Dangerous nonsense by Elizabeth Bernstein in today's Wall Street Journal

It amazes and mystifies me, that in order to suggest perfectly rational collaboration and non-confrontational help among family members, a writer for a well-respected publication would find it necessary to promote absurdities and tortured, irrational, anti-scientific propaganda.

Today's Wall Street Journal contains a featured health & wellness article by Elizabeth Bernstein entitled, "A Way Out of Depression: Coaxing a Loved One in Denial into Treatment Without Ruining Your Relationship."

Bernstein's basic point is, if somebody you love needs help, try to understand them and talk them into getting it without pathologizing them or offending them. Fine, who would argue with that?

But the writer bases her advice on the claim that a common symptom of depression is denial or lack of awareness, also known as anosognosia. This is said to be "a physiological syndrome that makes a person unable to understand that he's sick."

This is dangerous and degrading nonsense.

Major Depression, Bipolar Disorder, Schizophrenia and all other mental disorders are defined completely and authoritatively in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision ("DSM-IV-TR"). All symptoms are listed for every mental disorder. Not a single mention of anosognosia is to be found anywhere in the 943-page volume.

The next (fifth) edition of the DSM is due out in a couple years. The American Psychiatric Association has an entire website devoted to DSM-V, which can be searched efficiently to find scores of references about depression, bipolar disorder, schizophrenia, and how all these disorders will be defined, diagnosed and treated in the future, with all the additional research since DSM-IV was published in 1994. But one searches in vain on this website for any mention of anosognosia.

The question that's begged: Why did Elizabeth Bernstein insert this "physiological syndrome" which is not relevant enough to ever be mentioned in the psychiatric manual, into her article as a supposed common symptom of depression?

Anosognosia is a fairly obscure term coined in 1914 with regard to certain brain injuries and neurological conditions. It's causes are unknown. It's use in relation to mental patients who refuse treatment is new and controversial.

Over the past nine years, I've worked with a lot of people who refuse psychiatric treatment and don't believe they are mentally ill. I've worked with a lot of their psychiatrists, too, and their security therapy aides, and their social workers, and all the other state nuthouse staff who get paid for holding and treating people whether they like it or not. These guys never talk about anosognosia. They know their jobs.

I can tell you this: The only reason anyone would claim that a common symptom of depression is lack of awareness, denial, or anosognosia, is to justify "treating" someone against his or her will.

The only point is to be able to forcibly drug someone - that is, get five or six enforcers to hold her down screaming, as a doctor violently injects neuroleptic poison into her body - while still pretending it's for a "patient's" own good.

There is nothing else behind this, in Ms. Bernstein's article in today's Wall Street Journal. Ms. Bernstein may not make the connection. The Journal's editor may not feel responsible for such ugliness. But that is the only point.

The irony is that Ms. Bernstein's article really wants to suggest the opposite of forced treatment. But that's the trouble with psychiatry, it doesn't work, it's an enforced lie.

The nuthouse psychs I work with don't make stupid excuses like "anonsognosia" because they don't have to. With court orders, locked cells and armed security, they're pretty free to brutalize the people they control.

Who ... me??

The Canadian Mental Health Association is hosting a national conference October 22-24 in London, ONT entitled "Thriving in 2010 and Beyond". Several weeks ago they were soliciting proposals for presentations at the conference, and I submitted the following:

Psychiatric treatment cannot apparently be separated from some degree of coercion or deception. Mental ''patients'' are generally presumed to ''need'' overriding judgments by others with regard to their treatment. Yet despite all the intricate rationalizations for bypassing the plainly expressed will of patients under various circumstances, the professional consensus remains overwhelmingly in favor of collaborative treatment models.

The problem of coercion and deception in psychiatry, perhaps more than any factor, has separated mental treatment from other medical specialties. Some advocates have frankly suggested that involuntary treatment should be legally facilitated on a much wider scale than it is, while others have opined that psychiatry as we know it would actually disappear if its facility of formal state coercion were ever lost.

