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Crazy or just mad as hell?

06/08/2013

There have been many reasons posited for the unprecedented rise in the diagnosis of mental illness across the developed world in recent decades.

What was once the preferred official explanation – that better diagnostic methods and greater access to mental health professionals means that fewer crazies are now going undiagnosed – has now largely fallen out of favour, even within the bastions of mainstream psychiatry.

The US National Institute of Mental Health has condemned the new edition of the Diagnostic and Statistical Manual (DSM) for spreading the definition of mental illness so far that ‘normal’ has been pathologised. Authors of earlier editions of the DSM have been even more scathing.

It has long been recognised that the long-term prognosis for those diagnosed with psychotic illness in the third world is better than it is in countries where the patient is more likely to receive ‘state of the art’ therapies.

In  Anatomy of an Epidemic, journalist Robert Whitaker argues that it is the therapies themselves – specifically psychiatric medications – that are aggravating and perpetuating the symptoms of mental illness. Recent large-scale studies into bipolar disorder – the STAR*D and STEP-BD trials – support his case, showing that bipolar patients prescribed antidepressants have worse outcomes than those who do not receive the drugs. Dr S. Nassir Ghaemi, the director of the Mood Disorders Program at Tufts Medical Center and a proponent of psychiatric medication, suggests the more serious rapid cycling form of bipolar disorder that has reached epidemic proportions in recent decades is entirely iatrogenic – it is caused exclusively by antidepressants.

Another reason cited for the increasing burden on first world mental health systems is the increasing atomisation of society.

A generation or so ago most support for the mentally ill or those in danger of becoming so came from families and the community. Often it was pretty dysfunctional – locking up the crazy old aunt in the attic and not talking about her to outsiders – but the first port of call for those under psychological stress was usually friends, family or clergy. Small communities often found a place for the local ‘eccentric’ that didn’t involve psychiatrists, counselors or a formal diagnosis of mental illness. Many others would never have shown enough symptoms to qualify for a diagnosis because of the social support they received, even if it was only in the form of reduced demands and expectations.

Now an increasing number of people live on their own or share a home with only one or two others who are too pressed themselves to offer much in the way of support. Few would even consider turning to a priest or nun for psychological help. In fact the rise of Neo-Atheism and the wave of church-based sex scandals means that many now see the clergy themselves as pathologically deluded. When someone displays emotional extremes or psychotic symptoms in public they are now more likely to be greeted with fear and a police response than sympathy and a helping hand.Alejandro Jodorowski on internalised oppression

Clinical psychologist Bruce Levine has recently proposed an intriguing alternative reason for the surge in mental illness diagnoses, particularly of young people. Political suppression. Specifically, the suppression of young anarchists.

As Rich Winkel tried to tell Ralph Nader over a decade ago, psychiatry has worked hand in hand with oppressive authority since its inception.

One of the first ‘mental illnesses’ to be defined in the United States was drapetomania, the pathological tendency of some black slaves to run away from their masters. Fortunately the physician who discovered the disease, Samuel A. Cartwright, also developed therapies to cure it. Acute drapetomania could be treated by ‘whipping the devil’ out of the afflicted Negro, while chronic cases were best dealt with by cutting off the sufferer’s big toes. Neuroleptic drugs had not yet been invented.

Women, racial minorities and the poor have always born the heaviest burden of psychiatric pathologisation. Men such as F Scott Fitzgerald who found their wives socially inconvenient could always count on a cooperative psychiatrist to have them locked away. In ‘Toxic Psychiatry‘, Dr Peter Breggin documents the case of Elizabeth Packard, institutionalised at the behest of her husband Theophilus in 1860 for believing humans are basically good and slaves should be set free. The doctors agreed that these were signs of serious insanity. Theophilus then set about stealing her inheritance, selling all her property and moving interstate with her children.

But it is when psychiatrists join up with state authorities that the worst abuses take place.

