Allen Frances: Still Spinning the Story

Philip Hickey, PhD
108
2205

On March 4, 2020, the very eminent Allen Frances, MD, published an article in Aeon, which according to its “About” page is “a digital magazine, publishing some of the most profound and provocative thinking on the web. We ask the big questions and find the freshest, most original answers, provided by leading thinkers on science, philosophy, society and the arts.”

The article is called The lure of “cool” brain research is stifling psychotherapy.  The central theme is that prior to 1990, the National Institute of Mental Health (NIMH) “appreciated the need for a well-rounded approach [to mental health] and maintained a balanced research budget that covered an extraordinarily wide range of topics and techniques.”  However, since 1990, the opening year of the Decade of the Brain, the NIMH has “increasingly narrowed its focus almost exclusively to brain biology—leaving out everything else that makes us human, both in sickness and in health.”

It’s an interesting article, but the basic premise is similar to most of Dr. Frances’ recent material—that there are problems in the psychiatric field, but none of these problems can be blamed on psychiatry.

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Here are some quotes interspersed with my thoughts and observations.

“Having largely lost interest in the plight of real people, the NIMH could now more accurately be renamed the ‘National Institute of Brain Research.'”

“This misplaced reductionism arose from the availability of spectacular research tools (eg, the Human Genome Project, functional magnetic resonance imaging, molecular biology and machine learning) combined with the naive belief that brain biology could eventually explain all aspects of mental functioning. The results have been a grand intellectual adventure, but a colossal clinical flop. We have acquired a fantastic window into gene and brain functioning, but little to help clinical practice.”

So, the bio-bio-bio perspective that characterizes psychiatry today is the fault of the NIMH.  But let’s take a look at the NIMH leadership from its inception in 1949 to the present.  Here’s a list of the institute’s directors during that period.  (Source: Wikipedia)

 

 

 

 

 

 

 

 

So, whatever else may be said of the NIMH, apart from the two brief periods when psychologists were named as acting directors, it has always been firmly under the control of psychiatrists.

And psychiatrists have been promoting the brain illness theories at least since the time of Emil Kraepelin (1856-1926).  This promotion was interrupted by the psychoanalytic period, but was solidly re-established in both theory and practice by the late sixties.  Perhaps the most tangible indicator of this return to a biological perspective was the removal in DSM-II (1968) of the term “reaction” from the names of the various “psychiatric disorders”.  “Schizophrenic reaction” of DSM-I became “schizophrenia.” “Depressive reaction” became “major depression,” etc.  The significance of this was that in DSM-I, the various disorders were conceptualized as reactions on the part of the individual to various stressors.  In DSM-II, these disorders had become fully-fledged illnesses, which was precisely what psychiatrists needed to profit from the newly-emerging psychiatric drugs.  The shift in the ’50s and ’60s back to the bio-bio-bio perspective was a deliberate and calculated tactic on the part of the psychiatric leadership and the rank and file to enable them to cash in on the emerging drug bonanza and to enhance their perceived prestige.  Treating “real illnesses” with “real medicines” enabled them to believe that they were real doctors.

It is also noteworthy that in the late ’90s, Dr. Frances and his co-author Michael B. First, MD, were active cheerleaders for neuroscience.  Here’s a quote from their book Am I OK? A Layman’s Guide to the Psychiatrist’s Bible, 1998:

“The tremendous advances in neuroscience, brain imaging, and genetics are almost every day giving us a clearer picture of how the brain works to produce behavior—in both illness and health.  It is a source of wonder that we live at a time when it will be possible to have answers to questions that puzzled physicians and philosophers for at least the last five millennia.  The practical return from the neuroscience revolution will lead to more specific and effective treatments and hopefully also improved methods of prevention.” (p 415)

Dr. First, incidentally, was the Text and Criteria Editor for DSM-IV.

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Back to the Aeon article:

“Unfortunately, we don’t live in a rational world. Drug companies spend hundreds of millions of dollars every year influencing politicians, marketing misleadingly to doctors, and pushing pharmaceutical treatments on the public. They successfully sold the fake marketing jingle that all emotional symptoms are due to a ‘chemical imbalance’ in the brain and therefore all require a pill solution. The result: 20 percent of US citizens use psychotropic drugs, most of which are no more than expensive placebos, all of which can produce harmful side-effects.”

Note the unambiguous assignment of blame to pharma:  The result of their marketing is that 20 percent of US citizens use psychotropic drugs.  And the psychiatrists were simply the victims of misleading marketing.  The poor lambs.  Eight years of college plus three years of supervised residency, and they fall for a hoax like that!  Oh my!

In reality, psychiatrists promoted the chemical imbalance hoax with just as much vigor as pharma—perhaps even more so.  I have provided numerous examples of this—each more shameless than the next—in an earlier post.

The reality is that the blame for the chemical imbalance hoax lies fairly and squarely on the psychiatrists who pushed this drivel on their customers.  Their motivation in this regard was clear, unambiguous, and self-serving:  To induce people, who otherwise might not have done so, to take the pills.  In the ’50s and ’60s, there was a great deal of judicious skepticism among the general public concerning the use of quick-fix pills as “treatments” for problems of living, and there was a clear understanding among psychiatrists that this skepticism had to be neutralized.  Pharma certainly provided much of the funding, but it was psychiatrists who pushed the false and dehumanizing message.  Here’s a quote from Terry Lynch’s classic exposé Depression Delusion (2015):

“The public acceptance of the depression brain chemical imbalance notion as a fact has also been enormously helpful to psychiatry on several levels.  By promoting this concept as a fact or a likely reality for half a century, many psychiatrists have persuaded themselves and the public that they are real doctors treating real diseases.  The brain chemical imbalance fallacy being publicly accepted as truth has elevated the status of psychiatry, perhaps more than any other idea over the past fifty years.” (p 236)

And despite the vague self-conscious back-pedaling that we are seeing today, there has never been anything even remotely like an apology from organized psychiatry to the millions of people who were hurt and permanently damaged by this hoax.  In this regard, it is particularly interesting to note that in 2015 the APA abandoned their various earlier logos and adopted a stylized outline of a human brain as their official logo for all purposes.  I wrote about this matter here.

It also needs to be stressed that Dr. Frances played a personal role in the promotion of the chemical imbalance hoax.

Dr. Frances and the Promotion of the Chemical Imbalance Hoax

Here’s another quote from Am I OK?:

“Depression is really no different than hypertension.  Medicines that treat high blood pressure are taken to reestablish the body’s ability to maintain a normal blood pressure.  Antidepressants work in the same way—restoring brain neurochemistry to its original natural state.” (p 49)  [Emphasis added]

So, according to Drs. Frances and First, antidepressants restore “brain neurochemistry to its original natural state.”  This is a perfect example of the chemical imbalance hoax written specifically to convince a lay audience.

In addition, there is an endorsement of the chemical imbalance theory in Dr. Frances own DSM-IV (1994):

“Neurotransmitters implicated in the pathophysiology of a Major Depressive Episode include norepinephrine, serotonin, acetylcholine, dopamine, and gamma-aminobutyric acid.” (p 324)

The assertion that the neurotransmitters listed are “implicated in the pathophysiology of a Major Depressive Episode” is synonymous with the chemical imbalance theory as it is generally promoted and understood.

Psychiatrists Abandoned Psychotherapy by Choice

Back to Dr. Frances’s current article:

“Drug companies are a commercial Goliath with enormous political and economic power. Psychotherapy is a tiny David with no marketing budget; no salespeople mobbing doctors’ offices; no TV ads; no internet pop-ups; no influence with politicians or insurance companies. No surprise then that the NIMH’s neglect of psychotherapy research has been accompanied by its neglect in clinical practice. And the NIMH’s embrace of biological reductionism provides an unintended and unwarranted legitimisation of the drug-company promotion that there is a pill for every problem.”

The notion that the NIMH killed off psychotherapy is fanciful.  Psychiatrists stopped doing talk therapy once it became clear that they could double, or even triple, their income and enhance their prestige doing 15-minute med checks, which has now become their only stock-in-trade.  They could resume psychotherapy at any time.  Psychiatrists—leaders and rank and file—could also speak out against any facet of the NIMH’s agenda at any time, but I haven’t seen much of that.  They could also decline pharma’s generous invitations to become “thought leaders,” but I haven’t seen much of that, either.

Dr. Frances Was an Active and Paid Participant in the Promotion of Psychiatric Drugs

In 1996, Dr. Frances, along with his then partners John Docherty, MD, and David Kahn, MD, produced “Schizophrenia Practice Guidelines”  (The Journal of Clinical Psychiatry, 1996, Vol. 57, Supplement 12B).  These guidelines were essentially a marketing tool for the neuroleptic drug risperidone (Risperdal).  Dr. Frances, Dr. Docherty, and Dr. Kahn were paid $515,000 by Johnson & Johnson for this work, and it was stated by an expert witness in a subsequent court hearing (the State of Texas v. Janssen Pharmaceutica, a subsidiary of Johnson & Johnson 2004), that on July 3, 1996, Dr. Frances sent the following in an email to Janssen Pharmaceutica:

“We are also committed to helping Janssen succeed in its effort to increase its market share and visibility in the payor, provider, and consumer communities.”

