Thursday, March 4, 2021

Comments by J.

Showing 24 of 24 comments.

  • Hi B,

    I sympathize with your experience having been retraumatized and abused by psychiatrists in the past. I could have filed a lawsuit, that would have been stupid though since doctors have malpractice attorneys with deep financial pockets (typically win 9 out of 10 lawsuits). I could have filed a complaint with the Amercian Psychiatric Association which sole purpose is to protect ‘their own’. That would have got me nowhere fast. Only more pain, suffering and victimization during a period of time I was close to ending up in a psychiatric hospital. Believe me, I understand your pain.

    I’d just like to add that it’s interesting to observe who is choosing to respond to whom in these comments. It’s apparent that the divide still exists between those who treat are in the ‘know’, those with the PhDs and MFTs and MAs after their names and those who are trauma survivors need to be ‘informed’ by them. Titles and given one legitimacy in Mad in America forums. It also offers the possible benefit of making a name for oneself for the purposes of pubishing a book in the future.

    Trauma survivors want justice because they have been abused not only by their family of origin, but also by psychiatrists and mental health professional who like to leverage their credentials and professional experience to tell trauma survivors what trauma means and what treatment means because it’s clear we are too f’d up to figure that out on our own. I do not see forum as any different since their is a power differential that is subtly being played out in these exchanges. We survivors talk to each other. And the professionals talk to each other. Where is there a meeting of the two parties? Where is there an equal exchange of ideas or opinions? There isn’t. What does a trauma survivor have to add to the conversation, after all, it’s only their experience that is being talked about.

    Some people write articles, books and promote their professional services, and others sit in psychiatry offices on a weekly basis and receive abuse and inappropriate treatment which is an exploitation of the psychiatrist’s authority.

    When it comes to justice for trauma survivors, the professional ‘experts’ here are silent on the issue. Don’t expect them to activiely participate in changing the system or defending the rights of trauma survivors, they prefer intellectualizing and pontificating from the sidelines.

    Peace out, you all.

  • Well, Lieberman recently started following Donald Trump on Twitter. That does not surprise me in the least. I’d love to see the two of them at a speaking engagement toegther so I could here more from these two entertaining men. As Lieberman states: “I’ve treated thousands of patients with serious mental illness over my 30-year career and consulted on too many such criminal cases.” What further endorsement do we require? Who can argue with that? Sounds a lot like Donald Trump’s self endorsements.

    I do not think I have ever heard anyone who spoke with more hubris than Lieberman except maybe Donald Trump whose “Final Solution” is not so incompatible with the “The New World Order According to Lieberman”. In response to the Virginia shooting where the reporters were killed recently, he said, “In the [good] old days they had mental institutions for people like this because [Bryce Williams] was really, definitely borderline and definitely would have been and should have been institutionalized.” Apparently, Trump has been taking talking points from Lieberman.

    Lieberman and Trump love to point the finger at individuals rather than society. They like seemingly simple and straightforward solutions, which are really just ‘reactionary’ like drugging people and involunatrily locking people up (or in Trump’s case, rounding up all the illegals, sticking them in vans and within the first 24 hours he’s in office, those Mexican hoodlums will be out of the country).

    Trump’s basic attitude is: We all know that borderline crazies with guns should not be left wandering the streets. “They” are “sick” people that need to be treated as “sick”. “They” need to be off of the streets and out of our neighborhoods. The social order must be maintained at all costs, even at the cost of sacrificing individual freedoms and liberties.

    Lieberman states: “We are reluctant to infringe on people’s civil rights by forcing them to accept treatment, even though we do just that for communicable infectious diseases such as tuberculosis and various sexually transmitted diseases. But we must start using this law to treat patients in need, over their objections if necessary.”

    The question is, how is need defined? Who is to determine who is in need of treatment? Who defines who needs to be off the streets? Are psychiatrists the ultimate authority or is it the state that decides? Dr. Lieberman defers to the “law”.

    I think it is important to note that according to Lieberman, the power of the psychiatrist to exert his will over the patient comes from the letter of the “law” which is presumed to offer legitimacy for any decision the psychiatrist feels is in “society’s best interest’, not the individual’s. This does not sound all that different from the rhetoric of WWII Nazi Germany which legitimated the forced treatment of the undesirable elements of society.

    As Don Weitz notes in his article, Psychiatric Fascism ( http://www.whale.to/a/weitz.html ), FEAR, FORCE & FRAUD are the guiding principles that mental health experts and politicans use as part of an attempt to establish a new and improved social order which complies to their sense of an ideal world free of disruptive and chaotic elements.

    Welitz say, ” Hospital psychiatry with its emphasis on the control of inmate behaviour through high risk behaviour modification programs, biological “treatments”, physical and mechanical restraints, locked doors and wards, and seclusion/isolation rooms, have always exhibited several fascist elements. I want to focus on three: fear, force and fraud. These are the guiding principles and policies used to control citizens and groups in the population whom government leaders and other authorities, including the police and so-called mental health experts, have judged to be dissident, problematic or difficult to control.”

