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Ditto! Thank you Dogworld and anotherone. Merry Christmas to all…
One ‘last’ comment here, as what I last wrote reads rather limp, and failed to address the more critical socio-political links surrounding class and mental health.
I regard Class as a “Fair Game” playing field all of us must, consciously and unconsciously, navigate from cradle to grave. But when children, especially children from abusive family’s (physical or emotional violence, neglect, abandonment, etc.) are labeled and put on psychiatric drugs, all the while the family issues are systematically ignored-or otherwise substituted with foster care or other institutionalizing reifications, whatever “enculturating” class challenges or advantages that inform the abused-psychiatric kid, never get the “fair developmental” hearing unlabeled, un-drugged, and un-abused kids get. If a kid grows up in a bad home, poor or marginalized community, and is run through the “pediatric psychiatric-correction system” well… “Class” is just one more salient oppressive factor added to one’s constitutive/conditioned sense of powerlessness!
As a personal example, after I’d been on Ritalin for 2 years, my family moved from multi- racial and multi- cultural working class Detroit to (all-white) upper middle class Birmingham/Bloomfield Hills (I was 12). I know now the confusion and struggle I felt in my new environment was culture shock. I know “now” my family culture was the worst of a working class enculturated upbringing (stereotypically so), and that my peers were, effectively, enculturated (groomed) for professional lives and success-whatever their individual family situations. That difference is Fair Game! But when “my” Ritalin egregiously devolved to antipsychotics, all the while my working-class home imploded into crazy town, “class” is informing indelibly well below the surface of “everyone’s” awareness. Simply put…abused children should never be put on psychiatric drugs without their person “first” being provided the “structures” and care utterly necessary for a healthy life-in the first place. To do so “annihilates the symbolic” (the relationship/dialectical between the child’s external Life World and her inner world), and thus, relegates the child cum adult with some serious holes to fill…
After a sleepless night haunted by this topic, I woke to the realization that class is always present in MIA personal stories, however otherwise the story teller’s class consciousness was either not factored or, as class so often does, was repressed or brainwashed out of consideration. Sometimes when I read these personal stories, class screams out to me-often desperately, albeit, perhaps, as someone who’s spent the last decade reading far too much critical class consciousness (Marx onward). But the point I didn’t make, and the only one that really maters, is that I was deeply wounded at a myriad of class levels, a tidbit I had no inkling of until journaling brought it to the fore in shocking layers. Not understanding this neither negated its impact upon my life , nor but stunted greater wholeness/healing. I’m almost tempted to write another personal story surrounding that singular focus, but I’m too old and beat up to beat myself up further for that undertaking….
Dear Mr. Whitaker, You wrote: “Our personal stories, which are so important, do not yet convey the diversity of experiences in the psychiatric system that exist across racial diversities and across class diversities. We’ve tried, and while we haven’t succeeded, we will continue to try. Sometimes these populations we’re trying to reach are so isolated from any sort of mainstream approach that it’s been hard, but we’ve tried to it with video interviews and we’ll keep trying, but that’s the biggest disappointment”.
Well…FWIW, I very much tried to convey the “class element” in my personal story-however un-diverse I might otherwise be. I referenced working class at two different junctures, and submitted the phrase “working class analysis”, but was edited-out to read “layman’s contribution” More, I “intentionally” referred to myself as a retired mover for precisely class identification purposes (despite that a significant portion of my education and professional life would suggest a different “class”). So, then, though I don’t doubt you or MIA’s sincerity for a more inclusive representation, I am a bit bewildered by my experience with the class element and MIA. But, then, maybe certain working class types are more desirable here? If so, I don’t take it personally. In fact…I’ll reflect on ways a more inclusive representation might be achieved here. It’s the least I can do for the great work you do here, as well as the gift of giving my story a public hearing.
I just found and read Ian’s essay ‘Critical Psychology: What it is and what it’s not, and was blown away by dozens of passages in it-of which require multiple future readings to digest and integrate. But I thought, as I read it, I bet Dr. Dhar or someone else at MIA, has a focused blog on Ian’s work-similar blogs being a staple of MIA reading.. And sure enough! Essential reading. Thank you Dr. Dhar!
I just want to correct the ignorant portion of my comment surrounding Insane Medicine and Dr. Timimi’s “professional and philosophical intelligence”. To be clear, Insane Medicine is, in my opinion, a brilliant and scathing moral and ethical work of courageous professionalism-which is why I bought its hardcover edition. What I meant to say is that Dr. Timimi’s conversation with Aftab was at another philosophical level. I correct this misrepresentation of Dr. Timimi’s book, Insane Medicine, as a matter of my sense of personal responsibility. My apologies here…
An absolutely beautifully written story Laura. I am in awe of your ability to weave your own emotional and developmental journey within the larger material historical frameworks, and thus, “go back and get’ what fundamental truths and care were denied to you during your childhood, save the institutional reflex “care’ during your adulthood. I know your story with some degree of intimacy, having been misdiagnosed bi-polar at 15 and lithium-shackled for the next two years. If I wasn’t “undiagnosed” at 17, I doubt I would have lived past 30, the profundity of abuse, betrayal, and trauma covered up by my psychiatric diagnosis combined with devolving psychiatric care that would have otherwise ensued during my 20’s, would have been too much to not completely self destruct. So…I can’t imagine having to carry all that unattended grief and trauma while being weighed down by a fictitious bi-polar disorder and it physiological oppressive counterpart, “lithium”. But your story makes clear your strength and intelligence-whatever the dam test implies-as to how that was accomplished! Lastly…thank you for the music! As Andy Dufresne says in the Shawshank Redemption, “They can’t take that away from us”.
Sorry to pile-on reading recommendations, but Wendy Browns, “Undoing the Demos: Neoliberalism’s Stealth Revolution”, is essential reading surrounding the psycho-social and political implications of (ehh…for lack of a better term) late stage capitalism. Chapters 2 and 3 riff Foucauldian themes (Birth of Biopolitics Lectures, etc.). It’s impossible to read Browns book carefully and not come away overwhelmed by the implications to our collective future, much less the implications upon everyone’s mental and spiritual health (from an evolutionary standpoint-down).
One small point on the connotative portent from the word capitalism. Capitalism in the USA is different than, say, capitalism in Denmark or Algeria, etc. In Denmark, as well as dozens of other countries, nobody losses their home or becomes homeless as a result of medical bills, or is forced into debt peonage to finance an education so as to “have a chance” to avert a lifetime of economic precarity. In the US, neither is the case. Examples expound, pro and con, none of which the political individual and collective unconscious don’t weigh mightily.
Thank you Fi for this exquisitely written and compelling story. You’ve utterly nailed the 3rd person (omniscient) narrative while not loosing any of the subjective- punch of a 1st person narrative, and by doing so…flipped the psychiatric narrative back on psychiatry! I loved this allegorical effect, as well as the breadth of humanity you reclaimed through your story. Thank you….
An absolutely poetic and redeeming story; thank you Ruth for telling it so beautifully. Your story reminded me of the line in one of Sam Sheppard plays, ‘We are all a version of someone else’s story”. Nowhere is this more true than as a version of our parents or our children’s stories. FWIW, when your Mum placed her hand on her heart, it hit me hard. To have come so far and only then finally say what so long needed to be heard and seen, is utterly heartbreaking. Personally, I believe the intergenerational component to be one of the more looked-over and fumbled aspects in most mental health settings; a veritable developmental and healing gold mine when otherwise ventured, including the immeasurable benefits extending to the next generation as well. I’m grateful you had the opportunity to find a “capable” and supportive community from which to address these intergenerational issues.
Well…you articulated way better what I tried to convey-and was actually thinking (soft drift the one exception because I was more focused on the challenges of the individual child). Thank you for taking the time to clarify by providing real life examples to my more generalized outlines.
FWIW: I found a fascinating interview between Sammi Timmi and Awais Aftab-in Psychiatric Times, March 12, 2021. I was blown away by Timmi’s professional and philosophical intelligence, of which didn’t come through (for me) in his book, “Insane Medicine”. I highly recommend this article to anyone faced with “having to” or otherwise considering medicating their ‘kid’ for ADD. Here’s a smidgen of that exchange:
” A 1-acronym formulation (such as ADHD) has powerful consequences. It acts as a hypnotic suggestion on those around the child and influences what they might view as important. It has the potential to obscure, or at least render as secondary, the things that might bolster the child’s esteem and the parent’s sense of empowerment.
