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> To: [log in to unmask] > Subject: Psychology Today: Bob Whitaker on Psychiatric Drug Silencing > Date: Thu, 7 Oct 2010 14:41:27 -0700 > From: [log in to unmask] > > > [to get off this MFI free public alert list on human rights in mental > health see bottom] > ~~~~~~~~~~~~ > > Psychology Today Blog: > > Journalist Robert Whitaker asks BELOW: > > "Will we ever be able to have an honest discussion about psychiatric > medications?" > > Author describes his experience as controversial keynoter of > Alternatives 2010 mental health conference. > > Kick-start the discussion: Forward this news item! > > The US federal agency Substance Abuse and Mental Health Systems > Administration [SAMHSA] has funded an annual gathering of mental > health consumers and psychiatric survivors since 1985. > > This year's "Alternatives 2010" in Anaheim, California, which gathered > together more than 1,000 Americans diagnosed with psychiatric > disabilities, ended just a few days ago, and was one of the most > controversial. > > SAMHSA was nervous that keynoter Robert Whitaker -- author of the new > book Anatomy of an Epidemic -- would question mental health industry > claims about psychiatric drugs. He did. > > BELOW, Whitaker blogs yesterday, 6 October 2010, in Psychology Today > about his experience of breaking the silence about this taboo: > > ~~~~~~~~~~~~ > Join discussion in Psychology Today at bottom of below original > article here: > http://www.psychologytoday.com/node/48811 > You can break the silence, too -- Please forward this to colleagues. > ~~~~~~~~~~~~ > > SAMHSA, the Alternatives Conference, and the Story of an Opportunity > Lost > > By Robert Whitaker > > Oct 6 2010 > > In the last chapter of my book Anatomy of an Epidemic, I noted that if > our society is going to stem the epidemic of disabling mental illness > that has erupted during the past twenty years, then it needs to have > an honest discussion about what is truly known about the biological > causes of psychiatric disorders, and an honest discussion about how > the medications affect the long-term course of those disorders. The > illuminating powers of science could work their usual magic. But that > is a discussion that many in our society don't want to have, and my > recent experience at the Alternatives conference in Anaheim > illustrates that point, and reveals too why this is such a loss. > > The Background to the "Controversy" > > In Anatomy of an Epidemic, I basically followed a tried-and-true > journalistic path. I followed the evidence. I looked at how the > chemical imbalance theory of mental disorders arose, how it was > investigated, and how it never panned out. As Kenneth Kendler, > coeditor in chief of Psychological Medicine wrote in 2005, "We have > hunted for big simple neurochemical explanations for psychiatric > disorders and have not found them." Then I investigated how > psychiatric medications affect the long-term course of four major > mental disorders (schizophrenia, anxiety, depression, and bipolar > illness), and that involves doing an exhaustive survey of studies > conducted (or funded) by the National Institute of Mental Health, the > World Health Organization, and foreign governments for the past 50 > years. > > Now, when you do that, you discover a story of science quite at odds > with our societal belief that psychiatric medications fix chemical > imbalances in the brain and that they have dramatically improved long- > term outcomes. And when you write up this history of science, as I did > in Anatomy of an Epidemic, you do become unpopular in certain circles. > > In July, the National Empowerment Center, which is a peer-run advocacy > organization, invited me to be a keynote speaker at the Alternatives > Conference. The National Empowerment Center is funded by the Substance > Abuse and Mental Health Services Administration (SAMHSA), and SAMHSA, > I was told, had signed off on having me speak. However, once the > National Empowerment Center announced that I would be speaking at the > conference, SAMHSA quickly rescinded the invitation. In response, > MindFreedom, which is an activist group, organized a protest via the > Internet, asking people to contact both SAMSHA and the White House, > and within 36 hours, I had been publicly re-invited to speak. > > What people following this "controversy" didn't know was that my re- > invitation came with considerable strings attached. I had originally > been scheduled to give a workshop in addition to a keynote, but the > workshop was still cancelled. (I had planned to speak about a Finnish > program for treating psychotic patients that was producing excellent > results, and the prescribing of exercise as a treatment for > depression, which is now being done in Britain.) The other condition > was this: The National Empowerment Center was required to recruit a > psychiatrist, from a list of names provided by SAMHSA, to "rebut" my > keynote. And I would not be given an opportunity to respond to that > rebuttal. > > Now, if SAMSHA had wanted to organize a debate following my talk, that > would have been terrific. But this was a setup that SAMHSA seemed to > have torn from the pages of a 25-year old Soviet Union handbook: > invite dissident speaker and then denounce him! Normally, I wouldn't > have accepted such an arrangement, but I had been quite moved and > humbled by the protest that had led to my "reinvitation," and so I > figured, what the heck. It wasn't every day that you got to sit in a > ballroom with more than 1,000 people and hear your work denounced. > > As the conference approached, a new controversy reared its head. Will > Hall, who