From Beyond Meds

Think of those who are still subject to the care of mental health professionals. They are by definition subject to care, if my experience is to be taken seriously, and I for one do take it seriously, that considers them inherently less than equal. I remember when I was a clinician too. Some of these people who are prejudiced are well-meaning. But well-meaning and acting without prejudice are unfortunately not mutually exclusive. I don’t know how one extracts this insidious form of prejudice. They don’t see it in themselves…how do we help them see?

My solution is probably simplistic, but here goes. Just keep hammering home the message, politely, respectfully, but leave no one in any doubt as to why the attitude is objectionable. If you lose control, you will give “them” more ammunition to use against you and others like you. You will only haved confirmed their prejudice. Join forces with others and vary your media. Picket, write letters to the editor. Write letters in response to letters to the editor. Do book reviews. Remember the gay pride movement? Notice how respectful everybody is these days to homosexuals compared to what it used to be. Homosexuality was considered a mental illness, too, until the movement forced psychiatry to drop it from the DSM.

Saturday morning I attended a writers’ workshop on publishing and marketing. The discussion revolved around the latest technologies like Twitter, self-publishing on demand and a machine that chunks your manuscript out as a bound book. (There are twenty-eight of these machines around the world at an installation cost of $100,000 each.) I found out that you can get a ten minute e-mail so that you can send a one-off message and not be bothered with your mailbox filling up with spam afterwards.

Speaking of which, on Friday I was targeted by one of those e-mail scams using the familiar name a sophisticated man I know here who claims he was robbed in London and desperately needed money to get back home. Knowing that this was a fraudulent abuse of his good name, I sent a message back. Yes, yes, would like to help, what can I do? A day later, my “friend” is still broke and in London. Nobody has bailed him out yet. The new e-mail suggests that I wire the money to him through Western Union and send an e-mail as I set out for the office. I immediately wrote back and said that I tried to go, but the office was closed when I got there and that I hoped he had sorted himself out. His reply arrived the next day. “Alright no prob. I’ll have to reschedule my flight and as soon as it is done, kindly get back to me with the Western Union transfer details. I owe you alot!”

Technology . . . making our lives easier and less complicated.

Attending the writing group is to give me the push I need to get my book finished. This baby has been five years in the making. It’s time to give birth. I don’t want to give up the daily blogging, so I am going to have to find a way to get this done short of taking a leave of absence from my day job. The reason I have not given up is because I feel it is important to put out a positive perspective for once on schizophrenia. A positive perspective coming from a mother I hope will carry some clout. It would be excellent timing because it would coincide with the growing disillusionment with the biochemical romance that Robert Whitaker’s new book, Anatomy of an Epidemic, has demonstrated.

In the meantime, I have the added burden of struggling with the technology and the promotion. Self-publish or hound hundreds of agents to no avail? Twitter my accomplishments? I’m still dubious about Twitter. I fear that I am in a Twittering myself loop most of the time.

From Opednews.com

Decades ago, when Linus Pauling and Abram Hoffer first proposed mega-dose vitamin therapy as a serious treatment, mainstream medicine and the press promptly discredited this as quackery. To this day, the media faithfully bombards us with the message that vitamins and minerals are useless, harmful or even killing us.(1-6) When one considers the lowly vitamin pill as an economic rival to drugs, and the dependence of the media on drug company advertising, the motivation to discredit mega-dose vitamins becomes all too obvious. Seemingly oblivious to this negative message, physicians quietly go about their business using megadose vitamin therapy in the intensive care unit with considerable success. Recent reports of this have been appearing in medical journals, finally vindicating Linus Pauling and Abram Hoffer as yes, of course, they were right all along

My comment: This is a good article but it occurred to me that megadose niacin therapy is not one of the therapies used in the emergency room when someone is psychotic. It should be.

There is a flurry of recent blogsphere posts about the conflict of interest relationship between Dr. Thomas Insel, Director of NIMH and Dr. Charles Nemeroff, University of Miami, formerly of Emory University. I did a previous post in May where I voice my complaints about the NIMH’s focus on future magic bullets.

