Saturday, August 24, 2019

Comments by Welton

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  • PS: This quotation from Thomas Szasz summarizes one way of regarding the curse of psychiatric diagnoses:
    From Thomas Szasz, Psychiatry: The Science of Lies (Syracuse, NY: Syracuse University Press, 2008), pages 2-3 (italics in original).
    Objective (biological, chemical, physical) tests for diseases are based on the assumption that diseases are somatic phenomena. Accordingly, the claim that mental illnesses are brain diseases is profoundly self-contradictory: a disease of the brain is a brain disease, not a mental disease.

    Because there are no objective methods for detecting the presence or establishing the absence of mental diseases, and because psychiatric diagnoses are stigmatizing labels with the potential for causing far-reaching personal injury to the stigmatized person, the “mental patient’s” inability to prove his “psychiatric innocence” makes psychiatry one of the greatest dangers to liberty and responsibility in the modern world.
    The legal system recognizes the elementary distinction between innocence and guilt. The psychiatric system does not: it proudly rejects the concept of personal responsibility. Crime is a well-defined act. Mental illness is an ill-defined mental state. Criminal prosecution is defined, and popularly understood, as adversarial. Psychiatric treatment, even when forcibly imposed by law, is defined and widely accepted as nonadversarial. Those differences, together with the notion of mental illness, are the two great lies and injustices that undergird the psychiatric enterprise.

    It is possible to establish that a person accused of a crime is not guilty, that is, has not performed the illegal act attributed to him and is the victim of malicious prosecution serving, say, the personal-political ambitions of an unscrupulous district attorney; it is also possible to punish the person responsible for such malicious prosecution. In contrast, it is impossible to establish that a person diagnosed as mentally ill is not mentally ill and is the victim of malicious psychiatrization serving, say, the economic-ideological ambitions of the diagnostician; it is not possible to punish the person responsible for the injurious diagnosis that may be erroneous but, by definition, cannot be malicious.

    In the Anglo-American adversarial legal system, the accused is presumed innocent until proven otherwise, and the onus of proof of guilt is on the accuser. In the psychiatric-inquisitorial “medical” system, this relationship is reversed: the person diagnosed as mentally ill is presumed insane until proven otherwise, and the onus of disproof of insanity is on the (usually powerless) individual incriminated as “insane.” A priori, psychiatrists disqualify such claims of “psychiatric innocence” as evidence of the “insane patient’s” denial of his illness.

  • It certainly had the effect of a curse on me, the diagnosis of schizophrenia when I was 17 in 1965. After 53 years it still does, even though in 1974 I was “declared innocent” by subsequent psychologists and psychiatrists of ever having had any kind of mental illness and was able to stop taking all psychotropic drugs by 1975.

    Four years ago when I experienced “triggers” from prolonged chemotherapy and a bone marrow transplant for non-Hodgkins lymphoma, I consulted a psychiatrist at the cancer hospital, who told me I had PTSD from the electroshocks and drugs I was coerced into against my will when I was a teenager. That was helpful — to be told my “diagnosis” is a “disorder” that in my case was caused by psychiatric treatment (electroshock, and many many drugs) — but it did not take away the nightmares, triggers, and other problems.

    In my case, the original diagnosis was based on “diagnostic” comments my mother made such as “since she turned 14 she has not wanted to help around the house.” And my symptoms of fatigue and need for sleep were counted as psychiatric symptoms, even though the psychiatrist knew (or at least had in my medical file, although he might not have read it) the fact that three months previous I had been diagnosed by blood tests as having Epstein Barr virus, which was known even in 1965 to cause fatigue and sleepiness.

    If anyone had bothered to interview me or attempt counseling sessions they would have soon discovered that things at the home of my teenage self were chaotic, with two alcoholic parents who were monumentally unhappy and close to divorce. I was the classic “identified patient” or scapegoat, the youngest and most vulnerable member of my family.

