Monday, December 28, 2009

Brain fetish disorder

An article on December 26, 2009 in Pediatrics Week tells of a Carnegie Mellon study showing that intensive remedial reading courses change children's brains as reading skills improve.

Near the end of the article the (apparently fascinating) question is posed: "... whether intensive training brings about increased myelination that results in improved word decoding skills, or whether improved word decoding skills leads to changes in reading habits that result in greater myelination."

Can anyone explain how investigation of this question could possibly result in anything more useful than mysticism, just like the old quandry of whether the chicken or the egg came first?

I am familiar with the fetish about electro-chemical reactions and anatomical structures in the brain being all there is to, and the entire explanation and cause of, personality and behavior. But the single utility of that idea, as far as I can tell, is to motivate attempts to control personalities and behavior by fine-tuning brain chemistry with psychotropic drugs. We've been working on that project for decades and it has failed miserably.

Has anyone read The Utility of Force: The Art of War in the Modern World by General Rupert Smith? He writes about the destructive persistence in political policy making of the paradigm of industrial war, despite the fact that such war no longer exists.

It seems to me that there is a parallel and a relationship, to a similarly destructive persistence in culture creation, of the paradigm of the bio-mechanical individual.

More when I finish the General's book, maybe.

Wednesday, December 23, 2009

"Patients", right?

There has been a whole series of major muckraking articles in the Chicago Tribune about nursing homes in Illinois. Horror of horrors, there are violent, mentally ill felons in nursing homes! How could this happen? Grandma and Grandpa living in the room next door to rapists and murderers!? Who made such a terrible mistake? Who could be so corrupt?

Well, don't ask for whom the bell tolls.

Our belief in mental illness as a functional brain defect or chemical imbalance which should be treated with medicine necessarily demands that we create and tolerate the exact situations the Trib is complaining about with the most ostentatious moral outrage.

Sex offenders and violent criminals are living in nursing homes because they are officially patients. Remember? If they're patients why shouldn't they be in nursing homes? We've all decided mental illness is just like heart disease or cancer, so it's only fair!

The young murderer two doors down the hall from Grandpa strangled his girlfriend with a clothesline a few years ago because of schizophrenia, not because he was a bad guy. Schizophrenia gets treated with antipsychotic meds, especially those "atypical" ones, which are so much better than the old drugs. Remember? Medical science and brain research have made such wonderful progress, and breakthroughs are just right around the corner, if only we pay enough taxes for psychiatrists to "treat" more and more people.

The sex offender housed in the room next to Grandma isn't a despicable pervert, he's sick. Remember? It's all best understood in terms of his brain, which is is an organ just like the heart or the liver. So this guy's behavior is a medical issue, just like Grandma's diabetes. We can't discriminate, it's not nice and maybe it's not even legal.

Self-appointed media watchdogs complain about "compromised care" and trumpet elaborate, "early morning raids" by combined state and federal law enforcement agencies against nursing homes. I'm sorry, but this is a farce. 

Do we want to continue our delusional attempt to replace social justice and traditional law with medicine? The economics of our love affair with modern psychiatry are inexorable. Nursing homes will never be safe places again, and we have no right to believe they should be. Let's either knock off the hypocrisy or figure out how to eliminate the insanity defense (and any other psychiatric excuses) from our legal system.

Monday, December 21, 2009

Found it

Rodney Yoder managed to locate a website where I might actually be able to buy the "Brains get sick, too" poster! I have to print out a form, fill it in and mail it with a check (which is a little odd because it's offered on line, so it seems like I should be able to order it on line ... maybe NAMI will refuse to sell it to me because I'm not one of their faithful, we'll see).

Anyway, I'm becoming a collector of old propaganda, I guess. A few years ago, my kids got me several t-shirts from a vendor in Soho which had reproductions of old Soviet poster art, for example, inveighing the loyal proletarian populace against drinking anything but the official government liquor.

Someday, this poster with the sick brain will be a collector's item, like the Soviet stuff and Nazi memorabilia. But even if I can buy one that's brand new now, I think I'd rather have the particular one that has been displayed on the wall for several years at a real state nuthouse.

The "Arbeit Macht Frei" sign was recovered after the whole Polish army spent several days searching for it. An exact replica has been up over the black gate to Auschwitz since the recent theft. The original sign will have to be reassembled, because the thieves cut it into three pieces, presumably to more easily conceal it for smuggling. But it will of course be returned to its place, as the exact same piece made of iron piping which the Nazis originally put there for several years, when Auschwitz was ... what it was....

