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May 15, 2019
David Cohen - Mad Science, Psychiatric Coercion and the Therapeutic State
On MIA Radio this week, MIA’s Peter Simons interviewed David Cohen, PhD, a social worker, professor of social welfare, and Associate Dean for Research at the Luskin School of Public Affairs of the University of California, Los Angeles. He discussed his path to becoming a researcher focused on mental health, coercive practices, and discontinuation from psychiatric drugs. He studies the social construction of psychoactive drug effects, the union of law and psychiatry within a criminalization/medicalization system and envisions alternatives to the current mental health industrial complex and the medicalization of everyday life. He has also taught in Canada and France, and for over 20 years held a private practice to help people withdraw from psychiatric drugs. He is the author of over 100 book chapters and articles. His first book, published in 1990, was Challenging the Therapeutic State: Critical Perspectives on Psychiatry and the Mental Health System. His latest book, published in 2013, with colleagues, Stuart Kirk, and Tomi Gomory is Mad Science: Psychiatric Coercion, Diagnosis and Drugs.
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41 min
May 8, 2019
John Read - Fighting for the Meaning of Madness
On MIA Radio this week, MIA’s Akansha Vaswani interviewed Dr. John Read, a clinical psychologist at the University of East London, about the influences on his work and research on mental health over the years. John worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, in 1994, where he worked until 2013. He has published over 140 papers in research journals, primarily on the relationship between adverse life events (e.g. child abuse/neglect, poverty, etc.) and psychosis. He also researches the negative effects of biogenetic causal explanations on prejudice, the opinions, and experiences of recipients of antipsychotic and antidepressant medication, and the role of the pharmaceutical industry in mental health research and practice. John is on the Boards of the Hearing Voices Network – England, the International Institute for Psychiatric Drug Withdrawal and the UK branch of the International Society for Psychological and Social Approaches to Psychosis (www.isps.org). He is the Editor of the ISPS scientific journal ‘Psychosis.’  
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52 min
April 20, 2019
Lee Coleman – The Insanity Defence, Storytelling on the Witness Stand
This week on MIA Radio, we present our second chat with Doctor Lee Coleman. In the first interview in this series, we discussed Lee’s career, his views as a critical psychiatrist and his 1984 book Reign of Error. For this second interview, we focus on psychiatry in the courtroom and why the psychiatric expert witness role may be failing both the individual on trial and society at large. We also focus on Chapter 3 of Reign of Error: The Insanity Defence, Storytelling on the Witness Stand. In this episode we discuss: What led Lee to his involvement in the courtroom as a psychiatrist testifying as to the reliability of psychiatric testimony itself. How both psychiatrists and psychologists have been given a role by society to judge both the current mental state of an individual on trial and also the potential future behaviour of that individual. How important it is to address the three dimensions of past, present and future when looking at psychological testimony. The role of psychiatry in the trial of Patty Hearst, when required to provide evidence that she has been brainwashed and therefore was incompetent to stand trial. How Lee and a colleague, George Alexander, came to arrange a press conference to address the issue of the reliability of psychiatric or psychological testimony. How speaking out in this way ultimately led to many years of opposition not only by psychiatry but also by attorneys on both sides of the debate. The legal definition of the term ‘insanity’ and the context in which it is used. How if someone is found legally insane, the punishment may be far worse and the incarceration far longer than if that person were found guilty. The details surrounding the trial of Dr. Geza De Kaplany, who committed a gruesome murder but came to be represented at trial as having multiple personalities and being mentally disordered. The inconsistency often found in both the defense and prosecution in the courtroom when it comes to subjective assessments of the mental state of an individual. That it is crucial that people band together to share information and to actively demonstrate and have conferences and influence legislators because we can’t rely on media channels and we can’t rely on professional bodies. Relevant Links: Doctor Lee Coleman The Reign of Error YouTube - Competent to Stand Trial?- A Psychiatric Farce YouTube - Society Doesn't Need Protection from the "mentally ill" The Trial of Patty Hearst Geza De Kaplany To get in touch, email us at podcasts@madinamerica.com
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41 min
April 17, 2019
Jonathan Raskin - Constructing Alternatives to the DSM
  On MIA Radio this week, MIA’s Jessica Janze interviewed Dr. Jonathan Raskin, in the Department of Psychology at the State University of New York at New Paltz where he serves as department chair and teaches classes in psychology and counselor education. Dr. Raskin’s research is focused on constructivist meaning-based approaches in psychology and counseling. He recently authored a textbook titled Abnormal Psychology: Contrasting Perspectives. Dr. Raskin describes a recent article he wrote (What Might an Alternative to the DSM Suitable for Psychotherapists Look Like?) that highlights psychotherapists’ dissatisfaction with the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and suggests some principles for building alternative models.  What follows is a transcript of the interview, edited for clarity. **************** JJ: Welcome, Jonathan. I'm very excited to have you. Is there anything else you want to add about your background for our readers before we get started? JR: No, not at all. Thank you for inviting me to do this. JJ: Let's get started. What made you interested in working on alternative diagnostic systems for use in psychotherapy? JR: Yeah, that's a good question. I've always been interested in how people make meaning, and diagnostic systems are the way that mental health professionals make meaning of their client's experiences. So to me, all diagnostic systems are meaningful systems for making sense of the problems our clients bring to us. JJ: You take a constructivist approach to thinking about diagnosis. Can you break down what that means for us and how it applies to this issue of diagnosis?  JR: Many theories fall under the banner of constructivism, but broadly speaking, constructivism focuses on how people both individually and in conjunction with one another (and in more social kinds of configurations) construct understandings of themselves and the world. Then they use those constructions to guide their lives. To me, constructivism seems like an excellent theoretical approach to use in understanding diagnosis because each diagnostic approach can be viewed as a constructed meaning system for understanding and conceptualizing client concerns. JJ: Several alternative diagnostic systems have been promoted in recent years, including HiTop, the Power Threat Meaning framework, RDoC, and the PDM. What are your thoughts on these alternatives? JR: I think they're all interesting in their own ways. Let me talk about a few of them. I'll start with HiTop. That's the hierarchical taxonomy of psychopathology. It's a dimensional approach that tries to address the problem of comorbidity that afflicts DSM categories. Comorbidity is a confusing issue for people. When disorders are comorbid, they're diagnosed at the same time. One of the problems is that a lot of the DSM diagnoses are comorbid with one another. If you have too much comorbidity, the question that arises is, are the categories that we've constructed distinct from one another? HiTop thinks that comorbidity should be embraced instead of rejected. They say, “Yes, these DSM categories cluster together, we can group each of them under these broader spectrums.” The HiTop system uses six spectrum dimensions. Ultimately, the people who created HiTop feel that DSM disorders might be discardable, but for the time being, we can keep them. They say that there are really these co-morbid overlapping categories underneath these higher levels, six distinct spectra. HiTop sees this as a simpler approach because you can divide people's problems into how they score along these six different spectrum dimensions. It's still very early going. I think it has a lot in common with the big five personality research. If you like those, you'll like HiTop. If you don't like those, you might not be a fan of HiTop. Let me talk a little bit about RDoC. RDoC is the research domain criteria system. It's a research initiative at the moment. It's not a diagnostic system yet. They're trying to build a diagnostic system from the ground up, and they're doing that by trying to identify the ways that the brain is designed to function. Then, and only then, they will identify ways that it malfunctions. And so the categories that they create will be based on their identifying and diagnosing these specific malfunctions. The people involved in RDoC say, “We're doing this in the right way, whereas the DSM does it backward.” DSM starts with categories and then researchers race around trying to find out what the biological correlates of those categories are. RDoC says, “Let's understand the brain and how it works and then build categories based on observable differences between healthy and unhealthy brains.” It's a very medical model kind of approach. And if you like that, you'll like RDoC. If you don't like the medical model, you won't. What's really fascinating about [RDOC] is the idea that it wants to build the system from the ground up. It is not yet a diagnostic system; it's a research initiative. We don't have the ability to identify any kind of presenting problems based exclusively on these kinds of biological biomarkers just yet. Then there's the Power Threat Meaning framework (PTM), which is going 180 degrees in the other direction. PTM shifts the focus. It moves away from the medical model. It actually doesn't consider itself a diagnostic system. It rejects the idea of medical model diagnostic systems. It says that we need to depathologize people's problems by focusing on what the PTM identifies as the actual causes. It says that economic and social injustices are the root causes of emotional distress. The origins of distress lie outside the person. RDOC looks inside the person, and I think the DSM, in many respects, implies that it's inside the person. PTM emphasizes what has happened to people on a socio-cultural level and then how they've responded to it. It's a totally different approach. It's a non-diagnostic approach. Another approach is the Psychodynamic Diagnostic Manual (PDM). From its name, you can tell it’s an explicitly psychodynamic diagnostic manual that diagnoses problems through the lens of psychodynamic theory. So whereas the DSM has traditionally been atheoretical, in the sense that it's a descriptive, diagnostic manual describing problems, but it doesn't take a stance on what causes them, the PDM roots its approach explicitly in psychodynamic theory. All of these approaches are really interesting in their own way. The question is whether or not they'll catch on. JJ: You don't think that there is one particular diagnostic system that our society should switch to, is that correct? JR: I view diagnostic systems as tools. Like hammers, they're really helpful instruments. However, depending on the task I’m up to, I might be better off with a wrench or a pair of pliers or some other tool instead. So, I find it helpful to use the tools metaphor when considering diagnostic systems. One might find a given diagnostic system useful, or not, depending on the situation. Of course, it's always important to remember that diagnostic systems provide maps that can guide us, but we have to be careful not to mistake the map for the territory. I think the biggest barrier to developing viable alternatives to the DSM and the ICD is that these approaches cross theoretical perspectives by being mainly descriptive. But, when it comes to how a diagnostic system informs treatment, descriptive approaches, in many ways are lacking. That is, they don't take any stance on how to best approach the problems they identify or describe. So, their wanting to script nature makes DSM and ICD easy for everyone to adopt regardless of the theoretical viewpoint. But any theoretically driven system, things like the PDM or the power threat meaning framework or RDoC even, those systems in many ways might struggle to gain mass acceptance because their theoretical commitments will turn people off. Somebody who doesn't like a medical model brain approach won't use RDoC. Somebody who's really opposed to psychodynamic theories, or just not interested in them, won't use PDM. Somebody who doesn't take a social justice orientation to problems might not like PTM. By being theoretically well developed and informative about how to conceptualize and approach client problems, these alternative diagnostic systems ironically make themselves less broadly appealing. That can be a challenge for them. But, if they are tools you don't have to stick with just one, you could jump around from one system to the next depending on what you're up to that day. JJ: What about insurance companies? What do you think an alternative to the DSM system that could be used for insurance purposes would look like? JR: I’m not sure. It’s been suggested by a lot of people that a very practical thing we can do is use the DSM-5 V codes (which list circumstances or experiences, such as "Homelessness," "Poverty," and "High Expressed Emotion Level Within Family") because that might let us identify presenting problems while being less medicalizing and stigmatizing. Practically, those codes already exist, but we would need insurers to cover them for clinicians to begin using them. One of the reasons they don't get used is that insurance companies don't cover the code diagnosis. As I was describing a minute ago, I think theoretically coherent systems might prove to be more helpful to clinicians in a practical, everyday manner but they're less likely to be appreciated and used across clinicians and different theoretical orientations. That's the challenge. Being theoretically consistent and pure and developing something that a smaller group of people might like to use versus having something that would kind of cut across all theoretical orientations. The latter might be more descriptive, but potentially not the most clinically useful, but would help grease the wheels of insurance. JJ: Can you talk more about the importance of including service users and people with lived experiences in the development of any future alternatives? JR: I think it's very important to listen to service users because they're the ones impacted by whatever diagnostic system we develop and use. So we really need their feedback, especially if we want to avoid inadvertently harming them. JJ: How do you think diagnoses should be approached in therapy? How do you recommend clinicians approach these topics with people who come to see them?  JR: I think we often draw sort of an artificial line between diagnosis and treatment. George Kelly was the psychologist who developed personal construct theory, and he used to say that therapists have to continually revise their understandings of clients because clients are always in process and forever changing. That's why Kelly used the term transitive diagnosis. He said diagnoses are transitive because they are continually evolving. So given that, regardless of the diagnostic approach that a therapist takes, it seems to me very important for the therapist to not reify the diagnosis made because I think doing so locks the client in place in a way that can be highly limiting. That would be true across different diagnostic systems for me. Whichever system somebody’s adopting, you have to be careful not to be too literal or reifying about that system. So to me, thinking of diagnoses as meaningful constructions, as created understandings that might -for the time being- inform what we're doing, is terrific. But when we shift to seeing them as essential, unchangeable things we can lock ourselves in, and we can actually also unintentionally harm the people we're working with. JJ: More of a living system. JR: As Kelly said, you have to keep up with your clients. They're always in process, and you better keep up with them because if you're still using last week's a conceptualization and understanding, well, they may have moved on. JJ: Is there anything else that you wanted to add or talk to us about before we wrap up? JR: No, I mean just that I think this is a growing area that people are expressing interest in. I sense that a lot of clinicians don't really know much about different alternatives beyond the DSM and the ICD. And so, one of the things that I've been interested in recently is just helping the field have more knowledge; helping the clinicians out in the field become aware of approaches that they may not know much about. My sense is that clinicians are hungry for alternatives, but they don't necessarily know what the alternatives are. And then, at the same time, they also feel trapped in the sense that in order for them to get paid, they need to use the DSM. But it doesn’t mean, even if the issues of reimbursement haven't been resolved for other systems, it doesn't mean that they can't learn about and begin using these other systems in addition. It doesn't have to be an either-or. So my goal is to learn more about these diagnostic alternatives myself and then to help others out in the field learn about them as well. JJ: I think that's really great. Just talking about alternatives and getting the information out even if we do not necessarily subscribe to them or use them.  JR: Having an open discussion and dialogue about them is important, and I think people are very quick to make judgments about which approach they like or dislike. But I think if you want to develop alternatives, you have to be open-minded and be willing to talk with people who might be developing alternatives that are very different from what you yourself might develop and appreciate that each alternative may have advantages to it as well as disadvantages. JJ: I'm excited to see these theories evolve and to see how the field continues this conversation and I'm glad that you're a part of that. Your textbook compares and lays out the alternative diagnostic frameworks, right? JR: Yea, one of the things that I was very excited to do in the book was to present alternative perspectives across both diagnosis and treatment interventions. In the diagnosis chapter, I talk about RDoC; I talk about HiTop; I talk about the PTM framework; Because I think it's essential for students in the field to learn about these approaches. If we want to disseminate information about them, we have to cover them in the places where students are learning about them. I also spend a lot of time on DSM and ICD because those are the most influential approaches today. So all of them get covered, and they get covered as perspectives. Each one is a diagnostic perspective that a person might adopt depending on what the goal is in the given moment. JJ: Well I have to say, I really appreciate you doing this work. I appreciate your perspectives. I appreciate you coming on today and sharing this information with our readers. I do agree with you. I think it's so important to get this information out to people. Thank you so much for talking to us, and I look forward to hearing more about your work.  JR: Thank you very much. © Mad in America 2019
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16 min
April 13, 2019
Kelly Brogan - The Science and Pseudoscience of Women’s Mental Health
Science and Pseudoscience of Mental Health Podcast: Episode 3 This past week, I had the great pleasure to talk with Dr. Kelly Brogan, a leading voice in natural approaches to women’s mental health. Dr. Brogan began her career as a conventional psychiatrist, but following the birth of her first child, she felt bereft of energy and mental clarity and was diagnosed with an autoimmune condition called Hashimoto’s Thyroiditis. Informed by her doctor that she had a chronic illness that would require a lifetime of medication, she launched her own research into her condition which catalyzed a profound paradigm shift in her understanding of health and wellness. Her research led her to Robert Whitaker’s Anatomy of an Epidemic after which time she permanently retired her prescription pad while turning towards natural interventions that support the body’s innate capacity to heal. With degrees from MIT and Weil Cornell Medical College, triple board certification in psychiatry, psychosomatic medicine and integrative holistic medicine, and direct experience practicing within the parameters of conventional psychiatry, Dr. Brogan is uniquely qualified to challenge the pseudoscience of the chemical imbalance theory and the drug regimens that it spawned. At the same time, her rigorous education conferred the investigative tools that enabled her to identify the scientific principles that support mental health. She focuses on the integrative nature of the gastrointestinal, immune, endocrine and nervous systems and their seamless communication with the ecosystem that resides within the body – the microbiome – and the ecosystem that surrounds us. This science is at the core of her thirty-day wellness protocol which she outlines in her New York Times bestselling book: A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies and reclaim Their Lives. Our conversation addressed Dr. Brogan’s grave concerns about the recent rollout of Zulresso (brexanolone), a drug specifically designed, and approved by the FDA for the treatment of Postpartum Depression. Drug trials that qualified Zulresso for FDA approval in fact revealed that its efficacy is weak at best, and not clinically significant. After 30 days, it was actually less effective than placebo. It requires an invasive 60-hour IV infusion with side effects that include sedation – sometimes to the point of loss of consciousness, separation of mother and infant, and cessation of breastfeeding. Women diagnosed with Postpartum Depression are suffering, but impactful interventions need to take into account the complex cultural, socioeconomic, personal and biological underpinnings of their symptoms. Masking symptoms with a drug that causes further disruption to their lives, lessens the likelihood that they will receive effective support. Dr. Brogan estimates that 80% of women who enter her practice having been diagnosed with Postpartum Depression have undetected and untreated thyroid conditions. We also discussed the reckless prescribing of SSRI antidepressants to one in four American women, many of whom are pregnant, and the long-term epigenetic consequences of SSRIs following prenatal exposure. Dr. Brogan shared her approach to tapering from SSRIs both during pregnancy and as part of her general treatment protocol. Our conversation came to a close with a fascinating exploration of the science that informs the relationship between meditation and mental health. Dr. Brogan shared the transformative impact that her own daily meditation practice has had on her capacity to cope with stress. To learn more about Dr. Brogan’s clinical work and research, you can visit her website. For other interviews in this series, click here. © Mad in America
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60 min
April 3, 2019
Vance Trudeau - Antidepressant Exposure Across Generations
On MIA Radio this week, MIA's Zenobia Morrill interviews Dr. Vance Trudeau, a professor at the University of Ottawa in Canada. Dr. Trudeau describes a recent study he conducted, alongside a team of researchers, led by Dr. Marilyn Vera-Chang, that has implications for understanding of the long-term impact of antidepressant drug exposure (see MIA report). The study, titled Transgenerational hypocortisolism and behavioral disruption are induced by the antidepressant fluoxetine in male zebrafish Danio rerio linked antidepressant exposure to decreased coping behaviors in zebrafish that lasted several generations. Dr. Trudeau is the research chair in neuroendocrinology at the University of Ottawa, where he studies how the brain regulates hormonal activity in fish and frogs. Such analyses offer important insights into the effects of environmental exposures on human health because these hormonal systems are shared across species. © Mad in America 2019
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31 min
March 23, 2019
Lee Coleman - The Reign of Error
This week on MIA Radio, we chat with Doctor Lee Coleman. Lee trained in psychiatry during the 1960s, quickly adopting a sceptical attitude to the newly emerging field of biological psychiatry and rejecting the idea that drugs could be beneficial for so-called ‘mental disorders’. By the early 1970s, Lee’s professional life was divided between a small home-based practice of psychotherapy and a variety of activities – writing, speaking and political advocacy – focused on psychiatry’s role in society. His experiences led to writing the book Reign of Error in 1984 in which he brings to bear his lengthy experience in both clinical and legal issues surrounding Psychiatry and Society. Now retired, Lee devotes his time to public education that exposes the individual and public harms from today’s “mental health” industry. He seeks to support a grassroots movement to abolish forced “treatment” and provide tools to amplify the voices of those seeking change. The discussion today marks the first in what will hopefully be a series of interviews on a range of topics which will be released on the podcast over the coming months. In this episode we discuss: What led Lee to his interest in attending medical school during the 1950s and his fascination with the burgeoning field of biology. How, once he got to medical school, he found he did not care for psychiatry’s biological orientation. The Lee’s residency period was 1965 to 1969 and this marked a period of decline of psychoanalysis and the rise of biomedical psychiatry. That Lee came to see himself as part of what was called at the time ‘community psychiatry’ which was socially oriented. How, in the late 1960s, psychiatry was feeling the heat from psychologists, social workers and even some religious counsellors who started lobbying to get licenses to provide therapy. How psychiatry then started going on the offensive to redefine itself as having the leading medical expertise in mental health. That Lee was extremely concerned to learn about the legal power of psychiatry and this was a motivator to write The Reign of Error in 1984. How a book called Soledad Brother: The Prison Letters of George Jackson called into question much of what Lee had been taught during his residency. That Reign of Error is about both what is wrong with psychiatry and the fact that it is linked to the power of the State. That Lee has participated in well over 800 legal cases as an expert witness, but he has never testified as to the state of a person’s mind, instead he has testified on the state of psychiatry. That Lee has testified to the fact that psychiatrists are generally worse at assessing someone’s mental state than the average lay-person in the jury. How language can falsely lead us to believe that science underpins the actions of psychiatrists, something Lee refers to as The War of the Words. That we have to fight back by explaining properly what words like ‘treatment’ actually mean. How American psychiatry is leading the way to the worldwide drugging of citizens and that we need political action to resist this future. Relevant Links: Doctor Lee Coleman The Reign of Error Lee’s YouTube Channel Soledad Brother: The Prison Letters of George Jackson © Mad in America 2019
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57 min
March 20, 2019
Mark Horowitz - Peer-Support Groups Were Right, Guidelines Were Wrong - Tapering Off Antidepressants
Interview by Peter Simons. Dr. Mark Horowitz is a training psychiatrist and researcher and recently co-authored, with Dr. David Taylor, a review of antidepressant withdrawal that was published in Lancet Psychiatry, which we've written about here at Mad in America (see here). Their article suggests that tapering off antidepressants over months or even years is more successful at preventing withdrawal symptoms than a quick discontinuation of two to four weeks. Dr. Horowitz is currently completing his psychiatry training in Sydney, Australia, and has completed a PhD in the neurobiology of antidepressants at the Institute of Psychiatry at King's College, London. He is a clinical research fellow on the RADAR study run by University College, London. His research work focuses on pharmacologically informed ways of tapering patients off of medication. He plans to conduct studies examining the best methods for tapering medications in order to develop evidence based guidelines to assist patients and doctors.
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28 min
March 14, 2019
Gail Hornstein - First-Person Accounts of Madness and Global Mental Health
This week, MIA Radio presents the fifth in a series of interviews on the topic of the global “mental health” movement.” This series is being developed through a UMASS Boston initiative supported by a grant from the Open Society Foundation. The interviews are being led by UMASS PhD students who also comprise the Mad in America research news team. We interview Dr. Gail Hornstein, a Professor of Psychology at Mount Holyoke College in South Hadley, Massachusetts. She is the author of To Redeem One Person is to Redeem the World: The Life of Frieda Fromm-Reichmann and, most recently, Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness. In her work, she chronicles both the personal narratives of people with lived experience of being treated as “mad,” and also the growing movement of survivor and service-user activism. Her Bibliography of First-Person Narratives of Madness in English (now in its 5th edition) lists more than 1,000 books by people who have written about madness from their own experience; it is used by researchers, clinicians, educators, and peer groups around the world. She is now director of a major research and training project investigating how hearing voices peer-support groups work, supported by a grant from the Foundation for Excellence in Mental Health Care. This project is training dozens of new hearing voices group facilitators across the US and sponsors research to identify the key mechanisms by which this approach works.
