Thursday, November 26, 2020

Comments by Steve McCrea

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  • They are often prescribed “antipsychotics” because they become aggressive from taking stimulants, which is one of the well-known side effects of taking them. These kids get diagnosed with “bipolar disorder” because of their negative adverse reactions to the stimulants, (or sometimes they are prescribed without any further diagnosis) so instead of taking them off the stimulants (which INCREASE dopamine), they keep them on stimulants and give them “antipsychotics” (which DECREASE dopamine!) I mean, if you want to decrease their dopamine levels, why not start by NOT INCREASING THEM?

    There is nothing more logically stupid in the entire field of psychiatry (which is replete with logical stupidities from top to bottom). I saw it dozens, perhaps hundreds of times advocating for kids in foster care. It is appalling that this continues, and speaks to the moral depravity of the institution of psychiatry.

  • There is no question that these drugs have an EFFECT, and sometimes the effect seems positive or worth the cost. This does NOT mean there is something “wrong” with the child, or that the child is being “treated” for some “disease” or “disorder,” or that other children experiencing similar problems will be “helped” by whatever you felt worked for your child. Individual stories are valid, but scientific claims need to be made on overall data, not individual stories.

    Best of luck with your continuing challenges!

  • I’d be pretty f-ing insulted if I were called a “treatment non-responding anxiety patient.” Isn’t it clear how dehumanizing this whole idea is?

    I also wonder that the model here is to only provide therapy to those whose drug “treatment” seems to have “failed.” Why not start by talking to them before you decide to mess with their brain matter?

  • It sounds like we’re substantially on the same page. He has recently revealed some childhood trauma we did not know about, and he was operating with that inner secret (from himself, too), which no doubt made it difficult to make sense out of things. He also had an emotionally abusive partner he was escaping from, and I think the drugs provided escape for him, too. He was guided at first, but the person guiding him also had some serious issues and told him some very not helpful things. I think certain people just don’t do well with any kind of drug intervention. Nothing works for everyone, and we all have to find our own paths.

  • I think we’re getting into the difference between individual actions, which vary widely, and the system that has been devised, which is very narrow and rigid. There are most definitely individuals who can do great things within the system, and those who fight the system itself to do better (I was one of those for a while). I had a great therapist who really helped me back in the 1980s, though in fairness the DSM-III was just taking hold and therapists were more conversant with Jung and Rogers and Hoffer and Maslow and Bowlby and the like. But the system has changed, and is now rigged to encourage labeling and drugs and a discounting of the importance of experience and personality development as well as to ignore social impacts on human experience.

    I’d use the comparison of individual vs. systemic racism. There are individuals who really do choose to hate people based on their skin color or national origin or class. But the majority of people are able to manage relationships with individuals of varying backgrounds without overt hatred. Unfortunately, ALL of us are steeped in a culture of racism, and carry around images and assumptions and reactions that are “programmed” in by the society we’re a part of, to the extent that much of it, we don’t even notice. Some people are able to rise above this training to one degree or another, but most are only partially or marginally aware that such things are even happening.

    That’s how I see the psychiatric system. There are individuals within the system who can rise above the system’s assumptions, but the training and the culture surrounding “mental health” is warped in the direction of believing that “the mentally ill” are a specifically identifiable population, whose value and capabilities in life are less than the “normal” person, which of course the majority practitioners believe themselves to be. So even if people within the system do challenge the system to do better, they tend to make temporary stirs in certain areas which quickly settle back down into the status quo, because the system is supported by a huge culture of discrimination and condescension and power dynamics, and most of the practitioners are comfortable enough with it to keep supporting its basic assumptions.

    This is why I got out of the business myself. I decided at a certain point that continuing to participate, even as a rebel behind enemy lines, was a tacit approval of the system as it was. I saw the damage being done and realized that one person can’t change the entire culture. So I became and advocate, and earned a lot more inner peace.

  • I am most definitely saying that psychiatry as a pseudo-scientific philosophy/religion denies or minimizes the causal role of stress and trauma in any of their “diagnostic” categories. At the same time, they also systematically overlook REAL physiological problems, like sleep apnea or low iron for so-called “ADHD,” and deprive the client of actual medical care that they may need.

  • Looking again, I just thought it was an important distinction to make. It is common to use the term “illness” in a metaphorical sense, like “that is SICK!” or “she has mental illness” without any actual attempt to look for physiological illnesses, and without the consideration that stress and trauma cause physiological symptoms that can easily be interpreted as “illness.” Of course, these ostensible “symptoms” are intentionally framed as “illness” by the psychiatric community.