In Dr. Insel’s own words (I painted in my own highlights):

We must address mental illnesses, from autism to schizophrenia, as developmental brain disorders with genetic and environmental factors leading to altered circuits and altered behavior. Today’s state-of-the-art biology, neuroscience, imaging, and genomics are yielding new approaches to understanding mental illnesses, supplementing our psychological explanations. Understanding the causes and nature of malfunctioning brain circuits in mental disorders may make earlier diagnosis possible. Interventions could then be tailored to address the underlying causes directly and quickly, changing the trajectory of these illnesses, as we have done in ischemic heart disease and some forms of cancer. For serious mental illness, this is a new vision for prevention, based on understanding individual risk and developing innovative treatments to preempt disability.

I highlighted the word “supplementing” because here he is being disingenous. If anything, it’s the other way around. Psychological explanations for mental illness have been ignored by the brain biochemistry model. Dr. Insel believes mental illness is a brain disease.

Where Dr. Insel is not even bothering to look:

The placebo effect
Psychotherapy
Non-drug alternative therapies
What actually works for people
Orthomolecular therapy
Family therapies

He promotes the diseased brain version of mental health disorders because that’s where the money is today and will continue to be if the NIMH gets its way. If big money were in alternative therapies, Dr. Insel might be its public face, but it’s doubtful it would be him. If the NIMH were to look seriously into these matters, the way it stands now it would become a rump organization with a small office and skeleton staff in some industrial park or run-down storefront. He otherwise would have to go back to being a psychiatrist who makes a comfortable, but by no means lavish living by listening to patients. There is already competition in this area from psychologists. The 1950s is beginning to look like the Gilded Age for psychiatry. The big money is over for psychiatry if it abandons its disease mantra. Dr. Insel would be paid less than most of the people he went to medical school with and there would be no flying around the world giving keynote addresses.

The collapse of the biochemical model is looming. The NIMH has aligned itself with the pharmaceutical industrial complex which is beginning to show signs of unravelling from within. If the machinery collapses it will be thanks to bloggers, certain politicians, patients’ rights groups, investigative journalists, and lawsuits. The monopoly on information has been challenged by the internet and it’s looking unlikely that the diseased brain model can be sustained. Its end will be like the demise of the Soviet Union back in 1989 which had been building slowly for a long time and took everybody’s breath away with the speed of its collapse.

I have been a fan of Andrew Saul’s website for a few years. I even got to sit next to him at a luncheon. He’s like a rock star to me. I like his website motto: If you want something done right, you have to do it yourself. This especially includes your health care.

For those of you who don’t know it, his website, doctoryourself.com is a treasure trove of health advice from the vitamin perspective. Plus, it’s interesting. He has added some Frequently Asked Questions, which are in themselves very interesting. Here’s just a sample of the FAQs from what is billed as the “World’s Largest HEALTH HOMESTEADING Website.” I like that, too!

Doctor Yourself? Do you honestly think you can become your own doctor?

Very often, yes. This is neither impossible nor illegal, and is more and more essential all the time. Healing is too big a topic for any one person to know it all. While that statement includes me and you, it also includes your doctor. But it is not impossible to learn more than your doctor knows, particularly in key areas. You can go to any book or paper in print, read it, apply it, and draw practical conclusions from it. What you will read is just what any physician reads. In fact, you may discover material that your doctor never saw, or did see and never investigated. With a good bibliography, an inquiring mind, and gradual experience, there is no reason why you cannot gain considerable competence in treating yourself and your immediate family in many instances. Remember that in doing your research you will also learn when you really do need a physician.

How can you say this? Aren’t doctors the ones for this duty; isn’t it their special province to be the formally educated authorities on health?

