Tuesday, May 30, 2017

Comments by BPDTransformation, B.A.

Showing 100 of 1527 comments. Show all.

  • Even when parents are heavily involved, they are never the only cause. Many factors in today’s world put kids under great stress, including peers, teachers, the media, and so on. But, it is realistic to say that parents are very important both for kids who grow up to be emotionally well and often, but not always and to varying degrees, for kids who grow up to be seriously emotionally troubled.

  • It is also true that parents’ inability to take responsibility – again, a better word than blame – is a significant part of the problem.

    This is seen most prominently in the many thousands of NAMI parents who cling to the illusion that a mysterious brain disease is ruining their children, while the child sits at home, drugged up, unable to have relationships, for year after year.

    Meanwhile, via this fantasy the parent maintains the denial of the possibility that their inadequate caretaking might have figured quite prominently in their offspring becoming so inadequately troubled.

  • Harper should not use the word “blame” in my opinion. But, parents are often the cause of their children’s distress in large part. Who else would be neglecting and abusing the thousands of people who report such childhood trauma along with receiving mental illness labels? If not mostly parents.

    But identifying parents as a causative agent is not the same as blaming them. As John Read says, abusive and inadequate parents are subject to severe pressures of their own, including past internalized abuse and neglect from their own parents (the grandparents), lack of knowledge about how to effectively parent, poverty, work stress, addictions, and so on. We can see then that parents do not mistreat children mostly because they are evil or “bad”, but because they have been through difficult experiences themselves and are not able, at the time that they mistreat their children, to be the best parent that they could be.

  • Kjetil I think very similarly to you about adverse experiences not being illnesses. I really appreciate your humanistic stance and obvious compassion for people that you work with; I think that is one of the most healing things in a therapist or friend. Diagnoses and drugs in my experience usually tend to get in the way of creating these relationships.

  • Ok, you are right – my mistake. I expected it to be near the top of the New Comments, and not seeing it there assumed it was gone – but it is in fact nested at the bottom as a “new” response to an old comment here – http://www.psychiatrictimes.com/schizophrenia/quality-life-and-case-antipsychotics

    So it is there now… though will be interesting to see if, as a non-mainstream comment, it is allowed to stay. I doubt that it’s half-life is going to be very long.

  • It is ironic that Pies tried to appear balanced in this way:

    “We acknowledge, of course, that psychiatry’s critics often include the voices of dissatisfied individuals who have received psychiatric care. Those accounts are just as important to consider as the many stories of positive outcomes….”

    But despite giving lip service to the importance ofacknowledging people who are dissatisfied, Pies and/or his editors proceeded, apparently, to delete the carefully thought out respectful comment by Steven Morgan above.

    One can’t really have it both ways. If one’s own site arbitrarily deletes any comments that disagree with one’s position, similar to how a totalitarian state summarily snuffs out any disagreement with the party line, one can’t pretend to be open-minded and be taken seriously.

    If Pies came here and respectfully gave his opinion, his comment would stay up even if we disagree. But when other people go there and try to speak, their voices are extinguished. What is Pies afraid of?

  • Dave,
    Well done for speaking out and doing something about this by raising awareness.

    I have dealt with very similar despair/terror/suffering to you, I think, mainly because of severe traumas of various kinds and also partly due to drugs. It is so difficult and I pray that you are getting as much support as possible to be able to move along a gradual upwards path in how you are feeling and functioning.

  • It also makes no sense that Frances thinks he can reliably exclude Trump as having a DSM diagnosis. How could he possibly know this? He hasn’t examined Trump. The reverse Goldwater rule should apply here. So-called professionals shouldn’t be voting in or voting out psychiatric illnesses for those they’ve never met. Of course they shouldn’t really be applying these garbage labels at all.

  • Psychiatric diagnoses are indeed a fraud.

    But if you were to ever have a perfect “match”, it would be hard to do better than Donald Trump and Narcissistic Personality Disorder. This dude is hyperloaded with narcissism and excessive self-belief.

    And Frances is not even correct that psychiatric diagnoses as a rule cause distress and impairment. Higher level functional narcissistic people do not experience this, as Masterson, Adler, Rinsley, Kernberg wrote about long ago. Their arrogance and self-assuredness is problematic for others, but they do not usually feel or function worse because of it, except in the sense of not being able to have intimate relationships.

    It is funny how psychiatrists keep getting in trouble with their public statements – it’s hard not to, when one is standing on the crumbling edifice of psychiatric non-diagnoses that Frances and his minions tried to conjure into “illnesses” for the DSMs. There is simply nowhere to turn when your diagnoses do not hold wáter as real valid concepts.

  • Wow Pies and Pierre just got owned. That is truly embarrassing to have the two studies they cited exposed like this, as industry-funded, dropout-full, withdrawal-biased, scams…

    They just keep make it worse for themselves by opening their mouths / uncapping their pens.

    Robert, well done with this careful analysis. It’s much easier for you because your professional status and your income don’t depend on the maintenance of myths favorable to corporations which funds the APA, psychiatrists training programs, universities, etc.

    I still think you should not kowtow to Pies/Pierre’s use of “schizophrenia” as if there were such a singular disease entity, something Pies even admitted there probably is not in a footnote to his latest essay. The uncertainty of whether there is a valid coherent entity called schizophrenia adds another wrinkle into how to evaluate these studies. How can we even trust that comparable groups are being compared in these studies given that the diagnoses are invalid?

    And lastly, let’s get one thing straight: these are tranquilizers, not medications treating a disease. Seroquel and Risperdal are tranquilizers not medications, simple as that. The ord medications only serves the myth that psychiatry wants to sell, i.e. that severe problems in functioning/living are brain diseases. I hope you will start to separate yourself from repeating that euphemism.

  • Good comments above.

    As others have stated, a profession that founds itself on the myth that problems of thinking, feeling, and behaving – while they may be reflected in altered brain chemistry – are physical illnesses comparable to diabetes and cancer, and primarily treatable with psychoactive drugs, is not worthy of being saved. It needs to be abolished.

    Just as we would not wish to save the “professions” of illegal drug dealing, human trafficking, loan sharking, or underground dog fighting, neither should we try to save the profession of psychiatry, which compares to or exceeds the harms done by of these four nefarious “professions”. As a profession which inherently dehumanizes and deceives people about the nature of their problems, it is rotten to the core.

  • It is a huge myth that, if only it were more available, psychiatric “treatment” as it is currently practiced would resolve most people’s problems, would “fix” people and keep them safe.

    When one reflects on what “treatment” really is – confining a person for a few days or weeks, while giving them brain-dampening drugs that dull down their fear and rage, but do nothing to address the sources of their problems – it becomes clear why increased “treatment” will not “cure” the serious life problems faced by so many suffering people.

    The resources required to address the problems experienced by people labeled as “severely mentally ill” – which often include inability to trust others at a basic level, lack of support from family and friends, lack of job and educational opportunities, lack of housing and money, etc – these problems can in no deep way be addressed by confining someone in a “hospital” for 5-10 days and giving them drugs so they can’t feel anything. Because once the person is released from the hospital, and if and when the drugs are withdrawn, the underlying problems will still be there.

    Current American mental health “treatment” is therefore doomed to fail most of its clients. It is simply not adequate. Real treatment would involved provision of a high level of voluntarily chosen social, psychological, and economic resources, including housing support, job training, and most importantly, whatever social support a person wants, which might include long-term psychotherapy, group support, and the engagement of caring friends and family members.

