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Mental Illness or Social Sickness?

Mental Illness or Social Sickness?

by Susan Rosenthal

(Chapter 3 of SICK and SICKER: Essays on Class, Health and Health Care)

In the normal course of its functioning, capitalism deprives, injures, sickens and kills millions of people. What prevents the dispossessed from rising up to end this oppressive social arrangement?

To sustain itself, the ruling class erects institutions of social control backed by ideas that justify the way things are. One of these institutions is modern medicine, which developed as a system of diagnosing and treating individuals, not their social conditions.(1)

Medical ideology assumes that individuals malfunction for reasons that have nothing to do with the social world. The physician treats the injured worker, not the unsafe workplace that injured her.

Mental illness presents special problems for capitalism. The fact that social conditions generate mental distress is so obvious that a psychiatric industry is required to convince us otherwise.

Psychiatry presents itself as a branch of medicine that diagnoses and treats mental illness in the same way that other branches of medicine diagnose and treat physical illness. This claim does not hold up under scrutiny.

The science of diagnosing physical illness developed from an understanding of human physiology and diseases that cause the body to malfunction. A correct diagnosis identifies the problem, guides treatment and suggests an outcome. For example, a diagnosis of bacterial pneumonia identifies a type of lung infection that can usually be cured with antibiotics.

Diagnosis is a science because physical diseases show characteristic biological changes or “markers.” Almost everyone with a particular disease will show similar biological markers, while those without the disease seldom show these changes. The biological basis of disease makes it possible to diagnose physical illnesses scientifically and reliably. Mental illness is very different.

The Mind is Not the Brain

Parkinson’s Disease, Alzheimer Disease, Huntington’s Disease, Multiple Sclerosis, Neurosyphilis, etc. are all diseases of the brain. These diseases display characteristic biological markers that make it possible to diagnose them.

However, the mind is not the same as the brain. The mind is not a physical organ but develops out of a complex inter-relationship between the brain, the body and the social environment.(2) Mental distress can result when any of these components or their relationship is negatively affected.

Because the mind is more than the brain – studying the brain tells us nothing about the physical and social environment that shaped the mind.

Mental distress takes many forms, all of which create misery and none of which is a disease. Science has yet to detect biological markers in the brains of people with different forms of mental distress that are not present in people without those forms of mental distress. This is true even for schizophrenia, a disabling form of mental distress that is widely assumed to be genetically-based. The evidence says otherwise.

Studies from different countries show that living in a city gives a person a higher probability of developing schizophrenia than having a family member with schizophrenia. Moving from rural to urban centers increases the risk of developing schizophrenia, while moving in the other direction reduces the risk.(3) City living is associated with increased exposure to lead,(4) infection,(5) malnutrition,(6) and racial discrimination(7) – all of which have been linked with higher rates of schizophrenia.

These studies suggest that, while schizophrenia is not a genetic disease, it might still be a physical disease. However, schizophrenia has no biological markers. Schizophrenia is identified by evaluating behaviour.

Evaluating behavior is highly subjective, and the process for identifying schizophrenia is complex and confusing. As a result, mis-identification is common and leads to faulty research findings. For example, studies that report a higher incidence of schizophrenia in twins cannot confirm if these individuals actually have schizophrenia, because there is no objective way to confirm this diagnosis. If we don’t know what we are measuring, then we can’t measure it accurately.

Psychiatry is not a medical science; it is pseudoscience – ideology disguised as science.(8) Psychiatry developed to meet capitalism’s need for social control and psychiatrists’ need for paying customers.

Sigmund Freud

Before the 20th century, life stresses were viewed as spiritual problems or physical illnesses, and sufferers sought the help of religious advisers or physicians. Medical doctors treated “hysteria” and “nerves” as physical problems. Psychiatry was restricted to the treatment of severely disturbed people in asylums.(9)

The first classification of psychiatric disorders in the United States appeared in 1918 and contained 22 categories. All but one referred to various forms of insanity.

In 1901, Sigmund Freud revolutionized psychiatry by breaking down the barrier between mental distress and normal behavior.

In The Psychopathology of Everyday Life,(10) Freud suggested that commonplace behaviors – slips of the tongue, what people find humorous, what they forget and the mistakes they make – indicate repressed sexual feelings that lurk beneath the surface of normal behavior. Freud believed that repressed feelings should be treated to prevent them from generating anti-social behaviors.

By linking everyday behavior with mental illness, Freud and his followers released psychiatry from the asylum. Between 1917 and 1970, psychiatrists cultivated clients with a broad range of problems, and the number of psychiatrists practising outside institutions swelled from 8 percent to 66 percent.(11)

What were these psychiatrists treating? Because mental distress has no biological markers and is not a disease, psychiatry adopted the term, “mental disorder.”

Dictionary definitions of “disorder” refer to: a lack of order or regular arrangement (confusion); a disruption in mental or physical functioning; a breach of civic order or public disturbance (disorderly conduct); or any condition in which things are not in their expected places (deviation).

Who decides what is “order” and what is “disorder,” what is “normal” and what is “deviant”? These are not scientific or medical questions, but social and political ones.

Those who rule society make the rules. The ruling class defines orderly behavior as that which serves its interests and disorderly behavior as that which threatens its interests.

Because the needs of ruling classes change through history, what is considered normal and deviant has also changed. In contrast, real diseases do not change over time. Pneumonia in prehistoric times looked exactly the same as it does today.

Psychiatry doesn’t question the class system that generates mental distress; it targets the victims of the system and those who protest against it. Mental distress becomes the problem to be treated, not the social conditions that create distress.

Growing the Industry

Psychiatrists do not “diagnose” in the scientific sense of the word; they categorize and label. In North America, these categories and labels are determined by matching the patient’s complaints with groups of symptoms and behaviors listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is often called “the bible of psychiatry.” This is a fitting label because the DSM is based on dogma, not science.

The first edition of the DSM was published in 1952 and provided statistical information on 106 mental disorders. In 1980, the American Psychiatric Association (APA) expanded the DSM to include whatever psychiatrists think might be a disorder.

If there is general agreement among clinicians, who would be expected to encounter the condition, that there are significant number of patients who have it and that its identification is important in the clinical work, it is included in the classification.(12)

Since then, the DSM has grown on the same basis – the desire to maintain existing patients and include new ones who might seek help for any number of problems. The more people seek treatment, the more conditions can be entered into the DSM, and the more people can be encouraged to seek treatment for these new conditions. A profitable and self-perpetuating industry was born. According to one critic,

the DSM-IV is a catalogue. The merchandise consists of the psychiatric disorders described therein, the customers are the therapists, and this may be the only catalogue in the world that actually makes its customers money: each disorder, no matter how trivial, is accompanied by a billing code, enabling the therapist to fill out the relevant insurance form and receive an agreed upon reward.(13)

The DSM-IV, published in 1994, contained hundreds of disorders – everything from social phobia (shyness) to frotteurism (an irresistable urge to sexually touch fellow passengers on public transit).

The DSM-V, expected to appear in 2013, will offer “dimensional assessments” or degrees of severity (mildly neurotic?). This change will make it easier to label even more adults with mental disorders. And a new category – Temper Dysregulation Disorder with Dysphoria – could be applied to any angry, unhappy child. (14)

In 2005, a major study announced that “About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life…”(15) How is this possible? Has it become normal to be mentally ill, or has the definition of mental illness expanded beyond reason? Both are true.

Capitalism is a sick social arrangement that damages physical and mental health. And by expanding the definition of mental illness, more people can be labelled as sick and more profits can be made from selling them treatments. In Creating Mental Illness, Alan Horowitz observes,

…a large proportion of behaviors that are currently regarded as mental illnesses are normal consequences of stressful social arrangements or forms of social deviance. Contrary to its general definition of mental disorder, the DSM and much research that follows from it considers all symptoms, whether internal or not, expected or not, deviant or not, as signs of disorder.(16)

Most people know the difference between normal behavior (such as grief over the death of a loved one) and abnormal behavior (hallucinations) that might need treatment. However, with one exception, Post-Traumatic Stress Disorder, the DSM lists and categorizes symptoms outside of any cause or social context. This artificially inflates the number of people who are considered mentally ill and expands the potential market for drug treatment.

