Chris Bullard is the executive-director of the Sound Mind Live Festival, scheduled for May 20 in Brooklyn, New York.

A former touring musician. Bullard performed with acts such as Willie Nelson and Kris Kristofferson. Subsequent to receiving his MBA, he oversaw portfolio management at Acumen, a global non-profit impact investing fund focused on poverty alleviation.

Bullard created the festival based on his personal experience of overcoming mental health stigma after he was diagnosed with bipolar disorder in his mid-20s. Prior to founding Sound Mind, Chris also founded a music support group program for those affected by mental illness with the National Alliance on Mental Illness in New York City.

He holds a BA from the University of Southern California and an MBA from Fordham University.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

This week on the Mad in America podcast we are joined by Dr. Chris van Tulleken. Chris is an Infectious Diseases doctor at the Hospital for Tropical Diseases in London. He trained at Oxford and has a PhD in molecular virology from University College London, where he is an associate professor.

His research focuses on how corporations affect human health, especially in the context of child nutrition, and he works with UNICEF and the World Health Organization on this area. Chris is also one of the BBC's leading broadcasters for children and adults and his work has won two BAFTAs. In this interview, we talk about Chris's new book Ultra-Processed People: Why Do We All Eat Stuff That Isn't Food and Why Can't We Stop?

The book takes a deep dive into the science, economics, history, and production of ultra-processed food. In particular, we discuss some of the effects of UPF on our brains and bodies and how the food industry positions UPF to dominate our diets.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

This week on the Mad in America podcast, we hear from drug safety advocate David Carmichael. David has personal knowledge of the effects of psychiatric drugs, having experienced a family tragedy in 2004. David now uses his knowledge and experience to help people make informed choices about prescription drug use.

In November 2023, he will embark on a tour of 15 U.S. cities, aiming to educate and inform about the possible risks of antidepressant treatment. In this interview, we talk about David's experiences, his upcoming antidepressant safety tour, and the importance of fully informed consent at the time of prescribing.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

On the Mad in America podcast this week, we chat with author and educator Tanya Frank.

Tanya has worked as a college and university lecturer in the UK and taught middle school children, teens, and elders in the US. She has also trained as a wildlife guide in California and has been an advocate for people with lived experience of psychosis. Tanya’s work has appeared in the Guardian, the New York Times, and the Washington Post, as well as appearing in literary journals, including KCET Departures and Sinister Wisdom.

In this interview, we talk about Tanya’s recently released book entitled Zig-Zag Boy: Madness, Motherhood and Letting Go, which chronicles the experiences of her son Zach, who experienced psychosis as a 19-year-old. The book is a heartfelt and beautifully written account of dealing with mental distress and speaks movingly and honestly about the family’s struggles with broken healthcare systems in the US and the UK.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Pata Suyemoto is a feminist scholar, educator, curriculum developer, activist, and artist. Her work focuses on promoting racial equity in mental health and suicide prevention through teaching and advocacy. She advocates for equity and inclusion at all levels of mental health care, from grassroots organizations to state-level policy institutions. Dr. Suyemoto has spoken and written about being a suicide attempt survivor and about her struggles with chronic depression and PTSD.

Dr. Suyemoto earned her PhD in Education from the University of Pennsylvania, where she researched multicultural and anti-racist education. She currently serves as the Training Director for the National Asian American Pacific Islander Mental Health Association and leads the National Asian American Pacific Islander Empowerment Network.

She is also a leader in suicide prevention at the local and national levels, serving as the Equity Coordinator for the Massachusetts Coalition for Suicide Prevention and co-chair of the Greater Boston Regional Suicide Prevention Coalition. Dr. Suyemoto co-wrote an educational resource called “Widening the Lens: Exploring the Role of Social Justice in Suicide Prevention – A Racial Equity Toolkit.”

In this interview, Dr. Suyemoto discusses how her identities as a Japanese American woman and lifelong educator have influenced her work promoting racial equity in mental health and suicide prevention. She shares her efforts to build a national network of Asian Americans with lived experiences of mental health challenges and emphasizes the importance of equitable partnerships with those with lived experience in research, advocacy, and therapeutic contexts.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Camille Robcis is a Professor of History and French at Columbia University. She is the author of two books, The Law of Kinship: Anthropology, Psychoanalysis, and the Family in France, and her more recent book from 2021, Disalienation: Politics, Philosophy and Radical Psychiatry in Postwar France. Her areas of interest and expertise include European Intellectual History, with a focus on 19th and 20th Century France.

In her latest book, Disalienation, Dr. Robcis explores the highly experimental mid to late 20th Century French psychiatric efforts that, while sharing some similarities with other anti-psychiatric movements of that time, offer many novel insights into forms of psychiatry and psychotherapy that prioritize community and liberation.

Dr. Robcis offers a comprehensive account of the distinct approach to radical psychiatry known as Institutional Psychotherapy. In this interview, I had the opportunity to delve deeper into Dr. Robcis's interest in this approach and gain insight into what sets Institutional Psychotherapy apart as a groundbreaking form of radical psychiatry within its broader European and French context.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Erick Turner is an Associate Professor in the Department of Psychiatry at the Oregon Health and Science University (OHSU). He is also a senior scholar with OHSU’s Center for Ethics and Health Care.

Dr. Turner has been an FDA reviewer and has dedicated his work and life to improving research transparency. He’s well known for his work on publication bias and antidepressant trials, but his findings show that psychotherapy research is also riddled with problems.

What happens when those we trust with knowledge in our society betray us? In today’s interview, we discuss how dubious research practices are not simply the work of a few bad apples but instead built into the way we produce knowledge. We further explore the consequences of these practices on patients and the dangerous tradition of journal worship before exploring how many of these problems can be solved.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

On our podcast this week, we hear from Dr. Adam Urato.

Adam graduated from Harvard Medical School in 1997 and has been practicing medicine for over 25 years, specializing in obstetrics and gynecology. He cares for pregnant women on a daily basis as an attending maternal-fetal medicine physician at MetroWest Medical Center in Framingham, Massachusetts. He writes and lectures regularly on antidepressant use during pregnancy.

Adam has contributed to Mad in America’s continuing education efforts and his free course "Antidepressants and Pregnancy" can be found on Mad in America’s education section. It is an informative and comprehensive look into a little-discussed but very important area of women’s health.

For this interview, Adam joined me to discuss what we do and don’t know about the effects of antidepressants on babies and mothers and also the importance of counselling in order to aid families in making important decisions about pharmaceutical drug use.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

In this interview, we will cover his histography of psychiatry, engage with his writings on the DSM, and talk about what gives psychiatry its almost supernatural powers to rise from near death over and over and over.

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The Mad in America podcast is sponsored this week by Drs Rani and Suraj Holistic Psychiatry and Mental Health Coaching. Are you Ready to make a lasting change in your life? Then join Dr Rani Bora's 12-month group coaching programme named "Beyond Diagnosis".

Visit their website drsranisuraj.com today for more information and to join this unique programme.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

The Mad in America podcast is sponsored this week by Drs Rani and Suraj Holistic Psychiatry and Mental Health Coaching. Are you Ready to make a lasting change in your life? Then join Dr Rani Bora's 12-month group coaching programme named "Beyond Diagnosis".

Visit their website drsranisuraj.com today for more information and to join this unique programme.

***

Last fall, the New Haven Register reported that a group of Yale University students and alumni filed a federal lawsuit against the university challenging its policies and practices around students with mental health disabilities. But according to our guest, a lack of access to appropriate support, as well as discrimination against students struggling with their mental health, are all too common on American campuses.

Stefanie Lyn Kaufman-Mthimkhulu is the founder and director of the non-profit Project LETS, which stands for Let’s Erase the Stigma. Project LETS is a national grassroots organization and movement focused on creating innovative, peer-led alternatives to our current mental health system. Their work includes peer support and communicative care, political advocacy, organizing, and mutual aid.

Project LETS's mission looks beyond academia, though; led by and for people with lived experience of mental illness/madness, disability, trauma, and neurodivergence, it “seeks to build a world without systems of oppression where non-carceral responses to crises are the norm.” The organization is now active on about 30 college and high school campuses across the country.

Kaufman-Mthimkhulu is a 2017 graduate of Brown University with a degree in Medical Anthropology and Contemplative Studies, and was a 2018 Fullbright Scholar. They describe themselves as a "white, queer, non-binary, disabled, neurodivergent care worker who shows up for their communities as a Disability Justice and Mad Liberation educator and organizer, parent, doula, peer supporter, writer, and conflict intervention facilitator."

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

In December 2019, we wrote about the Hurdalsjøen Recovery Center, which is a private psychiatric hospital located about forty minutes north of Oslo, on the banks of stunning Lake Hurdal. The hospital was set up by its director, Ole Andreas Underland, to provide “medication-free” care for those who wanted such treatment or who wanted to taper from their psychiatric drugs.

In this interview, Robert Whitaker talks again with Ole Andreas to understand both the success of this pioneering approach and why this success might threaten its future.

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Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Today we are continuing with our look behind the scenes of Mad in America for our 200th podcast. Mad in America got started in January 2012 and so to celebrate a decade of critical comment and appraisal we thought it would be interesting to reflect on Mad in America’s mission and work by speaking to the people behind the scenes, who keep it running day-to-day.

Before we move on to our interviews, I want to pay tribute to the people at MIA who couldn’t join us for these interviews for one reason or another. Susannah Senerchia is our Assistant Editor and amongst other things, manages our Around the Web section. She is always finding interesting articles from the corners of the internet that help to tell of a shift in thinking about mental health. Also, of course, Mad in America relies heavily on the science news team as we discussed in part one of this podcast and for overview, we have our Board consisting of Robert Whitaker, Kermit Cole, Louisa Putnam, Olga Runciman and Claudia Esteve.

So, on to our interviews and we hear from coordinator of our continuing education webinars, Carina Ruggiero, science writer and blogs editor, Peter Simons, personal stories editor, Emmeline Mead, community moderator, Steve McCrea, and family resources editor, Miranda Spencer.

Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow.

This week is a special one for us at Mad in America, as it’s the 200th episode of our podcast. Our first interview was with attorney and author of Zyprexa Papers, Jim Gottstein, back in July 2017. For this and the next podcast, we’ll be talking to the people that make Mad in America what it is, the people behind the scenes, who keep it running day-to-day.

Later in this podcast, we will hear from staff reporter Amy Biancolli, science news editor Justin Karter and arts editor Karin Jervert, but to kick us off today, we hear from Mad in America founder, Robert Whitaker.

Bob worked as a newspaper reporter for a number of years, covering medicine and science. He is the author of five books, three of which investigate the history of psychiatry and the merits of its treatments. Those books are Mad in America,published in 2002; Anatomy of an Epidemic, from 2010, and he was co-author along with Lisa Cosgrove of Psychiatry Under the Influence, published in 2015.

He was also a director of publications at Harvard Medical School for a time during the 1990s.

Bob joined me to talk about how Mad in America got started and how it strives to achieve its aim of rethinking psychiatry.

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Madness: Fighting for Justice in Mental Health is an upcoming conference created by the Disruption Network Lab. The Lab examines the intersection of politics, technology and society, exposing the misconduct and wrongdoing of the powerful. This year, the conference will investigate systems of mental health care focusing on the prevailing discourses and practices, biases, and inequalities. It will explore the questions: What does it mean to have a just mental health care system and who has access to it? Who decides who is labelled as mad?

The conference is being held in Berlin, Germany, as well as streamed online free on November 25th through the 27th. You can view the conference live at disruptionlab.org/madness.

In this podcast, Mad in America’s Arts Editor, Karin Jervert, interviews the curator of the conference, Elena Veljanovska, and three artists—Dolly Sen, Anika Krbetschek, and Marcello Lussana—about art and transformation, human rights, and justice in mental health.

Dolly Sen is an internationally renowned writer, filmmaker, artist, and activist. Anika Krbetschekis a multidisciplinary artist and curator. And Marcello Lussana is a research associate and coordinator of the project Social Interaction Through Sound Feedback, Sentire.

These artists will be interviewed at the conference on Saturday the 26th at 8 pm CET/2 pm EST on a panel moderated by Lily Martin titled “Art and Survivor Empowerment.”

Morgan Shields is one of the few health policy researchers who focuses on quality of care and issues of coercion within inpatient psychiatry. Her research exposes how current healthcare settings are influenced by power imbalances, profit structures, and organizational priorities that are fundamentally misaligned with the human needs of individual patients.

Dr. Shields completed her Ph.D. in Social Policy at Brandeis University and is currently an Assistant Professor at the Brown School of Social Work at Washington University in St. Louis, where she also directs her own research group. She has published over 25 peer-reviewed articles in outlets such as Health Affairs, Psychiatric Services, and the JAMA Network.

She has also completed several policy reports for entities such as the U.S. Health and Human Services Office, and has served as a legal expert in cases related to psychiatric patient discrimination. In doing so, her research has effected change at the state and federal levels, prompting internal investigations and structural reforms within agencies such as the Veterans Health Administration and the Massachusetts Department of Mental Health.

In this interview, Dr. Shields discusses her current work, which aims to identify strategies for implementing patient-centered and equitable treatment within existing mental health care structures—toward a wholesale re-imagining of inpatient psychiatry.

This week we are sharing a special interview that’s being done as part of World Tapering Day. World Tapering Day is being held on the 4^th, 5^th and 6^th of November 2022 and it aims to raise global awareness of the need to safely taper psychotropic drugs. It has been organized by people with personal experience of the severe difficulties that can arise when stopping antidepressants, antipsychotics or benzodiazepines. If you would like to find out more or participate, you can visit the website WorldTaperingDay.org where you can sign up for a range of free-to-view webinars.

Our guest today is Anders Sørenson. Anders is a Danish clinical psychologist with a special interest in psychiatric drug withdrawal. He has undertaken research which assesses the state of guidance on psychiatric drug withdrawal. He has also paid close attention to tapering methods with the aim of identifying approaches which might make withdrawal more tolerable for people. 

In addition to his research work, Anders utilizes psychotherapy in his private practice when helping people to come off the drugs and we’ll get to talk about some of that in this interview.

Justin Karter is a staff psychologist at Boston College University Counseling Services. He is a recent graduate of the doctoral program in Counseling Psychology at the University of Massachusetts Boston, where he completed his dissertation research on the experiences of psychosocial disability activists in the Global South.

This week on the Mad in America podcast, we are joined by activist and artist Jim Flannery.

Born and raised in suburban Weathersfield, Connecticut, Jim was committed at four mental hospitals across the United States. There he received the best care available in the modern world… torture, which included seclusion, restraints, forced drugging, coercion, and a psychiatric diagnosis.

Later, he turned to the arts to speak out publicly about his experiences with the mental health system through performing stand-up comedy under the pseudonym Flim Jannery and now through music with his new album, "Sorry, It's Not Funny," which will be released on Friday, October 14.

In 2020, Jim began hearing voices, which opened his eyes to what he terms a genocide against neurodiverse people. He shifted his creative efforts towards hip-hop, believing the genre was the best medium to communicate his perspective.

You can hear the new album on the website jim-flannery.com. It’s also on Spotify, Apple Music, YouTube, Pandora, SoundCloud, and Tidal. 

Dr. Diana Rose wears many hats—academic, researcher, service user, and activist. She is a leading figure in user-led research and currently an Honorary Distinguished Professor at the Australian National University. Dr. Rose was previously Professor of User Led Research and Director of the Service User Research Enterprise (SURE) at King’s College. She was also lead in Patient and Public Involvement in several large research programmes at the Institute of Psychiatry, Psychology, and Neuroscience.

Apart from an impressive set of publications, Dr. Rose’s new book Mad Knowledges and User-Led Research is about to hit the markets. In today’s interview, she brings together her vast breadth of experience and depth of knowledge to talk about the challenges service users and survivors of psychiatry face when they take space as knowers and researchers in the Psy-disciplines.

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This week on the Mad in America podcast, we are joined by Dr. Jon Jureidini.

Jon is a child psychiatrist who also trained in philosophy, critical appraisal and psychotherapy. He has a continuing appointment as a professor in the School of Medicine at the University of Adelaide. He heads Adelaide University’s Critical and Ethical Mental Health research group, which conducts research, teaching and advocacy to promote safer, more effective and more ethical research and practice in mental health; and the Paediatric Mental Health Training Unit, providing training and support to medical students, GPs, allied health professionals, teachers and counsellors in non-pathologising approaches to primary care mental health.

He has an international reputation for his work on the evidence base for psychiatry and is a strong advocate for addressing the social determinants of mental health.

Jon, together with co-author Leemon B. McHenry, wrote the book The Illusion of Evidence-Based Medicine published in 2020. The book was followed by an opinion piece which appeared in the British Medical Journal in March 2022.

In this interview, we discuss the issues with evidence-based medicine and what led to the debasement of a system originally conceived to challenge extravagant claims and poor science.

This week on the Mad in America podcast, we are really pleased to be announcing the launch of a new global affiliated site: Mad in Ireland.

Mad in Ireland launches on August the 22^nd and joins our other global sites which include Mad in the UK, Mad in Canada, Mad in Finland and Mad in Brasil amongst others.

Joining me to discuss the launch and the important role that Mad in Ireland will play are Liam MacGabhann, Martha Griffin, Elaine Browne and Harry Gijbels who are part of the team that has been working hard to get the new site up and running.

You can visit Mad in Ireland from August 22nd here: https://madinireland.com

Please help them get up and running by visitng the site and sharing it on social media. Thank you.

Our guest today is Beverley Thomson. Beverley is a writer, researcher and speaker with a focus on psychiatric medication including antidepressants, benzodiazepines and ADHD drugs. She is interested in their history, how the drugs work, adverse effects, dependence, withdrawal and development of patient support services.

For the past 10 years, she has worked with organizations such as the British Medical Association, the Scottish Government and recently the UK All Party Parliamentary Group (APPPG) for prescribed drug dependence. She is currently part of a Scottish Government Short Life Working Group addressing the issue of prescribed drug harm and dependence in Scotland.

We talk about Beverley’s latest book, entitled Antidepressed: A Breakthrough Examination of Epidemic Antidepressant Harm and Dependence published by Hatherleigh Press in 2022. Featuring compelling accounts from people whose lives have been irrevocably harmed by prescribed antidepressants, Beverley’s work provides proof that there is no such thing as a magic pill and that pretending otherwise risks the lives and well-being of those who need help the most.

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If you find this podcast valuable, rating it 5 stars and leaving a review on iTunes or Spotify or sharing it on social media helps us to get the word out about these important conversations. Thank you.

In March 2022, a new grief-related disorder was officially adopted into mainstream mental health diagnosis nomenclature. Prolonged Grief Disorder (PGD) is a recent addition to the Diagnostic and Statistical Manual fifth edition text revision (DSM-5-TR). A PGD diagnosis is to be used when a person is grieving too long and too intensely.

In this interview, Kaori Wada, Psychologist, grief researcher, and Associate Professor and Director of Training at the University of Calgary, builds upon her recent paper on the Medicalization of Grief in conversation with MIA Science News Writer and Psychologist Zenobia Morrill. Wada articulates a history of institutional tensions and financial conflicts behind the creation of this new PGD diagnosis. She also discusses the ways PGD could shape how we collectively understand and respond to those grieving.

Wada’s work demonstrates that the creation of PGD was not based on scientific findings but appears to be entangled in long-standing arguments between camps of mental health professionals with different stakes in whether the diagnosis became legitimized. Further, PGD, as with other diagnoses, represents elements of mainstream psychological theory that tend to render deviations from Western cultural norms as “unhealthy.” Is diagnosis needed to provide support and care? If so, those most likely to experience marginalization, violence, and unjust loss are also most likely to be classified as having PGD, a mental illness.

At a time when the world is fraught with tragic loss—owing to causes ranging from political failures, state violence, and the COVID-19 pandemic—grieving has been transformed into a mental health disorder. But the complicated question of what a mental disorder is continues to be glossed over. The opportunity for psychiatric professionals to embrace humility seems to have reverted to the familiar “diagnose-and-treat” response. Will pharmacological intervention become the dominant “treat” response to a diagnosis of PGD?

A new grief disorder is a clear departure, however, from the way grief used to be described in the field as an example of something that is clearly not a mental health disorder, Wada shared. She exclaims: “To me, the medicalization of grief is controversial because it may fundamentally shake up the concept of a mental disorder, [how it has] been defined and understood.”

Wada and Morrill explore what this new PGD diagnosis may mean, reflecting on the ways the “diagnose-and-treat” logic seems to of experiences formerly considered part of the territory of being human. The need to pathologize experiences in order to address them represents a paradox. A new ethical and moral quandary befalls professionals tasked with determining when grief is an illness and when expressions of grief are inappropriate.

Will the public embrace this new disorder? Will the medicalization of grief be resisted? Will a pandemic of PGD diagnoses follow a global pandemic? Wada speaks to the personal and professional influences that shaped these curiosities and her approach to researching how grief is being construed in the mental health field.

Our guest today is sociologist and author, Doctor Andrew Scull. Andrew is a professor of Sociology and Science Studies at the University of California, San Diego, and recipient of the Roy Porter Medal for lifetime contributions to the history of medicine and the Eric T. Carlson Award for lifetime contributions to the history of psychiatry.

The author of more than a dozen books, his work has been translated into more than fifteen languages and he has received fellowships from, among others, the Guggenheim Foundation, the American Council of Learned Societies and the Shelby Cullom Davis Center for Historical Studies.

In this interview, we discuss his latest book, Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness, published by Harvard Press in May 2022.

Dirk Wittenborn, the screenwriter and novelist, described the book as "A riveting chronicle of faulty science, false promises, arrogance, greed, and shocking disregard for the wellbeing of patients suffering from mental disorders. An eloquent, meticulously documented, clear-eyed call for change."

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If you find this podcast valuable, rating it 5 stars and leaving a review on iTunes or Spotify or sharing it on social media helps us to get the word out about these important conversations. Thank you.

On our last podcast, Mad in the Family covered the effect of climate change and extreme weather events on children’s and mothers’ mental health. This one continues the conversation on environmental links to emotional distress: emerging research showing that pollution in the air and water can affect our minds and emotions, and that children are especially vulnerable, both while they are young and later in life.

Kristina Marusic is a Pittsburgh-based investigative reporter for Environmental Health News, an award-winning, non-partisan organization dedicated to driving science into public discussion and policy. Last fall, EHN collaborated with Allegheny Front on a five-part series, “Pollution’s Mental Toll: How Air, Water, and Climate Pollution Shape Our Mental Health.” They found that residents throughout western Pennsylvania were likely suffering changes to their brains due to pollution in the surrounding environment, even at levels below federal limits.

Prior to joining EHN in 2018, Kristina covered issues related to environmental and social justice as a freelancer for a wide range of digital media outlets including The Washington Post, Slate, Vice, Women’s Health, and MTV News, among others. Her reporting on environmental health for Public Source won first place in the Keystone Society of Professional Journalists’ Spotlight contest in 2017. Kristina holds an MFA in Non-Fiction Writing from the University of San Francisco and a bachelor’s degree in Creative Writing from Hofstra University. She is the co-founder and chair of the Pittsburgh chapter of the Association of LGBT Journalists.

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If you find this podcast valuable, rating it 5 stars and leaving a review on iTunes, Spotify or Facebook helps us to get the word out about these important conversations. Thank you.

Our guest today is Jessica Taylor, author of Sexy But Psycho: How the Patriarchy Uses Women’s Trauma Against Them, which was published in March by Little, Brown and quickly hit the London Times bestseller list. Based in England, she is a chartered psychologist with a PhD in forensic psychology and more than a dozen years of experience working with women and girls subjected to abuse and other trauma.

She's the founder and CEO of VictimFocus, a trauma-informed UK organization that challenges the blaming and gaslighting of victims—and advocates for change in how they're treated. She's also the author of the 2020 book Why Women Are Blamed for Everything: Exploring Victim Blaming of Women Subjected to Abuse and Trauma. 

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If you find this podcast valuable, rating it 5 stars and leaving a review on iTunes, Spotify or Facebook helps us to get the word out about these important conversations. Thank you.

On the podcast this week, we hear from Dr. Niall McLaren. Niall, known to many as Jock, is an Australian psychiatrist who worked for 25 years in the remote north of the country. Also an author, Jock's latest book is entitled Natural Dualism and Mental Disorder, the Biocognitive Model in Psychiatry, and it was published in December 2021.

Recently retired after 47 years, Jock joined me to talk about his experiences working in psychiatry and explains why the models that purport to guide psychiatric diagnosis and treatment are not what they seem.

Tara Thiagarajan is founder and chief scientist of Sapien Labs, a nonprofit organization that runs the Mental Health Million Project and its annual Mental State of the World Report, which uses an online survey to track mental wellbeing among internet-enabled populations around the world.

The 2021 report, just published, was the project's second annual effort. Authored by Thiagarajan and lead scientist Jennifer Newson, it surveyed more than 233,000 internet users in 34 countries. The overall objective, write the authors, is to “provide an evolving global map of mental wellbeing and enable deep insights into its drivers.”

Its results have considerable implications regarding mental health and the factors that contribute to it.

In this interview he talks about how the psychiatric discourse has left the clinic and entered workplace, how the DSM has been feminized to the detriment of women, how and why the ADHD diagnosis has shifted shape, and lastly, how the global move towards “mental health” and away from “mental illness” might not be positive or benign.

Note: To find out more and to register for the 26th International Network Meeting for the Treatment of Psychosis 2022, click here.

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May is Maternal Mental Health Month, and although we tend to hear a lot about postpartum depression, as our guest today has pointed out, perinatal distress is really a spectrum of reactions. Childbirth and new parenthood are major life transitions that involve many physical, psychological, and practical changes. These changes may interfere a little or a lot in a mother’s ability to function optimally and, in turn, affect her relationship with the child and the child’s development. Today’s global crises, including climate change, the pandemic, and war, can add an additional layer of stress so normalizing the experience is more important than ever.

Our guest is public health expert Jennifer Barkin, Ph.D., M.S., a Professor and Vice Chair of Community Medicine and Obstetrics and Gynecology at the Mercer University School of Medicine in Georgia. A biostatistician and psychiatric epidemiologist, Dr. Barkin was formerly an analyst at the University of Pittsburgh’s Epidemiology Data Center, where she designed the Barkin Index of Maternal Functioning (BIMF), the first patient-centered wellness assessment tool focusing on mothers’ daily lives during the first year after giving birth.  She is a peer reviewer for journals including Archives of Women’s Mental Health and serves on the Board of Directors for Postpartum Support International, Georgia Chapter.

The Visible Hands Collaborative in Pittsburgh, Pennsylvania is run by Alice Fox Thompson and Kenneth Thompson. Together, the father and daughter team is bringing a novel form of community healing developed in Brazil, called Integrative Community Therapy (ICT), to the United States for the first time.

Alice Fox Thompson is currently in her fourth year of medical school at Geisinger Commonwealth School of Medicine. Before medical school, Alice worked in community organizing and advocacy. She is interested in solidarity-based approaches to community and population mental health.

Kenneth Thompson is a psychiatrist trained at the Boston University School of Medicine. He has served as faculty at Yale University and the University of Pittsburgh and has been the director of many different psychiatric clinics. Ken currently serves as the Chief Medical Officer of the Pennsylvania Psychiatric Leadership Council, a unique state-level education policy and advocacy organization that he helped found.

Ken’s focus as a psychiatrist has always been on social medicine and community psychiatry, having written, consulted, and lectured extensively on issues of public service, whole-person treatment, primary health services, health equity, democracy, human rights, and more.

In this interview, Alice and Ken describe how they both came to Integrative Community Therapy and what they've learned in adapting it to their context in the Visible Hands Collaborative in Pittsburgh. They also discuss the connection between the emotional literacy and community support developed in their groups and broader processes for political change and social justice.

Executive Director Jahmil Roberts and Advocacy Director Yana Calou from the Trans Lifeline work towards connecting trans people to the community support and resources they need to survive and thrive. Trans Lifeline is a grassroots hotline and microgrants 501(c)(3) non-profit organization offering direct emotional and financial support to trans people in crisis – for the trans community, by the trans community. Their hotline is a peer support phone service run by trans people for trans and questioning peers and does not contact police without consent. The Cops out of Crisis initiative, which you can learn more about here, does advocacy work based on the negative impact of non-consensual law enforcement intervention and forced hospitalization on those in marginalized populations. The Trans Lifeline envisions a world where trans people have the connection, economic security, and care everyone needs and deserves – free of prisons and police.

This is the third and final interview in a series of conversations being conducted around the issue of hotline tracing and intervention. The first interview was with Vanessa Green, founder of Call the Blackline and the second was with Sera Davidow from The Wildflower Peer Support Line. It is part of Mad in America’s Suicide Hotline Transparency Project, which was born out of the belief that creating transparency and public access around suicide hotline intervention and call-tracing policies should be a priority. This project includes a directory of lines that do not trace or intervene without consent, a public poll, survivor interviews, and an open call for art. Please visit the project page to find out how you can participate.

He received his PhD at the University of Pennsylvania and taught at the New School for Social Research in New York City before returning to Australia. His books include Psychology in the Bathroom, Introduction to Personality and Intelligence, Yearning to Breathe Free: Seeking Asylum in Australia, and Introduction to the Taxometric Method.

In addition to his academic writing, Nick regularly contributes to The Conversation, Inside Story, and Australian Book Review. He has also written for TIME, The Monthly, The Guardian, The Washington Post, The Australian, and two Best Australian Science Writing anthologies. Nick is a Fellow of the Academy of the Social Sciences in Australia, the Society for Personality and Social Psychology, and the Association for Psychological Science.

In this interview, he discusses inflating concepts around harm and their effects on ourselves, our experience, and society at large. He also talks about his work on stigma and biogenetic explanations of mental disorders, calling it a mixed blessing.

In this interview, MIA speaks with Allan Horwitz and Sarah Fay about the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) and its impact on our society and our personal lives.

Allan Horwitz is an Emeritus Professor of Sociology at Rutgers University. He is the author or co-author of 11 books, a number of which have focused on the DSM and how the successive iterations of that manual have shaped societal thinking about mental disorders. His most recent book is DSM: A History of Psychiatry’s Bible.

Sarah Fay is a writer whose essays and articles have been published in the New York Times, the Atlantic and numerous other national publications. Her memoir, Pathological: The True Story of Six Misdiagnoses was published in March. She is also the founder of Pathological: The Movement, a public awareness campaign “devoted to making people aware of the unreliability and invalidity of DSM diagnoses, and the dangers of identifying with an unproven mental illness.”

Sera Davidow is a filmmaker, activist, advocate, author, and mother of two very busy kids. As a survivor of physical, sexual, and emotional abuse as a child and relationship violence as an adult, Sera has faced many challenges throughout her own healing process, including many ups and downs with suicidal thoughts, and self-injury. At present, she spends much of her time working as Director of the Wildflower Alliance (formerly known as the Western Mass Recovery Learning Community), which includes Afiya Peer Respite, recently recognized by the World Health Organization (WHO) as one of about two dozen exemplary, rights-based programs operating across the world. She also serves on several boards including the Massachusetts Disability Law Center (DLC) Board of Directors, the DLC’s Council Against Institutional and Psychiatric Abuse (CAIPA), as an advisory board member for the National Center on Domestic Violence, Trauma, and Mental Health (NCDVTM), and as a founding Board member of Hearing Voices USA. You can learn more about Sera and her work in an April, 2018 article in Sun Magazine.

Lynne Layton is a psychoanalyst in Cambridge, Massachusetts, and part-time assistant clinical professor of psychology at Harvard Medical School. Holding a Ph.D. in clinical psychology as well as comparative literature, she has taught courses on gender, popular culture, and psychoanalysis for Harvard’s Committee on Degrees in Women’s Studies and Social Studies. Currently, she teaches and supervises at the Massachusetts Institute for Psychoanalysis.

She recently published a book called Towards a Social Psychoanalysis: Culture, Character, and Normative Unconscious Processes and is the author of Who’s That Girl? Who’s That Boy? Clinical Practice Meets Postmodern Gender Theory(2004). She was also the co-editor of the books Narcissism and the Text: Studies in Literature and the Psychology of Self, Bringing the Plague: Toward a Postmodern Psychoanalysis, and Psychoanalysis, Class and Politics: Encounters in the Clinical Setting. Her involvement in editing peer-reviewed journals includes being the associate editor of the journal Psychoanalytic Dialogues and the former co-editor of the journal Psychoanalysis, Culture & Society.

She is the past president of Section IX, Division 39 of the American Psychological Association, Psychoanalysis for Social Responsibility, and co-founder of the Boston Psychosocial Work Group and Reflective Spaces/Material Places-Boston, a group of psychodynamic therapists committed to community mental health and social justice. She is also on the organizing committee for Grassroots Reparations Campaign, an organization working towards building a culture of repair.

In this interview, Layton discusses social psychoanalysis. She explores how her construct of "normative unconscious processes" can illuminate how oppressive systems are continually internalized and reproduced, both inside and outside the clinic.

Dana Becker is professor emeritus of social work and social research at Bryn Mawr College and has practiced as a psychotherapist for over three decades. With a doctorate in psychology and a master’s degree in social work, she has been an equal-opportunity critic of both fields in her work on the effects of therapeutic culture on women in the US.

These themes are explored in her books, Through the Looking Glass: Women and Borderline Personality Disorder (Westview Press, 1997) and The Myth of Empowerment: Women and the Therapeutic Culture in America (NYU Press, 2005). Her most recent book, One Nation under Stress: The Trouble with Stress as an Idea (Oxford University Press, 2014), tackles the effects of the therapeutic culture through an examination of the ideological work currently performed by the stress concept. Her work has received awards from the Society for the Psychology of Women.

Becker is known for her work on the use of borderline personality disorder to medicalize women’s problems. She has also advanced some significant criticisms of the way we talk about and deal with stress in our society and noted how feminist psychotherapy had been weakened in its revolutionary potential.

He was an expert evaluator for the European Research Council and the World Health Organization and currently is a member of the Swiss School of Public Health, the German Society for Social Psychiatry, and the European Public Health Association.

In this interview, we discuss Michael's recently released book entitled “Evidence-biased Antidepressant Prescription, Over-medicalisation, Flawed Research, and Conflicts of Interest.” The book addresses the overprescribing of antidepressants and it critically examines the current scientific evidence on the efficacy and safety of the drugs.

This week on the Mad in America podcast we hear from Johann Hari. Johann is an  internationally bestselling author whose books have appeared in 38 languages, and he was twice named National Newspaper Journalist of the Year by Amnesty International.

We last heard from Johann in 2018 about his then-new book Lost Connections: Uncovering the Real Causes of Depression and the Unexpected Solutions. Today, we get to talk about Johann’s latest book, Stolen Focus: Why You Can’t Pay Attention, released on the sixth of January 2022 in the UK and January 25th in the US and Canada.

For Stolen Focus, Johann went on a three-year journey to uncover the reasons behind our inability to focus and to understand how this crisis affects our wellbeing and society. Crucially, he learned how we can reclaim our stolen focus if we are prepared to fight for it.

In the face of the COVID pandemic, social and academic pressures, and an uncertain future, young people are struggling. Each week we see another news reports about a “mental health crisis” among youth in North America, including rising suicide rates. Last fall, a consortium of physicians declared poor youth mental health a “national emergency.” More recently, on December 7, 2021, the U.S. Surgeon General issued an advisory on Protecting Youth Mental Health, which prescribes actions by families, schools, governments, media and other stakeholders.

Typically, these announcements call for getting kids greater access to mental health diagnosis and treatment. As MIA readers know, that frequently leads to more screening, more labels, and more prescriptions for psychiatric drugs. In his practice with children and adolescents, his research, and his teaching, Dr. Elia Abi-Jaoude is pushing back on that approach in favor of alternatives that more closely involve families and take environmental elements into account. Here, he tell us why and shares how he works in his practice with youth in crisis.

Elia Abi-Jaoude, MD, FRCP(C) is a psychiatrist working mainly with children, adolescents, and their families at The Hospital for Sick Children in Toronto, Canada, primarily in an inpatient setting. He is also an assistant professor, researcher, and clinical educator at the University of Toronto.

Dr. Abi-Jaoude is interested in how social factors influence how we view the experiences of youth and in asking critical questions about some of psychiatry’s assumptions about diagnosis and treatment, particularly the influence of the pharmaceutical industry. He is coauthor of a journal article taking a second look at the research behind the famous Study 329, which found that certain psychiatric drugs did not improve teenagers’ depression symptoms better than no drugs, as had been claimed.

Sebastienne Grant is a professor of critical psychology at Prescott College in Prescott, Arizona. She currently serves as the program director for a Master’s program in Critical Psychology and Human Services. Dr. Grant received her PhD in Psychology: Consciousness and Society from the University of West Georgia.

Grounded in the traditions of Buddhism, critical psychology, existential-humanistic psychology, and transpersonal psychology, Dr. Grant is concerned with questions of wellbeing—both individual and societal.

She has written on transhumanism from Buddhist and existential perspectives, as well as the tensions of social justice under neoliberalism. Her most recent publication is a chapter titled “Addressing the Empty Self: Toward Socially Just Subjectivities” in the book Subjectivity in Psychology in the Era of Social Justice.

This book was co-written with several colleagues, including previous MIA podcast guest Dr. Bethany Morris.

Dawn Sonntag and Kermit Cole have collaborated on creating a 30-minute opera, For Life, that explores the possible harms that can come from psychiatric drugs. It’s a novel subject for an opera, which premieres online on January 15 at 9 p.m. EST. The opera will be performed by students at the Baldwin Wallace Conservatory of Music.

Dawn is an award-winning composer whose works have been commissioned by the Cleveland Opera Theater and the Hartford Opera Theater and performed at numerous music festivals in the United States and Canada. Her first opera, for which she also wrote the libretto, titled Verlorene Heimat, was a finalist in the 2021 American prize for opera. She wrote the composition for For Life.

Kermit Cole is well known to Mad In America readers. He cofounded madinamerica.com, and served as our editor for the first four years. He has a background in street theatre, having toured Europe as part of a mime troupe, and in the 1990s, produced a documentary about living with HIV. He has worked in various residential settings for people struggling with psychiatric difficulties and is trained in Open Dialogue therapy. He wrote the libretto for the opera.

Vincenzo Di Nicola is an Italian-Canadian child and adolescent psychiatrist and a Professor of Psychiatry at the University of Montreal where he co-directs the postgraduate course in psychiatry and the humanities. He has written extensively about the importance of relationality and dialogue in therapy and is one of the leading figures of social psychiatry.

Most recently, he received the 2022 Distinguished Service Award from the American Psychiatric Association. Di Nicola’s most recent book Psychiatry in Crisis (co-authored with Drozdstoj Stoyanov) offers a critical analysis of the discipline and points to the glaring gaps that must be addressed.

In this podcast we discuss an educational program called Emotional CPR (eCPR), a form of peer support anyone can use to assist youth (or adults) in emotional crisis.

Our guests are Oryx Cohen and Briza Gavidia of the National Empowerment Center, a Massachusetts-based nonprofit whose mission is to carry a message of recovery, empowerment, hope, and healing to people with lived experience with mental health issues, trauma, and/or extreme states.

