Wednesday, August 15, 2018

Comments by knowledgeispower

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  • Thanks, Sarah, for this list of great resources. I will give them out. People in crisis especially if expressing suicidal thoughts are routinely told to go to their local emergency room at a medical hospital to be evaluated by a physician or psychiatrist to see if meets inpatient level of care at psychiatric unit. Individuals often have long wait times in a crowded room and even if meet inpatient level of care have to wait days for a bed. This often itself is traumatizing. Having other resources available for someone to feel comfortable calling, attending, or going online to is very useful. Hope, help and healing is out there besides health care professionals and settings which unfortunately are not always helpful and even further traumatizing.

  • That is a good point, Julie. The ones I fear who never get a voice are the ones who do not know how to use a computer or have little to or no access to one, perhaps lack education and skills. People in group homes, nursing homes, foster homes, state hospitals… Many on MIA, myself included, are educated, skilled and probably have had more privileges and just sheer luck than others. Let’s not forget that there are others out there that have not been able to develop a voice due to abuse in their peraonal lives and in the dysfunctional mental health system, and have never been heard. Let’s not forget them.

  • Thank you, Steve, for taking on this role and the information and guidelines you provided. I respect your role and hope that I can always write within the expected guidelines. But if I do not I have no problem in you correcting me and providing critical feedback. Best to you and MIA.

  • Thanks, s_randolph, for sharing your good point especially coming from legal perspective. If no Section 12 then, there is no bite to psychiatry and psychiatric hospitalizations which rely on Section 12s to exist and be funded. I work mostly on an acute medical/surgical unit as well as other units like the ED. I am just trying to imagine what would happen if person came in psychotic, possibly violent and not wanting to go voluntarily on a Section 10/11 to an inpatient psychiatric unit. The hospital would just discharge to the street and patient given community resources. I do see more legal charges and police and court involvement. Psychiatric hospitalizations as they are now are certainly not healing environments. I want to see more peer run respites that provide a place for those with emotional distress to safely go to though so can avoid jail. There is a need.

    I agree that the insanity defense needs to go. A judge can use discretion in sentencing if mitigating circumstances that factored into the crime. Thanks for sharing your expertise.

  • Thank you, James and MIA editors, for all you do. I respect that Robert Whitaker describes MIA as “a forum” for information and discussion about the current problems and defects of the current mental health “dysfunctional system” as I call it, rather than MIA taking a definitive stand. I like this neutral stance and respect his integrity as a journalist and MIA publisher for this. There are several organizations that take definitive stands that MIA readers can join and participate.

    I love diversity of opinions and hope that more readers out there feel comfortable in joining discussions. Certainly many feel very strongly about issues presented in MIA and healthy debates are useful. Respecting each other’s views as well as understanding that individuals come from different perspectives and at different points of understanding is essential. Disagreeing without being “disagreeable” is a skill set that we all can be better at developing. Kindness always and respect that there are fellow human beings on the other side of a computer is helpful to remember. I hope more can feel welcome in this “community” that is growing and maturing. I hope the “quieter” readers will feel safe and comfortable to share.

  • Thanks, Brett, for doing your best to inform your clients. I have gotten myself in hot water with child psychiatrists when I questioned them on inpatient unit. I recall many times encountering the “What do you know, I am a MD” attitude. I use to reply back that I certainly had more in depth experience working with the client and their family and that my job is to advocate for their best interest.

    Questioning MDs is tough, not many are open to listening to other professionals which to me is their professional obligation. Lack of time, billing and insurance has created an isolated place for psychiatrists. Some are just really arrogant and condescending. I find that they often get triggered, perhaps guilty conscience.

    I would like to see therapists more proactive against psychiatry. As a group we should be defending and advocating for those we serve. We know now how harmful these drugs are. I am very vocal in my private practice about my feelings about psychiatric drugs and psychiatry as an institution but at the hospital I have to be more careful. I give patients information including drug side effects and MIA website as reference.

  • Thank you, Dr. Wedge, for a happy ending story. Kudos to the parents and you for your hard work. Very dismayed though unfortunately not surprised at how a child psychiatrist could even think of medicating and 8-year-old with abilify. This drug certainly would have slowed him down but at what cost? Adam would have learned nothing nor would have his parents who must have felt great satisfaction in trying new behavioral and parenting techniques and seeing positive results. Parenting is really tough these days. Let’s show them love and support not judgment and condemnation.

  • Thanks, danzig666, for reference to James Hillman’s work.
    “Psychosis” means for most, a break from reality and can include auditory and visual hallucinations as well as unusual, “bizarre” thinking, making it difficult to connect with others. Psychosis can certainly be from medical/physical causes, i.e. dementia or just a UTI. I find it interesting to look at how different cultures interpret this versus Western medical disease model which just tries to stop it through antipsychotics. Being curious and being willing to look at different ways of interrupting is useful. I am saddened when professionals stop listening to the person experiencing psychosis as if they make no sense at all. Dismissing the person only adds to their disconnection.

  • The income inequality in urban areas is remarkable to me. Last summer I was doing some in-home visits in the Boston area. I went into the projects in a small apartment with several people living together in a very confined space. The place needed repairs and updating and was depressing just to be in for an hour. Just a block away were beautiful high end townhouses with trees and beautiful grounds, shops and coffee houses. Seeing such disparity takes a toll on one’s soul.

  • Thanks, Bernalyn, for good researched article. To me shows how strongly outside influences beyond an adolescent’s control can negatively influence this age group. Urban environments with high crime and violence, overcrowding, low employment, poverty, noise and other types of pollution are the negative aspects of living in many cities. Lack of social cohesion to me is the most important factor that I see with regards to psychosis with adolescence.

    Adolescence is all about one’s relationship with peers. It is an age of pulling away from parental influence and finding one’s identity through one’s peers. A city that provides resources including spaces and activities for adolescences with the guidance of adults that seek to mentor and provide positive supports is needed. It is well worth the funds to provide jobs and meaningful activities for this age group.

    Adolescence is when most initial encounters with the mental health system and diagnosing begins. Create opportunities for health and growth in urban areas for ages 13-22 and you will see less hospitalizations and healthy young people. Adolescents can be a difficult and challenging group but they need us adults to provide them with an environment that allows them to thrive. They are our future.

  • A big issue for me in private practice as a LICSW that I see as malpractice and certainly bad care is that I can barely ever get a psychiatrist or another prescriber (NP, GP) to talk to me about one of their patients over the phone who is on their prescribed drugs. When I do for the five minutes usually I question why this “medication”, why this dose? Do you know what is going on in their life? Sometimes crisis is over and I want them to start tapering off. I can tell the psychiatrist has very little to no knowledge of what is going on in the client’s life and get very perturbed with me for asking these questions. Scares me to no end. I have never once in my over 20 year career ever had a psychiatrist initiate a call to me about their patient though I send letters telling the MD that I am seeing their patient and would like to collaborate. By the way, psychiatrists charge $350 for 45 min session if want both psychotherapy and psychopharmacology.

  • Hi littleturtle, I completely agree with having an “open mind” and “bio-psycho-social” model (I would add “spiritual” and “cultural” with that as well). The issue is the heavy medicalization and “bio” side of psychiatry and their overuse and misuse of psychiatric drugs which is their bread and butter. I am glad you like your psychiatrist and individually he may be doing right by you which I hope he/she is. However, psychiatry as an institution right now is in a corner they cannot get out of. If mental illnesses as they have claimed are not due to “brain diseases” and “chemically imbalances” then why would insurance companies and Medicare and Medicaid reimburse? And if their treatment of choice, psychiatric drugs, do harm, why would anyone go to a psychiatrist? If they go back to talk therapy they compete with lesser reimbursed therapists.

    The sad thing is that we do need more primary care physicians but of course specialization pays more so no new MDs want to go into primary care. We need the medical expertise of MDs.

