Thursday, December 9, 2021

Comments by BPDTransformation, B.A.

Showing 1526 of 1526 comments.

  • 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 –

    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 –

    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:

    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 –

    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 –

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

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

    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 . 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:

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

    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:

    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 – and Treating the Untreatable (Ira Steinman – see . 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:

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

  • 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.

  • Interesting article, am very glad to hear Garth has at least for now escaped from his tormentors.

    But a few questionable parts, including these statements by author McLaren:

    “Many victims of torture never recover”… what does this mean, I.e how is recovery being defined, and where is the data to support this? How is torture defined? Etc. McLaren should write more clearly.

    Also, in asserting that other psychiatrists may have misdiagnosed so-called “schizophrenia”. McLaren appears to believe that schizophrenia is a valid diagnosis that can be reliably identified. If so, where is the evidence for that? Many authors such as Bentall, Boyle, Poland, Kinderman, Read etc have laid bare the total lack of validity and the relative unreliability of the schizophrenia concept. In fact, their writing details how two people given this label can have nothing in common (i.e. only two out of five arbitrary behaviors are required… One can easily walk into a hospital and report hearing a voice and get diagnosed as having this illusion).

    Jock, there is a better way of thinking about and discussing severe psychotic conditions, in my opinion:

    We should not pretend that there is a schizophrenia out there that we know and that some enlightened people can reliably identify. It ain’t there baby.

    We should primarily debate behaviors and experience, not illusory illness diagnoses they are assumed to have.

    “In no other diagnosis can treatment be imposed by law.” – this appears mistaken, or perhaps it only applies to Australia; but in America multiple other psychiatric diagnoses can be have treatment imposed by law, such as bipolar, schizoaffective, psychosis not otherwise specified. Of course, the notion that these are in fact discrete illnesses is an illusion.

    Well done to McLaren for pointing out honestly how harmful and limited psychiatric treatment of psychotic states really is, and for adding to the chorus of voices exposing the symbiotic relationships between psychiatrists, the state, and Big Pharma.


    It’s sad to hear Garth say this:
    “My schizophrenia is really bad tonight, I’ve just had a visual hallucination.”

    This shows just how indoctrinated he was by the psychiatrists who told him he “had” “schizophrenia.” Hopefully eventually Garth will realize that there is nothing innately wrong with his brain, but so much wrong with how his psychiatric captors abused him, as well as potentially earlier traumas and deprivations he may have experienced.

  • Bruce,

    I agree, getting to know people who formerly identified with labels like “borderline” or “schizophrenic”, and who suffered severely but got better, is a crucial experience that can make mental health workers much more optimistic, encouraged and better informed about how to help those currently suffering.

    I try to be one of these people myself, through my blog here:

    I also have a chapter just published in this new book:

    Other chapters in the book get a bit overfocused on labels, but my chapter is straight from the heart and is about refuting labels like BPD and moving beyond the illness identity.

    I now have a really good life, working full-time, owning my own place, being financially secure, having friends etc… whereas once upon a time I was involuntarily hospitalized more than once, took more than 10 different drugs, and was nonfunctional, hopeless and in terror most of the time, being labeled both “borderline” and various schizo-diagnoses by different psychiatrists. I know this type of hard work/recovery can be achieved, and so have a lot of confidence when I speak to other people currently suffering or to mental health workers.

    Will Hall is a great guy, but I agree with oldhead he should not call psychiatric drugs “medications”, as this is an inaccurate designation for compounds that do not treat specific illnesses.

  • Oldhead, avoiding my point doesn’t change its validity: Noting that another person uses the term “bipolar” in no way constitutes acceptance of its validity for oneself. I’m not the only person in the thread who called you out for this illogical non-sequitur comment. Try acknowledging you might be wrong for once…

    As for what you’re talking about, can you translate that into English?

  • This is not always true: “terrorist will get their arms no matter what.” It’s more subtle than that. Not everyone will get a gun no matter what, terrorist or non-terrorist. If guns are harder to obtain, some terrorists will certainly still obtain them illegally, but those on the fringes / those who are on the borderline of being radicalized will have a harder time getting them, or those part-timers without the necessary dark market connections will not etc, and fewer of them may obtain high-powered weaponry and carry out deadly assaults. Thus legislation and policy can make a difference, but only on aggregate, and has to be looked at in the big picture, not via speculating about individual events.

  • It is interesting and disturbing how authors such as Brogan (and many other professionals) seem unable to understand or use the data about these drugs not being true “medications.” Nor to understand how calling them that advances a false narrative and misinforms clients about what these substances do.

    It reminds me of that story where a Jesuit priest describes how if he can get a young child into religious training for seven years, that child’s mind is his for life. This appears similar in some way to what happens to many psychiatrists – they get brainwashed for years with misinformation about how valid separable psychiatric diagnoses exist and can be “treated” with “medications”, and then they can’t get that misinformation out of their head…

  • Nice article Kelly, although I agree with Steve that the use of the word mental illness within is problematic.

    Regarding this, “Does that mean that they were never really mentally ill or clinically depressed, but just grappling with life circumstances? Should citizens in legitimate distress be treated with medication as if they had a brain chemical disorder?”

    The answer to the questions above are respectively “of course”, and “of course not”. Sad that we even have to ask these questions.

    There is no clear division between mentally ill and not mentally ill; there are no discrete mental illnesses.

  • Sera,

    This paragraph is a bit problematic:

    “So, no, he did not kill them because he was mentally ill or because he was of a different culture that we do not understand or have demonized for our own solace. He killed them because he was violent. He killed them because he wanted to and he had access to guns. He killed them because he felt alienated from and angry at society. He killed them because he felt numb to everything but intolerable indifference (sometimes drug-induced). He killed them because he’d been taught to have hate and rage in his heart, and to believe he was somehow righteously justified to act upon it.”

    Saying, “he killed them because he was violent” is kind of like saying, “Grass is green because it is green.” Explains nothing. Most of the rest refers to proximate causes, not ultimate causes based on personal relationships and the emotional environment in which someone grew up.

    The part about being from a demonized culture on the other hand, may in fact be part of the explanation. The United States has done tremendous damage to contemporary Islamic cultures (as they have done tremendous damage to us), killing hundreds of thousands of civilians in Iraq and Afghanistan during invasions mounted on false pretexts of weapons of mass destruction etc. This stuff does matter; our killing of innocents in Iraq and Afghanistan creates hatred, alienation and the desire to strike back. It’s uncomfortable to admit, but the US is not 100% pure or right in its invasion of Middle Eastern countries. Two sides to every story.

    To get a sense of what was going on in this guy’s mind we’d have to know more about his family background, key relationships, cultural/religious affiliations, and most important the quality and tenor of his relationships to family and friends throughout life. I’m willing to bet that during key formative periods of his life he was seriously emotionally neglected, abused, discriminated against, and marginalized. Someone growing up with two genuinely loving parents in a secure, loving family almost certainly would not randomly decide to walk into a nightclub and kill 50 people. Mental illness doesn’t make people do that either, since it is a ghost. Bad relationships, neglect, trauma, deprivation, stress, and isolation are almost always the ultimate culprits.

    Also Sera, did you know that when you say, “between my mother and I” it’s actually, “between my mother and me”? As an English major can’t resist correcting that 🙂

  • My initial thoughts about this predictable turn:

    Hmm… already, in the wake of this horrible tragedy of the 50 plus people killed at the Orlando gay nightclub, bullshit about the shooter being “bipolar” and this being an explanation for his actions is starting to spread.

    I am sure this illusion of “serious untreated mental illness” being the cause of the shooting will be seized upon to justify more coercion, more forced drugging, and more scape-goating of people given ridiculous unscientific labels like bipolar and schizophrenic.

    And the illusion will grow that if only the shooter had been confined or given drugs at the right time, that this tragedy could have been prevented…. yeah right.

    Meanwhile, little consideration will be given to the great likelihood that this man who committed this heinous act was likely himself abused, neglected, and/or discriminated against for long periods of time, had no one to talk to about it, and gradually internalized more and more hatred and sense of alienation that eventually led him to kill.

  • Just adding my two cents…. I think the comparison between common psychiatric treatment in America and slavery is quite apt, without even bringing race into it.

    Telling someone they have a brain disease and have to take drugs for life… and then coercing them to take the drugs…. and in this way creating terror and discouragement and lack of freedom in that individual, pressuring them to adopt the role of a sick person who will not work or have normal relationships… this is what happens to many, many, many so-called “serious mentally ill” people in America. This may not literally be slavery, but it is in effect much the same: It traps the person in a torturous half-life where they are not free to exit the arrangement or way of living that has been imposed upon them.

    It is in fact the most vicious form of slavery: enslavement of the mind.

    The psychiatric slave becomes a prisoner toiling to produce income for the psychiatric system via consuming drugs that get billed to taxpayers or the prisoner’s family/insurance. Psychiatric slaves are property of the corporations, much as much as literal slaves once tilled the cotton fields for their owners.

    And no, this isn’t just about black people. People of every race have been slaves throughout history – black, Hispanics, Asians, and some whites even today. Black people are just the most obvious from our American perspective historically.

    Today, white, black, yellow, and brown people are enslaved by psychiatric practices across America. We should not be afraid to say this.

  • I mean I don’t say it to their face, uprising. I was in NAMI meetings many years ago when people said these things; that’s why I left.

    Seeking to fill human needs does not necessarily mean people are ignorant, but the two can go together. People who are unaware of the lack of validity of psychiatric diagnosis can be more easily harmed by what psychiatry has to offer, in that they seek to fill their needs for an explanation of their suffering, but without being aware of the fallacious nature of the explanations nor the long-term harms they may expose themselves to as a consequence of believing they have a lifelong brain disease and/or taking antipsychotic drugs. It’s not their fault, and they can change their thinking; that’s why it’s important to spread the counter-messages to the viewpoint that extreme suffering is a symptom incurable brain disease requiring “medication”. But many people are very ignorant in this way and it is sad and harmful.

  • A couple more links:

    Charles Hugh Smith’s brilliant analysis of how American society is permeated by harmful myths that our government repeatedly promotes as “simulacrums”, like the candy Noel describes:

    And a book I read about how 13-16 year old boys are gradually stripped of their ability to be open and vulnerable by the demands of our culture:

    Now, responding a little more to the article itself, I could not agree more!

    The disgusting notion that one must identify as “having a mental illness” (i.e. an incurable brain disease) in order to “come out” and be accepted is simultaneously pathetic and extremely harmful, in all the ways Noel described.

    When I hear people say, “I’m not ashamed of my bipolar” or “I am a proud person living with schizophrenia”, my emotional response is: “You are an ignorant idiot”, although I wouldn’t say that. I have to remind myself how uneducated many of these people are about the (lack of valid) research on psychiatric diagnoses and on causal factors for human distress, and how powerful denial can be.

    Noel, enjoyed very much reading this – you have such a powerful clear voice. If things are to change then many, many people must start talking more openly about trauma, oppression, and the elephants that get hidden in the room like child abuse etc, as well as exposing the utter lack of validity and the harms of the disease model. We cannot just hope for things to change but must start actively engaging the relatively small amounts of people – hundreds or maybe even thousands – that we can each individually engage and reach the hearts of each year…. and trust that they will in turn advocate for a more human way of looking at trauma and distress to their networks. The powers that be are certainly not motivated to change the status quo at all; we must be the change.

  • The text below is adapted from a comment I made about this article in another forum, arguing that this article is very relevant to helping people labeled with “severe mental illness” become free from institutional/psychiatric oppression:

    While some might think this article is not relevant to “social and psychological approaches to psychosis”, I would argue it is. I think we can mostly agree that, for 99% of severely distressed people in the USA and in most countries around the world, access to effective social and psychological supportive approaches is abysmal and/or nonexistent. This is largely due to the dominance of the oversimplified disease model that Levine talks about, and the alliance between Big Pharma and leading psychiatrists/institutions in promoting a disease model of “schizophrenia”. As you know, this “schizophrenia illness approach” requires indefinite drugging while promoting a view of psychotic people as “other”, despite the lack of any scientific evidence supporting these views.

    Therefore, if we want to reach more people and make them aware of psychological and social approaches that can help these benighted people, more actions that directly reach the public, of the kind Levine describes below, will be necessary. The silence of most of us allows for the continued dominance of the disease model views of those with “severe mental illness” as being dangerous, inscrutable individuals needing to be indefinitely drugged.

    But with the internet’s ability to freely and widely promote unconventional viewpoints via self-created websites, videos, and articles, we do not have to wait for a larger organization to do anything: There is much that people wishing to humanize the public perception of psychosis can do on their own. To their credit, some people already speak out in this way. I encourage more of you to speak out directly and publicly about your views on severely troubled people and how they can be helped. This especially applies to experienced professionals in private practice and/or in prestigious academic positions, who have significant experience with psychotic people, but who remain mostly silent about their work outside of small circles of like-minded professionals, perhaps due to fear of how their colleagues or bosses will respond. Due to your credibility and experience, you are people we need to hear from along with survivors/families.

    If you respond to this, please remember that I am not totally anti-drug, and once took antipsychotics myself. This debate is not about drugs, which would not even be in the conversation very much if there were no so much profit to be made by forcing them on vulnerable people. It is about speaking up for the vision of the severely troubled person’s suffering as meaningful based on their experience, and of their pain and confusion as being able to be leavened by psychological/social approaches, and in some cases fully healed, visions we can all agree on I think! This message is therefore trying to encourage more people to actively join the limited number of existing folk who speak out publicly about their work and vision related to these goals.

  • “Total Remission” would imply there is some mysterious disease process that needs to be “cured” in people who have life problems… this ridiculous, simplistic concept is totally nonapplicable to the complexity and interpenetrating, interpersonal nature of people’s relational/functional problems.

    As Gerald Adler once said to me in Boston, “No one gets completely better, but we can get better enough to live well.”

  • Great story Emily. And very nice to hear that you are now helping other people as a social worker. From experience I know how suffering oneself gives a great attunement and perceptiveness to what other people in crises / in psychotic or borderline mental states are going through, and how to respond to them.

    Even though I’ve read about it so many times, I continue to be surprised every time I read about how poorly and inadequately our mental health system responds to people’s crises. Even many outpatient therapists are so poorly educated that they believe there is a disease called BPD that people either “have” or “don’t have.”

    I would like to invite you to check out my story, “How Risk-Taking Promotes Recovery from BPD”… I wouldn’t write about it in the same way now, since I believe less in the validity of labels like BPD, seeing it more as a developmental metaphor or meaningless label than an illness. But the risks I took in my getting well sound similar to some things you did:

  • It may be good later this year to consider a post discussing ideas for expanding what MIA does, which can be debated and brainstormed over by readers. The current state of income could be compared with what projected level of income would be needed to hire a reporter and add other operations. People with business / fundraising experience could offer ideas or offer their time on a volunteer basis in meeting the needed revenue – and of course, any reader even without a financial background could offer valuable ideas.

  • Madmom,

    Sorry to ask this in public but, and maybe you have answered it before but… do the laws of your state not allow your daughter to have any say in taking drugs or not? What about you, can you not take her home and choose what doctor she works with?

    I apologize if these are obvious or offensive questions. I am outraged by this situation and hope you daughter can be extricated from it.

    I am also at bpdtransformation (at) gmail (dot) com

  • Phil, illegal sales of psychiatric drugs are biggest on the Darknet.

    Anyone can go to and download the Tor Browser, access darknet markets like PirateBay and SilkRoad V2, and anonymously order drugs like Xanax, Seroquel, and Paxil in massive quantities that get delivered to your doorstep in unidentifiable mass mailer envelopes via your neighborhood postman.

    Here is the story of how the founder of the first DarkNet market sold legal and illegal drugs via Silk Road until he was caught:

    That Silk Road was closed down. But now, over 30 other illegal Darknet Markets have risen to take its place, and many of these sell psychiatric drugs, as I know from perusing them recently. Just look at the right side of the page here to see the active list of Darknet markets:

    I am not endorsing these markets or telling anyone to go buy off of them. I’m just saying that they exist and they are shipping illegal psychiatric drugs to people everyday. And our government currently is having great difficulty shutting them down or stopping the sale of illegal psychiatric or other drugs via these markets, given that many of the markets are housed on internet servers beyond US jurisdictions and accessible only via the secret TOR browser, which disguises most users’ location and identity so that ordinary people can order illegal items with less fear of police reprisals. Such a reality makes elites, of which Frances and Pies would be a part, feel out of control, when controlled substances are readily available to be shipped to anyone’s house for a tenth of a bitcoin. It is another destabilizing aspect of the internet.

  • Haha I love this, “Dr. Pies, meet Dr. Frances.” That was great.

    Good breakdown of all the hypocrisy from the ultimate two-face, Allen Frances. The Achilles heel of psychiatry continues to be the illusion that valid psychiatric diagnoses/illnesses can be created out of individual human behaviors. That is reason #1 why psychiatry will never be a real field of medicine and will never be free from the attack dogs like you and me. It will never have the respect or authority of a true science… and things will just get worse as the desperate search for genes and biomarkers fails, month and month after year after year. The sandcastle of psychiatry will continuously be eroded and the oxygen of false legitimacy that sustains its practitioners will be sucked away.

    It is so disingenuous of that hypocrite Frances to do the things he does does – to attack the DSM 5 while defending his baby the DSM 4, to defend “normality” while pretending that psychiatrists can reliably identify “pathology”, to criticize excessive drug using after he accepted hundreds of thousands of dollars to promote antipsychotic drugs based on fake diagnoses.

    I’m amazed he can say these things with a straight face. But then again, he has more than one face.

    I did a Google search for “Allen Frances” and here is what it came up with:

    No surprise.

  • Thanks for this article Jay; I support everything you are saying.

    It is in one sense amazing to see the degree of distortion in these researchers’ empty responses to the criticism, but at the same time not surprising, since they are motivated by the fear of losing their job and status if the hollowness of their research is exposed.

    Reading behavioral genetics, to me, is similar to reading astrological predictions, alchemy textbooks, or similarly ridiculous unscientific scams. I guess the difference is at least those disciplines don’t pretend to be a real science; whereas behavioral geneticists try to and do fool many people.

  • WOW – look at that military spending. Almost half of the 200 billion we spend is for our military’s “mental health”. Our military, for those who don’t know, is just above 1% of US population. So 1% of the population is costing the country almost as much as the other 99 percent, if these figures are correct. That would be incredible, and might indicate how much psychological damage is being done to people by our wars.

  • Haha, “projection”, isn’t that a little bit of shrink speak?

    You do give some props, but you can do even better 🙂

    And as for your clock, clocks need a lot of reassurance you know. If your clock is not showing its usual activity level and is seemin down in the dumps, you might consider taking it in to your local psychiatrist for a depression screening.

  • Ok noted, but let me say I think it might be helpful if you would dwell more often on things that you agreed with or can add to in others’ thinking, rather than entering a discussion only to criticize what you disagree with. This is probably a criticism that could apply to me too.

  • Harper,
    Thanks for reading my little story. Black and White Dudie are gone now, so I guess the Dudie that remains is more grey, although I don’t hear him anymore.

    Your two mechanisms are related to an idea proposed by WRD Fairbairn, in a slightly different form: The Moral Defense against Bad Objects (blaming the self to protect the object, in his writing from the 1940s).

    Both of these defenses you bring up are basically manifestations of a quantitative deficit of all-good self/other representations (primarily comes from neglect/deprivation), and/or conflict involving internalized trauma which gets replayed and defenses against (primarily comes from abuse). Gerald Adler, e.g. Borderline Psychopathology and Its Treatment was a good writer about this, as was Jeffrey Seinfeld, e.g. The Bad Object: Handling the Negative Therapeutic Reaction in Psychotherapy.

    Since we are plugging ourselves 🙂 You might like to see my article, “Splitting Explained”:

  • Oldhead, I do think it is a pretty vague, generalized term, and partly agree with you.

    As a very young person I studied psychoanalytic conceptions of emotional development – how we all need positive relationships, safety, support, etc in order to develop the emotional security to manage our feeling, start to function independently, and form intimate relationships etc. This was the basis of my worldview for many years and explains why I think as I do. I did also read writers like Szasz, Laing, etc. but later.

    Following from that reading, I see “psychosis” (mislabeled schizophrenia) as a vague term representing the most severe, early disruptions or blockage of that process. There are two defenses called splitting (seeing oneself and others as all good or all bad and rejecting awareness of the opposite side of the split) and fusion (dedifferentiation, i.e. not being able to see oneself and others as separate entities emotionally). So it does have a certain meaning to me based on my understanding of emotional development and how it can get interrupted by trauma and/or lack of love and support. But I see it as relational, not as an illness. And, of course I know people are different and individual.

    I would invite you to read my article about the developmental continuum here –

    I hope this explains a little bit. I do value your thinking and have learned from how you think about these issues a lot actually. People don’t change their thinking right away; it takes a lot of work and interaction.

    Also, I am not trying to be pedantic or speak like a shrink; this is stuff I learned that was and is useful to me.

  • They don’t want to lose their jobs and income; that’s another big factor. It’s not so hard to understand. These psychiatrists are getting $200-300k per year (or more), they drive Mercedes and BMWs, they own McMansions, their kids go to great colleges, they are respected as “expert doctors”… and to maintain this, they have to kowtow to the drug companies and preach that psychotic experiences constitute real brain diseases for which “medications” provided by the drug companies are required to “treat” them.

    If they gave up their profession and stopped prescribing willy-nilly, they might look forward to getting a $50,000 a year job as a therapist working with people for 60 minutes at a time rather than 15, while rarely or never giving patients drugs. Who would want to do that?

    It’s not really rocket science. And it’s no mystery why these same psychiatrists do not show more interest in Mr. Whitaker’s thesis. They have hundreds of thousands of reasons not to do so.

  • Some very good points Dee.

    Here is some more data on non-drug approaches that were successful:

    The bias almost bleeds from the way Pies and Frances selectively write about the issue.

    And yes, it is VERY disingenuous to suggest that people who get well never had “the illness” to begin with. What bullshit. For that to be valid, a biological or genetic mechanism or group of mechanisms would have to be identified as causing a discretely, validly defined schizophrenia illness in some cases but not others. I don’t think that’s happened yet…

  • If you can syndicate your posts by making them simultaneously on multiple platforms like MIA, HuffPo, PsychologyToday, and other Webzines, that would be great… and other MIA authors could do the same.

    Then, perhaps there would be some way for you to also get published in mainstream newspapers and/or TV shows. I don’t know anything about that. Maybe it is not possible because these outlets are scared of reprisals from their funders, the corporations.

  • I agree I call people crazy mofos too. What I don’t like is mainly the “chronically” part. It has the ring of the disease model and of “incurability.”

    On the other hand, how one uses the word crazy is important. If someone is really having a problem dealing with their life and is having delusions and hallucinations, I don’t think that is “crazy” – at least in one sense, i.e. in that they are just trying to cope and adapt as best the can using these anomalous modes of adaptation, and thus if understood, their craziness is not so “crazy.” Just crazy from a certain perspective, from the perspective of “normality.”

    Telling a friend they are crazy for making a certain decision or acting in a weird or funny way is different.

  • Ok Oldhead, here are some forums to make you cry:

    Just read the titles of these threads.

    The number of people on these forums for all sorts of “illnesses” – “schizophrenia” and dozens of others – who mainly believe they have an illness and often are taking drugs – is FAR greater than the number of people aware of let alone contributing to discussions on Mad In America.

    I am trying to find a way to engage more of these people by speaking in their language, at least at first.

    They would not understand the way you talk; it would be totally alien to them to think in non psychiatric terms, at least at first.

    Sometimes you have to meet people where they are to start.

  • I know that oldhead. I am using these terms deliberately and consciously, although ambivalently. Most people will never find such a site unless it uses medicalized terminology to get people in. I know how most young people think and write about these issues, since I am one. If you go on PsychCentral, PsychForums, and Reddit and look for the mental illness forums, you will see what I mean. These people in the system search on google for terms like “schizophrenia cure” and “schizophrenia recovery”, not for “antipsychiatry.”

    As you know, I don’t at all believe in the validity of the term schizophrenia, nor think that cure is an appropriate word.

    But framing a site with those terms in its “entrance” is a challenge to psychiatry – saying that experience they say is hopeless or intractable is, actually “curable” or transformable. It is in your face, and it rejects the status quo. Once I get people in the site, I will challenge these concepts and reframe them.

    I already have successful experience doing this on my “borderline” sites. I know that it works to help people, at least some people.

    I don’t think there is anything bad with being a psychologist, necessarily, by the way.

  • Thank you for this, Steve.

    I am glad you got better and were able to become functional again.

    I myself also once took both Zyprexa and Zoloft for psychotic experience/severe depression. These were 2 of at least 12 different psychiatric drugs I was on over several years!

    I agree with you that “disorder” is an inappropriate word for bipolar experience. To me, rapid alterations in mood simply speak to attempts to cope with a difficult environment and/or stem from a lack of internalized support from parents and peers which would help to regulate one word. There is writers called Murray Jackson and Michael Teixeira who wrote about bipolar states in this way. I do not take the idea of “bipolar illness” seriously anymore; there is no such thing.

    Based on psychoanalytic models, I understand bipolar conditions as representing an intermediate stage between “schizophrenic” and “borderline” states, at a period when the defense of splitting and a deficit of positive internalized soothing experience is still prominent: I have put a graphic explaining this in the article below.

    I also do not believe that bipolar states represent “natural variation”, so much as the understandable response to trauma, deprivation, isolation, and stress – at least in many cases.

    In any case, what is more important is that you are doing well and not overwhelmed by the idea that you have an incurable disease that makes you different. I hope you are starting to be able to help more people struggling with the same issues as you to get help, as I do myself.

  • Ok, thank you for the response Robert. Let me say, I do appreciate the work you are doing to challenge these people, and know you mean very well. Sometimes, in the zealousness of my feelings against psychiatric diagnosis, and the urgency of my desire to help people be free from the stigma of these words, I can get a little bit too critical. I will say I do think it is naïve to expect that these psychiatrist will get curious about their distortions. That does not mean I think you are a naïve person, only that I think you may be being a bit naïve in this one instance, based on your (admirable) hope that they would respond in a way that would be more hopeful. I am a cynic based on my experience in the system, and thus do not have this hope for them.

    Anyway, I am not going to go into a longer response to this idea now, only to say that I wonder whether it is absolutely true that one “one has to (write an article about how psychiatry weighs its evidence) within their diagnostic constructs.” Maybe it is true, for your purposes.

    But it seems to me that little progress results from these discussions of issues on psychiatry’s terms, as the slippery terminology and the illusion that real scientific/diagnostic constructs are being discussed seems to play into their hands.

    Meanwhile, I think that through focusing on Open Dialogue trials and in reaching people and helping them become free from the coercive, harmful aspects psychiatric system in whatever ways we can, we may be using our energy more effectively.

    I wonder what others think?

  • This is a valid critique; Whitaker should not have said “chronically crazy”, as that is stigmatizing. Psychotic experience does not mean people are “crazy”, it means they are using maladaptive strategies to survive the best way they can, in a way that may not make sense to the rest of us, but may have been lifesaving for them (although maladaptive now).

    I don’t think these psychiatrists are all renowned, btw. Perhaps Frances, but not the other three, two of whom even I, with all my obsessive reading about psychiatry, knew nothing about. Let’s not puff these people up more than they already inflate themselves. They aren’t that big.

    Here are words that are more palatable to me when writing about “schizophrenia”: severely distressed, having a crisis, anomalous experience, having a breakdown, going through a transformative experience, unable to function, having hallucinations or delusions.

    The above represents descriptive language that actually means something with reference to what is going on. The word “schizophrenia” is meaningless. It should at most be used to describe what other, ignorant people like Pies/Frances said to label another person (e.g. “labeled with schizophrenia.”).

    Terms like “chronically crazy” should never be used. No psychotic person is continuously crazy; every psychotic person has a smaller nonpsychotic part of their mind, as Bion described. And being psychotic is never a continuous or inevitably lifelong condition, as the Dutch survivor movement which is against the word “schizophrenia” has described drawing on their own experiences as psychiatric “patients”. (see Bill George, Jim Van Os)

    To Robert Whitaker: You should change the “chronically crazy” terminology in your article, because it is a problem.

  • Ok, after all the criticism, I also have some positive things to say.

    I agree with Robert that Pies/Frances and biological psychiatrists in general are profoundly defensive, subject to massive cognitive distortions, and also profoundly unaware of better approaches like Open Dialogue or intensive psychotherapy for severely distressed people that can lead to much better chances at a good outcome.

    Interestingly, I talked once to Martin Harrow, live (yes really), and I found out a lot about his history of working with psychotic people. It turns out he has never done intensive psychotherapy with people diagnosed as “schizophrenic”, although he has worked with a few of them once a week, but always from a disease model. So, even researchers like Harrow do not really know what they are missing. When I talked to Harrow, he kept using the words, “illness”, “disease”, “medication”, in a way that made it clear he sees things in biological and reductionist terms. The other thing I noticed is that he’s a very nice guy; but he’s simply profoundly ignorant. This is true of a lot of psychiatrists – nice, but very harmful.

    I have something positive that I am doing. I am working on a .com website about “curing so-called schizophrenia” that is going to be a major F U to biological psychiatry in as much as it will brutally expose the lack of validity of the “schizophrenia” diagnosis and the lack of efficacy of antipsychotic drugs, and, hopefully, a major source of encouragement to people diagnosed psychotic and stuck in the system. It will extensively describe successful psychotherapeutic/person-centered work with psychotic people and show how this can be accomplished without drugs. It will have a massive resource section and it will all be free. And I am going to talk to a few hundred people a year, on the phone and via email, as much as I can, about a non-medical approach to psychosis and how they get help outside the system. Like I already do with people labeled “borderline.”

    I can only speak to a few hundred people a year, and even though many thousands my read my website, my impact is limited. I have to trust that other psychiatric survivors and other non-medical model professionals will pick up the slack and DO SOMETHING to confront establishment psychiatry’s lies, like I am.

    Oh and, MIA could always publish one of my articles. Unless there’s some arbitrary reason not to…

  • But there’s more.

    It annoys me to see these type of phrases in here: “Medication is thought to be an essential treatment for schizophrenia.”

    I’m not sure why these type of words are being used. There is no medication for schizophrenia, since there is no such disease. A medication treats a specific medical condition, as I’ve said many times. There are psychiatric drugs. Let’s get the terminology right, Robert.

    Furthermore, “schizophrenia” should be in quotes. Japan and Korea already abolished that word, and there are movements in Europe and America to do away with it; for example the initiative by Van Os and the Dutch service users.

    So, don’t kowtow to pseudo-doctors by using their oppressive language. Many of us here do not appreciate the uncritical use of the (unquoted) word “schizophrenia”, with all its harmful implications, nor the use of the equally inappropriate usage of the word “medications” to describe antipsychotic drugs.

    I am going to keep repeating this in every article until people start to pay attention.

    The word “schizophrenia” should in my opinion not be used without quotes. And people so labeled should always be called “people labeled or diagnosed with schizophrenia”, and not “schizophrenia patients” or some other stupid medical term.

    One other thing, Pies was said to suggest, “the fact it wasn’t randomized provides an explanation for the results”.

    How can you have a valid/scientific randomized study when an arbitrary label like “schizophrenia” is being used, not a real illness entity?

