John Shirley: Mental State of the Union

by **thoughtographer** » Thu Mar 16, 2006 12:04 am

1. I'm Okay, If You Say So I'm sane, no, really, I am. I'm not insane. No, really, I'm not. Except...I've struggled with clinical depression and drug addiction, and these are both diseases of the brain. For a long time I made the same mistakes in life over and over, knowing better each time -- but doing it anyway. I was married and divorced four times before I figured out that I was giving in to relationship-wrecking compulsive behavior. But since I don't rave on the street, I don't stalk people or have delusions of grandeur or hallucinate or hear voices, let's pretend I'm not crazy. When I was young, I was in a mental hospital because of an overdose of a powerful street drug. The drug that put me there made me temporarily psychotic. I chased my mother around and smashed windows and I bit a cop on the leg as he cuffed me and I writhed vomiting and hallucinating in the back of his police car. I was strapped on my back on a table staring at a naked light bulb for two days, while the same movies played over and over in my head. Shattered glass flying in slow motion as I break the windows, over and over again like those mistakes in my later life, smashing every window in the house. It was the same Security Ward in Oregon in which Ken Kesey set One Flew Over the Cuckoo's Nest. One guy screamed at his penis, "Stop it, stop it, leave me alone!" (I know the feeling, actually.) Thanks to that horrible street drug, I was temporarily able to experience full psychosis, artificially induced-hence I know what one form of psychosis is like, and have a sense of what the psychotic endure: the sense of being strapped to an evil carnival ride going ten times too fast, everything nauseating, everything terrifying, and it never seems to stop. The feeling of being utterly subjected to forces outside of your control. All that you have left is the part of you that experiences the nightmare. But it was all over in 48 hours or so, and I was able to wake up from the nightmare. Some people are born into it; some people never wake up from it. It's so easy for the "sane" to shrug off the suffering of a psychotic. If only they knew... I was luckier than a relative of mine, who's bipolar -- or schizophrenic, depending on which doctor you ask -- and whose life has been hellishly undermined by it from the time he was a young man. The road of his life capriciously turns to quick sand under him, all of a sudden, as the voices and the paranoia and the hallucinations begin. He once spent all night talking to "Bob Dylan" in an alley in Sacramento. Perhaps there was no one with him in that alley, or perhaps it was some street alcoholic amusing himself babbling to a handy schizophrenic. I used to sometimes take care of that relative when he was a baby: a sweet, affectionate, bright toddler. Twenty years later that baby was waving a knife at cops on the street and warning them that he knew exactly who they were really working for. We deal with mental illness in different ways in our society. One way is, we make it a joke -- "They're coming to take me away ha ha they're coming to take me away ha ha to the funny farm where life is beautiful all the time and I'll be happy to see those nice young men in their clean white coats..." But we also romanticize madness. By calling it madness instead of sickness-the word madness has a melodramatic, Roderick Usher sort of sound to it. Usher, in the Poe's "The Fall of the House of Usher," spoke of being hypersensitive to sounds and impressions, his consciousness constantly under bombardment until he was driven to madness -- he was Poe's Poster Boy for the overwhelmed, the anxiety-raddled, and even now he could symbolize our dysfunctional relationship with our media, our technology and frantic lifestyle addictions; our ravening hunger for input that'll keep us one step ahead of having to live with ourselves...until we overload from it like modern Roderick Ushers. Sometimes kids can't deal with all the input -- and maybe with the toxins we've let them ingest, and the low-attention settings we've given them through our media conditioning -- and they are perceived to have Attention Deficient Disorder. Some of them really have something of the sort. But do the enormous numbers of kids who get a powerful amphetamine-related medication really have the disorder? Are those vast numbers of kids genuinely, definitely, truly in need of drugs like Ritalin, which permanently alter their neurological makeup? And is it a coincidence that Ritalin vastly enriches the pharmaceutical industry, an industry which makes, no exaggeration, twice the profits of other Fortune 500 companies? One day a few years ago we were suddenly confronted with mechanical voices on the telephone, menus and automated responses, press one if you want a recording to explain about this, press two if you want a recording to explain about that, and having pressed three, press four if you want an explanation of the explanation. You literally had to go through a maze to talk to the phone company about a problem with the phone -- and it's that way with most businesses now. Suddenly there was a new technology that was part of our lives and nobody asked us if we wanted it there. It was another maze to go through besides the mazes of streets and personal conflicts. Maybe there are too many tons of Just Too Much loaded on people. More and more people are flipping out and killing their wives and children -- a rash of people killing their children lately -- or blowing people away at work, or getting addicted to Oxycontin or Xanax or learning to lean on the panoply of antidepressants advertised on television as if they were skin creams or hair products. Everyone is Roderick Usher sometimes. We love the drama, the romance of madness-as opposed to mental illness. We love to imagine tortured artists wrenching the pearl of their genius from the tortured oyster of their suffering: Van Gogh half mad and all genius, never understood or appreciated. We all feel inadequately understood and under appreciated. We romanticize insanity or we ridicule it -- or we put it in the room where we keep the objects of our pity, a chamber we rarely enter, we toss some coinage through the door and dutifully look through the window at times, at the raving icon of human isolation on the street, the homeless and insane. Sure, it's understandable: we can only carry so much burden. So we compartmentalize life and people and ourselves to make it easier. And in that compartmentalization we methodically build mazes and then we complain we're lost in a maze. This is the society that thinks Celebrity Boxing is normal and...funny. 