Who needs psychiatry by Neil Gardner
No proof of mental illness rooted in biology by Dr. Keith Hoeller
Examples of myths that need busting:
*** “You have a ‘mental illness’ that is caused by a biochemical
*** “The medication we give you will correct your ‘biochemical
*** “You will always have to take psychiatric medications…”
The brochure was researched by MindFreedom Lane County Affiliate, and
can be used internationally.
Ron Unger, a mental health counselor who is affiliate coordinator,
led the effort to create the flyer, working with psychiatric survivors.
Said Ron, “The brochure does a good job of conveying the kinds of
deceptions that people in the mental health system are commonly
exposed to, compared to the kind of information people would hear if
they were told the truth.”
Links to citations and sources are also provided to back up the facts
in the MindFreedom “Truth Injection” brochure.
The pamphlet can be downloaded below:
The pamphlet in full text is below:
Common myths about mental and emotional problems – please scroll down:
- You have a “mental illness” that is caused by a biochemical imbalance, or some kind of brain defect or brain disease, or by a genetic predisposition.
- The medication we give you will correct your “biochemical imbalance.”
- “Recovery from mental illness” does not mean cure. Recovery just means learning to have a better life despite continuing to have the illness.
- Mental health medications are proven to be effective and reasonably safe. When people who have been diagnosed with a serious mental illness refuse medications, it is because they lack insight into their illness.
- Because of your diagnosis, you will always have to take psychiatric medications.
- If you have problems when you quit taking medications, this is proof you need to continue taking the medications.
- If you really want to be healthy, you will take whatever medication your prescriber suggests, for the rest of your life.
- If you do decide to get off medications, you cannot expect any help from your prescriber, whose job it is to keep you on your medications.
What you would hear if your mental health system told you the truth – please scroll down:
- These are all theories. Science does not have proof of what causes mental and emotional problems. There is no lab test for any of these conditions. Also, none of these theories are able to explain how many people with mental and emotional problems recover completely.
- Since no one knows if you have any “biochemical imbalance,” no one can promise to correct it!
- There are varying degrees of recovery from mental and emotional problems. Some people recover just enough to improve their life while mental and emotional problems continue. But others go on to have a full recovery, and need no further mental health care.
- The long term effectiveness of psychiatric medications has not been demonstrated in scientific studies. Even in the short term, some psychiatric drugs may not be any more effective than placebo. Many commonly used medications are quite dangerous, may potentially cause brain damage, and are part of the reason people in the USA public mental health system are dying 25 years earlier than average. Proven non-drug options exist but are not widely offered.
- For each diagnosis, there are people who have gotten off the medications, and then gone on to have very successful lives.
- Problems that arise upon quitting medications are often medication withdrawal effects, and can be minimized by tapering down slowly. Also, if you have been relying on medications to solve emotional problems, you may need to learn effective alternative solutions to these problems in order to accomplish a successful withdrawal.
- It’s your choice. It is important not to stop taking medication before you are ready. But for at least some people, getting off medication, even against a prescriber’s advice, may be the best solution. For example, long term studies show high rates of recovery among people diagnosed with “schizophrenia” who have gotten off medication successfully. Getting off medication can mean avoiding long term health risks (including risks of early death) associated with many of the medications.
- Unless a court has taken your rights away, you have the right to decide to terminate any given treatment. Since the mental health system got you started on medications, it also has a responsibility to help you terminate that treatment as safely as possible if that is your choice.
Dr. Peter R. Breggin, a psychiatrist author and outspoken critic of electroshock from New York State wrote articles about electroshock on huffngtonpost.com . Dr. Breggin has a huge webite also – Breggin.com The links for these articles are below:
Electroshock for children and involuntary patients by Dr. Peter R. Breggin
Disturbing News for Patients and Shock Doctors Alike by Dr. Peter R. Breggin
SCIENTIFIC PAPERS ON ELECTROSHOCKS
Dr. Breggin has a whole section on his website about electroshock – scientific papers –
Breggin’s website: www.breggin.com
Shock Treatment, Brain Damage, and Memory Loss: A Neurological Perspective
by John Friedberg, M.D. (a neurologist in California, USA)
Read about the 5 big lies about electroshock (ECT) in the TESTIMONY OF JOHN M. FRIEDBERG, M.D., NEUROLOGIST, BEFORE THE MENTAL HEALTH COMMITTEE OF THE NEW YORK STATE ASSEMBLY, May 18th, 2001
The link for this article is below:
Electroshock as a form of violence against women – by Dr. Bonnie Burstow
Psychiatry’s Electroconvulsive Shock Treatment – A crime against humanity – Lawrence Stevens, J.D.
