Tuesday, August 23, 2016

#23. Criminal Psychiatry: Medicine By & For Social Predators

This is Day 23 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982.  (More info here.)  Today we are talking about Principle 23.

Principle 23 reads in full as follows:

We believe that there should be no involuntary psychiatric interventions in prisons and that the prison system should be reformed and humanized.

You could hardly find a better fit if you looked for it.  By all appearances, the psychiatric industry was ready made for prisons.  Medicine without conscience commissioned to control citizens presumed to be without conscience.  Licensed psychological predators supervising alleged misanthropic predators.  Socially approved opportunists engaged to neutralize socially disapproved opportunists.  The psychopaths of science assigned to chaperone the psychopaths of culture.

Yep, the ironies never cease to abound.

Here's what I believe is the definitive paper on these issues thus far:

A Discussion Paper on Policy Issues at the Intersection of the Mental Health System and the Prison System 

-by Daniel Hazen and Tina Minkowitz, Center for the Human Rights of Users and Survivors of Psychiatry

(originally published at https://wgwnusp2013.wordpress.com/prison-system/)

1. Debunking the Myth: Prevalence of Psychosocial Disability in Prison – What Does It Mean?

It has become a commonplace of mental health advocates and criminal justice advocates, often without lived experience of incarceration in either system, to point to high numbers of people with mental health problems in prison, and argue for increasing transfer of direct control and supervision of such individuals to the mental health system.

We contest the implied assumption that the presence of people with mental health problems in prison is inherently shocking or problematic, as well as the recommendation of greater involvement of the medical-psychiatric system in social control as a response to this situation.

Given the traumatic backgrounds of people who end up in prison and the relationship of trauma to mental health problems, the prevalence of mental health problems by any measures should not be surprising. Trauma may be common among prisoners for reasons including discrimination in access to justice, discrimination in the definition of crime and in the establishment of penalties for
different crimes, as well as factors influencing the commission of criminal acts.

The gathering of information on mental health problems, whether by self-reporting or diagnosis, may change over time for reasons unrelated to people’s experience of distress. Diagnostic trends in particular change with the fluctuation of DSM/ ICD categories, and with the attention placed on mental health issues by authorities.

Given the traumatizing nature of prison – deprivation of freedom, toxic environment, bad food, strip searches, etc. – people inevitably experience distress and altered consciousness that can be labeled as mental health problems. The traumatizing nature of prison can been encapsulated in the degrading entry procedure, described from experience of a U.S. prison:

“Walking into a system where you are being given a number that becomes
your identification. A barber shaves your head, they have you strip your
clothes off and de-lice you, dropping this powder. There are 50 men in
this line. It has a humiliating, degrading, punishing effect immediately.
How trauma-insensitive that is, the anxiety that drives through your body is
incredible. It reminded me of the concentration camps. They say that
Germany was so bad but we’re doing the same thing. They call it
rehabilitation – they break you and rebuild you.”

The number of people labeled with mental health problems in prison is sometimes compared with declining numbers in psychiatric institutions, as if to argue that the psychiatric system by failing to confine people with psychosocial disabilities is creating the conditions for these individuals to commit crimes and be incarcerated in the prison system. It is a tautology that incarceration of any
demographic would stop those individuals from committing crimes. Human rights principles do not permit profiling and preventive detention based on psychosocial disability, any more than they would permit profiling and preventive detention based on race, gender or age. To the extent that the mental health system has been placed in the role of public safety official, with legal duties to confine individuals based on risk assessment of any kind, this is incompatible with the duty to serve the individual client and must be removed in order that the mental health profession may be able to comply with its human rights obligations.

Moreover, mental health treatment is far from being foolproof, reliable or safe. Expansion of mental health treatment, even when community-based, has not resulted in decrease of mental health problems, but rather in an upsurge, iatrogenic problems in both physical health and mental health, and enforced dependency on mental health providers for services that maintain individuals in
poverty and segregation.

2. Mental Health System is Coerced Compliance – Not a True Alternative to Prison

A. Diversion into Coerced Medical Disablement is Not a Viable Alternative to Incarceration

Diversion from the court system to coerced mental health treatment is also proceeding apace. “Mental health courts” in the U.S., although participation in them is voluntary at the outset, induct individuals into coerced compliance with treatment, in exchange for suspension of prison sentence. A guilty plea is required, and compliance with treatment is supervised by the court, with the possibility of a prison/ jail sentence being imposed if compliance is not deemed adequate.

In Japan, a preventive detention law for people with mental disabilities went into effect in 2005. Under this law, a person accused of a crime and deemed by the court to have a mental disability can be diverted from a trial of their guilt or innocence, to a hearing before a mental health tribunal to determine whether civil commitment should be imposed. This means that a person labeled with mental disability is denied the right to be considered innocent until proven guilty, and unlike all other criminal suspects can have detention imposed without proof of having committed the crime. Unlike the U.S. mental health courts, this diversion is not voluntary but is decided by the court.

The use of diversion schemes has been promoted as an alternative to the punitive sentences imposed by the “criminal justice” system, however we cannot consider it in any way an acceptable alternative, particularly when there are penalties for noncompliance with the prescribed treatment. Mental health treatment appears to many people to be beneficial to all concerned, to society as well as to the person accused of crime. But when the mental health system is made to do the duty of public safety official, it promotes neither public safety nor mental health. Irreparable harm is done by the coerced ingestion of mind-numbing drugs (the main modality of forced treatment), and by the narrative of incapability that removes a person from responsibility for, and confidence in, making deliberate choices to shape his/her own life.

Proponents of restorative justice, and of any theory of justice that supports re-integration, need to consider the implications of the social model of disability for their work, and to go deeper in imagining systems of accountability that respect human dignity. Coerced mental health treatment of people accused or convicted of crime is not restorative, and it does not contribute to meaningful re-integration.

It is furthermore a form of discriminatory violence that fits the criteria for torture and ill-treatment.

B. Double Discrimination Against People with Psychosocial Disabilities in Prison. 

People with psychosocial disabilities in prison experience double discrimination.

In some U.S. jurisdictions a person who has been given a psychiatric diagnosis is not eligible for programs with early leave such as work release and military style or modeled shock camps – 6 months of military style discipline and training after which the remainder is served on parole. (This blatant discrimination extends also to people with physical disabilities, for example if a person is unable to run with their legs.) Men and women with psychiatric diagnoses who have physical illnesses such as cancer or diabetes are often not treated for the physical illness which is explained as a psychiatric symptom.

In addition, state systems have access to past records. Due to having received a psychiatric label/diagnosis in the past, upon entry into the prison/penal system, a person can be placed in solitary confinement until being “seen” or evaluated by a mental health professional. This takes place in a segregated part of the prison, not the general population.

Forced drugging and confinement in a psychiatric unit within a prison can be similar to the way it’s done in psychiatric institutions, but double discrimination emphasizes a person’s status as being under the control of others.

“I felt, here I am a prisoner and mental patient. Those two things together left me with no liberty. I felt if I was captured by one, I could escape. Why would a judge listen to me not to medicate me, here I am a prisoner found guilty by judge and jury, there’s no way I’m going to win a medication hearing or a retention hearing. The hearing was very short, about a minute. The psychiatrist said, “You need to take this,” and that was it, bye, they send you back.

“There’s no access to a lawyer in the penal system for psychiatric things. No access to a phone. The culture inside prison is often controlled by gang activity, underground crime. There are a lot less phones in the psychiatric piece than in regular prison – 120 prisoners inside the psych hospital in prison, and two phones. You can’t get to the phone. And you have to be in programs all day.

“In the hospital they call you by name and not a number. You think you’re a person again in the psych ward and not in prison. My thing was, you’re getting out of one cage to be in another. This one’s shinier, more buttons… but that doesn’t make it not a cage.”

