It's a Rock Opera, full album, and this is the only full performance of it up. And, you have to click through to youtube to view it.
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Showing posts with label Psychiatry. Show all posts
Showing posts with label Psychiatry. Show all posts
Wednesday, January 9, 2019
Thursday, January 3, 2019
The Monster In Our House, What Psychiatric Medication Did To Our Father
"Trust us. We're Professionals."
Mad In America
Roberta Connors January 3, 2019
My cell phone rings.
“Is this ‘Robik’?” someone asks.
“That’s my nickname,” I answer, confused. “Who’s this?” It’s a police officer.
“We think we have your father here. He says he’s trying to get into your house.”
“I’m in my house. Where are you?” They’re outside, down the block. My mother and I run out to the street and approach the unforgettable scene: my father, old, grey and stiff, arms bleeding in handcuffs, is sobbing and yelling, surrounded by officers.
“You hurt me!” my father yells. “Why do you hurt me?” My mother and I, mortified and scared (please don’t shoot him, I pray to myself), run up to them.
“Does he have dementia?” an officer asks.
“Yes, I apologize for this.” I’m relieved to have an explanation. They take him out of the handcuffs and allow us to walk him home. My father tells me that he’s sorry, that he decided to take a walk but coming back he couldn’t discern which house was ours. So he started entering neighbors’ houses. We cry as we hold each other.
We had already warned him not to leave our house. We had already taken his car away. We were making plans to take away his cell phone. We were battling with the million little details of dementia. So we thought.
* * *
My father’s transition from being an independent person to one who could no longer care for himself was messy and prolonged. It took years for us to truly recognize his decline. We knew he was on antidepressants and anti-anxiety medications and that they didn’t seem to be successful. We supported his decision to sell his small business and go on disability because of debilitating stress and anxiety. He was nearing retirement age anyway. We agonized over his deteriorating driving skills and his increasing disorientation. We worried that he wasn’t taking his medications properly, or might even be over-medicating himself. But since he lived on his own — an hour away from family — we couldn’t be entirely sure what he was doing. To make matters worse, he was being sued by his downstairs neighbor for making excessive noise while walking in his home. We hired lawyers and acoustics experts and negotiated a settlement, but this is where my father seemed to spiral.
No one tells you when it’s time to take over for a parent’s care. You just realize that someone’s at the end of their rope, and they’re about to fall.
My realization came when my father’s housemate called us to let us know he had driven my father to his first electroshock treatment.
“Why is he getting electroshock treatments?”
“He says he’s depressed. He says he wants to die.”
When I called the clinic that was performing the “emergency” electroconvulsive therapy (ECT) on the advice of my father’s newest psychiatrist, it was clear to me that they did not know what medications he was taking, were expecting him to get himself to and from the clinic without driving (he planned to drive himself until we intervened and paid people to drive), believed he would actually follow their instructions (you’re not supposed to drive for at least a week after your last treatment), and believed he was on the brink of committing suicide. But my father was almost 70 and had never attempted suicide. I was alarmed.
Another important note: an MRI later revealed that my father suffered a mini-stroke (transient ischemic attack) some time before his psychiatrist signed him up for ECT.
“Do you know that my father is showing signs of memory loss and confusion?” I asked the clinician. “Are you sure electroconvulsive therapy won’t exacerbate this?”
“Although there can be mild memory loss from the ECT, your father is suffering from treatment-resistant depression, and the ECT can help him.”
He was wrong. It didn’t help.
* * *
You may have already heard that the statistics behind short-term and long-term effectiveness of psychotropic drugs are dubious — that for many people they simply don’t work or are harmful. You may have heard that the shifting emphasis on prescription drugs for mental health has not necessarily improved mental health. You may have heard about the hidden evidence that some antidepressants can increase a person’s risk of suicide. So consider this anecdote as a warning, with one important message: psychotropic drugs do not “balance” a person’s brain chemistry. They alter it, sometimes to an astonishingly harmful degree.
I never believed my father was clinically depressed. To the contrary, my father was gregarious, energetic and hard-working. He was a born performer, playing guitar, singing, performing as Santa Claus, emceeing wedding receptions, or reciting one of thousands of memorized poems and jokes. He had a witty, if caustic, sense of humor and he was always “on” in the company of others. The term “bipolar” or “manic depressive” would more aptly describe him, though his highs well outweighed his lows. I featured some of my father’s antics and talents in a compilation of old home movies — an entertaining glimpse into his typical disposition.
As I grew up, I recognized my father’s personality in people like Robin Williams (I’ll return to this point later). Like him, and like so many creatives with “dangerous gifts,” my father had demons. His marriage to my mother was deeply dysfunctional. He was a serial adulterer. His drinking of alcohol was likely influenced by his Russian genetic and cultural heritage. (Alcohol, I should note, is one of the most potent depressants a human can ingest.) And, as someone who had a family to support after immigrating to America at almost 40 years old, he shouldered immense levels of stress. He worked constantly. And the career he fantasized about, one full of music, singing and poetry, never materialized.
My father’s first foray into psychiatric medications coincided, not surprisingly, with the collapse of his marriage. A therapist prescribed Zoloft for depression. This was twenty years ago, before the term “chemical imbalance” was in vogue.
Following the Zoloft, two strains of a pattern emerged. Either my father would feel better and stop the medication, or he would feel worse and a doctor would increase his dose or introduce new medications. Throughout this pattern, my father continued to drink and never went to any sort of therapy. This lasted for close to two decades. He altered his mental state with pills and alcohol, which resulted not only in no improvement to his mental or emotional well-being, but ended with him abandoning his business and feeling worse than he ever had.
For me, there are a few clues that my father was misdiagnosed and mistreated. Medical professionals were probably rarely, if ever, exposed to the reality of my father’s bipolar personality, because when he was manically “happy” he was not making doctor’s appointments. It’s doubtful he confided in them about his level of drinking, partying and dysfunctional relationships with young women. Additionally, there was a language barrier. It was easier for my father to make simple statements, like “I’m depressed” and “I don’t want to live,” rather than try to find the appropriate English words to delve into his mental state and his manic lifestyle. He also probably became unable to differentiate between what might have been a side effect of one of the multiple prescriptions he was on, and what was his own self-diagnosed mental health issue. Most people, including doctors, don’t really know what the behavior they are seeing indicates. Unhappiness, sadness, boredom, stress, these can all come across to a doctor or patient as “depression.”
When he signed himself up for the ECT because he “wanted to die” and could hardly move his limbs, I’m betting his doctors and nurses didn’t stop to consider that a recent stroke and his self-medicating with alcohol and multiple psychiatric drugs might be contributing to his psychosis, or at least to cognitive impairment that could have led to the emotional devastation and anxiety he felt at the time.
One other thing I’m sure of: my father was a hedonistic pleasure-seeker. With his doctors, he found a high that could dull his senses and lift his mood. Although medical professionals may believe they are treating someone’s illness, my father, by ignoring things like therapy or sobriety, was enjoying the drug effect and sedation, the chemical fix for the unhappiness that came with the collision of his dreams and his reality. Meanwhile, the drugs wreaked continuous havoc to his brain.
Over the course of twenty years, my father was treated by or consulted with at least 16 different medical professionals who prescribed him a total of at least 21 psychotropic medications. He was frequently taking more than one medication at one time. Eventually, the antidepressants and anti-anxiety medications were not strong enough for him. His prescriptions were increasingly for antipsychotics, drugs that are used to treat schizophrenia and other psychoses, as well as anticonvulsants that are typically prescribed for mania.
Additionally, my father was taking medications for other maladies, like blood pressure, cholesterol and blood clots. It wasn’t until this year that someone pointed out to me that a statin can have neurological side effects, including depression, confusion and memory loss. My father had been on statins for years.
And, this is the hardest part for me to accept: It’s well-understood that SSRIs, along with several other drugs, increase the risk of a stroke. This is particularly true if a person has been on blood thinners, which my father had been. I’m still a bit enraged when I think about the fact that doctors didn’t warn my father that he could increase his chances of a stroke by being on blood thinners and antidepressants, especially considering that his blood pressure and cholesterol levels already made him a stroke risk.
* * *
Upon completing a whopping 11 ECT treatments, my father only became more disoriented, more forgetful and less coherent. We could no longer let him drive, so we sold his car and asked his doctor to notify the DMV that his driving was impaired. Having evidence of my father‘s recent mini-stroke and memory loss, the doctor surmised that it looked like he was beginning to suffer the early stages of dementia.
From then on, my father was ping-ponging between my sister, my mother and me as his caregivers. We prepared every meal, eliminated his access to alcohol, supervised nearly everything he did and dutifully took him to his medical appointments. This included an almost monthly visit with a psychiatrist. By 2018, my father was taking lithium for depression/bipolar disorder, lamotrigine for bipolar disorder, clonazepam for anxiety and sleep, donepezil for dementia, plus his statin and other medications.
Meanwhile, I became more and more alarmed by my father’s mental and physical decline. After reading a well-known tome about caring for someone with dementia — “The 36 Hour Day” — and joining a 20,000-member Facebook group for caregivers of people with dementia and Alzheimer’s, I was introduced to many symptoms that I recognized in my dad. He was emotionally volatile, frequently sobbing for no reason. His physical movements were impaired: he had trouble moving his limbs or bending his body in any way, which meant he never wanted to change his clothes, nor shower. His mental decline was staggering. He no longer understood basic facts, or people’s names, ages and relation to him. He had no ability to read, play guitar, or even watch television. All technology became a frustration to him. He had hand tremors. His writing ability regressed to the point that he couldn’t spell basic words and would write painstakingly and slowly, like a child. He asked the same questions over and over, compulsively agonizing about small facts. He had trouble seeing. He did damaging things on accident, like pour liquid soap into a cup and drink it, or leave a faucet on.
Worst of all, he developed extreme combativeness and aggression, even physically lashing out, and yelling angrily at the top of his lungs, often in public. We began to fear him and the increasing frequency of “catastrophic reactions” that are well-known in the world of dementia.
