For my concluding remarks at a workshop presentation to the Canadian Mental Health Association's "Thriving in 2010 and Beyond" conference, I wrote:
No brain research or fine-tuning of neurochemistry will ever replace an ability to communicate with a single individual face-to-face, no matter how insane, and change his or her mind. When you fail to do that, and when you are afraid, all the medicine and all the science of the past, present and future cannot rescue you from mental illness.
This essential point comes from my own nine years of experience as a legal advocate in forensic psychiatric institutions in Illinois. My clients are murderers, etc., found not guilty by reason of insanity. My job has been to get them released into the community though they refuse to take psychotropic medication.
I suppose I could have put mental illness in quotes, or made that last sentence read, "... cannot rescue you from what you call mental illness." But the presentation was, after all, to an audience of people who my friend Rodney Yoder has always insisted are professional mental patients. I guess it was unnecessary to rock the boat with Szaszian purity.
It also seems that the mental health world is fracturing. At the Canadian conference, it was clear (at least to me) that only a minority retain any orthodox "medical" view, wherein hope lies exclusively with research into brains and neurochemicals, and stigma is fought by making people believe schizophrenia is the same kind of "disease" as diabetes or cancer.
Most people are becoming aware that medicalization reinforces stigma, and that the best-financed parmaceutical researchers are admitting they can't even tell whether psychotropic drugs work.
The mentally ill are simply people with problems in living and relating to others. Little or nothing new about such general human complexity was discovered in these very recent centuries, or mere decades, which comprise the history of modern medicine. Psychiatrists have taken to descriptions which are a bit more standardized, and they've been clever about enforcing those descriptions to obtain a commercial advantage. Nothing more than that, and needless to say it hasn't helped.
Maybe there is hope for a shorter mass historical delusion than the 300-year Great Witch Hunt. Maybe we will not coerce people into "treatment" they don't want too much longer. Maybe we can soon stop dehumanizing and neuroleptizing and disabling people, "for their own good and to protect the community." That's what I'm working for, and prospects don't look that bad to me.
I have submitted a proposal for a workshop at the national conference of NAMI in July, 2011, based on what was pretty well received in Canada last month. The response from NAMI will tell me more. Stay tuned.
Tuesday, November 2, 2010
Friday, October 29, 2010
Medicalization = Stigma
The Treatment Advocacy Center recently called for, "Universal recognition that severe mental illness is medical, NOT behavioral". They say this would be a "breakthrough", but in fact it would be meaningless or delusory.
To begin with, how can "medical" and "behavioral" be mutually exclusive categories of illness? This would necessarily imply either that behavior is not affected by anything which medicine can remedy, or that we just never use medicine to change behavior even when it's possible to do so. Obviously, the widespread existence and practice of psychiatry itself contradicts this.
T.A.C. pretends to advocate only in regards to severe mental illness. So perhaps they mean that millions of people taking Prozac who were never actually psychotic or completely disabled by their blue moods have behavioral problems, not any medical illness. The same would probably go for the millions who take Ritalin to stay sharper in school or more focused on the job.
Yet all of these guys, I'm quite sure, would argue long & hard that their condition is medical, too. If not, then why should their insurance pay for their drugs? Seems to me a condition is medical exactly according to whether or not somebody takes medicine for it, simple as that.
I might add, whether people take "medicine" for a condition doesn't have much bearing on whether they are helped or cured, in any objective sense. Last time I checked, good Scotch whiskey was a great "cure" for just about anything according to somebody, somewhere. And those who find that long-honored cure to be more of a nuisance than whatever the disease was which needed "treatment" can then choose to solve their addiction with LSD. This is all perfectly medical, of course. But I think most of us would see some behavioral aspect....
The T.A.C. guys would have us believe that they, or some expert somewhere, can draw a sharp line between "medical" and "behavioral" - that this is a matter of Science after all, or Special Knowledge.
No. Even schizophrenia and bipolar remain putative diseases, with no proven biological basis or etiology. Actually whether anything called mental "illness" is medical or behavioral can only be a matter of viewpoint in social policy, economics, philosophy, prejudice, and/or various other fuzzy and subjective things.
As the National Institute of Mental Health recently put it, "... curremt diagnostic categories likely do not distinguish among causal factors or provide homogenous endophenotypes." (Translation: nobody knows what any of these so-called mental illnesses actually are!)
So why, exactly, do these oh-so-smart guys at T.A.C. think a meaningless and delusory "universal recognition" would be such a breakthrough?
Because they think it would justify forced psychiatry, that's why. That's the only reason.
Tom Szasz has said, "The subject matter of psychiatry is human conflict. However, perhaps because men are men and not animals, they cannot simply coerce, oppress or exterminate their fellows; they must also explain and justify it."
As far as T.A.C. goes, fraud is still fraud, and what goes around comes around.
