Ronald Pies In Psychiatryland

One of the biggest clown doctors going at the present moment has got to be Ronald Pies. It would be remiss of me to claim that in his latest post, Nuances, Narratives, and the ‘Chemical Imbalance’ Debate in Psychiatry, he has outdone himself. If there was anyone destined for a pie in the face that anyone has got to be Ronald Pies. I would be honored, in fact, to bestow upon Dr. Pies the moniker Ronald “Pie In The Face” Pies for all posterity. Ronald Pies is a marvel of nonsensical shrink think. In his latest escapade into the theory and practice of shrinkery, Pies, by some disingenuous twist of convoluted illogic, would blame “the chemical imbalance theory” on that bug-a-boo and will-o-the-wisp of modern psychiatry, antipsychiatry. Go figure.

Now, if you were to give credence to a recent online polemic posing as investigative journalism, you would probably choose the first or second statement. In the narrative of the antipsychiatry movement, a monolithic entity called “Psychiatry” has deliberately misled the public as to the causes of mental illness, by failing to debunk the chemical imbalance hypothesis. Indeed, this narrative insists that, by promoting this little white lie, psychiatry betrayed the public trust and made it seem as if psychiatrists had magic bullets for psychiatric disorders. (Lurking in the back-story, of course, is Big Pharma, said to be in cahoots with Psychiatry so as to sell more drugs).

Those first two statements Pies alludes to here would be those that indicate either “mental illnesses” were caused by “chemical imbalances” in the brain, or merely that more “serious mental illnesses” were caused by “chemical imbalances” in the brain. What we don’t get out of this story is precisely who was responsible for promoting and spreading this “chemical imbalance theory” that these people in some antipsychiatry movement would be exposing. Where is psychiatry here? Defending itself from those who would be exposing a discredited theory. Certainly it is not defending itself from the ones who would be promulgating that theory. Curious indeed.

Among his more bizarre notions is the notion that this “chemical imbalance” theory has more to do with some catecholamine hypothesis from many years back than it does with the development, marketing and advertising of those trendy psychiatric drugs still surging strong on the market of today.

To the extent the “chemical imbalance” notion took hold in our popular culture, it was due mainly to distorted or oversimplified versions of the catecholamine hypothesis. These were often depicted in drug company ads; pop psychology magazines; and, in recent years, on misinformed Websites and blogs. In short, the “chemical imbalance theory” was never a real theory, nor was it widely propounded by responsible practitioners in the field of psychiatry.

Does Dr. Pies mean that psychiatrists don’t use, or shouldn’t use, those drugs that would be advertised as purporting to correct some kind of postulated and theoretical “chemical imbalance”?  I think not. This leads to another question. To what extent has psychiatry, or the majority of its practitioners, colluded with pharmaceutical companies in producing an atmosphere that now has commercial interests in the media peddling pills, not just to medical professionals, but to the entire buying public perceived and re-envisioned as consumers who will purchase anything at the provocation of the most mesmerizing sound bite?

Psychiatry’s critics also conveniently omit reference to what was arguably the most prevalent paradigm in academic psychiatry, during the 1980s and beyond: the biopsychosocial model (BPSM) of Dr. George Engel. The BPSM has been subjected to much criticism, and some would argue that few psychiatrists nowadays use the BPSM in a systematic, evidence-based manner. And in recent years, several prominent psychiatrists have warned that “…pharmacotherapy and psychotherapy, the major treatment modalities in psychiatry, have become fragmented from one another, creating an artificial separation of the psychosocial and biological domains in psychiatry.”

In the latex gloved mitts of Dr. Pies, our babble here has degenerated into very nuanced babble indeed. If you will notice, despite the nip at bio babble unrefined, bio still has top billing in the theoretical credits. I don’t think this is entirely because of the order of words in the alphabet, or accidental. The mad doctor has shown himself sufficiently proficient in blurring the lines between disciplines to earn himself a rank of major distinction in the therapeutic circus. If criticism equals antipsychiatry, well, there you go. The message is coming in loud and clear. Don’t criticize psychiatry or you must be promoting the discredited “chemical imbalance theory”, too. Clown psychiatry rules!

