Tuesday, September 7, 2010

Dangerous nonsense by Elizabeth Bernstein in today's Wall Street Journal

It amazes and mystifies me, that in order to suggest perfectly rational collaboration and non-confrontational help among family members, a writer for a well-respected publication would find it necessary to promote absurdities and tortured, irrational, anti-scientific propaganda.

Today's Wall Street Journal contains a featured health & wellness article by Elizabeth Bernstein entitled, "A Way Out of Depression: Coaxing a Loved One in Denial into Treatment Without Ruining Your Relationship."

Bernstein's basic point is, if somebody you love needs help, try to understand them and talk them into getting it without pathologizing them or offending them. Fine, who would argue with that?

But the writer bases her advice on the claim that a common symptom of depression is denial or lack of awareness, also known as anosognosia. This is said to be "a physiological syndrome that makes a person unable to understand that he's sick."

This is dangerous and degrading nonsense.

Major Depression, Bipolar Disorder, Schizophrenia and all other mental disorders are defined completely and authoritatively in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision ("DSM-IV-TR"). All symptoms are listed for every mental disorder. Not a single mention of anosognosia is to be found anywhere in the 943-page volume.

The next (fifth) edition of the DSM is due out in a couple years. The American Psychiatric Association has an entire website devoted to DSM-V, which can be searched efficiently to find scores of references about depression, bipolar disorder, schizophrenia, and how all these disorders will be defined, diagnosed and treated in the future, with all the additional research since DSM-IV was published in 1994. But one searches in vain on this website for any mention of anosognosia.

The question that's begged: Why did Elizabeth Bernstein insert this "physiological syndrome" which is not relevant enough to ever be mentioned in the psychiatric manual, into her article as a supposed common symptom of depression?

Anosognosia is a fairly obscure term coined in 1914 with regard to certain brain injuries and neurological conditions. It's causes are unknown. It's use in relation to mental patients who refuse treatment is new and controversial.

Over the past nine years, I've worked with a lot of people who refuse psychiatric treatment and don't believe they are mentally ill. I've worked with a lot of their psychiatrists, too, and their security therapy aides, and their social workers, and all the other state nuthouse staff who get paid for holding and treating people whether they like it or not. These guys never talk about anosognosia. They know their jobs.

I can tell you this: The only reason anyone would claim that a common symptom of depression is lack of awareness, denial, or anosognosia, is to justify "treating" someone against his or her will.

The only point is to be able to forcibly drug someone - that is, get five or six enforcers to hold her down screaming, as a doctor violently injects neuroleptic poison into her body - while still pretending it's for a "patient's" own good.

There is nothing else behind this, in Ms. Bernstein's article in today's Wall Street Journal. Ms. Bernstein may not make the connection. The Journal's editor may not feel responsible for such ugliness. But that is the only point.

The irony is that Ms. Bernstein's article really wants to suggest the opposite of forced treatment. But that's the trouble with psychiatry, it doesn't work, it's an enforced lie.

The nuthouse psychs I work with don't make stupid excuses like "anonsognosia" because they don't have to. With court orders, locked cells and armed security, they're pretty free to brutalize the people they control.

Wednesday, September 1, 2010

Who ... me??

The Canadian Mental Health Association is hosting a national conference October 22-24 in London, ONT entitled "Thriving in 2010 and Beyond". Several weeks ago they were soliciting proposals for presentations at the conference, and I submitted the following:

Psychiatric treatment cannot apparently be separated from some degree of coercion or deception. Mental ''patients'' are generally presumed to ''need'' overriding judgments by others with regard to their treatment. Yet despite all the intricate rationalizations for bypassing the plainly expressed will of patients under various circumstances, the professional consensus remains overwhelmingly in favor of collaborative treatment models.

The problem of coercion and deception in psychiatry, perhaps more than any factor, has separated mental treatment from other medical specialties. Some advocates have frankly suggested that involuntary treatment should be legally facilitated on a much wider scale than it is, while others have opined that psychiatry as we know it would actually disappear if its facility of formal state coercion were ever lost.

Presenter has worked for nine years in Illinois forensic psychiatric institutions, advocating and litigating on behalf of involuntary patients, usually violent offenders who refuse psychotropic medication or continue to dispute diagnoses related to criminal court verdicts of ''not guilty by reason of insanity''. This niche is a dark place from which the general public, medical practitioners, legal professionals and civil servants desperately attempt to look away.

Unfortunately, the human condition shows no immediate sign of transcending violence and irrationality. Courts and other social institutions will be charged with ''doing something'' about bad behavior for the foreseeable future.

An alternate basic attitude will be suggested, 180 degrees opposite to current prevailing thought that mentally ill people can or should be ''helped'' by their neuro-biological betters whether they like it or not. Specific implications of a radically different attitude will be discussed for the architecture and practices of social institutions which we call either ''mental hospitals'' or ''prisons''.

Attendees will acquire rehabilitated purpose for mental health as a valuable social profession, and a viewpoint to inspire honest institutional innovation.

The Canadian Mental Health Association appears to me to be a close cousin to NAMI, in that their main focus is getting people to believe that mental illness is just like any other disease, e.g., of the kidneys, pancreas, heart or lung, and therefore medical solutions are the appropriate goal, just around the corner of research, etc. Of course, this is not my point of view at all.

Well, lo and behold, CMHA accepted my proposal for a presentation at their conference.... So now I have to deliver what I promised according to the description above. My talk, entitled "How to refuse psychiatry without upsetting the neighbors", will be from 10:15 to 11:15am on Saturday, October 23, at the London (Ontario) Convention Centre.

Should be cool.