My new article on Mad in America about the price we all pay for our universal and core needs for empathy, compassion and love not being met in our wasteland culture.
My new article on Mad in America about the price we all pay for our universal and core needs for empathy, compassion and love not being met in our wasteland culture.
In this Psychology Today interview I share about how the work of Jung and Laing helped me through extreme states and still informs my therapy work with others.
In this new article I sound the alarm on an ominous shift in how psychosis is diagnosed, that will use a system of bio-marker tests to label people in extreme states as being in a psychosis biotype group.
This entry first appeared at Mad In America on November 10, 2015.
I felt a chill go through my body when I read that the FDA has agreed to review for possible approval in early 2016 a new form of the drug Abilify that contains a microchip sensor capable of sending a message that indicates the exact time a tablet dissolves in the stomach. The message is recorded by a skin patch – along with data such as the person’s body angle and activity patterns – and, according to a press release from Proteus Digital Health, the developer of the device, “this information is recorded and relayed to patients on a mobile phone or other Bluetooth-enabled device, and only with their consent, to their physician and/or their caregivers.”
The Japanese drug giant Otsuka teamed up with Proteus Digital Health in 2012 to create this potentially profitable new “chip in a pill” just as its patent on Abilify – at $6.9 billion the #1 most profitable drug in the U.S. in 2013 – was set to expire in 2014, leaving one of Otsuka’s most valuable markets vulnerable to generics. It is especially ominous to me that our government is teetering toward passing the Murphy Bill, which would make forced in-home treatment the law of the land, at the same time it is lurching toward putting such an Orwellian device in the hands of a pharmaceutical company, courts, and families.
According to the Washington Examiner:
”The new smart drug could be particularly useful for ensuring the mentally ill continue taking their medications, not just by giving doctors a way to monitor their behavior, but courts as well…all but five states have court-ordered programs where a judge can mandate that offenders with severe mental illness stick with a treatment program as a condition of remaining in the community.”
As one Facebook commenter noted; putting a pill in your mouth and swallowing it, knowing it’s going to transmit a message to prove one is submissive and compliant, is beyond Orwellian – it feels fascistic. I agree. The social contract draws an invisible line that must be guarded against forces in a society that, driven by fears, fantasies of benevolence, or by simple greed, and are blind and deaf to the cries of its citizens as their bodily and personal integrity are ground into powder along with the preparations they are compelled to take in the specious name of “health” and “safety.”
Sometimes, radicalizing people politically takes a really callous, stupid, and dangerous threat to people’s liberty. This is one of those times.
The Washington Examiner article cites recent research that shows 74% of people who are started on antipsychotic medications stop taking them within 18 months. That’s the justification offered for a psych drug that monitors its own use.
“These individuals already have a history of problems due to their unwillingness or inability to voluntarily comply with treatment … this could be an important advance for them that would help them maintain treatment compliance.”
— D.J. Jaffe of the Mental Illness Policy Org.
Think about it: faced with the overwhelming 74% failure of a pharmaceutical intervention, why is the core issue deemed to be compliance rather than efficacy, and consumers’ safety & satisfaction? And why are we “gearing up” to ensure compliance in particular for a drug that even the FDA admits has an unknown mechanism of action?
What other medical specialty would blame its patients for so overwhelmingly choosing not to take the medications that have been prescribed to them? For a field that has taken on the charge of controlling and regulating social deviance, the ethical boundaries that the FDA should be protecting are blurred by the growing perception that people who are DSM-diagnosed are potential risks to society, despite overwhelming risk to the contrary; that a DSM diagnoses should be a signal that a person needs and deserves our protection.
Only a worldview that embraces the disease and deviance model of human emotional suffering would dare to suggest putting a sensor in a psychoactive substance to monitor and enforce its ingestion by an otherwise free citizen.
I believe that at some very basic level empathy seems to have failed in a society that sees the need to develop a sensor-equipped psychoactive substance. The blasé emphasis on prioritizing prescription compliance, without considering the profound subjective experience – to anyone, let alone a person in crisis – of having a digitalized foreign object inserted deep inside, an object that is in turn sending messages to an invisible outside presence. This oversight amounts to a vertiginous stumble forward in our society’s failure to muster empathy and compassion for its members, instead delivering them, in the form of a now-literally captive market, to the drug makers.
