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Introductory Comment
In Croydon, where I live, the Service User lobbying group that lobbies for improvements in
the local Mental Health System is called “Hear Us”.
Now this shouldn’t have to be said because, to “normal” people (i.e. not psychiatrists), the
concerns behind the name are self-evident, but sadly it does have to be said because even
the significance of the name “Hear Us” seems to be zoned out by those with agendas that
as assumed to be “more important”. The name “Hear Us” clearly indicates that a large
number of Service Users in the Croydon area feel that what they have to say about the local
Mental Health System is either not being registered by the Service Providers or it’s not being
taken seriously enough for it to be translated into meaningful and effective action.
And, “Hear Us” have a monthly newsletter with the name “In Our Shoes”. Again, to
“normal” people (i.e. not psychiatrists), the significance of the name “In Our Shoes” is also
self-evident, although, for the benefit of the congenitally obtuse (i.e. psychiatrists), let me
make it clear that many Croydon Service Users believe that Service User experiences of
Service Provision are either never taken seriously, and/or that really important, long-
overdue improvements never turn up at the coalface as a result of the never-ending
manufacture of excuses for inaction, and/or that Service Providers have a congenital
inability to overcome any obstacle more challenging than getting a job with the Service
Providers (which clearly can’t be that difficult judging by the incompetence-founded
haplessness of most of the staff that I have had the misfortune to have had to engage with so
far).
And, even the good staff I have encountered so far, seem to have no ideas whatsoever about
how to influence the bad ones, other than by dropping hints and fruitlessly hoping
that the bad staff will find ways of turning hints into miracles. Some of the worst problems
are “bad culture”, “bad leadership”, “bad internal communications”, “putting a gloss on
everything for the purposes of cover up”, “an aversion to setting expectations (because then
failure becomes possible)”, “an aversion to upsetting colleagues”, and “a cruel and callous
disregard when it comes to the matter of upsetting large numbers of Service Users, even
seriously”.
Is there no cure for this “disease”?
The term “Mental Health Problems” should be replaced with “Psycho-Social Health
Problems” which is better terminology because it’s less fear-provoking, and because such
problems actually relate to “dysfunction” across the faculties of the mind, the emotions,
social capacities and the spiritual.
And, the term “Mental Illness” should be replaced with “Emotional Disturbance”
which in extreme cases may manifest itself as a client becoming “Deranged”, although the
term “Deranged” should be used sparingly and only where it makes complete sense to do
so.
To put oneself firmly on a path towards meaningful recovery from “emotional disturbance”
one has to “go through” some pain, chaos, confusion, misery and fear before one
can “re-emerge” with the capacity for making more meaningful differences in one’s life.
In too many cases, psychotropic drugs inhibit the “going through” process, interrupting
progress, blocking progress, or even making matters worse, the result being it being made
hard or even impossible for any meaningful recovery to begin, progress and/or get anywhere
near complete enough in the client’s eyes.
And, all help should be as “client-centred” as possible and all matters of “chemical or
electrical intervention” (with drugs or ECT) should be a matter of “client consent”, except
in those few cases where there is a clear need to override client consent in the interests of
the client. Client consent must never be overridden in the interests of anyone else as it
is always “an abomination before the Lord” to “medicate” one person to address the
“sensibilities” of another. Even the preferences of someone who is considered by most to be
“chronically deranged” should be respected when those preferences are expressed clearly
and consistently.
And, it should almost always be preferable to “contain” someone in a “secure
environment” indefinitely than to “medicate” them without their consent.
However, according to my latest thinking, it may make sense to “enforce” PRN (as needed)
“medication” without consent in clear-cut cases of “problematic derangement”.
Also, in most cases, where a client is chronically dissatisfied with the “service response” even
to a limited degree, clinicians should conclude that they are doing some things or many
things wrong or very wrong, and should review their ways with a view to changing them
as a matter of the highest priority.
Regarding the use of so called “medication”, I conclude that “medication” does more harm
than good in a majority of cases, and I conclude that the assumption that “‘emotional
disturbance’ is a life-long condition which can only be helped through the use of life-long
‘medication’” is an abominable conclusion, because it’s the life-long use of “medication” that
virtually guarantees the life-long nature of any “psycho-social health problems”.
And, where clients are well enough to engage with “talking therapies”, the “going through”
process can be facilitated with specialist support such as Life Skills Training, Group Therapy,
Loss and Bereavement Counselling, Trauma Therapy, Schema Therapy, Cognitive
An environment is therapeutic only if it is homely, only if it’s staffed by people who are
thoroughly humanitarian and friendly, and only if client needs are met to the satisfaction
of a sizeable majority of the clients for most of the time.
In a therapeutic environment, self-help should be facilitated as much as possible, but
everyone’s frustrations should be managed well, and no one should be left “in limbo” for
extended periods of time (not leaving someone “in limbo” meaning that when the client sees
a need for a “way forward” with an important and/or urgent matter, he or she is not left
getting more agitated for any significant period of time with no way forward).
Anti-therapeutic environments are environments that, apart from not meeting the above
specifications, are staffed by people with agendas that serve some or many things other than
client interests. Such environments are damaging in that they can easily entrench existing
“psycho-social health problems” and problems of “emotional disturbance”, and/or make
matters a lot worse for clients with such problems.
