Monday, December 5, 2011

The Therapeutic/Protective Service State: Guerrilla Actions

Individuals who refuse psychiatry when their betters think they should accept it are quite likely to suffer wrathful coercion from what Tom Szasz calls the Therapeutic State.

Families and groups who are cynical about the proclaimed beneficence of the Protective Services State (e.g., "Child Protective Services" or "Department of Children and Family Services") may also be regarded essentially as though they are mentally ill. They will be presumed to not know what is best for their own children, and they will be asked to prove negatives which are impossible ("How can we know for sure that this won't happen again?").

Children misbehave, sometimes badly. Parents are not supposed to punish them anymore, they're supposed to turn them over to experts outside the family who are employed by the state. It's very similar to (and sometimes it directly and explicitly involves) forensic psychiatry.

So if your 13-year-old child rebels against a type-1 diabetes diagnosis, runs away from home, gets pregnant and learns how to selectively manipulate you and the CPS bureaucrats back and forth against each other depending on whom she wants to defy on any given day, well guess what? You're quickly going to feel very much like somebody who is involuntarily committed in a state nuthouse.

The key to understanding the similarity is the concept of institutional machines meant to do things that individual people shouldn't have to do or don't want to do. Forensic psychiatry and child protective services are attempts at dependable, impartial, no-fault, objective processes to relieve real people from having to pay attention. The experts running the machines supposedly know how people -- as cogs in other machines -- ought to work. It's all nonsense, of course. The real world results are consistently and embarrassingly terrible. And anyone who knows himself or herself to be more than just a cog in somebody else's machine instinctively hates both forensic psychiatry and child protective services, or at least they do when these institutions are aimed "incorrectly" (at them).

But by the time people find out that forensic psychiatry and child protective services alike are all about state tyranny, not about state therapy or state protection or helping anyone, well, it's too late, you "can't fight city hall." You have to collaborate (which means surrender) or the machine crushes you, and everyone -- even your family -- will say it's your fault!

Back in 1964 a young man named Mario Savio gave a beautiful speech in Berkeley, about making the machine stop. It was a clarion call for civil disobedience and guerrilla actions.

Now, a half-century after the Berkeley Free Speech Movement, we confront forensic psychiatry and child protective services, and we lose over and over again. How can we put our bodies upon the gears and upon the wheels and upon the levers, and upon all the apparatus, and make it stop?

The following three tactics or principles are suggested, as the most basic guerrilla strategy.

Tactic/principle #1. Don't participate, even tacitly. Don't acknowledge that anyone is trying to help you, if it doesn't feel like help to you. Don't let anyone say you agreed to something, if you don't think you actually did agree, freely. Never let anyone call something your duty or your job, if you never actually accepted it as such, yourself.

If your psychiatrist can't confirm that you have a "chemical imbalance" by way a blood test or a brain scan (which of course, they cannot do), don't accept his explanation about why the meds are therapeutic. If they get a court order for involuntary medication, make them hold you down to inject the drug into your body, never let them pretend it's not forced.

Never acknowledge the social worker's expertise or the guardian ad litem's authority over your child. Never fail to challenge their motives, which are egocentric, elitist, ignorant and mercenary. Never believe these people are acting in anyone's best interests but their own.

Just don't ever cave or agree, at least not in your heart. The little tyrants are trained and drilled to trick you into thinking that you have agreed when you haven't, that something was your idea when it wasn't, that something is best for you when it's their own arbitrary, pet theory. You might pretend, just to gain somebody's confidence or a tactical advantage. But don't ever forget what you know yourself.

Tactic/principle #2. Make it an expensive, time consuming nuisance. The reason the state makes machines and automatic, uniform processes is that people think they can't afford to deal with live individuals. So, be a very live individual. When somebody mentions a policy, make them show it to you in writing, then make them tell you its purpose. If answers don't make sense, keep asking, don't let it drop. Be that child who asks "Why?" to every answer, endlessly until all the parent has left is, "Because I say so!" The state pretends to rationality, not force, so it is more vulnerable than a parent, it has to keep explaining.

A friend told me years ago that the law is reasons (small r, plural). Whoever has more of them and is willing to stand up and say them longer than the other guy, wins. The reasons don't have to be all that good, either. They just have to be good enough that nobody is sure you don't believe them yourself. If you have more reasons, more questions, if you're staying longer and talking more than the little tyrant wants to, you'll win. You have to wear them down, be the squeakiest wheel they've ever heard.

