Sunday, June 25, 2017

Comments by Robert Berezin, MD

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  • Richard,
    I appreciate your responses.And discussion is what its all about.
    I do not regard myself as dogmatic. I write from my accumulated experience as I know the world to be, just as you do. I am cursed to have to think for myself and not follow any dogma. I also sense a kindred spirit with that same curse, although we don’t agree on some, if not, many things.

    It isn’t from dogmatism, nor being unscientific. I don’t agree that psychedelic drugs ‘might help people access certain traumatic memories that help them reprocess these past events in such a way (not previously possible) that allows the to move on from the negative power of said events”. My experience has taught me the opposite. In my experience, drug insights do not and can not get integrated in a real way. It is only emotional insights that are transformative, in the context of trust. I’ve not had the experience in my practice of not being able to access trauma. I have had the experience of dealing with pseudo drug insights which has to be disavowed, before the trauma can be accessed. These processes are what I have devoted my life to.

    In terms of high horses, I would say, “You can lead a horse to water, but you can’t make him float.”

  • Just a note. I am opposed to the taking of all psychoactive drugs, not just antidepressants, benzodiazepines, opiates, cocaine, and amphetamines. Hallucinogens are the most psychoactive of all of them. The case many of you make that they are different from the others is kind of silly. Each drug is obviously different from the others. They have different mechanisms of action and effect different receptor sites. LSD fires up the brain in a random fashion. The consequent disorganization affects specifically the area for perceptions.
    Keep in mind, we live our lives in our regular consciousness. Drug induced changes in consciousness aren’t a higher consciousness, but a different drug induced state of consciousness. Higher is just a false attribution. It’s also possible to play with consciousness without drugs. You may find your trips valuable which is not my business. It is my business to advocate for open usage or Psychiatric usage of hallucinogens.
    It’s also possible that one’s so-called insights from acid trips are quite illusory and do not translate into either love or wisdom. Even though they may not be physically addictive, the drugs are often psychologically addictive, which isn’t a ton of difference. We all live in the real world, not a drug world. As they say in Zen: First there was a mountain; then was no mountain; then there was a mountain as before
    The wards were filled with LSD psychoses in the seventies, whether you believe that or not. The very idea that hallucinogens will cure drug addiction and all the rest of psychiatric problems is nonsense. For people who are against psychiatric drugs (and I am one), I’m a little surprised that some of you actually believe in a chemical cure after all. Could this be a little hypocritical? The art of living a good life is very difficult indeed. It doesn’t only comes from mourning our traumatic pain. It comes from learning from our experience and finding our way to be open, honest, caring, non-judgmental, and courageous. Any way any of us get there is worthy of respect.

  • Rossa.
    What’s more important than anything else is your situation with your son. The last thing in the world I would want is to affect your relationship with hope. Other discussions are secondary.
    My reference to Geel, is a historical one. It was a unique situation in Europe where people with schizophrenia were respected and valued. This is in contrast to otherwise vicious and horrendous attitudes. This was an enlightened exception to what was going on. Current day Geel is not the issue at all. When drugs came into Europe in the fifties, that infected Geel too. Todays Geel bears little resemblance to historical Geel. I was just referencing it as something humane. There was a humane period in the United States in the early nineteen hundreds, here in Massachusetts, when the state hospital system began. Back then the idea was for a pastoral cure where beautiful acres of land was used for individuals to be in nature, and away from industrial life. It was only later that it got perverted into warehousing and ended up as snake pits. Wars, and lack of money destroyed a good idea.
    In my knowledge, throughout history there were many theories about schizophrenia, most of them were horrendous and wrong. Many originated in religious persecutions. There are lots of ideas around today, some may be right, and others may be wrong. Schizophrenia has been plagued by false ideas. I’m in favor of whatever is useful. Historically, outcomes from schizophrenia have brought a great deal of heartbreak to families. That does not mean it will in your case. In my experience I have had gratifying outcomes through the hard work of psychotherapy. If other approaches prove to be useful, then that would be great.
    I wish you the best.

