The case against psychiatry

The Case Against Psychiatry Why Psychiatry is Evil and Must Be Abolished Wayne Ramsay, J.D. Preface

The Case Against Psychiatry began as notes I wrote after attending the annual Mood Disorders Symposium at Johns Hopkins University in 1988. During the following days, months, and years I repeatedly re-read those notes, added ideas as they occurred to me, and read many books and articles about psychiatry. In the process I attended the Mood Disorders Symposiums at Johns Hopkins in 1989, 1990, 1991, 1992, 1993, and 1994, as well as other programs. Over time my notes became a large unpublished manuscript. In the 1990s I published excerpts from that manuscript as pamphlets using the pseudonym or pen name Lawrence Stevens. This book is updated and expanded versions of those pamphlets and four additional essays: The Myth of Psychiatric Diagnosis, Why the Myth of Mental Illness Lives On, Why Psychiatry is Evil, and The Future of Anti-Psychiatry Activism.

In these essays I have assembled the most credible witnesses against psychiatry I could find.

I am therefore as much an editor as an author. In every case where I can remember the source of facts or an idea I have given the writer or speaker credit. This approach enabled me to write a more convincing and compelling case against psychiatry than would have been possible by simply stating my personal opinions.

In recommended reading or videos at the end of some essays I have listed books, articles, and videos, all of which I have read or watched in their entirety, on the subject of the essay, and web sites I recommend, for readers who wish to learn more. _____________________________________________________ "[M]odern psychiatry has no rational or scientific basis." - Dr. Niall ("Jock") McLaren, an Australian psychiatrist, in his YouTube.com video, "DSM-5: Critical Review - Part 1" 2011) at 0:22 "I have sworn upon the altar of god eternal hostility against every form of tyranny over the mind of man." -Thomas Jefferson, September 23, 1800 _____________________________________________________ Contents

Does Mental Illness Exist?

Schizophrenia: A Nonexistent Disease The Myth of Biological Depression The Myth of Psychiatric Diagnosis Why the Myth of Mental Illness Lives On

Psychiatric Drugs: Cure or Quackery? (HTML) Psychiatric Drugs: Cure or Quackery? (PDF booklet) Psychiatry’s Electroconvulsive Shock Treatment: A Crime Against Humanity The Brain Butchery Called Psychosurgery The Case Against Psychotherapy Unjustified Psychiatric Commitment in the U.S.A. Is Involuntary Commitment for “Mental Illness” or “Dangerousness” a Violation of Substantive Due Process?

Why Psychiatry Should Be Abolished as a Medical Specialty Suicide: A Civil Right Psychiatric Stigma Follows You Wherever You Go for the Rest of Your Life Why Psychiatry is Evil The Future of Anti-Psychiatry Activism copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

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Does Mental Illness Exist?

Wayne Ramsay, J.D. "mental disease...The very term is itself nonsensical, a semantic mistake. The two words cannot go together except metaphorically; you can no more have a mental 'disease' than you can have a purple idea or a wise space." Psychiatrist E. Fuller Torrey, M.D., in his book The Death of Psychiatry (Penguin Books 1974), p. 36 "As I have stated in an earlier chapter, in the natural world there is no such thing as mental disease or defect, but rather certain patterns of behavior to which, in a given social context, we apply certain names which enable us to talk about and to effect certain changes in the social relationships of those who exhibit them and to effect changes in the individuals themselves. At best, we are left to the imposition of purely arbitrary criteria in selecting such persons." Psychiatrist Philip Q. Roche, M.D., winner of the American Psychiatric Association's Isaac Ray Award for outstanding contributions to forensic psychiatry and the psychiatric aspects of jurisprudence, in his book The Criminal Mind (Farrar, Straus and Cudahy 1958), p. 253

"... we have argued, the existence of a disease of mental illness has never been established ... together we've amassed over seventy-five years of teaching mental health courses in graduate schools of social work to thousands of students and practitioners ... after more than ten decades of determined research and the expenditure of untold sums, no one can verify that madness is a medical disease. ... There is, of course, the unpredictable but remote possibility that the psychiatric system produces it's 'Gorbachev,' a widely acknowledged leader and spokesperson who says plainly and loudly that the emperor has no clothes, that while many people could use help for their distress or have their disturbance contained to preserve our peace of mind, there is no mental illness." Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., & David Cohen, Ph.D., in their book Mad Science—Psychiatric Coersion, Diagnosis, and Drugs (Transaction Publishers 2013), pp. 195, 301, 302, 328 (emphasis in original) "Nobody should be diagnosed with mental illness." Paula J. Caplan, Ph.D., a psychologist, in her "Diagnosisgate" presentation at the annual conference of the National Association for Rights Protection and Advocacy (narpa.org) in Washington, D.C., August 23, 2015

All diagnosis and treatment in psychiatry presupposes the existence of something called mental illness, mental disease, or mental disorder. What is meant by disease, illness, or disorder? In a semantic sense disease means simply dis-ease, the opposite of ease. But by disease we don't mean anything that causes a lack of ease, since this definition would mean losing one's job or a war or economic recession or an argument with one's spouse qualifies as "disease". In his book Is Alcoholism Hereditary? psychiatrist Donald W. Goodwin, M.D., discusses the definition of disease and concludes "Diseases are something people see doctors for. ... Physicians are consulted about the problem of alcoholism and therefore alcoholism becomes, by this definition, a disease" (Ballantine Books 1988, p. 61). Accepting this definition, if for some reason people consulted physicians about how to get the economy out of recession or how to solve a disagreement with one's mate or a bordering nation, these problems would also qualify as "disease". But everybody knows this is not what we mean when we use the word disease. In his discussion of the definition of disease, Dr. Goodwin acknowledges there is "a narrow definition of disease that requires the presence of a biological abnormality" (Id). In his book Psychiatry— The Science of Lies (Syracuse University Press 2008, p. 33), psychiatry professor Thomas Szasz, M.D., says "Disease is an abnormal condition of the body, impairing its function." Dr. Szasz's definition of disease is consistent with the definition in Dorland's Illustrated Medical Dictionary, 32nd Edition (Elsevier Sanders 2012). Dorland's is the most highly respected medical dictionary in existence. Dorland's defines "illness" with a single word: "disease" (p. 914) and defines disease as follows (p. 527): dis.ease (dĭ-zēz) [Fr. dès from + aise ease] any deviation from or interruption of the normal structure or function of a part, organ, or system of the body as manifested by characteristic symptoms and signs; the etiology, pathology, and prognosis may be known or unknown. [underline added] By this definition, if no abnormality of the body can be found, no disease or illness can be known to exist. Unproved theories about etiology, pathology and prognosis are speculation. In this essay and those that follow, I will show there are no known biological or bodily abnormalities causing so-called mental illness or mental disease and that therefore they have not been proved to exist. Equally importantly, I will show so-called mental illness, disease, or disorder does not exist in even a non-

biological sense other than as a way of expressing disapproval of some aspect of a person's behavior or thinking.

The term "disorder" is often incorrectly used interchangeably with illness or disease. In January 2012 I had a conversation with a "board-certified behavior analyst", a type of mental health professional separate from psychiatry, psychology, counselling, and social work I had not heard of before. (See the Behavior Analyst Certification Board web site, bacb.com.) She told me she was employed full-time working with autistic children in a public school. When I questioned the reality of autism as a disease, she replied, "It's not a disease. It's a disorder." In Lecture 13 of his "Medical Myths, Lies, and HalfTruths" course (available on DVD at thegreatcourses.com), Steven Novella, M.D., a neurology professor at Yale School of Medicine, provides these definitions: The core myth of this lecture is that all diagnoses are the same and are equally valid, when the truth is that we arrive at these labels in very different ways.

For example, there are some diagnoses which we would call a disease, a disease like diabetes, which is a pathological disorder where we can identify that there is something specific malfunctioning in some specific part of the body that is leading directly to these signs and symptoms that make up the diagnosis.

We also may use the term "disorder". Now a disorder does not necessarily have any pathological change in any cells, but there is some problem with functioning that is identifiable. So an example of a disorder would be attention deficit and hyperactivity disorder.

Versus a syndrome: A syndrome is a list of signs and symptoms that tend to occur together.

The usual terms in psychiatry are illness and disorder. An introductory section of the American Psychiatric Association's most recent Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition published in 2013 (DSM-5), under the headline "Definition of a Mental Disorder" says "A mental disorder is a syndrome..." (p. 20). As Dr. Novella suggests, a diagnosis of "disorder" or "syndrome" is not as valid as diagnosis of a disease or illness because of the lack of a known biological cause or etiology.

The same definitions of disease (synonymous with illness) and disorder are given by Gwen Olsen, a former pharmaceutical manufacturer sales representative, in her YouTube.com video "Pharma Not in Business of Health, Healing, Cures, Wellness" (at the 5 minute, 48 second point): We need to be aware of what the differences are between diseases, between disorders, and between syndromes. Because if it doesn't have to be scientifically proven, if there are no tests, if there are no blood tests, CAT scans, urine tests, MRIs, if there is nothing to document that you have a disease, then you in fact do not have a disease: You have a disorder, and it has been given and has been diagnosed pretentiously.

Whether called an illness, disease, disorder, or syndrome, the reason responsibility for management, treatment, elimination, or cure is given to physicians (rather than for example police, clergy, psychologists, educators, or magicians) is belief in a biological cause.

The idea of mental illness, disease, disorder, or syndrome as a biological entity is easy to refute: In his book The Death of Psychiatry (Penguin Books 1974, pp. 38-39), psychiatrist E. Fuller Torrey, M.D., wrote "None of the conditions that we now call mental 'diseases' have any known

structural or functional changes in the brain which have been verified as causal." In his book The New Psychiatry, Columbia University psychiatry professor, Jerrold S. Maxmen, M.D., says "It is generally unrecognized that psychiatrists are the only medical specialists who treat disorders that, by definition, have no definitively known causes or cures. ... A diagnosis should indicate the cause of a mental disorder, but as discussed later, since the etiologies of most mental disorders are unknown, current diagnostic systems can't reflect them" (Mentor 1985, pp. 19 & 36, italics in original). In 1988, Seymour S. Kety, M.D., Professor Emeritus of Neuroscience in Psychiatry, and Steven Matthysse, Ph.D., Associate Professor of Psychobiology, both of Harvard Medical School, said "an impartial reading of the recent literature does not provide the hoped-for clarification of the catecholamine hypotheses, nor does compelling evidence emerge for other biological differences that may characterize the brains of patients with mental disease" (The New Harvard Guide to Psychiatry, Harvard University Press, p. 148). In 1992 a panel of experts assembled by the U.S. Congress Office of Technology Assessment concluded: "Many questions remain about the biology of mental disorders. In fact, research has yet to identify specific biological causes for any of these disorders. ... Mental disorders are classified on the basis of symptoms because there are as yet no biological markers or laboratory tests for them" (The Biology of Mental Disorders, U.S. Gov't Printing Office 1992, pp. 13-14, 46-47). In a December 1996 Psychiatric Times article, "Commentary: Against Biologic Psychiatry", psychiatrist David Kaiser, M.D., says "modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness." In his book The Essential Guide to Psychiatric Drugs, Columbia University psychiatry professor Jack M. Gorman, M.D., says "We really do not know what causes any psychiatric illness" (St. Martin's Press 1997, p. 314). In his book Blaming the Brain —The Truth About Drugs and Mental Health (Free Press 1998, p. 125), Elliot S. Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, says: "Contrary to what is often claimed, no biochemical, anatomical, or functional signs have been found that reliably distinguish the brains of mental patients." According to neurologist Fred Baughman, M.D., (Insight magazine, June 28, 1999, p. 13) "there is no scientific data to confirm any mental illness." In their textbook Neurobiology of Mental Illness (Dennis S. Charney, M.D. et al., Oxford Univ. Press 1999, p. vii), three psychiatry professors at Yale University School of Medicine say "We have so far failed to identify bona fide psychiatric disease genes or to delineate the precise etiological and pathophysiological basis of mental disorders." In his book Prozac Backlash (Simon & Schuster 2000, pp. 192-193), Joseph Glenmullen, M.D., clinical instructor in psychiatry at Harvard Medical School, says "In medicine, strict criteria exist for calling a condition a disease. In addition to a predictable cluster of symptoms, the cause of the symptoms or some understanding of their physiology must be established. ... Psychiatry is unique among medical specialties in that... We do not yet have proof either of the cause or the physiology for any psychiatric diagnosis." In his book Commonsense Rebellion: Debunking Psychiatry, Confronting Society (Continuum 2001, p. 277), psychologist Bruce E. Levine, Ph.D., says "no biochemical, neurological, or genetic markers have been found for attention deficit disorder, oppositional defiant disorder, depression, schizophrenia, anxiety, compulsive alcohol and drug abuse, overeating, gambling, or any other so-called mental illness, disease, or disorder." Allen Frances, M.D., chairperson of the DSM-IV Task Force (the committee that created the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (1994) and DSM-IV-TR (2000), criticizing the proposed Fifth Edition of this book scheduled for publication in May 2013, notes that "not even 1 biological test is ready for inclusion in the criteria sets for DSM-V" ("A Warning Sign on the

Road to DSM-V", psychiatrictimes.com, June 26, 2009). In his book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, HarperCollins 2013, pp. 10, 11, 244), Dr. Frances says "The powerful new tools of molecular biology, genetics, and imaging have not yet led to laboratory tests for dementia or depression or schizophrenia or bipolar or obsessive-compulsive disorder or for any other mental disorders ... We still do not have a single laboratory test in psychiatry. ...thousands of studies on hundreds of putative biological markers [for mental illness] have so far come up empty." In 2011, Hagop Akiskal, M.D., Professor of Psychiatry at the University of California at San Diego, acknowledged that "Despite the diligent search for biomarkers for the so-called functional mental disorders during the past 100 years, nothing specific has emerged" ("Biomarkers for Mental Disorders: A Field Whose Time Has Come", psychiatrictimes.com, November 18, 2011). In 2012, Connecticut psychiatrist Simon Sobo, M.D., acknowledged "We haven't yet discovered the etiology of any DSM-IV diagnosis" ("Does Evidence-Based Medicine Discourage Richer Assessment of Psychopathology and Treatment?" psychiatrictimes.com, April 5, 2012). In a lecture at the University of New England on February 25, 2013, British psychiatrist Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., said "There is just absolutely no evidence that anyone with any mental disorder has a chemical imbalance of any sort...absolutely none" ("Joanna Moncrieff—The Myth of the Chemical Cure; The Politics of Psychiatric Drug Treatment", YouTube.com, at 53:52). In 1991 in his book Toxic Psychiatry, psychiatrist Peter Breggin, M.D., said "there is no evidence that any of the common psychological or psychiatric disorders have a genetic or biological component" (St. Martin's Press, p. 291). 24 years later, on the Coast-to-Coast AM radio show on February 9, 2015, Dr. Breggin said "There is no known physical connection to any psychiatric disorder. There is no genetically determined cause. It's all drug company propaganda, because the pharmaceutical industry with its billions of [advertising] dollars, and the medical industry, thinks you're more likely to take drugs if you think you have a genetic or biological disease."

So if mental illnesses, mental diseases, or mental disorders or syndromes must have a biological etiology or cause to qualify as illness, disease, disorder, or syndrome, none have been proved to exist.

What has happened is this: Biologically normal people can perform or engage in a very wide range of thinking and behavior, only a narrow portion of which is acceptable to people in any given society. People, including psychiatrists, assume without proof that any thinking or behavior outside what is socially acceptable in any particular society must be caused by a biological abnormality. This unfounded assumption results in people who think or do things others dislike being thought to have biological problems when in fact they have none. When you falsely blame biological abnormality for behavior or thinking you dislike, you have created the myth of mental illness.

It is sometimes argued that psychiatric drugs "curing" (stopping) the thinking, emotions, or behavior that is called mental illness, disease, disorder, or syndrome proves the existence of biological causes of these supposed illnesses, disorders, or syndromes. Referring to psychiatric drugs, a psychologist once said to me "If the cure is biochemical, the cause must be biochemical." This argument is nonsense for two reasons: First, aside from placebo effect, psychiatric drugs don't work, as I explain in Psychiatric Drugs: Cure or Quackery? Second, stopping anything a person is doing by giving him a toxic, disabling drug proves nothing pathological about the behavior you are trying to stop: Suppose someone was playing the piano and you didn't like him doing that. Suppose you forced or persuaded him to take a drug that

disabled him so severely that he couldn't play the piano anymore. Would this prove his piano playing was a disorder or was caused by a biological abnormality or illness that was treated or cured by the drug? Most if not all psychiatric drugs are neurotoxic, producing a greater or lesser degree of general neurological disability. So they do stop disliked behavior and may mentally disable a person enough he can no longer feel angry or unhappy or "depressed". But this approach is destructive because it wipes out as much good as bad in a person's thinking, emotions, and behavior. Calling it a "treatment" or "cure" is absurd. Extrapolating from this that the drug must have cured an underlying biological abnormality that was causing the disliked emotions or behavior is equally absurd.

When confronted with the lack of evidence for their belief in mental illness, disease, disorder or syndrome as a biological entity, some defenders of the concept of mental illness or disorder, etc., will assert that mental illness or disorder can exist and can be defined as a "disease" (or illness or disorder) without there being a biological abnormality causing it. The idea of mental disease, illness, disorder, or syndrome as a nonbiological entity requires a more lengthy refutation than the biological argument.

People are thought of as mentally ill or disordered only when their thinking, emotions, or behavior is contrary to what is considered acceptable, that is, when others (or the so-called patients themselves) dislike something about them. One way to show the absurdity of calling something a disease, illness, disorder, or syndrome not because it is caused by a biological abnormality but only because we dislike it or disapprove of it is to look at how values differ from one culture to another and how values change over time.

In his book The Psychology of Self-Esteem, Nathaniel Branden, Ph.D., a psychologist, wrote: One of the prime tasks of the science of psychology is to provide definitions of mental health and mental illness. ...But there is no general agreement among psychologists and psychiatrists about the nature of mental health or mental illness—no generally accepted definitions, no basic standard by which to gauge one psychological state or other. Many writers declare that no objective definitions and standards can be established—that a basic, universally applicable concept of mental health is impossible. They assert that, since behavior which is regarded as healthy or normal in one culture may be regarded as neurotic or aberrated in another, all criteria are a matter of "cultural bias." The theorists who maintain this position usually insist that the closest one can come to a definition of mental health is: conformity to cultural norms. Thus, they declare that a man is psychologically healthy to the extent that he is "welladjusted" to his culture. ... The obvious questions that such a definition raises, are: What if the values and norms of a given society are irrational? Can mental health consist of being well-adjusted to the irrational? What about Nazi Germany, for instance? Is a cheerful servant of the Nazi state — who feels serenely and happily at home in his social environment — an exponent of mental health? [Bantam Books 1969, pp. 9596, italics in original]

Dr. Branden is doing several things here: First, he is confusing morality and rationality, saying that respect for human rights is rational when in fact it is not a question of rationality but rather of morality. So psychologically and emotionally locked into and blinded by his values is he that Dr. Branden is evidently incapable of seeing the difference. Additionally, Dr. Branden is stating some of his values. Among these values are: Respect for human rights is good; violation of human rights (like Naziism) is bad. And he is saying: Violating these values is "irrationality" or mental illness. Although their practitioners won't admit it and often are not even aware of it, psychiatry and "clinical" psychology in their very essence are about values—values concealed

under a veneer of language that makes it sound like they are not furthering values but promoting "health". The answer to the question Dr. Branden poses is this: A person living in Nazi Germany and well-adjusted to it was "mentally healthy" judged by the values of his own society. Judged by the values of a society in which human rights are respected, he was as sick (metaphorically speaking) as the rest of his culture. A person like myself however says such a person is morally "sick" and recognizes that the word sick has not its literal but a metaphorical meaning. To a person like Dr. Branden who believes in the myth of mental illness, such a person is literally sick and needs a doctor. The difference is a person like myself is recognizing my values for what they are: morality. Typically, the believer in mental illness, such as Dr. Branden in this quoted passage, has the same values as I do but is confusing them with health.

One of the most revealing examples is homosexuality, which was officially defined as a mental disorder by the American Psychiatric Association until 1973 but hasn't been since then, although some psychiatrists continued to think of homosexuality as a psychological or psychiatric abnormality or disorder for many years after that, and perhaps some still do. For example, "Even Robert Spitzer, M.D., the chief developer of DSM-III and called by some the psychiatrist of our time, recommended reparative psychotherapy for homosexuality in 2003" (H. Steven Moffic, M.D., "How to End a Psychiatric Epidemic: The Redemption of Psychiatry", psychiatrictimes.com, June 11, 2012). Homosexuality was defined as a mental disorder, a "Sexual deviation", on page 44 of the American Psychiatric Association's standard reference book, DSMII: Diagnostic and Statistical Manual of Mental Disorders (the 2nd Edition), published in 1968. In 1973 the American Psychiatric Association voted to remove homosexuality from its official categories of mental disorder. (See "An Instant Cure", Time magazine, April 1, 1974, p. 45). So when the third edition of this book was published in 1980 it said "homosexuality itself is not considered a mental disorder" (p. 282). The 1987 edition of The Merck Manual of Diagnosis and Therapy states: "The American Psychiatric Association no longer considers homosexuality a psychiatric disease" (p. 1495; note the confusion of "disorder" with "disease"). If mental illness were really an illness in the same sense that physical diseases are, the idea of deleting homosexuality or anything else from the categories of illness by having a vote would be as absurd as a group of physicians voting to delete cancer or measles from the concept of disease. The fact that mental disorders can be created or eliminated by having a vote shows they are more like criminal laws than diseases. Mental illness isn't "an illness like any other illness" because, unlike physical disease where there are physical facts to deal with, mental "illness" or "disorder" cannot be demonstrated to exist by reference to anything physical.

Unlike physical disease, mental illness or disorder is entirely a question of values, of right and wrong, of appropriate versus inappropriate. At one time homosexuality seemed so weird and hard to understand it was necessary to invoke the concept of mental disease, illness, or disorder to explain it. After homosexuals successfully demanded tolerance of their type of sexuality, it was no longer necessary and no longer seemed appropriate to explain homosexuality as a mental illness or mental disorder. In 2003 the highest court of Massachusetts ruled in favor of a right under the state constitution for homosexuals to marry a person of the same gender (Goodridge v. Department of Public Health, 798 NE2d 941). Later the highest courts of California (In re Marriage Cases, 183 P3d 384), Connecticut (Kerrigan v. Commissioner of Public Health, 957 A2d 407), and Iowa (Varnum v. Brien, 763 NW2d 862) did also. Elected officials as high as U.S. President Barack Obama, a Democrat, criticized people who discriminate against or have negative attitudes towards homosexuals, as did many speakers at the 2012 Democratic Party Convention. The 2012 Democratic Party Platform says "We support

marriage equality and support the movement to secure equal treatment under law for same-sex couples." On November 6, 2012 a majority of voters approved same-sex marriage by referendum in the states of Maryland, Maine, and Washington, the first time homosexual marriage was authorized by general election voters rather than by courts or state legislatures.

On June 26, 2015, the U.S. Supreme Court, by a 5 to 4 vote, ruled states are required by the Equal Protection Clause of the Fourteenth Amendment to issue marriage licenses to and recognize marriages between same-sex couples. In the span of a few decades, homosexuality went from being a mental illness or disorder to being a celebrated cause. Not coincidentally, the theories about biological abnormalities causing homosexuality I used to hear are no longer heard. As will become more apparent as we look at more examples, cultural values rather than biology define what is and is not a mental disorder.

Biological abnormalities are no more responsible for today's so-called mental illnesses than they are, or were, for homosexuality. Even if biological abnormalities were or are responsible for homosexuality and other supposed mental disorders, we wouldn't call them illnesses or disorders if we accepted those differences. The defining characteristic of a mental disorder is simply disapproval. _________________________________________________

THE DEFINING CHARACTERISTIC OF MENTAL DISORDER IS SIMPLY DISAPPROVAL _________________________________________________ Homosexuality is not the only mental illness or disorder abolished by psychiatric fiat: Neurosis, once thought a common problem, was abolished with the publication of DSM-III in 1980. DSM-III's Introduction (p. 9) says the concept of neurosis was abolished in part because "there is no consensus in our field as to how to define 'neurosis.'"

Being too active as a heterosexual has also been considered a form of mental illness or disorder. In a June 19, 2012 Psychiatric Times article, "History of Psychiatry—Hypersexual Disorder: An Encounter With Don Juan in the Archives", psychiatrictimes.com, Greg Eghigian, Ph.D., says that "Don-Juanism, or Don Juan syndrome, was indeed a recognized diagnosis that referred to forms of male hypersexuality. In history, it was most commonly known as satyriasis."

He quotes physician Michael Ryan who in 1839 said— Satyriasis and nymphomania are diseases in which the sufferers evince an irresistible desire for copulation, as well as abuse of the reproductive functions. The first disease attacks the male, the second the female. M.Deslandes is of opinion, and I fully agree with him, that there is no real difference between these diseases and unbridled masturbation; and that both ought to be considered species of insanity.

Contrast this 19th Century view of insanity, or what is now usually called mental illness, with that of the late 20th Century after attitudes about sexuality had changed: The 1970s and 1980s saw the birth of a new psychiatric "diagnosis" which is called by various names. One of the more popular terms for this new mental or psychiatric disease is ISD. These three letters stand for Inhibited Sexual Desire. A Reader's Digest article in 1989 says "Psychiatrists and psychologists say that lack of sexual desire—commonly called Inhibited Sexual Desire (ISD)— has emerged as the most common of all sexual complaints." The article says research on ISD is insufficient because "ISD ... was identified as a clinical entity only in the past decade." The

article refers to people who have this problem as "ISD patients" (David Gelman, "Not Tonight Dear", Reader's Digest, June 1989, p. 33 at 33-34. See also: Dr. Jennifer Knopf and Dr. Michael Seiler, ISD—Inhibited Sexual Desire, Warner Books 1990). ISD was officially recognized as a mental illness or disorder for the first time in the third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), published in 1980. It appeared in DSM-III's "Psychosexual Disorders" chapter as "Inhibited Sexual Desire" (p. 278) and "Inhibited Sexual Excitement" which the Manual says "has also been termed frigidity or impotence" (p. 279). This supposed disorder was carried forward into DSM-III-R (1987) as "Hypoactive Sexual Desire Disorder" wherein it is defined as "Persistently or recurrently deficient or absent sexual fantasies and desire for sexual activity" (p. 293) and into DSM-IV-TR (published in 2000, pp. 539-541) under the same name and DSM-5 (published in 2013) as "Male Hypoactive Sexual Desire Disorder" (p. 440) and "Female Sexual Interest/Arousal Disorder" (p. 433).

The above 1839 reference to "unbridled masturbation...that...ought to be considered [a] species of insanity", can be contrasted with attitudes about masturbation today. An article in a popular women's magazine in 1989 says "Many doctors and therapists acknowledge that masturbation can improve both your physical health and your mental outlook" (Beverly Whipple and Gina Ogden, "Learning To Be Your Own Best (Sexual) Friend", Cosmopolitan magazine, September 1989, p. 122). As psychiatry professor Thomas S. Szasz, M.D., says in his book The Second Sin (Doubleday 1973, p. 10): "Masturbation: the primary sexual activity of mankind. In the nineteenth century, it was a disease; in the twentieth, it's a cure."

At one time racism was common and accepted by most people as normal, but after racist attitudes were rejected, "those guilty of racism were considered to have a psychological disorder" (according to psychiatrist H. Steven Moffic, M.D., in his article "Psychism: Defining Discrimination of Psychiatry", psychiatrictimes.com, June 4, 2012). At the March 1975 meeting of the American Orthopsychiatric Association, the Association's Committee on Minority Group Children said "Racism is probably the only contagious mental disease" (A. Herndon, "Racism Said to Be America's Chief Mental Health Problem," Psychiatric News, January 21, 1976, pp. 1, 30, cited in Szasz, Schizophrenia, The Sacred Symbol of Psychiatry, pp. 190 & 227). Might racism be caused by a biological abnormality in the brain of a racist? Can mental illnesses be the result of teaching or indoctrination?

A cross-cultural example is suicide. In many countries, such as the United States and Great Britain, a person who commits suicide or attempts to do so or even thinks about it seriously is considered mentally ill. However, this has not always been true throughout human history, nor is it true today in all cultures around the world. In his book Why Suicide?, psychologist Eustace Chesser points out that "Neither Hinduism nor Buddhism have any intrinsic objections to suicide and in some forms of Buddhism self-incineration is believed to confer special merit." He also points out that "The Celts scorned to wait for old age and enfeeblement. They believed that those who committed suicide before their powers waned went to heaven, and those who died of sickness or became senile went to hell—an interesting reversal of Christian doctrine" (Arrow Books Ltd., London, England, 1968, p. 121-122). In his book Fighting Depression, psychiatrist Harvey M. Ross, M.D., points out that "Some cultures expect the wife to throw herself on her husband's funeral pyre" (Larchmont Books 1975, p. 20). Probably the best known example of a society where suicide is socially acceptable is Japan. Rather than thinking of suicide or "harakiri" as the Japanese call it as almost always caused by a mental disease or illness, the Japanese in some circumstances consider suicide the normal, socially acceptable thing to do,

such as when one "loses face" or is humiliated by some sort of failure. Another example showing suicide is considered normal, not crazy, in Japanese eyes is the kamikaze pilots Japan used against the U.S. Navy in World War II. They were given enough fuel for a oneway trip, a suicide mission, to where the attacking U.S. Navy forces were located and deliberately crashed their airplanes into the enemy ships. There has never been an American kamikaze pilot, at least, none officially sponsored by the United States government. The reason for this is different attitudes about suicide in Japan and America. Could suicide be committed only by people with psychiatric illnesses in America and yet be performed by normal persons in Japan? Or is acceptance of suicide in Japan a failure or refusal to recognize the presence of biological or psychological abnormalities which necessarily must be present for a person to voluntarily end his or her own life? Were the kamikaze pilots mentally ill, or did they and the society they come from simply have different values than we do? Even in America, aren't virtually suicidal acts done for the sake of one's fellow soldiers or for one's country during wartime thought of not as insanity but as bravery? As psychologist Edwin S. Shneidman says in his book The Suicidal Mind (Oxford University Press 1996, p. 5), "Some suicidal acts committed by people on what we call 'suicide missions' or who commit aberrant acts of terrorism are, when done by our side (in times of war), honored and rewarded by medals" (italics in original). Why do we think of such persons as heros rather than lunatics? It seems we condemn (or "diagnose") suicidal people as crazy or mentally ill only when they end their own lives for selfish reasons (the "I can't take it any more" kinds of reasons) rather than for the benefit of other people. The real issue seems to be selfishness rather than suicide.

What these examples show is that mental "illness", "disease", "disorder" or "syndrome" is simply deviance from what people want or expect in any particular society at any particular time and is not the result of biological abnormality. Mental "illness" or "disorder" is anything in human mentality greatly disliked by the person describing it. _________________________________________________

BECAUSE PSYCHIATRY ASSUMES BIOLOGICAL PROBLEMS CAUSE "MENTAL DISORDERS", THE PROFESSION IS BUILT AROUND A MISTAKEN PARADIGM _________________________________________________ The situation was aptly summed up in an article in the November 1986 Omni magazine (Gurney Williams III, "Psychofashion", Omni magazine, November 1986, p. 30): Disorders come and go. Even Sigmund Freud's concept of neurosis was dropped in the original DSM-III (1980). And in 1973 APA [American Psychiatric Association] trustees voted to wipe out almost all references to homosexuality as a disorder. Before the vote, being gay was considered a psychiatric problem. After the vote the disorder was relegated to psychiatry's attic. "It's a matter of fashion," says Dr. John Spiegel of Brandeis University, who was president of the APA in 1973, when the debate over homosexuality flared. "And fashions keep changing."

What is wrong with this approach is describing people as having a psychiatric disease, illness, disorder, or syndrome only because he or she doesn't match up with a supposed diagnostician's or with other people's idea of how a person "should" be in standards of dress, behavior, thinking, or opinion.

When a person's behavior violates the rights of others, it must be curbed or stopped with various measures, criminal law being one example. But assuming nonconformity or disliked behavior must be caused by biological abnormality only because it is contrary to currently prevailing values makes no sense.

One reason we do this is we do not know the real reasons for the thinking, emotions, or behavior we dislike. When we don't understand the real reasons, we create myths to provide an explanation. In prior centuries people used myths of evil spirit or demon possession to explain unacceptable thinking or behavior. Today most of us instead believe in the myth of mental illness. Believing in mythological entities such as evil spirits or mental illnesses gives an illusion of understanding, and believing a myth is more comfortable than acknowledging ignorance.

Because psychiatry is based on the assumption biological abnormality causes what is thought of as mental illness or disorder, the profession is predicated upon a mistaken paradigm. As psychiatry professor Thomas Szasz says in his book The Second Sin (Anchor Press 1973, p. 99), trying to eliminate a mental illness by having a psychiatrist work on your brain is like trying eliminate cigarette commercials from television by having a TV repairman work on your TV set. Biological "treatments" make no sense if the problem is not biological, and psychiatry has utterly and completely failed to prove what it "treats" is the result of biological abnormality. Looking for biological causes of "mental disorders" is like looking for electronic causes of bad television programs. _________________________________________________

LOOKING FOR BIOLOGICAL CAUSES OF MENTAL DISORDERS IS LIKE LOOKING FOR ELECTRONIC CAUSES OF BAD TELEVISION PROGRAMS _________________________________________________ Calling disapproved thinking, emotions, or behavior a mental illness or disorder might be excusable if mental illness was a useful myth, but it isn't, because an incorrectly diagnosed problem usually leads to counterproductive solutions. Rather than helping us deal with troubled or troublesome persons, the myth of mental illness distracts us from the real problems that need to be faced. Rather than being caused by a "chemical imbalance" or other biological problem, the nonconformity, misbehavior, and emotional reactions we call mental illness, disease, disorder, or syndrome are the result of difficulties people have getting their needs met and the behavior some people have learned during their lifetimes.

The solutions are teaching people how to get their needs met, how to behave, and using whatever powers of enforcement are needed to force people to respect the rights of others. These are the tasks of education and law enforcement, not medicine or therapy.

Recommended Reading

Thomas S. Szasz, M.D., The Myth of Mental Illness (Dell Pub. Co. 1961) Thomas S. Szasz, M.D., The Second Sin (Anchor Press 1973) E. Fuller Torrey, M.D., The Death of Psychiatry (hardcover: Chilton Book Co./paperback: Penguin Books, Inc. 1974)

Recommended Video

Stefan Molyneux, "There Is No Such Thing as Mental Illness", YouTube.com.

copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "SCHIZOPHRENIA: A Nonexistent Disease" ]

Schizophrenia A Nonexistent Disease Wayne Ramsay, J.D. "Another element which further muddles the scene is the way in which the term 'schizophrenia' has come to be used, especially in the United States and Soviet Union. Some professionals will label as 'schizophrenic' virtually anyone who looks cross-eyed or wears different color socks. Labels like 'borderline schizophrenic,' 'latent schizophrenic, 'pseudoneurotic schizophrenic' are used. As such the term has become almost meaningless and its demise, along with that of psychiatry itself, will be a welcome addition to the clarity of thought. ... The term 'schizophrenia' will wither away to the shelves of museums, looked back upon as an historical curiosity along with the crank telephone." — Psychiatrist E. Fuller Torrey, M.D., in his book The Death of Psychiatry (Penguin Books 1974, p. 160), before he began promoting the concept of schizophrenia

The word "schizophrenia" has a scientific sound that seems to give it inherent credibility and a charisma that seems to dazzle people. In his book Molecules of the Mind—The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin calls schizophrenia and depression "the two classic forms of mental illness" (Dell Publishing Co. 1987, p. 119). According to the cover article in the July 6, 1992 Time magazine, schizophrenia is the "most devilish of mental illnesses" (p. 53). This Time magazine article says "fully a quarter of the nation's hospital beds are occupied by schizophrenia patients" (p. 55). Books and articles like these and the facts to which they refer (such as a quarter of hospital beds being occupied by so-called schizophrenics) delude most people into believing there really is a disease called schizophrenia. Schizophrenia is one of the great myths of our time.

