Sunday, August 05, 2012

Post-Antipsychiatry


“Language is power, life and the instrument of culture, the instrument of domination and liberation”

-Angela Carter

Let me state at the outset that I am neither a clinician nor a social scientist. I'm not in the business of diagnosing patients OR developing critical theories on the concept of mental illness as a social construct. As a neuroscientist, I believe that learning about human brain function is essential to learning about "the mind," that the latter can be reduced to the former, and that "psychiatric disorders"1 are indeed caused by faulty brain function. This is not to say that society, culture, environment, and personal experiences play no role in the manifestation of "psychopathology".

What Is Mental Illness? Who gets to define it? Who gets to apply a label to another human being, and what does this mean? An ongoing debate over revisions to the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-5) has been covered extensively elsewhere, so I won't discuss that here. Another classification system, the ICD-10, is also used to define a whole host of mental illnesses.

The ability to label and categorize something (or someone) implies a certain degree of power and mastery over them. In the domain of psychiatry, several groups or movements have rebelled against not only labels, but against current treatments designed to "normalize" the problematic thoughts and behaviors. Below is my non-expert attempt to understand a few of these groups, which (by necessity) requires an effort to label them.


Antipsychiatry

Classic grassroots anti-psychiatry has its origins in the consumer survivor movement and is largely based on perceived (or real) abuses and negative side effects of psychotropic medications.2 It is anti-medical model, anti-label, anti-diagnosis, and anti-stigma. The Antipsychiatry Coalition is one example. The Icarus Project might be another:
The Icarus Project envisions a new culture and language that resonates with our actual experiences of 'mental illness' rather than trying to fit our lives into a conventional framework.

We are a network of people living with and/or affected by experiences that are commonly diagnosed and labeled as psychiatric conditions.

The Citizen's Commission on Human Rights (CCHR), run by the Church of Scientology, could be considered an extremist fringe member. Dr. Dave Touretzky maintains an excellent site on The Secrets of Scientology, and his 1998 SfN Poster is required reading for neuroscientists:
In a pamphlet called Psychiatry: Education's Ruin, CCHR urges concerned parents to write their elected representatives to demand:

  • a) that the practice of psychology or psychiatry be declared illegal in schools or colleges;
  • b) that the funding for all mental health programs, tests, research or administrative costs in schools be cut, and re-appropriated towards proven non-psychological/psychiatric teaching methods; and
  • c) that the government funding to mental health research institutes such as the U.S. National Institute of Mental Health be cut.

In the distant (and not-so-distant) past, I've been accused of lumping together various adherents of anti-psychiatric thought, from the academics to the quacks to the loons. Part of this stemmed from a foul-mouthed troll who used to haunt my blog, but those days are over [hopefully!]. Below is more nuanced look.


Critical Psychiatry


Critical Psychiatry is a professional movement started in the UK:
The Critical Psychiatry Network is a group of psychiatrists who first got together in 1998 to discuss changes to the Mental Health Act proposed at that time. The group consists of about 80 psychiatrists, mostly based in the UK, but there is also an international Critical Psychiatry Network of psychiatrists from around the world...3

Many members believe that mental disorder is fundamentally different from physical or bodily disease, and that trying to approach mental disorder in a medical framework strips it of its meaning, and dehumanises attempts at treatment.

Personally, I do not think that the act of defining mental disorders as diseases of the brain strips these illnesses of their meaning or necessarily dehumanizes treatment. I have disagreed with the views of Dr Joanna Moncrieff, one of the chairs of CPN, about whether depression can be considered a biologically-based brain disease (see The Pseudoscience of Anti-Psychiatry in PLOS Medicine).4 There are humane ways of improving the functioning of perturbed brains, which of course exist in bodies, which move around in society and are shaped by cultural and other influences. These ideas are highly interdisciplinary in nature (see Appendix 1) but may not be especially practical yet in terms of everyday clinical implementation.

An interesting combination of Critical Psychiatry and grassroots Antipsychiatry is Mad in America:
The site is designed to serve as a resource and a community for those interested in rethinking psychiatric care in the United States and abroad. We want to provide readers with news, stories of recovery, access to source documents, and the informed writings of bloggers that will further this enterprise.

The bloggers on this site include people with lived experience, peer specialists, psychiatrists, psychologists, social workers, program managers, social activists, attorneys, and journalists. While their opinions naturally vary, they share a belief that our current system of psychiatric care needs to be vastly improved, and, many would argue, transformed.

The next movement consists of localized, interdisciplinary academic groups and departments, many of which are based in Canada. They share with antipsychiatry a strong belief against labelling and stigma, then combine it with critical theory and identity politics.


Mad Studies

Mad Studies is a recent academic offshoot of Disability Studies, akin to Women's Studies and Queer Studies [aka LGBT Studies] before it. An interdisciplinary field that incorporates social science methodologies, historical analysis and a keen political awareness, its goals are to question and critique societal norms of mental illness, insanity, and "madness." Major themes include discrimination and social inequality, the participation of mental health peers in research projects, concern with language and semantics, and of course Michel Foucault and The History of Madness.