Oryx Cohen, M.P.A., is a leader in the international mental health consumer/survivor/ex-patient (c/s/x) or Mad Pride movement. Currently, Oryx is NEC’s Chief Operating Officer. Among other responsibilities, he organizes the national Alternatives Conference every three years and assists states that have an underdeveloped consumer/survivor voice to find that voice and then work toward transforming their mental health systems to become peer-driven and recovery-oriented. Oryx is also a lead trainer for Emotional CPR, or eCPR, and has conducted over 50 eCPR trainings around the world.

Prior to joining NEC, Oryx was Co-Director of the Western Massachusetts Recovery Learning Community. There, he helped to spearhead an innovative peer-run approach focusing on recovery, healing, and community. Oryx is also the co-founder of Freedom Center, the Pioneer Valley’s only independent peer-run support/activist organization.

Briza Gavidia is a certified Youth Emotional-CPR (eCPR) Educator. She is 21 years old and is a student at Fullerton College majoring in sociology. Briza is currently employed in a program assisting the elderly with daily activities. Her goal is to work in the mental health field so she can give young people real hope for a better future. She loves sharing her lived experiences with trauma and how she is tackling these challenges so she can become a stronger person.

Elisa Lacerda-Vandenborn is a professor at Werklund School of Education at the University of Calgary, Canada. She is currently part of several national and international research projects examining education in indigenous communities and the decolonization of mental health. Her writings explore alternate ways of understanding human suffering, challenge the dominant psychiatric worldview, and critique the Euro-American understandings of distress and disease.

Her interests include understanding different ideas of self, especially in indigenous communities, and how our ignorance about these differences harms people we say we are healing.

Lacerda-Vandenborn notes that “Psychology is not a very reflective discipline.” This is a conversation about lost indigenous children, psychology’s blind spots, and how we can address these concerns with epistemic humility.

On the Mad in America podcast this week, we hear from Renee Schuls-Jacobson. Renee was a teacher for two decades and she is now an author, artist, advocate and coach. In this interview, we discuss her book Psychiatrized: Waking up After a Decade of Bad Medicine which was released this year.

The book is a beautifully written account of Renee's experiences being prescribed the benzodiazepine clonazepam (Klonopin) for seven years. It talks of her experiences taking the drug as prescribed but perhaps more importantly, also tells of what happened to Renee as she made attempts to withdraw.

In this podcast, we hear from the renowned clinician and researcher Dr. Giovanni Fava. Dr. Fava is a psychiatrist and professor of clinical psychology at the University of Bologna in Italy. He is also a clinical professor of psychiatry at the University at Buffalo School of Medicine and Biomedical Sciences. Since 1992, he has been the editor-in-chief of the peer-reviewed medical journal Psychotherapy and Psychosomatics.

Dr. Fava has authored more than 500 scientific papers and is known for researching the adverse effects of antidepressant drugs. In a 1994 editorial, he argued that many of his fellow psychiatrists were too hesitant to question whether a given psychiatric treatment was more harmful than it was helpful.

He recently released his latest book entitled “Discontinuing Antidepressant Medications” published by Oxford University Press. The book is designed to be a guide for clinicians who want to help patients withdraw from antidepressants.

In this interview, we discuss the new book, approaches to antidepressant cessation and explore some of the concepts including novel psychotherapeutic approaches to withdrawal.

Hans Skott-Myhre is a Professor of Human Services at Kennesaw State University in Kennesaw, Georgia. Over the last 50 years, he has worked within a wide variety of human service settings, including residential homes, community health centers, inpatient psychiatric units, homeless youth shelters, transitional living programs, and prisons. About two decades ago, he transitioned into academia, where he now does research at the intersections of human services, psychology, cultural theory, and literature.

His recently published book titled “Post-Capitalist Subjectivity in Literature and Anti-Psychiatry: Reconceptualizing the Self Beyond Capitalism” explored how we might be different types of people if we didn't live in a capitalist society. The book draws on Marxist and post-Marxist theory and presents a nuanced analysis of antipsychiatrists' professional writings, including Franco Basaglia and R. D. Laing, as well as the work of fiction writers, including Franz Kafka and Gabriel García Márquez. Through this analysis, Skott-Myhre identifies alternative conceptualizations of self and community that take us beyond capitalist subjectivity.

In this podcast, which comes on the heels of reports linking social media use to reduced self-esteem in teen girls, eating-disorders therapist Shira Collings discusses person-centered, socio-culturally aware approaches to dealing with disordered eating and other food-related challenges in youth (and adults).

Shira Collings, M.S., N.C.C., is Mad in America’s Assistant Editor for MIA Continuing Education and the Youth Coordinator for the National Empowerment Center. She received her B.A. in Communication from the University of Pennsylvania and an M.S. in Counseling and Psychology from Troy University.

As a person with lived experience of recovery from diet culture, disordered eating, and trauma, Shira is passionate about supporting others in finding freedom with food, body acceptance, and the ability to be their full, authentic selves and live according to their values. She is an advocate for trauma-informed, person-centered approaches to mental health care.

Helena Hanson is professor and chair of translational social science and health equity and associate director for the center for social medicine at UCLA. As a psychiatrist and anthropologist, she has spent much of her career researching how race, class, gender, and social determinants of health affect psychiatric diagnosis and treatment.

Growing up in 1970's Oakland and Berkeley, California, Hansen witnessed the consequences of deinstitutionalization and mass incarceration policies firsthand. Losing family members to both the prison and mental health systems gave her a personal understanding of the social and structural failures she interrogates in her work today. She also draws on the principles she learned as a participant in AIDS-related activism to mobilize community organizations and champion mutual aid groups in combatting our current mental health crises.

In this interview, Hansen discusses how race and class affect psychiatric diagnoses and subsequent treatment, the moral implications of psychiatric diagnosis, structural competency, and more.

Schizophrenia is a psychiatric diagnosis that carries a heavy social stigma. However, experts have also questioned the validity and utility of the label. In response, some experts and service-user groups have called for different conceptualizations and terms for those experiencing psychotic symptoms.

Doctors Matcheri Keshavan and Raquelle Mesholam-Gately are currently tackling this issue. They recently completed a project in collaboration with the Consumer Advisory Board of Beth Israel Deaconess Medical Center in Boston, MA, examining the benefits and drawbacks of renaming schizophrenia.

Matcheri Keshavan, M.D. is the Stanley Cobb Professor of Psychiatry at Harvard Medical School and Academic Head of Psychiatry and Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center.

Raquelle Mesholam-Gately, Ph.D., is an Assistant Professor of Psychology in the Department of Psychiatry at Harvard Medical School. She is also the director of the Consumer Advisory Board and conducts neuropsychology research in the Psychosis Research Program at the Massachusetts Mental Health Center.

In this interview, they discuss what they learned about the issues surrounding the renaming of schizophrenia in their research with consumers and service users. In particular, they reflect on how this psychiatric diagnosis can impact the therapeutic alliance necessary for effective treatment and the overall quality of life of people diagnosed.

This week we talk with Professor Jim van Os and Doctor Peter Groot about their latest study which looks at the effectiveness of tapering strips to help people get off antidepressant drugs.

Jim van Os is Professor of Psychiatric Epidemiology and Public Mental Health at Utrecht University Medical Centre, the Netherlands and Peter Groot works with the User Research Centre of UMC Utrecht.

They both are involved with the development and study of tapering strips which are pre-packaged, gradually reducing dosage tablets that facilitate tapered withdrawal from psychiatric drugs. In this interview, we discuss their latest research paper which examines tapering strips in real-world use.

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Ursula Read is a research fellow and associate at King's College London. She holds a Ph.D. in anthropology from University College London, where she studied family experiences of mental illness and help-seeking and Ghana. Currently, her research addresses Global Mental Health, and she utilizes participatory research methods to explore the relationship between mental illness and social exclusion internationally.

Her recent work focuses on mental health care in Ghana, drawing attention to the need for rights-based approaches to mental health care. In doing so, she questions the movement for Global Mental Health: asking what this movement is doing currently and imagining what it could become.

Her research brings to light how those in the Global North and high-income countries can overlook what rights-based approaches to mental health care may actually look like when incorporated into Global Mental Health and enacted on the ground. She also is deeply concerned with the structural and social determinants of health and mental health and their interconnection with community resources, places of worship, faith, and overall health promotion.

Michael Ungar is the founder and director of the Resilience Research Centre at Dalhousie University in Canada. He is also a family therapist and professor of social work. He has received numerous awards, such as the Canadian Association of Social Workers National Distinguished Service Award (2012), and has authored around 15 books and over 200 peer-reviewed articles.

Dr. Ungar’s work is globally recognized and centers on community trauma and community resilience. In particular, his work explores resilience among marginalized children and families, especially those involved with child welfare and mental health services, refugees, and immigrant youth.

His research is spread across continents and challenges our traditional notions of trauma and resilience. Analyzing people’s risks and available resources, he scrutinizes simplistic ideas of individual perseverance and grit in the face of trauma. Instead, he implicates the role of context, circumstances, and ill-suited services in contributing to people’s psychological suffering.

Patricia Rush, M.D., M.B.A. is an internal medicine physician whose scientific focus is complex chronic illness.  Her over 40-year career has focused on working with underserved populations and promoting universal access to high-quality medical care. She spent 20 years in the Cook County (Illinois) Health System, including six years as director of their emergency department. From 2000-2008 ran a trauma-informed solo private medical practice in Chicago.

During this time, she completed in-depth interviews with more than 500 patients, which led her to identify a group of high-risk individuals with serious illnesses who also had a consistent pattern of extreme stress at a young age, including profoundly disordered sleep and emotional distress.

Until her retirement, Dr. Rush was also an Associate Professor of Medicine at the University of Chicago and now teaches neurodevelopment as a member of the Physician Workgroup of the Child Trauma Academy.

She was a co-founder and serves as a co-director of the Center for the Collaborative Study of Trauma, Health Equity, and Neurobiology, or THEN, in Chicago. The nonprofit works at the intersection of science education and social justice, exploring and communicating the links between early emotional trauma, inequality, human development, and chronic illness to a network of professionals and the public.

In this interview, she discusses a new and more integrated way to understand and treat physical and mental ailments in people of all ages that has important implications for how we raise our children.

Marcela Ot'alora works with the Multidisciplinary Association for Psychedelic Studies (MAPS) as the principal investigator for government research into MDMA-assisted psychotherapy. In addition to her role as principal investigator, she also worked as a co-therapist during earlier phases of MDMA psychotherapy research and currently leads the MDMA therapy training for MAPS. Ms. Ot'alora also works as a therapist using both ketamine and fine arts to treat trauma.

Ot'alora approaches her work with a humility learned from years of therapeutic experience:  “My clients and the participants in our studies have taught me that their healing looks so different than anything I could have imagined. If I come in leaving that agenda, leaving that bias aside, and being present with whoever is in front of me, they will surprise me every time about how healing works for them.”

In this interview, we discuss her research into MDMA-assisted psychotherapy and how the use of MDMA differs from more traditional substances such as antidepressants. We will also discuss ketamine-assisted therapy, the therapeutic use of fine arts, and the over-prescription of psychiatric drugs.

Michelle Funk is the Unit Head of the Policy, Law, and Human Rights at the Department of Mental Health and Substance Use at the World Health Organization. She has created and leads the WHO Quality Rights Initiative that aims to assess and improve human rights standards in existing services and advance the full implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD).

In this interview, we discuss the launch of the new “Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches.” The document is grounded on the principles of recovery and rights-based approaches. It presents successful examples of best practices in mental health service provision respecting dignity, moving to zero coercion, and eliminating neglect and abuse. Among the best practices showcased in the document are Open Dialogue as practiced in Tornio, Finland, Soteria Berne in Switzerland, Afiya House in Western Massachusetts, Basal Exposure Therapy in Norway, and Hearing Voices Support Groups.

The Guidance builds on the momentum created by the critical voice of Dainius Pūras, former UN Special Rapporteur on the Right to Health. Puras criticized the dominance of the biomedical model in the Mental Health field and highlighted the harms associated with ignoring the social determinants of health that impact a person’s mental health, such as violence, poverty, lack of proper nutrition, housing instability, lack of universal health coverage, discrimination and others.

In our conversation, Michelle Funk described the process of engaging stakeholders and persons with lived experience throughout the design and development of the document, the challenges of ensuring geographical representation given the global inequalities, and the hopes for the future.

Ilana Mountian is a researcher drawing on psychoanalytic, critical, decolonial, and feminist philosophies. She is the author of Cultural Ecstasies: Drugs, Gender, and the Social Imaginary, exploring discourses around drug use, gender, and drug policy. She is currently working on a book that will be published later this year by Routledge about otherness and mental health, focusing on immigration, drug use, and transsexuality.

Mountian is a member of the Discourse Unit, a group led by well-known critical psychologists Erica Burman and Ian Parker. The Discourse Unit is dedicated to providing teaching resources for qualitative and feminist work, producing radical academic work, and developing critical perspectives in action research.

In addition to her work as a researcher, Mountian is a psychoanalyst and a postdoctoral lecturer at the University of Sao Paulo Brazil and Manchester Metropolitan University.

In this interview, she discusses intersectionality and drug use, the disease model of addiction, psychiatric labels, and psychiatry's place in creating “otherness.”

This week on the MIA podcast we are providing the audio taken from our recent psychiatric drug withdrawal town hall held in May 2021.

For our third discussion, we are examining protracted problems that can arise after psychiatric drug withdrawal. Sometimes referred to as post-acute or post-withdrawal syndromes, these experiences can include chronic health problems and sexual dysfunction. What do we know and not know about responding to long- term health problems after coming off psychiatric drugs?

For references and slides mentioned in the discussion, visit this link: https://www.madinamerica.com/pdwref/

Panelists

Adele Framer

Adele Framer resides in San Francisco, USA. A survivor of 11 years of antidepressant withdrawal syndrome, in 2011, under the pseudonym Altostrata, she founded the peer support site SurvivingAntidepressants.org, currently containing more than 6,000 longitudinal case histories from its 14,000 members. A widely recognized patient advocate, she is a lay expert in psychiatric drug tapering and withdrawal syndromes.

Will Hall

Will Hall is a schizophrenia diagnosis survivor and longtime organizer with the psychiatric survivor movement. He is a PhD candidate at Maastricht University and lead researcher on the Maastricht World Survey on Antipsychotic Drug Withdrawal, and author of the Harm Reduction Guide to Coming Off Psychiatric Drugs, as well as host of Madness Radio and a co-founder of the Hearing Voices Network USA.

David Healy

David Healy is a Professor of Psychiatry in the Department of Family Medicine at McMaster University in Hamilton Canada. He has been raising concerns about withdrawal from antidepressants since the mid-1990s and was an expert witness in a successful legal case about withdrawal and dependence in 2004. He figures we have made little or no progress sorting the issues out and now have a major public health crisis on our hands.

Nicole Lamberson

Nicole Lamberson is a physician assistant as well as a patient suffering protracted harm following a rapid medical “detox” from prescribed benzodiazepines/Z-drugs & other psychotropic polypharmacy. She co- founded The Withdrawal Project, serves on the Medical Board of Benzodiazepine Information Coalition, & does outreach for Medicating Normal-The Film.

Hanna Pickard is a Bloomberg Distinguished Professor of Philosophy and Bioethics at Johns Hopkins University. She is also appointed with the William H. Miller Department of Philosophy, the Berman Institute of Bioethics, and the Department of Psychological and Brain Sciences.

Her expertise is deep and spread across a wide variety of disciplines. As an analytic philosopher, she specializes in philosophy of mind, philosophy of psychiatry, moral psychology, and clinical ethics. She also worked for a decade at The Oxfordshire Complex Needs Service, a specialist service in the NHS for people diagnosed with personality disorders and complex needs. Her work tends to address the sticky debates that arise in clinical practice.

She has over 35 academic publications and has co-edited The Routledge Handbook of Philosophy and Science of Addiction. Pickard maintains an important thread between clinical work in the real world and her philosophical writings, attending to topics like the nature of mental disorders, delusions, agency, character, emotions, self-harm, violence, placebos, therapeutic relationships, decision-making capacity, the self and social identity, and attitudes towards mental disorder and crime.

In this interview, she discusses her novel and possibly controversial model for understanding addiction, the numerous shortcomings of the neurobiological model, the importance of centering patient agency, and her work in therapeutic communities.

Katrina Michelle is a psychologist and the founder and director of The Curious Spirit, a transpersonally oriented psychotherapeutic practice that encourages transcendent personal exploration to remedy psychological suffering. She is a holistic psychotherapist currently serving as faculty at Columbia University School of Social Work and The Institute for the Development of Human Arts.

In addition to her practice, she also serves as the director of harm reduction for the Multidisciplinary Association for Psychedelic Studies (MAPS) and formerly worked as the executive director of the American Center for the Integration of Spiritually Transformative Experiences (ACISTE). To demystify awakening experiences through storytelling and art, she is also producing the film When Lightning Strikes.

Beginning in the world of traditional social work, Michelle was drawn to transpersonal psychology after her own spontaneous spiritually transformative experience. She now works to help create communities capable of holding these often difficult experiences, as western societies often lack the language and cultural understanding needed to integrate them into daily life.

In this interview, we discuss the place of psychedelics in psychotherapy, how spiritually transformative experiences can be mistaken for ‘mental illness,’ and the various resistances we have to these experiences.

Hannah Zeavin is a leading scholar investigating how mediated communications and technology impact our intimate relations. Her most recent work tackles teletherapy and digital mental health communications, which have seen a boon throughout the pandemic.

Zeavin is a Lecturer in the Departments of English and History at the University of California, Berkeley, and affiliated with the Berkeley Center for Science, Technology, Medicine, and Society. Zeavin is also a visiting fellow at the Columbia University Center for the Study of Social Difference. She received her Ph.D. from the Department of Media, Culture, and Communication at NYU in 2018.

Her first book, The Distance Cure: A History of Teletherapy, will be published by MIT Press this summer. Zeavin serves as an editorial associate and author for numerous publications, including the Journal of the American Psychoanalytic Association. She is also a co-founder of The Science, Technology, and Society Futures Initiative.

In this interview, she discusses her upcoming books and all things mediated communication, teletherapy, and technology. Zeavin approaches human relationality, including therapy, from the perspectives of literature and media studies. She explores the history of psychoanalysis and other forms of therapy, garnering fresh insights into our relationship with technology and each other–without the usual moral tenor of psychologists.

She also draws upon her research to discuss how care may take unexpected forms through technologies, enabling distanced intimacy and social change that transcends the psychology of the individual. We close by addressing the feminization of care labor, care as a cover for capture and control, and shifts in how we understand care, now and in the future.

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Our next psychiatric drug withdrawal town hall discussion will be held on May 14 2021, register here: https://www.eventbrite.co.uk/e/150023595613

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This week on the MIA podcast we are providing the audio taken from our recent psychiatric drug withdrawal town hall held in March 2021.

This discussion was aired live on March 12, 2021 and the panelists are Dr Giovanni Fava, Dr Peter Groot, Dr Mark Horowitz and Professor Joanna Moncrieff.

For this discussion, we asked what science and research can tell us about the experience of withdrawal. We discuss research effort that has called into question long-held professional beliefs about the effects of psychotropic drugs on the brain and nervous system.

Panelists

Giovanni Fava

Dr Giovanni Fava is Clinical Professor of Psychiatry at the State University of New York at Buffalo. He has authored more than 500 scientific papers and performed groundbreaking research in several fields. He is editor-in-chief of the journal Psychotherapy and Psychosomatics.

Peter Groot

Dr Peter Groot is a researcher who started using antidepressants. His own experiences helped him to develop a practical solution proposed by many patients to help prevent withdrawal problems from antidepressants and other psychotropic drugs.

Mark Horowitz

Dr Mark Horowitz is a training psychiatrist and psychiatric academic at University College London who is currently coming off psychiatric drugs. His work and research focuses on how to safely stop psychiatric medication.

Joanna Moncrieff

Dr Joanna Moncrieff is a psychiatrist based in community mental health services in North East London. She also teaches and researches at University College London. Joanna is one of the founding members and the co-chairperson of the Critical Psychiatry Network.

This episode of “Mad in the Family” discusses the links between nutrition and mental health, and the science that’s showing that diet may help improve or even prevent mental health issues in children and adults.

Julie Rucklidge: "Taking a one-a-day gummy bear might prevent you from getting scurvy, but it's not meeting the optimal amount that your brain needs.”

Julia's interest in nutrition and mental health grew out of her own research showing poor outcomes for children with psychiatric illness despite conventional treatments. In the last decade, the Mental Health and Nutrition Research Group has been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of issues such as ADHD, mood disorders, anxiety, and stress associated with traumatic events, such as earthquakes and mass shootings.

Julia's interest in nutrition and mental health grew out of her own research showing poor outcomes for children with psychiatric illness despite conventional treatments. In the last decade, the Mental Health and Nutrition Research Group has been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of issues such as ADHD, mood disorders, anxiety, and stress associated with traumatic events, such as earthquakes and mass shootings.

With her colleague Bonnie Kaplan, Ph.D., she is the author of a new book, The Better Brain: Overcome Anxiety, Combat Depression, and Reduce ADHD and Stress with Nutrition, which will be published April 20 by Houghton Mifflin Harcourt.

Anne Guy is a member of the council for evidence-based psychiatry (CEP) and works with the secretariat for the All-party Parliamentary Group for Prescribed Drug Dependence. She's the lead editor and author of “Guidance for psychological therapists: enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs.” (an abridged version can be found here). This guide is endorsed by the British Association for Counseling and Psychotherapy, the UK Council for Psychotherapy, the National Counseling Society, and the British Psychological Society. Dr. Guy is also a practicing psychotherapist that does not rely on a model of diagnosis to help her clients.

Beginning as a claims manager for an insurance company, she got an up-close view of how the healthcare system worked and saw the biggest problems clearly. This “systems view” followed her into her work as a psychotherapist, where she attempts to navigate systemic failures that have resulted in the over-prescription of psychiatric drugs.

In this interview, we will discuss withdrawal from psychiatric medications, problems with psychiatry's over-reliance on the biomedical model, the difference between “addiction” and “dependence,” and counseling beyond diagnosis. She notes that while withdrawal can be difficult, not everyone will experience it as severely as described—for example, research shows that 50% of people coming off antidepressants are likely to experience some kind of withdrawal reactions, with half of those describing them as ‘severe.’ Most reactions last weeks or months with a small group of people experiencing them for years.

Peter Sterling, now retired from the University of Pennsylvania, is a well-known neuroscientist, having co-authored a popular text, Principles of Neural Design. He is a lifelong political activist, and historians of psychiatry may remember his public criticisms of psychiatric treatments in the 1970s, most notably of electroshock and antipsychotics.

He could also be described as an ethnographer, as his travels among the indigenous people of Panama, where he now lives part-time, influenced his understanding of how the human brain was shaped in response to the demands of early hunter-gatherer societies.

He is the author of a recent book titled, What is Health: Allostasis and the Evolution of Human Design. His books raises this provocative question: What does our species require for a healthy life? And can we achieve this with drugs?

Bethany Morris is an assistant professor of psychology at Point Park University in Pittsburgh, Pennsylvania, where she teaches and does theoretical and qualitative research. Dr. Morris is a transdisciplinary scholar whose work bridges critical psychology, literature, philosophy, history, psychoanalysis, and film studies.

Early in her career, at Prince Edward Island University and Brock University in Canada, she studied alternative anti-psychiatric interventions for early-onset schizophrenia as illuminated by children’s literature. During this time, she was also thinking critically about issues of women’s stigmatization and oppression.

In recent years, her work has focused on using the ideas of French psychoanalyst Jacques Lacan to gain a further critical understanding of the oppression of women, psychology’s medical model, and other issues related to social justice.

Her recent publications include the co-authored book Subjectivity in Psychology in the Era of Social Justice, as well as her first solo-authored book, Sexual Difference, Abjection, and Liminal Spaces. Throughout her work is a sustained critique of Borderline Personality Disorder, both as a diagnostic category and the way that it is used toward misogynistic ends in popular culture.

This week on the MIA podcast, we discuss a recent paper that considers the support provided by online support groups when people seek help for psychiatric drug withdrawal. The paper is entitled ‘The role of Facebook groups in the management and raising of awareness of antidepressant withdrawal: is social media filling the void left by health services?’ It was published in the journal Therapeutic Advances in Psychopharmacology in January 2021 and the authors are Sherry Julo, Ed White and John Read.

Actor, singer, writer, and civil rights activist Donzaleigh Abernathy is goddaughter of the Reverend Dr. Martin Luther King, Jr., and daughter of the Reverend Dr. Ralph David Abernathy, King's best friend and partner in the civil rights movement — who co-founded the Southern Christian Leadership Conference and became president of it after King's assassination on April 4, 1968. Her mother was civil rights activist Juanita Abernathy.

As a child, Abernathy witnessed some of the most inspiring and formative moments of the civil rights movement — and some of the most sobering. She also grew up knowing and loving the man she called Uncle Martin, whose stances against racism, poverty, and war remain as relevant today as they were when he first voiced them. Also relevant are his calls for creative maladjustment, meaning the refusal to adjust to society's many ills.

Abernathy is the author of Partners to History: Martin Luther King, Ralph David Abernathy and the Civil Rights Movement. She also contributed to the Smithsonian Institute’s In the Spirit of Martin.

As an actor, she's known for her many roles in films — such as the civil war drama Gods and Generals — and many series, including the Lifetime drama Any Day Now and zombie-apocalypse series The Walking Dead. In addition, she is the lead soloist in a new choral piece, The Listening, composed by Cheryl B. Engelhardt for the Voices 21C Choir in New York City. It’s inspired by an anti-war speech King delivered exactly one year before his death, and it’s been released as a single and a video.

Helen Spandler is a Professor of Mental Health Studies at the University of Central Lancashire in the UK. She is the managing editor of Asylum, a non-profit radical mental health magazine.

She currently holds the Welcome Trust Investigator Award and is the principal investigator on a new research project about the role of MadZines (comics and graphic memoirs created by people with lived experience of psychosocial disabilities) in contesting mental health knowledge and practice.

With over four books and 40 publications to her name, professor Spandler has applied her expertise to a wide range of concerns. She has written about the psychiatric survivor movement, alternate interventions such as therapeutic communities, psychosocial disability, and grassroots activism concerning patient rights.

In this interview, she discusses the importance of placing human suffering before theoretical preferences. She argues that understanding truly listening to psychiatric survivors requires us to get accustomed to uncomfortable truths.

This week on the Mad in America podcast we turn our attention to prescription-drug-induced akathisia and joining me to discuss this is Jill Nickens. Jill is the president and founder of the Akathisia Alliance for Education and Research, a nonprofit organization formed by people who have personal experience of akathisia.

The group includes biochemists, psychologists, nurses, attorneys, business owners, and others who have survived akathisia, suicidality and devastating personal losses due, in part, to a lack of awareness by medical professionals. They have come together to inform and raise awareness to help minimize the risk of developing akathisia.

Akathisia is an extremely distressing neurological disorder that causes severe agitation, an inability to remain still and an overwhelming sense of terror. It is primarily caused by prescribed medications and the most common offenders are anti-psychotics, antidepressants, anti-nausea medications and antibiotics.

Janice Haaken is a professor emeritus of psychology at Portland State University, a clinical psychologist, and a documentary filmmaker. In addition to her work as a professor at Portland State University, Haaken has taught as a Fulbright scholar at Durham University (UK) and University College Cork (Ireland) and as a visiting professor at London School of Economics (UK), York University (UK), and University of Michigan Ann Arbor.

Her documentaries, including Guilty Except for Insanity (2009), Mind Zone: Therapists Behind the Front Lines (2014), Milk Men: The Life and Times of Dairy Farmers (2016), and Our Bodies Our Doctors (2019), focus on people and places on the social margins, drawing out their insights on the world around them. Jan has received numerous awards for her filmmaking, most recently the Lena Sharpe Persistence of Vision award at the 2019 Seattle International Film Festival.

Haaken publishes extensively in psychoanalysis and feminism, the history and politics of diagnosis, trauma, culture, and memory, and the dynamics of storytelling. In addition to Pillar of Salt: Gender, Memory and the Perils of Looking Back(2000) and Hard Knocks: Psychology and the Dynamics of Storytelling (2010), her new book is called Psychiatry, Politics, and PTSD: Breaking Down (2021).

In this interview, she discusses her background in anti-psychiatry and other social movements and her experience liaising between theory and praxis in feminist movements, Occupy Wall Street, Black Lives Matter, and #MeToo. Weaving a history of how both radical and normative ideas and diagnoses in mental health play out in social movements, Jan draws upon her books and films to discuss how activists and mental health professionals alike can better reflect upon their practices and the role they play within larger social systems. We close by following her recent work, which unpacks the benefits and drawbacks of the PTSD diagnosis for personal narratives, collective memory-making, the US military, NGOs, and global mental health critics.

This episode of “Mad in the Family” focuses on a non-drug method to bringing out the best in challenging children, particularly those diagnosed with “ADHD.” It is called the Nurtured Heart Approach® and its essence is that, in the words of our guest, “the same intensity that drives people crazy is actually the source of a child’s greatness." He is the approach’s creator, family therapist Howard Glasser.  Glasser has been called “one of the most influential living persons working to reduce children’s reliance on psychiatric medications” and is the author of the bestselling book, Transforming the Difficult Child and more than a dozen other books.

Glasser is also the Founder of the Children’s Success Foundation, whose  mission is to advance the work of the Nurtured Heart Approach by conducting training programs to support parents in building Inner Wealth® in their children, educators in formally implementing the approach in school systems, and therapeutic professionals to meet the unique mental health needs of “intense” children. A frequent keynote speaker at conferences  on treatment and education, he currently teaches certification trainings on his method, as well as in Dr. Andrew Weil’s program at the University of Arizona’s School of Integrative Medicine.

http://www.howardglasser.com/

https://childrenssuccessfoundation.com/

Lucas Richert is the George Urdang Chair in the History of Pharmacy at the University of Wisconsin, Madison, and historical director for the American Institute of the History of Pharmacy. His work explores prescription and illicit drugs, the American counterculture, and the influence of various power structures within and beyond psychiatry.

As a scholar of the pharmaceutical industry, Richert encountered a trove of historical documents that talked about the self-described radicals in mental health from the 1970s. “They cared about relevant issues, things that we talk about right now: racism, the environment, militarism, and political division. It really grabbed hold of me when I got these documents, they were a catalyst.” This project turned into his 3^rd book, Break on Through: Radical psychiatry and the American counterculture in which he examines the tumultuous 1970s in America with a focus “not just on the elite doctors and people in positions of power, but also wider societal trends.”

In addition to Break on Through, Richert has published A Prescription for Scandal: Conservatism, consumer choice, and the food and drug administration during the Reagan era and Strange Trips: Science culture, and the regulation of drugs. His fourth book, Cannabis: Global Histories, will be available later this year (2021).

In this interview, we will discuss the radical landscape of American psychiatry in the 1970s, “therapeutic” and “non-therapeutic” drugs and how they are classified as such, and feminist critiques of psychiatric institutions.

This week we are sharing the audio taken from our recent psychiatric drug withdrawal town hall held on January 15th 2021.

This was our initial, scene-setting discussion and the panelists are Adele Framer, also known as Alto Strata founder of surviving antidepressants, Luke Montagu, co-founder of the Council for Evidence-based Psychiatry, Swapnil Gupta, a psychiatrists with a specila interest in deprescribing and John Read, Professor of psychology and Chair of the International Institute for Psychiatric Drug Withdrawal.

This series aims to explore what we do and don’t know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants. We will seek to present and explore new understandings that are emerging from the professional and lived-experience communities. We will discuss the knowledge, skills and experience necessary to support those who may be having difficulty getting off psychiatric drugs. We will address questions of interest to both prescribers and patients alike.

Our next even in the series will be held on March 12th 2021 and registration details will be available on Mad in America in early February.

Mad in America, in partnership with the Council for Evidence Based Psychiatry and the International Institute for Psychiatric Drug withdrawal is arranging a series of free to attend online town hall discussions on psychiatric drug withdrawal.

We aim to explore what we do and don’t know about safe withdrawal from antidepressants, antipsychotics, benzodiazepines and stimulants.

We will discuss the knowledge, skills and experience necessary to support those who may be having difficulty getting off psychiatric drugs.

By doing this we hope to stimulate further discussion between service users and prescribers.

Our first discussion will be held on Friday January 15th at 10 AM Pacific time, 1 PM Eastern time and 6 PM GMT.

The panellists for the first discussion are Adele Framer, founder of Surviving Antidepressants; Swapnil Gupta, a Board Member of the International Institute for Psychiatric Drug Withdrawal and a psychiatrist with a special interest in deprescribing; John Read, Professor of Psychology and Chair of the International Institute for Psychiatric Drug Withdrawal; and Luke Montagu, co-founder of the Council for Evidence-based Psychiatry and member of the NICE guideline committee for safe prescribing and withdrawal.

To register for the first discussion, visit madinamerica.com and use the link at the bottom of the home page or click here:

https://bit.ly/psych-drug-withdrawal

We hope that these discussions will add to an increasingly detailed collection of knowledge and experiences that can inform prescribers when providing informed consent and when implementing gradual tapering regimes.

We very much hope you can join us.

Thomas Teo is a Professor of Psychology in the Historical, Theoretical, and Critical Studies of Psychology Program at York University, Toronto, Canada. He has spent his 20+ year career challenging the status quo in academic psychology. His unique approach to research has been described as both critical and meta-psychological. He often takes the discipline of psychology itself, including its methods and assumptions, as the target of his analysis.

He is currently the co-editor of the Review of General Psychology (Sage), editor of the Palgrave Studies in the Theory and History of Psychology, and co-editor of the Palgrave Studies in Indigenous Psychology. He is the former president of the International Society for Theoretical Psychology, of the American Psychological Association’s Society of Theoretical and Philosophical Psychology (Division 24), and former chair of the History and Philosophy of Psychology Section of the Canadian Psychological Association. He has a research record with more than 200 academic publications and refereed conference presentations.

In this interview, Teo expounds upon concepts covered in a recent Science News Article and explains what it means for him to be a critical psychologist. He outlines how, as he became disappointed with the general state of psychology in Western Europe and the Americas, he sought alternative approaches that could better account for how culture, society, and economics are entangled with psychology. This led him to look more closely at historical examples of fascism, as well as postcolonial authors, to better understand how the psychosocial dimensions of social power operate in the world today. As he explains, this has important implications for how we think about psychiatry, mental health, and disability.

Teo concludes the interview by foreshadowing some of his future work, which will further build on his concept of subhumanism to examine how subjectivity is shaped by the premium placed on certain lives. In contrast, others are constructed as less-than-human under neoliberal capitalism.

Piers Gooding is a Mozilla Foundation fellow (2020) and researcher at the Melbourne Social Equity Institute at the University of Melbourne Law School. His main interests are disability law and policy, international human rights law, the law and politics of mental health, and empirical legal research.

Gooding describes his scholarship as an interdisciplinary undertaking that blends theoretical inquiry with applied qualitative research at the local, national, and international levels. He has collaborated with the UN Special Rapporteur for the Rights of Persons with Disabilities and the World Psychiatric Association on recommendations for alternatives to coercion in mental health. He blogs at https://pgooding.substack.com/ and tweets at @p_gooding.

In this interview, he discusses his journey pursuing a human rights agenda in mental health. We focus on his efforts to marry international human rights law and the work of disability rights committees to ensure that people with psychosocial disabilities are not left out. He then talks about his longstanding work to prevent coercion in mental health and its connection to the digital, data-driven direction taken by the field as a whole. He elaborates the regulatory and ethical issues he has uncovered in his research at the intersection of mental health services and data-driven technologies and gestures at emerging methods of “algorithmic accountability” for addressing some of these issues.

Jennifer White is one of the founders of the Critical Suicidology Network, a growing international network of scholars interested in exploring alternatives to biomedical approaches to suicide prevention. Critical suicidology brings together persons with lived experience, mental health professionals, researchers, and activists “to rethink what it means to study suicide and enact practices of suicide prevention in more diverse and creative, less psycho-centric and less depoliticized, ways.”

She is a Professor in the School of Child and Youth Care at the University of Victoria in British Columbia, Canada. She has practiced as a counselor, educator, researcher, and advocate. White served for seven years as the Director of the Suicide Prevention Center in the Department of Psychiatry at the University of British Columbia.

She has written numerous articles and book chapters on suicide and self-harm and has co-authored two books: Child and youth care: Critical perspectives on pedagogy, practice and policy (2011), and Critical suicidology: Transforming suicide research and prevention for the 21st century (2016). Her current research focus centers itself around the contemporary discourse of youth suicide prevention, seeking alternatives to one-size-fits-all approaches.

She is currently leading a Wise Practices for Life Promotion project funded by the First Nations and Inuit Health Branch (FNIHB) of Health Canada. This project seeks to curate a series of wise practices for promoting life based on what is already working and/or showing promise in First Nations communities across the country. She is also conducting a study with family counselors to learn more about the challenges and opportunities they face with youth suicide prevention and the organizational conditions that support them to be most effective in their work. 

Tanya Luhrmann is a Watkins University Professor in the Anthropology Department at Stanford. Her work explores how cultural contexts shape the experience of mental distress, particularly voice-hearing and the symptoms associated with psychosis. She also turns the lens on the practice of Western psychiatry itself, investigating how the field represents the mind and how these representations influence our collective understanding of reality.

Luhrmann’s book When God Talks Back was New York Times’ Notable Book of the Year, and she has written numerous articles on psychosis, medical anthropology, and spiritual experiences. Recently, Our Most Troubling Madness: Schizophrenia and Culture was published by the University of California Press. Her newest book, How God Becomes Real: Kindling the Presence of Invisible Others, was published by Princeton in 2020.

Luhrmann describes herself as someone who is interested in different types of “realnesses.” Given that she grew up surrounded by different worldviews, it is not surprising that her work reflects this diversity of interests. It spreads across academic fields and geographical terrain – from anthropology to psychiatry on one side and Chicago to Chennai on the other. Throughout these writings, she has challenged many assertions of mainstream psychiatry, often to the annoyance of leading figures in the field.

In this interview, she talks about the damaging effects of a diagnostic identity and the often-unseen challenges that peer counselors can face. She also takes on big questions: What does it mean when a person with high scores on psychosis scales is functional in one culture but not in another? Are auditory hallucinations shaped by cultural experiences? Are they always a source of distress?

dele Framer, also known by her online handle Altostrata, is the founder of SurvivingAntidepressants.org, a critical and comprehensive peer-support website that features several thousand case histories of psychiatric drug withdrawal. The site is a hub of information on the topic, highlighting methods of safe drug tapering and recovery and underscoring the humanity of those in the grips of withdrawal.

Framer arrived at her expertise through personal experience. In 2004, after three years on 10 mg of paroxetine, she went off under medical supervision and suffered symptoms of withdrawal that her doctor discounted as relapse. She then went on to visit more than 50 psychiatrists, trying and failing to find someone knowledgeable in antidepressant withdrawal. Her own research into the topic, including close readings of journals and FDA recommendations, led her to the creation of SurvivingAntidepressants.org in 2011.