3. Accountability

A. Insanity Defense is Counter-Productive

Behind the schemes to divert people from courts and prisons into the mental health system lies a belief that people with psychosocial disabilities do not belong in a penal system, but instead need medical treatment in order to not re-offend. The traditional penal system objectives of retribution and deterrence are seen as inapplicable to people with psychosocial disabilities, who are considered uniquely unable to control their actions. The remaining objectives of incapacitation and rehabilitation (primarily in the form of compulsory medication and other incapacitating treatments) are intensified.

This is seen most clearly in the operation of the insanity defense and its equivalents in every legal system. This defense – that a person is not guilty, or cannot have responsibility imputed for a crime, because of his/her mental state at the time the crime was committed – is considered a pillar of our legal systems and a sacred right of defendants. At some times and in some places, where the objectives of retribution and deterrence were primary, it may have operated to allow people to avoid punishment that was seen as unfair given the circumstances.

However, ordinarily a verdict of insanity results in psychiatric rather than penal incarceration (and the Standard Minimum Rules on the Treatment of Prisoners so provide, in Rule 82). Whether it is labeled as punishment or treatment, the deprivation of liberty, lack of privacy, having one’s daily life controlled by authorities, assaults on personal dignity and integrity from strip searches to forced medication have substantially similar effects on people in both institutions. Both institutions promote a negative self-image and submitting to authorities rather than seeking internal self-justification and conscience.

There is, furthermore, an overlap between the two systems that discloses their underlying unity. Despite the label of “treatment,” the mental health system administers a wide range of punitive measures. These include “steps” or “levels” of increasing control, “privileges”, and the imposition of coercive regimes in response to “failure to comply with prescribed treatment”. Rehabilitation in prison, when imposed coercively, is substantially similar to forced mental health treatment (e.g. programs like “DARK”, psychological intervention, coercion to attend self-help groups, and programs to “correct the personality”).

The CRPD takes an opposite approach to responsibility of persons with disabilities for their own actions. Article 12, Equal Recognition Before the Law, provides that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life. Legal capacity implies both rights and responsibilities, and “all aspects of life” can encompass criminal as well as civil matters. As the Office of the High Commissioner for Human Rights has said, this requires abolition of the insanity defense and its replacement by disability-neutral concepts such as the subjective element of a crime (mens rea).

B. Community Responsibility and Support

Article 12 also provides that States Parties must provide access to the support needed by persons with disabilities in exercising their legal capacity. The Committee on the Rights of Persons with Disabilities has clarified that support “respects the autonomy, will and preferences of the person,” and that States Parties must replace all substituted decision-making schemes with support.

What might support look like in relation to crime and punishment?

It could start with community members taking responsibility to help avoid the commission of a crime and defuse conflict situations. Two examples:

“I was in the Apple Store and saw a kid bend down and took some
hardware or software for IPad, he ripped open the box and put it in his
sleeve. I had two choices – I could tell the staff, assumed he was going to
steal, maybe he was testing the staff. I said to him, ‘What you got there?’
He put it back and didn’t take it.”

“One gentleman was camped out in his parents’ backyard. The county
mental health director called me [as head of a peer advocacy center],
didn’t want to call police, didn’t want to go through routine, asked if we
would go over. The guy didn’t want respite, didn’t want any government
thing. He didn’t get locked up that I know of, and moved off his parents’

These examples might also be understood in a restorative justice framework, and there is a great deal of congruency between the values of restorative justice and the social model of disability as enunciated in the CRPD. Both promote intersubjective and relational .
processes for arriving at decisions, respect for individual dignity and the equality of persons, autonomy, and reliance on community members rather than the state. Both encourage personal accountability and responsibility as a manifestation of mutual respect. Both encourage a holistic and big picture approach to justice, which is simultaneously grounded in lived experience: what do participants need, what is lacking (or over-present) in our social and economic system that impacts on the current situation, what is crime and what should be criminalized?

The prison reform and abolition movement, particularly including current and former prisoners, have a significant role to play in developing guidance and policy and in sharing their experience and wisdom with the community. Prisoners with psychosocial  disabilities especially need to be consulted. This is a part of “re-integration” that is often overlooked.

The CRPD framework, restorative approaches to justice, and prison reform/abolition need to inform each other so as to transform our communities to promote social and individual healing, self-determination and mutual respect and accountability, for all people including people with disabilities. We need to reject one-sided approaches that either fail to address disability, or that address it from
a medical model rather than social model perspective leading to increased discrimination. We need to fundamentally change both the legal framework for civil and criminal responsibility, and the relationship of responsibility to the law itself. We need to simultaneously build the capabilities of communities and ensure that the law reflects and enforces values of fairness, equality, freedom
from torture and de-escalation of violence. The scope of the task should not overwhelm us, but inspire us to begin.


Kay Pranis, Restorative values, in Gerry Johnstone and Daniel W. Van Ness,
eds., Handbook of Restorative Justice (2007).

Wanda D. McCaslin, ed., Justice as Healing: Indigenous Ways (2005).

James J. R. Guest, Aboriginal Legal Theory and Restorative Justice, in Wanda
D. McCaslin, ed., Justice as Healing: Indigenous Ways (2005).

Tina Minkowitz, The Paradigm of Supported Decision-Making, presented at
Eötvos Loránd University, Bárczi Gustáv Faculty of Special Education, Budapest,
November 30, 2006.

Intentional Peer Support, http://www.mentalhealthpeers.com.

Center for the Human Rights of Users and Survivors of Psychiatry,

Questions for Reflection

We are building this work together.  Your lived experience is needed and valued.  It is essential to building our shared knowledge and expertise as a movement.  Please comment on any or all of these questions or in any way that speaks to you personally.

1. Have you ever experienced prison psychiatry?   
2. What would you like people of conscience to know about your experience?  
3. What do you see as the connection, if any, between legal and mental health concerns?
4. How could a society of conscience address these connections in an effective, principled manner?

5. If we were more interested in prevention than punishment, what would we be doing differently?

August 23, 2016:  Conference on Principle 23 

We will talk about Principle 23, including your responses, on September 23 from 9-11  PM EST.  (Call-in number/ contact information to be announced shortly.)

Monday, August 22, 2016

#22. 'Expert' Witlesses - Psychiatric Perversion of Justice and Due Process

This is Day 22 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982.  (More info here.)  Today we are talking about Principle 22.

Principle 22 reads in full as follows:

We believe that persons charged with crimes should be tried for their alleged criminal acts with due  process of law, and that psychiatric professionals should not be given expert-witness status in criminal proceedings or courts of law. 

Basic Rationale

Psychiatric perversion of the legal system must end. Psychiatry confounds rather than advances the cause of justice.  Mental health professionals are no better at predicting dangerousness to self or others than a toss of a coin. They are no better at judging intentions or motivations than anyone else. Their processes and methods are inherently subjective, power-imbalanced, self-indulgent and self-serving.

In actuality, the opinions of psychiatry carry weight not because of the factual accuracy, but because of the social power of their position.  At most, their function is to let the decision makers with real responsibility off the hook. They function as a socially-approved Nuremberg defense for judges and jurors to pass the buck and rely on a socially designated ‘expert’ authority.  Psychiatry should not be letting the proper socially-designated decision-makers off the hook, nor should it be usurping or undermining their rightful power.

This is a travesty of justice that must be ended. There is no reason that judges, law enforcement and ordinary citizens cannot do as well on their own.  These issues are necessarily difficult.  No human being - however experienced - is flawless at predicting the future.  Some things simply cannot be known in advance by human beings.  This, in fact, is the basic point of the protection against preemptive detention that is written into the bulk of our law.

Indeed, everywhere but psychiatry, people have to actually commit a crime - or engage in substantial preparation to do so - before they can be charged, arrested or detained.  Everywhere else but psychiatry, someone else's say so that you scare them or that they are afraid for you - without more - is not enough.  You have to actually do stuff or seriously threaten it - not just think or talk about it.  

Moreover, the stuff you do - and the way you go about it - has to violate an existing law that is already out there in the codes.  Even then, if the authorities want to keep you, they actually have to write up charges - listing exactly what you did and why it was wrong.  You also get a right to stay silent, to bail, to a timely hearing, to confront your accusers, to call witnesses on your behalf, to have an attorney help you with your defense.  All of this you get in regular court, but not in the farcical psychiatry-infested parallel proceedings that only apply to people who psychiatry has gotten to first and labeled 'mentally ill'. 

