Helena Hanson is professor and chair of translational social science and health equity and associate director for the center for social medicine at UCLA. As a psychiatrist and anthropologist, she has spent much of her career researching how race, class, gender, and social determinants of health affect psychiatric diagnosis and treatment.

Growing up in 1970's Oakland and Berkeley, California, Hansen witnessed the consequences of deinstitutionalization and mass incarceration policies firsthand. Losing family members to both the prison and mental health systems gave her a personal understanding of the social and structural failures she interrogates in her work today. She also draws on the principles she learned as a participant in AIDS-related activism to mobilize community organizations and champion mutual aid groups in combatting our current mental health crises.

In this interview, Hansen discusses how race and class affect psychiatric diagnoses and subsequent treatment, the moral implications of psychiatric diagnosis, structural competency, and more.

Schizophrenia is a psychiatric diagnosis that carries a heavy social stigma. However, experts have also questioned the validity and utility of the label. In response, some experts and service-user groups have called for different conceptualizations and terms for those experiencing psychotic symptoms.

Doctors Matcheri Keshavan and Raquelle Mesholam-Gately are currently tackling this issue. They recently completed a project in collaboration with the Consumer Advisory Board of Beth Israel Deaconess Medical Center in Boston, MA, examining the benefits and drawbacks of renaming schizophrenia.

Matcheri Keshavan, M.D. is the Stanley Cobb Professor of Psychiatry at Harvard Medical School and Academic Head of Psychiatry and Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center.

Raquelle Mesholam-Gately, Ph.D., is an Assistant Professor of Psychology in the Department of Psychiatry at Harvard Medical School. She is also the director of the Consumer Advisory Board and conducts neuropsychology research in the Psychosis Research Program at the Massachusetts Mental Health Center.

In this interview, they discuss what they learned about the issues surrounding the renaming of schizophrenia in their research with consumers and service users. In particular, they reflect on how this psychiatric diagnosis can impact the therapeutic alliance necessary for effective treatment and the overall quality of life of people diagnosed.

This week we talk with Professor Jim van Os and Doctor Peter Groot about their latest study which looks at the effectiveness of tapering strips to help people get off antidepressant drugs.

Jim van Os is Professor of Psychiatric Epidemiology and Public Mental Health at Utrecht University Medical Centre, the Netherlands and Peter Groot works with the User Research Centre of UMC Utrecht.

They both are involved with the development and study of tapering strips which are pre-packaged, gradually reducing dosage tablets that facilitate tapered withdrawal from psychiatric drugs. In this interview, we discuss their latest research paper which examines tapering strips in real-world use.

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Ursula Read is a research fellow and associate at King's College London. She holds a Ph.D. in anthropology from University College London, where she studied family experiences of mental illness and help-seeking and Ghana. Currently, her research addresses Global Mental Health, and she utilizes participatory research methods to explore the relationship between mental illness and social exclusion internationally.

Her recent work focuses on mental health care in Ghana, drawing attention to the need for rights-based approaches to mental health care. In doing so, she questions the movement for Global Mental Health: asking what this movement is doing currently and imagining what it could become.

Her research brings to light how those in the Global North and high-income countries can overlook what rights-based approaches to mental health care may actually look like when incorporated into Global Mental Health and enacted on the ground. She also is deeply concerned with the structural and social determinants of health and mental health and their interconnection with community resources, places of worship, faith, and overall health promotion.

Michael Ungar is the founder and director of the Resilience Research Centre at Dalhousie University in Canada. He is also a family therapist and professor of social work. He has received numerous awards, such as the Canadian Association of Social Workers National Distinguished Service Award (2012), and has authored around 15 books and over 200 peer-reviewed articles.

Dr. Ungar’s work is globally recognized and centers on community trauma and community resilience. In particular, his work explores resilience among marginalized children and families, especially those involved with child welfare and mental health services, refugees, and immigrant youth.

His research is spread across continents and challenges our traditional notions of trauma and resilience. Analyzing people’s risks and available resources, he scrutinizes simplistic ideas of individual perseverance and grit in the face of trauma. Instead, he implicates the role of context, circumstances, and ill-suited services in contributing to people’s psychological suffering.

Patricia Rush, M.D., M.B.A. is an internal medicine physician whose scientific focus is complex chronic illness.  Her over 40-year career has focused on working with underserved populations and promoting universal access to high-quality medical care. She spent 20 years in the Cook County (Illinois) Health System, including six years as director of their emergency department. From 2000-2008 ran a trauma-informed solo private medical practice in Chicago.

During this time, she completed in-depth interviews with more than 500 patients, which led her to identify a group of high-risk individuals with serious illnesses who also had a consistent pattern of extreme stress at a young age, including profoundly disordered sleep and emotional distress.

Until her retirement, Dr. Rush was also an Associate Professor of Medicine at the University of Chicago and now teaches neurodevelopment as a member of the Physician Workgroup of the Child Trauma Academy.

She was a co-founder and serves as a co-director of the Center for the Collaborative Study of Trauma, Health Equity, and Neurobiology, or THEN, in Chicago. The nonprofit works at the intersection of science education and social justice, exploring and communicating the links between early emotional trauma, inequality, human development, and chronic illness to a network of professionals and the public.

In this interview, she discusses a new and more integrated way to understand and treat physical and mental ailments in people of all ages that has important implications for how we raise our children.

Marcela Ot'alora works with the Multidisciplinary Association for Psychedelic Studies (MAPS) as the principal investigator for government research into MDMA-assisted psychotherapy. In addition to her role as principal investigator, she also worked as a co-therapist during earlier phases of MDMA psychotherapy research and currently leads the MDMA therapy training for MAPS. Ms. Ot'alora also works as a therapist using both ketamine and fine arts to treat trauma.

Ot'alora approaches her work with a humility learned from years of therapeutic experience:  “My clients and the participants in our studies have taught me that their healing looks so different than anything I could have imagined. If I come in leaving that agenda, leaving that bias aside, and being present with whoever is in front of me, they will surprise me every time about how healing works for them.”

In this interview, we discuss her research into MDMA-assisted psychotherapy and how the use of MDMA differs from more traditional substances such as antidepressants. We will also discuss ketamine-assisted therapy, the therapeutic use of fine arts, and the over-prescription of psychiatric drugs.

Michelle Funk is the Unit Head of the Policy, Law, and Human Rights at the Department of Mental Health and Substance Use at the World Health Organization. She has created and leads the WHO Quality Rights Initiative that aims to assess and improve human rights standards in existing services and advance the full implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD).

In this interview, we discuss the launch of the new “Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches.” The document is grounded on the principles of recovery and rights-based approaches. It presents successful examples of best practices in mental health service provision respecting dignity, moving to zero coercion, and eliminating neglect and abuse. Among the best practices showcased in the document are Open Dialogue as practiced in Tornio, Finland, Soteria Berne in Switzerland, Afiya House in Western Massachusetts, Basal Exposure Therapy in Norway, and Hearing Voices Support Groups.

The Guidance builds on the momentum created by the critical voice of Dainius Pūras, former UN Special Rapporteur on the Right to Health. Puras criticized the dominance of the biomedical model in the Mental Health field and highlighted the harms associated with ignoring the social determinants of health that impact a person’s mental health, such as violence, poverty, lack of proper nutrition, housing instability, lack of universal health coverage, discrimination and others.

In our conversation, Michelle Funk described the process of engaging stakeholders and persons with lived experience throughout the design and development of the document, the challenges of ensuring geographical representation given the global inequalities, and the hopes for the future.

Ilana Mountian is a researcher drawing on psychoanalytic, critical, decolonial, and feminist philosophies. She is the author of Cultural Ecstasies: Drugs, Gender, and the Social Imaginary, exploring discourses around drug use, gender, and drug policy. She is currently working on a book that will be published later this year by Routledge about otherness and mental health, focusing on immigration, drug use, and transsexuality.

Mountian is a member of the Discourse Unit, a group led by well-known critical psychologists Erica Burman and Ian Parker. The Discourse Unit is dedicated to providing teaching resources for qualitative and feminist work, producing radical academic work, and developing critical perspectives in action research.

In addition to her work as a researcher, Mountian is a psychoanalyst and a postdoctoral lecturer at the University of Sao Paulo Brazil and Manchester Metropolitan University.

In this interview, she discusses intersectionality and drug use, the disease model of addiction, psychiatric labels, and psychiatry's place in creating “otherness.”

This week on the MIA podcast we are providing the audio taken from our recent psychiatric drug withdrawal town hall held in May 2021.

For our third discussion, we are examining protracted problems that can arise after psychiatric drug withdrawal. Sometimes referred to as post-acute or post-withdrawal syndromes, these experiences can include chronic health problems and sexual dysfunction. What do we know and not know about responding to long- term health problems after coming off psychiatric drugs?

For references and slides mentioned in the discussion, visit this link: https://www.madinamerica.com/pdwref/

Panelists

Adele Framer

Adele Framer resides in San Francisco, USA. A survivor of 11 years of antidepressant withdrawal syndrome, in 2011, under the pseudonym Altostrata, she founded the peer support site SurvivingAntidepressants.org, currently containing more than 6,000 longitudinal case histories from its 14,000 members. A widely recognized patient advocate, she is a lay expert in psychiatric drug tapering and withdrawal syndromes.

Will Hall

Will Hall is a schizophrenia diagnosis survivor and longtime organizer with the psychiatric survivor movement. He is a PhD candidate at Maastricht University and lead researcher on the Maastricht World Survey on Antipsychotic Drug Withdrawal, and author of the Harm Reduction Guide to Coming Off Psychiatric Drugs, as well as host of Madness Radio and a co-founder of the Hearing Voices Network USA.

David Healy

David Healy is a Professor of Psychiatry in the Department of Family Medicine at McMaster University in Hamilton Canada. He has been raising concerns about withdrawal from antidepressants since the mid-1990s and was an expert witness in a successful legal case about withdrawal and dependence in 2004. He figures we have made little or no progress sorting the issues out and now have a major public health crisis on our hands.

Nicole Lamberson

Nicole Lamberson is a physician assistant as well as a patient suffering protracted harm following a rapid medical “detox” from prescribed benzodiazepines/Z-drugs & other psychotropic polypharmacy. She co- founded The Withdrawal Project, serves on the Medical Board of Benzodiazepine Information Coalition, & does outreach for Medicating Normal-The Film.

Hanna Pickard is a Bloomberg Distinguished Professor of Philosophy and Bioethics at Johns Hopkins University. She is also appointed with the William H. Miller Department of Philosophy, the Berman Institute of Bioethics, and the Department of Psychological and Brain Sciences.

Her expertise is deep and spread across a wide variety of disciplines. As an analytic philosopher, she specializes in philosophy of mind, philosophy of psychiatry, moral psychology, and clinical ethics. She also worked for a decade at The Oxfordshire Complex Needs Service, a specialist service in the NHS for people diagnosed with personality disorders and complex needs. Her work tends to address the sticky debates that arise in clinical practice.

She has over 35 academic publications and has co-edited The Routledge Handbook of Philosophy and Science of Addiction. Pickard maintains an important thread between clinical work in the real world and her philosophical writings, attending to topics like the nature of mental disorders, delusions, agency, character, emotions, self-harm, violence, placebos, therapeutic relationships, decision-making capacity, the self and social identity, and attitudes towards mental disorder and crime.

In this interview, she discusses her novel and possibly controversial model for understanding addiction, the numerous shortcomings of the neurobiological model, the importance of centering patient agency, and her work in therapeutic communities.

Katrina Michelle is a psychologist and the founder and director of The Curious Spirit, a transpersonally oriented psychotherapeutic practice that encourages transcendent personal exploration to remedy psychological suffering. She is a holistic psychotherapist currently serving as faculty at Columbia University School of Social Work and The Institute for the Development of Human Arts.

In addition to her practice, she also serves as the director of harm reduction for the Multidisciplinary Association for Psychedelic Studies (MAPS) and formerly worked as the executive director of the American Center for the Integration of Spiritually Transformative Experiences (ACISTE). To demystify awakening experiences through storytelling and art, she is also producing the film When Lightning Strikes.

Beginning in the world of traditional social work, Michelle was drawn to transpersonal psychology after her own spontaneous spiritually transformative experience. She now works to help create communities capable of holding these often difficult experiences, as western societies often lack the language and cultural understanding needed to integrate them into daily life.

In this interview, we discuss the place of psychedelics in psychotherapy, how spiritually transformative experiences can be mistaken for ‘mental illness,’ and the various resistances we have to these experiences.

Hannah Zeavin is a leading scholar investigating how mediated communications and technology impact our intimate relations. Her most recent work tackles teletherapy and digital mental health communications, which have seen a boon throughout the pandemic.

Zeavin is a Lecturer in the Departments of English and History at the University of California, Berkeley, and affiliated with the Berkeley Center for Science, Technology, Medicine, and Society. Zeavin is also a visiting fellow at the Columbia University Center for the Study of Social Difference. She received her Ph.D. from the Department of Media, Culture, and Communication at NYU in 2018.

Her first book, The Distance Cure: A History of Teletherapy, will be published by MIT Press this summer. Zeavin serves as an editorial associate and author for numerous publications, including the Journal of the American Psychoanalytic Association. She is also a co-founder of The Science, Technology, and Society Futures Initiative.

In this interview, she discusses her upcoming books and all things mediated communication, teletherapy, and technology. Zeavin approaches human relationality, including therapy, from the perspectives of literature and media studies. She explores the history of psychoanalysis and other forms of therapy, garnering fresh insights into our relationship with technology and each other–without the usual moral tenor of psychologists.

She also draws upon her research to discuss how care may take unexpected forms through technologies, enabling distanced intimacy and social change that transcends the psychology of the individual. We close by addressing the feminization of care labor, care as a cover for capture and control, and shifts in how we understand care, now and in the future.

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Our next psychiatric drug withdrawal town hall discussion will be held on May 14 2021, register here: https://www.eventbrite.co.uk/e/150023595613

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This week on the MIA podcast we are providing the audio taken from our recent psychiatric drug withdrawal town hall held in March 2021.

This discussion was aired live on March 12, 2021 and the panelists are Dr Giovanni Fava, Dr Peter Groot, Dr Mark Horowitz and Professor Joanna Moncrieff.

For this discussion, we asked what science and research can tell us about the experience of withdrawal. We discuss research effort that has called into question long-held professional beliefs about the effects of psychotropic drugs on the brain and nervous system.

Panelists

Giovanni Fava

Dr Giovanni Fava is Clinical Professor of Psychiatry at the State University of New York at Buffalo. He has authored more than 500 scientific papers and performed groundbreaking research in several fields. He is editor-in-chief of the journal Psychotherapy and Psychosomatics.

Peter Groot

Dr Peter Groot is a researcher who started using antidepressants. His own experiences helped him to develop a practical solution proposed by many patients to help prevent withdrawal problems from antidepressants and other psychotropic drugs.

Mark Horowitz

Dr Mark Horowitz is a training psychiatrist and psychiatric academic at University College London who is currently coming off psychiatric drugs. His work and research focuses on how to safely stop psychiatric medication.

Joanna Moncrieff

Dr Joanna Moncrieff is a psychiatrist based in community mental health services in North East London. She also teaches and researches at University College London. Joanna is one of the founding members and the co-chairperson of the Critical Psychiatry Network.

This episode of “Mad in the Family” discusses the links between nutrition and mental health, and the science that’s showing that diet may help improve or even prevent mental health issues in children and adults.

Julie Rucklidge: "Taking a one-a-day gummy bear might prevent you from getting scurvy, but it's not meeting the optimal amount that your brain needs.”

Julia's interest in nutrition and mental health grew out of her own research showing poor outcomes for children with psychiatric illness despite conventional treatments. In the last decade, the Mental Health and Nutrition Research Group has been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of issues such as ADHD, mood disorders, anxiety, and stress associated with traumatic events, such as earthquakes and mass shootings.

Julia's interest in nutrition and mental health grew out of her own research showing poor outcomes for children with psychiatric illness despite conventional treatments. In the last decade, the Mental Health and Nutrition Research Group has been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of issues such as ADHD, mood disorders, anxiety, and stress associated with traumatic events, such as earthquakes and mass shootings.

With her colleague Bonnie Kaplan, Ph.D., she is the author of a new book, The Better Brain: Overcome Anxiety, Combat Depression, and Reduce ADHD and Stress with Nutrition, which will be published April 20 by Houghton Mifflin Harcourt.

Anne Guy is a member of the council for evidence-based psychiatry (CEP) and works with the secretariat for the All-party Parliamentary Group for Prescribed Drug Dependence. She's the lead editor and author of “Guidance for psychological therapists: enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs.” (an abridged version can be found here). This guide is endorsed by the British Association for Counseling and Psychotherapy, the UK Council for Psychotherapy, the National Counseling Society, and the British Psychological Society. Dr. Guy is also a practicing psychotherapist that does not rely on a model of diagnosis to help her clients.

Beginning as a claims manager for an insurance company, she got an up-close view of how the healthcare system worked and saw the biggest problems clearly. This “systems view” followed her into her work as a psychotherapist, where she attempts to navigate systemic failures that have resulted in the over-prescription of psychiatric drugs.

In this interview, we will discuss withdrawal from psychiatric medications, problems with psychiatry's over-reliance on the biomedical model, the difference between “addiction” and “dependence,” and counseling beyond diagnosis. She notes that while withdrawal can be difficult, not everyone will experience it as severely as described—for example, research shows that 50% of people coming off antidepressants are likely to experience some kind of withdrawal reactions, with half of those describing them as ‘severe.’ Most reactions last weeks or months with a small group of people experiencing them for years.

Peter Sterling, now retired from the University of Pennsylvania, is a well-known neuroscientist, having co-authored a popular text, Principles of Neural Design. He is a lifelong political activist, and historians of psychiatry may remember his public criticisms of psychiatric treatments in the 1970s, most notably of electroshock and antipsychotics.

He could also be described as an ethnographer, as his travels among the indigenous people of Panama, where he now lives part-time, influenced his understanding of how the human brain was shaped in response to the demands of early hunter-gatherer societies.

He is the author of a recent book titled, What is Health: Allostasis and the Evolution of Human Design. His books raises this provocative question: What does our species require for a healthy life? And can we achieve this with drugs?

Bethany Morris is an assistant professor of psychology at Point Park University in Pittsburgh, Pennsylvania, where she teaches and does theoretical and qualitative research. Dr. Morris is a transdisciplinary scholar whose work bridges critical psychology, literature, philosophy, history, psychoanalysis, and film studies.

Early in her career, at Prince Edward Island University and Brock University in Canada, she studied alternative anti-psychiatric interventions for early-onset schizophrenia as illuminated by children’s literature. During this time, she was also thinking critically about issues of women’s stigmatization and oppression.

In recent years, her work has focused on using the ideas of French psychoanalyst Jacques Lacan to gain a further critical understanding of the oppression of women, psychology’s medical model, and other issues related to social justice.

Her recent publications include the co-authored book Subjectivity in Psychology in the Era of Social Justice, as well as her first solo-authored book, Sexual Difference, Abjection, and Liminal Spaces. Throughout her work is a sustained critique of Borderline Personality Disorder, both as a diagnostic category and the way that it is used toward misogynistic ends in popular culture.

This week on the MIA podcast, we discuss a recent paper that considers the support provided by online support groups when people seek help for psychiatric drug withdrawal. The paper is entitled ‘The role of Facebook groups in the management and raising of awareness of antidepressant withdrawal: is social media filling the void left by health services?’ It was published in the journal Therapeutic Advances in Psychopharmacology in January 2021 and the authors are Sherry Julo, Ed White and John Read.

Actor, singer, writer, and civil rights activist Donzaleigh Abernathy is goddaughter of the Reverend Dr. Martin Luther King, Jr., and daughter of the Reverend Dr. Ralph David Abernathy, King's best friend and partner in the civil rights movement — who co-founded the Southern Christian Leadership Conference and became president of it after King's assassination on April 4, 1968. Her mother was civil rights activist Juanita Abernathy.

As a child, Abernathy witnessed some of the most inspiring and formative moments of the civil rights movement — and some of the most sobering. She also grew up knowing and loving the man she called Uncle Martin, whose stances against racism, poverty, and war remain as relevant today as they were when he first voiced them. Also relevant are his calls for creative maladjustment, meaning the refusal to adjust to society's many ills.

Abernathy is the author of Partners to History: Martin Luther King, Ralph David Abernathy and the Civil Rights Movement. She also contributed to the Smithsonian Institute’s In the Spirit of Martin.

As an actor, she's known for her many roles in films — such as the civil war drama Gods and Generals — and many series, including the Lifetime drama Any Day Now and zombie-apocalypse series The Walking Dead. In addition, she is the lead soloist in a new choral piece, The Listening, composed by Cheryl B. Engelhardt for the Voices 21C Choir in New York City. It’s inspired by an anti-war speech King delivered exactly one year before his death, and it’s been released as a single and a video.

Helen Spandler is a Professor of Mental Health Studies at the University of Central Lancashire in the UK. She is the managing editor of Asylum, a non-profit radical mental health magazine.

She currently holds the Welcome Trust Investigator Award and is the principal investigator on a new research project about the role of MadZines (comics and graphic memoirs created by people with lived experience of psychosocial disabilities) in contesting mental health knowledge and practice.

With over four books and 40 publications to her name, professor Spandler has applied her expertise to a wide range of concerns. She has written about the psychiatric survivor movement, alternate interventions such as therapeutic communities, psychosocial disability, and grassroots activism concerning patient rights.

In this interview, she discusses the importance of placing human suffering before theoretical preferences. She argues that understanding truly listening to psychiatric survivors requires us to get accustomed to uncomfortable truths.

This week on the Mad in America podcast we turn our attention to prescription-drug-induced akathisia and joining me to discuss this is Jill Nickens. Jill is the president and founder of the Akathisia Alliance for Education and Research, a nonprofit organization formed by people who have personal experience of akathisia.

The group includes biochemists, psychologists, nurses, attorneys, business owners, and others who have survived akathisia, suicidality and devastating personal losses due, in part, to a lack of awareness by medical professionals. They have come together to inform and raise awareness to help minimize the risk of developing akathisia.

Akathisia is an extremely distressing neurological disorder that causes severe agitation, an inability to remain still and an overwhelming sense of terror. It is primarily caused by prescribed medications and the most common offenders are anti-psychotics, antidepressants, anti-nausea medications and antibiotics.