The link for this article is below:
Read the tesstimony of Leonard Roy Frank, an electroshock survivor and author at a public hearing on electroshock “treatment” before the Mental Health Committee of the NY State Assembly May 18th, 2001
The link for this article is: http://www.idiom.com/~drjohn/LFrank.html
Leonard Roy Frank wrote the “Electroshock Quotationary” . It has in it everything you ever wanted to know about electroshock. Leonard is an electroshock survivor, author and activist. Leonard edited the book called “The History of Shock Treatemnt”
The link for the “Electroshock Quotationary” is below:
The link for this article is below:
ELECTROSHOCKING ELDERLY PEOPLE: ANOTHER PSYCHIATRIC ABUSE by Don Weitz
“Electroshock is violence.”
– Ramsey Clark, former U.S. Attorney General, in an invited address at the
Annual Meeting of the American Psychiatric Association in New York City,
“If the body is the temple of the spirit, the brain may be seen as the
inner sanctum of the body, the holiest of places. To invade, violate and
injure the brain, as electroshock unfailingly does, is a crime against the
spirit and a desecration of the soul.”
– Leonard Roy Frank, shock survivor, editor and writer, 1991
Electroshock appears to be increasingly prescribed as a treatment for
“clinical” depression and other so-called mental disorders. Women and
elderly people, particularly old women, are its chief targets–more
damning evidence of psychiatry’s sexism and ageism. In the United States
during the last ten years, an estimated 100,000 people have been shocked
each year. In Canada, perhaps as many as 10,000 people, again mostly
women, have been electroshocked each year, but nobody knows for sure
because Health and Welfare Canada and the provincial health ministries do
not publish ECT statistics, some of which are available on request.
Besides, ECT statistics are notoriously inaccurate and unreliable, because
collection methods differ from province to province and state to state;
hospitals aren’t required to keep accurate ECT records and not all
hospitals are required to report ECT to provincial health ministries or
state mental health departments.
I have discovered some recent shock statistics in Ontario which point
to alarming trends:the increasing use of ECT and the targeting of women
and the elderly for electroshock. Consider these statistical highlights:
1) In 1993-94, 11,360 shock treatments were administered to
approximately 1,600 people in Ontario’s general, community and psychiatric
hospitals – an average of seven shocks per patients. In 1994-95, 12,865
shocks were administered to over 1,500 people, a 12 per cent increase.
2) Most electroshock (over 80 per cent) in Ontario is administered in
the public general hospitals, not provincial or private psychiatric
3) Over 40 per cent of electroshock has been administered to people 60
years and older during the last five years.
4) In 1994-95, 97 elderly people, including 72 women (60 years and
older), were subjected to 1,023 shocks in Ontario’s provincial psychiatric
hospitals – a high average of approximately 10 shocks per patient. In
Toronto’s Queen Street Mental Health Centre, over 70 per cent of the shock
patients are from its psychogeriatric unit.
5) In 1993-94, approximately 600 elderly people (60+ years) were
subjected to 4,033 electroshocks in Ontario’s general and community
6) In the provincial psychiatric hospitals, the number and proportion
of elderly people (65+ years) shocked grew from 70 (33 per cent) in
1990-91, to 82 (40 per cent) in 1993-94, to 44 per cent in 1994-95.
7) Among elderly and other ECT patients, significantly more women than
men are electroshocked: two to three timnes more women than men have been
electroshocked in both Canada and the United Stastes for many years.
8) During 1994-95 in the provincial psychiatric hospitals, 72 per cent
of elderly shock patients (75+ years) were women, and significantly more
ECT was administered to an elderly woman than an elderly man (average 10.9
ECTs vs. 8.7 ECTs).
