"We can absorb a terrorist attack. We'll do everything we can to prevent it, but even a 9/11, even the biggest attack ever . . . we absorbed it and we are stronger," Obama reportedly said in an interview with Bob Woodward.
I don't know really know what the President meant by that comment. It does sound cavalier and fairly arrogant to me. But, it got me thinking about those things that did help the country through that horror. On September 11th and the days that followed the country turned to God. Congress members sang "God Bless America" on the capitol steps. There was a massive gathering of citizens in Churches across the country to pray in unity with bells tolling simultaneously. The prayers in song, in speech and in hearts sent out by a humble nation beseeching Our Creator, were answered. To say we "absorbed" the attacks is to dismiss the miraculous blessings of divine grace, mercy and sanctification that were so necessary.
God shed His grace on this country following September 11th. So, what is meant by grace? It is a divinely bestowed enabling power. God blessed us with the power to overcome. Grace is the power we didn't know we had until we needed it. And we didn't know we needed it until we humbled ourselves enough to recognize it. To receive grace requires more of us than just asking. It requires us to put ourselves in a position to have access to true power. The attacks were not what humbled us, it was turning to God that humbled us, and than He enabled us to overcome and keep moving forward.
Grace is necessary for mercy. Mercy often is described as forgiveness. Well, forgiveness is indeed a merciful act, but mercy is more broad than that. To me mercy is a restoration of that which was lost. When combined with grace it becomes divine, and thus it is a power to restore those things which only divinity can. We all lost a sense of peace, safety, and freedom that day. God blessed us with buckets of mercy in order to restore those things again. Understand that sometimes that restoration takes a while. In fact the attacks are still very raw in some ways. But, through grace and mercy there is overcoming and there is restoration and it continues today.
Mercy is necessary for sanctification, the process of making something holy. We look back on that day with great sorrow, and also great respect, for those who were lost, many many heroes among them. One of the greatest miracles there is, is for something good to come out of something bad. It is truly divine. God can and does sanctify trials for our welfare. In short it is not trials that make us better people. Rather trials bring us to our knees, to God, and He makes us better. We were better, we were more unified and charitable to one another after that. To continue the process of sanctification we have to be willing to learn the lessons from that day, those attacks, and the processes we went through for overcoming.
We know our country will continue to experience trials, that is just a reality. But, if we have an attitude of just absorbing the next one, we are not exercising the humility necessary for the gifts that will get us through, grace, mercy and sanctification.
We are facing plenty of trials right now as a nation. We could most certainly use these gifts now. The answer for our trials is the same as it ever was, turn humbly to God.
Monday, September 27, 2010
Tuesday, September 21, 2010
Psychology/Psychiatry and the Left: Part Three
Atrophy. That's the word I think of when it comes to the results of so much of the practices of psychology/psychiatry over the last 100 years. There has been a lessening of personal responsibility and of personal belief in ones own strength to overcome.
Before I get too caught up in the descriptions of what I see that is going wrong I actually want to talk about positive changes, some positive trends. As you could probably guess from my previous posts I'm not a huge fan of diagnosing. I understand the point of it, particularly in providing direction for treatment. But, I just don't like labeling people especially at a young age as being dysfunctional. One of the newer modalities that I really like is positive psychology. Not long ago a new assessment tool was released to help "diagnose" character strength and virtues. I really appreciate this tool and its focus. By using it clinicians can identify with their clients those strengths and attributes that will help that individual overcome the problems they are currently facing. Human beings are equipped with an ability to heal when possible, and to adapt if necessary. That doesn't mean its easy or quick, just that we have the capacity. It also doesn't mean it has to be done alone. Sometimes our greatest strength lies in the supportive people we have around us.
What I like about positive psychology is that it helps individuals understand their own resources and to take charge of their own change. Clients are strengthened in the belief that they can be successful at overcoming because of themselves, not because of a pill or any other expert. My clients who make improvements own that change, and get all the credit for it. I'm humbled to be able to assist in some way, but they are using their own mental muscles to get better. They are then strengthened not just for the current trial but for whatever else might come their way. By virtue of our humanity we will all go through difficult things. It is essential to know we have the ability, the strength, to overcome.