Here is another point to consider:  Analytically speaking, the proper party to investigate and evaluate public safety concerns (if any) is law enforcement, not psychiatry.  Law enforcement holds the societally-designated public safety role.  Public safety is the defined responsibility of law enforcement, as well as the specific role for which law enforcement has been employed.  As such, law enforcement is far better positioned - and potentially far more experienced and reliable - than psychiatry for getting at objective truth about safety or danger.  Thus, law enforcement can and should be trained to effectively assess and skillfully respond to public safety concerns, thereby obviating any perceived need for psychiatric opinion or involvement.

Once these roles are clearly distinguished, the irony of psychiatric involvement in the court system becomes clear.  It would be unthinkable to let a police officer get up on the witness stand an render an opinion that basically says, "I did my homework and can tell you from my experience with a zillion criminals that Joe Smith here is really dangerous so you should lock him up as a preventive measure."  That clearly would not pass Constitutional muster and the officer would basically be laughed out of court.  Yet we basically let psychiatrists - who have far less experience with real danger than law enforcement and far more of a personal investment (guild interests, organizational interests, liability concerns, professional pride) in being seen as 'right' about their perception of the threat a person poses -- to render these kinds of irresponsible, prejudicial, self-serving opinions all the time.

No less important, ethically speaking, psychiatry has no business entering the public safety role.  The first duty of psychiatry, medicine and any so-called helping professional is to the person who has been entrusted to their care.  Any attempt to divide the responsibility inherently destroys not only the helping function, but also the possibility of any meaningful information resulting from the so-called therapeutic interaction.   In a word:

  1. The only way to get good information from the person about their real status is by establishing trust.  (Otherwise it is just an interrogation - which law enforcement can do just as well.) 
  2. In the absence of genuine trust, there can be no good information.  
  3. In the absence of good information, there is no expertise to offer.  
  4. In the absence of expertise, there is no basis for psychiatric court involvement.  
On the other hand, if trust actually is established, and the information actually is good, then there is no way for psychiatry to nonconsentually report to a court on the information that was entrusted.  The moment it does so, the professional obligation to the client, along with the trust that was created, is violated.

No less important, the moment trust is violated, the treatment relationship - not only with the psychiatrist in question but with the entire profession they represent - ends in the person's mind.  This means that once the professional obligation of duty to the client has been violated, there is no point in continuing to 'treat' the person. The treatment relationship itself has been so contaminated by the professional violation that no court or other rational decision-maker could reasonably expect anything therapeutic or helpful to occur.  

The clinical relationship - from that point forward - is by definition coercive.  The nature of the power imbalance and the inherent coerciveness are imprinted indelibly in the memory of the person entrusted to clinical care.  There is no way to unring the bell - for either the 'treater' or the 'treated.' 

It's over. 

This is really important to get.   The purpose of holding the person is for 'treatment'.  But the psychiatric testimony - in and of itself - has killed the possibility of legitimate 'treatment'.  Ergo, there is no rational legal basis for continuing to hold the person for 'treatment' - because at that point there is no reasonable expectation that anything resembling 'treatment' will ever again result. The only thing that will result is in the nature of master-servant, wherein  I do what you tell me to do, because I now know of the incredible power you hold over me, including the power you have to hurt me if I don't do it your way.  

You would think someone in the 'helping' professions - or the court system - would have figured this out.  The implications are pretty obvious to anyone sincerely interested in seeing them.  That alone shows how truly witless the so-called psychiatric experts are - as well as how self-serving the little courtroom dog and pony show the profession is operating really is.    

Stay tuned!

There is a lot more to come on this Principle.  We are delighted to announce that Ingrid Johanne Vaalund of Norway will be talking about this principle in relation to the Breivik case.  The Breivik case is an incredibly important case that came up in Norway after Anders Behring Breivik killed 77 persons, many of them children and youths, in two separate events in 2011. Prior to sentencing, Breivik went through two separate forensic evaluations - where so-called experts came to radically different conclusions.  The first evaluation determined that Breivik had a psychotic disorder, thus being legally unaccountable.  The second concluded that he had a personality disorder, thus being legally accountable.  Ms. Vaalund will discuss the implications of the Breivik case in relation to this Principle.   

Questions for Reflection

We are building this work together.  Your lived experience is needed and valued.  It is essential to building our shared knowledge and expertise as a movement.  Please comment on any or all of these questions or in any way that speaks to you personally.

1. Has psychiatry ever been allowed to testify against you in a court of law?   
2.  What would you like people of conscience to know about your experience?
3. What was the impact of that experience on your relationship with the psychiatrist in question? The treating facility?  The mental health profession in general?   
4. In your experience, how helpful, useful or accurate was the psychiatric opinion?
5. How helpful was the entire process in reducing the dangerousness or risk you were alleged to represent?
6.  Do you recommend this process to anyone who is sincere in their intent to address concerns about someone's dangerousness or risk? 
7.  What better alternatives are there?
8. How could we make them real?

August 22, 2016:  Conference on Principle 22 

We will talk about Principle 22, including your responses, on August 22 from 9-11  PM EST.  Details for listening or calling in will be announced shortly.

Sunday, August 21, 2016

#21. Dangerous Deprivations - Preemptive Detention of "The Mentally Ill"

Today we resume our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982.  (More info here.)  We take up where we left off - at Principle 21.

Principle 21 reads in full as follows:

We believe that alleged dangerousness, whether to one­ self or others, should not be considered grounds for denying personal liberty, and that only proven criminal acts should be the basis for such denial.

Today's Blog

Our blogger today is Karlijn Roex, a PhD-fellow residing in Cologne, Germany.  Her essay was first published as part of the Campaign to Support Absolute Prohibition of Forced Treatment and Commitment.  The Campaign represents an international effort to protect the integrity of the Convention of the Rights with Persons with Disabilities from infiltration and degradation by psychiatric guild interests.  

The Contested Freedom of the ‘Scary’: the use of coercion in psychiatry violates basic human rights - Karlijn Roex

Detention, solitary confinement, forced drugging; throughout history, societies have had the tendency to aggressively constrain people with psycho-social disabilities and preferred an security-obsessed instrumentalism above universal human rights. But recently, the use of coercion in psychiatry is a highly debated practice in human rights circles; witness the latest report of Human Rights Watch[1] on shackling. This increased interest has gotten a great impulse by the recent release of the UN Convention on the Rights of Persons with Disabilities. Drawing upon scientific work, ‘user’ narratives and moral principles, I support the call made by the Committee on the Rights of Persons with Disabilities (CRPD) to abandon the use of coercion in psychiatry.

According to authoritative documents of the Convention[2], the use of coercion in psychiatry is a form of discrimination of people with psycho-social disabilities, and violates the right of these people to enjoy autonomy and personal integrity. These principles are to be respected, regardless of any instrumental benefits that may result from applying coercive psychiatric interventions. But the perceived instrumental benefits are exactly why the use of coercion in psychiatry has long gone uncontested. And these benefits have moral significance too. People have the right to be protected against themselves, or against dangerous fellow-humans. In fact, many proponents of coercion in psychiatry follow this ethical ‘lesser evil’ reasoning. According to them, it is allowed to introduce an evil when a greater evil is prevented by this. Thus, such a lesser evil argument justifies the abandonment of some key fundamental human rights. This is dangerous, because human rights are typically abandoned during the times in which they are most needed[3]. In fact, these human rights are meant to protect our scapegoated minorities from being oppressed during times of public fear. In times of public fear, some human rights become a privilege of the non-scary, or if one prefers, of the ‘respectable section of society’[4]. In the context here, the lucky ones are the people without psycho-social disabilities. The scary, by contrast, have to deal with a contested freedom.

