Monday, September 24, 2018

Comments by Ron Unger, LCSW

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  • Yes, the idea that one approach will help everyone should be declared quite dead! But I think there is value in having a diversity of approaches, then people can find something that fits for them at a given time and place.
    Steve, I wonder if you watched any of the video? If you did, can you see how someone like John might be more ready to help someone after learning something like Process Work?

  • Hi BigPicture, sorry if you were waiting for a response, I didn’t think of anything to add to what you already said, at least nothing without making a longer post than I might be ready to do! I think you make some good points, many of them along the lines of what Alan Watts used to talk about when he said that sometimes you have to go out of your mind, to get back to your senses.

    And I agree about the post hypnotic trance thing. Going into at least a different kind of trance gives you at least the awareness that some other kind of processing is possible, even though it doesn’t tell you what “being truly awake” might be…..

  • Hi Steve, I agree with you that much of what is taught in standard approaches is either not helpful or is actually detrimental, but I don’t think that all attempts to educate people in how to help is useless – a good example is the Open Dialogue program, which relies a lot on education, though part of what they educate is also humility and staying uncertain! I think we need to work on sorting out what is helpful and what isn’t.

  • Lots of professionals were trained to think that talking with people about their “psychotic” experiences would just make them worse, so if they believed that, it’s not surprising that they would think that people who hear voices shouldn’t go to a hearing voices group. But it’s also so ridiculous – it shows the impact of bad ideas, that can make the whole mental health system quite mad, and not in a good way.

  • I’m glad you found the article liberating! I hope you watch the video too, I think you will find it much more helpful. And I know it is hard to get practitioners to change, but I think it is worthwhile to keep chipping away at it, just getting a few to change can make a big difference to the people those practitioners work with. And once enough change, the balance may shift and the current model of mostly mistreatment may come to be seen as the monstrosity that it is.

  • Wow, I really like your phrase, about how spirituality is looked at as a “decorative garnish on a plate of pharmaceuticals.” I may quote you on it. It really captures the way I’ve seen spirituality be approached by the mainstream, when it even approaches it at all! It’s like a frill people might be allowed to have as long as it doesn’t interfere with them properly attending to the main course, the drugs and suppression.

  • Thanks for your story. It’s curious the bit about realizing you (and others) were God and then trying to talk about it – this was easier for me as a young man when I started thinking the same way, because that perspective was more talked about at least in the “hippy” subculture. Writers who were popular at the time, Alan Watts and Baba Ram Dass, for example, had some good ways of talking about it.

    In the hearing voices movement they say hearing voices is only a problem if you don’t know how to handle it. I would also say that thinking you are God is only a problem if you don’t know how to handle it and relate to others from that perspective. If mental health professionals understood this, they would be better at really helping people instead of just trying to squish perspectives they can’t understand.

  • Thanks Sarah! One thing I really liked about the article is your analysis of how the special confidential relationship of therapy actually backfired for you and left you feeling worse about yourself.

    I think ideally, any therapist, or even anyone who is going to have some kind of confidential helping relationship, would be trained to recognize the possibility of this kind of dynamic and ways to overcome it.

    I do think there is a time and place where people want or need a space to talk confidentially about things they can’t bring up elsewhere, but ideally they get help finding ways to then get support elsewhere – either because they learn how to frame their issues in ways they can share with the others already in their lives, or they learn how to find people they can share with (if the current people in their lives are too judgmental.)

  • I also don’t find value in distinguishing “healthy depression” from “clinical depression.” “Clinical depression” too often just means a depression that the clinician is unable to, or too lazy to, understand the cause for!

    But I do think depression is kind of like fear: sometimes it is really helping us, and other times it is more based on misunderstanding, exaggeration, etc. So I might be depressed about my relationship or job or even my whole way of being in the world, and that might be helpful and realistic, because there might be something terribly wrong with my relationship or job or way of being in the world, and I need to slow down and face that and let it sink in so maybe I can find some other path. Or maybe I feel everything is depressing, but it really is just an irrationally dark view, and what I need to do is to question my dark thoughts and see the value of jumping back into life without making any big changes.

    A key thing here is that it shouldn’t be clinicians deciding which is which: people have to make these decisions for themselves, though clinicians can collaborate with them in doing that, or facilitate thoughtfulness about it. It helps to have a clinician who isn’t too sure that the only thing needed in each case is rosier colored glasses to look at the world through……

  • Thanks Annette for sharing your experience, and I hope you do write more as a blog post! I had something similar happen – experiences and time spent exploring perspectives that psychiatry sees as psychotic, but making sense of it as a process of healing and transformation. I think there can be real dangers in going through this kind of process, and it isn’t the same for everyone – some people go to deeper and more intense places than I did and need much more support to navigate it safely – but many more would get through it successfully if we aimed more at exploration and working through, not suppression.

  • Hi LavenderSage, it’s true I wrote this blog without addressing any possible spiritual perspectives. But I didn’t mean to rule them out. There is for example the view that the self is an illusion – so it doesn’t really make sense to say something is part of something that doesn’t exist! Or there is the view that we are all one – so anything or any being we encounter is really part of us, equally so whether it seems to be “in” us or “outside” of us. What is key I think is not quibbling over different ways of conceptualizing our own identity or that which seems to be outside of us, but rather of seeing the possibility of establishing relationships that respect both what might seem like our “self” and what seems like “other,” whether or not that seems to “others” to be inside or outside what we “should” – according to them – be seeing as our “self.”

  • Hi Bradford, I think I see it as a bit more complex than what you are suggesting. I think there are a range of possible ways humans can get into troubles or confusion, that they are on a continuum with extremes possible, that is we can have a panic attack and be sure we are about to die, be so depressed we can’t get out of bed for days, or be so “psychotic” that we believe and experience outlandish things (as when my friend David Oaks thought the CIA was making his teeth grow.) These sorts of problematic mental states existed before the DSM came along, but what professionals did was to make committees to divide it all up into neat categories, and then they started talking in weird ways, like saying that the person’s “schizophrenia” made them believe or do certain things, which then took them off the hook from having to try to actually understand what might have happened to the person and what they might be going through to get them to think or act that way.

  • One way of thinking about it is that voices and thoughts exist on a spectrum. At one end we have stuff that is distinctly a “thought” – there doesn’t seem to be any hearing component to it, and it seems consciously willed. At the other end are experiences that are distinctly “voices” – one may hear them so distinctly that one has to look to see if anyone is there, and they are definitely not consciously willed. Then there are various kind of in between experiences – which some people might call thoughts, and some might call voices, with no clear distinguishing line.

  • Thanks for the comment, and for the perspective on the Metamorphosis story – there really are so many different ways of interpreting things, and so often reality is too complex to be captured in any one of them. Which is why, in Open Dialogue, they are so dissatisfied when only one perspective on things is on the table! They always want to bring in more, since dialogue is impossible if only one view is present.

  • I agree that the “psychosis” does communicate, usually in a disguised way, what the problem is, and taking drugs to suppress what is happening often gets in the way of sorting out what it’s all about. That why I think it makes sense to only use drugs when people can’t find any other way to head off some immediate disaster, drugs should not be the cornerstone of treatment.