I have also noticed, and am a part of, a rise in the use of "alternative" treatments. They are called "alternative" because they do not fit the medical model. Some examples follow. Eye Movement Desensitization and Reprocessing or EMDR taps into the human systems' ability to process through trauma. Emotional Freedom Techniques or EFT which looks at helping individuals realign their own internal energy. Biofeedback which makes individuals aware of their own physiological processes and than clients learn skills to change their current processes into more healthy patterns. All these modalities have shown a shift in the approach to mental well being, more client focused and client driven. They all help to make a client aware of their own power for wellness. I don't wish to make an endorsement of these modalities as much as to make note of that pattern, the individual is the expert for their own systems and they have the power to heal themselves. I'm encouraged by this shifting, especially when I consider the effects of the medical model and government involvement in the mental health professions.
I love good parents, they are quite simply one of my favorite things. By 'good parent' I don't mean perfect parents. In fact one of the things I tell parents is that it is absolutely essential that they be imperfect, because their kids are, and they have to know you can be imperfect and still be good. Good parents do their utmost to help their children with whatever needs come up.
When parents are struggling with helping their children's emotional state or in their ability to focus often look to experts to help them. We have in society right now an absolute flood of children being medicated for ADHD and Bipolar disorder among other things. I'm troubled by this. I want to make it absolutely clear that I do not hold negative judgments of the parents who are seeking whatever help they can find. To be sure there are some kids who truly do have some positive changes when on medication. Parents who look for ways to help their children are good parents hands down. But, the mental health professionals have not done an adequate job of informing parents of all the statistics of efficacy (or lack thereof) of medication nor of informing parents of the negative realities that can result, such as stunted growth, disregulation of physiological systems and possibly dependence (even life-long) upon medication. Parents have been made to believe that someone else is the expert on raising their children. That is simply not the case.
Parenting is one of the hardest things in the world, but every parent is up to the job. I would encourage parents to look at alternatives to medication if able and to use those God given parenting skills. Absolutely seek support but recognize that you are the expert, the final say on raising your child belongs to you. You've got all the muscles, continue to strengthen and use them.
Now in speaking about government intervention I will be speaking specifically of what I've seen with clients who use Medicare Medicaid and SSI/SSDI for their mental health needs. I have no negative judgment on those individuals who use these programs. They are making use of what is available to them. Most people who use these programs feel they have few or no other options available to them. This is of course by design. The results of using government assistance in the mental health arena are detrimental. As there is a reliance on government for mental health there is a decrease in personal responsibility. That goes not just for clients but for professionals. I cannot stand having insurance dictate to me what treatment should be, and Medicare/Medicaid is the absolute worst at this. The practitioner is made to behave as if the government is the expert, which of course than separates the client even further from the reality that they are in fact themselves the expert and master of their own healing.
From my experience in working with individuals on government assistance for mental health services, I'll offer a few observations. These individuals have a much higher rate of missing scheduled appointments. I'm not sure I know the full extent of what that means, but I think when individuals feel less invested than they also feel less responsible. I've also noticed that efforts are made to maintain disability or financial status. In order to do so clients would tell me they could not seek better employment or make other significant improvements in their lives. If the point of government assistance is to truly assist, why than are individuals feeling and staying so stuck?
Another disturbing aspect I've noticed is government dictation of medication. Medicare, for instance, recently expanded their roles making more people eligible. This increase was not accompanied by a sufficient increase in available funds. At that time the medications that the government program would cover were altered, because of expense. So, I had clients who had become dependent upon a certain medication that suddenly they could not obtain, or afford. Can I say it was more than a little scary, in fact for some the reality was a life or death situation. I was quite frustrated with that development and can see it getting worse as we continue to march towards socialized medicine in the United States. Yuck!!
