Tuesday, January 22, 2019

Comments by TheSystemIsBroken

Showing 45 of 45 comments.

  • Just to clarify…if someone tells his lawyer that he just murdered someone, that lawyer is ethically obligated to maintain his confidentiality and defend him, despite knowing that he is guilty, but if a completely innocent person makes a comment that implies he may want to harm himself, it’s an ethical dilemma as to whether or not to report that client????

  • The “borderline” label seems like yet another example of psychiatry blaming and pathologizing the victim. This is from http://www.thesystemisbrokenblog.org/2014/11/16/abuse-victims-called-mentally-ill/:

    While some abusers have long psychiatric histories, or attempt to use a psychiatric label to justify their actions, many seem to effectively avoid labeling altogether. It seems like victims’ behaviors are more frequently pathologized, while abusers are simply spoken of as evil monsters. The problem is, many people who have suffered within the confines of the mental health system would actually rather be considered “evil” than “mentally ill.” Being “mentally ill” can often induce more fear in others than being a violent criminal, as we see criminals’ actions as wrong but not inherently irrational, while many consider “the mentally ill” to be prone to completely random, unexplained acts of violence, instigated by little more than faulty brain chemistry. The fact that many studies proclaim that there is no psychiatric label which, without consideration of other factors, is associated with a significant increase in violent behavior, is widely ignored. As abusers are seen as “bad,” yet rational, they can be looked at as more redeemable than their seemingly unstable victims…We must move towards a culture in which people can experience a wide variety of lasting effects from abuse or any other adversity without being pejoratively labeled, and where such individuals will never have to suffer without justice, safety or liberty on the basis of a presumed “mental illness.” We have an absolute responsibility to protect, support and find justice for those who have been harmed. When any given profession interferes with these noble goals, whether or not it is considered a “healing” profession, it must be stripped of both coercive power and assumed legitimacy.

  • I have no doubt that there have been some therapists who, historically, have planted such ideas in their clients’ minds in a way that was truly incorrect, but knowing many abuse survivors and having worked with them for years, most of what I have seen has been survivors dissociating from traumatic memories to the point that they are completely unaware of them (or, sometimes, of their entire childhoods). Later, when other parts of their life seem a bit more safe and stable, or upon entering into a trusting relationship (which could be with a therapist, friend, mentor, etc.), these memories start to come back, and are, quite often, disbelieved by those around them- including mental health professionals. While, in many cases, it is far too late to objectively confirm or deny whether or not a given event happened, I have repeatedly seen quite a bit of evidence arise that confirms these accounts.

    This site continuously outlines the need to take a good, hard look at so-called mental health professionals and the harm that many of them do in the name of “help,” but I feel that those of us who write or comment here are morally obligated to walk a fine line and not blame the victim in the process. Every article that, in any way, insults MH professionals is not necessarily an appropriate criticism- especially when the end result is inventing yet another reason for abuse survivors to be disbelieved.

  • I agree. Unfortunately, I don’t think we’ll ever know whether or not these drugs may have caused/worsened suicidal impulses for Robin Williams, although it is certainly possible. At best, psychiatry failed to help him, as it fails to help a remarkable portion of the people it claims to serve, and at worst, this was yet another iatrogenic tragedy.

  • I absolutely agree, Steve. I spent several years working with children who had been horribly traumatized, and even before I began questioning psychiatry, it horrified me that so many of these kids would identify themselves as a psych label. I don’t know why anyone feels the need to tell a child who was abused his whole life and then thrown around between a dozen or more foster homes, group homes, and other institutions that he is not more than entitled to be incredibly distressed about the things that he is dealing with, and instead hands him a bunch of labels and pills. With toddlers, trauma/other life experiences aside, EVERY toddler acts in ways that seem “bipolar” or “ADHD,” because THEY’RE TODDLERS. I mean, are we going to start bringing newborns to psychiatrists because they cry all the time, and are clearly “clinically depressed?”

    I think part of the problem is that psychiatry is primarily ruled by wealthy, white, career-oriented men who appear to have limited experience or awareness of how poverty, abuse, and discrimination impact people and of what normal child development even looks like. Now, I don’t question that some young children may be in intense emotional distress, but I cannot understand why the response would not be to ask what is so wrong in this child’s environment to make things so difficult for him. Or, we can just let the establishment continue to give lip service to preventing child abuse while it continues covering it up by labeling victims as “mentally ill.”

  • Agreed. I’d love to see the day when, instead of telling someone that they’re “clinically depressed” and have a “chemical imbalance” because they’re stressed about overwhelming financial problems, that a psychiatrist could write a prescription for cash, in the amount of the 8+ drug cocktails that his colleagues often prescribe. In fact, here are some other things that would have helped me far more than the psychotropics that were prescribed to me for years:

    1. A safe shelter from abuse;
    2. Empathy;
    3. Hearing that the traumas I endured were not my fault;
    4. Doing absolutely nothing, and not pushing drugs that simply dulled my emotions and made it impossible for me to truly heal.