The state appears to have all the money, but the little tyrants are often answerable for their efficiency or lack of it. If it's generally expected that one hearing will result in the efficient disposition of a case, the bureaucrat who can't finish it in three hearings can look pretty bad to his or her boss. When a member of a mental health treatment team has to have legal representation for a deposition and that has to go into his boss's budget, well, maybe the machine will figure out it's easier not to petition for involuntary treatment, or not to place a child in a foster home, after all.

Always ask for a change of venue, always ask for a different judge, but always have more reasons than anyone thinks you could possibly need. Always make them late for dinner.

And by the way, when it comes to this factor of expense, if you can easily pay thousands for a lawyer, it can help you a lot. But many lawyers (especially the ones whom the court appoints for you for free) really believe in the system you're fighting against. You can still use them, they are ethically required to follow your instructions and your strategy if they are representing you. But be aware that you may be spending (or paying for) lots of hours arguing with your own attorney. I hate to say it, but sometimes it might be better to study the law and represent yourself.

Tactic/principle #3. Always look for the good in each individual, even while you never miss an opponent's lie or illogical, arbitrary claim. Ultimately you can separate well-intended individuals from the state machines which they think they have to slavishly serve. Expect this to happen.

You are in the right, and a good person will know that. Get them to betray the empire, remove them from the matrix. Love your enemy.

If you are more persistent than they predict you could ever be, if you are a very creative nuisance, and if you look for the good in individuals and presume they will ultimately come around to your side, you'll be surprised how often you'll get defectors.

And you might end up a hero.

Wednesday, August 31, 2011

How do you "develop" alcohol abuse?

Today's Chicago Tribune headlines its Health & Family section with an article about teen drinking. The federal Centers for Disease Control did a survey which supposedly "indicates that youths who start drinking before age 15 are five times more likely to develop alcohol dependence or abuse later in life."

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

Will psychiatry die without psychosis risk?

The sudden demise of "Psychosis Risk" as a DSM-5 diagnosis may foretell the doom of psychiatry as we know it.

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

An utterly wonderful turn of phrase!

I LOVE this:

"He gets symptomatic over rights."

I heard it from a social worker at Elgin Mental Health Center the other day, I'll call her Cindie. A patient for whom Cindie was responsible had been complaining that several dvd's had been confiscated from him for no good reason. The patient is a straight-A, on-line college student. The confiscated dvd's were relevant to an anthropology class he was enrolled in. He even had a letter from his professor saying so.

But the bossman of the clinical unit, a nurse's aide named Alfonso, had to prove to this patient that college success counted for nothing. The staff at a state nuthouse can take away anything they want to take away, any time they want to. Patients are bugs to be squashed at Alfonso's whim!

Cindie supports this kind of squashing in the bughouse, because it's really the only way she can obtain respect for her profession and activities. Patients who go to college tend to avoid therapy groups, because they find out that their classes are infinitely more valuable than the basket weaving and navel gazing Cindie teaches. When one of these (upstart!) college kids gets out of the nuthouse, Cindie and her therapy groups might get less credit for it.

Alfonso just steps on bugs directly, and laughs. I actually have been amused in a sick sort of way, by his unflinching cruelty.

Cindie, being much weaker, has to say, "He gets symptomatic over rights."

That is just wonderfully pathetic.

Tuesday, May 31, 2011

English and Inquisitorial law

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

Cruel and Usual

Today's Chicago Tribune has a pair of editorials by Steve Chapman and Clarence Page, about the Supreme Court's order for California to release prisoners. Chapman mentions "Stalinist standards of barbarity," and Page notes how many offenders would actually prefer floggings as dealt out in Singapore or Malaysia, to five years in a California prison.

Ten years of experience tells me that many guys in state nuthouses would prefer prison to the even more barbaric gulag they find themselves confined in. In other words, prison is crueler than twenty lashes, but involuntary psychiatric commitment is worst of all.

Clarence Page says "as long as we insist on fooling ourselves with well-meaning fantasies," our correctional systems and all our attempts to protect good people from bad people will be unsuccessful. Steve Chapman recalls testimony from a former San Quentin warden, that the current system makes people worse.

