Marva says I'm a bully!

I have a client at Elgin Mental Health Center who drives me nuts. I like that, because it means the person is smart enough to get under my skin a little.

One of the staff on this client's "treatment" team is a nurse or security person (I don't even recall her exact title or role and it doesn't seem to matter) and a union boss (which probably does matter a lot). Her name is Marva. Perhaps that's a nickname for Marvelous, but I don't know.

My client gets under Marva's skin, too. And even though I really don't know Marva, haven't worked with her in the decade-plus that I've been advocating for people at EMHC, only met her once as far as I can recall (and in that instance I was actually impressed -- she seemed marvelous enough to me), it seems that somehow I must be getting under Marva's skin now, too.

Anyway, my client says Marva calls me a bully. Fascinating! Marva is the one who can  have people forcibly held down to be shot up with psych drugs on her whim (and has done so recently in fact)!

All I can do is talk and write. If my words carry any intimidating force, whether they are spoken to a judge in court, to a passerby on a sidewalk, to a public official in a letter, or in this blog; whether they are polite, or clever, or obnoxious, it's only because someone might agree with them.

I have no idea how I can "bully" anyone, unless they are afraid of me because I might find out something they are trying to hide. But anybody like that is "bullying" him or her self really, by his or her own guilty conscience.

I recently suggested that Marva may have been the one who attempted that stupid, anonymous "complaint" about me to the ARDC. She seemed like a long shot as a suspect, at the time. But so far, I've had no denials from anybody I named, so I can't rule any of them out.

I've gone back and forth. I thought Dan Hardy, Medical Director at Elgin, was the best suspect for awhile, because he is trained as a lawyer but hasn't practiced law for a very long time. He'd know the legal term, "defamation per se" but he might fail to realize that the ARDC never takes anonymous complaints about lawyers defaming psychs (the thought of that is just hilarious, really).

I also figured Dr. Malis or Dr. Hussain (two unit psychs at Elgin) might have pulled this goofy prank. But I've seen all three of these guys (Malis, Hussain and Hardy) since I wrote that last blog, and although none of them took any trouble to deny... they just didn't come across to me as very suspicious.

When people are afraid you'll find something out about them, they start being critical of you. It's an instinctive thing, they just can't help it.

So there's Marva, telling my client I'm a bully. Marvelous Marva!

Abused by a COWARDLY psychiatrist

This afternoon I received a letter dated June 3, from the Illinois Supreme Court's Attorney Registration and Disciplinary Commission (ARDC), informing me that on May 30 they had received an anonymous complaint regarding my conduct. The ARDC enclosed a copy of the complaint and stated, "We have reviewed the communication and have determined that further action by this Commission is unwarranted."

First of all let me just say, HAHAHAHAHAHAHA!!!

But perhaps I should elaborate.

This anonymous "complaint" was (supposedly) from a co-worker of Alicia S. Martin, M.D., the Elgin Mental Health Center psychiatrist whom I excoriated as an abuser, in my blog article of February 3, 2014. I accused Dr. Martin of abusing her patients, her employers and many other people for money, or for status, or possibly for other motives, none honorable.

Just to make sure I'm not misunderstood, I hereby reiterate, for the record, those precise accusations.

The next issue might be, who filed this anonymous "complaint" with the ARDC? What were his/her motives for doing so, and what did he/she expect to accomplish?

There are several people at Elgin Mental Health Center, I'm fairly sure, who don't like me. On one hand, I was once called a valuable member of a clinical treatment team, by a psychiatrist! On the other hand, my natural instinct is honestly to defeat treatment teams rather than to collaborate with them. I resist this instinct when a team is willing to follow the law, and I have considerable respect for many clinicians at Elgin. Almost all are well-intentioned, and many are capable of clever effects in helping. But they do not habitually follow the law, they cheat.

They cheat because they have to. It's impossible to do what the law, and the taxpayers, expect: routinely improve the behavior of bad guys with medicine. So the "forensic mental health" enterprise becomes (as I said in the offending blog about Dr. Martin) a racket.

