife are well. It takes patience and kindness and forbearance. Good luck.

  • I’m sorry, Mr. Blankenship, but I don’t believe that I have suggested here that anyone is less human than anyone else. However, I do believe, and I know from experience, that when you are in a psychotic state that you may simply be living in a different version of reality than others are, and that the expectations about responsibility that apply to the world that others are in but you are not in might not be responsibly applied to you. I am not in any way suggesting that there is a special category for some people, or that they are some sort of privileged “child” who is allowed to rampage as they want to. If you get right down to it, I believe that society should protect itself from dangerous, irresponsible people. But I also believe that there are times when society should make allowances for what someone is going through. That’s all I meant to say.

  • Thank you for thoughtfully presenting this article.

    Perhaps I misunderstand your personal comments, but I thought that they actually represented views similar to those of Dr. Thomas Szasz, for whom I have the deepest respect. His illumination of the myth of mental illness is fundamental to what I believe. I do, however, have two issues with Dr. Szasz. He was, after all, a very right wing conservative, a libertarian, and I believe that while he had important points to make, that he was mistaken about the fundamental nature of two things in regards to “mental illness.” Both of these issues involve the idea of personal responsibility.

    Let me say first of all that psychosis and schizophrenia, when you first experience them, are usually quite devastating experiences. You might find yourself truly believing that the President is trying to kill everyone, or that your neighbor is murdering people and burying them in the basement, and you might believe this totally and sincerely. You might, then, try to kill either the President or your neighbor whom you think is murdering people, and you might do this not because you are a malingering asshole, which is how Dr. Szasz essentially describes such people, but because you sincerely believe that you are helping people. This is not to justify or support such behavior. But there is, in fact, a case to be made for the insanity defense and the idea that you are not culpable for your actions in a criminal way. It’s not that you weren’t acting responsibly. It’s that you simply didn’t have the connection with the world that would enable you to act as other would act, but you were, in fact, trying to be responsible. And I don’t say that because I haven’t known people who were in mental hospitals, having used the insanity defense to escape personal responsibility for actions that they were fully aware were wrong. But there are some people who are so out of it (I would have been one of them) that they are truly unable to understand what their culpability might have been. This is a basic issue that goes to the heart of antipsychiatry’s personal responsibility issue, and I think that Dr. Szasz, as a right wing libertarian, got it wrong.

    As a personal note, I have not only seen people abuse the system to escape culpability, I have also seen people who were genuinely way out there who were dangerous. I have been threatened and personally assaulted by such individuals, and yet these very same individuals, when restored to their usual selves, have sometimes come to me, admitted that what they did was wrong, and apologized. So there is hope, but there are also times when people simply cannot be held responsible for what they have done, but without taking all sense of responsibility away from them for the rest of their lives.

    Deeper than that is the concept of disability. There is, quite simply, no way that some people who suffer from psychosis or schizophrenia could work. None at all. I know that I, personally, would have been so distracted by the phenomena that I saw happening around me that I would have followed them, become wrapped up in them, and been unable either to recall what my work assignment was or to even understand its importance in the light of what I was experiencing. Are there actually people who use their diagnosis to create excuses for themselves and malinger? Yes, certainly there are. But the reason that this is accepted as an excuse for claiming disability is actually valid, because some of us are disabled in that fashion. So Dr. Szasz, while doing an admirable job of pointing out one very small problem has actually stigmatized those who are having a genuine problem, which I know is real, because I had it. Now, denying people the role of social responsibility is in fact used as a justification for taking their power of making their own decisions away from them, and I deplore that situation and the people who do it. However, there are actually circumstances in which a person cannot be a responsible member of society as we normally construe it, and using Dr. Szasz’s rationale about it all is not sensible. Dr. Szasz saw social interaction as games. I do not. There is a real game element to it all, but it is certainly not the sum of what interaction or psychology is about.

    I find it unfortunate that antipsychiatry, in its efforts to create liberation for the “mentally ill,” is willing to close its eyes to the reality that these people (myself among them) actually face, simply in order to embrace an ideological position that is intended to liberate us.

    In other words, it’s not cut and dried. There ARE two sides to these questions, and simply brushing them away is neither intellectually honest nor psychologically sensitive. These are the two problems that I have with antipsychiatry’s excessively ideological position in these two areas.

    Respectfully, of course,
    Eric Coates

  • Thank you, sir. I have read this twice. Once earlier in the day, and then again tonight.

    I have been held captive in the psychiatric hospital a couple of times, and I always wonder what it is like for the kids. Here in New Hampshire we have two different wards in the state hospital for children. There is the one for the very young kids, like eleven or twelve years old and less (the pre-pubescents) and we have one where the older kids are. It’s strange. You seem them in the building, always in a group (the adults can get individual building “privileges,” but the kids don’t), most often as they are coming from the gym, where they engage in some serious play time and exercise, or from the library. They have the irrepressible spirits of children. I have always watched them, and they just don’t look disturbed in any way. They just look like kids. I’m sure that they have lives that are as complex as what the adults in the hospital go through. An institution is still an institution. A label is still a label. A psychiatrist is still a psychiatrist, and drugs are still drugs. Being away from home and a regular life is being in a kind of penitentiary, and you still want to escape.

    Thanks for sharing this. I really do always wonder what it’s like for the kids. You are obviously a humane and decent individual, and it’s nice to know that some people do escape. I am something of a nut about wanting to know the history of my state hospital, and I have had mental health workers who had been working at the hospital for thirty or forty years tell me the stories about the children they had seen who then spent their entire lives at the hospital. There was one girl that I was told about who had a bizarre, Kafkaesque story. Her father had simply left his daughter in the hospital, a perfectly normal girl, while he traveled to Europe on business, and unfortunately he died while she was there. She then spent her entire life as an inmate of the hospital. She had no one on the outside to help her leave — to find a job and an apartment and actually be able to leave. She was trapped there. I’m not saying that she was a better or more deserving person simply because she had never had problems. Far from it. But once you are caught in the system, it is almost impossible for most of us to really ever escape.

    I hope to see more of your writing soon. You obviously have a very important story to tell.

  • First of all, thanks very much for your article. I appreciate how it succinctly and clearly lays out some of the issues involved, and that it retains a humane sense of fallibility about one’s own decisions about what is right and what is wrong. It’s refreshing to see.

    Second, I doubt very much that this was a case of “mental illness.” I believe it was a case where the physical source(s) of his physical pain were simply unknown, which is a medical and scientific problem, not a psychological one. It is a reflexive habit of medical doctors these days to refer physical problems that they don’t understand to a psychiatrist. I believe this should be addressed, and that it should stop.

    And third, I have had plenty of time to consider whether mental difficulties are themselves a sufficient reason to kill oneself. There are two answers to this: 1) I believe that suffering is suffering, and that’s all there is to it, and you can die if you want to, and 2) that even more important is your right to die, for any reason, and at any time, and there shouldn’t even BE a debate about “mental illness” at all. The whole debate is a false dichotomy, or so I believe, and I think it should be stated clearly in those terms so we can all get over it and allow people to exercise free choice about their own fates.

    If God (I happen to believe in God, but have no problem with anyone who doesn’t: I was an atheist for a very long time myself) wants to keep you alive for some reason of His own, He will. Otherwise we should all get out of the way and permit people to exercise their own God-given will to make decisions about their own lives.

    Thanks again for the article. I hope I see more of your commentary in the future.

  • I’ve always thought — or at least I have in recent years, since I got old enough to think about it and had a reason to question what voices really are — that it was basically a case of words developing as a grunt to get another hominid’s attention, and then pointing. And then after a while they realized that there was no need to point. They could just grunt in the right way, and it got the whole job done.

