Frequent Obs

In a couple hours, I will attend a virtual staffing for a “patient” (AKA psychiatric slave) at Illinois’ most renowned psychiatric “hospital” (AKA plantation), Elgin Mental Health Center. This particular client does not take psychotropic drugs. He can be a tedious person to deal with, because he has an eye for detail and a habit of insisting that everyone else should be as avidly interested as he is, in the huge volume of details that he points out at random moments.

This guy is not delusional or psychotic. He’s quite bright, and the clinicians who run the unit he’s enslaved on admit knowing that he’s “high functioning”. In fact they apparently see him as so high functioning that he ought to take over some of their responsibilities.... There’s a “low functioning” slave on the same unit who constantly insults and threatens my client, and others. The staff (AKA overseers) do not often bother to control this behavior. My client was recently told he should be able to deal with it without help.

The problem is, of course, that the ways he could deal with it all get him in trouble. E.g., when the other patient says he is going to slit my client’s throat, my client could: 1) return the threat and end up in a fight, 2) retreat to his room, or 3) incessantly complain to staff. 

Option 1) would make my client “dangerous to self or others” and justify further, more severe enslavement. Option 2) would make him anti-social or “depressed” and justify further, more severe enslavement. Option 3) would make him “paranoid” or “delusional” or “anxious” and justify further, more severe enslavement.

The further, more severe enslavement that the overseers would like to justify consists first and foremost of psychiatric drugs. 

Secondarily, there’s something called “frequent obs” (meaning frequent observation). Clinicians on the unit are told to keep a very close eye on a particular slave and document their observations at fifteen-minute intervals. The slave is concurrently also denied certain property and privileges. This is all arranged to provide “safety”.

It’s nonsense in this case, a mere cover for provocation and retribution. This client has been on “frequent obs” or the even more severe “one-to-one” restriction for at least two months. The overseers don’t like it when he points out that they are failing to control the behavior of the “low functioning patient”. And the masters certainly don’t like it when any slave recovers from mental illness without agreeing to take their drugs for life.

The purpose of “frequent obs” here is to test my client, to see how long they can punish him for his undrugged recovery and his advocacy for his own and others’ rights. They hope his patience and steadfastness will fail, so they can say, “See, mental illness!”

It’s an ugly, cynical business.

Principles of an anti-psychiatry legal practice

Following are eight of the most important things I know and have learned from twenty years as an attorney, working exclusively to help individuals who would like to refuse psychiatry if they were only allowed to do so. These points are the general principles in the absence of which I would never have developed practical and tactical knowledge, which a friend of mine recently suggested could be of interest for purposes of a lawyers’ webinar she may host. But without at least a tentative understanding or conditional acceptance of the general principles, I suspect there would be limited value in suggesting specific tactics or trying to pass on my own peculiar experience with cases.

1.) State psychiatric hospitals and state employees HATE dealing with private attorneys who represent non-compliant patients. They will lie, cheat & steal to avoid this. One reason is, they may have to request their own legal representation from their state attorney general’s office, and that probably goes against their bosses’ budget at hourly rates. Another reason is, if they end up under oath in deposition or court testimony, their previous lying, cheating & stealing (or their bosses’ lying, cheating and stealing) may be discovered. 

2.) Public defenders usually (not always) HATE having to represent non-compliant mental patients. They believe in the system, or can’t be bothered to think outside the box. 

3.) Involuntary mental patients almost never have money to pay private attorneys, so they end up with public defenders or other public (similarly state-paid & state-obligated) advocates. 

4.) Adding up #1-3 above, it’s pretty obvious why the forensic psychiatric bureaucracy seems so omnipotent.

5.) But an important aspect of this scene is that the courts (judges) essentially abdicate their own responsibility to provide justice in many cases to psychiatrists, like the churches (clergy) abdicate their responsibility to provide moral leadership of people they can’t understand to psychiatrists. The one thing everyone is even more afraid of than viruses (which we suddenly know all too much about) is insanity. No one can  think about it or look at it, and so they are all fully dependent upon “experts” to think and look for them. 

6.) Ultimately, the only way an involuntary psychiatric patient attains freedom is by first realizing that they MUST change one person’s mind at a time by rational communication and truth alone, not by threats or lies. Even threats of legal action should absolutely be a last resort. (And I say that as an attorney for involuntary psychiatric patients!)

7.) The vast majority of mental health professionals of whatever stripe are well-intended people. They originally got into their business to help others. Then they got trapped by the lies that they didn’t invent.

8.) Notwithstanding #7 above, there are a very small minority of mental health professionals who are, or who have become for all practical purposes, irredeemably evil. Correctly identifying these few “true bad guys” is the single most valuable effort, for anyone who would fight the system.