Right now I am defending another forced drugging petition. The psychiatrist who filed that petition might be one of the best suspects for having authored this recent ARDC "complaint". His name is Dr. Richard W. Malis, M.D. So far, I have nothing quite so bad to say about Dr. Malis, as what I said before about Dr. Martin. However, he and I apparently do not get along. We'll just see.... If he tells me he did not write the anonymous "complaint", I will believe him, and I'll apologize for the accusation here. If he did write the complaint, I'll simply laugh at him, because it was a stupid waste of his time. But I don't think he's very stupid, so maybe he didn't write it.

Other possible anonymous complainants might include the psychiatrist Dr. Syed Hussain, M.D., one particular social worker on the White Cottage Unit named Mario, and another staff on White named Marva. There's also a psychiatrist on L Unit (name escapes me at the moment) who may feel that I've recently been too critical or insulting toward her. I would encourage any or all of these guys to let me know if the complaint was not filed/written by them. I will believe them, and apologize. But if they don't deny, I will probably continue to mention them, by name, as suspected idiots (for wasting their taxpayer-financed time) and cowards (for being afraid to put their name on the complaint).

The ARDC complaint ends with the statement, "This complaint is being filed Anonymously..." (the capitalization strikes me as a bit weird, by the way) "...as Mr. Kretchmar engages in intimidating behaviors towards the staff at Elgin Mental Health Center." Needless to say, this is my favorite part!

If writing and publishing this, new article is intimidation, well... expect much more of the same, and worse!

However, I'll also keep in mind the possibility, however remote, that somebody was honestly offended by my accusations against Dr. Martin, and that I am seen as a real threat to something that is thought to be good and that needs defense. I would actually love to believe that's the case. If this ARDC complaint was made by a good, well-intended person, I am no threat to that person, and I would consider it a most valuable opportunity if I could somehow engage in a discussion with them.

APA Annual Conference 2014: The Future of Psychiatry

At 3:30 pm on Tuesday, May 6th, APA President Jeffrey Lieberman opened his talk on "The Future of Psychiatry" by asking how many people in his audience were not psychiatrists. Along with only two others, I raised my hand.

Lieberman then asked each of us what we were doing there. I said that I was a lawyer working with psychiatrists. He queried, "What side are you on?" I shrugged from the back of the room and smiled, and after a moment he asked, "Are you on the side of truth?" I answered, "Absolutely! And justice, and the American way."

He then suggested that someone in the crowd should probably take my picture, just in case....

Lieberman is a politician and a PR man, but his viewpoint is a little incoherent, and he just never quite wins.

After a brief, fairly competent lesson on the history of psychiatry (he omitted a few chapters, of course, like the key role psychs played in the holocaust and the highly embarrassing "satanic abuse/multiple personality disorder" craze in the 1990's), the President of the APA offered his key predictions for the future:

     1. Psychiatrists will work more and more for large organizations. They will not be hands-on, direct care clinicians as much as they are now. This is due to simple economics, i.e., no one wants to pay psychiatrists for direct care, because they're not worth what they charge. But ideally in the future they can become the elite advisors or "captains" of treatment teams, mostly removed from human patients.

     2. Breakthrough technologies from scientific research into the brain, and the position of psychiatrists as first implementers of these new technologies, will be the single source of value and power to command public resources for the profession, going forward. Modern culture has not caught up with the overriding significance of the brain, but when it does psychiatrists will be able to assert their role as the real experts on all of life.

Whether these prognostications seem glorious or darkly threatening, there is a major countervailing factor. BRAIN was one of two key words in Lieberman's dissertation. The other word was STIGMA.

Stigma is purportedly the basic reason why psychiatrists don't have the power they should, and why they can't get paid enough. People don't like to talk about mental illness or admit having it, and they don't want their friends to know if they're seeing a psychiatrist.

Ironically, psychiatrists themselves may stigmatize psychiatry as much as the lay public does. An interesting poster in the exhibition hall described a recent research study in Belgium which concluded, "It could be useful to explicitly start with anti-stigma campaigns during medical training in order to avoid a continuing decrease in the number of candidate psychiatrists." One of the authors of the study told me that as little as ten years ago, there were on average seventy candidate psychiatrists per year in Belgium; now there are only ten or fifteen. She said the trends are the same throughout Europe. It's just too socially embarrassing to be a psychiatrist.