DSM population surveys include the grieving widow as well as the woman who is depressed for no apparent reason. These surveys also include people who are physically ill.

There are at least 60 physical diseases that can generate psychological symptoms.(17) Researchers estimate that from 41 to 83 percent of people being treated for psychiatric disorders are actually suffering from mis-diagnosed physical diseases like hypo- or hyper-thyroidism, heart disease, kidney failure, liver failure, immune-system diseases, malnutrition, nervous-system diseases and cancer.(18) These diseases cripple or kill when not properly treated. And many psychiatric drugs worsen physical diseases, sometimes fatally.

DSM-inflated rates of mental illness are typically accompanied by the warning that not enough people are getting treatment.(19) Whether all these people need or want psychological treatment is never questioned.

What is Being Treated?

The first edition of the DSM described mental distress as a reaction to some event, situation or biological condition. But when the second edition was published in 1968, the word “reaction” had disappeared.

By severing cause from effect, psychiatry removed mental distress from the realm of science. From then on, a mental illness would be anything the psychiatric profession chose to identify as a mental illness.

Most of the symptoms listed in the current DSM describe normal human responses to deprivation and oppression (anxiety, anger, depression) and ways that people try to manage unbearable feelings (obsessions, compulsions, addictions). However, psychiatry treats mental distress as a sign of inner malfunction instead of a reasonable response to unreasonable social conditions.

During the 1960s, psychiatrists medicated distressed women so they would accept their oppression. The Rolling Stones mocked this practice in their song, Mother’s Little Helper (1966):

Mother needs something today to calm her down

And though she’s not really ill, there’s a little yellow pill

She goes running for the shelter of a mother’s little helper

And it helps her on her way, gets her through her busy day

Social activists attacked psychiatry’s role in maintaining oppression. Dr. Alvin Poussaint recalls the 1969 convention of the APA,

After multiple racist killings during the civil rights movement, a group of black psychiatrists sought to have murderous bigotry based on race classified as a mental disorder. The APA’s officials rejected that recommendation, arguing that since so many Americans are racist, racism in this country is normative.(20)

The DSM lists hundreds of mental disorders covering a wide variety of behaviors in adults and children. Yet, sexism, racism, bigotry, homophobia (fear of homosexuality) and misogyny (contempt for women) have never been listed as mental disorders. In 1999, the chairperson of the APA’s Council on Psychiatry and the Law confirmed that racism “is not something that is designated as an illness that can be treated by mental health professionals.”(21)

Homosexuality was listed as a mental disorder until activists pushed for its removal in the 1974 revision of the DSM-II. However, the 1980 DSM-III listed feeling bad about being homosexual as a mental disorder.(22) In They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal, Paula Caplan explains,

In a culture that scorns and demeans lesbians and gay men, it is hard to be completely comfortable with one’s homosexuality, and so the DSM-III authors were treating as a mental disorder what was often simply a perfectly comprehensible reaction to being mocked and oppressed.(23)

Caplan describes the campaign to prevent “Masochistic Personality Disorder” from being included in the DSM. Women who refused to leave abusive spouses were being labeled with this disorder on the assumption that they enjoyed suffering. In fact, many abused women lack the resources to leave and risk being murdered if they try. Despite much protest, “Masochistic Personality Disorder” was added to the 1987 edition of the DSM, although it was later dropped.

Activists also rejected the inclusion of “Pre-Menstrual Dysphoric Disorder” (PMDD) in the DSM. According to Caplan,

The problem with PMDD is not the women who report premenstrual mood problems but the diagnosis of PMDD itself. Excellent research shows that these women are significantly more likely than other women to be in upsetting life situations, such as being battered or being mistreated at work. To label them mentally disordered – to send the message that their problems are individual, psychological ones – hides the real, external sources of their trouble.(24)

Human beings protest their oppression with open rebellion and through symptoms of sickness and distress. The prison system crushes the rebels, medicine treats the sick, and psychiatry subordinates the distressed. The goal of psychiatric “treatment” is to resign the discontented to their lot and drug the resisters into submission.

A Marketing Gold Mine

The psychiatric industry has provided a gold mine for the drug industry.

The Food and Drug Administration (FDA) will approve a drug to treat a mental disorder only if that disorder is listed in the DSM. Therefore, each new listing is worth millions in potential drug sales. Because most of the experts who construct the DSM are financially linked to the pharmaceutical industry, it’s not surprising that each new edition of the DSM lists more disorders than the previous one.

For DSM-IV, all of the experts working on the mood disorders (anxiety, depression, etc.) and “schizophrenia and other psychotic disorders” had ties to drug companies. The pharmaceutical industry also funds conventions and research related to disorders proposed for entry in the DSM because “what is considered diagnosable directly impacts the sale of their drugs.”(25)

Once the DSM lists a new mental disorder, drugs for that disorder are promoted for anyone who might fit the symptom checklist.

As soon as the DSM listed Pre-Menstrual Dysphoric Disorder (PMDD), pharmaceutical giant Eli Lilly repackaged its best-selling drug Prozac in a pink-pill format, renamed it Serafem, and pushed it as a treatment for PMDD. By creating Serafem, Lilly was able to extend its patent on the Prozac formula for seven more years.

The numbers of people diagnosed with any particular mental disorder rise rapidly after a drug is approved to treat that disorder.

Until the 1990s, Bipolar Disorder was thought to be uncommon in adults and non-existent in children. The recent explosion of Bipolar diagnoses followed approval of anti-psychotic drugs to treat it.

Beginning in the 1990s experts connected with the pharmaceutical industry began to argue that Bipolar Disorder was under-diagnosed in adults. Shortly after that, child psychiatrists began to argue that Bipolar Disorder was more common in children than previously thought.

Between 1995 and 2000, the rate of boys aged 7 to 12 labelled with Bipolar Disorder more than doubled. Today, Bipolar Disorder is the fastest growing psychiatric label applied to children.(26)

The New York Times reported that,

Some diagnoses of bipolar disorder have been in children as young as 2, and there have been widespread reports that doctors promoting the diagnosis received consulting and speaking fees from the makers of the drugs.(27)

By 2005, US drug companies were spending $4 billion a year on television and print ads to give their products the same level of brand recognition enjoyed by soft drinks and breakfast cereals.

Some drug companies offer coupons, free samples, free trials, and money-back guarantees for prescription drugs.

In 2002, hundreds of Florida residents were mailed a one-month starter supply of Prozac Weekly, a long-acting anti-depressant. The recipients were not taking this drug, had not requested it and had no idea why they received it. Investigators later discovered that doctors’ and pharmacists’ records had been mined to identify people who might try this anti-depressant.(28)

Drug companies bombard physicians with full-page ads promoting the broadest possible use of mood-altering drugs. Drug maker, GlaxoSmithKline, urged doctors to “Look for the Paxil spectrum in every patient,” adding, “The Paxil Spectrum. Treat One. Treat them all.”

Since Paxil was introduced as an anti-depressant in 1993, GlaxoSmithKline has paid almost $1 billion to resolve lawsuits over the drug, including $390 million for suicides or attempted suicides and $200 million to settle addiction and birth-defect cases. Compare these sums with the $11.7 billion that the company made from US Paxil sales between 1997 and 2006 alone.(29)

The more drugs are advertised, the more patients request them and the more doctors prescribe them.

In 2008, sales of prescription drugs in the US reached $291 billion, equivalent to $950 for every man woman and child in America. Sales of anti-psychotic drugs topped all other types of prescription drugs.(30)

To serve a sick system, psychiatry extracts the individual from society, splits the brain from the body, severs the mind from the brain and drugs the brain.(31)

The Assault on Children

Children are especially vulnerable to deprivation and have a limited capacity to articulate what’s wrong. So they protest in the only ways they can – with symptoms and behaviors that alert us that something is wrong in their world. And so very much is wrong!