    Dr. Lieberman focuses on the need to control difficult patients through force if necessary. Of course, what Lieberman fails to acknowledge in his analysis is that many of the mass shooters were on anti depressant medications which can cause extreme forms of aggression when they committed their crimes which were ironically prescribed by psychiatrists (the kind of drugs he endorses). Many mass shooters have been known to have histories of profound childhood abuse and neglect (complex trauma/attachment disorders) which Lieberman will not acknowledge because it does not comform to his mental health paradigm according to the DSM. Lieberman does not mention that evidence has shown that many shooters lived troubled lives and often sought the help of family, friends and their community. While Lieberman may suggest a lack of appropriate intervention or services is the culprit, the fundamental issue that he fails to recognize is the social context: these troubled individuals were in deep pain and lacked healthy attachments to others, an adequate interpersonal support structure, love and empathy.

  • [Not sure where to reply – sorry again if this gets posted in wrong place]

    Very interesting discussion, particular regarding ‘recovery’. I have a problem with the use of the word ‘recovery’, ‘post traumatic growth’, ‘resliency’ – all common complex trauma ‘speak’ that often says nothing much about the individual’s experience of complex trauma, but says more about the need to provide legitimacy to one’s perspective as the ‘expert’ or the one in the ‘know’. A lot of complex trauma articles and books homogenize the experience of complex trauma (i.e. – everyone follows a similar recovery path – all roads lead to nirvana or integration). People latch on to this work because they are often desperate for a solution to their pain and suffering. I’m not saying these works are without value, however, I think they are “oversold”. “Healing” (which I believe is a more honoring term for the process), in my experience, requires rejecting others definitions of what recovery should look like or what it should mean to me. I ulimtaely needed to reject the treatment and roadmap that was offered by therapist, and I needed to create my own.

    Moving beyond the experience of CPTSD or an identification with being a trauma survivor or a victim, is an individual process.

    I appreciate everyone’s comments here because it has prompted me to think more about these issues. I’d like to sit in a room with all of you and talk. I’m sure we could discuss this for hours!

    I like Alex’s comment:
    This is why I think this insidious social abuse is often a carry over from childhood. We internalize it and it becomes ‘familiar’ so we operate this way until we awaken to ourselves. Hence, society the way it is.

    Adult survivors of childhood trauma often get what they got as children – mistreatment, abuse, sense of alienation, a hostile world …
    The adult experiences often mirrors the childhood experience, but this mirroring cannot be explained away by merely attritbuting it to ‘repetition compulsion’ – that is, it is not only the choices the individual makes in relationships that causes the trauma survivor more pain and suffering as an adult, it’s the pathological elements of society that cause the distress. I think, this may be related to what Alex is alluding to in his comment? It is not so much that we are ‘sick’, it’s that we live in a ‘sick’ society that cannot provide the ‘holding’ that a trauma survivor requires as part of their healing.

    I’d also add that nature is kinder than most human beings. I think that is “undersold’. We are told that human connection is required in order to heal – however, that assumes that there are healthy people to bond with, and even within the mental health community, it’s difficult to find healthy people. Going off into the woods and hugging a tree can be more healing than hugging a person who cannot offer true empathy or compassion.

  • Hi bpdtransformation,

    I completely agree with your sentiments. Your comments are thoughtful. I enjoy reading them.

    Trauma survivors live with considerable ‘relational deprivation’ from the get go (from childhood) often through their adult lives. Dr. Bruce Perry makes the point in relationship with traumatized children, and I think the same thing applies to adult trauma survivors. A weekly session with a trauma therapist, regardless of their skill level, does not make up for a lack of meaningful connections with others in our neighborhoods or communities. Relational deprivation is also a ‘killer’ or a destabilizing influence insofar as it begets more emotional dysregulation. I know I spent most of my time in isolation when I was experiencing complex PTSD. The sense of alienation , isolation and hopelessness , I think, explains part of the reason for the high suicide rate among borderlines or those with trauma histories. Rather than recognizing the legitimate need for love, nurturing, and compassion, the borderline often portrayed as someone merely “acting out”. This is not conducive to healing, and when you do not have a “village” or community to offer support, it requires using one’s inner resources and resiliency to pull oneself through. I also benefited from informal support via a social media forum – and that is a poor substitute for love, companionship, touch that comes in physical form. It was a common comment among the peers I connected with that we understood each others pain better than our therapists who were often unhelpful and invalidating. The power of peer support cannot be underestimated. There is much need to develop these services so that more people can benefit. The onus needs to be put on social institutions and local communities to take responsibility to care for people who have suffered abuse rather than to demonize and stigmatize.