In the early 20th Century psychiatrists were quick to nail their colours to the mast of the eugenics movement. In 1920s Germany, psychiatrist Alfred Hoche and jurist Karl Binding developed the philosophy of ‘life unworthy of life‘, the notion that certain people, such as the mentally and physically disabled, should be executed so that health resources could be redirected to citizens more likely to contribute to the nation. Their book inspired the Nazi T4 Project, in which psychiatrists emptied the asylums of Germany by sending those who could labour to camps where they were worked to death and executing those who couldn’t, usually with lethal gas. Those psychiatrists would later take their expertise to the concentration camps where it would be used to industrialise the extermination of Jews, Gypsies, communists, homosexuals and Jehovah’s Witnesses.

In the 1950s Soviet psychiatrists under Andrei Snezhnevsky discovered ‘sluggish schizophrenia‘, a mental illness characterised by almost normal day-to-day functioning, but in which the patient developed ‘philosophical intoxication’ or ‘grandiose ideas of reforming the state’. Needless to say the Russian mental health gulag was soon full of political dissidents, would be emigrants and religious believers carrying this diagnosis.

When the CIA wanted to develop mind control techniques to counter what it falsely imagined to be the advanced brainwashing methods of the North Koreans it had no trouble recruiting large numbers of American, Canadian and British psychiatrists and psychologists to the cause. From the early 1950s to the late 1970s programs such as Project Bluebird, Project Artichoke, MKDELTA, MKSEARCH and MKULTRA employed thousands of mental health professionals dedicated to bending the will of government employees and unsuspecting civilians to the demands of the state using methods such as torture, hypnosis, psychological and sexual abuse, subsonic voice insertion, sensory deprivation and covert administration of drugs such as LSD. Although officially shut down by Congress in 1975 several MKULTRA projects continued into the 1980s and similar work is carried out to this day by the Defense Advanced Research Projects Agency (DARPA).

In Australia, notorious psychiatrist Dr Harry Bailey was referred many involuntary patients by the courts, including exhibitionists and homosexuals who, up until the 1970s, were considered criminally insane by the psychiatric establishment. These people were subjected to forced psychosurgery, electroshock and the often fatal barbiturate induced deep sleep therapy. It wasn’t until a media exposé in 1982 that authorities finally turned on Bailey and in 1985, having been publicly humiliated and under threat of imprisonment, he swallowed a bottle full of his own barbiturates. His suicide note read “Let it be known that the Scientologists and the forces of madness have won”.

According to Dr Levine, psychiatrists have now turned their attention to young anti-authoritarians, not at the direct behest of authorities but simply because their own outlook and training prejudices them to see anyone who resists authority, legitimate or not, to be mentally ill. Drawing on thirty years of clinical experience Levine states “many young people labeled with psychiatric diagnoses are essentially anarchists in spirit who are pained, anxious, depressed, and angered by coercion, unnecessary rules, and illegitimate authority”.

ADHD

As a result we now have an ‘outbreak’ of childhood mental illnesses such as Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) that are leading to the mass medication of young people whose symptoms basically consist of not behaving in a manner approved by authorities. ODD in particular is simply a description of children who resist the commands of adults. Even more conventional diagnoses such as schizophrenia and bipolar disorder are more likely to be applied to rebellious kids.

Levine’s patients have included many anti-authoritarian children who are locked in conflict with their authoritarian parents for reasons that have nothing to do with mental illness. Often defusing the confrontation and ‘curing the illness’ is just a matter of explaining to parents that attempts to coerce their kids into their own mindset will not succeed and will eventually destroy the parent-child relationship.

If only Liza Long, author of “I am Adam Lanza’s mother“, had consulted with Bruce Levine it may not have been necessary for her to equate her rebellious 13-year-old son with a mass murderer and resort to forced hospitalisation as a disciplinary measure.

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From → DSM, politics

7 Comments
  1. I really enjoyed that post. As a teacher, I often wonder about whether or not students are receiving medication (including growth hormones), or have been diagnosed with disorders. It seems odd that when I was a kid nobody had ADHD simply because nobody had heard of it. A kind might be labeled as “hyperactive” or simply a “spaz”. More likely a kid would just be seen as difficult, emotional, or rebellious. Those terms seemed good enough, and we all went about our business without recourse to psychiatrists or drug intervention. We never assumed a problem was biological or needed medication. It was just attitude or a situation.

    I just gotta’ love how any standing up to authority is “mentally ill”. Why don’t people rely on logic and argument to come to conclusions?

