Tags: antidepressants, bipolar, bipolar conversion, Bipolar UK, mania, National Bipolar Awareness Day
Two studies with nearly identical data yield very different conclusions. Beautiful lady or old hag? Both collected data showing that individuals initially receiving a diagnosis of “depression” and treatment with antidepressants convert to “bipolar” diagnoses at an impressively high rate.
But the survey released today (in honor of the UK’s “National Bipolar Awareness Day”) by Bipolar UK portrays the data on conversion as evidence of misdiagnosis and the need for better awareness of bipolar disorder by mental health professionals, while this study from 2004 attributes conversion, not to misdiagnosis, but largely to antidepressants’ tendency to cause mania (it is a PDR-listed side effect, after all).
Is the rise of bipolar diagnoses in the US (a 56% increase in adults between 1996 and 2004) and Western Europe a largely iatrogenic phenomenon?
I decided to write Bipolar UK to ask them their thoughts on the matter.
To: the folks at Bipolar UK
Subject: Enquiry Related to “Challenges to Diagnosis” Survey
First, let me wish you a happy National Bipolar Awareness Day!
I read the executive summary of your recent survey of individuals diagnosed as “bipolar” with great interest. I was particularly struck by two statistics you presented:
- 85% of respondents were diagnosed with and treated for depression before being diagnosed as bipolar
- 71% of those receiving delayed diagnosis felt that their symptoms had been made worse by antidepressants or sleeping pills
Your data reminds me of a widely cited 2004 study in which 87,920 individuals initially diagnosed with depression were followed for 5 years. 4182 eventually received a diagnosis of bipolar (“converted”) during the course of the study, and 81% of them were being treated with antidepressants. The authors state in their analysis that “the conversion rate amongst antidepressant-treated patients (7.7% per year) was 3-fold that amongst unexposed patients (2.5% per year).” These findings are quite consistent with yours.
Your interpretation of this data seems to be that the timely diagnosis of bipolar disorder is an area that needs improvement amongst mental health professionals, who currently are misdiagnosing many bipolar individuals with depression.
However, I would like to suggest to you another interpretation, one that the previously cited study puts forward. Its authors state that “It has long been known that antidepressant medications can precipitate mania in vulnerable individuals” and that “treatment with antidepressants is associated with … conversion hazards.” “Mania/hypomania” are also listed in the Physician’s Desk Reference as effects of both SSRIs and tricyclic antidepressants. The PDR entry on imipramine (the very first tricyclic antidepressant) explicitly states “Manic or hypomanic episodes may occur; consider decrease until episode is relieved.”
Is it possible that many of the respondents to your survey, and many of the individuals you serve – in short, people with “bipolar” diagnoses – are dealing with an entirely iatrogenic phenomenon?
On this inaugural “Bipolar Awareness Day,” I think it is vital that we pursue awareness, not only of the diagnostic criteria, but also of the very real possibility of diagnostic inflation that is iatrogenic in nature.
I look forward to hearing your thoughts on this.
Writer, mental health activist
Tags: bipolar, forced treatment, involuntary commitment, Jeneen Interlandi, medication adherence, New York Times
There is a famous optical illusion called the young lady and the old hag.
The drawing illustrates how one’s perception of an object can suddenly flip, and in a sense, the dueling histories [of psychiatry]… have that same curious quality. There is the “young woman” picture of the psychopharmacology era that most of American society believes in, which tells of a revolutionary advance in the treatment of mental disorders, and then there is the “old hag” picture… which tells of a form of care that has lead to an epidemic of disabling mental illness.
… If you think of the [psychotropic] drugs as “anti-disease” agents and focus on short-term outcomes, the young lady springs into sight. If you think of the drugs as “chemical imbalancers” and focus on long-term outcomes, the old hag appears. You can see either image, depending on where you direct your gaze.
- Robert Whitaker, Anatomy of an Epidemic
It’s my new favorite metaphor for looking at psychiatry (replacing the tried-and-true “Emperor’s New Clothes”). The gulf between what mainstream psychiatry preaches about mental and emotional distress and what alternative and critical thinkers have to say is vast. On one side is an almost completely biological interpretation of mental distress as a chronic disease requiring lifelong chemical intervention, “management,” compliance, and across-the-board lowered expectations – for livelihood, and life. On the other is the idea that extreme emotional states, if not directly iatrogenic, are often the result of environmental, social, and historical factor, are better not pathologized, and in some cases (specifically, a first break into psychosis) may actually be part of a psychic healing process.
The space between being dotted with possibilities as well, though a position located exactly in the middle is about as sturdy as a house built directly over the San Andreas Fault Line.