The blog Ruminations on Madness has posted a Mad Studies Bibliography, as well as a co-authored chapter [PDF] on user/survivor led research. Here’s a brief excerpt from the chapter's concluding remarks:
User/survivors can only speak with authority if traditional researchers, policy makers and members of the general public come to agree that systems change must be guided both by the lived experience of disability and recovery and through the ongoing critical questioning of often unspoken assumptions about power, truth, and science.

Ryerson University in Toronto recently hosted an international conference on Mad Studies. According to York University professor Geoffrey Reaume:
“Throughout mad people’s history, the academic elite have literally organized against mad people through a multitude of oppressive practices and ideas,” he says.

Through their medical faculties, universities conferred “power and legitimacy to enforce imposed practices ranging from lobotomy, ECT insulin-coma shock, excessive drug treatments, discriminatory labels.

“Now that some of us are in these elite positions within academia, it is essential to ensure we use this power and privilege to organize, to promote, research, write and engage the public about a topic that has too often in our history been interpreted through the views of medical-model academics.”

You can see some overlap with the Antipsychiatry/survivor movement, as the quote above indicates. People diagnosed with mental disorders are not ill, they're just different. The psychiatric/industrial complex is a coercive force designed to oppress and abuse the mad. Also note the re-appropriation of the stigmatizing word "mad", much as some members of the LGBT community have taken back slurs like "queer" and "faggot". Although there is a focus on language and terminology, Mad Studies is against labels. This is somewhat ironic, because impenetrable postmodern academic jargon is typical of the field.5

At the Critical Inquiries 2012 workshop [agenda - PDF], presentations included Research Design and Social Justice: Can a Research Question Constitute a Violation of Human Rights? and The Material-Discursive-Intrapsychic Construction of PMS: A Feminist Critical-Realist Analysis of Women’s Madness [abstracts - PDF]:
We are consistently told that women are more “mad” than men, evidenced by women’s higher rates of psychiatric diagnosis, often attributed to the reproductive body. Competing bio-medical, psychological and socio-cultural models adopt a realist epistemology and a discourse of medical naturalism, to position madness as a naturally occurring pathology within the woman, caused by biology, cognitions, or life stress. Feminist critics argue that this medicalises women’s misery, legitimises expert intervention, and negates the political, economic and discursive aspects of experience. However, the alternative model of social constructionism may appear to dismiss the “real” of women’s distress, and deny its intersubjective concomitants. In this paper, we argue that a critical-realist epistemology allows us to acknowledge the material-discursive-intrapsychic concomitants of experiences constructed as madness, and the relational context of women’s distress, without privileging one level of analysis above the other, in order to understand women’s greater propensity to be diagnosed as “mad”. ...

The Mad Studies adherents are not going to start a movement for change by presenting at intellectually elite conferences and publishing obscure, difficult to understand articles in academic journals alone. I would even argue that the academic language makes it a fundamentally exclusionary movement, unless there is another running discourse for the "mad masses." In addition, others have noted that most of the academic work is not interested in the accessibility of services. At first glance the field appears to exclude a major segment of its constituency, namely those who are impoverished and undereducated, who are likely to be the most severely ill [or alienated].

HOWEVER, many of these same academics are engaged in the community and lobby for systemic change. Some participate in more inclusive events such as PsychOUT: A Conference for Organizing Resistance Against Psychiatry. Although I do not agree with the mandate of CAPA, presentations such as A Supportive Housing Model provide concrete real world counterweights to How a counter-discourse to the psychopathology of ‘obsessions’ departs from the trope of ‘Mad genius’: An autoethnographic study of relationality from ‘local to universal’. This stark contrast raises an important issue that has arisen recently in the science blogosphere (see Appendix 2).


Concluding Thoughts


"Antipsychiatry is behind us!" This quote from the Critical Inquiries 2012 workshop was texted to me by an attendee. I found it very ambiguous. Does it mean that grassroots Antipsychiatry supports the academic field of Mad Studies? Or that the old guard of Antipsychiatry is over, replaced by the vanguard of Mad Studies? [The intended meaning was the latter.] Is Critical Psychiatry an elitist and esoteric professional organization with little impact on the everyday practice of psychiatry? Is the CAPA goal of dismantling the psychiatric system much different from that of Scientology's CCHR?6 As an outsider at odds with many of the views espoused there, I don't pretend to have any answers. But I have come away with a better understanding of those who basically oppose the paradigm of biological psychiatry (and more broadly, the entire research program of my field).


Footnotes

1 However one defines them... See Christian Jarrett on What is mental iIllness?, Scicurious on What is Psychopathology?, and the Neurocritic on the new Research Domain Criteria for Classifying Mental Disorders.

2 I'm not going to discuss Thomas Szasz here.

3 Further reading available on the Critical Psychiatry Website: What is Critical Psychiatry? and What was anti-psychiatry?