  • Richard,
    I certainly have addressed the scientific legitimacy of contemporary psychiatry many times. “Contemporary Psychiatric Diagnosis is a Fraud. The destructive and damaging fiction of biological ‘diseases’.” and many other blogs. I do my best to address the truth as I see it.
    When I started out there wasn’t any pharmaceutical psychiatry. My quest at that time was to promote good psychotherapy, which is still my quest. Although one does not need to be an MD to do therapy, I believe there continues to be a place for the doctorly practice of good psychotherapy. Not only that there is a huge need to be a doctor of the mind, as well as the body. The mind and the body are actually one thing. I feel its important to have that current vacuum filled with intelligence, care, and compassion.
    I do my best to speak out. I’m clear about the state of psychiatry in today’s world. My identity is not political. I am a practitioner and this is what I value. I have spent many years as a kind of street priest psychiatrist, working in housing projects and committed to the community. We all try to do good in our own way. Your fight with psychiatry as a medical specialty is not mine.

  • Of course the consequences of drugs creating brain problems is huge. That does not relate to psychotherapy. There needs to be a cessation, or a careful taper. Then there is grappling with the long term consequences of physical effects on the brain from the drugs. There is no doubt that a supportive relationship while going through this is important. There may well be underlying issues that would be useful to deal with in therapy, the reason why one was inappropriately given drugs in the first place.

  • As usual, I don’t disagree. Psychotherapy requires that the therapist be in fact trustworthy. The therapist can’t be in it for his own ego, or power, or control, never mind sadism. It really is a calling that proceeds from respect and love. Each therapist must find his own way sufficiently to not impose, but to listen. The art of therapy proceeds through responsiveness and intuition. Therapy is ultimately moral, (not moralistic) and the recovery of innocence and authenticity, the real source of strength to make it in this world. There are always dangers of misuse and as you say gaslighting, but we must do the best we can in this imperfect world.

  • Rossa,
    Let me try to clarify a few points. The issue as to how trauma is digested by our temperament is the essence of how the play of consciousness is written. In my understanding this is how consciousness is organized in the brain. It attends to how psychotherapy itself works by healing the trauma.
    I don’t understand your problem with Geel. It has been an environment where individuals with schizophrenia have been accepted and treated with respect and love and appreciated for who they are. It is simply historically accurate to recognize that many people with schizophrenia suffer some degrees of disability. This has been true throughout history. The situation in Geel does not have any relationship to psychotherapy which is a very recent practice.
    I am suggesting that people can recover very well from schizophrenia. And psychotherapy can be such an important help. Not everyone is the same. Some people end up with some disability and others do not. I have treated many people with schizophrenia. The comment about a first psychotic break was a reference to the fact that schizophrenia is not hopeless, as it is often assumed to be by todays incorrect standards. I certainly did not imply that there is no hope beyond the first episode.

  • Alex,
    I don’t disagree with anything you say. I deal with damage by therapist all the time. And furthermore, especially today, it’s almost impossible to find a good therapist. Just in case you didn’t know, I include you as a good therapist. I don’t care what people call themselves. Most people in the regular world of therapists should stop what they are doing and get a real job someplace else. There are good ones out there, but its mostly a matter of luck, or word of mouth to find someone.
    This does not mean that the real item can’t be taught. It needs a sympathetic person who has the internal grasp, the caring, and the humility. There are certainly too many people who bolster their own ego by being superior, in the ‘we/they’. Any good therapist has to come to terms with himself though his own process of discovery and caring. I also agree that great harm can be done. But nonetheless I know and value the beauty of the real process.
    I am sympathetic to those who have been wronged and damaged by gaslighting and diminishment of any kind. It is infuriating.

  • Alex,
    As you know I respect and value your work. Although we do have differences over forgiveness. In my work for the most part, the inclination to practice forgiveness is often a form of masochism in the service of re-establishing or maintaining with an abuser. Often one still seeks approval and fear of rejection no matter what. In my experience it is mourning that frees one from the corrosiveness of resentment. After digesting the pain, one simply moves away from it, and it loses power. That is what sets one free to be and to love. I don’t see any role for forgiveness. At the same time, I would never try to control my patients as to how they should feel. I respect their own authenticity to find their own way. If forgiveness is important to them so be it, unless it operates as a masochistic issue.
    So I hope in relation to our differences you can ‘forgive’ me.
    Dr. B

  • As you know, I certainly do not believe biology is destiny. Nurture is what is important, not epigenetics. I’m not as impressed by epigenetics as the apparent scholar bbthelpe. Believe me I understand the research and the methylization of DNA. I think we will find in the long run that epigenetic effects will prove to be quite minimal. There are Lamarkians of every generation since Darwin. The proof is not at all conclusive as to what methylzation actually does. The studies which demonstrate epigenetic effects are pretty weak, although they are highly touted by the faddish press.

