Tuesday, September 19, 2017

Refinement of American Slavery, Part 2

In our hypothetical narrative about young black Ben and old white Christy, the thing to understand, to get the correct perspective, would be that this is organized slavery, not merely an incident of abuse by one bad apple.

Just imagine, if Christy had frequently been backing Ben up to the door inside her office, or the door inside the office of another staff (let's just call him Bob H) and getting her jollies for a couple years, and if the doors had windows, so anyone who walked by on a busy clinical unit could look in... and if several other staff (let's just say another social worker named Drew, and the psychiatrist Dr. J) had actually confronted her on occasion, to a minimum degree at least (i.e., not quite saying, "Hey! Were you performing fellatio on that patient?" - but perhaps by asking, "Why were you in that room with Ben when he's not even your patient anymore?" - or perhaps just by giving the pair an accusing look of recognition).

At some point, people would have to be regarded as complicit. It could be said that they certainly would have known something was going on, unless they just didn't want to know. Unless the dominant culture of the plantation held "patients" (slaves) to be just a bit subhuman, so usually wrong and culpable, and "staff" (masters/overseers) to be naturally superior and benevolent, so always right and needing protection. At some point, it would be reasonably seen as organized slavery on the state-run plantation.

The medical perspective would be especially ugly. Sexual abuse is recognized more and more often in psychological literature as a cause of personality and mental disorders. Our hypothetical victim, young black Ben, is supposed to be committed to the Elgin MHC plantation for treatment that could improve his illness, which would of course be the exact opposite of being made worse because old white Christy wanted to make him her personal sex toy. The psychiatrist who is in charge of the treatment program, and the medical director who is her ultimate supervisor, and the department of the executive branch of state government which hires and fires people, all would have failed in their duties to prevent something like this from happening.

And in the final analysis, all of us, the taxpayers who fund and benefit from the plantation, should be ashamed. We would have set this up because we don't want to think about or look at insanity. On some level, of course, we would have known that psychiatry is destructive nonsense, not a regular medical specialty that ever cures anyone of anything. But we wouldn't have wanted to know. The plantation gives us valuable benefits by letting us believe we are a kinder, more rational society.

It's a strange thing that Americans want slaves, but they surely do.

Monday, September 18, 2017

Refinement of American Slavery

I had James Patrick Corcoran, M.D. on the witness stand last week. I had called him hoping to get an admission that he ordered Elgin Mental Health Center apparatchiks to undermine my client's request (and his treatment team's request, and the 10th floor's independent recommendation) for court-ordered pass privileges. Dr. Corcoran doesn't like my client, doesn't trust him, doesn't believe he should get privileges or progress toward release, because my client doesn't take psychiatric drugs. Because he doesn't take the drugs, Dr. Corcoran can't own him.

The drugs are the whip on the Elgin MHC plantation. If you take the drugs you're reduced to a subhuman, compliant slave. If you don't take them, you might be too literate, too willful and too interested in your own life.

It's a strange thing that Americans want slaves, but they surely do. The USA was founded on a system of slavery actually justified by Enlightenment arguments for scientific social organization, efficient production and greater human prosperity. Even as James Corcoran believes that every patient at Elgin should be drugged whether he or she likes it or not, and Jeffrey Lieberman believes that mastery of brain science will make psychiatrists rulers of the world, our most outstanding Virginian founders truly believed that their Negroes were in their best natural condition as slave laborers. They were quite certain that the plantations were the instrument of God's love for humanity as a whole, and that the world would soon come to adopt this ideal Southern social order.

(By the way, if anyone thinks I exaggerate the American history, let me just recommend two books: This Vast Southern Empire: Slaveholders at the Helm of American Foreign Policy, by Michael Karp; and Broken Churches, Broken Nation: Denominational Schisms and the Coming of the American Civil War, by C. C. Goen. And if anyone is interested in a much more thorough argument comparing American slavery to modern state psychiatry, please read the ultimate explication: Liberation By Oppression: A Comparative Study of Slavery and Psychiatry, by Thomas Szasz.)

The Southern plantations exploited the physical labor of black Africans, to build a fabulously wealthy cotton kingdom. The Elgin plantation exploits the violent threat of criminal perpetrators, to build a fabulously powerful political protection racket. In the mid-Nineteenth Century the European world desperately wanted cotton clothes and cotton sheets. Beginning in the mid-Twentieth Century, the American world desperately wanted to pretend we could medically "cure", instead of punish, bad behavior.

Hence, consider a completely hypothetical example (anyone who gets obsessed with circumstantial correspondences to real people or events in this narrative is, of course, paranoid and delusional!) of a young black man (let's just call him Ben).

Ben is found Not Guilty By Reason of Insanity on a charge of aggravated battery on a police officer, and committed to the Elgin plantation for a period not to exceed three years. The judge tells Ben's mother that if he just does what the doctors tell him, he'll probably be out much sooner than three years. But in this case, liberty will not come so easily or so soon.