One thing “The 36 Hour Day” and all medical professionals seemed to agree on was the obligation to treat a patient’s depression, even if (and maybe especially if) the patient has dementia. But this did not make sense to me. His treatment for depression had all but failed for 20 years; I couldn’t understand why medical professionals pursued this unicorn of a cure. While they were busy experimenting with his brain, my father was becoming a monster, and it agonized us that he was behaving so wildly and dangerously with everyone who cared for him (and in front of my small children — who hated being around him). The only reprieve we got was when he slept, which was often. After all, the majority of the drugs he was on had major sedating effects. But when he was awake, it was like dealing with an aggressive, 200-pound zombie. We were nearing the end of our ability to manage him. We considered two end-of-the-road options: a memory care facility and/or much heavier medications. We toured some facilities and asked the psychiatrist for Seroquel. Seroquel is a “black box” drug, which means it comes with the FDA’s most serious warning for serious or life-threatening risks. It also increases the mortality rate for dementia patients. Even though it’s specifically not approved for dementia, it’s well known as an off-label treatment. To my shock, after all the hand-wringing we did about the Seroquel, I found out that my father had already had a prescription for it several years earlier, before the dementia diagnosis.
Between all the appointments, medications and terror in our home, a thought continued to nag at me: how could this man suffer such a massive decline? He was barely 70 years old. The people at the memory care facilities were wheelchair-bound and decades older than him. There was no way he could sit alongside them. He never wanted to sit. He stood and paced frantically, he could walk for hours. If he went to a facility, they would only sedate him more, because he would be a combative nuisance.
When we took my father to a neurologist to see if there was anything new to report on his latest MRI, we learned that nothing had changed. There was nothing more going on in his brain than his original scan showed two years earlier.
“Can you at least test him? Find out how bad his dementia is? We don’t understand why he’s behaving this way,” I said. But the neurologist said my father seemed to be past the point of being capable of sitting through testing. He couldn’t sit at the appointment, he was complaining and yelling from the moment we entered the room, to the moment we exited.
“You know, the dose of Seroquel you have him on is not that high. You might consider increasing it,” the neurologist offered. I felt so defeated. Not a single drug was improving his condition.
“Okay, but can we at least take him off some of these other pills? They’re clearly not helping.”
“That’s a conversation you need to have with his psychiatrist.”
We’d already had that conversation. Her response was to replace lamotrigine with Trileptal. She didn’t even know, and then was fairly unconcerned, about his dementia diagnosis. She asked him how he felt, he talked through his mental fog about how depressed he was and how it was the worst day of his life, and she typed on her tablet and tweaked his prescriptions. It was a textbook case of what I later learned is referred to as the “15 minute med check.” After a few of these appointments, it was clear to me that my father’s brain was a problem no one could solve and no pill had ever seemed to solve. Not only that, the fact that he was making life in our home impossible seemed not to register with anyone.
I came to the conclusion that because doctors are always going to aim for “treatment,” it’s very difficult for them to accept the concept that drugs are doing more harm than good and that abandoning them might be warranted. They are not thinking about discontinuation, tapering and the complicated nature of a body’s and brain’s withdrawal symptoms. When the medical professionals had seemingly no interest in my father’s completely “insane” behavior, I looked more closely at his medications. The side effects were staggering: blurred vision, tooth pain, memory loss, muscle stiffness, depression(!), suicidal thoughts, drowsiness, insomnia, aggression. I read about the tragic misuse of sedating medications on people with dementia and small efforts to end the practice. I read about the use of these incredibly strong psychotropic drugs on children in the foster care system, on prisoners, on migrants. I read in the caregiver Facebook group how many caregivers were sedating their loved ones with hardcore drugs, and treating them for depression and anxiety, and yet still experiencing agitation and violence, just like we were. A study even shows that long-term use of benzodiazepines leads to a significantly higher risk of developing Alzheimer’s. “Unwarranted long term use of these drugs should be considered as a public health concern,” the study concludes.
I also read about “polypharmacy,” which is typically defined by a patient taking more than five medications at one time. Polypharmacy is associated with an increase in adverse drug events, reduced functional capacity and several geriatric syndromes.
What are we participating in, I wondered? Why aren’t the doctors who are seeing my father get worse and worse scrutinizing the medications more closely?
I’m going to cut to the chase here:
My father now uses Skype on his own to talk to friends. He has a tablet to watch YouTube. He reads. He plays guitar. He’s memorizing new poems. He recently transcribed, quickly and with perfect spelling, the song he sings in the YouTube video. He plays with my children almost daily and laughs uproariously. We got him a dog and he walks her and loves her. He rarely sobs. He almost never yells. He changes his clothes and can shower by himself. He can walk to the neighborhood pool by himself, swim, and walk himself back without getting lost. His memory has markedly improved. And his severe muscle stiffness is gone. Hand tremors, gone. He can hop, skip, even sprint. He does push-ups and sit-ups in his room every day without prompting.
How did this happen?
Well, three months ago—without any medical professional’s knowledge or assistance — we eliminated his last psychotropic prescription (please note: abrupt discontinuation is not recommended). We have him on a healthy diet and a routine of physical activity. And no alcohol. And a little THC.
It was as if my father, the one I knew, came back from the dead. As the months go by and I watch him emerge from his chemical stupor, I am in disbelief that such a profound change can happen in a person simply by removing the side effects of medications (by removing the medications themselves). It occurs to me that for so long what we thought was his declining mental state could actually have been a state of disinhibition, the way one might feel when they’re high or drunk. His wild and impulsive behaviors, his disorientation, the loud and combative aggression — in hindsight they seem like that of a person who spent his waking hours inebriated. And now, in a matter of months, he’s sober.
Just imagine if we had let my father stay on the medications, as doctors prescribed. We would have assumed, for example, that his inability to write was a symptom of his dementia. If we had told his psychiatrist “he’s no longer able to write,” she would have chalked it up to the recent dementia diagnosis we told her about, and would have continued right on keeping him in the chemical cage that took away his fine motor skills. He would have spent years in the stupor, unable to write his poems and songs. How many other people, I wonder, are stuck in a chemical cage, not realizing that their mental and physical well-being has deteriorated because of side effects? A mere six months ago, we were considering memory care facilities for my father, and would have put him on more sedatives to manage him, which now seems truly absurd.
Now the flip side: He did have a mini-stroke and we do think there is some mental fallout from that. He is, and will always be, a drug-seeker, looking for the magic fix. He tells us often how terrible he feels, how depressed he is. The more coherent he becomes, the more aware he is of his loneliness, his sadness, and his boredom. A pill — I’m convinced — won’t fix that. It never did. As his voluntary caregivers, we do what we can to keep him active and stimulated, as well as safe and healthy. We’re not going to let him drive, and we still supervise him almost everywhere. But — and I’m not exaggerating — all of the monster-like qualities that we thought were severe symptoms of his dementia have practically disappeared. The spectrum of his emotional volatility narrowed substantially. We’ve found ourselves questioning whether he has dementia at all.
* * *
So, a word about Robin Williams:
When Robin Williams committed suicide in August of 2014, within days the world began talking yet again about the need to treat depression. Everyone seemed to gloss over the fact that Williams was misdiagnosed with Parkinson’s disease. His wife wrote about “chemical warfare” in his brain, the symptoms of which went far beyond depression and into confusion, memory loss, paranoia, intense anxiety and insomnia. She was keen to pinpoint the final diagnosis — Lewy Body Dementia — as the culprit responsible for his suicide. Few talked about Williams’ multiple medications as a potential issue. Like the fact that he had taken two medications for Parkinson’s, which not only can lead to psychosis, but are specifically flagged as inappropriate for people with psychiatric disorders because they can lead to psychosis.
On top of the Parkinson’s drugs, Williams was also taking an antidepressant called mirtazapine, a “black box” drug with noted suicide risk. Additionally, Williams had taken out a prescription for Seroquel mere days before his suicide. Williams did indeed have “chemical warfare” in his brain. But we can never truly know how much of the culprit was his dementia, and how much was the number of psychosis-inducing, sedating, debilitating chemicals that the doctor who was “treating” him prescribed.
Susan Schneider, Williams’ wife, made clear that Robin Williams was being treated for depression. He was, after all, a star with the best medical resources and treatments available to him. It’s not like they weren’t going to treatment. Schneider described at least a year of doctor’s appointments, of trial and error with medications, of worsening symptoms, of a “terrorist” inside her husband’s brain. It was as if she was speaking about my father. But my father got better. He may still call himself depressed, but he’s sober, stable and coherent, the value of which he will probably never admit nor appreciate, because he doesn’t remember what the monster in him was like.
Having had this experience, the way I look at psychiatry and psychotropic medications has completely changed. Of course, I understand that they work for some people (though time and life changes also work). I know stories of people who have had specific mental conditions and behaviors that certain medications helped alleviate, usually in combination with self-care, psychotherapy and eventual discontinuation. Antidepressants might be an important tool in certain situations, though the benefits have repeatedly been shown to be small, especially when compared to a placebo.
However, I can say with certainty that doctors and psychiatrists often don’t really know if they’ve got the diagnosis, the treatment, or the symptoms right when it comes to mental health. They often aren’t taking time to understand the brain they are altering. They are often unaware of what other medications the patient might be taking. They don’t know if they’re treating the patient, or the patient’s side effects. And they can’t be sure that the cure isn’t worse than the disease.
If you are being treated with psychiatric medications, please consider my warning:
They are experimenting.
Every time.
On you.
At the end of the day, the psychiatric drugs you or your loved one are on are sedatives and chemicals. Some go so far as to call them neurotoxins. The longer you use them, the weaker your brain gets at being able to regulate itself on its own. The higher your risk of deleterious effects. And the harder it is to get off them. But sometimes that’s exactly what needs to happen.
Thank You Ms Connors and MIA.
Mad In America
Roberta Connors January 3, 2019
My cell phone rings.
“Is this ‘Robik’?” someone asks.
“That’s my nickname,” I answer, confused. “Who’s this?” It’s a police officer.
“We think we have your father here. He says he’s trying to get into your house.”