Coercive psychiatric interventions are decisions or actions imposed on the individual, without his/ her informed consent, based on psycho-social disability. In this regard, the CRPD has also come out against the use of this danger standard, or any other criteria, as a way of legitimizing psychiatric detention[5]. To be clear, the coercive interventions that are discussed here are not taken because of a criminal suspicion or criminal conviction. Today, most countries allow coercive psychiatric interventions only when an individual is considered dangerous to him-/herself or to others. However, the initial assessment of dangerousness is taken by psychiatrists only. A court is not yet involved in this initial decision to psychiatrically detain an individual. This is highly problematic, because the psychiatric perspective and security-obsessed instrumentalism are clearly dominating the process of key decision making, at the cost of the human rights perspective. At the moment where the psychiatrists’ initial decision is critically reviewed, marks of shame have already been added to the affected individual. Not only has this mark of shame been added through the unfavourable initial psychiatric guess, which gains much epistemological authority in our societies, but also because of the very stigmatizing practice of the detention itself[6]. It is then much harder for the affected individual to win credibility.

We therefore see that the conditions for coercive psychiatric interventions have become stricter over time, but that they fail to seriously challenge the practice of arbitrary detention. This may explain why the ‘stricter’ danger standard has not led to a decrease in the number of psychiatric detentions[7]. Probably, the innovation has rather served to silence any critical voices from the human rights corner. This silencing has been achieved by incorporating insignificant parts of the critical demands into the existing policy, without meaningfully changing any inherently oppressive and discriminatory principles[8]. Apparently, there is a high demand in society to confine people with psycho-social disabilities, and one of the main drivers behind this demand is a perceived danger.

Protecting people against themselves: the right not to be a false positive[9]

But what is wrong with this dangerous-criterion? Is it, for instance, not our moral duty to protect people from themselves when needed? Obviously, it is! But we should become reflect one more moment about our ability to assess mental states: when is someone to be considered a danger to him-/ herself? Let me take suicide as an example. As a researcher in this topic, the literature clearly shows me that assessing the risk of suicide in individuals is a very difficult task. Most people that disclosure suicidal thoughts do not commit suicide, especially women[10]. Secondly, psychiatric risk assessments are proven to be really unreliable[11], leading to many ‘false positives’: people who are considered a danger while they are actually not. The statement whether someone is a danger, is in fact a hypothesis about mental states and future behaviours. These are unobservable things that are hard to measure. Even when an individual has committed self-harming acts in the past, this does not necessarily make him dangerous for the present, or the future. Test results are likely to be biased and steered by common prejudices about people with psycho-social disabilities[12], ethnic minorities, and the poor[13]. Worse, the dangerousness claim is strictly not falsifiable, at least at a short term: how can one prove today that one will not kill himself soon? As a consequence of this, many individuals are subjected to coercive interventions because they were wrongly labelled as ‘dangerous’ and cannot easily escape this label. Escaping the dangerousness-label is made even more difficult by general mistrusting attitudes of hospital staff towards mental patients[14], and the fact that people tend to start behaving conform the stigma over time, due to its adverse effects on them[15]. The accumulation of humiliating interactions, which would frustrate every normal person, can lead to responses that can be termed as ‘aggressive’. How would you respond if you learn that you were wrongly informed about your legal status[16]concerning something as important as your freedom?

These ‘false positives’ are vulnerable people, just like people who are a real danger to themselves. But is it actually a wise strategy to expose such people to some of the very traumatic coercive psychiatric interventions? There are numerous accounts of patients or ‘ex-users’ of psychiatry that indicate how stressful and traumatic these interventions were to them. Indeed, some human rights advocates define some of these interventions as torture. There are even indications that exposure to such interventions can lead to post-traumatic stress symptoms and suicide[17]. There are user narratives that indicate that individuals without any previous suicidal tendencies became suicidal after being exposed to coercive interventions, such as solitary confinement. User narratives indicate how humiliating these experiences can be, with people losing their personal integrity, humanity and dignity. Affected individuals often carry along these feelings until long after the incidents.

Protecting people against their dangerous fellow-citizens: contesting the freedom of the ‘Other’

But what if a person is not a danger to him-/ herself, but to others? When we want to be protected against our dangerous fellow-citizens, then what is morally wrong with that? Well, nothing, but of course we have to come with reasonable grounds and evidence of this supposed danger. The mere existence of a psycho-social disorder, cannot point towards a certain danger. When an individual tells me that he is going to harm me, he can be prosecuted for threats. Most countries have also criminalized several public order disturbances. We can already prosecute anybody who has visibly undertaken preparations for committing a criminal offense, or who has clearly tried to commit a certain crime. Therefore: we already have a great law that protects us against dangerous fellow-citizens: the Criminal Law! Even greater, this law protects the citizen against the state and an over-feared community. We cannot just convict an individual because of a mere suspicion; instead, conviction requires that we have some tangible evidence against this individual.

With this great law in mind, why would we create another law especially for people with psycho-social disabilities? Because we are afraid of people with psycho-social disabilities. A mere suspicion of dangerousness in a person with mental illness is already terrifying enough, isn’t it? Why then bother about visible evidence for a criminal conviction? Mental health laws are the dubious innovation of a frightened society. These laws enable communities to incarcerate individuals with psycho-social disabilities when we suspect that they are dangerous. This suspicion is backed with test results from, again, very unreliable and biased psychiatric risk-assessments. As a consequence, we have created two types of citizenship: the ‘normal’ citizens and the scary semi-citizens. The latter group has found his freedom contested: it can be denied at any time, as soon as a suspicion of dangerousness arises. Whereas the majority of us can feel safe and count on the basic human rights principles that respect our freedom and integrity, there is a group in our society whose members can simply be detained without the regular battery of legal requirements.

This is an inconvenient leak in our modern democracies, and should concern every citizen. No citizen can find himself guaranteed at the ‘right’ side of the divide, because the boundaries between mental illness and normality are time-dependent and not nature-given. In the past, we have seen the ‘psychiatrization’ of homosexuality, political dissent, and poverty. This teaches us that mental health laws are a convenient way to subtly discipline certain categories of people; much more smoothly and subtly than explicitly prosecuting these deviants through criminal courts[18]. And although our societies are now to be considered ‘free-minded’, or ‘post-modern’, we should always be aware of the disciplinary potential of mental health laws. This disciplinary potential can be toxic in combination with the timeless fact that we are never aware of the oppressive ideas of our own time.

In all, let’s give it a shot and abandon the use of coercion in psychiatry towards history. Fear makes that we immediately grab towards the so-called ‘last resort’ of a coercive intervention, whereas there are instances in which a simple conversation would already help. Such a conversation would also help us, learning about the specific and different logics behind madness, and therefore render it a little bit less unpredictable and scary.

Karlijn Roex is a PhD-candidate in Sociology and human rights activist. She lives in Germany.

[1] Human Rights Watch (2016, March 20). Indonesia: Treating Mental Health With Shackles. Human Rights Watch. Retrieved 21 March 2016, from:https://www.hrw.org/news/2016/03/20/indonesia-treating-mental-health-shackles

[2] See for instance: CRPD. (2015). Guidelines on Article 14 of the Convention on the Rights of Persons with Disabilities – The right to liberty and security of persons with disabilities. New York: United Nations; CRPD. (2014). General Comment No. 1 (2014). Article 12: Equal Recognition Before the Law. New York: United Nations; United Nations Human Rights Committee (2015, October 10). Dignity must prevail – An appeal to do away with non-consensual psychiatric treatment World Mental Health Day. United Nations. Retrieved 10 March 2016, from: http://www.ohchr.org/en/NewsEvents/Pages/DisplayNews.aspx?NewsID=16583&LangID=E

[3] Hudson, B. (2009). Justice in a Time of Terror. British journal of Criminology, Delinquency and Deviant Social Behaviour, 5(49), 702-717; Roex, K.L. A. & Riezen, Van. B. (2012). Counter-Terrorism in the Netherlands and the United Kingdom: A Comparative Literature Review Study. Social Cosmos, 3(1), 97-110.

