Straight Bias Is Not Impartiality

If you’re going to write an article about bias, try not to make it biased. The subject of this Opinion Piece in the Philadelphia Inquirer, misleadingly titled, Don’t repeat biases of the past, authored by Jonathan Zimmerman, while claiming to castigate bigotry, would actually have us repeat the prejudices of the past.

Why do we regard one trait as changeable, while the other one is supposedly cast in stone? The question came back to the news this month, when prominent psychiatrist Robert Spitzer renounced his famous 2001 study claiming that some gays could become straight via so-called “reparative therapy.”

Mentioning protests in California and Philadelphia against such “reparative therapy”, Mr. Zimmerman says:

Methinks we doth protest too much. As the gay community has taught us, every human being has the right to determine her or his own sexual identity. By dismissing self-described “ex-gays,” then, we risk repeating some of the same bigoted tactics that have been used to condemn homosexuals themselves.

Considering that 20 % of US citizens are on psychiatric drugs, considering the multi-billion dollar drug companies that are profiteering on death and dying, considering the creeping medicalization that is making artificial invalids of vast swathes of the American public, methinks we doth protest too little. In fact, I was out there with other protesters protesting the American Psychiatric Association, and its labeling bible, at their annual convention in Philadelphia earlier this month.

Mr. Zimmerman, by the way, doesn’t identify himself in this article as an “self-described ex-gay”, but he does go to the heart of the problem.

Yet ex-gays say otherwise, insisting that they — not the psychiatrists — are the best judges of their own mental health. And that’s an exact echo of gays, who were stigmatized as “sick” by the same profession until the early 1970s.

Before the early 1970s homosexuality was listed as a psychiatric disorder in the psychiatrists label bible, the DSM. Heterosexuality was never listed as any such disorder in this label bible. The trans-sexual impulse and inclination, under the guise of gender identity disorder, is still listed as a “sickness” in this catalogue of “disorders”.

If anybody thinks sexual orientation is not set in stone, he or she is free to change their orientation. Betwixt homosexuality and heterosexuality you’ve got the bi-sexual identity as well, and that one Mr. Zimmerman leaves completely untouched. Some people claim to have physical affection for members of both sexes. Is Mr. Zimmerman suggesting this passion is a “sickness”?

My own view is that sexual experimentation is going to happen, and no amount of what amounts to moralistic preaching is going to stop it from happening. We have enough problems with those politicians who wish to look beyond their wives for satisfaction, comfort, solace, support, and/or relief.

If anybody wants to consult a mental health professional about changing their sexual preference they are free to do so. The idea that there must be a special therapy for people who want to change their sexual preference is ludicrous. Nobody is trying to change the sexual preference of heterosexuals, for instance. The implication would be that heterosexuality is wrong, and homosexuality is right. You have always been free to change your sexual orientation if you want to do so. The question here is, if you don’t want to change your sexual orientation, should you change it anyway? I leave that one where it belongs with the specific individuals who happen to be so afflicted, disturbed, curious or smitten. To state the matter in more precise terms, homosexuality is not a “disease”, nor is heterosexuality the “cure”. It would be misleading and prejudicial for us to treat them as such.

Scumbag Awarded Grant By Corrupt Health Agency

You know that corruption is rampant in the health care industry when a psychiatrist who has been chastised repeatedly for failing to disclose drug company payoffs wins a National Institute of Health grant. What exactly were they thinking? I suppose that they were thinking they could pull a big one over on the American people. This is the first grant that the NIH has awarded in 3 years time, and it has to go to a total scuzzball! BUZZZ!!!

The doctor is Charles Nemeroff who I have written about previously. The story is in Science Insider, Sanctioned Psychiatrist Gets First NIH Grant in 3 Years.

Charles Nemeroff’s lax reporting of at least $1.2 million in drug company payments to his employer, Emory University, and similar payments to other academic psychiatrists prompted a 2007 Senate investigation. Nemeroff stepped down as chair of psychiatry at Emory, and NIH suspended a $9-million grant he held for a depression study. In December 2008, Emory barred him from applying for NIH funding for 2 years.

