Comments by knowledgeispower

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  • Great to see this protest happening. Kudos to all who participated. Shattuck is a disgusting place and should have been closed years ago. Like nursing homes psychiatric units have been hit hard with COVID-19. We had many from a local psychiatric unit on my medical/surgical unit until the unit reopened as a COVID-19 positive unit with safety precautions. The issue here is that Massachusetts state is responsible for providing a safe environment for these patients and should have moved them right away to a safer location.

    There has been a lot of issues with finding placements during this pandemic though. Shelters are now full due to needing to have fewer residents. Cities and town officials need to step up and provide more safe places for people to go.

  • Great point, Sam, about how Bonnie promoted hope. She made you challenge conventional thinking about psychiatry and our culture.

    I also agree with you that psychiatry does not offer hope. If I am defining hope as desiring and considering the possible, psychiatry fails. To me psychiatry does not honor the human spirit and discounts the ability of humans to heal themselves through time, love and positive relationships and ignores societal, cultural, economic, institutional, familial, religious and environmental factors that influence us all.

  • Thank you, Lauren, for your lovely tribute to Janet. She was an inspirational woman, a healer with the courage to challenge the status quo. I loved that she told you that “nothing is wrong with you”. She saw the good in others and wanted to help others be whole. Thank you again for introducing her to me. I enjoyed reading more about her in the links and about “Re-evaluation counseling”. May her work live on through others.

  • Thank you, Peter, for sharing this study. The results are dramatic in showing that patients taking anticholinergic drugs are at much higher risk for getting dementia, especially if taking antipsychotics. I hope this leads to more studies to confirm these results as well as MDs being more cautious to prescribe these drugs. Dementia is a devastating illness to patients, their family members and caregivers.

  • Thank you, Megan, interesting subject you brought up. Also, I am sorry for the pain that others have caused you. You seem like a smart, honest and compassionate person which probably makes you a target for those without those traits.

    Misplaced anger and lack of accountability is rampant in our society including with therapists, psychiatrists, politicians, religious organizations as well as within some families. A sincere apology is almost a sign of weakness in our culture instead of it being one of courage, strength and humility. It helps us grow to take accountability of our words and actions. No one is perfect and we all make mistakes. I do believe in forgiveness even if the person who wronged me never apologizes, though that does not mean I would put myself again in position of being hurt again by that person nor even in a relationship with that individual if I could avoid it.

  • I have great respect for your work and integrity, Peter, and am so sorry for what happened to you at Cochrane Collaboration which you cofounded. I am very pleased that you will have another place to do your work, “Institute for Scientific Freedom”. Many will look forward to the new research you will do there. Your courage and perseverance are admirable.

  • The Open Dialogue approach is “too expensive”? Listening and connecting to a client takes patience and compassion. Dismissing a person who has psychosis and controlling him/her through forced drugging and hospitalization is far more expensive and certainly degrading. The problem is with many “professionals” who like control and power and do not have the ability or just too lazy to truly empathize and connect. Why are we in the field if connecting and healing is not the purpose? It certainly is frustrating, humbling and painful at times to be in it with someone experiencing difficult emotional states and psychotic thinking, but certainly worthwhile and one of the most rewarding experiences I have ever had.

    I was surprised to hear that Aaron Beck is still teaching at 97. I agree with writer that his approach is more “There is a problem in this person, how do we fix it?” versus a more humane and healing approach of “There is a person, how do we connect?”. Trust and respect in any relationship is essential. Thinking someone is broken does not create a healthy connection nor a healthy relationship.

  • I am sorry, Julie, for what happened to you, my heart goes out to you, as well as my anger toward those whose responsibility it was to care for you. You are right that professionals, especially medical professionals, who commit egregious actions will most likely never apologize due to fear of lawsuits and loss of license. The United States is far too litigious of a society but in cases of true harm it is a way of having some reparation.

    Doctors protect themselves very well in this society. I am on the phone almost daily with the hospital legal team. The MDs are very protected. It takes a lot of money and time for a patient to sue. Most of us cannot afford that. MDs have malpractice insurance as well as the backing of a team of hospital attorneys.

    Psychiatry as a whole will never apologize for the harm their institution has caused. It would mean lose of credibility and revenue. The Catholic Church paid dearly for their crimes through lawsuits, but you never real have a sense of real culpability or change. Institutions protect themselves first and foremost.

  • Thanks, Enrico, for thought provoking article. Guilt is an important signal that needs attention. A healthy adult relationship requires accountability on both sides. A wrongdoing whether intentional or not needs recognition and reparation in order for trust to exist and flourish.