    I’d be happy to check out what you say about John Mace if you could send me a good link. You probably know some.

    Good luck!

  • I like that phrase “symptomatic beliefs.” I hope I remember that one.

    However, I hope I can dissuade you from the idea that I think that ALL voices are evolution-based developments of the brain. I believe that our own internal voice, the one that everyone has, is from evolution, but that voices, so-called — the kind that voicehearers hear in addition to the usual voice — is NOT evolution-based.

    Think of it this way: God let us develop on our own (you might call that free will, although I don’t really think of it in those exact terms) and that then he might decide to pick a few people here and there to talk to himself. Or to have other beings talk to. I really do not believe that ALL voices are from our own brains. In fact, I’m pretty confident that it’s very different from that.

    Thanks for your comments. Glad to hear that you’re doing well with it all.

  • I’m sorry if I wasn’t clear exactly what I was writing about. I was NOT addressing the subject of the kinds of voices that voicehearers hear. Those are entirely different from that voice that EVERYONE has inside them, which sounds like your own voice talking to you. That is an entirely different affair. Also, I am not at all in agreement with the idea that voices (plural, as in voicehearers, not “normal” people) come from inside. I very much believe in God, for instance, and that he can talk to you and sometimes does. I believe that my voices are external, not internal. But I will be getting to that subject on my blog in another week or two, or whenever the editors choose to publish it. I hope you will find more to agree with in that one.

  • I really do agree with most of what you say. I’m not sure about the lacking accountability part — not being held responsible for what you do — because society does, after all, need to protect itself from harmful human beings who might prey on or hurt others, and punishment (and attempted reform) is sometimes necessary if society IS going to protect itself. Aside from that, I agree with you.

    Thanks for responding!

  • This is a very interesting discussion. I would be curious to know: are you a voicehearer? It sounds like you aren’t, since it is easier to discount the idea of an outside force when you haven’t been exposed to things like voices that you can clearly tell are NOT your own, and then you see enough things in the outside world that cannot be easily accounted for by the usual empirical world. Especially when the voices either tell you that something going to happen, or tell you what to do, and then when you do it, something extraordinary happens.

    I’m also not sure about the stripping layers away part. I think that’s a very deceptive metaphor that comes out of an outdated (i.e., we’ve grown past that conception of things) form of psychology. They’ve been talking about a “subconscious,” for instance, since long before either you or I were born. Yet there is no scientific proof for its existence at all. So: we can build nuclear reactors and spaceships headed to Mars, but we just haven’t found where this subconscious is located in the brain? I’m sorry, but I just don’t buy it. There are things we do that are NOT conscious, but I don’t think there’s a real SUBconscious, if you know what I mean.

    When you talk about “stripping thoughts away,” I think what you’re really talking about is learning to do 2 things. 1) You learn to see through what that prefrontal cortex (what I call the parasite) is saying, and this is what we achieve when we become mindful, whether that’s through the Buddhist tradition or the Jewish tradition or, hell, you just learn it on your own. Buddhists say that some people are just naturally enlightened and they never need to learn about it at all; it just comes naturally. And the other thing I think that you’re really talking about is 2) how hardwired many of our thoughts and habits are, right in our brain structure, and that you can learn to spot what’s there. For instance, I have what is now an instinctive reaction to much of life that is to simply relax about it. Yet when I was younger, I had a lot (and I mean a lot) of social anxiety and fear about the bigger world and about school. What I did was teach myself, through many years of effort, to basically just shake it off. It is almost impossible for anything to make me worry any more. And that was basically just a case of rewiring my own brain so that it doesn’t do the same thing any more. These are not “layers” after all. In no way does the brain resemble an onion. It’s more like a circuit board, where you can solder new connections into place.

    Anyway, sorry for the long ramble, but the subject interests me. Nice talking, and thanks for the thoughtful responses.

  • I don’t want to intrude on your own personal discussion here, but there is actually a Buddhist theory that the mind itself is the sixth sense. In other words, there is vision, hearing, touch, taste and smell, all of which come from the outside world. Buddhism — Tibetan Buddhism, at least — says that the mind is also a sense organ. We don’t know where our thoughts come from. They just appear and disappear. And in this sense, they are just like the other senses. We can’t explain where it comes from, what it’s really doing, or where it will go. The mind, the thought process, is in other words just another sense organ. So: are you responsible for your own thoughts? Do you create them? Probably not.

    So good luck with it all, and I hope you have a good discussion about it all.

  • First of all, although I am an actual voicehearer, I am not talking about “voices.” I am talking about the same voice that you and I have both heard in our own heads. Second, I thank you that you think I have actually summed up a lot of what’s hurting people. I’m glad about that.

    But to move on to the rest of what you have to say. YOUR internal voice may very well be different from mine. Yours may be helpful in some ways, just as my own was very, very helpful in some ways. And hurtful in some ways. But it really is not the same thing as who I feel I am. I am very much that deeper sense of my own self, and not the other thing that is talking to me. Your own internal voice seems to be more constructive than mine was. Even in my the realms of my own hypothesis, there is a lot of room for variation. Perhaps those of us who are loners, who are writers, who are a little bit too selfish — and I have been all of those things — don’t have a parasite that is quite as benign and helpful as other people might have? Perhaps you are pointing something out here that I hadn’t thought of — our human variation. Perhaps for some people it is not a parasite, but merely symbiotic. I can accept that idea. It’s a good one.

    However, I will have to disagree with you about “it’s not part of me.” I am quite confident that this thing that used to talk in my head was NOT, quite clearly, part of the me that is part of my deeper awareness. No. Not at all, and that’s not trying to disown it. It just wasn’t me, and I remember quite clearly how it has tried to impose itself on me. So maybe you actually have a symbiotic relationship with it, while mine is a little more . . . predatory. It might be just human variation. Or maybe it’s the Devil — that snake which is the power of speech — coming in to hurt us.

    I appreciate your idea of how evil actually serves what is good. That is a very old idea, actually, that comes from at least the time of the middle ages. In Dante’s Inferno, the Devil is trapped at the bottom of Hell, which is not made of fire, actually, but of ice. The worst traitors — and the Devil is a traitor, to God Himself — are trapped in this ice at the bottommost layer of Hell. And the Devil, who was an angel at one time, still has wings. And as he flaps his wings, trying to escape the ice, he also creates such a powerful wind that it cools the ice and keeps it frozen. That is how it all works. The evil that we do keeps us trapped in evil, simply because of who we are. And the good that we do also frees us to do more good, because that is who we are.

    The voice inside is also a part of that. I’m glad to have talked to you. I hope we meet again.

  • Psychosis is a hell of an experience, isn’t it? Glad you made it through. I’m psychotic all day long, every day, but it’s manageable for me most of the time. I would go back to “normal” any day, because it does get pretty exhausting. Nevertheless it’s a pretty remarkable thing to experience, and I wouldn’t be the same person without it. In fact, the old me is long gone. I hope you get a chance to revisit if you want.

    I know: who says that? But psychosis is a hell of a trip, and if it isn’t too horrifying, it’s something that everyone should experience at least once. There’s nothing like it.

  • I can tell that you are also another psych-ward survivor, or at least another one of us from the streets. We are a special breed, that’s for sure.

    I think of myself as being bilingual. I can talk psychotic or I can talk normal. I love talking to psychotics. I love talking to normal people too. Anyway, I really appreciate the poetry. It’s great. I have a whole wall here at home of psych ward art. It’s great. And I can talk in rhyme all day long, just like a rapper. It’s fun. Tiring, but fun.

    Good luck out there. It’s a crazy world.

  • I’m not interested in “promotion,” as it were (not to denigrate what you’re about, if that’s what you do), but I would certainly be happy to get out there and help the voicehearing cause. I’m also interested in psychology in general, so I would be happy to talk. I will email very soon with my own contact information.

