The Szasz Blog

Psychiatry, Psychology, and the Law -- an online course with Jeffrey Schaler, May 2007

2007-04-08T13:07:00.000-04:00

Psychiatry, Psychology, and the LawJLS-596 N01L
American University
Instructor: Jeffrey Schaler
May 14, 2007 to June 25, 2007

"This on-line course deconstructs concepts of mental illness, explanations for disease and behavior, and legal policies based on diverse explanations for both. It also investigates the insanity defense as legal fiction. In addition, it studies due process and involuntary commitment procedures and why and how society creates and welcomes the union of medicine and state, pharmacracy, and paternalistic practices based in psychiatric and psychological theories and practices."

The course is offered by American University in Washington, D.C. You can negotiate with your college or university for credit. If you are already a student at American University, check with your advisor or the appropriate person in charge about credit for this summer course. You must register through American University. Click http://www.american.edu/distanceed/courses.html to register.

This is an opportunity to study the ideas of Thomas Szasz, Jeff Schaler, and others concerning the myth and meaning of mental illness; the various explanations offered for mental illness--including theological, biological, psychological, and sociocultural explanations; and the various consequences of those explanations in diverse policy arenas including legal policy (involuntary commitment, the insanity defense, competency to stand trial, testamentary capacity, and general consequences for liberty and responsibility); clinical policy (including various biological "therapies," the meaning of psychotherapy, different types of psychotherapy, similarities between psychotherapy and religion, etc.); public policy (including various forms of formal social control, paternalism, how the state attempts to protect people from themselves in the name of public health and medicine; the consequences of drug prohibition, court-ordered treatment for addiction and First Amendment rights, problems facing doctors in terms of prescribing opiates for pain control, etc.); and various elements of social policy (the difference between formal and informal social control; conformity, compliance, and obedience to authority, etc.).

In the next week the full syllabus for this course will be available HERE. If you're interested in receiving a copy of the syllabus by email once it's ready, write to me at the following email address (written as is to avoid spam): schaler (at) american.edu. See past syllabi and evaluations by students of Schaler's teaching by clicking HERE

This is going to be an intense course with lots of reading, discussion, a mid-term examination, a final examination, and a paper. The course is taught through BlackBoard. You can only access the course by being registered as a student for it. For information on how to register, click at this url http://www.american.edu/distanceed/courses.html.

Researchers: Broken home linked to psychosis

2006-11-21T14:26:00.000-05:00

People from broken homes may be more prone to psychotic illnesses such as schizophrenia, research suggests.

Researchers said their findings suggest the illnesses are not simply brain diseases, but linked to factors such as social adversity.

They found much higher rates among black people, who were also more likely to come from broken homes.

The study, by London's Institute of Psychiatry, will appear in the journal Psychological Medicine.

The researchers examined data on people in south east London, Bristol and Nottingham, including 780 who showed signs of a psychotic illness.

They found schizophrenia was nine times more common in people from African Caribbean origin, and six times more common in people from black African origin than in the white British population.

In a second paper, they found that separation from one or both parents for more than a year before the age of 16, as a consequence of family breakdown, was associated with a 2.5 fold increased risk of developing psychosis in adulthood.

Family breakdown of this type was found to be more common in the African-Caribbean community (31%) than the white community (18%).

Researcher Dr Craig Morgan said: "These findings provide evidence that early social adversity may increase the risk of later psychosis.

"Such early adversity may be one factor contributing to the high rate of psychosis in the African-Caribbean population."

More work needed

However, Dr Morgan said more work was needed to fully understand how specific types of early social adversity might interact with pyschological and biological factors to cause psychosis.

Professor Robin Murray, who also worked on the research, said: "For the last 30 years the traditional view has been that psychosis is largely a genetic brain disease, and most psychiatrists have thrown out the view that social factors can have a major impact.

"These findings suggest it is not just a brain disease, and that social factors can also contribute to the onset of illness."

Professor Murray dismissed the idea that drug taking might contribute to raised rates of psychosis among the black population.

He said evidence showed that drug taking was no higher among black people than the general population.

He said it was possible that the discrimination and disruption encountered by migrants to the UK might play a role in their increased vulnerability to psychosis.

Paul Corry, of the mental health charity Rethink, said there was evidence to suggest that although psychotic illness was linked to the genes, it often took an external trigger for symptoms to become apparent.

He said: "These findings underline the need to approach the treatment of schizophrenia not just in purely medical, drug-based terms, but also by taking into account the wider social context that the patient is inhabiting at the time, and trying to ensure they are offered relevant support."

It is thought that around 1% of the population develop schizophrenia, or related conditions, such as manic psychosis, and depressive psychosis.

Up to 300,000 people have been diagnosed with schizophrenia in the UK.

All the conditions are associated with hallucinations, delusions and bizarre forms of behaviour.

Pyschotic illnesses have been linked to raised levels of the mood-altering chemical dopamine in the brain.

The Institute of Psychiatry is based at King's College London.

Judge rules against boy’s circumcision

2006-11-01T23:13:00.000-05:00

This is a most interesting legal decision. According to the Chicago Tribune,

In a case that has been closely watched by anti-circumcision groups nationwide, a Cook County judge ruled Tuesday that the medical benefits of the procedure are not clear enough to compel a 9-year-old Northbrook boy to be circumcised against his will.

The boy's mother and her new husband had claimed the operation was necessary to prevent recurrent episodes of redness and discomfort. The boy's father sought a court order barring the circumcision, which he called an "unnecessary amputation."

The mother has sole custody, but their 2003 parenting agreement gave her ex-husband a say in non-emergency medical decisions. The Tribune is not naming the parents in order to protect the boy's privacy.

In a written opinion handed down Tuesday, Circuit Court Judge Jordan Kaplan said, "The evidence was conflicting and inconclusive as to any past infections or irritations that may have been suffered by the child.

"Moreover," he continued, "this court also finds that the medical evidence as provided by the testimony of the expert witnesses ... is inconclusive as to the medical benefits or non-benefits of circumcision as it relates to the 9-year-old child."

Kaplan said the boy, as a minor, cannot make his own medical decisions but had indicated in a written statement that he does not want to be circumcised...

Clearly the court would not have intervened had the biological father not objected, but should courts ban genital mutilation of all minor males? If not, then why should the mutilation of minor females not also be permitted?

What types of unnecessary mutilation should be legally acceptable, and whose opinion should prevail? Who defines "medical"? If mutilation should be banned due to the lack of medical justification, should there be a religious exemption? If circumcision is not medically justifiable, what about ear piercing? Should a father be able to prevent his ex-wife from piercing her 9-year-old daughter's ears, with or without the child's consent? What if the child objects to the piercing? At what age should a child's opinion be considered by a court on such a matter?

It should never be taken lightly when a court's judgement replaces that of a parent, but I think that circumcision, except when medically indicated, if such a case can really exist, can properly be banned by courts. When a person reaches the age of majority he can always decide to be mutilated. But how can I then justify the ear piercing of a minor?

Confronting the "Good Death": Nazi Euthanasia on Trial, 1945-1953

2006-10-19T22:42:00.000-04:00

Has anyone read this book?

Confronting the "Good Death": Nazi Euthanasia on Trial, 1945-1953
by Michael S. Bryant

Book Description:
Years before Hitler unleashed the "Final Solution" to annihilate European Jews, he began a lesser-known campaign to eradicate the mentally ill, which facilitated the gassing and lethal injection of as many as 270,000 people and set a precedent for the Nazis' mass murder of civilians.

In Confronting the "Good Death," Michael Bryant tells the story of the U.S. government and West German judiciary's attempt to punish the euthanasia killers after the war. His fascinating work is the first to address the impact of geopolitics on the courts' representation of Nazi euthanasia, revealing how international power relationships played havoc with the prosecutions.

Drawing on primary sources and extensive research in archives in Germany and the U.S., Bryant offers a provocative investigation of the Nazi campaign against the mentally ill and the postwar quest for justice. His work will interest general readers and provide critical information for scholars of Holocaust studies, legal history, and human rights.

Obituary: Martin Roth

2006-10-19T16:32:00.000-04:00

Excerpts from lengthy obit by Claude M. Wischik in The Independent (UK) for Hungarian-born psychiatrist Martin Roth:

His textbook was a sure, humane and safe pilot for the discipline of psychiatry in ideologically stormy times: the transition from the post-Freudian thinking to the age of Prozac. These were times that Roth and his co-authors inspired with a unique blend of clarity, critical thought, breadth of scholarship, charm, and humanity. It was in the German tradition of Emile Kraepelin, who in his day transformed psychiatry with his clear descriptions of the major psychiatric syndromes, only to be swept aside in late life by the rise of the Freudians.

Freud, as Roth liked to say, was not a psychiatrist, but a neurologist. Freud has come to be loved more in departments of literature and the history of ideas than in departments of psychiatry. This is because he never really came to grips professionally with the stuff of mental illness. The times of vast psychiatric institutions housing populations in excess of 1,000 souls in varying degrees of torment and hopelessness are still etched in the collective social consciousness, and their residue lives on in the stigma which is still too often attached to mental illness...

He emerged from these battles with his characteristic intellectual fearlessness, tenacity and honesty. These qualities were particularly needed when it came to dealing with the anti-psychiatry movement. He eventually published as The Reality of Mental Illness (1986) the debate between himself and Thomas Szasz dealing with the question whether mental illness is merely a social construct. The proposition here was that there is no such thing as mental illness. Psychiatry merely provides a police and custodial service on behalf of the socio-political establishment to deal with deviancy.

According to Szasz and Scientology, the whole psychiatric enterprise is bogus. According to Ivan Illich, we have no business medicalising the rich brocade of human diversity. Roth's response to this came from his long experiences in the psychiatric hospitals, where one cannot escape from the reality and torment of mental illness, and where the post-modernist rhetoric becomes inaudible against the cries that echo along the corridors in the night. Mental illness is real illness: the problem is how to help.

Roth had a fine turn of phrase in these battles. I remember his advice when dealing with an opponent: "The rapier is better than the broadsword." Or when dealing with Jacques Derrida: "The tide of his rhetoric is unimpeded by the outcrops of fact lying in its path." Or on Illich: "a brooding presence in night, like a dysfunctional lighthouse, emitting shafts of darkness to confuse unwary travellers".

He had fierce battles also within psychiatry, the most renowned being with Robert Kendell on the difference between anxiety disorder and depression. Kendell argued that they form an undifferentiated spectrum of emotional disorder, too often seen together to be able to distinguish the two. Roth argued that they were distinct biological entities, with different clinical features, different genetics and different natural history. Who was right in the end? From the diagnostic point of view, and also now from the molecular genetics, Roth's concept has been enshrined in DSM and ICD. From a therapeutic point of view, there remains a large overlap in terms of treatment.,,

The enduring sadness of the biological revolution in psychiatry that Roth helped to inspire is that its early promise has not been fulfilled through new treatments. Kraepelin delineated the major disorders, schizophrenia and manic depressive disorder, in the 1890s. Although there are newer drugs that do much the same as the originals of the 1960s, no fundamentally new approaches have emerged. This is not for want of effort, as neuroscience research is now a vast worldwide enterprise. The problem is that these disorders have proved to be difficult to unravel, and the mechanism of these diseases, unlike that of Alzheimer's disease, leaves no discernible trace in the brain. Unravelling them may take several more generations of research...

Rothbard's attack on psychoanalysis

2006-10-13T11:58:00.000-04:00

Psychoanalysis as a Weapon
By Murray N. Rothbard
(Excerpt)

Thomas Szasz is justly honored for his gallant and courageous battle against the compulsory commitment of the innocent in the name of "therapy" and humanitarianism.

But I would like to focus tonight on a lesser-known though corollary struggle of Szasz: against the use of psychoanalysis as a weapon to dismiss and dehumanize people, ideas, and groups that the analyst doesn't happen to like. Rather than criticize or grapple with the ideas or actions of people on their own terms, as correct or incorrect, right or wrong, good or bad, they are explained away by the analyst as caused by some form of neurosis. They are the ideas or actions of neurotic, or "sick," people: so if the people themselves are not to be incarcerated in institutions as "mentally ill," then their ideas or attitudes may be treated in the same manner.

The unspoken assumption, of course, is that ideas or actions congenial to the analyst don't need "explaining" by psychoanalytic or other psychodynamic theories. Since they don't need "explaining," the implication is that they are normal, correct, and good, though of course no analyst, in his role as the embodiment of "value-free science," would ever be caught dead using such terms. For if he did so, he would have to take the ideas or actions of his opponents seriously, and set forth an explicit moral theory in doing so. He would not be able to dismiss them as "sick" or as people who are uniquely in need of being "explained."
----
Murray N. Rothbard (1926–1995) was dean of the Austrian School.
This article was a keynote address given at a special conference sponsored by The Institute for Humanistic Studies in 1980.

Opiate Romance

2006-10-13T10:11:00.000-04:00

Opiate Romance
by George Giles
LewRockwell.com

Theodore Dalrymple is a British Doctor who is also a gifted writer. He has written extensively on his experiences in medical practice in some of the world's worst places: the third world, the British prison system, and the slums of London. He is critical of socialism, especially the British variant. His latest book Romancing Opiates" with a subtitle of Pharmacological Lies and the Addiction Bureaucracy is an insightful look behind the scenes of heroin and methadone addicts and the addiction bureaucrats that service them.

Dalrymple prose is like reading Shakespeare where every moment is a pleasure. You find yourself reading and re-reading just to enjoy the beauty with which the English language can represent ideas with simple words strung together sequentially. The enjoyment is all the more ironic when we consider the subject of much of his writings, the failure of socialism, and his personal dealings with those that have failed under it...

Where the book really gets interesting is when he relates individual stories of the addicts and how mild addiction to heroin/opiates really is. The "illness" is minor, passes quickly and is not at all the hideous ritual as is popularly portrayed ad nauseum by the addiction bureaucracy and their sycophants. He also provides ample evidence, from first-hand experience as a medical expert, both observation and expert witness testimony, that the addiction is not easily acquired and is easily shed when circumstances mandate. Most addicts eventually tire of the lifestyle and prison as they grow older. This contravenes the conventional wisdom of the multi-billion-dollar pharmaceutical addiction bureaucracy that in many cases provides both the product and the treatment for the kind of exorbitant profit margins that only a government-mandated cartel can provide...

My criticism of this book is that he does not apply Thomas Szasz's logic of self-medication as an alternative to established therapeutic practices which are the product more of privileged elite thought leaders than scientific reality. He does not address the immense societal cost of drug criminality due to cartel-mandated exorbitant prices, enforcement, and interdiction costs or the costs that "drug wars" impart on the citizenry of most countries of the world. He also does not criticize the existence of the cartel of which he is a member. This is all forgivable if not excusable when you look at his extensive record of truly helping the downtrodden...

Plastic surgery: natural mood enhancer?

2006-10-09T15:23:00.000-04:00

Plastic surgery: natural mood enhancer?
SAN FRANCISCO, Oct. 9 (UPI) -- It has been proven that plastic surgery can improve self-esteem but a U.S. scientist says it can also act as a natural mood enhancer.

"Plastic surgery patients are taking a proactive approach in making themselves happier by improving something that has truly bothered them," said the study's author, Dr. Bruce Freedman, medical director of Plastic Surgery Associates of Northern Virginia. "While we are not saying cosmetic plastic surgery alone is responsible for the drop in patients needing antidepressants, it surely is an important factor."

In the study, 362 patients had cosmetic plastic surgery and 17 percent, or 61 patients, were taking antidepressants. Six months after surgery, however, that number decreased 31 percent, down to 42 patients. In addition, Freedman said 98 percent of patients said cosmetic plastic surgery had markedly improved their self-esteem.

"We have just begun to uncover the various physical and psychological benefits of plastic surgery," said Freedman. "By helping our patients take control over something they were unhappy about, we helped remove a self-imposed barrier and ultimately improved their self-esteem."

The study was presented Monday in San Francisco during the American Society of Plastic Surgeons 2006 conference.

Va. Parents Trying to Unadopt Troubled Boy-- Mother Says Caseworkers Failed to Disclose Child's Stormy History

2006-10-09T12:37:00.000-04:00

Va. Parents Trying to Unadopt Troubled Boy
Mother Says Caseworkers Failed to Disclose Child's Stormy History
By Brigid Schulte
Washington Post Staff Writer
Monday, October 9, 2006; A01

A talkative 9-year-old boy came to Helen Briggs on Valentine's Day 2000. She was a foster mother with years of tough love and scores of troubled kids behind her. But she grew to love this boy. Within the year, she'd talked her husband into adopting him.

Now, six years later, Briggs and her husband, James, a maintenance worker for the city of Alexandria, are taking the highly unusual step of trying to unadopt him.

In 2003, when the boy was 12, he sexually molested a 6-year-old boy and a 2-year-old girl still in diapers. She said it was only then, as she waited outside the courtroom for his sexual battery hearing and caseworkers handed her his psychological profile, that she found out just how damaged the boy had been when he came into her life.

The Washington Post generally does not name the subjects of juvenile court cases.

Briggs said she did not know he had lived in five foster homes since he was 16 months old. Nor that his alcohol- and drug-addicted biological parents had physically abused him, injuring his brain stem and impairing his ability to gauge the passage of time.

He'd been hospitalized seven times in psychiatric institutions and diagnosed as possibly psychotically bipolar. He'd thrown knives, kicked in walls, pulled out all his hair and threatened to kill himself. He'd heard voices telling him to do bad things. His confidential case file shows he most likely was sexually abused.

"I did not know any of that," Briggs said, though Virginia policy states that caseworkers should provide "full, factual information" about a child to adoptive parents. "They just told me he was hyperactive."
She said the state's failure to fully disclose the boy's background is tantamount to fraud.

State child welfare officials could not comment on the case because of confidentiality restrictions. But some caseworkers do not believe Briggs, records show. They think she wants to get out of paying child support.
Still, a Fairfax County court has granted Briggs's petition to relinquish custody. The boy, who has lived in institutions since his conviction, is now officially back in foster care. He asked to be put on suicide watch, records show, when the judge's decision came down.

Briggs hired an attorney to terminate her parental rights. But in Virginia, a child older than 14 must give consent. The boy, now nearing 16, wants Briggs to be his mother forever, according to the voluminous confidential case file and e-mail and phone records Briggs subpoenaed for her lawsuit and provided to The Post.

Briggs sought to file a "wrongful adoption" lawsuit. But under Virginia law, she needed to file within two years of discovering the boy's history. Instead, she wavered.

First, she wanted him home after he had completed his sex offender treatment. But then psychologists deemed him a "sexual predator." That meant Briggs could no longer be a foster parent, which she considers her job. Nor could she allow her three grandchildren in her house. Nor could she keep a little girl she had cared for since the day she was born.
She had to choose.

"You don't want to throw somebody away," she said. "But sometimes you have to."

Her choice has left her with none of the rights and many of the responsibilities of a parent. Caseworkers forbid her from contacting the child because he becomes so violent and angry when she does. Yet state law requires that she pay $427 a month in child support and cover court costs when he appears before judges who now decide what's best for him.
With no legal recourse, she is asking politicians to help her find a way out.
"At first blush, you think, 'What, you're trying to give up your kid? You're a jerk,' " said Virginia Del. David B. Albo (R-Fairfax). "Then you find this lady has received awards for all the foster work she's done. And that she never would have adopted the boy and put other children in danger if she had had the information that was withheld from her."

The technical term for what Briggs is trying to do is "dissolve" the adoption, as if all the bonds of love and hurt could simply vanish into thin air.

A Hopeful Start
When Briggs, 57, went to visit the boy for the first time, she said she saw a cute, happy child. She recalls caseworkers telling her that he was in a psychiatric hospital because he was too much of a handful for his great-aunt.

They were nearing desperation before they found Briggs, records show. Nobody wanted him.

A no-nonsense, old-school "professional parent," Briggs figured she could handle him. When the boy acted out, she gave him limits. When he began pulling his hair out, she had it shaved. And when he kept running away from school and her Lorton townhouse, she turned him over to her husband for a whupping, just like she got as a child -- until caseworkers called Child Protective Services.

Nonetheless, caseworkers noted that the boy thrived in her care. "The Briggs foster home is the most constructive and potentially successful placement option that this child has," they wrote.

Briggs hadn't planned on adopting anyone. There was just something special about this child. He was so thankful he had his own room, with the first bed he hadn't had to share in his whole life, she remembers him telling her.

If she got sick, he'd make her soup and rub her feet. At school, if he heard an ambulance, he'd be beside himself until school workers let him call home to make sure Briggs was okay. She understood, she said. So many people had abandoned the child.

As she was signing the adoption papers, she remembers nothing about a background briefing, as required by state policy. Only a caseworker asking skeptically, "Are you sure you want to do this?"

"Yes," she recalled answering. "I love him."

When the boy came to her, he was taking medications for mental illness, depression, delusions, seizures and attention-deficit hyperactivity disorder. He was considered a "therapeutic" foster child, one that comes with extra emotional, medical or behavioral baggage and a heftier monthly subsidy.

Some case workers think she must have known, records show. One wrote that Briggs wasn't being "entirely honest." However, nothing in the case file indicates she was given an oral briefing or a written summary of the boy's background, or access to his records. In some reports, details such as his psychiatric hospitalizations and sexual abuse are left out.

There are also notations of alarm when Briggs began taking the child off his medications, that perhaps she did not understand the gravity of his condition.

Briggs said she thought the medications were for hyperactivity. When the child began complaining of headaches, she took him to a psychiatrist caseworkers recommended. She asked if the boy needed all the pills. The psychiatrist, records show, said no.

"When he told me he was hearing voices, I told him it was just his conscience talking," she said.

Records show that caseworkers are vehemently against Briggs terminating her parental rights. "At least, if his parents win the lottery and die, he will inherit," one wrote in an e-mail. Some think she has rejected the boy because she needs the money she gets from foster children.

"That's a lie," Briggs said angrily.

A religious woman and active in her Sword of Spirit Deliverance Ministry Pentecostal Church, Briggs said being a foster mother is a calling. She's on disability, she explained, so it's one of the few things she can do to supplement her husband's blue-collar wage.

"The system needs to be revised. That's why I'm doing this," she said. "I should have known about the child. Because people get hurt."

And then there is another reason, one that woke up late one recent morning and, yawning, shuffled downstairs in fluffy white slippers with bells on the toes and nestled onto Briggs's ample lap: a little girl of 5, the child of a former foster daughter and Briggs's legal ward.

"I can't take him back," Briggs said, stroking the hair of the child she chose to keep.

Wrongful Adoption
If it is true what Briggs says, that she really didn't know the full extent of the boy's difficult young life, it would not be the first time.

The first "wrongful adoption" lawsuit was won in Ohio in 1986. Parents were told the 16-month-old they adopted was a healthy infant born to a teenage mother. When the child later developed a fatal disease and exhibited mental disorders, the parents discovered he was born to two middle-age mental patients.

Since then, states have enacted a patchwork of laws and written disclosure policies. Some states, such as Texas and Ohio, give adoptive parents access to a child's entire case file. In Maryland, social workers are required to prepare a written background summary and ask adoptive parents to sign it. Virginia's disclosure policy has no written requirement.

"I have seen so many adoptive parents come back and feel so angry and cheated that we didn't tell them about a child. And we did tell them," said Judith Schagrin, a Maryland social worker. "It's just that at the time, they were so hopeful and looking through a lens of love that they couldn't hear what we were saying."

But sometimes, because of the high turnover of case workers, information gets lost, assumptions get made, mistakes happen -- especially if the child is older. Especially if they've bounced around foster care for years. And especially, Schagrin said, if their sad and broken histories might scare away potential foster or adoptive families.

That pressure has intensified since 1997 because of a federal law that rewards states as much as $6,000 for every foster child adopted.

"I have seen caseworkers. They think, 'Oh, the family won't adopt the child if they know everything," Schagrin said.

Most adoptions take, especially for infants. But for children over 12, as many of 25 percent of the adoptions don't. They simply dissolve.

Full

"Experts" say term schizophrenia should be abolished

2006-10-09T09:30:00.000-04:00

Schizophrenia term use 'invalid'
BBC News
2006/10/09

The term schizophrenia should be abolished, experts have said.

They claim the category falsely groups a wide range of symptoms and encourages over-reliance on anti-psychotic drugs rather than psychological intervention.