    Therapists are taught to be “nonjudgmental” but this does not mean there is an absence of morality and that the therapist has no stance on what is right or wrong. I was consulting recently with another therapist about a couple I was seeing. The husband had an extramarital affair and was not taking very little responsibility for it and blaming the wife for leading him to the affair. I told the man with the wife present that what he did was “wrong” as it caused harm to another person. I was chastised for using the word “wrong” as appeared judgmental. It ended up the husband could not bear to hear the hurt he had caused so he minimized it and even displaced blame onto to his wife, the victim. Until his wife felt supported in therapy to be honest about her feelings and the husband could fully comprehend his wrongdoing by hearing his wife’s pain, truly take responsibility, and apologize was the couple able to heal and move on.

    Therapists make mistakes and can cause harm to our clients. We have to practice what we preach.

  • Thanks, littleturtle, for a balanced perspective. I work with dedicated group of internal and family medicine MDs. We see more patients who are IV heroin and fentanyl drug users in the hospital than patients who are addicted due to being prescribed for pain. We talk here a lot about abuse of power but what about abuse of free will? Certainly there are corrupt MDs but not the majority.

  • I almost cannot bear to hear of any more corruption in institutions. I do know that you and others are out there speaking the truth and that gives me hope. I will continue to push my legislators and write my state and national newspaper editors and television producers. I hope more people will spread the word and need for action.

  • Thank you, Lawrence, for generously sharing your knowledge and expertise here. Where does the responsibility lie then? Is it the American Medical Association for not setting the ethical tone for their members and advocating for responsible prescribing? Big Pharma is in the background here too. but I would not expect high ethical standards from them and it is the MDs who write the script.

  • Thanks, cali, for your perspective and acknowledgement that many people are in great physical pain from serious illnesses and not just “drug-seeking”. We should never be blaming the patient. I would like to see more research dollars and insurance payments for more holistic treatments, i.e. massages, Reiki. I was at a meeting at the hospital I work and I was astounded to hear a MD state how opiates pay the bills and how other treatments work but “not a money maker”. I wish you well.

  • Dear LavenderSage,
    Actually I was responding to what Fred77 who referenced me in his post: “To Steve, Ben, knowledge is power and any other therapists on this thread, respectfully I ask if you would please read carefully the comments posted by survivors and take some time to consider and post a response to each of them.” I have a right to say respectfully what I think just as much as you do. If that offends you I guess that is your issue not mine. There is no rules around how to engage in discussions here except to be respectful. I liked what Ben had to offer.

  • Hi Fred77, “Do all therapists operate on a diagnostic framework? Or are some actively eschewing diagnoses for the harmful generalisations they are? And where do they stand on ‘mental illness’?”. If you bill health insurance you need to put in a DSV or ICD-10 code. I tell clients this and it should be best practice for therapists to inform the client what they are going to put down as it does have ramifications, i.e. possible denial of life insurance. The lightest diagnosis is “Adjustment Disorder”. There is no way out of that except private pay. I like EAP, because I do not have to put down a DSV or ICD-10 diagnostic code. I think mental illness or what I prefer to call “mental well-being” is a continuum and that any one of us under stressful circumstances can get anxious, depressed or even psychotic. I have worked with many with horrendous, traumatic childhoods that has made working and relating to others difficult, and use drugs and alcohol to cope or just have lots of unresolved grief.

    I do not like the classification codes (DSM-V) nor do I like managed care companies. I want greater protection and privacy for clients from managed care companies.

  • Thanks, Fred77. I do not want to be in a position of defending mental health professionals. I can only speak to my own words and actions. I am outraged by many of the postings I read here and what “professionals” have done to those they were supposed to serve. Serious professional ethics violations that never got prosecuted.

    I want to practice ethically and authentically. I am very honest with telling my clients what I think of psychiatric drugs. I do not believe in having clients dependent on me as I want them to be their own expert. Empowerment and self-sufficiency is what drives me. It sickened me when I worked in DMH group homes as a direct care provider and Director to see how workers talked down to clients like they were children. It is a tough system to change. I just choose not to work directly with psychiatrists in psychiatric units nor DMH facilities any longer. There are great people who do great work with challenging clients and very difficult environments. I just see the need for radical change and MIA provides great information and has helped me in my pursuit. I am part of different organizations that question the status quo and professionals thinking.

  • Thanks, Fred, for your comments and since you named me I will try my best to respond to your comments. “Anyone who finds they are standing back and watching an amazing transformation take place for a client and thinking “wow, I did that, I love my job!”, I’m sorry to say is completely off the mark, and is needing to do a lot more inner work. If a client transforms, its because they transformed themselves.”. I agree completely that if someone makes changes in his/her life the kudos goes to the person who did the hard work to get there, not the therapist. I have never taken credit for someone changing. It does make me content that I tried my best to be of service to another and to listen and learn from others, but a lot of trial and error, and mistakes. I never stop learning and growing and I am truly blessed to be able to be of service to others. I am sorry if you misunderstood my comment to Ben. I liked his comments and his work is interesting. I remember a supervisor telling me “You are irrelevant” when I was a young therapist and though it hurt at the time, he was right that despite the numerous hours working on behalf of someone, I had missed that it was the client not I who was the agent of change.

