Allen Frances on the Benefits of “Antipsychotics”

On February 1, Allen Frances, MD, published an interesting article on the Huffington Post blog.  The article is called Do Antipsychotics Help or Harm Psychotic Symptoms?, and is a response to Robert Whitaker’s post of January 27:  “Me, Allen Frances, and Climbing Out of a Pigeonhole.  This post, in turn, was a response to Dr. Frances’s Psychiatric Medicines Are Not All Good or All Bad, which was published in the Huffington Post on January 15.  Readers may remember that I published a critique of this latter article on February 9.

A detailed analysis of the debate between Dr. Frances and Robert Whitaker is beyond the scope of this article.  My primary observation is that in his February 1 response, Dr. Frances does not address the points that Robert made on January 27.  Instead, he sets up caricatures of these points, and dispatches these caricatures with the skill and verve of a shadow-boxer who imagines he is engaged in genuine combat.

My present purpose is to take a closer look at Dr. Frances’s February 1 article, and to spell out some of its implications.  Here are some quotes, interspersed with my comments.

“Bob’s [Robert Whitaker’s] advocacy is ambitious, global, and future oriented- requiring a radical reconception of the US approach to people with psychosis. I am preoccupied more by the desperate, unmet needs of patients living dreadful lives in the current moment. In furthering his long range agenda, I believe Bob is misjudging what is best for severely ill people in the present. His recommended ideal treatment can only have a chance of success in an ideal treatment system. People who might do well with less medicine in his ideal world often get in terrible trouble if they try to stop medicine in our shamefully neglectful real world.”

Note the truly exquisite spin. Robert is “ambitious, global, and future-oriented”, while Dr. Frances is the humble pragmatist rising tirelessly to the daunting challenge of meeting the “unmet needs” of desperate “patients”.

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

“Bob acts as if there is an inherent tension between service users and psychiatric providers. I see the current animosity as an unfortunate and idiosyncratic phenomenon, peculiar to the US, and partly contributed to by Bob’s own passionate and somewhat misleading rhetoric.”

This is a huge issue.  The heart of the matter is that there is “tension” between psychiatrists, on the one hand, and some of their former clients, on the other.  Dr. Frances’s contention is that this conflict is not inherent, but, rather, is “an unfortunate and idiosyncratic phenomenon”, for which Robert Whitaker is, at least partly, to blame.

The reality, of course, is quite different. There is indeed “tension” between psychiatrists and many of their former clients.  This “tension”, which I would call out-and-out conflict, also embraces a very large, and growing, number of other mental health professions and members of the general public.  This conflict has arisen because:

  1. Psychiatry’s definition of a mental disorder/mental illness embraces every significant problem of thinking, feeling, and/or behaving, and psychiatry has been using this definition to medicalize problems that are not medical in nature for more than fifty years.
  1. Psychiatry routinely presents these labels as the causes of the specific problems, when in fact they are merely labels with no explanatory significance.
  1. Psychiatry has routinely deceived, and continues to deceive, their clients, the public, the media, and government agencies, that these vaguely defined problems are in fact illnesses with known neural pathology.
  1. Psychiatry has blatantly promoted drugs as corrective measures for these illnesses, when in fact it is well-known in pharmacological circles that no psychiatric drug corrects any neural pathology. Indeed, the opposite is the case.  All psychiatric drugs exert their effect by distorting or suppressing normal functioning.
  1. Psychiatry has conspired with the pharmaceutical industry in the creation of a large body of questionable, and in some cases fraudulent, research, all designed to “prove” the efficacy and safety of pharma products.
  1. A great many psychiatrists have shamelessly accepted pharma money for very questionable activities. These activities include the widespread presentation of infomercials in the guise of CEUs; the ghost-writing of books and papers which were actually written by pharma employees; the promotion of new drugs and “diagnoses” by paid psychiatric “thought leaders”; the publication of fraudulent advertising in psychiatric peer-reviewed journals; the acceptance of pharmaceutical money by the APA; targeting of captive and otherwise vulnerable audiences in nursing homes, group homes, and foster-care systems for prescription of psychiatric drugs; etc., etc…
  1. Psychiatry’s spurious diagnoses are inherently disempowering. To tell a person, who in fact has no biological pathology, that he has an incurable illness for which he must take psychiatric drugs for life is an intrinsically disempowering act which falsely robs people of hope, and encourages them to settle for a life of drug-induced dependency and mediocrity.
  1. Psychiatry’s “treatments”, whatever tranquilizing effects or transient feelings of well-being they may induce, are almost always destructive and damaging in the long-term, and are frequently administered involuntarily.
  1. Psychiatry’s spurious and self-serving medicalization of every significant problem of thinking, feeling, and/or behaving, effectively undermines human resilience, and fosters a culture of powerlessness, uncertainty, and dependency. Relabeling as illnesses, problems which previous generations accepted as matters to be addressed and worked on, and harnessing billions of pharma dollars to promote this false message is morally repugnant.
  1. Psychiatry neither recognizes nor accepts any limits on its expansionist agenda. In recent years, they have even stooped to giving neuroleptic drugs to young children for temper tantrums, under the pretense that these children have an illness called disruptive mood dysregulation disorder.

The anti-psychiatry movement has been in existence, and vocal, for decades.  But it had been successfully marginalized and ridiculed by pharma-psychiatry until the explosion of Internet access provided a voice that even pharma-psychiatry couldn’t silence.  Robert Whitaker has been a powerful, reasoned, and if I may say, restrained voice in these endeavors, and Mad in America is at this time one of the primary outlets for anti-psychiatry views and information.  But blaming the world-wide anti-psychiatry sentiment on Robert is a bit like blaming news reporters for wars, plagues, famines, and natural disasters.  It’s not only false, but betrays a fundamental disconnect with reality.  The anti-psychiatry movement exists because psychiatry is something fundamentally flawed and rotten.  And it is fundamentally flawed and rotten because its leaders have made it so.

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

“Bob’s misreading fails to take into account the fact that psychotic presentations vary greatly in cause, severity, chronicity, prognosis, and appropriate treatment. Many psychotic episodes are transient. Some are stress related- eg a soldier in combat, a college kid or traveller who becomes delusional when away from home. Some are a transient part of mood disorder and remain quiescent if the mood disorder is successfully treated. Some are related to substance intoxication or withdrawal. Some are caused by head trauma or medical illness. And some normal people have hallucinatory experiences that cause no impairment and have no clinical significance. Transient psychotic symptoms in the above situations may require a short course of antipsychotics, but these should be gradually tapered after the episode has resolved. Generally this can be done without much risk of return of psychosis- assuming the stressor, substance problem, mood disorder, or medical problem has resolved. Bob and I would agree on short term or no antipsychotic treatment for such transient psychoses.”

Once again, note the spin.  Robert Whitaker’s article was about people who had been labeled schizophrenic, but Dr. Frances is “refuting” Robert’s contentions by focusing on “psychotic episodes” that clearly do not meet the APA’s criteria for schizophrenia.  This discrepancy persists throughout Dr. Frances’s post.  In Robert’s article the word “schizophrenia” occurs 12 times, but in Dr. Frances’s response, the word is nowhere to be found.  Dr. Frances is obviously aware of these distinctions, and it’s extremely difficult to put a benign interpretation on this kind of obfuscation.

The central point of Robert’s paper is, I believe, contained in the following passage:

“Every important detail from the conventional narrative, which tells of a great medical advance, can basically be filed under the heading of ‘not really true.’ The arrival of the antipsychotics into asylum medicine did not lead to deinstitutionalization; a change in social policy did. The dopamine theory of schizophrenia arose from an understanding of how drugs acted on the brain, and not from an understanding of what was going on in the brains of people so diagnosed, and when researchers looked to see whether people diagnosed with schizophrenia had overactive dopamine systems as a matter of course, they didn’t find that to be so. The drugs were not like insulin for diabetes. Nor was there evidence that the arrival of the antipsychotics kicked off a great advance in outcomes for schizophrenia patients. Indeed, in a 1994 paper, Harvard researchers reported that long-term outcomes were now no better than they had been in the first third of the 20th century, when water therapies were a mainstay treatment.