Excessive seclusion is “an abomination before the Lord”, doing much more harm than good.
Seclusion in isolation should definitely be used only until “unmanageable derangement”
has subsided for around 5 to 10 minutes, and should be followed by “seclusion” with the
company of a single member of the staff team who is up for the job of “talking the
client down” into a place where the “seclusion” can be ended, with PRN “medication” being
given “as part of the deal”, but only with the consent of the client.
Ideally, “restraint” (legalised assault{?}, especially if injury results) should only be used
when a client is so clearly “unmanageable” that “restraint” is seen as necessary to get the
client into seclusion.
When “restraint” is used, but then seclusion is seen to be unnecessary, the client should be
“talked down” in a private room by a single member of the staff team who is up for this job.
And, again, PRN “medication” should be offered, but not imposed, as a matter of informed
consent.
And, PRN “medication” should be offered (not imposed) when it believed that it may help
the client, and it should never be offered for the benefit of anyone else, or because some
“rule” says it should, or to serve the needs of staff, or of any system.
And, all “restraints” should be regarded as staff team “failures” because it’s always
possible to “talk people down” if one’s individual and group de-escalation skills are good
enough. All staff should have a “de-escalation skill grading”, and when any member of the
staff team feels out of their depth they must be expected to get help immediately from staff
with a higher “de-escalation skill grading”. So, when an “incident alert” is activated, the
most experienced staff members should be expected to take charge of the situation.
And, all such “failures” should be reviewed with a view to learning what should be done in
future similar situations to avoid harm, avoidable distress, and unnecessary alienation.
Also, in any environment which is supposed to be therapeutic, the concept of
“punishment” should be avoided as much as possible. One should go out of one’s way to
avoid any client feeling “punished” for any reasons other than ones that are not completely
sound. When clients feel “punished”, their thoughts and feelings should be acknowledged,
and appropriate sympathy and/or apology should be found.
Total freedom for everyone is a dangerous myth. In pursuit of absolute freedom, we will all
end up feeling like “slaves” of one kind or another. The answer to feelings of “oppression” is
for everyone to always have plenty of options.
So, when negotiating with anyone, including psycho-social service professionals and
including clients, one should always solicit at least 2 alternative options from the other
person, and always suggest as least 2 options of your own, and always negotiate at least 2
compromise options in any difficult negotiation situation.
Person-to-Person Therapy
Acceptance and Commitment Therapy (ACT) is a modern therapy that has the objective of
achieving as much “psychological flexibility” as possible. It basically aims to undo the
obsessive, compulsive and addictive patterns that result from past trauma and too much
worrying about further future traumas. So, modelling “psychological flexibility” in one’s
own behaviour, and actively contradicting one’s own obsessions, compulsions and
addictions makes complete sense.
Peter K. Gerlach, author of the “Break the Cycle” programme, gives a good explanation as to
how “addictive personalities” gets passed down from one generation to the next, so I
recommend studying his work and working through his programme.
John Bradshaw, author of “Healing the Shame That Binds You”, also has much to say on the
subject of “addictive personalities”, their roots in “being excessively shamed”, and how to
recover.
Another therapy that is calling out for more attention is Schema Therapy which explains that
we see the world through “filters” (called “Schemas”) that have arisen as a result of past
traumatic experiences, and the way that one sees the world has to be adjusted if one is ever
to recover.
Then there’s my invention which I call “Modality Therapy”. In this therapy I have found it
extremely simple and helpful to label, as well as possible, everyone’s “operational mode”
(though perfection in such labelling is not required). See Appendix 3 for full details.
Then there’s my variation of the “Open Dialogue” group therapy process which is a facilitated
group healing process. See Appendix 4 for my “Open Dialogue Group Guidelines”.
Meditation
If you have stumbled across a kind of meditation that produces positive results for you, then
that’s all very well and good. But, I personally dislike most off-the-shelf versions of
meditation as they all seem very unnatural to me.
My own version of “meditation” involves “tuning in” to one’s own inner “tinnitus”, as and
when, in any idle moment.
“Tinnitus” is the whistling sound that can sometimes, if not often, be noticed in one or both
ears behind the sounds of the everyday world. I find that when I “tune in” to my inner
“tinnitus”, I get to notice it more clearly and more loudly. And, this technique requires no
special position, and it doesn’t matter at all whether one shuts one’s eyes or keeps them
open.
“Tune in” whenever you think to do so, whenever you can do so, whilst you get on with your
life, whatever you happen to be doing at the time. It can do no harm, and is likely to do much
good.
“Being there for another person” can be done in many ways. I will list some of the most
beneficial ways here:
1. Providing low-key company (relaxing together, parallel activity, occasional
inconsequential conversation).
2. Witnessing (being with and just paying attention to what is going on for the other
person, noticing the client’s existence for more than a few minutes at a time).
3. Listening (being with and gently encouraging the other person to do as much or as little
talking as they need to, as and when it suits them).
4. Hearing/Understanding (trying to make some sense of some of what is being said and
showing some understanding, support and encouragement only when we sense that
that understanding, support and encouragement is likely to be welcomed).
5. Making it as easy as possible for a client to process what needs to be processed in the
service of “going through” with as little “interference” as possible, where
“interference” is any communication or intervention generated by any
agendas other than the client’s agenda.
