Monday, December 5, 2011
Wednesday, August 31, 2011
I know it's politically correct to believe in alcoholism as a disease. Mental illness is also, of course, a disease or a bunch of diseases. One "develops" such diseases just like cancer or the measles.
That's how we're supposed to think, otherwise we might tend to blame somebody instead of curing them. God forbid any one of us should ever impose any idiosyncratic morality on anyone else, or judge anyone on any standard which is not explicitly and expertly medical....
And of course, modern medicine could eventually cure every human problem if we mere mortals will just pay enough taxes, and subordinate our inferior lay judgment for those superior understandings of the proclaimed experts about what's best for us.
On the other hand, maybe not.
Another article, this one in the Chicago SunTimes on the same day, features psychologist E. Scott Geller of Virginia Tech's Center for Applied Behavioral Systems. Geller's research doesn't seem to show that kids just inadvertantly catch the disease of drinking too much. His conclusion is more like, well, they get drunk on purpose because they like it.
Education toward "alcohol awareness" has proven useless in efforts over thirty years. When researchers took breathalyzers to college parties and bars to show students their blood alcohol content, it actually encouraged them to drink more.
What a surprise. But perhaps only to those who delude themselves with this fantasy of medical cures for any and all socially problematic or disagreeable behavior.
The rest of us know stupid and bad when we see it, not to mention free and responsible. We resort to time-honored moral constraints like blame, shame and regret, which actually work better than psychiatry.
Friday, August 26, 2011
History tells us that empires occasionally crumble overnight. My favorite example is the Aztecs. In 1519 the wealth and power of Tenochtitlan was literally beyond European imagining. Only two years later Hernan Cortez had not just taken Montezuma's throne, he had wiped out the Aztec religion and obliterated their whole society.
And who would doubt that things change faster today than they did in the sixteenth century?
Robert Whitacher loses hope against the wealth and power he sees lined up with the forces of the psychiatric empire. I've heard similar pessimism from no less than Thomas Szasz.
But that power is spread very thin. Subject peoples are bitter and impatient, and our modern sun god - science - is no longer easily placated.
Sometime back in 1950's America the idea arose: We've got some really bad people who do terrible things, but with modern medicine and the atomic bomb and so on, maybe instead of just punishing them we can fix their brains! Then we'll all be good people, no more bad people.
Everybody believed in modern medicine and feared the atomic bomb, so biopsychiatry was an easy sell.
But half a century later, nothing has happened. We have no improved definition of schizophrenia, let alone an objective diagnostic test or cure. The latest drugs are still no better than simple exercise, or a placebo. It requires the idiosyncratic charisma of a snake charmer like Patrick McGorry to inspire government budgets for mental health, and the twisted talent of an old adman like D.J. Jaffe to propagandize the crowds into "seeing" the emperor's new clothes.
In the last decade or two, basic genetic and biological research has made it more and more obvious that there will never be a simple cure for any "mental illness" - partly because we don't even know what we're talking about when we use that term. The disease model applies no better here than it does to poverty, or war. We are not improving human behavior medically. The naive, 50's-America optimism was evidently a delusion for psychiatry and its true believers.
But true believers must defend the faith, no matter how desperately. Enter "psychosis risk" and "prodromes" calling for "early intervention".
My friends at CCHR and elsewhere think these ideas are marketing schemes contrived by pharmaceutical companies. I rather see them as desperate, last-ditch, hail-Mary rationalizations for a doomed paradigm.
I can imagine old guys like Nate Kline and Freddy Goodwin (and let's add Bennie Rush into the mix, too) on the golf course or sitting around a coffee table with Pat McGorry, wondering what the hell's wrong. "It's too complicated, after fifty years and all the money we ever wanted, there's still no cure?!?! We can't just fail, guys. We can't let Pasteur and Salk be the last heros. Maybe if we start treating kids real early, these drugs will do something. Maybe the disease gets smart enough to hide, or fool us, unless we go after it when it's just getting started, even before anything's wrong... Let's just test 'em all and treat 'em, then we'll finally figure it out, and we'll finally create our super... uh, better... man."
But oops! Paddy (he's Irish, rght?) McGorry flat-out abandoned the plan just the other day. His renunciation of "psychosis risk" for DSM-5 purposes presents the sudden possibility that biopsychiatry is really coming to the end of its road. Not even Allen Frances, who has taken the early interventionists to task more than any other establishment figure, really seems to appreciate this.
These guys are all still dragging human sacrifices up the mountain. But the empire may be gone forever.
Saturday, June 11, 2011
Tuesday, May 31, 2011
The Chicago Sun-Times editorializes today on a proposal to encourage questions from jurors in civil trials. Unfortunately, the article perpetuates a critical misunderstanding of our system of law.
