In the mental health system, 1984 is the NOW 04/30/2013Posted by ALT in Activism, Patient Rights and Advocacy.
Tags: assisted outpatient commitment, forced drugging, George Orwell, human rights, mental illness, oppression, psychiatry
Too many Orwellian concepts have made the leap from fiction to disturbing reality in recent years.
The NEWSPEAK employed by pharmaceutical companies intent on selling ANY chemical they manage to patent to the largest population possible, in the process crafting a language where fundamental questions such as “Does this chemical have any therapeutic value whatsoever?” are impossible to ask. How does one question the effectiveness of a so-called “antipsychotic” medication’s ability to suppress psychotic symptoms?* The very word forbids such an impertinence. And when that same medication is later referred to as an “antidepressant,” doesn’t it seem as though it is an antidepressant, and it has ALWAYS been an antidepressant?
The DOUBLETHINK that proclaims we must fight stigma in mental health by promoting stigmatizing beliefs. Anti-stigma “activists” like Glen Close would have us preach the biological disease model (though it lacks credible scientific proof) far and wide, despite consistent research showing the disease model actually increases stigma, while a psychosocial model explanation slightly decreases it (and — incidentally — has quite a bit more scientific credibility).
The slogan emblazoned on the Ministry of Truth (IGNORANCE IS STRENGTH) in Orwell’s 1984 might as well be carved into the hearts of the many mental health professionals who maintain a death grip on their ignorance of the very unhelpful nature of their so-called “helping profession.” Unhelpful in the sense that:
1. The technical and impressive-sounding names of “diseases” passed down to them in the Diagnostic and Statistical Manual [DSM] — which are then applied cavalierly to any distressed individual that crosses their threshold — were literally voted into existence by committees of “experts,” a majority of whom receive large amounts of cash from pharmaceutical companies set to profit from the invention of new mental pathology. A far cry from the discrete, physical pathologies they’re proclaimed to be (“just like diabetes!” they say).
2. The pronouncements the helping profession often makes about the hopeless nature of so-called “mental illness” and the impossibility of recovery after assigning a diagnosis for life (once diagnosed, never undiagnosed) are USUALLY untrue.
More on that HERE.
3. The chemicals they peddle — often as the first and ONLY possible treatment — are significantly more dangerous and addictive than advertised and much less effective (that’s putting it mildly). Examine the long-term outcomes and you’ll be hard-pressed to find a single psychotropic drug that does not induce chronicity and worsen global functioning when compared to no medication.**
Yes, a willfully-maintained ignorance is key for many of the folks working in a mental health system who find strength in the sheer numbers of “professional” people who are willing to go on marching in lockstep to the beat of the drum of corporate, pharmaceutical profits — trampling many a distressed human being underfoot as they solider on. I saw it myself, in sickening detail, during my 2 years of employment with the Research Scientists who didn’t give a damn about data or truth, so bent were they on being mental health “experts,” winning more lucrative contracts to conduct research with predetermined outcomes, and (most important of all) curating the twin museum pieces of their innocence and self-respect.
Fragile artifacts from younger days, best kept under glass.
In the end…
In the grand, tragic finale of Orwell’s 1984, we witness the complete erasure of the final vestige of our protagonist’s personhood. Resistance was always futile, we learn; one way or another, the State would own him — body, mind, soul, and (above all) obedience.
This is the final domino, the last of the Orwellian metaphors in the process of being realized. Can you see it?
A passage through the mental health system is an assault on the fundamental personhood of an individual. With the advent of forced outpatient commitment, we’ve made it even more difficult for such travelers to resist the State’s attempt to fundamentally alter the ways they navigate their mental and emotional distress.
Our fellow citizens are exposed to the possibility of forced psychiatric drugging in their homes for what essentially amounts to thoughtcrime, and no place is a safe space to experience extreme thoughts and emotions (however dark they may be). 1984 is the NOW.
More still, when we as a society accept this possibility as just and right for those who “deserve” it (the homeless? the marginalized? the so-called “mentally ill”?), we demonstrate a love for Big Brother hitherto unknown in our society. We say, “yes, take it, own it, all of me – body, mind, soul, and obedience!”
1984 is the NOW, until the day that we say “ENOUGH!”
Not my body.
Not my mind.
Not my soul.
* Or the universal desirability of such an effect, for that matter?
** See also: Robert Whitaker’s Anatomy of an Epidemic
Obama’s Mental Health Policy Recommendations: Expect a little Good and lots of Bad and Ugly 01/22/2013Posted by ALT in Children's Mental Health, Mental Health Policy and Inititatives, Patient Rights and Advocacy.
Tags: mental health, Mental Health First Aid, mental health recovery, Newtown, President Obama, Project AWARE, The Time Is Now, WRAP
A life lesson: Whenever someone says they’re “doing it for the kids,” you can expect very little Good and LOTS of Bad and Ugly.
Doing it for the kids
A week ago Wednesday, surrounded by adoring children, President Obama presented his plan to protect our children and communities by reducing gun violence.
Part 4 of that four-part plan was entitled “Increasing Access to Mental Health Services,” which says:
If even one child’s life can be saved, then we need to act. Now is the time to do the right thing for our children, our communities, and the country we love.
That’s right, folks: this time we’re doing it for the kids.
Spare no expense when you’re doing it for the kids!
Obama’s proposals come with a big price tag: $55 million!
