Allen Frances Saving Psychiatry From Itself?

On October 12, 2014, the eminent psychiatrist Allen Frances, MD, participated in a panel discussion at the Mad In America film festival in Gothenburg, Sweden.  After the festival, he wrote an article – Finding a Middle Ground Between Psychiatry and Anti-Psychiatry – for the Huffington Post Blog, summarizing the positions he had discussed at the festival. The article was re-published on MIA on October 26, 2014.

The article is ostensibly an attempt to find common ground between psychiatry and its critics, but the piece contains numerous distortions and omissions which I think need to be identified and discussed.

Here are some quotes from the article, interspersed with my comments.

“There will never be any compromise acceptable to the die-hard defenders of psychiatry or to its most fanatic critics.

Some inflexible psychiatrists are blind biological reductionists who assume that genes are destiny and that there is a pill for every problem.

Some inflexible anti-psychiatrists are blind ideologues who see only the limits and harms of mental-health treatment, not its necessity or any of its benefits.

I have spent a good deal of frustrating time trying to open the minds of extremists at both ends — rarely making much headway.”

This is Dr. Frances’s opening passage.  Essentially what he’s saying here is that there are “extremists” on both sides of this issue.  Although he doesn’t say that these individuals are minorities, I think that this is implied.  Certainly those of us in the anti-psychiatry camp are a minority, but the implication that psychiatrists who are  “blind biological reductionists” represent a minority is, I suggest, simply false.  I have been retired now for 13 years, but in the previous twenty-five years, I doubt if I encountered more than three or four psychiatrists who were not “blind biological reductionists”.  The phrases “chemical imbalance” and “illness just like diabetes” were standard fare in psychiatry’s narrative, and the 15-minute “med check” was the standard “treatment” for all problems.

With regards to “inflexible anti-psychiatrists” being “blind ideologues”, I think I can speak from personal experience.  I am indeed inflexibly anti-psychiatry.  My position in this regard is based entirely on the fact that the various problems listed in the DSM (apart from those indicated as due to a general medical condition) are not illnesses, and that conceptualizing these problems as illnesses has done, and continues to do, vastly more harm than good.  I am – to use Dr. Frances’s term – inflexible on this matter in the same way that I am inflexible on the matter that the Earth is round rather than flat.

But, on the other hand, as I’ve stated many times on my website, if psychiatry will adduce convincing evidence that the various items catalogued in their manual really are illnesses, (i.e., stem from an identified biological pathology), then I will accept this evidence, apologize for my errors, and close the website. At the risk of understatement, this evidence is not to hand, and at present, psychiatry’s contentions, explicit and implicit, that the various problems that they “treat” are illnesses are nothing more than destructive, disempowering, self-serving, unsubstantiated assertions.

And lest there be any perception that psychiatry’s love-affair with biological reductionism is a thing of the past, here’s a quote from Jeffrey Lieberman’s June 19, 2012 video Causes of Depression.  Dr. Lieberman is Psychiatrist-in-Chief at New York Presbyterian/Columbia University Medical Center, and at the time of the video was President-elect of the APA.  The video was made by The University Hospital of Columbia and Cornell.

“…the way nerves talk to each other, and communicate, is through the secretion of a chemical called a neurotransmitter, which stimulates the circuit to be activated.  And when this regulation of chemical neurotransmission is disturbed, you have the alterations in the functions that those brain areas are supposed to, to mediate.  So in a condition like depression, or mania, which occurs in bipolar disorder, you have a disturbance in the neurochemistry in the part of the brain that regulates emotion.”

And lest there be any perception that Dr. Frances did not contribute to psychiatry’s ardent embrace of biological reductionism, here’s a quote from the Introduction to DSM-IV, of which Dr. Frances was the Task Force chairman:

“The terms mental disorder  and general medical condition are used throughout this manual.  The term mental disorder is explained above.  The term general medical condition is used merely as a convenient shorthand to refer to conditions and disorders that are listed outside the ‘Mental and Behavioral Disorders’ chapter of ICD.  It should be recognized that these are merely terms of convenience and should not be taken to imply that there is any fundamental distinction between mental disorders and general medical conditions… (p xxv) [Boldface added]

. . . . . . . . . . . . . . . . 

“Fortunately, though, there are many reasonable people in both camps who may differ markedly in their overall assessment of psychiatry but still can agree that it is certainly not all good or all bad. With open-mindedness as a starting point, common ground can usually be found;”

At the risk of appearing cynical, I see this as a rather facile attempt at divide-and-conquer.  Psychiatry is the Goliath here, and the anti-psychiatry movement is a very weak and poorly-provisioned David.  What Dr. Frances is doing is marginalizing the more extreme members of the anti-psychiatry camp, and attempting to gather the more moderate members into psychiatry’s fold, under the pretense that most psychiatrists are reasonable people who will welcome their input with “open-mindedness”.  In reality, apart from a truly tiny number of psychiatrists, there is no receptivity within psychiatry to the anti-psychiatry concerns.  In fact, the dominant feature of the present debate is psychiatry’s increased insistence that the problems they “treat” are indeed real illnesses, and that their “treatments” are safe and effective.

In a recent radio interview with Michael Enright on Canadian Broadcasting Corporation’s The Sunday Edition, Jeffrey Lieberman, MD, one of the most eminent and prestigious psychiatrists in the world, characterized Robert Whitaker as “a menace to society” for daring to suggest otherwise!  And there was scarcely a ripple of protest from psychiatry.

. . . . . . . . . . . . . . . .

“And finding common ground has never been more important. We simply can’t afford a civil war among the various advocates of the mentally ill at a time when strong and united advocacy is so desperately needed.”

Note the term “civil war” with its connotations of brother against brother, families torn apart, etc…  The message here is:  that those of us who are “open-minded” basically want the same thing, so why are we engaged in this struggle?  But note also the phrase “the mentally ill”.  The essential core of the anti-psychiatry movement is that the various problems embraced by psychiatry’s catalog are not illnesses.  But Dr. Frances dismisses this entire issue in the guise of being open-minded and conciliatory.

In addition, the phrase “the mentally ill”, with its connotations of amorphousness, homogeneity, and anonymity, is extraordinarily stigmatizing.  I would concede that person-first language is sometimes promoted to an excessive degree, but the phrase “the mentally ill” is not at all helpful.

Ironically, Dr. Frances uses this phrase in the context of advocacy!  “…various advocates of the mentally ill…”  I respectfully suggest that a good first advocacy step for Dr. Frances would be to stop calling the individuals concerned “the mentally ill”.

Incidentally, the phrase “the mentally ill” occurs in Dr. Frances’s paper three times; the phrase “the severely ill” occurs once.

And why is this “strong and united advocacy…so desperately needed”.  Because:

“Mental-health services in the U.S. are a failed mess: underfunded, disorganized, inaccessible, misallocated, dispirited, and driven by commercial interest. The current nonsystem is a shameful disgrace that won’t change unless the various voices who care about the mentally ill can achieve greater harmony.”

But, and Dr. Frances fails to mention this, it is psychiatry itself that has been running this “shameful disgrace” for the past 150 years or so.  And psychiatry was, and still is, a very willing and devoted partner to pharma, the major commercial interest.

Also note the guilt-trip:  if you’re not joining the great Allen-Frances coordinated unification drive, then you just don’t care about “the mentally ill”, (that phrase again).

 

. . . . . . . . . . . . . . . .

“…those who don’t need psychiatric medicine get far too much: We spend $50 billion a year on often-unnecessary and potentially dangerous pills peddled by Big Pharma drug pushers, prescribed by careless doctors, and sought by patients brainwashed by advertising. There are now more deaths in the U.S. from drug overdoses than from car accidents, and most of these come from prescription pills, not street drugs.”

But Dr. Frances neglects to mention that his own DSM-IV had a clearly expansionist agenda, details of which I’ve discussed in an earlier post.  It is the proliferation of “diagnoses” and the progressive relaxing of the criteria that enables the increases in prescribing.  And Dr. Frances has been a major player in this area.

He also neglects to mention his own interest-conflicted collaborative relationship with Janssen Pharmaceutica in the mid-1990’s in the promotion of Janssen’s drug Risperdal (risperidone).  In that regard, Dr. Frances was quoted in a witness report as stating:

“We are also committed to helping Janssen succeed in its effort to increase its market share and visibility in the payor, provider, and consumer communities.” [Boldface added]

. . . . . . . . . . . . . . . . 

“The mess is deeply entrenched because 1) there are few and fairly powerless advocates for the most disadvantaged; 2) the commercial interests are rich and powerful, control the airwaves and the politicians, and profit from the status quo; and 3) the mental-health community is riven by a longstanding civil war that distracts from a unified advocacy for the severely ill.

The first two factors won’t change easily. Leverage in this David-vs.-Goliath struggle is possible only if we can find a middle ground for unified advocacy.

I think reasonable people can readily agree on four fairly obvious common goals:

1.  We need to work for the freedom of those who have been inappropriately imprisoned.

2.  We need to provide adequate housing to reduce the risks and indignities of homelessness.

3.  We need to provide medication for those who really need it and avoid medicating those who don’t.

4.  We need to provide adequate and easily accessible psychosocial support and treatment in the community.”

There is indeed a David and Goliath aspect to this issue.  Pharma-psychiatry is Goliath; and the struggling anti-psychiatry movement is David.  But note how Dr. Frances has reconfigured this. Goliath is now “the commercial interests” (presumably pharma), and David is psychiatry (without, of course, the few “blind biological reductionists”) plus those “reasonable” members of the anti-psychiatry movement who genuinely care for “the mentally ill”.  Casting pharma and psychiatry as being on opposite sides of this issue, and portraying psychiatry as the powerless, innocent victim, are extraordinary feats of mental gymnastics.

. . . . . . . . . . . . . . . . 

“Eighty percent of all psychiatric medicine is prescribed by primary-care doctors after very brief visits that are primed for overprescribing by misleading drug-company advertising.”

But not a single one of those prescriptions could have been written if psychiatrists had not invented, and avidly promoted, the “illnesses” for which they are prescribed.

. . . . . . . . . . . . . . . .

 “Many psychiatrists also tend to err by being too quick to write prescriptions.”

But isn’t this an integral part of the medical model:  diagnose the illness, prescribe the treatment; follow-up.  This isn’t some kind of unforeseeable aberration.  Rather, this is psychiatry as psychiatrists – leaders as well as rank and file – have consciously and deliberately sculpted it over the past 50 years.  This spurious and destructive travesty is the inevitable culmination of psychiatry’s efforts to establish itself as a bona fide medical specialty.  The fact that it is such a colossal failure is not a reflection on the efforts of the participants, or the pharma money that fuelled those efforts.  Rather, it reflects the obvious fact that the medical model is not a useful way to conceptualize or approach non-medical problems of thinking, feeling, and/or behaving.   

. . . . . . . . . . . . . . . . 

“I think reasonable people can agree that we need to reeducate doctors and the public that medications have harms, not just benefits…”

Doctors need to be re-educated to the fact that medications have harms, not just benefits!  Don’t they read the PDR?   And note the use of the generic term “doctors” rather than psychiatrists, even though it was psychiatrists who routinely proclaimed the safety and efficacy of the drugs they pushed, and downplayed adverse reactions, when they mentioned them at all.  And it was the pharma-funded psychiatric research mill that churned out, and continues to churn out, the spurious studies that “established” the safety and efficacy of these products.

. . . . . . . . . . . . . . . . . 

“…it is equally ludicrous that anyone should be sent to jail for symptoms that would have responded to medication if the waiting time for an appointment had been one day, not two months.”

First, note the implication that the criminal behavior is a “symptom” that “would have responded to medication.”  But what of the increasing number of very serious criminal acts committed by people who are actually taking psychiatric drugs, particularly SSRI’s?

. . . . . . . . . . . . . . . . 

“When, more than 50 years ago, Tom Szasz began to fight for patient empowerment, freedom, and dignity, the main threat to these was a snake-pit state hospital system that warehoused more than 600,000 patients, usually involuntarily and often inappropriately. That system no longer exists. There are now only about 65,000 psychiatric beds in the entire country, and the problem is finding a way into the hospital, not finding a way out.”