Psychiatrists’ Say The Darnedest Things – 6/17/13

If I were going to include a periodic quote from the media on my blog, and I might eventually do so, the following might be a good place to start.

As part of a HuffPost Book Club discussion on the book that took place last year, Matthew Erlich, MD, a psychiatrist-researcher at the New York State Psychiatric Institute in the Division of Mental Health Services, told us that Caulfield would probably have been committed to a secure unit as a manic depressive at the time of the book.

This snippet was snipped from, Holden Caulfield Diagnosis: Psychiatrist Discusses Salinger’s Classic Character (VIDEO), Huff Post Books.

The main protagonist of the Catcher in the Rye, a great coming of age and prep-school novel, that many of us experienced first hand while growing up, has been reduced to a species of nervous disorder. Thank heaven Holden saw no reason to check himself into a psychiatric facility, huh? On the other hand, this scenario suggests alternate plot lines. What if J. D. Salinger had come up with a different twist? Holden could have been snatched up by the psychiatric authorities, and the mental patients’ liberation movement–it’s all anti-psychiatry to true believers–might have welcomed another fictional hero into their midst beyond the misbegotten, doomed, and mischievous Randle Patrick McMurphy from Ken Kesey’s One Flew Over The Cuckoo’s Nest.

Did I say, “might have“? Without rereading the novel, here’s what the wikipedia Catcher in the Rye page says.

Holden makes the decision that he will head out west and live as a deaf-mute. When he mentions these plans to his little sister Monday morning, she wants to go with him. Holden declines her offer, which upsets Phoebe, so Holden decides not to leave after all. He tries to cheer her up by taking her to the Central Park Zoo, and as he watches her ride the zoo’s carousel, he is filled with happiness and joy at the sight of Phoebe riding in the rain. At the conclusion of the novel, Holden decides not to mention much about the present day, finding it inconsequential. He alludes to “getting sick” and living in a mental hospital, and mentions that he’ll be attending another school in September; he relates that he has been asked whether he will apply himself properly to his studies this time around and wonders whether such a question has any meaning before the fact. Holden says that he doesn’t want to tell anything more, because surprisingly he has found himself missing two of his former classmates, Stradlater and Ackley, and even Maurice, the pimp who punched him. He warns the reader that telling others about their own experiences will lead them to miss the people who shared them.

Emboldened emphasis added.

Did you get that? Holden Caulfield was a mental patient. The mental hospital experience was his experience. Perhaps he’s still with our movement at this present moment. If it’s not too ‘schizoid’ a thing to say, I think I saw him in 2012 at the protest outside the APA convention in Philly I attended.

Hoarding, That Honest Industry

If you’re a pack-rat, it’s time to fumigate for psychiatrists. On the tail of two hit reality television shows (just in case you were wondering where “mental disease” came from), “hoarding disorder” has entered the DSM-5.

Hoarding disorder is a growing phenomenon, now recognized by the American Psychiatric Association’s newest edition of its Diagnostic and Statistical Manual of Mental Disorders. Difficult to treat and hard to manage, the disorder is believed to affect between 2 and 5 percent of the population, according to a 2012 study published in the Journal of Community Health Nursing.

The heading of the Courier-Post Online says it all, Hoarding has spawned TV shows, recognition as a mental disorder.

Cleanliness fetishists beware. It is not too late for non-conformists, free-thinkers, and other bohemian sorts to edit a book of disorders of their own invention. (Where are humorists when you need them?)

If you’ve got a treasure trove of personal knickknacks, be wary. There are now companies developed to help intrusive relatives and envious neighbors rob you of your fortune.

Inspired by a close family member’s hoarding, Ronald Ford Jr. of Camden launched his clean-out company, Hoarders Express, about a year and a half ago. His business handles one or two homes a week. Typically, he is called in by a relative, though only a homeowner is allowed to sign the contract giving his employees permission to haul away their possessions.

Cleanliness freaks, law and order types, meddling neighbors, misbegotten relatives, city council members, they’re all in this wide-ranging conspiracy together.

