The lead editorial in today's Chicago Tribune is entitled "Speak up". It offers an excellent example of the dangerously false logic in virtually all popular conversation about mental health and violence since the Tucson shootings.
To begin with we might ask ... WHY should we speak up when our friends, relatives, or neighbors seem troubled or unstable? Is it our intention to help the person, or to protect society?
Everyone would love to say both, of course, but that's worse than naive. The Trib editorial ignores or obscures the fact that these purposes often do not align at all. Why don't we just put angry, eccentric, and unpleasant people in concentration camps and fine-tune their brain chemistry until they are happier and fully social?
Could it be that we think everyone has certain human rights which we don't really like to take away? Like ... rights to refuse unwanted medical treatment, to be at liberty, to control one's own body, to have privacy, to be left alone, to speak and think one's own thoughts?
Could it be that we actually have no idea how to fine-tune anyone's brain chemistry to make them happy and perfect, or even to gently and reliably disable them from violence?
The Trib implicitly equates forced hospitalization and drugging with "help from your family doctor." Many thousands of psychiatric victims can attest to a stark, brutal difference. Society ignores this massive legacy at its own peril. In the last century, Soviet and Nazi psychiatric policies were based on a presumption that protecting the social order and "helping" certain types of individuals were easy goals to coordinate, given only the iron will to do so.
The opening paragraphs of the Trib editorial cite cases of individuals who supposedly were "helped" with their mental illnesses (Seung-Hui Cho and Steven Kazmierczak), but who promptly went out on shooting rampages, killing dozens of innocents. And by the way, there are plenty more of those. How exactly does pushing this sort of "help" protect anyone?
Wake up. We still need police in the world, and people who try to hurt others have to be stopped. But doing nothing might be much better than psychiatry!
Tuesday, January 18, 2011
Lincoln Caplan writes in today's New York Times that, "Medicine defines illness, the law responsibility. The fields long tried to resolve their differences scientifically."
In the context of mental illness and violent crime, this statement is bitter, bitter nonsense.
"Mental illness" is specifically and succinctly defined in most states' mental health and/or criminal codes. That's law. On the other hand, medicine (or at least its most relevant authority, the American Psychiatric Association's Diagnostic and Statistical Manual) makes a complete hash out of all attempts at any definition."Responsibility" is clearly related to response as in stimulous-response, which calls to mind a framework of experimental psychology based on principles of medicine.
So, it's possible to argue the precise opposite of Caplan's statement, i.e., "The law deines illness, medicine responsibility."The real differences which Mr. Caplan posits between medicine and the law presumably concern relative values of cure and punishment. But psychiatrists are happy to admit they have no cure; and lawyers quickly retreat from confiscation or vengeance to such euphemisms as equity and justice. The two fields long obfuscated these issues on purpose.
Attempts to abdicate human responsibility in favor of objective science are delusional. Medicine and the law both yearn for this savior, as they once cried out to God.Lincoln Caplan's remarks are useless. He wants to think science is good, politics are bad, the insanity defense is harmless. He wants us all really, really stupid.
Friday, January 14, 2011
People think they're being reasonable or even scientific when they say oh-so-carefully, that Jared Loughner, "likely, judging by the disjointed and delusional (etc., etc., etc.) has a (major mental disorder/schizophrenia/psychotic disorder/diseased mind/mental illness/blah-blah-blah)." See for example, the Jan. 10 LA Times.
The fact is, no care or conservatism whatsoever is warranted with such statements. A psychiatric diagnosis is no more objective than any arbitrary epithet. Anyone and everyone is free to call anyone and everyone else these names.
It's true that the clinical expertise of a psychiatrist or mental health professional is necessary to diagnose, only if by "diagnose" one means "get paid by an insurance company or the government for." Newspapers and media commentators presumably are not hoping to get paid as clinicians, so it's highly amusing that they are so self conscious about their statements.
Loughner killed and maimed a bunch of people, including a nine-year-old girl he'd never seen before. Of course he's a crazy, sick sonofabitch.
But nobody says any more than that when they pronounce him mentally ill.
