Wednesday, October 19, 2016

Moral Reconation Therapy verses Mental Illness

Over several years, Moral Reconation Therapy ("MRT") has become a big business at Elgin Mental Health Center. Some people (clinicians or patients - the difference is minimal) like it, and some don't. But veteran administrators in Illinois' "forensic mental health system" must be aware that it presents a rather interesting, perhaps a rather dangerous, intellectual problem.

MRT situates the problem of criminal recidivism in dysfunctional behavioral choices and deficient moral reasoning. Psychiatry situates the problem of an NGRI acquittee's dangerousness in mental illness, a disease like any other, in the brain.


The MRT therapist at Elgin is basically telling patients that their problem is they lie, cheat, steal, betray, victimize and blame other people; and the fact that they are where they are (locked up in that fake "hospital") is their own fault entirely. 


At the same time, the psychiatrist is basically telling patients that it's only the mental illness that limits their ability to make behavioral choices or to reason morally; it's not their fault at all, they just need to take drugs to adjust their brains.

I have several clients who have failed or opted out of MRT because they cannot honestly reconcile the demand for acceptance of sole blame with the demand for acceptance of psychiatric doctrine on mental illness. They figure one idea or the other must be bullshit. But it sure is unacceptable to mention this discrepancy! 

The psychiatrists sure will tell the judges that any patient who questions the "illness needing medicine" view lacks insight and therefore remains dangerous. The MRT therapists sure will tell judges that any patient who blames their brain disease is being manipulative and therefore remains dangerous. The bottom line is, you have to lie, in the right way at the right time, or you can't ever get out.

This is the essential, overriding lesson of forensic mental health: You must become a really competent liar, to others, to society, and to yourself.

It's a terribly expensive lesson, in blood, treasure and human dignity.

Tuesday, October 4, 2016

What state psychiatrists can't think about, or read

Last week I attended a monthly staffing for a client at Elgin Mental Health Center, and I made it a point to bring copies of three recent articles for the psychiatrist in charge (I'll just call her Dr. R).

Dr. R has told her patient (my client) repeatedly that I (being her pro bono attorney for several years) am really bad for her, that she should watch out for me, that members of my church hurt people... just common, ordinary, vague, stupid negative generalizations like that...

But it occurred to me that I should give Dr. R a little more insight into what my influence on her patient really is, if I could. The three articles I brought were pieces I had sent to my client, who is a very bright woman with a law school education.  She's chronically bored with the "treatment" routine that is worse than useless for her, and she appreciates decent reading material.

I told my client that I would bet her, dollars to donuts, that Dr. R would never read the three articles. This seemed to me an easy prediction, partly because I'm not even sure whether Dr. R can really read anything. She's old and I've occasionally wondered whether she's a little way along toward dementia. But even more of a problem for her, the articles very effectively challenge an orthodoxy of psychiatry as "medical help" for mental-illness-as-brain-disease. This psychiatrist simply cannot afford to consider such a challenge. Given her life-long career wholly within a failing paradigm that will be indicted by history as an atrocity, the cognitive dissonance would surely overwhelm her emotionally.

Yesterday Dr. R admitted to my client that as I predicted, she did not read the articles. It's too bad.

The first article of three is "A Veteran's Letter to Congress" by Dave Cope, a former Navy Lieutenant. My client is also a veteran, and she had similar experiences to the author's with harmful effects of SSRI's. The reason Dr. R would never be able to deal with this is that Lt. Cope clearly states the truth: no physiological dysfunction of the brain has ever been found to be characteristic of any mental illness, and psychiatric drugs disrupt normal brain functioning.

Dr. R has spent her life putting people on psychiatric drugs and lying to them about what the drugs really do. She has deceived countless patients into submitting to iatrogenic mental and physical disability. She is a criminal against humanity; her career could be compared to Mengele's. She can't confront that.

The second article is "From neuroleptics to neuroscience and from Pavlov to psychotherapy: more than just 'the emperor's new treatments' for mental illnesses?" by two German psychologists who argue that psychiatric drugs just don't work, the orthodox concept of mental illness and treatment is deeply flawed, and psychiatry has altered the course of depression, anxiety, schizophrenia and ADHD for the worse.