I’ve been seeing clients in therapy for over 35 years, and at no point can I imagine sitting a few feet away from a person in distress and suggest to them that they should consider having a device inside them that would let me know every day at a distance their most intimate experiences – let alone when they digest something, lie down, or when they have taken their meds. I couldn’t do it. It would feel ghoulish and perverse.
And I don’t want to be a part of a society that would do. Even – and perhaps especially – if it were being done “in my name.”
There is an aura of something shameful, a violation of a basic human right to privacy and bodily boundaries that is being ignored in the pursuit of this new digital monitoring of psychiatric medication. The shame is that, with a pill that records the moment of its absorption into our bodies, we are seeing the realization of a long-sought ideal of totalitarian governments; to cross the blood-brain barrier, gaining access to the very seat of our autonomy, and of our souls. With this, Otsuka could fairly revamp its marketing for Abilify by renaming it “Dis-Abilify,” without so much as risking – and potentially augmenting, in a society that seems to be exuberantly embracing an Orwellian ideal – its market share.
This is a time, if there ever was one, for citizens to act, and to act decisively; before the ability to make decisions, let alone act on them, is excised from our bodies completely by the next wave of pharma development.
Of course some will object to my characterization of those who developed this seeming well-meaning medical breakthrough as lacking a moral compass. But I have already heard the cries of outrage and fear from many of those for whom this Orwellian medicine is intended.
I’ll end here with an ever-more apt quote from C.S. Lewis –
“Of all tyrannies, a tyranny sincerely exercised for the good of its victims, may be the most oppressive.”
This entry first appeared at Mad in America on March 8, 2014.
The safety of our children is a sacred obligation we strive to preserve. Anything or anyone that harms them becomes the object of our distrust and potential wrath.
I want to raise the possibility that psychiatry, for all its accomplished champions like Thomas Insel of the NIMH, may have forgotten the elemental fear people feel for the safety of their children. If psychiatry becomes perceived as a consistently increasing threat to our children, then are its days as a monolithic social institution numbered?
This essay was prompted when I recently had a pronounced visceral reaction of repulsion as I read about dozens of young children being subjected to new MRI brain scan research. Many friends that I shared this research with had a similarly strong negative reaction. The NIMH-supported research article, “Disrupted Amygdala Reactivity in Depressed 4- to 6-Year-Old Children,” was reported in the Journal of the American Academy of Child and Adolescent Psychiatry. The two experimental groups were described as “… depressed 4- to 6-year-old children and their healthy peers.”
The pathologizing process of diagnosing and labeling a 4-year-old child as being a clinically depressed research subject and therefore unhealthy compared to their peers, is done with the assumption that making that medical diagnosis is in the best interest of the child.
It is harmful to assume something is wrong with a young child’s brain when there is no doubt ample evidence that something has happened or is happening in the child’s life, that is causing them distress, to say nothing about the negative effects of a child receiving a DSM identity-transforming diagnostic label and being officially categorized as an exceptionally young mental patient.
Plus, what does a doctor tell a 4-year-old child before the MRI machine starts? “Please hold very still now, because we need to find out if there is something wrong with your brain.”
The children in this research on depression were also described as being “medication-naive.” None of them had been on medications – yet. If the word “naive” was instead used to mean that the children were innocent, then that would be accurate because a 4-, 5-, or 6-year-old child is indeed innocent and is helplessly at the mercy of the adults who decide what happens to them.
For over 30 years, I’ve known and worked alongside many child psychiatrists. They are some of the most dedicated and caring people I have ever known. When I would repeatedly protest to them about the dangers of prescribing antipsychotic meds and SSRI’s to children and teens, the psychiatrists often, with true anguish would respond to me by saying, “But Michael, I have to do it! The latest brain imaging research says that psychosis damages the brain, and it has been shown that depression is caused by a lack of serotonin.”
