There has never been any literature supporting the use of antidepressants in children, except one study on prozac and adolescents, and that one was critiqued heavily for many flaws. It amazes me that psychiatrists are allowed to prescribe it. It’s malpractice.
When there is no objective way to determine who has a particular “diagnosis,” the concept of “comorbidity” completely loses any meaning it may have had.
And we can see exactly how helpful the psych drugs were in preventing further violence!
I agree with you, people should be judged on the danger and disrespect of their behavior, not some label affixed to them or some lenience based on “compliance with medication” or whatever else. We can see that compliance and safety don’t necessarily bear any relationship to each other.
I am not surprised to hear any of that. The system is set up so that narcissism is rewarded. Back when I got my own therapy (1982), there were requirements that therapists go through their own therapy before being allowed into the office, and there was strong recognition that the therapist could do a lot of damage if s/he had not dealt with his/her own issues and instead acted them out on the client. Nowadays, I’m not sure they even train counselors on the fact of unconscious motivations they might have. I’d say one takes one’s life in his/her hands applying to a random “therapist” for help today. Odds are better that you’ll get screwed over than helped. I think that was already true in 1982, but it’s far worse today.
“Treatment resistant depression” is a euphemistic way to say, “Our drugs didn’t work and we want to blame the client and/or the disease instead of admitting we failed. Plus it lets us keep ‘treating’ even though we’ve totally screwed it up!”
I think we see here that chatGPT is simply regurgitating what the most common or popular responses are to this kind of question on the internet as a whole. It is not the act of “artificial intelligence,” it’s the act of a very fast collector of other people’s ideas and statements, collating these into some “safe” statements that fit into the mainstream of what’s already been said. It’s INCREDIBLY unlikely that any AI program will look at the situation and conclude, “Well, a lot of people say that antidepressants improve imbalances in chemicals, but research by X, Y, and Z have proven this trope completely false. Evidence is that it originated in propaganda from pharmaceutical company marketing schemes.” ChatGPT is going to amplify the most commonly held beliefs. It will never be able to challenge them, because it can’t really think.
I didn’t meant to be critical, just to make that very point. I’d say the odds of finding what I call a “good therapist” these days are probably in the single digits.
Exactly! A theory with no concrete means of measurement is of next to no scientific value. It’s not wrong, it doesn’t even get to the point of being testable as being wrong! It’s just USELESS!
I will only take this moment to state that not ALL therapists see their role as to identify and/or correct defects in their clients. I think you are acknowledging that in your choice of words, but I want to make that explicit. My view has always been that the only ones who can tell us if therapy “works” are the ones receiving the therapy. They’re also the only ones knowing if something is “wrong” with them and/or what if anything they need to do about it. A good therapist works to help the client discover their own truths about themselves. Anyone who thinks they can “fix” or “improve” the client should be avoided like the plague!
The science does not support your assertions. No medication has been found to reduce suicide rates, and most antidepressants increase rates. Recovery rates have been shown to be LOWER when taking antipsychotics over the long term. Only 30% of users report significant benefits from antidepressants, which is barely more than benefit from placeboes. This is what the science says. Repeating mythology doesn’t make it true. How do you KNOW these things you have claimed to be true?
“Supposed to” is an interesting way to frame it. We know factually that a LOT of adults don’t act like responsible adults. Does that mean we just leave them to machinations of the pharmaceutical industry?
I don’t hear anyone saying the drugs don’t work. I hear someone saying that the data saying they DO work is biased. We already know that they work for less than half of the population at clinically significant levels – the most objective evidence says 30%. Don’t you think it’s fair to the other 70% to let them know they may not see the purported benefits? Do you think it wrong to let people know the actual adverse effect, including withdrawal, oops, I mean DISCONTINUATION effects, that plague many if not the majority of users? Do you deny that these drugs CAN cause harm to a significant subset of the population, based on the scientific data we now have available?
I’m pretty sure in the USA you can hire an attorney, it’s just that most victims of psychiatric incarceration can’t afford one or find one who does such work competently.
It is odd that “patients” are found to “lack insight” as proof of their “illness,” when the profession itself completely lacks ANY insight into what if anything is actually “wrong” with any one of their charges!
ChatGPT gives back from what it’s read, that’s all. It can assemble a ton of information from multiple sources, and maybe even modify its approach if you find it offensive and say so, but it’s not going to provide much outside of the accepted mainstream views. It might outline alternative views, but will identify them as potentially controversial. It’s just a distillation of the “conventional wisdom,” with some acknowledgement given to less popular viewpoints.
It is true that most psychiatric prescribing is done in a very robotic fashion, and would probably be BETTER done by robots, because at least personal prejudice and emotional reactions would be removed from the equation, and the robots wouldn’t hunt you down just because you didn’t follow their advice.
That’s what chatGPT and other AI seems to do – it gathers a huge amount of data and then mimics human responses using “information” it has gleaned from other sources. It does not have any kind of individual thinking or critical analysis, and it works based on what it is programmed to do. It would be easy as heck to program such an entity to simply not publish anything negative about psychiatry or drugs. The only thing that surprised me about Bob’s response is that it has not already been programmed to a pro-psychiatry bent.
Grey matter volume is decreased by antipsychotics. This has been proven in multiple studies. They like to blame it on “schizophrenia,” but pro-drug researchers found this was not the case.
That’s a great idea, actually! I’m guessing it would hem and haw about it, saying it’s “controversial” without really addressing the complete lack of scientific foundations. But who knows? The Chat app bases it’s “comments” on data gathered from billions of sources, and depending on the programming, it could come up with something critical.
My point is only that psychiatric “theories” are mostly mythology. This is only one more example. EVERYBODY said that back in the 70s, even though there was no actual research supporting this idea. When the research debunked the concept, it had some effect, but the myth, much like the “chemical imbalance,” was already so ingrained that few gave it a second thought, despite the research. This seems to me to be the core of psychiatric “theory” – come up with an idea that supports their desired narrative, put out lots of propaganda to promote this idea and pretend it’s all very “scientific,” and don’t research or ignore research in any area that might threaten the narrative. Not much science actually going on!
It is deeply disappointing to hear that professionals still toss around that idiotic trope that “ADHD kids react differently to stimulants.” That notion was debunked way back in 1978 by Judith Rapoport, et. al. It’s worth noting that Rapoport has been a big supporter of stimulants. She gave stimulants in low doses to non-ADHD diagnosed teens and found exactly the same response – less movement, better concentration on dull or repetitive tasks, etc. The only reason she said that people assume the “ADHD” kids react differently is because people are looking for that reaction. She called it “an artifact of observation.”
The fact that such nonsense is still spewed about by “professionals” proves to me how little actual basis any of these “diagnoses” and “treatment” are founded upon. They have to lie to themselves and others to even justify their interventions. It’s such bull!
I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.
This was my experience as well, working “behind enemy lines.” I wasn’t even a psychologist, just a “mental health professional.” We had very little power to alter what the psychiatrists decided to say or do. It was a constant battle, but had to be conducted as a “reasonable conversation” or you were quickly branded as an “anti-meds” worker. I eventually gave up on trying to change the system from the inside. I don’t think it’s possible. I’ve become more of an “abolitionist” the longer I work with this crazed system.
I would estimate that 9 out of 10 therapists are either sold out to the system or don’t really know how to be helpful. I was, indeed, very lucky. And this was in the 80s before the DSM III had taken hold. The odds are a lot worse today!
Can’t disagree with a word of that. The current system makes it as easy as possible to dismiss a client/patent’s concerns, ideas, plans, motivations, etc. and to blame the client for “having the disorder,” and blame “the disorder” for any failure or damage to the client. I think it is much, MUCH harder to find someone today working for the system who is worth seeing than it was back in the 80s when I went. And I was still lucky!
I meant the therapist. I have no problem with the client using his/her own power to his/her own benefit.
It matters because it applies to everyone, whether a therapist or not. What you’re saying is most therapists TAKE ADVANTAGE of their one-up power situation. But not all do so, even if it’s tempting. Same is true of humans you meet on the street, though they have less of a natural advantage in the power department, so it’s probably safer. But lots of “regular humans” take every advantage of their power over others and seek to maximize their influence at the expense of the person they are engaged with. It’s not fair to paint ALL therapists with that brush, any more than all humans. There are even psychiatrists here and there who have a heart and understand their power advantage and don’t use it to hurt their clients. Admittedly, not a common experience, but it happens. I had a fantastic therapist who REFUSED to “diagnose” me or interpret anything I said or did, but always put the question back to me. I kind of hated her for it, but it was the right approach, and I was much the better for my 15 months of weekly meetings with her. Worth every penny I spent. So it’s important not to overgeneralize about people we don’t know, just because they have a certain assigned “role” in “the system.” There are and have always been mavericks who do it their own way. I like to think I was one such.