[4] Berger, P.L. (1992). Sociology as a Form of Consciousness. In H. Robboy & C. Clark (edit.), Social Interaction. Readings in Sociology (pp. 6-22). Richmond: Worth Publishers.

[5] See for example CRPD. (2015). Guidelines on Article 14 of the Convention on the Rights of Persons with Disabilities – The right to liberty and security of persons with disabilities. New York: United Nations.

[6] Goffman, E. (1961). Asylums. Essays on the Social Situation of Mental Patients and Other Inmates. New York: Anchor Books; Becker, H. S. (1963). Outsiders. New York: The Free Press.

[7] At least in Europe. See: Salize, H. J., Dressing, H. & Peitz, M. (2002). Compulsory Admission and Involuntary Treatment of Mentally Ill Patients – Legislation and Practice in EU-Member States. Brussels: European Commission.

[8] This strategy to silence critics is widely analysed by the Foucaultian sociologist Mathiesen: Mathiesen, T. (2004). Silently Silenced. Essays on the Creation of Acquiescence in Modern Society. Winchester: Waterside Press. See also on this specific topic: Harding ,T.W. (2000): Human Rights Law in the Field of Mental Health: a Critical Review. Acta Psychiatrica Scandinavica, 101: 24-30

[9] Borrowed from Steadman, H. J. (1980). The Right Not to be A False Positive: Problems in the Application of the Dangerousness Standard. Psychiatric Quarterly, 2, 84-99.

[10] Cannetto, S. S. & Sakinosky, I. (1998). The Gender Paradox in Suicide. Suicide & Life Threatening Behavior, 28(1), 1-23 and Möller-Leimkühler, A. M. (2003). The Gender Gap in Suicide and Premature Death or: Why Are Men So Vulnerable? Eur Arch Psychiatry Clin Neurosc, 253: 1-8.

[11] Steadman, H. J. (1980). The Right Not to be A False Positive: Problems in the Application of the Dangerousness Standard. Psychiatric Quarterly, 2, 84-99; Madsen T, Agerbo E, Mortensen PB, Nordentoft M (2012) Predictors of psychiatric inpatient suicide: a national prospective register-based study. J Clin Psychiatry 73:144–151; Steeg S, Kapur N, Webb R, Applegate E, Stewart SL, Hawton K, Bergen H, Waters K, Cooper J (2012) The development of a population-level clinical screening tool for self-harm repetition and suicide: the ReACT self-harm rule. Psychol Med 42:2383–2394; Ryan C, Nielssen O, Paton M, Large M (2010) Clinical decisions in psychiatry should not be based on risk assessment. Australas Psychiatry 18:398–403.

[12] Link et al., (1999).Public Conceptions of Mental Illness: Labels, Causes, Dangerousness, and Social Distance. American Journal of Public Health, 89(9), 1328-1333; Perscosolido, et al. (2013). The ‘Backbone’ of Stigma: Identifying the Global Core of Public Prejudice Associated With Mental Illness. American Journal of Public Health, 103(5), 853-860.

[13] The population of involuntarily hospitalized psychiatric patients contains an overrepresentation of low-income indiivduals, black people, and people of an ethnic minority. See for example: Salize, H. J., Dressing, H. & Peitz, M. (2002). Compulsory Admission and Involuntary Treatment of Mentally Ill Patients – Legislation and Practice in EU-Member States. Brussels: European Commission.

[14] Goffman, E. (1961). Asylums. Essays on the Social Situation of Mental Patients and Other Inmates. New York: Anchor Books.

[15] Becker, H. S. (1963). Outsiders. New York: The Free Press.

[16] Something that appears to happen quite often in EU countries: see Salize et al. (2002)

[17] For instance: Large, M. M. & Ryan, C. (2014). Disturbing Findings about the Risk of Suicide and Psychiatric Hospitals. Soc Psychiatr Epidemiol, 49, 1353-1355.

[18] See also the different works of Michèl Foucault on this

Questions for Reflection

We are building this work together.  Your lived experience is needed and valued.  It is essential to building our shared knowledge and expertise as a movement.  Please comment on any or all of these questions or in any way that speaks to you personally.

1. Have you ever been preemptively detained by psychiatry?   
2. How did that affect you, your life, and your relationships with others in the relevant community where you lived?
3. What would you like others of conscience to know about your experience?
4. How do you recommend people of conscience respond if they are afraid for their safety or that of someone else?    
5. How can people protect both their own interests and those of others, while still respecting human rights...?
6. How do our systemic responses need to change in order to make potentially volatile situations safer for all concerned?   
7.  What factors, in your experience, lead up to situations becoming 'life or death'? 
8. If we were truly interested in prevention, what kinds of support would need to be available - and how would people access them - in order to prevent situations going from bad to worse?

August 21, 2016:  Conference on Principle 21

We will talk about Principle 21, including your responses, on September 21 from 9-11  PM EST. Karlijn will be our featured guest for that discussion.  The call-in number and details will be announced shortly.

Monday, August 1, 2016

Important Notice: Declaration of Principles Conference/ Blog - Postponed

As many know, there is a really important event in that has been called for tonight - Monday Aug. 1 @ 9 PM EST. Originally this was the start date & time for the Declaration of Principles Conference of Principle 1. Hopefully however, the forum below will generate a lot of energy and focus on racism, misogyny and violence. I will be attending this forum and encourage others of conscience to do the same.

A few days ago, I posted a request for feedback as to how to proceed with the Principles Conference that was scheduled to start today and continue daily throughout this month. The vast majority of support was for option #4:

4. Postpone the whole Declaration of Principles series until Sept 1 so that more energy and focus is available to address the pressing issues of racism, misogyny and violence that are front and center right now...

I appreciate so many people weighing in as to how to proceed with the seemingly conflicting needs present on our movement at this time. I also feel grateful for the thought and concern went into the feedback offered.

As a people we are having some necessary but also incredibly difficult conversations. To navigate them well will require the full energy and attention of everyone willing to offer this. My personal aspiration is to take the time and space needed to thoughtfully reflect and address my own culpability for social 'othering' in whatever ways that manifests for me. This includes internally (thoughts, assumptions, biases, preferences) and externally (actions, choices, words, deeds, tendencies to favor one group's way of thinking over another). It also include ways I may privilege some causes or concerns over others that has the effect of advancing the interests of some groups over others and thereby serves to reinforce white supremacy, misogyny, trans oppression, sanism - or some other kind of social exclusion mentality that I continue to hold (verbal/ academic privilege, ableism, classism, etc).

My hope is that, together, we can deepen our appreciation and understanding of the massive pain that exists among us - as well as generate ideas for moving forward together as intersectional allies dedicated to creating a truly human rights informed world for all people everywhere.

As always, the most important healing I need to do is in my own life and the relationships closest to me. For the time being, that has meant postponing this series to free up the energy and resources I need for meaningful self-reflection and personal change efforts.

If all goes well, I hope to pick up on Blog 21 on August 21 and then resume the Principles Conference starting with Principle 1 on or about September 1, 2016. The plan is to make the conference accessible by phone and internet, and as internationally as possible. Details will be updated in this blog, on facebook and in Google+, as they become available.

Thanks so much to all who have followed this series for your incredible enthusiasm, inspiration, dedication, participation and support.

Saturday, July 30, 2016

#20. No Pros, No Cops, No 911 - Policing Suicide Must End

This is Day 20 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982.  (More info here.)  Today we are talking about Principle 20.

Principle 20 reads in full as follows:

We believe that suicidal thoughts and/or attempts should not be dealt with as a psychiatric or legal issue.

Basic Rationale

Modern society has created a world that many of us do not want to live in. Many of us are in pain and can't imagine this ever changing. We sincerely ask if life is worth the effort.

No one should face these kinds of difficult decisions alone. These are difficult matters of conscience. We have not arrived at this place lightly. Almost invariably, there are overwhelming challenges, significant experiences of life to date and important competing values and needs.