Note the comprehensive nature of the commitment.  Drs. Frances, Docherty, and Kahn are confirming their commitment to promote Risperdal to consumers, medical prescribers, and payers.  It is particularly significant that sales of Risperdal increased dramatically from $172 million in 1994 to $1.726 billion in 2005.  Most of the sales during this period of growth came from off-label use, particularly for dementia and related problems (Forbes, November 12, 2013, J&J’s $2.2 Billion Settlement Won’t Stop Big Pharma’s Addiction To Off-Label Sales by Michael Bobelian).  In this context, the following quote from Am I OK? is particularly significant:

“The ‘antipsychotics’ work well for anxiety and agitation in many patients who are not psychotic.” (p 421)

So when we read the horror stories of elderly nursing home residents being brain-coshed with neuroleptic drugs, let’s remember that Dr. Frances played his part in this heroic saga, and honored the commitment that he had made to Janssen back in 1996.

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I have written more on Dr. Frances’ ties to Janssen here.  In addition, Paula Caplan, Ph.D., has written a comprehensive and compelling account of this entire sordid business.  Her article, which appeared in Aporia in January 2015, is titled Diagnosisgate: Conflict of Interest at the Top of the Psychiatric Apparatus.

Am I OK? Some Interesting Additional Quotes

Am I OK? has particular interest in the present context in that it is essentially a marketing document, selling psychiatric “illnesses” and “cures” to a lay audience.  Here are some interesting quotes:

“DSM-IV has achieved a central role in mental health circles because accurate diagnosis is now more important than ever.  For the first time, we have a science, not just an art, of psychiatry.  The field has come a long way from the shaman’s rattle or the doctor’s folk remedies or the alchemist’s mercury concoctions.  Using powerful imaging devices, we can actually visualize just how the brain works in sickness and in health.  We now have very effective tools for treating mental disorders, and the future looks even brighter.  Getting the right treatment almost always depends on having the right diagnosis.” (p 10)

There is no science in psychiatric diagnosis.  Apart from those diagnoses that are clearly due to a general medical condition (e.g. Alzheimer’s disease), the loose clusters of poorly-defined thoughts, feelings, and behaviors collated in successive editions of the DSM were not discovered in nature.  Rather, they reflect decisions made by the various APA committees and work groups, and faithfully embody the prejudices and vested interests of these groups.  There is, for instance, not a shred of evidence that people who meet five or more of the nine criteria for “Major Depressive Disorder” constitute an etiologically coherent group, or even that they have any sickness whatsoever.  This is what Thomas Insel, MD, then Director of NIMH, meant when he wrote:

“While DSM has been described as a ‘Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been ‘reliability’—each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.” (April 29 2013, here.)

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Back to Am I OK?

“One in five people has a psychiatric problem at any given moment, and half will have one in a lifetime.” (p. 10)

This is a classic piece of psychiatric disease-mongering.  Psychiatrists invent psychiatric “illnesses” and then “discover” that lots of people have them.  Consider this:  They could actually increase the spot prevalence to 90 percent, and there would be no piece of data that could contradict this.  There is no definition of a mental disorder other than that provided by the APA.  There is no objective etiological reality against which their criteria can be compared.  This is analogous to glaziers going around at night breaking windows, then fixing them the next day, and rejoicing in the fact that they have a lot of business!

By the same token, of course, psychiatrists could reduce the total prevalence to 1 percent by tightening the criteria.  But don’t hold your breath.

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“Know the following symptoms so well that you can spot emerging episodes before they get out of hand.  You can’t control the weather, but you can control depression.” (p 33)

Dr. Frances and Dr. First are actually encouraging people to memorize the “symptoms” of “Major Depressive Disorder” so that they can avail of psychiatric help before emerging episodes “get out of hand!”  This is grade A disease-mongering.

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“ECT [electro-convulsive therapy] is a terrifically effective treatment that is also relatively safe considering the great benefits that can often be gained.  ECT is especially useful for psychotic mood disorders, people who need a really fast response, medication nonresponders, and for those who cannot tolerate antidepressant medication.  Electroconvulsive therapy has a higher response rate (80 to 90 percent versus the 65 to 70 percent achieved by medication combinations) and also works more rapidly.  However, it has the disadvantage of providing fewer clues as to what type of medication is likely to work to prevent recurrence in the maintenance phase.  Due to misguided fears, ECT has been most typically considered a treatment of last resort when nothing else works.  It probably deserves to be used earlier and more often.” (pp 51-52)

One can only wonder how many hapless customers were drawn in by this kind of hyperbole: “terrifically effective”; “really fast”; “80 percent to 90 percent”; but note—only “relatively safe considering the great benefits” (emphasis added). Also note:  No mention of cognitive damage.

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“Antipsychotic medications [neuroleptic drugs] commonly have side effects.  These include feeling terrible, being slowed down or stiff, getting restless or being unable to sit still, developing tremors in the hands or feet, gaining weight, and having sexual problems.  Unfortunately, many patients deal with such problems by stopping their medication, usually without telling the doctor.  This is always a bad idea.  Most side effects can be reversed either by lowering the dose, switching to a different medication, or adding an ‘antidote’ (like Cogentin or Artane).  Fortunately, a whole new class of ‘atypical’ antipsychotics (Risperdal, Zyprexa, Seroquel, Zeldoc, and Clozapine) has recently become available.  These have much fewer side effects than the older medicines and may be more effective for many patients.  The new medicines are often a godsend and may help you feel ‘awakened.'” (p 324)

Note the profound understatement in describing akathisia as “getting restless” and “unable to sit still,” and tardive dyskinesia as “developing tremors in the hands or feet.” Note also that Risperdal is listed first in the names of the new neuroleptics.

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“Scientific research is now hot on the trail tracking down which specific genes are involved in which psychiatric disorders and determining how they exert their influence.  Within a decade we may well unlock at least some of the basic secrets of Schizophrenia, Bipolar Disorder, and Obsessive-Compulsive Disorder.  It won’t be a simple story.  Many genes are probably involved in producing each disorder and the precise patterns of causation will undoubtedly differ in different people.  The environmental factors that promote illness are remarkably varied and include complications related to childbirth, infections, physical trauma, family stressors, and all the other difficulties that must be faced in a long lifetime.  In contrast, a strongly supportive environment may help to protect against illness, particularly if the genetic loading is not all that strong to start with.” (p 415)

This was 22 years ago.  Presumably “scientific research” is still “hot on the trail.”

Finally

Dr. Frances continues to write on the flaws and ills of psychiatric practice, but never acknowledges the role that psychiatrists, including himself, played in the creation and maintenance of these problems.  The spurious promotion of psychiatric “diagnoses” as real illnesses, and the routine prescribing of chemical and electrical “cures” were, and still are, psychiatric inventions that continue to destroy individuals and undermine our cultural and personal resilience.

108 COMMENTS

  1. Hi Dr Philip, nice to see you back on MIA again.

    ‘Depression Delusion’ by Dr Terry Lynch is one of the best books I ever read.

    From Dr Terrys book “SELFHOOD”: –

    “PARANOID SCHIZOPHRENIA” RECOVERY STORY
    “….Stephen looked terrified, and I asked him why. He replied ‘I’m not sure I can get out of this place alive’. There were only the two of us in my office, and nobody in the waiting room. Objectively, there was no threat to Stephen, but he genuinely felt terrified for his life. He described the raw terror he felt almost constantly….

    ….I focused on enabling Stephen to progressively raise his level of selfhood. In particular, I worked with him on self-protection and self-generated security, because his lack of these dominated his life, the reason for his fear-filled thinking…

    …Stephen was now aware of his own terror and inability to make himself feel safe, whereas previously he was not aware of this and instead was entirely focused on the dangers that lay waiting relentlessly for him everywhere….

    ….In contrast, like a rabbit caught in headlights, Stephen would previously have become increasingly transfixed by an unfolding scenario outside of himself, that he was actually creating through outward projection of his feeling unsafe…

    …This practise had the desired effect. His level of self-protection and self-generated security began to increase, slowly at first, then gathering pace. Stephen made considerable progress in raising his level of selfhood, of which, for him, self-protection and self-generated security were key factors. Because he was doing well, his psychiatrist agreed to reduce his medication slightly, and I subsequently continued the process of gradually reducing Stephen’s medication.

    …Stephen has been off all schizophrenia medication for over three years. He lives a full life, goes where he likes, thrives in social situations, and has a level of selfhood higher that at any previous time in his life….”

    There’s no need for any Psychiatric Abuse.

    • Yes but these “untreated mental illnesses” do cause suffering which psychiatry can alleviate.

      Psychiatry alleviates the suffering of the families who are embarrassed by the person’s odd behaviors and don’t want to look like bad guys by simply not inviting him to parties. So getting Johnny shot up with 15 mg of Haldol a day will make him quiet and inactive. No more suffering.