Ben's psychiatrist (let's just call her Dr. J), and the Medical Director who supervises her, both hold a strong belief that Ben must have some brain disease which should be "treated" with psychiatric drugs. They can't say exactly what this brain disease is, beyond the label itself, or exactly why the drugs will help, beyond some urban legend about correcting chemical imbalances. The uncertainty and lack of validity in their beliefs is why Dr. J and the Medical Director are absolutely determined to convert Ben to them. If he is released, he'll have to be a living example of the power and beneficence of the Elgin plantation, he will have to evangelize the true psychiatric faith, to get Dr. J and the Medical Director more "patients" and more authority, and to prevent the public from realizing that their state salaries are worse than a waste of tax money. It's difficult for these people to tell for sure whether Ben truly believes in his brain disease and the drugs, because he's a shy and immature black man, who doesn't communicate well and who has never even had a girlfriend.

Speaking of which, Ben's social worker (let's just call her Christy) finds young black men to be terribly attractive. She has taken previous opportunities with Elgin plantation "patients" (let's just call two of them Angelo and Manseur), and those experiences were the single most thrilling times of all her work, the greatest reward of her career. Christy has been married for many years, and her relationship with her husband does not include passion any more, it's really almost a brother-sister thing.

To Christy, Ben looks like a perfect prospect. And after all, he is owned by the Elgin plantation. Christy is basically entitled to him, because she works for this institution which has the lofty purpose to help Ben....

(To be continued.)



Saturday, September 9, 2017

Help: It really is a Land of Enchantment

I am in Albuquerque, New Mexico for the wedding of a cousin's grandson. Unfortunately, two days before flying here I managed to get a horrendous cold, bordering on pneumonia. I arrived in the Land of Enchantment in much discomfort, but somehow made my expected appearance at a Friday night rehearsal dinner.

Meanwhile, my wife, on business in California and supposed to meet me in Albuquerque (it's her cousin, dammit!), had her flight cancelled and couldn't get in until midnight.

It's my long habit of personally delivering my wife to and retrieving her from airports when she travels. That saves cab fares and enables opportunity for much conversation. I like it.

But after the rehearsal dinner last night, Cousin Nancy was pretty sure she should "help" me, since I was sick, by picking up my wife and letting me sleep. I tried to explain that is just isn't "help" if I don't want it, and I was certain I would sleep better most of the night if I picked up my wife at midnight myself. So I set my alarm and figured I would rest from 10:00 to 12:00.

At quarter to twelve, I heard the door close. Nancy had gotten up and left fifteen minutes ahead of me, having decided unilaterally that she knew what I wanted better than I did. I was actually pretty pissed. But it seemed important not to spoil the family weekend with acrimony, so I got up and walked around the house for an hour, thinking about why people do things like this.

She should have simply said, "Listen, you're staying at my house, and I'm afraid you're too sick, so I'm not going to allow you to get up at midnight and drive to the airport, and since I am in charge, you'll just have to do as I say!" ... I would not have been offended, and I would have happily relented. Orders are orders.

But the pretense, "Oh, I just want to help," when in actual fact control is being exerted over the top of a disagreement, and tricking or invalidating or overwhelming the person you're pretending to "help", is extremely offensive. It's probably the biggest reason people refuse help. They've learned that those who say they want to help in fact want to overwhelm and control.The proclaimed "helpers" want a shortcut, they want to cheat because they are not smart enough to change a person's mind. They are unwilling to communicate with another live human being.

Help has to be honest, and it has to be acceptable to the person being helped, or it's just not help. Psychiatry is 99% covert, coercive control under a false guise of medicine. People hate that, and it's not necessary. Just tell the truth, like my cousin Nancy could have.

For abolition

To the degree that you are able to communicate with another person, you will be less afraid of them. No matter what that person ever did (and no matter what you ever did) in the past, to the degree that you are in communication now, any apparent need for force or trickery will be reduced.

Psychiatric drugs are force, not communication. The project is to change a person’s mind. Persuasion is or seems to have become impossible when a person is psychotic, so the drug controls the brain, which is part of the body. Handcuffs control the hands which are a part of the body. A blow from a police baton controls the head, which is a part of the body. A bullet controls the heart, which is part of the body. Clearly, handcuffs, billy clubs and bullets are not social or helpful communication from the view of the person on the receiving end. Obviously, neither are coerced psychiatric drugs.

State psychiatrists like Richard Malis and James Corcoran at Elgin Mental Health Center automatically speak of believing that “medication” would be “helpful” for “patients” diagnosed with so-called “serious mental illnesses”. Corcoran actually made a claim under oath just a couple days ago, that an individual who has shown no signs of active psychosis for many years should start taking antipsychotics to help cope with stress when he is no longer in a controlled environment. The idea was, I believe, that the drug will prevent a recurrence of symptoms.