In most schools, youngsters are forced to sit still in closed rooms for long periods of time and memorize information that has no connection to their lives. The ones who fall behind can be labelled with Reading Disorder, Mathematics Disorder and Expressive Language Disorder. The restless, defiant ones can be labelled with Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, Oppositional Defiant Disorder, and Disruptive Behavior Disorder Not Otherwise Specified. Once labelled, these children can be forced to take toxic, mind-altering drugs.

Even in families that can provide the material necessities of life, overstressed adults have insufficient time to meet their children’s emotional needs. When children protest by acting out, parents are encouraged (more often pressured) to consult doctors and other experts who “diagnose” these children, not the situation to which they are reacting.

Anxious youngsters who are not getting enough attention, or the right kind of attention, can be labelled with Separation Anxiety Disorder. Children who have suffered severe abandonment, abuse, trauma or neglect can be labelled Reactive Attachment Disorder. Although these children are reacting predictably to their plight, the DSM-IV declares them mentally ill. Such labels do nothing to change children’s situations so they can get what they need.

Using DSM criteria, millions of American children have been diagnosed with serious mental disorders. And drug companies are actively seeking more.

A 2007 DSM survey of 8- to 15-year-olds found that 9 percent met the criteria for Attention Deficit/Hyperactivity Disorder (ADHD). The study’s authors complained that fewer than half of these children had been diagnosed or treated. Noting that poor children were less likely to be on medication, the authors recommended “further investigation and possible intervention.”(32)

The new DSM V proposes to identify “risk syndromes” or the risk of developing a disorder like schizophrenia. Yet, studies of teenagers who were identified as having a high risk of developing psychosis found that 70 percent or more never develop the disorder. Defending this addition to the DSM, one prominent psychiatrist stated, “Concerns about stigma and excessive treatment must be there. But keep in mind that these are individuals seeking help, who have distress, and the question is, What’s wrong with them?”(33) (My italics)

No one is asking, “What do these children need, and how can we provide it?” To preserve a crazy-making system, the healthy, protesting child is labelled “crazy” and medicated into a subordinate, defeated child.(34)

Raising Living Standards

Depression is strongly linked with poverty, and alleviating poverty can lift depression.(35) This was demonstrated when a gambling casino opened midway through an 8-year study of child psychiatric problems.

This casino was owned by the First Nations and paid each aboriginal family a financial bonus that rose every year. These payments elevated 14 percent of the families out of poverty, while 53 percent remained poor. Thirty-two percent of the families were not poor to begin with.

Before the casino opened, the poor children were diagnosed with more than four times as many psychiatric symptoms as the children who had never been poor. After the casino opened, psychiatric symptoms among children who were no longer poor fell to the same level as children who had never been poor. In contrast, psychiatric symptoms remained high among the children who remained poor. Similar results were found in non-aboriginal children whose families had also moved out of poverty during the same period.(36)

Why would rising income improve child behavior?

At times, all children are impulsive, hyper-active, aggressive, and defiant. Children need supportive adults to help them manage strong emotions. When overstressed parents can’t meet their needs, children protest by acting out.

Rising incomes can meet enough of the parents’ needs that they, in turn, are more able to meet their children’s needs. Social support has the same beneficial impact.(37)

Since the 1980s, cuts in funding for education, family support and child services have led to an escalation in the number of children being diagnosed with psychiatric disorders and prescribed psychiatric drugs. Prescriptions for school-aged children commonly peak in September and drop in June – the duration of the school year.

One program offered an alternative to drug treatment. A trained social worker met weekly at home and at school with children diagnosed with ADD and their parents. While they were participating in this program, none of the children needed medication. When funding for the program ended, all the children became distressed and were put back on medications.

Child misbehavior always signals a crisis in their world. In a sane society, distressed children and their caregivers would get the support they need.

The psychiatric assault on children is fuelled by drug company propaganda that child behaviour problems are the result of “chemical imbalance,” not social injustice. Instead of challenging the deprivation that agitates children, psychiatry imposes conformity through medication. To force compliance, access to insurance benefits, medical care and social services depends on “having a diagnosis.”

Blaming the Victim

Capitalism not only denies the majority any real control over their lives, it also insists that this unfair arrangement be accepted as normal. To contain rebellion, all who are impoverished and oppressed are treated as personally inadequate, biologically defective, mentally ill – anything other than the victims of a heartless and exploitive system.

During slavery days, experts argued that Black people were psychologically suited for a life of slavery, so there must be something wrong with those who rebelled.(38) In 1851, the diagnosis of Drapetomania (runaway fever) was applied to slaves who showed a seemingly inexplicable longing to escape.(39)

During the Great Depression of the 1930s, American supporters of “racial purity” argued that social problems were best solved by preventing the “unfit” from propagating.

The Third International Congress of Eugenics, that convened in New York City, called for mass sterilization of unemployed workers and their children to eliminate “the existence among us of a definite race of chronic paupers, a race parasitic upon the community, breeding in and through successive generations.” One speaker declared that,

a major portion of this vast army of unemployed are social inadequates, and in many cases mental defectives, who might have been spared the misery they are now facing if they had never been born.(40)

In 1934, the editor of the New England Journal of Medicine proclaimed, “Germany is perhaps the most progressive nation in restricting fecundity among the unfit.”(41) Psychiatrists were especially enthusiastic. In 1931, the president of the American Psychiatric Association advised,

I believe the time has arrived when we should, as an Association, again most strongly express our approval of the procedure of sterilization as an effective effort to reduce the number of the defective population.(42)

Between the 1930′s and the 1950′s, the American Journal of Psychiatry published numerous articles in support of eugenic sterilization and euthanasia. One article recommended euthanasia for mentally disabled children, who “should never have been born — nature’s mistakes.” An editorial in the same issue advised psychiatrists to convince parents of such children “that euthanasia is the most humane solution.”(43)

While the Nazi genocide discredited talk of racial purity and euthanasia, psychiatry continues to champion the interests of the capitalist class by portraying its victims and opponents as sick or deviant and in need of “treatment” or punishment.

How should we diagnose this sick system?

We know what’s wrong. A few people accumulate wealth and power at the expense of everyone else.

What’s the treatment? Capitalism must be replaced with a socialist society that puts human needs first.

Who can deliver the medicine? The global working-class majority.

What’s holding us back? Lack of clarity and organization.

I don’t expect this diagnosis will ever appear in the DSM.

References

1. The only branches of medicine that examine social conditions – public and occupational health – are poorly funded and politically restricted.

2. Siegel, D.J. (2001). The developing mind: How relationships and the brain interact to shape who we are. The Guilford Press.

3. Pedersen, C.B. & Mortensen, P.B. (2001). Evidence of a dose-response relationship between urbanicity during upbringing and schizophrenia risk. Arch Gen Psychiatry. Vol. 58, No. 11, pp.1039-46.

4. Calamai, P. (2004). Lead exposure in womb linked to schizophrenia. Risk also found if mother had flu: 1960’s US data help unravel mystery. The Toronto Star, Feb. 15.

5. Opler, M.G.A., et al. (2004). Prenatal lead exposure, -aminolevulinic acid, and schizophrenia. Environmental Health Perspectives, Vol.112, pp.548-552.

6. St Clair, D. et al. (2005). Rates of adult schizophrenia following prenatal exposure to the Chinese Famine of 1959-1961. JAMA. Vol. 294, No. 5, pp.557-562.

7. Arehart-Treichel, J. (2003). Is schizophrenia a downside of urban life? Psychiatric News. American Psychiatric Association. May 16, Vol.38, No.10, p.37.

8. Kirk, S.S. & Kutchins, H. (1992). The selling of DSM: The rhetoric of science in psychiatry. New York: Aldine De Gruyter.

9. Horowitz, A.V. (2002). Creating mental illness. Chicago: University of Chicago Press.

10. Freud, S. (1901/1991). The psychopathology of everyday life. New York: Penguin.

11. Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York: John Wiley & Sons.

12. Spitzer, R.L., Sheeney, M. & Endicott, J. (1977). DSM III: Guiding principles. In Rakoff, V., Stancer, H. & Kedward, H. (Eds). Psychiatric diagnosis. New York: Brunner Mazel.