      Psychiatry also alleviates suffering of the mainstream public by use of the placebo effect. Every time a mass shooting occurs some prominent shrink tells the public that of course only the “mentally ill” murder people like that and give him even more unquestioned authority and he will stop violent crimes forever by giving all the “mentally ill” people the “treatment” they so richly deserve for the crimes of a few they may have nothing in common with. Other than a shrink’s badge of shame.

      Psychiatry alleviates the suffering of psychiatrists themselves. It stunk being the “Cinderella” of medicines. Now, thanks to drugs, shocks, and other forms of brain mutilation in the works they can show what honest-to-gosh-real-doctors they are.

      When they praise psychiatry as highly effective this is what they really mean.

  2. It’s quite an image “brain-coshing” elderly residents of nursing homes. But more acurate that calling it ‘medicine’. No doubt these frauds will be riding on the skirt tails of the ‘heroes’ who are actually doing ‘real medicine’ during this current pandemic.

    Speaking of riding….

    “This was 22 years ago. Presumably “scientific research” is still “hot on the trail.””

    Boans sings “An old cow poke went riding out one dark and windy day…….” Psychotic cows. who’da thought.

    Once again thank you Dr Hickey, your an assett to our community.

  3. Dear Dr Hickey,

    Appreciate your article.

    Some questions below might help me better understand why DSM psychiatry continues (or is still ‘allowed’) to continue, ‘spinning the story’ as you rightly put it.

    *Is it the case that biomedical DSM psychiatry (and all those psychologies/psy enterprises which ‘hand-maiden’ it) has ‘spun’ the DSM, with the large or sole aim of protecting psychiatry’s own professional guild role-identity (so they keep playing the ‘role’ of ‘rescuer-hero’ for ‘sick-victims’ in a never ending Karpman Drama Triangle)?

    *Whilst some dissenting psychiatrists-psychologists reject the DSM (and then find themselves censored, bullied or sacked) – why do various PhD qualified psychologists (and some life coaches, social workers, counsellors, psychotherapists etc) still refer to and support the DSM and Pharma drugs?

    *Is DSM biomedical psychiatry suffering from a dysfunctional mentally disordered state of ‘cognitive dissonance’ (Cosgrove, Whitaker et al) which prevents honest, ethical self-reflection to ‘regulate’ their ’emotions’ and professional ‘behaviour’?

    *If so – who gets to ‘diagnose’ DSM psychiatry under its own DSM?

    *If other professions (and other medical specialities) are required to scrutinse DSM psychiatry because it cannot check itself, is there something in the education and training of PhD psychologists, counsellors, social workers and psychotherapists for example (in the US or elsewhere) – that hijacks them from critiquing DSM psychiatry’s biomedical model, its pharma drugs and ‘mental health’ zeitgeists?

    *Is the notion of ‘mental health’ and a widespread ‘therapy culture’ in western capitalist society – key driving forces that keep the DSM ‘spinning’?

    (The same questions might also be asked about why the law and our legal systems, seem to have failed to independently scrutinise and curb the damage caused by DSM biomedical psychiatry?).

    Thanks for any suggested answers.

    Best wishes, Magdalene

      • There is plenty wrong with the DSM and behaviourally labelling individuals. Circular and seriously stigmatising labels for all kinds of things including being defiant of authority, sticking to your guts and what not. They all have serious consequences, socially and legally.

        If you want to be labelled, and that suits you, fine by me, as long as you don’t expect everyone else to do what suits you (and I don’t expect for someone who holds your opinions to suit my preferences either).

        I strive to stay away from both psychiatry, and vast swathes of the patient population who are equally pernicious.

    • Magdalene, since it appears that you are an attorney and are asking why the law and legal systems have failed to scrutinize and curb the damage caused by the DSM, please contact me at paulajcaplan.net, because as a psychologist who has done a great deal of work in the legal system, I have been working and writing extensively on that very thing for decades. I assume you are not in the U.S. (you use the spelling “scrutinise”), and wherever you are located, I hope to hear from you.

      • For years I had voices in my head screaming at me that I needed to rape my neighbor. I tried reasoning with the voices, saying “I don’t want to rape her! I don’t want to rape anyone!” But the voices wouldn’t listen. They kept insisting that I “Just rape her, already!” After several years of this torture I tried to kill myself. I failed and was put in a mental hospital for two months. I was given the diagnosis of schizophrenia and given an antipsychotic. Within one day of taking this antipsychotic the voices were gone. They only returned when I stopped taking the antipsychotic and went away again when I started taking the antipsychotic again. From my own experience, being given a diagnosis led to a treatment that worked. I haven’t tried to kill myself since. The DSM helped me.

        • I hear what you’re saying – you were in distress and you found the diagnosis and the drugs very helpful. I don’t want to invalidate that. But I have to disagree that the DSM helped you. The DSM did nothing except provide a billing code so they could charge the insurance company for neuroleptic drugs. The drugs seemed to be very helpful to you and worth whatever side effects you have to tolerate. Reading here, I hope you understand that your experience is not shared by everyone who takes these drugs.

          You might want to read some of Joanna Moncrieff’s work. She talks about the drug-centered (instead of disease-centered) approach to drugs. Drugs have effects. Some people find these effects helpful, some do not. There is no need for any “diagnosis” for them to seem helpful. And the diagnosis does not contribute to understanding why these things are happening to you or how to solve whatever problem is going on, or even to predicting which people will find them helpful or harmful. . The drug simply suppresses the manifestations you wanted to have suppressed. And that works for you, and well done. But your one personal experience does not necessarily apply to everyone who is involved. Not to mention that the DSM “diagnoses” a lot of other things besides “schizophrenia” that can be extremely damaging or can justify extremely damaging actions taken against a client, including discrimination and involuntary detention by the police, which understandably is highly traumatic to people who are forced to live through it.

          I would strongly suggest you read “Anatomy of an Epidemic” and also do some research into other peoples’ experiences so you can really see both sides of the situation. I’ve seen lots of people who feel like you do. I’ve also seen lots of people who feel their lives were destroyed by psychiatry. I think it would help a whole lot if you can try to understand why so very many people find psychiatry dangerous or unhelpful rather than just dismissing their stories and their observations as misguided without really trying to hear where they’re coming from and why.

        • Thank you, William T. Your comment seems to counter most the other commentaries here and I appreciate that. In divided matters, it is very easy to pick a side and then engage in group-think in answering any sort of “call to action.” Anchor biases and confimation biases render the results of most challenging pursuits sub-optimal. I’ll assert that most people – especially on empassioned matters are also vulnerable to engaging false dichotomies seeing divergent views as “opposites.” Again, William T – thank you for your contribution to the commentary. Contributions of earnest truths always better the collective end results. Best Regards.

          • So do you think the rest of us should be forcibly locked up and drugged? That’s what Allen Frances and all the members of the APA do and they use the DSM as an excuse.

            If others want to use their labels and take psych drugs that’s one thing. But it’s forcing these on law abiding citizens against our will that we have a problem with.

            The drugs made me hear voices and act weird. My label almost drove me to suicide. It’s very easy for William to get what he wants. Not so with the rest of us.

            And my heart almost gave out. I might be dead if I hadn’t escaped. No suicide attempts despite the Covid19 stress either. My parents and siblings are amazed and pleased at my improvement.

        • “The drug simply suppresses the manifestations you wanted to have suppressed.” At a cost.

          Did they give you the run down on the negative effects of the drugs William T? I get what your saying about them stopping the voices and I hope that this ‘treatment’ continues to work for you.

          But there are some significant effects of taking these drugs that need to be pointed out. I’m no expert in these drugs and maybe someone with a better knowldge of them can fill in the gaps but the way I understand it your trading 20 years of your life for relief from the voices. Might be a trade your willing to make. Your health will suffer as a result of long term use, might be a trade your ….. There is no guarantee that the drugs will continue to work at the doses your on, might be a trade…… Just as long as you’ve been fully informed of the consequences of taking them is all I would say.

          • Antipsychotics require an RX. Without the doctor and the DSM there would have been no RX and I wouldn’t have gotten the drug that saved my life. Do you think all drugs should be legal without RX, like Thomas Szasz did?

          • Hi, William,

            Doctors can prescribe drugs for any indication. It is not a requirement that they have a DSM “diagnosis.” Lots of people get antipsychotic drugs prescribed with no DSM “diagnosis” at all. They prescribe them for sleep problems, for “behavioral disorders,” to “augment antidepressants,” etc.