Correctly "diagnosing" Loughner obviously won't help any of his victims in the slightest way. It won't help him either, he'll spend the rest of his life in unpleasant circumstances and it'll end badly. It might briefly comfort people who are terrified to see any real evil in the world and prefer to hope no one's responsible for anything, it's all just fate or the gods or neurochemistry. But in the long run, they'll all remain equally helpless against what we're experiencing as random violence.
So who cares about flippancy? Say Loughner's mentally ill, schizophrenic, anything you want. Just don't believe it should have anything to do with public policy. There's no viable anti-violence strategy in the field of mental health. There's no security in widely-available psychiatric evaluation and treatment. These "experts" don't know evil from a hole in the ground. Their drugs cause violence at least as often as they disable perpetrators.
The only "benefit" from all this care and thought that's going into whether or not Loughner is mentally ill, or how to tell, or how to diagnose others before they're dangerous, is money into the pockets of a special priestly class: guys who started out in the last century as, and who basically remain, users, frauds, charlatans.
The University of Chicago's Mark Heyrman says that the Tucson shootings happened "because we have not offered treatment." I really have to laugh.
I just attended a university orientation day for new students and parents, right in Heyrman's neighborhood. One of the parent information sessions featured a bright young woman from the student counseling department. I think she was either a social worker or a psychologist.
The speaker graciously gave all of us naive lay people lots of professional tips about how to manage our children's emotional challenges and adaptations, what to do and say to help our kids deal with life in college, establish their identities and develop their autonomy. She detailed the "seven vectors of development" ... all kinds of good, standard psycho-stuff like that.
It seemed basically well-intentioned to me, but maybe just a little slick.
From the presentation, it was obvious that the college counseling department sees itself as a routine service for most, if not all, of the university student body. We were told of the therapy groups which meet regularly and the various support systems offered. Finally, we received a standing offer for all first-year students: ten free individual counseling sessions. (Count em - ten. Free!)
After the presentation, during a short Q & A, I asked what percentage of eligible students ever took any advantage at all of that "ten free sessions" offer. The answer came without pause, about 5%.
It occurred to me that one-in-twenty participation was inconsistent with the department's apparent pride in a universally needed, popular service, delivered at no cost to all comers. Then on the way out of this session, I picked up a business card which read:
Get to know Counseling Services. Counseling Services gives you tools to manage life during challenging times. * You are entitled to ten counseling sessions per academic year. * All services are completely FREE and confidential. * Individual, couples and group therapy are available. LET'S GET TOGETHER!
On the back was the following:
92% of students would recommend the college's Counseling Services to a friend.
I held onto that business card. The next info session was run by a dean, and toward the end of his time, during a rather slow Q & A, for some reason he turned directly to me and asked whether I must have at least one good question. I said well, I'd do my best....
How could it be that, while only 5% of students who were offered ten free counseling sessions accepted even one, 92% of students recommended Counseling Services to a friend? I showed him the card, and told him about the earlier presentation.
He said, well ... they should probably change that card ... they were just trying to promote their service, that's all.
So Mr. Heyrman, what are you talking about? People don't actually want mental health services for themselves. They are coerced to accept them, or they coerce others whose behavior they don't like.
Even simple counseling, for free, from an attractive twenty-something, is avoided by the overwhelming majority of college students. Not to mention the more dehumanizing "treatments" or "hospitalizations" which purport to be medical.
There is no mental health system today which is not ultimately founded and dependent upon the police force of the state. The talk by Heyrman and his ilk, about "services" and the people who "need" them is propaganda and fraud.
And by the way, preventing mass shootings is crime fighting, not medicine.
Wednesday, January 12, 2011
I have no problem acknowledging society's right to shoot its enemies, and I've said many times that the technical distinction between a bullet and a shot of Haldol seems frivolous to me.
But when the public official holding the gun or the syringe says he's only trying to help, he lies - probably because he's a coward.
Psychiatric practices, drugs, shock, could be legitimate (if limited) tactics in the fields of public safety, criminal justice and punishment, emergency crowd control, and warfare. But the pretense of "medical treatment" ruins any utility. Absent that pretense, I might have no real complaint about psychiatry.