  • Alex,
    I hope your move to the redwoods has brought you some peace. Thank you for the movie. I enjoyed it. I’m glad you decided to perform. Being a musician myself, I am familiar with the issues. I have to say it helped having some voices of angels on board. And the Band was a great choice for the finale.
    I always appreciate your clarity. And I wish you well as always.

  • Thank you Alex.
    I expect its just a matter of terminology. I think mourning is what is involved in coming to terms with the past. In my mind resentments are a major part of what needs to be mourned, which is how they lose their power to allow for the necessary shifts. Yes, and we then write a new play that doesn’t exactly change who we are, but allows us to be our best selves. I appreciate your sensibility and we share a common interest in “The impact of our feeling and emotional nature on how our brain interprets our experience and creates our personal reality …”

  • Daniel,
    I don’t think it’s possible to get scientific clarity on how serotonin actually operates on the brain with regard to mood and emotion, past a certain point. What I am suggesting is an explanation which covers the known facts, not just some of them. On this basis I feel reasonably clear. The theories that I have come across don’t even pretend to answer the various issues that have been addressed.
    If you find that there are other understandings that seem more accurate, I of course would be open to that. Knowledge is not a personal possession but a link in the ongoing chain of our collective understanding. If something else is more accurate than throw out what I saw and go with the truth.
    For sure simple chemical imbalance is just a joke. I haven’t seen anything else that addresses how ‘depression’ actually relates to a neurotransmitter and describes a feasible mechanism. This explanation incorporates the relation between the neurological and the human. Again, this is very fully developed in the book, through brain development and embryonic morphogenesis and how they relate to consciousness.

  • Thanks oldhead,
    Since I long ago stopped using Freudian/psychoanalytic terms I’m not capable of resuming now. I’m not being persnickety here, because I think it’s important to speak from a new and inclusive paradigm, where the language is simple, clear, meaningful, and understandable. I’ve lost patience years ago with theoretical ideas like ‘id’ that has no reference to actuality, but is a Freudian fantasy construct, and isn’t meaningful to me. I’d prefer to say it the way I did, that “However, what serotonin actually does is create a hardening of the self and an unconflicted selfishness. It intensifies an emotional hardening toward others. When fighting, you are hard and cruel. Your enemy is an “it,” not a person. There is an attitude of coldness and hatred toward your adversary. This amplifies the emotional reality of the invisible sadomasochistic personas. The escalated hardness and coldness from adding in extra fuel for aggression is often experienced as feeling good. This is due to the fact that there is no conflict over hurtfulness. This has been numbed. To heal from cruelty, you have to feel the appropriate remorse and regret.” Such a state has the potential, in certain people, to tend toward violence.

  • Daniel,
    This explanation covers all the bases. This is a paradigm that that actually explains ‘depression’. (I didn’t get into how different temperaments generate different symptoms.) As I said, serotonin affects the mappings of problematic plays. Yes, it can get depleted. This is generated by the endless internal war, not some biochemical flaw that creates some imbalance. It is the war that generates symptoms. Antidepressants don’t correct an imbalance, they temporarily feed the internally created hunger. The over feeding creates an imbalance. In the article I didn’t address how addictive antidepressants are. When they cease to feed the war hunger, more and more serotonin is demanded. If one ties to stop, they believe the imbalance is recreated. As if more serotonin fixes the imbalance again. Often pharmacological psychiatrists expertly add one or two more antidepressants to the mix. And then when that doesn’t work they go to antipsychotics and even shock treatments.
    I also didn’t address how problematic it is to discontinue (unnecessary and destructive) antidepressants. They create all kinds of debilitating symptoms. People often believe that their brain is truly damaged and the drugs are saving them. This is confusing, and is not true. MIA can tell you about these horrendous problems. Users commonly have horrific withdrawal symptoms that are almost never publicized. An array of frightening neurological symptoms appear when trying to detox off this psycho-active brain drug—vertigo, lightheadedness, burning or tingling sensations in the skin, difficulty with gait and balance, blurred vision, tremors, twitches and restlessness. Sometimes there are hallucinations. Often to discontinue antidepressants takes a year under careful supervision. And symptoms can continue for years after.
    Believe me I understand that there is not a lot of good psychotherapy out there. But insufficient therapy does not mean the understanding of how it all works is not correct. I feel so strongly that we need to promote good psychotherapy. I’m sorry to suggest my book, but this is where I fully address psychotherapy, which is not a simple subject. “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain.” In it I do address faith and religion, but in a very different context. I hope you read it and we can talk further.