I may choose an alternative label such as the child is “intense.” They engage with the world with an emotional intensity that provokes powerful emotions in those around them. We could see this as a gift that needs understanding, guidance, and nurturing, rather than using a label that views their behaviors as symptoms that need suppressing. With the cultural pressure to diagnose and medicate, this is not always easy, but maybe easier than we realize. In the last 5 years, I have started 1 child on stimulants, and although it helped ameliorate a dire situation in the short term, I do not think it has helped much in the long term. Much more common in my practice is to inherit young individuals on stimulants, where the perceived problems keep returning, but are now viewed through a medicalized lens leading down a one-way street of requests for increasing the dose or adding another medication in. Despite that, with time and patience, nearly every patient I inherit is off all stimulants by the time I discharge them at 18 years old, with their lives much improved”.
Excellent point, Steve (“diagnostic drift”). But, to me, reification is the more pernicious feature resulting from the ADD diagnosis. The distinction (at least as I think of it) is that “drift” speaks to the (unconscious) propensity/necessity to slap another/new diagnosis when the ADD “drug” treatment (cough, cough) fails; which, statistically, is all but a given. Reification, then, is the process resulting from “diagnostic drift’ by which the failure of the initial “treatment(s)” all but guarantee the failure of the next treatment iteration. Thus, the ADD kid bears the (complete) failure of the initial ADD diagnosis viz whatever myriad of familial, social (race, class, et al) “continue” being extensions of the southbound “diagnostic drift”.
I’m pretty sure you meant as much by drift? But I just wanted to make this distinction because reification is when diagnostic drift becomes “life consequences” resulting from an ADD diagnosis that, all things considered, should have taken a tract antithetical to the automaton, reflex-labeling and drugging tract to begin with (a whole other long winded topic). I apologize if I sound picky or prickly. But having lived a long life from an early childhood ADD “misdiagnosis”, I know this reductio ad absurdism ontic-space better than anyone should ever have to.
Bruce could have included, in my opinion, Psychiatry’s doubling down on its ADD protocols when they green lighted “medicating” toddlers (3 and above), as reported by Robert Whitaker in February of this year. As Mr. Whitaker meticulously demonstrated in his article, the science behind ADD as a neurological, physiological, or biological “disorder”, simply doesn’t exist (whatever behavioral affectations, etc. might or otherwise do exist). In this “scientific” light, therefore, this should have been the point where psychiatry deployed a 180 and implemented red-light constraints, and not obverse green. For me, the fact that psychiatry found it necessary to take this action and move in that respective direction (whereby no action was the minimal scientific responsible action!), is every bit as damming as the rest of psychiatry’s “nightmarish 2022 revelations”. To respectfully amend Raymond Dolan, “It remains difficult to refute a critique that psychiatry’s most fundamental characteristic is its ignorance”. . . . “willful ignorance’ is, I think, the more accurate and essential modifier.
I believe this ADD development is an important distinction. For all of psychiatry’s epistemic transgressions detailed in Bruce’s excellent article, they did not, as far as I understand, result in a change of treatment protocols that “doubled down” on false science. I find the ADD development to have been shameless and professionally gratuitous, and lays bare the irreconcilable “character” of psychiatry.
For the past several years institutional elites (I use the word respectfully and pro-constructivist, and NOT as a pejorative) have taken to the airways and books decrying the the (rampant) populous disregard for “expertise”. Tom Nichols, and his book, “The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters”, is an excellent example. Nowhere in Nichols book, or his multiple NPR appearances, etc., does he mention word one of where or how “established knowledge” has failed societies writ small and large. I mention Nichols because of the parallels between his critiques of expertise to that of the particular use and attributions of the “established knowledge” informing and constraining psychiatry. Nowhere has Nichols broached the discussion between functional episteme and critical episteme, or couple of dozen other critical and theoretical frameworks that (would) more adequately demonstrate the “more substantive” nature of the crisis of “expertise” he so rightly calls out.
Lastly, environmental scientist tell us that a 100 foot swell in sea level is already baked in (so long Miami, Manhattan, etc.). No matter what steps we take (and they are, to date, abysmally inadequate) we can not avert this 100ft sea-swell outcome. I mention this because I think its a good example of the “baked-in and exponential nature of the crisis facing psychiatry and (all) societies mental health in general. What’s already baked in to our mental health, its systems, and in every area of public life, comes from, in significant part, decades of misuse, misrepresentation, and exploitation of “established knowledge” by psychiatry. Like Nichols, I’d like to see a return to “the expertise of established knowledge”, nowhere more so than in psychiatry and the mental health professions.
Alishia, I find your story wise well beyond your years, and absolutely beautifully written! Your story is a generous allegory of how those murky, dense spaces of structural alienation are later pathologized by the MHIC. I suspect your work and struggle to cross this wasteland (from objectified alienations/oppressions to a more conscious and liberating life) is far more heroic than allotted here. It’s story’s like yours, especially from our younger generations, that give me hope. Thank you for telling your story so exquisitely.
I’m a bit confused as to the nature of (this) reply to a, IMHO, a wise and compassionate undertaking of the “art” of processing grief. No doubt this firebrand of scientific positivism could locate and attribute the neurite outgrowth of CNS neurons, et al., in Drapetomania subjects (the “mental illness” ascribed to slaves who fled their captors during the 19th century). Ascribing scientific attributions to human behaviors, if not entirely decontextualized (scrubbed of material biography, intersubjectivity, unconscious portent, etc…)-especially “an actual subject”, then, at best, selectively attributed, is not a remotely honest pursuit of sound episteme; a fact the Frankfurt School and legions of ensuing critical theorist have exposed and provided ample critiques/warning (of).
With regard to ADD as either epigenetic or neuro-pathology, etc.: 500 years ago, for example, ADD behaviors were scarcely a behavioral distinction, and more often than not, socially advantageous as well as-more importantly-evolutionarily advantageous. The point here is that what makes ADD (behaviors and manifest challenges) a disorder is, more often than not, the ADD subjects relationship to our techno-fetish–driven and neoliberal-precariat society, of which wasn’t remotely the case pre-industrialization. Moreover. as an obverse example, the self described ADD (hero) portrayed in Michael Lewis’s book, “The Premonition”, having ADD (or the neuro -atypical features thereof) was not only advantageous to this doctors career, it served the “greater good” of society, notably, where “neuro-typicals'” had failed. The implications of this intersection deserve far greater space than available here. Lastly, thanks Steve McCrea for your even handed and constructive comments here.
Thank you Bradford! That’s real talk…
I was so pleased to discover that such a ‘thing’ as the Journal of Attention Disorders existed. After processing-to the dismal extent possible, it occurred to me that in our neoliberal, technocratic utopian world, such a journal could not not-exist. How fortunate all the attention challenged people around the world are to have a journal dedicated to improving the quality and wellbeing of their cognitive lives. I can’t wait to jump in to (this) journal and learn everything there is to know about “attention disorders”.
But a couple questions do nag. For one, could it be that some the people at the JAS have some “attention” issues of their own? That the respondents at JAS have demonstrated an inability to follow through established protocols and standards, engage and communicate directly, save effectively, and, thus, respond systematically and developmentally-of which posed no small measure of unnecessary conflict and confusion to others, is rather consistent with the DSM’s guidelines surrounding ADD. Could it be that this failure of attention is more the result of an underlying or additional oppositional defiant disorder (or bi-polar power disorder)? Well…it’s really impossible from this distance to posit why the respondents at JAS have had such a difficult go of paying attention, and thus, acting (out) in a manner neither representational nor commensurate with their professional responsibilities. But the good news is that, whatever the causes, the answers can most certainly be found in the black and white of their journals.
Thank you Doctors Ophir and Shir-Raz for your work and bringing this more behind the scenes shenanigans to MIA. I look forward to reading Dr. Ophir’s book.
Thank you Javier for this excellent and most informative interview, as well as introducing (me) to Lynne Layton and her work. I really appreciate this MIA resources and the breath of fresh air to the mental health fields that far to often languish in obscurity and worse, the intentional or structural margins. Bravo MIA…
A deeply insightful and wise blog from a heroic journey by any definition. As someone who discovered the power of words through journaling, I’m privileged to read your story and your personal dance with language as one particular tool for transformation. Lastly….In my experience, this “process shift” in language is (or can be) the means to purge the internalized political (powerlessness) psychiatric diagnosis often imposes, and then, over time, take back our (stolen) Subjective Being from a psychiatric diagnosis. To me your story is a wonderful example of what that process can look like for others…. Best to you going forward Karin…
Dear Dr. Phil, I feared, viz one of your recent replies, that this fate was closer than hoped against. I’ve been so inspired by your critiques, their thoroughness to detail, exposed contradictions ,and intellectual-moral clarity. I still think there’s if not a book from your archives-to the forward thinking editor, then a treasure trove of the more consistent running exposes on psychiatry’s hoodwinking of mental health “out there”. I’m grateful to have found your writing, for it has helped to restore some faith that there are honest intelligent people still working in the mental health fields. Namaste Dr Phil.