            Besides which, billing codes are not the same as actual medical diagnoses. If they need to invent a billing code, let them invent a billing code, but let’s not get confused and pretend that a billing code means anything more than that you get paid by the insurance company. The original DSM was, in fact, invented so they could bill insurance companies for “therapy.” The idea that these codes represented actual disease states is quite a distortion of their original purpose, and is utterly unscientific, as there is little to no evidence to suggest that any of these arbitrary groupings by symptom create groups who actually have anything physiologically relevant in common. It would be like billing for “stomach pain.” Sure, you can bill the insurance company for that, but is it indigestion? An ulcer? A gall stone? An intestinal blockage? Appendicitis? Bowel cancer? Each of the things I listed could cause “stomach pain.” So doctors neither diagnose nor treat “stomach pain,” not if they are in any way competent. They’d look for the CAUSE of the stomach pain and treat THAT.” Psychiatry as a profession makes no effort to differentiate between depression due to a loss vs. depression due to a bad boss vs. depression due to insomnia vs. depression due to a low thyroid condition vs. depression due to a long struggle in a dead-end, meaningless job vs. depression due to my husband beating me randomly and controlling everything I do and trying to drive me nuts on purpose. So saying someone “has depression” is pretty close to meaningless.

            I believe the same is true for “schizophrenia.” Many people in the psychiatric field even agree with me on this, and there have been proposals to scrap it as a concept altogether. The fact that professionals in the field disagree as to whether it exists should be reason enough to see that it is not a real scientific concept. Nobody argues about whether cancer or broken legs or syphilis actually exist.

            So if you need a “diagnosis” to get the drug that you feel is necessary, by all means, get a “diagnosis.” I just ask that you not confuse this with an actual, scientific analysis of what is happening that is causing this phenomenon, nor even what to do about it. Antipsychotics can diminish hallucinations, and to a lesser degree, delusions, at least temporarily and at least in some people. That’s about all you can say about it. It is not “treating” a known disease, because no one knows what causes “schizophrenia” or if it’s even a “thing” that has a cause, vs. a phenomenon that is associated with many different causes and possible interventions.

            I hope that clarifies my position on this.

          • To “registeredforthissite” – I agree and would add that one could go without the MH stigma which goes along with those things as well. Should all drugs be legalized such that a person could make their own decisions about this. I would say yes and the reason I say yes is that it is quite evident there is no system which guarantees the best qualities of a prescriber. This fact makes things worse than neutral. Giving certain people the authority (license) to prescribe when the occurance of fools, sociopaths, money-grubbers and so forth is likely the same as in the general population FALSELY presents them as the go-to people for Rx’s. Get an a Rx from a licensed prescriber. First you must be able to find a REAL & LEGIT way to parse out the good prescribers from the bad. Prescribe for yourself? You must have good reason to believe that YOU are not a fool or undereducated. When the assignment of a certain quality (“safe precriber”) is given arbitrarily, it is contrary to science, good law, and good morals. Therefore, at base, all drugs should be made legal because if a risky decision is to be made, it is better to give that decision making right to the person the action will most directly effect. Regulatory boards/licensing boards? They were designed (supposedly) to assure the public of high quality care, but believe me, they have been bought and sold and brainwashed. I have spent twenty years watching the every move of the Psych Board, the Medical Board, and the Counseling Board in Oregon, and now the work I do has brought me into contact with licensed healthcare professionals in 25 states who’ve been professionally assaulted when those professionals have gone dissident, whistleblower or have had a “better idea.” So, no, there are no transparent overseers or checks and balances to keep “patients” safe.

          • Steve, lack of consensus does not make something unscientific – it just make things “unfinished.” Scientists are by definition are trained doubters and skeptics. Although it is becoming more and more difficult to trust scholarly articles in scientific journals, the ideal is “peer review.” A scientist (hopefully) does their best work and in publishing it are nearly universally required to demonstrate insight into the study’s short-comings and suggest where more studies need to be done. THEN, because it is made PUBLIC, other scientist get to PUBLICIZE their own critiques. What is needed is the resumption in a trust of the scientific process – a means by which ANYONE can read the arguements and counter-arguements and assess the qualities of experiments (tests) AND the reasoning used in coming to be for or against an assertion. The problem with medicine is that the results, which to say the least will ALWAYS be less than 100%, are tested on human beings often before they are certain enough and this is due to a combination of both supply AND demand. Although many object to testing on animals for moral reasons, logically, many would agree that the effect of drugs on animals will give us a cautious red light or green light in proceeding with tests on humans. Once a few successes are published with humans, many people want that drug immediately even though reason would say it is not ready for market. Others would say that it is absolutely irresponsible to release to the market drugs which are still to risky. Then there is the matter of costs. Certainly, from the supply side, we have TV commercials pushing drugs for problems people never even heard of before and prices can be artificially inflated. More legitimately, the safer a med is made, the longer the period in testing, the greater the delay of it’s release, and the higher the cost which gets passed on to the buyer. Sigh The solution is not in THIS box.

          • Consensus is completely unrelated to scientific truth. Scientific truth requires proof, usually in the form of vigorous efforts to DISPROVE a particular hypothesis repeatedly failing. The fact that “scientists agree” to something does not make it true or untrue – opinion is not science. And while “beyond a reasonable doubt” certainty is not always attainable, it should be the goal. Instead, what we see is so-called ‘scientists’ collecting evidence to support their own views and hiding things that would cause doubt. That is not science. That is marketing.

          • Yes, obtaining drugs requires an RX for now in many countries. And there are always questions that pertain to drug legalisation like “What if people misuse them, what if they don’t know what they’re doing?”.

            Yes, you either have to gain the knowledge of how to use them yourself or consult someone who knows how. However, the illegalisation of drugs and putting people in prison or back in the ward for such offenses simply ensures that the person is back in system, and has no escape from psychiatry or its adherents including the patient population or caretaker population.

            After supervision of drug use is received, and especially after people have already been on them for several years, there is no way to get these individuals out of your life simply due to drug illegalisation. This means getting labelled, getting incessant observations in psych. records, coercion no matter how subtle etc.

  4. “The article is called The lure of “cool” brain research is stifling psychotherapy. The central theme is that prior to 1990, the National Institute of Mental Health (NIMH) “appreciated the need for a well-rounded approach [to mental health] and maintained a balanced research budget that covered an extraordinarily wide range of topics and techniques.” However, since 1990, the opening year of the Decade of the Brain, the NIMH has “increasingly narrowed its focus almost exclusively to brain biology—leaving out everything else that makes us human, both in sickness and in health.””

    The premise mentioned above is false. Absolute nonsense.

    Allen Frances, architect of the disastrous DSM 1V, has managed to keep his name in the spotlights by pretending to be the chief critic of the DSM V. Allen Frances however is still very much more a part of the problem than he ever will be part of the solution. There were critics of the system prior to Allen Frances even if those critics had nothing whatsoever to do with the DSM IV.

    I would contrast with Allen Frances example that of Loren Mosher. Far from showing themselves open to new ways of thinking, the NIMH, way before 1990, shut his Soteria Project down by pulling the money out from under it and, more or less, gave him the pink slip for not pushing psychiatric drugs they way they thought he ought to have done.

    Gee, so the NIMH wasn’t so open minded before 1990 after all?

    Yep, that’s right. The NIHM has always been, it would seem, very close minded.

    Nice illusion, but no blue ribbon. Psychotherapists are widely known for their drug pushing proclivity anyway.

  5. “There is no definition of a mental disorder other than that provided by the APA.”

    Therein lies the problem. We have no “intelligence” other than humans over humans, which of course they are trying to rectify by “artificial intelligence”, which was programmed by “human intelligence”. It is all laughable if not so sad for humans to believe they have answers as to what diversity to cure, or to eliminate, or control.

    The “medical” establishment has their own laws which are supported by our legislators. They can tell the biggest lies, which are “blessed” by our high priests.
    It is the same religion which has gone on for eons, so nothing new. Same hierarchy.

    The shrinks that DO have the ability to think, would obviously not ascribe to the silly notions, wonderings that exist as an actual practice.

    It is simply embarrassing for them to speak up. And that pressure is as old as the hills also.

    Alan seems to think that he is a thinker. He waffles back and forth, looking for correct answers, believing he is being “critical”. I cannot help his “delusions”, no one can.

    When a mass murder happens, we all stay glued by the sheer atrocity of it all. Somehow collateral damage is not seen as mass murder, even though thousands or millions die, even though endless lifelong suffering is the result, and even throughout generations.
    They don’t give a shit, what harm they cause, or what ongoing harms they support through their weakness in not standing up for the false, for the dreamt up ideals, and according to their whims and notions. Which by the way never evolve from the first biggest mistake they made, thinking they are the humans that somehow were blessed, by nature, by “science” to decide who is a “mentally ill” subject.

    Are we sure that “mental illness” is not exactly that which looks for “IT”? Identifies “IT”?
    Is that not simply an obsession and preoccupation of that which you cannot define? It seems to be exactly the opposite of “thought”. Thought about others cannot be conclusive.

      • A guy I worked with many years ago used to say to me “Never let these contractors make their problems your problem”

        It was a piece of wisdom that served me well over many years, and good to see you repeating it here Oldhead 🙂

        Let the APA worry about it.

        Though I do note how effective the slander has been when it becomes my burden to prove I don’t have an illness that doesn’t exist. The Community Nurse makes up a straw man and my life is destroyed as a result of trying to prove he is a liar and a fraud, to liars and frauds. Oh well, what I know is that someone knows the truth, and those who deny that have their own burden to deal with at some point in the future.