    For almost four years I kept trying to tell them I was not crazy, that I needed someone to talk to and my parents did, too, but no one listened to a “schizophrenic” who was being shocked weekly, and coerced into taking neuroleptic drugs.

    After a 5-week hospitalization in 1966, initiated by my mother because she did not remember ordering me to come home from college (she was drunk when she did so) and thought I had just flown home on a whim, the psychiatrist was questioning me on the day of my release (from the hospital, not from the three more years of coerced out patient shock treatments, it later turned out).

    His most pressing question was whether I had attained a certain insight: “You must have known that if you came home from college like that, your parents would put you in the hospital, didn’t you?” He looked at me closely and I realized that my release from the hospital hinged on being able to lie successfully to him. The cat and mouse dynamic of this conversation was palpable. This man, who had hurt me over and over and who had blasted me into unconsciousness with an electrical surge when I was paralyzed and utterly powerless to resist, was now quizzing me, trying to seem casual, reasonable, trying to get me to be “reasonable” too, and agree that I should have known my parents would force me into a mental hospital if I came home from my first semester of college. (Nevermind that I had repeatedly told him during the 5 weeks that my parents had ordered me to come home — this was ignored when my mother was interviewed and, not remembering having done so, denied ordering me home.)

    I knew he was on the lookout for anything I might say that would reinforce his definition (diagnosis) of me, anything that might indicate a need for stronger drugs, more shocks. I knew what the truth was, I saw the situation clearly. But he had the power to destroy me and there was no way to convince him or anyone else that I did not need this kind of treatment, that I was not crazy. If I protested that I was not mentally ill, he would see the protest as a symptom of mental illness and conclude the treatment had not “worked.” I had no choice but to agree.

    I was one of the lucky ones. After three more years of outpatient shocks while attending a local college, I was able to get away from the psychiatrist and from my family situation. Having secured a job, I moved away to another state and found a psychologist who realized how grossly maltreated I had been. I attended therapy with the psychologist, who also referred me to a psychiatrist friend of his, who helped me withdraw successfully over a two year period from all psychotropic medications I had been taking (Thorazine, Compazine, Stellazine, Norpramin, Artane) for the past 10 years. By 1975 I was free of all psychotropic drugs, but not of the recurring nightmares, sadness, and other problems caused by the trauma of the treatment I had been subjected to; some of these consequences of the trauma of psychiatric abuse continue to this day, although I have been able to have something of a career and have been a partner in a stable and loving marriage of over 40 years.

    So, yes, psychiatric diagnosis was indeed a kind of curse for me.

  • Why isn’t there a TV series, long running, about a brave, humane, kind psychologist who works in a clinic and tries to help people by talking with them about their fears and sadness? The brave psychologist could be the hero of the piece and he or she could also try to help the patients and inmates by getting them off of psychotropic drugs? There could be villains — psychiatrists who push drugs and ECT, and there could be romance (between psychologists, psychiatrists, and even patients/clients). It could be an ensemble series, sort of like The Good Wife, that ran 7 seasons. There could be plenty of drama, and there could be more than one hero/heroine. Maybe such a series could help publicize and further the idea of the need for change in the practice of psychiatry and mental hospitals. Of course, the series would need excellent actors and high production values, which would mean it would need much money. And I am sure big Pharma would not sponsor it.

    There could even be retrospective episodes to past decades or even historical eras: one history I remember reading was about a woman who had been institutionalized for over 30 years for psychosis and depression. Finally someone thought to do a blood workup and discovered she had extreme hypothyroidism and no one had ever thought to test her. Of course, when she was originally hospitalized, there were no blood tests for thyroid levels. All the pain and anguish modern psychiatry has caused needs to be publicized, even in a commercial product, like a TV series.