I just heard on NPR that a new panel on the mental health of children is conveying (headed by a (psychiatrist?) from Georgetown U. The working recommendation is that all children over 8 be screened for anxiety, and all 12 year olds for depression, so as to get them the mental health care “they need” ASAP. This 60 second report acknowledged the pandemics affect on children’s mental health, as well as the increase in the percentage of children affected (of which I missed). Well…perhaps the first recommendation from this panel will be the type of psychotherapy Miranda received in 1975? If not, 2050 should be, to cynically borrow from Ted’s wise post, a real boom for psychiatry.
Excellent point Nick, and the difference theirin rather fertile opportunistic and or exploitative. BTW…nice translation of the DSM alongside Carroll; the parallel shudders…
Thank you Sarah, Allan, and Robert. FWIW: Solid showing Sarah on 1A alongside Thomas Insel. Your even handed and solid thesis seemed to me to have Insel on his heels, of which the host didn’t rock him much. That was the best mass media presentation of our psychiatry challenges I’ve heard presented to date.
So the DSM is invalid, and the “scientific” praxis psychiatry delivers from its diagnostic epistime is nearly as problematic as the DSM (or more?), then what, praytell, is psychiatry’s role in our societies? Well… perhaps psychiatry is the perfect surplus institution in our late stage neoliberal techno-meritocratic epoch? If, as postmodern philosophy and critical theorist posit, we live in an age of “representational crisis” (techno-scientific epistme as political capital for social organization to given power-structures as given and totality-as best I can capture in few words), then psychiatry is a pitch-perfect institution, no?
Excellent and essential reading for anyone working in the MHIC; thank you Dr. Moncrief. As usual, excellent observations and comments, too.
One observation, not too far removed from some of the above, if not (obviously) part and parcel. Given the nature of the superstructure (SS) Dr. Moncrief has (rather accurately, IMHO) critiqued here, there’s not much of a mystery as to how we got here, in pretty much every sector of the MHIC. Until this SS is fundamentally changed, change is little more than SS accommodation and or cosmetic. I know there’s nothing remotely profound in my comment here, but just wrote it to state the obvious.
Thank you Bruce for this fair and considerate critique. I agree, Insel should be given credit for his acknowledgements. But one wonders what he knew and when he knew it. And this sentence, , “it is axiomatic that most of them will oppose a paradigm shift that might threaten their status”, is spot on and part and parcel of what likely stood prominently between what and when Insel knew…. FWIW: I really look forward to reading your book!
Thank you Ann for telling your personal story along side the exceptionally well navigated professional narrative. So many telling intersections throughout: the principal, Tommy, Connors fate, etc. But I can’t help but wonder how many of these dynamics (bored kid, disorganized or chaotic home, bright, creative-and totally underserved pedagogically) are present with the vast majority of purported ADD Kids? And this is but the tip of the dynamic pool that undermines “individual” development…that can, and more often than not, mimic ADD. FWIW, I can relate to Connor’s boredom and Tommy’s creative mind (this is a profoundly challenging dynamic for children, nevermore so than those from broken homes), having had the Ritalin “cure” imposed on me 55 years ago. So I know rather well the critical role (exceptional) adults like you can play as a watershed in the (psychiatric) fate of a persons life.
Thank you, too, Steve McCrea for all your input here. Bravo and Ditto. Thank you Miranda too. It really means allot to me to hear in others what I carried alone.-as alienated shame- over my lifetime. Better late than never…
Lastly, the ADD capture is complete. Psychiatry’s work in the ADD/ADHD diagnostic and treatment praxis is now, having been long ago farmed-out, undertaken by family physicians, teachers, school administrations, media, and self diagnosing parents and adults. I suspect the 8% growth in ADD diagnosed kids from 1992 to 2015 (?) will grow as much or more in the next 25 years. Not sure where the tipping point-collapse is-or how it will arrive, but me thinks it will be an outside-in process. And I hope I live long enough too see it!
The conversation surrounding Marx is, predictably, despairing. I have yet to hear anyone invoking Marx in any public square-sans the academic square-in the context of his dialectical materialism or historicism, or any number of Marx’s copious philosophical treatises. In place of Marx’s towering genius and contributions (arguably, he gave birth to the dialectical critique, Lukacs, Gramsci, the Frankfurt School, and about another 5000 words of examples), the public is met with fear based weaponized tropes by the very people in power who understand very well what the 3 countries who kicked Marx out of Germany-his homeland, Belgium, and France, before being tenuously accepted in England: Marx understood power and its abuse like no human being before him. Marx’s dialectical genius recognized internal contradictions resulting from structure, i.e., negation, contingency, the negation of negation, etc. and as a result, the moral and ethical failures of power-as Richard Lewis so beautifully articulated some of the layers and their double-bind forces and actors. .
Marx was and is dangerous, which is why he remains so misunderstood, misused, and misrepresented. As economics Professor Emeritus U Mass Richard Wolfe says, he spent 4 years at Harvard undergrad, 2 at Stanford and 2 back and Harvard for his 2 masters, and to Yale for his Ph. D in economics, and not one word of Marx all those years. Why…because he “pokes holes” in narratives of power, and that is as much a problem for economies as it is psychiatry and every institution we have. It doesn’t take a Marx IQ to see why and how this is a bit of a problem for the meritocratic class who lead or otherwise prop up our institutions.
Lastly, regarding the comment “I see Marx and a petty criminal with a keen intellect who spent his life trying to explain why he disliked work”
The world could use more lazy people like Marx, people who had nothing better to do than earn a Ph. D, and be so intellectually and morally honest, that he was denied all teaching positions-of which he aspired employment with. The world could use more lazy people like Marx who learned to read and write (fluently) in 5 languages (German, Russian, French, Latin, and English-the last, and of which he wrote in). The world could use more petty thieves who, though economically oppressed and marginalized from pursuing his “earned” vocation, nonetheless, brings decades of “intellectual labor” to a fruition he knows will be lost on 99% of the people, yet, also knows are the seeds (flawed, but fertile) for future liberation. Lastly, if more of our PMC had the moral and intellectual spine of Marx, our institutions and society would be considerably healthier and genuinely robust.
Thank you Robert Whitaker for yet another generous offering of top shelf investigative journalism. (Where is the Murrow, Polk, or Pulitzer committee?).
The question begs, however: “How evidence based psychiatry has led to a tragic end”. To what end? If any of the several scientific organizations you meticulously cited had penned this analysis, then, perhaps, an actual End would be close at hand (rather than a precursor to the next institutional iteration. At some point, Orwellian terms like “evidence based” will no longer fool, and they’ll just have to say plainly what lies at the root of this gratuitous fundamentalist nonsense: “Take these pills kid or your parents get it in the head”. (Sorry…its laugh or cry)
A paragraph from the essay: “Yet, imagine this thought experiment. If the “evidence-based” assertions were removed from the discussion, what would most people think about giving a three-year-old who “talks excessively” or “who is easily distracted” a 5 mg dose of methylphenidate three times a day, which is a dosage deemed “optimal” in toddlers?”
So many chilling implications here. How could such ‘mildly different’ behaviors from a 3 year old compel powerful drugs? What, exactly, needs to be crushed here? Human spirit? Individuality? Difference itself? What is this compulsion in our societies to standardize everything down to the last nano-thingness? Make no mistake about the macro-implications of Mr. Whitakers essay: this essay says more about our institutions and society-or peon-propped-up psychiatry, than it does any child saddled with a ADD label, and their drugged persons in the never ending project of validating and propagating psychiatric and scientific virtue.
As a 64 year old man who was forced (albeit willingly at 9 years old) to take Ritalin to correct my “abnormal brain”-because the brain was so well understood in 1967, I’m not the least bit hopeful the ADD lever-lie is going away for decades to come. Its an institution now, and that fact alone is a house of cards.
Thank you Christine for this often ignored psych 101 refresher. When I hear some of the idiotic things some mental health professionals say or believe, I get a little confused as to what, exactly, drew them to work with vulnerable or wounded people? Honestly., some of these mental health professionals would inflict less damage on others had they been a guard at Gitmo, if not chanced a better career fit. To wit:
“one of the symptoms of a borderline personality disorder is those who have it feel like no one cares about them”.
One of the consequences of being abused from the toddler stage though adolescence is to have never truly or adequately known what it is to be cared for-when it mattered most. But…its much easier to slap the borderline label than undertake a time consuming and arduous process of helping ones client dis-identify with their abuser- imago introjects (or the resulting compromised social life in tow), so as to bring about an individuated adult.
Maybe one of the symptoms of a borderline mental health practitioner is someone who dispenses labels rather than the difficult work of love and care?
Thank you Till for this vital public service notice. Sadly our emails might as well be sent into the cosmic ether. Congress is a little too preoccupied these days to address such quotidian issues involving fundamental governance.
