Thursday, November 15, 2018

Comments by Russerford

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  • Kayla, my opening comment about Sandra being perceived as a “collaborator with the enemy” (i.e., mainstream psychiatry) was based on previous responses (by some) to articles she’s written here. I hadn’t read any of the comments here beforehand and agree with you that most of them have been positive. And in speaking of “real world credibility”, i was in no way trying to deny or denigrate the experiences of those, like you or my older daughter, who have been victimized by forced or strongly coerced psychiatric treatments that seemed to harm much more than help them. I am trying my best to advocate for such people, and I’m sure many others who comment here are doing the same! At the same time, my own experiences and those of a wide range of people I continue to hear from leads me to have an appreciation for just how knotty the dilemma(s) can be for anyone dealing with a severely psychotic state–the individuals themselves and those who love them and are trying to find the best way back to sanity. My sense is that some people (not you) find it easier to “posture” in a stance that something is always wrong or always right than to deal with the hard realities of situations in which each path is fraught with serious potential difficulties. Having said that, I am firmly in yours and Sandra’s camp in terms of strengthening the safeguards against forced drugging. Hope I’m not coming across as a politician here!

  • Bravo, Sandra! I’m commenting before looking over other comments, knowing there are certainly some if not many here who see you as too much of a “collaborator with the enemy”. I do not, even though I have a loved one who has many times been on the “sharp end of the needle” and was deeply wounded and damaged by “the system”. In fact, I am currently in the midst of a crisis involving yet another family member who is in the throes of a first episode psychosis. Fortunately, we got her out of the hospital fairly quickly and we are blessed to have a very thoughtful, careful, recovery-oriented psychiatrist (like you!) and many caring friends working with us. Once again, I applaud your courage, passion, honesty and candor. As I’ve said before, you have what I call “real world” credibility since you’re not just posturing but actually working to help people recover. Thank you for your advocacy and willingness to “go against the grain” of your profession.

  • Thanks for the heads up on this Bob. Its timely for me, as I’ve been thinking a lot lately on how to get the word out to doctors and mental health professionals that I know. Although my professional experience is nowhere near as extensive as yours, as a retired school psychologist who became enlightened on these issues fairly late in my career, I share a number of the feelings you express, particularly about regrets versus moving forward to promote positive change. I am most concerned about making a dent in the “false knowlege” that abounds among mental health professionals. Are there posters and/or flyers that can be printed about these courses?

  • John, I didn’t say the original design study was flawed, although it might be (consider there was no true control group; i.e., a group for whom there was NO treatment, which would control for the placebo or Hawthorne effect…but I realize there may be ethical concerns in offering participants “no treatment”). What I meant was that the conclusions drawn by the researchers after the 14-month study appear flawed (overly benign and lacking in cautionary information regarding the intensive medication group), at least in light of subsequent follow up information. I believe if researchers and mental health practitioners had the well-being of children at heart first and foremost, they would make a strong effort to counter or at least question the initial finding that appeared so favorable to intensive medication treatment for ADHD. I see no such strong cautionary statements; in fact, as has been stated, they appear to have “spun” the latter findings in a way that tends to support the initial “drug-friendly” conclusions.

    Your point about your own experience is very well taken, and as Steve said in his reply, it brings to mind critical psychiatrist Joanna Moncrieff’s recommendations for a “drug-centered” rather than “disease-centered” approach to treating mental and emotional symptoms. Unfortunately, owing to the predominance of the current disease-centered approach, the concept of “informed consent” is regularly violated (in my opinion) and many people (including kids) do not have the option of discontinuing a drug when its harmful effects outweigh its helpful ones (if such effects were ever even present).

  • Your point seems valid and is well taken, John. I only saw it after posting my comment below. Yes, from a strict scientific point of view, the “study” was not maintained as such after the 14-month period for the reasons you mention; therefore, the post-14-month follow up findings are mitigated. However, I believe the follow up strongly suggests the initial findings may be quite flawed. This seems consistent with short-term versus long-term research on other “psychiatric conditions” (none of which have any conclusive validity as “brain diseases”, to my knowledge), and the strong tendency in mainstream psychiatry to trumpet and base treatment standards on these short-term studies while ignoring or even denying the findings of long-term studies.

  • Regarding the MTA study on ADHD treatments, this is what I found on the NIMH (who funded the study) website, under “Questions and Answers”:

    “Because their treatment after the end of the study was not controlled, it is not possible to draw accurate conclusions about the effectiveness of interventions beyond 14 months, or determine if treatment improves long-term functioning. However, the observations collected from these uncontrolled follow-up assessments can provide information about the long-term course of ADHD itself. These data are being analyzed and reported as they become available.3”

    Is this why they trumpeted the initial 14-month results (most favorable to intensive medication treatment) but have muted subsequent results that have shown either no difference between treatment groups or worse long-term results for those in the more intensive medication treatment group?

    No matter how you explain this, it seems to be a prime example of how money and guild interests have come to trump honesty and commitment first and foremost to the patient in health care–especially in psychiatry. It is particularly egregious when children’s brains are increasingly put at risk from this dishonesty!

  • So sorry for the tragic loss of your precious son, Steven. I couldn’t agree more with your strong caution against relaxing the standards regarding “off label” use of psych meds with kids. I know from my many years as a school psychologist that the use of psych meds with kids has risen exponentially, with no sign of abatement. And the concept of “informed consent” is regularly violated in that the proposed benefits of medication are overinflated and the risks greatly understated; furthermore, dangerous falsehoods about the drugs balancing brain chemical imbalances and being “like insulin to a diabetic” continue to be blithely perpetuated. Even Dr. Duckworth, the Medical Director of NAMI (which tends to be VERY friendly toward psychotropic drugs and the biopsychiatry mindset), has stated that he NEVER prescribed antipsychotic medications to children. Thank you for this article and for sharing your very valuable “insider’s view” in exposing the dangers our children are being subjected to by the existing psychiatric system.

  • You make an excellent point here, Norman. I notice that many who have been indoctrinated in the “faith” of biopsychiatry confuse denial of the medical basis of psychiatric diagnoses with denial of the symptoms (which few if any of us in the “resistance” movement are doing. If the disclaimer you suggest was put into practice, and if a “drug-centered” rather than “disease -centered” approach was used (as suggested by psychiatrist Joanna Moncrief), then at least there would be some honesty in the process.

  • Once again you’ve hit the nail on the head, Phillip. Thank you for another excellent expose of the chicanery of psychiatry. Funny, as I was reading this I was thinking to myself, “What is that other new bogus childhood ‘syndrome’ they recently came up with?” And then there it was, just a few paragraphs down: “Disruptive Mood Dysregulation Disorder”. What an outrageous crock of crap! As a retired school psychologist, I’m well aware of how parents can be bamboozled and pressured to buy into this pseudoscientific crap! Thanks for your diligent, persistent, articulate presentations. You are giving us good ammunition to counter the harmful lies, half-truths and deceptions of modern biopsychiatry.

  • Yes, yes, David…I think I follow you. So do you think if the primal parents had been active participants in real trials with Eden Pharmaceutical, as co-producers, maybe the one son would’ve had the benefit of some good Ableify, thereby not engaging in delusional behavior that incurred the lethal fury of his brother, who was apparently jacked up on coCaine?

  • Thanks for another excellent article, James. I share your righteous indignation with the “never mind the conflicting and mitigating factors, just diagnose!” nonsense you bring to light here. I see a strong parallel to our special education system, in which i was immersed for many years as a school psychologist (now retired, still involved part-time). Like the DSM diagnoses, several of the special education diagnoses are quite ambiguous (e.g., “learning disability”, “emotional disturbance”, “other health impairment”) and subject to a variety of confounding factors, which can be difficult if not impossible to sort out. There’s a missing classification that i believe has at least as much validity as these ones I’ve mentioned: “School Toxicity Syndrome”. And the remediation is much more clear cut: change the environment! (Maybe I’ll see if I can get “The Onion” to publish my research on that one!)

    But back to the parallel between the mental health system and the special education system. I see a similar problem that stems partly from the erroneous application of a “medical model” to behaviors that really have no clear medical etiology. Furthermore, even with the best of intentions (which I’m not assuming are always present), the “cures” to these supposed “illnesses” have a rather dismal track record, whether in educational or mental health outcomes. With regard to both mental health and education, the difficulties that individuals experience are very real and often do need attention. And unless one is blessed with a built-in, supportive social network to provide that attention free of charge, someone has to pay for services. I won’t be so cynical to say that funding is the ONLY reason for the DSM and the special education classification system in our country, but it sure is a major factor! No label, no services. On the one hand, you could say it could be no other way; after all, we don’t have unlimited funds. So if you’re “in the system” and want to get needed services for your client, it appears you have to “hold your nose” and pick the best label.

    But as you, James, and several others have pointed out, there are many problems with this–some of them very grievous. Perhaps the worst is that the onus for the problem is placed squarely on the child or individual, who may have to drag that label (with all of it’s limiting implications) around for the rest of his/her life. And maybe even worse, in the case of DSM diagnosis, there is the strong likelihood of being subjected to a variety of mind- and body-altering drugs or other harmful “interventions”. And in any case, the REAL problem may never be addressed or even identified!

    Another problem that seems inherent in either system is that an ever-expanding array of procedures, regulations, specialists, etc. are interposed between the person needing help of some sort and the actual service! So funds that could be used for those in need get eaten up by the bureaucracy (and maybe that would include me!)