9) Women in their eighties and nineties have been electroshocked in
general, community and provincial psychiatric hospitals in Ontario. In
1993-94, a total of 102 shocks were administered to at least 10 women of
85 years and older in general and community psychiatric hospitals. In
1994-95, at least 14 women of 80 years and older were subjected to 158
shocks in eight provincial psychiatric hospitals,an average of 11 ECTs per
10) During 1994-95 in Ontario, the estimated cost of one electroshck
treatment, including physicians’ fees, drugs, use of a hospital bed and
nursing care, was $400. The (under) estimated total cost for all ECT that
year was well over $1,000,000.
Two very common psychiatric myths state: first, that electroshock can
prevent or greatly reduce the risk of suicide in people diagnosed with
“clinical depression” or “bipolar affective disorder”; and second, that
electroshock is safe and effective for old and physically ill people.
The first myth was exposed at least six years ago by Dr.Donald Black
and four colleagues. This study involving more than 1,000 depressed
patients in Iowa found that there were no significant differences in the
suicide rate among the various groups treated with electroshock,
antidepressants and no treatment. However, the higher percentage of deaths
among the shock patients (85 per cent higher at two-year follow-up than
the non-shock patients) clearly implicates shock as a contributing factor
in their deatths (Black et al.,1989).
Regarding the second myth, Drs.David Kroessler and Barry Fogel’s
longitudinal study involving sixty-five depressed patients 80 years and
older found that for the ECT group, 27 per cent died within one year
following the “treatment”, but only 4 per cent of the “medicated” group
died. In addition, one patient died after undergoing two ECTs. In other
words, this study together with several previous ones, clearly show that
electroshock threatens people’s survival, especially if they are old and
sick (Kroessler and Fogel, 1993).
Deaths related to or caused by electroshock are usually attributed to
medical conditions, not reported or simply covered up in the
medical-psychiatric literature. For exmple, only six or seven ECT-related
deaths in Canada have been reported in the Canadian medical-psychiatric
journals during the last fifty years. No doubt a serious underestimate or
cover-up. Nevertheless, respecred shock investigator and psychiatric
critic, Dr. Peter Breggin, has estimated the general ECT death rate as one
death for every 1,000 patients shocked, and a much higher rate of one
death per 200 for elderly patients. However, in its official
shock-promoting booklet the American Psychiatric Association claims the
ECt death rate from shock is !1 in 10,000″ patirents and that only “1 in
200″ patients suffer permanent memory loss (APA,1990). The Canadian
Psychiatric Association also claims there have been virtually no deaths or
medical complications from electroshock in Canada, despite the fact that
approximately 500 shock-related deaths and many more serious medical
complications (e.g.,cardiac arrest, other serious heart problems,
permanent epileptic seizures, brain damage) have been reported in the
English langugage medical-literature for over 50 years since the early
1940s when electroshock was first introduced in Canada and the United
Together with many shock survivors and other shock critics, Peter
Breggin wants electroshock banned, because psychiatrists routinely fail to
warn patients about the serious risks of permanent memory loss and brain
damage (a serious violation of informed consent), and because elderly,
sick and frail patients are being increasingly targeted for electroshock.
He explained his position in a recent phone interview with me last March:
“The escalating rate of shocking the elderly is one reason why I
have come out in recent years for a complete ban on the treatment.
The elderly are less able to defend themselves against shock
treatment, and their brains are more susceptible to devastating damage.”
Leonard Roy Frank, an electroshock-insulin shock survivor living in
San Francisco, shock critic, author and editor,insists that “ECB –
electroconvulsive brainwashing” is a more accurate term. He agrees with
Breggin and asserts, “the studies indicate that it’s the elderly who are
getting the most shock, and they’re the most vulnerable, not only
physically but politically” (Frank, 1996). A 1989 report from California’s
Department of Mental Health supports Frank’s assessment; it reveals that
48 per cent of the 2,503 people shocked that year in the state were 65
years and older. Frank claims the figure is currently over 50 per cent and
Electroshocking women and elderly patients is also on the rise in
England. For example, in a 1993 critique, patients’ rights advocate Alison
Cobb reports that “…women are the majority of ECT patients (about 70 per
cent), half are over 65 years of age. …59 per cent of the 100 (in the
study) … were aged over 65, the oldest being 92 years. Given the
vulnerability of older people’s memory and cognitive abilities, this has
to be a grave cause of concern…”,(Cobb,1993).