  • Throwing up suggests “ill.” Feeling depressed suggests “stressed” or “traumatized.” There are some people who are depressed because they are ill (low thyroid, chronic pain, iron deficiency, etc.) There are some people who throw up because they’re stressed or traumatized. To assume someone’s ill because they are depressed is dangerous and unscientific. Screening for illness makes sense. Assuming illness does not.

  • ‘Kwanzaa’s second principle, Kujichagulia, Swahili for “self-determination,” which reflects a sense of “defining, creating, naming, and speaking for oneself.” ‘

    If this second principle were put into place, the DSM and the standard of “care” in the “mental health” system would be immediately put to rest. The DSM’s purpose is to “define, create, name, and speak” for the “patient” and prevent the patient’s voice or viewpoint from being taken seriously.

    The author may actually have been fortunate that her colleagues didn’t immediately call the authorities and allowed the author to exercise her own self-determinism in deciding how to proceed with the assistance of her psychiatrist. I was a bit disturbed to hear her talking about the “stigma” of “mental illness” and even moreso being “stigmatized” for being black. I think the proper word here is “discrimination”, not “stigma!”

  • I think psychiatric practitioners who “treat” imprisoned “patients” are worse than the criminal justice system. At least alleged criminals have to be “Mirandized” and can have an attorney present during questioning, get a full trial and have to be convicted “beyond a reasonable doubt,” and have a specific and limited sentence. The “committed” have almost no rights, other than a “preponderance of evidence” trial in front of judges who are generally heavily biased against them. And they can be “held” indefinitely, or at least as long as their insurance holds out.

  • The other huge problem with “EBM” is that “evidence” will only accumulate when studies are done, and most studies are funded by the pharmaceutical industry. So any non-drug interventions (like peer support) will never gather enough evidence to be called “EBM,” even if the results are far superior to “treatment as usual.”

    And of course, the article does not take on the more fundamental problem, namely, that helping people suffering from emotional distress is not really “medicine” in the first place. Studying “depression” will never lead to a proper “evidence base,” because the researchers are studying a heterogeneous group, where some will be helped by one intervention and others will be not helped or harmed. If people are treated as individuals, we’ll get a lot better result than by lumping together a whole bunch of people with a wide range of issues and trying to “treat” them as if they had a medical problem that no one apparently can actually identify.

  • Yeah, if owning guns reduced crime, we in the USA would have the lowest crime rates in the world!

    But you are right, there is nothing to suggest that having a “mental illness diagnosis” makes one more predisposed to violent gun use. Heavy drug use (including LEGAL drugs like antidepressants and benzos) and domestic abuse are the highest associations with gun violence and have been for a long, long time. The “mentally ill” angle is just to create a scapegoat so those much larger REAL social problems can be ignored or minimized.

  • I recall an experiment where someone designed a computer program to act like a non-directive therapist. It asked basic questions like, “Tell me about your childhood,” and gave generic acknowledgements like “I see” or “Uh huh…” If someone went off on a tangent, the computer would say something like, “Let’s get back to your mother.” The users reported feeling better from using the program. I think it showed how desperate people are just to have someone listen to them, even though the “listening” was totally artificial. Perhaps the machine had an advantage, in that it was unable to give unsolicited advice or demonstrate prejudice or evaluate for the user what the computer thought their “real problem” was.

    Anyway, I think we’re sinking down pretty low when we’re trying to have computers provide “therapy.” Though the computer program may have a big advantage over a psychiatrist with a prescription pad. At least it won’t make you worse.

  • Very true! The problem is not that the information is not known and available, it is that there are so many people invested in the status quo who stand to lose money or status or both, that the facts are no longer relevant to their analysis. The only consideration is how to maintain power as long as possible before one is caught and held accountable. And this attitude extends very far beyond the boundaries of psychiatry.

  • I recall seeing a film of a nice, German family, small house with a garden and a white picket fence. The father was a German officer, was dressed up for work. Walked out the front door, said goodbye to the wife and kids, and turned up the street. The camera shows Buchenwald rising in the background and the father heading off for his job at the death camp.

    Individual humans do not have to be evil for their behavior to be evil, or for the institution they work for to be evil. Many “good” people are able to justify bad actions in a wide range of manners, and evil institutions are very generous in providing plausible justification for the actions they want people to be able to justify. Remember the Milgram experiment!