    I certainly don’t see any easy solution, but I do think we need to move toward a system that identifies specific needs tied to services, without reliance on bogus labels. Such a system would involve a complete overhaul of the current funding system. With the guild and financial interests at stake (as Robert Whitaker and Lisa Cosgrove so clearly elucidate in “Psychiatry Under the Influence”) that will surely be a daunting task!

    Russ

  • Excellent points, Duane. Like you, I’m not an anti-capitalist and do not think the “creeping socialism” we’ve witnessed in our country over the past fifty years or so is a good thing. Even though I detest collectivism as it’s manifested in totalitarian states over the past century, i increasingly believe that a loving, very supportive community is very conducive to real healing for those suffering from extreme emotional and mental distress. “Bear one another’s burdens, and so fulfill the law of Christ.” In such a community, perhaps the expensive psychotherapy would not be necessary…or at least less so; or the community of caring friends would pull together to cover the expense, sort of like the Amish do in building a barn for one of their own. One other thing on this: Here in New York State, insurance covers psychotherapy with the same co-pay as medical conditions, due to “Timothy’s Law”.

    Russ

  • Mickey, I heartily accept your apology and thank you for a very thoughtful reply. It’s clear to me that you’re a very honorable man. I was sincere in my first comment and I really admire your passion and commitment to translating these passions into corrective action! In my own passion I have sometimes said things that I later regretted… so we definitely share that human tendency. Keep up your strong voice and the honesty and good will you’ve demonstrated.

    In solidarity,

    Russ

  • Mickey, much of what you say resonates with me. I especially like your suggestion of “ju-jitsu techniques calculated to employ psychiatry’s own claims and tactics against itself.” I believe that is what Robert Whitaker has done and continues to do, in part. In my own small way, I believe I’m also employing that tactic in advocating for a couple people close to me who are to differing degrees caught in conventional biopsychiatry’s web. And I’ve also been active in trying to get the truth out in a number of other ways, and I do see a place for strong and active resistance against the “false knowledge” in contemporary mainstream psychiatry.

    However, I totally disagree with your following statement: “Jesus has often been cited as such an example [a “power-free good example”], but Jesus was murdered, and the example of the life he led has hardly had an effect on the quantity of evil in our contemporary world.” First off, I believe Jesus was and IS anything but power-free. I believe his life has had inestimable influence and real effect in dispelling evil in the world and promoting love, including in myself (although I’m very much a work in progress, continually in need of God’s grace). Clearly, evil still abounds in our contemporary world, including harmful practices in psychiatry and, in some cases, through “religious”, misguided people who claim to be acting in the name of God, or even Jesus! However, I will contend that the power of Jesus is very real, was perfectly manifested in his life, and has been very evident throughout history in the “good works” even of the very flawed people who (at times) through faith allow him to work through their lives.

  • Yes, Sandra, what you say brings to mind what I understand is one of the key principles undergirding the Open Dialogue approach: “tolerance of uncertainty”, which goes hand-in-hand with a humble honesty that acknowledges there is still a tremendous amount of mystery in all the states of mind and being that we call “mental illness”. I see the connection you mention with Joanna Moncrieff’s blog, as well as your own in reflecting on “Psychiatry Under the Influence” and “Mistakes Were Made (But Not by Me)”. I think it would certainly be more honest and avoid some of the more egregious treatment mistakes to approach things from a “drug centered” rather than a “disease centered” perspective, as Joanna has suggested. And your comments on the way doctor’s in training, by necessity, concentrate on absorbing a tremendous amount of information from their mentors, at the expense of critical thinking, certainly helps in understanding how faulty information and practices are perpetuated.

    I so appreciate your portrayal of the “lose-lose” scenario it terms of the way acute psychiatric hospital staff regard someone who ends up in the hospital while attempting medication taper, versus those who end of there while being “perfectly compliant”. I’ve witnessed both of those scenarios and it is truly maddening!

  • Thanks so much for this, too, Jim. I’ve long suspected this is the case and keep looking to see what “evidence” is used to support this apparently fallacious notion. We really need to bring this fact to the forefront, and confront the “false knowledge” of conventional psychiatry strongly, relentlessly, at every opportunity. Their myths have become far too entrenched, and it looks like unquestioned acceptance of such erroneous information played a significant part in the closing of Soteria Alaska and CHOICES, Inc.

  • Man, you’ve really nailed it here, Michael, in terms of what is needed and how much better it would be than the immediate and unrelenting brain drugging that almost every unfortunate soul experiencing a first episode psychosis now faces! It’s disgusting but not really surprising to hear that NAMI joined the gang responsible for closing those good programs you mention and were a part of. I’m trying to be a dissenting voice within my local chapter of that organization, but it’s increasingly hard. We need an alternative.

  • Jim, thanks so much for your efforts in Alaska, and your continuing work through PsychRights to bring needed attention and advocacy to those who continue to be caught up in the Gulag Psychepelago here in “the land of the free”. I like your following portrayal and rationale of Soteria Alaska: “… it is designed to prevent people who experience a first psychotic break from immediately being put on neuroleptics (hyped by the marketers as “antipsychotics), and thus transformed into chronic, disabled mental patients. It is pretty fair to say that 80% of such people so treated can get through their experience and on with their lives, compared to 5% of the people who can be considered recovered under the current psych-drugs-for-all, mainstream approach.” I find it both incredible and intensely frustrating that so very few in our current “mental health” system seem to have any inkling of this. Yes, to be fair, the 80% recovery figure (assuming this is that reportedly achieved by Open Dialogue treatment methodology in western Finland) needs to be replicated and corroborated. But what you ran into in Alaska seems to epitomize the saying that “false knowledge is more dangerous than ignorance”. The “psych-drugs-for-all” mainstream approach, as you so aptly put it, appears to be based on the false knowledge that psychosis is the manifestation of a progressive neurological malignancy that must be arrested by drugs at all costs. Ironically, this false knowledge often results in the very thing it purports to prevent: progressive neurological deterioration as a result of the intrusion and continued bombardment of toxic substances in the brains of its victims!

    Anyway, thanks for continuing to “fight the good fight”!

  • Laura, you da woman! This looks great, and I can’t wait to dig in! This kind of information, forum and dialogue is so desperately needed. I happen to think it’s the most needed of anything in the “mental health” domain. Unfortunately, it may be that not everyone who has been debilitated by psych drugs will be able to successfully taper completely off…but they sure have the right to try, with as much support as possible–and to at least reduce them as much as possible. As you know, there is precious little support for that among medical professionals with prescribing power. Thanks for your valiant efforts to help others achieve the freedom you’ve been enjoying since getting off your own toxic psych med cocktail. Your life is a great testimonial and inspiration to me, and I’m sure many, many others!

  • “Dr. Marder knows Elyn Saks who was the recipient of long term high quality psychotherapy yet, as she writes in her memoir, when she finally agreed to use neuroleptics, she felt much better. I think we can no more discount her story than discount the story of Joanna Greenberg or many others who recovered without using drugs. ” [I’ll add Laura Delano, David Oaks, Will Hall, a few personal friends (anonymous, since i don’t have their permission to mention their names)…as well as those who only use them only on a self-directed “as needed” basis, like Keris Myrick, Jim Gottstein, and another anonymous personal friend]

    I was just looking back at your response to bpdtransformation, and i do appreciate this comment.

    It resonated with me in terms of what I’ll call “real world balance” (something i see in all of your articles)–meaning it avoids posturing in a dogmatic way that essentially denies the real life experiences of some in order to maintain “purity” of an ideological viewpoint. I am incensed by the degree to which i see this kind of one-sided posturing happening by the promoters of the “chemical imbalance” theory of mental illness–those who, unfortunately still hold most of the power in the mental health industry despite the lack of valid scientific support for their ideology. I think those of us who are very critical of mainstream psychiatry (justifiably) need to scrupulously avoid that same error. While we rightly bring to light those who have successfully come off of debilitating psych meds, to deny the experience of someone whose life has been improved by use of these same meds is wrong, and detracts from our overall credibility.

  • Thanks again, Sandra, for your honest, candid, caring approach, and for co-presenting this extremely important workshop to some of those who most need to hear it. It is encouraging to hear of the high interest level.

    I see some references to Open Dialogue in the comments. bpdtransformation raised these questions/issues very articulately in the second comment above, so I won’t try to reiterate them. But I would like to ask, is Dr. Marder aware of the work in Northern Finland, and if so, what does he think of it? Does he believe they’re lying, or distorting the results in a self-deluded manner? Of course, first-episode psychosis cannot be equated with schizophrenia, notwithstanding the issue that “schizophrenia” is a rather ill-defined and far from unitary state of mind/being. So is that his “out”–that the success reported with Open Dialogue is because they are dealing with first episode psychosis, which may be transient anyway? If that is his position, would he be in support of refraining from use of neuroleptics, if at all possible, when treating first-episode psychosis? I seriously doubt it!

  • Sa, I’m probably posting this too late for you to see it (unless you checked the box for an email notice when there’s another comment on the same article)…Anyway, I REALLY appreciated your last response in our exchange on this article that starts with…

    “Sa on May 9, 2015 at 4:28 pm said:

    Russerford,

    I really ‘hear’ you on the point that vocal family advocates in leadership roles often seem very concerned with protecting the image of the psychiatric profession and supporting the resulting drug recommendations – I have had the same experience.”