In contrast, a scientific understanding of antipsychotics supported the patients’ counter-narrative. Thorazine, Haldol, and other first-generation antipsychotics powerfully blocked dopamine pathways in the brain, which reduced one’s capacity to respond emotionally to the world and to move about it. Hence the zombie feeling. Antipsychotics did cause brain damage, as could be seen in the twitchings of people who developed tardive dyskinesia after years on these drugs. Moreover, research had shown that in compensatory response to the drug’s blockade of dopamine receptors, the brain increased the density of its dopamine receptors, and, there was reason to worry that this increased the person’s biological vulnerability to psychosis. Given these facts, there was plenty of reason for people diagnosed with schizophrenia and other psychotic disorders to want to stop taking them.

In terms of the ‘evidence base’ cited by psychiatry for its use of the drugs, which is held up by psychiatry as its trump card in this battle of narratives, it is easy to see that the evidence for long-term use is flawed. Researchers had conducted any number of studies in which a group of stabilized patients were either maintained on an antipsychotic or abruptly withdrawn from the drug, and with great regularity, the drug-withdrawal group relapsed at a higher rate. This was seen as proving that continual drug use lowered the risk of relapse, and thus provided evidence for maintaining patients indefinitely on the medication. But, of course, another conclusion to be drawn is that the high relapse rate is a drug-withdrawal effect, and not evidence of the long-term risk of relapse in unmedicated patients. The relapse studies also didn’t provide any evidence about how well schizophrenia patients functioned on the drugs, or their quality of life, particularly over the long term.”

Note that the word “schizophrenia” occurs five times in this passage alone, and it is clear that Robert is referring to individuals who have been labeled schizophrenic and who have been “treated” from that perspective.  Dr. Frances’s discussions concerning transient “psychotic episodes” are not pertinent, particularly in the light of psychiatry’s long-held insistence that “schizophrenia” is a life-long degenerative illness.

So it’s not a case of Robert Whitaker misreading the matter, but rather one of Dr. Frances miswriting the matter.

Nor is the miswriting inconsequential.  By juxtaposing the terms “schizophrenia” and “transient psychotic symptoms”, Dr. Frances has managed to convey the impression that he personally favors a more selective and tapered approach to neuroleptic drugs than that which has been typically adopted by psychiatrists since the drugs first came on the market.  This approach has been:  keep taking the “medications” even after a first episode has been successfully “treated”.

Dr. Frances is also conveying the impression that he has favored a less-is-more approached since the ’60s:

“I began my career in psychiatry in the mid 1960s, just when antipsychotics were first being used widely. The new meds dramatically improved psychotic symptoms, but equally dramatically produced dreadful side effects, especially in the ridiculously high doses then being tried.”

and

“Troubled by this, I was one of the principal investigators on a multisite NIMH funded study testing the feasibility of two new approaches to reducing medication burden. The first was very low dose treatment; the second was expectant treatment, with meds used intermittently only when patients needed them. Patients were randomly assigned to 3 conditions: 1) standard dose injectible med; 2) one-fifth standard dose injectible med; 3) placebo injection with oral meds added as needed. All three groups also received intense individual and family therapy and social support, often done in the home. Many patients in the low dose and expectant groups did well, but the catastrophes were sometimes catastrophic and irreversible. I became convinced that the risks of going off meds for people with chronic psychosis usually overwhelm the benefits. It is the patients’ decision to make, but my advice has been not to rock the boat when chronic psychotic symptoms are responding to meds. Stay on the lowest possible dose, but stay on it over time. When psychosis has been chronic, the risks of discontinuing medication usually far outweigh the benefits.”

As I mentioned in my earlier article, I have been unable to find this particular study, and Dr. Frances provides no reference, so I have no way of ascertaining the methodology or the formal outcome/conclusions.  It does seem odd that Dr. Frances would refer to a piece of research in two successive articles without providing a citation to enable his readers to access the study.

Dr. Frances’s subjective assessment that the “catastrophes were sometimes catastrophic and irreversible” and his equally subjective conviction that “the risks of discontinuing medication usually far outweigh the benefits” are interesting, but obviously are subject to the kind of selection bias that formal studies are designed to overcome.  Dr. Frances saw individuals come off the “meds”, and subsequently crash and burn, but by the same token, those individuals who came off the “meds” and did well, wouldn’t necessarily have come to his attention.  Indeed, it is entirely credible that many of these latter individuals would have actively avoided the ministrations of psychiatry.

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

“Antipsychotics have many grave disadvantages that make them a last resort. They suppress symptoms, rather than curing them. They can cause unpleasant side effects and dangerous medical complications. They contribute to shortened life expectancy. And they are subject to wide overuse even when there is no indication. We should be extremely cautious and selective in their use quite independent of Bob’s tenuous claim that they worsen psychosis.”

This paragraph is interesting, particularly when compared with The Expert Consensus Guidelines for the Treatment of Schizophrenia published by Dr. Frances and his two colleagues, John Docherty, MD, and David Kahn, MD in 1996 (Journal of Clinical Psychiatry, Volume 57, Supplement 12B).  The final chapter in this supplement (p 51-58) is “A Guide for Patients and Families”.  Here are some quotes:

“Schizophrenia is a disorder of the brain like epilepsy or multiple sclerosis.  This brain disorder interferes with the ability to think clearly, know what is real, manage emotions, make decisions, and relate to others” (p 51)

Ongoing antipsychotic medication is necessary in both the acute and preventive phases. During the acute phase, medications help relieve the positive symptoms that are often out of control.  After the acute phase ends, ongoing antipsychotic medication greatly reduces the chances that acute symptoms will recur (a relapse).” (p 52) [Boldface in original text]

“The drugs used to treat schizophrenia are called antipsychotics.  They help relieve the delusions, hallucinations, and thinking problems associated with the disease.  These drugs appear to work by correcting an imbalance in the chemicals that help brain cells communicate with each other.” (p 53)

There is no evidence that the individuals whom psychiatry labels as schizophrenic have an imbalance in their brain chemicals.  Nor is there any evidence that neuroleptic drugs correct any neurological problem.  In fact, they are neurotoxic.

“The newer drugs are called atypical antipsychotics because they are less likely to cause some of the annoying and distressing side effects associated with the conventional antipsychotics.” (p 53)

So, the side effects which today Dr. Frances calls “dreadful”, and which he concedes cause “dangerous medical complications” and “shortened life expectancy”, he characterized in 1996 as “annoying and distressing”.  And this is not because any new information has been uncovered.  The devastating adverse effects of these products had been known for at least 30 years when Drs. Frances, Docherty, and Kahn (incorporated ironically as Expert Knowledge Systems, LLC) produced the document.  And given that the chapter in question is “A Guide for Patients and Families”, it is difficult to interpret this understatement as anything other than a deliberate attempt to deceive the target audience, and to counter any resistance individuals might have to ingesting these products.

“Usually patients respond well to treatment of a first episode of schizophrenia, but if there are repeated episodes or schizophrenia, symptoms sometimes persist despite treatment with the standard antipsychotic medications.  Fortunately, the newer drugs can often help patients whose symptoms no longer respond to the standard antipsychotic medications.  For such patients, the experts recommended that risperidone be tried first.” (p 53)

Incidentally, the Treatment Guidelines were funded by a grant from Janssen Pharmaceutica, the manufacturer of risperidone.  The promotion of risperidone, which is clearly evident throughout the guidelines, is not a coincidence.  It has been reported (here) that on July 3, 1996, Drs. Frances, Docherty, and Kahn (as Expert Knowledge Systems) wrote to Janssen:

“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.” (p 16)

This matter is in the public record (Texas v. Janssen LP, D-1GV-04-001288, District Court, Travis County, Texas), and has been reported by several writers, including Paula Caplan, PhD, but has never, to the best of my knowledge been addressed by Dr. Frances or either of his colleagues, although the venality of the statement is extreme even by psychiatric standards.  Drs. Frances, Docherty, and Kahn were reportedly paid $515,000 by Johnson and Johnson (owners of Janssen) for their work on the guidelines.