  • Perhaps we could also have denial-based therapy, collusion-based empathy, and non-existential based decision making. What do you think?

    I think that we could expand the healthcare system infinitely — if it hasn’t gotten there already (about which I have my suspicions — if only we created enough hyphenised adjectives to describe it all. We could even soon have raw-based cooking, shrimp-based gigantism, and even, most unbelievable of them all, human-based living. Wow!

  • I would like only to add this: I do not believe in “rebound”, but I do believe that when you come off the drugs, in the physical universe that God created, that you do, once again, enter his universe. There is no “rebound.” What there is is a kind of re-entry into God’s world, and that He created it this way on purpose. I am not trying to discredit any “science” of the brain. I am simply trying to emphasize the power of the world that God made.

  • I am an MIA author myself.

    I believe in the gradual discontinuation of drugs, but I do not believe in taking years to do it. I believe that one drug should be discontinued at at time — the most powerful one — but that each drug can be discontinued in a matter of a few months.

    Schizophrenia is a whole other topic, and the “rebound syndrome” is something that I do not believe exists. Rebound is not a result of drugs.

    Think of it this way. God knew exactly what human beings were a few thousand years ago. Religious — which is to say, schizophrenic — experience has been with us that whole time. Jesus and Mary, if they were with us now, would be subjected to a whole range of drug and neuro treatments.j

    There is no such thing as rebound. What there is is a re-emergence of the experience of God, which is nothing at all like what is described as “schizo” in the DSM. It is simply the re-emergence of the God experience — which is, yes, very painful and very difficult and very, very hard to get through. But there is no drug rebound. There is simply the re-emergence of the spiritual experience. And that is very different.

  • Mr. Bertino an supporters:

    I was myself a psychiatric prisoner for a very long time. Although there were no criminal charges involved — which very likely spared me the fate you are going through — I was also forced to endure the system, not because I was a problem, but because I resisted it.

    I am very, very, very interested in your case and will make it a priority to see that it is righted.

    I am the former bestselling author of “Hearing Voices” and a former blogger for this site.

    Issues of civil liberties are paramount for me. I will do what I can to see that you are freed.

    My email is: [email protected]. If you or your trusted contacts wish to communicate with me, this is where you should do it.

    It’s time for the bullshit to stop. In solidarity with you, my brother and fellow prisoner, I can only wish you courage to endure. I know it’s hard. I haven’t had to deal with it as bad as you, but I’ve been there. Love and peace, brother.

    Eric Coates

  • Oh, but damn. It only just occurred to me.

    While it’s probably great for you to make thousands and thousands and thousands of dollars from giving all your speeches (look at the top of the website for Robert Whitaker’s speaking schedule!), I guess that there hasn’t yet been enough of my people who are poisoned and killed by metabolic syndrome, and whose lives are rendered painful and meaningless before that happens, for you to get off your lazy ass and actually do the real reporting.

    The reporting that actually takes guts. I know, it’s really hard to cross swords with Allen Frances and Ronald Pies from a position of privilege, cause that must be really, really hard. I know it is, because you spend so much time telling us all about it that it must be a really, really big thing for you. Cause that’s the most important thing for us all to hear about. While millions of my people die. Millions and millions of them. Metabolic syndrome — you know what that is, right? Weight gain that distorts your body and makes life miserable. High blood pressure, and hyperlipidemia, and diabetes. Hey, if you’re lucky, you might even have them cut off your legs and even go blind before you die of a heart attack or a massive infection, twenty-five years before your time! But thank God that Robert Whitaker got to wear the black hat in his debate against Ronald Pies or Allen Frances! And now we can all hear about it again!

    Thank God that Mr. Robert Whitaker is on our side! He’s so bold and courageous. He hasn’t actually held anyone to account yet, but he’s a really tough customer. He even almost won the Pulitzer once.

  • You’re a journalist — and, according to most reliable and honest people, a pretty good one. You were even part of a team that was nominated for the Pulitzer Prize, right? Of course, I have a couple of those in the family, so I know what they actually mean, but hey? At least you got that much.

    One wonders why, after fifteen or twenty years of studying this subject, and reading all those medical reports and all those drug studies, and being paid large sums to trot all over the globe and give big speeches to all those audiences, why you haven’t yet reached a fairly obvious conclusion — one that should be fairly obvious to a big-time, almost-Pulitzer winner like you who runs this big investigative website.

    Which would be: Maybe the studies are designed NOT to reveal the information you’re looking for.

    I mean, you know David Healy and everything, right? So maybe you could have noticed — and maybe even pointed out for everyone in your really big audience that’s so impressed by your really, really big brain — that maybe all those studies you like to talk about (over and over and over and over again) don’t contain the information you’re looking for because . . . they’re deliberately designed not to reveal those things?

    Wow. What an idea! Would a major company — like a big pharmaceutical company, say? — actually HIDE what their drugs do?

    Are you a student of history, Mr. Whitaker? Because I’m pretty sure that there’s another guy down there in Boston, also affiliated with Harvard, who wrote a book called “The Cigarette Century”, in which he described how Big Tobacco — “a specialized part of the pharmaceutical industry”, in their own words — used their so-called research and published information to cover up what they were doing.

    Hmm. Maybe it’s time to be a little less timid about your conclusions and start asking why the studies don’t seem to supply the relevant information.

    You might even get that Pulitzer if you did. Then you could run around and shoot your mouth off even more and even get higher fees for your speeches, and use even more psychiatric conferences as stops on your book tours.

  • Thank you, Mr. Whitaker, for all that you and your wonderful staff are doing for the world. At some point in the future, they will write the history of our time, and they will write the history of what you did in the same terms as they write now about the Abolitionists who helped stop slavery. It’s truly that important, and I admire you and your staff, regardless of whatever minor disagreements we might have.

    I have tried to increase my monthly donation, and the website wouldn’t let me do it. It told me that I couldn’t. You might want to check into how all that business stuff works.

    Eric Coates

  • Thanks, Sarah. It’s a pleasure to see it all summed up so concisely. Although I’m still relatively new to reaching out to others through online sources, it’s a pleasure to see that the “hundreds of groups” you speak of are forming, and that there are more and more of us every day who are starting to take some kind of action. Personally, I believe it is time for us to form a sort of Underground Railroad and start moving people outside the system to where they can get help. I don’t believe we can stop the Murphy Bill, unfortunately. Which doesn’t, of course, mean that we shouldn’t try. But the history of prejudice that got us into this position in the first place, where the whole industrial/psychiatric/neurological/pharmaceutical/prison complex was able to capitalize on our weakness to build their damaging model and to profit from it all is exactly what is giving them the money to fund people like Murphy, and to keep control of the conversation by funding the psychiatry programs and the research and the endless, endless, endless drug ads. This is not to say that I despair. But I do think about this question of how we are going to free ourselves for much of every day, and I don’t know yet what can be done. But I’m thinking about it all, and I’m sure that there are plenty of other people who know the moral rightness of our position who are thinking about it too, like you are. Anyway, thanks for the article. It was a pleasure to read.

  • I was thinking that you might do a blog entry on just that — alternative approaches that would be compliant with the UN. I know that I would certainly find it useful, and one thing I do have to complain about with MIA is that there isn’t enough attention given to the positive alternatives. I know that someone like me would certainly benefit from a summation, with citations, of what can be done to comply with the UN. Otherwise, if no one is in compliance, what hope is there to create something that IS in compliance? I don’t mean to create work for you, but that positive next step is clearly crucial to what we’re all trying to do here.

    Thanks for your consideration.