In the case of the DSM, the very nature of the “diagnoses” makes them diminishing and insulting automatically, as they presume the doctor is able to decide what is wrong with you lacking any concrete testing or evidence of anything being wrong at all. It’s hard to see how a label ever improves anyone’s psychological well-being, unless it’s a label they themselves choose to apply. I see nothing helpful about doctors or psychologists or counselors buying into the DSM fiction campaign.
When people have seizures, our medical system intervenes to stop them because they are known to be dangerous. Yet psychiatrists are allowed to induce seizures for weeks on end and somehow that’s NOT going to create brain damage????
Exactly. The frontal lobes are the center of planning and organization, and hence motivation. It would be almost impossible to execute any kind of complex plan with the dopamine flow to your frontal lobes being so dramatically curtailed. And of course, there is permanent damage from which a person may or may not recover. All to “treat” a “disorder” that no one has any clue if it exists or what is wrong or what is being “fixed.”
Such rages are often caused by the very drugs meant to “treat” them. Stimulants for “ADHD” are the most common offenders, but SSRIs/SNRIs and antipsychotics can do it, too, plus benzo withdrawal is most definitely associated with violence for some users.
Nor for “major depression.” I can’t see how becoming more apathetic and unmotivated plus fatter plus experiencing “involuntary movements” can possibly make a person feel LESS depressed!
Wow, that sounds AWFUL! It sounds like you also had a bad case of akathesia! If you wanted to torture someone, it’s hard to imagine something more effective!
I can well imagine! These ads for the new “anti-TD” drugs always annoy the shit out of me – they make it look like these people have totally normal lives, are working full time and happy, and are just a bit embarrassed that they drop things or their face gets screwed up and looks funny. It’s very trivializing of the reality of TD!
I still don’t get why it’s BETTER for him to call himself “BPD” rather than just identifying what he wants to change and exploring the possible roots and motivations for that behavior? What’s the benefit of calling himself “Borderline,” even if he selects that label for himself?
I agree with this. In my own practice, I never “diagnosed” anyone except to make sure they got a kind of help we agreed they needed. And I told the client from the start that the “diagnoses” are just descriptions of what they already told someone and had no meaning beyond getting insurance reimbursement. Lacking a “diagnosis” never prevented any client I had from making progress. I’m guessing it made it easier for them to make progress, as I “normalized” their experiences and never gave the idea that there was something “wrong” with them that they couldn’t fix, which is the opposite of what these “diagnoses” do.
What’s wrong with saying, “You get scared when you go outside” instead of “You have agoraphobia?” How does the latter help in any way?
That’s why it’s called “Tardive” = “Delayed.” Some show no signs of it until they stop. For some, the only way to get it to go away is to maintain on neuroleptics/antipsychotics, which of course makes the problem slowly worse over time. It’s an awful price to pay!
And why don’t they look at the CAUSE of the TD, instead of “treating your TD movements,” as if this is just some minor thing that happens when you get “good treatment.”
You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!
I don’t think we should redefine our understanding of science. We need to establish a barrier between science and research vs. business and profits. Used to be professors were not allowed to profit from their college-funded or government-funded research. We should go back to those days!
It sounds like you’ve been through hell and are still kinda there!
With all due respect, it appears to me you’ve figured out these “doctors” don’t know the first thing about what they’re doing and their “diagnoses” are fantasies. Are you still looking to them for help? Or are you simply trapped in “the system” and having a hard time getting out of there? What do you see as your path forward?
I am sure there are such people. What’s unfortunate is that they do not appear to be the “thought leaders” in the field, and are in my observation frequently set upon by those with a different agenda. The problems with psychiatry are not those of individual psychiatrists being good or bad people or even good or bad clinicians. It is a matter of the profession itself being committed to misguided values and priorities, including the priority of making money as a profession and maintaining status, and the actual needs of the patients/clients in such a scenario too often take a back seat, if they get a seat at all.
I am always encouraged to find psychiatrists who take a saner approach, but in my experience (and I have more than a bit), they tend to be the minority, and with few exceptions, have little influence on how the profession as a whole considers the problem of “mental illness,” which they seem to have somehow obtained the right to define for the rest of us.
Quite so. It is my experience that telling another person what to think/believe, even if you’re 100% correct, robs them of the ability to realize it for themselves, so they have to either agree or disagree with you instead of realizing their own path. I think exploring possibilities/brainstorming can be fine, but as soon as we start telling the other person what to think of their life and what to do about it, we start doing damage.
Even the girl with “diabetes” can be talked to about how best to frame it from her viewpoint. Perhaps she comes up with, “I have to eat a special diet/take a drug to help” or “My body has trouble handling sugar and I have to take special precautions” or even “Sugar and I have a love-hate relationship.” Why not help her come up with what she feels comfortable instead of deciding what to call it and taking her options away?
Interesting story – I used to work for a crisis line. A woman I had talked to many times called in and said angrily, “Those doctors told me I have Borderline Personality Disorder! I don’t have Borderline Personality Disorder! How DARE they say that about me!” I asked her, “What did they say that meant?” She says, “Well, they didn’t exactly explain it, but they said I have it and I don’t!”
I said, “Let me get out the DSM and read off what they say defines this ‘personality disorder.'” So I read them off to her. “Emotionally volatile?” “Well, yeah, definitely.” “Sometimes feigns suicide for attention?” “Yes, I do that.” “Difficulty with trust in intimate relationships?” “Oh, yeah, for sure.” After I read a few more, she very calmly said, “Well, I guess I DO have it!”
How different would this have gone if they simply started with saying, “It seems to me like you get pretty emotional about things compared to most people. Does that seem true to you?” Or better yet, “What kind of things do you tend to do that you wish you didn’t?” And just describe the behavior instead of the label. She clearly had no trouble acknowledging the behavior she engaged in, was quite aware of it, in fact. But the act of labeling pissed her off big time! So why bother with the label? Why not start with the client’s framing of the problem and go from there?
Sorry, Jukia, but there is exactly zero evidence that the drugs increase suicidality by giving suicidal people the energy to commit suicide they were already planning. For one thing, almost all of these studies ELIMINATE anyone having any hint of suicidal ideation, so even if a few are being deceptive, the majority of these new cases of suicidality come from people who were NOT feeling suicidal before taking the drugs. The explanation you provide is a convenient one for drug companies and doctors who want to convince people that increased suicidality is not a concern, but Prozac in particular was kept off the market in Germany and I think also Italy initially back in the 80s because of increases in suicidal and aggressive behavior in those taking the drugs, so the claim has long been known to be false.
I’m not disputing that some people report getting great benefits from taking these drugs. But it’s not ALL people, and a lot of folks report having little to no effect or becoming worse on the drugs. To claim that being off psychotropic drugs is “FAR more dangerous” than being on them for “most profoundly mentally ill people” is an opinion which is not based on scientific study. In fact, read up on the Wunderlink and Harrow studies, among others, which show that those diagnosed with “psychotic disorders” who don’t take psychotropics actually do better on the average than those who do. Again, not saying some don’t benefit, but generalizing from anecdotes to broad sweeping statements of “truth” is not how science works.
That does kind of sum it up. That kind of thinking is even more destructive in psychiatry, because blaming the victim is the most overtly damaging thing you can do to a traumatized person.
If this guy hates and resents his own patients so badly, he needs to find another profession!
This is NOT new information, but I’m glad it’s being published and brought to people’s attention again. Is it creating depressive feelings really worth a 70% chance of turning in more homework and being less annoying to the adults around a child?
Not surprising to me, but this is important research! The industry relies heavily on claims that “accepting you have an illness” and that “treatment” is just like “insulin for diabetes” reduces “stigma” and makes it easier for people to feel OK about their “mental illness.” Those in charge know these claims are not actually TRUE, but justify using them as PR because “people are more likely to seek help.”
Like other stigma-based research on labels, these findings fly right in the face of these claims. There is no excuse or justification for lying to your clients in the first place, but this kind of research takes away the justification and exposes their “theories” for exactly what they are – propaganda to get more people onto psychiatric drug regimes!
But of course, this kind of thinking will either be ignored, or if it becomes popular enough, will be viciously attacked by the powers that be. We can’t have people HEALING THEMSELVES!!! Or even deciding they DON’T NEED TO BE HEALED!
Sounds brilliant, honestly! I will say from my own experience as a counselor that my goal was always to help the person study their own decisions and experiences and make new decisions (if need be) based on their own observations and conclusions. This seems like it cuts out the middle man and just takes people right there! Perhaps the most important point is that it communicates to the person that s/he CAN figure out what’s going on and what is needed through study and sharing, essentially the opposite of what they hear from the mainstream “mental health” system!
