This is Day 17 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982. (More info here.) Today we are talking about Principle 17.
Principle 17 reads in full as follows:
We oppose the medical model of "mental illness" because it dupes the public into seeking or accepting "voluntary" treatment by fostering the notion that fundamental human problems, whether personal or social, can be solved by psychiatric/ medical means.
Basic Rationale
By Tina Marie
The principle
about
which I write today, is a delicate matter that
frequently
raises cries of outrage by users of psychiatry
who feel that anyone who rejects the medical model of "mental illness" as based on valid medical diagnoses of a biological nature, is denying the validity of their suffering. So, I want to be clear to readers who use psychiatric services and those taking medications that (you feel) provide a sense of relief from your suffering...the perspective I am putting forth in support of this principle does absolutely nothing to invalidate your pain. And no, my views do not "stigmatize" you. They do the opposite. I want to make it clear that, I too, once shared your belief system. I too, spent many, many years cycling in and out of psychiatric units, taking enormous quantities of psychiatric drugs, seeing and feeling treatment results that appeared to confirm that my brain was biologically diseased by "bipolar disorder". My understanding is personal.
I was "voluntarily" sucked into the psychiatric system as a severely traumatized teen, where I remained trapped well into young-adulthood, hospitalized about 30 times, tried on nearly every psychiatric drug available, threatened with ECT, threatened with long-term psychiatric incarceration. You cannot begin to tell me that I just don't know how badly you or your family member suffers. I know in my heart, that even while you may embrace the medical model of "mental illness", somewhere underneath that lies the despair of believing oneself to be biologically broken and capable only of managing your "illness". That construct alone brings its own grief. But that's a topic for another time.
I was "voluntarily" sucked into the psychiatric system as a severely traumatized teen, where I remained trapped well into young-adulthood, hospitalized about 30 times, tried on nearly every psychiatric drug available, threatened with ECT, threatened with long-term psychiatric incarceration. You cannot begin to tell me that I just don't know how badly you or your family member suffers. I know in my heart, that even while you may embrace the medical model of "mental illness", somewhere underneath that lies the despair of believing oneself to be biologically broken and capable only of managing your "illness". That construct alone brings its own grief. But that's a topic for another time.
Although the medical model almost always fails to acknowledge the clear role that trauma plays in the vast majority of experiences that bring the designated patient into the psychiatric system, it continues, despite the lack of empirical validation, to be the model most embraced by users of psychiatry, their families and treatment providers. When trauma is, on occasion, acknowledged for its role in extreme distress, it is usually couched in terms of nothing more than a "trigger" for the onset of "the disease", which we are expected to understand as a "brain disease" that will then require life-long "treatment" with psychiatric drugs, ECT, incarceration in psychiatric facilities, monitoring in the community and any other intervention deemed necessary by the psychiatric "treatment" providers. Many survivors of psychiatry discovered this dragnet after "voluntarily" entering the psychiatric system.
Why does the Declaration of Principles place the word, voluntary, in quotes? Why do I put the word into quotes?
I'll ask you to ponder whether your willingness to seek psychiatric treatment, or your agreement to accept psychiatric treatment can be truly voluntary if you've been misinformed, or not informed at all about the risks associated with the treatment, the efficacy of the proposed treatment, and the long term outcomes of that treatment? Can it be truly voluntary if you were never offered other models of distress, other models for recovery, or lacked access to other, more (personally) desirable options for support and healing that you might have tried before "voluntarily" agreeing to accept psychiatric treatment based on the medical model of "mental illness"?
What if your doctor had said, "I don't know what's really causing your distress, but these chemicals might dull your pain and your joy as well. We don't know what the treatment might do to you in the long-term, or how it will affect your brain and body, but we have seen some very dangerous adverse effects in the clinical trials. We're also noticing that some of the chemicals cause atrophy in the pre-frontal cortex, but we don't intend to mention that to the public for at least another 20 years. These chemicals may cause diabetes and morbid obesity, but diabetes and morbid obesity are better than being crazy, right? Would you like to try this treatment?"