Janice Haaken is a professor emeritus of psychology at Portland State University, a clinical psychologist, and a documentary filmmaker. In addition to her work as a professor at Portland State University, Haaken has taught as a Fulbright scholar at Durham University (UK) and University College Cork (Ireland) and as a visiting professor at London School of Economics (UK), York University (UK), and University of Michigan Ann Arbor.

Her documentaries, including Guilty Except for Insanity (2009), Mind Zone: Therapists Behind the Front Lines (2014), Milk Men: The Life and Times of Dairy Farmers (2016), and Our Bodies Our Doctors (2019), focus on people and places on the social margins, drawing out their insights on the world around them. Jan has received numerous awards for her filmmaking, most recently the Lena Sharpe Persistence of Vision award at the 2019 Seattle International Film Festival.

Haaken publishes extensively in psychoanalysis and feminism, the history and politics of diagnosis, trauma, culture, and memory, and the dynamics of storytelling. In addition to Pillar of Salt: Gender, Memory and the Perils of Looking Back(2000) and Hard Knocks: Psychology and the Dynamics of Storytelling (2010), her new book is called Psychiatry, Politics, and PTSD: Breaking Down (2021).

In this interview, she discusses her background in anti-psychiatry and other social movements and her experience liaising between theory and praxis in feminist movements, Occupy Wall Street, Black Lives Matter, and #MeToo. Weaving a history of how both radical and normative ideas and diagnoses in mental health play out in social movements, Jan draws upon her books and films to discuss how activists and mental health professionals alike can better reflect upon their practices and the role they play within larger social systems. We close by following her recent work, which unpacks the benefits and drawbacks of the PTSD diagnosis for personal narratives, collective memory-making, the US military, NGOs, and global mental health critics.

This episode of “Mad in the Family” focuses on a non-drug method to bringing out the best in challenging children, particularly those diagnosed with “ADHD.” It is called the Nurtured Heart Approach® and its essence is that, in the words of our guest, “the same intensity that drives people crazy is actually the source of a child’s greatness." He is the approach’s creator, family therapist Howard Glasser.  Glasser has been called “one of the most influential living persons working to reduce children’s reliance on psychiatric medications” and is the author of the bestselling book, Transforming the Difficult Child and more than a dozen other books.

Glasser is also the Founder of the Children’s Success Foundation, whose  mission is to advance the work of the Nurtured Heart Approach by conducting training programs to support parents in building Inner Wealth® in their children, educators in formally implementing the approach in school systems, and therapeutic professionals to meet the unique mental health needs of “intense” children. A frequent keynote speaker at conferences  on treatment and education, he currently teaches certification trainings on his method, as well as in Dr. Andrew Weil’s program at the University of Arizona’s School of Integrative Medicine.

http://www.howardglasser.com/

https://childrenssuccessfoundation.com/

Lucas Richert is the George Urdang Chair in the History of Pharmacy at the University of Wisconsin, Madison, and historical director for the American Institute of the History of Pharmacy. His work explores prescription and illicit drugs, the American counterculture, and the influence of various power structures within and beyond psychiatry.

As a scholar of the pharmaceutical industry, Richert encountered a trove of historical documents that talked about the self-described radicals in mental health from the 1970s. “They cared about relevant issues, things that we talk about right now: racism, the environment, militarism, and political division. It really grabbed hold of me when I got these documents, they were a catalyst.” This project turned into his 3^rd book, Break on Through: Radical psychiatry and the American counterculture in which he examines the tumultuous 1970s in America with a focus “not just on the elite doctors and people in positions of power, but also wider societal trends.”

In addition to Break on Through, Richert has published A Prescription for Scandal: Conservatism, consumer choice, and the food and drug administration during the Reagan era and Strange Trips: Science culture, and the regulation of drugs. His fourth book, Cannabis: Global Histories, will be available later this year (2021).

In this interview, we will discuss the radical landscape of American psychiatry in the 1970s, “therapeutic” and “non-therapeutic” drugs and how they are classified as such, and feminist critiques of psychiatric institutions.

This week we are sharing the audio taken from our recent psychiatric drug withdrawal town hall held on January 15th 2021.

This was our initial, scene-setting discussion and the panelists are Adele Framer, also known as Alto Strata founder of surviving antidepressants, Luke Montagu, co-founder of the Council for Evidence-based Psychiatry, Swapnil Gupta, a psychiatrists with a specila interest in deprescribing and John Read, Professor of psychology and Chair of the International Institute for Psychiatric Drug Withdrawal.

This series aims to explore what we do and don’t know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants. We will seek to present and explore new understandings that are emerging from the professional and lived-experience communities. We will discuss the knowledge, skills and experience necessary to support those who may be having difficulty getting off psychiatric drugs. We will address questions of interest to both prescribers and patients alike.

Our next even in the series will be held on March 12th 2021 and registration details will be available on Mad in America in early February.

Mad in America, in partnership with the Council for Evidence Based Psychiatry and the International Institute for Psychiatric Drug withdrawal is arranging a series of free to attend online town hall discussions on psychiatric drug withdrawal.

We aim to explore what we do and don’t know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants.

We will discuss the knowledge, skills and experience necessary to support those who may be having difficulty getting off psychiatric drugs.

By doing this we hope to stimulate further discussion between service users and prescribers.

Our first discussion will be held on Friday January 15th at 10 AM Pacific time, 1 PM Eastern time and 6 PM GMT.

The panellists for the first discussion are Adele Framer, founder of Surviving Antidepressants; Swapnil Gupta, a Board Member of the International Institute for Psychiatric Drug Withdrawal and a psychiatrist with a special interest in deprescribing; John Read, Professor of Psychology and Chair of the International Institute for Psychiatric Drug Withdrawal; and Luke Montagu, co-founder of the Council for Evidence-based Psychiatry and member of the NICE guideline committee for safe prescribing and withdrawal.

To register for the first discussion, visit madinamerica.com and use the link at the bottom of the home page or click here:

https://bit.ly/psych-drug-withdrawal

We hope that these discussions will add to an increasingly detailed collection of knowledge and experiences that can inform prescribers when providing informed consent and when implementing gradual tapering regimes.

We very much hope you can join us.

Thomas Teo is a Professor of Psychology in the Historical, Theoretical, and Critical Studies of Psychology Program at York University, Toronto, Canada. He has spent his 20+ year career challenging the status quo in academic psychology. His unique approach to research has been described as both critical and meta-psychological. He often takes the discipline of psychology itself, including its methods and assumptions, as the target of his analysis.

He is currently the co-editor of the Review of General Psychology (Sage), editor of the Palgrave Studies in the Theory and History of Psychology, and co-editor of the Palgrave Studies in Indigenous Psychology. He is the former president of the International Society for Theoretical Psychology, of the American Psychological Association’s Society of Theoretical and Philosophical Psychology (Division 24), and former chair of the History and Philosophy of Psychology Section of the Canadian Psychological Association. He has a research record with more than 200 academic publications and refereed conference presentations.

In this interview, Teo expounds upon concepts covered in a recent Science News Article and explains what it means for him to be a critical psychologist. He outlines how, as he became disappointed with the general state of psychology in Western Europe and the Americas, he sought alternative approaches that could better account for how culture, society, and economics are entangled with psychology. This led him to look more closely at historical examples of fascism, as well as postcolonial authors, to better understand how the psychosocial dimensions of social power operate in the world today. As he explains, this has important implications for how we think about psychiatry, mental health, and disability.

Teo concludes the interview by foreshadowing some of his future work, which will further build on his concept of subhumanism to examine how subjectivity is shaped by the premium placed on certain lives. In contrast, others are constructed as less-than-human under neoliberal capitalism.

Piers Gooding is a Mozilla Foundation fellow (2020) and researcher at the Melbourne Social Equity Institute at the University of Melbourne Law School. His main interests are disability law and policy, international human rights law, the law and politics of mental health, and empirical legal research.

Gooding describes his scholarship as an interdisciplinary undertaking that blends theoretical inquiry with applied qualitative research at the local, national, and international levels. He has collaborated with the UN Special Rapporteur for the Rights of Persons with Disabilities and the World Psychiatric Association on recommendations for alternatives to coercion in mental health. He blogs at https://pgooding.substack.com/ and tweets at @p_gooding.

In this interview, he discusses his journey pursuing a human rights agenda in mental health. We focus on his efforts to marry international human rights law and the work of disability rights committees to ensure that people with psychosocial disabilities are not left out. He then talks about his longstanding work to prevent coercion in mental health and its connection to the digital, data-driven direction taken by the field as a whole. He elaborates the regulatory and ethical issues he has uncovered in his research at the intersection of mental health services and data-driven technologies and gestures at emerging methods of “algorithmic accountability” for addressing some of these issues.

Jennifer White is one of the founders of the Critical Suicidology Network, a growing international network of scholars interested in exploring alternatives to biomedical approaches to suicide prevention. Critical suicidology brings together persons with lived experience, mental health professionals, researchers, and activists “to rethink what it means to study suicide and enact practices of suicide prevention in more diverse and creative, less psycho-centric and less depoliticized, ways.”

She is a Professor in the School of Child and Youth Care at the University of Victoria in British Columbia, Canada. She has practiced as a counselor, educator, researcher, and advocate. White served for seven years as the Director of the Suicide Prevention Center in the Department of Psychiatry at the University of British Columbia.

She has written numerous articles and book chapters on suicide and self-harm and has co-authored two books: Child and youth care: Critical perspectives on pedagogy, practice and policy (2011), and Critical suicidology: Transforming suicide research and prevention for the 21st century (2016). Her current research focus centers itself around the contemporary discourse of youth suicide prevention, seeking alternatives to one-size-fits-all approaches.

She is currently leading a Wise Practices for Life Promotion project funded by the First Nations and Inuit Health Branch (FNIHB) of Health Canada. This project seeks to curate a series of wise practices for promoting life based on what is already working and/or showing promise in First Nations communities across the country. She is also conducting a study with family counselors to learn more about the challenges and opportunities they face with youth suicide prevention and the organizational conditions that support them to be most effective in their work. 

Tanya Luhrmann is a Watkins University Professor in the Anthropology Department at Stanford. Her work explores how cultural contexts shape the experience of mental distress, particularly voice-hearing and the symptoms associated with psychosis. She also turns the lens on the practice of Western psychiatry itself, investigating how the field represents the mind and how these representations influence our collective understanding of reality.

Luhrmann’s book When God Talks Back was New York Times’ Notable Book of the Year, and she has written numerous articles on psychosis, medical anthropology, and spiritual experiences. Recently, Our Most Troubling Madness: Schizophrenia and Culture was published by the University of California Press. Her newest book, How God Becomes Real: Kindling the Presence of Invisible Others, was published by Princeton in 2020.

Luhrmann describes herself as someone who is interested in different types of “realnesses.” Given that she grew up surrounded by different worldviews, it is not surprising that her work reflects this diversity of interests. It spreads across academic fields and geographical terrain – from anthropology to psychiatry on one side and Chicago to Chennai on the other. Throughout these writings, she has challenged many assertions of mainstream psychiatry, often to the annoyance of leading figures in the field.

In this interview, she talks about the damaging effects of a diagnostic identity and the often-unseen challenges that peer counselors can face. She also takes on big questions: What does it mean when a person with high scores on psychosis scales is functional in one culture but not in another? Are auditory hallucinations shaped by cultural experiences? Are they always a source of distress?

dele Framer, also known by her online handle Altostrata, is the founder of SurvivingAntidepressants.org, a critical and comprehensive peer-support website that features several thousand case histories of psychiatric drug withdrawal. The site is a hub of information on the topic, highlighting methods of safe drug tapering and recovery and underscoring the humanity of those in the grips of withdrawal.

Framer arrived at her expertise through personal experience. In 2004, after three years on 10 mg of paroxetine, she went off under medical supervision and suffered symptoms of withdrawal that her doctor discounted as relapse. She then went on to visit more than 50 psychiatrists, trying and failing to find someone knowledgeable in antidepressant withdrawal. Her own research into the topic, including close readings of journals and FDA recommendations, led her to the creation of SurvivingAntidepressants.org in 2011.

Registered members now stand at roughly 14,000, with around 56,000 visitors per month. The site features 6,000 case histories and contains more than 60 topics covering tips on the gradual tapering off of specific drugs. All of the site’s information is pulled from scientific papers, governmental advisories, and package inserts, and much of it has been shared across Facebook and other platforms on the web. The site has received mentions in scientific journals and mainstream outlets such as Psychiatric Times and Psychology Today.

Framer, who grew up in New York, has lived in San Francisco for more than 40 years. She’s now retired from a career in software user design.

Natalie Campo, MD, is an integrative psychiatrist practicing in Nashville, TN. She became interested in holistic treatment modalities in her first year of medical school at the University of Texas. In that same year, she was awarded an NIH grant to study infectious encephalitis in the Amazon Jungle. Upon her return, she sought out a physician whose primary care practice included holistic modalities, nutrition, and acupuncture. During medical school, on an externship, she started studying mindfulness and began using it with patients.

After medical school, Campo trained in psychiatry at Yale and in medical acupuncture at Harvard. She obtained certifications from the American Board of Psychiatry and Neurology and the American Board of Integrative and Holistic Medicine. For many years, she taught alternative, holistic, and natural treatment options for anxiety and PTSD as a Yale faculty member.

Campo currently resides in Nashville, where she serves as a Clinical Assistant Professor at Vanderbilt and provides consultation to the Osher Center of Integrative Medicine. In May of 2017, she participated in the World’s First Congress of Integrative Medicine in Berlin, Germany. She started her practice in Nashville called Mindful Medicine in 2011 to bring safe, effective treatments to people seeking relief from anxiety, depression, addiction, and the stress of a hectic lifestyle.

Kirk Schneider is currently running for President of the American Psychological Association (APA). He is a licensed psychologist and adjunct faculty at Saybrook University and Teachers College, Columbia University. He is well-known as the leading spokesperson for integrative, existential, and humanistic approaches to psychology, which emphasize the therapeutic relationship and the importance of confronting the deep paradoxes of being human, and the conflicts that arise from them, in psychotherapy.

He has authored or co-authored thirteen books, including the Wiley World Handbook of Existential Therapy, The Spirituality of Awe: Challenges to the Robotic Revolution, The Polarized Mind: Why It's Killing Us and What We Can Do About It, and, most recently, The Depolarizing of America: A Guidebook for Social Healing. Many trainees in counseling and clinical psychology will recognize Schneider from the APA Psychotherapy Training video series featuring his therapy work.

Schneider is campaigning to serve as President of APA to "to address the existential crises that are now flaring all about us." As he puts it:

In this interview, Schneider discusses his path into psychology, including his own struggles and growth, his approach to psychotherapy, and his scholarship on the psychology of awe and the polarized mind. Then we turn to his vision for psychology; a "whole-person" approach to healthcare, a "Psychologist General" of the United States, and the development of dialogue groups that address polarization and division.

Ronda "Ro" Speight is a mental health peer specialist and recovery advocate at the Mental Health Association of Westchester in Westchester County, New York. She is a person with lived experience with the psychiatric system and a trained co-facilitator in an innovative approach that combines peer support and principles of the Open Dialogue approach called Peer Supported (Partnered) Open Dialogue (POD). POD is currently being tested in a large randomized clinical trial in the UK.

Ro was a service recipient in the Parachute Program NYC, which provided mobile crisis services and implemented respite centers in New York City—combining Intentional Peer Support and Open Dialogue informed practices. The Parachute program was discontinued, but the peer respite model it introduced in New York continues to exist. Her engagement with peers in Parachute shaped her views on mental health care and inspired her to pursue a career as a peer specialist.

Identifying as a person of color, Ro was profoundly affected by her mother's professional success as a clinical social worker who holds a doctoral degree from the University of Pennsylvania. She is highly aware of the obstacles women of color face in society and brings a racial justice perspective to the highly innovative practice of Peer Supported (Partnered) Open Dialogue.

This week on MIA Radio we interview Dr. Stuart Shipko. Dr. Shipko is a psychiatrist in private practice in Pasadena, California and author of the books Surviving Panic Disorder, Xanax Withdrawal and Dr. Shipko’s Informed Consent for SSRI Antidepressants.

Stuart has over 30 years' experience as a psychiatrist and an extensive background in the psychotherapies. He writes for Mad in America on issues relating to SSRI withdrawal and he has a particular interest in the side effects and withdrawal effects of antidepressants and benzodiazepines and the need for informed consent when prescribing.

We discuss: SSRI withdrawal, Tardive Akathisia, informed consent and psychiatric drug tapering.

***

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This episode of “Mad in the Family” focuses on how adolescents can better manage and even overcome anxiety—something the news media and our own eyes tell us so many young people these days are struggling with.

Our guest is Jodi Amen, LCSW, a psychotherapist and coach who has more than 20 years of experience working with children, their parents, and helpers. A graduate of Columbia University School of Social Work, she has studied and taught Narrative Therapy around the globe and speaks to conferences, schools, and universities. Jodi is also trained in using complementary and alternative modalities including Ayurveda, mindfulness, yoga, energy healing, and herbalism.

A TEDx speaker and YouTuber, she is also a best-selling author. Her books include You 1, Anxiety 0, and most recently Anxiety....I'm So Done With You: A Teen’s Guide to Ditching Toxic Stress & Hardwiring Your Brain For Happiness(Skyhorse Publishing).

Jodi has a private practice in Rochester, New York, and is the mother of teenagers.

Nikolas Rose is a professor of Sociology in the Department of Global Health and Social Medicine at King's College London. His work explores how concepts in psychiatry and neuroscience transform how we think about ourselves and govern our societies.

Initially training as a biologist, Rose found his subjects unruly: "My pigeons would not peck their keys, and my rats would not run their mazes. They preferred to starve to death." He moved on to study psychology and sociology and has become one of the most influential figures in the social sciences as well as a formidable critic of mainstream psychiatric practice.

A prolific writer, Rose has over fifteen books to his name, including, most recently, Neuro with Joelle Abi-Rached (2013) and Our Psychiatric Future (2018), addressing the most pressing controversies in the fields of neuroscience and psychiatry. He is also a former Managing Editor of Economy and Society and Joint Editor-in-Chief of the interdisciplinary journal, BioSocieties.

Throughout his work, Rose emphasizes that one must look beyond origins, or "why something happened," and focus instead on the conditions under which ideas and practices emerge. The answers may not be comforting or straightforward, but they can help us to avoid band-aid solutions to complex problems.

Rose builds on the work of philosopher Michel Foucault to reveal how concepts in psychiatry and psychology go beyond explanation to construct and construe how we experience ourselves and our world. Consistent with Foucault's oft-quoted adage, "My point is not that everything is bad, but that everything is dangerous," Rose's work avoids simplistic explanations of why and how the mental health fields go awry and instead examines how injustices can happen without unjust people. In this way, his work often transcends critique and imagines new possibilities and ways of thinking about "mental health," "normality," "brains and minds," and, ultimately, the selves we might yet become.

Jussi Valtonen is both a novelist and a psychologist. As a novelist, his work has been compared to both George Orwell's 1984 and Aldous Huxley's Brave New World for the way it weaves together social commentary and science fiction to jolt readers into confronting difficult questions about the soon-to-come worlds we are creating in the present. His research as a psychologist investigates how changes to the human brain impact how we think, experience, and make sense of the world. This includes recent investigations of the role of psychiatric drugs and polypharmacy on cognitive decline and functional impairment.

Valtonen is from Helsinki and studied English, philosophy, and psychology in Finland before coming to the US to study neuropsychology at Johns Hopkins University and NYU.  He was also trained in screenwriting at the University of Salford in the UK and has worked as a journalist and science reporter.

He has written three novels and a short story collection. Carried by Wings (2007) was given second place in Bonnier's novel competition, and received a warm reception from both critics and bloggers. Valtonen's recent book, They Know Not What They Do (2014), won the Finlandia Prize, Finland's highest literary honor.

In this interview, Valtonen discusses how he found psychological science and literature to complement one another, the blind-spots in current psychiatric practice that harm patients, and how novels can help us to ask questions about the world we're creating.

This episode of the “Mad in the Family” podcast discusses the role of human interaction in child development. Specifically, how conflict and miscommunication between parent and child is not only O.K., but crucial to a young person’s social and emotional development. According to our guest, Dr. Claudia Gold, the “messiness” of our relationships is exactly what helps us build trust, resilience, and a solid sense of self in the world. That is the subject of her latest book, which she discusses with us.

Claudia Gold, M.D., is a pediatrician, infant-parent mental health specialist, author, teacher, and speaker based in western Massachusetts.

Dr. Gold practiced general and behavioral pediatrics for more than 25 years, focusing on a preventative model, and now specializes in early childhood mental health. She’s also the director of The Hello It’s Me Project, a rural community-based program designed to promote healthy relationships between infants and their caregivers.

In addition, she works as a clinician with FIRST Steps Together, a federally funded program for pregnant and parenting women with opioid-use disorders, and as an infant-parent mental health consultant at Volunteers in Medicine, Berkshires.

Dr. Gold serves on the faculty of the Infant-Parent Mental Health Fellowship Program at the University of Massachusetts—Boston, the Brazelton Institute at Boston Children’s Hospital, and the Berkshire Psychoanalytic Institute.

She is the author of four books on child psychology and development: Keeping Your Child in Mind, The Silenced Child, The Developmental Science of Early Childhood, and most recently, The Power of Discord, written with Dr. Ed Tronick and published in June 2020.

Claudia is the author of numerous articles, including Mad in America blogs, presents regularly for audiences of both parents and professionals around the world.

Ian Tucker is a professor and director of impact and innovation in the school of psychology at the University of East London. His expertise is in digital media, emotion, and mental health, he has published over 45 articles and book chapters and has a monograph book entitled Social Psychology of Emotion. He is currently authoring an Emotion in the Digital Age monograph for Routledge's Studies in Science, Technology, and Society series while working on several projects involving technology and mental health. 

In this interview, we discuss how Ian became interested in studying relationships between technology, emotion, and mental health. He addresses some limitations of traditional psychological approaches to these topics and overviews some of his main areas of concern with how digital technology is being used to track people’s emotions and regulate their mental health.

Drawing on philosophers like Gilbert Simondon and Henri Bergson, Ian also explores how digital technologies are being used within peer-to-peer communities to create information archives about experiences with distress and medication in ways that offer collective support. 

For our second interview for this World Benzodiazepine Awareness Day podcast I'm so pleased to get the chance to chat with Baylissa Frederick.

Baylissa is a psychotherapist, coach, and author with two decades of experience working with people from all over the world. She holds a Master's degree in therapeutic counseling and is involved in helping people affected by prescribed antidepressants tranquilizer and opiate physical dependence and withdrawal.