    Eric Coates

  • I hope I’m not too late to get your attention with a question regarding some of the contents of your writings. I am definitely now in the antipsychiatry camp, and I have read some of what you wrote about Canada’s violation of UN agreements about the forced treatment and incarceration of the mentally troubled. You seemed to suggest that the UN was very clear that such detainment of the “disabled” (I don’t consider myself disabled, but I guess we just have to deal with whatever language the agreements adopt) is illegal or unacceptable for the signatories of the agreement (I’m not sure what the exact language is) to engage in. What I did NOT find in your writing is what the alternatives are — i.e., rather than locking people up when they are, say, perceived to be unstable, what is done in other countries that are not in violation of the agreement? And how well does that work out for them? Even if you could simply point me in the direction of articles or books that might address that question, I would greatly appreciate it. I’m against the coercion, but I’m just wondering what is done in its stead by countries that do comply with UN standards of human rights.

  • I hope I’m not too late to get your attention with a question regarding some of the contents of your writings. I am definitely now in the antipsychiatry camp, and I have read some of what you wrote about Canada’s violation of UN agreements about the forced treatment and incarceration of the mentally troubled. You seemed to suggest that the UN was very clear that such detainment of the “disabled” (I don’t consider myself disabled, but I guess we just have to deal with whatever language the agreements adopt) is illegal or unacceptable for the signatories of the agreement (I’m not sure what the exact language is) to engage in. What I did not find in your writing is what the alternatives are — i.e., rather than locking people up when they are, say, perceived to be unstable, what is done in other countries that are not in violation of the agreement? And how well does that work out for them? Even if you could simply point me in the direction of articles or books that might address that question, I would greatly appreciate it. I’m against the coercion, but I’m just wondering what is done in its stead by countries that do comply with UN standards of human rights.

  • Your situation is one to which I have given a lot thought over the last few months. I was, until quite recently, a prisoner at New Hampshire Hospital in Concord, N.H., and the role and the feelings of the “mental health workers” and the nurses and even some of the psychiatrists was something that used to bother me. Obviously, you don’t get into those sorts of professions unless you start off with the belief on some level (1) that you care about people and (2) that you might be able to help in some way. Yet, when I looked around at what was, quite blatantly, a model based on nothing more than coercion and incarceration, and one where I was forced to take drugs and where I was taken down into restraints and isolated when I didn’t comply with whoever might be in charge, I couldn’t help but wonder what sorts of feelings were being felt by those people ass they manhandled me and forced a needle into my ass.

    In particular, there was a small group of nurses and “mental health workers” who obviously went out of their way to be compassionate and responsive “caregivers”. Yet, when it came right down to it, they would respond in line with the goals of the very same force of coercion (going in to care for or watch a restrained “patient”, etc.) that I was doing my utmost to resist, and though they did so looking unhappy about it, they did it nonetheless.

    I can see that not everyone, like some of the people I saw there, was a complete sellout who just wanted to uphold the system as it was then in operation. When I saw your comment about wondering what exactly “behavioral health” might be, I had to laugh, because I have wondered the exact same thing in the exact same words, and the only conclusion I could come to is that I just have no idea what “behavioral health” might be, unless one were to turn it into some kind of sick joke about not crashing your car through barriers on the highway and not having sex with someone who has a venereal disease. Seriously: what the hell is “behavioral health”? Can anyone answer that question without resorting to some circular explanation about “not harming yourself” or any of the other nonsense that is used as an excuse to forcibly drug people to “prevent harm”, especially when “harm” is usually the last thing that is being threatened? I have heard more rationalizations for brutality based on the excuse of “safety” than I could ever have imagined would be possible.

    I salute your courage in openly stating your problems with your institution and in openly admitting what is going on there and how you feel about it. Unless others also question their consciences, nothing can change. On the other hand, I have a fear centered on when all the compassionate “caregivers” abandon the system: after all, who will be left behind to run them? How much worse will it get without people like you there, or without all the people I saw myself who wanted to genuinely help? In the end, the whole system will be run by willing and eager collaborators in oppression. I don’t suggest that you stay, because to do so is to be a collaborator, and yet one can understand the argument for trying to stick around and mitigate the harm being done. It’s a terrible conundrum, and I can only say that I admire your willingness to risk exposure and to speak up publicly about this terrible conflict. I wish you the best, and I mean that sincerely, even as someone who so recently had to put up with the very kind of coercion you’re talking about, even when it came from people who I could tell were very like you in their deepest beliefs. Good luck.

  • Awesome. All you have to do is point at the facts and their own publications, and the whole story comes apart. And thanks for pointing out the work done by Philip Hickey. He and Bonnie Burstow are personal heroes of mine for pointing out some things that just don’t get attention, like what psychiatry’s dependence on the drug theory, absolute and unaccountable authority, and endless mendacity are keeping us all prisoners. Thanks as always.

  • Thanks for your courageous post. One thing I’ll mention. When whistleblowers started coming down on Big Tobacco, they were only a fraction of the size of Big Pharma. I’m not saying you need to watch out for your life, but the bottom line is that speaking up this way to these kinds of companies can be dangerous. I just spent 4 months in a psychiatric hospital, where the first thing I told them was that I was an MiA author and an author of books about Hearing Voices, and they kept me a prisoner for much longer than could ever be justified.

    Also, while I was there, a young woman came in who was a whistleblower on Medicare and the health industry. She was concerned when her family was overbilling Medicare, and she reported it to the FBI, I believe. The next thing she knew, she was a psychiatric “patient.”

    People who speak up on these issues are in danger. Big Tobacco used to threaten people’s lives, and I wonder how Jeffrey Milligand, who blew the whistle on Y-1, is doing now. People who speak up when there is this kind of money on the line — $24 billion to market drugs to doctors in recent years, as opposed to the merely $4 billion it takes to paralyze the evening news with drug ads — tend to have problems. I can only caution anyone who speaks up, or they might have a fate like I did.

    For 4 months I raged, argued, and tried to fight back. In the end I was drugged, against my will, and all the people who told me how “normal” I seemed came and went. I can only hope that this author, and others who speak out, will take precautions against the Big Pharma machine. It may not be very long before you too are “having problems,” according to the people around you.

    In China, this is called being “mentally illed.” They actually have a word for it. It’s like when, in Russia, a dissident was jailed and sent off to a gulag, called a “psychiatric hospital.”

    Please take all the cautions you can. You have a little too much courage for the current “system.”

  • A “conditional discharge” is New-Hampshire-speak for saying they can haul you back in any time they say. Technically, it means that 1) if you don’t take the meds, and they check your blood or your urine or whatever, and if the drugs aren’t there in the right levels, or 2) you, say, disagree with a social worker (“case worker”) or a psychiatrist, or, hell, the receptionist, I guess, then . . . you can be hauled back up to the state “hospital” and confined, with NO DUE PROCESS OF LAW, until they say.

    This creates an interesting situation where, for instance, you could be hauled in if your “psychiatrist”, say, decides they don’t like you having a beer now and then. One of the most menacing aspects of the collusion between all the “health professionals” who think they know something about the mind (without ever having studied it, according to the syllabi of the psychiatric schools) is that now, with it all combined into one institution, with “mental health” and “substance abuse” all paired into one system, the pharmaceutical companies now control the whole ball of wax. If you’re distressed, say, from the loss of a loved one, and you have a couple drinks down at the local bar, they can now haul you in for having had that drink. What this means in practice is that, while charging you loads of moolah for a prescription for Attivan or Lorazepam or whatever they call it, you can now go to what is more or less a jail if you dare to indulge in a non-prescription, non-pharmaceutical company drug.

    One of the most interesting aspects of my experience in the state institution was how nicotine was handled. I swear that 90% of the problems were caused by locked doors that no one could leave to go outside and have a cigarette. Rather than hand out some good nicotine gum, they handed out what was clearly some sort of substandard “polycrilex” nonsense that had virtually no impact, did it AT MOST every two hours, and then stood back and watched people scream and pound the counter for more.