    Your analysis of why so many family members seem blind to the pseudo-science behind the so-called “evidence base” in psychiatry was excellent, and resonates greatly with me. You brought out so many things I’ve also witnessed, such as the following:

    ” When confronted with stories of people who have recovered, many of these family members seem at some level so unable to imagine that recovery is possible, that they do not believe these people were ever severely ill.”
    Some years ago a colleague of mine, knowing the story of my daughter’s horrific experiences in psychiatric hospitalizations, mentioned a film that i finally checked out of the library: “Lorenzo’s Oil”…It’s very heart-rending, but I highly recommend it. It’s about the absolutely heroic efforts of two parents to advocate for their son, and eventually contribute to a breakthrough in treatment that helped prolong his life some, and greatly helped others with the same rare and usually fatal disease. One of the most poignant and disturbing issues brought out was how their efforts were actually OPPOSED by the advocacy group in place for this disease! They resisted them on the basis that “you are giving people false hope”!

    Also, your following point is key in this discussion:

    “Now add that for some families -although certainly not our family and according to the research not for the majority of people – dramatic positive changes can happen after drugs are introduced particularly in the short term, and even for a few, the benefits last long term. All of this helps me understand how families have been led to so fervently believe that the psychiatrist just needs to find the ‘right’ combination of drugs to make this miracle happen for their loved one.”

    I think this last point is SO important for people to note and understand! I believe it is a huge factor in perpetuating the aggressive drugging of altered states of mind and emotion. Because SOME people have an initial, dramatic positive response to medication, it is assumed that everyone needs this…and when they don’t respond as expected, higher doses and/or different drugs are thrown into the mix…or ECT, if all else fails! And the same holds true of those whose initially positive response turns not so good over time…Rarely is the thought of carefully tapering the medication given credence. And, of course, when a person sees their loved deteriorate after stopping medication (usually abruptly, because they feel so crappy and no one shows any interest in helping them carefully taper), this then confirms the myth that they have a “brain chemical imbalance for which they need to take medication for the rest of their life”.

    This is tragic, frustrating and disheartening. But, in the words of Winston Churchill, “Never give up!”

    Thanks again, Sa, for your very insightful comments.

  • Madmom,
    I want you to know that even though (as I said above) I’ve rejoined my local NAMI chapter, I’ve done so with the intention of being a dissident presence within this organization. Not to oversimplify, but i see three types of people at NAMI meetings: 1) Anguished and devastated newcomers (usually referred by someone in the mental health system), desperate for support and direction; 2) People who have been coming to meetings, feel they and their loved one has been positively supported, and have more or less bought into the biopsychiatric model of mental illness that NAMI promotes; and 3) the leaders, who have been thoroughly indoctrinated in the biopsychiatric model. Those in group 1 are the ones I’m most hopeful of supporting and those that are the most receptive to honest, open information and discussion; some in group 2 seem open to re-evaluating the “truth” of what they’ve been led to believe; group 3 vary from somewhat open (if they’re relatively new to leadership) to extremely defensive to the point of shutting down discussion or doing everything they can to prevent it in the first place.

    As I said, I’ve stepped back from involvement lately as the meetings have left me with feelings of frustration and futility…it just feels too much like paddling upstream against a powerful current.

    You mention “NAMI is supposed to be advocating for my daughter but they aren’t.” From what you’ve written in other posts about your daughter, I have much empathy for you on this. I have also experienced the leadership of my local NAMI showing no inclination whatsoever to intervene on my daughter’s behalf in terms of correcting potentially harmful, erroneous information in her hospital records. They bill themselves as “the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness”…yet, in my view NAMI’s leadership seems much more concerned with protecting the image of the psychiatric profession and the pharmaceutical industry than standing up for individuals who are harmed by them–in fact, they seem to be in denial that such harm even exists!

    I’m thinking more and more that an alternative to NAMI is sorely needed, and hopefully I’ll be a part of that.

  • I think you make a good point here, Sa. In keeping with the mantra “Think globally, act locally” I rejoined my local NAMI chapter expressly for the reasons you mention, since this is the organization that virtually ALL people/families in emotional/mental crisis get sent to in my area. I want to reach out to families in distress and try to be a “different voice” to the struggling and desperate family members who come there. At times I think I have had a modest, positive impact. I sense that families are very open to information when it comes from someone else who has experienced similar things.

    Unfortunately, I’ve been AWOL for a while now because of the feelings of discouragement and futility I was left with the last couple times. Sometimes there is so much erroneous information being endorsed by the leadership that to confront it all I would have to make myself even more of an irritating presence to some than I’ve already been, and I just don’t have the temperament for it lately. I may be coming to the point when I feel that the negatives outweigh the positives in terms of my continued involvement. Admittedly, I’m less hopeful than I was a couple years ago when Bob Whitaker was invited to present at NAMI’s national convention, and when Keris Myrick was the board president….but I’m hoping to regroup and get back in the mix.

    I keep musing about starting up some kind of local alternative to NAMI…a place that wouldn’t be beholden to the drug companies (who heavily fund NAMI) and where people could get honest, complete information and support, with no effort to coerce them toward a way of thinking that primarily serves the “system” rather than the individual experiencing mental and/or emotional distress. The trouble with this is I just don’t currently have the time and energy for such an undertaking…and I’m not sure if i have the personal skill set for such a venture.

  • “And with that example of activism in mind, I am now thinking of whether MIA could host a public discussion on “solutions,” and also mount a public campaign to publicize this issue.”

    Okay, I’m in! Here are two suggestion for rallying cries for such a campaign:

    SHRINK THE POWER OF SHRINKS!

    GET YOUR DRUGS OFF OUR BRAINS–SUPPORT DETOX NOW!

  • Very well said, Sera. Your articulate words speak for so many of us. I think the persistence of this “chemical imbalance” belief system is bringing out the bipolar in me! Just when I’m becoming more hopeful that this destructive myth is crumbling, I see depressing evidence that it just seems to keep chugging along!

  • Anyone remember Justina Pelletier? It was this kind of “junk science” diagnosis and “treatment”, coupled with draconian police state tactics, that kept her incarcerated at a locked psych ward at Boston Children’s Hospital and separated from her loving family for over a year. I was proud to be one of the protesters at the “Occupy the APA”/Free Justina rally in NYC last spring, and I’m glad to say justice (finally) prevailed…although it will not be complete until those responsible for this travesty are appropriately disciplined.

  • “Imagine a world where we allow for medical uncertainty. We allow medically unexplained symptoms to be part of our medical puzzles without patient apology and without doctor frustration.”

    This reminds me of one of the basic principles of Finnish “Open Dialogue”, something that i see as sadly lacking in conventional psychiatry: “tolerating uncertainty”. It is one of the seven basic principles of Open Dialogue and one of the key elements of Dialogic Practice.

    “Tolerating uncertainty is at the heart of dialogue. It is thus a specific element and an element that defines the other elements. In Open Dialogue, there is the fundamental orientation of creating an organic understanding of the crisis with everyone’s input (polyphony). This stance is based on the assumption, as well as our experience, that every crisis has unique features. Hasty decisions and rapid conclusions about the nature of the crisis, diagnosis, medication, and the organization of the therapy are avoided. Further, we do not give ready-made solutions such as specific, preplanned therapeutic interventions to the family or the single person in crisis.”

    http://umassmed.edu/psychiatry/globalinitiatives/opendialogue/

  • I appreciate your remarks, Jeffrey. While this article still leaves me feeling more hopeful, I don’t disagree about the need for justice. In fact, I’m working for it in some small local, “person-by-person” ways…and I’ve recently become part of something that will hopefully give me the opportunity to have a much broader impact. I really do wrestle with this issue–that is, how much to expend my efforts toward “re-education and reform” and how much toward bringing to justice those who seem impervious to change and blithely unconcerned about the damage they’re doing.

  • Thanks for this article, Sharna. I thought it was very incisive, concise and well written. It resonated with me in terms of what I’ll call “real world balance”–meaning it avoids posturing in a dogmatic way that essentially denies the real life experiences of some in order to maintain “purity” of an ideological viewpoint. I am incensed by the degree to which i see this kind of one-sided posturing happening by the promoters of the “chemical imbalance” theory of mental illness–those who, unfortunately still hold most of the power in the mental health industry despite the lack of valid scientific support for their ideology. I think those of us who are very critical of mainstream psychiatry (justifiably) need to scrupulously avoid that same error. We do not have conclusive proof that there is NEVER some kind of a legitimate brain disorder behind extremes in behavior, thinking or emotion, and to pretend that we do detracts from our overall credibility. As you say in one of your opening paragraphs,

    “It is not outrageous to suggest that a child’s developing brain might be disordered in some way, just as any other organ in the body might be, and that the solutions lies in correcting that disorder.”

    Of course, you go on to make clear your overriding concern about the inappropriate diagnosing and overmedicating of children in our culture.

    I see there’s a lot of discussion, apparently mostly critical, about “epignetics”. That’s an issue I haven’t become conversant about and I’m sure it would be good to look into this further. I’m a little concerned that we tend to zero in on the parts of an article that we object to. To me, there is much to like about your perspective. I’m certainly not discounting the objections, and I hope to look more into the issues mentioned.

  • Thank you, thank you, thank you, Janet! There is such a dire need for what you are doing. This is the kind of intensive support center I wish were available everywhere, since there are so many people caught in psychiatry’s deceptive and often life-diminishing web. It is good to know there is a brave and obviously independent-minded (i.e., “liberated”) doctor working with you, because like it or not most people trying to withdraw from toxic medications will need as an ally someone who can help with a very personalized taper. Keep us posted, and God bless you and all those involved in this noble project!

