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“Most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems… Withdrawal from psychiatric drugs should be done carefully under experienced clinical supervision.” Dr. Peter Breggin

May 21, 2013

Caught Being Offensive: DSM-5, Caught Between Mental Illness Stigma and Anti-Psychiatry Prejudice

Jeffrey Lieberman, president-elect of the American Psychiatric Association, wrote an invited commentary for Scientific American's MIND Guest Blog.  Lieberman's commentary is most remarkable for the lack of respect Lieberman apparently has for other professionals and for others with a different perspective than his own about the DSM, which has a profound influence on how we, as a society, treat people who experience emotional and/or behavioral difficulties.  I don't believe that Lieberman is unaware, uninformed or ignorant; however, in this commentary, he attempts to paint professionals and others who are critical of harmful, discriminatory psychiatric practices that are coercive and cause serious iatrogenic impairments; some fatal, as "real people who don’t want to improve mental healthcare."  
It's as if Lieberman believes there is only one way to look at the issues involved; if one's perspective in not aligned with his own, one is unworthy of consideration, possibly mentally ill, and undeserving of respect.  Presumably, Lieberman states, professionals who are "against the diagnosis and treatment of mental illnesses;" i.e. biological based hypotheses firmly believed in by the folks who arrive at the diagnostic criteria and treatment standards a consensus of p subjective opinions. Consensus is the foundation of psychiatry. Lieberman presumes too much about a diverse group of people. He seems to be intentionally misleading readers about the core issues the American Psychiatric Association and it's bible, The  Diagnostic and Statistical Manual are widely criticized for.  The DSM is being boycotted by some concerned professionals. 
a few excerpts from  "DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice" via Scientific American:
"But there’s another type of critique that does not contribute to this goal. These are the groups who are actually proud to identify themselves as “anti-psychiatry.”
"These are real people who don’t want to improve mental healthcare, unlike the dozens of psychiatrists, psychologists, social workers and patient advocates who have labored for years to revise the DSM, rigorously and responsibly. Instead, they are against the diagnosis and treatment of mental illnesses—which improves, and in some cases saves, millions of lives every year—and “against” the very idea of psychiatry, and its practices of psychotherapy and psychopharmacology. They are, to my mind, misguided and misleading ideologues and self-promoters who are spreading scientific anarchy."
"Being “against” psychiatry strikes me as no different than being “against” cardiology or orthopedics or gynecology—which most people, I think, would find absurd. No other medical specialty is targeted by such an “anti” movement."
"This relatively small “anti-psychiatry” movement fuels the much larger segment of the world that is prejudiced against people with disorders of the brain and mind and the professions that treat them. Like most prejudice, this one is largely based on ignorance or fear–no different than racism, or society’s initial reactions to illnesses from leprosy to AIDS. And many people made uncomfortable by mental illness and psychiatry, don’t recognize their feelings as prejudice. But that is what they are." end quote (emphasis mine)
The dubious claim that "mental illness is like any other illness" is (allegedly) used to "fight stigma."  According to grass roots advocates for the seriously mentally ill, who "fight the stigma" by claiming that having a "psychiatric disease" or "mental illness," is like having diabetes, and taking teratogenic drugs is like using insulin to regulate blood sugar...

Let's be real, this comparison is a spurious claim purportedly made to "bust the stigma of mental illness" and encourage people to seek psychiatric diagnosis and treatment.  The depression is caused by a chemical imbalance "metaphor" is a discarded hypothesis, a disproved hypothetical explanation for what was once called "endogenous depression." It was utilized to manipulate patients, and the general public in order to sell the psychiatric diagnosis = brain disease idea. Just as importantly these compaisons were drawn from thin air as part of a mass marketing strategy to sell psychopharmacology as an ethical, evidence based Standard Treatment for EVERY psychiatric diagnosis AS a putative disease. Once the general public in effect believe that any psychiatric diagnosis is evidence a person has a brain disease,  the public supported legislation allowing psychiatrists to have unwilling patients adjudicated as a person with a brain disease requiring psychiatric treatment...