  • That is so true. Children are taught that their views, goals, hopes and dreams are inconsequential and that they are completely at the mercy of whatever adults happen to be related to or otherwise responsible for them. Then, we blame children for not telling anyone when those same adults, who have absolute power of their lives, abuse them. Anyone else see a problem?

    I have this crazy theory about how to interact with children. It’s that children are actually human beings. They are not lumps of clay to be molded by those around them who have existed on this planet for a longer period of time. They have innate empathy and wisdom that cannot be ignored, and no matter what has happened to them, they are unbelievably resilient when they are provided with safety, loving support, and opportunities to talk about their experiences without facing any judgment. Yes, children often need guidance from adults, but there is a massive distance between collaborating with a child to help him make the best possible decisions and simply demanding compliance.

  • Creating genuinely safe, loving relationships with children and a being willing to advocate for what a given child truly wants (this arbitrary standard of doing what is “in the best interests of the child,” rarely seems to work out in the best interests of anyone but the adults calling all the shots) seem to work as much more effective “prevention.” The association between “psychopathology” and violent crime is very disturbing, especially in regard to children, who really shouldn’t be thrown into either category. I’ve worked with children who were involved with gangs and committed a range of violent acts, and found that for most of them, with some love, stability, and empowering support, were able to break free of these gangs, as they often described their reasons for joining as a need to belong and feel that someone cared about them. Oh yeah, and for several years, my volunteers and I accomplished all this for about $150/child.

  • Agreed. I’ve done quite a bit of research on this, and have found that the overwhelming majority of “confidential” hotlines will send police at the sole discretion of the individual answering the call. The following is the section on suicide hotlines on http://www.thesystemisbrokenblog.org/resources/ (resources for those looking for help with child abuse, domestic violence, psychiatric abuse, sexual assault and self-injury and their respective confidentiality policies can also be found on this page):

    Suicide

    National Suicide Prevention Lifeline- 800-273-TALK or http://www.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx- This is a 24/7 hotline that connects callers to their nearest suicide prevention agency to speak with a crisis counselor. The online crisis chat is only open from 2:00 PM to 2:00 AM EST. Crisis centers in the lifeline network are expected to call the authorities regarding callers who are attempting suicide during the call or who they deem to be “at imminent risk of suicide” (defined as the “desire and intent to die and has the capability of carrying through on his/her intent”) and are “unwilling or unable” to consent to the emergency intervention suggested by the hotline counselor. The term, “unable,” is not clearly defined, but is often assumed to include callers who are presumed to be experiencing psychosis. While the lifeline encourages counselors to use the “least invasive intervention,” crisis centers in the Lifeline network are required to have caller ID, and emergency intervention is often employed at the discretion of the crisis counselor. More information can be found at http://www.crisiscentersblog.com/wp-content/uploads/2007/11/emergency_intervention_policy_nspl_draft_11-07-07.pdf.

    Samaritans Crisis Hotlines- http://www.samaritansusa.org- This link provides information about the Samaritans’ crisis hotlines in the US and help finding the one closest to you. If there is no Samaritans hotline in your area, the Massachusetts statewide hotline (877-870-4673) and the Cape Cod hotline (508-548-8900) welcome callers from other states and countries. Samaritans hotlines tend to be the most confidential of all suicide hotlines, but individual policies differ by agency. The Rhode Island hotline (401-272-4044), the New Hampshire hotline (877-583-8336), the New York City hotline (212-673-3000), and the hotline serving Cape Cod (508-548-8900) appear to have a policy to not contact the authorities without a caller’s permission. The Cape Cod hotline has further specified that it has no caller ID and no way to trace where a call came from, and defines itself as “completely anonymous and confidential.” The Massachusetts statewide hotline (877-870-4673) will call the authorities if a caller “appears to be at imminent risk of death,” (ie. someone who calls while in the middle of a suicide attempt or while holding a loaded weapon) and more specific information about confidentiality issues can be found at http://samaritanshope.org/our-services/247-crisis-services/. The hotline serving the Greater Lawrence, Greater Haverhill, and Merrimack Valley area of Massachusetts does not use caller ID, but will, “very rarely,” contact authorities about callers.

  • Tracey, I loved your comment on how those who have never experienced any given state of mind should have no authority to decide who else does. One of the things that I found to be both fascinating and terrifying when I was locked up by psychiatry was that virtually every “patient” recognized that I had been incorrectly labeled, and yet, this was only recognized by three low-level staff members. I was locked up on the premise that I was “delusional” because that particular hospital had arbitrarily decided that a medical condition that multiple physicians had diagnosed me with was “not a real disease,” thus deeming my debilitating physical symptoms psychosomatic (I’ve written more on this at http://www.thesystemisbrokenblog.org/2014/03/26/i-am-justina-pelletier/). During my “hospitalization,” I had the following conversation with at least one “patient” on a daily basis:

    Other person: “Nothing’s wrong with you. What are you doing here?”
    Me: “These people are idiots. They’re trying to claim that I’m not really sick and that I’m, therefore, delusional.”
    Other person: “You could walk when you got here- now you can’t.”

