Saturday, November 22, 2014

A brain disease

The website of Treatment Advocacy Center currently features a short article by Joseph Bowers. I just ordered Mr. Bowers' book, just published about a year ago, which I will read for the purpose of discovering all possible, honest qualification or amendment of the opinion I am about to write here...

The article asserts that serious mental illness is brain disease, without offering any reference to specific supporting evidence, and without acknowledging any dispute, but apparently just presuming that readers simply must agree, perhaps because of the moral authority of the writer (Mr. Bowers), or perhaps because of the background information in the writer's book or in the literature of mental health/illness/psychiatry, or perhaps for some other reason which I am not able to identify at all.

Mr. Bowers begins:

   "When I hear or read about the opinions of people opposed to psychiatry, antipsychotic medication or assisted outpatient treatment, I often think that we are talking about different things and different people.

    "Sometimes I think that those opposed don’t even acknowledge the existence of people like me. I suffer from a serious brain disease that has been diagnosed as schizophrenia."

He claims to believe that his own life condition, his personal existence and experience, necessarily contradict any possible disagreement with psychiatry, antipsychotic medication or assisted outpatient treatment (AKA, forced drugging). People who have such disagreements could not possibly be aware of him. If such people were aware or could consciously consider him, they surely would not disagree.

He's talking about me, because I (mostly, but not categorically) do disagree with psychiatry, antipsychotic medication and assisted outpatient treatment.

This is an entirely natural human view (or lack of view) in a sense, exemplified by expressions like, "If I were you..." and "Walk a mile in my shoes...". But here it's childish, almost as if T.A.C. is robotically repeating the old third-grader chant, "I-know-you-are-but-what-am-I?" to any offered reasoning by nominal opponents. I don't think Mr. Bowers even wrote those opening two paragraphs in good faith. If he authored a whole book, he's probably smart enough to know better. (But I'll wait to read the book before I confirm that, I suppose.)

I certainly do acknowledge the existence of people like Mr. Bowers, especially if by "like" he means "also diagnosed with schizophrenia". I work with a number of them, as well as their doctors, or keepers, and the institutions which society has specially designated to deal with such people whether they like it or not. I spend several days per week working with diagnosed psychotics, and I've been doing it for twelve years. But I don't think of my clients as people with serious brain diseases: I think of them as psychiatric slaves. 

Mr. Bowers wrote those two opening paragraphs to sound reasonable, that's all. But it's too over-obvious. I think it reveals him to be a propagandist and a liar. Come to think of it, "Joseph Bowers" is such a common name, it's a bit "John Smith"-ish. Maybe this is not a real person, and that's why the writer "protesteth too much" that his existence is unacknowledged -- he's disguising it himself! (But again, I should at least read the book....)

Anyway, the writer, whatever his real name may be, continues:

    "When I talk about treatment, I am speaking about people with serious mental illness (a psychiatric brain disease). I put schizophrenia, severe bipolar disorder, schizoaffective disorder and severe clinical depression into this group. Those of us in this group experience psychotic episodes that include hallucinations and delusions, severe emotional swings and sometimes a strong desire to end all of our suffering once and for all.

    "I often suspect that when speaking about mental illness, some people are actually referring to those with much more moderate, less life-threatening symptoms. These people may have a “psychiatric disability” rather than a brain disease.

    "They might benefit from counseling, behavioral therapy or maybe even light doses of medication. But their diseases are not nearly as debilitating or life threatening as those with serious mental illness."

The apparent attempt here is to designate a group identity, and then to appear to carefully qualify who is part of the group and who isn't. As a speaker for the group, Mr. Bowers establishes a moral status that is more difficult to argue with. The implication is, the only way anyone can legitimately disagree with psychiatry, antipsychotic medication or assisted outpatient treatment, is if they disagree with it for those outside Mr. Bowers' self-defined group.

One problem is that the qualifications for membership in the group are very hazy. Schizophrenia is definitional only in the sense that any epithet is. If you're ever "diagnosed" you cannot definitively disprove it with all the science and all the money on earth. "Severe" bipolar or clinical depression (as opposed to "moderate" or "moderately serious" let's say) is completely relative as far as I know. And the category of "schizoaffective disorder" just confuses everybody, including experienced clinicians. 

There is mounting cynicism about these "diagnoses" throughout the professional world of mental health. Even the U.S. National Institute of Mental Health has disavowed their medical validity. Almost no one flatly asserts anymore, that these are, properly in a medical science sense, "diseases".

Again, if Joseph Bower is competent enough to write a whole book that anyone buys (and I just did buy it), I can't help thinking he's aware of these things. There's something wrong with this short article on T.A.C.'s website. There's no way it's as innocent as it appears.

Possibly the most telling paragraphs follow:

    "There is growing evidence that diseases like mine are largely physical in nature and cause. They are not caused by poor parenting, stress or extremely traumatic life events. They cannot be overcome by will power and are not related to a person’s character or intelligence, but instead require a combination of pharmacological and social support.

    "It stands to reason that treatments appropriate for people like me with serious brain diseases are not as appropriate for those less serious mental illnesses."

First of all, no one argues that serious brain diseases are caused by poor parenting, or that they can be overcome by will power. These are straw men. The argument has to do with the fact that there is not sufficient evidence, and it is not growing, that schizophrenia, bipolar, schizoaffective disorder and depression "are largely physical in nature and cause."

But whether or not people should be held accountable for their behavior will never be a matter of evidence. That will forever be a social decision, a question of ethics and policy. What "treatment" is appropriate for what person's mental problem under what circumstances can never be properly adjudicated as a matter of medicine.

Mr. Bowers is stating a religious creed in this article, not a rational argument. And as far as I am concerned, T.A.C. is for all practical purposes a religious cult. They have to convince people to believe in schizophrenia as a biological brain disease, because they think that peculiar faith will save the mental health world. They have to lie about "evidence" and invent straw man arguments. I happen to believe more or less the opposite, that mental illness is best understood as the individual's chosen behavior. (But I sincerely hope I am more relaxed about my faith than T.A.C. is about theirs!)

The final paragraph in the Bowers article is ironic:

    "I think that much of the raging controversy surrounding treatment issues involving mental illness could be lessened if we could just agree on who and what we are talking about."

If he admits there's a raging controversy, how can he blithely presume with parentheses that we'll all acknowledge serious mental illness as "a psychiatric brain disease"? 

And "who and what we are talking about" is not ever going to be the definitional boundary of Mr. Bowers' group, no matter how cleverly T.A.C. changes the subject.

The issue is psychiatric slavery, Mr. Bowers. There are growing numbers of abolitionists out there, and Billy the Torch is coming to burn T.A.C.'s city.


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