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Madness At The Top

Three statistics pertaining to the “mental illness” label in the USA that have recently come to light stand out. As I reported, the Medco report showed that 1 in every 5 Americans are now on a psychiatric drug. What I didn’t mention is that the rate of women to men on these prescription drugs is much higher, and so actually 25 % of women, or 1 out of every 4 women, are on a psychiatric drug at the present time. Then there was the recent study showing, as of a couple of years ago, fully 11 % of the population is taking an antidepressant drug. These statistics, of course, apply only to the USA, the current epicenter of the worldwide epidemic in “mental illness” labeling.

This is one more reason why I’d be irked by any article with the heading, as the article I ran across at Psych Central does, Do You Have “Complete” Mental Health? This article was published in the Adventures in Positive Psychology column, and positive psychology just happens to be one of my pet peeves.

The absence of mental illness does not necessarily constitute complete mental health. Someone may not have any mental illness but they may not be satisfied with their life or striving to reach their potential. They may be surviving but not thriving.

I’m offended by any definition that would equate completeness in mental health with satisfaction and an abstract potential. I feel that such a definition tends to serve the rich and powerful, and that it is based primarily upon falsehood and misconception. Given such a definition, the most “mentally healthy” people in the world are also going to be the richest and the most powerful people as well. People in impoverished situations would, by this definition, of course, be the most afflicted.

Someone who is flourishing is living with optimal mental health and may be experiencing subjective well-being in most or all of three general domains.

We are then given 3 general domains: Emotional well-being, psychological well-being, and social well-being. Emotional well-being is described as having “positive affect and a high-level of positive emotion”. Psychological well-being is described as having “a sense of purpose and meaning in life”. Social well-being is described as having “a sense of belonging and accepting the world around us”.

Well-being is further broken down, by a certain theoretical model, into 4 further divisions.

Flourishing – Someone who are high on subjective well-being and low on mental illness.

Languishing – Someone who is low on subjective well-being and low on mental illness.

Struggling – Someone who is high of subjective well-being but also high on mental illness.

Floundering – Someone who is low on subjective well-being and high on mental illness.

The only thing I think this model serves is an arrogant and deluded sense of smug self-satisfaction. I don’t think it has a whole lot to do with reality. When “complete” success is judged by some stock exchange figure flashed over Times Square, relative success is going to be relevant in other places. I certainly wouldn’t measure success in terms of material accumulation in this fashion, and even spiritual accumulation doesn’t quite cut the grade.

I, for example, don’t think it a good idea to praise people for flourishing when those very same people dump oil off the coasts of Alaska, Louisiana, and New Zealand. I don’t think of dumping oil as very healthy, mentally or physically. I certainly don’t think it to be very healthy to wildlife. You dump oil into the ocean, and that’s bad karma, for yourself, for the wildlife you impact so disastrously, and for everybody else. I don’t think it “mentally healthy” to ignore this fact.

99 % of the population is struggling, lanquishing, or floundering, by this definition, while 1 % of population is flourishing in a more objective sense. I want to point out again that there is something wrong with flourishing at the expense of life on this planet, and that apparently we’re still locking up the wrong people for being disturbed and disturbing. Were we to lock up, if not psychiatrists, then maybe a few drug company CEOs, it is my belief that the rate of psychiatric drug abuse in this country would go down appreciably.

15 Responses

  1. Is there a quiz we can do find out whether we are floundering or languishing, etc? There was a nineteenth-century writer whose diaries were published with the title “never completely submerged” which I think should be a category. I remember reading a definition of good mental health (unfortunately can’t remember where) which spoke about having a rewarding job, friends, etc and thinking that it wasn’t mental health, it was just good luck.

    • Tellingly Floundering is described as “low in subjective well-being and high in mental illness” so I presume a mental health screening test would catch anyone who was in such a state. The same mental health screening test, according to the descriptions we were given, also might catch any person who was Struggling. Lanquishing is a little more elusive it would seem. I quess if a person isn’t a smashing success, and the person isn’t also a nut-job, that person could be said to be Lanquishing.

      Simple enough, huh? Either you’re rich, and therefore, Flourishing, or you’re Lanquishing, and merely surviving. Otherwise you’re Struggling, or Floundering, and both of those are clinically bonkers.