  • I agree, when people do manage to get “less psychotic” and the problem seems to be just dissociative, then they are often told that they never had a psychotic disorder or “schizophrenia” to begin with. But somehow the fact that a mistake was obviously made in that case never gets them thinking that maybe the whole conceptual scheme, with its clear diagnostic separations, could be a mistake……

  • I would agree with you that the goal of identifying people with specific categorically distinct disorders is a fantasy! But the notion that people can have serious mental and emotional problems with which they can use help is not a fantasy. Rather than diagnosis, I much prefer trying to map out what might be going on for a particular person, or making a “formulation” of the problem. This can be individualized, but also draw on general knowledge of the kinds of problems that people often experience with different kinds of mental phenomena.

  • Hi Someone, I didn’t mean to suggest that I was assuming that “psychosis” is always something organic that can’t be approached with understanding and therapy, I just meant that this is a common assumption in the mental health field! What I was trying to suggest is that it often reflects just a further degree of alienation from one’s own experience, an alienation that often begins, as you suggest, with childhood trauma.

  • The recording of the webinar on this topic is now available, for free, at https://youtu.be/MO3_Odqq-7k I think Sean and his team are really on to something – for lots of people at least, I think turning toward the intense inner experiences they need to have and process, in a setting and at the time they choose, will be really effective in getting them to a place where they are no longer haunted by “disorders” that need suppression, by drugs or otherwise!

  • Hi JanCarol, I agree that this kind of work goes by different names and descriptions, including what we now call shamanic practice. I also agree with you that it offers a chance of true healing and entrance into the states of wellbeing you describe! So much different than spending the rest of one’s life trying to run away from certain experiences…..

  • Groups within society, or sometimes pretty much a whole society, can also be “out of touch with reality” and this is actually more dangerous than just an individual being out of touch, that’s something important to think about. Psychiatry is out of touch with reality when it ignores the down side of its treatment approaches. And critics of psychiatry are out of touch with reality when they exaggerate the down side of those treatments to make the issue seem more black and white than it is – for example by claiming that it’s a fact that the drugs are making people die 25 years earlier than average, when the science actually indicates the drugs as being one of a number of factors that are leading to early deaths – even if a very important factor.

    In my seminars on CBT for psychosis, I talk about how psychosis involves being disorganized and/or out of touch with reality, then I ask the students if any of them are perfectly organized or completely in touch with reality. If any answer “yes” I suggest they may be suffering from a grandiose delusion! I then introduce the dilemma, how can any of us decide for sure who is truly out of touch with reality if we are only partly in touch with reality ourselves? Then I suggest that what we really need to do is to dialogue about and investigate together different views about what reality might be, and that better approaches to “psychosis” work on that basis.

  • What most people mean by “psychosis” is being out of touch with important aspects of reality and/or being severely disorganized. Of course everyone is at least somewhat out of touch with reality, and somewhat disorganized, but it’s when it gets to seem extreme that people use the word “psychotic.”

    It’s kind of hard to argue that states of being extremely disorganized and out of touch with reality do not exist. I understand that some might like to use a different term for those states – some like the term “extreme states” – but it seems clear to most that these states of being do exist, and are worth talking about as something different than everyday states of mind.

    Some see “psychosis” as a medical problem that always implies a particular underlying medical condition. This theorized medical condition of course may not and probably does not exist – that is, some kinds of medical conditions can make people psychotic, but the fact that someone is psychotic is not good evidence that they have any particular underlying medical condition.

  • Hi Richard, what I was trying to say is that we need to accept something that doesn’t have its source in rationality, and this process may seem to be spiritual – about faith, not rationally sourced – though others might describe the same process in non-spiritual terms.

    The “validation by others” thing I agree is important, but it’s tricky. I developed my rational side in the first place in a large part so I could protect myself from the destructive side of the views of others. I was getting defined in a negative way by others, so learning to reject how they thought, to see the holes in their views, was important (just as it is important for those negatively defined by psychiatry to see the holes in the reasoning of psychiatry.) But then, if I wasn’t going to accept what others validated, what was I going to use as the basis of my understanding of world and self? It was like I had blown up the world and now had no where to stand on.

    What helped me was connecting with people who were at a similar point in their journey, and sort of making up our arbitrary starting point together. It was kind of like asserting “everything is true, we can start anywhere and make sense.” This did feel pretty spiritual to me – like rediscovering how the universe was created, out of nothing, out of the void – but someone else might have seen it in very different terms.

    I wrote more about some of these dynamics in this post https://www.madinamerica.com/2013/06/madness-and-play-exploring-the-boundary/

  • I’d like to comment on the two competing theories mentioned about the nature of the impairment of reasoning associated with “madness,” one involving the loss of reasoning, the other involving hyper-rationality detached from “the everyday world.” I would like to point out some ways these may be more complementary theories rather than competing ones, in the sense that the one leads to the other, like yin and yang.

    It might be more accurate to say that “sanity” is based not on reason, but on a balance or friendly relationship between reason and unreason, or as Marsha Linehan would put it, between “thinking mind” and “emotional mind.”

    In that case “insanity” is anything where this balance is missing. And often when there is imbalance, there is a going from one extreme to the other – so there might be hyper rationality detached from feeling; and then problems with that leading to feelings and emotions taking over, detached from rationality; and then problems from that leading to even more efforts to make “rational” distance from feelings and emotions that seem even more too dangerous to engage with.

    In my own experiences that were on the “psychotic” spectrum, it was these kinds of issues I was dealing with. I was very good at logic, but I also became aware of the emptiness of logic, and I would often quote Wittgenstein on that: “In fact all the propositions of logic say the same thing, to wit nothing.” To me that meant that everything was absurd or arbitrary, and rationality itself was an illusion. (Enter here a lot of disorganized or weirdly organized speech and behavior!)

    What brought me back to some approximation of “sanity” was something more emotional, an interest in human connection. I was particularly interested in connecting with others who could see the absurdities I saw: and once I found people like that, my interest in making the connections work made me focus more on that balance between reason and unreason that allowed me to connect with everyday life.

    It’s kind of humbling to many to recognize that our “sanity” is not based squarely on rationality, but on a mix of rationality with more arbitrary factors, something perhaps even more like spiritual revelation. But more awareness of this aspect of things would I think help us better understand some of the paradoxes around madness and some of the routes back to human connection.

  • I would like to thank Joanna for offering a thoughtful article about how we might best think about the problems that get called “mental disorders.”

    I know a lot of the focus of MIA, and especially of many of the commenters on MIA, is problems caused by those who try to “treat” “mental disorders” – and those problems are so great that it isn’t surprising some propose we would be better off if we just didn’t recognize anything like a “mental disorder” by whatever name – then there would be no efforts to “treat” anything, and no treatment induced damage!

    This approach unfortunately doesn’t work for the more severe forms of the problems that get called mental disorders – those problems can easily by themselves lead to severe life disruption and often death if not addressed in an adequate way. So playing “let’s pretend that the only kind of problem in the “mental health” field is the treatment itself” doesn’t play out well in the real world.