This is not entirely accurate.  The late Thomas Szasz, MD, was indeed concerned about coercive psychiatry, but he was even more concerned about psychiatry’s spurious medicalization of non-medical problems: what Dr. Szasz called the myth of mental illness.  And this latter concern is one that Dr. Frances consistently fails to address, or even acknowledge.  To abuse the late Dr. Szasz’s legacy in this way strikes me as dishonorable.  And to suggest that the concerns so forcefully expressed by Dr. Szasz are now a thing of the past is simply false.

. . . . . . . . . . . . . . . . 

“Anti-psychiatrists are fighting the last war. Psychiatric coercion has become largely a paper tiger: rare, short-term, and usually a well-meaning attempt to help the person avoid the real modern-day coercive threat of imprisonment.”

So psychiatric coercion is rare, short-lived, and is essentially an act of kindness to keep people out of prison.  But on August 28, 2014, Dr. Frances wrote an article on the Huffington Post Blog in which he lionizes D.J. Jaffe, whom he describes as “one of a small group of stalwart defenders of the 5 percent” (people with “severe mental illness”).  Dr. Frances provides an extensive quote from D J. Jaffe in which Mr. Jaffe clearly supports the infamous Tim Murphy bill, which, if implemented, would increase vastly the amount of coerced psychiatric “treatment” in the US.

. . . . . . . . . . . . . . . .

Depression is not an illness.  Childhood inattention is not an illness.  Painful and distressing memories are not illnesses.  Habitual criminality is not an illness.  Psychiatry’s routine medicalization of these and other non-medical problems is a disaster of monumental proportions, and Dr. Frances has been a major contributor to this process.

At the present time, psychiatry is being exposed as the self-serving, disempowering, and destructive charlatanism that it is.  The anti-psychiatry movement, though still the David, is gaining ground and adherents daily.  Psychiatry has no defense, and can see the edifice, so carefully and deceptively constructed over decades, crumbling by the day.

What Dr. Frances is trying to do is co-opt the anti-psychiatry movement, by marginalizing its more extreme members, while gathering the rest under a dubious banner of reasonableness and compromise.  But beneath the thin veneer of amenability, there are still the spurious, self-serving concepts and the destructive, disempowering practices of a system that is intellectually and morally bankrupt, and has no legitimate claim to being a medical specialty.

  • Mark Eccles

    Dr Allen Frances equates poverty with mental illness. “Sleeping on a stoop, stealing a Coke, or shouting on a street can get the person arrested.”

    If psychiatry owns the poor (instead of the criminal-jail system) then the poor get a monthly welfare cheque for their “illness”. That is compassion ( money for food and rent), but not medicine.

    To keep the illusion the “patient” is ill, they must be forced to take medications for the fictional brain chemical imbalance. And the drugs keep them from performing work, the drugs keep them indentured to psychiatry.

    This all comes to you from the taxpayer and the government. 15 trillion in debt
    National Debt Clock , April 20, 2012 https://commons.wikimedia.org/wiki/File:Usa_national_debt_20_April_2012.JPG

    The root of all evil is money, which psychiatrists want rather than the criminal system , to control the proletariat.

  • Dr. Hickey, I largely accept your view that medical psychiatry has been an abject and corrupt failure. There is excellent evidence for that conclusion. But I have profound doubts that anyone in the anti-psychiatry movement has a clue on what needs to be done to move beyond this failure to something better that genuinely aids people in deep distress. While I disagree with Allen Frances on the great majority of his public declarations, I am required by my own experience to agree on one point: many in the anti-psychiatry movement can indeed be quite accurately described as “blind ideologues” who will settle for nothing less than the total abolition of psychiatry in all its forms, without regard for whatever may follow after.

    I have encountered some of these folks in commentaries to articles on Mad In America. When I have suggested the beginnings of an actionable program of change toward better outcomes than those now observed, they made it thoroughly clear that unless I agreed with their premises in total and signed on unconditionally to destroy psychiatry in all its manifestations, I was unwelcome and suspected of being corrupt. The level of self-righteous wrath and anger in this community are beyond reasoning with. Such advocates consistently become remarkably silent when asked just how they intend to bring about the result they intend. And their effectiveness in fostering sustainable change is consequently just about zero.

    At the heart of issues in the modern healing arts is a basic reality: there are at least hundreds of thousands of people in the US and many more in the world at large, who struggle daily with far more than the social consequences of childhood abuse or neglect. At our present state of knowledge, we simply do not understand what produces the delusions, paranoid fear, and sensory distortions that are observed the most severely affected. We theorize in complicated terms about the connections between emotional trauma and cognitive breakdown. But in reality we haven’t a clue to reliably effective non-drug interventions that aid people back to independence and cognitive function. In my view, any proposal to abolish psychiatry without offering these people and their families a reliable alternative is highly irresponsible and ethically unsound.

    It has been argued by some in your blog, that talking therapy frameworks like Open Dialog offer a realistic alternative to medication. Perhaps for less disturbed people who can process a conversation, this might even be true. But In my view, for the more profoundly disturbed, such assertions are presently unproven and unreliable. I believe it is worth reading an article by Dr. Alex Langford (MD) titled “Open Dialogue: reflections on the model and the evidence” before we make such assumptions of a framework where the evidence is extremely thin and largely inconclusive. It is also pretty well proven that formulaic frameworks like Cognitive Behavior Therapy are no more effective than placebo in aiding the psychotic.

    Though we lack reliable psycho-social treatment protocols for those in emotional crisis or cognitive disarray, I believe it is still possible to move toward better outcomes. The four points offered by Allen Frances might be part of such a movement, regardless of the apparent distortions in his point of view. It may pain you, Phil, but there are millions of patient testimonials on the efficacy of short term medication in moderating severe mental health crises; we cannot simply ignore that evidence, even if we need to re-validate and qualify it by a balanced consideration of negative side effects and over-use in the long term.

    Two other measures seem to me worthy of consideration:

    1. Lobby Congress and the FDA for immediate banning of media advertising for prescription medications. Many of the present abuses of psychiatry are founded on the money stream that such advertising generates for Big Pharma.

    2. Lobby the NIH for inclusion of technically trained medical laymen on its research protocol reviews and practice standards committees. We need earlier intervention by disinterested experts, to detect when trials data are being tortured to produce the results demanded by pharmaceutical companies.

    Before you would abolish psychiatry, I believe you have an ethical obligation to offer a better alternative to people in need. It is not enough to point out the failures of present practice. You must point out the way(s) toward something better that actually works for those who need it.

    Sincere best regards,
    Richard A. Lawhern, Ph.D. (systems engineer)
    Advocate for chronic neurological face pain patients.

  • cledwyn bulbousons

    Trying to reason with people who currently or formerly worked in psychiatry about the label “mental illness”, the uses to which the term is conventionally put, and the discriminatory practices exercised on its basis, is useless, an exercize in futility, because belief in the validity of the concept forms the basis whereupon the legitimacy of the profession rests, the lynchpin without which the profession would crumble, its raison d’etre being the treatment of these so-called “diseases”.

    The maintenance of the belief in “mental illness” is a veritable survival imperative for the profession, explaining the entrenched, institutionalized denialism within the profession of the harms and injustices the use of this concept lends itself to and the predominant role of said concept in fostering social stigma.

    (Though it must also be stressed that prejudiced attitudes towards “the mentally ill” cannot entirely be attributed to this source. A great role is also played by the voluntaristic framing of suffering, that is, the belief in the supposed supremacy of the will, its ability to surmount the obstacles Nature, Fortune and Circumstance place in our paths; and by the belief that responsibility for suffering and adversity should almost always be borne on the shoulders of those whom they afflict, largely born of the tendency amongst life’s self-proclaimed “winners” to attribute the rich harvest of prosperity, which Nature’s blessing and Fortune’s favor largely afford, entirely to their own diligence. The corollary of this is the attribution of others’ misfortunes to the person who suffers them, wherefrom the tendency to blame victims largely originates, as well as the belief that all, say, depressed people, have to do to overcome their problems is “pull themselves together”, start thinking more positively, or engage in certain forms of activity that often do nothing to ameliorate their condition and from which some people are stopped from partaking in anyway, due to either structural barriers or a lack of the opportunities and advantages taken for granted by those who can avail themselves of them, but who disdain to acknowledge their role in their lives, lest it spoil the pleasure they take in themselves.)

  • S Randolph Kretchmar

    To paraphrase Abraham Lincoln, I would tell Allen Frances that this “civil war” he’s talking about will continue, until all the taxes and all the public treasure piled high by a hundred and fifty years of psychiatric slavery is taken back, until every drop of blood drawn with that psychiatric lash is repaid by another drawn by an anti-psychiatric sword. There will be no middle ground, ever.

  • S Randolph Kretchmar

    As a proud radical abolitionist, I would expect that psychiatry will destroy itself if it is merely denied its current facility of legal coercion. To any extent that this “medical specialty” actually helps people with “mental illness”, it will continue without the assistance of the police, and my estimation will have to be revised.

    End all forms of forced “treatment” and ban the “insanity defense”. That’s the actionable program of change. It was Tom Szasz’s simple prescription, from almost fifty years ago.

    But as far as I’m concerned, you are always entirely welcome to comment, I don’t suspect that you’re corrupt, and I would not ask for agreement in total!

  • all too easy

    No one, except you, promotes the idea that ADHD is not childhood inattention. No where is ADHD referred to as simply childhood inattention, except by people who hope it isn’t real. I understand perfectly why you do. Your fear of this disorder and your jealousy for real medical doctors is astounding. You don’t know what ADHD is, though you keep pretending that you do. You and your pals who never had successful practices despise those who have and do. Baughman, Breggin and other fools couldn’t compete with doctors who actually helped people, could they? No former client has sung your praises, correct? No one describes the breakthroughs your forms of therapies have made.

    ADHD is all too real and most afflicted with it respond wonderfully to stimulant medication.

  • all too easy

    Sorry clod, but it is your raison d’etre to condemn what defines you.

  • A good many other active participants at MIA seem a good bit less willing than you are to hear viewpoints other than their own. In effect, I was run out of the place on a rail for suggesting some of the points mentioned above.

  • So what is your alternative in trying to assist others who suffer in deep distress? Just leave them alone and expect a miracle?

  • No middle ground seems (at least to me) to dictate no useful solution. You seem not to want answers to human suffering, but rather to seek retribution and revenge. That’s a vendetta, not a program of real change.

  • People who have had the experience of suffering more harm than good and having to swim against the tide just to decolonize their minds from the lies they have believed about themselves and their medication are a bit thorny. Psychiatrists and marketing keeps giving them reason to stay angry by dismissing them as “crazy” for daring to speak up about the harm that has been done to them and acknowledging that they have been hurt by a profession with serious problems.

    Since the DSM-IV, psychiatry has become both mindless and unfeeling. I’m a very reasonable person and continually strive to speak precisely and fairly in most forums, but Mad in America is a place where coddling the feelings of random psychiatrists is not required.

    Now, many psychiatrists are now openly admitting that they’ve always known that the chemical imbalance model was untrue, but told patients that so they’d take their medicine. Lieberman does this, then calls all perfectly qualified critics “Scientologists” and assassinates their character with accusations that they don’t care about the “mentally ill” and don’t want them to get treatment. What kind of adult admits to a huge lie and then demands unconditional positive regard while defending what he believes to be science with nary a scientific thought?

    I’ll worry about the feelings of psychiatrists when they start showing some respect. It’s more than unbecoming when people with such power play the victim and refuse to recognize valid complaints. No branch of medicine and not adult is above criticism

  • Being on a drug that causes problem and corrects nothing, for a condition you don’t have is distressing. Why not work on that?

  • Fine in principle. But what are the concrete steps needed to “work on that” and change accepted practice standards of those who attempt to aid the deeply distressed?

  • Criticism is necessary but NOT ENOUGH. What are the concrete steps for getting from where we are now to better places than prison or a sleeping bag under a highway bridge, for those in severe emotional and cognitive distress?

