Showing 50 of 50 comments.
Thank you once again, sir, for spreading some light in this darkness.
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.
Thank you for your article, Dr. Burstow. You are as conscientious as always.
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.
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.
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.
It’s very important that all this be investigated. Very important.
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.
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.
Lovely article. Good for you and your family and the world around us. I hope you keep it up.
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.
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.
Thank you. I’m a big fan of what you’re doing, and while I know this isn’t a personal issue, it’s nice to get some response and know that you’re making a difference. You are.
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.
Wow. The rest of us owe you a debt we can never repay.
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.
Thanks for your article and for the discussion it created.
Valuable work. Thanks.
I think it’s a good idea in its basics — remove the power of pharma to bias researchers. But that doesn’t mean the public should be paying the bill for the research they need done. They should have to foot the bill for research into products they expect to profit from, with the name and producer of the drug completely blinded to the people doing the studies. And while we’re at it, let’s start requiring them to do real studies. No more mini-studies where you take someone withdrawing from one drug and put them up against someone else who’s using the drug for the first time, and then only watch for six weeks, and never study the long-term effects, or — almost as important, and completely neglected — what it’s like to withdraw from that drug and what the dangers are. The whole system needs to be radically reformed.
I knew that this was true in my own life. Bullying and abuse make you hypervigilant — alert and reactive to small things. You begin to react to small threats and stresses in excessive ways. You develop a tendency to react with a mindset of paranoia, without every realizing that that’s what it is happening. You believe your reactions are reasonable. And then, at some point in adulthood, you encounter some new source of stress, and you believe that your own bizarre and extreme thoughts are reality — and that’s how you go over the edge into madness. I have never seen the case laid out like this. I don’t understand half the references to different structures of the brain (I’m still learning!), but I can see the common theme. Abuse, followed by the brain adapting to it, followed by an inability to deal with new stressors. Thanks for confirming empirically what I knew in my gut had to be true.
“For example, 33 miners were trapped underground for 69 days in a copper mine near Copiapó, Chile in 2010. Although the miners were finally rescued and were treated as heroes, and in some cases as celebrities, many subsequently developed severe psychological symptoms caused by their ordeal, such as depression, anxiety, nightmares, and avoidant behavior. Because the causes of these symptoms are obvious and recognized, no one to my knowledge has suggested that the miners have genetically based brain disorders or “chemical imbalances.” It is clear that the miners’ experiences caused their symptoms, and the symptoms of most psychiatric conditions can also be seen in this way.”
I don’t think I’ve ever seen anyone put it so clearly before — so clear, concise, and virtually beyond any further discussion. Wonderful piece!
First of all, I’m sorry that I haven’t read all the comments. But I do want to respond to your article, and on the basis of personal experience.
I’m tapering off medication. I’ve been doing it in small steps. After trying to stop all in one shot, and suffering from bad results, I was finally told by my prescriber that the neurons in the brain adjust after 6 weeks to a new dose of this stuff. I stepped down what I was doing at a quarter dose at a time — based on what I was taking, of course — and it’s gone very well. I’ve had changes in mood and thinking, but after a short time I’ve gotten back to “normal”.
When I went on “medication” I needed something to slow down what was happening in my head. The voices, the delusions: the intensity was too much to survive. But after a few months, when I’d slowed down, the drugs no longer helped me. What they did was kill my ability to think, to feel, to interact with other people. They slowed down my psychosis, yes, but at the same time they took away everything else: my ability to be human. I don’t believe these drugs are entirely wrong, but I believe that they should only be used for the shortest time possible. As a brake, to halt the psychosis — not as a long term solution. In the end, they were killing me. I gained 100 pounds, developed diabetes, and finally spent my hours staring into space. I’m a writer. I write books, and do very well at it. Yet these drugs, while I was on them, were destroying my ability to write, to dream, to imagine, and to be one of the human race.
Please keep doing your research. Get people to look at all this stuff, and to do the research that shows what they really do.
First of all, I’d like to thank you for laying out your case in a clear and logical way. I wish I had your breadth of knowledge about all the different harms of psychiatry, and I’ll bookmark your article so as to read further among the sources you cite.
If I have one reservation about the current state of affairs with people who’ve chosen to speak up about psychiatry, it’s that there’s an awful lot of consciousness raising and yet a curious lack of proposals for what we can do about it on a systemic level. Maybe that’s just my ignorance showing, but that’s what I see when I look around. I wish I saw more articles like yours.