The academics also said the label stigmatised people as being violent, dangerous and untreatable...

Richard Bentall, professor of experimental clinical psychology, from the University of Manchester, said: "We do not doubt there are people who have distressing experiences such as hearing voices or paranoid fears.

"But the concept of schizophrenia is scientifically meaningless. It groups together a whole range of different problems under one label - the assumption is that all of these people with all of these different problems have the same brain disease."

He this can misinform treatment, and has encouraged the widespread use of "drastic biomedical interventions" as the first-line of treatment, rather than psychological help. He said although drugs were useful for some patients, too often they were given at extremely high doses and had some dangerous side-effects.

He said: "Overall, I think the concept is scientifically meaningless, clinically unhelpful and ultimately has been damaging to patients."

Paul Hammersley, also of the University of Manchester, who is involved with the Campaign to Abolish the Schizophrenia Label (Castle), wants the term dropped.

He said: "It is associated with violence, dangerousness, unpredictability, inability to recover, constant illness, constant need for medication and an inability to work. I cannot emphasise enough how stigmatising this label is."

But the academics could not give a definitive answer to what should replace the term schizophrenia if it was eliminated.

They pointed to Japan, where the category schizophrenia was replaced with "integrated disorder" in 2004, as a possible model.

And Professor Bentall suggested patients should be treated on the basis of individual symptoms, as opposed to an overarching category.

Robin Murray, professor of psychiatry at the Institute of Psychiatry, London, said most psychiatrists accepted term schizophrenia was imperfect but warned that were it discarded another method of classification must be devised.

He said: "If we don't have some way of distinguishing between patients, then those with bipolar disorder or obsessional disorder would be mixed up with those currently diagnosed as having schizophrenia and might receive treatments wholly inappropriate for them.

"Most psychiatrists would still agree that the term schizophrenia is a useful, if provisional, concept. My personal preference would be to replace the unpleasant term schizophrenia with dopamine dysregulation disorder which more accurately reflects what is happening in the brain when someone is psychotic. "

Til Wykes, professor of clinical psychology and rehabilitation at the Institute Of Psychiatry, said: "We should be careful not to throw the baby out with the bath water, as despite its limitations, a diagnosis can help people access much needed services.

"What all of us have to remember is that these are people with a diagnosis of schizophrenia, not 'the schizophrenic'."

Wikipedia: Szasz LSD trip "'one of the best experiences' he'd lived through"

2006-10-08T11:38:00.000-04:00

How appropriate that this perplexing comment should appear in the Wikipedia entry, "Reality":

"Thomas Szasz called his LSD trip near the end of his life "one of the best experiences" he'd lived through..."

After posting this I raised a bit of a stink over it in the Wikipedia discussion about the "Reality" page, and someone has now removed it. Wikipedia is a farce worthy of its time.

LSD treatment for alcoholism gets new look

2006-10-08T11:08:00.000-04:00

The Hindu
Sunday, October 8, 2006

Some participants still have not had a drink 40 years after the trials. For the past five years, Dr. Erika Dyck has been unearthing some intriguing facts related to a group of pioneering psychiatrists who worked in Saskatchewan, Canada in the '50s and '60s.

Among other things, the University of Alberta history of medicine professor has found records of the psychiatrists' research that indicate a single dose of the hallucinogenic drug LSD, provided in a clinical, nurturing environment, can be an effective treatment for alcoholism...

After perceiving similarities in the experiences of people on LSD and people going through delirium tremens, the psychiatrists undertook a series of experiments. They noted that delirium tremens, also know as DTs, often marked a "rock bottom" or turning point in the behavior of alcoholics, and they felt LSD may be able to trigger such a turnaround without engendering the painful physical effects associated with DTs.

"The LSD somehow gave these people experiences that psychologically took them outside of themselves and allowed them to see their own unhealthy behavior more objectively, and then determine to change it," said Dyck, who read the researchers' published and private papers and recently interviewed some of the patients involved in the original studies - many of whom had not had a sip of alcohol since their single LSD experience 40 years earlier...

"The LSD experience appeared to allow the patients to go through a spiritual journey that ultimately empowered them to heal themselves, and that's really quite an amazing therapy regimen," Dyck said...

In spite of the promise LSD showed as psychotherapy tool, its subsequent popularity as a street drug, and the perception of it as a threat to public safety, triggered a worldwide ban in the late 1960s - including its use in medical experiments. However, the ban on its use in medical experiments appears to be lifting, Dyck noted. A few groups of researchers in the U.S., including a team at Harvard, have recently been granted permission to conduct experiments with LSD.

"We accept all sorts of drugs, but I think LSD's 'street' popularity ultimately led to its demise," Dyck said.
------------
See also: LSD — The Problem-Solving Psychedelic

LP removes involuntary commitment from platform

2006-08-05T09:01:00.000-04:00

The Libertarian Party has removed opposition to involuntary commitment from its platform. Many party members support psychiatric power and have opposed that provision.

Inside Scientology

2006-05-12T12:20:00.000-04:00

Inside Scientology
February 2006
Rolling Stone
Unlocking the complex code of America's most mysterious religion
http://www.rollingstone.com/politics/story/9363363/inside_scientology

awards movie at www.schaler.net

2006-05-06T19:44:00.000-04:00

A Quicktime movie of the Szasz Award to Schaler on April 17, 2006, and his evening keynote speech is now available at http://www.schaler.net/awardsspeechmovie.html. The crowd was over 1,000 at the Beverly Hills Hyatt, in Los Angeles, California.

Experts Defining Mental Disorders Are Linked to Drug Firms

2006-04-20T15:39:00.000-04:00

"Every psychiatric expert involved in writing the standard diagnostic criteria for disorders such as depression and schizophrenia has had financial ties to drug companies that sell medications for those illnesses, a new analysis has found."

Andrea Yates offered plea deal

2006-02-28T01:10:00.000-05:00

A Texas woman who drowned her five children in 2001 has been offered a plea agreement under which she could be eligible for parole in 12 1/2 years, prosecutors said on Monday, but her lawyer rejected the deal.

Andrea Yates, 41, has until March 10 to accept the deal to avoid a March 20 retrial on capital murder charges for the drownings, prosecutors said.

As part of the agreement, Yates would have to accept a 35-year sentence, but would be eligible for parole after spending 17 1/2 years in custody, which would include the five years she's been behind bars since the killings.

Full Story

Head case

2006-02-22T16:22:00.000-05:00

http://www.signonsandiego.com/news/science/20060222-9999-lz1c22abnorm.html

San Diego Tribune

Head cased

For 100 years, the Journal of Abnormal Psychology has made mental note of our ever-changing (mis)behavior
By Scott LaFee

UNION-TRIBUNE STAFF WRITER
February 22, 2006

The latest edition of the Diagnostic and Statistical Manual – a kind of field guide to mental illness – cites more than 350 specific disorders, from autism and dyslexia to trichotillomania, which is the irresistible compulsion to pull one's hair out.

Then there's the list of generally recognized phobias, currently at almost 300, from apeirophobia (fear of infinity) to zemmiphobia (fear of the great mole rat).

In a world of 6 1/2 billion people, it's been said there are 6 1/2 billion personalities and 61/2 billion cases of human behavior outside the norm. Everyone, the argument goes, acts out in some way, displaying an eccentricity or behavior that is, well, abnormal.

But what's wrong with that? Is it really so bad to be terrified of the dark (achuophobia) or to become nervous, twitchy and a little scatter-brained after a few cups of coffee – all symptoms of a condition called “caffeine intoxication”? Is grumpiness a psychological malady?

For 100 years, cloaked beneath its plain cover, the writers and editors of the Journal of Abnormal Psychology have debated the tumultuous state and nature of human deviance, constantly asking themselves: What constitutes abnormal behavior? What causes it? What should be done?
“Psychology is the science of human behavior and the things that happen in the mind to create it,” said David Watson, a professor of psychology at the University of Iowa and a former Journal editor. “It's a subject that fascinates almost everyone because we all have notions of what's normal and what's not.”
In 1906, when Boston physician Dr. Morton Prince and colleagues founded the Journal, the psychological sciences were fledgling and fragmented. Seminal work was being done by Sigmund Freud, Carl Jung, Alfred Binet and Ivan Pavlov, but the early years of the Journal were frequently weighted with essays describing singular cases of people or behaviors that struck their authors as beyond the pale.
In 1914, for example, the Journal included accounts of reputed demonic possession, the analysis of a single dream recounted by the author and a paper titled “Hysteria as a weapon in marital conflicts.”

“The early Journal was a bit analogous to Lewis and Clark going west, describing everything they saw,” said Watson. “I don't know what kind of peer review existed then, but most people working in the field probably had never seen anyone with some of the problems described in the Journal. In fact, they may not have known some of these behaviors existed at all.”

Psychology, of course, has matured significantly over the past 10 decades, with the Journal providing a venue for greater scientific insight and debate. Superficial description has given way to deeper questions of causality. Advances in technology (brain imaging, computers) and techniques (surveys and diagnostic tools) have elevated the field.

Still, the original question posed by Journal founder Prince remains imperfectly and incompletely answered:

What is abnormal behavior?
Psychology 101
There is no normal – that is, no standard – definition. Abnormal behavior defies absolute description.

“It's still being debated,” said Tim Baker, a professor of psychology at the University of Wisconsin and the Journal editor. “To what extent is abnormal behavior something that is merely unusual? To what extent does it have to be problematic in terms of having harmful consequences to the individual or to people around the individual? It's a somewhat fuzzy concept.”

Depending on training and expertise, psychologists, psychiatrists and other mental health professionals employ various defining criteria. A textbook definition, however, would probably include one or more of these factors:
Statistical deviation: Broadly speaking, human behavior resembles a bell curve. Most people clump in the bulging middle. Behavioral characteristics that fall a certain distance from the average value tend to be considered abnormal.

Social norm violation: All cultures establish rules, expectations of the right and wrong way to do things. People whose behavior frequently violates these rules may be deemed abnormal.
Maladaptive behavior: Any behavior that causes harm, either to the individual or others. An alcoholic may be doing himself physical injury, but if he generally functions within society, that's individual maladaptive behavior. If the alcoholic's behavior harms others, that's socially maladaptive behavior.

Personal distress: If you are depressed, anxious or upset, the behaviors and thoughts relating to those feelings may be regarded as abnormal.
Medical disorder: Some abnormal behaviors relate to physiological disorders, such as Alzheimer's.
Each category has weaknesses.

“Who is to say that a person should or should not feel depressed about this or that in the world?” asked Jeffrey Schaler, a psychology professor at American University in Washington, D.C.

Schaler and others support the ideas of Dr. Thomas Szasz, a professor emeritus of psychiatry at State University of New York, who has long argued that mental illness is a myth because it cannot be “approached, measured or tested in a scientific fashion.”

“People label one another and they often call that label a diagnosis,” said Schaler. “But the labels we apply to those whose behavior disturbs us are not actual disease diagnoses. There are no signs when people label others with psychological disorders. There are only symptoms, claims, subjective reports. It takes at least two people for one to be labeled with mental illness.”

Shades of gray
The views of Schaler, Szasz and the similarly minded are the minority. Most psychologists say mental disorders are real afflictions, even if they can't be fully explained or cultured in a Petri dish.

Watson at the University of Iowa says it's all a matter of degrees. “There aren't necessarily clear points of difference between what's normal and abnormal. Abnormal behavior may just be an exaggeration of normal behavior.”

And what's normal depends on the tenor of the times. Ailments like schizophrenia have been the subject of Journal papers from the beginning.
“The patients studied back then sound similar to those studied now,” said Tom Oltmanns, a professor of psychiatry and psychology at Washington University in St. Louis. “The terms have changed, but not necessarily the diagnosis.”
But other disorders have emerged or changed with shifting social perspectives and mores. A century ago, he said, sexual disorders were “much more concerned with who was doing what to whom.” Abnormal sexual behavior was anything beyond heterosexual intercourse with one's spouse. Now, the focus is more on sexual dysfunction, a topic that was unheard of a century ago.

“I would like to think that psychology is driven more by science than culture, but people who think and write most clearly about it would say it's both,” Oltmanns said. “You can't define mental disorders in an abstract way independent of culture.

“The classic example is homosexuality. The first DSM (Diagnostic and Statistical Manual, published in 1952) considered it to be a form of abnormal psychology. But by the time the third DSM was published in 1980, the American Psychological Association had declared homosexuality was not a mental disorder. Our society had changed; our cultural view had changed.”

In one sense, though, homosexuality seems an exception to the rule. There are clearly a lot more recognized mental disorders and forms of abnormal behavior today than in Morton Prince's time, with more identified each year.

Depression, for example, wasn't a major topic in the Journal until the 1970s. Now it's a subject of serious clinical study, with dozens of subtypes. The same can be said of addictions. There are the obvious ones – alcohol, drugs, gambling – but who would have imagined discussions of Internet addiction even 20 years ago?

Some critics worry that this is a case of disorder-naming run amok. The current fourth edition of the DSM, published in 2000, is a whopping 943 pages. Baker, the Journal editor, is sympathetic to critics' concerns.

“I understand the fear that we might get to the point of having a disorder for earlobe-pulling. Or more seriously, the question about why disorders like autism and ADHD are being diagnosed so much more frequently now. Part of the answer is that we're simply more knowledgeable. The scope of psychology has broadened considerably.”

Richard Bootzin, a professor of psychology at the University of Arizona in Tucson, goes further: “I think more behaviors are seen as targets (for) medication and treatment. In the past, a lot of behaviors were dismissed as merely eccentric or odd because nobody believed or knew they were treatable.”

Mind meld
One of the major movements in modern psychology, according to Baker, is an increased attention to whether disparate disorders share common cause. Depression and anxiety disorders produce dramatically different kinds of abnormal behavior, for example, but perhaps they share certain causal factors.

Such factors, he said, are likely to be organic. Psychology, combined with molecular biology, genetics and medicine, is now morphing into a multifaceted endeavor. Watson speculates that continued advances may bring a day when psychologists and others will be able to identify genetic markers predisposing people to certain mental disorders.

“If that happens, perhaps we can devise treatments or therapies to prevent the disorder in the first place,” he said.

Would that spell an end to abnormal behavior?
Hardly, answered Watson. “New pathologies are always emerging. Our environment constantly encourages people to get into trouble in new and different ways.”

Put another way, nobody is devoid of at least a few minor psychological quirks or emotional eccentricities. Any person who is utterly and absolutely normal probably is not.

Special Ed Whistleblower on Unauthorized Restraint

2006-02-19T11:19:00.000-05:00

Special Education whistleblower reports unauthorized restraint of child at Greene County, NY school:

http://cryptome.org/teacher-axed.htm

(This site is a good source of information unfavorable to governments and others in power, and frequently acts as an outlet for government and corporate whistleblowers. For example, early last year, it revealed suspicious investigation tactics of the US Department of Homeland Security -- Lee)

Just one sip for Sipowicz to slip.

2006-01-18T08:17:00.000-05:00

Schaler, J.A. (2005). Just one sip for Sipowicz to slip. In G. Yeffeth (Ed.) What would Sipowicz do? Race, rights and redemption in NYPD Blue. Dallas, Texas: Benbella Books. pp. 63-71. (pdf of article in full thanks to Glenn Yeffeth, Publisher, BenBella Books.

Free booze benefits homeless alcoholics

2006-01-06T01:42:00.000-05:00

Free booze benefits homeless alcoholics

January 5, 2006

TORONTO, Ontario (Reuters) -- Giving homeless alcoholics a regular supply of booze may improve
their health and their behavior, the Canadian Medical Association Journal said in a study published
on Tuesday.

Seventeen homeless adults, all with long and chronic histories of alcohol abuse, were allowed
up to 15 glasses of wine or sherry a day -- a glass an hour from 7 a.m. to 10 p.m. -- in the
Ottawa-based program, which started in 2002 and is continuing.

After an average of 16 months, the number of times participants got in trouble with the law
had fallen 51 percent from the three years before they joined the program, and hospital emergency
room visits were down 36 percent.

"Once we give a 'small amount' of alcohol and stabilize the addiction, we are able to provide
health services that lead to a reduction in the unnecessary health services they were getting
before," said Dr. Jeff Turnbull, one of the authors of the report.

"The alcohol gets them in, builds the trust and then we have the opportunity to treat other
medical diseases... It's about improving the quality of life."

Copyright 2006 Reuters. All rights reserved.This material may not be published, broadcast,
rewritten, or redistributed.

Find this article at:
http://www.cnn.com/2006/WORLD/americas/01/05/toronto.booze.reut/index.html

Canadian Medical Association Journal article

See commentary at

See letter at http://www.cmaj.ca/cgi/eletters/174/1/50#3416

Mind Games at Gitmo

2005-12-13T21:21:00.000-05:00

"The question that the Pentagon leadership has been focusing on, and which was a key subject of discussion during our day at Gitmo, is whether there is an ethical difference between using psychologists rather than psychiatrists on interrogation teams... But this is a red herring. It is hair-splitting that detracts from the real issue of whether health professionals of any stripe can ethically be involved in interrogations that may involve coercive techniques or torture. The answer is clearly no."

Full article

R.W. Bradford, RIP

2005-12-10T23:20:00.000-05:00

R.W. Bradford, editor and publisher of Liberty magazine, passed away on Thursday.

Dear friends,

I am grieved to tell you that R.W. Bradford, founder of "Liberty," died on Thursday, December 8, at his home in Port Townsend, Washington. He was 58 and had fought heroically against cancer for many months.

Bill was surrounded by friends and family, and by the good wishes of his many friends throughout the world.

An upcoming issue of "Liberty" will feature a commemoration of Bill's life. His work will continue.

Stephen Cox
For "Liberty"

You can read more about R.W. Bradford here, here, and here.

The Politics of Mental Illness: Myth and Power in the Work of Thomas S. Szasz

2005-12-10T19:43:00.000-05:00

If mental illness existed, would compulsory hospitalization and treatment of those who presumably have it be justified?

Jan Pols is a Dutch psychiatrist who published a book (his thesis) about the writings and ideas of Thomas Szasz in 1984. His attitude towards Szasz is ambiguous. On the one hand he greatly admires him, on the other hand he rejects some of Szasz’s key arguments.

In Pols’s view, compulsory hospitalization and treatment are unjustified precisely because mental illness is real illness, and thus subject to the same ethical standards as somatic illness. He ends his book with a suggestion for eliminating compulsory hospitalization in the Netherlands.

When his book appeared, his colleagues received it with a great deal of hostility, even though this was at the tail end of the “antipsychiatry” era. It was a book destined to be quickly forgotten, particularly as on a world scale, not many people read Dutch. But now he has collaborated with translating it into English, and you can read it too, here: www.janpols.net

Psychiatry Ponders Whether Extreme Bias Can Be an Illness

2005-12-10T13:53:00.000-05:00

Psychiatry Ponders Whether Extreme Bias Can Be an Illness

By Shankar Vedantam
Washington Post Staff Writer
Saturday, December 10, 2005; Page A01

The 48-year-old man turned down a job because he feared that a co-worker would be gay. He was upset that gay culture was becoming mainstream and blamed most of his personal, professional and emotional problems on the gay and lesbian movement.

These fixations preoccupied him every day. Articles in magazines about gays made him agitated. He confessed that his fears had left him socially isolated and unemployed for years: A recovering alcoholic, the man even avoided 12-step meetings out of fear he might encounter a gay person.

Full

Cf. Is extreme racism a mental illness?

Partial transcript here

Milton Friedman Prize for Advancing Liberty

2005-12-04T11:52:00.000-05:00

What's New

Milton Friedman Prize for Advancing Liberty

The Cato Institute is pleased to invite nominations for the third biennial Milton Friedman Prize for Advancing Liberty. The prize, which carries a $500,000 award, will be personally presented to the winner at a dinner on May 18, 2006, in Chicago, where Milton Friedman lived and worked for many years.

The winner needs to meet only one criterion: to have made a significant contribution to advancing human liberty. Nominees may be from any and all walks of life. Scholars, activists, and political leaders have been among the hundreds of nominations submitted for the first two prizes. Nominations must be submitted by December 31, 2005.

Rhetorically Speaking

2005-11-30T20:28:00.000-05:00

Rhetorically Speaking

Towsontimes.com
11/30/05
By Bryan P. Sears
Richard Vatz cares about what you think, and why.

...

Vatz, who has degrees in sociology and rhetoric from the University of Pittsburgh, patterned his teaching career after Thomas Szasz, a psychiatry professor at Upstate Medical University in Syracuse, N.Y. ...

Austrian court holds British historian

2005-11-26T19:52:00.000-05:00

[Against-the-law-to-disagree-with-state dept.--JAS]

World Digest
Originally published November 26, 2005

Austrian court holds British historian
VIENNA, Austria // An Austrian court ruled yesterday that British historian David Irving must remain in custody on Holocaust denial charges despite his assertion that he now acknowledges the existence of Nazi-era gas chambers. The court said it considered Irving a flight risk. Denying the Nazis' systematic slaughter of 6 million Jews is a crime in Austria punishable by up to 10 years in prison. On Thursday, Irving's lawyer said the controversial right-wing scholar now acknowledges that Nazi gas chambers existed and admits that some of his past statements could be interpreted as denying people were gassed. In the past, Irving has claimed that Adolf Hitler knew nothing about the Holocaust, and he has been quoted as saying there was "not one shred of evidence" the Nazis carried out their "Final Solution."

Meditating teen draws thousands, Baltimore Sun

2005-11-24T15:44:00.000-05:00

Question: Is this person "schizophrenic?" Does this person have "ADHD?" Probably the opposite of "ADHD." Wouldn't most people meet the diagnostic criteria for "ADHD" if they sat down and tried to meditate for 2.5 hours a day? How about 2.5 minutes a day? And what of the people who believe this teenage boy is the reincarnation of Buddha? Are THEY "schizophrenic"? Why or why not?-- JAS
=================================================================================
Meditating teen draws thousands

Associated Press

November 24, 2005

KATMANDU, Nepal // A teenage boy has been meditating in a Nepalese jungle for six months, and thousands have flocked to see him, with some believing he is the reincarnation of Buddha, police and media said yesterday.

Ram Bahadur Banjan, 15, sits cross-legged and motionless with eyes closed among the roots of a tree in the jungle of Bara, about 100 miles south of the capital, Katmandu.

He's supposedly been that way since May 17 - but his followers have been keeping him from public view at night.

A reporter for the Kantipur newspaper, Sujit Mahat, said he spent two days at the site and about 10,000 people are believed to visit daily.

Soldiers have been posted in the area for crowd control, officials said.

A makeshift parking lot and a cluster of food stalls have sprung up near Banjan's retreat, an area not previously frequented by visitors.

Many visitors believe Banjan is a reincarnation of Gautama Siddhartha, who was born not far away in southwestern Nepal around 500 B.C. and later became revered as the Buddha, which means Enlightened One.

Others aren't so sure about the claims.

Police inspector Chitra Bahadur Gurung said officers have interviewed the boy's associates about their claim that Banjan has gone six months without food or drink.

Officers have not directly questioned the boy, who appears deep in meditation and doesn't speak.

"We have a team ... investigating the claim on how anyone can survive for so long without food and water," Gurung said.

Local officials have also asked the Royal Nepal Academy of Science and Technology in Katmandu to send scientists to examine Banjan.

Mahat said visitors can catch a glimpse of Banjan from a roped-off area about 80 feet away from him between dawn and dusk.

Followers then place a screen in front of him, blocking the view and making it impossible to know what he is doing at night, Mahat said.

"We could not say what happens after dark," Mahat said. "People only saw what went on in the day, and many believed he was some kind of god."

Buddhism teaches that right thinking and self-control can enable people to achieve nirvana - a divine state of peace and release from desire.

Buddhism has about 325 million followers, mostly in Asia.