And they seem geared towards one basic thing: get more children into professional mental health treatment (he even sets a specific goal of 750,000 children — pretty nice for Johnson&Johnson, Eli Lilly, et al to have advance notice of the number of new potential lifelong customers, eh? ).
What’s wrong with encouraging young people to seek treatment?
My parents did what millions of American parents have been taught to do: they saw how much emotional pain I was in, and they sought “help” for me in the “mental health” system. They had no idea that my entrance into a psychiatrist’s office as a young teenager would end up stripping me of my health, my hope, and my sense of Self. Today, we are able to come together as a family with forgiveness, acceptance, love, and gratitude, to talk about how counterintuitive my journey into a system of proclaimed “healing” ended up being; indeed, as the result of being “shielded from harm” by the “mental health” system, I experienced more harm than I could have ever imagined for myself.
—Laura Delano, in her essay “Free from Harm? Reflecting on the Dangers of the White House’s Proposed ‘Now is the Time’ Gun Control Plan” (you should read it… it’s good)
In other words, Obama’s placing the spirit of America’s youth on the altar.
Do it for the kids.
Mental Health First Aid: The Good?
So what exactly is the government buying with $55 million of my —and my fellow Americans’— hard-earned cash?
One of the proposed interventions, “Mental Health First Aid,” is a 12-year-old evidence-based practice (that’s on the verge of a lucrative adolescence, it seems). Developed and initially implemented in Australia, it’s a 12-hour course for the layperson that teaches people to:
- know the signs of mental health problems
- provide first aid for mental health crises (like suicidal behaviors, panic attacks, etc.)
- promote and enhance recovery.
These don’t sound like bad goals at all. And, really, much of the documentation on Mental Health First Aid is helpful, non-stigmatizing, very human (as opposed to institutional) stuff. For example, the Mental Health First Aid sheet on “psychosis” says:
How can I be supportive?
Treat the person with respect. You should try to empathize with how the person feels about their beliefs and experiences, without stating any judgments about the content of those beliefs and experiences…
Should I encourage the person to seek professional help?
You should ask the person if they have felt this way before and if so, what they have done in the past that has been helpful. Try to find out what type of assistance they believe will help them. Also, try to determine whether the person has a supportive social network and if they do, encourage them to utilize these supports.
Respect, dignity, being non-judgmental, activating a social support network of peers, friends, family, and asking the individual what sort of assistance he or she would prefer — quite frankly, that sounds fantastic!
That sounds like self-advocacy! That sounds empowering!
Actually, it sounds a lot like the principles of WRAP [Wellness Recovery Action Plan] – a wellness tool developed in part by Mary Ellen Copeland that has helped so many individuals reclaim their right to define wellness, and to find the resources they need for achieving it inside themselves…
Unfortunately, the emphasis on self-advocacy/determination and peer support is spotty at best when you examine the entire body of Mental Health First Aid literature. The truth is these folks are just as intent as Obama on directing people towards the “necessary professional help,” with self-care and self-help an optional second.
The Bad and the Ugly
Things go from bad to worse when you take a look at the Manual for Mental Health First Aid. In here, we learn that:
The symptoms of depression are thought to be due to changes in natural brain chemicals called neurotransmitters. These chemicals send messages from one nerve cell to another in the brain. When a person becomes depressed, the brain can have less of certain of these chemical messengers. One of these is serotonin, a mood-regulating brain chemical.
And a few pages further in the manual, we find these ugly sentiments:
A team of Australian mental health researchers has reviewed the scientific evidence for the effectiveness of a wide range of treatments for depression. The following rating system was developed to show the treatments whose effectiveness was best supported by the evidence:
☺☺☺ These treatments are very useful. They are strongly supported as effective by scientific evidence.
☺☺ These treatments are useful and are supported by scientific evidence as effective, but the evidence is not as strong.
☺These treatments may be useful and have some evidence to support them. More evidence is needed that they work.
Since when is a therapy that’s been shown to be no more effective than placebo [antidepressants] rightfully classified as ”very useful,” and “strongly supported…by scientific evidence”?
And they’re giving three smiley faces for electroconvulsive therapy, too?!
Electroshock devices still have not been thoroughly reviewed for safety by the FDA (if they were, they’d have to nail down that nasty little statistic of how many deaths by ECT per 100,000?), and many studies counter the “three smiley faces” rating, including this large literature review, whose authors state:
The cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.
—John Read and Richard Bentall in “The effectiveness of electroconvulsive therapy: A literature review“
Moreover, firsthand accounts of electroshock are often anything but “smiley.” In the words of Ernest Hemingway, a shock survivor:
Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient….
Imagine an alternative
Imagine an alternative. Imagine that the President recommended a course of action that emphasized self-reliance, empowerment, and advocacy, an “evidence based practice” that was steeped in the philosophy of respect and dignity for all (rather than just a semblance of it). One that emphasized treatments that were cost-effective or even free (rather than relying on very expensive, “appropriate professional help”), and one that pointed people towards achieving their visions for their lives, their wellness.
In other words, what if the president had set aside $55 million for the teaching of WRAP [Wellness Recovery Action Plans], or something like it, to anyone who so desired?
Those might be the last few dollars ever spent on so-called “mental health care”— with a population empowered to embrace its own humanity and resilience, there’d be no more need for it.