    We do need to continue to critique approaches that do more harm than good, but in a way that is balanced with an awareness that people do often require some kind of actual assistance with problems they have.

  • I haven’t had time to really review this in detail, but one quick comment: A lot of the basic questions suggested seem really good, but one I don’t care for. That is, “What did you have to do to survive?” This question seems to presume that the person had to do everything they did in order to survive, when in fact much of what we do in our attempts to survive may be unnecessary or even counterproductive – but still perfectly understandable given the threat we faced and what we felt at the time.

    So I’d replace that with a different question, “What did you do in your attempts to survive, and what impact did that have?” This can bring out both stories of responses that were really helpful, and ones that had other kinds of results. Some of the latter can be harder to talk about – it’s stuff we did that didn’t help our situation – but when we see it in the context of the story and the threat and what we were capable of at the time, it makes sense that we did it and also that we can act differently now.

  • I agree with Fiachra that one thing that can cause paranoia when stopping the drugs is just the rebound effect, the brain is used to the dopamine blocking effects of the drug, and with that gone, it starts over-reacting, like too much paranoia or suspicion. Of course, there’s also the problem that people can just be caught up in habits or patterns of thinking in ways that are too suspicious, the drugs dampen that down (by making everything seem less important) but then it bounces back when the drugs are stopped. So I would suggest starting to learn how to question one’s own paranoid thinking, by reading books like “Overcoming Paranoid and Suspicious Thoughts” and/or seeing a counselor who knows how to help with that – and then quitting the drugs only very slowly, so not too much paranoia comes out all at once.

  • Sometimes “approach” is a better term than “treatment” since it is more open ended. I appreciate JanCarol’s difficulty in making any kind of approach at all, with no backup. It’s easier when there is a team one can integrate with: then contact can be made, someone can connect with the individual, see more of what might be going on and what might be needed. And even if the person is so disruptive they have to be taken somewhere to insure the public safety, it would be nice if it was somewhere like I Ward, where there could be continued exploration of what needed to happen rather than just a suppression of anything “not normal.” https://www.madinamerica.com/2012/02/remembering-a-medication-free-madness-sanctuary/

  • Life is complex, and while doing forestry work really helped out at one point in my life, there was another point in my life where I was really stuck on some issues, unresolved trauma, etc. and I did find talk therapy to be helpful.

    Offering everyone, regardless of ability, some opportunity to earn a basic income would certainly undermine our current “fear of not having anything to offer the capitalist overlords” system! And that would really help resolve a lot of people’s problems, and if we had to choose between having any talk therapy or having the income scheme you describe we might do better with the income scheme, but the ideal combination if we could choose eveerything would probably still involve offering some talk therapy in my opinion.

  • Yes, it’s certainly true that talk therapy is not the best option for everyone! There are all sorts of things that might help. I think physical labor is one of the things that helped me “get grounded” – for me it was planting trees and doing other forestry work. So it was a mix of being physically active, being intimately in contact with nature, doing meaningful work and getting recognized for it, and social interaction with others in the course of the work, that had an effect.

  • I would say the idea that “psychotherapy” can help is just a variation on the idea that it can help to talk to another human being about one’s experiences.

    Of course, there are factors that might make “psychotherapy” more or less helpful than a simple conversation with a person trying to be helpful. For example, the therapist is at least usually paid (though sometimes is a volunteer) – getting paid could help the therapist be more focused and persistent in trying to help, though it could also be a corrupting influence. The therapist has training, some of which might help, and some might get in the way. Depending on the orientation of the therapist, he or she may buy into some mental health myths (or might not, and the non-therapist having a conversation might buy into myths, so it can be complex.)

    Anyway, it seems to me that it would be impossible to dismiss all of therapy as an unhelpful con without also dismissing the idea that people can have helpful conversations with each other. So maybe it would help to be less black and white about it all, and to recognize the possibility of both helpful and unhelpful exchanges. At least that’s my perspectivve, I recognize that some of your may really enjoy being harshly critical of anyone trying to offer menntal health assistance, and introducing nuance might cramp that style……….

  • Hi Maddestmike,

    I agree with you that one way we learn is to get messages that are the opposite of the truth, and then we follow them far enough to realize they are wrong, and that is how “the light gets in!” As you say, this isn’t a nice way to get to the truth, but it often works that way.

    I also think it is very tricky to talk about these topics, because words can be interpreted or intended so many different ways. I have quoted elsewhere the Discordian maxim that “all statements are true in some sense, false in some sense, meaningless in some sense…..” If we really listen to someone who seems to us to be “crazy” we may discover a sense in which what they are saying is true. At the same time, even what may be the greatest truths can be twisted into something which is very false or corrupt.

  • I agree with Daniel’s metaphor. We have to attend both to the system and the individual.

    Trauma is to some extent like a lie that gets told. If someone tells me a lie, the problem is initially the liar, but once I believe the lie, then the problem is inside me and I will also need to go through some changes to “get better.” If MDMA can help people reject lies that have become deeply embedded into them, that can be a good thing even if the person helping them is called a “psychiatrist.”

    I agree it will take more than just one thing to correct our messed up mental health system, and our messed up society, but going from a “daily drugging” model, to “use a drug at a strategic time to help create a transformative experience” model, would be a huge step in the right direction, and would be a substantial paradigm shift. (And it’s hard to see Big Pharma having much of a role, as the quantity of drugs required is minute, and already off patent.)

  • Hi JanCarol, even though at one level you are debating Richard, at another level I think you are moving toward the same point: that the separating of things can be a problem! So the idea that heaven and hell are somewhere “separate” from here can as Richard pointed out cause big problems – and even the idea that we either go to heaven or hell can be another kind of problematic separation (as opposed to the idea that we have experience of both, or that this same world can be seen or experienced as both heaven and hell, and more). Anyway, just a thought.

  • My sense is that Scott is mostly making sense here, and the criticisms are overblown!

    I see a huge difference between using a drug to essentially show someone that their brain can operate differently, and to get them to have an experience that helps them make constructive changes in a future that doesn’t involve taking the drug, compared with standard psychiatry which attempts to alter brain functioning every day.

    Of course, not all use of a drug like MDMA is likely to be transformative – but the combination of the drug with the right set and setting could I think have the potential to be truly healing. And healing, rather than daily drug suppression of the brain, would be a nice future focus for psychiatry. (Of course, if this was applied by force, it would be a disaster, and there are probably other ways to make this into a disaster, but I think Scott’s argument is just that we could take this in a good direction.

  • I would say that “love” and an awareness of oneness as at least one dimension of things is essential to healing. But there is a difference between real love and understanding of unity, and fake love for example that serves as a cover for aggression and corruption and abuse. I don’t think we should let the existence of the fake kind make us quit looking for the real stuff, instead, we just need to get better at telling one from the other.

  • I’m embarrassed to notice I had made an error in mentioning Chris Cole – it was really Tom Wootton’s Bipolar in Order work that I meant to reference! Sorry about that. I have asked the editors to correct it in the blog itself.