Registered members now stand at roughly 14,000, with around 56,000 visitors per month. The site features 6,000 case histories and contains more than 60 topics covering tips on the gradual tapering off of specific drugs. All of the site’s information is pulled from scientific papers, governmental advisories, and package inserts, and much of it has been shared across Facebook and other platforms on the web. The site has received mentions in scientific journals and mainstream outlets such as Psychiatric Times and Psychology Today.

Framer, who grew up in New York, has lived in San Francisco for more than 40 years. She’s now retired from a career in software user design.

Natalie Campo, MD, is an integrative psychiatrist practicing in Nashville, TN. She became interested in holistic treatment modalities in her first year of medical school at the University of Texas. In that same year, she was awarded an NIH grant to study infectious encephalitis in the Amazon Jungle. Upon her return, she sought out a physician whose primary care practice included holistic modalities, nutrition, and acupuncture. During medical school, on an externship, she started studying mindfulness and began using it with patients.

After medical school, Campo trained in psychiatry at Yale and in medical acupuncture at Harvard. She obtained certifications from the American Board of Psychiatry and Neurology and the American Board of Integrative and Holistic Medicine. For many years, she taught alternative, holistic, and natural treatment options for anxiety and PTSD as a Yale faculty member.

Campo currently resides in Nashville, where she serves as a Clinical Assistant Professor at Vanderbilt and provides consultation to the Osher Center of Integrative Medicine. In May of 2017, she participated in the World’s First Congress of Integrative Medicine in Berlin, Germany. She started her practice in Nashville called Mindful Medicine in 2011 to bring safe, effective treatments to people seeking relief from anxiety, depression, addiction, and the stress of a hectic lifestyle.

Kirk Schneider is currently running for President of the American Psychological Association (APA). He is a licensed psychologist and adjunct faculty at Saybrook University and Teachers College, Columbia University. He is well-known as the leading spokesperson for integrative, existential, and humanistic approaches to psychology, which emphasize the therapeutic relationship and the importance of confronting the deep paradoxes of being human, and the conflicts that arise from them, in psychotherapy.

He has authored or co-authored thirteen books, including the Wiley World Handbook of Existential Therapy, The Spirituality of Awe: Challenges to the Robotic Revolution, The Polarized Mind: Why It's Killing Us and What We Can Do About It, and, most recently, The Depolarizing of America: A Guidebook for Social Healing. Many trainees in counseling and clinical psychology will recognize Schneider from the APA Psychotherapy Training video series featuring his therapy work.

Schneider is campaigning to serve as President of APA to "to address the existential crises that are now flaring all about us." As he puts it:

In this interview, Schneider discusses his path into psychology, including his own struggles and growth, his approach to psychotherapy, and his scholarship on the psychology of awe and the polarized mind. Then we turn to his vision for psychology; a "whole-person" approach to healthcare, a "Psychologist General" of the United States, and the development of dialogue groups that address polarization and division.

Ronda "Ro" Speight is a mental health peer specialist and recovery advocate at the Mental Health Association of Westchester in Westchester County, New York. She is a person with lived experience with the psychiatric system and a trained co-facilitator in an innovative approach that combines peer support and principles of the Open Dialogue approach called Peer Supported (Partnered) Open Dialogue (POD). POD is currently being tested in a large randomized clinical trial in the UK.

Ro was a service recipient in the Parachute Program NYC, which provided mobile crisis services and implemented respite centers in New York City—combining Intentional Peer Support and Open Dialogue informed practices. The Parachute program was discontinued, but the peer respite model it introduced in New York continues to exist. Her engagement with peers in Parachute shaped her views on mental health care and inspired her to pursue a career as a peer specialist.

Identifying as a person of color, Ro was profoundly affected by her mother's professional success as a clinical social worker who holds a doctoral degree from the University of Pennsylvania. She is highly aware of the obstacles women of color face in society and brings a racial justice perspective to the highly innovative practice of Peer Supported (Partnered) Open Dialogue.

This week on MIA Radio we interview Dr. Stuart Shipko. Dr. Shipko is a psychiatrist in private practice in Pasadena, California and author of the books Surviving Panic Disorder, Xanax Withdrawal and Dr. Shipko’s Informed Consent for SSRI Antidepressants.

Stuart has over 30 years' experience as a psychiatrist and an extensive background in the psychotherapies. He writes for Mad in America on issues relating to SSRI withdrawal and he has a particular interest in the side effects and withdrawal effects of antidepressants and benzodiazepines and the need for informed consent when prescribing.

We discuss: SSRI withdrawal, Tardive Akathisia, informed consent and psychiatric drug tapering.

***

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This episode of “Mad in the Family” focuses on how adolescents can better manage and even overcome anxiety—something the news media and our own eyes tell us so many young people these days are struggling with.

Our guest is Jodi Amen, LCSW, a psychotherapist and coach who has more than 20 years of experience working with children, their parents, and helpers. A graduate of Columbia University School of Social Work, she has studied and taught Narrative Therapy around the globe and speaks to conferences, schools, and universities. Jodi is also trained in using complementary and alternative modalities including Ayurveda, mindfulness, yoga, energy healing, and herbalism.

A TEDx speaker and YouTuber, she is also a best-selling author. Her books include You 1, Anxiety 0, and most recently Anxiety....I'm So Done With You: A Teen’s Guide to Ditching Toxic Stress & Hardwiring Your Brain For Happiness(Skyhorse Publishing).

Jodi has a private practice in Rochester, New York, and is the mother of teenagers.

Nikolas Rose is a professor of Sociology in the Department of Global Health and Social Medicine at King's College London. His work explores how concepts in psychiatry and neuroscience transform how we think about ourselves and govern our societies.

Initially training as a biologist, Rose found his subjects unruly: "My pigeons would not peck their keys, and my rats would not run their mazes. They preferred to starve to death." He moved on to study psychology and sociology and has become one of the most influential figures in the social sciences as well as a formidable critic of mainstream psychiatric practice.

A prolific writer, Rose has over fifteen books to his name, including, most recently, Neuro with Joelle Abi-Rached (2013) and Our Psychiatric Future (2018), addressing the most pressing controversies in the fields of neuroscience and psychiatry. He is also a former Managing Editor of Economy and Society and Joint Editor-in-Chief of the interdisciplinary journal, BioSocieties.

Throughout his work, Rose emphasizes that one must look beyond origins, or "why something happened," and focus instead on the conditions under which ideas and practices emerge. The answers may not be comforting or straightforward, but they can help us to avoid band-aid solutions to complex problems.

Rose builds on the work of philosopher Michel Foucault to reveal how concepts in psychiatry and psychology go beyond explanation to construct and construe how we experience ourselves and our world. Consistent with Foucault's oft-quoted adage, "My point is not that everything is bad, but that everything is dangerous," Rose's work avoids simplistic explanations of why and how the mental health fields go awry and instead examines how injustices can happen without unjust people. In this way, his work often transcends critique and imagines new possibilities and ways of thinking about "mental health," "normality," "brains and minds," and, ultimately, the selves we might yet become.

Jussi Valtonen is both a novelist and a psychologist. As a novelist, his work has been compared to both George Orwell's 1984 and Aldous Huxley's Brave New World for the way it weaves together social commentary and science fiction to jolt readers into confronting difficult questions about the soon-to-come worlds we are creating in the present. His research as a psychologist investigates how changes to the human brain impact how we think, experience, and make sense of the world. This includes recent investigations of the role of psychiatric drugs and polypharmacy on cognitive decline and functional impairment.

Valtonen is from Helsinki and studied English, philosophy, and psychology in Finland before coming to the US to study neuropsychology at Johns Hopkins University and NYU.  He was also trained in screenwriting at the University of Salford in the UK and has worked as a journalist and science reporter.

He has written three novels and a short story collection. Carried by Wings (2007) was given second place in Bonnier's novel competition, and received a warm reception from both critics and bloggers. Valtonen's recent book, They Know Not What They Do (2014), won the Finlandia Prize, Finland's highest literary honor.

In this interview, Valtonen discusses how he found psychological science and literature to complement one another, the blind-spots in current psychiatric practice that harm patients, and how novels can help us to ask questions about the world we're creating.

This episode of the “Mad in the Family” podcast discusses the role of human interaction in child development. Specifically, how conflict and miscommunication between parent and child is not only O.K., but crucial to a young person’s social and emotional development. According to our guest, Dr. Claudia Gold, the “messiness” of our relationships is exactly what helps us build trust, resilience, and a solid sense of self in the world. That is the subject of her latest book, which she discusses with us.

Claudia Gold, M.D., is a pediatrician, infant-parent mental health specialist, author, teacher, and speaker based in western Massachusetts.

Dr. Gold practiced general and behavioral pediatrics for more than 25 years, focusing on a preventative model, and now specializes in early childhood mental health. She’s also the director of The Hello It’s Me Project, a rural community-based program designed to promote healthy relationships between infants and their caregivers.

In addition, she works as a clinician with FIRST Steps Together, a federally funded program for pregnant and parenting women with opioid-use disorders, and as an infant-parent mental health consultant at Volunteers in Medicine, Berkshires.

Dr. Gold serves on the faculty of the Infant-Parent Mental Health Fellowship Program at the University of Massachusetts—Boston, the Brazelton Institute at Boston Children’s Hospital, and the Berkshire Psychoanalytic Institute.

She is the author of four books on child psychology and development: Keeping Your Child in Mind, The Silenced Child, The Developmental Science of Early Childhood, and most recently, The Power of Discord, written with Dr. Ed Tronick and published in June 2020.

Claudia is the author of numerous articles, including Mad in America blogs, presents regularly for audiences of both parents and professionals around the world.

Ian Tucker is a professor and director of impact and innovation in the school of psychology at the University of East London. His expertise is in digital media, emotion, and mental health, he has published over 45 articles and book chapters and has a monograph book entitled Social Psychology of Emotion. He is currently authoring an Emotion in the Digital Age monograph for Routledge's Studies in Science, Technology, and Society series while working on several projects involving technology and mental health. 

In this interview, we discuss how Ian became interested in studying relationships between technology, emotion, and mental health. He addresses some limitations of traditional psychological approaches to these topics and overviews some of his main areas of concern with how digital technology is being used to track people’s emotions and regulate their mental health.

Drawing on philosophers like Gilbert Simondon and Henri Bergson, Ian also explores how digital technologies are being used within peer-to-peer communities to create information archives about experiences with distress and medication in ways that offer collective support. 

For our second interview for this World Benzodiazepine Awareness Day podcast I'm so pleased to get the chance to chat with Baylissa Frederick.

Baylissa is a psychotherapist, coach, and author with two decades of experience working with people from all over the world. She holds a Master's degree in therapeutic counseling and is involved in helping people affected by prescribed antidepressants tranquilizer and opiate physical dependence and withdrawal.

Baylissa is the author of the internationally successful self-help book Recovery and Renewal, the memoir With Hope in my Heart and two journals; Dearest Me and Dearest Friend. Baylissa herself was prescribed the benzodiazepine clonazepam, also known as Klonopin, for a form of dystonia, an involuntary movement disorder and she survived an intense withdrawal experience when coming off. She is now fully recovered and dedicates her time to helping and supporting others.

This week on MIA Radio, we present the second part of our podcast to join in the events for World Benzodiazepine Awareness Day 2020 (W-BAD). In part one, we interviewed Angela Peacock and talked about her experiences of taking and coming off benzodiazepines and also her involvement in the film Medicating Normal, which has a special screening and panel discussion on July the 11th at 1:00 PM EST.

And before we go on, I just wanted to say that these podcasts would not be possible without the efforts of W-BAD lead operations volunteer Nicole Lamberson, who goes above and beyond to make these interviews possible. Later in this episode, we will hear from Baylissa Frederick, who is a therapeutic coach and psychotherapist with over two decades' experience working with clients affected by prescribed drug injury. But before we chat with Baylissa, I'm delighted to get the chance to talk with clinical pharmacologist Dr. Jim Wright.

Jim is Emeritus Professor in the Departments of Anesthesiology, Pharmacology, and Therapeutics in Medicine at the University of British Columbia. Jim obtained his MD from the University of Alberta in 1968, and his PhD in pharmacology from McGill University in 1976. He is a practicing specialist in internal medicine and clinical pharmacology. He is also Editor in Chief of the Therapeutics Letter and he sits on the editorial boards of PLoS One and the Cochrane Library. Dr. Wright’s research focuses on issues relating to the appropriate use of prescription drugs, clinical pharmacology, clinical trials, systematic review, meta-analysis, and knowledge translation.

This week on MIA Radio we present a special episode of the podcast in advance of the events being held to mark World Benzodiazepine Awareness Day, July 11, 2020.

The reason we are sharing this interview early is to help draw attention to a special screening of the film Medicating Normal which will be shown on World Benzodiazepine Awareness Day itself. Following this special screening of the film, there will be an online panel discussion featuring people with lived experience of taking and coming off benzodiazepines. If you haven’t yet seen the film, this screening is not to be missed. The film will be shown at 1 pm EST on July 11 and you can get tickets here.

The film is presented by the Benzodiazepine Information Coalition, a non-profit organization that strives to educate about the potential adverse effects of benzodiazepines taken as prescribed and the Periscope Foundation which is a non-profit organization that funded the making and continues the outreach of Medicating Normal.

For our interview this week I am delighted to get the chance to chat with Angela Peacock who appears in the film and will be a panel member for the online discussion.

Angie served in the US Army from 1998-2004 and was medically retired after one tour in Iraq. She was medicated for post-traumatic stress since that time, going on and off benzodiazepines several times under a doctor’s care until coming off for the final time in January 2016.

She holds a Bachelor of Science in psychology and graduated in May 2019 from Washington University in St. Louis- Brown School of Social work with a Masters in social work. As a 2019 Veterans of Foreign Wars-Student Veterans of America, Legislative Policy Fellow, she is advocating for change in Benzo policy at the Department of Veterans Affairs. She is embarking on a community outreach effort to improve medication and health literacy among military veterans and their family members.

Angie chats about her experiences of being prescribed benzodiazepines, her journey off multiple medications, her continuing work in veterans advocacy and her thoughts about the film Medicating Normal.

Medicating Normal special screening and panel discussion

World Benzodiazepine Awareness Day

Benzodiazepine Information Coalition

Three Suicides: Honoring Lives Lost to Benzodiazepines

The Many Battles of a Benzo Injury: Jean’s Story

MIA’s Justin Karter interviews psychiatrist Awais Aftab about how “conceptual competence” uses philosophy to transform psychiatry.

Awais Aftab is a psychiatrist in Cleveland, Ohio, and Clinical Assistant Professor of Psychiatry at Case Western Reserve University.

He is a member of the executive council of the Association for the Advancement of Philosophy and Psychiatry. He has been actively involved in initiatives to educate psychiatrists and trainees on the intersection of philosophy and psychiatry.

He leads the interview series Conversations in Critical Psychiatry for Psychiatric Times, which explores critical and philosophical perspectives in psychiatry and engages with prominent commentators within and outside the profession who have made meaningful criticisms of the status quo. He is also a member of the Psychiatric Times Advisory Board.

In this interview, he explores his journey into both philosophy and psychiatry and how he understands the relationship between these two disciplines. Aftab goes on to discuss how he began the critical psychiatry interview series and what he has learned from this experience and the pushback he has received. He then elaborates on how studying the philosophical issues in psychiatry, through a “conceptual competence” curriculum, could transform the doctor-patient relationship and improve mental health care.

This week on MIA Radio we turn our attention to electroconvulsive therapy (known as electroshock in the US). It’s fair to say that ECT remains a controversial subject with proponents and detractors regularly disagreeing on its safety and efficacy. The number of psychiatrists willing to administer ECT, particularly in the UK, is in decline but we are still using it to administer electric shocks to the brains of an estimated 2,000 people each year.

In this interview, we discuss a recent paper from the journal Ethical Human Psychology and Psychiatry. The title is ‘Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses’ and it is written by John Read, Irving Kirsch and Laura McGrath. On MIA we have previously written about the study and its findings.

We hear from two of the authors, Professor of Psychology John Read from the University of East London and Professor of Psychology Irving Kirsch from Harvard Medical School.

We discuss:

• That the work aimed to review the quality of meta-analyses and any relevant clinical studies of ECT.
• How there have only ever been 11 studies that have compared ECT with sham ECT (SECT).
• Sham ECT is when the anaesthetic is administered but not followed by shocks to the brain.
• That in addition to reviewing the quality of the studies, the paper went on to consider the effect of placebo in the administration of ECT.
• That when reviewing the quality of studies, a 24-point scale was used and that the scorers were blinded to each other’s ratings.
• The 24-point scale included 5 basic Cochrane Collaboration criteria and an additional 19 quality indicators, some of which were specific to ECT procedures.
• The average quality score across all the studies was 12.3 out of a 24 maximum.
• One of the most important findings was that none of the studies reviewed were double-blind.
• The reason for this is that the patients can’t be blinded to the procedure because the adverse after-effects are very obvious.
• In reviewing the studies it was sometimes the case that only the treating psychiatrist was rating the effectiveness of the procedure, not the patient.
• The 5 meta-analyses themselves only contained between 1 and 7 of the eleven available studies.
• The recommendation from the paper is that the use of ECT should be suspended pending a properly controlled, rigorous clinical trial.
• That the UK’s National Institute for Health and Clinical Excellence (NICE) has decided to review their ECT recommendations in their depression guidelines, considering the review.
• That the Royal College of Psychiatrists has indicated that they will update their ECT position statement in light of the review.
• It has come to light recently that NHS Trusts in the UK are sometimes using out of date or incorrect information in their ECT guidance leaflets, an example of this is referring to ECT correcting a ‘chemical imbalance in the brain’.
• How the expectations of the treating doctor can influence the condition of the person undergoing the treatment.
• That the placebo effect can be large and long-lasting and that the more invasive the procedure, the larger the effect.
• That one of the characteristics of depression is the feeling of hopelessness and that when you are given a new treatment, it can instil a sense of hope which counters the hopelessness.
• That the call to prohibit ECT is because the negative effects of ECT are so strong, the fact that the evidence supporting it is so weak (especially in the long-term and beyond the improvement due to placebo) and that there are other means of addressing the difficulties that the person is dealing with.
• That placebos are, in essence, a type of psychological therapy.

Links and further reading:

Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses

Richard P. Bentall: ECT is a classic failure of evidence-based medicine

NICE guidance on the use of electroconvulsive therapy

Scott Greenspan recently received his doctorate in School Psychology from the University of Massachusetts Amherst. As a mental health counselor, he works to create opportunities for schools to be "hubs of wellness interventions." Scott's research draws from his own experiences working with youth in a variety of capacities, as well as his understanding of the vital role exercise plays in wellness.

His research has focused on the integration of physical activity within school-based mental health programs as well as gender-affirming school-based interventions for sexual minority and gender diverse youth. Scott is currently completing his pre-doctoral clinical internship at Judge Baker Children's Center in Boston and holds an appointment as a Clinical Fellow at Harvard Medical School.

In this interview, Scott discusses how a social justice approach informs his work and why it matters for schools to focus on gender diverse youth in sport. He addresses the influence that the COVID-19 pandemic may be having on adolescents and what parents and teachers can do to help. Scott offers practical solutions for integrating physical exercise into virtual learning. You can find out more about Scott on Linkedin and Twitter.

Dainius Pūras is a medical doctor and human rights advocate. He is currently serving the final year of his term as the United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of health. He is also a professor at Vilnius University, Lithuania, and the director of the Human Rights Monitoring Institute, an NGO based in Vilnius.

Pūras has been a human rights activist for 30 years involved in national, regional, and global activities that promote human rights-based policies and services, with a focus on mental health, child health, disabilities, and the prevention of violence and coercion. He was a member of the UN Committee on the Rights of the Child from 2007 to 2011.

From the time he was appointed to the United Nations Human Rights Council in 2014, Pūras has pushed for a paradigm shift in mental health care. During his mandate, he has written several reports that emphasize the importance of the social determinants of health and criticize the dominance of the biomedical model and the medicalization of depression. While his work has occasionally been met with derision from some mainstream psychiatric institutions, he continues to bring attention to coercive practices and human rights violations and to call for greater investment in rights-based approaches to mental health care and suicide prevention.

In this interview, Pūras discusses his own journey as a psychiatrist, his decision to get involved in human rights work, his goals for his UN reports, and the future of rights-based mental health care.

Sunil Bhatia is a professor and chair of the Department of Human Development at Connecticut College. He is the author of two books and over 50 articles and book chapters. He has received numerous awards for his work in the field of decolonizing psychology, cultural psychology, and qualitative methods and for studies of migrant and racial identities. Most recently, his second book, Decolonizing psychology: Globalization, social justice, and Indian youth identities,received the 2018 William James book award from the American Psychological Association APA).

The movement to decolonize psychology is led by interdisciplinary scholars demanding a move away from the biomedical model of mental health and its colonial roots, especially in the Global South. Bhatia has been writing about these issues for over two decades and has often encountered resistance for speaking against mainstream voices. He is now one of the foremost experts in the field of decolonial studies. His work asks vital questions: Who decides what psychology should study? How do economic and social systems influence psychology? Is it possible to address economic inequality and social issues in psychotherapy? Does psychology speak of people, about people, or does it try to speak for them?

This week on MIA Radio, we interview Nicole Beurkens, PhD, about the impact of the COVID-19 crisis and “quarantine life” on children with different types of behavioral, emotional, and neurodevelopmental challenges. Families may be understandably worried that the stress of lockdown may aggravate their child’s struggles. Yet, we hear some parents say the situation has changed their child for the better. Why might that be?

A unique combination of psychologist, nutritionist, and special educator, Dr. Nicole Beurkens has over 20 years of experience supporting children, young adults, and families.  She is an expert in evaluating and treating a wide range of learning, mood, and behavior challenges. Dr. Beurkens holds a doctorate in clinical psychology, master’s degrees in special education and nutrition, and is a Board-Certified Nutrition Specialist.  She is the founder and director of Horizons Developmental Resource Center in Grand Rapids, Michigan, where she leads a multidisciplinary team dedicated to exceptional evaluation and integrative treatment services, research on innovative treatment protocols, and professional training on best practices.

Dr. Beurkens is a highly sought-after international consultant and speaker, award-winning therapist, published researcher, and best-selling author.  Her work has been highlighted in numerous publications, and she is an expert media source.  When she isn’t working, Dr. Beurkens enjoys spending time with her husband and four children.

(audio to be added)

We discuss:

• Her background as a holistic therapist helping children with severe behavioral and emotional problems, which combines training and experience in special education, psychology, and nutrition. She integrates these skills to uncover and address the physical, social, and/or environmental “root causes” underlying her patients’ symptoms, which often include dietary, sleep, immune, and other previously undiagnosed issues.
• How “sheltering in place” slows down and simplifies life, which can benefit kids with neurodevelopmental, mental health and other challenges by reducing the usual heavy demands of school, therapies, and activities; allowing them to take the time they need to accomplish things; and letting them get more sleep.
• That schools tend to focus on academic achievement at the expense of developing other important skills such as planning, time management, and interpersonal relations. Being home offers parents an opportunity to focus on nurturing these life skills through planned and spontaneous family activities.
• How parents can leverage the plusses of staying at home and minimize the minuses. Lowering stress levels and activity overload is key: Parents should not only limit their expectations of their kids, but of themselves. That said, this is an opportunity for adult-child collaboration on household chores and decision-making, especially with older kids.
• The importance of maintaining balance between learning activities, personal development, play, creative pursuits, and exercise or movement, tailored to your child’s and family’s needs. These need not be structured to be valuable; some kids learn best through self-directed activity. Boredom and doing nothing can also be valuable; parents should not feel compelled to entertain or teach their children all day long.
• Specific strategies to support children with different types of challenges during this quieter period. For example, those typically given an ADHD diagnosis, whatever the underlying cause, struggle with planning, organizing, and follow-through. Now we can help them practice these skills and become more independent by developing their own goals and schedules for the things they want and need to do.
• The opportunities the pandemic offers children with anxiety to face their fears and “build resilience.” These include developing coping strategies with a parent or tele-therapist, such as practicing talking back to negative, scary thoughts, or inventing their own. It’s also important for parents not to dwell on dangers and worries in front of frightened kids and to limit kids’ exposure to the news media.
• How Dr. Beurkens is balancing her own personal and professional lives, including doing telehealth sessions while having all four kids and her husband around the house. She emphasizes that constant communication and renegotiating priorities are key, and advocates finding a daily structure that works for your job and your
• The importance of parents’ own self-care, including finding new ways to exercise and relax so you can be your best for your family. The need to “focus on what we can do rather than what we can’t.”

Relevant Links

Nicole Beurkens’s website

This week on MIA Radio we share the audio from our first Town Hall panel discussion. Mad in America, Open Excellence and the HOPEnDialogue project have collaborated to create an ongoing series of Town Hall discussions exploring the challenges, learnings and opportunities for personal and societal growth found through dialogical responses to crisis in the age of COVID-19.

The title of this first discussion is: Are We Living in the Most Dialogical Time Ever? And the hosts are Kermit Cole and Louisa Putnam.

COVID-19 has forced us all into new ways of being, new ways of relating to each other, and new ways of responding to each other in a time of crisis. These new ways reveal more clearly than ever how essential dialogue is to the human experience. 

What are dialogical practitioners doing — and learning — in this time of crisis? What do these learnings suggest or make possible that might have previously seemed unattainable? What insights do people who have lived with a sense of crisis, often cut off from “mainstream” dialogues, have to offer a world in crisis?

Hosts

Kermit Cole and Louisa Putnam are inspired by Open Dialogue to respond as a team to individuals, couples and families in crisis. They have hosted many symposia in Santa Fe, New Mexico to explore the intersections between Open Dialogue, Hearing Voices, and other Dialogical approaches, and recently completed their studies under Jaakko Seikkula to be Open Dialogue trainers.

Panellists

Jaakko Seikkula teaches Dialogical practice to the many people around the world who have been inspired by the Open Dialogue, the response to mental health crises in Tornio, Finland that Jaakko’s team created.

Richard Armitage is a dialogical practitioner and trainer in Denmark at a large centre for supported living and rehabilitation.

Iseult Twamley is a Clinical Psychologist and Open Dialogue Trainer/Supervisor. Since 2012 she has been Clinical Lead of the Cork  Open Dialogue Implementation, Ireland. 

Rai Waddingham is an Open Dialogue Practitioner, international trainer, and has created, established and managed innovative Hearing Voices Network projects in youth, prison, forensic, inpatient and community settings.

Andrea Zwicknagl is a peer support worker in Switzerland and a board member of HOPEnDialogue.

This week on MIA Radio, we interview Sam Himelstein, PhD, about the impact of the Coronavirus crisis and “social distancing” policies on adolescents, taking a look at the unique needs teenagers and young adults may have and the challenges they may present for parents, caregivers, and other family members.

Relevant Links

Center for Adolescent Studies

Family First Psychotherapy

Sam Himelstein’s website

Ian Puppe is an instructor and research associate in anthropology at the University of Western Ontario in Ontario, Canada. Puppe’s work focuses on the anthropology of First Nations peoples, global studies, social justice, and peace studies. As an instructor at the university, he teaches anthropology of tourism and Indigenous Studies. He also currently serves as the Canadian Anthropology Society’s (CASCA) archivist, assistant editor/research associate with the Franz Boas Papers: Documentary Edition and Co-Principal Investigator/Research Lead for the Sioux Lookout Zone Hospital Archives Project (SLZHAP).

Puppe has done ethnographic work on Algonquin Provincial Park in Ontario, and his research and writing investigate the relations between First Nation peoples and Canadian settler-colonial society. In this interview, he explores how Western approaches to mental health impacts Indigenous peoples, and how the imposition of psychiatric treatments can lead to harmful, unintended iatrogenic effects.

***

Please Support Us: Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you. https://www.madinamerica.com/donate/

Mab Segrest is Professor Emeritus of Gender and Women's Studies at Connecticut College and the author of Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum, and Memoir of a Race Traitor, both from the New Press. A long time activist in social justice movements and a past fellow at the National Humanities Center, she lives in Durham, North Carolina.

Please Support Us: Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you. https://www.madinamerica.com/donate/

This week on MIA Radio, we chat with Paula J. Caplan. Paula is a clinical and research psychologist, author of books and plays, playwright, actor, director, and activist. She was born and raised in Springfield, Missouri, attended Greenwood Laboratory School, received her A.B. with honors from Radcliffe College of Harvard University, and received her M.A. and Ph.D. in psychology from Duke University.

Currently, she is an Associate at the Du Bois Institute, Hutchins Center for African and African American Research, Harvard University. She has been a Fellow at the Women and Public Policy Program of the Kennedy School of Government at Harvard; a Lecturer in Harvard's Program on Women, Gender, and Sexuality in the Psychology Department. She is former Full Professor of Applied Psychology and Head of the Centre for Women's Studies in Education at the Ontario Institute for Studies in Education, and former Lecturer in Women's Studies and Assistant Professor of Psychiatry at the University of Toronto.

Paula is also a passionate and steadfast advocate for service members, veterans and their families. She has written: When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans and has founded the Listen to a Veteran! Project.

In this interview, we discuss Paula’s work to support service members, veterans and their families, and the role psychiatric drugs have played in harming these communities.

We discuss:

• Paula’s experiences that drove her towards working in mental health and advocating for veterans, which came from her father’s service in World War II. This included combat in the Battle of the Bulge.
• After hearing her father’s story that had been recorded as part of a history project, she learned her father had been a forward observer, and as result learned he had been on the front lines of the war. This led to her realizing that most American’s don’t understand military service and the only way of doing this, is through hearing veterans’ stories.
• Prior to the invasion of Iraq, she became concerned about the care of service members of veterans and veterans upon their return from war, and more concerned of the “psychiatrization”, diagnosing and prescribing psychiatric drugs to veterans.
• To get started in her efforts, she began by listening to a veteran share his experiences with her. The veteran talked for three hours, and Paula just listened. The next day, he called her and thanked her for listening, as he got a good night sleep for the first time in years.
• This led to her starting Listen to a Veteran, which was originally called “When Johnny and Jane Come Marching Home”. As part of this initiative, a veteran of any era can meet with another person who has volunteered to listen to the veteran share any stories or experiences they’re interested in sharing.
• Paula has faced barriers in getting this program expanded to the VA or throughout the “mainstream” mental health community because the system has been created to function based upon current “evidenced-based” best practices.
• How Paula is positive that we are currently causing harm to veterans and that alternative approaches need to immediately be implemented throughout the Department of Defense and Department of Veterans Affairs.
• How “therapy” needs to be dropped from the terms “art therapy”, “music therapy” and the like, so we can stop pathologizing individual experiences, and instead support people in doing things that improve their overall well-being.
• Any veterans who want to be a listener as part of Paula’s Listen to a Veteran initiative, or would like to have someone listen to them, they can go to listentoaveterans.org.

Welcome to MIA Reports, showcasing our independent and original journalism devoted to rethinking psychiatry. We take selected MIA Reports and provide them as audio articles. Click here for the text version of this and all of our MIA reports.

Medication-Free Treatment in Norway - A Private Hospital Takes Center Stage

Written by Robert Whitaker, read by James Moore with thanks to Birgit Valla for pronunciation assistance, first published on Mad in America, December 8, 2019.

The Hurdalsjøen Recovery Center, which is a private psychiatric hospital located about forty minutes north of Oslo, on the banks of stunning Lake Hurdal, was set up by its director, Ole Andreas Underland, to provide “medication-free” care for those who wanted such treatment or who wanted to taper from their psychiatric drugs. Norway’s health minister was urging public mental hospitals to offer such treatment, and this private hospital stepped forward before any public hospital had taken the plunge.

Hurdalsjøen opened on April 1, 2015. The first person to show up at its doors was 31-year-old Tonje Finsås, and she had a medical history that could fill volumes. She had developed an eating disorder when she was eight; she was put on antidepressants at age 11, which is when she started cutting herself; then came a prescription for a benzodiazepine; and soon she was cycling in and out of psychiatric wards with astonishing frequency. She arrived at Hurdalsjøen with prescriptions for 31 medicines, including three antipsychotics, and a record of 220 hospitalizations. She had spent most of the three previous years in isolation at a psychiatric hospital in Bergen, where she was watched over by two aides at all times, and was often restrained in a belt.

“I tried to kill myself every day,” she recalled. “I didn’t want to live anymore. This was not a life. Even a dog in a cage has it better than what you have in there.”

Although Lake Hurdal provides a beautiful setting, the hospital is located in a 1970s building, one that was used to treat people suffering from nervous problems, and inside it has an institutional feeling: small rooms located off a long hallway, not all that different from what you might find in an older psychiatric hospital. When Finsås balked at staying there, Underland proposed a novel solution.

Ian Parker is one of the most important contemporary critics of the discipline of psychology. A prolific writer, with over 25 books to his name, he has a formidable reputation in the fields of critical psychology, Marxist psychology, and psychoanalytic theory. He is a fellow of the British psychological society, Emeritus Professor at the University of Leicester, and the managing editor of the Annual Review of Critical Psychology. Parker is also a practicing psychoanalyst analyst and a member of the Centre for Freudian Analysis and Research and the London Society of the New Lacanian School.

His career reflects the principles he talks about – the importance of challenging powerful institutions and the need for collectively mobilizing against discrimination and exploitation. As the "Psy-disciplines" face increased scrutiny for involvement in past abuses, continued collusion with powerful and unjust institutions, and deep criticisms over current psychological research and practice, Parker's work has particular relevance.

His criticisms of psychology and psychiatry started from his university days as a student. He observed that while other social sciences were critical of their received knowledge and open to contributions from the civil rights and women's movements, psychology continued to reinforce old power relations and pathologized these same social movements. Since then, Parker has become one of the most well-known critics of mainstream psychology, and his work repeatedly questions the role of ideology and power in the field. These contributions are evident throughout his writing, including his four-volume 'major work' Critical Psychology (2011) and a Handbook of Critical Psychology (2015). He is currently the editor of the 'Concepts for Critical Psychology' series for Routledge.

This week on MIA Radio, we chat with Beatrice Birch who is the initiator of the residential healing community Inner Fire. For over 35 years, Beatrice worked as a Hauschka artistic therapist in integrative clinics and inspiring initiatives in England, Holland and the USA where the whole human being of body, soul and spirit was recognized and appreciated in the healing process. She has lectured and taught as far afield as Taiwan.

Her passionate belief in both the creative spirit within everyone and the importance of choice, along with her love and interest in the human being has taken her also into prisons where she has volunteered for many years offering soul support through Alternatives to Violence work and watercolor painting.

In this interview, we discuss how Inner Fire works to help the people that attend, and how a core principle of their healing work is that ‘human being are creators, not victims’.

We discuss:

Beatrice’s background and experiences as someone providing alternative help and support for mental and emotional challenges, including her time in the UK National Health Service (NHS) utilizing Hauschka artistic therapy and other artistic therapies alongside improving nutrition and connection to new skills.

How she came to be interested in the resilience of the human spirit, wanting to understand why some people cope and others do not.

That Beatrice worked for many years in prison settings, working with Alternatives to Violence (AVP) and providing artistic therapies to inmates before founding Inner Fire, based in Vermont.

Inner Fire is a proactive healing community officially recognised by the state of Vermont as a Therapeutic Community Residence (TCR) that has been operating as a 501(c)(3) non-profit for almost 6 years.

How Inner Fire provides a medication-free approach to recovery from debilitating or traumatic life experiences, helping people to reclaim their lives.

That Beatrice believes in the importance of allowing people to connect with their divine, creative selves and this leads to a core principle of Inner Fire which is that ‘human being are creators, not victims’.

Inner Fire doesn’t influence a person’s choice to stay on or come off psychotropic drugs, but they will work with people who want to gradually taper either to a comfortable level or off completely.

Beatrice presented a paper to ISPS Rotterdam entitled: Suppose ‘Mental Health’ is a Reductionist Term for ‘Soul Health’…

How Beatrice describes those that come for help as ‘seekers’ and those from Inner Fire that support them as ‘guides’.

That the focus of Inner Fire is participation, connection and community achieved by learning new skills in a group environment, getting people out of their heads and into their limbs.

The importance of rhythm when following the Inner Fire programme and how it is key to the healing process.

Inner Fire has a staff psychiatrist who has an appreciation of the spiritual dimensions of our lives, allowing spiritual and biological aspects to coexist.

How Beatrice’s experience is that while medications can be helpful for some for a time, typically one drug will lead to another and then another and ultimately to hospitalisation.

Where tapering is concerned, the seeker and the psychiatrist together decide on the tapering approach but that it is recognised that tapering must be slow and must adapt to the experience of the person trying to reduce.

That Beatrice wants to raise enough money to provide a space where people can freely express the emotion that often arises as they come off their psychotropic drugs.

Inner Fire is currently private pay and that people donating can therefore help seekers who want to attend but don’t have the financial resources.

How Inner Fire is not a profit-motivated enterprise because the focus is on the individual’s healing journey.

Bob Whitaker helped open the east wing of the Inner Fire home.

This week on MIA Radio, we interview Laysha Ostrow. Laysha is the founder and CEO of Live & Learn, a research and consulting company that specializes in the inclusion of people with lived experience of the mental health system.

She researches community-driven interventions that present safe and effective pathways to independence and empowerment. Ostrow earned her PhD from the Johns Hopkins School of Public Health and holds a master's degree in public policy from Brandeis. Ostrow is passionate about improving the experience of mental health service users, partially due to her personal experience with mental health systems. She has discussed some of her previous research on Mad in America.

Peter Stastny is a New York-based psychiatrist, documentary filmmaker, and a co-founder of the International Network toward Alternatives and Recovery (INTAR). He has been working on the development of services that obviate traditional psychiatric intervention and offer autonomous paths towards recovery and full integration.

Stastny has frequently collaborated with psychiatric survivors in conducting research and writing projects, including the book and major exhibit at the New York State Museum, The Lives They Left Behind: Suitcases from a State Hospital Attic(together with Darby Penney) and the edited volume Alternatives Beyond Psychiatry (with Peter Lehmann). He has directed several documentary films.

Psychiatric diagnosis has come under increased scrutiny in recent years following the release of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) in 2013.

Two organizations that played a prominent role in challenging the Bible of psychiatry prior to 2013, the British Psychological Society and the Society for Humanistic Psychology (American Psychological Association - Division 32) subsequently joined to form the Task Force for Diagnostic Alternatives (TFDA).

Today, February 12th, 2020, the TFDA released a new Open Letter regarding the reform and revision of diagnostic systems. MIA spoke with two leaders of the Task Force, Sarah Kamens, and Peter Kinderman about this effort.

Sarah Kamens is an Assistant Professor of Psychology, at the State University of New York (SUNY) College at Old Westbury and co-chair of the Task Force for Diagnostic Alternatives for the Society for Humanistic Psychology. Her research examines the intersections between extreme emotional distress and structural marginalization. More specifically, she studies the ways in which lived experiences of psychosis and trauma are entangled with social conditions in the world.