Back to the Treatment Guidelines document:

“The good news is that schizophrenia is very treatable.  A cure for schizophrenia, like diabetes, has not yet been found, but the symptoms can be controlled with medication in most people.  Prospects for the future are constantly brighter through the pioneering explorations in brain research and the development of many new drugs.  To achieve good results, however, you must stick to your treatment and avoid substance abuse.  Be sure to take your medicine as directed.  Even if you have felt better for a long time, you can still have a relapse if you stop taking your medication.” (p 54) [Boldface in original text]

“Because people with schizophrenia have to take their medications for a very long time, often for their whole life, it is very important to recognize and try to treat any side effects they may have from these medications.” (p 54)

“For patients who don’t take their medication regularly, more active interventions are likely to be needed to be sure the patient takes medications.  There are community treatment programs in which staff frequently go see patients and may give them their medications.  For such patients, the experts also recommended day hospitals where patients go 3-5 days a week and participate in several hours of programming that help insure that medication is taken.” (p 56) [Italics in original text]

“The most important factor in keeping patients with schizophrenia out of the hospital is having them take their medications regularly.  The best compliance with treatment is obtained when the family works with the patient to help him or her remember the medicine.  Sometimes long-acting injectable forms of medication are used when patients find it hard to take a pill every day.” (p 57)

The above quotes call into question Dr. Frances’s present assertion that coming off the “meds” is “the patient’s decision to make”.  This is even clearer in the guidelines proper where under the heading “Intervention During Continuation and Maintenance Treatment”, it states unambiguously:

Medication responsive patient – frequently not compliant   ■ Assertive community treatment (ACT);  Day hospital with medication management. (p 11)

There are a great many other passages in the schizophrenia treatment guidelines that indicate that Drs. Frances, Docherty, and Kahn promoted the use of neuroleptic drugs on a more or less indefinite basis.  The Schizophrenia Treatment Algorithm on pages 13 and 14, for instance, sets out in schematic form the treatments and adjustments that should be made in a variety of emerging situations.  In none of these situations is it suggested that the “medications” be stopped or that such a move even be considered.

But, in fairness to Dr. Frances and his colleagues, I have to acknowledge that there is a section headed “Psychosocial interventions” on page 11 of the guidelines.  Here’s the entire passage:

Psychosocial intervention

  • Ensure continuity from inpatient to outpatient care (e.g., schedule first outpatient appointment within 1 week of discharge, give enough medication to last until that appointment, telephone follow-up if patient misses appointment)
  • Psychoeducation for family to support and encourage medication compliance”

Incidentally, in the treatment algorithm mentioned earlier, under the neuroleptic complication “Agitation or insomnia”, only one intervention is given:  “Add benzodiazepine”.

In this context it needs to be stressed that the Schizophrenia Treatment Guidelines were widely distributed and influential.  Indeed, this was the intention from the start.  Here’s another quote from David Rothman’s expert testimony:

“The guideline team [Drs. Frances, Docherty, and Kahn] promised wide distribution of its product, including publication in a journal supplement.  The team was prepared to have J&J participate in its work, not keeping the company even at arms length.  With a disregard for conflict of interest and scientific integrity, the group shared its drafts with J&J.  On June 21, 1996, Frances wrote Lloyd [John Lloyd, J&J’s Director of Reimbursement Services]:  ‘We are moving into the back stretch and thought you would be interested in seeing the latest draft  of the guidelines project….Please make comments and suggestions.’  (Italics added).  So too, the group was eager to cooperate with J&J in marketing activities.  Frances wrote without embarrassment or equivocation:  ‘We also need to get more specific on the size and composition of the target audience and how to integrate the publication and conferences with other marketing efforts’  (Italics added)” (p 15)

Back to Dr. Frances’s current article:

“This debate does have serious real world consequences.  There is no more momentous decision in the life of someone who has had psychotic symptoms than whether or not to stop meds- and it always comes up in the treatment, often repeatedly. If the person’s symptoms have been brief and not life threatening, I fully encourage a decision to gradually taper and then stop. It is, under these circumstances, definitely worth the fairly minor risk of relapse to avoid the major risk of medication side effects and complications. Many of Bob’s most enthusiastic followers are in this category- harmed by prolonged overtreatment for transient problems.”

But there’s a catch 22.  For a “diagnosis of schizophrenia”, the DSM requires the presence of two or more of five “characteristic symptoms” for a significant portion of time during a one-month period “or less if successfully treated” [emphasis added].  And when this “diagnostic” determinant is coupled with psychiatry’s long-standing preference to use the drugs as the “treatment” of first resort, it is clear that the concept of transience in this context becomes meaningless.  There is no way of knowing if a person’s “symptoms” have been brief, if they are routinely suppressed with neuroleptic drugs as soon as they become evident.  The individual is still eligible for a “diagnosis of schizophrenia”, (a “life-long disease”) and will be pressured relentlessly by psychiatrists and the mental health system to continue to take the “meds” indefinitely.  And this is a situation to whose making Dr. Frances has been a major contributor.

Of course, we can all make mistakes, and we can all learn from our mistakes.  And if Dr. Frances is saying that his earlier enthusiasm for neuroleptic drugs and his downplaying of the entailed risks were mistakes, that would be one thing.  But to suggest that he has always been a proponent of moderation and restraint in this area is, I suggest, a distortion of the readily checkable historical facts.

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

Interesting as all these matters are, there is a much more fundamental issue that seldom gets aired:  the nature and effects of neuroleptic drugs.  In recent years, psychiatrists and pharma have been promoting the term “antipsychotics” for these products, denoting that they eliminate, or correct, psychotic thoughts in the same way, for instance, that antibiotics eliminate germs.  In fact, the term antipsychotic is much more a marketing device than an accurate descriptor, and it is to psychiatry’s shame that they have adopted and promoted the term so enthusiastically.  What these drugs are, and what they were originally called, is major tranquilizers.  Back in the 60’s and 70’s, their action was routinely likened to piling damp grass on a fire.  The fire wouldn’t go out, but its action and intensity were greatly reduced.  Nor are the actions of these products specific to psychotic thoughts and speech.  They suppress all activity.  In fact, they don’t normally eliminate delusions or hallucinations; rather they render the individual indifferent to them.  In the 50’s, the action of chlorpromazine, the first major tranquilizer, was likened to a chemical lobotomy.

A second factor that needs to be recognized is that people very seldom enter psychiatry’s orbit on the grounds of craziness alone.  One can be as crazy as one likes in the privacy of one’s home.  And indeed, I suggest that most of us adhere to some notions that would meet psychiatry’s definition of delusions:  “A false belief based on incorrect inference about external reality that is firmly held despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary.” (DSM-5, p 819).  I, for instance, believe that there are no mental illnesses:  that the medicalization of all significant problems of thinking, feeling, and/or behaving is a hoax, designed to enhance psychiatry’s prestige, and to sell pharma products.  I occasionally receive emails and comments suggesting that I must be crazy to entertain such ideas, and I suppose, from psychiatry’s point of view, my beliefs could be considered delusional. But, oddly enough, I’ve never been picked up on a 72-hour hold, or court-ordered to have a psychiatric evaluation.  Even if I were to stand peacefully on the sidewalk in front of a mental health center distributing anti-psychiatry pamphlets, it is unlikely that I would be molested, though I might be asked to keep a certain distance back from the door and not to impede pedestrian traffic, etc…

But, if I go inside the building and start noisily and agitatedly berating the psychiatrists, and tearing down the pharma-distributed infomercial posters, I will likely be arrested within five minutes.  And if I continue to express my views in a loud and agitated manner at the police station, and if my general presentation seems odd or eccentric, it is possible that I will be remanded to a psychiatric facility for a 72-hour evaluation, and will be assigned “a diagnosis of schizophrenia”.

This is the critical point.  It is the expression of unusual or non-conformist views, coupled with expressions of anger, agitation, and aggression, that precipitates many of these “diagnoses of schizophrenia” and subsequent “medical” incarcerations.  It is certainly possible for an individual to find himself in this situation without any display of anger or agitation.  But in many cases, it is presentations of this kind that draw official attention and result in civil commitment, incarceration, and forced drugging, even though the person may not have committed any crime.  And yet, amazingly, it is almost unheard of for these interventions to entail any inquiry into the source(s) of the agitation or any attempt to ameliorate the anger in any way other than with tranquilizing drugs.