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27 min
February 16, 2019
Alita Taylor - Open Dialogue - Making Meaning
This week on MIA Radio, we turn our attention to Open Dialogue and we chat with psychotherapist and Open Dialogue trainer Alita Taylor. Alita is a licensed Marriage & Family Therapist, trainer and facilitator based in Tacoma, Washington USA. Her passion is working from a community-based, non-expert, need-adapted Open Dialogue perspective, which utilizes social networks, family, and co-facilitation with other professionals. In this recent blog, Alita shares why Open Dialogue ‘cannot be taught, but needs a teacher‘. Love Is In the Air… I am in love. I’m in love with this way of working. And I won’t stop. Open Dialogue Washington began in 2018 upon my graduation/commencement from Jaakko Seikkula’s dialogic approaches to couple and family therapy trainer/supervisor training, in collaboration with Dialogic Partners and the University of Jyväskylä. In 2016, I embarked to partake in the best training course I had ever experienced as a family therapist. The embodiment I experienced working with my Open Dialogue colleagues felt like the missing key in psychiatry and psychotherapy. Something intangible, yet what I knew all along. Something ineffable, yet also a shared language. Something deeply and autonomically human, yet unrepeatable and fleeting. It led me onto a moment-by-moment path where everything I learned in my 27-year long career about systemic family therapy and emergency psychiatric protocols ebbed, and the present moment of love flowed, neither the ebbing knowledge nor the cresting wisdom having any lesser value than the other.  The complete work we do in mental health care is this ocean of love. We are in constant change when we are in crisis. Timelessness sets in. Growth is happening.  We don’t exactly know what we need. That is what mental health work is, sitting with this human happening. In the in-between space, something happens, and we don’t know what will. This is the paradox. We are navigating the ebb and flow of incoming knowledge we have from research and the ebb and flow in each patient and family’s difficulties (the meanings they make of them). “It cannot be taught, but it needs a teacher.” After getting trained to facilitate and supervise Open Dialogue, I found that this is the crux of the work, holding more than one truth. As human beings, as a society, as mental health practitioners, we must be able to ask what is helpful, and we must be willing to co-provide this “help” creatively, without barriers, between the digitized rows and columns of tick-boxes and presumptive diagnostic menus.  Remember the analog world of dials and infinite decimals? Agency lies within ourselves to expand the possibilities, to be willing to open to solutions that have not yet been tried. Michael Pohl wrote about dialogical leadership and culture in which he referenced Karl-Martin Dietz and Thomas Kracht of the Hardenberg Institute for Cultural Studies in Heidelberg, Germany. Michael remembered a discussion on whether dialogism can be taught or experienced. It was argued that the dialogic attitude cannot be learned and that any thought of teaching it is unnecessary. Michael disagreed. He writes, “It cannot be taught, but it needs a teacher.”— Medium.com, March 2018. In Helsinki and Tornio while learning the Open Dialogue approach, I had many teachers: Jorma Ahonen, Pekka Borchers, Birgitta Alakare, Aino Maija Rautkallio, Kari Valtanen, Tom Erik Arnkil, Jaakko Seikkula, Tapio Salo, Tanja Pihlaja, Eija-Liisa Rautiainen, Pekka Holm.  How did they do it? To quote Birgitta Alakare when she was asked about the beginnings of the development of Open Dialogue in the 1980’s, “It was not only me, it was all of us, everyone.” When we include all the stakeholders, all the voices, polyphonically, something extraordinary is given space to emerge. This is challenging to enact when there are systems of health care based on bed occupancy, lengths of stay, productivity, staff ratios, definitions of “emergency” or “inpatient” levels of care. Well, Open Dialogue Washington is bringing to the fore the question, “What is our role as helpers??”  To quote Mia Kurtti, Open Dialogue trainer of Tornio, Finland, “What are we really doing here?” Caring for our mental health, however defined (crises, hard times, depression, psychosis), is a human need that varies from moment to moment. I learn from every client and family I sit with. In Open Dialogue, multiple perspectives are allowed, in fact invited. Unusual experiences are uncategorized mystery, and understanding between client and family/social network is continuously underway. The course of schizophrenia was reversed in Western Lapland, and their inhabitants trust their mental health system. Hmmm… if we want to save State and Federal dollars and our own livelihoods, perhaps we should allow ourselves to practice psychotherapy and psychiatry with more questions than answers. Perhaps the ones in crisis will teach us what we didn’t know. Love is somewhere, here, in the air. Relevant links: Open Dialogue Washington Open Dialogue Training, April 2019 Open Dialogue UK
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31 min
January 26, 2019
Jim van Os - Towards Resilience and Possibilities and Away from Diseases and Symptoms
This week on MIA Radio, we interview Professor Jim van Os. Professor van Os is Chairman of the Division of Neuroscience at Utrecht University Medical Centre, Utrecht, The Netherlands, and Visiting Professor of Psychiatric Epidemiology at King’s College, Institute of Psychiatry in London. He trained in Psychiatry in Casablanca, Bordeaux and the Institute of Psychiatry and the Maudsley Royal Hospital in London. We last spoke with Jim for the podcast in August 2017 and this time we focus on a recent paper written by Jim and co-authors that was published in the journal World Psychiatry in January 2019. The paper is entitled ‘The diagnosis evidence-based group-level symptom-reduction model as organizing principle for mental health care. Time for change?‘ In this episode we discuss: What the diagnosis evidence-based group-level symptom-reduction model is and how it currently informs mainstream mental healthcare. How mental health funding and mental health professional partners work together to monitor and assess the effects of current evidence-based interventions. How this curative medical model is attractive, but often fails to work for patients. That the focus on biological, brain-based diseases and symptoms conflicts with the experience of people who are attempting to develop a narrative view of their difficulties and suffering. That the paper is an attempt to start a discussion about building a synthesis between the diagnosis, symptom-based medical world and the lived experience of individual people. How the creation of specific and discrete diagnoses has reinforced the symptom-led approach to mental health and has also necessitated the stratification of doctors into silos of expertise. How Jim favors a spectrum-based approach over a fixed diagnosis and that an example is autism spectrum disorder as described in DSM V. The limitations of using ‘target symptom reduction’ as an outcome measure for mental health. That symptom reduction can be beneficial in the short-term but is not a good long-term measure of recovery. That the paper attempts to make clear how important individual experiences are and the need to be sensitive to the existential domain, saying “restoration of health is not the goal, it is the means to enable a person to find and pursue meaningful goals, accordingly, the person’s existential values become central”. That the evidence suggests that any treatment effect or improvement is often down to meaningful interaction rather than the specific expertise of the treating professional. That, in many countries, we still see a huge gulf between mental healthcare and social care which remain separate and remote from each other and that this separation is not how the person experiences their world. The importance of including lived experience in the evidence base, particularly because randomized controlled trials, considered the gold standard of evidence, are often not conclusive in the field of mental health. That, in mental health, evidence shows that 30% to 40% of the response is down to placebo and the expectation of being helped. That the desire is to make the existential domain the primary lens through which to view human experience and to respond to mental or emotional suffering. That, arguably, ‘love is the most powerful evidence-based treatment in mental health’. Relevant links: Professor Jim van Os The evidence-based group-level symptom-reduction model as the organizing principle for mental health care: time for change? Tedx: Maastricht, Connecting to Madness ISPS Liverpool Conference Jim Van Os Keynote Address Schizophrenia does not exist © Mad in America 2019
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58 min
December 21, 2018
Darcia Narvaez - Reclaiming Humanity
In this second interview in our Science and Pseudoscience of Mental Health series, Dr. Sharna Olfman interviews Dr. Darcia Narvaez.  In 1955, Erich Fromm published a book called The Sane Society. The basic premise is that cultures that support our existential needs for love, community, autonomy, creative expression, purpose, meaning, and communion with nature, enable us to become fully actualized, sane human, beings. Cultures that fail to do so, engender mental illness. Darcia Narvaez,1 a Professor of Psychology at the University of Notre Dame, has taken up the mantle of Fromm’s quest to identify and promote sane cultural practices that foster mental health. A prolific multidisciplinary scholar, her recent books include Neurobiology and the Development of Human Morality: Evolution, Culture and Wisdom (2014) and Basic Needs, Wellbeing and Morality: Fulfilling Human Potential (2018). To read more about Dr. Narvaez' work, visit this link: https://www.madinamerica.com/2018/12/reclaiming-humanity-dawn/ © Mad in America 2018
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64 min
November 17, 2018
Will Davies - The Happiness Industry
When we discuss the issue of forced treatment, coercive mental health interventions like involuntary commitment, forced drugging, and electroconvulsive therapy usually come to mind. But force and coercion can be much more subtle. Many researchers and thought leaders have argued that our society mandates us to be happy and perform well-being at all times through cultural norms, media depictions, and workplace and school regulations. This week on MIA Radio we interview Will Davies, Reader in Political Economy at Goldsmiths University of London, and author of The Happiness Industry, a book that explores the rapidly growing culture of mandated happiness and well-being surveillance. In this interview, we discuss the increasing pressure people face to be happy and think positive, and how this pressure serves the interests of the corporate elite and the State. In this episode we discuss: What the “happiness industry” is and the history of its development How the notion that happiness can be quantified or measured, as well as advancements in neuroscience and medicalized frameworks of depression, have influenced our culture How employees are increasingly pressured to be happy or perform happiness within the workplace How people receiving welfare or government benefits are required to engage in positive thinking programs or cognitive behavioral therapy That holding individuals responsible for attaining their own happiness relieves responsibility from structural and institutional determinants of well-being The coercive and forceful aspects of the “happiness industry,” including surveillance in workplaces and mandatory self-help programs in schools The role that positive thinking and self-help culture play in upholding neoliberalism and capitalism Relevant Links: Dr. Will Davies The Happiness Industry: How the Government and Big Business Sold Us Well-Being The Managed Heart: Commercialization of Human Feeling The Power Thinker: Why Foucault’s Work on Power is More Important than Ever The Weariness of the Self: Diagnosing the History of Depression in the Contemporary Age Dr. Davies’ next book, Nervous States: Democracy and the Decline of Reason will be published by Norton in early 2019. © Mad in America 2018
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46 min
November 10, 2018
Sandy Steingard - Anatomy of a Psychiatrist
This week on MIA Radio, we interview Dr. Sandy Steingard. Dr. Steingard is Medical Director at Howard Center, a community mental health center where she has worked for the past 21 years. She is also Clinical Associate Professor of Psychiatry at the College of Medicine of the University of Vermont. For more than 25 years, her clinical practice has primarily included patients who have experienced psychotic states. Dr. Steingard serves as Board Chair of the Foundation for Excellence in Mental Health Care. She was named to Best Doctors in America in 2003 and writes regularly for Mad in America. She is editor of the book Critical Psychiatry, Controversies and Clinical Implications due in 2019. In this episode we discuss: What led Sandy to her career in psychiatry and her particular interest in the critical aspects of psychiatry and psychology. That Sandy’s initial interest was in biomedical explanations of psychotic experiences. How, in the late 80s, the advent of new antipsychotic drugs caused an initial excitement because of the promises made about safety and efficacy, but that Sandy came to realise the problems with the drugs. How she witnessed the over-promotion of the drugs and that the promotion was markedly different to the results of studies and her observations of patients that were taking them. How a series of disappointments and recognition of some inherent flaws in psychiatry led Sandy to her interest in alternatives. That the book, The Truth About the Drug Companies by Marcia Angel MD, had a big impact on Sandy’s view of the drugs during the 2000s. Other influential books were The Daily Meds by Melody Petersen and Side Effects by Alison Bass. That reading Anatomy of an Epidemic and particularly the problematic aspects of the long-term use of antipsychotic drugs caused Sandy to question how she was practising. That she found colleagues were sometimes angry at the conclusion that antipsychotic drugs might not be safe or lead to better outcomes for patients. That this led to the investigation of alternatives such as Open Dialog, training with Mary Olsen at the Institute of Dialogic Practice and discovering the Critical Psychiatry Network and the work of Dr. Joanna Moncreiff. How Sandy approaches practising from a critical perspective, particularly when expectations are in line with the dominant biomedical narrative. Her book, Critical Psychiatry, due in 2019 which aims to help clinicians apply transformational strategies in their clinical practices. That psychiatrists would be well served by welcoming lived experience input to their daily practice. Why informed consent should be viewed as an ongoing process rather than a one-time agreement. The problems that arise in clinical studies where experience is translated into a numerical form. Relevant links: Critical Psychiatry, Controversies and Clinical Implications (due 2019) How Well Do Neuroleptics Work? What We Are Talking About When We Talk About Community Mental Health The Truth About The Drug Companies by Marcia Angel MD (video) The Daily Meds by Melody Petersen (review) Side Effects by Alison Bass Open Dialog The Institute for Dialogic Practice Critical Psychiatry Network
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53 min
October 27, 2018
Derek Summerfield - Moving Global Mental Health "Outside Our Heads"
This week, MIA Radio presents the fourth in a series of interviews on the topic of the global “mental health” movement.” This series is being developed through a UMASS Boston initiative supported by a grant from the Open Society Foundation. The interviews are being led by UMASS PhD students who also comprise the Mad in America research news team. Over the past three weeks, we have published interviews with many of the leading voices in this debate. Immediately following the release of the report and the beginning of the Summit, on World Mental Health Day, psychiatric epidemiologist, Dr. Melissa Raven, was on the MIA podcast. She questioned the evidence base of the movement, pointing to statistical issues in the prevalence rates of mental disorders internationally, and called for a focus on addressing barriers to health rather than on individualized treatment. Mental health service-user activists, Jhilmil Breckinridge, of the Bhor Foundation in India, and Dr. Bhargavi Davar, of Transforming Communities for Inclusion (TCI) Asia Pacific were also on the podcast. Each discussed the lack of involvement of service-user and disability rights groups in the UK Summit and Lancet report and laid out alternative frameworks for addressing distress in ways that are sensitive to culture and social context. Next, Dr. China Mills, a critical psychologist and author of Decolonizing Global Mental Health, spoke to my colleague, Zenobia Morrill, about her experience attending the UK summit and the lack of attention that has been given to the ways in which austerity policies in Britain have contributed to the increased demand for mental health interventions. You can find these earlier interviews at the links below: 10/10/18 - Interview with Dr. Melissa Raven, psychiatric epidemiologist - The Global ‘Mental Health’ Movement – Cause For Concern 10/20/18 – Interviews with mental health service-user/psychosocial disability rights activists Jhilmil Breckenridge and Dr. Bhargavi Davar - Global Mental Health: An Old System Wearing New Clothes 10/24/18 – Interview by MIA research news editor Zenobia Morrill with Dr. China Mills, a critical psychologist and prominent critic of the global mental health movement – Coloniality, Austerity, and Global Mental Health Today I am very pleased to announce that we are joined by Dr. Derek Summerfield. Dr. Summerfield is an honorary senior lecturer at the Institute of Psychiatry in London and former Research Associate at the Refugee Studies Centre at the University of Oxford and consultant and Oxfam. He was born in South Africa and trained in medicine and psychiatry at St. Mary’s Hospital Medical School in London. Dr. Summerfield has published hundreds of articles in medicine and social science and has contributed widely to understanding the impact of war-related trauma and torture on people around the world. He has been an outspoken critic of the global mental health movement for several years, criticizing the medicalization of trauma through PTSD, the exaggerated prevalence rates in the epidemiological data, and the lack of awareness of the different cultural experiences and understandings of distress.
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57 min
October 24, 2018
China Mills - Global Mental Health - Coloniality, Technology and Medicalization
Today, we bring you the third in our series of podcasts on the topic of the global mental health movement. Part one of the series featured Dr Melissa Raven and part two featured Jhilmil Breckenridge and Dr Bhargavi Davar. These interviews are led by our Mad in America research news team. In this episode, we interview Dr China Mills. China participated in organizing the open letter in response to The Lancet Commission on Global Mental Health and Sustainable Development. In this interview, China shares her concerns and reactions to the Lancet’s proposal, elaborating on deeper issues related to the framing of global mental health as a “burden” and the underlying implications of coloniality, technology, and medicalization. In addition, China tells us about her insider perspectives after attending the Global Mental Health Ministerial Summit hosted by the UK government. In her recent piece for Mad in Asia about the summit, she writes: “It was ironic to listen to a range of UK Government minsters talk about the importance of mental health whilst sat in a room just over the river from Westminster, where governmental decisions to cut welfare, and sanction and impoverish disabled welfare claimants has so detrimentally impacted people’s mental health and led to suicide. It felt like arrogance on the part of the UK Government to position themselves as world leaders in mental health when in 2016, the UN found that the Government’s austerity policies had enacted ‘grave’ and ‘systematic violations of the rights of persons with disabilities’ . It was equally jarring, given the cuts to social security under austerity, to be transported by boat about 2 minutes away, to an evening drinks reception at the Tate gallery.” China Mills is a Lecturer in the School of Education, University of Sheffield, UK. Her research develops the framework of psychopolitics to examine the way mental health gets framed as a global health priority. In 2014, she published the book ‘Decolonizing Global Mental Health’ and has since published widely on a range of topics including: the inclusion of mental health in the sustainable development goals; the quantification of mental health and its construction as a technological problem; welfare-reform, austerity and suicide; and the intersections of psychology, security and curriculum. She is Principal Investigator on two British Academy funded projects researching the social life of algorithmic diagnosis and psy-technologies. China is a member of the editorial collective for Asylum magazine and for the journal, Critical Social Policy; and she is a Fellow of the Sheffield Institute for International Development (SIID).
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56 min
October 20, 2018
Jhilmil Breckenridge and Bhargavi Davar - Global Mental Health - An Old System Wearing New Clothes
Today, we bring you the second in our series of podcasts on the topic of the global mental health movement. These interviews are led by our Mad in America research news team. On October 9th and 10th, 2018, World Mental Health Day, the UK government hosted a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement mental health policies globally. In the same week, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal for “scaling up” mental health care globally. In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of policy-makers, psychologists, psychiatrists, and researchers. In our last episode, we were joined by Dr Melissa Raven, a critical psychologist and epidemiologist, who discussed problems with the scientific evidence base used by the global mental health movement. She also emphasized the need to consider responses to the distress and suffering of people globally that address the social determinants of mental health, including poverty, education, and healthcare. Today we turn our focus to the concerns raised by mental health activists in response to the UK summit and the Lancet report. To discuss these issues, we are joined first by Jhilmil Breckenridge, a poet, writer and mental health activist and later by social science researcher Dr Bhargavi Davar. Jhilmil is the Founder of Bhor Foundation, an Indian charity, which is active in mental health advocacy, the trauma-informed approach, and enabling other choices to heal apart from the biomedical model. Jhilmil also heads a team leading Mad in Asia Pacific; this is an online webzine working for better rights, justice and inclusion for people with psychosocial disability in the Asia Pacific region. She is currently working on a PhD in Creative Writing in the UK and, for the last three years, she has also been leading an online poetry as therapy group for women recovering from domestic violence. She is working on a few initiatives, both in the UK and India, taking this approach into prisons and asylums. Her debut poetry collection, Reclamation Song, was published in May 2018. For our second interview, we are joined by Dr Bhargavi Davar. She identifies as a childhood survivor of psychiatric institutions in India. She went on to train as a philosopher and social science researcher at the Indian Institute of Technology in Bombay and has published and co-edited several books, including Psychoanalysis as a Human Science, Mental Health of Indian Women, and Gendering Mental Health, while also producing collections of poems and short stories. Dr Davar is an international trainer in the Convention on the Rights of Persons with Disabilities (CRPD) and the founder of the Bapu Trust for Research on Mind and Discourse in Pune, India. This organization aims to give visibility to user/survivor-centred mental health advocacy and studies traditional healing systems in India.
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67 min
October 10, 2018
Melissa Raven - The Global Mental Health Movement - Cause for Concern
This week, we present the first in a series of interviews on the topic of the global ‘mental health’ movement. These interviews will be led by our Mad in America research news team and today’s interview is hosted by our lead research news editor, Justin Karter. In this episode, Justin interviews Dr Melissa Raven, who is a psychiatric epidemiologist, policy analyst and postdoctoral research fellow in the Critical and Ethical Mental Health research group at the University of Adelaide, South Australia. Originally qualified as a clinical psychologist, she then worked as a lecturer and researcher in public health and primary health care. Her current mental health research and advocacy is informed by a strong social determinants perspective and a strong critical orientation, which she applies to a range of topics, including suicide prevention, workplace mental health, (over)diagnosis, (inappropriate) prescribing, and conflicts of interest in mental health and the broader health/welfare arena. On October 10th, 2018, World Mental Health Day, The Lancet Commission on Global Mental Health and Sustainable Development published a report outlining a proposal to “scale up” mental health care globally. At the same time, the UK government is hosting a Global Mental Health Ministerial Summit with the intention of laying out a course of action to implement these mental health policies globally. In response, a coalition of mental health activists and service-users have organized an open letter detailing their concerns with the summit and report. The response has attracted the support of critical professionals, psychologists, psychiatrists, and researchers.