  • Biederman and company also cherry picked their non-placebo-controlled studies. Studies in Quebec, Australia (Raine Study) and in Finland showed that taking stimulants don’t improve any outcome measured in the “meta-analysis” discussed. Additionally, the OSU Medication Effectiveness Study showed no improvements in any outcome, except for a slight reduction in accidents for “medication” users. This issue has been studied for over 60 years now. If this stuff were so awesome, why aren’t there clear and unambiguous indications of positive results? How many “no result” findings have to happen before we conclude that it simply doesn’t have any long-term benefits?

  • That is my observation also. “Peers” are rarely considered equal partners, but more someone who can “talk at the client’s level” and thereby explain why the system is “right.” I’ve seen plenty of “peers” who intentionally and consistently buck that trend (Stephen Gilbert/Boren, for instance), and they can sometimes get some stuff done, but they are never considered actual peers to the professionals. As long as that condition pertains, “peer support” remains mostly coopted and lacking in significant influence beyond the level of an individual person’s situation.

  • Posting as moderator: It is possible that past moderators handle things differently. The Posting Guidelines do mention profanity, but in the context of being respectful to others. It could be interpreted that all profanity is banned, but I’ve read it as meaning profanity in reference to someone’s person or ideas would be out of bounds.

  • The difference is that I get to define what I think. is “wrong” in the mental/spiritual realm. If a doctor tests and finds I have low thyroid, s/he can then tell me what is “wrong” and we can make a plan. But no one can tell me it’s “wrong” for me to have flashbacks or feel anxious. Sometimes feeling anxious is absolutely RIGHT – it is my body warning me that I’m in danger! Sometimes it is right but not very helpful, like if I’m going for a job interview and there is a “danger” that I won’t get the job. Sometimes it was right at an earlier time but is being applied to a situation today where the application doesn’t work. So I would be “wrong” for applying it to this situation. But the anxiety isn’t in itself “wrong.”

    Establishing order is what we do as humans. So “disorder” can certainly be perceived as “wrong.” But someone else telling me that my emotional state is “wrong” because it doesn’t meet their criteria for “normal” is judgmental and is frequently destructive.

    As a therapist, I have no problem asking a client, “What’s wrong?” from the perspective of the client. But I would NEVER tell a client, “Your reaction to being sexually molested is ‘disordered’ (AKA WRONG!)” It’s not my job to decide, and that’s why the DSM labels are problematic. It makes people feel “wrong” for feeling the way they do, instead of helping them see the challenges they face in a new light, which is what therapy should be doing.

  • “…by convincing them that their troubles are just an inevitable result of what happened to them, and there is no possibility of them changing their reaction to something else and so getting more control over their lives.”

    I don’t think someone needs to believe there is something “wrong” with them to consider the possibility of changing their reactions/coping mechanisms. My emphasis has always been on how they WANT their lives to proceed as opposed to how they can be “fixed” in the sense of “returning to ‘normal’ (as defined by our social norms).

  • Harrow showed that people with more favorable prognoses prior tom the study had worse outcomes on drugs than those with less favorable diagnoses had when off drugs. So “favorable prognostic factors” did not associate with better outcomes, whatever Harrow might have speculated about it. I also understand that he reconsidered his first analysis in the light of further data and critiques, and I’m wondering if you were reading his first assessment.

  • POSTING AS MODERATOR:

    If there are specific posts that aren’t there, please let me know. Your posts are pretty much always posted without moderation, so I’m not sure what could be missing. E-mail me directly if you find something specific I need to look for.

    Steve

  • I agree, children are their weakest point. They can’t portray a two-year-old as a potential mass murderer needing to be “treated.” When you tell people about kids under one year old being on psych drugs, they are stunned. When you let people know that over half of foster youth over 12 are on psych drugs, people pay attention. A lot of the arguments for psych drugging and incarceration don’t sound nearly so convincing when kids are the victims.

  • Hi, Sandra,

    I guess I have a little concern about the idea of “diversity of opinions” in this context. My problem with it is this: those in the psychiatric world have a MUCH greater power and privilege than those that they ostensibly “treat.” I believe that conveys a much higher responsibility on them to insist that their “opinions” are based firmly upon scientific facts and knowledge. I think one reason you don’t have an answer is because opinions or “voices” can be valued differently by different people, and it is of course very, very easy for those in power to simply ignore the voices of those they have power over. So if we REALLY want to have a conversation where “all voices are heard,” I think we have to start with amplifying the voices of those who receive the services in question, such that their EXPERIENCES (not their OPINIONS) are considered the most vital data being examined. At the same time, those who have the power to ignore such voices would have to be restricted from positing their opinions as fact – they would have to present scientific data to support their opinions, AND would have to have their positions jibe with the reports of their “patients” or else not be considered valid.