Baylissa is the author of the internationally successful self-help book Recovery and Renewal, the memoir With Hope in my Heart and two journals; Dearest Me and Dearest Friend. Baylissa herself was prescribed the benzodiazepine clonazepam, also known as Klonopin, for a form of dystonia, an involuntary movement disorder and she survived an intense withdrawal experience when coming off. She is now fully recovered and dedicates her time to helping and supporting others.

This week on MIA Radio, we present the second part of our podcast to join in the events for World Benzodiazepine Awareness Day 2020 (W-BAD). In part one, we interviewed Angela Peacock and talked about her experiences of taking and coming off benzodiazepines and also her involvement in the film Medicating Normal, which has a special screening and panel discussion on July the 11th at 1:00 PM EST.

And before we go on, I just wanted to say that these podcasts would not be possible without the efforts of W-BAD lead operations volunteer Nicole Lamberson, who goes above and beyond to make these interviews possible. Later in this episode, we will hear from Baylissa Frederick, who is a therapeutic coach and psychotherapist with over two decades' experience working with clients affected by prescribed drug injury. But before we chat with Baylissa, I'm delighted to get the chance to talk with clinical pharmacologist Dr. Jim Wright.

Jim is Emeritus Professor in the Departments of Anesthesiology, Pharmacology, and Therapeutics in Medicine at the University of British Columbia. Jim obtained his MD from the University of Alberta in 1968, and his PhD in pharmacology from McGill University in 1976. He is a practicing specialist in internal medicine and clinical pharmacology. He is also Editor in Chief of the Therapeutics Letter and he sits on the editorial boards of PLoS One and the Cochrane Library. Dr. Wright’s research focuses on issues relating to the appropriate use of prescription drugs, clinical pharmacology, clinical trials, systematic review, meta-analysis, and knowledge translation.

This week on MIA Radio we present a special episode of the podcast in advance of the events being held to mark World Benzodiazepine Awareness Day, July 11, 2020.

The reason we are sharing this interview early is to help draw attention to a special screening of the film Medicating Normal which will be shown on World Benzodiazepine Awareness Day itself. Following this special screening of the film, there will be an online panel discussion featuring people with lived experience of taking and coming off benzodiazepines. If you haven’t yet seen the film, this screening is not to be missed. The film will be shown at 1 pm EST on July 11 and you can get tickets here.

The film is presented by the Benzodiazepine Information Coalition, a non-profit organization that strives to educate about the potential adverse effects of benzodiazepines taken as prescribed and the Periscope Foundation which is a non-profit organization that funded the making and continues the outreach of Medicating Normal.

For our interview this week I am delighted to get the chance to chat with Angela Peacock who appears in the film and will be a panel member for the online discussion.

Angie served in the US Army from 1998-2004 and was medically retired after one tour in Iraq. She was medicated for post-traumatic stress since that time, going on and off benzodiazepines several times under a doctor’s care until coming off for the final time in January 2016.

She holds a Bachelor of Science in psychology and graduated in May 2019 from Washington University in St. Louis- Brown School of Social work with a Masters in social work. As a 2019 Veterans of Foreign Wars-Student Veterans of America, Legislative Policy Fellow, she is advocating for change in Benzo policy at the Department of Veterans Affairs. She is embarking on a community outreach effort to improve medication and health literacy among military veterans and their family members.

Angie chats about her experiences of being prescribed benzodiazepines, her journey off multiple medications, her continuing work in veterans advocacy and her thoughts about the film Medicating Normal.

Medicating Normal special screening and panel discussion

World Benzodiazepine Awareness Day

Benzodiazepine Information Coalition

Three Suicides: Honoring Lives Lost to Benzodiazepines

The Many Battles of a Benzo Injury: Jean’s Story

MIA’s Justin Karter interviews psychiatrist Awais Aftab about how “conceptual competence” uses philosophy to transform psychiatry.

Awais Aftab is a psychiatrist in Cleveland, Ohio, and Clinical Assistant Professor of Psychiatry at Case Western Reserve University.

He is a member of the executive council of the Association for the Advancement of Philosophy and Psychiatry. He has been actively involved in initiatives to educate psychiatrists and trainees on the intersection of philosophy and psychiatry.

He leads the interview series Conversations in Critical Psychiatry for Psychiatric Times, which explores critical and philosophical perspectives in psychiatry and engages with prominent commentators within and outside the profession who have made meaningful criticisms of the status quo. He is also a member of the Psychiatric Times Advisory Board.

In this interview, he explores his journey into both philosophy and psychiatry and how he understands the relationship between these two disciplines. Aftab goes on to discuss how he began the critical psychiatry interview series and what he has learned from this experience and the pushback he has received. He then elaborates on how studying the philosophical issues in psychiatry, through a “conceptual competence” curriculum, could transform the doctor-patient relationship and improve mental health care.

This week on MIA Radio we turn our attention to electroconvulsive therapy (known as electroshock in the US). It’s fair to say that ECT remains a controversial subject with proponents and detractors regularly disagreeing on its safety and efficacy. The number of psychiatrists willing to administer ECT, particularly in the UK, is in decline but we are still using it to administer electric shocks to the brains of an estimated 2,000 people each year.

In this interview, we discuss a recent paper from the journal Ethical Human Psychology and Psychiatry. The title is ‘Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses’ and it is written by John Read, Irving Kirsch and Laura McGrath. On MIA we have previously written about the study and its findings.

We hear from two of the authors, Professor of Psychology John Read from the University of East London and Professor of Psychology Irving Kirsch from Harvard Medical School.

We discuss:

• That the work aimed to review the quality of meta-analyses and any relevant clinical studies of ECT.
• How there have only ever been 11 studies that have compared ECT with sham ECT (SECT).
• Sham ECT is when the anaesthetic is administered but not followed by shocks to the brain.
• That in addition to reviewing the quality of the studies, the paper went on to consider the effect of placebo in the administration of ECT.
• That when reviewing the quality of studies, a 24-point scale was used and that the scorers were blinded to each other’s ratings.
• The 24-point scale included 5 basic Cochrane Collaboration criteria and an additional 19 quality indicators, some of which were specific to ECT procedures.
• The average quality score across all the studies was 12.3 out of a 24 maximum.
• One of the most important findings was that none of the studies reviewed were double-blind.
• The reason for this is that the patients can’t be blinded to the procedure because the adverse after-effects are very obvious.
• In reviewing the studies it was sometimes the case that only the treating psychiatrist was rating the effectiveness of the procedure, not the patient.
• The 5 meta-analyses themselves only contained between 1 and 7 of the eleven available studies.
• The recommendation from the paper is that the use of ECT should be suspended pending a properly controlled, rigorous clinical trial.
• That the UK’s National Institute for Health and Clinical Excellence (NICE) has decided to review their ECT recommendations in their depression guidelines, considering the review.
• That the Royal College of Psychiatrists has indicated that they will update their ECT position statement in light of the review.
• It has come to light recently that NHS Trusts in the UK are sometimes using out of date or incorrect information in their ECT guidance leaflets, an example of this is referring to ECT correcting a ‘chemical imbalance in the brain’.
• How the expectations of the treating doctor can influence the condition of the person undergoing the treatment.
• That the placebo effect can be large and long-lasting and that the more invasive the procedure, the larger the effect.
• That one of the characteristics of depression is the feeling of hopelessness and that when you are given a new treatment, it can instil a sense of hope which counters the hopelessness.
• That the call to prohibit ECT is because the negative effects of ECT are so strong, the fact that the evidence supporting it is so weak (especially in the long-term and beyond the improvement due to placebo) and that there are other means of addressing the difficulties that the person is dealing with.
• That placebos are, in essence, a type of psychological therapy.

Links and further reading:

Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses

Richard P. Bentall: ECT is a classic failure of evidence-based medicine

NICE guidance on the use of electroconvulsive therapy

Scott Greenspan recently received his doctorate in School Psychology from the University of Massachusetts Amherst. As a mental health counselor, he works to create opportunities for schools to be "hubs of wellness interventions." Scott's research draws from his own experiences working with youth in a variety of capacities, as well as his understanding of the vital role exercise plays in wellness.

His research has focused on the integration of physical activity within school-based mental health programs as well as gender-affirming school-based interventions for sexual minority and gender diverse youth. Scott is currently completing his pre-doctoral clinical internship at Judge Baker Children's Center in Boston and holds an appointment as a Clinical Fellow at Harvard Medical School.

In this interview, Scott discusses how a social justice approach informs his work and why it matters for schools to focus on gender diverse youth in sport. He addresses the influence that the COVID-19 pandemic may be having on adolescents and what parents and teachers can do to help. Scott offers practical solutions for integrating physical exercise into virtual learning. You can find out more about Scott on Linkedin and Twitter.

Dainius Pūras is a medical doctor and human rights advocate. He is currently serving the final year of his term as the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of health. He is also a professor at Vilnius University, Lithuania, and the director of the Human Rights Monitoring Institute, an NGO based in Vilnius.

Pūras has been a human rights activist for 30 years involved in national, regional, and global activities that promote human rights-based policies and services, with a focus on mental health, child health, disabilities, and the prevention of violence and coercion. He was a member of the UN Committee on the Rights of the Child from 2007 to 2011.

From the time he was appointed to the United Nations Human Rights Council in 2014, Pūras has pushed for a paradigm shift in mental health care. During his mandate, he has written several reports that emphasize the importance of the social determinants of health and criticize the dominance of the biomedical model and the medicalization of depression. While his work has occasionally been met with derision from some mainstream psychiatric institutions, he continues to bring attention to coercive practices and human rights violations and to call for greater investment in rights-based approaches to mental health care and suicide prevention.

In this interview, Pūras discusses his own journey as a psychiatrist, his decision to get involved in human rights work, his goals for his UN reports, and the future of rights-based mental health care.

Sunil Bhatia is a professor and chair of the Department of Human Development at Connecticut College. He is the author of two books and over 50 articles and book chapters. He has received numerous awards for his work in the field of decolonizing psychology, cultural psychology, and qualitative methods and for studies of migrant and racial identities. Most recently, his second book, Decolonizing psychology: Globalization, social justice, and Indian youth identities,received the 2018 William James book award from the American Psychological Association APA).

The movement to decolonize psychology is led by interdisciplinary scholars demanding a move away from the biomedical model of mental health and its colonial roots, especially in the Global South. Bhatia has been writing about these issues for over two decades and has often encountered resistance for speaking against mainstream voices. He is now one of the foremost experts in the field of decolonial studies. His work asks vital questions: Who decides what psychology should study? How do economic and social systems influence psychology? Is it possible to address economic inequality and social issues in psychotherapy? Does psychology speak of people, about people, or does it try to speak for them?

This week on MIA Radio, we interview Nicole Beurkens, PhD, about the impact of the COVID-19 crisis and “quarantine life” on children with different types of behavioral, emotional, and neurodevelopmental challenges. Families may be understandably worried that the stress of lockdown may aggravate their child’s struggles. Yet, we hear some parents say the situation has changed their child for the better. Why might that be?

A unique combination of psychologist, nutritionist, and special educator, Dr. Nicole Beurkens has over 20 years of experience supporting children, young adults, and families.  She is an expert in evaluating and treating a wide range of learning, mood, and behavior challenges. Dr. Beurkens holds a doctorate in clinical psychology, master’s degrees in special education and nutrition, and is a Board-Certified Nutrition Specialist.  She is the founder and director of Horizons Developmental Resource Center in Grand Rapids, Michigan, where she leads a multidisciplinary team dedicated to exceptional evaluation and integrative treatment services, research on innovative treatment protocols, and professional training on best practices.

Dr. Beurkens is a highly sought-after international consultant and speaker, award-winning therapist, published researcher, and best-selling author.  Her work has been highlighted in numerous publications, and she is an expert media source.  When she isn’t working, Dr. Beurkens enjoys spending time with her husband and four children.

(audio to be added)

We discuss:

• Her background as a holistic therapist helping children with severe behavioral and emotional problems, which combines training and experience in special education, psychology, and nutrition. She integrates these skills to uncover and address the physical, social, and/or environmental “root causes” underlying her patients’ symptoms, which often include dietary, sleep, immune, and other previously undiagnosed issues.
• How “sheltering in place” slows down and simplifies life, which can benefit kids with neurodevelopmental, mental health and other challenges by reducing the usual heavy demands of school, therapies, and activities; allowing them to take the time they need to accomplish things; and letting them get more sleep.
• That schools tend to focus on academic achievement at the expense of developing other important skills such as planning, time management, and interpersonal relations. Being home offers parents an opportunity to focus on nurturing these life skills through planned and spontaneous family activities.
• How parents can leverage the plusses of staying at home and minimize the minuses. Lowering stress levels and activity overload is key: Parents should not only limit their expectations of their kids, but of themselves. That said, this is an opportunity for adult-child collaboration on household chores and decision-making, especially with older kids.
• The importance of maintaining balance between learning activities, personal development, play, creative pursuits, and exercise or movement, tailored to your child’s and family’s needs. These need not be structured to be valuable; some kids learn best through self-directed activity. Boredom and doing nothing can also be valuable; parents should not feel compelled to entertain or teach their children all day long.
• Specific strategies to support children with different types of challenges during this quieter period. For example, those typically given an ADHD diagnosis, whatever the underlying cause, struggle with planning, organizing, and follow-through. Now we can help them practice these skills and become more independent by developing their own goals and schedules for the things they want and need to do.
• The opportunities the pandemic offers children with anxiety to face their fears and “build resilience.” These include developing coping strategies with a parent or tele-therapist, such as practicing talking back to negative, scary thoughts, or inventing their own. It’s also important for parents not to dwell on dangers and worries in front of frightened kids and to limit kids’ exposure to the news media.
• How Dr. Beurkens is balancing her own personal and professional lives, including doing telehealth sessions while having all four kids and her husband around the house. She emphasizes that constant communication and renegotiating priorities are key, and advocates finding a daily structure that works for your job and your
• The importance of parents’ own self-care, including finding new ways to exercise and relax so you can be your best for your family. The need to “focus on what we can do rather than what we can’t.”

Relevant Links

Nicole Beurkens’s website

This week on MIA Radio we share the audio from our first Town Hall panel discussion. Mad in America, Open Excellence and the HOPEnDialogue project have collaborated to create an ongoing series of Town Hall discussions exploring the challenges, learnings and opportunities for personal and societal growth found through dialogical responses to crisis in the age of COVID-19.

The title of this first discussion is: Are We Living in the Most Dialogical Time Ever? And the hosts are Kermit Cole and Louisa Putnam.

COVID-19 has forced us all into new ways of being, new ways of relating to each other, and new ways of responding to each other in a time of crisis. These new ways reveal more clearly than ever how essential dialogue is to the human experience. 

What are dialogical practitioners doing — and learning — in this time of crisis? What do these learnings suggest or make possible that might have previously seemed unattainable? What insights do people who have lived with a sense of crisis, often cut off from “mainstream” dialogues, have to offer a world in crisis?

Hosts

Kermit Cole and Louisa Putnam are inspired by Open Dialogue to respond as a team to individuals, couples and families in crisis. They have hosted many symposia in Santa Fe, New Mexico to explore the intersections between Open Dialogue, Hearing Voices, and other Dialogical approaches, and recently completed their studies under Jaakko Seikkula to be Open Dialogue trainers.

Panellists

Jaakko Seikkula teaches Dialogical practice to the many people around the world who have been inspired by the Open Dialogue, the response to mental health crises in Tornio, Finland that Jaakko’s team created.

Richard Armitage is a dialogical practitioner and trainer in Denmark at a large centre for supported living and rehabilitation.

Iseult Twamley is a Clinical Psychologist and Open Dialogue Trainer/Supervisor. Since 2012 she has been Clinical Lead of the Cork  Open Dialogue Implementation, Ireland. 

Rai Waddingham is an Open Dialogue Practitioner, international trainer, and has created, established and managed innovative Hearing Voices Network projects in youth, prison, forensic, inpatient and community settings.

Andrea Zwicknagl is a peer support worker in Switzerland and a board member of HOPEnDialogue.

This week on MIA Radio, we interview Sam Himelstein, PhD, about the impact of the Coronavirus crisis and “social distancing” policies on adolescents, taking a look at the unique needs teenagers and young adults may have and the challenges they may present for parents, caregivers, and other family members.

Relevant Links

Center for Adolescent Studies

Family First Psychotherapy

Sam Himelstein’s website

Ian Puppe is an instructor and research associate in anthropology at the University of Western Ontario in Ontario, Canada. Puppe’s work focuses on the anthropology of First Nations peoples, global studies, social justice, and peace studies. As an instructor at the university, he teaches anthropology of tourism and Indigenous Studies. He also currently serves as the Canadian Anthropology Society’s (CASCA) archivist, assistant editor/research associate with the Franz Boas Papers: Documentary Edition and Co-Principal Investigator/Research Lead for the Sioux Lookout Zone Hospital Archives Project (SLZHAP).

Puppe has done ethnographic work on Algonquin Provincial Park in Ontario, and his research and writing investigate the relations between First Nation peoples and Canadian settler-colonial society. In this interview, he explores how Western approaches to mental health impacts Indigenous peoples, and how the imposition of psychiatric treatments can lead to harmful, unintended iatrogenic effects.

***

Please Support Us: Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you. https://www.madinamerica.com/donate/

Mab Segrest is Professor Emeritus of Gender and Women's Studies at Connecticut College and the author of Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum, and Memoir of a Race Traitor, both from the New Press. A long time activist in social justice movements and a past fellow at the National Humanities Center, she lives in Durham, North Carolina.

Please Support Us: Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you. https://www.madinamerica.com/donate/

This week on MIA Radio, we chat with Paula J. Caplan. Paula is a clinical and research psychologist, author of books and plays, playwright, actor, director, and activist. She was born and raised in Springfield, Missouri, attended Greenwood Laboratory School, received her A.B. with honors from Radcliffe College of Harvard University, and received her M.A. and Ph.D. in psychology from Duke University.

Currently, she is an Associate at the Du Bois Institute, Hutchins Center for African and African American Research, Harvard University. She has been a Fellow at the Women and Public Policy Program of the Kennedy School of Government at Harvard; a Lecturer in Harvard's Program on Women, Gender, and Sexuality in the Psychology Department. She is former Full Professor of Applied Psychology and Head of the Centre for Women's Studies in Education at the Ontario Institute for Studies in Education, and former Lecturer in Women's Studies and Assistant Professor of Psychiatry at the University of Toronto.

Paula is also a passionate and steadfast advocate for service members, veterans and their families. She has written: When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans and has founded the Listen to a Veteran! Project.

In this interview, we discuss Paula’s work to support service members, veterans and their families, and the role psychiatric drugs have played in harming these communities.

We discuss:

• Paula’s experiences that drove her towards working in mental health and advocating for veterans, which came from her father’s service in World War II. This included combat in the Battle of the Bulge.
• After hearing her father’s story that had been recorded as part of a history project, she learned her father had been a forward observer, and as result learned he had been on the front lines of the war. This led to her realizing that most American’s don’t understand military service and the only way of doing this, is through hearing veterans’ stories.
• Prior to the invasion of Iraq, she became concerned about the care of service members of veterans and veterans upon their return from war, and more concerned of the “psychiatrization”, diagnosing and prescribing psychiatric drugs to veterans.
• To get started in her efforts, she began by listening to a veteran share his experiences with her. The veteran talked for three hours, and Paula just listened. The next day, he called her and thanked her for listening, as he got a good night sleep for the first time in years.
• This led to her starting Listen to a Veteran, which was originally called “When Johnny and Jane Come Marching Home”. As part of this initiative, a veteran of any era can meet with another person who has volunteered to listen to the veteran share any stories or experiences they’re interested in sharing.
• Paula has faced barriers in getting this program expanded to the VA or throughout the “mainstream” mental health community because the system has been created to function based upon current “evidenced-based” best practices.
• How Paula is positive that we are currently causing harm to veterans and that alternative approaches need to immediately be implemented throughout the Department of Defense and Department of Veterans Affairs.
• How “therapy” needs to be dropped from the terms “art therapy”, “music therapy” and the like, so we can stop pathologizing individual experiences, and instead support people in doing things that improve their overall well-being.
• Any veterans who want to be a listener as part of Paula’s Listen to a Veteran initiative, or would like to have someone listen to them, they can go to listentoaveterans.org.

Welcome to MIA Reports, showcasing our independent and original journalism devoted to rethinking psychiatry. We take selected MIA Reports and provide them as audio articles. Click here for the text version of this and all of our MIA reports.

Medication-Free Treatment in Norway - A Private Hospital Takes Center Stage

Written by Robert Whitaker, read by James Moore with thanks to Birgit Valla for pronunciation assistance, first published on Mad in America, December 8, 2019.

The Hurdalsjøen Recovery Center, which is a private psychiatric hospital located about forty minutes north of Oslo, on the banks of stunning Lake Hurdal, was set up by its director, Ole Andreas Underland, to provide “medication-free” care for those who wanted such treatment or who wanted to taper from their psychiatric drugs. Norway’s health minister was urging public mental hospitals to offer such treatment, and this private hospital stepped forward before any public hospital had taken the plunge.

Hurdalsjøen opened on April 1, 2015. The first person to show up at its doors was 31-year-old Tonje Finsås, and she had a medical history that could fill volumes. She had developed an eating disorder when she was eight; she was put on antidepressants at age 11, which is when she started cutting herself; then came a prescription for a benzodiazepine; and soon she was cycling in and out of psychiatric wards with astonishing frequency. She arrived at Hurdalsjøen with prescriptions for 31 medicines, including three antipsychotics, and a record of 220 hospitalizations. She had spent most of the three previous years in isolation at a psychiatric hospital in Bergen, where she was watched over by two aides at all times, and was often restrained in a belt.

“I tried to kill myself every day,” she recalled. “I didn’t want to live anymore. This was not a life. Even a dog in a cage has it better than what you have in there.”

Although Lake Hurdal provides a beautiful setting, the hospital is located in a 1970s building, one that was used to treat people suffering from nervous problems, and inside it has an institutional feeling: small rooms located off a long hallway, not all that different from what you might find in an older psychiatric hospital. When Finsås balked at staying there, Underland proposed a novel solution.