Lieberman uses some sort of pseudo-logical nonsense to assert psychiatry is the like any other medical specialty. In reality, there are glaring exceptions: the primary one being psychiatrists, subjugate both the Police and the Courts, utilizing them as medical instruments to have unwilling patients adjudicated in Courts of Law---No other medical specialty substitutes legal adjudication for a medical diagnosis.  Once a psychiatrist or other designated mental health professional asserts the person has a brain disease, and further attests the alluded to "disease" can be effectively treated with neuroleptic and/or other psychotropic drugs and/or electrical shocks to the brain. 

The Rules of Evidence used by the Police and the Courts in any and every other type of legal procedure or process, are not required for these adjudicative procedures. The designated medical professional's claims are a professional opinion proffered in accordance with a political process developed by consensus. Ironically, the lowered standards are seemingly "justified" by widespread acceptance of, and presumably belief in the idea that a psychiatric diagnosis, or a mental illness means one is less than one once was, one is less than "normal;" one is less human. That  a person has a disease is at best, a shared professional opinion that is substituted for "evidence."  Serving in effect, as the evidence, this "fact" becomes the sole justification for mandating psychiatric treatment regardless of any actual benefit or adverse effect experienced by the person who is legally adjudicated and Court Ordered to psychiatric treatment under color of law.  

"tolerable side effects of diagnosis and treatment"
evidence of actual iatrogenic,  
"physician caused" harm

Conveniently,  Lieberman and biological psychiatry practitioners in general minimize the nature of the psychotropic drugs used by psychiatrists, psychopharmacologists develop the treatment standards by consensus. Imagine an oncologist diagnosing and treating cancer using diagnostic criteria and treatment standards derived through a political process, consensus. Imagine the uproar at "treating sick people like that!" The neuroleptic or so-called "anti-psychotic" drugs are only minimally effective for a minority of people with a diagnosis of schizophrenia.  Teratogenic drugs, they cause a myriad of iatrogenic diseases and impairments that are then medically neglected; increasing the risk a person will die an untimely iatrogenic, death.  Common drug-induced impairments specifically drug-induced brain damage, impairs a person's ability to realize they have been harmed, prevent further iatrogenic harm.  

Can there be any doubt medically neglected iatrogenic injuries and impairments have a profound effect on a psychiatric patient, adversely effecting length and quality of life?
The civil commitment laws in the U.S. lower the evidentiary standards used in civil and criminal legal procedure. Court hearings do not follow standard court procedures--- The courts in the U.S. do not require any evidence the person has a disease, to support a psychiatrist's expert opinion.   Psychiatrists need not offer any evidence the recommended treatment will "effectively treat" the person who is being adjudicated.  Psychiatric diagnoses and the treatment protocols used by psychiatry were created using a quasi-democratic political processes; not medical or scientific processes.  When any other medical specialist  testifies in a court of law, they are required to submit empirical evidence of the factual basis of their testimony in compliance with the Rules of Evidence used in Police procedure and Courts of Law. For example, psychiatrists who offer professional opinions in court in person or by affidavit, will attest, "patient x has schizophrenia, a brain disease that requires medical treatment." However, no supporting evidence to substantiate the assertions made is offered, or required. Evidence that psychiatric drugs and/or electroshock will effectively treat the person isn't needed to obtain a Court Order to force treatment upon a person who has been adjudicated.  That unsupported attestations instead of factual evidence can be accepted on faith, then used as a basis to deprive a person of their liberty, is evidence that attorneys assigned to defend people facing adjudication proceedings, are failing to defend their client's Constitutional Rights.
The DSM5 has been much discussed and debated, but it is more than an exaggeration to state the DSM5, "ignited a broad dialogue on mental illness and opened up a conversation about the state of psychiatry and mental healthcare in this country."   While the DSM5 has, and continues to be a catalyst for debate and discussion, it seems to me that the APA and the professionals involved with the DSM5, have stifled debate, and have refused to acknowledge, or respectfully listen to critics.  The fact is, Lieberman like most psychiatrists, is disparaging of people who self-identify as psychiatric survivors, ex-patients, or as "anti-psychiatry;" some of whom have been "discussing the state of psychiatry and mental healthcare in this country" longer then I've been alive...  
All due respect to Jeffrey Lieberman, his commentary reads like a juvenile justification, proffering lame excuses and abdicating having any personal or professional responsibility while offering no explanation for the lack of scientific basis for his "medical" specialty. The misguided attempt to rewrite history with the strange claim that asylums were, "humane warehouses," and opining that Freudian theory was a "brilliant fiction;" borders on being sci-fi fantasy. The first assertion evinces a bias for the psychiatric disease hypothesis, as well as willful blindness to the grievous harm done to real people in standard psychiatric practice. read  here
Lieberman and the American Psychiatric Association collectively refuse to acknowledge psychiatry's victims; in effect, invalidating an entire class of people. It's utterly despicable and adds insult to injury that the doctors who vehemently defend themselves, and their chosen profession, are willfully blind to those grievously injured by psychiatric treatment.

