California State University, Sacramento Division Of Social Work: Fill & Download for Free

Anything the Federal Government touches turns into a black-hole; no Federal Agency has ever looked at itself, and said: we need to lay-off 60% of you… and start over.Next, we come to State Governments, and here we find marked ‘differences, state to state. Just so you know HOW HUGE some of these State agencies are, I’ve listed all the agencies that have bellied up to the trough in California, and at the end of it, you need ask yourself ‘do we really need more?’ (or is somebody simply not doing their job?)These are all California State Agencies:California Academic Performance Index (API) * California Access for Infants and Mothers * California Acupuncture Board * California Administrative Office of the Courts * California Adoptions Branch * California African American Museum * California Agricultural Export Program * California Agricultural Labor Relations Board * California Agricultural Statistics Service * California Air Resources Board (CARB) * California Allocation Board * California Alternative Energy and Advanced Transportation Financing Authority * California Animal Health and Food Safety Services * California Anti-Terrorism Information Center * California Apprenticeship Council * California Arbitration Certification Program * California Architects Board * California Area VI Developmental Disabilities Board * California Arts Council * California Asian Pacific Islander Legislative Caucus * California Assembly Democratic Caucus * California Assembly Republican Caucus * California Athletic Commission * California Attorney General * California Bay Conservation and Development Commission * California Bay-Delta Authority * California Bay-Delta Office * California Bio Diversity Council * California Board for Geologists and Geophysicists * California Board for Professional Engineers and Land Surveyors * California Board of Accountancy * California Board of Barbering and Cosmetology * California Board of Behavioral Sciences * California Board of Chiropractic Examiners * California Board of Equalization (BOE) * California Board of Forestry and Fire Protection * California Board of Guide Dogs for the Blind * California Board of Occupational Therapy * California Board of Optometry * California Board of Pharmacy * California Board of Podiatric Medicine * California Board of Prison Terms * California Board of Psychology * California Board of Registered Nursing * California Board of Trustees * California Board of Vocational Nursing and Psychiatric Technicians * California Braille and Talking Book Library * California Building Standards Commission * California Bureau for Private Post Secondary and Vocational Education * California Bureau of Automotive Repair * California Bureau of Electronic and Appliance Repair * California Bureau of Home Furnishings and Thermal Insulation * California Bureau of Naturopathic Medicine * California Bureau of Security and Investigative Services * California Bureau of State Audits * California Business Agency * California Business Investment Services (CalBIS) * California Business Permit Information (CalGOLD) * California Business Portal * California Business, Transportation and Housing Agency * California Cal Grants * California CalJOBS * California Cal-Learn Program * California CalVet Home Loan Program * California Career Resource Network * California Cemetery and Funeral Bureau * California Center for Analytical Chemistry * California Center for Distributed Learning * California Center for Teaching Careers (Teach California) * California Chancellors Office * California Charter Schools * California Children and Families Commission * California Children and Family Services Division * California Citizens Compensation Commission * California Civil Rights Bureau * California Coastal Commission * California Coastal Conservancy * California Code of Regulations * California Collaborative Projects with UC Davis * California Commission for Jobs and Economic Growth * California Commission on Aging * California Commission on Health and Safety and Workers Compensation * California Commission on Judicial Performance * California Commission on State Mandates * California Commission on Status of Women * California Commission on Teacher Credentialing * California Commission on the Status of Women * California Committee on Dental Auxiliaries * California Community Colleges Chancellors Office, Junior Colleges * California Community Colleges Chancellors Office * California Complaint Mediation Program * California Conservation Corps * California Constitution Revision Commission * California Consumer Hotline * California Consumer Information Center * California Consumer Information * California Consumer Services Division * California Consumers and Families Agency * California Contractors State License Board * California Corrections Standards Authority * California Council for the Humanities * California Council on Criminal Justice * California Council on Developmental Disabilities * California Court Reporters Board * California Courts of Appeal * California Crime and Violence Prevention Center * California Criminal Justice Statistics Center * California Criminalist Institute Forensic Library * California CSGnet Network Management * California Cultural and Historical Endowment * California Cultural Resources Division * California Curriculum and Instructional Leadership Branch * California Data Exchange Center * California Data Management Division * California Debt and Investment Advisory Commission * California Delta Protection Commission * California Democratic Caucus * California Demographic Research Unit * California Dental Auxiliaries * California Department of Aging * California Department of Alcohol and Drug Programs * California Department of Alcoholic Beverage Control Appeals Board * California Department of Alcoholic Beverage Control * California Department of Boating and Waterways (Cal Boating) * California Department of Child Support Services (CDCSS) * California Department of Community Services and Development * California Department of Conservation * California Department of Consumer Affairs * California Department of Corporations * California Department of Corrections and Rehabilitation * California Department of Developmental Services * California Department of Education * California Department of Fair Employment and Housing * California Department of Finance * California Department of Financial Institutions * California Department of Fish and Game * California Department of Food and Agriculture * California Department of Forestry and Fire Protection (CDF) * California Department of General Services * California Department of General Services, Office of State Publishing * California Department of Health Care Services * California Department of Housing and Community Development * California Department of Industrial Relations (DIR) * California Department of Insurance * California Department of Justice Firearms Division * California Department of Justice Opinion Unit * California Department of Justice, Consumer Information, Public Inquiry Unit * California Department of Justice * California Department of Managed Health Care * California Department of Mental Health * California Department of Motor Vehicles (DMV) * California Department of Personnel Administration * California Department of Pesticide Regulation * California Department of Public Health * California Department of Real Estate * California Department of Rehabilitation * California Department of Social Services Adoptions Branch * California Department of Social Services * California Department of Technology Services Training Center (DTSTC) * California Department of Technology Services (DTS) * California Department of Toxic Substances Control * California Department of Transportation (Caltrans) * California Department of Veterans Affairs (CalVets) * California Department of Water Resources * California Departmento de Vehiculos Motorizados * California Digital Library * California Disabled Veteran Business Enterprise Certification Program * California Division of Apprenticeship Standards * California Division of Codes and Standards * California Division of Communicable Disease Control * California Division of Engineering * California Division of Environmental and Occupational Disease Control * California Division of Gambling Control * California Division of Housing Policy Development * California Division of Labor Standards Enforcement * California Division of Labor Statistics and Research * California Division of Land and Right of Way * California Division of Land Resource Protection * California Division of Law Enforcement General Library * California Division of Measurement Standards * California Division of Mines and Geology * California Division of Occupational Safety and Health (Cal/OSHA) * California Division of Oil, Gas and Geothermal Resources * California Division of Planning and Local Assistance * California Division of Recycling * California Division of Safety of Dams * California Division of the State Architect * California Division of Tourism * California Division of Workers Compensation Medical Unit * California Division of Workers Compensation * California Economic Assistance, Business and Community Resources * California Economic Strategy Panel * California Education and Training Agency * California Education Audit Appeals Panel * California Educational Facilities Authority * California Elections Division * California Electricity Oversight Board * California Emergency Management Agency * California Emergency Medical Services Authority * California Employment Development Department (EDD) * California Employment Information State Jobs * California Employment Training Panel * California Energy Commission * California Environment and Natural Resources Agency * California Environmental Protection Agency (Cal/EPA) * California Environmental Resources Evaluation System (CERES) * California Executive Office * California Export Laboratory Services * California Exposition and State Fair (Cal Expo) * California Fair Political Practices Commission * California Fairs and Expositions Division * California Film Commission * California Fire and Resource Assessment Program * California Firearms Division * California Fiscal Services * California Fish and Game Commission * California Fisheries Program Branch * California Floodplain Management * California Foster Youth Help * California Franchise Tax Board (FTB) * California Fraud Division * California Gambling Control Commission * California Geographic Information Systems Council (GIS) * California Geological Survey * California Government Claims and Victim Compensation Board * California Governors Committee for Employment of Disabled Persons * California Governors Mentoring Partnership * California Governors Office of Emergency Services * California Governors Office of Homeland Security * California Governors Office of Planning and Research * California Governors Office * California Grant and Enterprise Zone Programs HCD Loan * California Health and Human Services Agency * California Health and Safety Agency * California Healthy Families Program * California Hearing Aid Dispensers Bureau * California High-Speed Rail Authority * California Highway Patrol (CHP) * California History and Culture Agency * California Horse Racing Board * California Housing Finance Agency * California Indoor Air Quality Program * California Industrial Development Financing Advisory Commission * California Industrial Welfare Commission * California InFoPeople * California Information Center for the Environment * California Infrastructure and Economic Development Bank (I-Bank) * California Inspection Services * California Institute for County Government * California Institute for Education Reform * California Integrated Waste Management Board * California Interagency Ecological Program * California Job Service * California Junta Estatal de Personal * California Labor and Employment Agency * California Labor and Workforce Development Agency * California Labor Market Information Division * California Land Use Planning Information Network (LUPIN) * California Lands Commission * California Landscape Architects Technical Committee * California Latino Legislative Caucus * California Law Enforcement Branch * California Law Enforcement General Library * California Law Revision Commission * California Legislative Analyst's Office * California Legislative Black Caucus * California Legislative Counsel * California Legislative Division * California Legislative Information * California Legislative Lesbian, Gay, Bisexual, and Transgender (LGBT) Caucus * California Legislature Internet Caucus * California Library De velopment Services * California License and Revenue Branch * California Major Risk Medical Insurance Program * California Managed Risk Medical Insurance Board * California Maritime Academy * California Marketing Services * California Measurement Standards * California Medical Assistance Commission * California Medical Care Services * California Military Department * California Mining and Geology Board * California Museum for History, Women, and the Arts * California Museum Resource Center * California National Guard * California Native American Heritage Commission * California Natural Community Conservation Planning Program * California New Motor Vehicle Board * California Nursing Home Administrator Program * California Occupational Safety and Health Appeals Board * California Occupational Safety and Health Standards Board * California Ocean Resources Management Program * California Office of Administrative Hearings * California Office of Administrative Law * California Office of AIDS * California Office of Binational Border Health * California Office of Child Abuse Prevention * California Office of Deaf Access * California Office of Emergency Services (OES) * California Office of Environmental Health Hazard Assessment * California Office of Fiscal Services * California Office of Fleet Administration * California Office of Health Insurance Portability and Accountability Act (HIPAA) Implementation (CalOHI) * California Office of Historic Preservation * California Office of Homeland Security * California Office of Human Resources * California Office of Legal Services * California Office of Legislation * California Office of Lieutenant Governor * California Office of Military and Aerospace Support * California Office of Mine Reclamation * California Office of Natural Resource Education * California Office of Privacy Protection * California Office of Public School Construction * California Office of Real Estate Appraisers * California Office of Risk and Insurance Management * California Office of Services to the Blind * California Office of Spill Prevention and Response * California Office of State Publishing (OSP) * California Office of Statewide Health Planning and Development * California Office of Systems Integration * California Office of the Inspector General * California Office of the Ombudsman * California Office of the Patient Advocate * California Office of the President * California Office of the Secretary for Education * California Office of the State Fire Marshal * California Office of the State Public Defender * California Office of Traffic Safety * California Office of Vital Records * California Online Directory * California Operations Control Office * California Opinion Unit * California Outreach and Technical Assistance Network (OTAN) * California Park and Recreation Commission * California Peace Officer Standards and Training (POST) * California Performance Review (CPR) * California Permit Information for Business (CalGOLD) * California Physical Therapy Board * California Physician Assistant Committee * California Plant Health and Pest Prevention Services * California Policy and Evaluation Division * California Political Reform Division * California Pollution Control Financing Authority * California Polytechnic State University, San Luis Obispo * California Postsecondary Education Commission * California Prevention Services * California Primary Care and Family Health * California Prison Industry Authority * California Procurement Division * California Public Employees Retirement System (CalPERS) * California Public Employment Relations Board (PERB) * California Public Utilities Commission (PUC) * California Real Estate Services Division * California Refugee Programs Branch * California Regional Water Quality Control Boards * California Registered Veterinary Technician Committee * California Registrar of Charitable Trusts * California Republican Caucus * California Research and Development Division * California Research Bureau * California Resources Agency * California Respiratory Care Board * California Rivers Assessment * California Rural Health Policy Council * California Safe Schools * California San Francisco Bay Conservation and Development Commission * California San Gabriel and Lower Los Angeles Rivers and Mountains Conservancy * California San Joaquin River Conservancy * California School to Career * California Science Center * California Scripps Institution of Oceanography * California Secretary of State Business Portal * California Secretary of State * California Seismic Safety Commission * California Self Insurance Plans (SIP) * California Senate Office of Research * California Small Business and Disabled Veteran Business Enterprise Certification Program * California Small Business Development Center Program * California Smart Growth Caucus * California Smog Check Information Center * California Spatial Information Library * California Special Education Division * California Speech-Language Pathology and Audiology Board * California Standardized Testing and Reporting (STAR) * California Standards and Assessment Division * California State Administrative Manual (SAM) * California State Allocation Board * California State and Consumer Services Agency * California State Architect * California State Archives * California State Assembly * California State Association of Counties (CSAC) * California State Board of Education * California State Board of Food and Agriculture *California Office of the Chief Information Officer (OCIO) * California State Children's Trust Fund * California State Compensation Insurance Fund * California State Contracts Register Program * California State Contracts Register * California State Controller * California State Council on Developmental Disabilities (SCDD) * California State Disability Insurance (SDI) * California State Fair (Cal Expo) * California State Jobs Employment Information * California State Lands Commission * California State Legislative Portal * California State Legislature * California State Library Catalog * California State Library Services Bureau * California State Library * California State Lottery * California State Mediation and Conciliation Service * California State Mining and Geology Board * California State Park and Recreation Commission * California State Parks * California State Personnel Board * California State Polytechnic University, Pomona * California State Railroad Museum * California State Science Fair * California State Senate * California State Summer School for Mathematics and Science (COSMOS) * California State Summer School for the Arts * California State Superintendent of Public Instruction * California State Teachers Retirement System (CalSTRS) * California State Treasurer * California State University Center for Distributed Learning * California State University, Bakersfield * California State University, Channel Islands * California State University, Chico * California State University, Dominguez Hills * California State University, East Bay * California State University, Fresno * California State University, Fullerton * California State University, Long Beach * California State University, Los Angeles * California State University, Monterey Bay * California State University, Northridge * California State University, Sacramento * California State University, San Bernardino * California State University, San Marcos * California State University, Stanislaus * California State University (CSU) * California State Water Project Analysis Office * California State Water Project * California State Water Resources Control Board * California Structural Pest Control Board * California Student Aid Commission * California Superintendent of Public Instruction * California Superior Courts * California Tahoe Conservancy * California Task Force on Culturally and Linguistically Competent Physicians and Dentists * California Tax Information Center * California Technology and Administration Branch Finance * California Telecommunications Division * California Telephone Medical Advice Services (TAMS) * California Transportation Commission * California Travel and Transportation Agency * California Unclaimed Property Program * California Unemployment Insurance Appeals Board * California Unemployment Insurance Program * California Uniform Construction Cost Accounting Commission * California Veterans Board * California Veterans Memorial * California Veterinary Medical Board and Registered Veterinary Technician Examining Committee * California Veterinary Medical Board * California Victim Compensation and Government Claims Board * California Volunteers * California Voter Registration * California Water Commission * California Water Environment Association (COWPEA) * California Water Resources Control Board * California Welfare to Work Division * California Wetlands Information System * California Wildlife and Habitat Data Analysis Branch * California Wildlife Conservation Board * California Wildlife Programs Branch * California Work Opportunity and Responsibility to Kids (CalWORKs) * California Workers Compensation Appeals Board * California Workforce and Labor Development Agency * California Workforce Investment Board * California Youth Authority (CYA) * Central Valley Flood Protection Board * Center for California Studies * Colorado River Board of California * Counting California * Dental Board of California * Health Insurance Plan of California (PacAdvantage) * Humboldt State University * Jobs with the State of California * Judicial Council of California * Learn California * Library of California * Lieutenant Governors Commission for One California * Little Hoover Commission (on California State Government Organization and Economy) * Medical Board of California * Medi-Cal * Osteopathic Medical Board of California * Physical Therapy Board of California * Regents of the University of California * San Diego State University * San Francisco State University * San Jose State University * Santa Monica Mountains Conservancy * State Bar of California * Supreme Court of California * Teach California * University of California * University of California, Berkeley * University of California, Davis * University of California, Hastings College of the Law * University of California, Irvine * University of California, Los Angeles * University of California, Merced * University of California, Riverside * University of California, San Diego * University of California, San Francisco * University of California, Santa Barbara * University of California, Santa Cruz * Veterans Home of California

The City of Berkeley has a reputation to maintain; spending money as if ‘it doesn’t matter’ is the way they roll.Below is a statute that’s located at a spot (Bicycle/ I-80 Freeway Over Pass), which reflects the City IMHO, A beautiful crafting that, by it’s location… can’t be appreciated, despite the dumping of 2-million tax dollars so that the ‘bridge’ could be put across the freeway without having a central support.You’ll notice that presents a cacophony of ‘directions,’ and it would be more alarming in that it ‘fits’ Berkeley, except that it also represents the ‘direction,’ (or lack of it) of the entire State!The State frequently dips into the taxes ‘garnered for education,’ and dispenses it into the following California State Agencies:California Academic Performance Index (API) * California Access for Infants and Mothers * California Acupuncture Board * California Administrative Office of the Courts * California Adoptions Branch * California African American Museum * California Agricultural Export Program * California Agricultural Labor Relations Board * California Agricultural Statistics Service * California Air Resources Board (CARB) * California Allocation Board * California Alternative Energy and Advanced Transportation Financing Authority * California Animal Health and Food Safety Services * California Anti-Terrorism Information Center * California Apprenticeship Council * California Arbitration Certification Program * California Architects Board * California Area VI Developmental Disabilities Board * California Arts Council * California Asian Pacific Islander Legislative Caucus * California Assembly Democratic Caucus * California Assembly Republican Caucus * California Athletic Commission * California Attorney General * California Bay Conservation and Development Commission * California Bay-Delta Authority * California Bay-Delta Office * California Bio Diversity Council * California Board for Geologists and Geophysicists * California Board for Professional Engineers and Land Surveyors * California Board of Accountancy * California Board of Barbering and Cosmetology * California Board of Behavioral Sciences * California Board of Chiropractic Examiners * California Board of Equalization (BOE) * California Board of Forestry and Fire Protection * California Board of Guide Dogs for the Blind * California Board of Occupational Therapy * California Board of Optometry * California Board of Pharmacy * California Board of Podiatric Medicine * California Board of Prison Terms * California Board of Psychology * California Board of Registered Nursing * California Board of Trustees * California Board of Vocational Nursing and Psychiatric Technicians * California Braille and Talking Book Library * California Building Standards Commission * California Bureau for Private Post Secondary and Vocational Education * California Bureau of Automotive Repair * California Bureau of Electronic and Appliance Repair * California Bureau of Home Furnishings and Thermal Insulation * California Bureau of Naturopathic Medicine * California Bureau of Security and Investigative Services * California Bureau of State Audits * California Business Agency * California Business Investment Services (CalBIS) * California Business Permit Information (CalGOLD) * California Business Portal * California Business, Transportation and Housing Agency * California Cal Grants * California CalJOBS * California Cal-Learn Program * California CalVet Home Loan Program * California Career Resource Network * California Cemetery and Funeral Bureau * California Center for Analytical Chemistry * California Center for Distributed Learning * California Center for Teaching Careers (Teach California) * California Chancellors Office * California Charter Schools * California Children and Families Commission * California Children and Family Services Division * California Citizens Compensation Commission * California Civil Rights Bureau * California Coastal Commission * California Coastal Conservancy * California Code of Regulations * California Collaborative Projects with UC Davis * California Commission for Jobs and Economic Growth * California Commission on Aging * California Commission on Health and Safety and Workers Compensation * California Commission on Judicial Performance * California Commission on State Mandates * California Commission on Status of Women * California Commission on Teacher Credentialing * California Commission on the Status of Women * California Committee on Dental Auxiliaries * California Community Colleges Chancellors Office, Junior Colleges * California Community Colleges Chancellors Office * California Complaint Mediation Program * California Conservation Corps * California Constitution Revision Commission * California Consumer Hotline * California Consumer Information Center * California Consumer Information * California Consumer Services Division * California Consumers and Families Agency * California Contractors State License Board * California Corrections Standards Authority * California Council for the Humanities * California Council on Criminal Justice * California Council on Developmental Disabilities * California Court Reporters Board * California Courts of Appeal * California Crime and Violence Prevention Center * California Criminal Justice Statistics Center * California Criminalist Institute Forensic Library * California CSGnet Network Management * California Cultural and Historical Endowment * California Cultural Resources Division * California Curriculum and Instructional Leadership Branch * California Data Exchange Center * California Data Management Division * California Debt and Investment Advisory Commission * California Delta Protection Commission * California Democratic Caucus * California Demographic Research Unit * California Dental Auxiliaries * California Department of Aging * California Department of Alcohol and Drug Programs * California Department of Alcoholic Beverage Control Appeals Board * California Department of Alcoholic Beverage Control * California Department of Boating and Waterways (Cal Boating) * California Department of Child Support Services (CDCSS) * California Department of Community Services and Development * California Department of Conservation * California Department of Consumer Affairs * California Department of Corporations * California Department of Corrections and Rehabilitation * California Department of Developmental Services * California Department of Education * California Department of Fair Employment and Housing * California Department of Finance * California Department of Financial Institutions * California Department of Fish and Game * California Department of Food and Agriculture * California Department of Forestry and Fire Protection (CDF) * California Department of General Services * California Department of General Services, Office of State Publishing * California Department of Health Care Services * California Department of Housing and Community Development * California Department of Industrial Relations (DIR) * California Department of Insurance * California Department of Justice Firearms Division * California Department of Justice Opinion Unit * California Department of Justice, Consumer Information, Public Inquiry Unit * California Department of Justice * California Department of Managed Health Care * California Department of Mental Health * California Department of Motor Vehicles (DMV) * California Department of Personnel Administration * California Department of Pesticide Regulation * California Department of Public Health * California Department of Real Estate * California Department of Rehabilitation * California Department of Social Services Adoptions Branch * California Department of Social Services * California Department of Technology Services Training Center (DTSTC) * California Department of Technology Services (DTS) * California Department of Toxic Substances Control * California Department of Transportation (Caltrans) * California Department of Veterans Affairs (CalVets) * California Department of Water Resources * California Departmento de Vehiculos Motorizados * California Digital Library * California Disabled Veteran Business Enterprise Certification Program * California Division of Apprenticeship Standards * California Division of Codes and Standards * California Division of Communicable Disease Control * California Division of Engineering * California Division of Environmental and Occupational Disease Control * California Division of Gambling Control * California Division of Housing Policy Development * California Division of Labor Standards Enforcement * California Division of Labor Statistics and Research * California Division of Land and Right of Way * California Division of Land Resource Protection * California Division of Law Enforcement General Library * California Division of Measurement Standards * California Division of Mines and Geology * California Division of Occupational Safety and Health (Cal/OSHA) * California Division of Oil, Gas and Geothermal Resources * California Division of Planning and Local Assistance * California Division of Recycling * California Division of Safety of Dams * California Division of the State Architect * California Division of Tourism * California Division of Workers Compensation Medical Unit * California Division of Workers Compensation * California Economic Assistance, Business and Community Resources * California Economic Strategy Panel * California Education and Training Agency * California Education Audit Appeals Panel * California Educational Facilities Authority * California Elections Division * California Electricity Oversight Board * California Emergency Management Agency * California Emergency Medical Services Authority * California Employment Development Department (EDD) * California Employment Information State Jobs * California Employment Training Panel * California Energy Commission * California Environment and Natural Resources Agency * California Environmental Protection Agency (Cal/EPA) * California Environmental Resources Evaluation System (CERES) * California Executive Office * California Export Laboratory Services * California Exposition and State Fair (Cal Expo) * California Fair Political Practices Commission * California Fairs and Expositions Division * California Film Commission * California Fire and Resource Assessment Program * California Firearms Division * California Fiscal Services * California Fish and Game Commission * California Fisheries Program Branch * California Floodplain Management * California Foster Youth Help * California Franchise Tax Board (FTB) * California Fraud Division * California Gambling Control Commission * California Geographic Information Systems Council (GIS) * California Geological Survey * California Government Claims and Victim Compensation Board * California Governors Committee for Employment of Disabled Persons * California Governors Mentoring Partnership * California Governors Office of Emergency Services * California Governors Office of Homeland Security * California Governors Office of Planning and Research * California Governors Office * California Grant and Enterprise Zone Programs HCD Loan * California Health and Human Services Agency * California Health and Safety Agency * California Healthy Families Program * California Hearing Aid Dispensers Bureau * California High-Speed Rail Authority * California Highway Patrol (CHP) * California History and Culture Agency * California Horse Racing Board * California Housing Finance Agency * California Indoor Air Quality Program * California Industrial Development Financing Advisory Commission * California Industrial Welfare Commission * California InFoPeople * California Information Center for the Environment * California Infrastructure and Economic Development Bank (I-Bank) * California Inspection Services * California Institute for County Government * California Institute for Education Reform * California Integrated Waste Management Board * California Interagency Ecological Program * California Job Service * California Junta Estatal de Personal * California Labor and Employment Agency * California Labor and Workforce Development Agency * California Labor Market Information Division * California Land Use Planning Information Network (LUPIN) * California Lands Commission * California Landscape Architects Technical Committee * California Latino Legislative Caucus * California Law Enforcement Branch * California Law Enforcement General Library * California Law Revision Commission * California Legislative Analyst's Office * California Legislative Black Caucus * California Legislative Counsel * California Legislative Division * California Legislative Information * California Legislative Lesbian, Gay, Bisexual, and Transgender (LGBT) Caucus * California Legislature Internet Caucus * California Library De velopment Services * California License and Revenue Branch * California Major Risk Medical Insurance Program * California Managed Risk Medical Insurance Board * California Maritime Academy * California Marketing Services * California Measurement Standards * California Medical Assistance Commission * California Medical Care Services * California Military Department * California Mining and Geology Board * California Museum for History, Women, and the Arts * California Museum Resource Center * California National Guard * California Native American Heritage Commission * California Natural Community Conservation Planning Program * California New Motor Vehicle Board * California Nursing Home Administrator Program * California Occupational Safety and Health Appeals Board * California Occupational Safety and Health Standards Board * California Ocean Resources Management Program * California Office of Administrative Hearings * California Office of Administrative Law * California Office of AIDS * California Office of Binational Border Health * California Office of Child Abuse Prevention * California Office of Deaf Access * California Office of Emergency Services (OES) * California Office of Environmental Health Hazard Assessment * California Office of Fiscal Services * California Office of Fleet Administration * California Office of Health Insurance Portability and Accountability Act (HIPAA) Implementation (CalOHI) * California Office of Historic Preservation * California Office of Homeland Security * California Office of Human Resources * California Office of Legal Services * California Office of Legislation * California Office of Lieutenant Governor * California Office of Military and Aerospace Support * California Office of Mine Reclamation * California Office of Natural Resource Education * California Office of Privacy Protection * California Office of Public School Construction * California Office of Real Estate Appraisers * California Office of Risk and Insurance Management * California Office of Services to the Blind * California Office of Spill Prevention and Response * California Office of State Publishing (OSP) * California Office of Statewide Health Planning and Development * California Office of Systems Integration * California Office of the Inspector General * California Office of the Ombudsman * California Office of the Patient Advocate * California Office of the President * California Office of the Secretary for Education * California Office of the State Fire Marshal * California Office of the State Public Defender * California Office of Traffic Safety * California Office of Vital Records * California Online Directory * California Operations Control Office * California Opinion Unit * California Outreach and Technical Assistance Network (OTAN) * California Park and Recreation Commission * California Peace Officer Standards and Training (POST) * California Performance Review (CPR) * California Permit Information for Business (CalGOLD) * California Physical Therapy Board * California Physician Assistant Committee * California Plant Health and Pest Prevention Services * California Policy and Evaluation Division * California Political Reform Division * California Pollution Control Financing Authority * California Polytechnic State University, San Luis Obispo * California Postsecondary Education Commission * California Prevention Services * California Primary Care and Family Health * California Prison Industry Authority * California Procurement Division * California Public Employees Retirement System (CalPERS) * California Public Employment Relations Board (PERB) * California Public Utilities Commission (PUC) * California Real Estate Services Division * California Refugee Programs Branch * California Regional Water Quality Control Boards * California Registered Veterinary Technician Committee * California Registrar of Charitable Trusts * California Republican Caucus * California Research and Development Division * California Research Bureau * California Resources Agency * California Respiratory Care Board * California Rivers Assessment * California Rural Health Policy Council * California Safe Schools * California San Francisco Bay Conservation and Development Commission * California San Gabriel and Lower Los Angeles Rivers and Mountains Conservancy * California San Joaquin River Conservancy * California School to Career * California Science Center * California Scripps Institution of Oceanography * California Secretary of State Business Portal * California Secretary of State * California Seismic Safety Commission * California Self Insurance Plans (SIP) * California Senate Office of Research * California Small Business and Disabled Veteran Business Enterprise Certification Program * California Small Business Development Center Program * California Smart Growth Caucus * California Smog Check Information Center * California Spatial Information Library * California Special Education Division * California Speech-Language Pathology and Audiology Board * California Standardized Testing and Reporting (STAR) * California Standards and Assessment Division * California State Administrative Manual (SAM) * California State Allocation Board * California State and Consumer Services Agency * California State Architect * California State Archives * California State Assembly * California State Association of Counties (CSAC) * California State Board of Education * California State Board of Food and Agriculture *California Office of the Chief Information Officer (OCIO) * California State Children's Trust Fund * California State Compensation Insurance Fund * California State Contracts Register Program * California State Contracts Register * California State Controller * California State Council on Developmental Disabilities (SCDD) * California State Disability Insurance (SDI) * California State Fair (Cal Expo) * California State Jobs Employment Information * California State Lands Commission * California State Legislative Portal * California State Legislature * California State Library Catalog * California State Library Services Bureau * California State Library * California State Lottery * California State Mediation and Conciliation Service * California State Mining and Geology Board * California State Park and Recreation Commission * California State Parks * California State Personnel Board * California State Polytechnic University, Pomona * California State Railroad Museum * California State Science Fair * California State Senate * California State Summer School for Mathematics and Science (COSMOS) * California State Summer School for the Arts * California State Superintendent of Public Instruction * California State Teachers Retirement System (CalSTRS) * California State Treasurer * California State University Center for Distributed Learning * California State University, Bakersfield * California State University, Channel Islands * California State University, Chico * California State University, Dominguez Hills * California State University, East Bay * California State University, Fresno * California State University, Fullerton * California State University, Long Beach * California State University, Los Angeles * California State University, Monterey Bay * California State University, Northridge * California State University, Sacramento * California State University, San Bernardino * California State University, San Marcos * California State University, Stanislaus * California State University (CSU) * California State Water Project Analysis Office * California State Water Project * California State Water Resources Control Board * California Structural Pest Control Board * California Student Aid Commission * California Superintendent of Public Instruction * California Superior Courts * California Tahoe Conservancy * California Task Force on Culturally and Linguistically Competent Physicians and Dentists * California Tax Information Center * California Technology and Administration Branch Finance * California Telecommunications Division * California Telephone Medical Advice Services (TAMS) * California Transportation Commission * California Travel and Transportation Agency * California Unclaimed Property Program * California Unemployment Insurance Appeals Board * California Unemployment Insurance Program * California Uniform Construction Cost Accounting Commission * California Veterans Board * California Veterans Memorial * California Veterinary Medical Board and Registered Veterinary Technician Examining Committee * California Veterinary Medical Board * California Victim Compensation and Government Claims Board * California Volunteers * California Voter Registration * California Water Commission * California Water Environment Association (COWPEA) * California Water Resources Control Board * California Welfare to Work Division * California Wetlands Information System * California Wildlife and Habitat Data Analysis Branch * California Wildlife Conservation Board * California Wildlife Programs Branch * California Work Opportunity and Responsibility to Kids (CalWORKs) * California Workers Compensation Appeals Board * California Workforce and Labor Development Agency * California Workforce Investment Board * California Youth Authority (CYA) * Central Valley Flood Protection Board * Center for California Studies * Colorado River Board of California * Counting California * Dental Board of California * Health Insurance Plan of California (PacAdvantage) * Humboldt State University * Jobs with the State of California * Judicial Council of California * Learn California * Library of California * Lieutenant Governors Commission for One California * Little Hoover Commission (on California State Government Organization and Economy) * Medical Board of California * Medi-Cal * Osteopathic Medical Board of California * Physical Therapy Board of California * Regents of the University of California * San Diego State University * San Francisco State University * San Jose State University * Santa Monica Mountains Conservancy * State Bar of California * Supreme Court of California * Teach California * University of California * University of California, Berkeley * University of California, Davis * University of California, Hastings College of the Law * University of California, Irvine * University of California, Los Angeles * University of California, Merced * University of California, Riverside * University of California, San Diego * University of California, San Francisco * University of California, Santa Barbara * University of California, Santa Cruz * Veterans Home of CaliforniaThe Mayor of Berkeley obviously has political exasperation, as ‘spending money’ as if it’s not an issue towards well-meaning naive directions… puts him in the good stead with the Democratic Party, which presides from just across the Bay.

Psychiatry is an organized pre-mediated CRIME:Real Disease vs. Mental “Disorder”Psychiatric disorders are not medical diseases. There are no lab tests, brain scans, X-rays or chemical imbalance tests that can verify any mental disorder is a physical condition. This is not to say that people do not get depressed, or that people can’t experience emotional or mental duress, but psychiatry has repackaged these emotions and behaviors as “disease” in order to sell drugs. This is a brilliant marketing campaign, but it is not science.“…modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness…Patients [have] been diagnosed with ‘chemical imbalances’ despite the fact that no test exists to support such a claim, and…there is no real conception of what a correct chemical balance would look like.” —Dr. David Kaiser, psychiatrist.“There’s no biological imbalance. When people come to me and they say, ‘I have a biochemical imbalance,’ He say, ‘Show me your lab tests.’ There are no lab tests. So what’s the biochemical imbalance?” —Dr. Ron Leifer, psychiatrist“All psychiatrists have in common that when they are caught on camera or on microphone, they cower and admit that there are no such things as chemical imbalances/diseases, or examinations or tests for them. What they do in practice, lying in every instance, abrogating [revoking] the informed consent right of every patient and poisoning them in the name of ‘treatment’ is nothing short of criminal.” —Dr. Fred Baughman Jr., Pediatric NeurologistPsychiatric Disorders Voted Into ExistencePsychiatry's billing "Bible,” The Diagnostic & Statistical ManualPsychiatry’s diagnostic criteria are literally voted into existence and inserted into the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM). What is voted in is a system of classification of symptoms that is drastically different from, and foreign to, anything in medicine. None of the diagnoses are supported by objective evidence of physical disease, illness or science.“There are no objective tests in psychiatry, no X-ray, laboratory, or exam finding that says definitively that someone does or does not have a mental disorder.”—Allen Frances, Former DSM-IV Task Force Chairman and DSM-IV Task Force Vice Chairman Philipose Varghese“DSM-IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document…DSM-IV has become a bible and a money making bestseller—its major failings notwithstanding.”—Loren Mosher, M.D., Clinical Professor of Psychiatry“Every one’s brain is unique as it is designed to work in a unique way or this means no brains are 100% congruent by any aspects of chemicals or neurons or by any extents. Moreover, there are no lab tests, brain scans, X-rays or chemical imbalance tests for each individual to perceive that what the chemical count was or what it should be now. Brain goes through serious chemical changes at every moment and it is supposed to.” There is no such organ named ‘MIND’ all in your body. If so where is it? Do animals, birds, fish or any living organisms have mind? Do they have mental illness? Here one thing is sure ‘Mental illness’ is what is under development, over development or disproportional development of brain, which should be taken care of by a Neurologist. Does anyone know what the chemical balances of anyone’s brain are? If not what is mean by chemical Imbalances? – Philipose Varghese.“The way things get into the DSM is not based on blood test or brain scan or physical findings. It's based on descriptions of behavior. And that’s what the whole psychiatry system is.” —Dr. Colin Ross, psychiatristOne example: Mood disorder or Bi-polar. Mood is supposed to change and it is a normal brain function.“We can manufacture enough diagnostic labels of normal variability of mood and thought that we can continually supply medication to you…But when it comes to manufacturing disease, nobody does it like psychiatry.” —Dr. Stefan Kruszewski, Harvard trained Pennsylvania psychiatrist, 2004“In short, the whole business of creating psychiatric categories of ‘disease,’ formalizing them with consensus, and subsequently ascribing diagnostic codes to them, which in turn leads to their use for insurance billing, is nothing but an extended racket furnishing psychiatry a pseudo-scientific aura. The perpetrators are, of course, feeding at the public trough.” —Dr. Thomas Dorman, internist and member of the Royal College of Physicians of the UK, Fellow, Royal College of Physicians of CanadaPsychiatry Admits It Has No CuresIn 1963, the United States’ National Institute of Mental Health implemented community mental health programs. By 1994, the program had spent £30.5 billion and was clearly a failure—with associated clinics becoming little more than legalized drug pushers for the homeless.“We do not know the causes [of any mental illness]. We don’t have the methods of ‘curing’ these illnesses yet.” —Dr. Rex Cowdry, psychiatrist and director of National Institute of Mental Health (NIMH), 1995If anyone see a Psychiatrist that person would be a mental patient for life – just because he/she will be diagnosed by a psychiatrist for some sort of disorders such that reading disorder, curiosity disease, counting disorder, mood disorder etc… where no one knows what they are!“The time when psychiatrists considered that they could cure the mentally ill is gone. In the future the mentally ill have to learn to live with their illness.” —Norman Satorius, president of the World Psychiatric Association in 1994“What’s a cure? It’s just that it’s a term that we don’t use in the medical [psychiatric] profession.” —Dr. Joseph Johnson, California psychiatrist during court deposition, 2003If there is no Cure then what is meant by Treatment?Psychiatrists were surveyed about their “fantasies” about their practice. Their Number 1 fantasy was: 1: “…I will be able to ‘cure’ the patient.” The Number 2 fantasy was: “The patient wants to know what his or her problem is.” —Dr. Sander Berger, associate clinical professor of psychiatry at Michigan State University, Psychiatric Times, 1998No Brain Scans for Mental Illness: Psychiatrists claim that brain scans now show brain changes that “prove” mental disorders, such as schizophrenia and depression, are brain based. There is no scientific evidence to prove this: it remains what the “fine print” in the studies tell you: “suggests,” “May” and “it is hoped.”All the DSM-V defined mental diseases and disorders are properties and qualities of brain!“It is well established that the drugs used to treat a mental disorder, for example, may induce long-lasting biochemical and even structural changes [including in the brain], which in the past were claimed to be the cause of the disorder, but actually be an effect of the treatment.” —Dr. Elliot Valenstein, bio psychologist, author, blaming the Brain“Psychiatry’s claim that mental illnesses are brain diseases is “a claim supposedly based on recent discoveries in neuroscience, made possible by [brain] imaging techniques for diagnosis and pharmacological agents for treatment. This is not true.” —Dr. Thomas Szasz, Professor Emeritus of Psychiatry, New York University Medical School, Syracuse“There are increasing concerns among the clinical community that…neuroscientific developments [do] not reveal anything about the nature of psychiatric disorders….” —Dr. David Healy, psychiatrist, director of the North Wales Department of Psychological MedicinePsychiatric Drugs—Side EffectsPsychiatrists can’t predict what adverse side effects you might experience because not one of them knows how their drugs work.Most drugs deactivate brain functions and put the person into an idle state, where he could do nothing productive, mostly makes them sleepy and inactive – Philipose.Psychotropic drugs are increasingly being exposed as chemical toxins with the power to kill. Psychiatrists claim their drugs save lives, but according to their own studies, psychotropic drugs can double the risk of suicide. And long-term use has been proven to create a lifetime of physical and mental damage, a fact ignored by psychiatrists.Common and well-documented side effects of psychiatric drugs include mania, psychosis, hallucinations, depersonalization, suicidal ideation, heart attack, stroke and sudden death.Not only that, but The US Food and Drug Administration admits that probably one to ten percent of all the adverse drug effects are actually reported by patients or physicians.No Genetic Proof of Mental Illnesses“No claim for a gene for a psychiatric condition has stood the test of time, in spite of popular misinformation.” —Dr. Joseph Glenmullen, Harvard Medical School psychiatrist“….modern psychiatry has yet to convincingly prove the genetic/biological cause of any single mental illness.” —David Kaiser, psychiatrist“In forty years, ‘biological’ psychiatry has yet to validate a single psychiatric condition/diagnosis as an abnormality/disease, or as anything ‘neurological,’ ‘biological,’ ‘chemically-imbalanced’ or ‘genetic.’” —Dr. Fred Baughman Jr., child neurologist, Fellow of the American Academy of NeurologyThe Truth about Psychiatry: Citizens Commission on Human Rights PublicationsBy educating yourself with the facts about psychiatry, you will have the information you need to never become a victim of this vicious pseudo-science. Presented here are twenty CCHR publications detailing the harmful effects of psychiatry—from their destruction of artistic creativity to their blatant attacks on entire generations of children?Protect yourself with the truth. Find out what psychiatrists don’t want you to know.Unholy Assault: Psychiatry versus ReligionIntroduction[God (complex compound energy) created universe, people, people created further religions, religions created many gods, all are manmade idols.]What is the state of religion today?In an American town, senior citizens were told they could not sing Gospel songs or pray over their meals in their community center because it was a public building. Only after an extensive lawsuit were their rights vindicated.A child was told she could not give pencils to her school friends that had the word “Jesus” printed on them. Crying, she asked her mom, “Why does the school hate Jesus?” Mr. Kelly Shackelford, chief counsel for the Liberty Legal Institute, testified before the US Congress hearing on religious expression in 2004, “These young kids get the message. Their religion is treated the same as a curse word. These children are being taught at an early age, ‘keep your religion to yourself’, ‘it’s dirty’, ‘and it’s bad.’”In March 2004, the French Parliament enacted a law against schoolchildren wearing religious symbols in public schools, including the headscarves and veils worn by many Muslim girls, crosses that are too large, and Jewish yarmulkes.Obviously, attacks on religion are alive and well, but then they are also as old as religion itself. However, reports of sexual perversion among clergy that have stained the headlines of almost every country in the world, with multimillion-dollar lawsuits filed and won against the churches involved, are something entirely new. Here, churches face an insidious assault that is not only sapping their spiritual and material strength, but in some cases threatens their very survival.While this type of deadly affront is new, its origins date back to the late 1800s. It was then that psychiatrists first sought to replace religion with their “soulless science.” In 1940, psychiatry openly declared its plans when British psychiatrist John Rawlings Rees, a cofounder of the World Federation for Mental Health (WFMH), addressed a National Council of Mental Hygiene stating: “Since the last world war we have done much to infiltrate the various social organizations throughout the country…we have made a useful attack upon a number of professions. The two easiest of them naturally are the teaching profession and the Church.…”Another cofounder of the WFMH, Canadian psychiatrist G. Brock Chisholm, reinforced this master plan in 1945 by targeting religious values and calling for psychiatrists to free “the race…from its crippling burden of good and evil.” Viciously usurping age-old religious principles, psychiatrists have sanitized criminal conduct and defined sin and evil as “mental disorders.”In his book The Death of Satan, author Andrew Delbanco refers to the disappearing “language of evil” and the process of “unnaming evil.” Until psychiatry’s emergence, societies had operated with very clear ideas on “moral evil.” Today, however, we hear euphemisms like “behavioral problem” or “personality disorder.” Delbanco describes these as notions “…in which the concept of responsibility has disappeared and the human being is reconceived as a component with a stipulated function. If it fails to perform properly, it is subject to repair or disposal; but there is no real sense of blame involved.…We think in terms of adjusting the faulty part or, if it is too far gone, of putting it away.”As a result of psychiatrists’ subversive plan for religion, the concepts of good and bad behavior, right and wrong conduct and personal responsibility have taken such a beating that people today have few or no guidelines for checking, judging or directing their behavior. Words like ethics, morals, sin and evil have almost disappeared from everyday usage.Delbanco further states: “The repertoire of evil has never been richer. Yet never have our responses been so weak.…[W]e cannot readily see the perpetrator.…[The] malefactors are harder to spot.…So the work of the devil is everywhere, but no one knows where to find him.…[E]vil tends to recede into the background hum of modern life.…[W]e feel something that our culture no longer gives us the vocabulary to express.”The consequences have been devastating for both society and religion. It is not that evil itself has disappeared—evidence abounds of evil or destructive behavior running unchecked in society—and it is as difficult to confront as it has always been. Yet everyone wants to live in a society in which evil can be defined and defeated.Or do they?For more than a century, Mankind has been the unwitting guinea pig of psychiatry’s deliberate “social engineering” experiment that was conceived in hell. This experiment included an assault on the essential religious and moral strongholds of society. It could not proceed while Man could clearly conceive of, express and deal with evil. It lies insidiously behind our current social disintegration. And it is the epitome of evil, masked by the most social of outward appearances.Until recently, it was religion that provided Man with the moral and spiritual markers necessary for him to create and maintain civilizations of which he could be proud. Religion provides the inspiration needed for a life of higher meaning and purpose. In this crisis, it falls upon religious leaders to take the decisive steps.Men of the cloth need to shake off the yoke of soulless materialism spawned by psychology and psychiatry and put religion back into the hands of the religious.Indeed, religious leaders must take this responsibility, not only for the sake of religion’s survival but also for the survival of Mankind.The Real Crisis in Mental Health TodayIntroductionHow concerned should we be about reports that mental illness has become an epidemic striking one out of every four people in the world today? According to the source of these alarming reports—the psychiatric industry—mental illness threatens to engulf us all and can only be checked by immediate and massive increases in funding. They warn of the disastrous effects of withheld appropriations. What the psychiatrists never warn of is that the very diagnostic system used to derive the alarming statistic—their own Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and its equivalent, the mental disorders section of the International Classification of Diseases (ICD-10)—are under attack for their lack of scientific authority and veracity and their almost singular emphasis on psychotropic drug treatment.Professor Herb Kutchins from California State University, Sacramento, and Professor Stuart A. Kirk from the University of New York, authors of several books describing the flaws of the DSM, warn, “There are indeed many illusions about DSM and very strong needs among its developers to believe that their dreams of scientific excellence and utility have come true....”The “bitter medicine” is that DSM has “unsuccessfully attempted to medicalize too many human troubles.”Professor Edward Shorter, author of A History of Psychiatry, stated, “Rather than heading off into the brave new world of science, DSM-IV-style psychiatry seemed in some ways to be heading out into the desert.”We formulated this report and its recommendations for those with responsibility in deciding the funding and fate of mental health programs and insurance coverage, including legislators and other decision-makers charged with the task of protecting the health, well-being and safety of their citizens.The results of the widespread reliance by psychiatrists on the DSM, with its ever-expanding list of illnesses for each of which a psychiatric drug can be legally prescribed, include these staggering statistics:• Twenty million schoolchildren worldwide have now been diagnosed with mental disorders and prescribed cocaine-like stimulants and powerful antidepressants as treatment.• Psychiatric drug use and abuse is surging worldwide: More than 100 million prescriptions for antidepressants alone were written in 2002 at a cost of $19.5 billion (€15.9 billion).• One in seven prescriptions in France include a psychotropic drug and more than 50 percent of the unemployed—1.8 million—take psychotropic drugs.• Meanwhile, driven by DSM-derived mental illness statistics, the international mental health budget has skyrocketed in the last ten years.• In the United States, the mental health budget soared from $33 billion (€29.7 billion) in 1994 to more than $80 billion (€72 billion) today.• Switzerland’s spending on mental health increased from $73.5 million (€65 million) in 1988 to over $184.8 million (€165 million) over a ten-year period.• Germany currently spends more than $2.6 billion (€2.34 billion) a year on “mental health.”• In France, mental health costs have soared, contributing $400 million (€361 million) to the country’s deficit.In spite of record spending, countries now face escalating levels of child abuse, suicide, drug abuse, violence and crime—very real problems for which the psychiatric industry can identify neither causes nor solutions. It is safe to conclude, therefore, that a reduction in the funding of psychiatric programs will not cause a worsening of mental health. Less funding for harmful psychiatric practices will, in fact, improve the state of mental health.The evidence presented herein has been drawn from physicians, attorneys, judges, psychiatrists, parents and others active in the mental health or related fields. The consensus of these experts is that DSM-based, psychiatric initiatives such as the broadening of involuntary commitment laws and the expansion of so-called community mental health plans are detrimental to society in human and economic terms. The same applies to programs such as the screening for mental disorders of young children in schools.The claim that only increased funding will cure the problems of psychiatry has lost its ring of truth. Fields of expertise that are built on scientific claims are routinely called upon to deliver empirical proof to support their theories. When the Centers for Disease Control receive funds to combat a dangerous disease, the funding results in the discovery of a biological cause and development of a cure. Biological tests exist to determine the presence or absence of most bodily diseases. While people can have serious mental difficulties, psychiatry has no objective, physical test to confirm the presence of any mental illness. Diagnosis is purely subjective.The many critical challenges facing societies today reflect the vital need to strengthen individuals through workable, viable and humanitarian alternatives to harmful psychiatric options. We invite you to review for yourself the alternatives we have included. We respectfully offer the information in this report for your consideration so that you may draw your own conclusions about the state of mental health and psychiatry’s ability, or lack thereof, to contribute to its resolution.Schizophrenia – Psychiatry’s For Profit “Disease”IntroductionLife can sometimes be a real challenge. It can get very rough indeed. A family faced with a seriously disturbed and irrational member can become desperate in their attempts to resolve the crisis.To whom can they turn when this happens?According to psychiatrists, one should consult them as the mental health experts. But that is a deception, as many have discovered.Dr. Megan Shields, a practicing family physician for more than twenty-five years, and an Advisory Board member of the Citizens Commission on Human Rights, warns: “Psychiatrists know nothing about the mind, treat the individual as no more than an organ in the head (the brain) and have about as much interest in spirituality, standard medicine and curing, as an executioner has in saving lives.”In the film, A Beautiful Mind, Nobel Prize winner John Nash is depicted as relying on psychiatry’s latest breakthrough drugs to prevent a relapse of his “schizophrenia.” This is Hollywood fiction, however, as Nash himself disputes the film’s portrayal of him taking “newer medications.” At the time of his Nobel Prize award, Nash had not taken any psychiatric drugs for twenty-four years and had recovered naturally from his disturbed state.This is not to suggest that anyone taking prescribed, psychotropic drugs should immediately dispense with them. Due to their dangerous side effects, no one should stop taking any psychiatric drug without the advice and assistance of a competent nonpsychiatric, medical doctor.We wish to highlight, however, that there are solutions to serious mental disturbances that avoid the serious risks and flaws inherent in psychiatry.Any psychiatrist or psychologist who claims that “serious mental illnesses” are no different than a heart condition, gangrene of the leg or the common cold, is dealing in deception.As Dr. Thomas Szasz, professor of psychiatry emeritus at the State University of New York, Syracuse, states, “If we are to consider mental disease to be like physical disease, we ought to have biochemical or pathological evidence.” And if an “illness” is to be “scientifically meaningful, it must somehow be capable of being approached, measured or tested in a scientific fashion, as through a blood test or an electroencephalograph [recording of brain electrical activity]. If it cannot be so measured—as is the case [with]…‘mental illness’—then the phrase ‘illness’ is at best a metaphor and at worst a myth, and that therefore ‘treating’ these ‘illnesses’ is an equally…unscientific enterprise.”In practice, there is abundant evidence that real physical illness, with real pathology, can seriously affect an individual’s mental state and behavior. Psychiatry completely ignores this weight of scientific evidence, preferring to assign all blame to illnesses and supposed “chemical imbalances” in the brain that have never been proven to exist, and limits all practice to brutal treatments that have done nothing but permanently damage the brain and the individual.Knowing nothing about the mind, the brain, or about the underlying causes of serious mental disturbance, psychiatry still sears the brain with electroshock, tears it with psychosurgery and deadens it with dangerous drugs. Completely ignorant of what they are dealing with, they simply prefer the expedient approach of “throwing a hand grenade into a switchboard to fix it.” It sounds and looks impressive, but in the process destroys a whole lot that’s good, cures nothing but costs billions of taxpayers’ dollars each year.By destroying parts of the brain, the person is more tractable, but less alive. The original mental disturbance remains in place, just suppressed. This is psychiatry in action in the treatment of disturbed individuals.The information in this report is a warning for anyone who may be experiencing serious difficulties in life, or knows of someone who is, and who is looking for answers.There are alternatives to psychiatric treatment. Seek out and support them for they can repair and build. They also work. Avoid psychiatry because it only tears apart and destroys. And it never works.Rehab Fraud: Psychiatry’s Drug ScamIntroductionWhat hope is there?Wouldn’t a universal, proven cure for drug addiction be a good thing? And is it possible?First, let’s clearly define what is meant by “cure.” For the individual a cure means complete and permanent absence of any overwhelming physical or mental desire, need or compulsion to take drugs. For the society it means the rehabilitation of the addict as a consistently honest, ethical, productive and successful member. In the 1970s, this first question would have seemed rather strange, if not absurd.“Of course that would be a good thing!” and “Are you kidding?” would have beencommon responses.Today, however, the responses are considerably different. A drug addict might answer, “Look, don’t talk to me about cures. I’ve tried every program there is and failed. None of them work.” Or, “You can’t cure heredity; my father was an alcoholic.” A layperson might say, “They’ve already cured it; methadone, isn’t it?” Or, “They’ve found it’s an incurable brain disease; you know, like diabetes, it can’t be cured.” Or even, “Science found it can’t be helped; it’s something to do with a chemical imbalance in the brain.”Very noticeable would be the absence of the word, even the idea, of cure, whether amongst addicts, families of addicts, government officials, media or anywhere else.In its place are words like disease, illness, chronic, management, maintenance, reduction and relapse. Addicts in rehab are taught to refer to themselves as “recovering,” never “cured.” Stated in different ways, the implicit consensus that has been created is that drug addiction is incurable and something an addict will have to learn to live with—or die with.Is all hope lost?Before considering that question, it is very important to understand one thing about drug rehabilitation today. Our hope of a cure for drug addiction was not lost; it was buried by an avalanche of false information and false solutions.First of all, consider psychiatrists’ long-term propagation of dangerous drugs as “harmless”:• In the 1960s, psychiatrists made LSD not only acceptable, but an “adventure” to tens of ¬thousands of college students, promoting the false concept of improving life through “recreational,” mind-altering drugs.• In 1967, US psychiatrists met to discuss the role of drugs in the year 2000. Influential New York psychiatrist Nathan Kline, who served on ¬committees for the US National Institute of Mental Health and the World Health Organization stated, “In principle, He don’t see that drugs are any more abnormal than reading, music, art, yoga, or twenty other things—if you take a broad point of view.”• In 1973, University of California psychiatrist, Louis J. West, wrote, “Indeed a debate may soon be raging among some clinical scientists on the question of whether clinging to the drug-free state of mind is not an antiquated position for anyone—physician or patient—to hold.”• In the 1980s, Californian psychiatric drug ¬specialist, Ronald K. Siegel, made the outrageous assertion that being drugged is a basic human “need,” a “fourth drive” of the same nature as sex, hunger and thirst.• In 1980, a study in the Comprehensive Textbook of Psychiatry claimed that, “taken no more than two or three times per week, cocaine creates no serious problems.”• According to the head of the Drug Enforcement Administration’s office in Connecticut, the false belief that cocaine was not addictive contributed to the dramatic rise in its use in the 1980s.• In 2003, Charles Grob, director of child and adolescent psychiatry at the University of California Harbor Medical Center believed that Ecstasy ¬(hallucinogenic street drug) was potentially “good medicine” for treating alcoholism and drug abuse.Today, drug regulatory agencies all over the world approve clinical trials for the use of hallucinogenic drugs to handle anything from anxiety to alcoholism, despite the drugs being known to cause psychosis.The failure of the war against drugs is largely due to the failure to stop one of the most dangerous drug pushers of all time: the psychiatrist. The sad irony is that he has also established himself in positions enabling him to control the drug rehab field, even though he can show no results for the billions awarded by governments and legislatures. Governments, groups, families, and individuals that continue to accept his false information and drug rehabilitation techniques, do so at their own peril. The odds overwhelmingly predict that they will fail in every respect.Drug addiction is not a disease. Real solutions do exist.Clearing away psychiatry’s false information about drugs and addiction is not only a fundamental part of restoring hope, it is the first step towards achieving real drug rehabilitation.Psychiatric Rape: Assaulting Women and ChildrenIntroductionThere could be few more bitter experiences than the desperate victim who accepts help and is then betrayed by the “benefactor.”Imagine a 7-year-old girl who has been referred to a psychiatrist or psychologist for help with emotional problems related to incest. Suppose that the specialist then also sexually abuses the girl during “therapy.” What must be the emotional upheaval suffered by this tragic victim?Such despicable treachery in the wake of an already serious personal crisis could only burden the victim with further emotional scars and instability.It is also a damning criticism of those “professionals” entrusted with the task of helping people who are extremely fragile emotionally.On October 31, 2002, French psychotherapist Jean-Pierre Tremel was sentenced to 10 years in prison for raping and sexually abusing two young patients that the court recognized as being extremely vulnerable. Tremel, age 52, claimed his “treatment” was based on an “Oriental tradition” wherein “old men introduce girls to sexual practices.”Such “treatment” is never help. It is a disgusting betrayal in the guise of help, an all-too-frequent occurrence in the mental health industry:• A woman is statistically at greater risk of being raped while on a psychiatrist’s couch than while jogging alone at night through a city park.• In a British study of therapist-patient sexual contact among psychologists, 25 percent reported having treated a patient who had been sexually involved with another therapist.• A 2001 study reported that one out of twenty clients who had been sexually abused by their therapist was a minor, the average age being 7 for girls and 12 for boys. The youngest child was three.While compassion, common sense and decency declare that sexual abuse of patients is a serious and criminal act, psychiatrists and psychologists work hard to sanitize it—even when the victims of the exploitation are children. Combining the invented diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with subtle but perverse arguments, or even outright lies, they labor to decriminalize the sexual abuse of women and child patients.Meanwhile, mental health licensing bodies rarely mete out more than the wrist-slap—temporary license revocation—a charge of “professional misconduct” and temporarily suspend a practitioner’s license to practice.• In 2003, the Colorado State Board of Psychologist Examiners revoked the license of Dr. John Dicke, whose treatment of a 5-year-old boy included using sex toys. According to the boy’s father, his son had been “stripped naked, tortured, restrained, verbally abused, sexually abused, brainwashed and horrified by a dildo” during the alleged therapy.• In 1989, Dr. Paul A. Walters, psychiatrist in charge of student health at Stanford University, California, and former head of Harvard University’s Health Services’ Mental Health Division, was forced to resign after allegations of his having “frequent sex” with a female patient. The woman, who had been the victim of sexual abuse as a child, was awarded more than $200,000 in an out-of-court settlement. She said Walters had used her to perform oral sex on him, “sometimes as often as two out of three psychiatric analysis sessions per week.”Some psychiatrists, however, are criminally charged and convicted.