Ron, I admit that my statement may be factually incorrect. I am not an expert in the history of the gay rights movement. My point is that whether they talked or not, it wouldn’t have made any difference in the course of events. In accordance with Stephen Gilbert beliefs, it was society as a whole that caused the change in the DSM, not some direct discussions between gay activists and the APA. You just need to learn of Paula Caplan’s experience to convince yourself that’s how it happened.
If you look into the works of Jaakko Seikkula you’ll find references to russian literary critics not to Kraepelin. Open Dialogue may be part of a state healthcare system but it’s methods have nothing to do with medicine. The Open Dialogue group in Finland uses psychotropics as anesthesia. I wonder if they believe as I do that psychiatry should be considered a branch of anesthesiology.
I agree with Stephen Gilbert, no talking to psychiatry. The gay rights movement didn’t talk to psychiatry. The day the American Medical Association no longer recognizes psychiatry as medicine, they should offer to retrain all the unemployed psychiatrists as either neurologists or anesthesiologists.
Matt, as you describe, it was only after I connected with my intense anger and outrage that I was able to fire all the psychiatrists whom I had sheepishly followed and who almost destroyed my son. Only in my rage could I find the energy.
At the same time, I know there is much strength in finding peace as preached by Buddhism. In a previous blog you talked about the value you found in the teachings of Thich Nhat Hanh. Can you share any thoughts of that duality?
I can see skybluelight’s point. Delusions are real and that includes all religions. The problem is that psychiatry makes schizophrenic behaviour a manifestation of disease when being a defense against disease is closer to the truth. By convincing people that they have an irreversible disease, confounding illness with cure, and drugging them out of their minds with no end in sight, they crush any fighting chance for most. Psychiatry kills and dismissing crimes against humanity as irrelevant is not going to get much sympathy on this site.
Chaya, let me explain more.
If someone calls me anti-psychiatry, it gives me deep satisfaction because I know it comes from someone who believes established psychiatry has or will have all the answers. I happen to believe it has no answers and I’m not holding my breath. But that’s beside the point.
Likewise if somebody calls me anti-science in the sense I suggest in my previous comment. The difference being that science gets some things right. In that context I say that science can do harm and anti-science can do good.
Equating good morals to good science or bad morals to bad science is a mistake.
I won’t define what science is other than describe it as one of the pillars of western culture. But, in the heat of the moment, I made up the word anti-science and if it already exists I’m not sure what it means. Some worldviews maintain that there’s nothing wrong with science but that it misses the point, that science will never answer many fundamental questions in life. For those who believe that science will eventually yield the answers to all questions, such attitudes could be called anti-science. I definitely don’t belong to the group whose ultimate faith is in science, so I do create some confusion by using the word anti-science.
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Choice architecture is not an ideology, it is a reality. Being terrified by it and not acknowledging its existence and its inevitability is sticking one’s head in the sand. Demonizing choice architecture is like declaring nuclear physics evil because it paved the way to the atomic bomb.
That there are imposters posing as scientists – and fortunately some of the prominent ones are denounced on this website – does not invalidate science.
Choice architecture technology reminds me a lot of advertizing technology. I don’t like commercials – on the other hand I would not put a gag order on the fishmonger shouting “Fish for sale!”
The world is not black and white.
Whitaker seems to be concerned that his style is impairing the effect of his message on some of the European audience. I’m just saying that it doesn’t really matter. That’s all.
Hermes, I get it that you’re being sarcastic. But who is the target of your sarcasm? Me?
Yes, I believe that David was referring to the candidness of the American style. If someone is put off by candidness, more reason to be candid. Being arrogant is a problem, but that is not more American than European. In any case, Whitaker is not arrogant.
In Whitaker’s post above, in the ninth paragraph, David Cohen tells him that he may have ruffled the feathers of some Europeans because his style is too “American”.
Bob,
Old World intellectuals can be just as arrogant as New World intellectuals. So David Cohen´s view of being very “American” is not relevant, in my opinion. Americans have the succinctness of the Brits without the airs of superiority. People may not like Americans, but they like that particular quality.
Established thinkers will come across as arrogant when they overstep the boundaries of their contributions. I have yet to see you do that in either your writings or your talks. So whether you’re talking at the Vatican or at your local community college, it doesn’t matter, your fans love it.
Saying “all people get infected” – which is a lie – is worse than saying “a lot of people don’t get infected *and* a lot of people do get infected” – which is true. Not that you’re doing the former, but Will is doing the latter. The critical parts to doing the right thing are a) “you decide” and b) all the available and pertinent information is facilitated, even if sparse or contradictory.
Alto, I happen to agree with your position about a strict protocol for minimizing the risks of severe and prolonged withdrawal syndrome. And I agree that it should be promoted vigorously, like the anti-smoking campaign or safe sex. I don’t have a problem if you badger Will about being muddled or Laura about being wishy-washy. But I believe when you cross the line and accuse them of promoting cold turkey, you’re damaging your credibility and doing a disservice to your cause.
Altostrata, It is good to put things in simple terms as in DON’T DO IT. I respect your position like I respect the ER doctor who on a weekly basis tries to save the lives of maimed motorcyclists and wishes that motorcycles were outright banned. From a medical perspective, recommending excessively rapid discontinuation is malpractice.
Will Hall and Laura Delano do not take as categorical stance as you do. Both effectively did cold turkey themselves and they are aware, as you should be, that the proportion of people that succeed at cold turkey is not negligible. Both agree with you that a significant proportion of people who do try cold turkey suffer long term consequences. Neither reject your Russian Roulette analogy. But to allege that they are recommending cold turkey, either implicitly or explicitly, is wrong. Laura has reason to take offense. Your reaction when someone doesn’t agree 100% with you, is not justified.
Oops. I meant it *is* legal not to use them (helmets).
Altostrata, let me preface this comment by saying what an important resource your website is and how helpful it has been for me, even more so than books by Breggin or Will Hall’s Harm Reduction Guide. Personal narratives are so much richer than simple statistics or a few generalities; anecdotes are way underrated, especially when there are hundreds of them.
I don’t think Laura’s position is to deny the risks of cold turkey. Nor is it that the knowledge of risks should be withheld from persons considering discontinuation. Her point is that, ultimately, it is a personal decision.
I’m not sure what your position is. Is it that persons going cold turkey should be somehow fined, like in some jurisdictions motorcyclists without a helmet?
If the discussion is not about fundamental rights, then we are left with speculation about how risky cold turkey really is because of lack of quality statistical studies and of how stern the warnings should be.
You can encourage motorcyclists to wear helmets backed by all the statistics you want. In my state, where it is not illegal to use them, I don’t need a DOT study to know that a significant percentage of riders don’t. I wouldn’t expect anything different from (prescribed) drug users in their withdrawal. Who am I to tell them how to live or what risks they should take?
Yeah, tomaitoes, tomahtoes. But behind the words are things that really matter and it’s good you’re going there.
Sera, thank you for uncovering subliminal ways people are oppressed. Exposing these attitudes for what they are is what makes them change.