What if your doctor had said, "I don't know what's really causing your distress, but these chemicals might dull your pain and your joy as well. We don't know what the treatment might do to you in the long-term, or how it will affect your brain and body, but we have seen some very dangerous adverse effects in the clinical trials. We're also noticing that some of the chemicals cause atrophy in the pre-frontal cortex, but we don't intend to mention that to the public for at least another 20 years. These chemicals may cause diabetes and morbid obesity, but diabetes and morbid obesity are better than being crazy, right? Would you like to try this treatment?"
Would you volunteer to give it a go?
Lack of informed consent does not and cannot lead to a voluntary agreement to psychiatric treatment even if you've walked on your own into the psychiatrist's office or the hospital and asked for treatment.
For nearly three decades now, the medical model of "mental illness" has been beamed into our homes via pharmaceutical ads on TV, news broadcasts and talk shows, and more recently on that timeline, the internet. Everyone "knows" that "mental illness is just like diabetes". Right? Only an ignoramus would not know this "fact" by now. Not one discussion of "mental illness" by laypeople takes place without the (scientifically dispelled) assertion of the "chemical imbalance" theory as medical fact. You hear it all the time...people claiming that psychiatric drugs treat "mental illness" in the same way insulin treats diabetes. But there's no medical evidence to support that notion. Retaining excess amounts of serotonin in your neuronal synapses via the ingestion of Sertraline HCL does not treat the source of your "depressive disorder". If it makes you feel better, that's a separate matter. But your decrease in psychic pain doesn't validate the medical claims that were put forth so heavily in the mid-1990s via heavy-hitting direct-to-consumer pharmaceutical advertising. SSRIs don't address emotional distress or chemical "deficiencies" any more so than alcohol makes a person feel better by treating an ETOH "deficiency".
You may recall the original Zoloft commercial from the early to mid 1990s For my generation and those that follow, this is where our indoctrination really began. Prozac had already been on the market for a few years, but this little cartoon was advertising genius. Pfizer gave us a non-threatening, empathy-inducing, sad blob with which to relate and explained to us in very simple terms that if we feel badly and are having trouble enjoying things we used to enjoy, we have SYMPTOMS OF DEPRESSION, A SERIOUS MEDICAL CONDITION. It doesn't tell us that those "symptoms" are also part of the normal range of human emotions and behaviors, and it never suggests that there could be reasons other than A SERIOUS MEDICAL CONDITION that is at the root of our suffering. No, what it does is go on to explain that, "The cause of depression is unknown", and it "It may be due to a chemical imbalance"...cue the cartoon neurons spilling cartoon chemical molecules into their cartoon synapses. That's the psychiatric "science" on which the younger generations of users and survivors of psychiatry have cut their teeth. Many of us were small children, or not born yet at the time the Declaration of Principles were outlined, yet the explosion of pharmaceutical and psychiatric collusion in direct-to-consumer advertising overshadowed the warnings inherent in these principles. What most of our society now takes for granted as valid, scientifically-based medical fact was nothing more than a highly successful advertising ploy.
But what if you asked for it?
Let's examine treatment consent by a true medical standard: If your cardiologist wants to perform a procedure on you that might shorten your lifespan by 25-32 years, would you expect to be told that was a potential adverse effect? Of course, you would. And any cardiologist performing a procedure that might contribute to, or directly cause your death, must disclose the risks to you and obtain your signed consent. If you still agree to the procedure after being informed of the risks vs the benefits, then you are making a voluntary choice. If, as a cardiology patient, you refuse the proposed procedure, there won't be a team of nurses, techs and doctors coming to your room to take you down, strip your clothing, inject you and carry you off for a heart operation "for your own good".
For the psychiatric "patient" refusing "treatment", the outcome is often a show of force by "treatment" providers, whether by way of coercion and threats, actual physical force, or even incarceration in a psychiatric facility. It's important for the uninitiated to understand, that even if you walk into the emergency department or call 911 and go "voluntarily" for psychiatric treatment, once there, you have forfeited many of your civil rights. Even if you asked for the "treatment", you will be viewed as mentally ill and less than capable of rational decision-making.