9, 10, 11, 12…BUZZZ!!!!

Enter the corrupt good old boy system.

A year later, Nemeroff moved to the University of Miami Miller School of Medicine in Florida. This prompted concerns because Emory’s ban on NIH grants did not move with him. (Fueling the flames was a phone call in which National Institutes of Mental Health (NIMH) Director Thomas Insel apparently assured the University of Miami medical school dean that Nemeroff could seek NIH funding if he moved.)

You don’t think the NIMH has too much clout in the NIH, do you? Well, given a maneuver like this one, I certainly do.

The 2-year ban by Emory would have expired anyway. But Paul Thacker, a former staffer for Senator Chuck Grassley (R-IA) who led the Senate investigation, says NIH itself had the authority to impose a longer ban. “This shows they’re really not serious about the problem,” Thacker says.

When we are as corrupt as they come, I guess you could put it, we look after our own. I don’t know who else gets the wrong perpetuated by this gesture, but personally, I say, “shame on you NIH!” BUZZZ!

Did somebody say he withheld the reporting of 1.2 million dollars? This sleight gives new meaning to the expression, “that’s rich”. With that much of a kickback, there’s only one thing you can say, Dr. Nemeroff is solidly a one percenter. Again I say, “shame on you NIH!” That’s 99 % of the population you’ve passed over.

Former Dysfunctionaries Pursue Career Change In NYC

I notice words. I notice the arrangements they are laid out in. I have questions about those arrangements when I find the logic of whatever statement is being made faulty. Mental health issues treatment represents a black hole for the dispensing with any hint of logic in any statement made. I think we are still in the dark ages when it comes to the treatment of human distress chiefly because of the medical model approach to problems. Problems demand solutions, and a pharmaceutical is not the solution to any problem.

Huffington Post is carrying this article, authored by one Michael Friedman, with the heading, Art Helps People Live With Mental Illness. My most visceral response to this headline is to query why anybody would want to live with “mental illness”. An alternate heading, for instance, might run, Art Helps People Live Without Mental Illness. Apparently either art hasn’t progressed so far, and “mental illness” is still too clinging, for us to make any such statement right off the bat.

I am visiting the HAI Art Studio. All of the artists have mental illness, and the studio is funded as a mental health program designed to facilitate rehabilitation. But I would never have known that without being told.

Ask, live, and learn.

Everyone at the studio is working from his or her own artistic vision. Francis Palazzolo — the creative director of the program and a working artist — says that the individuality of the artistic experience is at the heart of the studio’s philosophy. “We do not have a single standard.” Sometimes Mr. Palazzolo offers suggestions to help the artists realize their personal vision or to experiment doing something different and challenging for them, but the goal is for each artist to be engaged in the effort to create images that speak to them personally.

What is the function of art? I imagine a person could waste reams of paper on that subject, and at the end of it all we’d be right back where we started, clueless. What is the function of a human being? It isn’t really important that we remember that a person labeled “mentally ill” is a person who dysfunctions. Leave it to psychiatrists. The function of a human being would lead to an equally annane and misdirected waste of paper if pursued to it’s most illogical conclusion.

When school is therapy, and art is school, I would hope there is a point at which students graduate, and patients recover.

I’m back on the subject of identity questions I’d like to pose to our student/patients, such as, are you a “mentally ill” person with an art hobby, or are you an artist who happens to be “mentally ill”? Career “mental illness” you will find, in this sense, can interfere with the creation of art. Likewise, I think that art might have a tendency to interfere with a “mental illness” career in optimal circumstances. We would hope maybe the “mental illness” identity could shrink to microscopic dimensions of insignificance, and the artistic identity might grow into more monumental proportions.

This is not to say that these residents and visitors to Soho have any less right to be there than any other inhabitant of that ville. I think such programs a good thing, and there is always the possibility that a formerly full-time mental patient might make a successful transition into the field of arts and crafts. Hopefully these “mental illness” labels don’t have to stick beyond any token advantaging use to which they may be put.