  • Hi Chris,

    [Apology ahead of time: Don’t know if this comment will appear above or below yours..]

    I think there are reasons to be encouraged. The information is being disseminated slowly bit surely. More social workers, juvenile justice personnel, teachers, school counselors, social service providers and others who work with “at risk” children are starting to understand how trauma & attachment impact the behavior of children that they serve.

    I have a background in education. I was a public school teacher for a number of years. I am also a trauma survivor and I now spend a lot of my time reading and writing about complex trauma. Thanks for asking, Chris.

    Good luck with your work too.

  • Hi Wayne,

    What it requires is that trauma survivors start politically organizing. When the American Psychaitric Association denied Dr. van der Kolk’s submission to have developmental (complex) trauma included in the DSM 5, it was purely a political move. It was also a slap in the face to people like me who know damn well what we have suffered in our childhood and how it is connected to our mental health problems. I am the survivor of incest and rape as a child. I came close to death as well. I had to put these memories away to survive my childhood. But this does not want to be acknowledged by psychiatry. I was told, as many others are told, that their pain and misery, their depression or symptomatology is genetic in origin. I was misdiagnosed as bipolar and put on dangerous psychiatric drugs that ended up harming me and inevitably did nothing to faciliate my treatment or healing from complex trauma. The etiology of my pain (and others who have complex trauma histories) is not acknowledged, therefore, their legitimacy as an authority needs to be put into question. American Psychiatric Association is not only a drug pusher, it is an instrument of “denial”and “gaslighting” because it denies the reality and experiences of the patients that it proports to be providing care. The failure to include the development trauma diagnosis only results in more misdiagnosis, more mistreatment and distreatment and more money for Big Pharma.

    It requires ‘will’ on the part of individuals dedicated to seeing changes in the mental health system. We could take some clues from the AIDS movement. They were able to successful lobby for more research and funding devoted to providing treatment for AIDS. Why should treating complex trauma or complex PTSD be any different?

    The problem is that psychiatry is still calling the shots. This needs to change, now. And we need to stop waiting for Dr. van der Kolk to take a stance or to act. We need to act. As much as I appreciate Mad in America hosting this topic, “talk is cheap” – where is the will of anyone to actually change anything through mental health activism?

    More research money devoted to discovering new psychiatric drugs is not the solution to ‘curing’ complex trauma. [We know this already].

    – We need to push for more research dollars spent for treatments that have shown efficacy in helping those with complex trauma: EMDR, neurofeedback, integrative/naturopathic solutions that address the immune system & heal the body (vitamins, supplements, herbs). And then, insurance needs to start paying for these forms of treatment.

    – We need to hold social media platforms such as PsychCentral, Psychology Today and HealthyPlace accountable for the information they post related to complex trauma as well as ADHD, borderline and bipolar disorder. Bipolar propaganda on sites such as PsychCentral needs to be exposed for what it is. Many people rely on these social media sites to make informed decisions about their mental health. However, when the information is false and misleading, when the motive is to promote psychiatric medications, it has the potential to cause harm to those who could benefit from complex trauma treatment.

    – We need integrative treatment centers – “healing communities” where people can get psychoeducation, yoga, meditation classes, EMDR, neurofeedback under one roof.

    – We need to hold psychiatrists accountable for such things as being ethically responsible for helping people taper off of medications.

    – We need to expand outreach to hospitals and primary care physicians who still are largely ignorant about the needs of the trauma survivor population. There needs to be some accountability there too. Too many people (including myself) have been retraumatized by doctors and in hopsitals by insensitive healthcare professionals who should know better, but who do not.

    – I’d also like to see some kind of voucher system set up through employers or insurance so that people can elect for themselves how they would choose to use their medical benefits. I’d much rather have benefits/subsidies for neurofeedback treatment or to see my naturopath rather than a Rx benefit package.

    I am confident changes can be made. It does require the organization of the major stakeholders (which includes trauma survivors, mental health providers – clinical psychologists, therapists, trauma reseachers, social service providers) to form a united front. Efforts made by groups that support ACE/Trauma Informed Practices being adopted in schools and medical settings is a step in the right direction. And that’s only a start. There’s still much more work to do.

  • Hi Anonime,

    Well, I know that Dr. van der Kolk is not affiliated with MIA, and I think he should be. I honestly feel my own sense of frustration with some of the trauma “experts’ in the field because I think they have considerable credibility and influence.

    I cannot answer your question regarding his lack of participation in the hearings. This could be for any number of reasons.

    Maybe we could draft a letter and send it to all relevant parties and ask for their support. I have thought of doing the same thing. I think that survivors of childhood trauma, in particular, need to start organizing politically. Trauma informed care is a human rights issue. We have the right to ‘trauma informed care’ and the ignorance of psychiatrists or other doctors and mental health providers is not an excuse to deny appopriate services and treatment.

