Campaign against the Schizophrenia Label

I just encountered the Campaign against Schizophrenia Label (CASL) while reading China Mills’ book, Decolonizing Global Mental Health . This is an important book for many reasons, chief among them being the other resources, research, ideas and people whose work I am getting to encounter as a result of this work. Anyhow this blog post is only about CASL, that too to note down what work they do or did and to link it to my work later.

So here is what the search for CASL brought for me. In brief it is here-

The idea that schizophrenia can viewed as a specific, genetically determined, biologically driven, brain disease has been based on bad science and social control since its inception. If the scientific argument against `schizophrenia’ is judged to be won, it remains to take the evidence to the people, to explain and develop the alternatives in the full light of day. This is why the campaign is led by Asylum, the magazine for democratic psychiatry, psychology, education and community development. We believe the time is fully ripe for a paradigm shift across the field of mental distress and that the alternative knowledges and resources are now in place to mobilise for change. No more will we view the scandal where intelligent persons are expected to accept discredited diagnoses for fear of being labelled as `lacking in insight’ and having treatment forced on them.

 

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Rejecting chemical imbalance theory

I had no mind to write another post for this ‘year’ if you please- its 21:30 in the evening and I am studying on my computer! New year’s eve!

But well…that’s phd research after all. My choices, so can’t grumble. However, this article  just landed up in my mailbox and seeing the word Prozac, I quickly opened it up. It seems so interesting and useful that I intend referring to it in my writing. And I think it must be shared further, so I have on all my social media sites, as well as preserving it here for future reference. After an excerpt I am attaching a link to the main article.

‘One reason the theory of chemical imbalances won’t die is that it fits in with psychiatry’s attempt, over the past half century, to portray depression as a disease of the brain, instead of an illness of the mind. This narrative, which depicts depression as a biological condition that afflicts the material substance of the body, much like cancer, divorces depression from the self. It also casts aside the social factors that contribute to depression, such as isolation, poverty, or tragic events, as secondary concerns. Non-pharmaceutical treatments, such as therapy and exercise, often play second fiddle to drugs.

Here is the full article

Why I insist on counseling/dialoguing

Many a person- whether who suffers themselves or a family care-giver ask me what is the most effective, non-drug treatment in Mental ‘Illness’. If I say offhandedly ‘counseling’ most are not able to understand why or how it can make a difference in a scenario where there is a ‘chemical deficiency’ in the brain. In this writing, I am about to shed further light on all these areas and intend to share a link of this with anyone, anywhere who wants to look out for alternatives- as the one sure way to put mental ‘illness’ behind.

I intend to go on this path one step at a time so that you can see for yourself what I am saying, why I am saying so and decide for yourself. I, of course, appeal to the sense of reason which I believe all of us are endowed with. I may at times refer to articles I have read in research or may not be able to pull them up suddenly- but nevertheless whatever I write here is something I have distilled in years of my research- in counseling, in mental health and in other areas especially communication studies. So starting with the first thing, I would like to offer you something about what is known as the theory of –

Chemical Imbalance in the Brain!

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Please understand that there is no organ called the ‘mind’ inside the body. There is either the brain or the heart- there is no intervening or interconnected space where the mind could be located. If there is a chemical imbalance, possibly we should be able to measure it? How do you measure the ‘imbalance’?

Say if your Haemoglobin is low, it shows in a blood test or if you have low Sodium or something like uric acid- these are all testable using proper techniques and verified. There is no such objective test about mental ‘illness’. In which case, what is not measurable can be ‘treated’? Think logically. If you agree that there is a chemical imbalance and that imbalance has to be brought into a proper balance then there ought to be means and measures to figure out the extent of the imbalance. Right? Wrong- no such diagnostic evaluation is ever performed.

So then, how is mental illness ‘detected’?

In other words, we have to rely on the ‘knowledge’ of the psychiatrist we are visiting to decide what mental ‘illness’ afflicts us. In other words, we have to believe that they have enough knowledge that regardless of what we have to say, they have the ability to figure out what mental illness it is and with what chemical it can ‘treated’.