So, when I offer some words of criticism, it is not intended to defeat positive action, but simply to point out some problems which you may very well have anticipated but simply neglected to go into here.
My belief is that psychiatry cannot be effectively abolished. I don’t know what steps you would take to abolish it, but if there is one thing we should all know from both evolution and economics, it is that when a profitable niche opens up, something will come along to fill it. You may abolish psychiatry, but it will crop up again under another name, just as slavery did when it turned itself into Jim Crow, where you may not actually have one person legally owning another but where you have a system of laws that deprives people of their freedom to move around or to choose their terms of employment or to vote their own interests, etc. With psychiatry, you may succeed in eliminating it as a specialty practice in medicine, but soon you will have new specialists cropping up to take their place — neuroscientists, nutrition experts, etc., etc. — all of whom will soon unite to protest the “stifling effect on science and medicine” that prohibiting any of their practices would entail. It will be only too easy for them to claim that the barbaric practices of the past have been left behind, even as they revive them in new forms, just as insulin shock gave way to electroshock, which gave way to lobotomies, which gave way to medications, and whose purpose was always the same: to incapacitate, pacify and silence all those unruly defectives. The other day I was talking to a friend, the mother of a woman with some psychological issues, about why I was mostly opposed to medication. She would hear absolutely none of it, except to tell me that I should “think of the families” and that it was important to have a range of options, a “balance” (just as you mentioned in your article), and I realized that what she was really saying, as much by the nature of her resistance as by anything she said, was that she was simply afraid. Her daughter has suffered, she has suffered, and she is afraid that without medication her daughter will suffer even more, and I think this is what people are mostly afraid of: that without medication, without psychiatry to hold their hands and assure them that this is the best possible treatment, that no one knows what will happen. They have a very real and very legitimate fear of chaos and suffering, and the pseudo-medical charlatans of the future will exploit that fear in the unlikely even that you should ever succeed in getting rid of the charlatans we have now.
My other belief is that abolishing psychiatry is irresponsible. Someone in the medical profession has to know how the brain works and how chemicals affect it, if only to reverse their current role of perpetrating harm to one where they protect us from harm in the future. If there were some way to liberate psychiatry from the malign influence of the pharmaceutical industry and from practicing on patients, if they simply did research about the brain and so forth, we might actually benefit from what they find out. In fact, by removing their motives to turn a blind eye to what is really going on with psychopharmacology, we might get them to turn out some honest results that have value. I have no idea how this change would come about, except through the continued efforts of people like yourself to learn the facts of psychiatry, think about the whole picture, and publish your conclusions so that the public can see what is going on and hopefully force the profession into meaningful reform by stripping away its abusive powers where possible and setting up a system of meaningful regulation to create transparency and accountability with their use of any powers that remain. As they say, sunlight is the best disinfectant.
I am not in favor of the current system and I would like to see it changed. But I don’t see how simply abolishing psychiatry is going to solve a problem that seems intrinsic to human nature, with its propensity toward greed, opportunism, and fear.
People who haven’t experienced “hallucinations” have no more standing in discussing them, whether philosophically or psychologically, than someone who has never balanced their checkbook talking about the workings of the stock market. You might sound very smart to people who haven’t been there, and even convince the committees that grant fellowships and awards and publications that you know something. All these people are ignorant. But in the end — when history looks back on you — you will sound exactly as well-informed as those who speculated about dragons in distant lands, and what would happen when you sailed off the edge of the earth. The only people who have any standing to talk about “hallucinations” are those who have had them, and those with the humility and long experience to work with such people. Imagine a free white man, with every privilege, writing in the nineteenth century about the experience of a black slave woman. That’s what we can expect from these outside experts. They can amuse themselves, and play with ideas, and in the end they will contribute nothing.
Dr. Steingard, I celebrate your central and concluding point: that we need to worry about what would take the place of psychiatry if psychiatry was banished. In the USSR, capitalism and private ownership of business was abolished. And what took its place? Another dysfunctional system, one which did no better than capitalism in fulfilling the public’s needs. I agree with you that what is needed is not a complete revolution against, but an evolution within, the practice of psychiatry.