13. Davis, L.J. (1997). The encyclopedia of insanity: A psychiatric handbook lists a madness for everyone. Harper’s Magazine. February.

14. Davis, L.J. (1997). The encyclopedia of insanity. Harper’s Magazine. February. List of DSM codes

15. Kessler, R.C. et. al. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. Vol.62, No.6, pp.593-602.

16. Horowitz, A.V. (2002). Creating mental illness. Chicago: University of Chicago Press. p.37.

17. Morrison, J. (1997). When psychological problems mask medical disorders: A guide for psychotherapists. Guilford Press.

18. Klonoff, E.A. & Landrine, H. (1997). Preventing misdiagnosis of women: A guide to physical disorders that have psychiatric symptoms. Thousand Oaks, CA: Sage.

19. Talen, J. (2005). Survey says nearly half of all Americans will be affected by a mental illness, some before adulthood. Newsday, June 7.

20. Poussaint, A.F. & Alexander, A. (2000). Lay my burden down: Suicide and the mental health crisis among African-Americans. Boston: Beacon Press, p.125.

21. Egan, T. (1999). Racist shootings test limits of health system and laws. New York Times, August 14, p.1.

22. Kirk, S.A. & Kutchins, H. (1992). “DSM and homosexuality: A cautionary tale” in The selling of DSM: The rhetoric of science in psychiatry. New York: Aldine De Gruyter, pp.81-90.

23. Caplan, P. (1995). They say you’re crazy: How the world’s most powerful psychiatrists decide who’s normal. New York: Addison-Wesley, pp.180-181.

24. Caplan, P.J. (2001). Expert decries diagnosis for pathologizing women. Journal of Addiction and Mental Health. Toronto. September/October. p.16.

25. Collier, R. (2010). DSM revision surrounded by controversy. CMAJ, January 12. Vol.182, No.1, pp.16-17.

26. Carey, B. (2006). What’s wrong with a child? Psychiatrists often disagree. New York Times, November 11.

27. Carey, B. (2010). Revising book on disorders of the mind. New York Times, February 10.

28. Kohn, D. (2003). Pitching Prozac: Prescription drugs not ordered by patients turn up in mailboxes. CBS. February 19. http://www.cbsnews.com/stories/2003/02/19/60II/main541202.shtml

29. Feeley, J. & Fisk, M.C. (2009). Glaxo said to have paid $1 billion in Paxil suits (update 2) December 14.

30. News Release. (2009). IMS Health reports US prescription sales grew 1.3 percent in 2008 to $291 billion. March 19.

31. Ross, C.A., & Pam, A. (1995). Pseudoscience in biological psychiatry: Blaming the body. New York: Wiley.

32. Froehlich T.E., et al. (2007). Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med. Vol.161, pp.857-864.

33. Cited in Carey, B. (2010). Revising book on disorders of the mind. New York Times, February 10.

34. Breggin, P.R. & Breggin, G. R. (1994). The war against children: How the drugs, programs, and theories of the psychiatric establishment are threatening America’s children with a medical ‘cure’ for violence. New York: St. Martin’s Press.

35. Duenwald, M. (2003). More Americans seeking help for depression. New York Times, June 18.

36. Costello, E.J. et al. (2003). Relationships between poverty and psychopathology: A natural experiment. JAMA Oct. 15, 290 (15), pp.2023-2029

37. Hawkins, J.D. et al. (2005). Promoting positive adult functioning through social development intervention in childhood: Long-term effects from the Seattle Social Development Project. Arch Pediatr Adolesc Med. Jan. Vol. 159, pp.25-31.

38. Poussaint, A.F. & Alexander, A. (2000). Lay my burden down: Suicide and the mental health crisis among African Americans. Boston: Beacon Press.

39. Cartwright, S. (1851). Report on the diseases and physical peculiarities of the Negro race. New Orleans Medical and Surgical Journal. May, p. 707.

40. Quoted in Chase, A. (1977). The legacy of Malthus: The social costs of the new scientific racism. Chicago: R.R. Donnelley & Sons, p.328.

41. Editorial. (1934). Sterilization and its possible accomplishments. N Engl J Med. Vol. 211, pp.379-80.

42. English, W.M. (1931). The feeble-minded problem. Am J Psychiatry. Vol. 88, pp.1-8.

43. Editorial. (1942). Euthanasia. Am J Psychiatry. Vol. 99, pp.141-3. Cited in Nathanson, J.A., &. Grodin, M.A. (2000). Letter re: Eugenic sterilization and a Nazi analogy. Annals of Internal Medicine, Vol. 132, No. 12. June 20, p.1008.

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22 Comments For This Post

  1. Daniel Haszard Says:

    Nov. 16/06

    My issue is Zyprexa which is only FDA approved for schizophrenia (.5-1% of pop) and some bipolar (2% pop) and then an even smaller percentage of these two groups. So how does Zyprexa get to be the 7th largest drug sale in the world?

    Eli Lilly is in deep trouble for using their drug reps to ‘encourage’ doctors to write Zyprexa for non-FDA approved ‘off label’ uses.

    The drug causes increased diabetes risk,and medicare picks up all the expensive fallout.There are now 7 states (and counting) going after Lilly for fraud and restitution.

  2. Andrew Says:

    December 31/06

    Toxoplasma gondii, a parasitic protozoid, has been linked to schizophrenia and lower IQ – affecting the brain by forming cysts.

    A recent study has revealed that toxoplasma infection may affect 20% of Americans and over half of all humans. This would make for an interesting study; simply take a blood test and correlate that with the psychiatric diagnosis. My guess is that the results would be stunning!

    The link to the article is available here: http://www.smh.com.au/news/national/parasite-makes-men-dumb-women-sexy/2006/12/26/1166895290973.html

  3. Marc R. Wolsky Says:

    July 6/08

    I found this article on the true value of the DSM fascinating. It examined the issue of the modern treatment of mental illness completely, and I couldn’t argue with the author’s professionalism from a doctor’s standpoint.

    However, the idea of socialism taking the place of a mental health establishment fueled by a desire for money instead of a scientific treatment of the patient lacks, as do many modern ideas, an exacting basis for thought. Understanding the world as you suggest, doctor, takes a method of analysis that is eminently rational, such as learning the true nature of cosmology. Until we grasp the infinite capacity of the human mind to make a leap of logic, and therefore really solve the riddles of existence, we will be trapped in the guess-work frame of the current scientific method.

    I would like to say that I found your thoughts on the infinite nature of the human mind delightful and you should be commended on being closer to the mark in a truly clinical presentation!

  4. cemmcs Says:

    May 19/2008

    An excellent book relating to this is “Mad in America” by Robert Whitaker.

  5. Lloyd Rowsey Says:

    May 19/2008

    Absolutely a masterpiece of synthesis. Congratulations, Doctor Rosenthal – from a man who discontinued Depakote (after 10 years) and Lamictal (after 6 months) three years ago, and at the age of sixty-six has never been in better mental health.

  6. Dave Silver Says:

    May 19/2008

    Dr. Rosenthal has given us a powerful Marxist perspective on how a sick society called capitalism produces mental problems.

  7. Edwin Pell Says:

    May 21/2008

    A good book on the subject of society or individual in mental illness is Erich Fromm’s book “The Sane Society” (1955).

  8. hp Says:

    May 21/2008

    Kurt Vonnegut’s son, Mark Vonnegut, wrote a very educational, enthralling book about his own schizophrenia. It’s called “The Eden Express.” I read it way back in ’74 or ’75, and to this day I am sometimes reminded of it.

  9. Jane Says:

    This is a great analysis of the mental health situation. I have always asked the question:
    “If you are well adjusted to an insane society – what are you?”

  10. barb sliger Says:

    I appreciate and agree with your analysis of psychiatry and its uses (and look forward to the Q & A in response to your book on Unwelcome Guests); however, as much as I think the corporate-state capitalist system has become a global totalitarian structure, is socialism really the best alternative? Surely, there must be a polity that’s neither totalitarian, corporate, capitalist, socialist (national or international) where people can retain their sense of personal sovereignty and responsibility such that they have genuine power to choose in accordance with basic human nature, and that includes choosing to organize with others on behalf of their best interests; but without it being socialist. Isn’t the left perspective, old and new, very much tied to how we – humanity – came to be in the current predicaments?