Now given all that I'll let you in on my ultimate and quite frankly unrealistic goal as a mental health professional: To work myself out of a job. I love my work. I love being able to be a support for others. My guiding principles as a therapist are 1) to have unconditional positive regard for every individual I work with 2) that the very best answers for an individuals problems come from the individuals themselves, my job is to guide them there and 3) that my absolute most basic relationship with my clients is that I'm their sister. The best thing I can do for my brothers and sisters is to be a support and to help them discover their own power and responsibility, their own muscles again.
I ponder again that original question that brought me into writing this three part post. Why would Communists want to take over the field of psychiatry? I think in the end it comes down to making people feel and believe that someone/something else is and/or should be in control and is the expert in keeping them safe. As a mental health professional I say phooey! Parents have the best answers for their kids, individuals have the best answers within themselves. The power really is inherent in the people.
I of course also believe strongly in God and that He has blessed us with the abilities to heal and grow and change. He has provided ways for all of that to occur. Healing may include social support, therapy, it may even include medication (just be educated on its use). I would never presume to know all of the right answers for each individual, but I do believe each individual can know them for themselves. I start out each work day on my knees, I know I need His inspiration. He will guide us all to the best practices and solutions. He gave us the muscles, He also gave us the tools to build them up.
Thanks so much for taking the time to read all of this. I know it was considerably longer than any thing else I've written. I just felt it was important to find out for myself and than to share with others what my own profession has been up to. Truth rocks, and so does sharing it.
God Bless,
Sarah Emily Jordan, MA, MA, LMHC
Before I get too caught up in the descriptions of what I see that is going wrong I actually want to talk about positive changes, some positive trends. As you could probably guess from my previous posts I'm not a huge fan of diagnosing. I understand the point of it, particularly in providing direction for treatment. But, I just don't like labeling people especially at a young age as being dysfunctional. One of the newer modalities that I really like is positive psychology. Not long ago a new assessment tool was released to help "diagnose" character strength and virtues. I really appreciate this tool and its focus. By using it clinicians can identify with their clients those strengths and attributes that will help that individual overcome the problems they are currently facing. Human beings are equipped with an ability to heal when possible, and to adapt if necessary. That doesn't mean its easy or quick, just that we have the capacity. It also doesn't mean it has to be done alone. Sometimes our greatest strength lies in the supportive people we have around us.
What I like about positive psychology is that it helps individuals understand their own resources and to take charge of their own change. Clients are strengthened in the belief that they can be successful at overcoming because of themselves, not because of a pill or any other expert. My clients who make improvements own that change, and get all the credit for it. I'm humbled to be able to assist in some way, but they are using their own mental muscles to get better. They are then strengthened not just for the current trial but for whatever else might come their way. By virtue of our humanity we will all go through difficult things. It is essential to know we have the ability, the strength, to overcome.
I have also noticed, and am a part of, a rise in the use of "alternative" treatments. They are called "alternative" because they do not fit the medical model. Some examples follow. Eye Movement Desensitization and Reprocessing or EMDR taps into the human systems' ability to process through trauma. Emotional Freedom Techniques or EFT which looks at helping individuals realign their own internal energy. Biofeedback which makes individuals aware of their own physiological processes and than clients learn skills to change their current processes into more healthy patterns. All these modalities have shown a shift in the approach to mental well being, more client focused and client driven. They all help to make a client aware of their own power for wellness. I don't wish to make an endorsement of these modalities as much as to make note of that pattern, the individual is the expert for their own systems and they have the power to heal themselves. I'm encouraged by this shifting, especially when I consider the effects of the medical model and government involvement in the mental health professions.
I love good parents, they are quite simply one of my favorite things. By 'good parent' I don't mean perfect parents. In fact one of the things I tell parents is that it is absolutely essential that they be imperfect, because their kids are, and they have to know you can be imperfect and still be good. Good parents do their utmost to help their children with whatever needs come up.