When I look at the illusion, my strongest inclination is to see the young lady. Only by staring intently for several minutes, carefully searching for the hag, can I find her – it’s the nose that does it, finally.
And though my strongest inclination is to see psychiatry-as-usual as the old hag, I recently had a experience of the beautiful lady, and in this case, it was the appeal to my heart that did it.
A daughter’s story
“When My Crazy Father Actually Lost His Mind,” by Jeneen Interlandi, ran in the New York Times magazine this weekend, and it is moving, heart-wrenching.
It’s a daughter’s retelling of her father’s most recent protracted manic episode, and the devastating costs – financial and otherwise – to her entire nuclear family. During a manic period that lasted from August 2010 until late February 2011, her father endured 5 emergency room visits, 4 arrests and court appearances, numerous police confrontations, 25 days in a psychiatric hospital and 40 in a county jail. Total medical expenses were more than $250,000.
Ms. Interlandi’s story is one of a frightened family desperately seeking a way to stabilize her father – and they felt that forced medication compliance, a stay in a psychiatric facility, or both, were the way to accomplish this.
Here’s what I thought should have happened: My father should have been hospitalized against his protestations until his mania subsided. Once it did, he should have been released under supervision and under the condition that he abstain from drinking, which can exacerbate the symptoms of bipolar syndrome, and adhere to a treatment plan involving some combination of talk therapy and medication. I imagined something like probation, but run by a mental health office instead of a criminal court.
- Jeneen Interlandi, in the New York Times magazine piece “When My Crazy Father Actually Lost His Mind”
And though we do not hear directly from her father about his experience, it seems he had different ideas about what should happen:
We wanted him to go to a state hospital, where he could be cared for until he came around to taking his medication or until his mania subsided … He wanted to go home. But he was unwilling to take any of the steps that we were laying out for him to get there. He insisted that nothing was wrong with him and refused to take mood-stabilizing medication.
- Jeneen Interlandi
Ultimately, Ms. Interlandi’s family got the kind of medication compliance plan they were looking for (complete with probation officer), and the story ends with a scene of domesticity in the Interlandi home.
I asked him what he remembered about the whole ordeal… He [said he] felt like some other being had possessed him for a time. And he hoped that whatever it was, it was gone for good. My mother echoed those sentiments, shouting from the kitchen that it was the only part of their marriage that she wished to forget. Both of them seemed perfectly happy to ignore the fact that bipolar disorder is considered to be a lifelong condition. They would bury this alongside their other shared tragedies until, eventually, it became just another story they told.
- Jeneen Interlandi
Threats of violence from a man who has fiercely loved his wife all the years of their marriage, half-hearted suicide attempts from this gregarious lover of life – one can understand why the author felt as if “an evil alien had invaded his mind and taken over his body.” My heart goes out to a family that managed to stick together through this bipolar nightmare (the author’s mother was told she might want to “get a divorce” by her doctor in the midst of the crisis; she promptly got a new one), and I am happy that, at least for now, they have found the stability they so ardently sought.
The beautiful lady grants them a return to domestic bliss.
The thrust of Ms. Interlandi’s article was that her family’s worst suffering was directly caused by the difficulty they had in getting her father committed and medicated – if only involuntary commitment were easier and there were more places for such people to be committed to, her father could have (her words) “been cared for until he came around to taking his medication.”
One can fairly say that stability via medication compliance was a top priority for this family; Mr. Interlandi’s return to his home was conditional and depended upon it.
Is this the only way to achieve stability?
It’s an important question, because the number of adults (and children, too!) experencing severe mania and being diagnosed with bipolar disorder is soaring. From 1996-2004, the number of adults given the bipolar diagnosis rose by 56%. And I’m sure most readers are familiar with the 4000% increase of childhood bipolar disorder diagnoses between 1998 and 2004.
How to explain this?
We turn again to the old hag, psychiatry-as-usual.
A person treated with an anti-depressant has a significant chance of experiencing mania and receiving a bipolar disorder diagnosis that is, in reality, describing an entirely iatrogenic (drug-induced) phenomenon.
A 2004 study of 87,290 people originally diagnosed with depression or anxiety found that those treated with anti-depressants “converted” to bipolar disorder at the rate of 7.7% per year – ultimately adding up to between 20% and 40% of all people treated with anti-depressants. And this survey found that 60% of people with a bipolar disorder diagnosis said they “had initially fallen ill with major depression and had turned bipolar after exposure to an antidepressant.”