    Again, the causes of the problems of people labeled “severely mentally ill” have never been proven to be primarily genetic or biological in any way. The evidence we have such as the Adverse Childhood Experiences study strongly suggests that the primary genesis of problems for most people who enter mental “hospitals” is in the adverse psychological and social experiences they have undergone that affect their brain chemistry, not in randomly misfiring neurons or bad genes. This is another reason for the failure of the modern AMerican mental health system: it is based no the myth that problems of behavior, thinking, and feelings are “brain-based illness” that are “treatable” by drugs. This delusion about the primarily biological/genetic origin of people’s suffering is one that would be more at home in a Franz Kafka novel than in reality, although, for many people trapped in the US mental health system, reality does indeed become more Kafkaesque as the years go by, as symbolized in stories such as The Metamorphosis or The Trial.

    Therefore, for many reasons, current mental health treatment in Massachusetts and America is doomed to continued failure. We are simply not willing to acknowledge the primary factors causing severe emotional distress, let alone to provide the intensive access to resources necessary to help those who have been nonfunctional, enraged, terrified, and/or hopeless for years or decades.

    Ultimately, we as a society should look in the mirror to see the reasons why the most vulnerable among us are doing so poorly.

  • Regarding the supposed success of these drugs, suppressing distress is not “success”. The research for both antidepressants (e.g. Kirsch) and neuroleptics (e.g. Sohler) show that the most these drugs do is suppress severe distress over the short term, and that in the long-term, there is no solid evidence base showing they make people more functional or emotionally well.

    And for goodness sake, if you are going to write an article challenging the disease model, don’t call these drugs “medications.” They are not comparable in any way to insulin or penicillin, which treat specific disease processes and are thus medications in the true sense. These are drugs, tranquilizers, neuroleptics, etc.. but not medications.

  • No, Whitaker doesn’t believe that. He is very aware, I think, the research strongly linking abuse/trauma/neglect/poverty to getting a psychotic diagnosis (John Read). These associations are very strong.

    I think Whitaker talks about how being withdrawn from antipsychotic drugs too quickly can cause a recurrence of psychotic experience (this is true), and how when one is on them for a long time, the brain adapts to them and needs them to function, and then it’s hard to get off without experiencing hallucinations/delusions etc again. But he wouldn’t think about it simplistically like that blogger thought. That blogger is just a guy with a vendetta who creates a straw man.

    Oldhead is also correct below that schizophrenia is not a valid diagnosis, and in a meaningful sense there is no schizophrenia. There is a continuum of more or less severe psychotic states that people have for different reasons, at different times, to greater and lesser degrees… and always in individual ways.

  • I enjoyed reading this article. It sounds like a great program, full of humanity and being with one’s emotions. It made me think of Courtenay Harding’s work in a nearby area of Vermont so many years ago. In spirit, it had some things in common with this, i.e. faith in the capacity of severe troubled people to recover.

  • “Problem with this is that Healing, Recovery, and Therapy are all still ways of putting the blame back onto the victims…. ”

    No. That’s an all negative way of looking at things. What healing, recovery, and therapy are all depends how the individual looks at things and what they want. We can’t make a blanket statement that healing, recovery, and therapy are all ways of putting blame onto victims. While they may mean these things to you, they often do not to others.

  • Yep, workers in the psychiatric system get away with soul murders all the time.

    By soul murders, I mean making people die decades too soon by polypharmacizing them with multiple forced antipsychotics, which make them get obese and die young of lifestyle diseases. And added to them, falsely informing the patients that they have incurable brain diseases called schizophrenia and bipolar which cause vulnerable people to feel even more hopeless.

    So rather than have a chance to form trusting relationships, make friends, return to work, etc; vulnerable people in a life crisis are turned into lifelong wards of the system – alone, miserable, drugged up, physically broken down, and feeling a lot of despair, terror and rage most of the time, then dying decades early. That is soul murder and that is what a lot of workers in the mental health system do. Only they always get away with it.

  • Hi Kenneth,
    Can you please send me a brief email – bpdtransformation (at) gmail (dot) com . I would send you one, but I don’t know your email and cannot tell what it is from the listserv. I’d like to ask you a question that would be better discussed off of this site.

  • Another good idea is a GoFundMe fundraiser for Reid’s legal defense. To his mom, look it up on Google. IT’s a website drawing attention to the person’s issue and soliciting donations.

  • Well done to Paul for persevering through so much.

    What a Kafkaesque trial to have to deal with fake doctors and fake diagnoses and real losses of freedom for so many years. It makes me think of what one of my fellow antipsychiatric commenters on here says, “Psychiatrists don’t treat the insane; they are the insane.”

    Along with the US, New Zealand is one of the worst, most coercive mental health systems on the planet, from all I’ve heard from several people involved in that system. As with the US, fear of risk infects every aspect of what is done within the system. Mental health workers are so scared of repercussions if a patient hurts themselves or another person that they cannot let people try getting off drugs, try having more freedom, risk being independent. It’s pathetic.

    Meanwhile New Zealander psychiatrists are so deluded into believing that diseases like schizophrenia and bipolar exist as discrete entities which can be treated by “medications”, that they are entirely unable to see the person beneath the label, and therefore unable to understand the person’s story and what non-biological or non-genetic causal factors might be involved in creating a person’s problems.

    As the article implies, psychiatric diagnoses like bipolar and schizoaffective are not valid illnesses, psych medications are not drugs treating illnesses, and psychiatrists are not doctors doing work comparable to real physicians. How many times have I written some version of this on here; probably over 1,000 now.

    Oh and, about the psych drugs, outside of a hospital environment it is in many cases pretty easy to trick psychiatrists into believing one is still taking an orally-taken drug when one is not. The diagnoses are subjective and unable to be confirmed via biomarkers. So whatever one tells a psychiatrist is usually believed, and when it comes to drugs, most psychiatrists are very gullible. I self-tapered off multiple psych drugs including an antipsychotic while easily deceiving the psychiatrist I was with that I was still taking them. Luckily I was not at a psychiatric prison at that time – it’s much easier to accomplish the deception as an outpatient. To this day that psychiatrist has no idea that for over a year I deceived him into thinking I was still taking the drugs and that they were still benefitting my “disorders”.

    This is one of the primary ways “patients” have of reversing the situation and gaining power over psychiatrists: by not taking their prescribed drugs and secretly directing their own treatment/recovery efforts.

  • Wow dude how stupid can you get. Why don’t you let the rest of us know where you got your crystal ball from? And why don’t you post your studies showing how taking psych drugs stops people from being violent..

    because you don’t have anything.

  • Lastly Reid, you don’t deserve prison, although I understand why you said that you do because you want to accept responsibility.

    The night you broke down you overwhelmed with difficult emotions and needed someone to take notice. Your behavior was a call for help, not a cruel attempt to harm other people. What you needed in response is not to be imprisoned, but to have someone sit with you and listen to you, to understand what is going on and what your needs are. Unfortunately our offical legal/psychiatric/prison system rarely provides this type of empathic response.

  • Reid, very sorry to hear about this. Although I am glad you have been able to make your voice heard.

    It sounds like the hospital administrators should be sued for keeping a person incarcerated when they are no longer any threat to anyone.

    This Orwellian, Kafkaesque story would seem to be a prime case for a legal challenge in the state supreme court or even the Supreme Court. Hard to believe this is happening here in the United States. Our social control system isn’t the same as North Korea or Iran; at least, I didn’t think it was…

    Maybe Jim Gottstein or another lawyer with knowledge of the psychiatric system would take on your case pro bono. There seems to be a very strong case that you should be released, if you are not evidencing violent behavior and/or inability to care for yourself currently.