Peter Kinderman is past president of the British Psychological Society (BPS) and a Professor of Clinical Psychology at the University of Liverpool. He is also a past guest on the Mad in America podcast and the author of A Manifesto for Mental Health, Why We Need a Revolution in Mental Health Care (2019) and A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing (2013).

This week on MIA Radio we share what is something of an anniversary for us at MIA. This interview marks one hundred episodes since we launched our podcast in July 2017. And for this episode, we interview David Joslin. David is a retired army medic, having served in Iraq in 2003 and Afghanistan in 2008. David currently works as a senior healthcare administrator and he has co-founded Remedy Alpine, a veterans therapeutic recreation non-profit dedicated to providing wilderness therapy adventures in Alaska.

David has also written for Mad in America, having published Broken is Not All I’ll Ever Be in August 2019 and he has recently launched a new podcast called Bullets to Beans, which is a military and veteran-centric podcast focused on current military and veteran topics, blended with discussions on mountain oriented recreational and adventure-based therapy programs.

We discuss:

• How upon leaving the military, David felt that he had lost his identity, suddenly working in private healthcare and not being able to care directly for colleagues as he had as a combat medic.
• That to help deal with the change, David started going out into the backcountry wilderness to find peace and healing.
• How this interest led him to meet Eric Collier, a like-minded veteran interested in wilderness hiking.
• How David and Eric saw the benefits to be had in sharing wilderness adventure experiences and launched their first event for veterans in 2017 and when they got home, realising the amount of interest in and support for similar future events.
• David and Eric then took the time to establish themselves as a business during the Winter of 2018.
• During 2019, David and Eric led 49 veterans into the Alaska wilderness and connected with 150 veterans via outreach and community enrichment events.
• That David came to see that many veterans attending the wilderness therapy had struggled with multiple medications, prescribed during their service years.
• How David’s experiences within the military led to treatment for Post-traumatic Stress Disorder, resulting in being prescribed a drug cocktail.
• How the initial drugs were followed by others for insomnia, drugs for nightmares, blood pressure problems and for focus and concentration.
• How at the height of David’s ‘better living through chemistry’ he was on 13 different drugs.
• That through David’s pharmacological training he realised that one of the top ten side effects of many of the drugs he had been put on was suicidal thinking.
• How David came to take himself off all his drugs and strongly advises others never to do this themselves.
• That it was planning his own suicide that brought him to face that his life was unsustainable, accepting that he didn’t want to live as he had been.
• As he was planning it, he found that he didn’t want to suffer and came to realise that he did want to live, and realised that the suicidal thoughts were very likely as a result of treatment.
• That during his service years, David had assisted with at least three suicide interventions and that caused him to consider what might be driving veterans to consider suicide.
  How having confronted his suicidal thoughts and coming off his drugs, David then went on to find solace and comfort in wilderness adventures.
• That David still sometimes struggles with nightmares, hypervigilance and social anxiety but that he could deal with this without feeling numbed by the drugs and by being away from society but with trusted colleagues and friends in an environment conducive to healing.
• That Remedy Alpine is now starting to work as a government contractor to provide recreationally-based programs to the veteran community.
• How Remedy Alpine operates year-round and provides single-day hikes, single overnight camping events and multi-day hikes which can range from 26 to 30 miles through the Alaskan mountains.
• The recent launch of the Bullets 2 Beans podcast which focuses on post-military life challenges.
• That Remedy Alpine were attendees at the Nature’s Grace Conference, which focussed on America's veterans and the healing power of nature.
• How Remedy Alpine is now focussed on expanding the business side, applying for grants, developing their therapeutic programs and training veteran peer mentors.

Relevant Links:

Broken Is Not All I’ll Ever Be

Remedy Alpine

Bullets 2 Beans podcast

Remedy Alpine on Facebook

Nature’s Grace Conference

This week on MIA Radio we chat with Professor John Read of the University of East London. John worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, in 1994, where he worked until 2013. He has published over 140 papers in research journals, primarily on the relationship between adverse life events (e.g. child abuse/neglect, poverty, etc.) and psychosis. He also researches the negative effects of biogenetic causal explanations on prejudice, the opinions, and experiences of recipients of antipsychotic and antidepressant medication, and the role of the pharmaceutical industry in mental health research and practice.

John joins us to discuss the UK licensing of esketamine nasal spray (Spravato) for so-called ‘Treatment Resistant Depression’. John led a group of 12 academics and professionals who wrote to the UK regulator expressing concerns about esketamine.

We Discuss:

• Concerns about the basic concept of using derivatives of hallucinogenic, addictive street drugs to address complex human problems.
• The particular details of the clinical trials that raise concerns about treatment with esketamine.
• How the US Food and Drug Administration approved Spravato in January 2019 and the European Medicines Agency recommended that member states approve it on October 17, 2019, giving 67 days for member states to comment.
• That the Medicines and Healthcare products Regulatory Agency approved esketamine for UK use.
• That there have been no trials of the efficacy of esketamine in the medium or long term, with most trials being only four weeks duration.
• That only one of the trials found a benefit for esketamine over placebo, yet this was deemed sufficient for licensing by the USA’s FDA.
• That there were deaths and suicides recorded during the esketamine clinical trials.
• The relationship between the drug regulators and funding from the pharmaceutical manufacturers.
• How there was no response from the MHRA to the concerns raised by John’s group.
• In addition, no reply was made to concerns raised by Sir Oliver Letwin writing on behalf of the All Party Parliamentary Group on Prescribed Drug Dependence as well as letters from independent researchers from Kings College London and a group of service users.
• A recent response to the approval by the UK National Institute for Health and Care Excellence.
• A response to the NICE announcement from the Science Media Centre.

This week on MIA Radio, we interview Wendy Dolin founder of the MISSD foundation. MISSD stands for Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin.

In 2010, Wendy’s husband Stewart Dolin was prescribed Paxil (paroxetine), a selective serotonin reuptake inhibitor ("SSRI") for mild situational anxiety. Within days, Stewart's anxiety became worse. He felt restless and had trouble sleeping. On July 15, 2010, just six days after beginning the medication, following a regular lunch with a business associate, Stewart left his office and walked to a nearby train station, despite not being a regular commuter. A registered nurse who was also on the platform later reported seeing Stewart pacing back and forth and looking very agitated. As a train approached, Stewart ended his life.

Founded in 2011, MISSD is a unique non-profit organization dedicated to honoring the memory of Stewart and others by raising awareness and educating the public about the dangers of akathisia. MISSD aims to ensure that people suffering from akathisia's symptoms are accurately diagnosed so that needless deaths are prevented.

Relevant Links:

Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin

MISSD on YouTube

MISSD Handout

MISSD Free one-hour Continuing Ed Course

Akathisia Stories - MISSD Podcast (Apple Podcasts, Spotify)

NYC Subway Ads Take Akathisia Out of the Darkness

Wendy Dolin Takes on GlaxoSmithKline And Wins — For Now at Least

Stewart Dolin’s Widow Loses $3 Million Verdict for Paxil Suicide on Appeal

Welcome to MIA Reports, showcasing our independent and original journalism devoted to rethinking psychiatry. We take selected MIA Reports and provide them as audio articles. Click here for the text version of this and all of our MIA reports.

The Whistleblower and Penn: A Final Accounting of Study 352

Written by Peter Simons, read by James Moore, first published on Mad in America, December 29, 2019.

Although the general story of ghostwriting in trials of psychiatric drugs is now pretty well known, the details of the corruption in specific trials are still emerging into the public record, often a decade or more after the original sin of fraudulent publication. The latest study to finally see the full light of day is GlaxoSmithKline’s study 352.

Perhaps the most infamous ghostwritten study is GSK’s study 329, which, in a 2001 report published in the American Journal of Psychiatry, falsely touted paroxetine (Paxil) as an effective treatment for adolescent depression. The company paid over $3 billion in penalties for fraud.

That same year, study 352 made its first appearance in the research literature. That was when Charles Nemeroff, who in the years ahead would become the public face of research misconduct, “authored” an article on the efficacy of paroxetine for bipolar disorder. It has taken 18 years for the full story of that corruption to become known, the final chapter recently emerging when a large cache of study 352 documents—emails, memos, and other internal correspondence between the key players—was made public.

The documents reveal a web of corruption that went beyond the fraud of ghostwriting into the spinning of negative results into positive conclusions, and the abetting of that corruption by an editor of the scientific journal that published the article. The documents also reveal a whitewashing of the corruption by the University of Pennsylvania.

However, it was the publication of these documents that provided Jay Amsterdam, an investigator in the trial who turned whistleblower after he smelled a rat, with a chance to say “case closed.” Amsterdam and Leemon McHenry have now published two articles that provide a step-by-step deconstruction of the study—the ghostwriting, the spinning of results, the betrayal of public trust.

Here is the story of that whistleblowing. 

This week on MIA Radio, we interview Amanda Burrill. After a successful career as a Surface Warfare Officer and Rescue Swimmer in the United States Navy, Amanda was on track to continue her career as a professional triathlete and marathon runner, as she had already been competing internationally still while in uniform. Around the time of her discharge, she was prescribed a cocktail of psychiatric medications that caused physical injuries and leading to an early end to her rapidly accelerating career. 

Amanda completed a Masters degree in Journalism from Columbia University, a culinary arts degree from Le Cordon Bleu in Paris, and continued her work as a travel and culinary journalist; all while surviving a cocktail of over a dozen psychiatric medications over eleven years. 

While being treated for a traumatic brain injury (TBI) by specialists at New York University in 2018, Amanda’s doctors raised concerns about the selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, stimulants, sleeping medications and mood stabilizers concurrently prescribed to her by the Department of Veterans Affairs. Over the next 12 months, Amanda was successful in withdrawing from her cocktail of meds, which included the SSRI, Zoloft. She now sees it as her mission to ensure what happened to her does not happen to others.

Dr. Anthony Ryan Hatch is a sociologist and associate professor of Science in Society, African American studies and Environmental Studies at Wesleyan University, who studies how medicine and technology impact social inequality and health.

Professor Hatch is the author of two books. His first book, Blood Sugar: Racial Pharmacology and Food Justice in Black America, critiques how biomedical scientists, government researchers, and drug companies use the concepts of race and ethnicity to study and treat ‘metabolic syndrome,’ a biomedical construct that identifies people at high risk of heart disease, stroke, and diabetes. His second book, Silent Cells: The Secret Drugging of Captive America, examines how custodial institutions like prisons, nursing homes, and the U.S. military use psychotropic drugs to manage mass incarceration and captivity in the United States.

His 2018 Wesleyan TedX talk is entitled “How Social Institutions Get Hooked on Drugs.”

Mary Watkins is a psychologist at Pacifica Graduate Institute who focuses on reorienting psychology toward social justice and liberatory ends. She has a foundation in the depth psychologies of Carl Jung and James Hillman, as well as holistic approaches to community healing such as indigenous, liberation, and eco-psychologies. She has worked in a variety of settings, such as immigration detention centers, prisons, and marginalized communities, with the aim of social transformation beyond the individual.

Her research interests include a focus on the restorative power of dialogue, creative imagination, forced migration, adoption, and socioeconomic justice. In addition to numerous articles, she has published several books, such as Waking Dreams, Invisible Guests: The Development of Imaginal Dialogues, Toward Psychologies of Liberation with Dr. Helene Shulman, Up Against the Wall: Re-imagining the U.S.-Mexico Border with Dr. Edward Casey, and most recently, Mutual Accompaniment and the Creation of the Commons.

Peter Mayfield is the founder and executive director of Gateway Mountain Center in California, an innovative program for helping youth learn, heal, and thrive

As a teenager growing up in California, Peter became an accomplished rock climber, and developed into one of the world’s best mountain climbers, rising to become chief guide of the Yosemite Mountaineering School. Yosemite is known for being a rock climbing mecca, offering climbers some of the most difficult ascents anywhere in the world.

He has enjoyed a 40-year career guiding people in mountain experiences and developing entrepreneurial enterprises. He is the founder of City Rock, the first full-service climbing gym in the world.

Today, he is passionate about changing the system of care for youth suffering from serious emotional disturbances and complex trauma. Gateway’s program,  ‘Whole Hearts, Minds and Bodies’ is the first nature-based therapeutic program in California to achieve full-service partner contracts with County behavioral health departments and certification as a MediCal provider. This means that California has recognized his nature-based therapeutic programs as providing a medical benefit.

In this interview, Peter speaks about his journey from mountaineering to his role as an educator and mentor, and how enabling children and adolescents to connect with nature has such a profound effect on their health and wellbeing.

If you'd like to know more about the work of the Gateway Mountain Center, you can visit the website www.sierraexperience.org

This week on MIA Radio, we interview Drs. Peter Breggin and Michael Cornwall their new initiative, Stop the Psychiatric Abuse of Children (SPAC!).

Peter Breggin, MD is a Harvard-trained psychiatrist and a former consultant at the National Institute of Mental Health who has been called "The Conscience of Psychiatry." For decades, he has made successful efforts to reform the field, including bringing a stop to lobotomy and psychosurgery. He has testified before the FDA and Congress, been an expert witness in many court cases involving the pharmaceutical industry and has appeared on Oprah and 60 Minutes, among other programs.

Dr. Breggin continues to criticize psychiatric drugs and “electroconvulsive therapy,” and promotes more caring, empathic and effective therapies. To that end, with his wife Ginger, he founded the Center for the Study of Empathic Therapy, Education and Living.  He is the author of more than 20 books, most recently Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions. Dr. Breggin maintains a private practice in Ithaca, New York where he treats adults, couples, and families with children.

Michael Cornwall, PhD has done therapy with children, teens and families since 1980 as well as specializing in therapy with people of all ages experiencing extreme states. He completed doctoral research on medication-free treatment of extreme states and is the editor of a two-volume special edition of the Journal of Humanistic Psychologyon extreme states. Dr. Cornwall has been a prolific MIA blogger since 2012 and a frequent Esalen Institute workshop leader on alternative approaches to extreme states. He is the director of the SPAC! project for Dr. Breggin’s Center for Empathic Therapy.

(audio)

We discuss:

• How SPAC was started in response to the introduction of the Monarch eTNS, an electric stimulation device worn on a child’s forehead at night that is touted as an alternative to ADHD medication, which was fast-tracked by FDA with little testing
• The extensive, downplayed adverse reactions found in testing the Monarch on children
• How the device is purported to work to target brain activity in certain areas, but likely affects other important neural areas and how this is likely to disrupt a child’s normal brain function
• Problems with the design of the studies on the Monarch and how deliberate intrusions into brain function make an individual child more docile but also more apathetic
• The potential widespread adoption of the Monarch device due to a partnership between the manufacturer and a pharmacy chain, the many uses for which it is being marketed, and anticipated psychiatric prescribing of the treatment by primary care doctors
• The nature and risks of ECT, another form of psychiatric “treatment” that targets the brain with electricity, intentionally causing a seizure and short- and long-term traumatic brain injury, and where to find ECT resources on Dr. Breggin’s website
• Reframing “ADHD” behavior as a sign of deficiencies in the teacher, classroom, or parenting approach rather than an illness in the child. What might cause inattentiveness in a young student and how doctors typically medicate the problem as a brain disorder
• Alternatives to high-tech interventions and drugs for helping inattentive or severely troubled youth alike, including modifications at school and entering family therapy. The importance of parents’ expressing love and discipline to change problematic behaviors, with examples from Breggin’s private practice
• How the medical model of psychiatry discourages identifying unmet human needs in young patients and their families, and the benefits of offering trauma-informed support and connection, with examples from Cornwall’s work in the public mental health system
• The importance of engaging children to identify what they need from adults in their lives, arming parents with new attitudes and communication tools for relating to their children, and the success they have had with such approaches
• How listeners can learn more about SPAC! and get involved with advocacy against conventional psychiatric treatment for children and for more compassionate and commonsense alternatives. The groundswell of interest they have received from parents and a variety of online resources available on these topics
• The right of parents to say no to dangerous drugs or devices doctors want to prescribe, and the importance of understanding the risks of resisting a medical professional’s authority or challenging a child’s school
• Reasons for parents and teachers be optimistic that even seemingly incorrigible children can be reached.

Relevant Links

SPAC! webpage, part of Dr. Peter Breggin’s Children’s Resource Center

ECT Resource Center

Center for the Study of Empathic Therapy, Education, and Living

MIA blogs

Monarch eTNS Inspires “Stop the Psychiatric Abuse of Children!” (SPAC!)

FDA Approves Using Electricity All Night Long on Children’s Brains

This week on MIA Radio we turn our attention to support for those who are struggling to withdraw from psychiatric drugs. Recently in the UK, this issue has become headline news with more and more attention being given to the work of groups such as the Council for Evidence Based Psychiatry and peer-led initiatives such as the Bristol Tranquilliser Project. 

December 4 2019, marks the release of guidance which has been specifically written to support psychological therapists and their clients in having discussions about taking and withdrawing from psychiatric drugs. The comprehensive guidance is a collaboration between psychologists, peer support specialists and psychiatrists and aims to provide important context and evidence-based support to psychological therapists, whatever their particular modality.

In this interview, we chat with psychotherapist  and project lead Dr. Anne Guy, Peer Support Specialist Paul Sams and Professor of Psychology John Read.

We Discuss:

• How the project to create guidance for psychological therapists got started.
• The need to address a significant gap in knowledge and experience, particularly given the numbers of clients who work with psychological therapists and are already taking or thinking of coming off psychiatric drugs.
• That therapeutic training previously hasn’t addressed the intersection of psychiatric drugs and the practice of therapy.
• How a recent survey showed that 96% of all therapists are seeing at least one client who is taking psychiatric drugs.
• That the guidance is not prescriptive but provides an opportunity for a therapist to respond to drug issues that other professionals may not have time available to address.
• The important distinction made between giving medical information and giving medical advice.
• How the guidance will be launched in Westminster, London on December 4 2019, and that people can read the guidance and view a Q&A here.
• That next year will see some Continuing Professional Development activities.
• How lived experience and peer support knowledge has been applied in developing the guidance.
• How the guidance opens up the conversation such that no go areas are addressed as part of the overall therapeutic discussion.
• That the approach is one of empowerment and supporting conversation rather than defining or being prescriptive.
• How the evidence-based part of the guidance came together and that there was a fairly consistent finding that around 50% of people coming off psychiatric drugs will experience some sort of withdrawal with around half of those describing the withdrawal effects as severe.
• That the guidance has provided the chance for psychologists, counsellors and psychotherapists to work together.

Relevant Links:

Read or download the guidance here.

View the guidance Q&A here.

© Mad in America 2019

This week on MIA Radio, MIA Correspondent Leah Harris interviews Celia Brown. Celia is a psychiatric survivor and a prominent leader in the movement for human rights in mental health. She is the current Board President of MindFreedom International, a nonprofit organization uniting 100 sponsor and affiliate grassroots groups with thousands of individual members to win human rights and alternatives for people labelled mentally ill.

Please Support Us:

Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you.

https://www.madinamerica.com/donate/

This week on MIA Radio, we interview US Navy Veteran and Co-Founder of Minority Veterans of America, Lindsay Church. Lindsay served from 2008-2012 as a Cryptologic Technician Interpretive (Linguist). During her time in the service, she attended language school at the Defense Language Institute in Monterey, CA where she learned Persian-Farsi. After spending two years at a cyber intelligence command, she left the Navy and returned home to Seattle.

Upon returning home, Lindsay attended the University of Washington where she earned her BA in Near Eastern Language and Civilization and Islamic Studies and an MA in International Studies – Middle East. At the University of Washington, Lindsay co-founded the office of Student Veteran Life, where she also served as the University Liaison for the Student Veterans of AmericaChapter there.

In 2017, Lindsay started the Minority Veterans of America to ensure there is a community of support around the underrepresented veterans so that we may see the true diversity of the U.S. military reflected in our veteran communities.

We discuss:

• • How Lindsay was enlisted in 2008 under “Don’t Ask Don’t Tell” and served all but three months of her time in the Navy under Don’t Ask Don’t Tell.
  • That Lindsay is a third-generation Navy veteran with many family members also serving.
  • How during her Navy career she had multiple health issues arising from an inverted sternum, but a surgical procedure was botched and she experienced multiple complications, spending 5 days in ICU with a collapsed lung.
  • How within 18 months of enlisting she had been prescribed 16 different medications including painkillers, antidepressants and anti-anxiety drugs.
  • How she then had to endure a number of further surgeries but managed to complete language school in spite of the surgeries and complications.
  • Lindsay recalls being amazed that she is alive considering the cocktail of meds she was prescribed.
  • How she came to be stuck for six months at a medical barracks in San Diego.
  • That Lindsay got to a point in 2010 where she felt that she couldn’t go on.
  • That she was being transitioned between Klonopin, Effexor, Valium and Zoloft almost every month which led to intense suicidal thoughts and how she considered jumping from a fifth-floor window.
  • That she recalls asking for psychological support but instead only received more psychiatric drugs.
  • How Lindsay made the decision in 2010 to get off the antidepressants and then in 2011 came off the opioids and has refused painkillers since, finally in 2012 she came off the anti-anxiety drugs.
  • Lindsay says that it hurts to have realized that suicidal thoughts occurred during times of being switched between psychiatric medications, and changes her way of viewing past events in her life.
  • How Lindsay notes that it is very easy to get referred into psychiatry and onto the drugs but very difficult to find appropriate psychological support.
  • That Lindsay moved back to Seattle after leaving the Navy in 2012 and is thankful her mom is a veteran, as she helped her navigate the VA.
  • How Lindsay’s experiences both with the military medical system but also witnessing pervasive misogyny, racism and homophobia in the American Legion, led her to resign her position and to co-found the Minority Veterans of America.
  • How she found that female veterans are 2.2 times more likely to die by suicide than their civilian counterparts and LGBTQ veterans are 2 times more likely to die by suicide than their civilian counterparts.
  • That she now works with people of color, women, LGBTQ and religious and non-religious minorities, many of whom are disenfranchised from the veteran community, so the goal is to bring people into a supportive community to break the isolation, because isolation is a killer.
  • How important social engagement is to address the isolation felt by minority veteran communities.
  • That as regards herself, she is working on reaching the person that she was five years ago when she didn’t think that she belonged or that her story was unique, or even worthy of even being told.
  • That if readers want to know more they can visit MinorityVets.org which is a non-profit.
  • How she feels that we don’t have another three to five years to address the suicide epidemic amongst the veteran community, Congressional action is needed now.

Please Support Us:

Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you.

https://www.madinamerica.com/donate/

This week on MIA Radio, MIA Correspondent Leah Harris interviews psychiatric survivor Dorothy Dundas. Dorothy is an activist, a mother, a mentor, and an incredible supporter of the activists in all of our movement-building work, going back several decades.

Relevant Links:

On Our Own by Judi Chamberlin: https://www.goodreads.com/en/book/show/5106590-on-our-own

Dorothy Dundas author page at Mad in America: https://www.madinamerica.com/author/dorothydundas/

Image of Dorothy's "Behind Locked Doors" poster: https://www.madinamerica.com/2014/05/behind-locked-doors/

To contact Dorothy and/or to order a "Behind Locked Doors" poster: https://www.facebook.com/dorothywdundas

Please Support Us:

Our work is made possible by the generous support of our readers. To make a donation please visit this page. Thank you.

https://www.madinamerica.com/donate/

Joseph Gone is a professor of both Anthropology and Global Health and Social Medicine at Harvard University. He is a clinical and community psychologist by training, and he conducts participatory research projects with community partners in Native American communities. His projects aim to rethink traditional mental health practices and incorporate Indigenous-healing practices. He has published over seventy-five articles on his work. His work includes both the critical analysis of psychological theories and concepts, such as indigenous historical trauma, as well as original research on new mental health programs such as the Blackfeet Culture Camp for the treatment of addiction.

As an undergraduate, he became interested in psychology because the field approaches the question of human experience from so many diverse vantage points -- taking up questions from the workings of the brain to what it means to be human. His love for ideas and his desire to contribute to the American Indian communities (as a member of Aaniiih-Gros Ventre tribal nation) led him to get a doctorate in clinical psychology. However, his experience is not simply that of a clinical psychologist or psychotherapist who addresses mental health at the individual level -- because sometimes, he explains, the remedies that help people “look less like healing and more like justice.”

This week on MIA Radio, we interview Professor of Psychology Dr. Steven C. Hayes.

Dr. Hayes is Nevada Foundation Professor in the Behavior Analysis program at the Department of Psychology at the University of Nevada. An author of 45 books and over 625 scientific articles, his career has focused on an analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering. He is the developer of Relational Frame Theory, an account of human higher cognition, and has guided its extension to Acceptance and Commitment Therapy (ACT), a popular evidence-based form of psychotherapy that uses mindfulness, acceptance, and values-based methods.

Dr. Hayes has been President of several scientific and professional societies including the Association for Behavioral and Cognitive Therapy, and the Association for Contextual Behavioral Science. He was the first Secretary-Treasurer of the Association for Psychological Science, which he helped form and has served a 5-year term on the National Advisory Council for Drug Abuse in the National Institutes of Health.

Dr. Hayes received a Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy and was recently named as a Fellow in the American Association for the Advancement of Science.

In this interview we talk about his recently released book, A Liberated Mind: How to Pivot Toward What Matters, which uses the principles of acceptance and commitment therapy to help readers overcome negative thoughts and feelings, turn pain into purpose, and build a meaningful life.

We discuss:

• What led Steven to his interest in psychology and, in particular, behavioral science.
• That his keen interest was to mix an understanding of human experience with analytical science.
• How he came to be standing on stage in Nevada at a 2016 TEDx talk, relating his experiences of panic disorder and ‘hitting bottom’.
• How Steven has dedicated his life to helping people understand how they can be their whole selves while dealing with their problems and distress.
• How his book ‘A Liberated Mind’ was in part based on his own experiences but also presents the voluminous research that underlies Acceptance and Commitment Therapy (ACT).
• That ACT is based on the psychological flexibility model and involved pulling at the threads of cognition and language to understand the fundamentals.
• How ACT is a combination of acceptance and mindfulness processes and commitment/behaviour changes, referred to in the book as ‘pivots’ and ‘turning towards’.
• That ACT allows us to be present with our difficulties in a way that we can learn from distress without becoming entangled.
• That the book defines six basic processes: defusion, self, acceptance, presence, values and action.
• How it is important not to believe that we need ‘fixing’ before we can move on with our lives.
• That acceptance is often seen as giving up or tolerance but is better viewed as the response to receiving a gift.
• How acceptance opens us up to the validity of our experiences and can help to achieve a healthy distance from distressing experiences.
• How pain, judgement and comparison impact our lives.
• That reliance on medications can mean that we become numb to experiences that we could learn from if we turned or pivoted towards them.
• That the guide to happiness is hidden within our misery.

Relevant links:

Steven C Hayes

The Liberated Mind: How to Pivot Toward What Matters

TEDx Nevada – Psychological flexibility: How love turns pain into purpose

Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy

© Mad in America 2019

Jennifer Freeman is a marriage and family therapist and an Expressive Arts Therapist. Since 2017, she has been researching narratives centered on how humans are facing climate change and responding to these challenging times of social impoverishment, ecological degradation, the Anthropocene, and the sixth great extinction.

She has been engaged in therapeutic conversations, international community work, teaching, and professional writing for the past 30 years based on narrative approaches. She is the co-author of the book Playful Approaches to Serious Problemsalong with David Epston and Dean Lobovits.

© Mad in America 2019

This week on MIA Radio we turn our attention to psychiatric drug withdrawal and in particular the work of the International Institute for Psychiatric Drug Withdrawal.

The Institute recently held a network meeting in Gothenburg, Sweden, where 40 leading experts from around the world came together to discuss the issues of dependence, withdrawal and iatrogenic harm relating to psychiatric drugs. The meeting participants included both professionals and those with lived experience.

We chat with IIPDW founder Carina Håkansson and IIPDW Board Member Professor John Read.

Following the meeting, the IIPDW released the following Press Release.

INTERNATIONAL EXPERTS CALL FOR SERVICES TO SUPPORT MILLIONS TRYING TO COME OFF PSYCHIATRIC DRUGS

The 40 international experts attending this weekend’s meeting (end of September 2019) of the International Institute for Psychiatric Drug Withdrawal (www.iipdw.org) voted to endorse the  recommendations of the recent Public Health England [PHE] review of ‘Dependence and withdrawal associated with prescribed medicines’ and pledged to try to implement them in the 15 countries they are from, and beyond. These include:

1. Enhancing clinical guidance and the likelihood it will be followed.
2. Improving information for patients and carers on prescribed medicines, and increasing informed choice and shared decision-making between clinicians and patients.
3. Improving the support available from the healthcare system for patients experiencing dependence on, or withdrawal from, prescribed medicines.
4. Further research on the prevention and treatment of dependence on, and withdrawal from, prescribed medicines.

Participants agreed that besides antidepressants and benzodiazepines other psychoactive drugs, e.g. antipsychotics, should be included. They also agreed with PHE that ‘the goal is to make sure that our healthcare system builds awareness and enhanced decision-making for better patient treatment and support. These recommendations are just the beginning. All parts of the healthcare system and the general population will need to engage with this complex problem and work together to find solutions’.

The meeting decided to hold a large international conference in Iceland in 2020.

The meeting organiser, Dr Carina Håkansson (Psychotherapist, Sweden), commented:

‘All our hopes were exceeded. So many plans, local and international, emerged from this gathering of inspirational experts and activists. The time for change on this issue has clearly arrived’ carina@utvidgaderum.se

Participants commented:

‘Psychiatric drugs destroyed 10 years of my life. I am so happy that we are finally addressing this issue of how to get off these drugs, which effects literally millions of people.’    Olga Runciman, Denmark (Psychologist, IIPDW Board Member) +45 27851003, orunciman@gmail.com

 

‘Doctors should be able to prescribe the tapering medication strips I demonstrated at the meeting, which are required to stop safely. This is crucially important’. Dr Peter Groot, Netherlands (UMC University Hospital, Utrecht) +31 622290233  p.c.groot@ziggo.nl

 

‘As an NHS Psychiatrist, I am aware how many lives are ruined by over-medication. We need to recognise that there are alternatives which are more powerful and less harmful.’ Dr Rex Haigh, UK (Berkshire) +44 7768 546983 rex.haigh@gmail.com

 

‘The strong commitment all weekend, from researchers, clinicians and people with experience of psychiatric drugs was inspiring. The denying and minimizing of psychiatry and the drug companies will no longer prevail’. Professor John Read, UK (University of East London, IIPDW Board Member) +44 7944 853 783  john@uel.ac.uk

 

“I return to Brazil with a willingness to help the process of psychiatric reform in my country vigorously address the damage that the alliance between psychiatry and the pharmaceutical industry has done to our population.” Professor Fernando Freitas (FIOCRUZ, Member of IIPDW Faculty) + 55 21 2260 9200 ffreitas@ensp.fiocruz.br

© Mad in America 2019

This week on MIA Radio, we chat with Professor Peter Kinderman. Peter is Professor of Clinical Psychology at the University of Liverpool, honorary Consultant Clinical Psychologist with Mersey Care NHS Trust and Clinical Advisor for Public Health England, UK. He was 2016-2017 President of the British Psychological Society (BPS) and twice chair of the BPS Division of Clinical Psychology. His research activity and clinical work concentrate on serious and enduring mental health problems, as well as on how psychological science can assist public policy in health and social care. His previous books include A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing, released in 2013.

In this interview, we discuss Peter’s new book, A Manifesto for Mental Health, Why We Need a Revolution in Mental Health Care, which presents a radically new and distinctive outlook that critically examines the dominant ‘disease-model’ of mental health care.

The book highlights persuasive evidence that our mental health and wellbeing depend largely on the society in which we live, on the things happen to us, and on how we learn to make sense of and respond to those events. Peter proposes a rejection of invalid diagnostic labels, practical help rather than medication, and a recognition that distress is usually an understandable human response to life’s challenges.

We discuss:

• What led Peter to his interest in psychology, having initially been interested in physics and philosophy.
• How his academic and clinical work have influenced each other throughout his career.
• Why it is important to challenge mainstream mental health messages, not just as an academic exercise but also for the good of society.
• That it is pretty clear that we currently have a very poor system for responding to emotional distress.
• How we are not offering real-world help for real-world problems.
• That it is vital for us to offer people an alternative framework of understanding to allow them to decide for themselves how best to frame and therefore respond to difficulty.
• That Peter has observed changes in language that are helping to support public realisation that ‘mental illness’ is an idea or theory rather than undeniable fact.
• How a psychosocially-based mental health response might work.
• That Peter’s would like to see psychiatrists treating children to be employed by the authority also in charge of education provision.
• How our hierarchical health system gives doctors enormous power.
• That the Nordic countries have evolved a more socially-integrated and community-based approach, which better integrates health and social care.
• How those that are critical of the illness model are sometimes viewed as ‘deniers of real experiences’, but that this is a mischaracterisation because it is more about understanding those experiences in a different way or using a different framework.

Relevant links:

A Manifesto for Mental Health – Why We Need a Revolution in Mental Health Care

A Prescription for Psychiatry – Why We Need a Whole New Approach to Mental Health and Wellbeing

Professor Peter Kinderman, University of Liverpool, talks about a manifesto for mental health at the DECP Annual Conference 2016

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© Mad in America 2019

On MIA Radio, we interview Anthropologist Zhiying Ma, who explores mental health care in China, including tensions between Western psychiatry and socially-oriented local frameworks.

Zhiying Ma is a cultural and medical anthropologist and disability studies scholar whose work explores the experiences and rights of those receiving mental health services in China. Her current book project, Intimate Institutions: Governance and Care Under the Mental Health Legal Reform in Contemporary China, investigates how the Chinese state has placed paternalistic responsibilities on families through their role in the care of those diagnosed with serious mental illnesses, in part through the practice of involuntary hospitalization.

Ma came to earn a Ph.D. in Anthropology after questioning psychology’s overemphasis on decontextualized human behavior while majoring in the subject as an undergraduate. She found that anthropology offered the more humanistic and socially oriented lens she was looking for, and this perspective informs her current work.

Ma collaborates with psychiatrists, social workers, human rights activists, lawmakers, families, and those with lived experience to not only conduct research but also to take part in China’s ongoing mental health policy discussions and push for community-based, socially inclusive care that is not simply “care as usual.”

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On MIA Radio this week, in the second of a number of podcasts focused on parenting issues, we interview Ben Furman MD. Ben is a Finnish psychiatrist, psychotherapist and internationally renowned teacher of the Solution-Focused approach to preventing and treating mental health problems in both children and adults. His numerous books have been translated into over 20 languages.

Relevant Links

Helping Children With Angry Outbursts

The Kid Skills App

Please donate

If you are enjoying the Mad in America podcast, please consider  donating to help us continue to provide free content. Thank you.

https://www.madinamerica.com/donate/

© Mad in America 2019

In our second week of MIA Veterans & Military Families, we interview U.S. Navy Veteran Dan Hurd. Dan is the Founder of Ride With Dan USAand the One Pedal at a Time Movement. After surviving his third suicide attempt, Dan became inspired to bicycle to all 48 States in the continental U.S. to help raise awareness about suicide. Along his journey, Dan has realized his attempts were likely caused by the medications he had been prescribed and now dedicates his life towards inspiring others to live life “One Pedal at a Time”. 

(audio to be added)

We discuss: 

• How Dan survived a rough childhood and came to be prescribed psychoactive medications as a teenager.
• That Dan found his time in the U.S. Navy to be the best time of his life.
• How he came to found Ride with Dan USAand the One Pedal at a Time Movement.
• Why he is biking all 48 states in the continental U.S., with a path that includes 25,000 miles and a three-year ride to raise awareness about suicide and to call for research.
• How all three of his suicide attempts were during periods of medication withdrawal.
• How his first attempt occurred in high school, six months before entering the U.S. Navy.
• How, a year after discharge from the Navy, Dan began getting prescribed medications again.
• Dan now realizes that meds were the likely cause of his suicide attempts. Life stressors were triggers, but medication withdrawal manufactured his risk.
• How Dan experienced severe physical pain as part of withdrawal from psychoactive medications, which was especially pronounced during the first year of his ride across the country.
• How his physical pain from withdrawal was so intense that it nearly ended his trip within the first six months of his journey.
• Dan talks about his concerns that psychoactive meds might have harmed his mother, and that her being prescribed these medications prior to his birth might have impacted his life today.
• How he hadn’t previously connected meds to his negative life events, specifically social isolation. Dan has gone from complete isolation while on meds to exploring all 48 states on his bicycle now that he is off of the drugs.
• How Dan has come to recognize medications aren’t solving a chemical imbalance, but instead are medicating symptoms, which led to polypharmacy.
• How Dan’s journey and sharing his story with others has helped him in his recovery and in finding balance in life.
• Dan’s Message to listeners: "Take life one step and one pedal at a time. If you’re experiencing challenges, tell everybody what is going on. Don’t expect help, because when you expect it, you’ll be disappointed. It’s when you’re asking for help and not expecting it, you’ll be happily surprised at what happens."

Relevant Links:

One Pedal at a Time Movement

Ride with Dan USA

Please support Mad in America - Donate now

Lillian Comas-Díaz is a pioneer in the field of ethnocultural approaches to mental health. She is both a clinical practitioner and multicultural feminist psychologist, writing numerous journal articles and books pushing the field toward more inclusive and less ethnocentric theories and practices.

She was recently awarded the 2019 American Psychological Association gold medal awardfor lifetime achievement and the practice of psychology, the first time a person of color has been recognized with the award. She credits the long-term, collective effort of professionals of color working on expanding psychology’s lens to include the perspectives of marginalized peoples’ experiences.

Comas-Díaz, along with her colleagues, recently introduced a special issue on the concept they call racial trauma (see MIA report). She describes racial trauma as “an insidious type of distress that many people of color and other marginalized individuals experience, where they are living in a society where racism, heterosexism, classism, and all those kinds of ‘isms’ are making the society oppressive towards those targeted groups.”

This week on MIA Radio we turn our attention to veterans, service members and military families. MIA has recently launched a new resource for military veterans which will provide news, personal stories and resources specific to veterans and their families. So to explain more about the new resources I am delighted to have been able to chat with Derek Blumke. Derek is the newest member of the MIA Team and he is the editor of the new veterans section.

Derek served 12 years in the US Air Force and Michigan Air National Guard before attending the University of Michigan where he cofounded Student Veterans of America. For his work, Derek received the Presidential Volunteer Service Award and was recognised at the White House by President Barack Obama for his leadership in supporting returning military veterans.

To listen and subscribe to the Mad in America podcast on Apple iTunes, click here. Listen also on Spotify, YouTube or Google Podcasts.