As it turns out, for many with a bipolar diagnosis, medication adherence is the key to instability, to increased mania and ever-more-rapid cycling. This is especially true for people who withdraw abruptly from their medications (as mania is a well-known symptom of rapid withdrawal from both antidepressants and mood stabilizers). And folks who do comply with long-term medication adherence have significantly worse mental and physical health outcomes than those who don’t – the science shows this over and over again.
It becomes clear from reading the New York Times comments section that Ms. Interlandi’s experience is not unlike that of many other families, desperate for a loved one’s return to stability that they believe can only be achieved by lifelong medication compliance, enforced, when necessary.
But how many of these beloved family members would never have experienced mania without previous exposure to a psychotropic drug? How many of these families would’ve been spared the endless cycling through moods, courts, hospitals, and jails, the threats, the attempted suicides if a family doctor had put away the prescription pad?
How many of the new bipolar diagnoses are iatrogenic?
Psychotroipcs as first line treatment, long term medication adherence, psychiatry-as-usual: beautiful lady or old hag?
People in mental or emotional distress more likely to consult a pastor than a psychiatrist 06/25/2012Posted by ALT in Mental Health Research, Philosophy/Spirituality.
Tags: church, mental health, religious counselor, spiritual distress, spirituality
In recent posts (here and here), I’ve asked some questions about the spiritual content of the psychotic visionary process, and the general tendency of mainstream psychiatry to deny – at all costs – that spiritual content as being in any way valid or “real.” Though the very language we use to describe our dealings with mental and emotional distress acknowledges its roots in the spiritual world (“psychiatrist” literally means “soul healer“), our society’s standard response is fundamentally clinical, biopsychiatric, and entirely secular.
Put simply, we do not acknowledge the possibility of mental and emotional distress as spiritual suffering; we claim it is wholly biological in kind. An imbalance of neurotransmitters maybe, or a genetic problem.
But is this how people experience such distress – as a biological problem requiring a chemical solution?
Here’s a statistic (and a partial answer to my quesiton): people going through mental and emotional distress are more likely to consult with a pastor or religious counselor than any other type of professional, and it is often the only type of professional help they seek (in one study, only 10% of people who sought help from a clergy member were referred on to a mental health professional).*
What kind of response do they get? I’m sure it varies widely – this study reported that responses were often positive, but about 1/3 of mentally distressed folks who sought help from the church got a negative reaction, “abandonment or lack of involvement” being the most common.**
On the flip side, this recent news story profiles a number of ways that churches across the country have attempted to reach out to folks with mental and emotional problems.
Some are offering home-cooked meals, personal hygiene items, and clothing, others do day programs with self-directed art, gardening, and other activities, or just a space to experience peace and quiet; all provide a culture of listening without judgment, a strong sense of community, and prayer. The focus is on faith, hope, and the possibility of healing.
The sense of community and the loving support are big reasons why people are interested in accessing the clergy and church for help.
Faith helps. Faith helps greatly. And coming to the church where everybody knows me, acknowledges that you’re there—that helps.
- Ruth Reskey, psychiatric survivor who accesses the clergy regularly for help (quoted here)
Another contributing factor could be the lack of mental health training that the clergy has received – they’re not trained in the art of diagnosis, and consequently, the art of over-pathologizing and stigmatizing.
But most of all…
We conclude that those coming to the clergy for help in times of psychological distress are seeking religious rather than psychological counseling. Spiritual help appears to be what they want.
- from this study, showing that 41% of participants turned to clergy first for mental health needs [emphasis added]
I say, give the people what they want!
*This does vary quite a lot across cultures, however here are three studies [from disparate cultural groups] showing this is true in El Paso, Texas amongst Caucasian and Latino populations, amongst African Americans, and in Northern England.
Photo credits: infobarrel.com
GUEST POST: One Friday Night 06/20/2012Posted by ALT in Guest Post.
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Written by Neil Miller
One Friday night I was at home. About 8:30 I felt an overwhelming wave of sadness wash over me. Not five minutes later I heard a voice (not mine) speak inside my skull. This voice was a first for me. What it said was “which means?” At that time I had adopted “which means?” as a cue to help me reason out or think through questions. Example: I might figure that A +B=C. It’s at this point I’d ask “which means.” By doing this I’d both check to see if I was headed the right direction and what’s next. The first time the voice spoke to me it tried to help me. Over the years that has changed. Now I hear everything from brutally abusive comments (sometimes known as guy talk), to enviable clarity of thought, to assist me with the little choices that go into everyone’s day, to sporadic, self-promoting humor. Who is this constant companion in my mind? Probably it’s my psyche’s remnant of dear old dead Dad. It’s as if that sociopath is speaking to me from beyond the grave. But, even writing these few words helped to kick another door open wide for me. Notwithstanding the reality that I’m a stable productive member of society, there are avenues of treatment I must explore to put (probably it’s) Dad in his place.