4 That August 2006 post initiated a lively discussion. I had nearly forgotten that Dr. Vaughan Bell took me to task for lumping together various adherents of anti-psychiatric thought:
This hardly puts the authors in the same category as Scientology. Your ad hominem attack on the authors really adds nothing to your argument.
5 Every academic field has specific jargon, so this is certainly not unique to Mad Studies and related social science disciplines. I'll be making an important point about that in Appendix 2.

6 However, one important distinction is that a stated goal of the Coalition Against Psychiatric Assault is building a better world, but $cientology is mostly concerned about money.

7 Granted, the line here is pretty thick.


Appendix 1 - Cultural Psychiatry (etc.)


Although not confined to critiques of psychiatry, cultural psychiatry is included as part of an interdisciplinary field exemplified by TheFPR.org:
The mission of the Foundation for Psychocultural Research (FPR) is to support and advance interdisciplinary research projects and scholarship at the intersection of psychology, culture, neuroscience, and psychiatry, with an emphasis on cultural factors as central, not peripheral.
This organization sponsors conferences, such as the 5th FPR-UCLA Interdisciplinary Conference, and funds academic centers, including the Center for Culture, Brain, and Development and the Program for Culture, Brain, Development, and Mental Health (CBDMH):
The primary objective of the CBDMH, which is co-directed by psychological anthropologist Douglas Hollan of UCLA and clinical psychologist Steven López of USC, is to establish a strong program in cultural psychiatry, with an emphasis on integrating neuroscience and social science perspectives.
The FPR also sponsored a workshop on Critical Neuroscience:
Critical Neuroscience probes the extent to which discussion of neuroscience—in ethical debates, policy texts, commercial and clinical projects—matches the achievements and potential of neuroscience itself. It examines the ways in which the new sciences and technologies of the brain lead to classifying people in new ways, and the effects this can have on social and personal life. It studies both the methods used to gain new knowledge, and the ways in which the knowledge is interpreted and used. The project aims at finding or creating a shared vocabulary for neuroscientists and social scientists in which they can talk about the potential of the tools, the analytical methods, the interpretations of the data. We also need a shared way in which to think about the barrage of media reports of all this work. Critical Neuroscience aims, more over, at drawing attention to any social or political imperatives that make certain research programs in neuroscience more attractive and better funded than others. We hope to introduce our observations into brain research itself, and to integrate them into new experimental and interpretive directions.
Since the mission of this blog has been "Deconstructing the most sensationalistic recent findings in Human Brain Imaging, Cognitive Neuroscience, and Psychopharmacology", it might informally fall under the rubric of Critical Neuroscience, although it has not specifically aspired to...
...seriously bridge the social and anthropological study of the neurosciences to the neuroscience laboratory by engaging neuroscientists and non-neuroscientists - philosophers, historians of science, anthropologists - in concrete collaborations focused on specific themes of cultural relevance.
The excellent Neuroanthropology blog is a better fit for that academic niche. Although broader in scope (with a long list of contributors), Somatosphere.net covers this ground as well.


Appendix 2 - When is it appropriate to use academic jargon?

Who gets to dictate a style of writing? Where is the line between use of technically precise but impenetrable academic jargon and fatuous tabloid oversimplification aimed at 9th graders?7 In some instances, scientists rail against churnalism and oversimplification of their results in popular media, yet want to constrain the language of other fields. Why is technical jargon necessary in biological (and harder) sciences but not in the social sciences or humanities? Those fields have their own paywalled specialty journals as well. On the one hand, science Writers should not fear jargon - "Researchers use complex language for a specific purpose." On the other, Why Don't Social Scientists Want To Be Read? You can just as easily ask Why don’t neuroscientists want to be read (except by neuroscientists)?

Audience matters.
Obviously, there's a difference between academic writing and 'popular' writing. Authors write differently for Sage Publication's Health vs. Men's Health. In my opinion, it's presumptuous to dictate the language that should be used by another academic discipline just because you don't understand it. It reveals a dangerous undercurrent of intellectual hierarchies and power (to which I am not immune).


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25 Comments:

At August 05, 2012 3:51 PM, Blogger Dominik Lukeš said...

Do you really "believe" that "[the mind] can be reduced to [neurology]" in any but the most trivial senses? It would seem to me that your blog is essentially about underscoring the dangers of trivial reductionism. As a linguist who is barraged by dismissive reductionism from neurosciences, I have argued on metaphorhacker.net that a non-reductionist neuroscience is indeed possible.

What I meant by that we do not need to deny the existence of a neural substrate to language while not actually believing that we can usefully reduce our understanding of language to them. In the same way that we do not reduce the understanding of multicellular organisms to individual cells, weather patterns to all the constituent components or gravity to quantum effects. Why wouldn't we expect that mental difference is not straightforwardly reducible to neurochemistry?

Like you, I don't have a lot of time for critical theories, but they build on the notion of social construction of concepts like illness which is supported by evidence as well as theory of natural selection. That does not mean to deny that targetted chemicals won't have an impact on the brain to bring a person's behaviour into line with social expectation. It also does not mean that such chemicals are not better for many of the people who are given them. But it does mean that we have to be very careful of what I call the "isomorphism fallacy". Just because WE "see" it, doesn't mean, we can find one-to-one correspondence on what WE identify as it's "constituent" level.