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31 min
October 4, 2018
Zach Bush - Healthy Planet/Healthy Mind
Sharna Olfman Ph.D interviews Zach Bush MD One of the few triple board-certified physicians in the country, with expertise in Internal Medicine, Endocrinology and Metabolism, and Hospice/Palliative care, Dr. Zach Bush abandoned his prestigious academic career in cancer research, and his conventional medical practice a decade ago, after coming to terms with the fact that not only were his pharmaceutically based research and treatment protocols ineffectual; they were making his patients sicker. He then opened a clinic in the middle of a food desert in rural Virginia, where he swapped out pharmaceutical interventions for the medicinal properties of plants. Now based in Charlottesville, Dr. Bush has assembled an outstanding group of scientists and clinicians who are at the forefront of research on the microbiome and epigenetics. He has developed an impactful approach to healthcare which directly challenges ‘big farming, ‘big pharma’ and conventional medicine.  https://www.madinamerica.com/2018/10/healthy-planethealthy-mind-zach-bush-md/    
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58 min
October 1, 2018
John Read and Sue Cunliffe - The 57th Maudsley Debate - This House Believes that ECT has no Place in Modern Medicine
This week on MIA Radio we turn our attention to Electroconvulsive Therapy (ECT) or Electroshock as it’s known in the US. On Wednesday, September 19th, this emotive and controversial intervention was discussed at the 57th Maudsley debate, held at Kings College London. The motion proposed was: “This house believes that ECT has no place in modern medicine”. Supporting the motion were Professor John Read who has undertaken several scientific reviews of the literature supporting the use of ECT and Dr Sue Cunliffe. Dr Cunliffe was a paediatrician until she herself underwent ECT, after which she became cognitively impaired and found herself unable to continue working. She now campaigns for the risks of ECT to be made more explicit and to directly address the professional denial of the damage that ECT can cause. Speaking against the motion were Professor Declan McLoughlin and Dr Sameer Jauhar. Both John and Sue took time out to talk about the debate and the wider issues surrounding ECT. Professor Read kindly shared his debate notes, which are provided below. Thank you to the Institute for bringing us all together. Let us first remind ourselves tha thistory is littered with procedures which people believed in- just as strongly as some psychiatrists believe, today, in electrocuting people’s brains to cause seizures - but which turned out to be ineffective or damaging. The list includes spinning chairs, surprise baths, standing people next to cannons, and, more recently, lobotomies. It was 80 years ago, in 1938, that Ugo Cerletti administered the first ECT, to a homeless man in Rome. After the first shock the man called out ‘Not another – it will kill me’. The theory back then was that people with epilepsy didn’t have schizophrenia so the cure for schizophrenia was to cause epilepsy. So Cerletti was driven by the genuine belief that causing convulsions by shocking the brain really might help people, by the genuine hope that we might finally have come up with an effective treatment. The story of ECT illustrates, yet again, however, what happens when our beliefs and good intentions are not tempered with good science. ECT quickly spread from Rome across Europe and America. Finally, an effective treatment! People who received it were discharged earlier….… by the doctors who gave it. But there were no studies for 13 years, by which time everyone just knew it worked, and their belief may have been very helpful to some patients. The first study on depression (which became the main target for ECT), in 1951, found that those who had ECT fared worse than those who had not had it. It made no difference. I have co-authored four reviews of the ECT research, most recently last year. There are only ten depression studies comparing ECT and placebo; placebo meaning the general anaesthetic is given but the electric shock is withheld. Five of those 10 found no difference between the two groups. The other five found, compared to placebo, a temporary lift in mood during the treatment period, among about a third of the patients. One of these five found that this temporary improvement was perceived only by the psychiatrists, but not by the nurses or the patients. Most reviews and meta-analyses assert, on the basis of these temporary gains in a minority of patients, that ‘ECT IS EFFECTIVE’ But none of them have ever identified a single study that found any difference between ECT and placebo after the end of the treatment period. There is just no evidence to support the belief that ECT has lasting benefits, after 80 years of looking for it. Similarly, there are no placebo studies to support another genuinely held belief: that ECT prevents suicide. There is nothing wrong with treatments working because of hopes and expectations. But passing 150 volts through brain cells designed for a tiny fraction of one volt causes brain damage. Indeed, autopsies quickly led to a new theory about how ECT works. In a 1941 article entitled ‘Brain damaging therapeutics’, the man who introduced ECT to the USA, wrote ‘Maybe mentally ill patients can think more clearly with less brain in actual operation’. In 1974 the head of Neuropsychology at Stanford wrote: ‘I’d rather have a small lobotomy than a series of ECT….I know what the brain looks like after a series of shock’. All ECT recipients experience some difficulties laying down new memories and in recalling past events. What is disputed is how many have long-lasting or permanent memory dysfunction, which might reasonably be called brain damage. Findings range from one in eight to just over half. A review of studies that actually asked the patients, conducted here at the Institute, found ‘persistent or permanent memory loss’ in 29 to 55%. Yet another belief is that ECT used to cause brain damage, in the bad old days, but not any more.  But a recent study found one in eight with ‘marked and persistent’ memory loss, …..  and also found much higher rates among the two groups who receive it most often, women and older people. The same study also found that the memory loss was not related to severity of depression. This is important because another belief about ECT is that the memory loss is caused by the depression, not the electricity. Psychiatric bodies in the UK and USA recite the belief that only ‘one in 10,000’ will die from having ECT, without producing a single study to support that belief.  Our reviews document large-scale studies with mortality rates between one in 1400 and one in 700, several times higher than the official claims, typically – unsurprisingly - involving cardiovascular failure. ECT in England has declined, from 50,000 a year in the 1970s to about 2,500. The number of psychiatrists who still believe, despite all the evidence, is dwindling fast. It may have been understandable for the psychiatrists of the 1940s to believe that ECT worked and was safe. They didn’t know any better. But if psychiatry wants to be an evidence-based discipline, to be part of modern medicine, it must acknowledge that, despite all its honourable intentions, it has got this one, like lobotomies, woefully wrong. Thank you. Links and Further Information To watch the debate on YouTube, click here. To read a report on the first ever Maudsley Debate, held in January 2000, which also discussed ECT, click here. ECT Accreditation Service (ECTAS) MECTA The effectiveness of electroconvulsive therapy: A literature review, John Read and Richard Bentall Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009  
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65 min
August 21, 2018
Conflicts of Interest Questioned in Review of Prescribed Drug Dependence
This week on MIA Radio, we discuss the UK Royal College of Psychiatrists representation on a Government-led review of Prescribed Drug Dependence. Professor Sami Timimi, a fellow of the Royal College of Psychiatry, and 30 other mental health experts, have formally asked the College to ‘replace Professor David Baldwin as its representative on The Expert Reference Group of Public Health England’s Review of Prescribed Medicines, with an RCPsych member who is not compromised by conflicts of interest with the pharmaceutical industry’. In this podcast, we hear from Professor Timimi, Psychiatrist Peter Gordon and campaigner Stevie Lewis. Both Peter and Stevie are people who have experienced withdrawal effects from antidepressant drugs. Conflicts of Interest Questioned in Royal College of Psychiatry’s Participation in Government-Led Mental Health Medication Review August 17, 2018 From: James Moore, antidepressant withdrawal sufferer, on behalf of the 30 other signatories to today’s letter.   London, UK – A fellow of the Royal College of Psychiatry, and 30 other mental health experts, have today formally asked the College to ‘replace Professor David Baldwin as its representative on The Expert Reference Group of Public Health England’s Review of Prescribed Medicines, with an RCPsych member who is not compromised by conflicts of interest with the pharmaceutical industry’. The Public Health England review1 was set up to examine a growing problem with patients becoming dependent on psychiatric drugs including antidepressants. In the UK, four million people are long-term antidepressant users2, with many of those unable to come off their drugs without debilitating and protracted withdrawal symptoms. Signatories to the complaint include 10 people whose withdrawal experiences have lasted between one and ten years, plus 11 psychiatrists and 8 mental health professors. In the Public Health England (2018) document ‘PMR ERG members declarations of interest’, Prof­essor Baldwin reports having received ‘personal honoraria for lecture engagements organised by AstraZeneca, Bristol-Myers Squibb, Eli Lilly Ltd, Glaxo-SmithKline, Janssen, H. Lundbeck A/S, Pharmacia, Pierre Fabre, Pfizer Ltd, Servier, and Wyeth Ltd’. In addition, he reports attendance at advisory boards of five companies and research funding from twelve. The signatories are worried that he could be unduly influenced by the large number of pharmaceutical manufacturers he has received income from. This concern is exacerbated by Professor Baldwin’s having already publicly minimised the withdrawal effects of antidepressants (Times 24.2.18), which was described as ‘misleading’ the public in the House of Lords3and led to a formal complaint against him4. Lead author of the letter, psychiatrist Professor Sami Timimi, a fellow of the Royal College, said: “DESPITE THE INCREASED AWARENESS OF THE PERNICIOUS INFLUENCE OF THE PHARMACEUTICAL INDUSTRY IN ALL SPHERES OF MENTAL HEALTH, THE RCPSYCH DOES NOT APPEAR TROUBLED BY THE POTENTIAL FOR MISLEADING THE MEDICAL COMMUNITY AND THE PUBLIC AND SOILING THE GOOD NAME OF THE PROFESSION OF PSYCHIATRY. WE FEEL THE NEED TO MAKE PUBLIC OUR OPPOSITION TO SOMEONE SO CONNECTED WITH THE PHARMACEUTICAL INDUSTRY BEING THE RCPSYCH’S REPRESENTATIVE ON A PUBLIC BODY APPOINTED WITH THE TASK OF WORKING FOR THE PUBLIC GOOD.” Another signatory, psychiatrist Dr Peter Gordon said: “EVIDENCE HAS REPEATEDLY FOUND THAT COMPETING FINANCIAL INTERESTS CAN LEAD TO DOCTORS RECOMMENDING WORSE TREATMENTS FOR PATIENTS5. IN THE UK, THE PHARMACEUTICAL INDUSTRY SPENDS OVER £40 MILLION A YEAR ON DOCTORS AND ACADEMICS WHO MARKET AND PROMOTE THEIR PRODUCTS6. I HAVE BEEN COMMUNICATING WITH MY COLLEGE FOR MANY YEARS ON THIS, YET IT REMAINS THE CASE THAT THE ROYAL COLLEGE OF PSYCHIATRISTS STILL HAS NO SINGLE, SEARCHABLE REGISTER THAT RECORDS FULL DETAILS OF INDUSTRY PAYMENTS MADE TO ITS MEMBERS. IT IS THEREFORE IMPOSSIBLE TO DETERMINE THE SCALE OF PAYMENTS THAT MAY HAVE BEEN MADE TO COLLEGE MEMBERS WHO ARE INVOLVED IN DEVELOPING POLICIES AND GUIDELINES OR EDUCATING ON THE PRESCRIBING OF PSYCHIATRIC MEDICATIONS.” Antidepressant withdrawal sufferer James Moore, also a signatory, said: “THERE ARE MANY PEOPLE OUT THERE LIKE ME, WHO HAVE FOUND THEMSELVES IN SEVERE DIFFICULTY AFTER TRYING TO COME OFF PRESCRIBED ANTIDEPRESSANT DRUGS. IN ORDER TO PROPERLY INVESTIGATE THIS ISSUE, IT IS VITAL THAT THE INFLUENCE OF THE PHARMACEUTICAL MANUFACTURERS IS NOT ALLOWED TO CORRUPT AN EVIDENCE-BASED AND HONEST APPRAISAL OF A PROBLEM POTENTIALLY AFFECTING MILLIONS OF PSYCHIATRIC DRUG USERS.” References 1. https://www.gov.uk/government/collections/prescribed-medicines-an-evidence-review 2. https://www.theguardian.com/society/2018/aug/10/four-million-people-in-england-are-long-term-users-of-antidepressants 3. http://bit.ly/2BgyzxX 4. https://www.madinamerica.com/2018/07/30-mental-health-experts-write-secretary-state-unprofessional-conduct-uk-royal-college-psychiatry/ 5. http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000352 6. https://www.bmj.com/content/360/bmj.k1380 © Mad in America 2018
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38 min
July 28, 2018
Julia Rucklidge - Nutrition, Mental Health and TED
This week on MIA Radio we interview Dr Julia Rucklidge. Dr Rucklidge is professor of clinical psychology at the University of Canterbury in New Zealand and she leads the Mental Health and Nutrition Research Group. Originally from Toronto, Canada, Julia completed her PhD at the University of Calgary followed by a post-doctoral fellowship at the Hospital for Sick Children in Toronto. In the last decade, she and her lab have been running clinical trials investigating the role of broad-spectrum micronutrients in the expression of mental illness, specifically ADHD, mood disorders, anxiety and stress. Julia has over 100 peer-reviewed publications and book chapters, has been frequently featured in the media and has given invited talks all over the world on her work on nutrition and mental health. We discuss: What led Julia to her interest in nutrition and how it may have a role in responding to mental disorders, particularly Attention Deficit Hyperactivity Disorder (ADHD). Why using the Recommended Dietary Allowance (RDA) of vitamins and minerals may not be the best approach when responding to psychological difficulties. How Julia went about setting up a Randomised Controlled Trial to investigate the effect of micronutrients and minerals on behavioral problems. That the most consistent finding of the study is that the individuals taking micronutrients improved more in their general functioning and impairment when compared to those just taking a placebo. That it’s hard to move away from the conception of mental illness as a chemical imbalance in the brain, partly because of the vested interest in keeping it alive. That there is no opportunity to patent nutrient therapies, so there is little incentive for research and limited commercial interests. Why a single nutrient response might not be the best approach for someone who wanted to use nutrition to improve their mental health and wellbeing. How a dietary deficiency of Niacin during the 1930s led to a condition called Pellagra which often manifested as psychotic symptoms. What led to the flagging of a 2014 TEDx talk Julia gave entitled “The surprisingly dramatic role of nutrition in mental health”. How Julia felt about her talk being flagged by TED. How many historical medical advances, now accepted as the standard of care, at the time flew in the face of conventional scientific thinking. How difficult it has been to communicate with TED about the flagging of the talk. How Julia hears from many people who get in touch to share that they are struggling with psychiatric medications and instead want to look to nutritional solutions. That the best advice is often simple, eat more fruits and vegetables and reduce the amount of processed food. Relevant Links: Mental Health and Nutrition Research Group Vitamin-mineral treatment of ADHD in adults: A one year follow up of a randomized controlled trial. Anxiety and Stress in Children Following an Earthquake: Clinically Beneficial Effects of Treatment with Micronutrients A double-blind randomised, placebo-controlled trial of a probiotic formulation for the symptoms of depression TEDx Christchurch: The Surprisingly Dramatic Role of Nutrition in Mental Health TED Betrays Its Own Brand By Flagging Nutrition Talk Contact the Mental Health and Nutrition Research Group Mad Diet by Suzanne Lockhart
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37 min
July 11, 2018
World Benzodiazepine Awareness Day 2018 - Part 2 - Robert Whitaker
This week on MIA Radio, we present a special episode of the podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2018. In part 2 of the podcast, we interview Mad in America founder, Robert Whitaker. For many of us, Robert needs no introduction as he is well known for his award-winning book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, which was released in 2010. Robert has been a medical writer at the Albany Times Union newspaper, A journalism fellow at the Massachusetts Institute of Technology and Director of publications at the Harvard Medical School. Besides many papers, journals and articles, Robert has written five books which include Mad In America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill in 2001, Anatomy of an Epidemic in 2010 and Psychiatry Under The Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform published in 2015. We discuss: What took Bob from writing as an industry insider covering clinical trials to founding Mad in America. How writing a story about the botched introduction of laparoscopic surgery led to an interest in how commerce was corrupting healthcare. How Freedom of Information requests led to an understanding of the corruption in the clinical trials of antipsychotic drugs. What led to writing the book Mad in America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill in 2001. That, when you look at the science, you see an enduring theme in psychiatry of treatments that are full of promise, but ultimately can lead to harm. That Bob came to these issues as a journalist who felt a sense of public duty to be an honest reporter of the facts and the science. The extraordinary history behind the revival of the market for benzodiazepines. How Valium became the western world’s most prescribed psychiatric drug during the late 1960s. How, in the 1970s, it became apparent that people were struggling to get off the drugs. That women’s magazines started to write about the experiences of women addicted to Valium, and it was recognised as a bigger issue than heroin addiction. That the reaction by the pharmaceutical manufacturers was to reconceptualize anxiety-related distress as depressive distress and move patients on to SSRIs. How in 1980, in the third version of the Diagnostic and Statistical Manual, a new disorder is named: Panic Disorder, leading the maker of Alprazolam, Upjohn, to get it approved specifically for the treatment of panic disorder. How the study published showed that the reduction in panic attacks in the medicated group over four weeks was greater than the unmedicated group, but the study actually ran for eight weeks, by which time there was no difference between the medicated and unmedicated groups. That in the six-week withdrawal phase of the study, 44% were not able to stop the drugs. How newspapers reported that Xanax (Alprazolam) was an efficacious, safe and non-addictive treatment for panic disorder. That what you see in the heart of the Xanax story is a betrayal of the public. The reasons why doctors often don’t review the papers that would lead them to conclude that benzodiazepines are highly problematic drugs. A paper from a new International Task Force on Benzodiazepines which seems to be a statement of intent to increase benzodiazepine prescribing. That people should keep on telling their stories of withdrawal and iatrogenic harm. The attempt in Massachusetts to pass a bill requiring informed consent. The problems inherent in using the language of withdrawal when the symptoms are protracted and that it would be more appropriate to describe this as a neurological injury. That the benzodiazepine community is doing an incredible service by alerting the public to what should be seen as a public health crisis. Relevant links: Revival of the market for Benzodiazepines Malcolm Lader: It is more difficult to withdraw people from benzodiazepines than it is from heroin International Task Force on Benzodiazepines    
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56 min
July 11, 2018
World Benzodiazepine Awareness Day 2018 - Part 1 - Nicole Lamberson, Josef Witt-Doerring, Chris Paige
This week on MIA Radio, we present a special episode of the podcast to join in the many events being held for World Benzodiazepine Awareness Day, July 11, 2018. In part 1, we chat with W-BAD Lead Operations Volunteer and Virginia Representative Nicole Lamberson who talks about the events being held for W-BAD. We hear from psychiatrist Dr Josef Witt-Doerring, who talks about a recent paper he co-authored entitled “Online Communities for Drug Withdrawal: What Can We Learn?”. We also hear from therapist and campaigner Chris Paige who discusses his own experiences taking and withdrawing from benzodiazepines. Finally, in part 2 of the interview, we get to chat with Robert Whitaker, science journalist and author of the books Mad in America and Anatomy of an Epidemic. First, I am very fortunate to have had the chance to talk with Nicole Lamberson. Nicole is Lead Operations Volunteer and Virginia Representative for W-BAD and she has kindly taken time out of her busy preparations to talk about how she became involved with W-BAD, some of the events and campaigns being held around the world and how people can get involved. Nicole has an immense passion for benzodiazepine awareness and its victims and hopes that her efforts ultimately spare many others from taking this painful, senseless, and totally preventable iatrogenic “journey”. We discuss: How Nicole first became involved with W-BAD. How discovering personal testimonies encouraged her to reach out to find out more about an awareness day held on the birthday of Dr Heather Ashton - July 11. What it feels like to be part of the benzodiazepine community. How there is is still no medical consensus about the effects of both taking and withdrawing from benzodiazepines. The W-BAD T-shirt campaign, which was organised in partnership with the Benzodiazepine Information Coalition and As Prescribed, an in-production documentary by Holly Hardman. Pamphlet distributions happening in Auckland, Paris, Boston and Torrington. That Wayne Douglas, W-BAD founder is on the Dr Peter Breggin hour on July 11 at 4pm New York time. That people can visit W-BAD events to find out more. That on social media, people can follow events using @WorldBenzoDay and the hashtag #WorldBenzoDay. That people can participate in many ways and that one of the most important ways to participate is to submit reports of adverse effects and withdrawal reactions to the appropriate regulator, links to which can be found on the W-BAD website. How important it is to share stories and personal experiences. That W-BAD is for anybody, not just those who are damaged by the drugs but also for families and friends and those recovered too. Relevant links: W-BAD [IN]VISIBLE T-shirt campaign How to participate in W-BAD Benzodiazepine Information Coalition As Prescribed by Holly Hardman (documentary film in production) International Task Force on Benzodiazepines Dr Heather Ashton The 2017 W-BAD podcast featuring Professor Malcolm Lader, Jocelyn Pedersen and Barry Haslam. Next, we chat with psychiatrist Dr Josef Witt-Doerring. Josef trained in Queensland, Australia before becoming a psychiatric resident at Baylor College of Medicine, Houston, Texas. He co-authored a paper published in Psychiatric Times entitled “Online Communities for Drug Withdrawal: What Can We Learn?” which received praise for openly addressing the issues of dependence and withdrawal and identifying the support activity that goes on in forums like Benzo Buddies and Surviving Antidepressants. We discuss: What led Dr Witt-Doerring to become a psychiatric trainee after attending medical school in Queensland, Australia. How reading Anatomy of an Epidemic led to an awareness of some of the consequences of psychiatric drug use from a critical perspective. What led to his research into online support forums for those who are seeking support for psychiatric drug withdrawal. That Josef was surprised at the amount of support activity in online forums like Benzo Buddies and Surviving Antidepressants. How the paper that Josef co-authored on learning from online communities found a great deal of support both amongst colleagues and patient advocacy organisations. How he feels that there is a general lack of awareness of dependence and withdrawal issues because the messages can be drowned out by more strident communications in marketing or promotional material. That the idea of ‘treatment resistant’ conditions is probably much more on a general doctors mind than adverse reactions or protracted withdrawal experiences. How Josef’s experiences have influenced his approach to prescribing central nervous system drugs. That he would like to think that if a doctor and patient can talk frankly and openly about the pros and cons of treatment, then that is likely to lead to a better relationship and a better outcome. That there is a dearth of support services for people struggling with the drugs, particularly at the end of treatment. How academic detailing programmes could help raise awareness and disseminate information that would lead to doctors being more confident about de-prescribing. How the language of addiction and dependence can sometimes be a barrier to recognition of drug withdrawal issues. That it may be better to look through a neurological injury lens rather than an addiction lens both in terms of understanding experiences but also to enable better treatment and support options. That the community of those affected should continue to share their stories and to raise petitions with professional organisations, such as the boards that licence psychiatrists and OBGYN’s. How, because of the huge variation in patient experience, it would be very difficult to mandate short-term prescribing. Relevant links: Online Communities for Drug Withdrawal: What Can We Learn? Benzo Buddies Benzodiazepine Information Coalition Surviving Antidepressants Malcolm Lader: Anxiety or depression during withdrawal of hypnotic treatments Our next guest is Chris Paige. Chris has a bit of an 'inside' perspective to add to the conversation for World Benzodiazepine Awareness Day in that he is a licensed therapist of over 20 years who was iatrogenically injured by a prescribed benzodiazepine. Chris has practised in a variety of settings including hospitals, schools, and foster homes and has taught at the undergraduate and graduate level. He has presented papers at national and international conferences, appeared on Dateline NBC for his work with children of divorce and had his own national magazine column called 'On The Couch with Chris Paige'. Chris is on the board the Benzodiazepine Information Coalition, a non-profit organization that advocates for greater understanding of the potentially devastating effects of commonly prescribed benzodiazepines as well as prevention of patient injury through medical recognition, informed consent, and education. Chris currently resides and practices in Florida. We discuss: How Chris first came to be prescribed a benzodiazepine in 2000. His recollections of being prescribed Klonopin (Clonazepam) for anxiety, taking between 1 and 2 milligrams per day. How, after three years use, he started to notice tremors and memory loss. That a neurologist explained that his symptoms may be medication related and advised a taper but gave no specific instructions. How Chris came off the Klonopin fairly rapidly but didn’t find it too difficult at the time. How, some years later, he was given an antibiotic for a prostate infection but rapidly developed psychiatric symptoms including anxiety, agitation and insomnia. That this led Chris to consult a doctor for some Klonopin tablets to manage this and that he took a total of 16 milligrams over the next 10 weeks. That he understands now that the antibiotic and the Klonopin compete at the same receptor in the brain, leading immediately to a tolerance to the drug. That because of this tolerance he became more sleepless, more agitated and more anxious and working was becoming increasingly difficult. How he came to be in a five-day detox programme in Vermont, where they took him off one and a quarter milligrams of Klonopin in just five days. How Chris realised that the detox approach was not right and wanted to leave. How the detox programme decided to replace the Klonopin with four different psychiatric drugs, two of which he has now ceased with two still to taper. That he felt that his brain and nervous system were severely shocked by making such rapid medication changes. How this led to Chris being admitted to psychiatric hospital which he describes as “possibly one of the most humiliating experiences he has ever endured.” How Chris felt when experiencing akathisia which was a relentless compulsion to move and gave him a feeling as if his whole body was being electrocuted and that he had been lit on fire. That he initially felt supported by friends and family but that quickly eroded when he didn't get better or accept harmful and dangerous treatment advice. That this led to the misunderstanding of his injury and it being mislabeled as an addiction problem. That ultimately the only places he found validation and support were online support forums. The losses that Chris endured during his struggles including his health, his psychotherapy practice and even his reputation. That Chris’s message is that there is hope for the future and the importance of reconnecting with the simple things in life. The lack of acknowledgement of the impact of trauma on a person’s life. Relevant links: Benzodiazepine Information Coalition Chris's profile at BIC In part 2 of this podcast, we will hear from science journalist and author Robert Whitaker.