When parents are struggling with helping their children's emotional state or in their ability to focus often look to experts to help them. We have in society right now an absolute flood of children being medicated for ADHD and Bipolar disorder among other things. I'm troubled by this. I want to make it absolutely clear that I do not hold negative judgments of the parents who are seeking whatever help they can find. To be sure there are some kids who truly do have some positive changes when on medication. Parents who look for ways to help their children are good parents hands down. But, the mental health professionals have not done an adequate job of informing parents of all the statistics of efficacy (or lack thereof) of medication nor of informing parents of the negative realities that can result, such as stunted growth, disregulation of physiological systems and possibly dependence (even life-long) upon medication. Parents have been made to believe that someone else is the expert on raising their children. That is simply not the case.
Parenting is one of the hardest things in the world, but every parent is up to the job. I would encourage parents to look at alternatives to medication if able and to use those God given parenting skills. Absolutely seek support but recognize that you are the expert, the final say on raising your child belongs to you. You've got all the muscles, continue to strengthen and use them.
Now in speaking about government intervention I will be speaking specifically of what I've seen with clients who use Medicare Medicaid and SSI/SSDI for their mental health needs. I have no negative judgment on those individuals who use these programs. They are making use of what is available to them. Most people who use these programs feel they have few or no other options available to them. This is of course by design. The results of using government assistance in the mental health arena are detrimental. As there is a reliance on government for mental health there is a decrease in personal responsibility. That goes not just for clients but for professionals. I cannot stand having insurance dictate to me what treatment should be, and Medicare/Medicaid is the absolute worst at this. The practitioner is made to behave as if the government is the expert, which of course than separates the client even further from the reality that they are in fact themselves the expert and master of their own healing.
From my experience in working with individuals on government assistance for mental health services, I'll offer a few observations. These individuals have a much higher rate of missing scheduled appointments. I'm not sure I know the full extent of what that means, but I think when individuals feel less invested than they also feel less responsible. I've also noticed that efforts are made to maintain disability or financial status. In order to do so clients would tell me they could not seek better employment or make other significant improvements in their lives. If the point of government assistance is to truly assist, why than are individuals feeling and staying so stuck?
Another disturbing aspect I've noticed is government dictation of medication. Medicare, for instance, recently expanded their roles making more people eligible. This increase was not accompanied by a sufficient increase in available funds. At that time the medications that the government program would cover were altered, because of expense. So, I had clients who had become dependent upon a certain medication that suddenly they could not obtain, or afford. Can I say it was more than a little scary, in fact for some the reality was a life or death situation. I was quite frustrated with that development and can see it getting worse as we continue to march towards socialized medicine in the United States. Yuck!!
Now given all that I'll let you in on my ultimate and quite frankly unrealistic goal as a mental health professional: To work myself out of a job. I love my work. I love being able to be a support for others. My guiding principles as a therapist are 1) to have unconditional positive regard for every individual I work with 2) that the very best answers for an individuals problems come from the individuals themselves, my job is to guide them there and 3) that my absolute most basic relationship with my clients is that I'm their sister. The best thing I can do for my brothers and sisters is to be a support and to help them discover their own power and responsibility, their own muscles again.
I ponder again that original question that brought me into writing this three part post. Why would Communists want to take over the field of psychiatry? I think in the end it comes down to making people feel and believe that someone/something else is and/or should be in control and is the expert in keeping them safe. As a mental health professional I say phooey! Parents have the best answers for their kids, individuals have the best answers within themselves. The power really is inherent in the people.
I of course also believe strongly in God and that He has blessed us with the abilities to heal and grow and change. He has provided ways for all of that to occur. Healing may include social support, therapy, it may even include medication (just be educated on its use). I would never presume to know all of the right answers for each individual, but I do believe each individual can know them for themselves. I start out each work day on my knees, I know I need His inspiration. He will guide us all to the best practices and solutions. He gave us the muscles, He also gave us the tools to build them up.