many years ago was given a diagnosis of "schizoaffective > disorder/schizophrenia," and who today works as a therapist (having > been off psychiatric medications for 17 years), had planned to give a > workshop that included discussing a "harm-reduction" approach to > withdrawing from psychiatric medications. Several years ago, Hall had > written a book on the subject, which had been published by two > advocacy groups, The Freedom Center and the Icarus Project, and given > that there are few books written by professionals on the circuit, his > had proven to be quite popular. But a few days before the conference > began, Hall was told that the printed description of his workshop in > the conference brochure had been changed to remove any mention about > "coming off drugs." Hall announced that he couldn't accept such > censorship, a new protest erupted, and then he was told that the > offending words could in fact be mentioned in an updated description > that would be added to the conference brochure. > > And all this occurred before an alternatives conference. > > Friday, October 1 > > On Friday morning, I was given about 45 minutes to speak, and after I > gave a brief overview of Anatomy of an Epidemic, I spoke at greater > length about this question: Is it true that people diagnosed with > schizophrenia (or other psychotic disorders) need to be on > antipsychotic medication all their lives? There is a fairly long line > of studies dating back to the 1960s that bear on this question, and > the conclusion to be drawn is this: If psychiatry wants to maximize > long-term outcomes, it needs to use antipsychotic medications in a > selective, limited manner. Time and time again, the studies showed > that there is a large subgroup of patients that would fare better if > they were never put on the drugs in the first place, or if they were > maintained on the drugs for only a short while. > > The beauty of this particular story of science is that it concludes > with a description of how western Lapland, in northern Finland, > started using antipsychotic medications in this manner in 1992, and > today their psychotic patients enjoy the best long-term outcomes in > the western world. Five years after a first psychotic episode, eighty > percent of their patients are either back in school or working. About > one-third of the patients have been exposed to antipsychotics during > this period, and about twenty percent end up taking the medication > regularly. And what I like most about this success story is that it > cannot be viewed, in any way, as an "anti-medication" story. It's a > "best-practices" story. > > Most of the audience understood this to be a "good news" tale, with > science telling us of a therapeutic path that led to high recovery > rates. And imagine if the program, at this national conference, had > been structured to have psychiatrists (or other providers) discuss the > talk I had just given. We could have spoken about whether a similar > therapeutic approach could ever be tried here, and with > representatives from SAMHSA there, perhaps this possibility could even > have leapt onto a national agenda. This could have been a moment for > transformative change in the treatment of first-episode psychosis in > this country, a change designed to put young people back onto a path > of real recovery, rather than down a path that led all too often to > chronicity and disability. But unfortunately, in that Hyatt Regency > ballroom, a much different process was underway. Several SAMHSA > officials were nervously huddled with the psychiatrist, Mark Ragins, > who had been selected to rebut my talk, apparently with a sense of > urgency that he effectively counter what I had said. No good news > allowed! > > When Dr. Ragins took the stage at lunchtime, he was remarkably candid. > He was here because SAMHSA wouldn't let me speak unless a psychiatrist > had a chance to rebut what I had said. This, of course, was startling > news to most in the audience, as few had ever been to a conference > where a second keynote speaker was brought in to discredit the first. > > There was, however, no real discussion by Dr. Ragins of the talk I had > given, or the issues brought up in Anatomy of an Epidemic. Instead, > Dr. Ragins used this metaphor to criticize Anatomy: In the book, he > said, I had provided readers with a "compelling picture" of a "close- > up of a car accident," but "we have to widen our view to decide if > freeways should be torn down." Dr. Ragins then discussed other factors > besides medication that might be causing the astonishing rise in the > number of disabled mentally ill in our society, such as the fact that > once people are on SSI or SSDI, there is a financial disincentive to > return to work (which I agree is a factor.) Finally, in apparent > reference to the many studies I cited in the book that had found that > medicated patients have worse long-term outcomes than the off- > medication group, he said: > > "Medical interventions are always correlated with worse (long-term) > problems . . . It is likely that all interventions 'done to' someone > to give them help or take care of them will have short-term benefits > that wane over time and may well become long-term negatives." > > I still am not quite sure how that was supposed to be a "rebuttal" to > Anatomy of an Epidemic. But that is how it was being pitched, and then > when Dr. Ragins detailed some of his thoughts on what promoted long- > term recovery -- "Love other people, family, partners, kids" was one > of the things he advised -- I could only think: Am I supposed to be > against this? Indeed, I had the feeling that if Dr. Ragins and I had > been on a