  11. Susan Rosenthal Says:

    Barb: the ideas in society are the ideas of the ruling class, which has successfully discredited the idea that ordinary people could ever run society collectively and democratically.

    That is what socialism is, and why it is the only social arrangement that can solve our problems and meet our needs.

    Our rulers confuse us with words and labels. Only actions reveal the truth. Any society that calls itself socialist, and yet denies people the right to decide the conditions of their work and their lives, is not socialist.

    Socialism cannot be voted in, or imposed by minorities, or achieved by force. Socialism is what happens when the majority takes collective control of society. See POWER and Powerlessness for more details.

  12. Marianne Vardalos Says:

    June 4, 2008

    Dear Susan,

    Congratulations on a lucid, comprehensive and critical article. I hope you won’t mind me submitting a public call for testimonials from parents and teachers who used to be part of the diagnosing machine, but have since enlightened themselves.

    PLEASE CIRCULATE WIDELY

    I am a sociologist firmly committed to the current anti-psychiatry movement seeking to expose ADHD, ADD, and most LDs, as fraudulent diseases.

    Critics of the ADHD industry often site the ‘educator-parental-psychiatric-pharmaceutical complex’ as complicit in the drugging of normal, disease-free, children. Yet, parents and teachers participating in the diagnostic process for these so-called diseases have the very best of intentions and are misguided and misinformed by the pro-psychiatry/pro-pharmaceutical culture they live in.

    A critical sociological perspective sees the present ‘epidemic’ levels of reporting mental disorder in children and youth to be a purely cultural shift. As we transfer from modernity to post-modernity the culture shifts away from whole-body interaction with nature, toward mind-only interaction with technology. Simply put, the new economy requires a workforce of docile bodies, immobile from the neck down but from the neck up, able to consume multiple images, monitor split screens and interact with several media at one time. Children either incapable or unwilling to comply based on nothing more than their unique character are deemed ill, disordered, diseased or otherwise. And the label is fraudulently substantiated with ‘evidence’ from biology, genetics and neurology.

    This project seeks to feature the testimonials of parents and teachers who enlightened themselves and refused to reproduce the prevalent practice of labeling kids as ill because they either can not or will not conform to the needs of the new techno-economy. This is an invitation to parents and teachers who once willingly participated in diagnosing children with ADHD-like symptoms but now that they are aware of the problems of the industry, have chosen instead to embrace those childrens’ special gifts and spirited personalities.

    If you, your child or your students have a story to tell, please send it to me at: mvardalos@laurentian.ca

    Please ensure stories are no longer than 3 pages (single spaced) in an MSword attachment or in the text of the email. You may change the identity of the child if you wish.

    DEADLINE: AUGUST 15th, 2008

    Marianne Vardalos, Ph.D
    Assistant Professor
    Department of Sociology
    Laurentian University @Georgian
    University Partnerships Centre
    1 Georgian Drive
    Barrie, Ontario Canada
    L4M 3X9
    mvardalos@laurentian.ca

  13. Fred A. Baughman, Jr., MD Says:

    I am thrilled to see this most important article by Dr. Susan Rosenthal. I offer my comments to add to our understanding of the fraud being perpetrated by the collusion of U.S. Psychiatry, Big Pharma and Big Government.

    People go to doctors because they don’t feel well, and, yes, the first duty of the physician is that of diagnosis. However the first question posed by the duty to diagnose is: “Is there a physical abnormality, the same thing as a disease, yes or no?”

    Not all persons with complaints-symptoms are subsequently found by examination or tests, to have an abnormality-disease. In fact, in most GP or internal medicine practices, as many at 40-50% are found to have no objective evidence of abnormality-disease. Those who are anxious, depressed, or sleepless have complaints but no disease. The diagnosis for this group (which includes all with psychiatric diagnoses) is “no evidence or disease” or NED. Sometimes they are called “no organic disease,” NOD. The persons in the NED/NOD categories, having been found to have no abnormality-disease are not medical patients and do not warrant medical or surgical treatments. Those found to have an abnormality-evidence of disease are then subjected to “differential diagnosis,” the second and final part of diagnosis, which asks: “Which disease?”

    Not only are psychiatric diagnoses “not at all scientific,” they are anti-scientific-pseudoscientific-fraudulent, because those making such diagnoses are trained physicians who are knowingly calling subjective classifications abnormalities-diseases, while knowing perfectly well they are not. All physicians, even those who go into psychiatry (leaving organic, physical medicine behind) take a basic course in medicine which teaches them of all things normal (anatomy, chemistry, physiology) all things abnormal (pathology-disease) and how to tell the difference. Nowhere in psychiatry are there actual diseases, i.e., gross, microscopic or chemical abnormalities.

    In his 1990 editorial “In Bed Together at the Market: Psychiatry and the Pharmaceutical Industry, psychiatrist-of-conscience, Matthew P Dumont, MD (Amer. J. Orthopsychiat. 60 (4), October, 1990:484-485) wrote: “Some years ago Nathan S Kline, one of the luminaries of psychopharmacology, wrote that ‘The contacts of psychiatry with the pharmaceutical industry have been so overwhelmingly beneficial that it would be well-nigh criminal to jeopardize them.’ As if one could! The profession should give up its coquettish claims to psychotherapy and social science and openly declare its identity as an arm of the drug industry. It need fear no indignant response from a federal government that defines private profit as its raison d’etre. Indeed, the May-June 1990 issue of the Alcohol, Drug and Mental Health Administrations newsletter featured a front page announcement of its own ‘partnership to speed up and intensify the development of medications for addictive and mental disorders.”

    For much of the 1800’s and first half ot the 1900’s neurology and psychiatry were combined as neuropsychiatry, with its clinicians practicing both, finding organic diseases in their role of neurologist and finding no evidence of disease, only subjective, emotional and behavioral problems in their other role, as psychiatrist.

    In 1948 neurology and psychiatry were established by the American Board of Psychiatry and Neurology as separate specialties. Neurology is to deal with the diagnosis and treatment of physical diseases (abnormality = disease) of the brain, more specifically, with the central and peripheral nervous system, and muscle. Psychiatry, on the other hand, was to deal with the emotional and behavioral problems of physically normal persons—not with actual disease ( with feeling anxious, depressed, manic, panicky, “hyper,” etc.) Patients referred to psychiatrists are previously determined, by neurologists and other non-psychiatric physicians, to be free of organic disease.

    The more psychiatry claims that its diagnoses are actual diseases, the more it seeks to link itself with neurology, to give the suggestion of organic, medical legitimacy to diagnoses that have none.

    Psychiatrists do not examine or test for physical/organic diseases. Their claims that they diagnose “chemical imbalances” of the brain is fraudulent. In contrast, neurologists, and all non-psychiatric physicians, determine (1) whether or not organic disease is present, and, (2) if so, which one it is. The process of distinguishing which, of several diseases a patient may have is called “differential diagnosis”. When no organic disease is found, but emotional and behavioral complaints persist, the patient is referred to a psychiatrist or some other type of mental health professional.

    In 1970 “hyperkinetic disorder (HKD)/ Minimal Brain Damage/Dysfunction (MBD) was first represented by psychiatry, in a Congressional hearing, chaired by Cornelius E. Gallagher, D-NJ, to be an actual disease. This made it fitting and acceptable to give truly-normal children drugs. Dr. Thomas C. Points, Deputy Assistant Secretary , Department of Health, Education, and Welfare (HEW): “Hyperkinesis is recognized by the medical community as one of the more common behavior disorders of childhood which, when diagnosed by a competent physician or medical team, lends itself to safe and effective drug treatment.” A letter to the Honorable Cornelius E. Gallagher, Chairman of this, the Right to Privacy Inquiry, from the Honorable Elliot L. Richardson, Secretary HEW 11/03/70: “As you notice stimulant drug treatment of children with this disorder began in the late 1930’s and has been widely accepted as safe and effective by the medical community.” “We have no vested interest in the use of any one treatment modality and are continuing to look for the most effective treatments and treatment combinations for this disorder.” NIMH is currently supporting a number of studies which involves other drugs, attempting to compare their efficacy to the stimulant drugs which are presently considered the standard reference drugs for the treatment of Hyperkinesis.” Elliott L. Richardson, Secretary. Here we have the secretary of HEW touting for the pharmaceutical industry.