  • Of course addiction is not a disease.

    Amazing how many people cannot understand this.

    Addiction is a matter of degree along a continuum, of lesser or greater attachment to certain things and their effects on psychological / biological processes over certain timeframes. It’s not like having or not having a physical illness.

  • Naas,

    Well done with coming off the drugs!

    I was on 12 different psychiatric drugs myself, including a majority of the same ones as you – no surprise since they are some of the most common. I came off all drugs about five years ago and have been drug free since then. Like some of your friends, I did it mostly without professional help (well actually, I was seeing a professional, but I tapered off secretly against their advice… unfortunately they weren’t the kind of supportive psychiatrist you were seeing).

    One big point of disagreement: I don’t share your hope about psychiatry – do not think the field is going to redeem itself. It is too heavily influenced by Big Pharma money, by the need to deny early childhood abuse and neglect via myths about brain diseases, via fear of ambivalence, uncertainty, and risk, and by the addictive quality of delusionally believing that one is “treating” problems by giving someone a pill, rather than understanding their story.

    What most psychiatrists do right now with diagnosing and drugging is a profitable and easy-to-perpetrate scam. Why take the hard road of helping people via long-term relationships? They can earn a lot and have a good life doing what they do with diagnosing and drugging. It’s the clients who suffer, and that’s not much motivation for most psychiatrists, who due to denial and ignorance are mostly not even aware of the harms they do.

    And a not sure what “clinical skills” you think psychiatrists have Naas, because most of them really don’t. They are just trained in identifying “symptoms” of pseudo-diagnoses and picking drugs which don’t even directly target the illusory diseases in the DSM. These are not “skills.” A real skill would be spending long periods of time really listening to what someone else is saying and developing a healing relationship with that individual. Or, learning how to engage a family and help it work out its self-destructive dynamics that are stopping one member from being able to function. These type of skills are not taught in psychiatrist training, so psychiatrists do not have them. You are right that they could have them, but most of them don’t…

  • I would add that in my mind, insulin and penicillin are true medications, as well as being drugs, whereas Zyprexa and Lamictal etc are not; they are drugs only. Meth and PCP are also drugs, but not medications….

  • Ken,
    My position is based on having noted that many dictionaries define “medication” as something like:

    A drug or other form of medicine that is used to treat or prevent disease

    The above is from – http://www.oxforddictionaries.com/definition/english/medication

    In our society, hearing the word “medication” is usually linked in the listener’s mind to thinking that the substance in question is being used to treat a physically-caused (i.e. brain chemistry imbalance caused) or genetically-influenced psychiatric “illness”. As you probably know from reading Whitaker’s work, this idea has been actively promoted by the drug companies and by some leading psychiatrists, at least in earlier years.

    I think that “medication” is a misleading and possibly harmful word for general psychoactive substances that affect mood/thought/ability to feel because syndromes / problems of self- and other- experience are qualitatively much different than physical diseases. A better word might be “tranquilizer.” That describes more directly what these substances do – they mostly sedate or limit the ability to feel things strongly.

    I wonder if you have taken these drugs yourself? If not you could always try them for a few weeks, and you might then be able to understand your clients’ experience even better. As I like to tell people, all you have to do is go in to your doctor and tell them you are hearing the word “Thud”, a la Rosenhan, and they’ll give you some Seroquel or Risperdal. Although in your case it would be even easier, as you could self-prescribe.

    Lastly, for me drug and medication are cousin words but not synonyms. A medication is a drug, but a drug is not necessarily a medication. For example, heroin and cocaine are drugs. But they are not medications treating an illness process. Similarly, Seroquel and Zyprea are drugs, but they are also not medications treating an illness, at least not in the strict medical sense. I hope you see this distinction – it is what I have been getting at with my comments.

    No, I am not referring to the verb instead of the noun. I am referring to the noun. I also do not think that using a drug like Zyprexa or Prozac is always harmful. A drug is not by nature harmful. It depends on how you use it and in what context. But I think it’s important to be honest with people that psychiatric drugs do not treat or directly address specific diagnoses / illness processes in the same way that drugs like insulin or penicillin do.

  • Hi BC, I would invite you to please check out my site, linked above in my reply to Nickfitz. On that site I elaborate on the developmental understanding of borderline states of mind, which I understand through my own experience, as well as from reading authors like Fairbairn, Masterson, Kernberg, Kohut, and other more recent writers. To me understood properly borderline states are not an illness but instead a pattern or way of relating based primarily on neglectful/inadequate/abusive experience with the world and other people.

    Below I will copy an excerpt from one of my longer articles about the Fairbairnian approach to understanding trauma / borderline states. If I wrote this article today, I would write it a little differently and not use language like “borderlines” to describe people…

    ————–

    Object Relations as a Theory

    Most people intuitively understand that our minds are filled with internal “images” or representations of people based on our experience in the outside world. In fact, we have many different images of ourselves and of other people inside our minds, and we often fantasize about these images when we are alone. These images could also be called emotional memories.

    These images or memories have feelings attached to them; they are a combination of cognitive/intellectual knowledge and positive/negative emotions. They are like our minds’ “code” for the knowledge and feelings we have toward ourselves and other people. We use these images as a map to understanding ourselves, others, and what is possible for us as we relate to the outside world. These ideas very roughly explain “object relations theory”, which is used by psychodynamic therapists to understand problems including BPD.

    The Endopsychic Structure of BPD

    Fairbairn created a model for how the abused person managed internal psychic representations of other people. He called this the Endopsychic Structure. This model explained the behavior of individuals who would later be diagnosed with Borderline Personality Disorder.

    In later versions of Fairbairn’s object-relations model, healthy development was promoted by a predominance of good, comforting, loving experience in early childhood relationships. A secure attachment to the parents allowed the child to confidently explore the world and to develop mature relationships as an adult.

    Fairbairn noted that good relationships in early childhood promoted the development of ego functions like tolerance for ambivalence (seeing things as mixtures of good and bad), frustration tolerance (being able to sacrifice short-term discomfort for long-term gain), the ability to comfort oneself, the ability to be alone and not feel abandoned, etc. The reader will recognize that these are exactly the ego functions that modern-day BPD sufferers do not have.

    Fairbairn called the mature adult ego the “central ego”, and noted that it contained a mixture of positive and negative perceptions of self and other, with the positive being stronger or integrated with the negative.

    By contrast, the borderline or abused person had a “split ego.” Fairbairn described how when abusive, neglectful experience predominated in childhood, the child seemed to hold apart the mainly negative experience in one part of his mind, and to keep the occasionally positive, redeeming experience in another. Integration (seeing people as mixtures of good and bad qualities) could not occur since it was too threatening. There was no reason for the abused person to combine the two sets of images and see how weak the good experiences had been and how helpless they really were, until the ratio of good-to-bad experience improved.

    Fairbairn realized that the abused person’s view of themselves and others was completely unrealistic, although they had enough of a hold on reality to avoid permanent psychotic regression (called schizophrenia today). Instead of seeing the outside world in shades of grey, the borderline saw people as all-good or (usually) as all-bad, and related to them as such.

    Everyone has slight distortions or differences in how they see the outside world, which is why we have the truism, “perception is reality.” But in the borderline’s case, these distortions of other people are massive and create serious relationship problems, since people are not nearly as bad or as good as the borderline thinks they are. People do not normally appreciate being the target of projections by borderlines who view them as saints or demons.

