Thursday, 29 December 2011

Robert Whitaker at Gothenburg

So, I went to Gothenburg, Sweden, last month where Robert Whitaker was giving a talk about his latest book Anatomy of an Epidemic, a lecture arranged by the Family Care Foundation.

The point of departure in his book is Whitaker's puzzlement about, that despite the claim that pharmacological treatments have improved treatment options within psychiatry, and therefore the lives of “mentally ill” people, an increasing number of these “mentally ill” people become chronic, on disability pay, suffering through more and more serious “side”-effects, and exposed to a greater and greater risk of early death.

To find answers to his questions, Whitaker conducts a thorough review of the research in the field of psychopharmacology in its entirety, and concludes that the picture painted by this research is somewhat different than the one psychiatry has delivered to the general public.

Whitaker's book, like its predecessor Mad in America , is a disturbing read. One thing is to see how the actual science in the field clearly and unmistakably proves psychiatry's storytelling about biological brain diseases and the superiority of psych drugs in their "treatment" to the public over the past decades to be just that: storytelling, with no basis whatsoever in any scientific evidence. This is what everyone familiar with the scientific research has known for a long time. Another thing still is to see the suspicion, which even many critics will not dare to covet: that psychiatry – almost from the outset – has understood that its own tales of the wonders of  psychopharmacology are lies equal to the stories of biological brain illnesses, so unmistakably confirmed in Whitaker's book by quote after quote of “expert” statements about the matter.

Like most other critics, Whitaker ended his lecture with the inevitable, politically correct: "I do know, that many people feel they are being helped by psychiatric medications, so there is a place for these drugs in treatment."

In the discussion that followed, I asked him why, after just presenting the scientific data - which all state one thing: that if people feel helped by psych drugs, then this must be attributed to either a placebo effect, and/or simply the fact that their judgment is impaired due to the drugs' influence, so in actual fact, there is no place for the drugs in "treatment",  in as far as this "treatment" is meant to truly help people in crisis - he still decided to end his presentation with what could be described as an apology for said presentation.

In the last chapter of Anatomy of an Epidemic, Whitaker takes a thorough look at the Finnish Open Dialogue approach, which, with its well-documented effecacy, is an alternative to the current biomedical approach to emotional crisis. Yet even Open Dialogue uses psych drugs -- in a very limited capacity, especially when it comes to "anti"-psychotics, and only as a "last resort". In answer to my question, Whitaker said he would like to see projects like Open Dialogue initiated, but with just one difference: no use of psych drugs at all. I would really like to see that, too! Like  Whitaker says, mankind has survived for thousands of years on this planet, without these drugs, so…

 

 The slides for Whitaker's presentation are here.

Thanks to Paul Englar for his huge help with the translation of this blog post.

16 comments:

Discover and Recover said...

Some very good points were made.
Excellent post!

Duane

Marian said...

Thanks Duane. Hope you had a happy X-mas, and wish you a great new year!

Duane Sherry, M.S. said...

Happy New Year to you, too!

Duane

Rossa Forbes said...

You say that the research indicates that people reporting being helped by the drug is either due to the placebo effect or impaired judgment due to the drug's influence. May I posit a different possible explanation? I have noticed that people with SZ are highly empathetic - this could make them more amenable to placebo in the first place, but it can also make them willing to relinquish their own judgment about whether the drug is working for them in favor of someone else's judgment, e.g. the doctor's or the family. I wouldn't necessarily think that the medication weakens their judgement although the meds do put a damper on the ability to take action.
Best wishes to you for a very Happy New Year.

Mark p.s.2 said...

regarding Rossa Forbes "SZ are highly empathetic".
I think I am more sensitive to sound. "One of the most commonly reported challenges for people with autism spectrum disorders (ASDs) is hypersensitivity to sound (Stiegler & Davis, 2010)"
Hypersensitivity = noise pollution that "normal" people get used to, living in their alien concrete city.

Rossa Forbes said...

Mark - are you a good musician, by any chance? Or, is sound more an annoyance?

Mark p.s.2 said...

"are you a good musician, by any chance? Or, is sound more an annoyance?"
I am not a musician. I wish I was. Sound is as powerful as smell to me. " the sense of smell and emotion come from the same areas of the brain."

Becky said...

Awesome post Marian!

As for explaining why the drugs appear to work for some--it is at best, a claim made in an attempt to support another, suspect claim--the belief the drugs actually are used to treat a "disease" called "schizophrenia" is to date a false claim with no basis in fact. So it would stand to reason that the drugs used being perceived as helpful to some is also not a claim based in reality. That is, the drugs are not actually "treating" anything, but are altering so many bodily systems. The impact, or the effects of the drugs are then reported as being therapeutic, primarily it is the professionals who prescribe them, and the family members who perceive the drugs to be 'working.' Why professionals and family members seem to think that they can determine what effects are "tolerable" and what effects are "intolerable" to the patient is another thing altogether... Believing the "schizophrenia is a disease and neuroleptics are the treatment;" these individuals see the drug effects as proof of the disease claim. Thinking effects of the drugs are "proof," is an error of attribution; among other things. The error is in concluding that symptom reduction for some patients validates the claim that neuroleptics treat a disease. The only thing that can validate the disease theory is finding the disease itself obviously. their belief "schizophrenia is a disease" a medical fact. Well---not without finding evidence of any disease it isn't!