  • The UMass Stress Reduction Program which Jon Kabat-Zinn, PhD pioneered is a wonderful program. It is broken down into 6 week course, homework and classes. I took it twice with Fernando de Torrijos as my teacher working inpatient unit and in community center. Nothing like a Spanish accent to help relax you! Progressive muscle relaxation, communication skills, and just being in one’s body. I still make copies of the course for my clients, families and friends. This program like DBT is a packaged program, ideas taken from years of Buddhist practice plus some Western psychology. Anytime an employer does something to enhance the well-being of their employees helps with burnout. Take care of the workers and they will be more loyal and productive people. Less reactivity is a great byproduct of this as well.

  • Shame on those who said that to you, Rachel777. It is completely abusive and wrong. What an oppressive and discriminatory environment. I think of Pat Deegan who in speeches said she felt that she could not tell her wish to get her PhD when she was entrenched in the mental system, but she secretly said to herself that she would and did. If you have a preconceived notion and projection onto someone or group, it will definitely negative influence the individual and the relationship. It takes a lot of inner strength and courage to fight it and to leave those oppressors. I am so glad you are out of that environment. I love reading your comments. You have a lot of great thoughts and glad you share them here.

  • I understand and agree that ideally clinicians should not be making that distinction and it should be the person that defines what they are experiencing. I am finding myself though having clients wanting FMLA, disability or school documentation completed by me and/or a MD stating that they cannot work or go to school due to depression. Of course the paperwork wants DSM-V clinical language to support it. Professionals are being forced into this by the client at times.

  • “Let’s NOT leave the door open for psychiatry and their oppressive Disease/Drug Based paradigm of so-called “treatment” to somehow determine what is a so-called “unhealthy” level of depression that we all need to pathologize with a “clinical” designation”. Great quote there, Richard. Let’s create a kinder, more loving and nurturing environment in ourselves and those in our immediate circle and outside of it, that is my cure for depression. Psychiatry and now GPs and NPs have done nothing for depression except feed its own self-interest and poison our bodies. Some people do not have supportive friends or family and the way out is making changes to that environment. I do not see anything wrong with seeing a therapist for a short-time if that helps. Priests, rabbis and ministers also can be helpful. But the goal of counseling or therapy should be connecting people with healthy supports in the community not having the individual overly dependent on a professional for support.

  • Thank you, Dr. Gnaulati, for a very good description of the differences in depression. Depression certainly is not a pleasant experience to go through and hard to be around sometimes those experiencing it. However, most depression goes in time with an environment of care, understanding and self-reflection. It is quite a learning and growing experience if one can see it as that. I have been there and it does hurt but the pain can also be a source of greater focus and clarity of values, self-acceptance and needs.

    I am very concerned about more MDs diagnosing this. I see this diagnosis on medical records all the time. It concerns me that patients do not even know that the Attending MD or PCP put it in their records which I see as very unethical. There are ramifications including denial of life insurance as well as providers viewing the patient differently. If this is on a medical record, we are required then to ask PASRR questions if going to a short-term rehabilitation facility. Invasive questions like “Have you been psychiatrically hospitalized in the past 2 years, does the patient exhibit evidence of a mental illness, etc.”. I find it discriminatory. And I find MDs whom I work with in family medicine, especially fairly new ones just assuming depression without getting to understand the context of the patient’s life.

    I liked how the posting discussed loss in many ways, not just the death of a loved one. I see many people in my private practice who have experienced loss of a meaningful job, loss of time due to demanding work environments leading to burnout, marriage issues and children lost in the midst of their parents’ struggles. In a medical hospital, there is loss of physical ability, new diagnosis of serious medical illnesses such as cancer, being on disability and loss of social and economic status related to this. Loss is very personal and how one experience it is different and has no set formula. Stages of grief by Kubler-Ross certainly have much validity for most: anger, bargaining, denial and acceptance, depression are not linear stages.

    I have a dear friend now who is going through a lot with his mother dying and has depression signs. It can be tough at times to support him as he can get irritable and lashes out at me at times so I try to just take care of myself, understand my limits of time and energy. I take walks with him and talk to him when I can. I bring food and flowers over and do my best to be understanding. “This too shall pass” is one of my mantras.

  • Ethically, a MD should be telling patients the pros and cons of treatment options including side effects of medications. The patient if deemed competent has a right to make whatever decision they feel is right for him/her given all the information needed to make an informed decision. This goes with all medical care. Omitting the harmful negative effects of psychiatric drugs to their patients has been one of the biggest sins of psychiatry.

    Your MD seemed to do the right thing by listening to you. Remember, we are the customer. We pay MDs for their services. We pay in the U.S. MDs better than any other country in the world.

  • Hi Rossa, I would suggest that this woman write down the reasons why she wants to get off haldol, i.e. “making me too tired”, “concerned about side effects”, etc. Then she should state why now she wants to get off, i.e. “I have supports such as… in my life now” “I have better coping skills that I learned”, etc. If the MD is not responsive and being “paternalistic”, i.e. “I know better than you the patient” attitude, she can say this is my decision and I want you to help as the prescriber since you know the dosages to taper down. If not responsive she should seek out a second opinion, find a MD then will help her to taper down and finally stop. As long as no Roger’s Order and no legal guardian, she has a right to stop a drug that she does not feel is right for her. if she comes across calm, rational and prepared then a MD should listen to his/her patient and do what they ask.

    The issue I see often is that patients often fear telling their provider their truth feelings and concerns. MDs and other professionals are often overconfident about their abilities and skills and quite often condescending, treating patients like children. Psychiatrists and a lot of mental health providers I have worked with see psychosis and mood disorders as a permanent condition, and if not “treated” by these poisons long term they will be in a psychiatric unit or homeless. They risk professional liability and many do truly believe these drugs work.

    Best to you and your friend. She is lucky to have you on her side.

  • Bingo, Rossa, what MD thinks that prescribing multiple psychiatric drugs is the right course of “treatment”? This is where I just cannot work with prescribers (MDs,NPs, GPs) who prescribe these very toxic cocktails any longer. I would make calls and try advocating for my clients. Questioning is never welcomed and I often got the ‘Who do you think you are, you are not a medical professional?”, the “I know better attitude, look at my degrees on the wall”. I would tell them that the client is half asleep now with me, has no energy at all, sleeps all day. The problem is many clients I worked with just are too trusting of the medical professionals and do what they are told, “the good patient”, right?

  • You are right, Rachel77. I wonder how many psychiatrists would take these drugs themselves knowing what they know? Instead of writing a script for these harmful drugs, why not write on a script pad, “Exercise, eat more fruits and vegetables, go out with some friends, find a meaning role in life, work, love…”? That’s right, would not make for reimbursement, “not a medical necessity”. Wow, what a way to make a living. I was going to become a corporate lawyer when I was in college. More ethics in that then psychiatry nowadays.

  • Thank you, CatNight, for your post and for the other thoughtful responses. I say that all the time to my colleagues, “How do I get myself out of this profession?”. “I want to be less needed”. As a “professional” in this field though much more radical then I ever was, and as a psychiatric survivor and a family member of psychiatric survivors, I too am concerned about authors writing about other’s experience. The publishing industry and editors want a good story and a best selling book. Personal stories often interest people.

    I have no problem with Lauren writing about her own experience in this most current book. I do wish her well and though I had a negative experience with her from her first book, I do empathize with her situation and hope as a woman and mother she finds strength and hope and peace. I wish I could have been friends with her long ago. I will put her name in my prayer box to wish kindness, health and wellbeing.

    Her experience with psychiatric medications does prove to me my own personal experience and my family members’ experience, and from most of those I serve in my role as a therapist and medical social worker who taken psychiatric “medications” and treatment. MIA’s purpose and Bob Whitaker’s findings in Anatomy of an Epidemic just validated years of experience and I am truly grateful for that, because now I have evidence to show my clients and to fight back a system that has truly gone astray from a healing and moral compass.