The central issue is not whether “antipsychotics” are effective in the treatment of “schizophrenia”, but rather, whether major tranquilizers are effective in the suppression of anger, agitation, and aggression.  And of course, they are, provided we discount the fairly common adverse effect of akathisia, the manifestation of which, incidentally, according to Dr. Frances’s own Guidelines, may be confused with – and the irony of this is beyond words – “psychotic symptoms”. (p 55).  (In other words, one of the long-established adverse effects of the drugs is to make a person seem crazy – and, presumably, eligible for more “treatment”!)  But, for the most part, the drugs are strong tranquilizers which reduce general activity and speech, and dampen feelings and emotions.

Neuroleptic drugs have often been called chemical straightjackets.  And the question as to whether or not these products should be used to control agitation, anger, and aggression, is not a medical matter.  It is a human rights/legislative issue.  The use of physical restraints by law enforcement officers is subject to ongoing legislative and judicial oversight, but the use of chemical restraints by psychiatrists is effectively unregulated.  The fundamental question is not:  are antipsychotic medications effective in the treatment of schizophrenia, but rather:  is it morally acceptable to use major tranquilizers, that have devastating adverse effects, as chemical restraints, frequently for years and even decades?  It is time to start calling a spade a spade; and it is beyond time for legislative and judicial bodies to recognize the abuse and deception in this area and to take appropriate action.  There is a pressing need to recognize that these products are not medications in any ordinary sense of the term.  They are chemical restraints.

  • Mark Eccles

    “these products are not medications in any ordinary sense of the term” , the same as the hospital is not a hospital in any ordinary sense of the term. It is a jail.

    Psychiatrists claim they want their patient to be intelligent, then give them drugs that rob them of their intelligence.

    The psychiatrist then claim they are helping the patient, and there are few able to contest the claims.

    Legislative and judicial bodies believe the lies of those in charge. Only when there is a mountain of evidence will something be done ( about the mistaken treatment methods), and that time is coming soon with the number of ( percentage of population) people judged mentally ill.

  • Circa

    Psychiatrists aren’t looking for intelligence; they’re looking for obedience.

  • Dustin Salzedo

    The treatment goals of psychiatry are simple: make victims dumb (silent) and docile (out of sight, out of mind). They are agents of the criminal justice system – paid thugs masquerading as physicians. As they are licensed to practice without sufficient controls and societal oversight, they are armed and dangerous.

  • all too easy

    Neither Dr. Eccles, The Circus Clown, nor Professor Gazebo has one shred of objective scientifically valid evidence to establish their whimpering claims. O, woe is me!

  • S Randolph Kretchmar

    The last 2 paragraphs are absolutely spot-on! I am currently litigating a federal lawsuit which illustrates that issue perfectly. In fact, I may take your phrasing here for a motion response that’s due in a couple days. Thanks!

  • Phil_Hickey

    Randolph,

    Good luck. Glad to be of help.

  • Phil_Hickey

    Mark,

    Thanks for coming in. I agree.

  • Phil_Hickey

    Dustin,

    Good point. But it’s even worse than that. Real law enforcement officers are regulated by law and by the courts. But psychiatrists are answerable to nobody but themselves.

  • Zoe

    Dr. Hickey,

    Soap-operas are also currently promoting medications. Recent storylines have included: ‘ADHD’, ‘schitzophrenia’, ‘bipolar disorder’, and ‘depression’. Characters are offered in a disturbed manner to invoke fear, and then following psychiatric intervention their health is markedly improved. The resident soap doctor then informs them that the medications have worked well, and if they stick with them their ‘sypmtoms’ shouldn’t return!

    It’s quite worrying.

    I look forward to your next article!

    Best Wishes

  • all too easy

    thanks zoe baby. solution: watch more soap operas. they have been proven to sedate the masses like opium. don’t take opium. try lemon juice after every black stool. revitalizes the dendrites in the anticolinergin urticaria colinergica regions of the mastoid process. they say i got intelligence personalty misbehavior syndrome.

    warm thoughts with no hope. don’t hope. hope will kill you. look at doofus bulbhead. very sick stool starter, that one!

  • bulbous1

    If I’m a doofus, what does that make you? I can only assume you have a colon for a brain, for your head seems to be full of shit. Your delusions of intellectual superiority are always in evidence in the voluminous vomitings and splenetic spewings that, in a lapse of judgement, you publish on this website. If you were as intelligent as you claim, you would never publish your embarrassing drivel, you nauseating little adolescent, hanging around this site like some vast cyber slug.

    Now sod off you odious little turd, and spread your debris somewhere else.

  • bulbous1

    Your pretensions so far outstrip your abilities, it’s embarrassing.

  • all too easy

    Ability causes hope. Hope is deadly. Don’t hope, bulbous. The reason you are stuck pondering the meaning of black stools is due to hope. Kill hope. Mankind has been fooled into believing there’s hope for millennia and look at the destruction it has caused. As far as that goes, look at you! No poor slob on earth is as miserable as thou art! My, you hate everything! You are one of a kind. You are so precious, nothing and no one can get under thine divine nerves. Far from the maddening thou livest, only condescending to visit the masses when you feel compelled by thine superior self to lecture your humble servants about the meaninglessness of life, to cull sympathy for the one, true Bozo, THOU!
    BTW, can you define pretensions while you are still in the mood to grace us with thine intellect, please, Dear Lord.

    You poor old sod, you see, it’s only moi.
    Army’s up the road. Salvation al a mode and a cup of tea. Them flowers bloom like madness in the spring. I thank god he stole the handle and the train it won’t stop going. No way to slow down.

  • bulbous1

    In this regards, Frances’ judgment might be somewhat impaired by the fact that he spent much of his career forcing these drugs into people’s bodies.

    I think his “moderation” with regard to psychiatric diagnosis is perhaps informed by a keen political instinct for what is expedient; it would be impolitic for psychiatry to brand the masses as mad. I mean, imagine the uproar if, for example, the diagnosis “Mad Herd’s disease” were to be included in the DSM. It would be political suicide, and may sound the death knell of the profession.

    Yet the masses are crazy-ape nuts, mad as ten bears in a chicken hutch, a symptom whereof is the gratuitously, supererogatorily oppressive demands it imposes upon its citizens in drilling them into conformity with its own ways through the assorted punishments meted out, either by the mob themselves whenever a man, in some particular of his person or thought, ventures at great peril off the beaten path; or by the executive branches of government of which institutional psychiatry is an example.

    All this crap about “saving normal” is irritating. Frances is a populist prostitute (the worse kind of prostitute), little more than an aged whore, jiggling his booty seductively at the masses.

    He puts one in mind of certain smack addicts who abase themselves sucking off old perverts for their latest hit, only he’s plumbing much lower depths of self-abasement fellating the mass-phallus (the worst kind of phallus) for his hit of fame and power.

    Democratic society is full of these whores, these courtiers of Hydra, abasing themselves with an eye to inveigling themselves into the mob’s good graces.

    The DSM’s invidious definition of delusion is telling. In stipulating, like Humpty-dumpty, that it is not enough simply for the belief of the delusional person to be at variance with the truth – whether this be proven or assumed – but that it must also go against the beliefs of the many, it preempts the criticism that delusions are common or universal. The use of such stipulative definitions in psychiatry is, of course, common, and they quickly and almost effortlessly fall into common usage.

    Such words are used legislatively, prescribing a set of rules for how a word should be used. Yet just as it is difficult to take seriously the profession’s claims to authority in distinguishing between rational and irrational behavior, likewise its claims to linguistic authority; and just as those who systematically abuse people shouldn’t be taken seriously in their claims to being experts upon them; likewise those who systematically abuse language shouldn’t be taken seriously when they lay down the law for the “proper usage” of a term, which in their boundless arrogance high-ranking psychiatrists presume to do when they try to impose their unfairly discriminating definitions upon the world, such as those that draw the line between rational thought, feeling and behavior on the one hand, and their opposite on the other, through societies of men and not men themselves, and thence mistreat them.