      • Posting as moderator:

        “Removed for moderation” indicates that a comment made by this person was removed due to violating the posting guidelines. There is generally communication between the moderator(s) and the poster providing information and providing an opportunity to edit the post for re-posting if appropriate. Sometimes the person chooses not to edit or there is no editing possible to resolve the issues, in which case, the comment is replaced with “removed for moderation” to hold the space it occupied.

        Contact me at smccrea@madinamerica.com if you have more questions about the moderation process.

        Steve

  6. “there are problems in the psychiatric field, but none of these problems can be blamed on psychiatry.” That disingenuous, unrepentant attitude is why I couldn’t even read Frances’ book.

    “Treating ‘real illnesses’ with ‘real medicines’ enabled them to believe that they were real doctors.” The problem with this is that none of the DSM disorders are real “genetic” diseases, even according to Frances.

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml
    https://www.wired.com/2010/12/ff_dsmv/

    “In reality, psychiatrists promoted the chemical imbalance hoax with just as much vigor as pharma—perhaps even more so.” Indeed, both the psychiatrists and psychologists promoted the “chemical imbalance” theory. My former psychologist tried to push that theory on me when I was picking up her medical records.

    “And despite the vague self-conscious back-pedaling that we are seeing today, there has never been anything even remotely like an apology from organized psychiatry to the millions of people who were hurt and permanently damaged by this hoax.” Don’t forget the hundreds of millions of people who’ve been killed, based upon the fraud of the DSM, and with the psych drugs, in the past 50 years.

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2015/mortality-and-mental-disorders.shtml

    “These guidelines were essentially a marketing tool for the neuroleptic drug risperidone (Risperdal).” It’s a shame Allen Frances, and the entire psychiatric establishment, seemingly forgot that they were taught in med school that the antipsychotics/neuroleptics can create psychosis, via anticholinergic toxidrome.

    https://en.wikipedia.org/wiki/Toxidrome

    The new medicines are often a godsend and may help you feel ‘awakened.’” No, they make you psychotic. But getting off those neurotoxins, and studying the systemic crimes of the psychiatric industry, does help you feel ‘awakened.’

    “Within a decade we may well unlock at least some of the basic secrets of Schizophrenia, Bipolar Disorder …” Well, yes, lucky us, we did. We “unlocked” the iatrogenic etiology of “bipolar.” It’s created with the antidepressant and ADHD drugs.

    https://www.alternet.org/2010/04/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america/

    And we “unlocked” the iatrogenic etiology of “schizophrenia,” too. The positive symptoms are created via antidepressant and/or antipsychotic induced anticholinergic toxidrome, as pointed out above. And the negative symptoms are created via neuroleptic induced deficit syndrome.

    https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome

    “It won’t be a simple story.” It’s not that complicated, it’s just a hard pill for the psychiatrists to swallow.

    “The spurious promotion of psychiatric ‘diagnoses’ as real illnesses, and the routine prescribing of chemical and electrical ‘cures’ were, and still are, psychiatric inventions that continue to destroy individuals and undermine our cultural and personal resilience.”

    Absolutely, the psychiatric industry is systemically destroying America from within. And all the “mental health” workers really should get out of the child abuse and rape covering up business as well, since that is the primary actual societal function of both the psychiatrists and psychologists, despite it being illegal.

    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
    https://staging-madinamerica.kinsta.cloud/2016/04/heal-for-life/

    Thank you as always, Dr. Hickey, for speaking the truth.

  7. Dear Dr. Hickey,

    I appreciate your article and your efforts. I have only done a quick read since it seems my computer is having some “neurological” problems but will be back for a deeper read and comment as soon as my computer responds to treatment.

    It seems as though your point is “accountability,” and here you have chosen to focus on the accountability (or lack thereof) of several parties; psychiatry, psychiatrists, specifiable individual psychiatrists, and Dr. Frances in particular. You may have touched on the accountability (or lack thereof) of some other parties as well. To invent someting called the 4 Cs – coherent, comprehensive, cohesive, and collective, I would suggest that there are no such 4 Cs for “psychiatry.” Therefore, I will suggest that if we are going to indict “psychiatry,” the indictment needs to be of a special kind. Perhaps, there is a special kind of indictment for each of the following; Dr. Francis, other specifiable individual psychiatrists, groups of psychiatrists (institutions, organizations, schools of thought, authoritative & regulatory bodies & these in relation to “stakeholders” such as Big Pharma and Wall Street). There can be no such thing as “psychiatry” without a modifier. Even “psychiatry in the present global zeitgeist” would work. Many would might think that such can go without saying, but I would disagree. Psychiatry is nominally “of the mind” and the human mind is boundless. Even neorologists are likely to agree. Telling us that there are more neurons – synapses – whatever in the brain than there are stars in the galaxy – or something like this, they must admit that they or even humankind is never going to get the final word on the matter of the mind or the brain or the array of thoughts, thought sequences, or mental phenomena which can be produced or concieved in the mind, the brain, or the mind-brain. Should psychiatry even exist as a field? Perhaps, but in a way which is much more humble. In fact, the humility needed in “psychiatry” is greater than in most other academic pursuits – not so much because of the unknowability of the mind but because in this unknowability methods of remedy for “psychiatric ills” are changing every decade and APPLIED brazenly to human beings with and/or without their reasonably and realistically INFORMED consent. Outsideof the complexities of the brain, the human BODY (as is addressed in medicine per se) is a much easier study, but for the mind, it is better we should limit the field of psychiatry to “theoretical psychiatry,” and appliy ourselves as a culture to more antropology, philosophy, nonviolent communications, self-reflection, mind-mastery skills, and social reconsruction. Thank you for your article, Dr. Hickey. I will read it more closely momentarily.

  8. Dr. Hickey, thank you for another compelling and very informative essay. Kudos for always dissecting and exposing the bull**** so very well!

    A couple of sentences (of many) that stand out:

    “Treating “real illnesses” with “real medicines” enabled them to believe that they were real doctors.”
    “Psychiatrists invent psychiatric “illnesses” and then “discover” that lots of people have them.”

    Yes, and how pathetic is that. Psychiatry is a most vile and corrupt institution and I thank you for continuing to write such important essays to expose the corruption. Best wishes, stay safe & healthy!

  9. Dr. Caplan’s “Diagnosisgate…” stands as the definitive disembowelment of Frances.
    The reverance (still!) that publishers continue to display towards his every utterance informs me they are specious amateurs doing no homework on psychiatry & the murderous malignancy he unleashed.

    His desperate attempts to erase his black history with ‘academic’ musings that strain to keep him in the public (& industry’s) eye, positioning himself as a ‘chastened-but-proud’ public servant, is simply the thinly-disguised plea to whitewash his unforgivable history….
    a pathetic, old f*#k-up.

    Hubris won’t allow him to go quietly & stop compounding the tragedies that define his career.

    Allen, you’ve helped no one and left a legacy of unspeakable pain, suffering, & death.
    It was your gift to me vis a` vis DSM IV. You owe me 15 years of my life with the excellent health that was taken from me…per your directives.

    Just shut up. Let THAT be your legacy.

  10. There was a “structural” family therapist by the name of Salvador Minuchin. His approach to family therapy was a “systems” approach in which the role of the therapist was to consciously enter a family system and disrupt it so that the problems interferring with a sustainable harmonious whole could find their way OUT of the system to be replaced with something more effective. At a point of impasse, he suggested attempts at buttressing strengths. Failing this, this he suggested the stystem – the structure, must be razed entirely. So – imagine we do that – “Burn psychiatry to the ground” and create great numbers of unemployed psychiatrists. Let’s say these psychiatrists claim to want to “still” help people somehow. Let’s say you are the Career Counselor at the Unemployment office. How would you set these people – these former psychiatrists – on a path of truly being more helpful?

  11. Thank you, Dr. Hickey, for this article. I really appreciate learing the evolution from DSM-1 using the term “reaction” to morphing into everything becoming “illnesses” and now “disorders”.

    Last year, I went through a PTS period in my life. Note that I don’t include the “D” because I consider it more of a response, condition, or reaction.

    Since then as I have shared my own story (involving a severe stress breakdown back in 1998 and how I was traumatized worse by both failures in the mental health system and also by their efforts to shove me back into the very role that broke me), I have explicitly stated that what I endured was no more an illness than a fractured leg.

    In fact, for years I have used this analogy. If I sit on a couch and put my feet up on a coffee table and add a half pound of stress each day, as that weight accumulates, at some point my knees will buckle. It has nothing to do with illness or even genetics. It has to do with stress and abuse. And when those knees collapse, will the person’s biochemistry be out of whack? Of course. But only looking at the biochemistry not only is a very flat observation of what happened, it does not even address the true condition that caused the injury.

    If focusing only on the biochemistry truly helps someone, then fabulous. There are way too many people, though, for whom those cocktails of drugs do not work.