Friday, December 18, 2009

The Auschwitz sign

AP wire this morning says the infamous "Arbeit Macht Frei" sign was stolen from Auschwitz. At the risk of making that most fatal error in all arguments (being the first to say "Nazi"), here's what what this story made me think of.

At Elgin Mental Health Center, in the lobby of the forensic building, there's a very clever poster, framed and prominently displayed for all visitors and family to see. It bears a copyright, I think, by the National Alliance for the Mentally Ill. It is a wonderful, iconic piece of Twentieth Century propanda art. It's getting pretty old and faded, so I recently told one or two guys in the administration at Elgin that I'll happily buy it from them if and when they decide to remove it. It should be preserved.

The poster is a colorful cartoon with the caption, "Brains get sick, too." It has a very cute, poor little personified brain, looking distressed, with a hot water bottle, thermometer, signs of the flu, etc. Then the copy tells about how mental illnesses are just like any other disease, implying of course that everybody should take psychotropic meds for their problems (like aspirin for a fever), and faithfully believe all those DSM "diagnoses" that the friendly, expert doctor-psychiatrists hand out, yada, yada, yada ... (standard NAMI line).

I called NAMI, but they can't sell me this poster, it's out of print. I really, really want it! Obviously, it's not the "Arbeit Macht Frei" sign, but it seems quite cool to me.

For the record, I promise not to steal it, no matter what.

Monday, December 14, 2009

X, Y and Z plus

Patient Z at Elgin Mental Health Center is doing surprisingly well. This is the guy they pretended they could forcibly drug if he continued to refuse psychotropic meds. (See my earlier article entitled "Despicable Coercion", posted November 21, 2009.) I intervened at the court hearing on a petition for involuntary treatment, and they immediately backed off. But if Z had not had a private attorney, he probably would have been convinced to go back on the dope.

I went to Z's monthly treatment plan review yesterday. Psychiatrist Y and social worker X were there, looking a little pensive. Dr. Amin Dhagestani, the head of psychiatry at Elgin Mental Health Center, also attended. I like Dr. Dhagestani, we have good conversations about various things, and he has at least read two books which are extremely critical of the whole mental-illness-as-brain-disease-treatable-with-drugs orthodoxy. I think he is assigned to these monthly staffings which I attend mainly to make sure I don't brutalize institutional staff somehow, or provoke them into saying things that could easily get the administration in trouble or the state sued. Nevertheless, I like him, he's bright.

Everybody acted pretty happy with Z's treatment progress this month. That's more than a little curious, considering that they were all very recently asking a court to allow forced drugging because Z refused meds, and he's still refusing meds. I also thought it was kind of interesting that nobody even mentioned my recent letter, written in my very best "radical bomb-thrower" adaptation (see Nov. 21 post).

Anyway, Z is all about how much better he feels now that he's off all psychotropic meds. He sleeps fine now, his prostate problems have disappeared, various other side effects have abated. He's beating younger guys at basketball and chess. And he looks very good.

Z wrote an 18-page "addendum" to his psychiatric chart. The document is cogent and insightful, perhaps even compelling, unless the reader has a strong prejudice against people labelled mentally ill. One point which Z repeats over and over again is that he's not mentally ill and he doesn't need or want medication to treat a non-existant disease. There are legal and social policy arguments against his position on this, but there are no medical ones at the moment. If Z were behaving in ways which people could generally recognize as psychotic, there would be an argument which would be called "medical" (even if that would require a radical therapeutic-statist definition). But Z's behavior is just fine.

So I think this situation will continue to be interesting. The patient insists he's not mentally ill. Thus he is ostentatiously committing the worst possible heresy, and the system really cannot tolerate that. But they don't seem to know what to do about it, either.

The only person in yesterday's staffing who was even willing to point out Z's "denial" as a problem was social worker X. And as a social worker she looked slightly inappropriate, when neither the treating psychiatrist Dr. Y, nor her boss, head of psychiatry Dr. Dhagestani, was interested in taking up the point. (Mental illness is a medical issue, isn't it? Shouldn't the M.D.'s sitting right there in the room have had something to say about the problem of the patient's denial of a long-recognized, properly diagnosed disease?)

Dr. Dhagestani was actually very complementary toward Z, and made a big point of telling him that his own thoughts and opinions, as the patient, are of utmost importance in the collaborative project of his treatment at Elgin Mental Health Center. This sounded really good.

Dhagestani also told Z that, of course he has every right to utilize any possible legal process which he and/or his attorney think appropriate. This sounded good, too!