    It is, indeed, difficult to manage, but not because there is a diversity of opinion, but because there is a differential of power, and those who have the power to make their opinions sound like facts are unwilling to set that power aside long enough to hear what the real effects of their “treatments” are. Present company excluded, I think.

  • I agree wholeheartedly – the tendency of the “professional” is often to force the person to be “reasonable,” and to re-a. ssume the roles they are rebelling against. Which is actually the very WORST thing you can do! A “mental health” crisis generally means that whatever role a person HAS been playing is not working. Maybe they need to reconsider how they’re living their life! Forcing them back into their old roles would drive them into apathy.

    Having a crisis is not an illness! And the solution is not to. force someone back to “normal,” whatever that is.

  • POSTING AS MODERATOR:

    In fairness to Oldhead, I have posted this last response (since Richard specifically referred to him in his post).

    I will be following Robert’s directive from here onward, and post things that relate to Terror Management Theory. Comments re: COVID are welcome as long as they are presented in that context. Any attempts to personalize negative responses will not be posted.

  • Pretty much, yeah. They don’t have to agree with each other or with US law, though US law can supersede them depending on the issue. “State’s Rights” vs. centralized government control has been an issue since the first Continental Congress back in the 1700s. It continues to play out today, right in front of our eyes. The intensity of the conflict over “mask mandates” is a reflection of that ongoing conflict. “Let’s act together in everybody’s interests” vs. “Washington isn’t going to tell US what to do!” Our current “liberal-conservative” spectrum is closely related to that theme, IMHO. Unfortunately, I think it can blind us to bigger issues on different spectra.

  • I agree, we know what we need to know about them. We know: 1) They mess with our brain chemistry, and indirectly, our brain structure, just like any “psychoactive drug,” including heroin, meth, alcohol, LSD, etc.; 2) there is no identifiable “illness” being treated, no means of distinguishing the “ill” from the “well,” so at best, these can be considered palliative drugs, similar to heroin for pain or aspirin for headaches; 3) all of these drugs have serious and in some cases deadly adverse effects, such that people taking the APs die 20-25 years earlier than the average person in society; 4) they all have withdrawal effects that generally lead to MORE of the “symptom” they are supposed to be suppressing; and 5) whatever unstudied long-term consequences exist, the evidence suggests that they are not good or helpful.

    What more needs to be known? A simple cost-benefit analysis says that we’re “treating” an unknown condition (if it even is a condition) with a drug that has largely unknown long-term consequences (other than early death and diabetes) and known short-term adverse effects which can be severe, and known withdrawal effects which can be worse than the “condition” being “treated.” The only benefit appears to be a temporary lessening of uncomfortable “symptoms” for an unknown proportion of the population using them. What argument is there for their continued widespread use? What happened to “first, do no harm?”

  • Certainly, state legislatures have done a ton of things that have forced the national government or national/international corporations to take notice. For instance, California set fuel emission standards that were higher than any other state. Because they wanted to sell cars in California, auto makers targeted making cars to meet those standards, even if other states didn’t require it.

    Laws governing “involuntary commitment” are made by the states and differ from state to state. Setting a different standard in a particular state and proving that it worked better is one very legitimate approach to handling the problem. The city of Berkeley, CA banned “electroshock therapy” for a while back in the 80s, and even though a judge overturned it, it got plenty of news coverage. It’s a legit strategy.

  • Thank you, Larry! That is very helpful.

    And I agree with you – it is one of those arguments like nature/nurture that can go on forever but not be resolved. Some of it gets down to values and priorities, and some comes down to perceptions vs. reality. The second part can be addressed through research, at least in part. The first is not resolvable except through quality communication, which I find few take the time to learn or execute.

  • Commenting as moderator:

    I have a suggestion. It is clear that we could go on and on about how this is proven or not proven or this is the right approach or that approach is really dumb and anyone who agrees with it is a fascist traitor and on and on. But I think you’re right – science does not make political decisions, and political decisions themselves can’t be altered by science. So let’s stick to the stuff that CAN be determined with more certainty!

    If someone believes hydrochloroquine works, please, share the studies showing that is true! If someone believes it’s dangerous, please share the source of that information – what side effects have been shown in studies to occur, and what’s the cost-benefit analysis? If someone thinks masks are dangerous, where is the data? If you believe they’re helpful, let us know the scientific reasons why.