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80 min
July 6, 2018
Peter Groot and Akansha Vaswani - Tapering Strips and Shared Decision-Making
On MIA Radio this week, Akansha Vaswani and Dr Peter Groot discuss Tapering Strips, a novel and practical solution for those who wish to taper gradually from a range of prescription drugs. Akansha is a doctoral candidate at the University of Massachusetts, Boston and her dissertation research will involve interviewing psychiatrists in the US about their experiences helping people stop or reduce their dose of antidepressant medication. Dr Groot is a researcher and geneticist who has led the development of Tapering Strips. In a recent study, published in the journal Psychosis, Dr Groot, together with Jim van Os, reported on the results of their trial which recorded the experiences of people using Tapering Strips. In this episode we discuss: What motivated Peter to be interested in and study the effects of coming off antidepressants drugs. That the observational study reported in Psychosis was based on questionnaires completed by users who had made use of tapering medication (Tapering Strips) to slowly reduce their medication dosage. How the questionnaire asked about withdrawal symptoms and the ease of tapering using the strips and whether people had tried to withdraw previously using conventional methods. That Tapering Strips offer a flexible and necessary addition to standard doses that have been registered by the pharmaceutical companies. That current guidelines advise doctors to let patients start on the same recommended dose of an antidepressant, without taking into account large differences that exist between patients (weight, sex, etc). How we would be surprised if, when we came to buy shoes or clothes, our choices were limited to only a few sizes, but we don’t question this limitation with our medications. How current guidelines are based on group averages and do not help a doctor to determine how a given individual patient should taper. How shared decision making, in which the patient and the doctor work in a collaborative way, can make tapering easier. How shared decision making has contributed to the success of the use of tapering medication and the availability of tapering medication makes shared decision making practically possible. How shared decision and the availability of tapering medication makes life easier for the doctor as well as for the patient. How working initially as a volunteer to develop Tapering Strips brought Peter into contact with Professor Jim van Os and the User Research Centre of Maastricht University. That, in the study, 1,750 questionnaires were sent, with 1,164 received, a response rate of 68%. Of those returned, 895 said their goal was to taper their antidepressant drug completely and 70% succeeded in this goal. That the median time taken for people in the study to withdraw from Venlafaxine was 56 days or two Tapering Strips. There were a variety of reasons reported for those who didn’t reach their goal, including the fact that some of the patients were still tapering. Other reasons reported for not withdrawing completely were due to the occurrence of withdrawal symptoms, relapse of an original condition or even issues related to reimbursement of the cost of the tapering medication by insurance companies. That 692 patients reported that previous attempts to withdraw had failed in comparison to the successful use of Tapering Strips. That people using multiple drugs should only ever taper one medication at a time and in discussion with a medical professional. That Peter’s goal for Tapering Strips is to make sure that people that want to withdrawal gradually can access Tapering Strips and have the cost reimbursed by health insurers. That Tapering Strips were not developed to get everyone off their antidepressant drug but to enable patients to get to a dosage that provides benefit for them (which can be zero) while minimising adverse effects. That people outside the Netherlands can get Tapering Medication, but only with a prescription signed by a certified doctor, instructions and receipt/order forms can be found at taperingstrip.org. That Tapering Strips are also available for antipsychotics, sedatives (benzodiazepines), analgesics and for some drugs other than psychotropics, like some anti-epileptic drugs, which are currently being developed. That Peter warns against tapering by taking doses on alternating days, particularly for drugs like paroxetine or venlafaxine that have a short metabolic half-life, because this will lead to more severe withdrawal symptoms. Relevant Links: Tapering Strips (website of the User Research Centre of Maastricht University) Treatment guidelines for the use of tapering strips Summary of the tapering study in the journal Psychosis (blog) Tapering Strips study from the journal Psychosis Peter Groot interviewed on Let's Talk Withdrawal Claire shares her experience with Tapering Strips (YouTube) Petition requesting use of Tapering Strips in the UK Mad in America report on Tapering strips study Prime Time for Shared Decision Making Mandatory Shared Decision Making © Mad in America 2018
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46 min
June 19, 2018
Sami Timimi and John Read - Latest Developments with The UK Royal College of Psychiatrists
This week on MIA Radio we provide an update on a complaint made to the UK Royal College of Psychiatrists by a group of thirty academics, psychiatrists and people with lived experience. We hear from both Professor Sami Timimi and Professor John Read who discuss recent events including the latest response from the Chief Executive Officer of the College. Relevant Links: Read the latest update on Mad in America Formal Complaint to the UK Royal College of Psychiatrists Royal College Of Psychiatrists Challenged Over Potentially Burying Inconvenient Antidepressant Data Professor John Read: The Royal College of Psychiatrists and Antidepressant Withdrawal UK Royal College Dismisses Complaint © Mad in America 2018
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30 min
May 17, 2018
Peter Gordon - Addressing the Divide Between the Arts and Medical Sciences
This week, we interview Dr Peter Gordon. Dr Gordon describes himself as a gardener with an interest in medicine. He trained in both medicine and landscape architecture before specialising in psychiatry and now works with older adults in Scotland. In addition, he is an activist and campaigner and has a range of creative interests including filmmaking, photography, writing and poetry. In this interview, we walk about Peter’s own experiences of psychiatric treatment and how we need to address the divide that exists between the arts and the medical sciences. In this episode we discuss: What led Dr Gordon to have combined interests in the arts and the sciences, training both in architecture and medicine. How Peter was interested in the plurality of thinking required for psychiatry as opposed to general medicine. How he feels that his training in both the arts and the sciences led to a more rounded appreciation of why purely biological approach might miss opportunities to help people. How Peter became an activist, partly in response to the commonly taught subjective/objective diagnostic approach. How we should be focussed on the potential of any medical intervention to cause harm and should consider this carefully alongside any potential benefit. How we need to take account of all experiences to ensure we provide the maximum benefit and minimum harm to people. Peter’s own experiences with the mental health system, taking antidepressant drugs and experiencing treatment within a psychiatric hospital. How stopping his antidepressant drug resulted in withdrawal effects and led to Peter’s only episode of severe depression. Why Peter is concerned that we seem to be downplaying the experiences of people who have struggled with psychiatric drugs. How Peter’s experiences have influenced his approach to prescribing. The dominance of the biological approach and why it should not dictate how we respond to individual experiences. How the evidence is starting to show that diagnosis can often disempower and bring about ‘otherness’. Peter’s plea for people to be kind to one another and work together to maximise well-being. Relevant links: Peter’s blog: Hole Ouisa The caption is wrong Paroxetine tablets [Film-coated] Peter’s films on Vimeo Mary Midgley Nathan Filer, The Shock of the Fall Raymond Tallis To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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24 min
May 12, 2018
Sera Davidow - Intersections Between Sexual Violence and Psychiatric Abuse
This week on MIA Radio we interview Sera Davidow, a psychiatric survivor and prolific activist for the human rights of people labeled mentally ill. Sera serves as the Director of the Western Massachusetts Recovery Learning Community and is a founding member of the Hearing Voices USA Board of Directors. Through her work, she has gained a range of experiences including starting up a peer respite, opening resource centers, and producing educational materials on non-coercive, non-pathologizing alternatives to the traditional mental health system. Sera is a regular blogger for Mad in America and has written extensively on the topics of forced treatment and sexual violence. In this interview, we discuss the parallels and intersections between coercive psychiatric care and sexual assault. In this episode we discuss: Sera’s lived experience as a psychiatric survivor and survivor of sexual violence. The similarities between sexual violence and forms of psychiatric abuse including forced drugging, forced intubation, forced catheterization, strip searches, restraint, and containment How even seemingly minor or routine parts of psychiatric hospitalization, such as regularly monitoring patients, can be violating The role that victim-blaming and gaslighting play in both sexual violence and psychiatric coercion That the language and terminology of the mental health system such as “mental illness,” “noncompliance,” and “anosognosia” serve to perpetuate violence That people’s discomfort with big emotions and taboo topics often prevent trauma survivors from speaking about their experiences within psychiatric settings How we can help providers and the general public understand the trauma and violence of psychiatric coercion Relevant Links: Sera Davidow A World That Would Have Us Doubt: Rape, the System, and Swim Fans Us, Too: Sexual Violence Against People Labeled Mentally Ill Feminism 101: What is Gaslighting? To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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39 min
May 3, 2018
Laura Delano - Connecting people through the Inner Compass Initiative and Withdrawal Project
This week, we interview Laura Delano. Laura is Co-Founder and Executive Director of the Inner Compass Initiative and The Withdrawal Project, which aim to create safe spaces for people to connect and the opportunity to learn about and be guided through the process of getting beyond the mental health system and off psychiatric drugs.  The passion she feels for the mission and vision of ICI arises from the fourteen years she spent lost in the mental health system and the journey that she’s been on since 2010, when she chose to leave behind a “mentally ill” identity and the various treatments that came with it, and gradually began to rediscover and reconnect with who she really was and what it means to suffer, struggle, and be human in this world.  Since becoming an “ex-patient”, Laura has been writing and speaking about her personal experiences and about the broader social and political issues sitting at the heart of “mental illness” and “mental health”. Since 2011, she has worked both within and beyond the mental health system. In the Boston area, she worked for nearly two years for a large community mental health organization, providing support to and advocating for the rights of individuals in emergency rooms, psychiatric hospitals, and institutional “group home” settings. After leaving the “inside” of the mental health system, she began consulting with individuals and families seeking help during the psychiatric drug withdrawal process. Laura has also given talks and workshops in Europe and across North America, facilitated mutual-aid groups for people in withdrawal, and organized various conferences and public events such as the Mad in America International Film Festival.  In this interview, we got time to talk about Laura’s personal experiences of the mental health system and what led her to co-found the Inner Compass Initiative and The Withdrawal Project. In this episode we discuss: Laura’s experiences as a patient in the mental health system, starting treatment aged thirteen and leaving the system behind aged 27. How she spent much of that time as a compliant patient, taking the medications and following the advice of her doctors. That, by 2010, she was on 5 medications (Lithium, Abilify, Lamictal, Effexor and Ativan) and had spent the last decade becoming worse and unable to properly engage with life. How she came to read Anatomy of an Epidemic by Robert Whitaker and that it was a profound moment of realisation. That Laura decided to take control of her life and became determined to get off the drugs as quickly as possible. How traumatic it was to come to the realisation that almost everything she had been told during treatment was overly simplistic or incorrect. That Laura did experience feelings of being a victim of psychiatry, but realised that this increased her emotional dependency on psychiatry and that it was necessary to move beyond that to feel free. That these experiences made Laura passionate about her own process of healing and rediscovering herself and helping others to find their way back to themselves after being psychiatrized. That as she healed she moved into a space of acceptance and gratitude and felt that the period around three years off the drugs was when she came to feel really alive and motivated again. That Laura feels that if we are going to move beyond the mental health system, it is about helping people to realise they don't need the mainstream system and point them to alternatives at a local level and creating physical spaces where people can come together. How Laura came to co-found The Inner Compass Initiative and The Withdrawal Project which aim to create safe spaces for people to connect and the opportunity to learn about and be guided through the process of getting beyond the mental health system and off psychiatric drugs. That The Withdrawal Project was highlighted in a recent New York Times article discussing antidepressant withdrawal. How ICI and TWP present information on many aspects of psychiatric drugs and withdrawal to help guide and inform people who do want to start the journey off their psychiatric drugs and away from the mental health system. That TWP connect is a free peer to peer networking platform that allows people to connect one on one with others who have similar experiences. How a similar peer to peer system is available on ICI to enable conversations about moving beyond the mental health system. That Laura wants to encourage people not to give up because we do heal from psychiatric drugs and that we need to spread that message far and wide. The need to both learn and unlearn when approaching how we take back our power and control of our lives after psychiatric treatment. How important it is to properly prepare before starting to taper from psychiatric drugs and how the Withdrawal Project can enable that preparation. The ‘speed paradox’ when coming off psychiatric drugs. How people can find out more about The Inner Compass Initiative and The Withdrawal Project. That Laura is keen to support local community initiatives to get underway. Relevant links: The Inner Compass Initiative The Withdrawal Project TWP Connect Learn about psychiatric drug withdrawal Inner Compass Initiative’s The Withdrawal Project Gets Mention in The New York Times—Is the Tide Finally Turning? The New York Times - Many People Taking Antidepressants Discover They Cannot Quit Read more about Laura’s journey into and out of the mental health system Laura’s presentation in Alaska, 2015 Anatomy of an epidemic by Robert Whitaker
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46 min
May 2, 2018
John Read - UK Royal College of Psychiatry Refuses to Retract Misleading Statement about Antidepressant Withdrawal and Dismisses Complaint
Today on MIA Radio we have a special episode which is devoted to recent developments in the UK involving a formal complaint lodged with the UK Royal College of Psychiatrists.  Professor John Read from the University of East London took time out to bring us up to date on the response to the complaint which was lodged on behalf of a group of thirty academics, psychiatrists and people with lived experience. Relevant links: Read the full reply letter on Mad in America Hear the Royal Society of Medicine’s podcast interview with Professor Wessely and Dr Clare Gerada The New York Times - Many People Taking Antidepressants Discover They Cannot Quit
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18 min
April 14, 2018
Jeffrey Michael Friedman - Trauma and Forced Psychiatric Treatment
This week on MIA Radio, we interview Jeffrey Michael Friedman, a clinical social worker and an activist in the psychiatric survivor's movement. Jeffrey provides trauma-informed therapy to victims of various forms of abuse and violence, including those who have survived abuses within the mental health system. In addition to his work in the mental health field, Jeffrey is actively involved in the harm reduction movement, which supports human rights and non-coercive services for people who actively use drugs. In this interview, we discuss why forced psychiatric treatment is a form of trauma and its impact on victims and their families. In this episode we discuss: How Jeffrey’s early experience with the alternative school system led to being othered and ostracized, which influenced his later involvement with the psychiatric survivor's movement. How the trauma-informed perspective offers an alternative framework to the traditional medical model of mental health. Why forced psychiatric treatment meets the definition of trauma, and more specifically, betrayal trauma. The psychological effects of involuntary commitment forced drugging and outpatient commitment. That forced treatment reinforces the notion that distress or crisis results from individual pathology rather than familial mistreatment or trauma. That victims of forced treatment may be less likely to seek medical care for physical health issues or receive proper medical treatment. How survivors can heal from forced treatment. The parallels between the harm reduction movement and the psychiatric survivor's movement, and similarities between safe consumption sites and peer services. That the addiction treatment industry, including 12-step programs, can be coercive in similar ways to the mental health system. Relevant Links: Jeffrey Michael Friedman, LCSW What is a Betrayal Trauma? What is Betrayal Trauma Theory? The Power Thinker– a brief description of Michel Foucault’s work on power and surveillance. Altruism Born of Suffering Principles of Harm Reduction Thomas Szasz: The Right to Take Drugs The Legal Industry for Kidnapping Teens – a description of the physically forceful transportation services that are sometimes utilized to transport teenagers to addiction treatment. Jeffrey Michael Friedman on SoundCloud Jeffrey can be followed on Twitter: @jmfriedman and Instagram: traumainformedpodcast Mad In America's Psychiatric Drug Withdrawal course To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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38 min
April 9, 2018
Russell Razzaque: Breaking Down Is Waking Up
This week, we interview Dr Russell Razzaque. Dr Razzaque currently works as a consultant psychiatrist and associate medical director in east London and, together with colleagues, he is leading a pioneering multi-centre Open Dialogue pilot in the UK National Health Service. In 2014 he released his book ‘Breaking Down Is Waking Up’ in which he explores alternative views of mental distress, their relationship to consciousness and comparisons to forms of spiritual awakening. In this interview, we discuss the relationships between mindfulness, Acceptance and Commitment Therapy and Open Dialogue and how the UK NHS is approaching the worlds first randomised controlled trial of Open Dialogue interventions for people struggling with emotional or psychological distress. In this episode we discuss: What led Dr. Razzaque to his interest in psychiatry and in particular some of the more unconventional aspects of the profession. How beginning to practice mindfulness nearly 20 years ago led to Russell starting to feel an incongruence between the dominant philosophy in psychiatry and what he was learning from his own mindfulness practices. That the dominant philosophy is one of trying to help people remove their pain and remove them from difficult and uncomfortable experiences, but in his own personal development, he was learning to sit with the pain and finding that valuable. How this led to an interest in novel therapeutic approaches like Acceptance and Commitment Therapy, originally pioneered by professor Stephen Hayes. That Russell felt disillusioned with the way that UK mental health services and systems were organised and realised that creating better outcomes for people would require system-wide change. How Russell came to be one of the leading figures in the worlds first multi-centre, fully randomised Open Dialogue Trial which seeks to establish the evidence base for Open Dialogue. That the trial involves eight NHS Trusts across the UK and that several hundred practitioners have already been trained in Open Dialogue therapy. That during the trial there will be randomly selected postcodes receiving Open Dialogue interventions compared with randomly selected postcodes receiving treatment as usual and that the results will be compared after three years. That this trial will allow us to answer questions about the efficacy of Open Dialogue because we will have built a strong evidence base. How colleagues have reacted to the Open Dialogue trial and why some might be threatened by the need to change. That Open Dialogue is a need adapted approach, so it is not fundamentally against any of the conventional interventions, but it encourages people to make their own choices, so medication use tends to significantly reduce. That it is necessary to change the power dynamic in current systems and approaches because the current methods lead to dependency, whereas Open Dialogue is about empowering and liberating the individual. That Russell is encouraged to find that many psychiatrists are willing to open up to new ways of thinking about mental and emotional distress. How spirituality and psychiatry can work hand-in-hand and how accepting spiritual explanations can sometimes lead to better understanding of personal experiences. That, in future, the system needs to change such that interpersonal relationships are put first and are seen as the key to successful outcomes. That we also need to adapt so that clinicians are trained to be present with distress and not just try to remove it.  How people can hear Russell speak at the upcoming Compassionate Mental Heath event in South Wales, being held on April 25th and 26th 2018. Relevant links: Russell Razzaque Breaking Down is Waking Up Open Dialogue trial Developing Open Dialogue Compassionate Mental Health
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40 min
March 17, 2018
Duncan Double - On Being a Critical Psychiatrist
This week on MIA Radio we interview Dr. Duncan Double. Duncan is a Consultant Psychiatrist at the Norfolk and Suffolk NHS Foundation Trust. He is founder of the Critical Psychiatry Network and also runs a critical psychiatry blog. He edited the book Critical psychiatry: The limits of madness published in 2006 and has written a number of journal articles and book chapters. We talk about Duncan’s experiences as a critical psychiatrist working within a bio-medically oriented profession. In this interview we discuss: How reading Freud as a teenager led Duncan to his interest in psychiatry. That, early in his training, he found it difficult to take to the overly physicalist aspects of what he was expected to learn. How he became interested in the work of RD Laing and Thomas Szsaz. How he left his studies for a time, working with drug users in London, studying for a psychology degree and working in banking. The formation of the Critical Psychiatry Network in January 1999. How critical psychiatrists take a different perspective from mainstream psychiatrists who tend to believe that mental illness is a brain disease. That critical psychiatrists are not so interested in arriving at a single word diagnosis, instead the focus is on understanding the person and why they have presented with the problems they have in the context of their life situation. That critical psychiatrists aim to minimise the use of coercion and have been against the introduction of community treatment orders. That the emphasis in treatment is on helping people improve their social situation and to be as independent as they want to be. How Duncan felt about a period of suspension which arose partly because of his different practices, being less concerned about formal diagnosis and using less medication than other psychiatrists. That critical psychiatry is still looking for more acceptance from the mainstream. That Duncan welcomes the more recent emphasis on recovery in mental health services. That Duncan does use medication but is very aware that the evidence for psychiatric treatment is biased for methodological reasons, for example, the difficulties having properly blinded placebo-controlled trials. That good science is often being sceptical about the evidence. That people can form attachments to their medication, so it is not surprising that people may become dependent on it and therefore may have discontinuation problems. Duncan’s critical psychiatry blog which he would like to invite readers to visit and that he would like to develop an Institute of Critical Psychiatry. Relevant Links: Critical Psychiatry Blog Critical Psychiatry Website The Critical Psychiatry Network Critical Psychiatry: The limits of madness (2006) My tutor said to me, this talk is dangerous What is Critical Psychiatry?