  • I am going to quote here an excerpt from a much longer piece Paris Williams shared with me recently, about the limitations of quantitative linear positivist research, which is relevant to this article (of which the examples Whitaker gives would be examples):

    “While there are a number of different scientific paradigms (also known as epistemologies) that have emerged in the West over the past centuries, the paradigm that has greatly dominated for several hundred years and continues to dominate today is positivism. The roots of positivism extend all the way back to the dawn of Western philosophy, with Aristotle’s emphasis on substance (matter) over pattern, and the belief that patterns or processes could be ultimately reduced to substance. The main cornerstones of positivism are “materialism,” “objectivity” and “reductionism”—these include the assumptions that all that exists can be reduced to matter or matter/energy; that we can understand the whole by isolating its parts and studying them individually; that by isolating these parts, we gain a greater understanding of the whole; that there is some absolute truth that we can observe as completely detached observers; and that it’s possible to observe this so-called objective world without influencing or biasing what we observe in any significant way.

    In my opinion (and in the opinion of many others who’ve grappled with these epistemological questions), the core tenets of positivism have been soundly debunked, and done so ironically by many of the same scientific fields that have emerged directly from positivism — especially modern physics, the life sciences (especially within ecology, microbiology and evolution theory) and systems theories such as chaos theory and complexity theory. The new picture that continues to emerge is that the whole is greater than the mere sum of its parts, that process itself appears to be more fundamental than matter, and that it really isn’t possible to observe the world in any kind of unbiased and entirely non-influential manner.

    The entrenchment of these positivistic tenets is especially evident when we look at our attempts to better understand subjective experiences (such as the so called mental disorders) by placing the vast majority of our attention on the brain and body rather than what is actually occurring within people’s minds, and by relying predominantly on randomized controlled trials, or RCTs, rather than on research that explores people’s actual experiences in situations that are as natural as possible. I don’t mean to completely discredit the value of controlled trials and quantitative analysis in general — I do believe that there’s a place for them as long as we don’t forget the very strict limitations of this kind of approach, especially when we’re dealing with (a) very complex systems such as living systems and organisms, which are guided by circular- and network-causality as opposed to linear causality (which is generally assumed within positivistic thinking), and (b) when we’re exploring experiences that are by their very definition subjective, which of course include those experiences that we label “mental disorder,” “mental illness” and “recovery.”

    The problem is that we’re not acknowledging these limitations, and all we have to do is take a look around to see the serious trouble this is causing. We have continued in full force for over a century trying to locate the so called mental disorders within the brain, but to absolutely no avail. Just think of what we could have accomplished in these many decades and with these many billions of dollars if we had instead been putting our emphasis on trying to understand people’s actual experiences and trying to address their actual needs. Imagine how different the world would be today if rather than seeking for those “magic bullets,” we instead focused on the cultivation and implementation of support systems that we already know work very well—addressing poverty and discrimination, cultivating relationships and negotiations between individuals and groups, ensuring that everyone has access to meaningful education and activity, providing individual- and family-based interventions and empathy-based sanctuaries to those in crisis, etc.”

    Paris’ ideas might seem tangential, but to me they really offer an important critique of the value of the back and forth debate between Whitaker and Frances/Pies about “the value of antipsychotics in the treatment of schizophrenia.”

    This debate exemplifies the malinvestment and waste of time and resources that goes into so much in American psychiatry. As Paris notes, we already know how to support people effectively without drugs. The primary reason for the debate Whitaker is wading into above is little to do with real science or attempts to help people at all. It has everything to do with the need of corporations to make money and the need of psychiatrists to continue to be seen as real doctors… which they are not!

    Further, Whitaker continues to seem to naively believe that psychiatrists will get curious about his points and want to explore them and change their way of practicing. He misunderstands these people and their motivations.

    Going back to the debate over the actual data itself, Whitaker and the reductionists researchers (like Pies/Frances) are interpreting these studies as if they might support some absolute position about antipsychotic drugs. But they are forgetting that the people are arbitrarily chosen, terrified/nonfunctional people, who have two out of five arbitrarily chosen behaviors, not people who have a specific disease. Thus, this is not a study of people who have a common condition. This is something that Whitaker tends to forget or overlook, over and over.

    I am also going to recopy my quote of Smedslund’s critique of this type of research.

    To Robert Whitaker, I encourage you to think about what this quote says about the value of the research you are discussing, and the uncertainty we should attribute to it:

    ““The main conclusion to be drawn from irreversibility is that empirical research in psychology… can only be seen as mapping temporarily stable statistical tendencies at the aggregate level. These mappings must be evaluated on pragmatic grounds, i.e. as yielding possibly useful knowledge in limited domains for a limited time…The regularity that is nevertheless observed cannot be taken to reflect permanent laws, but only temporarily stable feedback-loops. These are like whirls in a stream which are stable only as long as the total flow of water does not vary and the stones on the bottom maintain their positions… The findings in psychological journals may superficially appear to be of the same order as those reported in physics or chemistry and, hence, psychology may superficially look like an empirical and accumulative science. The conditional and transient nature of psychological findings is rarely acknowledged, perhaps because the publication and preservation of empirical findings will then appear unjustified since they cannot be taken to be useful in the future. The scarcity of attempted replications also allows psychologists to avoid thinking about this problem.”

    This really is a powerful critique, in my opinion. It means that single studies, or even a small number of such studies in different settings, really don’t allow us to make generalized conclusions about antipsychotic drugs which would apply to other settings. That is the myth that is operating behind so much of what psychiatrists say – the notion that the studies they run are similar in kind and quality to true experiments in physics or chemistry – and it’s important to see through it.

  • Ok, I am going to start this off with the possibly annoying point that “schizophrenia” is not a valid diagnosis, not a medical condition, and not something that can be reliably or meaningfully studied via the type of research that Whitaker is discussing above.

    The discussion above assumes that some coherent, valid entity called “schizophrenia” exists, and that the effects of antipsychotics on “it” can be known… but perhaps that is not the case.

  • Hi Ron,

    I like this article. A few comments on the “symptom” categories:

    Anxiety and Worry – while reading this I was thinking that if our ancestors, the apes and primitive hunter-gatherer humanoids, didn’t experience anxiety and fear, then they wouldn’t have survived very long! The Cro-Magnon that didn’t get scared when he saw the saber-toothed tiger is the one that dropped out of our gene line! In this way it makes little sense to think of anxiety itself as a “symptom” or “illlness”; but rather as an essential life-saving evolutionary strategy. But like you said, it can become too great or too little for the circumstances at hand, and not “fit” the external reality. Or, it can once have fit an earlier, very threatening reality, but not change or tone down to fit a new later reality. This is one aspect of what transference is about in psychology.

    Depression – I like the idea that depression is a signal that something is very wrong with some relationship or aspect of one’s life setting, a messenger, and one needs to do something about it. Some old forms of psychoanalytic therapy emphasized the ability to feel depressed and mournful for a limited period of time as evidence of maturity of character growth, versus the immature situations in which people ran away from feelings of loss into manic activity or avoidance.

    Mania – I think there is an author called Tom Wootton, who wrote “Bipolar in Order”, who suggests that bipolar states can be adaptive and don’t have to be construed as a negative. I do not agree with his disease model framing, but it is interesting.

    I like your idea about how getting grandiose and very active can be a response or fight back against negativity a person has been confronted with. I have experienced this myself. It is not an illness, just an attempt to do well!

    Psychotic thinking – I also like the idea of psychosis as a “high risk problem solving process”. This is a a new conceptualization and an interesting one.

    In severe psychosis, from the psychodynamic viewpoint, there are specific defenses which distort external reality heavily (I have personal experience of these). One of these is splitting – seeing oneself and others as totally good or totally bad and rejecting/not processing information to the contrary. In most psychotic states the focus is on all-bad views of oneself or other. This defense is very destructive, but it can also be adaptive because by preserving a few “all-good” images of oneself and others, one can avoid feeling hopeless in what may otherwise feel like a hopeless situation (e.g. splitting often develops in situations of severe abuse or deprivation, as a way of emotionally denying the reality of how bad/hopeless things seem, and thus being able to survive emotionally).

    Another defense in psychotic is fusion or undifferentiated mergers. This means that the person literally believes themselves to be some other external object that has some quality they want. For example, a psychotic person might think they are Jesus Christ. This can temporarily make them feel powerful, but then obviously it quickly leads to negative effects and massive distortions. It is also profoundly unrealistic. I remember Vamik Volkan talking about “schizophrenic” clients who would walk into his office, put their hand on the chair, and say, “I, the chair, think that this is a comfortable room.” It illustrated how they would tend to feel merged with whatever they were near or touching, and did not have firm boundaries between their sense of themselves and others. In a trusting relationship, the sense of separateness can start to develop and a psychotic person can feel less merged with the environment.

    I see the attempt to “suppress” or “Treat” “symptoms” with pills as being kind of like a crude attempt to divert or hold up a river stream by throwing rocks in it to block it. It might briefly work or divert the flow at first. But the pressure builds up behind the barrier, and it will eventually break through in some other way. Meanwhile the blocking of the stream does not change the source/cause of flow of feelings/issues from behind the barrier.

    I once had a voice that spoke to me. I am going to copy here a little bit of some writing I am working on for my website about that experience:

    Two Ghosts

    By around age 16, I had begun to be terrified, hopeless, and isolated a lot of the time. I was struggling greatly to cope with school, the pressure to have closer friendships and date, and the impending separation from my family that would come at age 18 when I was expected to go to college. It was in my late high school years that I first began hearing the two voices. From about ages 17 to 23, I heard two voices speak to me.

    Dudie the White

    One was a helpful voice that also had a visual component; it took the form of a friendly ghost that looked like the little ghost Boo from Mario, or the ghost Casper from the cartoon. I would internally hallucinate this ghost and hear it saying encouraging things to me, “You can do it”, “Help is out there”, “Don’t give up”, “Keep trying to find someone” and so on. The origin of these commands was the strong feeling I had that I needed to find someone trustworthy to talk to about the terror and anger I was feeling. They were really the things I wanted to say to myself, but my mind said it this way because imagining a separate entity saying the encouraging words (while remaining unaware at the time that Dudie was a creation of my own mind) made me feel less alone than if I had just talked to myself in the way a healthier person does.

    The ghost was named “Dudie”, because I would speak back to it and call it “Dude”, and then one day I began calling it Dudie. Dudie became like a companion that I imagined flying around with me. I imagined it to be a part of myself representing my soul, the vulnerable child-self in me, my heart. I remember imagining Dudie floating down the hallway of my high school with me, watching over me. Only I could see Dudie but not others, at least I thought so at the time. I was always afraid that harm would come to Dudie somehow. It makes me so sad to write this now… to think of how alone and scared I was as a teenager to need to hallucinate a companion ghost.

    At the time, I deluded myself that Dudie was real, that a little ghost really was talking to me. It was my mind’s way of tricking myself into feeling that I was not as alone emotionally as I really was. By hearing the voice of Dudie speaking to me, I no longer felt so alone. Looking back, it was a brilliant survival mechanism by which my mind sustained me during periods of unbearable loneliness and fear. It speaks to the mind’s ability to fragment and deceive itself when the person feels they are facing annihilation.

    Dudie the Black

    Unfortunately, there was another Dudie that was not so encouraging. The first Dudie, the “good” Dudie, was always colored white in my perception, a color which I think symbolized purity, innocence, hope, and goodness. I also think that the fact that Dudie was a ghost may have symbolized that I felt part of myself to be emotionally “dead” and needing resurrection and redemption, although I wasn’t aware of this possibility at the time. The “good” Dudie – the voice which provided hope – was probably based on the few real hopeful experiences I’d had at the time with real people in the outside world. These included the occasional times my mother and I talked intimately, the few times I’d seen a therapist, and a couple of friends who seemed to show genuine interest and kindness. Without them I don’t think any good Dudie would have existed.

    Anyway, the second Dudie was a black version of the first, with a mean streak. This voice, symbolized by a black ghost with sharp teeth, would shout at me things like, “You are doomed!”, “You’re going to die!”, “You should kill yourself!”, and when I was walking around my parents’ house, “You are in the House of Horror!”. It would mock me for doing anything wrong and tell me I was bad and evil and deserved to die soon. On occasion it would mock me, mockingly asking me to guess how many days I had left before I committed suicide. This made me so enraged. I remember it was always associated with feeling very afraid and angry, especially with feeling that my existence was threatened. The black Dudie was probably based on my father, who had physically abused me for years and was a terrifying, inscrutable figure, someone who you could never trust and never knew what was really going through his mind.

    During the times I felt the most terrified and hopeless, the black Dudie was more present, and the white Dudie would be absent. And during times I felt less unstable, the white Dudie was correspondingly more present. The two ghosts never spoke to each other, and only one was present speaking to me at a given time. There was no grey Dudie. Looking back, this obviously speaks to the splitting (only experiencing all-good or all-bad feelings at a given time) that was occurring in my mind. At first, in my late teens, I was so terrified, and so emotionally isolated from others, that it felt like I was just trying to survive utterly chaotic, unpredictable emotional storms on a minute to minute basis. I couldn’t really reflect on the meaning or origin of the two ghosts as I can now.

    This is getting long, but good post Ron and definitely identify with a lot of what you are saying.

    For me, not judging “Dudie” as a symptom of an illness and seeing the meaning and adaptive strategy behind these “ghosts” was really important in changing the way my mind worked.

  • Yeah this “in its infancy” bullcrap is not going to work as an excuse. Psychiatrists have had over 100 years to learn about the effects of trauma, neglect, poverty, stress, and isolation on human behavior and emotional experience, and has shown very little interest. Avoiding and denying the real causes of people’s suffering for over 100 years isn’t equivalent to “Oh we’re a young field; there’s a lot of progress still to be made…”

    There is a reason that psychiatry is so poorly regarded, which is that it regularly disregards evidence that its diagnoses are invalid, that suffering is caused primarily by non-biological factors outside the brain, and that it regularly coerces, misleads, and in some cases murders innocent people.

  • That is a good description of most psychiatric murders of severely distressed people. Slow motion murder, spiritual, psychological, and then physical, occurring over years or decades through drugging, discouraging, marginalizing, coercing.

  • I would add that I think the great effectiveness of some psychoanalytic work reported with psychosis is mainly because it is intensive and long-term and – in many cases – does not use antipsychotic drugs for long if at all. I would guess that if another type of psychotherapy – or whatever human to human relationship – engaged with a suffering person at length and frequently without heavy use of drugs, they would have similar results. I do also believe in the Dodo bird idea (the notion that common characteristics of psychotherapies are what are most important, not the name or distinctive characteristics of the therapy). This notion is reported in books like Duncan’s The Heart and Soul of Change.

    I do think with psychotic states that understanding transference and defenses such as splitting and projective identification can be useful, however, and these are psychoanalytic concepts. They provide maps to make sense of and find the origin of experiences (“symptoms”) such as delusions, hallucinations, and negative ways of relating to others not provoked by the present day behavior of the other. This is based on my experience, the best teacher.

  • Haha I just posted this as a comment on the MJA journal website. Of course it has to go to “The Editor” for review. I introduced myself as “Edward Dantes, from the School of Hard Knocks, Professor of Life Experience”. I know it won’t get accepted, but I wish I could be a fly on the wall to see the expression of the poor editor as he reads a dissenting comment from someone who sounds like a real human being, as opposed to one of the psychiatric professor drones.

  • What a strange article. It contains numerous distortions, such as:

    – the notion that a biologically-based illness called major depression exists.

    – it contains the illusion that CBT and Interpersonal Therapy are discrete entities that can be “studied” in the same way one might study a pill. Human relationships do not work in this reductionistic linear way.

    – it discusses “the effectiveness of therapy” (to do what?) without any mention of the frequency of therapy, length of therapy, quality of training and experience level of psychotherapists, or setting of the therapy, in any of the studies. This is bizarre to say the least. As if context did not matter, and human relationships (psychotherapy) are something we can make generalized statements about as if they were pills falling off an assembly line into little boxes.

    – It keeps using the word “effectiveness in treating” – effectiveness in treating exactly what? Where is the awareness of what people want, their lives, their hopes, their context? Clients are not simply docile targets for our treatments.

    – It contains phrases like this, “better targeting of existing treatments towards patients who are most likely to respond to them is probably our best hope for improving treatment outcomes.”

    Who really thinks like this about how to understand their fellow human beings? One almost feels as if the author of this article is an emotionless alien come here from a far off star to study these strange creatures, humans.

    I guess since news outlets like MJA cannot write about attempts to “treat” people in human terms, there is no other news to report.

  • Ok Gary,

    Here are some books on psychoanalytic or predominantly psychodynamic approaches to helping psychotic people;

    The Infantile Psychotic Self and its Fates by Vamik Volkan

    Treating the Untreatable by Ira Steinman

    Murray Jackson – Weathering the Storms

    Psychotherapy of Schizophrenia by Gaetano Benedetti

    Psychotherapy of Schizophrenia: Treatment of Choice by Bert Karon

    Delayed Post Traumatic Stress Disorders from Infancy by Clancy McKenzie

    The Regressed Patient by Bryce Boyer

    Schizophrenia: Innovations in Diagnosis and Treatment by Colin Ross

    Psychosis – Psychological Approaches and their Effectiveness by Brian Martindale

    The 40 or so lengthy case studies of formerly schizophrenic people who got well in the first three books are incredible. The later books contain more studies, data, and theoretical considerations about psychodynamics and psychosis.

    Also, check out these data on effectiveness of psychodynamic treatment of severe problems:

    The type of treatment I am talking about is 2-3 times per week or more psychotherapy for periods of 2-5 years, for a psychotic person. Large scale studies of this length of work have not been done, but intuitively, considering the superiority of long-term therapy in meta-analyses done by Knekt and Leichsenring, it makes sense that it might be very helpful.

    In practice such work is rarely done, but I believe the books above shows it often is very helpful, sometimes transformative, when it can be pursued in a benign non-coercive environment. To me it make sense – if you have intensive help with someone who believes you can get better, you are likely to do relatively better. Most treatments of psychosis are too short term or not intensive enough to be transformative, in my opinion.

    A lot of people, including perhaps yourself, simply lack the experience or faith to believe that psychotic people can really be understood psychologically and helped to transform their lives. And that is sad because they really can, as I know from personal experience.

  • Yep, psychiatry is not a real medical field at all; few people who study psychiatry closely would call it a true field of science.

    Good essay – interesting variable experiences with people from different ethnic background in the mental field.

  • This was an interesting post Gary. I’m being a bit flippant with the “Nope” answer (which was my first thought); of course it’s more complicated than yes or no. First, I would not call these workers “mental health” professionals, but “emotional well-being” professionals or “personal development” professionals or “crisis support” professionals… something more human and less medicalized.

    I have read research by Paul Knekt, Falk Leichsenring, and Barry Duncan (his book The Heart and Soul of Change is especially good), whose meta-analyses of psychotherapy (mostly focusing on outpatients, if I remember correctly) suggest that most of the time people are better off with psychotherapy than without, for both shorter and longer term treatments. And that, roughly, people who do therapy longer or more intensively tend to benefit more, at least up to a point.

    With inpatient psychotherapy – perhaps the type you did Gary (?) – I think distorting factors enter the picture, primarily that mental prisons are such untherapeutic environments, with overdrugging, coercion, fear of risk on the part of hospital staff, and the use of dehumanizing labels all negatively impacting the ability to develop trusting/loving personal relationships with clients – trusting positive relationships being the alpha and omega for successful work as you said. I’m not sure about all these negative factors operating in every mental prison, but from personal experience I’m pretty confident that they, along with the extremely short-term nature of stays, make therapy in inpatient settings harder to do effectively, or meaningless because it’s simply so short term: Problems that developed over years don’t get solved in days.

    I agree with your idea that in many cases, psychologically mature people could do about as good a job as trained professionals, especially for less severe life problems. I sometimes have the thought that I myself would be a much better supporter of psychotic people than many of the mental health workers who write about their work with difficult clients. That may not be saying much, though, given the paucity of attempts to truly understand psychotic people in depth.

    I think there are a few specialist approaches to extreme states (psychosis) that are truly “special” – e.g. Open Dialogue, and also certain intensive psychoanalytic approaches to so-called “schizophrenias” and “borderline conditions”, e.g. the work of Kleinian authors like Rosenfeld, Volkan, Schulman, and the work of American object relations like Rinsley, G. Adler, Kernberg, etc. Understanding how the human infant develops in terms of differentiation, splitting, separation-individuation, and how these processes get arrested and or regressed to/reversed in psychotic states, does give a unique viewpoint allowing one to understand how a very distressed person is relating and what relational causal factors might be contributing to the way they present themselves. I am speaking from experience here in my own therapy, which is only anecdotal of course, but also from reading hundreds of cases of psychotic people in intensive therapy. But this type of treatment is rarely available, nor has enough research been done on it.

    Meanwhile, I believe that fear of legal risk permeates everything to do with psychiatric prisons (my word for mental hospitals) and that this fear often prevents any useful engagement from happening. Successful relationships do not get formed when we try to control everything that someone else is doing: We know this from experience in our own relationships. But nevertheless, that is what happens every day in the mental prisons: mental health workers are so scared of clients suiciding, or overdosing, or being accused of malpractice, etc, that this dominates what happens and leads to constant over and covert coercion such as forced drugging, unforced but pressured drugging, isolation, 24 hour watches, fear of talking about difficult topics that might get strong emotional responses, etc.

    In my own life I find I mainly get good results by taking risks and doing things that have a good chance of working but don’t work every time. That is the opposite of what mental prison workers do: They hardly ever take or allow risks – like talking openly with a suicidal person about their options, or getting a person to open up about their most difficult feelings, or really doing anything new or innovative – and thus they almost always fail at helping people. That is why I think commenters who say that the real goal of mental prisons is not to help people, but to serve as a prison for undesirables and a profit center for psychiatrists/drug companies, are essentially correct.

    Lastly, I mostly warn people I talk to to stay away from mental health professionals at all costs, with the one exception being seeing a good outpatient therapist in a private/non-institutional environment, in some cases.

    Ok that’s enough right now but interesting post.

  • PTSD is another fake diagnosis.

    Yes, trauma is real, but having gone through trauma does not result in a diagnosable disorder. Responses to trauma are individual and occur on a continuum of severity. Let’s stop pretending that some people have PTSD and there’s a clear cutoff point where other people don’t. Reality don’t work like that…

  • It is fascinating to see how psychiatrists claim authority over all emotional-mental suffering, i.e. the ability to diagnose and treat “mental illnesses” from a cool Olympian height, to be regarded as “experts” in brain diseases… and yet, as a profession, many psychiatrists are afraid that they are regarded as charlatans, frauds, con-artists, and fake doctors.

    Psychiatrists speak of “great progress in developing effective treatments for mental disorders”… and yet they are facing a large deficit of young people wanting to train in their poorly regarded profession, which continues to come under relentless attack from myself and thousands of others, and will continue to indefinitely until it collapses.

    Of course, there is a reason that psychiatry is the only medical profession that has an anti-movement. Because it is not a true field of medicine, nor are psychiatrists real doctors. They are indeed charlatans, frauds, con-artists, and fake doctors… for the most part, anyway.

    It is ironic that someone like Breggin would even call himself a psychiatrist, given how different he acts and writes to most of his ilk. He would be better to name himself as a healer, enlightened critic, therapist, or modern world shaman.

  • Michael,

    Lovely article thank you. Yes, severe neglect can be absolutely debilitating. WRD Fairbairn used to write about how “a bad object is better than no object”, i.e., having a bad relationship is better than existing in a black hole where one is not related, for better or worse, to anyone or anything.

    Another extremely useful perspective comes from Heinz Kohut, with his focus on the crucial need for mirroring (support by external others of autonomy/independence) and idealizing (comfortable dependence on a supportive other) in the child and young adult… and older adult too. Failure of these needs to be met leads to the ontological insecurity that Laing wrote about, to fragmentation of what would have been a coherent self, and if the deficits are severe enough to psychotic defenses such as de-differentiation, psychotic projections (hallucinations), delusions, etc.

    I hope you will see fit to write a book about your therapeutic work with psychotic youngsters in the coming years. A book with compelling stories of meaningful work with 10-15 psychotic young people from a person-centered approach, showing the contrast between your understanding of them with that of the disease model, could be very compelling… and would add to the small library of such books that we need more of, which includes works by such authors as Paris Williams (Rethinking Madness), Ira Steinman (Treating the Untreatable), Ty Colbert (Healing Runaway Minds), etc.

  • Needless to say, by “eliminated” I don’t mean that psychiatrists should be killed. I mean that we would be better off if there were no psychiatrists employed, if the mental prisons were closed down, the drugging stopped, and present day mental health workers forced to retrain in professions that actually do more good than harm.

  • I agree with the other commenters – not sure how “reconciliation” would work given that the oppression by establishment psychiatry largely continues.

    Still, it sounds well-intended. I would have been interested to hear more direct quotes or stories from the actual conference – the article was a bit distant, removed, and theoretical. I didn’t click on all the links, partly because I wasn’t sure where to start with finding such stories.

    As for establishment psychiatric treatment, I wish I had been there to give my piece about the fraud that is mainstream psychiatry. When you bring together the elements of fake diagnoses, drugs/ECT targeted to fabricated diagnoses, the ineffectiveness of such drugs in reducing suffering and improving functioning, and the obsession with coercion and with controlling risk (often of suicide) in establishment settings… it’s very hard to rationalize that psychiatrists and their lackeys do very much worthwhile at all, nor that they would not be better off eliminated.

    To the author – why use the word “symptoms” to describe the troubled son in your article? … unless you believe that the person involved had a brain disease, which it sounds as if you at least doubt. The words we use matter… it’s easy enough to use a non-disease model term, like “problems” or “suffering”, instead.

  • Thanks for the essay Robert. Enjoyed reading it. Human consciousness is indeed incredible. The brain is so complex in the way it shapes and is shaped by the environment that it’s difficult to imagine how it works. This complexity lays bare the hubris of psychiatrists who think they can effectively “treat” life problems arising from the billions of individualized interactions between a mind-brain and the world over a lifetime… with a mass-produced pill. How stupid of them!

  • What an incredible story. Thank you for your courage in sharing this – truly incredible that you survived and are now functioning; well done!

    Your mother truly sounds like a nightmare. A terrible example of material projection, splitting, denial, identity diffusion in terms of the mother using the child to externalize her own problems, etc.

    It’s scary to think there are psychiatrists out there “treating” people who are this fucked up themselves.

    I was also diagnosed borderline, shot up on loads of drugs for years, and hospitalized multiple times.

    Here is my story:

  • Exactly… dialoguing and attempting to get those in power to change their minds will not work. More people speaking out publicly, exposure of fraud by drug companies and psychiatrists, lawsuits against psychiatrists, spreading counter-psychiatry information as widely as possible online, and forceful protests may be needed to make any significant impact against the psychiatric leviathan.

  • Robert,

    They are not going to be moved to curiosity. Their financial and professional survival depends upon dismissing and denying the facts you are uncovering. Even if some British psychiatrists privately felt curious, why would they publicly admit that? Their motive is in every case to deny and avoid arguments which threatens their professional position and ability to profit from continued prescribing of psychoactive drugs.

    They are very different than you – a financially unconflicted journalist who cares more about the people being harmed than about keeping your social standing or losing your income.

    When you said this, it sounded naïve to me:

    “It’s not that I would expect that either of these two mainstream representatives of British Psychiatry (from the Royal College of Psychiatry and a premier psychiatric journal), would be ready to accept the argument I had made. But one might hope that they would find a reason to support a further inquiry into the question, given that the rising disability rates tell of something going wrong with psychiatric care.”

    Hoping in this way is naïve. Why on earth would an establishment psychiatrist support a further inquiry into a set of questions that could eventually lead to the undermining of their professional position as doctors, the loss of their ability to earn very high salaries, and humiliation and embarrassment in general? Would you support such inquiries Robert, especially if they threatened your ability to pay your mortgage, support your family, be respected? I bet you’d be reluctant… and many of these people are much less honest and forthcoming than you are.


    They are not going to be moved to curiosity. Their financial and professional survival depends upon dismissing and denying the facts you are uncovering. Even if some British psychiatrists privately felt curious, why would they publicly admit that? Their motive is in every case to deny and avoid arguments which threatens their professional position and ability to profit from continued prescribing of psychoactive drugs.

    They are very different than you – a financially unconflicted journalist who cares more about the people being harmed than about keeping your social standing or losing your income.

    When you said this, it sounded naïve to me:

    “It’s not that I would expect that either of these two mainstream representatives of British Psychiatry (from the Royal College of Psychiatry and a premier psychiatric journal), would be ready to accept the argument I had made. But one might hope that they would find a reason to support a further inquiry into the question, given that the rising disability rates tell of something going wrong with psychiatric care.”

    You are an existential threat to them. Psychiatry is unlikely going to ever reform itself willingly. Kicking and screaming, if at all.

  • Good article Bruce. Very astute thinking.

    I am looking forward to reading the article on specific strategies that can be used against the establishment.

    I think the use of new technology, especially the internet and the ability of ordinary citizens to create websites and spread messages to millions, has to be one of the primary weapons. In past decades, this level and scope of disruptive communication by effective guerilla fighters was not available to confront those in power. We can see today that in China and Iran etc, this weapon is restricted and controlled. But in America today, this Achilles heel is left wide open by the limited freedoms we still have to go online and write as we would, and so we should use this to increasingly expose the psychiatric charlatans. As this site is already doing…

  • Also, Sun Tzu said:

    “Let your plans be dark and impenetrable as night, and when you strike, fall like a thunderbolt”


    “The general who wins the battle makes many calculations in his temple beforehand. The general who loses makes but few calculations”


    “Know your enemy, know yourself. A thousand battles, a thousand victories”

    Good inspiration for the struggle against first order psychiatry.

  • Steve, here is a favorite quote of mine from Smedslund’s essay, “Why Psychology Cannot Be an Empirical Science”. I believe it is relevant to the research Whitaker reports, and means one should be cautious about interpreting causal variables within that research:

    “The main conclusion to be drawn from irreversibility is that empirical research in psychology… can only be seen as mapping temporarily stable statistical tendencies at the aggregate level. These mappings must be evaluated on pragmatic grounds, i.e. as yielding possibly useful knowledge in limited domains for a limited time…The regularity that is nevertheless observed cannot be taken to reflect permanent laws, but only temporarily stable feedback-loops. These are like whirls in a stream which are stable only as long as the total flow of water does not vary and the stones on the bottom maintain their positions… The findings in psychological journals may superficially appear to be of the same order as those reported in physics or chemistry and, hence, psychology may superficially look like an empirical and accumulative science. The conditional and transient nature of psychological findings is rarely acknowledged, perhaps because the publication and preservation of empirical findings will then appear unjustified since they cannot be taken to be useful in the future. The scarcity of attempted replications also allows psychologists to avoid thinking about this problem.”

  • Steve, perhaps I’m misunderstanding your comment, but I don’t understand how the research could control for macroeconomic changes in different time periods. People only live once / outcomes only get measured once at a particular given time… and thus the confounding factors of different economic environments at different times cannot be totally controlled for, is my opinion.

  • Although, to be serious, an important issue with this article is whether the stigma resistance means:

    1) Falsely believing that one has a brain disease while rejecting stigmatization of said illusory “Brain disease”

    2) Rejecting the notion that hallucinations, delusions, and difficulty functioning represent a brain disease, and understanding one’s problems as understandable reactions to one’s life situation, thus rejecting the disease model.

    Or some third combination.

    I cannot get myself to go to some Schizophrenia Journal and read the article right now, just like I do not read Witchcraft Journal or Alchemy Journal.

  • Robert,

    Thanks for this interesting article! I was thinking that this seems like a “rehash” of many other articles here, which is true in a way, but you explained each concept well with relevant references.