Racism, Prejudice, Discrimination: Why Differences Are Important To Me

I have a very good friend who believes (as best I can tell) that I am racist, that she herself is racist, and that basically everyone is racist. I really don’t think so, but when I try to persuade her, she quickly retreats behind a knowing smile and a refusal to discuss it because “It’s no use, I’ll never change your mind and you’ll never change mine.”

It kind of discourages me, not so much because I dislike being called a racist; I know what my friend means, but what I dislike is what seems to me to be a misunderstanding on a very important subject, and my friend’s refusal to help resolve it. Either she doesn’t care, or I’m too damn mean when I argue.

I do not believe that my own race is superior, or even different in any significant way. I likewise do not believe that any race is inferior or different. As a matter of fact, the concept of race itself seems very impractical to me: certainly worthless for any scientific purpose, a vague and incoherent category.

There was a time in Western history when people did believe race was an important biological division of the human species, but almost no one with the slightest modicum of education thinks that now. My grandparents thought African Americans were constitutionally different from white people, less intelligent, more animalistic, uglier. But their generation’s belief in race was not a product of poor education, it was a product of elaborate miseducation.

Racism itself, apart from its implications, apart from the myriad social and political actions and effects that it causes, necessarily involves or refers to conscious belief, however complex or confused, in objective (probably biologically determined) distinctions between categories of human beings. E.g., skin color is said to be “white” or “black”. These dubious distinctions then have or are considered to have interpersonal, social and political implications.

If a white person feels uncomfortable sitting next to an African American on a bus, or doesn’t want to hire or let her children marry African Americans, that is an interpersonal or social effect. It may be caused by racism; but it may also be prejudice caused by insular experience or mistake. 

I can freely confess, as I think most honest people should, to various types of prejudice. I am prejudiced to some degree against non-English speaking people, people who favor drugs other than caffeine and alcohol, Californians, Southern Evangelicals and WASP elites, psychiatrists, and people who smell like food that I don’t eat. 

It’s  hard for me to be prejudiced against other races, per se, because I don’t know exactly what “other races” are. As a child I thought I knew, because I was miseducated. However, my miseducation was not elaborate enough to prevent me from noticing, when I actually met Jewish kids and black kids, that they were not significantly different from me because of anything called “race”.

I really prefer to hang out with people I know, people with whom I have more in common. We all do. But that’s not racism. It might be prejudice. There’s a big difference. Racism is a cause, prejudice is a possible effect of racism, and/or other causes. If you can’t see the difference, you will probably believe everyone is racist because everyone has some prejudices. But any particular prejudice, even the prejudice of a “white” person against a “black” person, may not be caused by actual racism at all.

Belief in race is very similar to belief in mental illness. Both concepts are mistaken, and products of elaborate miseducation. Importantly, both usually cause discrimination. Many types of discrimination, including employment and housing discrimination by race, and treatment or insurance discrimination against mental illness, are illegal or otherwise socially proscribed. 

I believe all discrimination based on erroneous concepts (e.g., “race” and “mental illness”) should be discouraged. But society cannot easily tell people what to believe and how to feel. Attempts to do that are propaganda, persuasion, public relations. It is more decisive to tell people what to do or not do. That’s law. The useful target is behavior, not belief or feelings. 

The present-day cult of confession of universal “racism” (maybe not quite universal, but certainly universal among all white people who don’t confess) is a serious impediment to understanding. Racism needs to be identified for what it actually is before it can be prevented from causing discrimination, volatile hatred, social conflict, violence, war. What it actually is, is the theory or conceptual error of defining a human individual by his or her biological, animal body.

Psychiatry does the same thing. Throughout its history, racism was endemic to it; psychiatrists actually led the way in developing the legal justifications and the methods of the Holocaust. Unwillingness to know about these things, and reluctance to learn more about them by discussing them with others, upsets me, in no small part because my children and grandchildren are Jewish.

We cannot be successful (and we shouldn’t want to try) teaching our children that it’s wrong to favor their own family, their own school, their own group. Prejudice and loyalty cannot be outlawed. There are few interesting games without opponents. But many forms of discrimination can and must be outlawed. Racial injustice and psychiatry are two peas in that pod.

Corcoran, Malis, Hussain, and Sobut: The Great Failure

Barton Swaim recently wrote in the Wall Street Journal that, “The great theme of the Trump years, the one historians will note a century from now, was the failure of America’s expert class. The people who were supposed to know what they were talking about, didn’t.”