Hi Matt,
Thanks for this post and all the previous ones. My adolescent son is on a slow neuroleptic taper and the family is his main support. For us, having such lucid accounts of others’ experiences is of invaluable help. I find a lot of commonality between your withdrawal stories, like Laura Delano’s most recent MIA post and the extended comment to that post by Greg Benson. All these stories invoke in me images of an mythic journey, like the Odyssey or the survival story in The Life of Pi. The drugs and their pushers are the Sirens or the island of meerkats. The willingness to engage in the journey and the heroic courage are the ultimate means of survival. They are the cure to the drugs and the circumstances that brought them about. I wonder how they are ever going to teach that in med school.
Phil,
I have learned much from you and your collegues at the Critical Psychiatry Network. The name you chose for the group is very fitting, your thinking is critical, not merely because it challenges established psychiatry, but also because it is good thinking in an absolute sense. If only for the absence of glaring logical fallacies you already stand apart from the vast majority of your profession. You make excellent points in your letter to the BBC regarding the problems in the methods and philosophy underlying neurological explanations of mental syndromes. However, I don’t think your letter will be very effective.
Journalists are disseminators, not referees. Science reporters select material by what is being funded and what scientific peers opine. Sometimes sensationalist value can play a role but I imagine that the BBC wouldn’t want to be associated primarily with that aspect. Your example of balanced reporting in cosmology is just a reflection of a vibrant and competitive community of scientists, with rival teams of similar academic power and position. The uncritical reporting on the psychiatric implications of neuroscience likewise just reflects how far from mainstream the critical thinkers in the field are. Expecting journalists to be better judges than those considered authorities by socieity at large is unrealistic. Journalists of the intellectual depth of Robert Whitaker are, and always will be, rare.
If I may, I would recommend you find and cultivate passionate and intelligent journalists who can recognize critical thinking when they see it. Challenge them on the issues, hold them by the hand and steer them to the corners that others prefer to keep obscure. You do the work for them; when junk is being promoted give them the insight and the material, if it exists, to expose it. They will be your megaphone because they know there also is an audience out there hungry for real understanding. You have the power of ideas and they have the power to broadcast. Just declaring that the BBC needs to improve its standards won’t be enough. You need to find a good partner – not an easy task – and work hard with him/her to get your ideas published to the widest possible audience. The BBC may or may not be the venue.
I agree, Bentall’s response is brilliant. Thanks for bringing it to the attention of MIA readers.
Hi Matt,
Relying on readers for financial support is a good model to have. It is unfortunate that you cannot not adopt a non-profit form, though I understand an LLC might have practical advantages. If there is a non-profit mission, MIA is one. Hopefully when MIA’s survival is more financially secure, you will be able to become legally non-profit. It is a political statement in a society where money rules.
I have to confess that I have not contributed before but have just been shamed into doing so. 🙂 We’re big NPR listeners at home. We switch channels when they have their drives but we do send in a check every year. I think regularly reminding the community to contribute – every individual within their means – is necessary.
I join all the other comments expressing thanks to you, Kermit and all those giving time and labor to MIA. Your expectations for MIA’s future are not misplaced.
Hi Donna, what is “ScrewU”?
Hi Sandy. Thank you for the references to studies that don’t receive the publicity that they should. The information is critical even if the conclusions will not come as a surprise to followers of MIA. I’d like to know how this information affects your personal practice. Though not as effective as hyped, is the use of neuroleptics justified at all? If the use is justified, under what circumstances? Peter Breggin, Phil Thomas, Joanna Moncrieff have made public their views on how psychiatry should be practiced and they are specific on their views of neuroleptic use. You should too. You did give some indications in your previous articles on MIA. The title of this series led me to expect you would give a synopsis of the concrete consequences of your evolving point of view and of some elaboration on the rationale of whatever changes your are making.
In a comment of mine in your previous article, I stated that you “supress” information. I regret having written that; I was wrong and I wish to take it back. I do believe there is a bias in how long-term brain atrophy of subjects using neuroleptics is being reported, however. In particular you refer to it as a risk. From my reading of the literature, I believe that the brain degeneration of diagnosed schizophrenics on such neuroleptic regimes is virtually certain as much as it is for Alzheimer’s disease. In Alzheimer’s disease, brain degeneration is not called a risk; it is a characteristic. Calling it a risk of long term neuroleptic use is a dangerous mischaracterization. Whether the cause is drugs or the inherent physiology of the cohort studied may not yet be determined beyond doubt but, as you note, the fate of monkeys is a good clue.
Matt. Ridicule, of what people say not who they are, can be a very effective at promoting the mission of MIA. The distinction is important. That is the fine line that is not to be crossed.
Matt, when you say you wish to create more hypocrites, I hope you mean those going in the opposite direction Torrey went.
Matt, thank you for the explanations. The rules are plain common sense and I support them. But as a big fan of Colbert myself, I’ll relish the attempts to go right up them without crossing.
With all this controversy, now I’m dying of curiosity to see Madness’ removed comment.
Matt and Kermit, any chance of getting it reinstated?
Cannotsay2013 and Belinda,
I’m inserting my comment here because I can’t farther down where your discussion is.
Related to AOT, there is another terrible abuse of human rights that is protected by the law. It is the psychotropic drugging of children and adolescents. From the minors’ perspective, their human rights are being violated with the complicity of their parents or, very frequently in the US, by their foster parents. These children are being forced into a quasi-irreversible path to mental patient careers, total disability, premature death and sometimes violence, to themselves or to others. This is a human tragedy of indescribable proportions; the violation of the human rights of these children is arguably more serious that of victims of adult involuntary commitment.
I don’t think the basic powers and obligations of parents towards their children are going to change anytime soon or even if they should. Robert Whitaker has a strategy to ultimately address the human rights violations to children executed by psychiatrists. It is not to explicitly and directly challenge social norms backed by the law, but to change public perceptions. As we have seen so dramatically in the last decade with gay marriage, once the polls go, the politicians and the Supreme Court justices will go. If the public opinion campaign, as promoted by Whitaker, is successful, laws to protect minors and adults from psychiatric crime will follow. Though totally I agree with Cannotsay2013 that, based only on fundamental philosophical and ethical principles, AOT laws should be repealed immediately, that’s not how the world works, unfortunately; I can see Belinda’s point. But I am a little taken aback by how she dismisses active protest. Does she think that past civil and human rights victories have been won by armchair intellectuals alone?
Laura, I would have gone to the MA rally and seen you speak in person but I’m not in the loop and didn’t get the info! Though delivered to few, the message is as powerful as it gets.
These proposed laws are terrifying.
Hi Seth,
From this thread it is not clear to me what your position on neuroleptic use is. Would you ban their use under any circumstances?
The comparison of alcohol and neuroleptics is interesting. I enjoy a glass of wine or two with dinner, not only for the taste but also for the warm, relaxing feeling. Now, in a purely hypothetical situation, if a psychiatrist prescribed an amount of alcohol that would make me pass out on a daily basis and he informed me that I needed it for the rest of my life, I’d tell him to go take a hike. In a very real situation that’s exactly what I did to the head of adolescent psychiatry at an Ivy League school when he told me that my son would have to take neuroleptics indefinitely. At the time my son had been on Abilify for more than a year, gained 100 lbs, developed metabolic syndrome, was in clear cognitive decline and still hearing voices.