The solid, peer-reviewed research I would then offer, attempting to counter their biochemical, genetic-based, disease model beliefs, would unfortunately not be taken seriously enough to change my psychiatrist coworkers’ minds.
To no avail, I would urge them to consider that valuable scientific inquiry in the broader field of psychology doesn’t have to be limited to only studying genetics and the physical human brain. They shunned the evidence proving the efficacy of psychosocial alternatives to psychiatric medications. They seemed compelled to elevate applied neuroscience as a reified paradigm of understanding and treating human psychological distress.
It should be no surprise that almost all psychiatrists continue to believe what they were taught in their medical training, and believe what is affirmed in every journal they read about the future of psychiatry being applied neuroscience, and that they believe what is repeated to them by every drug company rep who frequently visits them with medication samples.
The path seems to be clear ahead for even more research on preschool children’s brains, because NIMH Chief Thomas Insel has a clear vision that he is determined to make happen. When he says, “The future of psychiatry is clinical neuroscience based on a much deeper understanding of the brain,” Dr. Insel means that his five-year plan called the Human Connectome Project, that will build a baseline data base for brain structure and activity using MRI imaging is leaving the DSM era of psychiatry in the dust.
The DSM is an embarrassment for a world class research scientist like Insel. But what he envisions is much more ominous for children and everyone else.
Insel’s leadership at the NIMH has the very strong support of forced treatment advocate, Dr. E. Fuller Torrey, who says of Insel: “He is the best director we have ever had.”
Insel and newly-elected APA President Dr. Jeffrey Lieberman want to preside over a new era of psychiatry where it gains the stature of any other medical specialty based on hard science. Insel and Lieberman want a research-proven genetic and biological basis for psychiatry, to qualify it as a fully functioning and respected clinical neuroscience.
Dr. Lieberman has recently said in The Scientific American, that vocal critics of psychiatry are “Misinformed or misinforming self-interested ideologues and self-promoters who are spreading scientific anarchy.”
Dissidents such as may appear on Mad in America are dismissed as scientific anarchists by the head of the APA, while President Obama and Congress are hugely bankrolling the new NIMH research on the brain.
The dramatic future for psychiatry envisioned by Doctors Insel, Torrey and Lieberman as a golden age of applied neuroscience appears to be assured.
Is psychiatry, as such a powerful monolithic social institution, truly “too big to fail?” Or is there a hidden vulnerability present in the proud edifice?
I wrote a blog here on MIA a couple of years ago called “I Don’t Believe in Mental Illness, Do You?” What that means to me is that I don’t believe in the centuries-long medical model project of pathologizing human emotional suffering that is the hallmark of psychiatry.
The medical model never satisfied my answers about the causes and healings from my own experiences of emotional suffering and madness, or spoke to me as a reliable guide in helping the children and adults I provide therapy for. If I did believe in the medical model, I would surely do what my child psychiatrist friends unintentionally sometimes do – I would risk harming innocent children while truly believing that I am helping them.
What we believe can dictate what we do. But surely our beliefs should not result in children being harmed.
The problem is, that the medical model belief system sets psychiatrists up to be blind to its harmful applications. Psychiatrists who did lobotomies and sterilizations convinced themselves according to medical model tenets, that such harmful procedures were necessary and in the recipient’s best interest. The fact that child psychiatrists in Australia will actually administer ECT to children under 4 years old, and that antipsychotic and antidepressant medications are given to toddlers in the U.S., is dramatic continued proof of how the treatments dictated by a morally numb psychiatric science are still failing to pass the caregiver litmus test of “First, do no harm.”
Blindly failing that ethical test means that psychiatry is clearly in the process of losing the moral authority to deserve our trust, especially as we learn more of how our children are at risk of being harmed.
So, I have come to believe in recent years that Dr. Insel’s vision and the incredible psychiatric social experiment of pathologizing human emotional suffering will ultimately fail, because psychiatry will continue to zealously and blindly cross a morally repulsive line and forget that a great many people will never accept their children and grandchildren being exposed to danger.
I believe that at some point, those continued treatment excesses with our children will finally cause the general public to lose faith in and simply abandon psychiatry, moving on to a new paradigm of care where the growing demands for safe and nonpathologizing alternatives are met.