    Having this history to include in my own speaking (and writing) efforts is very helpful. Thank you for the brief history lesson!

      • Yeah, that old chemical imbalance thing is really shoddy, oldhead, and you are corrects as well, Steve M. But this has little to do with whether the administration of chemicals may be a good idea. A depressed person may be running a dopamine deficit or they may be depressed because their foster parents were always depressed and they’ve just recently died. If a medication helps alieviate that depression in whatever ways it was being expeirnced, then, there you go. If the right therapist can aleiviate those problematic feelings or behaviors to the individual’s satisfaction, there you go. And whatever is done, if the “treatment” makes things worse, than a different approach should be tried. Maybe the treatment or therapy is entirely outside the realm of psychiatry. If this is the case, can’t a person just get up and walk out of the institution (of psychiatry). It seems a little convoluted to keep going back there for help and then bitching about what you get there. If society will not build us a better alternative, then we must build it for ourselves. I mean who knows better than we what we want? In a way, I have already asked this question here. There were a couple of snappy answers (which I enjoyed), but I was really looking for a a deeper response.

        • It is not always possible for people to choose to walk away from psychiatry – many are forced either by forced treatment orders, threats of hospitalization, threats of loss of children, decisions made by parents or relatives of people in nursing homes, and on and on. Additionally, the propaganda that has been spread regarding these DSM “diagnoses” has had other destructive effects, to the point that people are so confused they don’t even know they have another option.

          I had a caller on the crisis line I worked for one time who had been trying antidepressants for over a year with no success. She was frantic and thought that she’d never get any kind of relief and was condemned for life to suffer this kind of emotional distress. Then I asked her, “Did you know there are other things you can do besides drugs?” She was suddenly calm and said, “No.” I said, “Well, there are.” And she said, “Oh. Well. That’s good!” She had been asking for help for over a year and had NO IDEA there was any other option besides drugs. Nobody had even discussed that with her. THAT is what is wrong with the system. If people want to take a drug because it makes them feel better, I’m totally OK with that. I am opposed to a system that lies to people and pretend to know things they don’t know. I’m opposed to a system that profits from hurting people. Yes, people do have a level of responsibility for their own decisions, but the issue with psychiatry extends far, far beyond individual choices to participate or not.

          Hope that clarifies things from my viewpoint.

          • Yes. Thank you. Good points. And even under the current system, people are taking steps to change it via venues such as this – MIA. Changing or radically replacing systems is hard. As a psychologist who refuses to work in the govern-mental system anymore (if you keep and practice with a state license, you practice govern-mental health) – I find it hard to set up alternatives. On one hand, authorities are likely to do ANYTHING to circumvent alternatives and on the other, one risks being seen as some freaky fringe kind of charlatan helper. All the while, there is the cultural “comfort” with the status quo which becomes the default because it is “familiar” and marketed as legit.

          • This is a great point, too. I was a “dissident mental health professional” in my day. It was obvious how quickly marginalized I would become if I just came right out and said “I don’t believe in all this DSM/drugging nonsense.” I had to learn to couch it all in proper “scientific language” and refer to studies and make it all into a big academic discussion. And mostly keep what I did in my own sessions pretty quiet. There is a lot of force brought onto any professional who won’t toe the party line, or at least that was my experience.

          • Steve, I was talking to someone earlier today and said that it seems that a huge problem in the mental health industry is that too often people seeking help are not give OPTIONS of what may or may not work for them.

            I also told him that what I found in my efforts to find professional help is that there is no real “process” for finding someone who would be a good match in terms of types of treatment approaches. That is, how could I find a “dissident mental health professional”.

            The process used to find a professional from what I could tell was like drawing names out of a hat.

            In my situation, I ended up coming up with every type of alternate treatment that I could as I fell through the cracks of the mental health system. I knew that drugs were an option, but I also felt that I wanted them to be a last resort. I found that the speed with which one psychiatrist reached for his prescription pad was way too fast. (I used to refer to him as a “professional drug pusher”.) And of course then I got accused of “rejecting treatment”.

            In my case, I ended up getting cut off twice on the phone with mental health professionals, I got misinformation about my medical leave benefits, I got two sets of medical leave paperwork filled out incorrectly and then threatened with termination for “rejecting treatment” because the Employees Assistance Program counselor determined that I hadn’t sought treatment even though I had begun working with a different professional. They were threatening to fire me from a job that contributed significantly to me having a severe stress breakdown. There is a HUGE logic problem in there.

            All of that of course only traumatized me worse.

            When I was finally fired, there were four termination dates floating around (and of course, I thought, “And you guys think I need help…”)

            Ultimately, you don’t abuse people like that and make no mistake, that type of treatment is ABUSE. Call the spade a spade. At least that is my take.

          • Exactly. It is abuse, yet if you have the nerve to call it out, then you are “treatment resistant.” There is no way to win that game except not to play.

            And it is totally “Caveat empor” (buyer beware) when it comes to counseling. If you don’t already know what you want, you get pot luck, and pot luck usually isn’t very lucky.

          • To pkolpin, about finding “dissident mental health professionals,” I’ll offer some thoughts. 1) such mental health professionals can be hard to find in state-bonafide circles and so a better pursuit might be to find dissident community such as may be found here. 2) In my experience there are dissident MH professionals who sort of “fly beneath the radar” within state-bonafide systems and you may have to go to the “underground” to find them in any quicker systematic way – sort of an “underground word-of-mouth.” In state or county subsidised systems, there are many MH professionals who find the only way they can keep a good conscience is to subvert the system. In much of my time in private practice I advertised “social activism as therapy.” Psych Today for instance, allows professionals to list their various modalities or skill sets. Three spaces are allowed for “write-in” modalities. For ME, social activism as therapy was at the top of my list. Then again, I am a person the authorities tried to kick out out of the profession. Once I started actively interfering in their bed-time with the American Psychological Association, they attacked me and my license was suspended for a year. Long after I served that year, never returning to my practice, an appellate court overturned the licensing boards’s ruling. I could practice WITH MY LICENSE now if I wanted to, but I am a full-time activist against all that BS now and I will never have my brain nor conscience constrained like that again. So, you are correct in your implication. You are not going to find an offices with signs outside reading “Dissident Mental Health.” Even “alternative mental health,” when advertised brazenly will get a professional put on a “watch list.” Then there is the matter of coersion and payment. Do you need anything from the state? Clemency? Food stamps? If MH treatment is a condition of getting it, any treatment off the state list won’t count. Need insurance to pay for your treatment? The insurance companies will require you get bonafide govern-mental. Lucky you are if you have the money to pay for your own treatment. You can chose whoever you want and you record need NEVER leave the professionals office. So – in this, there is classism, racism, genderism – al the things which affect your financial independence or dependence at play here. Anyway, those are some thoughts.

          • Steve, Caveat emptor is a great idea. Unfortunately, that is the nature of the problem for many seeking help. They don’t know what they want. For many, if they knew what they wanted, they’d be miles ahead. I think this may be one of the reasons to go to the “underground” – to get a fuller idea of the breadth of what is actually available. Too, getting SOME idea of what you do and do not want even if you don’t feel certain entirely, is valuable and usable and not to be dismissed.

          • I would even go so far as to say for some people, figuring out how to know what they want is the core job of therapy! So of course, such people won’t be certain what they want to start with, and a good therapist would know this. Sadly, there aren’t very many therapists out there whom I’d describe as good.

          • Thanks, Aerial Ballet, for your comment. Since I am not a professional in the industry, I didn’t realize how hamstrung the professionals are in even acknowledging their disdain for the current system. Talk about “oppressive”.

            In my case, it was through trial and error that I worked better people who were licensed clinical social workers and professional counselors. I found they they actually listened to me and helped reframe and even embrace my experiences.

            A week or so ago, I listened to a MIA podcast with Ian Parker who pointed out that it is typically the LCSWs and counselors who are more likely to look a the social elements and systems around a person to determine causality.

            In general, I would say that if a person “breaking out” of their unhealthy life and exhibiting high emotion and “psychotic” behavior, they or their family members are more likely to seek out a psychiatrist over other types of mental health practitioners due to the change in behavior. And that of course just leads a person right into that mess (excluding some of the psychiatrists who advocate for change like those involved with MIA).

        • Aerial Ballet, there is also a huge issue of informed consent regarding taking psych drugs. Some of these drugs may make people ‘feel better’ initially but they are not told the ‘better’ feeling doesn’t last long, or that these drugs will eventually damage their brain and body and attempting withdrawal is BRUTAL and sometimes not even possible.

          As well once they put their damaging DSM labels onto your electronic health records you will be viewed through the lens of these labels and face ongoing gaslighting and discrimination the rest of your life. Even though you may know/realize the labels are totally inappropriate and outright BS all health care professionals view them as the word of God. And in most cases you can never get your records amended or corrected in any way.

        • If a medication helps alieviate that depression in whatever ways it was being expeirnced, then, there you go.

          You mean on the road to hell?

          If the problem is political the solution is not medical.

          It seems a little convoluted to keep going back there for help and then bitching about what you get there.