Oh the suspense…
But I am a little curious, per- Philip Hickey’s penultimate blog, Addressing The Social Determinants of Mental Health, if complex PTSD ( especially as developmental trauma) will find it’s way into this redux ad nauseum. If memory serves, Bessel van der Kolk-and others- tried to no avail get it included in DSM V. My curiosity about this revolves mostly around APA President Pender’s assertions surrounding a (my words to sum) more inclusive consideration of the social determents upon their “customers mental health”. My curiosity here runs somewhat parallel to Senator Minchin’s final position on BBB; which is to say that I saw this outcome (and wrote as much) in July. Still…every once and a while its refreshing when scoundrels’ deliver some semblance of their words, or remotely deliver in the spirit of their institutions raison d’être. Failing that, I hope, at least, that this is the inaugural graphic edition, complete with action packed color dramatizations of psychiatrist saving their customers one DSM VI diagnostic frame after another.
I hear you Megan…It’s one thing to be disappointed or thoroughly let down by your everyday interloper, and another by someone who claims to be someone they turn out to not be, especially someone who’s supposed to more emotionally or psychologically evolved than a middle schooler in gym class.
True story: 8 years ago I made an appointment with a psychotherapist, the first in over a decade. When journaling uncovered so much betrayal and trauma I’d been blind to for decades, I knew I needed a ‘skilled witness’ to help me process the overwhelming unrecognized consequences, save grief. After all…my psychiatric kidhood didn’t just happen in the vacuum of my head, it happened in an array of human relationships: best to repair it there, right! From a ‘website’ reflecting a sea of smiling faces- who seemed to be experts at a dozen or more psychological categories, I picked one Ph.D. who specialized in trauma.
I wanted to start slow during that first appt, to build some trust, and get a feel for her ‘character’ (empathy, EQ, IQ, etc.), before jumping into the whole journaling thing. About 15 minutes in, apparently going to slow for her, she pressed, rather suspiciously. “why are you here, you can tell me”, before rattling off about a dozen psychological maladies (addiction, etc.) Before I could even respond, she gave an oral presentation of her resume, as if to convince me of her professional acumen. But when I looked up at her, I suddenly saw an insecure person, a woman who was neither sufficiently curious nor in awe of anything beyond her credentials or their institutional myths, save people or the world at large. I suddenly, and without any conscious intention, felt sorry for her (of which took some time to unpack). I then apologized to her, handed her $150 cash, thanked her for her time, and left (she emailed me to return half, of which I just ignored). To this day I consider it the best investment I’ve ever made, including my last donation to the MHIC.
My guess, Megan, you have more psychological and emotional acumen to offer than the psychotherapist you’ve entrusted, if not most (?). That can be a scary thing to come to terms with…
Thank you Miranda:)
Dear Lisa, I am saddened to read your life story and their health related issues. I felt like I was reading David Lynch adapting Dickens. I’ve yet to hear even one story whereby adults from abusive childhoods met with remotely helpful psychological help, much less not further marginalized or exploited. I, too, know this journey, and I am in awe of what you’ve been able to accomplish from where you started!
But I want to point out something that might sound a bit irrelevant: you lived your life like a heroine by not passing on your childhood abuse to your children. Sure…maybe you weren’t the full on mother you knew yourself to be, but you “stopped it’, and by not abusing or abandoning, etc. you’ve opened up doors to future generations (your daughters children and onward). My sisters did this too, they carried so much abuse and abandonment and did not recreate it with their own children, and it shows in every way! I hope you feel the pride and love you deserve for the rest of your life. Thank you for having the courage and love in your heart to share your story. K
I’m afraid I find this blog considerably problematic. First of all, I find the title of the NDRN’s report, “Desperation Without Dignity” if not rather Orwellian, then certainly deceptive. Would the report not be more accurately tilted “Institutional Child Abuse with Impunity”? Forgive me here if, by only reading this interview and not the report itself, I’ve missed something. And where was NDRN, etc., prior to Paris Hilton’s wealth and fame bringing these abuses to light? More, when Barrister Howard refers to the overuse and off-label drugging of children as “And sometimes in generous quantities”, is rather noxious. There’s more, but that’s enough irrelevance to invest in for one day.
Another excellent critique Philip. It just never ends… Your essay could have also been tilted, First Class Passengers On a Sinking Ship. Maybe a title to consider for that book Bret suggested?
No…thank you for all you are doing to advocate for Kathleen, and by extension, all the us- people lied to, exploited, and sucker punched by institutional mental health care. Like most every other institution, it, too, is under great pressure to be accountable and “evolve”, save ditch the historical amnesia and power tripping. It never ceases to amaze me, the wisdom, humanity, and the profound strength people like you, Kathleen, and MIA commenters, etcetera, have and bring into the world despite, and often, having been ‘spited’ by institutional mental health ‘care”. And that’s just upside down crazy making…
I thought the same thing as I read these replies Lisa. The tragic truth is that there are phalanxes of Kathleen’s in the world, children abused and betrayed on the developmental front end, and doubly betrayed by the mental health professions (et al) on the ever so vulnerable adult back-end. I very much count myself as someone in this ‘camp’. Richard Lewis said it best, IMHO: “Kathleen Fliller’s story should be REQUIRED READING for anyone coming anywhere near another human being in the so-called “mental health” system”( Thank you Richard!).
On that front, I would like to add, however futile, that the comment by Kathleen’s therapist that she was “too complex’, induced serious anger in me. I, too, have heard this sentiment from my pedagogically calcified psychotherapist. I suspect, and strongly believe, that this comment hurt Kathleen deeply; for it was necessary to point it out in her last human expression. Let me just say that, Kathleen’s complexity was a gift that her therapist will never know nor ever be burdened with. Instead of helping Kathleen unpack this complexity, its innate origins (e.g., her EQ!, etcetera), and the utter failure of her familial and social community to help her constructively cultivate that EQ in childhood-save not abuse and abandon her, her therapist (the rapist) ‘further pathologized her. I just had to write this out because it needed to be said, however far more I hope Kathleen knew this fact in the very marrow of her Being.
Thank you Lisa for publishing Kathleen’s story. I am in awe than Kathleen was able to capture her story with such clarity and depth while in the throes of akathisia. Though I can relate to so much of her story, including the compounded despair (ergo her therapist, etc.), I can’t imagine taking on akathisia after a life time of heartbreak. I’m right behind you Kathleen…
Bravo Sheelah, a thoroughly efficient and surgically concise critique of (some) of the more off-stage actors and shenanigans behind the ADD fraud. There’s nothing unique or rare with bad faith actors like Barkley, et. al, they have robust representation in all our institutions. But psychiatry is, if not the best place for these fundamentalist’s careerist to thrive-while chasing their theories like a dog its tail, then certainly a most excellent bunker to operate in institutional obscurity with impunity.
The first reported ADD ADHD-like issues were observed in 1798 in Scotland by a physician (sorry, the details escape my memory right now). I mention this history because though I do not subscribe to the ADD-ADHD diagnosis-in the least!, I do believe there are atypical brains that have or mimic one or more of the alleged ADD characteristics-whatever multi-variant (truama, etc.) other mimicking causes. My point here is that the ADD trope doesn’t show up (in the West) until the beginning of the Enlightenment and Capitalism, save the ensuing “rote compulsory” education. To wit: these children/people who suddenly do not make this epochal transition, were not only normal and vital to their communities, they very well were some of its most essential and productive members before this profound social and economic transition. Perhaps our historical institutional response to ADD-like behaviors is more a case of maladaptive evolution (societies unable to inclusively accommodate), than pathology? Your essay sure as heck suggest something along these lines…
What a powerful and wise narrative Jennifer. Exquisitely composed and written as well. It touched me deeply, having resonated with me in the way all childhood psychiatric diagnoses leave their pathologizing mark upon us, regardless of our individual circumstances or fate thereafter. For this alone…thank you. I really appreciated how you gave a reanimated (childhood) voice to capture those ‘fundamental’ developmental’ betrayals you couldn’t then give voice to throughout childhood, and did so on multiple levels. But the sentence, “I decided to leave my soul alone”, gripped my attention deeply. I just couldn’t help but wonder if that might be your (unconscious) 6 y/o person telling the ‘experts’-and the rest who followed-“to leave me alone”? ( saying to them…”I” got this, OKAY!) I don’t know, of course…But I do know that being left alone and being (psychiatrically) “violated” as a child are antithetical, and just maybe your sublime sentence understood perfectly ‘the giving back of what was once stolen’?