Tags: creative malajdustment, human being, human rights, injustice, John Taylor Gatto, Jr., Martin Luther King, mental health
On September 1, 1967, Martin Luther King, Jr. was invited to give a Distinguished Address to the American Psychological Association. The speech was in proofs for publication in the Journal of Social Issues when King was assassinated less than a year later.
[Read full speech here.]
“Our struggle for human freedom and dignity”
This was how Martin Luther King, Jr. referred to his work.
That struggle hasn’t ended!
Human dignity is trampled with every instance of dehumanization. Institutions (like public schools and the mental health system) are inherently dehumanizing, because they expect humans to behave like machines.
Human intelligence and thought are reduced down to standardized test scores. Human behavior is reduced down to the physical interplay between neurotransmitters (and perhaps a few “bad genes” as well), and subsequently blasted into oblivion with harsh chemical interventions.
What does it mean to be human? Humans are flesh and blood, soul and spirit – not machines. Humans have emotions and feelings. They have agency. Unlike a computer program, which has no choice but to follow each and every command given – even a command to self destruct – a human has free will, and can exercise it in his own interest (whatever that may be).
Beware anyone who tells you that a human – or any part contained therein – is a machine.
Poisoned to its soul
“White America needs to understand that it is poisoned to its soul by racism,” says King. “All too many white Americans are horrified not with conditions of Negro life but with the product of these conditions – the Negro himself.”
Transpose these words to the current state of mental health care in our society, and see the astounding insight here. Psychiatry is poisoned to its very soul – most of the self-proclaimed “soul healers” have abandoned their connection to the soul entirely, opting instead for the biochemical model of mental and emotional distress. And most of the treatments they offer are – literally – brain disabling, poisonous.
How many more stories do we need to hear of triumph over psychiatric adversity – of painstaking years spent withdrawing from medications that, in the long term, made distress chronic, and can bring with them a host of adverse effects far worse than the original distress – before we’ve heard enough? As inspiring as it is to hear about resilience and recovery, I anxiously await the day when there are no more stories like this to tell. When trauma is not a necessary part of each and every individual’s initiation into this society.
It gets worse. You see, poison spreads.
Did you think it could be compartmentalized? It cannot.
American society needs to understand that it is poisoned to its very soul – toxins in our environment, in our food, our water. Toxic consumerism, greed, and waste. Glamorized violence and a worship of death permeating every aspect of our culture.
Most of all, the poison of dehumanization – everywhere.
Nearly every human being, for the first 18 years of his life, is sentenced to serve time in a dehumanizing institution that is practically indistinguishable from a prison.
What do we teach in our schools today? How to read uncritically, how to ask only the questions written in the discussion section at the end of the chapter, how to assign only the meanings we are supposed to assign. In general, how to be remarkably incurious about many topics in history, science, economics, mathematics, etc.
But these are really secondary. Here are the primary lessons:
How to rank by numbers. How to judge, badger, and bully your fellow man.
How it feels to be constantly surveilled, subjected to random drug tests and unwarranted searches, how to grovel before police dogs and armed guards.
This is only the beginning. It goes on, through adult life. Especially for the unfortunates who live out their adult lives with institutions like the mental health system, the justice system, the social services system, etc. watching their every move.
And we as a society are horrified, not by the conditions of institutionalized life, but by its products: dehumanized, distressed individuals who are angry, and rightfully so!
Here is how King’s speech ended:
There are some things in our society, some things in our world, to which we should never be adjusted. There are some things concerning which we must always be maladjusted if we are to be people of good will. We must never adjust ourselves to racial discrimination and racial segregation. We must never adjust ourselves to religious bigotry. We must never adjust ourselves to economic conditions that take necessities from the many to give luxuries to the few. We must never adjust ourselves to the madness of militarism, and the self-defeating effects of physical violence… And through such creative maladjustment, we may be able to emerge from the bleak and desolate midnight of man’s inhumanity to man, into the bright and glittering daybreak of freedom and justice.
“Maladjustment” may not be a popular word these days. It is said that Adam Lanza was “maladjusted.”
But society has also judged as “maladjusted” people like Sandy Loranger, a Santa Cruz woman who went to jail for feeding soup to homeless people. When the judge offered her counseling instead of jail Sandy Loranger replied, “If feeding my fellow man is a crime, I am beyond rehabilitation.”
People like David Oaks and Mary Ellen Copeland, who started talking about real, long-lasting, stable, unmedicated recoveries from so-called schizophrenia and bipolar disorder, long before it was even considered scientifically possible.
People like Martin Luther King, Jr. himself, who knew that poison spreads and that injustice cannot be compartmentalized.
As I looked at what this war [Vietnam] was doing to our nation… I found it necessary to speak vigorously out against it. There are those who tell me that I should stick with civil rights, and stay in my place. I can only respond that I have fought too hard and long to end segregated public accommodations to segregate my own moral concerns. It is my deep conviction that justice is indivisible, that injustice anywhere is a threat to justice everywhere…
On some positions cowardice asks the question, ‘Is it safe?!’ Expediency asks the question, ‘Is it politic?’ Vanity asks the question, ‘Is it popular?’ But conscience must ask the question, ‘Is it right?!’ And there comes a time when one must take a stand that is neither safe, nor politic, nor popular. But one must take it because it is right. And that is where I find myself today.
Taking a stand that is neither safe, nor politic, nor popular, but RIGHT: this is the kind of positive creative maladjustment we’re talking about.
Taking a stand for human dignity. A stand for humanity.