    I do wonder – if these people with these archaic beliefs were the “best and the brightest”, what are the “worst and the dumbest” like? 🙂 Because the awareness of hopeful psychosocial approaches to suffering among these best and brightest people sounds pretty horrible.

    Regarding this: 3) “Medications are what patients.” – You must be missing a word here. Maybe “Medications are what patients need?” Of course not everyone does… and suffering people are not patients; patients would be people with a known medical illness, and hardly any pseudocategory in the DSM is a medical illness.

    I’d like to harp a little on my favorite point – the lack of validity and reliability of DSM diagnoses. This cannot be emphasized to people enough… because as soon as people forget it, they start talking about “schizophrenia” and “depression” as “illnesses” that people “have” that are “just like diabetes and cancer.” Once people believe this bullshit, their minds get warped and the can’t think about people in context and relationships anymore. It’s truly an invasion of the psychiatric mind-snatching labels.

    To take the example of the pseudoillness schizophrenia, that term hasn’t been taken seriously by many more evolved therapists and theoreticians for years. But most people don’t know that. They should be educated about Psychosis Spectrum Syndrome (From Van Os), not talked to as if the argument is “whether or not schizophrenia is an illness that is primarily genetically/biologically caused or primarily psychologically caused.” There is no singular schizophrenia period.

  • Robert, another point to consider is that it is not so simple as “Same Prevalence plus More Treatment” (equals more people “Disabled”). Additional factors that come to mind as driving rising disability in advanced economies include the following: 1) Western economies are increasingly being destabilized by the rise of automated/robot workers, 2) increasing offshoring of jobs from developed to developing nations, 3) increasing cutting of healthcare/retirement benefits in other parts of the economy, and 4) the gradually rising cost of fossil fuels (also can be understood as decreasing energetic return per unit of investment in fossil fuels/i.e lower EROEI). All of these factors are undercutting the ability of companies and governments to provide a true living wage, while driving global debt higher and higher.

    These factors together have made it harder to get and keep a good job. In a sense they have shoved vulnerable people in developed nations into disability programs, since it’s easier to survive on these programs than via paid work, which is harder and harder to find especially when one is suffering emotionally.

    I would even speculate whether these macroeconomic factors together are more important in the rise of disability rates than the increasing use of antidepressants. I don’t know that, but wouldn’t be surprised if it were true. On the other hand, my opinion of antidepressants based on reading Kirsch, Breggin, Moncrieff and others is still very low, and I’m pretty confident they contribute to rising disability too, given all their physical and psychological negative effects.

    Some good websites to check out that cover these economic factors would be:

    Among others…

  • One anecdote about a violent psychotic cousin off drugs proves absolutely nothing. It’s good that they stopped hurting others, but so what if one single person got on drugs and stopped being violent?

    If you are going to make an argument, bring actual scientific evidence to make that argument. Where is your data about the homicide risk of people who aren’t on drugs?

    Comparisons between behavior of people on and off meds been made in dozens of other articles on this site.

    Lacking the title Doctor before your surname could be considered an asset, since it means a person is less likely to be beset by conflicts of interest such as payments from drug companies.

    And perhaps you don’t know that schizophrenia is no longer considered a valid diagnosis by many:

    Psychotic states are real, and these people can be violent (although, not much more than most people at a group level), but there is no one unitary schizophrenia out there.

  • Nothing in what Davick said provides a basis for considering ADHD to exist as a valid and reliable disorder. The supposed diagnosis is still subjective, arbitrary, and overlaps with many other supposed “illnesses” in the fictitious DSM, such as conduct disorder, intermittent explosive disorder, OCD, anxiety disorder, etc.

    Davick’s thinking about ADHD being valid rests on rationalization and assuming his own conclusions – when defining a disease, real doctors do not start by picking a certain smaller arbitrary number out of a certain larger arbitrary number of supposed symptoms. Instead, they use a known etiology and clear evidence of causal processes to show that a proposed illness actually exists as a unitary, reliably identifiable entity. At this point, ADHD does not exist in this way, and is therefore a hoax.

  • Well done on this work, Robert.

    Will be interested to see how the debate plays out in terms of how much of it makes the news, what the content of any rebuttal is, and if it starts to affect policy.

    I hope the point will be made by some of the other panelists such as Timimi that the lack of valid diagnoses for use in prescribing these drugs is another serious, perhaps unfixable problem.

  • Yep, the same old. It’s hard to imagine the authors of these “recommendations” really see the people behind these bizarre non-illness labels like ADHD… there is no mention of the social or psychological context or meaning of behavior whatsoever. The tenor of the descriptions of these “people with ADHD” is so far removed from the subjective reality of relationships that people exist in as to be reminiscent of one of the stories by Franz Kafka, in which a senseless, inscrutable, cruel, bizarre situation confronts the protagonist.

    This example of ADHD policy is why I keep wondering if leading psychiatrists are really aliens implanted onto our planet from a forward operating base on Alpha Centauri, to mastermind the takeover of Earth via getting everybody so drugged up so that we can’t resist. But I guess if I told anyone this theory I’d probably get diagnosed with some severe mental illness and forcibly drugged by the extraterrestrials.

  • To give credit, a couple of the commenters did mention the social contextual issues that I listed above like poverty and loneliness. Most didn’t. With some of the college professors, one has to wonder if they have ever really gotten to know or worked with “mentally ill” people in person at all. They write with such a distance and sense of depersonalization that they sound almost like recently-arrived aliens studying these strange human beings with the so called mental illnesses.

  • Hard to give any credibility to this discussion when all the commenters are talking about “mental illnesses” as discrete things causing people’s problems, while giving hardly any mention to the poverty, abuse, neglect, and inequality that is driving the development of chronic terror/depressed feelings/inability to function (what is mislabeled “serious mental illness”).

    It’s simply jawdropping to see how simpleminded and ignorant some of the professors at some of our “best” universities are.

    I wonder what the return on investment for mental prisons in terms of reduced need for disability payments is. I bet it’s pretty terrible. Mental prisons are so terrified of risk (e.g. completed suicides) and so overinvested in drugging and restraining people that hardly any meaningful therapeutic relationships get formed there due to the coercion and dehumanization that are innately part of these institutions.

  • Scary to read this type of language:

    “The idea is that patients with mental illness, whose day-to-day functioning depends upon adherence to their medication, are a good initial target and proving ground for the Proteus technology…”

    Are psychiatrists not ashamed to be affiliated with companies that act in this way?

  • I was also surprised to read this:

    “3: If you take psychiatric drugs you can’t stay here”

    I had thought that the policy of some of these places would be that if you DON’T take psych drugs you can’t stay here. Kind of like a mental prison (hospital).

    I have not been at one of these shelters so don’t know. But I’d imagine they like people who take psych drugs because they’d have the illusion that their disturbing behavior is being “treated” in some reductionist way.

    I hope there will not come a day when you’re not allowed to live in America unless you’re taking psych drugs. We’re about one quarter of the way there right now.

  • Yes, having a safe reliable place to live is absolutely crucial for emotional wellbeing and security. It’s obvious but it bears repeating, given the fears that “major depressions” are skulking around run down parts of town, “schizophrenias” are lumbering down dark alleyways, and “bipolars” are haunting the dilapidated houses in the bad part of town. Most serious distress is heavily contributed to by stresses of living, of which not having a reliable affordable play to stay is one of the most basic.

    Winnicott and Searles wrote about how before a therapeutic trusting relationship could be developed, an “average expectable envnironment” or “good enough mothering situation was required. In practical terms that means a safe homelike environment without undue financial stress.

    The United States appears to be particularly bad for developed countries in terms of lack of support for vulnerable homeless citizens, especially children. In a county where 50% of the wealth is owned by 1% of the population, it’s not surprising so many are struggling. The misallocation of resources involved in this type of inequality is very severe; almost all homelessness could probably be eliminated by social programs depending on higher taxation, and the rich could still live quite well.

    I have never been homeless but have in the past been under significant financial stress and feared I would fall through the cracks… it is terrifying; it makes your existence as a coherent person feel threatened. Especially when you realize you are living in a capitalistic country in which there may be no safety net at all to catch you… welcome to the jungle. I had to resort to crime (theft) at some points to not enter a truly precarious situation where I couldn’t survive day to day. I’m not ashamed of what I did, and I would do it again. I saw myself as a Robin Hood like figure doing whatever was necessary to survive. And I was the best type of thief – the one that doesn’t get caught.

    This link is broken –

  • I think the article needs to more clearly link admitting that the DSM/Diagnosis is fraudulent and nonexistent, the idea that psych drugs are not medications treating (illusory) illnesses, and the idea of “slower psychiatry” in which drugs are applied cautiously in a Steingardian or Moncrieffian fashion. Without admitting that they are not treating medical diseases, I don’t believe that a slower psychiatry would succeed. This would essentially require admitting that psychiatrists are not doctors, but rather are similar to herbal shamans or drug dealers. That’s one reason it’s probably not going to happen.

  • Ron, if you want to make the contention that neuroleptics are better for psychotic people than placebo, you should explain how they are better and give studies supporting your contention. Right now I don’t believe this.

    Also, are they better in nullifying “symptoms” (i.e. emotional deadening), or better at producing the results that people actually want, like functioning well in a job, making friends, feeling well and alive again, etc.?

  • Ron, probably on the order of 1 or 2% of psychiatrists publicly admit that DSM diagnoses are fraudulent, as well as that psych drugs do not treat actual known diseases. A larger but still small minority believes these things but would not admit it for fear of exposure, humiliation or job loss. And most psychiatrists are deluded into believing the diagnosis and drugging koolaid. From reading resaerch by John Read I believe that number is around 90% of psychiatrists; a very large majority at least, that believe in the reality of serious diagnoses like major depression or schizophrenia being biological illnesses requiring drugs. It’s gonna be hard as hell to change that given the symbiotic relationship they have with the corporations. These psychiatrists are like drug addicts in a way; they need to cling to and infuse themselves with the lies about diagnoses and drugs to keep practicing their profession as profitably and guiltlessly as they do.

  • Or they could just be someone like me Ron. Someone who is not a psychiatrist but knows enough about psych drugs from actually taking them as well as researching them to advise people on the risks and benefits. Someone doesn’t have to be a psychiatrist to give good advice on psych drugs. In fact, not having the conflict of interests that usually accompany being a psychiatrist may make such an advisor more objective than a psychiatrist, who so often minimizes the side effect risks and long term harm potentials.

    The only problem with it is the legal risk which must be managed. But legal risk based on a corrupt system which certifies nondoctors as psychiatrists says nothing about the validity of advice given.

    I have given advice myself to quite a number of people about what to do regarding psych drugs. I am currently more of an influence over my father in this regard than his own psychiatrist, who I am presently successfully undermining.

  • Ron, this is a a true comment that Oldhead made. There is no significant difference between the way most psych hospitals are run and the way prisons are run in terms of the loss of freedoms, the degradation, humiliation, massive power imbalances, and outright abuses. I have been in psych hospitals and have friends who have been in prison. I wonder if you have been in one or both…

  • Ron, people like this already exist in the form of street drug dealers and in voodoo / witch doctors in developing nations (who prescribe herbs and other drugs that alter mood).

    Also, the potential side effects and effects on mood/behavior of the individual seem very unpredictable for psych drugs, and dependent on many factors that simply cannot be controlled or measured very accurately. It is a lot more complicated than with drugs that treat a known physical disease. This would be an argument in my book for withdrawing psych drugs from the market, as Gotszsche suggests. I think many here, perhaps even Ron, would agree with the idea that long-term outcomes of people in distress would likely get better without any drugs prescribed at all than if psych drugs remained available. Much circumstantial evidence like the WHO studies and Harrow/Wunderink supports this idea.

  • I would suggest that neuroleptics thus represent a sort of admission of failure, i.e. that other relationships or strategies or resources are not sufficient, intensive, or effective enough at a particular time, thus a “shut down” or the brain-mind system is needed. But perhaps a psychotic breakdown itself represents this type of failure of resources around the individual who becomes psychotsis. Still, In this way “slow psychiatry” might be viewed as a sort of last resort, rather than the first line intervention that it is today, with all the baleful consequences of this improper placement in the hierarchy of potentially helpful interventions.

  • It sounds like a rational idea Ron. I am supportive of either of these options as either is better than psychiatry at present.

    On the other hand, I am not really invested in reform or abolition in the same way that I am in spreading the message of escape/extrication – that psychiatric diagnosis and drugging/ECT is a fraud and there are many better ways to get help by leaving the system. I have to have a focus and it is in encouraging people to leave the system psychologically and physically and find alternatives, not reforming the system (an idea I think is doomed in the near future) or abolishing the system (something I think is also very unlikely anytime soon).

    Gradual progress toward the extinction of psychiatry can be accomplished if more and more people become aware of its weaknesses and choose not to take drugs, accept psychiatric diagnosis, and see psychiatrists. Those are the actions I want to encourage at present, and I hope others will also encourage others to do so.

    It is possible due to the vulnerability of those who are oppressed by psychiatry, and the financial and political power held by those who run it, that psychiatry will not collapse for a very long time. It may only be a global political breakdown, or a societal regression to early industrial conditions that predominated in the early 20th century, due to fossil fuel depletion, that will bring the end of institutionalized psychiatry. Most people think these things are impossible, but a careful study of past civilizations such as the Romans, Ottomans, etc., as seen in books like Jared Diamond’s Collapse and Chris Martenson’s The Crash Course, shows that this is not so; the indefinite perpetuation of psychiatry depends on fossil fuel-powered industrial production, and is thus vulnerable.

  • I agree with this; why would such a specialty be medical? I.e. related to physical diseases of biological or genetic origin?

    To be reasonable, such “specialists” should also be able to push all sorts of mood-altering substances. One could imagine “psychiatrists” prescribing vodka, beer, coffee, marijuana, different vitamins, antipsychotics or antidepressants, etc. Without the illusion that any one of these is treating some mental disease.

  • This is why this idea of slowed down psychiatry is not going to work, most probably. For psychiatrists to take a back seat as a smaller part of a treatment focus which is more relational and person-oriented, they would lose status, prestige, and most importantly income. They wouldn’t be able to charge $250-300 per hour (or per 15 minutes) anymore, and might lose many of their case load with a reduced focus on drugs. Therefore most psychiatrists will fight this movement with everything they have. No one wants to go extinct, financially or literally.

  • For someone in psychotic crisis, if the episode is acute, the chances are still better not sending them to a psych hospital and not getting on drugs. Otherwise the process of patientification and zombification begins and will likely turn an acute episode into a life as a “chronic schizophrenic”.

    So the answer would be for family or friends to educate themselves and try to help their loved one without going to a doctor who knows next to nothing about psychosis.

    For those without friends and family, most of them end up in prison or on the street and that is something we should be ashamed of as a nation. More money is needed to care for these people; and not only more money but more money focusing on psychosocial intervention not drugging. Without that nothing will change.

  • For the insurance question, many outpatient therapists and even some psychiatrists will collude with a client to give them some arbitrary label that they don’t even fit the criteria for in order to get insurance coverage. For example, my therapist and psychiatrist used to label me variously “dysthymic disorder”, “adjustment disorder”, “generalized anxiety”, “panic disorder”, even if I didn’t have these particular problems at the time. We would laugh about it because we were using whatever would get the system to pay. That is what you do; just do whatever it takes to take advantage of the existing system.

    On the other hand in hospitals and for people who cannot access professionals who see through the DSM’s smoke and mirrors, these labels are a real problem, especially if there is a requirement to take drugs. There is no easy answer to that in some cases. Whenever there are family or friends who can offer support, the person should attempt to leave the system. If not, there may not be any easy answers at all.

  • Steve,
    No they are not going to change; there is no real motivation to do so. Moreover, people like Dr. Steingard who are honest and self-examining are rare in the psychiatric field. Most people in the field tend to be narcissistic, close-minded, controlling, and uncomfortable with explanations that don’t fit their preconceived way of labeling and explaining disturbing behaviors. This is a field that attracts such people, given how simplistic and coercive it is. It is, as Gotszsche charged, a field with much in common with organized crime rings: Psychiatry is in fact a legalized criminal cartel, when it comes down to it.

    Although the comparison may be upsetting to those who like to think of themselves (perhaps unrealistically) as “balanced” and “moderate”, I cannot help saying again that expecting most psychiatrists to voluntarily stop overdrugging and invalidy diagnosing is like expecting a pathological liar to stop lying, a serial con man to stop swindling, a crack dealer to stop importing coke, etc. It won’t happen without a huge input of energy in each case. These people have no other training and they are making a lot of money using these invalid diagnoses and unevidenced drugs. Why would they stop?

    Ron’s article is basically wishful thinking and needs to be exposed as such.

  • Hi Ron,

    Given that ignorant and greedy people primarily control the institutions regulating psychiatry and have no motivation toward real change, my opinion is that rather than worrying about reforming the system, whenever possible people should vote with their feet by discontinuing drugs, rejecting diagnoses, not seeing psychiatrists, and exiting the system whenever possible if already involved, as well as helping others to do so. I know it is not easy to leave the system, to stop believing in diagnosis, or to taper off drugs, but people do have choices.

    And we cannot expect disease model psychiatrists to stop invalidly diagnosing and harmfully drugging, just like we cannot expect drug cartels to stop exporting heroin, lions to stop hunting antelope, or serial killers to stop murdering. It is what these people do: the financial and social-control motivation is far too strong to expect real change.

    I see this post as largely a rationalization for preserving aspects of the existing system that primarily profits psychiatrists. We need to recognize that Big Pharma companies and leading psychiatrists operate as legalized criminal cartels, as Peter Gotzsche writes about, with Big Pharma as the suppliers and psychiatrists as the distributors. Viewing it that way is not “extreme”, in my opinion; but simply objective.

    I think the first problem here is the following: “a medical specialty focused on mental and emotional problems.”

    A medical specialty focused on mental and emotional problems” is rather like a trash-removal company focused on skyscraper building, or a pet food company focused on home swimming pool refurbishment. Who would hire such a company? Why would such a company even focus on something unrelated to its expertise?

    This is a contradiction. Such a specialty would not be medical, i.e. related to processes primarily originating from or caused by physical factors, but would instead have to be relational and focused on the impact of environmental, person-to-person, setting-to-person social factors.

    Sure, some doctors could help with medical conditions related to emotional distress, but doctors already do that anyway. Why call that psychiatry?

    When you say, “even for conditions with causes unrelated to anything medical” – it is interesting you choose to use the words “even for”, as if such conditions were not so common. On the contrary, no supposed problem named in the DSM that I’m aware of has ever been proven to have a medical, biological, or genetic cause. Can anyone name one?

    Regarding, “modern psychiatry which actually does a very poor job of addressing these three areas of concern, due sometimes to over-reach, and sometimes to neglect.” I think the neglect part is correct, but the overreach part would be an understatement. This is a profession founded on ghost-like diagnoses fabricated out of nothing, which then creates drugs to treat these illusory conditions, and uses them over long time frames with no evidence of efficacy nor (often) adequate warning about the potential side effects. That is not overreach, it is fraud, and in some cases murder.

    Rather than eliminating the profession and then implanting something else, why does just eliminate it, period? There may not need to be a replacement.

    It is interesting that the 3 out of 5 points you suggest from Sandra relate to drugs. If anything, attempts to help people in crisis should have very little to do with drugs, maybe 5-10% of the effort should relate to drugs as a short-term optional palliative strategy which explicitly admits that the drugs are not given for any known medical disorder, but rather to damp down negative emotionals in general.

    The only reason drugs are being discussed continually is not because they are helpful or necessary for most troubled people (see the evidence in Whitaker’s Psychiatry Under the Influence, as well as Kirsch’s research, and Whitaker’s Timber article), but because they are profitable and without them psychiatrists and corporate leaders might lose their houses, cars, and prominent social positions. This is the real question here: To what degree should psychiatrists and drug companies lose their influence, power, and ability to profit off vulnerable people?

    My advice, which may or may not be right for any individual, but at a group level is almost certainly better than becoming involved in the system, would be: If you are not yet seeing an establishment psychiatrist, do not see one. If you have already become involved with the diagnose and drug system through such a psychiatrist, educate yourself about how to taper off safely and about resources for finding help from non-disease model therapists (or the few such psychiatrists) or support groups, and use these resources and self-education to extricate yourself from the system. For the few who do find more benefit from a psych drug than a placebo, face the truth that you are not using a medication that treats any disease, but simply dulling down your ability to feel your pain.

  • Interesting article, thank you. I hope you will be able to get this article published in some other places where it will be read online and in print in Australia.

    Similar distortions and denial to the ECT debacle operate when it comes to the attitudes of most psychiatrists in relation to psychiatric drugs in general and psychiatric diagnosis in general.

    This particular case is truly a Kafkaesque situation.

  • It is interesting that this article uses the phrase, “for the treatment of mental disorders” when discussing the use of micronutrients. This phrase assumes there are actually discrete mental “disorders” in existence a la DSM: There are not.

    The authors also admit that “science has been unable to establish any credibility for this perspective” (that drugs cure so-called mental disorders), yet they apparently are confused about the problem that discrete psychiatric disorder categories do not exist, are not scientifically credible/valid, and are not reliable.

    As for genetic research being 30-50 years away from delivering effective interventions, what makes you think that pipe dream is real? Genetic research into psychiatric categories that don’t exist is never going to reveal anything; it’s doomed.

    Ok, having made the usual antipsychiatry criticisms, I want to say that I support this movie and generally support the value of better diet and nutrition into helping people with life problems of any sort (not “mental disorders”, a demeaning, unwanted term). And, I respect that the authors are trying to pursue independent research that stands up to and diverges from the prevailing model of what is needed to “treat” people’s problems. I would just question why they continue to use unscientific, unevidenced terms like “mental disorders”, given that we know these categories are not scientific….

  • Jon,
    As you probably know more than you let on here, you should not expect any honesty from these pawns of Big Pharma: Big Pharma companies and those it sponsors operate as a legalized cartel, caring only about profits, and always willing to distort, subvert, and outright lie about the facts, whether or not it hurts their patients. Peter Gotszsche has already exposed these practices well in his books, like Psychiatry and Organized Crime.

  • Yes I agree. Like many things in American culture, our “mental health system” results in short-term “gains” (of billions of dollars of profit annually for drug companies from drugging young people) and long-term losses (of millions of young people unable to function who cost society hundreds of billions in disability payments over decades).

  • Vlado, great story, I really enjoyed reading it! You are a talented writer.

    Nina Agdal is pretty hot! I wouldn’t say an obsession with her is evidence of anything wrong with a red-blooded man.

    I like this quote, “”Don’t you think this place is like a human zoo where we’re the animals? You’re the zookeepers. You stare at us and we stare right back at you.” My comment was met with uncomfortable silence. ”

    That just about sums up my experience in a mental hospital, which I wrote about here:

  • Yes, I agree. America is the epicenter of poor “mental health” practices because of its capitalistic profit-focused obsession. Another factor is that severely distressed people are rarely able to fight back or speak up when or after the money is being made. In the other sectors you mention, I think poor/minority/abused/in crisis people are not overrepresented so much. People in serious distress, physically or mentally, are thus a particularly ripe target for profit-seeking corporations.

  • Steve,
    Good comment. It is perhaps not so amazing why the researchers sponsored by drug companies continue with this doomed “research.” The financial rewards are so very large; how many psychiatric researchers would give up their career, their six-figure income, and admit that much of what they’ve been taught is a lie, even if it is the honest thing to do?

    The phantom/simulacrum of “brain-based inherited psychiatric disorders” is sort of like an addictive drug that both Big Pharma companies and psychiatric researchers cannot get enough of. But there is no discrete anorexia, and even if there were, finding genes that contribute slightly to elevating its risk would do nothing to help people. Myths can be so so powerful once they are linked to money and profit… and also, once they are linked to a doomed hope of a quick fix for people suffering from complicated problems. Just look at how many people participated in this trial. The most they’ll ever get out of it is the Amazon gift card, not anything to help their eating problems.

    Eventually I think more people are going to wake up to this situation about psychiatric research. Because year, after year, after year, after year, no actual help or improvement to suffering people will come from psychiatric genetic research. In fact, I think it’s correct to say that no service user has ever been helped by psychiatric genetic research. Eventually more people will sense how the wool is being pulled over their eyes. Although, it seems to me that this research is so bad that it never even reaches the point of generating an intervention of treatment that might do anything to help a real person. So maybe the disconnect will persist due to the incredible degree of unreality of it all.

    I am a bit discouraged at the degree of unawareness among young people in America about all of this. But I hope that some tipping point will be reached where the current ignorance and lack of skepticism will shift into a new equilibrium where increasingly more people become aware of the lack of validity behind psychiatric research.

  • Good post Corinna, keep fighting.

    “Evidence-based” is a tired term that needs to be retired. In American mental health settings it has hardly anything to do with getting to know a person in depth, building a therapeutic relationship, focusing on what matters to them, looking at subjectivity and desire, etc. It usually means giving someone a few weeks of CBT (then stopping just when they start to respond) and a psychiatric drug to be continued indefinitely.

    By contrast, long-term family and individual interventions outside the disease model have yielded real life-transforming results for people in great distress. But our sorry institutions with their biomedical-dominated viewpoint have lost their souls and cannot remember that loving and understanding people is what heals.

    Here below I’m going to copy in a bunch of references I have for truly transformative approaches to people in extreme distress (commonly called “schizophrenia”). These will beat the “evidence-based guidelines” for “treating schizophrenia” anyday. This is one of my posts off the ISPS listserv in which I was trying to help out with some research for the Healing Voices movie:


    I have some leads on hopeful data for your researchers:

    •The 388 program in Quebec, Canada, has worked with over 250 psychotic young people, most diagnosed with “schizophrenia” and many already having had multiple hospitalizations, over the last 3 decades, in 2-3 times per week psychotherapy with limited drugging, at a residential center. They have excellent results with over 75% of people returning to work and social life. They record their data, since they receive government funding and need to justify their work, but have not formally published it. Their leader is Lucie Cantin; have a look at the website . They work in French so if you speak to them you may need a translator (I interviewed her myself on Skype). Here’s a talk by another director there, Danielle Bergeron, with subtitles describing the program:

    •Bent Rosenbaum has a 2012 study showing that two years of psychotherapy produced significantly better social and work functioning than drugs alone. Thep paper is “Supportive Psychodynamic Psychotherapy versus Treatment as Usual for First Episode Psychosis”. It was a randomized study of about 150+ people in Denmark. Here it is –

    •The largest study I know of is William Gottdiener’s 2002 meta-analysis of psychotherapy for schizophrenia – the one that contains pooled data on 37 studies of outcome for people diagnosed schizophrenia and given psychotherapy. The 37 studies include 2,642 people, given psychotherapy an average of 1.5 times a week for an average of 20 months (across all studies). 19 of the studies are randomized and 18 non-randomized. The data consistently show that getting psychotherapeutic help is associated with significant improvements in functioning for people diagnosed schizophrenic. In one way the meta-analysis considers the data, the effect size is such that about two-thirds of those getting the therapy significantly improve their functioning, whereas only one-third of those without improve. Interestingly, the meta-analysis finds that getting drugs in addition to psychotherapy yields no additional improvement beyond psychotherapy alone. So Gottdiener notes that his results are an argument for offering social support without drugs, counter to the wisdom of the time. This paper is available for free on ( ), or I have it. Many of the individual 37 studies in Gottdiener’s meta-analysis are worth reading in their own right; they include a few of the other papers listed here.

    •Lewis Madrona’ 2014 paper, “Results of a Transpersonal, Narrative, and Phenomenological Psychotherapy for Psychosis”, lists results of psychotherapy given by his therapy group to 51 psychotic people for an average of 2.5 years. The results are very impressive with 80% plus of the group, mostly being labeled bipolar or schizophrenic initially, having good functional outcomes, working/volunteering, without continued use of antipsychotics. I spoke to Madrona on the phone to find out some background data I’m quoting here. In the actual study Madrona tracks the decreases on the PANSS, HAM, BPRS, and other scales. This is a non-randomized study but the within group improvement is very impressive. The problem in this study was that the majority of the beginning group (who are not included in these results) had to drop out due to family interference, the effects of already being on strong drugs for a long time, or lack of money. This was less an issue in other studies, especially more holistic programs like Open Dialogue, 388, and the Psychosis Therapy Project. Here it is –

    •Roberta Siani and Orazio Siciliani have an impressive randomized study of intensive psychtherapy for schizophrenic clients, reviewed in the book Psychosis -Psychological Approaches and Their Effectivness by Martindale. The outcomes for about 50 clients, (only a subset of whom were labeled “schizophrenic”, some were “borderline” or another serious diagnosis,) are tracked on several psychological-functioning scales over a two year period in which the people received over 100 therapy sessions. It is a randomized study and the differences are clear. The schizophrenic people getting therapy improve enough that they are diagnostically in a range between borderline and neurotic functioning (according to the psychodynamic model of the authors), with a lot of improvement in ability to have intimate relationships. Here is the book which is available for as low as $3 used –

    •Dorothy Bonigal-Katz runs the Psychosis Therapy Project out of Islington Mind, London. They have not published formal data yet, but it is an example of an innovative project where psychotic people (about 45 are in the program getting therapy at any one time) can get low cost psychotherapy and not be forced to take drugs. They do have data showing clients are very satisfied with the approach, which is usually 1-2x per week psychoanalytic psychotherapy. Here is their site –

    •If enough time I would recommend interviewing one or more of the following: Lloyd Ross (New Jersey), Bert Karon (Michigan), Gustav Schulman (Finland), Gary Van den Bos (US, Washington DC), Brian Koehler (New York), Ira Steinman (San Francisco), Riccardo Lombardi (Rome, Italy). These authors each have much experience with intensive psychotherapy of psychosis, including in many cases without using drugs much or at all. For example, the former APA publisher and psychodynamic therapist Gary Van den Bos has kept case notes and recorded (unpublished) outcome data for over 100 schizophrenic people he treated over his 40 year career, with about 80% of those who stayed for at least one year recovering the ability to function, and in many cases becoming essentially normal and not symptomatic, according to Van den Bos. Again this data is not formally published, but formally published papers don’t have a monopoly on what is real or valid information (and may in fact be less valid than information given by people who are not subject to the pressures and distorting influences of the academic processing process). Most of these authors’ contact information is available on or via searching the internet.

    •The NIPS program in Scandinavia had some good results for psychotherapy of psychosis. Brian Koehler has this data; I have not been able to locate it yet (and Hi Brian, I still want to get it!). Also the Need Adapted approach of Alanen, which was a precursor to Open Dialogue in Scandinavia, had some good data… you might look into the ISPS book series for that, or this book –

    •British CBT for psychosis also has some good data. Their results are surveyed in several randomized studies of psychotherapy versus drugs only for psychosis given for periods of up to 1 year by Kuipers, Tarrier, Drury, and Kingdon in the book Psychosis: Psychological Interventions and their Effectiveness, by Martindale, linked above.