 
At August 05, 2012 4:10 PM, Anonymous Altostrata said...

I don't believe your typology is correct. The Icarus Project, for example, accepts treatment with psychiatric medication if it is a fully informed patients' preference.

From what I've seen, there are two incompatible groups among the grassroots population you call antipsychiatry.

One group allows that psychiatric disorders of some kind do exist, medications or other psychiatric treatments might be the preference of some patients, and there is a role for psychiatry in medicine -- if it is reformed.

The other group is considerably more radical. It rejects all psychiatric diagnoses and treatments and believes psychiatry as a discipline is intrinsically inhumane and completely unnecessary.

Both groups see contemporary psychiatric practice as dehumanizing, misguided, and often wrong -- positions shared by Critical Psychiatry and Mad Studies.

The way you're using the label "antipsychiatry" is not commonly how it's used. Anyone critical of psychiatry in any way is called antipsychiatry. Even psychiatrist Daniel Carlat, who is an enthusiastically practicing psychopharmacologist (until he went into government policymaking), has been lumped in with Scientology.

"Antipsychiatry" is as precise a label as "antiwar." Who gets labeled with it depends heavily on who's doing the labeling and their political or economic motivations.

 
At August 05, 2012 4:42 PM, Blogger The Neurocritic said...

Dominik Lukeš - You raised a lot of good points and reminded me that I wanted to include a levels of analysis type figure from Marr and link to a spatial vs. temporal resolution figure that situates the various neuroscience methods in space and time. I realize one could expand such figures to encompass the resesarch from Appendix 1, but I wanted to endorse a reductionist model at the outset, even if it sounds simplistic and wrong to social scientists. And although I'm critical of neuroscience, it's still my field.

Whatever nuanced view I would have presented, it would be still be called reductionist by those who oppose psychiatry -- since it comes from a neuroscientist who believes in the reality (but not exclusivity) of biological psychiatry.

 
At August 05, 2012 5:22 PM, Blogger The Neurocritic said...

Altostrata - The title of the post (Post-Antipsychiatry) was meant to convey the multiplicity of viewpoints critical of psychiatry and to move beyond the common usage of "antipsychiatry" that lumps Carlat with Scientology. As I mentioned in the post, I have done that in the past but tried to present a more informed overview here. And as stated, I'm well aware that the act of labelling someone "implies a certain degree of power and mastery over them."

Clearly, I'm not an expert. I tried to use cautious language in most instances but expected to get some things wrong. I've been rabidly attacked and threatened by the extremist antipsychiatry camp in the past, which didn't exactly make me sympathetic to the cause and willing to read more broadly. I recently became aware of Mad Studies and thought that presented a good opportunity to do so.

 
At August 05, 2012 7:48 PM, Anonymous Altostrata said...

I understand how that goes!

On the other hand, people really are being injured by psychiatric treatment. Given how promiscuously psychiatric drugs are prescribed, the number is likely in the millions.

Each FDA warning on a psychiatric drug represents some number of cases already injured, and if doctors don't heed the warnings (how many read the package inserts?), more will be injured.

Adverse effects are not a myth, and some do not resolve quickly, or at all.

While I have problems myself with psychiatric survivors who are rabid about psychiatric issues, I can understand why they would want the field of psychiatry to disappear from the face of the earth. (And often their ire extends to people who are sympathetic but do not entirely agree with them.)

 
At August 07, 2012 6:01 AM, Blogger Becky said...

Your post concludes with your claim that you are an outsider at odds with many of the views espoused---"But I have come away with a better understanding of those who basically oppose the paradigm of biological psychiatry"(and more broadly, the entire research program of my field)." Might I suggest you may have gained a deeper understanding had you corresponded with individuals whom you chose to write about? I am skeptical of your claim that you are an OUTSIDER--Regardless of what one's personal views of psychiatry or antipsychiatry may be, the reality is those who are directly affected due to a diagnosis more often than not are deprived of their fundamental Human Rights as a matter of course...THAT is something that should be of concern to everyone. I am puzzled as how you could have neglected to even mention the issue, as it is a primary issue recognized by virtually every group you mentioned.(other than biological psychiatry)

BTW at the beginning of your post you write, "In the domain of psychiatry, several groups or movements have rebelled against not only labels, but against current treatments designed to "normalize" the problematic thoughts and behaviors." I would argue that is not in fact a correct statement. The treatments have not been developed to normalize a pathologically abnormal physiological process as such an entity has never been identified, defined or understood. So there is no real basis for the claim that psychiatric treatments normalize something that has not been empirically identified and quantified, i.e. shown to be abnormal; a disease pathology. The treatments for some people extinguish undesirable symptoms and behaviors...not the same thing as normalize, at all.

 
At August 07, 2012 10:17 AM, Blogger The Neurocritic said...

Becky - The quote by Professor professor Geoffrey Reaume nicely
addresses the issue of concern to you.