    I would be interested in talking with you or anyone else at MIA that is interested in starting such a grassroot organization or movement to support such a cause. I have been interested in starting a nonprofit dedicated for specifically this purpose. And it is not something I can build alone.

  • Anonime,

    Your point about Dr. Felitti and Dr. van der Kolk lack of participation is well taken. There are several reason why I believe they do not engage in this kind of discussion. The most obvious reason is a conflict of interest given their professional positions. It’s a political tightrope.

    I will say the Dr. van der Kolk has been, and continues to be, an outspoken critic of psychiatry. He makes the case in the video: Psychiatry Must Stop Ignoring Trauma.

    http://bigthink.com/videos/psychiatrys-complex-relationship-with-trauma-with-bessel-van-der-kolk

    Also, he also shows his antipathies and sentiments known in a pitch for an alternative to psychaitric medications in the treatment of ADHD/ADD. He sees neuroscience has having a promising future in the treatment of trauma. If he’s correct we could conceivably see far fewer kids and adults taking stimulant medications as well as antidepressants and antipsychotics.

    Neurofeedback 2015 Research Funding Campaign
    https://vimeo.com/128399541

    The primary reason he needs to go around begging for money from the general public for neurofeedback research is because it’s not being funded by NIH and it’s not a psychiatric drug based treatment. It does not add money to the coffer of either Big Pharma or psychiatrists. Neurofeedback has already shown efficacy in ADD/ADHD and in helping those with trauma histories develop a greater capacity for emotional regulation. However, insurance reimbursement is not offered for non empircally based treatments, hence the need for published research studies.

    So while, Dr. Felitti and Dr. van der Kolk have not participated in this forum (and have no known affiliation with Mad in America, as far as I know), I think it’s safe to say that they share some of the same concerns as other authors and readers at this site. Dr. van der Kolk has spoken publically about his concerns about the current DSM and how it is being misappropriated, how people are being misdiagnosed and stigmatized (particularly borderline personality disorder which he believes is a attachment disorder). He has expressed his concerns regarding the overprescribing of psychiatric medication. He has offered his perspective regarding the close minded and short sighted perspective of many psychiatrists as well as the leadership of the APA in reference to his battle to get the developmental (complex) trauma diagnosis included in the DSM V. Both Felitti and van der Kolk have articulated the need for trauma informed care based upon solid research which they have conducted over the course of several years.

  • The tide is turning. Have faith, Steve.

    The old Jefferson Starship “Winds of Change” (1982) always makes me feel hopeful when I have my doubts.

    Robert Whitaker’s work as well as other authors featured here have contributed greatly to the paradigm shift, but so has the tireless work of many in the trauma field which has been fighting with the APA for the inclusion of the developmental diagnosis for many years.

    What the APA is just starting to recognize is that we are not going away any time soon, the resistance movement is building and gaining momentum. I see cracks in the mirror. I see a growing unease and reactivity on the part of the APA leadership especially those in high ranking university positions whose attempts at damage control are quite laughable. The fact that Dr. Jeffrey Lieberman blocks anyone who has anything critical to say about psychiatry or anything that suggests taking trauma seriously as a major public health issue that needs to be addressed will get the guy acting in a highly defensive and ‘reactive’ manner. The popularity of Dr. Richard Friedman’s recent disingenious article in the New York Times is a fine example of political spin doctor. “I love neuroscience, but it hasn’t resulted in any new treatments” LIE. “We need to put more money into psychotherapy research” – that was the red herring – that was the “tell”.

    Psychotherapy is not a cure or appropriate stand alone treatment for trauma. CBT & DBT have been researched to death. People have been drugged and CBT’d and we still don’t have less depressed people. Perhaps because what causes a great deal of pain and suffering can be traced back to their early childhood development (attachment).

    It’s also very difficult to get funding for any non pharmacutical drug that offers an alternative to psychiatric medications: somatically based interventions such as yoga, biofeedback, EMDR, herbal and holistic remedies are only a few of the healing modalities that come to mind that actually have shown efficacy with trauma but are not empirically validated. Hence, the insincerity of the comment made by Friedman that no advances in treatment have been made in neuroscience – the funding has not been there from the NIH the fund the research! Dr. Friedman does not mention the contributions that neuroscience has made in terms of our understanding of trauma. He’s not going to because it would mean that his ‘house of cards’ would collapse.

    So, I know that all of us together can make a change if we put up a united front and do not back down. Psychiatry’s influence is lessening as the “old white men” that make up most of the rank and file of the APA leadership are reaching retirement age. They have invested decades in an old paradigm of treating those with mental health conditions – they have invested their egos and careers – let them go down like a dying ship.

    Love the lyrics to the Jefferson Starship song. (I would highly recommend watching the original music video. It’s hillarious with old 80s hair and clothes). It has me feeling hopeful and upbeat every time I listen to the song.