Are we ready enough – are we “crazy” enough – to take on, in a peaceful loving creative way – what is called “normal”?
Why I’m Against Forced Medication 10/15/2012Posted by ALT in Activism, Patient Rights and Advocacy, Pharmaceuticals.
Tags: antipsychotics, forced medication, liberty, mental health
(download printable version here – if you agree with the following, DISTRIBUTE WIDELY!)
WHY I’M AGAINST FORCED MEDICATION:
Long-term use of psychotropic medications causes serious, potentially LIFE-THREATENING ADVERSE EFFECTS.
- Antipsychotics cause people to develop diabetes. They also cause obesity, heart disease, and brain shrinkage.
- The seriously mentally ill live (on average) 25 years less than the general population. Use of psychotropic medications is a significant contributing factor to this trend.
A person has the right to refuse treatment that could significantly decrease his/her quality of life and lifespan.
Psychotropic medications are LARGELY INEFFECTIVE at healing depression, psychosis, mania, and other mental health issues.
Medications, if they’re helpful at all, only SUPPRESS SYMPTOMS; long-term use almost always has negative results.
- A meta-analysis summing up most known clinical data demonstrated that SSRI antidepressants are no more effective than placebo at treating symptoms of depression.
- In a 15-year schizophrenia study, those who got off antipsychotic medication were 35% more likely to be recovered than those who took their medications for the duration of the study.
- The use of antipsychotics causes the brain to become more biologically vulnerable to psychosis over time, a condition called “supersensitivity psychosis.” A similar condition of chronic supersensitivity has also been noted with antidepressants/depression.
A person has the right to refuse treatment that is (at best) ineffective and at worst heightens and/or prolongs symptoms.
The argument that “forced medication is justified because it prevents violence” is a Catch-22.
Supporters of forced psychotropic medication use the fear of violence to justify their position, but individuals with mental health issues are far more likely to be the victims of violence than to perpetrate violent acts.
However, it is true that when a human being is using/abusing many mind-altering substances (like alcohol, most illicit drugs and many psychotropic medications), that person becomes more likely to commit a violent act.
- Almost all antipsychotics and SSRI antidepressants (and many tranquilizers) have violence-related adverse effects such as “suicidal ideation” “violent thoughts” “aggression” and “homicidal ideation” listed on their FDA-approved labels.
- Antidepressants approximately double the relative risk of suicide when compared to placebo.
A person has the right to refuse treatment that is known to increase the risk of committing acts of violence against self or others.
We are Americans. We are full citizens in this free and democratic republic.
We ALL have the right to make an INFORMED and UN-COERCED decision about what we put into our bodies.
 Newcomer, J.W. (2007). Antipsychotic medications: metabolic and cardiovascular risk. J of Clinical Psychiatry 68(4), pp 8-13.
 Ibid. See also: Physician’s Desk Reference.
 Ho, B., Andreasen, N., Ziebell, S., Pierson, R., Magnotta, V. (2001) Long-term Antipsychotic Treatment and Brain Volumes, A Longitudinal Study of First-Episode Schizophrenia. Archives of General Psychiatry 68(2), pp128-137.
 Parks, J., Svendsen, D., Singer, P., Foti, M.E. (Eds.) (2006). Morbidity and Mortality in People with Serious Mental Illness. NASMPHD Medical Directors Council: Alexandria, VA.
 Pigott, H.E., Leventhal, A.M., Alter, G.S., and Boren, J.J. (2010) Efficacy and effectiveness of antidepressants: current status of research. Psychotherapy and Psychosomatics, 79(5), pp 267-79.
 Harrow, M., Grossman, L., Jobe, T., & Herbener, E. (2005) Do Patients with Schizophrenia Ever Show Periods of Recovery? A 15-Year Multi-Follow-up Study. Schizophrenia Bulletin 31(3), pp. 723-734.
 Chouinard, G. (1980). Neuroleptic-induced supersensitivity psychosis. AJP 137, pp 16-20. Also: Chouinard (1991). Severe cases of neuroleptic induced supersensitivity psychosis. Schizophrenia Research 5, pp 21-23.
 Fava, G. (2003) Can long-term treatment with antidepressant drugs worsen the course of depression? Journal of Clinical Psychiatry, 64(2), pp 123-133.
One study found that individuals with serious mental illness were almost 12 times more likely than the general population to be victims of a violent crime (n = 32,449). Teplin, L.A., McClelland, G.M., Abram, K.M., & D.A. Weiner (2005). Crime Victimization in Adults with Severe Mental Illness. Archives of General Psychiatry 62(8), pp 911-921.
 Boles, S.M. & Miotto, K. (2003). Substance abuse and violence: A review of the literature. Aggression and Violent Behavior, 8(2), pp 155-174.
 Physician’s Desk Reference
 Healy, D. (2003) Lines of evidence on the risks of suicide with Selective Serotonin Reuptake Inhibitors. Psychotherapy and Psychosomatics, vol. 72: 71-79.
This is a human rights movement. Period. 10/08/2012Posted by ALT in Patient Rights and Advocacy.
Tags: APA, human rights, Laura Delano, mental health activism
This movement is not a “recovery” movement, a “peer” movement, or a “mental health” movement. It is a human rights movement, and must be understood no other way. Until our emotions, thoughts, and unique realities are defined solely as a part of the broad spectrum of human experience, never as “symptoms” or “mental health issues”, we will remain mired in oppression. When I identify as having “lived experience”, it isn’t of “mental health challenges”, or of “disorder” or “illness”; it means that I’ve lived the experience of being oppressed and dehumanized, and that the only thing I’ve “recovered” from is psychiatry, itself.