In his book Schizophrenia—The Sacred Symbol of Psychiatry, psychiatry professor Thomas S. Szasz, M.D., says "There is, in short, no such thing as schizophrenia" (Syracuse University Press 1988, p. 191). In the Epilogue of their book Schizophrenia—Medical Diagnosis or Moral Verdict?, Theodore R. Sarbin, Ph.D., a psychology professor at the University of California at Santa Cruz who spent three years working in mental hospitals, and James C. Mancuso, Ph.D., a psychology professor at the State University of New York at Albany, say: "We have come to the end of our journey. Among other things, we have tried to establish that the schizophrenia model

of unwanted conduct lacks credibility. The analysis directs us ineluctably to the conclusion that schizophrenia is a myth" (Pergamon Press 1980, p. 221). In his book Against Therapy, published in 1988, Jeffrey Masson, Ph.D., a psychoanalyst, says "There is a heightened awareness of the dangers inherent in labeling somebody with a disease category like schizophrenia, and many people are beginning to realize that there is no such entity" (Atheneum, p. 2). In 2011, Richard P. Bentall, Professor of Clinical Psychology at the University of Bangor in Wales (UK), said "Nobody in the academic, I mean hardly anybody, in academic psychiatry believes in the concept of schizophrenia now. It's pretty much on its way out. ... It is virtually useless. It is like star signs." ("Is there value in a psychiatric diagnosis?", YouTube.com at 1:26). In 2012 in his book Rethinking Madness (Sky's Edge, p. 17) psychologist Paris Williams, Ph.D., says "the diagnosis of schizophrenia is highly controversial. Despite over a century of intensive research, no biological markers or physiological tests that can be used to diagnose schizophrenia have been found, its etiology continues to be uncertain, and we don't even have clear evidence that the concept of schizophrenia is a valid construct."

Rather than being a bonafide disease, schizophrenia is a nonspecific term that designates almost anything and everything a human being can do, think, or feel that is greatly disliked by other people or by the so-called schizophrenics themselves. There are few socalled mental illnesses that have not at one time or another been called schizophrenia. Because schizophrenia is a term that covers just about everything a person can think or do which people greatly dislike, it is hard to define objectively. Typically, definitions of schizophrenia are vague or inconsistent with each other. For example, when I asked a physician who was the Assistant Superintendent of a state mental hospital to define the term schizophrenia for me, he with all seriousness replied "split personality—that's the most popular definition." In contrast, a pamphlet published by the National Alliance for the Mentally Ill titled "What Is Schizophrenia?" says "Schizophrenia is not a split personality". In her book Schiz-o-phre-nia: Straight Talk for Family and Friends, published in 1985, Maryellen Walsh says "Schizophrenia is one of the most misunderstood diseases on the planet. Most people think that it means having a split personality. Most people are wrong. Schizophrenia is not a splitting of the personality into multiple parts" (Warner Books p. 41). The American Psychiatric Association's (APA's) Diagnostic and Statistical Manual of Mental Disorders (Second Edition), also known as DSM-II, published in 1968, defined schizophrenia as "characteristic disturbances of thinking, mood, or behavior" (p. 33). A difficulty with such a definition is it is so broad just about anything people dislike or consider abnormal, i.e., any socalled mental illness, can fit within it. In the Foreword to DSM-II, Ernest M. Gruenberg, M.D., D.P.H., Chairman of the American Psychiatric Association's Committee on Nomenclature and Statistics, says "Consider, for example, the mental disorder labeled in the Manual as 'schizophrenia,' ... Even if it had tried, the Committee could not establish agreement about what this disorder is" (p. ix). The third edition of the APA's Diagnostic and Statistical Manual of Mental Disorders, published in 1980, commonly called DSMIII, is also quite candid about the vagueness of the term. It says "The limits of the concept of Schizophrenia are unclear" (p. 181). The revision published in 1987, DSMIIIR, contains a similar statement: "It should be noted that no single feature is invariably present or seen only in Schizophrenia" (p. 188). DSMIII-R also says this about a related (so-called) diagnosis, Schizoaffective Disorder: "The term Schizoaffective Disorder has been used in many different ways since it was first introduced as a subtype of Schizophrenia, and represents one of the most confusing and controversial concepts in psychiatric nosology" (p. 208).

In the November 10, 1988 issue of Nature, genetic researcher Eric S. Lander of Harvard

University and M.I.T. summarized the situation this way: "The late US Supreme Court Justice Potter Stewart declared in a celebrated obscenity case that, although he could not rigorously define pornography, 'I know it when I see it.' Psychiatrists are in much the same position concerning the diagnosis of schizophrenia. Some 80 years after the term was coined to describe a devastating condition involving a mental split among the functions of thought, emotion and behaviour, there remains no universally accepted definition of schizophrenia" (p. 105).

In his book Surviving Schizophrenia, published in 1988, psychiatrist E. Fuller Torrey, M.D., says so-called schizophrenia includes several widely divergent personality types. Included among them are paranoid schizophrenics, who have "delusions and/or hallucinations" that are either "persecutory" or "grandiose"; hebephrenic schizophrenics, in whom "well-developed delusions are usually absent"; catatonic schizophrenics who tend to be characterized by "posturing, rigidity, stupor, and often mutism" or, in other words, sitting around in a motionless, nonreactive state (in contrast to paranoid schizophrenics who tend to be suspicious and jumpy); and simple schizophrenics, who exhibit a "loss of interest and initiative" like the catatonic schizophrenics (though not as severe) and unlike the paranoid schizophrenics have an "absence of delusions or hallucinations" (p. 77). The 1968 edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-II, indicates a person who is very happy (experiences "pronounced elation") may be defined as schizophrenic for this reason ("Schizophrenia, schizo-affective type, excited") or very unhappy ("Schizophrenia, schizo-affective type, depressed")(p. 35), and the 1987 edition, DSM-III-R, indicates a person can be "diagnosed" as schizophrenic because he displays neither happiness nor sadness ("no signs of affective expression", p. 189), which Dr. Torrey in his book calls simple schizophrenia ("blunting of emotions", p. 77). According to psychiatry professor Jonas Robitscher, J.D., M.D., in his book The Powers of Psychiatry, people who cycle back and forth between happiness and sadness, the so-called manic-depressives or suffers of "bipolar mood disorder", may also be called schizophrenic: "Many cases that are diagnosed as schizophrenia in the United States would be diagnosed as manic-depressive illness in England or Western Europe" (Houghton Mifflin 1980, p. 165.) So the supposed "symptoms" or defining characteristics of "schizophrenia", at least in the last half of the 20th Century, were broad indeed, defining people as having some kind of schizophrenia because they have delusions or do not, hallucinate or do not, are jumpy or catatonic, are happy, sad, or neither happy nor sad, or cycling back and forth between happiness and sadness. Since no physical causes of "schizophrenia" have been found, as I explain later in this essay, this "disease" can be defined only in terms of its "symptoms", which as I have shown are what might be called ubiquitous. As attorney Bruce Ennis said in 1972 in his book Prisoners of Psychiatry: "schizophrenia is such an all-inclusive term and covers such a large range of behavior that there are few people who could not, at one time or another, be considered schizophrenic" (Harcourt Brace Jovanovich, Inc., p. 22). People who are obsessed with certain thoughts or who feel compelled to perform certain behaviors, such as washing their hands repeatedly, are usually considered to be suffering from a psychiatric problem distinct from schizophrenia called "obsessive-compulsive disorder". However, people with obsessive thoughts or compulsive behaviors have also been called schizophrenic (e.g., by Dr. Torrey in his book Surviving Schizophrenia, pp. 115-116).

Because mental illness, particularly serious mental illness, is thought by most people to have biological or chemical causes, and because schizophrenia is considered the worst of all supposed mental illnesses, what the various editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders say about physical, biological, or organic causes of

schizophrenia is ironic and revealing: The first page of the chapter titled "Schizophrenic Disorders" in the third edition, DSM-III (1980), says a diagnosis of schizophrenia is appropriate only if "The disturbance is not due to Affective Disorder or Organic Mental Disorder" (p. 181).

DSM-III defines "Organic Mental Disorders" as follows: "The essential feature of all these [organic mental] disorders is a psychological or behavioral abnormality associated with transient or permanent dysfunction of the brain" (p. 101). So by saying a diagnosis of schizophrenia is appropriate only if "The disturbance is not due to Affective Disorder or Organic Mental Disorder", DSM-III is defining schizophrenia as non-organic and as not caused by transient or permanent dysfunction of the brain. The next edition of this book, called the Third EditionRevised (DSM-III-R), published in 1987, says a diagnosis of schizophrenia "is made only when it cannot be established that an organic factor initiated and maintained the disturbance" (DSM-IIIR, p. 187). Underscoring this definition of "schizophrenia" as non-organic, or non-biological, and hence non-medical, is the 1987 edition of The Merck Manual of Diagnosis and Therapy, which says a (so-called) diagnosis of schizophrenia is made only when the behavior in question is "not due to organic mental disorder" (p. 1532).

Defining schizophrenia as being diagnosable "only when it cannot be established that an organic factor initiated and maintained the disturbance" (DSM-III-R) or as "not due to organic mental disorder" (Merck Manual of Diagnosis and Therapy, 1987) is inconsistent with the idea of schizophrenia as a disease, which creates difficulty justifying using drugs as a treatment for it, which is standard practice in psychiatry, including when the so-called schizophrenic refuses and must be forced to take supposedly antipsychotic drugs, either by threat of imprisonment in a mental hospital if he refuses, or with brute force by psychiatric personnel, typically by injection, if he refuses while "hospitalized", and sometimes with brute force by "Assisted" (Assaultive?)

Community Treatment (ACT) teams who come to people's homes to administer injections against the patient's will in his or her own home. It may be for this reason DSM-IV, published in 1994, and DSM-IV-TR, published in 2000, do not include as short and easily quoted an exclusion for biologically caused conditions from the definition of schizophrenia as are found in DSM-III and DSM-III-R. However, DSM-IV (1994) and DSM-IV-TR (2000) do include the following exclusion in the "Diagnostic criteria for Schizophrenia" (p. 286 in DSM-IV, p. 312 in DSM-IVTR): E. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

One might wonder: What is a "general" medical condition? Suppose a person has a bacterial or viral infection of the brain causing encephalitis (swelling of the brain) or brain cancer or a stroke? Would that be a "general" medical condition? No, that would be a specific medical condition (or to be semantically more precise, a specific health or biological condition or disease). DSM-IV (p. 165) and DSM-IV-TR (p. 181) both say "The term general medical condition refers to conditions that are coded on Axis III and that are listed outside the 'Mental Disorders' chapter of ICD. (See Appendix G for a condensed list of these conditions.)" ICD stands for International Classification of Diseases published by the World Health Organization.

Appendix G of DSM-IV and DSM-IV-TR lists probably every physical disease or biological problem known to occur in humans: Diseases of the Nervous System (e.g., Epilepsy, brain hemorrhage), Diseases of the Circulatory System, Diseases of the Respiratory System, Neoplasms (cancer, including of the brain), Endocrine Diseases, Nutritional Diseases, Metabolic Diseases, Diseases of the Digestive System, Genitourinary System Diseases, Histological

Diseases, Diseases of the Eye, Diseases of the Ear, Nose, and Throat, Musculoskeletal System Diseases and Connective Tissue Diseases, Diseases of the Skin, Congenital Malformation, Deformations, and Chromosomal Abnormalities, Diseases of Pregnancy, Childbirth, and the Puerperium, Infectious Diseases, and Overdose (naming various types of drugs including Hormones and Synthetic Substitutes). In other words, a careful reading of DSM-IV and DSM-IVTR shows these editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders do acknowledge that if it is biologically caused, it is not schizophrenia. DSM-IV-TR (p. 305) also says "No laboratory findings have been identified that are diagnostic of schizophrenia."

This "diagnostic" (actually descriptive) criterion for schizophrenia in DSM-5 might or might not be read as indicating schizophrenia is a medical or biological condition. So for clarification I sent the following e-mail to the American Psychiatric Association and its DSM-5 Task Force (apa@psych.org and dsm5@psych.org): July 18, 2014

To the American Psychiatric Association or the DSM-5 Task Force: Diagnostic Criteria "E" for schizophrenia in DSM-5 (p. 99) is this: E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

This can be understood as meaning either— The disturbance is not attributable to a medical (biological) condition, examples being the physiological effects of a drug of abuse or a medication or The disturbance is not attributable to a medical condition other than schizophrenia, e.g., a substance such as a drug of abuse or a medication.

The former interpretation indicates schizophrenia is not caused by a medical (biological) condition. The latter indicates schizophrenia is a medical (biological) condition. Which is correct?

If the latter is correct, what is the biological (medical) criteria for determining a person has schizophrenia? Page 102 of DSM-5 discusses differences in the brains of people with schizophrenia such as "Reduced overall brain volume", but on the preceding page (page 101) says "Currently, there are no radiological, laboratory, or psychometric tests for the disorder [schizophrenia]." All of the Diagnostic Criteria (on page 99) are behavioral rather than biological.

Respectfully, Wayne Ramsay Perhaps not surprisingly, I received no reply. Psychiatrists cannot admit schizophrenia is not a biological condition without admitting the invalidity of the concept of schizophrenia, which is arguably psychiatry's most well-known and most classic supposed mental illness, or what Dr. Szasz calls "the sacred symbol of psychiatry." At the same time, psychiatrists cannot claim schizophrenia is a medical or biological condition without providing medical or biological criteria, which they cannot do, because nothing of a

biological or medical nature can be found to define exactly what is meant by the term "schizophrenia".

As I document in Psychiatric Drugs—Cure or Quackery? and Psychiatry's Electroconvulsive Shock Treatment—A Crime Against Humanity, the "reduced overall brain volume" and other changes found in the brains in people said to have schizophrenia (or other supposed mental illnesses) are caused by the drugs or electric shock they are given, not their supposed psychiatric disorder or disease.

The non-biological nature of schizophrenia is indirectly admitted in DSM-5 by the fact that none of the criteria for a "diagnosis" of schizophrenia in DSM-5 are organic, biological, medical, or physical in nature. As I said in the above e-mail to the APA and discuss later in this essay, all "Diagnostic Criteria" for schizophrenia in DSM5 (they appear on page 99 of DSM5) are what a person thinks or perceives or how he behaves, and for how long. Nothing in the DSM5 definition of schizophrenia is physical or biological.

Similar to previous editions of the DSM, there are no tests of blood or cerebrospinal fluid, no imaging tests, no physical signs, nor anything else of a physical or biological nature that are "diagnostic" for schizophrenia in DSM-5.

Since schizophrenia is by definition non-organic, at least if one accepts the American Psychiatric Association's definitions and "diagnostic" criteria in the various editions of the DSM, the treatment of schizophrenia with drugs reveals illogical thinking by people who prescribe drugs as treatment for schizophrenia. Giving up "medicine" as a treatment for psychiatry's most famous and well-known "disease" might threaten psychiatrists' identity as doctors of medicine. I believe this is an important reason why psychiatrists continue to prescribe "medication" for "schizophrenia" and other supposed mental illnesses despite the lack of evidence any supposed mental illness is a biological condition, as well as why many psychiatrists continue to insist schizophrenia and other supposed mental illnesses are caused by brain disease despite the non-organic and non-medical definition schizophrenia in the various editions of the DSM and the inability to find anything of a biological nature causing any so-called mental illness.

An example is psychiatrist E. Fuller Torrey, M.D., in his book Surviving Schizophrenia: A Family Manual, published in 1988 when DSM-III-R was still current. You will recall DSM-III-R said schizophrenia may be diagnosed "only when it cannot be established that an organic factor initiated and maintained the disturbance" (DSM-III-R, p. 187). In Surviving Schizophrenia, Dr. Torrey says "Schizophrenia is a brain disease, now definitely known to be such" (Harper & Row, p. 5). But if schizophrenia is a brain disease, it is organic. In Surviving Schizophrenia, Dr. Torrey acknowledges "the prevailing psychoanalytic and family interaction theories of schizophrenia which were prevalent in American psychiatry", which would seem to explain the definition of schizophrenia as non-organic and not biologically caused in DSM-III (1980), DSM-III-R (1987), DSM-IV (1994), and DSM-IV-TR (2000) and at least implicitly in DSM5 (2013).

Today, schizophrenia is usually thought of as a type of psychosis, and non-psychotic schizophrenia would be thought by most mental health professionals an oxymoron, like a "correct error". For example, the Handbook of Clinical Psychopharmacology for Therapists, Sixth Edition, by psychology professor John D. Preston, Psy.D., psychiatrist John H. O'Neal, M.D., and pharmacist Mary C. Talaga, R.Ph., Ph.D. (New Harbinger Publications, Inc. 2010, p. 125), says "Schizophrenia refers to a disorder of longer than six months duration with prominent psychotic symptoms." In his book The Great Psychiatry Scam—One Shrink's Personal Journey (Manitou Communications 2008, p. 243), psychiatrist Colin A. Ross, M.D., says "Schizophrenia is a psychosis." In contrast, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM-II, 1968) includes the diagnosis "295.06

Schizophrenia, simple type, not psychotic" (p. 23). In his book Schizophrenia—Your Questions Answered, Trevor Turner, MBBS, MD, FRCPsych, Consultant Psychiatrist at Homerton Hospital and St. Martholomew's Hospital in London, says "What is 'simple' schizophrenia? This is an uncommon type of schizophrenia in which there is apparently no evidence of delusions, hallucinations or other obviously psychotic features" (Churchill Livingstone 2003, p. 15). DSM-IV-TR, which was the most recent and current DSM prior to the publication of DSM-5 on May 22, 2013, on the first page of the chapter titled "Schizophrenia and Other Psychotic Disorders", says this (p. 297): Despite the fact that these disorders are grouped together in this chapter, it should be understood that psychotic symptoms are not necessarily considered to be core or fundamental features of these disorders ... In fact, a number of studies suggest closer etiological associations between Schizophrenia and other disorders that, by definition, do not present with psychotic symptoms (e.g., Schizotypal Personality Disorder).

The quoted statement appears below and on the same page as the chapter title: "Schizophrenia and Other Psychotic Disorders". A layman definition of "schizophrenic" found in some dictionaries is internally inconsistent or containing contradictory characteristics or qualities. For example, the second of two definitions in the Shorter Oxford English Dictionary on Historical Principles, Fifth edition (Oxford University Press 2002, p. 2694) of "schizophrenic" is "Characterized by mutually contradictory or inconsistent elements, attitudes, etc." By this lay or colloquial definition of schizophrenia, the American Psychiatric Association's definition of schizophrenia in DSM-IV-TR is itself schizophrenic.

So is schizophrenia a type of psychosis, or is it not? The answer is nobody knows.

Reading the "Diagnostic Criteria" for schizophrenia in DSM-IV, DSM-IV-TR, and DSM-5 reveals how arbitrary and convoluted those supposedly diagnostic criteria are. The "diagnostic" (actually descriptive) criteria for schizophrenia in DSM-5 (p. 99) make delusions or hallucinations unnecessary (yes, not necessary) for the "diagnosis", because a person can qualify for a diagnosis of schizophrenia by having "Disorganized speech (e.g., frequent derailment or incoherence)" without either delusions or hallucinations. A person can have delusions or hallucinations (not caused by a substance such as a drug of abuse or a medication) yet still not qualify for a diagnosis of schizophrenia, because under Criteria B the following is also necessary: "For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is a failure to achieve expected level of interpersonal, academic, or occupational functioning.)"

Additionally, under Criteria C the "disturbance" must "persist for at least 6 months". So even if you are seeing huge pink elephants marching through your bedroom (and there really aren't any), you don't meet all the criteria for a "diagnosis" of schizophrenia if your hallucination about huge pink elephants is your only problem, and you are nevertheless doing great in the important aspects of life such as work and personal relationships and self-care, or you meet all the criteria except for the fact that you do so for only 5 months.

In Surviving Schizophrenia, Dr. Torrey quite candidly concedes the impossibility of defining what "schizophrenia" is. He says-

The definitions of most diseases of mankind has been accomplished. ... In almost all diseases there is something which can be seen or measured, and this can be used to define the disease and separate it from nondisease states. Not so with schizophrenia! To date we have no single thing which can be measured and from which we can then say: Yes, that is schizophrenia. Because of this, the definition of the disease is a source of great confusion and debate. [p. 73] What puzzles me is how to reconcile this statement of Dr. Torrey's with another he makes in the same book, which I quoted above and which appears more fully as follows: "Schizophrenia is a brain disease, now definitely known to be such. It is a real scientific and biological entity, as clearly as diabetes, multiple sclerosis, and cancer are scientific and biological entities" (p. 5). How can it be known schizophrenia is a brain disease when we there are so many definitions of schizophrenia and (as I describe later in this essay) research can find nothing wrong with bodies including brains of people who supposedly have schizophrenia?

Throughout the just over 100 years we've had the term schizophrenia, calling something schizophrenia, like calling something pornography or mental illness, has indicated disapproval of that to which the term is applied and nothing more. Like "mental illness" or pornography, "schizophrenia" does not exist in the sense that cancer and heart disease exist but exists only in the sense that good and bad exist. As with all other socalled mental illnesses or disorders, a "diagnosis" of "schizophrenia" is a reflection of the speaker's or "diagnostician's" values or ideas about how a person "should" be, often coupled with the false (or at least unproved) assumption that the disapproved thinking, emotions, or behavior is caused by a biological abnormality. Considering the many ways it has been used, it's clear "schizophrenia" throughout most of the years people have used the term has had no generally agreed upon meaning other than "I dislike it." In DSM5 as in previous editions of the DSM, simply disliking the way a person talks or acts or lives is a large part of the definition. Because of this, and because of the lack of anything biological or physical in the diagnostic criteria for schizophrenia in any of the various versions of the DSM, and because of the failure of research to uncover any biological causes of supposed schizophrenia, I lose respect for mental health professionals when I hear them use the word schizophrenia in a way that indicates they think it is a real disease. I do this for the same reason I would lose respect for someone's perceptiveness and intellectual integrity after hearing him or her admire the emperor's new clothes. While the layman definition of schizophrenia, internally inconsistent, may make sense in some situations, using the term "schizophrenia" in a way that indicates the speaker thinks it is a real disease is tantamount to admitting he doesn't know what he is talking about. _________________________________________________

"SCHIZOPHRENIA" DOES NOT EXIST IN THE SENSE THAT CANCER AND HEART DISEASE EXIST, ONLY IN THE SENSE THAT GOOD AND BAD EXIST _________________________________________________ Many mental health "professionals" and other "scientific" researchers do however persist in believing "schizophrenia" is a real disease despite the non-organic, non-biological diagnostic criteria in the various editions of the DSM. Influenced by those who came before them, they are

like the crowds of people observing the emperor's new clothes in Hans Christian Andersen's short story, unable or unwilling to see the truth because so many others before them have said schizophrenia is real. A glance through the articles listed under "Schizophrenia" in Index Medicus, an index of medical periodicals, or an Internet search, reveals how widespread the schizophrenia myth has become. Because these misguided "scientists" believe "schizophrenia" is a real disease, they try to find physical causes for it. As psychiatrist William Glasser, M.D., says in his book Positive Addiction, published in 1976: "Schizophrenia sounds so much like a disease that prominent scientists delude themselves into searching for its cure" (Harper & Row, p. 18). This is a silly endeavor, because questions about the definition of schizophrenia remain unresolved, such as whether schizophrenia is biologically caused, and whether schizophrenia necessarily involves hallucinations or delusions. Because of the absence of a clear and generally agreed upon definition of schizophrenia, these supposedly prominent scientists are searching for the cause of a problem they can't define—or put another way, they don't know what they are looking for. _________________________________________________

"SCHIZOPHRENIA" SOUNDS SO MUCH LIKE A DISEASE, PROMINENT SCIENTISTS DELUDE THEMSELVES INTO SEARCHING FOR ITS CURE _________________________________________________ According to three Stanford University psychiatry professors, "two hypotheses have dominated the search for a biological substrate of schizophrenia." They say these two theories are the transmethylation hypothesis of schizophrenia and the dopamine hypothesis of schizophrenia (Jack D. Barchas, M.D., et al., "Biogenic Amine Hypothesis of Schizophrenia", appearing in Psychopharmacology: From Theory to Practice, Oxford University Press 1977, p.

100.) The transmethylation hypothesis was based on the idea that "schizophrenia" might be caused by "aberrant formation of methylated amines" similar to the hallucinogenic pleasure drug mescaline in the metabolism of so-called schizophrenics. After reviewing various attempts to verify this theory, they conclude: "More than two decades after the introduction of the transmethylation hypothesis, no conclusions can be drawn about its relevance to or involvement in schizophrenia" (p. 107).

Columbia University psychiatry professor Jerrold S. Maxmen, M.D., succinctly describes what is, or until recently was, the most widespread biological theory of so-called schizophrenia, the dopamine hypothesis, in his book The New Psychiatry, published in 1985: "...many psychiatrists believe that schizophrenia involves excessive activity in the dopamine-receptor system...the schizophrenic's symptoms result partially from receptors being overwhelmed by dopamine" (Mentor, pp. 142 & 154). But in the article by three Stanford University psychiatry professors I referred to above they say "direct confirmation that dopamine is involved in schizophrenia continues to elude investigators" (p. 112). In 1987 in his book Molecules of the Mind Professor Jon Franklin concluded "The dopamine hypothesis, in short, was wrong" (p.

114).

The opposite theory also been proposed, namely that "schizophrenia" is caused by low levels of dopamine in the brain (Guy Chouinard, M.D. and Barry D. Jones, M.D., "Evidence of Brain Dopamine Deficiency in Schizophrenia", Canadian Journal of Psychiatry, November 1979, Vol. 24, p. 661).

In the words of psychologist Bruce E. Levine, Ph.D., in a book published in 2007, "Not too

long ago, psychiatrists were convinced that certain psychoses, especially schizophrenia, were caused by too much of the neurotransmitter dopamine. Today, psychiatry admits that most people diagnosed with schizophrenia have no evidence of increased dopamine, and some actually have reduced levels of dopamine" (Surviving America's Depression Epidemic, Chelsea Green Publishing Co., p. 104).

In Molecules of the Mind, Professor Franklin aptly describes efforts to find other biological causes of so-called schizophrenia: As always, schizophrenia was the index disease. During the 1940s and 1950s, hundreds of scientists occupied themselves at one time and another with testing samples of schizophrenics' bodily reactions and fluids. They tested skin conductivity, cultured skin cells, analyzed blood, saliva, and sweat, and stared reflectively into test tubes of schizophrenic urine. The result of all this was a continuing series of announcements that this or that difference had been found. One early researcher, for instance, claimed to have isolated a substance from the urine of schizophrenics that made spiders weave cockeyed webs.

Another group thought that the blood of schizophrenics contained a faulty metabolite of adrenaline that caused hallucinations. Still another proposed that the disease was caused by a vitamin deficiency. Such developments made great newspaper stories, which generally hinted, or predicted outright, that the enigma of schizophrenia had finally been solved. Unfortunately, in light of close scrutiny none of the discoveries held water. [p. 172] Other efforts to prove a biological basis for so-called schizophrenia have involved brain-scans comparing normal people with people considered schizophrenic. These efforts have been a dismal failure, because there is so much variation among normal people that it is impossible to determine from a brain scan whether a person is schizophrenic. According to psychologist Al Siebert, Ph.D., "A few individuals diagnosed with schizophrenia show certain brain abnormalities, but the brain scans of most people diagnosed with a schizophrenia fall within normal ranges" ("Unethical Psychiatrists Misrepresent What is Known About Schizophrenia", antipsychiatry .org/siebert.htm, accessed July 19, 2013).

Sometimes differences are found when comparing brain scans of identical twins when only one is a supposed schizophrenic, but the flaw in most of these studies is the so-called schizophrenic has been given brain-damaging drugs called neuroleptics as a so-called treatment for his so-called schizophrenia.

Anyone "treated" with these drugs will have the brain damage researchers falsely attribute to schizophrenia. Damaging the brains of people eccentric, obnoxious, imaginative, or mentally disabled enough to be called schizophrenic with drugs (erroneously) believed to have antischizophrenic properties is one of the saddest and most indefensible consequences of today's widespread belief in the myth of schizophrenia.

Brain-imaging studies of supposed schizophrenics who have never taken or been administered neuroleptics or other neurologically damaging drugs are equally invalid. Psychiatrist E. Fuller Torrey, M.D., in a book in 1997 in which he tries to prove schizophrenia is a brain disease, and coauthors, acknowledge brain scans are completely useless for diagnosing schizophrenia in people who do not have an identical twin, because variation between normal individuals is great enough differences thought to indicate schizophrenia "only become evident when an identical twin control is available for purposes of comparison" (Schizophrenia and Manic-Depressive Disorder, Basic Books 1997, p. 114). They also

acknowledge brain scans cannot be used to diagnose "schizophrenia" even in people who have an identical twin, because when comparing the brain scans of identical twins, only one of whom is thought schizophrenic, sometimes the normal twin's brain scan looks schizophrenic to researchers, and the supposedly schizophrenic's brain scan looks normal (see, for example, Id., pp. 107 & 114).

According to Christoff Koch, Ph.D., Professor of Cognitive & Behavioral Biology at California Institute of Technology (Caltech) and Chief Scientific Officer at the Allen Institute for Brain Science in Seattle, Washington, where he studies human brains using high-resolution magnetic resonance imaging (MRI), "We can't tell a schizophrenic brain from an autistic brain from a normal brain" (quoted in Carl Zimmer, "Secrets of the Brain", National Geographic, February 2014, p. 28 at 56). Similarly, in 2012 psychiatrist Daniel Carlat, M.D., said "As far as the MRI question, mostly that's charlatanism. ... I felt that they were, basically they were, the information that you could derive from such scans, was valueless" ("Daniel Carlat—Unhinged: The Trouble With Psychiatry", YouTube.com, uploaded September 11, 2012, at 47:31). In their book Brainwashed—The Seductive Appeal of Mindless Neuroscience (Basic Books 2013, pp. 23-24), psychiatrist and Yale University School of Medicine lecturer Sally Satel, M.D., and Emory University psychology professor Scott O. Lilienfeld, Ph.D., say there is "near-universal agreement among psychiatrists and psychologists that [brain] scans cannot presently be used to diagnose mental illness" and that "The failure of brain-imaging techniques to have made major inroads into the causes and treatment of mental illness" shows those who say brain-scans can be used in these ways are "pulling off little more than a brain scam." They say "In our view, the potential for functional brain imaging to mislead currently exceeds its capacity to inform" (Id. p. 121) and "Taken together, MRIs and CT [computerized tomography] scans provide valuable information about fixed anatomy but leave us largely in the dark about the brain's functioning" (Id., p. 4). They suggest contrary claims are "21st-century phrenology" (Id., p. 3). _________________________________________________ BRAIN SCANS ALLEGEDLY PROVING THE EXISTENCE OF SCHIZOPHRENIA ARE 21st-CENTURY PHRENOLOGY

_________________________________________________ Belief in biological causes of so-called mental illness, including schizophrenia, comes not from science but from wishful thinking or from desire to avoid coming to terms with the experiential or environmental causes of people's misbehavior or distress. The American Psychiatric Association's definition of schizophrenia as non-organic or non-medical in DSM-III, DSM-IIIR, DSM-IV, and DSM-IV-TR, and the failure to delineate a biological cause for schizophrenia or even an association between schizophrenia and anything of a biological nature in DSM-5, and the repeated and consistently unsuccessful efforts to find a biological cause of so-called schizophrenia, suggest "schizophrenia" belongs only in the category of socially/culturally unacceptable thinking or behavior rather than in the category of biology or "disease" where many people place it.

Recommended Reading

Theodore R. Sarbin, Ph.D., "Schizophrenia Is a Myth, Born of Metaphor, Meaningless", Psychology Today, June 1972, p. 18.

Thomas S. Szasz, M.D., Schizophrenia—The Sacred Symbol of Psychiatry (Syracuse University Press 1988)", especially Chapter 3, "Schizophrenia: Psychiatric Syndrome or Scientific Scandal?"

copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "The Myth of Biological Depression" ]

The Myth of Biological Depression Wayne Ramsay, J.D.

In the Introduction to his book Rethinking Depression (New World Library 2012, p. 3, italics his) California-licensed family therapist Eric Maisel, Ph.D., says this: One of the goals of this book is to help you remove the word depression from your vocabulary and, as a result, from your life. If depression were an actual disease, illness, or disorder you wouldn't be able to rid yourself of it just by removing it from your vocabulary. But since it isn't a disease, illness, or disorder, you can dispense with it right this second. What I would love for you to say is "I can't be depressed because there is no disease of depression!"

Similarly, in her book A Straight Talking Introduction to Psychiatric Drugs (PCCS Books, Ross-on-Wye 2009, p. 65), Joanna Moncrieff, M.B.B.S., M.Sc., MFRCPsych, M.D., Senior Lecturer in Mental Health Sciences at the University College, London, says this: ...it is important to say here that the term "depression" as currently used is misleading. ... there is no scientific evidence to support the idea that there are particular features of the brain that give rise to the particular feeling of depression.

Unhappiness or "depression" alleged to be the result of biological abnormality is called "biological" or "endogenous" or "clinical" depression. In her book The Broken Brain: The Biological Revolution in Psychiatry, University of Iowa psychiatry professor Nancy Andreasen, M.D., Ph.D., says "The older term endogenous implies that the depression 'grows from within' or is biologically caused, with the implication that unfortunate and painful events such as losing a job or lover cannot be considered contributing causes" (Harper & Row 1984, p. 203). Similarly, in 1984 in the Chicago Tribune newspaper columnist Joan Beck alleged: "depressive disorders are basically biochemical—and not caused by events or environmental circumstances or personal relationships" (July 30, 1984, Sec. 1, p. 16). A July 2013 Readers Digest article (pp. 132-133) says "For the past 50 years, the conventional wisdom among many psychiatrists was that depression was caused by a brain-chemical imbalance such as low levels of the feel-good hormone serotonin."

The concept of biological or endogenous depression is important to psychiatry for two reasons. First, it is the most common supposed mental illness. As Victor I. Reus, M.D., wrote in 1988: "The history of the diagnosis and treatment of melancholia could serve as a history of psychiatry itself" (appearing in: H. H. Goldman, editor, Review of General Psychiatry, 2nd Edition, Appleton & Lange 1988, p. 332). Second, all of psychiatry's biological "treatments" for depression—whether it is drugs, electroshock, or psychosurgery—are based on the idea that the unhappiness we call depression can be caused by a biological malfunction in the brain rather than life experience. The erroneous belief in biological causation justifies the otherwise unjustifiable use of biological therapies, primarily "antidepressant" drugs and electroconvulsive "therapy" (see Psychiatry's Electroconvulsive Shock Treatment—A Crime Against Humanity). The biological therapies for this nonexistent "disease" of depression and other socalled mental illnesses also in theory justify the existence of psychiatry as a medical specialty distinguishable from psychology, social work, and counselling.

Many professional and lay people today think depression can be caused by "chemical imbalance" in the brain even though no chemical imbalance theories of depression have been verified. As psychiatry

professor Thomas S. Szasz, M.D., said in 2006, "There is no evidence for a chemical imbalance causing mental illness, but that does not impair the doctrine's scientific standing or popularity" ("Mental Illness as a Brain Disease: A Brief History Lesson", szasz.com). Psychiatry professor Nancy Andreasen discusses some of the chemical imbalance theories of depression in her book The Broken Brain.

