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
Tags: dissident psychiatrist, mental health, mental illness, moral agency, Nelson Borelli, psychiatry
I am honored to present another guest post from reform-minded (former) psychiatrist Dr. Nelson Borelli. His website and manifesto are well worth reading, and the thoughts he puts forth here about moral agency and psychiatry come at a very important moment in the national dialogue about these topics.
By Nelson Borelli, M.D.
ALT_mentalities kindly invited me to write a critique on the practice of psychiatry. I accepted it with reluctance for several reasons.
First: There is not much original thought I can add to the matter after the monumental contribution of many others, Thomas S. Szasz and Karl Menninger in particular.
Second: Psychiatry,— and I will use that word to include psychiatry and other enterprises such as clinical psychology, social work and all “therapies,” and most respective practitioners — are faith-based organizations, not open to rational thinking and dialogue, let alone change.
Third: History seems to show that critiques to psychiatry are perceived as callous attacks to “science”, to psychiatry practitioners, and to the “mentally ill.” This is usually followed by the hardening of the faith and more closing of the thinking.
Yet I’ll try; the youthful vitality of ALT_mentalities inspires me.
Saving the Underdog
Psychiatry’s tragic course began in the sixteenth century when the political rulers lined up for execution of a woman because she was a “witch.” But a well-connected doctor saved her life by showing she was a sick woman, not a witch. The doctor was Johann Weyer. His deed was certainly good but the reason was bad. That saving-the-underdog became a tragedy of unlimited proportions. After half millennia the tragedy is still with us and it is growing.
The “witches’ law” was wrong then; many social intolerance laws are wrong now. Bad laws should be confronted morally, politically, because that is what they are. They are manmade laws.
Confronting them by “biological-disease” means results in tragedy. The heroic “biological”, medical shortcut is bad. It has built-in badness because it results in bad consequences for the hero (psychiatry) while the moral problems remain unresolved.
Visitors from another planet would be sympathetic to us in learning about our seemingly unsolvable moral problems: When does life begin in the unborn child? Is it permissible to unplug life-supporting equipment from the terminally ill? If so when? Is abortion permissible and if so when and in what circumstances? Should we abolish the death penalty in the USA? Do children have rights? If so what rights, at what age? Do we go for gun control or the Second Amendment? What are the boundaries between Personal and State rights? Et cetera.
Contemporary psychiatry is suffering the bad consequences of the heroic acts of “saving-the-underdog.” Psychiatry is discredited. Self paying patients are fewer and fewer. Third-party payers refuse to pay for “services.” The only thing that keeps the psychiatric industry alive is the state-sponsored/enforced “mental illness/mental treatment” dictum. Nor has the psychiatric industry’s “stigma” cry been working well either.
It is an unnecessary, self- inflicted tragedy, to put it mildly, (for the profit factor cannot be ignored). Psychiatry could be of help to the many folks who suffer from emotional problems. Psychiatry could have room in medicine as a (soft) branch of it. Although the causes and pathology of emotional problems remain obscure, they could continue to be investigated by scientists interested in the field. Emotional problems could be dealt with by professionals who are patient enough to deal (humbly) with diagnoses’ uncertainties by using trial-and-error techniques.
There are already some significant scientific contributions on the relationship between bodily physiology and the perception of emotional reactions. Psychoanalysis and related disciplines have also contributed to the understanding of human emotional conditions. Even the dreadful, drug-pushing, disease-manufacturing pharmaceutical industry has made some contributions. However limited the knowledge of psychiatry at present, there is room within medicine and related disciplines for a respectable Psychiatry specialty.
But that would require present day psychiatry to drop the “mental-illness” ideology.
Psychiatry & Moral Agency
At the core of the “mental illness” ideology is the notion that a person can lose moral agency, this is that the person is no longer able to know what he/she likes or dislikes, or is not able to form and execute (“correct”) personal opinions due to a “biological ill condition.” That is that the person has become “mentally ill.”
That is wrong.
The fact is that humans’ opinions cannot be (biologically) ill. This is a travesty with terrible consequences such as the deprivation of civil rights to citizens who have not committed any crimes.
A court of law may order involuntary psychiatric treatment, known as “Civil Commitment” for a “mentally ill” person. Although the large majority of the “mentally ill” persons are not subjected to involuntary treatment, all “mental Illness” diagnoses suggest possible Civil Commitment, that is, deprivation of personhood.