I concur with Steve, you’ve captured the fundamental bankruptcy of psychiatry as (I think) I’ve ever read in so few words. Not to put too fine a point on it, if I may, but far too often, after an initial diagnosis and subsequent drugging-from the very flawed and doomed premise you so clearly framed, further damage ensues through revised diagnosis and drugs viz the ‘very same’ premise. (the ADD diagnosis to bi-polar in zero flat an easy example) I understand this falls under the iatrogenic category. But I bring it up to point out that there is a critical distinction between incidental harm and structural harm, and I don’t think its a stretch to suggest that the iatrogenic harm from psychiatry is almost entirely, at this point, structural harm (reckless-intentional and imminent). But, even from this glaring failure point, not to mention the tragic personal and social cost, is yet deeper levels of passive structural failure/harm. No need to jump into that now, suffice to say that macro structures and their moral moorings have consequences beyond their institutions PR campaigns.
On a bit of an odd note, I grew up in a house with a chain around the refrigerator and a lock on the food cupboard. It wasn’t until I was in my 50’s that I realized the inexorable link between food and love, or that in my kidhood home both were scarce and fraught with shame, save danger. (For me this was a life changing insight) I now understand that as we take in our first oral nourishment at birth, it comes with whatever kind of attachment and love from whoever is providing the food; and thus we are forever (unconsciously) bound to. As an adult food was the one thing I gave myself whatever I wanted whenever I wanted it, knowing full well the origins of this defiant mindset. But when I made this connection in my 50’s, I understood instantly that my relationship patterns to myself and to others throughout my life was significantly informed/rooted by the very scarcity food and love had once been for me as a kid. Of course, five years of psychotherapy never got within galaxy of these insights, save a single comment about the chain and lock.
For the last several years I moved into a rather organic and harmonious space with food, of which I attribute to the journaling that led to the above insights. I don’t have any answers or suggestions surrounding eating issues. I just shared this post on the off chance that its unconventional observations might be a constructive piece for someone reading.
The short answer is no. But the “internet” has provided psychiatry with ample opportunity to designate the DSM moniker “Disorder” to a new set of-as this article aptly clarifies-not understood behavioral affectations. And when, as this weeks Facebook “whistleblower’s” 60 minutes interview and Senate testimony posited, known negative (psychological) impacts are “willingly” disseminated upon unknowing (and misbelieving) subjects, then where, exactly, does the “disorder” (really) reside?
I think its critically important, with regard to the internet, to factor that (only) 150 years ago there were no telephones, radios, tv’s, or, obviously, computers. So, then, it took us 250,000 years to develop language, another 51k to get to Guttenberg, another 400 hundred years to the telephone and radio, and “only” another 100 years to our current state of instant and inescapable “superimposed” global communication. What makes this history particularly important is that this pace of human communication, including their adaptive organizing systems, etc., is pushing the evolutionary envelope at an incomprehensible level and pace, a “minor” detail in how and why people are affected by the “internet”, save escapes the purview of contemporary mental health practitioners.
Can the Subaltern Speak? Well… apparently Western psychiatry is hearing voices. There are considerable critiques surrounding Western colonialisms’ current and imminent collapse, but the exporting of (our) psychiatry to the southern hemisphere is as good a marker of it’s desperate sate as most any other. At the very least, the fact that Western psychiatry “treatments” in both hemisphere’s are (effectively) identical, should sound multiple alarm bells.
Thanks Bruce for yet another scathing critique. Silly thought, if I may: why doesn’t Psychiatry (APA) have a counter MIA-like platform from which to tout their bounty success stories? Where are all the cured or otherwise helped people?
Well…I’m sorry but I’m just unable to fully follow the thread of your thinking here. But just to clarify, I don’t consider psychology a way of life, but rather an important if not essential feature of thinking from which to navigate life. Moreover, I don’t regard unconscious patterns as being anchored in organic brain issues (in the least!), but rather in human relationships and experiences-that largely escaped a more full and dynamic consciousness and responsiveness, save stage developmental constraints. FWIW, I regard professional psychology and psychology as a “personal” hermeneutical tool to be entirely antithetical. Best I stop here…
Thank you Robert Whitaker for this first rate investigative journalism. It’s taken me days to process this information, and even then, only at a fundamental level. Even more despairing (for me) is that this vastness of corruption flows downstream, where the next iteration (“mental health facility”) of epistemological phantasms and moral vacuity ratchet further before taking residence in the trusting patient or client (customer/user).
Thank you Richard and Brett, too, your prescient comments save my trying to say them with far less effectiveness and grace.
I don’t disagree with any of your points or objections, rebel! Though you were (likely) referring to Zenobia’s article, I will weigh in on my use of liberating just to clarify: by liberating I meant ones relationship to their own unconscious patterns, as well as where and how those patterns were anchored and remain symbolic (material) markers in our personal, social, and political relationships, save the structures that inform them. So, by liberating I mean only that “real” (substantive) new and more empowering choices can be made. Simply put, l think liberating is stage-development contingent, and invariably begs a more conscious (integrated) ontic and or existential struggle.
Thank you Rose for sharing your harrowing journey through this beautifully written and clear eyed narrative. So many important passages, but I found the Uber driver experience particularly compelling. I can’t help but think that most everyone regularly crosses path with someone in these ill-fitted shoes and never knows it.
Thank you Amy for this important and informative essay; another book I have to read!
Any diagnosis gets our attention, psychiatric diagnosis gets a slice of our Being. On a personal note, borrowing from the IQ passage and the cultural implications you mentioned; I was diagnosed with having an IQ of 86 when I was 12. 25 years later, upon telling my psychotherapist this, he was outraged, having spent considerable time and effort trying to convince me that I was “brilliant”. I know now, 50 years later, that that IQ test was administered to a prodigiously abused boy on Thorazine. I internalized that “understood” (intelligence) value for the rest of my life, despite considerable evidence to the contrary-of which the rest of my high school days spent in special education only worsened. My psychotherapist wasn’t the least bit outraged by my psychiatric betrayal, or remotely aware of the impact this drug most certainly had upon my IQ test, or that of my considerably shut-down state as a defense to my abuse while taking the dam test. My point here is that “misdiagnosis” is more often than not an act of violence, one with it’s own particular and diabolical (tragic) legacy.
So The JHU asserts “precision and tailored” treatments from the aegis of a research lab-in its nascent stage, no less, and then viz psychedelic’s? Impressive! At least Michael Pollan was wise and ethical enough to first experience psychedelics before writing about them-or asserting claims of precision; which bodes the question, how many flight hours will the corporate-MD-shaman administering them have? Well.. this should, if sufficiently undertaken, help expand the DSM V, perhaps to a new and separate sub-species? First as tragedy then as farce… then as interdependent hallucinators?
Thank you Zenobia for all the intelligence and moral clarity your work brings to us. This blog blew me away, including a few of its links I’d previously missed. I’ve waited a good long time for this kind of critique of the “talk-therapy” sector of the MHIC. There’s no less than 2 dozen theoretical and praxis inferences throughout that I’ve been wrestling with for some time, of which this blog really helped me better understand.
I would only add that the issue of power, as generously addressed throughout-if not the central theme, has another layer that is inescapable in conventional institutional talk-therapy, yet most often languishes unrepresented and unattended: abuse and abandonment in early childhood, including poor attachment (birth to 10 or so). These, too, are power issues, of which never come with an adequate narrative of how one adjusts’ or understands themselves with a coherent and objective historical lens, or their environment as a result, save the psycho-social cost. This lost (unconscious) narrative is often negatively compounded by some of the marginalizing cultural and depoliticalizing process you so effectively addressed, and will remain a permanent dialectical with either disastrous or liberating consequences throughout ones life.
This story is as much about 21st century capitalism as it is about psychiatry. Does Spriestersbach receive different “treatment” if he has a wallet with an ID and a residence in an upper-middle class neighborhood, a bevy of credit cards, family and friends with influence, etc.? But this story’s not entirely misrepresentational, psychosis, by its very definition, is rife throughout. Nothing sends a chill down my spine more than supremely confident, well credentialed professionals carrying out their marching orders; the “usual cruelty” the necessary affirmation of the professionals’ providence viz the subject’s guilt.
Your (continuing) story reminds me of Margaret Mead, who said, “Never doubt the that a small group of thoughtful, committed individuals can change the world; indeed it’s the only thing that has”. Thank you Tabitha for being on those individuals.
You made several important points in your story, but it was the line that “I am not sure what was worse: being abused on every level growing up while my community documented the torment I lived through while they labeled and medicated my pain, or being attacked for going public with my story from the very community that set me up to fail”, that hit hardest for me. My answer to your question is that the institutional betrayal is the more difficult issue to address, and thus, resolve. Jenifer Freyd and Carly Smith’s work out of the University of Oregon, etc. helped me begin to understand why this was so difficult for me, too. It may be different for you, but the info can’t hurt, and maybe (if new to you) be a source for your work moving forward.