    Let’s assume that Frances was right about the necessity of perpetrating violence against the brains of some people, it would still be left to the discretion of psychiatrists as to whom should be subjected to such violence. Maybe (but doubtfully) such power as this implies, in the hands of a few, would be borne responsibly, but in becoming the common property of so many individuals, its abuse is assured.

    Those who wish to control the world should start with themselves, for no man is so eminently worthy of being controlled as he who endeavors to control others, not that the word “control” crops up much in the the discourse of practitioners of forced psychiatry.

    As La Rochefoucauld said, everyone has the strength to bear the burden of others, and I would add make their sacrifices also. How easy it is for Frances, from his own comfortable situational and experiential remove, to expect others to bear their pharmacological and existential burden, and to sacrifice their rights.

    Where Frances acknowledges verbally the harms of neuroleptics, it puts me in mind of what Joseph Conrad described as a “diplomatic statement”, wherein everything is true but the sentiment which seems to prompt it.

    For him their harms are but a footnote in the history of psychiatric drugs, which tells of great progress in the treatment of “mental illness”. They are always given a cursory treatment in the writings of people like Allen Frances. Understandably, he is loath to go into great detail, as much as would an Inquisitor have been to go into great detail about the agony inflicted on a heretic by the strappado.

  • all too easy

    Confessing to the endless sin, Your endless whining sounds,
    honey, you will be praying til next Thursday to all the gods that you can count

    Forgivest thou me, Bulboa, for whilst I have been engaged in splenetic spewings, I have failed to anticipate and reach, ultimately, thine standards. Indeed, I confess, for too long I have grovelled in the pit of hope, making me much too much like thou. Abandon hope. Hope will make you ill. It will disease thine undiseased brain. Perchance you might find Old Charlie. T’is he who stole the handle after all, and the train, why, it will not stop going. No way to slow down, babe. NO WAY to slow down. Do you hear the pistons scraping? Steam breaking on your brow? Well, you better man. I saw him in the city and on the mountains of the moon. His cross was rather bloody, and he could hardly roll his stone, if you catch the drift, man

  • bulbous1

    All Too Easy, go away and flush yourself down the toilet, and take your rightful place in the ocean with all the other turds.

  • bulbous1

    Picking up where I left off, you are correct about the disempowering effects of the drugs.

    Some mental patients are the victims of social persecution, which brings them into the orbit of psychiatry. They are admitted and forced to take these chemicals of mass destruction. Then they are cast adrift in society by psychiatrists, who obviously, even if they were of a mind to do so, cannot forestall the contingency or eventuality that the “patient” will once again be subjected to the very social pressures that originally brought him there.

    Only now he has to wrestle with both the labels that psychiatry slaps on people with such reckless abandon, and the drugs they forcibly administer, equally heedless of the consequences, drugs which in many of their effects are so profoundly disempowering that, though the patient already lacked the protective coloration that wards off the attentions of predators, he now finds himself all the more the focal figure of the predatory appetites of a sanguinary mob, who scent weakness like bloodhounds scent blood, and set upon their victim with equal mercilessness.

    Leaving aside the ways in which the labels do so, the drugs disempower in a number of ways. For one they heavily sedate you, making social functioning difficult. This and other effects can lead to a mental confusion that puts a man/woman at a great disadvantage in his/her conflicts with others, a confusion leaving one’s thoughts weltering like leaves in the breeze that scatter ere you grasp them. They can also disfigure you, and the more mob-minded, whose lives are as empty as themselves, are always on the lookout for some irregularity to amuse themselves with, anything to escape peering into the void within.

    These problems get progressively worse and worse as the drugs rot away your brain. As the drugs dry up the wellspring of his resilience, the patient – his mental and physical strength on something of a descending curve, stuck between the Scylla and the Charybdis of society and the psychiatric “hospital” respectively – often kills himself, and of course if he fails he ends up back in a psychiatric ward! No asylum in this world outside of the grave.

    So the patient is caught in a vicious circle. I’ve seen this when I was in “hospital”. A man would be released, and then come back again crying because where he lived the fuckers just wouldn’t leave him alone. The patient would come to the ward and thence go back to society, and soon thereafter would come back, and so on and so forth.

    Alas, there’s little you can do. Some will say that one day people will look back in horror at such things, but this postponement of the enlightenment to the future – which one encounters in every age amongst the victims of hope – is but another spoke in the wheel of history, which turns and turns irrespective of the efforts of men – mostly recalcitrant to all that would reform them -, driven as it is by immutable, implacable laws, such as the nature of humanity itself, short of an alchemical transformation upon which trying to make any great improvements will always be like rearranging the chairs on the Titanic, or trying to mend a broken body by changing its attire!

  • all too easy

    broken record

    no proof exists that demonstrates SSRIs cause sedation. To bemoan the the psychiatric advancements born in the latter half of the 20th century surely says more about those who despise medicine than anything else. Poor Poopus C. Balboa, why he could sit back and stop railing to an audience of one-himself-if he would begin ingesting millions of milligrams of these lifesavers. Clooduspuss, personally needs an entire hospital staff of psychiatrists, psychologists, neurologists, lobotomists, and priests, rabbis, ministers and shaman.

    well he picked up gideons bible open at page one
    I thank god he stole the handle and the train it won’t stop going, no way to slow down.

  • anonymous

    all too sleazy, Piss off, poop-for-brains.

  • Anonymous

    It is the expression of unusual and non-conformist views, coupled with expressions of anger, agitation, and aggression, that precipitates most of these “medical” incarcerations.

    This is not something you’re in a position to quantify, this is just your assumption. And it’s a little offensive and prejudicial. You’re effectively saying that ‘most’ people who have been subjected to forced psychiatry engaged in anger, agitation and aggression in the lead-up to being targeted by state psychiatry. Most of the anger I’ve seen comes after one is aggressed upon by state psychiatry. By definition state psychiatry against people who have broken no law is the initiation of aggression by the state against the citizen. Numerous times, all it takes is a hearsay allegation of suicidal intentions, and no ‘unusual views, aggression and anger’ at all. To my knowledge you didn’t spend long periods of time as a detainee of forced psychiatry or regularly engage in initiating forced psychiatry against others so I can’t place much stock in your claims about ‘most’ forced psychiatry victims ‘precipitating’ their own forced psychiatry through anger and aggression. I think you’ve erred in that assessment.

    A second factor that needs to be recognized is that people very seldom
    enter psychiatry’s orbit on the grounds of craziness alone. One can be
    as crazy as one likes in the privacy of one’s home.

    Seldom? Most of the people I know who have been subjected to forced psychiatry will tell you it was a state empowered psychiatrist’s opinion that ‘craziness’ was present that is the driving factor behind their behavior or thoughts being psychiatrized. Since we are making unsourced claims about ‘most’ psychiatry detentions here today, I’d say ‘most’ of them come from one factor alone, having family members who have been indoctrinated to believe government psychiatry is the proper response to unusual things being thought or done by their children, since ‘most’ forced psychiatry is initiated against young adults.

    It is simply not true that one can be ‘as crazy as one likes in the privacy of one’s home’. Most of the people I know subjected to forced psychiatry, myself included, have had every aspect of our home behavior reported by family members we shared homes with at the time, to state psychiatry interrogators. Some of the meekest most peaceful women I have known, weakest, smallest, physicially, women, who have not engaged in any ‘aggression and agitation’ have been forcibly psychiatrized solely on the basis of their speech, writing and beliefs. Many times even the prejudicial framing of the person as ‘mentally ill’ by their parent on a 911 call can lead to immediate arrest when the cops turn up. I do not accept your ‘point’ that ‘most’ or ‘usually’ agitation and aggression are the leading factors, you haven’t quantified this in any way, and I don’t think you know the issue of forced psychiatry intimately enough and with enough breadth to be making such blanket claims. By far, in my experience, most of the ‘anger’ takes place after people are swarmed and surrounded by totalitarians in adversarial, emergent, rapidly changing standoff situations with government agents be they cops or forced psychiatry personnel, or even just parents who are threatening forced psychiatry on their kids.