          Very true. If you have a choice and there are no locks on the doors.

        • Aerial,
          How do we test “a deficit”? And where is evidence that “deficits” are in fact responsible for THAT particular state?
          People go back even if they never go back. Depending on what country one is in, once “smeared” with even just gossip, it is no longer safe.
          In Canada, it is enough that a GP starts rumors, for you to be treated accordingly.
          “patient seems frustrated”, “patient is anxious” “I think patient is depressed”, are good enough to be treated in that way.
          It is literally like a “high school setting”.
          And what looks like people getting “better”, even by patients, it eventually poops out, it often turns out tragic.

          And I would never fault a person for going “back”, if the reasons for doing so is because it is the only “gritz” around, many go because they have been culted. It takes a long time to really understand. And if their lives are shitty on many levels, that is exactly what psy takes advantage of.
          They always have. It has NEVER been about “help”.
          If people have nowhere to get food, they will go to an abuser to get some.

      • Thanks for your comment, Oldhead about the “out of whack” part of my initial post. It helps me clarify my phrasing in the future.

        By “out of whack” I relate that to being in significant pain. That is neurons firing in a different pattern. In the case of the collapsed knees, that would be the equivalent of a person writhing in pain. In my case, I could feel my brain working in VERY different patterns than usual. So even in my case, I would have said, ‘Yes, sure, my biochemistry is probably ‘out of whack’ — my mind just exploded.”

        If all you do is put a person on pain killers, you aren’t addressing the actual condition and injury. And you are doing nothing to help that person heal. And there is a high probability that the person might end up limping for the rest of their life.

        Thanks for your comment so that I can work to tie that together better — at least for my own situation.

        So in the analogy, the point that I need to bring in better is that by biochemist

  12. Aerial Ballet, Gosh, I don’t know about a “deeper response”, but…
    “It seems a little convoluted to keep going back there for help and then bitching about what you get there” stopped me cold.

    I made an appointment with my great insurance for insomnia caused by money stress. No DTS/DTO. Current in my bills. In 20 minutes I was told I was SMI for-life and given 3 drugs to take that evening, one being Seroquel. I my first Neuroleptic Malignant Syndrome ADR and hospitalized with paralysis for 8 hours.

    They told my freaked-out, terrified self that “…we caught you just in time, your mental illness caused that reaction, never stop the meds”…remember, I’m drugged to my eyeballs-my thoughts are not my own now, heavily sedated, and terrified and ashamed…in a hospital.
    I thought that appointment was going to be a 30-minute version of “You’re fine, just sleep-deprived, here’s some temazepam”…WTF.

    For the next eleven years, peering through the blunting, sedation, and a cacophony of dangerous side effects (A to Z with attendant hospitalizations-NEVER for behaviors) and realizing through the fog I’ve been gamed,..your “….can’t a person just get up and walk out of the institution (of psychiatry)” seems strikingly uninformed.

    “It seems a little convoluted to keep going back there for help and then bitching about what you get there” informs me you know nothing about the industry; manipulating drugged, addicted, folks is easy. And FEAR begins day one; fear of them, fear of losing support from loved ones, fear of losing yourself.

    And they LEGALLY owned my identity in the U.S. court system. Anything negative that I bumped up against for the rest of my life would be viewed through SMI goggles. Disastrous.
    With a diagnosis, your credibility instantly flies out the window notwithstanding the industry’s “We support a patient’s ability to self-advocate”…yeah, until you start.

    Knowing the tremendous damages that stopping these drugs do…, rebound, withdrawal, seizure, coma, death…and the very real prospect that withdrawal can send you into behaviors that WILL NOT help your case, only make you look ‘worse’…it’s dead if you continue, dead if you stop…and REALLY DEAD if you fail cause you’ll be bombed so hard with more, bigger, stronger drugs, institutionalization in a diaper will be your final destination…’for your own good’, of course.
    Plato’s Noble Lie runs throughout this universal narrative…and cash, of course.

    One more thing…when you’ve been poisoned that long, that hard for years, with a relentless narrative insisting that it’s YOU…Well, the secret terror I held inside was, after all that brain damage (I had lesions), swimming in a cesspool of drugs…was there any ‘THERE” left of my mind, personality, or intellect…without the drugs. As existential as that sounds, I have met others who talk about that private, profound fear also.

    I am the one that got away…my “lifelong diagnosis” was changed in 2016 to…wait for it…NOS Anxiety (no sh*t) following a sloppy psychotropic prescribing causing anaphylaxis (yikes).
    I blackmailed my way out, getting a doctor’s guidance for titration and withdrawal. It took almost 3 years, but I have the Mf*%ing paperwork-part of the deal…followed by 19 seizures that finally stopped in 2019.

    Yeah…just get up and walk out…thanks for that nugget.

    • Krista, Wow. First, I am so sorry that you endured all of that incompetence, abuse and trauma. I hadn’t really heard the phrase “psychiatric survivor” until I came across the MIA site. Your account certainly demonstrates that phrase.

      Last week I was talking with a man who had what he called a “severe nervous breakdown” back in the 1960s. We compared our stories and I shared my story of how I “fell through the cracks of the mental health system” (my phrasing). At one point as I shared my story, he said, “Penni, please don’t take this the wrong way, but to me, it sounds like you were incredibly lucky to have fallen through the cracks.” I told him that I didn’t take offense at his statement and that ultimately, I agree that I was very lucky — though of course it worsened my condition and traumatized me even more.

      It is when I hear accounts such as your that I realize truly how much worse and hellish such an experience could have been. I have told friends for years that on a scale of 1 to 10, I would rate my experience a 38. Experiences such as yours seem to be up in the 150 to 200 range. Of course I am being somewhat facetious in the concept of rating such things, but it is so off the charts, it is simply not relatable.

      I wish you health as you move forward.

        • oldhead — I guess it reinforces that I really was lucky. At the time it felt like falling into a crevasse of a glacier and just sliding further and further downward.

          What was funny was several years later, I was talking with a guy I used to work with who was very kind and helpful to me through my experiences. He knew what a bureaucratic mess the company was that we worked for. I didn’t realize that he didn’t know just how many system failures there were.

          At one point he said, “Gee, it almost sounds like it was a conspiracy by the Employee’s Assistance Program to get you out of the company.”

          I told him, “I find that funny because you can say that. If I say that, I’m paranoid.”

          He then said, “Well, you know they aren’t that smart to pull of something like that in a coordinated manner.”

          I agreed and told him, “Yes. That’s why I never said it was a conspiracy on their part.”

  13. Pkolpin, I am touched by your comments, but my experience in private and especially public (Medicaid) funded ‘care’ has been that variations of my core story are ubiquitous, not at all rare. The WTF awareness-creep is slightly different, often slower to manifest in private care. The heavy-handed crudeness of the ‘brain-care’ in community clinics is immediately alarming.
    Medicaid is eyeball-deep in these clients, AKA revenue-streams, who have no voice, no way out.

    My biggest detour in that path was my poor cognitive function following a 2nd NMS/paralysis, the anaphylaxis followed. My fear & outrage fueled a strategy out that targeted their Achilles Heel…cost and liability containment. I was able to parlay it into a safe exit.

    Corporate was completly untroubled to instantly jettison their Absolute, Inviolate, Principles of “life-long” SMI along with every other ‘evidence-based’, biomedical pronouncements of a decade…no problem…to keep the anaphylaxis event and me quiet…defining cynicism and venality for all time.

    I gave zero f*%cks about retribution in that moment… as long as I got out safe & alive…and documented.
    I did and am moving quickly towards a fantastic third act in my life.
    Thx for your well-wishes…the future is bright.

    • Krista, glad to hear the future is (finally) bright. It sounds like a dark journey for so long.

      your comment that experiences such as yours are not rare is what is so troubling to me. People seek / need help and the very system (industry) that is supposed to help actually worsens things so much more than anyone could ever expect.

      And those in favor of the biomedical model have so much influence in largely controlling the dialogue about mental health. The other day I pulled up the statistic that 1 in 6 Americans are on some type of psychiatric drug — most common was of course antidepressants. And most people take those drugs long-term or indefinitely.

      And in that case, I was very lucky because i have a master’s degree in statistics and I knew that those drugs were not initially designed for nor tested for such long-term use. In addition, I knew that there were probably very few, if any, tests on the combinations and interactions of multiple drugs taken together.

      To me, a significant percentage of the people expressing mental health issues and seeking help are the canaries in the coal mines — that our systems (institutions) are often destructive to people. To me, it seems that the mental health industry should be a breeding ground for activists for social change because I would guess a very high percentage of people who seek help in the mental health industry are those often traumatized even worse — as you described.

  14. pkolpin, Actiivism is great, all for it…BUT…please know without credibility (stripped at diagnosis) you don’t have an effective voice with anyone-ANYONE…and your drugged (“Once drugged, always drugged”). My leverage was cold-blooded…economics…the industry recognized it as the blackmail/business move that it was.