    •for older studies, there are two impressive ones: Barbro Sandin’s work with 14 men labeled schizophrenic, surveyed in the studies “Effects of Psychotherapy in Schizophrenia: A Retrospective Study” by Sjostrom (1985) and “Fully Recovered Schizophrenic Patients who Received Intensive Psychotherapy” by Cullberg (1991). These papers are older but still valid. I have both papers. The initially psychotic men given therapy were tracked for 6-8 years after intake and were functioning and feeling far better than men given drugs only. Here are links to the abstracts –


    •If you want to get these papers for free just ask me (email – bpdtransformation (at) gmail (dot) com), and to people on this list don’t tell the Feds that I am passing them around behind the journals’ backs 🙂

    •Lastly there is Benedetti’s chapter in his book Psychotherapy of Schizophrenia, “Individual Psychotherapy for Schizophrenia.” This is where Benedetti surveys the results of 50 psychotic people treated an average of 3x per week for an average of five years. The results were excellent with over 80% of the group functioning well, having good relationships, and “often leading to complete healing”, according to Benedetti. This paper is not online; I have the book which is available used on Amazon for cheap. Here is a link to an older version of the book which is cheaper used – – and another book by the same author surveying some other valuable data –

    •There are some other good Italian family therapy studies but I am not sure which they are. Maybe some others on the list can help with that.

    •Your researchers know about Open Dialogue, I would only tell them to emphasize that the excellent results in that approach were achieved over 3 separate Finnish cohorts (from about 1993 to 2005) and thus “replicated” at least for that geographic area. The issue now is obviously to have similar results in different locations, and with several major efforts underway to try out OD in different countries (see the recent article in MIA “Love is Dialogical” by Kermit Cole) that will hopefully happen.

    I hope this helps your researchers. I would even suggest they could list many of these resources in a bibliography so that more professionals and laypeople could become aware of the hope that is out there. If they have some links to further reading, I would further recommend including the following books: Rethinking Madness by Paris Williams and Treating the Untreatable by Ira Steinman for laypeople. And for professionals, Weathering the Storms by Murray Jackson and The Infantile Psychotic Self by Vamik Volkan. Find these books used for cheap on Amazon.

    Lastly, Brian Koehler recently posted on the listserv about his research showing that the neurobiology of schizophrena is really the neurobiology of chronic isolation, fear, loneliness, stress, and trauma. I recommend strongly highlighting this link… it is hopeful as these realities, while sad, are modifiable and healable, unlike a chronic brain disease. Brain Koehler has some formal academic writing about this so maybe he can share that with your researchers.

  • Is this real Phil? There’s actually a distinguished professor of eating disorders somewhere? And there are rankings of experts on eating disorders? How ridiculous.

    Before I read your article, I’m gonna write out for myself the problem with investigating, “the genetics of eating disorders such as anorexia”:

    Just like with feelings of unreality, depression, or anxiety, problems of over or undereating are problems of degree which exists in unique ways in different individuals at different times, in relation to different environmental stresses or deficits. Genes do not cause anything alone, but rather provide a template or modifiable set of possible developmental lines that is uniquely imprinted by the effect of environmental stimuli. Furthermore, the investigation into genes on eating disorders is already dead because there is no valid or reliable illness called anorexia out there; just real people who have serious but unique problems with undereating caused by different clusters of experiences, internal and external.

    Furthermore, even if you know of certain gene clusters that slightly increase risk at a group level, it doesn’t allow you to do anything significant to cure or change behavior in an individual. That takes relationships and higher level understanding of the complex causes of problems.

    So this initiative is doomed. The fact that the article even suggests that genes are causing a psychiatric disorder is ridiculous and should be an embarassment to these universities.

    I wonder if these people actually believe in the research they are doing? What do others think… the ignorance and stupidity to buy these reductionistic ideas about human behavior is unfathomable.

    And what a waste of money from the Welcome Trust. At a point in time when human civilizations are massively in debt, when the global economy is very shaky due to the ups and downs of fossil fuel prices and the looming spectres of peak oil and climate alteration, they are trying to find a gene for this ghostly disease.

    With regard to the barely-there results, these researchers are like a compulsive gambler who loses almost all his money, then finally wins a tiny percentage of it back. And then tries to go to find way more money to go back again and hope he’ll score big the next time. It is never going to work.

    With genes and psychiatric disorders, the house always wins.
    (Does DSM 5 really have over 800 pages? Thank God I’ve never read that shit in full.)

    Let’s see if that was on target…

    Yep, pretty much. As Phil said, just by sitting down and talking with one single person about their eating concerns for one hour, one can be more helpful to more people than these researchers with their millions of dollars of funding will ever be.

  • Ok Sera thanks. And I was wondering, did these revelations make the people take notice and seem to get it? Or did it seem to go in one ear and out the other, with only token acknowledgment? I’m guessing the latter.

    Fiachra, that description of psychotic states is based on my reading of books by therapists that work with psychotic people outside of the established system and see how different they are as individuals and how the can get well with sufficient time, support, and understanding. And, also based on my own experience of being psychotic for several years. I was once a voice-hearer… no longer… and was once nonfunctional and terrified most of the time, but that no longer either. Extreme states of fear and defensive reactions against terror (the cause of so-called schizophrenic symptoms) are extremely individual and variable depending on many factors like past relationships, current stress levels, how the individual conceptualizes their distress, the culture, etc. There is no one schizophrenia disease and it’s sad to see people think so simplemindedly.

  • Jonathan, good for you for doing this work.

    Can I ask though, do you not risk getting thrown out of the system/fired if you challenge orthodoxy in this way from within the system?

    I think people like you are very valuable and potentially life-saving to those you help within the system. However, I still want to see the psychiatric system as a whole fail or be drastically reduced in size. I do not think it will be meaningfully reformed by peers who are viewed as secondary supports to psychiatrists and other mental health workers. So while I support what you do on an individual level, I don’t support the continued involvement of peers in mainstream psych hospitals/psychiatrist-run mental health services in as much as they provide life support and the veneer of legitimacy to a system that continues to predominantly invalidly diagnose and harmfully drug. I support peer-run alternatives and ways of helping people peer to peer outside of the institutionalized psychiatric system. In fact, I am a “peer” myself in this way.

  • Sera, Can you give more details about how exactly you challenged the disease/defect model at this conference? Did you actually state that psychiatric diagnosis is invalid, there is no evidence for a disease process causing disturbances in psychotic people, that the evidence supporting long term use of psych drugs is weak to nonexistent?

    And if so what did people say to those things?

  • Wow, the first thought I had after reading this was, “Sheep!”, but of course I’m trying now to think about it as “people acting like sheep”, rather than “people actually are idiotic sheep”, thanks to Richard and Steve.

    Still, how much faith can I have in my fellow humans after reading this? If they are not mindless simpletons, most of these people certainly act like it. I guess it’s just hard to see that these people really don’t know what they don’t know. They have no idea what they are missing. I do have to wonder if people drawn to this sort of thing are those who want to deny the real causes of distress in others/their family using the simplistic biological model.

    The koala bear thing is pretty perverse. It’s a cute, harmless animal. But the people using it as their mascot will increase your chances of getting diagnosed and drugged with all the bad – and sometimes deadly – outcomes that follow from those things on average. This is one case where the presence of a koala bear may correlate with a deadly outcome.

    The part about psychosis is particularly upsetting. As has been repeated ad nauseum, there is no such thing as lifelong schizophrenia, but a syndrome or continuum of psychotic states that may be more or less severe, last more or less long, have many different causes at different times. And those states are not brain diseases, although the extreme distress people experience is expressed in brain chemistry.

    This motivates me to keep working on my own site about psychosis so I can put it out there as an alternative to this neurotrash.

  • Steve,
    Admittedly I have not worked in the mental health system and so do not know well the nuances of peer work in and outside the establishment system. As Malia’s comment suggests below, it may be important to differentiate between peers who work in peer-run agencies, peers who work in traditional psychiatric settings but try to bring reform, and peers who act as toadies of the disease model within traditional psych settings.

    People like you and Richard Lewis are like diamonds in the rough; rare shining stars in the dark hopeless void of biological psychiatry. I applaud you for trying to help people in this way, but I still do not support the involvement of peers in the establishment system… because I do not think it is going to work to reform that system. I think both kinds of peers within the system serve to prop it up in different ways. And thus I am against peers working in the system, although my knowledge is limited to my own experience in mental hospitals as a “patient”, not as a so-called peer worker.

    I do not judge Malia. I just researched her a little bit online and I see that she is trying to do a lot of good things. In my comments on this article, my attacks are against psychiatric diagnosing and drugging – as you know my outrage and disgust with its practices affects everything I write and think about psychiatry – and not against Malia personally, and not against peers personally. I think people who have suffered severely and support others from their own experience are almost always better at helping people than psychiatrists (although occasionally, they are one and the same).

  • Malia,
    I apologize if my comments were overly harsh. I do support your point about men and women being paid equally, of course. It sounds like your heart’s in a good place and you do a lot to help people, and I respect that.

    I am actually very supportive of the kind of agency you describe – an agency run by people who’ve gone through very difficult experiences, for people who’ve gone through very difficult experiences. This is the kind of support I try to give to people myself, through my site (bpdtransformation (dot) wordpress (dot) com)

    As you can tell, I have a virulent hatred for establishment psychiatry and want to see it destroyed. That is why I do not support the use of peers in top-down systems that are run by psychiatrists and that emphasize diagnosing and drugging, because I think the system is absolutely destructive of freedom and wellbeing. These latter peers are used as enablers of the tyrants, and we do not need them.

    But, when it comes to peers working in peer-run agencies that do not use or strongly deemphasize the medical model diagnosing and drugging, then I support the focus on equality there since that is a model that deserves support. The use of peers in county hospitals by contrast I would liken to the use of innocent drug mules by the Mexican cartels.

    Maybe you can write an article sometime about the type of work you do in a peer-run agency and how it differs from business as usual. I would like to read that.

  • And Wayne, I don’t just comment on boards like this; I actually do stuff too. I have a website about trauma recovery and I engage with a lot of people via email and phone trying to be helpful. Rather than give them meaningless diagnoses or drugs lacking an evidence base, I just listen to them and share my experiences in the mental health system and the dangers that I believe are involved in it. On many occasions, I recommend people to consider NOT visiting (or continue to visit) psychiatrists or peer specialists, because I honestly believe they are agents of a corrupt system, and that the danger of being turned into a lifelong drugged up mental patient is very high.

    It’s not paranoia if you’ve lived it and know how real the danger of such a system is.

  • Bc, my scientific research, which is just as valid as the research published in journals by biological psychiatrists, indicates that psychiatrists may be covert emissaries sent by superadvanced aliens that have established a forward base on the superhabitable planets surrounding Proxima Centauri, the star located 4.3 light years from Earth 🙂

    The idea is simple: to implant the aliens-disguised-as-psychiatrists in order to get everyone on Earth so drugged up that we won’t be able to resist when the aliens invade. It looks like this process is succeeding and they’re only a few years away from launching an interstellar invasion.

    Haha I realize this idea could probably get me diagnosed as having “schizophrenia”. I’ll let you all know how my “treatment” goes.

  • Wayne, You do the same thing you accuse us of – instead of engaging with the valid criticism that peer workers are supporting a system that perpetuates the practice of (invalid) diagnosis and drugging, you just criticize us as “trolls” and say we just want to attack others. But that is not what I’m doing – I’m making my points against the peer-worker model because I really believe they perpetuate psychiatric system which should be abolished. I do not believe peer workers are a good thing overall, because to see one, you have to also get a diagnosis and almost always also submit to seeing a psychiatrist and getting drugs. Thus seeing a peer worker WITHIN the system usually involves loss of freedoms and agency. I hope you can understand that, and not “self-righteously assume”, as you put it.

    The author of this article sounds like a great person, but as I said, there are many good and well intentioned people within a fraudulent corrupt system. And we are all for women being paid fairly. The bigger issue is that these people are enabling the continuation of the owning of psychiatry by diagnosing, drugging, and Big Pharma dominance.

    Don’t call people trolls; actually engage with people, Wayne.

  • Are these drug ads still on TV a lot?

    I don’t watch TV anymore. Only movies on Amazon video and my favorite sports shows streamed online.

    Hopefully less young people will be exposed to drug ads over time, because cable TV is dying.

    I haven’t seen psych drug ads on YouTube yet. Hopefully they will not be allowed on there.

  • Sera,

    It sounds like you either have somehow acquired demographic data about the skin color of MIA commenters, or you are making some pretty big assumptions.

    As for the rest, I agree with Oldhead’s comment.

    And nobody is stopping black, yellow, and brown people from coming on here. Nothing we have said about slavery should stop them either: slavery and racism are abominations/tragedies and of course, speaking for all of us I’m sure, we oppose slavery/racism. But the parallels between psychiatric practice, slavery, and discrimination are pretty clear, at least to some of us.

  • I also wish to take the article author up on this timely quote from their own article: “the first step is admitting you have a problem.”

    That quote might be applied to facing the problem of using so-called peer workers to support a system which is based upon invalid non-diseases that have been repudiated even by the leaders of your own profession (e.g. Hyman, Insel, Kupfer), and which insists on drugging almost everyone, including use of long-term drugging without an evidence base (in the case of antipsychotics).

    So how about admitting those problems, which would threaten the very existence of the system within which peer workers work, before worrying about pay equality for those lowly-based workers that are propping up a corrupt system?

    The silence is deafening.

  • After comments like these which dominated the last couple of articles, I am a bit surprised that authors like the one behind this article keep coming back to write, given that they receive mostly negative responses and seem in no way able to engage those who comment.

    On the other hand, it is hard to engage with someone who wants the extinction of your profession. It reminds me of that scene in Independence Day where the political leaders of Earth go to speak to the captured aliens, hoping to find some compromise or way of engaging the invaders, and the alien calmly and coldly informs the humans that he doesn’t want to talk to them, he wants to eliminate them for good.

    I imagine that that is a little bit what talking to me would feel like for a psychiatrist or mental health system worker. But I have little sympathy for this; I barely escaped from the mental health system’s oppressive diagnosing and drugging and I want nothing more than to see organized psychiaty destroyed or at least to save as many vulnerable people as possible from its voracious embrace. Although there are good people within the psychiatric system, that does not in any way make up for the utter corruption and fraudulence that is American psychiatry. It is a horrific system which is supported, however unwittingly, by all the individual psychiatrists and peer workers within it.

  • Many people do get better and deal with life problems outside of the mental health system. But it is the mental health system that does much of the academic reporting and controls the media via Big Pharma, so most of what is heard about in dealing with life problems is “treating mental illness.”

    I agree with you that legal support for survivors who want to oppose the system is sorely needed.

    Meanwhile, it is pathetic to see psychiatrists and mental health workers whine about being criticized by “anti psychiatrists”, while never coming up with any real arguments in support of diagnosing and drugging. The poor babies.

    Phil Hickey had a good article about psychiatry bashing here:
    “Medical students and trainee doctors are reporting that the badmouthing of certain medical disciplines is impacting on their freedom to choose psychiatry as a speciality, and the higher echelons of this specialist branch of medicine are fighting back.”
    This is a truly extraordinary statement. Medical students and trainee doctors are reporting that negative comments about psychiatry that they hear around the colleges are impacting on their freedom to choose psychiatry as a specialty! Impacting on their freedom to choose! The poor lambs! Those mean ol’ real doctors just keep picking on them, and you know, they just don’t know what to do with their lives. Shouldn’t this be a “diagnosis” for DSM-6: Excessive-insecurity-about-vocational-choice disorder? But have no fear my little lambs, your leaders are fighting back!”
    Hopefully the dearth of new trainee psychiatrists will also spread to a lack of new peer specialists within the system, both men and women. Anything that suffocates mainstream psychiatry’s resources, exposes its practices as unwanted, and hastens its demise is a good thing.

  • Yes oldhead agree. It is very harmful that our country is so focused on profit, achievement, controlling others, rugged individualism, etc. I can see that my young friends are really harmed emotionally by the desperate struggle to survive that our capitalistic financial system creates for young adults. It makes me be ruthless to profit from my own work enough that I will not be in danger of falling through the cracks. It’s a bad deal all around but hard to change… well, only a good deal if you have the advantages and connections needed to profit and survive in such a system. If you don’t you can be fucked.

    To the article author, I also like the title of the article, “Unhelpful Utterances”. That would be a succinct way to describe most of what biological psychiatrists say.

  • I agree with oldhead, American peer specialists are propping up a corrupt system based on illusory diagnoses like schizophrenia and major depression, and on ineffective and often dangerous treatments including neuroleptics which don’t have any long-term evidence base. We don’t need these long-term treatments without evidence bases, the invalid labels, or the peer specialists which one can often only see if one also sees a psychiatrists who labels and drugs you.

    Oldhead, that was a great analogy – female crack dealers may make a few bucks an hour less than their male counterparts, but we are not going to spend time worrying about that because they are supporting an industry that kills. The bigger picture is that the killer industry needs to be shut down, not that the enablers of that industry need to be paid equally. This goes for drug smugglers, drug dealers, hitmen for hire, pimps, those who enslave foreign workers, and peer workers in psychiatry. No, I’m not joking, and trying to understand why I am making such an “extreme” comparison might lead to some insight on the part of those in the system.

    Malia, yes I have been in the system, and I know what peer specialists do. They are mostly not bad people – in fact many of them are great, very well-intentioned people – but that doesn’t mean their job is necessary or helpful in the bigger picture. As long as the method of “treatment delivery” is based on the disease model, peer specialists are inadvertent enablers of an industry which breeds hopelessness, worsens outcomes, and chops years or decades off of people’s lives to profit off pill-pushing.

    Think about it – in most state systems one cannot be “in the system” and see a peer specialist without also seeing a psychiatrists and taking drugs. Thus seeing a peer specialist is by no means a safe activity, but may in fact be inevitably linked to the taking of drugs that perpetuate a disease model view and worsen the chance of chronicity and nonfunctionality. Here is some evidence for these contentions:

    Blame it on biology: how explanations of mental illness influence treatment has a good summary of how bio beliefs reduce empathy and warmth in providers, and decrease hope for non-bio treatments etc.

    •William Schultz wrote an 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, Ron Unger 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. –

    I bet the response to this of peer specialists will be to think that I am “antipsychiatry” or “extreme”. But as Upton Sinclair said, “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” This goes for men and women in the system.

    I would suggest avoiding peer workers in psychiatry since they are inextricably linked to becoming involved in the psychiatric system which involves labelling and usually drugging. There are much better options for support outside the system by making use of one’s own strengths, finding non-medical-model support groups, reading more hopeful approaches to emotional suffering, and getting therapeutic support from professionals or friends/family who don’t believe in DSM diagnoses.

    And in case it’s not clear, of course I don’t support women getting paid less than men in general. I just think that in this case it’s almost beside the point, because we do not need peer specialists propping up American psychiatry. Just let it fail already.

  • Yep, these ideas continue to have a strong hold in American psychiatry today. Just look at the latest claptrap from ignorant politicians like Tim Murphy, who keeps repeating that “those with serious mental illness” (as if there’s a clear dividing line) need a kind of treatment (i.e. involuntary drugging) different from the rest of us. I think the situation’s probably worse in America than any other country, as we were the country which shamefully invented the medicalized DSMs and propagated the myths about biological mental illnesses all over the world.

  • Sera,

    I think the comparison between psychiatrist/patient and slave/plantation owner is a good one. Psychiatrists are primarily involved in creating profit-slaves who serve Big Pharma, i.e. people who believe they have illusory brain diseases and will take drugs for life despite the lack of evidence of efficacy. These patients are at least somewhat analogous to slaves who toiled in the fields for decades creating profit for their white masters. A difference is the psych patients create profit by buying pills and/or allowing psychiatrists and Big Pharma to bilk insurance companies, whereas the slaves literally picked cotton to generate income for their masters.

    And many of the psych-slaves are black or other minority, while the psychiatrists are white. So it’s not such a stretch to go from white psychiatrists getting young minority people to toil in the pill-taking fields of the drug companies, to white landowners a couple of hundred years ago getting black slaves to pick their cotton. Both are great examples of exploitation by white people of minority and vulnerable people. It happens and we shouldn’t deny it.

  • Good article Bonnie. Many of the points in it are acute and telling, especially the following:

    – accepting the risk of suicide and not trying to control people paradoxically results in less suicides at a group level.

    – going to a mental hospital and encountering the dehumanization and discouragement of the medical model usually increases the risk of suicide at a group level.

    – engagement with the societal forces underlying suicide attempts is much more important than “detection” and stopping incipient suicide attempts. This point cannot be emphasized enough.

    After a childhood full of severe abuse, I was once suicidal and 10 years ago had a very clear plan involving jumping off a very high 300+ foot bridge in one of our major cities here in the US. I had written all my goodbye notes and was intent on carrying the deed out. It probably would have worked because such a high drop is almost always effective in killing. But I failed because my dear friend, my only close friend at the time, found my suicide note in my backpack only about 5 hours before I was going to drive to the bridge. As he told me later, he felt a 6th sense that something was very wrong and went searching in my bedroom for that “something”, an action he had never taken before. I probably wouldn’t be here if he hadn’t done this.

    Anyway, ironically, my friend got me committed involuntarily – he called the psych hospital and they surprised me and took me away in the police car, with my being confronted and shamed with the suicide note – which infuriated me and at first resolved me even more to kill myself after leaving the hospital. But this friend came and visited me and we talked every day and eventually I felt a bit of hope. I decided I would fight and not give up. This was during 2 weeks of being at the hospital where the drugs, group therapy, and psychiatrists were absolutely useless and did nothing to help me process what was going on. But my friend visited me every day and wouldn’t give up, and after that things got better.

    So ironically, even though I hate psych hospitals, I must admit their generalized limits can occasionally save lives, as they may have done mine… because without this one, I don’t think my friend could have stopped me from carrying out my plan at the time. Or, maybe he could have… I don’t know.

    In any case, the medical model approach of the hospital is a serious problem in making suicidal people even more hopeless. Luckily I knew by that time that biological brain diseases were fictions so didn’t internalize the psychiatrists’ lies, only enough pills to get me released upon which I promptly discontinued the drugs against doctors’ orders.

    The directors and leading psychiatrists at most psych hospitals are so profoundly afraid of legal liability that everything at the hospital becomes focused around controlling and labelling people, and real issues contributing to suicidal thinking can rarely be openly discussed.

  • I’m sorry you had to go through this. It sounds like you were smart enough to realize what the cons were up to.

    As most people here know, going to a mental hospital and addressing the real causes of one’s problems have very little to do with one another…

    The very notion that someone has or does not have an eating disorder is also somewhat ridiculous; it is too binary. People have different degrees of problematic eating patterns/behaviors at different times in response to different internal and external stresses. There’s no magic point at which one can say “Ah, she has this particular eating disorder” or “No, she doesn’t have it.” Psychiatrists continue to exist within their colorless, simplistic, delusional, materialistic, reductionist world where they think “mental illnesses” either exist or do not exist within the “patient.”

  • Richard,

    I was tempted to say that if something acts like a sheep, and is white, and has fur, and says “Baah”, is it not a sheep?

    But I won’t say that 🙂

    I think your point about speaking about people’s behavior and not labeling them in an essentialist way, which may be read as denying their potential for change, is a good one. And I will remember that.

    On another note, if you see this comment, can you please email me – bpdtransformation (at) gmail (dot) com .

    I have something I want to ask you backchannel. I wish we could have private mail on this site.

  • Fiachra,

    Research into SMI biological treatments are like fusion energy research – the breakthrough is always 5 or 10 years away – so tantalizingly close, but never materializing. What they don’t want to admit is that their treatments suck and very few people want to be treated in the way they treat people.

  • I am always vigilant, don’t worry. Although I think I have little reason to fear.

    The movie the Insider was a good example of what can happen when a whistleblower is publicly identified by the leaders of a legalized cartel like Big Pharma/psychiatry (or in that case, the tobacco industry).

  • Phil,

    I have read – cannot remember the sources now – in multiple locations that the drug companies are having very little success developing new drugs to “treat” the supposed illnesses of anxiety, depression, and psychosis. They had the first generation, and then the second generation/atypicals, but now new research appears to be stalling.

    I’m not sure why this is. But if it’s true, it would be very good news, as over the next several years, patents will start to expire. This loss of patent protected income will start to seriously undermine Big Pharma’s psychiatry drug income. And as you correctly pointed out, biological psychiatry in its current form simply cannot exist without the billions of dollars supplied by Big Pharma. Take away the massive profits and the related financial support to psychiatrists and institutions, and it opens a gaping wound that will quickly lead to the exposure and demise of psychiatric practice as currently run.

    Actually now I found some data:

    An excerpt:

    “In the past few years, one pharmaceutical giant after another—GlaxoSmithKline, AstraZeneca, Novartis, Pfizer, Merck, Sanofi—has shrunk or shuttered its neuroscience research facilities. Clinical trials have been halted, lines of research abandoned, and the new drug pipeline has been allowed to run dry… But the dry pipeline of new drugs bemoaned by Friedman is an indication that the drug industry has begun to lose faith in the myth it did so much to create. …

    Despite the BRAIN initiative recently announced by the Obama Administration, and the N.I.M.H.’s renewed efforts to stimulate research on the neurocircuitry of mental disorder, there is nothing on the horizon with which to replace the old story. Without a new explanatory framework, drug-company scientists don’t even know where to begin, so it makes no sense for the industry to stay in the psychiatric-drug business.

    And if loyalists like Hyman and Friedman continue to say out loud what they have been saying to each other for many years—that, as Friedman told Times readers, “just because an S.S.R.I. antidepressant increases serotonin in the brain and improves mood, that does not mean that serotonin deficiency is the cause of the disease”—then consumers might also lose faith in the myth of the chemical imbalance. “

  • You can call it time-traveling psychiatrists, oldhead.

    No seriously, that is a terrible thing. What I mean is that biological explosion started in the late 70s/early 80s, with psychiatry massively expanding its prominence and medicalized message starting in that period. Before 1980, psychiatrists did not practice or speak in so rigidly a biological-medical way as after, at least on average. But of course coerced psychiatry and the precursors of the present-day DSM labels existed long before 1980, unfortunately.

    I think you already know all of this.

  • JackDaniels,

    As others have said, the psychiatric system is designed to help those in power – i.e. corporations, shareholders of corporations, politicians funded by corporations, academics, and psychiatrists – gain power and cashflow. It has little or nothing to do with helping people; it is purely profit driven. Read Whitaker’s Psychiatry Under the Influence to gain an understanding of this. Starting in 1980, leading psychiatrists fabricated pseudo-diagnoses out of nothing and began systematically lying about the (inflated) effects of drugs and the (hidden) side effect risks. This is not a profession that helps; it is one that should be driven to extinction.

  • Yes, mental illness does discriminate, to be simplistic, or more accurately people discriminate against other people.

    One of the most simplistic things one will ever read, and it crops up time and time gain, is a psychiatrist writing, “Mental illness does not discriminate by race, gender, social class, etc.”

    I always laugh when I read that, at the utter absurdity of a trained professional that actually believes that.

  • America, a country with about 4% of global population, is the land where over 50% of antidepressants, over 60% of antipsychotics, and over 90% of stimulants are consumed, at least as of a few years ago (from Grace Jackson’s books available on Amazon).

    America is also the only country where a majority of the population believe that biological factors are the primary cause of emotional/”mental health” problems. John Read’s research showed that 24 out of 25 other countries surveyed (where they asked a broad range of people what causes feelings of depression, anxiety, confusion, etc) primarily thought in terms of social and psychological factors.

    So America is pretty pathetic when it comes to identifying the real causal factors behind life problems, as well as in taking way too many drugs. Of course, it’s not our fault (I am a US citizen)… the USA has by far the most drug company advertising and a very heavy penetration of pro-psychiatry views into educational and state institutions. US citizens cannot help being bombarded with this stuff, although one would hope more of them would fight it.

    Compared to America, almost any country is enlightened about mental illness, not that it exists.

  • Oldhead, with your propensity for rigidly insisting you are right about every aspect of the debate about psychiatry and antipsychiatry, you have little right to be calling anyone arrogant; you should speak for yourself.

    And unintelligent people are out there, as hard as it may be for you to see. Identifying that fact doesn’t automatically make a person mean or arrogant.

  • Bean, the fact is that when it comes to the real causes of mental health problems, most Americans are pretty ignorant and uneducated. John Read’s research shows that America is the only country that primarily believes in a primarily biological explanation for life problems. Given the lack of evidence for that point of view, and the fact that we like to imagine this country as a global leader, that’s pretty embarrassing. I don’t think it’s a stretch to describe Americans as sheep blindly following each other in support of an explanation with no evidence.

  • Fiachra,

    I agree with this. The ignorance of many people about the most common causes of psychotic breakdowns / feelings of extreme terror and rage is really profound.

    It is also not easy to find hopeful information about getting well after a psychotic breakdown, at least not via simple Google searches. However, there are at least 50-60 books on alternative successful approaches to getting well after psychosis, from the psychoanalytic, CBT, and other orientation approaches, if one knows how to search on Amazon.

    So no not surprising at all that most people believe their doctors – doctors who are in turn misled by their medical training, which falsely presumes the existence of a brain disease called schizophrenia.

  • Further, the phrase that bothered you (about dysfunctional patterns) should be put into context. John Bowlby, whose work I’ve read, was writing about abused children who never get good social support or therapy and for that reason (unfortunately) stayed isolated or in dysfunctional relationships due to those deficits. But Bowlby was also a psychoanalytic psychotherapist who knew from experience and believed that traumatized people could change their problematic patterns and become lastingly well if given sufficient support and a hopeful view about what is possible with support. His research on what people need to be emotionally well formed the basis for many later writers, like Gerald Adler and James Masterson, who wrote about how traumatized people could accomplish this and change their dysfunctional patterns into better ones.

    I hope this context is useful.

  • Isis,
    I want to weigh in with a message of support also; first, to thank you for your contributions here which are quite valid.

    Regarding this, “insecure attachment to primary caregivers becomes an enduring interpersonal pattern of dysfunctional relationships that persist throughout the lifespan.” – this is a poorly worded statement, but I understand how it would be worrying. It implies that insecure attachment is inevitably and deterministically lifelong and unchangeable, but this idea (which is partly an assumption) is not true at all… as we know from other reading, people who’ve undergone severe trauma at one point in time can change their life for the better in all sorts of ways and the change can be enduring.

    But that is a very poorly worded statement on the part of the article’s author, and if you are reading this, here’s a challenge from me to you (the article author) to change it.

    I agree that the laughter at MIA may be nervous laughter, as Oldhead said. I was recently reading that psychiatry is increasingly in trouble due to a lack of young people willing to train as new psychiatrists: the shortage is real, and it is in part due to an increasingly negative perception of psychiatry as a disrespected, harmful, unevidenced pseudoscience. MIA contributes to that, and professionals notice. Each of our words is only a drop or two, but altogether our little stream does erode the denial.

    I agree with you that MIA authors can and arguably should stop using terms like “mental illness”, “bipolar disorder”, “schizophrenia”, and other medicalized shams that distort and make a mockery of human subjectivity. You may have seen that every few articles I make these critiques as well.

    I do think MIA staff and authors are a little bit better than Robert Spitzer (was). He was a hardcore believer in the DSM’s fake categories. But agree with you that MIA authors should stop pandering to the medical model. People need to have the balls to speak about human suffering as it is really experienced, not as the powers that be want them to.

    People do read these comment threads and that is why I and oldhead are here responding. I hope you will keep commenting here. If you ever need support feel free to email me also, you can find my contact info on my site ( bpdtransformation (dot) wordpress (dot) com )

  • Lily,
    Adapting what the biological psychiatrists might say about the fake mental illnesses, being a sheep doesn’t discriminate by gender, income, race, sexual orientation, etc. People from all the groups believe that brain diseases primarily caused by genes and faulty chemicals are stalking the unfortunate among us. And all those people are sheep to me: calling these people sheep is not about class, and has nothing to do with blaming victims; it is about ignorance.