Dr. R is a psychiatrist, perhaps in the habit of summarily dismissing views of mere psychologists (members of a decidedly junior profession from an MD's perspective). But these authors are respected scientists writing in a mainline publication. Again, there's no question that their article could seriously threaten Dr. R's fragile self esteem by tweaking her guilty conscience. No way she would ever read it!

The third article is a discussion by Bruce Levine, Ph.D., about whether psychiatry should most properly be considered fraud or bullshit. It points out that the pillars of the establishment have now invalidated the "chemical imbalance" theory and the DSM. He explains with subtle but tragic humor that most psychiatrists have never been truth seekers, and it hasn't been in their interest to know what is true or false.

This explanation fits Dr. R perfectly. But her problem would be that it's no excuse, it's an indictment. She cannot ever read this one, either. It's terrifying to be assaulted by the truth of one's own evil.

My client hates the forensic mental health system. But I suspect her doctor ultimately suffers, as the perpetrator, even more than her victims.

Monday, October 3, 2016

Failure in Illinois

Several clients at Elgin Mental Health Center are being transferred to other Illinois Department of Human Services facilities. This is necessary because the Illinois Department of Corrections has commandeered Elgin's Dix and Jenks clinical units for "treatment" of convicted felons.

In the reception area at Elgin there is a fancy bronze plaque which attempts to define for the public what is being done with their tax dollars. It insists, more or less, "This is a hospital where many come to find physical, mental and spiritual restoration and true recovery."

I've been in and out of this hospital on a weekly basis for longer than a majority of the employees there have been on the IDHS payroll. I've never met a "patient" at Elgin who does not recognize that despite what the plaque in the lobby says, he or she is really serving time. They may learn to think of themselves as "patients" (although "consumer" and "recipient of services" are probably preferred nomenclature). But they also almost invariably talk about the amount of time they've been given, as though psychiatric commitment were a criminal sentence.

Clinical staff at Elgin frequently stress the crime a patient committed, as well as the judicial process which has effective seniority over their curative endeavors. For these doctors judges decide when their patients may be released, even though these judges explicitly defer to doctors on what should be done with their criminal defendants.

In short, the supposed distinction between criminality and mental illness is problematic and getting more problematic every day, especially when Elgin Mental Health Center is becoming part-Department-of-Human-Services, part-Department-of-Corrections.

Elgin is a venerable, even an historic institution, built at the end of the 19th century with the inspired purpose to treat crazy people more humanely. Its forensic patients today are not considered culpable for any violent crimes they perpetrated -- they couldn't really help it, they weren't really responsible -- because their mental illness made them do it. The modern, rational thing to do is cure the disease-like-any-other mental illness, not punish the innocent, unfortunate, sick person.

Soon there will be a dramatic, literally glaring demonstration that this whole idea is bullshit, as described so ably by Bruce Levine, Ph.D..

Elgin Mental Health Center, the hospital that helps people, will soon sport two newly built gun shacks, guard towers with flood lights, and a ten-foot-high razor-wire fence. It's an easy bet that the general public will not recognize these additions as symbols of a benevolent healing enterprise. Rather, they'll be reminded that all mental patients are probably dangerous and all criminals are probably insane. Criminality and mental illness: same-same.

Society reacts, always has reacted, and always will react, essentially the same way to people we dislike and people we fear. It's just not a medical issue, unless medicine itself is punitive.

Modern psychiatry was a punitive dead end. We should dump it.

Tuesday, August 2, 2016

To Congresswoman Jan Schakowski of Illinois

Dear Rep. Schakowski,

I am disappointed, although not surprised, that you chose to vote in favor of the Murphy bill (HR2646). Rather than just reflexively/reactively vote and campaign against you because of my fundamental disagreement with that political choice, I will try to communicate the basis of my original opposition and continuing advocacy regarding issues of mental health. I must presume an amount of patience on your part that may be inconsistent with your practical and simple time constraints. However, I invest my own valuable time in dialogue, as well. Perhaps it can become worthwhile for both of us.