Thanks so much for taking the time to read all of this. I know it was considerably longer than any thing else I've written. I just felt it was important to find out for myself and than to share with others what my own profession has been up to. Truth rocks, and so does sharing it.
God Bless,
Sarah Emily Jordan, MA, MA, LMHC
Tuesday, September 7, 2010
Psychology/Psychiatry and the Left: Part Two
History
So, today's discussion will be about drugs and docs, the former first. In doing so I think it is important to take at least a brief look at the history of the Food and Drug Administration (FDA), the government agency charged with the regulation of drugs. The FDA has its roots in the Pure Food and Drug Act of 1906. This act was signed by one of Progressivisms headliners Theodore Roosevelt. But, there is another figure who should be included in the discussion of the 1906 Act. His name is Upton Sinclair, and he was an avowed Socialist. The webpage for the FDA mentions Mr. Sinclair in its history.
Upton Sinclair wrote a book called The Jungle , his purpose in doing so was to convince the American public of the injustice of the Capitalist system. The book details some of the rather disgusting conditions of a meat packing plant. Instead of turning to Socialism the American public was simply grossed out. Sinclair famously stated "I aimed for America's heart and hit them in the stomach." Indeed. Sinclair was a very active Socialist in fact running for political office in California on the Socialist ticket with little success. He had a little more success running on the End Poverty in California (EPIC) ticket. His goal was the same for both tickets. He said about his EPIC run "The American people will take Socialism but they won't take the label. I certainly proved it in the case of EPIC. . .I think we simply have to recognize the fact that our enemies have succeeded in spreading the Big Lie. there is no use attacking if by a front attack. It is better to outflank them." Typical leftist m.o. is to change the name but not the goal.
I still have more studying to do before I form a complete opinion on the FDA, but just looking at the origins, and the leftists who influenced it certainly gives me pause and is a little off putting to say the least.
Psychopharmacology
Much of the information in this section comes from an eye opening book by Robert Whitaker titled Anatomy of an Epidemic
Drugs for mental health issues were first introduced in the mid 20th century. It was at this time that the Psychological fields were floundering a bit in trying to determine which direction and theoretical orientation to commit to. The model that won out was a medical one. A medical model means diagnosing and than treatment. Treatment in medicine of course includes well medicine.
Some important historical milestones include the 1938 Food and Drug Cosmetics Act, Whitaker explains on pp. 55-56 "The law required drug firms to prove to the Food and Drug Administration that their products were safe (they still did not have to prove that their drugs were helpful), and in its wake, the FDA began decreeing that certain medicines could be purchased only with a doctor's prescription," Also in 1946Congress passed the National Mental Health Act which meant that the government could sponsor research in the mental health field, providing grants. The National Institute of Mental Health (NIMH) was established three years later to oversee the reform. Yipee! The left specializes in regulation, and the mental health field gets to participate in that big time.
In accordance with the medical model for mental health in 1952 the Diagnostic Statistical Manuel (DSM) for mental disorders was published. The DSM and the subsequent revisions became the staple for diagnosing in the mental health arena. I must say my hardbound copy of the current DSM IV-TR has been a joy and is quite a useful doorstop among other things. It certainly is interesting to consider the various diagnoses that have been added and removed from the DSM. But, for now it is important to note that it originates from the medical model and is relied on for much of mental health treatment.
