No More Mr. Nice Guy!

Schizoid Nation

The year is 1965. Al Siebert is a promising young medical student who has just completed his Ph.D. in clinical psychology from the University of Michigan, and been awarded a post-doctoral fellowship at the prestigious Menninger Institute in Topeka, Kansas. The mission statement of the program is: "to foster a searching curiosity about clinical processes that will generate new research into the nature of these processes. The program allows Fellows a two-year 'moratorium' in which they are free to re-examine and reintegrate their theoretical, clinical and professional skills." Siebert is eager to put these principles into practice by asking, among other questions, why psychiatrists are so anxious to dominate their patients by forcing treatment on them when it is often ineffective.

Early on, he witnesses a disturbing incident where a resident brow-beats a newly admitted patient: "You must accept that you're mentally ill before we can help you." The patient refuses to do so, and the resident gets increasingly angry and overbearing. Siebert is shocked to learn that this is a routine ritual with new patients; there's been no mention of it in his training. Some residents are unhappy with this practice but are threatened with being dropped from the program if they don't go along. So much for fostering curiosity and re-examination of conventional wisdom!

Later on, Siebert interviews a patient who has been labelled "acute paranoid". He quickly realizes that the man is perfectly sane but hates his job and is unhappy in his marriage. His wife, parents and boss are all putting him under tremendous pressure to be someone he isn't. The patient reveals that he told the admitting physician, "Everyone's trying to push their thinking into my head." Bang! The poor guy is labelled schizophrenic, forced to believe that he is mentally ill, and committed to a mental hospital where he will be doped with powerful drugs but otherwise warehoused away and forgotten about.

Later, Siebert meets a young woman who seems genuinely schizophrenic. But when he simply treats her with kindness and no prejudgments, her self-esteem rises dramatically and a few weeks later she is judged well enough to be released. Siebert's colleagues regard this as a case of spontaneous remission and show an alarming lack of curiosity as to what worked and whether it could be repeated with other patients.

Siebert grows increasingly concerned that psychiatry is on the wrong track. Some of its practitioners seem to have a need to bolster their esteem by labelling everyone around them mentally ill. This compels them to force (often unwanted) treatment on their patients with scant regard for whether it actually helps. At the same time, psychiatrists seem blind to the relation between mental health and self-esteem in the patients.

Siebert talks about his ideas with his wife. She expresses horror and cannot accept his ideas. A few days later, Siebert gets a call from a colleague, telling him that his wife is starting psychotherapy and he needs to come in for an interview. Siebert and his wife come in to the clinic. Mrs. Siebert is asked to go back and wait in the waiting room. Siebert is very suspicious, but tells the psychiatrist about his ideas and how they upset his wife. Siebert's wife is called back to the office, and the psychiatrist tells her, "You were right, Mrs. Siebert, he is mentally ill."

What??? Siebert comes up with an interesting idea that challenges conventional psychiatric thinking and is supported by case studies - and his colleagues declare him mentally ill and want to lock him up! The program director tells Siebert, "Your ideas make me feel uncomfortable. You should be in a mental hospital."

Fortunately for him, Siebert knows how the system works. If he is admitted involuntarily to a mental hospital, it will be much harder to leave - and if he leaves without permission, the police can come after him and drag him back. Siebert checks in voluntarily and is put in a ward full of chronic, heavily medicated patients. He is forced to take Thorazine, even though no doctor has examined him or written a prescription for it. The drug makes him weak and lethargic until he learns to hide it under his tongue, then flush it down the toilet when the aides aren't watching.

Siebert eventually escapes from the hospital and uses his knowledge of the system to negotiate a "discharged against medical advice" release so he can get back his personal effects and won't have to spend all his life looking over his shoulder. Today he is a successful author and teacher who is helping others to overcome the stigma of being labelled schizophrenic. He regards his horrifying experience as an invaluable inside look at the psychiatric profession, more valuable than any prestigious fellowship.

I learned this shocking story in a book entitled Warning: Psychiatry Can Be Hazardous To Your Mental Health, by William Glasser. This book's contention is that mental illness is vastly over-diagnosed. There are of course conditions such as Parkinson's that are caused by physical damage or pathology in the brain, but the vast majority of people labelled mentally ill are simply unhappy or frustrated, either because they are trying to control other people or other people are trying to control them. The good news is that such people can often help themselves, or be helped by loved ones, sometimes even if they have severe symptoms such as fibromyalgia or rheumatoid arthritis for which no physical basis has been found. The bad news is that the medical system has no real interest in helping people; it just wants to prescribe a drug which will chemically lobotomize them, and then move on to the next patient.

In many ways the situation is worse today than in 1965. The use of electroconvulsive shock treatment has actually risen, fewer people get counseling, and more people are doped and zombified with successive generations of increasingly powerful "wonder drugs" such as Prozac, Zoloft and what not. The profession of psychiatry has more or less become a wholly-owned subsidiary of the pharmaceutical industry, which heavily underwrites psychiatric conferences, research and education, and steers development in the direction of more pill-popping.

The drugs that are pushed on the patient have often been hurriedly and inadequately tested, work no better than placebos, but can be addictive and have severe side effects such as tardive dyskinesia. Many of them are selective serotonin reuptake inhibitors, meaning they work on the brain in the same way as cocaine and methamphetamine. Basically nothing is known about their long term effects, particularly in the still developing brains of children. And yet Ritalin - kiddie crack - is routinely doled out to children just to get them to behave. It's for the convenience of teachers - there is no evidence that diseases du jour such as ADD and ADHD have any real medical basis, let alone that 20% of US children suffer from the mythical "chemical imbalances" that supposedly give rise to them but have never been objectively demonstrated to exist.

This appalling situation continues with no prospect of change because it is hugely profitable for the drug companies, and the HMO's love being able to fob people off with pills instead of costly and time-consuming counseling, though the chemical approach is probably more expensive for them in the long run. And in the current political climate, it's tempting to speculate that our lords and masters would like nothing better than a zonked-out, compliant and apathetic populace. Certainly, neonazi-cons like Charles Krauthammer make no secret of their desire to see "Bush Derangement Syndrome" written into the DSM-IV, a chilling echo of the abuse of psychiatry under the Stalinist-era USSR. (Anthony Black, another contributor to Glasser's book, points out the obvious hypocrisy in the US government waging a "war on drugs" while permitting the indiscriminate use of mind-altering and damaging drugs on a large percentage of its population by big pharma.)

In any case it's very scary to realize how easy it is for someone to get you locked away and subjected to a regimen of powerful and harmful drugs, even if you are totally sane, even for that matter if you are a professional and a respected community member. All dissent must be eliminated, all independent thought erased for the greater good of the therapeutic state - or at least its rulers! "Ask your doctor about Happy Sambo Pills - the miracle cure for drapetomania!"

Seriously though, Michel Foucault argued that the concepts of sanity and insanity were social constructs that reflect only the power of the "sane" over the "insane", and R.D. Laing argued that withdrawing into a fantasy world could be a rational response to living in an insane society. And then there's this gem of wisdom from Dan Quayle: "What a waste it is to lose one's mind. Or not to have a mind is being very wasteful. How true that is."

If you have any concerns about your mental health or that of a loved one, I urge you to seek out alternatives to mainstream treatment. Don't "ask your doctor" about some heavily hyped drug you saw advertised on TV; ask about other, non-chemical options such as counseling and group therapy. Read the book I cited above, or other books by psychiatric skeptics such as Peter Breggin, and take responsibility for your own mental health while helping loved ones to take responsibility for theirs. (But stay away from the scientologists, they're if anything even more harmful than the psychiatrists!)

Stay well!