2. Sicker-Than-Ever Society? Now hear this, an estimated 22.1 percent of Americans ages 18 or older suffer from diagnosable mental disorder in a given year -- and that's not just someone who's a little troubled and neurotic and goes to a therapist. I'm not counting myself. In 1998 that was 44.3 million Americans. Four of the ten leading causes of disabilities in the United States are mental disorders -- major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder. Many people suffer from more than one of those at a time. For the multiply-stricken, life can truly be a bitch-a hag, a harridan riding your shoulders and tearing at your skull with a serrated beak. About 18.8 million Americans have a depressive disorder. That's almost ten per cent of the adult population. Nearly twice as many women as men are affected by a depressive order each year. Why, because they have to live with American men? That's 12.4 million American women. Depressive disorders seem to be appearing earlier in life in people born in recent decades. Clinical depression often co-occurs with anxiety disorders and substance abuse -- and with substance abuse, clinical depression only gets worse, since narcotics damage the brain's ability to make mood regulators, endorphins, and serotonin. Whatever the cause, "Major depressive disorder" is the leading cause of disability in the USA and established market economies, worldwide. Bipolar disorder affects approximately 2 point three million American adults or about one point two per cent of the us population age 18 and older in a given year. Men and women are equally likely to develop bipolar disorder. In 1997 30,535 people -- that we're sure of -- died of suicide in the USA. It's probably more than that. More than 90 percent of people who kill themselves have a mental disorder or a substance abuse disorder. The suicide rate in young people increased dramatically over the last few decades. In 1997 suicide was the third leading cause of death among 15 to 24 year olds. Four times as many men than women commit suicide -- but women attempt suicide two to three times as often as men. (Ladies -- was it drama all along or was it inefficiency? Cut to the chase and see a therapist.) Approximately two point two million American adults -- apparently a lot of them attracted to San Francisco -- are schizophrenic. Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder and phobias. About 19 million Americans (13%) have diagnosable anxiety disorder. Many people have more than one anxiety disorder. Not all of them know it -- they just think they really need to drink a case of beer and watch six hours of television a night. Women are twice as likely to have an anxiety disorder, post-traumatic stress, generalized anxiety, agoraphobia and specific phobias. Of course those specific statistics don't point out that at least some of that -- especially post-traumatic stress -- probably does come to women after they've been abused by men: raped, beaten, or psychologically raped and beaten. Others are just neurologically prone to anxiety -- and there are imponderable causes having to do with the fact that, generalize as we might, every person is exquisitely individualized, having their own individual experiences from the moment of birth. It stuns me to look at a big crowd anywhere and think that each person-- if you could turn time backward for them and follow along -- would follow an individual path through millions of experiences in millions of places, each one with their unique joy and suffering and misunderstanding and understanding; each person in a kind of winding tunnel of personal experience. Try psychoanalyzing that vast accumulation of experience; try finding clear psychological causation in thousands of miles of experiential tunnel. About two point four million people have panic disorder... which often leads to agoraphobia. About three point three million Americans have OCD: Obsessive-compulsive disorder. Five point two million Americans have some form of serious post-traumatic stress disorder, usually after personal assaults such as rape, vicious muggings, parental abuse, or encounters with terrorism -- as in Oklahoma City, as in the 9/11 attacks -- or due to natural disasters, car accidents, and so forth. And the above statistics don't even venture into the terrifying world of Alzheimer's patients. So besides all the depressives grazing on Prozac (I used to be one), and all the children getting their attention spans chemically tweaked, we have this huge population of people with mental disorders. We raise money and we get help for all kinds of charities and sufferers -- but when did anyone last do a "walk for the mentally ill"? It might happen, but not very often. Maybe because we can't bear to imagine all that unjust suffering, we somehow cling to the idea that in someway mentally ill people have brought it on themselves. Not all mentally ill people are always just victims -- many of them may indeed collaborate with their own diseases, or succumb when they could fight. But that's easy for us to say. Those of us who don't hear voices in