Another story about my son is when he had his first and only major psychotic break – excuse the term, I know you don’t approve. The best way I can describe his state was that of a raging wild beast, cornered and poised to attack. He didn’t recognize who I was. With the police watching, the ambulance took him to the ER, where they injected ativan and haldol. I would have tried to prevent the intervention had I known at the time that I was in my right to do so, he hadn’t actually attacked or threatened anybody. I was so ignorant then. After a few hours he woke up, embraced me, told me how much he loved me and how ashamed he felt. I don’t know if it was the ativan, the haldol or if his state would have passed fairly quickly without the drugs; I’ll probably never know.
With my son’s case in mind, I ask if using a benzo for a few days is a bad thing. Though, from what I read, the risks of dependency and the subsequent complications of withdrawal become an issue after only a few weeks. Likewise, for how long and in what amounts is neuroleptic use by any given individual dangerous? What are the risks of dependency and of withdrawal? What are the chances of metabolic disorders? Will pertinent research convince even some of the ardent critics that a course of a couple months does not pose unacceptable risks? I think that there aren’t many easy answers and that the discussion is important. That is Sandy’s point. Personally, I’d regulate neuroleptic use so much as to make even some hard core liberal progressives wonder…
I am interested in your reaction to my questions.
The analogy of morphine with a neuroleptic is that both can relieve insufferable pain but don’t cure anything. The analogy with chemotherapy is that they both kill cells, one quickly, the other slowly. The commonality is that all of them will lead to premature death if taken in sufficient amounts and for sufficient time. There is absolutely nothing in common between cancer and psychosis. One is an illness and the other is not.
Jonah, I agree with you that forced psychotropic drugging is unethical; it is also enshrined by law. It is the only medical “treatment” that can be forced on patients. I say that long term neuroleptic prescription – whether voluntarily adhered to or not – is not currently considered malpractice but that it should in many circumstances if not most. Historically many human rights abuses from today’s perspective were enshrined by law, among classic examples are slavery, women and gays rights (rather lack thereof). Things eventually change but not without strife. Though I may sound a little harsh on Sandy sometimes, I recognize she is an agent of change and I profoundly respect that.
Hermes, I forgot to thank you for your references to the literature. They are pertinent and helpful.
This is the first time I get a compliment on MIA!! Thanks Jonah.
Hi Sandy,
I don’t know if in the future you will be engaging any of your patients in long term neuroleptic use but I’m sure you have plenty of colleagues in the Vermont mental health system that will. Would you be willing to urge them to have their patients periodically get a brain MRI? Once a year maybe? Not a bad idea to track their brain mass as a good clinical practice, no?
My point is not that a neuroleptic is the best short term treatment for psychotic conditions but that it would be hard to make the case that short term treatment is medical malpractice. As for long term treatment this is what I think: before someone is subjected to neuroleptic treatment, he should have a MRI performed on his brain. If after a few years of neuroleptic treatment the patient’s brain mass has diminished by 5% or the psychiatrist failed to perform the initial MRI, the patient should have an excellent chance of successfully suing his prescribing psychiatrists. Currently his chances are nil. That simple change in legal precedent would have at least as big an impact on global health as the anti-tobacco or anti-asbestos campaigns of the past.
Hi Sandy,
I do not have time to read all the previous comments so I apologize if I’m repeating a point already made. I feel very strongly about this.
There is a basic fact about neuroleptics – the most important one – which has been established for some time and which, I feel, you are suppressing in your article. It is that neuroleptics destroy the brain. In the 1950’s, psychiatrists called treatment with thorazine the chemical lobotomy. At the time they could only speculate about the physiology; what they could observe were the clinical facts. With good reason they made the analogy. When computed tomography became available they used the technology to longitudinally study the brains of schizophrenics. The most reputed researcher in field, Nancy Andreasen, and the psychiatric establishment at large were soon trumpeting that they had proved the degenerative nature of the disease. In the long term the brain mass of schizophrenics was decreasing alarmingly compared to healthy individuals. Twenty years later, Andreasen admits she now believes the reason her subjects’ brains were wasting were the neuroleptics they were ingesting, not a natural process of the condition. The establishment does not refute this fact, it only suppresses it. Most everyone who is familiar with the site, knows all this – I don’t like try your patience but diminishing the relevance is even worse.
I disagree with your claim that the short term efficacy of neuroleptics is inflated. A haldol dose for an acute psychotic episode is just as immediate and as effective as lobotomy. All the “major tranquilizers” and their successors are. I look forward to hearing your arguments on this point.
Though you will argue how the long term risks are minimized – and the risks are grave and plenty – you don’t have an issue with the long term certainties, brain atrophy and significant cognitive impairment being one of them. A risk is an event that has a significant chance of not happening, that’s why I don’t call brain atrophy a risk. I am curious whether in your clinical experience you know of anyone who has continually taken neuroleptics in a mid range therapeutic dose for more than ten years who is not cognitively impaired.
I disagree that the risks of delaying treatment are inflated, if by that you mean physiological risks and you believe they are made to be bigger than they actually are, because they don’t exist at all. Insomnia is a condition that causes other physiological ailments, psychosis is not. If you mean the risk of violent acts, I agree with you.
Morphine and chemotherapy for cancer are accepted as effective short term treatments. There are no good arguments that either should be used long term. The science to justify neuroleptics belonging to the same category already exists.
You’re right, Dan.  Anybody in a neuroleptic withdrawal program will be almost certainly sick. By definition.  The body may have been perfectly healthy the first time it walked into the psychiatrist’s office, but by the time it walked out, it was destined to become ill.  So really, what you are saying is that a medical doctor is needed on staff, to tend to the ills of the body.  But originally you specifically call for a psychiatrist and then qualify that they are extremely rare.Â
When the first such program becomes a reality and you put out the job description for hire, you might be better off by requiring a medical doctor knowledgeable in the pharmacology, physiology and clinical literature of psychotropic drugs. There is a good chance you may have to reject the nine psychiatrists who show up and hire the only non-psychiatrist that wouldn’t have applied had certification been required.Â
To be fair to psychiatrists, Thomas Szasz, Loren Mosher, Peter Breggin, Marius Romme belong to their ranks. Maybe a good way to define that extremely rare set of psychiatrists  you refer to are those who reject most of what they were taught in school.Â
Dan, fantastic post. You bring up a host of issues which immediately strike as very important and that aren’t much discussed, even on MIA. My personal experience is being the parent of an adolescent on a neuroleptic and supporting him along in the discontinuation. Almost all the points you make in the context of social programs translate directly to what may happen at a family nucleus level.