Cluttering can prevent a home’s inhabitants from getting out in case of a fire, [firefighter Bryce] Priggemeier explained, and makes it harder for firefighters to do their job. The threat of fire is a primary concern for code enforcement officials.

How’s that for a lame excuse to harass a relative or a neighbor?

If recyclers are helping to save the environments, hoarders have the jump on recyclers by saving the article that would be recycled. No junk, no need to recycle.

I say to you so called hoarders are the first wave in a new perspective on life. We shouldn’t be chastising people for their collections of non-collectibles. We shouldn’t be entreating them to get rid of their treasures. Instead we should be helping them to use their gifts more wisely. We should be training them to turn their treasures into art.

There is what we refer to as junk art, found art, outsider art and primitive art. Transform your hovel into a palace with your treasured trash, and you’ve eluded all the mental health cops in the world. Pat yourself on the back, and attach an exorbitant price-tag to it. With a little bit of talent or learning, you don’t have to get rid of it after all. You’ve gotten away with it.

Future Psychiatry

Make way for the DSM-6 1/2 & 3/4. Some Oxford University mad shrink, a certain Kathleen Taylor, she calls herself a neurologist, thinks that religious fundamentalism and cult group membership could become a disease in the future.

Don’t look now, but religious fundamentalists and those whose ideological beliefs border on the extreme and may be potentially harmful to society could soon be called crazy—in a medical sense.

Remind me to stay way clear of the border of extreme.

Taylor also warned against taking “fundamentalism” to mean radical Islamism.

The story/review, Is religious fundamentalism a mental illness?, is to be found at GMA News Online, ‘the go-to site for Philipinos’.

I’m encouraged by all this potential broadening of commitment criteria in a way.  Just imagine, in the future maybe we could lock up members of the Church of Biological Psychiatry. As is, they do an inordinate amount of injury while everybody just looks the other way.

Kathleen Taylor has written a book, “The Brain Supremacy”, on the dangers of brain technology, but, oh, I don’t know…

“What we perceive from our perspective as our legitimate self-defensive reaction to the psychosis of the enemy, is from the perspective of the same enemy our equally malignant psychotic self-obsession,” it [Digital Journal] added.

Here it comes, here it comes…World War III!

This just goes to show now that, beyond intoxicating substances, behaviors have been found to be addictive, the bag is open, and anything can crawl in. Should psychiatry be your career choice, I hope we can find a cure before it’s too late, and the bombs start falling all around us.

Nope, I Guess That Wasn’t A Signal From The Great Beyond After All

When it comes to the science in psychiatry, one of the spoofing Ig Nobel awards given this year should give the outside observer pause. The story on CNBC is titled, Blowhard silencer, dead-fish brain science win spoof Nobel prizes.

Specifically related to the field of neuroscience, psychiatry, mental health care, or brain research…

One of the more infamous studies winning an Ig Nobel was for research detecting meaningful brain activity in a dead salmon.

What was he or she thinking!?

It started as a lark, explains Craig Bennett of the University of California, Santa Barbara, who studies adolescent brain development using functional magnetic resonance imaging or fMRI, a technique for measuring brain activity.

Alright. Technology is big in psychiatry these days. If they can use technology effectively enough maybe they can convince folks that they actually are a legitimate science. Maybe.

The dead fish, being given brain scans, were shown pictures of objects–a pumpkin, a game fowl, another salmon.

“By random chance and by simple noise, we saw small data points in the brain of the fish that were considered to be active,” said Bennett. “It was a false positive. It’s not really there.”

The piece goes on to say…

The often-quoted study exposed the perils of fMRI science, which can be prone to false signals, and underscored the need to do statistical corrections to safeguard against such silly findings.

Perhaps Mr. Bennett understates the case.

“It’s a great teachable moment for how we should process the MRI data,” he said.

As they say in the trades, “We shall see.”

The “mental illness” causes cancer and injury theory

John Hopkins Medicine has a story out, Cancer and Injuries More Likely In People with Serious Mental Illness. Theory has it that this is because people given “serious mental illness” labels belong to an entirely different species than the general run of humanity.