Copyright © 2005, The Baltimore Sun | Get Sun home delivery

Bitter Pills

2005-11-21T12:54:00.000-05:00

http://www.time.com/time/pacific/magazine/article/0,13673,503051121-1130228-1,00.html

Monday, Nov. 14, 2005
Bitter Pills
They're prescribed to millions, but do the new antidepressants work? And are they worth the risk?
BY DANIEL WILLIAMS

There's really nothing funny about what happened to Rebekah Beddoe, except maybe for a little black comedy at the end. In 1999, a psychiatrist diagnosed her with postnatal depression, which she probably didn't have, and for the next three years multiple doctors treated her with drugs that she almost certainly didn't need. As episodes of deliberately cutting herself progressed to bouts of mental torment and suicide attempts, Beddoe's carers, concluding that her illness was worsening, kept upping her dosages and trying new medications. Nothing worked. Eventually, Beddoe acted on a different idea. Without telling anyone, she weaned herself off the drugs and gradually became well again. Her psychiatrist at the time assumed he was responsible for Beddoe's recovery. She remembers watching him one day from the other side of his desk, thinking that this eminent doctor was congratulating himself on having the skill to concoct precisely the right drug regimen. "I could also see his relief," Beddoe says. "It had been a difficult case, but he'd finally cracked it."

full

Misleading psychiatric ads . . . from www.MindFreedom.org

2005-11-21T11:44:00.000-05:00

Have a good Thanksgiving!
Jeff Schaler
=========================================
BELOW are more new media articles
about how psychiatric drug ads
may be misleading the public about
a "chemical imbalance," from:

* _Wall Street Journal_ 11/18/05

* _United Press International_ 11/10/05

* _WebMD_ 11/7/05

* _Time Magazine Pacific_ 11/21/05

AT BOTTOM are links to the latest
news about this controversy.

~~~~~~~~~~

_The Wall Street Journal_

November 18, 2005; Page B1

SCIENCE JOURNAL

By SHARON BEGLEY

Some Drugs Work To Treat Depression,
But It Isn't Clear How

Hardly any patients know how Lipitor
lowers cholesterol, how Lotensin
reduces blood pressure, or even how
ibuprofen erases headaches. But when
it comes to Prozac, Zoloft and Paxil,
ads and glowing accounts in the press
have turned patients with depression
into veritable pharmacologists, able
to rattle off how these "selective
serotonin reuptake inhibitors" keep
more of the brain chemical serotonin
hanging around in synapses,
correcting the neurochemical
imbalance that causes depression.

There is only one problem. "Not a
single peer-reviewed article ...
support[s] claims of serotonin
deficiency in any mental disorder,"
scientists write in the December
issue of the journal PLoS Medicine.

Indeed, a steady drip of studies have
challenged the "serotonin did it"
hypothesis. A 2003 mouse experiment
suggested that SSRIs work by inducing
the birth and growth of new brain
neurons, not by monkeying with
serotonin. In March, a review of
decades of research concluded that
something other than "changes in
chemical balance might underlie
depression." And as Jeffrey Lacasse
and Jonathan Leo write in PLoS
Medicine, although ads for SSRIs say
they correct a chemical imbalance,
"there is no such thing as a
scientifically correct 'balance' of
serotonin."

How did so many smart people get it
so wrong? Medicinal chemist Derek
Lowe, who works in drug development
for a pharmaceutical firm, offered an
explanation in his "In the Pipeline"
blog. "I worked on central nervous
system drugs for eight years, and I
can confidently state that we know
just slightly more than jack" about
how antidepressants work.

It is not for lack of trying. In
1965, psychiatrist Joseph Schildkraut
of Harvard University suggested that a
deficiency of a brain chemical causes
depression. With the success of drugs
that block the reuptake of these
chemicals, that idea started to look
pretty good.

Yet the evidence was always
circumstantial. You can't measure
serotonin in the brains of living
human beings. The next best thing,
measuring the compounds that
serotonin breaks down to in
cerebrospinal fluid, suggested that
clinically depressed patients had
less of it than healthy people did.
But it was never clear whether
depression caused those low levels,
or vice versa. A 2002 review of these
early experiments took them to task
for such flaws.

There had always been data that don't
fit the serotonin-imbalance theory.
Depleting people's serotonin levels
sometimes changed their mood for the
worse and sometimes didn't. Sending
serotonin levels through the roof
didn't help depression, a study found
as early as 1975.

There is little doubt that the SSRIs
do what their name says, keeping more
serotonin in the brain's synapses. But
the fact "that SSRIs act on the
serotonin system does not mean that
clinical depression results from a
shortage of serotonin," says Dr. Leo,
professor of anatomy at Lake Erie
College of Osteopathic Medicine,
Bradenton, Fla. No more so, anyway,
than the fact that steroid creams
help rashes means that rashes are
caused by a steroid shortage.

A clue to how SSRIs do work comes
from how long they take to have any
effect. They rarely make a dent in
depression before three weeks, and
sometimes take eight weeks to kick
in. But they affect serotonin levels
right away. If depression doesn't
lift despite that serotonin hit, the
drugs must be doing something else;
it's the something else that eases
depression.

The best evidence so far is that the
something else is neurogenesis -- the
birth of new neurons. When scientists
led by Rene Hen of Columbia
University and Ronald Duman of Yale
blocked neurogenesis in mice, SSRIs
had no effect. When neurogenesis was
unimpeded, SSRIs made the mice less
anxious and depressed -- for rodents.
As best scientists can tell, SSRIs
first activate the serotonin system,
which is somehow necessary for
neurogenesis. That is what takes
weeks.

Claiming that depression results from
a brain-chemical imbalance, as ads do,
is problematic on several fronts.
Patients who believe this are more
likely to demand a prescription. If
you have a disease caused by too
little insulin, you take insulin; if
you have one caused by too little
serotonin, you take serotonin
boosters.

Most people treated for depression
get pills rather than psychotherapy,
and this week a study from Stanford
University reported that drugs have
been supplanting psychotherapy for
depressed adolescents. Clinical
guidelines call for using both, and
for psychotherapy to be the
first-line treatment for most kids.
Psychotherapy "can be as effective as
medications" for major depression,
concluded a study in April of 240
patients, in the Archives of General
Psychiatry. Numerous other studies
find the same.

The hegemony of the serotonin
hypothesis may be keeping patients
from a therapy that will help them
more in the long term. The relapse
rate for patients on pills is higher
than for those getting
cognitive-behavior psychotherapy.

Some 19 million people in the U.S.
suffer from depression in any given
year. For many, SSRIs help little, if
at all. To do better, we have to get
the science right.

Write to Sharon Begley at
sciencejournal@wsj.com

http://online.wsj.com/public/article/SB113226807554400588-
piwLFSMdqttzAzHEXT3ehaYKXog_20061117.html?mod=tff_main_tff_top

or use this smaller url:

http://tinyurl.com/a7wwk

~~~~~~~~~

_United Press International_

Health Business

Study: Public misled by depression ads

WASHINGTON, Nov. 10 (UPI) -- The most
commonly prescribed anti-depressants
may be effective, but drug ads are
misleading about how the drugs work,
a new study suggests.

The study, published in the December
issue of the Public Library of Science
Medicine, focuses on manufacturers
that market the cutting-edge class of
anti-depressants known as selective
serotonin reuptake inhibitors.

The study results add to the
criticism of drug companies for
allegedly filling the airwaves with
slick but deceptive advertising on
various medications.

SSRIs can help relieve depression,
but the medical evidence that they do
so by correcting low levels of
serotonin in the brain is weak, and
therefore should be eliminated from
direct-to-consumer ads in magazines
and on television, the study's
authors said.

The authors were Jonathan Leo, a
professor of neuroanatomy at Lake
Erie College of Osteopathic Medicine
in Bradenton, Fla., and Jeffrey R.
Lacasse, a Ph.D. candidate at Florida
State University's College of Social
Work.

The duo attacked the widespread use
of the "serotonin theory of
depression" in their accompanying
text, saying clinical evidence does
not adequately support the statement
that serotonin imbalances in the
brain are responsible for clinical
depression.

"Depression and anxiety are
complicated issues that cannot be
explained in a 30-second commercial,"
the authors wrote. "When the serotonin
theory is portrayed with clever visual
portrayals that do not accurately
represent the neuroscience research,
consumers are led to believe that
medication is necessary for the
treatment for depression."

Leo added that, contrary to the
message in the ads, the prescribing
information on the drug labels do not
say that SSRIs correct serotonin
imbalances.

Leo and Lacasse called on the Food
and Drug Administration to exercise
more authority about what goes into
direct-to-consumer advertising to
make sure it is fair and balanced and
urged people to become more active in
their own care.

"In terms of real-life effects of
this advertising, we are concerned
that this oversimplified theory has
become the intellectual justification
for 10-minute office visits which
result in the prescription of
antidepressants for a variety of
ill-defined conditions," Lacasse
concluded. "In general, people need
to be more skeptical regarding claims
of chemical imbalance as explanation
for psychological distress."

http://www.upi.com/HealthBusiness/view.php?StoryID=20051109-043909-3242r

or use this smaller url:

http://tinyurl.com/d3rbf

~~~~~~~~~

WebMD Medical News

Essay Questions Role of
Antidepressants

Authors Challenge Link Between
Chemical Imbalance and Depression

By Salynn Boyles

Reviewed By Louise Chang, MD

Nov. 7, 2005 -- Do the most widely
prescribed antidepressants work by
correcting a chemical imbalance in
the brain? That's being challenged in
a newly published essay.

The essay's authors say the assertion
that depression results from an
imbalance in the brain chemical
serotonin and related chemicals is
not supported by the scientific
evidence.

They write that there is "a growing
body of medical literature casting
doubt" on the so-called "serotonin
hypothesis." But a widely known
antidepressant researcher who spoke
to WebMD disagrees.

Brown University psychiatry professor
Peter D. Kramer, MD, is the author of
Listening to Prozac and Against
Depression.

"The connection between what these
drugs do and what seems to be useful
in the treatment of mood disorders is
just as strong or stronger today as it
was 13 years ago when I wrote
Listening to Prozac," he says.

Kramer acknowledges that there is
still much to be learned about the
impact of brain chemistry on
depression and other mental
illnesses. He says it is unlikely
that serotonin imbalance alone
explains depression, but he adds that
Prozac and other antidepressants that
target serotonin clearly help many
people.

Are Ads Misleading?

Selective serotonin reuptake
inhibitors (SSRIs), include the drugs
Prozac, Paxil, Zoloft, Lexapro, and
Celexa. The drugs increase the
availability of serotonin, which acts
as a chemical messenger in the brain
among other areas.

Millions of Americans take SSRIs for
depression and other mood disorders,
and in the U.S. alone sales of the
drugs top $10 billion a year.

In a newly published essay, anatomy
professor Jonathan Leo, PhD, along
with colleague Jeffrey Lacasse, say
that SSRI ads aimed at the public are
often misleading.

Leo teaches neuroanatomy at Lake Erie
College of Osteopathic Medicine in
Bradenton, Fla.

"The advertising is not portraying
the science in a true light," Leo
tells WebMD.

He says the ads typically claim that
SSRIs restore the serotonin balance
of the brain but adds that there is
"no such thing as a scientifically
established correct balance of
serotonin."

Leo cites a 2002 review which found
that SSRIs were only slightly more
effective than placebo for treating
depression. He adds that efforts to
use brain imaging to document
chemical imbalances linked to mental
illness have proven disappointing.

He also points to studies suggesting
that nondrug treatments, including
psychotherapy and exercise, may be as
effective as drugs for treating
certain mental illnesses.

"As long as people are told about all
these things I have no problem with
using these drugs," he says. "Without
a doubt, they help some people. Our
point is that the explanation for why
they work is simplistic and
potentially misleading."

Movie Star Spat

Leo and Lacasse published their essay
in the December issue of the Public
Library of Science journal PLoS
Medicine. The Public Library of
Science is a privately funded,
nonprofit group that publishes
scientific and medical research and
makes it freely available on its web
site.

Leo says he hopes the paper will make
the public aware that there is
legitimate scientific debate about
whether depression is caused by
chemical imbalance.

"Professionals have researched and
debated this issue for years. It is
not just a public spat between two
movie stars," he says.

He is referring to actor Tom Cruise's
highly publicized criticism of actress
Brooke Shields, who wrote earlier this
year that SSRIs helped her recover
from postpartum depression after the
birth of her first child.

In a June appearance on NBC's Today
Show, Cruise called antidepressants
"very dangerous" and claimed there
was no proof that chemical imbalances
in the brain drive depression.

Shields responded in a New York Times
op-ed piece, calling Cruise's
assertions a "ridiculous rant."

Kramer tells WebMD that while the
serotonin hypothesis may not tell the
whole story, it has led to the
development of an important treatment
for depression and other mental
disorders.

"It turns out that the medicines that
affect serotonin do other things, such
as protect the nerve cells and enhance
[the generation of new nerve cells],"
he says.

SOURCES: Lacasse, J. PLoS Medicine,
December 2005; vol. 2: pp. 101-106.
Jonathan Leo, PhD, associate
professor of anatomy, Lake Erie
College of Osteopathic Medicine,
Bradenton, FL. Peter D. Kramer, MD,
clinical professor of psychiatry and
human behavior, Brown University,
Providence, R.I. Kirsch et al,
British Medical Journal. NDC Health
Corp.

http://www.webmd.com/content/Article/114/111406.htm

~~~~~~~~~

_Time Magazine Pacific_ 21 November 2005

The cover story has two articles, too
long to post here:

"Bad Medicine? Millions of people take
drugs to ward off depression. But skeptics
say the pills may do more harm than good."

"Taking on the Drug Defenders": A spotlight
on journalist Robert Whitaker, author of
_Mad in America_.

http://www.time.com/time/pacific/magazine/0,13674,503051121,00.html

or this smaller url:

http://tinyurl.com/azqc3

~~~~~~~~~

LINKS TO THE LATEST ON THE
CHEMICAL IMBALANCE CONTROVERSY:

BELOW are web pages with information
about the "chemical imbalance" controversy.

~~~~~~~~~

17 Nov. 2005: MindFreedom alert -- How you may
comment to the FDA about psychiatric drug ads:

http://www.intenex.net/pipermail/mindfreedom-news/2005-November/
000016.html

or use this shorter url:

http://tinyurl.com/7ettm

~~~~~~~~~

See the 11/14/05 MindFreedom alert about the
excellent essay published by PLoS debunking
advertising claims about a chemical imbalance:

http://www.intenex.net/pipermail/mindfreedom-news/2005-November/
000014.html

or use this smaller url:

http://tinyurl.com/cbzzu

~~~~~~~~~

Here is an 11/8/05 MEDSCAPE news article
about the topic and the PLoS essay:

http://www.intenex.net/pipermail/mindfreedom-news/2005-November/
000015.html

or use the smaller url:

http://tinyurl.com/8s5e2

~~~~~~~~~

Here is the text of the 12/05 PLoS essay
that debunks the "chemical imbalance" ads:

http://medicine.plosjournals.org/perlserv/?request=get-
document&doi=10.1371/journal.pmed.0020392

or use this smaller url:

http://tinyurl.com/8vywy

[For individuals who have trouble viewing
the above, MindFreedom has a plain text
version that can be e-mailed to you free.]

~~~~~~~~~

Here is a print PDF (205 K) version of the PLoS essay:

http://medicine.plosjournals.org/archive/1549-1676/2/12/pdf/
10.1371_journal.pmed.0020392-p-L.pdf

or use this smaller url:

http://tinyurl.com/bcwf3

~~~~~~~~~

For background by FDA on their request for comments:

http://www.fda.gov/OHRMS/DOCKETS/98fr/05-18040.htm

[Please note there is no "period" at end of this
URL; a previous alert added this, our apologies.]

If you have questions about the FDA process
contact Rose Cunningham at the FDA at
CUNNINGHAMR at cder.fda.gov

~~~~~~~~~

See MindFreedom's debate with Pfizer, Inc.,
manufacturer of Zoloft, about their
chemical imbalance claims:

http://www.mindfreedom.org/mindfreedom/pfizerlies.shtml

~~~~~~~~~

Also see the historic debate with the
American Psychiatric Association resulting
from MindFreedom's 2003 hunger strike:

http://www.mindfreedom.org/mindfreedom/hungerstrike.shtml

~~~~~~~~~~

PLEASE FORWARD THIS NEWS TO OTHERS

This news alert is forwarded as a free
public service by the nonprofit human rights
organization MindFreedom International.

* Win human rights campaigns in mental health.
* End abuse by the psychiatric drug industry.
* Support the voices of psychiatric survivors.
* Promote safe and humane options in mental health.

MindFreedom International unites 100 sponsor
and affiliate groups with individual members,
and is accredited by the United Nations as
a Non-Governmental Organization (NGO) with
Consultative Roster Status.

MindFreedom is one of the very few totally
independent groups in the mental health
field with no funding from governments,
drug companies, religions, corporations,
or the mental health system.

JOIN, DONATE, or give GIFT MEMBERSHIPS
to MindFreedom International today:

http://www.mindfreedom.org/join.shtml

For a MAD MARKET of books and products
to support human rights campaigns in
mental health: http://www.madmarket.org

MindFreedom International
454 Willamette, Suite 216 - POB 11284
Eugene, OR 97440-3484 USA

http://www.mindfreedom.org
email: office at mindfreedom.org fax: (541) 345-3737
office phone: (541) 345-9106
USA toll free: 1-877-MAD-PRIDE / 1-877-623-7743

~~~~~~~~~

Please forward this to all appropriate
places on and off the Internet, thank you!

_______________________________________________

If you are not on the MindFreedom-News alert list already, sign up for this free non-profit public service here:
http://www.intenex.net/lists/listinfo/mindfreedom-news

~~~~~~

To unsubscribe, send a blank email to
<a href="mailto:mindfreedom-news-unsubscribe@intenex.net">
mindfreedom-news-unsubscribe@intenex.net
</a>.

TeenScreen: A Front Group for the Psycho-Pharmaceutical Industrial Complex

2005-11-21T09:53:00.000-05:00

TeenScreen: A Front Group for the Psycho-Pharmaceutical Industrial Complex
Columbia University TeenScreen Program

TeenScreen is a very controversial so-called "diagnostic psychiatric service" aka suicide survey; done on children who are then referred to psychiatric treatment. The evidence suggests that the objective of the psychiatrists who designed TeenScreen is to place children so selected on psychotropic drugs . . .

Rosko on Thakkar-Schaler dialogue

2005-11-07T17:24:00.000-05:00

The assertion "90+% of patients are voluntary"is specious and misleading and ignores the following indelicate fact; namely, that ALL psychiatry is practiced under the shadow of involuntary commitment - EVERY interaction between psychiatrist and client can potentially result in involuntary "hospitalization" - thus, no psychiatric intervention can ever be truly voluntary.

A possibility once is a necessity forever.

Tom Rosko, MD
thomasjrosko@yahoo.com

Cf A Dialogue between Vatsal Thakkar and Jeffrey Schaler, August 28, 2005

A new movement advocating employment for the mentally ill is gaining momentum.

2005-10-31T00:43:00.000-05:00

The greatest analgesic, soporific, stimulant, tranquilizer, narcotic, and to some extent even antibiotic -- in short, the closest thing to a genuine panacea -- known to medical science is work. -- Thomas Szasz

(No, this quote wasn't with the Times article.)

-----------
On-the-job therapy
A new movement advocating employment for the mentally ill is gaining momentum.
By Daniel Costello
Times Staff Writer

October 31, 2005

YOU'LL never work again.

That's what those diagnosed with schizophrenia or other severe mental illnesses were told as recently as 10 years ago.

Today, they're getting different advice: Get a job. Doctors and treatment experts are recommending work — as security guards, bank tellers or teachers — as a powerful form of therapy.

This dramatic shift has been enabled by a new generation of antipsychotic drugs and a growing belief among experts that people with mental illness should try to "recover." That is, they should live their lives as normally as possible.

Most of those who work show improvement in their mental health and feel more satisfied with their lives, said Gary Bond, a psychology professor at Indiana University-Purdue University at Indianapolis.

"If we had a pill that was successful as work is for some people with mental illness, we'd give it to all of them," he said.

Steven Merriman, an athletic 49-year-old with schizophrenia, is one of the people thriving with help from new supported employment programs.

Merriman has had a difficult time holding a job since he was diagnosed with schizophrenia 25 years ago. Medication helps control his symptoms, such as anxiety and paranoia. Over the years, he's worked off and on in fast food, for a delivery company and at a hardware store.

Since last fall, however, the Torrance resident has been working a steady 20 hours a week at Lowe's Home Improvement as a customer service representative. He helps shoppers locate items in the store and loads packages into their cars. He recently got an excellent performance review and said he has had no problems with co-workers or customers.

As he walked through the wide aisles of the warehouse-size store recently, occasionally helping customers with questions, Merriman explained how making his own money and having a place to go makes him feel more worthwhile. "Work is a good therapy for someone like me," he said. "It helps you have a more satisfying life."

So far, the movement, called supported employment, has been held back by strict government rules. More than half the people with severe mental illnesses receive some government support; if they earned too much money, they could lose payments or health insurance.

But that, too, is starting to change. Last month, the U.S. Social Security Administration announced pilot supported employment projects in 20 cities. Under the new programs, people will be able to earn regular salaries without jeopardizing their benefits.

California is making similar changes. The state's Department of Mental Health recently announced plans to make supported employment a benchmark of its treatment programs. The state will fund the new work programs with money from Proposition 63, a state ballot initiative passed last year that could raise $280 million for new mental health services by the end of the decade.

"Helping people with mental illness find work can be a major step in their recovery and an important part in helping them develop a healthy psychological life," said Deborah Becker, a research professor at Dartmouth Medical School and a national expert on employment issues with the mentally ill.

Becker predicts up to a third of the 8 million Americans with a severe mental illness may eventually work alongside the general public. Currently 5% to 10% hold jobs.

Some caution

To be sure, mental health experts say mainstream jobs aren't for everyone. A recent case involving a schizophrenic woman who allegedly threw her three children in the San Francisco Bay has raised concerns that some people with mental illness are simply too sick to manage their daily lives, much less manage a job.

The new antipsychotic drugs that have significantly helped some patients haven't worked for everyone. And a significant portion of people with mental illness don't take their medication regularly. In an 18-month study released by the National Institute of Mental Health last month, three-fourths of the patients stopped taking their medications at least once.

Additionally, the mentally ill have higher rates of substance abuse than the general population, which can clearly cause havoc in the workplace.

"We have to be careful here," said Dr. Neal Adams, a Santa Cruz psychiatrist. "The important thing is that people don't feel that they have to work."

Doctors and counselors have long discouraged most mental health clients from working, fearing that the stress of bosses, co-workers or deadlines would overwhelm them. Clients who did work tended to volunteer at local charities or in group settings with other mentally ill people doing administrative or janitorial jobs.

Encouraging more of the mentally ill to find jobs could one day save the mental health system a considerable amount of money. But treatment providers say financial savings isn't their motivation. A growing body of research shows that people with mental illness fare better when they work. They also do better on the job than the general public might assume.

Dr. Judith Cook, a professor of psychiatry at the University of Illinois at Chicago, headed one the largest studies on the topic, which was released this year in the Archives of American Psychiatry. Cook followed 1,300 people with mental illness in seven cities over two years and found that up to 64% of them worked — several times the norm. There were no reports of anyone being violent or disruptive at work.

Cook also noted that participants in the study earned a total of $4.7 million during the two-year period.

Currently, even though many get government support, 70% of the mentally ill live on less than $20,000 a year, according to the National Alliance on Mental Illness. The majority of those who receive state and federal disability assistance — typically $800 to $900 a month — are allowed to earn only a minimal amount of additional money. If they earn more, they risk losing both their payments and the equally important health insurance provided under Medicaid.

On the career track

Under the new treatment approach, anyone who wants to work is encouraged to find a career that interests them and fits their skill set.

Depending on the severity of their illness, some are pursuing careers they abandoned when they got sick and are going back to work as teachers or flight attendants. Others are finding entry-level jobs in fast-food restaurants or as salespeople in department stores. Still, it's not easy to match up clients with jobs, said Paul Barry, associate director of the Village, a mental health center in Long Beach that finds housing and work for people with mental illness.

"Our biggest obstacle for our folks is not their mental illness, but the fact they may be 35 years old but vocationally act more like they're 16," he said.

Signs of schizophrenia and bipolar disorder typically appear in the late teens or early 20s, leaving many people unable to finish school or begin a career. As a result, many aren't attuned to how to act on the job, keep a schedule or deal with delicate office politics.

Barry said many clients got the hang of it after a few years but often switched jobs several times in the process.

It's illegal for employers to ask job applicants about their medical history, and experts say a significant number of mentally ill workers don't inform their employer about their illness.

The Village, like a growing number of mental health clinics, has its own job placement agency. It advertises as a general employment service and doesn't necessarily inform its clients that their workers have a mental illness.