We discuss:

• Derek’s time in the US Air Force and Michigan Air National Guard which saw him deployed to Afghanistan and Uzbekistan.
• How, following his service years, he transitioned to Community College in 2005 and then went on to the University of Michigan.
• How he came to feel that veterans were often isolated on campuses and this drove him to set up an organisation to provide support and connection for ex-service members, which became Student Veterans of America.
• That SVA is now the largest student organisation in the US and also the largest organisation of Iraq and Afghanistan veterans in the country.
• That during his three years running SVA, Derek became involved in legislative action to help send military service members to college (the Post-911 GI Bill).
• How veterans face unique challenges but shouldn’t be viewed as somehow broken or in need of specific support.
• That it was post-service experiences that led to Derek’s realisation that our approach to mental health could be leading to damage and harm.
• How Derek came to set up a tech company which he describes as ‘the most stressful and challenging time of his life’.
• That these stresses and strains led to being prescribed psychiatric drugs, initially Adderall but later having Ambien and Gabapentin added and eventually Zoloft too.
• How the side effects of this cocktail rendered Derek barely able to function and led to him moving back to Michigan.
• That he stopped socialising, stopped posting on social media and his social circle reduced because of the effects of the drugs.
• How these experiences led to questioning and some research and how he withdrew from five drugs over a month, with the most issues coming from the antidepressant Zoloft.
• His description of withdrawal effects including tinnitus, brain zaps, nausea, fatigue, anxiety and extreme dizziness.
• That he came to read the New York Times article: ‘Many people taking antidepressants find they cannot quit’ and realised he was in acute withdrawal.
• That it ultimately took Derek a year to come off the Zoloft.
• How he discovered Mad in America and realised that the messages in the mainstream mental health world do not do justice to the experiences that people are having with psychiatric drugs.
• How Derek got involved with MIA and came to lead our news veterans initiative.
• The suicide epidemic that has so severely affected the veterans community and how it results in more deaths than casualties from recent conflicts.
• That he hopes that the MIA veterans initiative will be seen as the equivalent of Yelp for veterans who want to read personal accounts and learn from unbiased and alternative sources.
• That Derek is starting a new non-profit: Walk There, which is designed to get people together to walk in their local area.

Relevant Links:

Mad in America Veterans Resources

Student Veterans of America

The Department of Veterans Affairs (VA)

The New York Times: Many People Taking Antidepressants Discover They Cannot Quit

Walk There

On MIA Radio this week, in the first of a number of podcasts focussed on parenting issues, we interview Dr. Craig Wiener, a licensed psychologist based in Worcester, Massachusetts, who specializes in the treatment of children, adolescents, and families.

In addition to over 30 years of private practice, Dr. Wiener is an assistant professor in the Department of Family Medicine and Community Health at the University of Massachusetts Medical School. Dr. Wiener is the author of three books. most recently Parenting Your Child with ADHD: A No-Nonsense Guide for Nurturing Self-Reliance and Cooperation. Earlier this year he debuted his three-part video series “ADHD: A Return to Psychology,” which appears on the Mad in America website and also on YouTube.

© Mad in America 2019

Pat Bracken is a psychiatrist who questions many of the fundamental assumptions of his field. He has worked as a psychiatrist in rural Ireland, inner-city and multi-ethnic parts of the UK, and in Uganda, East Africa.

Bracken, who holds doctoral degrees in both medicine and philosophy, calls for a movement toward critical psychiatry. He was one of the people involved in starting the Critical Psychiatry Network, an organization of psychiatrists, researchers, and mental health professionals that question the assumptions that lie beneath psychiatric knowledge and practice.

Through his clinical practice and his academic work in philosophy and ethics, he has seen the limits and dangers of standard approaches to mental health in the West. As a result, he has become an advocate for listening to different understandings of madness from those who are routinely ignored and dismissed — namely, service-users and people who themselves experience madness, and those from indigenous and non-Western cultures.

MIA’s Ayurdhi Dhar interviews Diana Kopua about the Mahi a Atua approach, the global mental health movement, and the importance of language and narratives in how we understand our world and ease our suffering.

Diana Kopua’s life resembles the stories she uses in her work. From a psychiatric community nurse to the head of the department of psychiatry for Hauora Tairawhiti in Gisborne, New Zealand, her 13-year long, arduous journey is both deeply personal and profoundly political. Kopua says she did this to “become a wedge that kept the door open to allow for indigenous leaders” in her world to change the system. One may call her a storyteller, but a story-gatherer might be more appropriate.

As a psychiatrist, Kopua deals in human distress but her interest does not lie in neat psychiatric classifications; instead, she focuses on understanding suffering through Maori creation stories, Purakau. She has developed Mahi a Atua, “an engagement, an assessment, and an intervention” to address the mental distress and suffering among the Maori of New Zealand. Mahi a Atua is not just a set of techniques or a culturally sensitive new therapy, but a drastically different way of conceptualizing the lived experience of the Maori.

Recently, along with art and culture expert Mark Kopua and critical psychiatrist Pat Bracken, she published a paper on this approach in Transcultural Psychiatry. Their work can be seen as an alternative to Western pharmaco-therapeutic interventions currently being promoted throughout the global South via the global mental health movement.

Researchers have critiqued the exporting of Western psychiatric practices, often citing the famous WHO study that reported better outcomes for people diagnosed with mental disorders in the developing world. As the only Ngati Porou (a Maori nation) psychiatrist in the world, working with a population known for poor mental health outcomes, Kopua’s work offers insight into what can be learned from local, Indigenous, and traditional healing methods.

There are many now calling for a “paradigm shift” in Western psychiatry, and in our interview, we covered topics ranging from the specifics of the Mahi a Atua approach, the global mental health movement, and the importance of language and narratives in how we understand our world and ease our suffering.

© Mad in America 2019

This week on MIA Radio, we present a special episode of the MIA podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2019.

2019 represents the fourth annual awareness day and each year it’s held on July 11 which is a significant date because it is the birthday of Professor Heather Ashton. Dr. Ashton is a world-leading expert in benzodiazepines and wrote the highly regarded Ashton Manual which aims to aid clinicians and patients in coming off benzodazepine drugs safely. She also spent many years personally assisting and supporting those who had experienced protracted benzodiazepine withdrawal.

Around the world there are many activities and events taking place as part of W-BAD, so to follow along with events and to get involved yourself, head over to World Benzodiazepine Awareness Day’s Facebook page and look out for the hashtag #WorldBenzoDay on social media.

In our two-part podcast, we hear from W-BAD volunteer and Project Manager for W-BAD Rocks of Kindness, Janelle. We also chat with physician and Director of the Benzodiazepine Information Coalition Christy Huff MD. Finally, in part two, we hear from Stephen Wright MD, addiction specialist and medical consultant to the Alliance for Benzodiazepine Best Practices.

W-BAD Rocks on Facebook

Rockin’ Against Benzos (closed Facebook group)

A Rockin’ Creative Outlet That’s Raising Benzodiazepine Awareness

#WBADROCKS – 1 Month, 5 Things We’ve Learned

W-BAD Rocks on Twitter and Instagram: @wbadrocks

On social media, look for the hashtag #WBADROCKS

A Xanax Prescription That Should Have Been Rejected

10 Tips To Help Patients Through Benzodiazepine Withdrawal

Follow Dr. Huff on Twitter

Dr. Huff’s Blogs and Media Appearances (Scroll down below her bio and click on logos)

BIC on Facebook @bzinfocoalition

BIC on Twitter @BZInfoCoalition

The Alliance for Benzodiazepine Best Practices

Benzodiazepine Related Problems: It’s Almost Never Addiction

Benzodiazepines and Z Drugs for Pain Patients: The Problem of Protracted Withdrawal Symptoms (PWS)

How Chronic Administration of Benzodiazepines Leads to Unexplained Chronic Illnesses: A Hypothesis

This week on MIA Radio, we present a special episode of the MIA podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2019.

2019 represents the fourth annual awareness day and each year it’s held on July 11 which is a significant date because it is the birthday of Professor Heather Ashton. Dr. Ashton is a world-leading expert in benzodiazepines and wrote the highly regarded Ashton Manual which aims to aid clinicians and patients in coming off benzodazepine drugs safely. She also spent many years personally assisting and supporting those who had experienced protracted benzodiazepine withdrawal.

Around the world there are many activities and events taking place as part of W-BAD, so to follow along with events and to get involved yourself, head over to World Benzodiazepine Awareness Day’s Facebook page and look out for the hashtag #WorldBenzoDay on social media.

In our two-part podcast, we hear from W-BAD volunteer and Project Manager for W-BAD Rocks of Kindness, Janelle. We also chat with physician and Director of the Benzodiazepine Information Coalition Christy Huff MD. Finally, in part two, we hear from Stephen Wright MD, addiction specialist and medical consultant to the Alliance for Benzodiazepine Best Practices.

W-BAD Rocks on Facebook

Rockin’ Against Benzos (closed Facebook group)

A Rockin’ Creative Outlet That’s Raising Benzodiazepine Awareness

#WBADROCKS – 1 Month, 5 Things We’ve Learned

W-BAD Rocks on Twitter and Instagram: @wbadrocks

On social media, look for the hashtag #WBADROCKS

A Xanax Prescription That Should Have Been Rejected

10 Tips To Help Patients Through Benzodiazepine Withdrawal

Follow Dr. Huff on Twitter

Dr. Huff’s Blogs and Media Appearances (Scroll down below her bio and click on logos)

BIC on Facebook @bzinfocoalition

BIC on Twitter @BZInfoCoalition

The Alliance for Benzodiazepine Best Practices

Benzodiazepine Related Problems: It’s Almost Never Addiction

Benzodiazepines and Z Drugs for Pain Patients: The Problem of Protracted Withdrawal Symptoms (PWS)

How Chronic Administration of Benzodiazepines Leads to Unexplained Chronic Illnesses: A Hypothesis

Last year, Lucy Johnstone and her colleagues in the UK launched the Power Threat Meaning Framework (PTMF), a set of ideas that represented a sharp departure from the biomedical conceptions that animate the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). This framework shifts the notion of “what is wrong with you” in the DSM to “what has happened to you,” and by doing so turns away from a medical process bent on diagnosing broken brains and toward a narrative response that tells of contexts, power dynamics, and systems.

At a time when the Movement for Global Mental Health is intent on exporting the Western biomedical approaches around the world, Johnstone and her PTMF team, which has included numerous individuals who identify as service users/survivors, are seeking to promote a radically different way of understanding distress. Responses to the PTMF have ranged the gamut from criticism to gratitude.

Johnstone, a consulting clinical psychologist who has experience working in adult mental health settings for many years, believes that the current mental health system has failed, and we are now in the process of witnessing its inevitable downfall. She questions whether a mental health system is needed at all. However, as Thomas Kuhn wrote in his work on scientific revolutions, a system cannot be fully abandoned until there exists a conceptual alternative for the system to move towards. The PTMF, Johnstone believes, offers that conceptual alternative that is necessary for a revolution.

In this interview, she reflects on the reaction to the PTMF, and the possibility that it will help stir up a revolution in the field. How is the framework to be used? Does it stand a chance of becoming adopted? She also tells of how her own life experiences and the influences on her work.

Relevant Links

Dr. Johnstone took part in an earlier interview after the PTMF was launched. You may view
this interview here: https://www.madinamerica.com/2018/03/dr-lucy-johnstone-power-threat-meaning-framework/

More about the PTMF:
Lucy Johnstone discussing the primary features of PTMF:
https://www.youtube.com/watch?v=tkNWQdVB4F0
A British Psychological Society report (with full document link to the framework included):
https://www.bps.org.uk/news-and-policy/introducing-power-threat-meaning-framework

© Mad in America 2019

This week on MIA Radio, we continue our series of discussions with Doctor Lee Coleman. In previous podcasts, we have discussed Lee’s views as a critical psychiatrist and the role of psychiatry in the courtroom. This time, we turn our attention to the need for action to address the inherent power held by psychiatry and how society might respond.

In this episode we discuss:

• How language has the power to trigger associations and can lead us to not question theories that are presented to us as facts.
• How we have come to equate psychiatric ‘treatment’ with interventions in other areas of medicine.
• The deception behind the names of the drugs used in psychiatry such as ‘antidepressants’ or ‘antipsychotics’.
• That society may well be blinded by language to the critical issues of the use of force and the relationship between the law and psychiatry.
• That, ultimately, society demands that psychiatry play the role that it does and therefore we need a societal and political response.
• That any movement to address the dominance of the medical model needs to educate the public at large and so needs resources to be able to provide that challenge.
• How the media often provides an amplified voice for mainstream messages leading to normalisation and lack of critical questioning of such messages.
• That we can and should partner with sympathetic media channels who are open to challenging mainstream messaging.
• That Lee will hopefully be leading a workshop at the 2019 NARPA (National Association for Rights Protection and Advocacy) Conference in Connecticut, USA.

Relevant Links

Article - Technology and Psychiatry

NARPA 2019 Conference

YouTube - Psychiatry's "War of the Words"

YouTube - Dealing With Powerful Opponents: Psychiatry, Government and Pharma

To get in touch, email us at podcasts@madinamerica.com

© Mad in America 2019

On MIA Radio this week, MIA’s Tim Beck interviewed Dr. Felicity Thomas and Dr. Richard Byng. Dr. Thomas is a Senior Research Fellow in the Medical School and a Senior Research Fellow on the Cultural Contexts of Health in the College of Humanities at the University of Exeter. She is also a co-director (with Professor Mark Jackson) of the WHO Collaborating Centre on Culture and Health and works closely with the WHO Regional Office for Europe project on the Cultural Contexts of Health.

Dr. Byng is a professor in primary care research at the University of Plymouth. Dr. Byng is also trained as a general practitioner with a particular interest in mental health care. Over the last 20 years, he has worked on various large-scale research projects related to access, commissioning, inter-professional working and implementation of evidence-based practice, while publishing extensively on topics related to the social contexts of health and professional care.

Together, Dr. Thomas and Dr. Byng have contributed to the DeSTRESS project, which consists of a team of researchers in the United Kingdom who seek to learn about why and how poverty-related issues have become increasingly pathologized. This includes exploring how high levels of antidepressant prescription and use are impacting people’s health and wellbeing in low-income communities in southwest England.

Their final report published in April 2019, entitled Poverty, Pathology, and Pills, situates increasing rates of mental health diagnosis and psychiatric prescriptions within socioeconomic and policy trends across the UK. An overarching conclusion of this research was that there is a need to reconceptualize the way that health professionals respond to poverty-related distress. This requires a response that recognizes the bio-psycho-social and reduces pressures on general practitioners (GPs) to make rapid decisions around diagnosing and prescribing.

On MIA Radio this week, MIA’s Gavin Crowell-Williamson interviewed Adriane Fugh-Berman, MD, a professor in the Department of Pharmacology and Physiology and in the Department of Family Medicine at Georgetown University Medical Center (GUMC).

She is the director of PharmedOut, a GUMC research and education project promoting rational prescribing and exposing the effects of pharmaceutical marketing on prescribing practices. Dr. Fugh-Berman leads a team of volunteer professionals that has deeply impacted prescribers’ perceptions of the adverse consequences of industry marketing.

She is interested in physician-industry relationships and is an expert witness in litigation regarding pharmaceutical marketing processes. She was formerly a medical officer in the Contraception and Reproductive Health Branch of the National Institute for Child Health and Human Development.

Dr. Fugh-Berman is the lead author on key articles on physician-industry relationships, including a national survey of industry interactions with family medicine residencies, exposés of how ghostwritten articles in the medical literature are used to sell drugs, an analysis of drug rep tactics, and an explanation of industry publication planning. 

She wrote the first chapter on alternative medicine to appear in Harrison’s Principles of Internal Medicine and authored the first clinicians’ reference text on dietary supplements, the 5-Minute Herb and Dietary Supplement Consult, as well as an evidence-based book aimed at consumers, Alternative Medicine: What Works. 

In addition to dozens of articles in peer-reviewed literature, Dr. Fugh-Berman coauthored The Truth about Hormone Therapy and co-edited The Teratology Primer. Dr. Fugh-Berman is the former chair of and currently writes a column for the National Women’s Health Network, a consumer advocacy group that takes no money from industry. Dr. Fugh-Berman has appeared on 20/20, the Today Show, and every major news network.

On MIA Radio this week, MIA’s Peter Simons interviewed David Cohen, PhD, a social worker, professor of social welfare, and Associate Dean for Research at the Luskin School of Public Affairs of the University of California, Los Angeles. He discussed his path to becoming a researcher focused on mental health, coercive practices, and discontinuation from psychiatric drugs.

He studies the social construction of psychoactive drug effects, the union of law and psychiatry within a criminalization/medicalization system and envisions alternatives to the current mental health industrial complex and the medicalization of everyday life. He has also taught in Canada and France, and for over 20 years held a private practice to help people withdraw from psychiatric drugs.

He is the author of over 100 book chapters and articles. His first book, published in 1990, was Challenging the Therapeutic State: Critical Perspectives on Psychiatry and the Mental Health System. His latest book, published in 2013, with colleagues, Stuart Kirk, and Tomi Gomory is Mad Science: Psychiatric Coercion, Diagnosis and Drugs.

On MIA Radio this week, MIA’s Akansha Vaswani interviewed Dr. John Read, a clinical psychologist at the University of East London, about the influences on his work and research on mental health over the years.

John worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, in 1994, where he worked until 2013. He has published over 140 papers in research journals, primarily on the relationship between adverse life events (e.g. child abuse/neglect, poverty, etc.) and psychosis. He also researches the negative effects of biogenetic causal explanations on prejudice, the opinions, and experiences of recipients of antipsychotic and antidepressant medication, and the role of the pharmaceutical industry in mental health research and practice.

John is on the Boards of the Hearing Voices Network – England, the International Institute for Psychiatric Drug Withdrawal and the UK branch of the International Society for Psychological and Social Approaches to Psychosis (www.isps.org). He is the Editor of the ISPS scientific journal ‘Psychosis.’

This week on MIA Radio, we present our second chat with Doctor Lee Coleman. In the first interview in this series, we discussed Lee’s career, his views as a critical psychiatrist and his 1984 book Reign of Error. For this second interview, we focus on psychiatry in the courtroom and why the psychiatric expert witness role may be failing both the individual on trial and society at large. We also focus on Chapter 3 of Reign of Error: The Insanity Defence, Storytelling on the Witness Stand.

In this episode we discuss:

• What led Lee to his involvement in the courtroom as a psychiatrist testifying as to the reliability of psychiatric testimony itself.
• How both psychiatrists and psychologists have been given a role by society to judge both the current mental state of an individual on trial and also the potential future behaviour of that individual.
• How important it is to address the three dimensions of past, present and future when looking at psychological testimony.
• The role of psychiatry in the trial of Patty Hearst, when required to provide evidence that she has been brainwashed and therefore was incompetent to stand trial.
• How Lee and a colleague, George Alexander, came to arrange a press conference to address the issue of the reliability of psychiatric or psychological testimony.
• How speaking out in this way ultimately led to many years of opposition not only by psychiatry but also by attorneys on both sides of the debate.
• The legal definition of the term ‘insanity’ and the context in which it is used.
• How if someone is found legally insane, the punishment may be far worse and the incarceration far longer than if that person were found guilty.
• The details surrounding the trial of Dr. Geza De Kaplany, who committed a gruesome murder but came to be represented at trial as having multiple personalities and being mentally disordered.
• The inconsistency often found in both the defense and prosecution in the courtroom when it comes to subjective assessments of the mental state of an individual.
• That it is crucial that people band together to share information and to actively demonstrate and have conferences and influence legislators because we can’t rely on media channels and we can’t rely on professional bodies.

Relevant Links:

Doctor Lee Coleman

The Reign of Error

YouTube - Competent to Stand Trial?- A Psychiatric Farce

YouTube - Society Doesn't Need Protection from the "mentally ill"

The Trial of Patty Hearst

Geza De Kaplany

To get in touch, email us at podcasts@madinamerica.com

On MIA Radio this week, MIA’s Jessica Janze interviewed Dr. Jonathan Raskin, in the Department of Psychology at the State University of New York at New Paltz where he serves as department chair and teaches classes in psychology and counselor education.

Dr. Raskin’s research is focused on constructivist meaning-based approaches in psychology and counseling. He recently authored a textbook titled Abnormal Psychology: Contrasting Perspectives.

Dr. Raskin describes a recent article he wrote (What Might an Alternative to the DSM Suitable for Psychotherapists Look Like?) that highlights psychotherapists’ dissatisfaction with the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and suggests some principles for building alternative models. 

What follows is a transcript of the interview, edited for clarity.

****************

JJ: Welcome, Jonathan. I'm very excited to have you. Is there anything else you want to add about your background for our readers before we get started?

JR: No, not at all. Thank you for inviting me to do this.

JJ: Let's get started. What made you interested in working on alternative diagnostic systems for use in psychotherapy?

JR: Yeah, that's a good question. I've always been interested in how people make meaning, and diagnostic systems are the way that mental health professionals make meaning of their client's experiences. So to me, all diagnostic systems are meaningful systems for making sense of the problems our clients bring to us.

JJ: You take a constructivist approach to thinking about diagnosis. Can you break down what that means for us and how it applies to this issue of diagnosis? 

JR: Many theories fall under the banner of constructivism, but broadly speaking, constructivism focuses on how people both individually and in conjunction with one another (and in more social kinds of configurations) construct understandings of themselves and the world. Then they use those constructions to guide their lives. To me, constructivism seems like an excellent theoretical approach to use in understanding diagnosis because each diagnostic approach can be viewed as a constructed meaning system for understanding and conceptualizing client concerns.

JJ: Several alternative diagnostic systems have been promoted in recent years, including HiTop, the Power Threat Meaning framework, RDoC, and the PDM. What are your thoughts on these alternatives?

JR: I think they're all interesting in their own ways. Let me talk about a few of them. I'll start with HiTop. That's the hierarchical taxonomy of psychopathology. It's a dimensional approach that tries to address the problem of comorbidity that afflicts DSM categories. Comorbidity is a confusing issue for people. When disorders are comorbid, they're diagnosed at the same time. One of the problems is that a lot of the DSM diagnoses are comorbid with one another. If you have too much comorbidity, the question that arises is, are the categories that we've constructed distinct from one another?

HiTop thinks that comorbidity should be embraced instead of rejected. They say, “Yes, these DSM categories cluster together, we can group each of them under these broader spectrums.” The HiTop system uses six spectrum dimensions. Ultimately, the people who created HiTop feel that DSM disorders might be discardable, but for the time being, we can keep them.

They say that there are really these co-morbid overlapping categories underneath these higher levels, six distinct spectra. HiTop sees this as a simpler approach because you can divide people's problems into how they score along these six different spectrum dimensions. It's still very early going. I think it has a lot in common with the big five personality research. If you like those, you'll like HiTop. If you don't like those, you might not be a fan of HiTop.

Let me talk a little bit about RDoC. RDoC is the research domain criteria system. It's a research initiative at the moment. It's not a diagnostic system yet. They're trying to build a diagnostic system from the ground up, and they're doing that by trying to identify the ways that the brain is designed to function. Then, and only then, they will identify ways that it malfunctions. And so the categories that they create will be based on their identifying and diagnosing these specific malfunctions.

The people involved in RDoC say, “We're doing this in the right way, whereas the DSM does it backward.” DSM starts with categories and then researchers race around trying to find out what the biological correlates of those categories are. RDoC says, “Let's understand the brain and how it works and then build categories based on observable differences between healthy and unhealthy brains.” It's a very medical model kind of approach. And if you like that, you'll like RDoC. If you don't like the medical model, you won't.

What's really fascinating about [RDOC] is the idea that it wants to build the system from the ground up. It is not yet a diagnostic system; it's a research initiative. We don't have the ability to identify any kind of presenting problems based exclusively on these kinds of biological biomarkers just yet.

Then there's the Power Threat Meaning framework (PTM), which is going 180 degrees in the other direction. PTM shifts the focus. It moves away from the medical model. It actually doesn't consider itself a diagnostic system. It rejects the idea of medical model diagnostic systems. It says that we need to depathologize people's problems by focusing on what the PTM identifies as the actual causes. It says that economic and social injustices are the root causes of emotional distress. The origins of distress lie outside the person. RDOC looks inside the person, and I think the DSM, in many respects, implies that it's inside the person. PTM emphasizes what has happened to people on a socio-cultural level and then how they've responded to it. It's a totally different approach. It's a non-diagnostic approach.

Another approach is the Psychodynamic Diagnostic Manual (PDM). From its name, you can tell it’s an explicitly psychodynamic diagnostic manual that diagnoses problems through the lens of psychodynamic theory. So whereas the DSM has traditionally been atheoretical, in the sense that it's a descriptive, diagnostic manual describing problems, but it doesn't take a stance on what causes them, the PDM roots its approach explicitly in psychodynamic theory.

All of these approaches are really interesting in their own way. The question is whether or not they'll catch on.

JJ: You don't think that there is one particular diagnostic system that our society should switch to, is that correct?

JR: I view diagnostic systems as tools. Like hammers, they're really helpful instruments. However, depending on the task I’m up to, I might be better off with a wrench or a pair of pliers or some other tool instead. So, I find it helpful to use the tools metaphor when considering diagnostic systems.

One might find a given diagnostic system useful, or not, depending on the situation. Of course, it's always important to remember that diagnostic systems provide maps that can guide us, but we have to be careful not to mistake the map for the territory.

I think the biggest barrier to developing viable alternatives to the DSM and the ICD is that these approaches cross theoretical perspectives by being mainly descriptive. But, when it comes to how a diagnostic system informs treatment, descriptive approaches, in many ways are lacking. That is, they don't take any stance on how to best approach the problems they identify or describe. So, their wanting to script nature makes DSM and ICD easy for everyone to adopt regardless of the theoretical viewpoint. But any theoretically driven system, things like the PDM or the power threat meaning framework or RDoC even, those systems in many ways might struggle to gain mass acceptance because their theoretical commitments will turn people off.

Somebody who doesn't like a medical model brain approach won't use RDoC. Somebody who's really opposed to psychodynamic theories, or just not interested in them, won't use PDM. Somebody who doesn't take a social justice orientation to problems might not like PTM. By being theoretically well developed and informative about how to conceptualize and approach client problems, these alternative diagnostic systems ironically make themselves less broadly appealing. That can be a challenge for them. But, if they are tools you don't have to stick with just one, you could jump around from one system to the next depending on what you're up to that day.

JJ: What about insurance companies? What do you think an alternative to the DSM system that could be used for insurance purposes would look like?

JR: I’m not sure. It’s been suggested by a lot of people that a very practical thing we can do is use the DSM-5 V codes (which list circumstances or experiences, such as "Homelessness," "Poverty," and "High Expressed Emotion Level Within Family") because that might let us identify presenting problems while being less medicalizing and stigmatizing.

Practically, those codes already exist, but we would need insurers to cover them for clinicians to begin using them. One of the reasons they don't get used is that insurance companies don't cover the code diagnosis. As I was describing a minute ago, I think theoretically coherent systems might prove to be more helpful to clinicians in a practical, everyday manner but they're less likely to be appreciated and used across clinicians and different theoretical orientations. That's the challenge. Being theoretically consistent and pure and developing something that a smaller group of people might like to use versus having something that would kind of cut across all theoretical orientations. The latter might be more descriptive, but potentially not the most clinically useful, but would help grease the wheels of insurance.

JJ: Can you talk more about the importance of including service users and people with lived experiences in the development of any future alternatives?

JR: I think it's very important to listen to service users because they're the ones impacted by whatever diagnostic system we develop and use. So we really need their feedback, especially if we want to avoid inadvertently harming them.

JJ: How do you think diagnoses should be approached in therapy? How do you recommend clinicians approach these topics with people who come to see them? 

JR: I think we often draw sort of an artificial line between diagnosis and treatment. George Kelly was the psychologist who developed personal construct theory, and he used to say that therapists have to continually revise their understandings of clients because clients are always in process and forever changing. That's why Kelly used the term transitive diagnosis. He said diagnoses are transitive because they are continually evolving.

So given that, regardless of the diagnostic approach that a therapist takes, it seems to me very important for the therapist to not reify the diagnosis made because I think doing so locks the client in place in a way that can be highly limiting. That would be true across different diagnostic systems for me. Whichever system somebody’s adopting, you have to be careful not to be too literal or reifying about that system. So to me, thinking of diagnoses as meaningful constructions, as created understandings that might -for the time being- inform what we're doing, is terrific. But when we shift to seeing them as essential, unchangeable things we can lock ourselves in, and we can actually also unintentionally harm the people we're working with.

JJ: More of a living system.

JR: As Kelly said, you have to keep up with your clients. They're always in process, and you better keep up with them because if you're still using last week's a conceptualization and understanding, well, they may have moved on.

JJ: Is there anything else that you wanted to add or talk to us about before we wrap up?

JR: No, I mean just that I think this is a growing area that people are expressing interest in. I sense that a lot of clinicians don't really know much about different alternatives beyond the DSM and the ICD. And so, one of the things that I've been interested in recently is just helping the field have more knowledge; helping the clinicians out in the field become aware of approaches that they may not know much about.

My sense is that clinicians are hungry for alternatives, but they don't necessarily know what the alternatives are. And then, at the same time, they also feel trapped in the sense that in order for them to get paid, they need to use the DSM. But it doesn’t mean, even if the issues of reimbursement haven't been resolved for other systems, it doesn't mean that they can't learn about and begin using these other systems in addition. It doesn't have to be an either-or. So my goal is to learn more about these diagnostic alternatives myself and then to help others out in the field learn about them as well.

JJ: I think that's really great. Just talking about alternatives and getting the information out even if we do not necessarily subscribe to them or use them. 

JR: Having an open discussion and dialogue about them is important, and I think people are very quick to make judgments about which approach they like or dislike. But I think if you want to develop alternatives, you have to be open-minded and be willing to talk with people who might be developing alternatives that are very different from what you yourself might develop and appreciate that each alternative may have advantages to it as well as disadvantages.

JJ: I'm excited to see these theories evolve and to see how the field continues this conversation and I'm glad that you're a part of that. Your textbook compares and lays out the alternative diagnostic frameworks, right?

JR: Yea, one of the things that I was very excited to do in the book was to present alternative perspectives across both diagnosis and treatment interventions. In the diagnosis chapter, I talk about RDoC; I talk about HiTop; I talk about the PTM framework; Because I think it's essential for students in the field to learn about these approaches. If we want to disseminate information about them, we have to cover them in the places where students are learning about them.

I also spend a lot of time on DSM and ICD because those are the most influential approaches today. So all of them get covered, and they get covered as perspectives. Each one is a diagnostic perspective that a person might adopt depending on what the goal is in the given moment.

JJ: Well I have to say, I really appreciate you doing this work. I appreciate your perspectives. I appreciate you coming on today and sharing this information with our readers. I do agree with you. I think it's so important to get this information out to people. Thank you so much for talking to us, and I look forward to hearing more about your work. 

JR: Thank you very much.

© Mad in America 2019

Science and Pseudoscience of Mental Health Podcast: Episode 3

This past week, I had the great pleasure to talk with Dr. Kelly Brogan, a leading voice in natural approaches to women’s mental health. Dr. Brogan began her career as a conventional psychiatrist, but following the birth of her first child, she felt bereft of energy and mental clarity and was diagnosed with an autoimmune condition called Hashimoto’s Thyroiditis. Informed by her doctor that she had a chronic illness that would require a lifetime of medication, she launched her own research into her condition which catalyzed a profound paradigm shift in her understanding of health and wellness. Her research led her to Robert Whitaker’s Anatomy of an Epidemic after which time she permanently retired her prescription pad while turning towards natural interventions that support the body’s innate capacity to heal.

With degrees from MIT and Weil Cornell Medical College, triple board certification in psychiatry, psychosomatic medicine and integrative holistic medicine, and direct experience practicing within the parameters of conventional psychiatry, Dr. Brogan is uniquely qualified to challenge the pseudoscience of the chemical imbalance theory and the drug regimens that it spawned. At the same time, her rigorous education conferred the investigative tools that enabled her to identify the scientific principles that support mental health. She focuses on the integrative nature of the gastrointestinal, immune, endocrine and nervous systems and their seamless communication with the ecosystem that resides within the body – the microbiome – and the ecosystem that surrounds us. This science is at the core of her thirty-day wellness protocol which she outlines in her New York Times bestselling book: A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies and reclaim Their Lives.

Our conversation addressed Dr. Brogan’s grave concerns about the recent rollout of Zulresso (brexanolone), a drug specifically designed, and approved by the FDA for the treatment of Postpartum Depression. Drug trials that qualified Zulresso for FDA approval in fact revealed that its efficacy is weak at best, and not clinically significant. After 30 days, it was actually less effective than placebo. It requires an invasive 60-hour IV infusion with side effects that include sedation – sometimes to the point of loss of consciousness, separation of mother and infant, and cessation of breastfeeding. Women diagnosed with Postpartum Depression are suffering, but impactful interventions need to take into account the complex cultural, socioeconomic, personal and biological underpinnings of their symptoms. Masking symptoms with a drug that causes further disruption to their lives, lessens the likelihood that they will receive effective support. Dr. Brogan estimates that 80% of women who enter her practice having been diagnosed with Postpartum Depression have undetected and untreated thyroid conditions.

We also discussed the reckless prescribing of SSRI antidepressants to one in four American women, many of whom are pregnant, and the long-term epigenetic consequences of SSRIs following prenatal exposure. Dr. Brogan shared her approach to tapering from SSRIs both during pregnancy and as part of her general treatment protocol. Our conversation came to a close with a fascinating exploration of the science that informs the relationship between meditation and mental health. Dr. Brogan shared the transformative impact that her own daily meditation practice has had on her capacity to cope with stress.

To learn more about Dr. Brogan’s clinical work and research, you can visit her website.

For other interviews in this series, click here.

© Mad in America

On MIA Radio this week, MIA's Zenobia Morrill interviews Dr. Vance Trudeau, a professor at the University of Ottawa in Canada. Dr. Trudeau describes a recent study he conducted, alongside a team of researchers, led by Dr. Marilyn Vera-Chang, that has implications for understanding of the long-term impact of antidepressant drug exposure (see MIA report).

The study, titled Transgenerational hypocortisolism and behavioral disruption are induced by the antidepressant fluoxetine in male zebrafish Danio rerio linked antidepressant exposure to decreased coping behaviors in zebrafish that lasted several generations. Dr. Trudeau is the research chair in neuroendocrinology at the University of Ottawa, where he studies how the brain regulates hormonal activity in fish and frogs. Such analyses offer important insights into the effects of environmental exposures on human health because these hormonal systems are shared across species.

© Mad in America 2019

This week on MIA Radio, we chat with Doctor Lee Coleman. Lee trained in psychiatry during the 1960s, quickly adopting a sceptical attitude to the newly emerging field of biological psychiatry and rejecting the idea that drugs could be beneficial for so-called ‘mental disorders’. By the early 1970s, Lee’s professional life was divided between a small home-based practice of psychotherapy and a variety of activities – writing, speaking and political advocacy – focused on psychiatry’s role in society.

His experiences led to writing the book Reign of Error in 1984 in which he brings to bear his lengthy experience in both clinical and legal issues surrounding Psychiatry and Society.

Now retired, Lee devotes his time to public education that exposes the individual and public harms from today’s “mental health” industry. He seeks to support a grassroots movement to abolish forced “treatment” and provide tools to amplify the voices of those seeking change.

The discussion today marks the first in what will hopefully be a series of interviews on a range of topics which will be released on the podcast over the coming months.

In this episode we discuss:

• What led Lee to his interest in attending medical school during the 1950s and his fascination with the burgeoning field of biology.
• How, once he got to medical school, he found he did not care for psychiatry’s biological orientation.
• The Lee’s residency period was 1965 to 1969 and this marked a period of decline of psychoanalysis and the rise of biomedical psychiatry.
• That Lee came to see himself as part of what was called at the time ‘community psychiatry’ which was socially oriented.
• How, in the late 1960s, psychiatry was feeling the heat from psychologists, social workers and even some religious counsellors who started lobbying to get licenses to provide therapy.
• How psychiatry then started going on the offensive to redefine itself as having the leading medical expertise in mental health.
• That Lee was extremely concerned to learn about the legal power of psychiatry and this was a motivator to write The Reign of Error in 1984.
• How a book called Soledad Brother: The Prison Letters of George Jackson called into question much of what Lee had been taught during his residency.
• That Reign of Error is about both what is wrong with psychiatry and the fact that it is linked to the power of the State.
• That Lee has participated in well over 800 legal cases as an expert witness, but he has never testified as to the state of a person’s mind, instead he has testified on the state of psychiatry.
• That Lee has testified to the fact that psychiatrists are generally worse at assessing someone’s mental state than the average lay-person in the jury.
• How language can falsely lead us to believe that science underpins the actions of psychiatrists, something Lee refers to as The War of the Words.
• That we have to fight back by explaining properly what words like ‘treatment’ actually mean.
• How American psychiatry is leading the way to the worldwide drugging of citizens and that we need political action to resist this future.

Relevant Links:

Doctor Lee Coleman

The Reign of Error

Lee’s YouTube Channel

Soledad Brother: The Prison Letters of George Jackson

© Mad in America 2019

Interview by Peter Simons.

Dr. Mark Horowitz is a training psychiatrist and researcher and recently co-authored, with Dr. David Taylor, a review of antidepressant withdrawal that was published in Lancet Psychiatry, which we've written about here at Mad in America (see here). Their article suggests that tapering off antidepressants over months or even years is more successful at preventing withdrawal symptoms than a quick discontinuation of two to four weeks.

Dr. Horowitz is currently completing his psychiatry training in Sydney, Australia, and has completed a PhD in the neurobiology of antidepressants at the Institute of Psychiatry at King's College, London. He is a clinical research fellow on the RADAR study run by University College, London. His research work focuses on pharmacologically informed ways of tapering patients off of medication. He plans to conduct studies examining the best methods for tapering medications in order to develop evidence based guidelines to assist patients and doctors.

This week, MIA Radio presents the fifth in a series of interviews on the topic of the global “mental health” movement.” This series is being developed through a UMASS Boston initiative supported by a grant from the Open Society Foundation. The interviews are being led by UMASS PhD students who also comprise the Mad in America research news team.

We interview Dr. Gail Hornstein, a Professor of Psychology at Mount Holyoke College in South Hadley, Massachusetts. She is the author of To Redeem One Person is to Redeem the World: The Life of Frieda Fromm-Reichmann and, most recently, Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness. In her work, she chronicles both the personal narratives of people with lived experience of being treated as “mad,” and also the growing movement of survivor and service-user activism. Her Bibliography of First-Person Narratives of Madness in English (now in its 5th edition) lists more than 1,000 books by people who have written about madness from their own experience; it is used by researchers, clinicians, educators, and peer groups around the world.

She is now director of a major research and training project investigating how hearing voices peer-support groups work, supported by a grant from the Foundation for Excellence in Mental Health Care. This project is training dozens of new hearing voices group facilitators across the US and sponsors research to identify the key mechanisms by which this approach works.

This week on MIA Radio, we turn our attention to Open Dialogue and we chat with psychotherapist and Open Dialogue trainer Alita Taylor. Alita is a licensed Marriage & Family Therapist, trainer and facilitator based in Tacoma, Washington USA. Her passion is working from a community-based, non-expert, need-adapted Open Dialogue perspective, which utilizes social networks, family, and co-facilitation with other professionals.

In this recent blog, Alita shares why Open Dialogue ‘cannot be taught, but needs a teacher‘.