But it’s a lie. The truth is, there’s absolutely no reliable medical or scientific evidence for any such theory of prophylactic drugging. Corcoran was in actual fact attempting to enlist the Cook County Circuit Court to punish or subdue an individual whom he believes to be a dissident. This particular patient doesn’t take drugs, and yet he appears to be fully recovered. His treatment team, along with independent evaluators, believe there is nothing to “treat” with medication. They have observed him on a daily basis, interviewed him, dealt with him consistently on the clinical unit. They all think he should progress through the gradient of increased privileges toward a conditional release, without drugs.

Corcoran and Malis cannot allow that to happen. They must enforce their own severe orthodoxy: Everybody at Elgin Mental Health Center takes psychiatric drugs whether they like it or not! These two are cracking down, and any patients who think they can avoid taking drugs will be crushed, slowly but surely. Any staff who may countenance people avoiding drugs will not be promoted, or even allowed to act or make decisions freely in their normal clinical capacity. It’s relentless and fascistic. Eventually there will be hell to pay, because it’s also against the law.

Fascists are terrified of people. They have to control others by deception or violence because they can’t change anyone’s mind with reason. They can’t communicate in present time.

It amazes me that Corcoran and Malis can so delude themselves as to believe they are in any way engaged in helping anyone. They remind me of antebellum Southern slaveholders who were so deluded as to truly believe they were doing what was best for their Africans by keeping them in chains. Those plantation owners and Southern politicians owned and controlled the government of the United States, and they had their own unconstrained way with it until 1860.

Perhaps there is a war that must continue until all the bureaucracy and political power piled by a century of false promises for coerced “hospitalization” and “treatment” shall be sunk, until every drop of blood drawn with the psychiatric lash shall be paid by another drawn with an antipsychiatric sword.

God help me, I must be Sherman. Uncle Billy, the torch.

Saturday, September 2, 2017

Illinois Criminal Code

    (720 ILCS 5/11-9.5)
    Sec. 11-9.5. Sexual misconduct with a person with a disability.
    (a) Definitions. As used in this Section:
        (1) "Person with a disability" means:
            (i) a person diagnosed with a developmental 
        
disability as defined in Section 1-106 of the Mental Health and Developmental Disabilities Code; or
            (ii) a person diagnosed with a mental illness as 
        
defined in Section 1-129 of the Mental Health and Developmental Disabilities Code.
        (2) "State-operated facility" means:
            (i) a developmental disability facility as 
        
defined in the Mental Health and Developmental Disabilities Code; or
            (ii) a mental health facility as defined in the 
        
Mental Health and Developmental Disabilities Code.
        (3) "Community agency" or "agency" means any 
    
community entity or program providing residential mental health or developmental disabilities services that is licensed, certified, or funded by the Department of Human Services and not licensed or certified by any other human service agency of the State such as the Departments of Public Health, Healthcare and Family Services, and Children and Family Services.
        (4) "Care and custody" means admission to a 
    
State-operated facility.
        (5) "Employee" means:
            (i) any person employed by the Illinois 
        
Department of Human Services;
            (ii) any person employed by a community agency 
        
providing services at the direction of the owner or operator of the agency on or off site; or
            (iii) any person who is a contractual employee or 
        
contractual agent of the Department of Human Services or the community agency. This includes but is not limited to payroll personnel, contractors, subcontractors, and volunteers.
        (6) "Sexual conduct" or "sexual penetration" means 
    
any act of sexual conduct or sexual penetration as defined in Section 11-0.1 of this Code. 
    (b) A person commits sexual misconduct with a person with a disability when:
        (1) he or she is an employee and knowingly engages in 
    
sexual conduct or sexual penetration with a person with a disability who is under the care and custody of the Department of Human Services at a State-operated facility; or
        (2) he or she is an employee of a community agency 
    
funded by the Department of Human Services and knowingly engages in sexual conduct or sexual penetration with a person with a disability who is in a residential program operated or supervised by a community agency.
    (c) For purposes of this Section, the consent of a person with a disability in custody of the Department of Human Services residing at a State-operated facility or receiving services from a community agency shall not be a defense to a prosecution under this Section. A person is deemed incapable of consent, for purposes of this Section, when he or she is a person with a disability and is receiving services at a State-operated facility or is a person with a disability who is in a residential program operated or supervised by a community agency.
    (d) This Section does not apply to:
        (1) any State employee or any community agency 
    
employee who is lawfully married to a person with a disability in custody of the Department of Human Services or receiving services from a community agency if the marriage occurred before the date of custody or the initiation of services at a community agency; or
        (2) any State employee or community agency employee 
    
who has no knowledge, and would have no reason to believe, that the person with whom he or she engaged in sexual misconduct was a person with a disability in custody of the Department of Human Services or was receiving services from a community agency.
    (e) Sentence. Sexual misconduct with a person with a disability is a Class 3 felony.
    (f) Any person convicted of violating this Section shall immediately forfeit his or her employment with the State or the community agency. 
(Source: P.A. 96-1551, eff. 7-1-11.)