The fact is that psychiatry is not able to predict criminal behavior on a given person. No legally responsible psychiatrist would publicly state to what percentage of probability a person would act criminally because there is no publication of any scientifically conducted study that objectively demonstrates such a prediction.
Human opinions can be wrong, or right, with respect to a prevailing social code of ethics. A quick look at the history of humans’ opinions shows that even very “important” opinions, come and go. Examples: The learned ones used to sure the Earth was flat. Now the learned ones differ as to whether humans were created or evolved. These are human opinions; they may be errors. But they are not forms of “insanity” or “mental illnesses.” Incidentally, the utterance “sick opinion/belief” is only a pejorative metaphor, an unfortunate metaphor because it is often used literally.
Unfortunately (or fortunately) we humans were born without a God-given “user’s- book.” If we were we might be angels of God like Adam and Eve were before they CHOSE to eat the apple.
Ever since, we are born with the ability to choose. We are born to be on our own stewardship.
One may or may not choose to use the Biblical story, but the fact is that each one of us is ultimately responsible for the management of our lives. We have to manage our lives by the use of science or inspiration and hope for the best. No guarantee of success.
Be aware of false “saviors” such as psychiatry that offer you the “the brain-made-you-do-it” way out as a means of angelic tranquility. If you go for it you become a robot; a Mental Patient Green Card carrier, with entitlements but deprived of personal moral agency.
Personal Moral Agency
Personal moral agency means that one is born with the ability to know, choose and act in accordance to what one thinks is right. Just in case: What you think is right may not be what others think is right.
Psychiatry did not get a “users’ book” from God either. Psychiatrists’ opinions on persons’ life management can be wrong, very wrong! Psychiatrist Egas Moniz won the 1949 Nobel Prize on the “benefits” of lobotomy on “psychotic patients.”
How to manage your life? Simple: Each of us gets information, input, from the world around us and from our own bodies. It’s up to each of us to look, examine, re-examine the information, look for more information and consult with others as needed. Then we reason. Then we act, execute. The more we work on the information, particularly information-that-I-do-not-want-to-know, and do the reasoning, the greater the chance that we would be pleased with our acts or execution at a later date. Of course there is no guarantee that we would be pleased with our acts at a later day. We humans are not perfect, period.
The more one practices on information gathering and reasoning, the greater the chances to be content with our acts at a future date. Unfortunately, just too often people choose to delegate to others the information gathering and reasoning. In so doing, they dull their minds; this is the ability-to-mind. Minding is an inborn ability. However, the quality of minding depends on how much we practice it.
The tragedy of psychiatry will eventually end in the same way other tragedies ended: the death of the hero. In this case, the “mental illness” heroic attempt to “solve” humans’ moral problems.
Good, serious psychiatry is badly needed. But even more needed is for us to get in touch with, to honor and respect our precious minds and humanness.
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
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: mental health, mental illness, peer support, spiritual emergence, spiritual emergency
[this is an excerpt from a recently published booklet entitled "Multicultural Competence, Intense Spiritual Experience, and Mental Health: A Self-help, Peer Support and Service Provider Technical Assistance Tool," written by Lauren Macuso.]
This letter was written by people who have lived through these [intense spiritual] experiences. We were called together for a reason: to create information that will help others through these experiences. Your healing and support has already begun!
What’s going on? What is this? I’m scared and don’t know what to do.
Be aware this is a process. Trust the process. It is a chance to let go of some things you no longer need and to explore and find new parts of yourself. You can make meaning from this experience. Find spiritually sensitive people to talk to.
Find someone safe who will respect your experience. If someone treats you like you are “crazy” or “mentally ill,” seek another person who is willing to be with you. There are people who are experienced in this and who understand this territory. It is important to find someone who will provide acceptance, understanding and reverence for your process. Someone who will not label your process, or stop it or “fix” it, but will hold witness without any agenda other than to hold sacred space and honor your innate wisdom and wholeness.
Even though your experience is powerful and special, be sure to take care of yourself—sleep, eat nutritious food, breathe, use centering practices, walk in nature. Be respectful of your body even if you feel good. Find a place of beauty and serenity to be in.
Find a way to express what is going on with you: painting, journaling, writing poetry, movement/dance/music, etc. Find a way to express yourself that feels authentic to you. Consider finding a culturally appropriate healing model that uses ceremony, ritual, or traditional counseling that feels authentic to you.
Trust your intuition to find the right help if you encounter any dark or negative energies, spirits or fears.
- from Multicultural Competence, Intense Spiritual Experience, and Mental Health, by Lauren Macuso