A Behavioral Approach to Mental Disorders

AN INTERESTING STORY Yesterday I came across the following on Twitter from Mental Health @Sectioned_. "I just met someone who told me their remarkable story about falling down the rabbit hole into psychiatric sectioning and forced medication. I listened with fascination to their intricate story in all its twists and turns, looping backwards and forwards with incredible details. The longer we spoke the more was revealed, the crazier and more believable it sounded. I was listening, probing for clarification, trying to grasp what happened and why. First the overview, then the highlights, then more details, expanding out, backing round, drawing me in. There were many parallels in our stories, and many contrasts. It reminded me why I don't really talk in detail about what happened to me: because, if you've not experienced it, it sounds unbelievable. Unless you've experienced the scorching reality of forced drugging, seclusion, assault by nurses and patients, it sounds like a mad fantasy. It's too far outside most people's realities for them to contemplate it being true, and so quietly assume you're deluded. So it smooths life's path to make light, to skirt over the details, to change the topic. And sometimes, sometimes, when I meet someone who's been through something similar, I listen to their story and realize I'm not the only one." ...

PRESIDENT’S SPEECH On June 3, President Obama delivered a speech on the expansion of mental health services. The occasion was the National Conference on Mental Health, which was held at the White House. "The truth is," the President told us, "in any given year, one in five adults experience a mental illness — one in five." In most human endeavors something is true only if it can be shown to be so. In psychiatry and politics, however, a statement becomes true if it's repeated often enough. For the past 60 years, the APA has been systematically expanding their diagnostic net until – surprise, surprise – it now envelops 20% of the population. With the lowering of thresholds in DSM-5, we can be sure that this number will continue to rise, and whoever is President then will be able to tell us that one in four of the population has a mental illness. Gosh! Note also that the President uses the term “mental illness” as opposed to “mental disorder.” The APA use the latter term in their manual to make the concept somehow more acceptable. But these “disorders” always morph into illnesses in application. ...

BACKGROUND On May 15, Peter Kinderman, PhD, of the University of Liverpool, posted an article on DxSummit.org. It was called So…What Happens Next? The gist of the article was that psychiatric “diagnoses” are conceptually spurious, unhelpful, and even hindersome in practice, and discourage practitioners from pursuing genuine explanations for the problems clients bring to their attention. It was an excellent piece, and I did a short post in which I recommended it strongly. ...

A NEW PARADIGM I’ve recently read an interesting article by Jacqui Dillon, Lucy Johnstone and Eleanor Longden. It’s titled Trauma, Dissociation, Attachment &Neuroscience: A new paradigm for understanding severe mental distress. The article was published in the Journal of Critical Psychology, Counselling and Psychotherapy (Vol 12, No 3, September 2012) Here are some quotes: "A new and profoundly important paradigm for understanding overwhelming emotional pain has emerged over the last few years, with the potential to change the way we conceptualise human suffering across the whole spectrum of mental health difficulties. It is a strongly evidence-based synthesis of findings from trauma studies, attachment theory and neuroscience, which offers new hope for recovery. It also presents a powerful challenge to biomedical model psychiatry in that it is based on scientific evidence that substantiates and attests to what many individuals with first-hand experience of mental health problems have always known –– that the bad things that happen to you can drive you mad." ...

The late George Albee, psychologist, never accepted the medical model of behavioral/emotional problems. He fought tirelessly for years to insulate psychology from the encroaching medicalization of its subject matter, and he died in 2006 believing that his efforts had failed. He authored more than 200 articles. As early as the 50’s and 60’s, he argued that social factors such as racism, poverty, and child abuse were largely responsible for the conditions known as mental illness. ...

I’ve recently come across an article by Ronald Pies MD on PsychCentral. It’s titled: Are the Puritans Behind the War on Antidepressants? Here’s the opening paragraph: "These are not good times for Prozac and its progeny. In the popular media, the use of antidepressants has been likened to swallowing 'expensive Tic-Tacs', while in professional journals, the effectiveness of these medications has been challenged, if not discounted. And even a casual Google search under the terms, “Antidepressants damage” turns up thousands of websites and articles claiming that these drugs cause brain damage, induce suicide, or lead to 'addiction.' Yikes!" ...

On May 27, David Brooks, a New York Times columnist, wrote a piece on psychiatry called Heroes of Uncertainty. It’s an interesting and somewhat contradictory article. Here are some quotes: "As the handbook’s [DSM-5] many critics have noted, psychiatrists use terms like 'mental disorder' and 'normal behavior,' but there is no agreement on what these concepts mean." "What psychiatrists call a disease is usually just a label for a group of symptoms." ...

On March 12 of this year, the Los Angeles Daily News ran an article by Susan Abram titled: Doctors report big pharma payouts for drug endorsements. It discusses the financial ties between physicians and drug companies in California. Here are some quotes: "In fact, hundreds of physicians, psychiatrists, and medical school faculty members across California are on the payroll of major drug companies, earning tens of thousands of dollars for speaking to other medical professionals at events held by industry leaders that make drugs such as Advair, Cymbalta, Viagra and Zoloft." ...

Thanks to Tommy Morrela on Twitter, I’ve become aware of The Wellbeing Foundation. They are located in Ireland. Here are some quotes from their About Us page. "To call human suffering a disease, something pathological, is deluded. The biological model of psychological distress has no basis in science; it takes away from the equation between 'healer', sufferer and society the need for understanding, compassion, healing, prevention and social and political change. The medicalisation of problems of living has to stop. We have a collective duty of care to bring about the destruction of psychiatry in its present form." ...

There’s an article in the current (May/June) issue of The National Psychologist called Compulsive pleasing is deceptive and dangerous. It’s written by Les Barbanell, EdD. (The National Psychologist is a newspaper-type publication for psychologists. It’s published in Ohio, in the US. Some of their material is posted online, but this article is not.) The article is about “the Caretaker Personality Disorder (CPD),” which apparently Dr. Barbanell invented in 2006 and has been promoting since. ...