    The Attachment to the Bad Object and Rejection of the Good Object

    The borderline’s unrealistic view of the outside world involved the belief that most people were untrustworthy, uncaring, rejecting, “bad”, etc. In other words, the borderline projected the original “bad object” experience with their parents onto new people they met. The “bad object images” – all the memories of abuse and neglect from parents – dominated their expectations of the outside world. They were emotionally blind to the reality that many kind, genuinely helpful new people existed.

    Not only were borderlines relatively unaware of potential help, but they actively rejected it when it appeared. Fairbairn saw that a new, helpful person could easily be mistrusted and seen as someone who would eventually disappoint, abandon, or turn on them. In this way the borderline feared that a new “hoped-for good object” would morph into a “bad object”.

    Fairbairn’s “moral defense” described how borderlines blamed themselves for the poor treatment they received in order to, 1) Protect the truly bad parents from blame and thereby avoid retaliation from that parent, and 2) Prevent awareness of the helplessness of their situation (i.e. “If only I were not so bad, my parents would treat me better.”).

    The moral defense created another massive obstacle, because it made borderlines blame themselves as “bad” and judge themselves as unworthy of help.

    The Inversion of the Normative Developmental Process

    Fairbairn understood how the abused child’s mistreatment early in life resulted in adult borderlines who continued to abuse themselves and form abusive, disappointing relationships with adult partners (or, simply avoid positive relationships and remain alone). It is no coincidence that women who repeatedly return to abusive partners frequently, but not always, have borderline psychopathology.

    This is the ultimate meaning of Fairbairn’s “attachment to the bad object.” It means that the borderline individual continually recreates and maintains bad relationships, whether he means to or not. By distrusting potential good new relationships and clinging to people who disappoint and reject him, the borderline remains attached internally (emotionally, at the mental image level) to “bad objects” and continues to believe that the world is rejecting and “bad” like in childhood.

    A dramatic example of the attachment to the bad object appears in Alfred Hitchcock’s film, Psycho. The leading character, Norman Bates, wants to befriend an attractive young woman who stays at his hotel. However, he later kills her (i.e. rejects the internal good object) and therefore maintains the attachment to the bad object, his possessive mother. Norman fantasizes that his mother, who is actually long dead, would be jealous, and would not want him to relate to this potential new good person. Therefore, Norman’s “internal bad object” (the mother) dominates his mind and makes him reject the good object. Norman Bates was actually psychotic, but the object relations mechanisms involved are similar to borderline object relations.

    The writer Jeffrey Seinfeld (in his book, The Bad Object) described how the borderline’s mental processes involved an “inversion of the normative developmental process.” What this means is that instead of seeking out good experience and rejecting bad experience, the person with BPD seeks out bad experience and rejects good experience. In other words, consciously or unconsciously the borderline individual does the opposite of what healthy people do. Borderlines are “attached to the internal bad object” – they avoid accepting, loving relationships, and stay attached to uncaring, abusive ones.

    What is Needed to Let Go of the Attachment to the Internal Bad Object

    In earlier posts, I wrote about how borderlines need to develop a dependent, trusting long-term relationship with a therapist or friend. This builds self esteem, develops basic trust in others, and helps to develop self-control, tolerance for ambivalence (not splitting), frustration tolerance, etc. A healthy ego, able to manage the challenges of adult living, can only be developed through long-term support and love, in other words, through good object relationships.

  • This is BS. People don’t have mental illness. People have problems in feeling, thinking, and functioning based mostly on experiences in the environment, especially with neglect, trauma, abuse, isolation, poverty etc. Stigma shouldn’t be the pseudo-stigma of defending the idea of having a “brain disease” and differentiating this from people like Trump. That is just total BS.

  • Ron,

    This is an important issue in general, and it particularly touches me personally.

    I experienced psychosis/voice-hearing and “borderline” states of mind for many years, and now function much better without nearly as many problems as in the past.

    But, I don’t tell anyone at my job as a teacher/coach that I once had these problems. In fact, I am scared to do so, because I have the paranoid fear – or maybe not so paranoid – that if I share that I once heard a voice, once was in terror all the time, once couldn’t function at all for long periods, once experienced severe mood swings frequently, once had diagnoses of all sorts of things including borderline and schizophrenic – that if I share these things, then I may lose my job and/or people may think I am some unstable person who should not work with children. That people will think I am/was an “other.”

    The risk reward for me seems simple: keep quiet, keep my job. Speak out, gain very little except some personal satisfaction, but risk losing my job.

    Maybe I should do it. What do others think?

  • Oh and Ken, let me say it again: psychiatric drugs are not “medications”. I hope this will get through to some people eventually. If you think labels have an important potential to influence people – and this article suggests you do – then perhaps you will consider that labeling generalized psychoactive compounds as “medications” (often described in the press as comparable to insulin for diabetes) is misleading and causes many people to mistakenly believe that people on psychiatric drugs have an “illness” or brain disease, which is being treated by said “medications”, when in fact these drugs work no differently or more specifically than various illegal street drugs in influencing mood…

  • Great article, Ken. You are doing a great job to have the culture change at your workplace so that there is more focus on the person’s story and less on the label.

    It is indeed disturbing to see the discourse that is so common in our country about “having bipolar disorder”, “being a borderline”, “living with schizophrenia”, and so on. Recently, it’s kind of perverse of me, but when I see some mainstream news story or NAMI parent say, “this person lives with schizophrenia”, I start laughing and have this image of aperson sitting in a living room with a monstrous demon sitting in the chair next to them, all day long… as if they are literally living alongside this fearsome, inscrutable, chronic, all-negative, monstrous disease-entity which they are fated to live with forever. That’s not that far off the presentation of “schizophrenia” that gets communicated by poorly-educated psychiatrists and NAMI families. But of course, there is no single disease called schizophrenia; schizophrenia is a not a concrete thing… using the defenses of fusion and splitting heavily, and defending against terror, rage, and despair via heavy use of these defenses along with denial/projection/avoidance etc, is not a disease or a “thing.” It is a lived experience, and one that is transformable.

    On my site, I wrote an article titled, “Why BPD Should Be Abolished, and What Should Replace It” that you might be interested in, here:

    https://bpdtransformation.wordpress.com/2015/06/26/26-why-bpd-should-be-abolished-and-what-should-replace-it/

    By the way, if you concretely answered your colleague’s question about what diagnosis this person he didn’t know had, and what drugs she was on, wouldn’t that be an invasion of privacy of the client?

  • The picture at the top of this page –

    https://www.bostonglobe.com/opinion/editorials/2016/07/01/mandate-treatment-for-mentally-ill/hwoJ5qUc5aR37RSPQdUyRJ/story.html

    of the three orderlies controlling the person with “mental illness” is symbolic of what is wrong with the approach to severe emotional distress in this country. It’s all about controlling people’s behavior and giving them drugs, not about listening to the suffering person and offering them resources that may actually help like housing, job training, psychotherapy, family support, friendship, kindness, etc.

    I think most people in our culture simply cannot understand what it is like to be in the system and be forced to take drugs, have an illness identity forced on you, have your movement and ability to think restricted, etc. Most people simply do not have the experience to relate, and understand so little about how emotional distress has been warped into “mental illness” that it is difficult to begin helping them understand what Big Pharma and the mental health industrial complex has done.

    Nothing else to say here – but another good essay, Sarah.