  • Thank you Uprising, I have seen this site before. But went back and looked at it again; I still think it is right about how the country is controlled.

    CHS has an alternate conceptualization of who controls America, i.e. 9 classes of people, here:

    A more interesting, to me, and rather disturbing way of looking at social inequality based on causal factors including debt and energy efficiency (energy mainly from fossil fuel being the thing that underlies almost our entire economy) is here:

    This energy/debt issue is why I am quite worried about our planet’s future (much more than global warming). It’s quite scary to think about what might happen if fossil fuels have a massive price spike and/or debt totally overwhelms the financial system. Also interesting to think that organized psychiatry only exists, along with our many other institutions, because of the fossil fuel energy support that started the industrial revolution only two centuries ago now.

    Anyway I have gotten off the topic. Although, it is interesting to think how temporary and small-scale the issues of psychiatric diagnosis and psych drugs are in comparison with the issues of debt, climate change, and fossil fuel dependence facing the global economy. Not that any of the issues are small to those that are affected, of course.

    Returning to the issue of “getting it”, I think that with other oppressed groups – for example gay people, women… they were not so clearly the object of a single massive profit-seeking leviathan (i.e. the several large Big Pharma corporations that make most psych drugs) and thus educated people and those in political positions of power may at least not have had that corrupt motivator for keeping them down.

    With psych survivors, who cut across these groups of ethnicity, gender, and class, what they have in common is that they are monetized as a product and that many of the people in power benefit directly or indirectly from their oppression, far more than if, for example, gay people were denied certain rights. If mad people get less drugs, jobs will be lost. Mad people might be likened more to the black slaves that tilled the fields in the 1800s, who were an asset not to drug companies, but to the plantation owners.

    Psych hospitals are in essence neo-planatations where poor, terrified people are made into life long drug-takers, i.e. incubators for drug company profits.

  • I skimmed through this article.

    There is no benefit whatsoever to the American elites and professional caste of recognizing that psychiatric diagnosis and our “mental illness” treatment system are respectively invalid and worse than useless. The primary motivators of those in power, i.e. self interest, profitability, and needing to control things, are not served by rejecting the brain disease/drug first narrative and embracing the uncertainty and individuality that are the true makeup of human suffering. So why would they pay attention to these ideas. Poor, suffering people are serving just fine as the fodder who buy the drugs that fund the corporations that fund their campaign contributions, so why try to understand them as people? I think forcible resistance by an highly organized group, much more highly organized than antipsychiatry people are at present, and with much more access to money and legal ability, is needed.

    An interesting article here examines just how unequal our nation is currently; surely this process is worsening the ability of disparate social classes to understand each other:

  • Here are examples of the appalling state of “care” that is provided to “those with mental illness” (labels) in one of our wealthiest states:

    To me this grim and violent situation can be understood as the endpoint of the disease model approach, what happens when you lie to people that they have mental illnesses, given them mostly useless drugs, and finally seclude them in totally untherapeutic environments where they have no freedom.

  • Interestingly, this article says, “”North Americans seem to be the kings and queens of overestimation. If you go to places like Japan, Korea or China, this whole phenomenon evaporates,” Dunning said.”

    To harp on a tangentially related topic, this seems to fit with American psychiatrists having done so much to overpromise (and underdeliver) on what their research into “the genetics and biological basis of mental illness” is going to discover and how it will result in improved “treatments.”

    Because the fact is that nobody on this forum can list even one single “patient” who has ever benefitted from American biological or genetic research into psychological “disorders”. And yet the billions of dollars continue to be collected into giant piles to be burned at our universities (oh sorry, used for “research”), year after year after year.

    I would guess that in 10 or 15 years the research psychiatrists will still be deluding themselves that they can find the genes that cause the illusory psychological disorders, not realizing that all the time these “disorders” are just labels given to people based on arbitrary clusters of behaviors.

    America does seem uniquely responsible for propogating the most stupid, ignorant, reductionist ways of conceptualizing human suffering all over the world via its researchers’ delusions about mental illness. What is wrong with our country…

    As our politicians might say, America is indeed “exceptional” when it comes to mental health “treatment” – exceptional for being one of the worst places in the world to become seriously emotionally troubled, despite being one of the wealthiest nations.

  • Steve, I think your idea is important – that facing the fact that social conditions are the main causal factor for psychological suffering may be too depressing to face. Facing the real prevalence of child abuse, emotional neglect, discrimination, economic oppression, poverty, greed, and other negative social factors – and admitting that parents and our own leaders inadvertently do these things to other people – is indeed very disturbing and upsets the psychic equilibrium (supported by denial) that many supposedly well-educated, successful people in our society are used to.

    On the other hand, until one faces up to what is really going on interpersonally and socially that is primarily causing people’s problems, very little can be done to ameliorate these issues.

    That is why I view identifying the abuse, neglect, and misunderstandings of parents, peers, and other people close to a distressed person as a positive thing, since it allows for taking responsibility and for change. The simplistic delusions about “blaming parents” and “brain diseases with mysterious genetic origins” on the other hand, should be exposed for their real functions, which include denial and protection of the abusers and those in power.

  • No Bean, doctors responsible for contemporary psychiatry do indeed lack for education. There are many kinds of education, and it sounds like you may not be very familiar with how psychiatrists are trained these days. They receive almost no training on social, psychological, and depth/psychodynamic approaches to understanding emotional distress. Instead they are spoonfed the lies that discrete psychiatric diagnoses exist and that drugs are the front line treatment, from day 1. This dismal state of affairs is discussed on several listservs such as ISPS and Psych Integrity, as well as touched on here from time to time.

    So in other words, psychiatrists are well educated -well educated in how to be reductionist fools with no understanding of the real causes of emotional suffering.

    If that is arrogant, so be it.

  • And I am not blaming the victims. People stuck in the mainstream mental health system (viewpoint) usualy lack the resources, awareness, or in some cases intelligence to have a more informed view and/or be able to make different choices about their emotional problems. Calling it their fault would be simplistic. It just is what it is. If blame should go anywhere, it would be aimed at some aspects of capitalism, corporations, and the leaders of a society that does not protect its most vulnerable.

    But let’s not sugarcoat it, dumb people are out there, and there lack of being able to think in depth about alternate explanations for emotional problems can be a problem. As the little boy in the Sixth Sense discovered in the alternate version of that movie: see dumb people&filters[primary]=images&filters[secondary]=videos&sort=1&o=2

    And here’s an article discussing the referenced phenomenon of “Illusory Superiority”:

    Most people won’t talk about “stupid” people because it’s considered mean or taboo in our society to suggest that another person is dumb or “retarded”, as some of the kids I work with occasionally call each other (and I do stop them). But this doesn’t magically make 90% of people smarter than average.

  • Sera, thank you for your response.

    As I said in comment above, there are other factors turning some of these well-educated people into “sheep”, at least when it comes to blindly accepting psychiatric diagnoses, as well. These include, as noted above – the denial and anxiety reduction the conventional MI narrative enables if one has a disturbed family member (seeing one’s family member as “mentally ill”), the profit motive if one is financially affiliated with the mental health industry mainstream, the fear of psychosis and extreme states. All familiar topics on MIA.

    Also, I think very, very few of the better educated people you are describing are truly well educated about the area of psychiatric diagnosis, particularly the philosophical and/or psychoanalytic approaches to it. How many of these bloggers do you think have read Bentall, Boyle, Poland, Read, Kirk, Caplan, Leo, Whitaker, Joseph’s books in depth (these books are accessible to the general reader as logical critiques of the mainstream approach to psychiatric diagnosis)? And how many have read about curative approaches to psychosis and extreme states such as those in Sullivan, Searles, Volkan, Hedges, Steinman, Williams, Jackson, Boyer, Robbins, Karon (fewer would, as these are specialist books).

    If one reads most of these books, it gets hard to maintain the denial about psychiatric diagnoses existing as reliable and valid medical illnesses.

    I bet the answer though, as to how many are well read in these areas among the bloggers you are discussing, is zero or very close to. If this is correct, their blather must therefore be understood as emerging largely out of ignorance, not intentional choice.

  • No uprising, the logical conclusion to the bleating masses is that people need to stop immediately believing whatever they read or are told, and do their own research to come to their own conclusions about “mental illness” and psychiatric diagnoses. A close examination of the literature from antipsychiatry and critical psychiatry authors, as well as common sense, would make most people who really thought about it at least question the conventional narrative about psychiatric “illnesses”. But few people seem interested in this self-examination and independent thinking.

    The fact remains that unfortunately, there are a lot of unintelligent, uneducated people out there, and these are the ones who tend to disproportionately end up in our mental health services. I obviously wish this were not the case. The real reasons behind it include lack of financial/social resources as well as profiteering by industry and “professionals.” But lack of being able to think for oneself and do one’s own research plays a part. Our culture today is pretty superficial.

    As for wealthy, Ivy League people leading, I actually think that many of them are sheep too. By sheep I mean people who buy the conventional narrative about “mental illness” (or whatever the mainstream is saying) without carefully examining the evidence. With well-educated (in other ways) people, this often occurs for a number of reasons – including the denial and anxiety reduction the conventional MI narrative enables if one has a disturbed family member (seeing one’s family member as “mentally ill”), the profit motive if one is financially affiliated with the mental health industry mainstream,

    Although yes, I sometimes feel contemptuous toward people who blindly accept the brain disease narrative, I always try to help people who want to find a more hopeful vision of emotional suffering to become aware of resources such as this site and the many authors/resources that I often write about in comments. I trust that you do the same.

  • This may sound arrogant, but maybe the problem is that a lot of Americans are either stupid or not educated enough to be able to think critically about the issue of psychiatric diagnosis.

    As amazing as it is to say, 50% of Americans are less intelligent than average, even though no one will admit they are.

    We should remember that most people on mainstream forums discussing psychiatry diagnosis tend to be disproportionately:

    – young, thus less wise due to life experience;

    – less well educated than most, because “mental illness” diagnoses disproportionately get given to those in the least advantageous social situations, i.e. those with less resources for coping and adaptation; and education is one of these resources. (Yes, “mental illness” does discriminate against the poor and minorities).

    – more likely to see themselves as not having agency, and thus more likely to accept deterministic lifelong diagnoses… those who believe more in determining their own fate, as opposed to taking a pill and accepting a diagnosis, don’t tend to stay in the system for long.

    Most Americans today are obsessed with Facebook, little games on I-phones, what TV show to watch, and how to make enough money to scrape by in our capitalistic system. The articles Sera linked are often the longest, most complicated pieces of writing such people have read in years; few Americans read books these days. Thus their ability to think critically and examine assumptions about “mental illness” and psychiatric diagnosis is either limited or nonexistent.

    The adaptive aspects of believing in mental illness diagnoses, at least in the short term, is that it provides an illusory explanation for one’s problems and a temporary sense of relief of personal responsibility for whatever is going on. For many of the sheep in our society – which, to be cynical but realistic, is full of drones who don’t examine their assumptions critically – these “advantages” of psychiatric diagnosis preclude any depth examination of the validity, reliability, or meaningfulness of psychiatric diagnosis. Further, many people simply cannot believe or admit that a medical profession has completely deluded them and the rest of the country about the nature of our distress.

    So Sera, I am not very optimistic this situation is going to change, given the ignorance, stupidity, and lack of resources of so many of our fellow Americans who believe in “mental illness” (and yes I’m saying this as someone who went to an Ivy League college, was valedictorian of their high school, and reads books all the time… to those simpletons who believe in “mental illness” causing your problems, hate me if you must).

  • I see. Yes, your description makes sense, thanks.

    I would say all of these psychiatric conceptualizations of chronicity/recovery fundamentally misunderstand the nature of human emotional development, both when it proceeds well into relative wellbeing/maturity, and when it gets developmentally diverted into primitive states using splitting/fusion/denial (i.e. psychotic states). Psychotic states are not physical illnesses but rather complicated individualized reactions to some mismatch, deprivation or trauma related to how the individual experiences their environment. The defenses used include especially fusion (nondifferentiation) and splitting, which operate as defenses against overwhelming feelings of despair, terror, and rage, as written about ably by authors like Volkan, Searles, and Boyer.

    Psychiatrists’ distortions about there being a brain disease called schizophrenia has not changed this reality one bit: psychotic people filling mental hospitals today are still experiencing terror/rage/despair, and still using the defenses of splitting and fusion to defend against those feelings, just like they were before psychiatrists invented the fiction of schizophrenia the brain disease.

  • Amazing to see this –

    “The key concept: if mental disorders are brain circuit disorders, then successful treatments need to tune circuits with precision. Chemicals may be less precise than electrical or cognitive interventions that target specific circuits.”

    This idea of depression as (a single) “disorder of brain circuits” is so reductionist and frankly, stupid, that it’s hard not to laugh when one reads about the ideas. Experiences of depression do not primarily originate inside brains, but between people and their environment and in relationships.

    These biological reductionist treatments are doomed to failure, the only winners may be the drug companies and the psychiatrists that they pay. Business as usual for the sociopathic businessmen running our country.

  • Robert,

    These ideas sound great. I watched the Courtenay Harding course on the Vermont story and the Martin Harrow course on better psychosis outcomes off drugs and found both useful.

    I would only caution you to reconsider using the word “mental disorder” (e.g. “micronutrients are a treatment for mental disorder”) – people’s life problems don’t break down neatly into discrete “disorders”, which has become a disease model term linked to empty words like bipolar as you know. People’s responses to life adversities are understandable efforts at coping and adaptation, not disorders.
    To many people with lived experience the word “mental disorder” comes across as impersonal, bizarre, even condescending. Try to use more empathic human language. Saying “treatment for mental disorders” makes you sound like a biological psychiatrist. Even the leaders of the NIMH admitted that the notion of discrete (DSM) disorders lack validity, so if they can do it, maybe you can too.

    Suggestions for replacement terms would be “problems in living” and “emotional distress” or “dealing with adversity.”

  • Hi Michael,

    Great article. I used to watch videos off Ogrish, Bestgore, Goregrish, etc myself, partly to make myself feel more alive/connected to reality (even if in a “bad” way), and partly out of a grotesque fascination with the material on there and the fact that people could commit these horrendous acts.

    I think antidepressant meds dull down the ability to feel and experience life strongly, and since people naturally long to feel alive, to be stimulated, and to feel connected, it is natural they would turn to things like “gore porn” to get a sense of being excited even through being horrified… feeling some sense of life inside oneself, even if it’s in relation to something truly horrifying, is better than feeling nothing at all.

    As Ronald Fairbairn (psychoanalytic thinker) said, “A bad object (experience/person) is better than no object”… or as James Grotstein said, something like, “Bad internal mental relationships plug the internal void and prevent the descent into a psychic black hole”. In other words such negative exciting experiences can serve as substitutes or counteracting forces to experiences of deadness, emptiness, and alienation, as you well described.

  • I basically agree… categorical divisions of emotional/living problems do not truly exist. Even describing them as variable continuums is fraught with difficulty, in a human world which is relativistic and operates in an unpredictable quantumlike chaotic way. The language of psychiatrists/psychologists, which I sometimes adopt due to lack of a better language, is based in a materialistic, deterministic, Newtonian, black and white medicalized way of thinking about human life that does not reflect how people really experience their worlds.

  • I think the “recovery” term originates from the physical illness model idea of a physical body that has been in a normally functioning homeostatic state, then becomes ill or dysregulated due to some pathogen or physical trauma, and then needs “curing” or “fixing”.

    Emotional development is different, more nuanced and complicated, and proceeds along a continuum that requires much more input from other people compared to physical development… which mainly requires good nutrition, some exercise, and shelter/physical homeostasis. Going through the symbiotic and separation individuation phases as a child and young adult is quite different than simply growing up as a physical body, and restarting emotional growth (after developmental arrests due to trauma or lack of emotional support) after interruptions in normative emotional development should not be mislabeled as “recovery”… it’s a simplistic word that does not do justice to what people work on as they grow emotionally.

    I would nominate the terms self-actualization or adaptive psychological development as replacements for “recovery”.

  • I will say that I agree with some others who want to reject the term “recovery”… as recovery is arguably a word of the disease model. It is a slippery slope… It implies that someone was well or normal, then became unwell, then needs to get back to normality or wellness. The problem is that for many severely disturbed people (often labeled borderline or psychotic), they have never been well or “normal” in the first place… their relationships and sense of self has been severely impaired since childhood. Thus recovery does not make sense for these people… recover to what? A past “good” state (that never existed)? They have to grow, mature, trust, become a person for the first time.

    Problem is I am not sure what word could replace recovery. Perhaps people are too varied and there cannot be one single term. Personal growth, maturation, self-actualization, gaining of agency, living the life you want, would be terms I’d suggest for consideration.

    Sorry Sandra… you see, I can’t go a whole article without finding something to disagree with, hehe 🙂

  • Sandra,

    Great article. Even though sometimes I disagree with your ideas, I always enjoy reading your articles as they are interesting, sometimes provocative (in a good way), and get me to think… so I always click to read them when I see them on MIA.

    In this particular article I don’t disagree with anything. It sounds like an awesome program Vermont has with the peers, and I would wish that it could be repeated in many other states. People (“peers”) who have been through very difficult experiences and gotten well are a very, very powerful motivator and hope-inducer in people currently suffering or hopeless. Kudos to your group for finding ways to use them to increasingly good effect.

  • Oldhead,
    It’s hard to talk to someone who’s as black or white about things as you are on this issue. I am only saying that experiences of extreme fear and rage, often accompanied by delusions or hallucinations as a way of warding off overwhelming feelings, are in fact real experiences that people have. If you can’t understand that, it looks like we will just have to disagree; I reject your presumptuous notion that I need to have an epiphany. Maybe you need to wake up to the idea that not all conceptual models of reality are invalid or oppressive.

  • Oldhead,

    Get real, everyone here has personal agendas. To be human is to be self-interested on some level.

    You’re entitled to opinion about “the right way” to get people to print something; but I feel different; exposing inconsistent, capricious practices is valid in my book.

    Try going a little easier on everyone else; you mainly pipe up when you want to criticize the 5% of what others say that you disagree with, rather than supporting the 95% of what you might have in common with them. It gets old…. pun not intended.

    As for being antipsychiatry, not everyone agrees with your definition of what antipsychiatry is; few people are pure enough for you…

  • Oldhead, I cannot figure out how to reply to your comment far above in the web of nested comments. I basically agree with your points. I am just saying that traumas of various kinds appear to be related to an increased chance of getting labeled with a (to the person, often meaningless) diagnosis. On the other hand, I do think that psychotic mental states are real and do have commonalities between different people; these people are still individuals, but they do have in common that they are often suffering and in terror a lot more than most people. I understand these things not from the broken disease model, but through the psychoanalytic model of emotional development. It is a much more human, empathic, respectful understanding, and I think that you would like it if you read it. Harold Searles, Lawrence Hedges, Ira Steinman, and Vamik Volkan are some of the good writers in that area.

  • KWB, You have my sympathies. I have also tried to write about recovery story for MIA but been unable to, supposedly because MIA feels uncomfortable with publishing my story anonymously. According to the editors, would have been fine with my story if I had been willing to go through with it under my real name, but that is not something I can do due to liability at my job.

    This position is, however, somewhat hypocritical on the part of Mad In America editors: the reason is that they have recently published not one, but two articles by other anonymous psych survivors, i.e. J. Doe (about benzo withdrawal) and Serafina (about the mental health court system). And the reason for anonymity in both was the same as the one I wanted, i.e. to protect the writers’ employment prospects and reputation. Therefore, the process by which MIA chooses to publish articles by people with lived experience is unclear, inconsistently applied, and seemingly capricious. When the editor likes another psych survivor, they publish their story anonymously, with me, who they apparently don’t like so much, I cannot be published anonymously.

    A reason behind this may be that MIA editors may be uncomfortable with the bluntness of my comments; I do not pull any punches in what I say and am severely anti-psychiatry. But that is not a reason to reject a story that is well-written and serves a good purpose, as mine was. Right now, MIA is in a bit of a drought and could use more articles. So guess what people, I’m still here and my story is still available for publication. To MIA editors, you know where to reach me.

    Your favorite commenter, “Edward”

  • Here’s some data for you:

    At a group level, risk of becoming psychotic 2.4 times greater after sexual abuse (20 studies), 2.9 times greater after physical abuse (13 studies), 3.4 times greater after emotional abuse (6 studies), 2.9 times greater after neglect (7 studies) 2.4 times greater after bullying (6), 1.7 times greater after parental death (8 studies). Not all but much of this sexual, physical, and emotional abuse comes from parents; therefore parents can and do cause psychosis:

    More interesting data:

    Most people labeled schizophrenic believe adverse interpersonal and social experiences caused them to become distressed:

    No evidence of genetic predisposition to “schizophrenia”:

    People experiencing 5 different types of abuse abuse 193 times more likely to become psychotic:

  • Here is some of the data right here –

    At a group level, the risk of becoming psychotic is 2.4 times greater after sexual abuse (20 studies), 2.9 times greater after physical abuse (13 studies), 3.4 times greater after emotional abuse (6 studies), 2.9 times greater after neglect (7 studies) 2.4 times greater after bullying (6), 1.7 times greater after parental death (8 studies). Not all but much of this sexual, physical, and emotional abuse comes from parents; therefore parents can and do cause psychosis:

    More interesting data:

    Most people labeled schizophrenic believe adverse interpersonal and social experiences caused them to become distressed:

    No evidence of genetic predisposition to “schizophrenia”:

    People experiencing 5 different types of abuse abuse 193 times more likely to become psychotic:

  • There is scientific proof Rossa about psychosis being often caused by parents (among many other things) – the article even notes that the ACE study (and John Read’s research) give strong evidence for psychosis being caused by abuse and maltreatment, and parents are the people that often, not always, abuse or maltreat their kids…

    This is different than autism or being gay, which are more linked to innate genetic predispositions.

  • GetitRight, autism and homosexuality are not great comparisons on this topic… we don’t have much data indicating that parental abuse and trauma cause those ways of being. But when it comes to psychoses and severe depression, there is a mountain of evidence covered in the article above showing that poor parenting is a major factor contributing to the development of these problems in young (and older) people. John Read’s research shows that children who get beaten and raped by their parents are several times more likely to get labeled schizophrenic than kids who don’t have this experience. So the data is now coming in, and we cannot deny that parents contribute to kids getting labeled “schizophrenic”, whatever that even means.

    And infantile parents do not usually want to speak up about beating, neglecting, or emotionally abusing their child. Who would? It’s a source of a lot of shame and guilt, even though it needn’t be if one understands that abuse/neglect is often transmitted from generation to generation, with no one first person being the one to affix blame to. But better to speak openly about it and for parents to acknowledge that abuse happens and that it’s often factors outside of their control (at the time) that led to them treating their child in ways they would wish could have been done different.

  • Alex, the suffering people we do not hear from are far more numerous than those we do, I’d wager. The number of silent, pill-taking, non-functional “mentally ill” people must outnumber those who speak out by dozens if not hundreds, or even thousands, to one.

    But yes I agree that victims of abuse can be powerful if they speak up. However, to this point I feel that not enough have done so and far too many people are complicit in believing the disease model idea that have a mental illness and need to indefinitely keep taking their pills.

  • This is a fine article, excepting some of the language about “mental illness”. There is no mental illness, only different degrees of problems in living and relating. The complexity of emotional development that Mahler, Schore, Stern, Bowlby write about does not break down into neat “disorders” and “normality.”

    Why is it so hard to talk about childhood abuse and neglect? A few likely reasons:

    – Ineffective, immature, unskilled parents don’t want to face their own pain or guilt nor the sense of loss that would be evoked by realizing what a poor job they did with their psychotic or depressed child. By deluding themselves that a child has a brain-based illness, their denial and avoidance is enabled. This phenomenon is visible in many NAMI parents, who are often emotional children themselves. The equation for them is simple: Sacrifice your child at the alter of Big Pharma and psychiatry’s illusory “brain disease” model, so that you can deny that you contributed to making them have a breakdown and quiet them down with drugs.

    – In general, it is threatening to realize that so many parents are actually harmful to their children. We like to have the idealized image of responsible parents and obedient children. The reality, that many tens of millions of parents are abusing and neglecting their children, if acknowledged would be very threatening to our sense of stability and rightness in the world. In a way, it is horrifying and unthinkable that so many parents mistreat their own children; to really face this issue would cause psychotic anxiety in some adults. Of course, the denial of what is really going on and the drugging down of the children just makes things worse in the long run… so like with many things, this denial is adaptive and protective at first, but harmful later.

    – As the commenter above says, acknowledging childhood trauma and moving “treatment” in the direction of addressing this trauma and away from drugging/denial threatens the primary profit model of large corporations operating in this arena. Solving problems is far less profitable than creating lifelong drug-takers. These sociopathic entities and their minions, the psychiatrists, need to maintain the flow of new victims into the disease and drug model; therefore, they encourage the discourse which denies life problems’ connection to trauma while dreaming up discrete brain based illnesses that never even existed in the way they imagine. These dynamics are why abused people and their families should avoid psychiatrists like the plague.

    – The last reason would be that psychiatric victims are on average very weak in their ability to fight back. What I mean by that is that the most vulnerable, voiceless, mostly uneducated, poor, minority people are disproportionately the victims of abuse and induction into the disease-drugging model. Therefore it is easy for powerful forces in society including corporations and abusive adults to marginalize and silence them. Unlike other movements involving gay people, women, African-Americans, etc, the psychiatric survivor movement has stopped and started because it does not have such a large proportion of emotionally healthy strong people championing its interests.

  • This situation can be readily understood, given that the NIMH is a front for the drug companies which provide much of its funding. Psychological understandings that don’t place drugs at the center of the picture would be harmful to the profits of the corporations and lobbyists that are choking NIMH’s freedom of thought like weeds, while perversely sustaining the organization as a Big Pharma pawn.

  • I think the authors of these articles like Bentall do not at all believe in schizophrenia as a pathology, but are either trying to write in a way which will read deluded mainstream audiences (whether the public or psychiatrists), or are scared that if they are too honest, that their job security might be forfeit.

  • Furthermore, nobody should be required to admit that they are “mentally ill” to ignorant judges within a psychiatric system that has already been exposed as having invalid pseudo-diagnoses, with even its leading figures such as Frances, Kupfer, Hyman, Insel admitting that there are no real valid illnesses in psychiatry.

    Such a system only stays in power by systematically profiting from and abusing the vulnerable, disempowered, and financially vulnerable, not through any semblance of honesty, fairness, or accuracy in describing nor addressing the nature of humans suffering.

    The abuse and profiteering occurs via a maze of lies within which the myth of valid psychiatric diagnoses and the illusion that psychiatric drugs are medications treating illnesses deceive a majority of Americans, unfortunately including the parents and loved ones of very distressed people. It is unfortunate in this regard that poor, minority, younger people are so often targeted by psychiatrists and mental prisons, given that these people tend to be less educated and less able to stand up for themselves.

    It must be so hard to deal with this stuff in court when the (supposedly impartial) “judges”, in a truly Kafkaesque and perverse situation, even believe the lies of the oppressors.

  • I hope things turn out well for you Serafina.

    I have encountered similar situations with mental prisons. The people in them may not be innately bad, but the political-legal system, which is so distorted by the disease model and by the massive fear of legal liability, turns the workers at mental prisons into little more than predatory oppressors. Then of course the treatment offered, drugs and disease-model therapy, usually does nothing. No wonder so many people make suicide attempts right after escaping from the mental prisons; it is very depressing to realize that the professionals are not willing or able to help you.

    I wrote about my experience in a mental hospital at bpdtransformation (dot) wordpress (dot) com, maybe you’d like to check it out.

  • Do you have any evidence for these far-fetched statements about genetic links for illusory labels like schizophrenia and bipolar?

    If so let’s hear them. And saying that most psychiatrists are deluded in what they believe (i.e. that these problems are heritable brain illnesses) is not an argument…

    You also seem deluded into believing that BPD and bipolar and so on are discrete separable illnesses that can be reliably identified… sad to see this.

  • Zetetic, the so-called schizophrenia findings you cite are very weak indeed.

    Firstly, there is no unitary illness called schizophrenia, and what severe psychoses there are exist along a spectrum of severity and could be understood as a continuum without a clear boundary with more troubled normality. Here Jim Van Os explains how schizophrenia does not exist but vulnerability to psychotic experience does –

    The claim of strong genetic links to this illusory illness (schizophrenia) has already been debunked here in other articles, for example:

    As these articles, particularly Jay Joseph, show, there is little reason at all to believe that there is some illness called schizophrenia that is heavily genetically influenced. That doesn’t mean severe psychosis is not real. But the primary causes are bad things happening in the world and in relationships, not genes. John Read’s research has convincingly demonstrated that as has the Adverse Childhood Experience study.

    We should always remember that schizophrenia is just a word arbitrarily given to people based on showing 2 out of 5 symptoms, meaning people labeled with it could have nothing in common. There is no unitary phenomenon or illness called schizophrenia at all. It’s time to let schizophrenia die.

    And what evidence do you have that neurotransmitters affect mood with the direction of causality going from the brain chemicals to mood? Perhaps a better explanation would be that changing brain chemistry and changing mood are reflections of person-environment interaction…

    If you have any authors, books, or papers to cite, maybe you could be taken more seriously…

  • Christy, a good book on this which reframes human suffering in relational terms if Working the Organizing Experience by Hedges.

    I would be interested to hear what ideas your daughter has on the origin / causes of her distress both at the present time and historically. Seeing a therapist may not fix things, but gaining real hard-won insight and developing/using interpersonal resources always will make things better over time.

  • It is interesting how few psychiatrists seem to take drugs themselves, or to let their kids have drugs prescribed to them. A psychologist I knew once told me a story about how his town’s most successful psychiatrist, with a huge practice where he drugged every kid, was adamantly against his own children receiving any drug when they began to have behavioral problems, and referred his own kids to the psychologist for non-drug psychotherapy!

  • A good recounting of the delusions, distortions, fabrications, and ignorance that has led to the present pitiful state of American psychiatry, Dr. Berezin. Although two more factors leading to this state should be added: greed and laziness. Many psychiatrists today are all too content to grovel at the altar of the drug companies, which they metaphorically do via lazily conducting 15-minute sessions followed by fake diagnoses and pill-pushing, while receiving large salaries that they emphatically do not deserve in relation to the actual value they provide relative to other professionals.

    The amazing thing is that so many psychiatrists today still tell themselves they are doing a good job at “treating” their patients’ “mental illnesses”. It just goes to show how easily and completely many human beings delude themselves into believing things that are adaptive for them but harmful for others.

    I am not sure why you consider people practicing mainly or only psychotherapy to be psychiatrists; they are not, and you seem confused about this terminology. To me you were basically a psychodynamic therapist who happened to have an MD, the MD might be useful for other reasons, but it’s not central to what you do, thus being a psychiatrist is not your primary identity.

    A psychiatrist is a pseudo-doctor who believes in the existence of fictional brain diseases with a biological or genetic basis and treats them with medications that do nothing except dull down the central nervous system. And that is not you, nor was it the psychodynamic therapists who happened to have MDs in the 70s.

    As for this, “The brain reflects behaviors, it doesn’t cause behaviors.” This summarizes well the contradiction and delusion at the heart of biological psychiatric research. The problem for research psychiatrist is that admitting this would require admitting that their diagnoses are fraudulent and that human problems are rarely or never, depending on the type of problem/feeling, caused by brain chemistry. It would be an admission that they are quacks. Psychiatric research is so weak and brittle because it requires assuming so many things that are simply false and unproven. That is why it’s so easy to see through the house of cards that is biological psychiatry, once you read widely outside of the biological research.