These editorialists are talking about prison systems. They probably believe that more psychiatry could be part of a solution. How ironic!

The more we spend on state psychiatry, the more mental illness we'll have, and the more danger that mental illness will pose to us.

At best, "mental illness" itself is a well-meaning fantasy, folks. We have NOT progressed beyond the lash; our cruelty increases with every passing year. State psychiatry is a far greater horror than the prison sentences it was supposed to replace, and the more we try to medicalize behavior the more horrible it will get.

We are NOT safer from unpredicted violence perpetrated by our unfathomable fellows. The doctors do NOT have a pill to cure evil, and they never will.

We're better off with overcrowded prisons than Elgin Mental Health Center. Maybe the lash beats them both.

Preventing unnecessary cruelty is a good human impulse, but all we're doing is averting our eyes.

Friday, May 27, 2011

1984

I had a client once whom I'll call Julio, who was NGRI for attempted murder -- long Thiem date, big-time Axis-I diagnosis, the works. He went back & forth from Elgin Mental Health Center to Chester Mental Health Center a couple times. He didn't like taking meds, so he stopped without mentioning it to his treatment team.

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

Courts and psychiatry

Criminal courts which occasionally find people who have committed horrible violent crimes "not guilty by reason of insanity" ("NGRI") absolutely must look at things from a view near the top of my scale of psychiatric faith. They would not otherwise prevent two of the most important purposes of criminal law: retribution and deterence. And they could not otherwise condemn a person to the dehumanizing torture of psychiatric treatment.

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

Scale of psychiatric faith/reality

(... Descending from trust/beneficence to renunciation/total enmity; any individual's understanding lies somewhere along this continuum...)

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

Don't collaborate with psychiatric oppressors!

The lead editorial in today's Chicago Tribune is entitled "Speak up". It offers an excellent example of the dangerously false logic in virtually all popular conversation about mental health and violence since the Tucson shootings.

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!

Tuesday, January 18, 2011

Lincoln Caplan, New York Times

Lincoln Caplan writes in today's New York Times that, "Medicine defines illness, the law responsibility. The fields long tried to resolve their differences scientifically."

In the context of mental illness and violent crime, this statement is bitter, bitter nonsense.

"Mental illness" is specifically and succinctly defined in most states' mental health and/or criminal codes. That's law. On the other hand, medicine (or at least its most relevant authority, the American Psychiatric Association's Diagnostic and Statistical Manual) makes a complete hash out of all attempts at any definition.

"Responsibility" is clearly related to response as in stimulous-response, which calls to mind a framework of experimental psychology based on principles of medicine.

So, it's possible to argue the precise opposite of Caplan's statement, i.e., "The law deines illness, medicine responsibility."

The real differences which Mr. Caplan posits between medicine and the law presumably concern relative values of cure and punishment. But psychiatrists are happy to admit they have no cure; and lawyers quickly retreat from confiscation or vengeance to such euphemisms as equity and justice. The two fields long obfuscated these issues on purpose.

Attempts to abdicate human responsibility in favor of objective science are delusional. Medicine and the law both yearn for this savior, as they once cried out to God.

Lincoln Caplan's remarks are useless. He wants to think science is good, politics are bad, the insanity defense is harmless. He wants us all really, really stupid.

Friday, January 14, 2011

Careful about Loughner's mental illness

People think they're being reasonable or even scientific when they say oh-so-carefully, that Jared Loughner, "likely, judging by the disjointed and delusional (etc., etc., etc.) has a (major mental disorder/schizophrenia/psychotic disorder/diseased mind/mental illness/blah-blah-blah)." See for example, the Jan. 10 LA Times.

The fact is, no care or conservatism whatsoever is warranted with such statements. A psychiatric diagnosis is no more objective than any arbitrary epithet. Anyone and everyone is free to call anyone and everyone else these names.

It's true that the clinical expertise of a psychiatrist or mental health professional is necessary to diagnose, only if by "diagnose" one means "get paid by an insurance company or the government for." Newspapers and media commentators presumably are not hoping to get paid as clinicians, so it's highly amusing that they are so self conscious about their statements.

Loughner killed and maimed a bunch of people, including a nine-year-old girl he'd never seen before. Of course he's a crazy, sick sonofabitch.