    This is all-important, but can hardly be imagined by most unless it has happened to them or theirs. The “disease” labels become part of all official records, whether they are a child or adult, and those records follow them everywhere and assure they are known to one and all as “seriously mentally ill.”

    But labels alone are not enough. They are drugged with chemicals that make them more or less physically dependent or addicted to the drug and more or less conspicuously abnormal and “seriously mentally ill” whereas, with the label alone there were no stigmata to see. This is why psychiatrists defy every urging that they diminish the dose. To do so means they give up control of the patient. The infamous case of Nate Tseglin of San Diego and Orange County, just stripped by his parents from the clutches of psychiatry is fresh in mind.

    Despite the serious adverse effects of the especially-dangerous anti-psychotics, the psychiatrists of the psychiatric hospital where Nate was a “pay-point” did nothing but increase the doses of drugs. By doing so, they kept control of Nate, making him one more “pay-point” in the extended industry. When Nate’s nightmare began he had no discernible disease. He has since suffered from seizures and grotesque involuntary movements (dyskinesias)due only to psychiatric drugs. this drug-poisoning is the only real disease in psychiatry.

    The following quote is from the American Psychiatric Association’s Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR) published in 2000, pages 88-89.

    “There are no laboratory tests, neurological assessments, or attentional assessments that have been established as diagnostic in the clinical assessment of Attention-Deficit/Hyperactivity Disorder. Tests that require effortful mental processing have been noted to be abnormal in groups of individuals with Attention-Deficit/Hyperactivity Disorder compared with peers, but these tests are not of demonstrated utility when one is trying to determine whether a particular individual has the disorder. It is not yet known what fundamental cognitive deficits are responsible for such group differences.”

    With no evidence of an actual disease or abnormality (to be made normal), on April 10, 2001, the Frontline production “Medicating Kids” reported that 6 million US schoolchildren have ADHD. And, as we know, children diagnosed with depression, ADHD, or a combination of the two (dual diagnosis) almost all take Schedule II, controlled, stimulant medication, mostly Ritalin and amphetamine.

    The clear, written intention of the APA to deceive and victimize the U.S. and the rest of the world (where they (with Big Pharma) vigorously export their scam) is found in the Introduction, xxi of the DSM IV under the definition of Mental Disorder. It reads:

    “Although this volume is titled the Diagnostic and Statistical Manual of Mental Disorders, the term mental disorder unfortunately implies a distinction between “mental” disorders and “physical disorders that is a reductionistic anachronism of mind/body dualism. A compelling literature documents that there is much “physical” in “mental” disorders and much “mental” in “physical” disorders.”

    The crux of the fraud is here: “A compelling literature documents that there is much “physical” in “mental” disorders and much “mental” in “physical” disorders,” without supplying a single citation-reference to a single proof that any one psychiatric “disorder” is real, i.e., a disorder/disease/physical abnormality.

    Author: The ADHD Fraud—How Psychiatry Makes “Patients” of Normal Children

  14. Dan Abshear Says:

    This Makes Me Sick

    When I was a child, I heard the phrase ‘war-monger’. I had to find out its definition, as I had no idea what that phrase meant.

    I knew others could, and were, labeled with this phrase, as I had heard it in the past directed at others whoever said these two words. So I felt a need to know what these words meant, and how they affected others who heard them.

    Finally, I found the answer: a warmonger is one who promotes war, which is undesirable or discreditable. In this case, one labeled this would have an affinity for what others are reasonably opposed to share the same views:

    Others promote other things besides war.

    Disease mongering is when a large pharmaceutical corporation implements various unethical if not illegal activities in order to sell more of their products by either creating or expanding a particular illness.

    They do this by creating the perception that others are likely ill in some way when, in fact, they are not. Those in the pharmaceutical company do not call this disease mongering, but rather conditional branding.

    Drug companies do this by seeking more of those who should be patients in need of treatment with the drug maker’s promoted medications, regardless if they are in need of such treatment or not, clinically.

    How this is done by these companies will be described soon.

    The drug makers clearly place the needs for their drugs to be for medical conditions whose treatment regimens are to be viewed by others as incomplete or unmet.

    The companies want to let the public know of the progressive increase for the disease states and how their products treat this illness better than what is available now or has been used in the past.

    How ironic it seems that drug companies, who make drugs to delay the progression of, or cure diseases with these drugs, wish for others to become as sick as possible to profit from their suffering that they create with disease mongering and sell more pills.

    This disease-mongering in fact does occur often to widen the diagnostic boundaries of an illness, disorder, or syndrome by creating awareness of such medical conditions to the public.

    The drug companies do this by utilizing in several ways the delivery of fabricated if not baseless information during this process.

    Usually, the pharmaceutical either creates or expands a disease state by deception directly to consumers, often. Then the consumer, who now believes that they are ill, go see their health care provider.

    The health care provider, due largely to the unfamiliarity of the patient’s symptoms expressed by the patient, if not the drug the patient is requesting, usually writes a prescription for the drug requested by the patient.

    First, let’s take a look at this label of disease mongering. It is inappropriate in that, unlike diseases and illnesses, mongering occurs with medical disorders and syndromes as well.

    It is accurate and authentic, however, that disease mongering does happen with deliberate intent and reckless disregard for the well-being of others by drug companies.

    There was a book written by Ray Moynihan and Allan Cassels called, “Selling Sickness” in 2005. The book thoroughly described how big pharmaceutical corporations are turning all of us into patients, and into a over-medicated society.

    Disease mongering progressively continues to create patients with illnesses, disorders, or syndromes that in fact may not exist without any intervention to discontinue this behavior.

    What the drug company implements to make sure this happens includes the following:

    1. Paying medical journals to publish fabricated clinical trials involving their promoted medications after paying those involved with such a clinical trial to create such fabricated data. That is disease mongering to the health care provider.

    2. Subjective screenings, such as those for various mood disorders. These screenings, as well as the affective disorders, which were rare until about 1995, involve leading questions often- created by the drug company. It was around this time that the United States was becoming more of a psychotropic nation.

    These screenings that involve the leading questions responded by select groups of people. They are asked these questions by certain disease state support groups who have been converted into front groups after being funded by those big pharma companies who produce drugs for particular mood disorders.

    3. Disease creations I: Social Anxiety Disorder, or social phobia: This condition is in the DSM IV which was published in 1994, and some were forced to delete the statement regarding this disorder that said, “Social Anxiety Disorder is not well-established, and requires further study.”

    Aside from what may be simply amplified introversion, social phobias are likely due to societal dysfunctions and certainly should not be labeled as a pathological condition requiring pharmacological treatment.

    4. Disease creations II: Premenstrual dysphoric disorder. I call this a mid-life crisis, yet it was entered by instruction by the APA (American Psychiatric Association) into the DSM (the psychiatrist’s bible) in 1993. Anxiety about the inevitable does not require pharmacological treatment.

    5. Direct to Consumer Advertising:. Most memorable were those commercials for erectile dysfunction. Their absurdness in creating these commercials appears to have multiple psychotic components:

    A healthy man who could probably run a marathon is having a decent time with his wife at some upper- middle class location.

    He is smiling all the time. Because now, his marriage is secure due to his ability to copulate- which was apparently absent before this wonder drug entered his system.

    Of course, it is not possible to have a happy marriage without intercourse, right?

    Then there are other conditions which are entirely natural in the human lifespan, yet have been determined to be diseases by those who can profit off of these lifespan events.