• An Orange County, California, psychiatrist, James Harrington White, was convicted of the forced sodomy of a male patient. After an investigation by Citizens Commission on Human Rights (CCHR), White was found to have drugged young men, then videotaped himself having sex with them. White was sentenced to prison for almost seven years.No medical doctor, social organization or family member should hand over any person to face the mental health “treatments” that pass as therapy today.This is one of a series of reports produced by CCHR that deal with mental health betrayal. It is issued as a public service and warning.Therapist sexual abuse is sexual abuse. Therapist rape is rape. They will never constitute therapy. Until this is widely recognized however, and prosecutors and judges treat every incidence of this as such, psychiatrists, psychologists and psychotherapists will remain a threat to any woman or child undergoing mental health therapyPsychiatric Malpractice: The Subversion of MedicineIntroductionAlan I. Leshner, psychiatrist and former head of the National Institute of Drug Abuse once stated: “My belief is that today...you [the physician] should be put in jail if you refuse to prescribe S.S.R.I.s [the new types of antidepressants] for depression. He also believe that five years from now, you should be put in jail if you don’t give crack addicts the medications we’re working on now.”In the many years of working on mental health reform, He have spoken to hundreds of physicians and thousands of patients, while helping to expose numerous psychiatric violations of human rights. However, until recently, the thought had never occurred to me that physicians’ rights might also be under assault. Why should a physician be jailed for refusing to prescribe an antidepressant for depression?Many primary care physicians have acknowledged there are numerous physical conditions that can cause emotional and behavioral problems, and the vital need to check for them first. It follows then that relying on an antidepressant to suppress emotional symptoms, without first looking for and correcting a possible underlying physical illness, could simply be giving patients a chemical fix, while leaving them with an illness that could worsen.What if a primary care physician or family practitioner correctly diagnosed and cured such a physical illness and the depression ended without psychoactive drugs? Could that physician then be accused of being unethical, or even be charged and jailed for the “criminal medical negligence” of not prescribing an antidepressant?Crazy, you say? Couldn’t happen? Well, perhaps. But it seems the day has come when a good physician can be accused of being unethical for practicing ethical medicine. Today, a physician, specialist or otherwise, can be criticized, bullied and treated like a “fringe” dweller for practicing workable, diagnostic medicine.This information has been gathered with physicians in mind, particularly those who would just like to practice nonpsychiatric medicine, who are driven by a high and caring purpose in the best Hippocratic tradition, and who want to be left to get on with the job of caring for people’s health to the best of their ability. It is for physicians who are concerned about the fact that millions of children are taking prescribed addictive, speed-like stimulants for a supposed mental disorder, Attention Deficit Hyperactivity Disorder (ADHD).There is a pervasive mental health thinking that appears in primary care medicine today. It is largely due to the “success” of psychiatry’s diagnostic system, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). This system and the mental diseases section of the International Classification of Diseases (ICD-10) have been heavily promoted as vitally necessary, mental disorder standards for nonpsychiatric physicians.But there is something else here. Psychiatry’s diagnostic system did not arrive in a spirit of professional respect for the traditions and knowledge of primary care medicine and other medical specialties. There was no letter of introduction saying, “We respect the sanctity and seniority of your relationship with your patients, and your wish to provide the best for them. Here is our diagnostic system, please look it over and first satisfy yourself from your own experience that we are on the right track. This is valid science. We would appreciate your feedback and constructive criticism. By all means holler for help if you need us. Yours in the quest for better health.”Instead, it arrived in effect saying, “Here is a young child with severe mental problems. Our expert diagnosis is already made, in which case you have to do no more than follow our strict drug prescription instructions and be subject to our expert supervision.” Or put otherwise, it says, “Your patients seem to trust you more than us, so here are how you have to diagnose their mental illness, from which they undoubtedly suffer.”This is the coercive undercurrent that has indelibly characterized psychiatry since it first assumed custodial duties within asylums 200 years ago. It is manifest in many different ways, and wherever it meddles, it is extremely destructive of certainty, pride, honor, industry, and initiative, and integrity, peace of mind, well-being and sanity. These are qualities that we must fight to preserve for all patients. And for all physicians.Inventing Disorders: For Drug ProfitsIntroductionHave you ever heard of the following mental disorders: reading disorder, disruptive behavior disorder, disorder of written expression, mathematics disorder, caffeine intoxication disorder, and nicotine withdrawal disorder, noncompliance with treatment disorder, or “physical abuse of a child problem and sexual abuse of a child problem”?These are a few of the 374 mental disorders that are listed in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) or in the mental disorders section of the World Health Organization’s International Classification of Diseases (ICD).Depicted as diagnostic tools, the DSM and ICD are not only used to diagnose mental and emotional disturbances and prescribe “treatment,” but also to resolve child custody battles, discrimination cases based on alleged psychiatric disability, augment court testimony, modify education, and much more. In fact, whenever a psychiatric opinion is sought or offered, the DSM or the ICD are presented and, increasingly accepted, as the final word on sanity, insanity, and so-called mental illness.Canadian psychologist Tana Dineen reports, “Unlike medical diagnoses that convey a probable cause, appropriate treatment and likely prognosis, the disorders listed in DSM-IV [and ICD-10] are terms arrived at through peer consensus”—literally, a vote by APA committee members—and designed largely for billing purposes.The “science-by-vote” procedure is as surprising to a layperson as it is to other health professionals, who have witnessed DSM voting meetings. “Mental disorders are established without scientific basis and procedure,” a psychologist attending the DSM hearings said. “The low level of intellectual effort was shocking. Diagnoses were developed by majority vote on the level we would use to choose a restaurant. Then it’s typed into the computer. It may reflect on our naiveté, but it was our belief that there would be an attempt to look at the things scientifically.”In 1987, a “self-defeating personality disorder” was voted in as a provisional label. Used to describe “self-sacrificing” people, especially women, who supposedly choose careers or relationships that are likely to cause disappointment, the “disorder” met with such protest from women it was subsequently voted out of DSM-IV.Lynne Rosewater, a psychologist who attended a DSM hearing presided over by one of the manual’s leading architects, psychiatrist Robert Spitzer, reported, “[T]hey were having a discussion for a criterion about Masochistic Personality Disorder and Bob Spitzer’s wife, [a social worker and the only woman in that meeting on Spitzer’s side of the debate] says, ‘I do that sometimes’ and he says, ‘Okay, take it out.’ You watch this and you say, ‘Wait a second, we don’t have a right to criticize them because this is a ‘science’?”Dr. Margaret Hagen, psychologist and author of Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice are blunt about the real motive that lies behind the DSM voting system: “If you can’t come up with the diagnosis, you can’t send a bill.”According to Professors Herb Kutchins and Stuart A. Kirk, authors of Making Us Crazy, “Far too often, the psychiatric bible has been making us crazy—when we are just human.” The “bitter medicine” is that DSM has “attempted to medicalize too many human troubles.”Kutchins and Kirk further state that people “may gain false comfort from a diagnostic psychiatric manual that encourages belief in the illusion that the harshness, brutality, and pain in their lives and in their communities can be explained by a psychiatric label and eradicated by a pill. Certainly, there are plenty of problems that we all have and a myriad of peculiar ways that we struggle…to cope with them. But could life be any different?”Paul R. McHugh, professor of psychiatry at the Johns Hopkins University School of Medicine said that because of the DSM, “Restless, impatient people are convinced that they have attention deficit disorder (ADD); anxious, vigilant people that they suffer from post-traumatic stress disorder (PTSD); stubborn, orderly, perfectionistic people that they are afflicted with obsessive-compulsive disorder (OCD); shy, sensitive people that they manifest avoidant personality disorder (APD), or social phobia. All have been persuaded that what really matters of their individuality are, instead, medical problems, and as such are to be solved with drugs.…And, most worrisome of all, wherever they look, such people find psychiatrists willing, even eager, to accommodate them.…In its recent infatuation with symptomatic, push-button remedies, psychiatry has lost its way not only intellectually but spiritually and morally.”In June 2004, John Read, senior lecturer in psychology at Auckland University, New Zealand, wrote “More and more problems have been redefined as ‘disorders’ or ‘illnesses,’ supposedly caused by genetic predispositions and biochemical imbalances. Life events are relegated to mere triggers of an underlying biological time bomb. Feeling very sad has become ‘depressive disorder.’ Worrying too much is ‘anxiety disorder.’ Excessive gambling, drinking, drug use or eating is also illnesses. So are eating, sleeping, or having sex too little. Being painfully shy has become ‘avoidant personality disorder.’ Beating people up are ‘intermittent explosive disorder.’ Our Diagnostic and Statistical Manual of Mental Disorders has 886 pages of such illnesses.…Making lists of behaviors, applying medical-sounding labels to people who engage in them, then using the presence of those behaviors to prove they have the illness in question is scientifically meaningless. It tells us nothing about causes or solutions. It does, however, create the reassuring feeling that something medical is going on.”DSM has become so widely relied upon within society that it has taken on the aura of scientific fact. Millions now use and believe in its diagnostic abilities, never once suspecting that the whole premise and the system itself are fraudulent. These people are at risk of making seriously wrong, even fatal, turns in either their own lives, or the lives of others.This report fills in the very large and deliberate gaps left by psychiatric propaganda about its key claim to “scientific” fame, the DSM.Psychiatry: Hooking Your World on DrugsIntroductionWhat is one of the most destructive things in your world today?If you answered drugs, then you share that view with the majority of people in your community. Illegal drugs, and their resultant violence and crime, are recognized as a major threat to children and society. However, very few people recognize that illegal drugs represent only part of the current drug problem. Today, we see a reliance on another type of drug, namely prescription psychiatric drugs.Once reserved for the mentally disturbed, today it would be difficult to find someone—a family member, a friend or a neighbor—who hasn’t taken some form of psychiatric drug. In fact, these have become such a part of life for many people that “life without drugs” is simply unimaginable.Prescribed for everything from learning and behavioral problems, to bedwetting, aggression, juvenile delinquency, criminality, drug addiction and smoking, to handling the fears and problems of our elderly, from the cradle to the grave, we are bombarded with information pushing us towards this type of chemical “fix.”Little surprise then that worldwide statistics show that a rapidly increasing percentage of every age group, from children to the elderly, rely heavily and routinely on these drugs in their daily lives. Global sales of antidepressants, stimulants, antianxiety and antipsychotic drugs have reached more than $76 billion a year—more than double the annual US government budget spent on the war against drugs.Authors Richard Hughes and Robert Brewin, in their book, The Tranquilizing of America, warned that although psychotropic drugs may appear “to ‘take the edge off’ anxiety, pain, and stress, they also take the edge off life itself…these pills not only numb the pain but numb the whole mind.” In fact, close study reveals that none of them can cure, all have horrific side effects, and due to their addictive and psychotropic (mind-altering) properties, all are capable of ruining a person’s life.Consider also the fact that terrorists have used psychotropic drugs to brainwash young men to become suicide bombers. At least 250,000 children worldwide, some as young as seven, are being used for terrorist and revolutionary activities and given amphetamines and tranquilizers to go on “murderous binges” for days. Yet these are the same drugs that psychiatrists are prescribing children for “learning” or “behavioral” problems.Understanding society’s skyrocketing psychiatric drug usage is now even more critical than ever. Internationally, 54 million people are taking antidepressants known to cause addiction, violent and homicidal behavior.How did millions become hooked on such destructive drugs? We need to look earlier than the drug.Before falling into the trap, each individual was convinced that these drugs would help him or her to handle life. The primary sales tool used was an invented diagnostic system, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders IV (DSM) and the mental disorders section of Europe’s International Classification of Diseases (ICD). Once diagnosed and the prescription filled, the harmful properties of the drugs themselves took over.Forcing widespread implementation of this diagnostic sham, psychiatrists have ensured that more and more people with no serious mental problem, even no problem at all, are being deceived into thinking that the best answer to life’s many routine difficulties and challenges lies with the “latest and greatest” psychiatric drug.Whether you are a legislator, a parent of school-aged children, a teacher, an employer or employee, a homeowner, or simply a community member, this report is vital reading.Our failure in the war against drugs is due largely to our failure to put a stop to the most damaging of all drug pushers in society.This is the psychiatrist at work today, busy deceiving us and hooking our world on drugsFew words on Mind:Mind is the set of cognitive faculties that enables consciousness, perception, thinking, judgment, and memory—a characteristic of humans, but which also may apply to other life forms.The part of a person that feels, thinks, perceives, wills, and especially reasonsThe organ or seat of consciousness; the faculty, or brain function, by which one is aware of surroundings, and by which one experiences feelings, emotions, and desires, and is able to attend, remember, learn, reason, and make decisions.The organized totality of an organism's mental and psychological processes, conscious and unconscious.The characteristic thought process of a person or group.Medical Definition of MIND1. The element or complex of elements in an individual that feels, perceives, thinks, wills, and especially reasons 2. The conscious mental events and capabilities in an organism 3.the organized conscious and unconscious adaptive mental activity of an organism.Dictionary definition of MIND:The human consciousness that originates in the brain and is manifested especially in thought, perception, emotion, will, memory, and imagination.The collective conscious and unconscious processes in a sentient organism that direct and influence mental and physical behavior.The principle of intelligence; the spirit of consciousness regarded as an aspect of reality. The faculty of thinking, reasoning, and applying knowledge. A person of great mental ability.a. Individual consciousness, memory, or recollectionb. A person or group that embodies certain mental qualities.c. The thought processes characteristic of a person or group; psychological makeup.Opinion or sentiment.Desire or inclination.Focus of thought; attention.A healthy mental state; sanity.Questions arise here.Do humans have an organ or part of organ called mind?If so where is it?If part of brain which neuron(s) is part of mind?Do animals have mind?Do animals have mental diseases?There are 10 million ‘well qualified’ psychiatrists, 100 million+ mental patients, 10,000+ medications all over the world.Why there is no one person is fully treated around the globe?There are no answers or Mind is an imaginary organ which never exists.Is the sentence, "The Mind cannot end the Mind," true or false?Someone recently said “The mind cannot end the mind.”On the surface it seems to make sense, and seems to imply any mental effort or spiritual practice will never help you make any “spiritual” progress because the mind cannot step outside itself. In fact, one might say it strengthens the minds grip.But on whom? Is there something or someone separate from the mind, a true self so to speak, that may be discovered or uncovered by spiritual practices such as meditation, concentration or pondering?First of all, to say the mind cannot end the mind assumes that the mind is a things and a monolith, such that any action it does only strengthens it making going beyond the mind impossible, and that only grace can allow “you” whoever you are, to find some “true self.”But is this the case? Actually not.What do we mean by mind? Certainly thinking, but what else?Even if we think about it for just a minute, we see the word mind means many things to most of us, not just a single entity. We understand it is a group of processes or faculties and not just thinking. It includes an ability to remember. It includes the ability to read, write and understand concepts. It includes the ability to add, subtract and perhaps do advanced math. It includes an ability to plan work or activities the next day. It is that which helps us judge distance and time without a clock or measure, and that which allows us to use clocks and measures to be more accurate. It includes the ability to imagine, as well as get lost in thought or imagination. It includes an ability to listen to, play and compose music, or create visual art.It also includes the ability to concentrate and focus attention. It is that which allows us to isolate a thought or emotion in one’s attention, focus on it, let the emotion or feeling grown and expand and then pass through one. One might say it also includes our concepts of self and boundaries.Therefore can we truly say that we cannot use the mind to step outside of hat we thought we were in order to have an expanded or contracted sense of self, of I-ness, or lack of I-ness?For example, we can use meditation on just relaxing into our experience of the world to find a growing sense of emptiness. We can use it to question all of our beliefs about everything, including who we are. We can use it to isolate an emotion such as love, anger or hate to sink deeply in it and merge with it.We can use it to isolate the I-am sensation, or else just the sense of He as Ramana taught and follow it backwards into the Self, the Raman I-I.We can definitely use it to control the inner energies and to aid Kundalini experiences through breath control and imaginations. We can use it to control and expand healing energies.So the sentence, “The mind cannot end the mind” just is wrong. It is a simplistic sentence that seems to make sense at first blush, but upon investigation is found wanting. He questioned that myself some time ago. If He have to rely on memory to "remember" who He is then it would be self-defeating but then He realized that any help one can get in the process is fine. Eventually what is happening is that "presence" or whatever it is, comes by itself without having to remember it. Pretty cool.Who am I? He is nothing but my brain so are you.Dualism is an illusionThoughts undeniably do exist, but our common sense understanding of them as being some spooky immaterial thing is false - ironically. The mind is a function of the brain.The feeling that we are separate from the external world, in a way that we THINK we can divide the universe in two, like a dualist... THAT is the real illusion, because half the time our brains are actively tricking us into thinking that there is both matter and mind, when in reality there are only PERCEPTIONS of "stuff" and perceptions alone. Brain state is the correct term for what these perceptions can be reduced to.Taking a monist stance through reducing everything to brain states, eliminates the problem of thinking so black and white in terms of "Mind and matter", which is actually a false dichotomy when you understand that both are subject to conscious experience.Developments in neuroscience have convinced me to believe that there is no real thing called the mind that is different from, for example, the keyboard He is typing on.The mind is not a real thing in that it doesn't exist out in the world. It is not something separate from the electrical impulses and hardware of the brain. Just like a computer program is simple a manifestation of code running through a computer, our minds are just relays of information passing through our brains.The mind as a whole escapes objective studies because belief in mind- independent reality is self-contradictory and by definition excludes subjective experience (awareness, 'consciousness') from reality. The mind's center therefore vanishes in studies which imply exclusive objectivism or empiricism. This conceptual difficulty can be counteracted by acknowledging that all mental and world structures arise within an unstructured origin- and-matrix for knowledge-structures and beliefs. The mind's structure is thus at the center of unreality. Use of such a zero-structure (non-structure) reference can also help to clarify some related conceptual difficulties and to bridge the gap between the 'two cultures'.Mental diseases are not diseases but the properties of brain. Everybody has a unique brain and it functions in a unique way. Human beings have no right to change it. A neurologist would be the right person to repair the brain and not a psychiatrist. The chemical balances of every brain are different as well as electrical impulses. All the time a psychiatrist asks a question to their patient “how do you feel?” if the answer is good/better/best, then psychiatrist will say “continue medication” or if not good “increase medication” still not good “change medication”. This is true psychiatrist’s practice all over the world or we call cruelty to the people in the name of science and medicine!Due to the lack of essential chemicals in brain, the brain functionalities will vary from person to person. Some would be antisocial behavior and should give window to make it up including disciplines, employment, income, essential minerals, etc…Mental Illness vs Brain Disorders: From Szasz to DSM-5February 28, 2014 | DSM-5By Awais Aftab, MD, MBBSDespite being a psychiatrist himself, Thomas Szasz was a lifelong ferocious critic of the institution of psychiatry. He attacked its foundations and practices and questioned its medical legitimacy. Although most psychiatrists remain unconvinced of his arguments, Szasz has been very influential by virtue of being psychiatry’s arch-adversary. A significant body of discourse on the notion of mental disorder by psychiatrists and non-psychiatrists alike has been centered on understanding and responding to his critique.Szasz’s basic contention is that mental illness is a myth. By asserting this, Szasz is not denying the existence of the conditions that psychiatrists call mental illness, or the suffering and distress experienced by people with these conditions. Rather, he is denying the classification of these conditions as medical diseases. For Szasz, diseases are demonstrable anatomical or physiological lesions, and he frequently refers to Virchow’s notion of cellular pathology as the basis of disease. It follows from this particular definition that the only sort of disease that can exist is physical.By definition, a disease of the mind is impossible. Disease requires a physical lesion; the mind is nonphysical. Ergo, the mind cannot be diseased. This is a logical deduction; the conclusion follows from the premises. This is what Szasz means when he says that this claim is “an analytic truth, not subject to empirical falsification.”1 Because mental disorders are not diseases in the literal, physical sense, they can only be diseases in a metaphorical sense. Mental illness, he says, “is a metaphor. Minds can be ‘sick’ only in the sense that jokes are ‘sick’ or economies are ‘sick.’”2 Psychiatric diagnoses only mimic medical diagnoses.If the conditions we call mental illnesses are not diseases, then what are they? Szasz argues that they are in fact problems in living, human conflicts, and unwanted behaviors. “Psychiatrists are not concerned with mental illnesses and their treatments. In actual practice they deal with personal, social, and ethical problems in living.”3 (Szasz’s critique of psychiatry extends to a moral and political dimension as well. He argues that the concept of mental illness undermines the principle of personal responsibility, which is the ground on which all free political institutions rest.)In this lifelong critique of mental illness as a myth, Szasz simultaneously maintained an interesting counterfactual conditional. In logic, a counterfactual conditional is an if-then statement indicating what would be the case if something were true, although it is not true. While insisting that mental illnesses are in reality problems of living and not diseases, he also argued that if the conditions we call mental disorders are found to have an underlying neuropathology, then it would prove that mental disorders are actually brain disorders, and the whole notion of mental illness was erroneous and superfluous to begin with. Szasz did not believe that mental disorders are brain disorders. He alleged until the end of his life that an underlying pathology for psychiatric disorders had not yet been demonstrated, but he was willing to entertain it as a hypothetical possibility. In his 1960 article “The Myth of Mental Illness,” Szasz wrote4:The assumption is made that some neurological defect, perhaps a very subtle one, will ultimately be found for all the disorders of thinking and behavior. Many contemporary psychiatrists, physicians, and other scientists hold this view. . . .I have tried to show that for those who regard mental symptoms as signs of brain disease, the concept of mental illness is unnecessary and misleading. For what they mean is that people so labeled suffer from diseases of the brain; and, if that is what they mean, it would seem better for the sake of clarity to say that and not something else.In 2011, he reiterated this argument5:When a person hears me say that there is no such thing as mental illness, he is likely to reply: “But He know so-and-so who was diagnosed as mentally ill and turned out to have a brain tumor. In due time, with refinements in medical technology, psychiatrists will be able to show that all mental illnesses are bodily diseases.” This contingency does not falsify my contention that mental illness is a metaphor. It verifies it. The physician who concludes that a person diagnosed with a mental illness suffers from a brain disease discovers that the person was misdiagnosed: he did not have a mental illness; he had an undiagnosed bodily illness. The physician’s erroneous diagnosis is not proof that the term “mental illness” refers to a class of brain diseases.Such a process of biological discovery has, in fact, characterized some of the history of medicine, one form of “madness” after another being identified as the manifestation of one or another somatic disease, such as beriberi or neurosyphilis. The result of such discoveries is that the illness ceases to be a form of psychopathology and is classified and treated as a form of neuropathology. If all the conditions now called mental illnesses proved to be brain diseases, there would be no need for the notion of mental illness and the term would become devoid of meaning.One can clearly see some assumptions at work here. For Szasz the notions of mental illness and brain disease are mutually exclusive. A condition can be either a mental illness or a brain disease—it cannot be both; it can have either a psychopathology or a neuropathology—it cannot have both. This exclusivity springs from the fact that for Szasz mental illness is non-disease (disease in only a metaphorical sense) and psychopathology is nonpathology (pathology in only a metaphorical sense). It is a matter of logic that a condition cannot be nondisease and disease (or nonpathology and pathology) at the same time.Szasz treats the concept of mental illness very literally as being purely a disease of the mind (and thereby an impossibility). This notion harks back to an old and outdated view that was generated from a psychoanalytical outlook of mental illness, which was the dominant psychiatry paradigm in the 1950s, when Szasz came up with his critique. There are 2 ways in which Szasz’s argument goes awry when applied to our current understanding of mental disorders. First, the concept of disease is not restricted to the presence of a physical lesion; second, the term “mental disorder” is now conceptualized in a manner that transcends mind-body dualism.For the most part, disease is understood largely in terms of suffering and functional impairment, which may or may not be associated with a structural lesion. R. E. Kendell explains this view succinctly6: “For most of human history disease has been essentially an explanatory concept, invoked to account for suffering, incapacity, and premature death in the absence of obvious injury, and suffering and incapacity are still the most fundamental attributes of disease.”Once we conceive of disease in terms of substantial or enduring states of suffering and incapacity, we are justified in applying it as a label to conditions in which disturbances in cognition, emotion, or behavior are associated with distress and impairment.The notion of mental illness began to change with the emergence of biological psychiatry. Most psychiatrists today do not believe in the mutual exclusivity of mental illness and brain disorders. Most mental disorders are presumed to have a neurobiological basis even in cases in which this basis is poorly understood. Although the terms “mental illness” and “mental disorder” are still used, the manner in which they are understood is very different from the old psychoanalytic view (and for that reason many psychiatrists argue that the terms should be abandoned). The notion of mental illness as distinct and divorced from the notion of a biological disorder reflects a dualistic understanding of the mind-body relationship, a dualism that has become increasingly untenable given the advances of neuroscience. While it may be true that in the 1950s, when Szasz came up with his critique, this particular dualistic understanding of mental illness was in fashion, psychiatrists have long abandoned such a view. Szasz failed to appreciate that in his critique and held on to his original position until his death in 2012.We still do not have fully satisfactory definitions of either disease or mental disorder, and He do not attempt to argue that the current conceptualizations are unproblematic. The aim instead is to show that the conceptualizations have changed in a manner such that Szasz’s assumptions are rendered invalid.To get an idea of how contemporary psychiatry understands mental disorders, let us look at what DSM has to say about it. DSM-IV acknowledges several things. The term “mental disorder” is misleading in the sense that it implies a distinction between mental disorders and physical disorders, reflective of a reductionist anachronism of mind-body dualism. The distinction between mental and physical is untenable. “Mental disorder” continues to be used because there is no appropriate substitute for it.“A compelling literature documents that there is much physical in mental disorders and much mental in physical disorders. The problem raised by the term ‘mental disorders’ has been much clearer than its solution, and, unfortunately, the term persists in the title of DSM-IV because we have not found an appropriate substitute.”7DSM-IV accepts that no definition adequately specifies precise boundaries for the concept of mental disorder. This concept, like many others in medicine and science, lacks a consistent operational definition that covers all situations. Because mental disorders are a heterogeneous category of disorders, no single definition captures the entire range of conditions that are currently included in this term. This lack of a precise definition is not restricted to psychiatry but can be found in the rest of medicine as well, where medical conditions are defined in various levels of abstraction.While acknowledging that no definition can capture all aspects of all disorders currently classified as mental disorders, DSM-5 provides us with a list of minimal criteria that must be met for a condition to be called a mental disorder:• A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning• The condition leads to significant distress and/or disability in social, occupational, or other important activities of daily life• The condition is not an expectable or culturally approved response to a common stressor or personal loss• Socially deviant behavior (such as political, religious, or sexual) by itself is not a mental disorder; it can, however, be the symptom of a mental disorder, if it can be shown that the deviant behavior is a part of a clinical syndrome reflective of an underlying dysfunction of mental functioning• The diagnosis of a mental disorder should have clinical utility; that is, it should assist psychiatrists in developing treatment plans and help them in the determination of expected treatment outcomes and prognoses (however, DSM-5 clarifies that the diagnosis of a mental disorder does not by itself indicate a need for treatment)Here we can find no trace of the old notion of mental disorder as being purely a disorder of the mind. DSM-5 clearly states that there is a dysfunction in psychological, biological, or developmental processes that underlie mental functioning, thereby cutting right across Szasz’s dichotomy of mental illness versus brain disorders. The DSM definition is not without its problems. For instance, it does not define dysfunction or address the basis of the norms of psychological functioning. Nonetheless, the point here is to show that the concept of mental disorder as it exists in DSM does not assume a distinction between mind and brain that underlies Szasz’s argument.Mental disorders, as we currently understand them, can very well be brain disorders and, in fact, many of them are. It should be clarified that not all mental disorders have an underlying detectable neuropathology. Many mental disorders, such as most personality disorders, paraphilic disorders, and gambling disorder, are still conceptualized largely in behavioral terms, and they can be said to have an underlying biological basis only in the sense in which all behavior has a biological basis. If all conditions that we call mental disorders had an underlying detectable pathology, Szasz’s criticism would become merely a linguistic complaint against the use of the term “mental disorder” to describe these conditions; however, for many conditions it is difficult to distinguish between their characterization as mental disorders and what Szasz calls “problems of living.”Does acknowledging that mental disorders often have underlying neuropathology imply that the diagnosis of these conditions as mental illness is in fact erroneous? Consider the case of schizophrenia. Many decades ago, schizophrenia was widely conceptualized as a disorder of the mind with no detectable abnormality in the brain. However, now we know that there are many underlying neurobiological abnormalities.8, 9 simultaneously, our conceptualization of mental disorders have changed such that a biological dysfunction underlying mental functioning is now part of the DSM definition. Schizophrenia remains a mental disorder because it constitutes a clinically significant disturbance in cognition, emotion regulation, and behavior, and the neurobiological abnormalities underlying it remain consistent with its characterization as a mental disorder because the conception of mental disorder has expanded to include biological dysfunction within its scope.This brings us to the question of the division of psychiatry from the rest of medicine—and neurology in particular. If at least some mental disorders also have underlying neurobiological dysfunction, then why should psychiatry exist as a separate specialty from neurology? This argument assumes that the division between medical specialties, in particular the division between psychiatry and neurology, exists on the basis of the ontological natures of the disorders they treat. This is an erroneous assumption. There need not be any ontological difference between neurological diseases and psychiatric diseases, in the sense that both depend on the brain as a necessary and sufficient condition for their existence.There is a significant overlap between the conditions treated by neurology and psychiatry, as evidenced by the subspecialty of neuropsychiatry. The justification for the existence of psychiatry as a separate specialty is not based on an understanding of what constitutes mental illness. Rather, the justification is based on the clinical nature of disorders (psychiatric disorders are predominantly disorders of behavior, cognition, and emotional regulation) and the requirement of specialized skills for treatment (e.g., psychotherapeutic techniques, psychopharmacology, ECT), among other considerations.Robert Daly writes10:[I]ndeed, psychiatrists and neurologists have a common interest in some kinds of cases, as expressed in the subspecialties of neuropsychiatry and behavioral neurology. But for the most part, neurology and psychiatry respond to different kinds of ill health and therefore exhibit different practical aims that require the acquisition and competent exercise of different practical skills. Each discipline also proceeds from a different body of theoretical knowledge and speaks the generic vocabulary of medicine in different voices.By all means, a debate is warranted on how valid these justifications are for the separate existence of psychiatry from neurology—and it is an ongoing debate—but what needs to be recognized is that psychiatry as a specialty is no longer distinguished from neurology on the basis of the absence of determinable neuropathology underlying the conditions of interest.Medicine's big new battleground: does mental illness really exist?The latest edition of DSM, the influential American dictionary of psychiatry, says that shyness in children, depression after bereavement, even internet addiction can be classified as mental disorders. It has provoked a professional backlash, with some questioning the alleged role of vested interests in diagnosisBritain's Division of Clinical Psychology is calling for the abandonment of psychiatric diagnosis, even as the American Psychiatric Association's DSM-5 seeks to codify more illnessesIt has the distinctly uncatchy, abbreviated title DSM-5, and is known to no one outside the world of mental health.But, even before its publication a week on Wednesday, the fifth edition of the Diagnostic and Statistical Manual, psychiatry's dictionary of disorders, has triggered a bitter row that stretches across the Atlantic and has fuelled a profound debate about how modern society should treat mental disturbance.Critics claim that the American Psychiatric Association's increasingly voluminous manual will see millions of people unnecessarily categorized as having psychiatric disorders. For example, shyness in children, temper tantrums and depression following the death of a loved one could become medical problems, treatable with drugs. So could internet addiction.Inevitably such claims have given ammunition to psychiatry's critics, who believe that many of the conditions are simply inventions dreamed up for the benefit of pharmaceutical giants.A disturbing picture emerges of mutual vested interests, of a psychiatric industry in cahoots with big pharma. As the writer, Jon Ronson, only half-joked in a recent TED talk: "Is it possible that the psychiatric profession has a strong desire to label things that are essential human behavior as a disorder?"Psychiatry's supporters retort that such suggestions are clumsy, misguided and unhelpful, and complain that the much-hyped publication of the manual has become an excuse to reheat tired arguments to attack their profession.But even psychiatry's defenders acknowledge that the manual has its problems. Allen Frances, a professor of psychiatry and the chair of the DSM-4 committee, used his blog to attack the production of the new manual as "secretive, closed and sloppy", and claimed that it "includes new diagnoses and reductions in thresholds for old ones that expand the already stretched boundaries of psychiatry and threaten to turn diagnostic inflation into hyperinflation".Others in the mental health field have gone even further in their criticism. Thomas R Insel, director of the National Institute of Mental Health, the American government's leading agency on mental illness research and prevention, recently attacked the manual's "validity".And now, in a significant new attack, the very nature of disorders identified by psychiatry has been thrown into question. In an unprecedented move for a professional body, the Division of Clinical Psychology (DCP), which represents more than 10,000 practitioners and is part of the distinguished British Psychological Society, will tomorrow publish a statement calling for the abandonment of psychiatric diagnosis and the development of alternatives which do not use the language of "illness" or "disorder".The statement claims: "Psychiatric diagnosis is often presented as an objective statement of fact, but is, in essence, a clinical judgment based on observation and interpretation of behavior and self-report, and thus subject to variation and bias."The language may be arcane, but the implication is clear. According to the DCP, "diagnoses such as schizophrenia, bipolar disorder, personality disorder, attention deficit hyperactivity disorder, conduct disorders and so on" are of "limited reliability and questionable validity".Diagnosis is often described as the holy grail of psychiatry. Without it, psychiatry's foundations crumble. For this reason Mary Boyle, emeritus professor at the University of East London, believes that the impact of the DCP's statement marks a dramatic shift in the mental health debate."The statement isn't just an account of the many problems of psychiatric diagnosis and the lack of evidence to support it," she said. "It's a call for a completely different way of thinking about mental health problems, away from the idea that they are illnesses with primarily biological causes."Psychiatrists say that such claims have been made many times before and ignore mountains of peer-reviewed papers about the importance that biological factors play in determining mental health, including significant work in the field of genetics. It also, they say, misrepresents psychiatry's position by ignoring its emphasis on the impact of the social environment on mental health.Most psychiatrists concede that diagnosis of psychiatric disorder is not perfect. But, as Harold S Koplewicz, a leading child and adolescent psychiatrist, explained in an article for the Huffington Post, "those lists of behaviors in the DSM, and other rating scales we use, are tools to help us look at behavior as objectively as possible, to find the patterns and connections that can lead to better understanding and treatment".Independent experts also say that it is hard to see how the world of mental health could function without diagnosis. "We know that, for many people affected by a mental health problem, receiving a diagnosis enabled by diagnostic documents like the DSM-5 can be extremely helpful," said Paul Farmer, chief executive of the mental health charity Mind. "A diagnosis can provide people with appropriate treatments, and could give the person access to other support and services, including benefits."But even Farmer acknowledged that diagnosis is imperfect. "For example it takes, on average, 10 years before a person with bipolar disorder gets a correct diagnosis, which comes with a number of mental and physical health implications, such as side-effects from the wrong medication," he said.But now the DCP has transformed the debate about diagnosis by claiming that it is not only unscientific but unhelpful and unnecessary."Strange though it may sound, you do not need a diagnosis to treat people with mental health problems," said Dr. Lucy Johnstone, a consultant clinical psychologist who helped to draw up the DCP's statement."We are not denying that these people are very distressed and in need have helped. However, there is no evidence that these experiences are best understood as illnesses with biological causes. On the contrary, there is now overwhelming evidence that people breaks down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse."Eleanor Longden, who hears voices and was told she, was a schizophrenic who would be better off having cancer as "it would be easier to cure", explains that her breakthrough came after a meeting with a psychiatrist who asked her to tell him a bit about herself. In a paper for the academic journal, Psychosis, Longden recalled: "I just looked at him and said 'I'm Eleanor, and I'm a schizophrenic'."Longden writes: "And in his quiet, Irish voice he said something very powerful, 'I don't want to know what other people have told you about yourself, He want to know about you.'"It was the first time that He had been given the chance to see myself as a person with a life story, not as a genetically determined schizophrenic with aberrant brain chemicals and biological flaws and deficiencies that were beyond my power to heal."Longden, who is pursuing a career in academia and is now a campaigner against diagnosis, views this conversation as a crucial first step in the healing process that took her off medication. "I am proud to be a voice-hearer," she writes. "It is an incredibly special and unique experience."Hers is an inspirational story. But to focus on one person's experiences would be to ignore the testimonies of others who believe that their mental distress has biomedical roots. Indeed, many people report that they can see no clear reason for their distress and firmly believe their life stories have little bearing on their mental state.Nevertheless the DCP believes the world of mental health treatment would benefit from a "paradigm shift" so that it focused less on the biological aspects of mental health and more on the personal and the social."In essence, instead of asking 'What is wrong with you?’ we need to ask 'what has happened to you?’” Johnstone said. "Once we know that, we can draw on psychological evidence to show how life events and the sense that people make of them have led to the current difficulties."A shift away from a biological focus would give succor to psychiatry's critics, who question society's reliance on the use of drugs or interventions such as electroconvulsive therapy to treat psychiatric breakdown.Prescriptions of antidepressants increased nearly 30% in England between 2008 and 2011, the latest available data.A recent article in the online edition of the British Medical Journal suggested "that only one in seven people actually benefits" from antidepressants and claimed that three-quarters of the experts who wrote the definitions of mental illness had links to drug companies.Professor Sir Simon Wessely, chair of Psychological Medicine at King's College London (KCL), argues that his profession has always emphasized the need to "look at the whole person, and indeed beyond the person to their family, and to society", and that claims psychiatry is being "taken over by the biologists" are unfounded.This defense, which will be outlined at a major international conference on the impact of DSM-5, to be held at KCL at the beginning of June, is often lost in a shrill debate.Indeed, it is noticeable just how vocal psychiatry's critics are becoming ahead of the publication of DSM-5. In an attempt to pour oil on troubled waters, Professor Sue Bailey, president of the Royal College of Psychiatrists, conceded that "many of the criticisms that are levelled at DSM" were valid but warned that the row was "distracting us from the real challenge, which is providing high-quality mental health services and treatment to patients and careers".Bailey insisted the manual's publication "won't have any direct influence on the diagnosis of mental illness in the NHS". But it will frame the wider debate about how people see mental health. As Wessely acknowledged, psychiatry's critics will seize on the manual's "daft" new categories of mental disorder to bolster claims that the profession is "medicalising normality".There is an irony here. Psychiatry lies wounded and much of the damage appears to be self-inflicted. The emotional scars may take decades to heal.How the Diagnostic and Statistical Manual of Mental Disorders is changingIN THE NEW MANUAL, DSM-5:■ Disruptive mood dysregulation disorder, or DMDD, for those diagnosed with abnormally severe and frequent temper tantrums.■ Binge-eating disorder. For those who eat to excess 12 times in three months.■ hoarding disorder, defined as "persistent difficulty discarding or parting with possessions, regardless of actual value".■ Oppositional defiant disorder, described by one critic as a condition afflicting children who say "no" to their parents more than a certain number of times.OUT OF THE MANUALThe term "gender identity disorder", for children and adults who strongly believe they were born the wrong gender, is being replaced with "gender dysphoria" to remove the stigma attached to the word "disorder". Experts liken the switch to the removal of homosexuality as a disorder in the 1973 edition.AND THE FUTURE?Hyper sexuality and internet addiction will both be included in a section that suggests they could become disorders following further research.CHAPTER 1:AN INDUSTRY OF DEATHThrough rare historical and contemporary footage and interviews with more than 160 doctors, attorneys, educators, survivors and experts on the mental health industry and its abuses, this riveting documentary blazes the bright light of truth on the brutal pseudoscience and multi-billion dollar fraud that is psychiatry.We think you have the right to know the cold, hard facts about psychiatry, its practitioners and the threat they pose to our children. Get the truthGovernments, insurance companies and private individuals pay billions of dollars each year to psychiatrists in pursuit of cures that psychiatrists admit do not exist. Psychiatry's “therapies” have caused millions of deaths.CHAPTER 2:ORIGINS OF PSYCHIATRYFrom its beginnings in the 1700s, using the practices of confining, restraining and isolating people with mental problems in institutions, psychiatrists have cashed in on human misery.CHAPTER 3:MAN REDEFINEDRedefining man as an animal without a soul, psychologists and psychiatrists thought man could be manipulated as easily as a dog could be trained to salivate at the sound of a bellCHAPTER 4:PSYCHIATRY: THE MEN BEHIND THE HOLOCAUSTThe Nazis killed millions. Their justification was psychiatry and psychology’s theory of eugenics—that certain people were inferior and should be exterminated and their kind bred out of the race. These architects of the Holocaust were never brought to justice.CHAPTER 5:PSYCHIATRY: CREATING RACISMFrom apartheid in South Africa to the Ku Klux Klan and experiments on minorities in the United States, the most brutal racists were inspired by eugenics which justified injustice, inhumanity and denial of human dignity to millions.CHAPTER 6:SOVIET PSYCHIATRYMen fight and die for the right to speak and act freely. Psychiatry conspired with those in power in Communist Russia to strip the rights of political dissidents and to define their “search for justice” as a mental disorder to justify their imprisonment.CHAPTER 7:BRAIN DAMAGE: PSYCHIATRY’S MIRACLE CUREIf an ice pick were accidentally shoved behind someone’s eyeballs, or they were jolted by 120 to 240 volts, leaving them convulsing and barely breathing, they would be rushed to a hospital. To a psychiatrist, these acts are “treatment.”CHAPTER 8:DRUGGING FOR PROFITPsychiatric drugs are not designed to cure, but to suppress symptoms and physically damage the person taking them. Claims of safety and efficacy are made with each new "miracle pill"; its dangers only later exposed. Psychiatric drugs kill.CHAPTER 9:PSYCHIATRIC COERCION AND RESTRAINTToday, psychiatrists’ use of physical and chemical restraints in mental institutions is a very lucrative procedure. Admitting that death is often inevitable from such procedures, psychiatrists literally get away with murder.CHAPTER 10:PSYCHIATRIC CRIMINALITYWorking in a “profession” made up of people who commit rape, extortion and fraud, many psychiatrists have received prison sentences and civil fines. Minimally, ten percent of psychiatrists sexually assault their patients, with one out of every twenty victims a minor.CHAPTER 11:INVENTING MENTAL ILLNESSPsychiatrists charge huge sums of money to insurance companies, governments and anyone else who will pay to “treat” made-up mental disorders.CHAPTER 12:KIDS IN PSYCHIATRY’S CROSS HAIRSMillions of children are given psychiatric labels for normal childhood behavior and prescribed psychiatric drugs that drive them to commit violent acts and suicide.CHAPTER 13:PSYCHIATRY: HIDDEN INFLUENCEPsychiatry has pushed its agenda of control, power and domination onto an unsuspecting society for over sixty years, infesting the fields of law enforcement, education, medicine, politics and many others.CHAPTER 14:CCHR: RESTORING HUMAN RIGHTS AND DIGNITY TO MENTAL HEALTHPsychiatrists act above the law—locking people up with no trial, stripping them of their human rights while enforcing unwanted treatments. The Citizens Commission on Human Rights has exposed, fought and won against psychiatry’s violations for over thirty-six years.PSYCHIATRY’S PRESCRIPTION FOR VIOLENCEDocumenting the impact of a multibillion dollar psychiatric-pharmaceutical industry, this powerful and graphic video contains interviews with experts, parents and victims. Dramatic recordings of actual 911 calls made by desperate family members—and even by a killer himself—convey the chilling reality behind today’s headlines. Here is the shocking truth underlying the current wave of violence devastating our homes, schools and communities.THE AGE OF FEARPsychiatry’s Reign of TerrorFrom instilling fear in asylum inmates with brutal treatments, to the modern application of restraint, senseless drugging and electroshock, psychiatrists have a long and hidden history of force, intimidation and outright terror.This is where Germany enters the picture, for it was here that psychiatry was born, here where psychiatry was nurtured and grew, and here where psychiatry would commit one of the world’s most horrific atrocities.Filmed in Germany and Austria, The Age of Fear contains shocking personal testimony and revealing inside footage that tell the true story of psychiatry, whose reliance on brutality and coercion has not changed since the moment it was born.THE HIDDEN ENEMY INSIDE PSYCHIATRY'S COVERT AGENDA“We have never drugged our troops to this extent and the current increase in suicides is not a coincidence.“Why hasn’t psychiatry in the military been relieved of command of Mental Health Services?“In any other command position in the military, there would have been a change in leadership.”– Lt. Col. Bart Billings, Clinical Psychologist U.S. Army Reserve, Ret.Today, with militaries of the world awash in psychiatry and psychiatric drugs, 23 soldiers and veterans are committing suicide every day. Psychiatrists say we need more psychiatry.But should we trust them?Or is psychiatry the hidden enemy?Featuring interviews with over 80 soldiers and experts, this penetrating documentary shatters the façade to reveal the real culprits who are destroying our world’s militaries from within.The most dangerous enemy is the one you never suspect…DIAGNOSTIC & STATISTICAL MANUAL: PSYCHIATRY'S DEADLIEST SCAMAn elaborate pseudoscientific sham...Its 943 pages long and lists out 374 mental “disorders.”It is the basis for the listing of mental disorders in the International Classification of Diseases that is used throughout the world.And though it weighs less than five pounds, its influence pervades all aspects of modern society: our governments, our courts, our military, our media and our schools.Using it, psychiatrists can enforce psychiatric drugging, seize your children and even take away your most precious personal freedoms.It is psychiatry’s Diagnostic and Statistical Manual of Mental Disorders, and it is the engine that drives a $330 billion psychiatric industry.But is there any proof behind the DSM? Or is it nothing more than an elaborate pseudoscientific sham?DEAD WRONG: HOW PSYCHIATRIC DRUGS CAN KILL YOUR CHILDFrom the makers of the award-winning documentaries Making a Killing: The Untold Story of Psychotropic Drugging and The Marketing of Madness: Are We All Insane? Comes this searing new documentary, exposing how devastating—and deadly—psychiatric drugs can be for children and families.Behind the grim statistics of deaths, suicides, birth defects and serious adverse reactions is the human face of this global drugging epidemic—the personal stories of loss and courage of those who paid the real price.Psychiatrists claim their drugs are safe for children?Once you hear what eight brave mothers, their families, health experts, drug counselors and doctors have to say instead, you will come away convinced of one thing…Psychiatrists are DEAD WRONG.THE MARKETING OF MADNESS:ARE WE ALL INSANE?The definitive documentary on psychotropic drugging—this is the story of the high-income partnership between drug companies and psychiatry which has created an $80 billion profit from the peddling of psychotropic drugs to an unsuspecting public.But appearances are deceiving.How valid are psychiatrist’s diagnoses—and how safe are their drugs?Digging deep beneath the corporate veneer, this three-part documentary exposes the truth behind the slick marketing schemes and scientific deceit that conceal a dangerous and often deadly sales campaign.In a bold and unprecedented move for any professional body, the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, issued a Position Statement today calling for the end of the unevidenced biomedical model implied by psychiatric diagnosis. The key message of the statement is:“The DCP is of the view that it is timely and appropriate to affirm publicly that the current classification system as outlined in DSM and ICD, in respect of the functional psychiatric diagnoses, has significant conceptual and empirical limitations. Consequently, there is a need for a paradigm shift in relation to the experiences that these diagnoses refer to, towards a conceptual system not based on a ‘disease’ model.”In brief, the argument is that the so-called ‘functional’ diagnoses – schizophrenia, bipolar disorder, personality disorder, ADHD and so on – are not scientifically valid categories and are often damaging in practice. The statement argues that we already have alternatives, such as psychological formulation, and that there is a need to work in partnership with service users and professional groups, including psychiatrists, in order to develop these further.The story made the front page of one of the UK’s best-known broadsheets, the Observer, sister paper to the Guardian, and there was a double-page spread inside (“Medicine’s big new battleground: does mental illness really exist?“, and “Psychiatrists under fire in mental health battle“). Within hours, over 500 comments (and counting) had been posted online, and the articles were being re-tweeted round the world. The articles quoted me, Professor Mary Boyle (author of ‘Schizophrenia: a Scientific Delusion?’) Eleanor Longden, researcher, campaigner and survivor, and Oliver James, psychologist and journalist, in support of the call for a non-medical approach to mental distress.Needless to say, there has been as much backlash as appreciation. Perhaps most predictably, Allen Frances, outspoken opponent of DSM-5, described the document (without having read it) as ‘extremist posturing by British Psychological Society, just as silly as DSM-5 and NIMH – why not a balanced biopsychosocial model’ (@AllenFrancesMD 12.5.13.) Many took advantage of a somewhat unhelpful online headline to dismiss the debate as inter-professional ‘turf wars’, while others accused the DCP of ignoring the role of biology.The actual statement makes it absolutely clear that these are misrepresentations. The DCP specifically states that ‘This position should not be read as a denial of the role of biology in mediating and enabling all forms of human experience, behaviour and distress.’ The statement also explicitly says that the argument is about ways of thinking, not about particular professions. The ‘turf wars’ accusation is particularly wide of the mark given that the DCP statement is simply a more measured reiteration of recent comments by some of the world’s most eminent psychiatrists: Allen Frances himself described DSM-5 as ‘deeply flawed and scientifically unsound’, while Dr Thomas Insel, NIMH director, said ‘Patients…deserve better’. Former NIMH director Dr Steven Hyman, was even blunter: he called DSM-5 ‘totally wrong, an absolute scientific nightmare’ and in response, the Chair of the DSM-5 committee, Dr David Kupfer, admitted “We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”The main difference – and of course it is a crucial one – between the position of these eminent psychiatrists and the DCP is that the former are determined to pursue the biomedical model at all costs. Indeed, NIMH has (as discussed on this site) announced the intention of launching a 10-year programme to pin down, once and for all, the elusive biomarkers that have evaded researchers so far. The project starts from the remarkably unscientific position of assuming what needs to be proved: in their words that ‘mental disorders are biological disorders.’ Flawed as this enterprise is, it will allow traditionalists to continue to claim that ‘We’re getting there – honestly!’ In the meantime, the overwhelming amount of evidence for psychosocial causal factors is once again relegated to a back seat.I was a member of the DCP working party which took 2 years to arrive, painstakingly and carefully, to this consensus statement. He believe there is nothing more important that a professional body can do than speak the truth about the evidence – and that is what this statement does. Nevertheless, given the nature of the issues, it is a brave move. He hope that other organisations will take heart – as they did from the original BPS response to the DSM-5 consultations in June 2011 – and join the DCP in calling for a more humane and evidence-based approach to mental distress.The British Psychological Society Condemns DSM 5But goes too far in trashing all of psychiatric diagnosisThe British Psychological Society (BPS) is a highly esteemed organization representing 50,000 members. Recently, it released an open letter to the American Psychiatric Association offering a harshly critical view of DSM 5. Most of the BPS criticisms are right on target, accurately pointing out the dangerous excesses of DSM 5. But some are so overly broad that the cogent points get lost in the shuffle, allowing the DSM 5 leadership to be archly dismissive of the entire letter. This is unfortunate because the BRS warning deserves serious consideration as we approach the endgame of DSM 5 decision making.The BPS is at its best when exposing those DSM 5 proposals that medicalize normal variability. It vigorously and convincingly opposes the DSM 5 tendency to turn the expectable reactions to life's difficulties (eg grief)into psychiatric illness. The letter rightly expresses particular concern about suggestions to include in DSM 5 the risk syndromes (eg psychosis risk) or the attenuated, milder forms of existing psychiatric disorders (eg mixed anxiety depression, mild neurocognitive, binge eating) .This portion of the BPS critique is crisply telling and completely true and goes to the heart of what is most wrong and most dangerous in DSM 5. Medicalizing normal experience stigmatizes and cheapens the human condition and promotes overtreatment with unnecessary and potentially harmful drugs. But the BPS critique goes too far and wide in denying the value of all psychiatric diagnosis.The most striking example is its seemingly blanket disdain applied equally for both schizophrenia and for 'psychotic risk syndrome' (lately in a name changing game aka 'attenuated psychotic symptoms'). The letter implies that these are more or less equally flawed and undeserving constructs. Most decidedly they are not. The BPS willingness to throw the valuable baby of schizophrenia out with the problematic bathwater of 'psychosis risk' reduces the force of its otherwise persuasive argument against the risky bathwater.Schizophrenia is admittedly a flawed construct with limited descriptive and explanatory power. It is a wildly heterogeneous with dozens of different presentations and probably hundreds of different causes (none of them known). This diverse group of schizophrenias contains within it a wide range of possible onsets, courses, severities, and treatment responses. There is no available biological test available for its diagnosis and none is on the horizon.All that said, schizophrenia remains a valuable diagnosis that economically captures a great deal of information and serves as a useful (if imperfect) guide to clinical care and research. The literature on schizophrenia accumulated over the past century is extensive and suggests at least the outlines of what we don't yet know. The BPS criticizes schizophrenia as a construct, but offers no viable alternative.In contrast, 'psychosis risk' is a relatively newcomer whose properties remain quite unknown. We don't know how best to define it, can't diagnose it accurately, don't know how to treat it, don't know if treating it has any lasting value, and don't know the extent of its harmful unintended consequences if it were to be made official.Most telling of all is the widespread opposition to including psychosis risk syndrome as an official diagnosis in DSM 5 even among those who have devoted their careers to researching it. The tipping point was reached recently when two of the most prominent promoters of psychosis risk (Patrick McGorry and Alison Yung) withdrew their support for its inclusion in DSM 5 and asserted publicly that it will not be included in Australia's ambitious new mental health program that is targeted at treating early presentations of schizophrenia.It is now only the DSM 5 diehards who are still hanging fast to the "psychosis risk" bandwagon- but unfortunately it is they who hold the final casting vote. The BPS is doing a great service in entering this fray and adding its strong voice to the diverse chorus trying to prevent this travesty. But BPS dilutes its valuable message when it simultaneously attempts a takedown of the venerable concept of schizophrenia (especially when there really is no currently available diagnostic alternative).Psychiatric diagnosis is admittedly imperfect, but also absolutely necessary; extremely easy to criticize, but so far impossible to replace. It gives comfort to the misguided DSM 5 workers (and protection for their worst ideas) if outside critiques can be dismissed by them as "antipsychiatry" broadsides. DSM 5 deserves and badly needs searching and sustained outside criticism, but this will be most effective if targeted to its numerous, egregious, and specific defects, not to the whole enterprise of psychiatric diagnosis.MAKING A KILLING:THE UNTOLD STORY OF PSYCHOTROPIC DRUGGINGPsychotropic drugs. It’s the story of big money—drugs that fuel a $330 billion psychiatric industry, without a single cure. The cost in human terms is even greater—these drugs now kill an estimated 42,000 people every year. And the death count keeps rising. Containing more than 175 interviews with lawyers, mental health experts, the families of victims and the survivors themselves, this riveting documentary rips the mask off psychotropic drugging and exposes a brutal but well-entrenched money-making machine.Who are the Organizers?The International DSM-5 Response Committee is sponsored by Division 32 of the American Psychological Association—the Society for Humanistic Psychology [http://www.apadivisions.org/division-32/index]. The Committee is comprised of leaders in the mental health field within the United States, the United Kingdom, and across the globe.Appointed by Louis Hoffman, Ph.D., President of the Society for Humanistic Psychology, the International DSM-5 Response Committee is Co-Chaired by Brent Dean Robbins, Ph.D., who is President-Elect of the Society for Humanistic Psychology and Director of the Psychology Program at Point Park University, and Peter Kinderman, Ph.D., who is Professor of Clinical Psychology at University of Liverpool, UK.Dr. Kinderman helped to develop the British Psychological Society’s critique of the proposed DSM-5 in the Spring of 2011. The document raised serious concerns about numerous proposals by the DSM-5 Task Force.The BPS’s seminal document inspired the “Open Letter to DSM-5” petition which was sponsored by the Society for Humanistic Psychology in August 2011. This document, co-authored by Sarah Kamens, M.A., Brent Dean Robbins, Ph.D., and David Elkins, Ph.D., and edited by Kevin Keenan, Ph.D., was published on the internet. Division 27 (Society for Community Research and Action: Division of Community Psychology) and Division 49 (Group Psychology and Group Psychotherapy) were the first organizations to sign on to the petition. Within months, over 50 national and international organizations endorsed the petition, and the petition was signed by over 14,000 individuals, primarily mental health professionals. The Open Letter Committee was composed of David Elkins (Chair), Frank Farley, Jonathan Raskin, Brent Dean Robbins, Donna Rockwell, and Sarah Kamens. Latest figures on the “Open Letter” are available on the petition website. [http://dsm5-reform.com]When the American Psychiatric Association refused to submit the DSM-5 to independent review, and when the DSM-5 Task Force decided to move forward with publication without addressing most of the concerns of the “Open Letter,” the good faith effort of the “Open Letter” came to an end.The International DSM-5 Response Committee is a broad coalition of leaders who have independently led groups in opposition to the DSM-5. They are gathered under one umbrella to bring a show of force and influence as the publication of the DSM-5 occurs in the Spring of 2013. The aim of this Committee is to foster consciousness raising about problems with the DSM-5 in order to alert professionals and consumers about some of the dangers of the new manual. The hope, too, is that an international conversation can bring to light real, potential alternatives that work.Brent Dean Robbins, Ph.D.Co-Chair, International DSM-5 Response CommitteePresident-Elect, Division 32 of APA—Society for Humanistic PsychologyDirector of Psychology and Associate Professor, Point Park UniversityContact: [email protected] Kinderman, Ph.D.Co-Chair, International DSM-5 Response CommitteeProfessor of Clinical Psychology, University of Liverpool, UKContact: [email protected] MembersRichard Bentall; Professor of Clinical Psychology, University of Liverpool, UKMary Boyle; Emeritus Professor of Clinical Psychology, University of East London, UKPat Bracken; Consultant Psychiatrist and Clinical Director of Mental Health Services, West Cork, EireJoanne Cacciatore; Assistant Professor; Arizona State University School of Social Work, USATim Carey; Associate Professor, Flinders University, AustraliaDavid Castle; Professor of Psychiatry, University of Melbourne, AustraliaJack Carney; Licenced Psychologist, Alabama, USAAnne Cooke; Clinical Psychologist, Canterbury Christ Church University, UKJacqui Dillon; Chair; Hearing Voices Network, UKSuman Fernando; Honorary Professor in the Faculty of Social Sciences and Humanities, London Metropolitan University, London, formerly consultant psychiatrist, UKDaniel Fisher; Consultant Psychiatrist, National Empowerment Centre, USADave Harper; Reader in Clinical Psychology, University of East London, UKLouis Hoffman; Continuing Education Coordinator, Society for Humanistic Psychology, USALucy Johnstone; Clinical Psychologist, Bristol UKDayle Jones; Associate Professor, University of Central Florida, USASarah Kamens; Society for Humanistic Psychology, USAPeter Kinderman; Professor of Clinical Psychology, University of Liverpool, UKPatrick Landman; Psychiatrist and Psychoanalyst; Paris, FranceEleanor Longden; Psychologist, London UKJason McCarty; Psychotherapist, British Columbia, CanadaNancy McWilliams; Psychologist and Psychoanalyst, Rutgers University, USAGordon Milson; Clinical Psychologist, Manchester, UKSharna Olfman, Ph.D., Professor of Psychology, Point Park UniversityBradley Olsen; President-Elect, Division 48 of American Psychological Association; President, Psychologists for Social Responsibility, Chicago, USAAna Padilla; University College London, London UKRichard Pemberton; Chair, British Psychological Society Division of Clinical Psychology, UKDave Pilgrim; Professor of Health and Social Policy, University of Liverpool, UKJohn Read; Professor of Clinical Psychology, University of Auckland, NZMelissa Raven; Research Fellow, Flinders University, AustraliaDonna Rockwell, Ph.D., Michigan School of Professional PsychologyBrent Robbins; President, Society for Humanistic Psychology, Div32 American Psychological Association, USADave Traxsom; Educational Psychologist, UKSara Tai; Senior Lecturer in Clinical Psychology, University of Manchester, UKPhil Thomas; Honorary Visiting Professor, University of Bradford, formerly consultant psychiatrist, UKSam Thompson; University of East London, UKSami Timimi; Consultant Psychiatrist, UKSteve Trenchard; Chair of ISPS UK (International Society for Psychological and Social Approaches to Psychosis), UKMartin Whitely; MLA, Parliament of Western Australia, AustraliaWhat is forced psychiatry?Forced psychiatry, also known as 'involuntary psychiatry', 'psychiatric commitment', 'involuntary treatment', 'forced treatment', 'assisted treatment', 'court ordered treatment', 'sectioning', 'psychiatric hold', is the forced imposition of psychiatric interventions upon an individual by the government, against the will of the person targeted. Forced psychiatry has a long and grisly history dating back a couple hundred years that most people are aware of, but today, in the modern era, this controversial government practice hides in the shadows. Behind the closed doors of psych wards, government mental health system workers carry out violent forced 'treatments' against the will of those that are undergoing mental and emotional crises. To add to the silence, the stigma of being labeled a 'mental patient' and the trauma from these horrific experiences at the hands of the system prevents more people speaking out and fighting for their rights. Many forced into psychiatry have died at the hands of the system. While forced psychiatry may be an issue society would rather keep hidden and not talk about, this doesn't make this controversy any less real, as millions of people worldwide have had psychiatry forced on them. We envisions a society where people no longer have to live in fear of psychiatry being forced on them, where human rights apply to all humans, not just those without psychiatric diagnoses.Why is forced psychiatry so controversial?Nobody denies that people can become very overwhelmed with life, and experience extreme states of mind or exhibit problematic thoughts, feelings and behaviors. Everybody at some point in their lives needs support, and anybody can undergo a crisis, or periods of overwhelm that would get labeled 'madness', or 'psychosis', or 'mental illness'. Growing numbers of people who've experienced these states of mind first-hand, and growing numbers of innovative mental health professionals, are beginning to see that society's response to these problems has been part of the problem, not part of the solution.More and more people are coming to see the importance of freedom of choice not only in the solutions to mental or emotional problems, but the importance of individuals having the freedom to develop their own interpretation of their problems, even if that interpretation is at odds with the interpretation put forward by psychiatry. Any reasonable person will admit that labels of 'mental illness' are subjective, not objective, and that psychiatry, the dominant profession in this area, is an inexact science. Many would be aware also of the growing body of evidence that psychiatric drugs do cause damage to the brain and body when used long term, and do come with all sorts of risk/benefit trade-offs. Forced psychiatry is controversial because it imposes, by force, a choice made by others on the individual who is going through a crisis, this represents government forcing its interpretation of the person's problems on them, and most brutally of all, forcibly altering that person's body against their will. Forced psychiatry represents the ripping away of choice in what treatment a person may want, what interpretation of their problems they may have, and what solutions that person may seek to their problems.Keep scrolling down to go straight to videosForced psychiatry represents government making the assumption that drug-based psychiatry is the 'only way' to be responding to the disparate problems that get labeled 'mental illness'. Forced psychiatry in a very real sense, hands the profession of psychiatry a state enforced monopoly on human emotional and mental overwhelms. But if we admit psychiatry is subjective, possesses no biological objective medical tests to prove its assertions that those it labels mentally ill have bona fide 'brain diseases', then it becomes orders of magnitude more controversial that government is granting this profession the power to enter your body by force, against your express wishes.Even doctors who can prove genuine bodily diseases with objective science, like heart surgeons do, don't have the power to forcibly meddle inside your body. Yet this profession of psychiatry has reserved the right to force itself into your brain, this is at odds with every modern human rights ethic, and must come to an end.Forced psychiatry usually involves the targeted person losing their right to own their own body. This can be a life destroying experience, and is experienced by many survivors of it, as torture. The United Nations Special Rapporteur on Torture agrees, and has as recently as 2013 called for the abolition of forced psychiatric interventions, as you'll see in video below.There can be no doubt, to reiterate, that people in mental distress and crisis can present challenges for those around them, but We believes there is always a way to respond to our fellow human beings who are in crisis without ripping away their dignity and human rights. Sadly, across the world, mental health systems respond not with compassion and a range of choices and approaches and paradigms, but with a monopolized, psychiatric drug based paradigm, rooted in the theoretical 'medical model' of psychiatryMillions of people around the world find mainstream psychiatry's drugs, labels and interpretations of their problems compelling and even helpful, we acknowledges this.It can be difficult for people to understand why others would object to having a popular chosen creed of 'mental help' forced upon them. We are not against voluntary psychiatry, if you've found a solution that you've found helpful in your life, then we are very happy to hear it. Allowing government to force psychiatric drugs on your neighbors, however, becomes a whole different controversy.Stripping basic human rights from people labeled 'mentally ill' is nothing new, governments, societies and those who choose to work in psychiatric wards have been dehumanizing 'involuntary patients' for generations. In fact, hundreds of thousands of people with psychiatric labels and other disabilities were murdered in the Holocaust. For generations, forced sterilization programs existed in western countries targeting those labeled 'mentally ill', only being abolished as recently as the 1970s. But societies still haven't got used to the idea of extending equality to those considered 'mentally ill'. Around the world, laws are on the books in most states and provinces that make it legal for psychiatrists and their staff to forcibly drug and forcibly electroshock people. Even a forced 'diagnosis' can change the course of a life. Reaching out for help from the mental health system often comes at the cost of your basic rights, and many live in constant fear of being assaulted by the coercive and violent procedures that are central to modern forced psychiatry.It is our position that nobody deserves to have their body assaulted by forced psychiatric drugging or forced electroshock. The drugs or 'medications' used in forced drugging are brain function disabling tranquilizer drugs, and although they go by the name 'antipsychotics', these drugs do not target or correct any biological abnormality that psychiatry can demonstrate or prove exists inside the 'patient'. They also come with massive side effects. It is clear that for expediency, to control people, these drugs are being used as chemical restraints, not as bona fide medicines. This is deeply inhumane, and a gross violation of human rights and the Hippocratic Oath. It is our position that chemical restraint, forced sedation, forced drugging, the coercive administration of psychiatric drugs, is a grossly invasive, cruel and unusual, decimation of the human right to bodily integrity. In all situations, in all cases, it is excessive force, excessively invasive, humiliating, and profoundly violent and traumatizing. It is our position that there is always a way to humanely deal with our fellow human beings no matter how distressed they may be.People forced into psychiatry are overwhelmingly innocent people, very few are criminals, yet these law abiding people lose more human rights than even a convicted criminal loses in a super-max prison. Those targeted for forced psychiatry lose the right to own their own body. Forced psychiatry is often described by many survivors of it, as being experienced as a kind of biological rape. These practices are not 'help', they are human rights abuses. Forced psychiatry represents dehumanizing the most distressed and overwhelmed individuals in society, during their weakest moments of life. In mistaking violence for 'help that people need' we as a society have committed atrocities for too long against those who are at their weakest. Forced psychiatry often drives people to suicide, traumatizes people for life, and crushes their sense of humanity and dignity. There are better ways to help. And if you take the time to thoroughly explore the website you will learn about the growing movement that fosters innovative alternative approaches to these problems.The UN says forced psychiatry is 'torture'Did you know that the United Nations' top torture monitor has recently spoken out against forced psychiatry?In a statement to a session of the United Nations Human Rights Council in Geneva in March 2013, the U.N. Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment of Punishment called for a ban on forced psychiatric interventions including forced drugging, shock, psychosurgery, restraint and seclusion, and for repeal of laws that allow compulsory mental health treatment and deprivation of liberty based on disability, including when it is motivated by “protection of the person or others.”Says the U.N.: “Deprivation of liberty on grounds of mental illness...that inflicts severe pain or suffering falls under the scope of the Convention against Torture.”We knows that many people both in the United States and abroad are being forced to have drugs put in their bodies against their will, even, shockingly, in their own homes under so called 'community' involuntary psychiatry orders. In many communities around the world, people are having their basic human right to self-determination and bodily integrity ripped away from them by violent mental health laws that crush dignity and hope. In many countries citizens targeted for forced psychiatry are denied even a court hearing. You can help we bring this tragedy out of the shadows, and if you are in need of protection from forced psychiatry, joining we may help you protect yourself against unwanted psychiatric intervention in your life and body. In a hostile world where the government thinks human rights abuses are 'help', you must plan for the future as best you can, by arming yourself with information and allies in the fight for human rights in the mental health system.Those who have forced psychiatry on their records, lose many rights for the rest of their lives. People who have been 'involuntary patients' are many times, often denied the right to own firearms, serve their nation as elected officials or serve in the military, serve in the intelligence community or defense industry in roles requiring a security clearance working with secret information, work as pilots, and many other career dreams destroyed by the decision made by others, to force a person into psychiatry. You can also lose the right to get travel or immigration visas to certain countries.Having been an 'involuntary patient' in the past makes it easier for this status to be forced on you in the future. Your status as an 'involuntary patient' can be used as part of efforts to strip custody of your children from you, and to prejudice divorce and property settlement proceedings. Health insurance rates in some countries can be higher for people who have been in forced psychiatry. Even when you've passed away, your involuntary patient status may be used to contest your will. The complete list of lifelong devastating effects of being forced into psychiatry is too long to completely list here, it just goes on and on. Millions of people since psychiatry was first handed these powers by government, have been forced to live lives of humiliation and fear. Millions of people, over many generations, have had their lives and bodies mangled and blighted by forced psychiatry. Survivors of it are forced to live in fear for the rest of their lives, fear that they may one day be targeted against their will for such 'help'. Can YOU be sure that if you ever had a mental crisis, that YOUR life would not be destroyed? Would you trust your loved one's life to forced psychiatry?We believe in the dignity and VOICE of every human being, no matter how mentally or emotionally distressed, and we understand from firsthand experience that brutality in the name of psychiatric treatment is a horrific and deeply degrading practice that must end. We all have the right to CHOICE and true, informed consent in mental health care.We stands in solidarity with the United Nations’ pronouncement that “free and informed consent should be safeguarded on an equal basis for all individuals without any exception… provisions allowing confinement or compulsory treatment in mental health settings must be repealed.”We are dedicated to fighting for the right of all people globally to be free from unwanted psychiatric labeling, drugging, and intervention.'Schizophrenia' label for the 'crime'It is a crime against humanity to give a profession of pseudoscientific neo-phrenologists the unlimited right to forcibly rape the brains of any human being in society they choose to label and smear, as with 'schizophrenia' label for the 'crime' of daring to experience extreme states of mind.This label decimates the humanity and equality of millions of people who have had this label put on them, usually forcibly, in a relationship with a quack psychiatrist forced on them by the 'mental health' laws. The destruction this label has caused is up there with the worst of racism and prejudice in human history. Psychiatry as usual, needs to hang its head in shame. Some people have extreme emotional problems, true; some people believe things that are not believed by all others, true. This is not a disease.These problems that people have are unique to the person and not the same as the next person's and not able to be correctly brought under the one umbrella term, the same pathetic psychiatry invented label. Any time you use the label 'Schizophrenic' to define a person you are guilty of assaulting that person's humanity. They are a person, who has had problems, and a quack profession which has discovered nothing at all about anybody's biology has put a label on them, and how dare you call them by that label that they didn't even ask for, wanted no part of, yet was forced on them by the government. How dare you. How dare you even call yourself someone who has concern for people with personal problems if you're willing to decimate their lives by forcing toxic drugs and quack labels on them?So many people in the psychiatric profession need to go to prison and be tried for crimes against humanity. How dare anybody be so arrogant as to put a label on somebody against their will? For shame.Concerns about ‘schizophrenia’ diagnosisThe use of ‘schizophrenia’ to describe problems of living is problematic for several reasons:1. ‘Schizophrenia’ does not seem to mean much (as an explanation for mental health problems) too many service users/survivors or their careers, relatives and friends.2. There are historical problems with the diagnosis, which originated 100 years ago at a time when psychiatry was dominated by racist thought, even more than it is today. It grew out of the 19th century idea of ‘degeneration’ which influenced eugenic theory and practice.3. The diagnosis of ‘schizophrenia’ has not proved useful as a basis for research into understanding mental health problems from a biological viewpoint. Its use in international study has confused rather than clarified issues around therapy for, and outcome of, mental health problems.4. In psychiatry, the use of powerful medication is not necessarily related to a diagnosis of ‘schizophrenia’. So the separation of the ‘schizophrenia’ diagnosis from drug treatment would make the use of medication more transparent, thus reducing its abuse.5. When looked at transculturally, ‘schizophrenia’ does not stand up as a useful way of identifying people with problems of living even when these are conceptualized as ‘mental’ ill health. For example, the experience of hearing voices is widely considered to be a symptom of ‘schizophrenia’, but many cultures see it differently, sometimes as a spiritual experience.6. When ‘schizophrenia’ as a diagnostic concept is used in a multi-ethnic setting, many problems emerges; in Britain it has become conflated with racist oppression, raising questions about the racist nature of the diagnosis itself along with psychiatric stigma.Mainstream Media Ignoring Psychiatric Crimes against HumanityHow can we, as a society claiming to be ‘evolved’ and civilized, continue to overlook the blatant misrepresentation of the facts regarding mental illness, psychopharmacology and conventional treatments of those suffering from normal emotional struggles? Hundreds of landmark criminal and civil cases and scientific studies have proven that psychiatric treatments of emotional issues are nothing more than wholesale crimes against humanity.Psychiatric Drug Interventions Kill and MaimCountless investigations are showing that shooting rampages are linked to psychiatric treatments…killers literally driven mad by treatment! Despite all this readily available information, mainstream media never refer to the countless scientific studies, court cases and psychiatric patient databases since 1970 proving that:• The DSM is a manual of fiction wherein all diagnoses are voted in or out on the whim of a handful of psychiatrists. Nudism, homosexuality and even wanting to run away from slave masters were ‘mental illnesses’ treated with drugs and lobotomies, until they were voted ‘out’ later. Diagnoses ‘point’ to nothing at all; they are created to facilitate insurance payments and legitimize the sale of the equivalent of street drugs. A patient is stuck with one for life, while studies show diagnoses actually worsen outcomes;• Not one single so-called mental illness is backed by scientific evidence of any kind, making psychiatric diagnoses nothing more than ‘opinions’ and moral judgments. Further, not one psychiatric drug has ever been proven to cure anything, but most, if not all, have been proven to do brain damage over time;• all psychiatric treatment, including electroshock and drugs, is designed to disable the brain…they are indisputably electrical and chemical lobotomies;• Many legitimate and peer-reviewed studies have proven that the brains of those diagnosed with depression, schizophrenia and all the other so-called mental illnesses DO NOT have brain abnormalities, chemical imbalances or any other pathology. However, once treated with psychiatric drugs, within a few short weeks and in some cases, after a few doses, the brains so treated with these drugs start to show objective evidence of brain disablement, particularly in the pre-frontal cortex, eventually leading to Parkinsonian tremors, severe hostility, emotional blunting and that is for starters;• The story of a chemical imbalance of depression is just that, a proven pharmaceutical marketing story with no legitimate scientific evidence to back it. Depression remains undefined, allowing doctors to treat concussions, brain injury (such as undetected shrapnel), painful menstruation, chemical toxicity and other physical issues as ‘mental illness’ in need of antidepressants;• all so-called ‘mental illnesses’ are nothing more than emotional hardship that many studies and institutions such as Soteria Project and the Quaker Hospitals have shown resolve within six months to a year with empathic therapy and lifestyle changes (including dietary), with few, if any relapses. Once treated with psychiatric drugs and electroshock, the patient is almost certain to have life-long bouts of drug-induced depression and psychosis and end up on disability, if not having committed suicide;• Since the advent of psychiatric treatment, disability in children and adults has increased 8-fold and the leading cause of addition in North American is now to prescription psychiatric drugs as patients are never told many of these drugs are more addictive than heroin. We thus have an epidemic of suicide and homicide directly linked to the use of psychiatric drugs and withdrawal.Mainstream Media Ignores Work of Ethical Doctors and Researchers, but Support Pharmaceutical PropagandaCourt-certified mental health experts such as Dr. Peter Breggin –- who has not only been pivotal in international landmark criminal and civil cases against psychiatry and Big Pharma, but who has written countless books such as medication Madness and Toxic Psychiatry — are rarely if ever interviewed by mainstream media.Many other ethical doctors, researchers and scientists who have compiled overwhelming documentation of the fraud that is psychiatric treatment and drug therapy are routinely ignored by the ‘don’t kill the mental health golden goose’ crowd who prosper from the victimization of the emotionally vulnerable.We continue to hear the propaganda of those who still push the status quo, as our society drowns in permanently damaged survivors of psychiatric treatments, while other dignified, effective treatments for sadness, anxiety, shyness, grief and fears, such as hypnotherapy, go unmentioned and suppressed, despite these treatments being praised by institutions such as the Mayo Clinic.Clinical Hypnotherapists have helped many mental health clients recover from their original emotional difficulties safely, only to watch them struggle to cope with the severe drug withdrawals and physical drug-induced damage for months thereafter.We must demand that the media let the public hear from the real experts – the ones who have been calling for a banning of psychiatry since 1970 and especially the banning of psychiatric treatment of children for normal childhood reactions to life’s bumps and bruises, and especially from the ones who have SCIENTIFICALLY proven that it is the conventional mental health treatments that are causing the epidemics of mental illness?Why Mental Illness is an Epidemic in the WorkplaceHow can we, as a society, continue to overlook the blatant misrepresentation of the facts regarding mental illness, psychopharmacology and conventional treatments of employees suffering normal emotional responses to intolerable work situations?Hundreds of landmark criminal and civil cases and scientific studies have proven that psychiatric drug treatments of emotional issues are nothing more than a wholesale crime against humanity and in practically all cases worsen outcomes. Countless investigations are showing that shooting rampages are linked to psychiatric treatments…killers driven mad by treatment. Now we are seeing the carnage reported as an epidemic of workplace disability that is threatening Canada’s economic potential (Financial Post, Mental Illness Adversely Affecting Canada’s Economic Potential).Rarely do professionals refer to the countless scientific studies, court cases, and psychiatric patient databases since 1970 proving that:(a) Since society’s reliance on psychiatric treatment of ‘mental illness’ has increased, disability has sky-rocketed because conventional treatment typically worsens employees situations over time. Since the advent of psychiatric treatment, disability in children and adults has increased 8-fold and the leading cause of addiction in North America is now prescription psychiatric drugs as patients are never told many of these drugs are more addictive than heroin. We have an epidemic of suicide and homicide directly linked to the use of psychiatric drugs and withdrawals;(b) all mental illnesses are nothing more than emotional hardships and unproductive reactions to life’s stressors that many studies and institutions such as Soteria Project and the Quaker hospitals have shown resolve within 6 months to a year with empathic therapy and lifestyle changes (including dietary), with few, if any relapses. Once treated with psychiatric drugs and electroshock, the patient is almost certain to have life-long bouts of drug-induced depression and psychosis and end up on disability, if not having committed suicide;(c) The DSM has been scientifically proven to be a manual of fiction wherein all diagnoses are voted in or out on the whim of a handful of psychiatrists. Nudism, homosexuality and even wanting to run away from slave masters were ‘mental illnesses’ treated with drugs and lobotomies, until they were voted ‘out’. Diagnoses are created to facilitate insurance payments and legitimize the sale of the equivalent of street drugs; a patient is stuck with the label for life despite countless studies showing diagnoses actually worsen outcomes;(d) not one single so-called mental illness is backed by scientific evidence of any kind, making psychiatric diagnoses nothing more than ‘opinions’ and moral judgments; further, not one psychiatric drug has ever been proven to cure anything, but all have been proven to do brain damage over time; millions of employees are showing up at work in a fog caused by psychiatric drugs, or in withdrawal distress as they try to wean off these drugs;(e) All psychiatric treatment, including electroshock and drug, is designed to disable the brain…they are indisputably electrical and chemical lobotomies;(f) Countless studies have proven that the brains of those diagnosed with depression, schizophrenia and all the other so-called mental illnesses DO NOT have brain abnormalities, chemical imbalances or any other pathology. However once treated with psychiatric drugs, within a few short weeks and in some cases, after a few doses, the brains so treated to these drugs start to show objective evidence of brain disablement particularly in the pre-frontal cortex, such as poor memory, agitation and reduced ability to learn complex tasks, eventually leading to Parkinsonian tremors, severe memory problems, tardive dyskinesia (tics), cardiovascular, kidney and liver diseases, hostility, emotional blunting and that is for starters;(g) The story of a chemical imbalance of depression is just that, a proven pharmaceutical marketing fabrication with no legitimate scientific evidence to back it. Depression remains undefined and does not typically resolve once a person is treated with drugs;Courts Now Finding that Mental Illness Treatments Cause Violent Behaviors and Worsening OutcomesCourt certified mental health experts such as Dr. Peter Breggin – who has not only been pivotal in international landmark criminal and civil cases against psychiatry and Big Pharma, but who has written countless books such as Medication Madness and Toxic Psychiatry, and so many other ethical doctors, researchers and scientists who have compiled overwhelming documentation of the fraud that is psychiatric treatment and drug therapy – are ignored by the ‘don’t kill the mental health golden goose’ crowd who prosper from the victimization of the vulnerable.Despite all the evidence, we continue to see mainstream media advance the propaganda of those who still push the status quo, as our society drowns in permanently damaged survivors of psychiatric treatments, while other dignified, effective treatments for sadness, anxiety, grief and fears such as hypnotherapy go unmentioned, despite these treatments being praised by institutions such as the Mayo Clinic.Workplace Stress is NOT Mental IllnessAs a Clinical Hypnotherapist who has helped many employees from all walks of life recover from their original emotional issues safely, only to watch them struggle to cope with severe drug withdrawal and physical damage for months, He have to ask when the media will let the public hear from the real experts…the ones who have been calling for a banning of psychiatry since 1970 and especially the banning of psychiatric treatment of children … the ones who have scientifically proven that it is the conventional mental health treatments that are causing the epidemics of mental illness and the imploding of our health care system?Do you feel that employers would be very wise to financially support employees who want to search out safe, dignified treatment modalities for mental illnesses and unproductive reactions to job stresses?Mental Illness: The Truth, the Whole Truth and Nothing but the Truth!To get healthy and stay healthy, you need the truth … the truth about what is in your water, your food and especially how your mind is conditioned. When clients struggling with mental illness seek my clinical hypnotherapy assistance to turn their emotional and physical health around safely we start with the facts:• Conventional medicine is not about ‘curing’ or ‘healing’; it is designed to suppress symptoms, which inevitably rise up as something worse later;• The medical-pharmaceutical complex is engaging in extraordinary levels of medical fraud, misrepresentation of facts, willful negligence, manipulation of clinical trials, control of mainstream media, manufacturing of mental illness, suppression of legitimate health information, ghost-writing and collusion – the result is that experts have deemed much of the information in ‘esteemed’ medical journals worthless and dangerous;• Mainstream medical information is controlled by Big Pharma – natural healings of cancer, mental illness and catastrophic illnesses are censored;• Mental illness is not brain disease. Brain disease has objective scientific evidence; ‘mental illness’ is nothing more than opinion with nothing to back it up. Mental illness is a term conjured up entirely by psychiatrists to meet the needs of pharmaceutical companies to sell illness-causing drugs. Further, diagnoses are ‘voted’ in and out on the whim of psychiatrists and drug companies – not a single mental illness is backed up by science;• According to psychiatrists, normal human emotion and reaction is mental illness and everyone needs to be ‘treated’. The conventional treatment for normal human emotions results in worsening conditions and epidemic levels of disability;• SWAG – (Scientifically Wild-Assed Guess) = the way psychiatry operates;• The brain is not the center of emotion; it reacts to emotions. He know of no one who has ever experienced a brain-break when hurt, betrayed, abandoned, neglected, abused, etc., but everyone has experienced heartbreak;• TV is the most powerful hypnotizer in the world; the timing, repetition and placing of commercials together with fear-mongering results in extreme consumer conditioning, especially toward pharmaceutical drugs;• Psychiatric drugs DO NOT heal or cure anything; they are designed to chemically lobotomize the human brain (pre-frontal cortex) to make the patient more compliant;• No one diagnosed as mentally ill ever starts off with a damaged brain. There is brain damage only after electro shock therapy and psychiatric drug treatment;• There has never been an objective finding of brain damage or chemical imbalance in the brains of the mentally ill, including schizophrenics and those suffering depression, OCD, panic, bipolar, ADHD, and anxiety. The notion that mental illness is caused by an imbalance in serotonin, dopamine or other brain chemicals was dispelled over 50 years ago, but doctors and pharmaceuticals still widely promote what they know to be absolutely false to sell drugs;• Bipolar was extremely rare prior to drug therapy and unheard of in children; today, drug treatment of depression has created an epidemic of drug-induced bipolar in adults and children;• Prior to drug therapy for depression and schizophrenia, a large majority of patients became well and returned to normal life after 6-12 months, rarely relapsing. Violence was extremely rare. Psychiatric treatment now causes them permanent disability and violence against self and others is epidemic;• GMO foods are linked to obesity, gastrointestinal issues in epidemic proportions; vaccines contain mercury causing neurotoxicity, especially in children; previously unheard of ‘autism’ is now turning up in epidemic numbers; antibiotics are linked conclusively to horrific new superbugs and depression – yet these feelings of being physically run down are called mental illness;• Reliable studies show that conventional treatments of mental illness are often useless, many resulting in catastrophic illnesses. Cancer was rare 50 years ago – now, we have an epidemic of new cancer types. Studies show that radiation and chemo treatments provoke more cancer and sexual dysfunction. Sexual dysfunction is surely to make a person feel sad, frustration and angry, but these natural reactions are labelled mental illness;• Big Pharma spends 66% of research funds on marketing, 33% on drug research. Nothing goes to alternative treatment research for despite statistics showing zero improvement in cancer survival rates in 60 years and worsening disability in the mentally ill; and• Homeopathy has been proven to be a most cost-effective, safe healing mechanism, with the elites around the world such as Rockefellers, the British Royals and countless celebrities and wealthy becoming life-long proponents. Kate Middleton, now wife of Prince Andrew resolved her severe and rare morning sickness issue with hypnotherapy. Bet that you didn’t hear that fact repeated in mainstream media!Recommendations on How to Get and Stay HealthyAccept full responsibility for your health;• TV is a poor source of reliable health information. Ditch it! Access responsible, independent sites such as NaturalNews.com, WDDTY.com and read Dr.Mercola, Dr. Wakefield, Dr. Breggin, Robert Whitaker, Irving Kirsch, Jeffrey Smith and other ethical scientists and doctors. Seek naturopathic/homeopathic/ hypnotherapeutic modalities for mind and body wellness;• Beware fear-mongering tactics; avoid ‘preventative’ surgical & drug treatments;• Avoid psychiatric drugs, electroshock and lobotomies that seek to cause your brain to malfunction. Psychologist Bruce Levine advises to keep kids away from psychiatric drugs and labeling; Dr. Peter Breggin advises everyone to avoid psychiatric drugs of all kinds;• Avoid all GMO foods, seek out organics, especially locally grown organics; if they weren’t hiding something, they wouldn’t mind labeling their products would they?• Learn to prepare meals…fast food can be healthy, cost effective and fun;• Remember that every living person experiences emotional issues sometimes; they can be resolved safely with the help of a qualified hypnotherapist; and• Remember that for every drug, conventional diagnostic tool, vaccine, antibiotic and diagnosis, there is a natural, cost-effective, safe alternative that won’t make you into a life-long medical case.My Humble Opinion on How to Heal from Mental IllnessTaking control of one’s life and health might seem frightening, but it’s a lot more frightening to be ill of something preventable. In 2011, over 150 million North Americans turned to alternatives to save themselves.David Russell said: ‘The hardest thing to learn in life is which bridge to cross and which to burn”. To thrive it seems we have to burn the bridge to conventional medical treatments, especially for mental illness, because they are designed to satisfy the drug companies, not the patient. After all, how many more man-made epidemics, especially in children, can we stand?On the Psychiatric Drugging of Children:Child advocates around the world are calling for a ban on the psychoactive drugging of children. Psychiatric drugs are not approved for use in children…they are prescribed off-label. These drugs are damaging millions of children. Can we continue to allow this?WARNING: never stop taking psychoactive drugs abruptly.The Effects Psychiatric Drugs Have on ChildrenMedicated children may be quieter for a while, but they often endure daily headaches, withdrawal symptoms, nausea and stomach cramps, suicidal thoughts, diabetes, stroke, depression, mania and hallucinations. Children routinely report feeling empty and unable to feel interest in anything. Most develop chronic physical health problems, stunting, obesity and uncontrollable muscular tics and movements. Many end up suffering irreversible drug-induced-polar disorder, as well as permanent emotional blunting.Every month four North American children die from psychiatric drug side-effects; every week a child commits suicide attributed to psychiatric drugs. In 2011, a Winnipeg Judge put the blame for the stabbing of a teenager by his friend squarely on the drug Prozac. At least 14 of the last 18 shooting rampages in the US are linked to psychiatric drug use…in the other 4 cases the information is kept secret.Researchers have shown repeatedly that there is no scientific support for any ‘mental disorder or illness’; they are voted in or out! The diagnosis of ADD/ADHD by the psychiatric profession is based on voodoo science, fraudulent clinical trials and misleading pharmaceutical marketing practices, the scale of which is unprecedented and well documented. (The ADHD Fraud by Fred Baughman).Prescription drug addiction is now the most serious addiction issue in North America. More children have become drug addicted, brain damaged, stunted in growth and permanently disabled by pharmaceutical drugs then from any other cause. (Anatomy of an Epidemic, the Emperors New Drugs by R Whittaker and Commonsense Rebellion by Bruce Levine).Bruce Levine, renowned psychologist and author, also advises parents to avoid any doctor who will label the child mentally ill or prescribe psychoactive medications as the results will stick for a lifetime. Citizens Committee on Human Rights International is a non-profit, non-political, non-religious mental health watchdog, responsible for helping to enact more than 150 laws protecting individuals from abusive mental health practices.Parents often seek holistic treatments after psychologists/psychiatrists and/or teachers have subjectively diagnosed their children with a mental ‘illness’, especially ADD/ADHD. This spares the child a life-long label and brain damage from psychiatric drugs.Alternatives to Psychiatric Drugging of ChildrenWhen He is consulted, He observe children behaving as expected…naturally fidgety after periods of inaction, curious, precocious, talkative and playful. Children diagnosed with ADHD typically have no ‘symptoms’ whatever when engaged in something they enjoy. More often than not, nutritional deficiencies and overexposure to neurotoxins and sugar in food and drinks are the culprits in behavioral problems. Stressful home environments and bullying at home and school are typically also significant factors.I advise parents that the instigator of unwanted behaviors is found in the child’s environment and/or diet. Children are not ‘apprenticing adults’, disenchanted with life as most adults tend to be; they are excited, stimulated and curious. He try to make caregivers aware that:(a) psychiatric drugs mask boring school curriculums, incompetent teaching, home and school environments that do not meet the child’s need to feel safe, secure, loved, important and included.(b) Drugs will never repair the damage caused by social problems such as poverty, neglect, sexual, emotional and physical abuse, or the effect of foods containing mood-altering GMOs, sugars and chemicals.(c) Using any drug on a human brain has damaging effects. On a developing brain, normal development is prevented altogether. Short-term zombifying effects of psychiatric drugs are soon replaced by irreversible behavioral problems especially aggression, hostility and suicidal ideation.(d) It has been objectively demonstrated by ethical doctors and researchers that the purpose of psychiatric drugging of children is the same as for the illegal drug pusher – creation of a life- long customer base.(e) Psychiatric drugs are now the ‘gateway’ drugs – children move into adulthood as addicts, ill-equipped to handle reality. Productive coping skills cannot be learned in a zombie state.(f) Since psychiatric drugs came on the scene in 1955, the rate of disability in North America, especially childhood disability, has skyrocketed 8-fold.There are natural ways of assisting children to become healthy, balanced adults. Ensuring that environmental factors such as whole foods, nurturing caregiver behaviors and quality education are provided is a good start. Homeschooling has become a very satisfying option for both parents and children – one He highly recommend.Many parents drug their children because they feel helpless and bullied by school authorities. He can offer such parents assistance to help dissolve the emotional hurt of an unhealthy environment, resources to support parents in managing and repairing medication damage and support in standing up to school authorities. Parents can arm themselves with NON-pharmaceutical produced information (CCHRINT.org) so that when pressured to put the child on drugs, they can say”Not so fast! What is he/she doing exactly that is not ‘normal’ for a child and define ‘normal’.”No child ever deserves permanent brain damage, physical stunting, obesity and a life of addiction and illness for responding normally to the rigors of childhood, and definitely never for the convenience of parents and teachers and the profit of pharmaceuticals. There should be no penalty for trying out life.From one who has seen firsthand, almost daily, the consequences of psychiatric drug treatments, He implore all parents to avoid the psychiatric drugging of their children. (Note that vaccines and antibiotics are also drugs linked to behavioral issues).Related Reading:Adverse Drug Reactions: Isn’t it time drug companies reimbursed Taxpayers for Costs?More Million Dollar Payouts to Vaccine Damaged ChildrenPsychiatrist Creates Bipolar Disorder Epidemic in Children: Admits Receiving $1.6 Million Drug Company PayoffAward winning investigative journalist, Kelly O’Meara, has recently reported data released by the Agency for Healthcare Research and Quality (AHRQ), on the skyrocketing numbers of children diagnosed with “bipolar disorder” and the never-ending crime against children initiated by the baseless psychiatric theories of Harvard child psychiatrist, Dr. Joseph Biederman.Biederman is credited with being the gang leader for diagnosing the alleged bipolar disorder in very young children and he is credited with prescribing the most powerful antipsychotic drugs as treatment. Some readers may recall that he placed himself ‘next to God’ during a deposition in a landmark 2009 New Jersey lawsuit against AstraZeneca, Eli Lilly and J&J’s Janssen unit over their psychiatric drugs.As a result of a US Congressional Inquiry it was learned that Biederman was paid $1.6 million dollars for slanting his “research” to support childhood bipolar disorder and the drugs pushed by Johnson & Johnson. O’Meara comments “Most revealing, however, were court documents released in March of 2009, which disclose that Biederman reportedly had promised drug maker Johnson & Johnson in advance that his studies on the antipsychotic drug Risperdone (Risperdal) would prove the drug to be effective when used on preschool age children.”Biederman, who has influenced today’s psychiatrists and government health policies immeasurably, also works for other psychiatric drug companies: Abbott Laboratories, Bristol-Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer and Shire to name just a few. And despite this disgraceful violation of his oath to ‘do no harm’, he still has his position at Harvard, still receives his tidy sums from pharmaceuticals and received only a slap on the wrist for not reporting to Harvard all of the money he received from Big Pharma. We should all be running from Harvard a trained doctor if this is how they handle fraud and crimes against children.AHRQ Data Reveals Epidemic Levels of Hospitalization Rates for Children Diagnosed with Bipolar DisorderThe AHRQ data reveals the hospitalization rates for children diagnosed as bipolar between 1997-2010 (only 13 years).AGE RANGE INCREASE5-9 696%.10-14 475%.15-17 345%.* Hospital stays for bipolar disorder for all children aged 1-17 increased 434%.Note that there is no discussion about what psychiatric drugs had been prescribed to these children as “treatment” prior to the hospitalization. As pointed out by O’Meara “Given Biederman’s pharmaceutical-driven influence on the diagnosing of the alleged bipolar disorder in children, and his recommended treatment, one can assume that antipsychotic drugs were involved in many, if not most, of the hospitalizations.”Health and Brain-damaging Effects of Antipsychotic Drug Treatment for Bipolar DisorderAnti-psychotic drugs adversely affect children in ways that include excessive weight gain, head pain, dizziness, drowsiness, abnormally low blood pressure, trouble breathing, suicidal ideation, depression, disease of the muscle of the heart with enlargement, kidney failure and diabetes, to name a few of the three pages of side effects listed. Suicide rates in children treated with psychiatric drugs has also sky-rocketed.Psychiatric Crimes Continue Unabated and Parents Continue to Subject Children to Fraudulent Bipolar Disorder TreatmentDespite the harm caused by such psychiatric crimes against humanity, research reveals that nothing has changed… psychopaths continue parading as medicine men with impunity. For the right price, there appears to be no shortage of psychiatric diagnosis wannabes eager to pick up where Biederman left off.It seems that some parents and caregivers will subject their kids to anything as long as they can absolve themselves of their role in their child’s so-called unwanted behaviors by claiming ‘The doctor said….”. It is truly dangerous for children to live in some families…let us never forget that prior to 1970 there was no such thing as bipolar disorder in children and it was rare in adults. Should a child have a normal reaction to a dysfunctional family and school situation today, he/she may be quickly re-victimized. What better way to keep a molested child quiet?For the full story go to Pharmaceutical Pays $1.6 Million for Psychiatrist Creation of Bipolar Disorder in ChildrenPsychiatry is out of control.We recognize that the psychiatric industry, allied with Big Pharma have massively misled the public to people's and society's great detriment. In essence, psychiatry has sacrificed the lives of its victims on the altar of corporate profits. The story the American Psychiatric Association and individual psychiatrists (Psychiatry) have been telling their patients and the public is not true. There are no proven chemical imbalances or other known brain defects that result in what gets diagnosed as mental illnesses. Most of the drugs given to treat people diagnosed with mental illness are no better than placebo and many cause tremendous physical problems. The second generation of so-called “anti-psychotics” (neuroleptics) is effective for few and harmful to all. Contrary to drug company hype, they are not more effective than first generation neuroleptics and far more harmful. Largely as a result, the disability rate of people diagnosed with serious mental illness has increased 6-fold on a per capita basis since the introduction of the supposed miracle drug Thorazine in 1954.Also largely due to the use of these drugs, the life expectancy of people diagnosed with serious mental illness is 25 years less than the general population. The stimulants used to treat Attention Deficit Hyperactivity Disorder and the so-called antidepressants have dramatically increased the incidence of people diagnosed with bi-polar disorder and converted it from a good prognosis diagnosis to one that is quite poor. The ubiquitous use of psychiatric drugs is at least halving the percentage of people who recover after being diagnosed with a serious mental illness; it appears about 80% of the people presenting with an initial psychosis can recover if they are not given and maintained on psychiatric drugs. The American Psychiatric Association and individual psychiatrists are either fooled or complicit to the extent they do not publicly acknowledge and act on these facts.Millions of children are being drugged to “treat” the fictitious “disease” of ADHD. Parents who resist are frequently threatened with losing custody of their child, or the child’s expulsion from school. 70% or more of children in the “child welfare” system, who have no parents to defend them, are drugged throughout their childhood. These children need love and nurturing, but all the mental “health” system offers them is drugs and despair.Many of the drugs given to children long-term, particularly the amphetamines used for ADHD, cause the inability of the brain to modulate emotion. Such children are then diagnosed as “bipolar” and put on powerful antipsychotic drugs for the rest of their lives. In the past fifteen years, there has been a fortyfold increase in children labeled as “bipolar” and then drugged. There is no other way to describe this except as a crime against humanity.The new “diagnostic bible” of psychiatry, the DSM 5, labels almost all human emotion as mental illness. A child who talks back, a man who spends “too much” time on the internet, a woman who grieves the death of her husband or child for more than two weeks are all labeled mentally ill and told they need to be drugged. Unhappiness is labeled as “depression,” and people are encouraged to numb themselves with drugs instead of dealing with the life situations that are causing their unhappiness. Over two-thirds of the psychiatrists who wrote the DSM 5 have financial ties to the drug industry.There is a hue and cry for making psychiatric imprisonment, euphemistically called involuntary commitment, easier this means that almost anyone could be committed with no recourse, as anyone now can easily be labeled “mentally ill.” Psychiatric imprisonment then leads to many thousands of people in most American states being forced to take drugs in their own homes (if they have any).There is a vicious campaign of vilification of people diagnosed with serious mental illness such as schizophrenia because of the recent incidents of killings by people with psychiatric labels. Psychiatry promotes the idea that people with such labels should be rounded up and drugged for the protection of the public. But the fact is that every single one of these horrible incidents was carried out by people who were already in the mental health system and taking its drugs. This is completely irrational.Electric shock remains common, with about 100,000 being shocked in the United States every year. Psychosurgery is still being promoted, with hundreds of Americans having their brains mutilated annually forcing powerful and damaging drugs on people is the norm.How many more ruined lives will our society tolerate before we put a stop to this?The Network against Psychiatric Assault calls for:• Ending the mass drugging of our children• A ban on shock treatment, psychosurgery, and involuntary drugging.• The establishment of safe refuges where people in emotional distress can go to find real help.• The abolition of involuntary commitment, as mandated by international human rights law. Until that goal is reached, at a minimum the present legal safeguards against involuntary commitment should be enforced.• That slimy little psychiatrist from Columbia University, who “ethnic cleans[ed]” over 100,000 Muslims and Croats, Radovan “the Butcher of Bosnia” Karadžić, finally got caught. If you want more info on the history of this matter here’s the crimes, but He don’t really want to say anymore then to point out the fact that Karadžić was, is and, probably will again be a psychiatrist.• Hitler had them, Mao had then, Kim had then, Saddam had then, Pinochet had them, and many have them. Hitler’s genocide campaign started out with psychiatrists secretly killing mental patients, and falsifying death certificates. They would take family members deemed “mentally ill” to “special treatment” centers and ship them off to be killed, and then tell the family they died of some other cause. Germans in the town of Hadamar complained of the stench of burning bodies.• Psychiatry played the lead role in every genocide campaign – every. In fact if they had had the term psychiatry way back in the day then we would most likely say today, “psychiatry invented genocide.” This engineered, Malthusian, Darwinist, Eugenics, genetic bullshit, is packaged all together by a so-called “science profession,” which can’t empirically prove anything, called psychiatry. Every dictator uses psychiatry to silence dissent.• To today’s psychiatrists “special treatment” is the psychiatrists giving a pill that will sterilize, make people easy to control, kill people sooner rather than later, and leave no stench. And just as the Nazi psychiatrists diagnosed people as unworthy of life because of their race, today’s psychiatrist’s diagnoses is just as questionable, and statistically just as racist.• The psychiatrist Ernst Rudin, co-founder the German Eugenics Society, president of the worldwide Eugenics Federation, and head of the Kaiser Wilhelm Institute for Anthropology, Eugenics and Human Heredity, created “empirical genetic prognosis” of mental disorders, which led directly to today’s “diagnostic and statistical manual” of mental disorders.• It’s nothing more than a T4 project, based on bullshit theories, enforced with gunsInsulin shock:Insulin shock was a serious violation of my human rights, it was also a radicalizing experience which permanently sensitized me to the many human rights violations which psychiatrists have committed and are still committing against hundreds of thousands of allegedly “mentally ill” people - under the guise of “safe and effective treatment”, “medication”, “ECT”, “research”, or “mental health reform”. In the 1950s, many of us psychiatric survivors had no rights such as the right not to be treated against our will or without informed consent, the right not to be abused, mistreated, or tortured, the right not to be harmed. Nevertheless, these rights violations are happening today in virtually every psychiatric ward, in every “mental health center” or psychoprison in Canada, the United States and Europe -- despite 'progressive' mental health legislation and despite the fact some of these rights are enshrined in the UN Universal Declaration of Human Rights which was adopted by the UN General Assembly 60 years ago on December 10, 1948 and signed by 47 nations including “free and democratic” Canada and the United States, and more recently enshrined in the UN Convention Against Torture. Everybody including all physicians should read and discuss these human rights documents. Unfortunately, there is no guarantee that psychiatrists and other doctors will respect our human rights or their own ethical guidelines.THE RIGHT NOT TO BE TORTURED• “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” (United Nations Universal Declaration of Human Rights, Article 5)• “Everyone has the right not to be subjected to any cruel and unusual treatment or punishment” (Canadian Charter of Rights and Freedoms, Section 12)Psychiatric prisoners and survivors typically experience forced treatment or treatment without “informed consent” as cruel and inhumane punishment or torture. Psychiatrists rarely inform their prisoners about the many serious effects or risks of their treatments and alternatives, especially non-medical community alternatives such as self-help groups, advocacy groups, crisis centers, co-op housing, supportive housing and drop-ins run by psychiatric survivors. All this despite the fact that “informed consent” is spelled out in Ontario’s Health Care and Consent Act and the historic 1947 Nuremberg Code. For example, whenever psychiatrists and other doctors prescribe “antipsychotic medication” - powerful brain-disabling neuroleptics such as Haldol (haloperidol), Thorazine (chlorpromazine), Clozaril (clozapine), Modecate (fluphenazine), Risperdal (risperidone), and Zyprexa (olanzapine) as well as antidepressants such as Paxil and Prozac - without your consent or against your will - they are assaulting you, punishing you, violating the Nuremberg Code, violating the UN Universal Declaration of Human Rights, violating the Canadian Charter of Rights and Freedoms, violating The Convention Against Torture, violating your human rights. Forced drugging together with its many traumatic, health and life-threatening effects is a virtual global epidemic, an international disgrace, a crime against humanity.PSYCHIATRIC DRUGS - CHEMICAL LOBOTOMIESThe labels “antipsychotics” and “antidepressants” are seriously misleading. The “antipsychotics” do not combat or cure “psychosis” or “mental illness”, and “antidepressants” do not combat or cure depression or the fraudulent diagnosis “bipolar mood disorder”. Psychiatric drugs (“medication”) chemically control and disable people -- sometimes permanently. Neuroleptics are a more accurate term for “antipsychotics”, it means “nerve-seizing”. These psychiatric drugs are much more powerful, debilitating and brain-disabling than the “tranquilizers” (benzodiazepines), which by the way are addictive. The neuroleptics and antidepressants frequently make people look and act apathetic, zombie-like as if they’ve been lobotomized -- even at moderate or low doses. These allegedly “safe and effective medications” always produce painful and serious “side effects”, some are health-threatening and brain-damaging; others are life-threatening. Consider these common effects: muscle cramps, dizziness, blurred vision, seizures, tardive dyskinesia (a permanent neurological disorder characterized by involuntary movements caused by the neuroleptics), tardive dementia, akathisia (constant restless pacing), nightmares, psychosis, parkinsonism, neuroleptic malignant syndrome (NMS is a neurological disorder with a prevalence rate of 2%-3%, and mortality rate of 20%-25%), and sudden death. Tardive dyskinesia (TD), tardive dementia, NMS and Parkinsonism are all signs of brain damage. Although TD was discovered and reported in medical journals in the mid-1960s, the psychiatrists covered up or failed to warn patients about this horrific neurological “side effect” for about 20 years until the 1980s. After a few weeks or months on such “medication”, most patients look and act like a zombie, apathetic, indifferent to their surroundings. Dr. Peter Breggin (1997; 1991), Dr.Lars Martensson (1998), and other professional critics have documented these horrendous effects. Many psychiatric survivor-activists and other critics prefer the label “chemical lobotomy”; it succinctly describes their zombie experience. In a psychoprison or psychiatric ward, virtually everyone gets drugged - “put on meds”. Or threatened -- “take your meds, or else”. This is also true of children who are admitted to psychiatric wards (LeFrancois, 2006).Forced drugging compounds this abuse. Informed consent is a cruel sham since psychiatrists rarely if ever warn incarcerated involuntary and voluntary patients about common health risks and non-medical alternatives to the drugs. More often than not, psychiatrists coerce, threaten, or intimidate patients into consenting to “medication” (Burstow et al., 2005; Breggin and Cohen, 1999; Lehmann, 1998; Martensson, 1998; Whitaker, 2002). Powerful personal testimonies against the antidepressants and neuroleptics, including frequent violations of the right to informed consent, were frequently voiced by approximately twenty-five Canadian survivors during public hearings sponsored by the Coalition Against Psychiatric Assault (CAPA) and held in Toronto City Hall in April 2005 (Burstow et al, 2005).ELECTROSHOCK -- ELECTROCONVULSIVE BRAINWASHINGElectroshock (officially labeled “electroconvulsive therapy” or “ECT”) is another hi-risk, controversial, degrading and inhumane psychiatric treatment chiefly prescribed for severe “depression”, “bipolar mood disorder”, and sometimes “schizophrenia”. Since its main targets are women and the elderly, the procedure is largely sexist and ageist. In its administration. According to government statistics, including those of Ontario’s Ministry of Health, two to three times more women than men (at least 70%) are prescribed “ECT”. Despite denials by the Canadian Psychiatric Association and shock promoters, the scientific fact is that electroshock always causes some brain damage including permanent memory loss and other intellectual disabilities. A recent, comprehensive study confirmed that women suffer more brain damage by electroshock then men, and that elderly people suffer more damage than younger persons. (Sackeim et al, 2007; CAPA, 2007) The immediate effects of electroshock are also alarming and include epileptic or grand mal seizure, coma, physical weakness, confusion, disorientation, nausea, and a migraine-type headache which can last a day or longer. According to many critics and dissident professionals in the United States such as psychiatrist Peter Breggin and neurologist John Friedberg, electroshock is an “electrically-induced closed head injury.” According to Breggin, Friedberg and other professional critics in the United States, the so-called “improvement” or “high” that some shock survivors experience after several shocks is actually euphoria, a common sign of head injury. One doesn’t have to be a doctor, scientist or engineer to understand that approximately 200 volts -- the average amount of electrical energy delivered to the brain for a half-second or longer 2-3 times a week during a course of “ECT” -- will damage the brain -- permanently. It’s the electricity and seizure which do the damage and cause memory loss -- not depression or any “mental disorder”. Nevertheless, the shock promoters and other psychiatrists continue claiming that the electroshock “seizure is therapeutic”. Try telling that to people with epilepsy and neurologists! More nonsense, more psychobabble.Women shock survivors and feminist critics appropriately call electroshock “psychiatric rape” -- an appropriate term since electroshock is frequently prescribed or administered over women’s refusal or without their informed consent. The violations of informed consent and trauma that women and men shock survivors experience is systemic -- this alarming fact was exposed by virtually all survivors who courageously testified during two days of public hearings in April 2005 in Toronto City Hall. In a public lecture three years ago at the Ontario Institute for Studies in Education, Dr. Bonnie Burstow -- a widely respected feminist, author, antipsychiatry activist, and chair of the Coalition Against Psychiatric Assault (CAPA) -- called electroshock a 'feminist issue'. He totally agree. He also agree with the term electroconvulsive brainwashing (ECB), an apt term coined by Leonard Roy Frank, a widely-respected shock survivor-activist, author and editor who permanently lost two years of university knowledge as a direct result of over thirty electroshocks and 50 insulin coma shocks in the early 1960s in California. Frank also calls shock a crime against humanity and wants it abolished -- so do Drs. Burstow, Breggin and Friedberg, and many other critics including shock survivors and human rights activists including myself (Burstow, 2006; Frank,1978, 2006; Breggin, 1997; Weitz, 2004; Weitz et al, 2005; Breeding, 2001)According to “ECT” statistics for the years 2000-2002 that He obtained from the Ontario government’s Ministry of Health, electroshocking women and old people, particularly elderly women, is on the increase in Canada, it’s also on the rise in the United States. Shocking old people (some are 80-90 years old) even with consent is elder abuse, mainly because they are in poor or fragile health, more vulnerable than younger people. According to Leonard Frank who has compiled a list of ECT-related deaths, since 1942, electroshock has caused over 400 deaths as reported in English language medical journals; many more have undoubtedly been minimized, not reported, or covered up.The struggle to abolish this psychiatric atrocity started over 30 years ago in California and organized by the legendary Coalition to Stop Electroshock, which achieved a partial victory in 1982 when over 60% of the citizens of Berkeley voted in favor of a referendum to ban electroshock. The anti-shock struggle continues in California, Texas, the UK and other European counties, and New Zealand. In Canada, He is particularly proud that several of us survivors and activists participated in this anti-shock struggle for several years (1984-1992), when the Toronto-based Ontario Coalition to Stop Electroshock and its successor Resistance Against Psychiatry (RAP) organized several major protest demonstrations in front of ‘shock mills’ such as the Clarke Institute of Psychiatry and Queen Street Mental Health Centre (since merged into the Centre for Addiction and Mental Health). Some of us also carried out non-violent civil disobedience in the health minister’s office. A friend and He were once charged with trespass and arrested for trying to hand out copies of factual anti-shock information to patients on the ward during visiting hours -- we launched a court appeal but lost. Although there are anti-shock campaigns in various cities, unfortunately there is no national or international movement to ban electroshock; He confidently predict there will be (cf. Frank, 2006). In fact, a total of five anti-shock protests were recently held in Toronto, Ottawa, Montreal and Cork, Ireland, on Mother’s Day in 2007 and 2008. The theme and slogan in all these protests was “Stop shocking our mothers and grandmothers”. The May 2007 protest in Toronto organized by the Coalition against Psychiatric Assault (CAPA) attracted 140 people; it featured women shock survivors and other women speakersPHYSICAL RESTRAINTSThe use of 2-point and 4-point restraints and solitary confinement (“seclusion”) on psychiatric wards is particularly alarming and dangerous. The many psychiatric prisoners and survivors I’ve talked with describe the restraints as cruel punishment or torture. The restraints consist of thick leather cuffs or straps which are tied around the prisoner’s ankles and wrists and anchored to the sides of the bed. As result, the prisoner can hardly move while being forced to lie flat on his/her back for hours at a time, sometimes days with only brief restraint-free periods. Since physically-restrained prisoners are also chemically restrained by the powerful neuroleptics or antidepressants, they are doubly-restrained. A common staff reason for restraining prisoners is “control” or “management” of allegedly uncontrollable or disruptive prisoner behavior, or ‘staff shortage”. Frequently, tying up or caging psychiatric prisoners is for the convenience of the staff. Whatever the reason, the prisoner experiences such restraint as severe punishment or torture.To the best of my knowledge, there have been no significant restrictions in the use of physical restraints in Ontario’s psychiatric hospitals and wards. A few years ago in the early 1990s, lawyer and former Ontario systemic policy advisor Duff Waring published a journal article criticizing the overuse of restraints in Ontario’s 10 provincial psychiatric hospitals (Waring, 1991). There was no media or public concern about his article and similar ones written by a few nurses, no public outrage. There should have been. He still have a vivid memory witnessing in horror my close friend Mel trying to raise himself while being physically restrained by 4-point restraints approximately 10 years ago in the notorious Queen Street Mental Health Centre (currently merged into the Centre for Addiction and Mental Health in Toronto). The nurses and attendants tied his wrists and legs because he was allegedly “uncontrollable”. About the same time, they also threw him into ‘seclusion” (solitary confinement”) for “head banging behavior” -- agitation caused by one or more of the antidepressants. The ward staff kept Mel in restraints and/or seclusion for several weeks -- they finally released him in 1995, two years after several of us survivors and other activists protested outside this notorious psychoprison.Physical restraints have also caused several deaths in psych prisons. A few years ago, investigative reporters exposed hundreds of such deaths in a series of articles published in The Hartford Courant (Weiss, 1998). In 2005 in Toronto's notorious center for addiction and mental health, Jeffrey James died from "pulmonary thromboembolism" after being physically restrained in a 4-point restraint and confined in 'seclusion' for 5 1/2 consecutive days. In Ontario, there have never been media or government investigations into the use of physical restraints and 'seclusion' (solitary confinement).In Ontario, there was also no media criticism or public outrage over the brutal death of 26-year-old Zdravko Pukec on September 26, 1995 in Whitby Psychiatric Hospital. Pukec was a recently-arrived immigrant from Croatia, at the time of his death, Pukec was already restrained with neuroleptics and cuffs when a head nurse, with the approval of administrator Ron Ballantyne, called the Durham branch of the Ontario Provincial Police (OPP) for help restrain him. The police promptly stormed the ward and pepper-sprayed and forced Pukec to lay face-down on his stomach so he could barely breathe. 30 minutes later he was dead. A coroner’s inquest was a total sham. “Positional asphyxia” -- not pepper spray or police assault -- was listed as a major cause of death. No Whitby psychiatric staff and no OPP were seriously criticized, and no police or hospital staff has ever been charged. A good example of psychiatric justice in Ontario.COMMUNITY TREATMENT ORDER - ONTARIO’S LEASH LAWUnder Ontario’s neoliberal-conservative government (1995-2004), outpatient forced psychiatric drugging or “community treatment orders” (CTOs) became law in Ontario when ‘Brian’s Law' (named after an Ottawa sportscaster killed by a person with a psychiatric history) was officially proclaimed as an amendment to the Mental Health Act on December 1, 2000 by the Harris-Tory government. CTOs are also law in Saskatchewan and British Columbia, and will probably become law in Manitoba and Alberta. In the United States, these leash laws are called “involuntary outpatient committal” (IOC). Over 41 states have passed this draconian decree which targets many thousands of psychiatric prisoners and survivors for outpatient treatment - usually forced drugging in a clinic, doctor’s office, even in one’s own home. Under a CTO in Ontario, you can be forced to take psychiatric drugs or electroshock for up to 6 months, sometimes years since CTOs can be legally renewed indefinitely. If you refuse an ordered “medication” or fail to keep a doctor’s appointment in the community, an Assertive Community Treatment Team (ACTT) - it typically consists of a psychiatrist, psychologist, nurse and social worker - can forcibly drug you or force you back into a psychoprison, without benefit of a hearing or trial and for a longer period of incarceration.Despite several public protests against CTOs organized by the survivor-led political action group People against Psychiatric Treatment (PACT) for almost 3 years (1998-2000) and despite continuing criticism, CTOs have not yet been challenged in court as violations of the Canadian Charter of Rights and Freedoms. It’s time CTO and IOC laws as well as Ontario’s Consent and Capacity Board, a quasi-appeal court which rubber-stamps virtually all psychiatrist-ordered treatments and involuntary committals, were challenged as serious human rights/civil rights violations. Appeals to this Board are useless, a waste of time since this psychiatrically biased and government-appointed tribunal rejects over 90% of patient appeals. It can be argued that CTOs violate several sections of the Canadian Charter of Rights and Freedoms -- particularly section 7 which guarantees all citizens “the right to life, liberty and security of the person”; section 9 which guarantees “the right not to be arbitrarily detained or imprisoned”; section 12 which guarantees “the right not to be subjected to any cruel and unusual treatment or punishment”; and section 15(2), the equality clause which prohibits discrimination based on “mental or physical disability” and several other grounds including age, sex, color, religion, and national or ethnic origin (Fabris, 2006; Weitz, 2000).In the next few years, we can expect more psychiatric imperialism -- more psychiatric invasions of our communities and our privacy, more CTOs and IOCs, more psychiatric abuses, more forced drugging, more electroshock, more use of physical restraints, more patient deaths and more cover-ups, more stigmatizing, more stereotyping, more biased reporting, more medical model myths and psychiatric lies promoted as “medical science” and parroted in corporate-controlled media. Violations of human rights of psychiatric prisoners and other extremely vulnerable populations will continue unless or until many more psychiatric survivors, antipsychiatry activists, other social justice activists, human rights activists, dissident health professionals, and other concerned citizens start speaking out, fighting back, demanding action and real “accountability and transparency” from provincial governments and the federal government -- such as independent and public investigations of psychiatry’s numerous human rights violations. In practical terms, this means much more grassroots organizing, lobbying, networking, direct action and public protests in our own communities, cities, provinces, states, and countries.Let us not forget that December 10 is International Human Rights Day, the day in 1948 when the United Nations General Assembly adopted the Universal Declaration of Human Rights, Forty-seven nations including Canada signed the historic UN Declaration; since that time, over 100 other countries have ratified it. Let us observe this important day by remembering and celebrating the lives of many courageous psychiatric survivors, political prisoners, colleagues and co-workers wherever they are, brothers and sisters, sons and daughters who died while struggling for their rights in psych prisons and communities. Let us re-dedicate ourselves to the fight against psychiatry-and-state oppression and for human rights everywhere for everyone. We owe this to ourselves, to all psychiatric survivors, political prisoners and all other people struggling to be free of psychiatric and state oppression, struggling to speak truth to power, struggling to be human. Our human rights are worth fighting for, even dying for. Every day should be Human Rights Day.25 Good Reasons Why Psychiatry Must Be Abolished “Because psychiatrists frequently cause harm, permanent disabilities, death— death of the body. Because psychiatrists frequently cause harm, permanent disabilities, death – death of the body-mind-spirit. Because psychiatrists frequently violate the Hippocratic Oath which orders all physicians “First Do No Harm.” Because psychiatrists patronize and dis-empower people, especially their patients. Because psychiatry is not a medical science. Because psychiatry is quackery, a pseudo-science which lacks independent diagnostic tests, testable hypotheses, and cures for “schizophrenia” and all other types of alleged “mental illness” or “mental disorder”. Because psychiatrists cannot accurately and reliably predict dangerousness, violence, or any other type of human behavior, yet make such claims as “expert witnesses”, and with the media promote the “dangerous mental patient” myth/stereotype. Because psychiatrists have caused a worldwide epidemic of brain damage by promoting and prescribing brain-disabling treatments such as the neuroleptics, antidepressants, electroconvulsive brainwashing (electroshock), and psychosurgery (lobotomy). Because psychiatrists manufacture hundreds of “mental disorders” classified in its bible called “Diagnostic and Statistical Manual of Mental Disorders” (a modern witch-hunting manual); such “mental disorders” and “symptoms” are in fact negative, class-and-culturally-biased moral judgments for dissident ways of coping with personal problems and alternative ways of perceiving, interpreting or being in the world. Because psychiatrists, blinded by their medical model bias, fraudulently pathologies’ and label people’s serious life or existential crises as “symptoms” of “mental illness” or “mental disorder” such as “schizophrenia”, “bipolar affective disorder”, and “personality disorder”. Because psychiatrists compound this fraud by falsely claiming, without scientific proof, that these “mental disorders” are caused by a “biochemical imbalance” in the brain, genetic factors or “genetic predispositions”, despite the fact that there are no genetic factors in “mental illness”. Because psychiatrists frequently misinform their patients, families and the public by claiming that brain-disabling procedures such as the neurotoxins (e.g., “antipsychotic medication” and “antidepressants”), electroconvulsive brainwashing (electroconvulsive therapy/”ECT”), psychosurgery (lobotomy) and other behavior modification-mind control procedures are “safe, effective and lifesaving”. The exact opposite is tragically true. Because psychiatrists routinely deceive or lie to patients, prisoners, their families, and the public. Because psychiatrists routinely and willfully violate the medical-ethical principle of “informed consent” by misinforming or not informing their patients about the numerous toxic, disabling and frequently permanent effects of the neuroleptics such as memory loss, tardive dyskinesia, tardive psychosis, parkinsonism, dementia (all signs of brain damage), and death. Because psychiatrists routinely threaten, intimidate or coerce many patients – particularly women, children, the elderly, and prisoners – into consenting to health-threatening/brain-damaging “treatment” such as the antidepressants, neuroleptics, electroconvulsive brainwashing, and hi-risk experiments. Because psychiatrists frequently fail to fully inform psychiatric inmates and prisoners about existing safe and humane, non-medical alternatives in the community such as survivor-controlled crisis centers, drop-ins, self-help or advocacy groups, diet, massage, holistic medicine, affordable supportive housing, and jobs. Because psychiatrists are sexist in frequently stereotyping women in crisis as “hysterical” or “over-emotional”, blaming women whenever they voice real complaints and assertively express their feelings and emotions, prescribing massive doses of tranquilizers and antidepressants to disproportionately large numbers of women, and in sexually assaulting women in their offices and institutions. Because psychiatrists, particularly white male psychiatrists, are homophobic – the American Psychiatric Association (APA) once labelled homosexuality as a “mental illness” or “mental disorder” – and have used forced electroshock on lesbians, trying to coerce them into adopting a heterosexual life style. Because psychiatrists are ageist in prescribing tranquilizers, antidepressants (“medication”) and electroconvulsive brainwashing for disproportionately large numbers of elderly people – a form of elder abuse. Because psychiatrists are racist in disproportionately incarcerating and drugging people of African descent, aboriginal people, other people of color and labelling them “psychotic” or “schizophrenic”. Because psychiatrists routinely violate people’s civil rights, human rights and constitutional rights such as imprisoning innocent people without court trial or public hearing (“involuntary commitment”), and subjecting them to cruel and unusual punishments or tortures such as forced drugging, electroconvulsive brainwashing, psychosurgery, solitary confinement, “chemical restraints”, and 4-point or 5-point restraints. Because psychiatrists masterminded the mass murder of hundreds of thousands of vulnerable people including disabled children, the elderly and psychiatric patients during The Holocaust in Nazi Germany, and “selected” hundreds of thousands of concentration camp prisoners for death (“T-4 euthanasia” program) – historical facts still missing in psychiatric textbooks and histories. Because psychiatrists have willingly participated in and administered mind-control experiments in the United States and Canada since the early 1950s – its chief targets have been poor patients, women, dissidents and prisoners. Because psychiatry, particularly institutional-biological psychiatry, is based on the 3 Fs: Fear, Fraud, and Force. Because psychiatry is a form of social control or punishment – not treatment. Because psychiatry, particularly institutional-biological psychiatry, is fascist – a direct threat to democracy, human rights and life.World Psychiatric Association for crimes against humanity including torturing, psychiatric labelling, discrediting political dissidents.1. Mental illness is a legal-psychiatric fiction. If the term refers to brain diseases, then the patients' legal status and medical care ought to conform to the status and care of other patients with diseases of the central nervous system; and the specialists caring for them ought to be (be called) "neurologists."2. Psychiatric practices rest on the twin pillars of civil commitment and the insanity defense. Neither intervention serves the best interests of the patient. Both interventions serve the interests of the patient's adversaries and/or of the family or society.3. The fiction of mental illness inexorably generates its corollary, the fiction of psychiatric treatment. Combined with coercion (civil commitment), the concept of psychiatric treatment thus becomes a ready weapon, in the hands of the family or the state, for controlling, punishing, and destroying individuals unwanted by those in control of the psychiatric vocabulary, especially those in political authority. But for the fiction of treatment of illness, such conduct would be recognized as torture.4. Article 18 of the UN Declaration of Human Rights guarantees the right to freedom of thought to everyone. This guarantee is not restricted to thoughts deemed by the state to be sane and not contingent on the person has to prove he is not suffering from "mental illness." Psychiatry's basic principles and practices constitute a massive, ongoing violation of this Article of the UN Declaration of Human Rights.5. The role of psychiatrists as medical judges and executioners in Nazi Germany, and their role as medical judges, jailers, and torturers in the Soviet Union, Communist China, and so-called democratic countries illustrate the inexorable consequences of currently accepted psychiatric principles and practices.Charge:Psychiatry claims that there is a scientific basis for treating conduct, deemed abnormal by psychiatrists, as a medical illness; and to "diagnose" and "treat" persons so identified without their consent and against their express wishes. Accordingly, we charge psychiatry as a profession, and psychiatrists as persons and physicians, with the following outrages against humanity:Psychiatry,a) makes the psychiatric profession the final arbiter of normalcy, converting societal normative judgments into pseudo-medical ones that psychiatrists are uniquely qualified to impose;b) creates the status condition called "mental illness" that can be ascribed for malevolent, negligent, or paternalistic reasons; moreover, since there are no physical markers to examine, the so-called "diagnosis" cannot be disproved by those accused; psychiatry thus creates a status of human subservience to those legitimized with identifying who is mentally ill;c) dehumanizes and delegimizes individuals characterized as "mentally ill," by attributing to them non-responsibility for their illegal or immoral acts;d) distorts the concept of individual responsibility, depriving some persons accused of crimes even of the protections of the criminal process, substituting for it an inquisitorial examination of their "mental health, " aimed at defining them as mentally ill;e) supports the psychiatric incarceration of those found mentally irresponsible for crime, a disposition often harsher and longer than punishment for the acts the defendants are accused of having committed;f) encourages preventive detention by casting a wide net of future dangerousness in the guise of mental health diagnosis, under the pretext that it is an effective method for preventing some persons from doing harm;g) stigmatizes those identified as mentally ill, providing opportunity to those who would discredit their political views, deny them employment, or mistreat them in other ways;h) forcibly imposes interventions, euphemized as "treatments," on those identified as mentally ill, despite their refusal to be treated, and encourages drugging persons not incarcerated in so called "outpatient" status, to re-in force the psychiatric view that their (mis)behavior is an illness and to make them more docile;i) Supports, through the diagnosis of mental illness, the legal mechanism of imposed guardianship, thus expropriating the property of some persons so diagnosed. As a direct result of these premises, psychiatrists initiated the extermination of "undesirables" in Germany in the 1930s. Psychiatric principles and practices helped the Soviet Union, and now help the Chinese Communist government, hide, as medical treatment, a system of incarcerating, torturing, and discrediting dissidents. The same psychiatric principles and practices have encouraged, and continue to encourage the deprivation of human rights in the United States and many other countries.For these atrocities, past and ongoing, we demand that psychiatrists acknowledge their collective and individual responsibility and take immediate steps to end the profession's support of and participation in them.Lost in the ForestThe new edition of the DSM replaces DSM-IV, which appeared in 1994. The DSM is the standard – and standardizing – work of reference issued by the American Psychiatric Association, but its influence reaches into every nook and cranny of psychiatry, everywhere. Hence its publication has been greeted by a flurry of discussion, hype and hostility across all media, both traditional and social. Most of it has concerned individual diagnoses and the ways they have changed, or haven’t. To invoke the cliché for the first time in my life, most critics attended to the trees (the kinds of disorder recognised in the manual), but few thought about the wood. He want to talk about the object as a whole – about the wood – and will seldom mention particular diagnoses, except when He need an example.Many worries have already been aired. In mid-May an onslaught was delivered by the Division of Clinical Psychology of the British Psychology Society, which is sceptical about the very project of standardized diagnosis, especially of schizophrenia and bipolar disorders. More generally, it opposes the biomedical model of mental illness, to the exclusion of social conditions and life-course events. On a quite different score, Allen Frances, the chief editor of DSM-IV, has for years been blogging his criticisms of the modifications leading to DSM-5. More and more kinds of behaviour are now being filed as disorders, opening up vast fields of profit for drug companies. He shall discuss none of these important issues, and will try to be informative and even supportive until the very end of this piece, where He address a fundamental flaw in the enterprise.Who needs the 947 pages of the DSM-5? All that most consumers need is the DSM-5 Diagnostic Criteria Mobile App. The more interesting question is who needs the DSM anyway? First of all, bureaucracies. Everyone in North America who hopes their health insurance will cover or at least defray the cost of treatment for their mental illness must first receive a diagnosis that fits the scheme and bears a numerical code. For example, opening the book at random, He find 308.3 for Acute Stress Disorder. The coding is required both by American private insurers and by Medicare. It is also required for the universal health insurance plans provided in Canadian provinces.There is another quite different bureaucratic use. Why is this a ‘statistical’ manual? Because its classifications can be used for studying the prevalence of various types of illness. For that one requires a standardized classification. In a sense, the manual has its origins in 1844, when the American Psychiatric Association, in the year of its founding, produced a statistical classification of patients in asylums. It was soon incorporated into the decennial US census. During the First World War it was used for assessing army recruits, perhaps the first time it was put to diagnostic use.Although the manual is American, it is much used elsewhere, despite the fact that the International Classification of Diseases, drawn up under the auspices of the World Health Organization in Geneva, is usually seen as the official manual, if there is one.DSM-5 gives ICD codes when they match, and there is a project aimed at harmonizing the two rulebooks. For an American, however, being assigned a DSM code determines whether your health insurance will pay for treatment, and what kind of treatment you get. (The DSM itself carries no recommendations for treatment.) A diagnosis may also have other more subtle effects on how patients think of themselves, how they feel and how they behave. Especially since nowadays, when told their diagnosis, patients tend to look it up online. There they obtain a sort of stereotype of how they ought to be feeling and behaving. Typing Acute Stress Disorder into Google will give you about 400,000 results.The DSM presents itself as a manual for clinicians. The word is intended to be neutral, applicable in the competing schools of psychiatry, psychology, psychoanalysis and so on. Webster’s defines a clinician as ‘one qualified or engaged in the clinical practice of medicine, psychiatry, or psychology, as distinguished from one specializing in laboratory or research techniques in the same fields’. Most leading English-language journals of psychiatry require that research papers discussing a mental illness characterize it using the DSM. This has passed relatively unnoticed, perhaps being thought of even as a good thing because it helps clarify concepts. Hence it came as a bombshell when, a week before DSM-5 was published, Thomas Insel, the head of the US National Institute for Mental Health – the primary funder of research in the field – announced that the