Wait, now the PSYCHIATRISTS are claiming “moral injury?” I suppose it DOES inflict “moral injury” of some sort if you’re constantly claiming to help people and yet so often make no improvements or make their lives agonizingly worse? Perhaps it’s time for a “Truth and reconciliation” circle as they ran in South Africa to help heal the “moral injuries” of the Apartheid regime? Do they expect us to feel sorry for them that their failures don’t feel very good to them???
I agree 100%! I always counted on my clients alone to provide whatever useful information was in play. THEY are the only ones who really know what’s going on or what might help! But that’s the opposite of the mainstream view. The DSM itself admits it doesn’t even bother to attempt to evaluate cause. What’s the point of a “diagnosis” that doesn’t try to identify what the actual problem is!
Ah, the irony! The main reason “professionals” hate “borderlines” so much is that it reminds them of their own failings! I’ve always believed that to be true – EVERYONE can behave in a “borderline” fashion! We just like to pretend it’s someone else and not us!
Well, I worked first for the Long Term Care Ombudsman program, which provides advocacy for seniors in nursing homes, assisted living facilities and adult foster homes/care homes. This is a US program that exists in every state, and while I was a paid employee, most of the Ombudsmen are volunteers. There are plenty of issues with psych drugs in nursing homes, I can tell you!
Then I worked for 20 years for the Court Appointed Special Advocates program (CASA), sometimes known as the Guardian Ad Litem program. This provides volunteers for kids in foster care who advocate to get them to a safe, permanent home as quickly as possible, and for them to be safe in the meanwhile. The number of kids on psych drugs is beyond comprehension, and the longer they are in the worse it gets! So I found plenty of opportunities there to get into the grill of the psych profession, in an effective way.
Mind Freedom, Inc. is also a more or less worldwide association of advocates for those in the “mental health” system, so the advocacy there is more direct.
There are no doubt other organizations I have not mentioned who do advocacy for those in psych “hospitals” or other “mental health” facilities. You’d have to look around where you live and see what’s happening there.
I’m glad to hear you are ready to take that step! It sounds like you certainly KNOW enough to do a great job – the trick is getting through the insane levels of resistance from the people who should know better, especially the psychiatrists themselves! But it’s worth it when you get a victory. I encourage you to go in that direction!
I always came from the belief that any advice or evaluation of what the client ought to do or ought to have done is counter to any effort to help. It’s nobody else’s job to tell the client what to think about their situation or what to do about it. Of course, I understand that most therapists these days don’t seem to hold that view. More’s the pity.
I really wish I could refer you to someone! Have you considered support groups for people traumatized in childhood? It hurts my heart to hear that such therapy, which used to be considered at least one of the main approaches, is virtually unavailable to you now.
I have found people associated with the domestic abuse or sexual abuse worlds to be much more likely to understand about trauma and approach it differently, in an empowering way. Perhaps a local women’s or domestic abuse helpline has a referral for a therapist who understands how to be helpful in these situations? They may also be a source for peer support groups, where you would at least meet others who have been through what you have (including the incredible rigidity and blindness of the so-called “mental health” services) and might have some support and/or ideas for healing? And maybe make a friend or two and feel a bit less lonely?
I’m much more inclined to recommend peer support these days than therapy, as so many therapists (as you report) have become handmaidens of the psych industry. Anyone starting off with diagnosing and recommending drugs should be immediately eliminated from consideration, and in your case, that sounds like everyone!
It is true, those clinicians who speak up are either dismissed as kooks or attacked. That’s what drove me out of the field, I couldn’t deal with being “behind enemy lines” all the time! Advocacy ended up being much more up my alley. Could use my skills without helping sustain a system that did so much harm!
Well, that’s certainly true, and that’s why I’m very distrustful of anyone coming out of current “psychology” or “mental health” training. I believe they focus a huge amount of time on DSM diagnoses and very little on actual ways to improve one’s own awareness and emotional availability to the clients, or actually helping to discover and evaluate what the CLIENT thinks is helpful and desirable. It’s very arrogant and disempowering, the opposite of what is actually helpful!
There is also a big difference between those who use scientific EVIDENCE as proof of their position and those who use scientific CONSENSUS (what ‘scientists’ tend to agree on) as proof of their positions. As has become very clear, many of the so-called “scientists” in the psychiatric field not only don’t rely on science for their conclusions, they actively attack any real science that contradicts their desired narrative. Corrupt “scientists” who benefit from their position of power should not be accorded any kind of special status. Only the science itself is worthy of discussion if we’re really interested in facts and knowledge!
I don’t disagree with anything you said. Except that “diagnoses” are not PART of the “therapy process,” they are the justification for assuming authority over the “clients,” and as such are the opposite of therapeutic. The “diagnoses” are an evil that extends FAR beyond the “treatments” it is used to justify. It starts the process of “othering” and allows people to discriminate and downgrade the “mentally ill” (as they call them) with impunity. If there were no “therapy” at all, the DSM would still be incredibly destructive!
I’m not ‘favoring the therapist’s position,” just describing what has to happen for it to work for the client. I fully acknowledge most “therapy relationships” don’t occur in this way and are mostly destructive or at best do nothing helpful.
And “borderline personality disorder” is a DSM diagnosis and has literally nothing to do with therapy, except as providing an excuse for certain kinds of “therapeutic interventions” that ignore the needs of the “client.”
I engaged in therapy that worked very well for me, and I wouldn’t be who I am without having done so. But I was lucky, very lucky. I’d have to be much MORE lucky today to find such a person, as I see most of those claiming to be “therapists” being guided down the wrong path. You yourself have acknowledged in the past that there are exceptions where people do benefit from a therapist, but we both agree it’s rare and in many cases not even possible. I’m not promoting therapy as a profession. I’m just describing what I see as necessary for it to work. Again, I’ve already agreed and acknowledged that most therapists are incapable of this level of awareness, and that one is just as likely to benefit from talking to someone they know who has some good listening skills. Therapy is a setup for most people, because of the inherent power imbalance and most “therapists'” inability to recognize let alone manage their own needs to heal their own power relationships. Alice Miller had it right.
I hope that clarifies where I’m coming from. Definitely not of the “everybody needs therapy” school of thought!
It CAN happen and DOES happen in some cases, but the incentive is to use one’s power for one’s own benefit. And you are right, this motivation is almost always unconscious and therefore very difficult to recognize for the therapist, even if it becomes obvious to their “clients.” Which is why I say you can’t really train someone to be a good therapist. They have to develop an acute awareness of power relationships and their own issues with power and be aware of these at all times when interacting with someone they are trying to assist. I’d say very few therapists ever meet this goal, and in fact, unless I’m wrong about what happens today in “training,” most of them aren’t even aware of it as a problem. So going to a random therapist is, indeed, a very dangerous undertaking. As research shows, your odds are just as good choosing a friend or colleague as someone with a degree.
My view is that a person can’t really be trained to be a good therapist. I agree, it has to do with the essence of the relationship between two people, and techniques or schools of therapy are borderline irrelevant. “Diagnosis” via the DSM is completely irrelevant. It’s not a “cookbook” procedure, it has to do with creating a safe space and respecting the right of the client to decide what is “right” or not and how to define and pursue “improvement” in their own worlds. I’m not sure what they train “therapists” to know these days, but I know they spend a lot of time on the DSM and “brain scans” and neurology, and it seems not very much on what actually helps people grow and develop in their own way.
That is the huge glitch. And I don’t even think they bother training new therapists/counselors about this any more. It’s all about the DSM. The odds of getting a helpful counselor have dropped dramatically from when I was in counseling back in 1983. Very few are really up to the job, and an incapable therapist can do a HELL of a lot of damage!!!
One approach I sometimes used with traumatized clients is to say, “I am guessing you don’t trust me at this point. I wouldn’t trust me either if I were you. You have no idea who I am or whether I’m a safe person, and distrust is very appropriate in such a situation. I’m hoping I can earn your trust over time.” Or something like that. Acknowledging the “rightness” of them being skeptical seemed to give the clients some sense of getting some power back. It always used to bother me when clients were dinged for “not trusting their therapy team.” I always said, “How do you know they can trust the therapy team?”
I wasn’t very popular with a certain kind of therapist…
Absolutely true. All depends on the therapist backing away from their one-up power relationship, but that still leaves them in the one-up position, because they get to decide if they want to abuse their power or not.
Not to mention, they are based almost 100% on bigotry and social assumptions and have zero foundation in any kind of scientific process. It’s basically rarified name calling.
I’m assuming the intent of a good and respectful therapist is to help the person before them to free up energy used to protect themselves from past traumatic experiences so they can use it to create a better life in the future, by their own definition, not the therapist’s. It is true that not everyone is prepared at a given time to go there, and such resistance should be respected as a behavior that meets a need for the client, something DBT seems not to recognize at all.