    The wording in the last italicized quote is slipshod at best anyway, ‘people very seldom enter psychiatry’s orbit’, are you talking about forced psychiatry/institutional psychiatry or psychiatry in general, tens of millions of people enter psychiatry’s orbit by their own volition and faith in psychiatry’s tenets.

    Allen Frances has never been worth anybody’s time. He’s a brain rapist, a human rights criminal who belongs in prison. Whitaker loses his shine year by year due to harboring unrepentant human rights abusers like Steingard in his nest.

    Rather than painting the millions of people subjected to the world-historical atrocity of forced psychiatry over the centuries as ‘mostly aggressive’ ‘usually aggressive and agitated’, you could make your point that major tranqulizer drugs are in fact used to shut people up and stop people doing things other people don’t want them to do, without claiming, that most of us are usually precipitating our own incarcerations with our most, usual, most, usual, most aggressiveness and agitation and anger.

    This article was way off. Way off. And I’m deeply tired of the constant raking over old coals of Whitaker-Frances or Whitaker-someone else public back and forths.

    Robert Whitaker has been a powerful, reasoned, and if I may say,
    restrained voice in these endeavors, and Mad in America is at this time
    one of the primary outlets for anti-psychiatry views and information.

    restrained voice? I know a lot of voices have been ‘restrained’ by being banned from commenting there. I know human rights abusers who forcibly drug innocent people are very well respected bloggers there, it’s not an anti-psychiatry site, it’s a critical of psychiatry/psychiatry reform site at best, weak tea, which has alienated large numbers of opponents of psychiatry, censoring some of the most articulate survivors of forced psychiatry all on the altar of ‘big tent inclusiveness’, they make it very clear that a coercive psychiatrist who still forcibly drugs the people she calls her ‘patients’ is a progressive hero JUST because she doubts long term efficacy of ‘antipsychotics’, it’s not exactly a place that is ‘antipsychiatry’ or even a place welcoming of free discussion and speech.

    But blaming the world-wide anti-psychiatry sentiment on Robert is a bit
    like blaming news reporters for wars, plagues, famines, and natural
    disasters. It’s not only false, but betrays a fundamental disconnect
    with reality. The anti-psychiatry movement exists because psychiatry is
    something fundamentally flawed and rotten. And it is fundamentally
    flawed and rotten because its leaders have made it so.

    It’s not psychiatry’s ‘leaders’ that make it so. The average foot soldier/true believer is far more dangerous to me than a faraway ‘leader’. Allen Frances has personally raped some peoples brains in his life, but probably not since the 1980s. I’m sure his victims are thankful that this predator retired to more lofty heights than having to continue to get his hands dirty stabbing people with syringes. Even in a psychiatry environment devoid of ‘thought leaders’ and ‘key opinion leaders’ and not awash with pharma money, like Soviet psychiatry, psychiatry was still a formidable destroyer of innocent lives.

    This ideology doesn’t require leaders so much as it requires the public’s and the state’s blind faith in its legitimacy. For hundreds of years psychiatric ideology has infiltrated almost every society on Earth and has become the final word in defining ‘strange or problematic behavior’. It did this without Allen Frances. It did this without Ron Pies. It did it without Wessley (or however you spell the Brit’s name I don’t care enough to look the spelling up), I urge you, don’t flatter these people by well and truly over-estimating and over-inflating their impact and worth in moving the world, at best, the only dent a bit player like Frances has put in the world is his role as expander of the ‘bipolar’ name-calling in Dehumanizing Smear Manual Number 4.

    Once the ideology of psychiatry came to exist, it didn’t need ‘leaders’ pulling strings, the average two bit quack graduating in psychiatry needs to know only one thing, ‘people act crazy that’s because they have a brain disease, stick them with these drugs it makes them shut up and stop acting crazy, rinse, repeat, 50,000 times, retire’… At best a few thousand people in the world read Frances’ Huffington Post blogs, it’s a left wing site hated by half of the population, and his is an obscure corner of Huffpo at best, don’t overestimate this over-tanned silver head molecular rapist’s impact on the world. He’s just another doctrinaire, and he’ll be gone in 20 years, replaced by another, and another, in Allen Frances’ life story what matters most is the moments of extreme violence where he brutally ignored the pleas of people who were begging him not to stab them with a needle full of drugs. He’s a brain rapist.

    If push came to shove, he reserves the right to end any ‘dialogue’ by invading your brain. This is why he doesn’t deserve any engagement, any attention, any oxygen, anyone to pretend he has ‘standing’ to engage in some public dialogue in the pages of the internet’s blogs and sites, because at the end of the day he’s a violent thug. So is Sandra Steingard, Mad in America’s allegedly progressive and enlightened psychiatrist.

    We need to get to the point where those who reserve the right to end a conversation by pickling your brain in major tranquilizer drugs by force, are seen for the unworthy interlocutors that they are, they are at the end of the day, violent thugs, with the mentality of rapists, who don’t believe in the inviolability of your right to own your own body, of anybody’s right to own their own body. They have the morality of a date rapist drugging someone’s drink, they will resort to forcibly drugging others to have their way with them, to control them, why anybody thinks such barbaric thugs have a rightful place in the staid gradual editorial back and forths of public discussion is beyond me.

  • Phil_Hickey

    Anonymous,

    Thanks for coming in, and for pointing out my error. As you say, I can’t quantify these matters, and your perceptions and assessments of these issues are as valid as mine.

    With regards to the other reasons that people can be forcibly detained and drugged, I did say: “There are other elements that can lead to a ‘diagnosis of schizophrenia’, civil commitment, and enforced drugging…” Intra-family conflict was one of the scenarios that I had in mind, and I did not state, or even imply, that expressions of anger/agitation were inappropriate or unjustified.

    With regards to critiquing the so-called thought leaders, my primary objective in all of this is to discredit psychiatry as the destructive hoax that it is, and to undermine its authority and power.

    Whether we like it or not, the “thought leaders” have influence over the rank and file, and, more importantly, over those who make and enforce public policy (including commitment laws). Whether these individuals are worthy of consideration and dialogue is, I suggest, beside the point. If we don’t refute them, then their nonsense stands, and the status quo remains.

    Again, thanks for coming in, and for the helpful feedback.

    Best wishes.

  • bulbous1

    Another quote on hope and optimism, this time from Mencken;

    “Of all the sentimental errors that reign and rage in this incomparable republic, the worst is that which confuses the function of criticism, whether aesthetic, political, or social, with the function of reform. Almost invariably it takes the form of a protest; ‘the fellow condemns without offering anything better. Why tear down without building up?’ So snivel the sweet ones; so wags the national tongue. The messianic delusion becomes a sort of universal murrain. It is impossible to get an audience for an idea that is not “constructive”- i.e., that is not glib, uplifting, and full of hope, and hence capable of tickling the emotions by leaping the intermediate barrier of intelligence.

    Unluckily, it is difficult for the American mind to grasp the concept of insolubility. Thousands of poor dolts trying to square the circle…The number of persons so afflicted is far greater than the records of the patent office show, for beyond the circle of frankly insane enterprise lie circles of more and more plausible enterprise, and finally we come to a circle which embraces the great majority of human beings. These are the optimists and chronic hopers of the world, the believers in men, ideas, and things. It is the settled habit of such folk to give ear only to whatever is comforting; it is their settled faith that whatever is desirable will come to pass. A caressing confidence- but one, unfortunately, that is not borne out by human experience.”

    Henry Mencken, “The Cult of Hope”

    Billions of people picking away at their ailments with all the futility of a chimpanzee picking away at the ticks and fleas laying perpetual siege to it.

    In democratic society there’s a whole army of quacks, purveyors of buncombe, and other assorted charlatans dedicated to the “Uplift”, as Mencken called it, evangelical preachers preaching the gospel of Hope to the congregation of the faithful, convulsing in concert under the hypnotic influence of some mountebank,

    Sowing in the morning, sowing seeds of blindness,
    Sowing in the noontide and the dewy eve,
    Waiting for the harvest, and the time of reaping,
    They shall come rejoicing, bringing in the sodding sheaves;

    Then one day, drunk on your own tears – and vomiting them back up – amidst the shattered remains of illusions lost, your arse the recipient of a gang-bang in which fate, fortune, circumstance, and man alike lustfully participate, the realization dawns upon you, you’ve been duped.