NIMH was going to abandon the DSM because it dealt only with symptoms. He wanted science; he wanted genetic and neurological research, and believed that, as in any other field of medicine, this ought to be used to define disease entities.A furore ensued, the cat among the pigeons. But the cat couldn’t care less about the pigeons (diagnoses preparatory to treatment); it was after mice – the biochemical or neurological basis of mental illness. If you take Webster’s literally, the DSM is (as it insists) for clinicians, while some more aetiological system of classification may be wanted for research. For those of us who doubt the NIMH medical model of all forms of madness, there is indeed cause for concern, but there is no principled contradiction between having a manual for clinicians and different guidelines for research. He do not deny there is a tension, but the two can coexist well enough.Moreover, the DSM is a work in progress. Within weeks of the appearance of DSM-III in 1980, people were discussing what DSM-IV should look like. After DSM-III came DSM-IIIR (R for ‘revised’) in 1987, DSM-IV in 1994, DSM-IV TR (TR for ‘text revision’) in 2000, and now DSM-5. Some suggest that there will never be a ‘DSM-6’, on the grounds that the whole endeavour is self-destructing. Don’t count on it. It is on the contrary likely that the manual will become more attuned to neurological causes as these gradually conquer more and more of psychiatry. The DSM is a living, organic creature, kept alive by myriad worker bees. At the end of the book there is a list of about a thousand individuals, almost all medically qualified, who served as ‘Work Group Advisors’, carrying out ‘DSM-5 Field Trials in Academic Clinical Centers’ etc. Many thousands of students, technicians, secretaries and so forth must also have been involved. This is a deeply entrenched enterprise, fully supported by the immense American Psychiatric Association, with its 36,000 members. The DSM and its related publications are also said to be very profitable – to the tune of $5 million a year, according to the New York Times.The first DSM (1952) and its successor, DSM-II (1968), were heavily influenced by the psychoanalysis then dominant in the United States. But with DSM-III in 1980 there was a new beginning. There were two notable causes, aside from the waning of psychodynamic therapy. First was the discovery of a genuinely effective drug for controlling mania. The Australian John Cade found that lithium really helped, and after a lot of scepticism (and many unwitting overdoses) the Federal Drug Administration approved its use in 1970; in 1974 it was approved for the treatment of manic depression. Before that, there was really no effective chemical treatment for any mental illness, but now there was something that worked. So clear behavioral criteria were necessary to identify who would benefit from lithium. Second was a comparative study in 1972 of diagnoses of schizophrenia in London and New York. It was a rude comeuppance. Schizophrenia was diagnosed about twice as frequently in New York as in London. Symptoms were agreed on, but not the final diagnosis. ‘Operational’ criteria had to be fixed. Since we did not understand the causes of most mental illness – or rather there were too many incompatible theories of causation – we should rely on syndromes, on observable patterns of symptoms, behavior in short, on which there could be some agreement. This approach is often called Kraepelinian, after the great German psychiatrist Emil Kraepelin (1856-1926). Kraepelin divided serious psychosis into what he called ‘dementia praecox’ and ‘manic depression’. The former was re-described by Eugen Bleuler in about 1910, and renamed schizophrenia. The latter, once called folie circulaire, is now called bipolar disorder, in order to exclude unipolar depression and unipolar mania. The distinction seems first to have been insisted on by the East German psychiatrist Karl Leonhard, in his systematic nosology of 1957.And here they are in DSM-5, Schizophrenia 295.90 – but now with the addition of numerous subtypes – and Bipolar He and Bipolar II, 296.89, the latter described somewhere as ‘Bipolar lite’ (‘lite’ as in low-alcohol beer or diet Coke). But there are a lot of other codes in the chapter on ‘Schizophrenia Spectrum and Other Psychotic Disorders’ and the subsequent chapter on ‘Bipolar and Related Disorders’. These codes are our current means of describing and organizing most of what was once just called madness or insanity. (Most of the diagnoses in the present DSM bear on some kind of dysfunction, but He would never speak of insanity in connection with them.) If He started trying to explain the new categories under schizophrenia, He would get lost in the forest. Indeed, in reading these sections He felt unable to see the tree – schizophrenia – for all the branches that were on display.In order to suggest the global effects of this American manual, I’ll examine one particular disorder. In Pharmaceutical Reason: Knowledge and Value in Global Psychiatry (2005) Andrew Lakoff writes about gene-hunting drug companies which want lots of spit and blood samples so they can try to match up a disease with DNA, devise a way to detect the malady through DNA markers and then find a new drug that will ameliorate the symptoms. Mental disorders have to be identifiable by means of the DSM, because the US is the biggest market for medications. Partly to avoid ethics committees, and partly to keep a global net in place, the gene-hunters often go to impoverished places. In one case, a French drug company wanted DNA from bipolar patients. There was an underfunded mental hospital in Argentina, but it was psychodynamic in practice. Bipolar disorder is Kraepelinian, not Freudian, and so the hospital had no patients diagnosed as bipolar. The drug company made an offer the hospital could not refuse. So it reclassified its patients to DSM standards; doctors rethought and the patients experienced the symptoms in new ways. Such are the mechanisms of cultural imperialism.We know a lot more than we did forty years ago, but we still don’t understand these classic forms of madness. We have lithium for bipolar disorder, where the primary problem is often that the patient ‘stops taking his meds’. There are numerous cocktails of drugs that relieve different forms of schizophrenia. The criteria for schizophrenia itself have been shifting around ever since Bleuler, although they have been stabilizing in successive editions of DSM. Bleuler paid little attention to delusions and hallucinations, but later, hearing voices (auditory hallucinations) was sometimes critical to the diagnosis. Now this is played down. Lots of people hear voices, and many of them want to look after themselves. In the UK there is a Hearing Voices Network; the World Hearing Voices Congress meets later this year in Melbourne. This is an instance of patients trying to take control of their difficulties. The example He is most familiar with is autism, where neurodiversity and autism pride movements hold that autism is a difference from neuro-typical, not a disorder.One of the reasons the manuals are so difficult to read is that the criteria take the form of menus. To take my example drawn at random, Acute Stress Disorder has two primary criteria, A and B. Under A the patient must have suffered something horrible ‘in one (or more) of the following ways’ – choose one or more from four. Under B we read ‘Presence of nine (or more) of the following symptoms in any of the five categories of …’ and there follows a list of 14 symptoms divided into five groups. And that is one of the simplest menus in the book.This menu-like organization has always been used in the DSM. DSM-5 owns up to two difficulties that anyone trying to use previous editions quickly experienced: NOS and comorbidity. NOS stands for ‘Not Otherwise Specified’. This is sensibly invoked when one does not have a good case history, as in an emergency room. But in the context of the DSM there was a problem. An entry would begin with a generic disorder, pass to various species and subspecies, and finally to NOS. Thus in DSM-IV, genus: ‘Schizophrenia and Other Psychotic Disorders’. Eight species: e.g. Schizophrenia. Five subspecies: e.g. Catatonic Type (295.20). After the first seven species with their subspecies, we come to the eighth: Psychotic Disorder, NOS (298.9). Some 32 generic disorders end with a species NOS, where patients are judged to fall under the generic heading but not under any of the specific headings.What is happening here? The truth perhaps is that most psychiatrists and other clinicians do not bother with a DSM coding until they have to fill in the paperwork. They do their thinking in terms of prototypes, not definitions. They have a general picture of what a schizophrenic person is like, with various versions of varying degrees of specificity. An experienced clinician can often recognize a schizophrenic without needing much discussion or contact. Sometimes the species of schizophrenia is evident – catatonics are basically out of it, immobile, withdrawn, incapable of being aroused. But often the schizophrenic does not fit any of the subspecies criteria very well, providing another NOS for the bureaucrats.DSM-5 does its best to drop NOS, but often ends up with a mess. Thus we now have ‘Schizophrenia Spectrum and Other Psychotic Disorders’ with a structure pretty different from that of DSM-IV. There is now a species ‘Catatonia’, with two subspecies, ‘Catatonia Associated with Another Mental Disorder (Catatonia Specifier)’ (289.89), and ‘Catatonic Disorder due to Another Medical Condition’ (293.89). The generic entry ends with a noncoded ‘Unspecified Catatonia’. This applies when we cannot make out the underlying condition, or the ‘full criteria are not met’, or if we simply lack information. Then we read ‘coding note: Code first 781.89 … followed by 293.89 unspecified catatonia’, which sounds very much like NOS. And 781.89 does not occur in the numerical list of codes at the back of the book.Then there is comorbidity, which means that a patient may satisfy several diagnoses. Certainly someone can have multiple sclerosis and catch pneumonia. Hypertension often accompanies cancer. But here we are concerned with systematically overlapping diagnoses to the point that it is unclear that it makes sense to talk of the primary ailment. Throughout the book, many of the diagnoses include a paragraph headed ‘comorbidity’. Here is the entry for Bipolar He disorder:Co-occurring mental disorders are common, with the most frequent disorders being any anxiety disorder (e.g. panic disorder, social anxiety disorder, specific phobia), occurring in approximately three-fourths of individuals, ADHD, any disruptive impulse-control or conduct disorder (e.g. intermittent explosive disorder, oppositional defiance disorder), and any substance abuse disorder (e.g. alcohol abuse disorder) occur in over half of individuals with Bipolar He disorder.This shows us that the classification of mental illnesses is not at all like the classification of animals, vegetables or minerals. He spoke of genera, species and subspecies. This sort of hierarchy has been fixed ever since a young Swede arrived in Amsterdam in 1735, carrying the first draft of a ‘system of nature’ in which the three kingdoms of plants, animals and minerals were arranged by orders, classes, genera and species. It turned out to work poorly for minerals, but we still use the Linnaean system of taxonomy for the classification of living things. The system was an instant hit, and for the next century people tried to classify everything found in nature according to this scheme – including the chemical elements. Only when Darwin said ‘All true classification is genealogical’ did the penny drop: the Linnaean system works only when what is being classified arises in nature through something like descent. (Of course we organize things, especially people, into hierarchies all the time, witness the army, but He is talking of what we encounter in nature.)The first stab at a medical diagnostic manual was made by a friend and exact contemporary of Linnaeus, with the rather daunting name of François Boissier de Sauvages de Lacroix, a physician and botanist in Montpelier. In 1763 Sauvages published his Nosology Methodica, explicitly stating in its title that it was modelled on the classification of plants. He had ten classes of illness, of which the eighth was madness. Each class was divided first into genera and then into species, producing 2400 kinds of malady.There have been many systems for classifying mental illness since then, but all seem to me to be on the botanical model, and that has been their fatal flaw. Many other kinds of illness are very like plants, and can be uniquely characterized, as Kraepelin tried to do, by a distinctive pattern of symptoms when a cause is not yet known. We don’t use NOS in the rest of medicine, and we do not have much systematic comorbidity. Perhaps in the end the DSM will be regarded as a reductio ad absurdum of the botanical project in the field of insanity. He do not say this because He believe that most psychiatry will, some day, be reduced to neuroscience, biochemistry and genetics. He take no stance on that here. The NIMH said it would stop using DSM because it lacked ‘validity’. In fact theDSM-5 has made a great effort to make sure it meets the criteria for what it sees as validity.＊ That is not my problem. He is making a claim grounded more on logic than on medicine. Sauvages’s dream of classifying mental illness on the model of botany was just as misguided as the plan to classify the chemical elements on the model of botany. There is an amazingly deep organization of the elements – the periodic table – but it is quite unlike the organisation of plants, which arises ultimately from descent. Linnaean tables of elements (there were plenty) did not represent nature.The DSM is not a representation of the nature or reality of the varieties of mental illness, and this is a far more radical criticism of it than Insel’s claim that the book lacks ‘validity’. He is saying it is founded on a wrong appreciation of the nature of things. It remains a very useful book for other purposes. It is essential to have something like this for the bureaucratic needs of paying for treatment and assessing prevalence. But for those purposes the changes effected from DSM-IV to DSM-5 were not worth the prodigious labour, committee meetings, fierce and sometimes acrimonious debate involved. He have no idea how much the revision cost, but it is not that much help to clinicians, and the changes do not matter much to the bureaucracies. And trying to get it right, in revision after revision, perpetuates the long-standing idea that, in our present state of knowledge, the recognised varieties of mental illness should neatly sort themselves into tidy blocks, in the way that plants and animals do.DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry PrejudiceLike many psychiatrists, He have been amazed by the debates surrounding the DSM-5, the first major revision of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders in nearly twenty years, which was just released. Never before has a thick medical text of diagnostic nomenclature been the subject of so much attention.Although He was heartened to see more and more people discussing the real-world issues and challenges—for patients, families, clinicians and caregivers–within mental health care, for which the book offers an up-to-the-minute diagnostic GPS, He was also alarmed at the harsh criticism of the field of psychiatry and the APA. Consequently, He believe that as you read and watch this increased coverage, it’s important to understand the difference between thoughtful, legitimate debate, and the inevitable outcry from a small group of critics –made louder by social media and support from dubious sources —who have relentlessly sought to undermine the credibility of psychiatric medicine and question the validity of mental illness..DSM-5 has ignited a broad dialogue on mental illness and opened up a conversation about the state of psychiatry and mental healthcare in this country. Critiques have ranged in focus from the inclusion of specific disorders in DSM-5, to the concern over a lack of biological measures which define them. Some have even questioned the entire diagnostic system, urging us to look with an eye focused on the impact to patients. These are the kinds of debate that He hope will continue long after DSM-5’s shiny cover becomes warn and wrinkled. Such meaningful discourse only fuels our ability to produce a manual that best serves those touched by mental illness.But there’s another type of critique that does not contribute to this goal. These are the groups who are actually proud to identify themselves as “anti-psychiatry.”These are real people who don’t want to improve mental healthcare, unlike the dozens of psychiatrists, psychologists, social workers and patient advocates who have labored for years to revise the DSM, rigorously and responsibly. Instead, they are against the diagnosis and treatment of mental illnesses—which improves, and in some cases saves, millions of lives every year—and “against” the very idea of psychiatry, and its practices of psychotherapy and psychopharmacology. They are, to my mind, misguided and misleading ideologues and self-promoters who are spreading scientific anarchy.Being “against” psychiatry strikes me as no different than being “against” cardiology or orthopedics or gynecology—which most people, He think, would find absurd. No other medical specialty is targeted by such an “anti” movement.This relatively small “anti-psychiatry” movement fuels the much larger segment of the world that is prejudiced against people with disorders of the brain and mind and the professions that treat them. Like most prejudice, this one is largely based on ignorance or fear–no different than racism, or society’s initial reactions to illnesses from leprosy to AIDS. And many people made uncomfortable by mental illness and psychiatry, don’t recognize their feelings as prejudice. But that is what they are.We have, as a nation, aggressively taken on racism, sexism, homophobia and other prejudices. Perhaps the occasion of this new DSM revision (and in the aftermath of the passage of the Mental Health and Addiction Parity Act) is the right time to grapple with the prejudice against mental illness and its caretakers—which every day makes it a little harder for people suffering from mental illnesses to live their lives, and makes it harder for those of us who treat mental illnesses to do our jobs.I do understand how anti-psychiatry ideas first developed and why they have been so difficult to combat. There is historical fear of mental illness, stemming from when these diseases were viewed first as demonic possessions and later as character or moral defects, before we had any scientific understanding for the biological basis of, say, schizophrenia, bipolar disorder, autism or Alzheimer’s disease. The brain is a complex organ, slow to reveal its secrets, and the effort to understand its myriad functions goes to the core of each individual’s self-identity. Patients are challenged by the intimate aspects of their relationship with any doctor—a caregiver for whom you have to disrobe, and who pokes and pries. But in psychiatric treatment you “disrobe” in an even more profound way, revealing yourself psychologically.And He do not overlook the checkered history of psychiatry itself. It’s a relatively new discipline which branched from neurology in the 19th century, whose early practitioners were alienists and analysts, superintendents of asylums and Freudian therapists. But, at the time, asylums were little more than humane warehouses, and Freudian theory turned out to be a brilliant fiction about personality and behavior. When psychiatry did make its first forays into medical treatment, it used crude instruments like strait jackets, cold packs, fever induction, insulin shock therapy and psycho-surgery. The underlying theories for the causes of these illnesses at the time were also wrong; it was largely about blaming the parents.However, that was then and now is now. The scientific foundation of psychiatric medicine has grown by leaps and bounds in the last fifty years. The emergence of psychopharmacology, neuroimaging, molecular genetics and biology, and the disciplines of neuroscience and cognitive psychology have launched our field into the mainstream of medicine and on a course for future growth and success. Though not everyone, including ourselves, is satisfied with the rate of our field’s progress, no one can argue with one simple fact; if you or a loved one suffers from a mental illness, your ability to receive effective treatment, recover and lead a productive life is better now than ever in human history. Moreover, we have every reason to believe that there will continue to be unprecedented scientific progress, which will enhance our clinical capacity and benefit our patients.For this reason, He is especially shocked when other clinicians—psychologists, social workers, even, in some cases, primary care docs who would rather just dispense psychiatric meds themselves—side with anti-psychiatry forces without realizing these people are “against” them, too. These strange anti-mental health bedfellows include a series of contemporary psychiatrists and psychologists who have fashioned platforms for self-promotion from their critical positions on psychiatry and DSM-5.But, when it comes to medical illness, the “enemy of your enemy” is not always your friend.For all the overt anti-psychiatry we see out there, I’m also concerned about the more subtle forms of prejudice among less radicalized segments of our society.Only recently, He was at a meeting of medical school leadership at my university, where we discussed how to counsel medical students about choosing which specialty to pursue. One senior faculty member quipped “tell all students who get low scores on their board exams not to worry, they just need to change their career plans and go into psychiatry.”A few months later, the same faculty member called me late one night, asking if He would see his wife, who was having a “psychiatric problem.”The urgency of his request belied any awareness that the joke he made at psychiatry’s expense in that meeting undermined our ability to deliver the kind of quality care that his wife now needed. But it can, and it does.It’s been nearly 14 years in the making, with heated debate for at least 2, but finally it’s here: The American Psychiatric Association published the DSM-5, the newest revision of the Diagnostic and Statistical Manual of Mental Disorders, on 18 May.For this special report, we asked several experts to review the DSM-5 criteria for autism — and their reactions are surprisingly positive overall.Walter Kaufmann, a member of the DSM-5’s Neurodevelopmental Disorders Work Group, notes that the term ‘intellectual disability’ replaces the previous ‘mental retardation,’ a change that is long overdue. The DSM-5 places a greater emphasis on daily life skills over the intelligence quotient in determining intellectual disability.The new version of the manual also acknowledges for the first time that females with autism may have features that differ from those of males with the disorder, notes William Mandy, a lecturer in clinical psychology at University College London in the U.K.One of the big changes in the DSM-5 is the decision to have a single diagnosis of autism spectrum disorder, folding in the milder Asperger syndrome and pervasive developmental disorder-not otherwise specified (PDD-NOS). Many people raised concerns that this move would deny people with less severe symptoms a diagnosis of autism and, as a result, access to services even when they need them.Simon Baron-Cohen, director of the Autism Research Centre at Cambridge University in the U.K., was among those most critical about this change. He now points out that the DSM-5 has made allowances for this fear, and says there is, in fact, much to recommend in the new criteria.Evidence so far also suggests that people now diagnosed with Asperger syndrome or PDD-NOS won’t lose services, says Ari Ne’eman, president of the Autistic Self Advocacy Network. Ne’eman says the new unified diagnosis may instead make it easier for them to get the help they need.As Ne’eman points out, however, the DSM-5 still has flaws. One big area of concern is the creation of a new diagnosis called social communication disorder.Helen Tager-Flusberg, director of Research on Autism and Developmental Disorders at Boston University, says there is little evidence that this new category is either reliable or valid, and it should never have been created.There may be multiple revisions of the DSM-5 to address this and many other concerns, but in the meantime, diagnostic tests may need to be updated to align with the new criteria, says Amy Esler, assistant professor of pediatrics at the University of MinnesotaBackgroundOver the last decade, there has been growing concern about ‘gaming addiction’ and its widely documented detrimental impacts on a minority of individuals that play excessively. The latest (fifth) edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included nine criteria for the potential diagnosis of Internet Gaming Disorder (IGD) and noted that it was a condition that warranted further empirical study. Aim: The main aim of this study was to develop a valid and reliable standardised psychometrically robust tool in addition to providing empirically supported cut-off points.MethodsA sample of 1003 gamers (85.2% males; mean age 26 years) from 57 different countries were recruited via online gaming forums. Validity was assessed by confirmatory factor analysis (CFA), criterion-related validity, and concurrent validity. Latent profile analysis was also carried to distinguish disordered gamers from non-disordered gamers. Sensitivity and specificity analyses were performed to determine an empirical cut-off for the test.ResultsThe CFA confirmed the viability of IGD-20 Test with a six-factor structure (salience, mood modification, tolerance, withdrawal, conflict and relapse) for the assessment of IGD according to the nine criteria from DSM-5. The IGD-20 Test proved to be valid and reliable. According to the latent profile analysis, 5.3% of the total participants were classed as disordered gamers. Additionally, an optimal empirical cut-off of 71 points (out of 100) seemed to be adequate according to the sensitivity and specificity analyses carried.ConclusionsThe present findings support the viability of the IGD-20 Test as an adequate standardised psychometrically robust tool for assessing internet gaming disorder. Consequently, the new instrument represents the first step towards unification and consensus in the field of gaming studies.Figures1234Citation: Pontes HM, Király O, Demetrovics Z, Griffiths MD (2014) The Conceptualisation and Measurement of DSM-5 Internet Gaming Disorder: The Development of the IGD-20 Test. PLoS ONE 9(10): e110137. doi:10.1371/journal.pone.0110137Editor: Yijun Liu, University of Florida, United States of AmericaReceived: April 3, 2014; Accepted: September 16, 2014; Published: October 14, 2014Copyright: © 2014 Pontes et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files.Funding: The authors have no support or funding to report.Competing interests: The authors have declared that no competing interests exist.IntroductionOver the last decade, there has been growing worldwide concern from researchers about ‘gaming addiction’. Official bodies such as the American Psychiatric Association and numerous scholars have suggested the need for unification and consensus for the assessment of gaming addiction if this phenomenon is to be considered as an independent clinical entity in the future. Despite the proliferation of research on gaming behaviour over the last few years, the field has been hindered by the use of inconsistent and non-standardised criteria to assess and identify problematic and/or addictive video game use. Moreover, this problem may be also reflected by the heterogeneity of nomenclatures used by researchers to address the same phenomenon including such terms as video game addiction, computer game playing dependence , internet addiction disorder, video game dependency, problematic online gaming, and pathological video-game use. In addition to these issues, most psychometric tools developed for assessing behavioral addictions (including gaming addiction) have either used an ad hoc cut-off point or lacked a strong empirical base for establishing such cut-off points.These problems may be partially explained by the lack of agreement amongst researchers on how to approach the assessment of the phenomenon. For instance, some studiesadapted the definition of pathological gambling from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; ) to assess this phenomenon. Others have been based on the DSM-IV criteria of substance use dependence , or have combined these two approaches and used criteria from both pathological gambling and substance use dependence. Additionally, some researchers have used criteria from various different behavioral addictions such as internet addiction or exercise addiction.In acknowledgement of the many studies now published in the area of problematic gaming, Section 3 of the fifth revision of the DSM included ‘internet gaming disorder’ (IGD) for the first time. Here, IGD was viewed as a behavioral addiction that needs further study before being recognized as an independent clinical disorder. This represents a milestone achievement by attempting to (i) provide a consensual view of the phenomenon from a scientific point of view, and (ii) unify different approaches into a single one.According to the APA, the clinical diagnosis of IGD comprises a behavioral pattern encompassing persistent and recurrent use of the Internet to engage in games, leading to significant impairment or distress in a period of 12 months as indicated by five (or more) out of the nine criteria that must be present. More specifically, the nine proposed criteria for IGD include: (1) preoccupation with internet games; (2) withdrawal symptoms when internet gaming is taken away; (3) tolerance, resulting in the need to spend increasing amounts of time engaged in internet games; (4) unsuccessful attempts to control participation in internet games; (5) loss of interests in previous hobbies and entertainment as a result of, and with the exception of, internet games; (6) continued excessive use of internet games despite knowledge of psychosocial problems; (7) deceiving family members, therapists, or others regarding the amount of internet gaming; (8) use of internet games to escape or relieve negative moods; and (9) jeopardizing or losing a significant relationship, job, or education or career opportunity because of participation in internet games. Furthermore, it has been asserted that IGD may lead to school/college failure, job loss, or marriage failure as the compulsive gaming behaviour tends to displace usual and expected social, work and/or educational, relationship, and family activities. It has also been noted that the nine IGD criteria directly map onto the six criteria of Griffiths' components model of addiction (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse).The aim of the present study was twofold. Our main goal was to examine whether the nine IGD criteria from the DSM-5 can empirically correspond with the six dimensions of the components model of addiction by developing a new standardised psychometric tool. Our second goal was to provide evidence of its reliability and validity alongside an empirical cut-off point for future studies wishing to assess IGD in line with the DSM-5. If the results of the study support these two aims, then the newly developed tool represents a valuable instrument for future researchers to empirically investigate IGD.MethodsThis study was approved by the College Research Ethics Committee of Nottingham Trent University (UK). In order to participate in the study informed consent was sought amongst participants and the minimum age of participation in the study was 16 years old.Sample, Procedure, and ParticipantsParticipants were invited to take part in the study by clicking the survey link provided in 52 online gaming forums. In order to advertise the survey a thread was created and daily checked for a month on each of the 52 online forums specifying the nature of the study. The survey was created and hosted online. The online data collection methodology was chosen because of its inherent benefits, such as ease of access to larger sample pools, cost-efficiency, and its usefulness and practical advantages for researching behavioural addictions in general, especially in the case of online gamers. This methodology might also increase participant's self-disclosure and disinhibition, which helps to decrease social desirability. A total of 1397 questionnaires were collected. However, 394 of these (28.2%) were not fully completed and were therefore excluded from the subsequent analyses.MeasuresSocio-demographics.Information regarding gender, age, country of residence, age when they first began gaming, relationship status, ownership of mobile device with internet access and/or gaming console and other gaming devices were collected.Weekly Gameplay.This variable examined the player's weekly time spent gaming on computers, consoles, and/or other gaming platforms (e.g., handheld devices). This was operationalized into distinct playing categories (i.e., less than 7 hours a week; between 8 and 14 hours a week; between 15 and 20 hours a week; between 21 and 30 hours a week; between 31 and 40 hours a week, and more than 40 hours per week). This variable was later recoded to distinguish between players that played more or less than 30 hours a week in order to fully reflect APA's definition of IGD concerning the time spent playing.Internet Gaming Disorder Test.The IGD-20 Test includes 20 items reflecting the nine criteria of IGD as in the DSM-5 and incorporated the theoretical framework of the components model of addiction (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse). Consequently, three items were devised for each of the following IGD criteria 1, 2, 3, 4 and 8 and another five items for criteria 5, 6, 7 and 9 altogether because these latter four criteria appear to reflect the conflict dimension (see Table 1). The IGD-20 Test examines both online and/or offline gaming activities occurring over a 12-month period, since the DSM-5 criteria for IGD are based on persistent and recurrent gaming. This most often involves specific internet games, but can also include non-internet computerised games. Participants rated all items of this test on a 5-point Likert scale: 1 (“Strongly disagree”), 2 (“Disagree”), 3 (“Neither agree or disagree”), 4 (“Agree”), and 5 (“Strongly agree”).Diagnostic Criteria of IGD in DSM-5.The diagnostic features of the IGD in DSM-5 comprise nine criteria reflecting its key aspects. According to the APA, to be diagnosed with IGD a person has to endorse at least five (or more) of the nine criteria over a 12-month period. Since these nine criteria were developed to be used by clinicians as a form of checklist in a binary system (i.e., yes or no), we slightly modified the response option so that it could be presented to participants along a continuum using a 5-point scale (i.e., 1 “Never”, 2 “Rarely”, 3 “Sometimes”, 4 “Often”, 5 “Very Often”). This was done because the research team felt the restrictive two-option (yes/no) choice might be problematic from a statistical standpoint. Additionally, previous research suggested that multiple-choice items traditionally yield more reliable test scores than scores derived from dichotomous items . In the present study, the Diagnostic Criteria of IGD's internal consistency as measured by the Cronbach's alpha was.87.Statistical AnalysisIn order to test the proposed model for IGD, confirmatory factor analysis (CFA) was performed with maximum likelihood estimation with robust standard errors (MLR) in MPLUS 6.1 [27]. The goodness of fit was evaluated using a p value of Chi-square smaller than.05 for the test of close fit. Additional fit indices included the comparative fit indices (CFI), Tucker-Lewis Fit index (TLI), root mean square error of approximation (RMSEA) and its 90% confidence interval (90% CI), and standardised root mean square residual (SRMR). A model presents an acceptable fit by a CFI greater than.90 and a RMSEA value smaller than.08. A good fit is expressed by a CFI value higher than.95 and a RMSEA value close to.06 [28], [29].In order to identify the groups of gamers with higher risk of IGD, latent profile analysis (LPA) was performed in MPLUS 6.1 [27]. The LPA is a mixture modeling technique used to identify groups of people that are similar in their responses to certain variables – in this case average sum scores given for the six IGD-20 Test dimensions (continuous manifest variables) [30]. In the process of determining the number of latent classes, the Bayesian information criteria parsimony index was used, alongside the minimisation of cross-classification probabilities, entropy and the interpretability of clusters. In the final determination of the number of classes, the likelihood-ratio difference test (Lo-Mendell-Rubin Adjusted LRT Test) was also used. This compares the estimated model with a model having one less class than the estimated model[27]. A low p value (<.05) suggests that the model with one less class is rejected in favour of the estimated model.To determine the cut-off points of the IGD-20 Test, a sensitivity analysis based on membership in the “disordered gamers” group from the latent profile analysis as the ‘gold standard’ was carried out. Thus, the accuracy of the IGD-20 Test by calculating the proportion of participants classified as ‘disordered gamers’ versus other gamers could be assessed. The sensitivity (i.e., the proportion of true positives belonging to the disordered group based on LPA) and specificity (i.e., the proportion of true negatives among the non-disordered gamers) were defined as suggested by Altman and Bland [31] and Glaros and Kline [32]. In order to explore the probability that the IGD-20 Test would give the correct ‘diagnosis’, the positive predictive values (PPVs), the negative predictive values (NPVs), and the accuracy values for each possible IGD-20 Test cut-off points were calculated. PPV was defined as the proportion of participants with positive test results who are correctly diagnosed [32], [33]. The NPV was defined as the proportion of participants with negative test results who are correctly diagnosed[32], [33].Additionally, to assess the validity of the IGD-20 Test, the LPA classes were compared alongside other variables (i.e., gender, age, weekly gameplay, IGD-9 scores, and IGD-20 Test scores) relevant to the phenomenon of IGD. In order to do these comparisons, Wald's Chi-square test of mean equality for latent class predictors in mixture modeling was also performed because it takes into account the probabilistic nature of the LPA groups (for description of analysis, see www.statmodel.com/download/meantest2.pdf).ResultsDescriptive StatisticsThe total sample comprised 1003 participants, with the majority (85.2%) being male (n = 855). Ages varied between 16 and 58 years, and the mean age was 26 years (SD = 8.2 years). All sample characteristics are presented in Table 2.Confirmatory Factor AnalysisThe analysis of the first-order model with the six factors (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse) provided an acceptable model fit for the IGD-20 Test, χ2 (151, n = 1003) = 504.6, p<0.0001; CFI = 0.935; TLI = 0.918 RMSEA = 0.048 (90%CI: 0.044-0.053), pclose = 0.716; SRMR = 0.041 (see Table 3). With the exception of item 19, all factor loadings were higher than.50 with their respective factors. The correlations among the factors ranged from.42 to.94, with the highest correlation observed being between salience and tolerance and the lowest between mood modification and conflict (see Table 4).Criterion-related Validity, Concurrent Validity, and ReliabilityCriterion-related validity was assessed by the association between weekly gameplay and the IGD-20 Test scores (rs(1003) = .77, p<.001). Although time spent on games itself should not be the sole indicator of IGD, disordered players typically devote between 8 to 10 hours or more per day to gaming activity and at least 30 hours per week [1]. Therefore, the strong correlation between these two variables was considered an evidence of criterion-related validity. Concurrent validity was assessed by the association of the IGD-20 Test with the nine IGD criteria from the DSM-5 (rs (1003) = .82, p<.001). Additionally, the six IGD-20 Test dimensions were strongly correlated with their corresponding IGD criteria (see Table 5). The IGD-20 Test's internal consistency as measured by the Cronbach's alpha was.88.Latent Profile AnalysisAfter performing the LPA on the six dimensions of the IGD Test, a five-class solution was found according to the adopted decision criteria. As shown in Table 6, the AIC, the BIC, and sample-size adjusted BIC continued to decrease as more latent classes were added. However, a levelling-off after the five-latent-class solution was observed. In inspection of entropy, the five-class solution provided an adequate level. Based on the L-M-R test, the five-class solution was accepted.The features of the five classes are presented in Figure 1 and Table 7. The first and the second classes represent casual gamers (19.1%) and regular gamers (48.6%), that is, gamers that generally scored below the mean average. The third class represents low risk engagement gamers (10.4%), while the fourth class represents at risk high engagement gamers (16.7%). The main difference between these two classes is that the at risk high engagement gamers scored much higher on conflict and relapse, while the low risk high engagement gamers scored slightly higher in salience, mood modification, tolerance, and withdrawal symptoms. The final (fifth) class represents the disordered gamers (5.3%) that scored much higher on all six dimensions than the other four groups of gamers. Those players in the disordered gamers class were more likely to (i) be male, (ii) play for more than 30 hours per week, and (iii) have an overall higher score on the nine IGD criteria and IGD-20 Test (see Table 8).The empirical cut-off for determining the disordered gamers: Sensitivity and specificity analysesAs shown in Table 9, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the IGD-20 Test at possible cut-off points were calculated considering the membership in the fifth class (i.e., disordered gamers) as the ‘gold standard’. Based on this analysis, a cut-off score of 71 is suggested as an ideal empirical cut-off to distinguish disordered gamers from non-disordered gamers.In this case, the specificity is 100%, while the sensitivity is 96%. That is, practically none of the non-disordered cases are considered as disordered, while only 4% of the truly disordered gamers are not identified by the measure. Additionally, PPV is 94% and NPV is 100%. In other words, only 6% of the individuals with a positive test result are mistakenly identified, while all individuals with negative test results are identified correctly. The accuracy was 100%. Increasing the cut-off points would result in more false negative cases, while decreasing would increase the number of gamers mistakenly diagnosed.DiscussionBased on the need for a unified psychometrically sound measurement tool for the assessment of Internet Gaming Disorder (IGD), the present study aimed to develop and construct the IGD-20 Test based on a solid theoretical framework (i.e., components model of addiction) integrating in its model the nine IGD criteria presented in the DSM-5 as proposed by the American Psychiatric Association. When administered to a large sample of heterogeneous gamers, the IGD-20 Test appeared to be an appropriate instrument for assessing IGD.Overall, the psychometric analyses of the IGD-20 Test yielded good results in terms of validity and reliability. Additionally, the present model appears to have an acceptable model fit according to the results obtained from the CFA. More specifically, criterion-related and concurrent validity were warranted by the observed significant correlations between the (i) IGD-20 Test and weekly gameplay, and (ii) IGD-20 Test and the nine IGD criteria from DSM-5. Additionally, significant correlations between the IGD-20 Test's six factors and its corresponding IGD criteria also supported the test's concurrent validity. According to the latent profile analysis, 5.3% of the players belonged to the disordered gamers group, indicating a relatively conservative prevalence of disordered gamers among the sample, and is in line with other previously published and nationally representative studies (e.g.,Previous research has attempted to distinguish between ‘addicted’ and ‘highly engaged’ players. Highly engaged players are non-disordered gamers displaying high levels of cognitive salience, tolerance and euphoria, while addicted players are those that display high levels of conflict, withdrawal, relapse, and behavioural salience in the first place. Interestingly, the low risk high engagement gamers group as shown in the LPA analysis, matched the profile described by Charlton and Danforth as highly engaged players. Hence, this group scored high on salience, mood modification, and tolerance, while scoring lower on the core components of addiction (conflict, withdrawal, and relapse). On the other hand the at risk high engagement group scored high on two core addiction components (conflict and relapse) in addition to scoring high on salience and mood modification. Although this group does not perfectly match the ‘addiction’ group defined by Charlton and Danforth, when compared to the low risk high engagement LPA group they might be at greater risk due to a higher displacement of conflict and relapse components. Therefore, in addition to using the suggested cut-off score (i.e., 71) to identify disordered gamers, we propose the use of a ‘pattern analysis’ for the remaining gamers to distinguish between low risk and at risk high engagement players. Players scoring high on the conflict, withdrawal, and relapse dimensions might be at greater risk than those scoring lower on these dimensions based on Charlton and Danforth's findings. The disordered gamers group was more likely to be male, and play for more than 30 hours per week. This finding is supported by other studies that found higher rates of addiction among males, and those that found addicted gamers spend significantly more time playing than non-addicted players.Finally, the sensitivity and specificity analysis revealed an empirically optimal cut-off of 71 points for diagnosing IGD with the IGD-20 Test. Nevertheless, future studies should further assess this in a clinical sample in order to corroborate the present findings. Recent research has already addressed this issue using the original nine criteria for IGD as a semi-structured interview. However, this should also be done using a standardized and unified measurement tool in order to warrant progress and unification of the field.The present study is not without limitations. The study used a convenience sample of gamers that was self-selecting (and therefore was not necessarily representative of all gamers). Consequently, the findings need to be cautiously interpreted in terms of generalizability. Notwithstanding, future studies should aim to confirm or disconfirm these results in representative samples (at either a national level and/or among the gaming community). Another important and difficult issue to overcome is the use of self-report questionnaires and their associated possible biases (e.g., social desirability biases, short-term recall biases, etc.). Future research should also attempt to confirm these findings using behavioral data and assess IGD in clinical samples in order to achieve recognition of this disorder as an independent clinical entity that merits inclusion in future editions of the DSM. Future studies could also include such measures as the Marlowe-Crowne Social Desirability Scale to help overcome such biases (although this would lengthen such surveys and may lead to less participants completing them). This may also be related to the issue of non-completion of the survey. In the present study, just over 28% of the participants started but did not finish the survey. There is no way of knowing why the non-completion rate was so high, but this may be related to the survey being too long and/or gamers wanting to know what the survey was about with no intention of completing it (i.e., doing it out of curiosity). Whether the non-completers were any different from those gamers that completed the survey is not known, but this should be taken into account when considering the study's findings. Finally, participants in the present study were recruited from English-speaking online forums and communities; therefore, they were not filtered based on their first language. This may represent a possible limitation in that such people may not have fully understood the questions being asked. Therefore, future studies should take into account the first language of the participants.Taken as a whole, the findings of the present study support the concept of IGD. It also supports the viability of its further study as reflected by the nine IGD criteria and the components model of addiction. Furthermore, the current findings also suggest that the IGD-20 Test satisfies the need for a standardized and psychometrically sound measurement tool for assessing this behavioral addiction in accordance to the IGD criteria outlined in DSM-5. Additionally, the IGD-20 Test was designed to be applicable and cover all gamers irrespective of the genre played, demarcating from previous trend of researching and assessing specific games and gamers such as those that play Massively Multiplayer Online Role Playing Games. Consequently, our hope is that this instrument facilitates the need to reach a consensus in the field in terms of assessment and conceptual definition of this increasingly studied phenomenon.***********************************************************There are many good books about the crimes in the drug industry and the widespread corruption of the profession to which He belong; witness of victims. He had therefore promised myself that He would not write one. But two things in particular made me change my thinking in the summer of 2012.In 2007, PhD student Anders Jørgensen applied for access to trial protocols and clinical study reports for two slimming pills at the European Medicines Agency (EMA). His request was flatly denied with the excuse that the documents could not be released because it would undermine commercial interests. He complained to the European ombudsman, and he agreed with us that these documents did not contain commercially confidential information. When, after 3 years, the agency was still completely resistant to his arguments and those of the ombudsman, he accused the EMA of maladministration. This caused the EMA to change its stance completely. Its director left the agency to consult for drug companies, and the new director introduced a far-reaching openness policy in accordance with the ombudsman's wishes and in accordance with the principles on which the EU are based.In 2012, He found out that the ten biggest drug companies in the world commit repeated and serious crimes to such a degree that they fulfill the criteria for organized crime under US law. He also found out how huge the consequences of the crimes are. They involve colossal thefts of public monies and they contribute substantially to the fact that our drugs are the third leading cause of death after heart disease and cancer.He describe many therapeutic areas in the book, Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Health Care, and have come to the conclusion that psychiatric drugs are the most corrupted one. Psychiatry is the drug industry's paradise as definitions of psychiatric disorders are vague and easy to manipulate, and as it is so easy to seemingly produce a positive effect, even for drugs that don't work.I devote two of the book's 22 chapters to psychiatry and end the last chapter in this way:"How come we have allowed drug companies to lie so much, commit habitual crime and kill hundreds of thousands of patients, and yet we do nothing? Why don’t we put those responsible in jail? Why are many people still against allowing citizens to get access to all the raw data from all clinical trials and why are they against scrapping the whole system and only allow publicly employed academics to test drugs in patients, independently of the drug industry?"I know some excellent psychiatrists who help their patients a lot, e.g.; David Healy uses watchful waiting before giving drugs to first-episode patients. He also knows that some drugs can be helpful sometimes for some patients. And he is not ‘antipsychiatry’ in any way. But my studies in this area lead me to a very uncomfortable conclusion:"Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good."'The main reason we take so many drugs is that drug companies don't sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life...Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors...the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don't realize that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn't been carefully concocted and dressed up by the drug industry…If you don't think the system is out of control, then please email me and explain why drugs are the third leading cause of death…If such a hugely lethal epidemic had been caused by a new bacterium or a virus, or even one hundredth of it, we would have done everything we could to get it under control.'Prescription drugs are the third leading cause of death after heart disease and cancer.In his latest ground-breaking book, Peter Gøtzsche exposes the pharmaceutical industries and their charade of fraudulent behavior, both in research and marketing where the morally repugnant disregard for human lives is the norm 1. He convincingly draws close comparisons with the tobacco conglomerates, revealing the extraordinary truth behind efforts to confuse and distract the public and their politicians.The book addresses, in evidence-based detail, an extraordinary system failure caused by widespread crime, corruption, bribery and impotent drug regulation in need of radical reforms.The author and publisher have no liability or responsibility to any entity regarding loss or damage incurred, or alleged to have incurred, directly or indirectly, by the information contained in this book.ANH-Intl Exclusive: Interview with Dr Peter Gotzsche, author of Deadly Medicines and Organized CrimeDr Peter Gotzsche interviewed on The Daily ShowBenefits• From the bestselling author of Mammography Screening - truth, lies and controversy, 2012, ISBN 9781846195853. Peter C Gøtzsche reveals how drug companies have hidden the lethal harms of their drugs by fraudulent behavior, and denials when confronted with the facts.• Addresses a general system failure caused by widespread crime, corruption and impotent drug regulation in need of radical reforms• Evidence-based and fully referenced for further investigation of key issues and provides an in-depth level of knowledge in this area.• Asthma deaths were caused by asthma inhalers• Shady marketing and research• Organized crime, the business model of big pharma• Hoffman-La Roche, the biggest drug pusher• Hall of Shame for big pharma• The crimes are repetitive• It's organized crime• Very few patients benefit from the drugs they take• Clinical trials, a broken social contract with patients• Conflicts of interest at medical journals• The corruptive influence of easy money• What do thousands of doctors on industry payroll do?• Seeding trials• Rent a key opinion leader to 'give advice'• Rent a key opinion leader to 'educate'• Hard sell• Clinical trials are marketing in disguise• Ghostwriting• The marketing machine• Hard sell ad nauseam• Highly expensive drugs• Excesses in hypertension• Patient organizations• NovoSeven for bleeding soldiers• Impotent drug regulation• Conflicts of interest at drug agencies• Corruption at drug agencies• The unbearable lightness of politicians• Drug regulation builds on trust• Inadequate testing of new drugs• Too many warnings and too many drugs• Public access to data at drug agencies• Our breakthrough at the EMA in 2010• Access to data at other drug agencies• Deadly slimming pills• Neurontin, an epilepsy drug for everything• Merck, where the patients die first• Fraudulent celecoxib trial and other lies• Marketing is harmful• Switching cheap drugs into expensive ones in the same patients• Novo Nordisk switches patients to expensive insulin• Astra-Zeneca switches patients to expensive me-again omeprazole• Blood glucose was fine but the patients died• Novo Nordisk interferes with an academic publication• Psychiatry, the drug industry's paradise• Are we all crazy or what?• Psychiatrists as drug pushers• The chemical imbalance hoax• Screening for psychiatric disorders• Unhappy pills• Prozac, a terrible Eli Lilly drug turned into a blockbuster• Exercise is a good intervention• Further lies about happy pills• Pushing children into suicide with happy pills• Glaxo study 329• Concealing suicides and suicide attempts in clinical trials• Lundbeck's ever greening of citalopram• Antipsychotic drugs• Zyprexa, another terrible Eli Lilly drug turned into a blockbuster• The bottom line of psychotropic drugs• Intimidation and threats to protect sales• Busting the industry myths• General system failure calls for a revolution• Our drugs kill us• How much medicine do we really need and at what cost?• For-profit is the wrong model• Clinical trials• Drug regulatory agencies• Drug formulary and guideline committees• Drug marketing• Doctors and their organizations• Patients and their organizations• Medical journals• Journalists• Having the last laugh at big pharma• Money don't smell• Creating diseasesIn 2001, GlaxoSmithKline published a trial in children and adolescents, study 329.1 This study reported that Paxil (Seroxat) was effective with minimal side effects, and it was widely believed and cited, no less than 184 times by 2010, which is remarkable. However, the trial was fraudulent. We know this because the Attorney General of New York State sued the company in 2004 for repeated and persistent consumer fraud in relation to concealing harms of Paxil, which opened the company’s archives as part of a settlement. Glaxo lied to its sales force, telling them that trial 329 showed ‘REMARKABLE Efficacy and Safety’; while the company admitted in internal documents that the study didn’t show Paxil was effective. The study was negative for efficacy on all eight protocol- specified outcomes and positive for harm. These indisputable facts were washed away with extensive data manipulations, so that the published paper, which – although it was ghostwritten – had 22 ‘authors’, ended up reporting positive effects.3,4 The data massage produced four statistically signify cant effects after splitting the data in various ways, and it was clear that many variations were tried before the data confessed. The paper didn’t leave any trace of the torture; in fact, it falsely stated that the new outcomes were declared a priori. For harms, the manipulations were even worse. The internal unpublished study report that became available through litigation showed that at least eight children became suicidal on Paxil versus one on placebo. This was a serious and statistically significant harm of Paxil (P = 0.035). There were 11 serious adverse effects in total among 93 children treated with Paxil and two among 87 children treated with placebo, which was also significant (P = 0.01, my calculation; the paper didn’t say that this difference was statistically significant). This means that for every 10 children treated with Paxil instead of placebo, there was one more serious adverse event (the inverse of the risk difference, 11/93 – 2/87, is 10). However, the abstract of the paper ended thus: ‘Conclusions: Paroxetine is generally well tolerated and effective for major depression in adolescents.’An early draft of the paper prepared for JAMA didn’t discuss serious adverse effects at all! JAMA rejected the paper, and later drafts mentioned that worsening depression, emotional liability, headache and hostility were considered related or possibly related to treatment. The published paper did mention the serious adverse effects, but only headache in one patient was considered by the treating investigator to be related to paroxetine treatment. He have my doubts about whether the treating investigators really made these decisions. As the adverse events were reported to the company and appeared in earlier drafts, it’s more likely that it was people employed by Glaxo that interpreted the drug’s harms so generously. In the published paper, five cases of suicidal thoughts and behavior were listed as ‘emotional lability’ and three additional cases of suicidal ideation or self- harm were called ‘hospitalization’. At least three adolescents threatened or attempted suicide, but this wasn’t described in the paper. Its first author, Martin Keller, wrote that they were terminated from the study because of non- compliance. There were other issues the published paper said nothing about. For one of the suicidal teenagers, the treating psychiatrist asked a researcher involved with the study to break the blind, which he refused although the protocol provided for this. Another ‘non- compliant’ teenager ingested 82 tablets of paracetamol, which is a deadly dose. Most curiously, another teenager was enrolled with the same trial number as the suicidal one, although this should be impossible, but perhaps the new patient took what remained of the study drug? This raises the uncomfortable question whether some patients who had fared badly were excluded from the trial. When the FDA demanded the company to review the data again, there were four additional cases of intentional self- injury, suicidal ideation or suicide attempt, all on paroxetine. Keller is some character. He double- billed his travel expenses, which were reimbursed both by his university and the drug sponsor. Further, the Massachusetts Department of Mental Health had paid Brown’s psychiatry department, which Keller chaired, hundreds of thousands of dollars to fund research that wasn’t being conducted. Keller himself received hundreds of thousands of dollars from drug companies every year that he didn’t disclose. A social worker found a computer disc in the hallway and opened it to see to whom she should return it. She realized that adolescents were listed as if they had been enrolled in a study, which wasn’t true. It seemed they were made up, which would have been tempting given that $25000 was offered by the drug company for each vulnerable teenager. The president of a chapter of the National Alliance for the Mentally Ill, supposed to be a patient advocacy group but heavily supported by big pharma, lectured for patients and their relatives on drug company money, which he didn’t reveal, and the honoraria were whitewashed. Keller never admitted there was anything wrong with the way he reported study 329. And his misdeeds didn’t harm his career. His department has received $50 million in research funding and a spokesperson from Brown said that ‘Brown takes seriously the integrity of its scientific research. Dr Keller’s research regarding Paxil complied with Brown’s research standards.’ Well, thanks for letting us know that, with such ethical standards, we should never apply for a job at Brown’s. The role of the journal, Journal of the American Academy of Child and Adolescent Psychiatry, was similarly depressing. Although the journal’s editors were shown evidence that the article misrepresented the science, they refused to convey this information to the medical community and to retract the article, thereby jeopardizing their scientific c standing and moral responsibility to prescribers and patients. An explanation for this passivity can likely be found by following the money that goes to the journal’s owner. What caused the greatest public uproar was that Glaxo pushed its drug for use in children, although it not only didn’t work in children, it was also very harmful, and it wasn’t even approved for use in children. The illegal marketing involved withholding trials showing Paxil was ineffective. An internal company document showed that the company knew what it was doing: ‘It would be commercially unacceptable to include a statement that efficacy had not been demonstrated, as this would undermine the profile of paroxetine.’ The ruthless marketing worked. From 1998 to 2001, five million prescriptions a year were being written for Paxil and Zoloft for children and adolescents.6 We should remember that there are real tragedies behind the numbers and real people who have paid with their lives for the companies’ unscrupulous lies, frauds and crimes: Matt Miller was unhappy. Having moved to a new neighborhood and a new school, Matt was thrust into unknown territory without his support system of old friends with whom he had grown up. That summer, Matt was prescribed Zoloft … and was told to call his doctor in a week. On a Sunday night, after taking his seventh pill, Matt went to his bedroom closet, where there was a hook just a little higher than he was tall. Matt hung himself, having to lift his legs off the floor and hold himself there until he passed out. He was only thirteen years old. Jeremy Lown, a teenager, suffered from Tourette’s syndrome. To treat his uncontrollable tics and verbal outbursts, his neurologist prescribed Prozac. Three weeks after starting the medication, Jeremy hanged himself in the woods behind his house. Candace, a 12- year- old girl, was prescribed Zoloft because she suffered from anxiety. She was a happy child that had never been depressed or had suicidal ideation. She hanged herself after 4 days. Vicky Hartman was given a sample pack of Zoloft by her child’s doctor. She didn’t suffer from any mental disorder but mentioned she needed a ‘pick- me- up’ to help with stress. Soon after starting the medication, she shot her husband and herself. A man hanged himself after taking Prozac, which his cardiologist had prescribed for chest pain, and a woman shot herself after taking the Prozac her family doctor had prescribed for migraine. Twenty- year- old student Justin Cheslek had trouble sleeping and was prescribed sleeping pills by his doctor. A few days later, he complained to the doctor that the pills made him feel groggy and ‘depressed’. The doctor gave him Paxil, and Justin told his mother that Paxil made him feel awful, wound up, jumpy and unable to sit still or concentrate. Two weeks later, the doctor gave him another SSRI, Effexor (venlafaxine), which caused a seizure after the first tablet. Justin still felt ‘really, really bad’ and 3 weeks after he took his first Paxil tablet, he hanged himself. Justin had no history of depression and if he hadn’t used the term ‘depressed’, he might not have been prescribed SSRIs. He just had trouble sleeping. In the days before his death, Justin described a feeling of wanting to jump out of his skin, a symptom typical of akathisia, which may lead to suicide. In November 2010, Nancy and Shaun McCartney’s 18- year- old son, Brennan, went to their family doctor with a chest cold. The extroverted high school student mentioned feeling sad over breaking up with a girl he’d been seeing for 3 months. He left with a script for an antibiotic and a sample pack of Cipralex. Nancy expressed concern, as Brennan had no history of depression, but he assured her the doctor had said it would help. On the fourth day, Brennan seemed agitated when he left the house and he failed to come home. The next day his body was found. He had hung himself in a local park. Nancy wanted to warn other Canadians about Cipralex and submitted an adverse reaction report, and when she noticed a typo on her entry, she called the Vigilance Branch requesting a correction. She also asked for an updated copy but was told she’d have to fi le an access to information request. Seven months later, anyone searching Cipralex on MedEffect would find 317 reports, including five suicides, 12 suicide attempts and many references to suicidal ideation, but not Nancy’s submission. When the journalist writing about the tragedy asked Health Canada why, its spokesperson responded weeks later saying the entry was in the database and provided a screen grab. However, subsequent searches using the same terms failed to find it. It’s unbelievable. Not even suicides reported to the authorities may be traceable in their records. Here is an example that the advertising of prescription drugs to the public, which is legal in the United States, can kill healthy people who don’t need them: Ten years ago my irrepressible teenage daughter Caitlin returned from holiday with relatives in the US, where prescription drugs are widely advertised; she saw an ad for an antidepressant drug called Prozac and wanted to try it. She went to our local GP and it took her 8 minutes to get the prescription. Sixty- three days later, during which time she descended into unprecedented chaos, including neural twitches, violent nightmares and self- harm, she hanged herself. CONCEALING SUICIDES AND SUICIDE ATTEMPTS IN CLINICAL TRIALS He shall explore here what the true risks of suicide and suicidality with SSRIs are. They are certainly much larger than what the drug companies have told us. David Healy performed a study in 20 healthy volunteers – all with no history of depression or other mental illness – and to his big surprise two of them became suicidal when they received sertraline. One of them was on her way out the door to kill herself in front of a train or a car when a phone call saved her. Both volunteers remained disturbed several months later and seriously questioned the stability of their personalities. Pfizer’s own studies in healthy volunteers had shown similar deleterious effects, but most of these data are hidden in company files. FDA reviewers and independent researchers found that the big companies had concealed cases of suicidal thoughts and acts by labelling them ‘emotional lability’. However, the FDA bosses suppressed this information. When safety officer Andrew Mosholder concluded that SSRIs cause increased suicidality among teenagers, the FDA prevented him from presenting his findings at an advisory meeting and suppressed his report. When the report was leaked, the FDA’s reaction was to do a criminal investigation into the leak. There were other problems. In data submitted by GlaxoSmithKline to the FDA in the late 1980s and early 1990s, the company had included suicide attempts from the washout period before the patients were randomized in the results for the placebo arms of trials, but not from the paroxetine arms. A Harvard psychiatrist, Joseph Glenmullen, who studied the released papers for the lawyers, said that it’s virtually impossible that Glaxo simply misunderstood the data. Martin Brecher, the FDA scientist who reviewed paroxetine’s safety, said that this use of the washout data was scientific call illegitimate. Indeed. He believe it’s fraud. David Healy wrote in 2002 that, based on data he had obtained from the FDA, three of five suicide attempts on placebo in a sertraline trial had occurred during washout rather than while on placebo and that two suicides and three of six attempts on placebo in a paroxetine trial had also occurred in the washout period. Healy’s observations weren’t denied by Pfizer and Glaxo, but Glaxo again provided a glaring example that their lies are not of this world: The ‘drug’ v. ‘true placebo’ analysis Dr Healy describes is not only scientific cally invalid, but also misleading. Major depressive disorder is a potentially very serious illness associated with substantial morbidity, mortality, suicidal ideation, suicide attempts and completed suicide. Unwarranted conclusions about the use and risk of antidepressants, including paroxetine, do a disservice to patients and physicians. So, should we trust people who deliberately hide suicidal harms of their drug and hide trials that showed no effect and make billions out of their frauds, who are only responsible to their shareholders, and who nonetheless wants us to believe that patient welfare is their primary concern? Or should we trust an academic like Healy whose job it is to take care of the patients? At least three companies, Glaxo, Lilly and Pfizer, added cases of suicide and suicide attempts in patients to the placebo arm of their trials, although they didn’t occur while the patients were randomized to placebo. These omissions can be important for the companies in court cases. For example, a man on paroxetine had murdered his wife, daughter and granddaughter and committed suicide, but in its defense, Glaxo said that its trials didn’t show an increased risk of suicide on paroxetine. The pervasive scientific c misconduct has distorted seriously our perception of the benefits and harms of SSRIs. As an example, a 2004 systematic review showed that, when unpublished trials were included, a favorable risk–benefit profile changed to an unfavorable one for several of the SSRIs. Also in 2004, a researcher used the full reports of Glaxo’s trials that were made available on the internet as a result of litigation, and he found in his meta- analysis that paroxetine increased significantly suicidal tendencies, odds ratio 2.77 (95% confidence interval 1.03 to 7.41) He included three trials, among them the unpublished study 377, which didn’t show that paroxetine was better than placebo (Glaxo had stated in an internal document that ‘There are no plans to publish data from Study 377.’) He also included the infamous study 329. He described that an 11- year- old boy who threatened to harm himself and was hospitalized was coded as a case of exacerbated depression, and that a 14- year- old boy who had harmed himself and expressed hopelessness and possible suicide thoughts and was hospitalized was coded as a case of aggression. It is widely believed that SSRIs only increase suicidal behavior in people below 25 years of age, but this is not correct. A 2006 FDA analysis of 372 placebo controlled trials of SSRIs and similar drugs involving 100 000 patients found that up to about 40 years of age, the drugs increased suicidal behavior, and in older patients, they decreased it (see Figure 18.1). However, as explained below, it is much worse than this. A major weakness of the FDA study is that the agency asked the companies to adjudicate possibly suicide- related adverse events and send them to the FDA, which didn’t verify whether they were correct or whether some had been left out. We already know that the companies have cheated shamelessly when publishing suicidal events. Why should they not continue cheating when they know that the FDA doesn’t check what they are doing? Furthermore, collection of adverse events was limited to within one day of stopping randomized treatment, although stopping an SSRI increases the risk of suicidality for several days or weeks. This rule therefore also seriously underestimated the harms of SSRIs.Other data show that the huge FDA analysis cannot be reliable. An internal Lilly memo from 1984 reported that the German drug agency described two suicides and suicide attempts among only 1427 patients on fluoxetine in clinical trials even though patients at risk of suicide were excluded from the trials. A memo from Lilly Germany listed nine suicides in 6993 patients on fluoxetine in the trials. In contrast, there were only five suicides in total in FDA’s analysis of 52960 patients on SSRI drugs, or one per 10000 patients, although one would have expected 74 and 68, respectively, based on the two Lilly reports, or 13 per 10 000 patients. Many suicides are missing in the FDA analysis. In a 1995 meta- analysis, there were five suicides on paroxetine in 2963 patients, which is 17 per 10000 patients. This meta- analysis wrongly reported two suicides on placebo, which had occurred in the washout period. The UK drug regulator was much more careful than the FDA and did not only search for suicide terms in the documents but also read text in case report forms and narratives. They showed that paroxetine was harmful in adults with major depressive disorder. There were 11 suicide attempts on paroxetine (3455 patients) and only one on placebo (1978 patients), P = 0.058 for the difference. He wonder why no suicides were reported, as we would have expected six on paroxetine. A 2005 meta- analysis that built on data in a report the UK drug regulator had made found nine suicides in 23804 patients, or four per 10000. This was an unusually low rate, and it has been shown that the companies underreported the suicide risk. There were other oddities; the researchers found that non- fatal self- harm and suicidality were seriously underreported compared to the reported suicides. A 2005 meta- analysis of published trials including 87650 patients conducted by independent researchers included all ages and found double as many suicide attempts on drug than on placebo. Even so, they found that many suicide attempts must have been missing, e.g. by asking the investigators, some of whom responded that there were suicide attempts they had not reported, while others replied that they didn’t even look for them in their trials. There were other issues related to trial design that likely led to underestimation of suicide attempts, e.g. events occurring shortly after active treatment is stopped might very well be caused by the drug but were not counted. It is abundantly clear that suicides, suicidality and violence caused by SSRIs are grossly underestimated, and we also know the reasons. First, there is outright fraud. Second, many suicidal events have been coded as something else. Third, the drug industry has taken great care to bias its trials by only recruiting people at very low risk of committing suicide. Fourth, the companies have urged the investigators to use benzodiazepines in addition to the trial drugs, which blunt some of the violent reactions that would otherwise have occurred. Fifth, some trials have run- in periods on active drug, and patients who don’t tolerate it aren’t randomized, which comes close to scientific misconduct, as it artificially minimizes the occurrence of suicidality. Sixth, and perhaps the worst of all the biases, events occurring shortly after active treatment is stopped, e.g. because the patients feel very badly, might very well be suicidal events caused by the drug but are often not registered. Seventh, many trials are buried in company archives and these are not the most positive ones. Given what He have just described above, and earlier, e.g. that middle- aged women who use duloxetine for urinary incontinence have a suicide attempt rate that is more than double the rate among other women of a similar age, my take on all this is:SSRIs likely increase the risk of suicide at all ages. These drugs are immensely harmful. LUNDBECK’S EVERGREENING OF CITALOPRAM Lundbeck launched citalopram (Cipramil or Celexa) in 1989. It became one of the most widely used SSRIs and provided the company with most of its income. That was a risky situation to be in but Lundbeck was lucky. Citalopram is a stereoisomer and consists of two halves, which are mirror images of each other, but only one of them is active. Lundbeck patented the active half before the old patent ran out and called the rejuvenated me- again drug escitalopram (Cipralex or Lexapro), which it launched in 2002. When the patent for citalopram expired, generics of Cipramil entered the market at much lower prices, but the price of Cipralex continued to be very high. When He checked the Danish prices in 2009, Cipralex cost 19 times as much for a daily dose as Cipramil. This enormous price difference should have deterred the doctors from using Cipralex, but it didn’t. The sales of Cipralex were six times higher in monetary terms than the sales of citalopram both at hospitals and in primary care. He calculated that if all patients had received the cheapest citalopram instead of Cipralex or other SSRIs, Danish taxpayers could have saved around €30 million a year, or 87% of the total amount spent on SSRIs. How it is possible for doctors to have such a blatant disregard for the public purse to which we all contribute and why can it continue year after year? The old recipe with a blend of money and hyped research seems infallible. A psychiatrist described vividly that when Lundbeck launched Cipralex in 2002, most of the Danish psychiatrists (she did say most, although there are more than a thousand psychiatrists in Denmark) were invited to a meeting in Paris. That meeting seems to have been enjoyable, ‘with expensive lecturers – of course from Lundbeck’s own “stable” – luxurious hotel and gourmet food. A so-called whore trip. Under influence? No, of course not, a doctor doesn’t get influenced, right?’ When the patent of Cipramil was expiring, Jack M Gorman published an article in a special supplement of CNS Spectrums, a neuropsychiatric journal he edits.39 The article concluded that escitalopram may have a faster onset of action and greater overall effect than citalopram’40 Gorman was a paid consultant to Forest that marketed both drugs in North America, and Forest paid Medworks Media, the publisher of CNS Spectrums, to print the article. At the same time, Medical Letter, an independent drug bulletin with no advertising, also reviewed the two drugs and found no difference between them. On one of the occasions where He was invited to give a lecture for Danish psychiatrists, He expressed my doubts that a drug could be better than itself to a person sitting close to me at the lunch table. She was a chemist working at Lundbeck and didn’t agree. She sent me a copy of Gorman’s paper, which on page 2 says: ‘Brought to you by an unrestricted educational grant from Forest Pharmaceuticals, Inc.’ Oh no, He thought He would never accept ‘an unrestricted educational grant’ from a drug company, not even in the form of a reprint, but here it was. All three authors worked for Forest, Gorman as a consultant and the others in the company. The paper was a meta- analysis of three trials that compared the two drugs with placebo. What am He supposed to make out of a paper published in a bought supplement to a journal edited by a person who is also bought by the company? Nothing, He would say. We cannot trust the drug industry, and a paper published this way is nothing but an advertisement. There are so many ways a trial can be manipulated, and in SSRI trials it’s particularly crucial how the statistician deals with dropped out patients and other missing values. On top of this, Lundbeck was in a pretty desperate situation. He therefore wouldn’t believe anything unless He got access to the raw data and analyzed them myself. But it isn’t necessary to go to such lengths. What Forest published was small differences between the two drugs and between active drugs and placebo. After 8 weeks, the difference between the two drugs was 1, on a scale that goes from 0 to 60, and the difference between active drugs and placebo was 3. Obviously, a difference of 1 on a 60- point scale has no importance for the patients. Furthermore, as explained in Chapter 4, it doesn’t take much un-blinding before we find a difference of 3 between active drugs and placebo, even if the drugs have no effect on depression. There is therefore no good reason to use a drug that is 19 times more expensive than itself. The official task of the government- funded Danish Institute for Rational Drug Therapy is to inform Danish doctors about drugs in an evidence- based fashion. In 2002, the institute reviewed the clinical documentation for Lundbeck’s meagain drug, escitalopram, and informed Danish doctors that it didn’t have clear Reduction in MADRS score 0 4 8 12 0 1 2 4 6 8 16 Placebo Cipramil Cipralex Weeks 226 Deadly Medicines and Organized Crime advantages over the old drug, which contained the same active substance. Lundbeck complained loudly about this in the press and said it was beyond the institute’s competence to give statements that could affect the international competition and damage Danish drug exports. Although it wasn’t beyond the institute’s competence to give recommendations about new drugs, whatever the consequences for drug exports, the institute was reprimanded by the minister of health and it declined to comment when asked by a journalist, for pretty obvious reasons. The Danish drug industry has tried for years to get political backing for closing down the institute, which is a thorn in its flesh, as it reduces sales of expensive drugs, but it hasn’t succeeded. It seems that our highly praised governmental institute is only allowed to tell the truth about imported drugs, not about drugs we export. An untenable position that shows that principles are only valid as long as they don’t cost too much. Two years after these events, the institute announced that escitalopram was better than citalopram and might be tried if the effect of citalopram hadn’t been satisfactory. The institute must have stepped on its toes to find a politically correct way to express themselves. Its information to doctors now stated that they should usually choose the cheapest SSRI, as there are no major differences between the drugs. About escitalopram it said that ‘Two studies have shown that the effect of escitalopram comes somewhat faster than that of venlafaxine and citalopram, but with about the same maximum effect’, and ‘In a single study it was made likely in a subgroup analysis that escitalopram is a little better in severe depression than venlafaxine and citalopram.’ He had a big laugh when He saw the four references in support of these statements. Paper is grateful, as we say; it doesn’t protest, no matter what you write on it. One of the academic authors was Stuart Montgomery, who concealed that he worked for Pfizer helping the company to get sertraline approved at the same time as he worked for the UK drug regulator that approved the drug. He laughed again when an employee from the institute was interviewed in the TV news. She was pressured by the journalist who asked her if she couldn’t imagine any situation where it might be an advantage that the drug worked faster. Yes, she said, if a patient was about to throw herself out the window! She learned the hard way how to deal with journalists. Jokes won’t do on the news, particularly not if they are about patients. It was doubly ironic, as it has never been demonstrated that SSRIs decrease the risk of suicide; they seem to increase the risk (see above). Four independent reviews of the evidence – by the FDA, the American advisory group Micromedex, the Stockholm Medical Council and the Danish institute – concluded that escitalopram offers no significant benefit t over its predecessor. The Cochrane review on escitalopram says that it’s better than citalopram but warns against this finding because of potential sponsorship bias. The trials were performed by Lundbeck and many negative antidepressant trials never get published. Furthermore, the reporting of the outcomes in the included studies was often unclear or incomplete. Analyses made by disinterested parties who have access to the data, such as scientists working at drug agencies, have repeatedly found that there are no important differences in benefits and harms of the various Pushing children into suicide with happy pills SSRIs, whereas what gets published is seriously misleading. Comprehensive reviews by other researchers have also failed to find important differences. In 2003, Lundbeck breached the UK industry code of practice in its advertising. The company breached the code on five counts, notably by claiming that ‘Cipralex is significantly more effective than Cipramil in treating depression’. The company also attributed adverse effects to citalopram in its literature on escitalopram that weren’t mentioned in promotional material for citalopram. This confirms the adage that it’s surprising how quickly a good drug becomes a bad drug when a more expensive drug comes around. The UK advertising campaign was intensive and highly successful, as escitalopram rapidly gained market share. Lundbeck’s CEO, Erik Sprunk- Jansen, retired in 2003 and started a company selling herbal medicine. One of the products is Masculine, which ‘Spices up your love life’, and is said to give extra energy that strengthens the lust and blood circulation, typical mumbo- jumbo pep talk for alternative medicine. It doesn’t seem to matter much what drug pushers sell, as long as they sell something. In 2011, we asked Lundbeck for unpublished trials of its antidepressant drugs, which we needed for our research on suicidality, but we were told that the company, as a matter of principle, doesn’t hand out the clinical documentation that forms the basis for marketing authorization. The same year, Lundbeck’s new CEO, Ulf Wiinberg, denied in an interview that the increase in suicidal events with happy pills in children and adolescents means that the drugs increase the risk of suicide. He even stated that treatment of depression in children and adolescents decreases the suicide risk, in violation of the labelling that warns that the drugs may increase the risk of suicide. Why does any doctor trust what the companies tell them? Events in America were also interesting. In 2001, Lundbeck’s American partner Forest had performed a trial of citalopram (Celexa) for compulsive shopping disorder (I’m not joking), and Good Morning America told the viewers that this new disorder could affect as many as 20 million Americans of which 90% were women. Gorman appeared as an expert in the program and said that 80% of the compulsive shoppers had slowed their purchases on Celexa. The ensuing flurry of publicity forced the APA to say it had no intention of adding such a disorder to the DSM. In 2010, the US Justice Department announced that Forest had pleaded guilty to charges relating to obstruction of justice and the illegal promotion of citalopram (Celexa) and escitalopram (Lexapro) for use in treating children and adolescents with depression. Forest agreed to pay more than $313 million to resolve criminal and civil liability arising from these matters and also faced numerous court cases from parents to children who had either committed suicide or had tried. There were also charges that the company launched seeding studies, which were marketing efforts to promote the drugs’ use. Two whistle- blowers would receive approximately $14 million, and Forest signed a Corporate Integrity Agreement. Six years earlier, a Forest executive had testified before Congress that Forest followed the law and had not promoted Celexa and Lexapro to children, although Forest had illegally done exactly that The government mentioned that Forest publicized and circulated the positive results of a double- blind, placebo- controlled Forest study in 2004 on the use of Celexa in adolescents while, at the same time, failed to discuss the negative results of a contemporaneous double-blind, placebo-controlled Lundbeck study on the use of Celexa in adolescents, finished in 2002 in Europe but only mentioned in a textbook in Danish in 2003 in a single line of a chart. For 3 years, Forest executives didn’t disclose those results within the company or to outside researchers who published results on Celexa, and the existence of the Lundbeck study first came to public light when the New York Times published an article about it. Only then did Forest acknowledge the study as well as another, earlier trial that also failed to show any benefits of Lexapro as a depression treatment for children. Forest’s official excuse for not mentioning the negative trials was that ‘there was no citable public reference for the authors to examine’. But drug makers often announce trials with positive results without waiting for the results to be published, e.g. Forest issued a news release that highlighted the outcome of the positive Celexa trial already in 2001, shortly after the trial’s completion. Forest had 19000 advisory board members and used illegal kickbacks to induce physicians and others to prescribe Celexa and Lexapro, which allegedly included cash payments disguised as grants or consulting fees, expensive meals and lavish entertainment. On one occasion, Forest paid physicians five hundred dollars to dine at one of the most expensive restaurants in Manhattan and called them consultants – for the evening it seemed, and they didn’t do any consulting. Vermont officials found that Forest’s payments to doctors in 2008 were surpassed only by those of Eli Lilly, Pfizer, Novartis and Merck – companies with annual sales that were five to 10 times larger than Forest’s. What was Lundbeck’s reaction to the crimes? ‘We know Forest is a decent and ethically responsible firm and we are therefore certain that this is an isolated error.’ Perhaps this confidence in Forest’s business ethics was related to the fact that Lexapro sold for $2.3 billion in 2008. At any rate, we do know something about what it means to be ‘a decent and ethically responsible firm’. In 2009, the US Senate released documents it had requested from Forest.61 They start out by saying that Forest will communicate that Lexapro offers superior efficacy and tolerability over all SSRIs, which is pure fantasy. We are also told that the antidepressant market is the most heavily detailed category in the drug industry and that the sales mirror the promotional effort. Forest will develop ghostwritten articles for ‘thought leaders’, which will ‘allow us to fold Lexapro messages’, and will also use thought leaders at sponsored symposia, which will be published in supplements to medical journals to ‘help disseminate relevant Lexapro data and messages to key target audiences’. The thought leaders, advisors and Lexapro investigators will be kept informed by monthly mailings, and Forest will use the consultant services of thought leaders and advisors to obtain critical feedback and recommendations on ‘educational and promotional strategies and tactics’. Forest recruited about 2000 psychiatrists and primary care physicians whom the company trained to ‘serve as faculty for the Lexapro Speakers’ Bureau Program’. It was obligatory that speakers used the slide kit prepared by Forest.The documents include details of a huge program of phase IV studies (seeding trials it seems) and describe that investigator grants would cover the costs of ‘Thought Leader Initiated Phase IV studies with Lexapro’. The outcome of all these studies seemed to have been determined beforehand, even before the studies started, as key messages were listed for each study:Escitalopram has the lowest potential for drug interactionsEscitalopram has an excellent dosing profileEscitalopram represents a new more selective and/or potent generation of SSRIsEscitalopram is an effective first-line treatment for depressionEscitalopram has a favorable side-effect profileEscitalopram has improved side-effect, drug interaction and safety profiles resulting from the removal of the inactive moiety, the R- enantiomerEscitalopram is a refinement of citalopram in terms of antidepressant effect and tolerability.Forest provided ‘unrestricted grants’ to professional societies, e.g. the American Psychiatric Association, so that they could develop ‘reasonable practice’ guidelines. What was meant by this was ‘to improve the percent of patients who adhere to the full duration of therapy’. Forest became a corporate sponsor of the American College of Physicians ‘which provides additional marketing opportunities’, and this organization was also involved with developing the ‘reasonable practice’ guidelines. He could throw up. Total corruption of academic medicine resulting in immense harms to patients who cannot get off the drug once they have adhered to ‘the full duration of therapy’. So this is a ‘decent and ethically responsible firm’, right? ANTIPSYCHOTIC DRUGS Antipsychotics are dangerous drugs that should only be used if there is a compelling reason, and preferably as short- term therapy at a low dose because the drugs produce severe and permanent brain damage. As explained above, even most patients with schizophrenia can avoid the drugs and it results in much better long- term outcomes than if they are treated and substantial financial savings as well. Antipsychotics increase the risk of dying substantially through a variety of mechanisms, which include suicide, cardiac arrhythmias, diabetes and major weight gains. The drug companies have caused tremendous harm by their widespread illegal and aggressive promotion of the drugs for off- label use. The legal use is also increasing, e.g. in children, the use of antipsychotics went up eight- fold between 1993–1998 and 2005–2009, and it doubled in adults. The story of antipsychotics has many similarities to that of the SSRIs. The clinical research wasn’t aimed at clarifying the role of the new drugs for clinicians and patients but was driven by marketing strategy, and new drugs were much hyped although large, independent government- funded trials found they weren’t better than old drugs. A trial of 498 patients with a first- episode schizophrenia found no difference in discontinuation rates between four newer drugs and haloperidol. Discontinuation rate is a sound outcome, as it combines perceptions of benefits and harms of the drugs. The study was funded by three drug companies but they were kept at arm’s length. Antipsychotics are standard treatment for bipolar disorder, which is mainly iatrogenic, caused by SSRIs and ADHD drugs, and they are also used for depression when treatment with an antidepressant is not enough. We now see advertisements, e.g. for AstraZeneca, about combination therapy for depression, and there are even preparations that combine the drugs in the same pill, e.g. Symbyax from Lilly, which contains Prozac (fluoxetine) and Zyprexa (olanzapine), two of the worst psychotropic drugs ever invented. Like for the SSRIs, there are many perverse trials supporting antipsychotics for virtually everything. In 2011, an AstraZeneca trial studying whether quetiapine could prevent the development of psychosis in people as young as 15 years ‘at risk’ of psychosis was stopped after protests that it was unethical. There is no good reason to believe that these drugs can prevent psychosis, in fact, they cause psychosis in the long run (see above) and most people ‘at risk’ would never have developed psychosis. A 2009 meta- analysis of 150 trials with 21533 patients showed that psychiatrists had been duped for 20 years. The drug industry invented catchy but entirely misleading terms such as ‘second generation antipsychotics’ and ‘atypical antipsychotics’, but there is nothing special about the new drugs, and as they are widely heterogeneous, it’s wrong to divide them into two classes. It’s remarkable that it was possible to show in a meta- analysis of published trials that new drugs aren’t better than old ones, as the research literature is so flawed. Haloperidol is the comparator in most of the trials, and their design is often flawed, using too high doses or too quick dose increases for haloperidol and other old drugs, resulting in a false claim that a new drug is similarly effective but better tolerated. An analysis of 2000 trials in schizophrenia revealed a disaster area of poor- quality research that didn’t even improve over time, and with 640 different instruments to measure the outcome; 369 of these mostly homemade scales were only used once! Unsurprisingly, an internal Pfizer memorandum shows that the flaws are introduced deliberately: If we were going to have to increase dothiepin dosage from 75 mg to 100 mg, we should do so at 1 week rather than at 2 weeks, which would result in a high drop- out rate on dothiepin due to side effects. By 2 weeks, patients have learnt to live with side effects. ZYPREXA, ANOTHER TERRIBLE ELI LILLY DRUG TURNED INTO A BLOCKBUSTER The deceptions worked, as always. Everybody wants a ‘modern’ drug, whatever that means, and this bad habit is extremely costly, even when the ‘modern’ drug is only an old drug in disguise. Olanzapine was an old substance and the patent was running out, but Lilly got a new patent by showing that it produced less elevation of cholesterol in dogs than a never- marketed drug!9 This was totally ludicrous, and in fact, olanzapine raises cholesterol more than most other drugs. It could therefore have been marketed as a cholesterol- raising drug, but that wouldn’t have made Zyprexa a blockbuster with sales of around $5 billion per year for more than a decade. A Cochrane review from 2005 reported that the largest trial with olanzapine had been published 142 times in papers and conference abstracts. He is not kidding, it was the same trial in 142 publications. The carpet bombing also included criminal activities, and the aggressive marketing made Zyprexa the most widely used antipsychotic drug in the world, although it isn’t any better than far cheaper alternatives. In 2005, Zyprexa was Lilly’s top- selling drug at $4.2 billion. Money, marketing and lies ensured that doctors didn’t use the old cheap drugs. In 2002, the sales of Zyprexa were 54 times larger than the sales for haloperidol in Denmark, amounting to a staggering €30 million a year, although our country is very small. There was no excuse for this. Two years earlier, a meta- analysis was published in the BMJ that concluded that ‘the new drugs have no unequivocal advantages for first line use’. The last time He checked the price for Zyprexa, it cost seven times as much as haloperidol. It’s irresponsible to waste so much money, and patient organizations contribute to this. They only know what the drug firms have told them, or what the psychiatrists have told them, which is about the same, as the psychiatrists also generally only know what the drug firms have told them. It was therefore not surprising when the chairman of an organization for psychiatric patients in 2001 called it unethical that Danish psychiatrists in her view were too slow to use the newer antipsychotics such as Zyprexa and Risperdal (Risperidone). A researcher explained that many patients on Zyprexa increased their body weight by 15–25 kg during a few months, that there was a risk of diabetes, and that increased cholesterol was commonly seen. He also commented on the adverse effects of Risperdal and said that the likely reason that the chairman wanted these drugs to be used much more was that the adverse effects were little known. Wise words indeed. In Chapter 3, He described that Lilly agreed to pay more than $1.4 billion for illegal marketing for numerous off- label uses including Alzheimer’s, depression and dementia, and Zyprexa was pushed particularly hard in children and the elderly, although the harms of the drug are substantial, inducing heart failure, pneumonia, considerable weight gain and diabetes. In 2006, internal Lilly documents were leaked to the New York Times, which demonstrate the extent to which the company downplayed the risks of its drug. Lilly’s chief scientist, Alan Breier, told employees in 1999 that ‘weight gain and possible hyperglycemia is a major threat to the long- term success of this critically important molecule’, but the company didn’t discuss with outsiders that a 1999 study, disclosed in the documents, found that blood sugar levels in the patients increased steadily for 3 years. Lilly instigated legal action against a number of doctors, lawyers, journalists and activists to stop them from publishing the incriminating leaked documents on the internet, and after the injunction, they disappeared. In 2007, Lilly still maintained that ‘numerous studies … have not found that Zyprexa causes diabetes’, even though Zyprexa and similar drugs since 2003 on their label had carried an FDA warning that hyperglycaemia had been reported. Lilly’s own studies showed that 30% of the patients gained at least 10 kg in weight after a year on the drug, and both psychiatrists and endocrinologists said that Zyprexa caused many more patients to become diabetic than other drugs. Zyprexa is likely more harmful than many other antipsychotics. In 2001, Lilly’s best- selling antidepressant Prozac was running out of patent and the company was desperate to somehow fool people into using Zyprexa also for mood disorders and called it a mood- stabilizer rather than an antipsychotic. It doesn’t stabilize the mood, and it was also a challenge that general practitioners were worried about the harms of antipsychotics, but Lilly was determined to ‘change their paradigm’. The internal documents say it all. In psychiatry, it doesn’t really matter which drugs you have, as most drugs can be used more or less for everything, and psychiatrists are easily amenable for manipulation, even in the way they define and name their diseases. Let’s estimate how many people Lilly has killed with Zyprexa. In 2007, it was reported that more than 20 million people had taken Zyprexa. A meta- analysis of the randomized trials of olanzapine and similar drugs given to patients with Alzheimer’s disease or dementia showed that 3.5% died on drug and 2.3% on placebo (P = 0.02). Thus, for every 100 patients treated, there was one additional death on the drug. Elderly patients are often treated with several drugs and are more vulnerable to their harms, which means that the death rate is likely higher than in younger patients. However, the reviewed trials generally ran for only 10–12 weeks, and most patients in real life are treated for years. Further, drugs like Zyprexa are most used in the elderly, and as deaths are often underreported in trials, the true death rate is likely higher than shown in the meta- analysis. One death in a hundred therefore seems a reasonable estimate to use. He therefore estimate that 200000 of the 20 million patients treated with Zyprexa have been killed because of the drug’s harms. What is particularly saddening is that many of these patients shouldn’t have been treated with Zyprexa. As Zyprexa is not the only drug, the death toll must be much higher than this. AstraZeneca silenced a trial that showed that quetiapine (Seroquel) led to high rates of treatment discontinuations and significant weight increases while the company at the same time presented data at European and US meetings that indicated that the drug helped psychotic patients lose weight. Speakers Slide Kit and at least one journal article stated that quetiapine didn’t increase body weight while internal data showed that 18% of the patients had a weight gain of at least 7%. AstraZeneca propagated other lies. It presented a meta- analysis of four trials showing that quetiapine had better effect than haloperidol, but internal documents released through litigation showed it was exactly the opposite: quetiapine was less effective than haloperidol. THE BOTTOM LINE OF PSYCHOTROPIC DRUGS How come we have allowed drug companies to lie so much, commit habitual crime and kill hundreds of thousands of patients, and yet we do nothing? Why don’t we put those responsible in jail? Why are many people still against allowing citizens to get access to all the raw data from all clinical trials and why are they against scrapping the whole system and only allow publicly employed academics to test drugs in patients, independently of the drug industry? He know some excellent psychiatrists who help their patients a lot, e.g. David Healy uses watchful waiting before giving drugs to first- episode patients. He also know that some drugs can be helpful sometimes for some patients. And He is not ‘antipsychiatry’ in any way. But my studies in this area lead me to a very uncomfortable conclusion: Our citizens would be far better off if we removed all the psychotropic drugs from the market, as doctors are unable to handle them. It is inescapable that their availability creates more harm than good."It is very sad when you use such a fantastic instrument as the randomized trial is and abuse it for monetary gains.When the drug industry cheats, with its data, it can some times kill tens of thousands of patients.""We have a system where drug regulators rely on what the industry tells them, and If the industry manipulated the evidence they can often earn billions of dollars compared to if they were honest.What I have seen with Psychiatry is worse than I have seen anywhere else.It is just incredible the extent the drug industry has cheated with its trials, and how it has withheld even lethal harms, suicides, from public view.""Their business model fulfills the criteria for organized crime according to US law."In the current conman game version of Psychiatry clinicians can mock diagnose people using an hour long office interview and Psychological word tests and then prescribe multiple patented medicines all of which "work" by drugging the brain. That they have no interest in correcting chemical imbalances is shown by the lack of differential diagnosis, pursuit of what underlying problems actually exist for a patient, and that the idea of using vitamins and other biochemicals as treatment is forbidden from mention and totally excluded from use. The "Meds" are each and all lucrative brain drugging chemicals. The "Diagnoses" can be one time Psychological affairs - Psychological diagnosing - leading to lifetime labeling and life time prescription drugging involving no Medical testing as these are non Medical, D.S.M. Psychiatric diagnoses.The tests by the drug company showed Prozac the first SRI caused suicide. Prior to it being marketed in the US this was known but it suicidality was presented, packaged, as a unsure controversy many many years later."It is terribly sad that the Psychiatrists at large cannot see how much harm they are causing." -- Interview with Peter GøtzscheWithin the same time period that Prozac was first approved by the FDA marketed in the US, L-Tryptophan was banned for many years by the FDA.Psychological Harassment or Workplace Psychological HarassmentPsychological Harassment consists of using psychological manipulations to induce stress, a weapon that uses coritsol and adrenaline, and wear a person out tactics to lead to a burnout to get rid of someone or eliminate their means of subsistence.Invisible Weapons: Psychological the Mind <-> Physical the BodyOne invisible weapon or technology that affects the mind, psychological manipulations or harassment is used to use another invisible weapon that affects the body, the weapon of high levels of stress and sleep deprivation,coritsol and adrenaline, which can lead to acid-base disorders and serious illness such as brain aneurysm, heart attacks, and cancer.Invisible Weapons: Means of Subsistence -> HomelessnessPsychological Harassment or Criminal Psychological Harassment is used to eliminate the means of subsistence of victims and to make them more vulnerable to organized crime. By eliminating the means of subsistence of victims the victims are unable to provide for themselves or defend themselves and can be driven to homelessness.A Law Enforcement ProcedureA law enforcement procedure exists that consists of sending cases or claims of Psychological Harassment or Criminal Psychological Harassment to hospitals and hospital staff members such as social workers and psychiatry.Credibility of Victims: Social Workers and Medical Professionals, PsychiatryMedical professionals and psychiatry are not there to conduct investigations but to treat medical conditions. Given the fact that psychiatry still denies that psychological harassment exists the medical psychiatric file that is created and psychiatry its self can be used to attack the credibility of victims of criminal psychological harassment or to discredit victims of other types of crime.Organized crime can use psychiatry and this law enforcement procedure to make victims vulnerable to criminal psychological harassment or crime.Medical community members have also been hiding or used to hide the effects of high levels of stress and sleep deprivation on the body of victims of this type of crime.Credibility of Victims: Advance Technology and AmmunitionLike psychological harassment or criminal psychological harassment that is denied to exist by psychiatry, advanced technology that uses sound, for example, can also be used by organized crime to allow or give psychiatry more credibility or more ammunition to attack or weaken the credibility of victims of organized crime.Organized Crime and Criminal Psychological Harassment NetworksOrganized Crime or Criminal Psychological Harassment Networks can use Criminal Psychological Harassment to further isolate and attack a victim’s credibility and use or exploit the law enforcement procedure of sending cases of criminal psychological harassment to social workers and psychiatric hospitals that are not law enforcement members, part of law enforcement, or criminal investigators for psychological evaluation.This procedure can be used to attack the credibility of victims of crime by organized crime or corrupt members of the medical community combined with the fact that psychiatry denies the existence of psychological harassment. As medical professionals, psychiatrists will tell you themselves they are not there to conduct investigations but to treat a medical condition or health issue.The Psychological Manipulation toolset describes a wide variety of psychological manipulation tools that are or can be used by Criminal Psychological Harassment Networks.Two Abusive Practices by Some Law Enforcement Organizations or MembersOne abusive practice by some law enforcement organizations is to send cases of criminal harassment or criminal psychological harassment to social workers and psychiatry resulting in an attack to the victim’s credibility and another one is false accusations of criminal mischief.Crime and Fraud in the Mental Health IndustryMedicaid/Medicare fraud. Sexual assault. Child molestation.Rape. Drug possession. Child pornography. Murder. Patient abuse.These are all crimes for which psychiatrists, psychologists and other mental health practitioners have been criminally charged, convicted and/or lost their licenses.A prison term or revoked license has not always stopped a psychiatrist from later attempting to acquire a license elsewhere or even to take up unlicensed practice or practice in a sector of the healing arts that is not regulated.Psychiatric and psychological professional associations do not police ethical breaches, violations of law or criminality in their ranks. Instead, as former president of the American Psychiatric Association (APA) Paul Fink, arrogantly admitted: "It is the task of the APA to protect the earning power of psychiatrists."1For these reasons, Citizens Commission on Human Rights developed this database that lists people in the mental health industry who have been criminally charged, convicted and/or sentenced as well as those who have been investigated and charged by state health care licensing boards. Utilizing this database and other investigative sources, members of the public, government agencies and others can track disciplinary or criminal cases, and verify whether a mental health practitioner has existing charges, and the result of prior charges including criminal or disciplinary records or convictions.De-registered, even criminally charged and jailed psychiatric professionals can skip states, even countries and continue practicing. Some of the most infamous mental health criminals continue to "care" for the most vulnerable in society by simply changing cities or countries.Because of this, the following database is being presented as a public interest service to law enforcement agencies, health care fraud investigators, immigration offices, international police agencies, medical and psychological licensing boards, and the general public.It is a list of convicted mental health practitioners reported to CCHR International since 1990. It is, by far, an incomplete list and does not include all cases reported to law enforcement agencies or the courts.You, too, can contribute to this public warning by reporting and sending documentary evidence about criminal arrests and convictions in the mental health industry to CCHR International: Fill out our Abuse Form.Many psychiatrists have an intimate knowledge of criminality-one which has nothing to do with the professions involvement in the expert witness field.• Between $20 billion and $40 billion is defrauded by the American psychiatric industry in any given year.• At least 10% of psychiatrists admit to sexually abusing their patients: In America, that's at least 4,500 rapes and, internationally, more than 15,000 rapes.• Psychiatrists, psychologists and psychotherapists have the dubious distinction of having laws specifically designed to curtail their tendency to commit sex crimes against those in their charge.• A 1992 study of Medicaid and Medicare insurance fraud in the U.S. showed psychiatry to have the worst track record of all medical disciplines.A close inspection of their disastrous results, reveals that psychiatrists are the last people who should be in charge of improving literacy, drug and criminal rehabilitation, or to be used as "experts" in our courtsIt is a crime against humanity to give a profession of pseudoscientific neo-phrenologists the unlimited right to forcibly rape the brains of any human being in society they choose to label and smear, as with 'schizophrenia' label for the 'crime' of daring to experience extreme states of mind.This label decimates the humanity and equality of millions of people who have had this label put on them, usually forcibly, in a relationship with a quack psychiatrist forced on them by the 'mental health' laws. The destruction this label has caused is up there with the worst of racism and prejudice in human history. Psychiatry as usual, needs to hang its head in shame. Some people have extreme emotional problems, true, some people believe things that are not believed by all others, true. This is not a disease.These problems that people have are unique to the person and not the same as the next person's and not able to be correctly brought under the one umbrella term, the same pathetic psychiatry invented label. Any time you use the label 'Schizophrenic' to define a person you are guilty of assaulting that person's humanity. They are a person, who has had problems, and a quack profession which has discovered nothing at all about anybody's biology has put a label on them, and how dare you call them by that label that they didn't even ask for, wanted no part of, yet was forced on them by the government. How dare you. How dare you even call yourself someone who has concern for people with personal problems if you're willing to decimate their lives by forcing toxic drugs and quack labels on them.So many people in the psychiatric profession need to go to prison and be tried for crimes against humanity. How dare anybody be so arrogant as to put a label on somebody against their will. For shame.The medical cartel, one of a handful of evolving super-cartels that strive for more power every day, is rife with so much fraud it's astounding. In the psychiatric arena, for example, an open secret has been bleeding out into public consciousness for the past ten years.THERE ARE NO DEFINITIVE LABORATORY TESTS FOR ANY SO-CALLED MENTAL DISORDER.And along with that:ALL SO-CALLED MENTAL DISORDERS ARE CONCOCTED, NAMED, LABELED, DESCRIBED, AND CATEGORIZED by a committee of psychiatrists, from menus of human behaviors.Their findings are published in periodically updated editions of The Diagnostic and Statistical Manual of Mental Disorders (DSM), printed by the American Psychiatric Association.For years, even psychiatrists have been blowing the whistle on this hazy crazy process of "research."Of course, pharmaceutical companies, who manufacture highly toxic drugs to treat every one of these "disorders," are leading the charge to invent more and more mental-health categories, so they can sell more drugs and make more money.But we have a mind-boggling twist. Under the radar, one of the great psychiatric stars, who has been out in front inventing mental disorders, went public. He blew the whistle on himself and his colleagues. And for 2 years, almost no one noticed.His name is Dr. Allen Frances, and he made VERY interesting statements to Gary Greenberg, author of a Wired article: "Inside the Battle to Define Mental Illness." (Dec.27, 2010).Major media never picked up on the interview in any serious way. It never became a scandal.Dr. Allen Frances is the man who, in 1994, headed up the project to write the latest edition of the psychiatric bible, the DSM-IV. This tome defines and labels and describes every official mental disorder. The DSM-IV eventually listed 297 of them.In an April 19, 1994, New York Times piece, "Scientist At Work," Daniel Goleman called Frances "Perhaps the most powerful psychiatrist in America at the moment..."Well, sure. If you're sculpting the entire canon of diagnosable mental disorders for your colleagues, for insurers, for the government, for Pharma (who will sell the drugs matched up to the 297 DSM-IV diagnoses), you're right up there in the pantheon.Long after the DSM-IV had been put into print, Dr. Frances talked to Wired's Greenberg and said the following:"There is no definition of a mental disorder. It's bullshit. I mean, you just can't define it."BANG.That's on the order of the designer of the Hindenburg, looking at the burned rubble on the ground, remarking, "Well, I knew there would be a problem."After a suitable pause, Dr. Frances remarked to Greenberg, "These concepts [of distinct mental disorders] are virtually impossible to define precisely with bright lines at the borders."Frances might have been referring to the fact that his baby, the DSM-IV, had rearranged earlier definitions of ADHD and Bipolar to permit many MORE diagnoses, leading to a vast acceleration of drug-dosing with highly powerful and toxic compounds.Finally, at the end of the Wired interview, Frances flew off into a bizarre fantasy:"Diagnosis [as spelled out in the DSM-IV] is part of the magic...you know those medieval maps? In the places where they didn't know what was going on, they wrote 'Dragons live here'...we have a dragon's world here. But you wouldn't want to be without the map."Translation: People need to hope for the healing of their troubles; so even if we psychiatrists are shooting blanks and pretending to know one kind of mental disorder from another, even if we're inventing these mental-disorder definitions based on no biological or chemical diagnostic tests---it's a good thing, because people will then believe there is hope for them; they'll believe it because we place a name on their problems...If this is medical science, a duck is a rocket ship.If I were an editor at one of the big national newspapers, and one of my reporters walked in and told me, "The most powerful psychiatrist in America just said the DSM is sheer b.s. but it's still important," I think I'd make room on the front page.If the reporter then added, "This shrink was in charge of creating the DSM-IV," I'd clear more room above the fold.If the reporter went on to explain that the whole profession of psychiatry would collapse overnight if the DSM was discredited, I'd call for a special section of the paper to be printed.I'd tell the reporter to get ready to pound on this story day after day for months. I'd tell him to track down all the implications of Dr. Frances' statements.I'd open a bottle of champagne to toast the soon-to-be-soaring sales of my newspaper.And then, of course, the next day I'd be fired.Because there are powerful multi-billion-dollar interests at stake, and those people don't like their deepest secrets exposed in the press.And as I walked out of my job, I'd see a bevy of blank-eyed pharmaceutical executives marching into the office of the paper's publisher, ready to read the riot act to him.Keep in mind that Dr. Frances' work on the DSM IV allowed for MORE toxic drugs to be prescribed, because the definition of Bipolar was expanded to include more people.Adverse effects of Valproate (given for a Bipolar diagnosis) include:acute, life-threatening, and even fatal liver toxicity;life-threatening inflammation of the pancreas;brain damage.Adverse effects of Lithium (also given for a Bipolar diagnosis) include:Inter cranial pressure leading to blindness;peripheral circulatory collapse;stupor and coma.Adverse effects of Risperdal (given for "Bipolar" and "irritability stemming from autism") include:serious impairment of cognitive function;fainting;restless muscles in neck or face, tremors (may be indicative of motor brain damage).Dr. Frances self-admitted label-juggling act also permitted the definition of ADHD to expand, thereby opening the door for greater and greater use of Ritalin (and other similar compounds) as the treatment of choice.So what about Ritalin?In 1986, The International Journal of the Addictions published a most important literature review by Richard Scarnati. It was called "An Outline of Hazardous Side Effects of Ritalin (Methylphenidate)" [v.21(7), pp. 837-841].Scarnati listed a large number of adverse effects of Ritalin and cited published journal articles which reported each of these symptoms.For every one of the following (selected and quoted verbatim) Ritalin effects, there is at least one confirming source in the medical literature:Paranoid delusionsParanoid psychosisHypomanic and manic symptoms, amphetamine-like psychosisActivation of psychotic symptomsToxic psychosisVisual hallucinationsAuditory hallucinationsCan surpass LSD in producing bizarre experiencesEffects pathological thought processesExtreme withdrawalTerrified affectStarted screamingAggressivenessInsomniaSince Ritalin is considered an amphetamine-type drug, expect amphetamine-like effectsPsychic dependenceHigh-abuse potential DEA Schedule II DrugDecreased REM sleepWhen used with antidepressants one may see dangerous reactions including hypertension, seizures and hypothermia convulsionsBrain damage may be seen with amphetamine abuse.A recent survey revealed that a high percentage of children diagnosed with bipolar had first received a diagnosis of ADHD. This is informative, because Ritalin and other speed-type drugs are given to kids who are slapped with the ADHD label. Speed, sooner or later, produces a crash. This is easy to call "clinical depression." Then comes Prozac, Paxil, Zoloft. These drugs can produce temporary highs, followed by more crashes. The psychiatrist notices the up and down pattern - and then comes the diagnosis of Bipolar (manic-depression) and other drugs, including Valproate and Lithium.In the US alone, there are at least 300,000 cases of motor brain damage incurred by people who have been prescribed so-called anti-psychotic drugs (aka "major tranquilizers"). Risperdal (mentioned above as a drug given to people diagnosed with Bipolar) is one of those major tranquilizers. (source: Toxic Psychiatry, Dr. Peter Breggin, St. Martin's Press, 1991)This psychiatric drug plague is accelerating across the land.Where are the mainstream reporters and editors and newspapers and TV anchors who should be breaking this story and mercilessly hammering on it week after week? They are in harness.And Dr. Frances is somehow let off the hook. He's admitted in print that the whole basis of his profession is throwing darts at labels on a wall, and implies the "effort" is rather heroic - when, in fact, the effort leads to more and more poisonous drugs being dispensed to adults and children, to say nothing of the effect of being diagnosed with "a mental disorder." I'm not talking about "the mental-disease stigma," the removal of which is one of Hillary Clinton's missions in life. No, I'm talking about MOVING A HUMAN INTO THE SYSTEM, the medical apparatus, where the essence of the game is trapping that person to harvest his money, his time, his energy, and of course his health---as one new diagnosis follows on another, and one new toxic treatment after another is undertaken, from cradle to grave. The result is a severely debilitated human being (if he survives), whose major claim to fame is his list of diseases and disorders, which he learns to wear, like badges of honor.More on “MIND”Before I discuss some of the ways the idea of mental illness is used to deprive persons of liberty and justice, I want to be clear with readers about the meaning of certain terms, and in some cases, my opinion of certain psychiatric-legal practices. In order to communicate effectively, we must agree on the meaning of these terms.“Mental illness” generally refers to how certain people behave. It can also be used to explain why people behave the way they do. It is a fact that there is no literal disease identified by pathologists as mental illness, be it a thought disorder, personality disorder, affective or mood disorder, and/or anxiety-based disorder. In the world of psychiatry and clinical psychology, there are multiple disorders included under each of those rubrics. Mental “disorder” is synonymous with mental “illness.” These are terms used by members of the mental health profession to do and not do certain things to certain people.Insanity is a legal term. It generally refers to a person’s alleged state of mind when he committed a criminal act. There are various ways in which courts have defined insanity. These include whether or not a person knew what he was doing at the time of the criminal act, and whether or not a person knew what he was doing was right or wrong. A person may know what he was doing and know that what he was doing was wrong, but claim, or psychiatrists may claim, that he could not resist the impulse to commit a crime. This is referred to as “irresistible impulse.” Under the “Durham rule,” jurors were told to figure out whether a defendant’s criminal act was the product of a mental illness. The jurors were not told what “product” meant, and they were not told what “mental illness” meant. Others believe that mental illness means irrationality. This raises the question, irrational according to whom? Many people, psychiatrists and legal experts alike, use the terms mental illness and insanity interchangeably. Yet mental illness is a pseudo-medical term. I do not believe a psychiatrist can determine via a psychiatric examination or any other way what a defendant’s state of mind was six months in the past when he committed a criminal act. I don’t think one person can know another’s state of mind in the present moment.The mental health profession includes psychiatrists, psychologists, social workers, and various categories of professional counselors. Since psychiatrists are the major players empowered by the state to commit persons to mental hospitals, make declarations regarding competence to stand trial, prescribe drugs, and give psychiatric examinations in court at the request of a judge, prosecutor and/or defense counsel in order to support an insanity plea, I’m using the word “psychiatrist” to stand for all members of the mental health profession. Many members of the mental health profession play key roles reinforcing belief in mental illness as a treatable literal disease.I differentiate here between contractual or consensual psychiatry and institutional or coercive psychiatry. There are, in my opinion, as many different schools of personality theory as there are religions, and as my colleague and friend Thomas Szasz points out in his book entitled The Myth of Psychotherapy: Mental Healing as Religion, Rhetoric and Repression (1978), treatment approaches to mental illness have more to do with religion and ethics than medicine and science. Moreover, the fact that drugs change behavior from socially unacceptable to socially acceptable does not mean a person needed that drug in a biological or chemical sense. Many people feel better after a glass of wine in the evening. This does not mean they suffer from wine deficiency.I am not an anti-psychiatrist. I do not object to people who want to believe or go to a psychiatrist who believes in mental illness. I do not think the state should prohibit people from ingesting strong drugs to change the way they feel, either by prescription or by using those drugs that are currently illegal. I believe in the repeal of all drug prohibition, including prescription drugs. In my opinion, drugs are intrinsically neither safe nor dangerous, neither good nor bad. This all depends on how one uses a drug. My concern here is with institutional or coercive psychiatry. In contractual or consensual psychiatry, the psychiatrist is an agent of the patient. The patient can fire the psychiatrist any time he wants to do so. In institutional or coercive psychiatry, the psychiatrist pretends to be an agent of the patient, but is really an agent of a state institution. The patient cannot fire his psychiatrist.While from my perspective I would oppose the violation of even one person’s rights through psychiatric coercion – while I would oppose even one person being involuntarily committed to a prison called a mental hospital – in reality thousands of people are held in mental institutions across the United States at any given time. Some were forced into a psychiatric facility and cannot get out. Others chose to enter a facility voluntarily and can’t get out. A large part of treating mental illness involves forced medication and forced electroshock therapy (ECT).There are many situations where the idea of mental illness is used to coerce people. I cannot cover all of them here, thus I’m narrowing my focus to three psychiatric strategies used to coerce people. There are more terms, definitions and descriptions we must be clear about before I describe these strategies.Disease versus BehaviorA disease refers to a histological (tissue) lesion, wound, or cellular abnormality. Mental illness is not included in standard textbooks on pathology because it refers to behavior, not cellular pathology. This distinction between behavior and disease is important because people tend to confuse the one with the other. Behaviors can be influenced by disease, and vice versa, however behaviors are not diseases, and vice versa. Smoking is a behavior. Lung cancer is a disease. Drinking alcohol is a behavior. Cirrhosis of the liver is a disease.Diseases are found in a cadaver upon autopsy. Behaviors cannot be found in a cadaver during autopsy for obvious reasons. Disease is something that a person has. Behavior is something that a person does.When I say there is no such thing as mental illness, I mean the following: The mind, consciousness, and thinking is not susceptible to disease. “It” cannot get sick or diseased. That represented by the pronoun “I” cannot get sick or diseased. The mind cannot be diseased because it is not a biological entity. STRICTLY SPEAKING, THERE IS NO SUCH THING AS THE MIND. Since there is no such thing as the mind, it cannot be ill or diseased. Put another way, the mind can be sick or diseased in a metaphorical sense only. Since the mind cannot be sick or diseased, it also cannot be healthy.Refer: http://www.cato-unbound.org/2012/08/06/jeffrey-schaler/strategies-psychiatric-coercionThe brain can be diseased, just as any part of the body can be diseased. The human body is susceptible to literal disease; the human mind is not. I can tell you a sick joke and you know what I mean by “sick joke.” I cannot give antibiotics or any other literal medicine to a sick joke. I can’t treat a sick joke. Since the mind cannot be diseased, or, since the mind can be diseased in a metaphorical sense only, like a sick joke, it cannot be treated, or given medicine, to make it healthy, except in a metaphorical way.None of this is to state or imply that people labeled or “diagnosed” as mentally ill are not engaged in certain behaviors that others may find disturbing. A person plucks out his own eyes; another amputates his penis; another injects saliva under her skin to deliberately create infection. Mental health professionals and laypersons alike “diagnose” or label the persons engaging in such disturbing behaviors as mentally ill. The behaviors clearly exist. They are sick only in the sense that a joke is sick, that is, they are sick in a metaphorical sense, but not in a literal sense.Description versus ExplanationIn my opinion, we must not confuse the accurate description of a phenomenon with an explanation for why the phenomenon exists. Schizophrenia, for example, is a term used to explain why people engage in certain behaviors that others find disturbing. It is also a term, as are the so-called mental disorders listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), used to deprive people of liberty when they have committed no crime and to absolve people of responsibility when they have committed a crime. While there is no such thing as mental illness, and while there can be no such thing as mental illness, people act as though mental illness is as real as cancer in order to do certain things to other people. Many people say, “just because we have not discovered the cause of mental illness does not mean we won’t discover a cause.” I disagree. We will never discover a cause for mental illness because there is no illness, no disease called mental illness. There is no “it.” “It” does not exist. “It” is not a discrete variable. The term and diagnosis of mental illness – and obviously there can be no accurate diagnosis of mental illness since there is no disease to diagnose – is a rhetorical device, a political and behavioral strategy that certain people, as we shall see, benefit from.While this perspective on mental illness is considered controversial and a minority opinion, it is in many ways simply the application of scientific rules for disease identification and classification. Pathologists do not include mental illness in standard textbooks on pathology. Behavior is not a tissue. Behavior is not a disease. There is nothing particularly controversial about pathology and nosology, the classification of diseases. Saying that schizophrenia is not a disease is no more controversial than saying that cancer is a disease.So, what is behavior? Behavior means mode of conduct, deportment. It refers to how a person acts. Behavior is an activity. Behavior is the expression of moral agency, the expression of values. We know something about what a person values by what she does. There is no such thing as an involuntary behavior. Even in a gun-to-the-head scenario, a person chooses to act one way versus another. An epileptic seizure is not an involuntary behavior. It is more like a neurological reflex. It is not voluntary; it is not the expression of choice or volition. Knee-jerk is a patellar reflex and is not volitional.Now, why a person engages in certain behaviors is an entirely different matter. When someone states “schizophrenia is a chemical imbalance,” I assert that they are being inaccurate. “Chemical imbalance” is an explanation for why a person engages in self-reported imaginings, what is referred to as hallucination, the primary characteristic of schizophrenia. (There is no such thing, no such disease, as schizophrenia.) There are socially acceptable self-reported imaginings, or hallucinations, and socially unacceptable ones. Claiming that Jesus has entered one’s heart may be a socially acceptable self-reported imagining. Claiming that Martians are beaming messages to me through the fillings in my teeth may be a socially unacceptable self-reported imagining. The former is referred to as a valued religious experience. The latter is referred to as schizophrenia, a type of mental illness.An explanation of a behavior may or may not be accurate, but an explanation of the behavior called or labeled as “schizophrenia” should not be confused with that same behavior’s description. People tend to confuse the two, just as people confuse behavior and disease, mind and brain, and so on.Categories of Explanations for BehaviorExplanations for behavior fall into four categories: Theological or spiritual explanations are one; biological explanations are a second and are focused primarily on the structure and function of the nervous system, specifically, how neurons communicate with one another; psychological explanations, including all the different theories about personality, are a third category; and finally we have socio-cultural explanations, a fourth category, where the meaning of a behavior is contingent upon the cultural context within which the behavior occurs.Socially acceptable and socially unacceptable behaviors vary by cultural context. Literal diseases do not. In the United States, homosexuality is no longer considered a disease. In Uganda, homosexuality is considered a disease, a sin, and a crime. Controversial legislation punishing homosexuality with the death penalty has been proposed in Uganda. Obviously, it is a very backward country, composed of very backward people, when it comes to protecting individual rights. Much of their antipathy towards persons who choose homosexual ways of having sex comes from religious influences.Using logic and empirical methods, people may gather evidence and try to find out which of the four categories of explanation for behavior is most accurate when it comes to describing, explaining, predicting, and controlling behavior. Yet much of what passes as “science” regarding psychiatric and behavioral research does not utilize Sir Karl Popper’s crucially important method of falsifying a hypothesis. Gathering “evidence” to support a hypothesis is the way most behavioral research is conducted. The fact that no two people are identical is generally disregarded when it comes to interpreting behavioral research. While the allele (mutation) of a specific gene responsible for “building” a specific neurotransmitter receptor may be a discrete variable, the behavior that is tested for correlation, ultimately for a causal relationship, is not a discrete variable. No two behaviors are identical.What we do or don’t do about abnormal behaviors referred to as mental illnesses, or mental disorders, is different from describing and explaining behavior. I refer to this as policy in four domains. How we describe and explain behavior has important implications for legal, clinical, social (sociologically, meaning informal social controls, including relational and self controls, without involvement on the part of the state), and public policy (sociologically, meaning formal social controls where the state is involved).Keeping in mind what I’ve written above regarding the meaning of and differences among certain terms as a context or background, I would now like to focus on how the idea of mental illness is used by institutional psychiatry. When it comes to legal procedures, including criminal and civil procedures, all four policy domains are involved in what people do and don’t do in the name of mental illness. None of the four policy domains are mutually exclusive.The Right to Refuse Psychiatric Treatment for Mental IllnessMost people recognize that literal treatment for literal disease is a choice, subject to consent. People have the right to refuse treatment when they have lung cancer, or are otherwise very sick, despite the fact that doing so may mean certain death. When you elect to undergo major surgery, you must sign a consent form. Even when you request a vaccination for influenza, you still must sign a consent form.There are three relatively uncontroversial situations in which treatment proceeds legally without consent: The first is the medical treatment of children. The second is the treatment of people when they are literally unconscious. And the third is the treatment of persons with contagious disease.Children may be treated, or poked with a hypodermic syringe to vaccinate, or to collect blood without their consent, mainly because the children are in a custodial or guardian relationship with their parent(s), and their freedom, like their responsibility, is limited. We accept that when a person is a child he or she may not fully comprehend the consequences of refusing treatment. Obviously, the distinction between adult and child is somewhat arbitrary. There are many people who are over twenty-one years of age who still act in immature ways. There are many people who are under twenty-one years of age who act in mature ways. It seems odd that courts will allow fourteen-year-old children to be tried as adults for particularly heinous criminal acts. However, fourteen-year-old children are not granted the freedoms and privileges of adulthood for demonstrating virtuous behaviors and for demonstrating a clear comprehension of the relationship between specific behaviors and their consequences. Most people recognize and accept that children can and should be coerced into receiving medical treatment when their parent(s) deem it necessary to do so. (Obviously, it is preferable to gently explain why the prick of a needle is necessary, however, children vary by age in terms of their understanding and willingness to submit to pain, regardless of why and who says doing so is necessary.)The second situation when medical treatment occurs without consent is when a person is literally unconscious. Consider a pedestrian crossing a street at a marked crosswalk during rush-hour traffic. Our imaginary pedestrian is hit by a car, and as he falls to the street he hits his head on the pavement and is knocked unconscious. Someone calls an ambulance, the ambulance arrives, and emergency medical technicians immediately begin to assess the person’s condition, treat him as necessary at the scene of the accident, then in the ambulance on the way to the hospital, and then by doctors and medical staff at the hospital. No one waits for our pedestrian-now-patient to regain consciousness so that doctors and other medical personnel can ask him if he wants to be treated, that is, if he consents to treatment. He might die if they wait. Our pedestrian-now-patient doesn’t have the conscious capacity to say yes or no, give or refuse consent to treatment, so we err in the direction of helping the person. Again, most people accept this second form of treatment without consent, as necessary.Our third and final situation involves a person who has contracted a contagious disease. Imagine an adult university student who becomes infected with a highly contagious form of viral meningitis. Once university and district medical personnel are alerted to the fact that this student is dangerously ill with a contagious form of meningitis, she is immediately quarantined and treated whether she gives consent or not. Why? Because others at the university can be infected or catch the disease simply by being in the same vicinity as our student sick with meningitis. Anyone in a classroom with her can catch the disease.In order to protect others from her disease, she must be removed, quarantined and treated for her disease, whether she gives consent or refuses to give consent for medical treatment. Remember, she is being sequestered and treated to protect others, as well as herself.When I use the word contagious here I am referring to a disease that others can contract simply by breathing the same air, dipping into the same food and drinking out of the same cup of water our sick student is using. That kind of contagious disease is a true public health matter. Syphilis and herpes are private health matters, the result of taking a behavioral risk with others. Getting AIDS from contaminated blood is a public health matter. Getting AIDS by practicing unsafe sex is a private health problem. I’m referring to the public health form of contagious disease. Most people accept these three situations or conditions as legal and ethically sound.Psychiatrists, on the other hand, twist these rather uncontroversial cases in extremely self-serving ways. They do this despite the fact that they tell us over and over again that mental diseases are just like physical diseases, and that mental patients should be treated exactly as people with real, physical diseases are treated. This is the essence of the mental health “parity” controversy. To wit:On October 3rd, 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed into law. This new Federal law requires group health insurance plans (those with more than 50 insured employees) that offer coverage for mental illness and substance use disorders to provide those benefits in no more restrictive way than all other medical and surgical procedures covered by the plan. The Mental Health Parity and Addiction Equity Act does not require group health plans to cover mental health (MH) and substance use disorder (SUD) benefits but, when plans do cover these benefits, MH and SUD benefits must be covered at levels that are no lower and with treatment limitations that are no more restrictive than would be the case for the other medical and surgical benefits offered by the plan.Mentally ill patients and drug addicts are not the ones who lobbied for this legislation. It was the “advocates,” that is, the families of those diagnosed with mental illness and addiction who lobbied for the parity legislation, as well as treatment providers, who lobbied the hardest. Treatment providers stand to gain the most by the passage of this legislation.As usual, the advocates and treatment providers plead altruism, that is, no self-interest.[1]Treatment providers forcibly “treat” people they and others consider “dangerous to self and others,” justifying what they do in the name of compassion and care. They take each of the three conditions I’ve just described – youth, unconsciousness, and danger to others – and blur the distinction between metaphor and literal disease and treatment.Treatment without consent for “mental illness” is justified by saying the person is like a child. Since we base the distinction between adult and child on chronological age, a person is either an adult or a child. If he’s twenty-one, he’s an adult. If he’s twenty, he’s a child. Psychiatrists and mental health professionals empowered by the state to commit someone involuntarily to a psychiatric “hospital” argue that a twenty-five year old person who refuses to bathe and take care of himself is really a child. He does not, in their opinion, exercise responsibility for himself because he cannot do so. He is a threat to himself. He may verbally or nonverbally abdicate all responsibility for himself and ask to be taken care of by others, for fear that he might hurt himself. (Again, I am most concerned with those who do not want help, who reject “help,” and who are coerced into “treatment” when they don’t want it.It doesn’t matter to me whether they express a “thank you clause” after they are released from a hospital, or after they are thoroughly drugged with major tranquilizers. In my opinion, when an adult refuses treatment his refusal must be respected. Otherwise, coercion occurs in the name of helping him. The intentions of psychiatrists and this man’s friends and family are irrelevant. They may certainly try to persuade, encourage, even beg him to go into a “treatment” facility. In the end, the man called a child has a right to refuse treatment and that refusal must be respected in the sense that psychiatrists keep their hands off him.Institutional psychiatrists are agents of the state. They are not agents of the designated patient. The state has no business inside a patient’s metaphorical head.According to psychiatrists who coerce this person into a psychiatric facility, the coercion must occur in order to protect him from himself. He “needs” to be deprived of his liberty, otherwise, “he will die with his ‘rights’ on,” as one staunch defender of involuntary commitment procedures responded to those concerned about violating people’s constitutional rights in the name of treating their mental illness. The more a person objects to being coerced into “treatment,” the more likely he is to be diagnosed with serious mental illness. He is labeled a child with mental illness, yet he is not literally a child. He is a metaphorical child, and he does not have a literal illness. He “has” a metaphorical illness. He has committed no crime.While mental health professionals may consider this to be the same as treating a literal child with a literal disease, the differences are clear; this is one way a person can be committed against his will to a psychiatric facility for “treatment.” Others consider this to be assault and battery committed by psychiatrists and the state, which has empowered them to do this to people. As Murray Rothbard once wrote at a symposium honoring Thomas Szasz, “diagnosis is a weapon.”Here is another example of distorted thinking on the part of someone who believes strongly in the existence of mental illness. Years ago I had an exchange with someone who was very angry about my views on mental illness. He calls himself a “libertarian.” He said, “I know mental illness is real, it almost killed me.” I wrote back to him explaining that in my opinion, “he” was “it.” There is no “it” separate from himself that almost killed him. He, apparently, almost killed himself. He did not want to take responsibility for himself, I informed him.In the unconsciousness approach, treatment without consent for “mental illness” is justified by saying the person “lacks insight” into his disease. “Depression is anger turned inward,” said Arnold Schwarzenegger in Terminator 3: Rise of the Machines. “Psych 101.” Which indeed it is. When a person diagnosed as mentally ill rejects the diagnosis, this rejection is “diagnosed” as a sign of his mental illness. (Signs and symptoms are different; signs are externally observable markers of disease, while symptoms are a part of the subjective experiences of the patient). Accurate diagnosis of disease requires identification of signs, not symptoms. While symptoms may lead to signs, symptoms alone are unreliable when making an accurate diagnosis of disease. All mental illnesses are based on symptoms alone, not signs. There are no signs of mental illness.) Hijacking the term “anosognosia,” psychiatrists assert that disagreeing with them is a manifestation of their mental illness, a kind of “heads I win, tails you lose” interaction. The doctor is always right, especially when he’s wrong.Here is the definition of anosognosia from The Treatment Advocacy Center; its executive director, E. Fuller Torrey, was originally a student of Thomas Szasz. He wrote The Death of Psychiatry, published in 1975:Impaired or lack awareness of illness – a neurological syndrome called anosognosia – is believed to be the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications. It is caused by damage to specific parts of the brain, especially the right hemisphere, and affects approximately 50 percent of individuals with schizophrenia and 40 percent of individuals with bipolar disorder. When taking medications, awareness of illness improves in some patients.A person is either conscious or unconscious, especially when they angrily try to reject and resist attempts at coercion in the form of involuntary commitment to a mental hospital. The more a patient resists and fights, the deeper his anosognosia, or “lack of insight.” This is a pathetic attempt on the part of psychiatrists to justify coercion. Obviously a person is conscious when he resists treatment, and obviously he has a right to resist treatment. This is very different from being unconscious after falling and hitting one’s head on the pavement. Nevertheless, mental health professionals assert that disagreeing with them is just another form of unconsciousness, and therefore coercion is justified.In the third condition, the metaphor of contagion, treatment without consent is justified on the assertion that the person is dangerous to others. A person with a literally contagious disease can unintentionally harm others. Likewise, a person with a metaphorically contagious disease can also allegedly and unintentionally harm others. He can commit acts of violence toward others and must be sequestered or put into a form of quarantine in order to protect the public from him, and he from himself. A literal situation with real contagion is twisted into a metaphorical situation in order to justify coercion in the name of compassion, care, and really, medicine.So, we see here how the three legal and ethical situations or conditions in which a person can be treated medically without consent, are twisted to serve the best interests of mental health professionals. Again, mental health professionals include psychiatrists, psychologists, social workers, and various categories of professional counselors.In each of these conditions the idea of mental illness plays a key role in forcing people into a mental hospital. People are deprived of liberty because others think they are a threat to others and themselves. Leaving aside the fact that a person’s body is his or her own property, and suicide is a right, not a crime, and the fact that the U.S. Supreme Court has upheld the constitutionality of involuntary treatment for mental illness, it seems to me that a profound injustice is occurring to persons labeled as mentally ill. This is social control masquerading as the literal and ethical practice of medicine. Literal treatment becomes metaphorical treatment, and metaphorical treatment for a metaphorical disease. Similia similibus curentur, as the homeopathic school often says – like cures like.It is important to note that while social “scientists” have been striving for years to accurately predict who is likely to commit acts of violence and who is not likely to do so, we cannot predict who is going to be violent with an accuracy greater than that predicted by chance. In other words, guessing who is going to be violent is as accurate as taking into consideration hundreds if not thousands of personality and demographic characteristics comparing violent to nonviolent people. So while many people clamor for more involuntary commitment to mental hospitals, along with gun control, in order to prevent mass murders like the one just committed in Aurora, Colorado, we cannot predict who is going to do it and who is not. That is a fact, not fiction.There is one final detail that we need to address. Even if we could predict who is going to commit a crime or act of violence and who is not with perfect accuracy, as shown in the movie Minority Report (2002), people are still being deprived of liberty when they have committed no crime. They are being deprived of their right to due process of law.Legal FictionInvoluntary treatment for mental illness and the insanity defense are two sides of the same coin. Both practices rest on the idea of mental illness. Both practices occur via the power of the state. In the involuntary treatment scenario, a person is treated as if he was a criminal and deprived of liberty when he has committed no crime. In the insanity defense, a person is treated as if he wasnot a criminal, and exculpated of criminal responsibility, even when he has committed a crime. If involuntary treatment is abolished as unconstitutional, then it would seem the insanity defense would be abolished as well, and vice versa. Since the idea of mental illness is the key to both, it seems as though it would be easy to get rid of both practices by showing a court that mental illness is a myth, as professor of psychiatry emeritus Thomas Szasz has written about for the past sixty years.Mental illness will continue to play a role in depriving people of liberty and justice as long as it is considered an apposite legal fiction. As Szasz has pointed out in his book entitled Insanity: The Idea and Its Consequences (1987), the greatest racial legal fiction before the Civil War was that negro slaves were three-fifths persons. The greatest medical legal fiction since the Civil War is mental illness, the idea that persons labeled as mentally ill are not full persons, full citizens, entitled to their full constitutional rights. It is as if the Bill of Rights had a postscript at the bottom reading “For mentally healthy people only.”A legal fiction is something that is false, asserted as true, and something that a court will not allow to be disproved. The late legal scholar Lon Fuller stated that in order to understand something as a legal fiction, one has to first identify the premise upon which the fiction rests, and then identify what purpose is being served by the fictional assertion. Szasz explained how mental illness is legal fiction in light of this point by Fuller in his book Insanity. The premise upon which mental illness as legal fiction rests is that the mind can be diseased just as the brain can be diseased. The purpose mental illness as legal fiction serves is to deprive of liberty persons labeled as mentally ill without letting them have due process of law. In other words, the purpose of the greatest medical legal fiction since the Civil War, mental illness, is to deprive people of their right to due process of law without violating their constitutional rights.Involuntary commitment rests primarily on asserting that a person’s mental illness causes them to be a danger to themselves and others. Variations on the insanity defense, for example, from the M’Naghten rules or the irresistible impulse doctrine, or Durham’s “product,” all attempt to claim that a person cannot form the necessary intent or mens rea to be responsible for a crime. There are some legitimate ways in which a person’s responsibility for criminal acts is diminished or absent.One example is when a person harms another in a situation involving self-defense. An auto accident suffered due to a heart attack or an epileptic seizure may be another. Two persons may get into a physical altercation and while neither party intends to kill the other, one person may still be killed, even without any intent.John Hinckley stalked and shot President Ronald Reagan. It appeared that he had the necessary intent or mens rea to be found guilty within the context of criminal law. However, he successfully pled not guilty by reason of insanity. There was no criminal responsibility. He was not punished as he might otherwise have been, and he was sent instead to St. Elizabeth’s Hospital in Washington, D.C. for treatment of his “insanity.”Theodore John “Ted” Kaczynski, the “Unabomber,” was charged with a crime for which he wanted to stand trial. He objected to his defense counsel’s attempts to have him examined by a psychiatrist for “schizophrenia.” Kaczynski did not want his political motives for mailing letter bombs to be undermined by a diagnosis of schizophrenia. He clearly understood that both the defense and prosecutors were attempting to do this. Mass killer Anders Breivik has likewise resisted the Norwegian legal system’s classification of insanity, again with the goal of advancing his political beliefs. It is interesting to note that not once have people arrested for Islamic terrorist activities either requested or been coerced into pleading not guilty by reason of insanity.ConclusionIn sum, two scenarios operate under the name of mental illness, and both lead to state-sponsored psychiatric coercion and injustice. The idea of mental illness is used to assign responsibility where it does not belong and to involuntarily commit people to mental hospitals. The idea of mental illness is also used to remove responsibility where it does belong, in the varieties of the insanity defense that I have briefly described. When liberty is deprived in the name of mental illness, responsibility for behavior is necessarily diminished. Thus involuntary treatment procedures are intimately connected to variations on the insanity defense.A positive correlation exists between liberty and responsibility. When we increase one, we necessarily increase the other. When we decrease one, we necessarily decrease the other. The myth is that a negative correlation exists between the two. We cannot increase liberty by adopting policies that ultimately diminish personal responsibility.My colleague and friend for many years, Thomas Szasz, agrees with me on many issues, and disagrees on many issues as well. In terms of abolishing the use of the idea of mental illness as the greatest medical-legal fiction since the Civil War, his belief, as expressed to me in personal communication, is that this can only be done by prohibiting a psychiatrist from being in a court room, testifying as an expert on behavior in a trial. I believe it can only be done by exposing mental illness as a metaphorical disease, and by showing judges and legislators that mental illness is the greatest medical-legal fiction since the Civil War, in the way that Lon Fuller has brilliantly described legal fiction.I believe that one of the greatest threats to liberty and responsibility we have known since the Spanish Inquisition can be found in institutional psychiatry, the confusing public health with private health, and the growth of the therapeutic state, that union of medicine and state that has come to replace the theocratic state in so many of its former functions.Professor Frances agrees that mental disorders are not diseases properly speaking, but he maintains that they are nonetheless useful analytic constructs. As to coercive psychiatric treatment, he argues it can indeed be a horrific abuse. Still, in some especially desperate cases it will be necessary to save lives and to prevent even greater harms. He recommends several practices designed to minimize the frequency and risks of coercive treatments.