On November 27, 2014, the Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and Schizophrenia. The paper was edited by Anne Cooke, of Canterbury Christ Church University. It challenges the psychiatric medical model that dominates mental health practice in Britain and throughout the world, and offers an alternative perspective on psychosis and on the condition known as schizophrenia.
On December 15, Psychology Today published a pro/con article on the BPS’s paper. Allen Frances, chair of the DSM-IV Task Force, critiqued the paper, while Anne Cooke presented the pro side. Anne’s opening paragraphs were:
“Our report has two main aims. Firstly, it is intended as a resource for people who have the experiences we think of as psychosis, and for their families. Secondly, we hope it will lead to significant change not only in mental health services, but also in wider society.
Our dream is that our report will contribute to a sea change in attitudes so that rather than facing prejudice, fear and discrimination, people who have these experiences will find those around them accepting, open-minded and willing to help.”
The pro-con piece generated a number of comments, including the following from DJ Jaffe, founder and executive director of Mental Illness Policy Org:
“Anne Cook starts her piece by explaining why the report should be ignored. It was not science being served, it was a predetermined policy objective:
‘Our report has ….main aims. …(W)e hope it will lead to significant change not only in mental health services, but also in wider society. Our dream is that our report will contribute to a sea change in attitudes so that rather than facing prejudice, fear and discrimination, people who have these experiences will find those around them accepting, open-minded and willing to help.’
That explains it’s problem. Like much ‘research’ it had a political objective. Rather than find the truth and let policy fall where it may, the author’s started with a policy and then fashioned a report to support it. Reports like this make it difficult to improve care for the most seriously ill.”
. . . . . . . . . . . . . . . .
The accusation of adapting one’s science to one’s pre-conceived ideas is a serious one, and it is an easy error for any of us to fall into. So it is right and proper that we examine Mr. Jaffe’s charge on its merits.
And the first thing that we notice is Mr. Jaffe’s editing. Editing quotes from other people’s work is not necessarily a bad thing. In fact, it’s generally necessary. One can’t quote everything that the other person has written, so one selects the sentence(s) on which one wishes to focus. But there is a critical responsibility to conduct our editing in a way that accurately reflects the other person’s position.
The most obvious feature of Mr. Jaffe’s editing is that he omits Anne’s first stated aim entirely. This was the aim of creating a resource for people who have the experiences/behaviors collectively known as psychosis. This seems like a serious omission on Mr. Jaffe’s part, with at least the potential for distortion.
But even if we let that go, we also need to ask if Mr. Jaffe’s characterization of Anne’s second stated goal is fair and accurate.
“Secondly, we hope it will lead to significant change not only in mental health services, but also in wider society.
Our dream is that our report will contribute to a sea change in attitudes so that rather than facing prejudice, fear and discrimination, people who have these experiences will find those around them accepting, open-minded and willing to help.”
Now Mr. Jaffe contends that in acknowledging this as one of the goals of the report, Anne was not serving science, but rather was serving “… a predetermined policy objective.”
“Like much ‘research’ it had a political objective. Rather than find the truth and let policy fall where it may, the author’s started with a policy and then fashioned a report to support it.”
But is this true? Let’s look at the facts. Firstly, the scientific evidence against standard bio-psychiatry has been mounting for decades. Secondly, the evidence in support of alternatives has been mounting commensurately. There is also abundant evidence that psychiatry’s medicalization of problems of thinking, feeling, and/or behaving actually leads to increased stigma and discrimination. Much of this science is documented in the BPS report, and is supported in the 40 pages of references.
Given this state of affairs, is it not entirely reasonable that a body such as the Division of Clinical Psychology of the BPS should aim for change, and should aspire to a world where the individuals in question will find “those around them accepting, open-minded, and willing to help”?
Anne’s and the BPS’s call for change is emphatically not a preconceived position to which the facts are made to fit. Rather, the facts are established, and it is these very facts that make it clear that change is long overdue.
AND INCIDENTALLY
Here’s an interesting quote from an address that Mr. Jaffe gave at the 1999 NAMI Conference:
“The next thing I’d like to say is marginalize the opposition. In spite of what you may think, living in NAMI world, there’s very little opposition to changing these laws [i.e. to make involuntary commitments more readily available]. The only opposition comes from a very vocal minority that is within the mental health community. So within the mental health community you can say there’s no unanimity, there’s certainly majority, but there’s only a tiny little fraction opposes. Now forget the mental health community, take this out to the public at large. And now you find the only opposition is this tiny minority within the mental health community. And that’s less than like one percent of the total population. So you will find that there is very little opposition to changing the laws once you get it outside a mental health arena.” (DJ Jaffe’s address at the 1999 NAMI Conference as published by MadNation)
So, could it be, could it possibly be, that Mr. Jaffe is the person with the preconceived ideas and the preconceived agenda? Back in 1999, he reportedly called for the marginalization of the “tiny minority” that opposes his agenda. So as long as the BPS report challenged Mr. Jaffe’s position, the drafters of the report (including the editor, Anne Cooke) had to be marginalized. As long as the report challenged the psychiatric orthodoxy that “mental illnesses’ are in fact neurobiological disorders (NBD’s), the drafters had to be marginalized.
But there is not, and never has been, a shred of evidence to support the notion that any DSM entity (other than those clearly identified as due to a general medical condition) is caused by neurological pathology. So – again – it is Mr. Jaffe who is adapting his science to his preconceived notions.
AND, AGAIN, INCIDENTALLY
Here are some more quotes from Mr. Jaffe’s earlier writings and speeches:
“Laws change for a single reason, in reaction to highly publicized incidents of violence.” (Ibid)
“The media is gonna report on violence no matter what we want, and we have to… turn it to our advantage.” (Ibid)
“As I’ve said, change happens as a result of acts of violence. And what…and so, when these acts of violence occur, the media goes out and writes stories about them, and then we start approaching the media. We have in New York…it’s called Kendra’s Law…it’s a law we’re trying to pass. It’s an outpatient treatment law…assisted outpatient treatment. What a brilliant phrase. It’s not involuntary commitment, it’s assisted outpatient treatment. That was…came out of the Treatment Advocacy Center.” (Ibid)
“According to a just released report by my friend, Dr. E. Fuller Torrey, individuals with neurobiological disorders (NBD, formerly known as ‘mental’ illness) who are not treated, are as a group more violent than the general population.” (Jaffe, DJ, How to reduce both violence and stigma, newsletter of Staten Island AMI, December 1994)
“It is important for AMI/FAMI to take the lead in passing laws implementing the above policies they have adopted. Otherwise others will take the lead and the important judicial and procedural protections that must be in place for consumers may not be included in legislation proposed by others. In addition, from a marketing perspective, it may be necessary to capitalize on the fear of violence to get the law passed.” (Ibid)
In other writings, Mr. Jaffe asserts that he wants to help individuals who have been labeled as schizophrenic and bipolar. The notion of capitalizing on society’s fear of violence by portraying these individuals as violent strikes me not only as cynical beyond words, but fundamentally incompatible with his stated aim.