But guess what? Z has been at Elgin for almost seven years. Dr. Dhagestani's slick PR is completely contradicted by the reality of Z's experience, and everybody knows it.

They'll either have to find some way to make this patient "mentally ill", or he's eventually going to give the system some kind of a serious shaking.

It looks like a battle, so I'll stay tuned.

Thursday, December 10, 2009

The ULTIMATE psychiatric success story??

OK, here it is! What everyone who ever hoped psychiatry could help them is looking for, believing in, and praying for....

Today's Chicago Tribune (Thursday, Dec. 12) contains a supplementary section called Triblocal, aimed at the northern Chicago suburbs of Wilmette, Kenilworth, Winnetka, Northfield and Glencoe, and described on its masthead as "A weekly journal written by residents of your community."

On page 14 under a column titled Healthbeat an article appears with no reporter's byline, headlined "Mental illiness is not hopeless". This is an extremely interesting piece, very worthy of close notice, and I'd like to explain why.

The article is ostensibly the wonderful success story of a 20-year-old from Boise, Idaho named Eric Buckner. Mr. Buckner was diagnosed from the time he was a child with various psychiatric ills including ADHD, Oppositional Defiance Disorder, Bipolar Disorder, and Schizophrenia. But apparently thanks to modern psychiatric medicine, he's quite well now. This is no small thing, because he really was a basket case for a long time. He was kicked out of seven schools, violent, suicidal, hopeless. Then he spent seven months in a psychiatric hospital, and he was cured.

At least, that's what whoever put this article together seems to want us to believe. That's the obvious synopsis. And so many people want so desperately to believe that this is possible, that it happens every now and then with modern best-practiced psychiatry, that if only there were enough tax money devoted to more research into the brain, this kind of result would be the rule, and mental illnesses would be as curable as tuberculosis.

Well, I think it's a fairytale. I'll bet my reputation it's a fairytale.

Find Eric Buckner. Ask him if he's cured. Ask him what those good medications are, how they helped him, and what else really helped him to become a normal, hopeful, productive and sociable young man. (There are hints in the article, actually: "good coping skills", education and "positivity" are all mentioned.) Then, follow Eric's progress for a few years.

In fact, find a hundred "Eric Buckners" (cases of severe mental illness which appear at any particular moment to have been treated with great success), and take a careful survey about the effectiveness of psychiatry. One or both of two possible facts will almost certainly become evident. Neither one is at all consistent with the slant of the story in today's Triblocal section....

The first possible fact is that the Eric Buckners of the world are not cured of any medical illness, and they know this perfectly well. They'll more correctly attribute their improved conditions in life to personal learning and personal discipline, if asked. They'll say they want to get off all the medications if and when they ever can. They'll say they kind of hate the drugs, the drugs do bad things to them. Their only real hope is to learn more -- about themselves as whole people, not about fine-tuning their brains. They'll say it's all about becoming more able -- in a psychological or spiritual sense, not as a neurological mechanism.

The second possible fact is that the Eric Buckners of the world only look good for a short time, then they go back to the nuthouse or they go out and shoot people.

Either way this article, "Mental illness is not hopeless", is a fairytale and a hoax if it means to promote, or even if it merely tolerates the current, insaity-as-brain-disease orthodoxy. It's terrible journalism, completely contrary to the public interest.

Will anyone prove me wrong?

And while I'm asking, who wrote this tripe? The only byline on the article is "McClatchy-Tribune News Service". Listed Triblocal staff include: Jane Jansen, General Manager; Kyle Leonard, Editor; Kelli Murray, Ass't Editor; Kimberley Reishus, Community Manager; Nona Willis Aronowitz, Reporter; Blair Chavis, Reporter. One of these people must know where this thing came from, what the motive was, whether Eric Buckner is even a real person.

Who wants to work on this? Let's investigate!

Tuesday, December 8, 2009

Why NOT refuse psychiatry?

Fifteen-year-old Allyssa Bustamante killed her nine-year-old neighbor in Jefferson City, MO just to find out what it felt like, according to the Associated Press. Of course, she had been "receiving mental health treatment" before committing the murder.

And the only likely "treatment" in the context of this story is psychotropic medication. Lots of people would say the drugs, the so-called "mental health treatment", caused this murder of a child by a child.

I'm not too sure about that, even though there are FDA warnings and clinical evidence about side effects like suicidal and violent behavior from these drugs. I still think maybe Allyssa Bustamante just did it. Or, maybe her parents or her school or society had something to do with it, since she's just a child.