Newswise — People with serious mental illness —schizophrenia, bipolar disorder and disabling depression — are 2.6 times more likely to develop cancer than the general population, new Johns Hopkins research suggests.

Hmmm. Either “serious mental illness”, or the drugs used in the treatment of “serious mental illness”, are carcinogens. Frankly, I’m betting it’s the drugs.

“The increased risk is definitely there, but we’re not entirely sure why,” says study leader Gail L. Daumit, M.D., M.H.S., an associate professor of medicine and psychiatry at the Johns Hopkins University School of Medicine. “Are these people getting screened? Are they being treated? Something’s going on.”

Well, maybe because the drugs being used are carcinogenic. Just like nicotine in cigarettes.

More bad news…

In a separate study, published online last month in the journal Injury Prevention, Daumit found that people with serious mental illness were nearly twice as likely to end up in a hospital’s emergency room or inpatient department suffering from an injury than the general population and about 4.5 times more likely to die from their injuries.

Again I think they should look into the relationship between psychiatric drugs and serious injury. There might be one there . Psychiatric drugs are known to cause serious injury in fact.

Wait. I know. We can’t do that. Think of all the crazies you’d be letting loose on the world. It’s gotta be ‘the disease’, right?

I feel that there is quite a bit less mystery involved in this phenomenon than do the authors of these research studies apparently. This is like the keystone cop holding some offending young punk up by the scruff of the neck, and not seeing him there in front of his nose at all. He’s just one more reason why there are vigilantes in the world today.

Pigeon Feeding ‘Mental Illness’ In Liverpool

The Liverpool City Council issued a report in which pigeon feeding was attributed to “mental illness” according to an article in Today Online, ‘People who feed pigeons are mentally ill’. I think the public outcry over the statement has probably convinced the Liverpool City Council that the statement was a mistake by now.

In a report from Liverpool City Council, the statement said: “Pigeon Feeding – Often undertaken by individuals with mental health needs.”

As a freshly discovered symptom of “mental illness”, I think pigeon feeding has got to be news.

I’ve heard it said that people who lack adequate housing are “mentally ill”, but pigeon feeders? You better watch what you do with that bird seed, and those bread crumbs there, fellow. They can get you into a whole lot of trouble.

The council based the report on a survey taken several years ago, but was unable to provide a copy to back up the claim.

Wouldn’t you know it? There in the park it seems we have here another victim of chronic pigeon feeding disorder. No wonder “mental illness” is said to afflict 1 out of every 5 people in the nation.

A Liverpool council spokesperson said: “The reference in the report relates to a survey carried out by the council about five years ago when it was considering whether to prosecute persistent pigeon feeders.

Ahha! Incorrigible pigeon feeders, no, you’re not innocuous in the slightest, and not only are you bad, but you’re mad as well.

I am Okay. You, on the other hand, are pigeon feeding shrink bait.

This is called the pigeon feeders are “sick”, we did a survey, system of urban planning and renewal.

If any of you other bird brains out there would like to design a stupid survey, maybe we can increase our reported wacko population even further. Increasing that population seems to be on the agenda in all sorts of places these days.

Not to fear, I read pigeon feeding is against the law in San Francisco. Maybe they can pass a law against it in Liverpool, too. Of course, that would make all pigeon feeders criminals.

All the young Scots nutters

The headline in The Scotsman screams, 47% of youth hide mental ill health. Next question, 47 % of what percent? The figure is given as 47 % of 10 % of Scottish youth. Alright. If 10 % of the youth in Scotland are wacko, I suggest that perhaps medicalization, and in particular the medicalization of childhood, and the growing up process, has gotten a little out of hand in that country.

This is part of another “end of stigma” campaign, and so the implicit message behind such campaigning is that young people should not be ashamed to seek counseling.

Meanwhile, just 17% believe young people with mental ill health will recover.

So encourage a kid to seek counseling, receive a diagnostic tag, and a drug prescription, and you’ve probably doomed the kid, or so most psychologically disturbed young people believe, for life. The figure via subtraction is 83 % of these disturbed young people, and treatment experts from first hand experience, believe the absolute worst about this devastating news. These are not good odds, folks.

