Adolescent Suicide and The Black Box Warning: STAT Gets It All Wrong, by Robert Whitaker

STAT has presented itself as a reliable publisher of health news, and it has a number of first-rate, experienced journalists who write for it. However, on August 29, it published an opinion piece on adolescent suicide and antidepressants that revealed, once again, how regularly the mainstream media publishes information about psychiatric treatments that is misleading and easily debunked.

. . .

In short, STAT has lent its good name to a “false” story. Its publication serves as yet another example of how society gets misled, time and time again, about what science really has to say about the merits of psychiatric drugs.

Risks of the current mental health & psychiatric system: angry, unhappy, violent people, and an unduly disabled citizenry

Soteria was “a special and more-than-good place” where people were treated with dignity and respect, compassion, understanding, love, and healing relationships. Since they were not dumbed down with neuroleptic drugs they could relate to, and learn from, its special environment.”(Loren Mosher MD) Mosher spent his professional career advocating for humane and effective treatment for people diagnosed as having schizophrenia and was instrumental in developing an innovative, residential, home-like, non-hospital, non-drug treatment model for newly identified acutely psychotic persons.  This psychosocial milieu-based residential treatment, known as the Soteria Project, showed consistently that its approach — a special social environment where drugs were generally not given — produced equivalent or better outcomes for patients treated there at 6 weeks and 2 years when compared with individuals that received “usual” hospital and neuroleptic drug treatment. Despite superior results compared to standard drug treatment, further funding for the Soteria Project was denied because, according to Mosher, the politics of psychiatry were increasingly controlled by the influence of pharmaceutical companies.

Similarly, Open Dialogue demonstrates far superior results as compared to USA standard care (drugs, hospitalization).  Harvard’s McLean Hospital has adopted this approach.  Open Dialogue is an innovative bio-psycho-social-spiritual network-based approach to psychological and emotional healthcare.  Decades ago, a  multidisciplinary team in Finland transformed the entire public psychiatric system from an old-style “chronic” hospital into an acute, community-based therapeutic facility.  After five years, 80% of those suffering acute psychosis for the first time in their lives experienced functional recovery (Seikkula et al., 2006).  They were working, studying, or looking for a job and not on government disability.  Open Dialogue may have the best outcomes in the world for psychosis (dialogicpractice.net).  

Anyone can experience psychosis, by the way.  People struggling to acknowledge and live in reality are people struggling to get through life just like everyone else, each for different reasons, some more obviously than others.  If we truly desire to help people who struggle and suffer, we need to wake up.  

The biomedical-reductionistic paradigm is “a history and science of a failed paradigm of care.” (Robert Whitaker, www.madinamerica.com).  The ethics that flow from that system do not reflect the realities of human nature and conduct, nor the possibilities of human choice.  Consequently, standard remedies miss the mark.  For example, according to Whitaker (Suicide in the Age of Prozac, 8/6/2018), there is a “body of collective evidence suggesting that mental health care, when it focuses on treatment with antidepressants, raises the risk of suicide at a general population level . . . the medicalized approach to suicide may make things worse.”  

The medicalization of human life and living is an abomination.  Extreme experiences of emotion and distortions of thought processes belong to the human condition.  They are meaningful, and, if allowed and with proper care, often resolve.  Whatever the experience, be it psychosis, depression, emotional instability or anxiety what is missing in our current conceptualization of “care”, and therefore needed to revolutionize our approach to madness and human suffering, is the understanding that symptoms arise in the context of human relationships.  

The ethics that flow naturally from this understanding will be consistent with the practices of Soteria, & Open Dialogue, and, the results of the longest running study on health & happiness: 

    • treat people with dignity and respect, compassion, understanding, and love.  
    • quality human relationships are more important than cholesterol, fame or fortune

    ________________

    Sources:

    • Response by Dr. Mosher to Psychobabble Scars, San Diego Weekly Reader, May 24th, 2003, Letter to the Editor, by Carla Jacobs
    • Robert Whitaker, Author of Mad in America: Bad Medicine, Bad Science, and the Enduring Mistreatment of the Mentally Ill
    • Antipsychotics in Open Dialogue Treatment:  a best use model of care, Robert Whitaker, April 2013
    • dialogicpractice.net  The Promise of Open Dialogue, January 1, 2014
    • The History & Science of a Failed Paradigm of Care, Robert Whitaker, April 2016
    • Psychiatrists Defends its Antipsychotics:  A case study of institutional corruption, Whitaker, 5/22/2017
    • Causation not just correlation, Whitaker, May 2016
    • Do Antidepressants work? Whitaker, 3/12/18
    • Drug Treatment in Medicine and Psychiatry: Papering Over Important Differences, Joanna Moncrieff, MD June 29, 2018
    • Abolishment of forced treatment is an ethical imperative, P. Goetzsche MD, 6/17/16
    • Forced treatment is torture, P. Breggin MD, 6/19/16
    • Suicide in the Age of Prozac, By Robert Whitaker - August 6, 2018 https://www.madinamerica.com
    • Robert Waldinger, Psychiatrist, psychoanalyst, Zen priest, Director of the Harvard Study of Adult Develpoment, one of the most comprehensive longitudinal studies in history. (https://www.ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness).  

    The latest hoax concerning human behavior: mayhem in Milwaukee is a case of "neurological trauma"

    It is certainly surprising to see what people put up with without protesting.  I refer to the mystifying, mythological, reductionistic-biomedical language used to postulate the reason Milwaukee is one of the most dangerous cities in the nation, known for its psycho-social-economic turbulence, and moral decay (“To address trauma, Journey House seeks therapists”, Milwaukee Journal Sentinel, by John Schmid, 7/18/2018).  To be sure, conditions affect growth & development.  A tree that only gets sun on one side will grow to be deformed on the side deprived of sunlight.  But to reduce freedom & responsibility to neurology is to make a false claim to knowledge.  

    "Human behaviour consists of complex, intentional and unpredictable responses to the unique history and circumstances of each individual. Unlike physical systems, including biological ones (i.e. human bodies), it cannot be captured or understood using universal formulae. Human behaviour can be explained and understood, but it is not ‘caused’ by other events in an inevitable fashion, as events follow each other in a mechanical system (see my previous blog on the philosophy of knowledge7). Although there are undoubtedly neurophysiological events taking place when someone feels depressed, for example, it is not clear that we will ever be able to map these precisely and consistently onto the emotional state. Indeed, for all the reams of research conducted on them, we still do not even know the precise functions of neurotransmitters, nor even, for example, the neurochemical basis of something as basic as arousal." (Drug Treatment in Medicine and Psychiatry: Papering Over Important Differences, Joanna Moncrieff, MD June 29, 2018) 

    The biomedical-reductionistic paradigm has failed to empower and restore people’s grip on life; it’s a “history and science of a failed paradigm of care” ( The History & Science of a Failed Paradigm of Care, Robert Whitaker, April 2016, Psychiatrists Defends its Antipsychotics:  A case study of institutional corruption, Whitaker, 5/22/2017,  Causation not just correlation, Whitaker, May 2016 ).  Such dogma confuses, obliterates, and disempowers human beings.  

    In order to respond effectively to any problem, one must accurately understand the problem.  Personal context matters.  So does the socio-political context.  Do the conditions associated with Milwaukee’s political system hinder the growth and development of individuals and Milwaukee society?  Dr. Thomas Sowell may think so: 

    “… evasion of responsibility for disastrous consequences of the prevailing social vision of our times, and the political policies based on that vision, over the past half century.  . . . You cannot take any people, of any color, and exempt them from the requirements of civilization - including work, behavioral standards, personal responsibility, and all the other basic things that the clever intelligentsia disdain - without ruinous consequences to them and to the society at large.  . . . Nonjudgmental subsidies of counterproductive lifestyles are treating people as if they were livestock, to be fed and tended by others in the welfare state - and yet expecting them to develop as human beings have developed when facing challenges of life themselves." ( The Inconvenient Truth about Ghetto Communities’ Social Breakdown, 5/5/2015, National Review)

    There are no simple explanations for complex psycho-socio-economic problems.  Few human beings get through life without emotionally traumatic experiences; some people struggle more than others, for different reasons. Extreme experiences and distortions of thought processes belong to the human condition: there will always be suffering.  Human beings develop through adversity; suffering can be an opportunity for maturation, an occasion to direct one’s life to what is essential.  Human development by way of adversity is a choice that reflects the burden of freedom, and requires responsibility.  