• Psychiatrists Create Their Own Reality by Jacob SullumJacob Sullum asks the mental health establishment for consistency: If mental disorders are not diseases, what justifies involuntary treatment? Evidence of criminal conduct is a matter for law enforcement, not mental health. And how is it that we punish sexual predators (on the theory that they are responsible) — then treat them afterward (on the theory that they aren’t)? Psychiatric diagnoses are ultimately arbitrary, Sullum argues, and they lead to the arbitrary exercise of power.• Calling Mental Illness “Myth” Leads to State Coercion by Amanda PustilnikAmanda Pustilnik argues that the most profound violations of liberty in this area don’t come from coercive psychiatry, but from the warehousing of the mentally ill in our criminal justice system. Such people aren’t more likely to commit crimes, but they fare badly in the criminal justice system, where unusual behavior leads to convictions, longer sentences, parole violations, and reincarceration.Groggy from the sodium amytal, Barbara Noel slowly opened her eyes. She was still lying under the blanket on her psychiatrist's couch, but now she could hear heavy panting sounds. As her vision came into focus, she saw Dr. Masserman's pockmarked face, eyes closed tightly, terribly close to her own. Then she felt his slow, rhythmic thrusts against her pelvisHe was raping herBarbara Noel had been in therapy with Dr. Jules Masserman, president of the American Psychiatric Association, for eighteen years.Her sessions often started with his telling her "it's very important for you to get rid of anything you're wearing that might be constricting."After undressing and being given her injection of sodium amytal, Barbara would lie down under a blanket and drift off into the unconsciousness Dr. Masserman claimed was necessary for her to overcome her "resistance" to therapy.addicted to the powerful drug. She had been told it would help her remember past hurts, but in fact this barbiturate had been found in brain control experiments to block memory.After Barbara had overcome her fear of speaking out, she reported Dr. Masserman to the police. He claimed she was "sick" and was lying. Soon, however three other female patients of his came forward with similar claims.Amazingly, the Psychiatric community supported its prominent member and retained him on the board of trustees for the American psychiatric Association even after he had settled out of court with Barbara Noel for $200,000 and the promise not to practice again By then Dr. Masserman was 80 years old.Barbara, a professional singer, had originally come to Dr. Masserman because she had begun to experience extreme facial pain when performing. She felt lucky to have been taken on by the renowned Dr. Masserman and was pleased when he initially pronounced her well adjusted.She just wanted help for her facial pain.By 1984, when she woke up prematurely to find Dr. Masserman on top of her, she had been given hundreds of unnecessary sodium amytal injections and had becomeAbuse Of Women By PsychiatristsElectric shock is the most brutal and damaging of all psychiatric "treatments."Two thirds of those who received electric shock therapy are WOMEN. Psychiatrists make up only six percent of all doctors, yet they account for thirty three percent of all the sexual crimes committed by doctors. In fact, the percentage of sexual molestation by psychiatrists is thirty-seven times greater than that of the general public. Psychiatrists themselves say that sixty five percent of their new patients tell them they have been sexually abused by their former psychiatrists. Eighty percent of psychiatrists who have sexual relations with their patients do so with more than one patient.Take the case of Canadian psychiatrist John Orpin. He was convicted of raping and sodomizing his female patients during their drug hypnosis therapy sessions. Orpin counseled his female patients that his penis was itself a healing staff and his anal rape of them "unconditional love."These cases are horrific, but they are not isolated.Current estimates are that 150,000 women have been sexually abused by their psychiatrists in the United States alone.The further toll on these women?1500 have committed suicide. Another 21,000 have tried to commit suicide.Another 16,000 ended up hospitalized because of the harm caused from this violation by their psychiatrist. Women are not only statistically in high danger of being raped by their psychiatrists, they are far more likely than a man to be drugged by him as well.A 1994 study showed that women are three times more likely than men to be prescribed drugs for exactly the same symptoms.Currently there are twice as many female psychiatric patients as men and half of these women are on psychiatric drugs.In fact, in North America two thirds of all psychotropic drugs are prescribed to women.In United States 660,000 people receive electric shock therapy annually. Two thirds of them are women.If drugs don't make them forget a sexual assault by their psychiatrist, 460 volts of electricity through their temples might. Ask the 36 year-old Glendale, California woman who sued her psychiatrist in 1984 for doing exactly that to her for exactly that reason.Ninety percent of psychiatrists are male and it was this group who originally coined the word "hysteria" for a "mental illness."Today it is this male dominated field that labels women with the "mental illness" of "premenstrual dysphoric disorder" ("dysphoric" merely means "ill feeling").As noted, a surprisingly large percentage of these men apparently used their psychiatric licenses to feed their unhealthy sexual appetites-legally.And profitably for the scant $12 of electricity it takes to administer those 660,000 electric shock treatments each year, psychiatrist receive $5 billion in return.Who Are These guys?These men would seem to be the least likely people we should entrust our mental health to.Psychiatrists have the highest suicide rate of any profession, a rate twice the average of medical professionals.An estimated twenty five percent commit sexual crimes.Of 800 psychiatrists convicted of a crime, forty three percent were convicted of fraud, theft and embezzlement.U.S. Representative Patricia Schroeder, (CO) Chairwoman of the 1992 House Select Committee on Children, Youth and Families, said that she found that psychiatrists have implemented "a systematic plan to bilk patients of their hard-earned dollars, strip them of their dignity, and leave them worse off than they were before they went for help." And those were the patients who were not subjected to any sexual assault.Rape is not the only brutality to come out of the field of psychiatry. American psychiatrist Walter Freeman toured the country in his "lobotomobile" hammering ice picks through the eye sockets of his patients. Once the tip reached the frontal lobes of their brains, he would slash the instrument back and forth to destroy the tissue. He described his technique as a "mercy killing of the psyche."Any other man who brutalized someone in this fashion would be convicted of assault and battery at the least.Freeman performed 3500 of these "treatments" without a slap on the wrist.Today the psychiatrists use scalpels or electrode implants - instead of Freeman's original ice pick - to destroy portions of the brain and cripple their patients. It's a high tech world now, but this psychiatric brutality is still medieval.Psychiatry's neuroleptic and psychotropic drugs perform a virtual chemical lobotomy on today's patients as well under the guise of correcting a "chemical imbalance.Never has there been any evidence of a chemical imbalance in the brains of those labeled with mental disorders. There is not a valid test available to determine if a chemical imbalance even exists.Psychiatrists themselves admit that.Yet a multibillion dollar business exists from the pens of psychiatrists writing prescriptions for these brain numbing and personality robbing drugs to correct this nonexistent imbalance.This is fraud far worse than anything Rep. Patricia Schroeder suspected.What is schizophrenia?Schizophrenia is a state of mind, characterized by abstract, nonlinear thought patterns. It tends to coincide with unpredictable, nonconformist behavior, and thus is considered by many people to be a disease. This common belief illustrates a misunderstanding of schizophrenia, fueled by fear of the unknown.Schizophrenia is not a disease. Schizophrenia is a natural and healthy phenomenon which occurs in everyone, to varying degrees, and need not have the stigma of disease attached to it."But Susan," you may say. "How can you possibly think schizophrenia is not a disease, when so many people are suffering because of it?" My answer is this. I don't believe that it's a disease, because there are also schizophrenic individuals who are notsuffering because of it. To me, a disease is something you want to be rid of. Like cancer. When you have a condition like schizophrenia, which occurs on a spectrum, like autism as well, or bipolarism, and it has the potential to create both advantages as well as disadvantages, I personally find it much more productive, and less emotionally damaging to an individual, to conceive of it as a personality type rather than a "disease" or a "disorder".This does not mean that I think you shouldn't get help if you feel you are suffering because of schizophrenia. However, there's a lot of damage being done to schizophrenic individuals out of sheer fear of the unknown. This fear causes some to systematically attempt the blind forcing of conformity onto people who will not benefit from it. For all the years that I have maintained this website, it has remained my most ardent hope that more people will seek a clearer understanding of schizophrenia, one that is not encumbered by the stigma of disease.Types of Schizophrenia Here, I have reorganized the types of schizophrenia, based on my own personal observations. These are not the same categorizations you will find in other manuals when speaking of primary, secondary, or tertiary schizophrenia.Primary schizophrenia may be considered a basic personality type, characterized by predominantly nonlinear thought and behavior patterns which are evident from childhood onward. Primary schizophrenics are extremely intuitive with acute, but shifting, emotional and perceptual sensitivities. Their ways of expressing themselves verbally are often misunderstood due to the abstraction and complex progressive metaphors which lead to their particular choices of words. They may experience what others might call "delusions". The nature of delusions will be addressed in greater detail below.They may come across as eccentric, capricious, impulsive, ambivalent or fickle; unpleasant traits to those who would prefer everyone to always behave in a predictable manner and to always move consistently in a linear, focused direction. However, not everyone can be the same, nor would we want them to be. Schizophrenic behavior plays an important role in the growth of a society, and this role will also be further discussed later on.Secondary schizophrenia is what happens when schizophrenia occurs in response to specific, external triggers. These triggers may be in the form of physical or emotional injury. They may correspond with specific brain abnormalities, or with a history of abuse, or with a specific traumatic incident, such as sexual assault. Secondary schizophrenia which occurs in response to emotional trauma belongs to a very specific process of healing and self-empowerment, which cannot be fulfilled if interfered with by those who wish to blindly force conformity on the individual undergoing the process.Because they are two inter-related processes, manifestations of secondary schizophrenia tend to bear strong resemblances to symptoms of post-traumatic stress disorder, which may include:Inability to concentrateInsomniaParanoiaHypervigilanceHypersensitivityMemory difficultiesPanic attacksAnxietyReactive depressionHallucinationsOne may think of secondary schizophrenia as a kind of psychological puberty, a necessary growth process to help adults cope with radical life changes. Can you imagine how difficult puberty would be for young people if we treated it like it were a disease? What if we gave medication to young men to keep their voices from changing, or gave medication to young women to keep them from growing breasts? What if we tried to keep anyone from growing pubic hair? This may sound like a strange idea but it's not too different from how many people behave toward manifestations of secondary schizophrenia.Imagine that someone you know has been in a terrible car accident. You see this person after the accident, and you see that they are using a wheelchair, because their legs have been broken. They have bandages all over. They have scrapes and scabs from where they were cut by broken glass. You do not think to yourself, "This is a person with a disease." Instead, you think to yourself, "This is a person who has been through a lot. This is a person who is healing." Likewise, this is how we should think about people who are suffering from secondary schizophrenia. Even though their injuries may not be as apparent to you, these are people who are healing. Their bodies are doing what they need to do.Certainly, there are things we can do to help the healing process along - this is where things like medication and therapy may be useful. But we should be careful to see these tools in the proper light: they are there to help ease the pain. They are not there to serve a pretense of normalcy. And they are not necessarily a lifelong necessity. As J. Ashley McNamara says in the film Crooked Beauty, "How can we stop telling you that you are wrong if you experience these things? And how can we, instead, help you to learn how to handle your sensitivities? That you might make the transition from having these sensitivities overwhelming you to having these sensitivities be giving you information you can use."Tertiary schizophrenia is self-perpetuating denial, or psychosis. It is characterized by "dead-end" thoughts and behaviors which severely impair the individual's ability to care for him or herself. The tertiary schizophrenic suffers from long contained or suppressed feelings of helplessness and frustration with no viable outlet and is locked into self-destructive behaviors with no observable responses to intervention.Manifestations of tertiary schizophrenia may include:CatatoniaSevere apathyAtypically extremeviolent or aggressive behaviorPhysical abuse to self or others Homicidal or suicidal tendencies HallucinationsIndividuals who are in a state of tertiary schizophrenia may require medication, or even involuntary hospitalization, to prevent them from harming themselves or others. Why change the definition of schizophrenia? Schizophrenia is commonly mistaken for a mental disorder because those who lead healthy schizophrenic lives rarely find themselves under scrutiny by Western medicine, and thus cannot be identified as schizophrenic under our culture's current criteria. By "healthy" I mean that they feel generally satisfied with their own ability to care for themselves autonomously and independently, even though their way of experiencing the world differs from the norm. Healthy schizophrenics can be recognized by their profound sense of spirituality and constant faith in their own multi-faceted perceptions. I propose that we adjust our definition of schizophrenia because the current definitions offered by Western culture are not only confusing, but they are also impairing our ability to understand and appreciate the important role of healthy schizophrenia in society today. What is the role of schizophrenia in society? We human beings have a tendency to become quite engrossed in the systems we build, so much so that we forget the real human values at the heart of our systems. We risk becoming completely automated in our behavior, because we stop thinking about the reasons for things and just do them out of a blind adherence to the system. This automation is a form of death, because it means that we stop changing, we stop questioning, we stop growing. Schizophrenia gives a breath of fresh air to stale, rigid systems by introducing change, by bringing into the equation an unpredictable element, functioning much like a "wild card" does in card games. The abstract, non-linear nature of schizophrenia lends well to creative endeavors, and schizophrenics throughout history have enjoyed success in society as artists, poets, musicians, authors, entertainers of all kinds - vocations which allow them avenues of expression for their unique personality traits which might otherwise have been disregarded as simply eccentric behavior. To treat schizophrenic thought as though it were a tragic impairment rather than realizing its true purpose as living art, a celebration of life, is to put a quite a nihilistic spin on something that occurs so completely naturally. What causes schizophrenia? Like life itself, schizophrenia is a spontaneously occurring phenomenon which has no cause.However, post-traumatic stress and other conditions may trigger schizophrenic episodes in someone who is not normally schizophrenic. In response to trauma, schizophrenia opens the mind to new possibilities, which facilitates the healing process. Post-traumatic individuals may use metaphor as a more comfortable form of communication (because talking about things in direct terms may be too upsetting), which is also facilitated by the schizophrenic mindset. The use of certain narcotics (such as cocaine or amphetamines) may also trigger schizophrenic episodes in someone who is not normally schizophrenic. This is also a form of secondary schizophrenia, which happens because these types of drugs disrupt the flow of neurotransmitters (such as dopamine or seratonin) in the body. What about the assertion that schizophrenia is a brain disease? The simple truth is that not all schizophrenics demonstrate any kind of brain abnormality. This is confirmed by Dr. E. Fuller Torrey in his book, Surviving Schizophrenia[1], as well as by Dr. Godfrey Pearlson in his news report at Schizophrenia.com, where he states that "structural neuroimaging studies such as CAT (computed axial tomography) and MRI (magnetic resonance imaging) measurements ... show subtle rather than dramatic changes, and the findings are not seen in all cases of schizophrenia, so they are not useful as clinical tests for making the diagnosis of the disorder." What about the toxoplasmosis connection? Secondary schizophrenia is a psychological healing response that is circumstance-specific - it may be in response to brain abnormalities, trauma, toxoplasmosis, or any number of different things. Secondary schizophrenia, by my classification, is a phenomenon that will essentially go away given enough time, or given the absence of its triggers. Primary schizophrenia is not dependent on such triggers. How does schizophrenia relate to epilepsy? Recent studies have confirmed that epileptic individuals are more likely to be schizophrenic than non-epileptic individuals. [3] As one might expect, frequent lapses in consciousness create a natural punctuation in an individual's reality perception such that an epileptic individual does not experience a linear reality in the same way that a non-epileptic individual would. Thus, the abstract, non-linear reality perception of an epileptic would quite naturally correspond with the abstract, non-linear reality perception of a schizophrenic.What is the difference between schizophrenia and split personality? The word "schizophrenia" originally comes from German words meaning "split" (skhizein) and "mind" (phrenos). This word origin is thought of as the cause for a misunderstanding in which people mistake schizophrenia for "split personality", also known as "dissociative identity disorder" (DID), "multiple personality disorder" or "multiple personality syndrome" (MPS). However, I would suggest that this misunderstanding comes from not just the name alone. After all, schizophrenic behavior, with its often capricious, erratic nature, may actually give one the impression of a "split mind"; hence, the reason a name meaning "split mind" was chosen to begin with for schizophrenia.The way that multiple personality syndrome is different, though, is that you have, in one individual, two or more very distinct personalities or identities, each with its own memory set which the other subpersonalities, also known as "alters" cannot access. So a person with MPS (or DID) actually suffers periodic episodes of amnesia, because each identity is not typically aware of the activities of the alters. This particular condition usually arises from episodes of intense childhood trauma or abuse.Something to consider is that secondary schizophrenia often occurs in response to trauma as well. So, although the source of the trauma, and hence the psychological response, may not be as extreme as one finds with MPS, there may still be some observable similarities. And I do believe these also contribute to the confusion between schizophrenia and split personality. I think what we are observing is a spectrum at one end of which we may find MPS (in more intense, severe cases) and at the other end (in less traumatic cases) we may find short episodes of schizophrenia in connection with post-traumatic stress.Trauma, in general, impacts our ability to access memory because some memories are just so painful that it's difficult to access them. These memories become compartmentalized and clothed in metaphorical descriptions, such that they may indeed give the appearance of a "split mind" although not to the same extreme that we may find in someone with MPS. What are tropes? Wikipedia offers the following definition of "trope": A trope is a rhetorical figure of speech that consists of a play on words, i.e. using a word in a way other than what is considered its literal or normal form. ... Trope comes from the Greek word, tropos, which means a "turn", as in heliotrope, a flower which turns toward the sun. We can imagine a trope as a way of turning a word away from its normal meaning, or turning it into something else. [4]A metaphor is a way of associating two things that have similar properties. They may be literal things, or they may be images, or concepts. Metaphors are a form of trope.Tropical expression is extremely common among schizophrenics. Perhaps schizophrenics are inclined toward thinking and speaking in tropes because it's a naturally non-linear way of communicating. Tropical language imbues words with profound, poetic meanings that speak to us on many different levels. William Shakespeare is famous for using tropes in his plays. Song lyrics of all genres abound with tropes.Tropical expression is also extremely common among people who have been severely traumatized. Tropes allow traumatized individuals the safety of deconstructing their painful memories into simple images that express their feelings but at the same time distance their conscious mind from the painful reality of what happened. Rather than using literal terms to describe what happened, they use symbols and metaphors. Traumatized individuals may also experience hallucinations, which are tropes that manifest themselves visually or aurally.An example of trauma expressing itself through trope is given by Rosemary Winslow in her essay "Troping Trauma: Conceiving /of/ Experiences of Speechless Terror", where she relates the story of a young woman whose grandfather assaulted her with a butcher's knife when she was five years old. In expressing the details of the event, a particular trope emerged in which the young lady saw herself as "a large snake, blood-red in color". Further examination revealed that she had seen a garden snake suffer a similar knife wound the summer before, wraught by her father's axe, and the young woman's psyche had associated the two events.For additional information, please see my essay on The Role of Metaphor in Recovery from Trauma.What are delusions?Delusions are beliefs which are found to be socially unacceptable. Dr. Fuller Torrey explains, "It is not the belief per se that is delusional, but how far the belief differs from the beliefs shared by others in the same culture or subculture." [6] For example, there was a time when it was considered delusional for an individual to believe that the Earth was spherical when it was commonly believed that the Earth was flat. Nowadays, you will find there are some Christians who think atheists are delusional, and vice versa.Most people think of delusion as a belief which persists in spite of evidence to the contrary. So, someone who believes himself to have been kidnapped by the government, and implanted with an electronic device in the brain - while the alleged implant fails to register on an x-ray scan - is someone who will likely be thought of as delusional. However, there are many, many beliefs held by people which are highly subjective, strictly experience-based, lacking in specific, empirical evidence, and thus virtually impossible to prove or disprove. Belief in God is one example. Belief that certain events are signs from God is another example. Belief that thoughts were implanted into one's brain from beings who come from the future is another example. The point is this: sometimes you think a person is being delusional, when for all you know, without any evidence one way or another, they could be right, and you could be wrong.Some delusions are complex forms of trope. For example, an individual may say that aliens came to visit him today. While it may be the case that the individual actually experienced a form of visual hallucination which involved aliens coming to visit, it may also be the case that this is an unconscious metaphor selected to symbolize the descent of new ideas upon the individual (new ideas meaning that they are foreign to the individual and thus "alien"). If the individual is speaking metaphorically, then no amount of arguing will convince him that aliens never came to visit. In order to get to the bottom of what is intended to be communicated, one must take the time to understand what aliens mean in that particular context.Another example of how trope may manifest as delusion: A person says that when her father looks at her, he is projecting thoughts into her brain. The psychiatrist hears this and says, "Ah! This lady is delusional." It may be, however, that this is a form of metaphorical expression which describes how the lady feels when she sees her father. It could be that, due to abuse as a child, she has unwanted memories of him that she has tried to forget. But when she looks at his face, those memories become inescapable. She feels as though unwanted thoughts are being projected from the sight of his face.Here is another example. Maybe her father is a kind and loving person who has done nothing questionable. But it might be that this same young lady did something that she regrets. Maybe she cheated on a lover. Maybe she shoplifted from a favorite store. Maybe when she sees her father's face, she is reminded of feeling guilty. These are only a few of dozens of possible examples. The point is that she has been inaccurately labeled as "delusional" simply because someone did not understand her choice of words. It is important to understand, then, that while some delusions may be evidence of genuine psychosis, as is the case in tertiary schizophrenia, many delusions are not really delusions at all but rather the result of plain and simple misunderstanding as to an individual's meaning. Other so-called delusions may occur when an individual has a genuine vision of potential truths which are not fully realized by the culture which surrounds him or her.The nature of hallucinationsMany schizophrenics experience hearing voices, and may also act on instruction from these voices. Auditory hallucinations, specifically in the form of hearing voices, are one of the criteria which may alone be used to confirm a clinical diagnosis of schizophrenia. [7] The March 11, 2002 issue of Newsweek reports that brain imaging studies of schizophrenics experiencing auditory hallucinations show conclusively that the voices they are hearing are registering in their brains as actual stimuli. In other words, "The voices the patients heard were therefore as real to them as the conversations in the hallways they passed through en route to the lab." [7] The same is true for visual hallucinations: to the person experiencing them, they may be as completely real as anything else they perceive.One must understand, then, that the individual who experiences schizophrenic hallucinations is neither willfully fabricating them, nor does he or she have any way, whatsoever, of determining where they come from. This may seem like an obvious point, but if you try to put yourself in the shoes of someone who experiences such things, you may find yourself coming up with perfectly understandable ways to explain them to other people. They may, indeed, seem exactly like the voice of God to you - and who could prove you wrong?Newsweek goes on to say that the individual's personal experiences and memories do have some apparent bearing on the nature of the hallucinations. "Why one person sees whales and another sees severed heads remains poorly understood. But the content of hallucinations probably reflects personal experience: in one patient the neuronal pathways activated during a hallucination run through the memories of seashore visits, while in another they intersect memories of pain and terror. [Andrea] Yates, who has a deeply religious background, had satanic hallucinations."Bearing in mind that some hallucinations may be tropes manifesting in the individual's psyche as representation of traumatic memory, it may prove very well worthwhile to make note of what the hallucinations are about. If they are visual hallucinations, what are they images of? What special significance do these particular images have to the schizophrenic individual? If they are auditory hallucinations, what are the voices saying? Too often, people seem unable to look past the diagnosis of schizophrenia to get down to these details. They think to themselves, "Oh, it's not real, so it's not important." However, the nature of these hallucinations may be of utmost importance. In cases where there is repressed emotional trauma involved (which is often the case), understanding the background of the hallucinations can be a critical key in the person's recovery. Messages from God? This is perhaps one of the most controversial matters pertaining to schizophrenia. Please note that not all schizophrenics who receive command hallucinations consider them as coming from God. Some may believe they come from aliens, or the Devil, etc. However, for the sake of this discussion, I am addressing the question of God specifically, since this is a frequently asked question by website visitors on their Google searches: In their auditory or visual hallucinations, do schizophrenics really receive messages from God? In order to answer this question, you have to start by asking yourself what God means to you. Defining God is a complicated matter alone. To simplify, let us start with the question of whether or not you believe in God.If you are an atheist, then perhaps this discussion does not apply to you, since you are already convinced that there is no God, and therefore it is impossible to receive messages from God. However, I have met a number of atheists who are deeply spiritual and who ascribe to a form of mysticism, what I would call a kind of respect for the unexplained. Sometimes you will be surprised to find that a person may share your beliefs but call them by different names.If you do believe in God, or are agnostic (undecided), then you are probably familiar with the idea of God being the creative source of life in the universe. Since we, as humans, are able to create things of our own, we find it easy to recognize ourselves as also being products of a creative process. If it is true that God created everything, then each and everyone of us are manifestations of God's creative process, and that means that any source of creative inspiration is a source of divine inspiration. Ask yourself where intuition comes from. How often have you acted on an intuition, a gut feeling, without having any rational explanation to support your decision? If you believe in God as a creative source, then it is not difficult to realize the possibility that intuition is a form of divine guidance.The question arises for many of why God would permit suffering in the world, and why would God tell people to do harmful things? It's not a simple question to answer. If God, as a creative process, is responsible for the existence of everything in this universe, then that means that God created both good and evil, and this is a reality that I think we would all do well to face. Alan Watts discusses this matter in great detail in his book, The Two Hands of God.For many, God expresses the realm of the unknown, the realm of the unexplained. If a schizophrenic says that he or she is receiving messages from God, why not try to get down to an understanding of what God means to that person? There exists a vast variety of personal conceptions of God, and obviously, not all are the same.Last but not least, we should keep in mind that sometimes people have a very unfavorable perception of themselves, maybe because of trauma, maybe because of growing up in a critical or abusive environment. They may feel that nothing they say or do is valid. In these cases, it is entirely natural for an individual to seek personal and spiritual validation by ascribing a divine value to the voices which come from within. Psychiatric and Psychological experiments in detail: Some of human guinea pigs were deprived of oxygen to simulate high altitude parachute jumps. Others were frozen, infested with malaria, or exposed to mustard gas. Doctors made incisions in their flesh to simulate wounds, inserted pieces of broken glass or wood shavings into them, and then, tying off the blood vessels, introduced bacteria to induce gangrene. This is how men and women were made to drink seawater, were infected with typhus and other deadly diseases, were poisoned and burned with phosphorus, and how medical personnel conscientiously recorded their agonized screams and violent convulsions; just a part of it.Example:When Anya Bailey developed an eating disorder after her 12th birthday, her mother took her to a psychiatrist at the University of Minnesota who prescribed a powerful antipsychotic drug called Risperdal.Created for schizophrenia, Risperdal is not approved to treat eating disorders, but increased appetite is a common side effect and doctors may prescribe drugs as they see fit. Anya gained weight but within two years developed a crippling knot in her back. She now receives regular injections of Botox to unclench her back muscles. She often awakens crying in pain.Isabella Bailey, Anya’s mother, said she had no idea that children might be especially susceptible to Risperdal’s side effects. Nor did she know that Risperdal and similar medicines were not approved at the time to treat children, or that medical trials often cited to justify the use of such drugs had as few as eight children taking the drug by the end.Just as surprising, Ms. Bailey said, was learning that the university psychiatrist who supervised Anya’s care received more than $7,000 from 2003 to 2004 from Johnson & Johnson, Risperdal’s maker, in return for lectures about one of the company’s drugs.Doctors, including Anya Bailey’s, maintain that payments from drug companies do not influence what they prescribe for patients.But the intersection of money and medicine, and its effect on the well-being of patients, has become one of the most contentious issues in health care. Nowhere is that more true than in psychiatry, where increasing payments to doctors have coincided with the growing use in children of a relatively new class of drugs known as atypical antipsychotics.These best-selling drugs, including Risperdal, Seroquel, Zyprexa, Abilify and Geodon, are now being prescribed to more than half a million children in the United States to help parents deal with behavior problems despite profound risks and almost no approved uses for minors.A New York Times analysis of records in Minnesota, the only state that requires public reports of all drug company marketing payments to doctors, provides rare documentation of how financial relationships between doctors and drug makers correspond to the growing use of atypicals in children.From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold.Those who took the most money from makers of atypicals tended to prescribe the drugs to children the most often, the data suggest. On average, Minnesota psychiatrists who received at least $5,000 from atypical makers from 2000 to 2005 appear to have written three times as many atypical prescriptions for children as psychiatrists who received less or no money.The Times analysis focused on prescriptions written for about one-third of Minnesota’s Medicaid population, almost all of whom are disabled. Some doctors were misidentified by pharmacists, but the information provides a rough guide to prescribing patterns in the state.Drug makers underwrite decision makers at every level of care. They pay doctors who prescribe and recommend drugs, teach about the underlying diseases, perform studies and write guidelines that other doctors often feel bound to follow.But studies present strong evidence that financial interests can affect decisions, often without people knowing it.In Minnesota, psychiatrists collected more money from drug makers from 2000 to 2005 than doctors in any other specialty. Total payments to individual psychiatrists ranged from $51 to more than $689,000, with a median of $1,750. Since the records are incomplete, these figures probably underestimate doctors’ actual incomes.Such payments could encourage psychiatrists to use drugs in ways that endanger patients’ physical health, said Dr. Steven E. Hyman, the provost of Harvard Universityand former director of the National Institute of Mental Health. The growing use of atypicals in children is the most troubling example of this, Dr. Hyman said.“There’s an irony that psychiatrists ask patients to have insights into themselves, but we don’t connect the wires in our own lives about how money is affecting our profession and putting our patients at risk,” he said.The PrescriptionAnya Bailey is a 15-year-old high school freshman from East Grand Forks, Minn., with pictures of the actor Chad Michael Murray on her bedroom wall. She has constant discomfort in her neck that leads her to twist it in a birdlike fashion. Last year, a boy mimicked her in the lunch room.“The first time, I laughed it off,” Anya said. “I said: ‘That’s so funny. I think I’ll laugh with you.’ Then it got annoying, and I decided to hide it. I don’t want to be made fun of.”Now she slumps when seated at school to pressure her clenched muscles, she said.It all began in 2003 when Anya became dangerously thin. “Nothing tasted good to her,” Ms. Bailey said.Psychiatrists at the University of Minnesota, overseen by Dr. George M. Realmuto, settled on Risperdal, not for its calming effects but for its normally unwelcome side effect of increasing appetite and weight gain, Ms. Bailey said. Anya had other issues that may have recommended Risperdal to doctors, including occasional angry outbursts and having twice heard voices over the previous five years, Ms. Bailey said.Fabrizio Costantini for The New York TimesAnya Bailey has a painful nerve condition called dystonia, in which the muscles in her back clench as a result of taking an antipsychotic drug.Dr. Realmuto said he did not remember Anya’s case, but speaking generally he defended his unapproved use of Risperdal to counter an eating disorder despite the drug’s risks. “When things are dangerous, you use extraordinary measures,” he said.Ten years ago, Dr. Realmuto helped conduct a study of Concerta, an attention deficit hyperactivity disorder drug marketed by Johnson & Johnson, which also makes Risperdal. When Concerta was approved, the company hired him to lecture about it.He said he gives marketing lectures for several reasons.“To the extent that a drug is useful, I want to be seen as a leader in my specialty and that I was involved in a scientific study,” he said.The money is nice, too, he said. Dr. Realmuto’s university salary is $196,310.“Academics don’t get paid very much,” he said. “If I was an entertainer, I think I would certainly do a lot better.”In 2003, the year Anya came to his clinic, Dr. Realmuto earned $5,000 from Johnson & Johnson for giving three talks about Concerta. Dr. Realmuto said he could understand someone’s worrying that his Concerta lecture fees would influence him to prescribe Concerta but not a different drug from the same company, like Risperdal.In general, he conceded, his relationship with a drug company might prompt him to try a drug. Whether he continued to use it, though, would depend entirely on the results.As the interview continued, Dr. Realmuto said that upon reflection his payments from drug companies had probably opened his door to useless visits from a drug salesman, and he said he would stop giving sponsored lectures in the future.Kara Russell, a Johnson & Johnson spokeswoman, said that the company selects speakers who have used the drug in patients and have either undertaken research or are aware of the studies. “Dr. Realmuto met these criteria,” Ms. Russell said.When asked whether these payments may influence doctors’ prescribing habits, Ms. Russell said that the talks “provide an educational opportunity for physicians.”No one has proved that psychiatrists prescribe atypicals to children because of drug company payments. Indeed, some who frequently prescribe the drugs to children earn no drug industry money. And nearly all psychiatrists who accept payments say they remain independent. Some say they prescribed and extolled the benefits of such drugs before ever receiving payments to speak to other doctors about them.“If someone takes the point of view that your doctor can be bought, why would you go to an E. R. with your injured child and say, ‘Can you help me?’ ” said Dr. Suzanne A. Albrecht, a psychiatrist from Edina, Minn., who earned more than $188,000 from 2002 to 2005 giving drug marketing talks.The Industry CampaignIt is illegal for drug makers to pay doctors directly to prescribe specific products. Federal rules also bar manufacturers from promoting unapproved, or off-label, uses for drugs.But doctors are free to prescribe as they see fit, and drug companies can sidestep marketing prohibitions by paying doctors to give lectures in which, if asked, they may discuss unapproved uses.The drug industry and many doctors say that these promotional lectures provide the field with invaluable education. Critics say the payments and lectures, often at expensive restaurants, are disguised kickbacks that encourage potentially dangerous drug uses. The issue is particularly important in psychiatry, because mental problems are not well understood, treatment often involves trial and error, and off-label prescribing is common.The analysis of Minnesota records shows that from 1997 through 2005, more than a third of Minnesota’s licensed psychiatrists took money from drug makers, including the last eight presidents of the Minnesota Psychiatric Society.The psychiatrist receiving the most from drug companies was Dr. Annette M. Smick, who lives outside Rochester, Minn., and was paid more than $689,000 by drug makers from 1998 to 2004. At one point Dr. Smick was doing so many sponsored talks that “it was hard for me to find time to see patients in my clinical practice,” she said.“I was providing an educational benefit, and I like teaching,” Dr. Smick said.Dr. Steven S. Sharfstein, immediate past president of the American Psychiatric Association, said psychiatrists have become too cozy with drug makers. One example of this, he said, involves Lexapro, made by Forest Laboratories, which is now the most widely used antidepressant in the country even though there are cheaper alternatives, including generic versions of Prozac.“Prozac is just as good if not better, and yet we are migrating to the expensive drug instead of the generics,” Dr. Sharfstein said. “I think it’s the marketing.”Atypicals have become popular because they can settle almost any extreme behavior, often in minutes, and doctors have few other answers for desperate families.Their growing use in children is closely tied to the increasingly common and controversial diagnosis of pediatric bipolar disorder, a mood problem marked by aggravation, euphoria, depression and, in some cases, violent outbursts. The drugs, sometimes called major tranquilizers, act by numbing brain cells to surges of dopamine, a chemical that has been linked to euphoria and psychotic delusions.Suzette Scheele of Burnsville, Minn., said her 17-year-old son, Matt, was given a diagnosis of bipolar disorder four years ago because of intense mood swings, and now takes Seroquel and Abilify, which have caused substantial weight gain.“But I don’t have to worry about his rages; he’s appropriate; he’s pleasant to be around,” Ms. Scheele said.The sudden popularity of pediatric bipolar diagnosis has coincided with a shift from antidepressants like Prozac to far more expensive atypicals. In 2000, Minnesota spent more than $521,000 buying antipsychotic drugs, most of it on atypicals, for children on Medicaid. In 2005, the cost was more than $7.1 million, a 14-fold increase.The drugs, which can cost $1,000 to $8,000 for a year’s supply, are huge sellers worldwide. In 2006, Zyprexa, made by Eli Lilly, had $4.36 billion in sales, Risperdal $4.18 billion and Seroquel, made by AstraZeneca, $3.42 billion.Many Minnesota doctors, including the president of the Minnesota Psychiatric Society, said drug makers and their intermediaries are now paying them almost exclusively to talk about bipolar disorder.The DiagnosesYet childhood bipolar disorder is an increasingly controversial diagnosis. Even doctors who believe it is common disagree about its telltale symptoms. Others suspect it is a fad. And the scientific evidence that atypicals improve these children’s lives is scarce.One of the first and perhaps most influential studies was financed by AstraZeneca and performed by Dr. Melissa DelBello, a child and adult psychiatrist at the University of Cincinnati.Dr. DelBello led a research team that tracked for six weeks the moods of 30 adolescents who had received diagnoses of bipolar disorder. Half of the teenagers took Depakote, an antiseizure drug used to treat epilepsy and bipolar disorder in adults. The other half took Seroquel and Depakote.The two groups did about equally well until the last few days of the study, when those in the Seroquel group scored lower on a standard measure of mania. By then, almost half of the teenagers getting Seroquel had dropped out because they missed appointments or the drugs did not work. Just eight of them completed the trial.In an interview, Dr. DelBello acknowledged that the study was not conclusive. In the 2002 published paper, however, she and her co-authors reported that Seroquel in combination with Depakote “is more effective for the treatment of adolescent bipolar mania” than Depakote alone.In 2005, a committee of prominent experts from across the country examined all of the studies of treatment for pediatric bipolar disorder and decided that Dr. DelBello’s was the only study involving atypicals in bipolar children that deserved its highest rating for scientific rigor. The panel concluded that doctors should consider atypicals as a first-line treatment for some children. The guidelines were published in The Journal of the American Academy of Child and Adolescent Psychiatry.Three of the four doctors on the panel served as speakers or consultants to makers of atypicals, according to disclosures in the guidelines. In an interview, Dr. Robert A. Kowatch, a psychiatrist at Cincinnati Children’s Hospital and the lead author of the guidelines, said the drug makers’ support had no influence on the conclusions.AstraZeneca hired Dr. DelBello and Dr. Kowatch to give sponsored talks. They later undertook another study comparing Seroquel and Depakote in bipolar children and found no difference. Dr. DelBello, who earns $183,500 annually from the University of Cincinnati, would not discuss how much she is paid by AstraZeneca.“Trust me, I don’t make much,” she said. Drug company payments did not affect her study or her talks, she said. In a recent disclosure, Dr. DelBello said that she received marketing or consulting income from eight drug companies, including all five makers of atypicals.Dr. Realmuto has heard Dr. DelBello speak several times, and her talks persuaded him to use combinations of Depakote and atypicals in bipolar children, he said. “She’s the leader in terms of doing studies on bipolar,” Dr. Realmuto said.Some psychiatrists who advocate use of atypicals in children acknowledge that the evidence supporting this use is thin. But they say children should not go untreated simply because scientists have failed to confirm what clinicians already know.“We don’t have time to wait for them to prove us right,” said Dr. Kent G. Brockmann, a psychiatrist from the Twin Cities who made more than $16,000 from 2003 to 2005 doing drug talks and one-on-one sales meetings, and last year was a leading prescriber of atypicals to Medicaid children.The ReactionFor Anya Bailey, treatment with an atypical helped her regain her appetite and put on weight, but also heavily sedated her, her mother said. She developed the disabling knot in her back, the result of a nerve condition called dystonia, in 2005.The reaction was rare but not unknown. Atypicals have side effects that are not easy to predict in any one patient. These include rapid weight gain and blood sugar problems, both risk factors for diabetes; disfiguring tics, dystonia and in rare cases heart attacks and sudden death in the elderly.In 2006, the Food and Drug Administration received reports of at least 29 children dying and at least 165 more suffering serious side effects in which an antipsychotic was listed as the “primary suspect.” That was a substantial jump from 2000, when there were at least 10 deaths and 85 serious side effects among children linked to the drugs. Since reporting of bad drug effects is mostly voluntary, these numbers likely represent a fraction of the toll.Jim Minnick, a spokesman for AstraZeneca, said that the company carefully monitors reported problems with Seroquel. “AstraZeneca believes that Seroquel is safe,” Mr. Minnick said.Other psychiatrists renewed Anya’s prescriptions for Risperdal until Ms. Bailey took Anya last year to the Mayo Clinic, where a doctor insisted that Ms. Bailey stop the drug. Unlike most universities and hospitals, the Mayo Clinic restricts doctors from giving drug marketing lectures.Ms. Bailey said she wished she had waited to see whether counseling would help Anya before trying drugs. Anya’s weight is now normal without the help of drugs, and her counseling ended in March. An experimental drug, her mother said, has recently helped the pain in her back.Almost every modern horror crime was committed by a known criminal who had been in and out of the hands of psychiatrists and psychologists, often many times.There is no particular reason to enumerate endless case histories of this; they occur too frequently in news accounts and the newspaper morgues are thick with them. And as such stories develop, it is found that the perpetrator had a long history, some even from childhood, of psychiatric and psychological treatment.Such a record of failure does not seem to come to the attention of legislators, and these continue to pour floods of money into the coffers of the psychiatrists, psychologists and their organizations. The public at large, by survey, seems to be aware of this state of affairs, if not the whole facts: The only real customers the psychiatrist and psychologist have are the governments—the public does not of its own volition go to them.The most charitable look at this would be that the psychologists and psychiatrists are simply incompetent. But other more sinister implications can be drawn.Developed in the latter part of the nineteenth century, they appeared on the militaristic scene of a rearming and conquest-minded Germany. At that time, the archcriminal Bismarck was laying the groundwork for the slaughters of World War I and World War II. It fitted with the philosophy of militarism that man was an animal and that there was neither soul nor morality standing in the way of the wholesale murder of war.Up until that time the Church had some influence upon the state and possibly some power in restraining bestiality and savagely insane conduct, but small as it might have been, it was incompatible with the unholy ambitions of the militarists. That man was only an animal after all, soulless and entitled to no decency, was bound to be a popular doctrine. That insanity consisted of urges to harm others would have been a very unpopular idea to government heads who had nothing else in mind. And so the notion that insanity was a physical disease was taken up avidly.The basic tenet of psychology is that man is just an animal. The basic tenet of psychiatry is that insanity is a physical disease. Neither has any proof that these tenets are correct. That man can be reduced to animalistic behavior does not prove that that is his true basic nature. That some physical diseases also produce mental aberration does not prove that any “mental illness” has bacteria or virus and indeed none have ever been isolated.The instigators, patrons and supporters of these two subjects classify fully and demonstrably as criminals.If the crimes committed by a government in one single day were committed by an individual, that individual would be promptly put in a cell and probably even a padded cell.Unfortunately, positions of power and authority attract to themselves beings who, all too often, need that altitude to exercise their lust for covertly or overtly harming others. Government positions are well suited to this use; they are also all too often held to be above any law. Some of the most notorious criminals in history have operated from government positions. This becomes statistically impressive when one counts the strewn corpses.Looking this over (and it is amply documented in any history book or newspaper) one can begin to make some kind of sense out of it. Spawned by an insanely militaristic government, psychiatry and psychology find avid support from oppressive and domineering governments. The employer of these people classifies, even in the most generous view, as criminal. Thus, it cannot be much wondered at that these subjects have no real success or even interest in detecting and handling criminals.One cannot go so far as to say that psychiatry and psychology knowingly create criminals or actively plan and implant their patients to commit crimes, even though it might look this way in some cases. Rather, these subjects are false subjects, based on false principles which are well suited to the demands and ambitions of their employers. Their technology is incapable of detecting, much less helping, the criminal. It is even doubtful if their employers, the governments, would tolerate a subject which could detect and resolve criminality—for who would be the first ones detected? Some amongst the governments, of course. No, the wolf would only favor a jury of wolves to judge the crime of killing sheep. That is why you see governments flooding out money for psychologists in schools and psychiatrists in government departments.With a complete, government-supported monopoly in the field of the mind, potential criminals will go right on remaining undetected until they injure or slaughter citizens and, having done so, become unrelieved or even confirmed in their habit patterns in the hands of psychiatrists and psychologists and re-released upon the world to further injure and slaughter citizens.The credence and power of psychiatry and psychology are waning. It hit its zenith about 1960; then it seemed their word was law and that they could harm, injure and kill patients without restraint. The appearance of an actual technology of the mind—Dianetics and Scientology—has played no small part in acting as a restraint. At one time they were well on their way to turning every baby into a future robot for the manipulation of the state and every society into a madhouse of crime and immorality. The world is still suffering from the effects of that domination.There is no real reason why, using the proper technology, the criminal cannot be detected and also reformed. One might also, by the use of False Data Stripping, redeem a psychologist or psychiatrist—though this would be made difficult by the fact that he achieves all his power and money from the state which might have quite different purposes for him.The world is turning, things change. And there may come a day when the mad dogs of the world are not given over to the charge of mad dogs. But that will be to the degree that you successfully carry forward Dianetics and Scientology.Over the years as a psychiatrist I've evaluated innumerable cases of individuals who have been driven over the edge by psychiatric drugs. Many of these men, women and children were evaluated for legal cases but others were not. When I was re-evaluating about a hundred of these real-life stories for my latest book, Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide and Crime, I began to see a pattern that I call medication spellbinding. Technically, the new scientific concept is called intoxication anosognosia: not knowing that you are intoxicated.Medication spellbinding has four basic effects.First, people taking psychiatric drugs rarely realize how much the drugs are impairing them mentally or emotionally. They often do not recognize that they've become irrational, depressed, angry, or even euphoric since beginning the medication.Second, if they do realize that they are having painful emotional feelings, medication spellbinding causes them to blame their feelings on something other than the drug. They may get angry at their husbands, wives or children, and become abusive. Or they might blame themselves and become suicidal. Often they confuse the harmful drug effect with their emotional problems and attribute their emotional distress to "mental illness."Third, medication spellbinding makes some people feel that they are doing better than ever when in reality they are doing much worse than ever. In one case, a man who was high on a combination of an antidepressant and a tranquilizer happily went on a daylight robbery spree in his hometown wearing no disguise. Another otherwise ethical citizen happily embezzled money while documenting the details in easily accessible company computer files. Both men thought they were on top of the world.Fourth, some people become so medication spellbound that they lose control of themselves and perpetrate horrendously destructive actions. My book opens with the story an otherwise kind and gentle man who became agitated on an antidepressant and drove his car into a policeman to knock him down to get his gun to try to kill himself. In another case, a ten-year-old boy with no history of depression hung himself after taking a prescription stimulant for ADHD. He documented the dreadful unfolding events while speaking in a robotic monotone into his computer.Particularly striking to me, of those who have survived, none of the people I have evaluated has ever perpetrated again after stopping the offending medication. There has been zero recidivism in the cases I have evaluated and who have stopped taking the medication.Similar effects can occur from alcohol and street drugs. When a person's drunk, he might think he's the life of the party when he's the death of it. And of course, alcohol and street drug intoxication are associated with a great deal of crime and violence. But there is a difference between the effects of taking alcohol or other drugs on your own and taking drugs prescribed by a physician. Most people believe that their doctor would never give them anything that could make them violent, suicidal, or just plain crazy. Often the doctor reassures the unwitting patient that he needs to take more of the drug that's driving him over the edge.The law in most states recognizes the difference between taking an intoxicating substance on your own and being prescribed one by a physician. If you do something irresponsible under the influence of alcohol or an illegal drug, the law is likely to hold you responsible. It is called a voluntary intoxication. You should have known better than to get intoxicated and you should have foreseen the consequences. But if you've been prescribed a drug, especially without being given any warnings about the risks, that's called an involuntary intoxication. You're not aware of the risks and dangers; you're simply following your doctor's prescription by taking something that's supposed to help you. The law looks more sympathetically on involuntary intoxications. Many states allow for a defense of not guilty because of an involuntary intoxication.It's important to understand that all psychoactive substances impair higher brain function and with that they impair judgment. People who are a little tipsy on alcohol or a little high on marijuana may experience it as enjoyable. Similarly, people who take psychiatric drugs may experience relief from emotional anesthesia or an artificial high on an antidepressant, tranquilizer, or stimulant. Or they may get some relief from the lobotomizing effect of an antipsychotic drug or the blunting impact of a mood stabilizer. In every case, the seeming improvement is a manifestation of brain dysfunction, and judgment is always impaired.I am not critical of the occasional and responsible use of legal recreational drugs like alcohol. But I do not believe that a drug can help people solve their personal problems. Psychiatric drugs -- like all psychoactive substances -- work by impairing brain function, and when we're under stress and have problems to solve we need a fully functioning brain and mind. We need to be able to take complete responsibility for ourselves and to think through our problems with rational clarity. All psychiatric drugs impair those higher mental functions.Instead of mind-altering drugs, we need courage, determination, self-discipline, and sound principles to face and overcome our personal problems. Counseling and therapy can help many people, but the contest is not between psychiatric drugs and psychotherapy -- it is between drugs and all of the many ways in which people learn to overcome emotional suffering and to triumph in life, including love, family life, devotion to the community, principled living, and spirituality.+++In the Soviet Union, a systematic political abuse of psychiatry took place[1] and was based on the interpretation of political dissent as a psychiatric problem.[2] It was called "psychopathological mechanisms" of dissent.[3]During the leadership of General Secretary Leonid Brezhnev, psychiatry was used as a tool to eliminate political opponents ("dissidents") who openly expressed beliefs that contradicted official dogma.[4] The term "philosophical intoxication" was widely used to diagnose mental disorders in cases where people disagreed with leaders and made them the target of criticism that used the writings by Karl Marx, Friedrich Engels, and Vladimir Lenin.[5] Article 58-10 of the Stalin Criminal Code—which as Article 70 had been shifted into the RSFSR Criminal Code of 1962—and Article 190-1 of the RSFSR Criminal Code along with the system of diagnosing mental illness, developed by academician Andrei Snezhnevsky, created the very preconditions under which non-standard beliefs could easily be transformed into a criminal case, and it, in its turn, into a psychiatric diagnosis.[6] Anti-Soviet political behavior, in particular, being outspoken in opposition to the authorities, demonstrating for reform, writing books were defined in some persons as being simultaneously a criminal act (e.g., violation of Articles 70 or 190-1), a symptom (e.g., "delusion of reformism"), and a diagnosis (e.g., "sluggish schizophrenia").[7] Within the boundaries of the diagnostic category, the symptoms of pessimism, poor social adaptation and conflict with authorities were themselves sufficient for a formal diagnosis of "sluggish schizophrenia."[8]The process of psychiatric incarceration was instigated by attempts to emigrate; distribution or possession of prohibited documents or books; participation in civil rights actions and demonstrations, and involvement in forbidden religious activity.[9] The religious faith of prisoners, including well-educated former atheists who adopted a religion, was determined to be a form of mental illness that needed to be cured.[10] Formerly highly classified government documents published after the dissolution of the Soviet Uniondemonstrate that the authorities used psychiatry as a tool to suppress dissent.[11]According to the Commentary on the Russian Federation Law on Psychiatric Care, persons who were subjected to repressions in the form of commitment for compulsory treatment to psychiatric medical institutions and were rehabilitated in accordance with the established procedure receive compensation. The Russian Federation acknowledged that psychiatry was used for political purposes and took responsibility for the victims of "political psychiatry."[12]Political abuse of psychiatry in Russia continues after the fall of the Soviet Union[13] and threatens human rights activists with a psychiatric diagnosis.[14]Political abuse of psychiatry is the misuse of psychiatric diagnosis, detention and treatment for the purposes of obstructing the fundamental human rights of certain groups and individuals in a society.[15] It entails the exculpation and committal of citizens to psychiatric facilities based upon political rather than mental health-based criteria.[16] Many authors, including psychiatrists, also use the terms "Soviet political psychiatry"[17] or "punitive psychiatry" to refer to this phenomenon.[18]In the book Punitive Medicine by Alexander Podrabinek, the term "punitive medicine", which is identified with "punitive psychiatry," is defined as "a tool in the struggle against dissidents who cannot be punished by legal means."[19] Punitive psychiatry is neither a discrete subject nor a psychiatric specialty but, rather, it is an emergency arising within many applied sciences in totalitarian countries where members of a profession may feel themselves compelled to service the diktats of power.[20] Psychiatric confinement of sane people is uniformly considered a particularly pernicious form of repression[21] and Soviet punitive psychiatry was one of the key weapons of both illegal and legal repression.[22]As Vladimir Bukovsky and Semyon Gluzman wrote in their joint A Manual on Psychiatry for Dissenters, "the Soviet use of psychiatry as a punitive means is based upon the deliberate interpretation of dissent... as a psychiatric problem."[23]Psychiatry possesses an inherent capacity for abuse that is greater than in other areas of medicine.[24] The diagnosis of mental disease can give the state license to detain persons against their will and insist upon therapy both in the interest of the detainee and in the broader interests of society.[24] In addition, receiving a psychiatric diagnosis can in itself be regarded as oppressive.[25] In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials.[24] In the period from the 1960-s to 1986, the abuse of psychiatry for political purposes was reported to have been systematic in the Soviet Union and episodic in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia.[26] The practice of incarceration of political dissidents in mental hospitals in Eastern Europe and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community.[27] Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience.[28] As scholars have long argued, governmental and medical institutions have at times coded threats to authority as mental disease during periods of political disturbance and instability.[29] Nowadays, in many countries, political prisoners are still sometimes confined and abused in mental institutions.[30]In the Soviet Union dissidents were often confined in the so-called psikhushka, or psychiatric wards.[31] Psikhushka is the Russian ironic diminutive for "mental hospital".[32] One of the first psikhushkas was the Psychiatric Prison Hospital in the city of Kazan. In 1939 it was transferred to the control of the NKVD, the secret police and the precursor organization to the KGB, under the order of Lavrentiy Beria, who was the head of the NKVD.[33] International human rights defenders such as Walter Reich have long recorded the methods by which Soviet psychiatrists in Psikhushka hospitals diagnosed schizophrenia in political dissenters.[29] Western scholars examined no aspect of Soviet psychiatry as thoroughly as its involvement in the social control of political dissenters.[34]As early as 1948, the Soviet secret service took an interest in this area of medicine.[35] It was one of the superiors of the Soviet secret police, Andrey Vyshinsky, who first ordered the use of psychiatry as a tool of repression.[36] Russian psychiatrist Pyotr Gannushkin also believed that in a class society, especially during the most severe class struggle, psychiatry was incapable of not being repressive.[37] A system of political abuse of psychiatry was developed at the end of Joseph Stalin's regime.[38] However, according to Alexander Etkind, punitive psychiatry was not simply an inheritance from the Stalin era as the GULAG (the acronym for Chief Administration for Corrective Labor Camps, the penitentiary system in the Stalin years) was an effective instrument of political repression and there was no compelling requirement to develop an alternative and expensive psychiatric substitute.[39] The abuse of psychiatry was a natural product of the later Soviet era.[39] From the mid-1970s to the 1990s, the structure of mental health service conformed to the double standard in society, that of two separate systems which peacefully co-existed despite conflicts between them:1. the first system was punitive psychiatry that straight served the institute of power and was led by the Moscow Institute for Forensic Psychiatry named after Vladimir Serbsky;2. the second system was composed of elite, psychotherapeutically oriented clinics and was led by the Leningrad Psychoneurological Institute named after Vladimir Bekhterev.[39]The hundreds of hospitals in the provinces combined components of both systems.[39]What was the abuse of psychiatry under the dictatorship of Stalin?[40] If a person was mentally ill, he was sent to a psychiatric hospital until his dying day.[40] If he was not quite mentally healthy but not quite ill, with his character traits, he was sent to a prison camp or shot.[40] When some allusions to the so-called socialist legality appeared, it was decided these people must be tried.[40] But soon it became realized that bringing the people who gave anti-Soviet speeches to trial made matters worse, they began not to be admitted to the court by being attributed with psychiatric diagnoses and declared insane.[40]Joint Session[edit]Main article: Pavlovian sessionA precursor of later abuses in psychiatry in the Soviet Union was the so-called "Joint Session" of the USSR Academy of Medical Sciences and the Board of the All-Union Neurologic and Psychiatric Association in October 1951. Held in the name of Ivan Pavlov it considered the status of several leading neuroscientists and psychiatrists of the time, including Grunya Sukhareva, Vasily Gilyarovsky, Raisa Golant, Aleksandr Shmaryan, and Mikhail Gurevich, who were charged with practicing "anti-Pavlovian, anti-Marxist, idealistic [and] reactionary" science that was damaging to Soviet psychiatry.[41] During the Joint Session these eminent psychiatrists, motivated by fear, had to publicly admit that their scientific positions were in error and they also had to promise to conform Pavlovian doctrines.[41] However, these public declarations of obedience proved insufficient as in the closing speech of the congress, the lead author of the event's policy report, Snezhnevsky stated that they "have not disarmed themselves and continue to remain in the old anti-Pavlovian positions", thereby causing "grave damage to the Soviet scientific and practical psychiatry". The vice president of the USSR Academy of Medical Sciences accused them of "diligently fall[ing] down to the dirty source of American pseudo-science".[42] The congressional members who articulated these accusations, among them Irina Strelchuk,Vasily Banshchikov, Oleg Kerbikov, and Snezhnevsky, were characterized by careerist ambition and fears for their own positions.[41] Not surprisingly, many of them were advanced and appointed to leadership positions shortly after the session.[41]The Joint Session also had a negative impact on several leading Soviet academic neuroscientists, such as Pyotr Anokhin, Aleksey Speransky, Lina Stern, Ivan Beritashvili, andLeon Orbeli. They were labeled as anti-Pavlovians, anti-materialists and reactionaries and subsequently they were dismissed from their positions.[41] In addition to losing their laboratories some of these scientists were subjected to torture in prison.[41] The Moscow, Leningrad, Ukrainian, Georgian, and Armenian schools of neuroscience and neurophysiology were damaged for a period due to this loss of personnel.[41] The Joint Session ravaged productive research in neurosciences and psychiatry for years to come.[41] It was pseudoscience that took over.[41]After the joint session of the USSR Academy of Sciences and the USSR Academy of Medical Sciences on 28 June — 4 July 1950 and during the session of the Presidium of the Academy of Medical Sciences and the Board of the All-Union Society of Neuropathologists and Psychiatrists on 11–15 October 1951, the leading role was given to Snezhnevky's school.[43] The 1950 decision to give monopoly over psychiatry to the Pavlovian school of Snezhnevsky was one of the crucial factors in the rise of political psychiatry.[44] The Soviet doctors, under the incentive of Snezhnevsky, devised a "Pavlovian theory of schizophrenia" and increasingly applied this diagnostic category to political dissidents.[45]Sluggish schizophrenia[edit]Main article: Sluggish schizophrenia"The incarceration of free thinking healthy people in madhouses is spiritual murder, it is a variation of the gas chamber, even more cruel; the torture of the people being killed is more malicious and more prolonged. Like the gas chambers, these crimes will never be forgotten and those involved in them will be condemned for all time during their life and after their death."[46] (Alexander Solzhenitsyn)Psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the USSR were used for political purposes.[47] It was the diagnosis of "sluggish schizophrenia" that was most prominently used in cases of dissidents.[48] Sluggish schizophrenia as one of new diagnostic categories was created to facilitate the stifling of dissidents and was a root of self-deception among psychiatrists to placate their consciences when the doctors acted as a tool of oppression in the name of a political system.[49] According to the Global Initiative on Psychiatry chief executive Robert van Voren, the political abuse of psychiatry in the USSR arose from the conception that people who opposed the Soviet regime were mentally sick since there was no other logical rationale why one would oppose the sociopolitical system considered the best in the world.[50] The diagnosis "sluggish schizophrenia," a longstanding concept further developed by the Moscow School of Psychiatry and particularly by its chief Snezhnevsky, furnished a very handy framework for explaining this behavior.[50] The weight of scholarly opinion holds that the psychiatrists who played the primary role in the development of this diagnostic concept were following directives from the Communist Party and the Soviet secret service, or KGB, and were well aware of the political uses to which it would be put. Nevertheless, for many Soviet psychiatrists "sluggish schizophrenia" appeared to be a logical explanation to apply to the behavior of critics of the regime who, in their opposition, seemed willing to jeopardize their happiness, family, and career for a reformist conviction or ideal that was so apparently divergent from the prevailing social and political orthodoxy.[50]Snezhnevsky, the most prominent theorist of Soviet psychiatry and director of the Institute of Psychiatry of the USSR Academy of Medical Sciences, developed a novelclassification of mental disorders postulating an original set of diagnostic criteria.[8] The Soviet model of schizophrenia is based on the hypothesis that a single fundamental characteristic, by which schizophrenia spectrum disorders are distinguished clinically, is their longitudinal course.[51] The hypothesis implies that there are three main types of schizophrenia:1. the continuous type that is defined as unremitting, proceeding with either a rapid ("malignant") or a slow ("sluggish") progression and has a poor prognosis in both instances;2. the periodic, or recurrent type that is characterized by an acute attack followed by full remission with minimal progression, if any;3. the mixed, or shift-like, type ("schubweise" — in German "schub" means phase or attack), a mixture of continuous and periodic types that occurs periodically and is characterized by only partial remission.[51]This systematization of schizophrenia types attributed to Snezhnevsky[52] is still used in Russia[53] and refers sluggish schizophrenia to the continuous type.[54]A carefully crafted description of sluggish schizophrenia established that psychotic symptoms were non-essential for the diagnosis, but symptoms of psychopathy, hypochondria, depersonalization or anxiety were central to it.[8] Symptoms referred to as part of the "negative axis" included pessimism, poor social adaptation, and conflict with authorities, and were themselves sufficient for a formal diagnosis of "sluggish schizophrenia with scanty symptoms."[8] According to Snezhnevsky, patients with sluggish schizophrenia could present as quasi sane yet manifest minimal but clinically relevant personality changes which could remain unnoticed to the untrained eye.[8] Thereby patients with non-psychotic mental disorders, or even persons who were not mentally sick, could be easily labelled with the diagnosis of sluggish schizophrenia.[8] Along with paranoia, sluggish schizophrenia was the diagnosis most frequently used for the psychiatric incarceration of dissenters.[8] As per the theories of Snezhnevsky and his colleagues, schizophrenia was much more prevalent than previously considered since the illness could be presented with comparatively slight symptoms and only progress afterwards.[50] As a consequence, schizophrenia was diagnosed much more often in Moscow than in cities of other countries, as the World Health Organization Pilot Study on Schizophrenia reported in 1973.[50] In particular, the scope was widened by sluggish schizophrenia because according to Snezhnevsky and his colleagues, patients with this diagnosis were capable of functioning almost normally in the social sense.[50] Their symptoms could be like those of a neurosis or could assume a paranoid character.[50] The patients with paranoid symptoms retained some insight into their condition but overestimated their own significance and could manifest grandiose ideas of reforming society.[50] Thereby, sluggish schizophrenia could have such symptoms as "reform delusions," "perseverance," and "struggle for the truth."