Nor should anyone facing such difficult matters of life and death be met with the modern crisis response.  Human beings in desperate need call crisis services sincerely wanting help, hoping for help and desperately hoping that something that feels like help exists. To die or not to die...?  This is likely the hardest decision any of us will ever face. We want - deserve -  someone on our side, who believes in us and cares about what we are going through in ways that are clearly more than 'just a job.'

Ideally, there would also be someone who can offer meaningful aid.  Someone who has access to resources that address the overwhelming real life needs that human beings in distress so often have. With regard to services that claim to offer 'professional help', we legitimately hope for, long for, have a right to expect that there will be someone on the other end of the line who knows how to navigate the world that we - not just they - actually live in.  In a world that claims to offer meaningful reasons for staying alive, we legitimately hope for, long for, have a right to expect that such people will appreciate the full extent of what we are going through -- plus offer realistic opportunities to go somewhere better from here.

So, who ever thought, in a 'civilized' society, that 'help' would come to mean that armed militia show up at your door, drag you off in handcuffs, forcibly inject you with debilitating poisons, mistake your compliance for recovery, and then proceed to bill you for the insult. If you weren't 'really' suicidal before, you certainly have good reason to be now.

Suffice it to say, the outcomes speak for themselves.  One of highest peaks for suicide is one week into hospitalization.  In other words, exactly when we discover the current system for the cold, hollow, empty shell that it is.  About that time, we put two and two together and our reasoning has never been more painfully rational or sane:

I was already miserable and desperate before.  I knew I couldn't find the way on my own.  I did the right thing. I swallowed my pride and called for help. I put my known life at risk (home, job, family, community respect).  Against my better judgment, I did what I was told and turned my fate over to the 'true' experts.  Yet, I feel worse and more hopeless than ever before. If this is the best my community has to offer, then what hope is there...?

Nor is it any surprise that our other peak for suicide is one week after discharge.  At this point, the system has convinced us we are better off on our own. We may or may not still want to die.  But, we certainly know the answer is not to be found inside the institutional walls.  So, we paste a smile on our faces, start looking grateful, and do whatever it is we need to do to convince the powers in charge to release us.

More often than not, we return to lives than have shattered in our absence.  Bills went unpaid, jobs were lost, partners left, kids were removed from the home.  Cherished pets starved to death. Everyone around us treats us both as if nothing happened -- and as if we are irreparably broken. The ambulance bill arrives.  Then the hospital bill.  Then the bills from all the independent providers not covered by insurance.

It's far worse than before.  Worse, in fact, than we imagined possible.  Yet, attempts at meaningful conversation are met with, Have you told that to your doctor?  The invariable response to legitimate feelings, Do you need to take your meds?  It's like conditioning the right to freedom of Jewish concentration camp survivors on the post-release assessment of their former Nazi guards.

This is a massive failure of human community if there ever was one.  What the vast majority of us want - what we wanted in the first place - are human beings who get it.  They don't need to be super-person, savior or healthcare expert extraordinaire.  In fact, it is often a lot better if they aren't.  A lot of what pushes a lot of us over the edge is feeling like we're the only ones.  Like somehow everyone else has it figured out, is living their little happy lives, and we're the only ones who are missing out.

So you can't imagine how healing - what a relief it can be - just to connect with others who are willing to admit to the questions.  They don't have to have the answers.  Just the fact that they're in the same boat and struggling too, is often enough.

These are the true heroes of our lives.  They're the folks who are able to show up as ordinary human beings.  They're willing to admit vulnerability and uncertainty.  Their biggest asset is just that they know what it's like to be there.  They get how overwhelming the challenges are, and how unbelievably painful and unrelenting the feelings have been. They have experienced, first hand, how slim the hope and possibilities can seem.  They know - not because they took a class but on a gut level because they've lived it - how much it is to ask someone to keep up hope and to keep putting one foot in front of the other in trying times like these.

When we find each other, it's priceless.   Contrary to the system assumption that we'll push each other over the edge or plot our shared demise, almost always we are just what we needed.

And, contrary to the system assumption that we can't be left to our own devices because we don't comprehend the value of life, in fact, we value life greatly.  We simply disagree as to how that valuing is best expressed.

Unlike the dominant culture, we see life as far more valuable than just the rote matter of going through the motions of staying alive.  We actually value the fundamental personhood of the human beings who are making that effort.  We respect their evaluation of whether - on whole - society has done its job.  Whether on whole, the effort required and returns offered are worthy of the person in question and have earned their trust and good faith in continuing to walk the earth.  In this regard, we respect one another to choose wisely.   We don't pretend to know what is right for someone else. We don't impose our vision or answers or values or judgment or conscience on anyone else.

From what we have experienced, this is the far safer, wiser option. It responds to the true needs of the person in the moment.  It offers sincere the respect, dignity, valuing of the individual as a person that is so often missing in the culture at large.  Compare this to the rote responses of a callous system that treats every 911 call the same and is concerned, first and foremost, with managing risk and liability. Imagine, if you will for just a moment, the sense of outrage and betrayal a person might feel - on the worst and possibly last day of their life - to find out the so-called help they've been offered actually has nothing to do with them. It's only about some hired gun's need to cover their a**?  That's more than enough to put you over the edge right there....

Instead of trying to convince or coerce human beings who have given up to keep on living, we need to invest our effort in a different direction.  We need to create the kind of communities that offer hope.  We need to offer relationships that are worthy of human effort and trust.  We need to open up a vision of a future that is worth someone staying alive for.  We need to clear the path to the resources needed to make what is possible actually attainable.

And if or when we fail to do that, we need to take stock of ourselves. This issue is way bigger than individuals, friends or families.  On a community and societal level, we need to look at how we are failing each other. We need to ask ourselves what is getting in our way?  Why wasn't someone, somewhere out there able to create a relationship meaningful enough - and why wasn't our community life as a whole rich enough or accessible enough - to inspire our comrade to stay alive.

We also need to consider long and hard what the person may have been trying to tell us.  We need to consider long and hard what - consistent with our own needs for self-preservation - we could have done differently.  We consider, long and hard, how not just the person, not just us, but also our whole concept of help - and our whole approach to helping - might need to fundamentally change.

Some Commitments We Could Make to Each Other

  • No pros, no cops, no 911
  • Offer human rights-informed, coercion-free spaces
  • Share from the heart & make space for each other to do the same
  • Hold each other’s truths with dignity, respect, interest and willingness to learn
  • Maintain a heavy dose of humility for the things we don't yet know or understand
  • Respect each person’s conscience and right to decide for themselves
  • Create real community, instead of 'support groups'
  • Change the world in ways that make it livable for all human beings
  • Support each other’s human rights, including the right to be left alone


Questions for Reflection

We are building this work together.  Your lived experience is needed and valued.  It is essential to building our shared knowledge and expertise as a movement.  Please comment on any or all of these questions or in any way that speaks to you personally.

1. Have you ever experienced a police or public safety offensive in response to a sincere expression of distress or a sincere question about staying alive?   
2. Have you ever been coerced, forced or policed to stay alive? 
3. What would you like others of conscience to know about your experience?
4. Think of a time you actually received sincere, truly helpful assistance from another human being.  What were the outcomes then?  
5. If standards of care were really caring, at a mimimum, that attitudes and behaviors should people in need be able to expect from professional helpers?
6. What are the most important things professional helpers can do to get better outcomes?   
7.  If we were sincere in our effort to make crisis help truly helpful, how would our approach to these issues change?  

August 20, 2016:  Conference on Principle 20

We will talk about Principle 20, including your responses, on August 20 from 9-11  PM EST.  The conference will convene on BlogTalkRadio.com/Peerly-Human

To join:

By Phone: (1)646-378-1629

By Internet: http://www.blogtalkradio.com/peerly-human

We welcome your participation.  Simply press #1 on your phone to speak with the show hosts.

More details are available at http://www.blogtalkradio.com/peerly-human

Post-Conference Reception

Those wishing to continue the discussion after the conference – or to talk informally with others who participated – may join us for the Post-Conference reception.  The reception will start immediately after the conference (11 PM EST) and continue til the wee hours or for as long as there is interest.