I do have a few comments that may seem like nit-picking. I intend them to be clarification or elaboration from my perspective on your words. First, when I see the words science and psychiatry in the same sentence I bristle, as in a psychiatrist that “knows … the science of rebound psychosis”. I also would disagree with qualifying as knowledge much of what they believe in. Most people anti-psychiatry – like many victims of psychiatry and myself – will nevertheless agree that biochemistry is a science. So it is important to have someone with an up-to-date understanding of the chemistry of all drugs involved, their physiology with the ramifications, and the clinical studies. You also need someone to prescribe them while they’re still being used. However, so far psychiatry as a discipline has rejected any attention to the study or knowledge of withdrawal; as far as I know the core of that knowledge is currently to be found in books like those of Breggin or Ashton or the Icarus Project or a few others and in the blogs, not in the academic journals. I would even question if the training of a medical or a psychology professional is particularly suited or provides any particular advantage to the general understanding of the withdrawal process. In your text you single out explicitly the psychiatrist as someone needing to “know” about tapering, about the pace, which drugs to go off first, to be experienced in withdrawal, to be a great listener, to have intuition. Those are knowledge and skills that *everyone* on staff should have. The psychiatrist has no particular authority in any of those areas. It reminds me of the story of when Dan Fisher, the blogger on this site, was first hospitalized. The only helpful person was the corpsman. The role of medical doctors in a drug withdrawal program should be like that of the EMS people present in a public gathering. It’s best when they just watch.
The point you avoid making explicitly is that psychiatrists, in the role they currently have in dealing with people suffering, need to be drastically disempowered. This is a huge problem, the biggest obstacle, in the realization of a model in the vein you propose. The bottom line is about power. Last time around Mosher was crushed, but much of his legacy, which you build upon, is far from dead.
Forgot to congratulate you for making the film a reality. I am looking forward to seeing it. Yet one more contribution of the RLC for us all.
I am not anti-religious but I am anti-psychiatry. The fundamental principle of religion – at least as Christianity was taught to me – is faith. One *believes* in God and that faith is unbeholden to anything else. Though I may not believe in God, I do believe that free will and the ability to believe is what defines our human condition. Philosophically and ethically I have nothing against the cornerstone of religion which is faith.
Psychiatry, as now overwhelmingly conceived in the West, purports itself a scientific consequence of the basic laws of physics. You, Sera, may believe that human behavior is ultimately and entirely explained by those laws, or not. It seems to me, either way, you respect that belief in others and I share that respect with you. In that sense neither you nor I are anti-psychiatry. However, psychiatry has developed an extensive body of what it calls knowledge that its practitioners claim must be accepted if one is to abide by the laws of logic. I happen to believe that the vast majority of psychiatric knowledge, as a scientific endeavor, is flawed. But psychiatry is much more than an intellectual or philosophical theory, it is the practice of enforcing its methods and indoctrinating society in the supremacy of its beliefs. As a practice of oppression, which is the preeminent social role of psychiatry, I am anti-psychiatry. If you say you respect people’s belief in chemical imbalance theories, I believe you. When you say that you are not anti-psychiatry, I have my doubts.
My son was on stimulants by age 7. Only by age 14 did he have a full psychotic break. Though it is impossible to know, I want to blame the continual use – not abuse by medical standards – of Ritalin/Focalin during 7 years. The studies are generally short term and can only pick up fairly immediate effects. Just like other psychotropic drugs, some of the insidious effects of stimulants may start emerging only in the long term. Not that the psychiatrists I dealt with cared to know…
Thanks Steve.
Does anybody know of recent research linking stimulant use – the standard kind like that being prescribed to children diagnosed with ADHD – to psychosis?
“Engaging with someone who is in distress but is not interested in getting any help remains the the biggest conundrum for me.”
Sandy, as my son struggles with prescribed drugs, I have the same dilemma. There are many things we wish to control but cannot. Sometimes, believing that we should control is part of the problem. Most of the times, your ability to help will depend more on your human qualities than on your medical formation.
MIA has been a great help to me this year. Your contributions are appreciated.
Thanks Ted. As I said my question was rhetorical. The real question is what can we do to protect the children? For my child the harm is already done. His experience pales in comparison to your story though. I really believe we need to recover the militancy of the civil rights movement of our younger years that you speak about. Thanks for your all contributions to MIA and to the cause of the victims.
It is true that stimulants have a black box warning about psychosis but it is in the context of intravenous use.
In this article is the story of a family where all four kids were put on stimulants. By admission of the parents two of the kids were not ADHD. The part of the story of most interest to me is that one of the kids developed psychosis and became suicidal at the age of ten after being on Adderall for five years. They then switched the child to Risperdal. My son was put on stimulants at age 7 and had a full blown psychotic break at age 14, though in hind sight there were signs of psychotic features since the age of 9, which did not change the psychiatrist’s decision, the psychologist’s recommendation or my perception on continuing the uninterrupted use of the stimulant drugs. The psychiatrist just added an antidepressant at age 9 because of his suicidal ideations.
I have not found any research on the long term effects of stimulant use in children and in particular any causal link to psychosis. My anecdote, the one in this article, and many others indicate that there may very well be a significant link. Why is there no serious effort by the medical establishment to know at least the statistics? On MIA this question is rhetorical. Even if it happens in only one of ten cases, like my son or the child in the article, then hundreds of thousands of children in the US alone are iatrogenically contracting “serious mental illness”.
I wonder if individual psychiatrists are liable for not disclosing these risks to their patients, case in point heart and liver problems with Pristiq?
Hi Phil,
I can understand Sandy’s hesitation to speculate about your question about “help-seeking” dependence; her goal is to report. So here’s my speculation based on not a lot of knowledge indeed.
I presume that even in Western Lapland there are some people who are needier than others, but I wouldn’t be surprised if the proportion of “help” dependence over there to be much less than in other environments. I see two ways it could happen. First, it seems that a fundamental premise of Open Dialogue is that the implicit message in every single action by the intervention team says “We respect you”. A natural effect of that message could be that the person/persons, target of the intervention, starts to believe “I should/can respect myself”, which is the seed of empowerment. No other system/society I know of seems to emphasize respect as much. Second, I get the impression that Tornio and its surroundings is a microcosm to some degree isolated from the rest of the world. In that small community, the vast majority of people is at some point exposed to the Open Dialogue approach and understands its message. That creates a social expectation of mutual respect, especially in times of personal crisis and that alone can be a powerful influence to all individuals.
If you have not seen Dan Mackler’s documentary about Open Dialogue, I highly recommend it. You can purchase it on his website. While I’m at it, I can high recommend all his other documentary work.
Sandra, I hope you don’t mind that I used your words. What Alison has not really reported on is whether the position of psychiatry department at Brown has changed at all or are they just as entrenched as ever.
Sinead,
My son is a victim of psychopharmacology and the crime committed against him would have not been possible without the fraudulent behavior of the psychiatrists who treated my son in particular and the psychiatric profession in general. I have not read Alison’s book but I believe the fight she picked in exposing study 329, having the JAACAP retract it and using the media to spread the word is extremely important. I take these issues personally.
However, I ask, shouldn’t a more appropriate title for this article have been:
“Outrage! Keller is 65, retires with benefits, titles and privileges intact.”
Alison creates the impression that Keller was pushed out. She should clarify.
So then why is it that
“it seems clear the timing is linked to the growing pressure to retract study 329”
??
So his departure could be totally unrelated to the scandal.
How old is Martin Keller? Has he reached normal retirement age or may his departure be premature?