    The piece of advice I wish I’d been given when I was very distressed, and which I now tell to others is this: Do not see psychiatrists, avoid contact with mental health workers as much as possible, do not take drugs, and do not believe in mental health diagnoses. Therapists can be fine if they work in a humanistic, relational, dialogical way like you do. But they are polar opposites to psychiatrists in their causal beliefs and in their way of working with people.

  • Not wrong. What I mean is they are not going to do anything to restrict/limit the massive overuse of these drugs or to provide more clear warnings of the dangers.

    Realistically, psychiatry is not a priority or an area of knowledge for the overwhelming majority of politicians. They don’t have the time or interest to educate themselves about this field. All they know is that at some point in time they are getting money from some lobbyist telling nice-sounding (if mostly false) things about psychiatric diagnoses and drugs, and so they are going to vote to do what that lobbyist wants without investigating the issue.

    But again that is probably less than 1% of their time, which is mostly spent legislating other matters. Psychiatry is not a big deal to most politicians relative to issues like taxes, jobs, trade, the overall state of the economy, the military, and even shiny objects like guns, marijuana or gay marriage.

    How much is policy on psychiatric drugs in the mainstream news? Hardly at all.

  • Great story. My pet Shih-tzu dog was so important to me during difficult times. Being able to care for a vulnerable, helpless creature makes one feel strong and caring and less vulnerable/helpless oneself.

  • The point I’d like to make, Donald, is that while genes may indeed increase risk of being overwhelmed more easily by whatever stressors cause a variety of psychotic experience (notice how different, i.e. less certain and less medical, that is than saying “these genes increase risk for the illness schizophrenia”), these studies do not in any way support the validity of psychiatric diagnoses and the studies in question remain questionable since they are based on arbitrary subjective judgments by psychiatrists. Even Bleuler and Kraepelin knew there were multiple “schizophrenias”, not one discrete disease like bipolar and schizophrenia. The degree of denial among modern psychiatrists, who want to appear truly medical and knowledgeable when they are not, and want to prescribe more pills than necessary for illusory “illnesses”, is a real tragedy and is harming many who are misled about what is known about the causes and potential ways to heal psychotic experience.

  • Donald,
    You seem unaware that these issues have already been covered in depth here:

    The genes in question make a very small contribution to the risk of the average person in the bigger picture. Nor do the create validity for the concepts schizophrenia and bipolar: these are still not discrete illnesses with any known etiology. The most one can say about this so-called “break through” study is that it creates a quarter of a percent greater risk for the average person to be (mis)labeled with an arbitrary psychiatric label such as bipolar. The problem at the core of psychiatric practice, which separates it from real fields of medicine, remains: the lack of valid reliable diagnoses.

  • Oldhead, my responses would be similar to what Ragnarok said; I think he has made a good and clear case for how one can use these terms without presuming a disease process… terms like “depressed” or “psychotic” are to be understood as loose, tentative, uncertain working hypotheses that describe certain experiences people may have at one time or another (and may have in common with some others), not as medical labels or judgments.

  • How about “criminal” – someone who commits criminal acts?

    I do think people labeled psychopaths tend to lack a conscience, and to not respect others’ personal or property rights… so they do tend to have those things in common with each other oldhead. Not all, but many.

    Psychopath is a term at least on one level based on what people observably do to others in the outside world… it doesn’t automatically presume a disease process.

  • One correction: Bali is not a country; it’s an island within a country. Perhaps you meant Indonesia.

    This is a great article… I am interested to hear if or how any psychiatrists responded to this. I imagine they did not, as acknowledging the correctness of these criticisms might be career suicide.

    I think change will only come from things like the following:
    – more of the public actively choosing not to use psychiatric treatments, including most importantly drugs, and rejecting the biological model. Starving an industry of customers is always an effective strategy for shrinking that industry. However that does not appear to be happening at all in the USA.
    – severely damaging lawsuits against individual psychiatrists and hospitals. If psychiatrists or hospital staff are imprisoned, massively fined, or disbarred as a consequence of harmful psychiatric treatment, this may change their behavior.
    – somehow, much greater publicity in the mainstream news and in leading journals about the harms and unscientific nature of psychiatric diagnoses and treatment. This has not appeared to be happening as of yet. I hope many more people will speak up as John Read has. I think most well-informed professionals, especially in America, are too scared of losing their job to be honest about what they think of biological psychiatry.

    We must remember that most psychiatrists operate as the tentacles of a criminal cartel which is operated primarily by the drug companies. The image of the little marionettes being manipulated by the “godfathers” at Big Pharma is an apt one for the mindlessness, ignorance, and harmfulness of psychiatrists who lie to their clients every day about “brain diseases” and “medications” to treat those imagined illnesses. The reaction of most psychiatrists to thist statement – i.e. denial and belittling of the messenger – would be an illustration of how unfree and ignorant they really are.

  • “involuntary commitment and forced treatment can be clearly seen for what they are.”

    Yes, what they are are attempts to profit from vulnerable people primarily – profit is the primary motivator behind the pseudoscience of psychiatry – and secondarily attempts to silence and control people that psychiatrists and family members would rather not take the time and make the effort to engage in less harmful coercive ways.

  • Corinna,

    Thanks for sharing your story.

    When I was in the psych hospital the doctor recommended me to get ECT, and luckily I already knew everything there is to know about it, so it was easy to refuse. My father on the other hand was not so lucky; he got a full course of ECT treatments that severe damaged his memory and ability to think clearly.

    What you say about the money in ECT is totally right. A nurse at the hospital I was at admitted to me that the doctors tried to push ECT on everyone possible because they could make so much money off insurers by giving it. It’s crime writ large; and the psychiatrists pushing it in this way should be imprisoned.

  • The answer is money. They want the cash and via pretending there is some unitary (fictional) brain disease called schizophrenia causing psychotic “symptoms” of hallucinations/delusions…. symptoms which are mainly caused in reality by bad shit happening to people, I.e. abuse, neglect, trauma, poverty, inequality, stress, etc, not any disease… perpetuating this myth supports antipsychotic sales and supports the perception that psychiatrists are real doctors.

    It’s as simple as that. Schizophrenia exists to help sell pills and help psychiatrists have status.

  • Same to you… and yes of course I know you are being sarcastic, but I really don’t give a damn.

    Rather than worry about my comments, maybe spend a little more time addressing the issues at hand and remember that we agree on much more than disagree. You are far too easily upset by what I say, maybe you have Internet Comment Easily Upset Disorder. I’m just joking man 🙂 . You have a good mind and we could use more comments from you on the actual issues not only on this but many other conversations. Yes, I’m being serious this time, this is not sarcasm…

  • Hey Yo Dude… I like Jay’s writing. I’m asking him to substantiate his assertion. I have bought and read his books and do not remember him clearly stating that schizophrenia is an invalid diagnosis… and he regularly writes about “schizophrenia” as if it were a valid discrete entity. I don’t think he believes this, but he falls into the pattern of using the oppressors’ labels as if they were valid, I feel.

  • No, of course Americans don’t have bipolar disorder. There is no such disease.

    Periods of manic activity are not caused by biological processes or genes… they are the results of many complex interactions between experience and genes, as your article suggested, with adverse and stressful psychological-social experiences as the primary cause of behaviors and thoughts that get labeled bipolar.

    Something this article doesn’t speak much about is trauma. Getting diagnosed schizophrenic and bipolar is heavily, heavily, heavily linked to being abused, neglected, bullied, discriminated against, poor, and having any variety of “bad shit” happen to you a lot. The primary causes of distressing behaviors and thoughts that get (mis)labeled bipolar is primarily bad shit happening, i.e. stress. Secondarily, I’m sure diet and other physical things going wrong can also be factors.

  • Richard thanks this is good food for thought. Surely yes the responsibility must be 90-95% on drug companies and their psychiatrist-minions for pushing the pills as treatments for non-illnesses and deceiving the public. It still astonishes me to this day how poorly informed most of the public is about psych diagnoses and drugs… on the other hand, they are alarmingly “well-informed” about the narrative that Big Pharma and psychiatrists push… this speaks to the power of the money and advertising you discussed.

  • Stephen,

    That may sometimes be true; I am doing the best that I can though and I do see the differentiation between others’ experience and myself some of the time. Also, I think many commenters on this forum operate in this way; sometimes truly seeing other people as unique others with their own experiences, and sometimes mistakenly assuming them to be more like themselves than is reality.

    By the way, your name isn’t Stephen Gilbert right? I assume you would not use your real name if you still work in a hospital..

  • I am making notes about this in my Word file as I read it, to add a little to the dialogue…

    In saying “have dramatically reduced the quality of the service the can provide”… Frances is implying that there was a past time when mental health services provided high quality help. This is completely unevidenced. For decades now, psychiatrists have mainly taken a diagnose and drug approach where people are rarely able to access intensive family or individual psychological help if they want it. I’d say the halcyon days that Janus (Frances) imagines never existed…

    Hickey is correct that depth intervention in American psychiatry was mainly confined to its psychoanalytic wing working with outpatients privately in the 1950/60s/70s especially. This help was not available to most people.

    The bio-bio-bio approach was adopted primarily for monetary reasons; psychiatrists could make 3x as much by seeing clients for 15 minutes at a time, making an arbitrary diagnosis, and lazily prescribing pills that don’t treat any known illness. That is what psychiatrists do.

    As Whitaker documents in Psychiary Under the Influence, leading psychiatrists and the APA very intentionally directed psychiatry as a profession toward the disease-model approach. They did invent this system; although part of the blame must go to the drug companies, and a smaller part of the responsibility to everyday Americans who are far too willing to believe what doctors tell them and far too eager to take a pill to “solve” their problems.

    Regarding primary care doctors, this problem will not go away so long as America is dominated by corporate advertising directly to doctors. This is one of the worst and most harmful things ever allowed in an advanced nation… and America is one of two nations that does it along with New Zealand.

    It’s funny to hear Frances say “prescribing the wrong meds”… there are no wrong or right meds. All psychiatric drugs do is limit a person’s ability to feel/think be exerting a generalized effect on the CNS… they never treat any specific illness. It’s always guesswork with these drugs and most people will be harmed or helped little if at all.

    To Phil, you should stop calling these people “very eminent”… they are not. Janus (my name for the two-faced Dr. Frances) is not eminent. Would you call a leading astrologist eminent? No… so don’t elevate these people. They are charlatans.

    It is amazing to hear Frances say that psychologists “deny any biological causation”… when no biological cause of any so-called DSM disorder has ever been proven, including with people labeled schizophrenic or bipolar. This is essentially a fabrication on Frances’ part. He is referring to evidence that is not there. We should call him out on this more publicly in every online forum possible. In fact I think I will go to the HuffPo forum and do so now.

    I see now that Phil made the exact same arguments that I just have… great minds think alike.

    It is interesting to note how Frances writes in a tautological,“e.g. excessive drugging is bad” that is hard to attack or pin down, but on the other hand is essentially meaningless and nonspecific. They are empty platititudes. Duh is right.

    It is amazing rereading all these statements from Janus to think how simplistic his thinking really is. It is like reading statements from a 4th or 5th grader…

    Haha it’s so funny to read the words intermittent explosive disorder. I can’t believe that term exists. What idiot believes in that…

    Phil’s ending is exactly right. Janus was complicit in creating the DSM 4 and expanding medicalization, and he is still nothing more than a Trojan horse. We should redouble our efforts and speak out in every possible forum against psychiatric diagnosing and treatment, as well as lobbying/supporting antipsychiatry initiatives legally and policy wise.

  • There is no guilt trip humanbeing. I rarely feel guilt and don’t think others should feel excessively guilty either. Life is too short.

    In the comments above I’m saying that playing the role of the victim, blaming doctors, lamenting over how bad the system is… that ain’t gonna do shit. It’s only by becoming informed, taking action, facing difficult feelings, and improving the real issues that are making your life difficult… that is how you make things better, gradually, with slow frustrating hard work. That is what I did. And as you said getting emotional support from family and friends is absolutely essential, and when internalized can be much more powerful than the medical model.

    With this being said, don’t take our disagreements too seriously! They are just people’s opinions on a web board. Relax…

  • Uprising,

    I think the burden should absolutely be on drug companies and doctors to be transparent and honest… but of course they aren’t as we’ve said.

    Again, saying the burden is on patients is not blaming them; just observing the fact that if they want to protect themselves they must take action and gain awareness without relying on their doctors.

    It is an unfair burden to have, but unfortunately, most people must learn about psych drugs either through harsh direct experience or through proactive research (rarely possible, but maybe a little more now with the internet), without the protection of a system where drug companies and doctors have to be transparent and honest.

    I was on 12 different psych drugs including two different benzos for periods of a few months each. This period spanned several years, all the drugs included. I was never warned or adequately informed of all the risks. At the time I was very naïve and ignorant about psych drugs. Many people simply do not know any better, like the younger me, and the myth of doctors as honest, unbiased, authoritative figures makes us even more vulnerable to the harm of their “treatment.”

  • Uprising,
    I do not mean to aggressively blame people, merely to identify problematic patterns that occur. Everyone is doing the best they can… unfortunately that’s often not good enough for many people to steer clear of harm around doctors and psych drugs, given the pressures of modern life and the way that doctors mislead and fail their clients.

    In an ideal world medical doctors should warn clients of risks around benzos and other psych drugs. But very few do as you know; true keepers of the Hippocratic oath are few. Ignorance and greed among doctors is widespread and so for their own protection more of the public must educate themselves if the benzo epidemic is to be reduced.

  • Here’s where the reply as meant for…

    on March 22, 2016 at 7:36 pm said:

    J. Doe,

    One anecdote is not proof of anything.

    I agree with you that people who are unfairly and unwittingly given benzos by their doctor and then get dependent on them should have a platform.

    However I think people have a responsibility to investigate the prescriptions they are given and vet the potential harms / side effects / dependence risk before they take the drugs. While ideally doctors could be trusted to adequately inform clients of risks, this is not the world we live in. Far too many Americans naively trust their doctors rather than doing their own background research. If more people took an attitude of skepticism and double-checked what their doctor was telling them, many more might find the benzo horror stories online and avoid taking the drugs before things get bad. Easy to say… but I think it’s important to encourage people to proactively take responsibility for educating themselves, ideally before taking any drugs, as sites like RXisk enable. Otherwise increasing numbers of people will fall victim to the culture of victimhood, passivity, blaming, and ignorance that is far too widespread in America.

  • J. Doe,

    One anecdote is not proof of anything.

    I agree with you that people who are unfairly and unwittingly given benzos by their doctor and then get dependent on them should have a platform.

    However I think people have a responsibility to investigate the prescriptions they are given and vet the potential harms / side effects / dependence risk before they take the drugs. While ideally doctors could be trusted to adequately inform clients of risks, this is not the world we live in. Far too many Americans naively trust their doctors rather than doing their own background research. If more people took an attitude of skepticism and double-checked what their doctor was telling them, many more might find the benzo horror stories online and avoid taking the drugs before things get bad. Easy to say… but I think it’s important to encourage people to proactively take responsibility for educating themselves, ideally before taking any drugs, as sites like RXisk enable. Otherwise increasing numbers of people will fall victim to the culture of victimhood, passivity, blaming, and ignorance that is far too widespread in America.

  • Yes I agree Fiachra and it’s amazing how almost any proactive option for dealing with emotional suffering – exercise, meditation, joining a social club, going to psychotherapy, getting more sleep, buying a pet – is both less harmful than psychiatric treatment (due to less side effects and pessimism) and at least as good if not much more effective at helping over the long run.

  • Richard; thank you, I don’t know so much about benzos as about other areas of emotional suffering so that’s why I don’t comment too much. I did not know much about iatrogenic dependence before I read J. Doe’s earlier articles.

    Yes it was lucky that I did not take the benzos that I took, Valium and Klonopin, for too long. They are so different from antidepressants in how they “hit you” with an immediate effect right away. In this way they can be profoundly addictive. I assume you have not taken them yourself?

    I think biological psychiatry must be attacked from all angles by many more service users/professionals than is happening currently if it is to be seriously undermined. I am your faithful ally in this effort.

    Funnily enough right now I have a little addiction to 5 Hour Energy (in other words to caffeine shots). I’m quite relieved it’s to that and not to benzos…

  • I agree with Richard’s thinking here. J Doe seems to have the notion of an all-or-nothing divide between iatrogenic dependence on benzos vs. addictive use of benzos. Reality is not so black or white. These problems must exist on complex continuums where people can have different degrees of one or both going on simultaneously, as Richard implies.

    I think focusing excessively on what the doctor does on prescribing and “causing” iatrogenic dependence, as J. Doe does, could be a defense against examining how one’s own choices – perhaps unconscious ones included – and life circumstances led one to take benzos in the first place. It appears to me to be a position that reduces agency and personal responsibility for the person taking the benzos, seeing them as a passive victim…

    Obviously we should be much more skeptical of and not trust doctors who prescribe benzos so much in the first place.

  • Agree with this comment Katie. The whole dialogue around discussing “severe mental illness” with its presumption that such people are fundamentally different from those “without severe mental illness:”… with their trauma/deprivation mostly ignored… it is a different universe these people like Pies are living in. The projections they make onto clients make any real dialogue or understanding virtually impossible… Psychotic and severely depressed rarely get truly well when the diagnose and drug approach is used. The focus is always on maintaining power/authority of psychiatrists and raking in profits for their masters the drug companies. People need to identify individuals like Pies as what they are – predators seeking to define vulnerable people according to their fraudulent mostly-biological model of human distress – and act accordingly, i.e. avoid/free oneself from “treatment” if at all possible.

  • A very good one, thank you Rossa. Because I didn’t believe in the brain disease lie and got help, I am no longer psychotic, work full time, own my own house, own my own investment property, run my own Meetup events where I have many friends, don’t have any remaining severe psychiatric “symptoms”, and am generally doing well.

    It will be obvious to others that you are not responding to the data or questions in play, but avoiding and rationalizing… the tactics of someone who doesn’t have a real argument. As for me saying that most people on MIA are dumb… where did I say that? Stop making stuff up…

    It’s nice to rationalize that people labeled “schizophrenic” are some hyper-enlightened version of humanity, but the fact is still that being severely psychotic sucks for many reasons noted above…

  • Ok here it is Rossa: dumb people are more likely to get labeled schizophrenic:

    Now where are your studies showing that people given this label are smarter?

  • Harold Searles is probably the most famous analytic therapist who ever worked with people labeled schizophrenic. He treated them for about 30 years at Chestnut Lodge in Maryland. His books Countertransference and Related Subjects and Schizophrenia and Related Subjects are some of the most insightful and human understandings of “schizophrenia” out there.

    In the quote I gave, Searles was talking about how while some people had the sympathetic idea that “schizophrenia” conferred unique advantages or insight on people, the reality of the chronically psychotic people he saw was that they were unable to function, unable to have healthy emotional relationships, and generally very hopeless and scared. So on the balance being severely psychotic is not a good thing for most people labeled with these so-called disorders.

  • Hmm, this is an interesting article Richard.

    I confess I have long thought of many, not all, long-term benzo users as being addictive in their use of the drug. It is obvious that benzos can be used by (again many, not all people) as a way to distract oneself from and numb difficult thoughts and feelings… in a similar manner to illegal drugs like opiates. I took benzos myself (Valium)… and could sense right away that the calming/emotionally relaxing sensations one gets from benzos could be profoundly addictive. I sensed the danger and stopped using them after less than 3 months, before I could get profoundly attached to them. It was difficult even then to stop, but I realized it would get worse later.

    As Peter Gotzsche says, it would probably be better if all these drugs were removed from the market. Benzos are mainly a way to dull down feelings of distress when better options of facing reality – talking to friends/family about your life problems, psychotherapy, exercise, having enough money and a job, etc. – are not available or are not easy. Their main function is to profit psychiatrists and drug companies, and perhaps secondarily to help people self-medicate and avoid facing their issues, as I was starting to do with them at one time.

  • Corinna,

    I think we may underestimate just how very powerful the drug companies are and how they have infected the thinking, functioning, and funding/lifeblood of mental health professionals and organizations through this country. Most mental health professionals are much more interested in maintaining their income – which automatically means maintaining the myths about life problems being illnesses treating with drugs – than taking an honest look at what is really going on. Who would put themselves out there and be honest if it meant losing their job?

    With middle class or upper-middle class people experiencing “mental health problems” – those suffering but with at least some financial resources and social support – I think the goal should be to never engage with the mental health system or if possible to extricate oneself from involvement with it as quickly as possible. The mental health system is like a dangerous cancerous organism that can severely wound and kill if one gets too close.

    For lower class people, they’re often fucked by the lack of resources. It’s a terrible tragedy that if they look for help or get into trouble and get forced into “treatment”, they are met by the idiocy of the “I will diagnose your life problems as a brain illness and you have to take drugs” approach.

    Although I hope I’m wrong, I expect that the next approach at dialogue will be quite similar to this one.

    One of the most important steps to take would be to prevent drug companies from advertising directly to doctors and the public, as in all other countries except New Zealand. At least some people like Bernie Sanders are supporting this. I think we should support and call for this initiative. This would change professional and public opinions if less people were being bombarded by misinformation about drugs.

  • As Harold Searles wrote, approximately “People with schizophrenia are not some hyper-enlightened variety of human being; they are indeed ill.”
    If you have evidence that people labeled schizophrenic get cancer much less often than those not so labeled, let’s see it Rossa. If this is true there should be some online studies or abstracts you can link…
    If you have evidence that most people labeled schizophrenic are smarter (and smarter in what way?) than the rest of us, let’s see that too. I think that is BS. I bet most people given that unfortunate label are more frequently uneducated and with a low IQ…. given how getting such a label correlates with being poor, uneducated, etc.
    It may be true that people who are severely psychotic are more empathic and sensitive to some, not all things than are people who have not undergone such experiences.
    Your relative, i.e. an anecdote, is not proof of anything.

  • Also Oldhead, it is unfortunately true that people who get labeled schizophrenic – which is just a label – tend to often have very miserable lives… this is simply because they more often get hosed down with antipsychotic drugs, discriminated against, and because they are often the victims of poor parenting and neglect/abuse… not because they actually have any disease called schizophrenia. All of these discussions are theoretical and correlational at a group level… not about what any individual experiences… and yes, I agree with you that the imagined group (“schizophrenics”) is largely arbitrary, artificial, and inappropriately reified.

  • Oldhead, we have had this conversation before. The semantics of this are very difficult. I am aware that the term schizophrenic is just a label given to people, as you know. Psychotic experiences that we call hallucinations, delusions, apathy, voice-hearing, etc are real… but individual and varied in every person who experiences whatever they experience. There is no single illness called schizophrenia with any genetic or biological basis, as we know… The word psychotic only refers to a syndrome of related experiences, not an illness.

    I do consider working full-time and getting married as correlating with well-being at a group level, yes. But it doesn’t at all mean that people cannot be very well and happy without being married or working full time. You are right about that.

  • It’s hard to understand what you are saying most of the time, but this is clearly a foolish comment. People labeled as schizophrenic die decades earlier, rarely work full-time or get married, have far higher levels of all sorts of physical illnesses, and generally lead miserable lives drugged up on antipsychotics. Being severely psychotic sucks and is something to become free from, not tout the benefits of.

    Also, schizophrenia is just a label given to people, not an illness people have. The idea you have seems to be that there’s some fundamental difference between schizophrenics (not a great word to use) and other people. And that’s just bullshit.

  • This is correct. Economic arguments are crucial. And economic arguments will almost certainly favor approaches like Open Dialogue which use a non-medical low-drug approach. This should be a primary focus of researchers doing pilot studies of Open Dialogue, to track reduction in hospitalization/costs to taxpayers in the years following intervention. This could be a powerful weapon against establishment psychiatry.

  • Come on dude… “all this site does is cancel out the zealotry and extremism of the APA”… even you know that’s bullshit.

    A lot of people on this site are honestly sharing about their experiences from different angles, as service users, as people developing new ways to help those suffering… some of them are even people who take and benefit from psych drugs.

    No one will take you seriously if you come on here and accuse Whitaker of putting things in “black and white/polarized terms”, but then you make a comment like that.

    Did you not hear the part where Whitaker acknowledges there are at least some people who need and benefit from psych drugs? He has said that many times. It seems you are unable to hear it.

    Also, Hassman, how do you justify writing on your own blog that MIA is run by “personality disordered folk” (people you don’t even know)? That’s just childish, and ridiculous, because you can’t diagnose people from a distance and be taken seriously…

    Other readers, I hope MIA will leave Hassman’s comment on here as a good example of a very narrow-minded and judgmental psychiatrist.

  • Wow what a heartbreaking story.

    This arrogance of the idiot psychiatrists enrages me… more must be done to stop these pieces of shit from ruining more lives and killing more people.

    Surely one of the biggest things that could be done in similar cases to this is to sue the psychiatrists involved in criminal court. Maybe that’s not possible due to lack of witnesses or lack of access to records. But a knowledgeable lawyer who knows what we know about the limitations and harms of psychiatric diagnoses and drugs could make a powerful case.

    As I’ve been writing in other comments, it’s only fines, disbarment, or prison that will make these professional sociopaths – psychiatrists – stop.

  • Here is an interesting chart to look at showing how abysmal the US sickcare system is:

    The US is spending an astounding 150% more than other advanced nations on average for its healthcare, and yet its people live less long than the average person in other advanced OECD nations.

    Antipsychotic drugs can be tied into this overall picture. They are just another area where corporations and their doctor-lackeys lie about the need for large-scale “treatment” (in this case, based on fabricated “disorders”), and then outrageously overprice the drug while bilking insurers/their clients, in order to gouge the middle and lower class people who are deluded into believing they need said treatment.

    It is strange to be a rare undrugged person living among so many ignorant, docile, drug-taking sheep.

  • Good post Robert. I find it interesting reading your analyses as they come from the mind of someone who is a journalist with a very analytical, investigative, logical mind… and I presume not someone who suffered from severe “mental illness” or treated those suffering from it… but someone whose distance from having or treating the problem gives them, to my mind, a certain objectivity that it might otherwise be difficult to have.

    Let me comment as I read through, from my perspective as someone who took antipsychotic drugs for years and was in extreme “psychotic-like” nonfunctional states as a young person…

    I would read these statements from Frances, “psychotic presentations vary greatly in cause, severity, chronicity, prognosis, and appropriate treatment”… as an admission that problems labeled schizophrenic are primarily non-medical and that his profession’s position on severe psychosis being a brain disease is a fabrication.

    It is ironic to hear this man, Allen Frances, who I call Janus (after the Roman two-faced god) because he first presided over the massive increase in medicalization/diagnosis, then once he had profited to the tune of millions, turned into a critic… it is ironic to hear this man admit that “antipsychotics… (are) a last resort”, and even admit that they shorten life expectancy, and yet he is so focused on defending them.

    The problem with the notion of “the severely and chronically ill” and “the good and bad prognosis patients” is that there is no reliable way of identifying who passes the boundary and qualifies as severely ill… and given certain interventions, some who are severely ill may move out of that area of the continuum and become moderately / mildly “ill”, to use the inappropriately medical language for emotional suffering. Thus “prescribing drugs properly” is going to be very difficult given the lack of precision or validity of psychiatric diagnosis. In fact, it is impossible.

    Prognosis is an inappropriate word for human emotional problems. Our struggles are too complex, individual, and modifiable to be split into “good and bad prognosis.” In this regard, Frances is thinking in a simplistic, split way reminiscent of borderline thinking…. this is the fantasy that psychiatry is an objective medical discipline. It is not, and it never will be.

    Meanwhile, Frances’ ideas do not consider very much what the client and their family want. The idea, as usual, is of doing what the psychiatrists consider best, as if their view should be valued more than the family and the experiencer.

    One should ask, about Pies’ title: “Effective and often necessary”…. Effective at what? The answer is effective at dulling down the person’s ability to feel so that they are progressively less able to deal with their emotional conflicts or to function.

    As for “schizophrenia”, Pies’ writing is already dead and buried at this point. The ignorance and stupidity of this assumption are incredible… There is no schizophrenia distinguishable from other psychoses: Here is Van Os’ manifesto again making this point –

    Every young psychiatrist should be required to read Mary Boyle, Richard Bentall, Jeffrey Poland, Stuart Kirk, Jim Van Os, to understand that the notion of a discrete entity called schizophrenia is an illusion. It’s not there. A real continuum of psychosis does exist, and people at the severe end of it tend to get labeled schizophrenic. But there is no reliable way of determining when someone is or is not in that part of the continuum, and that part of the continuum is not a discrete disease. This paradigm of psychiatry is so last-century… is it too profitable to give up?

    Furthermore, Pies writes that many people labeled schizophrenia have a very chronic course… that is false, and is a borderline blatant lie on his part. He really should know better. The WHO studies and the Vermont study refuted this myth long ago… 70% of the people meeting criteria for so-called schizophrenia in Open Dialogue got completely well… 75% of those in the Gifric program in Quebec, who were all schizophrenic, got well… how does Pies not know this? Is he really an expert? I feel sorry for the people labeled schizophrenic that have to see Pies as their psychiatrist….

    Robert, you should have made the case that schizophrenia is not valid… Pies is very weak in his support for this fallen idol, schizophrenia. Challenging this diagnosis in America must eventually be done.

    Ok, now I read further… train of thought going while I read the article… and see that you did this! Wow… great. The “group of schizophrenias” is an acknowledgement of the continuum/spectrum-like nature of psychotic experience. This was known by psychiatrists like Bleuler/Kraepelin long before Pies… people who were wiser than him, apparently.

    It will be interesting to see if Frances or Pies acknowledges or addresses the diagnostic problem. They probably will not. It is their Achilles heel… Denial and avoidance must be used by them to protect the holy grail that does not exist… schizophrenia.

    You are right that a treatment based on unscientific diagnoses cannot be evidenced based… yep…

    Even if drugs do reduce psychotic symptoms more than placebo in the short term for newly diagnosed people… it does not mean that they are “better” than not having drugs. Psychotic experiences can be meaningful and voices/hallucinations can be useful cues about past relational trauma and what a person is terrified of. Terror is the core of psychosis… and if a person cannot face their fears with a supportive other, they will probably not get better. Thus even if drugs do damp down the “symptoms”… it doesn’t mean they’re “better” for the people they are given to. That is the judgment of the psychiatrists. It’s not our judgment.

    Again, relapse is not necessarily a bad thing to be terrified or avoided… a return of psychotic experience can indicate that very difficult emotions are being triggered, and this can be an opportunity to work things through in a different way. One must examine the assumptions behind what psychiatrists say and do… so often they are just bullshit.

    In this picture here – – “Autistic-presymbiotic schizophrenia” – is the “poor prognosis” group that they are talking about… the most severely disturbed people who have often been through the most horrendous abuse and neglect. These are the people considered by psychoanalysts of old to have “nuclear or process schizophrenia” and today considered as the most severely mentally ill. But their prognosis can actually become good given sufficient support over a long enough time. Rinsley and Searles wrote about this type of long-term work… rarely available today. You can see in the diagram that “schizophrenia” is not distinguishable from “borderline” which is in turn not distinguishable from “narcissistic/neurotic” etc… problems fade into one-another; there are no discrete illnesses in early emotional development.