To join: 

By phone: (1)331-205-7196 (dial *67 for added privacy)

By internet: Uberconference.com/peerlyhuman

International: Local access numbers available at Uberconference.com/international

Friday, July 29, 2016

#19. People Have the Right to Be...

This is Day 19 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982.  (More info here.)  Today we are talking about Principle 19.

Principle 19 reads in full as follows:

We believe that people should have the right to live in any manner or lifestyle they choose.

Basic Rationale

I don’t know about you, but I’m tired and exhausted by a world that always seems to be asking for a better me.  I’m tired of the politics of scarcity and not enough.  I’m tired of kicking myself, driving my body and mind, to produce the next thing on the horizon that always seems urgently necessary.  I’m tired of what that does to me.  I’m tired of what that does to us – to the people around me, to the world around me, to the trees, grass, fields, animals, air, sky and water upon which we depend for shared existence. To the life within me that needs all of these things to live and with which I’ve been entrusted by the Universe to do right by during my time on the planet.

My body, every body, is made up of living cells. Tiny living beings that depend on us for their existence.  Tiny living beings that are every day giving themselves up – spending all of their tiny short existence, living and dying in good faith - in order to support the much larger enterprise that is we represent to them to be. 

I can tell you from lived experience -  from listening to their many voices – that, at least as regards to me, these tiny living beings upon which my life depends are not at all sure that the enterprise of me is worth it.  They are not at all sure it stands for something they believe in.  They are not at all sure that they are up for what I’m asking them to do.  They wonder, on a regular basis whether any good will come of their effort. 

Every day, the modern world is asking me to push them, cajole them, make them produce.  Every day the demands of modern life are asking me to force them to boot up, buck up, go along and get along.  Every day the propaganda of modern life is asking me to tell them – this is as good as it gets, stop complaining, get with the program.  If you want to survive, these are the terms, this is what you have to do.

These are the beings that are in ground level contact with how my existence is going.  They trying to get me an accurate read about that from their perspective.  They sincerely want me to know how they see it from where they are sitting.  They are trying to communicate with me honestly as to what is working, what isn’t, how it could be better, and what needs to change …

My objection to psychiatry is that it kills their right to vote.  Medical model (drug, shock, surgery) psychiatry doesn’t just affect me as a person, although the impact has its analogy.  To psychiatry, I’m basically just a human-sized cell.  Their job is to get me to function in a useful way so that the societal enterprise human beings have created has what it needs to function.  The meaning of my existence, from a psychiatric perspective, is to get me to the point where I can be plugged into one of the so-called essential organs of society that makes up our collective social body.  That way, I do my part to help produce the energy and functioning that support the world economy of corporate human existence. 

The drugs, shock, psychosurgeries that psychiatry is selling are all designed to make me useful from that perspective.  Basically, it is tantamount to being told by the larger systems that depend upon my energy and participation: You don’t like it?  Here’s a pill.  Now boot up, shut up, get back in the assembly line of life.

Seen for what it is, the core message of psychiatry is that we don’t effing matter:
  • Even if the big organism we belong to (human body, family, community, society) is doing something totally wrong for living beings. 
  • Even if the dominant culture we are a part of (individual, family, industry, race, religion, town or country) is heading itself – and all who support and depend on it - in directions that are killing all concerned, along with the resources needed for living. 
  • Even if the vast majority of voices are unhappy on the inside despite the appearance of conformity on the outside. 
  • Even if, as a body, person, culture or world we are passengers on a steam-roller to our collective physical, emotional, moral and spiritual demise. 
  • Even if our cumulative silence and compliance is what is allowing this to happen…. 
Even if any or all of these things, the message of psychiatry and the industry interests that allow it, is still the same.  Our collective voice, our collective concerns, our cumulative opposition don’t effing matter.  Our intuition, subjective knowing, voices, visions, beliefs, meanings, activations, animated and urgent expressions don’t matter.  The massive levels of anxiety and distress don’t matter.   The massive sum and culmination of every diagnosis on the books  - each registered not only visibly publicly to the families, neighbors, organizations and communities that refer us to psychiatry, but also individually, privately, behind closed doors that only the ‘experts’ are allowed to see and address - all don’t matter. 

None of these mechanisms for getting the collective body of human social existence good information about what human society is doing to human beings (not to mention other living beings) matters to psychiatry or the industries that support it one wit.

I can’t live with that.  I think your little vote counts and mine does too.  I hate that we are living this lie, telling each other to boot up and buck up, rewarding each other for doing that and killing everything valuable about living, each other, and the world we live in along with it. 

I suspect many others are out there who feel that way too. I suspect this is a big part of what it means to end up being the kind of person that gets labeled by psychiatry.  I suspect this is a big part of what transforms so many of us from confused compliant pill-popping patients to full-fledged fire-breathing, fiercely-determined anti-psychiatry activists, protestors and survivors. 

Something about the life spirit in us started rebelling against this a long time ago.  Something in us started questioning, resisting, pushing against, insisting, trying to find a better, more livable way.  As a people, as a movement, many of us are tired, beaten down, demoralized from this struggle. 

This principle is for us.  It was written in our honor.  It is dedicated to us and our efforts.  It affirms and advances our collective right to be.  It is about the value, the imperative, the absolute necessity of respecting human diversity.  It’s about the need to sincerely stop, look and question – rather than force compliance – when one of us breaks down.  It’s about trusting, listening to – actively seeking out -  the wisdom inherent on an individual, cellular level. 

It’s about taking seriously the egalitarian, inclusive, belief – inherent in the concept of being ‘peer.’ 
Not as ‘mentally ill’ peers on a recovery journey, but as worthy, respected human peers on a worthwhile, respectable human journey.  

In the former sense, we are tied to the opinions of experts, who substitute their judgments for our own about the value of our insights and truths – and ultimately the value of our lives.  As peers in the latter sense, we are entirely different beings. 

We are human beings, members of a human family.  We all are people of worth with valued insight.  

We all are endowed with reason and conscience uniquely our own.  We are born, each of us, with capacities and perspectives of value that urgently need to be seen and understood by those around us with shared power to affect our relevant worlds. 

As peers in this latter sense, none of us has the right to ‘Trump’ the value or lived experience of another. 

As peers in this latter sense, we give new meaning to ‘peer support.’  We take each other seriously – none of us as The Expert – but all of us as holding needed, valuable expertise.  
We determine to lean into the question of Rodney King, why can’t we all get along? We determine to go forward together, with mutual regard, leaving none of us behind. We determine to accept the challenge of Intentional Peer Support as social change:

 “It’s only working if it works for all of us.”

It stopped working for a lot of us a long time ago.  Perhaps, except in bits or blips, the working for all of us part never really even got started. 

At the same time, in my heart of hearts, I really want it to work for you, not just me.  I also really believe you want it to work for me, not just you.

That, for me, is the beauty of this thing called life.  It’s the beauty of the essential nature of the spirit that makes each of us alive, rather than dead. It says I’m willing to give a lot, sacrifice a tremendous amount.  Just don’t leave me out – don’t leave me behind.  I want me vote to count.  I want my vote to matter. 

It is willing in the voice of Dr. King to say, I may not get there with youOn some level, that’s ok with me.  Painful but ok.  Just so long as you are paying attention.  Listening.  Being aware.  Doing your best do register the heart and soul of what I am trying to communicate here. 
Because more than anything else, I want my existence to matter. I want to make it better for those here now.  I want to make it better for those who come on after.

Like you, like me, our families, neighbors, people across the planet we’ve never even met – like plants, like trees, like everything living on this earth.   - Like the cells in our bodies giving the best they have every day to make the enterprise of us possible - in good faith, even though they don’t particularly enjoy how we are going about it or the effects we are producing…

None of us, anywhere, on any level or dimension, wants our lives to be in vain. 

We all want our existence to express the preciousness of the spirit in us. 

We all know on some level that it is precious or we wouldn’t work so hard to protect it. 

We all want, on some level, living others to be there with us. 