“We need more programs like this,” Mr. Johnson tells me. “We need people to advocate for more funding so that more and more people with mental illness can have art in their lives and a reason to get out of bed in the morning.”

We need more programs that offer a full time mental patient the prospect of making a successful career change. I would hope that a program such as this one could potentially become one of those programs. We have more than enough adult kiddie art therapy kindergarten-type mess areas. Let’s hope this program can aspire to be a little better, and more fulfilling, than the obscure permanent misplacement that that kind of cul de sac must all too often represent.

Fraudulent Neuroleptic Drug Use Over 50 %

Fraudulent, or off-label, prescribing of neuroleptic drugs has reached ridiculous high levels; in fact, the % of people prescribed such drugs fraudulently, or for purposes for which they haven’t been approved by the FDA, is now well over 50 %. This is what a story on a research study for shows, Study: Reducing Off-Label Use of Antipsychotic Meds May Save Money.

Researchers say that 57.6 percent of patients prescribed antipsychotic medications in data from 2003 did not have schizophrenia or bipolar disorder, the conditions for which the drugs were approved for use. Use of medication for treatments that is not FDA-approved is called off-label use.

75 % of all neuroleptic drug prescription in the USA is covered by Medicaid. By ending the practice of fraudulently prescribing drugs the country could be saving great deal of money in health care. This is what the data (ca. 2003) collected from 42 states by the Centers for Medicare and Medicaid Services, and published in the American Journal for Managed Care, seems to suggest.

During 2003, 372,038 patients received an antipsychotic medication. Of these patients, 214,113, or 57.6 percent, did not have a diagnosis of schizophrenia or bipolar disorder. Diagnoses included other mental disorders: 35 percent, minor depression — 25.4 percent, major depression — 23.2 percent, no mental disorder — 18.8 percent, conduct disorder — 18.8 percent, and anxiety disorder — 16.2 percent.

The researchers behind this study understate the case. Atypical neuroleptic drugs cause a metabolic syndrome which is the primary reason people in mental health treatment are dying off on average at an age 25 years younger than the rest of the population.

“Antipsychotics were the highest selling medication class at $14.6 billion in 2009,” [professor of public health sciences, Douglass L.] Leslie said. “Medicaid bears a significant proportion of these costs. Hence, off-label use may be responsible for a considerable portion of state Medicaid budgets, with little or no documented clinical benefit and a substantial risk of adverse effects. Off-label use may be an area of potential savings with little impact on patient outcomes.”

If there is little or no clinical benefit and a substantial risk, how can you say with any degree of reliability that ceasing to use these drugs fraudulently would have little impact on outcomes? I would think that outcomes would be likely to improve a great deal if mental health professionals resorted to more treatments that were beneficial and that didn’t cause any potential life-threatening risks to overall physical health instead.

Fifty Years Down And Maybe A Clockwork Brown Could Use A Little Touch Up

I have for awhile now been doing almost daily internet searches for the appearence of the term anti-psychiatry in the news. In most instances this word is used as an expression of disparagement, or as an example of a trend from which a journalist or a blogger wishes to disassociate him or herself. If trend it is, it isn’t a very popular trend. These are the primary instances in which the term makes an appearance. There is another instance, too, when the term puts in an appearance, and that is when psychiatrists use the term themselves. Here the term is being used to scapegoat critics of conventional psychiatry. Anti-psychiatry is the great bug-a-boo of mainstream psychiatry today. It doesn’t have much of a substantial existence, and yet psychiatry feels a need to defend itself from this amorphous and mysterious malevolent force it feels is being directed against itself. Anti-psychiatry Disorder is the great white whale of a ‘sickness’ the contemporary megalomaniacal mad Dr. Ahab feels most challenged by.