the electric toothbrush, don't go for days without sleeping because of fear of what'll get them when they sleep. For the most part the mentally ill, and not just the ones on the street, are the abandoned-and it's easier for us to assume that there's nothing we can do to help and in some obscure way it's all their karma. Notoriously -- most readers will know this -- this is the one major industrialized nation with laughably inadequate socially-provided health care and that goes big-time for mental health care. If little is done for the uninsured poor with physical problems even less is done for the uninsured poor with mental problems. And what is done is under funded, hackneyed, saddled with uneducated health care workers who don't care because they're not paid enough to care -- I don't mean the doctors and nurses; I mean, for example, the generic "mental health workers" now found in mental hospitals. It used to be that assistants to doctors and nurses in mental hospital, so-called Psychological Technicians, or "psych techs", had to be well trained -- but they're being replaced by the untrained. To save money, asylums and hospices for the elderly stricken with Alzheimer's are now allowed to use people employed at minimum wage, workers who are untrained or barely trained. These sullen drudges resent what they're paid -- or what they're not paid -- and act out on their resentment by doing as little as possible. You get what you pay for in health care too, and at that rate of pay you tend to get people who can't get another job for a reason. That might be partly why at least one of San Francisco's mental hospitals for the uninsured has a high incidence of mental health care workers making deals with patients for sex -- usually the currency is cigarettes. And why that same hospital has a high incidence of mental health workers raping patients, and mental health workers stealing jewelry from patients. (Alzheimer's patients, by the way, routinely have jewelry stolen from them by minimum wage workers in nursing homes). Yes and this policy may be a large part of the reason that mental patients and Alzheimer's patients are often left in restraints unnecessarily so that they soil themselves and develop bedsores. Unsupervised, they hurt one another or commit suicide. 3. Racism, Poverty and Mental Health Racial and religious-minority groups are egregiously under-served by the mental health care system. A constellation of barriers deters minorities from seeking treatment. Language and cultural barriers make them unlikely to get treatment that meets their needs. Because the system is shaped by research on white middle class populations, mentally ill minority groups experience the mental health system as the product of white, European culture. Hispanic and Vietnamese and Cambodian people have problems complicated by their history. How many white mental patients had to escape the Killing Fields or napalm -- or life in the inner city ghetto? In some traditional societies mental health problems are viewed as spiritual concerns. Traditional religious authorities are not heard to say, "You don't need me as much as you need to see a psychiatrist." Sometimes having religion helps with stress, makes you less prone to breaking down, gives you a free support system -- but if you have a major mental illness, there's not a hell of a lot your religion can do for you. It might even add to your delusions with talk of demonic spirits. African-Americans are statistically less likely to voluntarily seek outpatient therapy. Besides cost issues and the stigmas associated with the mentally ill, the short reason is they just don't trust us. No more explanation is necessary -- except for why we don't do more to do outreach to provide reassurance and outpatient help in the black community. The overall mental health of Native Americans has barely been studied. What is apparent is that psychological illness is generally higher among Indians than the rest of the population -- alcohol abuse, which, of course, is self-medication, is especially prevalent and suicide occurs at alarmingly high levels. Lower economic status has been strongly linked to mental illness -- the poor are two-and-a-half times more likely to suffer from serious psychological problems. Poor women experience more physical danger from men. And of course the poor have less access to health care so they have less access to therapy and medication -- so things are more likely to get more seriously out of control. Meanwhile a wealthy matron in Beverly Hills pops another Xanax and wonders how some little woman in Texas can go mad and kill her five children. The poor are also more likely to be exposed to major environmental toxins. The refineries that keep breaking down and leaking are, many of them, snuggled right up against low-income communities. I stayed at a cheap motel once, in the San Fernando Valley, a block from the Budweiser brewing factory. This place put out some major fumes, sulfur dioxide probably among them, that burned the eyes and hurt my lungs -- and I was there only overnight. The factory is right smack in the middle of housing for the poor. They live with those burning eyes and aching lungs, and whatever neurological effects the pollution from the place may generate. Last time the EPA worked it out, almost two billion pounds of randomly mixed chemicals were dumped into our nation's water systems. In that same year two-and-a-half-billion pounds of chemicals were released into the atmosphere; with the total chemical attack on the environment estimated at almost six billion pounds. This is only in one year. Seventy thousand -- that's 70,000 -- chemicals in commercial use today have not been tested for neurotoxic effects. Known neurotoxins that we are most commonly exposed to -- these are not from that 70,000 group -- are lead, mercury, cadmium, and pesticides. Most of these toxins are colorless and odorless, making sensory detection impossible. Round Up and other herbicides are being quietly phased out after years of vast public use because we're just now finding they cause serious brain damage in children. The symptoms of those kinds of poisoning may come on slowly due to a gradual build up. The kid gets weirder and weirder and weirder and then one day... Here is just a partial list of common early subclinical symptoms of toxicity from toxins we routinely allow in our air and water: fatigue, lethargy, depression, headaches, allergies, chronic infection, nervousness, sudden anger, memory loss, and paralysis. Notice how many of these symptoms involve behavior. Mental illness is more prevalent than ever -- how much of it is because we're routinely poisoning ourselves? 