This particular wave of sadness was not a first for me, but, I’d never felt so swept up before. Not quite sure what to do, I told myself the voice and the sadness were two little oddities I didn’t need to think about. Monday morning I got to the office and soon took a call from the daughter of my largest client. My client was also a very dear friend. He’d passed away last week, she said. “When,” I asked. “Friday,” she said. I just had to ask this next question, “About what time, Cheryl?” “8:30 in the evening.” So that was my Friday night sorrow. I’d lost a dear friend and a valuable business contact. But, I felt the feelings 2 ½ days before I knew what the facts were. These feelings of sadness and grief didn’t happen in real time, they happened psychically, in advance. This was not a human experience I knew about or understood. Looking back, I believe I was in uncharted territory. I may have been in mourning all weekend and didn’t know it. Though I needed to share my sense of loss with his family and others; emotionally I was all used up by Monday. If only this story could end now I would continue to try and hide from my damnably complicated emotions.
My friends name was Joe.
Joe was Lebanese to my Jewish. He was Christian to my Jewish. His family didn’t trust me or like me. Joe wanted to take the risk of crossing the bridge to what everyone told him was a dangerous territory. He wanted to do business with a son of Israel. (I’m American born and never traveled to Israel, but, tribes always weigh to heavily on people’s minds.)
He’d made some money in his day and his family wanted to keep the money safe. They also felt protective of this ornery old man. Joe wanted to be a gambler. About the gambling, I sided with the family. After several rounds of my talking him out of high risk investments, the family declared a truce with me. Then, Joe and I finally had time to get to know each other. We found out we liked each other. Along with the itch to be a gambler, I found out he was savoring a private glee in keeping his family guessing about how he wanted to put his money to work. He really didn’t want to put more $’s into junk bonds and $.38 stocks. (I mean, after all, he was 90.) He was just checking his family’s temperature for anxiety about him. So be it. He made them respect him and he reciprocated their love and respect. And, sometimes there was a gleam in his eye.
He was old enough to be my Dad, even my granddad. At his age what did he have the energy left to like? He liked gambling, keeping his family guessing and he liked the TV show the A Team. The show had a lot of high risk behavior by our testosterone fueled, yet lovable band of heroes. The program was such goofy fun I liked it as well. I’d go over to his house and we’d watch reruns of The A Team together. I was never that relaxed and at ease with my dad.
When he died I felt like I lost a dad, a pal and a guy whose story deserves to be told. He bridged gaps of religion and nationality and ended up boasting about his Jewish stockbroker. In his life these were somewhat lesser accomplishments. Sooner or later Joe was going to die. I knew this. So, why did his death hit me so hard, why the wave of sadness and where did that premonition come from? I’m tempted to answer my question by quoting from a great, old Bob Dylan song, The Ballad of Frankie Lee and Judas Priest. In the song there was a “neighbor boy” who “muttered underneath his breath ‘nothing is revealed.’ “ Now is the time to gather more light together but, will the act of gathering light reveal anything? Let us hope for a glorious picture window for light to pour through, as if the window and the light were the product of the same gathering. Let us accept the reality that tiny little peep holes here and there are all that may be possible.
That Dylan song made several mentions of things waiting down the road. Things were certainly waiting for me down the road and close by. Joe died and suddenly I’m getting psychic premonitions and hearing voices. This happened to quickly, as if out of the blue, right? Not exactly. Joe’s friendship was a bulwark to me against having to deal with emotions and states of mind I’d refused to look at for many years. Joe died, the dam broke and I was flooded with emotions and psychic awareness. I was overwhelmed. Sixteen years before Joe died an astrologer told me I had tremendous psychic awareness. He said I probably wasn’t aware of it but I would become more aware of my psychic ability later in life. For 16 years I felt stirrings of my gift but tried to not look at it. Then, suddenly, I’m a faint reflection of Oedipus the King in that my fate was foretold and there was no way for me to avoid it. Now I wonder how to know my fate and continually align with it.
There is not a point on the map for someone like me. I’m a little bit psychic and a little bit psycho. For years I did not believe there was a group for me to gather with. There was not a group of people who could shelter my soul. And, to feel the human warmth of others like me was unimaginable. Recently, I may have found such a tribe but, I’m still surprised at my discovery. Thus, I don’t have the words to talk about it, the surprise is too great. However, there are gaps I want to bridge. One is the singular me learning much more about this tribe I may want to call my own. Here’s another gap to bridge; my psychic ability seems to be precognitive. But, I want to align with my fate. How is it possible for someone who is precognitive to believe in fate? I know how to end this article;
Joe, building bridges is how I will keep faith with you.