  • I keep hoping against hope that the duplicity and intellectual dishonesty that seems to abound in mainstream biopsychiatry, much to the detriment of those caught in it’s pernicious web, will be exposed and corrected. There is a proverb that says “Hope deferred makes the heart sick.” I’ve been alternately hopeful and heartsick in recent years.

    This article strikes me as more than a ray of hope. In “Anatomy of an Epidemic” Robert Whitaker related how the concept of dopamine supersensitivity was first raised by physicians Guy Chouinard and Barry Jones back in the late 1970’s, but quickly dismissed by some of the key opinion leaders in psychiatry. As Whitaker said, “Psychiatry desperately needed this discussion to go away.” And it did, mostly, for over thirty years.

    However, it seems to be making it’s way back into professional dialogue other that just among the “choir” (like here in MIA). This study, I believe, bears out the old addage that “You can fool some of the people some of the the time….etc.” Kudos to those who refuse to yield to the pressure of the power brokers who will defend the status quo at any cost. Eventually, the truth prevails.

  • “Before we ask questions or do anything, our primary responsibility is to see the mad person not as an other but as ourselves.”

    Yes, indeed. This might sound like a “nice thing to say”, but having been confronted by the descent into madness of a loved one (and the return to rationality, thankfully) I have become keenly aware of just how tenuous and really somewhat arbitrary this thing called “sanity” really is. I have come to believe that extreme states of mind and emotion are not really different in kind from what all humans are subject to–just different in degree, or maybe more accurately in duration of extremeness (since most of us experience these same extremes at times, however short-lived). I think this is also behind my desire to know “what happened” to people that I regularly see in visits to people in a local state psychiatric hospital and at another local mental health residential facility. What were they like, what did they experience as a child, as a teenager, as a young adult, etc….in other words, what brought them to their present state of being?

    In psychiatry we hear so much about double-blind studies, randomized clinical trials, statistical differences, treatment effects, etc. There is a place for such things, to be sure. However, I believe there is tremendous knowledge and understanding that can be gleaned through the detailed story of one single individual. The experience of one person is both powerful and irrefutable.

    “All it takes is the existence of one white crow to prove conclusively that not all crows are black”.

  • Frank, this is in response to your comments about the bias in our existing mental health system that strongly tends to regard “disease” as the source of negative outcomes.

    This strongly resonates with me from my experiences with the system. It also seems to me that psychiatric diagnoses are very convenient “wild cards” that serve to deflect honest, scientific analysis of the use of medication or other treatments, especially when you understand that these diagnoses have no objective basis in terms of blood tests, MRI’s, or any other definitive medical measures. I have seen how this works in practice, up close and personal. Rather than recognize a clearly adverse drug reaction, psychiatric practitioners refer to “the episodic nature of the illness”. And of course they want to have their cake and eat it too, so that if one uses this “episodic nature of the illness” to argue for giving the person in a crises state time to recover, with support other than drugs or electroshock, they are then all about the “evidence base” in favor of their drugs and ECT–an “evidence base” that conveniently ignores long-term studies and other evidence that does support their reductionist biopsychiatric orientation (i.e., religious conviction).

    And I believe it’s this selective attention placed on the “illness” (as a medical entity) that contributes to what I understand is a gross under-reporting of “adverse events” with drugs, resulting in a flawed data base which makes it all the more unlikely that future adverse drug reactions will be recognized for what they are!

    I really appreciate both this article and the ongoing commentary by all…thank you!

    Russ

  • Sera, I checked out the video above (well done!), as well as the web site, and just sent off a supportive email to Governor Baker. I know it’s HIS budget and he won’t actually be voting on it, but since I don’t live in Mass I didn’t know what else to do. If you have any suggestions about who else to send it to, please let me know.

    Russ

  • “There’s another issue with ‘evidence based,’ and that’s the process by which much research is done. People who have been psychiatrically labeled have historically been taken advantage of by researchers in a myriad of ways. They’ve been ill informed of risks, and sometimes not given any real choice at all. At times, their desperation for help has been preyed upon.”

    Excellent point, Sera. I believe this was part of a local hospital’s attempt to coerce my daughter into having ECT for her “treatment resistant mania”. Just prior to this she consented to having some psychiatric students observe her. The attending psychiatrist was a strong proponent of ECT, he was quickly pushing this as necessary (rather than stopping or at least greatly lowering the neuroleptic med that was causing akathisia–which staff would not acknowledge), and even said to her menacingly at one point, “You WILL have ECT!” I think he saw her as a great “subject” for study, since she is intelligent and articulate and might present a nice “before-after” picture of success for his students. Hey, what would be the harm of a few fried brain cells–she had plenty to spare! And if she turned out to be one of the unlucky ones…”Oh well, it was ‘clinically indicated’…We tried our best!”

    Fortunately, while in a desperate state (exacerbated by their ham-handed “treatment”) she resisted this pressure (with our support) and her mania subsided after they finally discontinued the offending medication.

    Nice article, Sera. Thanks!

  • …” he asked me what i thought was the most important thing for the study in terms of making it valuable. i said: ‘insist on working with people in a first episode — and try like hell not to medicate them. and after that focus on all the open dialogue stuff.’ but as far as i know it never happened. to me that’s sad.”

    Dan, as I remember, you addressed this issue in a piece your wrote after being on staff for a while in the Soteria Alaska program. And I totally agree with you, from my little slice of life experience and reading/study of the issue. Of course, there are people I know and dearly love who also need help, including full support in getting off (to the extent possible) the toxic substances they’ve been cajoled, coerced and outright forced onto…but that’s another issue!

    I think the major obstacle to what you’re suggesting (rightly) is a terrible “Catch-22” that totally underscores your point about the need to address this at a systems level. Here’s the catch: The well-entrenched “standard of care”–even more than that, the “belief system”, here in the U.S. is predicated on the notion (despite lack of conclusive evidence) that psychotic symptoms are the manifestation of an underlying brain disease that, if not arrested through the use of medication, will result in increasing neurological damage. Therefore, it would be unethical to authorize any intervention (even as a “pilot study”) that withholds needed treatment. This seems to me to be a maddeningly frustrating conundrum!

    But maybe I’m wrong on this–I would be comforted to know that there is not, in fact, such a pernicious dynamic in place to prevent the possibility of drug-free (or at least drug-minimal) first-episode psychosis treatment programs from ever seeing the light of day.

    Perhaps Sandra or some other practicing psychiatrist on this blog could weigh in on this question?

    Anyway, great article and great discussion!

    Russ

  • “Paradoxically, the entrenched models and techniques are reinforced by dint of their being only marginally effective thus keeping that revolving door in motion.”

    Yes! This hits the nail exactly on the head! Just like the practice of bloodletting, no? Because it “worked”, or at least seemed to work some of the time, and because doctors (as all fallible humans) tend to selectively perceive the “evidence” that supports what they already believe, misguided practice continues and becomes more deeply entrenched!

  • Thanks, Dan…always great to hear from you! Even though it hasn’t become as known as I’d like, I’ve also noticed Open Dialogue is getting increasing “press” and it’s been great to see it’s basic principles being implemented increasingly in various places here in the U.S., as you’ve mentioned. This is encouraging, even though I have more than a few moments of discouragement when I encounter how entrenched the “standard of care” for psychosis (i.e., “first and foremost, medicate!”) still seems to be in this and most other countries.

    Thanks for asking and responding to these questions, many of which I’ve wondered about and discussed with others over these past few years.

    If the results reported by the Open Dialogue practitioners in Lapland are true (and I have no reason to believe they’re fabricated or distorted), this really points to a tragedy of epic proportions here in the U.S. and elsewhere, don’t you think? Let’s just say, for the sake of making this point, that there is indeed a “subset” of 15-20 percent of people who experience psychosis who are better off taking and staying on antipsychotic medication. That means that 80 to 85 percent of people experiencing first-episode psychosis who come under “psychiatric care” in the U.S. are coerced or forced into taking very strong medications that they don’t really need and that often have devastating consequences to their bodies, brains, social/emotional well-being and lead to unnecessarily diminished lives! It’s an even greater tragedy if, as you believe, even the 15-20 percent who seem to need the meds really don’t!

    Yes, you CAN put a square peg in a round hole, or vice versa; I think we see it happening all the time in our Gulag Psychepelago–sadly, the corners of the square pegs get rounded off and the curved sides of the rounded ones are straighted! One size fits all, doesn’t it?

  • I wonder how many similar cases have been buried because “adverse events” with drugs are not properly reported? Psychiatric diagnoses are very convenient “wild cards” that serve to deflect honest, scientific analysis of the use of medication or other treatments. Keep in mind that these diagnoses have no objective basis in terms of blood tests, MRI’s, or any other definitive medical measures. I have seen how this works in practice, up close and personal. Rather than recognize a clearly adverse drug reaction, psychiatric practitioners refer to “the episodic nature of the illness”. And of course they want to have their cake and eat it too, so that if one uses this “episodic nature of the illness” to argue for giving the person in a crises state time to recover, with support other than drugs or electroshock, they are then all about the “evidence base” in favor of their drugs and ECT–an “evidence base” that conveniently ignores long-term studies and other evidence that does support their reductionist biopsychiatric orientation (i.e., religious conviction).