One thing I am quite sure of: The treatments prescribed by Allyssa's doctor or doctors did not prevent her from murdering her neighbor.

Does anybody see this as significant, at all?

Psychotropic drugs don't have to be proven to cause murders and suicides to be a bad idea. They just have to be useless, or slightly worse than useless.

The only thing these drugs are supposed to do is make people feel better and behave better.

Well, assuming this was the first murder for Allyssa Bustamante (at age fifteen), her behavior got much worse, not better. Even if she might say she feels just fine, most people would still conclude that the treatment didn't work due to the dead nine-year-old.

Psychiatry certainly does not work to reduce violence or improve the human condition. It has been around for most of a century now. Can anyone seriously argue that the world has gotten better because of psychiatric treatments? What mental illness was ever cured?

Could anyone argue that Allyssa received mental health treatment for reasons totally unrelated to any possibility that she might behave so badly, and that we therefore should not say her treatment failed, just because she murdered the little girl down the block in Jefferson City?

It seems to me that unless mental health treatments at least help to prevent child murders, they're pretty worthless. Everybody thinks medicine is valuable, so psychiatry must be, too. Well, maybe not. (Maybe that makes no more sense than thinking prayer is valuable, so executing witches must be, too.)

Tuesday, December 1, 2009

A couple relevant quotes

Bret Stephens, in today's Wall Street Journal:

None of these outfits are per se corrupt, in the sense that the monies they get are spent on something other than their intended purposes. But they depend on an inherently corrupting premise, namely that the hypothesis on which their livelihood depends has in fact been proved. Absent that proof, everything they represent -- including the thousands of jobs they provide -- vanishes. This is what's known as a vested interest, and vested interests are an enemy of sound science.

(Apply this to every state department of mental health, and every mental health association, professional specialty or clinical practice: The hypothesis that insanity, emotional trouble and everything else dubbed "mental illness" is brain disease which should be dealt with according to a medical model has not been proved!)

Lord Acton (quoted by Thomas Szasz in Liberation by Oppression):

It takes a gentleman to live on terms of hearty friendship and kindness and intimacy with men whose ideas and conduct he abhors and when he well knows that they view with contempt and horror the principles on which he shapes his own character and life.

(I aspire to this kind of gentlemanliness, after Tom Szasz's supreme example.)

Hey, you're human, right? So take drugs!

On "Good Morning, America" today, comedian/game show host Howie Mandel was all about recommending that everyone should get help, because everyone needs support, whether they are OCD or ADD or whatever.

He trumpeted the fact, "Hey, I'm medicated. My medication was just doubled, so I'm twice as happy as I should be! We just have to get rid of the stigma. I mean, you take care of your dental health -- why not take care of your mental health?"

Well guess what Howie, getting a tooth filled is a much, much clearer risk/benefit proposition than trying to feel better or trying to fix another person's behavior with psychotropic drugs. Pretending otherwise is socially irresponsible in the extreme. The "stigma" connected with mental illness could only be as irrational and unfair as people pretend it is if mental illness were as easily cured as cavities, and if Prozac and Zyprexa were as benign as toothpaste.

The "stigma" is first of all about the fact that almost every shooter since Columbine has been taking these drugs. Unexplained random violence and psychotropic drugs are new phenomena that appeared on our social scene pretty much together, so people wonder if maybe they have something to do with each other. That's the biggest "stigma" these days -- nobody wants to get shot when they're least expecting it.

The "stigma" is also about the fact that people don't like being lied to. Drug companies have paid billions in fines recently for improperly selling psychotropic drugs to cure everything that ails us. Psychiatrists like Joseph Biederman insist that every kindergarden kid with a problem will be happier on speed, and then we discover they say that because the drug companies pay them to. The National Alliance on Mental Illness claims to be there to educate families, but wait -- three quarters of their budget comes from Big Pharma!

I work in state institutions for clients who are forced to take psychotropic drugs because they committed violent acts and then convinced criminal courts the real cause was madness, not badness. I know about "stigma" from that rather extreme perspective. Anyone who behaves really, really badly (for example, by strangling his girlfriend with a clothesline or stabbing his father to death) will be stigmatized. And if they make effective amends and actually learn to behave better, that stigma might eventually go away. Who's the victim, and who's responsible?

If mental illness is disease just like tooth decay, my client murderers were never bad guys.

I'm all for people helping and supporting each other. But Howie Mandel isn't doing that by saying drugs will solve our problems in life, make us happy, stop us from killing each other. He's helping and supporting the drug companies.  He's defrauding us.  We need to understand that, and say so.