    Regarding the ” it’s not either or, it can be a whole range of both” comment, I very much agree. In fact, if it really is true that “the Way that can be spoken is not the true way” then whatever we speak will always be somewhat mixed up or “crazy” and if we recognize that, we might be able to be humble enough to be open to experiencing more of the truth and to seeing some truth in the different views of those around us.

  • Frank, I don’t recall me or anyone else here suggesting you should be persuaded, much less forced, to have any mental health treatment! But when you suggest all mental health treatment should be eliminated, you are advocating denying it to people who might want it and do poorly without some kind of assistance. And I don’t think you have any good argument for doing that.

    And I also don’t agree that advocating for some kind of assistance for mental and emotional problems means “medicalizing” those problems. It can rather be an open minded investigation into what the problem might be and into how it can be resolved. That might be making some kind of interpersonal change, or lifestyle change, or who knows what.

    Our current system of “assisting” is way too medicalized, and often is more unhelpful than helpful, but that just doesn’t prove that all help has to be that way.

  • Hi Frank,

    Are you proposing that no one should be paid to offer any kind of help or assistance to people who have any kind of mental or emotional distress, and who want help? It seems to me it’s one thing to say “help” shouldn’t be forced on people, or that people shouldn’t be tricked into thinking there is something wrong with them when really they are capable of getting on with things quite well without assistance – but there are plenty of people who get extremely distressed and confused before psychiatry ever gets to them – are you suggesting our world would be better if we just told those people to buck up and get on with life without any assistance? Or only with the volunteer assistance they might be able to find (which might be none, or very little?)

    I understand the “assistance” people get now is often worse than none at all, but I would maintain that it is possible to truly offer help, as we already see happening in some area, like where Open Dialogue is practiced.

    As for whether what I talked about in my post is science based – I would argue it is consistent with what we know scientifically even if it isn’t all “based” on science. After all, even the preference most of us have for being living instead of dead is not “based” on science, which has no way to define what is “better” in the absence of any assumptions about what we want to accomplish.

    I would argue the science around mental difficulties does indicate people do better when we talk to them in an open minded way about what might be the meaning of their experiences. And research also indicates that people who do recover are more likely to feel that what they went through led to some kind of transformation, not just a return to a state before the “disorder.”

    I don’t like religious dogma, but I do think spiritual language is one way of talking about realities that we all face, even those of us who don’t like spiritual language. And, thinking about how people who are talking very different from us may still be talking in some kind of way about something that is real is absolutely key to bringing respect for human differences into the mental health field.

  • I guess my perspective is that we do best when we are open to seeing there may be a problem within ourselves (unless we happen to be perfect?), and also when we aren’t too quick to think the problem is necessarily in ourselves or all in ourselves, and when we can join in social action to right wrongs, etc.

    As for your notion that psychotherapist are all avoidant of facing injustices, I wonder what you would make of my friend Chuck Areford, who has risked his job to be an outspoken critic of neuroleptics even decades ago when that was harder to do, and who more recently has been found week after week out in the rain organizing street protests, rush hour resistance https://rushhourresistance.org/

    I do agree that as a group, therapists tend too much to avoid speaking out about injustice. But over-generalizing doesn’t help – we also need to acknowledge those who move in the right direction.

  • I’m certainly not suggesting that we should quit paying attention to all the harmful things that happen that push people into psychosis. What I am suggesting is that within the process of the people who get diagnosed with psychosis, there is more going on than just the damage – there is also a person in there struggling to heal, and it’s in that struggle that the spiritual stuff happens. These “spiritual” experiences can be the foundation of a transformed and renewed life. If we can see and respect that, then I think we can be much more effective in helping people than if we just jump in and assume that everything that isn’t “normal” is pathology.

  • Hi Richard,

    Well, I always give myself mixed reviews, so I’m fine with you giving me one as well!

    For one thing, there’s always way more to be said about this kind of topic than can be said in any post of limited length, so there is always a lot left out. So I agree for example that I didn’t say anything about vulnerability to cults and such, and I agree with you that is a factor (though I did speak of the more general danger of bad ideas moving in when one has rejected the existing order and when one is really open, and being overly influenced by others like cult leaders is just one of the possibilities there.)

    I was aware that I could have said more about Dawkins and that perspective, but again, limited time, I decided to skip it. But here are a few of my thoughts. You mention that as you see it, there are there are “two separate definitions of “spirituality.” One is the unscientific belief of a spiritual world separate from the material world (God, Heaven, Hell, The Devil etc.) Another definition involves a search for meaning in life outside ourselves in various higher forms of human connectiveness, perhaps including in group efforts to transform the world into a better place.” But I think lots of other interpretations are possible. For example heaven can be thought of not as a literal place, like Disneyland, but as a dimension of consciousness that is possible when one approaches or understands existence in the right way. And this dimension of consciousness may not be very accessible to the “rich man” who relies instead on his riches to feel OK about things.

    I actually mentioned Satan only in the context of a story about Jesus that we have been told, so I don’t think what I wrote implied that he was necessarily more than possibly a hallucinatory/dream figure that someone named Jesus might have experienced when he was going through an extreme state of consciousness. But I do think Satan, like heaven, can be understood as an aspect or dimension of consciousness or a metaphor for a dimension of consciousness, so I would argue against anyone who would frame everything that has been said or written about Satan as nonsense.

    I do agree with you that religion is often fixated in distorted and dogmatic views that create great suffering, and psychosis for many may be an attempt to reverse or heal from that suffering. I do think that narrow minded religion is a threat not just to individuals but to the survival of the human race.

    As for why people like myself identify as God when we are in an extreme state, I could offer a few reasons. One is simply that this is a valid way of viewing our identity which we are rediscovering, an identity in which we are one with all of existence – for a coherent discussion of that perspective, see The Book, On the Taboo Against Knowing Who You Are, by Alan Watts https://terebess.hu/english/AlanWatts-On%20The%20Taboo%20Against%20Knowing%20Who%20You%20Are.pdf Another reason is that we are sometimes in the process of recreating the world by looking at it differently: we are all gods in the sense that we create our own worlds, and framing it that we are God helps bring attention to this proces.

  • I’m not familiar with Chris Cole’s perspective on psych drugs. But what I have appreciated is his perspective that the mood swings become not a problem when they are seen as providing parts of a bigger picture rather than something that either is taken too seriously (and dominates one’s point of view) or is seen as something that has to be eliminated (which is more the psychiatric perspective.)

    Mood swings may be more like voices: not a problem in themselves, but can be a problem if one’s relationship with them has problems. Like with voices, the problem may be usually either with giving them too much power or with focusing too much on trying to get rid of them (which in a backwards way also gives them more power, takes them too seriously.)

  • In my post I mentioned the webinar, “Recovery-Oriented Cognitive Therapy: Resiliency, Recovery & Flourishing” presented by Paul Grant and his team. The recording of that is now available at https://www.youtube.com/watch?v=YzyP7beP1r0

    I think it’s worth watching! They are advocating for a very humanistic approach, and talk about the need to change the whole culture around mental health treatment, and some practical ways to get a start on that. One thing they comment on is how “quiet” treatment centers become when the emphasis is on suppressing “pathology” and how they should and can be very lively when the emphasis shifts to how to help people more toward their aspirations.