Douglas Cameron, another outspoken shock survivor, critic and
co-founder (with Diann’a Loper) of the World Association of Electroshock
Survivors based in Texas, is extremely critical of the alleged safety of
psychiatry’s modern shock machines, which can deliver as much as 300 to
400 volts of electricity to the brain:
“All modern day Sine Wave and Brief Pulse ECT devices are more
powerful than early instruments. Modern day Brief Pulse suprathreshold
devices have not proved safer than Sine Wave suprathreshold devices. Side
effects have been
>convincingly identified as products of electricity. These facts warrant
the elimination of all ECT machines from the marketplace” (Cameron,1994).
Since 1995, there has been growing public protest against the only
shock machine in Whitehorse in The Yukon, stored in Whitehorse General
Hospital. Apparently, the shock machine hasn’t zapped anybody in
Whitehorse (yet). The Second Opinion Society (SOS), the Yukon’s self-help
advocacy group in Whitehorse, isn’t waiting. SOS has been organising
rallies and marches against the machine.
More than fifteen years ago in Toronto’s Sunnybrook Hospital (a
teaching, research and veteran’s hospital affiliated with the University
of Toronto), psychiatrists Harry Karlinsky and Kenneth Shulman were
electroshocking elderly people. Most were in their 70s, some in their 80s.
Karlinsky and Shulman (1984) reported having electroshocked thrity-three
elderly atients (62-85 years old). At a follow-up study six months later,
after having been subjected teo an average of 9 ECTs, only one-third of
ther patients “were doing well”. Karlinsky and Shulman concluded that
“clinically one is compelled to use ECT on an urgent or demand basis”.
Compelled? In my recent phone interview with Dr.Shulman, chief
psychiatrist at Sunnybrook, he said that electroshock is still
administered to old people but only “from time to time, a relatively small
number.” He couldn’t say how many, but recalled the average age of his
elderly shock patients is “73 or 74”. Shulman added he has “never heard”
of any deths or serius medical crises from ECT at Sunnybrook or any other
hospital in Canada. The ECT “mortality rate”, he added, was “similar to
that for (general) anaesthesia”. He insisted that electroshock “remains an
effective treatment for some debilitating and life-threatening
depressions”, and claimed the only ECT risk was “short-term memory loss”.
He also asserted that electroshock is not controversial, and claimed that
most patients “completely recover”. Shulman explained the use of
electroshock on the elderly in these terms: “If we didn’t use ECT, these
people would suffer tremendously and be at risk of dying”.
It is difficult to find any study to support the common psychiatric
claim that electroshock prevents suicide or minimises the suicide risk.
Further, the relapse rate from shock is over 60 per cent, which, according
to the American Psychiatric Association, still greatly minimises permanent
memory loss, brain damage and death from ECT (APA,1990).
Some elderly patients have also been electroshocked at Toronto’s
Clarke Institute of Psychiatry. Apparently nobody knows how many, partly
because no accurate,up-to-date ECT statistics are kept at the Clarke,
according to Dr. Barry Martin, head of its ECT Unit. In a recent phone
interview I had with Dr. Martin, he speculated that a total of “about 100
courses” were administered at the Clarke in 1995. Each course consists of
8-10 ECTs, at least 80-90 people were electroshocked last year. According
to Dr.Martin, the main reason for shocking old people is, “severe
depression that has not responded to medication” (e.g.,antidepressants).
Martin estimated the ECT death rate as “3-4 per 100,000
ECTs”, similar to that for “general anaesthesia”, and said he was “not
aware” of any ECT-related deaths in Canada or anywhere else.
During a 15-month period in 1993-94, eight people died in
Texas,”within two weeks of receiving electroshock”; over half were elderly
patients (Smith, 1995).The Texas elderly death rate from ECT at that time
was probably higher than 1 in 200.
Some very courageous shock survivors and advocacy groups are fighting
back and want electroshock abolished in the United States and Canada. For
example, 81-year-old Lucille Austwick successfully refused to be shocked
while languishing in a Chicago nursing home a couple of years ago
(Fegelman, 1995). While confined in the home, Austwick was depresseed, had
stopped eating and was becoming frail, so a psychiatrist wanted to shock
her. She repeatedly refused the “lifesaving:” treatment which she called
“bullshit”, and received strong legal support from the Illinois
Guardianship Commission and other advocates across the United States. Last
September, the Appellate Court “reversed the trial court’s ruling” which
had ordered a series of ECTs for her two years earlier.