- Laura Delano, HUMAN RIGHTS activist
from a speech given 10/6/12 in NYC as part of the protest of the APA’s “Institute on Psychiatric Services” conference
She gives fantastic speeches. Hope I can see her give one in person someday.
GUEST POST: Dr. Nelson Borelli 08/01/2012Posted by ALT in Guest Post, Patient Rights and Advocacy.
Tags: dissident psychiatrist, Dr. Nelson Borelli, mental health, mental illness
I am honored to present a guest post from reform-minded (former) psychiatrist Dr. Nelson Borelli. His website and manifesto are well worth reading — an inspiration to us all!
My Two Bits
The public needs to know that:
- There are many learned people who question the medical the validity of the concept of “Mental Illnesses.”
- The “Mental Illness/Mental Health” movement has evolved into an enormous Mental Industry (MI) supported by psychiatrists, clinical psychologists, social workers, “therapists” and their respective professional organizations, plus the pharmaceutical industry.
- If you think you are sick and you consult with a medical doctor and the doctor tells you that there is nothing wrong with you medically, that means your body is okay. If the good doctor suggests you see a psychiatrist, psychologist, social worker or “therapist”, think twice before you do it or you can get yourself in trouble.
- The moment you consult with a MI professional and you get a (DSM-IV) diagnosis you become a “mentally ill person”, the consequences of which you may like to assess.
- The worst consequence of getting a mental diagnosis is that you may be forced to receive psychiatric treatment against your will. (It is most unfortunate that the American Psychiatric Association continues to support the Civil Commitment law.)
- Another possible bad consequence is the prescription of mental (psychotropic) drugs because: a-they may worsen the person’s problem and b- by suggestion of the notion of “chemical imbalance”, they divert the person’s attention from the fact that we humans can get in troubles if we do not watch what we say or do, more so if we buck the identified norm in any way.
- There are medical illnesses that present themselves with psychological or emotional symptoms (among other symptoms) such as nervousness, fears, sadness, anger, restlessness, tiredness and the like. Once the medical illness is cured the symptoms disappear.
- Even “serious mental illness” can often times begin with personal misconceptions, bad habits or avoidance of facing difficult facts.
- A good, honest conversation with a trusted person may help you to “see” things you have been closing the eyes to and thus begin to solve the problem.
For more information the reader may go to my Webpage: nelson-borelli.com
July 30, 2012
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.
We’ve got a good thing going. Let’s keep it going!
Dystopian Dreams of a World Without the DSM 05/15/2012Posted by ALT in DSM-5, Patient Rights and Advocacy, Philosophy/Spirituality.
Tags: APA, biopolar disorder, diagnosis, DSM-5, eugenics, mental illness, psychiatry, schizophrenia
A world without psychiatry’s “Bible,” the DSM [Diagnostic and Statistical Manual]. I can see it now…
In this world, much like our own, there is still suffering. There is still poverty, crime, crushing sadness, despair. There is still violence. Regrettably, there may even still be some people who choose to take their own lives, preferring death over the pain of the moment.
But things are a helluva lot better in this world. Not perfect, mind you. Nevertheless a far more hospitable place for humans to be (in distress or not).
Not a utopia
I don’t promise you a utopia, because I have learned that utopian thought is always a trap. It inevitably leads to State supervision of, well, everything. We’ve got to maintain that perfect agreement about what constitutes the perfect order, right? At any cost. Moreover, utopian thought requires the mechanization (and consequently dehumanization) of the culture, the community, the human beings involved therein.
A feature of nearly all utopias has been addiction to elaborate social machinery like schooling and to what we can call marvelous machinery. Excessive human affection between parents, children, husbands, wives, et al., is suppressed to allow enthusiasm for machine magic to stand out in bold relief…
All machines are merely extensions of the human nervous system, artifices which improve on natural apparatus, each a utopianization of some physical function. Equally important, the use of machinery causes its natural flesh and blood counterpart to atrophy, hence the lifeless quality of the utopias. Machines dehumanize, wherever they are used and however sensible their use appears. Yet the powerful, pervasive influence of utopian reform thinking on the design of modern states has brought utopian mechanization of all human functions into the councils of statecraft.”
- John Taylor Gatto in “The Lure of Utopia”
So I give you, instead, some dystopian dreams of a world without the DSM.
In this world…
Psychiatrists, as a profession, en masse, have admitted: WE WERE WRONG.
“We shouldn’t have done it,” they will humbly concede. “We shouldn’t have insisted it was a fact that the ‘disorders’ we outlined in the DSM were objective, scientific, distinct pathologies (just like diabetes!) when we had virtually no proof of that. We shouldn’t have told our patients that they had ‘faulty genes’ or ‘faulty brains,’ that they were doomed to suffer chronically, for the rest of their lives, from the effects of chemical imbalances of neurotransmitters in their heads when we literally had no way of measuring balances of neurotransmitters [in the brain] in the first place, no way to establish a baseline for what is ‘normal’ and what is not.