  • Hi Tireless, am I correct in hearing that you believe there are problems with my views and so I need to change, but yours are definitely without any problem and no one should ask you to consider changing anything about them? Just asking. (Unfortunately, many mental health workers come on with the attitude that they are “sane” and don’t need to change, while the other is “insane” and does need to change: maybe you are just trying to turn that upside down, but I think the opposite of one mistake is often just another mistake.)

    Regarding your assertion that “psychotherapy is wrong because it is profiting from the suffering of others” – are you asserting it is wrong for anyone to be paid anything to try to assist people who are having psychological distress, because that would be “profiting?” Are you also opposed to anyone being paid to assist people who are having physical distress, like a doctor attending to a broken arm? Where do you draw the line at what is unacceptable “profiting?”

  • I think we are more likely to be able to come together and do well when we are open to the idea that we all have problems and probably need to change in some ways. So that includes the mental health system, families, social systems, and individuals, including but not limited to those who are diagnosed.

    And it does certainly often help to talk about it. Psychotherapy is just one way to talk, not always necessary, but can be helpful in my opinion. I can certainly understand wanting to ban bad psychotherapy, but I can’t see a reason to want to ban all of it!

  • Hi Sam, I was referring to voice hearers themselves “calling the bluff” of threatening voices that pretend to be able to do big harm if the voice hearer does not comply. That can often be important to help the voice hearer. Relationship, compassion, love, that stuff is all needed too – and it’s easier for the voice hearer to offer that once they aren’t terrorized by the voices!

    In some ways, working with voices is like working with children, or just other family members in general. Both boundaries and love are needed.

  • Hi Someone Else, I agree with you that we don’t have proof that telepathy doesn’t exist, so it always could be possible that it exists and a real person could be using it to communicate threats! But what we know for sure is unhelpful is believing that a voice belongs to someone external who can and will carry out threats, in the case when that is actually not true. Quite a few people have experienced being intimidated by threatening voices, and only once they learned to “call the bluff” of the voices were they able to regain control over their lives.

  • Are our thoughts “real or imagined?” That’s a good one!

    How about the answer that they are “really imagined?” Because imagination is itself a real thing!

    I do think there is such a thing as believing voices have a reality that they don’t have – like believing that voices belong to real people that can kill one’s whole family if one disobeys a command. But the opposite belief, that voices have no kind of reality at all and don’t provide any useful information at all, is also very unhelpful.

  • We know that antipsychotics work by suppressing dopamine, and we also know that dopamine is the brain transmitter most associated with anticipating something. That means it is associated with both hopes and fears, so suppressing it will suppress motivation along with things like grandiosity and paranoia. (Of course it gets complex, since some people who were overcome by paranoia might be more motivated to do everyday things once they are less paranoid, etc.)

    Richard Bentall reported the way they tell it a drug has antipsychotic properties in a rat. You train the rat to anticipate that if it hears a certain bell, it will be shocked unless it moves to another spot. Then if you give it a drug that has antipsychotic properties, it will quit responding to the bell (in anticipation of the shock) though it will still respond to the shock itself.

    I think if more people were aware of what these drugs do, they would be used much less frequently, in lower doses, and for more limited periods of time.

  • Hi Someone Else: I share your disgust for those who cover up pedophilia and the damage caused by it, for example those like NIMH who still pretend to not know that childhood trauma and abuse is a possible cause of psychosis down the road. But I don’t share your conclusion that everyone involved in mental health is part of the cover up, because I know quite a few people who are involved in that field who work to increase awareness of the problem. Of course, many of those have been abused themselves, and so they carry that fire, that sense of outrage, that doesn’t let them be easily shut up.

  • I resonate with what you are saying, highfellow! I like you sometimes wish I were more like others in some ways, but then at other times I really appreciate my differences. If I can remember that my differences have value even when I am wishing they weren’t there, and also remember that there might be value in the way others are even when I am feeling happy to be different from them, then maybe I can find some kind of balance. (Of course too much balance or moderation isn’t good either, as in the old saying, everything in moderation, including moderation!)

  • My entrance into becoming a counselor was different than most – I participated as an activist with MindFreedom for many years before I went to graduate school and then started working in the field. So I already had an awareness of how corrupt things could be. And I had the good fortune to be hired by an agency that did counseling but not drugs, and had leaders skeptical of drugs (the first time I heard the DSM compared to the Malleus Maleficarum (the book used to “diagnose” witches) was in a presentation made by one of the leaders of this agency to all the staff.) So I haven’t had the kind of pressure you experienced. I did work for a few years just part time at the county mental health department, where there was pressure to fit in with the medical people – but I deliberately bucked the pressure and gave them a hard time, till they decided they didn’t need me working there anymore.

    In another post, Will Hall wrote about how we have to do something about corruption if we are ever going to have the big changes we need. Pressure on professionals to go along with faulty views if they want to keep their job is just another kind of corruption.

  • I think it is important for a movement to both celebrate its successes as well as notice its failures, and I think it’s way overgeneralizing to say simply that we have so far failed.

    There are lots of people who have regained control of their lives due to help from our movement and the messages that we have promoted. These are real people with real success. That success should be counted, even though we know it is only a small minority that have been helped so far, and in many ways the oppression we fight is just spreading.

    I would agree that the bigger changes will require political change as Will indicates. But while I think we should see and work with how our movement links up with larger ones, like the one to get big money out of politics, I don’t think we should just give up all our mental health reform organizing to, say, focus exclusively on the money issue! A better approach I think is to present our issues as being just one of many where corruption is leading to bad outcomes.

    Getting the big money out of politics is also something that people have been working on for a long time, also not with great success! But if these efforts ever do succeed, it will be because the public notices the vast areas of corruption and the damage it is causing. Activists in our field can help by increasing awareness of corruption in our field, while also doing our best to bring a better approach wherever we can.

  • Thanks for writing about this. I practice and teach CBT, and I’m ashamed to have this kind of practice associated with CBT! It does violate some important principles, starting of course with the fact that CBT is supposed to be practiced by collaborating with the person receiving services, and with the aim of helping that person achieve that person’s goals, not the goals of the therapist or psychiatrist. It’s also supposed to be about helping people arrive at balanced thinking about a topic, which means exploring the positives and negatives of a given course of action – rather than deciding in advance what to promote!

    I think some professionals have become so convinced that the drugs are necessary, that they see any impulse to quit drugs as being completely irrational, and so they feel entitled to do whatever they can to get people to persist in taking them. As Noel Hunter pointed out recently, too many professionals spend way too little time considering that some of their own opinions may be wrong, irrational, etc.

  • Since 2013 the use of opiates has increased all over the US. Is it possible that this, and not legalized pot, might be behind any increase in teen use of opiates?