    You can rail all you want against the abuses of psychiatry. But you and I do not unilaterally change public policy or professional practice or insurance reimbursement criteria. Those things are changed by other people, some of them in the legal system and some now coming up through University training, and some of them patients in recovery whose experience can inform the rest of us who haven’t been where they were. So how can the levers of policy and power be reached and changed?

    Without an actionable program, this entire discussion becomes worthless word noise.

  • In his book “Chasing Normal”, Allen Frances characterizes the over-prescription of stimulants for kids diagnosed as having ADHD as a “fad”. He also gives compelling evidence of other fads in psychiatric practice, such as the so-called “recovered memory” debacle of the 1990s that ruined the lives of hundreds of innocent operators of child care centers. I disagree with many other things Frances has written, but I find the case compelling on this issue.

    Whitaker and Cosgrove follow the sharp expansion of ADHD as a diagnosis, under the uncritical advocacy of psychiatric professionals, in “Psychiatry Under the Influence — Institutional Corruption, Social Injury, and Prescriptions for Reform”. They also reveal that key figures who contributed to American Academy of Adolescent and Child Psychiatry standards of care for ADHD had significant financial conflicts of interest. The AAACP standards are also in conflict with NICE standards, in advocating off-label prescription of medications as the first line of treatment for the disorder, rather than a last resort if behavioral counseling and support are ineffective.

    Before you call anyone “fools”, I challenge you to reveal your own identity and background. What personal qualifications do you have to make such sweeping claims? When and where have you treated patients? You write as if you’d been paid by pharmaceutical companies to act as a shill.

  • all too easy

    Beloved, but deluded, Red, when you and yours attempt to argue with me, do yourselves a favor. Find someone who can keep up with me. You boys keep presenting the same silly, stupid, irrelevant information that has nothing to do with what I have to say. Sweetie, it makes no difference if some big shots have ties with pharma. It makes no difference if unethical boobs prescribe stimulants unnecessarily. George Wallace, a one-time devout democrat, was a racist.

    You remind me of the idiot who claims to have sons with ADHD and he never gave them any meds and they are fine. He honestly believes that is proof that ADHD doesn’t require meds.

    The question, the real question is, why don’t you find a life? I don’t mind crushing you in a true debate, but you are so far removed from being able to contest what I argue, it isn’t fair to you. Go away Red. Have a nice life. I’m sure you are a nice fella. You probably enjoy taking your dog for a walk or babysitting a grandchild. Find something you are good at and go for it.

  • You’re not crushing anybody, Bubba. Your arguments have no merit. They are merely tirades without substance or authority.

  • all too easy

    I think Roy Yoder should have been given a medal for abusing women. He’s may hero.

  • Phil_Hickey

    Red,

    Thanks for commenting.

    You have raised several important issues.

    1. On the contention that we should be developing viable alternatives to psychiatry before we call for its downfall, my primary response is: why? Historically, reform movements have always had two components: criticism of the status quo, and development of replacement systems. The two components are, of course, related, but there is no reason why they cannot proceed separately. Indeed, often it is not possible to make progress on alternatives until the abuses of the status quo have been thoroughly exposed.

    2. The anger and outspokenness run both ways in this debate. I personally receive a good deal of vitriol merely for pointing out that the various problems that psychiatry treats are not illnesses! The anger towards psychiatry usually comes from its victims, who have been horribly harmed, and is, in my view, very understandable. This is especially the case in that psychiatry is not an error; it is a deliberate, self-serving hoax, in which human life is literally destroyed for the sake of pharma profit and psychiatric prestige.

    3. You maintain that “we haven’t a clue” as to what produces the delusions, paranoid fear, and sensory distortions that some individuals experience, or how best to help. I think that this is an over-statement. From the 1920’s to about 1965-1970, there was a growing body of very successful research and practice in this area. I have touched on this issue here (comment reply to “Cledwyn and Francesca”). I also discussed it in a paper I wrote for the Behavior Therapist in September 2014. Here’s a quote:

    “Patterson and Teigen (1973) used operant conditioning to teach a psychotic client to provide factual answers to biographical questions, where previously her responses had been delusional. Walker and Buckley (1968) used a shaping program to teach attending behavior to a bright nine-year-old boy who, prior to the behavioral intervention had been extremely disruptive in class. Ullmann, Krasner, and Edinger (1964) used simple social reinforcement (“mmh-hmm”s, smiles, nods, etc.) to teach long-term hospitalized psychotic clients to give common (i.e. “normal”) associations to stimulus words. McLaughlin and Nay (1975) used response cost to reduce, to the point of virtual elimination, the frequency of hair pulling in a 17-year-old girl who had been assigned a “diagnosis” of trichotillomania.

    Even during the 60’s, behavior therapy was a thriving and successful field, generally considered to be on a par with, or even superior to, drug treatment in efficacy and safety. Since about 1970, however, it has declined both in popularity and perceived helpfulness relative to drug therapy which has become increasingly accepted not only in professional circles, but within society generally. This change was not evidence driven. Drug therapy was backed by pharmaceutical money and has become a multi-billion dollar global industry. Behavior therapy, in contrast, has no financial backers.” ( 161)

    The references quoted above are:

    Patterson, R L, & Teigen, J R, (1973). Conditioning and post-hospital generalization of nondelusional responses in a chronic psychotic patient. J Appl Behav Anal, 6(1), 65-70.

    Walker, H.M., & Buckley, N.K. (1968). The use of positive reinforcement in conditioning attending behavior. J Appl Behav Anal, 1(3), 245-250.

    Ullmann, L.P., Krasner, L., & Edinger, R.L. (1964). Verbal Conditioning of Common Associations in Long-term Schizophrenic Patients. Behav Res Ther, 2, 15-18.

    McLaughlin, J.G. & Nay, W.R. (1975). Treatment of trichotillomania using positive coverants and response cost: A case report. Behavior Therapy, 6(1), 87-91

    This psychosocial perspective didn’t just evaporate – it was systematically and deliberately suppressed by pharma-psychiatry in order to clear the field for the promotion of the chemical imbalance nonsense and the so-called drug revolution.

    4. I generally refrain from speculating on the causes of problems of thinking, feeling, and/or behaving, because in my view, the causes are as many as the individuals who have these problems. In other words, it’s never a question of what causes depression, say, but rather: why is this person, in this context, with this background, and these family members, etc., depressed?

    5. I don’t think that we can know, with anything approaching confidence, what the social consequences of severe childhood abuse/neglect might entail. I’m not sure what you have in mind when you insist that there must be “far more” to the matter than that, but in the absence of clarification, it sounds a bit like broken brain theory.

    6. I have read Dr. Langford’s paper and find it unimpressive. I generally support the principles underlying Open Dialog, but the anti-psychiatry movement doesn’t stand or fall on the merits or otherwise of one program. And I would certainly dispute Dr. Langford’s implications that psychiatry is already invested in these principles and would implement them but for lack of funding. The fact is that for the past fifty years, psychiatry has put its funding where its heart is: drugs and electric shock treatment, and 15-minute med checks. Lamenting the fact that there’s now no money for alternative approaches is disingenuous. I have critiqued other papers by Dr. Langford here and here.

    7. Psychiatric drugs are essentially similar to nicotine, alcohol, and street drugs. They provide a temporary feeling of well-being, at substantial long-term cost. The fact that there are “millions of patient testimonials on the efficacy of short-term medication in moderating severe mental health crises” neither pains me nor surprises me. Most users of nicotine, alcohol, cocaine, meth, etc.., will provide similar testimonials, at least until the adverse effects begin to be felt. The critical difference between alcohol, nicotine, and street drugs on the one hand, and psychiatric drugs on the other, is that the adverse effects of the former are avidly publicized, while those of the latter are, with equal avidity, suppressed.

    8. I believe that my primary ethical obligation in this area is to continually expose psychiatry as the destructive, self-serving, disempowering hoax that it is, and I find it heartening that the mainstream media are beginning to get the message.

    9. With regards to alternatives, I’m generally wary of programs, favoring instead the infusion into existing institutions (schools, for instance) of policies and philosophies that are enabling and empowering, rather than disempowering. For instance, I think it would be useful to have social skills trainers in our schools, to provide help to those children who do not receive this kind of skill training at home. It has long been my contention that helping people with problems of thinking, feeling, and/or behaving is not quantum physics. It’s a matter of listening patiently to people’s concerns, helping them conceptualize these problems in individualized, manageable terms, and helping them in the development of solutions. It’s not mysterious. It’s not hi-tech.

    Again, thanks for commenting, and best wishes.

  • Phil_Hickey

    Randolph,

    Nice!

  • Phil_Hickey

    Felonious Grammar,

    Well put!

  • Phil, I must shake my head sadly. While I respect and even agree with many of the points you make, I intuit that you are still mired in the same either/or guild war that has polarized and paralyzed psychiatry versus psychology for the last 50 years. In my view NEITHER the medical model nor the talking therapy and compassion model have proven to be adequate responses to the levels of anguish and cognitive disarray that are routinely observed in people who hear voices, suffer with delusions, and experience paranoid fear.

    At lesser degrees of disablement, there are millions of people in society who testify that they have done better under drug treatment than without it. Unless you can demonstrate a better and safer way to help, their testimony will discourage changes in government policy. The paralysis will continue.

    With regard to alternatives, do you seriously consider the arguments over such models to have been settled by INDIVIDUAL CASE REPORTS such as you reference???? Lacking repeatable protocols and large-scale observed trials, how would you train future professionals who propose to heal and aid those in distress? And how would you separate effective therapists from the charlatans who claim sweeping cures — which simply don’t replicate when examined independently?

    It would seem that your concept for change consists of nothing more than hoping something better will grow out of the discrediting of mainstream psychiatry’s abuses. In this, I sense that an analogy can be drawn to the cartoon of two mathematicians standing at the base of a huge black board covered with equations, with an equal sign but no result shown to the right. One says to the other “and then a miracle happens.”

    I don’t see the miracle, Phil — or any serious prospects of one. Your response, however well grounded in some areas, deeply disappoints me.

  • all too easy

    “This is especially the case in that psychiatry is not an error; it is a deliberate, self-serving hoax, in which human life is literally destroyed for the sake of pharma profit and psychiatric prestige.”

    That, my friend, smacks of paranoia. Please, prove you are correct making such a statement. Do this. Give us the names and addresses of every psychiatrist who perpetrates this hoax, knowingly, and with ill-will. You won’t. Phil, you can’t. Your hatred and jelousy blind you.

    “Psychiatrists and marketing keeps giving them reason to stay angry by dismissing them as “crazy” for daring to speak up about the harm that has been done to them and not acknowledging that they have been hurt by a profession with serious problems and that they’re entitled to be taken seriously.”

    Name names. You can’t. Ditto above. You need a full medical workup by a group of medical doctors. Or, prove the harm, specifically, in detail and based on the investigative work of professionals using scientific protocol and not an “observational” approach. What courage does it take to cry about how psychotropics ruined your lives and how nuch psychiatrists suck?

    “I’m a very reasonable person…” not according to the statements you’ve made here. “… and continually strive to speak precisely and fairly in most forums, but Mad in America is a place where coddling the feelings of random psychiatrists is not required.” Wrong again. (Transference is something you should study. You could benefit from it, if you had a teachable disposition.) It is the ultra-sensitive, non-functioning, big-mouths who cannot handle orfinary criticism that makes you cling to the belief that you are untouchable. Everyone is wrong, but you. No one has been hurt as deeply and as horribly as you. No one knows what pain really is, except you. And you broad brush psychiatrists like men criticize and demean women.

    “It’s more than unbecoming when people with such power play the victim and refuse to recognize valid complaints. (You just said many psychiatrists are joining your crowd!) “No branch of medicine and no adult is above criticism.” except you

  • S Randolph Kretchmar

    Answers are just not so academic. There’s real-life blood and treasure that it’s too easy to forget. My clients won’t forget.

  • S Randolph Kretchmar

    Don’t complain, let them. Just keep arguing.

  • S Randolph Kretchmar

    Phil is right, it will not be possible to make progress on alternatives until the abuses of the status quo have been thoroughly exposed. We are not currently operating in a field of rational progress or polite conversation, in mental health. There are moments in history when one side actually must defeat the other.