But the counselors often go a step beyond those at a regular employment agency. The counselor from Merriman's clinic, for instance, drove him around to look for openings. (Merriman is an avid cyclist, but does not drive.) She helped him fill out the application at Lowe's. She sat in with him during his interview and later gave him advice about what to wear on his first day of work.

Once someone is hired, the state may provide a stipend for clothes and transportation. Workers typically talk with counselors weekly — in person or over the phone — to sort through any problems that pop up.

Until 2004, Harvey Cochran of Long Beach was serially unemployed. Cochran, 40, who suffers from bipolar disorder, understands why he was repeatedly fired. He showed up late. He forgot to show up at all. During bouts of depression, he often didn't leave his room.

Cochran now works at a movie theater as an usher and behind the concession stand 15 hours a week. His job counselor has helped him better manage his schedule, as well as his relationships with bosses and co-workers. He recently got a raise from $6.75 to $7.15 an hour; and he has saved $1,000 in the last year.

Cochran also says he's more outgoing, and he likes being able to buy things he wasn't able to afford. For his recent 40th birthday, he bought himself a 36-inch television and a DVD set of the "Karate Kid" movies. "They're my favorite," he said.

Corporate aid

Employers are embracing the concept rather easily. The majority of clinics place individual clients with local businesses, but a number of larger companies also are signing on. Among them: Best Buy, Johnson & Johnson and Trader Joe's. All are hiring applicants with histories of mental illness as long as doctors say they are able to work.

In certain cases, employers are seeking out a small number of mentally ill workers as part of an overall effort to support the mentally ill.

Merriman's manager at Lowe's, Koko Ingram, says he is a "great employee." Lowe's uses anonymous shoppers to judge how often workers greet customers and how well they answer questions. "The last time, we got extra points because of how well Steven did," Ingram said.

Mental health advocates hope the public will become more sensitive and more comfortable around people with mental illness as they move into the mainstream workforce.

Mental health professionals also are encouraging more of their clients to go to college, hopeful that they will find long-term careers. Brenda Lee Riley, a 47-year-old Long Beach resident who suffers from paranoid schizophrenia, has finished six semesters at Cal State Long Beach. For years, Riley hardly left her apartment. Like many people with mental illness, she also battles a drinking problem. But her self-confidence has soared since enrolling in college.

One of the things she most likes about being on campus is the conversation. "People in college talk about things other people don't talk about," she said. "They talk about that DeLay guy getting arrested. They talk about politics and what's going on around the world."

She takes three classes a semester and has earned a 4.0 grade point average. Riley hopes to become an English professor.

Her main goal, in the meantime, is to stay focused.

"I understand it will be several years before I become a college professor," she said. But "I want to use my head. I want to help people and I want to work. I want to contribute."

Alberta readying law to seize drug addicts' kids

2005-10-22T22:40:00.000-04:00

Alberta readying law to seize drug addicts' kids
Sat. Oct. 22 2005 5:43 PM ET

The Alberta government is trying some drastic new measures to battle a growing problem. The province is preparing a new law that would allow it to seize children from parents who are either addicted to drugs or involved in the drug trade.

Children's Services Minister Heather Forsyth is developing the legislation, which is expected to be introduced in the legislature next spring. If passed, it will be the first legislation of its kind in Canada.

Forsyth says there are four situations in which children will be removed from a home: "If they are involved in a grow op situation, if they are involved in a meth house, if there is drug trafficking or if there's drug use being involved."

Premier Ralph Klein says the legislation is similar to the Protection of Children Involved in Prostitution Act, which allows the province to apprehend and detain child prostitutes.

That legislation was challenged as a violation of the Charter and the government had to make changes. But, Klein said he was not worried about a court challenge to the new legislation.

"There might be a challenge to this law. I don't know who would challenge it other than the bad guys, the people who have an interest in feeding drugs to children. If they want to challenge it, that's fine, if there are some deficiencies we will fix those deficiencies."

Alberta is also targeting crystal meth, a drug that has been growing in popularity recently, particularly in Western Canada.

Klein's wife, Colleen will head a new task force aimed at getting the drug off Alberta's streets.

"It is an absolute poison and a scourge on society and it is time to talk about it," said Klein.

Crystal meth is a highly addictive drug that is cheap and relatively easy to make with ingredients, like cold medicine, commonly available in drug stores.

The drug initially causes euphoria and the high caused by the drug can last eight to 10 hours. However, long-term use generally results in psychotic behaviour and hallucinations. There is also a high risk of kidney and liver damage.

Tenn. ‘ex-gay’ facility faces closure deadline

2005-09-23T22:14:00.000-04:00

NATIONAL NEWS

The Washington Blade

Tenn. ‘ex-gay’ facility faces closure deadline
Case could open new church/state debate

By EARTHA JANE MELZER
Friday, September 23, 2005

Tennessee officials extended by one week the deadline by which Love in Action — a Christian “ex-gay” organization — must either apply for a license or stop operating two group homes.

The group has until Friday, Sept. 23 to comply.

Love in Action is the largest and oldest program within Exodus International, a network of about 100 ministries focusing on changing the sexual orientation of clients...

full

What is a "disabling illness"?

2005-09-13T06:13:00.000-04:00

"According to a study published in the September issue of Archives of General Psychiatry, a therapy developed by researchers at the University of Pittsburgh School of Medicine has shown that simply maintaining a regular daily routine and coping with stress can virtually eliminate [bipolar disorder]."

"Reading this news story brought to mind an interview I did almost 35 years ago, with the late educator and home-schooling guru, John Holt. During the meetings we had, he covered a number of subjects, but it is significant to this topic that he had his own theories about "learning disabilities" and how individual differences in how different people learn things had been blown into a whole industry in itself. Even back then, the signs were all there, as Holt himself noted."

Full Story

A Dialogue between Vatsal Thakkar and Jeffrey Schaler

2005-08-28T15:25:00.000-04:00

[I am very grateful to Professor Vatsal Thakkar for kind permission to reproduce our recent dialogue. Please do not reproduce without a link to this post on The Szasz Blog. Thank you.– JAS}

----- Original Message -----
From: Thakkar, Vatsal
To: jschale@american.edu
Sent: Thursday, August 04, 2005 6:07 PM
Subject: feedback on your article

Dr. Schaler,

I just read your piece in The Conservative Voice. I don't think that most people would argue that abuses in psychiatry do occur, especially around commitment and forcible restraint and med administration. I am against this. I have talked other doctors, even superiors, OUT of committing patients. But to say that there is NO place for these interventions is foolhardy, since there has existed a severely mentally ill population since the beginning of recorded history. If we can't find a medical etiology in a patient who presents with symptoms of psychosis, unruly behavior, and no ability to care for themselves, what do you suggest we do with them?

I agree with Dr. Szasz on issues like the one above and certain aspects of his views of illegal drugs. However, Tom Cruise basically takes an all or nothing approach and claims all of psychiatry is a sham. Then a fine Ph.D. like yourself appears to defend him in your article. Then the reader of your article will view this debate as more akin to one about politics or religion rather than medicine or science. Then they will refuse to get help for symptoms for themselves or loved ones and that will be a tragedy.

Vatsal Thakkar, M.D.
Assistant Professor, Psychiatry
Vanderbilt University School of Medicine
vatsal.thakkar@vanderbilt.edu

-----Original Message-----
From: Jeffrey A. Schaler [mailto:jschale@american.edu]
Sent: Thu 8/4/2005 6:18 PM
To: Thakkar, Vatsal
Subject: Re: feedback on your article

Dear Dr. Thakkar,

Thanks very much for your letter, which I appreciate. You write: "But to say that there is NO place for these interventions is foolhardy, since there has existed a severely mentally ill population since the beginning of recorded history. If we can't find a medical etiology in a patient who presents with symptoms of psychosis, unruly behavior, and no ability to care for themselves, what do you suggest we do with them?"

I believe your reasoning is unsound. The fact that there has existed a population of people you and others label "severely mentally ill . . . since the beginning of recorded history" is irrelevant to the issue at hand, namely, whether psychiatrists as extensions and agents of the state should have the power to deprive innocent persons of liberty without due process of law. This is not a medical or scientific issue. It is a constitutional issue. * Institutional psychiatrists have absolutely no right to deprive innocent persons of liberty because you think they will harm themselves or others. Study the difference between the rule of law and the rule of man.

We cannot predict who will commit a crime with an accuracy beyond that expected by chance. Two things are necessary for criminal guilt: mens rea and actus reus. If there is no actus reus, there is no crime. On what basis do you think you have the right to deprive a person of liberty? Because you think he or she will commit a crime? The US Constitution does not say at the end, "PS: For mentally healthy people only."

Real doctors do not treat people against their will. If a person does not want to be treated by you, he or she has every right to refuse "treatment." What you are advocating has nothing to do with science or medicine. It has everything to do with social control. Even if you could find a lesion in the brain of a person who presents with symptoms of psychosis, that still does not justify depriving that person of liberty or "treating" him against his will.

You ask, "what do you suggest we do with them?" My reply: Nothing. You leave them alone. If they want help, you and others who want to help such a person may help them. If they break the law, they go through the criminal justice system. Otherwise, you leave them alone. A person has the right to refuse treatment for kidney failure, for lung cancer, etc. You are not being an ethical physician when you treat someone against his or her will. You are being a jailer. Trying to justify or legitimize depriving a person of liberty in the name of medicine and science is no excuse. You know that has nothing to do with science and medicine. You say it has something to do with science and medicine because you know what you're advocating is wrong. It goes against your sworn oath as a physician.

You continue, writing "I agree with Dr. Szasz on issues like the one above and certain aspects of his views of illegal drugs. However, Tom Cruise basically takes an all or nothing approach and claims all of psychiatry is a sham. Then a fine Ph.D. like yourself appears to defend him in your article. Then the reader of your article will view this debate as more akin to one about politics or religion rather than medicine or science. Then they will refuse to get help for symptoms for themselves or loved ones and that will be a tragedy."

Tom Cruise has every right to say what he wants to say. Would you deprive him of his freedom of speech? Many physicians think that psychiatry is a sham, and you know it. Many psychiatrists think it is a sham. The numbers of people doing their residencies in psychiatry is going down for good reason: Medical students know that psychiatry is a sham. Psychiatry has little to do with science and medicine. Why do you think the suicide rates are so high among psychiatrists? A bad investment.

You write "the reader of your article will view this debate as more akin to one about politics or religion rather than medicine or science." You know very well that the debate has precious little to do with medicine. Psychiatrists diagnose on the basis of symptoms, not signs. They treat people against their will, not by consent. They confuse theories with facts: There is no known lesion that causes "schizophrenia." Giving people drugs that change the way they feel and behave doesn't treat a neurochemical imbalance, and you know it.

When you, a psychiatrist, write that depriving people of liberty is science and medicine YOU are mistaking politics and religion for science and medicine. You are not telling the truth. Depriving people of liberty when they've committed no crime has little to do with science and medicine. Again, you know that very well. If people refuse to get help, that is their choice. You would do well to respect their wishes. If people want to see a psychiatrist, by all means they should be free to do so, just as they should be free to see a homeopath, an astrologer, or a chiropractor.

I suspect that if involuntary commitment and the insanity defense were abolished, psychiatry as a profession would collapse. People know psychiatry is fraud, that's why they don't like psychiatrists. Psychiatrists know that psychiatry is fraud, that's why so many of them commit suicide. How many cardiologists do you hear saying that heart disease is a real disease, based in science, over and over again? How many cardiologists deprive people of liberty in the name of "science and medicine"?

I've spoken and corresponded with a good number of psychiatrists such as yourself over the years and I know it is difficult to admit that you've made a tremendous mistake with your medical career by specializing in psychiatry. Not only is it based in junk science, it has very little to do with medicine. You have a choice: practice psychiatry on a purely consensual basis, or go back and specialize in some other area of medicine, a branch of medicine that does no harm to people in the name of treating them. That is, every other branch of medicine besides psychiatry.

Reconsider your position, Dr. Thakkar. You've no right to interfere in the lives of others who want nothing to do with you. It takes courage for you to see that in yourself. Look inside. Be brave.

Tom Cruise upset so many people such as yourself because what he said was right. Here, a layman, a movie star, knows more about science and medicine than psychiatrists. Pathetic.

Professor Jeffrey A. Schaler
Department of Justice, Law and Society
School of Public Affairs
American University
Washington, D.C.
jeffschaler@attglobal.net

----- Original Message -----
From: Thakkar, Vatsal
To: Jeffrey A. Schaler
Sent: Friday, August 05, 2005 12:40 AM
Subject: RE: feedback on your article

Wow! Quite a fiesty retort.

I don't know where to start. First of all, I know the difference between the law and medicine. But a group of lawmakers has entitled licensed physicians (not just psychiatrists) and licensed psychologists the power to temporarily deprive someone of their liberty based on what is defined by a "mental defect" in my state. Now I agree that this is vague and subject to interpretation. After 3 days in Tennessee, an involuntarily committed individual goes before a judge, then ever 15 days thereafter. I also serve on the board of the TN-ACLU and take personal liberty very seriously. I never attempt to force my beliefs on others, even when I think their decision is foolish. I am probably more on the liberal (conservative?) side of the equation compared to many/most other psychiatrists. All doctors push their treatments usually because they have seen it work so many times. In fact, society would punish me through malpractice suits and even revocation of licensure if I do NOT commit those like the example above.

Vanderbilt operates a psychiatric hospital where 90+% of the inpatients are voluntary. However, I worked at a state psychiatric hospital for five years where 90+% of the inpatients are involuntary. There is a special courtroom built within that hospital for fair review of cases, along with free counsel. Now a typical admission to this hospital will be a homeless schizophrenic who is crossing the interstate naked or something like that. Someone who seems possessed by demons. Someone who pays more attention to the voices in his head than to me doing the interviewing. Is it more ethical to let me release him because he refuses treatment and let him fade away into death by starvation or getting hit by a car? Or should I at least attempt to treat him so that his psychosis lessens and he can make more of an informed judgment about treatment? This case plays out thousands of times a year at this hospital. The patient is medicated, condition is improved, he can carry on a conversation and feed & bathe himself, knows to seek a shelter, but then upon discharge, quits taking his meds and then within 3 months is back at the admissions desk brought in by police. You state that they should go to jail. Even jailors bring patients in when they are defecating on themselves or trying to hang themselves.

Your accusation that more psychiatrists commit suicide because they see their profession as a scam is truly peurile. More physicians commit suicide than the general public. Psychiatry shares the spotlight with dentistry, anesthesiology, emergency medicine. Could it be that medical students who suffer psychiatric disorders go into psychiatry to help others with similar disorders and their original predisposition to these conditions increases their risk of suicide?

Just because something cannot be seen, touched, or heard, does not mean it does not exist. Yes, much of psychiatry is based on indirect evidence. But it is evidence nonetheless. Absence of tangible proof is NOT absence of existence. Bacterial infections in the middle ages were thought to be all manner of things, such as evidence of sinful behavior. We know better now.

Most of psychiatry, in contrast to what you allude, is based on voluntary and legal grounds. Eliminating involuntary treatments would do nothing but add to human misery and more numbers for jails and prisons. I practice mostly outpatient service and do not deprive anyone of their liberties.

If you think that NO mental illness manifests with physical symptoms, consider: PSEUDOCYESIS. It is nothing but physical, measurable symptoms without cause. A brain-body connection which has yet to be understood. It exists.

Tom Cruise has the right to say whatever he wishes.
You have the right to say whatever you wish.
As does Szasz, who I've read.
As do I.

I truly believe that in my lifetime science will prove you wrong and me right in this debate.

VGT

PS "Tom Cruise upset so many people such as yourself because what he said was right. Here, a layman, a movie star, knows more about science and medicine than psychiatrists. Pathetic."

I have to laugh...

From: Jeffrey A. Schaler [mailto:jschale@american.edu]
Sent: Saturday, August 06, 2005 3:44 PM
To: Thakkar, Vatsal
Subject: Re: feedback on your article

Vatsal Thakkar:

You write: "But a group of lawmakers has entitled licensed physicians (not just psychiatrists) and licensed psychologists the power to temporarily deprive someone of their liberty based on what is defined by a 'mental defect' in my state."

I believe Hitler "entitled licensed . . . .psychiatrists . . . to temporarily deprive [Jews and others] of their liberty based on what [was] defined by a 'mental defect' in [that] state." Think about what you've written.

You write: "Now I agree that this is vague and subject to interpretation." There is nothing vague about it. There is nothing to be interpreted if you are not free to go home!

You write: "I also serve on the board of the TN-ACLU and take personal liberty very seriously." Obviously you don't take it very seriously. A person is either free or imprisoned. A person is either entitled to due process or is not. You support depriving a person of liberty without due process. Stop creating excuses based in "compassion." Plenty of people are imprisoned, killed, harmed in the name of "compassion."

You write: "I am probably more on the liberal (conservative?) side of the equation compared to many/most other psychiatrists." Ah, so you're the least racist of the bunch, right? You belong to the Nazi party, but you're not as much a Nazi as the others, right? Look at what you're saying.

You write: "All doctors push their treatments usually because they have seen it work so many times." A person has the right to refuse treatment. You cannot treat someone without his consent. Psychiatry is the exception. Psychiatrists are not like real doctors in this respect (as well as in many other respects). It is either a contractual relationship or one based on coercion.

You write: "In fact, society would punish me through malpractice suits and even revocation of licensure if I do NOT commit those like the example above." I think Eichmann said something very similar, remember? Take responsibility for the harm you to do people in the name of treating them. Look how you avoid!

You write: "However, I worked at a state psychiatric hospital for five years where 90+% of the inpatients are involuntary." Ordinarily, one calls that a prison. In a hospital, a person can enter and leave voluntarily. You participated in assaulting and imprisoning people you diagnosed as "patients", deprived them of their civil rights, and call it "treatment." You know what that means . . .

You write: "Is it more ethical to let me release him because he refuses treatment and let him fade away into death by starvation or getting hit by a car?" Ethical? You have no right to imprison him. You have violated his civil rights by imprisoning him. You've committed a crime. When the Nazis gassed people were they "unethical" or criminals, murderers? Look how you try to ease your guilt by using the word "ethical."

You write: "You state that they should go to jail." Only if a person commits a crime. You jail and imprison people when they've committed no crime. They have no due process. You are participating in a criminal activity. Just because it's sanctioned by the state doesn't mean that it's not a criminal activity. The Nazi doctors were sanctioned by the state. Still, they were criminals.

You write: "Someone who seems possessed by demons." Is this person Muslim? He knows what Allah wants? Is he Christian? He knows what Jesus wants? Is he Jewish? He knows what God wants?

You write: "Your accusation that more psychiatrists commit suicde because they see their profession as a scam is truly peurile." Ask them. What do real doctors think of psychiatrists? What do real doctors think of the prisons you run in the name of "medicine?" How do psychiatrists feel about themselves in relation to real doctors? Ask around. Study it. See for yourself.

You write: "Just because something cannot be seen, touched, or heard does not mean it does not exist?" Does this mean you acknowledge that mental illness cannot be seen, touched, or heard? Is this why pathologists include something that cannot be seen, touched, or heard in standard textbooks on pathology?

You write: "We know better now." Can you tell the difference between a sinful behavior and a sick behavior? Do you consider yourself to be God? If so, you know what that means . . .

You write: "Yes, much of psychiatry is based on indirect evidence." Much of psychiatry is based on power and coercion. Take away the power of psychiatrists to coerce and you'd be out of business!

You write: "Absence of tangible proof is NOT absence of existence." There are many people you diagnose as schizophrenic who would agree with you. When you say that, you call it practicing psychiatry. When they say it, you call it being psychotic.

You write: "Bacterial infections in the middle ages were thought to be all manner of things, such as evidence of sinful behavior. We know better now." You are claiming that the state of psychiatry today is akin to that of knowledge of bacterial infections in the middle ages? On that we agree. I suggest you reread Thomas Szasz's The Manufacture of Madness. Psychiatrists burn people at the stake of ECT to cleanse their souls, aka, mental illness.

You write: "Eliminating involuntary treatments would do nothing but add to human misery and more numbers for jails and prisons." I see. That is why people don't want to see psychiatrists, right? That is why people comply with their medication regimens, right? People are miserable being treated against their will. They are suspicious of psychiatrists who deprive them of their freedom, who force them to take drugs they don't want to take. What you are saying is straight out of Orwell. Involuntary means they don't want it. How can involuntary, doing something to people they don't want, make them happy? Doing something to people they don't want makes YOU happy, not them. If they were happy with what you did "for" them, they'd come and see you voluntarily!

"If you think that 'NO; mental illness manifests with physical symptoms, consider: PSEUDOCYESIS. It is nothing but physical, measurable symptoms without cause. A brain-body connection which has yet to be understood. It exists." And the difference between that and lying, pretending, is . . . ? Pretending to be pregnant is not a mental illness. Neither is pretending to be a doctor. It's just pretending, lying, deception. Some people throw their whole life into it. Consider psychiatrists who believe in, diagnose, and treat "mental illness"? Not so unusual. And sanctioned by the state! Isn't that folie à deux if one has ever seen it?!

You write: "I truly believe that in my lifetime science will prove you wrong and me right in this debate." Science cannot prove involuntary commitment "right." What you are searching for is a brain lesion. If a new brain lesion is discovered, then that will be a new brain disease, subject to the same nosological criteria for disease classification as any other. It will not "prove you right" about mental illness. The mind can be sick in a metaphorical sense only. If you're so interested in searching for a brain disease, devote your life to neuroscience, instead of being a jailer masquerading as a doctor. You're a neuroscientist wannabe. Be a neuroscientist if you want to be. Commit yourself to that work. Stop looking for a lesion to ease your guilt as a psychiatrist. The lesion won't resolve your guilt. People still have the right to refuse treatment!

You write: "I have to laugh . . . " But you weren't laughing when Tom Cruise said what he said. You got upset. So did the American Psychiatric Association. Now THAT'S funny!

Jeff Schaler

Professor Jeffrey A. Schaler

----- Original Message -----
From: Thakkar, Vatsal
To: Jeffrey A. Schaler
Sent: Wednesday, August 10, 2005 11:54 AM
Subject: RE: feedback on your article

Pseudocyesis is NOT just “faking” a pregnancy:

TABLE 1. SIGNS AND SYMPTOMS OF PSEUDOCYESIS
Signs or Symptoms Percentage of Patients
Abdominal enlargement 63
Menstrual irregularities 56
Sensation of fetal movements 48
Gastrointestinal symptoms 41
Breast changes or secretions 40
Labor pains 28
Uterine enlargement 9
Cervical softening 6
From small.[sup.]5

There is no consistent or convincing neuroendocrine pathology that has been found to explain this. Yet. But then the same could be said of major depression. And bipolar disorder. And schizophrenia.

VT

From: Jeffrey A. Schaler [mailto:jschale@american.edu]
Sent: Wednesday, August 10, 2005 11:02 AM
To: Thakkar, Vatsal
Subject: Re: feedback on your article

Well, it's either real pregnancy or it's fake pregnancy, isn't it? What else could it be?? Look at the physical changes that occur when people starve themselves, e.g., "anorexia." Or make themselves obese? This is nothing unusual. People delude themselves in all sorts of ways, for all sorts of reasons. Please, tell me, if this is not fake pregnancy, and I certainly don't think you consider it to be real pregnancy, what "it" is? And what kind of conversation might you have with such a person, assuming the person came to see you voluntarily? What might you talk about in light of these symptoms?

Jeff Schaler
jeffschaler@attglobal.net

----- Original Message -----
From: Thakkar, Vatsal
To: Jeffrey A. Schaler
Sent: Wednesday, August 10, 2005 3:17 PM
Subject: RE: feedback on your article

I’m only trying to illustrate a mind-body experience which is inexplicable in its etiology, and cannot be simply “faked” (cessation of menses, lactation). Now if this same person is psychotic (delusional) to the point of wanting to give herself an abortion, she may need involuntary hospitalization!

VT

Vatsal Thakkar writes:
I’m only trying to illustrate a mind-body experience which is inexplicable in its etiology, and cannot be simply “faked” (cessation of menses, lactation). Now if this same person is psychotic (delusional) to the point of wanting to give herself an abortion, she may need involuntary hospitalization!