6. Making it easy for client to “get things off their chests” with as little “interference” (see
above) as possible.
7. Talking to the client with thoughtfulness, consideration, kindness, care and helpfulness,
even when that client is so preoccupied with his or her inner life that he or she is verbally
silent, only uttering the occasional word or phrase, or communicating in any way that
makes him or her hard or even impossible to understand with any clarity.
[Such thoughtfulness, consideration, kindness, care and helpfulness is
always noticed by the client, even when it looks like it has not been noticed,
and it provides the client with a incentive to express himself or herself
better which is an essential part of his or her journey towards some kind
of recovery].
The healing process of “going through” proceeds at a pace that is inversely proportional to
the amount of “interference” given, and so one should always be mindful of putting
downward pressure on “interference”, so as to facilitate as much “going through” as possible.
However, perfection in this area is not required because a client that has a great deal of
support in “going though” what he needs to “go through” will quickly become more tolerant
of a modest degree of “interference”, especially when that “interference” is perceived as
occurring for good reason and/or as a result of necessity.
It should be noted, however, that in the early stages of “going through” some clients will
become more “difficult to manage” and not less, but patience and professionalism are
recommended because the dividends associated with “being there” for clients in the “bad
times” as well as the “good” are always great.
Also, on the subject of “interference”, when aiming to provide “therapeutic engagement”
with anyone, one should be cautious about interrupting any silence. Silence can be
therapeutic because it gives the client a space in which to work things out for himself or
herself in the absence of “interference”. Too much silence can also be anti-therapeutic when
the client is prone to feeling, unsupported, misunderstood and/or abandoned (left to do
everything on his or her own). So, a balance needs to be struck, knowing that too much
silence is always better than too little. Therefore the rule of thumb should be: If in doubt
about whether to interrupt a silence, then don’t interrupt it.
What is written here applies to clients regardless of their degree of “emotional disturbance”,
but the effects of good practice with more disturbed clients will be noticed more clearly,
although good effects will show up more quickly with some clients as opposed to others.
Many clients talk unintelligibly for some of the time, if not much of the time. Some clients
hardly talk or communicate at all. The problem here is that as a result of this “acquired
behaviour” they rarely or almost never get any feedback from others showing that even parts
of “their story” have been well understood by another human being. This is unfortunate
because the resultant “isolation” forces them deeper into a chaotic inner world that is
disconnected from present time reality to some degree, maybe to a severe degree. The
chaotic inner world of such people is held in place by a network of past traumas and future
fears which may be beyond “unpicking” even with the help of the most experienced of
therapists.
The answer is to spend a lot of time with such clients providing them with company, waiting
patiently to pick up as many verbal clues as possible, observing patiently to pick up as many
non-verbal clues as possible, and deducing what patterns of thoughts and feelings might be
turning up for the client, repeating themselves in the client’s inner life, and doing battle in
the client’s present time reality.
And, as part of this process, as much feedback as possible should be given to the client to
show some understanding, support and encouragement of a kind that the client welcomes,
whilst being very mindful of the problem of too much “interference” (see above).
And, one should typically communicate with “emotionally disturbed” clients as if there’s
nothing concerning about their presentation (this is the opposite of “pathologisation” —
see below). Some nurses do this instinctively. Others do this to a lesser degree. But, sadly,
psychiatrists see no point in hiding their absurd prejudices, and they see every point
in treating their prejudices as incontrovertible facts that, when “challenged” by others (they
say “denied” by others) are taken to be clear evidence of those others’ insanity.
The 4 crimes of humanity (which become ever more damaging in psychiatry) are:
1. “Stigmatisation” or “Dehumanisation” (behaving in a way that conveys the idea
that another person’s experiences are valueless).
2. “Pathologisation” (making a massive big deal about something that in reality is of
little or no consequence in order to label another person as sub-human and to justify
inhumane treatment such as non-consensual chemical drugging and other kinds of
legalised oppression, bullying and/or abuse).
3. “Silencing” (getting one’s way by making out that someone is stupid by silencing
them).
4. “Selective Disregard” or “Refusing to Take Someone Seriously” (getting one’s
way by making out that someone is stupid by ignoring any “inconvenient” views that
they may have, often with some veiled pretence that there’s no selective disregard
going on).
And, all 4 of the above are exacerbated by what many would call “abuse of power”.
These 4 “crimes” cause “emotional disturbance”, they sustain it, and they inhibit, block,
slow down and/or reverse recovery, and so it makes no sense whatsoever for these
crimes to be ubiquitous in the practices of mainstream psychiatry.
The crime of “pathologisation” deserves special mention because it’s actually the number
one dogma of “modern” main-stream psychiatry in the UK, and most likely all over the rest
of the world.
As I speak, the number one job description entry of every Psycho-Social Health Service
“professional” is “pathologise, pathologise, pathologise”.
Doctors, nurses, social workers, and virtually everyone else are endlessly scanning for tell-
tale signs of “insanity” (even little or silly signs). Some people may sympathise with
pathologising tell-tale signs of something like “mania”, but the practice is so insane that even
an oddly coloured tie can be written down in psychiatric notes in such a way as to question
the client’s sanity.