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21 min
March 10, 2018
Tina Minkowitz - The Abolition of Forced Psychiatric Interventions
This week on MIA Radio, we interview Tina Minkowitz. Tina is an attorney and survivor of psychiatry who represented the World Network for Users and Survivors of Psychiatry in the drafting and negotiation of the United Nations’ Convention on the Rights of Persons with Disabilities. Tina is a strong proponent for the abolition of all forced psychiatric interventions and played a major role in attaining a shift in international law in favor of such a ban. In this interview, we talk about how the United Nations came to support the abolition of forced psychiatric treatment and why Tina believes that abolition of forced treatment, not reform, is necessary. In this episode we discuss: How Tina came to be interested in the intersection of international human rights law, disability rights law, and the issue of forced psychiatric treatment Why Tina believes in the abolition, not reform, of forced psychiatric treatment That the threat of forced treatment against some psychiatric survivors can be traumatic to the entire survivor community The barriers to the abolition of forced treatment, including public perceptions of people labeled mentally ill and lack of awareness of non-coercive alternatives That advocacy is needed to eliminate the 72-hour hold, not just ECT, forced drugging, or outpatient commitment Why forced treatment constitutes physical violence That we don’t need to put in place alternatives to the current mental health system in order to demand an immediate stop to forced treatment How mental health policy should center what we now consider alternative practices, such as peer-run services, hearing voices groups, and in-home supports How the issue of forced treatment fits within the disability rights framework Tina’s current activities with the Center for the Human Rights of Users and Survivors of Psychiatry Relevant Links: The Center for the Human Rights of Users and Survivors of Psychiatry Campaign to Support CRPD Absolute Prohibition of Commitment and Forced Treatment CRPD Course Committee on the Rights of Persons with Disabilities Convention on the Rights of Persons with Disabilities
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36 min
March 9, 2018
John Read - The UK Royal College of Psychiatrists and Antidepressant Withdrawal
Today on MIA Radio we have a special episode which is devoted to recent developments in the UK involving the Royal College of Psychiatrists. These events relate to the media coverage of a widely reported antidepressant meta-analysis in the Lancet, information on antidepressant withdrawal effects and a letter to The Times newspaper by the President of the Royal College Professor Wendy Burn and the Chair of the Royal College’s Psychopharmacology Committee, Professor David Baldwin. Professor John Read from the University of East London took time out to explain recent events and to talk about a formal complaint which has been lodged with the Royal College on behalf of a group of eminent psychiatrists and psychologists. Relevant links: Read the letter on Mad in America Press Release by the Council for Evidence-Based Psychiatry The Times: More People Should Get Pills to Beat Depression The Royal College’s leaflet on Antidepressant Withdrawal
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22 min
March 5, 2018
Lucy Johnstone - The Power Threat Meaning Framework
This week, we interview Dr Lucy Johnstone. Lucy is a clinical psychologist, trainer, speaker and writer, and a long-standing critic of the biomedical model of psychiatry. She has worked in adult mental health settings for many years, alternating with academic posts.  Lucy has authored a number of books, including 'Users and Abusers of Psychiatry’(Routledge 2000), and ‘A Straight-talking Introduction to Psychiatric Diagnosis’ (PCCS Books 2014) as well as a number of articles and chapters on topics such as psychiatric diagnosis, formulation and the role of trauma in breakdown. She has a blog on Mad in America.  Lucy kindly took time out talk to me about the new Power Threat Meaning Framework, an ambitious attempt to outline a conceptual alternative to psychiatric diagnosis which was published on January 12th this year by the Division of Clinical Psychology of the British Psychological Society. In this episode we discuss: Lucy’s background and what led her to be interested in mental health work, particularly in terms of being critical of current practice. The importance of acknowledging the reality of people’s experiences of distress along with questioning the dominant explanations for that distress. The fact that the diagnostic model has never been supported by evidence. How imposing a diagnosis often can be very damaging to people, by turning ‘people with problems’ into ‘patients with illnesses.’ Why we need to move towards the survivor slogan of “Instead of asking “What is wrong with you?” ask “What has happened to you?”’ The inception of the Power Threat Meaning Framework, which was funded by the Division of Clinical Psychology of the British Psychological Society, and the five-year journey to its release earlier this year. The composition of the core project team: Lucy, Mary Boyle, John Cromby, Jacqui Dillon, John Read, Peter Kinderman, Eleanor Longden, Dave Harper, Dave Pilgrim and a research assistant Kate Allsopp. The core team consists of psychologists and survivors/campaigners, many of whom are well known to MIA readers. Also involved were a consultancy group of service users/carers; a group of critical readers with a particular focus on diversity; and a number of others who contributed to particular sections or supplied good practice examples. How the Framework itself is not an official DCP or BPS position or policy document, nor is it a plan for services or for any other specific form of implementation. Rather, it is offered as a co-produced academic and conceptual resource to anyone who wishes to take on these ideas and principles and develop them further or translate them into practice. The Framework is necessarily dense because of its aim to move right away from the “DSM/ICD mindset” which is deeply rooted in Western culture. However, there are various accessible summaries of its core principles (see below.) How we already have a number of ways of supporting someone non-diagnostically, but what we didn't have before was a sound, evidence-based alternative to what diagnosis claims, but fails to do, which is to outline patterns in distress. How the Framework acknowledges the irreducible complexity of a person’s responses to their circumstances. The derivation of the title: The Power Threat Meaning Framework. The four main questions, which are: What has happened to you? Translated as “How is Power operating in your life?” How did it affect you? Translated as “What kinds of Threats does this pose?” What sense did you make of it? Translated as “What is the Meaning of these situations and experiences to you?” What did you have to do to survive? Translated as “What kinds of Threat Response are you using?” Finally “What are your strengths?” or “What access to Power resources do you have?” and to pull it all together, “What is your story?” These are not separate questions, since each of them implies and arises out of the others. That the aim is for people to be able to use these ideas and questions for themselves, not necessarily through an interaction with a professional. How the PTM Framework does not recognise a separate group of people who are ‘mentally ill’ but describes how we are all subject to, and affected by, the negative impact of power in some aspects of our lives. How it is particularly important to recognise the role of ideological power, or power over language, meaning and agendas. How the PTM Framework includes the concept of formulation, which is a semi-structured way of putting together someone’s story, but is much wider in scope and for that reason uses the preferred term “narrative” – which may be individual, group or community. How diagnosis often obscures someone's story, and how the Framework aims to help create narratives that restore the links between personal distress and social injustice. What the PTM Framework says about DSM and ICD attitudes to conceptualisations of distress in non-Western cultures. That since we are meaning-making creatures, at a very basic level the principles of power, threat, meaning and threat response apply across time and across cultures, although all expressions and experiences of distress are culturally-shaped. The regrettable exporting of Western psychiatric models across the world. How the Framework does not exclude or deny the role of biology, but integrates it as a mediator and enabler of all human experience, although not something that is always accurate or helpful to view as a primary cause. The reaction to the Framework, both positive and negative. The team very much welcomes feedback, much of which has been very helpful. Some of the more extreme reactions can be understood as predictable responses to the threat posed by the Framework to ideological power. How the reaction outside social media has been overwhelmingly positive. Emphasising again that the Framework is (unlike diagnosis) presented as a completely optional set of ideas, and a work in progress. The project team is very pleased that there is such widespread interest in taking these ideas forward in people’s own lives and settings. People are encouraged to explore these ideas for themselves via the links below. More resources will be added in due course. Relevant links: PTM Framework Introduction and Frequently Asked Questions The above link will take you to the following: Power Threat Meaning Framework Main document Power Threat Meaning Framework Overview PTM Framework Guided Discussion for applying these ideas to your own life or someone you are working with Presentation slides from the PTM Framework launch The Power Threat Meaning Framework 2 page summary You may also be interested in these articles and blogs on the Framework: Publication of the Power Threat Meaning Framework: Mad in America blog A mental health nurse’s first response to the launch of the Power Threat Meaning Framework My mother took her own life – and now I know a different mental health approach could have saved her An Alternative to Psychiatric Diagnosis? The PTM Framework, where do we go from here? I’ve Been Waiting for this Since I Was a Child The Power Threat Meaning Framework: a radically different perspective on mental health Lucy’s interview on Let’s Talk Withdrawal can be found here: Lucy’s interview on Let’s Talk Withdrawal (April 2017) To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018    
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40 min
March 3, 2018
Joanna Moncrieff - Challenging the New Hype About Antidepressants
This week, we interview Dr Joanna Moncrieff. Dr Moncrieff is a psychiatrist, academic and author. She has an interest in the history, philosophy and politics of psychiatry, and particularly in the use, misuse and misrepresentation of psychiatric drugs. As an author, Dr Moncrieff has written extensively on psychiatric drugs and her books include The Myth of the Chemical Cure, A Straight Talking Introduction to Psychiatric Drugs and The Bitterest Pills: the troubling story of antipsychotic drugs. She is one of the founding members of the Critical Psychiatry Network which consists of psychiatrists from around the world who are sceptical of the idea that mental disorders are simply brain diseases and of the dominance of the pharmaceutical industry. We talk about the recent meta-analysis of the efficacy and tolerability of 21 antidepressant drugs, widely reported in the UK news media on February 22nd. In the episode we discuss: The approach taken in the largest ever meta-analysis of efficacy and tolerability of 21 common antidepressant drugs. The problems inherent in comparing antidepressants with each other, as opposed to trials that compare the active drug to a placebo. That the main conclusion reached was that all the antidepressants studied were better than placebo at reducing depressive symptoms. The limitations of the study, particularly how response rate was selected as the primary outcome measure. That ‘response’  is mostly defined as a reduction in the Hamilton Depression Rating Scale (or other scale) rating of 50% or more during the study. That the response rate can artificially inflate the difference between drug and placebo. The problems with blinding in the supporting trials and the effects of including people who are already receiving antidepressant treatment. That the study did not include adverse effects or withdrawal difficulties, only dropout rates which are not representative of the whole picture of taking the drugs. The short-term nature of the supporting trials, mainly 8 weeks, with a range of 4 to 12 weeks, which cannot be easily compared with the real world experience of people taking the drugs for much longer periods. That, when the primary data is analysed (the depression rating scale scores)  the differences between placebo and antidepressants are very small and probably clinically insignificant. The uncritical and sensational nature of the media reporting of the study and the link to the Science Media Centre. The concerns about the reporting that depression is under-treated in the UK which is not supported by the results of the study. That people should carefully consider the balance of benefit versus risk, taking into account the potential for adverse effects or difficulties stopping the drugs. Relevant links: Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis Challenging the New Hype About Antidepressants The Hamilton Depression Scale Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences Efficacy of antidepressants in adults The Science Media Centre
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18 min
February 17, 2018
Michael Fontaine - What the Ancient World can Teach us About Emotional Distress
This week, we interview Professor Michael Fontaine. Michael is Professor of Classics and Associate Vice Provost of Undergraduate Education at Cornell University in New York. He regularly consults on Latin for museums, institutions, dealers, and collectors, having exposed forgery in Renaissance and Dutch Golden Age paintings. In 2016 he received the Thomas S. Szasz Award for Outstanding Contributions to the Cause of Civil Liberties. In the episode we discuss: How Michael came to be a Professor of Classics and Literature. How studying the ancient world helps us to understand what the first scientists thought about mental or emotional distress. The first use of the phrase ‘psychiatric ward’ which can be found at the Library of Alexandria in Northern Egypt. That the phrase that ultimately became the word ‘Psychiatry’ in ancient times actually meant a “Healing Place for the Soul” and is inscribed above library entrances even today (ΨΥΧΗΣ ΙΑΤΡΕΙΟΝ or Psyches iatreion). The links between the Rosenhan experiment and a comedic play written 2,200 years ago by the ancient Roman playwright T. Maccius Plautus. That, in the ancient world, there was no long term incarceration in prisons or asylums. The relationship between the Hippocratic/medical model (the humoral theory) and the Epicurean model of mental or emotional distress. That, in the ancient world, depression didn’t exist, and that the solutions for unhappiness were based in the community or in Philosophy. That about 1700 years ago, the Roman Empire entered a state of decline and it became mandatory to become Christian and during this time the philosophical view of mental distress died away to be overtaken by a supernatural understanding. Some of the similarities between the Epicurean model and the work of Thomas Szasz. How Michael came to know and discuss some of these matters with Thomas Szasz and, following his suicide in 2012, presented an academic paper to the American Psychiatric Association on Thomas Szasz’ legacy. The statistics that show that one in every four women around middle age in the US is taking an antidepressant. Michael’s essay on Schizophrenia in the ancient world. The distinction between the causes of, and the reasons for, our behaviour. Ron Leifer having his career ruined because of his support for the ideas of Thomas Szasz. A poem from 2,100 years ago by the Latin poet Catullus, that deals with transgender identity, even though it is generally believed that gender identity issues are a recent phenomenon (last 50 years or so). How Greek Tragedy can help us understand the world, particularly those of Euripides such as Medea Relevant links: On Being Sane in an Insane Place—The Rosenhan Experiment in the Laboratory of Plautus’ Epidamnus On Religious and Psychiatric Atheism: The Success of Epicurus, the Failure of Thomas Szasz Thomas Szasz Mental Disorders in the Classical World (A Review) Schizophrenia in the Golden Ass What Do the DSM, Elvis Presley, and Dionysus Have in Common? To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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41 min
January 27, 2018
Johann Hari - Lost Connections: Uncovering the Real causes of Depression and the Unexpected Solutions
This week, we interview journalist and author Johann Hari.  Johann is one of our foremost social science thinkers and writers. In addition to writing regularly for the New York Times and Independent newspapers, he has written extensively on social science and human rights issues. His 2015 book Chasing the Scream: The First and Last Days of the War on Drugs, challenges what we believe about addiction and his TED talk on our response to addiction has been viewed over 20 million times.  Johann was twice named ‘National Newspaper Journalist of the Year’ by Amnesty International. And he has been named ‘Cultural Commentator of the Year’ and ‘Environmental Commentator of the Year’ at the Comment Awards. In this interview, we talk about Johann’s latest book, Lost Connections: Uncovering the Real causes of Depression and the Unexpected Solutions, which has been called a ‘game changer’ and received plaudits for its explanation of the social and cultural issues leading to depression and anxiety. In the episode we discuss: How Johann became interested in journalism and began writing about social justice and human rights issues. What led to wanting to write a book that was partly based on his own experiences with depression and anxiety, but also that provided the evidence for social and cultural issues that may underlie the dramatic increase in the number of people needing support for emotional distress. The facts behind the chemical imbalance theory of mental illness. The role of the bio-psycho-social model of mental distress and why we may have focussed predominantly on biological interventions. Social prescribing as a means to enable connection between people who struggle with depression and anxiety. The Hamilton Depression scale and how it shows us that the effect of antidepressant drugs is small when compared to the improvements that can be achieved without drug therapy. How Johann would like to widen the definition of what may be considered an ‘antidepressant’. How disempowerment often lies at the heart of poor health. How stigma relates to our perceptions of an individual who is labelled mentally ill and how it changes if we think someone has a biological problem. Johann’s experiences in the Berlin district of Kotti. That people can hear audio of the many of the interviews held for the book at https://thelostconnections.com Relevant links: Lost Connections: Uncovering the Real causes of Depression and the Unexpected Solutions Johaan Hari talk at the Royal Society for the encouragement of Arts, Manufacturers and Commerce (RSA) Chasing the Scream: The First and Last Days of the War on Drugs TED Talk, Everything you think you know about addition is wrong To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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70 min
January 20, 2018
Kelli Foulkrod - Integrating Yoga with Psychotherapy
This week on MIA Radio, we interview Kelli Foulkrod. Kelli is the owner of the Organic Mental Health Center.  She is a therapist, yoga teacher, and mental health paradigm shifter based in Austin, Texas.  For the past 15 years, Kelli has worked in the mental health field and practised yoga. She has been integrating yoga and the healing arts into traditional psychotherapy for over eight years and is passionate about offering holistic mental health treatment options.   With many years experience in an academic research setting, Kelli bridges the gap between science and spirituality.  Kelli has experience serving clients populations of pregnant and postpartum women, grief and loss, psychosis, homelessness, substance abuse, teens, couples, and groups.  She offers individual, couples, and group psychotherapy services in addition to yoga therapy sessions, workshops, and retreats. In the episode we discuss: How Kelli started her journey as a psychology undergraduate at the University of Texas and working in clinical and academic research. How working in a neuroscience laboratory resulted in internal conflict and led Kelli to interest in and research into alternative modalities alongside her psychology studies. How Kelli experienced first hand the approaches that pharmaceutical manufacturers used when running clinical trials. That Kelli felt that modern psychology neglects the body and she started to practise yoga and meditation alongside studying for her masters degree in clinical psychology. That, to Kelli, modern mental health therapy feels egotistical and narcissistic and that she was resistant to becoming a clinical therapist. How people are hungry for alternatives but there are so few other options that people continue to get involved with mainstream medicine. The profound changes that occur when becoming parents and why this might lead to mental health difficulties. How we have lost touch with community and social connections that existed when we lived as tribal cultures. How shamanic ceremony and tradition can be understood and utilised in response to emotional distress. Relevant links: The Organic Mental Health Centre The Organic Mental Health Centre (Facebook) Yoga for depression - the research To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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45 min
January 6, 2018
Jennifer Bahr - Treating the Whole Person
This week on MIA Radio, we interview Dr. Jennifer Bahr. Dr Bahr is a passionate advocate for naturopathic approaches to health and wellbeing. She is the founder of Resilience Naturopathic which was founded with a mission to not only to provide an alternative to those who struggle with mental health conditions but to improve the way mental and behavioural healthcare is delivered in America.  Dr Bahr received her Doctor of Naturopathic Medicine from Southwest College of Naturopathic Medicine in Tempe, AZ. Prior to that she was an Arabic Translator for the US Government and served 6 years in the US Navy. She received her Bachelor of Science in Physiology and Neurobiology from the University of Maryland. She is the President of the California Naturopathic Doctors Association, the founding Vice President of the Psychiatric Association of Naturopathic Physicians, and a member of the House of Delegates for the American Association of Naturopathic Physicians.  She previously taught at Bastyr University and is a contributing writer for Homeopathy Today, Naturopathic Doctor News and Review, Mad In America, and The Wise Mom. In the episode we discuss: How Dr. Bahr came to be involved with the psychiatric system and prescribed psychiatric drugs. That receiving a diagnosis of bipolar disorder led to fears such as loss of employment and that the condition was permanent, feeling like a life sentence. How the psychiatric drugs, including Lithium, affected Dr. Bahr’s academic performance. How those experiences led to Dr. Bahr’s interest and study into non-medication based and naturally oriented approaches to supporting mental health and wellbeing. Why naturopathic medicine might be a good approach for mental health issues. That it is important to choose naturopathic approaches as a first step to avoid potential harm from medications prescribed through the mainstream system. The inherent problems with clinical trials of psychiatric drugs, such as placebo washout. How supporting the whole person is the aim of naturopathic approaches and how this contrasts with the mainstream psychiatric approach of relying heavily on trying to alter brain chemistry. That we should focus heavily on what is happening in our environment to help address the alarming increase in both physical and mental health problems. How people can find out more about Dr. Bahr and her work by visiting https://resiliencenaturopathic.com. Relevant links: Resilience Naturopathic Rx Resilience: Cultivating the Ability to Bounce Back  American Association for Naturopathic Physicians Institute for Natural Medicine To get in touch with us email: podcasts@madinamerica.com © Mad in America 2018
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43 min
December 23, 2017
Sir Robin Murray - Reframing Psychotic Illness
This week on MIA Radio, we interview Professor Sir Robin Murray. Professor Murray is an Honorary Consultant Psychiatrist in the Psychosis Service located at the Bethlem Royal Hospital in South London. He is also a Professor of Psychiatric Research at the Institute of Psychiatry. His research covers epidemiology, molecular genetics, neuropsychiatry, neuroimaging, neuropsychology and neuropharmacology.  Professor Murray’s main research interest is finding the causes of schizophrenia and bipolar disorder, as well as developing better treatments for these disorders.He is perhaps best known for helping to establish the neurodevelopmental hypothesis of schizophrenia, and for his work on the environmental risk factors relating to schizophrenia, such as obstetric events and cannabis use. In 2011, Professor Murray was awarded a knighthood for services to medicine and he is the second most widely cited psychiatrist in the world outside the USA. In this interview we discuss: •How Professor Murray came to psychiatry and what sparked his interest in research into psychosis. •Professor Murray’s work to counter the concept of schizophrenia as a debilitating brain disease and how we came to appreciate the many factors that may contribute to psychotic illness. •The importance of recognising the influence of social factors in the causes of psychotic illness. •The differences between the Diagnostic and Statistical Manual (DSM V) and the International Classification of Diseases (ICD 11). •How psychiatric diagnoses compare and contrast to diagnoses in other branches of medicine. •The question of whether schizophrenia is a real entity or purely an artificial construct. •How antipsychotic drugs exert their effects and the mechanisms by which they may lead, in some cases, to dopamine supersensitivity. •How we should be  cautious about the long-term prescribing of antipsychotic drugs. •The effect that limited healthcare resources have on psychiatric diagnoses and treatments. •What the future may hold for research into and treatment options for psychosis. Relevant links: Professor Sir Robin Murray The Psychosis Service at the Bethlem Royal Hospital 30 Years on: How the Neurodevelopmental Hypothesis of Schizophrenia Morphed into the Developmental Risk Factor Model of Psychosis  Webinar: Is Schizophrenia Dead Yet? Thou shall not criticise our drugs To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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54 min
December 16, 2017
Celia Brown - Surviving Psychiatry
This week on MIA Radio, we interview Celia Brown. Celia is a psychiatric survivor and a prominent leader in the movement for human rights in mental health. She is the current president of MindFreedom International, a nonprofit organization uniting 100 sponsor and affiliate grassroots groups with thousands of individual members to win human rights and alternatives for people labelled mentally ill. Celia also serves on the board of the National Empowerment Center and has co-chaired the planning committee for the National Alternatives Conference for the past few years. She was last year’s recipient of the Lifetime Achievement Award at the Alternatives Conference. In this interview, we talk about the history of the human rights movement to combat forced treatment and the important role Celia has played in it. In the episode we discuss: •The goals and values of the movement for human rights in mental health, specifically in regards to the issue of forced treatment •Celia’s role in the human rights movement and MindFreedom International •How the movement for human rights in mental health first started and its early achievements •The important role played by Judi Chamberlin in the formation of the consumer/survivor/ex-patient movement •How efforts to combat shock treatment and provide informed consent about psychiatric drugs have been a core part of the movement in recent years •The development of the peer specialist position and the peer support movement •How the human rights movement has developed alternative language to the terms and labels used by the mental health system •Some of the current tensions and divisions within the movement •Current ongoing advocacy efforts to combat forced treatment, including Tina Minkowitz’s advocacy work with the UN’s Convention on the Rights of Persons with Disabilities and the Disability Integration Act •Why the movement has faced challenges in changing policy and public opinion on the rights of people labelled mentally ill •How the movement for human rights in mental health has overlapped and intersected with other human rights movements, including the civil rights, feminist, and disability rights movements •The role Kate Millet played in bridging the psychiatric survivors movement with the feminist movement •How people can get involved in the movement for human rights in mental health by learning about the history of the movement, attending conferences, and seeking mentorship To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017  
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30 min
December 9, 2017
Chris Hansen - Making Connections Through Intentional Peer Support
This week on MIA Radio, we interview Chris Hansen. Chris started working in New Zealand as an activist after a psychiatric hospitalization 20 years ago.  She has provided advice and media comment locally, regionally and nationally, including work with the New Zealand Mental Health Commission and Ministry of Health.  She was a member of the New Zealand delegation to the United Nations for the development of the Convention for the Rights of Persons with Disabilities, as well as working as a board member for the World Network of Users and Survivors of Psychiatry.  For the past 12 years, she has worked with Shery Mead developing Intentional Peer Support and is currently in the role of director. In this interview, we talk about Chris’s personal experiences of the mental health system and how Intentional Peer Support approaches contrast with mainstream psychiatry.  In the episode we discuss: How Chris was working in the mental health system, before herself experiencing a psychiatric hospitalization. How she experienced personal loss during the time that she was hospitalized. How Chris found that her experiences led to a realisation that she didn't want to work on the medical side of the mental health system and instead focussed her efforts on peer support. That Chris’s experiences led to her becoming an activist, working locally, regionally and nationally in advisory and contract positions, including the NZ Mental Health Commission and Ministry of Health. That peer support gave Chris the hope, the inspiration and the desire to recover from her traumatic experiences of forced hospitalization and treatment with psychiatric drugs. How involvement with advocacy for the abolishment of forced treatment led Chris to work with the United Nations for the development of the Convention for the Rights of Persons with Disabilities, as well as working as a board member for the World Network of Users and Survivors of Psychiatry. How Intentional Peer Support works to makes connections with and support those who struggle with their mental health. How IPS supports and trains a wide range of organisations such as the mental health services, the police and people in the disability sector amongst others. How peer support distinguishes itself from mainstream psychiatric or psychological approaches. That learning to reconnect with people is vitally important in recovery.  Relevant links: Intentional Peer Support Intentional Peer Support, a personal perspective by Shery Mead Intentional Peer Support: Creating Relationships, Creating Change Intentional Peer Support, upcoming trainings To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017     