“I’m in my house. Where are you?” They’re outside, down the block. My mother and I run out to the street and approach the unforgettable scene: my father, old, grey and stiff, arms bleeding in handcuffs, is sobbing and yelling, surrounded by officers.
“You hurt me!” my father yells. “Why do you hurt me?” My mother and I, mortified and scared (please don’t shoot him, I pray to myself), run up to them.
“Does he have dementia?” an officer asks.
“Yes, I apologize for this.” I’m relieved to have an explanation. They take him out of the handcuffs and allow us to walk him home. My father tells me that he’s sorry, that he decided to take a walk but coming back he couldn’t discern which house was ours. So he started entering neighbors’ houses. We cry as we hold each other.
We had already warned him not to leave our house. We had already taken his car away. We were making plans to take away his cell phone. We were battling with the million little details of dementia. So we thought.
* * *
My father’s transition from being an independent person to one who could no longer care for himself was messy and prolonged. It took years for us to truly recognize his decline. We knew he was on antidepressants and anti-anxiety medications and that they didn’t seem to be successful. We supported his decision to sell his small business and go on disability because of debilitating stress and anxiety. He was nearing retirement age anyway. We agonized over his deteriorating driving skills and his increasing disorientation. We worried that he wasn’t taking his medications properly, or might even be over-medicating himself. But since he lived on his own — an hour away from family — we couldn’t be entirely sure what he was doing. To make matters worse, he was being sued by his downstairs neighbor for making excessive noise while walking in his home. We hired lawyers and acoustics experts and negotiated a settlement, but this is where my father seemed to spiral.
No one tells you when it’s time to take over for a parent’s care. You just realize that someone’s at the end of their rope, and they’re about to fall.
My realization came when my father’s housemate called us to let us know he had driven my father to his first electroshock treatment.
“Why is he getting electroshock treatments?”
“He says he’s depressed. He says he wants to die.”
When I called the clinic that was performing the “emergency” electroconvulsive therapy (ECT) on the advice of my father’s newest psychiatrist, it was clear to me that they did not know what medications he was taking, were expecting him to get himself to and from the clinic without driving (he planned to drive himself until we intervened and paid people to drive), believed he would actually follow their instructions (you’re not supposed to drive for at least a week after your last treatment), and believed he was on the brink of committing suicide. But my father was almost 70 and had never attempted suicide. I was alarmed.
Another important note: an MRI later revealed that my father suffered a mini-stroke (transient ischemic attack) some time before his psychiatrist signed him up for ECT.
“Do you know that my father is showing signs of memory loss and confusion?” I asked the clinician. “Are you sure electroconvulsive therapy won’t exacerbate this?”
“Although there can be mild memory loss from the ECT, your father is suffering from treatment-resistant depression, and the ECT can help him.”
He was wrong. It didn’t help.
* * *
You may have already heard that the statistics behind short-term and long-term effectiveness of psychotropic drugs are dubious — that for many people they simply don’t work or are harmful. You may have heard that the shifting emphasis on prescription drugs for mental health has not necessarily improved mental health. You may have heard about the hidden evidence that some antidepressants can increase a person’s risk of suicide. So consider this anecdote as a warning, with one important message: psychotropic drugs do not “balance” a person’s brain chemistry. They alter it, sometimes to an astonishingly harmful degree.
I never believed my father was clinically depressed. To the contrary, my father was gregarious, energetic and hard-working. He was a born performer, playing guitar, singing, performing as Santa Claus, emceeing wedding receptions, or reciting one of thousands of memorized poems and jokes. He had a witty, if caustic, sense of humor and he was always “on” in the company of others. The term “bipolar” or “manic depressive” would more aptly describe him, though his highs well outweighed his lows. I featured some of my father’s antics and talents in a compilation of old home movies — an entertaining glimpse into his typical disposition.
As I grew up, I recognized my father’s personality in people like Robin Williams (I’ll return to this point later). Like him, and like so many creatives with “dangerous gifts,” my father had demons. His marriage to my mother was deeply dysfunctional. He was a serial adulterer. His drinking of alcohol was likely influenced by his Russian genetic and cultural heritage. (Alcohol, I should note, is one of the most potent depressants a human can ingest.) And, as someone who had a family to support after immigrating to America at almost 40 years old, he shouldered immense levels of stress. He worked constantly. And the career he fantasized about, one full of music, singing and poetry, never materialized.
My father’s first foray into psychiatric medications coincided, not surprisingly, with the collapse of his marriage. A therapist prescribed Zoloft for depression. This was twenty years ago, before the term “chemical imbalance” was in vogue.
Following the Zoloft, two strains of a pattern emerged. Either my father would feel better and stop the medication, or he would feel worse and a doctor would increase his dose or introduce new medications. Throughout this pattern, my father continued to drink and never went to any sort of therapy. This lasted for close to two decades. He altered his mental state with pills and alcohol, which resulted not only in no improvement to his mental or emotional well-being, but ended with him abandoning his business and feeling worse than he ever had.
For me, there are a few clues that my father was misdiagnosed and mistreated. Medical professionals were probably rarely, if ever, exposed to the reality of my father’s bipolar personality, because when he was manically “happy” he was not making doctor’s appointments. It’s doubtful he confided in them about his level of drinking, partying and dysfunctional relationships with young women. Additionally, there was a language barrier. It was easier for my father to make simple statements, like “I’m depressed” and “I don’t want to live,” rather than try to find the appropriate English words to delve into his mental state and his manic lifestyle. He also probably became unable to differentiate between what might have been a side effect of one of the multiple prescriptions he was on, and what was his own self-diagnosed mental health issue. Most people, including doctors, don’t really know what the behavior they are seeing indicates. Unhappiness, sadness, boredom, stress, these can all come across to a doctor or patient as “depression.”
When he signed himself up for the ECT because he “wanted to die” and could hardly move his limbs, I’m betting his doctors and nurses didn’t stop to consider that a recent stroke and his self-medicating with alcohol and multiple psychiatric drugs might be contributing to his psychosis, or at least to cognitive impairment that could have led to the emotional devastation and anxiety he felt at the time.
One other thing I’m sure of: my father was a hedonistic pleasure-seeker. With his doctors, he found a high that could dull his senses and lift his mood. Although medical professionals may believe they are treating someone’s illness, my father, by ignoring things like therapy or sobriety, was enjoying the drug effect and sedation, the chemical fix for the unhappiness that came with the collision of his dreams and his reality. Meanwhile, the drugs wreaked continuous havoc to his brain. Over the course of twenty years, my father was treated by or consulted with at least 16 different medical professionals who prescribed him a total of at least 21 psychotropic medications. He was frequently taking more than one medication at one time. Eventually, the antidepressants and anti-anxiety medications were not strong enough for him. His prescriptions were increasingly for antipsychotics, drugs that are used to treat schizophrenia and other psychoses, as well as anticonvulsants that are typically prescribed for mania.
Additionally, my father was taking medications for other maladies, like blood pressure, cholesterol and blood clots. It wasn’t until this year that someone pointed out to me that a statin can have neurological side effects, including depression, confusion and memory loss. My father had been on statins for years.
And, this is the hardest part for me to accept: It’s well-understood that SSRIs, along with several other drugs, increase the risk of a stroke. This is particularly true if a person has been on blood thinners, which my father had been. I’m still a bit enraged when I think about the fact that doctors didn’t warn my father that he could increase his chances of a stroke by being on blood thinners and antidepressants, especially considering that his blood pressure and cholesterol levels already made him a stroke risk.
* * *
Upon completing a whopping 11 ECT treatments, my father only became more disoriented, more forgetful and less coherent. We could no longer let him drive, so we sold his car and asked his doctor to notify the DMV that his driving was impaired. Having evidence of my father‘s recent mini-stroke and memory loss, the doctor surmised that it looked like he was beginning to suffer the early stages of dementia.
From then on, my father was ping-ponging between my sister, my mother and me as his caregivers. We prepared every meal, eliminated his access to alcohol, supervised nearly everything he did and dutifully took him to his medical appointments. This included an almost monthly visit with a psychiatrist. By 2018, my father was taking lithium for depression/bipolar disorder, lamotrigine for bipolar disorder, clonazepam for anxiety and sleep, donepezil for dementia, plus his statin and other medications.
Meanwhile, I became more and more alarmed by my father’s mental and physical decline. After reading a well-known tome about caring for someone with dementia — “The 36 Hour Day” — and joining a 20,000-member Facebook group for caregivers of people with dementia and Alzheimer’s, I was introduced to many symptoms that I recognized in my dad. He was emotionally volatile, frequently sobbing for no reason. His physical movements were impaired: he had trouble moving his limbs or bending his body in any way, which meant he never wanted to change his clothes, nor shower. His mental decline was staggering. He no longer understood basic facts, or people’s names, ages and relation to him. He had no ability to read, play guitar, or even watch television. All technology became a frustration to him. He had hand tremors. His writing ability regressed to the point that he couldn’t spell basic words and would write painstakingly and slowly, like a child. He asked the same questions over and over, compulsively agonizing about small facts. He had trouble seeing. He did damaging things on accident, like pour liquid soap into a cup and drink it, or leave a faucet on.
Worst of all, he developed extreme combativeness and aggression, even physically lashing out, and yelling angrily at the top of his lungs, often in public. We began to fear him and the increasing frequency of “catastrophic reactions” that are well-known in the world of dementia.
One thing “The 36 Hour Day” and all medical professionals seemed to agree on was the obligation to treat a patient’s depression, even if (and maybe especially if) the patient has dementia. But this did not make sense to me. His treatment for depression had all but failed for 20 years; I couldn’t understand why medical professionals pursued this unicorn of a cure. While they were busy experimenting with his brain, my father was becoming a monster, and it agonized us that he was behaving so wildly and dangerously with everyone who cared for him (and in front of my small children — who hated being around him). The only reprieve we got was when he slept, which was often. After all, the majority of the drugs he was on had major sedating effects. But when he was awake, it was like dealing with an aggressive, 200-pound zombie. We were nearing the end of our ability to manage him. We considered two end-of-the-road options: a memory care facility and/or much heavier medications. We toured some facilities and asked the psychiatrist for Seroquel. Seroquel is a “black box” drug, which means it comes with the FDA’s most serious warning for serious or life-threatening risks. It also increases the mortality rate for dementia patients. Even though it’s specifically not approved for dementia, it’s well known as an off-label treatment. To my shock, after all the hand-wringing we did about the Seroquel, I found out that my father had already had a prescription for it several years earlier, before the dementia diagnosis.