One of the theories she describes is the belief that "depression" (what I think should be called simply unhappiness or severe unhappiness) is the result of neuroendocrine abnormalities indicated by excessive cortisol in the blood. The test for this is called the dexamethasonesuppression test or DST. The theory behind this test and the claims of its usefulness were found to be mistaken, however, because, in Dr. Andreasen's words, "so many patients with welldefined depressive illness have normal DSTs" (pp.

180182). An article in the July 1984 Harvard Medical School Health Letter reached a similar conclusion.

The article, titled "Diagnosing Depression: How Good is the 'DST'?", reported that "For every three office patients with an abnormal DST, only one is likely to have true depression. ... [And] a large fraction of people who are depressed by other criteria will still have normal results on the DST" (p. 5). Similarly, in an article in the November 1983 Archives of Internal Medicine three physicians concluded that "Data from studies currently available do not support the use of the dexamethasone ST [Suppression Test]" (Martin F. Shapiro, M.D., et al., "Biases in the Laboratory Diagnosis of Depression in Medical Practice", Vol. 143, p. 2085). In 1993 in her book If It Runs In Your Family: Depression, Connie S. Chan, Ph.D., acknowledges that "There is still no valid biological test for depression" (Bantam Books, p. 106). Despite its having been discredited, some biologically oriented psychiatrists are (apparently) so eager for biological explanations for people's unhappiness or "depression" that they continue to use the DST anyway. For example, in his book The Good News About Depression, published in 1986, psychiatrist Mark S. Gold, M.D., says he continues to use the DST. In that book Dr. Gold claims the DST is "highly touted as the diagnostic test for biologic depression" (Bantam, p. 155, emphasis in original).

In The Broken Brain, Dr. Andreasen also describes what she calls "the most widely accepted theory about the cause of depression...the 'catecholamine hypothesis.'" She emphasizes that "the catecholamine hypothesis is theory rather than fact" (p. 231). She says "This hypothesis suggests that patients suffering from depression have a deficit of norepinephrine in the brain" (p. 183), norepinephrine being one of the "major catecholamine systems" in the brain (pp. 231232). One way the catecholamine hypothesis is evaluated is by studying one of the breakdown products of norepinephrine, called MHPG, in urine. People with socalled depressive illness "tended to have lower MHPG" (p. 234).

The problem with this theory, according to Dr. Andreasen, is that "not all patients with depression have low MHPG" (Id). She accordingly concludes that this catecholamine hypothesis "has not yet explained the mechanism causing depression" (p. 184).

Another theory is that severe unhappiness ("depression") is caused by lowered levels or abnormal use of another brain chemical, serotonin. A panel of experts assembled by the U.S. Congress Office of Technology Assessment reported the following in 1992 (The Biology of Mental Disorders, U.S. Gov't Printing Office, pp. 82 & 84): Prominent hypotheses concerning depression have focused on altered function of the group of neurotransmitters called monoamines (i.e., norepinephrine, epinephrine, serotonin, dopamine), particularly norepinephrine (NE) and serotonin. ... studies of the NE [norepinephrine] autoreceptor in

depression have found no specific evidence of an abnormality to date. Currently, no clear evidence links abnormal serotonin receptor activity in the brain to depression. ... the data currently available do not provide consistent evidence either for altered neurotransmitter levels or for disruption of normal receptor activity.

Even if it was shown there is some biological change or abnormality "associated" with depression, the question would remain whether this is a cause or an effect of the "depression". A brain-scan study (using positron emission tomography or PET scans) found that simply asking normal people to imagine or recall a situation that would make them feel very sad resulted in significant changes in blood flow in the brain (José V. Pardo, M.D., Ph.D., et al., "Neural Correlates of Self-Induced Dysphoria", American Journal of Psychiatry, May 1993, p. 713). Other research will probably confirm it is emotions that cause biological changes in the brain rather than biological changes in the brain causing emotions. _________________________________________________

IN ALL OF HUMAN HISTORY THERE HAS NEVER BEEN EVEN ONE CASE IN WHICH IT WAS PROVED A PERSON FELT DEPRESSED BECAUSE OF A CHEMICAL IMBALANCE IN HIS OR HER BRAIN _________________________________________________ One of the more popular theories of biologically caused depression has been hypoglycemia, which is low blood sugar. In his book Fighting Depression, published in 1976, Harvey M. Ross, M.D., says "In my experience as an orthomolecular psychiatrist, I find that many patients who complain of depression have hypoglycemia (low blood sugar). ...Because depression is so common in those with hypoglycemia, any person who is depressed without a clear cut obvious cause for that depression should be suspected of having low blood sugar" (Larchmont Books, p. 76 & 93). But in their book Do You Have A Depressive Illness?, published in 1988, psychiatrists Donald Klein, M.D., and Paul Wender, M.D., list hypoglycemia in a section titled "Illnesses That Don't Cause Depression" (Plume, p. 61). The idea of hypoglycemia as a cause of depression was also rejected in the front page article of the November 1979 Harvard Medical School Health Letter, titled "Hypoglycemia—Fact or Fiction?".

Another theory of a physical disease causing psychological unhappiness or "depression" is hypothyroidism. In her book Can Psychotherapists Hurt You? psychologist Judi Striano, Ph.D., includes a chapter titled "Is It Depression—Or An Underactive Thyroid?" (Professional Press 1988). Similarly, three psychiatry professors in 1988 asserted "Frank hypothyroidism has long been known to cause depression" (Alan I. Green, M.D., et al., The New Harvard Guide to Psychiatry, Harvard Univ. Press 1988, p. 135). The theory here is that the thyroid gland, which is located in the neck, normally secretes hormones which reach the brain through the bloodstream necessary for a feeling of psychological well being and that if the thyroid produces too little of these hormones, the affected person can start feeling unhappy even if no problems result from the endocrine (gland) problem other than the unhappiness. The American Medical Association Encyclopedia of Medicine lists many symptoms of hypothyroidism: "muscle weakness, cramps, a slow heart rate, dry and flaky skin, hair loss ... there may be weight gain" (Random House 1989, p. 563). The Encyclopedia does not list unhappiness or "depression" as one of the consequences of hypothyroidism. But suppose you began to experience "muscle weakness, cramps...dry

and flaky skin, hair loss ... weight gain"? How would this make you feel emotionally?—depressed, probably. Just as hypothyroidism (hypo = low) is a thyroid gland that produces too little, hyperthyroidism is a thyroid glad that produces too much. Therefore, if hypothyroidism causes depression, then it seems logical to assume hyperthyroidism has the opposite effect, that is, that it makes a person happy. But this is not what happens. As psychiatrist Mark S. Gold, M.D., points out in his book The Good News About Depression: "Depression occurs in hyperthyroidism, too" (p. 150). What are the consequences of hyperthyroidism?: Dr. Gold lists abundant sweating, fatigue, soft moist skin, heart palpitations, frequent bowel movements, muscular weakness, and protruding eyeballs. So both hypo- and hyper- thyroidism cause physical problems in the body. And both cause "depression". This is only logical. It is hard to feel anything but bad emotionally when your body doesn't feel well or work properly. It has never been proved hypothyroidism affects mood other than through its effect on the victim's experience of feeling physically unhealthy.

Some people think chemical imbalance related to hormonal changes must be a possible cause of "depression" because of the supposed biological causes of women's moods at different times of their menstrual cycles. I don't find that argument convincing because I've known so many women whose mood and state of mind was consistently unaffected by her menstrual cycle. Psychology professor David G. Myers, Ph.D., labels premenstrual syndrome (PMS) a myth in his book The Pursuit of Happiness (William Morrow & Co. 1992, pp. 84-85). Of course, some women experience physical discomfort due to menstruation. Feeling lousy physically is enough to put anybody in a bad mood.

Some people believe women experience undesirable mood changes for biological reasons because of menopause. However, a study by psychologists at University of Pittsburgh reported in 1990 found that "Menopause usually doesn't trigger stress or depression in healthy women, and it even improves mental health for some". According to Rena Wing, one of the psychologists who did the study, "Everyone expects menopause to be a stressful event, but we didn't find any support for this myth" ("Menopausal stress may be a myth", USA Today, July 16, 1990, p. 1D).

It is also widely believed that women go through a period of depression for biological reasons after giving birth to a child. It's called postpartum depression. In his book The Making of a Psychiatrist, Dr. David Viscott quotes Dr. George Maslow, a physician doing an obstetrical residency, making the following remark: "Come on, Viscott, do you really believe in postpartum depression? I've seen maybe two in the last three years. I think it's a lot of shit you guys [you psychiatrists] imagined to drum up business" (Pocket Books 1972, p. 88). A woman who had given birth to eight (8) children, which in my opinion qualifies her as an expert on the subject of postpartum depression, told me what she called "postpartum blues" are real, but she attributed postpartum blues to psychological rather than physiological causes. "I don't know about the physiological causes", she said, but "so much of it is psychological." She said "You feel awful about your looks", because in our society a woman is "supposed" to be thin, and for at least a short time after giving birth a woman usually isn't. She also said after childbirth a woman feels considerable "physical exhaustion". Childbirth also is the beginning of new or increased parental obligations, which if we are honest we must admit are quite burdensome. The arrival of new or additional parental obligations and the realization of the negative ways new or additional parenthood obligations will affect a woman's (or man's) life is an obvious non-biological explanation for postpartum depression. It may not be until the actual birth of the child that parents realize how parenthood changes their lives for the worse, but a letter from a female friend of mine who at the time was only three

months pregnant with her first child illustrates that depression associated with childbirth may come long before the postpartum period: She said she was frequently breaking down in tears because she thought with a child her life would never the same and that she would be a "prisoner" and wouldn't have time to do what she wanted in life. A reason these psychological causes are often not candidly acknowledged and postpartum (or pre-partum) blues instead attributed to unproven biological causes is our reluctance to admit the downside of parenthood.

Another theory of biologically caused depression is based on stroke damage in the left front region of the brain causing depression. What makes it seem possible this might be neurologically caused rather than being a reaction to the situation a person finds himself in because of having had a stroke is stroke damage in the right front of the brain allegedly causing "undue cheerfulness." However, a careful reading of books and articles about neurology for the most part doesn't support the allegation of undue cheerfulness from right front brain damage. Instead, what most neurological literature indicates sometimes results from right front stroke-related brain damage is anosagnosia, usually described as lack of concern or inability to know their own problems, not happiness or cheerfulness (e.g., neurology professor Oliver Sacks in The Man Who Mistook His Wife for a Hat and Other Clinical Tales, Harper & Row 1985, p. 5).

Perhaps the most often heard argument is that antidepressant drugs wouldn't work if the cause of depression was not biological. But antidepressant drugs don't work. As psychiatrist Peter Breggin, M.D., says in his book Talking Back to Prozac (St. Martin's Press 1994, p. 200), "there's no evidence that antidepressants are especially effective". Or as British psychiatrist Joanna Moncrieff writes in her book The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment (Revised Edition, Palgrave Macmillan 2009, pp. 144 & 152)— ...contrary to current opinion, antidepressants are not superior to placebo even in the most severe forms of depression. ... The idea that antidepressants have a specific action on a biological process is still cited as the main justification for the idea that depression is caused by a biochemical abnormality. ...

However, the evidence reviewed above suggests that antidepressant drugs do not exert a specific effect in depression.

Psychologist Irving Kirsch, Ph.D., wrote an entire book bebunking the assertion that so-called antidepressants have antidepressant effects: The Emperor's New Drugs—Exploding the Antidepressant Myth (Basic Books 2010). In The Antidepressant Fact Book (Perseus 2001, p. 14) psychiatrist Peter Breggin, M.D., says "The term 'antidepressant' should always be thought of with quotation marks around it because there is little or no reason to believe that these drugs target depression or depressed feelings." There is even evidence that so-called antidepressants make people feel more depressed: According to Dr. Moncrieff, "Evidence suggests that for people without mental health problems, antidepressant drugs are unpleasant to take and make them feel worse. The evidence reviewed in the previous chapter suggests that we have no reason to believe that they elevate mood in patients either" (The Myth of the Chemical Cure, p. 171). Antidepressants are, in other words, a health care scam. Their only possible beneficial effect is placebo effect. This has not prevented drug companies from making billions of dollars selling supposedly antidepressant "medications", however. As California-licensed family therapist Eric Maisel, Ph.D., asks in his book Rethinking Depression (p. 240), "Has the 'mental

disorder of depression' been fabricated by the mental health industry to turn human unhappiness and the consequences of human unhappiness into a cash cow? ... You will have to decide if all this mental health labeling is a marvel of medical progress or a variation on the age-old penchant for selling snake oil." Even if so-called antidepressants did help (aside from placebo effect), that wouldn't prove a biological cause of "depression" any more than would feeling better from using marijuana or cocaine or drinking liquor. _________________________________________________

"ANTIDEPRESSANTS" ARE A HEALTH CARE SCAM

_________________________________________________ A careful reading of the books and articles by psychiatrists and psychologists alleging biological causes of the severe unhappiness we call depression usually reveals purely psychological causes that explain it adequately, even when the author believes he has given a good example of biologically caused depression. For example, in Holiday of Darkness: A Psychologist's Personal Journey Out of His Depression (John Wiley & Sons 1982), an autobiographical book by York University psychology professor Norman S. Endler, Ph.D., he alleges his unhappiness or so-called depression "was biochemically induced" (p. xiv). He says "my affective disorder was primarily biochemical and physiological" (p. 162). But from his own words it's obvious his depression was due primarily to unreturned love when a woman he got emotionally involved with, Ann, decided to "wind down" her relationship with him (pp. 2-5) and when he suffered a career setback (loss of a research grant) at about the same time (p. 23).

Despite his claims of biochemical causation, nowhere does he cite any medical or biological tests showing he had any kind of biological, biochemical, or neurological abnormalities. He can't, because no valid biological test exists that tests for the presence of any so-called mental illness, including allegedly biologically caused unhappiness (or "depression").

Similarly, in The Broken Brain, psychiatry professor Nancy Andreasen gives the example of Bill, a pediatrician, whose recurrent depression she thinks illustrates that "People who suffer from mental illness suffer from a sick or broken brain [emphasis Andreasen's], not from weak will, laziness, bad character, or bad upbringing" (p. 8). But she seems to overlook the fact that Bill's allegedly biologically caused recurrent depressions occurred when his father died, when he was not permitted to graduate from medical school on schedule, when his first wife was diagnosed with cancer and died, when his second wife was unfaithful to him, when he was arrested for public intoxication during an argument with her and this was reported in the local newspaper, and when his license to practice medicine was suspended because of stigma from psychiatric "treatment" he received (pp. 2-7).

One of the reasons for theorizing about biological causes of severe unhappiness or "depression" is sometimes people are unhappy for reasons that aren't apparent, even to them.

The reason this happens is what psychoanalysts call the unconscious: Freud's investigations shocked the Western world ... Comparing the mind to an iceberg, largely submerged and invisible, he told us that the greater part of the mind is irrational and unconscious, with only the tip of the preconscious and conscious showing above the surface. He maintained that the

larger, unconscious part—much of it sexual—is more important in guiding our lives than the rational part, even though we deceive ourselves into believing it is the other way around. [Ladas, et al., The G Spot And Other Recent Discoveries About Human Sexuality, Holt, Rinehart & Winston 1982, pp. 67]

In An Elementary Textbook of Psychoanalysis, Charles Brenner, M.D., says "the majority of mental functioning goes on without consciousness... We believe today that...mental operations which are decisive in determining the behavior of the individual...even complex and decisive ones—may be quite unconscious" (Int'l Univ. Press 1955, p. 24). A news magazine article in 1990 reported that "Scientists studying normal rather than impaired subjects are also finding evidence that the mind is composed of specialized processors that operate below the conscious level. ...Freud appears to have been correct about the existence of a vast unconscious realm" (U.S. News & World Report, October 22, 1990, pp. 60-63). An article in the June 2011 Psychology Today magazine tells us "Neuroscience has also confirmed another fundamental tenet of psychoanalytic theory—the idea that our motivations are largely unconscious ... 'Neuroscience tells us unambiguously that consciousness really is just the tip of the iceberg'" (Molly Knight Raskin, "The Idea That Wouldn't Die", p. 75 at 83). People's unhappiness or so-called depression being caused by life experience is not always obvious, because the relevant mental processes and memories are often hidden in the unconscious parts of their minds. _________________________________________________

DEPRESSED? IT'S NOT YOUR BRAIN. IT'S YOUR LIFE. _________________________________________________ This critical aspect of human psychology was missed or overlooked in an otherwise excellent book, The Loss of Sadness—How Psychiatry Transformed Normal Sorrow Into Depressive Disorder (Oxford University Press 2007) by Allan V. Horwitz, Ph.D., Professor of Sociology and Dean of Social and Behavioral Sciences at Rutgers University, and Jerome C. Wakefield, Ph.D., D.S.W., Professor of Social Work at New York University. Drs. Horwitz and Wakefield effectively debunk the American Psychiatric Association's concept of depression as a disorder except when there is no obvious cause in terms of life experience. They erroneously assume experiences in life and the thinking that cause sadness will always be obvious and easy to identify and that when no such cause can be readily identified, deeply felt or prolonged sorrow may indeed be a true biological or psychological "disorder" even though they, like all who support the idea of endogenous or biological depression, are unable to identify the supposed nonexperiential, biological causes and simply assume such causes must exist.

I believe unhappiness or so-called depression is always the result of life experience. There is no convincing evidence unhappiness or "depression" is ever biologically caused. The brain is part of our biology, but there is no evidence severe unhappiness or "depression" is sometimes biologically caused any more than bad TV programs are sometimes electronically caused. "[T]he question is not how to get cured, but how to live" (Joseph Conrad, quoted by Thomas Szasz, The Myth of Psychotherapy, Syracuse Univ. Press 1988, title page). "When mental health professionals point to spurious genetic and biochemical causes," of depression and recommend drugs rather than learning better ways of living, "they encourage psychological helplessness and discourage personal and social growth" of the sort

needed to really avoid unhappiness or "depression" and live a meaningful and happy life (Peter Breggin, M.D., "Talking Back to Prozac" Psychology Today magazine, July/Aug 1994, p. 72).

Recommended Reading Mary Ann Block, D.O., Just Because You're Depressed Doesn't Mean You Have Depression (Block System, Hurst, Texas 2007) Allan M. Leventhal, Ph.D., and Christopher R. Martell, Ph.D., The Myth of Depression as Disease: Limitations and Alternatives to Drug Treatment (Praeger, Westport, Connecticut 2006). These two psychologists summarize a central point of their book in a section title on page 58: "It's Not Your Brain, It's Your Life".

copyright 2014 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

The Myth of Psychiatric Diagnosis Wayne Ramsay, J.D. "It is always possible to make a psychiatric diagnosis on everyone." — psychiatrist Fredric Neuman, M.D., Director of the Anxiety and Phobia Center at White Plaines Hospital, White Plaines, New York, in his article "Is It Possible to Predict Violent Behavior?", psychologytoday.com, December 26, 2012

In a telephone conversation with a state legislator who at the time was Speaker of her state's House of Representatives, and who had been quoted in a newspaper saying she was proud to have sponsored legislation requiring health insurance policies to pay for psychiatric treatment, I referred to people being "accused of mental illness." She disagreed with or corrected me, saying "It's not an accusation. It's a diagnosis."

People who disagree with the concept of mental illness and with the associated idea of

psychiatric diagnosis call psychiatric diagnoses "labels". Such critics allege psychiatric "diagnoses" or labels are no more scientifically valid than pejorative nonscientific insults. As psychologist Jeffrey Schaler said in 2006, "Think of how when people get angry with one another, they inevitably resort to some kind of diagnosis. They say, 'You're crazy! You're mentally ill! You're paranoid!' Can you imagine somebody getting angry with someone and saying 'You have diabetes! You have Parkinson's Disease!'" ("Jeffrey A. Schaler, Ph.D., Professor of Psychology", YouTube.com, accessed Sept. 1, 2012). Accusing someone of mental illness is an insult. Accusing someone of having diabetes or Parkinson's Disease or any other physical illness is not.

Because we do not live our lives in isolation but in a society of other people, and because a psychiatric "diagnosis" changes how other people treat a person, a psychiatric "diagnosis" can deprive a person of many of life's most important opportunities and can harm or ruin a person's life. The childhood taunt, "Sticks and stones can break my bones, but words can never hurt me" simply is not true if the words are a psychiatric "diagnosis": The problem with psychiatric diagnoses is not that they are meaningless, but that they may be, and often are, swung as semantic blackjacks: cracking the subject's dignity and respectability destroys him just as effectively as cracking his skull. The difference is that the man who wields a blackjack is recognized by everyone as a thug, but the one who wields a psychiatric diagnoses is not. [Thomas Szasz, M.D., The Second Sin, Anchor Press 1973, p. 71]

Psychiatric "diagnosis" can result in a person who seems normal to the average person, and who is law-abiding, spending his or her whole life imprisoned in a mental institution rather than living in freedom. Psychiatric "diagnosis" can defeat the proper functioning of the system of justice, examples being a person being found not guilty by reason of insanity and avoiding punishment for a serious crime, or a good parent losing custody of his or her child. (See, for example, Chapter 8 "In the Best Interests of the Child—Parental Rights and Psychoexperts" in Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice, Regan/ HarperCollins 1997, by Boston University psychology professor Margaret Hagen, Ph.D.) Psychologist Paula Caplan, Ph.D., highlighted the gravity of psychiatric "diagnosis" in an interview on February 11, 2012 (MindFreedom Live Free Web Radio: "Paula Caplan v.

Psychiatric Labeling!", archived at blogtalkradio.com): Not until recently did very many people understand that psychiatric diagnosis is the fundamental building block of everything else bad that happens in the mental health system. If you don't get a label, you can't get put on drugs that might help you but are more likely to hurt you. If you don't get a label, then you can't lose your job or custody of your kids or your legal rights because of having a label. ...

When you hear somebody say "I lost custody of my children because I had a label that I thought was pretty mild, but you know what!: It 'proved' that I'm mentally ill, and they took my children away from me." ... You can't hear these stories, and year after year, more and more, and not try to do something about it. ... people's lives have been destroyed by getting a psychiatric label.

In his book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, published in 2013 (Harper Collins pp. xi, xii, 277), psychiatrist Allen Frances, M.D., says this:

I led the Task Force that developed DSM-IV [American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition] and also chaired the department of psychiatry at Duke [University], treated many patients ... DSM has gained a huge societal significance and determines all sorts of important things that have an enormous impact on people's lives like...who gets to be hired for a job, can adopt a child, or pilot a plane, or qualifies for life insurance ... Done poorly, psychiatric diagnosis can be an unmitigated disaster leading to aggressive treatments with horrible complications and lifeshattering impact. ... Psychiatric diagnosis is a serious business with major and often lifelong consequences.

In Chapter 3 of Saving Normal, "Diagnostic Inflation", Dr. Frances includes a section quite appropriately titled "The Power to Label Is the Power to Destroy" (p. 109).

Because of the damaging, even life-ruining power of psychiatric "diagnosis" (or of psychiatric "labels"), the validity, accuracy, reliability, and predictability of psychiatric "diagnosis" is important. Investigations repeatedly reveal psychiatric diagnosis has no reliability or validity.

In 1887 Nellie Bly (1867-1922), a newspaper reporter, feigned insanity to gain admission to New York's Blackwell's Island Insane Asylum. She described how she did it and what she saw at the Asylum in a book titled Ten Days in a Mad House (available from amazon.com and free on the Internet). "I had little belief in my ability to deceive the insanity experts," she wrote in Chapter 1, and in Chapter 2, "to be examined by a number of learned physicians who make insanity a specialty, and who daily come in contact with insane people! How could I hope to pass these doctors and convince them that I was crazy?" In Chapter 6, while at Bellevue Hospital, after it was apparent she had succeeded, before her transfer to Blackwell's Island, she wrote: "And so I passed my second medical expert. After this I began to have a smaller regard for the ability of doctors than I ever had before, and a greater one for myself. I felt sure now that no doctor could tell whether people were insane or not".

In chapter 7, listening to Tillie Mayard, a fellow patient at Bellevue Hospital, who had just found out she was in an insane asylum, after being told she was going to a "convalescent ward to be treated for nervous debility", Nellie Bly heard Ms. Mayard say to a doctor, "If you know anything at all you should be able to tell that I am perfectly sane. Why don't you test me?" Bly said the doctor "left the poor girl condemned to an insane asylum, probably for life, without giving her one feeble chance to prove her sanity." In Chapter 8, Bly describes this same Tillie Mayard pleading with a doctor after arriving at Blackwell's Island Insane Asylum: I could hear her gently but firmly pleading her case. All her remarks were as rational as any I ever heard, and I thought no good physician could help but be impressed with her story. ... She begged that they try all their tests for insanity, if they had any, and give her justice. Poor girl, how my heart ached for her! I determined then and there that I would try by every means to make my mission of benefit to my suffering sisters; that I would show how they are committed without ample trial.

Of herself, Bly wrote in Chapter 1, "From the moment I entered the insane ward on the Island, I made no attempt to keep up the assumed role of insanity. I talked and acted just as I do in ordinary life. Yet strange to say, the more sanely I talked and acted, the crazier I was thought to be by all except one physician, whose kindness and gentle ways I shall not soon forget." Of her own departure from Blackwell's Island, after intervention by her editor, she said:

I left the insane ward with pleasure and regret—pleasure that I was once more able to enjoy the free breath of heaven; regret that I could not have brought with me some of the unfortunate women who lived and suffered with me, and who, I am convinced, are just as sane as I was and am now myself.

A similar experiment was done in the 1970s by Stanford University psychology professor David Rosenhan and his colleagues and published in the January 19, 1973 issue of Science magazine ("On Being Sane in Insane Places", Vol. 179, pp. 250-258). Dr. Rosenhan and seven of his colleagues who had no history of or evidence of mental illness, called "pseudopatients" in the study, went to 12 different psychiatric hospitals on the East and West coasts of the U.S.A. as inpatients where they remained as long as 52 days. They found that no matter how normally they behaved they were not recognized as normal by the psychiatrists and other mental health professionals they came in contact with. Despite being normal, all were prescribed psychiatric drugs: "All told, the [eight] pseudopatients were administered nearly 2100 pills, including Elavil, Stelazine, Compazine, and Thorazine", which undermines the commonly held belief psychiatric drugs are given only to people who need them (as if anybody needs psychiatric drugs: See Psychiatric Drugs: Cure or Quackery?) When the results of this experiment were revealed to the psychiatrists and other staff members of another psychiatric hospital, they "doubted that such an error could occur at their hospital." Dr. Rosenhan said "The staff was informed that at some time during the following 3 months, one or more pseudopatients would attempt to be admitted into the psychiatric hospital." During that time the hospital staff identified "Forty-one patients...with high confidence, to be pseudopatients ... Twenty-three were considered suspect by at least one psychiatrist. ... Actually," said Dr. Rosenhan, "no genuine pseudopatient (at least not from my group) presented himself during this period." Dr. Rosenhan concluded the inability of psychiatrists and other mental health professionals to distinguish normal persons such as himself and his colleagues from true mental patients is "frightening." He said: How many people, one wonders, are sane but not recognized as such in our psychiatric institutions?

How many have been needlessly stripped of their privileges of citizenship, from the right to vote and drive to that of handling their own accounts? How many have feigned insanity in order to avoid the criminal consequences of their behavior, and conversely, how many would rather stand trial than live interminably in a psychiatric hospital but are wrongly thought to be mentally ill? How many have been stigmatized by well-intentioned, but nevertheless erroneous, diagnoses?

In his book Psychiatry: The Science of Lies (Syracuse University Press 2008, pp. 67-68), psychiatry professor Thomas Szasz, M.D., says "The assertion rests on an erroneous premise, namely, that the doctors were interested in distinguishing insane inmates properly committed from sane inmates falsely detained. The whole history of psychiatry belies this assumption. ... each time experience was consulted, it showed that the experts were unable to distinguish the sane from the insane".

The following described study titled "Suggestion Effects in Psychiatric Diagnosis" by psychologist Maurice K. Temerlin, Ph.D., was published in The Journal of Nervous and Mental Disease in 1968 (Vol. 147, No. 4, pp. 349-353): "In order to explore interpersonal influences which might affect psychiatric diagnosis, psychiatrists, clinical psychologists and graduate students in clinical psychology diagnosed a sound-recorded interview with a normal, healthy man." When a group of psychiatrists, psychologists, and psychology graduate students heard the tape-recorded interview after introductory remarks by "a professional person of high prestige" saying the interview was with a perfectly healthy man, the "psychologists, psychiatrists, and

graduate students agreed unanimously." When the tape-recording was heard by a group of psychiatrists, psychologists, and psychology graduate students after introductory remarks by "a professional person of high prestige" saying the recorded interview was with a man who "'looked neurotic but actually was quite psychotic' ... diagnoses of psychosis were made by 60 per cent of the psychiatrists, 28 per cent of the clinical psychologists, and 11 per cent of the graduate students", even though they had listened to the same tape-recording. This study like others shows psychiatric "diagnosis" has no reliability and no validity.

It is probably because nothing can be found wrong in the body including brain of supposedly mentally ill people, and because psychiatry has no biological tests distinguishing people who have so-called mental illnesses from those who do not, and therefore has no genuine illnesses or diseases to describe or "diagnose", that the American Psychiatric Association calls its manual the "Diagnostic and Statistical Manual of Mental Disorders", not the "Diagnostic and Statistical Manual of Mental Illnesses" nor the "Diagnostic and Statistical Manual of Mental Diseases". Even calling it a "diagnostic" manual is pretentious and factually incorrect if true diagnosis indicates the cause of a problem. The "diagnoses" in the DSM do not do that. The DSM is a manual of descriptions, not diagnoses. It could be more accurately named the American Psychiatric Association's "Mental Disorders Description Manual", or even more candidly, the American Psychiatric Association's "Disapproved Behavior Description Manual". _________________________________________________

THE DSM IS A MANUAL OF DESCRIPTIONS, NOT DIAGNOSES _______________________________________________________ The word "disorder" is the word "order" with the prefix "dis-", which means the opposite of. "Disorder" therefore is the opposite of order. To say something is "dis"-order is to say the opposite is proper. But who is to say what is proper behavior? Is it right for a private unelected organization to decide what behavior is permitted? Isn't that the responsibility of democratically elected law makers or legislators? Why should a private unelected organization such as the American Psychiatric Association (APA) be empowered to say what behavior is allowed and what behavior is prohibited in America or anywhere else? Who are they? Does the fact that the APA defines as "Hording Disorder" the keeping of so many belongings in your house or apartment they "congest and clutter active living areas and substantially compromises their intended use" (DSM-5, p. 247) mean you don't have a right to keep as many belongings in your home as you want? This isn't merely theoretical: I have a video court reporter record (on DVD) of a 72 year old man in Vancouver, Washington who seemed entirely normal and very intelligent in a one-hour, face-to-face interview with me in 2011 but who had shortly before been placed and was still under an involuntary guardianship imposed in large part because he supposedly had a "hording disorder." An article in Carol's Home News (October 2011, p. 2) says "Are you a night owl? ... It's not laziness, or simple insomnia, but a condition doctors call Delayed Sleep Phase (DSP) Disorder." In DSM-5, published a year and half after the quoted article, it is called one of the "Circadian Rhythm Sleep-Wake Disorders" (p. 390), specifically "Delayed Sleep Phase Type". It is defined as "a history of a delay in the timing of the major sleep period (usually more than 2 hours) in relation to the desired sleep and wake-up time", even though "When allowed to set their own schedule, individuals with delayed sleep phase type exhibit normal sleep quality and duration for age" (p. 391). Does a group of doctors deciding going to sleep at 4 a.m. and sleeping until noon is a disorder mean you don't have the right to sleep the hours you want?

Should you be subjected to involuntary treatment if you do? Legislators' delegation of their lawmaking power to a private organization such as the American Psychiatric Association or to individual physicians, as legislators have with laws authorizing involuntary "hospitalization" or involuntary outpatient "treatment" of people whose behavior or expression of ideas (or sleep schedule) falls within a category of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is an arguably illegal, unconstitutional delegation of legislative authority.

Persons no less authoritative than the chairpersons of groups that created the third and fourth editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, and their revisions (DSM-III, DSM-III-R, DSM-IV and DSM-IV-TR) have admitted the scientific invalidity their own (supposedly) diagnostic systems. In the Foreword to The Loss of Sadness—How Psychiatry Transformed Normal Sorrow Into Depressive Disorder by Alan V. Horwitz, Ph.D., and Jerome C. Wakefield, Ph.D., D.S.W. (Oxford University Press 2007, pp. vii-viii), Robert L. Spitzer, M.D., Professor of Psychiatry at New York State Psychiatric Institute says this: I was the head of the American Psychiatric Association's task force that in 1980 created the DSM-III (i.e., the third edition of the Diagnostic and Statistical Manual of Mental Disorders, the Association's official listing of recognized mental disorders and the criteria by which they are diagnosed). ... the very success of the DSM and its descriptive [as opposed to diagnostic] criteria at a practical level has allowed the field of psychiatry to ignore some basic conceptual issues that have been lurking at the foundation of the DSM enterprise, especially the question of how to distinguish disorder from normal suffering. ... My involvement in an earlier debate over whether to remove homosexuality from DSM-II in 1973 led me to grapple with the question of how to define mental disorder. I formulated the definitions of mental disorder in the introductions to the DSM-III, the DSM-III-R (the DSM's third edition revised), and the DSM-IV, which aim to explain the reasons that certain conditions were included in and other types of problems excluded from the Manual. Since then, Dr. Wakefield has critiqued my efforts in ways that I have largely become convinced are valid.

Allen Frances, M.D., was chairperson of the American Psychiatric Association's DSM-IV Task Force, making him the lead author and editor of DSM-IV (1994) and DSM-IV-TR (2000). Psychologist Paula Caplan, Ph.D., in her presentation at the 2012 National Association for Rights Protection and Advocacy Conference, accused Dr. Frances of being the single person most responsible for the pathologizing of normality in psychiatry (at least, prior to the publication of DSM-5). However, in a series of articles criticizing the newest version, DSM-5, many of them available at psychologytoday.com and psychiatric times.com and elsewhere on the Internet, Dr. Frances has vigorously criticized the lack of science and the pathologizing of normality in DSM-5, much of the time seemingly overlooking the fact that many of his criticisms are equally true of DSM-IV and DSM-IV-TR for which he as much as anyone is responsible.

Many silly supposed diagnoses in DSM-5 are also found in DSM-IV and DSM-IV-TR: I'll be giving you examples later in this essay. At other times, however, Dr. Frances has accepted responsibility for the psychiatric pathologizing of normal people. In a lecture at the University of Toronto on May 6, 2012, Dr. Frances said "I'm responsible for some of these changes, and in some cases I'm not too proud of the results ... mea culpa ... We're giving too much treatment to people who don't need it" ("Allen J. Frances

on the overdiagnosis of mental illness", YouTube.com, at 2:55, 11:00 & 29:30). In his book Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, Dr. Frances says his own DSM-IV "probably resulted in more harm than good ... DSM-IV did not save normal, or even protect it very well. ... Our [the DSM-IV Task Force's] changes contributed directly to the false epidemics of autistic, attention deficit, and adult bipolar disorder, and we did nothing to prevent the overdiagnosis of several other disorders" (HarperCollins 2013, pp. xiv, 73, 75). On November 8, 2011 he said "Since the DSM-5 suggestions will all broaden the definition of mental disorder, why should we not worry about diagnostic inflation and the massive mislabeling of normal people as mentally ill?" ("APA Responds Lamely to the Petition to Reform DSM-5", psychiatrictimes.com, bold print in original). In an article titled "The User's Revolt Against DSM-5: Will It Work?", psychiatrictimes.com, on November 10, 2011, Dr. Frances wrote "When it comes to DSM-5, experience has proven conclusively that the American Psychiatric Association (APA) will not attend to the science, evaluate the risks, or listen to reason. A user's revolt has become the last and only hope for derailing the worst of the DSM-5 suggestions. ...DSM-5 is such a mess."