And we certainly shouldn’t have partnered with drug companies, we shouldn’t have accepted their bribes, their promises of prestige and honor, allowing them such tremendous influence over the development of the diagnostic criteria. We shouldn’t have turned a blind eye to the terrible, terrible harm the pharmaceuticals they were so enthusiastically peddling were doing to our patients, to our communities. We should’ve looked further than the drug company-sponsored ‘research,’ we should’ve listened to what our patients were telling us, the facts that were staring us in the face, if only we were willing to take off the blinders so kindly provided us in our years of PhD training in pharma-sponsored schools and research hospitals.
Folks, we were wrong, and we’re deeply sorry for the harm we’ve caused. We’d like you to send back your DSMs (don’t worry, we’ll cover the postage), so that we can dispose of them in a safe and secure manner.”
(Dumping them down the drain, so to speak, simply won’t do.)
Now, as my significant other likes to say, there are three kinds of apology:
Type One: “I’m sorry you didn’t like it, but I fully intend to do it again.”
Type Two: “I’m sorry it happened, but it wasn’t really my fault.”
Type Three: “I’m sorry I did it, I take full responsibility for my actions, and I will make sure not to do that again.”
This will be a full-on, Type 3 apology, and it’s going to force all psychiatrists to ask of themselves some very serious questions about their profession, their practice, their beliefs about humankind. The self-proclaimed “soul healers” are going to do some critical thinking and some soul searching (like this). With humility and a greater sense of empathy, many (but probably not all) will emerge on the other side, repentant, contrite.
We move forward, having abandoned the purely “biopsychiatric” approach to mental illness, with a renewed commitment to seeing mental distress and madness for what they are (instead of trying to fit them to a biopsychiatric model that was flawed from the start, given its roots in pharmaceutical marketing campaigns, NOT actual observation of the process).
We move forward.
Our cultural narrative about mental distress has fundamentally changed.
Once this monumental apology has been issued, the books sent back, the labels redacted, “bipolar disorder,” “schizophrenia,” and “dysphoric mood disorder” won’t exist anymore as such. [oh wait, I guess Dysphoric Mood Disorder doesn’t quite exist yet… well, give it time, give it time.]
But there will still be people convinced of the coming apocalypse, walking circles around the city at night with visions of destruction surrounding them. There will still be children throwing terrible tantrums day in and day out. There will be racing thoughts, deep depressions, panic attacks; there will also be euphoria, epiphanic realizations of the oneness of humanity, creation, deep outpourings of love and spiritual healing.
Yes, there will still be “extreme states of consciousness” – some of which will be quite distressing to the people who experience them.
But our cultural narrative explaining the presence of such extreme states will have changed dramatically. When they are no longer catalogued “symptoms” of a fearsome “disease” that some people get and some people don’t, but just one part of a vast spectrum of human experiences possible to all humankind, it will no longer be feasible to adopt an us and them mentality.
“Mental illness” as the “bad genes” of “unfit stock” manifested? Not anymore. We weed out our old eugenical ideas about “the mentally ill,” roots and all (and that includes the idea that there exists a class of people called “the mentally ill” and another class called “the normal” and that the one is fundamentally different from and dangerous to the other).
We understand that ”it” (extreme states of consciousness and diasgreements with consensual reality) could happen to any one of us – and that if it does happen, each and every human deserves to be treated with compassion, respect, lovingkindness… like this.
In practical terms, we don’t give folks forced “intramuscular medication” (time-released injections), we don’t electroshock people against their will, we don’t chain them, humiliate them, perform experiments on them, stigmatize them, silence them, lie to them “for their own good,” condemn them to a slow, drug-induced death, brand them again and again as a “danger to society,” something fundamentally different, other. We don’t do any of these things because we refuse to violate anyone’s humanity – and we recognize that when we do this to someone else, we open the door to having it done unto us.
People are able to define, for themselves, their subjective experiences of reality.
Without a so-called “scientific” definition of mental illness spelled out in the DSM, readymade for the force-feeding, people will be left with a blank page on which to write out their own truths. Truths about our society, our world, and what is “acceptable” in these contexts. Truths about what it means to be well, right-minded, living right.
Those who reject the DSM are already doing this:
In the culture of the Icarus Project some years ago we developed a rough prototype of a document we call a Wellness Map (or affectionately a “Mad Map”.) It’s a very practical document to be written in good health and shared with friends and loved ones and it starts with the simple (yet not always easy to answer) question:
How are you when you’re well? What does wellness look like to you?
This question is followed by: What are the signs that you’re not so well?
and eventually: What are the steps that you and your community need to take to get you back to wellness?
-Sascha Altman DuBrul, in his essay “Mad Pride and Spiritual Community: Thoughts on The Spiritual Gift of Madness”
Maps of wildly diverse terrains, pages and pages of difference! What’s right for me may not be right for you – and that’s a beautiful thing. As you can see, this is no utopia. We don’t have to agree about what “perfect order” is [and then single-mindedly enforce that order everywhere]; we don’t even have to strive for perfection at all! We just have to be honest, creatively living our lives each day, mapping out our mental, emotional, and spiritual geographies, all the while respecting our fellow humans as they do the same. And most importantly…
We offer our compassionate, “un-professional” support to our fellow human beings in distress (and out of it!).
This is crucial. We humans weren’t made to be lonely – not in joy or grief, and certainly not in madness. We long to share our experiences, to bond, to connect, to feel the lovingkindness of someone else’s attention, care.
So in distress and out of it, we can follow as an example the standard of care provided by luminaries like Loren Mosher and John Perry . In distress and out of it, let’s be with each other, without judgment (diagnosis) or manipulation (“for your own good interventionism”), without “professional opinions” (self-fulfilling prophecies of chronicity and doom) or prescriptions (forced care).