Alright so we see some of the groundwork that had been laid out, let's take a look at some of the drugs. In 1954 the FDA gave its stamp of approval for a drug called Thorazine. It was initially billed as a tranquilizer but through a metamorphosis which included government and media became a disease fighting pill rather than just a tonic. Shortly after Thorazine's introduction a new "happy" pill called Miltown was also introduced with promises of Nirvana (the propaganda for this pill included a Salvador Dali exhibition for which he was paid quite well). Ch. 4 in Whitaker's book gives these details and more about these 2 drugs. Miltown became a predecessor for more modern drugs such as Prozac. Thorazine was given all sorts of credit for success in decreasing the amount and time of hospitalizations for individuals diagnosed with schizophrenia. But, Whitaker on pp. 92-94 uses hard facts to refute that notion. Here are some highlights. Prior to the introduction of Thorazine people admitted for a first schizophrenic episode in the 40's and 50's 75% were recovered enough in the first three years to return to the community, the majority within the 1st year. Returning to the community meant back to family and even work. California records from 1956 after Thorazine's introduction found that 85% who were not prescribed medication were discharged within 18 months. Those treated with the drug had a lower (74%) rate of discharge. So, why does Thorazine get credit as some breakthrough drug for schizophrenia patients being discharged from hospitals at an increased rate?
Well, credit was given to Thorazine when in reality it lay elsewhere. As Whitaker explains on p. 93, "The 1965 Medicare and Medicaid legislation provided federal subsidies for nursing home care, but no such subsidy for care in state mental hospitals, and so the states, seeking to save money naturally began shipping their chronic patients to nursing homes. That was when the census in state mental hospitals began to noticeably drop rather than in 1955, where Thorazine was introduced."
Well, blow me over with a feather, a government program caused a decrease in the appropriate care a certain population would receive? Whitaker goes into great detail on a number of diagnosis and their preferred medications. I highly recommend reading his book. Of particular note are the absolute explosions of the diagnosis of ADHD and Bipolar disorder. This is a disturbing pattern that has long been an irritant for me. While I believe that there can be some benefits from medications, I have felt strongly for some time that we are overdiagnosing and overmedicating. Whitaker's take down of Prozac is particularly well done.
Whitaker presents some other significant facts that I wish to highlight here. Social Security and Disability payments from the government are programs from the ideological left. From p. 250 Major Depression is the leading cause of disability in the US for people 15-40 year olds. With Bipolar Disorder 85% used to recover from this previously uncommon illness now only about 1/3 function well. In 1955 46,000 people were hospitalized with Anxiety and Manic Depressive (Bipolar) illness, today 40 million people have one of these diagnosis. More than 1.5 million people are on SSI or SSDI and that number is increasing at a rate of 250 children and 850 adults daily. I suppose it is possible that we are just struggling that much as a society, but it certainly begs for more explanation than that.
I'm just presenting facts here, and as I've stated before coming to any real conclusions will require much more study. A friend recently directed me to a book titled Manufacture of Madness by Thomas Szasz. But, I have to say that what I've found so far is in a word disconcerting. Given that psychology has been used in the past to justify the eugenic process of weeding out undesirables can you blame me for wondering if it continues to be used so now? As my boss Dr. Thurber pointed out to me "why put them in camps or sterilize them when you can just imprison them in their own homes."
Experts
Now one more note about the medical model. Doctors became the experts. I want to re-iterate here that I know some fine people who are psychiatrists and I do not wish to disparage them in any way. But, I do wish to point out that the model and orientation of psychiatry is driven by medication and by psychiatrists being the overseers of it.
One expert psychiatrist I want to highlight is Dr. Benjamin Spock. In doing so I'd like to state that I do not necessarily disagree with all of his assertions. But, he is one of the most famous psychiatrists in recent history. He became a go to expert on parenting. But, Dr. Spock also was quite politically active. He was a part of a movement called the New Left. Sounds inspiring no? It was a coalition of several leftists organizations. Dr. Spock advocated strongly for the passage of medicare. He was a vocal opponent of the Vietnam War. In 1972 Dr. Spock was the presidential candidate of the People's Party. Dr. Spock's platform called for free medical care, legalizing abortion and marijuana and guaranteed minimum income for families. I say as a sidenote that I find it a little shocking that a man known as a huge advocate for children was also a huge advocate for abortion. Again I don't disagree with all of Dr. Spock's techniques on parenting, but it is an uncomfortable reality that politically he was so far to the left. To refer back to part 1, why would taking over Psychiatry be a Communist goal? Well, I don't yet know the full answer to that, but to note that one of Psychiatry's biggest names was on the Communist side of things certainly says something.