[50] As Viktor Styazhkin reported, Snezhnevsky diagnosed a reformation delusion for every case when a patient "develops a new principle of human knowledge, drafts an academy of human happiness, and many other projects for the benefit of mankind."[55]In the 1960s and 1970s, theories, which contained ideas about reforming society and struggling for truth, and religious convictions were not referred to delusional paranoid disorders in practically all foreign classifications, but Soviet psychiatry, proceeding from ideological conceptions, referred critique of the political system and proposals to reform this system to the delusional construct.[56] Diagnostic approaches of conception of sluggish schizophrenia and paranoiac states with delusion of reformism were used only in the Soviet Union and several Eastern European countries.[57]On the covert orders of the KGB, thousands of social and political reformers—Soviet "dissidents"—were incarcerated in mental hospitals after being labelled with diagnoses of "sluggish schizophrenia", a disease fabricated by Snezhnevsky and "Moscow school" of psychiatry.[58] American psychiatrist Alan A. Stone stated that Western criticism of Soviet psychiatry aimed at Snezhnevsky personally, because he was essentially responsible for the Soviet concept of schizophrenia with a "sluggish type" manifestation by "reformerism" including other symptoms.[59] One can readily apply this diagnostic scheme to dissenters.[59] Snezhnevsky was long attacked in the West as an exemplar of psychiatric abuse in the USSR.[48] The leading critics implied that Snezhnevsky had designed the Soviet model of schizophrenia and this diagnosis to make political dissent into a mental disease.[60] He was charged with cynically developing a system of diagnosis which could be bent for political purposes, and he himself diagnosed or was involved in a series of famous dissident cases,[48] and, in dozens of cases, he personally signed a commission decision on legal insanity of mentally healthy dissidents including Vladimir Bukovsky, Natalya Gorbanevskaya, Leonid Plyushch, Mikola Plakhotnyuk,[61] and Pyotr Grigorenko.[62] In 1980, the Special Committee on the Political Abuse of Psychiatry, established by the Royal College of Psychiatrists in 1978, charged Snezhnevsky with involvement in the abuse[63] and recommended that Snezhnevsky, who had been honoured as a Corresponding Fellow of the Royal College of Psychiatrists, be invited to attend the College's Court of Electors to answer criticisms because he was responsible for the compulsory detention of this celebrated dissident, Leonid Plyushch.[64] Instead Snezhnevsky chose to resign his Fellowship.[64]In 1974, Western psychiatrists became curious about reports of the high rate of schizophrenia in the USSR: 5–7 per 1,000 population, as against 3–4 per 1,000 in the United Kingdom.[65] It was found that Soviet psychiatrists discovered a unique form of mental disease in political dissenters and called it sluggish schizophrenia.[65] Because of this form of schizophrenia, Russia in the 1980s had three times as many schizophrenic patients per capita as the USA, two times as many schizophrenic patients as West Germany,Austria and Japan.[66] There were not so many schizophrenic patients in any other country (of Western ones).[66]Political trend toward mass abuse onset[edit]The campaign to declare political opponents mentally sick and to commit dissenters to mental hospitals began in the late 1950s and early 1960s.[35] As Vladimir Bukovsky, commenting on the nascency of the political abuse of psychiatry, wrote, Nikita Khrushchev reckoned that it was impossible for people in a socialist society to have anti-socialist consciousness, and whenever manifestations of dissidence could not be justified as a provocation of world imperialism or a legacy of the past, they were merely the product of mental disease.[35] In his speech published in the state newspaper Pravda on 24 May 1959, Khrushchev said:A crime is a deviation from generally recognized standards of behavior frequently caused by mental disorder. Can there be diseases, nervous disorders among certain people in a Communist society? Evidently yes. If that is so, then there will also be offences, which are characteristic of people with abnormal minds. Of those who might start calling for opposition to Communism on this basis, we can say that clearly their mental state is not normal.The now available evidence supports the conclusion that the system of political abuse of psychiatry was carefully designed by the KGB to rid the USSR from undesirable elements.[67] According to several available documents and a message by a former general of the Fifth (dissident) Directorate of the Ukrainian KGB to Robert van Voren, political abuse of psychiatry as a systematic method of repression was developed by Yuri Andropov along with a selected group of associates.[68] He became the KGB Chairman in May 1967.[69] On 3 July 1967, he made a proposal to establish for dealing with the political opposition the KGB’s Fifth Directorate[69] (ideological counterintelligence).[70] At the end of July, the directorate was established and entered in its files cases of all Soviet dissidents including Andrei Sakharov and Alexander Solzhenitsyn.[69] In 1968, Andropov as the KGB Chairman issued his order "On the tasks of State security agencies in combating the ideological sabotage by the adversary", calling for struggle against dissidents and their imperialist masters.[71] He aimed to achieve "the destruction of dissent in all its forms" and insisted that the struggle for human rights had to be considered as a part of a wide-ranging imperialist plot to undermine the Soviet state’s foundation.[71] Similar ideas can be found in the 1983 book Speeches and Writings by Yuri Andropov:[72][w]hen analyzing the main trend in present-day bourgeois criticism of [Soviet] human rights policies one is bound to draw the conclusion that although this criticism is camouflaged with "concern" for freedom, democracy, and human rights, it is directed in fact against the socialist essence of Soviet society…On 29 April 1969, Andropov submitted to the Central Committee of the Communist Party of the Soviet Union an elaborated plan for creating a network of mental hospitals to defend the "Soviet Government and socialist order" from dissenters.[70] In this connection, a secret resolution of the USSR Council of Ministers was adopted.[73] The proposal by Andropov to use psychiatry for struggle against dissenters was implemented.[74]The USSR had 70 psychiatric hospitals and 21,103 psychiatric beds by 1926, 102 psychiatric hospitals and 33,772 psychiatric beds by 1935, 200 psychiatric hospitals and 116,000 psychiatric beds by 1955.[75] The Soviet authorities built psychiatric hospitals at a rapid pace and increased the quantity of beds for patients with nervous and mental illnesses from 222,600 to 390,000 between 1962 and 1974, and the expansion in the number of psychiatric beds was expected to continue in the years up to 1980.[76] In this period, Soviet psychiatry was dominated by a tendency different from the vigorous trend in Western countries to treat as many persons as possible as out-patients rather than in-patients.[76]On 15 May 1969, there was issued Decree No. 345–209 on "measures for preventing dangerous behavior (acts) on the part of mentally ill persons."[77] This Decree ratified the practice of having undesirables hauled into detention by psychiatrists.[77] Under this practice, the psychiatrists were told whom they should examine, and they might fetch these individuals with the assistance of the police or entrap them into coming to the hospital.[77] The psychiatrists doubled as interrogators and as arresting officers.[77] The doctors fabricated a diagnosis requiring internment, and no court judgment was required for confining the individual indefinitely.[77]By the end of the 1950s, the most commonly used method of punishing leaders of the political opposition became psychiatric commitment.[8] In the 1960s and 1970s, the trials of dissenters and their referral for "treatment" to special psychiatric hospitals of the system of MVD came out into the open before the world public, and information about "psychiatric terror," which the leadership of the Serbsky Institute was flatly denying, began to appear.[78] The bulk of psychiatric repression date from the late 1960s to the early 1980s.[79]Examination and hospitalization[edit]Political dissidents were usually charged under article 70 (agitation and propaganda against the Soviet state) and 190-1 (dissemination of false fabrications defaming the Soviet state and social system) of the Criminal Code.[8] Forensic psychiatrists were asked to examine those transgressors whose mental state the investigating officers had considered abnormal.[8]Practically in all cases, dissidents were examined in the Serbsky Central Research Institute for Forensic Psychiatry[80] which conducted forensic-psychiatric expert evaluation of persons brought to justice under political articles.[79] Certified, the persons were sent for involuntary treatment to special hospitals of the system of the Ministry of Internal Affairs(MVD) of the Russian Soviet Federative Socialist Republic.[79]The accused had no right of appeal.[8] The right was given to their relatives or other interested persons but they were not allowed to nominate psychiatrists to take part in the evaluation, because all psychiatrists were considered fully independent and equally credible before the law.[8]According to dissident poet Naum Korzhavin, the atmosphere at the Serbsky Institute in Moscow altered almost overnight when a Daniil Lunts became chief of the Fourth Department otherwise known as the Political Department.[35] Previously, psychiatric departments had been regarded as a 'refuge' against being dispatched to the Gulag, but thenceforth that policy altered.[35] The first reports of dissenters being hospitalized on non-medical grounds date from the early 1960s, not long after Georgi Morozov was appointed director of the Serbsky Institute.[35] Both Morozov and Lunts were personally involved in numerous well-known cases and were notorious abusers of psychiatry for political purposes.[35] Most prisoners, in Viktor Nekipelov’s words, characterized Daniil Lunts as "no better than the criminal doctors who performed inhuman experiments on the prisoners in Nazi concentration camps."[81]There was well-documented practice of using psychiatric hospitals as temporary prisons within two or three weeks around October Revolution Day and May Day to lock up "socially dangerous" persons who otherwise might protest in public or manifest other deviant behavior.[82]Struggle against abuse[edit]Main article: Struggle against political abuse of psychiatry in the Soviet UnionIn the 1960s, a vigorous movement grew up protesting against abuse of psychiatry in the USSR.[83] Political abuse of psychiatry in the Soviet Union was denounced in the course of the Congresses of the World Psychiatric Association in Mexico City (1971), Hawaii (1977), Vienna (1983) and Athens (1989).[8] The campaign to terminate political abuse of psychiatry in the USSR was a key episode in the Cold War, inflicting irretrievable damage on the prestige of medicine in the Soviet Union.[58]Classification of the victims[edit]Main article: Cases of political abuse of psychiatry in the Soviet UnionUpon analysis of over 200 well-authenticated cases covering the period 1962–1976, Sidney Bloch and Peter Reddaway developed a classification of the victims of Soviet psychiatric abuse. They were classified as:[84]1. advocates of human rights or democratization;2. nationalists;3. would-be emigrants;4. religious believers;5. citizens inconvenient to the authorities.The advocates of human rights and democratization, according to Bloch and Reddaway, made up about half the dissidents repressed by means of psychiatry.[84] Nationalists made up about one-tenth of the dissident population dealt with psychiatrically.[85] Would-be emigrants constituted about one-fifth of dissidents victimized by means of psychiatry.[86] People, detained only because of their religious activity, made up about fifteen per cent of dissident-patients.[86] Citizens inconvenient to the authorities because of their “obdurate” complaints about bureaucratic excesses and abuses accounted for about five per cent of dissidents subject to psychiatric abuse.[87]Incomplete figures estimated due to some archival documents[edit]In 1985, Peter Reddaway and Sidney Bloch in their book Soviet Psychiatric Abuse have provided documented data on some 500 cases.[88]According to the 1993 book by Russian psychiatrist Mikhail Buyanov, the harm inflicted by Soviet punitive psychiatry on the image of domestic medicine is, of course, great, but bears no comparison to the crimes of the Nazi doctors.[89] Now, when all the passions have cooled, one can say that the zeal of Soviet psychiatrists inflicted suffering on up to 100 or 120 people of all 280 million citizens of the former Soviet Union, Buyanov writes.[89] He adds that among the persons were many fanatical nationalists, religious sectarians, and political paranoiacs who after escaping to freedom corrupted the masses, сrammed their heads with nonsense, carried away immature people with their ideas through the connivance of the so-called progressive intelligentsia, and a result of it is wars, blood, and reciprocal hatred.[89]On basis of the available data and materials accumulated in the archives of the International Association on the Political Use of Psychiatry, one can confidently conclude that thousands of dissenters were hospitalized for political reasons.[50] From 1994 to 1995, an investigative commission of Moscow psychiatrists explored the records of five prison psychiatric hospitals in Russia and discovered about two thousand cases of political abuse of psychiatry in these hospitals alone.[50] In 2004, Anatoly Prokopenko said he was surprised at the facts obtained by him from the official classified top secret documents by the Central Committee of the CPSU, by the KGB, and MVD.[90] According to his calculations based on what he found in the documents, about 15 thousand people were confined for political crimes in psychiatric prison hospitals of the MVD system.[90] In 2005, Prokopenko, referring to the Document Fund of the Central Committee of CPSU and the prison records of the three hospitals — Sychyovskaya, Leningrad and Chernyakhovsk hospitals — to which human rights activists managed to get in 1991, drew the conclusion that psychiatry had punished about twenty thousand people for purely political reasons.[91] But this is only a little part, Prokopenko said, and the data on how many people in total had been in all of sixteen prison hospitals and in one and a half thousand open type psychiatric hospitals are inaccessible to us because the secret parts of the achieves of the prison psychiatric hospitals and hospitals overall are inaccessible.[91] The figure of fifteen or twenty thousand political prisoners in psychiatric hospitals of the MVD of the USSR was presented in the book Bezumnaya Psikhiatriya (Mad Psychiatry) by Prokopenko published in 1997[92] and republished in 2005.[93]An evidence of political abuse psychiatry in the USSR is based on Semyon Gluzman’s calculation indicating that the percentage of "the mentally ill" among those accused of the so-called anti-Soviet activity proved to be many times higher than among criminal offenders.[94][16] The attention to political prisoners paid by Soviet psychiatrists exceeded by at least 40 times their attention to ordinary criminal offenders.[94] 1–2 % of all the forensic psychiatric examinations carried out by the Serbsky Institute targeted those accused of anti-Soviet activity.[94][16] The figure of convicted dissidents in penal institutions was 0.05% of the total of convicts.[94][16] 1–2 % is greater than 0.05% by 40 times.[94][16]According to Viktor Luneyev, actual struggle against dissent was manyfold larger than it was registered in sentences, and we do not know how many persons were kept under surveillance of secret services, held criminally liable, arrested, sent to psychiatric hospitals, expelled from their work, restricted in their rights everyway.[95] No objective counting of repressed persons is possible without fundamental analysis of archival documents.[96] The difficulty of this method is that the required data are very diverse and are not in one archive.[96] They are in the State Archive of the Russian Federation, in the archive of the Goskomstat of Russia, in the archives of the MVD of Russia, the FSB of Russia, the General Prosecutor's Office of the Russian Federation, in the Russian Military and Historical Archive, in archives of constituent entities of the Russian Federation, in urban and regional archives, as well as in archives of the former Soviet Republics that now are independent countries of the Commonwealth of Independent States and the Baltics.[96]According to Russian psychiatrist Emmanuil Gushansky, the scale of psychiatric abuses in the past, the use of psychiatric doctrines by the totalitarian state are thoroughly concealed.[97] Archives of the MVD, the USSR Health Ministry, the Serbsky Institute for Forensic Psychiatry that store evidences of psychiatric expansion and regulations, on which this expansion was based, still remain closed to researchers like a tomb, he says.[97] Dan Healey has the same opinion that the abuses of Soviet psychiatry during the leadership of Stalin and more drastically after his decease in the 1960s-80s remain under-researched and main archives are still classified.[98] Hundreds of files on people who passed through forensic psychiatric examinations during the time of Stalin's rule at the Serbsky Institute are on the shelves of the highly classified archive in its basement[99]where Gluzman saw the files in 1989.[100] All of them marked only by numbers without names, surnames, any biographical data on the examinees[99] are unresearched and inaccessible to researchers.[100]Mayor of Saint Petersburg legal scholar Anatoly Sobchak wrote:The scale of the application of methods of repressive psychiatry in the USSR is testified by inexorable figures and facts. The work by the commission of the top party leadership headed by Alexei Kosygin in 1978 resulted in the decision to build 80 psychiatric hospitals and 8 special ones in addition to existing ones. Their construction was to be completed by 1990. They were being built in Krasnoyarsk, Khabarovsk, Kemerovo, Kuibyshev, Novosibirsk, and other parts of the Soviet Union. In the course of the changes the country underwent in 1988, 5 prison hospitals were transferred to the jurisdiction of the Ministry of Health from the MVD system, and other 5 ones were shut down. Hurried covering of tracks began through mass rehabilitation of patients, a part of them was mentally crippled (only in the same year 800,000 patients were removed from the psychiatric registry). Only in Leningrad 60,000 people were rehabilitated in 1991 and 1992. In 1978, 4.5 million people through the country were on the psychiatric registry. Its scale was equal to the population of many civilized countries.[101]In Ukraine, a study of the origins of the political abuse of psychiatry was conducted for five years on the basis of the state archives.[102] A total of 60 people were again surveyed.[102] All they were citizens of Ukraine, convicted of political crimes and hospitalized on the territory of Ukraine. As it turned out, none of them was in need of any psychiatric treatment.[102]Alexander Yakovlev(1923–2005), the head of the Commission for Rehabilitation of the Victims of Political Repression, a politician and historianIn the Commission for Rehabilitation of the Victims of Political Repression from 1993 to 1995, the Decree of the President of the Russian Federation on measures for preventing abuse of psychiatry was being prepared.[103] For this purpose, Anatoly Prokopenko selected suitable archival documents, and Emmanuil Gushansky at the request of the head of a department of the Commission Vladimir Naumov drew up the report.[103] It colligated both the archival data presented to Gushansky and materials received during the visit by the commission of theIndependent Psychiatric Association of Russia jointly with him to several psychiatric hospitals with strict observation (former special hospitals of the MVD system).[103] When materials for discussion in the Commission for Rehabilitation of the Victims of Political Repression have been prepared, the work has come to a standstill.[103] The documents failed to reach the head of the Commission Alexander Yakovlev.[103] The report on political abuse of psychiatry prepared by Gushansky with the aid of Prokopenko at the request of the Commission for Rehabilitation of the Victims of Political Repression has been unclaimed and denied publication even by the Nezavisimiy Psikhiatricheskiy Zhurnal.[97] The Moscow Research Center for Human Rights headed by Boris Altshuler and Alexei Smirnov and the Independent Psychiatric Association of Russia whose president isYuri Savenko were asked by Gushansky to publish the materials and archival documents on punitive psychiatry but showed no interest in doing so.[103] Publishing such documents is dictated by the needs of present life and by fears that use of psychiatry for non-medical purposes can be repeated.[104]In 2000, the Commission for Rehabilitation of the Victims of Political Repression included in its report only the following four phrases of political abuse of psychiatry:[105]The Commission has also considered such a complex, socially relevant issue, as the use of psychiatry for political purposes. The collected documents and materials allow us to say that the extrajudicial procedure of admission to psychiatric hospitals was used for compulsory hospitalization of persons whose behavior was viewed by the authorities as "suspicious" from the political point of view. According to the incomplete data, hundreds of thousands of people have been illegally placed to psychiatric institutions of the country over the years of Soviet power. The rehabilitation of these people at best was, and are usually today due to gaps in legislation, limited to removing them from the psychiatric registry.In the 1988 and 1989, about two million people were removed from the psychiatric registry at the request of Western psychiatrists that was one of their conditions for the admission of Soviet psychiatrists to the World Psychiatric Association.[106] Yuri Savenko provided different figures in different publications: about one million,[107] up to one and a half million,[108] about one and a half million people removed from the psychiatric registry.[109] Mikhail Buyanov provided the figure of over two million people removed from the psychiatric registry.[110]Theoretical analysis[edit]In 1990, Psychiatric Bulletin of the Royal College of Psychiatrists published the article "Compulsion in psychiatry: blessing or curse?" by Russian psychiatrist Anatoly Koryagin. It contains analysis of the abuse of psychiatry and eight arguments by which the existence of a system of political abuse of psychiatry in the USSR cаn easily be demonstrated. As Koryagin wrote, in a dictatorial State with a totalitarian regime, such as the USSR, the laws have at all times served not the purpose of self-regulation of the life of society but have been one of the major levers by which to manipulate the behavior of subjects. Every Soviet citizen has constantly been straight considered state property and been regarded not as the aim, but as a means to achieve the rulers' objectives. From the perspective of state pragmatism, a mentally sick person was regarded as a burden to society, using up the state's material means without recompense and not producing anything, and even potentially capable of inflicting harm. Therefore, the Soviet State never considered it reasonable to pass special legislative acts protecting the material and legal part of the patients' life. It was only instructions of the legal and medical departments that stipulated certain rules of handling the mentally sick and imposing different sanctions on them. A person with a mental disorder was automatically divested of all rights and depended entirely on the psychiatrists' will. Practically anybody could undergo psychiatric examination on the most senseless grounds and the issued diagnosis turned him into a person without rights. It was this lack of legal rights and guarantees that advantaged a system of repressive psychiatry in the country.[111]According to American psychiatrist Oleg Lapshin, Russia until 1993 did not have any specific legislation in the field of mental health except uncoordinated instructions and articles of laws in criminal and administrative law, orders of the USSR Ministry of Health. In the Soviet Union, any psychiatric patient could be hospitalized by request of his headman, relatives or instructions of a district psychiatrist. In this case, patient’s consent or dissent mattered nothing. The duration of treatment in a psychiatric hospital also depended entirely on the psychiatrist. All of that made the abuse of psychiatry possible to suppress those who opposed the political regime, and that created the vicious practice of ignoring the rights of the mentally ill.[112]According to Yuri Savenko, the president of the Independent Psychiatric Association of Russia (the IPA), punitive psychiatry arises on the basis of the interference of three main factors:[113]1. The ideologizing of science, its breakaway from the achievements of world psychiatry, the party orientation of Soviet forensic psychiatry.2. The lack of legal basis.3. The total nationalization of mental health service.Their interaction system is principally sociological: the presence of the Penal Code article on slandering the state system inevitably results in sending a certain percentage of citizens to forensic psychiatric examination.[20] Thus, it is not psychiatry itself that is punitive, but the totalitarian state uses psychiatry for punitive purposes with ease.[20]According to Larry Gostin, the root cause of the problem was the State itself.[114] The definition of danger was radically extended by the Soviet criminal system to cover "political" as well as customary physical types of "danger".[114] As Bloch and Reddaway note, there are no objective reliable criteria to determine whether the person’s behavior will be dangerous, and approaches to the definition of dangerousness greatly differ among psychiatrists.[115]Richard Bonnie, a professor of law and medicine at the University of Virginia School of Law, mentioned the deformed nature of the Soviet psychiatric profession as one of the explanations for why it was so easily bent toward the repressive objectives of the state, and pointed out the importance of a civil society and, in particular, independent professional organizations separate and apart from the state as one of the most substantial lessons from the period.[116]According to Norman Sartorius, a former president of the World Psychiatric Association, political abuse of psychiatry in the former Soviet Union was facilitated by the fact that the national classification included categories that could be employed to label dissenters, who could then be forcibly incarcerated and kept in psychiatric hospitals for "treatment".[117]Darrel Regier, vice-chair of the DSM-5 task force, has a similar opinion that the political abuse of psychiatry in the USSR was sustained by the existence of a classification developed in the Soviet Union and used to organize psychiatric treatment and care.[118] In this classification, there were categories with diagnoses that could be given to political dissenters and led to the harmful involuntary medication.[118]According to Moscow psychiatrist Alexander Danilin, the so-called "nosological" approach in the Moscow psychiatric school established by Snezhnevsky boiles down to the ability to make the only diagnosis, schizophrenia; psychiatry is not science but such a system of opinions and people by the thousands are falling victims to these opinions—millions of lives were crippled by virtue of the concept "sluggish schizophrenia" introduced some time once by an academician Snezhnevsky, whom Danilin called a state criminal.[119]St Petersburg academic psychiatrist professor Yuri Nuller notes that the concept of Snezhnevsky’s school allowed psychiatrists to consider, for example, schizoid psychopathy and even schizoid character traits as early, delayed in their development, stages of the inevitable progredient process, rather than as personality traits inherent to the individual, the dynamics of which might depend on various external factors.[120] The same also applied to a number of other personality disorders.[120] It entailed the extremely broadened diagnostics of sluggish (neurosis-like, psychopathy-like) schizophrenia.[120] Despite a number of its controversial premises and in line with the traditions of then Soviet science, Snezhnevsky’s hypothesis has immediately acquired the status of dogma which was later overcome in other disciplines but firmly stuck in psychiatry.[121] Snezhnevsky’s concept, with its dogmatism, proved to be psychologically comfortable for many psychiatrists, relieving them from doubt when making a diagnosis.[121] That carried a great danger: any deviation from a norm evaluated by a doctor could be regarded as an early phase of schizophrenia, with all ensuing consequences.[121] It resulted in the broad opportunity for voluntary and involuntary abuses of psychiatry.[121] But Snezhnevsky did not take civil and scientific courage to reconsider his concept which clearly reached a deadlock.[121]According to American psychiatrist Walter Reich, the misdiagnoses of dissidents resulted from some characteristics of Soviet psychiatry that were distortions of standard psychiatric logic, theory, and practice.[48]According to Semyon Gluzman, abuse of psychiatry to suppress dissent is based on condition of psychiatry in a totalitarian state.[16] Psychiatric paradigm of a totalitarian state is culpable for its expansion into spheres which are not initially those of psychiatric competence.[16] Psychiatry as a social institution, formed and functioning in the totalitarian state, is incapable of not being totalitarian.[16] Such psychiatry is forced to serve the two differently directed principles: care and treatment of mentally ill citizens, on the one hand, and psychiatric repression of people showing political or ideological dissent, on the other hand.[16] In the conditions of the totalitarian state, independent-minded psychiatrists appeared and may again appear, but these few people cannot change the situation in which thousands of others, who were brought up on incorrect pseudoscientific concepts and fear of the state, will sincerely believe that the uninhibited, free thinking of a citizen is a symptom of madness.[16] Gluzman specifies the following six premises for the unintentional participation of doctors in abuses:[16]1. The specificity, in the totalitarian state, of the psychiatric paradigm tightly sealed from foreign influences.2. The lack of legal conscience in most citizens including doctors.3. Disregard for fundamental human rights on the part of the lawmaker and law enforcement agencies.4. Declaratory nature or the absence of legislative acts that regulate providing psychiatric care in the country. The USSR, for example, adopted such an act only in 1988.5. The absolute state paternalism of totalitarian regimes, which naturally gives rise to the dominance of the archaic paternalistic ethical concept in medical practice. Professional consciousness of the doctor is based on the almost absolute right to make decisions without the patient's consent (i.e. there is disregard for the principle of informed consent to treatment or withdrawal from it).6. The fact, in psychiatric hospitals, of frustratingly bad conditions, which refer primarily to the poverty of health care and inevitably lead to the dehumanization of the personnel including doctors.Gluzman says that there, of course, may be a different approach to the issue expressed by Michel Foucault.[122] According to Michael Perlin, Foucault in his book Madness and Civilization documented the history of using institutional psychiatry as a political tool, researched the expanded use of the public hospitals in the 17th century in France and came to the conclusion that "confinement [was an] answer to an economic crisis... reduction of wages, unemployment, scarcity of coin" and, by the 18th century, the psychiatric hospitals satisfied "the indissociably economic and moral demand for confinement."[123]In 1977, British psychiatrist David Cooper asked Foucault the same question which Claude Bourdet had formerly asked Viktor Fainberg during a press conference given by Fainberg and Leonid Plyushch: when the USSR has the whole penitentiary and police apparatus, which could take charge of anybody, and which is perfect in itself, why do they use psychiatry? Foucault answered it was not a question of a distortion of the use of psychiatry but that was its fundamental project.[124] In the discussion Confinement, Psychiatry, Prison, Foucault states the cooperation of psychiatrists with the KGB in the Soviet Union was not abuse of medicine, but an evident case and "condensation" of psychiatry’s "inheritance", an "intensification, the ossification of a kinship structure that has never ceased to function."[125] Foucault believed that the abuse of psychiatry in the USSR of the 1960s was a logical extension of the invasion of psychiatry into the legal system.[126] In the discussion with Jean Laplanche and Robert Badinter, Foucault says that criminologists of the 1880—1900s started speaking surprisingly modern language: "The crime cannot be, for the criminal, but an abnormal, disturbed behavior. If he upsets society, it's because he himself is upset".[127] This led to the twofold conclusions.[127] First, "the judicial apparatus is no longer useful." The judges, as men of law, understand such complex, alien legal issues, purely psychological matters no better than the criminal. So commissions of psychiatrists and physicians should be substituted for the judicial apparatus.[127] And in this vein, concrete projects were proposed.[127] Second, "We must certainly treat this individual who is dangerous only because he is sick. But, at the same time, we must protect society against him."[127] Hence comes the idea of mental isolation with a mixed function: therapeutic and prophylactic.[127] In the 1900s, these projects have given rise to very lively responses from European judicial and political bodies.[128] However, they found a wide field of applications when the Soviet Union became one of the most common but by no means exceptional cases.[128]According to American psychiatrist Jonas Robitscher, psychiatry has been playing a part in controlling deviant behavior for three hundred years.[129] Vagrants, "originals," eccentrics, and homeless wanderers who did little harm but were vexatious to the society they lived in were, and sometimes still are, confined to psychiatric hospitals or deprived of their legal rights.[129] Some critics of psychiatry consider the practice as a political use of psychiatry and regard psychiatry as promoting timeserving.[129]As Vladimir Bukovsky and Semyon Gluzman point out, it is difficult for the average Soviet psychiatrist to understand the dissident’s poor adjustment to Soviet society.[130] This view of dissidence has nothing surprising about it—conformity reigned in Soviet consciousness; a public intolerance of non-conformist behavior always penetrated Soviet culture; and the threshold for deviance from custom was similarly low.[130]An example of the low threshold is a point of Donetsk psychiatrist Valentine Pekhterev, who argues that psychiatrists speak of the necessity of adapting oneself to society, estimate the level of man’s social functioning, his ability to adequately test the reality and so forth.[131] In Pekhterev's words, these speeches hit point-blank on the dissidents and revolutionaries, because all of them are poorly functioning in society, are hardly adapting to it either initially or after increasing requirements.[131] They turn their inability to adapt themselves to society into the view that the company breaks step and only they know how to help the company restructure itself.[131] The dissidents regard the cases of personal maladjustment as a proof of public ill-being.[131] The more such cases, the easier it is to present their personal ill-being as public one.[131] They bite the society’s hand that feed them only because they are not given a right place in society.[131] Unlike the dissidents, the psychiatrists destroy the hardly formed defense attitude in the dissidents by regarding "public well-being" as personal one.[131] The psychiatrists extract teeth from the dissidents, stating that they should not bite the feeding hand of society only because the tiny group of the dissidents feel bad being at their place.[131] The psychiatrists claim the need to treat not society but the dissidents and seek to improve society by preserving and improving the mental health of its members.[131] After reading the book Institute of Fools by Viktor Nekipelov, Pekhterev concluded that allegations against the psychiatrists sounded from the lips of a negligible but vociferous part of inmates who when surfeiting themselves with cakes pretended to be sufferers.[131]According to the response by Robert van Voren, Pekhterev in his article condescendingly argues that the Serbsky Institute was not so bad place and that Nekipelov exaggerates and slanders it, but Pekhterev, by doing so, misses the main point: living conditions in the Serbsky Institute were not bad, those who passed through psychiatric examination there were in a certain sense "on holiday" in comparison with the living conditions of the Gulag; and all the same, everyone was aware that the Serbsky Institute was more than the "gates of hell" from where people were sent to specialized psychiatric hospitals in Chernyakhovsk, Dnepropetrovsk, Kazan, Blagoveshchensk, and that is not all.[132] Their life was transformed to unimaginable horror with daily tortures by forced administration of drugs, beatings and other forms of punishment.[132] Many went crazy, could not endure what was happening to them, some even died during the "treatment" (for example, a miner from Donetsk Alexey Nikitin).[132] Many books and memoirs are written about the life in the psychiatric Gulag and every time when reading them a shiver seizes us.[132] The Soviet psychiatric terror in its brutality and targeting the mentally ill as the most vulnerable group of society had nothing on the Nazi euthanasia programs.[133] The punishment by placement in a mental hospital was as effective as imprisonment in Mordovian concentration camps in breaking persons psychologically and physically.[133] The recent history of the USSR should be given a wide publicity to immunize society against possible repetitions of the Soviet practice of political abuse of psychiatry.[133] The issue remains highly relevant.[133]According to Fedor Kondratev, an expert of the Serbsky Center and supporter of Snezhnevsky and his colleagues who developed the concept of sluggish schizophrenia in the 1960s,[134] those arrested by the KGB under RSFSR Criminal Code Article 70 ("anti-Soviet agitation and propaganda"), 190-1 ("dissemination of knowingly false fabrications that defame the Soviet state and social system") made up, in those years, the main group targeted by the period of using psychiatry for political purposes.[135] It was they who began to be searched for "psychopathological mechanisms" and, therefore, mental illness which gave the grounds to recognize an accused person as mentally incompetent, to debar him from appearance and defence in court, and then to send him for compulsory treatment to a special psychiatric hospital of the Ministry of Internal Affairs.[135] The trouble (not guilt) of Soviet psychiatric science was its theoretical overideologization as a result of the strict demand to severely preclude any deviations from the "exclusively scientific" concept of Marxism–Leninism.[3] This showed, in particular, in the fact that Soviet psychiatry under the totalitarian regime considered that penetrating the inner life of an ill person was flawed psychologization, existentionalization.[3] In this connection, one did not admit the possibility that an individual can behave "in a different way than others do" not only because of his mental illness but on the ground alone of his moral sets consistently with his conscience.[3] It entailed the consequence: if a person different from all others opposes the political system, one needs to search for "psychopathological mechanisms" of his dissent.[3] Even in cases when catamnesis confirmed the correctness of a diagnosis of schizophrenia, it did not always mean that mental disorders were the cause of dissent and, all the more, that one needed to administer compulsory treatment "for it" in special psychiatric hospitals.[3] What seems essential is another fact that the mentally ill could oppose the totalitarianism as well, by no means due to their "psychopathological mechanisms", but as persons who, despite having the diagnosis of schizophrenia, retained moral civic landmarks.[136] Any ill person with schizophrenia could be a dissident if his conscience could not keep silent, Kondratev says.[137]According to St Petersburg psychiatrist Vladimir Pshizov, with regard to punitive psychiatry, the nature of psychiatry is of such a sort that using psychiatrists against opponents of authorities is always tempting for the authorities, because it is seemingly possible not to take into account an opinion by the person who received a diagnosis.[138] Therefore, the issue will always remain relevant.[138] While we do not have government policy of using psychiatry for repression, psychiatrists and former psychiatric nomenklatura retained the same on-the-spot reflexes.[138]As Ukrainian psychiatrist Ada Korotenko notes, the use of punitive psychiatry allowed of avoiding the judicial procedure during which the accused might declare the impossibility to speak publicly and the violation of their civil rights.[139] Making a psychiatric diagnosis is insecure and can be based on a preconception.[140] Moreover, while diagnosing mental illness, subjective fuzzy diagnostic criteria are involved as arguments.[140] The lack of clear diagnostic criteria and clearly defined standards of diagnostics contributes to applying punitive psychiatry to vigorous and gifted citizens who disagree with authorities.[140] At the same time, most psychiatrists incline to believe that such a misdiagnosis is less dangerous than not diagnosing mental illness.[140]German psychiattist Hanfried Helmchen says the uncertainty of diagnosis is prone to other than medical influence, e.g., political influence, as was the case with Soviet dissenters who were stifled by a psychiatric diagnosis, especially that of "sluggish schizophrenia," in order to take them away from society in special psychiatric hospitals.[141]According to Russian psychologist Dmitry Leontev, punitive psychiatry in the Soviet Union was based on the assumption that only a madman can go against public dogma and seek for truth and justice.[142]K. Fulford, A. Smirnov, and E. Snow state: "An important vulnerability factor, therefore, for the abuse of psychiatry, is the subjective nature of the observations on which psychiatric diagnosis currently depends."[143] The concerns about political abuse of psychiatry as a tactic of controlling dissent have been regularly voiced by American psychiatrist Thomas Szasz,[144] and he mentioned that these authors, who correctly emphasized the value-laden nature of psychiatric diagnoses and the subjective character of psychiatric classifications, failed to accept the role of psychiatric power.[145] Musicologists, drama critics, art historians, and many other scholars also create their own subjective classifications; however, lacking state-legitimated power over persons, their classifications do not lead to anyone’s being deprived of property, liberty, or life.[145] For instance, plastic surgeon’s classification of beauty is subjective, but the plastic surgeon cannot treat his or her patient without the patient’s consent, therefore, there cannot be any political abuse of plastic surgery.[145] The bedrock of political medicine is coercion masquerading as medical treatment.[146] What transforms coercion into therapy are physiciansdiagnosing the person’s condition a "illness," declaring the intervention they impose on the victim a "treatment," and legislators and judges legitimating these categorizations as "illnesses" and "treatments."[146] In the same way, physician-eugenicists advocated killing certain disabled or ill persons as a form of treatment for both society and patient long before the Nazis came to power.[146] Szasz argued that the spectacle of the Western psychiatrists loudly condemning Soviet colleagues for their abuse of professional standards was largely an exercise in hypocrisy.[147] Psychiatric abuse, such as people usually associated with practices in the former USSR, was connected not with the misuse of psychiatric diagnoses, but with the political power built into the social role of the psychiatrist in democratic and totalitarian societies alike.[147] Psychiatrically and legally fit subjects for involuntary mental hospitalization had always been "dissidents."[148] It is the contents and contours of dissent that has changed.[148] Before the American Civil War, dissent was constituted by being a Negro and wanting to escape from slavery.[148] In Soviet Russia, dissent was constituted by wanting to "reform" Marxism or emigrate to escape from it.[148] As Szasz put it, "the classification by slave owners and slave traders of certain individuals as Negroes was scientific, in the sense that whites were rarely classified as blacks. But that did not prevent the "abuse" of such racial classification, because (what we call) its abuse was, in fact, its use."[145] The collaboration between psychiatry and government leads to what Szasz calls the "Therapeutic State", a system in which disapproved actions, thoughts, and emotions are repressed ("cured") through pseudomedical interventions.[149] Thus suicide, unconventional religious beliefs, racial bigotry, unhappiness, anxiety, shyness, sexual promiscuity, shoplifting, gambling, overeating, smoking, and illegal drug use are all considered symptoms or illnesses that need to be cured.[149]As Michael Robertson and Garry Walter suppose, psychiatric power in practically all societies expands on the grounds of public safety, which, in the view of the leaders of the USSR, was best maintained by the repression of dissidence.[150] According to Gwen Adshead, a British forensic psychotherapist at the Broadmoor Hospital, the question is what is meant by the word "abnormal."[151] Evidently it is possible for abnormal to be identified as "socially inappropriate."[151] If that is the case, social and political dissent is turned into a symptom by the medical terminology, and thereby becomes an individual’s personal problem, not a social matter.[151]According to Russian psychiatrist Emmanuil Gushansky, psychiatry is the only medical specialty in which the doctor is given the right to violence for the benefit of the patient.[152]The application of violence must be based on the mental health law, must be as much as possible transparent and monitored by representatives of the interests of persons who are in need of involuntary examination and treatment.[152] While being hospitalized in a psychiatric hospital for urgent indications, the patient should be accompanied by his relatives, witnesses, or other persons authorized to control the actions of doctors and law-enforcement agencies.[152] Otherwise, psychiatry becomes an obedient maid for administrative and governmental agencies and is deprived of its medical function.[152] It is the police that must come to the aid of citizens and is responsible for their security.[97]Only later, after the appropriate legal measures for social protection have been taken, the psychiatrist must respond to the queries of law enforcement and judicial authorities by solving the issues of involuntary hospitalization, sanity, etc.[97] In Russia, all that goes by opposites.[97] The psychiatrist is vested with punitive functions, is involved in involuntary hospitalization, the state machine hides behind his back, actually manipulating the doctor.[97] The police are reluctant to investigate offences committed by the mentally ill.[97] After receiving the information about their disease, the bodies of inquiry very often stop the investigation and do not bring it to the level of investigative actions.[97] Thereby psychiatry becomes a cloak for the course of justice and, by doing so, serves as a source for the rightlessness and stigmatization of both psychiatrists and persons with mental disorders.[97]The negative attitude to psychiatrists is thereby supported by the state machine and is accompanied by the aggression against the doctors, which increases during the periods of social unrest.[97]Vladimir Bukovsky, well known for his struggle against political abuse of psychiatry in the Soviet Union, explained that using psychiatry against dissidents was usable to the KGB because hospitalization did not have an end date, and, as a result, there were cases when dissidents were kept in psychiatric prison hospitals for 10 or even 15 years.[153] "Once they pump you with drugs, they can forget about you", he said and added, "I saw people who basically were asleep for years."[154]Residual problems[edit]In the opinion of the Moscow Helsinki Group chairwoman Lyudmila Alexeyeva, the attribution of a mental illness to a prominent figure who came out with a political declaration or action is the most significant factor in the assessment of psychiatry during the 1960–1980s.[155] The practice of forced confinement of political dissidents in psychiatric facilities in the former USSR and Eastern Europe destroyed the credibility of psychiatric practice in these countries.[27] There is little doubt that the capacity for using psychiatry to enforce social norms and even political interests is immense.[27] When psychiatric profession is discredited in one part of the world, psychiatry is discredited throughout the world.[156] Now psychiatry is vulnerable because many of its notions have been questioned, and the sustainable pattern of mental life, of boundaries of mental norm and abnormality has been lost, director of the Moscow Research Institute for Psychiatry Valery Krasnov says, adding that psychiatrists have to seek new reference points to make clinical assessments and new reference points to justify old therapeutical interventions.[155]As Emmanuil Gushansky states, today subjective position of a Russian patient toward a medical psychologist and psychiatrist is defensive in nature and prevents the attempt to understand the patient and help him assess his condition.[157] Such a position is related to constant, subconscious fear of psychiatrists and psychiatry.[157] This fear is caused by not only abuse of psychiatry, but also constant violence in the totalitarian and post-totalitarian society.[157] The psychiatric violence and psychiatric arrogance as one of manifestations of such violence is related to the primary emphasis on symptomatology and biological causes of a disease, while ignoring psychological, existential, and psychodynamic factors.[157] Gushainsky notices that the modern Russian psychiatry and the structure of providing mental health care are aimed not at protecting the patient's right to an own place in life, but at discrediting such a right, revealing symptoms and isolating the patient.[97]The psychiatrist became a scarecrow attaching psychiatric labels.[97] He is feared, is not confided, is not taken into confidence in the secrets of one’s soul and is asked to provide only medications.[97] Psychiatric labels, or stigmas, have spread so widely that there is no such thing as the media that does not call a disliked person schizo and does not generalize psychiatric assessments to phenomena of public life.[97] The word psikhushka entered everyday vocabulary.[97] All persons who deviate from the usual standards of thought and behavior are declared mentally ill, with an approving giggling of public.[97] Not surprisingly, during such a stigmatization, people with real mental disorders fear publicity like the plague.[97] Vilnius psychologist Oleg Lapin has the same point that politicians and the press attach psychological, psychiatric and medical labels; he adds that psychiatry has acquired the new status of normalizing life that was previously possessed by religion.[158] Formerly, one could say: you are going against God or God is with us; now one can say: I behave reasonably, adequately, and you do not behave in that way.[158] In 2007, Alexander Dugin, a professor at the Moscow State University and adviser toState Duma speaker Sergei Naryshkin, presented opponents of Vladimir Putin's policy as mentally ill by saying, "There are no longer opponents of Putin's policy, and if there are, they are mentally ill and should be sent to prophylactic health examination."[159] In The Moscow Regional Psychiatric Newspaper of 2012, psychiatrist Dilya Enikeyeva in violation of medical privacy and ethics publicized the diagnosis of histrionic personality disorder, which she in absentia gave Kseniya Sobchak, a Russian TV anchor and a member of political opposition, and stated that Sobchak was harmful to society.[160]Robert van Voren noted that after the fall of the Berlin Wall, it became apparent that the political abuse of psychiatry in the USSR was only the tip of the iceberg, the sign that much more was basically wrong.[161] This much more realistic image of Soviet psychiatry showed up only after the Soviet regime began to loosen its grip on society and later lost control over the developments and in the end entirely disintegrated.[161] It demonstrated that the actual situation was much sorer and that many individuals had been affected.[161]Millions of individuals were treated and stigmatized by an outdated biologically oriented and hospital-based mental health service.[161] Living conditions in clinics were bad, sometimes even terrible, and violations of human rights were rampant.[161] According to the data of a census published in 1992, the mortality of the ill with schizophrenia exceeded that of the general population by 4–6 times for the age of 20–39 years, by 3–4 times for the age of 30–39 years, by 1.5–2 times for the age over 40 years (larger values are for women).[162]According to Robert van Voren, although for several years, especially after the implosion of the USSR and during the first years of Boris Yeltsin's rule, the positions of the Soviet psychiatric leaders were in jeopardy, now one can firmly conclude that they succeeded in riding out the storm and retaining their powerful positions.[163] In addition, they also succeeded in avoiding an inflow of modern concepts of delivering mental health care and a fundamental change in the structure of psychiatric services in Russia.[163] On the whole, in Russia, the impact of mental health reformers has been the least.[163] Even the reform efforts made in such places as St. Petersburg, Tomsk, and Kaliningrad have faltered or were encapsulated as centrist policies under Putin brought them back under control.[163]Throughout the post-communist period, the pharmaceutical industry has mainly been an obstacle to reform.[164] Aiming to explore the vast market of the former USSR, they used the situation to make professionals and services totally dependent on their financial sustenance, turned the major attention to the availability of medicines rather than that of psycho-social rehabilitation services, and stimulated corruption within the mental health sector very much.[164]At the turn of the century, the psychiatric reform that had been implemented by Franco Basaglia in Italy became known and was publicly declared to be implemented in Russia, with the view of retrenchment of expenditures.[165] But when it became clear that even more money was needed for the reform, it got bogged down in the same way the reform of the army and many other undertakings did.[165] Russia is decades behind the countries of the European Union in mental health reform, which has already been implemented or is being implemented in them.[166] Until Russian society, Gushansky says, is aware of the need for mental health reform, we will live in the atmosphere of animosity, mistrust and violence.[166] Many experts believe that problems spread beyond psychiatry to society as a whole.[167] As Robert van Voren supposes, the Russians want to have their compatriots with mental disorders locked up outside the city and do not want to have them in community.[167] Despite the 1992 Russian Mental Health Law, coercive psychiatry in Russia remains generally unregulated and fashioned by the same trends toward hyperdiagnosis and overreliance on institutional care characteristic of the Soviet period.[168] In the Soviet Union, there had been an increase of the bed numbers because psychiatric services had been used to treat dissidents.In 2005, the Russian Federation had one of the highest levels of psychiatric beds per capita in Europe at 113.2 per 100,000 population, or more than 161,000 beds.[170] In 2014, Russia has 104.8 beds per 100,000 population and no actions have been taken to arrange new facilities for outpatient services.[171] Persons who do not respond well to treatment at dispensaries can be sent to long-term social care institutions (internats) wherein they remain indefinitely.[170] The internats are managed by oblast Social Protection ministries.[170] Russia had 442 psychoneurologic internats by 1999, and their number amounted to 505 by 2013.[172] The internats provided places for approximately 125,000 people in 2007.[170] In 2013, Russian psychoneurologic internats accommodated 146,000 people, according to the consolidated data of the Department of Social Protection of Moscow and the Ministry of Labour and Social Protection of the Russian Federation.[172] It is supposed that the number of beds in internats is increasing at the same rate with which the number of beds is decreasing in psychiatric hospitals.[173] Lyubov Vinogradova of the Independent Psychiatric Association of Russia provides the different figure of 122,091 or 85.5 places in psychoneurologic institutions of social protection (internats) per 100,000 population in 2013 and says that Russia is high on Europe's list of the number of places in the institutions.[174] Vinogradova states that many regions have the catastrophic shortage of places in psychoneurological internats, her words point out to the need to increase the number of places there and to the fact that the Independent Psychiatric Association of Russia is forcing transinstitutionalization—relocating the mentally ill from their homes and psychiatric hospitals to psychoneurological internats.[174]At his press conference in 2008, Semyon Gluzman said that the surplus in Ukraine of hospitals for inpatient treatment of the mentally ill was a relic of the totalitarian communist regime and that Ukraine did not have epidemic of schizophrenia but somehow Ukraine had about 90 large psychiatric hospitals including the Pavlov Hospital where beds in its children's unit alone were more than in the whole of Great Britain.[175] In Ukraine, public opinion did not contribute to the protection of citizens against possible recurrence of political abuse of psychiatry.[176] There were no demonstrations and rallies in support of the mental health law.[176] But there was a public campaign against developing the civilized law and against liberalizing the provision of psychiatric care in the country.[176] The campaign was initiated and conducted by relatives of psychiatric patients.[176] They wrote to newspapers, yelled in busy places and around them, behaved in the unbridled way in ministerial offices and corridors.[176] Once Gluzman saw through a trolleybus window a group of 20-30 people standing by a window of the Cabinet of Ministers of Ukraine with red flags, portraits of Lenin and Stalin and the slogan coarsely written on the white cardboard: "Get the Gluzman psychiatry off Ukraine!"[176] Activists of the dissident movement far from the nostalgia for the past also participated in the actions against changes in the mental health system.[176] But in general, it should be remembered that all these protest actions have been activated by nomenklatura psychiatrists.[176] The whole Ukrainian psychiatric system actually consists of the two units: hospital for treatment of acute psychiatric conditions and internat-hospice for helpless "chronic patients" unable to live on their own.[177] And between hospital and internat-hospice is desert.[177] That is why about 40 percent of patients in any Ukrainian psychiatric hospital are so-called social patients whose stay in the psychiatric hospital is not due to medical indications.[177] A similar pattern is in internats.[177] A significant part of their lifelong customers could have lived long enough in society despite their mental illnesses.[177] They could have lived quite comfortably and safely for themselves and others in special dorms, nursing homes, "halfway houses".[177] Ukraine does not have anything like that.[177]In the Soviet times, mental hospitals were frequently created in former monasteries, barracks, and even concentration camps.[171] Sofia Dorinskaya, a human rights activist and psychiatrist, says she saw former convicts who have been living in a Russian mental hospital for ten years and will have been staying there until their dying day because of having no home.[178] Deinstitutionalization has not touched many of the hospitals, and persons still die inside them.[171] In 2013, 70 persons died in a fire just outside Novgorod and Moscow.[171] Living conditions are often insufficient and sometimes horrible: 12 to 15 patients in a big room with bars on the windows, no bedside tables, often no partitions, not enough toilets.[171] The number of outpatient clinics designed for the primary care of the mentally disordered stopped increasing in 2005 and was reduced to 277 in 2012 as against 318 in 2005.[171] Stigma linked to mental disease is at the level ofxenophobia.[171] The Russian public perceive the mentally sick as harmful, useless, incurable, and dangerous.[171] The social stigma is maintained not only by the general public but also by psychiatrists.[171]Soviet mentality has endured into the present day.[171] For instance, in spite of the removal of homosexuality from the nomenclature of mental disorders, 62.5% of 450 surveyed psychiatrists in the Rostov Region view it as an illness, and up to three quarters view it as immoral behavior.[171] The psychiatrists sustain the ban on gay parades and the use of veiled schemes to lay off openly lesbian and gay persons from schools, child care centers, and other public institutions.[171] The chief psychiatrist of Russia Zurab Kekelidze in his 2013 interview to Dozhdsays that a part of the cases of homosexuality is a mental disorder, he counters the remark that the World Health Organization removed homosexuality from the list of mental disorders by stating that it is not true.[179] The trend to consider homosexuality as a mental disorder was supported by the Independent Psychiatric Association of Russia in 2005 when its president Savenko expressed their joint surprise at the proposal by the Executive Committee of the American Psychiatric Association to exclude homosexuality as a mental disorder from manuals on psychiatry, referred the proposal to antipsychiatric actions, and stated that ideological, social and liberal reasoning for the proposal was substituted for scientific one.[180] In 2014, Savenko changed his mind about homosexuality, and he along with Alexei Perekhov in their joint paper criticized and referred the trend to consider homosexuality as a mental disorder to Soviet mentality.[171]In 1994, there was organized a conference concerned with the theme of political abuse of psychiatry and attended by representatives from different former Soviet Republics — from Russia, Belarus, the Baltics, the Caucasus, and some of the Central Asian Republics.[181] Dainius Puras made a report on the situation within the Lithuanian Psychiatric Association, where discussion had been held but no resolution had been passed.[181] Yuri Nuller talked over how in Russia the wind direction was gradually changing and the systematic political abuse of psychiatry was again being denied and degraded as an issue of "hyperdiagnosis" or "scientific disagreement."[181] It was particularly noteworthy that Tatyana Dmitrieva, the then Director of the Serbsky Institute, was a proponent of such belittlement.[181] This was not so queer, because she was a close friend of the key architects of "political psychiatry."[181]In the early 1990s, she spoke the required words of repentance for political abuse of psychiatry[182] which had had unprecedented dimensions in the Soviet Union for discrediting, intimidation and suppression of the human rights movement carried out primarily in this institution.[183] Her words were widely broadcast abroad but were published only in the St. Petersburg newspaper Chas Pik within the country.[184] However, in her 2001 book Aliyans Prava i Milosediya (The Alliance of Law and Mercy), Dmitrieva wrote that there were no psychiatric abuses and certainly no more than in Western countries.[183] Moreover, the book makes the charge that professor Vladimir Serbsky and other intellectuals were wrong not to cooperate with the police department in preventing revolution and bloodsheds and that the current generation is wrong to oppose the regime.[185] In 2007, Dmitrieva asserted that the practice of "punitive psychiatry" had been grossly exaggerated, while nothing wrong had been done by the Serbsky Institute.[186] After that an official at the Serbsky Institute declared "patient" Vladimir Bukovsky, who was then going to run for the President of the Russian Federation, undoubtedly "psychopathic".[186]While speaking of the Serbsky Center, Yuri Savenko alleges that "practically nothing has changed. They have no shame at the institute about their role with the Communists. They are the same people, and they do not want to apologize for all their actions in the past." Attorney Karen Nersisyan agrees: "Serbsky is not an organ of medicine. It’s an organ of power."[187] According to human rights activist and former psychiatrist Sofia Dorinskaya, the system of Soviet psychiatry has not been destroyed, the Serbsky Institute is standing where it did, the same people who worked in the Soviet system are working there.[188] She says we have a situation like after the defeat of fascism in Germany, when fascism officially collapsed, but all governors of acres, judges and all people remained after the fascist regime.[188]In his article of 2002, Alan A. Stone, who as a member of team had examined Pyotr Grigorenko and found him mentally healthy in 1979,[189] disregarded the findings of the World Psychiatric Association and the later avowal of Soviet psychiatrists themselves and put forward the academically revisionist theory that there was no political abuse of psychiatry as a tool against pacific dissidence in the former USSR.[190] He asserted that it was time for psychiatry in the Western countries to reconsider the supposedly documented accounts of political abuse of psychiatry in the USSR in the hope of discovering that Soviet psychiatrists were more deserving of sympathy than condemnation.[60] In Stone’s words, he believes that Snezhnevsky was wrongly condemned by critics.[60] According to Stone, one of the first points the Soviet psychiatrists who have been condemned for unethical political abuse of psychiatry make is that the revolution is the greatest good for the greatest number, the greatest piece of social justice, and the greatest beneficence imaginable in the twentieth century.[191] In the Western view, the ethical compass of the Soviet psychiatrists begins to wander when they act in the service of this greatest beneficence.[191]According to St Petersburg psychiatrist Vladimir Pshizov, a disastrous factor for domestic psychiatry is that those who had committed the crime against humanity were allowed to stay on their positions until they can leave this world in a natural way.[192] Those who retained their positions and influence turned domestic psychiatry from politically motivated one to criminally motivated one because the sphere of interests of this public has been reduced to making a business of psychopharmacologic drugs and taking possession of the homes of the ill.[192] In Soviet times, all the heads of departments of psychiatry, all the directors of psychiatric research institutes, all the head doctors of psychiatric hospitals were the CPSU nomenklatura, which they remained so far.[192] The representative of nomenklatura in psychiatry had the scheme of career that is simple and often stereotyped: for one to two years, he run errands as a resident, then joined the party and became a partgrouporg.[193][192] His junior colleagues (usually non-partisan ones) collected and processed material for his dissertation.[192] Its review of literature, particularly in a research institute for psychiatry, was often written by patients, because only they knew foreign languages, and their party comrades were not up to it, the natural habitat did not stimulate learning a foreign language.[192]Robert van Voren also says Russian psychiatry is now being headed by the same psychiatrists who was heading psychiatry in Soviet times.[194] Since then Russian psychiatric system has not almost changed.[194] In reality, we still see a sort of the Soviet psychiatry that was in the late 1980s.[194] Russian psychiatrists do not have access to specialized literature published in other countries and do not understand what is world psychiatry.[194] Staff training has not changed, literature is inaccessible, the same psychiatrists teach new generations of specialists.[194] Those of them who know what is world psychiatry and know it is not the same as what is happening in Russia are silent and afraid.[194] The powerful core of the old nomenklatura in psychiatry was concentrated in Moscow, and it was clear that the struggle inside their fortress would be not only difficult, but also it would be a waste of time, energy and resources, so the Global Initiative on Psychiatry has been avoiding Moscow almost completely for all the years.[195] Instead, the Global Initiative on Psychiatry took active part in projects for reforming the mental health service in Ukraine, donated a printing plant to Ukrainian public, organized a publishing house, helped print a huge amount of medical and legal literature distributed for free, but the Ukrainian tax police accused the publishing house of manufacturing counterfeit dollars, and a significant part of humanitarian aid that the Global Initiative on Psychiatry had gathered in the Netherlands for Ukrainian psychiatric hospitals was stolen in Kiev.[195]Many of the current leaders of Russian psychiatry, especially those who were related to the establishment in Soviet period, have resiled from their avowal read at the 1989 General Assembly of the WPA that Soviet psychiatry had been systematically abused for political purposes.[196] Among such leaders who did so is Aleksandr Tiganov, a pupil of Snezhnevsky, full member of the Russian Academy of Medical Sciences, the director of its Mental Health Research Center, and the chief psychiatrist of the Ministry of Health of the Russian Federation. In 2011, when asked whether ill or healthy were those examined because of their disagreements with authority, Tiganov answered, "These people suffered from sluggish schizophrenia and were on the psychiatric registry."[197] According to Tiganov, it was rumored that Snezhnevsky took pity on dissenters and gave them a diagnosis required for placing in a special hospital to save them from a prison, but it is not true, he honestly did his medical duty.[197] The same ideas are voiced in the 2014 interview by Anatoly Smulevich, a pupil of Snezhnevsky, full member of the Russian Academy of Medical Sciences; he says what was attributed to Snesnevsky was that he recognized the healthy as the ill, it did not happen and is pure slander, it is completely ruled out for him to give a diagnosis to a healthy person.[198]In 2007, Mikhail Vinogradov, one of the leading staff members of the Serbsky Center, strongly degraded the human rights movement of the Soviet era in every possible way and tried to convince that all political dissidents who had been to his institution were indeed mentally ill.[199] In his opinion, "now it is clear that all of them are deeply affected people."[199] In 2012, Vinogradov said the same, "Do you talk about human rights activists? Most of them are just unhealthy people, I talked with them. As for the dissident General Grigorenko, I too saw him, kept him under observation, and noted oddities of his thinking. But he was eventually allowed to go abroad, as you know... Who? Bukovsky? I talked with him, and he is a completely crazy character. But he too was allowed to go abroad! You see, human rights activists are people who, due to their mental pathology, are unable to restrain themselves within the standards of society, and the West encourages their inability to do so."[200] In the same year, he offered to restore Soviet mental health law and said it "has never been used for political persecution." Human rights activists who claim it did, in Vinogradov’s words, "are not very mentally healthy."[201]Russian psychiatrist Fedor Kondratev not only denied accusations that he was ever personally engaged in Soviet abuses of psychiatry; he stated publicly that the very conception of the existence of Soviet-era "punitive psychiatry" was nothing more than: "the fantasy [vymysel] of the very same people who are now defending totalitarian sects. This is slander, which was [previously] used for anti-Soviet ends, but is now being used for anti-Russian ends."[202] He says that there were attempts to use of psychiatry for political purposes but there was no mass psychiatric terror, he calls allegations about the terror a propagandistic weapon of activists of the Cold War.[3] As Alexander Podrabinek writes, psychiatrists of punitive conscription and namely Kondratev are relatively indifferent to the public's indignation over illegal use of psychiatry both in Soviet times and now, they do not notice this public, allowing themselves to ignore any unprofessional opinion.[203] In response to the article by Podrabinek, Kondratev instituted a suit against Podrabinek underRussian Civil Code Article 152 on protecting one’s honor, dignity and business reputation.[204] According to Valery Krasnov and Isaak Gurovich, official representatives of psychiatry involved in its political abuse never acknowledged the groundlessness of their diagnostics and actions.[205] The absence of the acknowledgement and the absence of an analysis of made errors cast a shadow upon all psychiatrists in the USSR and, especially, in Russia.[205] As Russian-American historian Georgi Chernyavsky writes, after the fall of the communist regime, no matter how some psychiatrists lean over backwards, foaming at the mouth to this day when stating that they were slandered, that they did not give dissidents diagnoses-sentences, or that, at least, these cases were isolated and not at all related to their personal activities, no matter how the doctors, if one may call them so, try to rebut hundreds if not thousands of real facts, it is undoable.[206]In 2004, Savenko stated that the passed law on the state expert activity and the introduction of the profession of forensic expert psychiatrist actually destroyed adversary-based examinations and that the Serbsky Center turned into the complete monopolist of forensic examination, which it had never been under Soviet rule.[207] Formerly, the court could include any psychiatrist in a commission of experts, but now the court only chooses an expert institution.[207] The expert has the right to participate only in commissions that he is included in by the head of his expert institution, and can receive the certificate of qualification as an expert only after having worked in a state expert institution for three years.[207]The Director of the Serbsky Center Dmitrieva was, at the same time, the head of the forensic psychiatry department which is the only one in the country and is located in her Center.[207] No one had ever had such a monopoly.[207]According to Savenko, the Serbsky Center has long labored to legalize its monopolistic position of the Main expert institution of the country.[208] The ambition and permissiveness—which, due to proximity to power, allow the Serbsky Center to get in touch over the telephone with the judges and explain to them who is who and what is the guideline, although the judges themselves have already learned it—have turned out to be a considerable drop in the level of the expert reports on many positions.[208] Such a drop was inevitable and foreseeable in the context of the Serbsky Center efforts to eliminate adversary character of the expert reports of the parties, then to maximally degrade the role of the specialist as a reviewer and critic of the presented expert report, and to legalize the state of affairs.[208] Lyubov Vinogradova believes there has been a continuous diminution in patients' rights as independent experts are now excluded from processes, cannot speak in court and can do nothing against the State experts.[167]On 28 May 2009, Yuri Savenko wrote to the then President of the Russian Federation Dmitry Medvedev an open letter, in which Savenko asked Medvedev to submit to the State Duma a draft law prepared by the Independent Psychiatric Association of Russia to address the sharp drop in the level of forensic psychiatric examinations, which Savenko attributed to the lack of competition within the sector and its increasing nationalization.[209] The open letter says that the level of the expert reports has dropped to such an extent that it is often a matter of not only the absence of entire sections of the report, even such as the substantiation of its findings, and not only the gross contradiction of its findings to the descriptive section of the report, but it is often a matter of concrete statements which are so contrary to generally accepted scientific terms that doubts about the disinterestedness of the experts arise.[209] According to the letter, courts, in violation of procedural rules, do not analyze the expert report, its coherence and consistency in all its parts, do not check experts’ findings for their accuracy, completeness, and objectivity.[209]On 15 June 2009, the working group chaired by the Director of the Serbsky Center Tatyana Dmitrieva sent the Supreme Court of the Russian Federation a joint application whose purport was to declare appealing against the forensic expert reports of state expert institutions illegal and prohibit courts from receiving lawsuits filed to appeal against the reports.[208] The reason put forward for the proposal was that the appeals against the expert reports were allegedly filed "without regard for the scope of the case" and that one must appeal against the expert report "only together with the sentence."[208] In other words, according to Yuri Savenko, all professional errors and omissions are presented as untouchable by virtue of the fact that they were infiltrated into the sentence.[208] That is cynicism of administrative resources, cynicism of power, he says.[208]The draft of the application to the Supreme Court of the Russian Federation was considered in the paper "Current legal issues relevant to forensic-psychiatric expert evaluation" by Elena Shchukina and Sergei Shishkov[210] focusing on the inadmissibility of appealing against the expert report without regard for the scope of the evaluated case.[208] While talking about appealing against "the reports", the authors of the paper, according to lawyer Dmitry Bartenev, mistakenly identify the reports with actions of the experts (or an expert institution) and justify the impossibility of the "parallel" examination and evaluation of the actions of the experts without regard for the scope of the evaluated case.[208]Such a conclusion made by the authors appears clearly erroneous because abuse by the experts of rights and legitimate interests of citizens including trial participants, of course, may be a subject for a separate appeal.[208]According to the warning made in 2010 by Yuri Savenko at the same Congress, prof. Anatoly Smulevich, author of the monographs Problema Paranoyi (The Problem of Paranoia) (1972) and Maloprogredientnaya Shizofreniya (Continuous Sluggish Schizophrenia) (1987), which had contributed to the hyperdiagnosis of "sluggish schizophrenia", again began to play the same role he played before.[165] Recently, under his influence therapists began to widely use antidepressants and antipsychotics but often in inadequate cases and in inappropriate doses, without consulting psychiatrists.[211] This situation has opened up a huge new market for pharmaceutical firms, with their unlimited capabilities, and the flow of the mentally ill to internists.[165] Smulevich bases the diagnosis of continuous sluggish schizophrenia, in particular, on appearance and lifestyle and stresses that the forefront in the picture of negative changes is given to the contrast between retaining mental activity (and sometimes quite high capacity for work) and mannerism, unusualness of one's appearance and entire lifestyle.