4. Are Paranoids Right? If you know any seriously paranoid or bipolar people, you know that they may often fear that they are being poisoned. The irony is of course that they are being poisoned, though usually not as much as they think- And yet sometimes they are being poisoned almost as badly as they fear. Look at the Erin Brockovich case -- whole neighborhoods were genuinely being poisoned by smiling friendly people from Pacific Gas & Electric. The PG & E people were oozingly sweet when they dealt with that community and they knew they were exposing them to toxins and some of the PG & E employees knew they were doing real damage -- and they just covered it up. Same goes with the Monsanto case in Aniston. In both cases, the paranoid were right. Paranoids are afraid of medication -- because they think it's poison. The irony is double edged. Anti-psychotic medication is somewhat toxic -- there are no medications for schizophrenia or related diseases that aren't rife with nasty side effects. At the same time, most seriously affected schizophrenics and bipolars are even sicker without the medication. Despite its bad side effects, it does make it possible for them to live somewhat rationally in the bizarre civilization we've created. Yet they can see it's giving them permanent tremors and difficulty thinking; they find it makes them drool or lose control of their limbs at times. People have died from not-so-very-large doses of the anti-psychotic drug Haldol. So the paranoids are trapped -- they're trapped between their own fantasy and the reality of the necessity of taking the stuff that in turn feeds their fantasy by poisoning them for real. This is a nightmarish dilemma to be stuck in. Medication is sometimes badly selected -- people vary neurologically, but the same group of medications are given for most mental patients. Doctors don't want to take the time to be specific. If the patient feels the medication is making her sicker than it is helping him, and is resistant, the doctor or nurse or psych tech assumes the patient is just being paranoid. And they might be -- and yet they might be right! That is their real dilemma, the cognitive dissonance they live every day. Paranoids are afraid they're being spied on. Sometimes people are being spied on -- I get e-mail and phone calls from people who seem to know what my consumer patterns are, what I've bought recently, what insurance I don't already have, because marketing groups routinely sell information that should be private. Of course reality is notoriously subjective. And notoriously there were many powerful, effective people, like Abraham Lincoln, who suffered from "melancholia," or mental illnesses of various kinds. Louis Ferdinand Celine was compulsively anti-Semitic -- it was a sickness, not an ideology -- and he was one of the best writers of the early 20th century. Some of Coleridge's best writing emitted from states that are almost undistinguishable from schizophrenic hallucination. People talk about how this or that public policy is crazy, is insane. Surely it is insane, indeed, to knowingly dump 6 billion pounds of toxins into our food chain. To allow the destruction of forestland and the ocean life that creates the very oxygen we breathe. We still put arsenic and mercury and lead in the air. We take insane risks with nuclear power plants -- risks so notoriously high that no insurance company will insure the plants. And these things seem like madness. At the end of Bridge On The River Kwai the British commander kills t o protect the bridge he worked so hard to build and then deliberately blows up the bridge he killed to protect -- and as he does this the doctor says, "Madness...madness...madness..." When I was watching the Gulf War on television, just like an action-based television show about aerial combat, I was caught up in it -- I am opposed to any but the most absolutely necessary wars, but found myself really digging it when those smart bombs zipped from my country -- by extension from me -- to blow people up in that cross-hair marked building. I enjoyed it -- and I was opposed to it, both at once. I was insanely self contradictory -- but then I was just taking part in the collective mass hypnosis. We as a species are far more prone to mass unified behavior than we know. How else to explain what made the Khmer Rouge do what it did? How else to explain the Holocaust and whole towns in the American south partying around lynchings? How else to explain the lunacy of the McCarthy era? How else to explain Jonestown? We have a gift for dehumanizing human beings in our minds and making a sort of mass ritual of it -- and that is a form of insanity. What is insanity? Among other things, it's the idea that we're immune to consequences. A madman thinks he's invulnerable -- at times when he's not being paranoid, as our Sane Leaders were in the McCarthy era. We think we can dump billions of pounds of toxins into ourselves -- and not have one in three people come down with cancer and one in five with a psychiatric disorder. We are insane as a society. We are far more asleep, more automatic, more mechanistic in our reactions, our behavior than we know -- and that is something psychiatry diagnoses as disassociation. What if, as a society, we're far crazier than we realize? What if -- and that includes this magazine's hipster readership, each with his or her own set of conditioned psychological reflexes and insanely overblown vanities -- what if we're all truly -- not figuratively, but truly -- insane? We happen to be insane in a way that's functional, like a heroin addict who gets enough dope so he doesn't start screaming and manages to get through his day. But he knows his addiction in insanity. We're functional -- but insane. Maybe we really should have more sympathy for the guy who talks to the air in the subway station. Maybe we should commit more resources to help ourselves. * * * (First published in The Thresher, Issue 2, 2002)