Ron, I admit that my statement may be factually incorrect. I am not an expert in the history of the gay rights movement. My point is that whether they talked or not, it wouldn’t have made any difference in the course of events. In accordance with Stephen Gilbert beliefs, it was society as a whole that caused the change in the DSM, not some direct discussions between gay activists and the APA. You just need to learn of Paula Caplan’s experience to convince yourself that’s how it happened.
If you look into the works of Jaakko Seikkula you’ll find references to russian literary critics not to Kraepelin. Open Dialogue may be part of a state healthcare system but it’s methods have nothing to do with medicine. The Open Dialogue group in Finland uses psychotropics as anesthesia. I wonder if they believe as I do that psychiatry should be considered a branch of anesthesiology.
I agree with Stephen Gilbert, no talking to psychiatry. The gay rights movement didn’t talk to psychiatry. The day the American Medical Association no longer recognizes psychiatry as medicine, they should offer to retrain all the unemployed psychiatrists as either neurologists or anesthesiologists.
Matt, as you describe, it was only after I connected with my intense anger and outrage that I was able to fire all the psychiatrists whom I had sheepishly followed and who almost destroyed my son. Only in my rage could I find the energy.
At the same time, I know there is much strength in finding peace as preached by Buddhism. In a previous blog you talked about the value you found in the teachings of Thich Nhat Hanh. Can you share any thoughts of that duality?
I can see skybluelight’s point. Delusions are real and that includes all religions. The problem is that psychiatry makes schizophrenic behaviour a manifestation of disease when being a defense against disease is closer to the truth. By convincing people that they have an irreversible disease, confounding illness with cure, and drugging them out of their minds with no end in sight, they crush any fighting chance for most. Psychiatry kills and dismissing crimes against humanity as irrelevant is not going to get much sympathy on this site.
Chaya, let me explain more.
If someone calls me anti-psychiatry, it gives me deep satisfaction because I know it comes from someone who believes established psychiatry has or will have all the answers. I happen to believe it has no answers and I’m not holding my breath. But that’s beside the point.
Likewise if somebody calls me anti-science in the sense I suggest in my previous comment. The difference being that science gets some things right. In that context I say that science can do harm and anti-science can do good.
Equating good morals to good science or bad morals to bad science is a mistake.
I won’t define what science is other than describe it as one of the pillars of western culture. But, in the heat of the moment, I made up the word anti-science and if it already exists I’m not sure what it means. Some worldviews maintain that there’s nothing wrong with science but that it misses the point, that science will never answer many fundamental questions in life. For those who believe that science will eventually yield the answers to all questions, such attitudes could be called anti-science. I definitely don’t belong to the group whose ultimate faith is in science, so I do create some confusion by using the word anti-science.
Choice architecture is not an ideology, it is a reality. Being terrified by it and not acknowledging its existence and its inevitability is sticking one’s head in the sand. Demonizing choice architecture is like declaring nuclear physics evil because it paved the way to the atomic bomb.
That there are imposters posing as scientists – and fortunately some of the prominent ones are denounced on this website – does not invalidate science.
Choice architecture technology reminds me a lot of advertizing technology. I don’t like commercials – on the other hand I would not put a gag order on the fishmonger shouting “Fish for sale!”
The world is not black and white.
Whitaker seems to be concerned that his style is impairing the effect of his message on some of the European audience. I’m just saying that it doesn’t really matter. That’s all.
Hermes, I get it that you’re being sarcastic. But who is the target of your sarcasm? Me?
Yes, I believe that David was referring to the candidness of the American style. If someone is put off by candidness, more reason to be candid. Being arrogant is a problem, but that is not more American than European. In any case, Whitaker is not arrogant.
In Whitaker’s post above, in the ninth paragraph, David Cohen tells him that he may have ruffled the feathers of some Europeans because his style is too “American”.
Bob,
Old World intellectuals can be just as arrogant as New World intellectuals. So David Cohen´s view of being very “American” is not relevant, in my opinion. Americans have the succinctness of the Brits without the airs of superiority. People may not like Americans, but they like that particular quality.
Established thinkers will come across as arrogant when they overstep the boundaries of their contributions. I have yet to see you do that in either your writings or your talks. So whether you’re talking at the Vatican or at your local community college, it doesn’t matter, your fans love it.
Saying “all people get infected” – which is a lie – is worse than saying “a lot of people don’t get infected *and* a lot of people do get infected” – which is true. Not that you’re doing the former, but Will is doing the latter. The critical parts to doing the right thing are a) “you decide” and b) all the available and pertinent information is facilitated, even if sparse or contradictory.
Alto, I happen to agree with your position about a strict protocol for minimizing the risks of severe and prolonged withdrawal syndrome. And I agree that it should be promoted vigorously, like the anti-smoking campaign or safe sex. I don’t have a problem if you badger Will about being muddled or Laura about being wishy-washy. But I believe when you cross the line and accuse them of promoting cold turkey, you’re damaging your credibility and doing a disservice to your cause.
Altostrata, It is good to put things in simple terms as in DON’T DO IT. I respect your position like I respect the ER doctor who on a weekly basis tries to save the lives of maimed motorcyclists and wishes that motorcycles were outright banned. From a medical perspective, recommending excessively rapid discontinuation is malpractice.
Will Hall and Laura Delano do not take as categorical stance as you do. Both effectively did cold turkey themselves and they are aware, as you should be, that the proportion of people that succeed at cold turkey is not negligible. Both agree with you that a significant proportion of people who do try cold turkey suffer long term consequences. Neither reject your Russian Roulette analogy. But to allege that they are recommending cold turkey, either implicitly or explicitly, is wrong. Laura has reason to take offense. Your reaction when someone doesn’t agree 100% with you, is not justified.
Oops. I meant it *is* legal not to use them (helmets).
Altostrata, let me preface this comment by saying what an important resource your website is and how helpful it has been for me, even more so than books by Breggin or Will Hall’s Harm Reduction Guide. Personal narratives are so much richer than simple statistics or a few generalities; anecdotes are way underrated, especially when there are hundreds of them.
I don’t think Laura’s position is to deny the risks of cold turkey. Nor is it that the knowledge of risks should be withheld from persons considering discontinuation. Her point is that, ultimately, it is a personal decision.
I’m not sure what your position is. Is it that persons going cold turkey should be somehow fined, like in some jurisdictions motorcyclists without a helmet?
If the discussion is not about fundamental rights, then we are left with speculation about how risky cold turkey really is because of lack of quality statistical studies and of how stern the warnings should be.
You can encourage motorcyclists to wear helmets backed by all the statistics you want. In my state, where it is not illegal to use them, I don’t need a DOT study to know that a significant percentage of riders don’t. I wouldn’t expect anything different from (prescribed) drug users in their withdrawal. Who am I to tell them how to live or what risks they should take?
Yeah, tomaitoes, tomahtoes. But behind the words are things that really matter and it’s good you’re going there.
Sera, thank you for uncovering subliminal ways people are oppressed. Exposing these attitudes for what they are is what makes them change.