Swaim gives several examples, all of which are sharply political at this moment in time. Regardless of those particulars, and our current American ultra-emotional divisiveness aside, I think the fundamental prediction is absolutely, over-the-top-brilliant, and correct. (It is a prediction about the notations of historians a century into the future, so my bet about it is admittedly cheap. I’ll only pay or collect if I’m around in a hundred years....)

According to my neighbors and even my own family, I have two serious social failings, summarized under hate and fear: I don’t hate Trump enough, and I don’t fear Covid enough. I’m absolutely not bringing up Swaim’s opinion piece here to inspire any such continuing arguments.

Years ago I wrote about the dangers from catastrophic failures of confidence in authority, and how psychiatry contributes to that risk, as a “sub-prime crisis waiting to happen.” The “experts” who have failed more than any others are those in the mental health field! They are in a class by themselves, both because no other experts really have direct legal powers to force other people to comply with their prescriptions and believe in their opinions, and because their record of failure is far more sustained. When media pollsters or WHO and CDC advisors give advice, they at least have to rely on political leaders or government agencies to enforce it.

The epidemiology of illiteracy, substance abuse, family dysfunction, criminality, racism, mental disorder, depression and anxiety, shows a much longer record of failure than just the last couple of election cycles. It goes back more than half a century. These are problems to which our supposed mental health expert class should have attended with some success, if their vaunted brain science and behavioral knowledge had been real. The government-supported guild of forensic psychiatrists, psychologists and other assorted “professionals” has only tried, more and more desperately, to convince the public that they know what they’re talking about. They don’t.

James Corcoran, Richard Malis, Syed Hussain and Robert Sobut receive their salaries and benefits and pensions from the pockets of taxpayers. It’s a ripoff. These guys do and produce NOTHING in exchange, except dehumanization of individuals in their custody or their employ. They only create profound animosity and cynicism, and ruinous disability.

We pay them for that! We should stop, and we should collect restitution.

Open letter (email) to Tomislav Mihaljevic, MD, CEO of Cleveland Clinic

 Dear Sir,

I recently read a blog article which unabashedly promoted old misinformation about depression. Unfortunately, Cleveland Clinic appears to be implicated in this. 

The article itself can be seen at:

https://www.verywellhealth.com/what-is-clinical-depression-5092915

Author Sherry Christianson makes the statement that, 

“...clinical depression is a set of signs and symptoms that may add up to a chemical imbalance in the brain. This chemical imbalance is thought to be the underlying cause of clinical depression.”

As I believe you would know, the chemical imbalance “theory” of depression was rather officially disavowed, ten years ago. A recent article about the circumstances and implications is:

https://www.psychologytoday.com/us/blog/holistic-therapy/202009/questioning-the-chemical-imbalance-theory?amp

and the original disavowal (by no less than the editor, at that time, of Psychiatric Times) is at:

https://www.psychiatrictimes.com/view/psychiatrys-new-brain-mind-and-legend-chemical-imbalance

Since 2011, there has been voluminous discussion in public media, and increasing controversy about motives for the continued credulity and frequent mentions of this discredited idea — that “depression” (possibly meaning various indeterminate things) is a chemical imbalance that needs to be corrected in many people with drugs or electroshock. 

When I noticed that the website verywellhealth.com maintains a “proud partnership with Cleveland Clinic” it occurred to me that your institution is also promoting, perhaps inadvertently, the old urban legend. 

I would prefer not to believe that. Modern medicine confronts too many cynics these days, when we are fighting a world-wide pandemic, and we need to trust science. 

I would appreciate any clarification about this that you are willing to offer! My intention is only for broader understanding of the truth.

Yours truly,

S. Randolph Kretchmar

The Law Offices of Kretchmar & Cecala, P.C.

Wilmette, IL

847-370-5410 (mobile)

Does venerable Cleveland Clinic promote the old urban legend?

Yesterday Bob Fiddaman noted on Twitter another recent article, unabashedly promoting the infamous falsehood about depression being caused by a chemical imbalance in the brain. Bob has provided a critically important and very valuable service by “outing” idiots and charlatans who continue to push the all-too popular theory, which was disclaimed a decade ago by none other than the editor of Psychiatric Times as nothing more than an urban legend.

The article currently at issue was authored by Sherry Christianson, “a medical writer with a healthcare background” who “has worked in a hospital setting and collaborated on Alzheimer’s research,” appeared on the website verywellhealth.com, on 12/21/2020.

One has to wonder how any qualified professional medical writer could make this error or forward this bullshit. One must also question why the fact-checkers, medical review board and senior management team at "an award-winning online resource for reliable, understandable, and up-to-date health information" would allow any writer to assert admitted bullshit on its website.