  • “The study suggested that much of the drug level increase could have occurred after death, a finding that could explain the extremely high blood levels found in the two patients who died 3 to 4 days after receiving injections of appropriate doses of Zyprexa Relprevv.”

    Looks like a classic case of “begging the question”, a philosophical term that essentially means circular reasoning. We are asked to believe out of hand a couple of things that should properly be considered as critical questions of this investigation: 1) that there was no actual error in the dosage administered; 2) the dosages deemed appropriate are, in fact, not toxic for SOME people (since it is abundantly clear that different people can react very differently to the same medication/dosage).

  • Once again, mega-Kudos, Robert! Thanks so much for your persistent calling out of the repeated false story-telling of mainstream psychiatry. Their fabrications would be laughable if it weren’t for the virtually unchecked power these folks have over the unfortunate souls who fall under their “care”. Of course, they will always parade before the public those for whom their drugs and electric shocks have had a positive effect (although sometimes even this is rather misleading, since the benefits may be only for a relatively brief time). Sadly, it appears that even some of the brightest, most talented and perhaps initially well-meaning psychiatrists have become shills for Big Pharma, whose profits make the income of the illegal drug cartels look like “chump change”!

    Lieberman’s book and your review touch again on what I have come to believe is the most pernicious of the falsehoods that have been successfully promoted by psychiatry and the pharmaceutical companies: that mental illness (or at least schizophrenia in particular) is a progressive brain disease that if left “untreated” (i.e., undrugged) will result in continuous brain deterioration. This drives both the practice of heavily drugging the brains of individuals experiencing first-episode psychosis, and then failing to consider discontinuation of those same drugs once the person is “stable” (it appears that “stability” trumps recovery almost every time). While making these unsubstantiated claims about progressive brain disease underlying psychiatric symptoms, they ignore or deny that which has actually been proven: that brains exposed to the drugs they prescribe (particularly neuroleptics) decline in size in proportion to the dosage and duration of the drug.

    Thanks again, Robert, for this sorely needed antidote to the delusions of conventional psychiatry. To borrow on the phrasing of Lieberman himself in one of the quotes you include in your article above, “if shrinks are not treated with such truth injections, their brains get smaller and smaller.”

  • Thanks for this very intensive, thought-provoking article, Robert. I think you’ve really elaborated the huge reductionistic mistake inherent in biopsychiatry, i.e., reducing human consciousness and feelings to the “squirts and twitches” of neurons that simply need to be chemically regulated to correct problematic thoughts, feelings and behaviors. Your analysis in a way brings to mind the words of a famous, ancient king, who said “The heart of the wise is in the house of mourning”–even though I know that wasn’t really your point. I especially love your illustration of Eddie’s learning to play the B7 chord–that helps me understand and further appreciate the incredibly complex interplay between human consciousness, neurology, learning, behavior, etc.

  • So…since we hear so much about all the “undiagnosed” and “untreated” mentally ill in our society, struggling in anonymity, and since foster kids are apparently blessed with being more often diagnosed and treated, doesn’t it follow that foster kids should be, as a group, happier and more mentally healthy than kids in general? Where’s the research on that?

  • Well, thanks for keeping us abreast of the way the pharmaceutical companies are making boobs of themselves!

    Seriously, though, the coverups of the serious harm of psychotropic drugs would be laughable if not so tragic. And the fact they can take these kinds of “hits” in the way of million and billion dollar lawsuits and just keep on rolling and raking in billions makes the money made in the illegal drug trade look like chump change!

    Another tragic irony that I’m sure has been mentioned here and elsewhere: All the hoopla in our society and public schools about “saying no to drugs” (street drugs), while the number of kids on these toxic and pathetically understudied drugs has been rising exponentially–even forced on families and kids by the very institutions that are supposed to be educating and caring for them!

  • Yes, now reading the other comments above I also thank you, Jonathan, for your diligent efforts to bring this about. I certainly have my share of cynical and pessimistic moments in this fight, but we must press on! Here’s an excerpt from one of Winston Churchill’s famous speeches about another noble fight:

    “But we must learn to be equally good at what is short and sharp and what is long and tough. It is generally said that the British are often better at the last. They do not expect to move from crisis to crisis; they do not always expect that each day will bring up some noble chance of war; but when they very slowly make up their minds that the thing has to be done and the job put through and finished, then, even if it takes months – if it takes years – they do it.”

    And now let me take the liberty to slightly modify a following portion of that speech (modifications in brackets):

    “I am addressing myself to [my fellow freedom fighters against the Gulag Psychepelago] – surely from this period [ ] this is the lesson: never give in, never give in, never, never, never-in nothing, great or small, large or petty – never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.”

  • This is horrific, and to say it makes me angry is an understatement. But I’m not a bit surprised. I’ve experienced something very similar, although not quite as egregious, here in New York State.

    I used to live across the river from Trenton. As you crossed over the Delaware River from Pennsylvania into New Jersey (Route 1), when looking to the left there was another bridge with the lit slogan, “Trenton Makes, the World Takes”.

    If it’s still there, perhaps they should change it to “Trenton Abuses, the State Excuses”.

  • James, let me add my voice (a bit belatedly) to those who greatly appreciate the perspective you’ve brought through your articles. Actually, I haven’t read all of them yet, so I plan to go back and “fill in the gaps”. Ironically, as I was reading and discussing this one with my daughter–even as I was doing so because of the positive, uplifting, hopeful message–I took a temporary, dark departure into the bitter, angry thoughts that regularly re-emerge when I think about the way in which psychiatry can and does brutalize people in the name of healing and/or “stability”. In fact, I added some pretty graphic, crude remarks to those thoughts! Another irony: my daughter, who more than once has undergone very misguided, torturous experiences at the hands of psychiatry’s “healers”, does not seem nearly as subject to these forays into Bitterland as I am!

    At any rate, your article resonates with me, even as there is a part of me that resists it, for it seems to draw me to a higher, more hopeful place–the place of the One completely innocent victim/redeemer!

  • Richard, my first comment is below and this article has definitely influenced my thinking on this issue. Nevertheless, I find myself somewhere between yours and Jonathan’s stance on this at this point. There is a point you make that strongly resonates with me. Having witnessed very egregious aspects of psychiatric force and coercion in the “treatment” of a very dearly loved one, and the absolute power over their “patients” that psychiatrists in psychiatric hospitals have over individuals, I am not so sure that prisons (with all their horrific aspects) are worse. I have come to believe that a convicted felon has more rights and freedoms than an involuntarily committed psychiatric patient. In a prison, you at least usually have the benefit of fresh air and sunshine for at least a portion of the day. In my loved one’s case, she endured three months in a locked facility with neither. A prison sentence has a set time; a psychiatric “sentence” does not. I believe prisoners have more potential for good legal representation (although not usually without a ton of money) than psychiatric patients (in my experience, “mental health courts” are kangaroo courts in which the deck is heavily stacked in favor of hospital staff). In prison, they control your body; in a forced psychiatric setting, they control not only your body, but are allowed to saturate your brain with whatever they deem “clinically appropriate”–although this also happens, to some extent, in prison.

  • Richard, I’m really not trying to flatter you when I say you have made the most articulate and well-reasoned argument on this subject I’ve ever read or heard. It has definitely influenced me, as one who has been on board with the need to “reform the system”. I really do have to rethink my position on this. I haven’t yet read all of the the above responses, and your replies, but even with your excellent argument there is still a “chink in the armorl”, so to speak, in my mind. Maybe this has to do with a distinction between forced hospitalization and forced drugging (or other “treatment”, like ECT) that i believe markps2 is making above. For sure, it has to do with the lack of truly humane and personalized care for those in the midst of extreme emotional/mental states (i.e., psychosis).

    At any rate, let me give you a scenario as a way of presenting my continued concern:

    This type of scenario is of very real concern to me. I’m certainly not raising this as a “set up”, as it is an actual quandary that I’ve been faced with. In this scenario, you have an adult family member who is neither suicidal or homicidal, but dangerously delusional. For example (and this is not the actual situation in my personal experience), the loved one is convinced she is a covert agent of the CIA and must meet at midnight at a certain location–one that is known to be a hangout of drug addicts, prostitutes and violent criminals. She cannot be reasoned or talked out of this and, in fact, becomes angry and accusatory toward those who try to impede this “mission”. You want with all your heart to avoid the psychiatric unit at the local hospital, which was so demeaning and injurious to her in a previous episode.

    Okay, now let’s suppose we are fortunate enough to have Hearthside Healing, or Parachute NYC (about which I’ve heard good things), or one of the new Soteria Houses nearby. That would be wonderful, and a huge improvement in my local area (even though it is awash in all of the conventional mental health facilities and resources).

    But…in this delusional state, my family member will probably be no more likely to check into such a place as she would be to check into the local hospital’s psych ward.

    Some of you might say, “Well, she’s an adult. It’s her choice. Let her go and try to carry out her ‘mission’”. To me, loving her and knowing how irrational she is at the moment, that would be grossly negligent. There is the very real possibility that she would put herself in the hands of some very bad actors and end up greatly harmed, dead or missing.

    On the other hand, to facilitate her return to the hospital would be to put her back into the hands of those who have unchecked power to harm her body, mind and spirit.

    I think you have addressed this, in a way, in your article. This kind of real life scenario is what prevents me, at this point, from taking the absolute stance you are advocating; however, you’ve certainly made a good case for how “reform” may play right into the hands of the worst elements of the status quo.

    Thanks.