But, there’s actually no sense in pathologising any “symptom”.
Psycho-social Health Service professionals pathologise a large number of symptoms that
they have been trained to regard as “insanity indicators”, but I contend that even a large
number of such “insanity indicators” is meaningless. And, I believe that these “insanity
indicators” are catalogued, listed, recorded, re-recorded, copied and endlessly discussed
with the intention of “proving” “emotional disturbance” so that physical, chemical and
electrical intervention (drugs and ECT) can be justified and excused with impunity, even
though, in reality, and in most cases, significant or even major damage is being done.
There are actually 5 primary pathologisations that psychiatrists rely on to infer and/or
demonstrate, if not “prove”, “insanity” and to “prove” the “need” to “medicate” it away to
the highest possible degree and as quickly as possible. The 5 pathologisations are:
1. “Irrationality” (anything that cannot be described with mathematical equations, e.g.
“fear”, “anger” and “love”).
2. “Disinhibition” (flouting social “norms”).
3. “Irritability” and/or “agitation” (acting like something is wrong when the pathologiser
“needs” to believe that there’s nothing wrong).
4. “Aggression” (flouting social “norms”).
5. “Argumentativeness”, “being ‘stubborn/oppositional’” and/or “lacking insight”
(disagreeing with a psychiatrist with too much honesty and not enough politeness
and/or deference).
But, there are a large number of “symptom pathologisations” used to support the idea that
any or all of the above 5 might be problematic, if not highly problematic.
Here are some of the most popular “insanity indicators”:
“Pressure of speech”, “talking too loudly”, “talking too fast”, “shouting”, “being hard to
interrupt”, “paranoia”, “irrational fears”, “hearing voices”, “command hallucinations”,
“visual hallucinations”, “depression”, “anxiety”, “panic attacks”, “self-harm of any kind”,
“suicidal ideation”, “suicide attempts”, “suicide”, “bizarre communication and/or
behaviour”, “grandiosity”, “flight of ideas”, “appearance of agitation”, “appearance of
irritability”, “unusual dress”, “believing something to make sense when it’s deemed to be
absurd by the pathologisers”, “acting as if there’s a problem when the pathologiser ‘needs’
to believe that there is no problem”, “disagreeing with a psychiatrist too assertively, or with
aggression”, “believing that one is not especially unwell”, “believing that one’s supposed
unwellness is not especially problematic”, “unusual sleep pattern”, “behaviour/emotions
that the pathologiser doesn’t understand”, “behaviour/emotions that cause concern,
discomfort or fear for the pathologiser (whether those reactions are rational or not)”,
“PATHOLOGISATION” ALWAYS,
WITHOUT EXCEPTION,
CREATES MULTIPLE PROBLEMS
WITHOUT RESOLVING ANYTHING !!
Children come into this world with unique, individual personalities. Almost all children
have some problems coping with their environment of origin, but some children have
unusual personalities that are highly incompatible with their family culture and/or their
regional culture and subcultures. The children that seem to have the worst incompatibility
problems are the ones that are the most loving, caring, soft and gentle, and this probably
says something awful about modern day cultures in most countries.
Such children (and all children to a lesser degree) get stigmatised, pathologised, silenced
and selectively disregarded chronically and too often acutely. Such children receive similar
patterns of mistreatment from parents, guardians, other family members, schoolteachers,
other children, peers, bosses and colleagues. In the “wrong circumstances”, “emotional
disturbance” slowly or quickly arises and recurs.
Then, if such people have the misfortune to end up under the pathologising eye of the
Psych0-Social Health Service, the stigmatisation, pathologisation, silencing and selective
disregard kick in big time.
Then, those that succumb to “psychiatric invasion” lose quality of life and the motivation to
live well, before dying early and in ignominy.
Dr. Amen has little interest in biochemical models. Instead, he focuses on matters of brain
function. He uses brain scans to ascertain whether any parts of a person’s brain are
abnormally overactive or underactive and he then employs psychotropic drugs with a view
to restoring “normal” activity to any parts of the brain that are “out of kilter”.
He couples this methodology with a thoroughly “client-centred” approach to serving his
clients, so he has few, if any, seriously dissatisfied customers.
He does use “medication”, but he does so with intelligence.
And, he uses “anti-psychotic medications” reluctantly and sparingly, referring to them as
“heavy-duty interventions”.
See “Change Your Brain, Change Your Life” by Dr. Daniel G. Amen for further details.
Dr. Johnson has developed a group process much in concordance with the messages of this
document. Dr. Johnson does offer one-to-one “talking therapy”, but I agree with him that
group work is usually best.
His website is called “http://www.truthtrustconsent.com/” in line with the values of truth,
trust and consent that he considers to be essential if any kind of recovery is to be
facilitated.
Dr. Johnson used to run a unit at Parkhurst Prison, home to many of the “more serious
murderers” known. And, in around 5 years, his methods reduced prison violence rates to
almost zero.
[See http://www.nickdavies.net/1994/03/01/the-mad-world-of-parkhurst-prison/].
His methods are described in his books (see Appendix 5).
I also agree with Dr. Johnson and others that the causes of so called “madness” and
“badness” are virtually the same, and so the remedial responses need to be virtually the same
as well.