The purpose of trials under our English system is not entirely to get at the truth, at least not by any human means. We presume, with humility perhaps tragically lacking under the alternative Napoleonic system, that ultimate Truth may remain beyond mortal ken. When our conflicts go to court, we do what we're actually capable of doing as imperfect beings: we fight it out. Trials are adversarial rituals intended to ensure that even where there must be a winner and a loser, as few bystanders as possible should be hurt by the process of decision.
Carefully limiting violent conflict is a far more practical human purpose than establishing any Secure Reign of Exalted Truth. From the Inquisition, to the black gate and hot mushroom cloud of 1945, we have history's lessons against arrogance. Incidentally, jury service is often a brilliant exercise in this precise social reality!
So, in a much darker way, is any work which gets a person up-close-and-personal with state psychiatry. Mental health systems function on an inquisitorial model. The "doctor" (psychiatrist) knows The Truth - whether a person's chosen behavior is a symptom of disease, what label a person deserves, and what should be done about bad behavior (e.g., forced drugging). Courts abdicate their traditional role of decision in favor of this Medical Truth. A disparaging remark maliciously scrawled in a chart by a medicalized prison guard ("Security Therapy Aide") becomes a scientific fact in court!
Psychiatry degrades both medicine and the law. Psychiatry kills civilized humanity.
Sunday, May 29, 2011
Friday, May 27, 2011
Maybe he wasn't too good at "cheeking" the meds. I don't know. But somebody at Elgin suspected him, and they put him on crushed meds mixed in his food. He still managed to not take all his meds somehow. (I never wanted to know his particular technique or slight-of-hand, that would ruin the magic.) Right around this time he called me, because it wasn't easy.
Julio wanted me to convince his treatment team to put him back on the regular meds in pill form so he'd be able to cheek them more easily. I told him, well, I could do that maybe, but I really wanted him to come clean and refuse meds overtly. After a couple months he did that. Awhile later he was advising people that aliens were going to attack them spiritually, and the only way they could escape was to commit suicide. Of course, they sent him back to Chester.
Julio agreed to take some meds at Chester, and stopped talking about aliens and being Christ. The Chester psychs soon decided he was well enough to go back to Elgin. Thus the stage was set for an interesting meeting, which is my main story here....
Elgin, being a medium security facility, had to agree to take Julio back from Chester, which is a maximum security institution. So they all had a big video conference. The object was to figure out whether this patient was really better and could be trusted not to warn anyone about aliens or think he was Christ, in a setting which was not maximum security. It was sort of a parole hearing.
Julio was a smart man. He could put on a very professional face, with loads of intelligent confidence and agreeability. He admitted to everyone in the big video conference that he had "decompensated" and become delusional about the aliens and Christ and so on, at Elgin. He explained in great detail his own understanding of how that had occurred. He answered questions from various inquisitors readily as required. He really seemed like the kind of guy that any medium security nuthouse would be quite happy to have as a patient....
But his previous psychiatrist at Elgin was not buying it. She'd been fooled for months by this guy, when he'd told her he was taking his meds but it was a lie. Her only real job had been to prescribe the meds, manage the meds, evaluate how the meds were working. He had made her look very stupid, and she bore a grudge.
Everybody wanted to know Julio's attitude about meds. Why had he stopped taking them previously? How was he doing with them now? What was the dose? Did he understand that they helped him? Did he agree that he needed these meds to keep the delusions about aliens and Christ from coming back? (It was Abilify as I recall.... Nobody quite asked if he recognized that those delusions had been caused by an Abilify deficit in his brain, at least not in so many words. But they came pretty close.)
Then came key question from the Elgin psychiatrist: "If you're allowed to come back to Elgin, will you promise in advance to take whatever medication any doctor prescribes, and take it in crushed form, and take it in whatever dose your doctor thinks is right, and agree to change the dose or the medication whenever the doctor wants to?"
Julio had explained that the reason he had surreptitiously stopped taking meds was that he was afraid he'd be taken to court and forced to take them if he told anyone he just couldn't deal with the side effects anymore.
In one breath, all these "clinicians" insisted that the whole trick was collaboration. If Julio would just be open and honest with his treatment team, tell them his thoughts and his symptoms, etc., everything would work out well. This should be true. This is the theory of the forensic mental health system, and even the theory of mental health treatment in general, as it's presented to the public.
But in the other breath, the Elgin psychiatrist demonstrated exactly why it was impossible, why it's all a lie: "Promise in advance to take whatever meds your doctors tell you no matter what you think, or you'll never get out of Chester."
That's the way it still is in the state nuthouse system, and probably always will be.
"Take the meds we tell you to take no matter how bad you think they are, no matter how much they hurt you, or you'll never get out of here. Now admit that this is a hospital, and we're all collaborating to help you."
The terms Soviet psychiatry and psychiatric coercion are redundant. Voluntary psychiatry and psychiatric help are oxymorons.