I was the ultimate compliant patient with schizophrenia. As a result, I lost ten years of my life to a chemical lobotomy that left me unable to function for more than a couple hours at a time, that left me sleeping 14 hours a day, that left me completely unconnected to other people, and that destroyed my health — all because of the drugs that I was put on because psychiatrists would rather drug you into submissive quietude than support a system, like the Soteria model and others practiced throughout the world where modern medical psychiatry doesn’t dominate but that supports you during the difficult time that you go through your crisis.
I agree with you that in that I believe that psychiatry can be reformed and made useful. But first it must:
• completely reject the medical model
• completely reject the use of any coercion except in the case of threatened harm
• completely reject the use of any medication except when the patient is capable of truly informed consent without any form of coercion by others (see other recent MIA articles on the meaning of consent)
• completely embrace the trauma model of psychological distress, including social factors like abuse, bullying, ostracization, and the effects of poverty, racism, and classism
• completely embrace a system of community support where local agencies provide an environment where peer support from others with the same experience on a day-to-day basis, free of charge, replaces occasional appointments with “professionals” who restrict their services to hours of their own choosing and charge high prices to those in need
My list is only a beginning of what needs to be done to reform psychiatry. Can you expand on it, or will you remain only an apologist? As I said at the beginning of my response, I respect your position. But you will need to expand on what that really means in order to be credible to this disillusioned audience.
A fascinating article. I’ve wondered lately, as I get more and more interested in non-medical, community-based support systems, just where the limits of non-intervention lie. Much food for thought here. Thanks.
A thoughtful and informative piece. Thank you.
It is simply unbelievable that in this day and age that these kinds of experiments are going on. The United Kingdom is, in general, more responsive to the needs of those in mental distress than in the rest of the industrialized world. That these kinds of experiments continue even there is a reproach to the unfettered and unquestioned role of psychiatry as a pseudo-medical practice.
Well done, Laura. You might take this comment thread and turn it into a free-standing piece. It cuts right to the heart of the matter.
I don’t think that my commentary can illuminate anything that you haven’t. I just want to thank you for taking the time to make it clear to people that the backtracking bullshit that is now being put out there — probably with the purpose of heading off criticism and what I hope will be the massive class-action lawsuits to come for all this blatantly bad science, bad medicine, and damage to people’s lives — will not escape anyone notice any more than the lies and misrepresentations of the tobacco industry were able to escape detection in the end. I hope that your post becomes the basis of a book. Someone needs to document all this. Someone needs to put it all down so that history and society have a record of what really happened — now, before it is too late to make restitution to the victims.
As Robert Whitaker notes in his book Mad in America, antipsychotics are no longer “clean” drugs. The early antispychotics targeted specific dopamine pathways. Now, however, the atypical antispychotics target other pathways as well — such as serotonin, glutamate, etc. Which means that they are not only antipsychotics, but antidepressants as well.
Antidepressants have been shown to lead, for some people, to an increase in violence and psychotic experiences. Having had experience with this class of drugs myself, I can tell you that at least one of them leads to an increase in aggressive feelings and confrontational behaviors.
I would not be in any way surprised to learn that the newer atypical antipsychotics are leading to an increase in violent behavior on the part of what is otherwise a very peaceful population.
My only regret in reading this post is in learning that Dr. Leitner is retiring. I hope that in his leisure time he will devote some small part of his time to producing books and articles that might help enlighten us all.
Great article. Sorry for what you went through. Thanks for sharing. I will soon be pursuing my own records as well.
Wonderful article. Thanks.
Great article. The only thing I would add is that, in describing the idea of an imbalance as some kind of “metaphor,” I would suspect that the establishment is trying to head off suits for malpractice. There is, after all, nothing about the idea of an imbalance that is metaphorical. “My luv is like a red, red rose” — that’s metaphorical. Putting the idea out there, — a quite specific, detailed, and scientifically based idea — that the chemicals in your brain are out of balance is not metaphorical in any way. The problem is not the use of poetic language. It is the theory itself, and the actions that followed, using that theory as justification. Letting them call it a metaphor is to let them wriggle out of responsibility.
Nice work, Tina. There needs to be respect for the rights of those who are experiencing mental distress. No issue regarding mental illness is clear: the value of diagnosis; the value of hospitalization; the value of medication; the value of how we are represented in the media. But the world needs to address the almost unchecked power of psychiatry, which in the past meant forced hospitalizations, forced medications, forced treatments, and forced supervisions through the self-appointed bodies of psychiatry. It is time for us to be heard. As our British colleagues might say, “Good on you, love!”