  • Hey boans, thanks for your many excellent contributions here in MIA Land! I’m using this post to reply to your comments on the most recent article by Dr. Sandra Steingard, as for some reason there was no “reply” box on that one…so sorry for this “out of context” reply.

    Your comments about what happened to you in a recent emergency room in your locale resonated with me, for reasons I think you’ll understand if and when you read the article I’m going to give you the link to. Unfortunately, there was apparently a much “happier ending” to your fiasco than the one my daughter was subjected to.

    Anyway, here’s the link:

    http://www.mentalhealthexcellence.org/author/rstence/

  • Hi again, Dr. Steingard,

    As usual, I’m getting into the discussion late–maybe too late for you to notice and reply.

    Anyway, it was great to see you at the recent Symposium in Syracuse, and I really appreciated your input. While I thoroughly appreciated the discussion, I left a bit confused on one point. I know you’ve written and remarked on this topic before, so I’m hoping you’ll help clarify this for me.

    I wanted to raise a question about this at the recent symposium. Even the presenters who appear to be the most reform-minded (Dr. Harding and Dr. Harrow) seem to accept the consensus that first episode psychosis MUST be treated with neuroleptic meds (although i thought i noted a brief, passing comment by Dr. Dixon that may have suggested she does NOT believe this is always warranted). This appears to be based on the belief that there is a neurologically toxic subtrate to psychosis that must be arrested, as is true for seizures (although, as for that, isn’t it ironic that seizures are INDUCED through ECT as a means of ameliorating severe depression or mania?!)

    I’m keenly interested in this topic (I have “skin in the game”) and have read quite a bit about it, but I still have many questions. I’m not a psychiatrist, so perhaps I’m missing something. Part of the reason I’m skeptical about this has to do with Dr. Nancy Andreason’s research. She initially reported that her research documented loss of brain tissue in schizophrenic people over time, but retracted this later (as I understand it) upon further analysis of the data that showed this loss in brain tissue to be correlated with exposure to neuroleptic medication.

    So…Is there conclusive evidence that psychosis itself is a neurologically damaging process that needs to be curtailed as quickly as possible? If so, could you cite the research supporting this? I am aware of various DUP studies, but hold some skepticism about them, as well.

    Thanks.

  • “Sadly, though, this bill does not address the crux problem; the overreaching power that doctors in major medical centers and academic institution are exercising in disregard of citizens’ constitutional protections.”

    Thanks for bringing attention to this, Nancy. I’m glad to know someone else shares my disappointment with this. Of course it’s an outrage that wards of the state or ANY individuals, particularly very vulnerable children, would be treated as guinea pigs and I’m glad for any and all actions taken to put a stop to such abuse.

    When Justina’s and her family’s plight came to public attention (and thanks again for your part in that here in MIA), I immediately thought this debacle, once rectified, should give rise to a “Justina’s Law” that would protect all children and their families from ever falling into such a pernicious trap.

    I would think the Pelletiers would be in favor of having Justina’s Law address the problem in a broader, more fundamental way, as you so articulately lay it out. Does anyone know where they stand on this?

  • Kudos for hanging in there, AngryDad. Dr. Peter Breggin has some stories of parents standing up for their kids against drug-happy school staff, mental health professionals, etc. in “Medication Madness”. I’ve been there myself, although apparently nowhere near the intensity of your situation. I was privileged to have a small supportive role in another woman’s heroic story in standing up for her son and saying “no more” in spite of threats of Child Protective Services–what a horrible irony, eh? I’ve summarized her son’s story in my article “From Adversity to Advocacy”, published earlier this year at the Foundation for Excellence in Mental Health Care website: http://www.mentalhealthexcellence.org/author/rstence/

  • I really appreciate your responses, Jon. Since I’m checking back into this discussion a week later, you may not see this comment. But here goes anyway…

    I’ll give a specific scenario that is somewhat different from those you’ve mentioned, and is of very real concern to me. I’m certainly not raising this as a “set up”, as it is an actual quandary that I’ve been faced with. In this scenario, you have an adult family member who is neither suicidal or homicidal, but dangerously delusional. For example (and this is not the actual situation in my personal experience), the loved one is convinced she is a covert agent of the CIA and must meet at midnight at a certain location–one that is known to be a hangout of drug addicts, prostitutes and violent criminals. She cannot be reasoned or talked out of this and, in fact, becomes angry and accusatory toward those who try to impede this “mission”. You want with all your heart to avoid the psychiatric unit at the local hospital, which was so demeaning and injurious to her in a previous episode.

    Okay, now let’s suppose we are fortunate enough to have Hearthside Healing, or Parachute NYC (about which I’ve heard good things), or one of the new Soteria Houses nearby. That would be wonderful, and a huge improvement in my local area (even though it is awash in all of the conventional mental health facilities and resources).

    But…in this delusional state, my family member will probably be no more likely to check into such a place as she would be to check into the local hospital’s psych ward.

    Some of you might say, “Well, she’s an adult. It’s her choice. Let her go and try to carry out her ‘mission'”. To me, loving her and knowing how irrational she is at the moment, that would be grossly negligent. There is the very real possibility that she would put herself in the hands of some very bad actors and end up greatly harmed, dead or missing.

    On the other hand, to facilitate her return to the hospital would be to put her back into the hands of those who have unchecked power to harm her body, mind and spirit.

    This is what prompted me to ask the questions I did in my initial comment above. And your responses were obviously well thought out and somewhat helpful. But I still struggle to see how it would work in the kind of situation I’ve described.

    I’d be interested in any and all input on this.

    Thanks.

  • I strongly agree with most of what you say, Jon. That your background has included working in an inpatient psychiatric setting gives you more credence in my eyes. Some people’s comments, whether in favor of increased or decreased psychiatric hospital beds, seem naive and make me wonder whether they’ve ever really experienced or witnessed the extreme mental states that lead to civil commitments. Don’t get me wrong, I’m not justifying such commitments, and especially not the ill-conceived “treatments” forced on people in such extreme states. But I’m convinced that any really effective alternative (such as the “Open Dialogue” treatment model in the Lapland province of Finland) has to be very well thought out, carefully staffed and implemented.

    I’m totally on board with your vision of a very different type of crisis care, staffed primarily by peers and therapists; a place that would provide as you say “a space to experience deep distress and extreme states that is safe and caring”. And I further agree that increasing existing hospital beds is both untenable in terms of cost and ultimately leads to great harm to those it purports to help.

    However, I have to ask you to be very real and honest about this: Based on your experience, both in the inpatient psychiatric unit and in your current practice at “Hearthside Healing”, do you believe the primarily peer-staffed facilities you’re aware of would really be equipped to appropriately help people in the most distressing mental states (e.g., psychotic mania)? What about the issue of locked wards? Do you think this is ever warranted, and if not, what is the alternative? How would you address safety for residents and staff? You probably know that people in the “Torrey/Jaffe” camp have plenty of concerns and “scare stories” from people who disparage alternative programs as grossly inadequate (of course, we’re well aware of the very real “scare stories” that abound in the current “gulag psychepelago” system!)

    Part of the maddening dilemma, as i see it, is fueled by the pernicious circular reasoning of conventional psychiatry. Since the existing “standard of care” dictates that these extreme states be “treated” aggressively with medication, there is no allowance for non-drug interventions. Therefore, aside from the few drug naive distressed people who might find their way to such a progressive, primarily peer-staffed facility, many of those who come in will be in the throes of prescription drug withdrawal (perhaps mixed with effects of street drugs), or will need to have careful adjustment (hopefully tapering and eventual discontinuance) of the drugs they’ve been put on. And, of course, there’s the issue of very little funding and public support of such alternatives.

    Oi vay! But I like your spirit and ideas, and we have to keep plugging away!

  • What’s especially egregious is when they induce or exacerbate aggressive or otherwise “dysregulated” behavior with their ham-handed “treatments” (usually bombarding the individual’s brain with toxic chemicals) and then punish the resulting drug-induced behavior with seclusion, restraint and more drugging or shocking of the brain. I’ve witnessed it up close and personal, and it’s very sad and infuriating.

    Yet I’m thankful for this article and those who promoted this change in policy and practice in at least one hospital. I think we need to celebrate even small advances toward more sound and humanitarian practices, and try to promote this in our own circles of influence however we can.

  • David, I can’t tell you how wonderful it is to see this excellent article here on the “front page” of the MIA site! My heart sank when I heard of your terrible accident and I was grieved that perhaps we had lost one of the best advocates and spokespersons for those abused by mainstream psychiatry’s ill-founded practices.

    Well, I see that we have not lost you! You may not remember me, but I’ll never forget how amazed and blessed I felt about eight years ago when, after stumbling across an article you wrote (“Madness and the Mental Health System”) and looking up the phone number for your organization, Mind Freedom International, I heard your voice on the other end of the line. I was in a desperate moment because of the “no exit” nightmare my daughter was experiencing in the psych ward of a local hospital. Your genuine caring, compassion and commitment–with actions to back up the words– came through loud and clear and was a great comfort to me. She has recovered well in many ways, as I write this. I am thankful for this, although she still has a long way to go, i believe, to undo the damage inflicted upon her.

    We are definitely in different places in terms of religious belief and practice, and to me that underscores the very point you are making. When it comes to our passion to expose and stop abusive, coercive, de-humanizing practices in psychiatry, we are united! I believe within any group there is a human tendency to drift off message, form exclusionary “inner circles”, start to pick at one another over differences, etc. These, of course, undermine the unity needed to move forward and accomplish worthy goals.

