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.