  • I want to address what I feel are some misrepresentations. I must say that therapy is not ‘telling people they’re broken and defective and need to “repaired”’. And there is no implication at all that ‘badly developed personalities are to blame.’ People suffer because of how they adapt to trauma. The last thing in the world is some idea that they are to blame. Therapy is a respectful process that allows one to deal with their pain. In the context of boundaries, responsiveness and caring, one heals and recovers through their own authenticity. Therapy empowers the individual to fulfill themselves in their own way.
    In no way is it the imposition of some theory. It is listening to the story and following it wherever it leads. A therapist is not superior in any way to his patient. That would violate ‘respect’ itself, and would be adding violations on top of violations.
    Therapy is not about blame. We need to be clear where violations happen in order to face them an deal with them. Like Steve said – that we may raise our own children well.
    In addition most mothers are good mothers and that is the most important basis of love in the universe. It is what makes our children flourish and thrive. As I said before – there are all kinds of damaging traumas. These all need to be addressed. This does not mean some incorrect idea that I’m saying the real hidden cause is bad mothering. That is certainly not what I mean at all. It means that attending to and mourning the traumas of life is what therapy is about.
    And finally it is my experience that good therapy is a wonderful thing that frees people to be themselves, and to live and love well. That is what it is all about. It is not about control, or ego, or power or anything like that.
    In addition, I do not think it is the only way that people can deal with their struggles. What Alex talks about I also completely agree with. For me, psychotherapy is how I make my contribution.

  • I would add a few points: I have written extensively that trauma overrides and rewrites the original play of character. A great deal of therapy deals with such trauma of all kinds.
    The esssential point in the early years is that this is where the foundational play of character is written. This affects people all throughout life. The major forces at work there are parental. Brothers and sisters all have diferrent temperaments; parents don’t treat all children the same at all; Birth order makes a huge difference; kids adapt differently to deprivation and abuse; kids have different degrees of resiliance; do not imagine that people who come out of difficult circumstances don’t carry scars, they do. It is not misogeny to be clear about the the forces at work in the formative years. And again, maternal love is the most important thing in the universe.

  • I certainly agree that trauma from fathers, siblings, classmates, teachers etc. is major. However, the major player in the earliest formation of our character is mother, whether you like it or not. In general, mother is the most important figure – positively and negatively. The issue of deprivation is more subtle in its presentation, but not in its effects. A mother might seem to be doing all the good things, but something in the spirit isn’t there, and it affects the baby. Don’t get me wrong. I think maternal love is the most important thing on earth and I value it more than anything. One of the ways that a mother may effect her baby is – with a controlling father who intimidates mother and baby – the mother may not be able to provide sufficient nurturance due to being bullied. But the baby will nonetheless experience the absence of maternal nurture, even if it is not the mother’s fault. She is still the carrier of that nurture. It’s not about blame. I don’t know anything about your situation and I’m happy for you that your mother is a warm and wonderful person.
    I am addressing here the early formation of character which affects us all throughout life. There are certainly traumas all along the way that affect us powerfully and that of course needs to be dealt with.

  • bpdtransformation, B.A.
    I appreciate your thoughtful comments.
    I hope you will read my book, and I would be very interested in your response. In fact, what I have to say is closest to Fairbairn. It goes the next step and doesn’t even use a language of defences at all. It does encompass neuroscience which didn’t exist back then.
    When I started out psychiatry was not medicalized, and was purely humanitarian. I still hold out hope for a return to clarity. I think there is room for all practitioners, psychiatric and non psychiatric. And yes I don’t view it as medical. At the same time, in the best spirit, it is doctorly. I am often still suprised that later generations view psychiatry as medicalzed only. It didn’t used to be that way.

  • Honestly, it doesn’t really take a seven year study to know that talking to a patient is a revolutionary idea. Of course, we need psychotherapy; of course we need input from the community; medications may be relevant, but antipsychotics are not the treatment, but an aid to help diminish the terror. Schizophrenia is a human problem. People with schizophrenia are people. We need to make a relationship and deal with the psychotic character in psychotherapy. We need to treat the whole person. We have lost our way in believing that schizophrenia is some bio-neurological disorder.