Ian Parker is one of the most important contemporary critics of the discipline of psychology. A prolific writer, with over 25 books to his name, he has a formidable reputation in the fields of critical psychology, Marxist psychology, and psychoanalytic theory. He is a fellow of the British psychological society, Emeritus Professor at the University of Leicester, and the managing editor of the Annual Review of Critical Psychology. Parker is also a practicing psychoanalyst analyst and a member of the Centre for Freudian Analysis and Research and the London Society of the New Lacanian School.

His career reflects the principles he talks about – the importance of challenging powerful institutions and the need for collectively mobilizing against discrimination and exploitation. As the "Psy-disciplines" face increased scrutiny for involvement in past abuses, continued collusion with powerful and unjust institutions, and deep criticisms over current psychological research and practice, Parker's work has particular relevance.

His criticisms of psychology and psychiatry started from his university days as a student. He observed that while other social sciences were critical of their received knowledge and open to contributions from the civil rights and women's movements, psychology continued to reinforce old power relations and pathologized these same social movements. Since then, Parker has become one of the most well-known critics of mainstream psychology, and his work repeatedly questions the role of ideology and power in the field. These contributions are evident throughout his writing, including his four-volume 'major work' Critical Psychology (2011) and a Handbook of Critical Psychology (2015). He is currently the editor of the 'Concepts for Critical Psychology' series for Routledge.

This week on MIA Radio, we chat with Beatrice Birch who is the initiator of the residential healing community Inner Fire. For over 35 years, Beatrice worked as a Hauschka artistic therapist in integrative clinics and inspiring initiatives in England, Holland and the USA where the whole human being of body, soul and spirit was recognized and appreciated in the healing process. She has lectured and taught as far afield as Taiwan.

Her passionate belief in both the creative spirit within everyone and the importance of choice, along with her love and interest in the human being has taken her also into prisons where she has volunteered for many years offering soul support through Alternatives to Violence work and watercolor painting.

In this interview, we discuss how Inner Fire works to help the people that attend, and how a core principle of their healing work is that ‘human being are creators, not victims’.

We discuss:

Beatrice’s background and experiences as someone providing alternative help and support for mental and emotional challenges, including her time in the UK National Health Service (NHS) utilizing Hauschka artistic therapy and other artistic therapies alongside improving nutrition and connection to new skills.

How she came to be interested in the resilience of the human spirit, wanting to understand why some people cope and others do not.

That Beatrice worked for many years in prison settings, working with Alternatives to Violence (AVP) and providing artistic therapies to inmates before founding Inner Fire, based in Vermont.

Inner Fire is a proactive healing community officially recognised by the state of Vermont as a Therapeutic Community Residence (TCR) that has been operating as a 501(c)(3) non-profit for almost 6 years.

How Inner Fire provides a medication-free approach to recovery from debilitating or traumatic life experiences, helping people to reclaim their lives.

That Beatrice believes in the importance of allowing people to connect with their divine, creative selves and this leads to a core principle of Inner Fire which is that ‘human being are creators, not victims’.

Inner Fire doesn’t influence a person’s choice to stay on or come off psychotropic drugs, but they will work with people who want to gradually taper either to a comfortable level or off completely.

Beatrice presented a paper to ISPS Rotterdam entitled: Suppose ‘Mental Health’ is a Reductionist Term for ‘Soul Health’…

How Beatrice describes those that come for help as ‘seekers’ and those from Inner Fire that support them as ‘guides’.

That the focus of Inner Fire is participation, connection and community achieved by learning new skills in a group environment, getting people out of their heads and into their limbs.

The importance of rhythm when following the Inner Fire programme and how it is key to the healing process.

Inner Fire has a staff psychiatrist who has an appreciation of the spiritual dimensions of our lives, allowing spiritual and biological aspects to coexist.

How Beatrice’s experience is that while medications can be helpful for some for a time, typically one drug will lead to another and then another and ultimately to hospitalisation.

Where tapering is concerned, the seeker and the psychiatrist together decide on the tapering approach but that it is recognised that tapering must be slow and must adapt to the experience of the person trying to reduce.

That Beatrice wants to raise enough money to provide a space where people can freely express the emotion that often arises as they come off their psychotropic drugs.

Inner Fire is currently private pay and that people donating can therefore help seekers who want to attend but don’t have the financial resources.

How Inner Fire is not a profit-motivated enterprise because the focus is on the individual’s healing journey.

Bob Whitaker helped open the east wing of the Inner Fire home.

This week on MIA Radio, we interview Laysha Ostrow. Laysha is the founder and CEO of Live & Learn, a research and consulting company that specializes in the inclusion of people with lived experience of the mental health system.

She researches community-driven interventions that present safe and effective pathways to independence and empowerment. Ostrow earned her PhD from the Johns Hopkins School of Public Health and holds a master's degree in public policy from Brandeis. Ostrow is passionate about improving the experience of mental health service users, partially due to her personal experience with mental health systems. She has discussed some of her previous research on Mad in America.

Peter Stastny is a New York-based psychiatrist, documentary filmmaker, and a co-founder of the International Network toward Alternatives and Recovery (INTAR). He has been working on the development of services that obviate traditional psychiatric intervention and offer autonomous paths towards recovery and full integration.

Stastny has frequently collaborated with psychiatric survivors in conducting research and writing projects, including the book and major exhibit at the New York State Museum, The Lives They Left Behind: Suitcases from a State Hospital Attic(together with Darby Penney) and the edited volume Alternatives Beyond Psychiatry (with Peter Lehmann). He has directed several documentary films.

Psychiatric diagnosis has come under increased scrutiny in recent years following the release of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) in 2013.

Two organizations that played a prominent role in challenging the Bible of psychiatry prior to 2013, the British Psychological Society and the Society for Humanistic Psychology (American Psychological Association - Division 32) subsequently joined to form the Task Force for Diagnostic Alternatives (TFDA).

Today, February 12th, 2020, the TFDA released a new Open Letter regarding the reform and revision of diagnostic systems. MIA spoke with two leaders of the Task Force, Sarah Kamens, and Peter Kinderman about this effort.

Sarah Kamens is an Assistant Professor of Psychology, at the State University of New York (SUNY) College at Old Westbury and co-chair of the Task Force for Diagnostic Alternatives for the Society for Humanistic Psychology. Her research examines the intersections between extreme emotional distress and structural marginalization. More specifically, she studies the ways in which lived experiences of psychosis and trauma are entangled with social conditions in the world.

Peter Kinderman is past president of the British Psychological Society (BPS) and a Professor of Clinical Psychology at the University of Liverpool. He is also a past guest on the Mad in America podcast and the author of A Manifesto for Mental Health, Why We Need a Revolution in Mental Health Care (2019) and A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing (2013).

This week on MIA Radio we share what is something of an anniversary for us at MIA. This interview marks one hundred episodes since we launched our podcast in July 2017. And for this episode, we interview David Joslin. David is a retired army medic, having served in Iraq in 2003 and Afghanistan in 2008. David currently works as a senior healthcare administrator and he has co-founded Remedy Alpine, a veterans therapeutic recreation non-profit dedicated to providing wilderness therapy adventures in Alaska.

David has also written for Mad in America, having published Broken is Not All I’ll Ever Be in August 2019 and he has recently launched a new podcast called Bullets to Beans, which is a military and veteran-centric podcast focused on current military and veteran topics, blended with discussions on mountain oriented recreational and adventure-based therapy programs.

We discuss:

• How upon leaving the military, David felt that he had lost his identity, suddenly working in private healthcare and not being able to care directly for colleagues as he had as a combat medic.
• That to help deal with the change, David started going out into the backcountry wilderness to find peace and healing.
• How this interest led him to meet Eric Collier, a like-minded veteran interested in wilderness hiking.
• How David and Eric saw the benefits to be had in sharing wilderness adventure experiences and launched their first event for veterans in 2017 and when they got home, realising the amount of interest in and support for similar future events.
• David and Eric then took the time to establish themselves as a business during the Winter of 2018.
• During 2019, David and Eric led 49 veterans into the Alaska wilderness and connected with 150 veterans via outreach and community enrichment events.
• That David came to see that many veterans attending the wilderness therapy had struggled with multiple medications, prescribed during their service years.
• How David’s experiences within the military led to treatment for Post-traumatic Stress Disorder, resulting in being prescribed a drug cocktail.
• How the initial drugs were followed by others for insomnia, drugs for nightmares, blood pressure problems and for focus and concentration.
• How at the height of David’s ‘better living through chemistry’ he was on 13 different drugs.
• That through David’s pharmacological training he realised that one of the top ten side effects of many of the drugs he had been put on was suicidal thinking.
• How David came to take himself off all his drugs and strongly advises others never to do this themselves.
• That it was planning his own suicide that brought him to face that his life was unsustainable, accepting that he didn’t want to live as he had been.
• As he was planning it, he found that he didn’t want to suffer and came to realise that he did want to live, and realised that the suicidal thoughts were very likely as a result of treatment.
• That during his service years, David had assisted with at least three suicide interventions and that caused him to consider what might be driving veterans to consider suicide.
  How having confronted his suicidal thoughts and coming off his drugs, David then went on to find solace and comfort in wilderness adventures.
• That David still sometimes struggles with nightmares, hypervigilance and social anxiety but that he could deal with this without feeling numbed by the drugs and by being away from society but with trusted colleagues and friends in an environment conducive to healing.
• That Remedy Alpine is now starting to work as a government contractor to provide recreationally-based programs to the veteran community.
• How Remedy Alpine operates year-round and provides single-day hikes, single overnight camping events and multi-day hikes which can range from 26 to 30 miles through the Alaskan mountains.
• The recent launch of the Bullets 2 Beans podcast which focuses on post-military life challenges.
• That Remedy Alpine were attendees at the Nature’s Grace Conference, which focussed on America's veterans and the healing power of nature.
• How Remedy Alpine is now focussed on expanding the business side, applying for grants, developing their therapeutic programs and training veteran peer mentors.

Relevant Links:

Broken Is Not All I’ll Ever Be

Remedy Alpine

Bullets 2 Beans podcast

Remedy Alpine on Facebook

Nature’s Grace Conference

This week on MIA Radio we chat with Professor John Read of the University of East London. John worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, in 1994, where he worked until 2013. He has published over 140 papers in research journals, primarily on the relationship between adverse life events (e.g. child abuse/neglect, poverty, etc.) and psychosis. He also researches the negative effects of biogenetic causal explanations on prejudice, the opinions, and experiences of recipients of antipsychotic and antidepressant medication, and the role of the pharmaceutical industry in mental health research and practice.

John joins us to discuss the UK licensing of esketamine nasal spray (Spravato) for so-called ‘Treatment Resistant Depression’. John led a group of 12 academics and professionals who wrote to the UK regulator expressing concerns about esketamine.

We Discuss:

• Concerns about the basic concept of using derivatives of hallucinogenic, addictive street drugs to address complex human problems.
• The particular details of the clinical trials that raise concerns about treatment with esketamine.
• How the US Food and Drug Administration approved Spravato in January 2019 and the European Medicines Agency recommended that member states approve it on October 17, 2019, giving 67 days for member states to comment.
• That the Medicines and Healthcare products Regulatory Agency approved esketamine for UK use.
• That there have been no trials of the efficacy of esketamine in the medium or long term, with most trials being only four weeks duration.
• That only one of the trials found a benefit for esketamine over placebo, yet this was deemed sufficient for licensing by the USA’s FDA.
• That there were deaths and suicides recorded during the esketamine clinical trials.
• The relationship between the drug regulators and funding from the pharmaceutical manufacturers.
• How there was no response from the MHRA to the concerns raised by John’s group.
• In addition, no reply was made to concerns raised by Sir Oliver Letwin writing on behalf of the All Party Parliamentary Group on Prescribed Drug Dependence as well as letters from independent researchers from Kings College London and a group of service users.
• A recent response to the approval by the UK National Institute for Health and Care Excellence.
• A response to the NICE announcement from the Science Media Centre.

This week on MIA Radio, we interview Wendy Dolin founder of the MISSD foundation. MISSD stands for Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin.

In 2010, Wendy’s husband Stewart Dolin was prescribed Paxil (paroxetine), a selective serotonin reuptake inhibitor ("SSRI") for mild situational anxiety. Within days, Stewart's anxiety became worse. He felt restless and had trouble sleeping. On July 15, 2010, just six days after beginning the medication, following a regular lunch with a business associate, Stewart left his office and walked to a nearby train station, despite not being a regular commuter. A registered nurse who was also on the platform later reported seeing Stewart pacing back and forth and looking very agitated. As a train approached, Stewart ended his life.

Founded in 2011, MISSD is a unique non-profit organization dedicated to honoring the memory of Stewart and others by raising awareness and educating the public about the dangers of akathisia. MISSD aims to ensure that people suffering from akathisia's symptoms are accurately diagnosed so that needless deaths are prevented.

Relevant Links:

Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin

MISSD on YouTube

MISSD Handout

MISSD Free one-hour Continuing Ed Course

Akathisia Stories - MISSD Podcast (Apple Podcasts, Spotify)

NYC Subway Ads Take Akathisia Out of the Darkness

Wendy Dolin Takes on GlaxoSmithKline And Wins — For Now at Least

Stewart Dolin’s Widow Loses $3 Million Verdict for Paxil Suicide on Appeal

Welcome to MIA Reports, showcasing our independent and original journalism devoted to rethinking psychiatry. We take selected MIA Reports and provide them as audio articles. Click here for the text version of this and all of our MIA reports.

The Whistleblower and Penn: A Final Accounting of Study 352

Written by Peter Simons, read by James Moore, first published on Mad in America, December 29, 2019.

Although the general story of ghostwriting in trials of psychiatric drugs is now pretty well known, the details of the corruption in specific trials are still emerging into the public record, often a decade or more after the original sin of fraudulent publication. The latest study to finally see the full light of day is GlaxoSmithKline’s study 352.

Perhaps the most infamous ghostwritten study is GSK’s study 329, which, in a 2001 report published in the American Journal of Psychiatry, falsely touted paroxetine (Paxil) as an effective treatment for adolescent depression. The company paid over $3 billion in penalties for fraud.

That same year, study 352 made its first appearance in the research literature. That was when Charles Nemeroff, who in the years ahead would become the public face of research misconduct, “authored” an article on the efficacy of paroxetine for bipolar disorder. It has taken 18 years for the full story of that corruption to become known, the final chapter recently emerging when a large cache of study 352 documents—emails, memos, and other internal correspondence between the key players—was made public.

The documents reveal a web of corruption that went beyond the fraud of ghostwriting into the spinning of negative results into positive conclusions, and the abetting of that corruption by an editor of the scientific journal that published the article. The documents also reveal a whitewashing of the corruption by the University of Pennsylvania.

However, it was the publication of these documents that provided Jay Amsterdam, an investigator in the trial who turned whistleblower after he smelled a rat, with a chance to say “case closed.” Amsterdam and Leemon McHenry have now published two articles that provide a step-by-step deconstruction of the study—the ghostwriting, the spinning of results, the betrayal of public trust.

Here is the story of that whistleblowing. 

This week on MIA Radio, we interview Amanda Burrill. After a successful career as a Surface Warfare Officer and Rescue Swimmer in the United States Navy, Amanda was on track to continue her career as a professional triathlete and marathon runner, as she had already been competing internationally still while in uniform. Around the time of her discharge, she was prescribed a cocktail of psychiatric medications that caused physical injuries and leading to an early end to her rapidly accelerating career. 

Amanda completed a Masters degree in Journalism from Columbia University, a culinary arts degree from Le Cordon Bleu in Paris, and continued her work as a travel and culinary journalist; all while surviving a cocktail of over a dozen psychiatric medications over eleven years. 

While being treated for a traumatic brain injury (TBI) by specialists at New York University in 2018, Amanda’s doctors raised concerns about the selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, stimulants, sleeping medications and mood stabilizers concurrently prescribed to her by the Department of Veterans Affairs. Over the next 12 months, Amanda was successful in withdrawing from her cocktail of meds, which included the SSRI, Zoloft. She now sees it as her mission to ensure what happened to her does not happen to others.

Dr. Anthony Ryan Hatch is a sociologist and associate professor of Science in Society, African American studies and Environmental Studies at Wesleyan University, who studies how medicine and technology impact social inequality and health.

Professor Hatch is the author of two books. His first book, Blood Sugar: Racial Pharmacology and Food Justice in Black America, critiques how biomedical scientists, government researchers, and drug companies use the concepts of race and ethnicity to study and treat ‘metabolic syndrome,’ a biomedical construct that identifies people at high risk of heart disease, stroke, and diabetes. His second book, Silent Cells: The Secret Drugging of Captive America, examines how custodial institutions like prisons, nursing homes, and the U.S. military use psychotropic drugs to manage mass incarceration and captivity in the United States.

His 2018 Wesleyan TedX talk is entitled “How Social Institutions Get Hooked on Drugs.”

Mary Watkins is a psychologist at Pacifica Graduate Institute who focuses on reorienting psychology toward social justice and liberatory ends. She has a foundation in the depth psychologies of Carl Jung and James Hillman, as well as holistic approaches to community healing such as indigenous, liberation, and eco-psychologies. She has worked in a variety of settings, such as immigration detention centers, prisons, and marginalized communities, with the aim of social transformation beyond the individual.

Her research interests include a focus on the restorative power of dialogue, creative imagination, forced migration, adoption, and socioeconomic justice. In addition to numerous articles, she has published several books, such as Waking Dreams, Invisible Guests: The Development of Imaginal Dialogues, Toward Psychologies of Liberation with Dr. Helene Shulman, Up Against the Wall: Re-imagining the U.S.-Mexico Border with Dr. Edward Casey, and most recently, Mutual Accompaniment and the Creation of the Commons.

Peter Mayfield is the founder and executive director of Gateway Mountain Center in California, an innovative program for helping youth learn, heal, and thrive

As a teenager growing up in California, Peter became an accomplished rock climber, and developed into one of the world’s best mountain climbers, rising to become chief guide of the Yosemite Mountaineering School. Yosemite is known for being a rock climbing mecca, offering climbers some of the most difficult ascents anywhere in the world.

He has enjoyed a 40-year career guiding people in mountain experiences and developing entrepreneurial enterprises. He is the founder of City Rock, the first full-service climbing gym in the world.

Today, he is passionate about changing the system of care for youth suffering from serious emotional disturbances and complex trauma. Gateway’s program,  ‘Whole Hearts, Minds and Bodies’ is the first nature-based therapeutic program in California to achieve full-service partner contracts with County behavioral health departments and certification as a MediCal provider. This means that California has recognized his nature-based therapeutic programs as providing a medical benefit.

In this interview, Peter speaks about his journey from mountaineering to his role as an educator and mentor, and how enabling children and adolescents to connect with nature has such a profound effect on their health and wellbeing.

If you'd like to know more about the work of the Gateway Mountain Center, you can visit the website www.sierraexperience.org

This week on MIA Radio, we interview Drs. Peter Breggin and Michael Cornwall their new initiative, Stop the Psychiatric Abuse of Children (SPAC!).

Peter Breggin, MD is a Harvard-trained psychiatrist and a former consultant at the National Institute of Mental Health who has been called "The Conscience of Psychiatry." For decades, he has made successful efforts to reform the field, including bringing a stop to lobotomy and psychosurgery. He has testified before the FDA and Congress, been an expert witness in many court cases involving the pharmaceutical industry and has appeared on Oprah and 60 Minutes, among other programs.

Dr. Breggin continues to criticize psychiatric drugs and “electroconvulsive therapy,” and promotes more caring, empathic and effective therapies. To that end, with his wife Ginger, he founded the Center for the Study of Empathic Therapy, Education and Living.  He is the author of more than 20 books, most recently Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions. Dr. Breggin maintains a private practice in Ithaca, New York where he treats adults, couples, and families with children.

Michael Cornwall, PhD has done therapy with children, teens and families since 1980 as well as specializing in therapy with people of all ages experiencing extreme states. He completed doctoral research on medication-free treatment of extreme states and is the editor of a two-volume special edition of the Journal of Humanistic Psychologyon extreme states. Dr. Cornwall has been a prolific MIA blogger since 2012 and a frequent Esalen Institute workshop leader on alternative approaches to extreme states. He is the director of the SPAC! project for Dr. Breggin’s Center for Empathic Therapy.

(audio)

We discuss:

• How SPAC was started in response to the introduction of the Monarch eTNS, an electric stimulation device worn on a child’s forehead at night that is touted as an alternative to ADHD medication, which was fast-tracked by FDA with little testing
• The extensive, downplayed adverse reactions found in testing the Monarch on children
• How the device is purported to work to target brain activity in certain areas, but likely affects other important neural areas and how this is likely to disrupt a child’s normal brain function
• Problems with the design of the studies on the Monarch and how deliberate intrusions into brain function make an individual child more docile but also more apathetic
• The potential widespread adoption of the Monarch device due to a partnership between the manufacturer and a pharmacy chain, the many uses for which it is being marketed, and anticipated psychiatric prescribing of the treatment by primary care doctors
• The nature and risks of ECT, another form of psychiatric “treatment” that targets the brain with electricity, intentionally causing a seizure and short- and long-term traumatic brain injury, and where to find ECT resources on Dr. Breggin’s website
• Reframing “ADHD” behavior as a sign of deficiencies in the teacher, classroom, or parenting approach rather than an illness in the child. What might cause inattentiveness in a young student and how doctors typically medicate the problem as a brain disorder
• Alternatives to high-tech interventions and drugs for helping inattentive or severely troubled youth alike, including modifications at school and entering family therapy. The importance of parents’ expressing love and discipline to change problematic behaviors, with examples from Breggin’s private practice
• How the medical model of psychiatry discourages identifying unmet human needs in young patients and their families, and the benefits of offering trauma-informed support and connection, with examples from Cornwall’s work in the public mental health system
• The importance of engaging children to identify what they need from adults in their lives, arming parents with new attitudes and communication tools for relating to their children, and the success they have had with such approaches
• How listeners can learn more about SPAC! and get involved with advocacy against conventional psychiatric treatment for children and for more compassionate and commonsense alternatives. The groundswell of interest they have received from parents and a variety of online resources available on these topics
• The right of parents to say no to dangerous drugs or devices doctors want to prescribe, and the importance of understanding the risks of resisting a medical professional’s authority or challenging a child’s school
• Reasons for parents and teachers be optimistic that even seemingly incorrigible children can be reached.

Relevant Links

SPAC! webpage, part of Dr. Peter Breggin’s Children’s Resource Center

ECT Resource Center

Center for the Study of Empathic Therapy, Education, and Living

MIA blogs

Monarch eTNS Inspires “Stop the Psychiatric Abuse of Children!” (SPAC!)