    Speaking of religious groups and their involvement and/or stance with regard to the practices of psychiatry, I must say I’m extremely disappointed at how many of my fellow Christians have been bamboozled by the unholy alliance of Big Pharma and mainstream psychiatry and bought into the false and often damaging narrative promoted by these institutions. A “daydream” I’ve often had is picturing Jesus appearing at a “mental health” symposium being held in a Christian church, taking a bullwhip to the pharmaceutical reps and their “hired guns”, overturning their tables, and bellowing “It is written, My house shall be called a house of prayer, but you have made it an opium den!”–or something like that. Fortunately, I am working with some kindred spirits within my Christian community to shed the light of truth (hopefully in love) on this issue.

    I’m proud to say I’m a supporter of Mind Freedom International and Mad in America, both of which I thank God for (even for those of you in either group who may be offended that i mentioned God!). Thanks for your years of tireless advocacy, David. Keep up the good work!

  • Thanks, Philip for your continued work in exposing the psuedoscience, misleading information and outright deception behind what I call this “gulag psychipelago” that continues to ensnare so many of our fellow human beings. I really appreciate your diligent research and your well reasoned and articulated articles.

  • “What if instead of heading down this dead end again, we focus on the “socially isolated” part of the equation? Could we find ways together focused not as much on how to help get people into treatment, but how to help get them into life?”

    Excellent point, Mark…I totally agree!

    Even though I’m leery of all the psychiatric labels that get increasingly thrown around in our culture these days, there’s one that I think may have some validity/utility with regard to some of these mass murderers: malignant narcissism. I first heard it mentioned in reference to the boys who committed the mass shooting at Columbine. I also got a strong feeling of malignant narcissism (more than psychosis) in what Elliot Rodger revealed of himself in those videos he made before his murderous rampage in Santa Barbara. Social isolation was certainly a strong theme as well, and i wonder to what extent social isolation may be a “breeding ground” for malignant narcissism.

    At any rate, I agree that more efforts should be expended to get isolated people into life (not in a coercive way, though, which can be tricky) rather than looking for “treatment” (which usually translates to medication). Elliot Rodger apparently had plenty of “treatment”, and I believe it was revealed after the fact that Eric Harris and Dylan Klebold were both taking psychiatric medications.

  • Thanks, Francesca! Yes, I thought it was a bit strange that he seemed to be implying that since “the chemical imbalance hypothesis is difficult to disprove” that it follows that we can assume it’s true until disproven! In my response to his response, i included the following:

    “I hear your point about the difficulty disproving the chemical balance hypothesis; however, I’m concerned that the false story keeps going forward full steam (despite evidence to the contrary) that depression and other mental health difficulties are KNOWN to be caused by chemical imbalances in the brain, which can be corrected by specific medications. And then it seems to me that the potential benefits of these supposed “brain chemistry correcting” drugs tend to be greatly inflated and the risks minimized–which is contrary to the principal of ‘informed consent'”.

  • Thanks for another superb, articulate article, Joanna!

    I’m late to respond to this article, so my chances of getting feedback to this question are probably slim, but here goes:

    I’ve been trying, with some success lately, to have a dialogue with my PCP on the issue of psych meds in general and antidepressants in particular. In response to an article i attached to an email to him, indicating that the “low serotonin hypothesis” of depression has long been debunked, his defense of antidepressants included the following:

    ” I believe the chemical imbalance hypothesis is difficult to disprove until we have a thorough understanding of neurotransmitter metabolism at the level of the CNS. A blood serum level of serotonin or norepinephrine does not have to correlate with a neurosynapse serotonin or NE level. For example, most of our potassium is in the cells, not in the blood.”

    I’ve tried some internet searches to address this question of blood serum levels of serotonin or norepinephrine versus neurosynapse levels and haven’t come up with anything definite yet. I would really appreciate any light anyone has to shed on this issue.

  • I’m sure I read this excellent, informative article before, Paul, but I’m coming back to it because of a dialogue I’m having with my PCP about psych meds in general and antidepressants in particular. I doubt whether anyone will read this, given how long ago the article was written, but I’m hoping so because I’d like to get some feedback on a question. In response to an article i attached to an email to my family doctor, indicating that the “low serotonin hypothesis” of depression has long been debunked, his defense of antidepressants included the following:

    ” I believe the chemical imbalance hypothesis is difficult to disprove until we have a thorough understanding of neurotransmitter metabolism at the level of the CNS. A blood serum level of serotonin or norepinephrine does not have to correlate with a neurosynapse serotonin or NE level. For example, most of our potassium is in the cells, not in the blood.”

    I’ve tried some internet searches to address this question of blood serum levels of serotonin or norepinephrine versus neurosynapse levels and haven’t come up with anything definite yet. I would really appreciate any light anyone has to shed on this issue.

  • Wow! That’s more good news, and I’ll be VERY interested in what comes out of that discussion. As for answering my questions, you have in a general way. But more specifically, (1) do you think the idea of the state agency i mentioned not approving a drug unless there’s a tapering plan attached to it is a sound practice; and (2) doesn’t it make sense to never rule out that the POSSIBILITY of the minimum effective dosage (eventually) of any psychotropic medication would be zero?

    The reason I’m so interested in these questions is that most folks on psychotropic meds who want to try tapering are forced to do this on their own at present. It seems to me that if such a policy, and more importantly such a mindset, comes more into the medical/psychiatric mainstream, more people will have support in carefully tapering these toxic substances in a way that will have more chance of success. Now, when i call them “toxic substances” to be honest I cannot say that is ALL they are. I have seen instances, both with my daughter and others, where clarity of mind followed closely on the heels of the administration of a neuroleptic medication. However, in the cases I’m familiar with the question still remains as to what brought about the psychotic state in the first place, including medical “brain tinkering” that appeared dubious, at best. My experiences with doctors, psychiatrists and even mental health therapists, to date, tends to leave me discouraged and sometimes very angry. I sometimes see these professionals as little more than shills for the pharmaceutical industry, even though I don’t believe most of them are consciously so. “Commercialism masquerading as education”, to use your words. That’s a huge part of the problem, as i see it.

  • Hi Sandra, we’ve had some conversation about this before, so it’s kind of a continuation. I’m encouraged by your honesty, candor and willingness to challenge your colleagues while maintaining what seems to be a respectful dialogue–even your willingness to take some rather sharp criticism (at times) from some psychiatric survivors on this site who have been badly burned by the status quo.

    I resonate strongly with one of your last comments during the Q & A at the end of this presentation; that is, the real problem with the short time frame imposed on current acute care for psychosis (ten days!). This clearly fuels the reliance on heavy drugging with neuroleptics, and stands in the way of alternative non-drug approaches. Even with all the drugs (actually, because of them i would say) my daughter underwent several protracted, torturous “treatments” in which they put her brain through the wringer. Ironically, i believe it was this “rush to stabilize” (with drugs) that actually undermined her recovery! (The last time she was in an acute psychiatric ward of the local hospital for about three months, followed by a couple more months in the local state hospital).

    In response to the concern I expressed previously (and still have) about the lack of non-drug options that exists in our country (and most others) in treating psychosis, you stated something to the effect that it would be a great improvement if psychiatrists would at least adhere to the principle of prescribing the least effective dosage–a practice which is very robustly supported even “within the mainstream”. I’ve been thinking a lot about that recently and heard some very encouraging news that one of the agencies in New York State that works with people with developmental disabilities (it may be DDSO) has the policy that a psychotropic drug for any client will only be approved if it comes with a plan to taper it from the outset! I hope this is true (I plan to look into it further), and i hope such a policy expands to other state agencies. Actually, it would be even better, in my opinion, if they had policies and practices that sharply curtailed the use of these medications altogether.

    Now here’s the really good thing, at least in my mind at this point: Since we know that people have successfully tapered off of every psychotropic drug, the possibility that the “least effective dose” might be zero for any given person should always be considered. Of course, the tapering process would need to be done in a very careful, very individualized manner.

    What do you think?

  • I just received an email about H.R. 4574, the “Strengthening Mental Health in Our Communities Act”, recently sponsored by several Democrat congressional reps as an alternative to the Murphy Bill. I just sent an email message my NY Representative, Louise Slaughter, urging her support of that, as well as the “Parental Protection Act” mentioned here, which is being sponsored by a Republican congressman. I believe these bills should both have bipartisan support!

  • Thank you, Congressman Stockman! As I’ve said before, this case cries out for a “Justina’s Law” to begin to curb these misguided zealots (or worse!) and put in place a watchdog, with teeth! As I’ve also said before, I believe Justina’s case is merely the tip of an iceberg of heavy-handed psychiatric coercion that goes on routinely–especially with the unfortunate voiceless youngsters who end up as wards of the state.

  • Someone Else and Laura,

    I’m glad you’re discussing this issue of psychiatric records. I’ve also encountered varying resistance with this (getting my daughter’s records), but I’ve been pretty insistent and have gotten most of them. The discharge summaries from her hospital stays are riddled with errors and, of course, present things generally in a way slanted to justify their “treatment” while giving little or no indication of things that would call into question their “treatment” methods and decisions. I really think we need to press forward with full force in demanding full access to these records. I don’t think any other branch of medicine could get away with denying patients access to their records the way psychiatry does. They use the cloak of “confidentiality” and “best interest of the patient”, in my opinion, as a cover up. I think this one issue, if pressed, would go a long way towards exposing the shoddy, “hit or miss”, injurious practices that seem so prevalent in psychiatry.