Commonly, yes: but a doctor’s authority in America often exceeds his or her knowledge. Whole bodies of knowledge in healing are ignored because they are unorthodox and non-medical. A doctor’s education seems exhaustive, yet MDs study so much of drugs and surgery, and so little of nutrition, fasting, herbal remedies, spinal manipulation, massage, vitamin and mineral therapy, homeopathy, and more that we realize their qualifications are only partial. This takes nothing away from their dedication as individuals, but being individuals they are prone to following certain theories over other theories, particular practices over other alternatives, and holding opinions as well as facts. This is true with any person, certainly, but it is our responsibility to cover all possible ground in our efforts to cure and prevent illness. If we learn more than the doctor in areas of value to our health, it is our duty to apply this knowledge to the betterment of ourselves and our family. We need total health more than medically approved health. Our wellness should not be limited to our doctor’s experience, but enhanced by our own experience.

A lot of the media, professional organizations, politicians, and physicians aren’t going to concur with your ideas here, are they?

Nope, especially since I believe that alternative healing methods are much more than just temporary or half measures. I am not going to give you yet another “use drugs wisely” or “help your doctor help you” speech. That stops short of true wellness self-reliance because it always defers final say to the doctor, and trust medical, conventional treatments for the “real illnesses.” That will not be the case here. I believe that your doctor works for you, not the other way around. Your physician is your contractor, and it’s your jobsite. Following the government’s health advice, the American Medical Association, the American Dietetic Association, the syndicated doctor’s advice columns in the newspaper, or television commercials for patent remedies will not be recommended, either. Rather, I offer some unusual substantiation, references, research summaries, obscure clinical material, unpopular preventive or therapeutic measures, little known or under-used facts and approaches to do-it-yourself health. My presentation is incomplete, of course, because there is so much to know. Hopefully, this will be a starting point, sort of a “health homesteader’s handbook.”

The Three Christs of Ypsilanti
In one sense, Rokeach’s book reflects a remarkably humane approach for its era. We are asked to see ourselves in the psychiatric patients, at a time when such people were regularly locked away and treated as incomprehensible objects of pity rather than individuals worthy of empathy. Rokeach’s constant attempts to explain the delusions as understandable reactions to life events require us to accept that the Christs have not “lost contact” with reality, even if their interpretations are more than a little uncommon.

A cookbook for memories of sexual abuse
In the summer of 1990, Elizabeth Loftus got a phone call from an attorney in San Francisco. A man named George Franklin had been charged with murdering a child, based on the recollection of his daughter, Eileen. Loftus, a psychologist, had testified in dozens of cases about the fallibility of eyewitness memory. But this case was different. The murder had happened 21 years earlier. Eileen’s purported memory, however, was less than a year old. According to the prosecution, she had repressed it.

Truth or Consequences? Exploiting psychology in law and advertising
But Loftus was more than a trainee. She was a trainer. She had learned how to make people remember and believe things, and this knowledge was as useful to advertisers as it was to lawyers. Her only qualm about manipulation was that people might be harmed. And advertising didn’t strike her as terribly harmful. Most advertisers, she and her colleagues noted, were “unlikely to try to plant a negative memory, as has been the issue with false memories of childhood abuse.”

From: Pharmacological treatment of mental disorders in primary health care
© World Health Organization 2009

Basic principles of prescribing

1.16 In general, polypharmacy should be avoided. The term polypharmacy defines the concurrent use of two or more medicines belonging to the same pharmacological class (for example two or more antipsychotics or two or more antidepressants).

Please read Ron Unger’s latest post Anatomy of a Delusion, based on his reading of Robert Whitaker’s Anatomy of an Epidemic. He writes:

What I am struck by is the similarity between the dynamics around the delusions of those who get psychiatric labels, and the delusions of the mental health system itself.

His post then lists some really good delusions of the mental health system which are also uncannily similar to the delusions of mental health clients. This is Ron Unger writing at his usual best. Here’s number 4 on his list of delusions invested in by the client, which is darn similar to the delusion of the mental health system vis a vis medication, when you think about it.

Even starting to question the delusion is scary & upsets psychological equilibrium, as even considering that one might have been so wrong about something creates a sense of “losing one’s grip on reality.” This loss of equilibrium when one starts to question the delusion is taken as evidence that it should not be questioned.