The obsolescence of psychiatry may not happen in my lifetime, but you will see the tide turn even more in that direction when a first young blogger appears on Mad in America to proclaim, “I was diagnosed with bipolar disorder and put on antipsychotic medications when I was very young. Please understand, I was only four years old when they started injuring me.”
This entry first appeared at Mad in America on December 12, 2013.
When Richard Price was a young man, he experienced extreme states for which he was labeled schizophrenic and forcibly ‘treated’ with psychiatric medications, ECT, and insulin shock. He suffered from residual effects from this for the rest of his life. In 1962, Price and Michael Murphy founded the Esalen Institute on the Big Sur coast of Northern California. From its beginning, Esalen worked to create sanctuary for people who, like Price, experienced extreme states. “Esalen was Price’s revenge on the mental hospital!” says Murphy.
Both at the institute itself and through the creation of projects like the rigorously designed, NIMH-funded Agnews Project research, Esalen helped to create the contemporary model of madness sanctuary. Agnews, which yet stands as the largest randomly-assigned, double-blind study on first episode psychosis, showed a 70 percent lower re-hospitalization rate advantage from providing a med-free environment for people in initial extreme states; a result which provided impetus and support for John Weir Perry’s med-free sanctuary Diabasis House, and the creation of the I-Ward sanctuary that I served at and wrote about here on MIA in “Remembering a Medication-Free Madness Sanctuary”.
Dick Price also wanted Esalen to be the kind of outside-the-box think tank that could fundamentally re-vision the experience of madness away from the medical model vision. Price realized the applied practice of the medical model belief system was the cause of the greatest trauma in his life. Price said about his own experience that “The so-called ‘psychosis’ was an attempt towards spontaneous healing, and it was a movement towards health, not a movement towards disease.” He believed his experience of madness was not pathological but was full of meaning and was transformative, even perhaps touched with mystical power. He saw Esalen as a refuge for people in extreme states, “A space where it’s possible to live through experience rather than having it blotted out, a place where there aren’t the same negative self-definitions of someone going through this type of experience.”
In addition to Price’s commitment that Esalen provide refuge for those in extreme states, Esalen’s broader liberating influence on world culture would prove to be enormous, as pioneers in philosophy and psychology made it the birthplace and epicenter of the human potential movement. (Sascha Dubrul has written a great article here on MIA about the lasting relevance of the human potential movement for current activism.) The young and gifted Price and Murphy attracted figures like Alduous Huxley, Alan Watts, and Abraham Maslow, who helped put Esalen on the map with week-long and even month-long gatherings for re-visioning madness. Ongoing symposia with names like “The Value of Psychotic Experience” went on for the whole summer of 1968! Gregory Bateson, Murphy and Price, Alan Watts, RD Laing, Erik Erikson, Fritz Perls, John Weir Perry, Claudio Naranjo, Virginia Satir, Julian Silverman, Alan Ginsberg, Michael Harner, Joan Halifax, Stan Groff, and many others all contributed to a growing understanding of extreme states that continues to evolve, as it certainly always must. They saw a neglected possibility for humankind, rooted in a philosophy that has always served to bring a dimension of the sacred and numinous into view.
That ancient but always emerging mythic vision serves as a counterweight to the objectifying, pathologizing and materialistic world view that I believe makes the tragically narrow vision of psychiatry possible. Esalen’s role in altering the views and approaches to madness, or extreme states, continues to this day.
Last month, following in the tradition of passionately focused Esalen conferences, I organized a week-long invitation-only gathering there; “Alternative Views and Approaches to Psychosis.” This conference was preceded in 2011 and 2012 by a workshop and then a conference on alternative approaches to extreme states that began a revival of this aspect of Price’s work, one that had been dormant at Esalen since his death in 1985, when he was struck by a boulder while tending to the Esalen grounds following a flood.