This line of questioning leads to another question. If the situation is so dire, why have another “end of stigma” campaign? Maybe the kid’s better off untreated.

A fresh campaign has been launched by the organization [See Me] to try to encourage young people to think about their attitude and behaviour towards people of their age with such health issues.

Your mum, your pop, your school, your nation, your spam detector, etc., didn’t think to scare off such treatment salesmen and women? How incredibly (and I mean incredibly) sad!

Either I’m misreading something here, or somebody is over-reacting. Complete recovery can and does occur, believe me! It’s called reaching adulthood.

You, too, can acquire a psychiatric diagnosis!

If the sun has set on the age of Sigmund Freud, it certainly hasn’t set on the age of therapy. The Wall Street Journal just published a “how to” article about the quest some people have made to get, uh, whatever it is they offer. This article bears the heading, Help Wanted: a Good Therapist. Just think…Heaven forbid that one should be caught without a therapist.

Therese Borchard went through 6 shrinks before she came to the one she must have been looking for all along.

Finally, No. 7 diagnosed bipolar disorder, found medication that was effective, helped her to be less hard on herself and “salvaged the last crumb of my self-esteem,” says Ms. Borchard, who writes the popular “Beyond Blue” blog on Beliefnet.com.

Wow! Therapist No. 7 diagnosed her with the immensely popular bipolar disorder! Why am I not at all surprised by this development?…

Next question, is it possible that what she was really looking for was a “disease”? We used to have a word for this sort of thing, a word that has fallen into relative disuse, and that word is hypochondriac.

Patients who aren’t sure what’s wrong with them can be stumped about the type of therapist to call and ill-equipped to evaluate what they’re told during treatment. How well a therapist’s personal style matches a patient’s individual needs can be critical. But experts also say that patients shouldn’t be shy about pressing their therapist for a diagnosis and setting measurable goals.

What’s wrong with them is the big question some patients have, a doctor answers this question by justifying their role, as patients. He gives them a diagnosis, he writes them a prescription, and usually an insurance company takes care of the rest of the deal’s details.

What perfect other might an individual be looking for besides a therapist, and why is the individual more likely to be disappointed there than on the couch? Uh, excuse me, I digress.

If anything has changed, I imagine it’s that the talking cure has given way to the chemical fix.

About 3% of Americans had outpatient psychotherapy in 2007—roughly the same as in 1998—although the percentage taking antidepressants and other psychotropic drugs rose sharply, according to an analysis in the American Journal of Psychiatry last year. The same study found that the average number of visits dropped from nearly 10 in 1998 to eight in 2007.

Then, as I indicated, you’ve got people searching for the right “disease”, I mean, therapist.

By some estimates, one-quarter of the U.S. population has some kind of diagnosable mental illness. But many don’t believe they need help, don’t know how to get it, think they can’t afford it or that it won’t be effective. There’s also the lingering stigma attached to seeing a “shrink.”

Apparently somebody is estimating a large number of nut jobs, but my question is what’s in it for the estimator? One thing I know for certain is that when a lingering “stigma” is attached to seeing a shrink, the shrinks business should do a lot better when it is “eradicated”.

Note we’ve got 2 interesting “stigmas” in the new contemporary treatment lexicon now, and I happen to think they are related. We’ve got the “stigma” attached to having a “mental illness”, and we’ve got the “stigma” attached to seeing a shrink. Few people mention the other 2 “stigmas” affecting contemporary mental health treatment. There are also “stigmas” attached to losing a “mental illness” and not seeing a shrink. I feel certain that many more people would recover from their disabilities, and their shrink tasting habits, if it weren’t for these further “stigmas”.

Some clinics and university mental-health centers offer consultations to help evaluate which treatment might be best. “Patients shouldn’t have to decide this by themselves,” says Drew Ramsey, an assistant clinical professor of psychiatry at New York’s Columbia University, who says he loves to play “shrink matchmaker.”