Whitaker in his book, writes about the young woman/old hag optical illusion. This is the drawing that most of us are familar with that shows a young woman, if you look at the drawing one way, and an old hag if you focus on it another way. Whitaker is writing about it more in terms of a perceptual illusion in which the public prefers to believe that psychiatric drugs produce outcomes like the beautiful young woman, but he writes that a closer look will reveal what the public doesn’t see – long term use of psychiatric drugs reveals the old hag, an different picture.

The young woman/old hag drawing is also useful in explaining how illusions/delusions can quickly turn to disillusion when it comes to psychiatric medication. Seeing the beautiful young woman is the illusion that I invested in the first couple of years of Chris’s “illness.” Gradually, disillusionment set in and and I finally was able to see the old hag. Both are there, if you look for them, but once you have seen the hidden perception, it is hard to regain the original image. Now, trying to recapture the beautiful young woman image is almost impossible for me. I know she’s supposed to be there, but I don’t see her.

It’s Mother’s Day in France. Since I missed getting this out earlier, here are some selections from the New Yorker Book of Mom Cartoons.

Little girl dining out with her parents. “You order for me, Mommy. You know what I like.”

Little boy walking with his father: “Dad, if Mom ever gets another boyfriend, I hope he’s just like you.”

Mother and female friend sitting on couch with little boy spray painting “I need love” on the wall behind them. “Oh, he’s just trying to get my attention.”

Father and son about to cross in the middle of a busy street: “Tell your Mom we crossed at the corner.”

Gift card categories to choose from for Mother’s Day: Earth; Career; Loving, Biological; Surrogate; Unwed; Unfit

Hollywood producer type welcoming his ancient mother into his office: “Mom, baby!”

Woman at cocktail party: “I don’t have to choose between baby and a career. I’m a surrogate mother.”

Here is a comment that I posted today to Family Dysfunction and Mental Health: Dr. Allen, like so many psychiatrists, sees schizophrenia as a special case, a “true brain disease,” that is generally unresponsive to anything but medications.

Dr. Allen: When I began writing this blog, I expected to be attacked by those folks who think that child abuse and dysfunctional family interactions are a figment of the imagination of a bunch of whining liars, and that the problem with modern psychiatry is that we are just not prescribing near enough drugs. I was waiting with baited breath to hear the phrase, “Parent Bashing.”

My response:
Hang on, hang on, here. To quote you “This blog covers mental health, drugs and psychotherapy with an emphasis on the role of family dysfunction in behavioral problems.” A lot of what you call negative comments come from people who take issue with your opinion that schizophrenia and bipolar are “true” brain diseases. The commenters I have seen who take issue with your opinion of bipolar and SZ are people who actually believe (including me) that these conditions arise from Family Dysfunction. Many people diagnosed as bipolar and schizophrenic believe that it is family dysfunction that made them what they are and you are telling them that they are wrong? Oh, no, you have a true brain disease, you say. Take this pill and go away.

How many ways do you want to have this, Dr. Allen? To replay one of your answers to an earlier comment of mine, you wrote “I certainly do not want the mothers of psychotic patients to blame themselves for their child’s illness, as such guilt generally is toxic to everyone in the family.” Hello? Your blog is about linking Family Dysfunction to Mental Health. I am linking Family Dysfunction to Schizophrenia. Your professional view of schizophrenia is a bit schizophrenic, IMO. It is weird, quite frankly, that you see schizophrenia and bipolar as a brain disease and not a mental health problem.

I can’t help but notice that you are getting most comments from people with a bipolar or schizophrenia background. Something about your blog twigs with them, but not with other people, judging from the lack of comments. But you are dismissing them as being negative and insisting that THEY’VE got it wrong. You are getting almost no comments from anybody else, I’ve noticed. Where are the personality disorder people that you treat? Can’t they come up with a comment or two? What about fellow psychiatrists. Where are they in the comments? I would appreciate it if you would look at the people who actually are caring enough to respond to you and think about perhaps opening your mind just a smidgen to the possibility that mental health and family dysfunction includes schizophrenia and bipolar.