FDA Approves Using Electricity All Night Long on Children’s Brains

This week on MIA Radio we turn our attention to support for those who are struggling to withdraw from psychiatric drugs. Recently in the UK, this issue has become headline news with more and more attention being given to the work of groups such as the Council for Evidence Based Psychiatry and peer-led initiatives such as the Bristol Tranquilliser Project. 

December 4 2019, marks the release of guidance which has been specifically written to support psychological therapists and their clients in having discussions about taking and withdrawing from psychiatric drugs. The comprehensive guidance is a collaboration between psychologists, peer support specialists and psychiatrists and aims to provide important context and evidence-based support to psychological therapists, whatever their particular modality.

In this interview, we chat with psychotherapist  and project lead Dr. Anne Guy, Peer Support Specialist Paul Sams and Professor of Psychology John Read.

We Discuss:

• How the project to create guidance for psychological therapists got started.
• The need to address a significant gap in knowledge and experience, particularly given the numbers of clients who work with psychological therapists and are already taking or thinking of coming off psychiatric drugs.
• That therapeutic training previously hasn’t addressed the intersection of psychiatric drugs and the practice of therapy.
• How a recent survey showed that 96% of all therapists are seeing at least one client who is taking psychiatric drugs.
• That the guidance is not prescriptive but provides an opportunity for a therapist to respond to drug issues that other professionals may not have time available to address.
• The important distinction made between giving medical information and giving medical advice.
• How the guidance will be launched in Westminster, London on December 4 2019, and that people can read the guidance and view a Q&A here.
• That next year will see some Continuing Professional Development activities.
• How lived experience and peer support knowledge has been applied in developing the guidance.
• How the guidance opens up the conversation such that no go areas are addressed as part of the overall therapeutic discussion.
• That the approach is one of empowerment and supporting conversation rather than defining or being prescriptive.
• How the evidence-based part of the guidance came together and that there was a fairly consistent finding that around 50% of people coming off psychiatric drugs will experience some sort of withdrawal with around half of those describing the withdrawal effects as severe.
• That the guidance has provided the chance for psychologists, counsellors and psychotherapists to work together.

Relevant Links:

Read or download the guidance here.

View the guidance Q&A here.

© Mad in America 2019

This week on MIA Radio, MIA Correspondent Leah Harris interviews Celia Brown. Celia is a psychiatric survivor and a prominent leader in the movement for human rights in mental health. She is the current Board President of MindFreedom International, a nonprofit organization uniting 100 sponsor and affiliate grassroots groups with thousands of individual members to win human rights and alternatives for people labelled mentally ill.

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Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you.

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This week on MIA Radio, we interview US Navy Veteran and Co-Founder of Minority Veterans of America, Lindsay Church. Lindsay served from 2008-2012 as a Cryptologic Technician Interpretive (Linguist). During her time in the service, she attended language school at the Defense Language Institute in Monterey, CA where she learned Persian-Farsi. After spending two years at a cyber intelligence command, she left the Navy and returned home to Seattle.

Upon returning home, Lindsay attended the University of Washington where she earned her BA in Near Eastern Language and Civilization and Islamic Studies and an MA in International Studies – Middle East. At the University of Washington, Lindsay co-founded the office of Student Veteran Life, where she also served as the University Liaison for the Student Veterans of AmericaChapter there.

In 2017, Lindsay started the Minority Veterans of America to ensure there is a community of support around the underrepresented veterans so that we may see the true diversity of the U.S. military reflected in our veteran communities.

We discuss:

• • How Lindsay was enlisted in 2008 under “Don’t Ask Don’t Tell” and served all but three months of her time in the Navy under Don’t Ask Don’t Tell.
  • That Lindsay is a third-generation Navy veteran with many family members also serving.
  • How during her Navy career she had multiple health issues arising from an inverted sternum, but a surgical procedure was botched and she experienced multiple complications, spending 5 days in ICU with a collapsed lung.
  • How within 18 months of enlisting she had been prescribed 16 different medications including painkillers, antidepressants and anti-anxiety drugs.
  • How she then had to endure a number of further surgeries but managed to complete language school in spite of the surgeries and complications.
  • Lindsay recalls being amazed that she is alive considering the cocktail of meds she was prescribed.
  • How she came to be stuck for six months at a medical barracks in San Diego.
  • That Lindsay got to a point in 2010 where she felt that she couldn’t go on.
  • That she was being transitioned between Klonopin, Effexor, Valium and Zoloft almost every month which led to intense suicidal thoughts and how she considered jumping from a fifth-floor window.
  • That she recalls asking for psychological support but instead only received more psychiatric drugs.
  • How Lindsay made the decision in 2010 to get off the antidepressants and then in 2011 came off the opioids and has refused painkillers since, finally in 2012 she came off the anti-anxiety drugs.
  • Lindsay says that it hurts to have realized that suicidal thoughts occurred during times of being switched between psychiatric medications, and changes her way of viewing past events in her life.
  • How Lindsay notes that it is very easy to get referred into psychiatry and onto the drugs but very difficult to find appropriate psychological support.
  • That Lindsay moved back to Seattle after leaving the Navy in 2012 and is thankful her mom is a veteran, as she helped her navigate the VA.
  • How Lindsay’s experiences both with the military medical system but also witnessing pervasive misogyny, racism and homophobia in the American Legion, led her to resign her position and to co-found the Minority Veterans of America.
  • How she found that female veterans are 2.2 times more likely to die by suicide than their civilian counterparts and LGBTQ veterans are 2 times more likely to die by suicide than their civilian counterparts.
  • That she now works with people of color, women, LGBTQ and religious and non-religious minorities, many of whom are disenfranchised from the veteran community, so the goal is to bring people into a supportive community to break the isolation, because isolation is a killer.
  • How important social engagement is to address the isolation felt by minority veteran communities.
  • That as regards herself, she is working on reaching the person that she was five years ago when she didn’t think that she belonged or that her story was unique, or even worthy of even being told.
  • That if readers want to know more they can visit MinorityVets.org which is a non-profit.
  • How she feels that we don’t have another three to five years to address the suicide epidemic amongst the veteran community, Congressional action is needed now.

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This week on MIA Radio, MIA Correspondent Leah Harris interviews psychiatric survivor Dorothy Dundas. Dorothy is an activist, a mother, a mentor, and an incredible supporter of the activists in all of our movement-building work, going back several decades.

Relevant Links:

On Our Own by Judi Chamberlin: https://www.goodreads.com/en/book/show/5106590-on-our-own

Dorothy Dundas author page at Mad in America: https://www.madinamerica.com/author/dorothydundas/

Image of Dorothy's "Behind Locked Doors" poster: https://www.madinamerica.com/2014/05/behind-locked-doors/

To contact Dorothy and/or to order a "Behind Locked Doors" poster: https://www.facebook.com/dorothywdundas

Please Support Us:

Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you.

https://www.madinamerica.com/donate/

Joseph Gone is a professor of both Anthropology and Global Health and Social Medicine at Harvard University. He is a clinical and community psychologist by training, and he conducts participatory research projects with community partners in Native American communities. His projects aim to rethink traditional mental health practices and incorporate Indigenous-healing practices. He has published over seventy-five articles on his work. His work includes both the critical analysis of psychological theories and concepts, such as indigenous historical trauma, as well as original research on new mental health programs such as the Blackfeet Culture Camp for the treatment of addiction.

As an undergraduate, he became interested in psychology because the field approaches the question of human experience from so many diverse vantage points -- taking up questions from the workings of the brain to what it means to be human. His love for ideas and his desire to contribute to the American Indian communities (as a member of Aaniiih-Gros Ventre tribal nation) led him to get a doctorate in clinical psychology. However, his experience is not simply that of a clinical psychologist or psychotherapist who addresses mental health at the individual level -- because sometimes, he explains, the remedies that help people “look less like healing and more like justice.”

This week on MIA Radio, we interview Professor of Psychology Dr. Steven C. Hayes.

Dr. Hayes is Nevada Foundation Professor in the Behavior Analysis program at the Department of Psychology at the University of Nevada. An author of 45 books and over 625 scientific articles, his career has focused on an analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering. He is the developer of Relational Frame Theory, an account of human higher cognition, and has guided its extension to Acceptance and Commitment Therapy (ACT), a popular evidence-based form of psychotherapy that uses mindfulness, acceptance, and values-based methods.

Dr. Hayes has been President of several scientific and professional societies including the Association for Behavioral and Cognitive Therapy, and the Association for Contextual Behavioral Science. He was the first Secretary-Treasurer of the Association for Psychological Science, which he helped form and has served a 5-year term on the National Advisory Council for Drug Abuse in the National Institutes of Health.

Dr. Hayes received a Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy and was recently named as a Fellow in the American Association for the Advancement of Science.

In this interview we talk about his recently released book, A Liberated Mind: How to Pivot Toward What Matters, which uses the principles of acceptance and commitment therapy to help readers overcome negative thoughts and feelings, turn pain into purpose, and build a meaningful life.

We discuss:

• What led Steven to his interest in psychology and, in particular, behavioral science.
• That his keen interest was to mix an understanding of human experience with analytical science.
• How he came to be standing on stage in Nevada at a 2016 TEDx talk, relating his experiences of panic disorder and ‘hitting bottom’.
• How Steven has dedicated his life to helping people understand how they can be their whole selves while dealing with their problems and distress.
• How his book ‘A Liberated Mind’ was in part based on his own experiences but also presents the voluminous research that underlies Acceptance and Commitment Therapy (ACT).
• That ACT is based on the psychological flexibility model and involved pulling at the threads of cognition and language to understand the fundamentals.
• How ACT is a combination of acceptance and mindfulness processes and commitment/behaviour changes, referred to in the book as ‘pivots’ and ‘turning towards’.
• That ACT allows us to be present with our difficulties in a way that we can learn from distress without becoming entangled.
• That the book defines six basic processes: defusion, self, acceptance, presence, values and action.
• How it is important not to believe that we need ‘fixing’ before we can move on with our lives.
• That acceptance is often seen as giving up or tolerance but is better viewed as the response to receiving a gift.
• How acceptance opens us up to the validity of our experiences and can help to achieve a healthy distance from distressing experiences.
• How pain, judgement and comparison impact our lives.
• That reliance on medications can mean that we become numb to experiences that we could learn from if we turned or pivoted towards them.
• That the guide to happiness is hidden within our misery.

Relevant links:

Steven C Hayes

The Liberated Mind: How to Pivot Toward What Matters

TEDx Nevada – Psychological flexibility: How love turns pain into purpose

Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy

© Mad in America 2019

Jennifer Freeman is a marriage and family therapist and an Expressive Arts Therapist. Since 2017, she has been researching narratives centered on how humans are facing climate change and responding to these challenging times of social impoverishment, ecological degradation, the Anthropocene, and the sixth great extinction.

She has been engaged in therapeutic conversations, international community work, teaching, and professional writing for the past 30 years based on narrative approaches. She is the co-author of the book Playful Approaches to Serious Problemsalong with David Epston and Dean Lobovits.

© Mad in America 2019

This week on MIA Radio we turn our attention to psychiatric drug withdrawal and in particular the work of the International Institute for Psychiatric Drug Withdrawal.

The Institute recently held a network meeting in Gothenburg, Sweden, where 40 leading experts from around the world came together to discuss the issues of dependence, withdrawal and iatrogenic harm relating to psychiatric drugs. The meeting participants included both professionals and those with lived experience.

We chat with IIPDW founder Carina Håkansson and IIPDW Board Member Professor John Read.

Following the meeting, the IIPDW released the following Press Release.

INTERNATIONAL EXPERTS CALL FOR SERVICES TO SUPPORT MILLIONS TRYING TO COME OFF PSYCHIATRIC DRUGS

The 40 international experts attending this weekend’s meeting (end of September 2019) of the International Institute for Psychiatric Drug Withdrawal (www.iipdw.org) voted to endorse the  recommendations of the recent Public Health England [PHE] review of ‘Dependence and withdrawal associated with prescribed medicines’ and pledged to try to implement them in the 15 countries they are from, and beyond. These include:

1. Enhancing clinical guidance and the likelihood it will be followed.
2. Improving information for patients and carers on prescribed medicines, and increasing informed choice and shared decision-making between clinicians and patients.
3. Improving the support available from the healthcare system for patients experiencing dependence on, or withdrawal from, prescribed medicines.
4. Further research on the prevention and treatment of dependence on, and withdrawal from, prescribed medicines.

Participants agreed that besides antidepressants and benzodiazepines other psychoactive drugs, e.g. antipsychotics, should be included. They also agreed with PHE that ‘the goal is to make sure that our healthcare system builds awareness and enhanced decision-making for better patient treatment and support. These recommendations are just the beginning. All parts of the healthcare system and the general population will need to engage with this complex problem and work together to find solutions’.

The meeting decided to hold a large international conference in Iceland in 2020.

The meeting organiser, Dr Carina Håkansson (Psychotherapist, Sweden), commented:

‘All our hopes were exceeded. So many plans, local and international, emerged from this gathering of inspirational experts and activists. The time for change on this issue has clearly arrived’ carina@utvidgaderum.se

Participants commented:

‘Psychiatric drugs destroyed 10 years of my life. I am so happy that we are finally addressing this issue of how to get off these drugs, which effects literally millions of people.’    Olga Runciman, Denmark (Psychologist, IIPDW Board Member) +45 27851003, orunciman@gmail.com

 

‘Doctors should be able to prescribe the tapering medication strips I demonstrated at the meeting, which are required to stop safely. This is crucially important’. Dr Peter Groot, Netherlands (UMC University Hospital, Utrecht) +31 622290233  p.c.groot@ziggo.nl

 

‘As an NHS Psychiatrist, I am aware how many lives are ruined by over-medication. We need to recognise that there are alternatives which are more powerful and less harmful.’ Dr Rex Haigh, UK (Berkshire) +44 7768 546983 rex.haigh@gmail.com

 

‘The strong commitment all weekend, from researchers, clinicians and people with experience of psychiatric drugs was inspiring. The denying and minimizing of psychiatry and the drug companies will no longer prevail’. Professor John Read, UK (University of East London, IIPDW Board Member) +44 7944 853 783  john@uel.ac.uk

 

“I return to Brazil with a willingness to help the process of psychiatric reform in my country vigorously address the damage that the alliance between psychiatry and the pharmaceutical industry has done to our population.” Professor Fernando Freitas (FIOCRUZ, Member of IIPDW Faculty) + 55 21 2260 9200 ffreitas@ensp.fiocruz.br

© Mad in America 2019

This week on MIA Radio, we chat with Professor Peter Kinderman. Peter is Professor of Clinical Psychology at the University of Liverpool, honorary Consultant Clinical Psychologist with Mersey Care NHS Trust and Clinical Advisor for Public Health England, UK. He was 2016-2017 President of the British Psychological Society (BPS) and twice chair of the BPS Division of Clinical Psychology. His research activity and clinical work concentrate on serious and enduring mental health problems, as well as on how psychological science can assist public policy in health and social care. His previous books include A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing, released in 2013.

In this interview, we discuss Peter’s new book, A Manifesto for Mental Health, Why We Need a Revolution in Mental Health Care, which presents a radically new and distinctive outlook that critically examines the dominant ‘disease-model’ of mental health care.

The book highlights persuasive evidence that our mental health and wellbeing depend largely on the society in which we live, on the things happen to us, and on how we learn to make sense of and respond to those events. Peter proposes a rejection of invalid diagnostic labels, practical help rather than medication, and a recognition that distress is usually an understandable human response to life’s challenges.

We discuss:

• What led Peter to his interest in psychology, having initially been interested in physics and philosophy.
• How his academic and clinical work have influenced each other throughout his career.
• Why it is important to challenge mainstream mental health messages, not just as an academic exercise but also for the good of society.
• That it is pretty clear that we currently have a very poor system for responding to emotional distress.
• How we are not offering real-world help for real-world problems.
• That it is vital for us to offer people an alternative framework of understanding to allow them to decide for themselves how best to frame and therefore respond to difficulty.
• That Peter has observed changes in language that are helping to support public realisation that ‘mental illness’ is an idea or theory rather than undeniable fact.
• How a psychosocially-based mental health response might work.
• That Peter’s would like to see psychiatrists treating children to be employed by the authority also in charge of education provision.
• How our hierarchical health system gives doctors enormous power.
• That the Nordic countries have evolved a more socially-integrated and community-based approach, which better integrates health and social care.
• How those that are critical of the illness model are sometimes viewed as ‘deniers of real experiences’, but that this is a mischaracterisation because it is more about understanding those experiences in a different way or using a different framework.

Relevant links:

A Manifesto for Mental Health – Why We Need a Revolution in Mental Health Care

A Prescription for Psychiatry – Why We Need a Whole New Approach to Mental Health and Wellbeing

Professor Peter Kinderman, University of Liverpool, talks about a manifesto for mental health at the DECP Annual Conference 2016

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© Mad in America 2019

On MIA Radio, we interview Anthropologist Zhiying Ma, who explores mental health care in China, including tensions between Western psychiatry and socially-oriented local frameworks.

Zhiying Ma is a cultural and medical anthropologist and disability studies scholar whose work explores the experiences and rights of those receiving mental health services in China. Her current book project, Intimate Institutions: Governance and Care Under the Mental Health Legal Reform in Contemporary China, investigates how the Chinese state has placed paternalistic responsibilities on families through their role in the care of those diagnosed with serious mental illnesses, in part through the practice of involuntary hospitalization.

Ma came to earn a Ph.D. in Anthropology after questioning psychology’s overemphasis on decontextualized human behavior while majoring in the subject as an undergraduate. She found that anthropology offered the more humanistic and socially oriented lens she was looking for, and this perspective informs her current work.

Ma collaborates with psychiatrists, social workers, human rights activists, lawmakers, families, and those with lived experience to not only conduct research but also to take part in China’s ongoing mental health policy discussions and push for community-based, socially inclusive care that is not simply “care as usual.”

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On MIA Radio this week, in the second of a number of podcasts focused on parenting issues, we interview Ben Furman MD. Ben is a Finnish psychiatrist, psychotherapist and internationally renowned teacher of the Solution-Focused approach to preventing and treating mental health problems in both children and adults. His numerous books have been translated into over 20 languages.

Relevant Links

Helping Children With Angry Outbursts

The Kid Skills App

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© Mad in America 2019

In our second week of MIA Veterans & Military Families, we interview U.S. Navy Veteran Dan Hurd. Dan is the Founder of Ride With Dan USAand the One Pedal at a Time Movement. After surviving his third suicide attempt, Dan became inspired to bicycle to all 48 States in the continental U.S. to help raise awareness about suicide. Along his journey, Dan has realized his attempts were likely caused by the medications he had been prescribed and now dedicates his life towards inspiring others to live life “One Pedal at a Time”. 

(audio to be added)

We discuss: 

• How Dan survived a rough childhood and came to be prescribed psychoactive medications as a teenager.
• That Dan found his time in the U.S. Navy to be the best time of his life.
• How he came to found Ride with Dan USAand the One Pedal at a Time Movement.
• Why he is biking all 48 states in the continental U.S., with a path that includes 25,000 miles and a three-year ride to raise awareness about suicide and to call for research.
• How all three of his suicide attempts were during periods of medication withdrawal.
• How his first attempt occurred in high school, six months before entering the U.S. Navy.
• How, a year after discharge from the Navy, Dan began getting prescribed medications again.
• Dan now realizes that meds were the likely cause of his suicide attempts. Life stressors were triggers, but medication withdrawal manufactured his risk.
• How Dan experienced severe physical pain as part of withdrawal from psychoactive medications, which was especially pronounced during the first year of his ride across the country.
• How his physical pain from withdrawal was so intense that it nearly ended his trip within the first six months of his journey.
• Dan talks about his concerns that psychoactive meds might have harmed his mother, and that her being prescribed these medications prior to his birth might have impacted his life today.
• How he hadn’t previously connected meds to his negative life events, specifically social isolation. Dan has gone from complete isolation while on meds to exploring all 48 states on his bicycle now that he is off of the drugs.
• How Dan has come to recognize medications aren’t solving a chemical imbalance, but instead are medicating symptoms, which led to polypharmacy.
• How Dan’s journey and sharing his story with others has helped him in his recovery and in finding balance in life.
• Dan’s Message to listeners: "Take life one step and one pedal at a time. If you’re experiencing challenges, tell everybody what is going on. Don’t expect help, because when you expect it, you’ll be disappointed. It’s when you’re asking for help and not expecting it, you’ll be happily surprised at what happens."

Relevant Links:

One Pedal at a Time Movement

Ride with Dan USA

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Lillian Comas-Díaz is a pioneer in the field of ethnocultural approaches to mental health. She is both a clinical practitioner and multicultural feminist psychologist, writing numerous journal articles and books pushing the field toward more inclusive and less ethnocentric theories and practices.

She was recently awarded the 2019 American Psychological Association gold medal awardfor lifetime achievement and the practice of psychology, the first time a person of color has been recognized with the award. She credits the long-term, collective effort of professionals of color working on expanding psychology’s lens to include the perspectives of marginalized peoples’ experiences.

Comas-Díaz, along with her colleagues, recently introduced a special issue on the concept they call racial trauma (see MIA report). She describes racial trauma as “an insidious type of distress that many people of color and other marginalized individuals experience, where they are living in a society where racism, heterosexism, classism, and all those kinds of ‘isms’ are making the society oppressive towards those targeted groups.”

This week on MIA Radio we turn our attention to veterans, service members and military families. MIA has recently launched a new resource for military veterans which will provide news, personal stories and resources specific to veterans and their families. So to explain more about the new resources I am delighted to have been able to chat with Derek Blumke. Derek is the newest member of the MIA Team and he is the editor of the new veterans section.

Derek served 12 years in the US Air Force and Michigan Air National Guard before attending the University of Michigan where he cofounded Student Veterans of America. For his work, Derek received the Presidential Volunteer Service Award and was recognised at the White House by President Barack Obama for his leadership in supporting returning military veterans.

To listen and subscribe to the Mad in America podcast on Apple iTunes, click here. Listen also on Spotify, YouTube or Google Podcasts.