In any case, what I’m pointing out is that “resistance” (which is a word I would never use) has historically been viewed as an indicator of exactly what you said, that the person is feeling it is necessary to protect him/herself from danger. These mechanisms are developed for very real reasons to protect from very real dangers at the time, and one HOPES that therapy becomes a safe place to identify what these mechanisms are (help the person be conscious of them rather than having them be automatic), and for the CLIENT to re-evaluate for him/herself whether and when such approaches remain necessary. This should leave the client with all necessary defense mechanisms intact and usable, but cut down on the times they are used on a knee-jerk reactive basis when not really needed, such as becoming hostile to the butcher because he wears the same had your dad wore all the time and his voice sounds similar so he must be dangerous like your dad, etc. Gaining personal awareness and decision-making power over such responses should leave a person feeling more in control of his/her life in general. That’s the theory anyway, and it appears to have been very successful for the clients whom I worked with.
So the idea that the CLIENT is supposed to somehow abandon any “resistance” and just go along with what the “therapist” says is very, very damaging to the client. It is reinforcing the idea that they were WRONG for judging the past situation as dangerous, that the “authority figure’s” feelings are more important than the client’s, and that the big problem is not that the authority figure was abusive, but that the client wasn’t “understanding” enough of the needs of the authority figure and should try HARDER to repress and undermine any actions they took to feel safer. This is exactly the OPPOSITE of what I’ve found to be truly helpful, which is validating the client for taking necessary actions for self-protection and admiring their courage in doing so.
One of the very first things I did as a counselor/therapist was to help the client validate that the “crazy” things they tended to do were not crazy at all, but made perfect sense to them at some time in the past. I would share that I’ve found it helpful to look at what DOES make sense about the behavior (AKA to what extend DOES it act to protect them) and validate them for coming up with effective “coping mechanisms” for a difficult situation. Only after getting very clear on that point would I propose to the client the possibility that such mechanisms are often used by all of us humans in situations where they aren’t as helpful as their original intended purpose, and that becoming more aware and intentional about them, or even developing some new ones with our adult intelligence and recognition that in many cases the danger is not current, might be a good path to follow.
That gives maybe just a little feeling of how important it is for me to respect whatever behavior the client has come up with to survive in their world. I always assume that ALL their actions have purpose, and the question is only whether these actions continue to serve the purpose they were intended for in the present. I have never intentionally tried to force a person to drop or dismiss any behavior they feel is important to their safety and survival. I have tried to run only based on their own stated desire to change a certain pattern of behavior, and “resistance” is important in recognizing when the actual reason for the behavior is coming to light. Naturally, a person is entitled to hang onto whatever “resistance” they feel they still need. Therapy should only be in service of meeting their own goals, not mine!
It’s not the client’s responsibility to avoid “distracting and annoying” the clinician. “Resistance” is supposed to be part of the treatment, at least it used to be back when therapists knew what they were doing. If a person is “resisting,” it was supposed to indicate that you’re getting to an issue that needs to be addressed. It’s not a reason to punish the client!
If clients have to act in certain ways to keep the clinician happy, there is no therapy going on. That’s usually what got the client into their problems in the first place!
That’s exactly what my therapist said to me at the beginning. She said the goal was to develop my own internal “therapist” which I could consult directly and for her to become unnecessary for me as quickly as possible. She did a lot of good for me, but only because she was focused on helping ME become more independent, not in dragging out therapy so she’d get more fees and feel superior!
And this is how genetic testing COULD be helpful. Instead of testing for ONE GENE that creates ALL cases of “depression,” we should be testing for genes that explain a SMALL PART of the cohort which can actually be “treated” at its cause! Such discoveries will remove a certain number of sufferers, while not raising the belief or expectation that some magical one-gene solution will mean EVERYONE suddenly gets better!
Thanks for your thoughtful reply! I agree that these things are complicated, and I appreciate the acknowledgement that “fitting in” to the so-called “social norms” is NOT a sign of “neurotypicality” but of ability to adapt to what are generally unreasonable expectations. The “ADHD” kid in class can’t adapt, and so is identified as “divergent.” Of course, it’s better for him than being identified as “mentally ill,” but that classroom is FULL of kids who are just as miserable as he is and yet don’t act that out for whatever reason, whether better suppression skills or more fear of punishment or whatever. Those kids are not any more “typical” than anyone else, they just don’t make trouble for the adults and are therefore identified as “normal.”
Maybe the term “neuro” is what gives the word its “bioessentialist” undertone. Maybe if we simply identified ourselves as “divergent,” as in “diverging from expected social norms,” then everyone can get on board with “diverging” and maybe even find some new and better “social norms” that are easier for more people to live with!
Frank, while I agree that paying for a quality therapist (if one is fortunate enough to find one) is hardly a form of oppression, I have to say that I’ve seen PLENTY of garden variety straight-up intentional oppression of psychiatric “patients” in the name of “helping” them that most definitely would meet any definition of oppression you can come up with. Dishonesty, use of force, holding people against their will without cause, forcing “treatment” that causes brain damage and early death while claiming that all of these issues are the patients’ problem and were not caused by the “treatment. All of these things are offensive to any sense of justice, freedom, equality of rights and basic respect due to any human being. It seems to me you are singling out the relatively rare case of a free and relatively well off adult engaging in a more or less fair exchange of money for services, and assuming the purchaser has both the information and the wherewithal to resist efforts to indoctrinate or mistreat them at the hands of the therapist. That’s a lot of assuming!
If you slow down a minute and read some of the experiences shared here on MIA, you will see that the vast majority of commenters do not have the kind of experience you are describing. Many are forced against their will to do things they object to with neither information nor consent. Many more are lied to and emotionally manipulated into accepting a very unhealthy framing of their situation and into accepting “treatments” whose benefits are overblown and whose dangerous consequences are minimized or denied completely. This is the oppressive situation we’re dealing with. And it CAN happen in a paid therapy relationship, too.
I’m sure you are a caring person who probably does a good job helping your clients. What I don’t think you get is that you are an outlier in the world most of the posters live in. It’s very understandable that most are extremely skeptical of therapy in any form. It’s been used to hurt them!
My biggest problem with the term “neurodivergent” is that it implies there is a “normal” kind of neurology that “most people” have, and that one has to be “autistic” or “ADHD” or fit some label to be considered “neurodivergent.” I object very much to the idea that there is such a thing as “normal” vs. “divergent” neurology, in fact, genetic diversity is critical to species survival, and one of the great joys of humanity is the amazing degree of divergence that exists within the “normal” range of human behavior. Ultimately, I see us all as “neurodivergent” which means the term really has no meaning. It seems to me that the term “neurodivergent” reinforces the idea that “mental illnesses” are somehow neurological and are discernible by “divergence” from some kind of theoretical “norm.”
I have no problems with individuals identifying themselves as “neurodivergent,” but I can’t agree with such people deciding that I or others are “normies” and that one has to have special qualities to qualify as “neurodivergent.”
That’s my view of it. I’m sure others have their reasons that will diverge from mine!
As I intimated, I don’t think most psychiatrists understand or care about fast- vs. slow-metabolizers and so forth. I do appreciate your research, and that was specifically what I was recalling and referring to.
The difficulty with this approach is that it totally begs the question of what we are supposedly “treating” with these drugs. What we’re doing is manipulating brain chemicals and hoping we get lucky and find a drug that a person can live with that helps reduce his/her “symptoms” without saddling him/her with intolerable adverse effects. But of course, we have no idea if brain chemicals are in fact a causal agent in any of these cases, or how to distinguish the ones that are (if they exist) by any kind of objective means. It’s not really very different from observing that some people can take opioids or drink alcohol and be fine, while some are quickly overwhelmed by the drug’s effects and others seem to take a lot to have any effect at all. All fine information to have, but it hardly substitutes for figuring out and addressing WHY this person is distressed enough to be heading down to the bar every night to imbibe, and what we might do to alter that reality!
There has never been any literature supporting the use of antidepressants in children, except one study on prozac and adolescents, and that one was critiqued heavily for many flaws. It amazes me that psychiatrists are allowed to prescribe it. It’s malpractice.
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When there is no objective way to determine who has a particular “diagnosis,” the concept of “comorbidity” completely loses any meaning it may have had.
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And we can see exactly how helpful the psych drugs were in preventing further violence!
I agree with you, people should be judged on the danger and disrespect of their behavior, not some label affixed to them or some lenience based on “compliance with medication” or whatever else. We can see that compliance and safety don’t necessarily bear any relationship to each other.
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I am not surprised to hear any of that. The system is set up so that narcissism is rewarded. Back when I got my own therapy (1982), there were requirements that therapists go through their own therapy before being allowed into the office, and there was strong recognition that the therapist could do a lot of damage if s/he had not dealt with his/her own issues and instead acted them out on the client. Nowadays, I’m not sure they even train counselors on the fact of unconscious motivations they might have. I’d say one takes one’s life in his/her hands applying to a random “therapist” for help today. Odds are better that you’ll get screwed over than helped. I think that was already true in 1982, but it’s far worse today.