    The last time this discussion got started, it degenerated into a rhetorical shouting match that had to be discontinued. I don’t want that happening again. Let’s debate the issue like the intelligent, mature adults we all are, and put out the pros and cons without the hype and fear. After all, we’re not going to change the minds of most people by telling them they are wrong. Let’s put the data out there and let people decide for themselves! I’d be happy to be educated, especially about the value of Zinc and Vitamin C and D.

    So my suggestion here: instead of wasting time about whether Trump’s or Biden’s plans are good or bad or bad and worse, why don’t WE bring the science together and examine it? How about educating each other in a mutually respectful environment, and then we can all decide which plan(s) seems best to us? Does that sound do-able?

    I very much doubt bringing psychiatry to an end will realistically occur if people on the same side can’t work out a way of communicating respectfully about things we don’t agree about. Thoughts?

  • Working as an advocate for foster youth, I saw this same pattern over and over. Stimulants for “ADHD” leading to deterioration/aggression, leading to more drugs, leading to more deterioration, eventually leading to kids on 4-5 drugs who can’t maintain in a foster home and end up in residential “treatment” centers. And yet mentioning that the “treatment plan” seems to be leading to more and more deterioration is met with hurt feelings and outrage, or with complete dismissal. Isn’t “treatment” supposed to make you better?

  • Yeah, there was some study way back that claimed that “combined therapy was better than either medication or therapy alone.” It became some sort of mantra such that any challenge to it was met with derision, at least in the circles I was traveling in at the time, even though many future studies showed no such thing. It’s one of those myths like the “broken brain” myth that has little to no support, and yet persists like a bad case of poison oak.

  • Are these people freakin’ serious? What about a voice pattern could POSSIBLY be considered a “biomarker” for anything? I suppose that they will discover that “depressed” people speak in a flatter and less variable tone. Or we could just ASK the person how s/he is feeling instead of using all this technology to analyze their voices? How does this kind of idiocy pass for science?

  • And a lot of people given antidepressants don’t feel better or feel worse. See Kirsch’s works for the minuscule difference between AD’s and placebo when you look at all the trials together instead of cherry picking the ones they submit to the FDA. As for antipsychotics, yes, they do tend to reduce hallucinations and in some cases delusions in the short run, though certainly not for everyone. Unfortunately, long-term followup studies suggest that this is very much a temporary phenomenon, and that over the long term, people chronically using antipsychotics have MORE episodes of psychosis than those who use them intermittently or not at all. If you would read “Anatomy of an Epidemic,” you could see this research for yourself.

    I’m afraid a lot of what you’ve been led to believe about psych drugs is not actually true.

  • I’d be interested in hearing your “evidence of brain pathology” for any “mental illness” you’d like to name. Of course, all such research is tainted from the beginning, since the definitions of “Schizophrenia” and “bipolar” and “Borderline Personality Disorder” are all extremely vague and subjective, leading inevitably to heterogeneous groupings who can’t possibly have significant shared biological traits. But even accepting such vague definitions, the research I am familiar with shows at best very small correlations with any biological “cause,” the most optimistic being around 15% correlation with a mess of a hundred or more genes, and using multiple “disorders” for the correlation. Whereas the correlation between traumatic events and any of the “mental disorders,” including “schizophrenia” and “bipolar,” is extremely high, usually over 80%.

    And if you’re talking instead about fMRIs and PET scans, this research has long been critiqued for not being able to distinguish cause from function. What I mean is, if a “depressed brain” has a certain pattern (which has NOT been consistently shown, by the way), there is no way to know if that pattern CAUSES depression or RESULTS FROM the person feeling depressed. In fact, there is evidence that thinking depressing thoughts shifts the brain’s function in the direction associated with “depressed brains,” and thinking of something else returns to a more “normal” pattern.

    The other problem is that these scans are AVERAGED. So even if there is a tendency, for instance, for people who are diagnosed with “ADHD” to have a certain pattern when confronted with difficult tasks, only SOME of those so diagnosed have this pattern – there is a wide range of individual results, some of which conform closely to the pattern and some of which vary widely. This is why PET scans can’t be used as a diagnostic tool – there is NO consistent finding across large numbers of “ADHD”-diagnosed people.

    So the science I know of says that biology probably plays some role in how we react, but that there is no consistent biological pattern with any of the “mental illnesses” as defined in the DSM. The science also says that traumatic experiences are MUCH more highly correlated with any “mental illness” than any biological findings to date.

    I’m happy to read any research you have that would speak to this question. But so far, I can’t agree that the science to date agrees with or even suggests the conclusions you propose.