Let's look at examples of what Dr. Frances is talking about that show how unbelievably broad he and his colleagues and successors at the American Psychiatric Association have made the concept of mental illness or disorder. Open almost any page of DSM-5 and it becomes apparent the psychiatrists and others who wrote it appended the term "disorder" or "syndrome" to the words or phrases that describe almost all of life's ordinary and normal problems, challenges, and temptations, regardless of how minor.

In addition to carrying forward supposed disorders in DSM-IV-TR few persons outside psychiatry would consider mental illness or disorder, DSM-5 creates more.

One of the new mental disorders created with the publication of DSM-5 in 2013 is "Tobacco Use Disorder". You probably never thought a person who enjoys smoking cigarettes, pipes, or cigars, or using chewing tobacco has a mental disorder for only that reason, but now that DSM-5 has been published, they do. The "Diagnostic Criteria" for "Tobacco Use Disorder" (p. 571) say a person has the disorder (or illness?) if he or she manifests at least 2 of 11 criteria. The first 4 of the 11 are: "1. Tobacco is often taken in larger amounts or over a longer period than was intended."; "2. There is a persistent desire or unsuccessful efforts to cut down on or control tobacco use"; "3. A great deal of time is spent in activities necessary to obtain or use tobacco"; "4. Craving, or a strong desire or urge to use tobacco." Probably all tobacco users qualify as mentally disordered under these criteria.

In DSM-IV-TR (p. 631) and DSM-5 (p. 404), nightmares that cause you distress qualify you as having a mental disorder. In DSM-5 "Nightmare Disorder" is defined as "Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity" even if "On awakening from the dysphoric dreams, the individual rapidly becomes oriented and alert" if "The sleep disturbance causes clinically significant distress..."

Going to bed late and sleeping late is a "Circadian Rhythm Sleep Disorder...Delayed Sleep Phase Type" in both DSM-IV-TR (2000, p. 622) and DSM-5 (2013, pp. 390-391), but what if you're an early riser?

Might that also be a "disorder"? Yes, in this case the diagnosis (actually description) is "Circadian Rhythm Sleep-Wake Disorder ... Advanced Sleep-Wake Type" (DSM-5, p. 393; in DSM-IV-TR, p. 624, it is one of the "Unspecified Type" Circadian Rhythm Sleep Disorders). DSM-5 says "Advanced sleep phase type is characterized by sleep-wake times that are several hours earlier than desired or conventional times" and that "Individuals with advanced sleep phase type are 'morning types'" (p. 393). According to

psychiatry's current "diagnostic" standards, if you don't sleep and wake up at "conventional times" you have a mental disorder.

Lying or malingering is not just a moral problem but is "Factitious Disorder" in both DSM-IV-TR (p.

517) and DSM-5 (pp. 324-325).

In DSM-5 (p. 462) the criteria for "Oppositional Defiant Disorder", a supposed disorder in children, include "Often loses temper. ... Is often touchy or easily annoyed. ... is often angry and resentful" but only "with at least one individual who is not a sibling." In DSM-5, arguing with siblings is okay, but if you are a child, arguing with a parent or an adult means you have a mental disorder. Oppositional Defiant Disorder also appears in DSM-IV-TR (p. 102) but without the exemption for arguing with siblings.

Becoming angry too often is "Intermittent Explosive Disorder" in DSM-IV-TR (p. 663) and DSM-5 (p.

466).

Do you or have you ever suspected your spouse or intimate partner of infidelity? In that case you have or had "Obsessional jealousy", a subtype of "Other Specified Obsessive-Compulsive and Related Disorder" defined as "nondelusional preoccupation with a partner's perceived infidelity" (pp. 263-264).

No, that's not a misprint: This particular disorder is defined as "nondelusional", but it is still a mental disorder in DSM-5, as if a person should not care very much about a spouse's or intimate partner's infidelity.

Do you often like to get yourself a midnight snack? In that case you have "Night eating syndrome" defined as "Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal" (DSM-5, p. 354).

In DSM-5, "General Personality Disorder" (p. 646) is defined as "An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture." What does conformity with the expectations of the individual's culture have to do with health?

Consider "Social Anxiety Disorder (Social Phobia)": DSM-5 (pp. 203) says "The essential feature of social anxiety disorder is a marked, or intense, fear or anxiety of social situations in which the individual may be scrutinized by others" one example being "performing in front of others (e.g., giving a speech)."

DSM-5 (p. 203, bold print in original) says "Specify if: Performance only: If the fear is restricted to speaking or performing in public." That used to be called "stage fright". Now it is, supposedly, a mental disorder. Stage fright is uncomfortable, but is it a "disorder"? Isn't it normal?

According to Tony Dokoupil in his article "Is the Onslaught Making Us Crazy?", (Newsweek, July 16, 2012, p. 24 at 27-28): When the new DSM [DSM-5] is released next year [2013], Internet Addiction Disorder will be included for the first time, albeit in an appendix tagged "for further study." China, Taiwan, and Korea recently accepted the diagnosis, and began treating problematic Web use as a grave national health crisis. ... two psychiatrists in Taiwan made headlines with the idea of iPhone addiction disorder.

"Internet Addiction Disorder" does not appear in the index of the final published edition of DSM5, and I'm not finding it anwhere in the book. In Saving Normal (p. 225), Dr. Frances says "DSM-5 finally did back down on many of its worst suggestions when these were scorched in the press." While the DSM-5 Task Force may have been shamed or ridiculed out of the idea of Internet Addiction Disorder, "Internet Gaming Disorder" does appear in DSM-5 as a proposal

requiring further study. The "Proposed Criteria" for Internet Gaming Disorder (pp. 795-796) are as follows: Persistent and recurrent use of the Internet to engage in games, often with other players, leading to clinically significant impairment or distress as indicated by five (or more) of the following in a 12 month period: 1. Preoccupation with Internet games. (The individual thinks about previous gaming activity or anticipates playing the next game; Internet gaming becomes the dominant activity in daily life).

Note: This disorder is distinct from Internet gambling, which is included under gambling disorder.

2. Withdrawal symptoms when Internet gaming is taken away. (These symptoms are typically described as irritability, anxiety, or sadness, but there are no physical signs of pharmacological withdrawal.)

3. Tolerance—the need to spend increasing amounts of time engaged in Internet games.

4. Unsuccessful attempts to control the participation in Internet games.

5. Loss of interests in previous hobbies and entertainment as a result of, and with the exception of, Internet games.

6. Continued excessive use of Internet games despite knowledge of psychosocial problems.

7. Has deceived family members, therapists, or others regarding the amount of Internet gaming.

8. Use of Internet games to escape or relieve a negative mood (e.g., feelings of helplessness, guilt, or anxiety).

9. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of participation in Internet games.

Note: Only nongambling Internet games are included in this disorder. Use of the Internet for required activities in a business or profession is not included, nor is the disorder intended to include other recreational or social Internet use. Similarly, sexual Internet sites are excluded.

As mentioned in the above proposed criteria for Internet Gaming Disorder, "Gambling Disorder" also appears in DSM-5, and not merely as one of the "Conditions for Further Study". Gambling Disorder is listed in DSM-5 (pp. 585-589) as a 100% valid and not merely proposed mental disorder. In DSM-IV-TR (2000) it was called "Pathological Gambling" (p. 671). Gambling Disorder in DSM-5 has "Diagnostic Criteria" that are similar to those for internet Gaming Disorder: "Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress ... Has made repeated unsuccessful efforts to control, cut back, or stop gambling. ... Lies to conceal the extent of involvement with gambling" (etc.)

In an article published on psychiatrictimes.com on August 14, 2012, Dr. Frances says this: DSM-5 proposes to introduce a category of "Behavioral Addictions," with gambling as the first member and Internet addiction standing next in line to become a possible second. Behavioral Addictions could eventually easily expand to include passionate attachments to many other common activities. If we can be addicted to gambling and the Internet, why not also include addictions to shopping, excise, sex, work, golf, sunbathing, model railroading, you name it? All passionate interests are at risk for redefinition as mental disorders. ... It should not be counted as a mental disorder and be called an "addiction" just because you really love an activity, get a lot of pleasure from it, and spend a lot of time doing it. ... It is not "addiction" whenever someone gets into trouble because of over-spending, golfing too much, or

having repeated sexual indiscretions. That's our human nature, derived from many millions of years of evolutionary experience...

The title of the above quoted article is "Internet Addiction: The Next New Fad Diagnosis". In his book Saving Normal, Dr. Frances says "Fads in psychiatric diagnosis come and go. All of a sudden everyone seems to have the same problem. Quack theories explain the outbreak; quack treatments presume to provide cure. ... psychiatric diagnosis has always been, and still is, so faddish" (pp. 117 & 136). Harvard psychiatry professor Blaise A. Aguirre, M.D., makes a similar observation in his book Borderline Personality Disorder in Adolescents (Fair Winds Press 2007, p. 15): Psychiatric diagnoses appear to be like cultural fads that come and go. There was a time in child and adolescent psychiatry when everyone had post-traumatic stress disorder (PTSD), and then everyone had bipolar disorder, then Asperger's syndrome, and surely the next big diagnosis will come and go.

Can you imagine a physician saying "There was a time in medicine when we diagnosed everyone as having cancer, and then we started diagnosing everyone as having heart disease, and then we decided everyone had diabetes"? Dr. Aguirre blames "problems in diagnosing psychiatric disorders and the general absence of accurate diagnostic tools and procedures" in psychiatry (Id).

Appearing for the first time in DSM-5 is a childhood disorder called "Disinhibited social Engagement Disorder" (DSM-5, pp. 268-270). Like Gambling Disorder, General Personality Disorder, and Social Anxiety Disorder, Disinhibited Social Engagement Disorder is listed as a 100% valid and not merely proposed mental disorder. According to DSM-5, "The essential feature of disinhibited social engagement disorder is a pattern of behavior that involves culturally inappropriate, overly familiar behavior with relative strangers (Criterion A)." The "Diagnostic Criteria" for this supposed disorder are as follows: A. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following: 1. Reduced or absent reticence in approaching and interacting with unfamiliar adults.

2. Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age-appropriate social boundaries).

3. Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings.

4. Willingness to go off with an unfamiliar adult with minimal or no hesitation.

B. The behaviors in Criterion A are not limited to impulsivity (as in attention-deficit/hyperactivity disorder) but include socially disinhibited behavior.

C. The child has experienced a pattern of extremes of insufficient care as evidenced by one of the following: 1. Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults.

2. Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care).

3. Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios).

D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g.,

the disturbances in Criterion A began following the pathogenic care in Criterion C).

E. The child has a developmental age of at least 9 months.

Such supposedly diagnostic criteria obviously have nothing to do with real illness, disease, disorder, or any biological problem and are only deviance from what is considered wise or expected behavior, along with psychological theorizing about how a young person learned to behave this way. Frequent changes in adult care givers, making a young person too comfortable with new, unfamiliar adults, becomes "pathogenic".

The lack of anything abnormal from a biological perspective is also apparent in the sex-related "diagnoses" in DSM-5, some of which are amusing: DSM-5 includes "Voyeuristic Disorder", defined as "recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors" (p. 686). Perhaps this could have been called Peeping Tom Disorder. (If manifested only by fantasies or urges, and not actual behavior, it could and I think should be considered a type of Orwellian thought crime.)

Exhibitionism, a relatively minor sex crime that is still found in the penal codes of many states of the U.S.A., is now a mental disorder. In DSM-5, "Exhibitionistic Disorder" is defined as "recurrent and intense sexual arousal from the exposure of one's genitals to an unsuspecting person" (p. 689).

DSM-5 defines "Frotteuristic Disorder" as "recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person" (p. 691). In DSM-IV-TR it was called "Frotteurism" (p. 570).

When I was a teenager this was called "copping a feel". Now it's a mental disorder.

If Frotteurism or Frotteuristic Disorder is a diagnosable mental disorder, why isn't rape? In fact that proposal has been made. In Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice (Harper Collins 1997, p. 286) psychology professor Margaret A. Hagen, Ph.D., says the "American Psychiatric Association almost put the 'uncontrollable' desire to rape in the last DSM as a mental disorder. Perhaps it will make it into the next [fifth] edition." It didn't, but if rape ever does make it into a future edition of the DSM, maybe it will be called Paraphilic Rape Disorder. DSM-5 says "The term paraphilia denotes any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners" (p. 685, which after the American Psychiatric Association vote de-illness-izing homosexuality in December 1973 may be of either sex). Rape has in fact been called "Paraphilia Not Otherwise Specified, Nonconsent" by some psychologists: According to psychiatrist Allen Frances, M.D., "The proposal to create a mental disorder for rapists has been raised and unequivocally rejected 5 times" by the writers and editors of various editions of the DSM but "These repeated repudiations haven't prevented poorly trained psychologists testifying as alleged experts ... inventing the fake diagnosis 'Paraphilia Not Otherwise Specified, Nonconsent' and using it as an excuse to justify what are in fact unjustifiable psychiatric commitments" ("DSM-5 Confirms That Rape Is Crime, Not Mental Disorder", psychiatric times.com, February 23, 2013). However, there isn't much logic in including Frotteuristic Disorder and not Rape Disorder as a "diagnosis", so the reason we have Frotteuristic Disorder and not Rape Disorder in the DSM is probably more political and strategic than scientific: Defining rape as a mental disorder would get too much attention and discrediting news media coverage. It also would mean rapists are by definition mentally ill or disordered and therefore not criminally responsible for their crimes (and might

cause legislators dumb enough to take psychiatric "diagnosis" seriously to delete rape from state criminal codes!)

Comedians will find a treasure trove of material in DSM-5.

Dr. Frances' criticisms were for the most part ignored, and as the 2013 publication date for DSM-5 approached, in an article published February 13, 2013, Dr. Frances said this ("DSM5 in Distress", psychologytoday.com): DSM 5 remains a reckless and poorly written document that will worsen diagnostic inflation, increase inappropriate treatment, create stigma, and cause confusion among clinicians and the public. ... My view is that DSM 5 has taken a fatal hit internationally and is greatly discredited in the US. ... My mission now changes. The people working on DSM 5 are no longer my primary audience... My main job now is to alert the public and clinicians on ways to contain diagnostic exuberance and to fight back against excessive and misdirected treatment for people who are essentially normal.

Psychologist Paula Caplan, Ph.D., on February 11, 2012 on "MindFreedom (MF) Live Free Web Radio: Paul Caplan v. Psychiatric Labeling!" (archived at blogtalkradio.com, at the 12 minute, 58 second point), said this about the DSM: I started out as an advocate of the DSM because I believed their advertising, that it was scientifically grounded, and that it would help us help people, so that's why I was in that kind of work. And then when I was on two committees of DSM-IV, I was just horrified. One of my specialties is research methods, and I was appalled to see that when the science is good, but it doesn't fit with what they want, then they ignore it, they distort it, or they lie about it. And when the science is awful, I mean just poorly done, then they'll use that, if it fits with what they want to do.

In his book Psychiatry: The Science of Lies (Syracuse University Press 2008, pp. 18-19) psychiatry professor Thomas Szasz, M.D., says "Modern psychiatry with its Diagnostic and Statistical Manuals of nonexisting diseases and their coercive cures is a monument to quackery on a scale undreamed of in the annals of medicine."

Psychiatrist Ronald W. Pies, M.D., in an article titled "Can Psychiatry be Both A Medical Science and A Healing Art? The Case of Polythetic Pluralism", published October 19, 2011, at psychiatrictimes.com, said this: ...the last two DSMs [DSM-III and IV] can hardly be seen as exemplars of instantiations of "the medical model." As McHugh and Slaveney point out, DSM-III was primarily interested in enhancing diagnostic reliability—essentially, agreement on diagnosis among observers—and not in establishing the biological validity of any condition. Nor have biological factors been a central (or even a peripheral) part of DSM criteria from DSM-III to the expected DSM-5. [italics in original]

Similarly, Robert L. Spitzer, M.D., Chairperson of the American Psychiatric Association's Task Force on Nomenclature and Statistics in the Introduction to DSM-III (1980, p. 8) says this: Diagnostic Criteria. Since in DSM-I, DSM-II, and ICD-9 [International Classification of Diseases, 9th edition] explicit criteria are not provided, the clinician is largely on his or her own in defining the content and boundaries of the diagnostic categories. In contrast, DSM-III provides specific diagnostic criteria as guides for making each diagnosis since such criteria enhance interjudge reliability. It should be

understood, however, that for most of the categories the diagnostic criteria are based on clinical judgment, and have not yet been fully validated by data... [bold print in original, italics added]

Similarly, in his book Saving Normal, DSM-IV and DSM-IV-TR Task Force Chairperson Allen Frances says "Reliability means agreement and consistency—will different clinicians seeing the same patient arrive at the same diagnosis. Validity means truth" (Harper Collins 2013, p. 25). In an article in 2011 he says "For no apparent reason, the [DSM-5] field trials address the (really who cares) question of reliability and will offer nothing at all on the (really essential) questions of validity" ("DSM5 in Distress", psychologytoday.com, November 8, 2011).

Dr. Frances is right on this point: Only validity (truth) matters. If all the observers are wrong, their determinations or "diagnoses" have zero percent validity even if they have 100% agreement and therefore 100% "reliability". For example, at the time of the witch trials, inquisitors familiar with the criteria in the Malleus Maleficarum, a manual describing the characteristics of witches, might have had 100% agreement on who was a witch, but because witchcraft was a myth, and there were in fact no witches, their determinations that certain persons were witches had zero percent validity even if 100% of them were in agreement, and they therefore had 100% "reliability". This is the situation in which modern psychiatry, and those subjected to psychiatric "diagnosis" and "treatment", find themselves: The concept of mental "illness" or "disorder" is as invalid as the concept of witchcraft at the time of the witch trials. Some critics have argued that the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is similar to the Malleus Maleficarum. For example, in his essay Notes on Psychiatric Fascism, Don Weitz says "The DSM is the equivalent of the Malleus Maleficarum in the middle ages, which Spanish inquisitors used to identify, target, stigmatize and burn witches and heretics" (antipsychiatry.org/weitz2.htm, accessed June 10, 2013). ________________________________________________________

THE CONCEPT OF MENTAL "ILLNESS" OR "DISORDER" IS AS INVALID AS THE CONCEPT OF WITCHCRAFT AT THE TIME OF THE WITCH TRIALS ________________________________________________________ According to U.S. National Institute of Mental Health (NIMH) director Thomas Insel, M.D., in an article published on the NIMH web site on April 29, 2013, "The strength of each of the editions of DSM has been 'reliability' each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity." For this reason, he says, the "NIMH will be re-orienting its research away from DSM categories" ("Director's Blog: Transforming Diagnosis", nimh.nih.gov). No less than America's preeminent mental health government agency has rejected American Psychiatric Association DSM "diagnosis".

Unfortunately, Dr. Insel seeks to substitute an equally invalid approach: In the same article he says "Mental disorders are biological disorders involving brain circuits" and that the NIMH will seek to create "a new nosology" that is more scientific than that of the DSM, one based on biological factors. Because the defining characteristic of a mental "illness" or "disorder" is merely disapproval, and biology is no more the cause of mental illnesses or disorders than electronics are the cause of bad television programs, this NIMH effort is doomed to failure.

Contrary to Dr. Insel's observation, the DSM-5 interjudge "reliability" results were actually

poor, at least in the opinion of DSM-IV and DSM-IV-TR Task Force chairperson Allen Frances, M.D. In his book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (Harper Collins 2013, p. 175) Dr. Frances says this: APA [American Psychiatric Association] flunked - instead of admitting that its reliability results were unacceptable and seeking the necessary corrections that might meet historical standards, the goalposts were moved. Declaring by fiat that previous expectations were too high, DSM-5 announced it would accept agreements among raters that were sometimes barely better than two monkeys throwing darts at a diagnostic board.

In an article titled "A Response to 'How Reliable Is Reliable Enough?'" published at psychiatrictimes.com on January 18, 2012, Dr. Frances saysIn the past, "acceptable" meant kappas of 0.6 or above. ... For DSM-5, 'acceptable' reliability has been reduced to a startling 0.2-0.4. This barely exceeds the level of agreement you might expect to get by pure chance. ... Can "accepting" unacceptably poor agreement uphold the integrity of psychiatric diagnosis?

So actually DSM-5 "diagnosis" not only has no validity but also no "reliability".

If scientists in any field lack "reliability" (agreement among themselves), the field or discipline obviously lacks "validity" (truth), making inquiries into validity or truth unnecessary.

An example showing this is true of psychiatry is psychiatrists' testimony about whether or not James Holmes was insane when he killed 12 and injured 70 in a theater shooting in Aurora, Colorado in 2012. According to an Associated Press report, "Four of the psychiatrists who testified were asked to test his sanity. Two declared him sane and two others declared him insane."

Because of the lack general agreement in psychiatry exemplified by Dr. Frances' criticisms, examples like the above cited Holmes case, and rejection of DSM-5 "diagnosis" by the National Institute of Mental Health, and psychiatry's lack of scientific validity, psychiatric testimony does not meet legal criteria for acceptance as scientific or expert evidence in courts of law under either of the standards applied by courts in the U.S.A., namely, the "general acceptance" standard of Frye v. U.S., 293 F. 1013 (D.C. Cir. 1923) that is still used in some states, nor the scientific validity standard of Daubert v. Merrell Dow Pharmaceuticals, 509 U.S. 579 (1993) that applies in federal courts and other states of the U.S.A. Courts should recognize this and stop accepting psychiatric testimony. (See Frye standard in Wikipedia). Involuntary commitment law typically requires commitments be based on "competent psychiatric testimony". For example, Texas Constitution Article 1, Sec. 15-a provides that "No person shall be committed as a person of unsound mind except on competent medical or psychiatric testimony." However, there is no such thing as "competent psychiatric testimony" any more than there is, for example, "competent astrology testimony" or "competent palm reader testimony". In her book Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice (ReganBooks 1997, p.

99), Boston University psychology professor Margaret A. Hagen, Ph.D., says "Upon finishing graduate or medical school" mental health professionals "are not trained to perform the myriad tasks the legal system asks them to perform because no body of knowledge exists to support such training." She says testimony in court by mental health experts such as psychiatrists and

psychologists "do not even come close to meeting the current criteria for admissibility as expert testimony demanded by our courts" (Id., p. 301), and— When the law welcomes the astrologer into the courtroom as possessing the same status as the astronomer, when the court listens to the priest with the same critical judgment it applies to the testimony of the physicist, then and only then will the testimony of clinical psychologists about the formation and functioning of the human mind in general or in a particular individual make sense as expert testimony. [Id., p. 301]

Dr. Hagen laments the fact that "we buy the accreditation of psychiatry at medical schools as if it were on the same standing as any other medical specialty" notwithstanding the fact that it is not (Id., p. 303). She says "Judges and juries, the people alone, must decide questions of insanity, competence, rehabilitation, custody, injury, and disability without the help of psychological experts and their fraudulent skills" (p. 313). Of psychiatrists and psychologists as "expert" witnesses in court she says "That courtroom diagnosticians ignore even the wispiest constraints of reality in reaching their diagnoses is truly frightening" (Id., p. 262). She says that by accepting psychiatrists and psychologists as expert witnesses in court, "Society has created its own monster" (Id., p. 310). ________________________________________________________

THERE IS NO SUCH THING AS "COMPETENT PSYCHIATRIC TESTIMONY" ANY MORE THAN THERE IS "COMPETENT ASTROLOGY TESTIMONY" OR "COMPETENT PALM READER TESTIMONY" ________________________________________________________ How much of a monster we have created by recognizing psychiatric and psychological "diagnosis" as valid when it is not is illustrated by Robyn M. Dawes, Ph.D., a psychology professor at Carnegie-Mellon University, former head of the psychology department at the University of Oregon, and former president of the Oregon Psychological Association, in his book House of Cards: Psychology and Psychotherapy Built on Myth (Free Press 1994, p. 153-154). In his critique of psychological testing he says this: I would like to offer the reader some advice here. If a professional psychologist is "evaluating" you in a situation in which you are at risk and asks you for responses to ink blots or to incomplete sentences, or for a drawing of anything, walk out of that psychologist's office. Going through with such an examination creates the danger of having a serious decision made about you on totally invalid grounds. . .. Let me share an example of what can happen—it did happen.

He goes on to tell a true story of a young woman whose IQ he tested as 126, placing her in the ninetyfifth percentile, meaning her intelligence was superior to all but 5% of the population, who was determined to need involuntary commitment to a state mental hospital because of her interpretation of a single inkblot in what is known as the Rorschach inkblot test. While 40 of her 41 inkblot interpretations were reasonable, she thought inkblot number eight looked like a bear when it didn't to anybody else. Dr. Dawes says at a clinical staff meeting "the head psychologist displayed card number

eight to everyone assembled and asked rhetorically: 'Does that look like a bear to you?'" On the basis of this one inkblot interpretation the young woman was "diagnosed" as schizophrenic and (italics are Dr. Dawes'): "The staff over my objection further agreed that if her parents were ever to bring her back, she should be sent directly to the nearby state hospital. ... she may well have been condemned to serve time in that snake pit on the basis of a single Rorschach response." ________________________________________________________

INVOLUNTARY COMMITMENT TO A MENTAL HOSPITAL BECAUSE OF WHAT A PERSON SEES IN AN INKBLOT? ________________________________________________________ Because of such observations, Dr. Dawes says in the Preface, "My own decision to write this book has been motivated by two factors in particular: anger, and a sense of social obligation. ... far too much professional practice in psychology has grown and achieved status by espousing principles that are known to be untrue and by employing techniques known to be invalid." He agrees wholeheartedly with Boston University psychology professor Margaret A. Hagen (quoted above) about courtroom testimony by mental health professionals such as psychiatrists and psychologists, of which he says— But are they really the experts they claim to be? ... Should their opinions be recognized in our courts as having any more validity than the opinions of anyone else? In particular, are their opinions any better than those of judges, who have been selected on the basis of their legal record to make tough social decisions? Can these mental health practitioners, for example, make a better determination of whether a young child has been sexually abused than can be made of a careful consideration of the evidence without considering their opinions?

These questions have been studied quite extensively, often by psychologists themselves. There is by now an impressive body of research evidence indicating that the answer to these questions is no. ...

Professional psychologists and other mental health experts are often willing to testify, and they have a profound impact on others' lives in the absence of any evidence that what they do is valid. ... Lacking such evidence, [they] should be thrown out of court. [pp. 4, 25]

The absurdity of many of the so-called mental disorders in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders makes it seem the psychiatrists and others who wrote it did so as a joke, and (really!) I have often laughed heartily while looking through DSM-5. In fact, the laughs I've gotten while reading DSM-5 have been worth the $149 I paid for the book. However, the consequences of psychiatric and psychological "diagnosis" are often anything but a laughing matter. The authors of the various editions of the DSM including DSM-5 have written a ridiculous book, but their "diagnoses" are accepted as valid in American courts and elsewhere. Having one of the "mental disorders" in the DSM too often results in a life-changing psychiatric "diagnosis", a lifetime of incarceration or involuntary outpatient treatment, or loss of many of life's most important opportunities, such as admission to medical, law, or other school, or qualifying for licensure in a lucrative occupation, or being hired for a job.

This review of the lack of reliability and validity of psychiatric diagnosis and the absurd

notions in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders shows psychiatric diagnosis has nothing to do with health, nothing to do with anything abnormal in the body including brain, nothing to do with science, often nothing to do with common sense, and everything to do with currently prevailing ideas about how a person ideally "should" be as perceived by the people who wrote the various editions of the DSM and those who use it for "diagnosis".

The bottom line is this: Psychiatric "diagnosis" is nonsense and should be ignored by all.

Psychiatric "diagnosis" serving as the basis of state and federal laws and judgments of courts is the triumph of pseudoscience over justice.

Recommended Reading

Books Allen Frances, M.D., Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (HarperCollins 2013).

In this essay and others I have quoted some of Dr. Frances' statements with which I agree, and I commend him for going as far as he does in debunking much of what psychiatry is today. I disagree with his opinions, stated in Saving Normal, that there is such a thing as a true mental illness or disorder and that psychiatry has bona-fide treatment. With the exception of psychiatrists who entered psychiatry for the purpose of debunking or reforming it, it is undoubtedly difficult for a person to admit he devoted his entire working life to a profession that is pure quackery. I disagree with Dr. Frances' self-serving and self-justifying claims about aspects of psychiatry he thinks are valid, but these points of disagreement are less important than the criticisms of psychiatry he makes in Saving Normal.

Margaret A. Hagen, Ph.D., Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice (ReganBooks 1997)

Articles

2009 Allen Frances, M.D., "A Warning Sign on the Road to DSM-V: Beware of Unintended Consequences, psychiatrictimes.com, June 26, 2009 2010 Joanna Moncrieff, MBBS, MSc, FRCPsych, MD, "Psychiatric diagnosis as a political device", Social Theory & Health (2010) 8, 370-382. doi:10.1057/sth.2009.11 2011 Allen Frances, M.D., "Should Temper Tantrums Be Made Into A DSM-5 Diagnosis?", psychiatrictimes.com, October 13, 2011 Allen Frances, M.D., "Pediatricians Issue Dangerous New Treatment Guidelines for Attention Deficit Disorder", psychiatrictimes.com, psychologytoday.com, October 17, 2011: "...pediatricians can be just as reckless as psychiatrists in their recommendations for Attention Deficit disorder (ADD)."

Allen Frances, M.D., "Psychologists Petition Against DSM-5: Users Revolt Should Capture APA Attention", psychiatrictimes.com & psychologytoday.com, October 24, 2011 Allen Frances, M.D., "What Would A Useful DSM-5 Look Like? And An Update On the Petition Drive", psychiatrictimes.com, October 31, 2011 Allen Frances, M.D., "APA Responds Lamely to the Petition to Reform DSM-5", psychiatric times.com & psychologytoday.com, November 8, 2011 Allen Frances, M.D., "DSM-5: Living Document or Dead on Arrival?", psychiatrictimes.com, November 11, 2011 Allen Frances, M.D., "Counsellors Turn Against DSM-5: Can APA Ignore 120,000 Users?, psychologytoday.com & psychiatrictimes.com, November 17, 2011 Allen Frances, M.D., "Hebephilia is a Crime, Not a Mental Disorder", psychiatrictimes.com, December 15, 2011 Allen Frances, M.D., "APA Attempts to Defend Itself", psychiatrictimes.com, December 25, 2011 2012 Allen Frances, M.D., "A Response to 'How Reliable Is Reliable Enough?'", psychiatric times.com, January 18, 2012 Allen Frances, M.D., "DSM-5 and Diagnostic Inflation: Reply to the DSM-5 Task Force", psychiatrictimes.com, January 23, 2012 Allen Frances, M.D., "More Than 65,000 Grievers Must Be Heard-and Should Be Heeded", psychiatrictimes.com, March 6, 2012 Allen Frances, M.D., "Am I a Dangerous Man? No, but I Do Raise Twelve Dangerous Questions", psychologytoday.com, psychiatrictimes.com, March 16, 2012 Allen Frances, M.D., "Internet Addiction-The Next New Fad Diagnosis", psychiatrictimes.com, August 14, 2012 Allen Frances, M.D., "Definitive Study Rejects the Diagnosis of 'Psychosis Risk' and Finds No Treatment Benefit", huffingtonpost.com, psychiatrictimes.com, psychologytoday.com, April 16, 2012 2013 Allen Frances, M.D., "DSM-5 Confirms That Rape Is Crime, Not Mental Disorder", psychiatric times.com, February 21, 2013 Thomas Insel, M.D., "Director's Blog: Transforming Diagnosis", April 29, 2013, nimh.nih.gov Michael Mechanic, "Psychiatry's New Diagnostic Manual: 'Don't Buy It. Don't Use It. Don't Teach It.'", May 14, 2013, motherjones.com Recommended Videos

"Jeffrey A. Schaler, Ph.D., Professor of Psychology", YouTube.com (2006). If you watch only one of the videos I recommend, this 9-minute video is the one to watch.

"The DSM: Psychiatry's Deadliest Scam", YouTube.com

I recommend the two above Citizens Commission on Human Rights (CCHR) videos without endorsing CCHR itself nor the founder of CCHR, the Church of Scientology: See comment in The Future of Antipsychiatry Activism

copyright 2014 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Why the Myth of Mental Illness Lives On" ]

Why the Myth of Mental Illness Lives On Wayne Ramsay, J.D.

"The opinion that mental illness does not exist has been advanced by, among others, psychiatrist Thomas Szasz, sociologists Thomas Scheff and Erving Goffman, and psychologist Theodore Sarbin" (Judi Chamberlin, Own Our Own, National Empowerment Center 1977, p. 8). In his testimony before the Mental Health Committee of the New York State Assembly (state legislature) on May 18, 2001, neurologist John Friedberg, M.D., said this: I do not believe in mental illness. ... Psychiatric drugs and electroshock inflict real injury in the name of treating fictive maladies. ... My opinions are based on my years of experience with patients and review of records from all over the country as an expert witness in electroshock malpractice cases.

In 2011, Steve Balt, M.D., a psychiatrist at the UCLA-Kern Medical Center in Bakersfield, California, acknowledged "some argue convincingly that mental illness is itself a false concept" ("Is the Criticism of DSM-5 Misguided?", psychiatrictimes.com & thoughtbroadcast.com), citing an article by psychiatry professor Thomas Szasz. Dr. Szasz published his book The Myth of Mental Illness in 1961, which now in 2014 is fifty-three years ago. If mental illness is a myth, why do people still believe in mental illness?

One reason is the effects of repetition over time. The more often one hears a myth stated, the harder it is to bring oneself to use one's own powers of perception and reason to examine and question it. Almost everything we read in newspapers and magazines, and almost everything we see on television or hear on radio, and much of what we read on the Internet, discusses "mental illness" as if it were as real and valid a concept as heart disease or cancer. We tend to believe what those around us believe, and eventually "most of our stored misinformation is virtually [metaphorically] cast in concrete" (Donald G. Smith, How to Cure Yourself of Positive Thinking, E. A. Seemann Publishing, Inc., Miami, 1976, p. 73).

Another reason the myth of mental illness and other widespread myths persist is the risk to anyone who questions what almost everyone believes. Dare one be the first to declare the emperor has no clothes? People who clearly understand the mythical nature of a widespread belief risk the disapproval of others, or worse, if they speak the truth about these myths.

Historians have said those questioning the concept of witchcraft in the 1690s when the Salem witch trials took place risked being accused of being witches themselves. According to Peter Charles Hoffer, research professor of history at the University of Georgia, in his book The Salem Witchcraft Trials—A Legal History, "In the 1600s, popular or 'vernacular' belief in witches was repeated in the writings of the most learned men. ... In the late sixteenth century, many educated men assumed that there was a spirit (invisible) world, and that the Devil and His witches could move freely through it. ... Everyone believed in witches ... no lawyers stepped forward during the [witch] trials to help the accused", but if they had, the people making such accusations "would probably have accused the lawyers of witchcraft before long" (University Press of Kansas 1997, pp. 4, 78, 87, 89, 90).

Just as lawyers speaking on behalf of defendants in the Salem, Massachusetts witchcraft trials of the 1690s would have been in danger of being accused of witchcraft themselves, as a lawyer representing or speaking in defense of people accused of mental illness today, a reaction I sometimes get is people accusing me of being crazy. As psychiatry professor Thomas Szasz says in his book Suicide Prohibition—The Shame of Medicine, "The individual who assumes the task of setting such dislocations aright runs the risk of being destroyed in the process" (Syracuse University Press 2011, p. 105).