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I wish I were surprised.
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“Treatment resistant depression” is a euphemistic way to say, “Our drugs didn’t work and we want to blame the client and/or the disease instead of admitting we failed. Plus it lets us keep ‘treating’ even though we’ve totally screwed it up!”
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I think we see here that chatGPT is simply regurgitating what the most common or popular responses are to this kind of question on the internet as a whole. It is not the act of “artificial intelligence,” it’s the act of a very fast collector of other people’s ideas and statements, collating these into some “safe” statements that fit into the mainstream of what’s already been said. It’s INCREDIBLY unlikely that any AI program will look at the situation and conclude, “Well, a lot of people say that antidepressants improve imbalances in chemicals, but research by X, Y, and Z have proven this trope completely false. Evidence is that it originated in propaganda from pharmaceutical company marketing schemes.” ChatGPT is going to amplify the most commonly held beliefs. It will never be able to challenge them, because it can’t really think.
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I didn’t meant to be critical, just to make that very point. I’d say the odds of finding what I call a “good therapist” these days are probably in the single digits.
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Exactly! A theory with no concrete means of measurement is of next to no scientific value. It’s not wrong, it doesn’t even get to the point of being testable as being wrong! It’s just USELESS!
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I will only take this moment to state that not ALL therapists see their role as to identify and/or correct defects in their clients. I think you are acknowledging that in your choice of words, but I want to make that explicit. My view has always been that the only ones who can tell us if therapy “works” are the ones receiving the therapy. They’re also the only ones knowing if something is “wrong” with them and/or what if anything they need to do about it. A good therapist works to help the client discover their own truths about themselves. Anyone who thinks they can “fix” or “improve” the client should be avoided like the plague!
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The science does not support your assertions. No medication has been found to reduce suicide rates, and most antidepressants increase rates. Recovery rates have been shown to be LOWER when taking antipsychotics over the long term. Only 30% of users report significant benefits from antidepressants, which is barely more than benefit from placeboes. This is what the science says. Repeating mythology doesn’t make it true. How do you KNOW these things you have claimed to be true?
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“Supposed to” is an interesting way to frame it. We know factually that a LOT of adults don’t act like responsible adults. Does that mean we just leave them to machinations of the pharmaceutical industry?
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I don’t hear anyone saying the drugs don’t work. I hear someone saying that the data saying they DO work is biased. We already know that they work for less than half of the population at clinically significant levels – the most objective evidence says 30%. Don’t you think it’s fair to the other 70% to let them know they may not see the purported benefits? Do you think it wrong to let people know the actual adverse effect, including withdrawal, oops, I mean DISCONTINUATION effects, that plague many if not the majority of users? Do you deny that these drugs CAN cause harm to a significant subset of the population, based on the scientific data we now have available?
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I’m pretty sure in the USA you can hire an attorney, it’s just that most victims of psychiatric incarceration can’t afford one or find one who does such work competently.
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It is odd that “patients” are found to “lack insight” as proof of their “illness,” when the profession itself completely lacks ANY insight into what if anything is actually “wrong” with any one of their charges!
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Love the name! You’re all “in cahoots” with each other!
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ChatGPT gives back from what it’s read, that’s all. It can assemble a ton of information from multiple sources, and maybe even modify its approach if you find it offensive and say so, but it’s not going to provide much outside of the accepted mainstream views. It might outline alternative views, but will identify them as potentially controversial. It’s just a distillation of the “conventional wisdom,” with some acknowledgement given to less popular viewpoints.
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It is true that most psychiatric prescribing is done in a very robotic fashion, and would probably be BETTER done by robots, because at least personal prejudice and emotional reactions would be removed from the equation, and the robots wouldn’t hunt you down just because you didn’t follow their advice.
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Yup!
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You should give it a try! I bet the results would be quite telling.
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That’s what chatGPT and other AI seems to do – it gathers a huge amount of data and then mimics human responses using “information” it has gleaned from other sources. It does not have any kind of individual thinking or critical analysis, and it works based on what it is programmed to do. It would be easy as heck to program such an entity to simply not publish anything negative about psychiatry or drugs. The only thing that surprised me about Bob’s response is that it has not already been programmed to a pro-psychiatry bent.
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Grey matter volume is decreased by antipsychotics. This has been proven in multiple studies. They like to blame it on “schizophrenia,” but pro-drug researchers found this was not the case.
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I really don’t know. I’ve never done it. I don’t have much interest in chatGBT myself.
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Brilliant post!
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Who’da guessed it?
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I like that one, too!
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That’s a great idea, actually! I’m guessing it would hem and haw about it, saying it’s “controversial” without really addressing the complete lack of scientific foundations. But who knows? The Chat app bases it’s “comments” on data gathered from billions of sources, and depending on the programming, it could come up with something critical.
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My point is only that psychiatric “theories” are mostly mythology. This is only one more example. EVERYBODY said that back in the 70s, even though there was no actual research supporting this idea. When the research debunked the concept, it had some effect, but the myth, much like the “chemical imbalance,” was already so ingrained that few gave it a second thought, despite the research. This seems to me to be the core of psychiatric “theory” – come up with an idea that supports their desired narrative, put out lots of propaganda to promote this idea and pretend it’s all very “scientific,” and don’t research or ignore research in any area that might threaten the narrative. Not much science actually going on!
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It is deeply disappointing to hear that professionals still toss around that idiotic trope that “ADHD kids react differently to stimulants.” That notion was debunked way back in 1978 by Judith Rapoport, et. al. It’s worth noting that Rapoport has been a big supporter of stimulants. She gave stimulants in low doses to non-ADHD diagnosed teens and found exactly the same response – less movement, better concentration on dull or repetitive tasks, etc. The only reason she said that people assume the “ADHD” kids react differently is because people are looking for that reaction. She called it “an artifact of observation.”
The fact that such nonsense is still spewed about by “professionals” proves to me how little actual basis any of these “diagnoses” and “treatment” are founded upon. They have to lie to themselves and others to even justify their interventions. It’s such bull!
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I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.
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This was my experience as well, working “behind enemy lines.” I wasn’t even a psychologist, just a “mental health professional.” We had very little power to alter what the psychiatrists decided to say or do. It was a constant battle, but had to be conducted as a “reasonable conversation” or you were quickly branded as an “anti-meds” worker. I eventually gave up on trying to change the system from the inside. I don’t think it’s possible. I’ve become more of an “abolitionist” the longer I work with this crazed system.
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I loved “a la carte menu” as a description of the DSM. Kinda sums it up!
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Maybe this article can inspire you to do so?
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I would estimate that 9 out of 10 therapists are either sold out to the system or don’t really know how to be helpful. I was, indeed, very lucky. And this was in the 80s before the DSM III had taken hold. The odds are a lot worse today!
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Can’t disagree with a word of that. The current system makes it as easy as possible to dismiss a client/patent’s concerns, ideas, plans, motivations, etc. and to blame the client for “having the disorder,” and blame “the disorder” for any failure or damage to the client. I think it is much, MUCH harder to find someone today working for the system who is worth seeing than it was back in the 80s when I went. And I was still lucky!
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I meant the therapist. I have no problem with the client using his/her own power to his/her own benefit.
It matters because it applies to everyone, whether a therapist or not. What you’re saying is most therapists TAKE ADVANTAGE of their one-up power situation. But not all do so, even if it’s tempting. Same is true of humans you meet on the street, though they have less of a natural advantage in the power department, so it’s probably safer. But lots of “regular humans” take every advantage of their power over others and seek to maximize their influence at the expense of the person they are engaged with. It’s not fair to paint ALL therapists with that brush, any more than all humans. There are even psychiatrists here and there who have a heart and understand their power advantage and don’t use it to hurt their clients. Admittedly, not a common experience, but it happens. I had a fantastic therapist who REFUSED to “diagnose” me or interpret anything I said or did, but always put the question back to me. I kind of hated her for it, but it was the right approach, and I was much the better for my 15 months of weekly meetings with her. Worth every penny I spent. So it’s important not to overgeneralize about people we don’t know, just because they have a certain assigned “role” in “the system.” There are and have always been mavericks who do it their own way. I like to think I was one such.
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In the case of the DSM, the very nature of the “diagnoses” makes them diminishing and insulting automatically, as they presume the doctor is able to decide what is wrong with you lacking any concrete testing or evidence of anything being wrong at all. It’s hard to see how a label ever improves anyone’s psychological well-being, unless it’s a label they themselves choose to apply. I see nothing helpful about doctors or psychologists or counselors buying into the DSM fiction campaign.
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When people have seizures, our medical system intervenes to stop them because they are known to be dangerous. Yet psychiatrists are allowed to induce seizures for weeks on end and somehow that’s NOT going to create brain damage????