People with this diagnosis whose family members are invested in this belief system are only supported if they are compliant with taking the drugs---and are consistently given the message that their judgment is flawed and not as relevant as other peoples, not even about how they feel! Their parents, siblings or a psychiatrist---always seem to know better, even when it is their own perceptions, how they themselves are feeling, and how the drugs effect them. The person may be told the negative effects are "not that bad"; and told they HAVE to keep taking the drugs--OR ELSE--is implied--The drugs can cause avolition; which would obviously put them at risk of being victimized, easier to coerce and manipulate, and unable to act in defense of themselves...This does suit the bio-medical devotees purpose to control "those people with 'schizophrenia'" now doesn't it?

If the goal is to convince a person that they cannot act or think for themselves, then yes, the drugs can be effective, and work. I believe this is why they are praised by some professionals and family members, who exaggerate their efficacy while minimizing, if not ignoring altogether the very real harmful effects, including ignoring the iatrogenic illnesses caused by the drugs; which are then left untreated.

some professionals believe that not giving a person experiencing psychosis these drugs would be unethical---The irony is insisting that these drugs are "necessary medical treatment" which must be given by force if necessary is unethical---and despicable since it is based on perpetrating fraud---Neuroleptics treat a disease claim is outright fraud. These geniuses need to find a disease; but instead cause disease with the drugs.

It is obvious to me that these drugs work most effectively for those who profit financially from their sale; and for those who seek to control others to 'help' them.

Marian said...

Great comments everybody, thanks! Rossa, I'm not so sure that the empathy you refer to really is true empathy. To me it seems more like the victim's desperate attempt to always and at any cost live up to whatever expectations they perceive those they depend on to have toward them. In case the victim is a labelled person, their surroundings' (family, the system, society in general) expectations usually also include that the labelled person expresses gratefulness for the "help" they receive: "Thank you so much for the label and the pills! The label explains everything, and the drugs saved my life!!!"

However, it's probably the fact that we all, to one or the other extent, depend on each other that has us develop empathy as a necessary survival technique in a social context. That people labelled with "sz" often are more empathetic than others then only shows that they, as the victims they are, depend more on others than the average person.

Y.Z. said...

I was watching an interview with Robert Whitaker and he made it a point straight off the bat to distance himself from "anti-medication" and "anti-psychiatry" groups? Why?

Marian said...

Y.Z., because there's a very strong reluctance among both professionals, relatives, and consumers to listen to anything critical of their beliefs. So, if you want to reach a broader audience, and don't just want to "preach to the choir", you have to be diplomatic, and reassure people that you respect them and their belief system, before you can go on to deconstruct their belief system.

Rossa Forbes said...

He most likely said that about not being anti-medication and anti-psychiatry in order to gain converts to his ideas. There are many people who think medication is the be all and end all, and they would immediately not want to listen to what he has to say. There are also many people who seem to think that only raving nut jobs are anti-psychiatry. Why should he risk losing potential converts to his message? It's a politically correct thing for him to say, but it's also what I would expect he should do in order to get his message across to more people than just anti-meds and anti-psychiatry people.

Y.Z. said...

Absolutely. That's what i thought. it's okay, I love him anyway. What's funny is though, that anyone who's not of the "anti-psychiatry" "anti-medication" position will after reading his work, and being intellectually honest with themselves, will inevitably assume that position!

ben said...

Mankind has survived without these drugs....
Yes, and a few decades ago, it was commonplace for families to bury one or more children before the age of 5; and childbirth was a dangerous ordeal that lead to fatalities rather often compared to now... We used to die of TB, maimed by Polio, and watch our children suffer to death w/ Rubella (horrendous disease) & Mumps...
Asthma, Epilepsy and diabetes where death sentences less than 100 years ago.

Western Medicine and the Scientific Method have brought us a LONG WAY... I for one, don't want to go back to the old way.

I LIKE having a lifespan of almost 90 years and I see nations where our medicine and logic hasn't penetrated and all I see is needless suffering and backwards beliefs (snakes such as homeopaths who prescribe water & believe dilution increases potency; naturopaths who want to 'clean' your colon; accupuncturists that talk of chi and meridians...Chriopractors who believe your headaches are caused by your back being out of alignment! bunky bunk bunk)

The SSRIs are nothing short of miracle drugs. It's because they are so damn great that they are over prescribed -- i.e. you don't have that issue w/ Lithium (!!) -- For millions - popping a pill a day makes the depression and OCD go away, and the costs are minimal.

Progress is a beautiful thing.

Marian said...

ben, you're talking hogwash. Read up on the science, and get your facts straight, before you next time make a fool of yourself.

Becky said...

Perhaps Ben is attempting to imply it is miraculous to cause physical decline, I wonder if he laughs at people who have been disabled or less not so grievously impaired by psychiatric drugs as well?