    That’s the new Psychiatric-Neurological-Pharmaceutical-Prison Complex at work. Watch and see what it does next. They just installed ARMOR on the front of the building. I’m not kidding.

  • Mr. N, I can’t tell you how much I appreciate your words. I have the greatest respect for someone who managed to get through what you described without being trapped by the system and who has actually managed to come through it all, to disavow none of it, and to actually find words to say plainly what they felt they experienced without making any excuses for it or trying to redefine it or hush it up or squeeze it into some paradigm they either don’t believe in or would find artificial. I can only express my greatest respect for managing all of that and doing it with such seeming grace and wisdom that I can do little more than gesture toward it and say it’s there.

    I recently went through a very similar experience, in a very similar geographical area (southwest New Hampshire), but I was not able to find the kind of community you are talking about, though I tried desperately to find one, and I was swept up in the “mental health system” (I hate to even use the words, but they have yet to be replaced, so that I feel like I am using the words of the oppressor to describe the very experience I am talking about in an alien, evil, and misleading language), and all in spite of my best efforts to avoid it. I was trapped, literally, at the New Hampshire Hospital for several months while going through what I think are very similar experiences to what you describe, as best I understand them, and I can only wish I had been able to reach someone like you and the groups you facilitate. Again, I tried, but failed to find anyone like you, failed to avoid the system, and now I am more or less trapped again, on a conditional discharge that denies the validity of my experiences and that forces me to take drugs, which I regard as poison.

    In the coming days I will begin pubishing a regular blog for MIA in which I will describe my experience of this horrible “mental hospital,” and I will attempt to address the same sorts of issues you raised so eloquently and gracefully in your article. I can only hope that you will read it and contribute something to the discussion that ensues. I have the greatest respect for your points of view and for the Hearing Voices Network, and I remain, once and always, an admirer of the words you put down.

    Eric Coates

  • I see both sides of this issue. While it’s lamentable that people are put on antipsychotics, as I was for ten years (and was just forced to start them again when I couldn’t find a social support system like Soteria or Open Dialogue), I will say openly that I had great social support from my family and that it was indeed crucial. Without it, I would have been lost. I wish we didn’t have a system that forces us down the drug route, and I wish it was ALL socially based. That is what matters most to me and what I try to do with my time: give support to others around me. Even in a small town like my own, there are numerous individuals who need help on a daily basis, whether it’s something as simple as taking the time to talk to them, or taking the time and a little money to get someone a bottle of Benadryl so that when the antipsychotics akithisia (the tension and the shakes) gets too bad they can relax a little. At least this doctor — I wish we didn’t have to deal with them at all, but while we have to — is willing to look at something a little more than just the drugs. If we can start with people like that, maybe we can move the system back to where it used to be, where there were no drugs at all.

  • I’ve always wondered what the difference is between “clinical” depression and other, theoretically non-clinical depression is. I suspect that what is going on there is that psychiatrists have figured out they can bullshit the system for a few more dollars, and drag out the “medication adjustment” period for a few more days, and fill the beds a little longer, and so on and so forth, with Medicare dollars as the bottom line and goal about it all. Is clinical depression “real depression”? Is non-clinical depression “real depression”? Or does it take some legitimizer in a lab coat to say so for your feelings to be real? Does a Medicare billing form make the difference?

  • All I wanted to say when I read this was: Bravo!

    Then I read the comments.

    First of all, I wanted to agree with what Andrew said about what Whitaker was really doing — looking at the real effects of these drugs, versus how they’re portrayed in the rhetoric/marketing of the psychiatrists, the pharmaceutical companies, and picked up without examination by the press — and that I had the same reaction I did when I read Kelly’s piece: that it just didn’t make sense, that it was disconnected from what we’re actually talking about. And I felt exactly the same way Richard did about keeping our focus on the issue we’re coming together around, not getting lost in accomodation or lost in the crowd, compromising our goals away for minor gains. When the piece in question appeared, I was so annoyed at the idea of “decentering” that I couldn’t resist replying at greater length than I might have. The main points were:

    “First, I never got the impression that Robert Whitaker was trying to explain every change in disability (SSI/SSDI) as a consequence of psychotropic use. In fact, I’ve never gotten the impression that disability, per se, was even Mr. Whitaker’s larger concern. Mr. Whitaker is a medical journalist, and his focus is on medicine — specifically, on psychiatry, if I understand him correctly. While people tend to focus on his book Anatomy of an Epidemic, which talks about antidepressant use and the rise in disability, I see the focus on disability as a way of looking at the real-world effects of psychotropic use — in other words, psychiatric practice. The other book, which I’m sure you know but which people talk about less, is Mad In America, which focuses on the history of psychiatric treatment of “psychosis” and does not really focus on disability. Thus, the common theme of his work is psychiatry, and I see his discussion of disability as only one pathway — the one he has chosen to explore, possibly because it is a clear way to demonstrate what is really going on and what the long-term effects are of current psychiatric practice — to talk about psychiatric practice in general. So, to bring it back around to the unfortunate title of your piece — that Mr. Whitaker “missed the mark” in how he talks about the rise in disability due to the use of psychotropic meds, I think that it might actually be you who missed the point. He’s not talking about everything that’s happening with disability, because that’s not his main concern. He’s using disability to draw a larger picture of the effects of modern psychiatry. The name of this website, after all, is “Mad In America”, not “Disability In America”, and while your concern with the larger issues surrounding disability is laudable and important and it’s good for us to know about other issues, you may have mistaken what Mr. Whitaker’s larger focus is, if I understand it correctly myself.

    Second, I disagree with you completely that we need to “decenter” from the discussion of medication. While some people who are well acquainted with the subject may be familiar with its broad outlines and ready to expand their focus to other areas, there are lots of other people who are using this website to explore the subject for the first time, or to keep up on current information and perspectives. The movement to change psychiatric practice — which is the real focus of this website, not disability — is starting to gather some steam, but the broad societal change hasn’t happened yet, and to “decenter” from medication is the very last thing we need to do at this point. If anything, we need to center on it even more and with even greater purpose: tie the broad range of perspectives together into a cohesive and panoramic picture that the public and practitioners can understand so that enough people will grasp enough of the whole dynamic that we’ll create enough momentum for change. Right now, many pieces of the picture are out there — the emptiness and failures of the current chemical imbalance model, the long history of psychiatry’s failures and the dangers of its coercive power, the long-term consequences of psychotropic use, the dangerously corrupt practices of the pharmaceutical industry and how it is intertwined with the psychiatric establishment. The pieces are out there, and I would like to see someone come along and create a unified picture of how it all works. And, if I get my druthers, there will be someone like you who has a broad knowledge of how public policy and government programs actually work involved in putting that picture together, because without that knowledge of the system, any attempts to implement change will be hampered along the way by institutional interests, just as Big Tobacco did, in order to preserve their own interests and profits, often by seeming to concede to changes while ensuring they were implemented in ways that worked to their own advantage.”

    In short, I thought the whole piece took a great idea — broadening awareness to other issues — and presented it in the most tone deaf way possible, not only by suggesting we aren’t aware of the broader social issues and learning from and supporting other movements (I know I am, but I don’t talk about that here) but by suggesting we should reach some sort of false accomodation over our central issues in order to achieve . . . what? Our own defeat?