Between all the appointments, medications and terror in our home, a thought continued to nag at me: how could this man suffer such a massive decline? He was barely 70 years old. The people at the memory care facilities were wheelchair-bound and decades older than him. There was no way he could sit alongside them. He never wanted to sit. He stood and paced frantically, he could walk for hours. If he went to a facility, they would only sedate him more, because he would be a combative nuisance.
When we took my father to a neurologist to see if there was anything new to report on his latest MRI, we learned that nothing had changed. There was nothing more going on in his brain than his original scan showed two years earlier.
“Can you at least test him? Find out how bad his dementia is? We don’t understand why he’s behaving this way,” I said. But the neurologist said my father seemed to be past the point of being capable of sitting through testing. He couldn’t sit at the appointment, he was complaining and yelling from the moment we entered the room, to the moment we exited.
“You know, the dose of Seroquel you have him on is not that high. You might consider increasing it,” the neurologist offered. I felt so defeated. Not a single drug was improving his condition.
“Okay, but can we at least take him off some of these other pills? They’re clearly not helping.”
“That’s a conversation you need to have with his psychiatrist.”
We’d already had that conversation. Her response was to replace lamotrigine with Trileptal. She didn’t even know, and then was fairly unconcerned, about his dementia diagnosis. She asked him how he felt, he talked through his mental fog about how depressed he was and how it was the worst day of his life, and she typed on her tablet and tweaked his prescriptions. It was a textbook case of what I later learned is referred to as the “15 minute med check.” After a few of these appointments, it was clear to me that my father’s brain was a problem no one could solve and no pill had ever seemed to solve. Not only that, the fact that he was making life in our home impossible seemed not to register with anyone.
I came to the conclusion that because doctors are always going to aim for “treatment,” it’s very difficult for them to accept the concept that drugs are doing more harm than good and that abandoning them might be warranted. They are not thinking about discontinuation, tapering and the complicated nature of a body’s and brain’s withdrawal symptoms. When the medical professionals had seemingly no interest in my father’s completely “insane” behavior, I looked more closely at his medications. The side effects were staggering: blurred vision, tooth pain, memory loss, muscle stiffness, depression(!), suicidal thoughts, drowsiness, insomnia, aggression. I read about the tragic misuse of sedating medications on people with dementia and small efforts to end the practice. I read about the use of these incredibly strong psychotropic drugs on children in the foster care system, on prisoners, on migrants. I read in the caregiver Facebook group how many caregivers were sedating their loved ones with hardcore drugs, and treating them for depression and anxiety, and yet still experiencing agitation and violence, just like we were. A study even shows that long-term use of benzodiazepines leads to a significantly higher risk of developing Alzheimer’s. “Unwarranted long term use of these drugs should be considered as a public health concern,” the study concludes.
I also read about “polypharmacy,” which is typically defined by a patient taking more than five medications at one time. Polypharmacy is associated with an increase in adverse drug events, reduced functional capacity and several geriatric syndromes.
What are we participating in, I wondered? Why aren’t the doctors who are seeing my father get worse and worse scrutinizing the medications more closely?
I’m going to cut to the chase here:
My father now uses Skype on his own to talk to friends. He has a tablet to watch YouTube. He reads. He plays guitar. He’s memorizing new poems. He recently transcribed, quickly and with perfect spelling, the song he sings in the YouTube video. He plays with my children almost daily and laughs uproariously. We got him a dog and he walks her and loves her. He rarely sobs. He almost never yells. He changes his clothes and can shower by himself. He can walk to the neighborhood pool by himself, swim, and walk himself back without getting lost. His memory has markedly improved. And his severe muscle stiffness is gone. Hand tremors, gone. He can hop, skip, even sprint. He does push-ups and sit-ups in his room every day without prompting.
How did this happen?
Well, three months ago—without any medical professional’s knowledge or assistance — we eliminated his last psychotropic prescription (please note: abrupt discontinuation is not recommended). We have him on a healthy diet and a routine of physical activity. And no alcohol. And a little THC.
It was as if my father, the one I knew, came back from the dead. As the months go by and I watch him emerge from his chemical stupor, I am in disbelief that such a profound change can happen in a person simply by removing the side effects of medications (by removing the medications themselves). It occurs to me that for so long what we thought was his declining mental state could actually have been a state of disinhibition, the way one might feel when they’re high or drunk. His wild and impulsive behaviors, his disorientation, the loud and combative aggression — in hindsight they seem like that of a person who spent his waking hours inebriated. And now, in a matter of months, he’s sober.
Just imagine if we had let my father stay on the medications, as doctors prescribed. We would have assumed, for example, that his inability to write was a symptom of his dementia. If we had told his psychiatrist “he’s no longer able to write,” she would have chalked it up to the recent dementia diagnosis we told her about, and would have continued right on keeping him in the chemical cage that took away his fine motor skills. He would have spent years in the stupor, unable to write his poems and songs. How many other people, I wonder, are stuck in a chemical cage, not realizing that their mental and physical well-being has deteriorated because of side effects? A mere six months ago, we were considering memory care facilities for my father, and would have put him on more sedatives to manage him, which now seems truly absurd.
Now the flip side: He did have a mini-stroke and we do think there is some mental fallout from that. He is, and will always be, a drug-seeker, looking for the magic fix. He tells us often how terrible he feels, how depressed he is. The more coherent he becomes, the more aware he is of his loneliness, his sadness, and his boredom. A pill — I’m convinced — won’t fix that. It never did. As his voluntary caregivers, we do what we can to keep him active and stimulated, as well as safe and healthy. We’re not going to let him drive, and we still supervise him almost everywhere. But — and I’m not exaggerating — all of the monster-like qualities that we thought were severe symptoms of his dementia have practically disappeared. The spectrum of his emotional volatility narrowed substantially. We’ve found ourselves questioning whether he has dementia at all.
* * *
So, a word about Robin Williams:
When Robin Williams committed suicide in August of 2014, within days the world began talking yet again about the need to treat depression. Everyone seemed to gloss over the fact that Williams was misdiagnosed with Parkinson’s disease. His wife wrote about “chemical warfare” in his brain, the symptoms of which went far beyond depression and into confusion, memory loss, paranoia, intense anxiety and insomnia. She was keen to pinpoint the final diagnosis — Lewy Body Dementia — as the culprit responsible for his suicide. Few talked about Williams’ multiple medications as a potential issue. Like the fact that he had taken two medications for Parkinson’s, which not only can lead to psychosis, but are specifically flagged as inappropriate for people with psychiatric disorders because they can lead to psychosis.
On top of the Parkinson’s drugs, Williams was also taking an antidepressant called mirtazapine, a “black box” drug with noted suicide risk. Additionally, Williams had taken out a prescription for Seroquel mere days before his suicide. Williams did indeed have “chemical warfare” in his brain. But we can never truly know how much of the culprit was his dementia, and how much was the number of psychosis-inducing, sedating, debilitating chemicals that the doctor who was “treating” him prescribed.
Susan Schneider, Williams’ wife, made clear that Robin Williams was being treated for depression. He was, after all, a star with the best medical resources and treatments available to him. It’s not like they weren’t going to treatment. Schneider described at least a year of doctor’s appointments, of trial and error with medications, of worsening symptoms, of a “terrorist” inside her husband’s brain. It was as if she was speaking about my father. But my father got better. He may still call himself depressed, but he’s sober, stable and coherent, the value of which he will probably never admit nor appreciate, because he doesn’t remember what the monster in him was like.
Having had this experience, the way I look at psychiatry and psychotropic medications has completely changed. Of course, I understand that they work for some people (though time and life changes also work). I know stories of people who have had specific mental conditions and behaviors that certain medications helped alleviate, usually in combination with self-care, psychotherapy and eventual discontinuation. Antidepressants might be an important tool in certain situations, though the benefits have repeatedly been shown to be small, especially when compared to a placebo.
However, I can say with certainty that doctors and psychiatrists often don’t really know if they’ve got the diagnosis, the treatment, or the symptoms right when it comes to mental health. They often aren’t taking time to understand the brain they are altering. They are often unaware of what other medications the patient might be taking. They don’t know if they’re treating the patient, or the patient’s side effects. And they can’t be sure that the cure isn’t worse than the disease.
If you are being treated with psychiatric medications, please consider my warning:
They are experimenting.
Every time.
On you.
At the end of the day, the psychiatric drugs you or your loved one are on are sedatives and chemicals. Some go so far as to call them neurotoxins. The longer you use them, the weaker your brain gets at being able to regulate itself on its own. The higher your risk of deleterious effects. And the harder it is to get off them. But sometimes that’s exactly what needs to happen.
Thank You Ms Connors and MIA.
Thursday, October 25, 2018
American Psychiatric Association Adds ‘Obsessive Categorization Of Mental Conditions’ To ‘DSM-5’
the onion
WASHINGTON—As part of their ongoing mission to keep their classifications updated with the most recent available findings, the American Psychiatric Association announced Thursday the supplemental addition of “Obsessive Categorization of Mental Conditions” to the fifth edition of the Diagnostic and Statistical Manual Of Mental Disorders. “We’ve seen a significant increase in the number of people reporting an urgent, uncontrollable desire to research, report on, and catalog the symptoms of various mental disorders,” said head researcher Paula Ramos, stressing several times that the most apparent signs of OCMC include the compulsive noting of minute details regarding thousands and thousands of perceived signs of illness followed by extreme organizational tendencies and repeated attempts to achieve publication in prominent medical journals. “Our findings indicate that this condition exists in a spectrum, with some sufferers focusing on general diseases while others are more prone to clustering within a specific subset of the mental health field. We’re confident that continued study will assist doctors in more easily identifying and treating this debilitating disorder, and what we’ve painstakingly catalogued as its 117 common variants and 286 sub-variants, so that its sufferers can go on to live productive, untroubled lives.” Ramos also suggested that OCMC itself could be merely part of a much larger, though mostly benign, mental disorder involving obsessive attempts at educating oneself in order to help others.