panel together, we would have found much common ground, and > that he might have thought that there was considerable merit to the > Western Lapland approach. But the chance to have that productive > discussion had been lost. > > A Postscript > > During the conference, D. J. Jaffe, who has close ties to the National > Alliance on Mental Illness, having served on its national board of > directors, wrote a blog about the conference for The Huffington Post, > describing it as a waste of taxpayer money. My presence there, he > argued, was evidence of why this was so. The keynote speaker, Jaffe > said, had written that "antipsychotic drugs do not fix any known brain > abnormality nor do they put brain chemistry back into balance," and > readers were left to understand that, given that everybody knew that > mental disorders were caused by chemical imbalances, I was a bit of a > loony-tune. > > So what was the real purpose of this blog? NAMI is a powerful > political group, heavily funded by pharmaceutical companies, and in my > opinion, Jaffe was delivering a warning. He was telling the National > Empowerment Center and other consumer groups that they risked losing > their funding if they did not, in the future, march in lockstep with > psychiatry's official story, which is that mental disorders are known > brain illnesses, and that the drugs are like "insulin for diabetes." > No more invitation by the National Empowerment Center to speakers who > would say otherwise. > > At such moments, I have to confess that I begin to lose all hope. It > seems quite impossible that our society will ever be able to have a > thoughtful, honest discussion about what is truly known about mental > disorders, and about the merits of psychiatric medications. The forces > lined up against such a discussion are simply too great. > > ~~~~~~~~~~~~ > * > ACTION * ACTION * ACTION * > > "Join the discussion"! Please add your comment to Psychology Today > discussion at bottom of Whitaker's piece here: > > http://www.psychologytoday.com/node/48811 > > YOU can break the silence, for free. Forward this news! > > ~~~~~~~~~~~~ > > More info on this controversy: > > Report on MindFreedom successful campaign to support Whitaker speaking: > http://3.ly/whitakervictory > > MFI alert about attack on Alternatives 2010 by D.J. Jaffe's blog: > http://3.ly/mfijaffe > > To go directly to Jaffe's attack on Alternatives 2010: > http://3.ly/huffingtonjaffe > > MFI director David Oaks blogs about Alternatives 2010, and Jaffe attack: > http://www.mindfreedom.org/mfi-blog > > Psychologist/Author Bruce Levine blogs on HuffPost defending > Alternatives 2010... you can still comment: > http://3.ly/levinejaffe > > MindFreedom's Facebook page also has a discussion on controversy: > http://www.facebook.com/pages/MindFreedom-International/33579368821 > > Influential mental health author Pete Earley is a "velvet glove" > blogger who supports says he supports mental health consumer > empowerment, and the iron fist of more forced drugging. He posted a 4 > October entry attacking Alternatives 2010: > > http://www.peteearley.com/blog/2010/10/04/an-alternative-voice > > Pehaps because of what Earley calls a "firestorm" of comments, he > apparently changed his mind the next day, blogging 5 October in an > "Answering Critics" entry that he "supports" Alternatives 2010, if it > meets his standards. He also disabled all comments "until further > notice": > > http://www.peteearley.com/blog/2010/10/05/alternatives-2010-answering-critics > > Mental health consumer and psychiatric survivor leaders called it back > in July, when they issued a statement at a SAMHSA summit, warning > about "undue influence of the pharamceutical industry" in mental > health care. Your group is encouraged to endorse the urgent call: > http://www.mindfreedom.org/kb/psychiatric-drugs/bastille-2010 > > ~~~~~~~~~~~~ > > REMEMBER: > > PLEASE USE the Internet to kick start this discussion -- that some in > the US government think is taboo. > > There are more than 10,000 on this MindFreedom News public alert list > -- please forward to YOUR colleagues, friends, relatives. > > Add a brief personal note of encouragement at the top for them to... > > FORWARD this news item to others those who support human rights and > alternatives in mental health! > > Please post on blogs, Twitter, Facebook, and more! Break the silence > with YOUR free mind! > > ~~~~~~~~~~~~ > > JOIN - DONATE - RENEW with MindFreedom International! > > http://www.mindfreedom.org/join-donate > > MFI is one of the few totally independent activist coalitions in > mental health advocacy. > > After 24 years of organizing, MFI is now one of the largest voice of > and for survivors of psychiatric abuse in history! > > Please join, re-join or renew your MindFreedom International > membership here with a tax-deductible gift of any size: > > http://www.mindfreedom.org/join-donate > > MFI gets NO funding from mental health industry, drug companies, > government and religions. > > That means MindFreedom International counts on YOUR donations: > > http://www.mindfreedom.org/join-donate > > ~~~~~~~~~~~~ > If you did not get this e-mail directly from mindfreedom-news and > would like to be on the free public alert list, sign up here: > http://www.mindfreedom.org/mfi-faq/MFI-news-public-email-alert/ > ~~~~~~~~~~~~ > > Want to STOP getting these free public MFI news alerts? > > Two easy ways: > > 1) UNSUBSCRIBE AUTOMATICALLY: > > Send a blank email from the e-mail address you want to remove to: > > [log in to unmask] > > When you get the automatic unsubscribe confirmation message in a few > moments be sure to reply. 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