by * » Thu Mar 16, 2006 7:51 am

<a href="http://www.lipmagazine.org/articles/feattalvi_141_p.html">link</a> A Mad, Mad Nation: Mental Illness and the Drugging of Rebellious Tendencies Interview by Silja J. A. Talvi 10.29.01 We are, for all of our phenomenal accomplishments, a nation in psychic pain. Mental illness looms everywhere, forming a debilitating and destructive backdrop to our fast-paced, materialistic American lives. Depression, anxiety and Attention-Deficit Disorder (ADD)—and the medications to "treat" them—are so commonplace that they warrant their own prime-time commercials and full-page, glossy advertisements. The long list of mental disorders grows longer, year by year. Depression has grown tenfold since 1900. Half of Americans, we are told according to a 1999 U.S. Surgeon General's report, will experience a mental disorder at least once in a lifetime. More than 16% of Americans are believed to have anxiety disorders. At least five million Americans are on Ritalin or similar drugs. And where there is suffering, it seems, there is profit to be made. With roughly one in four American adults now on psychiatric medications, the parent companies of the best-selling prescription drugs—Prozac™ (Eli Lilly), Zoloft™ (Pfizer), and Paxil™ (GlaxoSmithKline) among them—are raking in the rewards of both large-scale emotional anguish and aggressive pharmaceutical marketing campaigns. In his new book, Commonsense Rebellion: Debunking Psychiatry, Confronting Society, author and clinical psychologist Bruce E. Levine tackles the prevalence of psychiatric disorders—and the tide of prescription drugs prescribed for those disorders—head-on. Our societal emphasis on viewing mental disorders as diseases akin to diabetes or cancer is not only deeply flawed, Levine argues, but dangerously diversionary. He insists that the real issues underlying rising levels of mental suffering in our country have much more to do with omnipresent and deeply warped societal expectations than the psychiatric industry would care to admit. He frames such "illnesses" themselves as rebellion against what he calls an "increasingly impersonal and coercive institutional society." Levine finds fundamental flaws in the ways that we treat those among us who grapple with mental suffering, pressuring them to return to "normal." Indeed, he describes the normalcy to which we are all are expected to acclimate as a dulling void of disconnectedness and dehumanization: a place of alienation from work, of mass living, of suburban detachment and urban anonymity, of false and misleading "democracy" and of creativity-sapping commercialism. He is quick to point out that the many American men and women who feel they have been helped by mood-lifting pharmaceutical drugs are not wrong for seeking relief, but argues that those medications—used to treat any number of different disorders—are not what they seem. Commonsense Rebellion reaches for solutions as much as it offers criticism, presenting, in the process, a glimmer of the world of possibilities both inside and outside the existing social framework. In this interview with LiP, Levine shares his perspectives on rehumanizing our society and weaning ourselves from harmful notions about mental disorders. One of the primary themes in Commonsense Rebellion is your contention that our high national rates of mental illness in the US are, in fact, natural reactions to the rapid growth of what you term an "institutional society," and that this society has created so much discontent and disconnection that many of us are actually breaking down because of it. Tell me more about that. [Drug companies have marketed] the idea of biochemical brain imbalances. But if you just [employ] simple common sense, you don't have to know anything about genetics or biochemistry…just take a look at 30 years ago: we have twice as many overweight children now compared with then; we have a tripling of suicide rates of teen boys compared to the 1960s and a quadrupling compared to the 1950s. So, simply, there's something going on here that isn't just genetic or biochemical. There's something going on here with our society. People need to understand that, yes, we're in the wealthiest society by far in the history of the world, but in order to achieve that wealth, efficiency, productivity and consumerism, we become one-dimensional. And we have sacrificed virtually all of the things that human beings need to stay alive. [What happens] when you become industrialized, institutionalized…you lose any kind of self-criticism. That's what we've done. And there are dramatic effects that you can see. You note throughout your book that no biochemical, neurological or genetic markers have been found for ADD, depression, schizophrenia, anxiety, alcoholism, gambling, or any other mental illnesses we can think of. Does this mean that these mental illnesses simply don't exist? Or that we need to start thinking about them differently? That is the core question. Here's the problem. [From] a purely scientific view, there has been no biochemical evidence that there