Thank You the Onion.
WASHINGTON—As part of their ongoing mission to keep their classifications updated with the most recent available findings, the American Psychiatric Association announced Thursday the supplemental addition of “Obsessive Categorization of Mental Conditions” to the fifth edition of the Diagnostic and Statistical Manual Of Mental Disorders. “We’ve seen a significant increase in the number of people reporting an urgent, uncontrollable desire to research, report on, and catalog the symptoms of various mental disorders,” said head researcher Paula Ramos, stressing several times that the most apparent signs of OCMC include the compulsive noting of minute details regarding thousands and thousands of perceived signs of illness followed by extreme organizational tendencies and repeated attempts to achieve publication in prominent medical journals. “Our findings indicate that this condition exists in a spectrum, with some sufferers focusing on general diseases while others are more prone to clustering within a specific subset of the mental health field. We’re confident that continued study will assist doctors in more easily identifying and treating this debilitating disorder, and what we’ve painstakingly catalogued as its 117 common variants and 286 sub-variants, so that its sufferers can go on to live productive, untroubled lives.” Ramos also suggested that OCMC itself could be merely part of a much larger, though mostly benign, mental disorder involving obsessive attempts at educating oneself in order to help others.
Thank You the Onion.
Tuesday, October 23, 2018
How Our Government Helps Drug-Dealing Doctors Kill Us
madinamerica
Lawrence Kelmenson, MD October 21, 2018
Psychiatry and Pain Management’s soaring profits since 1990 were fed by a unique combination of favorable circumstances never before seen: First, they’re paid mostly by federal funds. These include Medicaid, Medicare, and tax subsidies for employer-paid healthcare. But unlike other federally subsidized industries, health industry goods and services are covered by insurance, so high costs don’t deter client use of them. Just imagine all the fine food and posh restaurants we would access if we had hunger insurance that paid for them.
Mental health and pain treaters have advantages over other industries that rely on insurance payments: Medicare and Medicaid, being federally funded, are able to spend endless public money with few restrictions on coverage, regardless of cost. For example, Medicare costs jumped after a 2008 law raised mental health reimbursement from 50% to 80%.1 Private health insurers tried to rein in rising mental health costs, but were blocked by 1996,2 2008, and 20103 parity laws that forbade mental healthcare limits, copays, deductibles, or certification requirements from being greater than for physical care. This is part of why private insurance is now so costly.
To tap into this endless money, the pain and ‘mental illness’ fields made use of another advantage: Unlike events covered by other types of insurance, an illness is an arbitrary concept. Doctors can thus broaden its definition in order to broaden their domain: It can be a subjective physical perception with no clear or treatable source. For example, chronic pain became an illness. Illnesses do not even need to be physical: Painful thoughts and feelings, and kids acting like kids, also became illnesses. This was endorsed by a 1992 law4 that granted funds for services for the ‘one quarter who will suffer from mental disorders’, and for biomedically-focused mental illness research to be done at the NIH.
So, unlike other insurers that can verify house fires, car wrecks, or death, health insurers can’t verify mental illness or pain. Unlike other MDs, psychiatrists and pain doctors can invent infinite chronic (and thus lucrative) illnesses. Each client can be labeled with many different ones; there’s no limit. And each illness can justify a doctor’s luring the patient into lifelong addiction to euphoria-giving pills.
These MDs can also pad profits by putting clients on disability: Clients will then return regularly/eternally to prove ongoing disability, to ensure that their SSD checks and food/housing/healthcare assistance continue. Since they won’t work, they’ll have the time (and health insurance) to do so. A 1984 law5 made adult disability approval hinge on subjective functional impairment instead of objective disease evidence; this made mental illness (or chronic pain) easier to get SSD for. In 1991,6 the Social Security administration made child disability also hinge on functionality instead of illness proof. Child SSI cases rose five-fold soon after, mostly for mental illness.7 So illness-creators opened doors to disability benefits as well as insurance cash; that’s convenient, since their addictive ‘meds’ make it hard to work.
Two 1990 laws8 9 specified depression, ADHD, etc.to be valid causes of disability (before then, schizophrenia was the only ‘mental illness’ considered disabling). This further eased access to SSD/SSI funds. These laws also rewarded these illnesses by making life-easing accommodations available to those who ‘have’ them. For example, Billy prefers to play video games rather than do homework. By getting him labeled ADHD, his busy parents and teachers won’t have to struggle to teach him good work habits, since he’ll now be given less schoolwork (he’ll also be drugged into submission, so he won’t need to be raised). And his label may qualify his family for SSI, Medicaid, and other benefits.
400 million addictive prescriptions are filled yearly.10 It’s caused so much addiction and overdosing, including among kids who steal their parents’ pills, that the lifespans of white Americans have dropped steadily (they use 2.5 times as many psych11 and opioid12 ‘meds’ as non-whites). Then a 2000 law13 authorized doctors to treat the addictions they caused with yet more opioids (suboxone, or prison heroin). It’s such blatant drug-dealing that this law had to be enacted to make it legal (it circumvented a 1914 law14 that criminalized the prescribing of opiates to maintain addicts’ addictions). Suboxone is often peddled at drug rehabs, where clients thus score rather than quit drugs. Since the 2008 parity law made insurers cover treatment for addiction the same as for physical illness, these rehabs make a killing.
Mental health treaters capitalized on all these favors to become our most costly healthcare sector15 and a major cause of healthcare becoming our government’s top expense and top tax subsidy. Costs of other government programs also spiked, due to mental health, pain, and addiction treaters baiting and trapping millions into reliance on Social Security and other benefits. Since 2016, Congress has had to divert funds from the SS retirement to the SS disability trust fund,16 since the latter couldn’t keep up with all its mental illness and chronic pain claimants (its main recipients17). Businesses cut full-time workers in order to avoid paying their costly healthcare as is required by law. This drove yet more people to seek federal benefits. Nearly a fourth of Americans are on Medicaid now.
Psych drug and opioid prescribers are bankrupting us and exploding our debt. We spend more on healthcare and its addictive pills than all other nations, yet are still pounded by propaganda about “millions suffering needlessly from untreated mental illness.” Things will only get worse; many more mental health laws are on the way. 18 19 20 21 22 23 24 25 26
Deja Vu
Something similar actually did occur before: The British East India Company, aided by England’s parliament which invested in it, bailed it out, and made laws giving it monopolies, dominated trade in the East in the 1700s. It helped spread British colonialism there. In the 1800s, it profited greatly by growing opium in India and selling it in China. This hurt China’s economy by siphoning its silver and turning industrious Chinese people into idle, unproductive addicts. Its emperor finally halted opium imports after his son (China’s prince) died of an overdose (as did our “Prince”). The BEIC reacted by conquering, with British assistance, all Chinese ports and nearby areas, in order to ensure continued opium selling. This began what China calls its “century of humiliation” in which a great empire was brought to its knees and subjugated by England, France, and Japan.27
Are we at the start of our own lost century, with psych pill and opioid dispensers taking on the BEIC’s role? Like our drug-dealing doctors, it succeeded largely due to close alliance and support from its government every step of the way. The only difference is: Our own healers and leaders are killing us!
Show 27 footnotes
Previous articleMr. Rogers, Trauma-Informed Care, and the Limits of Information
Next articleNew Report Points to Gaps in the Evidence for Pediatric Bipolar Disorder
Lawrence Kelmenson, MD
Lawrence Kelmenson has practiced psychiatry for 32 years, working with children, adults, and families. He graduated medical school from State University of New York, and completed psychiatric residency training at Cornell. He then became staff psychiatrist, and later medical director, of Craig House Hospital in Beacon, New York until 2000, and has since conducted a psychotherapy-based private practice in Cold Spring, New York.
Thank You Dr Kelmenson and MIA.
Wednesday, October 10, 2018
The Global ‘Mental Health’ Movement – Cause For Concern
madinamerica
Justin Karter 10/10/2018
This week, we present the first in a series of interviews on the topic of the global ‘mental health’ movement. These interviews will be led by our Mad in America research news team.
[Ed; at the link. Listen to interview]
In this episode, we interview Dr. Melissa Raven, who is a psychiatric epidemiologist, policy analyst and postdoctoral research fellow in the Critical and Ethical Mental Health research group at the University of Adelaide, South Australia. Originally qualified as a clinical psychologist, she then worked as a lecturer and researcher in public health and primary health care. Her current mental health research and advocacy is informed by a strong social determinants perspective and a strong critical orientation, which she applies to a range of topics, including suicide prevention, workplace mental health, (over)diagnosis, (inappropriate) prescribing, and conflicts of interest in mental health and the broader health/welfare arena.
On October 10th, 2018, World Mental Health Day, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal to “scale up” mental health care globally. At the same time, the UK government is hosting a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement these mental health policies globally.
In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of critical professionals, psychologists, psychiatrists, and researchers.
Thank You Mr Karter and MIA.
Justin Karter 10/10/2018
This week, we present the first in a series of interviews on the topic of the global ‘mental health’ movement. These interviews will be led by our Mad in America research news team.
[Ed; at the link. Listen to interview]
In this episode, we interview Dr. Melissa Raven, who is a psychiatric epidemiologist, policy analyst and postdoctoral research fellow in the Critical and Ethical Mental Health research group at the University of Adelaide, South Australia. Originally qualified as a clinical psychologist, she then worked as a lecturer and researcher in public health and primary health care. Her current mental health research and advocacy is informed by a strong social determinants perspective and a strong critical orientation, which she applies to a range of topics, including suicide prevention, workplace mental health, (over)diagnosis, (inappropriate) prescribing, and conflicts of interest in mental health and the broader health/welfare arena.