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Exactly. The frontal lobes are the center of planning and organization, and hence motivation. It would be almost impossible to execute any kind of complex plan with the dopamine flow to your frontal lobes being so dramatically curtailed. And of course, there is permanent damage from which a person may or may not recover. All to “treat” a “disorder” that no one has any clue if it exists or what is wrong or what is being “fixed.”
Chemical stun gun is a great description!
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Such rages are often caused by the very drugs meant to “treat” them. Stimulants for “ADHD” are the most common offenders, but SSRIs/SNRIs and antipsychotics can do it, too, plus benzo withdrawal is most definitely associated with violence for some users.
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Nor for “major depression.” I can’t see how becoming more apathetic and unmotivated plus fatter plus experiencing “involuntary movements” can possibly make a person feel LESS depressed!
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Wow, that sounds AWFUL! It sounds like you also had a bad case of akathesia! If you wanted to torture someone, it’s hard to imagine something more effective!
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I can well imagine! These ads for the new “anti-TD” drugs always annoy the shit out of me – they make it look like these people have totally normal lives, are working full time and happy, and are just a bit embarrassed that they drop things or their face gets screwed up and looks funny. It’s very trivializing of the reality of TD!
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I still don’t get why it’s BETTER for him to call himself “BPD” rather than just identifying what he wants to change and exploring the possible roots and motivations for that behavior? What’s the benefit of calling himself “Borderline,” even if he selects that label for himself?
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I agree with this. In my own practice, I never “diagnosed” anyone except to make sure they got a kind of help we agreed they needed. And I told the client from the start that the “diagnoses” are just descriptions of what they already told someone and had no meaning beyond getting insurance reimbursement. Lacking a “diagnosis” never prevented any client I had from making progress. I’m guessing it made it easier for them to make progress, as I “normalized” their experiences and never gave the idea that there was something “wrong” with them that they couldn’t fix, which is the opposite of what these “diagnoses” do.
What’s wrong with saying, “You get scared when you go outside” instead of “You have agoraphobia?” How does the latter help in any way?
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That’s why it’s called “Tardive” = “Delayed.” Some show no signs of it until they stop. For some, the only way to get it to go away is to maintain on neuroleptics/antipsychotics, which of course makes the problem slowly worse over time. It’s an awful price to pay!
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And why don’t they look at the CAUSE of the TD, instead of “treating your TD movements,” as if this is just some minor thing that happens when you get “good treatment.”
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🙂
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Much like “ECT” aka shock therapy. If you kill off the RIGHT brain cells, things just get better and better!
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You are absolutely right! These behaviors serve a definite purpose, and unless it’s a truly safe environment, they will be needed again and again! It has to be up to the person him/herself to decide which of those historical coping measures remain relevant. In a typical psychiatric environment, defensive measures are generally quite essential!
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I don’t think we should redefine our understanding of science. We need to establish a barrier between science and research vs. business and profits. Used to be professors were not allowed to profit from their college-funded or government-funded research. We should go back to those days!
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Hi, Donna!
It sounds like you’ve been through hell and are still kinda there!
With all due respect, it appears to me you’ve figured out these “doctors” don’t know the first thing about what they’re doing and their “diagnoses” are fantasies. Are you still looking to them for help? Or are you simply trapped in “the system” and having a hard time getting out of there? What do you see as your path forward?
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I love the astrology analogy! If it helps to believe you have Taurus traits, go for it, but let’s not pretend we’re practicing medicine!
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Well, they always accuse “BPD”-labeled clients of “splitting.”
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I particularly like the term “splitting” in the title. Nice touch!
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I am sure there are such people. What’s unfortunate is that they do not appear to be the “thought leaders” in the field, and are in my observation frequently set upon by those with a different agenda. The problems with psychiatry are not those of individual psychiatrists being good or bad people or even good or bad clinicians. It is a matter of the profession itself being committed to misguided values and priorities, including the priority of making money as a profession and maintaining status, and the actual needs of the patients/clients in such a scenario too often take a back seat, if they get a seat at all.
I am always encouraged to find psychiatrists who take a saner approach, but in my experience (and I have more than a bit), they tend to be the minority, and with few exceptions, have little influence on how the profession as a whole considers the problem of “mental illness,” which they seem to have somehow obtained the right to define for the rest of us.
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Excellent questions! I wish I had the answer!
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Quite so. It is my experience that telling another person what to think/believe, even if you’re 100% correct, robs them of the ability to realize it for themselves, so they have to either agree or disagree with you instead of realizing their own path. I think exploring possibilities/brainstorming can be fine, but as soon as we start telling the other person what to think of their life and what to do about it, we start doing damage.
Even the girl with “diabetes” can be talked to about how best to frame it from her viewpoint. Perhaps she comes up with, “I have to eat a special diet/take a drug to help” or “My body has trouble handling sugar and I have to take special precautions” or even “Sugar and I have a love-hate relationship.” Why not help her come up with what she feels comfortable instead of deciding what to call it and taking her options away?
Interesting story – I used to work for a crisis line. A woman I had talked to many times called in and said angrily, “Those doctors told me I have Borderline Personality Disorder! I don’t have Borderline Personality Disorder! How DARE they say that about me!” I asked her, “What did they say that meant?” She says, “Well, they didn’t exactly explain it, but they said I have it and I don’t!”
I said, “Let me get out the DSM and read off what they say defines this ‘personality disorder.'” So I read them off to her. “Emotionally volatile?” “Well, yeah, definitely.” “Sometimes feigns suicide for attention?” “Yes, I do that.” “Difficulty with trust in intimate relationships?” “Oh, yeah, for sure.” After I read a few more, she very calmly said, “Well, I guess I DO have it!”
How different would this have gone if they simply started with saying, “It seems to me like you get pretty emotional about things compared to most people. Does that seem true to you?” Or better yet, “What kind of things do you tend to do that you wish you didn’t?” And just describe the behavior instead of the label. She clearly had no trouble acknowledging the behavior she engaged in, was quite aware of it, in fact. But the act of labeling pissed her off big time! So why bother with the label? Why not start with the client’s framing of the problem and go from there?
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Sorry, Jukia, but there is exactly zero evidence that the drugs increase suicidality by giving suicidal people the energy to commit suicide they were already planning. For one thing, almost all of these studies ELIMINATE anyone having any hint of suicidal ideation, so even if a few are being deceptive, the majority of these new cases of suicidality come from people who were NOT feeling suicidal before taking the drugs. The explanation you provide is a convenient one for drug companies and doctors who want to convince people that increased suicidality is not a concern, but Prozac in particular was kept off the market in Germany and I think also Italy initially back in the 80s because of increases in suicidal and aggressive behavior in those taking the drugs, so the claim has long been known to be false.
I’m not disputing that some people report getting great benefits from taking these drugs. But it’s not ALL people, and a lot of folks report having little to no effect or becoming worse on the drugs. To claim that being off psychotropic drugs is “FAR more dangerous” than being on them for “most profoundly mentally ill people” is an opinion which is not based on scientific study. In fact, read up on the Wunderlink and Harrow studies, among others, which show that those diagnosed with “psychotic disorders” who don’t take psychotropics actually do better on the average than those who do. Again, not saying some don’t benefit, but generalizing from anecdotes to broad sweeping statements of “truth” is not how science works.
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That does kind of sum it up. That kind of thinking is even more destructive in psychiatry, because blaming the victim is the most overtly damaging thing you can do to a traumatized person.
If this guy hates and resents his own patients so badly, he needs to find another profession!
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Gotta wonder what the “objections” were that were raised by “other professionals?” “This might work and we’d have to give up our absolute power?”
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This is NOT new information, but I’m glad it’s being published and brought to people’s attention again. Is it creating depressive feelings really worth a 70% chance of turning in more homework and being less annoying to the adults around a child?
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Not surprising to me, but this is important research! The industry relies heavily on claims that “accepting you have an illness” and that “treatment” is just like “insulin for diabetes” reduces “stigma” and makes it easier for people to feel OK about their “mental illness.” Those in charge know these claims are not actually TRUE, but justify using them as PR because “people are more likely to seek help.”
Like other stigma-based research on labels, these findings fly right in the face of these claims. There is no excuse or justification for lying to your clients in the first place, but this kind of research takes away the justification and exposes their “theories” for exactly what they are – propaganda to get more people onto psychiatric drug regimes!
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But of course, this kind of thinking will either be ignored, or if it becomes popular enough, will be viciously attacked by the powers that be. We can’t have people HEALING THEMSELVES!!! Or even deciding they DON’T NEED TO BE HEALED!
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Sounds brilliant, honestly! I will say from my own experience as a counselor that my goal was always to help the person study their own decisions and experiences and make new decisions (if need be) based on their own observations and conclusions. This seems like it cuts out the middle man and just takes people right there! Perhaps the most important point is that it communicates to the person that s/he CAN figure out what’s going on and what is needed through study and sharing, essentially the opposite of what they hear from the mainstream “mental health” system!