      Bad Luck Disorder, that’s a good one! Although there hasn’t been a mention of it in the current revisions of the DSM, perhaps it is coming. I feel certain, in fact, that that’s exactly what many people in the mental health system maze actually have, Bad Luck Disorder. That’s what you get when your economic system is a shrewd form of gambling. 20,000 to 1 odds means 19,999 losers.

      The mental health system is about selling drugs, and with those drugs, the notion of “mental illness”. Let me quote, by way of example, a recent article in the Lexington Courier-Journal, Multiple mistakes? Author details flaws in famous psychiatry case:

      The popularity of “Sybil” brought an obscure condition, multiple personality disorder, and the grotesque abuse that caused it into American living rooms. Journalist Debbie Nathan, in her new book, “Sybil Exposed” (Free Press, $26), points out that only 80 cases of multiple personalities had been identified in the 200 years before Schreiber’s book came out. By 1990, after multiple personality disorder had entered psychiatric textbooks and the popular imagination, 40,000 cases were recorded.

      Flora Rheta Schreiber’s book Sybil came out in 1973. From 80 cases to 40,000 cases, that’s gotta be some humdinger of a %-age increase!

  2. Since having been used as plot devices in novels and movies the general public are fascinated by the idea of multiple personality and “Munchausen’s Syndrome”.

    In real life people who could be said to resemble “sufferers” of these so called disorders are unintelligent, manipulative, malingering, obsessive, tedious, dishonest and often criminal.

    They’re not mentally ill they are just assholes.

    • Well, the Sybil Exposed book, from what I’ve read about it, goes onto show that the biggest victim of the Sybil hoax was “Sybil” herself. The psychiatrist, the book author, and the movie director all made money at her expense, in addition to prestige. “Sybil” herself lost a job, lost a much improved living situation, and was rendered dependent by debt to her shrink.

      I think for some people the mental health treatment junkie trip can become an easy pit to fall into, but a difficult pit to climb out of. All the words you use to describe people victimized by psychiatry could readily be used to describe some of the people surrounding them, and contributing to their general sense of pathos and malaise.

      People have assholes, people are not assholes. Not in the main anyway. Perhaps it would be better for me to say that tolerant people are not assholes. People, by and large, are human, and therefore, prone to make mistakes.

    • Rod, you are bastard and you need to check yourself. I guess and I think Iam right, that you creepy and affraid to socialize animal. Just simple you are hater and misanthrope. For real. period.

  3. You are right on the money here. I like:
    Floundering – Loser
    Struggling – Unlucky
    Languishing – Lazy
    Flourishing – Banker

    I believe there are a great number of people who would like to see the latter “completely submerged”.

    As for “Sybilgate”, I think that it is highly likely that a number of attention seekers jumped on the bandwagon along with others who wanted to present an excuse for behaving differently, if not necessarily oddly or, at worst, badly. I also believe, however, that there were people experiencing problems who felt liberated by hearing Sybil’s story because they could put a name to their experiences for perhaps the first time.

    I am sorry to hear about what happened to Sybil but it does not surprise me. The people around her were parasitic. That is always an issue with psychiatry, incidentally. I am not sure that the majority of providers – or perpetrators if you prefer – of treatment can be trusted to have the cure of a patient at heart. A lot of people would be out of jobs if everyone got better. Pharmaceutical companies would be in trouble, of course, and we are probably only aware of a fraction of the time, effort, money, and political influence they invest in keeping the drug sales juggernaut rolling.

    Rod, the terms you use could be applied to some people within any cross-section of society. Using them in this way, they appear to be put-downs exclusively for those who give the impression of having mental health issues.
    How would you feel if you were met with such put-downs when dragging a broken leg? Or bleeding from a gunshot wound?

    The problem with any afflictions of the mind is that they are invisible to the naked eye. We are so visually oriented as a species that we find it difficult to comprehend things that we cannot see. It does not mean that there is nothing there. Equally, it does not mean that there is something there.

    Another difficulty is the notion that we are beings whose parts exist separately from one another. We would never think that our feet could walk without our legs, yet it would appear that the majority of people like to think that our mental health can be separated from our emotional health, our physical health, and even our spiritual health. This is not the case; we are complex organisms in delicate balance and the parts of us are integrated into our whole. We can experience symptoms in any part of ourselves.