"Mental health" first of all means a medicalized view of human thought, emotion and behavior. We presume modern medicine can add value to our problem solving in these realms of life. We look back over the past century and a half at apparent miracles: control or eradication of horrible diseases like smallpox and polio, success with ever more complex surgical procedures, big increases in survival rates for blood and other cancers. Why should we not want and expect such miracles to improve our rationality itself, our capacity for joy, and our social comity?

Our mental health "system" is based on one other presumption: M.D. psychiatrists, Ph.D./Psy.D. psychologists, licensed nurses and clinical social workers, and various other mental health professionals have special knowledge due to their education and training, which enables them to help people in general with problems in thinking, feeling and behaving. Whether or not this constitutes curing disease, and whether the brain is the entire substrate and ultimate explanation of all things human, are fascinating philosophical discussions, but well beyond my point here.

I have spent fourteen years working full time, almost entirely pro bono, dead center in our mental health system. By nine o'clock this morning I'd already had two half-hour phone conversations with individuals adjudicated unfit to stand trial on violent felonies. I've been attending monthly staffings for patients at Elgin Mental Health Center since before most of the employees out there were hired. When I attend the annual American Psychiatric Association conference, I recommend specific classes and seminars to staff at EMHC, encouraging them to attend. People at APA ironically call me "Doctor".

You refer to our mental health system as something that can be improved. My experience says it needs to be essentially abolished. It is an error, an absolute wrong turn by civilization, and it will ruin us.

I hastily qualify this statement to mean... not that we shouldn't strive for rationality and reason, not that we shouldn't help people in distress, not that we shouldn't regulate and improve behavior. These are all universal human purposes. They are frustrated rather than aided by everything that has been built up over the last century to become our "mental health system". In my opinion, human thinking, emotion and behavior are not medical issues at all. But regardless of that. it is clear to me that my taxes are more than wasted on the salaries and pensions of mental health professionals.

The so-euphemistically-called "Assertive Community Treatment" of HR2646 is in fact coercive psychiatry Tim Murphy, Fuller Torrey,  t he Treatment Advocacy Center (or Torture Advocacy Center, a name more accurately aligned with United Nations human rights standards, which still abbreviates to T.A.C.), et al, promote a cynical statistic of fewer people jailed. But I can refer you to a whole lineup of real individuals in Illinois who would prefer to be in an honest prison compared to the much more dehumanizing circumstances of state psychiatric control.

The only conceivable way a "treatment policy" could save public money and human lives over a "jail policy" is if treatment actually worked. It does not, and that is an increasingly recognized fact. The APA's "antipsychiatry" bogeyman and their "stigma" justification cannot obscure admissions by such as Thomas Insel, M.D., recent Director of the National Institute of Mental Health (in sum: psychiatric diagnosis is invalid, psychiatric drugs do not work). If you are not familiar with the emerging consensus in this field, you should ask yourself why.

Coercion and force inevitably bring covert resistance and violent revolt. Only education, in the sense of imparting real knowledge and practical skill, will open the door to collaboration and social order. The psychiatric views of Murphy, Torrey and T.A.C. presume that honest education is not possible and coercion is thus necessary to deal with a certain class of "disordered" individuals -- defined only by Murphy, Torrey and T.A.C. without reference to objective scientific evidence. They degrade medicine and the law, catastrophically. I see this every day in courts and mental "hospitals". 

I would be more than happy to provide you with more specific arguments or counter-arguments, and any quantity of   anecdotal or controlled scientific  evidence, in connection with any statement I have made in this email. I only hope you may have some interest going forward.

I'll only conclude with a simple and specific, if apparently radical agenda, for you to easily recall my advocacy. 

1.) Outlaw all forms of involuntary "hospitalization" for mental disorder. (We already have prosecution and imprisonment; the distinction is fraudulent.)

2.) Abolish forced mental "treatment". (We already have police action and criminal punishment; the distinction is frivolous.)

That's all. If these two political targets were accomplished, any complex considerations about mental health systems would resolve. What the APA protests as "antipsychiatry" would disappear. (Perhaps psychiatry would as well, perhaps not, no matter.) "Stigma" of mental illness would disappear. People would be free to honestly help each other, and our dignity as human beings would no longer be under such withering assault.