I commend Dr. Campbell for this approach in her psychiatry practice. That said, its pretty pathetic that I feel the need to do so. I mean… what is so commendable about acknowledging the molestation of a five year old, at least long enough to glean a “holistic” view of the Childs life, including that for which he/she cannot speak to or for? Why is this fundamental moral, ethical, and epistemological step so impossible for legacy psychiatry? (its a rhetorical question…)
But the truth is Dr. Campbells work is considerably more challenging than her institutional predecessor; she has to clean up their damage before her work can begin, work rooted in reality. I suppose its good work as time and money go, with an ever increasing supply of prospective “clients” coming down the pike.
Lastly, what of all the children who haven’t had the “privilege” of the kind of care Dr. Campbell provides? Not only is their molestation (or whatever the unrepresented repressed violence or betrayal) drugged and labeled, all future behavior will be viewed through the psychiatric lens. If there’s also additional violence, be it neglect or betrayal, etc. it will, like Jason’s story, be forever silenced along with the molestation; “the violence of organized forgetting” (Giroux); no more molestation, only the outline of a psychiatric subject.
Looks to me that you are indeed a writer Charlotte, and it sounds to me as if this thread is the foundation of a hilarious novel. I can imagine Zadie Smith riffing this thread for one hell of a redemptive romp. My personal thanks for doing a wonderful job of showing just how malnourished (many of) these mental health “professionals” are. One can imagine if any one of the long-millennia-list of artist, writers, or intellectual’s, came into their technocratic expertise, we’d never know the likes each one as a result, lest they escape, as you have, before they scrubbed them of the genius of the wounds eye (James Hillman).
When Paula’s essays appeared here, a current of warm anticipation shot through me; her wisdom, humanity, and integrity were a most nourishing fodder to my personal institutional mental health odyssey. It was impossible to not think, if even for a second, how great a privilege it would have been to have her as my therapist. I got more from any one of Paula’s essays than four years of psychotherapy with my paint-by-numbers-careerist-therapist. I’ll miss her, and can only imagine the scope and effect she had upon of lives of others, having touched mine from so afar.
Thank you Richard for your thoughtful reply! I really haven’t read Dr. K that closely over the years as you and others have. I regard any psychiatrist who calls out the pseudo science (the medical model, but also the whole DSM farce,- of which I find to be decidedly more a political tome than a scientific document) is as good as they have to offer. I think its all but impossible for Dr. K to come around to reasonably understanding and empathizing with the forces his profession and its proxy actors (as I noted above) have upon the minds and hearts of people that “seek their counsel” in the first place. The dialectical chasm is just too wide, and the historical fallout too deep.
On free will, there’s a lot of “emerging science” to suggest that we don’t have a free will, but are more saddled with the ontic perception of having one viz the social matrix and our individual consciousness, etc.. I’m not going down this rabbit hole here! But it might be a good discursive segue to make my point. If psychiatry ditched its medical model and used psychotropic drugs sparingly, and never reflexively long term, and if they worked closely with “effective” psychotherapist. of which every psychiatric patient was provided, utilizing, for example, the PTM framework, and several other support systems (I could go on with examples of the mitigation of oppressive economic, social, and political forces, but the point rests’) would the “free will of the psychiatric patient” change, save dramatically? Me thinks so! But we’ll never know of course, at least not until the free will of psychiatry and institutional capitalism reaches the level that its subjects have to exercise day-in and day-out.
You make many important points KS. The world is full of young people who’ve been failed by schools, their familial homes, and various adults and professionals. One of the fundamental crisis’s in our communities is the absence of critical pedagogy in all classrooms, starting in 1st grade! This goes to your comment about teaching kids what to think rather than how to think, including your own adult starting line of an 8th grade education. There are countless books on this subject, and not only is it not changing, it’s going in reverse at alarming rates. But I like your analogy of “adrift”, its connotatively open ended without blame, and journey-like redemptive.
Removed for moderation.
Lawrence, you asked:
Do you agree that a “mental illness/brain disease” identity has become popular because it can work well for people in many different ways? I can understand how it’s easier to view oneself as purely brainwashed, rather than to acknowledge that one’s choices may to some degree be unconsciously driven by socially-unacceptable motives.
I most certainly agree that people do “adopt” the mental illness disease identity because there are a myriad of ” personal payoffs”. But I’m not so sure that the more compelling “unconscious” motivations are more the “socially acceptable” payoffs than the “socially unacceptable motives” you noted (?). The dialectical between ones unconscious or subconscious motives to (our external) prominent social markers, save our collective mythic trajectory-especially when morally and ethically and “materially” signified at techno-deliverable saturation levels, is an almost impossible task for anyone to adequately recognize, save even begin to understand, let alone begin tackling.
And this is where Steve’s comment about the doctor/psychiatrist responsibility is critical mass to me. The word here is “epistemological integrity”, and it’s binary corollary “epistemological violence”-from the Kraepelin-medical brain/disease-mental illness model (supported and promulgated by 5 DSM”s, Capitalism, etc. et.al) is where the psychiatrist/patient rubber hit the 3 decade socio-political road where we all now roll .The mental illness/brain disease model was thoroughly sold to all of us for at least 20 years now (?), everywhere almost without exception, including our psychologist and “family therapist” whose job it seems was/is to “close the sell”, as if any personal counter-narrative were lock’em-up proof of our mental illness.
Lastly, I may have used “brainwashing’ poorly and lost sight of how others might have read it. FWIW, I consider myself to have been “brainwashed” for most of my life. a fact anyone who knows me would be shocked or laugh at upon hearing. I consider myself brainwashed not because I’m stupid or a lazy thinker, but precisely because for decades I listened to my “real external” cues at the expense of my inner cues. Waking up is hard work, painful, very painful, lonely, “threatening”, and most unpopular. So…by brainwashing I meant someone who learns their external “authoritative” cues at the expense of their own inner cues, including the hard work of forging a healthy and empowering dynamic dialectical between the two, including substantive “epistemological agency.
Thank you Lawrence for important questions and insights. I hoped my comments were more addition than subtraction.
What a knock-it-out-of-the-park essay! It’s so dam good I just had to say WOW and thank you Emily! I also believe your on the road to recovery, as well as share your anger-though mine directed at the psychotherapist sector. Unfortunately I suck at anger, but I am learning, albeit slowly, that anger can be a very good ally if I stay disciplined and mindfully vigilant, which is to say, remain compassionate to others and to myself. It sounds to me like you and anger make a great recovery team! Please keep us posted on Michael Gray’s reply, I expect it to be a hoot if he does. But I also hope you keep writing in the coming months and years as your recovery unfolds. The world is full of hero figures, just not full of real life hero story’s, and your recovery story might very well be shaping up to be just that kind of story.
I apologize Lawrence for my rather lopsided and hard-boiled critique of your excellent and important article. I’ve always appreciated your integrity and humanity at the crux of your essays, this essay no exception. Thank you!
Well… Herr Doctor, no argument with your analysis, but psychiatry couldn’t have accomplished such a thorough brainwashing of the populous without the total buy-in and “sell-out” of just about every last one of our institutions. By the time someone reaches their 10 minute “psychiatric” assessment, they’ve been” primed” for years by AMA medicine from psychiatry all the way down through to the family physician. most every layer and representation throughout our mental health providers, big pharma, education from k-12 teachers and administrations to school boards and onward to universities, then cycling back to medicine, advertising, more advertising, legal systems, Congress-both as commission and omission, news reports where the “psychiatric” narrative is overtly and covertly disseminated, all the while social media and family and friends are more likely than not to be parroting the-as noted in your blog- psychiatric narrative as if possessing “critical personal knowledge”. So I have to wonder…when someone “looks deep into themselves”, do they see all these “hard to acknowledge” actors in their emerging “insights”?
I’ve been reflecting on your story for a couple days Ruby, feeling your your struggle in time, going forward in life so as to authentically articulate your potential in this world, all the while your foundation to do has been complicated by experiences that neither add up nor offer a clear path forward. I can’t comment on the medication challenges you face-though I do find Kindredspirit’s comments quite wise, but your thinking and long term goals feel very promising and achievable to me. But what I can say is that it’s well documented that initial psychotic episodes often occur when young people first leave home, and especially when other difficult experiences occur in tow. I only mention this to suggest what (might be) triggered during this very stressful developmental leap is more a physiological response to an earlier miscarried or traumatized developmental phase, than a “permanent” body/brain problem, and thus, “fixable”! Though I am of the belief that breakdowns “can” be a great gift to us, especially creative people like you Ruby. As for the Nurse Ratchet’s of the world… never underestimate the hollow intentions of small minded people with a little bit of power, nothing threatens them more than courageous awakening people like you Ruby, of which your beautifully written story here so clearly shows you to be!