For the psychiatric "patient" refusing "treatment", the outcome is often a show of force by "treatment" providers, whether by way of coercion and threats, actual physical force, or even incarceration in a psychiatric facility. It's important for the uninitiated to understand, that even if you walk into the emergency department or call 911 and go "voluntarily" for psychiatric treatment, once there, you have forfeited many of your civil rights. Even if you asked for the "treatment", you will be viewed as mentally ill and less than capable of rational decision-making.
I want to get into the underlying social problems that make this principle so crucial to reforming the ways we, as a society, view and approach people experiencing extreme states. I want to talk about how vulnerable we were and are to accepting and embracing the medical model, why this dysfunctional, ineffective model persists in dominating the discourse around "mental illness" and the approaches we take as a society to helping people in distress. But I also want to talk about how and why many users of psychiatry and their families remain deeply wedded to these constructs that have been falsely put forth as medical facts.
I'm going to lead into this next part of discussion by briefly touching on my own history and induction into the psychiatric system:
Like many other users and survivors of psychiatry, I survived long-term childhood trauma. By the time my abuser left our household, I was 16, already very broken, suicidal, left with the enormous responsibility of caring for two younger siblings while our custodial parent worked 65 hours week, including overnights, and had absolutely no idea that I was a trauma survivor, or that anything about my family or living situation, or the things I'd endured for 16 years to that point were not healthy, not normal and were extremely abusive. I would (and did) tell people I had no reason to be distressed. I just was. I "knew" I was defective, and that it had to be some fault within me that I would feel terrified and hopeless and unable to function. I was totally and primed and ready to hear The Good News About Depression:Cures and Treatments in the New Age of Psychiatry. I spent my babysitting money to buy it, and I was sold. There was my answer. I had a medical problem, and medication can make it better. That explained it. Next, I needed to convince my dad that I needed to see a psychiatrist for the magic bullet. It wasn't hard. Families love this model too.
Like many other users and survivors of psychiatry, I survived long-term childhood trauma. By the time my abuser left our household, I was 16, already very broken, suicidal, left with the enormous responsibility of caring for two younger siblings while our custodial parent worked 65 hours week, including overnights, and had absolutely no idea that I was a trauma survivor, or that anything about my family or living situation, or the things I'd endured for 16 years to that point were not healthy, not normal and were extremely abusive. I would (and did) tell people I had no reason to be distressed. I just was. I "knew" I was defective, and that it had to be some fault within me that I would feel terrified and hopeless and unable to function. I was totally and primed and ready to hear The Good News About Depression:Cures and Treatments in the New Age of Psychiatry. I spent my babysitting money to buy it, and I was sold. There was my answer. I had a medical problem, and medication can make it better. That explained it. Next, I needed to convince my dad that I needed to see a psychiatrist for the magic bullet. It wasn't hard. Families love this model too.
You see, it wasn't anyone's "fault" that I was abused and neglected and pretty relentlessly tormented by the violent parent that took off on my family the Autumn after the summer of my 16th birthday. No, I was just dealing with a medical problem. It was okay with me that there was no real reason for my suffering other than this mysterious medical condition known as "depression". It was okay with me, mainly because I thought my family was "normal" and that I was the problem. I had everything I needed and more. I lived in a 5 bedroom house with a swimming pool on a half acre in a rural suburb of upstate NY just minutes from the lake. I had my own room. I had my own car even though I didn't have my driver's license. My dad had a great job at a Fortune 500 company. We had health insurance, and I had access to health care!
That access to health care made the whole downward spiral possible. Yes, I was "willing and able to access treatment". For, I had heard the Good News! (first about Jesus Christ and then about psychiatry) And no one ever told me that there might be some reason other than a medical issue, or that maybe I didn't need medication, (or didn't need medication forever and ever, amen.) I walked into a psychiatrist's office by appointment and walked out with a prescription and samples of Prozac to start that evening. The psychiatrist had run down a "symptom" list first, but never inquired about potential causes. I simply had a "disease" called "Depression", because I felt bad for more than two weeks, and this all happens for "unknown reasons" that may be due to a "chemical imbalance". Hooray for modern medicine!