Psychiatrists and other medical staff at St.Mary’s Hospital in
Madison, Wisconsin were found to be violating the human rights of several
elderly patients subjected to electroshock against their will (Oaks,
1995). Sparked by the courageous whistleblowing of psychiatric nurse
Stacie Neldaughter, who was “fired after refusing to directly assist with
a shock treatment”, several women shock survivors and anti-shock activists
organised a public protest outside the hospital in September 1994. In
January 1995, the Wisconsin Coalition for Advocacy issued a detailed and
scathing 75-page report based on its own investigations, which documented
serious violations of informed consent and other rights involving at least
eight elderly women patients.
In Toronto from 1983 to 1992, there have been several anti-shock
protest demonstrations, particularly in front of the Clarke Institute of
Psychiatry and Queen Street Mental Health Centre. Non-violent civil
disobedience (“sit-ins”) were also held in the office of at least two
Ontario health ministers, organised by the Ontario Coalition to Stop
Electroshock (succeeded by Resistance Against Psychiatry). During a
non-violent public demonstration against electroshock in front of the
Clarke in May 1988, shock survivor Jack Wild and I were charged with
“trespass” and arrested while trying to hand out alternative and accurate
shock information to patients on one ward during visiting hours. We were
arrested on the ward while engaged in a non-violent sit-in, fined over $50
each and lost our court appeals (Phoenix Rising, 1998).
Unfortunately, there have been no shock cases in Canada since
“Mrs.T.” in 1983 (Weitz,1994). The “Mrs.T.” case involved a young,
allegedly suicidal but cxompetent women who firmly and repeatedly refused
shock while being asked to consent by both her psychiatrist and a regional
review board while incarcerated in Hamilton Psychiatric Hospital. Although
the case lost, “Mrs.T.” was not electroshocked. The national publicity and
public outcry arising over the fact that people in Canada could still be
shocked against their will led to a few important amendments in Ontario’s
Mental Health Act, which now prohibits electroshock or other treatment for
any person who refuses. However, electroshock can still be adminsitered
against the will of an “incapable” person if he or she did not instruct a
substitute decision-maker otherwise while capable. (Note: The judge’s
decision in a 1997 Ontario court case involving a mother’s refusal to
consent to shock for her “incapable” daughter” is pending.)
In March 1994 at a public City Hall meeting before the Toronto
Mayor’s Committee on Aging (TMCA), I presented some alarming ECT
statistics from the Ontario government’s Ministry of Health which showed
that a disproportionately large number of people being electroshocked in
Ontario’s psychiatric facilities were elderly people (over 40 per cent)
and women (over 65 per cent). In one Final Report, the Committee recommend
that, “the Chair of the TMCA should be asked to write to the Minister of
Health to inform her of the data on ECT and the deep concern of the TMCA
about the apparent misuse of this therapy.”
There is still no law banning electroshock in Ontario, Canada or the
United States for elderly people or anybody else. However, some states
have outlawed shock for young children. For example, Texas has banned
shock for children under 16 years old, and California banned it for
children under 14. There are no such age restrictions in Canada.
I believe that electroshocking old people is elder abuse.
Electroshock is a crime against humanity. It should be abolished.
[acknowledgement – My sincere thanks to Lenard Roy Frank for his valuable
American Psychiatric Association (1990). The practice of
>electroconvulsive therapy. Washington: APA.
Black,D.W., Winokur,G., Mohandoss,E., Woolson,R.F. and Nasrallah,A. (1989)
“Does treatment influence mortality in depressives?” Annals of Clinical
Psychiatry, 1(3), 165-173.
Breggin,P.R. personal communication in March 1996. Also see: Breggin,
Toxic Psychiatry (St. Martin’s Press,1991), and Breggin, Disabling
Treatments in Psychiatry (Springer Publishing Co,1997)
California Department of Mental Health (1989). Electroconvulsive
therapy (ECT) report. Sacramento,California.
Cameron,D.G. “ECT:sham statistics, the myth of convulsive therapy and
the case for consumer misinformation”. Journal of Mind and Behaviour,
Clark,R (1983) From an invited address during the annual meeting of the
American Psychiatric Association in New York, May 1983.
Cobb,A. (1993) Safe and effective? MIND’s views on psychiatric drugs,
ECT and psychosurgery. London: MIND Publications.