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Wait, now the PSYCHIATRISTS are claiming “moral injury?” I suppose it DOES inflict “moral injury” of some sort if you’re constantly claiming to help people and yet so often make no improvements or make their lives agonizingly worse? Perhaps it’s time for a “Truth and reconciliation” circle as they ran in South Africa to help heal the “moral injuries” of the Apartheid regime? Do they expect us to feel sorry for them that their failures don’t feel very good to them???
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Sounds safer and more reliable than any of the drugs on offer!
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I agree 100%! I always counted on my clients alone to provide whatever useful information was in play. THEY are the only ones who really know what’s going on or what might help! But that’s the opposite of the mainstream view. The DSM itself admits it doesn’t even bother to attempt to evaluate cause. What’s the point of a “diagnosis” that doesn’t try to identify what the actual problem is!
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Their constant failure to provide true informed consent ought to make almost all of them vulnerable to malpractice charges!
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Ah, the irony! The main reason “professionals” hate “borderlines” so much is that it reminds them of their own failings! I’ve always believed that to be true – EVERYONE can behave in a “borderline” fashion! We just like to pretend it’s someone else and not us!
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Well, I worked first for the Long Term Care Ombudsman program, which provides advocacy for seniors in nursing homes, assisted living facilities and adult foster homes/care homes. This is a US program that exists in every state, and while I was a paid employee, most of the Ombudsmen are volunteers. There are plenty of issues with psych drugs in nursing homes, I can tell you!
Then I worked for 20 years for the Court Appointed Special Advocates program (CASA), sometimes known as the Guardian Ad Litem program. This provides volunteers for kids in foster care who advocate to get them to a safe, permanent home as quickly as possible, and for them to be safe in the meanwhile. The number of kids on psych drugs is beyond comprehension, and the longer they are in the worse it gets! So I found plenty of opportunities there to get into the grill of the psych profession, in an effective way.
Mind Freedom, Inc. is also a more or less worldwide association of advocates for those in the “mental health” system, so the advocacy there is more direct.
There are no doubt other organizations I have not mentioned who do advocacy for those in psych “hospitals” or other “mental health” facilities. You’d have to look around where you live and see what’s happening there.
I’m glad to hear you are ready to take that step! It sounds like you certainly KNOW enough to do a great job – the trick is getting through the insane levels of resistance from the people who should know better, especially the psychiatrists themselves! But it’s worth it when you get a victory. I encourage you to go in that direction!
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This is what Alice Miller talks about in her books. You might be interested in reading some of her works!
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I always came from the belief that any advice or evaluation of what the client ought to do or ought to have done is counter to any effort to help. It’s nobody else’s job to tell the client what to think about their situation or what to do about it. Of course, I understand that most therapists these days don’t seem to hold that view. More’s the pity.
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Exactly!!!!
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I really wish I could refer you to someone! Have you considered support groups for people traumatized in childhood? It hurts my heart to hear that such therapy, which used to be considered at least one of the main approaches, is virtually unavailable to you now.
I have found people associated with the domestic abuse or sexual abuse worlds to be much more likely to understand about trauma and approach it differently, in an empowering way. Perhaps a local women’s or domestic abuse helpline has a referral for a therapist who understands how to be helpful in these situations? They may also be a source for peer support groups, where you would at least meet others who have been through what you have (including the incredible rigidity and blindness of the so-called “mental health” services) and might have some support and/or ideas for healing? And maybe make a friend or two and feel a bit less lonely?
I’m much more inclined to recommend peer support these days than therapy, as so many therapists (as you report) have become handmaidens of the psych industry. Anyone starting off with diagnosing and recommending drugs should be immediately eliminated from consideration, and in your case, that sounds like everyone!
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Being a good person in a destructive system still contributes to supporting the destructive system. That’s why I’m not a counselor any more!
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It is true, those clinicians who speak up are either dismissed as kooks or attacked. That’s what drove me out of the field, I couldn’t deal with being “behind enemy lines” all the time! Advocacy ended up being much more up my alley. Could use my skills without helping sustain a system that did so much harm!
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Well, that’s certainly true, and that’s why I’m very distrustful of anyone coming out of current “psychology” or “mental health” training. I believe they focus a huge amount of time on DSM diagnoses and very little on actual ways to improve one’s own awareness and emotional availability to the clients, or actually helping to discover and evaluate what the CLIENT thinks is helpful and desirable. It’s very arrogant and disempowering, the opposite of what is actually helpful!
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There is also a big difference between those who use scientific EVIDENCE as proof of their position and those who use scientific CONSENSUS (what ‘scientists’ tend to agree on) as proof of their positions. As has become very clear, many of the so-called “scientists” in the psychiatric field not only don’t rely on science for their conclusions, they actively attack any real science that contradicts their desired narrative. Corrupt “scientists” who benefit from their position of power should not be accorded any kind of special status. Only the science itself is worthy of discussion if we’re really interested in facts and knowledge!
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I don’t disagree with anything you said. Except that “diagnoses” are not PART of the “therapy process,” they are the justification for assuming authority over the “clients,” and as such are the opposite of therapeutic. The “diagnoses” are an evil that extends FAR beyond the “treatments” it is used to justify. It starts the process of “othering” and allows people to discriminate and downgrade the “mentally ill” (as they call them) with impunity. If there were no “therapy” at all, the DSM would still be incredibly destructive!
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I’m not ‘favoring the therapist’s position,” just describing what has to happen for it to work for the client. I fully acknowledge most “therapy relationships” don’t occur in this way and are mostly destructive or at best do nothing helpful.
And “borderline personality disorder” is a DSM diagnosis and has literally nothing to do with therapy, except as providing an excuse for certain kinds of “therapeutic interventions” that ignore the needs of the “client.”
I engaged in therapy that worked very well for me, and I wouldn’t be who I am without having done so. But I was lucky, very lucky. I’d have to be much MORE lucky today to find such a person, as I see most of those claiming to be “therapists” being guided down the wrong path. You yourself have acknowledged in the past that there are exceptions where people do benefit from a therapist, but we both agree it’s rare and in many cases not even possible. I’m not promoting therapy as a profession. I’m just describing what I see as necessary for it to work. Again, I’ve already agreed and acknowledged that most therapists are incapable of this level of awareness, and that one is just as likely to benefit from talking to someone they know who has some good listening skills. Therapy is a setup for most people, because of the inherent power imbalance and most “therapists'” inability to recognize let alone manage their own needs to heal their own power relationships. Alice Miller had it right.
I hope that clarifies where I’m coming from. Definitely not of the “everybody needs therapy” school of thought!
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It CAN happen and DOES happen in some cases, but the incentive is to use one’s power for one’s own benefit. And you are right, this motivation is almost always unconscious and therefore very difficult to recognize for the therapist, even if it becomes obvious to their “clients.” Which is why I say you can’t really train someone to be a good therapist. They have to develop an acute awareness of power relationships and their own issues with power and be aware of these at all times when interacting with someone they are trying to assist. I’d say very few therapists ever meet this goal, and in fact, unless I’m wrong about what happens today in “training,” most of them aren’t even aware of it as a problem. So going to a random therapist is, indeed, a very dangerous undertaking. As research shows, your odds are just as good choosing a friend or colleague as someone with a degree.
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My view is that a person can’t really be trained to be a good therapist. I agree, it has to do with the essence of the relationship between two people, and techniques or schools of therapy are borderline irrelevant. “Diagnosis” via the DSM is completely irrelevant. It’s not a “cookbook” procedure, it has to do with creating a safe space and respecting the right of the client to decide what is “right” or not and how to define and pursue “improvement” in their own worlds. I’m not sure what they train “therapists” to know these days, but I know they spend a lot of time on the DSM and “brain scans” and neurology, and it seems not very much on what actually helps people grow and develop in their own way.
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“I find them really annoying, so they must be ‘mentally ill.’ Otherwise, it might mean I’m just impatient and judgmental!”
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That is the huge glitch. And I don’t even think they bother training new therapists/counselors about this any more. It’s all about the DSM. The odds of getting a helpful counselor have dropped dramatically from when I was in counseling back in 1983. Very few are really up to the job, and an incapable therapist can do a HELL of a lot of damage!!!
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This is all very well said!
One approach I sometimes used with traumatized clients is to say, “I am guessing you don’t trust me at this point. I wouldn’t trust me either if I were you. You have no idea who I am or whether I’m a safe person, and distrust is very appropriate in such a situation. I’m hoping I can earn your trust over time.” Or something like that. Acknowledging the “rightness” of them being skeptical seemed to give the clients some sense of getting some power back. It always used to bother me when clients were dinged for “not trusting their therapy team.” I always said, “How do you know they can trust the therapy team?”