To begin with, how can "medical" and "behavioral" be mutually exclusive categories of illness? This would necessarily imply either that behavior is not affected by anything which medicine can remedy, or that we just never use medicine to change behavior even when it's possible to do so. Obviously, the widespread existence and practice of psychiatry itself contradicts this.
T.A.C. pretends to advocate only in regards to severe mental illness. So perhaps they mean that millions of people taking Prozac who were never actually psychotic or completely disabled by their blue moods have behavioral problems, not any medical illness. The same would probably go for the millions who take Ritalin to stay sharper in school or more focused on the job.
Yet all of these guys, I'm quite sure, would argue long & hard that their condition is medical, too. If not, then why should their insurance pay for their drugs? Seems to me a condition is medical exactly according to whether or not somebody takes medicine for it, simple as that.
I might add, whether people take "medicine" for a condition doesn't have much bearing on whether they are helped or cured, in any objective sense. Last time I checked, good Scotch whiskey was a great "cure" for just about anything according to somebody, somewhere. And those who find that long-honored cure to be more of a nuisance than whatever the disease was which needed "treatment" can then choose to solve their addiction with LSD. This is all perfectly medical, of course. But I think most of us would see some behavioral aspect....
The T.A.C. guys would have us believe that they, or some expert somewhere, can draw a sharp line between "medical" and "behavioral" - that this is a matter of Science after all, or Special Knowledge.
No. Even schizophrenia and bipolar remain putative diseases, with no proven biological basis or etiology. Actually whether anything called mental "illness" is medical or behavioral can only be a matter of viewpoint in social policy, economics, philosophy, prejudice, and/or various other fuzzy and subjective things.
As the National Institute of Mental Health recently put it, "... curremt diagnostic categories likely do not distinguish among causal factors or provide homogenous endophenotypes." (Translation: nobody knows what any of these so-called mental illnesses actually are!)
So why, exactly, do these oh-so-smart guys at T.A.C. think a meaningless and delusory "universal recognition" would be such a breakthrough?
Because they think it would justify forced psychiatry, that's why. That's the only reason.
Tom Szasz has said, "The subject matter of psychiatry is human conflict. However, perhaps because men are men and not animals, they cannot simply coerce, oppress or exterminate their fellows; they must also explain and justify it."
As far as T.A.C. goes, fraud is still fraud, and what goes around comes around.
Friday, October 8, 2010
DSM5 proposal
Diagnostic criteria for 295.001 Prodromal Anosognosia
A. Excessive avoidance for a period lasting longer than a few weeks, for reasons not related to economic austerity, of normally effective medications or over-the-counter remedies for common discomforts such as cold symptoms, allergies, headaches, muscle soreness, hangover, or difficulty falling asleep.
B. Failure to visit a medical doctor for routine checkups for a period lasting longer than two years.
C. Failure to obtain health insurance; or consistent failure, neglect or refusal to answer official communications from insurance authorities, complete necessary forms and questionaires, or otherwise responsibly attend to administrative details which are recognized as necessary for fair and effective medical insurance coverage.
D. Habitual or repeated patronage of internet websites which puport to "expose psychiatric violations of human rights" or "advocate prosecution of psychiatric crimes".
E. A confirmed record of any four or more of the following statements of effective opinion, not subsequently disavowed:
A. Excessive avoidance for a period lasting longer than a few weeks, for reasons not related to economic austerity, of normally effective medications or over-the-counter remedies for common discomforts such as cold symptoms, allergies, headaches, muscle soreness, hangover, or difficulty falling asleep.
B. Failure to visit a medical doctor for routine checkups for a period lasting longer than two years.
C. Failure to obtain health insurance; or consistent failure, neglect or refusal to answer official communications from insurance authorities, complete necessary forms and questionaires, or otherwise responsibly attend to administrative details which are recognized as necessary for fair and effective medical insurance coverage.
D. Habitual or repeated patronage of internet websites which puport to "expose psychiatric violations of human rights" or "advocate prosecution of psychiatric crimes".
E. A confirmed record of any four or more of the following statements of effective opinion, not subsequently disavowed:
- Mental illnesses are not real brain diseases.
- Mental illnesses can be controlled by individual will.
- There is no objective medical test to diagnose or rule out any DSM disorder.
- Psychotropic medications have dangerous side effects.
- Children can become addicted to Schedule II stimulants.
- Psychiatrists perpetrate fraud and abrogate the right to informed consent.
- Psychiatry kills.
- The insanity defense should be abolished.
- Involuntary commitment should be abolished.
- Psychiatry is pseudo-science.
Tuesday, September 7, 2010
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.
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.
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.
Wednesday, September 1, 2010
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.
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
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.
Monday, August 2, 2010
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!
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!
Friday, July 30, 2010
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.
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