And, I agree with Dr. Johnson when he says that, if you know what you’re doing, use of
“medication” can be avoided, “medication” should be used sparingly, “medication” need only
be used as a short-term emergency measure, and/or that use of “medication” as a long-term
remedy is a mistake.
In his individual and group therapy, Dr. Johnson uses a powerful metaphor as follows:
“Inside of you is a box. The box is closed tightly and you don’t know what’s inside. It’s
wrapped in chains and padlocked. When you are ready, and only when you are ready; when
you are ready for the truth, when you are able to trust those who you are with, and when
you consent to taking a risk; then you can begin, in your own time, to unlock the padlocks
and remove the chains, one at a time. Then, when you are ready, in your own time, and with
the support of others, you can begin slowly to open the lid of the box with a view to peeking
inside before closing the lid quickly should you not like what you find inside.
Then, you peek inside, and what do you find? — NOTHING: the box is completely
empty !!
You dismantle the box and throw it away, and/or burn it. Your problem is solved.”
The significance of this metaphor is that all “psycho-social health problems” are born of, and
held in place by, suppression and repression of fear, anger and terror, but whereas the
original problems must have had some connection with reality, the lasting problems can be
based largely on illusion and/or delusion.
Dr. Johnson prepares his clients for working with this metaphor by facilitating the building
of an interest in truth, by facilitating the building of trust, and by facilitating the building
of the confidence necessary to give consent to beneficial risk-taking.
He does this through the use of facilitation, therapy, psychodrama and “chair-work”
(facilitating dialogue with absent others who are represented by and empty chair). And, in
this process, he encourages the expression of repressed wishes, hopes, dreams, fears, terrors,
angers, furies, losses, hurts, miseries and pains.
Because of his “anti-psychiatry” stance, Dr. Johnson has been banned by the “South London
and Maudsley NHS Foundation Trust” (“SLaM” for short), and most likely from many other
NHS Trusts as well. He has been banned from having any involvement with Trust matters.
Why do mainstream psychiatric establishments try every trick in the book to disable their
critics, and those with good ideas, instead of trying to learn from them? I will leave the
readers to for his or her own views.
And, despite achieving amazing results (see the link above), Dr. Johnson’s unit at Parkhurst
Prison was closed down by a Conservative Government on the grounds that “one must not
treat criminals, let alone murderers, with any kind of kindness, thoughtfulness and
consideration”. Where else have I seen people being responded to as if they were sub-human
(see “stigmatisation” and “dehumanisation” above) ?!?!?!
Talking Therapy, Group Therapy, Life Skills Training and “Open Dialogue”
“Talking Therapy” is not popular with governments because it’s seen as expensive (whilst
drugs are seen {wrongly?} as relatively “cheapish”). “Group Therapy/Training” is therefore
a better option from a financial point of view. But, “Group Therapy/Training” is actually
much better from a therapeutic, well-being and recovery point of view too. This is because
it’s much more like real life, with human beings learning from the thoughts, feelings and
experiences of other human beings, many of whom are finding themselves in “similar boats”.
Individual “Talking Therapy” will still be needed because some clients will feel too
uncomfortable in groups to join such groups and do useful work, but one aim of individual
“Talking Therapy” should be to get everyone involved in group work at the earliest
opportunity.
One group-work model that is extremely effective in bringing about great well-being and
recovery results in an unforced way is a therapeutic process called “Open Dialogue”. And,
another group-work model that works very well has been developed by psychiatrist, Dr. Bob
Johnson (see above).
All group-work needs to be facilitated/moderated by one or more people skilled in getting
people to open up and risk conflict so that that conflict can be resolved in ways that benefit
all members of the group instead of giving in to the demands of the few at the expense of
others, the many, or the all.
And, where clients are well enough to engage with “talking therapies”, the “going through”
process can be facilitated with specialist support such as Life Skills Training, Group Therapy,
Loss and Bereavement Counselling, Trauma Therapy, Schema Therapy, Cognitive
Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT).
And, the re-learning of useful Life Skills is essential (as talked about above).
Group Therapies also work extremely well when well facilitated by someone who has no
problem handling conflict because they are confident that they know what to do to ensure
that conflict is resolved to everyone’s satisfaction as and when it turns up.
And, as all “psycho-social health problems” are grounded in trauma, loss and/or
bereavement, then Trauma Therapy, Loss and Bereavement Counselling and Schema
Therapy can all have great value.
And, CBT is well-known for its efficacy in many cases, and, although ACT (Acceptance and
Commitment Therapy) is the “new kid on the block”, early evidence suggests that this
emerging therapy has equal or greater value than CBT.
Standard New
Dynamic
Diagnosis Diagnosis
Rejection of dishonesty and/or rejection of
mixed messages resulting in attachment to
Autism,
Dishonesty things that make perfect sense such as
Autistic Spectrum
Intolerance logic, mathematics, science, music and
Disorder (ASD),
Syndrome transportation logistics, and/or
Asperger’s Syndrome
withdrawal and separation from “idiots”
(i.e. most people).
Rejection of anything that causes
Bullshit
confusion as a result of not making any
Bi-polar Intolerance
sense resulting in the tendency to trust
Syndrome
oneself not enough and/or too much.