The concluding post on the subject will be my personal perspective in working in the mental health field.
So, today's discussion will be about drugs and docs, the former first. In doing so I think it is important to take at least a brief look at the history of the Food and Drug Administration (FDA), the government agency charged with the regulation of drugs. The FDA has its roots in the Pure Food and Drug Act of 1906. This act was signed by one of Progressivisms headliners Theodore Roosevelt. But, there is another figure who should be included in the discussion of the 1906 Act. His name is Upton Sinclair, and he was an avowed Socialist. The webpage for the FDA mentions Mr. Sinclair in its history.
Upton Sinclair wrote a book called The Jungle , his purpose in doing so was to convince the American public of the injustice of the Capitalist system. The book details some of the rather disgusting conditions of a meat packing plant. Instead of turning to Socialism the American public was simply grossed out. Sinclair famously stated "I aimed for America's heart and hit them in the stomach." Indeed. Sinclair was a very active Socialist in fact running for political office in California on the Socialist ticket with little success. He had a little more success running on the End Poverty in California (EPIC) ticket. His goal was the same for both tickets. He said about his EPIC run "The American people will take Socialism but they won't take the label. I certainly proved it in the case of EPIC. . .I think we simply have to recognize the fact that our enemies have succeeded in spreading the Big Lie. there is no use attacking if by a front attack. It is better to outflank them." Typical leftist m.o. is to change the name but not the goal.
I still have more studying to do before I form a complete opinion on the FDA, but just looking at the origins, and the leftists who influenced it certainly gives me pause and is a little off putting to say the least.
Psychopharmacology
Much of the information in this section comes from an eye opening book by Robert Whitaker titled Anatomy of an Epidemic
Drugs for mental health issues were first introduced in the mid 20th century. It was at this time that the Psychological fields were floundering a bit in trying to determine which direction and theoretical orientation to commit to. The model that won out was a medical one. A medical model means diagnosing and than treatment. Treatment in medicine of course includes well medicine.
Some important historical milestones include the 1938 Food and Drug Cosmetics Act, Whitaker explains on pp. 55-56 "The law required drug firms to prove to the Food and Drug Administration that their products were safe (they still did not have to prove that their drugs were helpful), and in its wake, the FDA began decreeing that certain medicines could be purchased only with a doctor's prescription," Also in 1946Congress passed the National Mental Health Act which meant that the government could sponsor research in the mental health field, providing grants. The National Institute of Mental Health (NIMH) was established three years later to oversee the reform. Yipee! The left specializes in regulation, and the mental health field gets to participate in that big time.
In accordance with the medical model for mental health in 1952 the Diagnostic Statistical Manuel (DSM) for mental disorders was published. The DSM and the subsequent revisions became the staple for diagnosing in the mental health arena. I must say my hardbound copy of the current DSM IV-TR has been a joy and is quite a useful doorstop among other things. It certainly is interesting to consider the various diagnoses that have been added and removed from the DSM. But, for now it is important to note that it originates from the medical model and is relied on for much of mental health treatment.
Alright so we see some of the groundwork that had been laid out, let's take a look at some of the drugs. In 1954 the FDA gave its stamp of approval for a drug called Thorazine. It was initially billed as a tranquilizer but through a metamorphosis which included government and media became a disease fighting pill rather than just a tonic. Shortly after Thorazine's introduction a new "happy" pill called Miltown was also introduced with promises of Nirvana (the propaganda for this pill included a Salvador Dali exhibition for which he was paid quite well). Ch. 4 in Whitaker's book gives these details and more about these 2 drugs. Miltown became a predecessor for more modern drugs such as Prozac. Thorazine was given all sorts of credit for success in decreasing the amount and time of hospitalizations for individuals diagnosed with schizophrenia. But, Whitaker on pp. 92-94 uses hard facts to refute that notion. Here are some highlights. Prior to the introduction of Thorazine people admitted for a first schizophrenic episode in the 40's and 50's 75% were recovered enough in the first three years to return to the community, the majority within the 1st year. Returning to the community meant back to family and even work. California records from 1956 after Thorazine's introduction found that 85% who were not prescribed medication were discharged within 18 months. Those treated with the drug had a lower (74%) rate of discharge. So, why does Thorazine get credit as some breakthrough drug for schizophrenia patients being discharged from hospitals at an increased rate?