We discuss:

• Derek’s time in the US Air Force and Michigan Air National Guard which saw him deployed to Afghanistan and Uzbekistan.
• How, following his service years, he transitioned to Community College in 2005 and then went on to the University of Michigan.
• How he came to feel that veterans were often isolated on campuses and this drove him to set up an organisation to provide support and connection for ex-service members, which became Student Veterans of America.
• That SVA is now the largest student organisation in the US and also the largest organisation of Iraq and Afghanistan veterans in the country.
• That during his three years running SVA, Derek became involved in legislative action to help send military service members to college (the Post-911 GI Bill).
• How veterans face unique challenges but shouldn’t be viewed as somehow broken or in need of specific support.
• That it was post-service experiences that led to Derek’s realisation that our approach to mental health could be leading to damage and harm.
• How Derek came to set up a tech company which he describes as ‘the most stressful and challenging time of his life’.
• That these stresses and strains led to being prescribed psychiatric drugs, initially Adderall but later having Ambien and Gabapentin added and eventually Zoloft too.
• How the side effects of this cocktail rendered Derek barely able to function and led to him moving back to Michigan.
• That he stopped socialising, stopped posting on social media and his social circle reduced because of the effects of the drugs.
• How these experiences led to questioning and some research and how he withdrew from five drugs over a month, with the most issues coming from the antidepressant Zoloft.
• His description of withdrawal effects including tinnitus, brain zaps, nausea, fatigue, anxiety and extreme dizziness.
• That he came to read the New York Times article: ‘Many people taking antidepressants find they cannot quit’ and realised he was in acute withdrawal.
• That it ultimately took Derek a year to come off the Zoloft.
• How he discovered Mad in America and realised that the messages in the mainstream mental health world do not do justice to the experiences that people are having with psychiatric drugs.
• How Derek got involved with MIA and came to lead our news veterans initiative.
• The suicide epidemic that has so severely affected the veterans community and how it results in more deaths than casualties from recent conflicts.
• That he hopes that the MIA veterans initiative will be seen as the equivalent of Yelp for veterans who want to read personal accounts and learn from unbiased and alternative sources.
• That Derek is starting a new non-profit: Walk There, which is designed to get people together to walk in their local area.

Relevant Links:

Mad in America Veterans Resources

Student Veterans of America

The Department of Veterans Affairs (VA)

The New York Times: Many People Taking Antidepressants Discover They Cannot Quit

Walk There

On MIA Radio this week, in the first of a number of podcasts focussed on parenting issues, we interview Dr. Craig Wiener, a licensed psychologist based in Worcester, Massachusetts, who specializes in the treatment of children, adolescents, and families.

In addition to over 30 years of private practice, Dr. Wiener is an assistant professor in the Department of Family Medicine and Community Health at the University of Massachusetts Medical School. Dr. Wiener is the author of three books. most recently Parenting Your Child with ADHD: A No-Nonsense Guide for Nurturing Self-Reliance and Cooperation. Earlier this year he debuted his three-part video series “ADHD: A Return to Psychology,” which appears on the Mad in America website and also on YouTube.

© Mad in America 2019

Pat Bracken is a psychiatrist who questions many of the fundamental assumptions of his field. He has worked as a psychiatrist in rural Ireland, inner-city and multi-ethnic parts of the UK, and in Uganda, East Africa.

Bracken, who holds doctoral degrees in both medicine and philosophy, calls for a movement toward critical psychiatry. He was one of the people involved in starting the Critical Psychiatry Network, an organization of psychiatrists, researchers, and mental health professionals that question the assumptions that lie beneath psychiatric knowledge and practice.

Through his clinical practice and his academic work in philosophy and ethics, he has seen the limits and dangers of standard approaches to mental health in the West. As a result, he has become an advocate for listening to different understandings of madness from those who are routinely ignored and dismissed — namely, service-users and people who themselves experience madness, and those from indigenous and non-Western cultures.

MIA’s Ayurdhi Dhar interviews Diana Kopua about the Mahi a Atua approach, the global mental health movement, and the importance of language and narratives in how we understand our world and ease our suffering.

Diana Kopua’s life resembles the stories she uses in her work. From a psychiatric community nurse to the head of the department of psychiatry for Hauora Tairawhiti in Gisborne, New Zealand, her 13-year long, arduous journey is both deeply personal and profoundly political. Kopua says she did this to “become a wedge that kept the door open to allow for indigenous leaders” in her world to change the system. One may call her a storyteller, but a story-gatherer might be more appropriate.

As a psychiatrist, Kopua deals in human distress but her interest does not lie in neat psychiatric classifications; instead, she focuses on understanding suffering through Maori creation stories, Purakau. She has developed Mahi a Atua, “an engagement, an assessment, and an intervention” to address the mental distress and suffering among the Maori of New Zealand. Mahi a Atua is not just a set of techniques or a culturally sensitive new therapy, but a drastically different way of conceptualizing the lived experience of the Maori.

Recently, along with art and culture expert Mark Kopua and critical psychiatrist Pat Bracken, she published a paper on this approach in Transcultural Psychiatry. Their work can be seen as an alternative to Western pharmaco-therapeutic interventions currently being promoted throughout the global South via the global mental health movement.

Researchers have critiqued the exporting of Western psychiatric practices, often citing the famous WHO study that reported better outcomes for people diagnosed with mental disorders in the developing world. As the only Ngati Porou (a Maori nation) psychiatrist in the world, working with a population known for poor mental health outcomes, Kopua’s work offers insight into what can be learned from local, Indigenous, and traditional healing methods.

There are many now calling for a “paradigm shift” in Western psychiatry, and in our interview, we covered topics ranging from the specifics of the Mahi a Atua approach, the global mental health movement, and the importance of language and narratives in how we understand our world and ease our suffering.

© Mad in America 2019

This week on MIA Radio, we present a special episode of the MIA podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2019.

2019 represents the fourth annual awareness day and each year it’s held on July 11 which is a significant date because it is the birthday of Professor Heather Ashton. Dr. Ashton is a world-leading expert in benzodiazepines and wrote the highly regarded Ashton Manual which aims to aid clinicians and patients in coming off benzodazepine drugs safely. She also spent many years personally assisting and supporting those who had experienced protracted benzodiazepine withdrawal.

Around the world there are many activities and events taking place as part of W-BAD, so to follow along with events and to get involved yourself, head over to World Benzodiazepine Awareness Day’s Facebook page and look out for the hashtag #WorldBenzoDay on social media.

In our two-part podcast, we hear from W-BAD volunteer and Project Manager for W-BAD Rocks of Kindness, Janelle. We also chat with physician and Director of the Benzodiazepine Information Coalition Christy Huff MD. Finally, in part two, we hear from Stephen Wright MD, addiction specialist and medical consultant to the Alliance for Benzodiazepine Best Practices.

W-BAD Rocks on Facebook

Rockin’ Against Benzos (closed Facebook group)

A Rockin’ Creative Outlet That’s Raising Benzodiazepine Awareness

#WBADROCKS – 1 Month, 5 Things We’ve Learned

W-BAD Rocks on Twitter and Instagram: @wbadrocks

On social media, look for the hashtag #WBADROCKS

A Xanax Prescription That Should Have Been Rejected

10 Tips To Help Patients Through Benzodiazepine Withdrawal

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Last year, Lucy Johnstone and her colleagues in the UK launched the Power Threat Meaning Framework (PTMF), a set of ideas that represented a sharp departure from the biomedical conceptions that animate the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). This framework shifts the notion of “what is wrong with you” in the DSM to “what has happened to you,” and by doing so turns away from a medical process bent on diagnosing broken brains and toward a narrative response that tells of contexts, power dynamics, and systems.

At a time when the Movement for Global Mental Health is intent on exporting the Western biomedical approaches around the world, Johnstone and her PTMF team, which has included numerous individuals who identify as service users/survivors, are seeking to promote a radically different way of understanding distress. Responses to the PTMF have ranged the gamut from criticism to gratitude.

Johnstone, a consulting clinical psychologist who has experience working in adult mental health settings for many years, believes that the current mental health system has failed, and we are now in the process of witnessing its inevitable downfall. She questions whether a mental health system is needed at all. However, as Thomas Kuhn wrote in his work on scientific revolutions, a system cannot be fully abandoned until there exists a conceptual alternative for the system to move towards. The PTMF, Johnstone believes, offers that conceptual alternative that is necessary for a revolution.

In this interview, she reflects on the reaction to the PTMF, and the possibility that it will help stir up a revolution in the field. How is the framework to be used? Does it stand a chance of becoming adopted? She also tells of how her own life experiences and the influences on her work.

Relevant Links

Dr. Johnstone took part in an earlier interview after the PTMF was launched. You may view
this interview here: https://www.madinamerica.com/2018/03/dr-lucy-johnstone-power-threat-meaning-framework/

More about the PTMF:
Lucy Johnstone discussing the primary features of PTMF:
https://www.youtube.com/watch?v=tkNWQdVB4F0
A British Psychological Society report (with full document link to the framework included):
https://www.bps.org.uk/news-and-policy/introducing-power-threat-meaning-framework

© Mad in America 2019

This week on MIA Radio, we continue our series of discussions with Doctor Lee Coleman. In previous podcasts, we have discussed Lee’s views as a critical psychiatrist and the role of psychiatry in the courtroom. This time, we turn our attention to the need for action to address the inherent power held by psychiatry and how society might respond.

In this episode we discuss:

• How language has the power to trigger associations and can lead us to not question theories that are presented to us as facts.
• How we have come to equate psychiatric ‘treatment’ with interventions in other areas of medicine.
• The deception behind the names of the drugs used in psychiatry such as ‘antidepressants’ or ‘antipsychotics’.
• That society may well be blinded by language to the critical issues of the use of force and the relationship between the law and psychiatry.
• That, ultimately, society demands that psychiatry play the role that it does and therefore we need a societal and political response.
• That any movement to address the dominance of the medical model needs to educate the public at large and so needs resources to be able to provide that challenge.
• How the media often provides an amplified voice for mainstream messages leading to normalisation and lack of critical questioning of such messages.
• That we can and should partner with sympathetic media channels who are open to challenging mainstream messaging.
• That Lee will hopefully be leading a workshop at the 2019 NARPA (National Association for Rights Protection and Advocacy) Conference in Connecticut, USA.

Relevant Links

Article - Technology and Psychiatry

NARPA 2019 Conference

YouTube - Psychiatry's "War of the Words"

YouTube - Dealing With Powerful Opponents: Psychiatry, Government and Pharma

To get in touch, email us at podcasts@madinamerica.com

© Mad in America 2019

On MIA Radio this week, MIA’s Tim Beck interviewed Dr. Felicity Thomas and Dr. Richard Byng. Dr. Thomas is a Senior Research Fellow in the Medical School and a Senior Research Fellow on the Cultural Contexts of Health in the College of Humanities at the University of Exeter. She is also a co-director (with Professor Mark Jackson) of the WHO Collaborating Centre on Culture and Health and works closely with the WHO Regional Office for Europe project on the Cultural Contexts of Health.

Dr. Byng is a professor in primary care research at the University of Plymouth. Dr. Byng is also trained as a general practitioner with a particular interest in mental health care. Over the last 20 years, he has worked on various large-scale research projects related to access, commissioning, inter-professional working and implementation of evidence-based practice, while publishing extensively on topics related to the social contexts of health and professional care.

Together, Dr. Thomas and Dr. Byng have contributed to the DeSTRESS project, which consists of a team of researchers in the United Kingdom who seek to learn about why and how poverty-related issues have become increasingly pathologized. This includes exploring how high levels of antidepressant prescription and use are impacting people’s health and wellbeing in low-income communities in southwest England.

Their final report published in April 2019, entitled Poverty, Pathology, and Pills, situates increasing rates of mental health diagnosis and psychiatric prescriptions within socioeconomic and policy trends across the UK. An overarching conclusion of this research was that there is a need to reconceptualize the way that health professionals respond to poverty-related distress. This requires a response that recognizes the bio-psycho-social and reduces pressures on general practitioners (GPs) to make rapid decisions around diagnosing and prescribing.

On MIA Radio this week, MIA’s Gavin Crowell-Williamson interviewed Adriane Fugh-Berman, MD, a professor in the Department of Pharmacology and Physiology and in the Department of Family Medicine at Georgetown University Medical Center (GUMC).

She is the director of PharmedOut, a GUMC research and education project promoting rational prescribing and exposing the effects of pharmaceutical marketing on prescribing practices. Dr. Fugh-Berman leads a team of volunteer professionals that has deeply impacted prescribers’ perceptions of the adverse consequences of industry marketing.

She is interested in physician-industry relationships and is an expert witness in litigation regarding pharmaceutical marketing processes. She was formerly a medical officer in the Contraception and Reproductive Health Branch of the National Institute for Child Health and Human Development.

Dr. Fugh-Berman is the lead author on key articles on physician-industry relationships, including a national survey of industry interactions with family medicine residencies, exposés of how ghostwritten articles in the medical literature are used to sell drugs, an analysis of drug rep tactics, and an explanation of industry publication planning. 

She wrote the first chapter on alternative medicine to appear in Harrison’s Principles of Internal Medicine and authored the first clinicians’ reference text on dietary supplements, the 5-Minute Herb and Dietary Supplement Consult, as well as an evidence-based book aimed at consumers, Alternative Medicine: What Works. 

In addition to dozens of articles in peer-reviewed literature, Dr. Fugh-Berman coauthored The Truth about Hormone Therapy and co-edited The Teratology Primer. Dr. Fugh-Berman is the former chair of and currently writes a column for the National Women’s Health Network, a consumer advocacy group that takes no money from industry. Dr. Fugh-Berman has appeared on 20/20, the Today Show, and every major news network.

On MIA Radio this week, MIA’s Peter Simons interviewed David Cohen, PhD, a social worker, professor of social welfare, and Associate Dean for Research at the Luskin School of Public Affairs of the University of California, Los Angeles. He discussed his path to becoming a researcher focused on mental health, coercive practices, and discontinuation from psychiatric drugs.

He studies the social construction of psychoactive drug effects, the union of law and psychiatry within a criminalization/medicalization system and envisions alternatives to the current mental health industrial complex and the medicalization of everyday life. He has also taught in Canada and France, and for over 20 years held a private practice to help people withdraw from psychiatric drugs.

He is the author of over 100 book chapters and articles. His first book, published in 1990, was Challenging the Therapeutic State: Critical Perspectives on Psychiatry and the Mental Health System. His latest book, published in 2013, with colleagues, Stuart Kirk, and Tomi Gomory is Mad Science: Psychiatric Coercion, Diagnosis and Drugs.

On MIA Radio this week, MIA’s Akansha Vaswani interviewed Dr. John Read, a clinical psychologist at the University of East London, about the influences on his work and research on mental health over the years.

John worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, in 1994, where he worked until 2013. He has published over 140 papers in research journals, primarily on the relationship between adverse life events (e.g. child abuse/neglect, poverty, etc.) and psychosis. He also researches the negative effects of biogenetic causal explanations on prejudice, the opinions, and experiences of recipients of antipsychotic and antidepressant medication, and the role of the pharmaceutical industry in mental health research and practice.

John is on the Boards of the Hearing Voices Network – England, the International Institute for Psychiatric Drug Withdrawal and the UK branch of the International Society for Psychological and Social Approaches to Psychosis (www.isps.org). He is the Editor of the ISPS scientific journal ‘Psychosis.’

This week on MIA Radio, we present our second chat with Doctor Lee Coleman. In the first interview in this series, we discussed Lee’s career, his views as a critical psychiatrist and his 1984 book Reign of Error. For this second interview, we focus on psychiatry in the courtroom and why the psychiatric expert witness role may be failing both the individual on trial and society at large. We also focus on Chapter 3 of Reign of Error: The Insanity Defence, Storytelling on the Witness Stand.

In this episode we discuss:

• What led Lee to his involvement in the courtroom as a psychiatrist testifying as to the reliability of psychiatric testimony itself.
• How both psychiatrists and psychologists have been given a role by society to judge both the current mental state of an individual on trial and also the potential future behaviour of that individual.
• How important it is to address the three dimensions of past, present and future when looking at psychological testimony.
• The role of psychiatry in the trial of Patty Hearst, when required to provide evidence that she has been brainwashed and therefore was incompetent to stand trial.
• How Lee and a colleague, George Alexander, came to arrange a press conference to address the issue of the reliability of psychiatric or psychological testimony.
• How speaking out in this way ultimately led to many years of opposition not only by psychiatry but also by attorneys on both sides of the debate.
• The legal definition of the term ‘insanity’ and the context in which it is used.
• How if someone is found legally insane, the punishment may be far worse and the incarceration far longer than if that person were found guilty.
• The details surrounding the trial of Dr. Geza De Kaplany, who committed a gruesome murder but came to be represented at trial as having multiple personalities and being mentally disordered.
• The inconsistency often found in both the defense and prosecution in the courtroom when it comes to subjective assessments of the mental state of an individual.
• That it is crucial that people band together to share information and to actively demonstrate and have conferences and influence legislators because we can’t rely on media channels and we can’t rely on professional bodies.

Relevant Links:

Doctor Lee Coleman

The Reign of Error

YouTube - Competent to Stand Trial?- A Psychiatric Farce

YouTube - Society Doesn't Need Protection from the "mentally ill"

The Trial of Patty Hearst

Geza De Kaplany

To get in touch, email us at podcasts@madinamerica.com

On MIA Radio this week, MIA’s Jessica Janze interviewed Dr. Jonathan Raskin, in the Department of Psychology at the State University of New York at New Paltz where he serves as department chair and teaches classes in psychology and counselor education.

Dr. Raskin’s research is focused on constructivist meaning-based approaches in psychology and counseling. He recently authored a textbook titled Abnormal Psychology: Contrasting Perspectives.

Dr. Raskin describes a recent article he wrote (What Might an Alternative to the DSM Suitable for Psychotherapists Look Like?) that highlights psychotherapists’ dissatisfaction with the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and suggests some principles for building alternative models. 

What follows is a transcript of the interview, edited for clarity.

****************

JJ: Welcome, Jonathan. I'm very excited to have you. Is there anything else you want to add about your background for our readers before we get started?

JR: No, not at all. Thank you for inviting me to do this.

JJ: Let's get started. What made you interested in working on alternative diagnostic systems for use in psychotherapy?

JR: Yeah, that's a good question. I've always been interested in how people make meaning, and diagnostic systems are the way that mental health professionals make meaning of their client's experiences. So to me, all diagnostic systems are meaningful systems for making sense of the problems our clients bring to us.

JJ: You take a constructivist approach to thinking about diagnosis. Can you break down what that means for us and how it applies to this issue of diagnosis? 

JR: Many theories fall under the banner of constructivism, but broadly speaking, constructivism focuses on how people both individually and in conjunction with one another (and in more social kinds of configurations) construct understandings of themselves and the world. Then they use those constructions to guide their lives. To me, constructivism seems like an excellent theoretical approach to use in understanding diagnosis because each diagnostic approach can be viewed as a constructed meaning system for understanding and conceptualizing client concerns.

JJ: Several alternative diagnostic systems have been promoted in recent years, including HiTop, the Power Threat Meaning framework, RDoC, and the PDM. What are your thoughts on these alternatives?

JR: I think they're all interesting in their own ways. Let me talk about a few of them. I'll start with HiTop. That's the hierarchical taxonomy of psychopathology. It's a dimensional approach that tries to address the problem of comorbidity that afflicts DSM categories. Comorbidity is a confusing issue for people. When disorders are comorbid, they're diagnosed at the same time. One of the problems is that a lot of the DSM diagnoses are comorbid with one another. If you have too much comorbidity, the question that arises is, are the categories that we've constructed distinct from one another?

HiTop thinks that comorbidity should be embraced instead of rejected. They say, “Yes, these DSM categories cluster together, we can group each of them under these broader spectrums.” The HiTop system uses six spectrum dimensions. Ultimately, the people who created HiTop feel that DSM disorders might be discardable, but for the time being, we can keep them.

They say that there are really these co-morbid overlapping categories underneath these higher levels, six distinct spectra. HiTop sees this as a simpler approach because you can divide people's problems into how they score along these six different spectrum dimensions. It's still very early going. I think it has a lot in common with the big five personality research. If you like those, you'll like HiTop. If you don't like those, you might not be a fan of HiTop.

Let me talk a little bit about RDoC. RDoC is the research domain criteria system. It's a research initiative at the moment. It's not a diagnostic system yet. They're trying to build a diagnostic system from the ground up, and they're doing that by trying to identify the ways that the brain is designed to function. Then, and only then, they will identify ways that it malfunctions. And so the categories that they create will be based on their identifying and diagnosing these specific malfunctions.

The people involved in RDoC say, “We're doing this in the right way, whereas the DSM does it backward.” DSM starts with categories and then researchers race around trying to find out what the biological correlates of those categories are. RDoC says, “Let's understand the brain and how it works and then build categories based on observable differences between healthy and unhealthy brains.” It's a very medical model kind of approach. And if you like that, you'll like RDoC. If you don't like the medical model, you won't.

What's really fascinating about [RDOC] is the idea that it wants to build the system from the ground up. It is not yet a diagnostic system; it's a research initiative. We don't have the ability to identify any kind of presenting problems based exclusively on these kinds of biological biomarkers just yet.

Then there's the Power Threat Meaning framework (PTM), which is going 180 degrees in the other direction. PTM shifts the focus. It moves away from the medical model. It actually doesn't consider itself a diagnostic system. It rejects the idea of medical model diagnostic systems. It says that we need to depathologize people's problems by focusing on what the PTM identifies as the actual causes. It says that economic and social injustices are the root causes of emotional distress. The origins of distress lie outside the person. RDOC looks inside the person, and I think the DSM, in many respects, implies that it's inside the person. PTM emphasizes what has happened to people on a socio-cultural level and then how they've responded to it. It's a totally different approach. It's a non-diagnostic approach.

Another approach is the Psychodynamic Diagnostic Manual (PDM). From its name, you can tell it’s an explicitly psychodynamic diagnostic manual that diagnoses problems through the lens of psychodynamic theory. So whereas the DSM has traditionally been atheoretical, in the sense that it's a descriptive, diagnostic manual describing problems, but it doesn't take a stance on what causes them, the PDM roots its approach explicitly in psychodynamic theory.

All of these approaches are really interesting in their own way. The question is whether or not they'll catch on.

JJ: You don't think that there is one particular diagnostic system that our society should switch to, is that correct?

JR: I view diagnostic systems as tools. Like hammers, they're really helpful instruments. However, depending on the task I’m up to, I might be better off with a wrench or a pair of pliers or some other tool instead. So, I find it helpful to use the tools metaphor when considering diagnostic systems.

One might find a given diagnostic system useful, or not, depending on the situation. Of course, it's always important to remember that diagnostic systems provide maps that can guide us, but we have to be careful not to mistake the map for the territory.