On October 10th, 2018, World Mental Health Day, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal to “scale up” mental health care globally. At the same time, the UK government is hosting a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement these mental health policies globally.
In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of critical professionals, psychologists, psychiatrists, and researchers.
Thank You Mr Karter and MIA.
Thursday, September 20, 2018
Groucho Marx, The Laws of My Administration
Hat Tip to American Greatness
Great column on the Democrat Punch and Judy fits of hysteria trying to Bork the confirmation of Trump's 2nd Supreme Court nominee: Brett Kavanaugh.
The Playbook, the Press, the Plan, and the Patsies
https://amgreatness.com/2018/09/19/the-playbook-the-press-the-plan-and-the-patsies/
Sunday, September 16, 2018
State Medical Board Has A Simple Solution To Help Amid Physician Mental Health Crisis
No, No way, and No Way in Hell.
Everyone else who gets stuck with Dr. Psychiatrist/Psychologist's life wrecking 'Diagnosis' even if they don't get drugged, are screwed with it for the rest of their ruined life.
US Constitution Amendment 14 Sec 1:
Section 1. All persons born or naturalized in the United States,
and subject to the jurisdiction thereof, are citizens of the United
States and of the State wherein they reside. No State shall make or
enforce any law which shall abridge the privileges or immunities of
citizens of the United States; nor shall any State deprive any person of
life, liberty, or property, without due process of law; nor deny to any
person within its jurisdiction the equal protection of the laws.
dailycaller
Evie Fordham | Politics and Health Care Reporter
The physician suicide rate is double that of the general population and even higher than the military veteran suicide rate.Doctors are afraid to admit mental health problems for fear of losing their licenses.
Washington state’s medical community is changing licensing application questions to combat this.
The Washington State Medical Commission (WMC) is taking a step to combat the high suicide rate among physicians by making physician licensing questions more friendly to doctors who have sought psychiatric help.
Updates to Washington state’s licensure questions will focus on an individual’s current impairment rather than if a doctor has had mental health problems at any point in the past. Many doctors fear their reputations and even licensure are at risk if they seek help from a psychiatrist for feelings of burnout or even suicidal thoughts.
Currently, many doctors are “having to sneak out of town, pay cash and use a fake name” when seeking help from a mental health professional, family physician Pamela Wible told Kaiser Health News. She is a self-proclaimed “voice for ideal medical care” and has gathered more than 1,000 stories of doctor suicides for her website to help people better understand the issue.
The WMC expects to update the questions in December after the changes were voted on in June, WMC Executive Director Micah Matthews told The Daily Caller News Foundation via email.
“Historically, medical license applications asked if the applicant has ever had any medical conditions or substance abuse that may impair their practice,” Matthews told TheDCNF. “The updates alter those questions to if they have current conditions or substance abuse issues.”
Many medical organizations are rethinking the policies they have in place because the physician suicide rate is double that of the general population and even higher than the military veteran suicide rate. The physician suicide rate is 28 to 40 per 100,000 individuals per year compared to approximately 12 per 100,000 individuals per year in the general population, according to data presented at the American Psychiatric Association’s 2018 annual meeting.
Licensing question changes like the ones that WMC is making are in line with 2018 wellness and burnout recommendations from the Federation of State Medical Boards, spokesman Joe Knickrehm told TheDCNF via email.
“The FSMB has heard encouraging news from a number of state boards that they are in the process of actively reviewing their licensing application questions,” Knickrehm told TheDCNF. “It is too early to tell how many boards have changed their questions, but we have heard from at least a dozen boards that are discussing it. It’s also important to note that not all boards do ask about an applicant’s mental health.”
The WMC’s updates also includes a safe harbor provision that operates in tandem with the Washington Physicians Health Program (WPHP). (RELATED: Why Is The Physician Suicide Rate So High, And What’s The Medical Community Doing To Change It?)
“WPHP participants can answer ‘no’ to questions about impairing illness if they are ‘known to WPHP,’ which means that they have informed WPHP of their behavior or condition and they are complying with WPHP’s requirements for evaluation, treatment, and monitoring,” Matthews told TheDCNF.
“[This] creates an added layer of confidentiality [and] provides prospective license applicants with a powerful incentive to proactively seek assistance if needed,” he continued. “These changes are intended to reduce the fear of professional sanction and public disclosure of health information that are barriers to help-seeking among physicians.”
The WMC and WPHP hope the changes will encourage doctors to confront any mental health problems head-on. More than half of physicians have symptoms of burnout, which “manifests as emotional exhaustion, loss of meaning in work, and feelings of ineffectiveness,” according to a 2014 Mayo Clinic survey. Burnout can harm physicians’ mental health and even make them feel like taking their own lives is the answer.
Factors such as increased pressure on physicians and lack of contact with other physicians is contributing to burnout and other symptoms, Dr. Chris Bundy of WPHP told TheDCNF via telephone. (RELATED: Michigan Republican John James Dings Opponent Debbie Stabenow For Taking Money From Drug Industry She Claims To Fight)
“Health care is a rapidly changing and dynamic environment, and it’s been hard for organizations to keep up,” Bundy told TheDCNF. “A lot of the changes have fallen squarely on the shoulders of physicians on the front lines of patient care, and now we need to redesign those systems.”
Follow Evie on Twitter @eviefordham.
Send tips to evie@dailycallernewsfoundation.org.
Soviet Style Abuse of Psychiatry Is Now Practiced In The United States
Saturday, July 21, 2018
The Story of A Professional Delusion: Do Psychiatrists Believe Their Own Words?
madinamerica
On February 24th of this year, a conference was held in Sydney,
Australia which featured a number of prestigious local and overseas
speakers as well as former psychiatric patients. Titled Mental Health in Crisis,
it was intended to provide a forum for well-researched alternative
views on the state of modern psychiatry. The next week, most of the
speakers went to New Zealand for further seminars in five cities. During
that week, a newspaper published an article quoting Prof. Peter
Gotzsche, director of the Nordic Cochrane Centre
in Copenhagen, whose research showed that antidepressants are a
dangerous and relatively ineffective class of drugs, and who recommended
they should be severely restricted. In his view, general practitioners
should not be authorised to initiate them, and they should not be given
to children or adolescents. On March 9th, the Royal Australian and New
Zealand College of Psychiatrists (RANZCP) issued a press statement
strongly criticising the article. In particular, it stated:
This reminds me of another rather fractious interchange I had with the well-known psychiatrist Ronald Pies. Readers may recall that some years ago, in his role as editor of the online publication Psychiatric Times, Dr Pies penned a fulmination against the “narrative” of the “chemical imbalance” hypothesis of mental disorder:
To continue, earlier this year, I published an article1 which showed that all claims made on behalf of ECT by the RANZCP have no basis in fact. A newspaper article based on the same figures scored me a complaint, which was rather difficult to understand because all I did was collect figures from different advocates of ECT to show their claims are self-contradictory.
Similarly, in July 2017, the Australian Human Rights Commission held an enquiry into the Convention on Torture, whose full name is Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and to which Australia is a signatory. I submitted a paper (mine is No. 3) which showed firstly, that detained psychiatric patients met the Convention’s definition of detained persons; second, what was done to them amounted to “treatment” and third, the patients themselves often said their treatment felt like torture.
Needless to say, this provoked yet another complaint that I was dragging the noble name of psychiatry in the mud, that psychiatrists are terribly nice people with good intentions who would never dream of torturing people. That may be convincing to somebody who doesn’t know psychiatry’s ghastly history,2 but anyway, the Medical Board dismissed the complaint in under 24 hours (I must say I never take complaints personally because I know it’s not me that they dislike, just what I’m saying).
Finally, an intensely personal essay3 in the influential Lancet Psychiatry extolled the virtues of psychiatry’s biopsychosocial model, originally developed by the psychiatrist George Engel. Linda Gask, a psychiatrist who does not conceal her own mental problems, concluded:
Let’s pause to look at these facts:
On the one hand, we have a bunch of ideas that Blind Freddy can see are either idiotic or completely false, and on the other, we have a very large group of highly educated, mostly intelligent, mostly sober and well-behaved people who swear by them.
Is there a tablet for cognitive dissonance? Thanks, I’ll take two.
Talking of cognitive functions, let’s try a little exercise in epistemology, the philosophy of knowledge. The goal is to assign each of the above statements to an epistemological category. We’ll go through them in reverse order, starting with No. 5. This one interests me greatly. How can anybody read Engel’s work and come away with an idea that matches the power and scope of, say, the modern synthetic theory of evolution? Or the standard model of physics? Or plate tectonics? Immunology? It’s ludicrous because it simply isn’t there, but I think the answer is that psychiatrists are too scared to look at the truth, which is that they don’t have a model of mental disorder.6 Instead, they clutch Engel’s pseudo-model to their chests like a security blanket. Standing in a group chanting “We believe, oh Engel, we believe,” is much less scary than asking: “Do I really know what I’m doing?” That is, it’s just another example of believing a comforting lie rather than confront a scary truth, which is terribly human. Human, but hardly edifying.
No. 4, torture. Oh dear, do any humans ever believe they are doing bad things? A few, but most of humanity’s more egregious crimes against itself have been committed in the pursuit of noble ideals. Hitler’s plan in his war for Lebensraum was to wipe out 30 million Slavs in the first year but that was noble because his Aryan races ranked higher in the cosmic order than mere Slavs. And in his final testament, his notorious Table Talk, he fully expected that the world would be grateful for his sideline in getting rid of the Jews. Ernst Rüdin, psychiatrist and architect of the T4 Program, which sterilised and murdered hundreds of thousands of mental patients, and prototype of the Final Solution, did not believe he was doing anything wrong: he explicitly ordered that their deaths should be easy. Even Stalin thought he was doing the proletariat a favor — well, those that survived. As Kenneth Clarke said in another context:
As an aside, Rüdin’s very successful efforts to sterilise and murder pre-war Germany’s population of people diagnosed with schizophrenia had no effect on the post-war incidence of the condition, which is a problem if you want to believe it’s all genetic.
