Psychiatry and the Easter faith

Why do you look for the living among the dead?

Mourners visiting a tomb were asked this question one morning, long ago.

I ask it today of anyone who might study the mind or presume to heal mentally caused ills within a framework alienated from religion or in non-religious fields.

Lately we favor the proposition that bad behavior and unpleasant feelings are sicknesses or diseases of the brain. We believe doctors who specialize in behavior (but tellingly, not doctors who actually specialize in the brain) can solve social problems by medical means. We even tend to believe that scientific medicine is the best and most vital route to happiness in general.

We are apparently so far gone as to accept on faith that an individual exists only as chemical reactions in synapses, only as a brain, grey matter, mud. We look in the mirror and see only a machine, which we expect to entirely predict and control without reference to any concept of soul.

We spend millions to research drugs to heal our souls, and find only drugs that fail to heal earlier drugs. We excuse our worst behaviors by lamenting the wrong drugs and the missing drugs. We don't tell the truth, we don't live the truth, and we don't know the truth.

This is psychiatry. We look for the individual, the living, in places of the dead.

He is not here. He is risen.

Passover and NGRI

A report in today's paper by Chicago Tribune reporter Amanda Marrazzo illustrates our moral confusion, and a lesson from the Passover Haggadah may offer a touchstone, about criminal responsibility and mental illness.

Ruth R. Wisse recalls in today's Wall Street Journal how her father had emphasized the message, "And the Lord brought us forth out of Egypt -- not by the hands of an angel, and not by the hands of a seraph, and not by the hands of a messenger, but the Holy One, blessed be he, himself, in his own glory and in his own person."

Likewise, when we face the toughest tasks in life we should not merely, automatically defer to agents and presumed experts. When society and the state consider what to do with those people who are most difficult, it must not try to create "scientific" machines which need no supervision.

Use of psychiatric "diagnosis" and evaluation in forensic circumstances is really just the attempt to employ experts and messengers, if not angels. We try to create a bureaucracy to confront such mental extremity as will make any one of us tell some fellow human being (whether or not aloud), "I don't like you, I don't understand you, and I don't know what to do with you."

Mothers killing their children, random, inexplicable violence and school shootings are our Egypt. There will be no exodus, we will win no freedom, by the hands of psychiatry. Doctors do not know the causes of insanity. The promised land is not in our brains or our DNA.

The pretense of forensic mental health is that responsibility, culpability, human emotion and reaction, thought and behavior can be explained and controlled by medically examining and manipulating people. We have established state institutions and clinical services employing thousands of professionals under this pretense. Presently the media are calling for more establishment, more clinicians, more laws requiring that more people be controlled and "treated" -- all for more (much more) money.

And it doesn't work. It's slavery.

Amanda Morrazzo has been a freelance reporter for a long time. Why would she make the clear error of  saying a hearing will determine how long a defendant will be in custody after being found not guilty by reason of insanity (NGRI)? The hearing referred to will set a Thiem date -- the date when the insane defendant must be released regardless of any "treatment" success or failure. This custody is not for punishment: theoretically it only serves justice by helping the defendant while protecting society.

It's a lie of course. Forensic psych patients are tortured and dehumanized and taught to cleverly deceive society and themselves. They are more dangerous when they are released with their "diagnoses" and their lifetime prescriptions. The drugs are barely tolerable for limited, utterly unpredictable amounts of time, and the time bombs tick in our Egypt. People know instinctively when they are punished by others too weak to not pretend they are helping.

We want improved "mental health" but the term itself has become the forlorn hope for an angel or a seraph or a messenger. It is not by such that we will be brought out.

We may redeem ourselves in our own glory and our own persons, only when we can do this most difficult task ourselves. Sooner or later we must each talk to our own crazy people face to face and learn to change minds without force.

It's cheaper to kick somebody's ass

My attention returns from Hollywood to Southern Illinois. Chester to be precise, in Randolph County.... One reverts to a peculiar frame of mind, about as far away from Hollywood as it's possible to get culturally, without departing (which has become, in my lifetime, amazingly difficult) from Western Civilization itself.

C. Rodney Yoder was my first client, and he remains my closest conscious connection to both Southern Illinois and Dr. Thomas Szasz. Rodney referred me to an article today, which reports that a Cook County judge recently found a 55-year-old defendant not guilty of attempted murder by reason of insanity. (NGRI verdicts are still curiously common in bench trials, although they've long been a much tougher sell to juries.)

This defendant had been held as unfit to stand trial at Chester Mental Health Center and forcibly drugged with various psychotropic poisons for several years. All the heroic "treatment" ultimately had produced no change, according to a testifying state psychiatrist.

The article makes special mention of a proclamation the defendant once made in court: "I'm not a psychopath, I'm a sociopath." Many people would say this was just an incoherent outburst from a sub-human madman. However, my own professional experience has taught me to consider whether it might mean something. This murderer might have been telling us he'd rather be in prison for the rest of his life than in a state nuthouse.