    Common sense, right? If my issue was truly an emotional one, then arguably (meaning, based on psychiatry’s pseudo-scientific arguments), immediately taking me off the medication/supplement regiment that was carefully dictated by my real doctors and essentially forcing me onto neuroleptics would have been helpful, rather than leading to disastrous medical consequences. However, while my fellow “patients” understood what was really going on, the only staff member who immediately understood was a night-shift worker who happened to have a brother with one of the same medical diagnoses. The other two, who eventually understood to a degree, only did so because after three days of this, one of them bothered to speak with my therapist, as I had requested from the moment I got there as I knew she would confirm everything I had told them (the psychiatrist had barred staff from speaking to the medical doctors who called on my behalf, as I was told it would “feed into my delusions,”). It’s a bit ironic that all of these folks who were labeled “psychotic,” “incompetent,” and “without insight,” outnumbered the staff who seemed capable of making an accurate “diagnosis” at least 8:1.

  • Re: Actually, I am all for the decriminalization of drug use, but I am not for decriminalization of other nonviolent crimes, broadly speaking.

    Simply, I think, with few exceptions, sentencing for non-violent crimes should be dealt with in ways that do not involve prison sentences.

    I completely agree with you here. I am for the full decriminalization of drug use, and find it horribly hypocritical that our society has created this strange dichotomy between “bad” drugs that “bad” people must be stopped from taking and “good” drugs that “crazy” people must take (even when they don’t want to) when many of these drugs work in similar ways. Frankly, as long as people are not harming anyone while on any kind of drugs, it is none of the government’s business what substances someone chooses to introduce into his own body. I believe that many nonviolent crimes should not be considered crimes at all, and are really just used for the police to exercise arbitrary power and ignore constitutional rights (loitering, disturbing the peace, public indecency, public intoxication, etc.), but I see a clear distinction between nonviolent, victimless crimes such as these and nonviolent crimes that do victimize people (such as stealing), which should have consequences, but consequences that match the crime and the harm that was done with due consideration for the circumstances leading to it. For example, if someone steals a loaf of bread because he is starving, I believe that providing such a person with resources to help him (ie. food stamps) would be more appropriate than punishment (although I would support such a person being required to use his food stamps to buy a new loaf of bread for the store he stole from), while someone like Bernie Madoff, for example, certainly deserves to be punished for his actions, but I would prefer a punishment such as mandating that he divide all of his savings between the people he victimized and award them at least 75% of any future income. It seems to me that when you deprive others of their rights and safety (through commission of a violent crime), it is justified to deprive you of your liberty (through imprisonment), and if you deprive someone of their financial resources, a more appropriate response would be to deprive you of your financial resources. I really should have used the term, “victimless crimes,” rather than, “nonviolent crimes,” (you’d think I would have learned by now that trying to post a thoughtful response while half asleep rarely turns out well!).

  • Hi Jonah,

    I completely agree with your last comment- I should have phrased my thoughts on this matter a bit more carefully. I do not think that prison is appropriate for anyone who did not commit a violent crime, and I think that when someone has committed a violent crime, that such a person should not avoid punishment because of a “mental illness” label. Other than criminals who simply have no empathy whatsoever, it seems to me that most violent criminals justify their actions to themselves through thinking that could clearly be seen as not based in reality or “delusional,” (ie. “The child I sexually assaulted was acting seductive,” “I had to kill him because he slept with my wife,” “I know she said ‘no,’ but she REALLY wanted me to do it.”). I’m not sure how anyone can distinguish between a “sane” and “insane” murderer.

    Personally, I have been victimized by quite a few different people, only one of whom had a “serious mental illness” label, and I found some of the responses to the assault that this person committed against me to be infuriating (ie. “Well, you know he’s REALLY sick.”). I do not believe that this man’s thinking could have been any more muddled than any of my other abusers, who were constantly justifying their actions in ridiculous ways, such as by insisting that abuse is mainly the fault of the victim. As much as I can certainly have some empathy for someone who, for example, killed because of misinformation he had been told by the voices he was hearing, and I hope that this might allow for a bit of leniency during sentencing, I do not think that we can reasonably argue that people with psych labels are not dangerous and psychiatrists should not have any legal power over their lives while simultaneously insisting that folks with labels should get a free pass on criminal acts because “they can’t help it.” As much as prison rarely reduces recidivism rates, we all agree that there must be repercussions for violence, and I worry about how many people deemed “NGRI” will fail to take any responsibility for their actions and, as a result, commit even more heinous crimes.

    Honestly, I wonder how many people who are deemed “mentally ill” after entering prison are truly done so for the convenience of the prison staff, who save money by replacing guards with chemical restraints (psych drugs). I believe that psychiatry must get out of the business of social control (including through such “diversion programs”), and only has any hope of actually helping anyone if psychiatrists are completely stripped of legal authority and assumed legitimacy.

    Thanks for helping me to clarify my comments on this!