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34 min
December 2, 2017
George Atwood - Shattered Worlds, the Experience of Personal Annihilation
This week on MIA Radio, we interview Dr. George Atwood. Dr. Atwood has devoted a substantial part of his life to the study and treatment of what he refers to as ‘so-called psychosis’.  He has authored or coauthored several books, including The Abyss of madness published in 2011 and more than one hundred articles. In the episode we discuss: The story of how Dr. Atwood came to be interested in “so-called psychosis,” including what piqued his interest as a high school student, and his work under mentors Austin DesLauriers and Silvan Tomkins. An overview of his more recent work on intersubjective theory with collaborator and friend, Robert Stolorow. After studying what he refers to as “madness” for over 50 years, Dr. Atwood offers his perspective that madness is not a disease or illness existing within a person, but a subjective experience of self-dissolution or catastrophe. How diagnostic classification systems can result in the false reification of mental diseases in a way that obscures individual realities. The phenomenological approach, or the study of individual human subjective experiences, as offering a hopeful future in a shifting away from “illness” or “disorder” frameworks. How psychotherapy, as a healing process, includes the relational context between clinician and patient, meriting a dedication to personal histories and contexts rather than overt symptoms.  The history of the term “schizophrenia,” and how terms such as these are embedded in a Cartesian medical model. A few of Dr. Atwood’s clinical cases and particularly his perspectives on “so-called psychosis” and “so-called bipolar disorder.” Dr. George Atwood's Personal Website with Works and Lectures To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017  
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55 min
November 25, 2017
Noel Hunter and Brett Francis - Diagnosis, Empowerment and Equality
Download to listen later... This week on MIA Radio, we share the time between two interviewees; clinical psychologist Dr. Noel Hunter and entrepreneur and author Brett Francis. Dr. Noel Hunter is a clinical psychologist in New York and an advocate for the rights of people diagnosed with mental disorders. She believes in a trauma-informed, humanistic, person-centred approach to understanding problems in living.  She has trained in community mental health, state hospital, residential, and college counselling settings.  Dr. Hunter is on the board of directors for the Hearing Voices Network – USA, the International Society for Ethical Psychiatry & Psychology, and the National Association for Rights Protection and Advocacy. She is an Associate Editor for the peer-reviewed journal Ethical Human Psychology & Psychiatry and has been a guest editor for Asylum Magazine.  Brett Francis is a professional speaker, mental health advocate, author and entrepreneur.  Brett was herself diagnosed with Tourette's Syndrome and ADHD at 6 years of age, leading to being medicated for over eleven years and subsequent difficulties with anxiety, depression and obsessive-compulsive disorder. She is now passionate about supporting and encouraging open and honest discussions about mental health and disabilities and giving confidence to those struggling. In the episode we discuss: Dr Noel Hunter How Dr. Hunter came to be involved with the mental healthcare system. That Noel found that if she did reach out and discuss her experiences, she felt punished or accused of ‘seeking attention’. That these experiences made Noel want to fight back and become a therapist and advocate who took a different approach. That Noel feels that building trust within the therapeutic relationship is a fundamental part of a therapists job. That it is healthy to be sceptical of the mainstream system and for people to be afraid of getting help because of the potential of being re-traumatised by treatment. That the medical model ultimately leads to avoidance and harm. Whether there can ever be equality in the therapeutic relationship.  Brett Francis How Brett came to be diagnosed and medicated at a very early age. Her experiences taking the antipsychotic drug Haloperidol, and that she felt it disrupted her schooling. How Brett decided not to be limited by her diagnoses but instead focussed on tackling the stigma and misinformation prevalent in mental healthcare. That we should support and encourage people to talk about their struggles and we should do that through education. That creating communities and social connections can be enormously helpful in responding to emotional or psychological distress. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017      
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49 min
November 18, 2017
Joseph Firth - The Role of Exercise and Nutrition in Early Psychosis
This week on MIA Radio we interview Dr Joseph Firth. Dr Firth is a postdoctoral research fellow at Western Sydney University. His research focuses on the role of exercise and nutrition in first episode psychosis in young people. In this interview we discuss: That Dr Firth completed his PhD in Manchester, UK, which focussed on the role of exercise in the treatment of psychosis in young people. That he now works on a programme of adjunctive and novel treatments for psychosis, particularly the role of exercise and nutrition and including technology and mobile health. How results show that exercise can reduce symptoms in young people such as the cognitive deficit, lack of motivation and social withdrawal and that these are symptoms that the medications don’t really help with. That, in the very early stages of psychotic illness, there are currently few interventions other than therapy, so exercise and nutrition could have a role in reducing the need for antipsychotic drugs and even potentially affect the onset of psychotic symptoms. That qualitative research has shown that young people report that their symptoms are reduced or become less troubling when they exercise. How exercise and nutrition have key roles in reducing the health inequalities that are seen in young people treated with antipsychotic drugs. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017  
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24 min
November 11, 2017
Jay Joseph - Why Schizophrenia Genetic Research is Running on Empty
This week on MIA Radio we interview Dr Jay Joseph. Dr Joseph is a clinical psychologist and author who brings a critical perspective to claims in the media and the academic literature that disordered genes underlie psychiatric disorders. His most recent books are The Trouble with Twin Studies: A Reassessment of Twin Research in the Social and Behavioral Sciences and the 2017 e-book Schizophrenia and Genetics: The End of an Illusion. In this interview, we discuss the evidence that psychiatry puts forward in support of the claim that mental disorders have an important genetic basis and the reasons why psychiatry is still searching after many decades of failed attempts. In the episode we discuss: How Dr Joseph, as a clinical psychologist, came to be interested in the validity of the diagnosis of schizophrenia. How he then became interested in the assertions by psychiatry that diagnoses such as schizophrenia had a genetic basis. That he discovered that the evidence for genetic factors underlying major psychiatric disorders is very weak and based mainly on twin and adoption studies. That, despite decades of work, there have been few if any discoveries of disordered genes that cause the major psychiatric disorders. How twin and adoption studies are used to try and demonstrate the relationship between genetics and mental disorders. That people are being told that their mental illness is genetically based which is not supported by evidence and it is rather like the chemical imbalance myth in this regard. That a disorder or condition ‘running in the family’ means that it is ‘genetic’ is also a common misconception. That psychiatry seems to be focused on finding the ‘cause’ of mental disorders within the body, rather than acknowledging that social and environmental factors are the main causes of trauma, distress, and psychological dysfunction. Relevant links: Dr Jay Joseph Schizophrenia and Genetics: The End of an Illusion Bias and Deception in Behavioral Research Schizophrenia Genetic Research – Running on Empty To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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34 min
November 4, 2017
David Healy - Seeking a Cure for Protracted, Medication-related Sexual Dysfunction
This week we interview Dr David Healy.  Dr Healy is an internationally respected psychiatrist, psychopharmacologist, scientist, and author. A professor of Psychiatry in Wales, David studied medicine in Dublin, and at Cambridge University. He is a former Secretary of the British Association for Psychopharmacology and has authored more than 200 peer-reviewed articles and 20 books, including The Antidepressant Era and The Creation of Psychopharmacology and his latest book, Pharmageddon, published in 2012.  David is a founder and CEO of Data Based Medicine Limited, which operates through its website RxISK.org, and is dedicated to making medicines safer through online direct patient reporting of drug side effects. In this interview, we discuss Post SSRI Sexual Dysfunction (PSSD) and Dr Healy’s novel and innovative approach to finding a cure. A recent email to Dr Healy starkly highlights the problem: I took X for 16 years without any side effects. Stopped 7 months ago and all hell broke loose. Some of the side effects I got in the first week after quitting are: no libido, cold testicles/penis, pain around penis and anus, tinnitus, erectile dysfunction, tingling, numbness...  Life is not very good these days. I am married with beautiful children. They have lost their father. If I can do anything to help, don't hesitate to get in touch. I would like to give you my biggest thanks for what you are doing and wish you all the best with the fundraising. In the episode we discuss: How Dr Healy came to set up Data Based medicine and RxISK.org. Why RxISK are focussing on Post SSRI Sexual Dysfunction (PSSD). That genital numbness can occur very quickly upon taking an ssri antidepressant and can also be triggered by drugs such as Roaccutane (isotretinoin) and Propecia (finasteride). What led to setting up the RxISK Prize. How people can get involved with the campaign. That it’s often people not involved with healthcare who get motivated to take action. How empowering it is to enable people harmed by pills to be part of the solution. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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29 min
October 28, 2017
Gordon Warme - The Relationship Between Culture and Psychiatric ‘Disorders’
This week we interview Dr Gordon Warme. Dr Warme is a medical doctor specializing in psychiatry. He trained with Karl Menninger at the Menninger Clinic in the US and at Heidelberg University in Germany, and has been a faculty member at the Menninger Clinic, the University of Kansas, and has been an academic at the University of Toronto for 40 years. His most recent book, published in 2016 is Brain Evangelists: How Psychiatry Has Convinced Us to Believe in Its Far-Fetched Science and Dubious Treatments in which he blows the whistle on modern psychiatry, arguing that, in the long history of medicine, biological and chemical “abnormalities” in psychiatric patients have never been identified, and labels such as schizophrenia and depression are misleading metaphors that dehumanize patients. In the episode we discuss: How Dr Warme came to specialise in psychiatry. His experience of being trained by doctors who had a strong psychoanalytic approach. That Sigmund Freud wanted psychiatry to be scientific, but Dr Warme feels that this led Freud astray. The relationship between culture and psychiatric ‘disorders’. Watching, describing and talking as important therapeutic skills to develop. Dr Warme’s view of how drugs are used in psychiatry and that he hasn’t prescribed for many years. The Rosenhan Experiment. Where psychiatry is heading as a profession. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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41 min
October 21, 2017
David Mielke - Educating in the era of the psychiatric diagnosis
This week we interview David Mielke. David is a psychology graduate and teacher in a California high school who has become increasingly concerned about the number of children that he teaches that have a psychiatric diagnosis and how many are on psychiatric drugs. In this interview, we discuss David’s experiences as an educator and how teachers can empower students to have more confidence in themselves. In the episode we discuss: How David studied psychology and then came to be a teacher at Culver City High School in California. How an experience witnessing electroshock therapy made an indelible mark on his approach to educating. How David knew from interacting with his students that most often their struggles were because of difficult circumstances such as issues at home rather than brain diseases in need of diagnosis. How David has witnessed many of his students have internalised their diagnostic labels. The relationship between a psychiatric diagnosis and learned helplessness. The tensions that may arise between school policies and guidance, teachers and parents when a psychiatric diagnosis is involved. The power inherent in psychotherapy to connect with and support people in difficulty. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017 
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52 min
October 14, 2017
Olga Runciman - Moving Beyond Psychiatry
This week on the Mad in America podcast we interview Olga Runciman.  Olga is an international trainer and speaker, writer, campaigner, and artist. She co-founded the Danish Hearing Voices Network and sees the role of the Hearing Voices Movement as post-psychiatric, working towards the recognition of human rights while offering hope, empowerment, and access to making sense of individual experiences.  Olga was a psychiatric nurse working in social psychiatry but today she is a psychologist and since 2013 she has had her own private practice in Denmark, working with people who have been labelled schizophrenic or psychotic. Olga is herself a psychiatric survivor and a voice hearer too. In this interview we discuss Olga’s professional and personal experiences of the psychiatric system and how she now helps and supports healing and recovery in others. In the episode we discuss: How Olga became a specialist psychiatric nurse in Denmark, believing at the time the reasons given for psychiatric diagnoses. How she came to see that there was little evidence or corroboration to underpin the diagnosis and treatment that she witnessed. How Olga was also a voice hearer, but kept this hidden from her psychiatric colleagues. How, when experiencing stress and trauma, Olga came to be admitted to a psychiatric ward, diagnosed as schizophrenic and treated with a cocktail of psychiatric drugs. Olga’s experiences of the antipsychotic drug Clozapine. How Olga came to stop her psychiatric drugs which she had been taking for ten years. Psychiatry’s story of hopelessness and chronic illness that is so often sold to patients. How Olga now views her work from a post-psychiatry perspective. Relevant links: Psycovery Olga’s posts on Mad in America  The Hearing Voices network International Institute for Psychiatric Drug Withdrawal  Postpsychiatry: a new direction for mental health  To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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46 min
October 7, 2017
Bonnie Burstow and Nick Walker - An Introduction to Cognitive Liberty
This week, Mad in America editor Emily Sheera Cutler presents the first in a series of interviews that examine the many important issues around forced treatment and cognitive liberty. The series will examine philosophical, theological, and sociological perspectives on coercive treatment. In this first part, Emily interviews two well known and very respected academics and activists Bonnie Burstow and Nick Walker. Central to both Bonnie and Nick’s work is the concept of cognitive liberty or freedom and integrity of the mind. Early proponents of cognitive liberty have defined it as the right to control one’s own consciousness and be free from mind-altering drugs and technologies, as well as the right to use mind-enhancing drugs and technologies without facing legal consequences. Contemporary proponents of cognitive liberty have expanded the definition to include the right to experience and express each and every thought, feeling, state of mind, and belief as long as it does not harm anyone else. Both Bonnie and Nick describe cognitive liberty as the right to express oneself authentically. In this first episode, they get to the core of why so many human rights activists oppose forced treatment – it can interfere with people’s rights to be themselves. In this episode we discuss: How Bonnie became an antipsychiatry activist and scholar, and why she sees the institution of psychiatry as a human rights violation How Nick became a neurodiversity scholar through his involvement with the Autistic rights movement The difference between the neurodiversity paradigm, which views neurological, mental, and cognitive differences on the natural spectrum of human diversity, and the pathology paradigm, which assumes there is a right way or healthy way of being and to differ from it is unhealthy What it means for each person to have cognitive liberty and be able to express their own unique way of being and processing the world without repercussions How psychiatry curtails our cognitive liberty and freedom of mind by pathologizing difference to justify forceful and coercive measures The social model of disability, which states that people are disabled by lack of access and discrimination, not by medical conditions or internal deficits How the social model of disability intersects with neurodiversity and antipsychiatry but also falls short That Applied Behavior Analysis (ABA) constitutes a human rights abuse against Autistic children, forcing and coercing them to act more normal and less different That other behaviour therapies and even humanistic therapies can be coercive as well That the autism industry profits off of the pathology paradigm, convincing parents there is something wrong with their Autistic children and that it is not okay to be Autistic, and their children need to be subjected to ABA and other “treatments” How antipsychiatry and neurodiversity intersect with feminism and queer studies Why it is necessary for educators to teach students “mad literacy” from an early age The importance of writing and publishing literature with accurate, positive representations of neurodivergent and Mad people How we can build communities in which people support one another through emotional distress without violating anyone’s autonomy or restricting anyone’s freedom Why the conventional notion of “suicide prevention” is problematic and can serve to take away people’s coping skills How the ideas of somatic therapy can help us support people in distress Relevant Links Bonnie Burstow Nick Walker Bonnie Burstow’s articles for Mad in America The Bonnie Burstow Scholarship in Antipsychiatry Autonomous Press Throw Away the Master’s Tools: Liberating Ourselves from the Pathology Paradigm by Nick Walker Neuroqueer: An Introduction by Nick Walker The social model of disability vs. the medical model of disability To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017 
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78 min
September 30, 2017
Michael O’Loughlin - Exploring Narrative Approaches to Psychological Distress
This week, Mad in America’s news editor Justin Karter interviews Professor Michael O’Loughlin. Professor O’Loughlin is a college professor and researcher at Adelphi University on Long Island. He is a licensed psychologist and a psychoanalyst in private practice in New Hyde Park, New York. Dr O’Loughlin writes critically about the biomedical model of psychiatry and psychology and also has a deep interest in psychiatric rights and social justice issues. In 2015 as an editor he launched a book series entitled Psychoanalytic Studies: Clinical, Social, and Cultural Contexts, with Lexington Books.  In August 2017, with colleagues Dr. Awad Ibrahim (University of Ottawa), Dr, Gabrielle Ivinson (Manchester Metropolitan University), and Dr. Marek Tesar (University of Auckland), as series co-editors, he launched a book series, Critical Childhood & Youth Studies: Clinical, educational, social and cultural inquiry, to be published by Lexington Books. Professor O'Loughlin talks about his childhood experiences and how they influenced his narrative and conversational approach to psychological distress.  In this episode we discuss How Dr O’Loughlin’s early experiences growing up in Ireland led to a deep interest in social justice issues, particularly poverty and inequality. That as a young man in college he engaged in charity work and activism. How, more recently, he became interested in psychiatry when he was appointed as a lecturer in clinical psychology, but realised that there weren’t required courses on trauma or psychosis. That this led to teaching courses in intergenerational trauma and the way that our history shapes us as people. That Michael has engaged in autobiographical writing to understand the way that deprivations and injustices that he experienced had a formative impact on his own thinking and writing. That another course on madness and psychosis was perceived by clinical psychology students as radical, leading to a realisation that mainstream psychology is a very conservative discipline. How he became interested in interviewing psychiatric patients and telling stories that represented a diverse group of people and experiences of psychiatric services. That this led to a project at Fountain House in New York City to see if narratives could be reinforced and shared. That Michael does not himself use the terms mental illness or disorder because he feels that we need to be flexible and that even this terminology can be traumatising. How he has recently focused on creating spaces where participants can share their experiences and stories and it shouldn’t be a classification or categorization exercise. That he has found many that have experienced the psychiatric system have felt that the system impeded their recovery. That a collaborative team of Adelphi academics, Fountain House staff and Fountain House members will together publish research. That Professor O’Loughlin feels that psychology and psychiatry are traditional and reactive disciplines and that psychiatry has been driven by pharmacological concerns. How Michael’s work with children is grounded in his own childhood experiences and a sense that human beings need nurturing spaces and validation. That Michael is extremely disturbed about the medicating young children with drugs that are not known to be safe for them such as antipsychotic drugs. The unwillingness to understand that a child's distress has an origin and that we have a responsibility to engage with the child and create a space for them to communicate. How we define normality within such a narrow range that children find it very difficult to conform to society’s expectations. That there seems to be little room for a child in school, only room for a student. That psychoanalysis has tools to understand our emotions and experiences but also has tools to help understand societal drivers that may underlie psychological distress. The worry that talking therapies are being replaced by tick lists and categories and that we need to bring stories back into psychology. Relevant links: Michael O’Loughlin, PhD Psychoanalytic Studies: Clinical, Social, and Cultural Contexts Arthur Frank Kathryn Bond Stockton To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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28 min
September 23, 2017
Irving Kirsch - The Placebo Effect and What It Tells Us About Antidepressant Efficacy
This week I have had the honour of interviewing Dr Irving Kirsch. Dr Kirsch is Associate Director of the Program in Placebo Studies and lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also Professor Emeritus of Psychology at the University of Plymouth and the University of Hull in the UK and University of Connecticut in the US. He has published 10 books and more than 250 scientific journal articles and book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion. He originated the concept of response expectancy. His meta-analyses on the efficacy of antidepressants were covered extensively in the international media and influenced official guidelines for the treatment of depression in the United Kingdom. His 2009 book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, was shortlisted for the prestigious Mind Book of the Year award and was the topic of 60 Minutes segment on CBS and a 5-page cover story in Newsweek. In this interview, we discuss Dr Kirsch’s research into the placebo effect and the efficacy of drugs used for depression. In this episode we discuss: How, as an undergraduate student, Dr Kirsch became interested in behavioural therapy but that he doubted the rationale behind these approaches That this led to an interest in beliefs that people had and research into the placebo effect How, while working at the University of Connecticut, his research into the placebo led to an interest in the efficacy of antidepressant drugs when compared to placebo How his work led to the surprising conclusion that, were antidepressant drugs were concerned, the placebo effect was so large that there was very little room for a meaningful drug effect How this changed Dr Kirsch’s views on antidepressant drugs entirely, causing him to ask whether the risks were worth the small benefit for depressed patients That a belief that a person has can affect their response to a drug either in a positive way (placebo) or in a negative way (nocebo) Dr Kirsch found that there are many conditions that can show a profound placebo effect including depression, anxiety, irritable bowel syndrome, pain, Parkinson’s disease and asthma  That the placebo tends to have a greater effect in conditions that have a large psychological component when compared to functional disorders such as diabetes That placebo can have an effect even if the patient knows that they are taking an inactive tablet and that part of this response is down to classical conditioning That Dr Kirsch is working on ‘open-label placebo’ which is being able to prescribe placebo to patients without deception That Dr Kirsch used to refer depressed patients for antidepressant treatments, but that his research made him a disbeliever when looking at the evidence of efficacy when compared to placebo How, when you give someone a new treatment, that often will counter feelings of hopelessness that characterise depressive experiences That in looking at this size of this effect, it made clear that the difference between placebo response and antidepressant response was so small that it was not clinically significant That even drugs with very different modes of action resulted in virtually identical responses in patients, for example, Tianeptine, which is an SSRE (selective serotonin reuptake enhancer) and decreases serotonin levels between neurons, this drug should make depressed people worse but instead, it showed the same efficacy as SSRI antidepressants How, when looking at the clinical trials used to demonstrate antidepressant efficacy, it became clear that the obvious nature of antidepressant adverse effects meant that trial participants would often “break blind” and they would know if they were in the active drug group or the placebo group, this would naturally influence the results of the trial That, in a small number of studies, an active placebo was used, which was a substance that mimicked the side effects of the active drug while having no clinical effect itself That in these active placebo studies, you were much less likely to get a significant difference between drug and placebo when compared to trials that used an intern placebo That the trials conducted by pharmaceutical manufacturers are designed to show their drug in the best possible light and so they do not use active placebo in their studies That Dr Kirsch feels that when conducting trials for drugs used for depression, patients should be asked early on in the trial whether they think they are in the active group or the placebo group and that this question would help ensure the trials were reliable How, when using the data from unpublished trials, the difference between placebo effect and drug effect was even smaller How Dr Kirsch was pleased that other researchers found his conclusions controversial because it meant that they were paying attention to the study and that others who have replicated the approach have found similar results That influencing clinicians to better balance risk vs benefit will take time and that we need to share the data and discuss the conclusions as much as we can to allow change to happen  That people do need help with depression and that there are many different interventions that are at least as effective as antidepressants but without the associated risk How we can’t infer that ‘off-label’ prescribing is effective until the studies have been undertaken for a particular disorder Relevant Links: Dr Irving Kirsch The Emperor’s New Drugs: Exploding the Antidepressant Myth The Emperor’s New Drugs: Exploding the Antidepressant Myth (video) 60 Minutes: Treating Depression: Is there a placebo effect? (video) Antidepressants and the Placebo Effect Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017  
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32 min
September 18, 2017
Peter Breggin - The Conscience of Psychiatry (Part 2)