When it comes down to it, I think there is very little difference between anti-psychiatry and non-psychiatry. Non-psychiatry is basically indifferent to, and not in need of, psychiatry. I think non-psychiatry has a great future. Anti-psychiatry, on the other hand, is more dependent on psychiatry. Anti-psychiatry is antipathetic to psychiatry, and this creates no end of problems for psychiatrists. Its future is tied up with the future of psychiatry. I don’t think it very ironic at all that a psychiatrist came up with the term anti-psychiatry. Disciples of Christianity came up with the beast 666, the Anti-Christ, to describe the nemesis and antithesis of their own faith. Atheism is altogether another creature entirely. Faith is the key-word here, and faith is not a matter for scientific inquiry. Science itself demands a certain amount of healthy skepticism.

Recently Dr. Edward Shorter, a psychiatrist, a historian, and a critic of critics of contemporary psychiatric practice co-authored with Susan Belanger, another partisan of coercive treatment, an article for the Oxford University Press blog, Anti-psychiatry in A Clockwork Orange. A Clockwork Orange is turning 50. One Flew Over the Cuckoo’s Nest, another classic, achieved 50 not so long ago as well, but these two experts were not so enthused about celebrating that momentous occasion.

Political interest in behavioural programming is represented by the Minister of the Interior (whom Alex nicknames Minister of the Inferior, or — in a nod to the truncations of George Orwell’s dystopian classic 1984 — Int Inf Min). The “Min” visits the prison to implement the treatment in order to fight crime “on a purely curative basis. Kill the criminal reflex.” He reappears as Alex’s “cure” is demonstrated and boasts to the media about government efforts to suppress “young hooligans and perverts and burglars.” In fact the police are now recruiting former hooligans to rough up whomever they choose and round up enemies of the Government, an agenda suggested by the Minister’s earlier comment about clearing the prisons for “political offenders.” This combination of political tyranny and abusive (Pavlovian!) conditioning in a future Britain where adolescent thugs speak a mixture of Cockney rhyming slang, archaisms, and anglicized Russian (“Propaganda. Subliminal penetration,” a doctor suggests) creates an additional sinister note that would have been especially potent in the Cold War era when A Clockwork Orange was published.

Now if we interpret this work in the way that Dr. Shorter and Ms. Belanger interpret this work it has something to do with the cold war era in which it came out. What neither of them are looking at is the way this work relates to the increasing medicalization of life taking place in our own time. After calling insulin shock, metrasol therapy, and ECT used extensively durring the 1930’s “highly effective”, a claim I find highly dubious. The authors point out ECT gained popularity in the 1950s. Then we get this paragraph.

Beginning in the 1950s, a series of revolutionary drug treatments arose: antipsychotics, antidepressants and anxiolytics. So widespread was their use that, by the time Burgess penned Clockwork, they had become the subjects of cocktail party chitchat. Medical psychotherapy, which had ruled the roost in previous decades, was wobbling (the Brits never had much interest in Freud’s psychoanalysis) and was about to be pushed out the door. All these innovations lent themselves marvelously to being parodied, sent up, and pulled down by scornful novelists.

This is hardly the end of the story. Those revolutionary treatments didn’t turn out to be so revolutionary after all. This psychiatric drug treatment revolution has lead, rather than to an end of “psychosis” in our lifetime as was hoped, to the favoring of drug maintenance over any approach emphasizing the possibility and hope of achieving complete recovery from, say, the youth, immaturity and thuggish nature exhibited by the chief protagonist of A Clockwork Orange, Alex. People in mental health treatment are also dying off at an earlier age than the rest of the population because of these drugs. Rather than eluding the “laws and conditions appropriate to a mechanical creation”, those “laws and conditions” are incorporated into a lifetime prescription drug taking regimen.

I’d say the times haven’t changed so much as these mental health professionals would envision them to have changed, and maybe the Anthony Burgess classic novel, and the movie based on that novel, could use a serious update to illustrate how similar the treatments parodied in his book are to treatments still being practiced on a widescale and regular basis today.

Psychiatrists and Psychiatric Survivors Meet In The APA’s Radical Caucus

The Radical Caucus

On May 6, 2012, the day after a historic protest at the annual convention of the APA in Philadelphia, following speeches by Robert Whitaker, Jim Gottstein, and Keris Myrick at the Church of St Luke and the Epiphany, about six psychiatric survivors present at this same mini-conference headed out to participate in the Radical Caucus of the American Psychiatric Association at the Courtyard by the Marriot Downtown.