  • I feel that much of this thread has focused on the usual fear-mongering about people who are deemed “mentally ill” having to contend with police rather than psychiatrists. In regard to that point, if we decriminalized emotional distress (eliminated forced psychiatry), the overwhelming majority of people who are labeled “mentally ill” would have no reason to enter the criminal justice system. There is no other group that can be locked up (whether in a hospital or prison) for behavior that cannot be prosecuted in a criminal court. Most people are incarcerated in psychiatric hospitals because they are presumed to be psychotic or a danger to themselves. Neither of these presumptions, even if they are well founded, are indicative of criminal activity. If someone who is labeled with a “mental illness” does, in fact, wind up being charged with a crime, I assert that such a person will rarely, if ever, be treated more fairly in the mental health system than the criminal justice system. Most people who plead “NGRI” spend more time in psych lockup than they ever would have in prison, and if they are harmed by a guard or another inmate, they will have an even more difficult time being believed. If we want to keep people who are deemed “mentally ill” out of prison, the way to do that is not to lock them up elsewhere- it’s to focus on the decriminalization of drug use and other nonviolent crimes. Not to mention that we need to create more voluntary, peer-run alternatives that people actually want to go to before they even find themselves in the kind of state that currently justifies force.

  • These hotlines should have a responsibility to either ensure callers’ absolute confidentiality, or announce their lack of anonymity in a big and obvious way (ie. as soon as you call, hearing a recording that states, “We can trace calls, even if you dial *67 first, and if we arbitrarily determine that you’re in danger of harming yourself, we may repeat everything you say to the police.”). I know of a couple that are truly anonymous and will not report callers, but most do, scarily regularly. If anyone’s interested, I created a brief resource guide including different hotlines and sources of support, including their specific confidentiality policies at http://www.thesystemisbrokenblog.org/resources/.

  • This seems like absolute common sense- if you make the environment a bit nicer, people will act a bit nicer. But it seems to neglect real solutions at the same time, throwing out the idea of working with people in a compassionate and trauma-informed way in favor of an attitude of, “Let’s put down some nice throw rugs to make people forget we’ve locked them up for having committed no crime whatsoever.” Other than the obvious solution- not hospitalizing people against their will- trauma-informed care really does work when it’s properly implemented. A brief training will clearly not do the trick. Those outside “hospitals” must understand that these “emergency interventions” are used in clearly dire situations, like when my friend had an upsetting phone conversation and slammed the phone down very hard. She was in her eighties, had no history of violence, and, sensing the immediate reaction of the staff, put her hands in the air and continuously repeated that she was calm, but clearly, she posed an imminent threat and required restraint. Personally, I do not use violence, even in self-defense (more due to fear and multiple disabilities than anything else), but here’s the difference between a trauma-informed approach and psychiatry as usual. I was once hospitalized following a suicide attempt. I was on suicide watch for a couple of days, and became very upset when I was told that I could not take a shower without a staff member in the room. I began yelling at the staff who, instead of responding with fear of this “crazy” person screaming at them, understood that I have a sexual abuse history and found that concept to be very threatening. They gave me some space and promised me that nobody there was going to hurt me or look at me without my clothing on, and asked if we could sit down and come up with a solution that would work for everyone which, with the promise of safety, was accomplished quite easily. In contrast, a few years later, when I was being forcibly hospitalized for the crime of having a disease that an ER arbitrarily deemed “not real” (despite having been diagnosed by multiple, independent physicians), I was told I needed an EKG before I could be brought to the psych unit. I refused, citing the fact that a police officer had left the building only a few minutes before to discuss the sexual assault which had actually brought me to the ER in the first place and not wanting to remove any clothing, and was told that if I refused, I would be tied to the bed. I can absolutely see how someone in such a position could become violent. I really believe that the enormous distinction in how I was being treated was based on which psychiatric labels I had acquired- when I was only diagnosed with PTSD and depression, this seemed to make me a human deserving of respect, and when I was considered to have a delusional disorder, I was deserving of being treated with about as much respect as the nice, colorful walls and throw rugs that psychiatry is now aiming to patronize people with.

  • I worked with children in foster care for years and can absolutely affirm this. They get these kids hooked on drugs and then, send them off with no resources, no life skills, no families to fall back on, and no ways of coping with all they’ve been through, and then, they have to deal with crazy withdrawals from drugs they didn’t want in the first place. They get told that they’re mentally ill for being deeply, understandably traumatized and caseworkers often see psychiatric hospitals as appropriate “placements” for these children.

  • There are so many important points in this article, but I just have to share that, “there’s the decidedly creepy ‘guest,’” immediately made me think of how Belle was considered both a “guest” and a prisoner in the beast’s castle in “Beauty and the Beast.” Sounds awfully familiar to “guests” in psych lockups, doesn’t it?

  • Children often have difficulty expressing themselves with words when they are suffering, sometimes leading to these prolonged tantrums. Here’s the problem when we just punish (or torture, in this case): I once had the pleasure of getting to know an incredible child who, as a toddler, would sporadically throw temper tantrums and attack one particular person (I’ll call him “X”). I chalked it up to “terrible twos” and would bring him to the corner for a “time out,” and I would sit next to him and tell him that it’s not okay to hurt people and ask how he would feel if X did that to him. His response was, “X makes me angry,” and I told him that even when we’re angry, it’s not okay to hurt people. A couple of years later, he told me that X was abusing him. I wish that I had been listening to the message this little boy was trying to send me. I wish that everyone who is responsible for caring for a child who has “excessive” tantrums or acts out violently would look just a little further and question what in that child’s life upset him so much. I learn from my mistakes- why can’t psychiatrists?