    Sometime after Shiloh, one of General Sherman’s adjutants lamented about so many “young Southern bucks” who would never, ever, stop fighting. He asked the general what could be done, with what seemed to be a whole population of extremists.

    Sherman, the master strategist, answered without hesitation, “Kill them. Kill them all.”

  • all too easy

    That should be Rod Yoder, not Roy.

  • So apart from the wholesale slaughter of psychiatrists, HOW would you move toward rational progress and polite conversation? The Devil is often in the details, Randolph.

  • all too easy

    “neurochemical distractibility/impulsivity (NDI)” “NDI is caused by irregular neurotransmitter activity, specifically low levels of whole-blood serotonin or high levels of epinephrine/norepinephrine. The symptoms are classic deficits in attention and executive functioning, as the name suggests, and NDI is treated with stimulants, just like ADHD.”

    “While many skeptics believe that ADHD is a fabrication of drug companies and the medical establishment, the symptoms of attention-deficit and hyperactivity are all too real for millions of individuals who often cannot function without treatment.” Dr. Richard C. Saul M.D.

    Dr. Phil says, “And now their voices are joined by Richard C. Saul, MD, an experienced and highly regarded neurologist who practices in the Chicago area. He has written a book, ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder, which is due out next month. The book is sure to present a formidable challenge to the orthodoxy and practices of organized psychiatry, with regards to this particular “diagnosis,” that has seen an almost four-fold increase in prevalence from 1987 to the present day.”
    Phil didn’t read the book he praises. Saul simply gives ADHD a new name which describes exactly the DSM definition of ADHD

  • all too easy

    Do you intentionally try to sound like Rod Yoder? Wonderful fella, that Yoder dude.

  • S Randolph Kretchmar
  • Your blog entries seem remarkably temperate, given your confrontational premises. Am I correct in perceiving that lobbying for changes to the legal system for violent offenders might comprise a central element of your pathway toward a (more) rational process? Would you have any suggestions for ways to improve social and personal outcomes for others not involved with the criminal justice system?

  • S Randolph Kretchmar

    Geez, I hate to be too remarkably temperate…
    It seems to me that if I can stop, or make it sufficiently difficult for psychiatrists to force “treatment” on the worst of the worst (psychotic killers, etc.), then I can stop them from forcing it on anyone. If they can’t force it on anyone, psychiatry as we know it will wither away.

  • Rob Bishop

    I’m enjoying your writing. Fascinated by the idea too much compliance might be a cause of mental illness. And that acting
    out is compliance with one’s own unsocial instincts and selfish desires. The concept of personal agency needs to become part of our culture and educational system! These day everything from obesity to depression is called an illness. My 12 year old asks me questions such as, “Did Hitler have a bad childhood?” and I reply, “Possibly not.” More and more we embrace the idea we are not in control…

  • S Randolph Kretchmar

    Thank you.

  • But how do you actually DO this “stopping” or “making difficult” thing? Psychiatrists are empowered by multiple public laws to do exactly what they’re doing. Absent changes to those laws, they’ll predictably go right on doing it. Expecting spontaneous changes in public policy when large amounts of money oppose your point of view seems to me akin to magical thinking.

  • Perhaps well put, but totally ineffective and non-relevant. Until somebody successfully sues these b*astards for fraud and related crimes, the status quo WILL NOT CHANGE!

  • S Randolph Kretchmar

    I’ve been working on this “stopping” or “making difficult” thing for 13 years now, and whether it’s magical thinking or not, it seems to me like I am getting somewhere. At least I am on the ground, behind the locked doors, in the institutions with psych slaves and their keepers, in court making arguments, on a regular basis.

    State psychiatrists and “forensic mental health” bureaucrats cut corners on the law. They cheat. The reason it has been so easy for them to do this is that no one wants to be involved with violent psychotics: not judges, not public defenders, not taxpayers, not reporters. These cases just get turned over to the “experts”, and everyone else abdicates whatever responsibility the social context suggests they should bear.

    I know how to catch them when they cheat. They have to pay their own legal counsel when I do; and soon enough I will make them start writing checks to me for it, as well. It hasn’t been as quick as I once hoped, but I can see the future as well as, e.g., Jeffrey Lieberman.

  • all too easy

    You are an idiot.

  • Rob Bishop

    Negativity is a choice. It’s not a mental illness.

  • all too easy

    Stalking me is an obsession. See a good SHRINK.

  • Anonymous

    Listen to this joker,

    “cognitive breakdown”

    Hey dude, guess what! Just because people are thinking thoughts you’d rather they not, saying things, believing things, you’d rather them not say or believe, doesn’t mean you’re in possession of any evidence their ability to think, has “broken down”. If you think you are in possession of such evidence, table it. Also, using language like “the psychotic” just shows what a dinosaur you are.

  • Anonymous

    Millions of smokers testify that a cigarette calms them down, without a ‘viable alternative’ I’m not convinced they shouldn’t keep administering the ‘treatment’ that they testify works for them!

  • Lung cancer and heart disease are acceptable side effects? Hmmmm.

  • all too easy

    A deliberate self-serving hoax. Phillip, have you had a good mental health check-up lately?

    You do know, we never went to the moon, right? All so called evidence that we did was produced in a Hollywood studio. You believe that, I hope.

    How does talk-therapy work, Phil? What mechanism releases a client’s disturbed behavior and thinking, exactly, as one talks about her life? How can a person express her thoughts, Phil? You can’t even prove how the brain thinks or what a thought is. Go ahead and try. What is a thought and from whence doth it come? Nail it down for us genius. Remember, the mind doesn’t exist.

    Not a chance

  • Anonymous

    You’re the one claiming the ‘side effects’ of so-called ‘short term’, psychiatric drugging are acceptable. The above comment was mocking your putting forward the ‘testimony of millions of people who take a drug’ as if it proves something ‘medical’ what they say about their own drug-taking.

  • all too easy

    You should talk. You breathe untreated air, I bet. Do you know what is in the air you breathe? Most don’t. Don’t feel bad. Just don’t breathe the air and you will be fine.

  • Sarcasm rather often doesn’t convey well in print, Anonymous. And I am not claiming that side effects of short term medication are acceptable to all. Possibly millions of patients have found them to be, despite what may be similarly large numbers of patients who found both primary and secondary effects of medication unacceptable or actively dangerous. This duality of patient response is one of the elements that make correction of the present credibility crisis in psychiatry truly difficult. Different people respond differently, even to the same treatment protocols.

    No one individual or small group of individuals gets to set policy on the use or withholding of psychiatric meds. Certainly nobody active in this forum. Ultimately such public policies may come down to whatever insurance companies are willing to reimburse. Relatively small numbers of patients in crisis have the financial resources to pay for their own care unaided.

    Serious independent research and correction of cherry-picking in data analysis by pharmaceutical companies can help provide insights into what actually works and for whom, versus what doesn’t work or may be damaging and dangerous for large numbers of people. Improved protocols and observational practice might give us a better idea of which patients with which complaints are best helped with talking therapies. It certainly won’t be all patients all of the time, any more than with medication treatments.

    The notion that a miracle will happen if only pharmaceutical companies can be sufficiently punished or coercive psychiatrists driven out of practice, doesn’t hold up to even casual observation. And denial of assistance requested by millions of people (both patients and their families) is fundamentally unethical. The contestants in this p*ssing contest will have to do a lot better than that if any genuine healing is to occur. If all you’re here for is revenge, then you contribute nothing.

  • Anonymous

    “despite what may be similarly large numbers of patients who found both primary and secondary effects of medication unacceptable or actively dangerous.”

    What kind of an inhuman monster then, would support a government policy of forcing these substances (that are dishonestly called ‘medications’) into law-abiding citizens’ bodies?

    I don’t want, and aren’t dumb enough, to expect a ‘miracle’, I just want people like you and the millions like you, who support the violence of coercive psychiatry laws, to be neutralized. Nobody owes you or anybody, ‘scientific evidence’ that if humans name-called as ‘mentally ill’ are given equal human rights, that everything will be ok, it won’t in many cases, it will in many cases, but at least appalling human rights abuses will stop. Stop calling people ‘patients’, this isn’t real medicine. I don’t, nobody here does, this isn’t MIA, I come here to get away from MIA, why are you even wheeling in MIA?, nobody here calls for the ‘denial’ of requested services. I’m not anything but an abolitionist of
    psychiatry’s unearned right to initiate violence against law-abiding
    people and the subversion of the criminal justice system by psychiatry. If someone wants and asks for, this pile of quackery, psychiatry, they can have it, I just don’t want it, and don’t want to live in fear of it being violently forced on me. If you want this ridiculous profession’s ‘help’ Red, I won’t be standing in your way. Kindly don’t be one of the people standing in the way of me saying no. That is all I ask, too much to ask, apparently.

  • You aren’t being asked to accept medication, Anonymous. My concern is that millions of people who HAVE accepted medication either in the short term or the long term, have found that they do better than without medication. And I see no evidence that anybody has much in the way of solutions for people who are so profoundly disturbed that they literally cannot hold a conversation with others, over the yammering of voices that only they hear. What would you have the healing arts do for these people — apart from letting them drift into homelessness and sometimes suicide?

  • Anonymous

    The only people who ‘literally’ cannot hold a conversation are the
    unconscious and those without a larynx or a tongue. Other than that,
    there are people who are currently not holding a conversation. That is
    all you can objectively know. At this time, they are talking to you in
    the manner you’d rather them talk to you. Their individual situations
    will vary. In your zeal to paint people you know nothing about as
    ‘unable, literally’ to do things, you show a complete lack of
    understanding that such people may simply not wish to converse with
    ‘others’, or haven’t come into contact with ‘others’ who know how to
    reach them, or maybe the world trying to converse with them, is a
    hostile world to them, who knows?. I’ve personally been labeled the
    ‘most mentally ill’ person ‘admitted’ to an entire ‘mental hospital’ in a
    given week, and locked in solitary confinement. I know about these
    states of mind infinitely more than you do, an outside observer, who has
    merely, and I cannot overemphasize ‘merely’ enough, read about them, or
    witnessed them from the outside. And even from my position of lofty
    comparable insight, I’m still not in every person’s head, only my own,
    and I don’t claim to know what any given individual, or god forbid,
    ‘group’ of people are thinking, or are ‘unable’ to do, or are
    ‘incapable’ of. In fact, I’m one of the rare few who know how harmful it
    is to blanketly paint people as ‘incapable’ of things, solely based on
    the ‘evidence’ that they ‘are not currently doing that thing’.

    I
    completely, vehemently reject your take on, and allegation, of some
    phenomenon you call ‘voices only they can hear’. If there is something
    to be ‘heard’, literally ‘heard’, rather than imagined, what would you
    know about it? Only what psychiatry has put out there in the air, the
    unproven narrative that this is some ‘fact’ that ‘happens to people’. My
    opinion is that people imagine they are ‘hearing’ a ‘voice’, these are
    self-conversations, they anthropomorphize one side of the
    self-conversation as being ‘outside of them’, quite similar to religious
    prayer, and this phenomena only constitutes a problematic thing only
    insofar as they disrupt relations with others, relations with others are
    not a health issue so why the hell would I apply a ‘healing art’ to
    these relations?

    You pose as this great self-declared savior of
    ‘the most disturbed’, and ‘these people’, you ignore Hickey’s reminder
    that there is no ‘these people’, there are only individuals with unique
    life situations and life problems, there is no homogenous lump of ‘these
    people’ like there are with groups of people with real disease such as
    cancer, but maybe the raw hostility you evoke in someone like me should
    tell you you’re way off, way on the wrong track. The only reason I am
    not dead by suicide or homeless, is because I was able to get the hell
    away from people who consider these problems to be ‘health problems’ and
    a sign of ‘incapability’ or ‘literally cannot do things’, how dare
    anybody even speak of ‘letting me drift’ into anything, you don’t get a
    say, at all, in what I drift into unless I break the law, in which case I
    and all people should be treated equally under the criminal law justice
    system, and your complete ignorance of how many people don’t ‘drift’
    into suicide, but are rather driven to it, by the meddling quacks you
    refer to as somehow practicing an alleged ‘healing art’, is outrageous.
    You began your comment by claiming I am not ‘being asked to accept’ a
    poisonous substance that has been forced into my body in the past and
    can be forced into it at a moment’s notice by the do-gooder violent
    ideologues who self-servingly claim they are saving people from
    ‘homelessness and suicide’, you’re obviously wrong.