I always enjoy reading your essays Karin, your a beautiful writer, and I almost always glean emotional insights from the depth of your well written narratives. Big thanks for fitting Michael Meade into your essay! Man…its so cool to see his wisdom reaching so far and wide (beyond men’s issues).
Thank you E Biden for so clearly and poignantly sharing your story. For many of the reasons you outlined, I just can’t understand how any psychiatrist doesn’t feel as intellectually and morally challenged as you’ve so aptly depicted? I can’t imagine the forces you face day in and day out. It’s got to be challenging enough not having peer or professional support, save working in a virtual state of constant or imminent opposition, but to also have so much external structural and cultural opposition (a rather long list, actually!), must feel despairing at times? I will only add on this front, “ditto” cbd-md’s intelligent and wise comments!
Re: your observations of the role psychotherapist and psychologist have had in diagnosing and advocating psychotropic meds to treat “their” diagnosis. I don’t know when psychologist and psychotherapist became such handmaidens to psychiatry (the 80’s?), but their abandonment (at whatever scale exists) of patient centered psycho-dynamic and critically conscious (social, historical, transpersonal, etc.) praxis, is a grave loss to our commons.
No advice here, just a couple observations:
It might be helpful to find a more humanistic oriented graduate program like Goddard College (for example)? Do some research on the more progressive programs and contact one of the advisors or instructors with a few of your concerns and objectives. Find a program that adequately responds to your questions and concerns. There has been, for example, some very excellent and-for me, anyway-inspiring articles and interviews from university teachers right here on this website! Here’s the most recent, for example: https://www.madinamerica.com/2021/03/feminism-psychoanalysis-critical-psychology-interview-bethany-morris/
I hope this helps some Astra.
Thank you so much Laura for so beautifully articulating the more seedier interpersonal and banished-from-view inner workings of of the mental health industrial complex. Kind of makes one feel like taking a shower after 50 minutes with their “psychotherapist”.
With regard to the BPD diagnosis; as psychiatrist Irvin Yalom quipped. the “BPD diagnosis is an insult” What Yalom ‘likely’ failed to recognize is that the insult was actually more aptly an insult to psychiatry and the rest of the mental health industry. Personally I think that the BPD diagnosis is-whatever otherwise flimsy or reckless heuristic attributions, far more manifest developmental trauma than anything else. But, then, since few adults have gleaned an adequate narrative from their childhood abuse-what critically happened and critically “didn’t happen” (to borrow from Winnicott), and since the adult therapist is likely working from multiple flawed material and disease paradigms, there’s really little opportunity to fix what got broken, save leaving therapy little more than the better “therapized actor” so as to get and go along in life as well as possible.
I’m afraid your a wounded healer Laura, at least as your chosen vocation and life experience has fated you. Unfortunately that healing will be yours and your patients-as they choose- alone, and not the mental health fields writ large and small. It kind of makes me chuckle to think that 20 or 30 years from now that the mental health industry might just be mostly populated by former users like Laura and others, and as a result, a far saner corner of the world than previously inhabited. I wish you well on your journey Laura, your on your way now…
Richard, thank you for your kind reply. FWIW, I’ve always appreciated and gave close attention to your post over the last several years.
I don’t think most therapist have a clue how to treat or help clients with significant long term multiple traumas in childhood. Hell… I don’t think most mental health professional offer more than superficial technocratic palliatives. If I went into therapy now with the critical consciousness and development I’ve gleaned the last decade-at least when it comes to my childhood, I scare the bejesus out of most every psychotherapist; of this I’m certain.
To answer your two questions. #1 Both my brothers committed suicide in their 40’s, both having never exceeded the 9th and 10th grade, had severe drug and alcohol abuse/addiction, while also being frequent flyers in the criminal justice system; both were profoundly damaged.#2 Yes there were significant splits to be sure! But they did not in anyway revolve around who had it worse. In fact, I happen to think my youngest sister had it the worst. The “splits” were unconscious roles and fragmentations that never saw the light of day beyond my own years of work to understand.
I wish you well Richard.
Steve, I copy and pasted the definition…”Munchausen syndrome by proxy (MSBP) is a mental health problem in which a caregiver makes up or causes an illness or injury in a person under his or her care, such as a child, an elderly adult, or a person who has a disability. Because vulnerable people are the victims, MSBP is a form of child abuse or elder abuse”.
I merely examined the dynamic (while journaling) more out of it’s curious parallel to the above indicated ” “makes up” than arrived and any attribution one way or the other. I really couldn’t care less what “technical” professionally sanctified term does or doesn’t apply to my mother or my experiences of her. More, what I didn’t have space to include in this essay, save that of so much-for example, is that my mother tried to have me legally committed to another psychiatric institution when she got wind (through my sister) that I was going in the Marine Corp. Throughout her life she insisted I was a “manic depressive” and disturbed (from a distance of no closer than 2000 miles, and only through my father).
That’s an astute observation Bananas, and one I had to examine while journaling. But there wasn’t room for this topic to be explored in such a short and complex essay. Munchausen’s by proxy is so difficult to recognize (especially in real time) in its usual form, that recognizing and adequately addressing it through the “mental health arena is all but impossible.
Thank you SE for taking the time to read and reply to my story!
Thank you for your kind words DW. You said something very important that I think needs to be responded to: “You had nobody”.
That’s not entirely accurate… I didn’t “inside” my parental home to be sure! But I had several adults who came to my aide. defense, and mentorship; teachers, a high school counselor, my basketball coach, friends, friends parents, a social worker, and PSH!, This is a critical distinction because many abused and psychiatrically captured kids “don’t have “anybody”! I had unbelievable support from people outside my parental home. There’s no doubt in my mind that I would have never reached 30 if not for that support. Moreover, I’ve been profoundly blessed by opportunities and people throughout my life from which I escaped the fate of my two brothers, etc. At 63, my heart aches for all the kids abused and psychiatrically captured who aren’t getting the type of advocacy I did as a kid. I wrote this for them (not me).
Thanks Sam! Its one thing for an adult to receive a psychiatric diagnosis and entirely another for a child. The child’s identity is more vulnerable and malleable than the adults, save less able to advocate for themselves with adult-like aptitudes and experience. What made me write this story was the documentation on the percentage of abused children-especially in foster care where the abuse narrative often thickens-who receive psychiatric diagnosis and drugs which, not uncommonly, lead to a lifetime of more of both.
Thank you Katel for your kind words/ Funny you should suggest a memoir on this subject… Trying to sufficiently capture the essence of this story in 2600 words was a foolish undertaking. This may be a personal story, but its less about me than it is about the legacy of childhood abuse and psychiatric betrayal, however inadequately written. I only wrote it because I felt that in conveying some of the absurdities and structural ignorance surrounding the legacy of childhood psychiatry along side prodigious abuse, that it might lend something to the larger, if not more substantive discourse. Trying to demonstrate the dynamism of memory rooted in childhood trauma intrinsic to ego and identity formations vis a vis 40 years of adult living in 2600 words was a disservice to the subject matter.
Sadly… all I can muster here is schadenfreude Oh well…
As Fredric Jamison brilliantly laid out in his book “The Political Unconscious”, every last area of our lives is political. My experience with psychotherapist is that they will defend or remain silent to whatever their client is unconscious of “and to”, nevermore so than when that unconsciousness is a violence (betrayal or egregious constitutive injustice from which undeniable psycho-social and emotional injury occurs) that is in direct or indirect opposition to the cultural, social, economic, et al., interest of the psychotherapist personal and professional interest, all the way to the “power’ end point. When I look back at my psychotherapy from the mid-nineties, and factor the difference in my education and overall awareness-and their lived experiences, including significant reclaimed “political unconsciousness” (i.e., childhood violence and betrayal I suppressed from recognizing beyond internalized personalization’s, etc.), I now realize my psychotherapist breathtaking complicity to that violence. I suspect that my psychotherapist, like most mental health “professionals”, viewed their professional success as getting me back out into the bewildered herd (society) with renewed vigor, and ever the more personally and politically unconscious vis a vis “our psychotherapy”.
What a beautifully written story Ekaternia. I also read it allegorically as a story of how “Power” can steal by dint of the sheer opportunity of double binds and the exploitation of the limits of (whatever) organizational discourse available (of which you wonderfully illustrated in your story). Isn’t this dynamic rather ubiquitous in our neoliberal world? But on the issue of dignity, it seems to me all the while you maintained-and strengthened yours, W was throwing hers away. I can’t help but think anyone who would stoop so low be anything but miserable or dead inside. I hope her employer read this! I doubt W’s reading could make a dent in (her) consciousness.
Actually… as Zizek might say, it works very well for the drug companies; part and parcel (as my lazy “etc”. intimated) and craven-optimal-well in fact.