[212]According to the commentary by the Independent Psychiatric Association of Russia on the 2007 text by Vladimir Rotstein, a doctrinist of Snezhnevsky's school, there are sufficient patients with delusion of reformism in psychiatric inpatient facilities for involuntary treatment.[107] In 2012, delusion of reformism was mentioned as a symptom of mental disorder in Psychiatry. National Manual edited by Tatyana Dmitrieva, Valery Krasnov, Nikolai Neznanov, Valentin Semke, and Alexander Tiganov.[213] In the same year, Vladimir Pashkovsky in his paper reported that he diagnosed 4.7 percent of 300 patients with delusion of reform.[214] As Russian sociologist Alexander Tarasov notes, you will be treated in a hospital so that you and all your acquaintances get to learn forever that only such people as Anatoly Chubais or German Gref can be occupied with reforming in our country; and you are suffering from "syndrome of litigiousness" if in addition you wrote to the capital city complaints, which can be written only by a reviewing authority or lawyer.[215]According to Doctor of Legal Sciences Vladimir Ovchinsky, regional differences in forensic psychiatric expert reports are striking.[216] For example, in some regions of Russia, 8 or 9 percent of all examinees are pronounced sane; in other regions up to 75 percent of all examinees are pronounced sane.[216] In some regions less than 2 percent of examinees are declared schizophrenics; in other regions up to 80 percent of examinees are declared schizophrenics.[216]In April 1995, the State Duma considered the first draft of a law that would have established a State Medical Commission with a psychiatrist to certify the competence of the President, the Prime Minister, and high federal political officials to fulfill the responsibilities of their positions.[217] In 2002, Ukrainian psychiatrist Ada Korotenko stated that today the question was raised about the use of psychiatry to settle political accounts and establish psychiatric control over people competing for power in the country.[218] Obviously, one will find supporters of the feasibility of such a filter, she said, though is it worthwhile to substitute experts’ medical reports for elections?[218] In 2003, the suggestion of using psychiatry to prevent and dismiss officials from their positions was supported by Alexander Podrabinek, whose book Punitive Medicine had contributed to struggle against political abuse of psychiatry in the Soviet Union. He suggested that people who seek high positions or run for the legislature should bring from the psychiatric dispensary a reference that they are not on the psychiatric registry and should be subjected to psychiatric examination in the event of inappropriate behavior.[219] Concerned about the problem, authorities ruled that the Russian Mental Health Law should not be applied to senior officials and the judiciary on the ground that they are vested with parliamentary or judicial immunity.[220]A psychiatrist who violates this rule can be deprived of his diploma and sentenced to imprisonment.[221] In 2011, Russian psychiatrists again tried to promote the idea that one’s marked aspiration in itself for power can be referred to psychopathic symptoms and that there are statistics about 60 percent of current leaders of states suffering from various forms of mental abnormalities.[222]Documents and memoirs[edit]The evidence for the misuse of psychiatry for political purposes in the Soviet Union was documented in a number of articles and books.[223] Several national psychiatric associations examined and acted upon this documentation.[223] The United States Government Printing Office published documents on political abuse of psychiatry in the Soviet Union in 1972, 1975, 1976, 1984, and 1988.[224] From 1987 to 1991, the International Association on the Political Use of Psychiatry published forty-two numbers of Documents on the Political Abuse of Psychiatry in the USSR[225]archived by the Columbia University Libraries in archival collection Human Rights Watch Records: Helsinki Watch, 1952–2003, Series VII: Chris Panico Files, 1979–1992, USSR, Psychiatry, International Association on the Political Use of Psychiatry, Box 16, Folder 5–8 (English version) and Box 16, Folder 9–11 (Russian version).[226] In 1992, the British Medical Association published some documents on the subject in the book Medicine Betrayed: The Participation of Doctors in Human Rights Abuses.[227] A number of various documents and reports were published in Information Bulletins by the Working Commission to Investigate the Use of Psychiatry For Political Purposes, Chronicle of Current Events by the Moscow Helsinki Group[228] and in the books Punitive Medicine by Podrabinek,[229] Bezumnaya Psikhiatriya (Mad Psychiatry) by Anatoly Prokopenko,[230] Reckoning With Moscow: A Nuremberg Trial for Soviet Agents and Western Fellow Travelers by Vladimir Bukovsky,[231] Sovietskaya Psikhiatriya—Zabluzhdeniya i Umysel (Soviet Psychiatry: Fallacies and Wilfulness) by Ada Korotenko and Natalia Alikina,[232] and Kaznimye Sumasshestviem (The Executed by Madness).[233]The widely known sources including published and written memoirs by victims of psychiatric arbitrariness convey moral and physical sufferings experienced by the victims in special psychiatric hospitals of the USSR.[234] In 1965, Valery Tarsis published in the West his book Ward 7: An Autobiographical Novel[235] based upon his own experiences in 1963–1964 when he was detained in the Moscow Kashchenko psychiatric hospital for political reasons.[236] The book was the first literary work to deal with the Soviet authorities' abuse of psychiatry.[237] In 1968, the Russian poet Joseph Brodsky wrote Gorbunov and Gorchakov, a forty-page long poem in thirteen cantos consisting of lengthy conversations between two patients in a Soviet psychiatric prison as well as between each of them separately and the interrogating psychiatrists.[238] The topics vary from the taste of the cabbage served for supper to the meaning of life and Russia's destiny.[238] The poem was translated into English by Harry Thomas.[238] The experience underlying Gorbunov and Gorchakov was formed by two stints of Brodsky at psychiatric establishments.[239] In 1970, Natalya Gorbanevskaya published her book Polden: Delo o Demonstratsii 24 Avgusta 1968 Goda na Krasnoy Ploshchadi (Noon: The Case on the Demonstration of 25 August 1968 at the Red Square)[240] translated into English under the title Red Square at Noon.[241] Some parts of the book describe special psychiatric hospitals and psychiatric examinations of dissidents. In Gorbanevskaya’s book, On Special Psychiatric Hospitals ("Madhouses"), a work by Pyotr Grigorenko written in 1968, was published.[242] In 1971, Zhores Medvedev and Roy Medvedev published their joint book A Question of Madness: Repression by Psychiatry in the Soviet Union describing the hospitalization of Zhores Medvedev for political purposes and the Soviet practice of diagnosing political oppositionists as the mentally ill.[243] 1975 saw the article My Five Years in Mental Hospitals by Viktor Fainberg.[244] In 1976, Viktor Nekipelov published in samizdat his book Institute of Fools: Notes on the Serbsky Institute[245] documenting his personal experience at Psychiatric Hospital of the Serbsky Institute.[246] In 1980, the book was translated and published in English.[247] Only in 2005, the book was published in Russia.[248]In 1977, British playwright Tom Stoppard wrote the play Every Good Boy Deserves Favour that criticized the Soviet practice of treating political dissidence as a form of mental illness.[249] The play is dedicated to Viktor Fainberg and Vladimir Bukovsky, two Soviet dissidents expelled to the West.[250] In 1978, the book I Vozvrashchaetsa Veter… (And the Wind Returns…) by Vladimir Bukovsky, describing dissident movement, their struggle or freedom, practices of dealing with dissenters, and dozen years spent by Bukovsky in Soviet labor camps, prisons and psychiatric hospitals, was published[251] and later translated into English under the title To Build a Castle: My Life as a Dissenter.[252] In 1979, Leonid Plyushch published his book Na Karnavale Istorii (At History’s Сarnival) in which he described how he and other dissidents were committed to psychiatric hospitals.[253] At the same year, the book was translated into English under the title History's Carnival: A Dissident's Autobiography.[254] In 1980, the book by Yuri Belov Razmyshlenia ne tolko o Sychovke: Roslavl 1978 (Reflections not only on Sychovka: Roslavl 1978) was published.[255] In 1981, Pyotr Grigorenko published his memoirs V Podpolye Mozhno Vstretit Tolko Krys (In Underground One Can Meet Only Rats), which included the story of his psychiatric examinations and hospitalizations.[256] In 1982, the book was translated into English under the title Memoirs.[257] In 1983, Evgeny Nikolaev’s book Predavshie Gippokrata (The betrayal of Hippocrates), when translated from Russian into German under the titleGehirnwäsche in Moskau (Brainwashing in Moscow), first came out in München and told about psychiatric detention of its author for political reasons.[258] In 1984, the book under its original title was first published in Russian which the book had originally been written in.[259] In the 1983 novel Firefox Down by Craig Thomas, captured American pilot Mitchell Gant is imprisoned in a KGB psychiatric clinic "associated with the Serbsky Institute", where he is drugged and interrogated to force him to reveal the location of the Firefoxaircraft, which he has stolen and flown out of Russia.[260] In 1987, Robert van Voren published his book Koryagin: A man Struggling for Human Dignity telling about psychiatrist Anatoly Koryagin who resisted political abuse of psychiatry in the Soviet Union.[261] In 1988, Reportazh iz Niotkuda (Reportage from Nowhere) by Viktor Rafalsky was published.[262] In the publication, he described his confinement in Soviet psychiatric hospitals.[263] In 1993, Valeriya Novodvorskaya published her collection of writings Po Tu Storonu Otchayaniya (Beyond Despair) in which her experience in the prison psychiatric hospital in Kazan was described.[264] In 1996, Vladimir Bukovsky published his bookMoskovsky Protsess (Moscow trial) containing an account of developing the punitive psychiatry based on documents that were being submitted to and considered by thePolitburo of the Central Committee of the Communist Party of the Soviet Union.[265] The book was translated into English in 1998 under the title Reckoning With Moscow: A Nuremberg Trial for Soviet Agents and Western Fellow Travelers.[231] In 2001, Nikolay Kupriyanov published his book GULAG-2-SN[266] which has the foreword by Anatoly Sobchak, covers repressive psychiatry in Soviet Army, and tells about humiliations Kupriyanov underwent in the psychiatric departments of the Northern Fleet hospital and theKirov Military Medical Academy.[267] In 2002, St. Petersburg forensic psychiatrist Vladimir Pshizov published his book Sindrom Zamknutogo Prostranstva (Syndrome of Closed Space) describing the hospitalization of Viktor Fainberg.[268] 2003 saw the book Moyа Sudba i Moyа Borba protiv Psikhiatrov (My Destiny and My Struggle against Psychiatrists) by Anatoly Serov who worked as a lead design engineer before he was committed to a psychiatric hospital.[269] In 2010, Alexander Shatravka published his book Pobeg iz Raya(Escape from Paradise) in which he described how he and his companions were caught after they illegally crossed the border between Finland and the Soviet Union to escape from the latter country and, as a result, were confined to Soviet psychiatric hospitals and prisons.[270] In his book, he also described methods of brutal treatment of prisoners in the institutions.[270] In 2012, Soviet dissident and believer Vladimir Khailo’s wife published her book Subjected to Intense Persecution.[271] 2014 saw the book Zha Zholtoy Stenoy(Behind the Yellow Wall) by Alexander Avgust, a former inmate of Soviet psychiatric hospitals who in his book describes the wider circle of their inhabitants than literature on the issue usually does.[272]The use of psychiatry for political purposes in the USSR was discussed in three television documentaries—They Chose Freedom produced by Vladimir V. Kara-Murza in 2005,[273] Prison Psychiatry produced by Anatoly Yaroshevsky of NTV in the same year,[274] Parallels, Events, People (an episode Punitive Psychiatry) produced by Natella Boltyanskaya for the Voice of America in 2014[275]—and in the TV interview Psychiatric Practices in the Soviet Union produced by C-SPAN on 17 July 1989 with the participation of William Farrand, Peter Reddaway, Darrel Regier, who were members of the US delegation during its visit to Soviet psychiatric facilities in February 1989.[276]+++The Protest Psychosis: How Schizophrenia Became a Black Disease is a 2010 book written by psychiatrist Jonathan Metzl (who also has a Ph.D. in American studies), and published by Beacon Press,[1] covering the history of the 1960s Ionia State Hospital—located in Ionia, Michigan and now converted to a prison. The facility is claimed to have been one of America's largest and most notorious state psychiatric hospitals in the era before deinstitutionalization.The book focuses on exposing the trend of this hospital to diagnose African Americans with schizophrenia because of their civil rightsideas. The book suggests that in part the sudden influx of such diagnoses could be traced to a change in wording in the DSM-II, which compared to the previous edition added "hostility" and "aggression" as signs of the disorder. Metzl writes that this change resulted in structural racism.+++In “The Myth of Mental Illness,” published in 1961, Szasz argued that behaviors that colleagues attributed to diseases of the brain actually described “problems in living.” He called treating people against their will “a crime against humanity” in a 1992 profile in The Post-Standard.“I am probably the only psychiatrist in the world whose hands are clean,” Szasz told the newspaper. “I have never committed anyone. I have never given electric shock. I have never, ever, given drugs to a mental patient.”The approach Szasz rebelled against treated people as patients whose behavior somehow failed to meet the expectations of government or some other authority, said Dr. Rebecca King, a protege of Szasz who practices child and adolescent psychiatry in Syracuse and teaches at Upstate Medical University.He believed people should seek a psychiatrist’s help after they themselves recognized a problem, and that the psychiatrist should help them talk through the issue and provide advice, when asked, King said.Szasz did not spark a revolution in psychiatry, but inspired practitioners to look at the moral and legal propriety of some practices, in particular cases, said Dr. Robert W. Daly, a professor of psychiatry, and of bio-ethics and humanities at Upstate Medical University who studied under Szasz.“Many of the specific things he sought to bring about have not changed. We have civil commitment laws and so on,” Daly said. “But the discussion of the use of coercion and forced treatment and all that, I think he had a real impact on the discussion of those matters within the profession and within the law itself. He helped sensitize everybody to what in fact they were doing.”Born in Hungary, Szasz (pronounced ZOZ) emigrated to the United States in 1938 and graduated at the top of his class from the University of Cincinnati medical school in 1944. He became a professor of psychiatry in 1956 at what is now Upstate Medical University in Syracuse.Szasz became the school’s most popular professor, attracting residents who specifically wanted to study with him, according to a history of the psychiatry departmentpublished in the university’s Alumni Journal in 2006.“The Myth of Mental Illness,” one of 35 books and hundreds of articles written by Szasz, gained him an international reputation.Later writings generated a political backlash from Albany in the early 1960s that almost cost him his job, caused a rift with his boss and split the faculty, the Alumni Journal said.In another controversial move, Szasz and the Church of Scientology founded the Citizens Commission on Human Rights, a group critical of psychiatry. He later distanced himself from the church.Szasz’s critics disputed his position on mental illness, contending that science had found genetic or chemical bases for some mental disorders. HIs backers, and some detractors, credited him with standing against the misuse of psychiatry.His daughter, Dr. Margot Szasz Peters, said her father would talk about his work with her when she was in high school. The talks provided "great life and professional lessons," Peters, a dermatologist, said in an email to The Post-Standard.“Most of all, he was a role model of kindness and honestly," she said, "I was always struck that even those who disagreed with his views looked to him with respect, admiration and affection.”Szasz retired from Upstate in 1990.He was sued for malpractice two years later by the widow of a man Szasz was treating, claiming the man committed suicide six months after Szasz instructed him to stop taking lithium. The suit was settled two years later for an undisclosed sum.Szasz retired from private practice in 1995.Upstate Medical University honored Szasz with an honorary doctor of science degree in 2001. His numerous other awards included the Free Press Association’s Mencken Award, the Jefferson Award from the American Institute for Public Service and the American Hungarian Foundation’s George Washington Award.+++Psychiatry, like fascism, must be outlawed, rather than merely reformed.In this article we shall take a close look at some attemptsPSYCHIATRY, LIKE FASCISM, MUST BE OUTLAWED,RATHER THAN MERELY REFORMED by Justice LoverIn this article we shall take a close look at some attempts in the last few years to reform psychiatry from the outside, as those very few psychiatrists who proposed changes from inside the profession have been completely ignored by the vast majority of the shrinks.Before doing that we would need to find the answer to some basic questions, such as : if psychiatry is bad -which it is ,of course ! - then why has it been given the legal power it has to oppress people under the pretext of "medical treatment " ? Why has it been accepted by mainstream medicine as a legitimate "Medical Specialty", when it should have been obvious to any medical practitioner that psychiatry is dangerous quackery ? Why have most human rights organisations refused to protest, much less condemn, the fascist practices and human rights violations by the shrinks all over the world ?The answer to all such questions is one : psychiatry is a tool for oppression used against ordinary people under the cover of "Medical Specialty" to secure and perpetuate the rule of big business. Since big business owns and controls the Media and the state itself, the risks involved in exposing the crimes of psychiatry and of the drug corporations, have scared away people. Furthermore, psychiatry is not merely for the benefit and enormous profits of Big Pharma, the big partner of psychiatry, but also for the benefit of the entire ruling class. Hence the support of the ruling class for the crimes of psychiatry.Once this essential truth is grasped , all the questions and riddles regarding the role of psychiatry get their full answer . It also explains why the attempts to refrom psychiatry have all failed. This is important to understand now, on the eve of the Dresden conference of psychiatrists, which will take place on the 6th of next month, in the latest attempt by psychiatrists to fool people and to confuse them.Exactly 9 years ago the French philosopher, Michel Foucault, organised a public tribunal in Berlin to protest the crimes of psychiatry. Now, hardly anyone - and least of all the shrinks themselves - knows or remembers anything about that tribumal and its verdict. So let us read its original verdict to remind people as follows :http://www.foucault.de/index.htm"Foucault Tribunal on the state of PsychiatryThe Verdict of the Foucault TribunalWe conclude that, being unwilling to renounce the use of force, violence and coercion, psychiatry is guilty of crimes against humanity: the deliberate destruction of dignity, liberty and life. Most of all through the legal category of "mental patient" which permits a total deprivation of human and civil rights and the laws of natural justice.Furthermore, psychiatry cannot pretend to the art of healing, having violated the Hippocratic Oath through a conscious use of harmful drugs, which caused in particular the world wide epidemic of tardive dyskinesia, as well as other interventions which we recognize as tortures: involuntary confinement, forced drugging, four point restraints, electroshock, all forms of psychosurgery and outpatient commitment.These practices and ideology allowed the psychiatrists during the Nazi era to go to the extreme of systematic mass murder of inmates under the pretext of "treatment".Psychiatry not only refuses to renounce the force it has historically obtained from the state, it even takes on the role of a highly paid and respected agent of social control and international police force over behavior and the repression of political and social dissent.We find psychiatry guilty of the combination of force and unaccountability, a classic definition of totalitarian systems. We demand the abolition of the "mental patients" laws as a first step toward making psychiatry accountable to society. To this end, compensation will have to be made for the harms it has done. Public funds must also be made available for humane and dignified alternatives to Psychiatry.Reasons for the VerdictThe defense speaks of the therapeutic necessity for psychiatric coercion and, if necessary, the use of physical force. They admit though, that in "good psychiatric institutions" as little coercion as possible is used. Coercion is apparently not therapeutic, rather it is dependent on the type of psychiatry practiced. We condemn all forms of psychiatric coercion as a violation of human rights.The laws for the mentally ill prescribe psychiatric coercion in the case of danger to oneself or others. In practice this is widely transgressed. The matter is only one of endangerment; no crime has been committed. This means that preventive detention is being practiced.The defense describes someone as being mentally ill because his ability to help himself is reduced. They believe that he should be relieved of certain societal demands because of impairments in his ability to experience and behave as expected by society.We are of the opinion that the accepted idea of illness is inadequate. In this case an institution such as a psychiatric hospital cannot offer any assistance.We are of the opinion that treatment by doctors should only be applied on a voluntary basis.It is especially dangerous that many judges are biased and that they agree with the expert opinions of the psychiatrists.Psychiatric survivors have a right to demand financial compensation for any pain and suffering they experienced.Berlin, 2nd of May 1998 ."Three years later, the crimes of psychiatry were condemned again , and this time by the famous tribunal of Bertrand Russell, the Russell Tribunal , as follows :http://www.freedom-of-thought.de/index.html"Verdict of the Russell Tribunal on PsychiatryAs a result of the evidence it has heard in its first session in Berlin over the weekend of June 30/July 1, 2001, the Tribunal is convinced that the serious abuse of human rights in the name of psychiatry is widespread but largely unrecognized.In accordance with the United Nations Declaration of Human Rights the majority of the jury deeply deplore the incarceration of people against their will in the name of psychiatry. The perpetration of such practices is a threat to individual and collective liberty everywhere.We consider the concept of "mental illness" and the "medical model" of psychiatry to explain human behaviour dangerous and fallacious because it is deterministic (particularly in the case of bio-psychiatry) deprives people of choice and responsibility. It even justifies concepts such as the legal category of "mental patient" which permits a total deprivation of human and civil rights and actually is used to exculpate anti-social and criminal actions.We deplore the action of the Free University which reneged upon its promise to host the Tribunal following pressure of its Department of Psychiatry. Nevertheless we are determined to continue our investigations and hearings and to use the media and all means of communication available to explore these abuses and to alert public opinion to the dangers to human freedom presented by the uncritical acceptance of the claims and practices of psychiatry. We think further investigation should be conducted to explore specific psychiatric abuses: forced drugging, electroshock, four point restraint and involuntary hospitalization.Strict legal and political supervision of mental hospitals and psychiatric practices is a prerequisite for the effective protection of human rights. Legal mechanisms should include legal representation, access to relevant documents, civil or criminal liability for incarceration and prohibition of discrimination against "mental patients". Further political and public steps should be taken including critical public examination of the role of psychiatry, its scientific basis and the justifiability of contemporary psychiatric practice.Psychiatry not only refuses to renounce the force it has historically obtained from the state, it even takes on the role of a highly paid and respected agent of social control and international police force over behaviour and the repression of political and social dissent.We find psychiatry guilty of the combination of force and unaccountability, a classic definition of totalitarian systems. We demand the abolition of the "mental health" laws as a first step toward making psychiatry accountable to society. To this end, compensation should be made for harms it has done. Public funds should be made available for humane and dignified alternatives to coercive psychiatry."Recently, a mental health worker in the USA, the head of California Network of Mental Health Clients, published an article, under the title , Force and Coercion( http://www.mhcan.org/writing/Zinman.html ). The views expressed there are typical to those who work for the mental health industry but regard themselves as "progressives", namely, they are opposed to some forms of psychiatric coercion, but not to psychiatry. The author of the article lists those forms as follows : Electroshock (ECT), Seclusion and Restraint, and the expansion of coercive "treatment"to involuntary outpatient commitment. Other than those cases the "progressive" mental health workers are prepared to compromise (at the expense of their clients, of course) with the shrinks. They are certainly not willing to lose their well paid jobs by getting rid of psychiatry altogether !+++“What’s a guy gotta do around here to lose a little credibility?” asked ProPublica reporter Jesse Eisinger in a 2012 piece about top Wall Street executives who created the financial meltdown but who remain top Wall Street executives, continue to sit on corporate and nonprofit boards, serve as regulators, and whose opinions are sought out by prominent op-ed pages and talk shows. Wall Street is not the only arena that one can be completely wrong and still retain powerful influence.Influential “thought leader” psychiatrists and major psychiatry institutions, by their own recent admissions, have been repeatedly wrong about illness/disorder validity, biochemical causes, and drug treatments; and also, in several cases, have been discovered to be on the take from drug companies—yet continue to be taken seriously by the mainstream media.While Big Pharma financial backing is one reason that psychiatry is able to retain its clout, this is not the only reason. More insidiously, psychiatry retains influence because of the needs of the larger power structure that rules us. And perhaps most troubling, psychiatry retains influence because of us—and our increasing fears that have resulted in our expanding needs for coercion.But before discussing these three reasons, some documentation of psychiatry’s lost scientific credibility in several critical areas.Psychiatry’s Lost Scientific CredibilityDSM Invalidity. In 2013, the American Psychiatric Association’s diagnostic bible, the DSM, was slammed by the pillars of the psychiatry establishment. Thomas Insel, director of the National Institute of Mental Health (NIMH)—the highest U.S. governmental mental health official—offered a harsh rebuke of the DSM, announcing that the DSM’s diagnostic categories lack validity, and he stated that “NIMH will be re-orienting its research away from DSM categories.” Also in 2013, Allen Frances, the former chair of the DSM-4 taskforce, published his book, Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life.Biochemical Imbalance Theory Debunked. It was a great surprise for NPR reporter Alix Spiegel in 2012 to discover that the psychiatric establishment now claims that it has always known that the biochemical imbalance theory of depression was not true. Ronald Pies, editor-in-chief emeritus of the Psychiatric Times stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” NIMH director Insel had already told Newsweek in 2007 that depression is not caused by low levels of neurotransmitters such as serotonin. However, psychiatry made no serious attempt to publicize the fact that the research had rejected this chemical imbalance theory, a theory effectively used in commercials to sell antidepressants as correcting this chemical imbalance—an imbalance which psychiatry knew did not exist.Rethinking the Effectiveness of Antipsychotic and Antidepressant Drug Treatments. In 2013, NIMH director Insel also announced that psychiatry’s standard treatment for people diagnosed with schizophrenia and other psychoses has not been helpful to many people and needs to change so as to better reflect the diversity in this population. Citing long-term treatment studies, Insel concluded that in the long-term, many individuals who have been diagnosed with psychosis actually do better without antipsychotic medication. With respect to antidepressants, “60 Minutes” in 2012 reported on what antidepressant researchers have long known: placebos do almost as well as antidepressants even in drug-company studies that are biased in favor of the antidepressants. The “60 Minutes” report focused on research psychologist Irving Kirsch who used the Freedom of Information Act to study published and nonpublished drug company studies involving 6,944 patients from the FDA database trials of the six most popular antidepressants (Prozac, Paxil, Zoloft, Effexor, Celexa, and Serzone).Psychiatric Treatments May Cause Increased Suicide. The FDA —despite protests by the psychiatric establishment—has issued “black box warnings” about the potential for increased suicidality for patients under the age of 25 who use antidepressants. In 2014, AlterNet reported “Research Suggests That Psychiatric Interventions Like Admission to a Mental Facility Could Increase Suicide Risk” about a University of Copenhagen study comparing Danish individuals who committed suicide to matched controls between the years 1996 and 2009. The researchers found that taking psychiatric medications in a prior year was linked to a 5.8 times increase in suicide; contact with a psychiatric outpatient clinic was associated with an 8.2 times increase; visiting a psychiatric emergency room was linked to a 27.9 times increase; and admission to a psychiatric hospital was linked to a 44.3 times increase in suicide.While correlation by itself does not necessarily mean causation, an accompanying editorial in the same journal where the article was published pointed out that associations with the features detailed in this particular study indicate a good possibility of a causal relationship. Among the reasons why psychiatric treatment could well cause increased suicide, besides the adverse effects of medication, is the stigma and trauma of treatment, as the editorial authors state: “It is therefore entirely plausible that the stigma and trauma inherent in (particularly involuntary) psychiatric treatment might, in already vulnerable individuals, contribute to some suicides.”Creating Stigma with Biochemical Defect Theories. In the psychiatry establishment, it has long been proclaimed that framing mental illness as a brain disease or a biochemical defect would result in less stigmatization. But the Canadian Health Services Research Foundation (CHSRF), in a review of the research titled “Myth: Reframing Mental Illness as a ‘Brain Disease’ Reduces Stigma” reported in 2012: “Despite good intentions, evidence actually shows that anti-stigma campaigns emphasizing the biological nature of mental illness have not been effective, and have often made the problem worse.” One example is a 2010 study in Psychiatry Research that reported for the general public, the acceptance of the “biogenetic model of mental illness” was associated with a desire for a greater social distance from the mentally ill. The CHSRF review states: “The evidence shows us that while the public may assign less blame to individuals for their biologically-determined mental illness, the very idea that their actions may be beyond their conscious control can create fear of their unpredictability and thus the perception that those with mental illnesses are dangerous. . . leading to avoidance.”Corruption of Psychiatry by Big Pharma. Big pharma heavily funds university psychiatry departments, sponsors conferences and continuing education for psychiatrists, advertises in their professional journals, and pays well-known clinicians and researchers to be speakers and consultants. I documented in Surviving America’s Depression Epidemic in 2007 and updated in Truthout in 2012 how virtually every way the public and doctors get information about mental health has been corrupted by drug company dollars. In 2008, Congressional investigations of psychiatry revealed that major psychiatry institutions such as the American Psychiatric Association and several “thought leader” psychiatrists, including Harvard psychiatrist Joseph Biederman, were on the take from drug companies, creating obvious conflicts of interest and further damaging psychiatry’s credibility.The New York Times reported the following about Biederman: “A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007”; and the Times later reported that Biederman had pitched Johnson & Johnson that his proposed research studies on its antipsychotic drug Risperdal would turn out favorably for Johnson & Johnson—and then delivered the goods. Biederman was only one of several thought leader psychiatrists exposed by Congressional investigations. The DSM diagnostic manual is published by the American Psychiatric Association (APA), and according to the journal PLOS Medicine, “69% of the DSM -5 task force members report having ties to the pharmaceutical industry.”Why Psychiatry Retains Power Despite Lost CredibilityDrug companies need the general public to take psychiatric drug prescribers seriously, and so Big Pharma financially support psychiatry institutions and thought leaders. And Big Pharma has huge clout over the mainstream media via the mainstream media’s dependency on Big Pharma’s advertising dollars. While Big Pharma is the most obvious reason that psychiatry retains power despite a loss of scientific credibility, it may not be the most important reason. Psychiatry serves the needs of the power structure in general. And in our increasingly fear-based society, psychiatry meets our own increasing needs for coercion.Meeting the Coercion Needs of the Power StructureRuling elites and power structures—from monarchies to military dictatorships to the U.S. corporatocracy —have routinely used “professionals” to control the population from rebelling against economic inequalities and social injustices so as to maintain the status quo. Power structures routinely rely on police and clergy, and today the U.S. power structure also uses mental health professionals. Medication and behavior modification “treatments” have been utilized to subvert resistance to a dehumanizing status quo, be it in a family or in the larger society. The following are a few examples of how both psychiatry and psychology have met the needs of the power structure in return for status and money.MKULTRA: A piece of American history sounds like the rant of a crackpot conspiracy theorist but ultimately was confirmed decades later by the U.S. Congress’s Church Committee investigations, acknowledged by the U.S. Supreme Court, and documented in The Search for the "Manchurian Candidate": The CIA and Mind Control: The Secret History of the Behavioral Sciences by former State Department officer John Marks. Ewen Cameron, president of the American Psychiatric Association in 1953, sought powerful ways to break down patient resistance, and he experimented with LSD as well as with electroshock and sensory deprivation. The CIA, under a project code-named MKULTRA, eager to learn more about Cameron’s techniques, funded him as well as other renowned psychiatrists in the 1950s and 1960s to conduct brainwashing experiments.Assistance in Interrogation/Torture: Shortly after the tragic events of September 11, 2001, the American Psychological Association (APA) made high-level efforts to nurture relationships with the U.S. Department of Defense (DOD), the Central Intelligence Agency (CIA), and other government agencies. As Truthout reported in 2014, the APA aimed “to position psychology and behavioral scientists as key players in U.S. counterterrorism and counterintelligence activities.” The APA not only condoned but actually applauded psychologists’ assistance in interrogation/torture in Guantánamo and elsewhere.Subverting Resistance by U.S. Soldiers: Psychiatrists and psychologists have subverting resistance by U.S. soldiers in the wars in Iraq and Afghanistan via psychiatric drug “treatments” and behavioral manipulations. According to the Navy Times in 2010, one in six U.S. armed service members were taking at least one psychiatric drug, many of these medicated soldiers in combat zones. Martin Seligman, a former president of the American Psychological Association, has consulted with the U.S. Army’s Comprehensive Soldier Fitness positive psychology program (as I reported in AlterNet in 2010). Seligman achieved not only “social position and rank” for himself but several million dollars for his University of Pennsylvania Positive Psychology Center, according to the Philadelphia Inquirer, which quoted Seligman saying, “We’re after creating an indomitable military.”Pathologizing and Medicating Noncompliance: Both psychiatrists and psychologists pathologize and medicate anti-authoritarianism and noncompliance, which I described in AlterNet in 2012. Many individuals diagnosed with mental disorders are essentially anti-authoritarians, and a potentially large army of anti-authoritarian activists are being kept off democracy battlefields by mental health professionals who have pathologized and depoliticized their pain.Meeting Our Needs for Coercion“It seems to me that this coercive function is what society and most people actually appreciate most about psychiatry. . . . Psychiatry has never ever needed scientific evidence to spread its ideas and practices, and possibly never will.” —David Cohen, researcher, UCLA professor of social welfare, practicing clinical social worker, and co-author of Mad Science.Early in my career for two years, I worked as a psychiatry emergency room therapist. I observed countless instances of police dragging agitated people into the E.R. who were then forcibly placed in restraints. Some of those police remained in the E.R. to watch—in both admiration and envy—as to how quickly an injection of Haldol or some other antipsychotic drug could calm the person.All societies, communities, and families coerce and control members who frighten them. However, the kinds of behavior that frightens people vary enormously, and thus what is permissible to control and coerce varies enormously. So, while it would be fairly universal for a society to coerce and control someone who is physically attacking another of its members, it is quite historically exceptional—as is done in U.S. society—to use antipsychotic drugs to subdue a bored seven-year old who is resisting classroom controls. In December 2012, the Archives of General Psychiatry (renamed JAMA Psychiatry) reported that, between 1993-2009, there was a seven-fold increase of children 13 years and younger being prescribed antipsychotic drugs, and that nonpsychotic conditions such as “disruptive behavior disorders” were the most common diagnoses in children medicated with antipsychotics, accounting for 63% of those medicated.The dramatic growth of antipsychotic drugs in the United States is largely about ever-increasing societal acceptance of using drugs to control unwanted behaviors. Antipsychotics grossed over $18 billion a year in the United States by 2011, and by 2013 one antipsychotic drug, Abilify, was the highest grossing of all drugs in the United States with nearly $6.5 billion in sales. In addition to children—especially foster children—the burgeoning U.S. antipsychotic market includes the elderly in nursing homes and inmates in prisons and jails, where antipsychotic drugs are a relatively inexpensive way to subdue and more easily manage these populations.In a 2014 article, “It’s the Coercion, Stupid!” David Cohen, in the tradition of Michel Foucault’s Madness and Civilization, updates how the societal need for psychiatry’s “extra-legal police function” compels society to be blind to psychiatry’s complete lack of scientific validity. Cohen notes: “Society’s appreciation for psychiatric coercion subtly, but radically, imbalances the playing field. Because of psychiatric coercion, society gives psychiatric theories a free pass. These theories never need to pass any rigorously devised tests (as we expect other important scientific theories to pass), they only need to be asserted.”Thus, journalists’ continued exposure of psychiatry’s lack of science and its corruption by Big Pharma has had virtually no impact on reducing psychiatry’s influence. Substantive mental health reform will not come about unless society itself is reformed to be less fearful and less in need of controls and coercions. For example, if society could return to the idea that there are many extremely intelligent adolescents who are not “academics” and who do not need extended standard schooling but some other form of education to succeed in many occupations, then adolescent rebellion against standard schooling would not be so frightening for parents—and the compulsion to coerce and control via behavioral manipulations and psychiatric medications would disappear.Cohen concludes, “Let’s face it: No one cares that psychiatric research of the past 50 years failed to turn up one finding of use for a scientific clinical psychiatry.”Of course Cohen cares and so do all genuine scientists, but Cohen is right that as long as society needs the “extra-legal” coercion that psychiatry provides, society needs to remain in denial about the scientific illegitimacy of psychiatry. Without a decreased societal demand for coercion, psychiatry abolitionists should beware that if psychiatry ever does lose its clout, another coercive institution would likely fill the vacuum.I have talked with hundreds of people previously diagnosed by other professionals with oppositional defiant disorder, attention deficit hyperactive disorder, anxiety disorder and other psychiatric illnesses, and I am struck by (1) how many of those diagnosed are essentially anti-authoritarians, and (2) how those professionals who have diagnosed them are not.Anti-authoritarians question whether an authority is a legitimate one before taking that authority seriously. Evaluating the legitimacy of authorities includes assessing whether or not authorities actually know what they are talking about, are honest, and care about those people who are respecting their authority. And when anti-authoritarians assess an authority to be illegitimate, they challenge and resist that authority—sometimes aggressively and sometimes passive-aggressively, sometimes wisely and sometimes not.Some activists lament how few anti-authoritarians there appear to be in the United States. One reason could be that many natural anti-authoritarians are now psychopathologized and medicated before they achieve political consciousness of society’s most oppressive authorities.Why Mental Health Professionals Diagnose Anti-Authoritarians with Mental IllnessGaining acceptance into graduate school or medical school and achieving a PhD or MD and becoming a psychologist or psychiatrist means jumping through many hoops, all of which require much behavioral and attentional compliance to authorities, even to those authorities that one lacks respect for. The selection and socialization of mental health professionals tends to breed out many anti-authoritarians. Having steered the higher-education terrain for a decade of my life, I know that degrees and credentials are primarily badges of compliance. Those with extended schooling have lived for many years in a world where one routinely conforms to the demands of authorities. Thus for many MDs and PhDs, people different from them who reject this attentional and behavioral compliance appear to be from another world—a diagnosable one.I have found that most psychologists, psychiatrists, and other mental health professionals are not only extraordinarily compliant with authorities but also unaware of the magnitude of their obedience. And it also has become clear to me that the anti-authoritarianism of their patients creates enormous anxiety for these professionals, and their anxiety fuels diagnoses and treatments.In graduate school, I discovered that all it took to be labeled as having “issues with authority” was to not kiss up to a director of clinical training whose personality was a combination of Donald Trump, Newt Gingrich, and Howard Cosell. When I was told by some faculty that I had “issues with authority,” I had mixed feelings about being so labeled. On the one hand, I found it quite amusing, because among the working-class kids whom I had grown up with, I was considered relatively compliant with authorities. After all, I had done my homework, studied, and received good grades. However, while my new “issues with authority” label made me grin because I was now being seen as a “bad boy,” it also very much concerned me about just what kind of a profession that I had entered. Specifically, if somebody such as myself was being labeled with “issues with authority,” what were they calling the kids I grew up with who paid attention to many things that they cared about but didn’t care enough about school to comply there? Well, the answer soon became clear.Mental Illness Diagnoses for Anti-AuthoritariansA 2009 Psychiatric Times article titled “ADHD & ODD: Confronting the Challenges of Disruptive Behavior” reports that “disruptive disorders,” which include attention deficit hyperactivity disorder (ADHD) and opposition defiant disorder (ODD), are the most common mental health problem of children and teenagers. ADHD is defined by poor attention and distractibility, poor self-control and impulsivity, and hyperactivity. ODD is defined as a “a pattern of negativistic, hostile, and defiant behavior without the more serious violations of the basic rights of others that are seen in conduct disorder”; and ODD symptoms include “often actively defies or refuses to comply with adult requests or rules” and “often argues with adults.”Psychologist Russell Barkley, one of mainstream mental health’s leading authorities on ADHD, says that those afflicted with ADHD have deficits in what he calls “rule-governed behavior,” as they are less responsive to rules of established authorities and less sensitive to positive or negative consequences. ODD young people, according to mainstream mental health authorities, also have these so-called deficits in rule-governed behavior, and so it is extremely common for young people to have a “duel diagnosis” of AHDH and ODD.Do we really want to diagnose and medicate everyone with “deficits in rule-governed behavior”?Albert Einstein, as a youth, would have likely received an ADHD diagnosis, and maybe an ODD one as well. Albert didn't pay attention to his teachers, failed his college entrance examinations twice, and had difficulty holding jobs. However, Einstein biographer Ronald Clark (Einstein: The Life and Times) asserts that Albert's problems did not stem from attention deficits but rather from his hatred of authoritarian, Prussian discipline in his schools. Einstein said, “The teachers in the elementary school appeared to me like sergeants and in the Gymnasium the teachers were like lieutenants.” At age 13, Einstein read Kant's difficult Critique of Pure Reason—because Albert was interested in it. Clark also tells us Einstein refused to prepare himself for his college admissions as a rebellion against his father’s “unbearable” path of a “practical profession.” After he did enter college, one professor told Einstein, “You have one fault; one can’t tell you anything.” The very characteristics of Einstein that upset authorities so much were exactly the ones that allowed him to excel.By today’s standards, Saul Alinsky, the legendary organizer and author of Reveille for Radicalsand Rules for Radicals, would have certainly been diagnosed with one or more disruptive disorders. Recalling his childhood, Alinsky said, “I never thought of walking on the grass until I saw a sign saying ‘Keep off the grass.’ Then I would stomp all over it.” Alinsky also recalls a time when he was ten or eleven and his rabbi was tutoring him in Hebrew:One particular day I read three pages in a row without any errors in pronunciation, and suddenly a penny fell onto the Bible . . . Then the next day the rabbi turned up and he told me to start reading. And I wouldn’t; I just sat there in silence, refusing to read. He asked me why I was so quiet, and I said, “This time it’s a nickel or nothing.” He threw back his arm and slammed me across the room.Many people with severe anxiety and/or depression are also anti-authoritarians. Often a major pain of their lives that fuels their anxiety and/or depression is fear that their contempt for illegitimate authorities will cause them to be financially and socially marginalized; but they fear that compliance with such illegitimate authorities will cause them existential death.I have also spent a great deal of time with people who had at one time in their lives had thoughts and behavior that were so bizarre that they were extremely frightening for their families and even themselves; they were diagnosed with schizophrenia and other psychoses, but have fully recovered and have been, for many years, leading productive lives. Among this population, I have not met one person whom I would not consider a major anti-authoritarian. Once recovered, they have learned to channel their anti-authoritarianism into more constructive political ends, including reforming mental health treatment.Many anti-authoritarians who earlier in their lives were diagnosed with mental illness tell me that once they were labeled with a psychiatric diagnosis, they got caught in a dilemma. Authoritarians, by definition, demand unquestioning obedience, and so any resistance to their diagnosis and treatment created enormous anxiety for authoritarian mental health professionals; and professionals, feeling out of control, labeled them “noncompliant with treatment,” increased the severity of their diagnosis, and jacked up their medications. This was enraging for these anti-authoritarians, sometimes so much so that they reacted in ways that made them appear even more frightening to their families.There are anti-authoritarians who use psychiatric drugs to help them function, but they often reject psychiatric authorities’ explanations for why they have difficulty functioning. So, for example, they may take Adderall (an amphetamine prescribed for ADHD), but they know that their attentional problem is not a result of a biochemical brain imbalance but rather caused by a boring job. And similarly, many anti-authoritarians in highly stressful environments will occasionally take prescribed benzodiazepines such as Xanax even though they believe it would be safer to occasionally use marijuana but can’t because of drug testing on their jobIt has been my experience that many anti-authoritarians labeled with psychiatric diagnoses usually don’t reject all authorities, simply those they’ve assessed to be illegitimate ones, which just happens to be a great deal of society’s authorities.Maintaining the Societal Status QuoAmericans have been increasingly socialized to equate inattention, anger, anxiety, and immobilizing despair with a medical condition, and to seek medical treatment rather than political remedies. What better way to maintain the status quo than to view inattention, anger, anxiety, and depression as biochemical problems of those who are mentally ill rather than normal reactions to an increasingly authoritarian society.The reality is that depression is highly associated with societal and financial pains. One is much more likely to be depressed if one is unemployed, underemployed, on public assistance, or in debt (for documentation, see “400% Rise in Anti-Depressant Pill Use”). And ADHD labeled kids do pay attention when they are getting paid, or when an activity is novel, interests them, or is chosen by them (documented in my book Commonsense Rebellion).In an earlier dark age, authoritarian monarchies partnered with authoritarian religious institutions. When the world exited from this dark age and entered the Enlightenment, there was a burst of energy. Much of this revitalization had to do with risking skepticism about authoritarian and corrupt institutions and regaining confidence in one’s own mind. We are now in another dark age, only the institutions have changed. Americans desperately need anti-authoritarians to question, challenge, and resist new illegitimate authorities and regain confidence in their own common sense.In every generation there will be authoritarians and anti-authoritarians. While it is unusual in American history for anti-authoritarians to take the kind of effective action that inspires others to successfully revolt, every once in a while a Tom Paine, Crazy Horse, or Malcolm X come along. So authoritarians financially marginalize those who buck the system, they criminalize anti-authoritarianism, they psychopathologize anti-authoritarians, and they market drugs for their “cure.”The psychopharmacological era brought a wealth of new drugs to psychiatry. These, it was hoped, would treat patients and also be tools to dissect psychiatric disorders at their joints, thereby furthering the science of psychopathology (Delay et al., 1955). In addition, the 1950s saw the emergence of controlled trials, and many thought these methods would help curb the excesses of the pharmaceutical industry. Finally the new drugs were made available on prescription-only by doctors who it was thought were less likely to be influenced by industry than non-professionals, and better able to understand research and its implications. Consider then what happened in 1964, when Frank Fish reported the outcomes of neuroleptic treatment for 474 patients classified according to Leonhard’s criteria for systematized or unsystematized schizophrenia (Fish, 1964). Of those with unsystematized schizophrenia, 75% responded to neuroleptics, while only 23% of systematized schizophrenics responded. Within the unsystematized group, 84% of the affect-laden paraphrenias responded, while only 1% of systematic catatonias responded. This finding appeared to bear out the hope that the new psychotropic drugs would help carve our traditional disorders at their joints. But Fish’s findings and Leonhard’s classification vanished from sight, with the advent of DSM-III, as did distinctions between neurotic depression and endogenous or melancholic depression, which were based on responsiveness to treatments like ECT. Meanwhile, bipolar depression is now widely discussed, even though the treatment differences between unipolar and bipolar depression are much less than those among the schizophrenias reported by Fish, or between neurotic and melancholic depression. In addition, new disorders like social phobia and panic disorder flourish even though all apparently respond to the same interventions. Why the eclipse of Fish’s findings and the disappearance of melancholia, given that potential differences in treatment responsiveness were the reason to classify in the first instance? Few academics, however, have noticed the increasing gap between the former hope that new psychotropic drugs would help carve nature at its joints and the reality of psychiatric practice, which is that the neuroleptics became antipsychotics that it was impossible not to give to all psychotic patients despite good evidence that many would not benefit (Ban, 1987). One reason for the mismatch between rhetoric and reality stemmed from the very methods put in place to control the industry. Strapped into a supposed clinical trial straitjacket, pharmaceutical companies found that the new methods meant that barely beating placebo would get a license for all affective disorders or all psychoses (Ban 2006). There was no incentive for companies to find treatments that had big effects on particular syndromes and they aimed instead for blockbuster drugs that worked across a broad spectrum of psychotic or affective disorders. Clinical trials, which began as a means to contain therapeutic claims, had been transformed by company marketing departments into a means to fuel new therapeutic bandwagons. If the drugs “work”, surely it would be unethical for clinicians not to use them? This is but one example of a marketing process that has developed since the 1970s that has stood the science of psychopharmacology on its head. Rather than drugs being used to carve nature at its joints, nature instead is being used to differentiate drug brands whose differences are trivial. THE LEVERS OF POWER The new marketing has availed of the use of brands, a weakening of patent laws, an industrialization of the clinical trial process, the willingness of physicians to be sold diseases and their inability to manage uncertainty. But above all it has been aided by physician ignorance of marketing. Pharmaceutical brands stem from the late 19th century when the German company, Kalle, took out a copyright on the trade name Antifebrin for a new antipyretic agent that they could not patent. The power of brands can be seen from the success of Aspirin and Heroin a few years later that continue to have much greater recognition than their generic compounds (Healy, 1997). Companies brand more than the name of drugs. For instance, although only shown to have effects on mania, the adverts for Depakote referred to it as a mood-stabilizer. Had Abbott referred to Depakote as prophylactic for bipolar disorder, the FDA would have declared the adverts illegal. The term mood-stabilizer, while connoting prophylaxis, was essentially meaningless and as such not subject to legal action (Healy, 2006a). Since the launch of Depakote in 1995, over a hundred articles a year have had the term mood-stabilizer in their titles or abstracts; textbooks carry chapters on the group of moodstabilizers, and physicians include mood-stabilizers along with antidepressants and antipsychotics as a major psychotropic group. There seems almost no recognition that the term is little more than an advertising rubric that did not exist before 1995. In a similar fashion, academic clinicians and others refer to SNRIs, as though this term has a clinical or pharmacological meaning, unaware of the extensive market testing that weeded out alternative acronyms and settled on this brand. Two developments in the patent system made an increased focus on brands possible. First in the 1960s, older laws enabling companies to take out process patents were phased out, so that only one company could have a fluoxetine, making a blockbuster Prozac possible. As a consequence companies have a much greater incentive to aggressively defend and conceal the hazards of their compounds than before (Healy, 2004). Second, where the patent system once aimed at rewarding substantial novelty that clearly contributed to public utility, the system has moved toward rewarding even trivial novelty with diminishing regard for evidence of benefit. Thus Abbott gained a patent on semisodium valproate for mania even though sodium valproate had already been demonstrated to be useful for mania (United States Patent, 1991; 1993). Lilly were enabled to get a patent on olanzapine on the basis that it was less likely to produce elevations of cholesterol and triglycerides in dogs compared to ethyl-flumepazine (United States Patent, 1992); a finding that is dramatically at odds with its effects in man (Lieberman et al., 2005). A third factor has been that companies gained control of clinical trials in the 1980s, when clinical research organisations (CROs) took over from academic physicians as the organisers of trials. As of 2000, CROs ran more than two thirds of clinical trials undertaken by industry, worth $30 billion (Davies, 2001; Getz & De Bruin, 2000). Privatized research of this sort is profoundly different to previous clinical research. CROs have transformed human subjects research, restructured controls of disclosure and confidentiality, and managed intellectual property in an entirely new way. RCT data collected by CROs is more clearly proprietary than when a federation of academic centers conducted trials. CROs provide a privatized IRB system (ethics review) that grants ethical approval to company studies, when university centers might not (Lemmens & Freedman, 2000). CROs have made it possible to move trials on drugs for Western markets into Asia or Africa, in a way that university departments could not have done (Petryna, 2006 Whether this move has been prompted by concerns to avoid regulatory oversight, or cost considerations is less clear. Even in trials done in Western settings, it is now clear that CRO run psychotropic trials have included bogus patients (Healy, 2004). But of perhaps even greater importance is a fourth factor, namely that companies now control the production of the scientific literature. In the case of drugs on patent, a significant proportion of the trials undertaken that do not return the right result now remain unpublished, while a majority of those published are in all probability ghostwritten, and bear an ambiguous relationship with their underlying data (Healy & Cattell, 2003). The changing authorship of trials was first noticed in the mid-1990s. In response journals tightened up their authorship criteria. At this point there was little hint that the great majority of company trials appearing in major journals might be ghost-written. But by 2000, 75% of the RCTs appearing in major journals like JAMA, NEJM and the Lancet were sponsored by pharmaceutical companies, and it now seems unlikely that companies would have been prepared to leave the preparation of any sizeable proportion of these key marketing tools in academic hands. The picture that emerges is of an academic medicine transformed from what it had been during the 1960s. The difficulties are best symbolised by the paediatric SSRI trials, where we have the greatest known divide in medicine between the raw data on an issue on the one side and the published accounts purporting to represent those data on the other. The data can now be seen to indicate that the drugs do not convincingly work and are hazardous, but prior to the release of the data the scientific literature universally portrayed these agents as safe and effective (Healy, 2006b). One of these trials, study 329 on paroxetine, offers a landmark for the point at which science turned into marketing. An internal company assessment of this trial in 1998 had concluded that this and another study had shown paroxetine did not work for children but that it would not be commercially acceptable to publicize this finding. Instead the positive findings from the study would be published; they were in an article whose authorship line contains some of the best known names in psychopharmacology (Keller et al., 2001). There has been a recent sense of crisis about the clinical trial literature. But this has not led us to address the processes that gave rise to the divide outlined above, which must be assumed to be ongoing and producing comparable divides elsewhere in psychiatry and medicine. Instead, the focus has been on whether authors declare their conflicting interests (Fava, 2007). This focus must look good to marketing departments who would prefer the field to think that our problems stem from a few corrupt academics rather than from company practices that restrict access to data while still claiming the moral high ground of science. The irrelevance of conflicting interests can be seen from a consideration of the process of guideline creation. Recent guidelines for schizophrenia and for bipolar disorder that have been drawn up by experts funded by industry do not differ from independent guidelines (Healy, 2006b; submitted for publication). The process by which industry has captured guidelines lies not in payments to experts but rather in ensuring the published clinical trial evidence on which they are based can only permit one conclusion. Even independent guidelines for schizophrenia and bipolar disorder now advocate using on patent agents rather than older generic agents, although FDA and other regulators, who have seen the raw data, have made it clear it would be illegal for companies to make claims of superiority for newer over older agents. But as companies have realized for some time, the regulators do not regulate academics. And guidelines drawn up by independent academics are now among the most powerful marketing tools that pharmaceutical companies have. Part of the power in guidelines appears to stem from clinical discomfort with uncertainty, and psychiatry’s perennial concerns about its status as a science. Trials in which drugs barely beat placebo on rating scale measures are read as evidence that drugs “work”, when philosophically it would be more accurate to state that in fact these trials offer evidence that it is simply not possible to say the drug does nothing and that most of whatever benefit there is stems from non-specific factors (Healy, submitted for publication). The emergence of trial results indicating that drugs do something but it is uncertain just what those benefits are should, almost by definition, have marked the point at which scientific investigation of the drugs began, not the point at which independent scrutiny of the drugs in fact has finished. Is there a population within the clinical trial cohort that shows a more substantial response to this specific agent? Given that these drugs are clearly not nosolytic, what functional changes do these agents bring about that may be beneficial for some and what light do any functional changes there may be shed on the constitution of psychosyndromes? But uncomfortable it would seem with how little we know, and unable to force companies to undertake the research clearly called for, clinicians are vulnerable to the apparent certainties offered by guidelines. Although regulators have refused to endorse claims that newer agents are superior to older agents, clinicians inhabit a world in which the academics involved in guidelines dispel any qualms they might have about using their favourite brands in preference to less expensive and possibly more effective agents. Control of the scientific literature and the clinical trial process has enabled companies to monger diseases (Moynihan & Cassels, 2005). Disorders such as social phobia, panic disorder, and depression have been sold in the expectation that sales would follow (Healy, 1997). Epidemiological research that establishes how many people might potentially meet criteria for particular conditions provides some of the most valuable data for this disease mongering, as Michael Shepherd, the founder of psychiatric epidemiology, has noted ruefully (Shepherd, 1998). This selling of disorders has gone hand in hand with a marketing of risk and fear. Early hints of depression must be detected and treated in order to reduce the risks of suicide, alcoholism, divorce, and career failure and treatment must continue to reduce the risk of relapse. Where treatment of a disease might mandate treating one person per hundred, with treatment stopping once the condition responds, treatment of those at risk of a disease or its consequences mandates the treatment of one in ten, and has no natural stopping point (Heath, 2006). But there is more to disease mongering than this. Physicians have always been able to prescribe antidepressants for minors. The significance of company efforts to seek licenses for SSRIs for paediatric depression did not therefore lie in the opportunities such licensing might have opened up for the recognition and treatment of neglected disorders. Licenses to market SSRIs for adolescent depression would have marked the point at which companies were enabled to convert the vicissitudes of childhood and adolescence into disorders to be treated rather than any enabling of physicians. Company marketing is less and less about spreading recognition of established disorders and increasingly about pathologizing vicissitudes. A license for Viagra, for instance, became a means for companies to question young men with normal sex lives as to whether things couldn’t be better. Any of life’s vicissitudes are now grist to the marketing mill, and companies with a license do not baulk at changing our understanding of what it means to be human, if it captures a niche for the product. There are no academics drawing this to wider attention, perhaps because physicians in general fail to understand where disease mongering comes from. BRAND FASCISM1 The opportunities to focus on brands linked to changes in patent law, a greater ease in getting patents, and an increasing control of the means of knowledge production from the 1970s onwards, set against psychiatry’s internal uncertainties, have enabled pharmaceutical companies to refashion psychiatry (and much of medicine). Where once scientists and clinicians, including those linked to companies, thought about medicine and molecules in scientific and clinical terms, they have been edged out by marketers who see molecules as pawns in a game of capturing market niches. The shift has been subtle and all but imperceptible from the outside, but it has become the driving force in all that companies now do (Applbaum, 2004). At the heart of events is the failure of physicians to understand modern marketing. Despite regular surveys from marketing companies about the properties of a desirable antidepressant or antipsychotic, and despite the participation of clinical academics in opinion leader (focus) groups, clinicians confuse marketing with the trinkets, free lunches, lecture fees, and trips to conferences, sponsored by company sales departments. They fail to see that they are the source of the knowledge that goes into creating brands and fail to see their role in virally transmitting new brands. The actual differences between modern antidepressants and modern antipsychotics are minimal; the perceived differences come almost entirely from sophisticated consumer research aimed at understanding what physicians might swallow. In this process, academics have three roles. First, as repositories of psychiatric knowledge their role is to help companies understand what the average clinician might perceive as a development. Second as opinion leaders they help deliver the company message to non-academic clinicians. Third, they lend their names to ornament the authorship lines of journal articles and programmes of academic meetings reporting the results of the most recent company studies. These academic meetings have come to resemble political rallies, where the faithful assemble to hear about the evils to be vanquished and the new methods to do this. It has been some time since a trace of uncertainty entered into any of our major meetings, even though we are living through a profound medical crisis in that the health of our patients is worsening (Colton & Manderscheid, 2006) and there is open debate about the corruption of our science by companies (Angell, 2005; Kassirer, 2005). The adverse effects of psychotropic agents are only aired if it suits the marketing interests of some company. Meanwhile companies have commandeered most of our platforms and journal space to present their products under the banner of science, while flouting the basic norms of science - to make data publicly available. In the past Stalin earned the epithet of The Engineer of Human Souls on the basis of his ability to shape the way people thought, now the market leads patients to queue D. Healy Epidemiologia e Psichiatria Sociale, 16, 3, 2007 208 1 The term brand fascism was coined by Kal Applbaum, author of The Marketing Era.up to confess their bipolarity or whatever is au courant. Nothing is inconceivable - not even the diagnosis of bipolar disorder in utero (Healy, 2006a). The market arranges for the formerly independent voices of physicians to be silenced by the una duce, una voce process of guidelines. Of course guidelines state that they are not law, but any commentary on whether one must adhere to them makes it clear that any deviations without justification dramatically increase the medicolegal risks of practice (Healy, submitted for publication). And the element of coercion may soon increase with payments being linked to guideline adherence. The market arranges for critics of current products to be marginalized or silenced in a manner that fits well with other fascist traditions. Anyone who criticizes a brand is likely to have “friends” planted in the audience to monitor what they say and if need be challenge it; is likely to have their utterances or writings scrutinized for possible legal actions; is likely to have “friends” and colleagues interrogated about their personal lives; is likely to find “friends” complain them to whatever body monitors their registration as a physician; and is at distinct risk of losing their job (Thompson et al., 2001; Blumsohn, 2006a, b; Healy, 2006c). Companies are adept at manipulating the sibling rivalries inherent in academia to their own ends, making very acute the question of what is the good academic to do in such circumstances. Aside from specific career threatening moves, some of the most powerful public relations companies on earth will take on the more general task of discrediting the critic and reversing their influence. The methods include canceling meetings where the critic has been invited to speak (Fugh-Berman, 2006), planting hostile reviews of any books they might write, and spreading the word that this person is trouble (Healy, 2004). Added to this are difficulties with even major journals that might be thought impervious to company influence. Fearful of industry, even the most distinguished journals in the field faced with articles accepted by the peer review process may hold these articles up in their legal departments for years. Alternately, where links to companies give the perception of conflict of interest that can be managed by a declaration of interests, links to a legal action on behalf of an injured plaintiff give actual conflicts of interest that require a rejection of the article. Just as everything was crumbling behind the rhetoric of Stalinism, so also there is good evidence that outcomes within mental health are deteriorating. While the absolute numbers of patients occupying beds in asylums began to fall in the 1950s, the numbers of both voluntary and involuntary admissions per annum has been rising steadily since then. In North Wales, for instance, there has been a 15-fold rise in mental health admissions since the 1940s; compulsory detentions into mental illness units have risen three-fold; admissions for serious mental illness have risen 7-fold (Healy et al., 2001; 2005). Rates of suicide for patients with schizophrenia have increased over 10-fold (Healy et al., 2006), and general mortality for serious mental illness has increased (Healy et al., 2005). Evidence from elsewhere suggests this mortality is likely to correlate with the numbers of psychotropic drugs given (Joukamaa et al., 2006). The picture in North Wales is mirrored widely. Uniquely, among major illnesses in the Western world, the life expectancy for patients with serious mental illness appears to be declining (Colton & Manderscheid, 2006). While changing social expectations and other social factors play some role in these deteriorating outcomes, nevertheless this profile is inconceivable against the background of current rhetoric that endorses the practice of evidence based medicine with the latest and the best treatments. The physical treatments we use and the way services are organised around those treatments cannot but play some part in these outcomes. What we are seeing now is not what happens when treatments work; it is not what happened to the dementia paralytica services after the discovery of penicillin. REVOLUTION OR REFORMATION? I have outlined here and elsewhere (Healy 2004) aspects of the current set-up that enables a handful of shrewd advisors and marketers, to take advantage of the immense marketing power of pharmaceutical companies, to infect academia and health care with an academic immune-deficiency virus (AIV). The defense reactions that might have been expected from prestigious journals and professional bodies in response to the virus seem to be paralyzed. Quite the contrary the virus seems to have been able to subvert normal defenses to its own purposes. These defenses have reacted almost as though it was their programmed duty to shield a few fragile companies from the malignant attentions of a pharmacovigilante. Our professional organisations as clinicians, scientists and academics need to take stock of the current situation and engage with the new corporate campus. Our major journals and academic meetings need to do more or they risk losing brand value. Given an increasing company focus on lifestyle markets rather than on treatments for serious diseases either in the West or elsewhere, one option might be to attempt Epidemiologia e Psichiatria Sociale, 16, 3, 2007 209 The engineers of human souls & academiato separate a more traditional medical market from an enhancement market, with a variety of physicians, but perhaps psychiatrists in particular, having to choose between being doctors or lifestyle engineers. Another way forward lies in the recognition that drugs are not made in company laboratories - chemicals are. In order for a drug to come into being, two things have to happen. First, healthy volunteers and later patients in clinical trials agree to take these chemicals to see what happens. Willingness to participate in these studies was borne out of the global calamity of World War, when conditions of scarcity mandated the development of the first controlled trials. We participated on the basis that taking risks might injure us but would benefit a community that included our friends, relatives and children. We did so for free. At first this worked and extended the compass of human freedom from the epidemics and other scourges to which our ancestors had been subject for millennia. But now this data freely given is sequestered by corporations who market selected parts of it back to us under the banner of science. This business model has made these corporations the most profitable on the planet. This model however, at least within psychiatry, is one that demonstrably jeopardizes the health and well being of our friends, relatives and children. Second, companies take the inner aspirations and fears of both patients and psychiatrists to transform a chemical into a drug and also to mould a strategy designed to get patients to consume drugs more faithfully than they would do if they were living in a totalitarian regime and were ordered to consume. This is what branding and patenting is about. It yields the biggest profit margins in history, significant amounts of which go to ensuring a continuing hold on academic minds, and through academics the public mind. There are both ethical and scientific grounds to object. It is not clear that companies own the data of clinical trials other than by force majeure. Whether they do or not, it is time for clinicians to consider whether it is ethical to enter their patients into such “exercises”. The consent form should at the very least contain an explicit statement that the company may sequester any data from the trial, rendering it unavailable for scientific use. It is unlikely that patients currently entering trials know this, or would accept involvement in trials on this basis. The scientific grounds to object lie in the fact that current academic practices breach the norms of science by not making data available. If we are to be scientific we must object. This can only be good for both psychiatry and companies in that a psychopharmacology of the sort we now have will inevitably be sterile and is only capable of rescue by the serendipitous discovery of new agents. In objecting, it may be possible to ally with scientists and clinicians working within pharmaceutical companies who for the last two decades have been even more aware than clinicians about how marketing has changed the character of their roles. Many of them would wish to see these developments undone.