We all want, on some level, to be there on the same page with living others.

Otherwise, it wouldn’t be so darn painful when we clearly aren’t.   

Questions for Reflection

We are building this work together.  Your lived experience is needed and valued.  It is essential to building our shared knowledge and expertise as a movement.  Please comment on any or all of these questions or in any way that speaks to you personally.

1. What dose it mean to you to have the right to be you...? 
2. How has psychiatry - and the overall psychiatrization of human experience - interfered with that right?   
3. What has it that cost you, those you care about, and psychiatry at large, when others have insisted you be something that you're not?
4. If we took seriously the value and message of human diversity, how could we change the world for the better?
5. What would need to change about how we are relating to ourselves and each other to truly value and respect each other's 'right to be'?
6. I, personally, would like to redefined 'help' from meaning how to get each other to 'make it' based on socially defined standards to 'supporting each other to voice the truth of our experience and to live fully into who we long to be.'  That's what would work for me.  But how about you: How would you redefine help in a way that respects and honors you right to be?  

August 19, 2016:  Conference on Principle 19 

We will talk about Principle 19, including your responses, on August 19 from 9-11  PM EST.  The conference will convene on BlogTalkRadio.com/Peerly-Human.

To join:

By Phone: (1)267-521-0167

By Internet: http://www.blogtalkradio.com/peerly-human

We welcome your participation.  Simply press #1 on your phone to speak with the show hosts.

More details are available at http://www.blogtalkradio.com/peerly-human

Post-Conference Reception

Those wishing to continue the discussion after the conference – or to talk informally with others who participated – may join us for the Post-Conference reception.  The reception will start immediately after the conference (11 PM EST) and continue til the wee hours or for as long as there is interest.

To join: 

By phone: (1)331-205-7196 (dial *67 for added privacy)

By internet: Uberconference.com/peerlyhuman

International: Local access numbers available at Uberconference.com/international

Thursday, July 28, 2016

#18. Psychiatric Jargon is a Sham, a Gimmick, the Ultimate Shell Game

This is Day 18 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982.  (More info here.)  Today we are talking about Principle 18.

Principle 18 reads in full as follows:

We oppose the psychiatric system because they substitute jargon for plain English and are fundamentally stigmatizing, demeaning, unscientific, mystifying, and superstitious. 


Plan English vs. Psychiatric Jargon

Psychiatric inmate.................... Mental patient
Psychiatric Institution........... Mental hospital/mental health center
Psychiatric system. .............. Mental health system
Psychiatric procedure............... Treatment/therapy
Personal or social difficulties in living..... Mental Illness
Socially undesirable characteristic or trait................................ Symptom
Drugs........... Medication
Drugging...................... Chemotherapy
Electroshock................. Electroconvulsive therapy
Anger................... Hostility
Enthusiasm....... Mania
Joy.....................  Euphoria
Fear  …..   Paranoia
Sadness/unhappiness... Depression
Vision/spiritual experience. ............... Hallucination
Non-conformity ........................ Schizophrenia
Unpopular belief. ......................... Delusion

Basic Rationale

Today's commentary was provided by an anonymous donor.  Thank you!

This is a society that seeks to label everything. When we call something a name, we make an association. For example, if I type purple, you automatically know what the word means. Sometimes labeling things helps us understand and make sense of the world around us. But there are also times when giving something a name and defining it to never challenge it again can be destructive. I write the words mentally ill and we all have an individual conception of what that is whether we are right or wrong or somewhere in between. The term “mental illness” is one that is diffuse and has little meaning. It clumps all the diagnostic terms of the DSM into a nice neat group. But, life is seldom that easy and we have been duped into the idea that we are “helping” someone by acting this way.

Psychiatry, in labeling people with mumbo jumbo terms that have no basis in science, is engaging in bullying. The amazing thing that I see is that they have a whole society coming alongside of them to engage in the same power play. We are so accustomed to calling someone “bi-polar” or an “addict” that we don't even take the time to understand what we are saying much less challenging what it means and what we are doing to the person we are placing a notch below us socially. This is often done with some kind of reasoning that ends with “mental health services help people”. But are they helping or marginalizing? Are they assisting or engaging in subtle abuse? If psychiatry were viewed as a bully (which they are by engaging in derogatory means of describing people and asserting their power in doing so) as our school children are the outrage would spark a flurry of at least lip service regarding a problem. Amazingly enough though, our whole society has no hesitation to label someone with a psychiatric term and see nothing wrong with it.

But, there is something wrong with this. There is something wrong with the lack of anyone talking about the power struggle between the service providers and those they deem “in need of treatment”. Psychiatry is a product not a discipline of medicine and “mental health” is what they promote without so much as being questioned to describe what the product is. And even though they can show little quantifiable success or substantiate their practices with scientific proof of any kind, they are trusted without question. And thousands are funneled into this system, stripped of basic human rights, and are silenced because they are “crazy”. Such is the power that words can have. This is the power that psychiatry has been given to destroy lives in a subtle socially acceptable way. And, the really frightening part is to understand that those selling mental health for profit have found their way into true medicine, court systems, social services, group homes, schools, supportive employment programs, homelessness, the military, politics... it's hard to think of a place they haven't claimed. We have promoted their name calling, their codes of “disease speak” to a level that is simply staggering. This would not be as terrifying if psychiatry were actually able to do what they say they will and “help” people. But, this group has little interest in doing any such things and one simply needs to read a paper, volunteer at a school or walk down a city street to understand this isn't happening. I wonder how much longer it will be before average people begin to understand this and demand more. For now it seems people are happy handing out labels that don't fit and are wrong, humiliating and demeaning so those who are in power can hand out a pill that the drug companies have told them works to help. This is a gimmick. A sham. The ultimate form of the shell game and no one seems to be willing to call it what it is. 

If history is an indicator then it seems this problem will not change until there is such a large number who are injured by the practices of social control and moral policing that psychiatry engages in actually turn the tide. The real challenge here is to start in your own daily life to stop going for the quick fix for your own guilt and see people differently. Stop using words like “anxiety” and “depression” to describe yourself. Quit using the terms AD/HD to describe children and “dementia” to describe the forgetfulness of the elderly. Stop placing everyone, including yourself, in a box of someone else's making. Quit buying the product and quit trying to sell it. In the end that's all psychiatry really is. A quick answer that makes us all feel good for “helping” when in fact nothing has changed for the person we put a name to. In order to truly help we have to change us and how we act and stop casting our shadows on those who are vulnerable.

Questions for Reflection

We are building this work together.  Your lived experience is needed and valued.  It is essential to building our shared knowledge and expertise as a movement.  Please comment on any or all of these questions or in any way that speaks to you personally.

1. Have you experienced psychiatric labeling? 
2. What would you like others of conscience to know about this experience?  
3. How do you define your experience on your own terms??
4. Compare your own understandings with that of psychiatry - which do you find more useful and why?  
5. What if any needs does labeling serve for you? What other, more respectful ways could we address them?
6. If we really valued human differences and/ or the inner wisdom of our experience, what would happen to derogatory labeling? 
7.  How would we need to think about each other differently to get beyond derogatory labeling - psychiatric or otherwise?  

August 18, 2016:  Conference on Principle 18 

We will talk about Principle 18, including your responses, on August 18 from 9-11  PM EST.  The conference will convene on BlogTalkRadio.com/TalkWithTenney.

To join:

By Phone: (1)267-521-0167

By Internet: http://www.blogtalkradio.com/talkwithtenney

We welcome your participation.  Simply press #1 on your phone to speak with the show hosts.

More details are available at http://www.blogtalkradio.com/talkwithtenney

Post-Conference Reception

Those wishing to continue the discussion after the conference – or to talk informally with others who participated – may join us for the Post-Conference reception.  The reception will start immediately after the conference (11 PM EST) and continue til the wee hours or for as long as there is interest.

To join: 

By phone: (1)331-205-7196 (dial *67 for added privacy)

By internet: Uberconference.com/peerlyhuman

International: Local access numbers available at Uberconference.com/international