    To add to the “no drugs, good outcomes list”… would be the data from Gottdiener’s meta-analysis available on psychrights, the 388/Gifric program’s results from French-speaking Quebec, the outcomes for people in Mauritius who were labeled schizophrenic before drugs reached the island… written about by Matt Irwin and available on psychrights, the results achieved by many ISPS therapists and written about in books by authors like Vamik Volkan, Bryce Boyer, Ira Steinman, Murray Jackson, and others…

    What Frances should admit is that American “schizophrenics” have a quality of life that – mostly sitting at home, watching TV, not working, or even on the streets and in prison – that is much worse than people in poor countries who are less often given drugs. The WHO results by Hopper supported this idea, and the recent international study by Haro confirmed that advanced-nation psychotic people are still doing worse, although now that more drugs are in poor countries they are doing worse too. Results overall for psychiatric treatment are not good. It sucks balls. People hate it…

    “What shall we do?” Great, provocative question.

    Thanks for encouraging dialogue with this article Robert…

  • Wow thank you Kermit. What a fantastic report. Your passion really shows through in this. I am with you; I love Open Dialogue’s approach and have been telling many people about it.

    I think Seikkula’s 3 outcome studies are very convincing and the philosophy behind it is so right.

    Also, think that most of Open Dialogue’s core principles are not so different from the core ideas behind depth psychoanalytic psychotherapy with psychotic people – respect for the individual, providing immediate help, honoring of otherness, focusing on intersubjectivity. Where OD differs is largely in the greater focus on the social network and the team.

    It should work… showing someone love and using the strengths in a person’s social network should work anywhere. There is no reason it can’t work outside of Tornio.

  • I agree with pretty much everything in Paula’s article. The one thought I have is that people (arbitrarily) given mental illness labels are probably a bit more violent, on average than people not given such labels. Of course the labels are an artificial distinction for a complicated spectrum of problems of increasing severity in different contexts… but the logic would be that people who are more often enraged, terrified, and delusional may tend to lose their temper a bit more often than people who are more well-adjusted and less often upset. Furthermore, most violent criminals in prisons would probably get labels of borderline disorder or sociopath if they were evaluated by a psychologist. So I think there probably are links between early childhood abuse/neglect, violent behavior, and mental health labels, at least if one looks in certain places like prisons.

    However, even if true this changes nothing about what Paula said. Whether or not people given these false labels are a little more violent than some other arbitrarily selected group, they have rights and should not be forced to do things nor be lied to about the nature of their distress.

  • This is why I’m glad I don’t work in reforming mental health. It is so much better to leave the “System” and be involved in a regular job with relatively “normal” people. With my website, I mainly try to speak to people from an independent, external 1-to-1 position about leaving the System, i.e. not believing in one’s diagnosis, stopping taking drugs if possible, stopping seeing psychiatrists, and how to find an effective non-medical psychological therapist.

    Arguing with ignorant sheep about whether life problems are brain diseases and whether drugs are necessary is mostly a waste of time… one does get jaded by it after a few years. Most of these people who believe in the medical model don’t even know what they’re missing.

    The existing behavior control system is basically a con game designed to generate billions in profits for the drug companies and to control undesirables (i.e. people acting in ways that scare others). If the profits are seriously threatened – and they are threatened by the truth that drugs are rarely absolutely necessary, that drugs don’t do jackshit for most people in the long run, and that life problems are not brain diseases – then those introducing those truths will be attacked. One’s energy is better directed elsewhere rather than arguing with ignorant bleating sheep and fighting the drone-like minions of the corporations.

  • Ron,

    I too think it may be exaggerated when people say things like, “People with severe mental illness live 25 years less than normals.” It’s almost a laughable statement when you think about how concrete and reductionistic it is. These problems occur on a continuum with so many factors influencing each case positively or negatively.

    What is not exaggerated is the horrifying reduction in quality of life that results from childhood trauma/deprivation compounded with being lied to that you have a brain disease. This results in chronic terror, ontological insecurity, and being unable to do the things most people want to do because you can’t get the psychological or social help you need. The scale of these losses is just terrible for most people labeled schizophrenic. Given the awful quality of life of most people who are maintained on neuroleptics for life, it’s a mercy if most of them die a few decades sooner.

  • Thanks Ron for this post.

    Regarding Open Dialogue I am pleased to see that a new trial of Open Dialogue has been planned and is rolling out in Atlanta, Georgia. I expect that this news will be forthcoming on MIA.

    Something you didn’t get to write much about is the severe costs that are incurred when workers in the mental health system promote the myth that psychotic experiences are evidence of a brain disease. The cost is 2-3 decades of most psychotic people’s lifespan (through coerced drugging and transmission of a hopeless view of one’s problems as a brain disease), countless lost opportunities for the psychotic person to heal and have a normal job, friends, and family, and untold excruciating suffering for the psychotic person and their family.

    In this regard, many parents who buy into the disease model view – as an understandable short-term strategy to protect themselves from unbearable ambivalence or guilt about their childen’s situation – are in fact condemning their children to a nightmarish half-life as zombified, nonfunctional, pilltaking sociall outcasts. This is the sad reality behind the many ignorant, foolish parents who post on NAMI websites and other similar forums lamenting their children with “brain diseases”. The costs of these simple-minded, often poorly educated parents’ delusions for their children’s future wellbeing are very severe… and many of the parents never even realize that with better information, they could have restored their child to a full life. Or, they realize much too late, after their child is dead or their best years have passed them by.

    I think the reality that views refuting the medical model of “schizophrenia” threaten Big Pharma money and psychiatrists’ status as medical doctors are also important. Big Pharma and psychiatrists stand to lose much if the fact that good evidence for the brain disease hypothesis of “schizophrenia” is very weak or nonexistent is revealed. This explains why the most primitive defensive operations can be seen in the tragic babbling of biological psychiatrists and NAMI parents about “severe mental illnesses”. Primitive defensive operations meaning denial, avoidance, projection, and projective identification. That is what people do when they don’t have a real argument – they fabricate things to protect their interests. And we can see this happening with these groups.

    Vulnerable, troubled parents – many of whom are subject to “borderline” and psychotic processes themselves that were partly responsible for their children’s breakdown – must be enabled to see how much they and their children could gain from more effective approaches to psychosis. That is where Open Dialogue could be so valuable. Ignorant parents will not abandon the myth of the disease model until they have something better to invest in that they feel does not blame them. Hopefully in the next few years Open Dialogue research in the UK and the USA will support the efficacy of this approach and provide a real alternative to threaten the diagnose and drug approach.

  • Younger age is one of the many things which lead to and is linked to ADHD… along with cycles of the moon, horoscopes, the movement of the tides, how the psychiatrist is feeling on that particular day, what psychiatrist the kid happens to go to, how much the psychiatrist needs to get a client by prescribing Ritalin, and so on…

  • I agree… I see what you mean… it’s two sides of the same coin. Can’t be really diagnosed, can’t be overdiagnosed, can’t be underdiagnosed, it’s a fake diagnosis which doesn’t exist, etc. What I mean is something nonexistent can’t really be diagnosed at all with any validity…

    There’s really no “it” in the first place. There is no ADHD.

  • Carrie,

    I liked your story and agree strongly that most psychiatric models of “disorders” and “recovery” totally ignore context and environment as important shapers of human behavior and adaptation.

    I agree with your criticism of Laing’s notion of psychosis as transformative or a possibility for self-exploration. I did not find this either; rather experiencing psychotic states as a life-threatening nightmare to be escaped from at any cost possible.

    Your writing touched upon a point I often feel… that “recovery” is a misnomer for getting better from an emotional breakdown. It presumes that a state of normality of health predominated at some point in a person’s life, followed by suddenly becoming “ill”… followed by (hopefully) a return to the original state of functioning. So, point A, then point B, then point A. Of course this model would be hopelessly simplistic. Better words for what people strive for are maturation, wellbeing, personal development, safety, fulfillment, salvation, deliverance. Not recovery, which is a covert Trojan horse word of the medical model.

    I have to criticize this:

    “When contemplating the aetiology of illness and the possibility of recovery, I’m frequently reminded that lupus has no cure, that bipolar disorder has no cure, that I must learn to live with them as I would learn to live with obnoxious neighbours.”

    I am not sure if you believe this lie (that bipolar disorder has no cure), or whether you are simply recalling what others have told you – in any case, this is false on multiple levels… it has never been proven that “bipolar disorder” has no cure. The problems with this notion are myriad… on one level, I could argue convincingly that there is no valid discrete condition called bipolar disorder, as numerous writers have powerfully done for “schizophrenia” (e.g. Bentall, Read, Kirk, Poland, Boyle, Mancuso). So, of course a nonexistent disease cannot have a cure… there is no bipolar disorder to compare to lupus.

    On another level, manic states occurring along a continuum between more severe psychotic experiences (often mislabeled “schizophrenia”) and less severe psychotic states (often mislabeled “borderline personality disorder”) are real for those who experience them… but if you speak to skilled psychodynamic therapists who’ve worked with people having these experiences (I have spoken to a number of these who’ve worked with many people who were labeled “bipolar”), those people by and large have gotten better, and in some cases never had manic episodes again. So freedom or “cure” (an inappropriately medical word) for people supposedly having “bipolar” states is quite possible… contrary to what you have been told.

    I have had psychotic and borderline experiences myself and am speaking from experience that they are transformable / “curable”, in the inappropriately medical language. So, I’m not talking down to you. I encourage you to join me in refuting the notion of the incurability of these “disorders”… and to not even believe in the validity of said “disorders” as medical conditions… as hopefully you already do (not).

  • Maybe we should get art drawn by biological psychiatrists, showing how they experience the world as a grim, Kafkaesque, colorless place in which human drones (more like walking human dollar symbols) enter their offices for 15 minutes at a time to receive their tranquillizers, before abruptly disappearing, with the psychiatrist knowing nothing more about them as people than before they entered…

  • It is ironic how writers like Levy, and a number of other commenters and writers on MIA, go conspicuously silent when this criticism of the word choice “medications” is brought up. To me it shows that they are partly under the sway of the medical model. We should remember that all that has to happen for the enemy to win is for good people to do nothing, to be silent…

  • That is terrible.

    I would like to see some statistics on what proportion of people taking neuroleptics are getting these forced long-acting injections… I doubt it’s a large proportion of the total, but that could be wrong. These are the cases you hear about the most, the very horrific ones… it happens most often to people who are poor and cannot financially move away or support themselves, i.e. escape…

  • The medical model does have much false credibility, Even, but challenging it has to start somewhere. Once upon a time, things like women not voting, black people being enslaved on farms, and the Earth being flat had credibility. But those changed, even though when they were first challenged, those bringing the new ideas were dismissed as crazy. The change has to start somewhere and bringing legal challenges like this is a place to start.

    Perhaps the legal writer on this site you mean is James Gottstein.

  • Oldhead, I know that they don’t deserve it really; you are right. It’s just the cynical side of me coming out. The bullshit about mental illness spouted by the establishment can make anyone a bit jaded after a while. I need a vacation.

    It is true that access to information is probably more important than intelligence. However, there are a very very large amount of dumb-sounding mofos going around saying totally delusional things about “mental illness”… maybe that’s just how misinformation sounds.

    And let us not deny… dumb people are out there. 50% of people are below average in IQ, even if 90% of people don’t think they are (and I’m not in the bottom 50 percent… of course not). I bet dumb people are overrepresented among those who believe mental illnesses are real brain diseases for which you have to take drugs. Of course it’s not their fault and these people are even more in need of accurate information than those who are smarter and/or more educated in other ways.

    And I am a skeptic by nature and I rarely accept what corporations or the mainstream says. In fact, if the mainstream or corporations are saying something, I usually automatically suspect that it is false or not the whole story.

  • I am tempted to say that most American people deserve what they get, since they are mostly not smart enough to educate themselves about what is really going on with psychiatric diagnoses and drugs… instead, the mindless sheep continually bleat about not finding the right drug, about lack of resources for “mental illness”, about the hope for future breakthroughs in treating “brain diseases”… these things ain’t coming baby. If you want to get better you have to extricate yourself from the system and find your own way.

    Sometimes I have the thought that natural selection is operating in a particularly cruel way through American psych hospitals ruining people’s lives and stopping them from having jobs and families.

  • The other way would be to come from a family with at least some money and ability to support you, and to either move geographically or to lie to those in the local system and self-taper off the drugs in secret. Unless they have started somehow intrusively monitoring whether people actually take drugs at home (or measuring drug level in bloodstream somehow?), it should be possible to get ones prescriptions, get money from the government, but throw the pills away…

    I think if someone is poor and dependent on the system for money, it must be very very difficult.

  • Having been a “patient” in a mental hospital years ago, I know how this works Stephen… psychiatrists certainly do not deserve to be paid what they are for dispensing mostly useless pills for illusory “illnesses”. The practice of psychiatric drugging in mental hospitals is one of the biggest scams, perhaps the biggest, scam going.

  • Rachel, I would question why you call psychoactive drugs “medications”… giving that the “illnesses” they supposedly “treat” are not known to be actual discrete medical conditions, and therefore these chemical compounds are not truly medications that treat physical diseases. That is what a medication is usually defined as, a chemical compound that treats a disease of known physical origin. It is better to admit that psychiatric drugs are not this type of “medication”, but rather substances having generalized damping or amping effects on the central nervous system.

  • I relate to the unhealthy pressures on men very much. I am the son of two parents who went to Ivy League schools, and went to such a university myself. I was also the class valedictorian (highest GPA) in my high school, as well as a high school varsity and college athlete. I was obsessed with beating others in grades and in sports, with my whole self-worth riding on this achievement. During much of this time, I was also struggling with borderline and psychotic states of mind, and the periods where I could not work or compete effectively due to my emotional breakdowns were even more difficult due to the isolation and judgment I felt society had toward me for not achieving enough.

    After college, I was obsessed with making more money than the other men in my work field, and with how women perceived me based on my job success. This continues to some degree to this day. I am still preoccupied with having power over others, with “beating” others, and with being “the best”, even though I know the feelings of omnipotence that I get from these things will not really make me happy.

    But today I am healthier than before… I am able to have intimate friendly relationships with other men (despite not being gay), and do not work 7 days a week anymore. I am also financially secure enough that I do not have to worry about money, and I know that making more money at this point will do nothing to make me happier… once you have enough, more money is just pieces of paper or numbers on a computer screen. And, I do not compare myself to others so much because I know that happiness in relationships and loving oneself are so much more important than achievement. Having said that, I am still very competitive.

    I think it’s important for those men who can to set examples that men can and should have close intimate friendships with other men, that men can and do need supportive dependent relationships with other men and women… that a man’s wellbeing depends on much more than work and achievement… and that it is ok to be vulnerable and open about feelings as a man. In fact, being open and vulnerable emotionally in a man is a sign of strength and of a “real man”, not the false Western ideal myth of the unfeeling, totally self-sufficient man.

  • Steve, the answer is the extinction of psychiatry. Psychiatry needs to be abolished, period. There can be no redemption, no rapprochement, no forgiveness for a profession based on fraudulent lies to the degree that biological psychiatry today is.

  • I agree with that. I guess I should have said… some of the loudest most prominent voices that many people identify with psychiatry… I agree that psychiatry is a discredited rogue psychiatrist, more like a POS.

  • Also, psychiatric medication is a misnomer… there is no psychiatric medication, since medications treat a specific disease. Rather, there are neuroleptics and psychoactive drugs of various kinds. It’s best to admit this instead of trying to pretend that psychiatry is a real field of medicine giving “medications” for real “mental illnesses”…

  • I like this idea, “Depression is an opportunity”. It is a signal… makes me think of the Chinese understanding of crisis.

    To Dr. Brogan, I wonder why if you do not believe in the core tenets of your field… why you continue to identify and practice as a psychiatrist?

  • John,

    These people are not going to respond to you. Why don’t you try to engage a pro bono lawyer on behalf the family to sue the psychiatrists and the hospital? You could educate him on the issues involved and be a key expert witness. This case might make a difference for GD and it could also set an example which would deter psychiatrists from future similar conduct. You’d have to do some research to find a lawyer willing to take the case… but I think it would be worth it.

    I was recently involved in a legal case against a property management company. My business partner and I spent months writing letters and emails complaining to them and asking them to rectify their mistakes. We even complained to the state licensing board. All were ignored. It was only when we took them to court and sued for a large amount of money that they responded. And we beat them in court. They eventually had to settle, and they were shamed.

    These people act like legalizd mafia or cartels protecting their “turf”… they care nothing for their clients or constituents. But if the court system still works in Australia, you should help the family to bring a lawsuit to sue the psychiatrists involved… you’d have a strong case given the lack of evidence on their side.

    I encourage you to do this and report the results later this year here on MIA.

  • The t-shirts thing is funny and pathetic. This suggests to me that I should design some anti-psychiatry t-shirts and have them airlifted and mass-dropped over British psychiatry training programs. The t-shirts would be covered in slogans like, “I couldn’t be a real doctor, so I chose psychiatry”, “If only we had even one valid diagnosis… The Lament of a Psychiatrist”, “What medical profession’s treatment only work better than placebo 10-15% of the time? (Hint, Psychiatry)”…. etc.

    As I was saying in the MIA report on this topic, criticizing psychiatry’s fraudulent diagnostic system and ineffective, harmful “treatments” is not only not a bad thing… it is something that should be encouraged, legitimized, and increased. These criticisms should be pursued with relentless, targeted focus. The goal should be to make psychiatry into a pariah of a profession that no young student wants to participate in due to its terrible reputation, contributing to its collapse due to unavailability of new trainees. Psychiatry should become… already is… the new alchemy, the new witchcraft, and the new astrology.

    The word “bashing” is inappropriate, suggesting that attacking what most psychiatrists in America do is unprincipled, gratuitous, and undeserved. But nothing could be farther from the truth. Mainstream psychiatry’s own leading figures have condemned its fraudulent diagnostic system; accumulating research continues to point to the woeful lack of efficacy of its main “treatment” (drugs), and leading psychiatrists like Pies, Wessely, Torrey, Carroll, etc. remain unresponsive to legitimate criticism.

    As to the notion that “bashing psychiatry has the wider effect of stigmatizing people with mental health disorders”… what a sad sack of shit from these nondoctors (my word for psychiatrists). First of all the “disorders” they reference are not even valid conditions. Secondly, the main reason for the existing stigma is the lies these guys have been putting out about a biological/genetic component to said “disorders” that supposedly (not really) makes the people so-labeled fundamentally “other” and different than “normals.”

    Saying “psychiatrists are not actual doctors” and “psychiatry is not real medicine” is not “bashing”… it’s called facts, people 🙂 Saying “psychiatrists are not real doctors” is like saying “hippos are not antelopes”… it’s a fact.

    Ironically, Wessely was quite correct to say that psychiatrists are wasting their time by training in this field. Well… wasting their time as far as providing real help to most clients. Not wasting their time in terms of getting paid 3-4x as much as most mental health workers without doing anything significantly more to deserve this increase.

    And mentally ill patients, whatever that means, don’t deserve or need doctors at all for the most part… they deserve competent therapists, if they so choose.

    If anyone from the APA or the Royal College of Psychiatrists is reading this and you’d like to hire me, a psychiatric survivor, to give a keynote address about the future of psychiatry at your 2016 conference, please inquire within. I can be reached at [email protected] . My speech would sound pretty much like the paragraphs above…

  • It’s based on black people being diagnosed with “schizophrenia” at a rage 200-300% the rate of the general population; and my assumption that most or almost all of these people are drugged. If you do a Google search for “schizophrenia racial disparities” or “schizophrenia overdiagnosed in African Americans” you will find the data.

    It’s not black people’s fault that they’re more often poor, abused, neglected, discriminated against, etc. than other races; all things that correlate with being more likely to get these labels per the ACE study…

  • Here is the beginning section of a long essay I’m writing refuting the NIHH and NAMI’s position on “schizophrenia”. I have written it using some medical language, in order that those deluded by the medical model will be able to find it in the first place. I hope readers here find it interesting… still working on finishing this piece:

    How to Cure Schizophrenia: Eight Stories Proving that NIMH, NAMI, and APA Are Lying to the Public about Schizophrenia’s “Incurability”


    Pro and Con: A) Seven Experienced Therapists Saying Schizophrenia Can be Cured
    B) Three Psychiatric Organizations Saying Schizophrenia is Incurable

    In this essay I’m going to show that “schizophrenia” can be cured via intensive psychotherapy.

    First, I’ll quote seven experienced therapists who helped formerly schizophrenic people become genuinely well. To those who believe that schizophrenia is a lifelong brain disease, such hopeful statements may sound impossible. But consider that these quotes come from people who have worked intensively with hundreds of schizophrenic clients in long-term psychotherapy. The quotes that follow come from bureaucrats or psychiatrists who, for the most part, have never made a serious attempt to understand people labeled schizophrenic psychologically:

    Seven Masters Therapists On Curing Schizophrenia

    Italian-American psychoanalyst Silvano Arieti, commenting on his decades of experience doing intensive psychotherapy with schizophrenic clients,

    “If by cure we mean the reestablishment of relatedness with other human beings, closeness with a few persons, love for the spouse and children, a reorganization of the personality that includes a definite self-identity, a feeling of fulfillment, or of purpose and hope – and this is the cure we want – the answer to this question (“Can Schizophrenics Be Cured?”) is still yes. In my experience we can obtain these results in a considerable number of cases.

    I have already mentioned that, as a result of psychotherapy, many formerly schizophrenic patients achieve a degree of psychological maturity far superior to the one that existed prior to the psychosis… In reviewing the cases of schizophrenic patients that have been treated with intensive psychotherapy, I have come to the conclusions that my optimistic predictions proved to be accurate in by far the majority of cases.”

    (From “Interpretation of Schizophrenia”)

    Italian psychotherapist Gaetano Benedetti, commenting on his study of 50 schizophrenic patients given psychotherapy for an average of 5 years each:

    “These formerly schizophrenic patients made remarkable clinical, interpersonal, and social improvement, often leading to complete healing… These cases show that there is a correlation between the deep affection of the therapeutic relationship, clinical improvement, and maintenance of post-therapeutic contact… All the patients, through letters, phone calls, or occasional sessions were eager to show the therapists their social and emotional improvement.”

    (from Psychotherapy of Schizophrenia, chapter 17, “Individual Psychoanalytic Psychotherapy of Schizophrenia”).

    American psychoanalyst Bryce Boyer, commenting on his study of 17 schizophrenic patients in long-term psychotherapy:

    “The psychotic core was fundamentally altered, as a rule, within two years… Fourteen [of 17 total] schizophrenic patients appear thus far to have outcomes which can be classified as satisfactory, or in some cases, most encouraging… It is suggested that the psychotic process is reversible in some patients and that we, as analysts, might aim not at encapsulation of at least some psychoses, but at their cure.”

    (Psychoanalytic Treatment of Schizophrenic and Characterological Disorders, Chapter 3, “Office Treatment of Schizophrenic Patients”).

    Turkish psychoanalyst Vamik Volkan, commenting on his six phases of long-term psychotherapy for schizophrenics:

    “If there is no interference from the environment, and the therapist commits no major technical errors, the schizophrenic patient will visit his terror and emerge from it with progressive development… After this experience the patient no longer feels like a “bad seed” with a core full of “bad” affects. When the infantile psychotic self is dissolved, the patient will never again be schizophrenic… Only in the termination phase is the formerly schizophrenic individual expected to mourn genuinely as an adult on leaving the analyst. With most former schizophrenics, mourning continues silently for many years after treatment has been concluded.”

    (The Infantile Psychotic Self,

    American psychoanalyst Lawrence Hedges, commenting on the transformability of schizophrenic mental states, which he calls “organizing” experience,

    “By now the limitations in empathic instruments about which Kohut speaks have been considerably altered so that sustained and reliable empathic immersion in psychotic and borderline states under many conditions is deemed possible. It turns out that the dread of reexperiencing the primordial fear and chaos… can be satisfactorily accomplished.

    All organizing states (i.e. schizophrenic conditions) are transformable… I know of no reason that, given the proper containing conditions, organizing experience cannot be brought into a therapeutic relationship for analysis so that channels once closed off can be analyzed, thereby opening them to human contact and further development.”

    (page 197 and page

    New Zealand-based therapist Paris Williams, commenting on the recovery research about so-called schizophrenia,

    “Myth #3: People Cannot Fully Recover from Schizophrenia… While there continues to be the widespread belief in our society that people diagnosed with schizophrenia generally do not recover, the actual research tells a very different story… The finding that recovery rates are quite high is surprisingly robust. The authors of the largest such series of studies – the World Health Organization – have concluded that “the overarching message is that schizophrenia is largely an episodic disorder with a rather favorable outcome for a significant proportion of those afflicted.”

    “As we have seen, the recovery research strongly suggests that, when supported in a compassionate and empathic environment, psychosis often (and perhaps even ordinarily) resolves automatically. In addition to this, there is significant evidence that a psychotic episode sometimes provides a breakthrough into profound healing and even psychological and emotional growth.”

    (Rethinking Madness, pages 39-41, and page 65)

    American psychiatrist Edward Podvoll, commenting on the recovery journeys of several formerly psychotic men,

    “There is a moment in the midst of madness when things suddenly begin to make sense again. One feels that one has come back into oneself. One has become the “operator”, as Henri Michaux called it. It is an island of clarity where one is suddenly freed from the fixed mind of delusion… Frequently this moment carries with it an uncanny confidence that the worst is over and that one will become well again.” (From “Recovering Sanity”, page 209).

    American Psychiatry’s View of Schizophrenia as an Incurable Lifelong Brain Disease

    Now, compare these viewpoints on the potential for cure and healing in “schizophrenia” with the viewpoint of our National Institute of Mental Health (NIMH), an institution which happens to be funded by pharmaceutical companies:

    “Schizophrenia is a chronic, severe, and disabling brain disorder… Many people with schizophrenia are disabled by their symptoms. The disorder makes it hard for them to keep a job or take care of themselves… Most people who have the disorder cope with symptoms throughout their lives. There is no cure for schizophrenia.”

    Here is what our main consumer-led – and coincidentally drug company-funded – patient-rights organization in the United States, the National Alliance for the Mentally (NAMI), has to say about schizophrenia:

    “Schizophrenia is a complex, long-term medical illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others… There is no cure for schizophrenia.”

    And the American Psychiatric Association; the main organization representing psychiatrists, and also heavily funded by drug companies, defines schizophrenia in this way:

    “Schizophrenia is a chronic brain disorder that affects about one percent of the population… there is no cure for schizophrenia.”

    You would almost think the same person is writing these snippets! While these sources give lip service to helping people with schizophrenia “live well with their illness” and “effectively manage their symptoms”, the underbelly of these viewpoints is that someone with schizophrenia will always be less well than “normal” people, always have “the illness”, and never fully recover.

    To the idea that schizophrenia is incurable, my response is “enough is enough”: this essay will expose the myth of schizophrenia’s incurability.

    Goals of This Essay

    In this piece, I will review the history of psychodynamic psychotherapy for schizophrenia. I will show that major improvement and/or cure of psychotic experience is not only common but expectable in good treatment. Furthermore, many people fortunate enough to access long-term psychotherapy for psychosis (as well as many who get well without therapy) have become enduringly non-psychotic. This is very different from “managing an illness” – these former schizophrenics are able to live, love, work and do all the things that any normal person enjoys doing, free of psychotic symptoms.

    Let me retrace now some of the major books on psychodynamic psychotherapy for schizophrenia, along with Amazon links. Because psychosis is a fascinating subject and a developmental precursor to borderline states, and because I have a family member who has had psychotic experiences, I have spent the last 10 years studying these works.

    What I hope the reader will see is how much literature is actually out there showing that “schizophrenia” can be meaningfully understood in social and psychological terms. Not only that, but these books contain scores of stories of people labeled schizophrenic who become psychosis-free and live a fulfilling life.

    (still working on finishing this; about 40 psychodynamic books to cite and many case studies to summarize…)

  • Michael,

    I recommend you to stop using the word “a schizophrenic” to define a person in your writing. It is stigmatizing and inaccurate. If you would not use the word “a cancer” to label a person who is believed to have a cancer, or “a Parkinson’s” then you should not call a person a schizophrenic…. it is insulting. Of course, “schizophrenia” is not even comparable to those conditions in ontological reality in the first place, maybe this usage even less appropriate, something you should know…

  • Good comment… psychiatry is nothing more than a strip-mining project targeted at sucking money out of the young, uneducated, poor, vulnerable, and distressed (and out of their insurers) by feeding them harmful drugs disguised as “treatments” for illusory “illnesses”. Those turning the gears of the machine are primarily very wealthy, white, male, old psychiatrists and lawmakers. The psychiatric scam is disgusting and despicable and demands a much more forceful response from our citizenry than it’s getting currently.

  • Screening for an absence of happiness does sound like the beginning of an Orwellian totalitarian state… people should be encouraged to be less than happy sometimes… and see it as a possible signal informing them of problematic areas of their lives… most people also don’t need or want a “professional” to “screen” them for “absence of happiness”.

    Being worried, afraid, ambivalent, sad etc are not evidence of illness or dysfunction needing “treatment”…

  • The word “Schizophrenia” usually, not always, implies the user of the term is thinking in a reductionistic medicalized way. There is no schizophrenia, as Jim Van Os and John Read’s research shows, and so we should abandon this word… it almost always is used to refer to the notion that someone has a brain disease that is partly or wholly caused by unknown genetic or biological factors… which is just bullshit since we don’t have that knowledge.

    The Van Os and Read research strongly suggest that along the psychotic continuum there is no way of reliably cutting off certain people as “schizophrenic” and others as “non-schizophrenic”… and that up to 10% of people experience varying degrees of psychotic “symptoms” at some point in their life. “Schizophrenic” processes do in fact become present to varying degrees in so-called healthy or normal people when under severe stress, and in many people held in prolonged isolation, hostage situations, or warzones for long periods.

  • Circa, it is a problem that you think, apparently, that one has to label or crystallize or concretize emotional-thinking-behavioral problems as discrete reified entities with the word “disorder”… one can describe problems as logical understandable responses to stressors and deficits without employing the words “disorder”, “illness” etc, which are inappropriately medicalized and assume knowledge we do not have.

    I agree that there are no mental disorders, in the sense that human life problems do not divide discretely into separable categories that are valid (or very reliable). I encourage you to check out the Formulation narrative approach to life problems (written about on this site by Lucy Johnstone) and the developmental relational approach to emotional suffering (written about by Lawrence Hedges and available for free in his book Relational Interventions at… there are other, arguably better approaches, apart from conceptualizing our behavioral problems as”disorders”. This doesn’t at all mean that the problems people have are not very distressing and maladaptive for their circumstances… but that is different from their being a medical “disorder” or from being abnormal in the sense of not being an understandable response to stressors at a particular time in the past.

  • Right, it’s reasonable and not pathological… being afraid of dogs is therefore not a “disorder” or “pathological” (meaning bizarre/inappropriate/out of context)… it makes sense!

    The semantics of this is what is difficult. What many of us here would like is to be able to talk about life problems without assuming defect or inappropriate medicalized responses in the person who is doing some behavior. Being scared of dogs because they bit you just is what it is, an entirely understandable response to scary dogs. It’s not an evidence of some discrete “condition” one has…

  • Circa, there are always causes and reasons, even if they are invisible to us at a particular time. Adverse psychosocial experiences are the cause of many or most emotional and functional problems (what you call “disorders”) as shown in the ACE Study. It’s also possible that innate constitutional vulnerability to stress, or a lack of support of various kinds, can result in a person evidencing these problems. But such responses are never inappropriate or abnormal if one considers the deeper causes… they always make sense from a certain perspective. Also, they are not primarily medical problems. That is why I think the word disorder is inappropriate.