A related reason for the persistence of the concept of mental illness is support by supposed experts—psychiatrists and psychologists—who make money and acquire professional prestige with the use of the concept. Their status as experts would be lost and their incomes would drop dramatically if the falseness of the concept of mental illness were widely and generally acknowledged. As Judi Chamberlin wrote in her book about psychiatry, "Leaving the determination of whether mental illness exists strictly to the psychiatrists is like leaving the determination of the validity of astrology in the hands of professional astrologers" (Own Our Own, p. 9). Support for a myth from those perceived as experts, even if they actually are not experts, makes a myth harder to question.

The inexplicit nature of the concept of mental illness also contributes to the perpetuation of this myth. Consider another myth: Can it really be proved evil spirits do not exist, and that they do not possess people? Even as perceived by those who believe in it, the concept of mental illness is as amorphous and difficult to pin down in specific terms as the idea of evil spirit possession. Some, like Millen Brand in an article in 1970 in The Journal of Contemporary Psychotherapy titled "Is Mental Illness a Myth?" argue against the notion that "because 'mental illness' isn't a medical or physical illness, it doesn't exist at all" (Summer 1970, Vol. 3, p. 13).

Psychologist Vernon W. Grant, Ph.D., in his book This Is Mental Illness says this:

There is, again, a certain tendency in popular thinking to suppose that mental illness includes something more than the symptoms. Thus a person is said to be doing or saying certain things because is mentally ill. The illness, supposedly, causes him to act and speak as he does. ... It would be misleading, however, to say that the abnormal ways of feeling and perceiving are caused by "mental illness." These ways of feeling and perceiving are the illness. Too often the term suggests a mysterious something behind the unusual behavior. [Beacon Press 1963, p. 4, italics in original] Other mental health professionals argue there is a mysterious something behind, or causing, the person's behavior, or so-called symptoms, and that this mysterious something is a still undiscovered "chemical imbalance" in the brain or some other brain abnormality. They argue mental illness is, by definition, a disease of the brain, even if current science can find nothing wrong with the brains of supposedly mentally ill people. Mental health professionals can't agree among themselves about whether mental illness is physical or non-physical. Being a vague concept makes the concept of mental illness more difficult to disprove and reject than it would be if it were clearly defined.

Also helping to perpetuate the myth of mental illness is the desire of some people to avoid personal responsibility for their actions and their lives. These are the people who telephone or write to me hoping I will, as a lawyer, help them prove that because of their supposed mental illness they are not responsible for something they did. These also are the people who go to a mental health professional and in effect say "Doctor, make me happy": It is much easier to swallow supposedly antidepressant pills than get a better education or a better job, or a better marriage or intimate relationship, or be cured of a serious health problem like cancer. People who neglect or mistreat their children sometimes rely on the concept of mental illness to relieve them of responsibility for how their children turn out as adolescents or adults. What have they done wrong? In many cases, the answer is plenty. But they prefer to believe a disease (mental illness) that "could happen to anyone" intervened and that "It's no one's fault."

Another reason, mentioned in my essay Does Mental Illness Exist?, is our discomfort with ignorance.

When we don't understand the real reasons for something, we often create myths to give us an illusion of understanding. Believing a myth is more comfortable than acknowledging ignorance. For example, ancient man did not understand the why behind rain and therefore created the myth of the Rain God. As man gained a knowledge of meteorology and hence a true knowledge of the why behind rain, the Rain God was no longer needed, and the Rain God idea was discarded. Earlier in human history, being baffled by the thinking and behavior of some people, people theorized the existence of evil spirits or demons and created the myth of demon possession, the belief that people behaved strangely or wrongly because they were possessed by evil spirits. In the words of A. John Rush, M.D., "Deranged behaviors were typically considered curses from the gods by the Ancients... During the Dark Ages, Western civilization returned to beliefs in possession and supernatural forces as explanations for psychiatric disorders" ("Diagnosis of Affective Disorders" in Depression Basic Mechanisms, Diagnosis, and Treatment, Guilford Press 1986, p.

2). Today we attribute thinking or behavior we dislike and don't understand to mental illness. However, mental illness is just as much a myth as curses by gods or possession by evil spirits. Often we just don't know why people think or act as they do. Rather than acknowledge our ignorance, which makes us uncomfortable, we create myths such as evil spirits or mental illnesses to provide an explanation.

Why aren't all crimes considered mental illnesses or the result of mental illness? Some people do say

"all criminals are sick." However, for those of us who don't agree with this viewpoint, the difference between crime and mental illness typically is this: When we feel we understand the motives behind the disapproved behavior, we make the behavior a statutory offense. When we do not understand the motives behind disapproved behavior, we cover up our ignorance of these motives by creating a myth— the myth of mental illness—and say mental illness caused the behavior (and punish the supposedly mentally ill person with involuntary "hospitalization" or an involuntary outpatient commitment order, and forced psychiatric "therapy" such as "involuntary medication", or involuntary guardianship of his person and property). The myth of mental illness deludes us into believing we understand the reasons for disliked behavior that we in fact do not understand.

Another reason for continued belief in mental illness is drug company advertising designed to convince everyone mental illness is biologically caused. Marcia Angell, M.D., former editor-in-chief of the New England Journal of Medicine, in her book The Truth About Drug Companies—How They Deceive Us and What To Do About It (Random House 2005, p. 88) approvingly quotes bioethicist Carl Elliott saying "The way to sell drugs is to sell psychiatric illness." Psychiatrist Colin A. Ross, M.D., makes a similar comment in his autobiographical book The Great Psychiatry Scam—One Shrink's Personal Journey (Manitou Communications, Inc. 2008, p. xv): "Whatever makes mental illness be biological sells drugs."

In Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (HarperCollins 2013, p. 104), psychiatrist Allen Frances says "Psychotropic drugs are now among the very top best sellers for the drug companies. Their stock prices would be cut by more than half were it not for the antipsychotics, antidepressants, stimulants, antianxiety agents, sleeping pills, and pain meds. ... At the very top of the Pharma hit parade are the antipsychotics at a resounding $18 billion a year." Do you think drug company executives and advertising departments will tell the depressing truth about their products if widespread awareness of the truth would cause their company stock to be worth less than half what it is now? It is more likely they are determined to maintain the myth that mental illness is biological and to hide the harm done by psychiatric drugs so they can continue to earn huge profits from selling psychiatric drugs. Advertising mental illness as biological when it is not to sell more psychiatric drugs may be unethical, but as Dr. Angell warns us in The Truth About Drug Companies (p. 250), "Drug companies are in business to sell drugs. Period." And drug companies have huge advertising budgets.

I believe one of the most important reasons the myth of mental illness persists is what I call the inadequacy of rule of law. "Rule of law" is a sacred concept in American jurisprudence. On the day she was sworn-in as a U.S. Supreme Court justice, Sonia Sotomayor spoke eloquently about how deeply and sincerely she believes in rule of law. With the exception of civil commitment and involuntary guardianship laws, laws that fail to put people on notice of what is required or prohibited are invalidated by American courts as void for vagueness. An example is Papachristou v. City of Jacksonville, 405 U.S. 156 (1972), wherein a unanimous U.S. Supreme Court overturned the decision of lower courts and declared a Jacksonville, Florida vagrancy ordinance unconstitutionally vague. The Supreme Court said this: This ordinance is void for vagueness, both in the sense that it "fails to give a person of ordinary intelligence fair notice that his contemplated conduct is forbidden by the statute," United States v. Harris, 347 U.S. 612, 347 U.S. 617, and because it encourages arbitrary and erratic arrests and convictions.

Thornhill v. Alabama, 310 U.S. 88; Herndon v. Lowry, 301 U.S. 242. Living under rule of law entails

various suppositions, one of which is that "[all persons] are entitled to be informed as to what the State commands or forbids."

Judged by this standard, all laws authorizing civil commitment for mental illness, or loss of civil rights in involuntary guardianship (of adults), are void for vagueness and unconstitutional because they do not allow people of ordinary intelligence to know in advance what behavior or expression of ideas or outward display of emotions may result in losing their liberty or civil rights because of a "diagnosis" of mental illness and an involuntary inpatient or outpatient commitment or involuntary guardianship.

One might argue the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) delineates what is and what is not a mental disorder, and hence what speech and behavior is and is not allowed, and that therefore the DSM provides the constitutionally required notice of what the state commands or forbids. However, the "Cautionary Statement" at the beginning of DSMIV-TR (p. xxxvii) explicitly disclaims the Manual provides guidance for legal purposes: It is to be understood that inclusion here, for clinical and research purposes, of a diagnostic category such as Pathological Gambling or Pedophilia does not imply that the condition meets legal or other nonmedical criteria for what constitutes mental disease, mental disorder, or mental disability. The clinical and scientific considerations involved in categorization of these conditions as mental disorders may not be wholly relevant to legal judgments, for example, that take into account such issues as individual responsibility, disability determination, and competency.

An introductory chapter in DSM-5, published in 2013, includes a similar disclaimer titled "Cautionary Statement for Forensic Use of DSM-5" (p. 25): ...it is important to note that the definition of mental disorder included in DSM-5 was developed to meet the needs of clinicians, public health professionals, and research investigators rather than all of the technical needs of the courts and legal professionals. ... When DSM-5 categories, criteria, and textual descriptions are employed for forensic purposes, there is a risk that diagnostic information will be misused or misunderstood. These dangers arise because of the imperfect fit between the questions of ultimate concern to the law and the information contained in a clinical diagnosis. In most situations, the clinical diagnosis of a DSM-5 mental disorder such as intellectual disability (intellectual developmental disorder), schizophrenia, major neurocognitive disorder, gambling disorder, or pedophilic disorder does not imply that an individual with such a condition meets legal criteria for the presence of a mental disorder or a specified legal standard (e.g., for competence, criminal responsibility, or disability). For the latter, additional information is usually required beyond that contained in the DSM-5 diagnosis ... assignment of a particular diagnosis does not imply a specific level of impairment or disability. ...

Nonclinical decision makers should also be cautioned that a diagnosis does not carry any necessary implications regarding the etiology or causes of the individual's mental disorder or the individual's degree of control over behaviors that may be associated with the disorder.

Even if the DSM is nevertheless accepted as a valid standard for legal judgments, it fails to provide the constitutionally required notice of what the state commands and forbids, failure to comply with which may result in forced treatment or loss of liberty, because the DSM does not state which supposed disorders justify involuntary commitment, or loss of civil rights, and which do not.

Should a man with the DSM-5 diagnosis "Male Hypoactive Sexual Desire Disorder" (DSM-5, p. 440), defined as "Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity" be involuntarily committed? It is an official mental disorder, but would anybody advocate involuntary commitment of a man only because he has no interest in sex? What about a woman with "Female Sexual Interest/Arousal Disorder (DSM-5, p. 433-437), which has a definition similar to that of the male version of this supposed disorder? Or looking back at DSM-IV-TR (published in 2000), how about diagnosis "315.00 Reading Disorder"?: "The essential feature of Reading Disorder is reading achievement (i.e., reading accuracy, speed, or comprehension as measured by individually administered standardized tests) that falls substantially below that expected given the individual's chronological age, measured intelligence, and age-appropriate education" (p. 51). Reading Disorder was carried forward into DSM-5 as "Specific Learning Disorder...With impairment in reading" (DSM-5, pp. 6667). How about involuntary treatment for DSM-IV-TR diagnosis "315.1 Mathematics Disorder" (p. 53), which has a definition similar to that of Reading Disorder? Mathematics Disorder was carried forward into DSM-5 as "Specific Learning Disorder...With impairment in mathematics" (DSM-5, pp. 66-67). Or consider DSM-IV-TR diagnosis number "315.2 Disorder of Written Expression" defined as "writing skills...below those expected given the individual's chronological age...[etc.]", carried forward into DSM-5 as "Specific Learning Disorder...With impairment in written expression" (DSM-5, p. 66-67). Other examples are DSM-IV-TR diagnosis numbers 302.73 and 302.74, "Female Orgasmic Disorder" (p. 547) and "Male Orgasmic Disorder" (p. 550), both of which are defined as difficulty achieving orgasm, and both of which are official psychiatric diagnoses or disorders or diseases. "Female Orgasmic Disorder" also appears in DSM-5 (p. 429). DSM-5 defines the following as mental disorders: "Erectile Disorder" (p.

426), "Premature (Early) Ejaculation" (p. 443), and "Delayed Ejaculation" (p. 424). Would anybody advocate involuntary inpatient or involuntary outpatient treatment only because a man has any of these sexual "disorders"? Other examples are Tobacco Use Disorder (e.g., smoking too much, DSM-5, p. 571), Child Onset Fluency Disorder (Stuttering, DSM-5, p. 45), General Personality Disorder ("behavior that deviates markedly from the expectations of the individual's culture", DSM-5, p. 646), and Nightmare Disorder (DSM-5., p. 404). Might involuntary treatment be appropriate for someone with one of the "Circadian Rhythm Sleep-Wake Disorders" such as "Delayed Sleep Phase Type" (going to sleep very late and sleeping late into the next day, DSM-5, pp. 390-391) or "Advanced Sleep-Wake Type" (early to bed and early to rise, DSM-5, p. 393)? Like DSM-IV-TR, DSM-5 does not state which of these or other supposed mental disorders qualify a person for involuntary hospitalization or involuntary outpatient treatment.

In The Manufacture of Madness (Harper & Row 1970, p. 68), psychiatry professor Thomas S. Szasz, M.D., says "psychiatry shows an unmistakable tendency to interpret all kinds of deviant or unusual behavior as mental illness." At one time, homosexuality was an example. Would it have been appropriate to subject all homosexuals to involuntary treatment prior to the American Psychiatric Association's vote in 1973 to de-designate homosexuality as a mental disorder? DSM-II (published in

1968, p. 44) said homosexuality was a mental disorder but did not say all homosexuals should be treated involuntarily if they refuse treatment for their homosexuality. However, it probably happened to homosexual adolescents whose parents were upset by their homosexuality. Some of those adolescents may even have been lobotomized as treatment for their homosexuality: In Psychosurgery—Damaging the Brain to Save the Mind (HarperCollins 1992, pp. 21 & 50), Joann Ellison Rodgers of The John Hopkins Medical Institutions says in the middle decades of the 20th Century— Rapists, pedophiles, homosexuals, exhibitionists, and transvestites were all candidates for lobotomies. ...

Many lobotomies, for example, were performed on the institutionalized mentally ill to stop or limit 'bizarre' sexual behavior, which at that time meant masturbation, homosexuality, and for women, almost any overt desire for sexual release.

Similarly, in 2005 Emad N. Eskandar, M.D., G. Rees Cosgrove, M.D., and Scott L. Rauch, M.D., of Massachusetts General Hospital and Harvard Medical School said: Psychiatric neurosurgery was first introduced as a treatment for severe mental illness by Egas Moniz in 1936. ... despite a lack of objective therapeutic benefit, psychiatric neurosurgery was enthusiastically adopted by practitioners of the day. At the height of enthusiasm, psychiatric neurosurgery was recommended for curing or ameliorating schizophrenia, depression, homosexuality, childhood behavior disorders, criminal behavior and uncontrolled violence. ["Psychiatric Neurosurgery", neurosurgery.mgh.harvard.edu, accessed February 5, 2014, underline added]

Lobotomizing people as treatment for masturbation, homosexuality, or normal heterosexual desire is an example of harm caused by psychiatric "diagnosis" that is based on deviance from cultural norms or values rather than demonstrated biological abnormality. It is also an example of why I call psychiatry evil.

I have uncovered no 21st Century reports of involuntary psychosurgery, but brain-damaging "medication" and electroshock are given to people over their objection every day in the U.S.A., either of which is capable of inflicting brain damage as severe as occurs with psychosurgery. _________________________________________________

LOBOTOMY AS TREATMENT FOR HOMOSEXUALITY? _________________________________________________ People are committed involuntary to mental hospitals every day in the U.S.A. because they have "suicidal ideation" despite the fact that neither the DSM nor civil commitment laws put people on notice they are allowed to think about some things but not other things. Where is it written, even in the DSM, that Americans are not permitted to even think about ending their own lives—and that if they do loss of liberty may be the consequence?

This leaves aside the equally important question of whether the there is a right to freedom of thought under U.S.A.'s First Amendment (made applicable to the states by the Fourteenth Amendment), similar state constitutional provisions (e.g., Article 1, Section 8 of the Texas Constitution), or constitutional provisions in other countries, that should take precedence over

psychiatry's supposedly diagnostic (but actually only descriptive) classification system and the State's statutory involuntary commitment criteria.

It should be obvious that one of the purposes of the DSM is to allow mental health professionals to bill health care insurance companies and government programs such as Medicare and Medicaid for virtually anything (which is one reason health care insurance premiums are exorbitant, and one reason health care is bankrupting the government and the economy). Much normal human thinking and behavior at least arguably falls within a category of mental disorder in the DSM. The supposedly diagnostic (but actually only descriptive) criteria in the DSM are so broad many commentators and critics have correctly said there probably is no human being alive who falls within none of the DSM's various categories of mental disorder, and most people meet the criteria for several psychiatric diagnoses simultaneously. For example, "In court testimony, under oath, Jay Katz, a professor of psychiatry at Yale, admitted that 'If you look at DSM-III you can classify all of us under one rubric or another of mental disorder'" (quoted in Thomas Szasz, Insanity—The Idea and It's Consequences, Syracuse University Press 1997, p. 57). In his book The Hyperactivity Hoax, board-certified neurologist and psychiatrist Sydney Walker III, M.D., says "The other major flaw of DSM, related to the first, is that it labels virtually everything as some type of disorder. Thus, a child who sees a DSM-oriented doctor is almost assured of a psychiatric label and a prescription, even if the child is perfectly fine" (St. Martin's Press 1998, p. 23; italics are Dr. Walker's). According to Marcia Angell, M.D., Senior Lecturer in Social Medicine at Harvard Medical School and former editor-in-chief of The New England Journal of Medicine, in her endorsement on the dust cover of Dr. Allen Frances' book, Saving Normal, Dr. Frances "was once the most influential psychiatrist in the country, as head of the task force that compiled the last [fourth] edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM)". Yet even this highly esteemed psychiatrist, Dr. Frances, says he "met many other friends working on DSM-5 who were similarly excited by their pet innovations and soon discovered that I personally qualified for many of the new disorders that were being suggested by them for inclusion for DSM-5" (Saving Normal—An Insider's Revolt Against Outof-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, HarperCollins 2013, p. xvii). Dr. Frances cites "a study that found 83 percent of kids qualify for mental disorder diagnosis by the time they are twenty-one" (Id., p. 177: Journal of American Academy of Child and Adolescent Psychiatry: "Cumulative Prevalence of Psychiatric Disorders

by Young Adulthood: A Prospective Cohort Analysis from the Great Smoky Mountains Study", Vol. 50, No. 3, (2011) pp. 252-261). In their book Mad Science: Psychiatric Coercion, Diagnosis, and Drugs (Transaction Publishers 2013, p. vii), three social work and social welfare professors (Stuart A. Kirk, et al.) say "According to the latest American Psychiatric Association methods of diagnosing mental illness, nearly one hundred million people, 25 to 30 percent of the US population, have a mental illness during any one year, and half of the population will have a mental illness during their lifetime." Similarly, in 2011 Dr. Vernon Coleman, a British physician, wrote that "diagnostic symptomotology is so vague and far reaching that I could, without much difficulty, find some definable mental illness in every person in the UK" (Do Doctors and Nurses Kill More People Than Cancer?, European Medical Journal 2011, p. 32). In Whores of the Court: The Fraud of Psychiatric Testimony and the Rape of American Justice (ReganBooks 1997, p. 250), Boston University psychology professor Margaret A. Hagen, Ph.D., says "The newest (1994) Diagnostic and Statistical Manual of Mental Disorders provides the civil litigant with literally hundreds of possible disorders, each neatly laid out with the necessary symptoms.

It is hard to imagine that anyone could live in today's society and not be diagnosed with at least one of these many disorders." _________________________________________________

THE DSM LABELS VIRTUALLY EVERYTHING AS SOME TYPE OF DISORDER _________________________________________________ DSM-5 broadens the categories of mental disorder even more than DSM-III, DSM-IV or DSM-IV-TR. According to Dusan Kecmanovic, professor of psychiatry and political psychology at Sarajevo University, "it will be difficult to be normal after the publication of DSM-5" ("DSM5: The More It Changes The More It Is the Same", Psychiatria Danubina, 2013; Vol. 25, No. 2, pp. 94-96). (Americans should keep this in mind when considering laws to keep guns out of the hands of the "mentally ill": Since nearly everyone qualifies as mentally ill under current criteria, such laws could in application be a de facto repeal of the Second Amendment.) In her book, The Trouble With Drug Companies, Dr. Marcia Angell says "few psychiatric disorders have objective criteria for diagnosis" (p. 88). Actually, none do. The vague, unreliable, unpredictable, and invalid nature psychiatric diagnosis enables and encourages arbitrary "diagnosis" and arbitrary involuntary treatment. That violates the constitutional standard stated by the Supreme Court in Papachristou.

The constitutional law requirement that government must tell you what is and is not allowed before it may do anything to you as a consequence of your failure to act as expected is only fair.

That's why the U.S. Supreme Court has declared it to be constitutionally required.

There is, however, a problem with this constitutional requirement, or said another way, there is a problem with rule of law: We can't always anticipate and articulate, in advance, everything a human being might possibly say or do that other human beings, upon being made aware of it, will consider unacceptable.

This epiphany came to me in 1992 when I was sitting at a table in a restaurant in Manhattan with the woman I was dating at the time. Our table was located next to a window on the other side of which was a sidewalk. A man who looked like he was homeless put his face very close to the window as he stared at us, pointed at us, made funny faces, and did an odd sort of dance. His behavior was distracting and inappropriate, but how would one write a law prohibiting what he was doing?: Don't look into or get too close to restaurant windows? Don't point at people?

Don't make funny faces? Don't dance on the sidewalk? Similarly, I once saw a man sleeping on the floor in a hotel corridor with his face against a dirty carpet. At first I thought he might be dead, but after several seconds of observation I could see he was breathing. I advised the hotel front desk clerk who roused the man and told him he couldn't sleep there and told him to go sleep in his hotel room. The next day in a Subway Sandwich Shop a patron who looked like he was homeless began singing loudly and vastly off-pitch along with the music playing on speakers in the ceiling of the shop, disturbing everyone in the shop. Examples abound in the evidence introduced at involuntary commitment and involuntary guardianship hearings. After I think I've heard and seen everything, the behavior or ideas of a proposed patient in an involuntary commitment for supposed mental illness or of the proposed adult ward in an involuntary guardianship trial confronts me with yet another example of unacceptable thinking or behavior I wouldn't have thought of had I been given the job of writing a state's criminal code and other laws. It is largely because of this difficulty that we have the concept of mental illness.

Sociologist Thomas Scheff has defined mental illness as "residual rule-breaking": "After crime," wrote two of his critics, "perversion, drunkenness, bad manners, there are always those diverse

grab-bag violations for which the culture has no explicit label—the 'residual rules' broken by those deemed mentally ill" (Rael Jean Isaac & Virginia C. Armat, Madness in the Streets, Free Press/Macmillan 1990, p. 49). The concept of mental illness allows us, as a society, to impose sanctions, that is, punishment (called "therapy") on law-abiding people who fail to live in accordance with our expectations about what conduct people should and should not engage in, and what beliefs or thoughts people should or should not express. As psychiatry professor Thomas Szasz said in 1994, "when I grew up in Hungary—1920s, 1930s—it was very, very clear that psychiatry was essentially a jail function. There were blue coated policemen and white coated policemen." ("Thomas Szasz on Socialism in Health Care", YouTube.com at 1:24:42). In "Mental Illness as Brain Disease: A Brief History Lesson", Dr. Szasz says "The contention that mental illness is brain disease is as old as psychiatry itself: it is an integral part of the grand lie that psychiatry is a branch of medicine and healing, when in fact it is a branch of the law and social control" (szasz.com, accessed August 2, 2014). Similarly, in 2011 three authors including psychology professor Mark Rapley and psychiatrist Joanna Moncrieff call psychiatry "the enterprise of policing human conduct" (Rapley, et al., Medicalizing Misery, Palgrave Macmillan 2011, p. 4). British psychiatrist Suman Fernando says "psychiatry...from the very beginning...has been concerned with social control" (Id., p. 50). In Madness—A Brief History, Roy Porter, Professor of the Social History of Medicine at the University College, London says "To many the psychiatrist seemed to have been reduced to acting as society's policeman or gatekeeper, protecting it from the insane" (Oxford University Press 2002, p. 186). The role of psychiatrists as police is also underscored by the subtitle of Louise Armstrong's book And They Call It Help— The Psychiatric Policing of America's Children (Addison-Wesley Pub. Co. 1993). Blue-coated police enforce written laws. White coated police—psychiatrists—enforce unwritten laws prohibiting thinking and behavior we either didn't think to write a law against or choose not to (for reasons discussed below) or for which we just can't find the right words (like my above examples). Psychiatry's roles as (1) part of the medical profession and (2) de facto police who enforce society's unwritten laws are obfuscated and confused, resulting in violators of society's unwritten laws not having the benefit of the protections that exist in criminal law. Violating society's unwritten laws is called mental illness or disorder. The punishment is imprisonment called involuntary hospitalization, psychological and physical misery and brain damage caused by "involuntary medication" or involuntary electroconvulsive "therapy".

Oddly, violators of our unwritten laws tend to be punished more harshly than those who violate our written laws: Would anyone advocate drug or electroshock induced brain damage as punishment for bank robbery or even murder? Our current approach circumvents the difficult task of defining, in advance, what is and is not permitted and permits us to impose especially severe punishments. It is easier to call people mentally ill and incarcerate and punish them with supposed treatment for their supposed mental illness than it is to anticipate everything people might do that is unacceptable and enact laws prohibiting the behavior. _________________________________________________

PSYCHIATRISTS AND THEIR CO-WORKERS ARE WHITE-COATED POLICE WHO ENFORCE SOCIETY'S UNWRITTEN LAWS _________________________________________________ Sometimes belief in mental illness, or a pretense there is such a thing as mental illness, is the only way we can impose sanctions for disliked speech or behavior because, if we were to write laws clearly describing what is prohibited, it would be obvious we are violating the

constitutional rights of the accused with such laws. For example, people are often forced into psychiatric "treatment", including involuntary hospitalization, because of what they say rather than because of what they do. Does this violate the First Amendment guarantee of freedom of speech? Does the First Amendment protect only speech other people consider sane or rational?

Refusing to speak when other people think you should is another example.In 2011 I was an observer at an involuntary commitment hearing of a man whose "Selective Mutism" (rarely saying a word to anyone, DSM-IV-TR diagnosis 313.23, p. 125) was his main supposed symptom of supposed mental illness, and at that hearing (after expiration of the time he could be held on a criminal charge) he was involuntarily committed to Kerrville State Hospital. In Wooley v.

Maynard, 430 U.S. 705 at 714 (1977), the U.S. Supreme Court said "the right of freedom of thought protected by the First Amendment against state action includes both the right to speak freely and the right to refrain from speaking at all." Texas Jurisprudence, a legal encyclopedia, says "Liberty of silence is included by the guarantee of liberty of speech" (9 Tex.Jur. Constitutional Law ยง91, p. 525). Because it would be unconstitutional, nobody is going to write a law saying you must speak with people. Nevertheless, engaging in normal conversation with those around you is an expectation nearly everyone has. Therefore, mutism or selective mutism can become "mental illness" motivating involuntary "treatment" and did in this case despite the constitutional right to, in the U.S. Supreme Court's words, "refrain from speaking at all." It is possible to incarcerate a person because he exercises a constitutional right such as refusing to talk if the ostensible or supposed reason is "mental illness" rather than the constitutionally protected action or inaction.

We could enact criminal laws against mutism, or unconventional religious or philosophical beliefs, or converting to a religion your family abhors, or loudly expressing nonreligious beliefs most people disagree with, or being grandiose or obnoxious, or revealing oneself to be excessively unhappy ("depressed"), or talking aloud to oneself with others present, or admitting to thinking about suicide, or attempting suicide. We don't, because writing such laws wouldn't seem right. In many cases such laws would be an admission of how narrow-minded, intolerant, authoritarian, and even despotic we sometimes are, including in nations like the United States of America where freedom is frequently touted as the reason for American patriotism. Frequently, such laws would be impossible to reconcile with America's First Amendment guarantee of freedom in thought and expression or similar guarantees in other democracies and Article 19 of the United Nations Universal Declaration of Human Rights adopted by the United Nations General Assembly in Paris on December 10, 1948: Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media...

State and federal laws authorizing civil commitment for mental illness in the United States of America and other nations routinely violate this right to freedom of opinion and expression.

Freedom of thought, opinion, and expression is respected in the U.S.A. if a person thinks Jesus is the Son of God but not if he thinks he is the Son of God, or if he thinks others are persecuting him (and others disagree), or if he thinks his life is not worth living (and others disagree), or if he has other thoughts other people consider crazy or bothersome. As psychiatry professor Thomas Szasz wrote in 1973: "If you talk to God, you are praying; If God talks to you, you have schizophrenia" (The Second Sin, Anchor/Doubleday 1973, p. 113). We on the Western side of what was once (prior to the breakup of the USSR) called the Iron Curtain like to think of

ourselves as freedom-loving people who uphold human rights. The concept of mental illness permits us to violate our professed values about freedom and disregard the principal of rule of law without admitting to ourselves this is what we are doing. It permits us to violate what the American Declaration of Independence of July 4, 1776 says are the God-given and unalienable rights of all men (and women): "...that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness." The myth of mental illness permits us to deprive law-abiding people of their supposedly unalienable right to liberty and pursuit of happiness, and because of fatal effects of psychiatric "treatment" such as sudden death caused by neuroleptic "medications" effect on the heart, or neuroleptic malignant syndrome, or electroshock, or physical restraint (causing asphyxiation), sometimes even their right to life, by pretending we are "treating them for their mental illness." Ron Leifer, M.D., a psychiatrist, said it well in an article titled "A Critique of Psychiatry and an Invitation to Dialogue" in Ethical Human Science and Services, December 27, 2000 critpsynet.freeuk.com: The problem is that society demands a greater degree of social control than law allows. The public wants to be protected from unconventional, threatening, and dangerous behavior. There is, thus, a public mandate for a covert form of social control which supplements rule of law. Medical-coercive psychiatry, in alliance with the state, performs this function disguised as medical diagnosis and treatment. ... involuntary, coercive psychiatry serves society by providing a supplemental form of social control which, because it is covert or disguised, preserves our national pride by giving us the appearance of being a nation of free individuals under law. On the other hand, when the covert is exposed it can be seen to violate the honored values on which this nation was founded.

An example that was prominently featured in news reports in New York City in 1987 was the use of the concept of mental illness to get homeless people off the streets and out of the public parks of the City. A New York Times article called it "a Koch administration program to involuntarily hospitalize severely mentally ill homeless people living on city streets" (Josh Barbanel, "New York Ordered to Find Care for Homeless Woman", The New York Times, November 25, 1987, p. B3). Rather than admit the real motive was getting rid of these people whose presence was irritating to other people, New York City Mayor Ed Koch asserted the purpose was to get them "hospitalized" (involuntarily, of course) for allegedly needed "mental health" treatment. It was a classic case of oppression disguised as benefaction. New York lawmakers could have created a law making it illegal to be homeless or to sleep on park benches, sidewalks, or in subway stations and swept homeless people into detention facilities of some kind. But they couldn't or didn't want to accept the moral implications of such a choice and therefore preferred to use supposed mental illness as an excuse to justify incarcerating homeless people. This was intellectually dishonest, because the real reason was disapproval of or annoyance with homeless people, and because imprisonment does not become benign merely because it is called hospitalization.

Even if it were possible to anticipate everything people might do that we as a society want to prohibit, and even if we didn't care if writing such laws clearly and explicitly reveals we are violating human and constitutional rights with such laws, in many cases it would be impossible to write a statute that would prohibit the behavior we want to prohibit without encompassing other behavior we do not want to prohibit. An example is crying in public. A person who cries in public too often, or for reasons with which few others sympathize, or for reasons others don't

understand, bothers other people. Few would advocate making it illegal to cry in public, because there are circumstances in which most people think crying in public is understandable and acceptable and shouldn't be prohibited. People are expected to intuitively know when it is okay to cry in public and when it isn't. A person who cries in public for reasons with which others are unsympathetic or at times others dislike, or more often and more loudly than other people think is appropriate, is breaking a residual rule of behavior, that is, a rule that isn't written anywhere but which people are nevertheless expected to know about and abide by.

Violating this unwritten expectation may result in punishment called involuntary psychiatric treatment, including involuntary "hospitalization" for major depressive disorder or some other supposed diagnosis. How and when and how loudly to express one's anger, even verbally and without threatening others with physical harm, is also the subject of residual rules of conduct the violation of which might result in involuntary psychiatric "treatment", including involuntary "hospitalization" or an involuntary outpatient commitment court order compelling a person living in his own house or apartment to appear at a clinic for bi-weekly or monthly injections of a long-acting drug intended to treat a supposed mental illness such as inappropriately expressed anger. _________________________________________________

THE CONCEPT OF MENTAL ILLNESS PERMITS US TO VIOLATE OUR PROFESSED VALUES ABOUT FREEDOM AND RULE OF LAW WITHOUT ADMITTING TO OURSELVES THIS IS WHAT WE ARE DOING _________________________________________________ In a letter dated October 14, 2009 I proposed the above ideas to retired psychiatry professor Thomas S. Szasz, who I had shortly before visited in his home town of Manlius, New York: I believe the reason the myth of mental illness continues is not only or even mainly because people do not understand its scientific invalidity, although that is of course a factor. I believe one of the most important reasons the concept of mental illness continues to be accepted legally and otherwise is it is impossible to write into criminal codes and other laws all commonly held expectations of behavior—and people's desire to enforce these unwritten expectations. Mental illness is the rationalization used to punish people who violate unwritten rules—with punishment called involuntary hospitalization, and with torture inflicted as punishment but called treatment for the supposed but actually nonexistent "mental illness". ... I think overcoming this problem is an important challenge facing people like you and me who want America and other nations to be governed by rule of law rather than arbitrary after-the-fact determinations of what behavior was right or wrong.

With my above letter I gave Dr. Szasz a tape recording I had made of the speeches including his own at the Thomas S. Szasz Tribute Dinner I had attended in Manhattan in 1990. Dr. Szasz's reply in an e-mail on 10/19/2009 was "Dear Mr. Ramsay, Many thanks for the tape - and your letter, with which I agree completely. Marginal rule violation and its punishment is the name of the game. Best wishes, Thomas Szasz" _________________________________________________

MARGINAL RULE VIOLATION AND ITS PUNISHMENT IS THE NAME OF THE GAME _________________________________________________ We as a society and as citizens of democracies would be more honest if we discard the myth of mental illness, repeal our civil commitment laws, and in their place enact a criminal law that openly acknowledges legislators are unable to anticipate and write a law against every act that should be prohibited. Such a law might be titled "Criminal Conduct NOS". It seems the majority of psychiatric diagnoses in involuntary civil commitment for mental illness I have seen end with the letters NOS, e.g., Personality Disorder NOS or Psychotic Disorder NOS. In his book Hippocrates Cried: The Decline of American Psychiatry (Oxford University Press 2013, p.