  • That’s an excellent point. The Patriot Act is definitely another example of that. The difference is, post 9/11, when there was that horrible explosion of anti-Muslim sentiment, most of us recognized it as blatant bigotry, and realized that a couple of extremists were not in any way indicative of all Muslims. After each mass shooting, if the shooter had ever received a psych label or was presumed to have mental health issues, “lock up and drug the ‘mentally ill'” is actually considered a legitimate policy position, as it’s “for their own good.”

  • That’s an interesting point. I definitely agree in the sense that there is an enormous push for forced “treatment” anyway, but the opportunistic TAC and Tim Murphy-types definitely use these tragedies to further this agenda. The NRA has such a political stronghold, that their arguments about guns not being the problem, but simply crazy people who need to be locked up, is gaining traction. I think it’s a combination of opportunistic groups that take advantage of these tragedies and groups like the NRA trying to cover for pushing policies that kill people. The problem is, the population at large seems to buy into it. I think we need to be honest with ourselves within this movement- we’re not going to change the views of the NRA, NAMI, E.F. Torrey or Tim Murphy, but we can change the views of the people, and that’s a powerful thing.

  • Thank you for bringing up this important point. It seems like every community/state that has been affected by mass violence responds with an ongoing call for more “mental health care,” meaning more drugs and more force. It would seem ironic if it wasn’t so sad that we’re trying to solve the problem of violence by traumatizing more people and forcing them onto drugs that are known to directly cause violent thoughts and impulses. I don’t understand this “#treatmentbeforetragedy” rush to lock up and forcibly drug everyone with a psychiatric label when the common factors amongst mass shooters are right in front of our faces: they have suffered from some sort of injustice (or perception thereof), they want revenge, they lack the empathy to care about their intended victims, and they have some sort of access to lethal weapons. I’ll leave gun control out of this because this country seems unable to have a reasonable conversation about it without it turning into NRA members screaming about locking up all the crazed, potential killers out there (that would be us, apparently), but wouldn’t this assessment indicate that what we need is not more “mental health care,” but real efforts to combat child abuse, bullying, and other injustices in young people’s lives and making it an absolute priority to treat young people with empathy and respect so they learn to treat others the same way? I wrote a bit more about this in my article, “Violating the Human Rights of Those Presumed to be ‘Mentally Ill’ to Prevent Mass Murder Ignores the Real Causes of Violence,” at http://www.thesystemisbrokenblog.org/2014/07/07/real-causes-of-violence/.

  • You’re probably right. I’ve never received either of those labels, so I can’t speak from personal experience, but I have heard people who have say that as far as quality of care and rights violations go, there’s nothing worse than a Schizophrenia label, and it certainly seems that anything that can be labled as “psychosis” virtually guarantees dehumanizing “treatment.” Just from a personal standpoint, I appreciate that a “NOS” label was used by my former therapist to try to protect me from misconceptions about the diagnosis that more accurately fit with what I was experiencing, although I fully acknolwedge that neither diagnosis involved any form of psychosis, which may be why my experience with that label was more positive.

  • This is my favorite paragraph- “As can be seen, the category “Not Otherwise Specified” greatly enhances the mental health professional’s ability to successfully diagnose, treat, label and permanently stigmatize any patient whose illness might otherwise slip through the screening examination undetected – potential clients who would fall under the radar, bypassing the social safety net and tragically escaping the warm loving embrace and abundant therapeutic benefits of our nation’s glorious mental health system.”

    I do want to offer a bit of a side note on the “NOS” category, however. I’ve seen multiple cases where therapists will use an “NOS” diagnosis for billing in order to avoid using a more stigmatizing label, like “Psychotic Disorder NOS” instead of Schizophrenia, or “Dissociative Disorder NOS” instead of DID. Obviously, having a system where therapists need to label people in order to be paid is horrific, but under the current system, there is a bit of a hidden value in these otherwise ridiculous “NOS” diagnoses.

  • “The blunt reality of their harmfulness will actually be difficult for them to see, because two criteria required for entering the fraternity of biological psychiatry are: 1) a limited capacity for empathy, and 2) profound unawareness of this.”

    Sounds like “anasognosia” to me. Can we replace forced neuroleptic injections with forced truth injections for the “doctors” who order or administer them? It’s the humane thing to do- they lack awareness and don’t know what’s good for them.