are these imbalances. When the right wing hears someone criticizing psychiatry, they get all excited. They want to hear that everybody's doing all right, and that this is much ado about nothing. I tell these guys, "Wrong, you got an estimated 750,000 people a year trying to kill themselves. You got over 2,000 a day. There is something going on out there." The question is, what do we call it? The problem in our society is that nobody gives a damn about anybody until they have an illness. Then they have to care about them. Prior to 1980, there was no such thing as "Post Traumatic Stress Disorder". All these guys come back from Vietnam, abused and used and exploited by this country, and they're in bad shape. There's no doubt about the fact that they're having all these kinds of strange symptoms. They're having nightmares; they're isolating themselves. At first, the right wing is going, "to heck with them, they're being sissies, there's nothing to worry about." Typical liberals are going, "No, these guys are really hurting here, we have to do something." But the only way we can do something for them is to declare them mentally ill and come up with this diagnosis of PTSD so we can treat them. Let's forget about the fact of how the hell they got that way. Was it helpful, ultimately, to medicalize their condition that way? What does that do in the long term? The problem is is that what ends up happening in a pharmaceutical-dominated industry is that as soon as you medicalize [a condition], it becomes something to drug. So, for example, in 1999, Zoloft was officially declared as treatment for PTSD. And now, kids who are bored in school and then get diagnosed with ADD, they're going be put on Ritalin or other amphetamines. So, what good have you done here by medicalizing? Certainly, [we've] made pharmaceutical companies incredibly wealthy. Prozac in the year 2000 made over $2.5 billion dollars a year, which is more than Coors grosses. I think what people have to understand is that there are huge incentives for these multibillion dollar, multinational pharmaceutical companies to have these conditions medicalized. Then, down the food chain, you have your psychiatrists, psychologists and social workers who certainly make a living out of [so-called "syndromes"] being medicalized. There are huge incentives to see more and more human conditions and problems as illnesses. In some sense, everybody wins, except for the fact that what ultimately happens here is not just that we have a lot of silly diagnoses. [The worst] problem is not even the fact that a lot of these drugs are highly dangerous and ineffective…or that pharmaceutical companies have utterly corrupted the industry. The major problem, for me, is that what we've done with this huge expansion of the business and medicalizing of all of our difficulties has diverted us from examining a society that has grown increasingly dehumanizing. Doesn't medication actually play any kind of a useful purpose in, for instance, helping severely depressed people or suicidal people through self-destructive periods in their lives? First of all, they don't do research on these anti-depressants, including the SSRIs like Prozac, Paxil, Zoloft, on suicidal people. For a lot of reasons, including ethical [ones]..So there's absolutely no scientific evidence that any of these things will help anybody from being less suicidal, and there's a lot of anecdotal evidence and a lot of lawsuits out there that have said that these things have pushed them over the top and [actually made people] more suicidal. There's the case, in June, of the Wyoming jury that awarded $8 million in damages to the family of a man who killed his wife, daughter, and granddaughter before committing suicide. They determined that Paxil caused him to go over the edge. Right. There's no evidence that any of these drugs are effective with suicidal people. So, am I just saying that I want drug prohibition here? For me, again, another core issue of Commonsense Rebellion is that what I want to do is help people to get rid of hypocrisy about drugs in America. The marketing of the pharmaceutical companies is to get people to think that these things are medicine akin to insulin. That's a great marketing move. For me, if you understand what these medicines are, comparing them to insulin is comparing apples to oranges. If you want to compare apples to apples, compare these psychiatric drugs to illicit drugs For example, let's start with Ritalin. The ADD drugs...are classified by the DEA as Schedule II psycho-stimulants. That means that they have highest potential for abuse and addiction, but also have some medical potential. All of those drugs affect the neurotransmitters: dopamine, norepinephrine, serotonin, What other drug out there is a Schedule II psycho-stimulant that affects those same neurotransmitters? Cocaine. Exactly. The World Health Organization, 30 years ago compared cocaine to these kinds of drugs. None of these things that I'm talking about, really, should be shocking. People have written this stuff for a long time…you just don't hear about it. I'm interested in what happened with Prozac being repackaged as Sarafem.