Friday, September 1, 2017

OBSTRUCTION OF JUSTICE!

In deposition under oath today, the Chief of Security at Elgin Mental Health Center, William Epperson, testified that an incident of staff engaging in sexual contact with a patient is being investigated by his department.

Hey Chief Bill: THAT'S A CRIME! Have you reported it to law enforcement? If not, you are obstructing justice (in all likelihood, along with various others).

Should be loads of fun going forward....

Wednesday, August 30, 2017

Fraud on the court, obstruction of justice

An "officer of the court" is any person who has an obligation to promote  justice and the efficient operation of the judicial system. Medical experts, hired by a party or appointed by a court, are officers of the court because their testimony and expertise is supposed to guide the court's decision-making with technical knowledge, skills or experience unavailable to lay fact finders.

"Fraud upon the court" has been defined by the 7th Circuit Court of Appeals as that species of fraud which defiles or attempts to defile the court itself, or which is perpetrated by officers of the court so that the judicial machinery can not perform its task of impartially adjudicating cases.

Fraud upon the court voids the orders and judgments of that court. It is clear and well settled Illinois law that any attempt to commit fraud upon the court vitiates the entire proceeding. Any decision produced by fraud upon the court is in essence not a decision at all. The orders and judgment of that court are void, of no legal force or effect.

So consider proceedings on petitions for court-ordered privileges or conditional release, when a state psychiatrist has convinced a "patient" to take a sub-therapeutic dose of medication entirely to create the impression the patient is "complying with treatment".

I heard one high-level state psychiatrist, Dr. James P. Corcoran, M.D., (annual state salary almost  a quarter-million $) suggest precisely this fraud just the other day, and I have heard of it many times in the past from various patients and doctors at Elgin Mental Health Center and other state institutions throughout Illinois. "Just a very small amount" of a drug is frequently pushed on a patient with the explicit encouragement, "It'll look good to the judge!" In fact, I am pretty sure I have several species of similar fraudulent statements to a patient by EMHC staff recorded (e.g., see the transcript in an earlier post).

When a doctor who knows better (or should) pretends that an ineffective dose of a drug is active medical "treatment" of a real illness, or when he claims that it is a preventative or prophylactic measure when no such use has ever been validated by the FDA or any scientific research, and when that doctor inserts such nonsense into records that he knows will be in evidence in court proceedings, he certainly commits fraud upon the court. And anyone else who goes along with it, who signs court reports and fails to point out that an ineffective dose of a drug, "...just to look good to the judge" is not valid treatment, becomes an accessory to this fraud.

_________________________


Obstruction of justice is a serious criminal offense under Illinois state law. The conduct that constitutes obstruction may sometimes seem trivial, but the consequences can be prison time.

720 ILCS 5/31-4 states, in relevant part:

"(a) A person obstructs justice when, with intent to prevent the apprehension or obstruct the prosecution or defense of any person, he or she knowingly commits any of the following acts:

     "(1) Destroys, alters, conceals or disguises physical evidence, plants false evidence, furnishes false  information; or
     "(2) Induces a witness having knowledge material to the subject at issue to leave the state or conceal himself or herself; or
     "(3) Possessing knowledge material to the subject at issue, he or she leaves the state or conceals himself; or...."

An experienced social worker at Elgin Mental Health Center instantly admitted under oath yesterday, that she was aware criminal charges could be brought against a female staff member who has sexual contact with a male patient.

I have no direct knowledge or evidence, myself, regarding the Christie and Ben story. I have been assured however, that there is such evidence (a video, in fact!). Anyone who knows anything about that sure better be talking to law enforcement.

And anyone who is tired of being part of the Illinois "forensic mental health" mafia sure better start thinking like a whistleblower.

Wednesday, July 26, 2017

The Terror of Christy & Ben?

Here's something I know from personal experience.

When a group is subjected to certain simultaneous pressures, or when its leaders choose to take it down a certain road, that group and even some individuals in it will become actively psychotic. The most deadly combination is:

1.  the loyalties of the group and within the group suddenly become uncertain or indistinct;
2.  the group or some members are suddenly subject to unusual emotion and confused morality; and
3.  the group suddenly places a very high value on secrecy.

At the moment there appears to be a bit of group psychosis at Elgin Mental Health Center. Patients are being subjected to unreasonable searches and seizures with no explanations. Restrictions of rights are arbitrary and undocumented, contrary to all rules and policy. Capable and well-intended clinicians are overruled by the administration even on the minutiae of treatment plans. Those who actually deal with the court system are given false information and thereby embarrassed.