Where have all the prophets gone? (Part Two) 06/19/2012Posted by ALT in Philosophy/Spirituality, Psychosis.
Tags: collective unconscious, dry bones, Ezekiel, Far Side of Madness, John Perry, prophet, psychosis, schizophrenia, visionary
[read Part One here]
(New International Version)
The hand of the Lord was on me, and he brought me out by the Spirit of the Lord and set me in the middle of a valley; it was full of bones. 2 He led me back and forth among them, and I saw a great many bones on the floor of the valley, bones that were very dry. 3 He asked me, “Son of man, can these bones live?”
I said, “Sovereign Lord, you alone know. ”
4 Then he said to me, “Prophesy to these bones and say to them, ‘Dry bones, hear the word of the Lord! 5 This is what the Sovereign Lord says to these bones: I will make breath [in Hebrew, the word also means “spirit”]enter you, and you will come to life. 6 I will attach tendons to you and make flesh come upon you and cover you with skin; I will put breath [spirit] in you, and you will come to life. Then you will know that I am the Lord. ’”
7 So I prophesied as I was commanded. And as I was prophesying, there was a noise, a rattling sound, and the bones came together, bone to bone. 8 I looked, and tendons and flesh appeared on them and skin covered them, but there was no breath in them.
9 Then he said to me, “Prophesy to the breath; prophesy, son of man, and say to it, ‘This is what the Sovereign Lord says: Come, breath [spirit], from the four winds and breathe into these slain, that they may live.’” 10 So I prophesied as he commanded me, and breath entered them; they came to life and stood up on their feet—a vast army.
11 Then he said to me: “Son of man, these bones are the people of Israel. They say, ‘Our bones are dried up and our hope is gone; we are cut off.’ 12 Therefore prophesy and say to them: ‘This is what the Sovereign Lord says: My people, I am going to open your graves and bring you up from them; I will bring you back to the land of Israel. 13 Then you, my people, will know that I am the Lord, when I open your graves and bring you up from them. 14 I will put my Spirit in you and you will live, and I will settle you in your own land. Then you will know that I the Lord have spoken, and I have done it, declares the Lord. ’”
This was the text for the sermon I heard at the church of my childhood, a few weeks ago. I had never encountered this story before, and it floored me.
What powerful imagery, and how relevant to our times! A valley of dry bones, the people dead and desiccated, no breath to enliven them… until the Spirit reclaims them. And I was struck – thunderstruck, really — by the fact that Ezekiel’s vision bears a striking resemblance to the visions experienced by many during a so-called “psychotic episode”: death and destruction, an Apocalypse, the voice of God, a rebirth.
In The Far Side of Madness, John Perry proposes a series of interrelated archetypal images/ideas that consistently make an appearance in the psychotic process (though not necessarily in a linear fashion):
A. Center – A location is established at a world center or cosmic axis
B. Death – Themes of dismemberment or sacrifice
C. Return to beginnings
D. Cosmic Conflict – a battle between good and evil
E. Threat of Opposite
F. Apotheosis - direct communication or identification with God
G. Sacred Marriage
H. New Birth
I. New Society/a New Age
J. Quadrated World – a fourfold structure of the world or cosmos
(from John Weir Perry’s Far Side of Madness)
Perry illustrates, with numerous case studies, the amazing regularity with which these features appear in psychotic processes. Ezekiel’s vision contains many of them: death (dismemberment), cosmic conflict, apotheosis, new birth (the bones and flesh made alive), and quadrated world (breath “from the four winds”). The book of Ezekiel, an account of Ezekiel’s seven visions from God, contains them all.
The idea that some [not all] psychotic processes are spiritual in nature, and serve (in part)* to convey a message from the divine, is an old one. In fact, in many traditional cultures, it was and is the dominant interpretation of these experiences.
But in our culture, the idea that psychosis/the visionary process has value for the individual experiencing it and the community to which he belongs is downright revolutionary!
On the micro level — the individual — it is valuable as
a self-healing process – one in which, specifically, the pathological complexes dissolve themselves. The whole schizophrenic turmoil is really a self-organising, healing experience.