Love Is In the Air…

I am in love. I’m in love with this way of working. And I won’t stop. Open Dialogue Washington began in 2018 upon my graduation/commencement from Jaakko Seikkula’s dialogic approaches to couple and family therapy trainer/supervisor training, in collaboration with Dialogic Partners and the University of Jyväskylä.

In 2016, I embarked to partake in the best training course I had ever experienced as a family therapist. The embodiment I experienced working with my Open Dialogue colleagues felt like the missing key in psychiatry and psychotherapy. Something intangible, yet what I knew all along. Something ineffable, yet also a shared language. Something deeply and autonomically human, yet unrepeatable and fleeting. It led me onto a moment-by-moment path where everything I learned in my 27-year long career about systemic family therapy and emergency psychiatric protocols ebbed, and the present moment of love flowed, neither the ebbing knowledge nor the cresting wisdom having any lesser value than the other.  The complete work we do in mental health care is this ocean of love.

We are in constant change when we are in crisis. Timelessness sets in. Growth is happening.  We don’t exactly know what we need. That is what mental health work is, sitting with this human happening. In the in-between space, something happens, and we don’t know what will. This is the paradox. We are navigating the ebb and flow of incoming knowledge we have from research and the ebb and flow in each patient and family’s difficulties (the meanings they make of them).

“It cannot be taught, but it needs a teacher.”

After getting trained to facilitate and supervise Open Dialogue, I found that this is the crux of the work, holding more than one truth. As human beings, as a society, as mental health practitioners, we must be able to ask what is helpful, and we must be willing to co-provide this “help” creatively, without barriers, between the digitized rows and columns of tick-boxes and presumptive diagnostic menus.  Remember the analog world of dials and infinite decimals? Agency lies within ourselves to expand the possibilities, to be willing to open to solutions that have not yet been tried.

Michael Pohl wrote about dialogical leadership and culture in which he referenced Karl-Martin Dietz and Thomas Kracht of the Hardenberg Institute for Cultural Studies in Heidelberg, Germany. Michael remembered a discussion on whether dialogism can be taught or experienced. It was argued that the dialogic attitude cannot be learned and that any thought of teaching it is unnecessary. Michael disagreed. He writes, “It cannot be taught, but it needs a teacher.”— Medium.com, March 2018.

In Helsinki and Tornio while learning the Open Dialogue approach, I had many teachers: Jorma Ahonen, Pekka Borchers, Birgitta Alakare, Aino Maija Rautkallio, Kari Valtanen, Tom Erik Arnkil, Jaakko Seikkula, Tapio Salo, Tanja Pihlaja, Eija-Liisa Rautiainen, Pekka Holm.  How did they do it? To quote Birgitta Alakare when she was asked about the beginnings of the development of Open Dialogue in the 1980’s, “It was not only me, it was all of us, everyone.”

When we include all the stakeholders, all the voices, polyphonically, something extraordinary is given space to emerge. This is challenging to enact when there are systems of health care based on bed occupancy, lengths of stay, productivity, staff ratios, definitions of “emergency” or “inpatient” levels of care.

Well, Open Dialogue Washington is bringing to the fore the question, “What is our role as helpers??”  To quote Mia Kurtti, Open Dialogue trainer of Tornio, Finland, “What are we really doing here?”

Caring for our mental health, however defined (crises, hard times, depression, psychosis), is a human need that varies from moment to moment. I learn from every client and family I sit with. In Open Dialogue, multiple perspectives are allowed, in fact invited. Unusual experiences are uncategorized mystery, and understanding between client and family/social network is continuously underway. The course of schizophrenia was reversed in Western Lapland, and their inhabitants trust their mental health system. Hmmm… if we want to save State and Federal dollars and our own livelihoods, perhaps we should allow ourselves to practice psychotherapy and psychiatry with more questions than answers. Perhaps the ones in crisis will teach us what we didn’t know. Love is somewhere, here, in the air.

Relevant links:

Open Dialogue Washington

Open Dialogue Training, April 2019

Open Dialogue UK

This week on MIA Radio, we interview Professor Jim van Os. Professor van Os is Chairman of the Division of Neuroscience at Utrecht University Medical Centre, Utrecht, The Netherlands, and Visiting Professor of Psychiatric Epidemiology at King’s College, Institute of Psychiatry in London. He trained in Psychiatry in Casablanca, Bordeaux and the Institute of Psychiatry and the Maudsley Royal Hospital in London.

We last spoke with Jim for the podcast in August 2017 and this time we focus on a recent paper written by Jim and co-authors that was published in the journal World Psychiatry in January 2019. The paper is entitled ‘The diagnosis evidence-based group-level symptom-reduction model as organizing principle for mental health care. Time for change?‘

In this episode we discuss:

• What the diagnosis evidence-based group-level symptom-reduction model is and how it currently informs mainstream mental healthcare.
• How mental health funding and mental health professional partners work together to monitor and assess the effects of current evidence-based interventions.
• How this curative medical model is attractive, but often fails to work for patients.
• That the focus on biological, brain-based diseases and symptoms conflicts with the experience of people who are attempting to develop a narrative view of their difficulties and suffering.
• That the paper is an attempt to start a discussion about building a synthesis between the diagnosis, symptom-based medical world and the lived experience of individual people.
• How the creation of specific and discrete diagnoses has reinforced the symptom-led approach to mental health and has also necessitated the stratification of doctors into silos of expertise.
• How Jim favors a spectrum-based approach over a fixed diagnosis and that an example is autism spectrum disorder as described in DSM V.
• The limitations of using ‘target symptom reduction’ as an outcome measure for mental health.
• That symptom reduction can be beneficial in the short-term but is not a good long-term measure of recovery.
• That the paper attempts to make clear how important individual experiences are and the need to be sensitive to the existential domain, saying “restoration of health is not the goal, it is the means to enable a person to find and pursue meaningful goals, accordingly, the person’s existential values become central”.
• That the evidence suggests that any treatment effect or improvement is often down to meaningful interaction rather than the specific expertise of the treating professional.
• That, in many countries, we still see a huge gulf between mental healthcare and social care which remain separate and remote from each other and that this separation is not how the person experiences their world.
• The importance of including lived experience in the evidence base, particularly because randomized controlled trials, considered the gold standard of evidence, are often not conclusive in the field of mental health.
• That, in mental health, evidence shows that 30% to 40% of the response is down to placebo and the expectation of being helped.
• That the desire is to make the existential domain the primary lens through which to view human experience and to respond to mental or emotional suffering.
• That, arguably, ‘love is the most powerful evidence-based treatment in mental health’.

Relevant links:

Professor Jim van Os

The evidence-based group-level symptom-reduction model as the organizing principle for mental health care: time for change?

Tedx: Maastricht, Connecting to Madness

ISPS Liverpool Conference Jim Van Os Keynote Address

Schizophrenia does not exist

© Mad in America 2019

In this second interview in our Science and Pseudoscience of Mental Health series, Dr. Sharna Olfman interviews Dr. Darcia Narvaez. 

In 1955, Erich Fromm published a book called The Sane Society. The basic premise is that cultures that support our existential needs for love, community, autonomy, creative expression, purpose, meaning, and communion with nature, enable us to become fully actualized, sane human, beings. Cultures that fail to do so, engender mental illness. Darcia Narvaez,¹ a Professor of Psychology at the University of Notre Dame, has taken up the mantle of Fromm’s quest to identify and promote sane cultural practices that foster mental health. A prolific multidisciplinary scholar, her recent books include Neurobiology and the Development of Human Morality: Evolution, Culture and Wisdom (2014) and Basic Needs, Wellbeing and Morality: Fulfilling Human Potential (2018).

To read more about Dr. Narvaez' work, visit this link:

https://www.madinamerica.com/2018/12/reclaiming-humanity-dawn/

© Mad in America 2018

When we discuss the issue of forced treatment, coercive mental health interventions like involuntary commitment, forced drugging, and electroconvulsive therapy usually come to mind. But force and coercion can be much more subtle. Many researchers and thought leaders have argued that our society mandates us to be happy and perform well-being at all times through cultural norms, media depictions, and workplace and school regulations.

This week on MIA Radio we interview Will Davies, Reader in Political Economy at Goldsmiths University of London, and author of The Happiness Industry, a book that explores the rapidly growing culture of mandated happiness and well-being surveillance. In this interview, we discuss the increasing pressure people face to be happy and think positive, and how this pressure serves the interests of the corporate elite and the State.

In this episode we discuss:

• What the “happiness industry” is and the history of its development
• How the notion that happiness can be quantified or measured, as well as advancements in neuroscience and medicalized frameworks of depression, have influenced our culture
• How employees are increasingly pressured to be happy or perform happiness within the workplace
• How people receiving welfare or government benefits are required to engage in positive thinking programs or cognitive behavioral therapy
• That holding individuals responsible for attaining their own happiness relieves responsibility from structural and institutional determinants of well-being
• The coercive and forceful aspects of the “happiness industry,” including surveillance in workplaces and mandatory self-help programs in schools
• The role that positive thinking and self-help culture play in upholding neoliberalism and capitalism

Relevant Links:

Dr. Will Davies

The Happiness Industry: How the Government and Big Business Sold Us Well-Being

The Managed Heart: Commercialization of Human Feeling

The Power Thinker: Why Foucault’s Work on Power is More Important than Ever

The Weariness of the Self: Diagnosing the History of Depression in the Contemporary Age

Dr. Davies’ next book, Nervous States: Democracy and the Decline of Reason will be published by Norton in early 2019.

© Mad in America 2018

This week on MIA Radio, we interview Dr. Sandy Steingard. Dr. Steingard is Medical Director at Howard Center, a community mental health center where she has worked for the past 21 years. She is also Clinical Associate Professor of Psychiatry at the College of Medicine of the University of Vermont. For more than 25 years, her clinical practice has primarily included patients who have experienced psychotic states. Dr. Steingard serves as Board Chair of the Foundation for Excellence in Mental Health Care. She was named to Best Doctors in America in 2003 and writes regularly for Mad in America. She is editor of the book Critical Psychiatry, Controversies and Clinical Implications due in 2019.

In this episode we discuss:

• What led Sandy to her career in psychiatry and her particular interest in the critical aspects of psychiatry and psychology.
• That Sandy’s initial interest was in biomedical explanations of psychotic experiences.
• How, in the late 80s, the advent of new antipsychotic drugs caused an initial excitement because of the promises made about safety and efficacy, but that Sandy came to realise the problems with the drugs.
• How she witnessed the over-promotion of the drugs and that the promotion was markedly different to the results of studies and her observations of patients that were taking them.
• How a series of disappointments and recognition of some inherent flaws in psychiatry led Sandy to her interest in alternatives.
• That the book, The Truth About the Drug Companies by Marcia Angel MD, had a big impact on Sandy’s view of the drugs during the 2000s.
• Other influential books were The Daily Meds by Melody Petersen and Side Effects by Alison Bass.
• That reading Anatomy of an Epidemic and particularly the problematic aspects of the long-term use of antipsychotic drugs caused Sandy to question how she was practising.
• That she found colleagues were sometimes angry at the conclusion that antipsychotic drugs might not be safe or lead to better outcomes for patients.
• That this led to the investigation of alternatives such as Open Dialog, training with Mary Olsen at the Institute of Dialogic Practice and discovering the Critical Psychiatry Network and the work of Dr. Joanna Moncreiff.
• How Sandy approaches practising from a critical perspective, particularly when expectations are in line with the dominant biomedical narrative.
• Her book, Critical Psychiatry, due in 2019 which aims to help clinicians apply transformational strategies in their clinical practices.
• That psychiatrists would be well served by welcoming lived experience input to their daily practice.
• Why informed consent should be viewed as an ongoing process rather than a one-time agreement.
• The problems that arise in clinical studies where experience is translated into a numerical form.

Relevant links:

Critical Psychiatry, Controversies and Clinical Implications (due 2019)

How Well Do Neuroleptics Work?

What We Are Talking About When We Talk About Community Mental Health

The Truth About The Drug Companies by Marcia Angel MD (video)

The Daily Meds by Melody Petersen (review)

Side Effects by Alison Bass

Open Dialog

The Institute for Dialogic Practice

Critical Psychiatry Network

This week, MIA Radio presents the fourth in a series of interviews on the topic of the global “mental health” movement.” This series is being developed through a UMASS Boston initiative supported by a grant from the Open Society Foundation. The interviews are being led by UMASS PhD students who also comprise the Mad in America research news team.

Over the past three weeks, we have published interviews with many of the leading voices in this debate.

Immediately following the release of the report and the beginning of the Summit, on World Mental Health Day, psychiatric epidemiologist, Dr. Melissa Raven, was on the MIA podcast. She questioned the evidence base of the movement, pointing to statistical issues in the prevalence rates of mental disorders internationally, and called for a focus on addressing barriers to health rather than on individualized treatment.

Mental health service-user activists, Jhilmil Breckinridge, of the Bhor Foundation in India, and Dr. Bhargavi Davar, of Transforming Communities for Inclusion (TCI) Asia Pacific were also on the podcast. Each discussed the lack of involvement of service-user and disability rights groups in the UK Summit and Lancet report and laid out alternative frameworks for addressing distress in ways that are sensitive to culture and social context.

Next, Dr. China Mills, a critical psychologist and author of Decolonizing Global Mental Health, spoke to my colleague, Zenobia Morrill, about her experience attending the UK summit and the lack of attention that has been given to the ways in which austerity policies in Britain have contributed to the increased demand for mental health interventions.

You can find these earlier interviews at the links below:

10/10/18 - Interview with Dr. Melissa Raven, psychiatric epidemiologist - The Global ‘Mental Health’ Movement – Cause For Concern

10/20/18 – Interviews with mental health service-user/psychosocial disability rights activists Jhilmil Breckenridge and Dr. Bhargavi Davar - Global Mental Health: An Old System Wearing New Clothes

10/24/18 – Interview by MIA research news editor Zenobia Morrill with Dr. China Mills, a critical psychologist and prominent critic of the global mental health movement – Coloniality, Austerity, and Global Mental Health

Today I am very pleased to announce that we are joined by Dr. Derek Summerfield.

Dr. Summerfield is an honorary senior lecturer at the Institute of Psychiatry in London and former Research Associate at the Refugee Studies Centre at the University of Oxford and consultant and Oxfam. He was born in South Africa and trained in medicine and psychiatry at St. Mary’s Hospital Medical School in London. Dr. Summerfield has published hundreds of articles in medicine and social science and has contributed widely to understanding the impact of war-related trauma and torture on people around the world. He has been an outspoken critic of the global mental health movement for several years, criticizing the medicalization of trauma through PTSD, the exaggerated prevalence rates in the epidemiological data, and the lack of awareness of the different cultural experiences and understandings of distress.

Today, we bring you the third in our series of podcasts on the topic of the global mental health movement. Part one of the series featured Dr Melissa Raven and part two featured Jhilmil Breckenridge and Dr Bhargavi Davar. These interviews are led by our Mad in America research news team.

In this episode, we interview Dr China Mills. China participated in organizing the open letter in response to The Lancet Commission on Global Mental Health and Sustainable Development. In this interview, China shares her concerns and reactions to the Lancet’s proposal, elaborating on deeper issues related to the framing of global mental health as a “burden” and the underlying implications of coloniality, technology, and medicalization. In addition, China tells us about her insider perspectives after attending the Global Mental Health Ministerial Summit hosted by the UK government. In her recent piece for Mad in Asia about the summit, she writes:

“It was ironic to listen to a range of UK Government minsters talk about the importance of mental health whilst sat in a room just over the river from Westminster, where governmental decisions to cut welfare, and sanction and impoverish disabled welfare claimants has so detrimentally impacted people’s mental health and led to suicide. It felt like arrogance on the part of the UK Government to position themselves as world leaders in mental health when in 2016, the UN found that the Government’s austerity policies had enacted ‘grave’ and ‘systematic violations of the rights of persons with disabilities’ . It was equally jarring, given the cuts to social security under austerity, to be transported by boat about 2 minutes away, to an evening drinks reception at the Tate gallery.”

China Mills is a Lecturer in the School of Education, University of Sheffield, UK. Her research develops the framework of psychopolitics to examine the way mental health gets framed as a global health priority. In 2014, she published the book ‘Decolonizing Global Mental Health’ and has since published widely on a range of topics including: the inclusion of mental health in the sustainable development goals; the quantification of mental health and its construction as a technological problem; welfare-reform, austerity and suicide; and the intersections of psychology, security and curriculum. She is Principal Investigator on two British Academy funded projects researching the social life of algorithmic diagnosis and psy-technologies. China is a member of the editorial collective for Asylum magazine and for the journal, Critical Social Policy; and she is a Fellow of the Sheffield Institute for International Development (SIID).

Today, we bring you the second in our series of podcasts on the topic of the global mental health movement. These interviews are led by our Mad in America research news team.

On October 9^th and 10^th, 2018, World Mental Health Day, the UK government hosted a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement mental health policies globally. In the same week, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal for “scaling up” mental health care globally. In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of policy-makers, psychologists, psychiatrists, and researchers.

In our last episode, we were joined by Dr Melissa Raven, a critical psychologist and epidemiologist, who discussed problems with the scientific evidence base used by the global mental health movement. She also emphasized the need to consider responses to the distress and suffering of people globally that address the social determinants of mental health, including poverty, education, and healthcare.

Today we turn our focus to the concerns raised by mental health activists in response to the UK summit and the Lancet report. To discuss these issues, we are joined first by Jhilmil Breckenridge, a poet, writer and mental health activist and later by social science researcher Dr Bhargavi Davar.

Jhilmil is the Founder of Bhor Foundation, an Indian charity, which is active in mental health advocacy, the trauma-informed approach, and enabling other choices to heal apart from the biomedical model. Jhilmil also heads a team leading Mad in Asia Pacific; this is an online webzine working for better rights, justice and inclusion for people with psychosocial disability in the Asia Pacific region. She is currently working on a PhD in Creative Writing in the UK and, for the last three years, she has also been leading an online poetry as therapy group for women recovering from domestic violence.

She is working on a few initiatives, both in the UK and India, taking this approach into prisons and asylums. Her debut poetry collection, Reclamation Song, was published in May 2018.

For our second interview, we are joined by Dr Bhargavi Davar. She identifies as a childhood survivor of psychiatric institutions in India. She went on to train as a philosopher and social science researcher at the Indian Institute of Technology in Bombay and has published and co-edited several books, including Psychoanalysis as a Human Science, Mental Health of Indian Women, and Gendering Mental Health, while also producing collections of poems and short stories. Dr Davar is an international trainer in the Convention on the Rights of Persons with Disabilities (CRPD) and the founder of the Bapu Trust for Research on Mind and Discourse in Pune, India. This organization aims to give visibility to user/survivor-centred mental health advocacy and studies traditional healing systems in India.

This week, we present the first in a series of interviews on the topic of the global ‘mental health’ movement. These interviews will be led by our Mad in America research news team and today’s interview is hosted by our lead research news editor, Justin Karter.

In this episode, Justin interviews Dr Melissa Raven, who is a psychiatric epidemiologist, policy analyst and postdoctoral research fellow in the Critical and Ethical Mental Health research group at the University of Adelaide, South Australia. Originally qualified as a clinical psychologist, she then worked as a lecturer and researcher in public health and primary health care. Her current mental health research and advocacy is informed by a strong social determinants perspective and a strong critical orientation, which she applies to a range of topics, including suicide prevention, workplace mental health, (over)diagnosis, (inappropriate) prescribing, and conflicts of interest in mental health and the broader health/welfare arena.

On October 10th, 2018, World Mental Health Day, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal to “scale up” mental health care globally. At the same time, the UK government is hosting a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement these mental health policies globally.

In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of critical professionals, psychologists, psychiatrists, and researchers.

This week on MIA Radio we turn our attention to Electroconvulsive Therapy (ECT) or Electroshock as it’s known in the US. On Wednesday, September 19^th, this emotive and controversial intervention was discussed at the 57^th Maudsley debate, held at Kings College London.

The motion proposed was: “This house believes that ECT has no place in modern medicine”.

Supporting the motion were Professor John Read who has undertaken several scientific reviews of the literature supporting the use of ECT and Dr Sue Cunliffe. Dr Cunliffe was a paediatrician until she herself underwent ECT, after which she became cognitively impaired and found herself unable to continue working. She now campaigns for the risks of ECT to be made more explicit and to directly address the professional denial of the damage that ECT can cause. Speaking against the motion were Professor Declan McLoughlin and Dr Sameer Jauhar.

Both John and Sue took time out to talk about the debate and the wider issues surrounding ECT.

Professor Read kindly shared his debate notes, which are provided below.

Thank you to the Institute for bringing us all together.

Let us first remind ourselves tha thistory is littered with procedures which people believed in- just as strongly as some psychiatrists believe, today, in electrocuting people’s brains to cause seizures - but which turned out to be ineffective or damaging. The list includes spinning chairs, surprise baths, standing people next to cannons, and, more recently, lobotomies.

It was 80 years ago, in 1938, that Ugo Cerletti administered the first ECT, to a homeless man in Rome. After the first shock the man called out ‘Not another – it will kill me’.

The theory back then was that people with epilepsy didn’t have schizophrenia so the cure for schizophrenia was to cause epilepsy. So Cerletti was driven by the genuine belief that causing convulsions by shocking the brain really might help people, by the genuine hope that we might finally have come up with an effective treatment.

The story of ECT illustrates, yet again, however, what happens when our beliefs and good intentions are not tempered with good science.

ECT quickly spread from Rome across Europe and America. Finally, an effective treatment! People who received it were discharged earlier….… by the doctors who gave it. But there were no studies for 13 years, by which time everyone just knew it worked, and their belief may have been very helpful to some patients. The first study on depression (which became the main target for ECT), in 1951, found that those who had ECT fared worse than those who had not had it. It made no difference.

I have co-authored four reviews of the ECT research, most recently last year. There are only ten depression studies comparing ECT and placebo; placebo meaning the general anaesthetic is given but the electric shock is withheld. Five of those 10 found no difference between the two groups. The other five found, compared to placebo, a temporary lift in mood during the treatment period, among about a third of the patients. One of these five found that this temporary improvement was perceived only by the psychiatrists, but not by the nurses or the patients.

Most reviews and meta-analyses assert, on the basis of these temporary gains in a minority of patients, that ‘ECT IS EFFECTIVE’

But none of them have ever identified a single study that found any difference between ECT and placebo after the end of the treatment period. There is just no evidence to support the belief that ECT has lasting benefits, after 80 years of looking for it.

Similarly, there are no placebo studies to support another genuinely held belief: that ECT prevents suicide.

There is nothing wrong with treatments working because of hopes and expectations. But passing 150 volts through brain cells designed for a tiny fraction of one volt causes brain damage. Indeed, autopsies quickly led to a new theory about how ECT works. In a 1941 article entitled ‘Brain damaging therapeutics’, the man who introduced ECT to the USA, wrote ‘Maybe mentally ill patients can think more clearly with less brain in actual operation’.

In 1974 the head of Neuropsychology at Stanford wrote: ‘I’d rather have a small lobotomy than a series of ECT….I know what the brain looks like after a series of shock’.

All ECT recipients experience some difficulties laying down new memories and in recalling past events. What is disputed is how many have long-lasting or permanent memory dysfunction, which might reasonably be called brain damage.

Findings range from one in eight to just over half. A review of studies that actually asked the patients, conducted here at the Institute, found ‘persistent or permanent memory loss’ in 29 to 55%.

Yet another belief is that ECT used to cause brain damage, in the bad old days, but not any more.  But a recent study found one in eight with ‘marked and persistent’ memory loss, …..  and also found much higher rates among the two groups who receive it most often, women and older people.

The same study also found that the memory loss was not related to severity of depression. This is important because another belief about ECT is that the memory loss is caused by the depression, not the electricity.

Psychiatric bodies in the UK and USA recite the belief that only ‘one in 10,000’ will die from having ECT, without producing a single study to support that belief.  Our reviews document large-scale studies with mortality rates between one in 1400 and one in 700, several times higher than the official claims, typically – unsurprisingly - involving cardiovascular failure.

ECT in England has declined, from 50,000 a year in the 1970s to about 2,500. The number of psychiatrists who still believe, despite all the evidence, is dwindling fast.

It may have been understandable for the psychiatrists of the 1940s to believe that ECT worked and was safe. They didn’t know any better.

But if psychiatry wants to be an evidence-based discipline, to be part of modern medicine, it must acknowledge that, despite all its honourable intentions, it has got this one, like lobotomies, woefully wrong.

Thank you.

Links and Further Information

To watch the debate on YouTube, click here.

To read a report on the first ever Maudsley Debate, held in January 2000, which also discussed ECT, click here.

ECT Accreditation Service (ECTAS)

MECTA

The effectiveness of electroconvulsive therapy: A literature review, John Read and Richard Bentall

Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009

This week on MIA Radio, we discuss the UK Royal College of Psychiatrists representation on a Government-led review of Prescribed Drug Dependence. Professor Sami Timimi, a fellow of the Royal College of Psychiatry, and 30 other mental health experts, have formally asked the College to ‘replace Professor David Baldwin as its representative on The Expert Reference Group of Public Health England’s Review of Prescribed Medicines, with an RCPsych member who is not compromised by conflicts of interest with the pharmaceutical industry’.

In this podcast, we hear from Professor Timimi, Psychiatrist Peter Gordon and campaigner Stevie Lewis. Both Peter and Stevie are people who have experienced withdrawal effects from antidepressant drugs.

Conflicts of Interest Questioned in Royal College of Psychiatry’s Participation in Government-Led Mental Health Medication Review

August 17, 2018

From: James Moore, antidepressant withdrawal sufferer, on behalf of the 30 other signatories to today’s letter.  

London, UK – A fellow of the Royal College of Psychiatry, and 30 other mental health experts, have today formally asked the College to ‘replace Professor David Baldwin as its representative on The Expert Reference Group of Public Health England’s Review of Prescribed Medicines, with an RCPsych member who is not compromised by conflicts of interest with the pharmaceutical industry’.

The Public Health England review¹ was set up to examine a growing problem with patients becoming dependent on psychiatric drugs including antidepressants. In the UK, four million people are long-term antidepressant users², with many of those unable to come off their drugs without debilitating and protracted withdrawal symptoms. Signatories to the complaint include 10 people whose withdrawal experiences have lasted between one and ten years, plus 11 psychiatrists and 8 mental health professors.

In the Public Health England (2018) document ‘PMR ERG members declarations of interest’, Prof­essor Baldwin reports having received ‘personal honoraria for lecture engagements organised by AstraZeneca, Bristol-Myers Squibb, Eli Lilly Ltd, Glaxo-SmithKline, Janssen, H. Lundbeck A/S, Pharmacia, Pierre Fabre, Pfizer Ltd, Servier, and Wyeth Ltd’. In addition, he reports attendance at advisory boards of five companies and research funding from twelve.

The signatories are worried that he could be unduly influenced by the large number of pharmaceutical manufacturers he has received income from. This concern is exacerbated by Professor Baldwin’s having already publicly minimised the withdrawal effects of antidepressants (Times 24.2.18), which was described as ‘misleading’ the public in the House of Lords³and led to a formal complaint against him⁴.

Lead author of the letter, psychiatrist Professor Sami Timimi, a fellow of the Royal College, said:

“DESPITE THE INCREASED AWARENESS OF THE PERNICIOUS INFLUENCE OF THE PHARMACEUTICAL INDUSTRY IN ALL SPHERES OF MENTAL HEALTH, THE RCPSYCH DOES NOT APPEAR TROUBLED BY THE POTENTIAL FOR MISLEADING THE MEDICAL COMMUNITY AND THE PUBLIC AND SOILING THE GOOD NAME OF THE PROFESSION OF PSYCHIATRY. WE FEEL THE NEED TO MAKE PUBLIC OUR OPPOSITION TO SOMEONE SO CONNECTED WITH THE PHARMACEUTICAL INDUSTRY BEING THE RCPSYCH’S REPRESENTATIVE ON A PUBLIC BODY APPOINTED WITH THE TASK OF WORKING FOR THE PUBLIC GOOD.”

Another signatory, psychiatrist Dr Peter Gordon said:

“EVIDENCE HAS REPEATEDLY FOUND THAT COMPETING FINANCIAL INTERESTS CAN LEAD TO DOCTORS RECOMMENDING WORSE TREATMENTS FOR PATIENTS⁵. IN THE UK, THE PHARMACEUTICAL INDUSTRY SPENDS OVER £40 MILLION A YEAR ON DOCTORS AND ACADEMICS WHO MARKET AND PROMOTE THEIR PRODUCTS⁶. I HAVE BEEN COMMUNICATING WITH MY COLLEGE FOR MANY YEARS ON THIS, YET IT REMAINS THE CASE THAT THE ROYAL COLLEGE OF PSYCHIATRISTS STILL HAS NO SINGLE, SEARCHABLE REGISTER THAT RECORDS FULL DETAILS OF INDUSTRY PAYMENTS MADE TO ITS MEMBERS. IT IS THEREFORE IMPOSSIBLE TO DETERMINE THE SCALE OF PAYMENTS THAT MAY HAVE BEEN MADE TO COLLEGE MEMBERS WHO ARE INVOLVED IN DEVELOPING POLICIES AND GUIDELINES OR EDUCATING ON THE PRESCRIBING OF PSYCHIATRIC MEDICATIONS.”

Antidepressant withdrawal sufferer James Moore, also a signatory, said:

“THERE ARE MANY PEOPLE OUT THERE LIKE ME, WHO HAVE FOUND THEMSELVES IN SEVERE DIFFICULTY AFTER TRYING TO COME OFF PRESCRIBED ANTIDEPRESSANT DRUGS. IN ORDER TO PROPERLY INVESTIGATE THIS ISSUE, IT IS VITAL THAT THE INFLUENCE OF THE PHARMACEUTICAL MANUFACTURERS IS NOT ALLOWED TO CORRUPT AN EVIDENCE-BASED AND HONEST APPRAISAL OF A PROBLEM POTENTIALLY AFFECTING MILLIONS OF PSYCHIATRIC DRUG USERS.”

References

1. https://www.gov.uk/government/collections/prescribed-medicines-an-evidence-review
2. https://www.theguardian.com/society/2018/aug/10/four-million-people-in-england-are-long-term-users-of-antidepressants
3. http://bit.ly/2BgyzxX
4. https://www.madinamerica.com/2018/07/30-mental-health-experts-write-secretary-state-unprofessional-conduct-uk-royal-college-psychiatry/
5. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000352
6. https://www.bmj.com/content/360/bmj.k1380

© Mad in America 2018

This week on MIA Radio we interview Dr Julia Rucklidge. Dr Rucklidge is professor of clinical psychology at the University of Canterbury in New Zealand and she leads the Mental Health and Nutrition Research Group. Originally from Toronto, Canada, Julia completed her PhD at the University of Calgary followed by a post-doctoral fellowship at the Hospital for Sick Children in Toronto. In the last decade, she and her lab have been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of mental illness, specifically ADHD, mood disorders, anxiety and stress.

Julia has over 100 peer-reviewed publications and book chapters, has been frequently featured in the media and has given invited talks all over the world on her work on nutrition and mental health.

We discuss:

• What led Julia to her interest in nutrition and how it may have a role in responding to mental disorders, particularly Attention Deficit Hyperactivity Disorder (ADHD).
• Why using the Recommended Dietary Allowance (RDA) of vitamins and minerals may not be the best approach when responding to psychological difficulties.
• How Julia went about setting up a Randomised Controlled Trial to investigate the effect of micronutrients and minerals on behavioral problems.
• That the most consistent finding of the study is that the individuals taking micronutrients improved more in their general functioning and impairment when compared to those just taking a placebo.
• That it’s hard to move away from the conception of mental illness as a chemical imbalance in the brain, partly because of the vested interest in keeping it alive.
• That there is no opportunity to patent nutrient therapies, so there is little incentive for research and limited commercial interests.
• Why a single nutrient response might not be the best approach for someone who wanted to use nutrition to improve their mental health and wellbeing.
• How a dietary deficiency of Niacin during the 1930s led to a condition called Pellagra which often manifested as psychotic symptoms.
• What led to the flagging of a 2014 TEDx talk Julia gave entitled “The surprisingly dramatic role of nutrition in mental health”.
• How Julia felt about her talk being flagged by TED.
• How many historical medical advances, now accepted as the standard of care, at the time flew in the face of conventional scientific thinking.
• How difficult it has been to communicate with TED about the flagging of the talk.
• How Julia hears from many people who get in touch to share that they are struggling with psychiatric medications and instead want to look to nutritional solutions.
• That the best advice is often simple, eat more fruits and vegetables and reduce the amount of processed food.

Relevant Links:

Mental Health and Nutrition Research Group

Vitamin-mineral treatment of ADHD in adults: A one year follow up of a randomized controlled trial.

Anxiety and Stress in Children Following an Earthquake: Clinically Beneficial Effects of Treatment with Micronutrients

A double-blind randomised, placebo-controlled trial of a probiotic formulation for the symptoms of depression

TEDx Christchurch: The Surprisingly Dramatic Role of Nutrition in Mental Health

TED Betrays Its Own Brand By Flagging Nutrition Talk

Contact the Mental Health and Nutrition Research Group

Mad Diet by Suzanne Lockhart

This week on MIA Radio, we present a special episode of the podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2018.

In part 2 of the podcast, we interview Mad in America founder, Robert Whitaker. For many of us, Robert needs no introduction as he is well known for his award-winning book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, which was released in 2010.

Robert has been a medical writer at the Albany Times Union newspaper, A journalism fellow at the Massachusetts Institute of Technology and Director of publications at the Harvard Medical School. Besides many papers, journals and articles, Robert has written five books which include Mad In America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill in 2001, Anatomy of an Epidemic in 2010 and Psychiatry Under The Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform published in 2015.

We discuss:

• What took Bob from writing as an industry insider covering clinical trials to founding Mad in America.
• How writing a story about the botched introduction of laparoscopic surgery led to an interest in how commerce was corrupting healthcare.
• How Freedom of Information requests led to an understanding of the corruption in the clinical trials of antipsychotic drugs.
• What led to writing the book Mad in America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill in 2001.
• That, when you look at the science, you see an enduring theme in psychiatry of treatments that are full of promise, but ultimately can lead to harm.
• That Bob came to these issues as a journalist who felt a sense of public duty to be an honest reporter of the facts and the science.
• The extraordinary history behind the revival of the market for benzodiazepines.
• How Valium became the western world’s most prescribed psychiatric drug during the late 1960s.
• How, in the 1970s, it became apparent that people were struggling to get off the drugs.
• That women’s magazines started to write about the experiences of women addicted to Valium, and it was recognised as a bigger issue than heroin addiction.
• That the reaction by the pharmaceutical manufacturers was to reconceptualize anxiety-related distress as depressive distress and move patients on to SSRIs.
• How in 1980, in the third version of the Diagnostic and Statistical Manual, a new disorder is named: Panic Disorder, leading the maker of Alprazolam, Upjohn, to get it approved specifically for the treatment of panic disorder.
• How the study published showed that the reduction in panic attacks in the medicated group over four weeks was greater than the unmedicated group, but the study actually ran for eight weeks, by which time there was no difference between the medicated and unmedicated groups.
• That in the six-week withdrawal phase of the study, 44% were not able to stop the drugs.
• How newspapers reported that Xanax (Alprazolam) was an efficacious, safe and non-addictive treatment for panic disorder.
• That what you see in the heart of the Xanax story is a betrayal of the public.
• The reasons why doctors often don’t review the papers that would lead them to conclude that benzodiazepines are highly problematic drugs.
• A paper from a new International Task Force on Benzodiazepines which seems to be a statement of intent to increase benzodiazepine prescribing.
• That people should keep on telling their stories of withdrawal and iatrogenic harm.
• The attempt in Massachusetts to pass a bill requiring informed consent.
• The problems inherent in using the language of withdrawal when the symptoms are protracted and that it would be more appropriate to describe this as a neurological injury.
• That the benzodiazepine community is doing an incredible service by alerting the public to what should be seen as a public health crisis.

Relevant links:

Revival of the market for Benzodiazepines

Malcolm Lader: It is more difficult to withdraw people from benzodiazepines than it is from heroin

International Task Force on Benzodiazepines

This week on MIA Radio, we present a special episode of the podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2018.

In part 1, we chat with W-BAD Lead Operations Volunteer and Virginia Representative Nicole Lamberson who talks about the events being held for W-BAD. We hear from psychiatrist Dr Josef Witt-Doerring, who talks about a recent paper he co-authored entitled “Online Communities for Drug Withdrawal: What Can We Learn?”. We also hear from therapist and campaigner Chris Paige who discusses his own experiences taking and withdrawing from benzodiazepines. Finally, in part 2 of the interview, we get to chat with Robert Whitaker, science journalist and author of the books Mad in America and Anatomy of an Epidemic.

First, I am very fortunate to have had the chance to talk with Nicole Lamberson. Nicole is Lead Operations Volunteer and Virginia Representative for W-BAD and she has kindly taken time out of her busy preparations to talk about how she became involved with W-BAD, some of the events and campaigns being held around the world and how people can get involved.

Nicole has an immense passion for benzodiazepine awareness and its victims and hopes that her efforts ultimately spare many others from taking this painful, senseless, and totally preventable iatrogenic “journey”.

We discuss:

• How Nicole first became involved with W-BAD.
• How discovering personal testimonies encouraged her to reach out to find out more about an awareness day held on the birthday of Dr Heather Ashton - July 11.
• What it feels like to be part of the benzodiazepine community.
• How there is is still no medical consensus about the effects of both taking and withdrawing from benzodiazepines.
• The W-BAD T-shirt campaign, which was organised in partnership with the Benzodiazepine Information Coalition and As Prescribed, an in-production documentary by Holly Hardman.
• Pamphlet distributions happening in Auckland, Paris, Boston and Torrington.
• That Wayne Douglas, W-BAD founder is on the Dr Peter Breggin hour on July 11 at 4pm New York time.
• That people can visit W-BAD events to find out more.
• That on social media, people can follow events using @WorldBenzoDay and the hashtag #WorldBenzoDay.
• That people can participate in many ways and that one of the most important ways to participate is to submit reports of adverse effects and withdrawal reactions to the appropriate regulator, links to which can be found on the W-BAD website.
• How important it is to share stories and personal experiences.
• That W-BAD is for anybody, not just those who are damaged by the drugs but also for families and friends and those recovered too.

Relevant links:

W-BAD

[IN]VISIBLE T-shirt campaign

How to participate in W-BAD

Benzodiazepine Information Coalition

As Prescribed by Holly Hardman (documentary film in production)

International Task Force on Benzodiazepines

Dr Heather Ashton

The 2017 W-BAD podcast featuring Professor Malcolm Lader, Jocelyn Pedersen and Barry Haslam.

Next, we chat with psychiatrist Dr Josef Witt-Doerring. Josef trained in Queensland, Australia before becoming a psychiatric resident at Baylor College of Medicine, Houston, Texas. He co-authored a paper published in Psychiatric Times entitled “Online Communities for Drug Withdrawal: What Can We Learn?” which received praise for openly addressing the issues of dependence and withdrawal and identifying the support activity that goes on in forums like Benzo Buddies and Surviving Antidepressants.