  • I agree, Steve. Truth can certainly be painful. When there is love, honesty and trust in families there is room for forgiveness. Mistakes and small hurts can happen without permanent damage. I deal with big mistakes and big hurts and traumas with many of the individuals and families I encounter. Some of the damage just cannot ever be fully repaired. Sincere apologies, accountability and reparation are often needed to at least have the possibility of healing and repair. I have had some wonderful experiences of families healing from traumas and being stronger for it. Sometimes takes many years, but it can happen.

  • Seek to understand versus judge. Healing in my experience takes place in that type of environment. Labeling through DSM V codes hurts and does not help. Often just reinforcing the original trauma and abuse. It never addresses the root causes which are numerous and varied and need time, compassion, and understanding to sort out. We live in a quick, solution-focused, non-processing world unfortunately. Thanks again, Julie. You are kind, sensitive and wise.

  • You have a good point, Rachel777 though I do not want to judge Lauren too harshly though my friends and partner knows how her name gets me upset. Lauren’s education and career was predominately in the mainstream medical model of psychiatry and traditional psychotherapy. She has a certain status as a memoir writer, writing about her own struggles. Though she is courageous in some ways, she cannot go against it completely, It would ostracize her too much. Maybe she just trusts the system too much as it has become her second family.

    Kay Redfield Jamison is also a psychologist, works at John Hopkins and wrote about her own struggles. I just find that they cannot leave mainstream psychiatric model. They both found notoriety due to their struggles. They are both products of their time and have done well in their careers within the system. Fame and money have their blessings and their curses.

    I am still continuing to distance myself from mainstream psychiatric and psychological models. I want some new writers and new perspectives, a new generation that drives out psychiatry and eliminates the power dynamics and abuse in the mental health system. I see wonderful, new perspectives from MIA and elsewhere. The establishment is not wanting to lose power and privilege so keep moving forward. Lots of work to be done.

  • Lauren took the book title itself from a resident, a lovely Vietnamese man who desperately wanted to be an American citizen. The title is from a poem he wrote about the United States. I remember taking him to an immigration attorney and being told if we pursued it she definitely thought he would be deported due to his mental illness. He loved this country very much, more than most Americans born here. He had seen huge violence, poverty and trauma in his own country and found the United States to be paradise compared to Vietnam. I still think of him fondly when I see Vietnamese pizza on a menu which he introduced me. I was young and naive then and learned so much from these men. They helped me to better understand those with trauma and not to be afraid to look beyond the diagnoses that mental health system placed on them. The medications back then: clozaril, mellaril, haldol, thorazine, etc. made them so unhealthy.

    Great point, Julie, about being careful about writing about “someone you were close to after they die or after you lose touch irreparably”. I have a personal experience with that in my own family. My cousin who was a nurse and a therapist, wrote a book about her mother, my aunt who I loved very much. My cousin undoubtedly had a very difficult childhood. Her mother was in and out of psychiatric units during her childhood and had explosive rages toward her.

    My issue with her book was that she blamed a lot of her mother’s issues on our grandmother, an Irish Catholic woman with 10 children. Her oldest died in WWII and another died of influenza. My paternal grandmother died before I was born but my father, the youngest, adored her. He and other family members were very hurt by her book.

    I found out from another aunt when she was in an assisted living facility, that this aunt was sexually abused by a neighbor at age 2 and it was kept quiet by the family. This information that I shared with my cousin seemed to help her understand reasons why my aunt, her mother, acted in the ways she did. Psychiatry by the way, did nothing to help my aunt. Labeled and drugged, she ended up drinking, overweight and died rather young.

    Keep up the wonderful writing, Julie. You are very gifted. Your strengths need to be shared.

  • Nice review, Julie. Unfortunately I do not think as highly of Lauren as you. She is certainly a good writer. I worked with Lauren during my first job as a residential counselor in Boston area working with a small group of men with some horrific backgrounds and trauma. Lauren was the psychologist in the outpatient practice next store. Her first book, “Welcome to My Country” was written about these men. She made quite a lot of money off their stories. They should have received some of this. She promised them musical instruments but to my knowledge years after did not ever get them. She had them sign releases, most from their legal guardians. I had respect and love for these men and hope that they are doing well.

  • Thanks, Shannon, for interesting article. Good for the US/Canadian Pharmaceutical Policy Reform Working Group for advocating for much needed reform in the pharmaceutical industry. Certainly there will be resistance from the Big Pharma but the public wants this. Single-payer system allows for better negotiating of prices and forces pharmaceutical companies to lower their prices. This is going to take the public to pressure their legislators to advocate for this. It is the right thing to do. I spent this weekend for a class looking at financial statements for one pharmaceutical company. They spend millions for lawyers to defend intellectual property rights. Corporate self-interest should not be driving drug prices, need should. You need the government to help regulate Big Pharma, because they have no real self-interest in doing it themselves. Financial loss for Big Pharma, oh, well. They will survive and people will be better off for it.

  • Thanks, Alex, you live in the world I want to be in. I want to share a lovely researcher’s work, Tania Singer, PhD, a social neuroscientist, who did a large study, The ReSource Project. showing how meditation, empathy and gratitude practices show tangible, positive prosocial results. https://www.youtube.com/watch?v=n-hKS4rucTY. I am very interested in changing our society into a more compassionate, caring one especially our economic systems.

  • This is a very interesting and relevant article. “Social, educational and economic disparities between therapists and clients are often evident. If psychological therapy exerts its restorative influence through communication and guided action, how can effective communication take place when therapists and clients are worlds apart. The relationship is the cornerstone to effective therapy but differences in social class, education level, wealth, as are differences in race, culture, gender, religion and other factors certainly exist. Acknowledging those differences is important. Social class is often a taboo of sorts to discuss in the United States. A therapist should examine his/her biases and prejudices about this topic as not to inflict harm upon a client through judgment. We all have blindspots so need a fearless examination of them.

  • I love hearing from both of these wonderful individuals. Laura’s discussion and recommendation about planning for withdrawal and having the necessary supports in place to safeguard oneself against withdrawal effects was excellent. I also like Laura’s story and the need for active listening and having outlets and supports for adolescents and young adults in communities. Adolescence is the time when psychiatric diagnoses are often made. We need as a society to better understand our young people and their struggles and provide non-medical/psychiatric interventions.

  • Absolutely agree with this article in getting rid of the label “schizophrenia” which I see as outdated, not accurate, overly and misused diagnosed, and certainly not helpful to those labeled with this. It never does address the root causes. The diagnosis conjures up life long, disabling condition that one never recovers from which is just not true.

    I agree with Frank Blankenship that once this diagnosis is removed out of the psychiatric lexicon then the rest will fall as well. There might be hope to remove the DSM-V once and for all and no future versions.

  • Interesting article, Matt, thank you for your thoughts and ideas. I have a very difficult time with using language that is more empowering, dignified, not medicalized and not stigmatizing. I always ask how would I want to be identified. My years of practice in this insane “mental health” system at various levels has mostly shown me that there are “societal illnesses”. I would love to see a more unified movement that more people can identify with like the “me too”, LGBT and other social movements.

  • I agree, Stephen, that MDs hold too much power that is unchallenged which creates the seed for unethical behaviors. It reminds me of a time when one would never confront or question a Catholic priest and we know what happened with that institution. Schools and teachers want quiet, behavior free children. Parents do not want to keep being called about their children who are having behavioral issues at school. They may not want to look at their parenting and/or their marriage issues that may be the underlying cause of the behavioral disturbance. Then we have psychiatry and pharmaceutical with their solution of pills and the false narrative of brain diseases. Perfect storm here. I see it as child abuse. If parents were giving their children marijuana or alcohol I would be filing 51A but psychiatric drugs with MD signing off is legal.