Let’s make maps together; let’s be fellow geographers of the human condition. Allow for grief in response to the deep sadness that is inevitably a part of life. Allow for terrible fear, at times, and unbelievable joy. Allow for madness as a transformative process, when it occurs; the birthing of a new consciousness. Allow a safe passage, in loving company, through difficult times. Allow our fellow human beings to emerge, on the far side of their extreme states of consciousness, “weller than well.”
We move forward. We don’t look back.
Tags: Carmelo Valone, dehumanization, homeless, Kelly Thomas, police brutality, schizophrenia, Talk of the Nation
Have you heard the story of Kelly Thomas, a 37-year-old homeless man diagnosed with “schizophrenia” who was beaten to death by 4 policemen last July in Orange County, California?
It’s reemerged as a topic of discussion recently because of an Op-Ed piece published in the Los Angeles Time by a psychiatric survivor named Carmelo Valone. Entitled “My Kelly Thomas Moment,” the author makes no bones about it: this could have been him.
I had my Kelly Thomas moment on a hot summer night in Boston in 1995…The Boston police officers who responded that night weren’t exactly boy scouts when they restrained me, but I did live to see another day. Because of that, I’ve had the chance to improve, something Thomas didn’t get….
It would be easy to conclude that Thomas was homeless by choice because he refused to take medication to treat a range of symptoms that had been diagnosed as schizophrenia. But things are more complex than that. I myself have never been truly homeless, but I have refused mental healthcare on many occasions, often when I was at my most vulnerable… I am today a functional part of this dysfunctional world we call Los Angeles, and it has been quite a while since I needed any form of inpatient treatment. But there have been times — and this is not an easy thing to admit — when mental illness took over my life.
- Carmelo Valone, in “My Kelly Thomas Moment”
Fact of the matter is— when it comes to alternative experiences of reality, or “mental health challenges” (if you’d like to call them that), psychosis, mania, extreme emotional states; fact of the matter is, it could be any of us.
As a society we long to place the mentally ill in some kind of category separate from the rest of human existence, so that we can chant blindly to ourselves “this would never happen to me, this would never happen to me.” Folks, that’s dehumanization; and aside from being a terrible way to handle the blessing that is human difference! individuality!, it also leads to all sorts of behaviors that are absolutely unacceptable. Like forced electroshock.
Like beating a man to death in the street.
Back to the testimony of psychiatric survivor Carmelo Valone.
Valone was interviewed briefly by Neil Conan on NPR’s “Talk of the Nation” yesterday. I highly recommend you check it out. He expressed himself admirably, even in the face of some very negative opposition (check out the caller – a psychiatrist – at 11 minutes in… YIKES!). Through it all, he maintained a position that I applaud: namely, that the behavior of a person like Kelly Thomas or himself comes primarily from not being heard, from being stigmatized and isolated by his label, from being made hopeless by the lack of compassion from his fellow men, from being dehumanized.
Some stand-out moments:
VALONE: [...] I almost – I almost want to say that these police officers were the mentally ill ones, and Kelly Thomas was the sane one in the situation. I mean, they tasered him. They smashed him with the taser, buttons, the flashlights. They broke his throat. I mean, it’s horrifying. I mean, I had nightmares about it for months, and I feel very badly for his family.
CONAN: Of course, the police officers have something to say on their side, as well. They felt threatened by someone who is out of control.
VALONE: He had no weapons though, you know? He had no weapons. He wasn’t posing any sort of threat from what the witnesses say.
- From Valone’s interview on “Talk of the Nation”
VALONE: […] I didn’t become violent because I stopped taking my medication. I was violent because I was frustrated because no one was listening to me, OK? This is a problem I’d heard, time and time again, because I have friends that are in the psychiatry field – a number of them. And people seem to equate not taking the medication with violence.
- From “Talk of the Nation”
Who’s on Trial?
2 of the 4 officers involved in the death of Kelly Thomas will stand trial, one for second-degree murder and the other for involuntary manslaughter. But let’s not pass it all off on them. WE – as a society of humans – need to examine ourselves. Why are the homeless so maligned? Why are the mentally ill shunted off to the side, neither to be seen or heard as they struggle to speak about their experiences?
Let’s all take a close look at the myriad ways dehumanization darkens our coexistence. With warmth and a little loving kindness, perhaps we can shed some light on the reasons why, 15 years ago, Carmelo Valone wandered the streets of Boston, hopeless and without a voice; why Kelly Thomas walks the streets no more; and why so many of us can, heads held high, walk right past the suffering of our fellow human beings without a glance.
DSM-5 conflicts of interest hit mainstream media; protestors rally, but is it for the right reasons? 03/14/2012Posted by ALT in DSM-5, Mental Health Policy and Inititatives, Patient Rights and Advocacy.
Tags: APA, conflict of interest, DSM-5, John Perry, mental health, Occupy the APA, psychiatry, psychosis, schizophrenia
I’m no journalist.
I did write for my high school newspaper (I can recall a particularly riveting article about different styles of shoes!), but these days I’m strictly a blogger, cavalierly inserting humor, my own biased opinion, and all manner of distractions and sidetracks into my “articles.”