VT

Schaler: No, you are avoiding the issue again. You have not been addressing the points I make. Involuntary hospitalization is not treatment. It is imprisonment, the deprivation of a person's liberty. Giving herself an abortion, whether she is pregnant or not, is still behavior. You and I may find it upsetting that someone wants to cut out parts of her body, but a person has a right to do it. After all, how do you think plastic surgeons make their living doing cosmetic surgery? The doctor who treats himself has a fool for a patient. It is still behavior. A person believes in God. That is a delusion. Would you deprive that person of liberty for believing in God? People who believe in God have long harmed others and themselves in the name of their delusion. You are not illustrating "a mind-body experience." Either the person is pregnant or she is not. If she is not pregnant, her "pregnancy" is fake. If she has a disease that causes hormonal problems, signs and symptoms, then she has a disease. Still, she has a right to refuse treatment. Wanting to be pregnant is not a disease. Pretending to be pregnant is not a disease. Not wanting to be pregnant or a mother is not a disease. Why is it that undergraduate students understand this, and yet you do not? I suspect you are pretending not to understand. I suspect you're beginning to realize that what you've been believing in is a house of cards, something that falls down easily when certain fundmental premises, i.e., only the body can be diseased, are exposed as false.

I would like to post our dialogue on the Szasz Blog. May I have your permission to do so?

Jeff Schaler

From: Thakkar, Vatsal
To: Jeffrey A. Schaler
Sent: Saturday, August 27, 2005 11:31 PM
Subject: RE: feedback on your article

Dr. Schaler,

I don’t know if I got back to you on this—you may post the discussion if you post it in its entirety.

Also, I am teaching medical students next week—may I use your emails?

VGT

Do not condemn the judgement of another because it differs from your own. You may both be wrong.
--Dandemis

From: Jeffrey A. Schaler
To: Thakkar, Vatsal
Sent: Sunday, August 28, 2005 8:11 AM
Subject: Re: feedback on your article

Yes. Thanks very much. We're both busy. I appreciate the dialogue.
Kind regards,

Jeff Schaler

*Strictly speaking it is a moral and political issue. The Supreme Court has repeatedly upheld the constitutionality of involuntary mental hospitalization. I believe the Supreme Court has ruled in error. The constitutionality of involuntary mental hospitalization is like the constitutionality of slavery.

Sharfstein statements in Psychiatric News

2005-08-27T13:45:00.000-04:00

Big Pharma and American Psychiatry: The Good, the Bad, and the Ugly
Steven S. Sharfstein, M.D.
Psychiatric News August 19, 2005
Volume 40 Number 16
© 2005 American Psychiatric Association
p. 3

"...In my last column, I shared with you my experience, and APA's, in responding to the antipsychiatry remarks that Tom Cruise made earlier this summer as he publicized his new movie in a succession of media interviews. One of the charges against psychiatry that was discussed in the resultant media coverage is that many patients are being prescribed the wrong drugs or drugs they don't need. These charges are true, but it is not psychiatry's fault—it is the fault of the broken health care system that the United States appears to be willing to endure. As we address these Big Pharma issues, we must examine the fact that as a profession, we have allowed the biopsychosocial model to become the bio-bio-bio model. In a time of economic constraint, a "pill and an appointment" has dominated treatment. We must work hard to end this situation and get involved in advocacy to reform our health care system from the bottom up...."

Full

Cindy Sheehan is Right

2005-08-21T21:11:00.000-04:00

Cindy Sheehan is Right
By Sheldon Richman

Whatever happened to personal responsibility? Casey Sheehan volunteered to serve.

"For more than eight decades Western politicians have used the Middle East for their own purposes. It is not surprising that that has created a hatred for imperial policies which motivates people, inexcusably, to murder innocents. (Over the years, western empire-builders have not exactly been meticulous about sparing innocents.) Recognizing the roots of this hatred and acting accordingly do not constitute surrender, as the neoconservatives believe, but rationality."

In other words, the bombing of the World Trade Center on September 9, according to Sheldon Richman, is our fault.

Full article here

Rebecca Hartong on Schaler

2005-07-22T20:45:00.000-04:00

----- Original Message -----
From: "Rebecca Hartong"
To:
Sent: Friday, July 22, 2005 5:20 PM
Subject: Comment for Szasz Blog

In regard to the 7/22/05 post "Questioning Mental Illness" --
I listened to the Lehrer show interview and found it interesting. I'm
curious how Dr. Schaler explains something like autism. Brain disease?
(Are there diagnostic laboratory tests that can be performed to detect
autism?) Or is it a freely chosen behavior?

---
Rebecca Hartong

Cf. http://wnyc.vo.llnwd.net/o1/bl/bl072205c.mp3

Dear Ms. Hartong:

Look in a standard textbook of pathology and see if autism is listed there.
If it is not listed, ask a pathologist why it is not included. If it is
included, then autism refers to a disease. There are specific physical
signs that meet the nosological criteria for disease classification. I
would be surprised if these are well defined and predict the label of
"autism".

All behavior is freely chosen, there is no such thing as involuntary
behavior. Behavior means mode of conduct; deportment. A seizure, for
example, is not considered behavior. It is a neurological reflex. Autism
is generally regarded as a developmental disorder, not a mental illness or a
disease. Children labeled autistic have difficulties learning certain
cognitive tasks; they generally do not display the kind of psychological,
emotional, and social competence necessary for self-sufficience, autonomy.
Do they do things they want to do? Of course. Does their behavior seem
irrational, self destructive, etc. at times? Certainly. Can behavior be a
disease? Never. Diseases are only of the body. This said, I am no
specialist on what is labeled autism.

Thanks for writing.

Jeff Schaler

Jeffrey A. Schaler, Ph.D.
Department of Justice, Law and Society
School of Public Affairs
American University
4400 Massachusetts Ave., NW
Washington, DC 20016-8043 USA
Office telephone 202.885.3667, cell phone 240.460.0987
E-mail: jeffschaler@attglobal.net Home page: www.schaler.net
http://spa.american.edu/listings.php?ID=68

Questioning Mental Illness

2005-07-22T13:20:00.000-04:00

The Brian Lehrer Show

Questioning Mental Illness
Friday, July 22, 2005
Listen to it http://www.wnyc.org/shows/bl/episodes/07222005

Decades ago, psychiatrist Thomas Szasz shocked the mental health establishment by suggesting that mental illness is a myth devised to stigmatize individuals for their unacceptable behavior. Despite the advent of Prozac and Zoloft, the idea still has its supporters.

Oregon Mulls Prescriptions for Cold Medicines

2005-07-22T05:28:00.000-04:00

A followup to my earlier post on pseudoephedrines: Oregon, the bastion of freedom known as state-supported suicide, is considering making decongestants prescription-only.

Sex on the brain

2005-07-21T21:16:00.000-04:00

Sex on the brain
by Mark Pilkington
Thursday July 14, 2005
The Guardian (UK)

Under the auspices of Utah's Lighted Candle Society (LCS), [Judith] Reisman and Victor Cline, a clinical psychologist at the University of Utah, began raising money from American conservative and religious organisations. They hope to raise at least $3m to conduct MRI scans on victims under the influence of porn and so prove their theories correct. They foresee two possible outcomes: if they can demonstrate that porn physically "damages " the brain, that might open the floodgates for "big tobacco"-style lawsuits against porn publishers and distributors; second, and more insidiously, if porn can be shown to "subvert cognition " and affect the parts of the brain involved in reasoning and speech, then "these toxic media should be legally outlawed, as is all other toxic waste, and eliminated from our societal structure ".

What's more, people whose brains have been rotted by pornography are no longer expressing "free speech " and, for their own good, shouldn't be protected under the First Amendment.

Brian's BlogThe Official Blog of The Brian Lehrer Show

2005-07-21T19:23:00.000-04:00

July 21, 2005

Cruise Correct?

Decades ago, psychiatrist Thomas Szasz (that's "SAHZ", it's Hungarian) proposed the crazy idea that the concept of mental illness is bunk. Unlike, say, cancer, it's difficult to definitively diagnose or prove a mental problem. What's more, the idea of mental illness has been used in the past to stigmatize and punish individuals whose behavior is frowned upon, like homosexuals.

But is America ready to dump the insanity plea?

And what would happen if everyone just went off Prozac and Zoloft?

Could Tom Cruise really be right? (Szasz did work with the Scientologists' Citizens' Commission on Human Rights).

Tune in tomorrow to hear Jeffrey Schaler, a Szasz disciple and the proprietor of the szaszblog.

In the meantime, send us your questions, suggestions, rants, and raves!

Posted by leboheme at 04:51 PM

Szasz, Cruise, and Schaler: Stop Making Sense by John Grohol

2005-07-19T22:30:00.000-04:00

Szasz, Cruise, and Schaler: Stop Making Sense

by John Grohol

Psych Central
Tuesday, July 19, 2005

I admire Jeffrey Schaler, a psychologist and a devout Szaszian, because I’m in agreement with many of Szasz’s views about mental illness in general.

But I disagree with the premise of his blog entry about Tom Cruise’s antics criticizing psychiatry and his dismissal of Scientology’s influence on Cruise’s carefully scripted public comments.

But so much of this is semantics. Does Schaler’s argument make as much sense if you use the much more widely-accepted term, “disorder” for these conditions, rather than the medical term, “disease”? Most of the professionals I know and have worked with in the field recognize mental disorders are not the same as medical diseases, and also recognize that we’re at the infancy of understanding them. (It’s often other, third parties that simplify these concepts to a point of blurring the lines between them, not the professionals who treat people.)

. . .

Full

War of the words: Harvard doc KOs Scientology-backed documentary

2005-07-19T17:23:00.000-04:00

War of the words: Harvard doc KOs Scientology-backed documentary
By Jessica Heslam
Tuesday, July 19, 2005 - Updated: 07:30 AM EST

He won actress Katie Holmes' heart and lured millions of Americans to this summer's blockbuster ``War of the Worlds,'' but not everyone is eager to jump on the Tom Cruise bandwagon.

A Harvard doctor turned down an offer from filmmakers after learning the Hollywood A-lister's religious group - the Church of Scientology - was behind it.

Founded by the Church of Scientology and psychiatrist Thomas Szasz, the Citizens' Commission on Human Rights is producing a series of documentaries on the mental health system - with a focus on human rights abuses.

The group recently contacted Dr. John Abramson for an interview. Abramson, a Harvard Medical School clinical professor, penned ``Overdosed America,'' a book that criticizes the drug industry.

But Abramson declined the offer when he learned the church's stance on psychiatric drugs. The short documentaries will be part of a Los Angeles exhibit and distributed for educational purposes. A longer documentary is also in the works.

``I have nothing against Tom Cruise. It's the absolute position against the drugs that I don't want to be associated with,'' said Abramson, who said some people can benefit from drugs.

And the Harvard doctor turned down the offer in the weeks before ``TomKate'' and a series of public rants by the Scientology-obsessed Cruise.

Cruise has blasted actress Brooke Shields for taking antidepressants to treat her post-partum depression and got into a tense beef about psychiatry on the ``Today'' show with Matt Lauer. The 41-year-old Cruise has said he overcame dyslexia through Scientology. He became a Scientologist after the release of ``Top Gun'' in 1986.

Brian Lehrer will explore "decades long influence of Thomas Szasz"

2005-07-18T09:49:00.000-04:00

Perhaps someone can offer more detail, but I was greeted this morning by a promo for WNYC radio's Brian Lehrer show that promises a discussion about Thomas Szasz this coming Friday. The show airs live at 10 am (EDT). It is available via a live Internet broadcast, and is also archived as a Podcast. Click on the title of this post for links.

If you don't yet listen to Podcasts, probably the easiest way to locate, download, listen to, and archive them is with iTunes, which can be downloaded free. (Podcasts are recordings in the MP3 format. iTunes is available for both PCs and Macs.)

Thinktank: "Pleasure Drugs" to boom

2005-07-15T21:06:00.000-04:00

Mind-altering drugs could be as common as coffee within a couple of decades, to boost performance at school and at work, to "unlearn" addiction, and to erase memories of distressing events such as a terrorist attack, according to a government think-tank.

...

Sir David King, the Prime Minister's chief scientific adviser, who led the think-tank, said: "We are on the verge of developments that could possibly move us into a world where we could take a drug to help us think faster, relax, sleep more efficiently or even subtly alter our mood to match that of our friends."

...

One problem raised by the report is that the pharmaceutical industry might change its focus from drugs that treat mental health to cognitive enhancers, "mental cosmetics" and treatments for addiction. "The pharmaceutical industry may not make new medicines for mental health conditions," he said.

Full Story

Foresight Report

Kessler on Cruise

2005-07-15T10:32:00.000-04:00

July 10, 2005
Cf. Cruising Szasz

My esteem for Tom Cruise has gone up sever notches because of his interest in Szasz's writings. Since he's a powerful voice in Hollywood, he can write out psychiatric mendacity from his movie scripts or at least demonstrate psychiatric quackery with the story line should the opportunity arise - I think the movie "Rain Man" may have been a recipient of Cruisian influence - how? One, by showing that Raymond (Hoffman's character) had reasons for why he did what he did and why he say didn't want to fly - he knew the safety record of every single airline. Two (at least it was obvious to me), at the end of the movie, Raymond was asked to make a choice between the assylum where he stayed which he had made his home and had all the things he enjoyed and going with his younger brother. What he did (his
solution to the dilemma) could have been interpreted two ways. The conventional way of interpreting his "autistic" silence was that he was not ready to go into the real world and cope with the pressures he would encounter - that is the way I believe most people viewed Raymond - Tom Cruise's character was playing a conventional person - not a Szaszian - and believed Raymond was best left at the assylum. The way I interpreted it was much more subtle - Raymond actually loved both his brother and the assylum - he really didn't want to offend either by making a choice - he knew if he made a choice it would also be upsetting to himself as well - he just didn't want the pressure. So he allowed the choice to be made for him, avoiding the dilemma and making both satisfied that the best choice was made. This was perfect to me - I used the approach that behavior has reasons. I wonder if the director and Cruise (as well as Hoffman) knew that they knew.

Martin Kessler
titaniummdk@hotmail.com

Prominent Psychologist Faces Whippits Charges

2005-07-13T04:05:00.000-04:00

A prominent psychologist who specializes in eating disorders faces criminal charges after she inhaled propellant from whipped cream cans and collapsed on a supermarket floor in May, police say.

Full Story

Considering she thinks dieting is ineffective at weight loss, and wants "Truth in dieting" laws passed, isn't this just a stunt to get "harmful" products removed from store shelves? All she'll get is a slap on the wrist, but she hopes the publicity will lead to bans on products containing N2O.

Hear Music When No One’s There? You’re Hallucinating

2005-07-12T10:15:00.000-04:00

“Seven years ago Reginald King was lying in a hospital bed recovering from bypass surgery when he first heard the music. …Each day, the music returns. …Last year, Mr. King was referred to Dr. Victor Aziz, a psychiatrist at St. Cadoc's Hospital in Wales. Dr. Aziz explained to him that there was a name for his experience: musical hallucinations. …There is no standard procedure for treating musical hallucinations. Some doctors try antipsychotic drugs….” (New York Times)

Another part of living medicalized. According to the American Heritage Dictionary, a hallunication is the "Perception of visual, auditory, tactile, olfactory, or gustatory experiences without an external stimulus and with a compelling sense of their reality, usually resulting from a mental disorder or as a response to a drug."

See: ”Mental Illness: Psychiatry’s Phlogiston” by Thomas Szasz

Cross-posted at The Foundation for Economic Education

P.S.: There's a great 1950 Irving Berlin song called "(I Wonder Why) You're Just In Love," which has wonderful lyrics, including (with my commentary):

"I hear singing and there's no one there [auditory hallunication]
I smell blossoms and the trees are bare [olfactory halluncination]....
You don't need analyzin' [Szaszian!]
It is not so surprisin'
That you feel very strange but nice....
You're not sick [Denial]
You're just in love"

Hear the music and read the lyrics here.

Parkinson's drug Mirapex accused of causing gambling addiction

2005-07-12T04:43:00.000-04:00

I'm sure you'll all scoff at this one.

Scientists finally find effective schizophrenia treatment

2005-07-11T22:50:00.000-04:00

Cigarettes!

According to researchers at the Yale School of Medicine,

"Cigarette smoking may improve attention and short-term memory in persons with schizophrenia by stimulating nicotine receptors in the brain, according to a study by Yale School of Medicine researchers in the June issue of The Archives of General Psychiatry.

"Persons with schizophrenia smoke two to three times more than smokers without mental illness, said the researchers. They found that when study subjects with schizophrenia stopped smoking, attention and short-term memory were more impaired, but, when they started smoking again, their cognitive function improved. No effects from stopping or resuming smoking were observed in smokers without mental illness.

"Participants with and without schizophrenia were then asked to smoke while taking a drug called mecamylamine, which blocks nicotinic acetylcholine receptors in the brain, preventing the nicotine from acting on those receptors. Mecamylamine blocked the ability of smoking to improve cognitive deficits in schizophrenia, but not in persons without mental illness. The findings suggest that when people with schizophrenia smoke, they may in part be self-medicating with nicotine to remedy cognitive deficits."

The implications are quite profound. Cigarettes will eventually be available by prescription only to people diagnosed as mentally ill. This will lead to a huge number of previously undiagnosed people eager to qualify as mentally ill so they can obtain cigarettes. This will not be difficult since smoking is itself evidence of mental illness. Libertarians will loudly demand medical tobacco laws. Physicians who prescribe too many cigarettes will land in jail. The Association of American Physicians & Surgeons will expand its Communicate and Cooperate project to include reporting cigarette abusing patients to law enforcement. With exclusive access to the slimming benefit of smoking, schizophrenics will be the only people in America who are not diabetic. Reason magazine will feature a piece by Sally Satel urging mandatory smoking treatment. China will become the major source of illicit tobacco in the U.S., each pack having a street value of $1,500. Massive federal funding will be directed to our Chinese allies in their war to eradicate tobacco crops. The Chinese will be be able to buy our best military armaments, and we will give them logistical support. Cigarettes will be offered as inducement for schizophrenics to join the all volunteer armed forces in their Indonesia campaign. Tobacco will replace meth as the number one drug of abuse in America.

But then I jest, don't I?

Cruising Szasz by Jeffrey A. Schaler

2005-07-09T22:14:00.000-04:00

Cruising Szasz
By
Jeffrey A. Schaler

Actor Tom Cruise created quite a stir on June 25 when he called psychiatry a “pseudoscience,” asserted a chemical basis for Attention Deficit Hyperactive Disorder doesn’t exist, and said that anti-depressant drugs masked problems-in-living. He used the actress Brooke Shields as a case in point, citing her postpartum depression, engendering a fair amount of hostility from those who disagreed with him, including Ms. Shields. The New York Times published her rejoinder on July 1. Cruise was criticized by psychiatric apologists and sycophants as irresponsible and dangerous for speaking his mind – and the truth.

A lot of people seem to have misunderstood what Tom Cruise said. It is not necessarily the case that he’s a Scientology-brainwashed wacko, or that his ideas about psychiatry even came from the Church of Scientology. Cruise learned a lot about psychiatry from the writings of psychiatric abolitionist Thomas Szasz. Throughout the world, Szasz is considered an intellectual heavyweight, someone whose ideas about medicine, disease, science, liberty and responsibility should be taken seriously.

Cruise has read a lot of Szasz’s writings and he admires Szasz a great deal. (See a photograph taken last year of Szasz with his arm around Cruise at http://www.szasz.com/szaszcruise.gif.) His words echo Szaszian ideas. Szasz has upset many psychiatrists over the years because he is a member of the psychiatry and psychoanalysis clubs criticizing its own. In real science this is expected to occur in order to advance scientific knowledge—theories must be falsifiable. In pseudoscience, such criticism is forbidden.

The American Psychiatric Association (APA), responding to Cruise’s comments on NBC’s Today Show, asserts in a press release dated June 27 that “science has proven that mental illnesses are real medical conditions . . . and that it is unfortunate that a small number of individuals and groups persist in questioning its [mental health’s] legitimacy.”

Is this claim by the APA actually true, or is it political rhetoric? Why would the APA be upset with someone who questions its legitimacy, disagrees with its ideas, explanations, and policy recommendations regarding “mental illness?”

Actress Brooke Shields is understandably upset. She responded to Cruise claiming she has a disease caused by changing levels of estrogen and progesterone during and after pregnancy. This disease allegedly kept her from being the “loving parent . . . [she] is today.” It is difficult to argue with someone who uses her own experience to prove that something is scientifically correct. If one shows how she is wrong, one can easily be accused of lacking compassion. Compassion has nothing to do with the truth. Critics of psychiatry are frequently accused of lacking compassion. I fail to see how depriving an innocent person of liberty, forcing a person to take drugs she doesn’t want to take, and shocking her brain with electricity against her will—all done in the name of treating mental illness—are indications of compassion.

What of the substance of Cruise’s arguments? The truth is science has never proven that mental illnesses are “real” medical conditions, anymore than it proved homosexuality is a disease. (Homosexuality was declassified as a disease by the APA in 1973, largely due to the writings of Thomas Szasz.) The truth is standard textbooks on pathology do not list mental illnesses among real diseases like cancer, rheumatoid arthritis, and syphilis. Why? Because only the body can be sick, not behavior.

Certainly people exhibit irrational, socially unacceptable and abnormal behavior for all sorts of reasons. But it is wrong to call behaviors diseases. Diseases refer to physical lesions, wounds of the body, not behaviors, conduct, or deportment.

In other words, Cruise is right. The truth is there is no evidence to support the idea that anti-depressant drugs cure or restore chemical imbalances, even though they may certainly help people to feel better about themselves. Szasz pointed this out years ago. These drugs influence chemicals in the body, but then everything we do is accompanied by chemical and electrical changes in the body. This is simply not the same as saying the changes in our body make us do this or that. We cannot tell who is depressed by drawing blood, studying fluid balances, or looking at pictures of the structure and function of the brain. There is no such thing as asymptomatic “mental illness”—yet there most certainly is when it comes to real diseases like cancer and heart disease.

Szasz is best known for his insistence that “mental illness” is a metaphor, and that we go astray if we take the metaphor literally. Yet belief in mental illness is not his main target. In Szasz’s view, individuals should be free to devote themselves to any variety of psychiatric belief and practice. What Szasz objects to is forcing people to see (or not see) a psychiatrist, to reside or not reside in a mental hospital, to partake (or not partake) of drugs, and to believe (or not believe) in any specific set of ideas. Cruise, again echoing Szasz, rightly objected to the involuntary administration of psychiatric “treatments.”

One way people try to discredit both Szasz and Cruise is by playing the Scientology-is-a-cult card. Today, it is as fashionable to criticize Scientologists and Scientology as it was to criticize Jews and Judaism in 1930s and 1940s Germany. Scientology is recognized by our federal government as a religion and demands the same respect and tolerance we show any other religion. Instead of asking why Scientology endorses Thomas Szasz’s ideas, we should be asking why other religions do not.

The rule of cults is “thou shalt not disagree.” Break the rule and you break the spell. Cruise broke a rule: Thou shalt not criticize psychiatry. Some say psychiatry is a cult. What is most upsetting to those in the psychiatry cult? That someone who attracts a lot of attention should dare to point out that the emperor called psychiatry has no clothes. That is exactly what Mr. Cruise has done. In so doing, his head sticks out above the crowd, to be sure, speaking truth to power, but largely because he is standing on the shoulders of Thomas Szasz.

[Cf. The enemy of my enemy is my friend at www.szasz.com ]

Jeffrey A. Schaler, Ph.D., a psychologist, is a professor at American University’s School of Public Affairs. His latest book is Szasz Under Fire: The Psychiatric Abolitionist Faces His Critics (Open Court, Chicago, 2004). He is the owner and producer of www.szasz.com and his website is www.schaler.net.

Subject: SLAVERY OF A PSYCHIATRIST ( FOR THE SZASZ BLOG)

2005-07-07T18:36:00.000-04:00

SLAVERY OF A PSYCHIATRIST

From: "Sergio Ivan Linares" <sergioivanlinares@hotmail.com>

A therapist is a puppet of the State, betraying his patient

He is more than a fool.

Psychiatrists analyzing, using nosology

is a waste of time, for himself, for the patients.