    Examples include osteoporosis and menopause, as well as erectile dysfunction. It’s insane the FDA approves pharmaceuticals for these natural events that occur normally in a human being.

    Finally, there are the required medical guidelines for various disease states, such as dyslipidemia. Drug companies that make medications to treat this disease are more than happy to support the financial needs involved in creating these guidelines.

    Dyslipidemia, for example:

    Publications such as the Lipid Letter, and Lipid Management, both offered more aggressive management of the lipid profiles of the patients of the readers.

    And both publications were funded completely by those big pharma companies that promote statins.

    Same with cholesterol screenings that occur often that are implemented by those drug companies with drugs that treat the disorder of dyslipidemia.

    A myth is something unproven. A false belief, or invented story.

    Disease Mongering is not a myth. Large pharmaceutical corporations promote illness and disease- not desired by anyone and discredited by many, and these companies do this for profit and profit only.

    I worked for three of the largest pharmaceutical companies in the world for over a decade, and the disease mongering protocols were similar if not identical with all of these companies consistently.

  15. Anonymous Says:

    “Most of the symptoms listed in the DSM describe human responses to deprivation and oppression (anxiety, agitation, aggression, depression) and the many ways that people try to manage unbearable pain (obsessions, compulsions, rage, addictions).”

    I think this is the most important sentence in the article. This was why it took me two weeks to get out of a mental hospital when I was 19 at Shands Vista in Gainesville, Florida.

    After being admitted at Shands, I was put in a car with two men who did not tell me where I was going. I was then driven on the highway to the next exit and down a long road to the mental institution. The next morning of my admittance, I was awoken around 6AM by 3 doctors who stared down at me. I sat up and tried to figure out where I was and who these people were. All three of them frowned down at me.

    They asked me if I knew why I was here. They talked down to me and the more they talked the more I lost hope. There was no kindness in their voices; there was no feeling that they were their to help me. Rather, I felt that they were there to examine and punish me. This did not improve over the next 2 weeks. They woke me up and asked me the same exact questions every single day. They asked me if I knew why I was there and what I had done- every single day. I began to think that they wanted a different answer and that I would be there until they had indoctrinated me enough to give the right answer. I began to fall deeper and deeper into psychosis.

    I would come to realize that the only people who would help me were the volunteers and lower-level employees. The people that helped weren’t the nurses and doctors who walked around with symptom check lists and who seemed to treat their time at Vista as some sort of stepping stone to better things- nor was it the graduate students. The people that helped were the less educated people. Some of the black women gave me advice as they realized that there was good inside of me. Unfortunately, I would usually never see the same volunteer or lower-level employee for many than 2 or 3 consecutive days before then they were gone. I learned to make sure I knew every single employee’s name. I wrote them down and practiced them. I wrote thank you notes- the only thing that seemed to cause a few of the nurses to sympathize with me. This was not so with the doctors; they were cold, methodical, and (I assume) over-worked.

    The main living area, the only common area, was a good deal smaller than 1/2 or 1/3 of a typical high school cafeteria. This area, along with my shared room, was the only area I used. I was not instructed about any of the rules of Vista, I was not shown how to use the phone (and I never was able to), and it was not explained that I could choose my own meals. The first day was the worst day of my life. I felt that I would never leave this place. I lost all hope. The sheets did not fit the beds. The puzzles were mixed together and missing pieces- as if someone decided it would be funny for people already suffering from mental anguish.

    The only Bible in the common room had the cover torn from it and was missing a number of pages. Some of the other patients were well beyond my own condition, walking around shouting at walls and each other. One lady must have been there for weeks if not months/years. I would speculate that while Vista did not cause all her problems, it could very likely have been responsible for her complete loss of reality- something which would happen to me during the next week (temporarily thankfully). I was terrified that this might be the person I would become. Another lady had a cast on her arm from where she had just tried to slit her wrist. At any given time, there were about 15-25 people in this small section of Vista. Very few people in Gainesville even know this place exists, however, I have spoken with friends who also had traumatic Vista experiences.

    For the first few days I tried to stay in my room, but I was compelled to spend time in the common area talking to other patients “if I wanted to leave.” The beautiful gardens outside mocked me as if I were a prisoner looking out at something beautiful and free that I would never again enjoy.

    Most of the classes were demeaning and humiliating- like coloring cut out paper fish- activities that must have literally been taken from a kindergarten class. I would say that half of the classes caused my symptoms to become worse. They showed traumatic videos of people experiencing various problems, they only supported talk from people who supported their viewpoints, and they discouraged dissension. Some of the class volunteers were incredibly helpful. They would cover some of the required material, but they would mainly give other advice that helped me make it through my stay. I wish I could thank these people so that they could know how much they helped me.

    The demeanor of all the employees changed during visits- they acted helpful and friendly- only to return to their original apathetic disinterested demeanor after visitation. I felt as if my whole world had been shrunk down to this one room and that they were coming from somewhere else to visit me. I was discouraged from accepting meals from my family because it “wasn’t fair to other patients.” There was no floss. I was mocked when my parents brought me a better toothbrush.

    Boredom was the most difficult thing to deal with after fear. There was nothing to do except try to put together puzzles that were mixed up with each other and try to watch the one small TV. We were allowed outside to a porch area several times a day. Unfortunately, despite the rules against tobacco (which I later found on a door and read), people smoked cigarettes during each break. I had quit smoking cigarettes a year before and did not want to be outside when people were smoking. Thus, I rarely went outside to the porch, and I never had any fresh air. I dreamed of running away. I felt broken and bruised, and I increasingly believed that this was what I deserved. I don’t remember the specific rules and rights, but I remember reading that one requirement was that they would explain the rules and rights to us upon our admission- something that they never did. They discouraged any discussion of the rules, and the actual running of this section of Vista followed some sort of unwritten code that I had to learn over my stay.

    When I asked for a different Bible, I was told that the torn Bible was good enough. However, there was no title to say what type of Bible it was and it was missing dozens of pages. Throughout my stay, I asked for a United Methodist Pastor to see me or any other type of Minister- one of the promised rights of my stay. However, I was not visited by any Pastor or any Minister- rather I was taken outside to the screened smoking porch by a Shands’ Chaplain. When he did not offer any advice other than asking me repeatedly what denomination I was, I tried to walk inside and he grabbed me while I squeezed my body inside through the door. Terrified and bewildered I retired to my room.

    Students from UF came by to help us do ridiculous “work out programs” such as rotating your hips and touching your toes- great things for the 60+ year old patients. However I was 19 (one of the youngest patients) and did not find these very helpful. I could feel my muscles deteriorating, and I was losing weight. For the first five days, the same sign was left up- it read something like this: “Quote of the day: Try your best every single day,” Funny

    I finally began treating my stay as if I were a POW;it was the only thing that made me feel that it wasn’t my fault and that I might have a chance of being free. I tried to spend my next days doing everything I could to move towards freedom. Terrified but with renewed hope I began to train my mind, and I tried to work out in whatever way I could. I used accounting textbooks to practice math- afraid my mind was deteriorating in this terrible place. My father brought me a family Bible that I had to read in private. I was mocked whenever anybody saw me read a Bible, and I was discouraged from reading it or from praying. In private, I did push-ups, sit-ups, and jumping jacks. I knew that improving myself physically as well as mentally was the only way I could ever regain my health.

    They began to give me high doses of anti-psychotic medicine. One day I silently prayed to myself before taking the medicine- afraid that they were slowly medicating me to the zombie-like stage of the mentally unstable in movies like One Flew Over the Cuckoo’s Nest. The doctor yelled at me to stop praying. The doctor I used after my release commented on how ridiculous the dosage was. As an aside, this Psychiatrist (after my stay) saved me life by simple medication adjustments and by gaining my trust (setting aside judgments about what I said and what I had endured). I was diagnosed as bipolar with severe depression.

    I’ll be graduating from UF next semester, and (hopefully) attending law school the following Fall. I’m afraid other patients admitted to Vista at Shands will never be as fortunate. I’m sure there are other people around the world who enter with the same problems I had and are never freed. There are some things that occurred there that I will never be able to talk about. When I left the hospital, I was told that there was a survey I could take but that there was no reason to do it and that I shouldn’t do it. I didn’t care, I just wanted to leave.