This week we have a very special guest for you, it has been my honour to be able to interview Dr. Peter Breggin. Dr. Breggin is a Harvard-trained psychiatrist and former Consultant at the National Institute of Mental Health (NIMH). He has been called “The Conscience of Psychiatry” for his many decades of successful efforts to reform the mental health field. His work provides the foundation for modern criticism of psychiatric diagnoses and drugs, and leads the way in promoting more caring and effective therapies. His research and educational projects have brought about major changes in the FDA-approved Full Prescribing Information or labels for dozens of antipsychotic and antidepressant drugs. He continues to educate the public and professions about the tragic psychiatric drugging of America’s children. He has authored dozens of scientific articles and more than twenty books, including medical books and the bestsellers Toxic Psychiatry and Talking Back to Prozac. His most recent three books are Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions; Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Murder; and Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families. As a medical-legal expert, Dr. Breggin has unprecedented and unique knowledge about how the pharmaceutical industry too often commits fraud in researching and marketing psychiatric drugs. He has testified many times in malpractice, product liability and criminal cases, often in relation to adverse drug effects and more occasionally electroshock and psychosurgery. A list of his trial testimony since 1985 is contained in the last section of his Resume on Dr. Breggin's website. Dr. Breggin has taught at many universities and has a private practice of psychiatry in Ithaca, New York. For a career as long and distinguished as Dr. Breggin’s we have decided to devote two episodes to hearing him speak. This first part covered Dr. Breggin's career, his views on psychiatry and psychiatric drugs and also recent developments with the trial involving Michelle Carter. Part 2 of the interview focuses more on recent events surrounding the trial and alternatives to psychiatric drugs. In this episode, we discuss: That Bristol County Juvenile Court Judge Lawrence Moniz sentenced Michelle Carter to a two-and-a-half-year term, with 15 months in jail and the balance suspended plus a period of supervised probation.  How Judge Moniz granted a defense motion to stay the sentence, meaning she will remain free pending her appeals in Massachusetts. That if Michelle lost all of her appeals in 2-3 years time, Michelle may be facing custodial time. That attempts to limit Dr. Breggin’s right to blog about the trial were stopped and the Judge’s final order in response to DA makes no criticism or censorship of Dr. Breggin That Dr. Breggin reviewed thousands of text messages between Michelle and her friends and between Michelle and Conrad Roy, but that one particular part of a text exchange formed the central plank of the case against Michelle. That Dr. Breggin is keen to show, through the Michelle Carter blogs, what is happening to our children when they become involved with psychiatry and psychiatric drugs That Dr. Breggin appreciates the suffering of the family of Conrad Roy because he kept hidden how bad his mental health difficulties were How Dr. Breggin also appreciates how Michele had been tormented and attacked by the press during the trial How the authorities went to extremes to exclude the role that psychiatric drugs may have played in the events surrounding Michelle and Conrad That Dr. Breggin has observed that many that he has helped that have been wounded by psychiatry, have shied away from becoming reformers themselves How, when working with clients, Dr. Breggin makes sure he takes the time to ensure that potential clients know who he is and how his approach differs to mainstream psychiatry That Dr. Breggin feels that the hostility towards those who question the use of psychiatric drugs has reduced over the last 10 to 20 years How Dr. Breggin feels that the psychiatric drugging of our children is tantamount to organised child abuse because the child cannot make a judgement for themselves That many children end up taking the drugs to please their parents That the drug that Michelle Carter was taking (Celexa/Citalopram) was not approved by the FDA for treating children That Dr. Breggin’s view is that emotional or psychological difficulties often are precipitated by childhood trauma That people often then react to the current world as if it were the world that they found traumatic and difficult as a child That good therapy has much in common with coaching in sport or certain aspects of religion or good teaching That all psychoactive substances, including psychiatric drugs, have a general effect on the brain and often this intoxication affects a persons ability to relate emotionally to family and friends How helping people with their mental health comes down to loving, caring, relationship, coaching and guidance That these principles have much in common with good religion or philosophy Relevant Links Peter Breggin’s personal website Peter’s blogs on Mad in America: Part 1 Part 2 Part 3 Part 4 Part 5 Michelle Carter Blogs and Archives The handwritten note from the DA to the Judge about stopping Dr. Breggin’s blog Judge’s Final Order in Response to DA Makes No Criticism or Censorship of Dr. Breggin Toxic Psychiatry Talking Back to Prozac Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Murder Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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45 min
September 9, 2017
John Read - What the Science and Evidence Tell Us About Electroshock (ECT)
This week we have an interview with Professor John Read. Professor Read worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, where he worked until 2013.  He has served as Director of the Clinical Psychology professional graduate programmes at both Auckland and, more recently, the University of Liverpool. He has published over 120 papers in research journals, primarily on the relationship between adverse life events (eg child abuse/neglect, poverty etc.) and psychosis. He also researches the negative effects of bio-genetic causal explanations on prejudice, the opinions and experiences of recipients of anti-psychotic and anti-depressant medication, and the role of the pharmaceutical industry in mental health research and practice. John is on the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis (www.isps.org) and is the Editor of the ISPS’s scientific journal ‘Psychosis’. He also a member of the BPS’s Alternatives to Diagnosis working group. In this episode we discuss professor Read’s research interests and in particular, the science and evidence base for Electroconvulsive Therapy or Electroshock as its known in the United States. In this episode we discuss: How Professor Read became interested in psychology, partly because of difficulties in his younger years and he wanted to understand those experiences That his first experiences with patients in a psychiatric ward would be that people often wanted to share traumatic experiences, but that the psychiatrists didn't seem that interested That, by and large, mental health services around the world prefer to count symptoms and to medicate rather than to understand what has happened in a person’s life How John came to have an interest in and research the efficacy and safety of Electroconvulsive Therapy (Electroshock) That ECT is designed to induce a grand mal seizure and it started as a treatment for people diagnosed as schizophrenic That the justification in the 1940s was that schizophrenics did not suffer with epilepsy and epileptics did not suffer with schizophrenia, so psychiatry made the leap to inducing epileptic seizures as a ‘cure’ for schizophrenia That nowadays it is not used for people labelled as schizophrenic but it is most often used for treating depression How actually it is not the diagnosis that is the best predictor of who gets ECT, it’s age and gender Women aged over 60 are twice as often given ECT as men, and people over 60 are given it 2-3 times more often as those under 60 That the other rationale given for ECT treatment is the tendency for ECT to obscure traumatic memories because of memory loss That the science and evidence tells us that after 70 years there has never been a single study showing that ECT is better than placebo beyond the end of the treatment period That placebo in this sense is like sham surgery, the anaesthetic is given but not the electricity That during the treatment (usually 3-4 weeks and an average of 8-10 sessions) roughly a third of those treated gain some lift of mood but that even for this minority of responders, the effect wears off after a few weeks That this explains why some people will give anecdotal evidence that ECT saved their life and that they tend to have repeated treatments because they want the same life of mood That the method used to assess success of the procedure is most often a rating scale or a ‘clinical judgement scale’ and these methods are open to bias That there is not a single study that has ever shown that ECT can ‘prevent suicide’ when compared to placebo, the claims that it can are based on anecdotal evidence That Earnest Hemingway killed himself shortly after receiving ECT saying “it was a brilliant cure, but unfortunately we lost the patient” That there are temporary effects such as headaches after the procedure, but the enduring difficulties are often with memory loss which can be short term or longer term memories Roughly a third of people will have serious, debilitating and ongoing memory loss which is caused by the brain damage caused by ECT That the Guardian newspaper reported in April 2017 that ECT use was increasing in the UK but that their figures were wrong That a third of psychiatrists will use ECT, a third will only use it after other options have been explored and a third will not use it under any circumstances That ECT can get catatonic people moving and speaking but it is not difficult to artificially stimulate mood and it should not be seen as a cure That there haven't been any placebo controlled trials of ECT since 1985 and that was the last of only four that have ever been done that compared ECT with placebo after the end of treatment How the fact that we do not have any successful trials showing that ECT is effective should mean that psychiatry either puts effort into proper research or that the procedure should be stopped That John feels that eventually we will look back at ECT in the same way that we now view lobotomy, blood letting, rotating chairs and the like How the principle should be informed consent and that people should be able to get treatment that they feel will help them but only if they know fully the risks and benefits and if they have been offered alternatives There is a low but signifiant death rate from ECT, partly down to the general anaesthetic and partly due to cardiovascular failure because of the induced seizure but this death rate is never mentioned to potential patients That it is probably down to the placebo effect of having attention and a procedure that expectations are created and hope is raised That there is effort being put now into transcranial magnetic stimulation (TMS) and people can actually shock themselves using this method That if we have large numbers of people walking round depressed, we really need to start asking questions about our society rather than trying to artificially eradicate those feelings That John’s view is that depression is largely cause by depressing things happening to people rather than because of depressive illness and assuming that we can identify the parts of the brain that are ‘diseased’ To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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32 min
September 2, 2017
Bob Fiddaman - Taking on the Pharmaceutical Regulators and the Seroxat Scandal
This week we have an interview with Bobby Fiddaman. Bobby is a very well known author, blogger and researcher who has been writing about psychiatric drugs and the many issues involved for over 11 years. In 2011 he released his book, ‘The Evidence, However, Is Clear…The Seroxat Scandal’ which is a powerful and explosive account of his experiences taking and withdrawing from the antidepressant Seroxat.  He is a rockstar of the movement to expose the truth about psychiatric drugs, to many he is a hero and to some, he is an uncompromising agitator. His blog has been viewed over 2 million times and he is respected by many and also well known by the pharmaceutical regulators and many of the pharmaceutical manufacturers too.  I was keen to ask Bobby about his own experiences of the mental health system, his research and campaigning over the years and his relationships with the UK and US pharmaceutical regulatory bodies. In this episode we discuss: How, in the late 1990s, Bobby had health problems which made working difficult and this led to low mood and a doctor prescribing Seroxat (Paxil, Aropax, Paroxetine) How he felt that his moods and emotions were blunted by the drug and he recalls not feeling empathy or emotion That eventually his pay was stopped and he was retired on ill health grounds but by this time his financial position was difficult and he became divorced That Bobby took 21 months to wean himself off the Seroxat using a liquid form, going from 40 milligrams to 22 milligrams a day over 19 months That he then quit cold turkey, against doctor advice, because he just want to get rid of the stranglehold that the drug had on him How Bobby felt that his short term memory was affected by being on the drug That sometimes it is harder for friends and family to experience someone going through withdrawal, because they don't know what is happening to the person that they love That these experiences promoted Bobby to write his 2011 book, ‘The Evidence, However, Is Clear…The Seroxat Scandal’ How Bobby stumbled across an article by the investigative journalist Evelyn Pringle and that set the ball rolling with his own blog How Bobby’s blog started to cover the experiences of families who had experienced tragedy due to psychiatric drugs That the blog hosts guest writers so people can tell their own story in their own words How Bobby knows that the pharmaceutical manufacturers and the regulators are regular visitors to his blog That Bobby has been told that his blog makes GlaxoSmithKline ‘cringe’ and this is a measure of the impact of his work That Bobby feels that the manufacturers should just come clean and let the truth come out about the drugs, the clinical trials, the adverse effects and the withdrawal problems That many people don't understand that compensation and out of court settlements often just allow the truth to remain hidden How Bobby was present for the entire trial between Wendy Dolin and GlaxoSmithKline and was shocked by the behaviour of GSKs attorneys That the term ‘akathisia’ is not well known but is implicated in many suicides related to antidepressant and antipsychotic drugs That doctors need to listen to patients to understand the wide range of effects of the drugs That Bobby feels that the regulators, particularly the UK MHRA, should hang their heads in shame because they know about the problems with the drugs but do nothing in response That there is an incestuous relationship between the pharmaceutical manufacturers and the regulators How Bobby has had several meetings with the MHRA over the years, including meeting the CEO, but he feels that they meet to appease rather than take action in response to concerns That Bobby also set up a meeting between MHRA and Dr. David Healy  That the regulators are totally funded by the pharmaceutical industry How Bobby now highlights celebrities who promote the chemical imbalance theory of mental illness That social media has had a big impact on the ability of people to get together and share experiences and make their voices heard How the MHRA Yellow Card scheme is meant to work How, when you start asking questions about follow up, you find that no action is taken and the database of adverse events is worthless That nowhere on the labelling is a list of the benefits of antidepressant drugs That in order to make the drugs safer, we should listen to patient concerns That Bobby uses humour as a tool for getting the message heard How Bobby would like to encourage others to write about their experiences To get in touch with us email: podcasts@madinamerica.com   © Mad in America 2017  
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47 min
August 20, 2017
Peter Breggin - The Conscience of Psychiatry (Part 1)
This week we have a very special guest for you, it has been my honour to be able to interview Dr. Peter Breggin. Dr. Breggin is a Harvard-trained psychiatrist and former Consultant at the National Institute of Mental Health (NIMH). He has been called “The Conscience of Psychiatry” for his many decades of successful efforts to reform the mental health field. His work provides the foundation for modern criticism of psychiatric diagnoses and drugs, and leads the way in promoting more caring and effective therapies. His research and educational projects have brought about major changes in the FDA-approved Full Prescribing Information or labels for dozens of antipsychotic and antidepressant drugs. He continues to educate the public and professions about the tragic psychiatric drugging of America’s children. He has authored dozens of scientific articles and more than twenty books, including medical books and the bestsellers Toxic Psychiatry and Talking Back to Prozac. His most recent three books are Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions; Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Murder; and Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families. As a medical-legal expert, Dr. Breggin has unprecedented and unique knowledge about how the pharmaceutical industry too often commits fraud in researching and marketing psychiatric drugs. He has testified many times in malpractice, product liability and criminal cases, often in relation to adverse drug effects and more occasionally electroshock and psychosurgery. A list of his trial testimony since 1985 is contained in the last section of his Resume on Dr. Breggin's website. Dr. Breggin has taught at many universities and has a private practice of psychiatry in Ithaca, New York. For a career as long and distinguished as Dr. Breggin’s we have decided to devote two episodes to hearing him speak. This first part covers Dr. Breggin's career, his views on psychiatry and psychiatric drugs and also recent developments with the trial involving Michelle Carter. Part 2 of the interview will focus more on the trial and Dr. Breggin’s involvement. In this episode, we discuss: How, age just 18, Dr. Breggin worked as a volunteer in a metropolitan state hospital in 1954. That his immediate impression was a comparison with German concentration camps as he witnessed the brutality including lobotomy and insulin coma therapy. How when the drugs were introduced, primarily Thorazine, the patients would quieten, becoming docile and obedient. That this was brain damage for the purpose of control. That Dr. Breggin then wanted to go to medical school and become part of the reform movement. That, in the 1950s, there were still psychiatrists that had an interest and training in  psychological therapy or psychoanalytic approaches, and social and community psychology. That this also resulted in psychiatry becoming very hostile towards psychosocial approaches, which were less expensive and better. Then, in the 1960s, psychiatry went into partnership with the drug companies and got richer. That Dr. Breggin then entered private practice and learned that lobotomy was making a comeback. This led to a multi year, international campaign to halt the use of lobotomy and psychosurgery in the western world. Since then, Dr. Breggin has also campaigned tirelessly to make changes in the FDA labelling of psychotropic drugs. That Dr. Breggin feels blessed to have been able to stand up for others but also occasionally feels worried by the attacks from the psychiatric establishment. How Dr. Breggin feels that we should tell the truth about psychiatric drugs and that claims of ‘scaremongering’ is a mechanism to reduce criticism of the drugs. That informing people is very different compared to frightening them. That each individual person is still the best judge of when and how to go about withdrawing from psychiatric medications. That Dr. Breggin feels that psychiatry has no economic incentive to change, so the consumer has to stop going to psychiatrists for medications. How the District Attorney in the Michelle Carter case is now trying to stop Dr. Breggin's Mad in America blogs about her case. Relevant Links Peter Breggin’s personal website Dr. Breggin’s blogs on Mad in America: Part 1 Part 2 Michelle Carter Blogs and Archives The handwritten note from the DA to the Judge about stopping Dr. Breggin’s blog Toxic Psychiatry Talking Back to Prozac Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions Medication Madness: the Role of Psychiatric Drugs in Cases of Violence, Suicide and Murder Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families. To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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35 min
August 19, 2017
Rani Bora - Innate Health and Resilience, How It Differs to Mainstream Psychiatric Treatment
This week, we interview Dr. Rani Bora.  Dr. Bora is a qualified Psychiatrist and Mental Health and Resilience Coach. She has studied a number of approaches to mental well-being – both traditional and non-traditional, and she focuses on holistic approaches to supporting people with their mental wellness. Since deepening her own understanding of the paradigm of ‘Innate Health and Resilience’, she has committed herself to sharing this understanding in her coaching and training and has witnessed remarkable transformation in individuals whom she has supported. In this interview we discuss Dr. Bora’s background in psychiatry, how she came to move away from more traditional psychiatric approaches and the concept of innate health and resilience. In this episode, we discuss: How Dr. Bora graduated from medical school in 1997 and became interested in connecting with people leading to specialising in psychiatry That Rani found working in India as a psychiatrist very different compared to the UK and there were very few community services with most services delivered in a hospital setting That after working in the UK, Dr. Bora became interested in self help and personal development That this led to training in parallel both as a psychiatrist and as a life coach studying Neuro Linguistic Programming (NLP), Emotional Freedom Techniques (EFT) and Narrative Coaching That Rani came to see that using tools and techniques as a quick fix can be problematic, because difficulties can re-surface once people stop using the tools and techniques That Innate health and resilience (also known as the three principles) is a new paradigm pointing to the health and wellbeing within all and how the mind works That the three principles are mind, thought and consciousness That Rani sees medication and mindfulness as tools but they don’t really address the root cause of emotional distress That having an understanding about how the mind works can help people to heal from emotional difficulties or trauma That people are more resourceful than they think they are and Rani helps people to discover that resourcefulness within themselves Rani’s mentor, US Psychiatrist Dr. Bill Pettit, reminds us that a diagnosis doesn't define a person, only describes symptoms That people experiencing mental health difficulties are not different to the rest of society, but medicine quite often labels and separates Rani believes that “you cannot fail at being yourself” That if people accept themselves with their perceived flaws and limitations and realise that these individual differences are what make us unique and human, it means less judgement and self criticism That Rani feels that we focus too much on what is lacking in people and on diseases and symptoms That we also focus too much on mental illness rather than mental health That Rani does work with clients who expect medication, but that she often finds other ways to work with people That Rani wants to know the outcome people are looking for and often finds that the medical model has its limitation in helping people with their real needs in life That Rani would like the research to focus more on empowering people and what helps people recover That Rani feels that it’s very important that we also focus on the health of those in the medical community who are supporting others, as the lack of resources can be associated with enormous strain and stress That Rani would like people to reflect on the fact that they are not broken, even given what happened in the past or what diagnoses they have There is something at the core of who we are that cannot be damaged by our experiences To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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32 min
August 11, 2017
Jim van Os - Rethinking Biological Psychiatry
 This week, we interview Professor Jim van Os. Professor van Os is Chairman of the Department of Psychiatry and Psychology at Maastricht University Medical Centre, Maastricht, The Netherlands, and Visiting Professor of Psychiatric Epidemiology at King’s College, Institute of Psychiatry, London.  He trained in Psychiatry in Casablanca, Bordeaux and the Institute of Psychiatry and the Maudsley Royal Hospital in London. In 2011, he was elected member of the Royal Netherlands Academy of Arts and Sciences (KNAW); he appears on the 2014 Thomson-Reuter Web of Science list of the world’s most influential scientific minds of our time. He is Director of Psychiatric Services at Maastricht University Medical Centre and runs a service for treatment-resistant depression and first episode psychosis. I was keen to ask professor van Os about his views on biological psychiatry, why we should sometimes challenge schizophrenia, psychosis and other diagnostic terminology and how he sees the future of mental healthcare. In this episode, we discuss: How Jim became interested in Psychology and Psychiatry, partly because of the experiences of family members That Jim felt that training in many parts of the world allowed him to see variations in psychiatric models and this led to him questioning the biological model That Jim also saw how dominant the prescribing of medication but noticed the wide variation in practices How Jim observed in France a willingness by the treating doctors to accept that they didn’t know what the root cause of a mental health difficulty That some of the diagnoses that psychiatrists rely on are actually cultural agreements between professionals and that if a patient accepts the idea that they have a diseased brain, it can be limiting for that patient That we should be able to admit that we don’t know causes but we can still help and support people who struggle with their mental health That there is a 25% yearly prevalence of mental disorders, but many nations have a capacity for only 4% to 6% of the general population That selection criteria to get help and support with their mental health just don’t work because we cannot precept outcomes for people That there are interesting developments in eCommunities where people can participate in online communities to share experiences, for example ‘Proud to be Me’ in the Netherlands. That diagnoses are starting to function as an economic measurement of mental illness and treatment and some cannot access treatment without a diagnosis, which perpetuate the diagnostic paradigm That there were attempts in the most recent Diagnostic and Statistical Manual (DSM V) discussions to adopt ranges or dimensions of disorders, but the proposal was shot down That it would have been historic if dimensions were adopted in the DSM because then the discussion between the clinician and the patient would have had to change That there is some dimensionality in DSM V, represented as ‘spectrum disorders’ which are the first step towards acknowledging the variations inherent in human experiences That Jim saw in his own family that the initial ‘relief’ of receiving a diagnosis was undone when more and more diagnoses were added That a label of Schizophrenia can mean that other people do not know what to expect and find it difficult to relate psychologically to that person and their experiences That the Maastricht User Research Centre has been discussing the language used in psychiatry, in particular the terms psychosis and schizophrenia and trying to find more helpful terms, for example hyper-meaning That sometimes terms such as ‘susceptibility’ and ‘syndrome’ are far more helpful than giving someone the message that they have a brain disease   That biological psychiatry has been trying to reverse engineer and validate the concept of schizophrenia by investigating case control differences That there is more awareness developing about the critical appraisal of diagnostic terminology That the mental health sector should not be viewed as a separate entity, but should reinvent itself as an inclusive local community that is there to connect with people and their range of experiences That patients often indicate that what got them better was community and connection and meaning and empowerment That the User Research Centre, led by Dr. Peter Groot, have developed a solution to help patients withdraw slowly and gradually from their psychiatric medications That when prescribing medication, we should encourage people to monitor their experiences to allow a better discussion about treatment continuing or stopping based on evidence That if we suppress difficulties with medication, it can make it more difficult for the person to build up coping mechanisms To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/h1CHc5 To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017  
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54 min
August 5, 2017
Kermit Cole - Dialogical Approaches to Extreme States
This week, we interview Kermit Cole. Kermit’s first career was in film and television, directing, amongst others, Living Proof: HIV and the Pursuit of Happiness in 1994. Kermit has undergraduate and master’s degrees in psychology from Harvard and he has over two decades experience working with people in extreme states. He likes to say that he likes to work with trauma, especially when it’s being called something else – such as “psychosis”. Together with his partner Louisa Putnam, he works with couples and families with members who have been labeled as having a mental illness, seeking other ways to understand their struggles – ways that often lead to better outcomes. Kermit has been part of the team at Mad in America since it was founded in January 2012. I was keen to ask Kermit about what led to his interest in therapeutic work, his experiences of supporting those in extreme states and his thoughts on Open Dialogue and dialogical approaches in general. In this episode, we discuss: How Kermit came to be involved with a photo project that aimed to change the dominant image usually portrayed for those with HIV or AIDS and how that led to his 1994 film: Living Proof: HIV and the Pursuit of Happiness How Kermit came to feel that a persons life should not be appraised based on its duration How Kermit went on to make the transition from film maker to supporting others with their mental health and wellbeing That Kermit came to feel that having a camera got in the way of the connection that he wanted to make with people How he went back to study and developed an interest in trauma and its impact on people and came to develop the skills necessary to be comfortable dealing with extreme states  His experiences working on a helpline for people experiencing suicidal thoughts and in a group home setting How it felt to support those in distress without judgement or control, but just being with them and how not being alone sometimes makes a big difference How sometimes supporting someone means not judging but also not colluding with beliefs that may come across as delusional, and how this is different to the approach of trying to medicate away behaviour that has been classified as aberrant That Kermit feels blessed that he could choose between schooling and study or the risk of depression, diagnosis and hospital, but that many are not so fortunate How Kermit and Louisa work together to support people struggling with their mental health through a family therapeutic approach and based on Open Dialog principles That it is important to respond to a network that is in crisis, such as the family unit, rather than a single individual That this approach used in Tornio, Finland resulted in excellent outcomes for patients and a lowering of municipal expenditure on mental health crises  How Louisa and Kermit approach working together in an open dialog model How, if you can find a way for people to safely do what they would naturally want to do, then it can be helpful How Kermit became involved with Mad in America after reading Robert Whitaker’s books That taking medication could almost be viewed as an act of communion That life, being human, hurts, but by learning to connect we can ameliorate the trauma  To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/AiNFNk To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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46 min
July 29, 2017
Pratima Singh - Exploring Alternatives to Biological Psychiatry