Are we not attributing some super-human, godlike powers to the psychiatrist? The only measures s/he has are your verbal testimonies and those of your family members ( in case you have not gone alone). By listening to some story that you narrate about yourself, the psychiatrist is able to ‘detect’ by the superhuman ability they are endowed with, to figure out the chemical imbalance you have hidden in the folds of your brain, which of course nobody else can see.

Your folks have simply taken you there because of some behaviours that you have been displaying of late! So then, there you go- you get a ‘proper’ diagnosis and you are ‘oh so relieved’ that all the uncertainty of where those behaviors were coming from. You know now, they are your ‘schizophrenia’, ‘social anxiety, or bipolar’ or any other diagnostic self, wreaking havoc inside you. In other words you are now richer in your knowledge  about your ‘diseased self’ and you know which tribe/category you belong to.

This method of ‘detecting’ mental illness is strongly condemned and criticized by thousands of people worldwide and their numbers are only growing. I joined their ranks after nearly two decades of taking psychiatric medication, but not without understanding what they were saying.

But what is the alternative then?

If not mental illnesses what could these behaviours be?

Do you really believe if someone is shouting at the top of their lungs, they are ‘ill’ and not simply angry? They may be saying what whatever I am seeing around is not fair, not right or simply a masquerade. Isn’t is possible?

I have heard scores of people in counseling sessions as well as in my research (usually these are non-overlapping people) and in nobody’s story, have I heard anyone sound ‘mad’. I have only seen a huge suffering, an accumulation of agony over time, which they have not been able to talk out with anyone, as a result of which they have been imprisoned alone with their experience and left to deal with it, by themselves, with whatever means they have. Listen to this story. I am quoting here in bits and pieces, as the boy who narrated this story to me, was discussing this with me in a counseling session- on phone. We never met in person. From the last that I heard from him (he was 27, several years ago) he was setting up his business enterprise. For this sharing my focus is how his ‘pathology’ came to be established. He was forced to enter medical college, regardless of his ability to focus…

“Our home was part of my parents’ nursing home. My mother being a gynecologist would sometimes come home straight from a delivery…with her hands blood soaked. As an eight-nine year old I could not bear the sight of blood. I got into a habit of cleaning and clearing- repeatedly, washing my hands, restoring things in an orderly fashion around the house. I started imagining things. Soon my behavior was noticed in the family, and my parents took me to a psychiatrist friend. He gave an OCD diagnosis…

“I could not understand much in class for I would be so doped with the effect of the medication[1].  But no matter what I said to him, my father would not allow me to drop college education. He would not talk to me, to try finding out what was bothering me. As a desperate measure I came home one day, took off my clothes, and went and lay down in the corner of the living room- naked, curled up, utterly weak and helpless. I was hoping my parents would try to see my desperation and communicate with me, possibly attempt understanding my point of view. Instead, my father went and gathered the neighbours, to show my ‘madness’ or how inappropriate my behavior was. May be in some way to tell himself and others that I deserved to be given the severest treatment.

“Nobody can do anything if you are referred to the nursing home of Dr…It is a one way entry- once you enter, you cannot decide when to go back and neither your relatives or family can check in on you. They are only about ECT. They have a whole system set in place for giving ECTs to people without anyone being in position to oppose, protest or even express anything. If you challenge them you will be only treated more harshly by the ward-boys and the nursing staff. They will sedate you so much that you cannot even remember who you are. My father being a doctor, demanded to be let in…and he decided immediately that I do not have to be there any longer.”

Speaker: Jayesh[2], 27 years, Diagnosis: OCD, Schizo Affective Disorder.

[1] “Risperidone. Clomipramine. Modafinil., sometimes lithium…some mood stabilizers. Don’t remember the name though. They used to switch drugs and alter doses very often.”

[2] Name changed

After my conversations with him and when, I understood his really complicated family story, my only focus was to bring him to understand how he had dealt with everything in his situation,and how it was really the choice open to him.

Isn’t a child the weakest person in a group of people, where all are adults? Children end up facing the flak from all sides- from parents, grandparents, step-parents, doctors, teachers and so forth. Someone who is weak in one situation will not remain weak forever, if they can be helped to deal with the situation which overwhelms them. of course we can choose to pick the person in their difficult situation and identify them as ‘sick’ or ‘needing treatment’. But really, it NEVER NEVER NEVER WORKS.