  • Thank you GetItRight,
    I agree with most of what you said. As far as number (1) is concerned. I agree and I go to great lenghts in my book to spell that out. I was using as much shorthand as I can in a blog. I think people have gone overboard with the return to LeMarkian anti-Darwin transmission to subsequent generations. In fact in my opinion such ideas are rather weak with not a lot of evidence. (2) I include emotional neglect as co-equal to abuse.It is major and has such import regarding attachment. (3) I agree. (4) I’m not all impressed with EMDR. In all honesty, I think it is a silly fad. As far as I’m concerned it’s all about mourning. That isn’t to say that feelings are and memories aren’t located in the body. They are. I find that they are accessible by paying attention to them. It was a typo, and I meant to say what you wrote, “that ought to be a safe harbor for attachments?”. As far as your last point, I’ve been impressed that it is all encompassed in the human story.

  • I am sorry for your struggles. Antidepressants are addictive. There can be horrible effects of all kinds from discontinuation. And people end up believing their initial symptoms return. To stop medication, one has to do it very slowly over the course of a year. And still it is problematic. Unfortunately it should be done under the care of a psychiatrist. I wish you could find someone to work with, even two hours away, if just to deal with discontinuing the drugs.

  • Sandra,
    Of course psychotherapy could as effectively be offered by other’s without medical training. I was however, writing about psychiatry in this post. I have addressed that elsewhere. I cannot easily address the dogmatic question. In blog’s I have to resort to shorthand. I don’t mean to seem to be selling the book, but if you are genuinely interested as to whether the ‘psychotherapy of character’ is dogmatic, I would hope your would read it. I’d be happy to discuss it.

  • You have underscored what this article is about. Empathy is a form of projective self-involvement. As far as transforming empathy into compassion, I suggest you are barking up the wrong tree. There is an entirely different mechanism for what you are calling compassion. Instead of Buddhist training, the potential and natural presence of responsiveness has been there all along. This is shown in my blog- “What is Love?” – http://robertberezin.com/what-is-love-an-ode-to-motherhood-on-mothers-day/

  • Was pleased to receive such a nice tweet from Brett Morgen, the writer/director of ‘Montage of Heck’…

    Brett MorgenVerified [email protected]
    This is intense. Don’t agree w/ everything, but fascinating. Reflections on ‘Montage of Heck’
    Los Angeles, CA

  • I can tell you my opinion. I do not think that neuroleptics cause schizophrenia. I have seen only two episodes of anticholinergic intoxication syndrome. Despite the similarities of the description, the differences are obvious. It truly is a toxic state. If you’ve ever seen it, it is clear. Schizophrenia has been present to the same degree since recorded time. Neuroleptics have been around for only the past sixty-five years. In my opinion the best treatment for schizophrenia is caring, responsiveness, and respect, with an understanding society. In my experience, good psychotherapy has been enormously helpful in my patient’s lives. In working with some patients neuroleptics can help people contain unbearable terror. In those cases I give the control to my patients. This is NOT the treatment. Much of the time the drugs annihilate the spirit and make people zombified. They can generate all kinds of horrible long term side effects. The real issues to deal with are purely human ones.

  • Several things:
    Oddly “In the best tradition of science, one exception proves the rule.” is the correct way to say it even though it would seem disproves would make more sense. The meaning of prove in this case is closer to ‘tests’…
    I do entertain that schizophrenia has a possible genetic component. However, in my personal experience I have not found it harder regarding psychotherapy. In fact, such therapies have been very rewarding.
    I would be the first person to recognize and honor nature and nurture.

  • I would like to add a last comment. In no way do I diminish the issues for these children and their parents. As I have said, my heart goes out to them. My main point is that they are NOT diseased. There are so many children who believe, no matter how it couched, by the dominant ADHD community that they have a brain disorder, certainly not by me. And this is not the case. They go through their life with this belief. I have dealt with many patients who grow up really believing that they have a genetic-neurological brain disease. I couldn’t be more sensitive to the issues of ‘social suffering and self loathing’. I deal with this all the time. My explanation of temperaments is intended as an alternative explanation as to why this occurs, which I believe is the real reason. It is not a ‘molecular psychiatric’ problem at all. It operates on an entirely different level of brain functioning and brain mapping. This does not diminish the problematic realities. This helps to understand why it happens. And I certainly respect efforts like yours to help. There should be more people like yourself. Whether you like it or not, in addition, there can be, I’m not saying always at all, abuse and deprivation in childhood which contributes to these kids spinning further out of control. If you believe that’s not the case, you may be naïve. Other children with different temperaments will present with very different symptoms. I am certainly in agreement with you that you do not believe in medicating children. The harm done to these children is enormous. Keep in mind that the drug companies and the APA are medicating far more children than just these kids. What is happening to our children is truly frightening.