On the other hand, there are literally thousands of people walking around with psychiatric diagnoses who do NOT feel deprived of their fundamental human rights.

This post is by no means the first that I've had interactions with individuals opposed to psychiatry. Also, I *have* spoken to a friend who is a moderate within Mad Studies and to another person who attended Mad Studies conferences but is not an adherent (the person who texted me from the Critical Inquiries workshop).

Finally, I could spend days and days reviewing the evidence of alterations in brain function among individuals with particular diagnoses, but I don't think that would convince you. You could start by reading about the new Research Domain Criteria for Classifying Mental Disorders.

 
At August 07, 2012 2:11 PM, Blogger Becky said...

Are you seriously suggesting that since not ALL psychiatric patients feel deprived of their Human Rights, it is a non issue?

Your comment in response to my previous comment is insulting frankly. "I could spend days and days reviewing the evidence of alterations in brain function among individuals with particular diagnoses, but I don't think that would convince you." I don't know you and you certainly do not know me---FYI I am not opposed to psychiatry--I am opposed to the utter lack of informed consent and the Human Rights violations I have witnessed... I am opposed to being misled, disrespected and outright lied to.

I am disappointed in your condescending tone...Your failure to address the Human Rights issue by quoting someone who apparently thinks it's ok to violate the Human Rights of psychiatric patients--so long as not every one of them FEELS violated; is simply a way to avoid, rather than state a reasoned justification for your failing to even Human Rights violations are a major reason why psychiatry has lost public trust, etc...

It is so much about who is correct in the interpretation of data, or whether or not the drugs treat actual diseases or just cause them, to me. What I am concerned with is the actual real world outcomes ---in the aggregate, the real world outcomes are indefensibly lousy IMO. My son was used in the TEOSS drug trials without permission in spite of my protests--I can assure what was done had NOTHING to do with ethical research, ethical Medicine and it certainly had NOTHING to do with the Best Interests of the patient. One can't help but wonder, "Why is so much dishonesty, coercion and even police powers and Force of Law is required to practice psychiatry?"

 
At August 07, 2012 4:03 PM, Blogger The Neurocritic said...

Of course I'm not in favor of violating the human rights of psychiatric patients or anyone else. My point is that not all patients feel that psychiatric treatment is a violation. In addition, scientists who work with human subjects take training in the responsible and ethical conduct of research. Many do not conduct clinical trials or treatment studies but perform more basic research that may in the future help others. Do you believe that the vast majority of scientists who do brain research want to help other people? Because that is my understanding of the field.

I'm surprised you think Professor Reaume is in favor of violating the Human Rights of psychiatric patients:

Reaume had found his calling as a historian and a social activist: to uncover the experiences and perspectives of people with psychiatric disabilities and in so doing carry on the fight for social justice for this marginalized segment of society.

"I’m doing stuff that for too long has been ignored," says Reaume. "My historical work is a form of social justice. I’m trying to change attitudes and give history back to the community of people that lived it. I’m using history to fight the prejudices that exist today."

About the time his book came out, Reaume and a collective of other psychiatric survivors founded the Psychiatric Survivor Archives of Toronto (PSAT). Dedicated to preserving the history of people who have experienced the psychiatric system, it is the first archive of its kind in the world, as far as Reaume knows. "The need for these archives has grown out of a recognition that our history has been too often ignored or trivialized by mainstream historians, researchers and medical professionals," says the archives brochure. Donations of original newsletters, first-person accounts, news stories, artwork and recordings of talks have arrived from all over the world -- Canada, the United States, Holland, Norway, Mexico and Brazil -- and provide an invaluable record of psychiatric survivor activism especially since the 1970s.

If you do, it's best that you take it up with him.

If I offended you that was not my intent. Perhaps you do know a lot about neuroscience. However, your implication was that I am somehow unethical, which is very far from the truth. You do not know me either.

 
At August 07, 2012 8:02 PM, Blogger The Neurocritic said...

Becky - Is the the trial you're talking about?

Treatment of Early Onset Schizophrenia Spectrum Disorders (TEOSS)

If in fact your son was enrolled in a clinical trial without your permission, that is indeed a serious ethical violation. Have you reported this to NIH?

 
At August 07, 2012 10:55 PM, Blogger Becky said...