He hides in his own misery of truth-lies. He knows what's the

true. He deceives himself, he is wasting his time and the patients

time. He is the same of a patient is: IRRESPONSIBLE

War of two religious worldviews

2005-07-07T18:26:00.000-04:00

The Washington Times
www.washingtontimes.com
War of two religious worldviews
By Keith Hoeller
Published July 7, 2005

While it's generally best not to get medical information from either Hollywood celebrities or the mainstream media, the recent debate between Tom Cruise and Brooke Shields illuminates two important First Amendment issues: freedom of religion and freedom of the press. For these two actors hew to two very different philosophical and religious views of human nature and the mainstream press has decided to support one view over the other.

While Mr. Cruise believes problems in living are not caused by "mental illnesses" cured by psychiatric drugs, Miss Shields believes the opposite. Unfortunately for Mr. Cruise, Miss Shields' views have in effect become America's state religion, which is widely supported by the mainstream media.

On NBC's "Today" show, Mr. Cruise said he had carefully studied the history of psychiatry, that it is a pseudoscience, that children are being put on psychiatric drugs against their will, without their parents knowing the side-effects, that Ritalin is a drug available on the street, that there is no such thing as a chemical imbalance, and that psychiatric drugs do not cure anything but merely mask the real problems.

All his statements went against the dominant ideology, as espoused by "Today" host Matt Lauer. To get his points across, Mr. Cruise had to interrupt Mr. Lauer, who kept framing the questions within the framework of psychiatry.

After his expression of a heretical view, the mental health movement's high priests promptly went into action. The American Psychiatric Association and the National Alliance for the Mentally Ill, both heavily funded by drug companies, assured the public Mr. Cruise was wrong and the mentally ill need and benefit from their daily psychiatric drugs.

The New York Times, which routinely publishes opinions favorable to psychiatry, promptly published an op-ed by actress Brooke Shields, who has just published a book blaming her loathing of motherhood on "postpartum depression" and crediting antidepressants with making her a happier mother.

However, neither the APA, nor NAMI, nor Miss Shields offered any credible scientific evidence to support their claims that depressed people have a bona fide chemical imbalance that is cured by antidepressant drugs.

For in fact psychiatrists have yet to conclusively prove any mental illness is caused by a chemical imbalance of any kind. They have yet to develop a single physical diagnostic test to prove anyone even has a mental illness. And yet everyday in America people are either forced, coerced or misled to take psychiatric drugs to solve their personal problems.

Many psychiatrists, psychologists, therapists, counselors, theologians and philosophers of all stripes have been criticizing the shaky scientific status of psychiatry for decades -- long before the Scientologists.

Mr. Cruise came under personal attack from critics who refused to address the issues. Instead of being depressed and taking psychiatric drugs, Mr. Cruise was madly in love without taking any drugs. Worse, he repeatedly expressed his love for Katie Holmes in public. There must be something wrong with him, the media insinuated.

Instead of belonging to a mainstream religion, he belongs to Scientology, which has studied psychiatry extensively. At a time when the Catholic Church has been sending sexually abusive priests to psychiatrists instead of to jail, Scientology may well be the only religion to routinely criticize the use of force and fraud by psychiatrists and the drug companies.

Joining with psychiatrist Thomas Szasz, author of "The Myth of Mental Illness," Scientology founded the Citizens Commission on Human Rights to help Americans who feel their civil rights have been violated by the mental health movement.

Like Red-baiting of the 1950s, when people were silenced just by calling them communists, the mental health movement has gotten good at Scientology-baiting, and the media have jumped on the bandwagon. Reporters or editors often ask me if I am a Scientologist when I express views critical of psychiatry. Other non-Scientology critics report similar experiences.

While we supposedly live in a country where freedom of religion is a fundamental principle, this freedom has often not been extended to minority religions or to nonbelievers.

In a country where mental health has become the exclusive state religion, backed by mental health laws, police powers, forced incarceration and drugging, it would be nice if the free press supported freedom of religion, instead of stifling it.

Keith Hoeller is editor of the Review of Existential Psychology & Psychiatry, Seattle, Wash. Copyright © 2005 News World Communications, Inc. All rights reserved.

Cruise's rant under analysis

2005-07-06T08:26:00.000-04:00

http://www.nydailynews.com/city_life/health/story/325375p-278124c.html

New York Daily News - http://www.nydailynews.com

Cruise's rant under analysis
By
JORDAN LITE
DAILY NEWS HEALTH WRITER
Wednesday, July 6th, 2005

When Tom Cruise railed against psychiatry and antidepressants on the "Today" show, many people wondered if the high-strung actor wasn't in need of a shrink himself.

But the "War of the Worlds" star was really giving voice to widely held suspicions that Freud and his followers are quacks - and that drug companies are concealing important information about their mind-mending products.

Cruise went a step further and criticized actress Brooke Shields for taking antidepressants to treat the postpartum depression she suffered after the birth of her daughter. Cruise also declared there was no credible science to back up most claims of mental illness, an assertion that flies in the face of a century of documented research.

"These questions have been answered" by technology that reveals mental illnesses as diseases, said Dr. Peter Kramer, a psychiatrist and author of "Against Depression."

For Cruise and others who attack psychiatry, therapy and the use of drugs to treat mental illness, their criticisms may disguise an ideological agenda that is not really about medicine at all.
POSSIBLE POLITICAL LINK
Some have speculated that Cruise has been influenced by Dr. Thomas Szasz, who is associated with libertarianism and believes that mental illness is a myth used to justify state-sponsored social control through medical treatment. Szasz co-founded an advocacy group that is sponsored by the Church of Scientology, a religion Cruise adheres to.

The church's position on mental illness includes striking similarities to that of Szasz. But the Rev. John Carmichael, president of the church's New York branch, insists that its stance is not based on Szasz's writings.

"These attacks tend to have some political or religious agendas thrown in where it's not always clear that the ultimate target really is psychiatry," Kramer said. "There really may be some other, ultimate target."

Cruise's remarks came on the heels of "One Nation Under Therapy: How the Helping Culture Is Eroding Self-Reliance," published in April. Co-written by a psychiatrist and a philosopher, both of whom are scholars at the politically conservative American Enterprise Institute, the book argues that an entire industry built on our presumed psychological trauma is threatening the American "character" of stoicism and courage.

The authors, Dr. Sally Satel and Christina Hoff Sommers, diverge from Cruise in that they acknowledge mental illness exists and that therapy and medications are appropriate for some people.

But they wonder what Americans' unquestioning acceptance of therapeutic techniques in classrooms and other nonmedical settings - a phenomenon they call "therapism"- says about how we think of ourselves as human beings. Much of the time, such self-examination turns ordinary human experiences of sadness, anxiety and neurosis into pathology, the women write.
"Psychotherapy has oversold itself as offering salvation," Sommers said.

"This country was forged on the American creed: a combination of self-reliance, problem-solving, personal responsibility, striving for excellence.

"'Therapism' is an alternative life philosophy. It does not emphasize stoicism and reticence and problem-solving. It's about self-absorption, it asserts the essential fragility of human beings," she said. "In a way, what we're seeing is that American society is now somewhat divided: The creed's still alive, but you also find those who are very much trying to replace it with therapism."

Americans may be especially receptive to such arguments at this moment in U.S. history. In the past year, drug companies have faced mounting criticism over their concealment of damaging information about the effects of antidepressants on children, as well as what they knew about the risk of suffering a stroke or heart attack from using arthritis medications.

Those scandals, arising out of a backdrop of multibillion-dollar campaigns to market prescription drugs to consumers in advertisements and the tendency of industry to test its own products, are stirring intense debate within the medical community about how doctors and patients alike should interpret information about these medications.

Critics of the drug industry, while careful not to endorse Cruise's views, said he has nonetheless forced a national conversation about the regulation, marketing and use of the drugs in the United States.

"By raising this question, he has put it on the table," said Dr. John Abramson, a family doctor and author of the book "Overdosing America," which takes the pharmaceutical industry to task for its marketing strategies.

"He has put it on the table in a way that's easily rejectable, but I am sympathetic with Tom Cruise's position because doctors and the public really can't get the accurate information, so the perception that these drugs are supposedly overused is a reasonable one and is a product of the best scientific evidence not being available," Abramson said.

COMPETING POINTS OF VIEW
But if Cruise's rant hit an already-sensitive nerve in America, the source of his criticism of the drugs - rooted in his belief in Scientology - is separate from that of consumer watchdogs who are challenging the companies on the basis of their business practices.

That's a distinction the average person won't make when they consider Cruise's position, but it is one that makes all the difference in whether someone will reject the concept of treatment outright or take a more measured view, Kramer said.

In many ways, the "War of the Worlds" actor's comments reflect broader societal battles between faith and reason, Kramer said. In addition to the therapy-prescription drug debate, conflicts are raging over whether to teach children creationism or evolution, as well as over whether abstinence-only education or curricula that discuss a variety of options, including condoms and contraceptives, best reduce rates of teen pregnancy and sexually transmitted diseases.

Which means that observers can't chalk Cruise's stance up to, well, mental illness. Instead, it shows the often uncomfortably close relationship between philosophy or politics and the behavioral sciences.

"I don't think one has to be mentally ill to hold false beliefs," Kramer said. "There's a broad problem in this country regarding science on the one hand and emotion, religion and idiosyncratic beliefs.

"As a culture we don't always give science or medicine primacy and that's problematic. We endanger ourselves."

Ironically, scientists used to be called on to offer opinions about issues of the day, rather than celebrities, Kramer noted.

"Freud and Einstein wrote about matters of war and peace. Here, we have the excess in the opposite direction where you have people with very little scientific background giving opinions about medical and scientific matters," he said.

"Probably we are better off without either," he added.

SF Outdoor Smoking Ban Hard to Enforce

2005-07-02T15:29:00.000-04:00

Lawlessness was rampant Friday on the green green grass of San Francisco.

On the first day of the ban on smoking in public parks, countless smokers were lighting up, inhaling, blowing gray curlicues into the glorious afternoon sunshine and generally flouting society's newest edict.

"You got nothing else to do out here?" said Joe Gallo, a visitor who was celebrating his arrival from Boston an hour earlier with deep draws on a Cohiba cigar in the middle of Union Square.

"I mean, we've killed 100,000 Iraqis, and the president has lied to us, and you're telling me this is the most important thing you have to worry about in San Francisco," Gallo said. "Amazing."

...

Supervisor Michela Alioto-Pier, who last year wrote the ordinance that is believed to be the most comprehensive outdoor smoking ban in the United States, was getting just a bit fired up herself about the city not living up to its end of the deal.

"Our job is to write the law," she said. "We're not supposed to enforce it. This is frustrating."

"When I (heard) that nothing is being done, I thought 'Wow, that's outrageous,' " she said. "This is the law of the land."

Full Story

Photograph of Thomas Szasz and Tom Cruise, circa 2004

2005-07-01T18:24:00.000-04:00

Drug Prohibition Hysteria: Fentanyl Edition

2005-07-01T17:29:00.000-04:00

GAINESVILLE, Fla. --- Drug abusers are increasingly turning to a slow-release form of a powerful painkiller for a quick and dangerous high, University of Florida researchers warn. The trend is raising alarm as the number of people dying from an overdose of the drug fentanyl, an opioid 100 times more potent than morphine, rises.

Addicts are misusing a clear patch that transfers a controlled dose of fentanyl through the skin into the bloodstream over the course of a few days, UF experts say. The adhesive patch is typically prescribed to treat postoperative pain or chronic pain conditions, but in some cases is being misused, often with deadly consequences.

...

Dr. Albert Ray, medical director of Pain Medicine Solutions in Miami and a past president of the American Academy of Pain Medicine, said that the UF study brings necessary attention to the importance of physician and patient education regarding addictive disorders.

“There is nothing wrong with the patch, the problem is with addictive disorders,” Ray said. “Any drug has the potential for abuse. This study is useful for raising awareness of the need for educating prescribing physicians on the importance of screening and monitoring their patients for addictive disorders in order to help decrease the abuse of the patch.”

From a University of Florida press release, June 30, 2005

Shock & Awe at Home

2005-07-01T15:34:00.001-04:00

Sandra Day O'Connor Resigns

2005-07-01T15:34:00.000-04:00

Sandra Day O'Connor, the first woman appointed to the U.S. Supreme Court and a decisive swing vote for a quarter-century on major legal issues, announced her resignation today effective upon the confirmation of her successor.

Full Story

Decongestants Targeted in Meth Crackdown

2005-07-01T15:06:00.000-04:00

Makers of cold medicine are reformulating their products to make it nearly impossible to convert them into illegal methamphetamine in the crude home labs that have sprung up across the USA.

For years, meth addicts have purchased large quantities of over-the-counter decongestants, such as Sudafed, that contain pseudoephedrine. Pseudoephedrine can be cooked with household products into methamphetamine, a highly addictive illegal stimulant.

In response, many states have passed laws that make it more difficult to purchase the medicine. Some now require people who purchase it to show identification and register in a ledger. Others require drugstores to place the medicine behind the pharmacy counter.

Full Article

BMA drops euthanasia opposition

2005-06-30T17:26:00.000-04:00

Doctors have voted to drop their opposition to changes to the law which would allow terminally ill patients to be helped to die.

The British Medical Association conference said it should end its current stance against euthanasia and physician-assisted suicide.

When the BMA discussed the issue earlier this week, doctors spoke powerfully for and against change.

But delegates backed a neutral position at Thursday's vote.

They agreed that the question of the criminal law in relation to assisted dying was "primarily a matter for society and for Parliament".

Doctors backed a motion stating: "The BMA should not oppose legislation which alters the criminal law but should press for robust safeguards both for patients and for doctors who not wish to be involved in such procedures."

The BMA now neither opposes or backs campaigns for assisted dying.

...

Different models have been established in countries where some form of right to die has been allowed.

In Holland, assisted suicide and voluntary euthanasia are responsible for one in 40 deaths.

Whereas, one in 700 deaths in the US state of Oregon are from assisted suicide - voluntary euthanasia is not allowed.

Click header for full story.

BBC News
6/30/2005

Psychiatrists hit back at Cruise

2005-06-28T16:50:00.000-04:00

Actor Tom Cruise has been criticised by the American Psychiatric Association (APA), following remarks he made on US TV attacking psychiatric medicine.
"It was irresponsible for Mr Cruise to use his movie publicity tour to promote his own ideological views," it said.

Cruise called psychiatry a "pseudo science", after NBC host Matt Lauer questioned the 42-year-old's stance against anti-depressant drugs.

Click header for full article.

BBC News
6/28/05

Scientologists vs. Psychiatrists: Why they don't get along

2005-06-25T09:15:00.000-04:00

A Slate.com contributor's explanation for the conflict.

Officials Say Drug Raids Found Clubs Were a Front

2005-06-24T16:50:00.000-04:00

Officials Say Drug Raids Found Clubs Were a Front
New York Times, June 24, 2005
By DEAN E. MURPHY

SAN FRANCISCO, June 23 - Federal authorities said Thursday that they had cracked the biggest case ever involving the use of medical marijuana dispensaries in California as a cover for international drug dealing and money laundering, which they said extended to Canada and countries in Asia.

"This organization had been operating for over four years," Javier F. Peña, the special agent in charge of the Drug Enforcement Administration in San Francisco, said at a news conference. "It is now dismantled."

In court documents unsealed here, the federal authorities accused a 33-year-old San Francisco man, Vince Ming Wan, of leading a multimillion-dollar operation in the trafficking of marijuana and Ecstasy that used three medical marijuana clubs in the city as a front.

United States Attorney Kevin V. Ryan said that an arrest warrant had been issued for Mr. Wan on charges of conspiracy to distribute more than 1,000 marijuana plants, but that he remained at large. Twenty other people, all from San Francisco and its suburbs, were charged with a variety of crimes, including conspiracy to grow and traffic in marijuana plants, conspiracy to distribute Ecstasy and conspiracy to engage in money laundering.

Mr. Ryan said the two-year investigation was continuing and could result in more arrests and charges. In addition to Mr. Wan, seven other suspects remained at large on Thursday.
"We're not talking about ill people who may be using marijuana," Mr. Ryan said. "We're talking about a criminal enterprise engaged in the widespread distribution of large amounts - millions of dollars, if you base it on historical evidence - of marijuana and other drugs, and money laundering their proceeds from these activities."

Agents from the D.E.A., the Internal Revenue Service and other federal agencies executed search warrants on Wednesday at the three medical marijuana clubs. Twenty-three residences, businesses and other growing locations in San Francisco were also searched.

Agents hauled away more than 9,000 marijuana plants. In all, a drug agency official said, the investigation yielded 18,000 marijuana plants over the two years with a wholesale value of $17 million. The official, Special Agent Jose Martinez, said it was the largest drug investigation ever by federal authorities that involved medical marijuana dispensaries. In addition, the court documents said, some of the marijuana was grown in Canada.

Kenneth J. Hines, assistant special agent in charge of the I.R.S. in Oakland, said the authorities were still tracking financial transactions in Asia that Mr. Hines said had been funneled through 40 bank accounts at 12 financial institutions by two of the suspects, Phat Van Vuong, 30, and Richard Wong, 28, both of San Francisco.

Mr. Hines, who declined to name the country or countries that were involved, said the suspects had also bought automobiles, real estate and "other high-end items" with the money in an attempt "to disguise illegal proceeds derived from their activities."

California has allowed the distribution of medical marijuana since voters approved a statewide ballot measure in 1996, but the state law is in conflict with federal narcotics laws. Mr. Ryan said the timing of the investigation, called Operation Urban Harvest, had nothing to do with a ruling by the United States Supreme Court two weeks ago that upheld the authority of federal officials over marijuana, even in the states where it is permitted for medical purposes.

An affidavit unsealed Thursday said that one of the suspects, Enrique Chan, 26, described in detail how the clubs were used as "a backbone" for illegal sales. The affidavit said Mr. Chan estimated that only half of the people who bought medical marijuana were really sick.

"You'll get busted, but you remember, you got to beat the prosecution in court," Mr. Chan told an undercover agent, according to the affidavit. "So if it comes down to a battle in court, what are you gonna do? You're going to bring patients in court, like really sick patients with cancer, have them sit on the stand for you. And no jury is gonna try, is gonna convict you."

When Medical Marijuana is Misused

2005-06-24T16:45:00.000-04:00

When Medical Marijuana Is Misused
New York Times
June 24, 2005
http://www.nytimes.com/2005/06/24/opinion/24fri4.html?oref=login

Those who believe, as we do, that marijuana should be legally available for medical treatments have to be concerned about reports of abuses in California's pioneering medical marijuana program. If the abuses cannot be curbed, a political backlash could undermine the ability of thousands of patients to get marijuana to treat the nausea of chemotherapy, the loss of appetite that accompanies AIDS and other medical problems.

The future of medical marijuana in California and 10 other states that allow its use is already precarious given a recent Supreme Court decision that the federal government may prohibit and prosecute the possession and use of marijuana for medical purposes. Nobody yet knows what impact that decision will have on the states but raids by federal agents on medical marijuana dispensaries in San Francisco this week could be harbingers of a broader crackdown. Public officials would be wise to clean up their programs lest flagrant abuses by a few bad actors bring about destruction of a program that benefits many.

In this environment, it was worrisome to read a first-person report in The Times on June 12, that the writer, a 31-year-old marathon runner, found it "shockingly easy" to obtain marijuana in San Francisco. Although she was in peak health, she sought medical marijuana on the grounds that she suffered a migraine headache every month or so. After her own health plan turned her down, she got a recommendation from a clinic doctor who never asked to see her medical records. His say-so was enough to get her an identification card from the city's health department, along with cards for two friends she had designated as "primary caregivers" so that they could pick up her marijuana if she felt too ill to fetch it herself. That laissez-faire transaction sounds like an easy target for anyone seeking to denigrate the whole program.

Californians who support medical uses of marijuana see the danger and are already moving to tighten regulations. Public officials and even medical marijuana advocates in California have been looking for ways to rein in abuses and oversee the dispensaries. Stronger regulation, some say, would help defuse opposition and send a message that, whatever federal drug officials may have in mind, the state stands behind its medical marijuana law.

Bill would force mentally ill to take their meds

2005-06-24T16:37:00.000-04:00

Bill would force mentally ill to take their meds
Tuesday, June 21, 2005
- Bangor Daily News
http://www.bangornews.com/news/templates/?a=115371

AUGUSTA - The mental health community is divided over a proposed new law that would require some people with mental illness to take prescribed psychiatric medications or face involuntary admission to a state hospital.

The initiative, known as "community commitment," had all-but-unanimous bipartisan support in both the House and Senate during the recently adjourned legislative session, but has been held over for reconsideration because it would draw about $600,000 over the next two years from the state's bare-bones General Fund.

Lawmakers on the budget committee may approve the fiscal note when they reconvene in special session at the end of this month. If not, the bill will be reintroduced in the regular fall session.

The Maine chapter of the National Alliance for the Mentally Ill, a leading organization that advocates for patients' rights, has refused to take a position on the community commitment bill for fear of splintering its membership. A NAMI spokeswoman said last week that while some providers and family members see the measure as a way to keep people healthy and productive, others find it coercive and an infringement of personal rights.

In its final amended form, L.D. 151, An Act to Improve the Delivery of Maine's Mental Health Services, would set up a one-year, Augusta-based pilot project to treat a maximum of 50 people. It would trigger a court review of patients with multiple psychiatric hospitalizations and repeated outpatient noncompliance with their medication orders. When those patients are discharged from Riverview Psychiatric Center in Augusta - one of Maine's two public psychiatric hospitals - they could be ordered by a court to participate in an "assertive community treatment" process, or ACT.

ACT provides intensive outpatient support and monitoring with a team of mental health professionals. While there are already a number of ACT teams working with recently discharged patients in Maine communities, they don't have the authority to require medication compliance and often simply stop seeing patients who drop off their radar or become noncompliant, hostile or uncontrolled.

The pending law would create a new ACT team dedicated to serving community commitment clients. If team members determined that a client has stopped taking medications as ordered and is showing even mild symptoms, the team would be empowered to have the client readmitted to the hospital against his will. Once restabilized, the client could once again be discharged to community commitment and the ACT program. The law would limit the initial commitment period to four months and subsequent discharges to more than one year.

The measure also would fund temporary housing for those assigned to the program.

The bill's sponsor, Sen. John Nutting, D-Leeds, said Monday that family members, frantic to protect the well-being of their loved ones, have been a primary driver of the proposal. Other pressures include the societal costs of having people with poorly controlled mental illness living in Maine communities, as well as the cost of repeated hospitalization or incarceration of those who become dangerous. The measure has the support of a broad coalition of health care groups and law enforcement officials.

According to Nutting, 42 other states have community commitment provisions. In New York, he said, the average length of stay in psychiatric hospitals has decreased from 50 days to 15 days, and there has been a 78 percent decrease in the number of inmates in the state's prisons and jails who have a diagnosed mental illness.

In New Hampshire, Nutting said, the average length of time a psychiatric patient stays compliant with medications after discharge has risen from 31/2 months to 11 months since the state enacted an outpatient commitment process.

Nutting's bill has engendered strong opposition from Maine's Disability Rights Center. Public Policy Director Helen Bailey said last week that people with mental illness have the same rights as those with other illnesses.

There are good reasons why people may choose not to take their medications, she said, and the right to do so should be protected. Some drugs cause intolerable side effects, and some should not be taken, for example, if a woman is pregnant. Some people have no transportation or other complicating factors and are unable to get their medications, she added.

Accepting that ACT teams should sometimes be more aggressive in maintaining therapeutic relationships with difficult clients, Bailey said it's appropriate to beef up their accountability without "putting the onus on the people with mental illness."

The debate over LD 151 has focused on a few "anecdotal situations," Bailey said, but the real problem is the overall quality of care being provided in the community mental health system.

At the Bangor Area Homeless Shelter, Executive Director Dennis Marble said he supports the idea of community commitment, while acknowledging that its coercive aspect is a problem. Many of his clients regularly cycle through the mental health system, Marble noted - they get hospitalized to get their medications straightened out, are discharged for follow-up services in the community, function well for a time and then gradually get worse. When they reach the point where they are a danger to themselves or others, they get recommitted to the hospital, or are imprisoned.

With each cycle, Marble said, people with mental illness take longer to restabilize. They also suffer "cumulative consequences to their overall health," he said, including worsening chronic conditions such as heart disease or diabetes, loss of nutritional health and injuries due to loss of judgment.