  • I’m not sure what is meant by scientific evidence. I will point out you are looking in the wrong place. In fact, there is no scientific evidence about ADHD at all. It is unnecessary to disprove something that has no evidence in the first place. On the other hand I have presented information that what is called ADHD is a function of a certain constellation of temperaments. And when the child is subject to deprivation and abuse, the behaviors can spin way out of control. I am very sympathetic to parents raising these children. I will repeat my own comment – “Of course I understand how challenging it is to raise kids like this. I respect above all, the devotion, dedication, and love that it takes. (This is of course true for all kids). I do not use the name ADHD because it means a child is diseased and this is absolutely not so. The label itself is demeaning. I re-emphasize that it comes from one’s temperament. Raising these kids with good-enough boundaries and good enough love, is very, very difficult. Of course I am deeply sympathetic. (There are no perfect parents. We try, we make mistakes, we learn). I understand all this and I respect and feel for parents who deal with this. When you add in the traumas of deprivation and abuse, these kids spin way out of control. And the problem is nightmarish. It requires all kinds of approaches that need to be sensitively thought out. However, there is no place for stimulants. Other children, subject to deprivation and abuse, with different temperaments respond with different symptoms. They too are not diseased and should not be drugged.”
    ADHD is not a brain disease, It is a problem of temperament, (as well as complicated by trauma to children, but not always) which I spelled out in this blog. You should think with an open mind. If you want some ‘scientific facts’, check out – “A Primer for School Psychologists and Counselors”, by Peter R. Breggin, MD – http://ablechild.org/resources/important-reading/documents-reports/psycho-stimulant-effects-on-children/

  • Steve,
    You are thoughtful as always. Of course I understand how challenging it is to raise kids like this. I respect above all, the devotion, dedication, and love that it takes. (This is of course true for all kids). I do not use the name ADHD because it means a child is diseased and this is absolutely not so. The label itself is demeaning. I re-emphasize that it comes from one’s temperament. Raising these kids with good-enough boundaries and good enough love, is very, very difficult. Of course I am deeply sympathetic. (There are no perfect parents. We try, we make mistakes, we learn). I understand all this and I admire what you have done. When you add in the traumas of deprivation and abuse, these kids spin way out of control. And the problem is nightmarish. It requires all kinds of approaches that need to be sensitively thought out. I know that you agree that there is no place for stimulants. Other children, subject to deprivation and abuse, with different temperaments respond with different symptoms. They too are not diseased and should not be drugged. There may be some medical elements, but in my experience, this is not significant. You may differ. I think it would be a great idea for you to write your book.

  • ADHD is a ficticious disease. It does not exist. There are certainly kids who have more active temperaments who need to be dealt with appropriately. Some children with these temperaments, when subject to formative trauma may well spin out of control. They need appropriate care, mostly within the family and school environments. There is no good use for amphetamines at all, ever, no matter what the dosage. Speed is a bad drug period. It’s history is very dark. Psychiatry is not about brain diseases at all. As I said, personality operates on a higher level of brain organization than the molecular. Of course character issues are manifest in the brain. Everything is. Change does not take place by changing the brain. Personality change takes place through therapy and the brain follows suit. Psychiatric drugs are destructive – antidepressants, benzodiazapenes, amphetmines, etc. Schizophrenia and manic-depression have an additional brain element, unlike all the rest, that may be genetic, may be epigenetic, or early trauma. There can be a place for judicious use of some anti-psychotics or Lithium for people to come out of awful states of terror, or out of control mania.(and there is no place for destructive antidepressants in the depressive side of manic-depression.) This is not the treatment. Good psychotherapy is.

  • There are times in the treatment of schizophrenia when a patient is horrendously terrified. I don’t impose med’s on anbody. Sometimes it helps to get back intactness. I give the control to my patient. The real work has nothing to do with med’s. It is the psychotherapy.

  • In my understanding there is no such thing as child manic-depression. There is no science to it. Dr. Biederman and friends extrapolated that since someone becomes manic-depressive later in life than it must start in childhood. So put the child on drugs. There’s no basis for this whatsoever. The last thing a child needs to be on are psychoactive drugs. And in my understanding ADHD is a made up ‘condition’ to be treated with, of all things, amphetamines. Yes there are some children who are active and can spin out of control, but this is not a disease. In a subsequent post I will address how temperament and child rearing generates so called psychiatric conditions. I don’t believe in these medicalized diagnoses as if that defines who a person is. It’s not. Sometimes, its useful to characterize the nature of someone’s struggle in the service of being thoughtful about how to approach them.