™. I began noticing those commercials a while back and thinking: "Why have I never heard of this syndrome, premenstrual dysphoric disorder (PMDD) before?" So, Sarafem is just repackaged Prozac, isn't it? How do they get away with inventing a syndrome for the sake of repackaging a drug? The DSM IV (shorthand for the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders) has about 400 different diagnoses. PMDD is in the appendix, so it has not quite made the big 400. It's one of the "up and coming" stars. I'm sure it will be in the next one. It's just straight-out marketing. They realized it was smarter, if they wanted to market to women, to go with pink and lavender colored pills, and Sarafem was a nice, feminine name, so they repackaged Prozac, which is fluoxitine chloride. Do you have a sense as to how successful their marketing campaign has been? Are women out there deciding that they have PMDD and asking for Sarafem? My sense anecdotally is that it's been a fantastically effective campaign. Women are going to the doctor and saying they're having these kinds of problems. Especially when they're going to see their doctor in their HMO, and have [about] 10 minutes with them, what I hear back from women is that they're told, "Well why don't you think about Sarafem?" Explain the "rebellion" component of your book title. What I believe is that a lot of what people call mental illness and disease now are kinds of rebellions against what's around them. What people need to understand when they take a look at others doing self-destructive drinking or not paying attention in their classroom is that there's a kind of rebellion. That if you really pay attention to these people and get to know what they're all about, they're angry, resentful about something going on around them. What a lot of people have done over the ages, and you see this both politically and psychologically, is [have] their rebellion without wisdom. Their rebellion becomes self-destructive. A lot of what people do, without help, good parenting, good teaching, good counseling, is [rebel irrationally], without thought. And then they make life worse for themselves and everybody around them. What I do, clinically—and what I argue for in the book—is try to understand and assume that there's a reason ... for why someone is angry, depressed [or] bitter. What you are supposed to be doing as a counselor, teacher or parent, is [to] help folks move into a more constructive kind of rebellion…as opposed to what we do in our culture, our society, and certainly within the mental health business, which is to try to squash rebellion. And worse than that, not even identify it as such. The ultimate invalidation is to look at some kid who is refusing to pay attention or behave well, and not respect that there's something by way of rebellion and resistance going on there, and then to medicalize it and then to drug it. [It's] no accident that the greatest growth in diagnoses and in our population of people on drugs [have to do with] kids and teenagers. One of the reasons is that there's more and more pressure on kids to conform and comply. The thing that most embarrasses me about my business is that I'm utterly convinced that all of this will be obvious to people down the road—especially kids who have gone through it—that there was a kind of rebellion going on and it was squashed by biochemical means. But the thing is, it won't ultimately work. It won't. As we know, lots of these teen shooters have been on these psychiatric drugs. Things won't work the way they want them to work. These drugs are short-term, and they get folks to be a little bit more compliant in the short-term, but in the long-term—like all of the attempts to control people—you produce resentment and resistance and even more anger. And God knows what kind of horrific behavior is going to be happening more and more down the road. You refer to yourself, in one of the chapters of the book, as a "dissident shrink," and you allude to similarly-minded patients' rights groups and dissident professional organizations that have sprung up around the country. What, exactly, does it mean to be a dissident shrink? Is it an easy place for you to be in?EzCode Parsing Error:] That's a great question. I would say, for me, emotionally, given how embarrassed I've been about what's happened to this field in the last decade especially, it's about one of the few terms I could use to describe myself that feels OK. When I first heard about folks using that term about five years ago, my initial reaction was, "Calling yourself a dissident is kind of elevating yourself." But then when I thought about it some more, what you're basically saying is that you're dissenting with the mainstream view, the vast majority of psychiatrists and now, more and more psychologists, who [believe that] if people are not adapting, they either need to be drugged or behaviorally manipulated. There's absolutely no attention paid to the fact that there are some severe problems going on in society... [The psychiatric profession doesn't] care about the fundamental dehumanizing parts of our industrialized order of things at all. And therefore, what they're [encouraging is something] like what Howard Zinn refers to in A People's History of the United States as "the coming revolt of the guards." If [teachers and psychologists] only help people adapt to a kind of dehumanized social order, they're nothing more than guards. That's why it's so important for  People...are hearing that we've become this wonderfully high-tech society and that there are all these wonderful jobs in computer technology and biotechnology. But the reality is that the four leading jobs through the year 2005, as projected by the US Department of Labor, are cashiers, janitors, retail sales clerks, and waiters/waitresses. Prison guards are way up there, too. How is that happening? You've got the "Wal-Martization" of society...You've got a culture taking people out of mom-and-pop independent jobs. When a Wal-Mart comes to town, it's estimated that 100 mom and pop stores go under. All of these folks now get to work as retail clerks and cashiers and that sort of thing. But what happens is that the quality of jobs in America are now devoid of a lot of things they had before when they weren't making much money. A hundred years ago, you had many people busting their butts farming and working [who] didn't have that much money. But they had some degree of autonomy, some control over their lives. [There was] community among fellow farmers, and a feeling of usefulness. They could solve problems on a regular basis, and their life had meaning. They were