-John Weir Perry, in this interview
But there is an analog at the macro level, the level of the community, that is equally important:
Our new understanding shows that the process of re-connection to the Unconscious [psychosis]… is nonetheless made up of the same stuff as seers, visionaries, cultural reformers and prophets go through. They also experience much of the same content, except that in their case it is specifically concerned, first and foremost, with the culture itself.
Any kind of therapy that deals with the psyche at this deeper level of the collective unconscious, one comes to the inevitable realisation that we are not going along in our psychic life, you know, just in a realm of interpersonal relationships. A very powerful culture such as ours projects huge patterns, huge conflicts and turmoils, and we all experience them, although we may not be conscious of their inner meaning at all.
In this sense, Humankind is still enormously alienated; the point is, it doesn’t happen just in Washington and Moscow – it happens within the psyche of the whole people…
This brings up the question of myth-form. You see, the big problems facing society are perceived in symbolic, mythic expression, and for this reason their resolution takes place on the symbolic, mythic level as well. If there’s work going on in a culture to reorganise itself, then it’s a process that must occur on both levels simultaneously: individuals will go through their personal visions, and collective spokesmen will express collective visions, which get worked out and implemented on a cultural level.
- John Weir Perry, in this interview**; emphasis added
Where have all the prophets gone?
Does this culture have problems of epic proportions facing it? I would say: YES. Are we in need of reorganization, a drastic reordering of priorities, some serious soul-searching? Again, my opinion – YES.
And is it possible that somewhere in the vast expanse of humankind exists a visionary, one who will journey across an archetypal landscape and bring back to us a spiritual message, a breath of life to the dry bones of our culture of death?
Will we listen?
Or will we label (as psychotic) and medicate (with “anti-psychotics”) until that voice grows silent?
* They also serve as a process of self -reorganization, psychic re-invention.
** More from John Perry on these ideas in this excellent video interview, recently uploaded to YouTube (!):
Where have all the prophets gone? (Part One) 06/18/2012Posted by ALT in Philosophy/Spirituality.
Tags: mental health, prophet, psychiatry, soul healing, spirituality, visionary
I haven’t talked about spirituality much here. In some ways, that’s a glaring omission, given that this blog is concerned mainly with a critique and rethinking of mainstream psychiatry, literally, “soul healing.” The big critique being mainstream psychiatry’s denial of the soul, its insistence on treating only the bodies and the brains, forgetting the spirit that brings them to life.
I’ve avoided it because, well, I didn’t want to offend. Most people (myself most definitely included) are allergic to proselytization — run at the first hint of it.
So, fair warning: I’m going to start talking about spirituality. I may even talk about some of my spiritual beliefs. But with the important caveat that while this evolving faith seems to be true for me, something entirely different may be true for you. And I respect that.
A spiritual battle
I view the struggle for mental rights and freedoms as a battle to secure for the discerning and self-actualizing part of a human being – “soul,” if you will – the right to exist, fully and dynamically. From this perspective, it’s almost inappropriate to approach questions of wellness, of being-in-the-world, from an entirely clinical, secular point of view, because these issues are inextricably tied up with matters of the heart (the seat of spiritual insight).
Again, we’re not robots, not just bodies with a helping of brains on top – there’s a spirit in there that makes us alive! With that spirit we quickly transcend the bare chemical fact of our existence. Carbon atoms bonded to other carbon atoms? That is only the beginning; truly, we are much, much more!
So a person in emotional distress needs more than a chemical intervention, a pharmaceutical or a “natural” vitamin for the body (though a vitamin probably wouldn’t hurt…). This person needs spiritual comfort and guidance. Mind, body, and spirit – I believe that healing requires a balance of all three.
This battle for mental rights and freedoms is fought on several levels: we say forced treatment is a violation of a citizen’s rights (body) and a thinking individual’s free will (mind). But we must not forget the spiritual ramifications – to be restrained, secluded, unwillingly drugged or shocked, is it not a violation of the living spirit?
Anne Woodlen, whose writing I greatly admire, states it starkly:
American medicine treats the body with drugs until it kills the soul. It’s rather like a root canal: the tooth is left in place but the nerve is taken out… More and more people are crying out in spiritual pain, and their cries are being silenced with drugs… You call this caring—this business of silencing the pain of wounded spirits?
- Anne C. Woodlen, “Mind, Spirit, or Soul” [emphasis added]
We live in a society where every spirit, every human being, is systematically assailed. No one escapes entirely. How did this come to pass?
How did we, as a society, come to be so very, very sick?
A related question
I grew up attending Baptist church services every Sunday. In sermons, and in conversations, I would often hear a question that seemed to trouble whoever asked it, and it troubled me, too:
Where have all the prophets gone?