Psychiatry is failing to perform an ethical medical duty: to HELP those with iatrogenic injuries recover, psychiatry forgets to "First, do no harm..." Lieberman, is not unusual, he abdicates responsibility for the harm caused real people by treatments he vehemently defends as effective and necessary medical treatments.  Lieberman seems to be encouraging a perspective that pretends my son, Isaac, and others with profound, disabling iatrogenic injuries from psychiatric treatment aren't worthy of being respected or having their human rights preserved. Equally important, Lieberman seems unaware of having an ethical duty to the victims, the countless current and former psychiatric patients who are in critical need of medical treatment for their profound iatrogenic injuries and impairments.

I'm biased from the experience of witnessing the horrifying manner psychiatrists have treated, and in reality, mistreated and disabled my son before he was an adult.  My son at the age of 7 had an IQ of 146, and could do triple digit addition in his head, without using his fingers.

Christmas 2011, he used his fingers to count the seven remaining days until Christmas. He is 25 years old and I take care of my precious son, who was disabled by psychiatrists who acted with impunity. It is a bittersweet privilege; it is an honor. Lieberman's attitude seems prejudiced to me, but like I said, I'm biased. I'm a MadMother who knows that my son deserved to be heard, who knows he needed to be helped to process the violence which caused the traumatic injuries he sustained as the victim of violent crime at 3 years old. Instead, he was repeatedly traumatized by mental health professionals, social workers who allowed psychiatrists to inflict the iatrogenic injuries that he will likely die from. 


Unknown said...

The comments on Lieberman's blog were uniformly condemning of his ridiculous self-serving argument.

Anonymous said...

Aw, man, so well put. I was duped by psychiatrists for years. I saw a really good You-Tube today, here's the link:, anything by the Open Paradigm Project I have been really impressed with. Psychiatry is a joke and they do not help people. Most people I know go to psychiatrists and they don't really expect GOOD care, they expect a guy with degrees in frames on the wall and dollar signs in his eyes. When you go to a hospital for psych care in the US, you don't expect real care, you expect to be abused and treated like you are a criminal, not like you are there because of true human suffering. No, the staff act like you've done some terrible thing and you're there for your punishment, which you "deserve," and you are there because you "belong" there, you are with "your kind." You don't have real feelings, and they talk about you in the third person like you aren't present, right within your earshot. "Let's put her on this drug next." And they force you. My doctor told me her hospital wanted me to shut up about the abuse they did to me so they wanted her to give me antipsychotic drugs. To make sure I kept my mouth shut, they said, saying I was a liability problem, a troublemaker. I fired her and she is no longer at that hospital. Strange thing, life is.


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