    Hope makes lowly circus clowns of us all, setting us up daily, for many a pratfall.

    Moving on, regarding the comments about the drugs robbing people of their intelligence, whilst their harmful effects are well documented, I would remind people that having a healthy brain is not synonymous with its judicious, proper usage, though to what uses we should put them is obviously a matter of a debate. Intelligence is not the exclusive property of men whose brains are considered “healthy”. A brain can be ravaged by disease, yet still its owner might be far more intelligent than those who exercise their minds on trivialities, or use them as a storehouse for the preservation of epistemological junk.

    Maupassant, Strindberg and Nietzsche, though their brains were being devoured by syphilis, were still well above the norm of intelligence, and Maupassant, with his disease-ravaged brain, bequeathed to the few men (for taste, like wisdom, like goodness, like genius, is always in limited supply, and the former and the latter quite frankly seem to be on the verge of extinction at present) attentive to the beauties of the written word some of his most brilliant and insightful stories.

    Moving on again.

    “I occasionally receive emails saying I must be crazy to entertain such ideas…”

    Someone once said to Diogenes that he was out of his mind, to which he replied that it is not that he is out his mind, but that he doesn’t have the same mind as his interlocutor.

    How far we haven’t advanced in the past couple of millennia. Plus ca change…

    None are so mad as those who think they are sane. One of the contemporary symptoms of the mental murrain (metaphorically speaking, of course) afflicting the herd in every age is the belief in their own sanity, their own reasonableness.

    Yet to paraphrase Ambrose Bierce, for the masses, as for all men, reason is little more than the weighing of possibilities in the scales of desire; or as Conrad said, “the use of reason is to justify the obscure desires that move our conduct, impulses, passions, prejudices, and follies, and also our fears.”

    All this talk about man being an autonomous, rational agent is just the flatulence of lunatics, and on the basis of the invidious, arbitrary distinction drawn between men in this regards rests the inequitable distribution of rights and responsibilities. Yet given that desire is broadly coextensive with credulity, it is little wonder that the shibboleth aforementioned persists.

    Wearing anything but a straitjacket, a man looks as absurd as an ape in regal garments.

    Desire is the eminence grise wielding power behind the scenes under the “Reign of Reason”, which applies as much to the soi-disant arbiters of reason, and lovers of science and truth, as it does to the madman, or as I should say, the man so designated. Short of attainment to a Nirvana-like state of freedom from the self – that cross all men have to bear – it is impossible for any man to be reasonable, save perhaps in the lucid intervals separating the successive spasms of the human heart, when the ebb of desire, unimpaired by the appetites, passions, and fears that move it, allows for the free-functioning of the faculties, though even this is probably wishful thinking.

    “Man is the reasoning animal. Such is the claim. I think it is open to dispute…his record is the fantastic record of a maniac.”

    Mark Twain

    Coming back to the lunacy of the herd, there is almost nothing dreamt of in the philosophy of the masses that is to be found on earth, yet as a general rule it is precisely they who most eagerly cast aspersions on the minds of others, one of life’s little insufferable ironies.

    Though “philosophy” might be the wrong word here, for many of the men and women who make up the broad masses are like parrots, which in speaking give off the illusion that there are real, choate ideas in their heads, for such people develop the ape-like faculty of imitation almost out of all proportion to the rest, which never mature to the point at which independence of thought becomes possible – which to the slave mind always seems a sign of “madness”, “stupidity”, or “evil”, and is attacked accordingly – the lack whereof comes to seem to them a mark of true superiority, for self-love will take refuge in inferiority when under threat; the world is full cocks standing very proudly, very proudly indeed, atop their own dunghills.

    “We think very few people sensible, except those who are of our opinion.”

    La Rochefoucauld

    And in proportion as the mind that distorts it is simple, is the world perceived to be so.

    Philosophical knowledge and conviction being inversely correlated, it is impossible to reason with la canaille, for whom the world is but a wall to bounce their bullshit off, to borrow from Celine.

  • all too easy

    now that’s downright vicious. “poop-for-brains” how am i to get over the devastation, the crushing terror from that uncalled for attack? woe is me!

  • doppelganger

    Woe is you.

  • Molly

    I read this article through to the end, very carefully, as I want to really get a good grasp of these issues – and you are such an excellent person/professsional to be getting this information from. Thank you!

    I’ve jumped into the fray – a bit harsh at times (referred to Dr. Healy and his support/promotion of ECT as being ‘sociopathic’ in nature, think I said something like ‘sociopaths like Dr. Healy’ in a comment on MAD and of course was too harsh but that is the level of ‘anger, agitation and aggression’ I have towards what’s gone on in the past 20 years plus. A large part of it, from what I understand, from Dr. Allen Frances’ leadership of the DSM-4 and the horrors that came to be, such as the phony ‘bipolar spectrum’ (brainchild of his colleague Ronald, Pies, M.D. from my brief research) and many new categories created to target and sell antipsychotics and other pharma meds to (increase focus on targeting the elderly and children).

    If it wasn’t for you, Robert Whitaker and others sharing of these issues and bringing them to light in a public forum such as MAD website and this blog, etc. I really would not have been able to learn what I’ve been able to and speak out in my own way (own blog, book) – same I am sure with many others.

    So please keep fighting the fight. So others like myself who do not have a professional connection to psychology/psychiatry (disclaimer: Ihave received care for a mental illness – BP-1 – why I have a personal connection to the issues and motivation to speak out) can learn, seek out additional information and participate in the discussion too.

    best, Molly

  • bulbous1

    Most of the people who, in my experience, are the quickest to cast aspersions on the sanity of critics of psychiatry (which I of course do myself, with the important distinction that I have tried to democratize society’s lexicon of lunacy) are just dumb yokels and people of inferior faculties, the principal seat of whose self-worth is the group to which they belong, which gives meaning to the senseless existence of men. Their group being the focal point of their feelings in this regards, any attack thereupon is taken extremely personally, such as can be seen with certain perfect specimens of fanaticism who have commented on here.

    In the tempest of emotions stirred up by the criticisms of the mental health movement, and the desperate attempt to restore order to their feelings, they take refuge in delusions of persecution, and if they attack you, they irrationally assume it is in requital of an attack of much greater magnitude.

    Owing to the fact that the world seems simple in proportion as the mind that perceives it is itself so, they believe they are in possession of the absolute truth. They are naive realists, which everyone is until they start thinking philosophically about the world, which is why one cannot argue with fools.

    “The essence of tyranny is the denial of complexity.”

    Jacob Burckhardt

    To paraphrase John Mill, such people confuse their certainty with absolute certainty. He goes on, “unfortunately for the good sense of mankind, the fact of their fallibility is far from carrying the weight in their practical judgment, which is always allowed to it in theory; for while everyone knows himself to be fallible, few think it necessary to take any precautions against their own fallibility.”

    This tendency becomes all the more marked not just the more philosophically naive the individual is, but also the more accustomed he is to deference and to agreement, both of which in part explain the intolerance of the mob, which Mill’s writings on liberty and the tyranny of the herd have done nothing to curb. And, of course, beliefs are often held with all the more conviction the greater in number are those who believe them, from which can be deduced the greater skepticism of men in relation to their beliefs when they lack the comfort blanket numerical preponderance over other beliefs affords.

    I see that Mr Frances has published yet another defense of psychiatric force and violence.

    In an attempt to shore up the tottering edifice of involuntary psychiatry he adduces stats that AOT “works”. All right then, why not force people into treatment for cancer, a disease whose existence rests on a far sturdier foundation than the ipse dixits of psychiatrists and popular opinion? Cancer treatments are often effective, yet this is not seen as a justification for imposing it on others.

    To which Frances and his ilk would reply that the patient lacks insight. Ipse dixit.