So the one sure way is talking it outDSC00091

Have you ever been troubled by something, nothing big, and felt better by talking it out to someone? That is the sort of relief we experience when we take a burden off our chest- an unburdening, a lightness. In counseling, years of what someone has been carrying inside can be expressed- it is called catharsis.

Anyone who looks at someone they counsel in two ways- as an ‘ill’/sick person who needs to be shown the way, or as a fighter who has been dealing with their life despite all his givens, suffering, challenges and negativity. At least I am like that. I think the person who seeks counsel is really looking for a way out- nobody wants to share their suffering with an unknown person. In the story of the narrator hides the hero- waiting for a little affirmation, support and acknowledgement from the environment, a little guidance (if at all they do) from someone they can repose trust and faith in. They are pretty much capable of dealing with their lives. And if they are not, that is the role of the therapist- to support them in becoming such a person.

Suffering of the spirit cannot be healed by external chemicals- it requires support and to be listened to. Suffering becomes behaviours, when it is unbearable for a person., and behaviours, when they seem ‘odd’ to members of the family, are taken as ‘illnesses’- which they are not. If they really had been illnesses, then an illness has a lifespan. You cannot have malaria or dengue forever- you just take medicine for awhile and recover. You do not have to be put on life-long medication. But psychiatry puts you on lifelong medication because they cannot address your suffering.

The suffering may be coming from the fact that you are living in a noisy neighbourhood and just when you go to bed, your neighbours start fighting and it disturbs your sleep, makes your heart palpitate or something. It could be because  you are worried about your career as everyone is doing exceedingly well in your class and you cannot even sit down to study. It could be because you see pimples on your face and you feel that everyone is noticing them and laughing at you.

Every person’s suffering is real for them- no matter how it seem to another. But every counselor/therapist/psychotherapist or helping professional approaches the act of counseling with a different perspective. Most of them (at least in India) go with the same diagnostic categories as psychiatrists and they insist people adhere to their medical regimen, while taking counseling. I cannot imagine what is the point of such counseling, if it does not reduce your suffering and instead only consolidates it further, so you require medicine, which in fact produces more distress and side-effects.

If someone is struck with such a counselor/therapist they should immediately understand that this is not the person who can help them recover or go off medication, or even less than that, support them in any significant decision making in their life. Choosing or landing with a proper therapist is one of the most complicated parts of the riddle of helping yourself/ your loved one.

So why i insist on counseling is-

  1. To get an objective view of your situation
  2. To seek support from someone who does not reduce your suffering to a chemical condition.
  3. To understand where you are going wrong socially, because that is what is inviting your ‘label’
  4. To be willing to work on things within yourself with an external guide, who is interested that you get better at dealing with your life’s challenges
  5. To cut the suffering short.

Of course you can be argumentative and insist that you really are ‘schizophrenic’, ‘bipolar’ , obsessive compulsive, socially anxious or anything else- and no counselor can really help you. By all means, if this is what you believe, then really nobody can help you. Because the first level of direction has to come from within you. If you believe in the illness label, then you really ARE ILL. But if you believe you can get well and you will, somehow or the other, you will find a way- and that is the hero…who comes into the world wearing a thousand different faces, and wins his/her battle- sooner or later. The fool can be enamoured by all the noise and the propaganda of the industry that there is a huge incidence of mental illness and half the world is going to be mentally ill. If they did not do this propaganda, how would they sell you the drugs- your dreamers!

The writing paradox

There is a slight contradiction I am facing at present. Since I am reading so much, there is a need to write equally as much. But what is happening instead is that I am not writing at all! I am somewhat overwhelmed by the reading. Thanks for academic writing, which is spread in three or four directions, I am simply not able to take notes or make blog entries about whatever I am reading.

Due to a sudden twist of fate that I cannot delve into for the moment I have been studying about the Global Mental Health Movement- and my particular interest lies in the role of the World Health Organization (W.H.O.) I hope to delve into that at a later point more thoroughly- this is the stage of doctoral research and one cannot look at every single institution in its entirety.