    • Thanks, G. M.

      Just to clarify, I think we disagree about some things, too. Chiefly I’m not one to encourage the “mental illness” excuse. What is the “mental illness” excuse? When a person makes a mess, and then says, “I shouldn’t be held accountable for this mess because my “mental illness” made me do it”, that person could be said to be using the “mental illness” excuse. It doesn’t matter whether the devil, or any other attributed force, is credited with being responsible for your messes, you are the one responsible for the messes your body makes. I’m not saying here that marginalization, disempowerment, discrimination, and prejudice don’t come with psychiatric imprisonment and treatment. I’m just saying that people aren’t, as a rule, damned by biology to displaying inalterably unacceptable behavior for a lifetime. The power and wealth disparities exist, as well as the attendant prejudice and discrimination issues, and they need to be faced head on and addressed.

  4. Well, we agree and disagree about this too. I do not encourage the “mental illness excuse” any more or less than any other excuse for the worst of things people do. But that is when it is used as an excuse.

    Perhaps, under any circumstances, it is better to think of reasons for things rather than excuses for them. The level of accountability a person might face depends on whether that person makes a mess of their own or someone else’s life to any great degree. We do hold people accountable. We put them in prison or, if it is deemed appropriate by someone who does or does not have a real clue whether it is appropriate, we put them in mental “hospitals”.
    I don’t think there are many people who get away with it, so to speak. It seems like the majority of people would take your point of view, don’t you think?

    I agree that “as a rule” people are not “damned by biology”.
    But some people are damned by biology. Others are damned by conditioning. That’s the nature nurture argument but there is evidence to support that the brain can change fundamentally through conditioning anyway.
    Mental illness happens. Do you really think that it doesn’t exist at all?

    “Inalterably unacceptable behavior”. Hmmm. Weren’t you the one saying elsewhere that people should not be condemned for being different? What is “unacceptable behavior” in your book?

    I like to think that one can alter one’s behaviour but I am not so sure that everyone can. I do think that most mental health issues are temporary, however, and I worry that people fall into the trap of being labelled “mentally ill” and of identifying themselves that way. If someone is weak-minded, it is a powerful identifier to be given.

    Saying that the “power and wealth disparities” and the “attendant prejudice and discrimination issues” need to be dealt with will provoke no argument from me. I would like to hear your plan for seeing that we do that successfully in my lifetime, however(!)

    • Simplify, simplify, simplify…

      Regarding messes. You make a mess, you clean it up. That’s what accountability is all about. When somebody else cleans up your messes, we’ve got a problem.

      Fewer people are damned by biology than are damned by psychiatry. When you’ve got psychiatry doing pseudo-science, that happens. We call this damnation biological medical model psychiatry. Do things differently, and you’re saving people rather than damning them.

      When I referred to “inalterably unacceptable behavior” I was being ironic. I was actually referring to the view held by biological medical model psychiatry. Biological psychiatry sees “behaviors” as “symptoms”. I myself believe that there is nothing wrong with being different, and that this labeling of difference is mostly about intolerance. I don’t think of behavior as inalterable.

      If you take a more positive view, it stands to reason, you are likely to have more successful outcomes than if you take a negative view. I’m not saying anyone would have a 100 % success rate, but biological psychiatry tends to take a very fatalistic view of personal problems, and I feel this influences their results. Those results, if you haven’t noticed, have been very negative.

      How do we deal with power and wealth disparities, and with prejudice and discrimination? Well, for starters, by joining the Occupy Movement, and by protesting those inequalities that exist. Change the overall system of government you are operating under, and you change the paradigm as well.

  5. I do not think that we know enough to say how many people are damned by biology versus how many are damned by psychiatry. I know that mental illness exists but I do think the term can be an incorrect one for what is going on for many individuals, whether this be because illness is more complex or because of what happens to people when they come into contact with bad doctors and bad medicine.

    It would be great if everyone cleaned up their own messes but I think it is unrealistic to think that everyone is going to. Hopefully, one would not leave a child with a dirty nappy or leave an old person lying in their own faeces. I do know this happens to people with mental health problems, incidentally, whatever their ages.