Two psychiatrists that I know about have posted about this Radical Caucus event, or rather non-event, already. I would like to clear up a little of the confusion that may have been sowed by their interpretations of the occasion.

I was more dismayed than surprised by the announcement in the flyer of this event. I was put off right away by the qualifying part reading, “Although biomedical research is important…” That statement concedes more to the eugenic policies of medical model psychiatry than I think necessary. It was also a good indication of how radical these psychiatrists, despite the rhetoric, were not.

Psychiatrist Bradley Lewis did an Op-Ed piece on the caucus for the Mad In America website entitled Reflections on the 2012 Radical Caucus Meeting.

This year’s American Psychiatric Association (APA) convention was a charged affair owing to a number of factors, including the intense DSM V controversy, the recent high profile critiques of the profession (such as those by Robert Whitaker and Marcia Angell), the presence of documentary filmmakers shooting an expose on the APA’s role in an iatrogenic death from antipsychotics, and the new energy, participation, and strategies that Occupy Wall Street protesters brought to meetings. Out of all this, one of the most fascinating moments in the conference was when “APA Radical Caucus” invited psychiatric activists from Mindfreedom and the Icarus Project to their annual caucus meeting.

Correction: We weren’t invited, specifically, nor were we crashing the caucus. The first sentence on the flyer announcing the event reads: “The Radical Caucus of Members of the APA invites everyone to a meeting to discuss how to make psychiatry and the APA more relevant to the people of this country.”

Emphasis added.

Everyone didn’t show up, but we did show up.

Part of the reason that the AACP members of the Radical Caucus were defensive is that they think they have been trying to live up to recovery concerns. There are two main problems with being too self-congratulatory here. The first is the way that recovery has been taken up is largely controlled by psychiatrists rather than consumers themselves. It is the psychiatrists, powerful budget administrators, and increasingly big pharma marketers who are having disproportionate influence on how consumers can participate and picking which consumers are appropriate. That means many activists are increasingly wary about the way that “recovery” is being adopted. Second, and more to the point of this meeting, the psychiatric activists at this meeting were not talking about recovery. They were talking about coercion and forced treatment.

We were also talking about, and I don’t know how it could have escaped Dr. Lewis’s attention, the harm that comes of treatment, forced or otherwise. This harm is harm of which psychiatrists are the direct source. Some of us, all of us were not pursuing this line of questioning, felt that many of the psychiatrists attending the caucus were guilty of doing serious harm to many of the patients they saw in practice.

The other entry was posted by British psychiatrist Duncan Double on his Critical Psychiatry blog, and bears the heading, Occupy APA.

A particular issue currently is the DSM-5 revision. As I have mentioned previously, I have signed up for the campaign to abolish psychiatric diagnostic systems like DSM. I think it would help psychiatry to be without a diagnostic system for a while. It managed without one until 1948. The American psychiatric system has become very dependent on DSM for billing purposes, but I’m sure the insurance companies could develop an alternative system unrelated to DSM. After all, in the UK, clusters have been created for the introduction of payment by results without requiring an ICD diagnosis.

On this score, at least, we would be in agreement. This need to ‘abolish psychiatric diagnostic systems’ was, in some measure, what the protests of the day before had been all about. One has to wonder though a little about his saying “for a while”. Does this indicate some subconscious reluctance on his and his associates part to carry through on the aims of their campaign?

I think the caucus itself just showed how far removed we are from any real and meaningful dialogue with most psychiatrists on these issues. I’m not saying this dialogue won’t arrive, I’m just saying it’s a long way off as of yet.

I wasn’t particularly impressed by most of the psychiatrists in attendance although one, who also leaves a comment under Bradley Lewis’s Op-Ed piece, Pittsburg psychiatrist Wesley Sowers, stands out for having had the decency to hold a conversation with a few of us psychiatric survivors following this meeting.

