Apologies to Gianna Kali at Beyond Meds for continously mooching off her post ideas, as I did yesterday, but her post today has inspired me once more. Inspire may not be the right word. I’ve got to vent. Dr. Mark Foster is a primary care physician in Colorado who is often a guest blogger at Robert Whitaker’s Mad in America blog. Today he writes about a teenage patient who’s been on Adderall for years. His father is with him in the examining room and expresses consternation after he gets a lecture from Mark about the wisdom of having a kid on Adderall for 10 years. “But, it’s a disease, isn’t it?” he says to the doctor.
Believe it or not, my sympathies here are with the father, mainly because this post about childhood use of Adderall shows how much people have been jerked around by the medical profession when it comes to mental health. Now, we’ve got a chirpy young doctor telling the old man that he’s got it completely wrong. Pa’s been jerked around since before this guy went to medical school, now suddenly he’s getting a lecture that supposedly everybody else knows but him.
Parents and their idiotic ideas aside, doctors have been the willing handmaidens of pharma and have been only too willing to push the idea that there is something called ADD or ADHD and there’s a medication for it. Consider the opposite. Suppose this father initially resisted putting his child on meds. He’d be up against teachers, other parents who have put their kid on meds, perhaps his own family doctor suggesting that “research shows that untreated hyperactivity leads directly to jail,” and the media telling him that the latest research shows how these drugs “protect the brain.”
So, I often do get angry because I know we’ve really been had and almost no person in a position of medical authority who families turned to in the past twenty years was curious enough or responsible enough to question the sales job.
Well, you might say, our chirpy young doctor here hasn’t got everything that right, he neither, as he himself still is in the grip of his professional training to a certain extent. Just as Dad is in the grip of everything he was told about “ADD”/”ADHD” in the past.
Robert Whitaker posted a link to another of Mark Foster’s letters to him on FB some time ago. The letter in question is here: http://www.madinamerica.com/madinamerica.com/Foster/3A6A98B1-4585-45EF-B9E8-84AC40610D7B.html. I posted a critique in the comments on FB that, as I see, is far too long to post here, but that can be boiled down to me questioning the idea that emotional distress would be any different from real “mental illness”, an idea that Mark Foster, too, seems to firmly believe in. — Sounds familiar, doesn’t it? Sigh. — And I asked, how Mark Foster justified this opinion of his. I didn’t get an answer on FB, and contemplated to email him about this, but never did. To see his bafflement at Dad’s ignorance about “ADD”/”ADHD” adds a whole new dimension to his own failure at looking critically at his beliefs about “mental illness”. I’ll maybe email him anyway.
The FB thread is here: http://www.facebook.com/permalink.php?story_fbid=183982571621370&id=527390073
Ok, I’m not really getting the … what is it, resentment? of Dr Mark Foster. I read the letter linked in the comment above and I thought it was very good. I do not participate in facebook so I can’t follow Marian’s critique.
I liked the letter. And it seems to me that we’ve wanted doctors to become more aware about prescribing psych drugs, and this man has. How is that bad?
B’ham
Hi, B’ham – I don’t resent Dr. Foster, in fact it’s good that doctors are beginning to clue in. Marian’s looked further into Dr. Foster’s beliefs. Marian and I both try to probe the limits of certain doctors beliefs when it comes to schizophrenia and other “serious” mental health labels. Unfortunately, there are many doctors, and it seems that Dr. Foster is one of them, who would not properly treat my son because these doctors would say, well, he’s a “true” schizophrenic. Game over. That I believe is Marian’s point about Foster. So, people who have been “misdiagnosed” as these doctors would say, will be encouraged to think about getting off their meds because they have a biochemical imbalance while those who are considered “true” schizophrenics are considered intrinsically crazy. This attitude is rampant.
Rossa, that was my point, exactly.
B’ham, I posted my Facebook comment on my blog: http://diffthoughts.blogspot.com/2011/02/emotional-disturbances-vs-psychosis.html
Thanks Rossa and Marian.
I am still making my way through the blog entry, Marian. (The white text against the vivid black background is tough on the eyes, a little bit, by the way)
YOU SAID:
Basically, the same applies to this quote, and my question here would be, exactly where do we draw the line between what Mark Foster calls a “pathological disturbance” on the one hand, and existential, to human nature very natural, emotional suffering, “endemic to the human experience”, as Mark Foster says?
I SAY:
I am an *extreme* amateur here, so bear with me. I would draw the line at delusions. I do not think mental illness is biologically based (I think whatever chemical changes occur, occur secondarily, they do not CAUSE anything), but I do believe people have delusions. I’ve seen videos (Rufus May) of doctors who are able to talk through patients when they are having delusions. Because of these videos, I conclude that they are not biologically based and are a coping mechanism sort of. But if I were to draw a distinction between someone who’s received a diagnosis of depression or GAD and someone who’s received a diagnosis of say schizophrenia, delusions would be it.
YOU SAID:
Psychiatry as a medical speciality stands and falls with “schizophrenia”,
I SAY: I wholeheartedly agree!!!
B’ham – In terms of diagnosing, I would tend to agree that “delusions” are the defining line. However, what psychiatry calls “delusions”, I call insight. Psychiatry doesn’t want to understand what is at the base of these so-called delusions. As a medical speciality, schizophrenia is its bread and butter, which Marian points out, so why would it bother to kill the golden goose by actually helping patients to work through their “delusions?”
Hm, I don’t know if I agree altogether here. I think that what is called “delusions”, just like the rest of the “symptom” spectrum, lies on a continuum with what, based on cultural norms, this too, is seen as a “normal” belief. One or the other Norwegian psychologist (can’t remember the name) wrote in an article (can find it, if someone is interested, but it’s in Norwegian) some time ago that the difference between belief and “delusion” is that beliefs usually are held by an organized group of people in society, while “delusions” are more individual. That means there’s no qualitative difference: a belief is not more true than a “delusion”. If there was an organized group of people in society where believing one was Jesus was part of this groups belief system, someone who was a member of this group, and believed they were Jesus, could not be labelled “delusional”. This corresponds to an anecdote I once heard, about a guy in Australia, I think it was, who got psychiatrized because he went outside in the middle of the night, only wearing a white sheet, and danced. His family got him out of the psych prison (aka “hospital”) by showing up there, everybody only wrapped in a white sheet, and telling the shrink, dancing outside in the middle of the night, only wrapped in a white sheet, was part of their religion, so their family member wasn’t “insane”, but had only practised their religion. Another example is psychiatry itself. Without having a shred of objective, scientific evidence to support its beliefs about what “mental illness” is, the whole business might be called “delusional”. It is only because psychiatry’s beliefs are held by an organized group of people in society (= the professionals), and in addition by the majority of people in society in general, that psychiatry’s belief system isn’t seen as “delusional”. Well, other than by the critics. BTW, cf. Mary Boyle’s book “Schizophrenia: A Scientific Delusion?” Bottom line: there is no objective criterion for the distinction between “insanity” and “normalcy”. All there is is our fear of “insanity”, and of what it means to our existence that there is no way to definitely delimit ourselves from this worst of our nightmares.
Oh, BTW, the italics in the book title are of course mine.