A cautionary tale of a stupid young doctor (me) who collaborated in the massive misdiagnosis and mistreatment of a teenage girl (Mindy Lewis).
I'm a little surprised that my friend, Allen, didn't mention the new genome study just released,corroborating my unifying Bipolar theory. Showing Bipolar genes overlapping with Schizophrenic genes.
Mindy is only half correct.
Dear David P or Tea Leaves,
You are probably aware that psychiatry with aid from the robber barrons of their time invented the bogus, evil, predatory eugenics theories in the 1930's that unleashed the gassing to death of those they stigmatized as "mentally ill" and otherwise inferior that greatly influenced Hitler when writing Mein Kampf. Psychiatry then persuaded Hitler to expand their psychopathic predation by transferring their gassing apparatus to concentration camps to more effectively exploit and murder those they called "human vermin" and other so called medical terms like the bipolar and schizophrenia fraud fads later used to prey on all humanity for greed, power and sadism. Those who ran the Nuremberg Trials admitted that without psychiatry, the Holocaust probably would never have happened. See articles by Dr. Peter Breggin, the conscience of psychiatry since it doesn't have its own.
Here is one of many articles exposing the true evil agenda of falsely claiming that genes cause various diseases and bogus, voted in DSM stigmas now declared invalid junk science by even your chief, Dr. Thomas Insel, Head of NIMH. Of course, anyone who had done the slightest research has known for decades that the DSM is total evil fraud and pseudoscience invented to blame the victims while denying all social, environmental and other contexts of abuse related stress and trauma and other human inflicted evil while selling out to Big Pharma to push the latest lethal drugs on patent to make global billions at the cost of countless destroyed lives.
And here's another one:
Dr. Jay Joseph has also exposed the evil fraud and right wing oppressive, predatory agenda behind biopsychiatry's neverending search for The Missing Gene and The Gene Illusion along with many others.
Thus, you may wish to reconsider bragging about your great contribution to the latest monstrous eugenics/euthanasia ploys.
Unfortunately even in cases when it is finally recognized that a diagnosis is incorrect, a new diagnosis will be given, further contributing to the seemingly impulsive need for human behavior and cognition to be clustered into a tight "diagnosis" or really a label, that not only constricts treatment options to typical protocol where there is a failure to think with open-mindedness and use standard medication strategies both to support pharmaceutical companies and what the "latest and greatest" medication is but also has the potential to restrict the patient's free-will in how they want to live their lives, what they should and should not do with their own body chemistry, and critical thinking has the tendency to be misperceived as "non-compliant" as opposed to rational, reasonable, and a having a healthy skepticism where both the doctor's point of view is grasped yet weighed with one's internal awareness of what's really going on inside and the various factors ranging from environmental, cognitive styles, and competence to stand for what's true has the risk of being discouraged.
The mini-mental status exam isn't inherently bad in itself, but when every single behavior, appearance, and expression of one's viewpoint is labeled and the cognitive bias on the part of the examiner to mold perceptions to fit into particular categories, then this both de-humanizes the individual and acts as a barrier for acceptance and mutual cooperation between the examiner and patient. It initially may take a lot of courage for the patient to re-asses what diagnosis was given out and realize the fallacy of always believing what label is placed on their behavior, but it is important for the sake of allowing freedom to explore who one really is on the inside and know what truly is helpful or harmful for their own well-being. Obvious exceptions are cases where a patient has disorganized thinking and thus lacks the capacity for awareness of both the process of observation, their internal observation, and the cultivated discipline to see through their own cognitive biases. Once a patient has organized thinking, in my opinion, active cultivation of such awareness and inner-discipline is vital for the patient's well-being and gaining freedom. This is a good approach as freedom does not negate the judgment of the examiner but allows great cooperation, understanding, and compliance of what actually helps the patient.
I was glad to hear you finally admit that,
"It was only later when I had gathered much greater experience in the wider world of psychiatry and life that I realized I was also hurting people and learning a lot of the wrong things"
This is a long way from your past unapologetic defense of psychiatry. My hope is that one day you'll recognize that the whole psychiatric enterprise is nothing but a huge lie with the dual purpose of helping governments with social control (like the Inquisition used to do) and Big Pharma make obscene amounts of money out of psychiatric drugs.
For now I am happy that you seem to be headed in the right direction.
This comment of yours, while still finding the appropriate spin to still defend psychiatry, is a good step in the right direction.
I pray that God will give you strength to recognize, before you leave this world, that psychiatry is an unscientific quackery that destroys more lives than it helps.
With all due respect, Dr. Frances, neither you or anybody else knows how many people are injured by psychiatric treatment.
Even a ratio of hundreds to thousands, is such a significant rate of injury -- The FDA considers a 1% adverse effect rate as "common" -- that psychiatry, if it were to become a responsible medical specialty, would routinely review such injuries and make recommendations for improvements in clinical practice.
There are no such process improvement programs in place in psychiatry, in any academic program, hospital, or clinical setting.
Not only do the injured go uncounted, they go unrecognized. Clinical psychiatry has tremendous difficulty identifying adverse reactions. It's more likely that an injured patient gets an escalated psychiatric diagnosis than an acknowledgement of medical error.