That access to health care made the whole downward spiral possible. Yes, I was "willing and able to access treatment". For, I had heard the Good News! (first about Jesus Christ and then about psychiatry) And no one ever told me that there might be some reason other than a medical issue, or that maybe I didn't need medication, (or didn't need medication forever and ever, amen.) I walked into a psychiatrist's office by appointment and walked out with a prescription and samples of Prozac to start that evening. The psychiatrist had run down a "symptom" list first, but never inquired about potential causes. I simply had a "disease" called "Depression", because I felt bad for more than two weeks, and this all happens for "unknown reasons" that may be due to a "chemical imbalance". Hooray for modern medicine!
Within a few days, I attempted suicide with many more attempts to follow over the years to come during my time as a professional psychiatric patient. The attempt was seen as part of the "disease", although; we now know that SSRIs are highly dangerous for children and adolescents, a warning that was already being heeded in the UK. That was the beginning of my decline, and a history that's far too detailed to address here.
The question I had for the first couple of years afterward was, Did I go into that treatment voluntarily? I now say no. No, I did not. I was duped, like so many users and survivors of psychiatry have been duped. Families have been duped. They seek treatment for their beloved children thinking they are doing what is right. Other families seek to force psychiatric control and "treatment" on family members as a way to avoid culpability for abuse, to gain financial control, to gain custody and for many other self-serving purposes. It's easy to be angry at those who intentionally inflict psychiatric labels and treatment for their own gains. It's harder to blame those families who have also been duped, but we still need to look at the motivations of those families to wholeheartedly embrace the medical model without question.
The question I had for the first couple of years afterward was, Did I go into that treatment voluntarily? I now say no. No, I did not. I was duped, like so many users and survivors of psychiatry have been duped. Families have been duped. They seek treatment for their beloved children thinking they are doing what is right. Other families seek to force psychiatric control and "treatment" on family members as a way to avoid culpability for abuse, to gain financial control, to gain custody and for many other self-serving purposes. It's easy to be angry at those who intentionally inflict psychiatric labels and treatment for their own gains. It's harder to blame those families who have also been duped, but we still need to look at the motivations of those families to wholeheartedly embrace the medical model without question.
I'm reminded of an instance during my second psychiatric incarceration on a general hospital psychiatric unit at age 21, when an elderly mother labeled with "schizophrenia" spoke about her guilt as a parent and shared that her adult son was diagnosed with mental illness that she attributed to her self-described abusive parenting. Here was a parent admitting abuse, saying that she recognized her treatment of her adult child caused him severe mental health problems. Well-informed mental patient that I was, I pointed out to the mom that it couldn't have been anything she did to her son. Mental illness is genetic. It runs in families, and it wasn't her fault. No ma'am! I also remember the deep relief that spread across her face. Her bodily tension released. She smiled and thanked me profusely. Staff looked at me approvingly. I knew I'd done well. To this day, I feel guilt that I might have eliminated any chance that she and her son could work through what had happened to him, so that he might heal. She was also suffering deeply, and we were there together trying to figure things out. I don't know what I would say if placed in that position today, but it would be very different and probably not much of an immediate relief.
In the American culture of rugged individualism, when you're tired and broken and need and want help, you have the option to "legitimize" your pain with a medical "diagnosis", and this is a comfort to people. I know this "legitimization" via the doctor's excuse is a compelling factor to people in distress. To treat our human problems, both social and personal, as a medical problem in need of medical treatment is enticing on multiple levels. But beyond that, this medicalization of distress has become mandatory for the vast majority of people seeking mental health care and support systems that are often only affordable by way of health insurance.
I get it when users of psychiatry and family members want to, or need to embrace the suffering as a medical problem, to take pills, go to programs and to fall into step in a regime that rewards compliance in a way that mommy or daddy would never have approved of you.The simple act of complying, or even appearing to comply with psychiatric "treatment" can reap huge rewards for the designated patient in the family, often also referred to as the family scapegoat. When families report "improvement", what's really taking place?
I get it when users of psychiatry and family members want to, or need to embrace the suffering as a medical problem, to take pills, go to programs and to fall into step in a regime that rewards compliance in a way that mommy or daddy would never have approved of you.The simple act of complying, or even appearing to comply with psychiatric "treatment" can reap huge rewards for the designated patient in the family, often also referred to as the family scapegoat. When families report "improvement", what's really taking place?