So, on one hand Jeffrey Lieberman sees great and increasing power for the psychiatric elite as captains of a medical-industrial complex ruled by those who know the secrets of the brain. But on the other hand, he and the APA are now hiring crack PR firms to fight stigma, because after decades of public campaigning nothing has worked, and psychiatrists around the world can't even admit their profession to ordinary people in social circumstances.

With his forlorn hope that scientific miracles and arbitrary assertion of authority can save the psychs from the black stigma magic in the nick of time, there is an obvious schism between Jeffrey Lieberman and reality. Funny how that reminds one of a once-postulated "disease", schizophrenia.

There is no unity of view, or authority, in psychiatry. It's a profession falling apart.

As I left the hall after the President of the APA had given his speech on the future of psychiatry, I was approached by a doctor who asked me where I practice law. I told him Chicago, and he responded that he had family there, including six siblings who were all lawyers. He said that despite what Lieberman had implied earlier, as far as he was concerned I was welcome at the APA.

Allen Frances & Samuel Sewell (an Update)

Several years ago, I read one or two articles by Allen Frances and suggested that he might be a constructive force for reforming the cruel, corrupt and inhuman field of "mental health". Little did I know at the time I wrote that blog article that he would soon be considered a leading critic of American-style, "label-'em-&-drug-'em" psychiatry.

Dr. Frances recently published a curious little book: Essentials of Psychiatric Diagnosis: Responding to the Challenge of DSM-5 (NY: The Guilford Press, 2013). I just got a copy from Amazon of the revised edition (published only four months after the original -- no idea why such a quick revision was necessary & I am curious about that).

On one hand, the book is replete with cautionary statements about various DSM-5 "diagnoses", and Frances does consistently suggest that labeling people with psychiatric disorders is a dicey business.

But on the other hand this is a clear, opportunistic attempt by the erstwhile most-powerful-psychiatrist-in-America to maintain some vestige of his remunerative franchise as a famous diagnostician despite replacement of his very own DSM-IV last May.

I initially found it disappointing and ironic that Dr. Frances is now making money by ostentatiously piggy-backing on the sale of the APA's new DSM-5.  His book even looks exactly like the DSM (albeit smaller), with the same typefaces and formatting.  With the exception of a 16-page introductory chapter, it follows the DSM outline chapter-by-chapter and diagnostic-code-by-diagnostic-code. It is, effectively, a DSM-5 supplement. Minor omissions of individual diagnoses and an altered sequence of disorders are insignificant changes. If I were the APA, I might consider some sort of intellectual property claim...

Under a very thin guise of criticism, it sure seems that Allen Frances is actually supporting the psych status quo. He just wants to continue making money from it like he used to when DSM-IV was king of the hill. Frances has never repudiated the central idea, that unwanted human emotion and bad behavior must be essentially brain disease, treatable according to the medical model. He merely hopes psychs will be more conservative in asserting their philosophy and a bit more careful about damaging people, so the profession can avoid calamitous bad PR.

But there is another interpretation and a more optimistic view. We probably don't need dramatic, road-to-Damascus conversions, or even Judge Sewell apologies, to end specific psychiatric evils in the world and bring a new, freer day of human dignity. Little by little, the culture is changing. It might get much better pretty soon, and in future decades history might credit Allen Frances for some sort of personal mea culpa leading to positive changes, even if he himself never intended any such thing.

The real changes will never come from correcting such middling problems as Frances sees with DSM-5. They will come from total elimination of the one thing which Frances never addresses directly, although his arguments all hint around about it and point toward it: legal coercion of "treatment".

In fact, psychiatric "diagnosis" is not done for any purpose of finding useful treatment, it's done to justify "treatment" which is useful mainly to people other than the patient. The patient arrives, directly or indirectly, because the police bring him in.

And for the moment at least, Dr. Frances is still in the business.

Abused by a psychiatrist

Dr. Alicia S. Martin, M.D., was a staff psychiatrist at Elgin Mental Health Center in Illinois for some years. She just retired last week.

I define psychiatric abuse as physical, emotional, social or financial injury, harm, damages, fraud or deception, perpetrated in the name of or under cover of mental healing.

Dr. Martin abused her patients, her employers (Illinois taxpayers, including me) and many other people. I would guess that she did it for money, to satisfy her appetite for personal status, and to cover up the fact that she had no idea how to do the job she was supposed to do, among other possible motives.