  • Thank you, David, for your article with great questions and comments. I have a wonderful 3rd grade teacher friend who is struggling with children telling her that they cannot and will not do work because they are on “Individual Education Plans” (IEPs) due to ADHD. I see 8-year-old boy whose divorced parents are still angry at each other in my therapy practice telling me how broken his brain and how he is not smart in school, because he has ADHD. I had a 17-year-old junior girl’s parents wanting me to diagnose their daughter with ADHD so that she would not get below a B in classes and hopefully get into a college that is beyond her current abilities. I see a lot of this as problems with the schools not engaging and motivating students as some MIA readers have stated. I often help kids with their homework and much of it is online and quite boring. I see parents who are so busy having full-time careers that they just do not have the time and energy to spend with their children doing homework, playing and reading together. I see adults who are angry that they were essentially forced by their parents and the schools to take medications as children and adolescence years that they did not want and be given a diagnosis that followed them.

    I see psychiatry and certainly pharmaceutical industry both looking for short-term fix with pills that do nothing for a child’s self-esteem and negative long-term health consequences. I remember going to Cape Cod conference for a week years ago with Edward Hallowell, MD, the ADHD/ADD guru, to see what this new fad diagnosis was and thinking what a hoax diagnosis this was and how terrible to use one’s MD status to promote it. Psychiatrists need DSM diagnose in order to get paid rather well by health insurance companies. A MD/PHD said in another conference I went last fall that he is often asked to consult in schools. A boy he said was poor and had a challenging family situation. He did not think medications were the answer but admitted that he still gave ADHD medications to him, because “if I didn’t some other MD would” and the school which pays him wanted him to “fix” the boy. What kind of society are we if we do not put children’s well-being ahead of professional self-interest and greed?

  • The problem is not who diagnoses bipolar disorder in children and adolescents. It is the diagnosis itself that is wrong. Bipolar disorder in children was a big cash cow for psychiatry. Lifetime diagnosis and years of medications that we know have negative effects on the growing brain as well as further victimizing children for reactions to their environments, i.e. home, school, peer group. These environments are the problem, not the children. Loving, nurturing environments are the key not years of medications and deferring to psychiatrists and family medicine physicians. Do not put absolute trust in MDs. I work with family medicine MDs and with psychiatrists in the past, they think within a box. We need to love our children, empower parents to be more effective, nurturing caregivers, not medicalize normal childhood behaviors or reactions to negative, traumatic environments.

  • I agree, Steve. Billionaires gave millions to political campaigns and politicians that had incentives to act in their interest. Our current administration is full of former Goldman Sach executives. Ayn Rand, Russian-American author of Atlas Shrugged and The Fountainhead is the political philosophy that Trump and Paul Ryan espouse. We are no longer a republic but a plutocracy.

    I do have optimism stemming from my conversations from many adolescents and young adults who want change. More people are getting politically active and running for office. Perhaps some MIA readers will see office. In Massachusetts we have organizations like Emerge which help to train people to run for office.

  • Dear Richard, thank you for sharing your talent and your thought-provoking article. Economic justice is very tied to social justice. I agree that psychiatry with the government’s backing has been successful at dis-powering marginalized groups in order to quell rebellion. It is a different beast then something like we saw in other countries like communist China or Russia with ethnic cleansing but still oppression. Capitalism as it is today is deadly and the continued treating of humans as commodities will eventually end our world. Humans are capable of destruction but also of great compassion and love for one another.

    As Robert Reich’s book, The Common Good, states, we need to get back to thinking not in the selfish manner that capitalism and economic inequality promotes but thinking of the good of all. There is a lack of trust in society of all our institutions due to the dominance of the one percent who are controlling our society. Trickle down economics does not work. We need power from the bottom up and a more fair and just economy.

  • 1% of the United States population owns 40% of the wealth in this country. That is outrageous. Let’s reign in capitalism with legislation that protects the worker.

    I was proudly with 700 social workers today at Boston statehouse and advocating for raising minimum wage to $15/hour as well as paid Family Medical Leave. Raise Up, a nonprofit organization also advocating for those making over $1 million a year to pay to help pay for transportation and higher education costs. Single payer legislation is on its way. Please get to know your state senators and representatives through emails, calls and in person discussions. They are there to serve us. Democracy works if citizens educate themselves and get involved.

  • Great suggestion! I found Freud to be egoistical and consumed with creating a. false medical science. Freud was a Jewish man who was discriminated in his time. He found a way to make himself important. I spent a year reading his work and just found a lack of care and appreciation for the patients he treated. I found him to be condescending toward his patients. Smart man undoubtedly but troubled himself. Perhaps too much cocaine use.

  • Well said, Rachel777! I am impressed with your humor and intelligence. How crazy making, disempowering and demeaning to label someone with a diagnosis that is not evidenced-based, is really a short-term problem in most cases, a temporary reaction to an environmental stressor, and then the treatment is a medication that causes side effects that are disabling and makes you even sicker, feel worse about yourself causing more isolation. I am so sorry for the hurt and pain you endured. I see it all too often. Peace and loving kindness to you.

  • Thanks, Rachel, for your comment. I do agree that poor relationships especially abusive and toxic relationships can cause and contribute to severe mental symptoms of depression and anxiety and even psychosis. Alcoholism and addiction to drugs are often from attachment issues.

    How does one learn how to have healthy relationships? Therapy certainly can be helpful in understanding relationship patterns, childhood family dynamics and with healing trauma, as well as learning what healthy relationships are. I think everyone can relate to relationship issues at certain times, whether with spouse, parent, one’s child, supervisor, etc. Life can be very difficult at times. Understanding, acceptance, love is needed but all of us.

    How one relates to relationships with institutions of society such as school, work, church and one’s community are vital as well. Those can become unhealthy as well. Bibliotherapy and support groups can be very helpful. Having a meaningful role on society, i.e. caregiver, worker, student, volunteer, parent, can bring purpose.

    Oftentimes I know in my own life I have had to take a hard look at myself and reassess my values, my career goals, my health and nutrition, finances, and my relationships and find ways to continue to grow and change. I continually want to be a better partner, friend, sister, daughter, worker, community member, etc. Healing and growth takes courage and self reflection but also resources. I wish more funds for “mental health” went to supporting and building more caring and supportive communities. Disconnection is harmful.

  • I think there certainly is a sensitivity that is very understandable about being “blamed” for getting “institutionalized” by psychiatry when I see the responsibility in the hands of the medical professionals for propagating dependence and profiting off it. I think Lawrence is an ethical person and I think it is unfair for him to hold the whole bag for psychiatry’s sins. He has written extensively about how wrong psychiatry has gone. People certainly can and do overcome their circumstances which should give hope that one has inner strength and their own innate ability instead of reliance on psychiatry and drugs that we know now are harmful. Reduce demand and psychiatry will go away.

  • Hi Lawrence,
    Your comment, “my focus here was on alternative explanations of why people who take any psych drug long-term, not just the zombifying ones, invariably deteriorate and have such trouble coming off them.” The reason why people stay on long-term is because they have been told by MDs that they need it. Also when people try getting off they have reactions to coming off that terrify them to get back on. MDs tell individuals you have a brain illness, a disease, and you need to take these “medications”. I have heard MDs tell their patients that “See you tried getting off and look what happened?” The message is “trust me, I know better than you”.

    MDs and NPs are the one writing the scripts. Where is the medical professional responsibility knowing the dangerous effects of these drugs to just not prescribe? Why is there not more outrage now among medical professionals now that there is clear evidence that these drugs do nothing at best and certainly do more harm than good. Where are the health care ethics MDs are supposed to follow: beneficence, non maleficence, autonomy and justice?