This year, the Esalen conference was attended by 40 people involved in one way or another in the mental health revolution that is daily chronicled here on Madinamerica. People with lived experience brought their invaluable perspective to a gathering that included peer counselors, psychiatrists, therapists, authors, film makers, researchers, mental health services administrators and family members. A great many of the 40 people who gathered felt a sense of urgency to come up with collaborative, strategic ways to unite against the ever-growing human rights abuses of forced treatment. Those human rights abuses are being justified more and more in the name of protecting society from the suspected danger of people who have been given a psychiatric label. That public demonizing of those of us with lived experience of extreme states is being fueled by wide-scale fear mongering and draconian laws that threaten all who experience extreme states.
A number of us at the Esalen gathering committed to work together to fight human rights oppression on many fronts, via media, public education, legal campaigns, and expanding on existing – and developing new – humane, alternative supports for those in extreme states.
Dick Price was a psychiatric survivor whose compassion still touches us now. I know I wouldn’t be writing here on MIA if not for him, because the I-Ward medication free extreme state sanctuary I went to work at in 1980 would never have existed without the Agnews research Price made happen. John Perry’s Diabasis House – that I did my doctoral research on – never would have existed either.
So, thank you Richard Price, for fatefully touching my life, but so much more for helping so many people in extreme states receive the love you were denied in your hour of need, and escape the soul-shrinking diminishment of self-worth, and the hopelessness that a psychiatric diagnosis can inflict. Esalen lives on as an example of what can happen – for individuals and for society at large – when we respond to the extremes that sometimes come with human life not with fear and control but with receptivity and encouragement. There’s no knowing – ahead of time, at least – how much accrues to each of us and to society at large when we learn to listen to the voices – weak, tenuous, or frightening as they may sometimes be – of people who are struggling with the process of coming-to-be in a world that often silences or eliminates them before they have a chance. Dick Price’s voice was silenced early but lives on in the place in which he came to live and die; a memory and evidence of what can happen when the best of mind, body, spirit and community are given a chance to come together.
This entry first appeared at Mad in America on October 29, 2013.
In Butte County, California, Law Enforcement and NAMI have recently partnered to provide identification cards for people in the mental health system. The cards reveal the person’s psychiatric diagnosis and current medication prescriptions. The voluntary photo ID cards are called ‘White Cards.’
The goal is to help law enforcement have on-the-spot psychiatric information, about someone they are questioning. The local NAMI president explained the ID cards also include a person’s triggers, like . . . “If you get too close, I get violent.”
This White Card project may be well-intentioned, but it makes me very uncomfortable. I believe it is a form of psychiatric profiling that could be adopted by law enforcement around the United States, with the powerful political backing of NAMI, and the tacit if not public support of psychiatry.
The operative stigmatizing equation appears to be “mental patient” = unacceptable danger to others. Will police believe that “good,” compliant and NAMI-aligned “mental patients,” who will be able to show the police a White Card with their diagnosis and prescribed medications, make up a lower risk group, than people without a White Card, who reject being identified by a diagnosis, and may not be taking meds?
Will people without White Cards be seen as potentially more dangerous by the police?
And won’t the police eventually want a data base of all White Card holders to cross check against when someone hands them a White Card, creating a kind of watch list?
I can imagine staff at psychiatric hospitals pressuring confined people, to sign up for a White Card as a new and added criterion for their discharge.
I can imagine staff at mental health clinics urging people who are court-ordered to receive forced treatment in the community to also get a White Card.
The cards can be obtained at a NAMI office, or at the police station.
Supplying people with “mental patient” identification cards, conveys the implication that something is proven, that predicts a person’s behavior about potential violence, whereas the state of the scientific research, cannot support such an ID card project aimed at violence prevention. It ends up being psychiatric profiling – a whole class of people becomes the socially identified scapegoat, based on the fears and projections of others. Once again we see the psychiatric diagnosis process serving as a public degradation ceremony, that effectively strips personal identity away, to legitimize the enforcement of the regulation of deviance in our communities.
This White Card project is happening against the backdrop of over 40 states oppressing people with forced, in home treatment laws.
Draconian measures imprisoning and forcibly medicating and giving ECT to people, are challenged now by the UN, which equates forced psychiatric treatment with torture, as Tina Minkowitz has so well documented here on Madinamerica.
This joint Law Enforcement/NAMI White Card project looks to be another ominous development to me.