    Oh and…

    People don’t empty salt and pepper shakers for no reason at all 🙂

  • Disorder is an inappropriate word for multiple reasons, Circa…. including that life problems occur on spectrms or continuums without clear boundaries… and that most life problems the manifestations of which get labeled “disorders”… are not inappropriate or abnormal responses to stress (as the word “disorder seems to imply”… but rather entirely understandable and “normal” responses to abnormal or overwhelming conditions of stress, poverty, neglect, abuse, trauma, and other “bad” things.

  • After sharing this in ISPS, I’m gonna put this on here as well: These interviews below represent the types of results and client-satisfaction we could be having if the focus for psychotic people were more on effective psychotherapy rather than “To Use Drugs, or Not to Use Drugs”…


    Hi All,

    In the last 2 weeks I got a chance to speak to a couple of skilled therapists of psychosis, Gary Van den Bos and Dorothee Bonigal-Katz. I wanted to report a little bit of what we discussed, because I know they want others, in particular young therapists, to hear about their work.

    Gary Van den Bos is the co-author of Psychotherapy of Schizophrenia, which he wrote with Bert Karon. Gary and I live about only 10 minutes apart, in McLean, Virginia outside Washington DC. So we met in person at a coffee shop in McLean because I wanted to ask him some questions about his book and his life’s work, and after repeatedly nagging him I finally got him to meet me. He’s now retired after many years as head publisher of the APA… during which time he also worked in a private therapy practice with many severely psychotic people labeled “schizophrenic” and “bipolar”, often young people who had been hospitalized and started therapy with Gary upon getting out of the hospital.

    Over more than 40 years as a therapist Gary told me he’s worked with over 100 psychotic men and women in serious attempts at psychotherapy, i.e. 1 year or more, usually meeting at least twice a week or more often. Most people he worked with for at least 2-3 years, often longer. He worked most often with no antipsychotic medication at all, or occasionally with low doses, tapering down as quickly as possible.

    Gary said that about 80-85% of “initially schizophrenic” people that he worked with got much better, i.e. became non-psychotic, were able to work, have relationships, and not need drugs. Of these 80-85% , he said perhaps two-thirds were “essentially normal, and you would never know they had had serious emotional problems if you didn’t ask them”… and another third were “mildly disturbed, but feeling and functioning much better.”

    Gary also told me that the majority of young psychotic people he worked with were able to have long-term intimate relationships and/or get married and have families (something which gives the lie to the notion that schizophrenia is a disease innately associated with low fertility… more like associated with rarely getting sufficient help to get well).

    Gary said that he felt it often takes a year or a bit longer for a young psychotic person to begin to develop a trusting relationship in psychotherapy of the kind that can lay the ground for eventually resolving the psychosis. He felt that a large majority of therapists/psychiatrists – perhaps 80% or more, he told me – simply don’t work with “schizophrenia” from a perspective that will work to heal the person, believing mistakenly, rather, that they have a brain disease requiring drugs…. this of course makes the work much harder and often impossible.

    It was great speaking to Gary.

    Then yesterday I got to speak to Dorothee Bonigal-Katz, a psychoanalyst in London, UK… we spoke on the phone after I emailed her and set up a time to speak. I was interested because she runs a “Psychosis Therapy Project” sponsored by a nonprofit mental health charity called Islington Mind. On the charity’s website, not much detail on the project is available so I wanted to find out more.

    Dorothee said that the idea of the Psychosis Therapy Project is to offer people with a label of schizoprhenia or bipolar long-term, open-ended psychotherapy for as long as they want at very affordable, low-cost sliding scale prices. Most or all of the cost is subsidized by the charity.

    Currently, the project has about 14 therapists, including Dorothee, the lead therapists, working with about 45 different psychotic clients. Some of the 14 therapists are young therapists and some psychoanalytic candidates… Dorothee is the leader and tries to teach the younger therapists about effective psychotherapeutic approaches to psychosis. The clients are usually seen 1x or 2x a week, although sometimes 3-4x a week, depending on what the client wants.

    Dorothee said that the setting of the Psychosis Therapy Project is a kind of clubhouse where clients can come for weekly meals outside of their therapy sessions, get peer support from other clients, create art in a drawing room… the idea is to develop a community around the therapy sessions.

    The Psychosis Therapy Project hasn’t done formal outcome research, as its primary goal is to serve its clients, but Dorothee says that most clients are very happy with the therapy they get. Additionally, in the last 2 years, the 45 people in psychotherapy have a 0% rehospitalization rate, and this is in a population of people with a long history of hospitalizations and “sections.” Also, Dorothee noted to me how the majority of clients stay in therapy for the long-term; the drop-out rate is relatively low and Dorothee feels the unpressured environment and the clubhouse help clients stay in contact. Clients are also free to leave for a period and return later, and their therapy doesn’t have any set end date.

    The approach Dorothee teaches (as the leader of the group of 14 therapists) is based on a Freudian, Lacanian, and Laingian understanding of regressed mental states which emphasizes relinquishing labels and assumptions (Dorothee was trained in Paris, France). The Psychosis Therapy Project focuses especially on “listening without trying to fix the psychotic person, without trying to solve their problems right away”. In this, their approach is the opposite of most English psychiatrists and mental health services, who are primarily concerned with “eliminating symptoms” and with controlling behavior.

    Dorothee said that the people doing the best tend to be those who never took drugs or who come off them quickly after hospitalization… .I’ve heard this so many times now that it didn’t surprise me at all.

    Lastly Dorothee talked about The Psychosis and Psychoanalysis conference in London that is going on in a few months… noting that they have 250 signups so far. She encourages others to come.

    It was great talking to Dorothee too!

    I share these accounts of my talks in the hope that you will find them useful, and because I want to generate more awareness that intensive psychotherapy of psychosis, usually with low-or-no drugs, can be very valuable and effective. From reading mainstream psychiatric accounts, one might never know that these kind of successes existed, relatively rare as they are in the sea of overdrugged failure that pervades American and global “treatment” of psychosis.

    The tragic thing is that these positive outcomes could be so much more common, were we as a society to abandon the brain disease-life long drugging model and adopt a primarily person-centered, psychologically/socially oriented, hopeful conception of psychosis and recovery. That would, of course, require giving up most of an average of $18 billion in annual profits from sales of antipsychotic drugs… something psychiatrists and drug companies do not seem too keen on, even though the massive overdrugging contributes to preventing millions of psychotic young people from recovering to the point where they can become enduringly non-psychotic and live normal lives with jobs, friends, and families.


  • I do not think distress is synonymous with defect or flaw. It is a more subjective, experiential, human word. Here is the Oxford dictionary definition of distress:

    “extreme anxiety, sorrow, or pain”

    I agree that psychiatric institutions ought to be abolished, but do not agree that approaches to human pain like Open Dialogue or psychoanalytic psychotherapy are about “kissing-ass your way into a decent living” based on “invalidated notions.” You might want to read more about the approaches in question before you judge them…

  • I agree with the authors that the narratives of psychiatry vs. antipsychiatry get very binary, and falsely position psychiatry as central and more important than other approaches. In reality psychiatry is only central because it is such a profitable scam, not because its ideas have merit or produce good outcomes.

    I suspect that many people would think I am very antipsychiatry – and yes I do have a virulent hatred for biological psychiatry’s core ideas – but I do not even think of myself primarily as antipsychiatry. I want to be pro-what-works best for ameliorating severe distress, which seem to be things like Open Dialogue approaches, psychoanalytic psychotherapy approaches, Formulation/No-Label approaches, approaches emphasizing social and psychological factors, low-and-no drug approaches which respect the individual’s ability to choose, etc. Most of the research posted on MIA seems to be showing that these approaches usually lead to better outcomes and more hope than using diagnoses and primarily drugs.

    To undermine psychiatry and make it obsolete we need better alternatives available; that is what the first focus should be in my opinion, with the arguments around psychiatry itself being secondary. Psychiatry is threatened more by people abandoning it and moving toward what works for them… continuing to focus most attention on psychiatry may paradoxically help psychiatrists stay in power.

    Our nation’s political discourse over the last several years shows that attacking the other side without ever offering an alternative does not inspire people, promote progress, or build unity. We need the courage to be for things that are better than psychiatry.

  • Robert et al,

    Here’s an article on Astra Zeneca’s new drug, Zombiestra, which I found rather entertaining:

    This supports my idea that the main function of psychiatric drugs is to stop people feeling fully alive.

    As Donald (and Mussolini before him) says, “It’s better to live for one day as a lion, than a hundred years as a sheep.” Far better to have the courage to face your feelings and not undergo the process of zombification (drug taking), than to become one of the millions of American sheep who bleat idiotically about having “mental illnesses” and needing their “meds” to keep themselves in “remission.” So pathetic.

  • This is an interesting discussion; while reading it I was reflecting on how rarely I see psychiatrists speak with this degree of openness and awareness of nuance and complexity. Those who are able to look at these conflicting issues together tend to more often be psychologists, psychotherapists, professors in related disciplines, and others whose status and income is less dependent on adhering closely to the biological-defect model. It often strikes me how brittle and vulnerable psychiatrists must feel as they attempt to maintain their house of cards which is increasingly coming under assault as more and more people realize how fraudulent the lies about diagnoses, drugs, and biological-genetic causation of social problems are. No wonder they use the most developmentally primitive defenses – i.e. denial, projection, and avoidance – to such a degree, remaining prisoners of the corporations and institutions that pay their rich salaries.

    While it is nice to think that biological psychiatrists could become more open-minded, I do not think that the most important changes need to come from within the system. Rather, the most important voices are not professionals and experts but the people – members of the public, especially those suffering emotional distress (with “lived experience”) and their families. Change needs to come forcibly from outside the system, from people demanding change and refusing to continually accept the lies about diagnoses and drugs.

    In this age of the internet and fast communication, the common people can be enabled to more effectively speak their truth and to demand change of the status quo, and to live the change they want. Most experts, most of all biological psychiatrists and researchers, are not interested in fundamentally changing the status quo – why would they be; they profit so much from the system of fake diagnoses (e.g. “schizophrenia”) and from barely helpful, often harmful neuroleptics and other poisons.

    We need articulate, clear, forceful speakers from among psychiatric survivors and other interested members of the public, who can speak their truth and expose the depth of the scam that mainstream psychiatrists and their allies are perpretrating. I intend to be one of those people, and many potential or present others are here at MIA, in ISEPP and ISPS, Mindfreedom, or working on their own. Let us have faith that what we are doing will result in transformations, in openings of the eyes of many more people to the realities of human suffering and how best to alleviate it.

  • This phenomenon of hearing one’s own speech could be understood at a much deeper level, which acknowledges traumatic experience, as the activity of split-off subselves within a person’s mind generating the voices as a way of replaying unresolved trauma and trying to communicate their needs to the main self. I have given a brief description of how this might work in my comment below.

  • I think this notion is often correct – “voice-hearing” can represent the activity of semi-autonomous alters, i.e. segments of a person’s mind that are not consciously accessible to that person and function independently. The defense of splitting/dissociation underlies this ability. The split-off sectors (sub-serlves) of mind that generate voices that the main self “hears” are usually charged with very strong negative emotions (rage, terror, despair); it was the experience of these feelings that initially causes many psychotic breakdowns, and that is why many voices are negative or persecutory, because they are playing out or speaking back to the main self the experience of the sub-selves which remember the trauma. In another way, the sub-selves could be understood to be protecting the primary self from experiencing unbearable affects all the time.

    I once had a voice like this, but I don’t anymore because I resolved the feelings that were causing the voice-hearing.

  • This is correct. I also recommend that Moncrieff stop using the term “disorder” for psychosis. Psychotic states are not disorders or illnesses. They are understandable responses to overwhelming stresses of various kinds. If sufficient stress had existed in their early lives, Joanna Moncrieff and other professionals would quite likely be delusional, nonfunctional psychotic people stuck taking drugs within the system, rather than the well-functioning sane people they are today. Anyone can become psychotic under sufficient stress; it’s not a “disorder.”

    Also, people don’t “have” or “not have” psychotic disorders… this is another illusion on Moncrieff’s part, although perhaps she doesn’t even believe it. New research by Van Os et al shows that psychotic experiences occur on a continuum fading into normality and that we cannot draw any sharp lines between those who have or don’t have these experiences.

    The words we use are very important.

    However, readers can be aware that to get such a study approved, Moncrieff likely has to pander to the authorities by calling people’s problems “disorders” like “schizophrenia”, even though I bet she doesn’t believe fully in these words…

  • This looks like a good study. Joanna, I strongly support what others are saying about extending the study period to 5 years. 2 years is not nearly long enough… as demonstrated in the Wunderink study and by the experience of many that recovering from a psychotic breakdown often takes 4-6 years or more. It often takes 12-24 months just to get a little bit of stability in one’s life after things have fallen apart, let alone really start to improve. At this point, the study looks interesting; but I doubt if it will yield very meaningful results given only a 2 year window.

    A comment upon this, “People who have had just one episode may be supported to try and discontinue treatment, but most people with recurrent episodes are recommended to stay on antipsychotic medication for the rest of their lives. Mental health services put in a great deal of effort to ensure that people are ‘compliant’ or ‘adherent’ with this strategy.”

    It should be pointed out that one doesn’t always have to stay in contact with psychiatrists and mental health services (leaving the system, when possible, is often the ideal option; many of those who do best are never heard from within the system again, generating Harding’s “Clinicians’ Illusion” about poor outcomes for those remaining within the System).

    Also, it is often quite easy to deceive mental health services about whether or not one is actually taking the drugs. Families and sufferers should be enabled by those of us who have done it to learn about how to self-taper off the drugs and to deceive one’s treatment team is necessary. If staying in contact with mental health services is necessary for various reasons (e.g. to continue getting disability income), then lying to the treating doctors about what one is really doing (i.e. secretly self-tapering) is a viable option that should be encouraged by those of us in the underground. This is what I did and I recommend that others seriously consider it.

    Mental health services often do not have the resources or surveillance necessary to reliably know who is taking drugs and who is not. Probably many more people than we are aware of are secretly self-tapering or noncompliant, but we wouldn’t know about it because they hide it for obvious reasons. This could be conceived of as another kind of “clinician’s illusion” – the illusion by a psychiatrist that one’s clients are reliably taking their drugs, when inevitably many of them are not. Near the end of my “treatment”, I used to delight in how my old psychiatrist naively thought I was taking the antipsychotics, when in fact I had stopped long ago.

    The illusion persists that tapering off is unwise without the support of psychiatrists – this is a myth that only supports the illusion of psychiatrists as viable authority figures along with the false notion that the client and family should not trust their own intuition about what is best for them. A wealth of resources on how to self-taper now exists:

    Sufferers and families should be referred to these withdrawal materials so they can develop a sense of agency and feel that they can take the risk of doing what they feel is best (which may in many cases be self-tapering), regardless of what the “authorities” want.

    Self-tapering can be a positive thing because it represents taking action and moving away from the “sick patient” role. I encourage more people taking antipsychotics to consider self-tapering, with or without the support of their psychiatrist.

  • I see from the article that a large proportion of students (27% in this sample) actually change their career choice (Dropping out of psychiatry) as a result of attacks against the profession. So this emboldens me to continue these attacks in every forum possible… and I hope that others will redouble their efforts too. I feel absolutely no guilt about this, in fact I feel pride.

  • John,

    Thank you for the public service of exposing this outrageous situation, and showing a tragic, reprehensible example of where public officials are unable or unwilling to honor their oaths to protect the public. Unfortunately, too many immature, vindictive, uncaring people people work within power positions in the “mental health” field, and we are seeing a few of them here in your narrative.

    If I had my way in a case like this, I would break through the hospital walls with an Abrams tank in a scene straight out of an Arnold Schwarzenegger Terminator movie, free the “patient” from their restraints, and take him to a quiet healing place where these creeps could never get their hands on him again. Unfortunately, in real life we can’t do that so it falls to the public and people like yourself to speak up against these atrocities… and hopefully, to lawyers knowledgeable about mental health law (of whom we are greatly in need of more) to bring lawsuits against the psychiatrists and officials involved. This case certainly seems to me to be one where monetary and criminal damages should be sought against the psychiatrists.

    I encourage you to refer the family to legal services if you have not already. I hope I will be seeing these psychiatrists’ name as people who’ve been fined for malpractice, and ideally as practitioners who are disbarred and thrown in the Big House.

  • Because I like you Richard, I will say sorry if it offended you personally. I wouldn’t say it for anyone else 🙂

    The truth is, I didn’t even read the comment thread in full at the time I made the comment, and of course didn’t mean to offend anyone. I have read the article, but I don’t feel I know enough about the topic to comment.

    I just wanted to correct Frank’s spelling error. That’s how much it annoyed me when I saw it on the new comments list. I was seized by this burning desire and couldn’t stop myself. This probably means I have a disorder (“grammar obsessive compulsiveness?”) that needs psychiatric treatment.

  • Richard,

    I’m an English major and cannot stand to see “you’re” written as “your”. Nothing more, nothing less. Relax. I will not apologize for this; I haven’t done anything wrong.

    I still like your writing too, by the way. You have a great heart.

  • This is a questionable statement by Steingard. It is also elevating anecdotal evidence in a way that is not really reliable or evidence of anything.

    Also, the statement does not clearly causally link “taking these drugs” to “dramatic improvement”, although it implies this link. The possibility remains that the drugs could be doing nothing or causing harm, and the dramatic improvement could result primarily or wholly from Steingard or other people’s attempts to help, or from the client’s attempt to help.

    I can’t resist the opportunity to take cracks when people are covertly supporting the “drugs work” / biological model without good evidence…

  • Good for you the cat. I had a similar experience; after all the harms that happened to me at the hands of psychiatrists; I swore I would speak out too. Don’t stop, I enjoy hearing your voice. Even if you are a little crazy about guns.

  • Sandra,

    I have another thought for you, regarding this:

    “Efficacy of the drugs: When the antipsychotic drugs were first used, it seemed to be helpful for many people who took them. However, if you look at current meta-analysis on efficacy they still all favor antipsychotic drugs. However, the effect size of recent studies is much lower than is generally acknowledged.”

    This has to be understood in terms of how efficacy is defined and measured. The “efficacy” being referred to is in reducing delusions and hallucinations over a period of a few weeks or months. When the long-term side effect profile is considered, the symptom reduction is hardly a net gain in the long term for most people, nor does it relate to functioning better nor usually to negative symptoms (more important to many clients). The perspective or desire of the client is never considered… “efficacy” is more about making them less of a disturbance to the family and treating clinician.

    Outside of Open Dialogue, some of the best long-term outcomes with psychotic clients have been achieved by long-term psychotherapies under practitioners such as Gaetano Benedetti, Ira Steinman, Murray Jackson, Gary van den Bos, Bert Karon, the 388 project’s French therapists, David Garfield, Vamik Volkan, Bryce Boyer, Harold Searles, Daniel Dorman, and others. These therapists work either with no drugs at all, or with limited low-dose uses of drugs which are usually tapered down as quickly as is realistically possible. People can work on their fears and goals far better this way, when they have access to as much of their conflictual feelings as possible. This perspective is largely lost in mainstream psychiatric settings, in which there is so much overfocus on an intervention that often should not matter much at all in the long term (drugs). The only reason for this overfocus is the drug companies’ need to profit and psychiatrists’ need to be seen as real doctors treating actual illnesses. It has little or nothing to do with what is best for clients.

    I would suggest you revisit the Gottdiener meta-analysis that I linked above, and note how adding antipsychotic drugs to long-term psychotherapy of schizophrenia did nothing whatsoever to improve outcomes, in a sample of 2,600 clients drawing from 37 different studies. In the long-term, the efficacy of antipsychotics, if any, is probably even worse and less meaningful for quality of life than in the short-term. Again, antipsychotics should not be the central issue in helping psychotic people – the relationship with the person and their family should be central, and their goals should be first, not the goals of the treating “doctors” to use drugs.

  • Richard,

    I read your two comments and am supportive.

    To Oldhead,

    I am sure we agree on much more than disagree. You know that I comment a lot on MIA, donate money to MIA, have my own site, support other psychiatric survivors to avoid the system, etc. because I care about helping people and am heavily anti-diagnosis and drugging. So I think it is better to focus on what we have in common than to squabble over the few areas we might not agree totally. I can disagree with you on a few things and still support you overall, and vice versa, I hope.

  • Oldhead, it’s not shrink speak. It’s a good paper. Read it. Seikkula is one of the least medical model people out there. He does really good work helping families and suffering individuals.

    Can you provide a reference for the Buddha agreeing with you? If there’s no transcript of the Buddha saying this then I’m not going to believe it. I only believe things that are in published papers. 🙂

  • Oldhead,

    I don’t support forced drugging ever; have not said so in any comment. I was saying hypothetically that if forced drugging were used much less frequently and for shorter duration, that would be way less harmful than the current nightmare where people are forced to stay on drugs for months or years. It would still be bad for those people who are drugged, and I would still be against that.

    My opinions are my own. I am not speaking for you or anyone.


    Due to the time it would take to read I’m going to skip the 200 comments right now, but if this issue comes up more substantially in a new article will certainly be interested to see the discussion. I am not in a position to influence policy, anyway… I’m just a person with a normal non-psychiatry job… so my position is not as important as those who are involved on a day to day basis. Sorry. I do support your work.

    More nested comments needed…. and editing…

  • It sound to me like you haven’t been on the inside of a psych hospital and seen delusional people trying to physically attack the nurses. Sometimes this is caused by drugs, but sometimes it’s not… sometimes the person is murderously angry and just wants to hurt somebody. People in these states can’t always make a free choice to get help… they are too angry and scared. In these cases action must be taken so people don’t get hurt. That’s why sometimes brief seclusion and/or restraints are used. Maybe restraints shouldn’t be… but if not, there needs to be another way of stopping them from hurting others.

  • Kayla, the point is murderous people have to be stopped from killing. Restraints is one method. If there’s a less invasive way, I’m all for it. If putting them in a locked room, where they can at least walk around, for a period until they calm down works, maybe that is better. One might still have to briefly restrain or hold onto the person to get them in there. My point is that there has to be some method for stopping crazy people who are trying to cause physical harm to others.

  • Oldhead,

    This comment amuses me… I don’t formally identify myself as an antipsychiatrist. I have my own views. But if you think about things in this rigid way, then I guess so, I am a traitor to your cause!

    Maybe you think that if some deluded person comes at me wielding a knife, I (and by proxy, anyone trying to help a psychotic person) should just stand there and let them stab me through the heart. I don’t think so. I’d do everything I could to bludgeon them into submission, tie them up, and leave them restrained until they stopped trying to cause harm.

    It’s easy to sit in front of your computer and write about how force is always wrong. But when someone’s trying to murder you, you’ll fight back. Force is sometimes necessary to survive. I’m a ruthless survivor who will do practically anything to survive… I’ve been involved in real fights for my life, both metaphorically and literally. I know that sometimes people won’t listen to reason and the only way to stop them from hurting you is to subdue them with force. That’s my harsh experience, and I’d do it again if I had to.

    Ironically, Altman (who I haven’t heard from) used to write about how violence is always wrong. I also disagreed with her then. Sometimes the end justifies the means.

    I wonder how many people who believed they would never use force against a psychotic client have done so when they get attacked by that person. It reminds me of Macchiavelli’s quote, “The promise given was a necessity of the past, the word broken is a necessity of the present.”

  • Open Dialogue viewpoint has a lot in common with some psychoanalytic viewpoints like Robert Stolorow’s Intersubjectivity – i.e. viewing problems through the eyes of both people experiencing it, and seeing how they are each influencing each other in ways that contribute to the problem. It is the complete opposite of the medical model of “mental illness”, which assumes that emotional problems exist in a closed world of the individual, with external social factors mattering little.

    Other psychoanalytic writers in this vein include Donnel Stern and Lawrence Hedges.

  • Works to help people who are terrified, delusional, and nonfunctional, and estranged from family, become able to return to school and work, have better relationships, and not be overwhelmed with fear and delusions, Oldhead… and do this much more frequently than simply giving a person drugs and telling them they have an incurable brain disease. The first paper I cited, Five Year Experience of Nonaffective First Episode Psychosis, gives the results most clearly.

  • Well, now it appears that the MIA article has been rewritten to give more of a sense of what the full article is actually about… thanks Justin.

    Nevertheless, these journal-publishing companies act like legalized cartels or highway robbers, controlling the flow and accessibility of information, and seeking to bilk universities, students, and the publics of massive amounts of money. This is why, if I am interested in reading something, I now only download such articles illegally (the preferred option) or if that fails, beg the researcher to give it to me for free, or if that fails, forget about it. This is the best response to Elsevier and their ilk; don’t buy from them.

    I don’t know how the money flow works in terms of what the publisher gets vs what Cosgrove and the other authors get. In this era of increasing inequality, I suspect that much of the money from such an overpriced piece flows to the owners of the journal-publishing company, and relatively little to the actual authors.

  • Richard,
    I read your article, and basically agree with it. I certainly agree that forced drugging or ECT should never be used.

    As for forced restraint, despite reading the article, I was not convinced that it should NEVER be used. There are a very few instances that come to my mind – like a psychotic person coming at you with a knife or a baseball bat, believing you to be a person from their past that has to be killed – in which temporary physical restraint, while undesirable, may be necessary to prevent harm of others. I know that if a delusional person were coming at me murderously wielding a knife, I would not hesitate to use whatever force I could to stop them, and to restrain them afterwards. Of course the goal would be to try to calm the person down, get them into a state where they’re not trying to kill others, remove the physical restraint as quickly as possible, and do so without ever using any injectibles/drugs or other things put INTO their bodies.

  • Here is a major study to look at, Keith Laws. This meta-analysis would also be relevant to people labeled bipolar, since as Van Os has argued bipolar and schizophrenia are not truly distinct conditions but rather continuums that fade into each other.

    This is a meta analysis comparing effects of psychodynamic, CBT ,and supportive therapies on over 2,600 people labeled schizophrenic – taken from over 37 different studies, 19 randomized and 18 not randomized. Therapy length on average was 20 months, 1.5 times a week. The results strongly support psychotherapy of all kinds for psychosis. This information needs to get out more.

  • Steve, most evidence for long-term psychotherapy – on people with any diagnosis, not just “schizophrenics” who of course are just humans too – contradicts your notion that long-term therapy may be harmful. You might check out The Heart and Soul of Change by Barry Duncan in which much research on shorter and longer-term psychotherapy is summarized. Another book by his group is The Great Psychotherapy Debate by Wampold et al.

    Also ,you can find studies online and in print by Paul Knekt (Helsinki Psychotherapy Study), William Gottdiener (The Benefits of Individual Psychotherapy for People Diagnosed with Schizophrenia), Gaetano Benedetti (Individual Psychotherapy for Schizophrenia, in his book Psychotherapy of Schizophrenia), Roberta Siani (self-psychology therapy for psychosis, summarized in the book Effective Psychological Approaches to Psychosis by Martindale), Falk Leichsenring (several meta-analyses comparing long-term, greater than 1 year length therapy, to short therapy of a few months).

    If you search on Google and Amazon used books you can find links to these. Sorry I am too lazy to find them all right now.

    Some of these studies concern psychotic people only and others troubled people more generally. But the large majority that I’ve read generally point to the position that more help for longer tends to be better. It doesn’t mean that for some people staying dependent on a therapist too long could not be a bad thing. There is much variation among individuals of course.

  • Do a search on Google for psychiatric diagnoses and economic status.

    “Mental illnesses” do discriminate against the poor, contrary to the denials of deluded psychiatrists and ignorant politicians. Compare to the wealthy and middle class, there is more violence, stress, abuse, and neglect among poor people – and so within this group there is inevitably more emotional distress and inevitably more people labeled with pseudo-illnesses like schizophrenia.

    This is also why black people get diagnosed with schizophrenia 2-3x more often than white people. It’s obviously not because having black skin makes people become psychotic. It’s because having black skin correlates with being poorer, getting abused and neglected more as a child, getting discriminated against and bullied more, getting poorer nutrition, and generally being treated like shit. Those are the real causal factors of severe distress.

    Of course, a few sad-sack psychiatrists are saying that “schizophrenia” is “overdiagnosed” in blacks, as if schizophrenia were some thing that existed outside of the racial or social context. But nobody outside of psychiatry can believe their fairy tales…

  • I do not support forced drugging and certainly in an ideal world would like to see no forced drugging and far fewer drugs period. Nevertheless, if forced drugging were only used for at most a few days at a time, it would be a massive improvement over the current situation where many people are forced to take drugs for months or years under community orders.

    Sometimes politically one has to make compromises to get to an eventual destination one wants to reach.

    And as for restraints, I don’t think you can realistically ethically argue that restraints should never be used. If someone is trying to kill other people, they have to be stopped from doing this, at least until they calm down a little. It’s an unfortunate reality. Ideally talking to and comforting them would always work, but we both know that’s not always possible. However restraints and seclusion should be used far less and only for the most serious physical threats.

  • The four psychiatrists in the case – Jurriaan Peters, Simona Bujoreanu, Alice Newton, and Colleen Ryan – should all face massive fines, disbarment from the “profession” of psychiatry, and prison time. Robbing a person of over a year of their life via incarceration for a nonexistent “disease”, inflicting psychological torture on them, pressuring the girl to take drugs without warning of the long-term side effects… what these psychiatrists did is kidnapping and (psychological) rape and they deserve severe punishment.

  • I agree the forced drugging aspect is really a problem. Even many “reform” psychiatrists support forced drugging. I think forced drugging should not be used under any circumstances; except perhaps limited use of brief-duration tranquilizers (or ideally just restraints) in cases where a person is about to kill or grievously harm themselves or others.

    But the forced, month-after-month use of court-ordered antipsychotics is totally wrong. These drugs don’t treat any known illness and come with a host of horrific side effects. The process is totally unscientific, disrespectful, and dehumanizing. The psychiatrists who support this practice are not true doctors, and should be disbarred and in some cases thrown in jail.

  • I want to put in a positive comment for Sandra Steingard, whose writing I often criticize when she comes out with essays here. Being “in the system” as a psychiatrist in America for decades like she has, and then coming to question one’s assumptions to the degree that she has, is very impressive. Although I do not agree with her on everything I respect her writing and wish that many more psychiatrists would follow her example and start to question the foundations of the disease model. Well done Sandra.

  • The arrogance, stupidity, and ignorance of someone like Dr. Pies is breathtaking. This is most evident when he assumes that “a lack of medical training” undermines the ability of critics to make valid criticisms of long-term antipsychotic use. This, despite the fact that “schizophrenia” has never been proven to be a valid medical illness.

    Pies says, “schizophrenia is usually a very chronic illness” – It is incredible in this day and age that people like Pies still believe these lies. The World Health Organization and Vermont studies disproved this notion decades ago – most people fully recover or improve significantly.

    I read the linked essay, and the bias in terms of Pies wanting to find or twist data to support the efficacy of antipsychotics is so blatant.

    Meanwhile, the relative oblivion toward the great value of psychotherapy and family therapy for psychotic people continues, with antipsychotic drugs discussed in isolation as if they were the most important treatment under consideration.

    Pies continually writes as if “schizophrenia” were a distinct disease with a clear cut-off point separable from other psychoses/emotional problems. The acceptance of this has to stop. A better model is available: of psychosis as a continuum with no clear cut-off point delineating “schizophrenic” or “non-schizophrenic.” Psychiatric research into “schizophrenia” should be abandoned. Abolishing schizophrenia and moving to a more uncertain continuum-based conceptualization of psychotic states is both realistic and more hopeful for suffering people and their families.