But nobody says any more than that when they pronounce him mentally ill.

Correctly "diagnosing" Loughner obviously won't help any of his victims in the slightest way. It won't help him either, he'll spend the rest of his life in unpleasant circumstances and it'll end badly. It might briefly comfort people who are terrified to see any real evil in the world and prefer to hope no one's responsible for anything, it's all just fate or the gods or neurochemistry. But in the long run, they'll all remain equally helpless against what we're experiencing as random violence.

So who cares about flippancy? Say Loughner's mentally ill, schizophrenic, anything you want. Just don't believe it should have anything to do with public policy. There's no viable anti-violence strategy in the field of mental health. There's no security in widely-available psychiatric evaluation and treatment. These "experts" don't know evil from a hole in the ground. Their drugs cause violence at least as often as they disable perpetrators.

The only "benefit" from all this care and thought that's going into whether or not Loughner is mentally ill, or how to tell, or how to diagnose others before they're dangerous, is money into the pockets of a special priestly class: guys who started out in the last century as, and who basically remain, users, frauds, charlatans.

Tucson and the "need" for mental health

The University of Chicago's Mark Heyrman says that the Tucson shootings happened "because we have not offered treatment." I really have to laugh.

I just attended a university orientation day for new students and parents, right in Heyrman's neighborhood. One of the parent information sessions featured a bright young woman from the student counseling department. I think she was either a social worker or a psychologist.

The speaker graciously gave all of us naive lay people lots of professional tips about how to manage our children's emotional challenges and adaptations, what to do and say to help our kids deal with life in college, establish their identities and develop their autonomy. She detailed the "seven vectors of development" ... all kinds of good, standard psycho-stuff like that.

It seemed basically well-intentioned to me, but maybe just a little slick.

From the presentation, it was obvious that the college counseling department sees itself as a routine service for most, if not all, of the university student body. We were told of the therapy groups which meet regularly and the various support systems offered. Finally, we received a standing offer for all first-year students: ten free individual counseling sessions. (Count em - ten. Free!)

After the presentation, during a short Q & A, I asked what percentage of eligible students ever took any advantage at all of that "ten free sessions" offer. The answer came without pause, about 5%.

It occurred to me that one-in-twenty participation was inconsistent with the department's apparent pride in a universally needed, popular service, delivered at no cost to all comers. Then on the way out of this session, I picked up a business card which read:

Get to know Counseling Services. Counseling Services gives you tools to manage life during challenging times. * You are entitled to ten counseling sessions per academic year. * All services are completely FREE and confidential. * Individual, couples and group therapy are available. LET'S GET TOGETHER!

On the back was the following:

92% of students would recommend the college's Counseling Services to a friend.

I held onto that business card. The next info session was run by a dean, and toward the end of his time, during a rather slow Q & A, for some reason he turned directly to me and asked whether I must have at least one good question. I said well, I'd do my best....

How could it be that, while only 5% of students who were offered ten free counseling sessions accepted even one, 92% of students recommended Counseling Services to a friend? I showed him the card, and told him about the earlier presentation.

He laughed.

He said, well ... they should probably change that card ... they were just trying to promote their service, that's all.

So Mr. Heyrman, what are you talking about? People don't actually want mental health services for themselves. They are coerced to accept them, or they coerce others whose behavior they don't like.

Even simple counseling, for free, from an attractive twenty-something, is avoided by the overwhelming majority of college students. Not to mention the more dehumanizing "treatments" or "hospitalizations" which purport to be medical.

There is no mental health system today which is not ultimately founded and dependent upon the police force of the state. The talk by Heyrman and his ilk, about "services" and the people who "need" them is propaganda and fraud.

And by the way, preventing mass shootings is crime fighting, not medicine.

Wednesday, January 12, 2011

Fuller Torrey in today's Wall Street Journal

I have no problem acknowledging society's right to shoot its enemies, and I've said many times that the technical distinction between a bullet and a shot of Haldol seems frivolous to me.

But when the public official holding the gun or the syringe says he's only trying to help, he lies - probably because he's a coward.

Psychiatric practices, drugs, shock, could be legitimate (if limited) tactics in the fields of public safety, criminal justice and punishment, emergency crowd control, and warfare. But the pretense of "medical treatment" ruins any utility. Absent that pretense, I might have no real complaint about psychiatry.