In short, the place is freaking out. There's an atmosphere of insecurity. People tell each other, "Well gee, things look bad. Some huge change is happening, what exactly it is can't be revealed, but it's not good for you." (This is almost an exact quote, by the way, from statements by a psychiatrist to a patient today!) The Program Director and Medical Director both resigned recently. These were guys who had been in charge at Elgin for many years. One very capable person who was offered the Program Director job flatly refused to take it. The temporary Medical Director is a slightly shadowy administrator-without-portfolio, whose title and real state job no one is sure of.

No one knows who's responsible. No one knows who's dangerous. No one knows when anything can get done or when some really big shoe might drop.

Somebody is desperately trying to hide something, but in deathly fear that it will be discovered at any moment. That's the source of the terror.

Maybe I'm over-dramatizing this, or believing crazy people who are lying to me. Or maybe it's no acute, new situation, but just a chronic condition in forensic mental health.

Tuesday, July 18, 2017

Jeffrey Lieberman's Totalitarian Mind

Years ago, I was present when Jeffrey Lieberman gave a talk to psychiatrists which included a suggestion that they could rule the world as elite captains of treatment with an iron fist of brain science.

At the time I recognized a vaguely totalitarian intent, but I discounted it, perhaps in part because I was distracted when the outgoing APA President gratuitously singled me out of the crowd of a couple hundred. He attempted to put a stigma on me, maybe unknowingly as a harmless joke, maybe not.

Since then, Lieberman has been a steadfast proponent and defender of the American, hyper-medicalized, coercive psychiatric orthodoxy. He testified before at least one Congressional committee. He lambasted the New York Times for their anti-psychiatry tendencies despite their positive review of his book. He's the single most obvious spokesman for the bad guys.

I follow Dr. Lieberman on Twitter. Today I noticed an interesting conversation. At 3:34 PM on 7/15/17, Jeffrey tweeted disapprovingly about a NY Times opinion piece by op-ed writer Pagan Kennedy: Ancient Cure for Alzheimer’s? via @nytimes Hmmm? Not much of #Medical relevance here. More like anthropol fiction. 

Maybe this was an unremarkable comment by itself, but Jeffrey and the Times are kind of an item, so it got my attention. 

At noon on 7/16/17, there was a reply from a Canadian psychiatrist, Dr. Garth Kroeker: While no "cure" is established, I find this article thought-provoking.  Always good to show respect for a unique perspective. Dr. Kroeker was not automatically buying into Jeffrey's disapproval of the Times' incipient divergence from the pure faith of medicine.

Jeffrey's correction of his professional colleague at 6:54 PM the same day is what I find revealing: Agree but precious editorial space could be better used for more substantive info on #Alzheimers or other brain disorders. 

This is the tweet of a little corporal with apocalyptic ambitions. It's elitist arrogance even beyond what got us a President Donald Trump! "Precious editorial space" apparently is some commodity that must be regulated by psychiatric experts for the good of that majority of us who are stupid and impressionable, freedom of the press be damned.

And never mind that "brain disorders" (as opposed to brain diseases) is a term to obfuscate the fact that psychiatrists have no objective medical specialty. Never mind that "more substantive info" is inherently subjective. (E.g., Lieberman and Whitaker surely have radically opposed views regarding what is "more substantive info" about research on the use of antipsychotic drugs!)

Jeffrey's point (whether he's willing to state it overtly or not) is that psychiatrists should rule. We can replace the Constitution, religion, all our laws and customs, with psychiatric wisdom.

Jeffrey Lieberman is actually advocating and attempting to instigate the darkest version of thought reform. This is an unusually pure form of totalitarianism, or totalism

Most mental health professionals are good. They got into the business they are in to help people. Perhaps that didn't work out well, and they got caught up in a bureaucratic machine, became cogs in the wheels, got stupid, etc. But the true intention of 39 out of 40 was to help.

There are a very few however, who are truly bad people. It is extremely valuable to identify those outstanding few, because their power and influence actually must be obliterated.

Dr. Jeffrey Lieberman is one of those outstanding few.

Monday, June 19, 2017

A criterion for recovery

When a criminal defendant is found not guilty by reason of insanity, he or she is involuntarily committed until no longer mentally ill and dangerous. Such recovery is very difficult to prove, especially to the clear and convincing standard usually required. "Not mentally ill" is almost impossible by definition, because mental illness is officially known to be incurable, and no objective test exists to rule it out. Of course there's "remission", but that only means the mental illness may come back at any time with little or no warning.

Thus once an "NGRI" verdict is in, an insanity acquittee is virtually forced to profess faith in psychiatric treatment and slave away in the temples of forensic mental health orthodoxy, until sufficient favor is curried from the masters and high priests, who alone and arbitrarily, can affirm or deny the necessary recovery before the judge.

If the NGRI verdict disposes of a violent criminal charge, the acquittee effectively faces a choice between long incarceration or permanent status as a consumer of mental health services. I.e., you're either locked up for life, or drugged for life (and your drugged life may be shorter). There is virtually no way to mitigate that choice, no matter how you feel, how you think, or how you behave.