39), psychiatrist Michael Alan Taylor, M.D., says "upward of a third of psychiatric patients end up being given the label NOS (Not Otherwise Specified)." Even with the ever-increasing number supposedly diagnostic categories with each new edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, resulting in each edition being a bigger book with more diagnoses (or descriptions) than the last, psychiatrists continue to find it necessary to use "NOS" diagnoses. If we are going to incarcerate people on the basis of a supposed diagnosis ending with the letters NOS, why not have a criminal law with a name ending in NOS that does the same thing? Criminal Conduct NOS might be defined as "an act not mentioned in this Penal Code but which the defendant knew or if he was a reasonable person of ordinary intelligence would have known he should not have performed." Replacing civil commitment law with a criminal or penal code provision such as Criminal Conduct NOS would represent a constriction of the power of families and government to incarcerate and punish people for (otherwise) lawful but bothersome behavior, or what Dr. Szasz called marginal rule violation, compared with today's laws authorizing civil commitment for supposed mental illness, for these reasons: To obtain a conviction for Criminal Conduct NOS, the prosecution would be required to prove the defendant was guilty of specific past act rather than allowing imprisonment (called involuntary "hospitalization") and corporal punishment and psychological torture (called involuntary "medication" or involuntary electroshock) for an alleged, arbitrarily and often vaguely defined state of mind such as depression or schizophrenia or bipolar or personality disorder, or predicted future conduct—"dangerousness". The "clear and convincing" standard of proof permitted by the U.S. Supreme Court in civil commitment for supposed mental illness in Addington v. Texas, 441 U.S. 418 (1979), and employed in many states of the U.S.A., would be replaced with the more stringent standard of proof "beyond a reasonable doubt" that applies in criminal cases. Most Americans have a right to trial by jury in civil commitment for mental illness, but many do not. If civil commitment laws are repealed and Criminal Conduct NOS added to each state's criminal code, the defendant's right to trial by jury would be respected to the same extent it is in other criminal cases, because legislators and judges would no longer be playing word games or employing deceptive semantics to avoid respecting defendants' constitutional rights, including the right to trial by jury, by calling the proceedings "civil" or "special" rather than criminal. The judge or jury would be required to find the defendant not only did the act alleged but knew, at that time, what he did was wrong or that a reasonable person of ordinary intelligence would have known what he did was wrong. To avoid convicting a person who lacked the mental capacity of a reasonable person of ordinary intelligence of a "criminal" offense, the judge or jury would have to be empowered to find the defendant did the act alleged, that a reasonable person of ordinary intelligence would have known the act was wrong, but that the defendant lacked the mental capacity of a reasonable person of ordinary intelligence, withhold adjudication of a "criminal" offense, and sentence the

defendant to a type of incarceration or program deemed educational or therapeutic.

Some will object to this approach because it does not allow intervention to prevent future acts. My response is we can't predict a person's future conduct reliably enough to justify incarceration as a preventive measure. In the words of a clergyman whose Sunday sermon I saw on C-Span on January 1, 2012, "The only evidence of what a person will do in the future is their record of what they have done in the past" (Rev. Bill Tvedt, Jubilee Family Church, Oskaloosa, Iowa). A person's future conduct cannot be proved by any burden of proof, not even "preponderance of the evidence", unless perhaps he says he is going to do something, or he has a long history of similar acts in the past. (See Is Involuntary Commitment for "Mental Illness" or "Dangerousness" a Violation of Substantive Due Process?) Substituting a criminal law titled Criminal Conduct NOS for current civil commitment law is only a partial solution, because sometimes people's behavior is bothersome but does not justify criminal prosecution, including Criminal Conduct NOS. Enforcement of private property rights that give property owners authority regarding what can be done on their property may be the best solution in some situations.

In summary: Because there is no credible evidence of any so-called mental illness being caused by biological abnormality, so-called mental illness is definable only as thinking or behavior that is considered unacceptable. Without a biological abnormality proved to be the cause of the behavior or supposed symptoms, a supposed mental illness does not qualify as true illness or as true disease. The word "mental" implies non-physical: A person can no more have "mental illness" than he can have mental cancer. It is possible to have brain cancer but not mental cancer. For similar reasons, it is possible to have a brain disease but not a mental disease.

Likewise, it is no more possible to have a "mental" illness than it is possible to have a "religious illness" or a "political illness". Religious and political thinking are aspects of mentality, and in fact many people are subjected to involuntary commitment because of ideas they consider religious. Mental illness does not exist, except as a concept in the minds of people who believe in mental illness. Involuntary psychiatric "therapy" is punishment for thinking or behavior people dislike, not health care as people like to think and as legislators and judges assume. If the so-called professionals in what we call mental health allowed themselves to use only the term brain disease (not "mental illness") and refused to believe a brain disease is present unless true physical, biological (not merely mental, emotional, or behavioral) evidence is found, most if not all psychiatric and psychological "diagnosis" (confusing values with health) would cease. But then, as psychiatrist Ronald Leifer points out (above), we as a society would be stuck with rule of law, and "the public will be deprived of an extra-legal means of maintaining domestic tranquility" ("A Critique of Psychiatry and an Invitation to Dialogue", Ethical Human Science and Services, December 27, 2000, www.critpsynet.freeuk.com/critique.htm, accessed March 9, 2013).

Belief in mental illness continues for all the above reasons, none of which are valid from a logical or scientific or legal and constitutional standpoint. copyright 2014 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Psychiatric Drugs: Cure or Quackery?" ]

Psychiatric Drugs: Cure or Quackery?

Wayne Ramsay, J.D.

"In thinking back to all the inpatient units I've been associated with (six) and the patients who were admitted to them (thousands), the most important thing we did for many was to stop the irrational medications they were prescribed by psychiatrists." Psychiatrist Michael Alan Taylor, M.D., in his book Hippocrates Cried: The Decline of American Psychiatry (Oxford University Press 2013, p. 167) "There is no evidence that any class of psychiatric drug acts by reversing or partially reversing an underlying physical process that is responsible for producing symptoms." Joanna Moncrieff, MBBS, MSc, MRCPsych, MD — Senior Lecturer in Mental Health Sciences, University College, London, "Psychiatric diagnosis as a political device", Social Theory & Health, Vol. 8, 4, pp. 370-882 (2010) "For every class of psychiatric drugs, long-term studies (a few months or more) have continued to show no proof of effectiveness. ... all psychiatric drugs have serious long-term adverse effects and tend to produce chronic brain impairment (CBI)." Psychiatrist Peter R. Breggin, M.D., in his book Psychiatric Drug Withdrawal—A Guide for Prescribers, Therapists, Patients, and Their Families (Springer Publishing 2013), pp. 70 & 265 "I'm someone who has been gravely harmed by psych drugs and just trying to pick up the pieces of my life to carry on with it. ... I've been off psych drugs for 4 years now and still debilitated by them. ... I'm continually astounded at the downward pull of these pills on my life even now.

Makes me think that I must somehow help others from psychiatry when I recover myself." E.R., female, age 35, in Michigan, in e-mail to me in 2015 "I've lost everything. ... Klonopin took it all." L. A., female, age 55, New York, in a telephone conversation with me in 2014 or 2015 "...how then can we distinguish psychopharmacology from quackery?" Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D., & David Cohen, Ph.D., in their book Mad Science—Psychiatric Coercion, Diagnosis, and Drugs (Transaction Publishers 2013), p. 275 Psychiatric drugs harm the brain, often permanently. Psychiatric drugs have no beneficial effects for those who take them (except, sometimes, a placebo effect, if taken in a dose low enough for their toxic effects to not be pronounced—or relief of withdrawal symptoms when attempting to reduce dosage or stop taking the drug). Psychiatric drugs and the physicians, physician assistants, nurse practitioners, and (in some states of the U.S.A.) psychologists who prescribe them, and

judges who order their administration, are dangers to your health. Legislators and governors who enact laws authorizing "treatment over objection" with psychiatric drugs, and judges who approve involuntary psychiatric "medication" orders, and those who carry out the orders, are subjecting people to misery and to brain-damage that is often not reversible, and they are violating human rights. Because government licensing of health care practitioners exists to protect the public from harmful or unscientific treatment, the use of psychiatric drugs by licensed practitioners should be prohibited by law—except for patients who are already addicted to a psychiatric drug and need to be withdrawn slowly, or who must continue taking a drug for life to avoid intolerable withdrawal symptoms.

Most of what you need to know about psychiatric drugs or "medications" is found in a 457 page book published in 2008 by psychiatrist Peter R. Breggin, M.D., Brain-Disabling Treatments in Psychiatry, Second Edition (Springer Publishing Company): ...except for the brain dysfunction and biochemical imbalances caused by psychiatric drugs, there are no known abnormalities in the brains of people who routinely seek help from psychiatrists ... For this edition of this book, the concept of brain-disabling treatment has been updated and expanded with...new information on the neurotoxicity and cytotoxicity of all antipsychotic drugs. ... All biopsychiatric treatments share a common mode of action: the disruption of normal brain function. ... all the major categories of psychiatric drugs—antidepressants, stimulants, tranquilizers (antianxiety drugs), mood stabilizers, and antipsychotics—are neurotoxic. They poison neurons, and sometimes destroy them. ... The currently available biopsychiatric treatments are not specific for any known disorder of the brain. One and all, they disrupt normal brain function, without correcting any brain abnormality. ... even if one or another psychiatric disorder someday turns out to have a biological basis, that in no way would justify inflicting psychiatric drugs on these patients, thereby compounding their underlying brain disorder with drug toxicity. ... Ironically, psychiatric drugs do not cure or ameliorate central nervous system disorders; they cause them. [pp. xxiii, xxvii, 2, 7, 8, 43]

As Dr. Breggin further states in a video available on his web site, breggin.com, and on YouTube.com, "Simple Truths About Psychiatry—How Do Psychiatric Drugs Really Work?" (Part 2, at the 8 minutes and 18 seconds point), "If you're getting an effect from a psychiatric drug, it's a disabling effect." In The Antidepressant Fact Book (Perseus 2001, p. 168), Dr. Breggin says "If a drug has an effect on the brain, it is harming the brain. Science has not found or synthesized any psychoactive substances that improve normal brain function. Instead, all of them impair brain function." In 2011, Harvard psychiatry professor Blaise A. Aguirre, M.D., whose biography claims he is an expert in psychopharmacology, in a lecture about borderline personality disorder (BPD), said "almost everybody" who comes into his adolescent treatment unit at McLean Hospital (a psychiatric hospital in Massachusetts) as a patient comes in "on polypharmacy" and that because of this "they're so shut down" and are "a zombie" and that the only way to help them with psychotherapy (that is, by talking with them) is to withdraw them from psychiatric drugs. He said "about a quarter [of his patients] leave [his psychiatric treatment unit] on no medications and just feeling a lot better" and that "There's no evidence that [psychiatric] medication is going to add capacity that you didn't have to start with" ("BPD In Adolescence: Early Detection and Intervention" at the National Education Alliance Borderline Personality Disorder conference in Atlanta, Georgia,

November 4, 2011, YouTube.com, 35:15 to 36:30). Whether intentionally or not, Dr. Aguirre's remarks acknowledge psychiatric drugs always subtract from or reduce mental functioning and never add to or improve mental functioning as well as making people feel worse rather than better. _________________________________________________

IF YOU'RE GETTING AN EFFECT FROM A PSYCHIATRIC DRUG, IT'S A DISABLING EFFECT. _________________________________________________ As Dr. Breggin makes clear in Brain-Disabling Treatments in Psychiatry and several other books, and as journalist Robert Whitaker documents in Anatomy of an Epidemic (see Recommended Reading at the end of this essay), and as I will show in more detail in what follows, psychiatry has no medications. Psychiatry has drugs. While it isn't apparent from their medical dictionary definitions, as the words have come to be used, "drug" and "medication" are not entirely synonymous. The word "medication" implies benefit. The word "drug" does not necessarily. For example, heroin and cocaine are drugs, but I've never seen or heard anyone call either a medication. This is why advocates of psychiatric drugs usually call them "medication" and critics usually call the same substances "drugs". All medications are drugs, but a chemical or compound can be a drug without being a medication. All of psychiatry's drugs fall outside the usual meaning of the word medication because they do not help and in many if not most cases inflict harm. Another reason psychiatric drugs are not medications is medication, by the usual definition, cures or reduces the symptoms of a disease (a disease, or illness, being an abnormality of the body that impairs its function), and no psychiatric drug does that. As Dr. Peter Breggin says (in the last sentence of the above indented quote), in psychiatry, "medication" is something that gives you a disease.

The idea of a mentally ill person being "stabilized on medication" is a myth perpetrated by pharmaceutical companies seeking to maximize profits by selling more of their "medications", biologically oriented psychiatrists and psychologists who prescribe them, drug company financed advocacy groups such as the National Alliance on Mental Illness (NAMI), and script writers for television shows and motion pictures who in their fictional accounts portray mentally ill people as violent or irrational when they stop taking their "medication". The reality is today people called mentally ill are not "stabilized on meds" but disabled by drugs. Because of their sedating effects, psychiatric drugs can temporarily suppress violent, irritating, or vexing thinking or behavior, but they also cause temporary and permanent damage to the brain and eventual behavioral problems and increase risk of death in persons taking them. Being not only neurotoxic but cytotoxic (which means poisonous to living cells in general), psychiatric drugs often harm not only the brain but harm other parts of the body, too. In Your Drug May Be Your Problem—How and Why to Stop Taking Psychiatric Drugs (Perseus Books 1999, p. 81), psychiatrist Peter Breggin and clinical social work professor David Cohen say neuroleptic or "antipsychotic" drugs "subject almost every system in the body to impairment. Research, including a recent study, indicates that these drugs are toxic to cells in general."

Testimony of psychiatrists and patients in involuntary civil commitment and treatment-overobjection hearings give the impression that about 90% of hospital psychiatry today consists of psychiatrists trying to force people to take their so-called medications and the "patients" trying to avoid them. Most psychiatric drugs make people feel miserable, so most people resist taking them. Psychiatric drugs are so harmful they should be taken by nobody, but they are forced upon patients in psychiatric hospitals. Many people living outside hospitals are court-ordered to take psychiatric drugs while living in their own homes or as a condition of release from a psychiatric hospital.

Punishing people by compelling them to take psychiatric drugs that make them feel bad and harm their health, while falsely believing or pretending the drugs are treating an illness, may force people to change their (outwardly expressed) ideas or their behavior to avoid this punishment, but this is not health care.

In his article, "A Critique of Psychiatry and an Invitation to Dialogue" (published in Ethical Human Science and Services, December 27, 2000), psychiatrist Ron Leifer, M.D., asks, "If mental illness is a social construct rather than a bodily illness, then questions naturally arise about the use psychiatric drugs. What does it mean to prescribe a drug for a metaphorical illness?" It means the use of psychiatric drugs is pseudoscience and quackery.

Because psychiatric drugs interfere with normal functioning of the brain (and hence the mind) and other parts of the human body and do not treat any bona-fide disease, their use is health care quackery, not health care. _________________________________________________

PSYCHIATRY HAS HARMFUL DRUGS BUT NO TRUE MEDICATIONS _________________________________________________ In the 1970s when I sat in on a psychiatry class with a medical student friend, the professor told us "Research has shown we do not need to sleep, but we do need to dream." According to Jessica Payne, Ph.D., associate professor of psychology and director of the Sleep, Stress, and Memory Lab at the University of Notre Dame, "during sleep, your mind and body are actually highly active with processes critical for your physical and mental health. ... sleep is as important to your well-being as diet and exercise" (quoted in Real Simple magazine, realsimple.com, August 2014, p. 105 at 106). The dream phase of sleep, called the rapid eye movement (REM) phase, is the critical part. Contrary to the claim psychiatric drugs such as major and minor tranquilizers, so-called antidepressants, and mood stabilizers are useful as sleeping pills, their real effect is to inhibit or block real sleep, particularly the critical REM or dream phase. In an

article titled "The Effects of Antidepressants on Sleep", Andrew Winokur, M.D., Ph.D., Professor of Psychiatry and Director of Psychopharmacology at the University of Connecticut, and Nicholas DeMartinis, M.D., Assistant Clinical Professor at the University of Connecticut and an employee of Pfizer, Inc., say "Virtually all of the SSRIs [Selective Serotonin Reuptake Inhibitor antidepressants] have been noted to suppress REM sleep". They say "The majority of TCAs [Tri-Cyclic Antidepressants] markedly suppress REM sleep" and that the MAOIs (MonoAmine Oxidase Inhibitors) Phenelzine and Tranylcypromine used as antidepressants "have been demonstrated to produce REM suppression". They also say "with the selective SNRIs [Serotonin and Norepinephrine Reuptake Inhibitors, which is another class of supposedly antidepressant drugs], the general pattern of effects reported are ... disruption of sleep continuity and prominent suppression of REM sleep" (psychiatrictimes.com, June 13, 2012). In his lecture at the 2011 Empathic Therapy Conference in Syracuse, New York, psychiatrist and psychoanalyst Douglas C. Smith, M.D., of Juneau, Alaska said this: Dreaming, it turns out, is absolutely essential to life. We cannot live without dreaming. There are experiments where you can deprive people of REM sleep, and they go crazy very quickly. If you do it with lab animals—'cause all mammals have REM sleep dreams—if you deprive lab animals of REM sleeping, they die sooner than they would of starvation. So we need to dream more than we need to eat. ... I worry about psychiatric medicines because—for many reasons, but here's another one, if you hadn't thought of this one—all psychoactive substances impair dreaming. They all inhibit or impair in some way the normal dreaming process, the REM cycle. You can see it with EEGs and the sleep studies.

Even sleeping pills impair normal sleeping.

A self-help magazine advises: "Do not take sleeping pills unless under doctor's orders, and then for no more than 10 consecutive nights. Besides losing their effectiveness and becoming addictive, sleepinducing medications reduce or prevent the dream-stage of sleep necessary for mental health" (Going Bonkers? magazine, premiere issue, p. 75). In his autobiography, Pulitzer Prize winning writer William Styron says after taking Nardil, Halcion, and Ativan, he did not dream for "many months" (Darkness Visible, Random House 1990, pp. 60, 70, 71, 75). Sleep deprivation experiments on normal people show loss of sleep causes hallucinations if continued long enough (according to Maya Pines in her book The Brain Changers, Harcourt Brace Jovanovich 1973, p. 105). So what would seem to be one of the likely consequences of taking drugs, such as psychiatric drugs, that inhibit or block real sleep? In psychiatry, where words and phrases imply or suggest the opposite of the truth, drugs that suppress the rapid eye movement or REM or dream phase of sleep, making a person more susceptible to hallucinations, are called "antipsychotic"! Many psychiatric drugs induce what looks like sleep to an uninformed or miseducated observer (which seems to include most mental health professionals), but the drugs actually induce a dreamless unconscious state—not sleep. By impairing REM sleep, psychiatric drugs cause rather than cure what is typically thought of as mental illness, which as Robert Whitaker documents in his book Anatomy of an Epidemic (Crown Publishers 2010), has become epidemic rather than being reduced or eliminated during psychiatry's psychopharmaceutical era starting in the 1950s and 1960s and continuing to the present day. _________________________________________________

IN PSYCHIATRY, "MEDICATION" GIVES YOU A DISEASE (RATHER THAN CURING or TREATING ONE) _________________________________________________ Psychiatrist Douglas C. Smith also said this in the aforementioned lecture: If you look at the research on lab animals that get deprived of REM sleep, they become kind of psychotic. They become aggressive. They can be violent. They actually become more, they call it, more instinctually driven. They want sex more, indiscriminately. They eat more. And they become more aggressive. Well, who does that remind you of? You know, of people that are on psychiatric drugs. I've heard stories today [at this conference] about some people that have become extremely violent— suicidal or aggressive [while taking psychiatric drugs]. ... One thing that's coming out in the psychiatric literature, there's more awareness now, especially with antidepressants—I think it might be all psychiatric drugs, psychoactive substances—but with antidepressants, there's data that with long-term use you have chronic insomnia. And boy, do I see that, more and more it seems like I'm seeing it [in my clinical practice].

The most dramatic examples of harm from psychiatric drugs are the deaths they cause, such as from neuroleptic malignant syndrome, neurological and cardiac problems caused by psychiatric drug toxicity, and people who become violent or suicidal when under the influence of a psychiatric drug who would not be if left in their normal unmedicated state. The effect of psychiatric drugs on the rapid eye movement phase of sleep is one explanation for psychiatric drug induced impulsivity, violence, suicide, and homicide. Another is something called frontal lobe syndrome.

In his book Borderline Personality Disorder in Adolescents (Fair Winds Press 2007, p. 82) Harvard psychiatry professor and medical director of the Adolescent Dialectical Behavioral Therapy Center at McLean Hospital Blaise A. Aguirre, M.D., says this about the frontal lobes of the brain: The Frontal Lobes

The frontal lobes are the part of the brain entrusted with executive function. This includes the ability to accomplish the following: • Recognize future consequences resulting from current actions • Choose between good and bad actions • Hold and weigh opposing viewpoints • Override and suppress unacceptable social responses • Determine similarities and differences between things or events ...

People who have had accidents or trauma that have damaged their frontal lobes often display irritability, impulsivity, and angry outbursts.

Do psychiatric drugs damage or disable the frontal lobes of the brain, causing people taking them to display "irritability, impulsivity, and angry outbursts" in the form of violence, homicide, and suicide?

Psychiatrist Grace Jackson, M.D., suggests exactly this in her book Rethinking Psychiatric Drugs (AuthorHouse 2005, pp. 125-127, bold print in original):

A second possible mechanism of antidepressant-related suicide involves the impairment of activity within the frontal lobes. These brain regions are believed to be the critical centers of personality, impulse control, and executive functioning. Several teams of clinicians have been trailblazers in documenting the appearance of a reversible, amotivational syndrome in both adults and children treated with SSRIs [Selective Serotonin Reuptake Inhibitors, a category of supposedly antidepressant drugs]. Ultimately recognized by the prestigious Textbook of Psychiatry, the apathy syndrome refers to the delayed manifestation of behavioral changes in patients receiving serotonergic drugs, whose symptoms include apathy, flat affect, diminished motivation, and disinhibited actions. These features suggest a frontal lobe syndrome occurring eight weeks or more after the initiation of pharmacotherapy, or in many patients, after an increase in dose. One team of investigators corroborated the syndrome using neuroimaging studies in a 23-year-old patient who was treated with fluoxetine (Prozac) for obsessive compulsive disorder. In their research, the findings from SPECT [Single Photon Emission Computer Tomography] scans obtained before and after four months of daily medication revealed a 108% reduction in frontal lobe blood flow. These changes in blood flow paralleled reductions in motivation, attention, and memory, as well as decrements on neuropsychological tests designed to measure frontal lobe functions... Additional theories have been advanced as possible mechanisms of antidepressant-related violence. These include synergistic actions between alcohol and medication, whereby the disinhibiting effects of both substances hinder impulse control. Others have noted the potential for antidepressant therapy to provoke a wide variety of psychiatric symptoms, including mania, paranoia, hallucinations, panic attacks, or obsessive ruminations—all of which may contribute to suicidal and/or homicidal behaviors.

Psychiatrist Peter Breggin gives examples of people who became violent or suicidal in ways that were out-of-character for them in their unmedicated state in his book Medication Madness—The Role of Psychiatric Drugs in Cases of Violence, Suicide, and Crime (St. Martins Griffin 2009). Millions of people are prescribed psychiatric drugs that increase the risk they will become violent or suicidal, perhaps because of interference with the rapid eye movement or REM phase of sleep, perhaps by disabling the parts of the brain that would normally inhibit them from acting on angry or violent or suicidal impulses such as the frontal lobes. An eleven minute, twenty second YouTube video, "Psychiatric Drugs and Mass Shootings" includes many examples of psychiatric drugs seeming to cause homicide and suicide.

In her book The Predictor Scale: Predicting & Understanding Behaviors (Clifton Legacy Publishing 2013, p. 98), Faye Snyder, Psy.D., says "We have learned that some people react to anti-psychotics and anti-depressants in such a way that they become insanely psychotic, including acting out suicidal and homicidal fantasies."

Rather than correctly recognizing prescription psychiatric drugs as the problem, violence and suicide by people under the influence of psychiatric drugs have increased demands to "keep mentally ill people on their medication". Drug company advertising and biopsychiatric propaganda has been so successful, and fictional television crime shows and movies so misleading, that what in many cases caused the problem is thought of as the cure. _________________________________________________

DRUG COMPANY ADVERTISING AND BIOPSYCHIATRIC PROPAGANDA HAS BEEN SO SUCCESSFUL, AND FICTIONAL TELEVISION CRIME SHOWS AND MOVIES SO MISLEADING, PSYCHIATRIC DRUGS THAT CAUSE VIOLENCE ARE THOUGHT TO PREVENT VIOLENCE _______________________________________________________ Today's perception of mental illness causing violence also confuses cause and effect in another way: People are not violent because they are mentally ill. They are called mentally ill because they are violent.

If psychiatric drugs are harmful, why do psychiatrists prescribe them?: First, they have been taught to do so. Second, they need to use medicine to establish and maintain their identity as medical doctors. As British psychiatrist Joanna Moncrieff says in her book The Bitterest Pills—The Troubling Story of Antipsychotic Drugs (Palgrave Macmillan 2013, p. 112), psychiatric drugs such as (so-called) antipsychotics are "central to the image that psychiatry was constructing of itself as a bona fide medial specialty." Third, using drugs insulates psychiatrists from competition from non-physician psychotherapists who cannot write prescriptions. Fourth, by writing a prescription, psychiatrists (and others with prescribing authority) can justify their fee even if they have no understanding of what is happening to a person psychologically or emotionally and can offer no helpful counselling.

Psychiatric drugs are good for psychiatrists and other prescribers. They are bad for patients.

Seeing the harm done by psychiatric "medication", Dr. Douglas Smith helps people slowly withdraw from them. At the 2011 Empathic Therapy Conference he also said— One of the most pleasurable things about my work is seeing people come alive as they come off their [psychiatric] medicines. ... I mean, it's wonderful. ... To take a 28 year old young man that's been doped up, you know, on antipsychotics for a long time, and gradually work him off, and watch him come alive, it's so rewarding. It's one of the best things about what I do. ... It baffles me that psychologists are trying to get prescribing privileges.

The Worthlessness of FDA Approval

You are probably wondering how psychiatric drugs get approval from government agencies such as the U.S.A.'s Food & Drug Administration (FDA) if they are as harmful as indicated here.

There are several reasons.

One reason is former drug company executives who seem to have more loyalty to their former employers than to the public hold high positions within the FDA. Another reason is FDA officials who have never worked for a drug company acquiesce to drug company proposals in hopes of gaining favor and being hired at eye-popping salaries by the companies they (theoretically) regulate during their stint at the FDA. In the words of Princeton University economics professor Paul Krugman in a book published in 2012—

Consider, for example, the revolving door, in which politicians and officials end up going to work for the industry they were supposed to oversee. That door has existed for a long time, but the salary you can get if the industry likes you is vastly higher than it used to be, which has to make the urge to accommodate the people on the other side of that door, to adopt positions that will make you an attractive hire in your postpolicy career, much stronger than it was thirty years ago. [End this Depression Now!, W.W.Norton & Co., p. 87]

In his book Pharmocracy (Praktikos Books 2011, p. 153), Life Extension Foundation Co-Founder William Faloon cites an Associated Press report saying "a record number of FDA employees are leaving the agency to go to work for pharmaceutical companies." He says "the FDA functions primarily to protect the financial interests of the pharmaceutical industry, not the public's health" (p. 152). In an article published in 2007, Marcia Angell, M.D., a senior lecturer at Harvard Medical School and former editor of the New England Journal of Medicine, says "The FDA now behaves as though the pharmaceutical industry is its user, not the public" ("Taking back the FDA", Boston Globe, February 26, 2007). Experts on FDA advisory panels are often simultaneously paid consultants for drug companies. According to Dr. Vernon Coleman, a British physician, "Governments say they can't find any doctors without conflict of interest to sit on committees assessing drugs" (Do Doctors And Nurses Kill More People Than Cancer?, European Medical Journal 2011, p. 34). Until this incestuous relationship between drug companies and the FDA is stopped by laws preventing anyone who has been employed by a drug company in recent years from serving at the FDA, and prohibiting FDA officials from accepting employment at drug companies for many years after leaving the FDA, and prohibiting experts on FDA advisory panels from accepting money from drug companies for many years before and after serving as consultants for the FDA, the FDA will probably continue to foster and protect the best interests of drug companies more than the best interests of the public.

Another reason for the approval of bad drugs is inadequate standards for drug approval. There must be two drug studies showing the drug being tested is better than a placebo (a pill with no active ingredients), with no limit on the number of studies that may be conducted in an effort to get the required two favorable studies. It doesn't matter if the drug company must do 100 studies to come up with 2 that show the proposed new drug is better than placebo. The other 98 studies showing the drug being tested is no better than or worse than a placebo will not prevent approval of the drug. As Peter R. Breggin, M.D. & David Cohen, Ph.D., say in their book Your Drug May Be Your Problem—How and Why to Stop Taking Psychiatric Medications (DaCapo/Perseus 2007, p. 7): "In order to approve a drug, the FDA requires only two positive studies, but drug companies invariably have to conduct many clinical trials before they can come up with a couple of positive clinical trials." Psychiatrist Daniel Carlat, M.D., in a lecture available on YouTube.com, says "The FDA's bar for proof of effectiveness is one of the lowest bars you can imagine" ("Daniel Carlat—Unhinged: The Trouble With Psychiatry", uploaded September 11, 2012, at 24:19).

Many critics also allege that allowing drug companies to control the studies needed for FDA approval of the company's drugs allows the drug company to manipulate the results. For example, in his book Overdosed America (Harper Perennial 2008, p. xvii), described on the front cover of the paperback edition as "How the pharmaceutical Companies Are Corrupting Science, Misleading Doctors, and

Threatening Your Health", John Abramson, M.D., of the clinical faculty of Harvard Medical School says "Rigging medical studies, misrepresenting research results published in even the most influential medical journals, and withholding the findings of whole studies that don't come out in a sponsor's favor have all become the accepted norm in commercially sponsored medical research." In the first edition of Your Drug May Be Your Problem—How and Why to Stop Taking Psychiatric Drugs (Perseus Books 1999, pp.

189-190), Drs. Breggin and Cohen say— But isn't psychiatry science? Isn't faith in psychiatry based on facts? On research? Can't we "trust in research"? The sad truth is that, in the field of psychiatry, it is impossible to "trust in research." Nearly all of the research in this field is paid for by drug companies and conducted by people who will "deliver" in the best way possible for those companies. ... Sadly, even well-informed people too often put their faith in psychiatry and psychiatric research. It is the same as putting their faith in a drug company.

In her book Side Effects—A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial (Algonquin Books 2008) Alison Bass shows how drug studies are deliberately falsified for the purpose of getting useless or harmful drugs approved and sold. She provides facts proving "that doctors who receive consulting or other personal income from drugmakers are more likely to report positive findings about a particular drug than researchers who don't receive money from the industry" and "psychiatry was the specialty with the highest number of doctors receiving payments from drug companies" (p. 224).

In his book Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (HarperCollins 2013, p. 212), psychiatrist Allen Frances says "The legal psychiatric drug industry has thrived through the aggressive spread of misinformation." _________________________________________________

PEOPLE ARE NOT VIOLENT BECAUSE THEY ARE MENTALLY ILL. THEY ARE CALLED MENTALLY ILL BECAUSE THEY ARE VIOLENT. __________________________________________________ Drug studies that are not paid for nor controlled by the drug company that is seeking approval for the drug are far more likely to show the drug is ineffective or harmful. The result is many drugs are approved for sale to the public that should not be. Government approval of a drug is little or no assurance of its effectiveness or safety. This is true for all drugs, not just psychiatric drugs.

Studies indicating psychiatric drugs are helpful are of dubious credibility not only because of dishonest drug company manipulation but also because of professional bias by psychiatrists employed in psychiatric drug testing. All or almost all psychiatric drugs are neurotoxic and for this reason cause symptoms and problems such as dry mouth, blurred vision, lightheadedness, dizziness, lethargy, difficulty thinking, menstrual irregularities, urinary retention, heart palpitations, and other consequences of neurological dysfunction. Psychiatrists deceptively call these "side-effects", even though they are the only real effects of today's psychiatric drugs.

Placebos (or sugar pills) don't cause these problems. Since these symptoms (or their absence) are obvious to psychiatrists evaluating psychiatric drugs in supposedly double-blind drug trials, the drug trials aren't really double-blind, making it impossible to evaluate psychiatric drugs impartially. This allows professional bias to skew the results.

In the Introduction to his book The Great Psychiatry Scam—One Shrink's Personal Journey (Manitou Communications 2008, p. xii) psychiatrist Colin A. Ross, M.D., says "I will prove to you that over 90% of medication prescriptions for psychiatric inpatients have no scientific basis."

In her book The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment, Revised Edition (Palgrave Macmillan 2009, p. 242) Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., Senior Lecturer in the Department of Mental Health Sciences at University College London, U.K., says— In retrospect the physical treatments of the mid-20th century, such as insulin coma therapy and frontal lobotomy, stand revealed as dangerous and degrading procedures perpetrated on vulnerable people in the name of medical progress. In the same way the multiple and long-term drugging of modern day psychiatric patients will surely some day be acknowledged as a dangerous fraud.

Review of Psychiatry's "Medications" by Type "ANTIDEPRESSANTS": The Comprehensive Textbook of Psychiatry/IV, published in 1985, says "The tricyclictype drugs are the most effective class of antidepressants" (Williams & Wilkins, p. 1520). But in his book Overcoming Depression, published in 1981, Dr. Andrew Stanway, a British physician, says "If anti-depressant drugs were really as effective as they are made out to be, surely hospital admission rates for depression would have fallen over the twenty years they've been available. Alas, this has not happened. ... Many trials have found that tricyclics are only marginally more effective than placebos, and some have even found that they are not as effective as dummy tablets" (Hamlyn Publishing Group, Ltd., p. 159-160). In his book Psychiatric Drugs—Hazards to the Brain, published in 1983, psychiatrist Peter Breggin, M.D., asserts "The most fundamental point to be made about the most frequently used major antidepressants is that they have no specifically antidepressant effect. Like the major tranquilizers [neuroleptics] to which they are so closely related, they are highly neurotoxic and brain disabling, and achieve their impact through the disruption of normal brain function. ... Only the 'clinical opinion' of drug advocates supports any antidepressant effect" of so-called antidepressant drugs (Springer Pub. Co., pp. 160 & 184). In another book published 30 years later, commenting not only on the older supposed antidepressants available in 1983 such as tricyclics (TCA's) and monoamine oxidase inhibitors (MAOI's), but also the newer so-called antidepressants such as selective serotonin reuptake inhibitors (SSRI's) like Prozac, and serotonin and norepinephrine reuptake inhibitors (SNRI's), and with the benefit of another 30 years of research to back-up his claim, Dr. Breggin says "It is now abundantly clear that antidepressants in the long-term make people more depressed and often disabled" (Psychiatric Drug Withdrawal, Springer Publishing 2013, p. 137). In her book The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment (Palgrave MacMillan 2009), Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., Senior Lecturer in the Department of Mental Health Sciences at University College London, U.K., includes three chapters on supposedly antidepressant "medications" (pp. 118-173) including a chapter titled "Is There Such a Thing as an 'Antidepressant'?" in which she concludes there is not. Psychologist Irving Kirsch, Ph.D., makes a similar argument in his book The Emperor's New Drugs—Exploding the Antidepressant Myth (Basic Books 2010).

Psychiatry professor Richard Abrams, M.D., has said "Tricyclic Antidepressants...are minor chemical modifications of chlorpromazine [Thorazine] and were introduced as potential neuroleptics" (in: B. Wolman, The Therapist's Handbook, p. 31). Being neuroleptics (marketed as antidepressants), they have the same harmful effects and risks. In his book Psychiatric Drugs—Hazards to the Brain, Dr. Breggin calls the tricyclic antidepressants "Major Tranquilizers in Disguise" (p. 166). Psychiatrist Mark S. Gold, M.D., has said antidepressants can cause tardive dyskinesia (The Good News About Depression, Bantam 1986, p. 259). (See below for my critique of neuroleptics.)