Fegelman,A. (1995) “Forced shock therapy faces key legal test”. Chicago
Tribune, May 2, 2995.
Frank,L.R. (1991). “San Francisco puts electroshock on public
trial:feature report”. The Rights Tenet, Winter 1991.
Frank,L.R. (1996) Personal communication on February 28, 1996.
Karlinsky,H. and Shulman,K. (1984). “The clinical use of
electroconvulsive therapy in old age”. The Journal of American Geriatric
Society, 32, 83.
Kroessler,D. and Fogel,B.S. (1993) “Electroconvulsive therapy
for major depression in the oldest old”. The American Journal of Geriatric
Oaks,D. (1995) :”Zap back against forced shock”. Dendron, 36,1-5.
Phoenix Rising (October 1988). “Toronto Protesters Arrested for Trying
to Distribute Shock Information”, 22-23.
Smith,M. (1995) “Eight in Texas die after shock therapy in fifteen
mnonth period”. The Houston Chronicle, March 7, 1a.
Weitz,D. (1984) “Shock case: a defeat and victory”. Phoenix Rising,
Biographical note: Don Weitz is a psychiatric survivor, antipsychiatry
and antipoverty activist in Toronto. He is co-founder of the former
antipsychiatry magazine Phoenix Rising, former board member of Support
International (a coalition of approximately 100 survivor and human rights
advocacy organizations in 14 countries), and co-founder of the Coalition
Against Psychiatric Assault (CAPA). He is also host-producer of
“Antipsychiatry Radio” on CKLN (88.1FM) in Toronto. This unique program
airs around 6:30pm on the last Friday every month.
Center for the Human Rights of Users and Survivors of Psychiatry Welcomes the Interim Report by the United Nations Special Rapporteur on Torture
See the link below for the report:
Dr. Mosher, a psychiatrist resigns from the American Psychiatric Association (APA)
see why he resigned from the APA by viewing his letter:
This is a copy of a letter by Dr. Mosher resigning from the American Psychiatric Association. Note that Dr. Mosher was a pioneer in establishing programs of psychosocial community care in the field of psychiatry (e.g., Sartoria); his publications in that regard have been very influential (e.g.: Mosher, L., & Burti, L. (1989). “Community mental health: Principles and practice”. New York: Norton.).
Loren R. Mosher M. D.
2616 Angell Ave
San Diego, CA 92122
Ph: 619 550-0312
Fx: 619 558 0854
December 4 1998
Rodrigo Munoz, M.D., President
American Psychiatric Association
1400 94 Street N. W.
Washington, D.C. 20005
After nearly three decades as a member it is with a mixture of pleasure and disappointment that I submit this letter of resignation from the American Psychiatric Association. The major reason for this action is my belief that I am actually resigning from the American Psychopharmacological Association. Luckily, the organization’s true identity requires no change in the acronym.
Unfortunately, APA reflects, and reinforces, in word and deed, our drug dependent society. Yet, it helps wage war on drugs. Dual Diagnosis clients are a major problem for the field but not because of the good drugs we prescribe. Bad ones are those that are obtained mostly without a prescription. A Marxist would observe that being a good capitalist organization, APA likes only those drugs from which it can derive a profit – directly or indirectly.
This is not a group for me. At this point in history, in my view, psychiatry has been almost completely bought out by the drug companies. The APA could not continue without the pharmaceutical company support of meetings, symposia, workshops, journal advertising, grand rounds luncheons, unrestricted educational grants etc. etc. Psychiatrists have become the minions of drug company promotions. APA, of course, maintains that its independence and autonomy are not compromised in this enmeshed situation.
Anyone with the least bit of common sense attending the annual meeting would observe how the drug company exhibits and industry sponsored symposia draw crowds with their various enticements while the serious scientific sessions are barely attended. Psychiatric training reflects their influence as well; i.e., the most important part of a resident curriculum is the art and quasi-science of dealing drugs, i.e., prescription writing.
These psychopharmacological limitations on our abilities to be complete physicians also limit our intellectual horizons. No longer do we seek to understand whole persons in their social contexts rather we are there to realign our patients’ neurotransmitters. The problem is that it is very difficult to have a relationship with a neurotransmitter whatever its configuration.