E. Fuller Torrey is perhaps the leading pretender in the whole macabre scene of psychiatry and civilization. His arguments degrade human dignity and public safety. Torrey endangers well-intended human beings with his nonsense in today's paper.
Supposedly, various people's "untreated schizophrenia" has caused senseless killings over the years, and if we'd only made sure people had been treated, the world would've been safer. The latest occasion for this ridiculous proposition from the fossil Torrey is the Tucson shootings by Jared Loughner.
Curiously, Loughner's "diagnosis" is presumed to be an obvious conclusion, despite the fact that no one has said he was ever evaluated by a doctor for any mental illness. Likewise, the other examples of "untreated schizophrenia" offered by Torrey may be complete speculation. Nobody worries about that though, because the function of the psychiatric diagnosis is merely to justify "treatment" after the fact anyway. Loughner and other killers obviously needed to be "treated" because they did violent harm, so the "diagnosis" is accepted. It just lacks normal medical sense, insofar as medicine has any purpose to help the patient who takes it.
Of course it could be said that it would help society if we put everyone who's likely to commit a violent crime on meds to disable them from violence. This could perhaps be justified, if we could only predict who's likely to commit violent crime and who's not. But we don't know how to do that. Psychiatrists and psychologists don't usually pretend to be good or reliable at it, unless an attorney is paying them lots of money after the fact of a crime.
(One notable historical exception to the characteristic professional humility occurred in the Nazi era, when psychiatrists exercised plenty of official authority over who needed to be killed and who didn't.)
E. Fuller Torrey isn't even responsible enough to argue that psychiatrists can predict violence, he just plays to pervasive public ignorance. He knows that we all wish Jared Loughner had been "treated", and we're all eager to believe in violence-reducing medicine.
But the only violence-reducing "medicine" may be forcible restraint, the real threat of justice and retaliation. Psychiatry thus becomes the utterly illusory "reason" into which we retreat from tough social responsibility. We buy into it to the extent we are cowards, incapable of personal responsibility for justice, unwilling to protect ourselves, our families or our communities.
When someone threatens to harm others, they should be stopped. Pretending that they should be "helped" rather than stopped, or that stopping them should be the same thing as "helping" them, is nonsense.
Indulging such nonsense will ruin all attempts at worthwhile culture and reduce our civilization itself to dust.
E. Fuller Torrey will be remembered for far worse harm than Jared Loughner.
Monday, January 10, 2011
OK, everyone thinks of course, Jared Loughner is mentally ill.
The problem is, nobody knows what that means. Or I should say, "mental illness" carries no meaning which can contribute to security against random violence by future Jared Loughners.
There is no viable anti-violence strategy in the field or profession of mental health.
There is supposed to be such a strategy, but it doesn't exist. The public presumes if somebody's crazy, and they hurt or threaten other people, then they get treated so they'll be less violent.
The trouble is, this "treatment" is highly unreliable. It makes some people more violent.
All one need do is observe a well-contested trial where psychiatric expert opinion is deemed relevant. Any side can pay their psychiatric whores for the court, but the pretense of medical science would only be laughable if it weren't so terrifying.
Illinois paid hundreds of thousands of tax dollars to convince juries that C. Rodney Yoder was a ticking time bomb and absolutely had to be imprisoned in the Chester nuthouse for life to protect the community. They were wrong. Yoder refused all treatment, got out, and has been a productive citizen.
A Chicago judge recently let a murderer found not guilty by reason of insanity go free without any psychotropic meds. Half a dozen psychiatrists testified in unanimous agreement, and the murdered victim's mother was in court to see her daughter's killer released.
Bottom line? Mental illness means nothing.
Jared Loughner took aim with his Glock 9mm at a nine-year-old girl he'd never seen before, and he pulled the damned trigger. That was horrifying, crazy, evil, inhuman. But it wasn't caused by an illness, and it won't be an issue for medicine. It'll be an issue for justice.
A jury of ordinary people will decide what to do with Loughner, not a doctor. And if the jury sentences him to death, they should draw straws for who flips the switch to kill him.
True believers condemn politicians for exploitation and think more "treatment" is the answer to the Tucson tragedy. They probably think a machine carries out a death sentence, too.
Those who've been in the nuthouse know not to whistle past the graveyard.