    If there are
    millions of people who want to take these substances, I’m not standing
    in their way. I don’t want these drugs, and the ‘solution’ that has kept
    me out of the category of being name-called once more as ‘profoundly
    disturbed’, is the passing of time, maturity, self-help, self-education,
    and complete independence from psychiatry. You might live in some
    version of the world where there’s a free, open possibility of the
    ‘gathering of evidence’ and the ‘systemetization’ for ‘solutions’, for
    corralling disturbing people and getting them to shut up and stop
    believing things and thinking thoughts you and society would rather they
    not think, which is ALL ‘reforming’ the thoughts of ‘the most
    disturbed’ is about, but I don’t live in that version of the world Red. I
    live in the version of the world where I’m living in the era of
    monopolisitic ‘biological’ psychiatry pseudoscience, which has a
    government given licensing monopoly on even attempting to ‘help’ people,
    where most of the people working in this area are violent human rights
    abusers I wouldn’t want anything to do with, where I will have a
    built-in disincentive to trust government systems for the rest of my
    days, and where private, self-initiated planning, education, maturation
    and coping strategies are all there is ever going to be. Open Dialogue?
    something I couldn’t give a shit about because I’m never going to put my
    body, life and trust in the hands of some MD psychiatrist or a pack of
    brainwashed social workers, who incidentally are people who I find
    morally repugnant for their career full of human rights crimes
    (participating in locking people up and force drugging them).

    You
    need to somehow see, that you’re being quite unreasonable by calling on
    people like me to ‘suggest a system’, I don’t want a system, I want to
    hide from the ‘system’, the ‘system’ is a threat to me. You might also
    want to examine the stark fact that you’re living in a world where
    psychiatry doesn’t wish to learn from recoveries like mine, doesn’t wish
    to engage, study, adapt, develop, integrate, at all, it just wants to
    continue to mindlessly blame brains that it cannot even prove are
    diseased, for all of these human problems. So stop acting like we even
    live in a world that is amenable to any ‘public policy’ solution to such
    disparate problems as ‘uncle Ed believes the CIA is spying on him’ or
    ‘my niece Jane starves herself’, life is messy Red, it’s infinitely
    complex, the imposition of some ‘system’ that uses violence to meddle
    forcibly in people’s problems, is bound to make those problems worse,
    much of the time, and that cost, that collateral damage in innocent
    lives, is a crime against humanity.

    What we need is freedom, to
    be let alone, where multiple, voluntary, non-monopolistic, forms of help
    and self-help can arise, and people can pick and choose amongst them.
    And don’t dare give me this ‘oh but the people who are too disturbed to
    find something that works for them’, I have been in positions where I
    would be labeled as such a person, and I found something that works for
    me. What do I want? I want society to one day rip away psychiatry’s
    power to force itself on people. Do I think that is realistic in my
    lifetime? No. Do I think that the public could be educated as to the
    vulgar human destruction and abhorrence of the destruction of innocent
    life that these powers enable? sure, over time, yes, and it will involve
    the testimony of people like me. As for the rest of my life, I just try
    and recover from the harm done to me and to take in alternative thought
    on these complex matters, and develop my own take on it all, all
    firmly, non-negotiable, in the private, person to person sphere and
    internet sphere, and I’m not interested in the slightest in calls like
    yours, for some ’empirical base’ of ‘solutions’, because that is like
    calling for an ’empirical base’ of solutions for witch hunting in the
    middle ages, we do not, do not, do not, do not, live in a world where
    official policy is anything but a psychiatric theocracy on this issue. I
    hold no faith in convincing the psychiatry fanatics to change, have no
    desire to ‘reform’ or interact with, and in fact mortally fear, the
    ‘system’, I view it, as unreformable, and I thank my lucky stars every
    day, that I didn’t render myself some passive dependent on ‘someone
    coming up with a solution’, I came up with my own solution, because
    nobody has a more, and nobody could ever have a more, thorough
    understanding of my life and the unique life problems I encountered that
    landed me with my psychiatric name-calling labels.

    We are NOT
    in this together. There is me, my fellow psychiatric survivors, some
    small amount of theorists and intelligent people I consider worth
    listening to, such as Hickey, and then there is the mindless mass of
    humanity that would not skip a beat if I was killed tomorrow from a
    forced injection in a ‘mental hospital’. They are not sincere
    ‘advocates’, they are scary, indoctrinated ideologues, who believe in
    ‘healing arts’, and ‘necessary but regrettable measures to stop
    homelessness’, the leading and most disabling ‘yammering voice’ I hear
    in my head, is the endless cacophony of well-meaning supporters of
    violence against me, who think I am part of some homogenous group, think
    I ‘need’ and deserve their terrifying ‘concern’ lest I be homeless
    under a bridge. The message I want to convey to these people is, stay
    away from me, I don’t want your help, I find it repugnant and one of the
    darkest elements of humanity, on par with great historical atrocities,
    that millions of people have had to suffer through being forced into
    psychiatry.

    You said to Kretchmar, “Psychiatrists are empowered
    by multiple public laws to do exactly what they’re doing. Absent
    changes to those laws, they’ll predictably go right on doing it.
    Expecting spontaneous changes in public policy when
    large amounts of money oppose your point of view seems to me akin to
    magical thinking.”

    I
    certainly don’t expect ‘spontaneous change’ in a world that has been
    throwing people into the psychiatric meat grinder for centuries. All I
    can do is testify and appeal to the public to come to our rescue. I
    don’t bother trying to convince the violent human rights criminals who
    choose to work in the ‘system’ to stop doing what they are doing. Maybe
    in 100 years or 200 years of raising awareness of how much harm
    psychiatry does, its powers can be taken away from it. Who knows?

    You said to Phil,

    ” In my view NEITHER the medical model nor the talking therapy and
    compassion model have proven to be adequate responses to the levels of
    anguish and cognitive disarray that are routinely observed in people who
    hear voices, suffer with delusions, and experience paranoid fear.”

    In
    your view, in your view, in your view…. hmmm. Using a 5 dollar word
    for ‘thinking’ called ‘cognitive’ doesn’t make what you’re saying any
    more grounded in ‘science’. Just because what someone is thinking in any
    given moment of their lives is not ‘arrayed’ the way you’d prefer,
    doesn’t mean you have earned the right to define them as ‘suffering’ or
    ‘anguished’, in point of fact, a great many of the people in this world
    who are name-called as deluded are quite ecstatic and pleased to believe
    what they believe, and only become anguished or experience suffering
    when an ‘adequate response’ imposer, locks them in a cage and tortures
    them with drugs and unwanted interrogations from psychiatrists.

    You
    also don’t live in a world where a ‘compassion model’ or a so-called
    talk ‘therapy’ model is even LEGAL to set up and try, such is the degree
    to which the brain-blaming quack psychiatrists hold a legal monopoly.
    That is to say, it is not as if I, a survivor of extreme states of mind,
    or any group of people like me, have the legal freedom to buy a house,
    hang out my shingle, employ other interested helpers, and start offering
    services to paying families, is it? of course not, people like you
    would be ‘demanding data’, out ‘outcomes’.

    So for you to claim
    that there is some, what? pure open, ready to try anything, free
    environment of establishing and studying ‘models’, is just bizarre. You
    don’t live in such a world, you live in a world tainted, by centuries of
    psychiatric monopolization, and systematic, prejudiced exclusion of any
    lessons that can be learned by the success people like me find when we
    ‘go our own way’ away from psychiatry. You simply do not live in a
    world, nor do any of us, where there is a free hand ‘to convince
    government with evidence’, to ‘create evidence’, to ‘try new things’, or
    in fact ‘where a compassion model has had the freedom to be tried’.

    You
    worked in military systems, where order, systemetization, improvements,
    refinements, order, control, command, hierarchies, all work hand in
    glove to keep a complex system running smoothly. You’re a retired
    gentleman where you can count on the government not becoming heavy
    handed with you, or taking your home off you, or your right to feel safe
    from you, your right to own your own body. Your life experience is that
    if you don’t break the law, you have nothing to fear. You betray a
    blatant lack of understanding of the five-alarm state of terror that
    survivors of forced psychiatry are forced to live with every day. We are
    sentenced to fear our doors being kicked down at any time, a phone call
    from family to authorities, some innuendo and smearing, some accusation
    of ‘disturbance’ is all it takes for me to lose all of my freedoms,
    including my freedom to own my own brain. I live with this extreme
    situation, and I still recovered and find success, I do it without any
    outside ‘expertise’ being brought to bear in my life. In a just world,
    in an open world, where the freedom to study and gather evidence and
    treat people reasonably existed, there might be ‘professionals’ who
    could learn a lot from people like me, but nobody is interested Red, and
    I”m not interested in wasting my time trusting them.

    I am not
    interested in ‘reforming’ a system that was born-dead, infused with a
    deadly cancer of false assumptions from the get-go, I’m not interested.
    We don’t live in a non-corrupt society where the ‘rule by experts’ can
    be applied to these problems without immense damage to innocent life. We
    don’t live in a world where something as complex as to why a million
    different individuals with a million different life stories are going to
    be able to be stopped from living under a bridge by ‘gathering data’
    and ‘testing solutions’ of ‘what to do to them’, which will of course be
    dishonestly called doing something ‘for them’, as you’ve called it.

    You
    also said, “You can rail all you want against the abuses of psychiatry.
    But you and I do not unilaterally change public policy or professional
    practice or insurance reimbursement criteria. ”

    Red, you can
    talk like that about things like breast cancer, but not something
    infected with the psychiatry religion’s theocratic government control.
    Thinking anybody born today, lives in a world where government is open
    to seeing through psychiatry’s fraud, is simply not realistic. We ‘rail
    against’ psychiatry’s atrocities, because it is human nature to want to
    try and tell the world what they’ve done and are doing, wanting to
    testify, and gather allies, does not always translate to having faith
    government is going to listen. I don’t believe government is going to
    listen. Government is not something I have much faith in. In the current
    day, it is a complete waste of time to communicate with anybody but the
    public or between ourselves.

    “Those things are changed by other
    people, some of them in the legal system and some now coming up through
    University training, ”

    What you call training I call the
    psychiatric seminary. Universities are going to continue to spread the
    psychiatry religion, and train harmful, indoctrinated fools, who will go
    out into the world and destroy lives. I am not interested in
    interacting with these people, it is a waste of time.

    “and some of them patients in recovery whose
    experience can inform the rest of us who haven’t been where they were. ”

    Ha!
    Number one, don’t call me a ‘patient’, I was nobody’s ‘patient’, I’m a
    survivor of an atrocity, an unforgivable meddling in my life that nearly
    killed me and well yet shorten my life. I don’t live in a version of
    the world where the ideologues trained in the universities are willing
    to learn from and listen to me or anybody like me.

  • Anonymous

    “So how can the levers of policy and power be reached and changed?”

    Short
    answer, I don’t care, in the short or medium term, it is a waste of
    time. I’d like to see society become profoundly aware of the inhumanity
    of psychiatry over the course of a few generations, and finally liberate
    all people from the prospect of psychiatry’s violence being initiated
    against them. Anything I plan on doing in my lifetime, involves nothing
    but documenting, collating, communicating, psychiatry’s crimes, so that
    people can arm themselves with information so they never wind up in my
    position.

    I believe in networking and assisting my fellow
    survivors of psychiatry’s violence, with information and solidarity, and
    I don’t believe in wasting time appealing to government or to
    psychiatry.

    “Without an actionable program, this entire discussion becomes worthless word noise.”

    I’m
    living my ‘actionable program’, what I’ve learned and the growth I’ve
    attained, the success I’ve attained, the fact I’ve not been locked up in
    an institution in years, involved a hell of a lot, thousands of hours,
    of reading people like Hickey’s thought, it involved talking about and
    reading about these issues, and it is not worthless word noise to me.

    “such assumptions of a framework where the evidence is extremely thin
    and largely inconclusive.”