Presenter has worked for nine years in Illinois forensic psychiatric institutions, advocating and litigating on behalf of involuntary patients, usually violent offenders who refuse psychotropic medication or continue to dispute diagnoses related to criminal court verdicts of ''not guilty by reason of insanity''. This niche is a dark place from which the general public, medical practitioners, legal professionals and civil servants desperately attempt to look away.

Unfortunately, the human condition shows no immediate sign of transcending violence and irrationality. Courts and other social institutions will be charged with ''doing something'' about bad behavior for the foreseeable future.

An alternate basic attitude will be suggested, 180 degrees opposite to current prevailing thought that mentally ill people can or should be ''helped'' by their neuro-biological betters whether they like it or not. Specific implications of a radically different attitude will be discussed for the architecture and practices of social institutions which we call either ''mental hospitals'' or ''prisons''.

Attendees will acquire rehabilitated purpose for mental health as a valuable social profession, and a viewpoint to inspire honest institutional innovation.

The Canadian Mental Health Association appears to me to be a close cousin to NAMI, in that their main focus is getting people to believe that mental illness is just like any other disease, e.g., of the kidneys, pancreas, heart or lung, and therefore medical solutions are the appropriate goal, just around the corner of research, etc. Of course, this is not my point of view at all.

Well, lo and behold, CMHA accepted my proposal for a presentation at their conference.... So now I have to deliver what I promised according to the description above. My talk, entitled "How to refuse psychiatry without upsetting the neighbors", will be from 10:15 to 11:15am on Saturday, October 23, at the London (Ontario) Convention Centre.

Should be cool.

Neil Steinberg on the non-fungibility of people

Kudos to Neil Steinberg in today's Chicago Sun-Times! His column is entitled, "Racists live in a world of interchangeable people." He points out that unlike money (one $20 bill is worth the same and has the identical use as any other $20 bill), people are individuals, and totally non-fungible.

Biological/medical psychiatric theory and practice are in fundamental conflict with this fact of life. The clearest statement I have ever read about this was 23 years ago, by Pulizter winner Jon Franklin: "We will have to turn our backs on the duality and, with it, the faith of our fathers.... We will have to look into the mirror, surrender illusion, and make peace with the fact that we're staring at a machine. We are mechanisms, pure and simple, explainable without resort to the concept of soul."

Machines are fungible, built from finite, interchangeable parts, lacking any free will, useful and valuable only to the extent that they are predicted and controlled. They are dead. This is how psychiatry sees people. As historians have often noted, psychiatry is also fundamentally racist.

It is vitally important however, to recognize that the general character of a field of theory and practice cannot be automatically applied to every practitioner in that field. I say that psychiatry is an essentially racist field, but I do not that say Dr. C is a racist, or that Dr. J is a racist. In fact, these individual psychiatrists, whom I know personally, are basically good people. Why they do what they do is a long and complex tragedy which will only end when that central understanding, so well-stated by Neil Steinberg today, becomes universal.

Individual people are alive. Minds are not brains. Emotion, behavior and human society will not actually be improved, and mental illness will not be cured, by fine-tuning neurochemistry. Jon Franklin was wrong, NAMI is wrong.

This is a problem: confront it!

Gimme a break, Judge!

I note in yesterday's Chicago Tribune that a federal judge was upset with nursing home operators who distributed deceptive information sheets to mentally ill residents. Hon. William Hart of the U.S. District Court for the Northern District of Illinois accused the operators of employing scare tactics about a proposed legal settlement to convince vulnerable patients and family members not to take their business elsewhere.

I have to laugh out loud.

What else, exactly, do Judge Hart, the Trib and the public think the whole "mental illness" industry is all about? Medical psychiatry would not exist without fraud and coercion, which are its basic, essential stock in trade.

Ever since I have been advocating for patients at Elgin Mental Health Center, that state institution has continuously, freely and enthusiastically distributed the most deceptive information in existence about mental illness: NAMI fliers and brochures which attempt to convince the public that depression, bipolar disorder, schizophrenia and anxiety disorders (along with anything else graced by a magic DSM code) are proven brain diseases.

This is a bald, flat-out lie, invented for no other reason than to sell drugs that dehumanize and control people. Every state institution I have ever been to in Illinois does the same thing.