Evidence so-called antidepressants make people feel worse, not better, is found in a study of Paxil, a best selling so-called antidepressant in the selective serotonin reuptake inhibitor (SSRI) category: It was found that "'suicide-related events' occurred almost four times more often in patients taking Paxil than in those taking a sugar pill" (Alison Bass, Side Effects—A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial, Algonquin Books 2008, p. 221).

It is because of evidence of this sort that on October 15, 2004, the U.S. Food & Drug Administration (FDA) began "requiring black box warnings on all thirty-two antidepressants currently on the market, old [tricyclic, MOAI] as well as new [SSRI, SNRI]", advising doctors and patients that supposedly antidepressant drugs make people more rather than less likely to commit suicide (Id., p. 218). Such a warning wouldn't be needed if so-called antidepressants had the favorable effects their manufacturers and biologically oriented psychiatrists claim. _________________________________________________ "WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

"Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24..."

(FDA required warning in advertisements for supposedly antidepressant "medications") __________________________________________________ The FDA warning (above) indicating so-called antidepressants do not promote suicidal thoughts and behavior in "patients over age 24" is obvious nonsense that probably reflects either poor design of the studies or bias by researchers: Why would a drug promote suicidal thoughts and behavior in a 21 year old but not a 31 year old?

In The Antidepressant Fact Book (Perseus 2001, p. 107) psychiatrist Peter R. Breggin, M.D., says "There are so many potential hazards involved in taking SSRIs that no physician is capable of remembering all of them and no patient can be adequately informed about the dangers without spending days or weeks reviewing the subject in a medical library."

LITHIUM, the classic "mood stabilizer" is said to be helpful for people whose mood repeatedly changes from joyful to despondent and back again. Psychiatrists call this manicdepressive disorder or bipolar mood disorder. Lithium was first described as a psychiatric drug in 1949 by an Australian psychiatrist, John Cade. According to a psychiatric textbook: "While conducting animal experiments, Cade had somewhat incidentally noted that lithium made the animals lethargic, thus prompting him to administer this drug to several agitated psychiatric patients." The textbook describes this as "a pivotal moment in the history of psychopharmacology" (Harold I. Kaplan, M.D. & Benjamin J. Sadock, M.D., Clinical

Psychiatry, Williams & Wilkins 1988, p. 342). Apparently, the fact that lithium induces lethargy is the only rationale for its use. A supporter of lithium as psychiatric therapy admits lithium causes "a mildly depressed, generally lethargic feeling". He calls it "the standard lethargy" caused by lithium (Roger Williams, "A Hasty Decision? Coping in the Aftermath of a ManicDepressive Episode", American Health magazine, October 1991, p. 20). One of my cousins was diagnosed as manic-depressive and was given a prescription for lithium carbonate. He told me, years later, "Lithium insulated me from the highs but not from the lows." It should be no surprise a lethargy-inducing drug like lithium would have this effect. Amazingly, psychiatrists sometimes claim lithium wards off feelings of depression even though lethargy-inducing drugs like lithium (like most psychiatric drugs) promote feelings of despondency and unhappiness— even if they are called antidepressants.

Lithium is often described by health care scientists and physicians as "toxic" and as capable of inflicting bodily harm. According to the National Kidney Foundation— Lithium may cause problems with kidney health. ... The amount of kidney damage depends on how long you have been taking lithium. It is possible to reverse kidney damage caused by lithium early in treatment, but the damage may become permanent over time. [Lithium and Chronic Kidney Disease", kidney.org, accessed 7/21/2015]

Taking lithium makes people 30 times more likely to die (D. Ruschena, et al., "Choking deaths: the role of antipsychotic medication", British Journal of Psychiatry, Nov. 2003, Vol. 183, pp. 446-50, ncbi.nlm.nih.gov).

As with all biological treatment in psychiatry, lithium is administered as "treatment" for a "condition" or supposed mental illness for which there is no biological evidence.

MINOR TRANQUILIZERS (benzodiazepines): Included in this category are Ativan, Halcion, Klonopin, Librium, Valium and Xanax. Doctors who prescribe them say they have calming, antianxiety, panic-suppressing effects or are useful as sleeping pills. Anyone who believes these claims should read the article "High Anxiety" in the January 1993 Consumer Reports magazine, or read Chapter 11 in Toxic Psychiatry (St. Martin's Press 1991), by psychiatrist Peter Breggin, both of which allege the opposite is closer to the truth. British physician Vernon Coleman says "The benzodiazepines have caused infinitely more sorrow and despair than all illegal drugs put together" (benzo.org.uk, accessed January 15, 2015). Like all psychiatric drugs, the so-called minor tranquilizers don't cure anything but are merely brain-disabling drugs. In one clinical trial, 70 percent of persons taking Halcion "developed memory loss, depression and paranoia" ("Halcion manufacturer Upjohn Co. defends controversial sleeping drug", Miami Herald, December 17, 1991, p. 13A). According to the February 17, 1992 Newsweek, "Four countries have banned the drug outright" (p. 58). "Halcion has been categorically banned in the Netherlands" according to William Styron in his book Darkness Visible—A Memoir of Madness (Random House 1990, p.

71). Britain banned Halcion in 1991 ("Sleeping pill Halcion banned by Britain", Baltimore Sun, October 3, 1991, baltimoresun.com). Yet Halcion remains legal in the U.S.A. In his book Saving Normal, psychiatrist and psychiatry professor Allen Frances, M.D., says this about Xanax and the FDA (HarperCollins 2013, p. 216): Xanax has been more a wonder of profitability and longevity than a useful medication. Its therapeutic dosage is often high enough to be addicting, and its severe withdrawal anxiety is enough to keep

patients hooked for life. Attempt at withdrawal may bring on severe panic or anxiety symptoms that are worse than the problems the patient started out with. Xanax is also a frequent collaborator with other prescription drugs and alcohol in iatrogenic overdoses and deaths. It has little role, if any, in the proper practice of medicine. If there was a proper war against prescription drug misuse, Xanax would be an early casualty—but under current policies the FDA has no mechanism to rein in drugs that do more harm than good.

In his book Toxic Psychiatry, psychiatrist Peter Breggin, speaking of the minor tranquilizers, says "As with most psychiatric drugs, the use of the medication eventually causes an increase of the very symptoms that the drug is supposed to ameliorate" (p. 246).

David Knott, a physician at the University of Tennessee, in 1976 warned: "I am very convinced that Valium, Librium and other drugs of that class cause damage to the brain. I have seen damage to the cerebral cortex that I believe is due to the use of these drugs, and I am beginning to wonder if the damage is permanent" (quoted in Robert Whitaker, Anatomy of an Epidemic, Crown Publishers 2010, p.

137).

ADHD DRUGS: Like all psychiatric "medications", drugs for attention deficit hyperactivity "disorder" (ADHD) are given for a supposed illness or condition nobody can show exists in a biological sense. Diagnosis is subjective. No laboratory test for ADHD exists. "There is no convincing evidence for either short- or long-term improvement in cognitive ability or academic performance" in those taking drugs for ADHD (Peter R. Breggin, M.D., Brain-Disabling Treatments in Psychiatry, Second Edition, Springer Publishing Co., 2008, p. 285). The harmful effects of drugs that supposedly treat ADHD include psychosis, mania, aggression, suicide, cardiovascular risks including heart attack, stroke, sudden death, brain atrophy, destruction of brain cells, permanent suppression of height and temporary suppression of weight (Id., pp. 296, 299, 307, 311, 315).

NEUROLEPTICS: Even as harmful as psychiatry's (so-called) antidepressants and lithium and (so-called) antianxiety agents (or minor tranquilizers) and ADHD drugs are, they are nowhere near as damaging as the neuroleptics, now most often (although incorrectly) called "antipsychotic" drugs. "Neuroleptic" means nerve-seizing. At one time these drugs were called "major tranquilizers", but over time the myth that they are anti-psychosis developed. Included in this category are "older" or "typical" neuroleptics such as Thorazine (chlorpromazine), Mellaril, Prolixin (fluphenazine), Compazine, Stelazine, and Haldol (haloperidol) and "newer" or "atypical" or "second generation" neuroleptics such as Abilify, Clozaril, Geodon, Invega, Latuda, Risperdal, Seroquel, and Zyprexa. Contrary to the often-repeated claim the newer or so-called atypical or second-generation neuroleptics are less likely than "older" or "typical" neuroleptics to cause neurological damage manifested by movement disorders, sometimes called "extrapyramidal side effects", such as tardive dyskinesia, dystonia, and akathisia, the National Institute of Mental Health (NIMH) Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study in 2005 found that "Contrary to expectations, movement side effects (rigidity, stiff movements, tremor, and muscle restlessness [dyskinesia, dystonia, and akathisia]) primarily associated with the older medications were not seen more frequently with perphenazine than with the newer drugs", perphenazine being one of the older or "typical" neuroleptics chosen because "perphenazine is an effective older antipsychotic that is less likely to produce EPS

[extrapyramidal side effects]" than most "typical" or first-generation neuroleptics. This study found that "taken as a whole, the newer medications ["atypical" neuroleptics] have no substantial advantage over the older medication [perphenazine, the "typical" neuroleptic] used in this study" ("Questions and Answers About the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness Study (CATIE) — Phase 1 Results", September 2005, available at www.nimh.nih.gov).

In terms of their psychological effects, these so-called antipsychotics, or major tranquilizers, cause misery—not tranquility. They reduce a person's ability to think and act. By disabling people, they can stop almost any thinking or behavior the "therapist" wants to stop. But this is simply disabling people, not therapy. The drug temporarily disables or permanently destroys good aspects of a person's personality as much as bad. In the words of Dr. Joanna Moncrieff, a British psychiatrist and Senior Lecturer in Mental Health Sciences at the University College, London, the neuroleptic or supposedly antipsychotic drugs are "not selective. They're not simply suppressing the psychosis. They're suppressing everything" ("Joanna Moncrieff—The Myth of the Chemical Cure—the Politics of Psychiatric Drug Treatment", February 25, 2013, YouTube.com, at 28:35).

Whether and to what extent the disability imposed by the drug can be removed by discontinuing the drug depends on how long the drug is given and at how great a dose. The neuroleptic, so-called major tranquilizer/"antipsychotic" drugs damage the brain more clearly, severely, and permanently than any others used in psychiatry. In his book Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (Perseus 2002, p. 191) journalist Robert Whitaker says "Neuroleptics have been found to cause a dizzying array of pathological changes in the brain." Joyce G. Small, M.D., and Iver F. Small, M.D., both Professors of Psychiatry at Indiana University, criticize psychiatrists who use "psychoactive medications that are known to have neurotoxic effects", and speak of "the increasing recognition of long-lasting and sometimes irreversible impairments in brain function induced by neuroleptic drugs. In this instance the evidence of brain damage is not subtle, but is grossly obvious even to the casual observer!" (Behavioral and Brain Sciences, March 1984, Vol. 7, p. 34). According to Conrad M. Swartz, Ph.D., M.D., Professor of Psychiatry at Chicago Medical School, "While neuroleptics relieve psychotic anxiety, their tranquilization blunts fine details of personality, including initiative, emotional reactivity, enthusiasm, sexiness, alertness, and insight. ... This is in addition to side effects, usually involuntary movements which can be permanent and are hence evidence of brain damage" (Behavioral and Brain Sciences, March 1984, Vol. 7, pp. 37-38).

A report in the Mental and Physical Disability Law Reporter indicates some courts in the United States have considered involuntary administration of neuroleptic (so-called major tranquilizer or antipsychotic) drugs to involve First Amendment rights "Because ... antipsychotic drugs have the capacity to severely and even permanently affect an individuals' ability to think and communicate" ("Involuntary medication claims go forward", January-February 1985, p. 26, emphasis added).

In a concurring opinion in Rennie v. Klein, 720 F.2d 266 (3rd Cir 1983), three U.S. Court of Appeals judges (Weiss, et al.) said this: Unlike the temporary and predictable effects of bodily restraints, the permanent side effects of antipsychotic drugs induce conditions that cannot be corrected simply by cessation of the regimen. The permanency of these effects is analogous to that resulting from such radical surgical procedures as a prefrontal lobotomy.

For this reason, neuroleptic or "antipsychotic" drug use, especially when administered for a long time, has been called a "chemical lobotomy."

In Molecules of the Mind: The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin says "This era coincided with an increasing awareness that the neuroleptics not only did not cure schizophrenia—they actually caused damage to the brain." (Dell Pub. Co. 1987, p. 103). Psychiatry professor Richard Abrams, M.D., has acknowledged, "Tardive dyskinesia has now been reported to occur after only brief courses of neuroleptic drug therapy" (in: Benjamin B. Wolman (editor), The Therapist's Handbook: Treatment Methods of Mental Disorders, Van Nostrand Reinhold Co. 1976, p. 25). In his book The New Psychiatry, published in 1985, Columbia University psychiatry professor Jerrold S. Maxmen, M.D., says "The best way to avoid tardive dyskinesia is to avoid antipsychotic drugs altogether. Except for treating schizophrenia, they should never be used for more than two or three consecutive months. What's criminal is that all too many patients receive antipsychotics who shouldn't" (Mentor, pp. 155-156). In my opinion, Dr. Maxmen doesn't go far enough: His characterization of administration of neuroleptic (so-called antipsychotic or ma#or tranquilizer drugs) as "criminal" is accurate for all people, including those called schizophrenic, even when the drugs aren't given long enough for the resulting brain damage to show up as tardive dyskinesia.

In Psychiatric Drugs—Hazards to the Brain (Springer Pub. Co. 1983, pp. 70, 107, 135, 146) psychiatrist Peter Breggin, M.D., says this: The major tranquilizers [neuroleptics] are highly toxic drugs; they are poisonous to various organs of the body. They are especially potent neurotoxins, and frequently produce permanent damage to the brain. ...tardive dyskinesia can develop in low-dose, short-term usage... the dementia [loss of higher mental functions] associated with the tardive dyskinesia is not usually reversible. ... Seldom have I felt more saddened or more dismayed than by psychiatry's neglect of the evidence that it is causing irreversible lobotomy effects, psychosis, and dementia in millions of patients as a result of treatment with the major tranquilizers.

_________________________________________________

POWER TO DRUG A PERSON BY FORCE IS POWER TO DISABLE OR KILL HIM ________________________________________________________ In the same book Dr. Breggin, says that by using drugs that cause brain damage, "Psychiatry has unleashed an epidemic of neurological disease on the world" one which "reaches 1 million to 2 million persons a year" (pp. 109 & 108). In Brain-Disabling Treatments in Psychiatry, Second Edition (Springer Pub. Co. 2008, p. 62), Dr. Breggin says "The best approach to neuroleptics, in this author's opinion, is never to use them."

In Brain Disabling Treatments in Psychiatry, Second Edition (Springer Publishing Co. 2008, p. 112) Dr. Breggin says "prescribing physicians cannot fully inform patients about the risks associated with

neuroleptics because no one except the most self-destructive patient would knowingly take such toxic drugs."

Critics of psychiatry say reform will not come from within psychiatry but must come from outside psychiatry, such as from the public, legislation, or judicial decisions. The author of the Preface of a book by four physicians (William E. Fann, M.D., et al., Tardive Dyskinesia: Research & Treatment, SP Medical & Scientific 1980) implicitly supports this view: In the late 1960s I summarized the literature on tardive dyskinesia ... The majority of psychiatrists either ignored the existence of the problem or made futile efforts to prove that these motor abnormalities were clinically insignificant or unrelated to drug therapy. In the meantime the number of patients affected by tardive dyskinesia increased and the symptoms became worse in those already afflicted by this condition. ... there are few investigators or clinicians who still have doubts about the iatrogenic [physician caused] nature of tardive dyskinesia. ... It is evident that the more one learns about the toxic effects of neuroleptics on the central nervous system, the more one sees an urgent need to modify our current practices of drug use. It is unfortunate that many practitioners continue to prescribe psychotropics in excessive amounts, and that a considerable number of mental institutions have not yet developed a policy regarding the management and prevention of tardive dyskinesia. If this book, which reflects the opinions of the experts in this field, can make a dent in the complacency of many psychiatrists, it will be no small accomplishment." [Preface to: William E. Fann, M.D., et al., Tardive Dyskinesia: Research & Treatment, SP Medical & Scientific 1980]

These harmful so-called antipsychotic drugs are forced upon patients and prisoners despite being ineffective for their supposed purpose. In the second edition of their book Your Drug May Be Your Problem—How and Why to Stop Taking Psychiatric Medications (DaCapo/Perseus 2007, p. 101), Drs. Breggin and Cohen say "Contrary to claims, neuroleptics have no specific effects on irrational ideas (delusions) or perceptions (hallucinations)." Similarly, in his book Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, (Harper Collins 2013, p. 198, 199), psychiatrist Allen Frances, M.D., says people thought psychotic are given "atypical antipsychotic medications that have no proven efficacy. And most damning, these drugs have extremely dangerous complications." On the next page he says, "there is no proof whatever that antipsychotic medications are effective in preventing psychotic episodes."

Why, therefore, are these drugs called "anti-psychotic"?

In some studies, so-called antipsychotic or neuroleptic drugs have been found to cause rather than suppress psychosis. For example, in the U.S. Food & Drug Administrations (FDA's) "Focused Safety Review of Invega, March 14, 2013"—Invega being a so-called "atypical" supposedly anti-psychotic "medication"—it was found that "the most common serious AE [Adverse Event]" of taking Invega "was schizophrenia" ("Pharmaceutical Companies, the Largest Legal Settlements in US History and Illegal Marketing of Antipsychotic Drugs", by Attorney Stephen Sheller, at Dr. Peter Breggin's 2013 Empathic Therapy Conference, Syracuse, New York). Schizophrenia is generally considered a type of psychosis.

Calling drugs that cause psychosis "anti-psychotic" is typical of the misleading use of words in psychiatry. Psychiatry is a field in which words invert the truth: Drugs that make people more depressed

are called "antidepressant". Drugs that make people more anxious, particularly during withdrawal, are called "anti-anxiety" or "anxiolytic". Toxic substances that cause disease are called "medication".

An article in a 2007 issue of Neuropsychopharmacology by scientists in the departments of psychiatry, statistics, and neuroscience at the University of Pittsburgh (Pennsylvania) said "Both in vivo [during life] and post-mortem investigations have demonstrated smaller volumes of the whole brain and of certain brain regions in individuals with schizophrenia. It is unclear to what degree such smaller volumes are due to the illness or to the effects of antipsychotic treatment." So researchers studied the effect of supposedly antipsychotic or neuroleptic drugs on monkeys, since only humans, not monkeys, are thought to be capable of having schizophrenia. They found "chronic exposure of macaque monkeys to haloperidol [Haldol, a "typical" antipsychotic] or olanzapine [Zyprexa, an "atypical" antipsychotic], at doses producing [blood] plasma levels in the therapeutic range in schizophrenia subjects, was associated with significantly smaller total brain weight and volume, including an 11.8-15.2% smaller gray matter volume in the left parietal lobe." The study suggests reduced brain size in individuals who take neuroleptic/antipsychotic "medications" are due to "antipsychotic"/neuroleptic "medications", not "schizophrenia" (Glenn T. Konopaske, et al., "Effect of Chronic Exposure to Antipsychotic Medication on Cell Numbers in the Parietal Cortex of Macaque Monkeys", Neuropsychopharmacology, Vol. 32, pp.

1216-1223).

The brain-damaging effect of supposedly antipsychotic drugs was also confirmed in an article in the February 2011 Archives of General Psychiatry that reported on a study of "Two hundred eleven patients with schizophrenia who underwent repeated neuroimaging". The study found "smaller brain tissue volumes and larger cerebrospinal fluid volumes. Greater intensity of antipsychotic [neuroleptic] treatment was associated with indicators of generalized and specific brain tissue reduction... More antipsychotic treatment was associated with smaller gray matter volumes. Progressive decrement in white matter volume was most evident among patients who received more antipsychotic treatment" (Beng-Choon Ho, MRCPsych; Nancy C. Andreasen, M.D., Ph.D., Steven Ziebell, B.S., Ronald Pierson, M.S., Vincent Magnotta, Ph.D., "Long-term Antipsychotic Treatment and Brain Volumes: A Longitudinal Study of First-Episode Schizophrenia", Vol. 68, No. 2, pp. 128-137).

The most severe side-effect of neuroleptics is death from neuroleptic malignant syndrome and other neurological malfunction caused by these "medications" such as cardiac arrhythmia (uncoordinated heartbeat). In Brain-Disabling Treatments in Psychiatry, Second Edition (Springer Publishing Co. 2008, p.

83), Dr. Breggin cites Gill, et al., in 2007 finding "Both the older and the atypical neuroleptics were associated with in increased risk of death at all assessment times, including 180 days, by a factor of 1.311.55 times."

Why do the so-called patients accept such "medication"? Sometimes they do so because of ignorance about the neurological damage and risk of death to which they are subjecting themselves by following their physician's or psychiatrist's advice to take the "medication". But much if not most of the time, neuroleptic drugs are literally forced into the bodies of the "patients" against their will. In his book Psychiatric Drugs—Hazards to the Brain, psychiatrist Peter Breggin, M.D., says "Time and again in my clinical experience I have witnessed patients driven to extreme anguish and outrage by having major tranquilizers forced on them. ... The problem is so great in routine hospital practice that a large percentage of patients have to be threatened with forced intramuscular injection before they will take the drugs" (p. 45).

Psychiatric Rape

Not only is this a kind of tyranny, but the forced administration of a psychiatric drug can be compared, physically and morally, with rape. Compare sexual rape and involuntarily administration of a psychiatric drug injected intramuscularly into the buttocks, which is a part of the anatomy where the injection is often given: In both sexual rape and involuntary administration of a psychiatric drug, force is used. In both cases, the victim's pants are pulled down. In both cases, a tube is inserted into the victim's body against her (or his) will. In the case of sexual rape, the tube is a penis. In the case of what could be called psychiatric rape, the tube is a hypodermic needle. In both cases, a fluid is injected into the victim's body against her or his will. In both cases it is or may be in (or near) the derriere. In the case of sexual rape the fluid is semen. In the case of psychiatric rape, the fluid is Thorazine, Prolixin or some other braindisabling drug. The fact of bodily invasion is similar in both cases if not (for reasons I'll explain) actually worse in the case of psychiatric rape. So is the sense of outrage in the mind of the victim of each type of assault. (Victims of electroshock or ECT which was forced on them typically feel the same way.) Some who are not "hospitalized" (that is, imprisoned) are required to report to a doctor's office for injections of a long-acting neuroleptic like Prolixin every two weeks by the threat of imprisonment ("hospitalization") and forcible injection of the drug if they don't comply.

Why is psychiatric rape worse than sexual rape? As brain surgeon I. S. Cooper, M.D., says in his autobiography: "It is your brain that sees, feels, thinks, commands, responds. You are your brain. It is you. Transplanted into another carrier, another body, your brain would supply it with your memories, your thoughts, your emotions. It would still be you. The new body would be your container. It would carry you around. Your brain is you" (The Vital Probe: My Life as a Brain Surgeon, W.W.Norton & Co. 1982, p. 50, emphasis in original). The most essential and most intimate part of you is not what is between your legs but what is between your ears. An assault on a person's brain such as involuntary administration of a brain-disabling or braindamaging "treatment" (such as a psychoactive drug or electroshock or psychosurgery) is a more intimate and morally speaking more horrible crime than sexual rape. Psychiatric rape is in moral terms a worse crime than sexual rape for another reason, also: The involuntary administration of psychiatry's biological "therapies" cause permanent impairment of brain function. In contrast, women usually are still fully sexually functional after being sexually raped. They suffer psychological harm, but so do the victims of psychiatric assault. I hope I will not be understood as belittling the trauma or wrongness of sexual rape if I point out that I have counselled sexually raped women in my law practice and that each of the half-dozen or so women I have known who

have been sexually raped have gone on to have apparently normal sexual relationships, and in most cases marriages and families. In contrast, the brains of people subjected to psychiatric assault often are not as fully functional because of the physical, biological harm done by the "treatment". _________________________________________________

AN ASSAULT ON A PERSON'S BRAIN, SUCH AS INVOLUNTARY ADMINISTRATION OF A PSYCHIATRIC DRUG, IS A MORE INTIMATE ASSAULT THAN SEXUAL RAPE _________________________________________________ In his interview with Dr. Joanna Moncrieff on 10/23/2013, psychiatrist Peter Breggin said this about the so-called antipsychotic, or neuroleptic "medications": I feel more strongly, that we do know where we stand, that they are toxins. They ruin brain function, ultimately. They're shortening lifespans, in some studies indicating up to twenty years being lopped off peoples' lives on these drugs long term. I feel more strongly that in fact they're just a disaster, that we'd do better without them, and that in a sane society they'd be illegal. ... The [psychiatric] profession just refuses to look at this because...it threatens it's very core, its very identity. It's like taking a hammer away from a carpenter, maybe even the nails, too. [Dr. Peter Breggin Hour at 42:30, underline added] Similarly, a year later in 2014 British psychiatrist Joanna Moncrieff said "I've found that the psychiatric establishment really does not want to engage in discussion of this issue of what its drugs are actually doing, possibly because that is just too dangerous and too difficult to rebut" ("Madness, Drugs and Capitalism: an Exploration by Dr. Joanna Moncrieff" YouTube.com, November 18, 2014, at 39:45).

A report by the National Association of State Mental Health Program Directors, "Morbidity and Mortality in People with Serious Mental Illness", in October 2006, states in bold italics, "People with serious mental illness (SMI) die, on average, 25 years earlier than the general population. State studies document recent increases in death rates over those previously reported" (p. 5). These increased death rates correspond with the advent and increase in use of psychiatric drugs. In BrainDisabling Treatments in Psychiatry, Second Edition, psychiatrist Peter Breggin says "Until the advent of neuroleptic drugs, it was observed that patients diagnosed with schizophrenia lived normal life spans" (p. 82). Now that people thought to have serious mental illness such as "schizophrenia" are being drugged, they are dying 25 years sooner than average.

Psychiatrists continue damaging and killing "patients" with "medications" rather than admit psychiatric drugs are harmful—and lethal if taken long enough—because it is difficult for them to acknowledge the harm they have inflicted and continue to inflict on their patients, and because widespread recognition of what psychiatric drugs really do would bring about the end of psychiatry as a profession.

Since psychiatric drugs are not effective and have horrible, even lethal, effects on health, why are legislatures and courts authorizing their involuntary administration? The answer is legislators and judges sincerely believe mental illness (a) exists, and (b) is caused by biological abnormalities that can corrected by drugs. They are, in other words, misinformed. Instead of authorizing involuntary administration of psychiatric drugs, lawmakers and judges should be prohibiting their use (with the exception of attempts at phased withdrawal for people who are already taking them).

On a TV talk show in 1990, psychoanalyst Jeffrey Masson, Ph.D., said he hopes those responsible for harmful psychiatric "therapies" will one day face "Nürnburg trials" (Geraldo, Nov. 30, 1990).

Use in Nursing Homes

These very same brain-damaging (so-called) neuroleptic/antipsychotic drugs are routinely administered—involuntarily—to mentally healthy old people in nursing homes in the United States. According to an article in the September/October 1991 issue of In-Health magazine, "In nursing homes, antipsychotics are used on anywhere from 21 to 44 percent of the institutionalized elderly... half of the antipsychotics prescribed for nursing home residents could not be explained by the diagnosis in the patient's chart. Researchers suspect the drugs are commonly used by such institutions as chemical straightjackets—a means of pacifying unruly patients" (p. 28). I know of two examples of feeble old men in nursing homes who were barely able to get out of their wheelchairs who were given a neuroleptic/antipsychotic drug. One complained because he was strapped into a wheelchair to prevent his attempts to walk with his cane. The other was strapped into his bed at night to prevent him from getting up and falling when going to the bathroom, necessitating defecating in his bed. Both were so physically disabled they posed no danger to anyone. But both dared complain bitterly about how they were mistreated. In both cases the nursing home staffs responded to these complaints with injections of Haldol—mentally disabling these men, thereby making it impossible for them to complain.

Theory of Action: Unknown

Despite various unverified theories and claims, psychiatrists don't know how the drugs they use work biologically. In the words of Columbia University psychiatry professor Jerrold S. Maxmen, M.D.: "How psychotropic drugs work is not clear" (The New Psychiatry, Mentor 1985, p. 143). According to the Psychopharmacology Institute web site (psychopharmacologyinstitute.com ©2015, accessed Feb. 20, 2015), edited by Flavio Guzman,

M.D., a psychiatrist and Adjunct Professor of Pharmacology and Neurosciences at the University of Mendoza, "The exact mechanism of action of antipsychotic drugs is unknown."

All of today's commonly used psychiatric drugs suppress brain and other nervous system function, even basic functions such as heartbeat and motor control. The result is deaths from cardiac irregularities in persons taking supposedly antipsychotic drugs, and iatrogenic (physician-caused) neurological diseases such as tardive dyskinesia, dystonia, akathisia, and drug-induced dementia.

None of today's psychiatric drugs have the specificity (e.g., for depression or anxiety or psychosis) that is often claimed for them. In The Truth About the Drug Companies (Random House 2005, p. 82), Marcia Angell, M.D., says "In 1987, the FDA approved Prozac for the treatment of depression; in 1994, for the treatment of obsessive-compulsive disorder; in 1996, for bulimia". In his book Blaming the Brain—The Truth About Drugs and Mental Health (Free Press 1998, p. 105), Elliot Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, says— Psychiatrists prescribe Prozac and the other selective serotonin reuptake inhibitors not only for depression, but also for obsessive-compulsive disorders, panic disorders, various food-related problems (including both anorexia and bulimia), premenstrual dysphoric syndrome (PMS), attention-deficit/ hyperactivity disorder (ADHD), borderline personality disorder, drug and alcohol addiction, migraine headaches, social phobia, arthritis, autism, and behavioral and emotional problems in children, among many other conditions.

A February 2011 article in Pharmacoepidemiology and Drug Safety ("Increasing off-label use of antipsychotic medications in the United States, 1995-2008", Vol. 20, Issue 2, pp. 177-184) by Caleb Alexander, M.D., Assistant Professor of Medicine at the University of Chicago, and Randall Stafford, M.D., Ph.D., Associate Professor of Medicine at Stanford Prevention Research Center, et al., says "Although approved initially for schizophrenia, antipsychotic medications also are used for numerous other conditions, including other psychoses, bipolar disorder, delirium, depression, personality disorders, dementia, and autism." In a lecture at the National Educational Alliance—Borderline Personality Disorder (BPD) conference in Atlanta, Georgia on November 4, 2011, psychiatrist Kenneth Silk, M.D., said drugs as diverse as SSRI antidepressants, mood stabilizers, and both typical and atypical antipsychotics have been used as "treatment" for BPD ("Medication: The Positives and the Negatives—Kenneth Silk, MD", YouTube.com at 39:55-41:10). In We've Got Issues—Children and Parents in the Age of Medication (Riverhead Books 2010, p. 171), Judith Warner recalls that "In the late 1970s ... antianxiety meds were being given—rightly or wrongly—as treatment for a wide array of problems, including depression." Why would an "anti-anxiety" drug be used for depression if psychiatric drugs have any specificity rather than a general disabling effect? Reading or hearing such comments from psychiatrists and other mental health professionals and other observers, or paying attention to advertising for psychiatric drugs and seeing some initially advertised as antipsychotic later advertised as useful against depression (e.g., Abilify), or supposed antidepressants advertised as effective in quitting smoking or suppressing obsessive-compulsive disorder or other problems, it eventually becomes difficult to avoid the conclusion that any and every psychiatric drug is used to treat any and every supposed psychiatric problem. All psychiatric drugs are mentally disabling generally and therefore can be used to reduce anything in

human thinking or behavior (both good and bad). So why are some called "antianxiety", and others "antipsychotic" or "antidepressant" or "mood stabilizers"? The answer is salesmanship. Claims that any particular type of psychiatric drug is specifically effective against any specific type of psychiatric problem is salesmanship, not science.

How Psychiatrists Decide Which Drug to Prescribe: Guesswork According to psychiatrist Daniel J. Carlat, M.D., in his book Unhinged—The Trouble With Psychiatry (Free Press 2010, pp. 83, 84, 86)— The fact is that psychopharmacology is primarily trial and error, a kind of muddling through different candidate medications until we hit on one that works. ...we rely largely on intangible factors to make these decisions. ... What to do in a case like this, in which the first drug loses its effectiveness? The process of selecting a second agent is guesswork. ... Such is modern psychopharmacology. Guided purely by symptoms, we try different drugs, with no real conception of what we are trying to fix, or of how the drugs are working. [underline added] In their book Mad Science—Psychiatric Coercion, Diagnosis, and Drugs (Kirk, et al., Transaction Publishers 2013), three social work professors reach a similar conclusion: Also, together we've amassed over seventy-five years of teaching mental health courses in graduate schools of social work to thousands of students and professionals ... It seems to us, on the other hand, that clinical psychopharmacology—the medically sanctioned use of psychoactive drugs for the treatment of medically legitimated distress and misbehavior (termed mental disorders)—has always been a pseudoscientific enterprise. ... nearly all psychotropic drug classes end up prescribed for all groups of disorders ... there are no demonstrated biological anomalies for any drug to target to "cure" the mental disorders in question. ... no radical innovation based on genetic knowledge is leading the way to find any curative compounds in psychiatry, because there is simply no idea about what specific part of the body, if any, need fixing when people suffer or misbehave. ... Psychoactive drugs, let us note, are prescribed in the absence of demonstrated physical pathology. [pp. 301, 250, 262, 251, 254, 255, italics in original] According to Jack M. Gorman, M.D., in his book The Essential Guide to Psychiatric Drugs, 4th Edition (St. Martin's/Griffin 2007, p. 6), psychiatrists decide which drug to prescribe on the basis of "clinical lore, experience, and intuition" rather than bona-fide science.

This could be called "The Myth of Psychopharmacology": "...ology" means knowledge. For example, "Nephrology" is knowledge about kidneys, and "psychology" is knowledge of the psyche, or mind. But in the case of "psychopharmacology", the knowledge is absent. "Psychopharmacology", in other words, is a form of quackery.

The haphazard way therapists chose which psychiatric drug to prescribe is also admitted, at least

tacitly, in the Handbook of Clinical Psychopharmacology for Therapists, Sixth Edition, (John D. Preston, Psy.D., et al., New Harbinger Publications 2010, pp.179-180), written by a psychologist, a psychiatrist, and a pharmacist. For depression, their advice about choosing a supposedly antidepressant "medication" is mostly about avoiding so-called side-effects. They admit "No antidepressant has been proven consistently superior to another" (p. 170), and "Despite our knowledge of some of the important mechanisms of action of these medications, we still do not really know how they relieve depression" (p.

169). They say "Whichever antidepressant is chosen first, the question of what to try if the first one doesn't work may arise" (p. 179). They suggest "switching classes of antidepressants (i.e., if first treated with an SSRI [selective serotonin reuptake inhibitor], switch to a norepinephrine or dopamine reuptake inhibitor, such as bupropion) versus switching within class (i.e., from one SSRI to another SSRI)" (pp. 179180, italics theirs).

There is no rational way for a drug prescriber to know one so-called antidepressant will be more effective than another, because there are neither biological nor psychological tests to indicate, for example, that one patient suffers from a type of depression that will be relieved by a tricyclic antidepressant but not a SSRI, another patient a type of depression that will be relieved by a SSRI and not a tricyclic, and another patient a type of depression that will be relieved by a SNRI (serotonin and norepinephrine reuptake inhibitor) but not a tricyclic nor SSRI, and another patient a type of depression that will be relieved only by a MAOI (monoamine oxidase inhibitor). The situation is the same for all psychiatric drugs, such as supposedly antipsychotic and supposedly anti-anxiety drugs. As Dr. Gorman says, it's all "clinical lore, experience, and intuition". That's guesswork, not science.

Like Taking Insulin for Diabetes?