The discussion was slated to continue afterwards at the Alma de Cuba. The Alma de Cuba struck me as more the kind of a restaurant a psychiatrist would chose over a psychiatric survivor because they can afford it. One psychiatric survivor called it, “gourmet”. This psychiatric survivor called it, “pricey”. It seemed the psychiatric survivors and psychiatrists were seated at separate tables for the most part, and so the ensuing discussion must have been rather limited.

There will be other APA Conventions, other protests, and other caucus meetings in the years to come. Perhaps at some point in the future we will really be able to work together on aims we hold in common. Alas, if so, that point is still far far away.

Missing From The Radical Caucus: Clancy McKenzie

All of the psychiatrists who took part in the Radical Caucus were there to attend the convention of the American Psychiatric Association. All of the psychiatric survivors, whether with MindFreedom, or the Icarus Project, or completely independent, were there as part of a protest directed against this same American Psychiatric Association, over the upcoming release of its label bible, the DSM-5, that took place on the previous day.

We had among the planners of this protest, and marching alongside the demonstrators, a psychiatrist. This psychiatrist even had some of his patients taking part in the protest with him. His name is Dr. Clancy McKenzie. There is a world of a difference between a psychiatrist like Clancy who was willing and able to march with the demonstrators and those psychiatrists who found it convenient or opportune to attend the APA convention. It is unfortunate that he wasn’t around to attend this Radical Caucus the next day. If my hat goes off to anybody, then it goes off to Clancy McKenzie. He did something real, and that something real wasn’t kowtowing to the APA, publishers of the DSM.

5/5/12 Philadelphia

Connecticut college student and monitor of the event, Caitlin Belforti, speaking at the Friends Center in Philadelphia.

New York activist Daniel Hazen speaking.

Aki Imai is from Ohio. He launched the Our Life After Labels submission-based blog.

Joe Rogers, a Philly local, is the director of the National Mental Health Self-help Clearinghouse.

Signs of the times.

John Judge read a statement of support from Paula J. Caplan who was unable to attend.

Long time San Francisco activist and retired attorney Ted Chabasinski.

The backdrop for the mornings events.

Godly Mathew once spent one hundred consecutive days protesting against psychiatric abuse outside Philadelphia’s Friends Hospital.

Down with psychiatric labels. Up with human beings.

Ted’s banner.

Inside the Friends Center events get underway.

Outside of the Friends Center where the rally took place.

Inside again.

The march to the Convention Center minutes away.

Director of the Anchorage Alaska based Center for Psychiatric Rights lawyer Jim Gottstein.

The demonstration outside of the Convention Center.

Pedestrians crossing the street.

Protesters outside of the Convention Center.

Demonstrators and pedestrians.

The Icarus Project well represented.

The shrinks label bible, in revision, and its discontents.

What’s that? Psychopharmacomania?

David Oaks, director of MindFreedom International, at the microphone beside Philadelphia native Susan Rogers.

Amid other not so spontaneous eruptions of Mad Pride!

Top 25 Unwritten Mental Health Book Titles

1. Kicking the Bipolar Habit

2. Mental health recovery without drugs

3. Making a molehill out of a molehill

4. How to prevent a mental ill health epidemic

5. After schizophrenia after bipolar disorder after depression

6. Erasing the stigma against mental wellness

7. Mental health for dummies

8. I lost a mental illness, and you can, too.

9. Psychiatry exposed psychiatry debunked

10. Resilience as a lost art

11. Mental health system survival guide

12. Life beyond the mental health clinic

13. The mental illness joke book

14. Taking the illness out of mental

15. I’m Okay. You’re mental.

16. How to make an income

17. Kicking the disability benefit habit

18. Finding yourself in the manual of imaginary illnesses

19. The how to guide of mental health recovery

20. Freedom of thought from the mental health field

21. Mental hospitals inside and out

22. Deconstructing mental disorder diagnoses

23. People without labels

24. Beating the odds, eluding statistical analysis

25. Taking the exit from doom

& for good measure

26. Making friends and keeping them: the social skills handbook