    Winds of Change
    Walk softly through the desert sands
    Careful where you tread
    Underfoot are the visions lost
    Sleeping not yet dead

    Hang on – Winds starting to howl
    Hang on – The beast is on the prowl
    Hang on – Can you hear the strange cry?
    Winds of change are blowing by

    Mountains crumble and cities fall
    Don’t come to an end
    Just lie scattered on the desert floor
    Waiting for the wind

  • I agree with these comments. I also think there is a growing consensus that drugging kids is not a healthy way to raise kids. The NAMI/APA Alliance is losing ground as a result of the backlash against drugging kids. ADD/ADHD and bipolar disorder in childhood populations are grossly overdiagnosed whether psychaitry wants to admit that or not. But parents are also frustrated by psychiatrists when drugs do not work or their kids are having problems in school and they don’t understand why. The legitimacy attention deficit disorder and conduct disorder (or intermittent explosive diorder) as diagnosis has been put into question since attachment issues has been identified as the source of the problem, not so much trauma per se. Dr. Bruce Perry’s The Neurosequential Model provides a way for clinicians to provide specific, individualized interventions based on a child’s stage of brain development. This kind of understanding of neuroscience also informs Dr. Dan Siegel’s work. He’s written a number of books on the subject as well as provided workshops and training for both parents and clinicans. His latest work emphasizes teaching healthy parenting skills. This work is becoming more mainstream as more social workers, teachers and therapist seek training and accepted as a preferable way of working with kids and families that sturggle with these issues. Thirdly, Dr. Margaret Blaustein at the Justice Resource Institute in Boston has developed the ARC (Attachment- Self Regulation-Competency) model that emphasizes education for caregivers, parent-child sessions, and parent workshops.

    Alternatives to medications such as introducing meditation and yoga in school settings, for example, providing biofeedback as an alternative to medications in clinical settings have been demonstrated to facilitate emotional regulation or the calming of the nervous system which is the primary issue with these kids.

    The key to success with these models requires not blaming or guilting parents. Rather the emphasis is on providing optimal emotional regulation through attentive, responsive and nurturing care from primary caregivers. Most parents want to do right by their kids. They just don’t always have the necessary skills. This is where education comes in as well as the acknowledgement that it “takes a village”. We will not raise healthy children if we do not invest in their care.

  • Yes. Lithium is very good at numbing the brain, numbing emotions, disconnecting you from ‘life’, your sense of yourself and creativity. I think it can be ‘life saving’, but at what cost to the human spirit? There are other ways to achieve a life worthy living. a life that is not defined by a existential ‘being unto death’ and ‘looking forward to the experience’ kind of GOTH/EMO – death = freedom. There are other possibilities. There are other ways to live in the world that do not require the intervention (or imposition) of mind altering substances that enable us to numb our pain while also let us live a zombie like existence. That was my experience, anyways, for what it’s worth. A lithium free existence is so much worth living.

  • I will not apologize about talking about trauma, child abuse or neglect. It happens in middle class neighborhoods too. People treat TRAUMA as if it is a four letter word. Part of the reason is the because people do not want to believe that domestic violence, incest, the rape and human trafficking of minors occurs in white middle class and upper middle class neighborhoods. It’s a dirty little secret.

    Corrina, you are right to say that as a middle class kid you may not have been traumatized by your parents. However, many kids develop attachment disorders as a result of the kind of parenting they experienced as young children. This is not a subject that is easily broached with a parent – i.e. the kind of parenting they provided their children has led to disruptive behavior in school, for example, or that what they are told is ADHD behavior is really a result of the way their brain developed as a result of early childhood experiences with their parent. It’s much easier for a psychiatrist to suggest that a child needs medications because of some genetic predisposition towards brain abnormality rather than as a result of poor parenting. Statistics show that over 60% of children develop some form of unhealthy attachment in relationship to their parents. It’s not the exception. It’s the norm. Our society is not raising healthy children, and those children raised in unhealthy environments is not limited to the inner city or poor neighborhoods.

    I’m not suggesting that there was anything wrong with your parents or the way that you were parented. I’m just want to make clear that it is not quite accurate to depict the issue as mere ‘maltreatment’ or as a function of society in general. There are specific reasons ways in which children are traumatized which are connected to early parental attachment. These have neurological consequences in terms of subsequent brain development. Attachment failure can also be viewed as trauma in a clinical sense since the kinds of brain changes that occur are similar in either case.