Philip… the deconstruction and historical accounting in the body of your work on these issues, including the moral and ethical thrust therein, is nothing less than heroic. I for one am grateful for all the attention to detail and they’re ever generous contradictions, etc…maybe as grateful as Pies and company are ungrateful.
Not only is further exploration of cause discarded, as you astutely point out Steve, but the very process of arriving at psych-diagnosis has, after years of psychiatric scientism and DSM and social inculcation, etc., etc., encouraged a frivolous heuristic reflex to psych-diagnosis, from which miserably fails the diagnostic process itself. There are endless scenarios and examples for how these ruptured/compromised process occur- and then unravel, of course… (Sami Timmi, IMO, did a wonderful job addressing this intersection and a few of its dynamics). I point this out here because it was a prominent feature for me as a kid, and I know first hand that whatever diagnostic mistakes were made, no matter how glaringly egregious, they will never be met with any semblance of recognition from a professional mental health (“expert”). Go figure…
What a beautiful interpretation and examination of sound Karin! I’m grateful there are people like you who do the hard work or brining meaning (and hope) to those dynamics languishing in tropes and memes (spaces) dispensed through power. Thank you!
FWIW: I’ve recently become more aware of sound as a (far more) critical aspect of consciousness. I recently bought a “white noise” machine to assist with sleep and tinnitus mitigation. What I discovered is that I know I’m awake before I can hear it (the rain, etc.), and feel my body first-and thoughts-before I can make out the sound. I won’t go further with my observations, but suffice to say there’s allot of room for further examination of sound!
I’ve waited a very long time to read a book-written by a psychiatrist-such as Insane Medicine; thank you Dr. Timimi for writing just that book. May your intellectual integrity and moral vigor catch fire in your profession, as well as with all “practicing” mental health professionals.
Yes.. this really hits (me too) hard. Julie and Stephens post and articles a ray of courage and hard won intelligence. As sad as the loss of both is, it-for me at least-makes this space and MIA all the more important, if not critically necessary. Namaste Stephen and Julie (I see you and you were seen!), and you made a difference!
I second that madmom, “required reading for all mental health clinicians!
John, your writing is not only devastatingly good (IMO),but poetic and politically surgical to boot. It reminded me of the James Hillman except below, your story articulating the hard won wisdom in Hillmans observation:
“Power, the move towards superiority in all helping professions and the polarization into weak and strong (patient and doctor, pupil and teacher, etc.). This destructive antithesis occurs when the doctor loses touch with his own vulnerability, the teacher his own ignorance, and the social worker with his own asocial immorality. Help and healing depend altogether, upon maintaining the shadow awareness of inferiority”.
James Hillman, Healing Fiction
Noted oldhead. But the point I was trying to make (however poorly) was that there is no apolitical, only the illusion and or delusion of being apolitical; thus the “unconscious” dynamic. That we believe ourselves “apolitical’ is but an arraignment of our (individual and or collective) unconsciousness through the limits of consciousness, i.e., intelligence, socializations and culture, time, and history’s ruptures and unraveling’s (shifting) etc..
Jim, I highly recommend a reading of Fredrick Jamison’s ” The Political Unconscious” At the beginning there’s a paragraph so remarkable, that I posted it on my fridge for a time. In that paragraph, after a blistering linguistic unpacking, Jamison posits that everything and everywhere is “political”. I can’t imagine reading Jamison (or dozens of others), with that of being reasonably conscious, and not understand this; however butchered the word is in our contemporary culture, etc.
That said… beautiful article Itay!
Thank you oldhead for following up my rather emotional personal story with a nice objective summation of the point I hoped to make-and likely lost in my approach.
This is an excellent article that, for any one reading Zizek or any number of political theorist (Zizek a Hegelian, Marxist theorist and Lacanian analyst), is nothing new. But I have to take issue with this quote, precisely because it’s framing is, IMO, too ubiquitous and woefully reductive and simplistic: “It is actually a caste system in which there are only two classes: the privileged, first-class owners and the lowly workers who could actually crash the system if they banded together…”
I disagree here on several points, but will only make the following point through a personal story:
I’m simply unable to conflate large swaths of the working poor and lower middle class people with a good 10-20 percent of the “professional managerial class” (PMC). When, for instance, my 42 year old working class sister attempted suicide by taking her ex-husbands sleeping pills, she was arrested, convicted, and spent 6 months in jail, from which her already tragic life spiraled into a successful suicide a couple years later. She had no (zero) criminal record or contact with the criminal justice system before this arrest. Why I use this as an example is that, she was herded through this fate by lawyers, judges, social workers, etc. These fine professionals did their job, precisely as they were educated and subordinated to for the capitalist order. And lets be clear here…my sister is but a drop in an ocean of disposable working class and poor people from which the PMC serve and protect the very system they now decry in droves. Yea… Rosenthal is dead right, we are in deep shit. Welcome to the stink PMC.
So much commentary portent in this article I don’t know where to begin. But with regard to this little ditty… “Researchers have now embraced the idea that PTSD is a heritable disease with a genetic base. A recent study has claimed to have actually found the loci of the genetic risk”,
Great! Now we know who to send into combat! Before anyone can be sent into war (battle), they must first prove to not possess this “genetic base”. I mean… that not only sounds fair, but think of the “billions” saved by the VA with regard to ‘all’ PTSD treatments. And, now that we have the “science” here (snicker, snicker..), why don’t we exchange all known children currently in traumatic environments with children without this “loci of genetic risk”? I can think of a dozen examples from which this kind of science(tism) and the living, no-skin-in-the-game data collide like an apocalyptic wet dream. Good article Noel!
Sorry MIA! I made this comment again today thinking yesterdays hadn’t registered (the website was unresponsive yesterday , so I closed out thinking my comment lost).
When does “pride” cross over into delusion, be it through intellectual insouciance or moral vacuity? I mean…the political figure represented in this article begs this question, at least for me. And what then, when ones delusion’s are internalized (co-opted) by others who, too, believe pride the agency of their beliefs and actions? Just thinking out loud here about pride as something real (i.e., something grounded in ones acts or other material interactions, etc.) as opposed to it’s more conflated impersonations.
Seems to me there can be a very fine line between pride and delusion, your above “political individual’ a good example. Pride grounded in something substantively material, be it ones acts or others responses to them (excluding sociopathic enablers, etc.-no need to elaborate here!) More…what happens when ones delusions become others reality and people suffer, either materially or psychically? Me thinks, at least for starters, it’s critical to call out the absence of pride, as well as the abundance of its delusional impersonations.
Beautifully told Elizabeth! As you stated “Where were these tests when I first entered treatment as a 17 year old?” There should be a law mandating a comprehensive physical (metabolic panel and CAT scan, etc.) before any regiment of psychotropic drugs can be administered (a 10 day emergency declaration the only exception, for example). This would at least provide the patina of science to psychotropic drug ‘treatment” which, as your psychiatrist demonstrated, is as about as epistemologically sound as a ten year-old with his/her first chemistry set. I keep wondering…when have enough stories like yours and so many others going to result in a class action lawsuit: not to win so much), but as a watershed to the diseased, false psychiatric narrative itself?
Thank you Joe for telling your story of parental abandonment and psychiatric betrayal. The truly diabolic part, at least from my very distant point of view, is that you were deeply affected (duh…what five year old wouldn’t be!) by your parents disappearance, from which psychiatry took that psychological hole and drilled down as far as a five year old boy could neither comprehend nor stop: Forever! To have dug yourself out to this point, and to tell your story with this much clarity and grace, is to have taken a heroic journey, everything psychiatry will never undertake nor possess.
I’ve been wondering lately… that when our institutions finally immolate (for reasons not so dissimilar to psychiatry’s predicament) will that be the end of psychiatry, or the best of all possible worlds for them? My money’s on the latter.
Wow! I’m not sure which blows me away more, your courage to tell this story as you have, or the courage in your having lived it? But I’m pretty sure you’re living the hero’s life from here on out, from which a most fortuitous fate not possible before your first psychiatric encounter, will find you a most deserving representation. You Rock! And your story only grows in leaps and bounds from here.
Tipping points, however tragically overdue, usually don’t result from any single qualitative event, as in even the most devastatingly honest and thorough New Yorker article-that didn’t happen. My point here is what is psychiatry’s tipping point? My guess… long after the most damage possible has been achieved. Is there any mystery that psychiatry and the mental health professions are making the world sicker, exponentially so? I imagine, for a moment, psychiatry having to answer to Congress, perhaps four or so committees. I imagine class action law suits. I imagine a spin-off branch of psychiatry and governing body (as in headed by Dr. Bregin-like minded doctors) from which conventional-historical psychiatry starves to death. I imagine institutions working as the health of its denizens their defacto raison d’etre. But, then, maybe these are a few of the reasons why psychiatry (seems) to have no tipping point?