  • Kenneth,

    I really like this essay, and when I first saw it, thought it would make a good MIA entry. Here are my thoughts about it shared previously:

    I thought this excerpt was particularly insightful:

    “How do we learn to regulate our affects? You know with that affect regulator medicine. Never heard of it you say…it’s called safe, secure, consistent interpersonal relationships. That stuff we did with our kids, you know all that pain and heartache, worry, fear if not terror not knowing how things are going to work out, staying with it no matter the provocations to give up…you know all that easy stuff! Well how does that all play out in an urban mental health center? Not well.”

    The trap you describe is real: if the doses of drugs (yes they are drugs, not medications 🙂 …) are lowered, as you described, the young person may become more emotionally volatile; the family or case worker will often respond by saying “this is an expression of your mental illness” and pressure them to take more of the drug. A trusting relationship is not supported by this enactment, because the parent/case worker is not acting as a self-object being responsive to the young person’s genuine needs for affective containment / empathy / understanding. Rather, they are treating the person as an object or a disease needing to be drugged, and not listening to what is really going on with the person emotionally. The parent or case worker thereby reinforces the internal rejected self / rejected object images, over the needed vulnerable self / good object images, to use a little bit of Fairbairn’s object relations language.

    I remember reading a book called Treatment of the Severely Disturbed Adolescent by Donald Rinsley, who was a respected psychiatrist at the Menninger Clinic in Topeka, Kansas. He worked back in the 60s and 70s when people actually tried to engage troubled youngsters in therapeutic relationships instead of just drugging them. Rinsley wrote about “presymbiotic schizophrenia” and “symbiotic psychotic” (i.e. severely borderline) young people from a developmental viewpoint, understanding the young people he worked with according to the quality of their relationships with parents and peers historically and currently.

    Rinsley said that even when he could see a young person in intensive therapy 3 or 4 times a week, and involve the family, it was still very hard work, and it would often take 3-5 years of building a trusting relationship and working through difficult feelings to help a very disturbed young person to become more functional, and this in optimal conditions. And, this was when the culture of drugging everything, and the focus of ejecting people from secure hospital settings as quickly as possible, had not taken hold yet. So I imagine it is even harder for you to work with young people now…

  • These are some pretty “loose associations” to say the least.

    Elvis was screwed up, but to link him and the Greek gods with psychotic states is a little bit out there. The latter are usually based on long-term stress, trauma, and neglect, and involve real and severe suffering and inability to function. By contrast, there’s going to a concert and going wild about some hot guy…

    As the commenter above said, just look at videos of Justin Bieber and Miley Cyrus today. Human nature doesn’t change that much over a few decades.

  • HI Oldhead,
    I am very sympathetic to your criticism.
    I basically agree that the concrete, linear, reductionistic measured used are not very meaningful. Much more value can be found in asking people to describe their experience, i.e. in qualitative narrative accounts.
    This type of research above only allows for making guesses about the most general trends, from the perspective of whatever is considered important (perhaps arbitrarily) by the investigator, as you pointed out.
    I agree that too much medical model residue is in this type of study. The studies by Seikkula from Finland are better. When things come to America they always seem to get tainted by the reductionistic and objectification of the disease model.

  • Another successful analyst with psychotic people would be Murray Jackson, in his book Weathering the Storms –

    https://www.amazon.com/Weathering-Storms-Psychotherapy-Murray-Jackson-ebook/dp/B005WH0PZQ/

    A more modern therapist of psychosis who uses psychoanalytic principles but is not an analyst is Ira Steinman:

    https://www.amazon.com/Treating-Untreatable-Healing-Realms-Madness-ebook/dp/B00582MGQQ/

  • The analysts Bryce Boyer, Vamik Volkan, Harold Searles, Silvano Arieti, and Peter Giovacchini had much success with psychotic clients. Their work is reported here:

    https://www.amazon.com/Schizophrenia-Primitive-Ment-Peter-Giovacchini/dp/0765700271/

    https://www.amazon.com/Interpretation-Schizophrenia-Silvano-Arieti/dp/0465034292/

    https://www.amazon.com/Infantile-Psychotic-Self-Fates-Schizophrenics/dp/1568213794/

    https://www.amazon.com/Regressed-Patient-Bryce-L-Boyer/dp/0876686269/

    https://www.amazon.com/Collected-Schizophrenia-Related-Subjects-Maresfield/dp/0946439303/

    The treatment accounts in these books are pretty remarkable, and inspiring…

    Psychoanalytically informed psychodynamic therapy is also different from psychoanalysis. That is what these analysts are using in most cases with psychotic clients, not psychoanalysis per se. But again the most important thing is the relationship as perceived by the client…

  • Hi Seth,
    Just saying that academic studies should not be privileged above qualitative / case-based reports all the time. Thousands of academic studies of “schizophrenia” have gotten us pretty much nowhere in helping these people. Working to process difficult feelings and gradually forming a trusting relationship is where it’s at in psychotherapy of psychosis, as the authors I mentioned discuss in their work…

  • Several years ago, I heard a voice, was in terror, was paranoid, and couldn’t function.

    But now I work full-time, don’t have these symptoms, live independently, and I don’t take any drugs.

    No one pays for me, liberalminority.

    Further, you provided no argument for your contentions. The whole point of these studies is that being on the drugs longer correlates with less ability to function. The opposite of what you said…

  • Fiachra,
    I agree that psychotic states are predicated on deep severe anxiety. Karon, in his book Psychotherapy of Schizophrenia: Treatment of Choice, wrote about how severe terror lay at the core of psychotic mental states. Also, Vamik Volkan did this in his book The Infantile Psychotic Self and Its Fates.

    Fiachra, I wonder if you would be interested in being an ISPS member (see http://www.isps.org) . You might like the listserv of ISPS. I like your comments here and think you would add a lot to the discussion in other places . I encourage you to check it out!

    To respond to Seth, there are some analysts who like Karon have had much encouraging success with psychotic people, including Gustav Schulman, Bryce Boyer, Vamik Volkan, and Gaetano Benedetti. They have written about their work in books that are available on Amazon. Just because results aren’t written about in an academic sounding paper with university letterhead, doesn’t mean they aren’t real..

    I agree with what you say Seth about the quality of the relationship and therapy of almost any orientation being helpful at a group level, as Duncan’s research shows.

  • I had posted this comment about this study in another forum. Generally, I agree with the author that this is a promising study that deserves further investment. Although, I think some of the data reported in the study is unclear or not sufficient, as noted below.

    The most impressive thing to me, like Stephen Gilbert, was the positive response of individuals and families to the approach. That is a huge contrast from what I’ve heard about responses to treatment as usual… most people that I’ve talked to hate traditional psychiatric treatment.

    ————————

    It’s good to see something positive on the list about a treatment that is making a difference:

    http://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201600271

    I read this paper and then reread parts of Seikkula’s original research:

    http://psychrights.org/Research/Digest/Effective/fiveyarocpsychotherapyresearch.pdf

    The American paper says that,

    “Clinical outcomes were generally positive. Results of linear mixed-model analyses showed a significant positive change in symptoms, functioning, and need for care, as measured by the BPRS (p<.001), BASIS-R (p=.002), and SCLFS (p<.001), respectively; average work or school hours per month (p<.001); and hospital days (p=.023). The change in DSES score approached significance (p=.07). Nine of 14 participants were working or in school at one year."