Aside from being released from the (unreasonable) socially-dictated expectation of taking personal responsibility for pulling oneself up by the bootstraps, the medical solution continues to absolve our society from working to resolve the social problems of poverty, abuse, poor nutrition, inadequate education and homelessness to name a few. The medical model places human distress generated by all those social and personal problems into a dirty, little bundle, labels it medical and ships the bundle off for sanitizing by a system that reaps massive financial profits. We don't even need to talk about the motivations of a for-profit health care system when it comes to creating life-long "patients". Medicalizing "mental illness" has been a dreadfully successful means of ensnaring people in distress in a system that rarely ever addresses the underlying issues, but rather, de-voices, disconnects and disempowers us, uses us as cash cows, and promotes a culture that dehumanizes us as unacceptably different by way of mental defect.
Earlier in this post, I pointed out that my rejection of the medical model of "mental illness" does nothing to invalidate your suffering. I also told you that my views (and Principle 17, I should add) don't "stigmatize" you. This is truth.
A stigma is a mark of disgrace. The mark you are given as a user (and or survivor) of psychiatry is the "diagnosis", or usually multiple "diagnoses". Those are the stigmata. They have marked you and declared you to be "mentally ill". When you shout about "stigma", what you're really referring to is discrimination, unjust actions that are based solely on a malefactor's perception of you as defective in some way and unworthy of equal rights and equal treatment . The psychiatric labels you embrace and wear, often as a deeply embedded false identity, are the very thing you denounce, the very thing that opens the door to discrimination. When you embrace that psychiatrically stigmatized identity, you negate yourself and your lived experience. I know that's something that will make some readers intensely angry. It used to make me angry as well. I didn't see that connection while I was immersed in the system. It's a painful realization.
Studies from around the world have shown that the medicalization of "mental illness" has led to increasingly negative views of people labeled with "mental illness". Treating emotional distress and extreme states as problems that can be solved by psychiatric and medical means has not led to greater understanding and empathy. It has not led to a reduction of discrimination, or as some improperly call it, "stigma". It has, in fact, increased these problems exponentially.
“The results of the current study suggest that we may actually treat people more harshly when their problem is described in disease terms,” Mehta wrote. “We say we are being kind, but our actions suggest otherwise.” The problem, it appears, is that the biomedical narrative about an illness like schizophrenia carries with it the subtle assumption that a brain made ill through biomedical or genetic abnormalities is more thoroughly broken and permanently abnormal than one made ill though life events. “Viewing those with mental disorders as diseased sets them apart and may lead to our perceiving them as physically distinct. Biochemical aberrations make them almost a different species.”
The medical model of "mental illness" as a means to deal with social and personal problems, with criminal justice issues, with poverty, homelessness, with addictions and violence, has been a miserable failure, and it will continue to fail. It can't do anything else. Our society is crumbling, and it's not for lack of psychiatric treatment. Psychiatry cannot and does not address the root causes of the social and personal disasters that bring people down and keep them down. It simply doesn't have the tools. It doesn't have the motivation, and too many people still want the mirage of hope that psychiatry projects to the world.
August 17, 2016: Conference on Principle 17
We will talk about Principle 17, including your responses, on August 17 from 9-11 PM EST. The conference will convene on BlogTalkRadio.com/TalkWithTenney.
To join:
By Phone: (1)267-521-0167
By Internet: http://www.blogtalkradio.com/talkwithtenney
We welcome your participation. Simply press #1 on your phone to speak with the show hosts.
More details are available at http://www.blogtalkradio.com/talkwithtenney
Post-Conference Reception
Those wishing to continue the discussion after the conference – or to talk informally with others who participated – may join us for the Post-Conference reception. The reception will start immediately after the conference (11 PM EST) and continue til the wee hours or for as long as there is interest.
To join:
By phone: (1)331-205-7196 (dial *67 for added privacy)
By internet: Uberconference.com/peerlyhuman
International: Local access numbers available at Uberconference.com/international
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