    I am one of two known clients who were diagnosed (2004) following the bipolar gold-rush following Allen Frances’ piloted DSM IV (1995) expansion of criteria for bipolar. (see the cover of Time mag 2002 “Young and Bipolar” and everywhere else in the lexicon and media) AND reversed, changed, vacated the LIFELONG DIAGNOSIS. A Navy jet pilot, United pilot, Harvard grad. He sued for 35 million, so far No Bueno.

    RxISK.org (Dr. David Healy) 4/26/2020 “Starship Corona: Captain’s Log” also addresses some of the topics you have mentioned vis a vis psychotropic drug use, with an alarming connection to what’s occurring right now.

    Dr. Healy also wrote MY gateway essay ” The Latest Mania; Selling Bipolar Disorder” PLOS Med 2006 …. I was both shattered and massively relieved when I read it in 2013. This guy had nailed the simple line from A to B and the horrific results…in 2006. Sigh.

    It was all business, not personal. That turned out to be the key for my negotiation out.

    I also recommend Gary Greenberg’s scorching, sarcastic, and factual “The Book of Woe: The DSM and the Unmasking of Psychiatry” 2013.

    I will also point you to my 4-part essay in 2018 “A Unicorn: Changing a Diagnosis” RxISK.org, explaining with minimum editorializing and personal drama (just the timeline of some major events) and ironic humor (I hope), the oh-so-easy-and quick-entrapment; one day I was living the dream in my custom beach house, employed, bills current, great insurance, no DTS/DTO…the next day I was bipolar 1 for life and in a hospital, drugged to the floor (on a plastic sheet) and paralyzed…soon to be homeless and bankrupt, couch surfing at 54 years old…not pretty. I was in shock for years.

    There’s a Kubler-Ross arc, not necessarily in the order that most equate with it. Acceptance often comes first as your terrorized, physically crippled immediately, and whispered soothing reassurances (‘We’ve got this’) are relentless. Your brain is alien to you. In that state, you’ll accept a hand from the Devil himself. And they’re already aware of your pliability with the drugs,..your neurotransmissions are deliberately re-routed and blunted.

    I avoid the emotional blow-by-blow of each poison pill for 11 yeas and it’s damage, and emphasize the philosophy and politics that I stumbled against, drugged to my eyeballs…resulting in quantifiable brain damage but somehow absorbing and questioning more and more frantically as I spiraled down every year.

    My outrage, sturdy DNA and ‘I won’t die in this dump’ mentality drove me to listen to my lizard brain and Sun Tzu “The Art of War”, MY bible, my salvation. Channeling an attorney’s dispassionate frame of mind was key. Facts, THEIR handbooks, statutes, contemporaneous notes (a parallel file)…and legal (in my state) tape recordings. Whoops.

    It was business, not personal.

    I also contributed a 2-part essay here-MIA, 2019 “”Full Moral Status; part 2 addresses SAFETY and strategy to achieve it while your in there. pinballing on the drugs.

    Moral outrage isn’t effective for me; it simmers way back in my head. I am an alpha predator to their soft underbelly, I figured out the code. Cold, calculated EFFECTIVE ACTION plans interests me. VERBS.

    I have my clinical records for 10 years and TEXTS with my exit doctor (3 years, now the VP/CMO). He asked me out for a date…in a text…a month before I was to be ‘released’ with the papers….talk about blackmail.
    And I reported it to my old therapist at the time.

    It will be the ‘big finish’ to the narrative…starting the little book (with names) after I move. Already have a publisher. Delicious.

    I am patient, THEY taught me that.

    Revenge is a dish best served cold, indeed.

    All the rest of the dialogue about how amoral, evil, destructive, greedy they all are is…. ‘yeah, I know’.

    Sorry, I DO go on.

    • Hi Krista — sorry that in my attempt to be brief, I didn’t expound enough. And no need to apologize for your last post about “going on” because there is a lot of useful information that you have referenced for me to look into as well. It helps arm me with more material as I continue with discussions wherever I can. It has only been in the last couple of years that I have moved into the realm of public speaking. I too am supposedly “mentally ill” for the rest of my life. Was diagnosed bipolar. But at the same time, I knew that their models were seriously wrong. Or if I want to be euphemistic, “their models are missing some key elements”. And I knew that I was part of the model that was missing.

      The key word in my statement was “should”. My comment was directed at how dysfunctional and even abusive systems create painful mental health reactions / responses / conditions in individuals. Systems can be anything, large or small — families, schools, religions, and even economic systems such as capitalism that don’t adequately address poverty and promote addiction to buy more material things. Systems can be dysfunctional systems such as toxic work environments, unhealthy living conditions and such.

      In short, the world is “crazy”. The world is “bipolar” (which literally is true with its north and south poles). The world is “schizophrenic” or whatever other description that you want to put on an individual.

      From what I can tell, too often when a person acts out against such dysfunction and abuse, and act out in a way that isn’t linguistically or behaviorally acceptable because it causes pain at a very core level of the individual (you mentioned your ‘lizard’ brain). Some might call that the unconscious, the soul or other things.

      Instead, that individual ends up labeled with who knows what. Yes, often bipolar or schizophrenic — or oppositional defiance order or, or, or. The point I was trying to make is that often (and I might even say “usually” people act and react against such dysfunctions which are often authoritarian structures.

      If the mental health systems really functioned as they should, and yes, that is a HUGE, non-existent “if” at this point, the professionals would first assess what situations and stresses and environments a person is caught up in and help individuals understand what they are reacting against. In that sense the individual is the canary in the coal mine.

      In my opinion, if the mental health system worked as it should, those who seek help would gain an even better understanding of weaknesses or even outright failures in the systems around them. And that is what would breed the activism to bring about changes or open up discussion around the unhealthy dynamics.

      So instead of breeding activists to help improve our surroundings and systems, the mental health industry too often stomps on and “punishes” those who act out, rebel, or even collapse while crutching that dysfunction. Talk about authoritarianism and abuse! And yes, people should be winning MAJOR lawsuits against those who abuse and traumatize people so badly.

      Your comment of “lizard brain” ties me to a recent podcast by Will Hall where he interviewed Sean Blackwell who wrote a book entitled “Bipolar or Awakening” — https://staging-madinamerica.kinsta.cloud/2020/03/breathwork-bipolar-psychosis-sean-blackwell/. It doesn’t mention “lizard brain”, but does talk to the elements of our psyche that are not linguistic and at the true core of things. I added a lengthy comment to that about my experiences and how it relates to the awakening concept. I didn’t know it at the time, but my experience was very much an “awakening”.

      So thanks again for your post and references and thanks also for letting me clarify the intent of my comment above. Some may say that I am too “idealistic”. That’s OK. I look around and see so much system abuse and conditioning that these are major undertakings, major shifts that I see are needed. The world needs to “wake up” as well. The systems we currently have cause serious trauma. And as Carl Jung would say, “We can only change that which we accept.” (Just my take.)

    • “the oh-so-easy-and quick-entrapment; one day I was living the dream in my custom beach house, employed, bills current, great insurance, no DTS/DTO…the next day I was bipolar 1 for life and in a hospital, drugged to the floor (on a plastic sheet) and paralyzed…soon to be homeless and bankrupt, couch surfing at 54 years old…not pretty. I was in shock for years.”

      Why do I read this and imagine the staff at a hospital sitting discussing their success at the ‘treatment’ you were receiving and discussing the possible ‘tweaks’ and the effects that might have.

      Can I ask Krista is your 4 part article on the RxISK.org website? I suppose in a democaratic society it may be possible to obtain legal representation, whereas here in Australia it is a publically known fact that the State can deny access to any legal representation (and lie to you in the process, and in fact have a lawyer lie to you). They simply tie matters up in an authority that was brought into being as a watchdog for corruption in the public sector. I must say I admire the way that over the years the Corruption and Crime Commission has been corrupted and they have turned what was a fairly tame labrador into a vicious Rottwieler which now attacks the very people it was designed to defend from police (and public servant) corruption. I’m most impressed, as is our Prime Minister who has labelled it a “kangaroo court’ (and he should know one when he sees it lol). Secret hearings and the evidence of corruption can not be used in our Courts thus making prosecution of serious criminal offences impossible. They do ‘hang one out to dry’ every once in a while so the public doesn’t think they’re doing nothing but …. I had a senior police officer explain to me that they’re a “bunch of secretary’s” and nothing more.

  15. pkolpin, Thank you for your thoughtful response.
    I reference ‘lizard brain’ as fight, flee, or freeze which is not entirely, biologically accurate…but you get the idea.

    I don’t know if you are aware of the work of Bruce McEwen (“The Hostage Brain”)and associates on the “allostatic load” that all people carry and the manifestations that result.
    I find it a simple, clear explanation of how life affects the brain and body which may result in changes in it’s ability to maintain homeostasis.
    I am very comfortable with this narrative regarding physiological response to stress and trauma…we all have some or a lot.

    Allostatic load nullifies the APA, their DSM, and pharma marketing for relentless sedation (psychotropics). It’s a big problem for them.

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