    This is encouraging. It would also be great to see this data in more detail, in a format similar to that given on page 8 of the Seikkula paper (in the tables). Maybe that data is available somewhere… from the data given in the American paper, one cannot really get a sense of the degree or strength of functional or symptomatic improvement between baseline and followup in the American study, just that there were some (unknown) amount of positive change…

    Hopefully a larger-scale study with an N of 40 plus people, over at least two years, will be able to be funded. The sample size in this group is pretty small.

    Also, the American article said, "This study had important limitations, including a small sample, diagnostic heterogeneity, lack of a control group, missing data, and unblinded clinical ratings."

    Perhaps what it meant to say is there are no valid diagnoses in psychiatry. Of course, one can't say that when applying for funding… also, I don't know how you can have a valid control group when the diagnoses being used are not valid and a control group may or may not be comparable. It seems to me that the assumptions of American materialistic linear science, which try to apply the principles used in real sciences such as chemistry and physics to the field of psychology, are a poor fit for the variability, complexity, and unpredictability of human beings… have to remind myself that this does not mean there cannot be some value in these papers; it just means they should be interpreted more cautiously and relativistically.

  • As a psychiatric survivor myself, having been in two mental prisons, and one who has experienced the abjectly ineffective, harmful, and pathetic treatments which are common in America’s mental prisons, I agree with most of this author’s statements.

    Otto, I applaud you for writing so honestly and courageously about your experience.

    And as much as those working within the system might not like to hear this story, there is no answer to most of these criticisms: psychiatric diagnoses are totally lacking in validity and weak in reliability. Telling people they have a brain disease and must be on drugs is a regular practice in mental prisons. People are frequently harmed, and indeed even murdered, by psychiatric “treatments.”

    There is a reason fewer and fewer young people want to train as psychiatrists: because the general public increasingly lack respect for the field of psychiatry, while they are becoming more and more aware of how fraudulent, unscientific, and harmful its paradigms are.

    I like what Ragnarok says: Psychiatrists don’t treat the insane. They are the insane.

    Has a nice ring to it.

  • What actual arguments based on evidence or logic do you have…

    This article is saying that symptoms do get reduced in the short term, but in the long term, being on antipsychotics correlates with progressively worse outcomes over time.

    It doesn’t say people should never get antipsychotics…

  • Bob,

    A faithful hound can be very useful!

    I appreciate that you put a note at the end of this piece cautioning about the issue with “schizophrenia” not being a disease… as you know the nonvalidity of the disease model conception of “schizophrenia” is an important point of contention that we – antipsychiatrists and former prisoners of the system – have with psychiatry. More importantly, there is absolutely no scientific evidence that a discrete brain disease called schizophrenia exists.

    I will go now to read the whole paper.

  • Personality disorders are not discrete illnesses:

    https://bpdtransformation.wordpress.com/2015/10/19/27-the-kleinian-approach-to-understanding-and-healing-borderline-mental-states/

    as the diagram in my post here shows… but overlapping emotional-developmental levels. It doesn’t really make sense to talk about a non-discrete part of a continuum as something that is passed down genetically…

    As Fairbairn discussed – faulty relationships with caregivers are the primary cause of borderline mental states, which are fully reversible and curable with sufficient help over time…

  • Apparently the leaders of most countries disagree with you dude. Thank god you’re not in charge! As much as I may not like some of our elected leaders, they are more humane than you…

    Of course, even the most severe “mental illnesses” can improve and in some cases be cured given sufficient social and psychological support over time.

    Let me give you a couple of references: Rethinking Madness (Paris Williams – see http://www.rethinkingmadness.com – and Treating the Untreatable (Ira Steinman – see http://treatingtheuntreatable.com/) . These are stories of people who were once delusional/psychotic/”schizophrenic” who got well and in some cases became good, loving parents.

    Stop making assumptions about what people are or are not going to be able to do. You don’t get to decide what people are capable of…

  • Criminality is a modifiable spectrum. Some criminals can and do reform themselves, so we should not put ourselves in the position of being ultimate judges of who is ever allowed to reproduce or not.

    Yes, of course many people here have suffered through being raised by an emotionally disturbed, abusive parent, including myself. Glad that you weren’t in charge of our nation’s social policy, otherwise I might not be here…

  • Many people here provide a lot of social support to family members and friends with very serious problems. What are you doing to help others?

    People don’t need a label of mental illness to be understood and helped.

    Of course constant sadness or anger is not an illness. It is a subjective experience that has a foundation in the past experiences between a person and their environment. While emotionally distressing experiences can lead to or increase the chances of physical illnesses, those experiences are not in themselves physical diseases.

  • Exactly; it is about content/logic and discussions of phenomena using language that fits the way real people experience their lives… not about high-sounding academic credentials or Ph.Ds…

    Medicalizing life problems as “mental illnesses” does not fit the bill, and that is why this author Scull is wading into charlatan territory, tenured professor or not…

  • Some people who cannot care for themselves on a consistent basis can be helped via social support to become functional and able to care for themselves, and can then engage in relationships and become good parents.

    Your comment is abhorrent and inhuman, and fits the thinking that the Nazis used when they sterilized thousands of people with no consideration given to those people’s potential for growth and improvement in better social conditions.

  • Wow what a terrible article!

    As oldhead said, “Accepting, then, that there is such a thing as mental illness…”

    Um, no…

    Problems in living; i.e. human distress caused by unsatisfactory interaction between the individual and their environment which is expressed in brain chemistry, are not discrete illnesses…. how hard is it to understand that, Scull?

    It’s probably a waste of time to even write this comment. This dude will probably just deny to himself that there is any problem and keep on writing as if he is an authority on this area…

    I too read about half this article and then gave up. It’s so pedantic, distant, ascetic, and frankly boring that it’s not worth the metaphorical paper it’s printed on. Even cheap internet paper…

    Most of the points in the paper focus on white, male, rich people and their “expert” view of the problems in living of their fellow human beings. This shit really gets old.

    It’s time to stop putting these people on a pedestal, because frankly people are tired of these “experts” and their inane views on imagined “mental illnesses.”

    We want to hear more from people with lived experience of severe distress (not the same thing as saying someone “has a mental illness”), and more about individuals, not more from “experts” who don’t understand or articulate the subjective experience of the people they are talking about (of whom the author of this article seems like a good example).

  • I agree with your thought, Fiachra, The complexity and variation and individuality of psychotic experience / severe human suffering is why taking twin studies and saying they prove a strong genetic basis for a label like “schizophrenia” – a syndrome mistakenly believed to be a unitary “illness” – is foolish and laughable when one sees through the charade.

  • Yes Jay, as Howard Miller notes above, you might do well to be cautious about reifying “schizophrenia” in the way you write your excellent critiques of genetic research.

    The biggest problem underlying these twin studies in my opinion, apart from the Equal Environment Assumption, is the lack of validity of the label schizophrenia. There are loads of different ways different people can be “diagnosed” with this illusory “illness.” There is not a true discrete medical condition called “schizophrenia”, no one “schizophrenia”, but rather a continuum of psychosis that one can move into or out of, experience more or less severely, at different times of life. Please consider introducing this into your articles somehow.

  • I agree that we agree on most points Michael. I just think it is important not to throw broad sweeping statements out there that are not based on careful analysis and on some level of data. The data I shared suggests that psychotherapy is more a positive than a negative in the long-term for most, not all people… thus, we could be doing damage by discouraging people from seeking it by overfocusing on its negatives and painting it with too broad a brush. That was my concern. But overall I applaud what you are doing in questioning the axioms of a truly ignorant, stupid, harmful, arrogant profession.