I was in a monthly staffing at EMHC on Wednesday, during which the patient (my client) appealed to his treatment team with a manifestly rational and well-informed argument, that psychotropic drugs had never been helpful to him. They had in fact tortured him and damaged him. He wanted the help of these clinicians, to progress toward conditional release on a treatment plan without meds.

This patient was not demanding, hostile, or even very unrealistic. He hasn't taken any meds for about a year now, and there's nothing really wrong with him. If the treatment team dealt with him on just some part of his own terms, he'd quickly prove to them that he is in fact well.

But forget it! State psych-slave-keepers cannot bring themselves to think that way. At least, not until somebody demonstrates that it will cost too much not to.

They were all about interpreting every little disagreement, every departure from the most perfect adherence to their psychiatric religion and unconditional expressions of fealty, as the "rigidity of the patient's thinking" - caused, of course, by his not taking psychotropic meds. It's pure nonsense, every bit as despicable as the nursing home operators' deceptive information sheets, complained of by Judge Hart.

The treatment team seemed to actually believe the nonsense themselves, until I spoke up and agreed with the patient. I was rather quickly cut off with, "Well, enough has been said about meds, let's just move on." The truth was unacceptable, the motive was utterly malevolent.

There's no use in soft-pedaling any of this. The State of Illinois obstructs informed consent and perpetrates a continuing crime against humanity.

Maybe it's good to imprison the mentally ill

My friend C. Rodney Yoder recently brought an article co-written by George Pawlaczyk of the Belleview (Illinois) News-Democrat to my attention. George had been an ally years ago, but Rodney was disappointed because the article, about abuse of prisoners at Tamms Correctional Center, paid far too much lip service to the mental health racket. Rodney had been involuntarily committed for twelve years at Chester Mental Health Center.

Both Tamms and Chester are singular super-max facilities, the only ones in the state. Rodney commented in an email to me that he would much rather have done twelve years at Tamms than at Chester. I asked him to explain why.

NAMI and other such so-called "mental health advocacy" groups make a huge hue and cry over mentally ill people being imprisoned rather than treated. This is a ridiculous red herring, because there is no difference when they're treated against their will, which they almost always are.

The fact is people in "mental hospitals" are prisoners. In my experience, many of them would rather be in honest prisons.

Anyway, for what it's worth, here's Yoder's perspective:

For one thing, Tamms is safer than CMHC. There is no possibility there of guards dogfighting inmates who are always kept isolated physically from one another. I endured HUNDREDS of physical assaults at CMHC in twelve years. One could conceivably just behave well and catch up on their reading at Tamms, while getting three meals a day and free laundry and dish washing and dental and medical care, optometric care, etc.

And the whole enterprise would be intrinsically more HONEST at Tamms. One would be there to be punished. The guards there are arguably not under intense pressure to concoct spurious bad behavior reports or to engineer "incidents" to be used as justification for the custody. I was on pins and needles at Chester when my involuntary commitments were about to expire, because I knew the pigs, nurses, and administrators would be wanting "incidents" to put in their latest petition. It was easy for a nurse or pig to give some subhuman animal a cigarette or candy bar or cup of coffee to start a fight with me or assault me (they'd then claim my defense of myself was an act of mental illness-driven agression). The Tamms guards don't have any conceivable interest in fabricating bad behavior claims against inmates. At Chester the pigs had an additional psychological need to cast me and other inamtes as wicked, deranged, perverse, symptomatic, or whatever description rationalized their psychiatric slave trade. At Tamms the inmates aren't EXPECTED to act or "be mentally ill".

At Tamms I would never have had to have some punk criminal tell me I'd be there for all my life while he'd be quickly liberated via psychoquack ass-kissing and shucking and jiving. And I wouldn't have had to watch that same punk criminal return and repeat this scenario multiple times all the while evading punishment for serious crimes.

At a place like Tamms. outside do-gooders and bleeding hearts would have given a shit about my welfare. None of these people ever protested what goes down in CMHC. They laughed at my plight and DENIED THE REALITY of it. At Tamms, no Mark Heyrman type lawyer would work to hurt me and claim he was actually helping me.