So, our guild organization provides a rationale, by its neurobiological tunnel vision, for keeping our distance from the molecule conglomerates we have come to define as patients. We condone and promote the widespread overuse and misuse of toxic chemicals that we know have serious long term effects: tardive dyskinesia, tardive dementia and serious withdrawal syndromes. So, do I want to be a drug company patsy who treats molecules with their formulary? No, thank you very much. It saddens me that after 35 years as a psychiatrist I look forward to being dissociated from such an organization. In no way does it represent my interests. It is not within my capacities to buy into the current biomedical-reductionistic model heralded by the psychiatric leadership as once again marrying us to somatic medicine. This is a matter of fashion, politics and, like the pharmaceutical house connection, money.
In addition, APA has entered into an unholy alliance with NAMI (I don’t remember the members being asked if they supported such an organization) such that the two organizations have adopted similar public belief systems about the nature of madness. While professing itself the champion of their clients the APA is supporting non-clients, the parents, in their wishes to be in control, via legally enforced dependency, of their mad/bad offspring. NAMI, with tacit APA approval, has set out a pro-neuroleptic drug and easy commitment-institutionalization agenda that violates the civil rights of their offspring. For the most part we stand by and allow this fascistic agenda to move forward. Their psychiatric god, Dr. E. Fuller Torrey, is allowed to diagnose and recommend treatment to those in the NAMI organization with whom he disagrees. Clearly, a violation of medical ethics. Does APA protest? Of course not, because he is speaking what APA agrees with but can’t explicitly espouse. He is allowed to be a foil; after all he is no longer a member of APA. (Slick work APA!)
The shortsightedness of this marriage of convenience between APA, NAMI and the drug companies (who gleefully support both groups because of their shared pro-drug stance) is an abomination. I want no part of a psychiatry of oppression and social control.
Biologically based brain diseases are convenient for families and practitioners alike. It is no fault insurance against personal responsibility. We are just helplessly caught up in a swirl of brain pathology for which no one, except DNA, is responsible. Now, to begin with, anything that has an anatomically defined specific brain pathology becomes the province of neurology (syphilis is an excellent example). So, to be consistent with this “brain disease” view all the major psychiatric disorders would become the territory of our neurologic colleagues. Without having surveyed them
I believe they would eschew responsibility for these problematic individuals. However, consistency would demand our giving over “biologic brain diseases” to them. The fact that there is no evidence confirming the brain disease attribution is, at this point, irrelevant. What we are dealing with here is fashion, politics and money. This level of intellectual/scientific dishonesty is just too egregious for me to continue to support by my membership.
I view with no surprise that psychiatric training is being systemically disavowed by American medical school graduates. This must give us cause for concern about the state of today’s psychiatry. It must mean, at least in part, that they view psychiatry as being very limited and unchallenging. To me it seems clear that we are headed toward a situation in which, except for academics, most psychiatric practitioners will have no real relationships, so vital to the healing process, with the disturbed and disturbing persons they treat. Their sole role will be that of prescription writers, ciphers in the guise of being “helpers”.
Finally, why must the APA pretend to know more than it does? DSM IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document. To its credit it says so, although its brief apologia is rarely noted. DSM IV has become a bible and a money making best seller – its major failings notwithstanding. It confines and defines practice, some take it seriously, others more realistically. It is the way to get paid. Diagnostic reliability is easy to attain for research projects. The issue is what do the categories tell us? Do they in fact accurately represent the person with a problem? They don’t, and can’t, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder. So, where are we? APA as an organization has implicitly (sometimes explicitly as well) bought into a theoretical hoax. Is psychiatry a hoax, as practiced today?
What do I recommend to the organization upon leaving after experiencing three decades of its history?
1.. To begin with, let us be ourselves. Stop taking on unholy alliances without the members’ permission.
2.. Get real about science, politics and money. Label each for what it is – that is, be honest.
3.. Get out of bed with NAMI and the drug companies. APA should align itself, if one believes its rhetoric, with the true consumer groups, i. e., the ex-patients, psychiatric survivors etc.
4.. Talk to the membership; I can’t be alone in my views.
We seem to have forgotten a basic principle: the need to be patient/client/consumer satisfaction oriented. I always remember Manfred Bleuler’s wisdom: “Loren, you must never forget that you are your patient’s employee.” In the end they will determine whether or not psychiatry survives in the service marketplace.
Loren R. Mosher M. D.