We discuss:

• What led Dr Witt-Doerring to become a psychiatric trainee after attending medical school in Queensland, Australia.
• How reading Anatomy of an Epidemic led to an awareness of some of the consequences of psychiatric drug use from a critical perspective.
• What led to his research into online support forums for those who are seeking support for psychiatric drug withdrawal.
• That Josef was surprised at the amount of support activity in online forums like Benzo Buddies and Surviving Antidepressants.
• How the paper that Josef co-authored on learning from online communities found a great deal of support both amongst colleagues and patient advocacy organisations.
• How he feels that there is a general lack of awareness of dependence and withdrawal issues because the messages can be drowned out by more strident communications in marketing or promotional material.
• That the idea of ‘treatment resistant’ conditions is probably much more on a general doctors mind than adverse reactions or protracted withdrawal experiences.
• How Josef’s experiences have influenced his approach to prescribing central nervous system drugs.
• That he would like to think that if a doctor and patient can talk frankly and openly about the pros and cons of treatment, then that is likely to lead to a better relationship and a better outcome.
• That there is a dearth of support services for people struggling with the drugs, particularly at the end of treatment.
• How academic detailing programmes could help raise awareness and disseminate information that would lead to doctors being more confident about de-prescribing.
• How the language of addiction and dependence can sometimes be a barrier to recognition of drug withdrawal issues.
• That it may be better to look through a neurological injury lens rather than an addiction lens both in terms of understanding experiences but also to enable better treatment and support options.
• That the community of those affected should continue to share their stories and to raise petitions with professional organisations, such as the boards that licence psychiatrists and OBGYN’s.
• How, because of the huge variation in patient experience, it would be very difficult to mandate short-term prescribing.

Relevant links:

Online Communities for Drug Withdrawal: What Can We Learn?

Benzo Buddies

Benzodiazepine Information Coalition

Surviving Antidepressants

Malcolm Lader: Anxiety or depression during withdrawal of hypnotic treatments

Our next guest is Chris Paige. Chris has a bit of an 'inside' perspective to add to the conversation for World Benzodiazepine Awareness Day in that he is a licensed therapist of over 20 years who was iatrogenically injured by a prescribed benzodiazepine. Chris has practised in a variety of settings including hospitals, schools, and foster homes and has taught at the undergraduate and graduate level.

He has presented papers at national and international conferences, appeared on Dateline NBC for his work with children of divorce and had his own national magazine column called 'On The Couch with Chris Paige'. Chris is on the board the Benzodiazepine Information Coalition, a non-profit organization that advocates for greater understanding of the potentially devastating effects of commonly prescribed benzodiazepines as well as prevention of patient injury through medical recognition, informed consent, and education. Chris currently resides and practices in Florida.

We discuss:

• How Chris first came to be prescribed a benzodiazepine in 2000.
• His recollections of being prescribed Klonopin (Clonazepam) for anxiety, taking between 1 and 2 milligrams per day.
• How, after three years use, he started to notice tremors and memory loss.
• That a neurologist explained that his symptoms may be medication related and advised a taper but gave no specific instructions.
• How Chris came off the Klonopin fairly rapidly but didn’t find it too difficult at the time.
• How, some years later, he was given an antibiotic for a prostate infection but rapidly developed psychiatric symptoms including anxiety, agitation and insomnia.
• That this led Chris to consult a doctor for some Klonopin tablets to manage this and that he took a total of 16 milligrams over the next 10 weeks.
• That he understands now that the antibiotic and the Klonopin compete at the same receptor in the brain, leading immediately to a tolerance to the drug.
• That because of this tolerance he became more sleepless, more agitated and more anxious and working was becoming increasingly difficult.
• How he came to be in a five-day detox programme in Vermont, where they took him off one and a quarter milligrams of Klonopin in just five days.
• How Chris realised that the detox approach was not right and wanted to leave.
• How the detox programme decided to replace the Klonopin with four different psychiatric drugs, two of which he has now ceased with two still to taper.
• That he felt that his brain and nervous system were severely shocked by making such rapid medication changes.
• How this led to Chris being admitted to psychiatric hospital which he describes as “possibly one of the most humiliating experiences he has ever endured.”
• How Chris felt when experiencing akathisia which was a relentless compulsion to move and gave him a feeling as if his whole body was being electrocuted and that he had been lit on fire.
• That he initially felt supported by friends and family but that quickly eroded when he didn't get better or accept harmful and dangerous treatment advice.
• That this led to the misunderstanding of his injury and it being mislabeled as an addiction problem.
• That ultimately the only places he found validation and support were online support forums.
• The losses that Chris endured during his struggles including his health, his psychotherapy practice and even his reputation.
• That Chris’s message is that there is hope for the future and the importance of reconnecting with the simple things in life.
• The lack of acknowledgement of the impact of trauma on a person’s life.

Relevant links:

Benzodiazepine Information Coalition

Chris's profile at BIC

In part 2 of this podcast, we will hear from science journalist and author Robert Whitaker.

On MIA Radio this week, Akansha Vaswani and Dr Peter Groot discuss Tapering Strips, a novel and practical solution for those who wish to taper gradually from a range of prescription drugs.

Akansha is a doctoral candidate at the University of Massachusetts, Boston and her dissertation research will involve interviewing psychiatrists in the US about their experiences helping people stop or reduce their dose of antidepressant medication. Dr Groot is a researcher and geneticist who has led the development of Tapering Strips.

In a recent study, published in the journal Psychosis, Dr Groot, together with Jim van Os, reported on the results of their trial which recorded the experiences of people using Tapering Strips.

In this episode we discuss:

• What motivated Peter to be interested in and study the effects of coming off antidepressants drugs.
• That the observational study reported in Psychosis was based on questionnaires completed by users who had made use of tapering medication (Tapering Strips) to slowly reduce their medication dosage.
• How the questionnaire asked about withdrawal symptoms and the ease of tapering using the strips and whether people had tried to withdraw previously using conventional methods.
• That Tapering Strips offer a flexible and necessary addition to standard doses that have been registered by the pharmaceutical companies.
• That current guidelines advise doctors to let patients start on the same recommended dose of an antidepressant, without taking into account large differences that exist between patients (weight, sex, etc).
• How we would be surprised if, when we came to buy shoes or clothes, our choices were limited to only a few sizes, but we don’t question this limitation with our medications.
• How current guidelines are based on group averages and do not help a doctor to determine how a given individual patient should taper.
• How shared decision making, in which the patient and the doctor work in a collaborative way, can make tapering easier.
• How shared decision making has contributed to the success of the use of tapering medication and the availability of tapering medication makes shared decision making practically possible.
• How shared decision and the availability of tapering medication makes life easier for the doctor as well as for the patient.
• How working initially as a volunteer to develop Tapering Strips brought Peter into contact with Professor Jim van Os and the User Research Centre of Maastricht University.
• That, in the study, 1,750 questionnaires were sent, with 1,164 received, a response rate of 68%.
• Of those returned, 895 said their goal was to taper their antidepressant drug completely and 70% succeeded in this goal.
• That the median time taken for people in the study to withdraw from Venlafaxine was 56 days or two Tapering Strips.
• There were a variety of reasons reported for those who didn’t reach their goal, including the fact that some of the patients were still tapering.
• Other reasons reported for not withdrawing completely were due to the occurrence of withdrawal symptoms, relapse of an original condition or even issues related to reimbursement of the cost of the tapering medication by insurance companies.
• That 692 patients reported that previous attempts to withdraw had failed in comparison to the successful use of Tapering Strips.
• That people using multiple drugs should only ever taper one medication at a time and in discussion with a medical professional.
• That Peter’s goal for Tapering Strips is to make sure that people that want to withdrawal gradually can access Tapering Strips and have the cost reimbursed by health insurers.
• That Tapering Strips were not developed to get everyone off their antidepressant drug but to enable patients to get to a dosage that provides benefit for them (which can be zero) while minimising adverse effects.
• That people outside the Netherlands can get Tapering Medication, but only with a prescription signed by a certified doctor, instructions and receipt/order forms can be found at taperingstrip.org.
• That Tapering Strips are also available for antipsychotics, sedatives (benzodiazepines), analgesics and for some drugs other than psychotropics, like some anti-epileptic drugs, which are currently being developed.
• That Peter warns against tapering by taking doses on alternating days, particularly for drugs like paroxetine or venlafaxine that have a short metabolic half-life, because this will lead to more severe withdrawal symptoms.

Relevant Links:

Tapering Strips (website of the User Research Centre of Maastricht University)

Treatment guidelines for the use of tapering strips

Summary of the tapering study in the journal Psychosis (blog)

Tapering Strips study from the journal Psychosis

Peter Groot interviewed on Let's Talk Withdrawal

Claire shares her experience with Tapering Strips (YouTube)

Petition requesting use of Tapering Strips in the UK

Mad in America report on Tapering strips study

Prime Time for Shared Decision Making

Mandatory Shared Decision Making

© Mad in America 2018

This week on MIA Radio we provide an update on a complaint made to the UK Royal College of Psychiatrists by a group of thirty academics, psychiatrists and people with lived experience. We hear from both Professor Sami Timimi and Professor John Read who discuss recent events including the latest response from the Chief Executive Officer of the College.

Relevant Links:

Read the latest update on Mad in America

Formal Complaint to the UK Royal College of Psychiatrists

Royal College Of Psychiatrists Challenged Over Potentially Burying Inconvenient Antidepressant Data

Professor John Read: The Royal College of Psychiatrists and Antidepressant Withdrawal

UK Royal College Dismisses Complaint

© Mad in America 2018

This week, we interview Dr Peter Gordon. Dr Gordon describes himself as a gardener with an interest in medicine. He trained in both medicine and landscape architecture before specialising in psychiatry and now works with older adults in Scotland. In addition, he is an activist and campaigner and has a range of creative interests including filmmaking, photography, writing and poetry.

In this interview, we walk about Peter’s own experiences of psychiatric treatment and how we need to address the divide that exists between the arts and the medical sciences.

In this episode we discuss:

• What led Dr Gordon to have combined interests in the arts and the sciences, training both in architecture and medicine.
• How Peter was interested in the plurality of thinking required for psychiatry as opposed to general medicine.
• How he feels that his training in both the arts and the sciences led to a more rounded appreciation of why purely biological approach might miss opportunities to help people.
• How Peter became an activist, partly in response to the commonly taught subjective/objective diagnostic approach.
• How we should be focussed on the potential of any medical intervention to cause harm and should consider this carefully alongside any potential benefit.
• How we need to take account of all experiences to ensure we provide the maximum benefit and minimum harm to people.
• Peter’s own experiences with the mental health system, taking antidepressant drugs and experiencing treatment within a psychiatric hospital.
• How stopping his antidepressant drug resulted in withdrawal effects and led to Peter’s only episode of severe depression.
• Why Peter is concerned that we seem to be downplaying the experiences of people who have struggled with psychiatric drugs.
• How Peter’s experiences have influenced his approach to prescribing.
• The dominance of the biological approach and why it should not dictate how we respond to individual experiences.
• How the evidence is starting to show that diagnosis can often disempower and bring about ‘otherness’.
• Peter’s plea for people to be kind to one another and work together to maximise well-being.

Relevant links:

Peter’s blog: Hole Ouisa

The caption is wrong

Paroxetine tablets [Film-coated]

Peter’s films on Vimeo

Mary Midgley

Nathan Filer, The Shock of the Fall

Raymond Tallis

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week on MIA Radio we interview Sera Davidow, a psychiatric survivor and prolific activist for the human rights of people labeled mentally ill. Sera serves as the Director of the Western Massachusetts Recovery Learning Community and is a founding member of the Hearing Voices USA Board of Directors.

Through her work, she has gained a range of experiences including starting up a peer respite, opening resource centers, and producing educational materials on non-coercive, non-pathologizing alternatives to the traditional mental health system. Sera is a regular blogger for Mad in America and has written extensively on the topics of forced treatment and sexual violence.

In this interview, we discuss the parallels and intersections between coercive psychiatric care and sexual assault.

In this episode we discuss:

• Sera’s lived experience as a psychiatric survivor and survivor of sexual violence.
• The similarities between sexual violence and forms of psychiatric abuse including forced drugging, forced intubation, forced catheterization, strip searches, restraint, and containment
• How even seemingly minor or routine parts of psychiatric hospitalization, such as regularly monitoring patients, can be violating
• The role that victim-blaming and gaslighting play in both sexual violence and psychiatric coercion
• That the language and terminology of the mental health system such as “mental illness,” “noncompliance,” and “anosognosia” serve to perpetuate violence
• That people’s discomfort with big emotions and taboo topics often prevent trauma survivors from speaking about their experiences within psychiatric settings
• How we can help providers and the general public understand the trauma and violence of psychiatric coercion

Relevant Links:

Sera Davidow

A World That Would Have Us Doubt: Rape, the System, and Swim Fans

Us, Too: Sexual Violence Against People Labeled Mentally Ill

Feminism 101: What is Gaslighting?

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week, we interview Laura Delano. Laura is Co-Founder and Executive Director of the Inner Compass Initiative and The Withdrawal Project, which aim to create safe spaces for people to connect and the opportunity to learn about and be guided through the process of getting beyond the mental health system and off psychiatric drugs. 

The passion she feels for the mission and vision of ICI arises from the fourteen years she spent lost in the mental health system and the journey that she’s been on since 2010, when she chose to leave behind a “mentally ill” identity and the various treatments that came with it, and gradually began to rediscover and reconnect with who she really was and what it means to suffer, struggle, and be human in this world. 

Since becoming an “ex-patient”, Laura has been writing and speaking about her personal experiences and about the broader social and political issues sitting at the heart of “mental illness” and “mental health”. Since 2011, she has worked both within and beyond the mental health system. In the Boston area, she worked for nearly two years for a large community mental health organization, providing support to and advocating for the rights of individuals in emergency rooms, psychiatric hospitals, and institutional “group home” settings. After leaving the “inside” of the mental health system, she began consulting with individuals and families seeking help during the psychiatric drug withdrawal process. Laura has also given talks and workshops in Europe and across North America, facilitated mutual-aid groups for people in withdrawal, and organized various conferences and public events such as the Mad in America International Film Festival. 

In this interview, we got time to talk about Laura’s personal experiences of the mental health system and what led her to co-found the Inner Compass Initiative and The Withdrawal Project.

In this episode we discuss:

• Laura’s experiences as a patient in the mental health system, starting treatment aged thirteen and leaving the system behind aged 27.
• How she spent much of that time as a compliant patient, taking the medications and following the advice of her doctors.
• That, by 2010, she was on 5 medications (Lithium, Abilify, Lamictal, Effexor and Ativan) and had spent the last decade becoming worse and unable to properly engage with life.
• How she came to read Anatomy of an Epidemic by Robert Whitaker and that it was a profound moment of realisation.
• That Laura decided to take control of her life and became determined to get off the drugs as quickly as possible.
• How traumatic it was to come to the realisation that almost everything she had been told during treatment was overly simplistic or incorrect.
• That Laura did experience feelings of being a victim of psychiatry, but realised that this increased her emotional dependency on psychiatry and that it was necessary to move beyond that to feel free.
• That these experiences made Laura passionate about her own process of healing and rediscovering herself and helping others to find their way back to themselves after being psychiatrized.
• That as she healed she moved into a space of acceptance and gratitude and felt that the period around three years off the drugs was when she came to feel really alive and motivated again.
• That Laura feels that if we are going to move beyond the mental health system, it is about helping people to realise they don't need the mainstream system and point them to alternatives at a local level and creating physical spaces where people can come together.
• How Laura came to co-found The Inner Compass Initiative and The Withdrawal Project which aim to create safe spaces for people to connect and the opportunity to learn about and be guided through the process of getting beyond the mental health system and off psychiatric drugs.
• That The Withdrawal Project was highlighted in a recent New York Times article discussing antidepressant withdrawal.
• How ICI and TWP present information on many aspects of psychiatric drugs and withdrawal to help guide and inform people who do want to start the journey off their psychiatric drugs and away from the mental health system.
• That TWP connect is a free peer to peer networking platform that allows people to connect one on one with others who have similar experiences.
• How a similar peer to peer system is available on ICI to enable conversations about moving beyond the mental health system.
• That Laura wants to encourage people not to give up because we do heal from psychiatric drugs and that we need to spread that message far and wide.
• The need to both learn and unlearn when approaching how we take back our power and control of our lives after psychiatric treatment.
• How important it is to properly prepare before starting to taper from psychiatric drugs and how the Withdrawal Project can enable that preparation.
• The ‘speed paradox’ when coming off psychiatric drugs.
• How people can find out more about The Inner Compass Initiative and The Withdrawal Project.
• That Laura is keen to support local community initiatives to get underway.

Relevant links:

The Inner Compass Initiative

The Withdrawal Project

TWP Connect

Learn about psychiatric drug withdrawal

Inner Compass Initiative’s The Withdrawal Project Gets Mention in The New York Times—Is the Tide Finally Turning?

The New York Times - Many People Taking Antidepressants Discover They Cannot Quit

Read more about Laura’s journey into and out of the mental health system

Laura’s presentation in Alaska, 2015

Anatomy of an epidemic by Robert Whitaker

Today on MIA Radio we have a special episode which is devoted to recent developments in the UK involving a formal complaint lodged with the UK Royal College of Psychiatrists. 

Professor John Read from the University of East London took time out to bring us up to date on the response to the complaint which was lodged on behalf of a group of thirty academics, psychiatrists and people with lived experience.

Relevant links:

Read the full reply letter on Mad in America

Hear the Royal Society of Medicine’s podcast interview with Professor Wessely and Dr Clare Gerada

The New York Times - Many People Taking Antidepressants Discover They Cannot Quit

This week on MIA Radio, we interview Jeffrey Michael Friedman, a clinical social worker and an activist in the psychiatric survivor's movement. Jeffrey provides trauma-informed therapy to victims of various forms of abuse and violence, including those who have survived abuses within the mental health system.

In addition to his work in the mental health field, Jeffrey is actively involved in the harm reduction movement, which supports human rights and non-coercive services for people who actively use drugs.

In this interview, we discuss why forced psychiatric treatment is a form of trauma and its impact on victims and their families.

In this episode we discuss:

• How Jeffrey’s early experience with the alternative school system led to being othered and ostracized, which influenced his later involvement with the psychiatric survivor's movement.
• How the trauma-informed perspective offers an alternative framework to the traditional medical model of mental health.
• Why forced psychiatric treatment meets the definition of trauma, and more specifically, betrayal trauma.
• The psychological effects of involuntary commitment forced drugging and outpatient commitment.
• That forced treatment reinforces the notion that distress or crisis results from individual pathology rather than familial mistreatment or trauma.
• That victims of forced treatment may be less likely to seek medical care for physical health issues or receive proper medical treatment.
• How survivors can heal from forced treatment.
• The parallels between the harm reduction movement and the psychiatric survivor's movement, and similarities between safe consumption sites and peer services.
• That the addiction treatment industry, including 12-step programs, can be coercive in similar ways to the mental health system.

Relevant Links:

Jeffrey Michael Friedman, LCSW

What is a Betrayal Trauma? What is Betrayal Trauma Theory?

The Power Thinker– a brief description of Michel Foucault’s work on power and surveillance.

Altruism Born of Suffering

Principles of Harm Reduction

Thomas Szasz: The Right to Take Drugs

The Legal Industry for Kidnapping Teens – a description of the physically forceful transportation services that are sometimes utilized to transport teenagers to addiction treatment.

Jeffrey Michael Friedman on SoundCloud

Jeffrey can be followed on Twitter: @jmfriedman and Instagram: traumainformedpodcast

Mad In America's Psychiatric Drug Withdrawal course

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week, we interview Dr Russell Razzaque. Dr Razzaque currently works as a consultant psychiatrist and associate medical director in east London and, together with colleagues, he is leading a pioneering multi-centre Open Dialogue pilot in the UK National Health Service.

In 2014 he released his book ‘Breaking Down Is Waking Up’ in which he explores alternative views of mental distress, their relationship to consciousness and comparisons to forms of spiritual awakening.

In this interview, we discuss the relationships between mindfulness, Acceptance and Commitment Therapy and Open Dialogue and how the UK NHS is approaching the worlds first randomised controlled trial of Open Dialogue interventions for people struggling with emotional or psychological distress.

In this episode we discuss:

• What led Dr. Razzaque to his interest in psychiatry and in particular some of the more unconventional aspects of the profession.
• How beginning to practice mindfulness nearly 20 years ago led to Russell starting to feel an incongruence between the dominant philosophy in psychiatry and what he was learning from his own mindfulness practices.
• That the dominant philosophy is one of trying to help people remove their pain and remove them from difficult and uncomfortable experiences, but in his own personal development, he was learning to sit with the pain and finding that valuable.
• How this led to an interest in novel therapeutic approaches like Acceptance and Commitment Therapy, originally pioneered by professor Stephen Hayes.
• That Russell felt disillusioned with the way that UK mental health services and systems were organised and realised that creating better outcomes for people would require system-wide change.
• How Russell came to be one of the leading figures in the worlds first multi-centre, fully randomised Open Dialogue Trial which seeks to establish the evidence base for Open Dialogue.
• That the trial involves eight NHS Trusts across the UK and that several hundred practitioners have already been trained in Open Dialogue therapy.
• That during the trial there will be randomly selected postcodes receiving Open Dialogue interventions compared with randomly selected postcodes receiving treatment as usual and that the results will be compared after three years.
• That this trial will allow us to answer questions about the efficacy of Open Dialogue because we will have built a strong evidence base.
• How colleagues have reacted to the Open Dialogue trial and why some might be threatened by the need to change.
• That Open Dialogue is a need adapted approach, so it is not fundamentally against any of the conventional interventions, but it encourages people to make their own choices, so medication use tends to significantly reduce.
• That it is necessary to change the power dynamic in current systems and approaches because the current methods lead to dependency, whereas Open Dialogue is about empowering and liberating the individual.
• That Russell is encouraged to find that many psychiatrists are willing to open up to new ways of thinking about mental and emotional distress.
• How spirituality and psychiatry can work hand-in-hand and how accepting spiritual explanations can sometimes lead to better understanding of personal experiences.
• That, in future, the system needs to change such that interpersonal relationships are put first and are seen as the key to successful outcomes.
• That we also need to adapt so that clinicians are trained to be present with distress and not just try to remove it. 
• How people can hear Russell speak at the upcoming Compassionate Mental Heath event in South Wales, being held on April 25^th and 26^th 2018.

Relevant links:

Russell Razzaque

Breaking Down is Waking Up

Open Dialogue trial

Developing Open Dialogue

Compassionate Mental Health

This week on MIA Radio we interview Dr. Duncan Double. Duncan is a Consultant Psychiatrist at the Norfolk and Suffolk NHS Foundation Trust. He is founder of the Critical Psychiatry Network and also runs a critical psychiatry blog. He edited the book Critical psychiatry: The limits of madness published in 2006 and has written a number of journal articles and book chapters.

We talk about Duncan’s experiences as a critical psychiatrist working within a bio-medically oriented profession.

In this interview we discuss:

• How reading Freud as a teenager led Duncan to his interest in psychiatry.
• That, early in his training, he found it difficult to take to the overly physicalist aspects of what he was expected to learn.
• How he became interested in the work of RD Laing and Thomas Szsaz.
• How he left his studies for a time, working with drug users in London, studying for a psychology degree and working in banking.
• The formation of the Critical Psychiatry Network in January 1999.
• How critical psychiatrists take a different perspective from mainstream psychiatrists who tend to believe that mental illness is a brain disease.
• That critical psychiatrists are not so interested in arriving at a single word diagnosis, instead the focus is on understanding the person and why they have presented with the problems they have in the context of their life situation.
• That critical psychiatrists aim to minimise the use of coercion and have been against the introduction of community treatment orders.
• That the emphasis in treatment is on helping people improve their social situation and to be as independent as they want to be.
• How Duncan felt about a period of suspension which arose partly because of his different practices, being less concerned about formal diagnosis and using less medication than other psychiatrists.
• That critical psychiatry is still looking for more acceptance from the mainstream.
• That Duncan welcomes the more recent emphasis on recovery in mental health services.
• That Duncan does use medication but is very aware that the evidence for psychiatric treatment is biased for methodological reasons, for example, the difficulties having properly blinded placebo-controlled trials.
• That good science is often being sceptical about the evidence.
• That people can form attachments to their medication, so it is not surprising that people may become dependent on it and therefore may have discontinuation problems.
• Duncan’s critical psychiatry blog which he would like to invite readers to visit and that he would like to develop an Institute of Critical Psychiatry.

Relevant Links:

Critical Psychiatry Blog

Critical Psychiatry Website

The Critical Psychiatry Network

Critical Psychiatry: The limits of madness (2006)

My tutor said to me, this talk is dangerous

What is Critical Psychiatry?

This week on MIA Radio, we interview Tina Minkowitz. Tina is an attorney and survivor of psychiatry who represented the World Network for Users and Survivors of Psychiatry in the drafting and negotiation of the United Nations’ Convention on the Rights of Persons with Disabilities. Tina is a strong proponent for the abolition of all forced psychiatric interventions and played a major role in attaining a shift in international law in favor of such a ban.

In this interview, we talk about how the United Nations came to support the abolition of forced psychiatric treatment and why Tina believes that abolition of forced treatment, not reform, is necessary.

In this episode we discuss:

• How Tina came to be interested in the intersection of international human rights law, disability rights law, and the issue of forced psychiatric treatment
• Why Tina believes in the abolition, not reform, of forced psychiatric treatment
• That the threat of forced treatment against some psychiatric survivors can be traumatic to the entire survivor community
• The barriers to the abolition of forced treatment, including public perceptions of people labeled mentally ill and lack of awareness of non-coercive alternatives
• That advocacy is needed to eliminate the 72-hour hold, not just ECT, forced drugging, or outpatient commitment
• Why forced treatment constitutes physical violence
• That we don’t need to put in place alternatives to the current mental health system in order to demand an immediate stop to forced treatment
• How mental health policy should center what we now consider alternative practices, such as peer-run services, hearing voices groups, and in-home supports
• How the issue of forced treatment fits within the disability rights framework
• Tina’s current activities with the Center for the Human Rights of Users and Survivors of Psychiatry

Relevant Links:

The Center for the Human Rights of Users and Survivors of Psychiatry

Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment

CRPD Course

Committee on the Rights of Persons with Disabilities

Convention on the Rights of Persons with Disabilities

Today on MIA Radio we have a special episode which is devoted to recent developments in the UK involving the Royal College of Psychiatrists. These events relate to the media coverage of a widely reported antidepressant meta-analysis in the Lancet, information on antidepressant withdrawal effects and a letter to The Times newspaper by the President of the Royal College Professor Wendy Burn and the Chair of the Royal College’s Psychopharmacology Committee, Professor David Baldwin.

Professor John Read from the University of East London took time out to explain recent events and to talk about a formal complaint which has been lodged with the Royal College on behalf of a group of eminent psychiatrists and psychologists.

Relevant links:

Read the letter on Mad in America

Press Release by the Council for Evidence-Based Psychiatry

The Times: More People Should Get Pills to Beat Depression

The Royal College’s leaflet on Antidepressant Withdrawal

This week, we interview Dr Lucy Johnstone. Lucy is a clinical psychologist, trainer, speaker and writer, and a long-standing critic of the biomedical model of psychiatry. She has worked in adult mental health settings for many years, alternating with academic posts.

 Lucy has authored a number of books, including 'Users and Abusers of Psychiatry’(Routledge 2000), and ‘A Straight-talking Introduction to Psychiatric Diagnosis’ (PCCS Books 2014) as well as a number of articles and chapters on topics such as psychiatric diagnosis, formulation and the role of trauma in breakdown. She has a blog on Mad in America.

 Lucy kindly took time out talk to me about the new Power Threat Meaning Framework, an ambitious attempt to outline a conceptual alternative to psychiatric diagnosis which was published on January 12th this year by the Division of Clinical Psychology of the British Psychological Society.

In this episode we discuss:

• Lucy’s background and what led her to be interested in mental health work, particularly in terms of being critical of current practice.
• The importance of acknowledging the reality of people’s experiences of distress along with questioning the dominant explanations for that distress.
• The fact that the diagnostic model has never been supported by evidence.
• How imposing a diagnosis often can be very damaging to people, by turning ‘people with problems’ into ‘patients with illnesses.’
• Why we need to move towards the survivor slogan of “Instead of asking “What is wrong with you?” ask “What has happened to you?”’
• The inception of the Power Threat Meaning Framework, which was funded by the Division of Clinical Psychology of the British Psychological Society, and the five-year journey to its release earlier this year.
• The composition of the core project team: Lucy, Mary Boyle, John Cromby, Jacqui Dillon, John Read, Peter Kinderman, Eleanor Longden, Dave Harper, Dave Pilgrim and a research assistant Kate Allsopp. The core team consists of psychologists and survivors/campaigners, many of whom are well known to MIA readers. Also involved were a consultancy group of service users/carers; a group of critical readers with a particular focus on diversity; and a number of others who contributed to particular sections or supplied good practice examples.
• How the Framework itself is not an official DCP or BPS position or policy document, nor is it a plan for services or for any other specific form of implementation. Rather, it is offered as a co-produced academic and conceptual resource to anyone who wishes to take on these ideas and principles and develop them further or translate them into practice.
• The Framework is necessarily dense because of its aim to move right away from the “DSM/ICD mindset” which is deeply rooted in Western culture. However, there are various accessible summaries of its core principles (see below.)
• How we already have a number of ways of supporting someone non-diagnostically, but what we didn't have before was a sound, evidence-based alternative to what diagnosis claims, but fails to do, which is to outline patterns in distress.
• How the Framework acknowledges the irreducible complexity of a person’s responses to their circumstances.
• The derivation of the title: The Power Threat Meaning Framework.
• The four main questions, which are:
  • What has happened to you? Translated as “How is Power operating in your life?”
  • How did it affect you? Translated as “What kinds of Threats does this pose?”
  • What sense did you make of it? Translated as “What is the Meaning of these situations and experiences to you?”
  • What did you have to do to survive? Translated as “What kinds of Threat Response are you using?”
  • Finally “What are your strengths?” or “What access to Power resources do you have?” and to pull it all together, “What is your story?”
• These are not separate questions, since each of them implies and arises out of the others.
• That the aim is for people to be able to use these ideas and questions for themselves, not necessarily through an interaction with a professional.
• How the PTM Framework does not recognise a separate group of people who are ‘mentally ill’ but describes how we are all subject to, and affected by, the negative impact of power in some aspects of our lives.
• How it is particularly important to recognise the role of ideological power, or power over language, meaning and agendas.
• How the PTM Framework includes the concept of formulation, which is a semi-structured way of putting together someone’s story, but is much wider in scope and for that reason uses the preferred term “narrative” – which may be individual, group or community.
• How diagnosis often obscures someone's story, and how the Framework aims to help create narratives that restore the links between personal distress and social injustice.
• What the PTM Framework says about DSM and ICD attitudes to conceptualisations of distress in non-Western cultures.
• That since we are meaning-making creatures, at a very basic level the principles of power, threat, meaning and threat response apply across time and across cultures, although all expressions and experiences of distress are culturally-shaped.
• The regrettable exporting of Western psychiatric models across the world.
• How the Framework does not exclude or deny the role of biology, but integrates it as a mediator and enabler of all human experience, although not something that is always accurate or helpful to view as a primary cause.
• The reaction to the Framework, both positive and negative. The team very much welcomes feedback, much of which has been very helpful. Some of the more extreme reactions can be understood as predictable responses to the threat posed by the Framework to ideological power.
• How the reaction outside social media has been overwhelmingly positive.
• Emphasising again that the Framework is (unlike diagnosis) presented as a completely optional set of ideas, and a work in progress. The project team is very pleased that there is such widespread interest in taking these ideas forward in people’s own lives and settings.
• People are encouraged to explore these ideas for themselves via the links below. More resources will be added in due course.

Relevant links:

PTM Framework Introduction and Frequently Asked Questions

The above link will take you to the following:

Power Threat Meaning Framework Main document

Power Threat Meaning Framework Overview

PTM Framework Guided Discussion for applying these ideas to your own life or someone you are working with

Presentation slides from the PTM Framework launch

The Power Threat Meaning Framework 2 page summary

You may also be interested in these articles and blogs on the Framework:

Publication of the Power Threat Meaning Framework: Mad in America blog

A mental health nurse’s first response to the launch of the Power Threat Meaning Framework

My mother took her own life – and now I know a different mental health approach could have saved her

An Alternative to Psychiatric Diagnosis?

The PTM Framework, where do we go from here?

I’ve Been Waiting for this Since I Was a Child

The Power Threat Meaning Framework: a radically different perspective on mental health

Lucy’s interview on Let’s Talk Withdrawal can be found here:

Lucy’s interview on Let’s Talk Withdrawal (April 2017)

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week, we interview Dr Joanna Moncrieff. Dr Moncrieff is a psychiatrist, academic and author. She has an interest in the history, philosophy and politics of psychiatry, and particularly in the use, misuse and misrepresentation of psychiatric drugs. As an author, Dr Moncrieff has written extensively on psychiatric drugs and her books include The Myth of the Chemical Cure, A Straight Talking Introduction to Psychiatric Drugs and The Bitterest Pills: the troubling story of antipsychotic drugs.

She is one of the founding members of the Critical Psychiatry Network which consists of psychiatrists from around the world who are sceptical of the idea that mental disorders are simply brain diseases and of the dominance of the pharmaceutical industry.

We talk about the recent meta-analysis of the efficacy and tolerability of 21 antidepressant drugs, widely reported in the UK news media on February 22^nd.

In the episode we discuss:

• The approach taken in the largest ever meta-analysis of efficacy and tolerability of 21 common antidepressant drugs.
• The problems inherent in comparing antidepressants with each other, as opposed to trials that compare the active drug to a placebo.
• That the main conclusion reached was that all the antidepressants studied were better than placebo at reducing depressive symptoms.
• The limitations of the study, particularly how response rate was selected as the primary outcome measure.
• That ‘response’  is mostly defined as a reduction in the Hamilton Depression Rating Scale (or other scale) rating of 50% or more during the study.
• That the response rate can artificially inflate the difference between drug and placebo.
• The problems with blinding in the supporting trials and the effects of including people who are already receiving antidepressant treatment.
• That the study did not include adverse effects or withdrawal difficulties, only dropout rates which are not representative of the whole picture of taking the drugs.
• The short-term nature of the supporting trials, mainly 8 weeks, with a range of 4 to 12 weeks, which cannot be easily compared with the real world experience of people taking the drugs for much longer periods.
• That, when the primary data is analysed (the depression rating scale scores)  the differences between placebo and antidepressants are very small and probably clinically insignificant.
• The uncritical and sensational nature of the media reporting of the study and the link to the Science Media Centre.
• The concerns about the reporting that depression is under-treated in the UK which is not supported by the results of the study.
• That people should carefully consider the balance of benefit versus risk, taking into account the potential for adverse effects or difficulties stopping the drugs.

Relevant links:

Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis

Challenging the New Hype About Antidepressants

The Hamilton Depression Scale

Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences

Efficacy of antidepressants in adults

The Science Media Centre

This week, we interview Professor Michael Fontaine. Michael is Professor of Classics and Associate Vice Provost of Undergraduate Education at Cornell University in New York. He regularly consults on Latin for museums, institutions, dealers, and collectors, having exposed forgery in Renaissance and Dutch Golden Age paintings. In 2016 he received the Thomas S. Szasz Award for Outstanding Contributions to the Cause of Civil Liberties.

In the episode we discuss:

• How Michael came to be a Professor of Classics and Literature.
• How studying the ancient world helps us to understand what the first scientists thought about mental or emotional distress.
• The first use of the phrase ‘psychiatric ward’ which can be found at the Library of Alexandria in Northern Egypt.
• That the phrase that ultimately became the word ‘Psychiatry’ in ancient times actually meant a “Healing Place for the Soul” and is inscribed above library entrances even today (ΨΥΧΗΣ ΙΑΤΡΕΙΟΝ or Psyches iatreion).
• The links between the Rosenhan experiment and a comedic play written 2,200 years ago by the ancient Roman playwright T. Maccius Plautus.
• That, in the ancient world, there was no long term incarceration in prisons or asylums.
• The relationship between the Hippocratic/medical model (the humoral theory) and the Epicurean model of mental or emotional distress.
• That, in the ancient world, depression didn’t exist, and that the solutions for unhappiness were based in the community or in Philosophy.
• That about 1700 years ago, the Roman Empire entered a state of decline and it became mandatory to become Christian and during this time the philosophical view of mental distress died away to be overtaken by a supernatural understanding.
• Some of the similarities between the Epicurean model and the work of Thomas Szasz.
• How Michael came to know and discuss some of these matters with Thomas Szasz and, following his suicide in 2012, presented an academic paper to the American Psychiatric Association on Thomas Szasz’ legacy.
• The statistics that show that one in every four women around middle age in the US is taking an antidepressant.
• Michael’s essay on Schizophrenia in the ancient world.
• The distinction between the causes of, and the reasons for, our behaviour.
• Ron Leifer having his career ruined because of his support for the ideas of Thomas Szasz.
• A poem from 2,100 years ago by the Latin poet Catullus, that deals with transgender identity, even though it is generally believed that gender identity issues are a recent phenomenon (last 50 years or so).
• How Greek Tragedy can help us understand the world, particularly those of Euripides such as Medea

Relevant links:

On Being Sane in an Insane Place—The Rosenhan Experiment in the Laboratory of Plautus’ Epidamnus

On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz

Thomas Szasz

Mental Disorders in the Classical World (A Review)

Schizophrenia in the Golden Ass

What Do the DSM, Elvis Presley, and Dionysus Have in Common?

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week, we interview journalist and author Johann Hari. 

Johann is one of our foremost social science thinkers and writers. In addition to writing regularly for the New York Times and Independent newspapers, he has written extensively on social science and human rights issues. His 2015 book Chasing the Scream: The First and Last Days of the War on Drugs, challenges what we believe about addiction and his TED talk on our response to addiction has been viewed over 20 million times. 

Johann was twice named ‘National Newspaper Journalist of the Year’ by Amnesty International. And he has been named ‘Cultural Commentator of the Year’ and ‘Environmental Commentator of the Year’ at the Comment Awards.

In this interview, we talk about Johann’s latest book, Lost Connections: Uncovering the Real causes of Depression and the Unexpected Solutions, which has been called a ‘game changer’ and received plaudits for its explanation of the social and cultural issues leading to depression and anxiety.