  • Trauma is the right word. I wish I could put stars or happy faces on all the comments I like here. So many good comments that point out how research is propagating so much misinformation about mental health and so called, ‘bipolar disorder’. The rates of bipolar disorder and ADHD being diagnosed among young people it’s completely absurd and out of control! I think it is a form of child abuse to misdiagnose these kids and force them on medications. I will be seeing my psychiatrist next week and I will be bringing a few books with me that he can read at his leisure:

    #1 – Dr. Bessel van der Kolk, “The Body Keeps Score”
    #2 – Dr. Sebern Fisher, “Calming the Fear”
    #3 – Dr. Bruce Perry’s article, “Children’s hyperactivity ‘is not a real disease’, says US expert”
    http://www.theguardian.com/society/2014/mar/30/children-hyperactivity-not-real-disease-neuroscientist-adhd

    I am now of the opinion that a psychiatrist has no business being a psychiatrist if they are not trauma informed and have not kept up on the latest in neuroscience research when it comes to attachment issues and trauma. I’m sure my psychiatrist writes prescriptions for teenagers every day for antidepressant medications and ADHD drugs. His specialty is adolescent care, and I am sad every time I see them walking outside his office while I await my turn. Time to stop the nonsense. Time for psychiatrists to do some soul searching and self reflection about their practices, priorities and commitment to the patient (especially when it involves the well being of children).

  • Similar experience. Diagnosed with depression. I was on Effexor. Then the ‘kindling effect’. Then mood swings. Then bipolar diagnosis. Then lithium. Then kidney disease. Then forced off lithium. Then intensive trauma therapy. No more depression. No more mood swings. No more need for psychiatric medications. No more need for psychiatry. (Gotta love that) 🙂

  • Good point about the importance of establishing a trusting relationship with one’s therapist, especially for those of us with a trauma history. It has been empirically established that the relationship with one’s therapist is the greatest factor in determining the perceived success of treatment by both the patient’s and the therapist’s perspective. This is more important than any particular treatment modaility that is used in the service of treating trauma.

    While I always like the idea of someone being ‘nice to me for a few weeks’ (over not having anyone at all to listen to my problems!) that’s not, unfortunately, how the trauma therapy process unfolds. Dr. Hoffman is right to say that ‘trauma therapy’ can never be a exact science. It is better thought as a labor of love and an art form. It requires a special person to be able to be present to someone’s pain. It also requires creativity to be able to address the trauma in a way that feels honoring to the patient as well as using modalities that are suitable in a particular case. Trauma treatment requires an individualized treatment plan which is part of the ongoing assessment that a skilled trauma therapists does during the course of their work with a client.

  • Exactly. People have a tendency to read these kind of study without questioning it. What is meant by psychotherapy? It takes several years of therapy for a person to heal from trauma or PTSD. This study was done over a period of between 3 and 4 months. That is a small window into the trauma stabilization, processing and recovery periods. Successful trauma treatment never relies on one specific treatment modality. “Exposure therapy” can be useful if done in small increments and when done at an appropriate time during the course of treatment.

    Dr. John Markowitz loses credibility with me when he states that focusing on “current interpersonal encounters rather than past trauma,” could be a good alternative to exposure therapy. PTSD cannot be healed without some effort to make sense of past experiences, this can be accomplished through a number of different means (EMDR included), however, it is not accomplished through “talk therapy”. Dr. van der Kolk makes this point in his book, “The Body Keeps the Score”.

    So, while I can see that in this short term study that it is possible that interpersonal therapy was more effective than exposure therapy, it says nothing about the long term prognosis for these individuals with PTSD.

    The comment regarding the lack of efficacy among those with major depression was also telling because the effectiveness of exposure therapy is connected to one’s ability to stay within a window of tolerance. A depressed patient is not typically going to be able to engage in this type of work because they are not sufficiently ‘aroused’, they are ‘hypoaroused’. They tend to be shut down, in other words, which becomes a challenge for the therapist treating them.

    Pat Odgen PhD., a trauma expert talks about these challenges and the window of tolerance, here: http://lifespanlearn.org/documents/OgdenChapter.pdf

    Depressed patients may ‘respond’ more positively to interpersonal therapy (they may be more active participants in treatment) however, it does not mean that their issues with PTSD or trauma will effectively be resolved in this manner. This is why these short term reserach studies are of limited value since they do not add to the understanding of how to treat trauma appropriately. Rather, the study serves to discredit exposure therapy as an invalid treatment modality, when in fact, it’s only one of many types of interventions that professional trauma therapists use in their work.

  • Bipolar is not a reliable diagnosis. That’s the problem. Research on bipolar is sketchy and slippery and serves to reinforce the “mood stabilization’, “it’s all genetic”, “it’s all in your head”, “you need this medication else you’ll never get better” doomsday “create a pharmaceutical drug dependency” paradigm.

    Love your comment: “Almost anyone has more sense than researchers in this field”. Research isn’t done for the purposes of making sense, is it? It is done in order to legitimate particular kinds of treatment interventions: psychiatric medications. There seems to be tons of money to support whatever research idea they come up with. I do a “forehead slap” every time I read this crappy research that just serves to reinforce psychiatry’s own self serving perspective.