  • Thank you for this fascinating article, and I truly hope that, in time, you are able to heal from this tragic event. I certainly believe that trauma can have a significant impact on behavior, but I never believe that it can be an excuse for causing harm to another human being. As a point of comparison, the overwhelming majority of my biological family is extremely abusive. Other than the one other relative that I know of who left the family and never went back, most of them deny their own abuse and then, proceed to act it out on the next generation. This has been going on for four generations, that I know of. I understand the root of my relatives’ actions, but I do not, in any way, excuse such actions (except under very specific circumstances, such as when I’ve seen very young children who truly did not understand what they were doing act out in this way). I made a choice to leave most of this family behind and do everything in my power to find safety and healing, and even in moments when I’ve been tempted to deny my own history, I could never imagine causing any kind of harm to a child. To be fair, part of that is because I simply don’t understand what even makes people want to do such things, but part of it is a very conscious decision that I would never cause the kind of harm that I suffered to another human being. In the end, everything is a choice, and bad experiences are not an excuse to harm others- even when that harm is not caused by the worst of intentions. While we certainly need to understand where our opponents are coming from, I truly hope we can make the distinction between understanding and excusing.

    It amazes me that these very rare incidents of violence at programs that serve as alternatives to hospitalization become publicized and used as an excuse for pro-force opponents to cite the need for forced interventions, while the daily violence that occurs in locked psych units goes largely unnoticed. I was once in a hospital where one nurse stated that every staff member there (and there were at least a couple dozen) had been attacked by a patient. This was attributed to the crazy and violent nature of these individuals, rather than the more logical conclusion- that when you treat people like caged animals, some of them will act like caged animals. I very much appreciate the logic, reason, and empathy that you bring to this conversation.

  • Jeremy, I couldn’t agree more. I’ve never lost someone closer to me than a grandparent or roommate I knew for only a month, but I have good friends who have lost people who were very close to them and, in some cases, it took years for them to put their lives back together, if they were able to at all. That’s not pathological- it’s human nature. What bothers me more, though, is that the DSM not only allows for no comparable “grace period” for someone who’s just been traumatized, but has two separate sections which only apply to trauma survivors (not to mention that I doubt there’s a single diagnostic category that doesn’t apply primarily to trauma survivors). I wrote at length about this in my own article, “According to Psychiatrist, Trauma Survivors Are Mentally Ill,” at http://thesystemisbrokenblog.wordpress.com/2014/03/06/psychiatrists-trauma-survivors-mentally-ill/.

  • B, I agree with you 100%. I remember when I was preparing for the ACTs, I was scolded because my writing was “too creative” and I was told to “just follow the format.” I repeatedly stated that that is not my style of writing, and was told not to “make a political statement out of this” and “just do well on the test.” This is education? I feel that I didn’t get a real education in any subject until I reached college. My idea of education is the professor who didn’t scold me for correcting her in class, but approached me after class to thank me for my comment, tell me that she thought I was correct and that it had reminded her of a book on the discussion topic, and offered me a copy to read and discuss with her. My idea of education is the professor who, two years after I took his class, was still gladly answering my questions about one of the assigned books for that class, which I was just fascinated by. My idea of education is the professor who had no problem admitting that he didn’t know the answer to my question, but promised he would find it. My idea of education is the professors who became friends, who I approached with personal problems and responded with kindness and understanding. Test-based education, rather than open, person-based education is not conducive to learning- just short-term memorization.

  • Thank you so much for bringing this issue to my attention. I was previously unaware that even involuntary patients automatically lose their constitutional rights, and am, simply, horrified that our society allows people in emotional distress to lose their liberties, but those that harmed or traumatized those individuals and led to their distress can own deadly weapons. I was prompted to write about this on my own blog, in an article which I titled, “My Abuser Gets To Keep His Civil Rights, But I Don’t,” (found at http://wp.me/p4ht3r-53). We have one mass shooting after another, and would rather blame those with psychiatric labels than come up with real solutions.

  • B, I can relate to so much of what you said and I thank you for bringing this up. I actually wrote this on my own site earlier this month, in an article about the many problems with pathologizing reactions to abuse:

    “All too often, a panicked, seemingly unstable victim recounts a story that sounds too horrific to be true to officers with little empathy and inadequate training and when they speak to the perpetrator, he is calm, poised, respectful, and able to give what sounds like a more plausible version of events. This can lead officers to assume that the victim is, simply, mentally ill and imagining the abuse. When the victim has already been labeled as mentally ill, the chance of officers seeing the truth in such a situation moves from ‘unlikely’ to ‘not a chance in hell.'”
    The full article can be found at http://thesystemisbrokenblog.wordpress.com/2014/05/10/pathologizing-abuse/.

    I find it to be absolutely horrific that hospitals seem to think they have the right to forcibly physically examine or strip search people. One time, I had a slightly better experience with this. As I was being admitted to a hospital, I was told I would need to be strip searched, and I completely freaked out and repeatedly stated that nobody was allowed to touch me and nobody was allowed to see me without my clothes on. One employee quietly said, “PTSD,” to the other, and I was asked if I would feel more comfortable covering myself with a screen and just removing one article of clothing at a time and showing them my clothes so they could see that I wasn’t keeping anything dangerous in my clothes. I asked them to promise that they would not, in any way, look at me or take the screen away, which they agreed to, and I ended up feeling far less violated than I otherwise would have.