Why doesn’t God send us messengers anymore?
The Old Testament is full of prophets, visionaries, men who saw God, talked with God. If a society was on the path to ruin and evil, God sent someone with a message, a mandate, to make things right. These were real, undeniable miracles, and they happened all the time!
This stuff would be big news, today, right? You just don’t miss a man proclaiming the word of the LORD and then ascending to heaven in a chariot of fire.
Ultimately, I learned to accept that for some mysterious reason, God doesn’t do big, obviously miraculous stuff like that anymore. He answers prayers and works on the small-scale, individual level – but sending messengers with miraculous visionary and prophetic powers to lead a community back to righteousness? That’s a thing of the past; it just doesn’t happen like that anymore. This answer to the question never did sit quite right with me, but it was the best I had.
Until I revisited the church of my childhood a few weeks ago after a long absence, and a resoundingly powerful answer, one that has been building for a while, finally burst into being in my consciousness. There are still spiritual messengers that come to us with a vision of healing, societal change – but they’re silenced. Routinely, as a matter of course. They MUST not be allowed to speak.
This “business of silencing the pain of wounded spirits” and the quelling of revolutionary visions for community-wide healing are one and the same. The practice of biopsychiatry encompasses them both.
I repeat: it is a spiritual battle.
(to be continued…)
Tags: anti-psychiatry, bully, Dr. Allen Frances, mental health activism, Occupy the APA, psychiatry
What does the term “bully” mean?
If you’d asked me that question 10 or even 5 years ago, I probably would’ve answered that a bully is:
- A young person (almost always male)
- In school
- Who uses muscles and aggression to terrorize and manipulate his peers and (more so) his inferiors.
But it doesn’t seem to mean that anymore.
Exhibit A, from my hometown:
Homeless people requesting money, food, or aid on the street (of which I see an increasing number in my city) are apparently bullies, manipulating innocent passers-by into giving them money instead of the city-wide coalition for the homeless [which will, of course, distribute funds in a fair and equitable manner, or so we are told on the other side of The Box]. So we should put our donations in “The Box” and say “NO” to bullies.
[My significant other and I always joke about dumping a big pot of soup in The Box. How long does it take 5 full time, fully educated/certified employees – supported by Box donations – to distribute 5 cups of soup? And will the soup be any good by the time they get around to doing it?]
I myself have been told that what I do with my writing here on ALT_mentalities is akin to “cyber bullying.” Funny. I thought I was critiquing erroneous articles and bad “scientific studies,” and perhaps doing a little musing here and there. I was not aware of the “hurtful nature” of my writing.
It seems that one of the main effects of the bullying public awareness campaign that began more or less a year ago has been to vastly expand the boundaries of the term. The word bully now carries a dizzying array of new connotations – hater, criminal, maybe even dissident, protestor, reformer — we’re at the point now where any person who disagrees with a dominant paradigm can be labeled a “bully,” and promptly booted from the discussion. Or, as in my first example, forced to find a new mode of survival in a field of ever diminishing options. Forced, most likely, to become dependent on that lovely city-wide coalition staffed by certified people who, out of sheer goodness, would help even the despised bullies of the city.
To every critical thinker, every person engaged in the search for mental balance, every activist fighting for mental rights and freedoms, and every soul participating in a healthy critique of the industry that calls itself “psychiatry,” searching for a more human and human alternative:
You’re in danger of being called bully. And it’s total bull.
What does the term “anti-psychiatry” mean?
On the surface, it seems pretty simple. “Anti-psychiatry” = Against psychiatry. “Psychiatry” seems to refers to the Western practice of psychiatrization, including (but not limited to) a biopsychiatric model of mental illness as brain disease, “scientific” diagnosis with the DSM, psychotropic medication as first line treatment, chronicity and decreased lifespan an assumed, prophetic outcome of “treatment.”
That probably describes a lot of folks, myself unabashedly included.
But we must remember the true meanings of the language of mental health. Go to the Greek, and you find that to be “anti-psychiatry” is to be “against soul healing.” Well that’s no good! The major critique of psychiatry [and, again, by psychiatry we mean the Western practice of psychiatrization here] is its complete lack of respect for, failure to even acknowledge the existence of, the soul.
Recently, psychiatrists have been talking amongst themselves, most notably in their trade journal Psychiatric Times, about the “rise” of virulent anti-psychiatry.
Sometimes I wonder if hatred of psychiatrists is one of the few remaining forms of acceptable bigotry. If the vitriol on many anti-psychiatry Web sites is any indication, the answer may be yes.