There should be clear, objective criteria for recovery from mental illness. These should not be made up separately by treatment teams for each patient. They should be universally accepted signs that any person is no longer mentally ill. Acquiring a formal education could surely be such a sign. Learning (or teaching someone else) a second language could be one, too. Regularly performing any function (e.g., janitorial or secretarial) essential to the operation of the forensic clinical community might qualify. It seems like if psychiatrists can create diseases by voting on complex lists of symptoms and contingencies (as in the DSM), then formulating general criteria for recovery from mental illness wouldn't be impossible. The only thing preventing that exercise is the completely irrational presumption itself, that nobody is ever cured of mental illness.

One possible criterion occurred to me today. Maybe it's just because I'm a lawyer, but....

When a forensic psychiatric patient files a lawsuit against the state, that behavior is generously despised by the powers that be. Elgin Mental Health Center and the Illinois Department of Human Services suffer when they are sued. They have to get the Attorney General to appear at least once in their defense; sometimes they even have to go through civil discovery. If the complaint is not frivolous on its face, if it's not completely delusional, it might cost significant money, and the money will have to come out of somebody's already-dicey budget. Somebody will be blamed for the nuisance, and it will probably be somebody in addition to the patient-plaintiff.

Now almost anybody can file a lawsuit. That's the way our system is designed. But filing lawsuits that lose is tediously unrewarding. Most people won't do it repeatedly, and forensic mental patients especially dislike being pathologised as "litigious". There's always an Assistant State's Attorney just waiting to trumpet such a credible symptom of illness, in arguments against court ordered privileges or release.

So what if (this does happen) a patient files a lawsuit against the state that succeeds, or what if he or she files lawsuits on multiple occasions that are not quickly and cheaply defeated? That should be a particularly reliable criterion for "not mentally ill" or "no longer mentally ill".

To win a civil lawsuit, or even to keep one going for very long, a person has to be able to predict multiple sides of often complex arguments. He or she has to have some appreciation for the social basis of law, and patiently follow socially evolved procedures and court rituals. Only litigators (whether they are regular lawyers or jailhouse lawyers) who think effectively, control emotions and behave well have any real chance in court. If they are mental patients they have to be even better, because they are overwhelmingly stigmatized from the word go.

Thus, if an NGRI patient is known for causing trouble with lawsuits, it should be strongly suspected that he or she is no longer mentally ill.

Wednesday, May 24, 2017

The APA is corrupt

Dr. Paul Appelbaum, M.D., a psychiatrist from Columbia University and a past President of the APA, was one panelist in the symposium I attended today in San Diego, entitled "The Battle Over Involuntary Psychiatric Care". This was Dr. Appelbaum's seventh presentation during the week of APAAM 2017. Clearly, he is an APA star.

Dr. Appelbaum did not "battle" at all, however. He gave a fairly boring synopsis of the history of involuntary psychiatry, the main point of which was that it was only beginning in very recent times when voluntary hospitalization even became a concept. Historically, everything was involuntary. He believes now that society will not relinquish its dangerousness-only-based justification for forced treatment, despite the fact that there may be better justifications. In particular, he considers that the possibility of successful treatment should be a basis.

In other words, whether or not a person is truly dangerous to themselves or others, it might make sense to force them into "treatment" that will work and actually help them live better. It seems illogical (to Dr. Appelbaum) that a person can meet legal criteria for involuntary hospitalization and yet be allowed to refuse "treatment". These issues should suggest a new look at the laws, which were more or less all created in the 1970's. The doctor's opinions were communicated in a very calm, conservative way that could be interpreted as banal arrogance. No need for any "battle" in any event.

What Dr. Appelbaum fails or refuses to consider is that his own concept of "treatment" (that would be drugs, drugs, drugs, and nothing but drugs) is something that many people do not want and go to enormous trouble to escape from. It is damaging. It causes disability, dehumanization and loss of life. 

This reality is something that Dr. Appelbaum seems to completely deny, or to be completely ignorant of. In fact when one member of the audience brought up the recently less controversial position that long term "maintenance" on antipsychotic drugs is bad for recovery from psychosis, he threw out a citation of the new article by Jeffrey Lieberman saying neuroleptics aren't bad for people at all! That article, of course, was meticulously criticized and decisively refuted by Robert Whitaker in a MadInAmerica  blog. (What a surprise, Dr. Appelbaum didn't mention Whitaker's criticism.)

Drs. Appelbaum, Lieberman and their ilk are exactly what Whitaker refers to as "a case study of institutional corruption". If they are American psychiatry, then American psychiatry has little or no future. 

I asked Dr. Annette Hanson, M.D., about the future of psychiatry. Dr. Hanson is one of the authors of the book, Committed: The Battle Over Involuntary Psychiatric Care, from which the symposium's name was derived. She graciously signed my copy of her book, and got her co-author Dinah Miller, M.D. to do the same.