    I still keep a small private practice, because I love my clients and seeing them do well. I have a full-time job so I do not need my private practice to financially support myself so I charge what is affordable to my clients. I do not take away their power by telling them I know better. I work collaboratively. I speak openly to clients on psychiatric drugs and read off the side effects as the MD or NP that prescribe it did not thoroughly do so. I challenge their diagnoses when they come in saying “I am damaged, I have bipolar, I have ADHD, I am depressed, anxious, etc”. I speak openly about getting off these drugs as I have never seen any of my clients benefit from long-term use. Certainly in a crisis situation, a small dose has been helpful to them. I will not argue with them for this. But there is NO SKILL in a pill. I am honest about them and require that they do the work, i.e. look within, examine one’s history with family, friends, work, take a fearless look at their lives, read books, work on their careers, spirituality, stress management, exercise, family relationships, hobbies, express themselves through journaling, blogging, etc. and discuss what they want from their lives and what is meaning to them. My clients are healthy people and I see them as that. Individuals like me struggling in a world that has ups and downs. I am in it with them but my job is to get them to not need me but to find other ways to view the world and their relationships. I want my clients to be happy and fulfilled. Why else would I do this work? Healing and health is the motive. But why do psychiatrists do their work? I am still wondering despite fearfully knowing the answer. How do psychiatrists justify their high fees and the disastrous results?

  • Thanks, Lawrence, for article and those who responded. “Learned helplessness” is certainly a valid phenomenon. I saw it in the adult units in the state hospital as well as in group homes for those with “severe and persistent mental illness”. This occurs because of the philosophy of these places. I saw the cause as paternalism and a sense that these individuals had permanent disabilities and no chance of being functional human beings. When you have low expectations and that is what you get. Being a “good patient” also meant doing what the staff wanted, i.e. go to groups, take medication and do not cause any disruption to make the staffs’ jobs more difficult.

    I would say that this article puts too much blame on the victims. MDs are in a position of power and trust in this society. Many seem to enjoy their status and power position and love the dependency that others transfer on them. Psychiatry truly has taken advantage of those most vulnerable in society: the poor and traumatized. They have lost any trust society placed on them.

    Freud certainly was a great intellectual of his day, and I enjoyed reading some of his work, “Civilization and Its Discontent” was my favorite which I remember reading first in theology class in college. Psychoanalysts are always interesting but psychoanalysis is more for the white upper classes and misses race and socioeconomic issues. Freud was obviously wrong about sexual abuse and women. It is 2018 and women fortunately have gotten more social, economic and political power than in Freud’s day. We no longer have to have “penis envy”.

  • Hi madmom, managed care is here to stay. ACOs for Medicare and Medicaid are in full force to save costs. $14-$16 billion is the Masachusetts Medicaid budget alone. Unsustainable health care costs which are continuing to rise with aging population. Parity law is not often enforced. I met one attorney, Meiram Bendat, JD, PHD in California whose practice is enforcing the mental health parity laws.

    The problem as you stated is “ineffective and inhumane involunatary incarcerations”. I cannot even recommend in good conscience any inpatient psychiatric units any more. I know some great people who work in some better than other places but the cost of some of these facilities is astronomical and the care is still medications as standard of care.

    Psychiatric drugs pay the bills for these facilities. Psychiatrists become cash cows. Good treatment and care is no longer the center and mission. It is staying alive. Menninger Clinic used to be a beacon of good care, but when I was studying there as a fellow it was their last year in Topeka they were unable to be financially viable and had to merge with Baylor Methodist in Houston. It is our U.S. healthcare system and reimbursement rates for behavioral health that is much less than medical care. The standard of care for mental health treatment also that is upheld by the self-interested American Psychiatric Association as well as in part the American Psychological Association is the problem as well. Psychiatric drugs do not heal, they treat symptoms but do not address underlying root causes. Forced treatment just breeds distrust. No thanks, I am out.

    You sound like a very loving and protective mother. Your daughter sounds like a lovely young lady. I trust in your love and your daughter’s resilience.

  • You are very bright, gifted and a fabulous writer, Julie. I learn a lot from you. I could see you doing many things. Massachusetts Rehabilitation Commission and UMass Medical School Work without Limits has been a very useful resource for getting individuals with disabilities jobs in my area. I like navigating complex, archaic systems and enjoy helping others apply and get resources in their communities they may not know about.

  • Recovery Learning Communities in Massachusetts are state funded, Dept. of Mental Health. They are certainly not political activism centers. DMH is old school “take your medications”, psychiatrists rule, medical model… Western MA RLC’s are at least the most radical in Massachusetts. I am sure Sera Davidow does a great job in her role and certainly is a great advocate there, but she certainly cannot say as a paid government funded program employee the most radical thoughts and ideas at MIA without some repercussions. I would give money to an independently funded agency that is peer run and politically active. Other organizations including my own, NASW, is reluctant to go against the MDs.

  • Stephen, I applaud you for trying to make a difference from within and I am sure you do make a positive difference even amidst those who may not agree with you.

    We use to do debriefings after every restraint, a horrible thing to experience for patient and staff. For a while they were helpful and often painful. What could we have done better? Self-reflection and criticism of ourselves was encouraged for awhile. Restraints did go down. However, criticize the psychiatrist who ordered the restraint which I had seen incorrectly done several times and experience ostracizing and career suicide. I and others fought some good battles and won sometimes with HR, but MDs ruled and were considered more important to the hospital.

  • I agree, Darby, should be independent organization, run by peers, have own way of running it. I am just telling you my experience with peers within traditional settings which does not work, they become just as “professionalized” and indoctrinated as the rest of us. They have to do similar roles and documentation and follow agency rules. These agencies whom I have worked are funded by Department of Mental Health. Their mission sounds like it is peer recovery focused but really mission in my experience is to keep the agency alive, co-dependency model. DMH was tough at times, too tough, and in meetings would make statements with peers and staff present, “That working is what adults do and not working should not be an option”. Recovery Learning Communities have been helpful but funded by DMH here in Massachusetts so not completely independent. Funding for independently run agencies is a battle that is worth fighting. Training is part of any agency even peer run groups. You have to decide on policies, etc. when become an organized entity.

  • I agree, Dan, with allying with others. Human rights violations, abuse of power and discrimination should be fought with a united front by everyone. Injustice is injustice. Reaching out to law schools has been useful as well as already existing legal/advocacy organizations such as Center for Representation. I would really like to see a class action suit where the funds go into funding organizations that support alternatives to mainstream mental health. I have spoken to attorney friends and say that it would be a long and expensive process. I still think it can be done. There have to be some idealistic young attorneys out there.

    There are many stakeholders in changing the current mental health system which is embedded in our healthcare system which needs reforming. This includes insurance companies, government, health care providers, the powerful AMA, as well as patients and their families. Healthcare is not a right in the United States. I think it should be. Healthcare costs are continuing to soar and not sustainable Our population is aging. We have a lot of battles ahead. Let us continue to have productive discourses. We do not have to all agree, but agree to be respectful and seek to listen and understand one another. None of us is perfect human beings with all the answers.

  • Dear madmom, I am definitely not saying that peers are less able to be discrete with self-disclosure. My point is actually that peers are actually in a much more vulnerable and authentic place then clinicians. I think that this can have far more healing power. Hearing trauma stories can have effects on anyone and thus my point is that processing it with others can be very helpful as MIA reader here do.
    My experience is with the start of peer specialists in traditional psychiatric inpatient and community mental health settings. I left working in these places due to lack of progressive change and abuse and power struggles by professionals that was very harmful. I refuse to work in setting with psychiatrists and forced treatment of any kind. I have challenged and been beaten down quite a bit by colleagues and psychiatrists. I advocate for those harmed by society in all forms. I see most professionalization in the “mental health field” as causing harm, an unequal power over others versus collaboration. I do not want any part of harmful power system. I want to be an honest and sincere human being in the struggle and pain I see around me and be able to be of some benefit to others. I work with those with physical illnesses now but certainly the pain and suffering of homeless, addiction and poverty is there as well. I asked God for help every day. I have met such incredible children, adults and families along the way. They changed me more in ways I can never give back. I wish you and your daughter much wellness.