- Ronald Pies, “Moving Beyond Hatred of Psychiatry: A Brave Voice Speaks Out,” in Psychiatric Times
Those who try to help people with psychological problems also become stigmatized…
Unfortunately, sometimes in a society, those discriminated against will fight internally or compete against one another. So it is in the US at times, especially with gang conflicts. A psychoanalytic explanation for this phenomenon could be “identification with the aggressor.”
Now we may be seeing more and more of that in our field as the antipsychiatry movement of Scientologists seems to be expanding to former patients and their families who felt they were hurt by psychiatry. While some anger and criticism is surely warranted, the vitriol and call for the end of psychiatrists seems to border on hate speech.
- H. Steven Moffic, “Psychism: Defining Discrimination of Psychiatry,” in Psychiatric Times; emphasis added
Aha! Now we’re getting somewhere. Anti-psychiatrists are “aggressors.” They engage in “hate speech.” And the beliefs they espouse, the critiques they publish, their every critical thought about psychiatry likely has its roots in Scientology, whose virulent anti-psychiatry beliefs have “spread” to some non-scientologist psychiatric survivors and their families.
Maybe even a few former professionals, too. Like Alice Keys, a recused psychiatrist who blogs at Mad In America about what reading Robert Whitaker’s books has done and continues to do to her perspective on the Western practice of psychiatrization.
What Moffic is essentially saying is that anyone he describes as “anti-psychiatry” is a bully [remember – aggressive hate speech] and as such should be not be engaged with – not by psychiatrists or any other mental health professionals – because doing so would only instigate a Stockholm Syndrome-like effect where professionals would “identify with the aggressors.”
By which I think he means mental health professionals might actually start to agree with the critique of psychiatrization or at least consider its many salient points.
Presumably this is Alice Keys’ diagnosis.
We’ve got their attention!
I found Moffic’s article about anti-psychiatry especially interesting because almost 5 months ago, he published a Psychiatric Times blog where he claimed that:
Thankfully, the anti-psychiatry movement has died down. In an unexpected way, there’s more of a pro-psychiatry movement becoming embedded in our systems. These are our patient consumers and peer specialists.
- H. Steven Moffic in January Psychiatric Times blog
A lot has changed in 5 months! Moffic and the psychiatric community at large have noticed that they’re under intense public scrutiny. Protestors are coming out to events like the APA conference, inconveniently lifting their voices, sharing their message with an increasingly receptive public. And as much as Allen Frances and his ilk would like to confine scrutiny to the development of the DSM alone – they can’t. Like an ocean wave, critical thought about many of Western psychiatrization’s dehumanizing practices is pushing inexorably towards the shore of the general public’s consciousness.
To my fellow critical thinkers, those who question Western psychiatrization but wholeheartedly support “soul healing,” … I say again, we’ve got their attention!
Now here’s how we keep the positive momentum going, here’s how we sidestep their name-calling, here’s how we rip off the label of anti-psychiatry/bully so that more and more people can hear our message:
1. First, let’s honestly consider psychiatry’s critique. Are we bullies? Are we aggressors? When we tell our stories about what we’ve seen of psychiatry, when we recount scientific studies, research by folks like Robert Whitaker and Loren Mosher, philosophical ideas about the causes and purposes of so-called “mental illness” from John Perry, RD Laing, and Carl Jung, are we engaging in “hate speech”? Are we distorting the truth?
My friends, to the best of my knowledge, we are not.
We are telling the truth as best we can, we are building up a body of experiential, anecdotal, as well as scientific, knowledge as we go, we are engaging in honest and sincere dialogue with anyone who cares to join us, whether they “belong” to our “movement” or not. We want to find balance. We want to find real “soul healers.”
Psychiatry’s label does not describe us.
2. If we’re not bullies, let’s not act like bullies! What I mean by this is: no violence. Let it be, as MindFreedom International’s slogan states, “a united, non-violent revolution to rethink psychiatry.” Psychiatrists, social workers, mental health professionals at large are welcome to be a part of this re-thinking, assuming, of course, that they, too, agree to be non-violent in their engagement with fellow human beings.
PLEASE NOTE: This does not mean that survivor stories containing violence should not be told, that voices speaking with passion or strong emotion should be silenced, that only certain material is now considered legitimate (“non-violent”), a part of this dialogue. It would be foolish address the label of “bully” and “anti-psychiatry” by allowing only politically correct voices of sugary sweetness to be heard!
Rather, let’s follow the basic rules of productive conversation – we stick to the facts. We do not libel anyone. We call a spade a spade, certainly, but we don’t use name-calling for its own sake.