My question was, "Given a presumed, hypothetical continuation or acceleration of two trends, how do you see the future of psychiatry and the law? The two trends have been repeatedly suggested and evidenced during the week of the APA conference. They are: 1) the substantial loss of faith in a pure medical/brain-pathology model of psychosis; and 2) the loss of public will to force people into treatment for mental illness."

Dr. Hanson liked my question, and we had a short conversation. She practices in the field of correctional (i.e., prison) psychiatry. Her experience has much in common with my own. People have to be "treated" by alert human beings who understand them and care, and take time to predict what they think and what they will do as people. It may take years, patience, much trial and error, many steps back for many steps forward, much negotiation, etc., before a violent criminal said to be "mentally ill" becomes well and civil. This is a teaching project far more than any procedure for medical cure. In short, the psychiatrist must talk the "patient" into changing his attitudes and his behavior.

Obviously this is a far cry from the Appelbaum-Lieberman vision of psychiatric power based on medical technology and access to legal force. Those guys are on their way out.

I also told Dr. Hanson to let her co-author know I am a member of the group she claims she had to "ambush" to get a statement for her book. (See pages 34-36 of Committed.) More conversation, please!

APA Annual Meeting 2017 (San Diego)

Interesting thoughts provoked by a session on outpatient commitment, or "Assisted Outpatient Treatment" yesterday...

When a court requires an individual to be "treated" although he/she truly and competently wishes not to be, are we trying to help that person, or are we controlling risks and adverse influences in the community? Certainly either purpose is legitimate. The two combined may even describe civilization itself rather fully.

But helping people and controlling them are distinct, separate activities. In psychiatry, especially involuntary psychiatry, they are hopelessly confused. And that may even describe the whole problem rather fully.

The session I attended featured seven speakers: Dinah Miller, M.D., from Maryland; Ryan Bell, M.D., J.D. and Kimberly Butler, LCSW-C, from New York; Erin Klekot, M.D., from Ohio; Mustafa Mufti, M.D., from Delaware; Adam Nelson, M.D., from California; Marvin Schwartz, M.D., from North Carolina.

Dr. Miller, the moderator, was the biggest reason that I actually came to this conference. She and co-author Annette Hanson, M.D. recently published a fascinating book, Committed: The Battle Over Involuntary Psychiatric Care (Baltimore: Johnson Hopkins University Press, 2016). They are also running a symposium today based on that book, at APAAM 2017.

Amost all my life, I've been an advocate for the total abolition of psychiatry. Many people interpret that to mean I am opposed to helping people with "mental illness" or opposed to medical treatment or science generally. None of that has ever been true.

My friend Tom Szasz said that psychiatry as we know it would wither away if it only lost its facility to acquire and retain "patients" using the police power of the state. I have long believed this is a compelling argument and a highly reliable prediction. In fact, it has primarily informed my career as a lawyer and my advocacy as an abolitionist.

Now an even more fundamental framework is occurring to me. Is "treatment" help, or control? If so-called "mental health professionals" could be required to honestly confront that distinction with their "patients" many things could improve.

When you have four security guards hold a woman down, struggling and screaming, for a nurse to force a needle into her body and inject a drug that will alter her mind against her will, there is simply no chance that your "patient" will experience it as help. You should not be allowed to call it help, or even to think that you are helping. Your lie will degrade you, and if your "patient" gets any wind of it she will hate you and forever dream of revenge.

On the other hand, precisely the same violence recognized openly and officially as control, while regrettable, may be an inevitable compromise in an imperfect society subject to disagreements and fears. That can be forgiven. It also may not require creation of elaborate bureaucratic machinery to protect falsehoods in the institutions where I practice law. 

Dr. Miller said yesterday that she doubts forced treatment can or should be justified as a public health measure. I absolutely argue the opposite: it must and can only be justified as a public health measure! The public has a right, and will always assert the right, to protect itself. If subduing a violent person (or even a merely obnoxious person) with antipsychotic medication were workable as public protection or community improvement, we would probably be confident in involuntary psychiatry as morally justified control.

But if you are a doctor and you honestly want to help a person in front of you, it will be necessary to find the insight and patience to treat that person only with his or her informed consent.

Dr. Bell, who had more direct experience with outpatient commitment (in New York) than anyone else on the panel, responded to a question I asked, about whether patients might occasionally change the minds of clinicians, even about such fundamental issues as what is wrong with them and what is needed. He told a story of a man he treated for some years. The end point was, yes, a human being's autonomy must be respected or help simply does not occur. 

This seems obvious and fundamental. There should be a rule or a law. 

Sunday, April 9, 2017

Constitutional Amendment 28

   Section 1. [Abolition of Forced Mental Treatment]
   Neither involuntary mental hospitalization, nor coerced mental treatment of any competent person whose refusal of help is clearly expressed for any reason or for no reason, shall be permitted within the United States or any place subject to their jurisdiction; nor shall the presumption of any person's mental competence require medical or scientific proof; nor shall benevolent medicine be considered to justify criminal justice or lawful security measures.
   Section 2. [Power to Enforce this Article]
   Congress shall have power to enforce this article by appropriate legislation.