I stated no opinion about Professor Reaume whatsoever. What I said was the fact that not all psychiatric patients FEEL as if their Humamn Rights are violated is NO excuse for failing to even mention this issue---as it underlies many of the critics and psychiatric survivors valid criticisms of psychiatry. The fact of the matter is some patient's Human Rights are violated as a matter of course...In all reality given the nature of the mechanism of action of the neuroleptics, and the SSRIs--as well as other psychiatric drugs--anything less than full disclosure prior to prescribing the drugs is inexcusable. For those who die from the effects of the drug/s who take the drugs as prescribed and were not warned about the risk---these are in fact called, "natural" deaths. In all reality it is Iatrogenic Homicide. Hiding behind Standard Practices which were developed and implemented by consensus for diagnoses which are developed by the same quasi-democratic process instead of being derived from ethically conducted and reported Clinical Trial Results. All of which, IMO makes calling drug-induced iatrogenic damage 'side effects;' and drug-induced deaths as 'natural' a blatant lie. My son was a victim of violent crime at the age of three resulting in a major heald trauma and severe PTSD he was then victimized by mental health professionals with impunity. He was given Risperdal a decade before it was approved for ANY use whatsoever in children. He had a 146 IQ and could do triple digit math in his head and didn't need to use his fingers...The Christmas before last, he needed to use his finger to count the 7 days remaining until Christmas. Every single psychiatrist who has treated my son has lied to me EVERY ONE. A professor who taught every one of the psychiatrists who have mistreated my precious son used to be MY psychiatrist when I was a teenager. Imagine my utter horror to be told, "no psychiatrist would see anything wrong" with what a Federally Funded Researched did to my son. He told me that any parent who did not agree to the drugs being prescribed would at best be perceived as ill-informed and at worst, impaired themselves.

yes it was the TEOSS trials my son was used like an animal without consent and in spite of my vehement protests. It is a conservative estimate that $1 million dollars in fraud was committed by the State of Washington in his "care" The medicaid fraud continues to this very day; as does the medical neglect of his iatrogenic injuries. It is how psychiatry is practiced in the real world where I live.

I want to be clear: I do not hate psychiatry, and I do not consider myself anti-psychiatry. I also do not believe that no psychiatrist would see anything wrong with how my son was treated...I am PRO Informed Consent. I am PRO ethical research and ethical practice---I think it is despicable that medical professionals repeatedly LIED to me and disabled my once brilliant son. I am a MadMother for good damned reason. Once upon a time I dreamed of a career in psychiatric research, but life and it's responsibilities have set me on another path. I hope some day to meet an ethical psychiatrist in person, who can help me help my son.


http://involuntarytransformation.blogspot.com/2011/12/jon-mcclellans-testimony-to-us-senate.html

http://involuntarytransformation.blogspot.com/2011/12/some-expert-jon-mcclellan-claims-he-has.html

http://involuntarytransformation.blogspot.com/2011/09/how-it-was.html

http://involuntarytransformation.blogspot.com/2010/12/age-of-consent-is-used-by-unethical.html

As for reporting the crime to the NIH--I fail to see how that would do any good...NO regulatory authority has ever investigated any of the crimes I have reported that have victimized my son since the first time almost twenty years ago...NOT ONCE. My son is 24 years old.

 
At August 07, 2012 11:04 PM, Blogger Becky said...

My comments are not intended to imply you are unethical---in all reality if I believed you to be unethical, I would not have bothered to leave a comment at all... I tend to say exactly what I mean--so if you were offended, please accept my apology--it was not my intent to do so.

 
At August 08, 2012 12:51 AM, Anonymous Anonymous said...

dear neurocritic, not nec. an ethic violation if son is old enough and has competence. here in the the uk it used to be called gillick competence'

 
At August 08, 2012 3:03 AM, Blogger The Neurocritic said...

Becky - Being familiar with the functioning of IRBs, I know they take ethical violations very seriously. Information about the Office for Human Research Protections at NIH:
http://www.hhs.gov/ohrp/

Staff listing for the Division of Compliance Oversight:
http://www.hhs.gov/ohrp/about/staff/index.html


Anonymous - Thank you for your comment. I was trying to be polite...

 
At August 08, 2012 11:33 AM, Blogger Sigrun said...

I live in Norway, Scandinavia. Norway loves to export human rights to Africa, but doesn't realize that also our own citizens have human rights. Health professionals, even those who use restraints and force patients to take medication, are not educated in human rights! So, they can violate patients' human rights even without knowing it. Hardly anybody cares, except from patients and a few lawyers. Even Amnesty International in Norway is not interested in the human rights violations in the mental health system.

 
At August 08, 2012 12:29 PM, Blogger Becky said...

In answer to the anonymous who rather that reading any one of my links suggested that I am incorrect about Consent, and what was done to my son. he was a kid of 13 and while Washington State has with Pharma and NAMI help lowered the age of consent for MH tx to 13, he was unable to hold a conversation at all...so Informed Consent. It is nice to know anonymous puts two cents in without perhaps reading to see if maybe I may know WTF I am talking. And you are too much "trying to be polite" truly disappointing Yes the site you share I have visited it so often and linked so many times they have taken most of it down The Belmont Report, etc... is now ARCHIVED, and much of the other useful info. that just a short time ago was readily accessible; is now hidden...It is obvious to me if it not to you---these violations against people with a psychiatric diagnosis are not in fact taken seriously at all. You are deluded, if you actually believe they are. Really seriously deluded.

 
At August 08, 2012 1:40 PM, Blogger Becky said...