No. 3, about ECT, is easy:
No. 2. Ah, the good Dr Pies. I detect a touch of professional jealousy here. He doesn’t like the naive reductionist biological approach favored by the likes of Thomas Insel7 8 as he believes he’s more sophisticated than that, but even he can see that when the NIMH disburses its $1.5 billion a year, the lion’s share goes to basic biological research and his side hardly gets a look it. So he stamps around the place, banging lecterns with his shoe and growling to whoever will listen, but guess who keeps his newspaper afloat? That’s right: drug companies.
And so we arrive at Number 1: Why would a sensible person thrice deny the empirically-established fact that psychiatrists hardly ever give any information about their drugs, and the little they do give is sugar-coated and highly misleading?
Option No. 1A: They’re idiots.
Let’s assume they don’t have the brains to analyse a complex question and arrive at the right answer. They’d get lost crossing the street. No, we can dismiss this because they passed medical school. How, we don’t need to know.
Option No. 1B: They’re sheep.
If in order to get your ticket in psychiatry, and get a job, and keep it, and be able to go to conventions and have people talk to you, and have people sit through your lectures without walking out, and get your papers published, you have to believe that black is white, what do you do? That’s right, you go with the flow. Listen to the words of the esteemed Brother Chomsky:
Option No. 1C: They’re deluded.
A delusion is a fixed, false belief, out of context with the healthy subject’s cultural, social, educational and intellectual background.
Alert readers will be aware that this immediately leads to the conclusion that reality is simply a shared delusion; conversely, it’s not a delusion if enough powerful people say it isn’t. Enough powerful people are saying that psychiatrists only ever prescribe drugs after due blah blah, so it’s true and it isn’t a delusion and anyway, who’s objecting? You are, young woman? Listen to me, girly, you’d better think carefully before you say too much more, just think about your career and your kids ending up on the street. So what’s the truth about the emperor’s new clothes? That’s better. Don’t forget it.
That’s not really a delusion, more like a cult where a few charismatic people dominate a much larger number and control their thinking and everybody’s too insecure to challenge them. Psychiatry as a cult? I think somebody has already suggested that.
Option No. 1D: They’re talking shit.
Tucked between truth and falsity there is a further epistemological category, defined as bullshit. The person who talks shit has no regard for truth; it is an instrument for him, to be wielded and abandoned as the moment suits him. His utterances are neither true nor false but are designed to sway the audience on an emotional level. Mr Donald Trump is a master bullshitter. He says any bit of shit that comes into his head. If the crowd roars, he laughs and repeats it but if they don’t react, he immediately forgets it and moves to something else. He remembers the bits that got a cheer and the rest didn’t exist; if you say it did, that’s fake news (lies).
I have argued that psychiatry is stuffed full of bullshit10 and, at first glance, the “only ever” statement appears to qualify. However, the essence of a bullshit statement is that it is neither true nor false, it is a non-propositional form to which those logical categories don’t apply: “Make America Great Again.” “My country, right or wrong.” “Would I be here if I didn’t love you?” “Our wonderful sportsmen.” It doesn’t actually say anything that can be pinned down, which is the entire point. But this statement, that psychiatrists only ever prescribe blah blah most certainly can be pinned down. It’s been pinned down, and it’s been proven false. It may have started as bullshit but it ended up as crap.
Option 1E: They’re lying.
Telling a lie is an act with a sharp focus. It is designed to insert a particular falsehood at a specific point in a set or system of beliefs, in order to avoid the consequences of having that point occupied by the truth.11
I believe this is what happened. The people responsible for this travesty looked at the truth (that psychiatrists hardly ever tell the truth about their drugs) and realised they didn’t like what would flow from that fact getting loose. So they removed it and substituted a falsehood (only ever) whose consequences they could live with. On July 6th, I sent a letter to the newly-installed president of the RANZCP, reiterating my allegation that the claim was false, and that everybody involved knew it was false:
The last word goes to the inestimable Richard Feynman, in his 1974 lecture Cargo Cult Science:
Thank You Dr McLaren and MIA.
The Story of a Professional Delusion: Do Psychiatrists Believe Their Own Words?
The prescription of antidepressant or antipsychotic medications is something that a psychiatrist only ever does in partnership with the patient and after due consideration of the risks and benefits (emphasis added).
As described on MIA, I lodged a lengthy complaint
with the RANZCP, alleging that, as the responsible officials, the
president and board had breached their own code of ethics at a number of
points; in particular, the claim about prescribing habits was patently
false. This has gone back and forth and, predictably, my complaints have
been dismissed. On June 29th, the incoming president of the college
wrote to me:
The (original press) statement also acknowledges… the careful consideration given when prescribing medications.
That is, he essentially repeats the false claim that drugs are “only
ever” prescribed after a friendly discussion between the caring doc and
the grateful patient. Some months ago, I published the results of a pilot study on my 176 active files, which showed that psychiatrists hardly ever
give information to patients regarding the risks of their drugs (I
would have thought that any psychiatrist who was still breathing would
know this: patients are routinely thrown to the ground and jabbed
despite their furious objections or tearful pleading. Part of his
defence was that psychiatrists have good intentions).This reminds me of another rather fractious interchange I had with the well-known psychiatrist Ronald Pies. Readers may recall that some years ago, in his role as editor of the online publication Psychiatric Times, Dr Pies penned a fulmination against the “narrative” of the “chemical imbalance” hypothesis of mental disorder:
I am not one who easily
loses his temper, but I confess to experiencing markedly increased
limbic activity whenever I hear someone proclaim, “Psychiatrists think
all mental disorders are due to a chemical imbalance!” In the past 30
years, I don’t believe I have ever heard a knowledgeable, well-trained
psychiatrist make such a preposterous claim, except perhaps to mock it.
On the other hand, the “chemical imbalance” trope has been tossed around
a great deal by opponents of psychiatry, who mendaciously attribute the
phrase to psychiatrists themselves… In truth, the “chemical imbalance”
notion was always a kind of urban legend- – never a theory seriously
propounded by well-informed psychiatrists.
In a comment (since deleted), I suggested that perhaps Dr Pies had
spent the last thirty years holed up in a cave in Patagonia because
patients tell me that all the time: “The other psychiatrists said I have
a chemical imbalance of the brain and I have to take drugs all my
life.” I don’t believe patients make that up and I don’t believe the
trope originated with them: it came straight from psychiatrists in their
latter-day role as purveyors of chemical bliss.To continue, earlier this year, I published an article1 which showed that all claims made on behalf of ECT by the RANZCP have no basis in fact. A newspaper article based on the same figures scored me a complaint, which was rather difficult to understand because all I did was collect figures from different advocates of ECT to show their claims are self-contradictory.
Similarly, in July 2017, the Australian Human Rights Commission held an enquiry into the Convention on Torture, whose full name is Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and to which Australia is a signatory. I submitted a paper (mine is No. 3) which showed firstly, that detained psychiatric patients met the Convention’s definition of detained persons; second, what was done to them amounted to “treatment” and third, the patients themselves often said their treatment felt like torture.
Needless to say, this provoked yet another complaint that I was dragging the noble name of psychiatry in the mud, that psychiatrists are terribly nice people with good intentions who would never dream of torturing people. That may be convincing to somebody who doesn’t know psychiatry’s ghastly history,2 but anyway, the Medical Board dismissed the complaint in under 24 hours (I must say I never take complaints personally because I know it’s not me that they dislike, just what I’m saying).
Finally, an intensely personal essay3 in the influential Lancet Psychiatry extolled the virtues of psychiatry’s biopsychosocial model, originally developed by the psychiatrist George Engel. Linda Gask, a psychiatrist who does not conceal her own mental problems, concluded:
…the biopsychosocial model is, and remains, a model for the whole of medicine — not just psychiatry.
This is a little alarming. First, George Engel was not a
psychiatrist, he was a gastroenterologist. Granted, he had a dual
appointment with the department of psychiatry and had undergone
psychoanalysis, but that’s not the same. Second, he did not write for
psychiatry but for general medicine. All his case examples are medical.
Finally, and damningly, in 1998 I showed that his ‘biopsychosocial
model’ wasn’t a theory, nor a model, nor anything, because Engel never
actually wrote it.4
Indeed, in 2004, I went so far as to say that any psychiatrist who
claimed there is a biopsychosocial model is committing scientific fraud,5 but Dr Gask and all Engel’s fervent disciples manage to brush that off.Let’s pause to look at these facts:
- Very senior psychiatrists repeatedly insist that psychiatric drugs are “only ever” prescribed after a friendly chat involving “due consideration of the risks and benefits…” However, everybody knows that every day in every town in the world, mentally troubled people are wrestled to the ground and injected, but if they complain, they will get more, not less, drugs.
- A very influential psychiatrist bursts his boiler over the calumny that a “knowledgeable, well-trained… well-informed psychiatrist” would ever use the expression “chemical imbalance of the brain.” Tens of thousands of psychiatrists actually do use it, as do drug companies, family doctors and just about everybody else. A Google search yields 1,180,000 citations in 0.48secs.
- Certain psychiatrists in Queensland take vigorous exception to the public being told that Australia uses ECT 600% more than New Zealand, even though on every conceivable demographic factor, the populations are the same. The only difference between the two countries is that the surge in ECT in Australia is almost entirely in private practice, and New Zealand has no private psychiatic industry. Even though the RANZCP code of ethics explicitly forbids exploiting patients, private hospitals charge what they like (the only figure I have is $620 per shock, which would be a shock in its own right). Queensland uses ECT 1000% more than the British National Health Service, and it is all but banned in Italy, where it was invented, but apparently none of that counts as evidence of exploitation.
- Psychiatrists object bitterly to the idea that anything they do could count as torture because their intentions are honorable. A considerable proportion of psychiatric patients don’t actually like being locked up, trussed up and/or stripped naked and injected with powerful, psychoactive chemicals which induce a wide range of exceedingly unpleasant, long-term and/or dangerous side effects, and/or shocked, and liken their experience to torture, which brings them under the purview of the Convention on Torture because, very foolishly, the Convention defines torture as what the recipient feels about it, not what the perpetrator intends by it.