  • I think peers are being more and more professionalized whether that is good or not it is going the way of other professions with certifications, etc. If getting paid, you are a professional. Friends, family or volunteers do not get paid. If get paid should be some standards, shouldn’t there? I wish that people would just volunteer and that natural supports like friends, family, ministers/priests would be more active and helpful. But we live in a culture of disconnection. Sadly, the disconnection is what is causing the problems.

  • Good points, bron76! Peer specialists definitely need lots of training and supervision. Working with individuals in crisis situations is emotionally draining and triggering as well. Peers are in a more vulnerable position in my opinion then clinicians like myself who are trained not ever to self-disclose unless in the benefit of the client’s progress in their goals. I have hired and supervised adult peers and had the first adolescent peers who were former patients who I knew as their individual and family therapist. There are similar issues of “transference” and “countertransference”, “overidentifying”, “vicarious traumatization” etc. that new clinicians have. Sorry for the clinical language, hard to de-program. Just because you have been through a similar experience of being labeled and in the mental health system does not mean you can fully be in the shoes of another. That needs to be acknowledged in the peer to peer relationship. I fully support having all peers run respite programs. I see the benefit just like I see the current benefit of “Recovery Coaches” for those with addictions.

  • Thank you, Bob, for this a lovely and hopeful story. Amazing what a safe, nurturing and nonjudgmental environment can do. Free from fear of being harmed and accepting others as they are. Common sense so why so hard to achieve in the United States? $5,500/month is cheap compared to the $1,000-$1,200/day price tag of private and state hospitals in U.S. which is the cost to have nurses and psychiatrists present. Take out the medical model and create more of a sanctuary with rules for safety and reasonable expectations. Healing is really pretty simple.

  • Thanks, Darby, for your article and your work. The dominant medical model and ego degreeism entrenched model always seemed to aggressively overshadow the “peer recovery speciailists” in places I worked, psychiatric adolescent state hospital and city community mental health centers. An entire culture change at the very top down was needed with all getting trained in peer support model and principles as well as the agency fully embracing and holding everyone accountable to those principles. There was a lot of lip service and praise for peer support on the surface but have yet to see an agency fully internalize the peer support model.

    Many of the professionals I worked did not want the peer support model, because they benefitted from the old model in their status, power, autonomy and income. Some were just so used to one way of doing things, not wanting to change that inertia set in which becomes frustrating to those who wanted change. Some like myself just left these entrenched systems in disgust and exhaustion.

    Thank you for your efforts. I do believe that change is possible.

  • Hi TirelessFighter3,
    I agree that some psychiatric drugs can contribute and even be the precipitating cause of someone committing suicide. “Talk psychotherapy” especially psychoanalytic therapy is not always advised for certain individuals at certain times, i.e. in crisis, psychotic. Some individuals just are not good candidates for pure “talk therapy” and may benefit from more “supportive counseling” with less emphasis on the past, and may benefit better from family therapy, group therapy, expressive therapy or no therapy at all, i.e. community supports, journaling, bibliotherapy, etc..

    But I disagree that professionals or least all, “make people believe their anger and distress are not warranted, and that it is they themselves that are the problem”. That certainly is not how I nor many of many fellow therapists, especially if clinical social workers as social work is based on theory of interaction between “person in environment”. One needs to look at the individuals family, culture, religion, work environment, socioeconomic class, and wider political and social environment. Trauma-informed therapy looks at all sources of distress. Individuals have a right to be angry at the political and social environment they are in and therapy itself cannot change those bigger issues but therapists certainly have an obligation to point out these factors and injustices.

  • I agree, littleturtle, humans are much more complex and deserve individualized care and treatment more than a single, one fit model. This takes time and effort to achieve for whose of no fault of their own life has hit them unfairly hard. Those who take the time and effort to do the work do not need medication, endless therapy, being hooked to state and human services their entire life and being on social security disability. Developing good coping strategies for life, having supported, positive supports is what heals in my opinion. http://1.bp.blogspot.com/-09T2sGHVarw/UVlqn7fvPEI/AAAAAAAAAms/GATB54Eg23Q/s1600/Infographic+(biopsychosocial+model)2.jpg

  • Thanks, PatH80 for the link to approach to depression that has broader view of looking at depression, causes and treatment options. Psychopharmacology psychiatry which I call modern day psychiatry is far too narrow and self-serving. I like the “service to others” and “bibliotherapy” recommendations. There is something about doing for others when depressed even though certainly do not feel up to it. Good books with positive messages about being human are always helpful. I am sure all of us have some good books to recommend for this. Being good to our bodies with massages and relaxing baths help with self-care. Speaking kindly to oneself also has been helpful with depressed clients and myself when life is a stressful. Depressed individuals often think negatively about themselves and are very harsh toward themselves. Cognitive-behavioral therapists work on changing the thinking patterns and refuting automatic thoughts and replacing with more realistic and less punitive ones. Also being in touch with anger is important. Psychoanalysts would say depression is “anger inward” which has some merit.

  • Thank you, Dr. Brogan, for presenting this study. The healthcare ethic is first do no harm and secondly provide a benefit for the patient. I see no benefit in antidepressants and certainly have seen harm. At best they provide a placebo effect or initial boost but inevitably my clients in my private practice tell me that the antidepressant is dong nothing or causing side effects. I have actually seen patients on the pediatric ICU unit and adult medical/surgical unit in the hospital I work attempt suicide using their prescribed antidepressant medications. What a strange and horrible irony.

    Exercise, good nutrition, balanced life, spirituality, meaningful role in life and supportive, nonjudgmental listening from caring individual does wonders. Time and love heals. Antidepressants disempower individuals and give a sense that inner psychic and natural pain caused by being human can be solved by a toxic pill. Humans are made to feel pain and experience suffering. Humans also have the capacity to heal, to love and be loved.

  • Dear Robert,
    I love the story of Scrooge and his transformation. Thank you for looking at the story as one of trauma and need for processing and grieving, forgiveness, humility and kindness. Human resilience and the power of transformation are what gives me hope in a world certainly full of suffering but also one of compassion and kindness. I wish you and all MIA a wonderful holiday season.

  • Thank you, Dr. Kelmenson, for another great article. In community mental health psychiatrists are taking hundreds of clients on their caseloads. There just was no way that they could know these seriously and chronically mentally and physically disabled patients well.

    I do feel for some of them who are truly in it to help and heal but find out quickly when they start working the reality of how psychiatry is actually practiced. In meetings I remember in a busy community mental health agency where I was a director one second career psychiatrist who was just starting working was trying to get to know her clients in more depth. She wanted to get to know her patients better and had long meetings with her patients and direct care staff. She was quickly burning out though as she was falling behind on seeing the required number of patients a day, the 15-minute standard. Though I complimented her to her supervisor, the medical director, about her dedication to her patients; I was met with anger by the medical director who said she needed to focus on completing her billing and notes. The agency could not financially survive without this. Reimbursement rates from the state health insurance continue to be very low.

    Ironically it was the lowest paid employees, the residential staff and case managers who actually knew the patients the best in group homes. The master level clinicians who were very underpaid did not stay long, just long enough to get their license and find better paying positions. Peer specialists also were terribly paid and what I saw not well treated and respected. The ones that stayed were nurses and psychiatrists who were the better paid. The individuals in these programs needed the most care and time but got improperly trained staff with huge turnover, and psychiatrists who did not have the time to do anything but bill and were not aware of their patients deeper lives and activities. Patients stayed on the same psychiatric drugs because it was easier to do and paid the bills. Shameful system that does not serve the interest of the individual needing help.