Marble said he "gets comfortable" with the idea of community commitment when he focuses on the notion of community - both as a source of caring intervention and as a system with limited financial resources. Unmanaged mental illness costs the state a lot of money, he noted - dollars that could be better spent providing health care to a broad range of Mainers.

Bangor Publishing Companywww.bangornews.com/

Massachusetts Considering Mandatory Health Insurance

2005-06-22T16:29:00.000-04:00

Massachusetts residents who choose not to obtain health insurance would face tax penalties and even the garnishing of their wages under a proposal Governor Mitt Romney unveiled yesterday.

Full Story

Ron Paul Continues His Fight against Psychiatric Screening of Children

2005-06-21T17:17:00.000-04:00

This was issued today by the Liberty Committee, chaired by U.S. Rep. Ron Paul of Texas:

The American tradition of parents deciding what is best for their children is under attack. The pharmaceutical industry wants universal mental screening for every child in America, including preschool children. But universal screening alone is not what the pharmaceutical industry wants. The real payoff for the drug companies is the drugging of children that will result -- as we learned tragically with Ritalin -- even when parents refuse!

The drug companies want your children to be "screened." The psychiatric establishment wants to do the "screening." And even a recent presidential commission (New Freedom Commission on Mental Health) supports it all. These powerful groups want your children "screened" -- whether or not you, as parents, give permission.

Congressman Ron Paul, an OB/GYN physician for over 30 years, is desperately trying to keep the drug companies, politicians and federal bureaucrats from becoming parents to your children. Dr. Paul will introduce this week an amendment to the Labor, HHS, and Education Appropriations Act for FY 2006 that will withhold funds from being used to implement or support any federal, mental screening program.

In a letter to his congressional colleagues, Dr. Paul states: "As you know, psychotropic drugs are increasingly prescribed for children who show nothing more than children’s typical rambunctious behavior. Many children have suffered harmful effects from these drugs. Yet some parents have even been charged with child abuse for refusing to drug their children. The federal government should not promote national mental health screening programs that will force the use of these psychotropic drugs such as Ritalin."

If you think this action alert is about something that "can't happen here," think again. In 1995, the state of Texas launched the Texas Medication Algorithm Project. (WorldNetDaily.com, June 21, 2004)

The state of Illinois has also approved a mental health screening program. The Illinois legislature passed the Children’s Mental Health Act of 2003 which will provide screening for "all children ages 0-18" and "ensure appropriate and culturally relevant assessment of your children's social and emotional development with the use of standardized tools." In addition, all pregnant women in Illinois are to be screened for depression.

Dr. Karen R. Effrem, a pediatrician and leading opponent of universal screening with EdAction states: "Universal mental health screening and the drugging of children, as recommended by the New Freedom Commission [presidential commission], needs to be stopped so that many thousands if not millions of children will be saved from receiving stigmatizing diagnoses that would follow them for the rest of their lives. America’s school children should not be medicated by expensive, ineffective, and dangerous medications based on vague and dubious diagnoses."

Dr. Effrem warns:

1. Parental rights are unclear or non-existent under these screening programs.
2. Parents are already being coerced to put their children on psychiatric medications and some children are dying because of it.
3. Mental health screening does not prevent suicide.
4. Mental health diagnoses are "subjective" and "social constructions" as admitted by the authors of the diagnostic manuals themselves.
5. Most psychiatric medications do not work in children.
6. The side effects of these medications in children are severe.
7. The untoward influence by the pharmaceutical industry, or at least the impropriety, is abundantly clear in two important aspects of this issue.
8. Merging screening with the academic standards required by No Child Left Behind, as is happening in Illinois, will lead to diagnosis for political reasons. School mental health and violence prevention programs funded by NCLB and government counterterrorism operations are already using such criteria as "homophobia" and "defenders of the US Constitution against federal government and the UN" to label school children and US citizens as mentally unstable and violent. (EdAction.org)

Urge your U.S. representative to vote "yes" on the Paul amendment to stop universal mental screening of children. If your U.S. representative does not vote "yes" on the Paul amendment, he or she supports screening your children without your permission -- just as the drug companies want.

The U.S. House will vote on the Paul amendment Thursday or Friday. Send your e-mail message today and call your U.S. representative too. Also, please spread the word.

Medical Marijuana

2005-06-20T10:53:00.000-04:00

My take on the Raich medical-marijuana case is posted here at The Future of Freedom Foundation website.

Study Shows Big-Brained People are Smarter

2005-06-18T11:45:00.000-04:00

Virginia Commonwealth University, "ranked nationally by the Carnegie Foundation as a top research institution," is once again at the leading edge of scientific research, according to a press release

In a study that "could settle a long-standing scientific debate about the relationship between brain size and intelligence," Michael A. McDaniel, professor in management in VCU’s School of Business has found, in a meta-analysis of studies that used "MRI-based brain assessments," that big-brained people are smarter. This has long been suspected, but in the darker ages the tools were too crude to provide conclusive proof.

"Before MRIs, scientists often used external skull measurements or waited until a person died to estimate brain size. The external skull measurements were only approximate estimates of brain volume."

Not only should this discovery put a handsome new furrow in Charles Murray's brow as he laments the hopelessness of the puny-brained lower classes, but it is apparently a giant leap forward for personnel managers.

As an industrial and organizational psychologist, McDaniel works with employers to screen job applicants and measure their performance. He said employers will appreciate his findings because intelligence tests are the single best predictor of job performance.

Will they show their appreciation by requiring applicants to have MRI-based brain assessments?

Dr. McDaniel must keep his students spellbound with the following sort of insight:

“On average, smarter people learn quicker, make fewer errors, and are more productive.”

It is therefore disheartening that the professor is unable to properly spell either the first or last name of the famous German researcher, Friedrich Tiedemann

"Ever since German anatomist and physiologist Frederick Tiedmann (sic) wrote in 1836 that there exists 'an indisputable connection between the size of the brain and the mental energy displayed by the individual man,' scientists have been searching for biological evidence to prove his claim."

Shouldn't Dr. McDaniel, the article's reviewers, and the editors of the journal Intelligence, be big-brained enough to know who Tiedemann was and how to spell his name? Tiedemann's fame is so enduring that, for a brain-sizer, mispelling this name is equal to a geneticist not knowing how to spell "Crick" or "Watson."

The press release is accessed by clicking the title of this post. A pdf of the full article is here. An abstract of the article, "Big-brained people are smarter: A meta-analysis of the relationship between in vivo brain volume and intelligence," is here.

You'd have to be crazy: Mental illness is the new normal

2005-06-17T06:54:00.000-04:00

Jacob Sullum has a new column in which he ridicules the aforementioned survey revealing the ubiquity of "mental illness."

As the psychiatric iconoclast Thomas Szasz has been arguing for many years, mental illness is a literalized metaphor that conceals more than it reveals.

"Snake Phobias, Moodiness and a Battle in Psychiatry"

2005-06-14T11:13:00.000-04:00

This exercise in question-begging is in today's New York Times.

The Legality of the Use of Psychiatric Neuroimaging in Intelligence Interrogation

2005-06-13T23:28:00.000-04:00

SEAN KEVIN THOMPSON
Cornell University - School of Law

Abstract:

This Note seeks to analyze the legality of the use of fMRI during the interrogation of foreign detainees in U.S. custody. It assesses the legality of using fMRI in the interrogation of POWs and civilians detained during an armed conflict, arguing that the use of fMRI to detect deception in the voluntary statements of these detainees would be permissible, but that the use of fMRI to extract cognitive information from a nonconsenting detainee would not. The Note also examines the legaity of using fMRI in the interrogation of unlawful combatants, whether they are held in U.S. territory or abroad. The Note argues that the use of fMRI to extract cognitive information from a nonconsenting unlawful combatant held in U.S. territory may "shock the conscience" and, therefore, violate U.S. obligations under International Humanitarian Law. The analysis will vary on a case-by-case basis, depending on the level of force used to effect the scan and the government interest involved. Because, under current U.S. policy, unlawful combatants held outside U.S. territory are only protected by the U.S. Federal Anti-Torture Statute, fMRI in any form would be permissible in the interrogation of these detainees.

Full Report

Joan Kennedy stripped of rights by judge, family

2005-06-13T00:05:00.000-04:00

What a sadly fitting event this is in the year of Rosemary Kennedy's death. "Losing your sharp edge" around the Kennedys is a spiritual, if not literal, death sentence. How dare they call this a "settlement."

Joan Kennedy Settles Guardianship Case
By MICHAEL KUNZELMAN
The Associated Press
Sunday, June 12, 2005

BOSTON -- Joan Kennedy has reached a settlement with her children that calls for two trustees to manage her estate, while a guardian supervises her personal affairs, a source close to the case said Sunday.

The settlement also calls for the former wife of U.S. Sen. Edward Kennedy to enter a program to treat her alcoholism, the source said on condition of anonymity.

Kennedy's three children, including U.S. Rep. Patrick Kennedy, D-R.I., had been scheduled to appear in court Monday to ask a judge to appoint a permanent legal guardian to manage their mother's finances and to make decisions about her health.

The hearing was canceled following the agreement on the settlement, said Patrick Kennedy's spokeswoman, Robin Costello. She declined to provide any further details.

Joan Kennedy's attorney also declined to comment on the settlement, but said his client will not have a permanent legal guardian managing her estate.

The anonymous source said the guardian ad litem will monitor Joan Kennedy's finances and health and report to a judge, but will not have the power to make decisions for her. The source also said her estate _ including a $6.4 million oceanfront home on Cape Cod _ will be held in a trust and managed by two trustees.

Joan Kennedy, 68, has been arrested several times for drunken driving and gone through rehab repeatedly. In March, she was hospitalized with a concussion and a broken shoulder after a passer-by found her sprawled on a Boston sidewalk.

Kennedy didn't contest her children's bid for guardianship last July, when a judge ruled she was "incapable of taking care of herself by reason of mental illness."

More details from a prior article:

Bruce D. Bixby, a Boston lawyer who specializes in probate law, said awarding permanent guardianship would forever change Joan Bennett Kennedy's life. He said the guardianship would remain in effect unless she convinces a judge that she can live on her own again.

''If you commit a crime, you go to jail," Bixby said. ''In a guardian situation, if you start losing your sharp edge, you can wind up having all your freedoms taken away indefinitely -- without ever having harmed a soul. . . . You can't be in charge of your own money, you can't be in charge of healthcare decisions."

Hamilton Naki, 78, Self-Taught Surgeon, Dies

2005-06-11T11:34:00.000-04:00

Hamilton Naki, 78, Self-Taught Surgeon, Dies

NY Times
Obit.
June 11, 2005

By MARGALIT FOX

Hamilton Naki, a laborer who became a self-taught surgeon of such skill that Dr. Christiaan N. Barnard chose him to assist in the world's first human heart transplant in 1967, but whose contribution was kept secret for three decades because he was a black man in apartheid-era South Africa, died on May 29 at his home in Langa, near Cape Town. He was believed to have been 78.

The cause apparently was heart trouble, according to African and British newspapers, which reported the death.

The transplant, which took place on Dec. 3, 1967, at Groote Schuur Hospital in Cape Town, made medical history. It also made Dr. Barnard, who was young, handsome and white, world famous.

Dr. Barnard began to acknowledge Mr. Naki's work only after the end of apartheid in 1991. In an interview shortly before his death in 2001, he called Mr. Naki "one of the great researchers of all time in the field of heart transplants."

Mr. Naki, who left school at 14 and had no formal medical training, spent five decades working at the University of Cape Town. Originally hired as a gardener there in about 1940, he acquired his formidable surgical skills through years of silent observation and covert practice at the university's medical school. He retired in 1991.

In 2003, the university awarded Mr. Naki an honorary master of science degree in medicine.
Although South Africa's apartheid laws forbade blacks from performing surgery on whites, Mr. Naki's skills were so esteemed that the university quietly looked the other way. He worked alongside Dr. Barnard for decades as a lab technician, perfecting his craft and assisting in many operations on people. Operating on animals, Mr. Naki also taught surgical techniques to generations of medical students.

"If Hamilton had had the opportunity to perform, he would have probably become a brilliant surgeon," Dr. Barnard told The Associated Press in 1993.

Hamilton Naki was born, most likely in 1926, in a poor, rural village in Transkei, a largely black former British protectorate in what is now South Africa's Eastern Cape Province. At 14, lacking the money to continue his education, he hitchhiked to Cape Town to find work. The university hired him to tend its grounds and tennis courts.

In the late 1950's, Mr. Naki took a job at the medical school, where he cleaned lab animals' cages. He was quickly recognized for his intelligence, keen powers of observation and steady hands, and was gradually allowed to become involved in more serious work.

Mr. Naki learned to anesthetize animals, and eventually to do surgery on them, operating on rabbits, pigs, dogs and even a giraffe. Many of the animal surgeries he performed, including coronary bypasses and heart and liver transplants, helped to perfect techniques that were later used on humans.

"Hamilton Naki had better technical skills than I did," Dr. Barnard said in an interview quoted in The Daily Telegraph of London this week. "He was a better craftsman than me, especially when it came to stitching, and had very good hands."

But because of his race, Mr. Naki's role in the world's first heart transplant remained unknown for years.

On Dec. 2, 1967, Denise Darvall, a young white South African woman, was hit by a car as she was crossing a Cape Town street. Taken to Groote Schuur Hospital, she was declared brain-dead. Her family gave permission for her heart to be transplanted into the chest of Louis Washkansky, a 55-year-old grocer whose own heart was failing.

As a black man, Mr. Naki could not operate on Ms. Darvall even after she was dead. But Dr. Barnard so prized his ability that he drafted him as a member of the team that would lift out her heart.

In a painstaking operation lasting many hours, Mr. Naki's team removed Ms. Darvall's heart, washing it repeatedly to cleanse it of her blood before introducing some of Mr. Washkansky's. On Dec. 3, Dr. Barnard transplanted the heart into Mr. Washkansky, who lived for 18 days before dying of pneumonia.

During his years at the university, Mr. Naki lived on the outskirts of Cape Town in a one-room shack without electricity or running water. When he retired, he was paid a gardener's pension, far less than a lab technician's.

Mr. Naki is survived by several children, and many grandchildren and great-grandchildren, according to the reports in overseas news media.

In 2002, Mr. Naki was awarded the Order of Mapungubwe, one of South Africa's highest honors, for outstanding contribution to medical science.

In an interview with The Guardian of London in 2003, Mr. Naki expressed little bitterness about a lifetime spent working in the shadows. "I was called one of the backroom boys," he said. "They put the white people out front. If people published pictures of me, they would have gone to jail."

Lilly to settle Zyprexa claims for up to $690M

2005-06-10T10:34:00.000-04:00

The Indianapolis Star
June 10, 2005

Lilly to settle for up to $690M: Deal may resolve 8,000 Zyprexa claims

Eli Lilly and Co. said Thursday it will pay up to $690 million to settle legal claims by about 8,000 patients alleging they were harmed by the antipsychotic Zyprexa, Lilly's top-selling drug.

The proposed settlement comes six months before the first trial in a rash of Zyprexa lawsuits is scheduled to begin in federal court in New York.

The Indianapolis drug maker said it's not admitting in the agreement that its star drug caused the diabetes-related injuries alleged by claimants, many of whom are schizophrenia patients. The drug also is approved to treat manic depression...Lilly has maintained that its drug is not to blame for diabetes-related problems. Lechleiter said schizophrenia patients are prone to weight gain and also suffer a fourfold greater incidence of diabetes than the general population.

But according to a Pfizer press release, reprinted on a NAMI affiliate site, "antipsychotic" drugs are themselves responsible for weight gain among "schizophrenics":

"The dramatic weight gain often associated with some of the most widely prescribed antipsychotic medicines is the side effect most likely to cause patients to stop taking their medication, according to a nationwide survey of psychiatrists released today at the 155th annual meeting of the American Psychiatric Association."

The press release also says:

"Ninety percent of the psychiatrists surveyed by Roper Starch Worldwide said they believe that weight gain not only affects compliance, but patients' self-esteem as well, and 80 percent said they believe weight gain adversely impacts their patients' overall quality of life."

Schizophrenics have self-esteem? Who knew? And this self-esteem is adversely impacted by weight gain, but not by imprisonment, restraint, electroshock, and the rest of the psychiatric armamentarium? Or perhaps obliterating the self-esteem and quality of life of persons labeled schizophrenic is the point. It sure doesn't seem to harm the quality of life and self-esteem of the psychiatrists.

One Quarter of Us Are Mentally Ill?

2005-06-07T09:49:00.000-04:00

Oh here we go again. According to a Harvard study, 25 percent of Americans are mentally ill, and 25 percent of those are severely mentally ill. Read about it here. The New York Times story, headlined "Most Will Be Mentally Ill at Some Point, Study Says," is here. Here's a choice quote: "Pretty soon," he [Dr. Paul McHugh, a professor of psychiatry at Johns Hopkins University] said, "we'll have a syndrome for short, fat Irish guys with a Boston accent, and I'll be mentally ill."

Thoughts on Raich Decision

2005-06-07T05:03:00.000-04:00

Monday's decision in Gonzales v Raich is a mixed bag. While "medical" exceptions to drug laws were rightly rejected, states' rights to regulate intrastate commerce without federal interference were considerably weakened, and the federal war on drugs strengthened. On the whole, the decision is a net loss for liberty.

The majority wrote:

First, the fact that marijuana is used "for personal medical purposes on the advice of a physician" cannot itself serve as a distinguishing factor. 352 F. 3d, at 1229. The CSA designates marijuana as contraband for any purpose; in fact, by characterizing marijuana as a Schedule I drug, Congress expressly found that the drug has no acceptable medical uses. Moreover, the CSA is a comprehensive regulatory regime specifically designed to regulate which controlled substances can be utilized for medicinal purposes, and in what manner. Indeed, most of the substances classified in the CSA "have a useful and legitimate medical purpose."

...

Accordingly, the mere fact that marijuana--like virtually every other controlled substance regulated by the CSA--is used for medicinal purposes cannot possibly serve to distinguish it from the core activities regulated by the CSA.

Yes, whether the use is "medical", "recreational," or whatever, should have no bearing on the statute's legality. "Medical" marijuana is to commerce laws, what "good" speech is to speech codes.

But why should the utilitarian effects of local laws on interstate markets -- the effects of which can surely not be predicted in advance -- have any bearing on federal power?

The majority continued:

Second, limiting the activity to marijuana possession and cultivation "in accordance with state law" cannot serve to place respondents' activities beyond congressional reach. The Supremacy Clause unambiguously provides that if there is any conflict between federal and state law, federal law shall prevail.

Even when the Constitution does not enumerate those federal powers?

Justice Scalia, having already run over the Ninth Amendment, proceeds to nullify the Tenth:

Finally, neither respondents nor the dissenters suggest any violation of state sovereignty of the sort that would render this regulation "inappropriate," id., at 421--except to argue that the CSA regulates an area typically left to state regulation. See post, at 6-7, 11 (opinion of O'Connor, J.); post, at 8-9 (opinion of Thomas, J.); Brief for Respondents 39-42. That is not enough to render federal regulation an inappropriate means. The Court has repeatedly recognized that, if authorized by the commerce power, Congress may regulate private endeavors "even when [that regulation] may pre-empt express state-law determinations contrary to the result which has commended itself to the collective wisdom of Congress."

The majority decided, in effect, that anything which can be construed to "affect" interstate commerce, even if it doesn't cross state lines, validates federal law, and that it trumps state law. Since growing and using marijuana locally can "affect" interstate markets (by reducing demand for them), the reasoning goes, the feds have every right to step in and regulate local commerce, even if nothing crosses state lines, and even if no money changes hands.

The dissent led by O'Connor let itself get trapped into economic arguments about the effects on interstate markets, while at the same time pretending that they weren't relevant:

Even assuming that economic activity is at issue in this case, the Government has made no showing in fact that the possession and use of homegrown marijuana for medical purposes, in California or elsewhere, has a substantial effect on interstate commerce. Similarly, the Government has not shown that regulating such activity is necessary to an interstate regulatory scheme. Whatever the specific theory of "substantial effects" at issue (i.e., whether the activity substantially affects interstate commerce, whether its regulation is necessary to an interstate regulatory scheme, or both), a concern for dual sovereignty requires that Congress' excursion into the traditional domain of States be justified.

Again:

There is simply no evidence that homegrown medicinal marijuana users constitute, in the aggregate, a sizable enough class to have a discernable, let alone substantial, impact on the national illicit drug market--or otherwise to threaten the CSA regime. Explicit evidence is helpful when substantial effect is not "visible to the naked eye." See Lopez, 514 U. S., at 563. And here, in part because common sense suggests that medical marijuana users may be limited in number and that California's Compassionate Use Act and similar state legislation may well isolate activities relating to medicinal marijuana from the illicit market, the effect of those activities on interstate drug traffic is not self-evidently substantial.

And again:

The Government has not overcome empirical doubt that the number of Californians engaged in personal cultivation, possession, and use of medical marijuana, or the amount of marijuana they produce, is enough to threaten the federal regime. Nor has it shown that Compassionate Use Act marijuana users have been or are realistically likely to be responsible for the drug's seeping into the market in a significant way.

The dissent undermined its own arguments, by playing into this utilitarianism.

The dissent also let itself get swayed by personal opinions:

To ascertain whether Congress' encroachment is constitutionally justified in this case, then, I would focus here on the personal cultivation, possession, and use of marijuana for medicinal purposes.

O'Connor seemed apologetic about the effects her decision might have:

Relying on Congress' abstract assertions, the Court has endorsed making it a federal crime to grow small amounts of marijuana in one's own home for one's own medicinal use. This overreaching stifles an express choice by some States, concerned for the lives and liberties of their people, to regulate medical marijuana differently. If I were a California citizen, I would not have voted for the medical marijuana ballot initiative; if I were a California legislator I would not have supported the Compassionate Use Act. But whatever the wisdom of California's experiment with medical marijuana, the federalism principles that have driven our Commerce Clause cases require that room for experiment be protected in this case. For these reasons I dissent.

In his solo dissent, Justice Thomas wrote:

Respondents Diane Monson and Angel Raich use marijuana that has never been bought or sold, that has never crossed state lines, and that has had no demonstrable effect on the national market for marijuana. If Congress can regulate this under the Commerce Clause, then it can regulate virtually anything--and the Federal Government is no longer one of limited and enumerated powers.

The majority holds that Congress may regulate intrastate cultivation and possession of medical marijuana under the Commerce Clause, because such conduct arguably has a substantial effect on interstate commerce. The majority's decision is further proof that the "substantial effects" test is a "rootless and malleable standard" at odds with the constitutional design.

But Thomas relied on the medical model to bolster his arguments:

... The Court of Appeals found that respondents' "limited use is distinct from the broader illicit drug market," because "th[eir] medicinal marijuana ... is not intended for, nor does it enter, the stream of commerce." Raich v. Ashcroft, 352 F. 3d 1222, 1228 (CA9 2003). If that is generally true of individuals who grow and use marijuana for medical purposes under state law, then even assuming Congress has "obvious" and "plain" reasons why regulating intrastate cultivation and possession is necessary to regulating the interstate drug trade, none of those reasons applies to medical marijuana patients like Monson and Raich.

Wow, to hear a Supreme Court Justice say that equal treatment under the law doesn't apply!!!

California's Compassionate Use Act sets respondents' conduct apart from other intrastate producers and users of marijuana. The Act channels marijuana use to "seriously ill Californians," Cal. Health & Safety Code Ann. §11362.5(b)(1)(A) (West Supp. 2005), and prohibits "the diversion of marijuana for nonmedical purposes," §11362.5(b)(2).⁴ California strictly controls the cultivation and possession of marijuana for medical purposes. To be eligible for its program, California requires that a patient have an illness that cannabis can relieve, such as cancer, AIDS, or arthritis, §11362.5(b)(1)(A), and that he obtain a physician's recommendation or approval, §11362.5(d). Qualified patients must provide personal and medical information to obtain medical identification cards, and there is a statewide registry of cardholders. §§11362.715-.76. Moreover, the Medical Board of California has issued guidelines for physicians' cannabis recommendations, and it sanctions physicians who do not comply with the guidelines. See, e.g., People v. Spark, 121 Cal. App. 4th 259, 263, 16 Cal. Rptr. 3d 840, 843 (2004).