always learning new things. There were all these wonderful human things going on. Today, you hear from the International Center of Technologies that 80% of Americans find their jobs meaningless. A lot of these people are clients of mine who work, who have six-figure incomes. We're not just talking about clerks and waitresses. We're talking about folks at the highest levels of society who are basically doing something they have no respect for and they find utterly useless. You've got teachers out there spending half of their year teaching to these damn proficiency exams. You've got people working in managed care HMOs, and they know the whole thing is one big silly bureaucratic game. You've got people in all aspects of society working those kinds of jobs. If you don't think that has much of an impact on mental health, then [you] don't know human beings. I'm intrigued, in particular, by your chapter on "Mass Society." Mass living, as you point out, is a relatively recent event in human history. What, if anything, can we do to avoid the suffering and alienation that you're talking about in the context of our lives in a mass society? The first thing that people have to do is to understand that when you're in these kinds of mass living environments, they do have all these negative impacts. So the first thing is not to pathologize your anxiety and depression and anger. The first thing to do is to understand that it's probably pretty legitimate. The second thing to do is to try to navigate these systems [so as] to have as little mass living as possible. So, what the heck does that mean? You can refuse to shop in Wal-Mart or shop there as little as possible. Not for moral or political reasons, but just for psychological reasons. When you go into an owner-operated store that sells things that Wal-Mart does, maybe you'll pay a bit more...but what's going to happen there? There's a chance that you're going to make friends with that owner, and you'll feel good about keeping your money there in your community. That owner-operator will know what you do for a living, and he's maybe going to turn other customers onto what you're all about...There are all kinds of ways that good things can happen when you're in a kind of human-scale environment. Many people make their living working for corporations and big companies. Is there truly a choice where this kind of thing is concerned? Yes and no ... I think it is unrealistic to believe that you can totally extricate [yourself]. You can do a little, but mainly, what you're doing is finding people out there who are like you and thinking about things like that In the year 2001, life is all about keeping the light of what it means to be a human being alive. Keep the torch of it alive. If your goal is not just to change society, but to have a more human life for yourself and your family and your friends—and you're thinking and acting locally, thinking interpersonally, and caring some about global [issues]—you're going to have a chance at a lot of successes. You'll be able to pull off some satisfying things, You're going to be able to pull off a LiP Magazine, for example ... It just warms my heart to know about you guys and see what you're about. What you guys are is "commonsense rebellion." For me, that's the only way that you're going to keep the torch of humanity alive. And at some point in time, with all of these kinds of examples out there, if more and more of society happens to go that way, that's great. But if you're focusing on changing things at the kind of grand political level of national elections and stuff, you're going to eventually become cynical, helpless and hopeless. That's my clinical psychological approach. I've seen it happen in too many people. Do you have words of optimism and encouragement for people suffering with psychological pain? How might they go about finding this sort of path you're describing? What I've found from my patients over the last 16 years is that the people who I see who are depressed and anxious are a lot of the most likable people I know. To me, it usually indicates that their soul is still intact. They're capable of feeling hurt, loss, pain—they haven't utterly anesthetized themselves like a lot of society. Take a look: one out of four people are on psychiatric drugs. So, the first thing is, feel good about yourself that you're human enough to still feel hurt, anxiety and pain. The second thing is, forgive yourself for probably doing a hell of a lot of stupid things with that—self-destructive things, unkind, selfish things to yourself and others. The third thing is that once you understand that there are good reasons for why you're feeling the way you are, you want to move into finding a way to transform your life. That can be a real, satisfying, lifelong project. Partially, what you start to understand is that you [need to] develop, in your life, a community of people who are like you, a community of people who really dig you. People who, when you see them and they see you, are really excited. [If] they're interested in who you are, and you're interested in who they are, then at that point in time, you're starting to create a more human life for yourself. ** embeded links at the original (though not all of them are still working)

by **slimmouse** » Thu Mar 16, 2006 12:19 pm

If you indeed are the author of the first post, then please accept my profoundest apologies for any misunderstandings between us. Yet more food for my mind.

by **thoughtographer** » Thu Mar 16, 2006 1:53 pm

I am not John Shirley, though I think he has a few interesting points. You should check out his <a href="http://johnshirley.net/DesktopDefault.aspx">blog</a> sometime.

John Shirley: Mental State of the Union

John Shirley: Mental State of the Union

Re: John Shirley: Mental State of the Union

Thoughtographer.

Re: Thoughtographer.

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