I think the distinction between sociopath and a psychopath boils down to this: If you're a sociopath, the rest of us will sooner or later gang up to kick your ass; if you're a psychopath, the rest of us will sooner or later gang up to "treat" you.

From the criminal's point of view, the right to choose one situation or the other might be desirable. Some would rather fight to the death, others would rather be (psychiatric) slaves.

For society on the other hand, it's a simple question of utility. There's little or no benefit from either course of action, but it's probably much cheaper to kick somebody's ass.

I'm not sure whether I would stand for the rights of murderers to decide their fates or not. But when somebody wants to go to prison, maybe they should be allowed to save the state the 400% higher expense of involuntary psychiatric "hospitalization". The only counterpoint to that, as far as I can see, is that if we find a murderer to be mad instead of bad, it allows some of us us to pretend we're being humane and scientific.

That's nonsense, of course. They know it down in Chester, too, even if they don't in Hollywood.

Jennifer Lawrence blew it

Oh man, I liked her! Falling up the stairs was cool, but how could she say something this stupid?

"It's just so bizarre how in this world if you have asthma, you take asthma medication. If you have diabetes, you take diabetes medication. But as soon as you have to take medicine for your mind, it's such a stigma behind it."

Nobody has to take medicine for their mind. In fact, there's probably no medical doctor anywhere who would hand a patient a prescription and say, "This is for your mind."

Psychotropic medications can be said to either control behavior or treat the brain. But doctors don't consider that they medicate minds, because they don't know what minds are, or even whether they exist. It's just not their business.

Maybe Jennifer Lawrence believes the mind and the brain are the same thing, so she uses the two words interchangeably.

And maybe she has no clue that asthma and diabetes are pretty objective conditions of the body which any given person either has or does not have, whereas the mind is a concept which has never been nailed down, photographed or perfectly tested for.

Maybe she has never heard that it's theoretically entirely impossible to prove an absence of mental illness, though courts and juries expect defendants or prosecutors to try from time to time, usually to the detriment of somebody's most fundamental rights to privacy and liberty. Maybe she's oblivious to the problem of a complete lack of scientific validity in the diagnosis of specific mental disorders, and even an embarrassingly low degree of simple reliability.

Maybe she's never heard of black box warnings on the "medicines" which she thinks people take "for their minds". Or maybe she thinks the FDA has also warned that asthma and diabetes drugs cause suicidal and homicidal ideation, long-term disability and early death. So everything's equally risky, everything's the same as everything else.

Or, maybe she's just really stupid, which would be upsetting considering what a beautiful, great actress she is.

There's one darker possibility. Maybe, like many people who glibly repeat the Pharma/APA/NIMH/NAMI orthodoxy, Jennifer Lawrence figures it will pay well enough that she doesn't care who it hurts.

Hollywood and psychiatry's demise

I have often referred to Thomas Szasz's theory that absent the facility of state coercion, psychiatry as we know it would rapidly fade away. And I think my own objections to psychiatry would become effectively irrelevant if all forms of the insanity defense and involuntary treatment were simply abolished.

However, if you see psychiatry as a legitimate medical specialty, and believe or hope that brain research will enable more effective treatments and understanding of the causes of mental illness, you might not imagine that it ever could or would fade away, any more than physics, or society itself, or truth.

Culture is the continuing combined attempt of humanity to assign meaning to the experienced world. It is created truth, rather than discovered truth. It may randomly partner or compete with science, and it may be a stronger or a weaker influence than science upon events of all kinds, depending on circumstances. Any prediction of cultural trends is probably arrogant by definition. (Oh, well...)

The high priests of science do research funded by the United States government, and the high priests of culture make Hollywood movies. Right now, from the perspective of us common people who merely market and consume brands, we have apparent competition.

President Obama is calling for breakthrough brain research and "mental health" solutions to endemic human violence. Hollywood is making movies like Silver Linings Playbook and Side Effects.

At first glance, these two films present dramatically different pictures of psychiatry.

Silver Linings shows both psychiatrists and patients as entirely human, tragic and adorable. The mental health system is part of the background, but it's not very relevant because ultimately things can turn out the way good people want them to. In almost total contrast, Side Effects shows both psychiatrists and patients to be criminals, motivated entirely by money and spite. The mental health system is utterly, irredeemably corrupt, and no one ever helps anyone, no matter what they say.

But the contrasts are less interesting, as culture, than the complementary influence these two films might exert toward undermining psychiatry's brand.

Hollywood now seems to completely discard all reference to the 20th Century ideal of beneficent scientific medicine, in these portrayals of bad behavior as a public health issue. The characters in Silver Linings and Side Effects are all equally out of control and unpredictable. The "diagnoses" are random and irrelevant, and the doctors are clearly not Ben Casey or Marcus Welby.

Never mind whether someone on a "therapeutic" dose of Seroquel can ever be a beautiful dancer, dance still cures unhappy and crazy people. And never mind whether a drug can really cause a sleepwalking murder, everyone in the mental health business is a dangerous liar anyway.