    In contrast, one time, I was about to be admitted to another hospital and told I would need an EKG before being admitted. I asked what this involved, and as soon as I heard that I would have to remove my shirt, I adamantly refused. I was told that if I did not cooperate, I would be tied to a bed so they could perform this procedure. I cooperated at that point, but repeatedly told the employee not to touch me, that I was more than capable of placing and removing the electrodes on my own. She ignored me and did it herself, stating that I wasn’t doing so fast enough. There are no circumstances in which this would be appropriate, but, just hours earlier, the hospital staff was well aware that a police officer had been at the hospital to talk to me about the attack that actually brought me to the ER in the first place, and that I have a long history of sexual abuse. Incredible.

  • Is anyone else sick of this trend of pathologizing anger? Sometimes, anger is just anger. It’s a natural, human emotion, and a very appropriate one in many situations. I once saw a psychiatrist who diagnosed me with bipolar disorder, on the basis that “sometimes I seem very depressed, and other times, I get angry at her.” She was certainly right that I was feeling very depressed, but amazingly, given this supposedly biologically-based brain disease, she was the only person in my life (other than my abusers) who I repeatedly expressed any anger towards. If she had taken the time to ask why I got angry at her, maybe she could have found out that I was frustrated that every time I mentioned having been sexually assaulted, her response was to encourage me to examine what I could have done differently to prevent that from happening, which hurt me deeply and, as a staunch victim’s rights advocate, struck me as blatant victim-blaming. Thankfully, I had a far more understanding therapist who repeatedly, vocally objected to this diagnosis, but the psychiatrist did not budge in her position on this issue. When I went to the ER following a very violent incident with someone who was abusing me, and the injuries I had, as well as my pre-existing medical conditions, were not only ignored, but I was told that I wasn’t really medically ill and was just delusional, and that I was going to be involuntarily detained on a psychiatric unit because of that belief, shockingly, this made me angry. I never acted violently or aggressively or even raised my voice to the staff, but I was visibly angry and repeatedly, firmly insisted that my therapist and my medical doctors be contacted to verify that I was not delusional. Instead of examining that maybe, they had it wrong and that even if I had been delusional, they did not have legal grounds to institutionalize me as I was a danger to no one (does it bother anyone else that a presumption of “psychosis” seems to mean the laws don’t apply?), the hospital staff told me that my anger scared them and threatened to physically restrain me although none of my passionate pleas for reason or sarcastic comments about how even prisoners get a phone call (when I was told the hospital was refusing to contact my therapist or medical doctors and I could not do so myself), not to mention, the incredible physical limitations placed on me by a disease that this hospital arbitrarily decided does not exist, indicated I might physically attack anyone.

    A few weeks ago, I found out that I will, most likely, have lifelong medical problems due to damage inflicted by one of my abusers. When I found this out, I went on a very sarcastic, angry rant about this person and the many systems that have failed me and protected him, after which, I immediately apologized to my best friend, who had listened to this, and told her that I was just upset by what my doctor had told me. She lovingly told me that I didn’t need to apologize, and that she totally understood why I was angry. When I saw how much more angry the people who are closest to me were about this than I was, I started thinking that maybe my anger isn’t quite as pathological and problematic as the mental health system would like me to believe. In fact, I once spoke to a therapist who told me that my anger is “completely appropriate and not at all excessive under the circumstances.” I think, for those of us who have repeatedly gone back and forth between abusive situations and psych hospitals, it’s easy to learn that anger is always inappropriate and only gets you into trouble- these are crucial lessons to unlearn, and if more “professionals” do not want to help make it happen, we certainly should.

  • I would love to see a 12-step group for psychiatric survivors, perhaps, modeled after other 12-step groups indicated for survivors of other traumas, such as ACA and SIA, especially since it seems as if many members of these fellowships have really seen the best and worst of what mental health “care” has to offer, from loving therapists who truly helped them heal to forced hospitalizations and denial that they were even abused. If anyone’s interested in starting such a thing, I’d be glad to help.

  • Thank you for sharing such a wonderful, final lecture with us. The debunked “biological brain disease” theory has to go. I grew up in an extremely abusive family, which has, basically, concluded that all the struggling teens and young adults in the family “just have a chemical imbalance in their brains,” and that “taking medications to correct this imbalance is just like taking insulin for diabetes.” I suppose that was an easier explanation for the adults in my family than considering that the supposed “mental illness” epidemic plaguing my entire generation of this family might lead one to think that physically, sexually and emotionally abusing one’s children throughout their entire childhoods and encouraging others to do the same does not, often, help them grow into happy, well-adjusted adults. When I ended up in a psych hospital, my complaints about my family were completely ignored, and the “doctor” seemed to find it appropriate to talk to my mom behind my back to encourage her to “tell me to take my meds.” He also thought that returning me to my parents’ house was a more appropriate “discharge plan” than encouraging me to return to my own home. It seems that the “biological brain disease” psychiatrists don’t find themselves in the best of company…

    If anyone’s interested, I wrote quite a bit more about the massive problem of pathologizing reactions to abuse: http://thesystemisbrokenblog.wordpress.com/2014/05/10/pathologizing-abuse/