  • Thank you for your supportive comment Ragnarok. Psychiatric diagnosis and the myth that problems of living/behavior can be reduced to “psychiatric diagnoses” are the Achilles heel and the lynchpin of psychiatry. Discussing the drugs using the reductionistic research involving psychiatric diagnosis is often a distraction from the main issues you named, i.e. the fraudulence of the entire psychiatric edifice of diagnoses and treatments of “disorders.”

    As I commented above, it does not make much sense to me to title a conference about alternatives “An International Conference and Institute on Psychiatric Drug Risks”.

  • I did read the blog; I don’t comment on articles I haven’t read. The Symposium is titled “An International Symposium and Institute On Psychiatric Drug Risks and Withdrawal” – so I assumed that its primary subject was related to its title, i.e. psychiatric drugs. That’s what most people would assume I think!

    To me, I feel the opposite of you – far too often the focus with discussion about mental health problems is on psychiatric drugs and should they or should they not be taken, do they or do they not have such and such side effects, how much do they help or not, are they dangerous for whom, etc.

    To me, speaking globally (not just in small pockets of Northern Europe) we need much more focus on alternatives, i.e. psychotherapy research, Open Dialogue research, respite care centers, peer to peer work, a focus on listening to individuals andt heir stories etc. You may not see this because you often do focus on alternatives, but you’re one of the few, and now you’re doing a conference which is titled about drugs, and that bothered me….

    The degree of (over)focus on psychiatric drugs is what bothers me; they would not be a big deal if they were not so profitable to the corporations. These drugs are about profiting from vulnerable people and making money for shareholders, primarily, not about whether the drugs treat any actual illnesses…. they don’t. It all comes down to the money.

    Anyway, I will not be at this conference, as to me these conferences always give the main voices to professionals, and are not welcoming places for people with lived experience who don’t work in the field. Our views are not respected; neither at these meetings nor within groups like ISPS. I am going to start my own site and reach out to people directly in a way that will be more authentic, as I have in fact started doing already…

  • Michael,

    If you’re crazy then I’m also frickin’ nuts because we share many of the same beliefs.

    It’s pretty clear from research I’ve read that accepting one has a “mental illness” worsens your chances of getting better and developing an independent satisfying life… here’s a sampling:

    Blame it on biology: how explanations of mental illness influence treatmenthas a good summary of how bio beliefs reduce empathy and warmth in providers, and decrease hope for non-bio treatments etc. 
    William Schultz wrote and article on how focusing on biology increases “prognostic pessimism” and will provide access to his academic article on the issue – check out this link.  
    On the same theme, something I wrote, It’s Not Just the Drugs; Misinformation Used to Push Drugs Can Also Make Mental Problems Worse   
    Prejudice and schizophrenia: a review of the “mental illness is an illness like any other ” approach documents how these beliefs increase stigma and hopelessness.   
    And Effects of a chemical imbalance causal explanation on individuals perceptions of their depressive symptoms describes a bit of research into immediate negative psychological effects that happen when people are falsely led to believe that their depressive experiences are definitely caused by a chemical imbalance.
    Drugs don’t do shit to address the root causes of one’s life problems, nor do they treat any specific brain disease… they just dull down the central nervous system and reduce the ability to feel pain, but also the ability to be motivated and constructively deal with conflicts. And they make you believe you have a brain disease you can do very little else about, which is pretty depressing.

    One of my proudest achievements was rejecting the notion that I had a mental illness and needed to be on drugs, and deceiving my psychiatrist by self-tapering myself off drugs and leaving the mental health system of my own accord.

    Can’t believe those dumb mofos told you, “Stop telling people they can get better”. I assume getting better means they can really get well and no longer have any brain disease called “schizophrenia” or “major depression”… even though of course the supposed signs of these maladies don’t represent diseases people have in the first place.

    But Michael, have to call you out clearly on one thing: your comment about psychotherapy was pretty unsupported and speculative. The major meta-analyses by Barry Duncan, Paul Knekt, Falk Leichsenring, et al show that most people who get psychotherapy tend to have better functional outcomes and be less distressed than similar people not getting psychotherapy. This is on average. It doesn’t mean psychotherapy can’t do harm. Of course “it” can. “It” is just some form of human relationship. And psychotherapy isn’t like a pill coming off an assembly line. Human relationships vary greatly in so many ways…

    Saying “it is far from benign” about psychotherapy is pretty meaningless as a generalization. It’s like saying, “human relationships are far from benign.” I guess that might have a grain of truth, but it’s pretty meaningless. And on the whole human relationships are soul-supporting and good, in my opinion… far more good comes out of relationships than bad, in my opinion – for most, not all people. We’d die without others. The same goes for psychotherapy – on average, according to the authors I cited.

    If you want to make statements like that about psychotherapy, you need to have data!! And you don’t have it… your statement about psychotherapy was about as unevidenced as the unsupported claims you accused psychiatrists of making about drugs and psychiatric treatment outside psychotherapy. If you can name authors / titles of major studies / meta-analyses showing how most people are worse off with psychotherapy than without, let’s see it…

    By the way psychotherapy is far less available than drugs and many people who want a human relationship with a therapist cannot get it. So the speculations about grief and bereavement counselors, and about ptsd and availability of counselors, are questionable too…

    I’m not being paid to support psychotherapy. I just don’t think you have the data to support what you’re saying about it… it showed in your article. And I don’t like when people make broad sweeping claims without any data…

    Here’s some of my data:

    http://psychrights.org/Research/Digest/Effective/BGSchizophreniaMeta-Analysis.htm

    http://bgrosjean.com/files/Psychodynamic_20psychotherapy.JAMA.2008_1_.pdf

    These are meta-analyses, not single studies. The difference does matter… also this…

    https://www.amazon.com/Heart-Soul-Change-Delivering-Therapy/dp/1433807092/

  • Looks like the simpletons are out again in force at the Globe.

    It’s the same old same old…

    – Drugs to nothing to address the causes of problems and do not treat any specific illness. Long term, on average, they provide very little benefit over placebo… and benefit is only defined as dulling down the ability to feel, anyway, not making your life better, not what people really care about, i.e. getting housing, being financially secure, making friends, having a girlfriend-boyfriend, having a good job.

    – “Lack of access to treatment” is supposedly the problem, but all treatment is is recommending or forcing people to take drugs and seeing a delusional doctor who thinks you have a brain disease and makes you more pessimistic. So that ain’t gonna work baby…

    – People are too in denial or don’t have the support to face up to the fact that getting better from trauma, neglect, and not-being-a-mature-strong-human being requires a shitload of emotional support, patience, hard work, time, and money/resources. There is no drug to cure faulty or arrested emotional development. And so more psychiatric treatment – with treatment defined as drugging and controlling a person – ain’t gonna do shit.

    – It is just pathetic to see the ignorance of NAMI fools who recount platitudes like, “We need to get more people access to treatment.” Kind of like saying, “We need to drop more people in pots of slowly boiling water as if they were frogs”… and the simpletons who think they can say, “18% of people have a mental illness, and 82% of people don’t and are normal.”… HOW FUCKING STUPID ARE THESE PEOPLE FROM NAMI AND THE MAINSTREAM MEDIA? More like ignorant, I know. It is pretty exasperating sometimes.

  • I like many of the people in this conference Sandra but I question the (over)focus in so many conferences on psychiatric drugs and how to withdraw from them. I say this as someone who was on 12 psychiatric drugs, including antipsychotics, and who withdrew from several at the same time, and am now on none. Also, I helped family members to taper off.