For example, agitation, sleeplessness, or akathisia caused by antidepressants are often misdiagnosed as emergence of bipolar disorder, calling for even more harmful polypharmacy.
Clinical psychiatry is widely ignorant of techniques to taper people off psychiatric drugs and is apt to diagnose withdrawal symptoms as relapse or emergence of a new, exotic psychiatric disorder demanding strenuous treatment -- much to the detriment of the patient's wellbeing.
The high rate of misdiagnosis and mistreatment is well documented, most recently regarding psychiatrists prescribing antipsychotics for children http://tinyurl.com/mq6gx4u and antidepressants in general http://www.ncbi.nlm.nih.gov/pubmed/23548817
This cannot entirely be laid to prescribing by general practitioners.
As your own anecdote above demonstrates, psychiatric diagnosis and treatment is subject to fads that gain traction regardless of patient harm.
Your opinion that "those who have suffered damage from ill conceived and poorly delivered treatment and are understandably angry and eager to protect others from a similar fate" are an inconsequential minority dwarfed by those experiencing huge benefit from psychiatric treatment is grounded in hope rather than fact.
Please call for psychiatry to systematically study damage from psychiatric treatment and put processes in place to develop clinical recommendations reducing injury.
Thank you Dr. Frances for this insightful post on one aspect that motivates your call for reform. For a short version of Mindy's Story. And thank you, those of you who are experiential experts, for yor lucid comments.
If the APAs were to collect and evaluate the stories of thousands of survivors they would find Mindy's experience is extraordinarily common.
Some people are followers--they can't resist the societal pressure of being labelled by authorities; they experience what I believe is called mortification--a death of a part of themselves--to accept the role given them of mentally ill.
Others, like Mindy, have the inner strength to resist and recover.
Back in the 1960s schizophrenia was indeed the diagnosis-du-jour. Thousands of Vietnam veterans were labelled schizophrenic just as today soldiers returning from Afghanistan and Iraq with brain injuries are being labelled borderline personality disorder. A LABEL IS NOT AN ILLNESS. And misdiagnosis needs correcting.
Gregory Bateson pointed out, years ago, that systems in nature are sustainable and adaptable because they are organized through homeostasis--a concept that is the basis of 1st semester physiology--and they have feedback systems. He recognized that human cultures function in much the same way. But when systems lose their feedback mechanisms we find what is happening in many institutions today--first it was the tobacco industry, decades ago; now it's seen on Wall Street in financiers and businessmen; in the pharmaceutical and insurance companies that have virtually hijacked doctors and hospitals both in physical and mental health. Also politicians. And the food-processing industry that denies that adding refined sugars to practically everything is the cause of the obesity/diabetes epidemic.
Such widespread systems failure calls out for reform--and only the mental health system can explain what is happening. But first it must heal itself.
J. Heller, in Catch-22, got away with criticising the military by using satire and the absurd. Gregory Bateson called it Double-Bind--(see also Paul Gibney (May, 2006)--The Double-Bind Theory: Still Crazy-Making After All These Years (about failures in the mental health system in Australia).
We have a choice of doing nothing. Or of moving in the direction of finding solutions.
Dr. Frances, psychiatric survivors are your best allies in your campaign to reform the DSM.
The argument that the number of those injured by psychiatry is inconsequential relative to all the good psychiatry does undermines your own criticism of the DSM-5: That it will cause overdiagnosis and overprescription.
The existence of those injured by psychiatry PROVES your critique is valid and a real medical issue.
But if you argue that real-world injury from psychiatry is inconsequential now, what's the problem with more diagnosis and more prescription via the DSM-5?
Please join with us in recognizing, not dismissing, the extent of injury done by psychiatry now and the potential expansion of this endangerment wrought by the DSM-5.
You've challanged Dr. Frances in his contradictions--you're brief and right on target.
But does he read the feedback (and take it seriously into consideration)?
WHAT'S NEEDED is a SURVEY/vote among survivors of the mental "health" system--
Has psychiatric treatment helped or hindered your life?
Has it been confusing or a Catch-22 (we'll help you if you accept you can't get well)?
Have you restabilized--have you recovered--how much--and are you living a meaningful life?
Have meds helped--are there negative side effects--how bad?
What has helped more--doctors and counselors--or peer support?
Is emotional growth important to healing?
MH professionals need some honest feedback. (Not--Yes, thank you so much, doctor--please don't list me as a difficult patient or oppositional or dangerous).
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WHEN will things eve change ?
In Wales MH services are certainly a CINDERELLA Service and well & truly in the Dark Ages as we still have the last 19th Asylum left standing in UK : at Whitchurch Hospital
For years so - called mental health ' professionals' , I hesitate to use that word , have toted the term RECOVERY around as though it were the Holy Grail. But what else would,one expect from a 21st Mental Health service, even in Wales, but that or at the very least empathy ?
Within the last three weeks on a dis-used ward of this Dickensian Hospital SWP found a cannabis factory in situ at the hospital .
I rest my case.
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Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.
It can take a radical reboot to get past old hurts and injustices.