    Shands is one of the top hospitals in the country, and it is a shame that things such as this happen in their mental rehabilitation center. My experience caused enough stress for my family and myself, and I am moving on to better things. I have no interest in holding any institution or individual responsible; I only hope that this might be taken into account to help improve Vista and similar institutions.

  16. Dan Abshear Says:

    The Corporate Funded Birth Of Disease Through Unease

    Attempts to convince normally healthy people that they are in fact sick and there for require pharmacological intervention can significantly inflate the market specific to the disease state whose boundaries diagnostically are now artificially expanded through disease mongering.

    The financial cost to both the individual and the community due to disease mongering is rather high. Deliberate separation from the pharmaceutical industry- as well as a tactical plan for thorough critical analysis- are necessary to combat disease mongering.

    Furthermore, educating patients who in fact may not be patients by empowering them to make correct decisions regarding their health are of importance as well.

    Disease mongering is medicalization, which is the deliberate marketing plan of turning what are normal and common lifespan events that are far from chronic into fictional medical conditions.

    Through propaganda, disease mongering creates the perception among others that occurrences that are within normal limits are in fact concerning symptoms. This leads others to believe that risks are potentially disease states.

    This propaganda done by the pharmaceutical industry is performed through public awareness campaigns ad nauseum in mass media with the intent to strongly persuade others to seek and acquire new marketed treatments by this industry.

    In addition, the creation of support groups for these disease states that are not are provided by the pharmaceutical industry that are in reality front groups for members of this industry.

    Clinical data shared with the public is often fabricated, embellished, or misrepresented. The frequent claim that a drug provides relative risk reduction greatly of a disease state believed to exist is a manipulation by the drug company. Absolute risk reduction, however, is the true representation of the efficacy of a drug.

    For example, if drug A states that it provides a 50 percent relative risk reduction in the progression of alopecia often sounds impressive to many. In reality, this may and often means that out of, say, 100 people, two had progressive alopecia. Yet with drug A, only 1 out of 100 had alopecia.

    When the ladder, absolute risk reduction, is presented, it gives the impression that drug A really is not that efficacious after all.

    The copious amounts of advertising by the pharmaceutical industry is done so with the intent to create fear, anxiety, or sadness upon the viewer about their lack of ideal health that deceptively is far from the truth.

    As a society in the U.S., we are falsely led to believe that youth and efficacy as an individual should be acquired at any cost. Any fallacy perceived by one that prevents the acquisition of youth and efficacy ultimately leads many others to eliminate such fallacies.

    Examples of diseases simply created by drug companies include erectile dysfunction, which is a symptom often of a truly existing disease, social phobia, which is simply introversion- a normal personality component of humans, as well as male pattern baldness, which occurs naturally in about half of men due to genetic predisposition.

    The danger and consequences of disease mongering include the waste of often precious medical resources, as well as the possibly of causing iatrogenic harm to one seeking restoration of their health.

    And the pharmaceutical industry has allies with their business plans of disease mongering. These include again front groups, hired journalists, public relations companies hired by drug companies, as well as doctor groups.

    All utilize mass media to facilitate their objective. Disease Mongering is more frequent presently due to lifestyle drugs- drugs that do not delay the progression of authentic disease, or treat these diseases, but rather comfort a consumer rather than a patient.

    Lawmakers in the United States are aware of disease mongering. However through over saturated lobbying by those in the pharmaceutical industry, such government officials have chosen not to intervene to prevent this potentially dangerous marketing tactic.

    This is concerning, considering that presently the restructuring of the health care system in the United States is in its first phase. Disease mongering is not contributing, but in fact is corrupting this restructuring.

  17. emphryio Says:

    Good article and happy to see some good comments.

    This is an interesting question BTW: “If you are well adjusted to an insane society – what are you?”

    It at least seems to me that on the one hand people in minority movements like socialism feel the need to portray themselves as happy for various reasons. At the same time, again, what does it actually mean to be happy in an insane society?

    Furthermore I suspect the actual main reason that people “believe” in capitalism is simply that they want to be happy and thus they need to believe the system they’re stuck in is the best of all possible worlds. (Panglossianism.)

    Or that, anyway, along with a MSM that has brainwashed people into thinking there is no alternative.

  18. Lisa Geiger Says:

    I think this article has some excellent points which goes right back to my pet peeve, that people are getting psychoanalyzed too much, and understood too little partly, because their social situation, is ignored.

    I suspect if there was less of a gap between rich and poor, fear of starving to death being one example, a lot of the dysfunction induced by stress would probably be reversed and possibly the myths that divide us would either be exposed for what they are, or forgotten and written off as horrible errors/biased opinions from a dark age which held back the majority of the human species, so that a small percentage of people could live like Kings and Queens and dictate like Gods while misusing the word democracy to actualize their own personal agendas.

  19. Lisa Geiger Says:

    This is a very interesting subject, when you think about it.

    Internal conflict is a terrible thing, and could be created very easily, by marketers, social workers, even peers/bosses who tease/bully.

    The connection of war mongering and mental illness mongering is very good.

    I would think though, the effect of the mental injury is very difficult to cure. It is not like a broken leg, but when is a broken leg called an illness anyway?

    Broken sense of identity, is probably very dangerous psychologically, and could be used to injure people in ways they would not be able to fix themselves, since it may be based on the social disconnection.

    I would think the social disconnection could be backed up by official manuals and professional institutions, not on purpose I would think, but as an unintended consequence of the “diagnosis”.

    The real issue is being able to compete for income, so a person can integrate and live a normal life.

    That is the worse thing I think about the mental health industry.

    They put a label on people, which alienates the patient, and legitimizes the disconnect the person’s immediate social structure might have given but takes away out of fear of the label, then the problems related to being socially disconnected kick in, and the personal deterioration is then continued to be misdiagnosed as part of the mental illness which is probably manufactured through consent the way war appears to be, and sexism, and racism, and all those things that keep us apart, do.

  20. Christophe Says:

    “The social movements of the 1960’s opposed psychiatry’s focus on inner conflict and emphasized the social sources of sickness instead.”

    The above excerpt is pretty much the paradigmatic model that still informs most of the institutional side of psychiatry. With more psychiatrists working for the state in some capacity, the idea of contractual-consensual psychiatry seems ever more quaint a notion. Not to dialate to much, however, to whom does the psychiatrist-or the profession for that matter-hold its allegiance? To the state or to the individual. By examining the various laws, PUBLIC policies and, generally, the professional rhetoric, the answer is self evident. One ineluctable outcome of the push for greater social health, has resulted in appreciable erosions of civil liberties (Take the “right to treatment” law that stands to punish both physician, for failing to “treat” and, patient, for refusing coercive measures.
    As a Libertarian on most matters social and political, I cannot sit idly by without voicing my concern at those abridgements and erosions of rights, even under the aegis of “Therapeutic” measures. As long as a culture seeks such an institution to “care” for the deviants and, problematic individuals-those who have committed no crime-the state will continue its present course, along side the MH apparatus it has empowered.

  21. Andrew Wells Douglass Says:

    Be careful not to somehow turn attacks on psychiatry and pharmaceuticals into proof that mental illness is a fabrication. This is like attacking medicine for using leeches. That early methods were misguided or corrupt in no way bears on the existence of treatable disease. It is a rather tired rhetorical trick to attempt otherwise. Throwing in footnotes and a scholarly tone does nothing to correct this execrable logical fallacy.

  22. Susan Rosenthal Says:

    Mental illness is not a fabrication. Social conditions truly make people sick.

    At the same time, mental illness is not a disease. The disease is capitalism. Mental illness is one of the consequences of capitalism, as are child abuse, domestic violence, poverty, hunger, and war. None of these miseries are called diseases.

    I am convinced that if my patients were provided with sufficient financial and social support, most would recover. No real disease would respond to such measures.

    Calling mental illness a disease hides its social causes, so we focus on the victim and do nothing to stop the system from creating more illness and more victims.

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