    The problem is that by focusing so much on the nature of psychiatric drugs and psychiatric drug withdrawal, and do they work at all, do they work a little, how difficult is it to withdraw for whom, when should we withdraw, etc…. all of this focus continues the conversation on the home ground of psychiatry and Big Pharma… they want to be the conversation to be about drugs, even if it’s critical, I think.

    By contrast, I think shifting the conversation even more to alternatives and to developing success stories of outcome – as Sandin did, for example, as Open Dialogue did/is doing – is a more valuable investment of resources proportionally. Creating genuine alternatives where people get “cures”, rather than just criticizing practice as usual (i.e. drugging), is the way to go in my opinion. We should build more structures and groups/publications that people admire and will want to join, not just hold meetings criticizing drugs. Do more to build new structures, not just attack the old (the focus of criticizing and attacking drugs also leaves people vulnerable to being attacked as “antidrug” and “antipsychiatry”, whereas focusing on new approaches that work and proving that they works cannot be attacked as easily).. Maybe I am misunderstanding the conference and it is equally about alternatives, but it doesn’t sound that way. You know that I very much like your work…

  • I am heavily anti-NAMI, like several of the commenters here. The combination of the drug company money, and the commitment of many NAMI families to avoiding self-examination and denying the possibility that dynamics within the family may contribute to the problems their children have, have been and still are deadly.

    Personally, and this is not very nice, but I feel that NAMI tends to attract simple-minded, less educated people with fewer resources: these are the sheep that are more easily deceived by the disease model lies. There is probably a grain of truth to this perception, and it’s a sad reflection on the lack of awareness about how weak the basis for psychiatry’s claims about “severe mental illness” is, on the strength of the Big Pharma propaganda, and of how invested in denial many American families are.

    I agree with the focus on reaching out to individual NAMI members with an alternate perspective.

    Certainly don’t agree with partnering or allying with NAMI or any of its subgroups in any formal way. This would be similar to partnering with groups that promote slavery, illicit hard drug trafficking, or terrorism. Lest we forget, NAMI is a group that is supporting forced drugging, that generally supports telling people they have a lifelong brain disease, and generally supports the idea that drugs should always be a maintenance treatment.

  • Great article. I posted an excerpt of this on the ISPS listserv, with the following comments:

    The part about anosognosia being inserted in the bill as a rationale to forcibly drug people and invade their privacy is particularly offensive.

    If ratified, this bill will mark a new low, if that is possible, in stupidity and ignorance among our elected representatives, in greed and ass-kissing by drug company lobbyists, and in ignorance among NAMI families supporting policies that will do nothing over the long-term to help their emotionally crippled children get well.

    Of course, this bill is going to do absolutely nothing to stop mass shootings. The next one is due to happen in the next couple of weeks… hardly a difficult prediction to make.

    It is sad to see America in the state it is today. I have to say that as a young person I am ashamed to be a citizen of a country that acts in the way that we do collectively, that oppresses and abandons and tortures the weak, the traumatized and the sick. I was not able to celebrate yesterday, since so many people in America are not really free.

    I encourage those of you who haven’t already given up to make your opinions known to your elected representatives.

    Forgive my cynicism.

  • But Philip, 15% of kids having ADHD only leaves about 5-10% of the junior population free for having other disorders, like Intermittent Explosive Disorder, Misbehaving Syndrome, Call of Duty Overplaying Disorder, Sibling Rivalry Disorder, Drapetomania, etc.

    Oh wait… these things can be co-morbid. Haha how could I forget that!

  • Thanks for this article Chaya.

    I agree that a therapist who does not believe in diagnosis and does not (over)focus on drugs can be very valuable; it has been for me.

    Many traumatized people have great difficulty trusting and forming sustaining relationships outside a structured environment – at least at first – and so for them a therapist can be a valuable ally in getting them to the point where they can satisfy more of their own needs in non-professional relationships. In my view diagnosis and drugs basically get in the way of this process, or at least do nothing to address these basic needs or whatever life trauma/neglect that caused them not to be met.

  • No surprise here – the main potential results of acknowledging how ineffective antipsychotics are in the long-term, and how they can cause effects like tardive dyskynesia/brain shrinkage, are job loss, loss of prestige, loss of income, and shame for the profession. No wonder psychiatrists are burying their heads in the sand.

    I would be tempted to avoid it all too if I had such a profitable scam/con going…

    This brings to mind the behavior of tobacco executives decades ago who did everything to deny and avoid evidence about tobacco being harmful. It’s human nature to lie, avoid, deny, deceive, obfuscate, and bullshit when confronted with information that will likely reduce one’s prestige and income. Exactly what psychiatrists are doing right now…

  • Philip, good to see you posting again.

    Thank you for exposing two-face / Janus (Frances) again. What a weird dude. I guess when you’ve built your reputation and career on fraudulent invalid diagnoses, it’s hard to fully admit how broken and meaningless the structures you helped create are.

    It’s incredible that now 15% of American kids are getting labeled as “having ADHD”. I had no idea that it had gotten that bad. What a bunch of fricking bullshit. There is no discrete illness called ADHD. I work with kids all the time and it’s obvious that you can’t arbitrarily subjectively measure the behaviors and utterances of the kids and reliably say that some have this disease called ADHD and others don’t. Problems with attention occur on a continuum and vary in different settings over time, and there is no evidence they represent a unitary disease nor that they are caused by brain chemistry or genes.

  • It is sad to see the simpleton journalists spewing forth the illusion that if only more “mentally ill” people were able to get “treatment” – i.e. being isolated, told you have a brain disease, restrained, drugged – that things would get better.

    Most mental hospitals do absolutely nothing to help people, instead just trying to control and coerce them – something which paradoxically makes them more afraid and isolated. This may for a short time keep vulnerable people safe from suicide, but then of course they get out and can do whatever they want. Much of a stay at a mental hospital is wasted time sitting on a bed, eating terrible food, attending meaningless group therapy sessions about “managing illness symptoms”, and being pressured to take and try new psychiatric drugs which reinforce the ill identity. For the most part, the only people that can help “patients” at all at a mental prison are their fellow inmates, not the warden-psychiatrists.

    If you take away the term “mental illness”, and just talk about people who have been through more abuse, stress, poverty, and discrimination, of course these people are going to more easily get angered, have less ability to regulate their feelings, and be more prone to act out destructively. So, it should be a surprise that some such people (those who get these arbitrary meaningless labels) are more violent toward themselves or others than other members of the population who have had less abuse, stress, poverty, and discrimination in their past. Why wouldn’t they be more likely to do those things?…. but it doesn’t mean they’re fundamentally different or that they should be coerced into useless “treatments”. If those who do hurt others or themselves were treated better or had more resources they would probably be functioning fine and not become violent.

    They don’t have discrete mental illnesses, but they have been through a lot of bad shit.

    A lot of the blame for these problems has to go toward the profit motive and the greed that underlies capitalistic corporations, and to the incredible ignorance that permeates most of the American public, who like sheep believe almost anything they are told about “mental illness.”

  • Yes, I agree these things are torture. My point is that making a generalized statement like “many people tortured never recover”, as if that were a known fact (but with no data to back it up provided by McLaren) is kind of meaningless. Severity, length, kind of tortures vary greatly, as well as the resilience and resources or lack thereof of people subjected to whatever torture. Also, recovery is partly subjective and occurs in degrees. It’s not all or nothing… that’s why that statement didn’t make sense to me.