Well, credit was given to Thorazine when in reality it lay elsewhere. As Whitaker explains on p. 93, "The 1965 Medicare and Medicaid legislation provided federal subsidies for nursing home care, but no such subsidy for care in state mental hospitals, and so the states, seeking to save money naturally began shipping their chronic patients to nursing homes. That was when the census in state mental hospitals began to noticeably drop rather than in 1955, where Thorazine was introduced."
Well, blow me over with a feather, a government program caused a decrease in the appropriate care a certain population would receive? Whitaker goes into great detail on a number of diagnosis and their preferred medications. I highly recommend reading his book. Of particular note are the absolute explosions of the diagnosis of ADHD and Bipolar disorder. This is a disturbing pattern that has long been an irritant for me. While I believe that there can be some benefits from medications, I have felt strongly for some time that we are overdiagnosing and overmedicating. Whitaker's take down of Prozac is particularly well done.
Whitaker presents some other significant facts that I wish to highlight here. Social Security and Disability payments from the government are programs from the ideological left. From p. 250 Major Depression is the leading cause of disability in the US for people 15-40 year olds. With Bipolar Disorder 85% used to recover from this previously uncommon illness now only about 1/3 function well. In 1955 46,000 people were hospitalized with Anxiety and Manic Depressive (Bipolar) illness, today 40 million people have one of these diagnosis. More than 1.5 million people are on SSI or SSDI and that number is increasing at a rate of 250 children and 850 adults daily. I suppose it is possible that we are just struggling that much as a society, but it certainly begs for more explanation than that.
I'm just presenting facts here, and as I've stated before coming to any real conclusions will require much more study. A friend recently directed me to a book titled Manufacture of Madness by Thomas Szasz. But, I have to say that what I've found so far is in a word disconcerting. Given that psychology has been used in the past to justify the eugenic process of weeding out undesirables can you blame me for wondering if it continues to be used so now? As my boss Dr. Thurber pointed out to me "why put them in camps or sterilize them when you can just imprison them in their own homes."
Experts
Now one more note about the medical model. Doctors became the experts. I want to re-iterate here that I know some fine people who are psychiatrists and I do not wish to disparage them in any way. But, I do wish to point out that the model and orientation of psychiatry is driven by medication and by psychiatrists being the overseers of it.
One expert psychiatrist I want to highlight is Dr. Benjamin Spock. In doing so I'd like to state that I do not necessarily disagree with all of his assertions. But, he is one of the most famous psychiatrists in recent history. He became a go to expert on parenting. But, Dr. Spock also was quite politically active. He was a part of a movement called the New Left. Sounds inspiring no? It was a coalition of several leftists organizations. Dr. Spock advocated strongly for the passage of medicare. He was a vocal opponent of the Vietnam War. In 1972 Dr. Spock was the presidential candidate of the People's Party. Dr. Spock's platform called for free medical care, legalizing abortion and marijuana and guaranteed minimum income for families. I say as a sidenote that I find it a little shocking that a man known as a huge advocate for children was also a huge advocate for abortion. Again I don't disagree with all of Dr. Spock's techniques on parenting, but it is an uncomfortable reality that politically he was so far to the left. To refer back to part 1, why would taking over Psychiatry be a Communist goal? Well, I don't yet know the full answer to that, but to note that one of Psychiatry's biggest names was on the Communist side of things certainly says something.
The concluding post on the subject will be my personal perspective in working in the mental health field.
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