    To be honest, I thought that Kelly, even if he thinks he’s on some higher path of unity, is actually a great voice for the other side of this issue. He’s got lived experience, he’s getting his Ph.D., and he can throw around quotes about structural this and structural that and sound perfectly reasonable to someone who hasn’t got their eye on the prize: stopping the drugs and the coercion, and replacing it with something that actually works. The tobacco industry set up a thing called the Tobacco Industry Research Committee (TIRC) that was staffed with all kinds of well-meaning academics who were willing to confuse the issues in pretty much the same way and keep the public confused about what cigarettes were really doing to people, just like they’re trying to pretend the psych drugs aren’t just about as bad. If Kelly hasn’t gotten a call from one of their PR firms yet, offering him a corner office at NAMI or some other institution they bankroll, he might expect one soon after he graduates. I’ve got lived experience too, and it annoys me that he used that as a claim of authority in his comments up at the top of this section to try to delegitimize and beat down someone else’s point of view that a lot of people with lived experience would agree with and when having lived experience doesn’t mean you know everything and that you can’t learn from other people who don’t have it. I think people have been pretty respectful overall in how they responded to him, and tried to focus on the good things he had to say, but that’s only another example of his tone deaf approach. We need every ally we can get, and that doesn’t include trying to fault Whitaker’s argument for failing to make a point it wasn’t even looking at or talking about, and it doesn’t include deligitimizing anyone’s point of view on the basis of who they are. He complained about a “straw man” argument? Catechizing us all again? And then he concludes with one that’s “ad hominem.”

  • “Zombie” is exactly the word I always use to describe it. Just to shake it up a little now and then, I sometimes use the expression “brain dead”, or I might compare it to being in solitary confinement for a few years: a kind of mental and social jail cell where you can’t really think, feel, or relate to anyone around you. Lately, I’ve been seeing this guy at the gym, and you can spot it right away: the weight gain, the dead staring eyes and expressionless face, the slow shuffling steps. I say this not to shame anyone for their appearance, but because that was me for a few years, and once you’ve seen it in the mirror for a while, you can spot it immediately. The guy is so doped up that it’s like broadcasting to everyone around him that something is wrong, and everyone acts accordingly — the same way I was treated for years — which is to ignore him completely. Being in that state essentially enacts a social death on top of the internal death you’re already being subjected to, at least if it’s as bad for you as it was for me and lots of other people I see, and now when I see him I can’t help thinking that he’s been buried alive. He’s been buried alive, and no one is listening, because he probably doesn’t even realize that he should be screaming his lungs out. And if he did, how many people would actually listen to him? Or would they just tell him these are “side effects” that he needs to get used to? Side effects, they call them — as if reducing him to this state wasn’t the whole point. They can’t fix you, but they sure can keep you quiet and manageable, and that works out great for a who doesn’t want to feel uncomfortable or inconvenienced by the ugliness of your struggle while you’re working things out.

    Jeffrey, I’m going to quote you some day. The amazing way our experience is disregarded — that our point of view is almost always invalidated and disregarded, whether it’s viewing any concerns we might raise as a “lack of insight” or “non-compliance”, regardless of how legitimate it would be coming out of anyone else’s mouth in any other circumstance, or the way our point of view is deliberately excluded from the profession by quietly keeping us out, when in any other circumstance someone who’s actually dealt with a problem themselves (diabetes, sports injuries, cancer . . . anything at all) is considered a valuable resource — all of that speaks volumes about how the psychiatric profession really works and what its priorities are. It seems that it’s only when one of their own finally points out the elephant in the room that it’s considered legit, and as outrageous as it may be that this report even needed to appear, maybe we’ve got an ally out there — someone in the profession who’s willing to go through the motions of dressing it all up as a study in order to get our point of view out there. It’s easy to forget that a few of them still have functioning consciences, that they’re appalled at what they’re seeing, that it was psychiatrists like Szasz and Laing who got the conversation moving, or that there are some of them out there now who want to change how it works, but you see signs of it now and then. I figure any psychiatrist who dares to write for this site has to have a lot of guts and integrity to run the risk of being excluded by the rest of their own profession, taking a chance with whether they’ll be able to hold onto a job while expressing their doubts or their opposition — the same kind of courage and integrity that it takes for a cop or a member of the maffia who dares to come clean about what’s really going on — and I have to give the people who put this article out there some kudos.

  • I’m having a little trouble with my browser at the moment, so if my comments appear in the feed more than once, I apologize. Here are my comments:

    Thanks for taking the time to write your article and trying to expand the discussion.

    First of all, I’d like to say that I agree with some of your main points, at least at this point in my process of learning about the whole subject of “mental illness.” For instance, I also believe that there is a physiological process involved in every aspect of being human, whether it’s the way our minds work and our bodies function, and that the whole system is intertwined, and that we ignore it at our peril. Shifting the emphasis away from crude, blunt-force manipulation of the brain with chemicals or electroshock, with all their disastrous long-term effects, does not mean that we shouldn’t pay attention to and study the brain. A renewed emphasis on psychological processes as actually lived does not exclude understanding the biological processes that underlie them. If anything, understanding the important effects of nutrition and how that affects the body’s ability to handle stress or the brain’s ability to regulate itself is hugely important, as are the effects of exercise and meditation or a practice like yoga, etc., in giving us the tools to change how we use our minds and our bodies for the better. Supportive social environments and meaningful work also affect the whole system, and psychiatry, if it was truly concerned with the whole person — mind and body and environment — would look at all of it. So even if antipsychiatry makes some very important points, I am not opposed to the idea of psychiatry in principle — the study and practice of medicine as it relates to the mind — if it could be brought around to actual medicine that optimizes the functioning of the whole person, instead of the crude and shortsighted and often disastrous methods it uses now, which the forces of institutional complacency and conformity reinforce through a myopic focus on incremental and virtually meaningless changes to those methods while blinding them to their disastrous results and deflecting attention away from other solutions. Of course, I don’t know if you agree with all that, but it’s my take on the subject.

    I agree with you also that medication needs to be less the sole focus of our concern than it is now, but that’s also where we seem to part ways.

    First, I never got the impression that Robert Whitaker was trying to explain every change in disability (SSI/SSDI) as a consequence of psychotropic use. In fact, I’ve never gotten the impression that disability, per se, was even Mr. Whitaker’s larger concern. Mr. Whitaker is a medical journalist, and his focus is on medicine — specifically, on psychiatry, if I understand him correctly. While people tend to focus on his book Anatomy of an Epidemic, which talks about antidepressant use and the rise in disability, I see the focus on disability as a way of looking at the real-world effects of psychotropic use — in other words, psychiatric practice. The other book, which I’m sure you know but which people talk about less, is Mad In America, which focuses on the history of psychiatric treatment of “psychosis” and does not really focus on disability. Thus, the common theme of his work is psychiatry, and I see his discussion of disability as only one pathway — the one he has chosen to explore, possibly because it is a clear way to demonstrate what is really going on and what the long-term effects are of current psychiatric practice — to talk about psychiatric practice in general. So, to bring it back around to the unfortunate title of your piece — that Mr. Whitaker “missed the mark” in how he talks about the rise in disability due to the use of psychotropic meds, I think that it might actually be you who missed the point. He’s not talking about everything that’s happening with disability, because that’s not his main concern. He’s using disability to draw a larger picture of the effects of modern psychiatry. The name of this website, after all, is “Mad In America”, not “Disability In America”, and while your concern with the larger issues surrounding disability is laudable and important and it’s good for us to know about other issues, you may have mistaken what Mr. Whitaker’s larger focus is, if I understand it correctly myself.