I don’t think we’re talking a dating service for shrinks here. No, that could get a whole lot of shrinks in a whole lot of trouble, and in more ways than one, of course.

Even close relationships sometimes fail to get at the right issues. Victoria Maxwell, 44, an actress and blogger from Half Moon Bay, British Columbia, says she worked with a therapist for 2½-years as a teenager and liked her enormously. But she never made much progress, because the therapist didn’t recognize Ms. Maxwell’s underlying bipolar disorder. “I became a really insightful depressed person. But it wasn’t helping my depression,” she says.

Remember, if a wrong diagnosis has been made, no matter what it is, its probably bipolar disorder. We call this wrong diagnosing misdiagnosis because “well” people don’t visit shrinks.

Good To Know

Today is Mad Hatter Day. I stumbled across the following explanatory bit of information at Ari Rapkin’s website. His birthday is the day following Mad Hatter Day.

MadHatterDay is a holiday in October. It fills the need for a second crazy day in the year, almost exactly half a year from April Fools’ Day. The real spirit of MadHatterDay is turnabout: The nonsense we usually have to pretend is sane can be called madness for one day in the year; the superficially crazy things that really make sense can be called sane on MadHatterDay.

I guess…

I looked into this matter because a performer is entertaining at an establishment this evening in my locality, and crediting the reason with being it’s Mad Hatter Day.

MadHatterDay is 10/6. The date was chosen from the illustrations by John Tenniel in Alice’s Adventures in Wonderland, wherein the Mad Hatter is always seen wearing a hat bearing a slip of paper with the notation “In this style 10/6”. We take this as inspiration to behave in the style of the Mad Hatter on 10/6 (which is October 6 here, although in Britain MadHatterDay occurs on June 10…but I digress…) Some astute observers have noted that the paper in the Mad Hatter’s Hat was really an order to make a hat in the style shown, to cost ten shillings sixpence. However, it is well known that Time Is Money, and therefore Money Is Time, and therefore 10/6 may as well be the sixth of October.

Alices Adventures go on and on, don’t they? Nonsense prevails.

MadHatterDay began in Boulder, CO, in 1986, among some computer folk who had nothing better to do. It was immediately recognized as valuable because they caused less damage than if they’d been doing their jobs. It was announced that first year on computer networks. In 1987 it gained minor local recognition. In 1988, it was first recognized as an official holiday by an area business, and also received its first national press coverage by news services (who are always desperate for an unlikely story). It is almost certain that the national election also gave MadHatterDay a good boost in 1988.

Good things generally come in threes, don’t they?

My interest in this matter is that I’ve been working on bringing Mad Pride celebrations and a Mad Pride Day to Florida. I would imagine that there could be a relationship between these Mad Hatter Day events and Mad Pride. Mad Pride though is more closely related to Gay Pride, and if you’ve got any questions about that subject, I advise you to do a little research. Mad Hatter Day celebrates silliness. Mad Pride shows up the silliness of seriousness, and the seriousness of silliness, for what they are. There’s a difference. Mad Pride celebrates difference. Mad Pride is completely serious about its silliness.

I read an article recently referring to what it termed the normality of madness. I would like to add that there is generally much madness in what is commonly referred to as normality. I’ve read articles from a certain psychiatrist who would make presidents Kennedy, Lincoln and Roosevelt out to be nuts while seeing sanity in presidents Reagan, Bush, and Nixon. I just don’t think so…AT ALL. Look deeper, and the veneer of normality vanishes. Mad pride says it’s okay to be different. We’re fine with that. We won’t lock you up for it either.

Thinking, not so deeply on the subject at all, maybe Mad Hatter Day would be a good day to schedule a Mad Pride event on in the future.

A Mad Pride Day and a Mad Hatter Day makes a lot more sense to me than a Mental Illness Awareness Day or a Mental Health Awareness Day. Regarding the later pair, take your pick, they’re both the same. I think that that is a day we frankly don’t need to be made aware of. Maybe if we called it Psychiatric Disorder Labeling Day instead that would make more sense. Madness, on the other hand, is fine. If this is your day to go bonkers, make the best of it. We’re with you on this matter.