I wasn’t very popular with a certain kind of therapist…
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Absolutely true. All depends on the therapist backing away from their one-up power relationship, but that still leaves them in the one-up position, because they get to decide if they want to abuse their power or not.
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Not to mention, they are based almost 100% on bigotry and social assumptions and have zero foundation in any kind of scientific process. It’s basically rarified name calling.
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I’m assuming the intent of a good and respectful therapist is to help the person before them to free up energy used to protect themselves from past traumatic experiences so they can use it to create a better life in the future, by their own definition, not the therapist’s. It is true that not everyone is prepared at a given time to go there, and such resistance should be respected as a behavior that meets a need for the client, something DBT seems not to recognize at all.
In any case, what I’m pointing out is that “resistance” (which is a word I would never use) has historically been viewed as an indicator of exactly what you said, that the person is feeling it is necessary to protect him/herself from danger. These mechanisms are developed for very real reasons to protect from very real dangers at the time, and one HOPES that therapy becomes a safe place to identify what these mechanisms are (help the person be conscious of them rather than having them be automatic), and for the CLIENT to re-evaluate for him/herself whether and when such approaches remain necessary. This should leave the client with all necessary defense mechanisms intact and usable, but cut down on the times they are used on a knee-jerk reactive basis when not really needed, such as becoming hostile to the butcher because he wears the same had your dad wore all the time and his voice sounds similar so he must be dangerous like your dad, etc. Gaining personal awareness and decision-making power over such responses should leave a person feeling more in control of his/her life in general. That’s the theory anyway, and it appears to have been very successful for the clients whom I worked with.
So the idea that the CLIENT is supposed to somehow abandon any “resistance” and just go along with what the “therapist” says is very, very damaging to the client. It is reinforcing the idea that they were WRONG for judging the past situation as dangerous, that the “authority figure’s” feelings are more important than the client’s, and that the big problem is not that the authority figure was abusive, but that the client wasn’t “understanding” enough of the needs of the authority figure and should try HARDER to repress and undermine any actions they took to feel safer. This is exactly the OPPOSITE of what I’ve found to be truly helpful, which is validating the client for taking necessary actions for self-protection and admiring their courage in doing so.
One of the very first things I did as a counselor/therapist was to help the client validate that the “crazy” things they tended to do were not crazy at all, but made perfect sense to them at some time in the past. I would share that I’ve found it helpful to look at what DOES make sense about the behavior (AKA to what extend DOES it act to protect them) and validate them for coming up with effective “coping mechanisms” for a difficult situation. Only after getting very clear on that point would I propose to the client the possibility that such mechanisms are often used by all of us humans in situations where they aren’t as helpful as their original intended purpose, and that becoming more aware and intentional about them, or even developing some new ones with our adult intelligence and recognition that in many cases the danger is not current, might be a good path to follow.
That gives maybe just a little feeling of how important it is for me to respect whatever behavior the client has come up with to survive in their world. I always assume that ALL their actions have purpose, and the question is only whether these actions continue to serve the purpose they were intended for in the present. I have never intentionally tried to force a person to drop or dismiss any behavior they feel is important to their safety and survival. I have tried to run only based on their own stated desire to change a certain pattern of behavior, and “resistance” is important in recognizing when the actual reason for the behavior is coming to light. Naturally, a person is entitled to hang onto whatever “resistance” they feel they still need. Therapy should only be in service of meeting their own goals, not mine!
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The whole sham depends on the DSM for its foundation.
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It’s not the client’s responsibility to avoid “distracting and annoying” the clinician. “Resistance” is supposed to be part of the treatment, at least it used to be back when therapists knew what they were doing. If a person is “resisting,” it was supposed to indicate that you’re getting to an issue that needs to be addressed. It’s not a reason to punish the client!
If clients have to act in certain ways to keep the clinician happy, there is no therapy going on. That’s usually what got the client into their problems in the first place!
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So do I! It was decades later before I realized how fortunate I had been to draw the good therapy hand I did!
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That’s exactly what my therapist said to me at the beginning. She said the goal was to develop my own internal “therapist” which I could consult directly and for her to become unnecessary for me as quickly as possible. She did a lot of good for me, but only because she was focused on helping ME become more independent, not in dragging out therapy so she’d get more fees and feel superior!
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Apparently, regular trips to the gym or outdoor walks already meet that standard!
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And this is how genetic testing COULD be helpful. Instead of testing for ONE GENE that creates ALL cases of “depression,” we should be testing for genes that explain a SMALL PART of the cohort which can actually be “treated” at its cause! Such discoveries will remove a certain number of sufferers, while not raising the belief or expectation that some magical one-gene solution will mean EVERYONE suddenly gets better!
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Thanks for your thoughtful reply! I agree that these things are complicated, and I appreciate the acknowledgement that “fitting in” to the so-called “social norms” is NOT a sign of “neurotypicality” but of ability to adapt to what are generally unreasonable expectations. The “ADHD” kid in class can’t adapt, and so is identified as “divergent.” Of course, it’s better for him than being identified as “mentally ill,” but that classroom is FULL of kids who are just as miserable as he is and yet don’t act that out for whatever reason, whether better suppression skills or more fear of punishment or whatever. Those kids are not any more “typical” than anyone else, they just don’t make trouble for the adults and are therefore identified as “normal.”
Maybe the term “neuro” is what gives the word its “bioessentialist” undertone. Maybe if we simply identified ourselves as “divergent,” as in “diverging from expected social norms,” then everyone can get on board with “diverging” and maybe even find some new and better “social norms” that are easier for more people to live with!
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Frank, while I agree that paying for a quality therapist (if one is fortunate enough to find one) is hardly a form of oppression, I have to say that I’ve seen PLENTY of garden variety straight-up intentional oppression of psychiatric “patients” in the name of “helping” them that most definitely would meet any definition of oppression you can come up with. Dishonesty, use of force, holding people against their will without cause, forcing “treatment” that causes brain damage and early death while claiming that all of these issues are the patients’ problem and were not caused by the “treatment. All of these things are offensive to any sense of justice, freedom, equality of rights and basic respect due to any human being. It seems to me you are singling out the relatively rare case of a free and relatively well off adult engaging in a more or less fair exchange of money for services, and assuming the purchaser has both the information and the wherewithal to resist efforts to indoctrinate or mistreat them at the hands of the therapist. That’s a lot of assuming!
If you slow down a minute and read some of the experiences shared here on MIA, you will see that the vast majority of commenters do not have the kind of experience you are describing. Many are forced against their will to do things they object to with neither information nor consent. Many more are lied to and emotionally manipulated into accepting a very unhealthy framing of their situation and into accepting “treatments” whose benefits are overblown and whose dangerous consequences are minimized or denied completely. This is the oppressive situation we’re dealing with. And it CAN happen in a paid therapy relationship, too.
I’m sure you are a caring person who probably does a good job helping your clients. What I don’t think you get is that you are an outlier in the world most of the posters live in. It’s very understandable that most are extremely skeptical of therapy in any form. It’s been used to hurt them!
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My biggest problem with the term “neurodivergent” is that it implies there is a “normal” kind of neurology that “most people” have, and that one has to be “autistic” or “ADHD” or fit some label to be considered “neurodivergent.” I object very much to the idea that there is such a thing as “normal” vs. “divergent” neurology, in fact, genetic diversity is critical to species survival, and one of the great joys of humanity is the amazing degree of divergence that exists within the “normal” range of human behavior. Ultimately, I see us all as “neurodivergent” which means the term really has no meaning. It seems to me that the term “neurodivergent” reinforces the idea that “mental illnesses” are somehow neurological and are discernible by “divergence” from some kind of theoretical “norm.”
I have no problems with individuals identifying themselves as “neurodivergent,” but I can’t agree with such people deciding that I or others are “normies” and that one has to have special qualities to qualify as “neurodivergent.”
That’s my view of it. I’m sure others have their reasons that will diverge from mine!
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I am shocked, SHOCKED to find that GAMBLING has been going on in this establishment!
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As I intimated, I don’t think most psychiatrists understand or care about fast- vs. slow-metabolizers and so forth. I do appreciate your research, and that was specifically what I was recalling and referring to.
The difficulty with this approach is that it totally begs the question of what we are supposedly “treating” with these drugs. What we’re doing is manipulating brain chemicals and hoping we get lucky and find a drug that a person can live with that helps reduce his/her “symptoms” without saddling him/her with intolerable adverse effects. But of course, we have no idea if brain chemicals are in fact a causal agent in any of these cases, or how to distinguish the ones that are (if they exist) by any kind of objective means. It’s not really very different from observing that some people can take opioids or drink alcohol and be fine, while some are quickly overwhelmed by the drug’s effects and others seem to take a lot to have any effect at all. All fine information to have, but it hardly substitutes for figuring out and addressing WHY this person is distressed enough to be heading down to the bar every night to imbibe, and what we might do to alter that reality!
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