    I
    don’t want a “framework”, I don’t require “conclusions”, I just want
    you the governments you vote for to stay the hell away from me, and
    allow me to rebuild after the atrocities society has stood by silently
    and unleashed on millions.

    “It is also pretty well proven that formulaic
    frameworks like Cognitive Behavior Therapy are no more effective than
    placebo in aiding the psychotic.”

    This
    name-called “Psychotic”, “the psychotic”, was tired, years ago, of the
    well-meaning, yet terrifying “helpers” who seek to “weigh evidence”
    about “effectiveness” about how to help me, a firm, I don’t want your
    “help” should suffice. Just sit there with your mortgage paid off, on
    the computer and live out your retirement, I’ll be busy fearing my door
    being kicked down by people trained on “evidence on what helps The
    Psychotic”, scum bags, who are willing to rip away my right to make
    decisions, and impose their decisions on me and on my body, when they
    are not the ones who have to pay the cost of those decisions.

    “Though
    we lack reliable psycho-social treatment protocols for those in
    emotional crisis or cognitive disarray, I believe it is still possible
    to move toward better outcomes.”

    How’s this for a “protocol”, me,
    my friends and allies in the forced psychiatry survivor community of
    individuals scattered across the world, will just continue to help
    ourselves and do everything in our power to stay as far away as possible
    from those who think they were put on this Earth to meddle in the
    “outcome” of our lives. We will continue to decry the crimes done to us
    in the name of “help”, and do our best to highlight the ignorance of
    people who accuse us, of offering “homelessness or suicide”, to whom? to
    ourselves?

    You said to Phil,

    “It would seem that your concept for change consists of nothing more than
    hoping something better will grow out of the discrediting of mainstream
    psychiatry’s abuses.”

    After
    psychiatry was discredited in my mind, my quality of life improved
    dramatically. Psychiatry discredits itself, but thinkers like Phil who
    help to lay it all out, help a lot of people, and guess what, despite
    what you think, that ‘those people’ the ‘really serious cases’ who are
    ‘in need of a protocol not just Phil’s ‘nothing more than
    discrediting”, are actually right here, at this blog, following his
    work, and gaining personally from a lot of his articles.

    I’m going to end this comment soon, you said initially,

    “I have encountered some of these folks in commentaries to articles on
    Mad In America. When I have suggested the beginnings of an actionable
    program of change toward better outcomes than those now observed, they
    made it thoroughly clear that unless I agreed with their premises in
    total and signed on unconditionally to destroy psychiatry in all its
    manifestations, I was unwelcome and suspected of being corrupt. The
    level of self-righteous wrath and anger in this community are beyond
    reasoning with.”

    I
    don’t care what psychiatry exists, or what psychiatry millions of
    people seek out and buy, I do care if there is psychiatry bashing down
    my door and hauling me away. That is all I care about. If you don’t
    understand the anger that genuine human rights abuses and wide-scale
    atrocities and second class citizenship bring, maybe you’ve had a very
    fortunate position in society.

    “Such advocates consistently become remarkably silent
    when asked just how they intend to bring about the result they intend.
    And their effectiveness in fostering sustainable change is consequently
    just about zero.”

    I’m
    not the people on MIA you were talking about, but maybe people become
    silent with you the same way they become silent with “All Too Easy” the
    ignorant troll, they simply don’t want to engage with people who fail to
    acknowledge what the situation is.

    You say “At the heart of
    issues in the modern healing arts is a basic reality: there are at
    least hundreds of thousands of people in the US and many more in the
    world at large, who struggle daily with far more than the social
    consequences of childhood abuse or neglect.”

    There it is again,
    “healing arts”, some kind of indirect way of claiming
    “medical/scientific expertise” ought to be brought to bear on these
    infinitely unique life problems of millions of unique individuals. I
    simply do not see you as someone with any insight into my daily
    struggles at all. As evidenced by what you say below,

    “At our present state of knowledge, we simply do not understand what
    produces the delusions, paranoid fear, and sensory distortions that are
    observed the most severely affected. We theorize in complicated terms
    about the connections between emotional trauma and cognitive breakdown.
    But in reality we haven’t a clue to reliably effective non-drug
    interventions that aid people back to independence and cognitive
    function. In my view, any proposal to abolish psychiatry without
    offering these people and their families a reliable alternative is
    highly irresponsible and ethically unsound.”

    What
    is ethically unsound, is believing you’re legitimate in standing behind
    and voting for a government that would force me into the violent arms
    of a group of ideologues who believe my “cognitive function” needs
    “intervening upon”, who believe that intimate parts of my body, my life,
    my thoughts, are just fodder, without my consent, for “expanding” “our”
    (apparently you’re part of an “our”) so-called “state of knowledge”,
    guess what, life, life itself, in modern civilization can “produce”
    people who are having life problems, your little sound-bite catch
    phrases like “sensory distortions”, as though you know anything about
    what I sensed or anything about what I’ve been through, shows me you are
    a supporter of “interventions” that have nearly ruined my life in the
    past, are willing to live in a world where these things are unleashed on
    people against their will, and I do believe you are a supporter of
    horrible things, that did the most to destroy my independence, I clawed
    my way back to independence in spite of the meddlers, and you dare call
    what I’ve done in my own life, the absence of psychiatry in my life,
    “irresponsible and ethically unsound”, people like you say “if not
    psychiatry then what?”, my life is mine, my body is mine, if I say no to
    psychiatry that means no psychiatry for me, the life I’ve been able to
    rebuild post-psychiatry, is free of psychiatry, ALL I want, is equal
    rights and to no longer live in fear of psychiatry being forced on me,
    which governments do, every minute of every day, force on millions
    globally, if you don’t support my right to say no to psychiatry, you’re
    not my advocate at all, you’re just another person willing to throw me
    under the bus onto the pile of collateral damage skulls, the mass grave
    psychiatry and associated do-gooders have created for centuries on the
    paternalistic, violent notion that it would be “dubious to let ‘these
    people’ have the freedom to help themselves”. I don’t need to show you
    or any other human, any “replicated protocols” proving I deserve not to
    live in terror of my door being kicked in, I was born with the human
    right not to be subjected to psychiatry’s violence, it was only
    supporters of this violence who took that right away from me. No
    systematized “protocol” has ever existed Red, that didn’t destroy
    innocent lives. Psychiatry does kill, maim and destroy many millions of
    lives, since it came into existence, those who want to be free of it,
    don’t owe you “enough data” to “justify” an end to the violence against
    their person and their humanity.

  • all too easy

    Yawn

    i’ve been through it all – a very extreme state of mind at the age of 17, & in response being very badly treated, violently sectioned against my will on a locked ward, forced injected with drugs, locked in strong rooms – the works. The system is no different today. There is very much a conspiracy of silence around the whole thing, & the treatment of the genuinely ‘mad’. What is going on with it all, all around the World, happening & has happened to millions of people, is a disgusting indictment on humanity. Yes, there are other bad thing in this World – But with this there is no real acknowledgement, nor validation, & understanding. Just denial, trivialisation & invalidation. Future humanity will look back in utter disgust, just as we do to past psychiatric abuses/practises (those that see & acknowledge them). We’re still in the dark ages with it all.

    The abuse happened at the Old Manor Psychiatric Hospital in 1991 (Sailsbury/UK). If you research the papers from around 1994 they ran reports on a large scale abuse case that had come to light, centered around that hospital, during a 6 year period where the worst of the abuse took place – they had found hundreds of home made sex videos that had been made by the staff, of them sexually abusing patients – & a number of complaints had been made, concerning the physical & sexual abuse of patients. The main director had done a runner at the time. The particular articles i read at the time were in the independent newspaper. The hospital has been long closed down.

    The abuse centered around the locked ‘Bourne’ ward, & i stayed there during the middle of the 6 year period when the worst of the abuse took place.

    i was so heavily drugged on medications, & had been admitted in a very extreme/psychotic state – most of my stay there is a total blank. i do have a very clear memory of ‘coming to’ naked on a bed (in my room that used to be locked at night) with sheets covered in blood & shit, in a very distressed state & 4 nurses around me in a panicked state. i was taken to the bathroom, bathed & the sheets changed & put back into bed. There are other memories as well.

    Can i be categorically sure i was sexually abused on that ward? i don’t know – it was 25 years ago. i don’t remember the names of any of the staff – at the time i was in severe alcoholism/addiction & going through a lot of severe psychosis – that i didn’t properly address for another 10 years.

    i remember being regularly wrestled to the floor by 4 nurses, restrained, pants pulled down, injected with drugs, & being locked in the strong room – on many occasions. Sometimes being left without food for days & being so drugged that i became too weak to stand up.

    i know the reality of what has & does happen in such places. Systemic abuse cases are always coming to light in the UK in institutions – & such places have been & i expect still are often rife breeding grounds & very attractive for psychopaths & sexual deviants.

    i say mildly violent because that is the truth, i broke something & i pushed someone away from me – that is the sum total of it all. The violence given to me wasn’t warranted/justified.

  • all too easy

    “PEOPLE NEED GENUINE UNDERSTANDING, CARE, HELP AND SUPPORT”
    a recovering victim of psychiatric violence and abuse

     

    “We live in such a wonderful, advanced, humane & civilised society – where people are fucked up, abused & fed a load of poison because they have brain diseases that no one can find. What a bunch of retarded fucking idiots.”

    “We need to kill more immigrants as well, & perpetuate some more wars to keep the economy going – You know it all makes sense.” 

    “do you know who all too easy is by any chance?

    Me? No idea – Another brain dead/brain washed fucking retard by the sounds of it. Do you know? 

    You are either a troll, or extremely naive if you believe the people you refer to give a fuck about you or any other mentally ill person.”

    “If you wanna argue I’ll throw you a few scraps, prepare to look like a fool”

    “Phil is being as objective as possible with these articles, it’s not his fault all the evidence points to the so called ‘wonderful people’ being crooks in white coats.” 

    “How very clever of you, what a good boy you are – have a star.”

    “hahaha I thought you were his alternate account trolls have those. I figured I’d throw him a few scraps and engage in a minor scuffle with the beast, but from the attitude of your comment I’m beginning to wonder if this one is too toxic to touch. I don’t want to let a single comment of his exist untarnished by our reminders that he is indeed a troll, every one must be debunked on the spot so that any naive new folks will know which path is right”
    she is quite the spokeswoman for mental health
    I’m reminded how grateful i am that we have secure psych hospitals and psychotropic meds

  • all too easy

    “Some inflexible psychiatrists are blind biological reductionists who assume that genes are destiny and that there is a pill for every problem.” Phil Hickey

    Name one.

  • anon11

    You’re quoting the wrong person. It wasn’t Phil Hickey who said that. It was Allen Frances. You should ask him.

    Moron.

  • Angela Ursery

    Thank you so much for this post. I find it fascinating how Frances sees himself as now being the moderate center of mental health issues (not at all connected, surely, to being kicked to the curb by his DSM colleagues), while still singing most of the old “trust us, we’re psychiatrists” song he helped write long ago. (With friends like these…) As well, Frances appears to think we’ve all forgotten how long he lived off the pharma tit, how well he draped legitimacy over greed, and how little he thought of “patients” (until recently) as hopeless bags o’ skin needing to rely forever on pills and men like him.

  • all too easy

    “Well, try this: “…psychiatrists regularly
    lie, and thus we need to be cautious before we take Bernard’s account at face
    value.” That’s a blatant, bad faith insinuation that I am a liar. Now
    you want to walk it back? You have forfeited your credibility, cannotsay. Good
    riddance.” Carroll–this guy is one smart cookie.

    She’s a dear. She says you lie and then says she never said that, expecting to be taken seriously. She has never had any credibility, not with me.

    “Is it a good idea to rely on this potted summary by a New York Post journalist to deny the existence of ADHD? Let’s get a few things clear. First, ADHD did not come about by fiat of the American Psychiatric Association. The condition was recognized many years ago from the bottom up in the trenches of child psychiatry. The diagnostic label ADHD was applied in DSM-III to the much older term hyperkinetic syndrome of childhood, which persists in ICD-10.” Carroll

    They know. They like to anger good folks who are way too patient with them.