    Maybe instead of making recreational pot illegal again, so sacrificing tax revenue, turning the recreational pot market over to black market people, and then spending lots more tax money to arrest and imprison people (and you have to add on the massive social cost of harming the people who are imprisoned) – maybe instead of that idiocy, we could actually spend a little money helping protect teens from abuse and helping them find something better to do than use drugs? Remember rat park http://www.brucekalexander.com/articles-speeches/rat-park/148-addiction-the-view-from-rat-park

  • You wrote that “These findings underscore the impact of early onset of marijuana use on executive function impairment independent of increased frequency and magnitude of use.” Well no, they don’t. You are jumping ahead of the actual evidence.

    The problem is that the experimenters didn’t just randomize kids into those who were going to smoke early and those who wouldn’t smoke: instead, they worked with a group who self selected to smoke or not. And a contrary hypothesis would be that those who decide to smoke a lot are those who already are likely to have the brain differences you mentioned. The marijuana itself may have nothing to do with it.

    I seem to recall a study where it was found that kids who smoke marijuana were more likely to have been sexually abused, and the sexual abuse itself may be what often led to brain changes that then led to vulnerability to psychosis. Other kinds of trauma, and factors in addition to that, could also be at play. I’m not saying we should rule out the possibility that pot is itself causing serious problems, it’s just that we shouldn’t jump to that conclusion, especially when there are so many people ready to ruin lives in another way, by throwing people in prison for the crime of using or selling substances not provided by psychiatry.

  • Chuck, if the experience of taking pure THC is so terrible, I’m sure we don’t need laws to keep people from doing it! One of the nice things about having pot be legal is that people can know about the balance of THC and CBD in the strain they are buying, so they are more likely to get the experience they want.

    Of course, it’s also possible that some people will enjoy the same drug that another person hates. People don’t all react the same to a substance.

    I would agree that it makes sense to discourage pot use in adolescents, and that at least in some cases, pot use can contribute to psychotic experiences (I had that happen to me when I was a teenager.) But it is not clear that pot on average is making more teenagers psychotic – see articles like https://www.scientificamerican.com/article/can-marijuana-cause-psychosis/ We need a balanced approach to this topic, not one that exaggerates problems and then advocates for arresting and imprisoning people to “solve” those problems (without ever considering that there are huge costs to labeling people’s choices as criminal and locking them up.)

  • I find all the concern about the potency of the drug to be a little lame. In the past, people had to smoke a lot of pot to get really high if they wanted to – and they did, when they wanted that. Now people don’t have to smoke nearly as much. Smoking less seems good for the person’s lungs. The idea that high potency equals danger seems to rest on the idea that people will get way more high just because it is more potent – as though people have no ability to regulate how much they smoke, or otherwise ingest.

    Like any drug, we need to hear about the bad as well as the good about pot. But for too many years, we have had lots of hype about how bad it is, and all this concern about dosage sounds like more hype to me. (For example, the hype that pot use leads to other drugs. In regards to opiates for example it seems more likely that pot use leads to less opiate use – https://www.nbcnews.com/health/health-news/legalized-marijuana-could-help-curb-opioid-epidemic-study-finds-n739301 )

  • I like Mark Twain’s comment: “Let us consider that we are all partially insane. It will explain us to each other; it will unriddle many riddles; it will make clear and simple many things which are involved in haunting and harassing difficulties and obscurities now.”

    I agree with Sera that there are problems with calling Trump mad: but there are also big problems with not noticing he is in a sense mad! So I don’t have an answer to offer, maybe we just need to have a dialogue that won’t have a solution.

  • Jolly Roger, I think I will choose to leave this dialogue, as you keep making lots of assumptions that don’t relate at all to what I see happening, such as your claim that therapists always stand with and make excuses for abusive authorities.

    But before I go, I would like to say something in response to Masson’s statement you quoted, “The practice of psychotherapy is wrong because it is profiting from another person’s misery.” Would you say the same about a doctor who helps people with broken bones? After all, the doctor would have no job were it not for the misery of those with the broken bones.

    My point would be that if what the doctor or therapist do actually helps with healing, then their practice is worth something.

  • Jolly Roger, it sounds like you must have had some pretty terrible experiences of “psychotherapy.” I wonder though if you ever consider that perhaps some others have had very different experiences, and may have been helped by therapists?

    I think you are making a false conclusion when you suggest that if injustice is the cause of problems, then there shouldn’t be any focus on helping the individual change.

    In the case of physical trauma, we know that’s not the case. If my arm is broken during an assault, that’s an injustice, but I also need to work on changing the state of my arm, because there is now a problem with it. And the problem with my arm doesn’t go away even if the injustice of the assault is fully recognized and those who assaulted me are punished or apologize and reform themselves or whatever.

    I think mental and emotional trauma is often the same. It starts with injustice and abuse, and we do need to recognize that, but also we need to create the conditions for healing within the individual, and in the experience of many of us, a good therapist can be helpful with that.

  • Tim, I don’t think anyone here has proposed saying that people taking drugs can’t be counted as being engaged in recovery! The discussion, instead, was always about whether or not it made sense to say they were “fully recovered.” I objected to that only because it implied that such a person was done with recovery, and being done or finished with recovery of course implies that one couldn’t possibly recover any more, which would imply that there was no possibility of ever recovering more to the point of being able to get off the drugs.

    By the way I don’t believe in rating people as somehow “better” or “worse” because of the degree of recovery they have achieved. There’s a lot more to life than recovery from specific problems. A person may have been in an accident, and still walk with a cane, and so they aren’t “fully recovered” from the accident but they may be making amazing contributions to the world not being made by others who were never in such an accident or who were but are now indeed fully recovered. The same with particular mental/emotional injuries or difficulties. I agree with you that “mad diversity” is complex, as is human diversity generally, and there is so much about the value of each human being that is unrelated to whether or not they have “fully recovered” from any particular problem.

    I understand that people relying on drugs to stay stable etc. may decide it isn’t worth the risk and the effort to try and get off the drugs. I can’t tell them they are wrong, because I don’t know if they are wrong or right. But what I do know is wrong is anyone telling such people that we know they have gotten as far along on the road to recovery (or healing, if you prefer that word) as is possible, when for all we know, it really is possible for them to go further, if they decide that matters to them.

  • I found myself agreeing with everything that was said in this post!

    One way of conceptualizing psychosis is to see it as the mind’s attempt to turn to confront things that seem to the person otherwise too much to face. This seems to be “loosing one’s mind” because at first one cannot have a coherent mind in relation to those things (which might range from childhood abuse that was never integrated to facts about existence that no one in the culture seems willing to face.) But if people are supported, they can often find a way to face what were formerly overwhelming aspects of existence in a coherent way.

    One reason this process is so hard for our society as a whole to grasp, is because we can’t really support people in this process without acknowledging that there is a lot out there that most all of us have not learned to face directly……

  • Hi Daniel,

    As I see you respond to these comments I start to understand your thinking better. If you are talking about recovery as meaning just finding a way back to having a place in society, then it does make some sense to say one can be “fully recovered” and still taking some psych drugs.