    Addiction, co-occurring conditions, and Humanity 101

    The thing about open dialogue that is so simple and compelling is that it is the same model humans have used to cooperate, help each other, and progress throughout history. It’s getting all the stakeholders, the people who care, in the same room, on the same page. It’s putting the puzzle that’s fallen apart back together.

    We all know how to do this because it is a human thing, not an “addiction” thing. Addiction is a proxy for meaningful relationship.

    Dr. Nelson interviewed for article in MKE Lifestyle Magazine

    “What these problems all have in common is they restrict a person’s consciousness, shrinking their world, and closing them off,” says Dawn Nelson, a clinical psychologist and founder of the Centre for Human Flourishing. Managing these disorders can be hard work. “I try to counsel and facilitate their willingness to do something for themselves. My job is to help them develop the motivation and courage and willingness to help themselves,” she says.

     

    Dr. Nelson's Tips for Dealing with Divorce

    Latrice Knighton is a member of the Sterling Law Offices partner team and an award-winning divorce attorney, life coach, and speaker. She helps clients resolve their problems by using legal techniques and smart tactics learned through decades of experience.  She is able to help clients by offering the best practical advice.  by Latrice Knighton, J.D., May 15, 2018

    Every person going through a divorce is experiencing some emotions about the process.  It could be fear, anxiousness, anger, relief, confusion, sadness, disappointment, etc.  You may benefit from having someone to talk to about how you are feeling so you can focus on getting the best resolution of your divorce case for both you and your family.

    I interview Dr. Dawn Nelson of the Centre for Human Flourishing (centreforhumanflourishing.com) so you know how a psychologist can help you in a divorce, and coping tips for those going through a divorce.

    What makes a good life? Lessons from the longest study on happiness

    What keeps us happy and healthy as we go through life? If you think it's fame and money, you're not alone – but, according to Zen Priest, Harvard Professor and psychiatrist Robert Waldinger, you're mistaken. As the director of a 75-year-old study on adult development, Waldinger has unprecedented access to data on true happiness and satisfaction. In this talk (12 minutes), he shares three important lessons learned from the study as well as some practical, old-as-the-hills wisdom on how to build a fulfilling, long life.

    Is Addiction a Disease? The current medical consensus about addiction may very well be wrong

    The prevailing wisdom today is that addiction is a disease. This is the main line of the medical model of mental disorders with which the National Institute on Drug Abuse (NIDA) is aligned: addiction is a chronic and relapsing brain disease in which drug use becomes involuntary despite its negative consequences.  

    . . . 

    Yet, though there are positive aspects to seeing addiction in this light, it seems unduly pessimistic and, though no one will deny that every behavior has neural correlates and that addiction changes the brain, this is not the same as saying that, therefore, addiction is pathological and irreversible.

    And there are reasons to question whether this is, in fact, the case.

    Why are so many people dying from opiate overdoses? It’s our broken society Marc Lewis

    Never mind the ‘war on drugs’ or laying all blame with pharmas, this epidemic exists because millions live in a world without hope, certainty and structure

    • Marc Lewis is a neuroscientist and author of The Biology of Desire: Why Addiction Is Not a Disease

     

    Dr. Nelson on the Dr. Breggin Hour, Archive

    My guest Dawn R. Nelson has a PsyD as well as a Masters in Divinity, and comes from a rich background of thoughtfully providing human services.  She conducts her private practice based on principles similar to my Guidelines for Empathic Therapy and will inspire other therapists to practice true to themselves and their ideals.   She exemplifies a growing consensus that therapists should be genuine and caring, as well as informed about the importance of childhood and nurturing in respect to who we are as adults.   She renews my faith in the future of psychotherapy.

    The DSM and the Medical Model: New Video

    "It [this video] lays bare the counterproductive nature of the medical model and the pseudoscience and elitism that support it. . . . few people understand the World Health Organization definition of mental health as a social welfare issue of “well-being.  . . . emotional suffering (mental distress) is a natural reaction to distressful experiences, rather than a disease.  The social welfare narrative also advocates that physical health directly affects mental health: physical sickness, allergies, nutritional deficits, fatigue, and environmental toxins can all lead to mental distress."