It is freely and officially acknowledged by mental health professionals generally, and by those employed in institutions run by the Illinois Department of Human Services, that treatment of the mentally ill should occur according to collaborative plans which consider a patient's views. The State's Mental Health Code actually requires this model (see 405 ILCS 5/2-102) for involuntary patients.

Part of the reason is that we all want to believe we can refrain from brute force, because we're so modern and scientific and compassionate. I'm cynical about it from the long view, but I'm usually willing to give some benefit of doubt to individuals.

Another part of the reason is that coerced or forced "treatment" almost always does more harm than good, so well-intended people try pretty hard to stay away from it.

But things have not gone well over the last century or so in forensic psychiatry. Society started to expect miracle cures from medicine, and psychiatry started to insist it was a medical specialty. So by the middle of the Twentieth Century, psychiatrists were on the hook to save American communities from all bad behavior, especially violence. Beginning in the 1960's, they sought to fulfill this new duty by fine-tuning the brain chemistry of people who committed violent crimes or otherwise behaved badly enough to land in the criminal justice system.

The whole concept was a categorical, miserable failure, ultimately acknowledged as such from the very top of the "scientific research" food chain.

But today we're stuck with a court system and a huge, bureaucratic, alternative custody establishment, which once had high hopes that psychiatry would make bad people good, and which remains more or less unaware that it was all nonsense from the get-go. Elgin Mental Health Center is a clear demonstration. They talk about collaborative treatment models even as they routinely and constantly coerce their "patients" (slaves) to take dehumanizing, harmful neuroleptic drugs.

Once in awhile some not-guilty-by-reason-of-insanity ("NGRI") murder acquittee says he/she doesn't want to take the drugs anymore, doesn't believe the drugs help, doesn't agree with the whole psychiatric view of things. The system can't really tolerate such dissent.

What happens then is this... The patient's psychiatrist files a petition for involuntary administration of psychotropic medication under Section 2-107.1. It's not entirely inconceivable that such a petition could be filed in good faith; however, most of the time everyone involved knows perfectly well that while the court is theoretically being asked for an order giving clinicians complete discretion to torture a human being, the real intention is merely to convince a particular recalcitrant patient and any others who might take an example to "consent voluntarily" to take their psychiatric drugs.

Dr. Alicia S. Martin filed such a petition in October, against a client of mine. This patient had actually stopped taking his medication unbeknownst to her sometime earlier, and he was feeling much better for that. He told me that without the drugs, he could suddenly think clearly and even read. He didn't feel like a zombie anymore, and he liked that. He wasn't causing any trouble on the clinical unit at Elgin, not fighting or threatening anyone.

The petition recited lots of "history" and many opinions and conclusions, but few if any actual facts. Our motion to dismiss was denied, but the court granted requests for formal civil discovery including leave to take Dr. Martin's sworn deposition.

Confronted with a deposition, Dr. Martin retired and the petition was withdrawn. Oops....

This was ABUSE.

It was attempted extortion of the patient, who was only exercising his right to make his own medical decision by informed consent. There was absolutely no deterioration, suffering or threatening behavior which could have justified involuntary administration of psychotropic medication under the law. The petitioner knew that very well. She proved it by running away from a deposition!

At best, if any genuine mental "treatment" of this patient had in fact been possible, it was delayed for those three months when he was being threatened with court sanctioned torture at the hands of the people who were supposed to help him.

This particular petition was only one nefarious act within the larger racket. The machine cannot run efficiently and legally at the same time, because the statutory and constitutional requirements of "least restrictive environment" and consideration for informed consent cannot be satisfied without revealing the utter falsehood... that mental illness is known brain disease, and psychiatrists know how to treat it with drugs. Section 2-107.1 petitions are simply the preferred tactic to evade those requirements.

Alicia Martin defrauded the taxpayers of Illinois for years by collecting her state salary under the false pretense that she could do the job they were willing to pay her for. She continues to defraud them if she collects any pension in her retirement.

To cover up the lie and the fraud, Dr. Martin's patients were coerced and occasionally brutally forced, to take drugs which harmed them and caused permanent disability (diabetes, tardive dyskenesia) and/or early death. They were also carefully taught to lie, to back up the rotten system by pretending they had been helped, after they were released into the community. 