    The people who care for other people and who actually care about them too are very special people. Sadly, they tend not to be in charge and I think that is a core issue. The people who are in charge tend to be those who strive for that more often than those who simply want to care for people.

    Psychiatry is supposed to be there for when somebody is unable to clean up their own mess, whether because they were never able to do so or because they have suddenly or gradually become unable to do so. I agree that for the most part it is not there for this purpose and I agree that the whole field is something to be very wary of.

    I am deeply suspicious of most doctors and especially so of psychiatrists. Who said that they were the perfect beings with perfect views who could tell the rest of us how we should be and think? Quis custodiet ipsos custodes? (Who will guard the guards themselves.)

    I hear what you say regarding being ironic. I do not think of behaviour being something one cannot change as I said but equally I do not think that symptoms cannot be changed. It really has to be the right help that is given although and I have my doubts that, for a lot of people, this help is going to come from psychiatrists and their ilk.

    One of the biggest problems is the fact that these people are drawn to poking around in other people’s minds because their own need fixing. In your terms, they have their own messes to clear up but don’t want to face them so they project their messes onto other people. I think that this is very dangerous, both to the genuinely ill and to the mental health tourist.

    The other big problem, as I have implied, is the sheer arrogance that many of these people display. Yes, they do more damage than good. Whether psychiatrist or other, I invariably cringe when I hear or read references to “the experts”. With psychiatrists, however, who deems them so expert? Other psychiatrists normally. I think the only experts on mental illness are those who have experienced it first hand. It is not like sewing someone up and then seeing a wound heal, it is so much more complex than that. It does not have to be mental health as the subject matter either; the further away doctors get from the nuts and bolts of putting someone back together or treating an infection, the less they know about the consequences.

    I do not concur with the fatalistic viewpoint held, which is why I have conducted research outside of psychiatry (as discussed between us elsewhere.) As I have mentioned, it appears to me that healing is not the primary target within psychiatry, managing is. Your average psychiatrist is like a pencil-pushing middle manager making sure he holds onto a job by creating problems to solve; only it is drugs he is pushing, not pencils. Furthermore, most psychiatrists are in the pay of some pharmaceutical company or another and I know that the few with a conscience who try to buck this trend are squeezed until they toe the line.

    When people have supposedly unmanageable conditions, (when they resist being controlled), they almost invariably end up being incarcerated. It is more convenient to lock people up and say that they cannot be helped than it is to admit one has not got a clue how to help a person or that there is nothing wrong with that person’s mind at all.

    I think it is a good thing that people are angry about the current economic situation. Those culpable for this mess should be prevailed upon to clean it up, don’t you think? The real culprits think that they are untouchable. After all, they have taken such pains to make sure that they are.
    I think a really important thing for everyone to remember is to pass on to future generations the fact that they should never become complacent about the rights that they have. We must always be vigilant lest our rights be taken away whilst we are sleeping.

    • I’m not arguing religion with you, G. M. If the DSM is your good book, it’s not my good book.

      Biology is used to explain why some people don’t recover from their “serious mental illness” labels. The thing is that if recovery rates differ greatly between countries this suggests that environment has a great deal to do with the label, too. The more social and environmental factors have to do with the development of “serious mental illness” labels, the less heredity has to do with that development.

      A book that I recommend reading is Robert Whitaker’s Mad In America. Mad In America looks at World Health Studies conducted from the 70s to the 90s showing the full recovery rates for “serious mental illness” in poor and developing countries to be nearly twice that of the same rates in the developed world. The reason given for these higher recovery rates is that the poorer countries don’t use psychiatric drugs to the extent that we use them here in the West. People who fully recovery from their “mental illness” labels apparently aren’t eternally damned by biology, nor are they damned by fatalistic thinking.

  6. Please. I had to look it up for one thing and I doubt it has anything within its pages I want to read for another. You are being provocative.
    You have to know by now that although I agree with you on many points, I maintain that it is not everyone who is simply screwed up by doctors and drugs. Some people out there are genuinely ill and not all of them are just going to miraculously get better without help.

    The reason many people don’t recover from their labels is as I have described. There is no money in people recovering, is there? Profit has nothing to do with biology.

    I cite social and environmental factors. They affect us. Yes, they also affect the labelling. Heredity also affects us.