Nevertheless, this ABC news article from yesterday (“DSM-5 Under Fire for Financial Conflicts of Interest”) follows the exact argument I put forward in my little piece entitled “For the DSM-5 Task Force, Being Greasy Never Been So Easy!” Whoa, did I inadvertently produce some journalism here?
I have to admit, I liked my title better.
Ok, ALT; stop patting yourself on the back!
Done. Now let’s dig in.
The ABC story was fueled by the publication of an academic analysis of the conflicts of interest of the various DSM-5 committees, conducted by the same researcher (Lisa Cosgrove) who published a similar analysis in the days of DSM-IV development.
As I wrote awhile ago, it’s practically a conflict-of-interest OLYMPICS! Cosgrove found that about ¾ of the work groups have a majority of members with major ties to the pharmaceutical industry. Some standout groups include:
- Mood Disorders Group: 67% of members report ties to industry
- Psychotic Disorders: 83%
- Sleep/Wake Disorders: 100%
Moreover, when comparing the figures from the DSM-5 to her previous analysis of the DSM-IV workgroups, Cosgrove has found that in about half the work groups, conflicts of interests have only gotten worse.
[click to enlarge]
It appears that the APA thought transparency alone would be a solution to their metastisizing “conflict of interest” problem.
Well, they’re wrong. We can clearly see the giant, throbbing tumor now, but the fact is it’s still there.
The whole point of disclosing conflicts of interest is determining whether someone is unencumbered enough to participate in a decision-making/fact-finding process. For this to be in any way legitimate, there must be some threshold where the person’s conflicts of interest are too great, where they are removed from the process. But the APA apparently has no limit.
Oh, sure, they say something about “no more than $10,000/year directly from the pharmaceutical industry and no more than $50,000 in pharma stock options” … but with major gaps in their disclosure policy and no dollar amounts made public, how can we be sure this is any less of an empty gesture than the rest of their carefully choreographed “transparency” dance?
DSM detractors say the darndest things…
A wave of protest against the DSM has been building over the past few months, but I’m not sure that I’ll be able to unite with the mainstream (or “middle way”) DSM protesters. Here’s why:
Middle way protestors are against the DSM-5 in particular, criticizing the development process, the addition of so-called “unscientific diagnoses,” financial conflicts of interest of the developers, etc.
The idea being that we simply need a better process for creating this thing. And that the botched development of the DSM-5, which will result in flaws that could’ve been avoided with more rigorous procedures, is a risky business because it might turn the tide of public opinion against the very institution of the DSM; which would be terrible because we need some kind of DSM in order to treat mental illness at all. The DSM detractors quoted in this article all seem to fall into that camp; Allen Frances, David Elkins, and Cosgrove herself.
But there’s another camp, which I and many others belong to. Instead of being against the DSM-5 in particular, we’re against the institution of the DSM, period. Instead of arguing that the DSM-5 is marginalizing, stigmatizing, unscientific, we argue that the practice of diagnosing people itself is all of these things and worst of all… dehumanizing!
In ABC’s coverage, only the “middle way” DSM detractors are represented. And I find myself feeling a little piqued by what they have to say. For example:
Dr. Allen Frances, who chaired the revisions committee for DSM-4, said the new additions would “radically and recklessly” expand the boundaries of psychiatry.
“They’re at the boundary of normality,” said Frances, who is professor emeritus of psychiatry at Duke University. “And these days, most diagnostic decisions are not made by psychiatrists trained to distinguish between the two [normality and mental illness, presumably]…”
- From ABC News article “DSM-5 Under Fire for Financial Conflicts of Interest”
The boundary of normality? He speaks as if he knows exactly where that is! And that the DSM-IV catalogs “diseases” that fall well beyond it.
I beg to differ.
Take so-called “schizophrenia,” or psychosis, for example. As John Perry so nicely puts it:
In my opinion, the real pathology in psychosis does not reside in the “mental content,” the images and the symbolic sequences. All of that appears to be a natural psychic process, present and working in all of us. This is normal madness, so to speak. The schizophrenic “disorder” lies rather in the ego, which suffers from a constricted consciousness… The problem of the prepsychotic state is how to discover the impassioned life, and nature has its own answer in the form of a turbulent ordeal, a trial by immersion in the source of the passions – that is, a psychosis.
- John Perry, in The Far Side of Madness
[If you liked that quote and have some time on your hands, read this!]
From Perry’s point of view, psychosis is often a naturally transformative and healing process, somewhat like childbirth. If there is such a thing as a “boundary of normality” (which I doubt), it falls well within it. Psychosis is the ”normal” response of a psyche needing to heal.
Here’s another rather disturbing quote from the middle camp:
“My best hope would be for the APA to respond in a substantive way to the concerns we’ve raised. They have an opportunity here to make a correction that would give the appearance, if not the reality of developing a diagnostic instrument that’s objective and has integrity.”
- Lisa Cosgrove, in the ABC News article DSM-5 Under Fire for Financial Conflicts of Interest; emphasis added
A semblance of objectivity and integrity – not necessarily the real thing – is her best hope for the DSM committee??
Way to aim high!
Should all the DSM-V detractors put aside their differences and join together to protest the DSM-V, or are the two camps far enough apart that their protests really can’t align?
As you ponder, consider this: a large DSM-5 protest (Occupy the APA) is planned for May 5th in Philadelphia at the site of the APA convention. The middle way camp will necessarily be inside the convention (most of them belong to the APA, after all), while the rest of us will be standing outside, barred from entry.
It appears that more than mere distance separates our two camps.