Incidentally, I tried while at CMHC to get arrested and removed to the safety of a jail.Years later, when I was SPURIOUSLY jailed, I wrote and stated that I much PREFERRED jail to the CMHC. Lest anyone doubt my sincerity.

Psychiatry vs. medicine in seven steps

On a number of occasions, I have explained to people my personal understanding of the difference between psychiatry and other medical practice. I don't think anyone has ever said this particular explanation was inaccurate. Some people have seemed thoughtfully skeptical perhaps, but no one has ever said, no, you're misrepresenting it, or no, that's not true.

I'll try to concisely outline this explanation here, so anyone who reads it can think about it and tell me if, and how, it may be off the mark.

I think of this as a narrative sequence of interactions among a doctor, a patient, possible other people, and facts in a clinical setting.

In most medical practices and specialties it goes this way:

1. A person has some sort of pain, malfunction of the body, or other symptoms.

2. The person takes himself to a doctor and complains, asking for a solution.

3. Doctor listens, inspects the body, does any of various medical tests, verifies presence or absence of objective abnormalities.

4. Doctor evaluates the data and makes a diagnosis.

5. Doctor offers the patient a recommended treatment with full information regarding risks and benefits.

6. Informed patient accepts the treatment or goes elsewhere for another opinion.

7. Patient or third party pays doctor.

In psychiatry, by contrast, it goes like this:

1. A person behaves in ways upsetting to someone else.

2. Someone else who is upset with the person convinces him to go to a psychiatrist, or takes him to one like-it-or-not, and complains about the behavior, asking for a solution.

3. Psychiatrist listens, believes the complaints, briefly interviews the patient.

4. Psychiatrist prescribes treatment which he hopes might restrain the patient's unacceptable behavior about which someone else complains.

5. Psychiatrist looks in the DSM for a diagnosis to justify treatment.

6. Patient is convinced by various devices, or coerced, to accept treatment.

7. Patient or third party pays psychiatrist.

OK. It seems to me the most notable difference is the precisely reversed sequence of steps 4 and 5. (I wrote about this at least once before.) But the only step that is the same for regular medicine and psychiatry is number 7, somebody pays.

You, readers, please tell me what's wrong with this understanding.

Amazing amazing

Another Elgin Mental Health Center staffing, same day as (actually immediately following) the one I wrote about on Friday, July 9th. Same psychiatrist, Dr. C....

My client, Mr. N, is a foreign national. He's been at Elgin 3-4 years now, NGRI on an aggravated battery charge, Thiem date circa 2028. Never took meds. I don't remember what his Axis I diagnosis is. (But of course, with Dr. C, that's "not so important".)

It took a long time to convince Dr. C that this guy could progress toward expanded privileges and even conditional release without ever taking "prophylactic" psychotropic meds. I went to court once and took Dr. C's deposition. More recently, though, N was finally on a treatment program which consisted of therapy groups only. It still always seemed to me, until this staffing the other day, that Dr. C would make it take as long as possible for N. He seemed in no rush to admit that this patient, with whom absolutely nothing was wrong medically, psychologically or any other way, was progressing at all.

Anyway, first item in the staffing: the facility has a letter of detainer from the Immigration and Naturalization Service. INS wants N, so the Illinois Department of Human Services will give him up.

But ... what of the fact that N is still in need of mental health services on an in-patient basis?

Well, Dr. C says that's no problem. Since INS wants the patient, it'll be easy to convince the criminal court he's suitable for conditional release. If INS didn't want N, he'd be kept at Elgin for more treatment, but a letter of detainer from a federal agency is apparently an instant cure for N's mental illness. It's all a matter of clinical psychiatry, of course.

Or rather, it's all a matter of forensic psychiatry. The "clinical" pretense is only there as marketing. This is not medicine, it's carefully euphemized punishment for and restraint of crime. Psychiatrists who work for the state are not doctors so much as they are jailers and hangmen.

And guess what? Their work only confuses everything and everybody. This system is a disaster and a fraud. It should be torn down, the foundations should be ripped out, and the ground should be plowed with salt so nothing will ever grow there again for the rest of time.