  • I once spoke to a domestic violence agency, which I was seeking shelter from after running away from a really horrible situation. One of their first questions was, “Have you ever received a psychiatric diagnosis?” I stated that I had been diagnosed with PTSD and DID. The response was, “DID is a really serious diagnosis. Are you taking any medication?” I bit my tongue on the “serious diagnosis” thing, not thinking it would be useful to lament about dissociation being a critical survival skill for people who grew up in terribly abusive environments, and stated that I’m extremely chemically sensitive and have been instructed by my doctors to avoid all pharmaceutical medication, and that even if I wanted to be medicated, there is no drug that will “cure” you of trauma and dissociation. The response was that they couldn’t help me because they “have to think of the safety of other residents.” I have no criminal record, nor any history of or propensity towards violence, but the psych labels alone were enough to determine that I was, somehow, a potential threat and undeserving of the protection I could have been offered. Assuming people with psychiatric labels to be violent is akin to assuming people who, in any way, appear to be of Arab descent, to be terrorists, or assuming people who identify as anything other than definitively heterosexual to be child molesters, except that most of society can, at this point, see the incorrectness and ridiculousness of stigmatizing those groups based on outdated stereotypes- those of us with psychiatric labels have not been afforded the same decency.

  • Here’s a hypothetical, using this kind of logic. A young woman who is being abused by her husband wants to purchase a gun to give her some feeling of safety in her own home. For the time being, I’ll ignore the statistical fact that that gun could pose a serious threat to that young woman’s life if it ends up in her husband’s hands, as she has the legal right to decide whether she believes it will make her situation better or worse. Her husband decides that he doesn’t want her owning a gun, and calls the gun shop as a “concerned family member,” warning the owner that his “mentally ill” wife will soon arrive to try to buy a gun that she will use to end her life, and asking the store owner to stop her from buying one. The young woman, who is visibly shaken and appears frantic, is “stalled” while the store owner calls the police to hospitalize this young woman. While this may seem like a rare and nearly impossible hypothetical, I know three people who have been reported to the authorities for some version of “acting crazy” by their abusers- two out of those three people were involuntarily hospitalized. I am very supportive of reasonable gun control policies, and see no reason why someone who has been convicted of a violent crime should have access to guns. However, turning gun shop owners into armchair psychiatrists and instructing them to conduct instantaneous risk assessments of their customers- a task that even those with years of training consistently prove they are unable to do- just seems to be casting an even wider net for who will be forcibly brought into and, likely, traumatized by our very broken mental health system.

  • Here’s the problem with studies of this nature: sexual abuse survivors are already stigmatized and deemed to be a threat to others based on nothing more than acts committed against them. Speaking from my own experience, I was once running a program to help traumatized children, which I was receiving many awards for, as well as consistent praise from referring agencies on how my volunteers and I were able to get through to children that the establishment had largely given up on. As soon as it became well-known that I had been sexually abused, I was told that I could no longer work with these children, based solely on misconceptions regarding my own history. I am in no way denying that those who were sexually abused are, statistically, more likely to become violent, and it is an unfortunate reality that I have seen as the cycle of abuse perpetuates itself within my family. However, my interpretation of these events is that it is a conscious choice on the part of the individuals acting out violently to not deal with what happened to them in any substantial way, and simply deny it ever happened and take it out on those around them. This is a choice that I do not make, and I am not alone in this decision, as some of the least violent people I know came from the most violent environments. Promoting these kinds of studies promotes misconceptions among abuse survivors, and can become a self-fulfilling prophecy. I have had children I was working with who acted out violently state that they did it because it happened to them, as if this serves as a complete explanation, because they had always been looked at as if they were dangerous simply because they had been victimized. My point? We have to be careful with presenting this type of information so that it can be used to help abuse survivors- not further stigmatize them. I fully understand that people who are “mentally ill” and, especially, people who are psychotic, are being unfairly stigmatized and blamed for violent acts when they occur, but let’s not scapegoat one oppressed group in order to protect another.

  • Dr. Lawhern, I sincerely thank you for this article. I was involuntarily detained in a psychiatric hospital and had an ongoing domestic violence situation I was in ignored by the police because a psychiatrist, who spoke to me for all of, maybe, twenty minutes, declared that a medical condition I had been previously diagnosed with did not exist and I was really just delusional. While hospitalized, I was forced to stop taking all medications and supplements that were prescribed to me or encouraged by my medical doctors, and coerced into taking antipsychotics. Within days, I became largely unable to walk, which the hospital staff appeared to believe was intentional on my part. My doctors were left completely out of any decision-making, and the psychiatrist on staff refused to speak to them, citing that it would “feed into my delusions.” The larger tragedy for me is that I now have to live with a very dangerous situation indefinitely, because as soon as the police heard the word “delusional,” any charges that would have been brought on my behalf against the individual who was repeatedly sexually assaulting me were not. Psychiatric opinion was deemed more reliable than medically-proven fact, even when a nurse who had administered a rape kit following one of these attacks informed the police that there was, in fact, physical evidence of sexual assault. I’ve written more of my story on a blog article called, “I Am Justina Pelletier,” at http://thesystemisbrokenblog.wordpress.com/2014/03/26/i-am-justina-pelletier/. Atrocities such as these have to stop.