- Large numbers of psychiatrists around the world think that a model that was never written licenses both their immense and essentially unaccountable power over people who have broken no laws, and their outrageous fees.
On the one hand, we have a bunch of ideas that Blind Freddy can see are either idiotic or completely false, and on the other, we have a very large group of highly educated, mostly intelligent, mostly sober and well-behaved people who swear by them.
Is there a tablet for cognitive dissonance? Thanks, I’ll take two.
Talking of cognitive functions, let’s try a little exercise in epistemology, the philosophy of knowledge. The goal is to assign each of the above statements to an epistemological category. We’ll go through them in reverse order, starting with No. 5. This one interests me greatly. How can anybody read Engel’s work and come away with an idea that matches the power and scope of, say, the modern synthetic theory of evolution? Or the standard model of physics? Or plate tectonics? Immunology? It’s ludicrous because it simply isn’t there, but I think the answer is that psychiatrists are too scared to look at the truth, which is that they don’t have a model of mental disorder.6 Instead, they clutch Engel’s pseudo-model to their chests like a security blanket. Standing in a group chanting “We believe, oh Engel, we believe,” is much less scary than asking: “Do I really know what I’m doing?” That is, it’s just another example of believing a comforting lie rather than confront a scary truth, which is terribly human. Human, but hardly edifying.
No. 4, torture. Oh dear, do any humans ever believe they are doing bad things? A few, but most of humanity’s more egregious crimes against itself have been committed in the pursuit of noble ideals. Hitler’s plan in his war for Lebensraum was to wipe out 30 million Slavs in the first year but that was noble because his Aryan races ranked higher in the cosmic order than mere Slavs. And in his final testament, his notorious Table Talk, he fully expected that the world would be grateful for his sideline in getting rid of the Jews. Ernst Rüdin, psychiatrist and architect of the T4 Program, which sterilised and murdered hundreds of thousands of mental patients, and prototype of the Final Solution, did not believe he was doing anything wrong: he explicitly ordered that their deaths should be easy. Even Stalin thought he was doing the proletariat a favor — well, those that survived. As Kenneth Clarke said in another context:
They suffered from that most terrible of delusions, they believed themselves to be virtuous.
Psychiatrists firmly believe that leaving a mental disorder untreated
is a very much worse sin than locking a person up and pumping him full
of drugs that they know will shorten his life. Why do they believe this?
You’d have to ask them, but I expect they would say something like,
“Have you no humanity? Think of the poor schizophrenic huddled in a
doorway in winter.” Indeed, but there are plenty of poor people huddled
in doorways and nobody bothers much about them. I think we could class
this as an example of psychiatrists not taking the effort to sort out
what’s good for them (lots of busy hospitals stuffed full of patients,
lots of conferences in nice resorts, research grants and so on) and
what’s good for the man on the receiving end of the needle. But who
cares about him anyway, we all know he’s nuts.As an aside, Rüdin’s very successful efforts to sterilise and murder pre-war Germany’s population of people diagnosed with schizophrenia had no effect on the post-war incidence of the condition, which is a problem if you want to believe it’s all genetic.
No. 3, about ECT, is easy:
It’s difficult to get a man to understand something when his salary depends on his not understanding it. (Upton Sinclair)
If you can earn up to $250 for about two minutes of “work” by
believing ECT is the greatest, only a fool or a churl wouldn’t believe
it. That is, psychiatry’s fascination with ECT is a simple case of
Skinnerian positive reinforcement (if you’re rewarded for doing
something, you’re more likely to do it again). It means that if we
stopped paying people for giving ECT, it would soon die out.No. 2. Ah, the good Dr Pies. I detect a touch of professional jealousy here. He doesn’t like the naive reductionist biological approach favored by the likes of Thomas Insel7 8 as he believes he’s more sophisticated than that, but even he can see that when the NIMH disburses its $1.5 billion a year, the lion’s share goes to basic biological research and his side hardly gets a look it. So he stamps around the place, banging lecterns with his shoe and growling to whoever will listen, but guess who keeps his newspaper afloat? That’s right: drug companies.
And so we arrive at Number 1: Why would a sensible person thrice deny the empirically-established fact that psychiatrists hardly ever give any information about their drugs, and the little they do give is sugar-coated and highly misleading?
Option No. 1A: They’re idiots.
Let’s assume they don’t have the brains to analyse a complex question and arrive at the right answer. They’d get lost crossing the street. No, we can dismiss this because they passed medical school. How, we don’t need to know.
Option No. 1B: They’re sheep.
If in order to get your ticket in psychiatry, and get a job, and keep it, and be able to go to conventions and have people talk to you, and have people sit through your lectures without walking out, and get your papers published, you have to believe that black is white, what do you do? That’s right, you go with the flow. Listen to the words of the esteemed Brother Chomsky:
Still, in the universities or in any
other institution, you can often find some dissidents hanging around in
the woodwork—and they can survive in one fashion or another,
particularly if they get community support. But if they become too
disruptive or too obstreperous—or, you know, too effective—they’re
likely to be kicked out. The standard thing, though, is that they won’t
make it within the institutions in the first place, particularly if they
were that way when they were young—they’ll simply be weeded out
somewhere along the line. So in most cases, the people who make it
through the institutions and are able to remain in them have already
internalized the right kinds of beliefs: it’s not a problem for them to
be obedient, they already are obedient, that’s how they got there. And
that’s pretty much how the ideological control system perpetuates itself
in the schools.9
I’d say it’s a case of the echo chamber effect, where a group of
people sit in a circle and a man says to the woman on his right: “The
woman on my left just said that everybody she’s spoken to agrees the
emperor is wearing wonderful new clothes, so I’ll agree. Pass it on.”
Nobody has the courage to stand up and state the obvious.Option No. 1C: They’re deluded.
A delusion is a fixed, false belief, out of context with the healthy subject’s cultural, social, educational and intellectual background.
Alert readers will be aware that this immediately leads to the conclusion that reality is simply a shared delusion; conversely, it’s not a delusion if enough powerful people say it isn’t. Enough powerful people are saying that psychiatrists only ever prescribe drugs after due blah blah, so it’s true and it isn’t a delusion and anyway, who’s objecting? You are, young woman? Listen to me, girly, you’d better think carefully before you say too much more, just think about your career and your kids ending up on the street. So what’s the truth about the emperor’s new clothes? That’s better. Don’t forget it.
That’s not really a delusion, more like a cult where a few charismatic people dominate a much larger number and control their thinking and everybody’s too insecure to challenge them. Psychiatry as a cult? I think somebody has already suggested that.
Option No. 1D: They’re talking shit.
Tucked between truth and falsity there is a further epistemological category, defined as bullshit. The person who talks shit has no regard for truth; it is an instrument for him, to be wielded and abandoned as the moment suits him. His utterances are neither true nor false but are designed to sway the audience on an emotional level. Mr Donald Trump is a master bullshitter. He says any bit of shit that comes into his head. If the crowd roars, he laughs and repeats it but if they don’t react, he immediately forgets it and moves to something else. He remembers the bits that got a cheer and the rest didn’t exist; if you say it did, that’s fake news (lies).
I have argued that psychiatry is stuffed full of bullshit10 and, at first glance, the “only ever” statement appears to qualify. However, the essence of a bullshit statement is that it is neither true nor false, it is a non-propositional form to which those logical categories don’t apply: “Make America Great Again.” “My country, right or wrong.” “Would I be here if I didn’t love you?” “Our wonderful sportsmen.” It doesn’t actually say anything that can be pinned down, which is the entire point. But this statement, that psychiatrists only ever prescribe blah blah most certainly can be pinned down. It’s been pinned down, and it’s been proven false. It may have started as bullshit but it ended up as crap.
Option 1E: They’re lying.
Telling a lie is an act with a sharp focus. It is designed to insert a particular falsehood at a specific point in a set or system of beliefs, in order to avoid the consequences of having that point occupied by the truth.11
I believe this is what happened. The people responsible for this travesty looked at the truth (that psychiatrists hardly ever tell the truth about their drugs) and realised they didn’t like what would flow from that fact getting loose. So they removed it and substituted a falsehood (only ever) whose consequences they could live with. On July 6th, I sent a letter to the newly-installed president of the RANZCP, reiterating my allegation that the claim was false, and that everybody involved knew it was false:
For myself, I am forced to conclude that
senior officials of the college lied, lied again, and are now trying to
conceal their lies. I believe that the broader membership of the RANZCP
would agree with me, as would any reasonable member of the general
public. I believe that any person found guilty of such behaviour would
not be a fit person to hold office in the RANZCP, and I am sure most
members would agree with me.
In view of the repeated failure of
officials of the RANZCP to follow its approved procedures, I see no
cause to believe that they have acted in good faith in this matter, nor
that they have any intention of doing so. Accordingly, I shall refer the
matter to the Australian Charities and Not-for-Profits Commission,
under which the RANZCP is registered.
By the time you read this, that complaint will have been lodged.
Meantime, let’s go back to the question posed in the title: Do
psychiatrists believe their own words? I think they do because, crammed
in their little intellectual echo chamber, the overwhelming majority
don’t have the courage to question anything in case it brings the wrath
of the profession down on their heads — or in case it affects their
incomes. For a mainstream psychiatrist, there’s only one thing worse
than realising you’ve been in an echo chamber all your career, and
that’s being kicked out of it.The last word goes to the inestimable Richard Feynman, in his 1974 lecture Cargo Cult Science:
The first principle is that
you must not fool yourself—and you are the easiest person to fool… I
would like to add something that’s not essential to the science, but
something I believe, which is that you should not fool the layman when
you’re talking as a scientist… I’m talking about a specific, extra type
of integrity that is more than just not lying, but bending over backwards to show how you may be wrong, an integrity that you ought to have when acting as a scientist. And this is our responsibility as scientists… (emphasis added)
Show 11 footnotesThank You Dr McLaren and MIA.
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