    Second, I disagree with you completely that we need to “decenter” from the discussion of medication. While some people who are well acquainted with the subject may be familiar with its broad outlines and ready to expand their focus to other areas, there are lots of other people who are using this website to explore the subject for the first time, or to keep up on current information and perspectives. The movement to change psychiatric practice — which is the real focus of this website, not disability — is starting to gather some steam, but the broad societal change hasn’t happened yet, and to “decenter” from medication is the very last thing we need to do at this point. If anything, we need to center on it even more and with even greater purpose: tie the broad range of perspectives together into a cohesive and panoramic picture that the public and practitioners can understand so that enough people will grasp enough of the whole dynamic that we’ll create enough momentum for change. Right now, many pieces of the picture are out there — the emptiness and failures of the current chemical imbalance model, the long history of psychiatry’s failures and the dangers of its coercive power, the long-term consequences of psychotropic use, the dangerously corrupt practices of the pharmaceutical industry and how it is intertwined with the psychiatric establishment. The pieces are out there, and I would like to see someone come along and create a unified picture of how it all works. And, if I get my druthers, there will be someone like you who has a broad knowledge of how public policy and government programs actually work involved in putting that picture together, because without that knowledge of the system, any attempts to implement change will be hampered along the way by institutional interests, just as Big Tobacco did, in order to preserve their own interests and profits, often by seeming to concede to changes while ensuring they were implemented in ways that worked to their own advantage.

    To take just a moment to address your point about the potential usefulness of psychotropics, while I too have lived experience, as you do, and while I take listening to what people with lived experience have to say about their experience extremely seriously, as you also seem to do, I do not automatically think that makes every one of those people universally and unquestionably well-informed on every single issue that affects them — and I say that out of lived experience too. For many years I was the model psychiatric patient: always medication-compliant, never questioning the good judgment or enlightened care of my psychiatrist. I took the minimal and skewed information he gave me (“You might gain some weight, and we’ll need to monitor your blood sugar” — not that they would probably skyrocket, with all the bad effects that follow) as sufficient information to give my “informed consent”, never suspecting that the process had been reduced to a parody of what it was meant to be. I believed he was saving my life — even as my body ballooned up and I developed high blood sugar and high cholesterol and more and more medications of other kinds were pumped into my body as a result of the whole metabolic syndrome, and over the years of his treatment I gradually grew more and more physically and mentally incapacitated, until I reached a point where I stopped functioning in any meaningful way as a human being and spent what few hours of the day I wasn’t sleeping just staring off into space, with nothing at all going on in my head — no thought, no emotion — and made never a peep as all meaningful connection to other people and the quality of my own life disappeared. Yet I would have reported to anyone who asked, as they sometimes did, that I was doing the best that could be hoped for — or that’s what I believed, according to my assessment of the possibilities within the framework of limited expectations that I had been taught. And so, in my present life, when I listen to a couple people I know who claim that they couldn’t get through the day without their antidepressants, that it enables them to function, I don’t accept their statements without looking into it further. It’s possible they’re right. Maybe they couldn’t cope without psychotropics. I don’t fight with depression, and I can’t claim to be an expert on it. But if being “medicated” for depression resembles being “medicated” for psychosis in any way, then I suspect there is a lot more to the picture than they may even be aware of themselves. That antidepressants are almost exactly as effective as placebos leads me to suspect that that’s all these friends of mine are experiencing — the placebo effect — as difficult as that might be to see in oneself (although it’s a very interesting effect of how our thinking can determine our experience, and deserves more exploration). Or that, like me, they are coming from a place where they simply don’t realize that there are other ways to do this — that although they may think antidepressants are the best they can hope for, maybe they don’t know about exercise and good nutrition and meditation and getting into the effects of trauma and developing some insight into what’s going on for them and how to deal with it more effectively. That is, they might know the words for those things, but not the experience of those things from the inside. They may, as I did, be mistaking impairment for the best possible outcome out of a sheer lack of knowledge, and who knows what they might learn if they could get outside the information bubble and seemingly unavoidable alternative of modern psychiatry and its presentation of itself as the principal if not sole authority on the subject of “mental health,” which is how it presents itself in spite of its limited perspective and unacceptably poor outcomes, and which is so thoughtlessly accepted without question and then repeated in the media to the exclusion of what I and many others believe to be more effective solutions. So, yes, we should listen to people with lived experience, but we should also not forget that their experience is also — in a phrase you seem to favor — contextually dependent.

    The last main thing I’d like to mention also relates to the “decentering” of the discussion away from medication. As I said, I wouldn’t remove it from a central position at all. But I would like to expand the center to include a complementary focus on the alternatives — the effective alternatives. If one wants to replace something, one should do one’s best to show what it might be replaced with. There is a great deal of attention paid to psychiatry’s harms and its need to reform, but less attention paid to what will be done to reform it. I guess it’s natural that anger and outrage motivates people to protest, and that happiness and contentment draws less attention or the desire to make noise. The personal stories on this website often focus on the harms of psychotropics and coercion, while going less often into what the positive solutions are. That’s only natural, of course, since so many of us, either ourselves or our loved ones, have been subjected to those harms: that’s our common ground. And if less focus is put on exploring the solutions together, that might also be because a lot of us haven’t found them yet, or are only just learning about them. We see articles that talk about Soteria or Open Dialogue — but mostly as general outlines, lacking focus on the real mechanics of how they work. In some personal stories, we see references to nutrition and exercise and meditation and so forth — but all we get, for the most part, is the broad outlines, a passing reference. But these are complex and sometimes difficult topics, and what people need — or what I needed, and still sometimes need — is a place to start with it all. For instance, I meditate, but that came about because I had the intuitive sense that meditation was about self-understanding, which I sensed I needed, and since no one (and certainly not my psychiatrist) was going to come along and just give me that information, I had to explore the subject on my own. Fortunately I like reading, I’m not intimidated by new subjects, and I’m willing to read things over and over again until I connect with them. The books are out there if you go out and hunt them down and dig through enough of them until you find one you can understand. But without that determination, and the good fortune of being pretty well educated and a reader by nature, I would most likely have never gotten into it all. And I know from talking to other people that most people don’t meditate because they don’t know what meditation really is. They have this notion, probably picked up from popular representations of people who have meditated a long time and who are pretty happy as a result, that you just sit down one day and a little magical lightbulb of bliss goes off over your head right away, and if it doesn’t then you’re doing it wrong — that you’re supposed to just instantly arrive at enlightenment or something, or you “just can’t do it right” — and they quit trying. But meditation doesn’t work that way, and maybe no one has ever told them that. To understand your own mind, you have to actually watch it for a while, experience what it’s going through, and just live with it. The end of the suffering — at least as I’ve experienced it — isn’t because you don’t feel pain any more. If anything, you’ll feel the pain even more deeply for a while. But you have to open yourself to it, go through it, in order to see where it comes from and how to work with it and how it loses its power over you, the same way a con man or a liar loses their power over you once you catch on to what they’re doing. But I don’t see a lot of discussion of the actual mechanics of meditation or the other positive alternatives. I see lots of documentation of all the miseries of psychotropics and withdrawal from them, which are necessary, but only passing references to the details of the positives, and while it’s at least mentioned in passing, it doesn’t do much to share the experience and get some insight into how things might work. So, yes, there needs to be more of a focus on things besides medication. Not at the cost of focussing on psychotropics, because that’s a fight that needs to be fought until it is won. Only that besides focussing on the harms of psychiatry, there needs to be an additional focus on the positive alternatives — which may even have the added benefit of reforming psychiatry from the outside, since, like Western medicine in general, they tend to not pick up on (or even dismiss and undermine) the importance of issues outside their traditional focus until the public forces them to look at what everyone else already knows (at which point they look around, do some “validation studies,” write some popular books, set up an institute to appropriate control of the conversation, and then give each other awards and honorary degrees in order to publicly congratulate themselves once again on how they’re moving in ever more progressive directions . . . but I don’t really care who takes the credit in the end as long the change finally happens!).