    Also the comment” “Not being on lithium could give more people a chance to face difficult feelings.” This is also true in the way the Dr. Peter Breggin makes clear in his writing. However, many people prefer to be drugged, prefer to live in a mind numbing semi dissociative state rather than having to face the truth of their lives and their past.

    Of course, the cost of healthcare would be exorbitant if individuals were given full permission to face those difficult feelings by working it through in a therapeutic setting, Doing deep therapeutic work requires more than a psychiatric medication and ten to twelve sessions of CBT and some yoga. The state of the mental health system in England is the greatest challenge in furthering trauma informed care. When British citizens are begging for access to psychiatric services, when the services are just not there because of lack of resources, where is the will to provide meaningful and sustainable healing for individual’s pain and suffering?

  • Rather than focusing on “Lithium and Suicide: What Does the Evidence Show?”, the focus should be, “Why the heck are people put on lithium (a toxic substance) in the first place? Lithium numbed my brain. Lithium numbed the trauma. Lithium dosage was increased from 900 to 1200 to 1500 to 1800 mg. per day, and still the depression broke through. I did not have bipolar disorder. I had a trauma history that was not acknowledged by my psychiatrist. And it is not acknowledged by you, Dr. Moncrieff. Nor have I seen the word, TRAUMA, mentioned in any of the other limited readings I have done of your work.

    As much as I respect your work on exposing the dangers and limitations of psychiatric medications, and your general critical position towards psychiatry, I do not believe you take your critique far enough. Until Mad in America and other writers that represent what I consder to be the “Mental Health Intelligensia” wake up to the reality of trauma and its all ubiqitous manifestations through various DSM diagnoses (whether it be ADHD, Bipolar, Borderline Personality Disorder, Depression, Schizophrenia), your work will not have much impact on psychiatry as it is currently practiced.

    Calling the ’emperor’ on the fact that he has no clothes on, might make him feel embarassed for a short while, but believe me, his ‘ego’ is big enough. He’ll just find another suit to wear. The latest article by Dr. Richard Friedman, head of psychiatry, expressed the typical arrogance of American psychiatrists who present themselves as concillitory when, in fact, they have mastered political posturing in its finest form.

    http://www.nytimes.com/2015/07/19/opinion/psychiatrys-identity-crisis.html

    There is nothing revolutionary about his thoughts. Nothing that acknolwedges trauma. Nothing that suggests any interest in providing meaningful treatment that would faciliate healing other than psychotherapy which in the form of CBT doesn’t exactly have a great track record either. None of what he proposes is conducive to healing trauma or is consistent with the latest findings in neuroscience (which he claims to LOVE – but I would say, more accurately LOVES to HATE because to fully embrace the findings would require him to rethink his work on clinical depression and its etiology).

    The reason I mention Friedman’s piece is because it was noted by you on Twitter as a newsworthy item, and I think it is very telling of your perspective when it comes to mental health reform and the role in which you believe psychiatry should play. What does he suggest as a prescription for what ails the psychiatry field today? More research money devoted to studying psychotherapy. This is complete and utter nonsense to anyone who possesses a trauma informed understanding.

    I was disappointment by what I felt I sensed was an alignment of your sentiment with his views. I cannot help but see everything that you profess is worthy of study (e.g. – the rate of suicide and lithium use) through my own trauma informed lens. From my perspective, it’s a non issue.

    As far as suicide goes, I would say that most people that commit suicide are in immense psychic pain. The more relevant question in my mind is where does that pain originate? A) Is it genetic? B) Is it drug induced? C) Or is it trauma or childhood abuse/neglecy related? I would say ‘C’ is the correct answer in more cases than we would care to acknowledge.

    In my case, I do not think that lithium prevented me from committing suicide (although anyone with the amount of trauma I endured from childhood would have most likely already killed themselves. I chalk up my survival to resiliency!) Lithium did cause me to acquire kidney disease. It did cause me to have thyorid issues. Thank you for acknowledging its limitations, Dr. Moncrieff! I will need to have my blood levels checked and have to see a doctor every year for the rest of my life. I also have the constant worry in the back of my head that one day, I might need to go on dialysis and could experience an early death. It could be viewed as being analagous to being on death row. The date of your impending death has not been determined, but it’s something you cannot help but focus some attention.

    I’d like to see the scope of the discourse about psychaitry expanded. Let’s talk about misdiagnosis and overdiagnosis of bipolar disorder. Let’s talk about borderline personality disorder as it relates to attachment disorders and childhood trauma. Let’s leverage your immense knowledge about the limitations of psychiatric drugs to create some meaningful and long lasting mental health reform.

    I think the problem lies less in the fact that people are given lithium, rather the problem is with the associated diagnosis ‘bipolar’ which is something psychiatrists love to diagnose because it conveniently circumvents the issue of trauma and the need to talk about it in the treatment setting. The “mood stabilization” discourse is reaffirmed and remains unquestioned and unchallenged. The patient bows the authority of the psychiatrist as “all knowing” authority, and the lies and denial of trauma continues as patient/doctor play a game of collusion.