Saturday, January 28, 2017

Rescinding psychiatric "diagnoses"

Dr. Lucy Johnstone, British clinical psychologist and author, recently suggested that a psychiatrist who was praised for his recent, honest about-face regarding his entire life's work on "schizophrenia" could be respected even more if only he would rescind the invalid diagnoses he has saddled so many people with over the decades. This is a great idea just waiting for practical implementation.

My first thought is a standardized form, which could be used immediately by anyone, but gradually accepted and made more and more "official" under whatever organizational and legal rules or policies can be successfully lobbied in support.  For example:

RESCINDED DIAGNOSIS

Name of individual:__________________________________________________

Address of individual:________________________________________________

Date of birth:_____________________________ Gender:__________________________________

Name of mental health professional:__________________________________________

Affiliation:_______________________________ License:__________________________________

STATEMENT:
The individual identified above was given a diagnosis of: ____________________________________________________________ on or about___________(date), by (check one): ___Me ___ a mental health professional whom I have identified as: ___________________________________(name), of ___________________________________(institution and/or address).
I hereby declare this diagnosis to be invalid from this date forward, because of the following (check all that apply):
___ the original diagnosis was based only upon symptoms of which this individual no longer complains, or observations which are not apparent or susceptible to any objective validation in present time;
___ the original diagnosis is no longer considered to be any valid disorder by mental health professionals;
___ the original diagnosis is an unscientific and arbitrary characterization which serves no medical or psychological purpose to help the individual or protect society;
___ other (please summarize):



Therefore, pursuant to _______________________________(specify at least one specific rule, statute, case precedent, ethics code or regulation), enacted on _____ (date) by _________________________ (name of authority), I hereby caution all persons, that any future or continuing reference to, or use of, the above invalid diagnosis, if such reference or use could create any disadvantage to the individual identified in this document, may subject you to civil and/or criminal liability for defamation, discrimination or fraud.

(Signed)

(Witnessed/Notarized)


Monday, January 9, 2017

Michael A. Cohen, dumb hack

A recent article in the Boston Globe is just beyond amazing, for its combined arrogance and naïveté.

Dylan Roof, the murderer of nine black parishioners at the Emanuel AME Church in Charleston, SC, is about to be sentenced to death. The journalist is obviously writing from an anti-death-penalty perspective, which is fine with me, I'm neither pro- nor anti-death penalty, in any general way...

But the real point author Michael A. Cohen wants to make is apparently more about mental illness and crime: "(T)here is perhaps no better example of the inherent flaws in the death penalty -- and the problematic way that the criminal justice system deals with mental illness -- than this case." Dylan Roof supposedly has "a broken brain", for which phrase Cohen cites celebrity TV psychologist Dr. Xavier Amador.

Dr. Amador (at least as Cohen quotes him) quite confidently diagnoses Dylan Roof with schizophrenia. Never mind that Amador has never examined Roof. Never mind that Roof apparently experiences no hallucinations, and he demonstrates no disorganized speech and no grossly disorganized or catatonic behavior. The only "delusions" that can be ascribed to Roof are his racist beliefs. Amador says that Roof shows flat affect and is unable to express emotions. But how does he know that, just from the media about the trial?

Even referring to the diagnostic criteria for schizophrenia in DSM-5 as if it were valid and reliable (which is a real stretch or fantasy), we should notice that Dr. Amador's "diagnosis" of Dylan Roof is pure speculation. But Amador is a TV psych. He makes his living largely by entertaining people, maybe not so much by effectively treating them.

Why would a journalist of Mr. Cohen's stature get so serious about repeating the glib psychobabble and speculation? Cohen seems to believe that Amador is saying something substantial, something that can be analyzed for significant implications about society and justice, etc. But it's pretty obvious to anyone who can read, it's all nonsense.

Something about motive here seems inexplicable....

Well... people hate to look at death, don't they? They fear death, they fear insanity, and they fear evil. Whenever they can, they pretend that these things don't exist, or at least that they're far away. Mental illness, schizophrenia and Dr. Xavier Amador are merely social fashion, to help with the pretense.

And I'm sorry, but Michael A. Cohen is a dumb hack when he writes an article like this.

Judges and lawyers appreciate the nature of "mental illness" better than psychiatrists: at least they occasionally admit they have no idea what causes people to be evil or how to cure them.

All of those "great strides (that) have been made in understanding these illnesses within the public health community" enabled no prediction and no protection against Dylan Roof's bullets, and they offer no solution and no reassurance, whatsoever, for the future.

Those "great strides" are trips and stumbles in the dark, by idiots preyed upon by charlatans. There is no scientific knowledge here, only pretense and fear.