The implications are even darker over the years. More and more disabled dependents nurse bitter grudges and wait to take their vengeance against the world if they can ever covertly engineer sufficient recovery to work, and plan, and perhaps buy a gun....

Dr. Martin's "patients" were never cured or effectively treated. They were ABUSED.

So was I. And so were YOU!

Gettysburg and a New Birth of Freedom

One hundred fifty years ago today, two massive armies arrived and began to slaughter each other at a small crossroads town in Pennsylvania. One eventual result of the Battle of Gettysburg was that men came to be considered more equal in their rights to live and to be free than they had ever been imagined to be before.

Equality in freedom and the universal individual responsibility which it demands are actually a huge problem. They mean we must ultimately communicate with our fellows, come to agreements with them, and understand them. For too many of us such a task seems ignoble. When we have certainty that a thing is right, why should we have to explain it to others who fail or refuse to see the truth? Perhaps those others are slightly less human than we are; perhaps we simply cannot communicate with them to any productive effect.

In state nuthouses where "patients" are involuntary and "doctors" force them to take drugs which gradually disable and dehumanize them, we see essentially the same institution of slavery that derived from the Confederate world view refuted at Gettysburg. Tom Szasz wrote a whole book about this.

In George Orwell's Animal Farm, the single great commandment evolved: "All animals are equal. But some animals are more equal than others." Those who were "more equal" (pigs) carried whips.  At Elgin Mental Health Center, the watchword is collaboration. But some people (patients) are required to collaborate more than others.

The world view refuted at Gettysburg was consistent with the idea that mental health or ill-health, though defined and evidenced only in interpreted behavior, is a genetic/biological issue. In Antebellum America some people were inferior by nature and were best suited as forced laborers. They often "had drapetomania" and tried to run away. In today's America, some people "have schizophrenia" and don't believe that antipsychotic drugs help them. We conclude that some of us must control others with force and coercion, and we pretend it's for the best.

But our nation will never see a new birth of freedom so long as the people believe the orthodox medical psychiatric myths, that insanity is brain disease and human beings are just animals. Those honored dead, who gave the last full measure of devotion on Little Round Top and Cemetary Ridge, will have died in vain.

It is for us, the living ... to outlaw all forced treatment, to ban the insanity defense, and to separate psychiatry forever from the state. Then and only then shall human dignity itself not perish from the earth.

What mental illness is

Mental illness is simply the problem of bad behavior, inseparable categorically from a continuum of crime.

Our attempts to distinguish mental illness from crime speak well of our human impulse to mercy. But often those efforts also point to our collective guilty conscience, and they present a terrible indictment of our organizational and logical evaluation life skills. Human nature and human society has not changed much in thousands of years, all triumphal pretenses to "science" aside.

This is an opinion which I come to from twelve years of legal representation and advocacy on behalf of involuntary mental patients (Tom Szasz called them psychiatric slaves). I have periodically had the same repeated realization: very few mental health professionals, lawyers, human rights activists or other critics of psychiatry, let alone all other people who pay bills and collect fees, are much oriented toward or even much conscious of, the issue of coercion in mental "treatment".

In the first article I ever wrote for this blog, I said everything starts and ends with the nuthouse. People who participate in the environment and operations of locked, maximum-security state institutions for psychotic killers and perverts have unassailable claims to citizenship. Anyone who has not been in a nuthouse has probably never had to confront certain questions... such as why we even try to separate so-called "mental illness" from crime.

The court says, "Hey, this guy did a terrible, disgusting thing. But maybe instead of just punishing him we can fix him."

Well, that's a good impulse. It's mercy.

Then we try to fix the murderer, or the child molester, with medicine. And these days we usually insist that he can be fixed only with medicine. If the criminal/patient doesn't agree with our medical approach, with the "diagnosis" and "treatment", then we fall back on a very complex and thorough system of enforcement.

This directly opposes our original impulse to mercy. We begin to remind ourselves of the Inquisition. We quickly become confused, start wasting blood and treasure, and look back at the continuing failure of humanity to progress or evolve.

(TO BE CONTINUED...)