I think the biggest barrier to developing viable alternatives to the DSM and the ICD is that these approaches cross theoretical perspectives by being mainly descriptive. But, when it comes to how a diagnostic system informs treatment, descriptive approaches, in many ways are lacking. That is, they don't take any stance on how to best approach the problems they identify or describe. So, their wanting to script nature makes DSM and ICD easy for everyone to adopt regardless of the theoretical viewpoint. But any theoretically driven system, things like the PDM or the power threat meaning framework or RDoC even, those systems in many ways might struggle to gain mass acceptance because their theoretical commitments will turn people off.

Somebody who doesn't like a medical model brain approach won't use RDoC. Somebody who's really opposed to psychodynamic theories, or just not interested in them, won't use PDM. Somebody who doesn't take a social justice orientation to problems might not like PTM. By being theoretically well developed and informative about how to conceptualize and approach client problems, these alternative diagnostic systems ironically make themselves less broadly appealing. That can be a challenge for them. But, if they are tools you don't have to stick with just one, you could jump around from one system to the next depending on what you're up to that day.

JJ: What about insurance companies? What do you think an alternative to the DSM system that could be used for insurance purposes would look like?

JR: I’m not sure. It’s been suggested by a lot of people that a very practical thing we can do is use the DSM-5 V codes (which list circumstances or experiences, such as "Homelessness," "Poverty," and "High Expressed Emotion Level Within Family") because that might let us identify presenting problems while being less medicalizing and stigmatizing.

Practically, those codes already exist, but we would need insurers to cover them for clinicians to begin using them. One of the reasons they don't get used is that insurance companies don't cover the code diagnosis. As I was describing a minute ago, I think theoretically coherent systems might prove to be more helpful to clinicians in a practical, everyday manner but they're less likely to be appreciated and used across clinicians and different theoretical orientations. That's the challenge. Being theoretically consistent and pure and developing something that a smaller group of people might like to use versus having something that would kind of cut across all theoretical orientations. The latter might be more descriptive, but potentially not the most clinically useful, but would help grease the wheels of insurance.

JJ: Can you talk more about the importance of including service users and people with lived experiences in the development of any future alternatives?

JR: I think it's very important to listen to service users because they're the ones impacted by whatever diagnostic system we develop and use. So we really need their feedback, especially if we want to avoid inadvertently harming them.

JJ: How do you think diagnoses should be approached in therapy? How do you recommend clinicians approach these topics with people who come to see them? 

JR: I think we often draw sort of an artificial line between diagnosis and treatment. George Kelly was the psychologist who developed personal construct theory, and he used to say that therapists have to continually revise their understandings of clients because clients are always in process and forever changing. That's why Kelly used the term transitive diagnosis. He said diagnoses are transitive because they are continually evolving.

So given that, regardless of the diagnostic approach that a therapist takes, it seems to me very important for the therapist to not reify the diagnosis made because I think doing so locks the client in place in a way that can be highly limiting. That would be true across different diagnostic systems for me. Whichever system somebody’s adopting, you have to be careful not to be too literal or reifying about that system. So to me, thinking of diagnoses as meaningful constructions, as created understandings that might -for the time being- inform what we're doing, is terrific. But when we shift to seeing them as essential, unchangeable things we can lock ourselves in, and we can actually also unintentionally harm the people we're working with.

JJ: More of a living system.

JR: As Kelly said, you have to keep up with your clients. They're always in process, and you better keep up with them because if you're still using last week's a conceptualization and understanding, well, they may have moved on.

JJ: Is there anything else that you wanted to add or talk to us about before we wrap up?

JR: No, I mean just that I think this is a growing area that people are expressing interest in. I sense that a lot of clinicians don't really know much about different alternatives beyond the DSM and the ICD. And so, one of the things that I've been interested in recently is just helping the field have more knowledge; helping the clinicians out in the field become aware of approaches that they may not know much about.

My sense is that clinicians are hungry for alternatives, but they don't necessarily know what the alternatives are. And then, at the same time, they also feel trapped in the sense that in order for them to get paid, they need to use the DSM. But it doesn’t mean, even if the issues of reimbursement haven't been resolved for other systems, it doesn't mean that they can't learn about and begin using these other systems in addition. It doesn't have to be an either-or. So my goal is to learn more about these diagnostic alternatives myself and then to help others out in the field learn about them as well.

JJ: I think that's really great. Just talking about alternatives and getting the information out even if we do not necessarily subscribe to them or use them. 

JR: Having an open discussion and dialogue about them is important, and I think people are very quick to make judgments about which approach they like or dislike. But I think if you want to develop alternatives, you have to be open-minded and be willing to talk with people who might be developing alternatives that are very different from what you yourself might develop and appreciate that each alternative may have advantages to it as well as disadvantages.

JJ: I'm excited to see these theories evolve and to see how the field continues this conversation and I'm glad that you're a part of that. Your textbook compares and lays out the alternative diagnostic frameworks, right?

JR: Yea, one of the things that I was very excited to do in the book was to present alternative perspectives across both diagnosis and treatment interventions. In the diagnosis chapter, I talk about RDoC; I talk about HiTop; I talk about the PTM framework; Because I think it's essential for students in the field to learn about these approaches. If we want to disseminate information about them, we have to cover them in the places where students are learning about them.

I also spend a lot of time on DSM and ICD because those are the most influential approaches today. So all of them get covered, and they get covered as perspectives. Each one is a diagnostic perspective that a person might adopt depending on what the goal is in the given moment.

JJ: Well I have to say, I really appreciate you doing this work. I appreciate your perspectives. I appreciate you coming on today and sharing this information with our readers. I do agree with you. I think it's so important to get this information out to people. Thank you so much for talking to us, and I look forward to hearing more about your work. 

JR: Thank you very much.

© Mad in America 2019

Science and Pseudoscience of Mental Health Podcast: Episode 3

This past week, I had the great pleasure to talk with Dr. Kelly Brogan, a leading voice in natural approaches to women’s mental health. Dr. Brogan began her career as a conventional psychiatrist, but following the birth of her first child, she felt bereft of energy and mental clarity and was diagnosed with an autoimmune condition called Hashimoto’s Thyroiditis. Informed by her doctor that she had a chronic illness that would require a lifetime of medication, she launched her own research into her condition which catalyzed a profound paradigm shift in her understanding of health and wellness. Her research led her to Robert Whitaker’s Anatomy of an Epidemic after which time she permanently retired her prescription pad while turning towards natural interventions that support the body’s innate capacity to heal.

With degrees from MIT and Weil Cornell Medical College, triple board certification in psychiatry, psychosomatic medicine and integrative holistic medicine, and direct experience practicing within the parameters of conventional psychiatry, Dr. Brogan is uniquely qualified to challenge the pseudoscience of the chemical imbalance theory and the drug regimens that it spawned. At the same time, her rigorous education conferred the investigative tools that enabled her to identify the scientific principles that support mental health. She focuses on the integrative nature of the gastrointestinal, immune, endocrine and nervous systems and their seamless communication with the ecosystem that resides within the body – the microbiome – and the ecosystem that surrounds us. This science is at the core of her thirty-day wellness protocol which she outlines in her New York Times bestselling book: A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies and reclaim Their Lives.

Our conversation addressed Dr. Brogan’s grave concerns about the recent rollout of Zulresso (brexanolone), a drug specifically designed, and approved by the FDA for the treatment of Postpartum Depression. Drug trials that qualified Zulresso for FDA approval in fact revealed that its efficacy is weak at best, and not clinically significant. After 30 days, it was actually less effective than placebo. It requires an invasive 60-hour IV infusion with side effects that include sedation – sometimes to the point of loss of consciousness, separation of mother and infant, and cessation of breastfeeding. Women diagnosed with Postpartum Depression are suffering, but impactful interventions need to take into account the complex cultural, socioeconomic, personal and biological underpinnings of their symptoms. Masking symptoms with a drug that causes further disruption to their lives, lessens the likelihood that they will receive effective support. Dr. Brogan estimates that 80% of women who enter her practice having been diagnosed with Postpartum Depression have undetected and untreated thyroid conditions.

We also discussed the reckless prescribing of SSRI antidepressants to one in four American women, many of whom are pregnant, and the long-term epigenetic consequences of SSRIs following prenatal exposure. Dr. Brogan shared her approach to tapering from SSRIs both during pregnancy and as part of her general treatment protocol. Our conversation came to a close with a fascinating exploration of the science that informs the relationship between meditation and mental health. Dr. Brogan shared the transformative impact that her own daily meditation practice has had on her capacity to cope with stress.

To learn more about Dr. Brogan’s clinical work and research, you can visit her website.

For other interviews in this series, click here.

© Mad in America

On MIA Radio this week, MIA's Zenobia Morrill interviews Dr. Vance Trudeau, a professor at the University of Ottawa in Canada. Dr. Trudeau describes a recent study he conducted, alongside a team of researchers, led by Dr. Marilyn Vera-Chang, that has implications for understanding of the long-term impact of antidepressant drug exposure (see MIA report).

The study, titled Transgenerational hypocortisolism and behavioral disruption are induced by the antidepressant fluoxetine in male zebrafish Danio rerio linked antidepressant exposure to decreased coping behaviors in zebrafish that lasted several generations. Dr. Trudeau is the research chair in neuroendocrinology at the University of Ottawa, where he studies how the brain regulates hormonal activity in fish and frogs. Such analyses offer important insights into the effects of environmental exposures on human health because these hormonal systems are shared across species.

© Mad in America 2019

This week on MIA Radio, we chat with Doctor Lee Coleman. Lee trained in psychiatry during the 1960s, quickly adopting a sceptical attitude to the newly emerging field of biological psychiatry and rejecting the idea that drugs could be beneficial for so-called ‘mental disorders’. By the early 1970s, Lee’s professional life was divided between a small home-based practice of psychotherapy and a variety of activities – writing, speaking and political advocacy – focused on psychiatry’s role in society.

His experiences led to writing the book Reign of Error in 1984 in which he brings to bear his lengthy experience in both clinical and legal issues surrounding Psychiatry and Society.

Now retired, Lee devotes his time to public education that exposes the individual and public harms from today’s “mental health” industry. He seeks to support a grassroots movement to abolish forced “treatment” and provide tools to amplify the voices of those seeking change.

The discussion today marks the first in what will hopefully be a series of interviews on a range of topics which will be released on the podcast over the coming months.

In this episode we discuss:

• What led Lee to his interest in attending medical school during the 1950s and his fascination with the burgeoning field of biology.
• How, once he got to medical school, he found he did not care for psychiatry’s biological orientation.
• The Lee’s residency period was 1965 to 1969 and this marked a period of decline of psychoanalysis and the rise of biomedical psychiatry.
• That Lee came to see himself as part of what was called at the time ‘community psychiatry’ which was socially oriented.
• How, in the late 1960s, psychiatry was feeling the heat from psychologists, social workers and even some religious counsellors who started lobbying to get licenses to provide therapy.
• How psychiatry then started going on the offensive to redefine itself as having the leading medical expertise in mental health.
• That Lee was extremely concerned to learn about the legal power of psychiatry and this was a motivator to write The Reign of Error in 1984.
• How a book called Soledad Brother: The Prison Letters of George Jackson called into question much of what Lee had been taught during his residency.
• That Reign of Error is about both what is wrong with psychiatry and the fact that it is linked to the power of the State.
• That Lee has participated in well over 800 legal cases as an expert witness, but he has never testified as to the state of a person’s mind, instead he has testified on the state of psychiatry.
• That Lee has testified to the fact that psychiatrists are generally worse at assessing someone’s mental state than the average lay-person in the jury.
• How language can falsely lead us to believe that science underpins the actions of psychiatrists, something Lee refers to as The War of the Words.
• That we have to fight back by explaining properly what words like ‘treatment’ actually mean.
• How American psychiatry is leading the way to the worldwide drugging of citizens and that we need political action to resist this future.

Relevant Links:

Doctor Lee Coleman

The Reign of Error

Lee’s YouTube Channel

Soledad Brother: The Prison Letters of George Jackson

© Mad in America 2019

Interview by Peter Simons.

Dr. Mark Horowitz is a training psychiatrist and researcher and recently co-authored, with Dr. David Taylor, a review of antidepressant withdrawal that was published in Lancet Psychiatry, which we've written about here at Mad in America (see here). Their article suggests that tapering off antidepressants over months or even years is more successful at preventing withdrawal symptoms than a quick discontinuation of two to four weeks.

Dr. Horowitz is currently completing his psychiatry training in Sydney, Australia, and has completed a PhD in the neurobiology of antidepressants at the Institute of Psychiatry at King's College, London. He is a clinical research fellow on the RADAR study run by University College, London. His research work focuses on pharmacologically informed ways of tapering patients off of medication. He plans to conduct studies examining the best methods for tapering medications in order to develop evidence based guidelines to assist patients and doctors.

This week, MIA Radio presents the fifth in a series of interviews on the topic of the global “mental health” movement.” This series is being developed through a UMASS Boston initiative supported by a grant from the Open Society Foundation. The interviews are being led by UMASS PhD students who also comprise the Mad in America research news team.

We interview Dr. Gail Hornstein, a Professor of Psychology at Mount Holyoke College in South Hadley, Massachusetts. She is the author of To Redeem One Person is to Redeem the World: The Life of Frieda Fromm-Reichmann and, most recently, Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness. In her work, she chronicles both the personal narratives of people with lived experience of being treated as “mad,” and also the growing movement of survivor and service-user activism. Her Bibliography of First-Person Narratives of Madness in English (now in its 5th edition) lists more than 1,000 books by people who have written about madness from their own experience; it is used by researchers, clinicians, educators, and peer groups around the world.

She is now director of a major research and training project investigating how hearing voices peer-support groups work, supported by a grant from the Foundation for Excellence in Mental Health Care. This project is training dozens of new hearing voices group facilitators across the US and sponsors research to identify the key mechanisms by which this approach works.

This week on MIA Radio, we turn our attention to Open Dialogue and we chat with psychotherapist and Open Dialogue trainer Alita Taylor. Alita is a licensed Marriage & Family Therapist, trainer and facilitator based in Tacoma, Washington USA. Her passion is working from a community-based, non-expert, need-adapted Open Dialogue perspective, which utilizes social networks, family, and co-facilitation with other professionals.

In this recent blog, Alita shares why Open Dialogue ‘cannot be taught, but needs a teacher‘.

Love Is In the Air…

I am in love. I’m in love with this way of working. And I won’t stop. Open Dialogue Washington began in 2018 upon my graduation/commencement from Jaakko Seikkula’s dialogic approaches to couple and family therapy trainer/supervisor training, in collaboration with Dialogic Partners and the University of Jyväskylä.

In 2016, I embarked to partake in the best training course I had ever experienced as a family therapist. The embodiment I experienced working with my Open Dialogue colleagues felt like the missing key in psychiatry and psychotherapy. Something intangible, yet what I knew all along. Something ineffable, yet also a shared language. Something deeply and autonomically human, yet unrepeatable and fleeting. It led me onto a moment-by-moment path where everything I learned in my 27-year long career about systemic family therapy and emergency psychiatric protocols ebbed, and the present moment of love flowed, neither the ebbing knowledge nor the cresting wisdom having any lesser value than the other.  The complete work we do in mental health care is this ocean of love.

We are in constant change when we are in crisis. Timelessness sets in. Growth is happening.  We don’t exactly know what we need. That is what mental health work is, sitting with this human happening. In the in-between space, something happens, and we don’t know what will. This is the paradox. We are navigating the ebb and flow of incoming knowledge we have from research and the ebb and flow in each patient and family’s difficulties (the meanings they make of them).

“It cannot be taught, but it needs a teacher.”

After getting trained to facilitate and supervise Open Dialogue, I found that this is the crux of the work, holding more than one truth. As human beings, as a society, as mental health practitioners, we must be able to ask what is helpful, and we must be willing to co-provide this “help” creatively, without barriers, between the digitized rows and columns of tick-boxes and presumptive diagnostic menus.  Remember the analog world of dials and infinite decimals? Agency lies within ourselves to expand the possibilities, to be willing to open to solutions that have not yet been tried.

Michael Pohl wrote about dialogical leadership and culture in which he referenced Karl-Martin Dietz and Thomas Kracht of the Hardenberg Institute for Cultural Studies in Heidelberg, Germany. Michael remembered a discussion on whether dialogism can be taught or experienced. It was argued that the dialogic attitude cannot be learned and that any thought of teaching it is unnecessary. Michael disagreed. He writes, “It cannot be taught, but it needs a teacher.”— Medium.com, March 2018.

In Helsinki and Tornio while learning the Open Dialogue approach, I had many teachers: Jorma Ahonen, Pekka Borchers, Birgitta Alakare, Aino Maija Rautkallio, Kari Valtanen, Tom Erik Arnkil, Jaakko Seikkula, Tapio Salo, Tanja Pihlaja, Eija-Liisa Rautiainen, Pekka Holm.  How did they do it? To quote Birgitta Alakare when she was asked about the beginnings of the development of Open Dialogue in the 1980’s, “It was not only me, it was all of us, everyone.”

When we include all the stakeholders, all the voices, polyphonically, something extraordinary is given space to emerge. This is challenging to enact when there are systems of health care based on bed occupancy, lengths of stay, productivity, staff ratios, definitions of “emergency” or “inpatient” levels of care.

Well, Open Dialogue Washington is bringing to the fore the question, “What is our role as helpers??”  To quote Mia Kurtti, Open Dialogue trainer of Tornio, Finland, “What are we really doing here?”

Caring for our mental health, however defined (crises, hard times, depression, psychosis), is a human need that varies from moment to moment. I learn from every client and family I sit with. In Open Dialogue, multiple perspectives are allowed, in fact invited. Unusual experiences are uncategorized mystery, and understanding between client and family/social network is continuously underway. The course of schizophrenia was reversed in Western Lapland, and their inhabitants trust their mental health system. Hmmm… if we want to save State and Federal dollars and our own livelihoods, perhaps we should allow ourselves to practice psychotherapy and psychiatry with more questions than answers. Perhaps the ones in crisis will teach us what we didn’t know. Love is somewhere, here, in the air.

Relevant links:

Open Dialogue Washington

Open Dialogue Training, April 2019

Open Dialogue UK

This week on MIA Radio, we interview Professor Jim van Os. Professor van Os is Chairman of the Division of Neuroscience at Utrecht University Medical Centre, Utrecht, The Netherlands, and Visiting Professor of Psychiatric Epidemiology at King’s College, Institute of Psychiatry in London. He trained in Psychiatry in Casablanca, Bordeaux and the Institute of Psychiatry and the Maudsley Royal Hospital in London.

We last spoke with Jim for the podcast in August 2017 and this time we focus on a recent paper written by Jim and co-authors that was published in the journal World Psychiatry in January 2019. The paper is entitled ‘The diagnosis evidence-based group-level symptom-reduction model as organizing principle for mental health care. Time for change?‘

In this episode we discuss:

• What the diagnosis evidence-based group-level symptom-reduction model is and how it currently informs mainstream mental healthcare.
• How mental health funding and mental health professional partners work together to monitor and assess the effects of current evidence-based interventions.
• How this curative medical model is attractive, but often fails to work for patients.
• That the focus on biological, brain-based diseases and symptoms conflicts with the experience of people who are attempting to develop a narrative view of their difficulties and suffering.
• That the paper is an attempt to start a discussion about building a synthesis between the diagnosis, symptom-based medical world and the lived experience of individual people.
• How the creation of specific and discrete diagnoses has reinforced the symptom-led approach to mental health and has also necessitated the stratification of doctors into silos of expertise.
• How Jim favors a spectrum-based approach over a fixed diagnosis and that an example is autism spectrum disorder as described in DSM V.
• The limitations of using ‘target symptom reduction’ as an outcome measure for mental health.
• That symptom reduction can be beneficial in the short-term but is not a good long-term measure of recovery.
• That the paper attempts to make clear how important individual experiences are and the need to be sensitive to the existential domain, saying “restoration of health is not the goal, it is the means to enable a person to find and pursue meaningful goals, accordingly, the person’s existential values become central”.
• That the evidence suggests that any treatment effect or improvement is often down to meaningful interaction rather than the specific expertise of the treating professional.
• That, in many countries, we still see a huge gulf between mental healthcare and social care which remain separate and remote from each other and that this separation is not how the person experiences their world.
• The importance of including lived experience in the evidence base, particularly because randomized controlled trials, considered the gold standard of evidence, are often not conclusive in the field of mental health.
• That, in mental health, evidence shows that 30% to 40% of the response is down to placebo and the expectation of being helped.
• That the desire is to make the existential domain the primary lens through which to view human experience and to respond to mental or emotional suffering.
• That, arguably, ‘love is the most powerful evidence-based treatment in mental health’.

Relevant links:

Professor Jim van Os

The evidence-based group-level symptom-reduction model as the organizing principle for mental health care: time for change?

Tedx: Maastricht, Connecting to Madness

ISPS Liverpool Conference Jim Van Os Keynote Address

Schizophrenia does not exist

© Mad in America 2019

In this second interview in our Science and Pseudoscience of Mental Health series, Dr. Sharna Olfman interviews Dr. Darcia Narvaez. 

In 1955, Erich Fromm published a book called The Sane Society. The basic premise is that cultures that support our existential needs for love, community, autonomy, creative expression, purpose, meaning, and communion with nature, enable us to become fully actualized, sane human, beings. Cultures that fail to do so, engender mental illness. Darcia Narvaez,¹ a Professor of Psychology at the University of Notre Dame, has taken up the mantle of Fromm’s quest to identify and promote sane cultural practices that foster mental health. A prolific multidisciplinary scholar, her recent books include Neurobiology and the Development of Human Morality: Evolution, Culture and Wisdom (2014) and Basic Needs, Wellbeing and Morality: Fulfilling Human Potential (2018).

To read more about Dr. Narvaez' work, visit this link:

https://www.madinamerica.com/2018/12/reclaiming-humanity-dawn/

© Mad in America 2018

When we discuss the issue of forced treatment, coercive mental health interventions like involuntary commitment, forced drugging, and electroconvulsive therapy usually come to mind. But force and coercion can be much more subtle. Many researchers and thought leaders have argued that our society mandates us to be happy and perform well-being at all times through cultural norms, media depictions, and workplace and school regulations.

This week on MIA Radio we interview Will Davies, Reader in Political Economy at Goldsmiths University of London, and author of The Happiness Industry, a book that explores the rapidly growing culture of mandated happiness and well-being surveillance. In this interview, we discuss the increasing pressure people face to be happy and think positive, and how this pressure serves the interests of the corporate elite and the State.