Hi Matt,
Thanks for this post and all the previous ones. My adolescent son is on a slow neuroleptic taper and the family is his main support. For us, having such lucid accounts of others’ experiences is of invaluable help. I find a lot of commonality between your withdrawal stories, like Laura Delano’s most recent MIA post and the extended comment to that post by Greg Benson. All these stories invoke in me images of an mythic journey, like the Odyssey or the survival story in The Life of Pi. The drugs and their pushers are the Sirens or the island of meerkats. The willingness to engage in the journey and the heroic courage are the ultimate means of survival. They are the cure to the drugs and the circumstances that brought them about. I wonder how they are ever going to teach that in med school.
Phil,
I have learned much from you and your collegues at the Critical Psychiatry Network. The name you chose for the group is very fitting, your thinking is critical, not merely because it challenges established psychiatry, but also because it is good thinking in an absolute sense. If only for the absence of glaring logical fallacies you already stand apart from the vast majority of your profession. You make excellent points in your letter to the BBC regarding the problems in the methods and philosophy underlying neurological explanations of mental syndromes. However, I don’t think your letter will be very effective.
Journalists are disseminators, not referees. Science reporters select material by what is being funded and what scientific peers opine. Sometimes sensationalist value can play a role but I imagine that the BBC wouldn’t want to be associated primarily with that aspect. Your example of balanced reporting in cosmology is just a reflection of a vibrant and competitive community of scientists, with rival teams of similar academic power and position. The uncritical reporting on the psychiatric implications of neuroscience likewise just reflects how far from mainstream the critical thinkers in the field are. Expecting journalists to be better judges than those considered authorities by socieity at large is unrealistic. Journalists of the intellectual depth of Robert Whitaker are, and always will be, rare.
If I may, I would recommend you find and cultivate passionate and intelligent journalists who can recognize critical thinking when they see it. Challenge them on the issues, hold them by the hand and steer them to the corners that others prefer to keep obscure. You do the work for them; when junk is being promoted give them the insight and the material, if it exists, to expose it. They will be your megaphone because they know there also is an audience out there hungry for real understanding. You have the power of ideas and they have the power to broadcast. Just declaring that the BBC needs to improve its standards won’t be enough. You need to find a good partner – not an easy task – and work hard with him/her to get your ideas published to the widest possible audience. The BBC may or may not be the venue.
I agree, Bentall’s response is brilliant. Thanks for bringing it to the attention of MIA readers.
Hi Matt,
Relying on readers for financial support is a good model to have. It is unfortunate that you cannot not adopt a non-profit form, though I understand an LLC might have practical advantages. If there is a non-profit mission, MIA is one. Hopefully when MIA’s survival is more financially secure, you will be able to become legally non-profit. It is a political statement in a society where money rules.
I have to confess that I have not contributed before but have just been shamed into doing so. 🙂 We’re big NPR listeners at home. We switch channels when they have their drives but we do send in a check every year. I think regularly reminding the community to contribute – every individual within their means – is necessary.
I join all the other comments expressing thanks to you, Kermit and all those giving time and labor to MIA. Your expectations for MIA’s future are not misplaced.
Hi Donna, what is “ScrewU”?
Hi Sandy. Thank you for the references to studies that don’t receive the publicity that they should. The information is critical even if the conclusions will not come as a surprise to followers of MIA. I’d like to know how this information affects your personal practice. Though not as effective as hyped, is the use of neuroleptics justified at all? If the use is justified, under what circumstances? Peter Breggin, Phil Thomas, Joanna Moncrieff have made public their views on how psychiatry should be practiced and they are specific on their views of neuroleptic use. You should too. You did give some indications in your previous articles on MIA. The title of this series led me to expect you would give a synopsis of the concrete consequences of your evolving point of view and of some elaboration on the rationale of whatever changes your are making.
In a comment of mine in your previous article, I stated that you “supress” information. I regret having written that; I was wrong and I wish to take it back. I do believe there is a bias in how long-term brain atrophy of subjects using neuroleptics is being reported, however. In particular you refer to it as a risk. From my reading of the literature, I believe that the brain degeneration of diagnosed schizophrenics on such neuroleptic regimes is virtually certain as much as it is for Alzheimer’s disease. In Alzheimer’s disease, brain degeneration is not called a risk; it is a characteristic. Calling it a risk of long term neuroleptic use is a dangerous mischaracterization. Whether the cause is drugs or the inherent physiology of the cohort studied may not yet be determined beyond doubt but, as you note, the fate of monkeys is a good clue.
Matt. Ridicule, of what people say not who they are, can be a very effective at promoting the mission of MIA. The distinction is important. That is the fine line that is not to be crossed.
Matt, when you say you wish to create more hypocrites, I hope you mean those going in the opposite direction Torrey went.
Matt, thank you for the explanations. The rules are plain common sense and I support them. But as a big fan of Colbert myself, I’ll relish the attempts to go right up them without crossing.
With all this controversy, now I’m dying of curiosity to see Madness’ removed comment.
Matt and Kermit, any chance of getting it reinstated?
Cannotsay2013 and Belinda,
I’m inserting my comment here because I can’t farther down where your discussion is.
Related to AOT, there is another terrible abuse of human rights that is protected by the law. It is the psychotropic drugging of children and adolescents. From the minors’ perspective, their human rights are being violated with the complicity of their parents or, very frequently in the US, by their foster parents. These children are being forced into a quasi-irreversible path to mental patient careers, total disability, premature death and sometimes violence, to themselves or to others. This is a human tragedy of indescribable proportions; the violation of the human rights of these children is arguably more serious that of victims of adult involuntary commitment.
I don’t think the basic powers and obligations of parents towards their children are going to change anytime soon or even if they should. Robert Whitaker has a strategy to ultimately address the human rights violations to children executed by psychiatrists. It is not to explicitly and directly challenge social norms backed by the law, but to change public perceptions. As we have seen so dramatically in the last decade with gay marriage, once the polls go, the politicians and the Supreme Court justices will go. If the public opinion campaign, as promoted by Whitaker, is successful, laws to protect minors and adults from psychiatric crime will follow. Though totally I agree with Cannotsay2013 that, based only on fundamental philosophical and ethical principles, AOT laws should be repealed immediately, that’s not how the world works, unfortunately; I can see Belinda’s point. But I am a little taken aback by how she dismisses active protest. Does she think that past civil and human rights victories have been won by armchair intellectuals alone?
Laura, I would have gone to the MA rally and seen you speak in person but I’m not in the loop and didn’t get the info! Though delivered to few, the message is as powerful as it gets.
These proposed laws are terrifying.
Hi Seth,
From this thread it is not clear to me what your position on neuroleptic use is. Would you ban their use under any circumstances?
The comparison of alcohol and neuroleptics is interesting. I enjoy a glass of wine or two with dinner, not only for the taste but also for the warm, relaxing feeling. Now, in a purely hypothetical situation, if a psychiatrist prescribed an amount of alcohol that would make me pass out on a daily basis and he informed me that I needed it for the rest of my life, I’d tell him to go take a hike. In a very real situation that’s exactly what I did to the head of adolescent psychiatry at an Ivy League school when he told me that my son would have to take neuroleptics indefinitely. At the time my son had been on Abilify for more than a year, gained 100 lbs, developed metabolic syndrome, was in clear cognitive decline and still hearing voices.