    I can certainly address individual posts more often but I also ask that some MIA readers hold back generalizations and listen and hear as well. I understand that many have had negative past experiences with professionals but it does seem that this precludes dialogue as many have already made negative assumptions. It is really hard to not see and talk to people in person. A lot is lost online.

  • Thank you, Ben, for sharing your experience and thoughts around psychoanalysis. I find that psychoanalysts especially ones who call themselves “Freudians” take themselves far too seriously. I did not like the dependency that was promoted between therapist and patient. I like some of Freud’s work and do use some of the concepts, “psychodynamic approach” in my practice as a clinical social worker/psychotherapist with adults, but use a variety of methods and techniques from different schools and practices depending on the client and presenting issue.

    Solution-focused, collaborative, strength-based and narrative family therapy are wonderful ways of helping children and families to focus on their resiliences and strengths and it works. Shorter time and often more effective than psychoanalysis.

    I loved watching you speak on Youtube and your website has very interesting books for children. You seem to be a very caring and compassionate person and therapist. Thank you for contributing here on MIA. You made me remember why I love what I do.

  • Thanks, Vortex, for the resources you mentioned and this subject. I see a lot of parents under tremendous work and financial stress. Many were laid off in corporate mergers and have had to commute longer distances to make a living. They have fewer time to spend at home doing homework and enjoying their children. No longer can one parent just stay at home for the first few years of a child’s life. Alcohol and drug use has been a huge issue, destroying lives and families. Divorces and just unhappy marriages, because they are exhausted and stressed out and have less time to be together as working 60 hours/week each. Add to that news stories of school violence, an unstable political environment, automation, fewer meaningful jobs and less money to go on vacations and you have a toxic environment.

    Children are the causalities of all these forces. They feel their parents’ anxiety. Many talk to me about their parents fighting. They feel stress at school and the pressure in high school to do well. STEM education is being pushed at them and some just are not that interested in that. They feel their future is very uncertain with fewer choices.

    I encourage families to talk to one another, play games, paint, draw, read, listen to music, nature walks, meditation, pray together, hugs and kisses, practice gratitude and tell each other often how much you love and appreciate each other. Have a computer and iphone free time. Life is tough and family time should rejuvenate and help us to face the world.

  • This is a very thorough and well researched article. Thank you for mention of “Alternatives to Suicide” That is the way to save lives by keeping it simple, treating people and their experiences with respect and having peers who have been there talk about their experience. Kudos to Western RLC for doing such great work. I just saw “The Virtues of Non Compliance” which was very well done as well.

    I have gone to a lot of suicide prevention trainings for professionals and certainly good information about how to discuss this topic openly with clients. I have certainly had many suicidal clients in the past 20 years and I certainly tried my best to be a helpful support. But honestly hearing it from someone who has been there without the power dynamics of professional vs. client, is far more effective.

  • I am sorry, Megan, from what sounds like a non-empathic response from a couple’s therapist. It sounds like he was not validating your thoughts or your feelings. This was not a therapeutic, healing discourse and actually sounded like it was a re-traumatizing experience. I would recommend talking to the therapist directly about your experience and see how he responds. Writing it out like you did can certainly help you to focus and be calm and centered when talking to him. I would want to know if I harmed someone.

    I understand that you are angry but making blanketed statements that “helping” professionals, that they can never be wrong and that any friction or trouble between therapist and client must be due to that client’s diagnosis (or that the client needs a diagnosis). Because ‘the therapist is always right””. I know I am wrong a lot. Being a therapist does not mean trying to be right at al. To me therapy is about assisting others to find their own truth and as a couples therapist I teach more productive communication skills. I have to practice this myself. I like emotion-focused therapy myself for couples. I wish you the best.

  • I understand that this article was in the “First Opinion” section of STAT, but it still carries an air of authority coming from two professors who should be experts in research. This is just poorly researched and shows a bias in favor of antidepressant medications as the best solution for suicide prevention and for downplaying the side effects of these drugs. Very concerning that so called “experts” on research from prestigious schools are not doing their homework and having such a pro-medical model approach to solving mostly psychosocial problems.

    Thank you, Mr. Whitaker, for critical analysis of this STAT publication as well as other articles out there in mainstream and professional publications that are misleading and incorrect. We need to hold professional organizations, publications and “experts” accountable.

  • Thank you, Peter, for this article. I see many cases of overdoses, accidental and intentional, from all types of psychiatric drugs at the hospital for all age groups. These drugs are serious and potentially life threatening. I would prefer that no child nor adolescent be prescribed these toxic drugs. Parents at least need to closely monitor and dispense these to their children and adolescents. Lock boxes may be needed if concern for possible suicide attempt or intentional misuse.

  • 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. 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.

  • 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.