Yours very truly,


Randy Kretchmar
Constituent

Saturday, May 21, 2016

Psychiatric "diagnosis"

It has been almost five years since Allen Frances started criticizing the DSM, several years since Ron Pies admitted that no psychiatrist who knows anything should ever talk about "chemical imbalances in the brain", and almost exactly three years since Thomas Insel disavowed the whole system of mental health "diagnosis" as lacking scientific validity.

This week another stellar authority came out as -- exaggerating just a bit, I suppose -- an effective antipsychiatrist.  Stephen M. Stahl made a presentation at the APA's annual conference in Atlanta, in which he stated categorically, "Our psychiatric diagnoses are not diseases." He also informed his audience, "There is no known gene for any major psychiatric disorder, nor is one ever likely to be found. Genes do not code for psychiatric disorders. Genes do not code for psychiatric symptoms."

Dr. Stahl is, of course, the author of Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. In its third or fourth edition by now, the book is absolutely the authoritative text on why it makes sense to "treat" human problems in thinking, feeling and behavior with medicine. We may wonder whether when he points out that there are actually no diseases being "treated", Stahl triggers all kinds of cognitive dissonance and problematic consequences for most of the people who buy his book.

I recently cross examined a psychologist who works for the Criminal Division of the Circuit Court of Cook County, Illinois, who insisted under oath that mental illnesses are in fact brain diseases. State-employed clinicians routinely tell my clients that they need more "insight into their illnesses" (by which is meant, the patient must accept and profess true faith in the "diagnosis" of "schizophrenia"/"bipolar"/whatever, as a lifelong genetically-caused brain disease that he or she "has"), or else they will never be eligible for release from Elgin Mental Health Center.

It is very difficult to understand how state psychiatrists get away with lying and misrepresenting their own field and their own activities as a matter of course, to the extent that they do. It seems to me they will have to start talking about things differently, especially when under oath. There is no rational scientific or ethical excuse for deceiving the public into a false belief that state psychiatric "hospitals" successfully medicate anyone to be better behaved or less dangerous. They restrain people and disable them, but they don't help.

On the other hand, I had an amazing conversation with a state psychiatrist about "diagnosis" just the other day, prompted by my discussion of Stahl's presentation in Atlanta. According to this doctor, who is not originally from a Western culture, there are only two or three valid psychiatric "diagnoses". The first is "disconnected from reality". The second is "too connected to reality". A possible third might be something like, "eccentric manufactured reality", as with a person who is hallucinating on street drugs, or perhaps a truly strange or antisocial personality.

The category of "too connected to reality" is brilliant, and it probably needed a non-Western mind to describe. In Anglo-American culture, we figure "reality" is our benevolent anchor, which we can reasonably hope to shape according to our own purposes. In India however, "reality" is draconian, crushing, absolutely merciless. Of course, depression, anxiety, etc., are a matter of being too connected! One has to separate somewhat from oppressive circumstances to find peace.

My friend also specified -- and by the way, I almost find myself looking over my shoulder, wondering who might have me in a pillory for calling a psychiatrist my friend! -- a critical principle: no matter what diagnosis is assigned to a patient, it becomes appropriate or necessary to treat somebody if and only if they are socially or occupationally disabled by their mental illness. That means that when they get along well enough in their own community with other people, just leave them alone. It doesn't matter how bad their "mental illness" might seem to some professional.

This view is that psychiatrists actually treat conditions existing in the relationships between people and society, not illnesses confined to individual bodies (or brains). That seems honest enough to me.

I just think, still... they do a terrible job and ought to be fired.


Sunday, May 8, 2016

It has to be on purpose

Last week on Thursday, May 5, 2016, at about 10:30 AM, a patient at Elgin Mental Health Center was told by staff that the best way to get permission to have an MP-3 player would be to go to court and sue the state for that privilege. Supposedly, "No MP-3 players allowed" is policy.

But... the same patient has had an MP-3 player before at Elgin Mental Health Center. That was on a different clinical unit, so maybe the "policy" isn't facility-wide. Maybe it's just "policy" for the unit this patient is on now. Or maybe it's a new "policy". Of course, any policy that is real is written. People often say ""It's policy," when the truth is, it's arbitrary retribution or the decision of one person about one other person or one situation in one moment.