Rejection of blame resulting in not
Blame knowing who to blame resulting in
Schizophrenia Intolerance tendencies to self-blame and suicidal
Syndrome ideation and/or other-blame and
murderous ideation.
Rejection of rejection resulting in feelings
of isolation resulting in tendencies to find
Depression, Anxiety, Rejection
ways of attracting both positive and
Panic Attacks, Intolerance
negative attention, positive to attract
Self-harm and Suicide Syndrome
“love” and negative to keep untrusted
others at a distance.
Rejection of responsibility resulting in
Responsibility
chronic indecisiveness resulting in a sense
Personality Disorder Intolerance
of worthlessness resulting in an inability to
Syndrome
decide whether, or not, to grow up.
Rejection of criticism resulting in
excessive self-criticism resulting in
confusion and loss of identity resulting in
Criticism
Obsessive/Compulsive an obsessive need to create meaning in life
Intolerance
Disorder (OCD) resulting in compulsively repeating
Syndrome
anything that gives even temporary relief
from feeling pathetic, and the fear of
remaining pathetic indefinitely.
Inverse
New Diagnosis Dynamic
Diagnosis
Rejection of disturbance resulting from
early-life stigmatisation,
pathologisation, silencing and selective
Inverse Autism,
Disturbance disregard resulting in believing whatever
Autistic Spectrum
Intolerance is convenient to believe in order to evade
Disorder (ASD),
Syndrome any kind of inner disturbance and
Asperger’s Syndrome
resulting in a compulsion to relieve the
disturbance of others, real or
conveniently imagined.
Rejection of embarrassment resulting in
Embarrassment
a rejection of complexity leading to
Inverse Bi-polar Intolerance
simplistic thinking leading to mistrust of
Syndrome
complexity leading to idiocy.
Rejection of shame resulting in not
Shame knowing who to shame resulting in
Inverse Schizophrenia Intolerance tendencies to self-aggrandisement,
Syndrome shaming, and the stigmatisation of
shamelessness.
Inverse Depression, Rejection of grief resulting in feelings of
Grief
Anxiety, superiority resulting in attachment to
Intolerance
Panic Attacks, immediate, black and white half-truths,
Syndrome
Self-harm and Suicide even in the face of complex questions.
Rejection of irresponsibility resulting in
Irresponsibility
Inverse living in accordance with elaborate
Intolerance
Personality Disorder “rulebooks” with arrogance,
Syndrome
stubbornness and little or no flexibility.
Rejection of faith resulting in inability to
Inverse Faith
trust anyone, including oneself, resulting
Obsessive/Compulsive Intolerance
in susceptibility to indoctrination,
Disorder (OCD) Syndrome
bigotry and dogma.
NOTES:
1. Inverse Autism is apparent in cults and/or in religious and political fanaticism.
2. Mainstream psychiatry is a cult and/or a religion/“political grouping” led by fanatics,
and supported by fools who need to make a living somehow.
3. Mainstream psychiatrists “suffer” from all of the above “inverse disorders”, although it
would be truer to say that it’s their “victims” that “suffer” the most.
4. “Normal” people “suffer” from some of the above “inverse disorders” to varying degrees.
My autism began at an early age when I realised that my mother’s “love” for me was “fake”
in some important ways.
And, I believe that the “refrigerator mom” concept in cases of “autism” and/or
“Asperger’s Syndrome” is not as stupid as it may at first sound.
And, I also believe that MMR-related (Measles, Mumps and Rubella injection-related)
autism has something to do with perceptions of betrayal associated with perceptions of
allowing a stranger to inflict the invasion and/or pain of an injection. Parents who preside
This document has been put together whilst I have been detained, quite unnecessarily,
in a psychiatric hospital on a “Section 3”, and the hospital Psychiatric Consultant says that
“I could be here for a long time” — LOL !!!
And, I’m now humourously referring to myself as the “King of Anti-Psychiatry” because this
title was jokingly conferred on me by my Primary Nurse (many a true word said in jest? —
LOL).
I can tell you that mainstream psychiatrists are desperate for psychiatry to be give the
status of a respectable science, however, psychiatrist members of the UK’s Critical
Psychiatry Group admit that mainstream psychiatry is more of an art (I say a black art).
And, in the anti-psychiatry movement, psychiatry is called a “pseudo-science” because it’s
seen to be based on false assumptions justified by “science” used in selective ways so as
to lend plausibility to what “normal people” would like to be true.
The primary false assumption is the relevance of the “medical model”. The “medical
model” does apply to broken bones, diabetes and dementia (a physical disease of the
brain), but it has no place whatsoever in matters of the mind and any matters
psychological.
The brain may be the physical seat of the mind, and distorting and/or perverting brain
function with mind-bending chemicals clearly affects the mind in one way or another, but
“emotional disturbances” are problems of the mind, not of the brain.
What mainstream psychiatrists are trying to do is akin to debugging a computer program by
messing with the hardware instead of properly resolving the software problems. No wonder
those in the know see mainstream psychiatry as a “pseudo-science” that mostly delivers poor
results and/or makes matters worse.
And, I haven’t studied this matter, but the following guess makes sense to me. Mainstream
psychiatrists and/or their researchers look for “correlations” between things like
“symptoms”, “conditions”, “diagnoses”, “behaviours”, and the “effectiveness” of
“medications” (and other “treatments”) in putting downward pressure on the “demonised”
symptoms, conditions, diagnoses and behaviours.