This week, we interview Dr. Pratima Singh. Dr. Singh completed her medical degree in India, before moving to the UK to work at the Maudsley NHS Hospital in London as an adult Psychiatrist. Dr. Singh has a deep interest in alternatives to biological approaches to psychiatry and the use of psychotropic medications. I was keen to ask Dr. Singh about her background, what led her towards psychiatry as a medical speciality and what she feels about the future of psychiatric care. In this episode, we discuss: ▪How Dr. Singh completed her medical degree in India and became interested in psychiatry  ▪That Dr. Singh felt uncomfortable with the predominantly biological approach to psychiatry including the use of medications and that her interest was in psychotherapy as a therapeutic intervention ▪That there is a recruitment and retention problem within psychiatry ▪That 15 years in psychiatry has given Dr. Singh a nuanced and humble attitude to helping people with their mental health ▪That Dr. Singh felt that her discontent with biological psychiatry continued during her training ▪That, in the UK, General Practitioners (family doctors) actually deal with 80% of mental health problems ▪Patients may then be referred by the GP to therapy teams in secondary care, commonly known as Community Mental Health Teams (CMHT) ▪These teams include psychiatrists, occupational health specialists to try and address a range of service user needs ▪That there is also acute care, or crisis teams, where support is given for psychiatric emergencies ▪Recently there has been diversification to include specialisms like eating disorders, learning disabilities or neuropsychiatry but provision differs across the UK ▪That Dr. Singh feels that we have too rapidly and too dramatically cut down the amount of in-patient beds, leaving a gap and increasing the pressure on the community teams ▪That in the UK we struggle to provide a brief intervention model because many service users often require more time ▪That Dr. Singh feels that the majority of people that she sees have already been put onto psychotropic medications by their GP and often this is too early in the process ▪That there are patients now that say they do to want to try medication ▪That the evidence for using so much medication for emotional distress is weak ▪That psychiatrists do not have tests to help predict how a medication will affect a patient or if they will struggle to withdraw ▪That Dr. Singh would like us to understand the medications better especially why some people struggle even if they try to withdraw slowly ▪That, as professionals we need to listen to patients experiences of adverse effects or withdrawal difficulties  ▪That Dr. Singh feels that it is a privilege to be able to engage with patients in this way but that we must be very carful not take advantage or to harm the patient despite our best intentions ▪That we need a completely different mindset to better manage mental health difficulties ▪That Dr. Singh prefers to look at the wider issues in a persons life to try and find the best way to support them including diet, exercise or other potential issues such as metabolic problems or nutritional deficiencies ▪How sometimes a therapeutic relationship can feel like an arranged marriage ▪That a new model would only work if the intervention is early enough in the process, if we engage with people too late, it can be more difficult to help ▪How Dr. Singh remembers her first interaction with a patient and uses this to guide her in listening to the patients own wisdom and experience  ▪That Dr. Singh took some time to undertake a Leadership and Management fellowship and that this really helped her to stand back and appreciate the issues and to listen to the customer ▪That full disclosure and informed consent is so important ▪Functional medicine and how it differs to mainstream psychiatric approaches  ▪That functional medicine is a holistic approach that considers the whole person ▪and underlying root cause of chronic illness ▪In a functional approach there are no specialities ▪The place of recovery colleges in co-producing training in holistic ways of ▪maintaining health ▪That we still tend to think about contemplative practices as something to try rather than a core skill necessary for good mental health ▪That there is not enough evidence to influence a closed mind ▪That many of the best discoveries in medicine come from observation rather than from a laboratory ▪Dr Singh’s hope that psychiatry can return to a place of creativity and openness  To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/zbxncn To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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64 min
July 22, 2017
Monica Cassani - Achieving Health in Body, Mind and Spirit
This week, we have an interview with Monica Cassani. Monica has seen the mental health system from both sides – as a social worker and as a person whose life was severely ruptured by psychiatric drugs. She writes critically about the system, as well as holistic pathways of healing without medication.  Monica’s website, Everything Matters Beyond Meds, is comprehensive library of information containing more than 5,000 blog posts, information articles, videos, personal experiences and shares many natural methods of self-care for finding and sustaining health in body, mind and spirit. Her blog also deals with wider issues in the socio/political and spiritual realms as they pertain to mental health and human rights issues surrounding psychiatry. I was keen to ask Monica about her own experiences of the psychiatric system, how a persons sensitivity can be affected by psychiatric treatment and how she helps and supports others to achieve health in body, mind and spirit. In this episode, we discuss: ▪How Monica came to be involved with the psychiatric system ▪How treatment was repeatedly forced on Monica ▪That the lack of information available meant that Monica felt she had no alternatives to the standard model of treatment ▪That she was threatened with committal to a State Asylum ▪How, because of the medications, Monica became non verbal and had difficulty walking ▪The betrayal that Monica felt after trusting and being failed by the medical system ▪How she has been drug free for more than 8 years after being on a substantial cocktail of five different medications for over 25 years ▪That Monica became focussed on getting past the drugs and on her work and took a harm reduction approach to getting off her medications ▪How Monica saw her withdrawal from the drugs as a rebellion and felt emancipated once she was medication free ▪That Monica witnessed clients struggling with the drugs and even, tragically, dying from their effects ▪How Monica views hypersensitivity and its relation to her healing ▪That Monica feels, in some ways, far healthier now than before the drugs but in other respects she feels that she struggles with things that others may find easy ▪That hypersensitivity seems to be common in those who have taken or withdrawn from psychiatric drugs ▪That most in the mental health system do not have the necessary experience to help those who have struggled with their medications ▪How Monica came to set up and invest time in her blog: Everything Matters Beyond Meds ▪How Monica was inspired by the work of the journalist Philip Dawdy and motivated by her family ▪How Everything Matters Beyond Meds combines science and holistic approaches in presenting options for people to support their health and wellbeing ▪That Monica takes a hands off approach to helping  and supporting others because she recognises the coercive nature of medical approaches and respects the right of the individual to choose for themselves ▪How people taking or withdrawing from psychiatric drugs tend to neglect their bodies and that preparation is important before tapering off medications ▪That diet is particularly important when considering withdrawing from psychiatric drugs To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/oTo3g1 To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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29 min
July 15, 2017
Will Hall - A Harm Reduction Approach to Mental Health and Wellbeing
This week, we have an interview with Will Hall. Will is a mental health advocate, counsellor, writer, and teacher. Will advocates the recovery approach to mental illness and is recognised internationally as an innovator in the treatment and social response to psychosis. In 2001, he co-founded the Freedom Center and from 2004-2009 was a co-coordinator for The Icarus Project. He has consulted for Mental Disability Rights International, the Family Outreach and Response Program,  and the Office on Violence Against Women, and in 2012 presented to the American Psychiatric Association‘s Institute on Psychiatric Services. As an author, Will has written extensively on mental health, social justice, and environmental issues, he is well known for the excellent Harm Reduction Guide to Coming Off Psychiatric Medications which is one of the first places that listeners should look to for help and support when considering taking or withdrawing from psychiatric medications.  Will’s latest book is Outside Mental Health: Voices and Visions of Madness, released in 2016 it presents interviews with more than 60 psychiatric patients, scientists, journalists, doctors, activists, and artists to create a vital new conversation about empowering the human spirit. Outside Mental Health invites us to rethink what we know about bipolar, psychosis, schizophrenia, depression, medications, and mental illness in society. Will also hosts Madness Radio which broadcasts on FM and is also available as a podcast. For listeners, I recommend that you listen in and subscribe to the Madness radio podcast, particularly as the Harm reduction guide to coming off psychiatric medications can be heard in full here. In this episode, we discuss: ▪How Will became involved with the psychiatric system while living in the San Francisco Bay area ▪His experiences of being treated with a wide range of psychiatric drugs ▪How he came to meet with other psychiatric survivors and take control of his own recovery ▪The setting up of the Freedom Centre in Western Massachusetts ▪The creation of the ‘Harm reduction guide to coming off psychiatric drugs’ ▪How this led to Will’s work in counselling, training and education around psychiatric drugs ▪How Will approached collaborating with a wide range of contributors to develop the Harm reduction guide ▪That Will wanted to adopt a careful, non judgemental approach to his work to support people with their medications ▪How Will feels he reached more people because they knew that they weren’t going to be judged ▪That the research and evidence does not support the idea that psychiatric drugs are treating some brain disease or correcting an underlying brain chemical imbalance ▪The fear that exists around these kind of mental health difficulties ▪The dangers of psychiatric drugs ▪That people with lived experience of psychiatric medications need to share their experiences, particularly where withdrawal is concerned ▪That sometimes passivity can contribute to reliance on medications but people need to take their health into their own hands ▪That we should really be looking to a community based approach to supporting people with emotional distress or trauma ▪That we need to create healthy communities that support each other ▪That if people are considering stopping their psychiatric drugs they should make use of the Harm reduction guide because there is no single answer ▪That people should also make sure that they have a support network in place because stopping the drugs can become an isolating experience ▪That drug withdrawal is a life change process not just a chemical change in your brain ▪That psychiatry can make not claim to have answered the mind/body question ▪That fear is a big factor when considering not relying on medication ▪That where withdrawal is concerned, time tends to be on your side if you can get through the discomfort and difficulty   To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/18cg4L To get in touch with us email: podcasts@madinamerica.com  
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31 min
July 11, 2017
World Benzodiazepine Awareness Day 2017 - Raising Global Understanding
This week, we have a special episode to join in with the events being held for World Benzodiazepine Awareness Day. World Benzodiazepine Awareness Day seeks to raise global awareness of iatrogenic benzodiazepine dependence, the dangers of its adverse effects and the associated withdrawal syndrome, which can last for years. To give some context around the issues with Benzodiazepines, we have three interviews in this episode. Firstly we talk to Professor Malcolm Lader who is Emeritus Professor of Psychiatry from Kings College London and is globally recognised as an expert on Benzodiazepines. Following that we talk with Jocelyn Pedersen. Jocelyn is a US based campaigner who shares her own experiences with Benzodiazepines and talks also about her views of the medical response to the issues of dependance and iatrogenic harm. Finally, we talk to Barry Haslam. Barry is a veteran UK campaigner who shares his experiences and also what we should be doing to help those dependant or damaged from use of these medications. Barry has been instrumental in raising awareness and taking action for last 30 years and is well known in political and medical circles. Interview 1, Professor Malcolm Lader In this interview we discuss: ▪Professor Lader’s training in medicine and how he specialised in psychopharmacology and psychiatry ▪That he went on to become involved in research, particularly around tranquilliser dependance and adverse effects ▪How Benzodiazepines were created in the 1950s, replacing Barbiturates because they were generally safer in overdose ▪That the first Benzodiazepine created was Librium (Chlordiazepoxide) soon followed by Valium (Diazepam) ▪That for a time, Valium was the most widely prescribed drug on the planet ▪That the advantages are that Benzodiazepines are relatively safe in overdose but they can result in dependance (likely a 1 in three chance) at therapeutic doses ▪That by 1975, Professor Lader’s Addiction Research Unit at the Maudsley hospital in London were becoming increasingly concerned by the number of people who were being referred to them for specialist help ▪How this led to Professor Lader’s famous quote on a BBC Radio 4 interview that it was “easier to withdraw people from Heroin than from Benzodiazepines” ▪That Opioid withdrawal caused an acute, very unpleasant withdrawal experience but Benzodiazepines caused a protracted withdrawal that was actually more difficult for many people to deal with ▪How they were left with patients who had successfully withdrawn from Opioids like Heroin but were still having trouble with the Benzodiazepines like Ativan ▪How the British Medical Association have only recently become engaged in the issues of dependance and withdrawal to give advice to their members (General Practitioners) ▪That the regulators don’t have sufficient influence to get doctors to prescribe Benzodiazepines in a more responsible way ▪That much of the long term use of psychiatric medications comes down to lack of monitoring of patients by doctors ▪That there have been cases where long term prescribing of Benzodiazepines has been seen to be negligent on the doctors part and that this has led to some out of court settlements ▪That the treatment of dependance is not simple or straight forward so it is much better to educate GPs upfront to intervene before people have the chance to become dependant ▪How we are now repeating some of the same mistakes made with Benzodiazepine prescribing with Opioid analgesics and antidepressants too ▪That the increase in prescribing of psychiatric drugs is partly down to greater recognition of mental health difficulties but also that we do not have enough people trained in non pharmacological interventions ▪That Pharmacists can play a pivotal role in monitoring, advising and supporting patients ▪How Professor Lader became involved in the educational resource the Lader-Ashton organisation ▪That Professor Lader welcomes this second Benzodiazepine Awareness Day because knowledge and education about the related issues is important ▪That people who are currently taking a Benzodiazepine should make themselves aware of the risks and benefits and talk to their prescriber if they are concerned ▪The concerns around the lack of research in this area and that we need ring fenced money to better understand how best to help and support dependant patients ▪That the prediction of the efficacy of psychiatric drugs from biochemistry to animal experiments to human treatment is very poor, so the Pharmaceutical industry is losing interest in psychotropic drugs ▪That psychiatric drugs largely offer symptomatic relief and so their usefulness is limited and we also need to focus on the safety issues Interview 2, Jocelyn Pedersen In this interview we discuss: ▪How Jocelyn first came into contact with benzodiazepines, having had family illness difficulties and finding that she suffered with insomnia but wanting something that was safe to take while pregnant ▪How her doctor recommended the nonbenzodiazepine tranquilliser Ambien (Zolpiden) which Jocelyn used for less than a week because she felt that it was affecting the baby ▪How Jocelyn, after stopping the Ambien even after such a short usage period, found that she couldn’t sleep, couldn’t eat or even do basic things like reading or watching TV ▪That Jocelyn, in trying to explain the wide range of symptoms she was experiencing had a range of physical examinations and tests that all came back negative ▪That doctors explained away her constellation of symptoms as postpartum depression ▪How doctors then prescribed the Benzodiazepine Ativan at 1mg and Effexor, telling her to only take the Ativan until the Effexor ‘kicked in’ ▪That, for Jocelyn, the Effexor never did ‘kick in’ because she was suffering Benzodiazepine withdrawal ▪That upon doubling the dose of Ativan, Jocelyn felt better but she knew that it was only meant for short term use ▪How she found that every time she tried to reduce, even by a small amount like 0.25mg, she was unable to function ▪How three years later, Jocelyn decided it was time to get off the Ativan because she was suffering other health issues ▪How Jocelyn realised that Benzodiazepines like Ativan are teratogens and dangerous in the first months of pregnancy and that being pregnant, Jocelyn had no option but to withdraw ▪That on starting her tapering, Jocelyn was unable to do much else but writhe on the floor in agony, describing even a small reduction as “descending into hell” ▪How Jocelyn’s husband, having found online support groups like Benzo.org.uk realised that what was happening was Benzo withdrawal ▪That Jocelyn, then suffering a miscarriage, ended up in the ER, begging the ER doctor to switch her over to Valium ▪That Jocelyn then spent the next year and a half tapering from Valium ▪How Jocelyn then started to join online support groups, learning how to do a proper taper like that recommended by Professor Heather Ashton ▪That it is very difficult to communicate to friends and family members what is happening, with many assuming it is merely depression or anxiety ▪That it is important to avoid the use of addiction terminology, because people struggling with withdrawal have more in common with those that have a traumatic brain injury or neurological damage ▪That often the only thing between someone and even more suffering is the Benzodiazepine, so it’s not as simple as just wanting to get off ▪That it has been just over two years since Jocelyn finished her taper and there has been considerable improvement but there are still lingering effects ▪That changing her diet made a significant difference to Jocelyn’s health and wellbeing ▪How Jocelyn became involved with campaigning and started her own YouTube channel BenzoBrains ▪How she wanted to be able to add some validity when approaching legislators and lawyers so she founded the Benzodiazepine Information Coalition, a non profit organisation ▪How these and other groups help to educate medical professionals, particularly in terms of avoiding addiction terminology but also to provide guidance on the right approach to take with someone who is dependant ▪How Jocelyn observes some mistakes in how doctors treat those who are iatrogenically harmed, particularly doctors who suddenly stop prescribing because they are worried about the legal aspects, this can leave a dependant person in a very difficult place ▪Secondly while doctors may be cautious about Benzodiazepines, they still readily prescribe other psychiatric medications and even recommend them to treat Benzodiazepine withdrawal effects ▪That a total ban or strict regulation and control of prescribing is an approach which would harm many people who are dependant ▪That what patients need is the proper information to help them successfully and safely get off the drugs ▪That people taking Benzodiazepines shouldn’t be scared by the horror stories but should take time to educate themselves and to accept that the path to being drug free might not be easy but healing is a journey and takes time ▪Jocelyn’s involvement with the forthcoming documentary film: As Prescribed directed by Holly Hardman ▪That much of the funding in this area of research goes to addiction services rather than specifically to help someone who is dependant ▪The difficulty that some people have in accepting that they may be dependant on a prescribed medication ▪The disempowering nature of the message that someone has to take a medication for life and that they have a chronic health condition ▪The message that Jocelyn has for people is that they are capable of more than they know and they can get through the experiences of withdrawal and be stronger for it Interview 3, Barry Haslam In this interview we discuss: ▪How Barry came into contact with Benzodiazepines in 1976 when he had a stress related breakdown due to the combined pressure of working full time  and studying ▪That Barry has no memory of the period 1976 to 1986 and he has had to piece together what happened from medical records and the recollections of family members ▪How a doctor put Barry firstly on Librium (Chlordiazepoxide), followed by a number of antidepressants and also Valium for a time ▪How Barry ended up on a huge dose of 30mg of Ativan (Lorazepam) per day ▪This happened because Barry was experiencing withdrawal effects because of tolerance to the drugs but the doctors didn’t recognise these effects so increased the dosage in response ▪That Barry suffered such powerful daily headaches that he ended up taking 12 opiate painkillers per day in addition to the Ativan ▪That in December 1985, Barry, suffering uncharacteristic aggression, felt that enough was enough and he had to quit the drugs ▪That he had some psychological support when he first started to withdraw but for the majority of the time he did it alone ▪How he dropped from 30mg to 2mg of Ativan in 9 months as well as stopping the opiate painkillers ▪For the last period he transferred to Valium (Diazepam) which took 5 months to come off ▪He did this with no guidance and very little support because the doctors had abandoned him ▪How he experienced many unpleasant physical symptoms including violent daily vomiting, hallucinations, feeling of things crawling under his skin and lost half of his bodyweight ▪How Barry feels that it was the love and support of his wife and family that got him through that 15 months of hell ▪That there is virtually nowhere for people struggling with withdrawal to go to get help and support ▪That these issues receive far less attention and funding than alcohol or nicotine dependance ▪That Barry feels that the health services are too frightened of litigation and that prevents them from directly addressing theses issues ▪How Barry joined an organisation called Oldham Tranx, a peer support group run by drug dependant patients and how Barry became chairman ▪How the local paper, the Oldham Chronicle supported Barry in his campaigning ▪How Addiction Dependency Solutions (now called One Recovery) started to help people in 2004 and is the first NHS funded facility in the UK ▪That we should get Government policy makers in the Department of Health to issue guidance to all local Clinical Commissioning Groups to ensure that similar services are set up across the country and in other parts of the world too ▪We should introduce peer support groups based on the model already in place in Oldham ▪How Professor Heather Ashton ran a withdrawal clinic in Newcastle for twelve years and learned a great deal from the patients experiences ▪That putting these services in place would save lives, Barry estimates that in the UK alone 20,000 lives have been lost since 1960 due to suicide, poisoning and road traffic accidents related to Benzodiazepine use ▪How Barry missed out on his daughters growing up because of the memory loss caused by the drugs up but now can enjoy seeing his three grandchildren grow into adults ▪How Barry has met so many good people in the community of those who needed help and support and that gives him the drive to continue campaigning ▪That even many years after the drugs have been stopped, they can continue to cause a range of health problems ▪That we need hard, clinical evidence of the damage cause by Benzodiazepine drugs as part of the evidence base for future legislative action ▪That this is national problem and needs to be tackled by national governments ▪That dependant patients should continue to put their experience back into the system and that will help society ▪Barry’s wish to have recognised the selfless and tireless work of Professor Heather Ashton including her withdrawal protocols that are used worldwide and that the British Government have never formally recognised her great service and the lives that she saved ▪That every doctors surgery should have a copy of Professor Asthon’s Benzodiazepine withdrawal manual ▪That Barry wants to pay tribute to all of those who have taken their own lives because of Benzodiazepines, either because the horrors of withdrawal or the increased suicidal thinking To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/QU9XLU To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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90 min
July 8, 2017
Mo Hannah - Changing the Teaching of the Biological Model
This week on the Mad in America podcast, we talk to Dr. Maureen (Mo) Hannah.  Mo is a Professor of Psychology at Siena College, New York, where she has taught since 1992. She is a licensed New York State psychologist practicing with older adolescents and adults. Mo is an Advanced Imago Relationship therapy Clinician and serves as an Academic Faculty member of Imago Relationships International. Her clinical and research interests revolve around couples therapy, intimate partner violence, and transpersonal psychology. She serves as the Editor of Family and Interpersonal Violence Quarterly and has published seven books and numerous chapters and articles. In 2004, she co-founded and continues to serve as Chair of the annual Battered Mothers Custody Conference. In this episode, we discuss: ▪Mo’s experiences with the psychiatric system, both personally and professionally ▪How poor care in the mental health system led to an unexpected and devastating family loss ▪That Mo feels that her families needs and views were not taken into account when discussing treatment for her elder daughter, Monique ▪The difficulties that parents encounter when a child is old enough to be covered by HIPAA laws, meaning that treatment is not discussed with parents ▪How Alex, Mo’s younger daughter, was put onto antidepressants following the loss of her sister but she had little to no intervention to ensure that the drugs were the right treatment for her ▪That Doctors do not tell patients about withdrawal effects when stopping psychiatric drugs ▪That Alex suffered profound withdrawal effects 3-4 months after she had ceased the drugs, one of the worst issues being extreme insomnia but also anxiety, obsessive thinking and guilt ▪That it was very clear these were drug related effects and not a mental health problem ▪That Doctors should be better informed so they can help their patients make an informed choice about drug treatment ▪That Mo used to be more open to drug therapy discussions with her patients but she  now is very cautious to warn people about potential effects and impacts of withdrawal ▪That Mo has also changed her teaching approach to ensure that her students understand that the view of antidepressant drugs that we have been sold is not the reality that many experience ▪That the view of the drugs as safe, effective and non addictive is too simplistic ▪Mo’s own experiences with Prozac and finding that her own withdrawal was difficult but not as bad as she had witnessed with Alex, and that our experiences of withdrawal can vary widely ▪How Alex had also sought treatment outside the mental health system, in a naturally oriented facility, but still found that knowledge of how to support someone in withdrawal was virtually non existent ▪That Alex is now recovering, but it is a slow process ▪People going through withdrawal need family and friends support and probably not go near a treatment facility ▪Mo’s experience of the ‘biological model’ of psychiatry in her Doctoral clinical internship training and how dominant that message was ▪That people should think long and hard before committing to an antidepressant, they should research the pros and cons and look into all the available non drug options for help first To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/DD9nMY To get in touch with us email: podcasts@madinamerica.com   © Mad in America 2017
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37 min
June 30, 2017
Jim Gottstein - Patient Rights in Mental Healthcare
This week on the Mad in America podcast, we talk to Jim Gottstein, president and founder of the organisation Law Project for Psychiatric Rights. Jim talks to us about his own experiences with the psychiatric system, patient rights in mental healthcare and the recent trial between Wendy Dolin and the UK Pharmaceutical manufacturer GlaxoSmithKline. In this episode, we discuss: Jim’s experiences growing up in Alaska How Jim became involved with the psychiatric system That Jim was told he was mentally ill and he needed drugs for the rest of his life and would never be able to practice law again How found a Psychiatrist who told him that anyone who doesn’t sleep could become psychotic and that he could manage the problem How his experience with the psychiatric system changed the focus of his life About his involvement in a case involving the State of Alaska stealing a million acre land trust for the “mentally ill” That the book ‘Mad in America‘ by Robert Whitaker provided a litigation roadmap for challenging forced psychiatric drugging How Jim formed the organisation Law Project for Psychiatric Rights (PsychRights) to mount a strategic legal campaign against forced drugging and Electroshock in the USA How the number of people detained or forcibly treated in the mental health system is dramatically out of step with the reality demonstrated by Open Dialog and Soteria type approaches That changing public attitudes to the hidden parts of the mental healthcare system is very important How cases can arise very rapidly, requiring almost immediate response which is sometimes difficult That the deck is really stacked against the patient because they are having to defend themselves against medical professionals and their lawyers while they have no credibility because they are charged with being mentally ill The events in the trial between the widow of Stuart Dolin and the UK Pharmaceutical manufacturer GlaxoSmithKline That it was a legal first because Wendy Dolin sued the manufacturer of the brand name drug, Paxil, even though Stuart Dolin was taking the generic version of the drug manufactured by Mylan How Wendy Dolin’s lawyers came up with a common law negligence claim against GSK that GSK had a duty to provide accurate information about the drug How GSK manipulated the science of the clinical trials to downplay the suicide risk That Dr. Joseph Glenmullen and Dr. David Healy were key expert witnesses That the jury unanimously found GSK guilty of withholding information That GSK have stated their intention to appeal the verdict How the appeal process will work Why we shouldn’t trust what Pharmaceutical manufacturers tell us about clinical trials The lack of informed consent where the prescribing of psychiatric drugs is concerned That outcomes for patients who have either not taken, or withdrawn from, antipsychotic drugs are much better than for those who continue with the drugs To listen on Mad in America: https://goo.gl/tyyLmt Podcast show notes: https://goo.gl/QpjVsA To get in touch with us email: podcasts@madinamerica.com © Mad in America 2017
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45 min
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