    Trauma may continue to be ignored by some academicians, but trauma survivors know the truth. And we will not be silenced despite our lack of academic credentials and affiliations.

  • Thanks for posting this video. It would be nice to see more trauma awareness building content on this site. Psychiatry has long ignored trauma. Psychiatrists need to be more thoughtful about prescribing medications and diagnosis. Too many people are misdiagnosed with supposed brain biochemistry disorders when the root of their pain and suffering is trauma. It is not enough to critique the DSM or question the role of Big Pharma. We need to start questioning why trauma is denied? Why are so many psychiatrists uncomfortable asking the difficult questions? When will trauma informed practices become so much integrated into healthcare systems that psychiatry will have no choice to adapt to this new paradigm of understanding mental health?

  • Again, I’m not sure how the emphasis on the “complication of memory” adds to your argument. Our thinking has since evolved regarding somatic symptomotology (which is no longer strictly referred to as ‘recovered memory’, btw) in the context of re experiencing events related to childhood trauma. If you are referring to Elisabeth Loftus’ understanding of the ‘complications of memory’, it should be noted that she is a researcher that has viciously attacked those who have claimed to be sexually abused and traumatized in court. A trauma survivor wrote to her that her research amounts to the equivalent of “saying the Holocaust never occurred”. Of course, I do not know that you are referring to Loftus’s work, but I am assuming as much since you do not provide a specific research reference. I cannot imagine why this would be such an important point of emphasis for you in the context of your topic “mistakes we [as psychiatrists] made” unless you suggest there’s still to be addressed in this area? Your article is not clear in this regard. No leading trauma expert would argue that memories (or the stories that we tell to make sense of childhood trauma events) are 100% accurate. This does not mean that a trauma did not occur. It just means that our interpretation of trauma through somatic symptoms will never offer a completely accurate accounting of events. I *know* I was raped by three men when I was eleven. I can’t tell you with complete accuracy what happened. But I *know* it occurred. Psychoanalysis was obviously never an exact science when in its understanding of the unconscious and memories. However, it was Freud, Bleuler, Janet and Jung who began seriously considering trauma a worthy subject of investigation. The problem remains that psychiatry still denies that developmental and complex trauma exist, that dissociative identity disorder exists, that it’s important to take a full history of someone’s trauma past, that bipolar disorder is often overdiagnosed when really it’s a case of someone with ‘borderline personality disorder’ which is really a case of ‘attachment disorder’ and manifests as emotional dysregulation and mood swings. There are a number of serious questions that psychiatry needs to start asking about trauma, and the least relevant one is the validity of someone’s childhood trauma experience.

  • The “blind spot”, to me, is not recognizing trauma or treating the subject matter respectfully in your article. Not sure why the focus on recovered memories which, really, you are inferring, in many cases was ‘false memories’. The greatest issue that psychiatry faces today is its failure to recognize trauma and lack of healthy childhood attachment as the etiology of most psychopathologies despite the many neuroscience research advances. I am frustrated by MIA general lack of acknowledgment of this issue. I agree with the general MIA stance that psychiatric medications have been overprescribed, that there are many dangeous associations with taking these medications. Also I am uncomfortable with the allliance of psychiatry to Big Pharma. But until, the author of this article, and other writers at Mad In America start acknowledging the all pervasive nature of trauma, and how it directly impacts treatment of many individuals through misdiagnosis, I do not see that these critiques add significant value.

    I have been gaslighted by a psychiatrist who claimed that I had false memories. I guess I should have been flattered because most do not even ask about childhood or an individual’s trauma history. Psychiatry is so much in the Dark Ages when it comes to understanding trauma. “False memories” is pretty much a non issue now that more sophisticated means of treating trauma have been developed. Anyone in their right mind that thinks a person willfully makes up trauma memories has their own level of denial going on. Nothing of the evolution of trauma research was mentioned here except the limitations in psychiatry’s understanding from the 1970’s era?

    I have been to several talks by leading trauma experts with hundreds of people in attendance. However, not one psychiatrist was present in any of the lectures I have attended. Isn’t that telling of the psychiatrist’s interest in the latest findings in trauma research and treatment? Memories will be considered ‘false’ by definition since it does not fit in the paradigm by which many psychiatrists operate. They do not even believe in the legitimacy of the complex trauma or DID diagnosis. So again, what is the point of the remarks about false memories since no context is provided? It’s disingenous to infer that a psychiatrist is a person to judge a memory as false or legitimate, in the first place, given their limited understanding and professional training in this area. This has always been the case, and it is very much connected to prejudices against women who are ‘hysterics’ and ‘borderlines’ and not to be believed, after all.