    Lacks insight into what? Into an airy disease process for which no evidence is forthcoming, and anyway, even if the diagnosis of “schizophrenia” mapped onto a discrete pathological entity, it still wouldn’t justify incursions into the human body, that once inviolably private place.

    This conviction of his own infallibility casts a somewhat absurd complexion on his criticism of Mr Whitaker for his failure to admit uncertainty in the article Phil discusses above. The world is full of pots jeering at kettles, as La Rochefoucauld said. This is the man who is so convinced that he is right, he believes he has the right to impose his beliefs on others.

    Yet this is to be expected. Mr Frances, for his all his politeness, is inordinately arrogant, and far too accustomed to getting his own way and to deference to be otherwise, I would surmise.

    All this talk about “treating severe mental illness” and sundry associated phrases are but the pious incantations of demagogues sending swine into a swoon, including those who utter them.

    I would surmise that underneath all this pious piffle is the desperate attempt of a man to justify to himself a lifetime of practicing psychiatric violence.

    He invokes the retrospective gratitude of some of the “patients” who find themselves caught up in the web of organized deceit carefully spun by propagandists of psychiatric violence and slavery.

    There are a number of problems with this. Firstly, in proportion as a man lacks faith in his own judgment, is he found to defer to that of the world at large, and even those who nevertheless set great store by their own judgment are at the mercy of society to some extent. Lacking the comfort-blanket that numerical superiority and the imprimatur of convention affords, even the wisest and the most intellectually courageous are ever beset with doubts.

    Most people lack the courage to struggle against the tide of popular sentiment and opinion, and when heresy in this respects is often interpreted as symptomatic of a disease, it’s hardly surprising that many show gratitude, fearful of repeating the nightmare.

    Frances completely ignores the immense pressure the “patient” is under to conform.

    There is a difference between being grateful and whether or not one ought to be grateful. The world is full of people who are grateful for being bullied and mistreated and who claim they deserve it.

    Should we infer from the fact that some women claim they deserve to be abused by their husbands that such abuse is good? And why should one privilege the retrospective testimony of such people over that which they offered at the time?

  • all too easy

    You are more guilty than any one for mistreating others. You should be ashamed. But, not cydhopperpuss. Clyde can rationalize away anything. Not once has he offered assistance in a practical way to anyone, ever. What a stuck-up, prideful, waste of a life. Woe is Clod. .

  • doppelganger

    Woe is you. What a waste of life you are. Moron.

  • Phil_Hickey

    Molly,

    Thanks for coming in, and for your encouraging words.

    Best wishes.

  • bulbous1

    Once it is understood that the “patient”, thrust by circumstance into the orbit of the forced psychiatrist, is often suffering from an almost crippling sense of self, the whole thing takes on an even more sinister complexion.

    Now everyone has to suffer in this regards; everyone has his cross to bear up the Calvary to which the species is condemned, but the burden of self-consciousness is nevertheless disproportionately borne by those to whose lot falls the greater part thereof; by those who are more delicately constituted and who lack the thick skin and insensibility that fortifies men of a more coarse-grained nature against life’s myriad misfortunes; and by those who find themselves the occupants of a degrading, demeaning position in the social order, with all that that entails emotionally, for in human society the law is, as it were, devour or be devoured; not a man rises in the social order who isn’t by the lifeblood of another empowered; just as flesh feeds upon flesh, egos feed upon egos, amongst friends, as amongst foes.

    Anyone who cares to examine who generally falls within the orbit of the institution of involuntary psychiatry will see that the vulnerable, and the powerless, and those of low social status are over-represented, that is, people much more likely to have a weak sense of self.

    Owing to the evocation of feelings of trauma and humiliation, by dint of an association of ideas and circumstances, past and present, the whole procedure comes to be experienced as obviously horrible, but the worst part of it is the total disregard for the consequences it might have for a person’s already fragile sense of self when, with reckless abandon, psychiatrists and their lackeys coercively administer their “treatments”.

    Now if a person is really a danger to others – and the rule of dangerousness to self or others is perhaps honored more in the breach than the observance, which observance discriminates along the lines of class, status and race – then society obviously has the right to protect itself, but the use of chemicals of mass destruction is not necessary. If it were, how ever did the species cope without them?

    Alas, men are apt to confound what is necessary with what is merely desirable. The man who desires to do something with an eye to gaining some advantage comforts himself with the belief that he has to do it. Whilst it maybe necessary for the psychiatrist to force a “patient” into “treatment” in the proper discharge of his professional duties, “treating” people forcibly when their consent cannot be gained is not so.

    Yet the world at large tells us that such things are necessary, and most men, lacking faith in their own powers of judgment, defer to that of the world, which though right on some matters, is nevertheless usually prepossessed in favor of mediocrity in moral, intellectual and creative life, and a fortiori under democratic dispensations, where the man of superior tastes, idea, morals, and imagination perforce must labor under the yoke of the tyranny of the majority, hiding their light under a bushel, lest the donkeys in confederacy against them prick up their ears and start braying and bellowing at them. Little wonder that Cioran described democracy as a “festival of mediocrity”.

    Not that the majority of people are necessarily that bad. Mark Twain was perhaps right when he said that lynch mobs were largely made up of individuals terrified lest they fall foul of their neighbors. Many men who constitute the conformist many are themselves the victims of the reign of terror by which the masses maintains order and insures mindless conformity from its members, often people who by themselves are really not that bad, just cowards, as all men are deep down.

    Yet I digress. We live in a society that places a higher cultural valuation on positive than negative liberty. Indeed it is hard to imagine a society any different; in a world where might is right, that is, a world where the powerful can do pretty much whatever they want, the former concept is much more serviceable to the ends of the mighty than the latter, and it is ultimately they that control the marketplace of ideas.

    Nevertheless, John Gray perhaps rightly points out that there has been a decline of the value of negative liberty and that this has coincided with the rise of the cult of “humanity”.

    “Freedom among humans is not a natural condition. It is the practice of mutual non-interference- a rare skill that is slowly learnt and quickly forgotten. The purpose of this ‘negative freedom’ is not to promote the evolution of humans into rational beings or to enable them to govern themselves; it is to protect human beings from each other. Divided against itself, the human animal is unnaturally violent by its very nature. The old-fashioned freedom of non-interference accepts this fact. For that very reason, this freedom is bound to be devalued in a time when any reference to the flaws of the human animal is condemned as blasphemy.”

    John Gray, The Soul of the Marionette

  • betty sainz

    Cledwyn, that troll is completely obsessed with you and seems to crave your attention above all else. So creepy. Plus, he’s incredibly disrespectful to Dr. Hickey and commenters on this blog. I second your suggestion that he flush himself. What a turd!

  • bulbous1

    Regarding the comment about people casting aspersions upon one’s sanity, allowing for the fact that there is always an element of truth in this, given that all human flesh is heir to madness, the problem is is that generally these people lack even a basic understanding of the ideas under discussion, with which one’s writing presupposes rudimentary familiarity.

    Yet as the theory Dunning Kruger effect suggests – and this is amply borne out by experience – a man’s sense of superiority is inversely proportional to his knowledge and ability, a rule that I think holds good in most cases.

    So what happens is, faced with their own incomprehension and incompetence, which men are loath to concede, they proceed thence to the comforting conclusion that the person whose knowledge or ability is far in advance of their own on a subject must be “stupid”, “evil”, or “mad”.

    Just as Samuel Beckett said that men are always blaming the problem of their feet on their shoes, men are always blaming others for their ignorance, incomprehension and incompetence. This can be seen in the field of aesthetic criticism. No matter how little, for example, people generally know about the art of writing, film-making, etc., everyone has an opinion about how you should express yourself, opinions expressed all the more arrogantly the more manifestly incompetent the person is who expresses it.

    And if a person can’t make sense of the work of art under “analysis”, for such people, it is always the problem of the artist, whose work is dismissed as the product of a madman, or an idiot, or simply “pretentious”.

    “The fundamental cause of the trouble is that in the modern world the stupid are cocksure while the intelligent are full of doubt.”

    Bertrand Russell

  • johnnybe

    More power than a king or a queen.