In this episode we discuss:

• What the “happiness industry” is and the history of its development
• How the notion that happiness can be quantified or measured, as well as advancements in neuroscience and medicalized frameworks of depression, have influenced our culture
• How employees are increasingly pressured to be happy or perform happiness within the workplace
• How people receiving welfare or government benefits are required to engage in positive thinking programs or cognitive behavioral therapy
• That holding individuals responsible for attaining their own happiness relieves responsibility from structural and institutional determinants of well-being
• The coercive and forceful aspects of the “happiness industry,” including surveillance in workplaces and mandatory self-help programs in schools
• The role that positive thinking and self-help culture play in upholding neoliberalism and capitalism

Relevant Links:

Dr. Will Davies

The Happiness Industry: How the Government and Big Business Sold Us Well-Being

The Managed Heart: Commercialization of Human Feeling

The Power Thinker: Why Foucault’s Work on Power is More Important than Ever

The Weariness of the Self: Diagnosing the History of Depression in the Contemporary Age

Dr. Davies’ next book, Nervous States: Democracy and the Decline of Reason will be published by Norton in early 2019.

© Mad in America 2018

This week on MIA Radio, we interview Dr. Sandy Steingard. Dr. Steingard is Medical Director at Howard Center, a community mental health center where she has worked for the past 21 years. She is also Clinical Associate Professor of Psychiatry at the College of Medicine of the University of Vermont. For more than 25 years, her clinical practice has primarily included patients who have experienced psychotic states. Dr. Steingard serves as Board Chair of the Foundation for Excellence in Mental Health Care. She was named to Best Doctors in America in 2003 and writes regularly for Mad in America. She is editor of the book Critical Psychiatry, Controversies and Clinical Implications due in 2019.

In this episode we discuss:

• What led Sandy to her career in psychiatry and her particular interest in the critical aspects of psychiatry and psychology.
• That Sandy’s initial interest was in biomedical explanations of psychotic experiences.
• How, in the late 80s, the advent of new antipsychotic drugs caused an initial excitement because of the promises made about safety and efficacy, but that Sandy came to realise the problems with the drugs.
• How she witnessed the over-promotion of the drugs and that the promotion was markedly different to the results of studies and her observations of patients that were taking them.
• How a series of disappointments and recognition of some inherent flaws in psychiatry led Sandy to her interest in alternatives.
• That the book, The Truth About the Drug Companies by Marcia Angel MD, had a big impact on Sandy’s view of the drugs during the 2000s.
• Other influential books were The Daily Meds by Melody Petersen and Side Effects by Alison Bass.
• That reading Anatomy of an Epidemic and particularly the problematic aspects of the long-term use of antipsychotic drugs caused Sandy to question how she was practising.
• That she found colleagues were sometimes angry at the conclusion that antipsychotic drugs might not be safe or lead to better outcomes for patients.
• That this led to the investigation of alternatives such as Open Dialog, training with Mary Olsen at the Institute of Dialogic Practice and discovering the Critical Psychiatry Network and the work of Dr. Joanna Moncreiff.
• How Sandy approaches practising from a critical perspective, particularly when expectations are in line with the dominant biomedical narrative.
• Her book, Critical Psychiatry, due in 2019 which aims to help clinicians apply transformational strategies in their clinical practices.
• That psychiatrists would be well served by welcoming lived experience input to their daily practice.
• Why informed consent should be viewed as an ongoing process rather than a one-time agreement.
• The problems that arise in clinical studies where experience is translated into a numerical form.

Relevant links:

Critical Psychiatry, Controversies and Clinical Implications (due 2019)

How Well Do Neuroleptics Work?

What We Are Talking About When We Talk About Community Mental Health

The Truth About The Drug Companies by Marcia Angel MD (video)

The Daily Meds by Melody Petersen (review)

Side Effects by Alison Bass

Open Dialog

The Institute for Dialogic Practice

Critical Psychiatry Network

This week, MIA Radio presents the fourth in a series of interviews on the topic of the global “mental health” movement.” This series is being developed through a UMASS Boston initiative supported by a grant from the Open Society Foundation. The interviews are being led by UMASS PhD students who also comprise the Mad in America research news team.

Over the past three weeks, we have published interviews with many of the leading voices in this debate.

Immediately following the release of the report and the beginning of the Summit, on World Mental Health Day, psychiatric epidemiologist, Dr. Melissa Raven, was on the MIA podcast. She questioned the evidence base of the movement, pointing to statistical issues in the prevalence rates of mental disorders internationally, and called for a focus on addressing barriers to health rather than on individualized treatment.

Mental health service-user activists, Jhilmil Breckinridge, of the Bhor Foundation in India, and Dr. Bhargavi Davar, of Transforming Communities for Inclusion (TCI) Asia Pacific were also on the podcast. Each discussed the lack of involvement of service-user and disability rights groups in the UK Summit and Lancet report and laid out alternative frameworks for addressing distress in ways that are sensitive to culture and social context.

Next, Dr. China Mills, a critical psychologist and author of Decolonizing Global Mental Health, spoke to my colleague, Zenobia Morrill, about her experience attending the UK summit and the lack of attention that has been given to the ways in which austerity policies in Britain have contributed to the increased demand for mental health interventions.

You can find these earlier interviews at the links below:

10/10/18 - Interview with Dr. Melissa Raven, psychiatric epidemiologist - The Global ‘Mental Health’ Movement – Cause For Concern

10/20/18 – Interviews with mental health service-user/psychosocial disability rights activists Jhilmil Breckenridge and Dr. Bhargavi Davar - Global Mental Health: An Old System Wearing New Clothes

10/24/18 – Interview by MIA research news editor Zenobia Morrill with Dr. China Mills, a critical psychologist and prominent critic of the global mental health movement – Coloniality, Austerity, and Global Mental Health

Today I am very pleased to announce that we are joined by Dr. Derek Summerfield.

Dr. Summerfield is an honorary senior lecturer at the Institute of Psychiatry in London and former Research Associate at the Refugee Studies Centre at the University of Oxford and consultant and Oxfam. He was born in South Africa and trained in medicine and psychiatry at St. Mary’s Hospital Medical School in London. Dr. Summerfield has published hundreds of articles in medicine and social science and has contributed widely to understanding the impact of war-related trauma and torture on people around the world. He has been an outspoken critic of the global mental health movement for several years, criticizing the medicalization of trauma through PTSD, the exaggerated prevalence rates in the epidemiological data, and the lack of awareness of the different cultural experiences and understandings of distress.

Today, we bring you the third in our series of podcasts on the topic of the global mental health movement. Part one of the series featured Dr Melissa Raven and part two featured Jhilmil Breckenridge and Dr Bhargavi Davar. These interviews are led by our Mad in America research news team.

In this episode, we interview Dr China Mills. China participated in organizing the open letter in response to The Lancet Commission on Global Mental Health and Sustainable Development. In this interview, China shares her concerns and reactions to the Lancet’s proposal, elaborating on deeper issues related to the framing of global mental health as a “burden” and the underlying implications of coloniality, technology, and medicalization. In addition, China tells us about her insider perspectives after attending the Global Mental Health Ministerial Summit hosted by the UK government. In her recent piece for Mad in Asia about the summit, she writes:

“It was ironic to listen to a range of UK Government minsters talk about the importance of mental health whilst sat in a room just over the river from Westminster, where governmental decisions to cut welfare, and sanction and impoverish disabled welfare claimants has so detrimentally impacted people’s mental health and led to suicide. It felt like arrogance on the part of the UK Government to position themselves as world leaders in mental health when in 2016, the UN found that the Government’s austerity policies had enacted ‘grave’ and ‘systematic violations of the rights of persons with disabilities’ . It was equally jarring, given the cuts to social security under austerity, to be transported by boat about 2 minutes away, to an evening drinks reception at the Tate gallery.”

China Mills is a Lecturer in the School of Education, University of Sheffield, UK. Her research develops the framework of psychopolitics to examine the way mental health gets framed as a global health priority. In 2014, she published the book ‘Decolonizing Global Mental Health’ and has since published widely on a range of topics including: the inclusion of mental health in the sustainable development goals; the quantification of mental health and its construction as a technological problem; welfare-reform, austerity and suicide; and the intersections of psychology, security and curriculum. She is Principal Investigator on two British Academy funded projects researching the social life of algorithmic diagnosis and psy-technologies. China is a member of the editorial collective for Asylum magazine and for the journal, Critical Social Policy; and she is a Fellow of the Sheffield Institute for International Development (SIID).

Today, we bring you the second in our series of podcasts on the topic of the global mental health movement. These interviews are led by our Mad in America research news team.

On October 9^th and 10^th, 2018, World Mental Health Day, the UK government hosted a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement mental health policies globally. In the same week, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal for “scaling up” mental health care globally. In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of policy-makers, psychologists, psychiatrists, and researchers.

In our last episode, we were joined by Dr Melissa Raven, a critical psychologist and epidemiologist, who discussed problems with the scientific evidence base used by the global mental health movement. She also emphasized the need to consider responses to the distress and suffering of people globally that address the social determinants of mental health, including poverty, education, and healthcare.

Today we turn our focus to the concerns raised by mental health activists in response to the UK summit and the Lancet report. To discuss these issues, we are joined first by Jhilmil Breckenridge, a poet, writer and mental health activist and later by social science researcher Dr Bhargavi Davar.

Jhilmil is the Founder of Bhor Foundation, an Indian charity, which is active in mental health advocacy, the trauma-informed approach, and enabling other choices to heal apart from the biomedical model. Jhilmil also heads a team leading Mad in Asia Pacific; this is an online webzine working for better rights, justice and inclusion for people with psychosocial disability in the Asia Pacific region. She is currently working on a PhD in Creative Writing in the UK and, for the last three years, she has also been leading an online poetry as therapy group for women recovering from domestic violence.

She is working on a few initiatives, both in the UK and India, taking this approach into prisons and asylums. Her debut poetry collection, Reclamation Song, was published in May 2018.

For our second interview, we are joined by Dr Bhargavi Davar. She identifies as a childhood survivor of psychiatric institutions in India. She went on to train as a philosopher and social science researcher at the Indian Institute of Technology in Bombay and has published and co-edited several books, including Psychoanalysis as a Human Science, Mental Health of Indian Women, and Gendering Mental Health, while also producing collections of poems and short stories. Dr Davar is an international trainer in the Convention on the Rights of Persons with Disabilities (CRPD) and the founder of the Bapu Trust for Research on Mind and Discourse in Pune, India. This organization aims to give visibility to user/survivor-centred mental health advocacy and studies traditional healing systems in India.

This week, we present the first in a series of interviews on the topic of the global ‘mental health’ movement. These interviews will be led by our Mad in America research news team and today’s interview is hosted by our lead research news editor, Justin Karter.

In this episode, Justin interviews Dr Melissa Raven, who is a psychiatric epidemiologist, policy analyst and postdoctoral research fellow in the Critical and Ethical Mental Health research group at the University of Adelaide, South Australia. Originally qualified as a clinical psychologist, she then worked as a lecturer and researcher in public health and primary health care. Her current mental health research and advocacy is informed by a strong social determinants perspective and a strong critical orientation, which she applies to a range of topics, including suicide prevention, workplace mental health, (over)diagnosis, (inappropriate) prescribing, and conflicts of interest in mental health and the broader health/welfare arena.

On October 10th, 2018, World Mental Health Day, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal to “scale up” mental health care globally. At the same time, the UK government is hosting a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement these mental health policies globally.

In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of critical professionals, psychologists, psychiatrists, and researchers.

This week on MIA Radio we turn our attention to Electroconvulsive Therapy (ECT) or Electroshock as it’s known in the US. On Wednesday, September 19^th, this emotive and controversial intervention was discussed at the 57^th Maudsley debate, held at Kings College London.

The motion proposed was: “This house believes that ECT has no place in modern medicine”.

Supporting the motion were Professor John Read who has undertaken several scientific reviews of the literature supporting the use of ECT and Dr Sue Cunliffe. Dr Cunliffe was a paediatrician until she herself underwent ECT, after which she became cognitively impaired and found herself unable to continue working. She now campaigns for the risks of ECT to be made more explicit and to directly address the professional denial of the damage that ECT can cause. Speaking against the motion were Professor Declan McLoughlin and Dr Sameer Jauhar.

Both John and Sue took time out to talk about the debate and the wider issues surrounding ECT.

Professor Read kindly shared his debate notes, which are provided below.

Thank you to the Institute for bringing us all together.

Let us first remind ourselves tha thistory is littered with procedures which people believed in- just as strongly as some psychiatrists believe, today, in electrocuting people’s brains to cause seizures - but which turned out to be ineffective or damaging. The list includes spinning chairs, surprise baths, standing people next to cannons, and, more recently, lobotomies.

It was 80 years ago, in 1938, that Ugo Cerletti administered the first ECT, to a homeless man in Rome. After the first shock the man called out ‘Not another – it will kill me’.

The theory back then was that people with epilepsy didn’t have schizophrenia so the cure for schizophrenia was to cause epilepsy. So Cerletti was driven by the genuine belief that causing convulsions by shocking the brain really might help people, by the genuine hope that we might finally have come up with an effective treatment.

The story of ECT illustrates, yet again, however, what happens when our beliefs and good intentions are not tempered with good science.

ECT quickly spread from Rome across Europe and America. Finally, an effective treatment! People who received it were discharged earlier….… by the doctors who gave it. But there were no studies for 13 years, by which time everyone just knew it worked, and their belief may have been very helpful to some patients. The first study on depression (which became the main target for ECT), in 1951, found that those who had ECT fared worse than those who had not had it. It made no difference.

I have co-authored four reviews of the ECT research, most recently last year. There are only ten depression studies comparing ECT and placebo; placebo meaning the general anaesthetic is given but the electric shock is withheld. Five of those 10 found no difference between the two groups. The other five found, compared to placebo, a temporary lift in mood during the treatment period, among about a third of the patients. One of these five found that this temporary improvement was perceived only by the psychiatrists, but not by the nurses or the patients.

Most reviews and meta-analyses assert, on the basis of these temporary gains in a minority of patients, that ‘ECT IS EFFECTIVE’

But none of them have ever identified a single study that found any difference between ECT and placebo after the end of the treatment period. There is just no evidence to support the belief that ECT has lasting benefits, after 80 years of looking for it.

Similarly, there are no placebo studies to support another genuinely held belief: that ECT prevents suicide.

There is nothing wrong with treatments working because of hopes and expectations. But passing 150 volts through brain cells designed for a tiny fraction of one volt causes brain damage. Indeed, autopsies quickly led to a new theory about how ECT works. In a 1941 article entitled ‘Brain damaging therapeutics’, the man who introduced ECT to the USA, wrote ‘Maybe mentally ill patients can think more clearly with less brain in actual operation’.

In 1974 the head of Neuropsychology at Stanford wrote: ‘I’d rather have a small lobotomy than a series of ECT….I know what the brain looks like after a series of shock’.

All ECT recipients experience some difficulties laying down new memories and in recalling past events. What is disputed is how many have long-lasting or permanent memory dysfunction, which might reasonably be called brain damage.

Findings range from one in eight to just over half. A review of studies that actually asked the patients, conducted here at the Institute, found ‘persistent or permanent memory loss’ in 29 to 55%.

Yet another belief is that ECT used to cause brain damage, in the bad old days, but not any more.  But a recent study found one in eight with ‘marked and persistent’ memory loss, …..  and also found much higher rates among the two groups who receive it most often, women and older people.

The same study also found that the memory loss was not related to severity of depression. This is important because another belief about ECT is that the memory loss is caused by the depression, not the electricity.

Psychiatric bodies in the UK and USA recite the belief that only ‘one in 10,000’ will die from having ECT, without producing a single study to support that belief.  Our reviews document large-scale studies with mortality rates between one in 1400 and one in 700, several times higher than the official claims, typically – unsurprisingly - involving cardiovascular failure.

ECT in England has declined, from 50,000 a year in the 1970s to about 2,500. The number of psychiatrists who still believe, despite all the evidence, is dwindling fast.

It may have been understandable for the psychiatrists of the 1940s to believe that ECT worked and was safe. They didn’t know any better.

But if psychiatry wants to be an evidence-based discipline, to be part of modern medicine, it must acknowledge that, despite all its honourable intentions, it has got this one, like lobotomies, woefully wrong.

Thank you.

Links and Further Information

To watch the debate on YouTube, click here.

To read a report on the first ever Maudsley Debate, held in January 2000, which also discussed ECT, click here.

ECT Accreditation Service (ECTAS)

MECTA

The effectiveness of electroconvulsive therapy: A literature review, John Read and Richard Bentall

Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009

This week on MIA Radio, we discuss the UK Royal College of Psychiatrists representation on a Government-led review of Prescribed Drug Dependence. Professor Sami Timimi, a fellow of the Royal College of Psychiatry, and 30 other mental health experts, have formally asked the College to ‘replace Professor David Baldwin as its representative on The Expert Reference Group of Public Health England’s Review of Prescribed Medicines, with an RCPsych member who is not compromised by conflicts of interest with the pharmaceutical industry’.

In this podcast, we hear from Professor Timimi, Psychiatrist Peter Gordon and campaigner Stevie Lewis. Both Peter and Stevie are people who have experienced withdrawal effects from antidepressant drugs.

Conflicts of Interest Questioned in Royal College of Psychiatry’s Participation in Government-Led Mental Health Medication Review

August 17, 2018

From: James Moore, antidepressant withdrawal sufferer, on behalf of the 30 other signatories to today’s letter.  

London, UK – A fellow of the Royal College of Psychiatry, and 30 other mental health experts, have today formally asked the College to ‘replace Professor David Baldwin as its representative on The Expert Reference Group of Public Health England’s Review of Prescribed Medicines, with an RCPsych member who is not compromised by conflicts of interest with the pharmaceutical industry’.

The Public Health England review¹ was set up to examine a growing problem with patients becoming dependent on psychiatric drugs including antidepressants. In the UK, four million people are long-term antidepressant users², with many of those unable to come off their drugs without debilitating and protracted withdrawal symptoms. Signatories to the complaint include 10 people whose withdrawal experiences have lasted between one and ten years, plus 11 psychiatrists and 8 mental health professors.

In the Public Health England (2018) document ‘PMR ERG members declarations of interest’, Prof­essor Baldwin reports having received ‘personal honoraria for lecture engagements organised by AstraZeneca, Bristol-Myers Squibb, Eli Lilly Ltd, Glaxo-SmithKline, Janssen, H. Lundbeck A/S, Pharmacia, Pierre Fabre, Pfizer Ltd, Servier, and Wyeth Ltd’. In addition, he reports attendance at advisory boards of five companies and research funding from twelve.

The signatories are worried that he could be unduly influenced by the large number of pharmaceutical manufacturers he has received income from. This concern is exacerbated by Professor Baldwin’s having already publicly minimised the withdrawal effects of antidepressants (Times 24.2.18), which was described as ‘misleading’ the public in the House of Lords³and led to a formal complaint against him⁴.

Lead author of the letter, psychiatrist Professor Sami Timimi, a fellow of the Royal College, said:

“DESPITE THE INCREASED AWARENESS OF THE PERNICIOUS INFLUENCE OF THE PHARMACEUTICAL INDUSTRY IN ALL SPHERES OF MENTAL HEALTH, THE RCPSYCH DOES NOT APPEAR TROUBLED BY THE POTENTIAL FOR MISLEADING THE MEDICAL COMMUNITY AND THE PUBLIC AND SOILING THE GOOD NAME OF THE PROFESSION OF PSYCHIATRY. WE FEEL THE NEED TO MAKE PUBLIC OUR OPPOSITION TO SOMEONE SO CONNECTED WITH THE PHARMACEUTICAL INDUSTRY BEING THE RCPSYCH’S REPRESENTATIVE ON A PUBLIC BODY APPOINTED WITH THE TASK OF WORKING FOR THE PUBLIC GOOD.”

Another signatory, psychiatrist Dr Peter Gordon said:

“EVIDENCE HAS REPEATEDLY FOUND THAT COMPETING FINANCIAL INTERESTS CAN LEAD TO DOCTORS RECOMMENDING WORSE TREATMENTS FOR PATIENTS⁵. IN THE UK, THE PHARMACEUTICAL INDUSTRY SPENDS OVER £40 MILLION A YEAR ON DOCTORS AND ACADEMICS WHO MARKET AND PROMOTE THEIR PRODUCTS⁶. I HAVE BEEN COMMUNICATING WITH MY COLLEGE FOR MANY YEARS ON THIS, YET IT REMAINS THE CASE THAT THE ROYAL COLLEGE OF PSYCHIATRISTS STILL HAS NO SINGLE, SEARCHABLE REGISTER THAT RECORDS FULL DETAILS OF INDUSTRY PAYMENTS MADE TO ITS MEMBERS. IT IS THEREFORE IMPOSSIBLE TO DETERMINE THE SCALE OF PAYMENTS THAT MAY HAVE BEEN MADE TO COLLEGE MEMBERS WHO ARE INVOLVED IN DEVELOPING POLICIES AND GUIDELINES OR EDUCATING ON THE PRESCRIBING OF PSYCHIATRIC MEDICATIONS.”

Antidepressant withdrawal sufferer James Moore, also a signatory, said:

“THERE ARE MANY PEOPLE OUT THERE LIKE ME, WHO HAVE FOUND THEMSELVES IN SEVERE DIFFICULTY AFTER TRYING TO COME OFF PRESCRIBED ANTIDEPRESSANT DRUGS. IN ORDER TO PROPERLY INVESTIGATE THIS ISSUE, IT IS VITAL THAT THE INFLUENCE OF THE PHARMACEUTICAL MANUFACTURERS IS NOT ALLOWED TO CORRUPT AN EVIDENCE-BASED AND HONEST APPRAISAL OF A PROBLEM POTENTIALLY AFFECTING MILLIONS OF PSYCHIATRIC DRUG USERS.”

References

1. https://www.gov.uk/government/collections/prescribed-medicines-an-evidence-review
2. https://www.theguardian.com/society/2018/aug/10/four-million-people-in-england-are-long-term-users-of-antidepressants
3. http://bit.ly/2BgyzxX
4. https://www.madinamerica.com/2018/07/30-mental-health-experts-write-secretary-state-unprofessional-conduct-uk-royal-college-psychiatry/
5. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000352
6. https://www.bmj.com/content/360/bmj.k1380

© Mad in America 2018