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However, the sense I have been getting of late is that I have understood how psychiatry is systematically pushed forward at the behest of the W.H.O. under various guises. In countries like India, the level of knowledge of the average person is very low- even the educated here are quite docile, and unquestioning of authority. In such a milieu the institution of organized medicine is never questioned by anyone- least of all psychiatry, which everyone believes is out there to help people in their suffering and despair. Nobody knows that psychiatry does not have an agenda for treatment for complete cure for any so-called mental illness. Their only agenda is to be middle agents for medicine making companies.

Millions of people keep taking psychiatric medication in the belief that they will be relieved of their suffering by taking the medicines regularly. Families are more so the agents and ensurers of this belief. They make sure the ‘patient’ remains compliant and takes medication regularly. Family is the chief arm of propagation of medical regimen. Sad but true. Even research in public mental health (eg. Addhalakha, 2008) confirm my observation.

The likelihood that anyone can understand the Global Mental Health Movement or how the new Mental Healthcare act is really no shot in the arm for Indian people is highly unlikely. Meanwhile people like me have to keep looking for solutions and understanding the invisible spider’s web that weaves and weaves and ensnares the gullible- for this is the researcher’s chosen task and challenge. Of course I do not expect that people will start reading research or get interested in what one has to say- but that is their calling, this being mine!

So this is the contradiction- the need to write and yet not finding the inspiration, for I know there are no takers for it yet! I find myself increasingly writing for an international audience. It was never intended that way- what tragedy.

A fortnight of books

Nothing makes my heart glad as much as the arrival of a new book- even if I cannot read it immediately. The sense of it’s arrival as a part of my world, my home, my bookshelves makes me feel richer and deeply satisfied. Books have been a important companion to me, equally as much as music and my dogs.

But today turned out to be a special day in a different way- in addition to another book about an allied area (the area being Global Mental Health), an author sent me his book- something which does not happen frequently. But when it does, the sense of happiness is more than when I myself go and get the book. Today Bruce Cohen sent me his. I have been reading his work of late, with great appreciation and interest, therefore decided to write to him. Today he wrote back after a few days of my email and also sent me one of his earlier books– a book about narratives in mental health of those who currently use mental health services as ‘users’.

 

As usual I am unable to write on this blog- due to the work lying in many domains, the least of which is counseling for now. But the research is happening in so many folders that it is simply not feasible to write a blog post. However, I must come back to the book by China Mills that I laid my hands on awhile back. It happened in a circular way- I was not planning to look at the issue of the Global Mental Health in the course of my Phd, because I thought it had nothing to do with my qualitative work or even the legal work that I would be undertaking.

But the truth is that when one does a doctoral research, you cannot but understand the whole picture in detail, in precision and in diverse ways. To do my current research I am not only studying psychiatric research and that in Transcultural Psychiatry, but things as diverse as Linguistics, Political Science, Sociology, Family Studies, Critical Psychiatry, Critical Psychology, Social Psychology and perhaps more, certainly not less. It is not the easiest of ways to study certainly.  But then what is the point of doing something so passionately and not understanding all aspects of it, at least to a smaller if not greater dimension?

I have been wary of the Global Health Movement because I did not quite  understand it- but now I am beginning to see how the WHO is pushing the idea of psychiatrization into poorer countries of the Global South at the behest of the ‘richer’ countries of the Global North. I understood this in a different way longer back but now the whole picture is becoming more and more clear. Just now started reading the book, which interestingly seems to have done at least some part of the story-telling in India itself! More of this, if I can muster the time, when I venture further into the book.

Psychiatry- the rotten egg!

This is not my original post but a post that I am re-blogging from another source. It is so worthwhile that I feel the need to save it on my blog too! The excerpt in blue is from the main post by the author.

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What’s glaringly missing from the paper is the recognition that real medical specialties have no need for such vaunting self-promotion, because:  their basic concepts are valid, their methods are salutary, and they routinely maintain a high level of critical self-scrutiny.  Psychiatry, by contrast, is fundamentally flawed and rotten – a wrong turning in human history – which no amount of whitewash or fatuous window-dressing can retrieve.  Encouraging psychiatrists to become cheerleaders to this pernicious hoax needs to be seen for what it is:  a desperate, though futile, attempt on the part of a dying profession to forestall its inevitable fate.

Here is the original post by Phil Hickey.