In the episode we discuss:

• How Johann became interested in journalism and began writing about social justice and human rights issues.
• What led to wanting to write a book that was partly based on his own experiences with depression and anxiety, but also that provided the evidence for social and cultural issues that may underlie the dramatic increase in the number of people needing support for emotional distress.
• The facts behind the chemical imbalance theory of mental illness.
• The role of the bio-psycho-social model of mental distress and why we may have focussed predominantly on biological interventions.
• Social prescribing as a means to enable connection between people who struggle with depression and anxiety.
• The Hamilton Depression scale and how it shows us that the effect of antidepressant drugs is small when compared to the improvements that can be achieved without drug therapy.
• How Johann would like to widen the definition of what may be considered an ‘antidepressant’.
• How disempowerment often lies at the heart of poor health.
• How stigma relates to our perceptions of an individual who is labelled mentally ill and how it changes if we think someone has a biological problem.
• Johann’s experiences in the Berlin district of Kotti.
• That people can hear audio of the many of the interviews held for the book at https://thelostconnections.com

Relevant links:

Lost Connections: Uncovering the Real causes of Depression and the Unexpected Solutions

Johaan Hari talk at the Royal Society for the encouragement of Arts, Manufacturers and Commerce (RSA)

Chasing the Scream: The First and Last Days of the War on Drugs

TED Talk, Everything you think you know about addition is wrong

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week on MIA Radio, we interview Kelli Foulkrod. Kelli is the owner of the Organic Mental Health Center.  She is a therapist, yoga teacher, and mental health paradigm shifter based in Austin, Texas.  For the past 15 years, Kelli has worked in the mental health field and practised yoga. She has been integrating yoga and the healing arts into traditional psychotherapy for over eight years and is passionate about offering holistic mental health treatment options.  

With many years experience in an academic research setting, Kelli bridges the gap between science and spirituality.  Kelli has experience serving clients populations of pregnant and postpartum women, grief and loss, psychosis, homelessness, substance abuse, teens, couples, and groups.  She offers individual, couples, and group psychotherapy services in addition to yoga therapy sessions, workshops, and retreats.

In the episode we discuss:

How Kelli started her journey as a psychology undergraduate at the University of Texas and working in clinical and academic research.

How working in a neuroscience laboratory resulted in internal conflict and led Kelli to interest in and research into alternative modalities alongside her psychology studies.

How Kelli experienced first hand the approaches that pharmaceutical manufacturers used when running clinical trials.

That Kelli felt that modern psychology neglects the body and she started to practise yoga and meditation alongside studying for her masters degree in clinical psychology.

That, to Kelli, modern mental health therapy feels egotistical and narcissistic and that she was resistant to becoming a clinical therapist.

How people are hungry for alternatives but there are so few other options that people continue to get involved with mainstream medicine.

The profound changes that occur when becoming parents and why this might lead to mental health difficulties.

How we have lost touch with community and social connections that existed when we lived as tribal cultures.

How shamanic ceremony and tradition can be understood and utilised in response to emotional distress.

Relevant links:

The Organic Mental Health Centre

The Organic Mental Health Centre (Facebook)

Yoga for depression - the research

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week on MIA Radio, we interview Dr. Jennifer Bahr. Dr Bahr is a passionate advocate for naturopathic approaches to health and wellbeing. She is the founder of Resilience Naturopathic which was founded with a mission to not only to provide an alternative to those who struggle with mental health conditions but to improve the way mental and behavioural healthcare is delivered in America. 

Dr Bahr received her Doctor of Naturopathic Medicine from Southwest College of Naturopathic Medicine in Tempe, AZ. Prior to that she was an Arabic Translator for the US Government and served 6 years in the US Navy. She received her Bachelor of Science in Physiology and Neurobiology from the University of Maryland. She is the President of the California Naturopathic Doctors Association, the founding Vice President of the Psychiatric Association of Naturopathic Physicians, and a member of the House of Delegates for the American Association of Naturopathic Physicians. 

She previously taught at Bastyr University and is a contributing writer for Homeopathy Today, Naturopathic Doctor News and Review, Mad In America, and The Wise Mom.

In the episode we discuss:

• How Dr. Bahr came to be involved with the psychiatric system and prescribed psychiatric drugs.
• That receiving a diagnosis of bipolar disorder led to fears such as loss of employment and that the condition was permanent, feeling like a life sentence.
• How the psychiatric drugs, including Lithium, affected Dr. Bahr’s academic performance.
• How those experiences led to Dr. Bahr’s interest and study into non-medication based and naturally oriented approaches to supporting mental health and wellbeing.
• Why naturopathic medicine might be a good approach for mental health issues.
• That it is important to choose naturopathic approaches as a first step to avoid potential harm from medications prescribed through the mainstream system.
• The inherent problems with clinical trials of psychiatric drugs, such as placebo washout.
• How supporting the whole person is the aim of naturopathic approaches and how this contrasts with the mainstream psychiatric approach of relying heavily on trying to alter brain chemistry.
• That we should focus heavily on what is happening in our environment to help address the alarming increase in both physical and mental health problems.
• How people can find out more about Dr. Bahr and her work by visiting https://resiliencenaturopathic.com.

Relevant links:

Resilience Naturopathic

Rx Resilience: Cultivating the Ability to Bounce Back 

American Association for Naturopathic Physicians

Institute for Natural Medicine

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2018

This week on MIA Radio, we interview Professor Sir Robin Murray. Professor Murray is an Honorary Consultant Psychiatrist in the Psychosis Service located at the Bethlem Royal Hospital in South London. He is also a Professor of Psychiatric Research at the Institute of Psychiatry. His research covers epidemiology, molecular genetics, neuropsychiatry, neuroimaging, neuropsychology and neuropharmacology. 

Professor Murray’s main research interest is finding the causes of schizophrenia and bipolar disorder, as well as developing better treatments for these disorders.He is perhaps best known for helping to establish the neurodevelopmental hypothesis of schizophrenia, and for his work on the environmental risk factors relating to schizophrenia, such as obstetric events and cannabis use.

In 2011, Professor Murray was awarded a knighthood for services to medicine and he is the second most widely cited psychiatrist in the world outside the USA.

In this interview we discuss:

•How Professor Murray came to psychiatry and what sparked his interest in research into psychosis.

•Professor Murray’s work to counter the concept of schizophrenia as a debilitating brain disease and how we came to appreciate the many factors that may contribute to psychotic illness.

•The importance of recognising the influence of social factors in the causes of psychotic illness.

•The differences between the Diagnostic and Statistical Manual (DSM V) and the International Classification of Diseases (ICD 11).

•How psychiatric diagnoses compare and contrast to diagnoses in other branches of medicine.

•The question of whether schizophrenia is a real entity or purely an artificial construct.

•How antipsychotic drugs exert their effects and the mechanisms by which they may lead, in some cases, to dopamine supersensitivity.

•How we should be  cautious about the long-term prescribing of antipsychotic drugs.

•The effect that limited healthcare resources have on psychiatric diagnoses and treatments.

•What the future may hold for research into and treatment options for psychosis.

Relevant links:

Professor Sir Robin Murray

The Psychosis Service at the Bethlem Royal Hospital

30 Years on: How the Neurodevelopmental Hypothesis of Schizophrenia Morphed into the Developmental Risk Factor Model of Psychosis 

Webinar: Is Schizophrenia Dead Yet?

Thou shall not criticise our drugs

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week on MIA Radio, we interview Celia Brown. Celia is a psychiatric survivor and a prominent leader in the movement for human rights in mental health. She is the current president of MindFreedom International, a nonprofit organization uniting 100 sponsor and affiliate grassroots groups with thousands of individual members to win human rights and alternatives for people labelled mentally ill.

Celia also serves on the board of the National Empowerment Center and has co-chaired the planning committee for the National Alternatives Conference for the past few years. She was last year’s recipient of the Lifetime Achievement Award at the Alternatives Conference.

In this interview, we talk about the history of the human rights movement to combat forced treatment and the important role Celia has played in it.

In the episode we discuss:

•The goals and values of the movement for human rights in mental health, specifically in regards to the issue of forced treatment

•Celia’s role in the human rights movement and MindFreedom International

•How the movement for human rights in mental health first started and its early achievements

•The important role played by Judi Chamberlin in the formation of the consumer/survivor/ex-patient movement

•How efforts to combat shock treatment and provide informed consent about psychiatric drugs have been a core part of the movement in recent years

•The development of the peer specialist position and the peer support movement

•How the human rights movement has developed alternative language to the terms and labels used by the mental health system

•Some of the current tensions and divisions within the movement

•Current ongoing advocacy efforts to combat forced treatment, including Tina Minkowitz’s advocacy work with the UN’s Convention on the Rights of Persons with Disabilities and the Disability Integration Act

•Why the movement has faced challenges in changing policy and public opinion on the rights of people labelled mentally ill

•How the movement for human rights in mental health has overlapped and intersected with other human rights movements, including the civil rights, feminist, and disability rights movements

•The role Kate Millet played in bridging the psychiatric survivors movement with the feminist movement

•How people can get involved in the movement for human rights in mental health by learning about the history of the movement, attending conferences, and seeking mentorship

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week on MIA Radio, we interview Chris Hansen. Chris started working in New Zealand as an activist after a psychiatric hospitalization 20 years ago. 

She has provided advice and media comment locally, regionally and nationally, including work with the New Zealand Mental Health Commission and Ministry of Health. 

She was a member of the New Zealand delegation to the United Nations for the development of the Convention for the Rights of Persons with Disabilities, as well as working as a board member for the World Network of Users and Survivors of Psychiatry. 

For the past 12 years, she has worked with Shery Mead developing Intentional Peer Support and is currently in the role of director.

In this interview, we talk about Chris’s personal experiences of the mental health system and how Intentional Peer Support approaches contrast with mainstream psychiatry. 

In the episode we discuss:

• How Chris was working in the mental health system, before herself experiencing a psychiatric hospitalization.
• How she experienced personal loss during the time that she was hospitalized.
• How Chris found that her experiences led to a realisation that she didn't want to work on the medical side of the mental health system and instead focussed her efforts on peer support.
• That Chris’s experiences led to her becoming an activist, working locally, regionally and nationally in advisory and contract positions, including the NZ Mental Health Commission and Ministry of Health.
• That peer support gave Chris the hope, the inspiration and the desire to recover from her traumatic experiences of forced hospitalization and treatment with psychiatric drugs.
• How involvement with advocacy for the abolishment of forced treatment led Chris to work with the United Nations for the development of the Convention for the Rights of Persons with Disabilities, as well as working as a board member for the World Network of Users and Survivors of Psychiatry.
• How Intentional Peer Support works to makes connections with and support those who struggle with their mental health.
• How IPS supports and trains a wide range of organisations such as the mental health services, the police and people in the disability sector amongst others.
• How peer support distinguishes itself from mainstream psychiatric or psychological approaches.
• That learning to reconnect with people is vitally important in recovery. 

Relevant links:

Intentional Peer Support

Intentional Peer Support, a personal perspective by Shery Mead

Intentional Peer Support: Creating Relationships, Creating Change

Intentional Peer Support, upcoming trainings

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017 

This week on MIA Radio, we interview Dr. George Atwood. Dr. Atwood has devoted a substantial part of his life to the study and treatment of what he refers to as ‘so-called psychosis’.  He has authored or coauthored several books, including The Abyss of madness published in 2011 and more than one hundred articles.

In the episode we discuss:

• The story of how Dr. Atwood came to be interested in “so-called psychosis,” including what piqued his interest as a high school student, and his work under mentors Austin DesLauriers and Silvan Tomkins.
• An overview of his more recent work on intersubjective theory with collaborator and friend, Robert Stolorow.
• After studying what he refers to as “madness” for over 50 years, Dr. Atwood offers his perspective that madness is not a disease or illness existing within a person, but a subjective experience of self-dissolution or catastrophe.
• How diagnostic classification systems can result in the false reification of mental diseases in a way that obscures individual realities.
• The phenomenological approach, or the study of individual human subjective experiences, as offering a hopeful future in a shifting away from “illness” or “disorder” frameworks.
• How psychotherapy, as a healing process, includes the relational context between clinician and patient, meriting a dedication to personal histories and contexts rather than overt symptoms. 
• The history of the term “schizophrenia,” and how terms such as these are embedded in a Cartesian medical model.
• A few of Dr. Atwood’s clinical cases and particularly his perspectives on “so-called psychosis” and “so-called bipolar disorder.”

Dr. George Atwood's Personal Website with Works and Lectures

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

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This week on MIA Radio, we share the time between two interviewees; clinical psychologist Dr. Noel Hunter and entrepreneur and author Brett Francis. Dr. Noel Hunter is a clinical psychologist in New York and an advocate for the rights of people diagnosed with mental disorders. She believes in a trauma-informed, humanistic, person-centred approach to understanding problems in living.  She has trained in community mental health, state hospital, residential, and college counselling settings.  Dr. Hunter is on the board of directors for the Hearing Voices Network – USA, the International Society for Ethical Psychiatry & Psychology, and the National Association for Rights Protection and Advocacy. She is an Associate Editor for the peer-reviewed journal Ethical Human Psychology & Psychiatry and has been a guest editor for Asylum Magazine.  Brett Francis is a professional speaker, mental health advocate, author and entrepreneur.  Brett was herself diagnosed with Tourette's Syndrome and ADHD at 6 years of age, leading to being medicated for over eleven years and subsequent difficulties with anxiety, depression and obsessive-compulsive disorder. She is now passionate about supporting and encouraging open and honest discussions about mental health and disabilities and giving confidence to those struggling. In the episode we discuss: Dr Noel Hunter How Dr. Hunter came to be involved with the mental healthcare system. That Noel found that if she did reach out and discuss her experiences, she felt punished or accused of ‘seeking attention’. That these experiences made Noel want to fight back and become a therapist and advocate who took a different approach. That Noel feels that building trust within the therapeutic relationship is a fundamental part of a therapists job. That it is healthy to be sceptical of the mainstream system and for people to be afraid of getting help because of the potential of being re-traumatised by treatment. That the medical model ultimately leads to avoidance and harm. Whether there can ever be equality in the therapeutic relationship.  Brett Francis How Brett came to be diagnosed and medicated at a very early age. Her experiences taking the antipsychotic drug Haloperidol, and that she felt it disrupted her schooling. How Brett decided not to be limited by her diagnoses but instead focussed on tackling the stigma and misinformation prevalent in mental healthcare. That we should support and encourage people to talk about their struggles and we should do that through education. That creating communities and social connections can be enormously helpful in responding to emotional or psychological distress. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017

This week on MIA Radio we interview Dr Joseph Firth. Dr Firth is a postdoctoral research fellow at Western Sydney University. His research focuses on the role of exercise and nutrition in first episode psychosis in young people.

In this interview we discuss:

• That Dr Firth completed his PhD in Manchester, UK, which focussed on the role of exercise in the treatment of psychosis in young people.
• That he now works on a programme of adjunctive and novel treatments for psychosis, particularly the role of exercise and nutrition and including technology and mobile health.
• How results show that exercise can reduce symptoms in young people such as the cognitive deficit, lack of motivation and social withdrawal and that these are symptoms that the medications don’t really help with.
• That, in the very early stages of psychotic illness, there are currently few interventions other than therapy, so exercise and nutrition could have a role in reducing the need for antipsychotic drugs and even potentially affect the onset of psychotic symptoms.
• That qualitative research has shown that young people report that their symptoms are reduced or become less troubling when they exercise.
• How exercise and nutrition have key roles in reducing the health inequalities that are seen in young people treated with antipsychotic drugs.

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week on MIA Radio we interview Dr Jay Joseph. Dr Joseph is a clinical psychologist and author who brings a critical perspective to claims in the media and the academic literature that disordered genes underlie psychiatric disorders.

His most recent books are The Trouble with Twin Studies: A Reassessment of Twin Research in the Social and Behavioral Sciences and the 2017 e-book Schizophrenia and Genetics: The End of an Illusion.

In this interview, we discuss the evidence that psychiatry puts forward in support of the claim that mental disorders have an important genetic basis and the reasons why psychiatry is still searching after many decades of failed attempts.

In the episode we discuss:

• How Dr Joseph, as a clinical psychologist, came to be interested in the validity of the diagnosis of schizophrenia.
• How he then became interested in the assertions by psychiatry that diagnoses such as schizophrenia had a genetic basis.
• That he discovered that the evidence for genetic factors underlying major psychiatric disorders is very weak and based mainly on twin and adoption studies.
• That, despite decades of work, there have been few if any discoveries of disordered genes that cause the major psychiatric disorders.
• How twin and adoption studies are used to try and demonstrate the relationship between genetics and mental disorders.
• That people are being told that their mental illness is genetically based which is not supported by evidence and it is rather like the chemical imbalance myth in this regard.
• That a disorder or condition ‘running in the family’ means that it is ‘genetic’ is also a common misconception.
• That psychiatry seems to be focused on finding the ‘cause’ of mental disorders within the body, rather than acknowledging that social and environmental factors are the main causes of trauma, distress, and psychological dysfunction.

Relevant links:

Dr Jay Joseph

Schizophrenia and Genetics: The End of an Illusion

Bias and Deception in Behavioral Research

Schizophrenia Genetic Research – Running on Empty

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week we interview Dr David Healy. 

Dr Healy is an internationally respected psychiatrist, psychopharmacologist, scientist, and author. A professor of Psychiatry in Wales, David studied medicine in Dublin, and at Cambridge University. He is a former Secretary of the British Association for Psychopharmacology and has authored more than 200 peer-reviewed articles and 20 books, including The Antidepressant Era and The Creation of Psychopharmacology and his latest book, Pharmageddon, published in 2012. 

David is a founder and CEO of Data Based Medicine Limited, which operates through its website RxISK.org, and is dedicated to making medicines safer through online direct patient reporting of drug side effects.

In this interview, we discuss Post SSRI Sexual Dysfunction (PSSD) and Dr Healy’s novel and innovative approach to finding a cure.

A recent email to Dr Healy starkly highlights the problem:

I took X for 16 years without any side effects. Stopped 7 months ago and all hell broke loose. Some of the side effects I got in the first week after quitting are: no libido, cold testicles/penis, pain around penis and anus, tinnitus, erectile dysfunction, tingling, numbness... 

Life is not very good these days.

I am married with beautiful children. They have lost their father. If I can do anything to help, don't hesitate to get in touch. I would like to give you my biggest thanks for what you are doing and wish you all the best with the fundraising.

In the episode we discuss:

• How Dr Healy came to set up Data Based medicine and RxISK.org.
• Why RxISK are focussing on Post SSRI Sexual Dysfunction (PSSD).
• That genital numbness can occur very quickly upon taking an ssri antidepressant and can also be triggered by drugs such as Roaccutane (isotretinoin) and Propecia (finasteride).
• What led to setting up the RxISK Prize.
• How people can get involved with the campaign.
• That it’s often people not involved with healthcare who get motivated to take action.
• How empowering it is to enable people harmed by pills to be part of the solution.

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week we interview Dr Gordon Warme. Dr Warme is a medical doctor specializing in psychiatry. He trained with Karl Menninger at the Menninger Clinic in the US and at Heidelberg University in Germany, and has been a faculty member at the Menninger Clinic, the University of Kansas, and has been an academic at the University of Toronto for 40 years.

His most recent book, published in 2016 is Brain Evangelists: How Psychiatry Has Convinced Us to Believe in Its Far-Fetched Science and Dubious Treatments in which he blows the whistle on modern psychiatry, arguing that, in the long history of medicine, biological and chemical “abnormalities” in psychiatric patients have never been identified, and labels such as schizophrenia and depression are misleading metaphors that dehumanize patients.

In the episode we discuss:

• How Dr Warme came to specialise in psychiatry.
• His experience of being trained by doctors who had a strong psychoanalytic approach.
• That Sigmund Freud wanted psychiatry to be scientific, but Dr Warme feels that this led Freud astray.
• The relationship between culture and psychiatric ‘disorders’.
• Watching, describing and talking as important therapeutic skills to develop.
• Dr Warme’s view of how drugs are used in psychiatry and that he hasn’t prescribed for many years.
• The Rosenhan Experiment.
• Where psychiatry is heading as a profession.

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week we interview David Mielke. David is a psychology graduate and teacher in a California high school who has become increasingly concerned about the number of children that he teaches that have a psychiatric diagnosis and how many are on psychiatric drugs.

In this interview, we discuss David’s experiences as an educator and how teachers can empower students to have more confidence in themselves.

In the episode we discuss:

• How David studied psychology and then came to be a teacher at Culver City High School in California.
• How an experience witnessing electroshock therapy made an indelible mark on his approach to educating.
• How David knew from interacting with his students that most often their struggles were because of difficult circumstances such as issues at home rather than brain diseases in need of diagnosis.
• How David has witnessed many of his students have internalised their diagnostic labels.
• The relationship between a psychiatric diagnosis and learned helplessness.
• The tensions that may arise between school policies and guidance, teachers and parents when a psychiatric diagnosis is involved.
• The power inherent in psychotherapy to connect with and support people in difficulty.

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017 

This week on the Mad in America podcast we interview Olga Runciman. 

Olga is an international trainer and speaker, writer, campaigner, and artist. She co-founded the Danish Hearing Voices Network and sees the role of the Hearing Voices Movement as post-psychiatric, working towards the recognition of human rights while offering hope, empowerment, and access to making sense of individual experiences. 

Olga was a psychiatric nurse working in social psychiatry but today she is a psychologist and since 2013 she has had her own private practice in Denmark, working with people who have been labelled schizophrenic or psychotic. Olga is herself a psychiatric survivor and a voice hearer too.

In this interview we discuss Olga’s professional and personal experiences of the psychiatric system and how she now helps and supports healing and recovery in others.

In the episode we discuss:

How Olga became a specialist psychiatric nurse in Denmark, believing at the time the reasons given for psychiatric diagnoses.

• How she came to see that there was little evidence or corroboration to underpin the diagnosis and treatment that she witnessed.
• How Olga was also a voice hearer, but kept this hidden from her psychiatric colleagues.
• How, when experiencing stress and trauma, Olga came to be admitted to a psychiatric ward, diagnosed as schizophrenic and treated with a cocktail of psychiatric drugs.
• Olga’s experiences of the antipsychotic drug Clozapine.
• How Olga came to stop her psychiatric drugs which she had been taking for ten years.
• Psychiatry’s story of hopelessness and chronic illness that is so often sold to patients.
• How Olga now views her work from a post-psychiatry perspective.

Relevant links:

Psycovery

Olga’s posts on Mad in America 

The Hearing Voices network

International Institute for Psychiatric Drug Withdrawal 

Postpsychiatry: a new direction for mental health 

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week, Mad in America editor Emily Sheera Cutler presents the first in a series of interviews that examine the many important issues around forced treatment and cognitive liberty. The series will examine philosophical, theological, and sociological perspectives on coercive treatment.

In this first part, Emily interviews two well known and very respected academics and activists Bonnie Burstow and Nick Walker. Central to both Bonnie and Nick’s work is the concept of cognitive liberty or freedom and integrity of the mind. Early proponents of cognitive liberty have defined it as the right to control one’s own consciousness and be free from mind-altering drugs and technologies, as well as the right to use mind-enhancing drugs and technologies without facing legal consequences. Contemporary proponents of cognitive liberty have expanded the definition to include the right to experience and express each and every thought, feeling, state of mind, and belief as long as it does not harm anyone else. Both Bonnie and Nick describe cognitive liberty as the right to express oneself authentically. In this first episode, they get to the core of why so many human rights activists oppose forced treatment – it can interfere with people’s rights to be themselves.

In this episode we discuss:

• How Bonnie became an antipsychiatry activist and scholar, and why she sees the institution of psychiatry as a human rights violation
• How Nick became a neurodiversity scholar through his involvement with the Autistic rights movement
• The difference between the neurodiversity paradigm, which views neurological, mental, and cognitive differences on the natural spectrum of human diversity, and the pathology paradigm, which assumes there is a right way or healthy way of being and to differ from it is unhealthy
• What it means for each person to have cognitive liberty and be able to express their own unique way of being and processing the world without repercussions
• How psychiatry curtails our cognitive liberty and freedom of mind by pathologizing difference to justify forceful and coercive measures
• The social model of disability, which states that people are disabled by lack of access and discrimination, not by medical conditions or internal deficits
• How the social model of disability intersects with neurodiversity and antipsychiatry but also falls short
• That Applied Behavior Analysis (ABA) constitutes a human rights abuse against Autistic children, forcing and coercing them to act more normal and less different
• That other behaviour therapies and even humanistic therapies can be coercive as well
• That the autism industry profits off of the pathology paradigm, convincing parents there is something wrong with their Autistic children and that it is not okay to be Autistic, and their children need to be subjected to ABA and other “treatments”
• How antipsychiatry and neurodiversity intersect with feminism and queer studies
• Why it is necessary for educators to teach students “mad literacy” from an early age
• The importance of writing and publishing literature with accurate, positive representations of neurodivergent and Mad people
• How we can build communities in which people support one another through emotional distress without violating anyone’s autonomy or restricting anyone’s freedom
• Why the conventional notion of “suicide prevention” is problematic and can serve to take away people’s coping skills
• How the ideas of somatic therapy can help us support people in distress

Relevant Links

Bonnie Burstow

Nick Walker

Bonnie Burstow’s articles for Mad in America

The Bonnie Burstow Scholarship in Antipsychiatry

Autonomous Press

Throw Away the Master’s Tools: Liberating Ourselves from the Pathology Paradigm by Nick Walker

Neuroqueer: An Introduction by Nick Walker

The social model of disability vs. the medical model of disability

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017 

This week, Mad in America’s news editor Justin Karter interviews Professor Michael O’Loughlin.

Professor O’Loughlin is a college professor and researcher at Adelphi University on Long Island. He is a licensed psychologist and a psychoanalyst in private practice in New Hyde Park, New York. Dr O’Loughlin writes critically about the biomedical model of psychiatry and psychology and also has a deep interest in psychiatric rights and social justice issues.

In 2015 as an editor he launched a book series entitled Psychoanalytic Studies: Clinical, Social, and Cultural Contexts, with Lexington Books. 

In August 2017, with colleagues Dr. Awad Ibrahim (University of Ottawa), Dr, Gabrielle Ivinson (Manchester Metropolitan University), and Dr. Marek Tesar (University of Auckland), as series co-editors, he launched a book series, Critical Childhood & Youth Studies: Clinical, educational, social and cultural inquiry, to be published by Lexington Books.

Professor O'Loughlin talks about his childhood experiences and how they influenced his narrative and conversational approach to psychological distress. 

In this episode we discuss

How Dr O’Loughlin’s early experiences growing up in Ireland led to a deep interest in social justice issues, particularly poverty and inequality.

That as a young man in college he engaged in charity work and activism.

How, more recently, he became interested in psychiatry when he was appointed as a lecturer in clinical psychology, but realised that there weren’t required courses on trauma or psychosis.

That this led to teaching courses in intergenerational trauma and the way that our history shapes us as people.

That Michael has engaged in autobiographical writing to understand the way that deprivations and injustices that he experienced had a formative impact on his own thinking and writing.

That another course on madness and psychosis was perceived by clinical psychology students as radical, leading to a realisation that mainstream psychology is a very conservative discipline.

How he became interested in interviewing psychiatric patients and telling stories that represented a diverse group of people and experiences of psychiatric services.

That this led to a project at Fountain House in New York City to see if narratives could be reinforced and shared.

That Michael does not himself use the terms mental illness or disorder because he feels that we need to be flexible and that even this terminology can be traumatising.

How he has recently focused on creating spaces where participants can share their experiences and stories and it shouldn’t be a classification or categorization exercise.

That he has found many that have experienced the psychiatric system have felt that the system impeded their recovery.

That a collaborative team of Adelphi academics, Fountain House staff and Fountain House members will together publish research.

That Professor O’Loughlin feels that psychology and psychiatry are traditional and reactive disciplines and that psychiatry has been driven by pharmacological concerns.

How Michael’s work with children is grounded in his own childhood experiences and a sense that human beings need nurturing spaces and validation.

That Michael is extremely disturbed about the medicating young children with drugs that are not known to be safe for them such as antipsychotic drugs.

The unwillingness to understand that a child's distress has an origin and that we have a responsibility to engage with the child and create a space for them to communicate.

How we define normality within such a narrow range that children find it very difficult to conform to society’s expectations.

That there seems to be little room for a child in school, only room for a student.

That psychoanalysis has tools to understand our emotions and experiences but also has tools to help understand societal drivers that may underlie psychological distress.

The worry that talking therapies are being replaced by tick lists and categories and that we need to bring stories back into psychology.

Relevant links:

Michael O’Loughlin, PhD

Psychoanalytic Studies: Clinical, Social, and Cultural Contexts

Arthur Frank

Kathryn Bond Stockton

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week I have had the honour of interviewing Dr Irving Kirsch.

Dr Kirsch is Associate Director of the Program in Placebo Studies and lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also Professor Emeritus of Psychology at the University of Plymouth and the University of Hull in the UK and University of Connecticut in the US. He has published 10 books and more than 250 scientific journal articles and book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion. He originated the concept of response expectancy. His meta-analyses on the efficacy of antidepressants were covered extensively in the international media and influenced official guidelines for the treatment of depression in the United Kingdom. His 2009 book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, was shortlisted for the prestigious Mind Book of the Year award and was the topic of 60 Minutes segment on CBS and a 5-page cover story in Newsweek.

In this interview, we discuss Dr Kirsch’s research into the placebo effect and the efficacy of drugs used for depression.

In this episode we discuss:

• How, as an undergraduate student, Dr Kirsch became interested in behavioural therapy but that he doubted the rationale behind these approaches
• That this led to an interest in beliefs that people had and research into the placebo effect
• How, while working at the University of Connecticut, his research into the placebo led to an interest in the efficacy of antidepressant drugs when compared to placebo
• How his work led to the surprising conclusion that, were antidepressant drugs were concerned, the placebo effect was so large that there was very little room for a meaningful drug effect
• How this changed Dr Kirsch’s views on antidepressant drugs entirely, causing him to ask whether the risks were worth the small benefit for depressed patients
• That a belief that a person has can affect their response to a drug either in a positive way (placebo) or in a negative way (nocebo)
• Dr Kirsch found that there are many conditions that can show a profound placebo effect including depression, anxiety, irritable bowel syndrome, pain, Parkinson’s disease and asthma 
• That the placebo tends to have a greater effect in conditions that have a large psychological component when compared to functional disorders such as diabetes
• That placebo can have an effect even if the patient knows that they are taking an inactive tablet and that part of this response is down to classical conditioning
• That Dr Kirsch is working on ‘open-label placebo’ which is being able to prescribe placebo to patients without deception
• That Dr Kirsch used to refer depressed patients for antidepressant treatments, but that his research made him a disbeliever when looking at the evidence of efficacy when compared to placebo
• How, when you give someone a new treatment, that often will counter feelings of hopelessness that characterise depressive experiences
• That in looking at this size of this effect, it made clear that the difference between placebo response and antidepressant response was so small that it was not clinically significant
• That even drugs with very different modes of action resulted in virtually identical responses in patients, for example, Tianeptine, which is an SSRE (selective serotonin reuptake enhancer) and decreases serotonin levels between neurons, this drug should make depressed people worse but instead, it showed the same efficacy as SSRI antidepressants
• How, when looking at the clinical trials used to demonstrate antidepressant efficacy, it became clear that the obvious nature of antidepressant adverse effects meant that trial participants would often “break blind” and they would know if they were in the active drug group or the placebo group, this would naturally influence the results of the trial
• That, in a small number of studies, an active placebo was used, which was a substance that mimicked the side effects of the active drug while having no clinical effect itself
• That in these active placebo studies, you were much less likely to get a significant difference between drug and placebo when compared to trials that used an intern placebo
• That the trials conducted by pharmaceutical manufacturers are designed to show their drug in the best possible light and so they do not use active placebo in their studies
• That Dr Kirsch feels that when conducting trials for drugs used for depression, patients should be asked early on in the trial whether they think they are in the active group or the placebo group and that this question would help ensure the trials were reliable
• How, when using the data from unpublished trials, the difference between placebo effect and drug effect was even smaller
• How Dr Kirsch was pleased that other researchers found his conclusions controversial because it meant that they were paying attention to the study and that others who have replicated the approach have found similar results
• That influencing clinicians to better balance risk vs benefit will take time and that we need to share the data and discuss the conclusions as much as we can to allow change to happen 
• That people do need help with depression and that there are many different interventions that are at least as effective as antidepressants but without the associated risk
• How we can’t infer that ‘off-label’ prescribing is effective until the studies have been undertaken for a particular disorder

Relevant Links:

Dr Irving Kirsch

The Emperor’s New Drugs: Exploding the Antidepressant Myth

The Emperor’s New Drugs: Exploding the Antidepressant Myth (video)

60 Minutes: Treating Depression: Is there a placebo effect? (video)

Antidepressants and the Placebo Effect

Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week we have a very special guest for you, it has been my honour to be able to interview Dr. Peter Breggin.

Dr. Breggin is a Harvard-trained psychiatrist and former Consultant at the National Institute of Mental Health (NIMH). He has been called “The Conscience of Psychiatry” for his many decades of successful efforts to reform the mental health field.

His work provides the foundation for modern criticism of psychiatric diagnoses and drugs, and leads the way in promoting more caring and effective therapies. His research and educational projects have brought about major changes in the FDA-approved Full Prescribing Information or labels for dozens of antipsychotic and antidepressant drugs. He continues to educate the public and professions about the tragic psychiatric drugging of America’s children.

He has authored dozens of scientific articles and more than twenty books, including medical books and the bestsellers Toxic Psychiatry and Talking Back to Prozac. His most recent three books are Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions; Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Murder; and Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families.

As a medical-legal expert, Dr. Breggin has unprecedented and unique knowledge about how the pharmaceutical industry too often commits fraud in researching and marketing psychiatric drugs. He has testified many times in malpractice, product liability and criminal cases, often in relation to adverse drug effects and more occasionally electroshock and psychosurgery. A list of his trial testimony since 1985 is contained in the last section of his Resume on Dr. Breggin's website.

Dr. Breggin has taught at many universities and has a private practice of psychiatry in Ithaca, New York.

For a career as long and distinguished as Dr. Breggin’s we have decided to devote two episodes to hearing him speak. This first part covered Dr. Breggin's career, his views on psychiatry and psychiatric drugs and also recent developments with the trial involving Michelle Carter.

Part 2 of the interview focuses more on recent events surrounding the trial and alternatives to psychiatric drugs.

In this episode, we discuss:

That Bristol County Juvenile Court Judge Lawrence Moniz sentenced Michelle Carter to a two-and-a-half-year term, with 15 months in jail and the balance suspended plus a period of supervised probation. 

How Judge Moniz granted a defense motion to stay the sentence, meaning she will remain free pending her appeals in Massachusetts.

That if Michelle lost all of her appeals in 2-3 years time, Michelle may be facing custodial time.

That attempts to limit Dr. Breggin’s right to blog about the trial were stopped and the Judge’s final order in response to DA makes no criticism or censorship of Dr. Breggin

That Dr. Breggin reviewed thousands of text messages between Michelle and her friends and between Michelle and Conrad Roy, but that one particular part of a text exchange formed the central plank of the case against Michelle.

That Dr. Breggin is keen to show, through the Michelle Carter blogs, what is happening to our children when they become involved with psychiatry and psychiatric drugs

That Dr. Breggin appreciates the suffering of the family of Conrad Roy because he kept hidden how bad his mental health difficulties were

How Dr. Breggin also appreciates how Michele had been tormented and attacked by the press during the trial

How the authorities went to extremes to exclude the role that psychiatric drugs may have played in the events surrounding Michelle and Conrad

That Dr. Breggin has observed that many that he has helped that have been wounded by psychiatry, have shied away from becoming reformers themselves

How, when working with clients, Dr. Breggin makes sure he takes the time to ensure that potential clients know who he is and how his approach differs to mainstream psychiatry

That Dr. Breggin feels that the hostility towards those who question the use of psychiatric drugs has reduced over the last 10 to 20 years

How Dr. Breggin feels that the psychiatric drugging of our children is tantamount to organised child abuse because the child cannot make a judgement for themselves

That many children end up taking the drugs to please their parents

That the drug that Michelle Carter was taking (Celexa/Citalopram) was not approved by the FDA for treating children

That Dr. Breggin’s view is that emotional or psychological difficulties often are precipitated by childhood trauma

That people often then react to the current world as if it were the world that they found traumatic and difficult as a child

That good therapy has much in common with coaching in sport or certain aspects of religion or good teaching

That all psychoactive substances, including psychiatric drugs, have a general effect on the brain and often this intoxication affects a persons ability to relate emotionally to family and friends

How helping people with their mental health comes down to loving, caring, relationship, coaching and guidance

That these principles have much in common with good religion or philosophy

Relevant Links

Peter Breggin’s personal website

Peter’s blogs on Mad in America:

Part 1

Part 2

Part 3

Part 4

Part 5

Michelle Carter Blogs and Archives

The handwritten note from the DA to the Judge about stopping Dr. Breggin’s blog

Judge’s Final Order in Response to DA Makes No Criticism or Censorship of Dr. Breggin

Toxic Psychiatry

Talking Back to Prozac

Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions

Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Murder

Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families

To get in touch with us email: podcasts@madinamerica.com

© Mad in America 2017

This week we have an interview with Professor John Read. Professor Read worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, where he worked until 2013. 

He has served as Director of the Clinical Psychology professional graduate programmes at both Auckland and, more recently, the University of Liverpool.

He has published over 120 papers in research journals, primarily on the relationship between adverse life events (eg child abuse/neglect, poverty etc.) and psychosis. He also researches the negative effects of bio-genetic causal explanations on prejudice, the opinions and experiences of recipients of anti-psychotic and anti-depressant medication, and the role of the pharmaceutical industry in mental health research and practice.

John is on the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis (www.isps.org) and is the Editor of the ISPS’s scientific journal ‘Psychosis’.

He also a member of the BPS’s Alternatives to Diagnosis working group.

In this episode we discuss professor Read’s research interests and in particular, the science and evidence base for Electroconvulsive Therapy or Electroshock as its known in the United States.

In this episode we discuss:

• How Professor Read became interested in psychology, partly because of difficulties in his younger years and he wanted to understand those experiences
• That his first experiences with patients in a psychiatric ward would be that people often wanted to share traumatic experiences, but that the psychiatrists didn't seem that interested
• That, by and large, mental health services around the world prefer to count symptoms and to medicate rather than to understand what has happened in a person’s life
• How John came to have an interest in and research the efficacy and safety of Electroconvulsive Therapy (Electroshock)
• That ECT is designed to induce a grand mal seizure and it started as a treatment for people diagnosed as schizophrenic
• That the justification in the 1940s was that schizophrenics did not suffer with epilepsy and epileptics did not suffer with schizophrenia, so psychiatry made the leap to inducing epileptic seizures as a ‘cure’ for schizophrenia
• That nowadays it is not used for people labelled as schizophrenic but it is most often used for treating depression
• How actually it is not the diagnosis that is the best predictor of who gets ECT, it’s age and gender
• Women aged over 60 are twice as often given ECT as men, and people over 60 are given it 2-3 times more often as those under 60
• That the other rationale given for ECT treatment is the tendency for ECT to obscure traumatic memories because of memory loss
• That the science and evidence tells us that after 70 years there has never been a single study showing that ECT is better than placebo beyond the end of the treatment period
• That placebo in this sense is like sham surgery, the anaesthetic is given but not the electricity
• That during the treatment (usually 3-4 weeks and an average of 8-10 session