"I was trying to be polite..." WOW I gave you the benefit of the doubt; obviously not warranted...

re: "Do you believe that the vast majority of scientists who do brain research want to help other people? Because that is my understanding of the field." I believe that that is at least part of the intent...Human beings are complex---particularly really intelligent ones who determine that since they have such a high level of intelligence, truly listening to others and responding genuinely is not all that important when you 'know how their brains work.' In fact, I would say that without the ability to have a genuine positive regard for others--at least until the do something which demonstrates they are unworthy of your positive regard; one would be at a serious disadvantage in their endeavor to 'help people.' I would even go so far as to say that without a genuine positive regard for others particularly people who may not be as intelligent or as educated as yourself, one could do a great deal of very real harm to people they endeavor to help through their research...I assure you, being less than forthright and less emotionally honest is no way to be polite---in all reality, it is rude and it is insulting.

 
At August 08, 2012 3:46 PM, Blogger The Neurocritic said...

Becky - By asking whether you have contacted NIH, and then providing the explicit information for the Division of Compliance Oversight, I was trying to be helpful (and yes, polite). Since you feel very strongly that there was an ethical violation in an NIH-sponsored clinical trial, those are the people you should contact.

 
At August 14, 2012 12:58 AM, Anonymous Finefrenzy said...

I haven't read all your piece at this point. I just want to advise on the origin of "anti-psychiatry". The term originated, not in the grassroots consumer/user/survivor movement, but was coined by David Cooper (1931-1986), a radical (revolutionary Marxist, existentialist) South African psychiatrist when working in London, UK, in his book 'Psychiatry and Anti-Psychiatry' (Paladin, 1967).

Dr Cooper was a colleague of Scottish psychiatrist and psychoanalyst RD Laing, working together with him and other psychiatrists - e.g. Aaron Esterson, Joseph Berke, Leon Redler, Morton Schatzman - social worker Sid Briskin, and novelist Clancy Sigal, for instance, to establish the Philadelphia Association. This was (and still is) a charity which set up a number of community houses to provide places of 'asylum', of refuge, to people experiencing 'madness', extremes of mental distress, as an alternative to hospitalisation.

Although the term has often been attached to RD Laing, Dr Laing himself, however, wrote in his (1985) autobiography that he had never called himself an anti-psychiatrist although he largely agreed with Cooper's analysis. Others who have been labelled as "anti-psychiatry" include Hungarian/US psychiatry professor and critic of state, particularly compulsory, psychiatry, Dr Thomas Szasz. As a right-wing libertarian at the other end of the political spectrum from Cooper, Szasz has vehemently disowned the "anti-psychiatry" label.

I have not, in the time I've had, been able to find out what exactly Cooper meant by "anti-psychiatry", although he also wrote of making an "anti-diagnosis" I believe.

It was, I think, a term of its time, born of the radical social movements of the 1960s and 70s, aimed at challenging the way things were done in, and what was believed by, 'establishment' institutions of the time. At around the same time, for instance, Cooper and others set up the "London Anti-University" in London's East End to explore counter-cultural and radical political themes and conversations.

Yes, as I say, I think that "anti-psychiatry" is a term of its time (the 1960s and 70s), and I'd suggest that it makes as much sense to try to label modern-day social movements and organisations as "anti-psychiatry" as it would to call some 21st century people, say, "flower children" or "suffragettes".

 
At August 14, 2012 6:52 AM, Blogger Jorge Campo said...

You wrote in part:

learning about human brain function is essential to learning about "the mind," that the latter can be reduced to the former, and that "psychiatric disorders" are indeed caused by faulty brain function.

I think I will have to know what "mind" means to you before I go further with your statement. So far, it seems to represent a sort of vitalism or essentistic point of departure without revision. Am I correct?

In your second phrase you put "psychiatric disorders" in quotes, which, I guess, must mean you don't believe in them. If so, why consider if they are or not due to a brain function?

Would you consider any type of learning due to a brain function too?

As a note aside: I am quite happy to discover your blog today. I think it has an excellent quality. Congratulations.

 
At August 17, 2012 6:12 AM, OpenID madphenomenology said...

Only because so many people continue to visit my blog from this post have I decided to (briefly) reply. I understand that you're not any sort of "expert" on antipsychiatry, critical psychiatry, alternative mental health, etc. But if so, why write a post like this--misleading on so many levels--particular given how many people will actually mistake it for a serious exposition of these movements?

Honestly I wouldn't know how to even begin to address all the over-simplifications and inaccuracies, but for a start, I might ask if you have ever actually read the work of the co-founders of the Icarus Project? Sascha DuBrul,for example, is hardly an anti-psychiatrist, particularly by your definition. (See, for example, his post here: http://www.madinamerica.com/2012/05/mad-pride-and-spiritual-community-thoughts-on-the-spiritual-gift-of-madness/) And the online Icarus community supports many many different (and often contradictory) positions.

"Mad Studies," further, is an extremely ambiguous proto-field with quite profound differences across national contexts. Nor, I think, should user/survivor research be so easily conflated with Mad Studies (certainly the former would not meet your definition of the latter) & yet you quote a user/survivor researcher paper of mine as an example of "Mad Studies." In the future, please please have more conversations with a variety of people actually immersed in these areas of discourse before (so naively & misleadingly) "typologizing" and categorizing them.