George Orwell, how do you do!
Monday, April 25, 2011
Judges know that it is their job to actually punish criminals, not merely to rehabilitate them. Society has always demanded this. Part of the theory is very simple -- people don't like being punished, so if they have good certainty that they are likely to be punished for certain acts (murder, robbery), they will try to refrain from committing those acts and there will be less trouble in the world. The other part of it is just the old "eye-for-an-eye" deal. In any event, punishment for crime has a long and solid foundation in the experience of humanity.
At some point we started thinking punishment shouldn't be cruel and unusual, and that thought apparently merged over into an idea that we shouldn't punish anyone at all if we can avoid it. This probably isn't unnatural for people experiencing little or no crime over an extended period. They wonder if, after all, there aren't any real bad guys. Judges know better of course. But they often need to get elected or appear human and gentle at cocktail parties. When we're not starving or being shot, we all shy away from punishing others.
Psychiatrists offer this spectacular mirage: insanity is brain disease. Every crime appears to be an insane act to the society defining it as a crime. So perhaps punishment won't stop crime, but curing brain disease will. Once again, judges know better, deep down, but they get talked into this, by certain oh-so-nice people around them.
Well, if it were true and it worked, we'd all be less worried about crime and insanity these days. Witness the whole Loughner affair, it seems to me the opposite is the case.
Courts feel moral pressure from opposite directions. A motive to be civilized, medical-scientific and social wherever possible tends toward confidence in psychiatric expertise. Fear of punishing wrongfully makes it very difficult to admit what psychiatric treatments really do to people.
Most of my clients would have preferred sentences to prison over commitments to psych institutions. Their "hospitalizations" were honestly experienced as nightmares of torture, not least because everyone pretended to be helping them. In prison at least the deal is honest.
Ironically, judges punish most wrongly by trying not to punish.
Convincing a murderer to lie (they all know it's a lie) ... that the reason for the crime was not actually his or hers, or in fact any reason at all, but merely a concatenation of neurotransmitters and receptors that can only ever be understood or managed by The Doctor ... is true dehumanization, the worst kind of torture. (And the drugs are no picnic either.)
This is why courts finding defendants NGRI remain ever after touchy about definitions of mental treatment. It has to be medical. The defendant had to be insane, and his or her insanity had to be a real brain disease.
Otherwise, the judge obstructed human justice and handed out perverted, cruel punishment from mere cowardice and error.
Criminal judges simply cannot afford to understand psychiatry from any point of view other than the top levels of utmost faith.
Friday, April 22, 2011
Psychiatry is a medical specialty which cures "mental illnesses" which are in fact diseases of the brain.
Pschiatry is the study, diagnosis and treatment of mental disorders, which include various affective, behavioral, cognitive and perceptual disorders.
Psychiatry is the medical treatment of socially problematic or dangerous human deviance.
Psychiatry is social control by various means and technologies traditionally considered to be medical, backed up by the coercive power of the state.
Psychiatry is the attempted, usually temporary and wildly unpredictable, iatrogenic disabling of unwanted behavior, whereby one more powerful person imposes "treatment" upon another weaker person; this is justified by medical metaphor.
Psychiatry is the forcible violation of personhood, and an attempt to destroy all concept of individual responsibility.
Friday, January 21, 2011
To begin with we might ask ... WHY should we speak up when our friends, relatives, or neighbors seem troubled or unstable? Is it our intention to help the person, or to protect society?
Everyone would love to say both, of course, but that's worse than naive. The Trib editorial ignores or obscures the fact that these purposes often do not align at all. Why don't we just put angry, eccentric, and unpleasant people in concentration camps and fine-tune their brain chemistry until they are happier and fully social?
Could it be that we think everyone has certain human rights which we don't really like to take away? Like ... rights to refuse unwanted medical treatment, to be at liberty, to control one's own body, to have privacy, to be left alone, to speak and think one's own thoughts?
Could it be that we actually have no idea how to fine-tune anyone's brain chemistry to make them happy and perfect, or even to gently and reliably disable them from violence?
The Trib implicitly equates forced hospitalization and drugging with "help from your family doctor." Many thousands of psychiatric victims can attest to a stark, brutal difference. Society ignores this massive legacy at its own peril. In the last century, Soviet and Nazi psychiatric policies were based on a presumption that protecting the social order and "helping" certain types of individuals were easy goals to coordinate, given only the iron will to do so.
The opening paragraphs of the Trib editorial cite cases of individuals who supposedly were "helped" with their mental illnesses (Seung-Hui Cho and Steven Kazmierczak), but who promptly went out on shooting rampages, killing dozens of innocents. And by the way, there are plenty more of those. How exactly does pushing this sort of "help" protect anyone?
Wake up. We still need police in the world, and people who try to hurt others have to be stopped. But doing nothing might be much better than psychiatry!