E. Fuller Torrey is perhaps the leading pretender in the whole macabre scene of psychiatry and civilization. His arguments degrade human dignity and public safety. Torrey endangers well-intended human beings with his nonsense in today's paper.

Supposedly, various people's "untreated schizophrenia" has caused senseless killings over the years, and if we'd only made sure people had been treated, the world would've been safer. The latest occasion for this ridiculous proposition from the fossil Torrey is the Tucson shootings by Jared Loughner.

Curiously, Loughner's "diagnosis" is presumed to be an obvious conclusion, despite the fact that no one has said he was ever evaluated by a doctor for any mental illness. Likewise, the other examples of "untreated schizophrenia" offered by Torrey may be complete speculation. Nobody worries about that though, because the function of the psychiatric diagnosis is merely to justify "treatment" after the fact anyway. Loughner and other killers obviously needed to be "treated" because they did violent harm, so the "diagnosis" is accepted. It just lacks normal medical sense, insofar as medicine has any purpose to help the patient who takes it.

Of course it could be said that it would help society if we put everyone who's likely to commit a violent crime on meds to disable them from violence. This could perhaps be justified, if we could only predict who's likely to commit violent crime and who's not. But we don't know how to do that. Psychiatrists and psychologists don't usually pretend to be good or reliable at it, unless an attorney is paying them lots of money after the fact of a crime.

(One notable historical exception to the characteristic professional humility occurred in the Nazi era, when psychiatrists exercised plenty of official authority over who needed to be killed and who didn't.)

E. Fuller Torrey isn't even responsible enough to argue that psychiatrists can predict violence, he just plays to pervasive public ignorance. He knows that we all wish Jared Loughner had been "treated", and we're all eager to believe in violence-reducing medicine.

But the only violence-reducing "medicine" may be forcible restraint, the real threat of justice and retaliation. Psychiatry thus becomes the utterly illusory "reason" into which we retreat from tough social responsibility. We buy into it to the extent we are cowards, incapable of personal responsibility for justice, unwilling to protect ourselves, our families or our communities.

When someone threatens to harm others, they should be stopped. Pretending that they should be "helped" rather than stopped, or that stopping them should be the same thing as "helping" them, is nonsense.

Indulging such nonsense will ruin all attempts at worthwhile culture and reduce our civilization itself to dust.

E. Fuller Torrey will be remembered for far worse harm than Jared Loughner.

Monday, January 10, 2011

Tucson and mental illness

OK, everyone thinks of course, Jared Loughner is mentally ill.

The problem is, nobody knows what that means. Or I should say, "mental illness" carries no meaning which can contribute to security against random violence by future Jared Loughners.

There is no viable anti-violence strategy in the field or profession of mental health.

There is supposed to be such a strategy, but it doesn't exist. The public presumes if somebody's crazy, and they hurt or threaten other people, then they get treated so they'll be less violent.

The trouble is, this "treatment" is highly unreliable. It makes some people more violent.

All one need do is observe a well-contested trial where psychiatric expert opinion is deemed relevant. Any side can pay their psychiatric whores for the court, but the pretense of medical science would only be laughable if it weren't so terrifying.

Illinois paid hundreds of thousands of tax dollars to convince juries that C. Rodney Yoder was a ticking time bomb and absolutely had to be imprisoned in the Chester nuthouse for life to protect the community. They were wrong. Yoder refused all treatment, got out, and has been a productive citizen.

A Chicago judge recently let a murderer found not guilty by reason of insanity go free without any psychotropic meds. Half a dozen psychiatrists testified in unanimous agreement, and the murdered victim's mother was in court to see her daughter's killer released.

Bottom line? Mental illness means nothing.

Jared Loughner took aim with his Glock 9mm at a nine-year-old girl he'd never seen before, and he pulled the damned trigger. That was horrifying, crazy, evil, inhuman. But it wasn't caused by an illness, and it won't be an issue for medicine. It'll be an issue for justice.

A jury of ordinary people will decide what to do with Loughner, not a doctor. And if the jury sentences him to death, they should draw straws for who flips the switch to kill him.

True believers condemn politicians for exploitation and think more "treatment" is the answer to the Tucson tragedy. They probably think a machine carries out a death sentence, too.

Those who've been in the nuthouse know not to whistle past the graveyard.