But, these are just “correlations” that prove nothing in any individual case. And,
these “correlations” are just used to justify blanket social control of human beings with
the “mind-bending chemicals” that Service Users call the “chemical cosh” and the
“chemical straightjacket”.
And, the final obsession that mainstream psychiatrists have these days is their belief that
without effective(?) chemical intervention, the “emotionally disturbed” will inevitably
“relapse”, and what starts off as “mild anti-social behaviour” will inevitably escalate,
About Psychiatrists
Fun-Lover Perfectionist
Controller Peace-Maker
There are 4 “Personality Styles” as detailed above. We all have a primary and secondary
style, perhaps some people have a tertiary and quaternary style.
“Empaths” express feelings to share information about person problems with each other
with a view to helping others, and/or with a view to soliciting help for themselves.
“Psychopaths” express feelings so as to create problems for others with a view to
pressurising and/or forcing others to give them what the “psychopaths” think they need.
“Fun-lovers” solve their problems by having fun. “Perfectionists” solve their problems
by becoming loners or members of select groups. “Peace-makers” are into self-
manipulation and tend to attract other “peace-makers”. And, “controllers” are into the
manipulation of others and tend to attract “victims” who have any kind of “perfectionist
streak”.
“Controllers” or “narcissistic psychopaths” have little or no capacity for “empathy”,
and/or their capacity for “empathy” is deceptive. They “need” victims who provide them
with what is called “narcissistic supply”. “Controllers” feel good about themselves only
by feeling sorry for others, so they need one or more people to look down on. They especially,
latch on to “empaths in trouble” who mistake pity for compassion, and apparent
compassion for capacity for empathy, but the psychopaths’ “deceptive empathy” and
their “need” to feel good about themselves regardless of the consequence for others
inevitably causes their “victims” to begin acting like “cornered rats”.
Too many managers, politicians and psychiatrists are “controllers”.
Most psychiatrists are “controllers” who have been given too much power by successive
governments. These “narcissistic psychopaths” feel good when they appear to “help” people
who seem to benefit from drug therapy, and they also feel good when they outmanoeuvre
“empaths in trouble” when these people try to put psychiatrists rightly in the wrong.
The world does not need “controllers”. “Control” does not exist in the animal
kingdom. Somehow, the “controller” style must be eliminated !!
Sadly, “narcissistic psychopaths” are typically very clever people, so ousting them from all
positions of authority is going to be hard, but the good news is that this will happen, and
sooner than one might think.
What does it mean that the man who killed 12 people at the Washington Naval Yard had told
people that he was “hearing voices”?
I have spent 30 years as a psychiatrist treating people who are psychotic. Almost every day
I meet with individuals who hear voices that no one else hears, are sure the TV or radio is
talking to them or have such confused thinking that it is hard to understand what they are
trying to tell me.
Sometimes these patients lead quiet lives. But not uncommonly these voices get them into
trouble. I’ve had patients who call the police repeatedly, demanding that they stop bugging
their phone. And others who stay up all night talking back at the voices. Some accuse family
members of being involved in the torment.
In many cases, this is a frightening experience — for the people I see and those who love
them. And the labels we use — “schizophrenia,” “bipolar disorder,” “psychosis” — only
crudely capture these experiences.
About 60 years ago, a group of drugs was discovered that appeared to quiet the voices,
improve the clarity of thought and lessen the preoccupation with delusion beliefs. Originally
called major tranquilizers and later renamed antipsychotic drugs, these have been
considered essential for the treatment of people with schizophrenia.
Once it was clear that these drugs were helpful in the short term, questions arose over how
long people should remain on them. Studies done in the 1970s and 1980s looked at people
who were stabilized after being treated with antipsychotic drugs for several months and then
followed them for up to two years. Some continued on the drugs, while others stopped
taking them. The relapse rate was much higher in the group that stopped the medications.
Based on these studies, treatment guidelines now state that people should stay on anti-
psychotics indefinitely.
The problem with “indefinitely” is that antipsychotic drugs have many troubling side effects.
They can cause muscle stiffness, tremor and something called tardive dyskinesia, where
muscles in the face or limbs move uncontrollably. But the belief — my belief — was that this
was the unfortunate price paid to help people who were suffering.
Many people do not want to take these drugs because of the side effects or because they do
not think of themselves as ill. After all, if the government is using telemetry to transmit
messages into your brain, the solution is to turn off the source of the transmission, not to
take a pill. I considered myself a successful psychiatrist when I was able to use my powers
of persuasion to convince a reluctant patient to stay on the drugs.
Yet, over the past 15 years, my attitude has shifted. I have become deeply disturbed by the
marketing practices that many pharmaceutical companies began to use in the 1990s to push
their new medications.
Like many of my colleagues, I awaited the new drugs with enthusiasm, hoping that they
would have fewer terrible side effects. Leading psychiatrists who had worked on the
development of the drugs also said that they not only were less likely to cause neurological
problems but also were more effective.
Quickly, though, I started to think that their benefits were being inflated and their side
effects minimized. With one drug in particular, it was clear after a year that my patients
were gaining weight at alarming rates: 20, 30, even 100 pounds in a matter of months, a real
threat to their health.