  • Another great article, Laura…thank you! Your story, vision, passion, compassion and bold leadership continue to be greatly inspiring! Carol and I will be taking the Staten Island Ferry to Manhattan tomorrow morning. We’ll see you at the protest/rally.

    One other thing: When you spoke of those “close to my heart”, naming some of the fallen victims of psychiatry “and the countless brothers and sisters who’ve been hidden away behind years of heavy neuroleptics in group homes and state institutions” it reminded me of the sad souls i see every week when i visit my friend at a local “single residence occupancy” mental health facility. They’ve been conditioned to dutifully line up every day to take the drugs that are considered so essential to their mental health, while it is abundantly clear that they have suffered physical, emotional and social harm from these toxic substances. There HAS to be a better way, and it’s good to keep these beaten down folks in mind as we meet tomorrow.

  • I’m pretty much on the same page as you on this issue and many others here on MIA, Wiley, and I applaud Dershowitz for taking the stand he has on this and offering his services pro bono. However, there’s no way he’s a “right winger”!! Here’s how he describes himself: “I am a centralist liberal, and I get along very well with centralist conservatives. What I don’t like are extremists on either side…”

    I’ll make no bones about the fact that I’m generally on what would be considered the “conservative” side of many issues. However, if Justina’s case were being championed by the most liberal group imaginable, that would not at all deter me from joining them in decrying the blatant injustice being perpetrated on Justina and her family. Actually, I’m somewhat hopeful this case may illustrate there can be “common ground” and civil discourse between people across the wide political spectrum in our current world.

  • Thanks, Corinna. I like the following, especially:

    “We can speak with all the human eloquence and advocacy zeal, we can reveal all the mysteries of the mental health world, we can have advocacy efforts that move mountains, but if we don’t love, we have nothing. We are just a resounding gong.”

    That’s something i really need to keep in mind, as an antidote for the anger and bitterness that keeps welling up over how my daughter has been ravaged by the “mental health” system. Advocacy, yes; unproductive, bitter anger, no.

    “The only thing that matters is faith, expressing itself through love.”

  • …oh, and get a load of this, straight from Massachusett’s DCF website:

    “Supporting Children, Strengthening Families.”

    DCF Core Values

    The DCF Core Values are anchors that ground our practice. DCF is committed to making these values more than words on paper. By strengthening the links between the Department, families and communities, DCF will move closer to service delivery systems that reflect the core values:

    Child-driven
    Family-centered
    Community-focused
    Strength-based
    Committed to Diversity and Cultural Competence
    Committed to Continuous Learning

    HOW CRUELLY IRONIC!!

  • Nancy, thanks so much for this beautifully written article on behalf of Justina and her family! I wish this could appear on the front page of every newspaper in the country. I will certainly be posting it to my Facebook timeline. Is is going to take a million people surrounding the Massachusetts capitol and refusing to leave until Justina is freed to end this Stalinesque nightmare?

    I’ve called the Governor’s Office (Deval Patrick) twice already, asking that he intervene to restore Justina’s civil rights. I urge anyone reading this to contact him at the following:

    Phone: 617.725.4005
    888.870.7770 (in state)
    Fax: 617.727.9725
    TTY: 617.727.3666

    I also contacted the Interim Commission of Massachusetts’ Department of Children and Families, Olga I. Roche. Please call her office about this: 617-748-2000

  • Kudos, Barry, to you and your wife for having the courage and perseverance to pull through such a horrendous ordeal and then champion this issue in such an effective and saving way for so many! Your article is an encouragement to me to promote the awareness of the tremendous need for detox from psych meds here in the U.S.–and then have something done about it!

  • Another excellent article, Philip…thank you! I don’t really know what the current stats are, but i have long suspected that the apparent resurgence of ECT in recent years is connected to the increasing prescription of antidepressant medications. This article you cite by Rif El-Mallakh strengthens that suspicion. Like psychotropic meds, i’ve heard ECT spoken of by local psychiatrists and others as if it’s the best thing since sliced bread! Of course we know ECT is primarily used for “treatment resistant depression”, although it is also used for “treatment resistant mania” (which is what they tried to coerce my daughter to take it for). In either case, it seems so typical of psychiatry’s woefully ham-handed approach to things: after your full bore chemical assault fails, you turn to shocking the brain and inducing convulsions. If it were as benign as they portray, why isn’t it the first line of “treatment” instead of a last resort?? And why do they give people anti-convulsives if it isn’t because convulsions cause brain damage? And why don’t they conduct pre- and post-ECT neuropsychological assessments, including follow-up at periodic time points? Surely such studies would dispel the concerns of nay-sayers like me, no? Of course, we hear about and from those for whom “ECT saved my life!” Well, i certainly wouldn’t want to take that away from anyone. However, what they may not realize is that the ones who “saved their life” pushed them off the cliff in the first place. Luckily, they landed on a ledge below and the “ECT rescue helicopter” didn’t drop them to the canyon floor below! (We don’t hear too much about those unfortunate victims.)

  • From the Mirriam-Webster online dictionary:

    ep·i·dem·ic
    noun \ˌe-pə-ˈde-mik\

    medical : an occurrence in which a disease spreads very quickly and affects a large number of people

    : a sudden quickly spreading occurrence of something harmful or unwanted
    Full Definition of EPIDEMIC
    1
    : an outbreak of disease that spreads quickly and affects many individuals at the same time : an outbreak of epidemic disease
    2
    : an outbreak or product of sudden rapid spread, growth, or development

    Here is an excerpt from a review of “Anatomy of an Epidemic” by Dr. Marcia Angell, former editor-in-chief of the the New England Journal of Medicine:

    “A large survey of randomly selected adults, sponsored by the National Institute of Mental Health (NIMH) and conducted between 2001 and 2003, found that an astonishing 46 percent met criteria established by the American Psychiatric Association (APA) for having had at least one mental illness within four broad categories at some time in their lives. The categories were “anxiety disorders,” including, among other subcategories, phobias and post-traumatic stress disorder (PTSD); “mood disorders,” including major depression and bipolar disorders; “impulse-control disorders,” including various behavioral problems and attention-deficit/hyperactivity disorder (ADHD); and “substance use disorders,” including alcohol and drug abuse. Most met criteria for more than one diagnosis. Of a subgroup affected within the previous year, a third were under treatment—up from a fifth in a similar survey ten years earlier.”

    If you compare the numbers of people who would have been considered mentally ill in, say, 1940, to the above estimate, I believe this would constitute an increase that most people would consider one of “epidemic proportions”.

    However, as astounding and alarming as the increase in prevalence of what is considered “mental illness” has been over the past half-century or so has been, this wasn’t really the main point being made in Robert Whitaker’s book, as I understand it. He was not primarily making the case that psychotropic medications are causing the burgeoning numbers of people who are, or could be, diagnosed with a mental illness. He was pointing out that since the advent of psychotropic medications, the numbers of people being PERMANENTLY DISABLED by mental illness has been rising. This, of course, flies in the face of the narrative that continues to be repeated: that psych meds, by correcting the underlying brain chemical imbalance, have ENABLED more and more people who would otherwise have been institutionalized to live a healthy, happy and productive life.

    Anyway, thanks for your thought-provoking comments, Mental2. This is the kind of dialogue we need!

  • Excellent points, Steve, and so well summarized! And I join you in affirming Madmom’s caring and support for her daughter. Another heartrending thing I’ve witnessed is how few people in these locked psychiatric wards get visits from family or friends from “the outside”.

    I always appreciate your comments here at MIA, Steve. If you want to make another try at shedding some needed light on these issues at the next NASP convention, I’d be honored to join you in that venture if you’d like…but first I’ll have to re-register and pay my dues!

  • Madmom, I know very well the pain you’ve described so well. I witnessed and experienced very similar things during each of my daughter’s several hospitalizations. It’s so maddeningly frustrating when you have to watch your loved one decompensate under psychiatric “treatment” that is so damaging; and then to have to “go along with it” as a parent, because if you don’t you’ll be cut out of the picture entirely and then have no ability to at least have continued contact with your loved one and perhaps some ability to influence the “treatment”. The irony is, those in charge believe they’re reducing the severity and chronicity of “the brain disease” by medicating quickly, aggressively and continuously; in fact, the long-term studies (such as that recently published by Dr. Martin Harrow) indicate just the opposite! These biopsychiatric zealots always use “anosognosia” of people in extreme emotional/mental states as a justification for forced drugging. Why don’t we hear more about “anosognosia” of hospital staff?? In my experience most seem oblivious to the clearly evident damage being done on a daily basis to the victims of their “treatment”. My wife and i witnessed very clear symptoms of continuing akathisia in our daughter during her second lengthy hospitalization; however, it was never identified or mentioned by hospital staff, and we only became familiar with the term much later when her outpatient psychiatrist identified it from our description. And every week when I have lunch with my friend (diagnosed with schizophrenia) it is heartbreaking to see how physically and/or emotionally debilitated most of his fellow SRO residents have become–and, of course, they’re all well trained to dutifully line up for the meds that assure they will remain in this diminished state! Thankfully, my daughter has been out of the hospital for over 20 months and has recovered very well in many ways. However, she remains dependent on these substances which have clearly been very toxic, with no medical support to taper responsibly and instilled with the fear of relapse and re-hospitalization if she tries to “go off the plantation”.