    “Second, the straw man argument about cursory and thoughtless prescribing of medication does not describe best practice recommendations. For those, see this nuanced review from UK:” Carroll

    They all throw that in constantly as well just to argue and to aggravate. They love to argue. LOVE IT!

    “Cannotsay, I am not going to keep this exchange going forever, but I am not going to let you get away with bs and hand waving, either.

    To your first response, I already gave you examples of quantifiable metrics for clinical improvement. You might say that clinimetric measures like quality of life and social functioning deserve precedence over HRSD scores, and I might agree with that, but HRSD is not absolute nonsense. I should know. Max Hamilton was a good friend of mine, and a straight shooter. Plus, there are plenty of hard end points, as I described earlier. And please do not try to claim that clinical hypotheses are nonfalsifiable or that clinical science is not a science. As for measuring brain activity, don’t get carried away with fMRI pictures that can be measured accurately but that have a tenuous relationship to the clinical phenomena.

    On your earlier point 1, now you are back pedaling. I think you really don’t grasp the uncertainty that clinicians in general medicine and psychiatry deal with every day.

    On your earlier point 2, please don’t play rhetorical games and please don’t be disingenuous. You must know perfectly well that my examples were not single case anecdotes. I expected better from you as a serious interlocutor. And please quit the hand waving about no benefit from psychiatric interventions. Remember lithium? Remember benzodiazepines for catatonia? Remember the original antidepressant drugs? They had a NNT of 3 compared to 10 for the commercially favored newer agents.

    On your earlier point 3, you have utterly misrepresented what I said. That is not what I expect of a logical interlocutor. It is obvious from what you say that you have had some tragic experiences. I wish you well in your efforts to recover from those, but I don’t think “the destruction of psychiatry” is part of an effective plan.

    I won’t come back to this thread. I hope for you that your
    smarts can finally get you to a good place. Ave
    atque vale.” Carroll

    It is a labor of love, at great cost and personal sacrifice, to try to educate the close-minded and brainwashed. We do the best we can. That is all we can do.

  • Cledwyn “Corpsey”

    Assuming that line attributed to you by Phil is true, specifically where he claimed you maintain that on this side of the divide nobody seems to have a clue as to what produces, what in our age, is considered as severe mental illness, I could see how you’ve come to that conclusion, given the ignorance and seeming indifference to human suffering of many in anti-psychiatric circles, but as regards my own views on human suffering, I’m not inclined to defer to your judgement in this regards, given that this is a subject that incessantly has laid claim to my thoughts and energy like no other, in the elucidation of which I have been able to bring my studies in the humanities to bear.

    No subject has exercised my thoughts quite like human suffering. If I am clueless, it is certainly not for want of trying, though, respectfully, I see nothing in your writings that would confer upon you the authority to pass judgement on a subject you seem to have little to say about, in contradistinction to my own voluminous writings on depression, paranoia/fear, anxiety and delusions, and the innumerable distal and proximal, internal and external, causes thereof.

    What I have tried to do in this regards is draw upon the works of genius, yet genius, it would seem, is like a fruit tree, that extends so far above the soil from which it has sprung, few can access its yield; genius attains to heights so far above the age from whose soil it springs, its fruits, it would seem, can only by savored by those who, borne on imagination’s wings, can ascend to the celestial heights from which the genius surveys life on this pitiful globe.

    Yet the masses, ever apt to disdain as sour the grapes whose juices they cannot savor, instead of giving genius its due, are in confederacy against him in every age, as they are any man of superior faculties and morals, all of which, incidentally, partly explains the dominion of error, mediocrity and stupidity over human society.

    Given all this, I’d probably have to agree with anyone who said that most on this side of the divide are clueless, given that most critics of psychiatry are a part of this ongoing conspiracy against those who have illumined humanity, and the nature and condition thereof, under the light of their genius, genius being to the landscape of human experience and nature what the sun is like to a terrain otherwise enveloped in darkness, the lodestar guiding men over the turbulent waters of Error to the way of Truth.

    As regards delusions, it would be impossible to give a full exposition of my thought here, but what I will say is that I reject the conceited notion held by most that delusional thinking is the exclusive privilege of denominated mental patients, and the invidious comparison between “us and them” it implies. Quite clearly that isn’t the case, but irrationality is blind. Men are as good as pointing out the flaws in others as they are bad in pointing them out to themselves.

    The human mind did not evolve to assist man in his search for truth, but for survival. Men are necessarily mad. We all of us withdraw regularly from reality into the protective walls of fantasy.

    Yet the delusions of mental patients seem to come in for a disproportionately large amount of scrutiny, even though, for the most part, they occasion no suffering, and actually make life more bearable for those who “suffer” from them.

    Why is this? What about the delusions of those whose scope of influence and power extends over such a large area that the consequences thereof must be borne on the shoulders of millions, such as those people who stand in judgement on the thoughts of others as if they were Reason’s special elect. to wit, your psychiatrists?

    As always, the imbalance of power between the oppressed and the oppressor leads to a corresponding imbalance in the extent to which the behaviors of each is scrutinized.

    As regards this obsession with mental patients who entertain thoughts about themselves either deemed or actually delusional, apart from this imbalance of power which keeps those on the wrong side thereof under the spotlight (which can be seen also in the history of slavery and the witch-hunts, as Szasz pointed out), one reason is because people can’t stand the thought of people, especially those they assign to some degrading and demeaning role in the social order, based on their appearance, their race, their character, their opinions, or whatever; people can’t stand the thought of such persons entertaining ideas above the station to which they have been assigned by others, or to simply put a value on themselves others do not see in them.

    They must be made to suffer. Great effort is expended to destroy the self-image they take take pleasure in through the insinuation thereinto of the boundless loathing men feel for any whose judgement of themselves conflicts with that of their own; great effort is expended in trying to implant our own ideas in such people, under the pretense of shining the lumens naturale into the darkness in which their diseased minds are supposedly enveloped.

    By dint of the malice people generally feel towards the man whose spirit endeavors to break free from its social bonds, the man who seeks to wrest back control over himself and the story he tells in relation thereto; by dint of this malice, such people who entertain ideas about themselves that may or may or not outstrip their actual qualities and achievements, forfeit any claims to our sympathy, and the desire to humiliate that person takes a hold.

    So the question is not just what causes delusions, but why the obsessive focus on those of certain mental patients?

    Time does not permit me to go further, so I will address other points you have made in this comment, and the comments attached thereunder, over the coming days.

  • Phil_Hickey

    Angela,

    Thanks for coming in. Given all that’s been exposed, I can’t understand why Dr. Frances doesn’t just retire and get out of the limelight. But I suppose legacy is important!

    Best wishes.

  • The Right Hon. Cledwyn B’stard

    As for what causes paranoia, the universality thereof must be stressed. Paranoia is not just something that happens to mental patients, something rarely acknowledged because of the imbalance of power and the focal imbalance that corresponds thereto, of which I spoke in the preceding comment.

    Fear and suspicion of others, whether or not there is an exact one-to-one correspondence between it and the reality, can be adaptive in alerting one to the very real dangers men have in their environment, which experience alerts man to the existence thereof, especially for those whose psycho-social development has taken place within a hostile environment, in which the individual is exposed to the kind of pressures many are insulated from.

    Negative experiences are the incubator of negative thoughts, be they about ourselves or something lying outside us. True, they are perhaps only a necessary and not sufficient condition of negative thoughts. Dispositional factors might play a role. It is not just our environment that differentiates our lot. Ascending through the gradation of human consciousness, from the stupidest boxer, up through the many intermediate degrees to the top where genius sits enthroned, the capacity for suffering increases, the arrows of outrageous fortune penetrate deeper.

    Learning also plays a huge role. Some people, having sounded creation’s sinister depths, and of the supposed finest flowering thereof, man, live in understandable fear. They have crossed a kind of epistemological rubicon, like has happened with so many artists and philosophers, such as Schopenhauer, Cioran, Bergman (it was not for nothing that Bergman said he felt as if he was in his natural habitat in a psychiatric ward amongst mental patients) and Samuel Beckett, who acquired knowledge about this world that left behind an indelible mark on their psyches, knowledge of the immense wretchedness and injustice of human existence, of the profound negativity of things.

    As a general rule, the finest minds are always steeped in pessimism and cynicism. Rare indeed is it to find, for example, a great novelist, who isn’t at heart a pessimist, who doesn’t portray the world as alternately terrifying, absurd, rotten, unjust, cruel, and depressing.

    It is no wonder that most men, deemed sane by psychiatrists, put such a low value on knowledge, treating it as trash and their minds as epistemological waste-baskets in which they deposit throwaway facts (like these people on general knowledge quiz shows), tranquilizing themselves with trivia, as Ernest Beckett said, prizing knowledge only insofar as it is in their advantage to do so.

    So learning and the degree to which consciousness attains in the individual can be important in understanding things such as extreme depression and fear.

    A man is much like a tree, in that the composition of the soil in which it takes root, and the direction of the wind, affect which way it grows. To understand a man, especial attention must be paid to the soil in which he grows and to the winds of Fortune and Circumstance, which blow against some men more than others. Yet just as with a tree, the genus to which it belongs cannot be ignored in accounting for its differences to other trees, likewise with man his disposition must not be disregarded.

    As concerns the anger of some of the people you have dealt with, it is of course important that people try to contain their anger within the limits of civility, where necessary, but contextualizing this anger is important.

    Many ethical objections thereto are inadmissible when those abandoned by society to the predations of others, as is the case with many mental patients and those from whom they are descended, are engaged in the struggle for survival and dignity. There are uses to which anger can legitimately put, such as in setting beside the motive a person may have for victimizing someone a strong counter-motive to desist therefrom. Sometimes anger and aggression are enough to scare a predator off, where one lacks the requisite protective coloration to escape its attention in the first place, for which reason anger is common amongst second-class citizens.

    Some people no doubt see some of your comments as threatening, especially those pertaining to the subject of forced psychiatry. Perhaps these people should do more to resist these emotional reflexes, but this anger is nevertheless often understandable.

    You asked what should we do about supposedly severely mentally ill people whose decisional capacity you seem to impugn, apart from leaving them to drift into homelessness and suicide.

    That a person would choose to remain on the streets, braving the inclemencies of the weather, the provocations of others, and struggling to procure the means for the preservation of such an existence, forgoing so-called hospitalization, experience of which no doubt having furnished them insight into the degradation and iniquity generally associated therewith; this seems to me a pretty poor compliment to the proponents and practitioners of involuntary psychiatry, so it is little wonder that its propagandists have felt the need to avail themselves of the expedient the diagnosis of mental illness affords in dismissing the testimony such unwillingness to comply provides against the whole institution and the conditions that obtain within the confines of the psychiatric “hospital”.

    You seem to think there is something inherently wrong with leaving someone free to commit suicide, as if a worse fate awaits the potential felo-de-se if he succeeds. No man has the right to stand sentinel-like over the exit-gate to another’s suffering, who refuses to accept life on the terms it sets, which for many means being preyed upon by others, being imprisoned in an undesirable or diseased body, or assigned to some role within the social order that only degrades and demeans, and which for all of us means participating in a life that is little more than a dance of death in which pain takes the lead sometimes, and boredom most of the rest.

    As concerns suicide, time does not permit me to give a comprehensive exposition of my thought as regards this act, nor to counter the many objections appertaining thereto, so I will confine myself to only a few more comments.

    So painful is life that, without this blind attachment to existence, and its correlative, a terror of death (both so strong that no matter how much the intellect repudiates life, the heart nevertheless longs for it), both existing a priori in human consciousness, which keep us tethered to a life that oppresses us from its commencement to its conclusion; absent this, life would be little more than a suicidal orgy, and the local authorities and emergency services would be working 24/7 to stem the flow of the rivers of blood resulting therefrom. To wish to escape a life such as constitutes that of most men is entirely sane, and considerably more so when such a desire holds in its iron grip the minds of men born in this world, but not of it, who only when beneath the ground can be said to be in their natural habitat, unwilling as they are to render themselves serviceable to a wicked world and to adapt thereto, and unable as they are to find above ground asylum from it.