    Really great post with wonderful examples, such as the mental disease of the slave who wants to escape (and the treatment). Sometimes I wonder why I bother with blogs as opposed to reading journals and established news sources. You just reminded me why I like blogs.

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    • Thanks for such an eloquent display of appreciation.

      I’m pleased to say I easily qualify for a bipolar I diagnosis and would have done so for decades before I got my first official lunatic label in the mid 1990s. I have found the assistance offered by the Australian mental health system to be unhelpful at best and catastrophic at worse.

      I’ve been shrink and pill free for over a decade – though I did seek out some counselling for my depression and suicidality about five years ago. It didn’t really help but the psychologist was also a human rights activist so we had some enjoyable chats on topics of mutual interest at least.

      I know some people who’ve been seriously fucked over by psychiatrists (especially forensic ones) and psychiatric medication so this is a topic close to my heart.

      You know something? I honestly think ‘mental illness’ is one of the best things that ever happened to me. Except it didn’t ‘happen’ to me. It is me.

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      • I think of myself as sane. But since I’ve been conspicuously talented at visual art since I was a kid, anything crazy about me I’ve always thought a constructive and useful part of being an artist. As you pointed out in the first blog I read, “insane” could be defined as trying to escape a life of slavery. If one were actually to have tried to escape slavery because one realized one was doomed, and it could mean a better life, if would be a brave act of sanity in response to insane situations. Will check out the links you shared to other posts later. Looking forward to it when I’m not too busy to sink my teeth in it.

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        • I’ve been conspicuously odd since I was a kid, so I guess the ‘insane’ label always seemed to fit. Didn’t worry me too much though, they didn’t medicate crazy kids back in those days.

          Teachers, scout masters, etc were always on my folks about my ‘behavioural problems’ and there was talk about ‘special schooling’ for a while but I don’t remember any adults ever using words like ‘lunatic’ or ‘mentally ill’ around me. Other kids were a different matter though.

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        • Perhaps you can do some posts detailing some of your peculiar behaviors in the past.

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        • I wouldn’t know where to start.

          Probably the closest I’ve come so far is ‘The two truths‘ in which I narrate how getting furious at a piece of science journalism, then abusive towards my uncle, led to the epiphany I allude to in ‘A moment in October‘. Or there’s ‘After the concert‘ that hints at how my work with sex offenders and their victims fucked up how I relate to my female friends. I think that’s fixed now, thanks to another psychotic break that happened not long after my ‘moment in October’, but which came at the cost of utterly destroying the relationship I had with the woman from ‘After the concert’ (I haven’t detailed that bit, because I’m still too ashamed of it).

          I could tell many stories about how, during mania or hypomania, I’ve done incredibly stupid, offensive, self-destructive, funny, clever, creative or brave things and the effects it’s had on my life. There are couple of pieces like that on my blog already as well as poems that are inspired by such events (I think. Usually I’m not sure where the poems are coming from. I even wrote a poem about that).

          But mostly I’m trying to let this blog just come out as ‘it wants to’.

          The stuff in ‘About Neurodrooling’ is true. This is the venue for venting the things that my friends and family are probably sick of hearing about.

          But the stuff about my narcissism is true too.

          I subscribe to Theravada more than Mahayana and don’t see the bodhisattva concept as consistent with my reading of anatta (anatman). But something about what has happened to me since last October seems to have cured me of a lot of the shit that other people seem to struggle with too. I would like so much to be able to help other people find what I have found – yet can see that their paths aren’t mine. I can also see others – such as born again Christians – who seem to have the same motivations coming from similar experiences yet what they try to tell me comes across as brain-dead drivel.

          I’m hoping if I flounder around on this blog for long enough I might stumble across some way to give at least a few people something of the gift that dropped into my lap.

          So there you go.

          A self-confessed lunatic who doesn’t believe in bodhisattvas and wouldn’t know enlightenment if a Roshi hit him over the head with it imagining that he has something worthwhile to tell other people and he might find out how to do it if he just keeps spouting nonsense onto an internet that is already packed with similar nonsense from similarly deluded people.

          Told you I was a wanker.

          Is that peculiar enough for you?

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  2. Reblogged this on .

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