    Thanks for your article. Even if I disagree on what I think you meant on some points, the discussion itself is important to have. I guess I went rather far afield in my comments, but I thought you deserved a thorough response. I suspect that some other responses will not be as civil, but I recognize the good intent behind your thinking. But, while I wholeheartedly endorse free discussion, I wouldn’t catechize Mr. Whitaker on the failures of his work with a sensationalist title when you don’t seem to have taken quite enough time to consider its purpose or — there’s that word again — the context it depends on.

  • I’d be interested to know where the money really went for a couple reasons.

    When the Master Settlement came along between the tobacco companies and the states in the late 90s, the idea was that a certain percentage of tobacco revenue had to be paid to each state each year. This agreement was reached with a clear and stated purpose: to provide funding for tobacco education and anti-smoking campaigns, particularly for young people, who have been the historical targets of Big Tobacco’s marketing, with the result that many of them were hooked at a young age, which is to say when they didn’t know better and couldn’t make truly informed decisions about tobacco’s harms and so became lifelong consumers of the product (a general strategy on the part of people who sell mind-altering chemicals that we might find familiar).

    But that hasn’t happened. For instance, in my state of New Hampshire, Big Tobacco has been ponying up about $50 million a year. Where is that money going? Not to tobacco education or anti-smoking campaigns. No, it’s actually going to balance the budget. Instead of addressing the harms it was meant to address, and prevent them, it’s now being treated as just another revenue source. In fact, it has in a way made the state complicit with Big Tobacco. The state now has an interest in Big Tobacco getting as much money as possible, in order to get more money every year as its share. Probably the last thing we can expect is for this windfall to ever be used for what it was meant for. But that’s getting a little off topic.

    I would be very interested to know if California is using the new revenue to provide new or expanded programs and services in addition to what was already there, or if the money is only being used to pay for services that already existed, allowing the state to shift money that used to go to mental health services to other areas. If how the states are using the tobacco settlement money is any indication, the people of California need to demand accountability and transparency in how the money is being spent.

  • Thanks for your comments. I have been thinking lately that the way to stop current psychiatric practices — the drugs that debilitate and eventually kill people, which consumes simply enormous public resources, and the extremely expensive recurrent hospital stays and endless psychiatric bills — might be the way to attack the system and put something else in its place. For instance, just to use my own case as an example: A hospital stay, even a brief one, costs many thousands of dollars. When I became psychotic, I cost the system more than $10,000 in just a few days. After I became psychotic, I was given disability — at a cost of more than $1,000 a month. Since I was prevented by the drugs from ever truly recovering, and in fact further disabled by medication even after the real psychosis passed, that meant it became a permanent expense to the public. (In the interests of total disclosure, I’ve only just completely eliminated meds and haven’t yet rebuilt my life enough to get off it, even though I’m getting there.) Psych meds also come at a premium: more than $700 a month for the single drug I was on, and I was one of the lucky ones who resisted being sucked into the system of polypharmacy, where you might be juggling numerous expensive meds. Because that antipsychotic stopped my metabolism, it caused immense weight gain and high cholesterol and high blood pressure and high cholesterol — and now we’re talking more bills to medicare, not only for drugs (insulin alone is $350 for a supply that might last as little as a month, but that really does vary, so it’s only a ballpark number . . . but then there’s the other stuff, which added up to at least a $100 a month.) Now add doctor’s bills — for follow ups and dealing with new problems as they emerge. Even now, I am dealing with the fallout of what happened to my body, and though I have eliminated the big-ticket items like antipsychotics and insulin, the expenses haven’t ended. And there’s another cost: while disabled, social security paid my child support to the tune of $500 a month. So: instead of my returning to being productive as soon as I might be able, for many years I have been an enormous drain on the system — to the tune of roughly $30,000 a year. And since I haven’t had to be rehospitalized or had multiple psych drugs, I suspect that I’m one of the cheap ones.

    Perhaps what we need to do is reframe the entire public debate away from the personal costs of current psychiatry, because there seems to be a kind of blind spot about mental difficulties in our country. The public debate is framed mostly by fear of what those with mental difficulties are going to do, and it is from this fear, unthinkingly played on by the media, that psychiatry derives its power. Desperate people will turn to the people who present themselves as having the answers, and in our society, that’s psychiatry. The human picture of what actually happens to most people who come under the influence of that system is completely obscured. Psychiatry’s harms are swept under the rug, maybe because there is this constant triumphal march about their supposed progress, how they’re supposedly helping, while their actual record is almost never examined. That ten years on antipsychotic shortens your life expectancy by five years, for example. And maybe the way to attack the system is to reframe the discussion outside their rhetoric of illusory scientific progress and cast it in terms of actual economic costs. If we can contrast the public cost of community-based models like Soteria, or even the costs of a program like Open Dialogue in Finland, we might discover that all of a sudden people will stop being distracted by psychiatry’s rhetoric and become more openminded to examining actual outcomes. Talking money might wake people up to shift the model away from the current system and get us the funding we need to set up something that works — based on humane conditions, mutual respect, no forced medication, and community support — long enough for us to prove on a large scale that it works.

  • Thanks! If this was easy to figure out, it would have been done a long time ago. Sharing perspectives from different sides of the debate is important and valid. My feeling is that community-based programs have never been funded sufficiently to be as effective as they could be, and that models like Soteria are given up on far too soon. They’re never treated as more than pilot programs — and expected to produce instant results by people with vested interests, like psychiatrist, who can’t show instant results either — if they can show any results at all — and who feel threatened that someone else would set up a model of support that isn’t under their own control. If someone had a physical illness, like cancer, everyone would expect that it might take years to ever solve it and for that person to recover. But with mental difficulties, there’s no realistic picture in people’s heads. Some people work through their troubles quickly, while others need time, and maybe a lot of time — but we’re so fixated as a society on a quick fix that we expect instant results. It can be scary to deal with people who seem out of control, and if drugging them and locking them up relieves the public’s anxiety, the public will go for that option, and community-based programs will never get a chance to show their long-term outcomes. And I’m quite confident that the psychiatric establishment, given a chance, will pay no more than lip service to community solutions while actually undermining them at every step, whether by strangling their funding (every dime lost to community support is a dime not collected for appointments or medication) or by coopting them and turning them into yet another channel for coercion — turning them into the deceptively named “assisted” outpatient treatment programs. An object lesson is the history of state asylums. The original success of asylums was a result of the respectful and humane environment of the moral treatment model brought from Europe, where everyone was respected and no one’s freedom curtailed, and people had time to recover. It was so successful that state hospitals were built all over the country. But what happened next was that they were gradually corrupted by outside forces. Doctors — the self-appointed experts — took over and began to impose their treatments: cold baths, spinning, wrapping, insulin shock, electroshock, lobotomies, disabling drugs — and they brought with them the whole hierarchical structure of coercion and control, of the “expert” who supposedly knows more about the “patient” that she does herself, thus justifying their control. At the same time, the hospitals became a dumping ground for society’s undesirables. While those who recovered were able to return to the community, only those who didn’t were left behind, and they accumulated in number. Other undesirables — hopeless drunks, and teen rebels, and the socially disobedient, and blacks who spoke out for their civil rights, and communists, and unmarried pregnant women — were confined there, and kept there, because they were committed by other people who had been granted that coercive power. (The way the Soviet Union used mental hospitals and diagnosis and drugs should be a lesson to us all.) The whole purpose and structure of the asylums was subverted. If asylums were to return in something that resembled their original form, where it was about respect and freedom and being part of real community, I’d be all in favor. That would be a haven, not a prison. But if asylums return in the form they had in the past few decades, I have little hope that they will help anyone recover. Are the old asylums any better than the de facto system of “mental health care” that now dominates the country in the form of the prisons and jails? I don’t think so. Thanks for speaking up about the complex issues involved and your concerns.