Of course, written policy, officially adopted pursuant to administrative codes and statutes by a state agency, if it were unjust or unnecessarily in violation of rights, would call for litigation. One goes to court to deal with such official conflicts. But civil litigation is expensive, and almost any predictable conflict can be resolved by cheaper means. When it comes to states, here are many developed avenues for conflict resolution. This is because states don't want to spend taxpayer money unnecessarily.


A recent Federal Appeals Court decision highlights this situation in Illinois. In Hughes v. Scott, 2016 U.S. App. LEXIS 5349, Richard Posner wrote the opinion overturning a lower court's dismissal of the plaintiff's claim that his First Amendment right to petition the government for redress of grievances had been violated by staff at an Illinois forensic psychiatric institution.


The defendant had argued, and the lower court had agreed, that Hughes' due process rights had not been abridged, because he was able to sue. It was substantially the same argument as that of the Elgin staff member on Thursday: if you want an MP-3 player on this clinical unit, go ahead and sue us for it!


Never mind that the only reason a state mental health employee ever says that is, it's a very easy presumption that the patient will not sue. Forensic psychiatric patients just about never have the resources to hire attorneys for every little complaint. Nobody wants to know or mess with what happens on a daily basis inside state mental hospitals, either. So, "Sue me," really, is kind of like just the common, "F___ you!"


Well, in the one case, Hughes did sue. In his opinion overturning the lower court's dismissal of that suit, Judge Posner wrote,



"(P)erhaps the most remarkable feature of this case is the defendants' insistence in defiance of the Illinois Administrative Code that Hughes has no need to invoke grievance procedures because he can always sue, as he has done. What makes this contention remarkable is the
fact that the interests of Rushville (the state institution), of the Illinois Department of Human Services, and of the taxpayers of this almost bankrupt state, obviously are best served if grievances are handled at the facility level rather than by the court system, which is far more costly. Does Rushville have an unlimited budget, so that it can pay lawyers to defend against lawsuits brought only because the institution refuses to obey the Administrative Code and respond to Hughes' grievances, preferring instead to ridicule him and drive him to sue Rushville staff?

"We don't get it. But we have said enough to require that the judgment of dismissal be vacated and the case returned to the district court to try to make sense of the conduct of the defendants and their institution, and to determine whether they are in fact improperly impeding the plaintiff's constitutional right to petition government for redress of grievances."


So, what do you know? The staff member who told a patient last week to sue for an MP-3 player was glibly, arrogantly, refusing to respond a grievance. Clearly the interests of Elgin Mental Health Center, the Illinois Department of Human Services, and the taxpayers of this almost bankrupt state, are remarkably contrary to what this staff member did, exactly as in the Hughes v. Scott case.


Perhaps we will see whether this was a violation of the patient's constitutional rights.


Thursday, April 28, 2016

A Quick Correction

A client whom I have represented at Elgin Mental Health Center ("Louanne") for several years is often told by her so-called "treatment team" (AKA tormenters) that I will only represent her until her money runs out, that I will run in the other direction when that day comes, that I am using her and that she is to be pitied because of that, that I don't have her best interests at heart, etc., etc., etc..

Well... I wish Louanne had any money. I actually don't think she has ever paid me a dime, although she may have offered to do so, in some small amount, at one time or another. I've always figured that if I'm ever to be personally compensated for the work I do, the payment will have to come from the state when I win some big case against them.

As I stated when I first started this blog some years ago, I became an attorney late in life in order to advocate for the universal human right to refuse psychiatry. Since that time, it has occasionally occurred to me that maybe I should get paid by clients. But given the nature of the work, that rarely happens. I'll have to permanently scavenge off the enemy's land, like Uncle Billy Sherman learned how to do, in his greatest innovation of military strategy.

To be misunderstood by the other side is an advantage in a conflict. But to achieve purposes without expensive battle it is necessary to change minds on the other side, and that is the only necessity. Changing minds requires communication, which is always disrupted to some degree by misunderstanding.

I will represent Louanne until her right to refuse psychiatry is secure and unquestioned. I don't give a shit about her money. She knows that pretty well. Her tormenters should know it, too.