Another story about my son is when he had his first and only major psychotic break – excuse the term, I know you don’t approve. The best way I can describe his state was that of a raging wild beast, cornered and poised to attack. He didn’t recognize who I was. With the police watching, the ambulance took him to the ER, where they injected ativan and haldol. I would have tried to prevent the intervention had I known at the time that I was in my right to do so, he hadn’t actually attacked or threatened anybody. I was so ignorant then. After a few hours he woke up, embraced me, told me how much he loved me and how ashamed he felt. I don’t know if it was the ativan, the haldol or if his state would have passed fairly quickly without the drugs; I’ll probably never know.
With my son’s case in mind, I ask if using a benzo for a few days is a bad thing. Though, from what I read, the risks of dependency and the subsequent complications of withdrawal become an issue after only a few weeks. Likewise, for how long and in what amounts is neuroleptic use by any given individual dangerous? What are the risks of dependency and of withdrawal? What are the chances of metabolic disorders? Will pertinent research convince even some of the ardent critics that a course of a couple months does not pose unacceptable risks? I think that there aren’t many easy answers and that the discussion is important. That is Sandy’s point. Personally, I’d regulate neuroleptic use so much as to make even some hard core liberal progressives wonder…
I am interested in your reaction to my questions.
The analogy of morphine with a neuroleptic is that both can relieve insufferable pain but don’t cure anything. The analogy with chemotherapy is that they both kill cells, one quickly, the other slowly. The commonality is that all of them will lead to premature death if taken in sufficient amounts and for sufficient time. There is absolutely nothing in common between cancer and psychosis. One is an illness and the other is not.
Jonah, I agree with you that forced psychotropic drugging is unethical; it is also enshrined by law. It is the only medical “treatment” that can be forced on patients. I say that long term neuroleptic prescription – whether voluntarily adhered to or not – is not currently considered malpractice but that it should in many circumstances if not most. Historically many human rights abuses from today’s perspective were enshrined by law, among classic examples are slavery, women and gays rights (rather lack thereof). Things eventually change but not without strife. Though I may sound a little harsh on Sandy sometimes, I recognize she is an agent of change and I profoundly respect that.
Hermes, I forgot to thank you for your references to the literature. They are pertinent and helpful.
This is the first time I get a compliment on MIA!! Thanks Jonah.
Hi Sandy,
I don’t know if in the future you will be engaging any of your patients in long term neuroleptic use but I’m sure you have plenty of colleagues in the Vermont mental health system that will. Would you be willing to urge them to have their patients periodically get a brain MRI? Once a year maybe? Not a bad idea to track their brain mass as a good clinical practice, no?
My point is not that a neuroleptic is the best short term treatment for psychotic conditions but that it would be hard to make the case that short term treatment is medical malpractice. As for long term treatment this is what I think: before someone is subjected to neuroleptic treatment, he should have a MRI performed on his brain. If after a few years of neuroleptic treatment the patient’s brain mass has diminished by 5% or the psychiatrist failed to perform the initial MRI, the patient should have an excellent chance of successfully suing his prescribing psychiatrists. Currently his chances are nil. That simple change in legal precedent would have at least as big an impact on global health as the anti-tobacco or anti-asbestos campaigns of the past.
Hi Sandy,
I do not have time to read all the previous comments so I apologize if I’m repeating a point already made. I feel very strongly about this.
There is a basic fact about neuroleptics – the most important one – which has been established for some time and which, I feel, you are suppressing in your article. It is that neuroleptics destroy the brain. In the 1950’s, psychiatrists called treatment with thorazine the chemical lobotomy. At the time they could only speculate about the physiology; what they could observe were the clinical facts. With good reason they made the analogy. When computed tomography became available they used the technology to longitudinally study the brains of schizophrenics. The most reputed researcher in field, Nancy Andreasen, and the psychiatric establishment at large were soon trumpeting that they had proved the degenerative nature of the disease. In the long term the brain mass of schizophrenics was decreasing alarmingly compared to healthy individuals. Twenty years later, Andreasen admits she now believes the reason her subjects’ brains were wasting were the neuroleptics they were ingesting, not a natural process of the condition. The establishment does not refute this fact, it only suppresses it. Most everyone who is familiar with the site, knows all this – I don’t like try your patience but diminishing the relevance is even worse.
I disagree with your claim that the short term efficacy of neuroleptics is inflated. A haldol dose for an acute psychotic episode is just as immediate and as effective as lobotomy. All the “major tranquilizers” and their successors are. I look forward to hearing your arguments on this point.
Though you will argue how the long term risks are minimized – and the risks are grave and plenty – you don’t have an issue with the long term certainties, brain atrophy and significant cognitive impairment being one of them. A risk is an event that has a significant chance of not happening, that’s why I don’t call brain atrophy a risk. I am curious whether in your clinical experience you know of anyone who has continually taken neuroleptics in a mid range therapeutic dose for more than ten years who is not cognitively impaired.
I disagree that the risks of delaying treatment are inflated, if by that you mean physiological risks and you believe they are made to be bigger than they actually are, because they don’t exist at all. Insomnia is a condition that causes other physiological ailments, psychosis is not. If you mean the risk of violent acts, I agree with you.
Morphine and chemotherapy for cancer are accepted as effective short term treatments. There are no good arguments that either should be used long term. The science to justify neuroleptics belonging to the same category already exists.
You’re right, Dan.  Anybody in a neuroleptic withdrawal program will be almost certainly sick. By definition.  The body may have been perfectly healthy the first time it walked into the psychiatrist’s office, but by the time it walked out, it was destined to become ill.  So really, what you are saying is that a medical doctor is needed on staff, to tend to the ills of the body.  But originally you specifically call for a psychiatrist and then qualify that they are extremely rare.Â
When the first such program becomes a reality and you put out the job description for hire, you might be better off by requiring a medical doctor knowledgeable in the pharmacology, physiology and clinical literature of psychotropic drugs. There is a good chance you may have to reject the nine psychiatrists who show up and hire the only non-psychiatrist that wouldn’t have applied had certification been required.Â
To be fair to psychiatrists, Thomas Szasz, Loren Mosher, Peter Breggin, Marius Romme belong to their ranks. Maybe a good way to define that extremely rare set of psychiatrists  you refer to are those who reject most of what they were taught in school.Â
Dan, fantastic post. You bring up a host of issues which immediately strike as very important and that aren’t much discussed, even on MIA. My personal experience is being the parent of an adolescent on a neuroleptic and supporting him along in the discontinuation. Almost all the points you make in the context of social programs translate directly to what may happen at a family nucleus level.