  • I appreciate the interesting article from Emily and the comments from others about this controversial diagnosis. When I studied with psychoanalysts it was the diagnosis to fear when treating if you did not have extensive training and experience. “Management of countertransference” trainings were a common training for new therapists as this personality disorder could throw a therapist into an abyss of either hatred and anger and thus retaliation against the patient/client or boundary violations as the therapist wrongly tried to meet the bottomless needs of the client. The diagnosis reportedly was caused by “an invalidating” childhood, usually meaning a mother who was consumed in her own narcissism and unable to meet the emotional needs of the child. The patient’s/client’s behaviors including suicidal threats and attempts and self-injurious behaviors. I did find these behaviors rampant on an adolescent inpatient psychiatric unit. Most labeled were females and some gay males. We used Dialectical Behavior Therapy which Marsha Linehan, PhD created, a psychologist who has come out as a former psychiatric patient labelled with this diagnosis herself. It is a skilled based curriculum of lessons taken from variety of sources including Buddhism. It is a good compilation of lessons with the hope of being more centered in the “wise mind” vs. the overly emotional or intellectualized mind. Most of the adolescents had taken years of DBT and were better experts at it than I was who needed to quickly learn it. The information in it is good for anyone but to do DBT according to the rules one needed to be in a DBT group and have a DBT outpatient therapist. I did see improvement in certain types of behaviors that we were trying to target, i.e. self-injurious behaviors and suicide attempts. My problem was that they had to go back to their families with same environments. Relapse was common and often they would come back to the hospital. Best treatment I found was working with the parents and siblings and creating a healthier environment for the system itself. Changing a toxic environment with consistent rules and boundaries and mutual respect does wonders.

    The diagnosis itself is very stigmatizing even on a psychiatric unit where you would think trained staff would be more caring but not always. We had to fight the language of staff, i.e. “manipulative” behaviors and “splitting”. Everyone is an individual with his/her own personal experiences, social economic background, gender, culture, religious or not religious background, and education that putting individuals into this limiting diagnostic category is absurd and truly not respectful nor humane. Adolescence and young adulthood is tough enough without adding a misunderstood and misleading diagnosis. Self-consciousness and fitting in with peer group, moving from the family of origin to more independence as an adult is tough. Having maladaptive and unhealthy coping strategies such as cutting and threatening suicide serve a purpose which can be retrained. This diagnosis was created by mainly psychiatrists, “the thought leaders” from APA which wants to be seen as a credible, scientific entity on par with the AMA and other medical professionals.

  • Beautiful tribute to a very intelligent, kind and thoughtful young man. Thank you, MIA editors. I enjoyed his posts very much on MIA which made me think and question how I was trained and increased my desire to fight for change. His death is not in vain. As Winston Churchill stated, “Never, never give up”. MIA readers and dissident professionals please keep pushing for change in the current mental health system, DSM-V, and how we view and treat our fellow human brothers and sisters. Things are changing, you are making a difference. We are all in this life together. Prayers of peace to Matt’s loved ones in this time of grief.

  • Thank you, for this article. My issue with MAT addiction and psychiatrists prescribing suboxone, methadone, vivitrol and campral is that very few individuals I see at the hospital and in the community ever get off these drugs. This is similar issue as with psychiatric drugs. As a social worker, it is very difficult to get patients into skilled nursing facilities on these drugs and many facilities just will not take individuals on these drugs. Discrimination but also facilities do not have doctors that know enough about them to continue to prescribe them. Some patients swear by the drugs usefulness. I have serious concerns that many individuals with addictions do not do the hard work of recovery and like those taking psychiatric drugs, just listen to the MD who has no financial interest in taking an individual off. Good old fashion 12 step meetings, sponsor and living a life away from people, places and situations that trigger use. Not easy but many people have done it. People in recovery are powerful individuals. I learned a lot from many early in my career. There is a lot of wisdom in those 12 steps.

  • Thank you, Dr. Kelmenson, for a great article. I appreciate your integrity in a world lately that seems to be increasingly lacking of this virtue. This is big business and big money for MDs. In the city near me a psychiatrist well-known for his overprescribing, get ’em and out 15 min. session for $300 just bought a building for over 4 million dollars. I saw one of his patients in the hospital, she was on a truckload of psychiatric drugs, no therapy, just drugged. Her partner is dying of cancer. I talked to her for awhile and gave her a hug, not something I usually do but she was hurting so badly. She said my psychiatrist does not even ask me what is going on in my life and has no idea. She feels rushed by him in session with his quick “How are you doing?”. I gave her other resources, Board of Medicine complaint and wrote a scathing review online about the MD. I feel so helpless watching so vulnerable people being abused by “medical professionals” who care more about their own wallets than the health and well-being of others.

  • I understand your point, Jolly Roger. There is a lot of childhood abuse out there. It is a fallacy about the greatest danger for children is abuse by strangers “stranger danger”. It is actually those closest, in one’s own family, that I have seen the greatest damage to safety, trust and security. This type of collaborative approach is definitely not for all families. Safety is always first. I worked with some really abusive parents. But most of the time parents do really want to do right by their children and in a nonjudgmental environment they can learn how to be better parents. It takes real courage to look at oneself and change negative patterns. Some cannot do it and continue to abuse. Therapists also have to have the courage to tell parents who are abusive that what they are doing is causing harm. Mandated reporting is our professional ethical obligation, though not saying that solves the problem. DCF has its issues as well.

  • I understand your point, Jolly Roger. There is a lot of childhood abuse out there. It is a fallacy about the greatest danger for children is abuse by strangers “stranger danger”. It is actually those closest, in one’s own family, that I have seen the greatest damage to safety, trust and security. This type of collaborative approach is definitely not for all families. Safety is always first. I worked with some really abusive parents. But most of the time parents do really want to do right by their children and in a nonjudgmental environment they can learn how to be better parents. It takes real courage to look at oneself and change negative patterns. Some cannot do it and continue to abuse. Therapists also have to have the courage to tell parents who are abusive that what they are doing is causing harm. Mandated reporting is our professional ethical obligation, though not saying that solves the problem. DCF has its issues as well.

  • Great article, thank you, Zenobia. For the family members and the therapist to view the transcripts of sessions would help each to be more mindful and accountable to the healing process and to each other. When I was trained in family therapy we had one way mirrors and had supervisors call us on phones during sessions and tell us what we were doing right and wrong. We wrote process recordings that we handed in to supervisors with our thoughts and reactions to sessions. By having all those in the family session review what was said, have time to think about it and come back together to critique oneself, each other and the process takes time and effort, but I can certainly see the benefit.

  • Nicely said, Frank, I completely agree as well. I see every day in a city hospital the depressed, demoralized, unemployed population on government welfare who got on disability for reasons I do not understand “depression”, “anxiety”,and “bipolar” who are now getting more unhealthy from lack of mental and physical activity. Our disability policies are not helping to empower in any way. Psychiatry gets them sicker with their drugs that cause all sorts of medical complications. Human service agencies need dependent people to survive so not all that motivated to empower people to leave them. It is also really difficult to get off SSI and SSDI if you are now out of the workforce for years, not developing new work skills and social skills that come with being with others and challenging oneself. There needs to be better financial incentives to get off disability. The medical costs are astronomical for taking care of a population that is used to being taken care of by the government (taxes from those of us who work and pay taxes), has fractured families and social networks, and has unhealthy lifestyles. Employment is therapeutic and good for one’s self-esteem. The disability policies need to change to help people become productive members of society.

  • Thank,Dr. Breggin, for a deeper understanding of this tragic story of confused and suffering adolescents. I know that the psychiatric medication piece was not taken very seriously in the trial with more of a need to seek justice through repudiation of Michelle’s character. Good family therapy for both Michelle and Conrad’s families would have been so valuable here not psychopharmcology psychiatry. They were just teenagers, they needed guidance from the adults in their lives. Where is the repudiation of the adults who did not seem to be a positive presence in their lives?