  • Yes. These large group experiences can actually cause trauma to participants. As a survivor of psychiatric abuse in the 1960s (10 years of neuroleptic drugs and almost 4 years of electroshock), I somehow knew to avoid Erhard Seminars and all the rest when I heard about them in the 1970s. I believe asking someone who has been traumatized by violence or abuse or by the psychiatric system itself to “take responsibility” for their fears of further abuse is simply more abuse! Although the psychiatric system never succeeded in totally brainwashing me (I never accepted the label of “mentally ill” and I was never in any way mentally ill), it did cause me to have nightmares, fear of medical procedures, various “trigger” symptoms, hyperarousal, exaggerated startle response, etc. etc. for more than 50 years. I recounted my experiences with the 1960s psychiatric system in my memoir, From the Lion’s Mouth, published in 2014, in the hopes that it might help other people avoid or heal from the folly and abuse of the biomedically based psychiatric system.
    Thanks for your post and thanks to Emily for this informative article.
    Julia Welton

  • This is a heartbreaking set of histories and all too typical of the biomedical model of mental health operative since the 1950s and even before. I believe that relatively “mild” abuse — emotional and verbal abuse rather than physical and/or sexual abuse of children — often results in symptoms that may not involve actually physically hearing voices telling the person they are “worthless.” Instead, sometimes symptoms of this “less extreme” abuse can involve what has been referred to as “negative self-talk” or feelings of being worthless, stupid, etc. with no actual “hallucinatory” symptoms.

    Even though I never had any delusion or any kind of hallucination, I was diagnosed in the 1960s as paranoid schizophrenic and endured 10 years of major tranquilizers as well as almost 4 years of electroshock. All of this was the result of being the “identified patient” in a family with two functional-alcoholic parents who underneath it all were extremely unhappy and somehow, I believe, did not want their alcoholism or unhappiness discovered. I was “identified” as the patient when I was 17, because of such simple things as the fact that at age 14 I began to be “less helpful around the house.”

    I was among the fortunate in that even after the years of psychiatric abuse, I refused to accept the diagnosis I had been labeled with. I found good, caring psychologists who helped me withdraw from all psychotropic drugs, and with whom I was able to talk about and heal from what had happened to me as a child and teenager. I have recounted my history in a memoir, “From the Lion’s Mouth: Healing from Trauma, Electroshock, Scapegoating, and Grief in a Dysfunctional Family and Psychiatric System” published in 2014. The more survivors of psychiatric abuse speak out, I believe, the more we can help others avoid the trauma of psychiatric abuse, or heal from it.

  • Thank you for your essay. I agree totally with the torture definition, having been subjected to coerced drugging and electroshock for almost 4 years as a teenager back in the 1960s. I have long seen the way the doctors “treated” me as torture, except, I always felt like in a “typical” torture scenario (television, not reality) the torturers are trying to extract information (WWII resistance fighters tortured by the Gestapo to reveal names, etc. etc.). But in my case I was only 17 when they started. I would have done anything they asked me to do if only they would have stopped the electroshock, but they did not see things that way, and never told me how I should behave or what information I was supposed to reveal to them that would make them stop — hence, I felt like I was being tortured and the reason for the torture was being withheld. The closest literary analogy I have found was in Orwell’s 1984. There was no “talk therapy” of any kind offered by the man who shocked me and nothing of that kind at the hospital. From the nurses’ notes I acquired 30 years later I was able to see that the doctors wanted me to “socialize” with the other inmates, play games, etc. Complaining about the treatments only resulted in your being shocked an extra time, or more medication. The doctor duped my parents into cooperating with him, and they did not listen to me when I told them it was harming me, so I had to shut up and hold on. They finally stopped when I turned 21 and made a comment that they could no longer do this to me on the strength of my signatures (coerced) at age 17 and 18. 21 was the legal age in that state at that time.