I do have a few comments that may seem like nit-picking. I intend them to be clarification or elaboration from my perspective on your words. First, when I see the words science and psychiatry in the same sentence I bristle, as in a psychiatrist that “knows … the science of rebound psychosis”. I also would disagree with qualifying as knowledge much of what they believe in. Most people anti-psychiatry – like many victims of psychiatry and myself – will nevertheless agree that biochemistry is a science. So it is important to have someone with an up-to-date understanding of the chemistry of all drugs involved, their physiology with the ramifications, and the clinical studies. You also need someone to prescribe them while they’re still being used. However, so far psychiatry as a discipline has rejected any attention to the study or knowledge of withdrawal; as far as I know the core of that knowledge is currently to be found in books like those of Breggin or Ashton or the Icarus Project or a few others and in the blogs, not in the academic journals. I would even question if the training of a medical or a psychology professional is particularly suited or provides any particular advantage to the general understanding of the withdrawal process. In your text you single out explicitly the psychiatrist as someone needing to “know” about tapering, about the pace, which drugs to go off first, to be experienced in withdrawal, to be a great listener, to have intuition. Those are knowledge and skills that *everyone* on staff should have. The psychiatrist has no particular authority in any of those areas. It reminds me of the story of when Dan Fisher, the blogger on this site, was first hospitalized. The only helpful person was the corpsman. The role of medical doctors in a drug withdrawal program should be like that of the EMS people present in a public gathering. It’s best when they just watch.
The point you avoid making explicitly is that psychiatrists, in the role they currently have in dealing with people suffering, need to be drastically disempowered. This is a huge problem, the biggest obstacle, in the realization of a model in the vein you propose. The bottom line is about power. Last time around Mosher was crushed, but much of his legacy, which you build upon, is far from dead.
Forgot to congratulate you for making the film a reality. I am looking forward to seeing it. Yet one more contribution of the RLC for us all.
I am not anti-religious but I am anti-psychiatry. The fundamental principle of religion – at least as Christianity was taught to me – is faith. One *believes* in God and that faith is unbeholden to anything else. Though I may not believe in God, I do believe that free will and the ability to believe is what defines our human condition. Philosophically and ethically I have nothing against the cornerstone of religion which is faith.
Psychiatry, as now overwhelmingly conceived in the West, purports itself a scientific consequence of the basic laws of physics. You, Sera, may believe that human behavior is ultimately and entirely explained by those laws, or not. It seems to me, either way, you respect that belief in others and I share that respect with you. In that sense neither you nor I are anti-psychiatry. However, psychiatry has developed an extensive body of what it calls knowledge that its practitioners claim must be accepted if one is to abide by the laws of logic. I happen to believe that the vast majority of psychiatric knowledge, as a scientific endeavor, is flawed. But psychiatry is much more than an intellectual or philosophical theory, it is the practice of enforcing its methods and indoctrinating society in the supremacy of its beliefs. As a practice of oppression, which is the preeminent social role of psychiatry, I am anti-psychiatry. If you say you respect people’s belief in chemical imbalance theories, I believe you. When you say that you are not anti-psychiatry, I have my doubts.
My son was on stimulants by age 7. Only by age 14 did he have a full psychotic break. Though it is impossible to know, I want to blame the continual use – not abuse by medical standards – of Ritalin/Focalin during 7 years. The studies are generally short term and can only pick up fairly immediate effects. Just like other psychotropic drugs, some of the insidious effects of stimulants may start emerging only in the long term. Not that the psychiatrists I dealt with cared to know…
Thanks Steve.
Does anybody know of recent research linking stimulant use – the standard kind like that being prescribed to children diagnosed with ADHD – to psychosis?
“Engaging with someone who is in distress but is not interested in getting any help remains the the biggest conundrum for me.”
Sandy, as my son struggles with prescribed drugs, I have the same dilemma. There are many things we wish to control but cannot. Sometimes, believing that we should control is part of the problem. Most of the times, your ability to help will depend more on your human qualities than on your medical formation.
MIA has been a great help to me this year. Your contributions are appreciated.
Thanks Ted. As I said my question was rhetorical. The real question is what can we do to protect the children? For my child the harm is already done. His experience pales in comparison to your story though. I really believe we need to recover the militancy of the civil rights movement of our younger years that you speak about. Thanks for your all contributions to MIA and to the cause of the victims.
It is true that stimulants have a black box warning about psychosis but it is in the context of intravenous use.
In this article is the story of a family where all four kids were put on stimulants. By admission of the parents two of the kids were not ADHD. The part of the story of most interest to me is that one of the kids developed psychosis and became suicidal at the age of ten after being on Adderall for five years. They then switched the child to Risperdal. My son was put on stimulants at age 7 and had a full blown psychotic break at age 14, though in hind sight there were signs of psychotic features since the age of 9, which did not change the psychiatrist’s decision, the psychologist’s recommendation or my perception on continuing the uninterrupted use of the stimulant drugs. The psychiatrist just added an antidepressant at age 9 because of his suicidal ideations.
I have not found any research on the long term effects of stimulant use in children and in particular any causal link to psychosis. My anecdote, the one in this article, and many others indicate that there may very well be a significant link. Why is there no serious effort by the medical establishment to know at least the statistics? On MIA this question is rhetorical. Even if it happens in only one of ten cases, like my son or the child in the article, then hundreds of thousands of children in the US alone are iatrogenically contracting “serious mental illness”.
I wonder if individual psychiatrists are liable for not disclosing these risks to their patients, case in point heart and liver problems with Pristiq?
Hi Phil,
I can understand Sandy’s hesitation to speculate about your question about “help-seeking” dependence; her goal is to report. So here’s my speculation based on not a lot of knowledge indeed.
I presume that even in Western Lapland there are some people who are needier than others, but I wouldn’t be surprised if the proportion of “help” dependence over there to be much less than in other environments. I see two ways it could happen. First, it seems that a fundamental premise of Open Dialogue is that the implicit message in every single action by the intervention team says “We respect you”. A natural effect of that message could be that the person/persons, target of the intervention, starts to believe “I should/can respect myself”, which is the seed of empowerment. No other system/society I know of seems to emphasize respect as much. Second, I get the impression that Tornio and its surroundings is a microcosm to some degree isolated from the rest of the world. In that small community, the vast majority of people is at some point exposed to the Open Dialogue approach and understands its message. That creates a social expectation of mutual respect, especially in times of personal crisis and that alone can be a powerful influence to all individuals.
If you have not seen Dan Mackler’s documentary about Open Dialogue, I highly recommend it. You can purchase it on his website. While I’m at it, I can high recommend all his other documentary work.
Sandra, I hope you don’t mind that I used your words. What Alison has not really reported on is whether the position of psychiatry department at Brown has changed at all or are they just as entrenched as ever.
Sinead,
My son is a victim of psychopharmacology and the crime committed against him would have not been possible without the fraudulent behavior of the psychiatrists who treated my son in particular and the psychiatric profession in general. I have not read Alison’s book but I believe the fight she picked in exposing study 329, having the JAACAP retract it and using the media to spread the word is extremely important. I take these issues personally.
However, I ask, shouldn’t a more appropriate title for this article have been:
“Outrage! Keller is 65, retires with benefits, titles and privileges intact.”
Alison creates the impression that Keller was pushed out. She should clarify.
So then why is it that
“it seems clear the timing is linked to the growing pressure to retract study 329”
??
So his departure could be totally unrelated to the scandal.
How old is Martin Keller? Has he reached normal retirement age or may his departure be premature?