 
At August 17, 2012 12:17 PM, Blogger The Neurocritic said...

madphenomenology - Isn't it a good thing that more people are reading your blog, including mental health professionals and science writers and neuroscientists who may not have found it before? Isn't this the whole point of interdisciplinary work? I never pretended to be an expert, this is one person's view from the outside.

I expected to be wrong in places, and commenters like Altostrata corrected me on The Icarus Project:

"Everyone is welcome, whether they support the use of psychiatric drugs or not, and whether they identify with diagnostic categories or not."

And as I replied earlier, I tried to use cautious language in most instances ("might be another," "could be considered") but expected to get some things wrong.

I haven't talked to any Critical Psychitrists in the CPN, but I have spoken to attendees at Mad Studies conferences. Many are academics, but some are consumer/researchers in favor of improvements in treatment, services, and housing. Still others might be considered survivor/academics with more radical views. With a diverse group like that, not everyone speaks the same language. If academics want to be inclusve in such venues, they might consider that some in the audience do not have college educations.

On the other hand, Mad Studies Academics publishing in scholarly journals use a specific language, much like scientists use technical terms to convey precise ideas. This is entirely appropriate. When either group wants to reach the public, they should talk and write differently. When academics in different fields want to talk to each other, they should adapt so they can be understood.

And the line between user/survivor research and Mad Studies isn't that clear, because I have encountered individuals who do both (e.g., http://blogs.psychcentral.com/channeln/2012/08/toronto-video-art/).

 
At August 17, 2012 1:53 PM, OpenID N said...

Yes, part of my point was precisely that the lines between areas of discourse are often vague and ambiguous--especially in the case of madness & psychiatry. And I wish you'd emphasized that more in your post & in fact wonder & worry about the usefulness of the whole 'project' of categorization and typologization you decided to undertake. (I suppose I might ask what your motivation is/was for doing so...?)

Also my personal approach to things, and what I'd like to see more of here, is a more substantive attempt to immerse yourself in different discursive areas & contexts BEFORE writing about them. I.e. read broadly and widely, listen to the very different perspectives presented in a forum like Madness Radio, talk to a VARIETY of different researchers, theorists, activists, etc. (Variety, of course, is the key.) I think that if you did, if you dug around a bit more, and really engaged with these (actually rather stunningly complex and very often contradictory) "movements" and texts you wouldn't have categorized or described them in the way you did.

Finally, I absolutely agree re the importance of disciplinary crossings, but would prefer to see it done "right"--i.e. involving the sort of engagement I describe above, engagement that moves interdisciplinary work forward rather than simply reifying or further consolidating the differences between areas and disciplines. (Certainly I agree that one--everyone--needs to learn to carefully articulate their positions in contextually appropriate ways. But this doesn't just require using appropriate language, but also taking ones subjects, objects & interlocutors seriously, as they are, for what they are.)

--N

 
At August 18, 2012 10:56 AM, Blogger The Neurocritic said...

N - I didn't intend for this to be a comprehensive or authoritative source about different movements against mainstream psychiatry and how they might intersect and overlap. These are just my impressions and opinions in a blog post, which is informal and not thoroughly researched. Such an undertaking would be very time consuming. I do think it's a worthwhile project, but I'm not the person to write such a piece. I work long hours doing neuroscience research and I don't have the time or background knowledge to complete such a project in a short amount of time. You would be in a much better position to write a scholarly treatment of the topic, if you were so inclined.

My reasons for writing this in the first place stemmed from talking to attendees at a Mad Studies workshop. I was struck by the ambiguity of the statement "Antipsychiatry is behind us" (taken out of context). Hence Post-Antipsychiatry. To give one example, anti-psychotropic drug isn't necessarily the default position anymore. This may be common knowledge to some but it wasn't to me.

My history of interactions with psychiatry critics on this blog has been less than pleasant, you might say. I have been threatenend and insulted for doing brain research. These individuals have taken the radical stance that any type of biologically-based intervention is barbaric. It didn't seem to matter if patients sought out and freely chose such treatments.

Another reason for the undertaking was the reaction (via social media grumblings) of hostile but less rabid psychiatry critics to my statment in a recent post (EMPowered to Kill):

"Furthermore, Leeann Ramsay wants to launch an investigation into whether EMPowerplus™ played any role in her brother's death, subverting the antipsychiatry paradigm of blaming psychotropic medications for suicides and homicides."

The grumblings seemed to suggest that I lumped everybody into one "antipsychiatry" camp.

I can appreciate your view that this post is under-researched and selective, but it wasn't intended to be comprehensive. I came away from it knowing more than I did beforehand, and I think many readers did too.

 
At August 18, 2012 2:39 PM, OpenID N said...

Fair enough. Thanks for being a good sport.

And yes, I can sympathize with you re a certain subset of activists who seem ready to attack and vilify anyone with any interest or investment in neuroscience research. Personally I find it really counterproductive... (Though I do think we generally need to approach NS research in a much more nuanced & critical way. Yet another reason why robust interdisciplinary discourse and work is so important...)

 

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