The Dilemma
This created a dilemma for me: If the drugs that are helpful in the short run may be harmful
over time, what do I do for the person who is unable to have a conversation because the
voices in his head are so loud?
If the medications stop the voices, do I suggest he come off the drugs and risk relapse? Or
do I suggest he stay on them and reduce his chances for a full recovery? If I suggest that he
stop the drugs and then something bad happens, I may be blamed for his relapse, while I am
unlikely to be blamed 30 years from now when he has diabetes.
Doctors are held to a standard of “accepted community practice.” What if my own research
has led me to a conclusion that is at odds with accepted community practice? What if
accepted community practice is so distorted by pharmaceutical advertising in favor of these
drugs that it is suspect and unreliable?
Two years ago, I decided to invite my patients into this conversation. I explain to them what
I have read and what conclusions I have drawn, as well as the conflicting views of other
psychiatrists.
I have been monitoring those who have chosen to wean themselves from the antipsychotic
drugs they have been taking, in some cases for 20 years or more. What has been most
striking is that my patients make careful and deliberate decisions. Many psychiatrists fear
that having this conversation will lead to massive dropping of the drugs, but this has not
been my experience. Some do — most often, the ones who have stopped them multiple times
in the past — but most are cautious. Of the 64 people I have tracked, 40 decided to try a
A Slow Reduction
A man I have known for many years has had some serious bouts with psychosis. He has
been hospitalized multiple times, and his thoughts have put him — though not others — at
personal risk. However, the medications have also put him at risk. He is now overweight
and has diabetes and his kidneys are not working well. He spends a good part of his day
sleeping and the rest watching TV.
We have tried in the past to reduce his dose, but these efforts have never gone well. Within
days he would be hallucinating and delusional. However, recently we found that with a very
slight reduction in dose, he would relapse for about a month but then improve. Perhaps it
was his age or greater experience, but he was able to get through the bad days without getting
into trouble, and once things quieted down in his mind he felt better. We have agreed to
slowly proceed.
His family supports his choice. We all understand the risk of dose reduction, but we see it
in the context of all of the risks. Maintaining his current dose is not without consequence. I
have known him for a long time, but the problems of schizophrenia tend to start early and
he is still a young man. Even if it takes five years to get him on a significantly lower dose, we
have the opportunity to improve the long-term quality of his life.
The Dutch study shifted the focus away from the belief that we need to eradicate all
symptoms of schizophrenia to a focus on improving the quality of patients’ lives and health,
the relationships they have, the work they do. Some people can learn to live with voices.
Some people find that the voices have a significant meaning for them and that
communicating with them is what is most important. Some people can learn to talk
themselves down from delusional thoughts. And some people might choose hearing voices
over being 30 pounds overweight and tired all of the time. The point is that this is not a
choice I should be making for my patients; it is a choice I need to make with them.
In “Modality Therapy”, one regularly labels the “operational mode” of each participant,
including oneself in any conversation of any size.
“Operational mode” labels are best described by example:
Someone might be in “troubleshooting mode”, “education mode”, “therapy mode”, “wait and
see mode”, “relaxation mode”, “self-defence mode”, “survival mode”, “self-care mode”,
“other-care mode”, “responsible person mode”, “crazy mode”, “begging mode”, “pleading
mode”, “persuasion mode”, “self-destruct mode”, “depression mode”, “listening mode”, or
“absorption mode”.
Any approximate label will do, but the best labels are one’s that make some sense to all
persons present.
Some of the above “mode labels” may require further explanation:
“Wait and see mode” is where one largely shuts up and just waits for interesting things to
turn up such as a change of mode in another or in oneself.
“Crazy mode” applies when someone is consistently not making much sense, probably
because of not listening that well to what others are saying.
“Self-destruct mode” occurs when someone is consistently acting like their own worst
enemy.
“Depression mode” occurs when one is feeling highly unmotivated.
“Absorption mode” is just my preferred word for “listening mode”.
“Responsible person mode” occurs when someone decides that there’s a job that needs to be
done and just gets on with doing it.
“Self-care mode” occurs when starts doing things to take care of oneself, even leaving the
conversation to do something more important, and/or to get oneself a cup of tea.
I don’t know why “Modality Therapy” helps everyone involved, but I know it does. Perhaps
it helps because it raises one’s awareness of changes in “operational mode” that serve people
well, and habitual “operational modes” that need a bit of unsticking.
And, the process seems to affect its users at a subconscious level, so there’s no need to
practice “Modality Therapy” frequently — just the occasional top-up seems to do the trick.
Further Reading
“Emotional Health”
“(What Emotions Are and How They Cause Social and Mental Diseases)”
by Dr. Bob Johnson.
“Unsafe at Any Dose (Psychiatric Drugs Do More Harm Than Good)” by Dr. Bob Johnson.
Useful Training
http://www.criticalpsychiatry.co.uk/index.php?option=com_content&view=article&id=66
:mission-statement&catid=36: The Critical Psychiatry Group, UK.
http://opendialogueapproach.co.uk/: Open Dialogue UK.
http://sfhelp.org/site/pkg.htm:
“Breaking the Cycle (of Childhood Wounding by Adult Addicts)” by Peter K. Gerlach.