    But the distinction still seems clunky to me. To use an analogy to something physical, I’m imagining a tennis player who suffers an injury, which gets bad enough that she can no longer play. Using terms the way you are using them, one would say that she was “fully recovered” once she could return to the game without impairment, whether or not she was still wearing a brace or needed regular physical therapy etc. to keep functioning. But one would only say that she was “fully healed” when no such supports were needed.

    I don’t think though that most people make such distinctions between “recovery” and “healing” – instead, the terms get used more interchangeably. And if people want to make the kind of distinction you are making, they use a few more words: for example, our imagined tennis player might say “I have made a full recovery in terms of my tennis game, but I can still only function at that level if I wear a brace…..” This both outlines the progress that has been made and describes what is not yet “recovered.”

  • I think there is indeed a big paradox in looking for a “cure.” When someone believes they have an illness that makes them fundamentally different than everyone else, then they will seek a fundamental change in themselves to fix or “cure” or eliminate the problem. But if there really was no fundamental difference in the first place, then there will be no way to make this fundamental change, and the person will just feel stuck being “ill!”

    The only way out of this is to give up the search for a “cure” and look for ways to get on with life while being the person one is. So instead of getting rid of one’s paranoia for example, one might look for a way to live with it and not take it too seriously, to balance it with other thoughts and feelings. Eventually one might find that the paranoia is still present in some form, but is no longer interfering (but maybe is even being helpful some of the time, helping one avoid being too trusting.)

    A lot of the problem with mental health treatment approaches is that they get people focused on getting rid of parts of themselves or reactions within themselves that they have learned to frame as “illness” – when a better approach might be to just accept those parts and reactions while experimenting with relating to them differently, so that life can proceed. Once people do that they might discover that they aren’t fundamentally different than other people at all, that we all face that task for example of having paranoia (and reason for paranoia!) yet also the need to keep paranoia in check, and we all can recover from temporary losses of balance in managing this, even when that loss of balance has been more extreme.

  • Hi Frank, I get it that “heartbeats of hope” could come across as sappy, but I think Daniel Fisher sometimes emphasizes emotional stuff because in the past he was around people who convinced him emotions and feelings were something to be eliminated and pushed away, and he only put his life back together once he made space for emotion and feelings. He’s very aware of how affect is central to our existence, and I don’t think he’s wrong about that – Michael Cornwall emphasizes the same thing.

    I agree with you that “resolve” is sometimes a better word, but “recovery” does have a wide meaning as well. One recovers not just from illnesses but also from traumas, and one can recover after losing one’s balance, etc.

  • Yes, recovery is a tricky concept, especially when you include the idea of “vulnerability to relapse.” Some people would say that if you have had a mental breakdown or had been caught up in addiction, then you should always consider yourself to be more vulnerable than the average person, always “in recovery” rather than recovered. But as Ron Bassman has pointed out, this may not be true in particular in regard to mental breakdown or crisis. He noted that as a result of his recovery from two episodes of psychosis, it was possible that he had learned a lot and gotten stronger in various ways that actually left him less vulnerable to future episodes of psychosis than was the average person. The same could be true of some people who had previous trouble with addictions.

  • Hi Steve, I very much agree with you that it is difficult to determine exactly how many of the early deaths that bad psychiatric practice is causing. That issue is open for debate. But my point is simply that we shouldn’t talk as if we know that psychiatry is causing all of them, when we have reason to believe that some early deaths would happen even if psychiatry did not exist.

    And I agree with you that corrupt psychiatrists will try to paint us as extremists whenever we criticize them. My point there is simply that we shouldn’t make it easy for them by making claims we can’t back up with facts.

  • A few more points:

    In response to FeelinDiscouraged: I don’t feel any need to always get along with psychiatrists. I was fired from one job for repeatedly criticizing them, and where I work now I was recently attacked by a psychiatric nurse as being a danger to my clients because I’ve attacked his belief that he can know that some people need to stay on drugs.

    To Uprising: I do believe that anytime we express views that are more “radical” than are justified by the facts, that we are being a liability to our movement. I think just as we insist that psychiatry should face facts, we should also be willing to do so.

    And samruck2, yes, you are correct that I see myself aligned with Whitaker, being critical of bad psychiatry or opposing psychiatric corruption, but not being opposed to any thoughtful and restrained medical assistance with mental or emotional problems.

  • Michael, if you really are at risk of coming across to people as an irrational fanatic, and then if I point that out to you, I hope you can see that’s a friendly action. Much as if you were at risk of driving off a cliff and I pointed that out, it would be a friendly action, an effort to help you out. I’m trying to save you from going over the cliff, because I support the main drift of what you are doing, and I don’t want you to lose your credibility by making claims you can’t back up. You have enough claims that are solid, why not rely on those?

    By the way, in response to FeelinDiscouraged, I agree that educating the public is more doable than educating most psychiatrists. But still, it takes having some credibility, which is easily lost when we put forward supposed “facts” that are easily disproved.

  • Richard, we probably just have to agree to disagree here. You aren’t convincing me of anything. I know that sometimes it is important to condemn something as both harmful and useless – as it was with the Vietnam war. But that model or metaphor doesn’t fit everything. Sometimes those who imagine themselves the “vanguard” go overboard and lose credibility as they start making attacks that go beyond anything that can be justified. Then the whole movement that “vanguard” is part of is weakened. That’s my view, and I don’t imagine it will shift anytime soon. I hope some of those reading these comments will be able to take my points into account and will become more effective as a result.

  • Michael, in his comments for example, made points about how patients are dying at dramatically high rates under psychiatric care, and he even explicitly said he sees the deaths that happen when under the care of psychiatrists to be “wrongful deaths.” I actually agree with Michael that many of these deaths are due to bad treatment, my point is simply that it is wrong to suggest that they all are, when many people who are having severe mental crisis would die earlier than usual even if there were no psychiatrists.

    There are certainly plenty of wrongs being practiced by mainstream psychiatry, and ignoring of evidence for wrongs, we don’t need to be exaggerating to make our points.

  • Richard, I’ve already stated that my interest is only in defending psychiatry against unfair attacks, not against the fair ones. And you are right, this does have something to do with my interest in appearing credible as an educator – but I also want to convince as many of the contributors and readers here as I can to also frame arguments so as to come across as credible, rather than as fanatics making irrational attacks! My interest is in seeing us really persuading people (not just the choir members) and causing change to be made, and that does require coming across as credible in my opinion.

  • Hi Seth,

    I very much agree with the idea of holding psychiatry responsible for all the things it is guilty of, many of which you list. I am simply opposed to charging it with offenses that it is not guilty of. I think this weakens our case overall. All psychiatry has to do then is refute the false charges we have made, then use the fact that these false charges were easily refuted to imply that all the other charges are also baseless.

    We are much better off focusing on the issues where we are clearly right, and where psychiatry and the mainstream mental health system has been clearly wrong!

  • Michael, are you saying that if psychiatrists lie and say psychosis is a medical illness when it isn’t, then it is OK to hold them responsible for every early death, even though we would expect many of those with psychosis to also die early if there were no such thing as a psychiatrist?