    I do not rate psychiatric drugs – you know that I think a one-size-fits-all approach is inappropriate – nor do I consider mental illness a permanent issue in a lot of people. I would hazard a guess that in most cases one can recover from it as one can recover from many illnesses. I do think, however, that the labels are much harder to recover from in the existing culture.

    When mental illness is treated as something that can be cured, things will change. To encourage this, I would consider legislation specifying that huge fines be levied against psychiatrists who do not bring their patients to a certain level of recovery within a certain time frame; like we do with builders who do not complete on time and so forth.

    I am being whimsical but it is true that the incentive can only be one of self-interest for well paid doctors in a capitalist country.

    I would be interested to read the book you mention but I will say that I have a deep mistrust of statistics. People often tend to seek out literature that presents an argument that supports their existing thinking, as those who prepare such literature tend to seek out material that supports theirs. I am just throwing that out there in case you haven’t considered it. Try “Freakonomics” (Steven D. Levitt, Stephen J. Dubner) for a great exposure of the use and abuse of statistics. It is a bit self-congratulatory and don’t waste your time with the section on children’s names; the first part of the book is a good read.

    • You’re right about the profit motive. “Mental health” is a business. Without people claiming to have “mental illness” there are no “mental health” services. The business end of the enterprise all too often works counter to the health end. “Healing” too many people would throw a number of people out of work. On the other hand, recruit more and more patients, and you will never be without a job. There is an endless supply of potential “mental cases” out there in the world right now just waiting to be “diagnosed” and “sedated”. This “mental health” industry (re: The Manufacture of Madness) is intimately tied up with the drug industry. All the more reason for a recruitment drive if you don’t want that industry to go belly-up with the other. The DSM interprets things broadly enough so that all sorts of behaviors can come under the scrutiny of professionals looking to drum up business. Of course, this business end of the matter has nothing to do with the fact that 1 in every 5 people in the USA is on a psychiatric drug at the present time, he said facetiously.

      Yes, statistics can be juggled, and a large amount of skepticism on any subject is commendable. This is precisely one of the reasons why I recommend reading Robert Whitaker. Whitaker in Mad In America, and also in Anatomy of an Epidemic, gives us information the experts themselves have come up with, but that is often suppressed. Whitaker is not a mental health professional, he is an investigative journalist in this field. Statistics don’t lie, but people do. If you want the real statistics, and those statistics that some mental health professionals don’t want you to have, then I’d recommend reading either of Robert Whitakers two books on the subject.

      For more information, you can visit Robert Whitaker’s website and his Psychology Today blog:

      Mad In America

      Psychology Today Blog Mad In America

  7. Thank you for the references. I have had a quick read of the Laura Delano story so far on Mad in America and look forward to reading the rest of it.

    I do not know if you have looked at things from the other side, so I would like to recommend that you check out magazines and other materials that are aimed at investors. I am sure it will interest you to see pharmaceutical companies presenting themselves as gargantuan profit making machines without the spin they usually drum up for the masses.

    Hoovers.com is a great resource; they used to give away quite a lot for free but now it is subscription only. It might be worth you signing up for a free trial, you know, you can get a real inside view.

    This is an excerpt from Bill Bonner’s “last word” in the latest edition of MoneyWeek, which is a reasonably well-balanced and accessible publication; my notes in brackets:

    A friend told me about the I-70 corridor from Washington, DC, to Gaithersburg and Frederick, Maryland. It’s the centre of the biotech industry – very near the source of its funding, regulators, and market, in Bethesda.
    “What a business!” he told us. “Their research is done at taxpayers’ expense by the National Institutes of Health (NIH)… or funded by it. They come out with these shock and awe new drugs. Investors (of initial capital) think they’ve got an aspirin, Motrin or Viagra on their hands, (or a Prozac or a Xanax) so they go into the marketplace and sell billions in shares to investors. Then they sell the patented drugs back to the government.
    “The US government is the biggest drug buyer in the world (and pusher). It doesn’t quibble on prices, because a lot of the people who work at NIH and other health bureaucracies know that if they want to make real money they’ll move up the road to the biotechs… and with the salary and options they have a chance of making beaucoup money. It’s all very cosy.”

    Isn’t it now..

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