    At one point the psychiatrist who “treated” me asked me if I understood why I had been abducted from the airport (by my parents — because I called home from college crying!) and placed in a mental hospital against my will. He said I should have known that this would happen. I knew no such thing, but I knew enough to lie to him, since I had intuitively figured out (underneath all the drugs and shocks I had received for 5 weeks in the mental hospital) that I had to lie and say I should have known. Of course this did not help me during the next 3 years of coerced outpatient treatments.

    As I grow old, my fear of mistreatment increases, since I know that elderly women are still “targeted” for electroshock. I have had many PTSD symptoms ever since the first summer I was subjected to electroshock, the summer of 1965. Over the years the symptoms have decreased, but some are still present, and others surface now and again in times of stress. I am lucky to be alive at all, and even more lucky to have had something of a career, and a long marriage with a good man. I think often of others who were not so lucky.
    Thank you for your essay.

  • I am very confused by the fourth part of the definition of treatment resistant depression:
    “(iv) the absence of physical illness or psychosocial dysfunction, which should be the primary focus of treatment.”

    Does this mean that TRD is characterized by “the absence of physical illness or psychosocial dysfunction”? Perhaps I am not well informed, but the wording here suggests to me that someone diagnosed with treatment resistant depression has no physical illness and has no problems (dysfunction) in their psychological and social life.

    Seems to me that anyone with depression would have problems (dysfunction) in psychological and social life and that treatments tried should definitely include counseling and psychotherapy.

    But the only “treatment” the definition recognizes seems to be drug treatment.

  • The psychiatrist who victimized me (1965-1972) was eventually fired from the hospital for indiscriminate use of electroshock. Apparently he was “disciplined” by the Alabama Board of Medical Examiners for indiscriminate use of electroshock — but the disciplinary action was not made public and was a simple order to cease practicing for a certain number of years — he was allowed to keep his license, but under the gentlemen’s agreement type of medical board standards back then, there was no public notice of any of it.

    But what I specifically wanted to say here is another quotation or paraphrase. I read somewhere a new (to me) definition of the words guilt and shame which struck me as incredibly revealing. When I feel shame, I am mainly concerned with my own self — how I look or seem to other people. When I feel guilt I am mainly concerned with the pain or damage I have caused to another person. That is when I would seek forgiveness — if I feel guilt about something, I want to, as much as possible, make up for the pain or harm I have caused another person, because I am concerned about the other person. If I feel shame about something I want to conceal what I have done, excuse it, etc.

    I doubt the doctor who harmed me and also damaged many other people during his practice of electroshock was ever concerned with the harm he did any of his patients. And the medical board of the time helped him hide his shame by not making public what had happened.

    The dysfunctional psychiatric system shames its patients with stigmatizing labels and “treatments” which render its patients vulnerable and ashamed, all the while denying and hiding its own shame. Let us hope that movements like Mad in America can contribute to a major change in psychiatry.

    My own experience is related in my book: From the Lion’s Mouth: Healing from Trauma, Electroshock, Scapegoating and Grief in a Dysfunctional Family and Psychiatric System, byJulia Hoeffler Welton.

  • Regarding forgiveness: I do not believe forgiveness is needed or necessary. Sometimes it is impossible, I think, because true forgiveness takes two people. Before an injured person can even possibly forgive a perpetrator, the perpetrator must recognize the injustice and violence of his (or her) actions and realize the harm he (or she) has done to the injured person. The perpetrator must seek forgiveness from the person who was injured. Miroslav Volf has much to say about forgiveness in his book, The End of Memory. One relevant quotation is this: “If no one remembers a misdeed or names it publicly, it remains invisible. To the outside observer, its victim is not a victim, and its perpetrator is not a perpetrator; both are misperceived because the suffering of the one and the violence of the other go unseen – the first when the original deed is done and the second when it disappears. This injustice of hiding wrongs fuels the strong urge many victims feel to make known what they have suffered, even if some are hesitant to speak up. Since the public remembering of wrongs is an act that acknowledges them, it is therefore also an act of justice. This holds true at both the personal and broader levels.”