  • Purdue did have to pay a small fraction of their profits in lawsuit over misleading marketing for OxyContin. I am currently concerned about psychiatry prescribing suboxone, methadone, vivitrol, antabuse and campral for alcohol and drug dependence, “medication assisted treatment”. Forget about 12 step meetings and recovery work. Psychiatry has the answer in a pill.

  • Thank you, dfk, for your comments. If I were a psychiatrist who had been prescribing drugs that had caused harm to patients, because that was how I was taught by the medical school and other professionals who were my mentors and colleagues, and now from experience and lots of research and just common sense saw that what I was doing was not right I would be in a state of distress. My conscience would hound me until either I admitted that I was on the wrong course and then take action. Some psychiatrists have done this. It takes courage. Most continue to go on with blinders. They are choosing to ignore the evidence, covering up the truth with more lies, and attacking those who are speaking the truth. Is this any different reaction to other corruption we have seen in past history? You are right psychiatrists are just humans. But the profession of medicine has a higher calling. We should expect that the medical field acts out of well being for the patients they serve with treatment that is evidenced-based. It would be their own suicide if they admitted their wrongdoings, so they keep on with defending their disease model. I would respect an apology but taking full responsibility would mean the profession admitting they cannot to act in a harmful way toward patients despite mounting evidence that they are doing more harm then good, that there are safer, alternative ways of healing emotional distress and psychosis. I would personally need to leave such a profession and have to speak out against it.

  • Thank you, Michael, for a terrific article. My experience with working in a state hospital, community mental health and outpatient, and on a medical unit is that psychiatrists are for the most part rigid in their thinking, distant from their patients. arrogant and self-righteous. Their self-interest is to me at the heart of this. They want to continue to earn a 6 figure salary and keeping themselves in power at the top of the food chain giving orders to those who actually talk and listen to those we serve and their families. Prescribing these dangerous and unnecessary drugs is easy money. They complain in meetings about being paid so little compared to other MDs in other specialities. I have given some of them books including Mr. Whitaker’s Anatomy of an Epidemic and DVDs, and even had trainings on person centeredness and recovery-oriented therapy but most sadly ignore the information. I have been friendly with many and most are very complimentary of the work I do with patients and their families.
    But I have lost so much respect for them due to them not wanting to change their ways and hurting patients that I now warn my clients about seeing a psychiatrist and the drugs they prescribe. I do believe that in some cases psychiatric drugs are helpful but short term use. The field is corrupt, no doubt in my mind. I do see changes. Keep up the pressure MIA.

  • Wonderful article, thank you again, Mr. Whitaker. Person-centeredness, self-determination and strength-based treatment that allows the person seeking help to be an active partner and participant in their health. Looking at “symptoms” in a deeper and wider manner that shows deep respect and trust between “clients” and those providing support. The unit will be a challenge but most likely a worthwhile one. Best to Norway!

  • So do more testing and find out that a lot of children, adolescents and adults are depressed, then what? Force them to see therapists and psychiatrists? How about create better communities with more opportunities for children and adolescents to play and be kids, how about better jobs and a better economy so parents do not have to worry about providing for their families, better workplace polices to allow for taking time off to care for aging parents, parenting education, and promoting nurturing environments for all.

    These screenings only cause extreme anxiety and “medical student syndrome”, where you become overly concerned about having illnesses. Let’s solve the underlying problems.

  • Good for you, FeelinDiscouraged! I hope you feel empowered. I get so incensed when I read about codependent and unethical providers. The goal of therapy should be assisting a client in meeting their stated goals in a timely and effective manner. Empowering the client to think for himself or herself, understanding a person’s spiritual and cultural background and respecting this. We at just a guide, a facilitator, not the director. The client is the director of their own life and the expert in their own healing. Best to you in pursuing your dreams.

  • Dear Suzanne, My deepest sympathy and prayers during your grief for you and your family as you grieve the loss of your father. He sounded like a wonderful person with a loving family.

    Was the healthcare proxy invoked? Was the hospital contacting family about his care? Haldol and Ativan? That is terrible first line “treatment”, really Behavior control. Seroquel and risperdal as PRNs maybe if sundowning in dementia patients with violent outbursts. But hospital should be talking to HCP and family about any such treatment. Elders certainly are very vulnerable in this healthcare system. Families are often not close by and sometimes estranged. I see a lot of elders being neglected and alone. Other families I have are needing to take FMLA and quit their jobs trying to care for their parents.

    Good hospital staff should be trained to serve patients who are “acting out”. It takes patience. You never take it personally even when sworn at and hit which has happened many times to me. Patients are often just scared, helpless and confused. How horrible to be in a place you did not choose and with people you do not know and facing death.

    My advice is to have healthcare proxy completed and discuss end of life decisions when one is healthy. Appoint a healthcare proxy and alternate whom you know will carry out your wishes. Family meetings by phone and in person should be happening at the hospital. If not ask for them. ” Honoring Choices” is a great resource for this. If have more than $2,000 in the bank consult an elder attorney or at least understand elder law.

  • I agree, Aria. I would love students of psychology, social work and psychiatry to have a book in their studies about experiences such as Monica’s and many, many others harmed as a guide to good care and what to do and what not to do. Mad in America and Anatomy of an Illness sitsin my book case for clients, families and other providers to read. I still have my Psychodynamic Psychiatry by Glenn Gabbard, MD and Inside Out Inside In by Joan Berkoff in a prominent place but lacking books about being a patient in a system that has become very harmful and dysfunctional. I would love a new generation to learn from the past and move on to a more enlightened, egalitarian model of care.

  • “Mental illness” is used as a smoke and mirror technique to avoid looking at macro issues of institutional corruption on all levels of society which need restructuring and dismantling. It may feel that if we just “treat” at the micro level, the “mentally ill” individuals, then all will be well. Bandaids are not enough for a severed arm. Psychiatry thought they had the answers to societal problems with drugs and forced treatment. Our society is more mentally, physically and spiritually sick then I have ever seen it. Psychiatry failed. They will never fully admit it, but we know the truth. The drugs with their side effects, the diagnosing, and labeling that destroys individuals and families at their core sense of self-efficacy and self-worth is truly the evil and sin that psychiatry and therapy as well has perpetuated and profited. Stay politically active MIA and continue to use vehicles such as media, writing to politicians and protests to educate others and to curb the growth of psychiatry as an institution that is rooted in bad science.

  • Interesting article and comments. Labeling Trump “mentally ill” is a way of discrediting him and taking away his power. Same thing we do to all those labeled with DSM diagnoses. Trump obviously has a large ego and when you have lots of money and influence which billionaire businessmen do, people around you who benefit from that bow down to you certainly easy to create a false grandiose sense of self.

    Trump is a strange byproduct of our current society, a “symptom” like you mentioned Sera. American society is certainly very ill right now. The poor and disabled are being pushed further off the economic cliff with fewer hopes of getting out. Lack of good jobs and financial security has sparked this. It has caused fear, anger and mistrust. People get angrier when feel sense of scarcity and look to scapegoat and bully those whom they identify as weaker instead of looking at the institutions that we created that hold the real power and influence. Americans have seen tough times before and have been able to make positive changes.

    I have hope that American ingenuity and our innate sense of justice, fairness and compassion will prevail. We are much better off caring about one another then dismissing and disconnecting from one another.

  • I can see your point, Sally, in naming and explaining overintellectualized therapies it appears and certainly has the potential to dehumanize. I do not espouse psychopharmacology or psychotherapy wholeheartedly. I hope for a time when people are just able to be present and care for another without ever the need for a paid professional. I pray that no one ever needs to be hospitalized or medicated. I can honestly say I did not become a clinical social worker and psychotherapist for the money. I wanted to understand and help alleviate human suffering. I did study many types of therapies with distinguished clinicians and psychoanalysts but just tools. When you sit face to face with a child who has been abused or an adult with delusions and hallucinations those theories and techniques are just that. The human connection is what heals.