    If a man wishes to expedite his journey to the grave to which we are all heading, then good for him. Life isn’t a Frank Capra movie. You may disagree with my view of life, as no doubt almost everyone does (I must be on to something then), and of course I could be wrong, for which reason I am apt to take precautions against my own fallibility, hence why as an anti-natalist I don’t seek to impose my views on others through laws prohibiting procreation.

    People who entertain a rosier view of human existence must likewise take precautions against their own fallibility and leave whether or not life is worth living to the discretion of he who lives it, instead of acting from a position of assumed infallibility, which is the essence of fanaticism.

  • cledwyn bulbs

    Concluding my discussion of psychiatric force, I reject the notion that psychiatry should forcibly drug violent criminals, and a fortiori the people undergoing the kind of experiences of which you speak.

    The history of forced psychiatry, indeed, of the world, shows that it is better men live and learn by the consequences of their own mistakes than by those of others, assuming they are truly in error, so that, even if the efficacy of some “treatments” coercively administered to some psychiatric patients were conceded, it is nevertheless better men are left to choose for themselves.

    As for the legal standard of dangerousness to others, this is perhaps honored more in the breach than in the observance. Nevertheless there can be little doubt that “forced treatment” is aimed at some people prone to violence, such as the so-called criminally insane.

    Here, for me, is where the pretense that the primum mobile of the whole sordid endeavor that is involuntary psychiatry, is compassion, really begins to crumbles, becoming frankly unsustainable, not that I believe it is the sovereign motive as regards the coercive interventions of mental health professionals in the lives of people who clearly don’t pose a threat to others.

    For me, in such cases, psychiatrists and psychiatric nurses dealing with such people, in deeming as medical treatment the work they do, are adorning themselves with borrowed plumage, and when you strip away all the finery, what you are left with are professionals whose real role is as servants of the public will and that of the state, functionally equivalent to that of jailers and torturers.

    Whilst I obviously support the right of society to defend itself, I only recognize the ethical legitimacy of the talionic principle, which I believe is in surreptitious operation here, insofar as the requital of evil with evil serves some higher end and not just simple vengeance, the desire for which I believe largely underpins the support for the institution of involuntary psychiatry, though most often what counts as evil seems to me nothing more than feelings, thoughts and behaviors society has no business concerning itself with.

    Examples of the legitimate application of the principle of lex talionis would be where the requital of evil with evil is ordained by necessity, such as in WW2 with the rampaging Nazi hordes, or where one counterattacks in order to secure one’s existence or dignity.

    The violation of that former stronghold of privacy, that erstwhile sanctum sanctorum, the human body, cannot be justified on such grounds, including in the case of violent criminals. Insofar as the objective is to control people, and not simply meting out vengeance and punishment, far more ethically sound means exist.

    I fear that history is repeating itself here. The technology brought to bear, the official identity of the oppressor and the oppressed and the official rationale defining their relations, and the era, all these may differ, but the contemporary persecution of the mental patient, and the historical persecution of the witch, the heretic, the enemies of the state and the unruly slave, all have a common substratum. Taken together they form a suite of variations on the same theme, man’s inhumanity to man. In the dance between oppressor and oppressed, the music set thereto and the official identity of the dancers may change, but the patterns it traces remain the same.

    “…history always pretends to relate something different; for it is like the kaleidoscope, that shows us a new configuration at every turn, whereas really we always have the same thing before our eyes.”

    Arthur Schopenhauer

    Regarding the comment about alternatives, from a negative utilitarian perspective it is hard to see how any alternative could be worse than what psychiatry has offered heretofore. Insofar as the objective of the profession is to honor the Hippocratic injunction, first do no harm, the whole endeavor has been a disaster.

  • cledwyn goodpuddings

    I think lust is the root of all evil, for it’s through the appeasement thereof that a person conceives a child.

    The Adam and Eve story (which may not be true sensu proprio but is sensu allegorico), expresses this beautifully, in which the first man and woman (in what is the original bit of rumpy pumpy) make bacon, whereupon Eve gives birth to Cain and Abel, to whom the fallen nature of the parents is passed, with all the suffering and evil that that entails.

    And what happened to Cain and Abel? The former murdered the latter, which story symbolizes in the person of Cain the wickedness of the species, and in the person of Abel the suffering thereof. In bringing a child into this world one merely adds to the list of the world’s victims and victimizers; this seems to be the story’s purport.

    Yet look also at the havoc lust introduces into the lives of individuals! It is the acid that corrodes human relations; to sow the seeds of discord between friend and friend, man and woman, and between family members, Cupid sends Eris into the world, under the guise of romantic love.

    Men and women, brought together in lust, as they are as a general rule, part in mutual hatred and acrimony. It turns saints into sinners. Reason is powerless to insure a man’s life against this most terrible force of nature.

    In the form of romantic love, lust visits such suffering upon he held under its sway that men naturally seek deliverance through death, expediting their journey thereto by their own hands.

    The lovelorn mind passes over a person’s inner essence, instead laying stress on the superficialities that surround it, on a person’s looks, the power they wield, a person’s wealth, reputation, and status. True, people claim otherwise, but one can see from the fact that the Elephant Man never inspired passionate love what really matters in our choice of partners.

    Yet the validity of its claim to being the root of all evil rests on the fact that lust forms the basis whereupon the odious business of begetting brats is transacted, and no, I’m not just talking about the fact that your average child is a nano-Nazi, within the paltry proportions of whose puny frame abides an appetite only human flesh can satisfy and that can only be checked by superior force (absent which universal carnage would prevail).

    (The behavior of children, their mercilessness, the malicious amusement they derive from the sight of anyone who seems fundamentally different to them, their stupendous amour-propre and self-importance which experience has not yet cut down to size, their symbolic cannibalism, and reliance on scapegoating as a mechanism of social cohesion, all of it affords insight into the human will untrammeled by reason and ethical maxims).

    The only way to expiate the sin of being born, as Calderon described it, and adding to the sum-total of the world’s evil and suffering, is to abstain from adding to the world’s ever-burgeoning ranks of malicious morons and their victims, but even otherwise good people, desperate to go on humping like sexually incontinent rabbits, delude themselves that the solution to the world’s evil and suffering lies in the eradication of one of the infinite range of forms they assume, that the solution lies in reforming this world and some aspect thereof, which history (sacrificial altar, genocidal orgy, graveyard of failed utopian schemes, succession of variations on the same depressing theme) shows to be as impossible a task as that which befell the lot of the Danaides, and Sisyphus.

    Following from this, it can be said that man’s optimism, his Pelagianism, his Enlightenment faith in progress and the infinite perfectibility of the nature and condition of man, can largely be traced to his inveterate humping!

  • all too easy

    Where does lust claim to be the root of all evil, CLODHOPPER: Chapter 4, vs. 9?

  • Rob Bishop

    Interesting perspective, somewhat in agreement with Buddhist
    teachings that all types of desire cause human suffering.

  • all too easy

    ICSPP was founded by P. Breggin who was its Director

    The attorney for the defense, “asked him, as director of the Center for
    the Study of Psychiatry, how many employees he had —
    which Breggin was bound to admit was just a single part-
    timer.”

    “You are deliberately obscuring the reasons for my
    resignation from the Board of Directors of ICSPP. The issue
    isn’t simply one of disagreement. The issue is one of honesty,
    integrity, and courage. You can’t have integrity and be
    consistently, self-servingly inconsistent, as you are. I voiced
    my concern regarding contradictions ever since the first time I
    spoke out at the annual meeting you cite. The inconsistency
    then concerned your testifying as an expert witness against
    anti-depressant pharmaceutical companies. Your testifying,
    under oath (!) that Prozac caused a man to commit suicide and
    homicide contradicts your position that neurotransmitters don’t
    cause people to commit suicide and homicide. You said you’d
    considered that, but that this was your decision. I said it was
    your downfall. It exemplifies your opportunistic dishonesty:
    Defense of the “downtrodden mental patient” is so holy a cause
    that it justifies lying for it.”

    In a letter from Jeffrey A Schaler, former Board of Director member, to Pete Breggin.

    Oh yes. Let’s not forget to mention how in court, Good Old Pete, provided his expert opinions for 2 full days for exactly how much? In keeping with your denunciation of the greedy BP and their drug dealing cohorts in white smocks, it was free, no?

    “So, Peter, on the one hand you assert for years that Thomas
    Szasz was your teacher and that mental illness is a myth and,
    when it suits your purpose, you even hide behind his skirt, as
    you tried in court in the case against Lilly. You’ve held, in your
    various writings, that behavior is a choice. You have advocated
    a “problems-in-living” approach to explaining abnormal behavior.
    You base your method of psychotherapy on such explanations. And you
    further assert there’s no evidence to support the idea that the
    brain causes behavior.

    On the other hand, you either ignored or did not know of
    any environmental factors in Wesbecker’s life — nor did you
    apparently even consider them — , i.e. you eschewed your
    “problems-in-living” explanation, and asserted, for $45,000.00,
    that Prozac caused Wesbecker to commit homicide and suicide.
    You asserted a causal relationship between brain and behavior
    was fact — even while you criticized biologically-based

    psychiatrists for confusing theory with fact.”

    Jeffrey A Schaler, former Board of Director member, to Pete Breggin

    $45,000 for 2 days? FORTY FIVE THOUSAND for 2 days.

  • all too easy

    Some of the most compelling studies he reviews show that, prior to the advent of psychiatric meds in the 1950s, the course of most psychiatric disorders was much shorter and less debilitating, with more people returning to optimal functioning and complete recovery. But, as E. Fuller Torrey, a psychiatrist who has devoted his career to understanding the root causes of schizophrenia, points out in his critical review of Whitaker’s book, it has been known for centuries that about a third of people diagnosed with schizophrenia resume normal functioning without treatment. Moreover, the pre-medication “natural course” studies Whitaker cites included many people who were not in fact schizophrenic, but had less serious illnesses which are not necessarily chronic: hence the false appearance of better premedication outcomes. Hannah Wolfe

  • all too easy

    However, the reality is that many people may have access only to medication, and these data are not a reason to eschew the only viable option for relief. Moreover, there is a big difference between saying that the drug companies and psychiatrists, for reasons of financial gain, overprescribe, and sometimes mis-prescribe medications, and arguing that the medications themselves are the cause of mental illness

    Many of us can point to patients, friends, family members, or our own positive experience with psychiatric medications. Some of this may be a placebo effect; some may be the result of poorly understood, but nonetheless real, medical benefits. Moreover, for every overmedicated person, there is another unmedicated one who has been denied access to treatment, or who refuses treatment due to distrust (often warranted) of psychiatric medications. While psych meds are no “magic bullet,” they may indeed, in spite of their profitability, be reasonable “damage control.”

    Anatomy of an Epidemic can be thought-provoking reading for those with some knowledge of the history of mental illness and of the data on effectiveness of psychiatric medication. The book could be misleading or even dangerous if used on its own to make a personal determination about whether to take psych meds or not. And even more dangerous in the hands of the managed-care moguls who I can imagine cravenly using Whitaker’s arguments to withhold needed medication from even more people. Hannah Wolfe

  • all too easy

    Whitaker has nothing good to say about antipsychotic medications. He calls them “not just therapeutically neutral, but clearly harmful over the long term” and claims that the drugs themselves cause many of the symptoms of schizophrenia. Like Scientologists and other antipsychiatry groups, Whitaker exaggerates the adverse effects of antipsychotic drugs, saying, for example, that tardive dyskinesia occurs “in a high percentage of patients.” He also includes statements that are patently erroneous. For example, he claims that “even moderately high doses of haloperidol were linked to violent behavior,” when, in fact, studies have shown that haloperidol and other antipsychotics decrease violent behavior in individuals with schizophrenia. Many of Whitaker’s errors originate in his liberal footnoting of Dr. Peter Breggin, who has acknowledged having received support from Scientology, as a source.
    Dr. E. Fuller Torrey

  • all too easy

    Breggin has issues. To be using his “work” as a basis for substantiating claims in an argument over medications and mental health is grave error.

    It is no surprise that he condemns pro-psych as a money making enterprise while listing the alleged sums he’s won for anti-psychiatry plaintiffs. What a riot.