    It seems to me that you are dodging the question of whether or not it is OK to leave the impression with readers that psychiatry is to blame for all of the early deaths of those diagnosed with “psychotic disorders” etc. As you know, I very much am in favor of blaming them for SOME of these deaths. But if we are ever to get beyond preaching to the choir, we need to use arguments that we can back up with facts, we need to avoid sounding like we are exaggerating anything. Blaming psychiatrists for all of the early deaths plays well for the MIA audience, where most (with good reason) are angry with psychiatry. But it doesn’t hold up when looked at critically, so it makes your argument unlikely to carry beyond the “choir.”

  • Michael, it seems to me your post would be read by most anyone as blaming psychiatrists for the 25 year early death rate, which you call “obscene.” Would you agree that it comes across as blaming them for that?

    My point is simply that we should take care to only blame psychiatrists for what they are actually responsible for, and no more. Your article was about the stupidity of psychiatry, and what they are to blame for. When figuring out how much psychiatry is to blame for early deaths, it’s really irrelevant whether the early deaths are caused by some physical or organic process, or something else; the key question is just whether and to what extent psychiatry is to blame for them. I think it is clear that most anyone reading your article would think you were blaming psychiatry for all of the early deaths, while I think the evidence would indicate they are only responsible for some of them. Do you agree or disagree?

  • I certainly agree with the main point, that mainstream psychiatry with its disease model shows a lack of good sense or judgment.

    But I would also point out that good sense or judgment are not so easy to come by when we are facing something that seems threatening.

    Terrible experiences are threatening to people, and so they often lose their good sense or judgment and become mad (or become fools, as the medieval expression had it.) Those faced with madness feel threatened, and often lose their good sense and judgment, and embrace destructive dogmas like the medical model.

    But it doesn’t stop there: because people who feel threatened by the foolishness and destructive power of psychiatry don’t always show the best “sense and judgment” either.

    One way this comes out is exaggerating the wrongs of psychiatry, which has the unfortunate effect of reducing the credibility of our movement.

    Michael, you wrote that “….psychiatry stands alone among all other medical specialties with a death rate of psychiatric patients that has them dying 25 years sooner than the average life expectancy. And this obscene death rate is for so-called diseases — such as what wrongly gets called schizophrenia — that have zero lethal, physical or organic risk.”

    Really, “zero” lethal risk for the kind psychic turmoil that gets called “schizophrenia”? It seems to me that this is actually far from the truth. Without any help from psychiatry, madness can lead to suicide or extreme or risky behavior of many sorts that can lead to early death. And those who become mad are often people previously subjected to childhood abuse, which we know puts people at risk for an early death from a huge number of ailments.

    I think we come across as much more credible and effective when we “only” blame psychiatry for contributing to the early death rate by pushing dangerous drugs that often aren’t needed, rather than blaming them for all the deaths when that accusation is easily refuted.

    I think we all have important truths to tell, but we can only manifest “good sense and judgment” when we also watch out for our own errors and seek to correct them, rather than dig in and defend them. Michael, I know that you in particular have important truths to tell! I hope that all of us, the “mad,” the psychiatrists and mental health workers, and those who critique psychiatry etc., will find the space to slow down and notice errors, so we can all come to really practice “good sense and judgment,” qualities that are not easy to find!

  • Bonnie, I want to notice that in your last comment before this one, you agreed that some medical assistance could be of use for some people who had mental and emotional difficulties, but then stated this could always be done just as well by a general practitioner. I refuted that notion, and explained why it would make no sense to ban doctors from specializing in this area.

    Now, instead of attempting to refute my point, or alternatively acknowledging that I was correct, you are just redirecting attention to another flawed argument, which is the notion that all of psychiatry rests on myths and misrepresentations.

    Clearly, “mainstream” psychiatry does rely on such myths and misrepresentations. But you aren’t just calling for abolishing the sort of psychiatry that relies on such myths and misrepresentations: you are calling for abolishing all of any possible psychiatry, all of any branch of medicine specializing in helping people with mental and emotional problems. For this argument to make sense, you have to give us a reason for society to stop any group of medical doctors from specializing in helping with mental and emotional problems even in a well informed and humble and humane way: and you have clearly failed to provide reasons to to that.

  • Hi Oldhead, you may imagine that the psychiatric people I talk to sometimes “fear and loathe” antipsychiatry, but I’ve been in these conversations, and it’s obvious to me that the term is one they see as making someone easy to dismiss, like calling them a Scientologist or a flat earther or a racist. What they have a much harder time dealing with, what they can’t easily dismiss, is someone who has a clear focus on what’s wrong with particular psychiatric practices and who can articulate why these practices are harmful.

  • Hi Julie, I think you are right that for most people, the only “help” they might actually need from a psychiatrist is help getting away from or free from any kind of psychiatric intervention!

    But there are other kinds of stories. People can get into terrible mental states, or even end up dead due to mental and emotional distress, without ever encountering the mental health system, so we can’t blame that system for all the terrible problems people experience. And sometimes people actually get pretty well informed non-medical help with mental and emotional problems, and are still stuck in some terrible states. And sometimes people who are stuck in those ways actually do find some help in psychiatric interventions.

    This may be rare, but if it happens even once or twice, that implies that abolishing all of psychiatry would be a mistake, as it would make that kind of help impossible. So it makes more sense to simply call for abolishing all of the corrupt or misguided parts of psychiatry – that can be done without denying anything to people whose story is different from many MIA contributors, and who actually might benefit from something that could be called “psychiatric.”

  • Bonnie, I want to notice that you are no longer claiming that any possible good work done by someone calling themselves a psychiatrist “is not medical in nature” – I’m glad you are abandoning that flawed argument which you offered earlier.

    But it seems you are now falling back onto another flawed argument, which is the idea that while medical methods may sometimes be helpful, we should nevertheless abolish any attempts by anyone to specialize in offering medical help for mental and emotional concerns, and seek to make sure that any such help will only be offered by medical doctors who have no special expertise in this area!

    I do understand the sentiment behind the above argument. If a specialty is corrupt, and mainstream practitioners within that profession have beliefs and practices that routinely cause great harm, then one is likely to do better going for help to someone who is not a specialist.

    But really what is needed in the big picture is simply the elimination of the corruption, not the elimination of the specialty.

    It should be noted that people routinely get lots of terrible “help” from general practitioners as well as from psychiatrists. A non-corrupt psychiatry, like any good specialty, would seek to sort out what is truly helpful from what is not, and would guide general practitioners in becoming more effective in helping, and in stopping doing the harmful practices. It would also be seeking to understand more complex questions and possible interventions that may be beyond the grasp of general practitioners, as in the work being done by the doctors in the mental health excellence article I linked to above, where they were finding and treating metabolic problems that contributed to very serious depression. I know, this sort of thing is currently rare, because psychiatry by and large is currently very corrupt. But it is possible, and the possibility of any specialized medical help for people with mental and emotional problems means that any call to completely abolish such specialized help will inevitably come across as fanatical and illogical, and as an overreach. It’s a much stronger position to simply be against “bad psychiatric practice” which can be understood to include most all of what mainstream psychiatrists do (including believe in the DSM.)