The plot thickens, when we notice that verywellhealth.com is “a proud partner of The Cleveland Clinic, the #2 rated hospital in the U.S.”

I emailed the website this morning, as follows:

TO: feedback@verywell.com

Sent: 01/05/2020, at 8:53 AM

RE: What Is Clinical Depression?

Dear Sir/Madam,

Sherry Christianson’s article of 12/21/2020 on your website, contains this statement:

“Clinical depression is a set of signs and symptoms that may add up to a chemical imbalance in the brain. This chemical imbalance is thought to be the underlying cause of clinical depression."

Ms. Christianson should know better, and verywellhealth.com should never have allowed this statement to appear on its website. 

The first of the two sentences is technically true only with its prospective, MAY add up to.... Of course, the cited “signs and symptoms” MAY also add up to various other things instead, e.g., a meningioma, cancer, recent bereavement causing loneliness, or unemployment leading to probable poverty. Or those “signs and symptoms” MAY add up to nothing with any more specific name than “life”. 

The second of the two sentences is inaccurate without an additional clause to modify or ascribe “thought to be” such as, “...by uninformed laypeople whose opinions are affected from deceptive marketing.”

The “chemical imbalance in the brain” meme has no connection whatsoever to scientific or clinical medicine. This should not be news to you. 

No less an authority than Ronald Pies, MD, author of the world’s leading textbook on psychopharmacology, exposed the “chemical imbalance” meme some years ago as an urban legend, not any credible theory in psychiatry. (See, https://www.psychologytoday.com/us/blog/holistic-therapy/202009/questioning-the-chemical-imbalance-theory?amp, and Dr. Pies’ original statement in 2011, https://www.psychiatrictimes.com/view/psychiatrys-new-brain-mind-and-legend-chemical-imbalance.)

Hence, verywellhealth.com has opened itself up to charges of deceptively misinforming the public, and even health care fraud. In the least, the referenced Christianson article is utterly inconsistent with any purpose such as you claim, for helping “more than 30 million people each month to feel better and be healthier.”

In fact, promoting a long discredited urban legend about depression makes you, and by association even such a top-ranked institution as Cleveland Clinic, look ridiculous.

Yours truly,

S. Randolph Kretchmar

Attorney, Wilmette, IL

847-370-5410 (mobile)

The injustice of forensic psychiatry: one case

 For several years a client of mine at Elgin Mental Health Center refused all psychotropic medication.This was a guy who’d been found NGRI on a fairly minor criminal charge. If he’d plead guilty and served his sentence, he certainly would have been out long before now. As it is, he’ll probably serve the maximum sentence he could have received, but in the nuthouse instead of prison, which is worse. 

I’m sure at the time of his criminal proceeding, Jack (not his real name) was terrified of prison and thought being “treated” at a “hospital” would be an easier sentence. He told me today that they have never helped him in any way, they’ve only tormented him, disrespected him, lied to him, and discriminated against him (he believes for being white: I think it’s for not getting better with so-called “medicine”).

Jack’s psychiatrist is Vikramjit Gill, MD, whom I have written both good and bad things about, several times in this blog. Dr. Gill was absolutely certain that one psychiatric drug or another would help Jack and enable him to get out of EMHC sooner. He was so certain that he made a rather unconditional promise: if Jack didn’t like the drugs and wanted to stop taking them, that would be fine.

Well, if Jack’s statement to me today is any indication, he doesn’t see any purpose in taking the drugs. Unless it is that he still believes, despite evidence, that Dr. Gill will get him out of EMHC quickly if he doesn’t refuse. But the drugs may now be having the opposite effect from what Dr. Gill had hoped. Jack is no longer as anxious and withdrawn as he once was. Instead, he’s aggressive.

If I had to predict, I would say, of course Dr. Gill will change the drugs or increase the drugs or add other drugs. He gave up long ago on helping Jack with anything but drugs, and he probably never knew how to do anything else to begin with, or never believed anything else could be done. The only thing Dr. Gill uses communication with other human beings (especially patients) for, is talking them into taking drugs. Dr. Gill’s boss, James Patrick Corcoran, has testified under oath that he doesn’t believe Dr. Gill is particularly competent in forensic psychiatry. Dr. Gill is probably only still employed at EMHC because they can’t get anyone better, so they can’t fire him.

The thing about forensic psychiatry is, it’s not a helping profession. EMHC is a plantation, not a hospital. Dr. Corcoran is a slavemaster, not a doctor, who doesn’t ask or expect overseers like Gill to help anyone, but only to control the owned human beings in such a manner as will not look bad to the taxpayers. The taxpayers think forensic psychiatry is about justice, but it’s the ultimate injustice. Jack is a representative case.