This class of intrastate users is therefore distinguishable from others. We normally presume that States enforce their own laws, Riley v. National Federation of Blind of N. C., Inc., 487 U. S. 781, 795 (1988), and there is no reason to depart from that presumption here: Nothing suggests that California's controls are ineffective.

Oh, really? :-)

No one argues that permitting use of these drugs under medical supervision has undermined the CSA's restrictions.

On the contrary, I'd argue that the use of these drugs under "medical" supervision undermines CSA's restrictions, morally speaking. The majority was right on that one -- there cannot be "medical" or other exceptions. But neither side is willing to go so far as to end the war on drugs.

Even Thomas was swayed by the utilitarianism -- he just qualified it with the medical model:

But even assuming that States' controls allow some seepage of medical marijuana into the illicit drug market, there is a multibillion-dollar interstate market for marijuana. Executive Office of the President, Office of Nat. Drug Control Policy, Marijuana Fact Sheet 5 (Feb. 2004). It is difficult to see how this vast market could be affected by diverted medical cannabis, let alone in a way that makes regulating intrastate medical marijuana obviously essential to controlling the interstate drug market.

Thomas concludes:

In sum, neither in enacting the CSA nor in defending its application to respondents has the Government offered any obvious reason why banning medical marijuana use is necessary to stem the tide of interstate drug trafficking. Congress' goal of curtailing the interstate drug trade would not plainly be thwarted if it could not apply the CSA to patients like Monson and Raich. That is, unless Congress' aim is really to exercise police power of the sort reserved to the States in order to eliminate even the intrastate possession and use of marijuana.

Ah, now you understand!!!

So the side which has historically been more inclined to support states' rights against federal intrusion, used the medical model for its arguments, and supported the federal war on drugs as much as it possibly could, personally if not legally. It was as though they were saying: "We don't like the federal government intruding into states, and we cannot really find a legal reason to support it, but we sincerely support the federal drug war, and will do everything we can to preserve it. As long as you can make it a medical exception, we're fine with leaving it up to the states, no matter how much it undermines the rule of law."

The majority opinion is more consistent, both internally and with past behavior, even though it sanctions federal power that the Tenth Amendment, and common sense, should not allow.

Neither side recognized an individual's right to drug use, or the right of an individual to engage in commerce without state and federal interference. The Justices tried to second-guess the effects of state and federal drug laws on the market, to justify their legal reasoning, and supported preserving the federal war on drugs as much as their sense of the law would allow. Liberty lost.

Other analyses of this ruling can be found Here, Here, Here, and Here.

Addiction in America: Addiction is a Choice? Christian Network Journal, June 2005

2005-06-05T16:01:00.000-04:00

Why Addiction is a Choice

by Jeffrey A. Schaler
Christian Networks Journal
June 5, 2005

Anyone listening to the incessant propaganda for what is called "the disease model" of addiction might suppose that all experts on addiction agree with it. But this is far from the truth. People who have spent a lifetime studying addiction are divided in their opinions. I am one of many psychologists who maintain that addiction is not a disease but a choice.

Some people suppose they can show that addiction is a disease by pointing out that it is a serious problem, that people can destroy or impoverish their lives by excessive consumption
of some chemical substance or by an obsessive preoccupation with some pastime like gambling or sex. I do not dispute that some forms of addiction constitute a serious problem. What I do dispute is the assumption that serious problems are always necessarily medical in nature. Serious problems may be social, or moral, or existential.
People can make unwise choices. People can make self-destructive choices. People can make evil choices, though in our society there is not always agreement about which choices are evil, which are good, and which are morally neutral. It's also true that people can make sensible, constructive, and heroic choices. If we are going to claim that people are not responsible for their bad choices, how can we claim that they are responsible for their good choices? If we are not to blame people for their harmful actions, then how are we to praise them for their fine or noble action?

If someone has made an unfortunate choice, they may be in need of help. My judgment that addiction is a choice is not an excuse to be uncaring. I do not want to be hard on people who are suffering from the difficulties of life. But I believe we do not help people most effectively by classifying their behavior as symptoms of some mysterious and entirely mythical illness. We can help people by offering them advice, or perhaps by enabling them to improve their circumstances so that they are better able to cope, and thus do not feel impelled to take refuge in particular chemical substances.

The full article is accessible by purchase here

CDC Team Investigates an Outbreak of Obesity

2005-06-02T21:32:00.000-04:00

Next assignment: a pandemic of stupidity.

New York Times
By GINA KOLATA
Published: June 3, 2005

C.D.C. Team Investigates an Outbreak of Obesity

For the first time, the Centers for Disease Control and Prevention has sent a team of specialists into a state, West Virginia, to study an outbreak of obesity in the same way it studies an outbreak of an infectious disease.

Kerri Kennedy, the program manager at the West Virginia Physical Activity and Nutrition Program, said the state had requested the agency's investigation.

"We were looking at our data," Ms. Kennedy said, and saw that "we are facing a severe health crisis."

The state ranked third in the nation for obesity - 27.6 percent of its adults were obese, compared with 20.4 percent in the country as a whole. And, Ms. Kennedy said, "our rate of obesity appears to be increasing faster than the rest of the nation."

Full

Don't say "drug" when you mean "medication"

2005-06-01T20:56:00.000-04:00

We can only hope that Lewis H. Richmond has continued his indefatigable effort to clear up this small matter. Inexplicably, we also refer to psychiatrists -- like Richmond himself -- as doctors.

American Medical News
31 Jul 2000
Letters to the Editor

Don't say "drug" when you mean "medication"

For many years I have written and spoken about the need for doctors to differentiate between the terms "medication" and "drug."

It makes little sense for people to "say no to drugs" (illegal substances) and "say yes to drugs" (medications). I would hope our national organizations consider the implications of the confusing message that many physicians give when referring to medications as drugs. Further complicating this issue is the fact that we refer to facilities that dispense medications as "drugstores" rather than "medication stores."

--Lewis H. Richmond, MD San Antonio

René Talbot's review of "Szasz Under Fire"

2005-05-31T22:43:00.000-04:00

I don't believe that this has been referred to in the blog. René Talbot has a review of Szasz Under Fire in the March/April 2005 edition of Radical Philosophy.

"Szasz's replies are to the point, sometimes full of polemic and irony but always based on the libertarian ground of his thinking."

Full

Psychiatrist Testifies Crime Was Driven By Mental Illness

2005-05-31T22:09:00.000-04:00

Another appearance by Park Dietz, one of the leading psychiatric "whores of the court," to use Margaret Hagen's phrase. (Hagen contributed a chapter to Szasz Under Fire.)

KCCI-TV (Iowa)

Psychiatrist Testifies Crime Was Driven By Mental Illness
Tape Plays Of Huss' Arrest After Killing

A psychiatrist testified Thursday that a convicted murderer's act was driven by mental illness -- not by sex.

State prosecutors are asking a Polk County jury to declare Loren Huss a sexually violent predator.

In 1986, he killed his girlfriend, Marilyn Sheets, and then mutilated her body. If the jury finds it was a sexually motivated homicide, that could sway its decision on whether Huss is a predator.

Late Thursday, the defense played a disturbing audiotape that police recorded when they tried to take Huss into custody just after they found Sheets' body.

For several minutes, you can hear Huss repeat the same Bible passage while screaming, laughing and crying. It took five police officers to subdue him.

During this trial, Huss testified that he was delusional that night. He said he thought his girlfriend was the devil and he thought he was going after the devil.

Some physical evidence at the crime scene, including the fact that Sheets was found naked, helped lead psychiatrists hired by the state to conclude the killing was a crime partly driven by sex.

A defense psychiatrist said Thursday that the killing was driven by Huss' mental illness.

"We ask the question, is this more like the behavior of a man who was just engaged in sexual activity or is this more like the behavior of a man who had just engaged in psychotic activity? It's an easy call," said psychiatrist Dr. Park Dietz.

Prosecutors argue that the homicide shows Huss acted on his sexual urges. They also point out incidents in the years before the murder, including a rape and another case when Huss attacked, stripped and badly beat a woman in a parking lot.

Prosecutors say it's a pattern. Huss said he's no longer a threat and he should be released.

KCCI (with link to video of this "news" story)

Police training to handle people off medication, in unstable state

2005-05-31T21:39:00.000-04:00

Mental illness spurs lessons

Police training to handle people off medication, in unstable state

By Wendy Harris
Post-Crescent staff writer

Outagamie County sheriff’s deputy Wang Lee “responded” to a noise complaint at an apartment Friday to discover a 20-something man and his female friend in party mode.

The man was intoxicated, but he also was talking a mile a minute, and at first was unusually gregarious as he invited Lee and another officer to join the party.

As Lee tried to talk the man into turning down the loud music, he became belligerent. But Lee played it cool, took his time and discovered the man’s bottle of Depakote, a prescription drug commonly used to treat bipolar disorder. The man had gone off his medication and was in the midst of a manic phase.

“It’s a different way of thinking,” Lee said later. “We’ve been trained to notice and identify people in crisis and know the symptoms and signs.”

Friday’s incident wasn’t real, but rather a role-playing scenario that culminated a week of training for law enforcement personnel. The goal was to teach them how to identify mental illness during calls and how to diffuse situations.

“It’s better to practice with an actor and process the mistakes you make rather than make them in real life,” said Karen Aspenson, executive director of the National Alliance for the Mentally Ill-Fox Valley.

The Crisis Intervention Team (CIT) training, organized by the local NAMI office with support from the Appleton Police Department, is the only training of its kind so far in the state.

Full

Drugs, Sex, and AIDS by Paul Varnell, Independent Gay Forum

2005-05-31T14:43:00.000-04:00

Drugs, Sex, and AIDS

By Paul Varnell

First published May 18, 2005, in the Chicago Free Press.

Recently, our fair city of Chicago issued a report by an ad hoc group calling itself The Chicago Task Force on LGBT Substance Use and Abuse.

The original advocates of the report deserve credit for wanting to address a long-standing problem in the gay community. But the final report, long-delayed and over-edited in order to offend no one, was so infected with drug treatment industry myths, mealy-mouthed social worker jargon and such feeble suggestions for dealing with the problem that it was almost useless.

The report called for a “safe, visible, sustained and supportive dialogue on the topic of substance use and abuse.” It confidently asserted that “not all substance use is problematic.” It preachily admonished us all to be “supportive and nonjudgmental about ... substance use and abuse” and urged us to “find common ground on which to define when substance use becomes abuse.”

Full

Sentenced to Church

2005-05-31T13:41:00.000-04:00

A Kentucky judge is facing criticism for letting some drug and alcohol offenders attend worship services instead of going to jail or rehab.

District Judge Michael Caperton said he's trying "to help people and their families."

He said there's no violation of the separation of church and state because he said "worship services" instead of "church." He also said it's optional for the offenders.

An American Civil Liberties Union lawyer said the practice has "serious constitutional problems." The lawyer said the judge is letting people who go to services avoid jail, while people who decline have to go to jail. The lawyer said that violates the state's required "neutrality" toward religion.

The judge has offered the option about 50 times to repeat offenders. It's unclear what effect the sentence has had.

Full Story

British Medical Journal's clever plan to increase violent crime

2005-05-27T15:37:00.000-04:00

BMJ 2005;330:1221-1222 (28 May), doi:10.1136/bmj.330.7502.1221
http://bmj.bmjjournals.com/cgi/content/full/330/7502/1221

Reducing knife crime: We need to ban the sale of long pointed kitchen knives

"Britain in the grip of knives terror—third of murder victims are now stabbed to death." Daily Express,, 31 January 2005
"Stabbing rampage kills one, injures five—a large kitchen knife was found." Independent, 24 December 2004

Violent crime in the United Kingdom is increasing; figures from London show a 17.9% increase from 2003 to 2004,1 and one easily accessible weapon used in many incidents is the kitchen knife. Unfortunately, no data seem to have been collected to indicate how often kitchen knives are used in stabbings, but our own experience and that of police officers and pathologists we have spoken to indicates that they are used in at least half of all cases. UK government statistics show that 24% of 16 year old boys report carrying knives or other weapons and 19% admitting attacking someone with the intent to harm.2 Although other weapons—such as baseball bats, screwdrivers, and chains—are also carried, by far the most common weapons are knives.3 In the United Kingdom in the first two weeks of 2005 alone, 15 murders were attributed to stabbings and 16 other non-fatal attacks.4

To tackle this increasing problem, various measures are being considered by the government, particularly targeting the adolescent age group. These include raising the minimum age for purchasing a knife from 16 to 18 years and allowing head teachers the power to search pupils for knives.5 However, not all crimes are committed with newly purchased knives, and every household and home economics department in schools contains a plethora of readily available weapons. The modern stainless steel kitchen knife has a high quality blade that makes it unnecessary to look further for another lethal weapon.

Most domestic kitchen knives are based on two designs, the dagger variety with a pointed tip—for example, vegetable knife or carving knife—and the blunt round nose variety—for example, bread knife. When using a knife to harm, a blunt nosed knife is unlikely to cause serious injury, as penetrating clothing and skin is difficult with it. Similarly an assault with a knife with a short blade such as a craft knife may cause a dramatic superficial wound but is unlikely to reach deep structures and cause death. A dagger type knife, however, can penetrate deeply. Once resistance from clothing and skin is overcome, little extra force is required to injure vital organs, increasing the chance of a fatality (likened to cutting into a ripe melon).6

As knives are so readily available, does a culinary reason exist for so many domestic knives to be of the dagger variety, or are we just sticking to tradition? Knives as we recognise them were made first from copper and bronze between 3000 and 700 bc, and some are very similar in design to those used today. Personal eating knives were first used in Britain in the 14th century and became commonplace during the 1800s when manufacturing processes improved.7

Knives were used to spear meat, lifting it from plate to mouth, so pointed tips were vital for this function. Also, with repeated sharpening of a flat blade, a pointed tip inevitably develops. However, now domestic knives do not need sharpening, and numerous other kitchen utensils can be used to spear food. The current practice of eating with forks and blunt ended table knives was introduced in the 18th century to reduce the injuries resulting from arguments in public eating houses. In 1669, King Louis XIV of France noted the association between pointed domestic knives and violence and passed a law demanding that the tips of all table and street knives be ground smooth.8 Today many households have a block of kitchen knives of which several will be of the long pointed variety.

Perhaps the pointed kitchen knife has a culinary purpose that we have failed to appreciate? We contacted 10 chefs in the UK who are well known from their media activities and chefs working in the kitchens of five leading London restaurants. Some commented that a point is useful in the fine preparation of some meat and vegetables, but that this could be done with a short pointed knife (less than 5 cm in length). None gave a reason why the long pointed knife was essential. Domestic knife manufacturers (Harrison-Fisher Knife Company, England, personal communication, 2005) admit that their designs are based on traditional shapes and could give no functional reason why long pointed knives are needed. The average life of a kitchen knife is estimated to be about 10 years.

Many assaults are impulsive, often triggered by alcohol or misuse of other drugs, and the long pointed kitchen knife is an easily available potentially lethal weapon particularly in the domestic setting. Government action to ban the sale of such knives would drastically reduce their availability over the course of a few years. In addition, such legislation would make it harder to justify carrying such knives and prosecution easier.

The Home Office is looking for ways to reduce knife crime. We suggest that banning the sale of long pointed knives is a sensible and practical measure that would have this effect.

Emma Hern, specialist registrar in emergency medicine, Will Glazebrook, specialist registrar in emergency medicine Mike Beckett, consultant in emergency medicine

Immediate treatment of people who may have contracted HIV could be doing more harm than good, researchers claim

2005-05-26T09:36:00.000-04:00

I was drawn to that subhead, "Immediate treatment of people who may have contracted HIV could be doing more harm than good, researchers claim."

Instead of some distressing news about the ineffectiveness of early treatment of infected persons, we learn that the drugs may not prevent those treated from behaving irresponsibly, and that they cost the UK's National Health Service money. It may as well be an article about how leg casts may do more harm than good because they allow skydivers to jump again.

The taxpayers shouldn't be on the hook for medical treatments. But a physician should no more concern himself with the future sex habits of an HIV-infected homosexual than he should the jump plans of a skydiver. HIV transmission requires that two persons engage in risky behavior, except when rape occurs, and voluntary sexual behavior should be no business of medicine or the state. People have just as much right to infect themselves with HIV as they do to commit suicide, and the responsibility to cope with the physical and economic consequences, lamentable though they may be. (And there is nothing wrong with charitably helping ill people.)

Beware physicians who define treatment as doing harm or good in a way that doesn't pertain to the person being treated. That is medicine in service to "society" and the State, not to the individual.

BBC News
25 May 2005

Concerns over early HIV treatment
Immediate treatment of people who may have contracted HIV could be doing more harm than good, researchers claim.

The treatment, known as PEPSE, can reduce the chance of infection if taken within 72 hours of potential exposure.

But sexual health experts from London's Mortimer Market Centre warn knowledge treatment is available could increase risky behaviour and HIV transmission.

...The researchers, led by Dr John Richens, write in the journal: "We are concerned that there is pressure to make PEPSE available for homosexual men regardless of cost and without proper consideration of possible negative consequences on service delivery and HIV transmission.

"We believe that there is a distinct danger that the promotion of PEPSE could reinforce rising trends in risky sexual behaviour and might add to, rather than lessen HIV transmission."

Dr Martin Fisher, an HIV/Aids consultant at Brighton and Sussex University Hospitals NHS Trust, said it was true there was not a robust evidence base for the policy.

But he said concerns that PEPSE treatment would lead to complacency and risky sexual behaviour had not been borne out by the data which was available.

He said: "In the two studies that have examined behaviour after individuals have taken PEPSE, the opposite appears to occur.

He added that, while PEPSE could cost up to £1,000 per patient, it was still significantly cheaper than providing treatment for HIV infection, which costs up to £1m.

Dr Fisher also said PEPSE is given to healthcare workers after occupational exposure, where the absolute risk is lower than that of risky sex between gay men.

And Will Nutland, of the Terrence Higgins Trust, said: "There is no firm research foundation on which to base the argument that increasing the availability of PEPSE will lead to an increase in sexual risk taking."

He added: "Ensuring that key at-risk communities know that PEPSE is available, and that it is not a morning after pill, is an important strand in the UK's HIV prevention strategy.

"Additional funding should be made available to key sexual health centres to provide PEPSE under strict prescribing criteria".

http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/4578647.stm

Anti-social behaviour 'inherited'

2005-05-25T15:40:00.000-04:00

BBC News
Tuesday, 24 May, 2005

Anti-social behaviour 'inherited'

Anti-social behaviour in some children could be the result of their genetic make-up, a study says.
UK research on twins suggests children with early psychopathic tendencies, such as lack of remorse, are likely to have inherited it from their parents.

These young children may also display inherited anti-social behaviour, the Institute of Psychiatry team found.

...

Professor Marian Fitzgerald, visiting professor of criminology at the University of Kent, said this early-onset anti-social behaviour was different from that seen more commonly among teens aged 15-17.

"Most people who get involved in crime and anti-social behaviour are not genetically predisposed..."

Full article here:

http://news.bbc.co.uk/2/hi/health/4575551.stm

Anti-depression implant?

2005-05-24T09:23:00.000-04:00

The U.S. Food and Drug Administration may soon approve a medical device that would be the first new treatment option in the United States for severely depressed patients in a generation, despite the misgivings of many experts who say there is little evidence that it works.

The pacemaker-like device, called a vagus nerve stimulator, is surgically implanted in the upper chest. Its wires are threaded into the neck, where it stimulates a nerve leading to the brain.

It has been approved since 1997 for the treatment of some epilepsy patients, and the drug agency has told the manufacturer that it is now "approvable" for severe depression that is resistant to other treatment. But in the only rigorously controlled trial conducted so far in depressed patients, the stimulator was no more effective than sham surgery.

Full Story

Cruel Compassion, The American Enterprise Online

2005-05-19T15:04:00.000-04:00

Cruel Compassion
By
Karlyn H. Bowman (kbowman@aei.org), Sally Satel, Christina Hoff Sommers

TAE contributing editor Karlyn Bowman recently sat down with Dr. Christina Hoff Sommers and Sally Satel, M.D., resident scholars at the American Enterprise Institute, to discuss their new book One Nation Under Therapy: How the Helping Culture is Eroding Self-Reliance.

TAE: You criticize what you call "therapism." What is that?

CHRISTINA HOFF SOMMERS: Therapism celebrates emotional self-absorption and the sharing of feelings. Its proponents believe that vulnerability, not strength, characterizes the American psyche. They see us as an anguished, emotionally apprehensive population that requires a vast array of counseling to cope with the trials of everyday life.

TAE: Let's start with the myth of the fragile child.

Full

Why Smoking is Good for Houston

2005-05-17T04:59:00.000-04:00

After months of debate, a ban (effective September 9) was placed on smoking in indoor dining areas.

...

When City Councilman Michael Berry voted against the recent smoking ban, he said, "If you don't like smoking restaurants, don't go to them. What we heard over and over again, and it disturbs me, is this notion that 'I want to go to [someone's restaurant], and I want to tell him how to serve me on my terms,' which is 'I want you to serve me with no smoke,' even though he wants to serve those people who smoke."

There were plenty of nonsmoking restaurants in this city before the ban... The owners of these places made the decision to not allow smoking, just like other owners chose to let people light up. Now the decision's been made for all of them.

...

What we are suggesting is that City Council overstepped its bounds by enacting the smoking ban, placing the success of the hospitality industry and its workers in jeopardy, all the while ignoring the social benefits of smoking as well as a slew of more pressing issues. Kids shouldn't take up smoking, but when it comes to rational adults, we think choice is a good thing.

Call us crazy.

Full Editorial

The Fit Tend to Fidget, and Biology May Be Why, a Study Says

2005-05-16T02:18:00.000-04:00

I saved an article from the Jan 28 New York Times from which the following is excerpted:

The Fit Tend to Fidget, and Biology May Be Why, a Study Says
By DENISE GRADY

Overweight people have a tendency to sit, while lean ones have trouble holding still and spend two hours more a day on their feet, pacing around and fidgeting, researchers are reporting in findings published today.

The difference translates into about 350 calories a day, enough to produce a weight loss of 30 to 40 pounds in one year without trips to the gym - if only heavy people could act more restless, like thin ones.

-------

The normally dependable psychiatric publicists at the Times surprisingly failed in this instance to note that fidgeting is a symptom of mental illness. This is a gross oversight that could have been avoided had their liberal bias not dissuaded them from reading The Heritage Foundation's "A Policymaker's Guide to Mental Illness."

http://www.heritage.org/Research/HealthCare/BG1522.cfm

Who in his right mind wouldn't rather be a heavy person than mentally ill? Not too heavy though, lest one waddle into another mental illness: obesity.

Psychiatric wonder drugs to the rescue! They induce good, synthetic fidgeting and pacing while vanquishing the mental illnesses that are associated with bad, natural fidgeting and pacing. Given the scientifically precise dosage, you can feel great about your improved physical and mental fitness as you stride around the facility. Who says you can't have your cake and eat it, too?

Tel Aviv court accepts terminally ill patient’s request to be disconnected from life support

2005-05-11T11:17:00.000-04:00

Ynetnews.com

'Death with dignity’ OK’d

Tel Aviv court accepts terminally ill patient’s request to be disconnected from life support
By Vered Luvitch

TEL AVIV - A 59-year-old terminally ill patient should be allowed to disconnect from life support machines, the Tel Aviv District Court ruled Monday morning.

Yael Hirschorn has been suffering from Muscular Dystrophy for the past eight years. The illness has forced her to remain in bed and connected to a respiration machine at all times. Meanwhile, her only way to communicate with those around her is through the use of her eyelids.

Hirschorn’s daughter petitioned the court and asked that her mother not be reconnected to the respiration machine once it is disconnected for regular cleaning.

Full

Just What We Need

2005-05-05T18:07:00.000-04:00

From George Will's column today (not bad, really):

"Fox is working on a pilot about 'a priest teaming with a neurologist to examine unexplained events.'"

As Murray Rothbard used to say, "Are we to be spared nothing?"

Manias and obsessions

2005-05-01T10:40:00.000-04:00

Word---Definition
ablutomania ---mania for washing oneself
aboulomania---pathological indecisiveness
agromania---intense desire to be in open spaces
andromania---nymphomania
anglomania---craze or obsession with England and the English
anthomania---obsession with flowers
aphrodisiomania---abnormal sexual interest
arithmomania---obsessive preoccupation with numbers
Full