These are not ideas which enable psychiatry as we know it. In fact it's pretty safe to say that if most people agreed with the reality of these ideas, they would not come up with a system wherein psychiatric experts get primary jurisdiction over who should be locked up without trial, who should be forcibly drugged, who should be excused from criminal responsibility.

The reason psychiatry has the power it has in Western countries, is that once upon a time a couple of generations ago, people would have found Hollywood's depictions of mental health issues in both Silver Linings Playbook and Side Effects to be completely unrealistic or even offensive.

We live in a different world now, and I think despite President Obama's urgings, psychiatry as we know it is a nearly lost cause.

Update - Billy's case a win

A couple months ago I outlined the case of a client whom I called Billy. His motion for pass privileges was recently granted by the court, despite the objections of the State and the psychiatric expert who said Billy should never get any privileges at all until he takes meds.

Of course, the expert tried to say things like... Billy lacked insight into his mental illness, Billy was refusing treatment, etc., etc. But everyone knew perfectly well, that all she really meant was, unless and until Billy caves, and sucks up to us and convinces us that he truly believes psychotropic drugs help him and treat his illness - well, he'll just never go anywhere.

This became obvious when the psychiatrist admitted under cross examination that the standard of practice in psychiatry was supposed to be determined by results from scientific studies, none of which she had ever read. The State tried to make a point that academic psychiatry and research were, after all, less important than forensic psychiatry, which is for criminals and doesn't need to consider any science. But it was too late.

Billy's judge sustained various objections to my cross examination of the psychiatrist. He noted that she was just saying, well, Billy is a special kind of paranoid schizophrenic because he had committed a brutal murder, and therefore maybe he should be kept on drugs for the safety of the community. Really, the judge's comments often seemed like he was making the State's case.

But after several hearings, the judge said he wanted to think it over. When his decision was announced, Billy won.

I think this judge just wasn't buying into the whole orthodox psychiatric viewpoint any more. He heard the evidence in this case, and began to doubt if severe mental illness is really any known brain disorder or disease after all. His decision certainly was that Billy need not take the drugs just to have a supervised off-grounds pass privilege. And that, despite what the psychiatric "expert" swore to.

I was encouraged.

Lloyd Sederer, psychiatry and violent crime

The forced-drugging crowd think they can make hay with the Sandy Hook shootings. New York's director of Mental Health wrote in a recent Wall Street Journal op-ed about what he calls the tragedy of mental health law. 

Lloyd I. Sederer, M.D., thinks the tragedy is that mental health law doesn't work to protect communities. Well, guess what? It never has and never, ever will. The real "tragedy of mental health law" is that any state psychiatry exists in the first place.

Our version of this monstrosity was probably generated back in the 1950's by an apparently humane consideration: "Maybe instead of just punishing these people who do terrible things, we can fix them."

Of course, fixing people meant mechanically somehow, like fiddling with their brain chemistry, because people were, after all, understood to be just mechanisms....

It seems that any social institution based on a fundamental misconception will progress through predictable phases, from inspirational creation through ever more onerous work, confusion, complexity, enforcement, incomprehension, ultimately arriving as a nightmare, in dark and tragic farce.

One of the most frightening examples of Orwellian "newspeak" I've seen in a long time, is Lloyd Sederer's call for "user-driven design" of mental health services. User-driven, in the context of the easier forced treatment regime which Sederer favors, must be when patients become pieces of burning fuel to drive roaring combustion in the engine of state psychiatry, producing nothing, taking society precisely nowhere, but deafening and blackening the soul.

Sederer cynically complains that law plays a more prominent role in psychiatry than in any other medical specialty. But psychiatry is more an arm of the law than it is a real medical specialty. Psychiatrists themselves wanted it that way and planned it, beginning at least as early as the 1940's. And without such a prominent role of law - that would be without involuntary commitment or forced treatment, and without the insanity defense excuse for criminal acts - psychiatry would have a much-reduced presence in society or none at all. As Thomas Szasz often suggested, it might just wither away.

The claim that serious mental illness makes it difficult for patients to assess their own need for treatment is a veiled statement of the ultimate "anosognosia" myth which serves only to make the Hippocratic Oath irrelevant and medicine a blind servant of a totalitarian state. 

What really makes it difficult for patients to assess their own needs is psychiatric lies about the nature of mental illness itself, and about the risks and benefits of dangerous drugs, electroshock and other brutal methods of control merely disguised as "treatment".

The rules and procedures for patient protection do not exceed common sense so much as they exceed all comprehension. But that's not because they are outdated and unnecessary. It's because they're a product of constant back-and-forth efforts in evasion, mitigation, alteration and restoration over many decades, as the original, fundamental misconception has gradually produced incontrovertible empirical proof that the system will just never work.

What we need to do is give it the hell up. We can help our fellow man and make our communities safer, but never by "diagnosing" people with fake diseases and drugging them into disability.

We can start with total abolition of involuntary "hospitalization" and "treatment", and the insanity defense.

Only when we erect a wall of separation between psychiatry and the state will the tragedy of mental health law be over.