It is often asserted that taking a psychiatric drug is like taking insulin for diabetes. Although psychiatric drugs are taken continuously, as is insulin, it's an absurd analogy. Diabetes is a disease with a known physical cause. No physical cause has been found for any of today's so-called mental illnesses. The mode of action of insulin is known: It is a hormone that instructs or causes cells to uptake dietary glucose (sugar). In contrast, the modes of action of psychiatry's drugs are unknown—although even advocates of psychiatric drugs as well as critics theorize they prevent normal brain functioning by blocking neuroreceptors in the brain. If this theory is correct it is another contrast between taking insulin and taking a psychiatric drug: Insulin restores a normal biological function, namely, normal glucose (or sugar) metabolism. Psychiatric drugs interfere with a normal biological function, namely, normal neuroreceptor functioning. Insulin is a hormone that is found naturally in the body. Psychiatry's drugs are not normally found in the body. Insulin gives a diabetic's body a capability it would not have in the absence of insulin, namely, the ability to metabolize dietary sugar normally. Psychiatric drugs have an opposite kind of effect: They take away (mental) capabilities the person would have in the absence of the drug. Insulin affects the body rather than the mind. Psychiatric drugs disable the brain and hence the mind, the mind being the essence of the real self.

There Are No Justifiable Uses of Psychiatric Drugs

In the final analysis, "there are no justifiable uses of psychiatric drugs" (Dr. Joanna Moncrieff, The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment, Revised Edition, Palgrave Macmillan 2009, p. 15, summarizing the view of Dr. Peter Breggin, which she says "usefully highlights the general character of psychotropic drugs.") Adults should have a right to use whatever drugs they want, but the use of psychiatric drugs by licensed professionals is an example of medical professionals failing to adequately regulate themselves and the failure of state legislatures, Congress, and regulatory agencies like the USA's Food and Drug Administration (FDA) to protect the public. The information I have gathered in this essay should inspire everyone to do what they can to discourage or end the use of psychiatric drugs.

Caution: Stopping taking psychiatric drugs abruptly can cause severe, even life-threatening, withdrawal problems. For advice about how to withdraw from psychiatric drugs, see Psychiatric Drug Withdrawal—A Guide for Prescribers, Therapists, Patients, and Their Families (Springer Publishing 2013) by psychiatrist Peter R. Breggin, M.D., or Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Medications (Da Capo Press 2007) by Dr. Breggin and clinical social work professor David Cohen.

Recommended Reading

Books John Abramson, M.D., Overdosed America—The Broken Promise of American Medicine (Harper Perennial 2008) Marcia Angell, M.D., The Truth About Drug Companies—How They Deceive Us and What To Do About It (Random House 2005) Alison Bass, Side Effects—A Prosecutor, A Whistleblower, and a Bestselling Antidepressant on Trial (Algonquin Books of Chapel Hill 2008) Peter R. Breggin, M.D., Psychiatric Drugs—Hazards to the Brain (Springer Publishing Co., New York, 1983) Peter R. Breggin, M.D., Toxic Psychiatry—Why Therapy, Empathy and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the "New Psychiatry" (St. Martin's Press 1991) Peter R. Breggin, M.D., Talking Back to Prozac (St. Martin's Paperbacks 1994) Peter R. Breggin, M.D., Antidepressant Fact Book: What Your Doctor Won't Tell You About Prozac, Zoloft, Paxil, Celexa, and Luvox (Perseus 2001) Peter R. Breggin, M.D., and David Cohen, Ph.D., Your Drug May Be Your Problem—How and Why to Stop Taking Psychiatric Medications (Perseus 1999). I read this first 1999 edition. A "Fully Revised and Updated" edition was published in 2007 (by Da Capo/Perseus).

Peter R. Breggin, M.D., Brain-Disabling Treatments in Psychiatry, Second Edition (Springer Publishing Co. 2008)

Peter R. Breggin, M.D., Psychiatric Drug Withdrawal—A Guide for Prescribers, Therapists, Patients, and Their Families (Springer Publishing Co. 2013) Vernon Coleman, M.B.Ch.B., D.Sc.(hon), How to Stop Your Doctor Killing You (European Medical Journal 2003), especially the chapter titled "Why Mental Health Care Isn't Always Worth Having".

Allen Frances, Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (Harper Collins 2013).

I recommend this book despite my disagreement with the author about the validity of the concept of mental disorder and his belief that psychiatry has bona-fide treatment.

Joseph Glenmullen, M.D., Prozac Backlash (Simon & Schuster 2000) Stuart A. Kirk, et al., Mad Science—Psychiatric Coercion, Diagnosis, and Drugs (Transaction Publishers 2013) Irving Kirsch, Ph.D., The Emperor's New Drugs—Exploding the Antidepressant Myth (Basic Books 2010) Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment, Revised Edition (Palgrave Macmillan 2009) Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., A Straight Talking Introduction to Psychiatric Drugs (PCCS Books 2009) Joanna Moncrieff, M.B.B.S., M.Sc., MRCPsych, M.D., The Bitterest Pills—The Troubling Story of Antipsychotic Drugs (Palgrave MacMillan 2013) Colin A. Ross, M.D., The Great Psychiatry Scam—One Shrink's Personal Journey (Manitou Communications, Inc., Richardson, Texas 2008).

Colin A. Ross, M.D., and Alvin Pam, Ph.D., Pseudoscience in Biological Psychiatry (John Wiley & Sons, Inc. 1995) book review Elliot Valenstein, Ph.D., Blaming the Brain—The Truth About Drugs and Mental Health (Free Press 1998) Robert Whitaker, Mad in America (Perseus 2002). In this book, the author documents that fact that people considered insane or mentally ill were more likely to recover and live good lives before the invention of modern biological psychiatry (psychiatric drugs, electroshock, and psychosurgery).

Robert Whitaker, Anatomy of an Epidemic—Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown Publishers 2010). In this sequel to Mad in America, Robert Whitaker reviews the evidence of harm caused by each class of psychiatric drugs and documents the increase in mental disability and illness caused by their use.

Articles

Ginger Ross Breggin, "On Being Human", empathictherapy.org Dr. Peter Breggin, "New Research: Antidepressants Can Cause Long-Term Depression", Huffington Post (huffingtonpost.com), 11/16/2011

Monica Cassani, "How antidepressants (and benzos) ruined my life: Luke Montagu", July 18, 2015 — Beyond Meds: Alternatives to Psychiatry, http://beyondmeds.com "High Anxiety", January 1993 Consumer Reports magazine Siphiwe Sibeko, "Psychiatric Drugs Kill 500,000 Western adults annually, few positive benefits — leading scientist", rt.com, May 13, 2015; original article: "Does long term use of psychiatric drugs cause more harm than good?", British Medical Journal, 12 May 2015.

Julia Llewellyn Smith, "Lives 'left in ruin' by rising tide of depression drugs", The Telegraph (UK), 27 April 2014 Recommended Videos

"Psychiatric Drugs Are More Dangerous Than You Ever Imagined", YouTube.com and breggin.com. This is an excellent 9-minute video by Dr. Peter Breggin that should be seen by anyone and everyone taking, prescribing, or advocating the use of psychiatric drugs.

"Psychiatry causes harm, and it's widely denied...", YouTube.com. In this less than 2 minute video, Joanna Moncrieff, a psychiatrist and senior lecturer in Mental Health Sciences at the University College, London, summarizes the evidence showing psychiatric drugs harm people and that most of her fellow psychiatrists don't care.

"Generation Rx", by Kevin P. Miller, available on DVD from amazon.com and usually also on eBay.com, not to be confused with the A&E film by the same title. See amazon.com.

"The Drugging of Our Children", A Gary Null Production, garynull.com, available from amazon.com.

"NUMB: A Documentary, The Depressing Truth About Antidepressants". Watch this documentary before starting or stopping an SSRI antidepressant such as Paxil. This documentary illustrates the fact that psychiatric drugs such as SSRIs are often much easier to start than to stop and that even tapering off them slowly may be unsuccessful. The film ends with the film maker switching from Paxil to Prozac but being unable to stop taking SSRI "antidepressants" without intolerable withdrawal symptoms. See numbdocumentary.com.

"Psychiatric Drugs and Mass Shootings", YouTube.com. This video provides evidence psychiatric drugs cause violent behavior, contrary to the common view about mentally ill people needing to be "stabilized on meds" to prevent violence. I recommend this Citizens Commission on Human Rights (CCHR) video without endorsing CCHR itself nor the founder of CCHR, the Church of Scientology: See comment in The Future of Anti-Psychiatry Activism. copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Psychiatry's Electroconvulsive Shock Treatment" ]

Psychiatry's Electroconvulsive Shock Treatment A Crime Against Humanity Wayne Ramsay, J.D.

"It is a good bet that history will view ECT as one of what neuroscientist and author Elliot S. Valenstein calls 'great and desperate cures'—and its promoters as kin to the promoters of lobotomy." Peter Sterling, Ph.D., Professor of Neuroscience, Perelman School of Medicine, University of Pennsylvania, "ECT damage is easy to find if you look for it", Nature, Vol. 403, 20 January 2000, p. 242 Electroconvulsive "therapy", often abbreviated ECT, is a misleading term. ECT is not a therapy, contrary to the claims of its supporters. ECT damages the brain and cures nothing. It has been banned in some countries, including Italy, Slovenia, and some cantons of Switzerland (according to Larry Tye in his ironically titled book Shock: The Healing Power of Electroconvulsive Therapy, Penguin 2006, p. 22, coauthored with Kitty Dukakis). A January 28, 2011 WebMD report says "As many as 100,000 patients receive ECT each year in the U.S., mostly for severe depression or other disorders that do not respond to medications" ("Electroconvulsive Therapy Under New Scrutiny" by Todd Zwillich & Laura J. Martin, M.D.) Psychologist Harold Sackeim, Ph.D., one of the world's most well-known researchers on ECT, estimates

that worldwide two million people have ECT each year ("Sackeim says 2 million a year have ECT", YouTube.com, accessed July 12, 2012).

A U.S. Surgeon General report in 1999 says "The exact mechanisms by which ECT exerts its therapeutic effect are not yet known." In Unhinged: The Trouble With Psychiatry, a book published in 2010, psychiatrist Daniel J. Carlat, M.D., says "The major problem with ECT is identical to the problem with psychiatric medication. While ECT works, we have no idea how or why" (Free Press, p. 167). A WebMD report updated January 11, 2013 says "It is not known exactly how this brain stimulation helps treat depression. ECT probably works by altering brain chemicals..."

In fact, the way ECT works is known. Claiming its mechanism of action is unknown conceals ECT's actual mode of action: It damages the brain sufficiently to impair whatever thinking the "patient" was engaging in. It therefore can be and is used to eliminate anything that is disliked in human mentality, not only depression but (so-called) schizophrenia, mania, catatonia, bi-polar (or manic-depressive) disorder, delusions, anxiety — whatever. An example is a woman for whom I filed an amicus curiae brief with a New York court in 2013 whose psychiatrist sought to give her ECT over her objection because she thought she had cancer, which the psychiatrist said was a delusion. Because ECT is not selective, it also reduces or eliminates good aspects of human mentality, including intelligence, memory, and normal human emotions. When used for depression, ECT makes the "patient" no longer remember what he (or more often, she) was unhappy about and ruins the "patient's" ability to think clearly about whatever was troubling him.

Psychiatrists often claim severe unhappiness or so-called depression, for which ECT is often used, is caused by unknown biological abnormalities in the brain and that by some unknown mode of action ECT corrects these unknown biological abnormalities. This nonsensical claim is at best speculation, and there is no valid evidence for it. In his book The Emperor's New Drugs: Exploding the Antidepressant Myth (Basic Books 2010, pp. 100 & 177), psychologist Irving Kirsch, Ph.D., says, "Depression may result from a normally functioning brain ... Depression may not even be an illness at all." Depression cannot be "treated" because it is not a disease. It is a normal response to sad events or unmet needs. People become depressed because they live depressing lives, not because of a chemical imbalance or other malfunction in their brains.

ECT is also used to frighten or torture the "patient" into conformity with others' expectations.

ECT, often called electroshock or shock treatment, consists of as little as 20 volts (Carlat, Unhinged, p. 162) to as much as hundreds of volts being passed through the brain: The Thymatron System IV electroshock machine specifications say the "stimulus output" is limited to 450 volts with a constant 0.9 amp current and a duration of up to 8 seconds. A WebMD report titled "Electroconvulsive Therapy (ECT)" updated January 11, 2013, says "The electrical stimulation, which lasts up to 8 seconds, produces a short seizure." Eight (8) seconds is a long time to have up to 450 volts surging through your head. If you've ever gotten a jolt from an electrical outlet, which is 110 to 120 volts (in North America, up to 240 volts in other countries), you won't doubt this. The electrodes are placed on each side of the head at about the temples, or sometimes on two places on the same side of the head so the electricity will pass through just the left or right side of the brain (which is called "unilateral" ECT). Psychiatrists falsely claim ECT consists of a very small amount of electricity being passed through the brain. For example, Nancy Andreasen, M.D., Ph.D., a University of Iowa psychiatry professor, in her book for the lay public describes electroshock as "passing a very small amount of electricity through the brain" (The Broken Brain, Harper

& Row 1984, p. 207, italics added), and nowhere in her book does she mention any numbers indicating how much electricity is used. The American Psychiatric Association's model "ECT Consent Form" says the electricity used in ECT is "a small, carefully controlled amount of electricity", and it also omits mention of the actual numbers (The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging — A Task Force Report of the American Psychiatric Association 1990, Appendix B, p. 156). The power applied in ECT is nowhere close to small. It could kill the "patient" if the current were not limited to the head. The electricity in ECT is so great it can burn the skin on the head where the electrodes are placed. Because of this, psychiatrists use electrode jelly, also called conductive gel, to prevent skin burns from the electricity. The electricity going through the brain causes seizures so strong the so-called patients sometimes break their own bones during the seizures. To prevent this, a muscle paralyzing drug (called a muscle "relaxant") is administered immediately before the so-called treatment (see, e.g., Carlat, Unhinged, p. 163).

In September 1977 in the American Journal of Psychiatry, psychiatry professor Max Fink, M.D., said "Seizures may also be induced by an anesthetic inhalant, flurothyl, with no electrical currents, and these treatments are as effective as ECT" (p. 992). On the same page he says seizures induced by injecting a drug, pentylenetetrazol (Metrazol), into the bloodstream have therapeutic effects equal to seizures induced with ECT. Why would seizures induced by any of these very different methods — gas inhaled through a gas mask, electricity passed through the head, or a drug injected into the bloodstream — be equally "therapeutic"?

One answer is found in Understanding the Brain, a course consisting of 18 hours of recorded lectures

by Jeanette Norden, Ph.D., Professor of Cell & Developmental Biology at Vanderbilt University School of Medicine, and Professor of Neurosciences at Vanderbilt University College of Arts and Sciences. She says "Each time a seizure occurs, neurons die" and that therefore "it is very important to control seizures" (Teaching Company 2007, Lecture 6). Psychiatrists eliminate "bad" (but also good) thinking and behavior by inducing seizures and killing neurons.

What are neurons? Wikipedia tells us "Neurons are the core components of the nervous system, which includes the brain" (Wikipedia, "Neuron", accessed April 5, 2011). The same point is made in a medical school textbook, Basic Clinical Neuroscience, Second Edition (Wolters Kluwer-Lippincott Williams & Wilkins 2008), written by three Saint Louis University School of Medicine professors: Paul A. Young, Ph.D., Professor and former Chairman of the Department of Anatomy and Neurobiology, Paul H. Young, M.D., Clinical Professor of Neurosurgery, and Daniel L. Tolbert, Ph.D., Professor of Anatomy and Surgery.

On page 1 they say "The basic functional unit of the nervous system is the neuron." Also on page 1 they say "Neurons respond to stimuli, convey signals, and process information that enable the awareness of self and surroundings; mental functions such as memory, learning, and speech, and the regulation of muscular contraction and glandular secretion." On pages 9 & 10 they say "All functions of the CNS [Central Nervous System], that is, awareness of sensations, control of movements or glandular secretions, and higher mental functions, occur as the result of the activity of excitatory and inhibitory synapses on neurons". They also say "Nerve cells are extremely fragile" and that "The brain and spinal cord [are] also very fragile" (p. 2).

In Lecture 9 of her Understanding the Brain course, Dr. Norden says "An abnormal electrical discharge could set up seizures in the brain or could even kill neurons." According to Dr. Mogens Dam, neurology

professor at Aarhus University Hospital, Aarhus, Denmark, "Not only convulsive seizures are thought to damage the brain. New investigations indicate that the abnormal electrical activity accompanying even minor attacks as partial seizures may also lead to cells dying" ("How the Brain Works", http://www.epilepsy.dk, accessed July 1, 2011). According to Jack M. Parent, M.D., neurology professor and director of the Neurodevelopment and Regeneration Laboratory at the University of Michigan Medical School, "In some experiments, electrical stimulation is used to induce seizures in rats (referred to as 'electrical kindling'). These studies have shown that certain populations of brain cells may die after single or repeated brief seizures" ("Do Seizures Damage the Brain?", also at http://www.epilepsy.com/ articles/ar_1064856376, accessed July 1, 2011). __________________________________________________

EACH TIME A SEIZURE OCCURS, NEURONS DIE ________________________________________________________ Some neuroscientists believe lost neurons are never replaced. Among them are the three Saint Louis University School of Medicine professors who wrote the above cited neuroscience textbook: All cells in the human body are able to reproduce, except nerve cells. As a result, the loss of neurons are irreparable; a neuron once destroyed can never be replaced. ...the degeneration of neuronal cell bodies anywhere in the nervous system and the degeneration of the CNS [Central Nervous System] axons are irreparable. [Basic Clinical Neuroscience, 2nd ed., p. 13] In Understanding the Brain, Professor Jeanette Norden, Ph.D., says "Neurons are non-mitotic cells, and that means that if they are damaged and they die they are not replaced" (Lecture 7). In his book When the Air Hits Your Brain: Tales of Neurosurgery (Fawcett Crest 1996, pp. 3-4), neurosurgeon Frank Vertosick, Jr., M.D., says this: Unlike other parts of the body, the brain and spinal cord have little capacity for self-repair. If a general surgeon injures a piece of bowel during an abdominal operation, she simply stitches the injury, or if that's not possible, removes the injured segment. With eight yards of bowel there's plenty to spare.

Even a trashed heart or liver is replaceable. But when I cut a nerve, it stays cut. Neurosurgeons do things that cannot be undone.

There are neuroscientists who believe brain cells (neurons and supporting cells called glia) can regenerate. A National Institutes of Health (NIH) publication updated on December 8, 2005 titled "The Life and Death of a Neuron" says this: Until recently, most neuroscientists thought we were born with all the neurons we were ever going to have. ... For some neuroscientists, neurogenesis in the adult human brain is still an unproven theory. ...

Although the majority of neurons are already present in our brains by the time we are born, there is evidence to support that neurogenesis (the scientific word for the birth of neurons) is a lifelong process.

[NIH Publication No. 02-3440d, http://www.ninds.nih.gov/disorders/brain_basics/ninds_neuron.htm, accessed July 1, 2011]

If in fact brain cells can regenerate, that may explain why persons given electroshock regain some of the thinking and learning ability and memories they lost to the "treatment" after enough time has gone by after the so-called treatment. However, the experience of persons given electroshock suggests this recovery of memory and ability is not complete but only partial.

Lee Coleman, M.D., a psychiatrist, says this about ECT: The rationale for electroshock was formerly couched in psychoanalytic terms, with punitive superegos sometimes requiring repeated shocks of 110 volts for appeasement. Only then could guilt be assuaged and discontent be relieved. It is much more common now to hear equally absurd neurophysiological explanations, this time the idea being that these electrical assaults somehow rearrange brain chemistry for the better. Most theorists readily agree, however, that these are speculations; in fact, they seem to take a certain satisfaction in shock treatment's supposedly unknown mode of action. ... The truth is, however, that electroshock "works" by a mechanism that is simple, straightforward, and understood by many of those who have undergone it and anyone else who truly wanted to find out. Unfortunately, the advocates of electroshock (particularly those who administer it) refuse to recognize what it does, because to do so would make them feel bad. Electroshock works by damaging the brain. Proponents insist that this damage is negligible and transient—a contention that is disputed by many who have been subjected to the procedure. Furthermore, its advocates want to see this damage as a "side effect." In fact, the changes one sees when electroshock is administered are completely consistent with any acute brain injury, such as a blow to the head from a hammer. In essence, what happens is that the individual is dazed, confused, and disoriented, and therefore cannot remember or appreciate current problems.

The shocks are then continued for a few weeks (sometimes several times a day) to make the procedure "take," that is, to damage the brain sufficiently so that the individual will not remember, at least for several months, the problems that led to his being shocked in the first place. The greater the brain damage, the more likely that certain memories and abilities will never return. Thus memory loss and confusion secondary to brain injury are not side effects of electroshock; they are the means by which families (perhaps unwittingly) and psychiatrists sometimes choose to deal with troubled and troublesome persons. [The History of Shock Treatment, edited by Leonard R. Frank, p. xiii.]

Psychiatrists who administer ECT claim there is no evidence ECT causes brain damage. For example, in his book Hippocrates Cried: The Decline of American Psychiatry (Oxford University Press 2013, pp. 94 & 98), psychiatrist Michael Alan Taylor, M.D., says this: In contrast to the public image of ECT, and after years of treating patients suffering from mood disorders and patients with other severe behavioral syndromes, many of these patients also treated with ECT, participating in ECT research, and considering all the alternatives, I detailed in my medical advanced directives that if I had any one of those behavioral syndromes, that I did not want any of the other treatments commonly prescribed, I want ECT. ... Some patients receiving ECT also lose memories of

events that occurred during the weeks before treatment started. This information loss is spotty but permanent. It is never widespread and does not involve future long-term information storage. Patients do not forget their lives, their biographical information, their skills, or their stores of knowledge.

Personalities don't change. There is no brain damage. Those who say there is damage are either ignorant, have been misled, or are being purposely misleading.

Similarly, a publication of the U.S. National Library of Medicine and National Institutes of Health (NIH) states reassuringly, "Electroconvulsive therapy (ECT) is a very effective and generally safe treatment..."

(Electroconvulsive Therapy:Medline Plus Medical Encyclopedia, updated 8/1/2012).

But in fact, it didn't take long after ECT was invented in 1938 for autopsy studies revealing ECT-caused brain damage to begin appearing in medical journals. This brain damage includes cerebral hemorrhages (abnormal bleeding), edema (excessive accumulation of fluid), cortical atrophy (shrinkage of the cerebral cortex, or outer layers of the brain), dilated perivascular spaces in the brain, fibrosis (thickening and scarring), gliosis (growth of abnormal tissue), and rarefied and partially destroyed brain tissue.

Psychiatrist Peter R. Breggin, M.D., carefully documents the evidence for each of these types of brain damage caused by ECT in his book Electroshock: It's Brain Disabling Effects (Springer Publishing 1979).

Carl Walker, J.D., M.D., a Bexar County, Texas Medical Examiner, was my Legal Medicine professor at St. Mary's University School of Law. In a class lecture, Dr. Walker said during autopsies of brains of people who had ECT he found fibrous bands of scar tissue between the electrode placement points where normal brain tissue had been destroyed and replaced by scar tissue. Commenting on the extent of brain damage caused by ECT, neurosurgeon Karl H. Pribram, M.D., once said: "I'd rather have a small lobotomy than a series of electroconvulsive shock. ... I just know what the brain looks like after a series of shocks, and it's not very pleasant to look at" (APA Monitor, Sept.-Oct. 1974, pp. 9-10). Sidney Sament, M.D., a neurologist, describes ECT this way: "Electroconvulsive therapy in effect may be defined as a controlled type of brain damage produced by electrical means. No doubt some psychiatric symptoms are eliminated...but this is at the expense of brain damage" (Clinical Psychiatry News, March 1983, p. 4).

Although he is a defender of ECT, Duke University psychiatry professor Richard D. Weiner, M.D., Ph.D., has admitted that "the data as a whole must be considered consistent with the occurrence of frontal atrophy following ECT" (Behavioral & Brain Sciences, March 1984, p. 8). The frontal lobes, which are responsible for higher mental functions, get most of the electricity in ECT and shrink as brain cells die.

Dr. Weiner also admits "Breggin's statement that ECT always produces an acute organic brain syndrome is correct" (Id., p. 42). Organic brain syndrome is organic brain disease. In Brain Disabling Treatments in Psychiatry, Second Edition (Springer Publishing 2008, p. 237), Dr. Breggin says "There is also an extensive literature confirming brain damage from ECT. The damage is demonstrated in many large animal studies, human autopsy studies, brain wave studies, and an occasional CT scan study." He concludes "ECT is a wholly irrational, unjustifiable treatment" (p. 226).

In an article in the British Journal of Psychiatry, three psychologists say "The ECT patients' performance was also found to be inferior on the WAIS [Wechsler Adult Intelligence Scale]" and "The ECT patients' inferior Bender-Gestalt performance does suggest that ECT causes permanent brain damage" (Donald I. Templer, Ph.D., et al., "Cognitive Functioning and Degree of Psychosis in Schizophrenics given many Electroconvulsive Treatments", Vol. 123 (1973), p. 441 at pp. 442, 443).

In Lecture 36 of her Teaching Company course, Understanding the Brain, neuroscientist and Vanderbilt University School of Medicine professor Jeanette Norden, Ph.D., says "Short of having massive brain damage, what we call IQ doesn't change." So if ECT causes less than massive brain damage, before-and-after IQ (Intelligence Quotient) testing of persons who receive ECT will show no change in IQ. However, before-and-after IQ testing of persons given ECT typically shows a loss of 20 to 40 points.

In his book Brain-Disabling Treatments in Psychiatry, Second Edition, psychiatrist Peter Breggin includes a case study of a woman he titles "A Life Destroyed by ECT" wherein he says after ECT "Her overall IQ had dropped 20 points" (p. 220). In her book Doctors of Deception—What They Don't Want You to Know About Shock Treatment (Rutgers University Press 2009, pp. 8, 181), Linda Andre cites cases of herself and others who had IQ tests before and after ECT: "Those of us who had prior IQ test scores for before and after comparison found we'd lost roughly the same number of IQ points — thirty to forty. In all our cases, the results indicated acquired brain injury." Lowered Intelligence Quotient (IQ) in persons given ECT strongly indicates ECT causes brain damage that is neither trivial nor transient, as those who promote ECT claim, but massive and permanent.

According to neurologist John Friedberg, M.D., in his book Shock Treatment Is Not Good For Your Brain—A Neurologist Challenges the Psychiatric Myth (Glide Publications 1976, pp. 29 & 31, italics in original), "the EEGs [electroencephalographs] of the subjects of shock therapy are always abnormal. ... when careful tests and objective measurements are applied, the only consistent effect of ECT is brain damage."

In Understanding the Brain, Jeanette Norden, Ph.D., says of Alzheimer's disease, "One of the truly horrible things about this disease is that it robs the person of the sense of themselves because it robs them of the memories of their lives" (Lecture 33). The same can be said of ECT. A woman who had ECT described these effects of ECT on her memory: "I don't remember things I never wanted to forget— important things—like my wedding day and who was there. A friend took me back to the church where I had my wedding, and it had no meaning to me" (quoted in: Peter R. Breggin, M.D., Electroshock: It's Brain Disabling Effects, p. 36). Another woman found "ECT made her forget everything from her daughter's recent birthday party to whether she had a husband" (Larry Tye, Shock: The Healing Power of Electroconvulsive Therapy, p. x, italics added). An article in 1980 says one of the effects of shock treatment is "Life-ruining long-term memory loss; some patients have even forgotten they had children" (Carlyle C. Douglas, "Shock Therapy Makes Patients Suffer and Doctors Rich", Moneysworth, August 1980, p. 14). In 2001 I heard a State Representative who was also a Registered Nurse (RN) tell a New Hampshire legislative committee that after ECT one of her patients could not remember his own name.

Professional people who have sought treatment for depression and had ECT have lost a lifetime of professional knowledge and skill to this so-called therapy. (See, for example, Berton Roueché's article in Recommended Reading, below). A woman who had ECT at San Antonio State Hospital told me ECT wiped out her entire college education. In Texas, state law requires those considering ECT be warned "there is a division of opinion as to the efficacy" of ECT and its risk of "permanent irrevocable memory loss" (Texas Health & Safety Code §578.003). But in most states people undergoing ECT voluntarily do so without any warning of the brain damage and associated memory loss and intellectual impairment to which they are about to be subjected — the psychiatrist suggesting ECT usually being the person least likely to give this warning. Psychiatrists usually deceive patients and their families by saying the only adverse effect of ECT is amnesia for events shortly before and shortly after the time of the "treatment".

ECT advocates deceive the public, patients, legislators, and judges by claiming ECT as administered today is different and less harmful than in the past. One such claim is the addition of anesthesia, a muscle paralyzing drug, and oxygenation (making the "patient" breath air or 100% oxygen) prevent ECTcaused brain damage. In fact, neither anesthesia nor muscle paralyzing drugs nor breathing oxygen stop what electricity does to the brain. Autopsy study, EEGs, and observation of those who have received ECT indicate those given ECT with anesthesia, a muscle paralyzing drug, and forced breathing of air or oxygen experience the same brain damage, memory loss, and intellectual impairment as those given ECT without these modifications.

Some ECT advocates claim a new type of electricity used today, brief pulse, causes less harm than the older type, sine-wave (which is what comes out of a standard 120 volt a.c. household electric outlet). In contrast, one prominent ECT supporter, psychiatry professor Richard D. Weiner, M.D., Ph.D., cites studies that "demonstrated sine wave and bidirectional pulse stimuli produced equivalent amnestic changes" (Behavioral & Brain Sciences, March 1984, p. 18). According to Chicago Medical School psychiatry professor Richard Abrams, M.D., in his textbook Electroconvulsive Therapy, 400 volts is a typical peak voltage produced by the newer brief-pulse ECT devices (Oxford U. Press 1988, p. 113). This is more than double the highest voltages produced by the older sine-wave machines. The below photograph of an older MedCraft electroshock machine shows a maximum voltage (far right knob) of 170 volts rather than 400 or 450, and a maximum shock duration (lower right knob) of 1.0 second rather than up to 8 seconds delivered by newer ECT devices. The voltage being more than twice as high, and the shock duration being many times longer, suggest today's electroshock or ECT devices do more harm.

(left click image to enlarge, � or "Back" to return)

It is typical in psychiatry for official pronouncements to state the exact opposite of the truth.

An example is the aforementioned article by the U.S. National Library of Medicine and National Institutes of Health, "Electroconvulsive Therapy" (updated 8/1/2012), which says "Since ECT was introduced in the 1930s, the dose of electricity used in the procedure has been decreased significantly" (italics added).

Claims that the new "unilateral" ECT in which the electricity is run through only one side of the head is less damaging are also false. Concentrating the current in a smaller area of the brain is likely to be more damaging to the affected region of the brain (Breggin, Toxic Psychiatry, p.

438; Breggin, "Brain Damage From Nondominant ECT", American Journal of Psychiatry 143:10 (October 1986), pp. 1320-1321).

Another problem is psychiatrists usually use higher doses of electricity for "unilateral" than "bilateral" ECT: In one study, psychiatrists used 1½ times seizure threshold for bilateral ECT and 6 times seizure threshold for "unilateral" ECT (Kellner, et al, "Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial", The British Journal of Psychiatry (2010) 196: 226-234): That's 4 times more current for "unilateral" ECT. An explanation sometimes given is more electricity is needed to cause a convulsion when a smaller portion of the brain is shocked.

The idea behind "unilateral" ECT is to spare the parts of the brain responsible for verbal (speech) and mathematical skills (non-emotional, computer-like intellectual functions). These functions are believed to be located in what is misleadingly called the dominant side or

hemisphere of the brain. In most people, this supposedly dominant cerebral hemisphere is the left hemisphere. However, this is not true in about 5% of right-handed people and 30% of lefthanded people, according to psychologist Sally P. Springer, Ph.D. & neurology professor Georg Deutsch, Ph.D., in their book Left Brain, Right Brain—Perspectives from Cognitive Neuroscience, 5th edition, (W.H.Freeman & Co. 1998, p. 22). So a problem is difficulty determining which side of the brain to shock in any particular individual. Sometimes psychiatrists inadvertently shock the supposedly dominant verbal/mathematical hemisphere of the brain when they are trying to spare it.

Usually, the side of the brain intended to get the electricity in unilateral ECT is called the non-dominant side. This supposedly non-dominant side of the brain is primarily responsible for our emotionality and sexuality, artistic, creative, and musical ability, visual and spatial perception, athletic ability, unconscious mental functions, and some aspects of memory.

According to psychologist Sally P. Springer & neurology professor Georg Deutsch in their book Left Brain, Right Brain—Perspectives from Cognitive Neuroscience, 5th edition, the concept of cerebral dominance "underestimates the role of the right hemisphere" (p. 15). They say "the view of the right hemisphere as the minor or passive hemisphere is inappropriate" (p. 18). According to Oliver Sacks, Professor of Neurology at New York University School of Medicine, this supposedly non-dominant hemisphere is "of the most fundamental importance" because it provides "the physical foundations of the persona, the self" without which "we become computer-like" (The Man Who Mistook His Wife for a Hat and Other Clinical Tales, Harper & Row 1985, pp. 5, 20). The side of the brain electroshocked in supposedly non-dominant hemisphere unilateral ECT is at least as important to us as the other parts of our brains.

If emotions guide our behavior more than reason, as much evidence and observation suggests, this emotional, supposedly non-dominant cerebral hemisphere (whether it be left or right in any particular individual) may actually be the dominant hemisphere. The verbal, mathematical, and reasoning abilities localized in the supposedly dominant cerebral hemisphere are merely tools we use, not our essential selves.

In the 2002 edition of his textbook Electroconvulsive Therapy (Oxford University Press), Richard Abrams, M.D., advocates the opposite approach if the patient's livelihood depends on those (he assumes) right-brain, supposedly non-dominant functions. While acknowledging many psychiatrists say "unilateral treatment electrodes should be placed over the right hemisphere in order to avoid the speech areas" (p. 131), he says "In my view ... left unilateral ECT" is "a viable alternate choice for musicians, artists, architects, and others who rely on unimpaired righthemisphere functioning" (p. 136). That's right, he says "unimpaired", acknowledging electroconvulsive "therapy" impairs the parts of the brain subjected to the electric shock. But as Dr. Sacks says in The Man Who Mistook His Wife for a Hat and Other Clinical Tales, those supposedly non-dominant cerebral hemisphere functions are "of the most fundamental importance" to everyone.

ECT's other mode of action is the fear it inspires. Fear of the "treatment" and harmful effects on the brain also explain why insulin coma "therapy" and seizures induced with no electrical currents, such as by injecting a drug, pentylenetetrazol (Metrazol), into the bloodstream, or forcing the "patient" to inhale a seizure-inducing gas such as flurothyl can be as effective as electroshock. In his book Against Therapy, psychoanalyst Jeffrey Masson, Ph.D., asks: "Why do psychiatrists torture people and call it electroshock therapy?" (Atheneum 1988, p. xv). One of my clients at San Antonio State Hospital told me at one point in his past he was unhappy with what was happening in his life and that he therefore "withdrew" and was diagnosed (actually

described) as catatonic. He said in response to his catatonia he was given electroshock (ECT), after which, he said, "I came out of it right away." I asked him why. He replied, "'Cause I realized, if I didn't, they was gonna kill me!" In his book Breakdown, psychologist Norman S. Sutherland points out that in his observations ECT "was widely dreaded", and "there are many reports from patients likening the atmosphere in hospital on days when ECT was to be administered to that of a prison on the day of an execution" (Signet 1976, p. 196).

Defenders of ECT say the use of anesthesia makes ECT painless. That argument misses the point. It is the mental disorientation, the memory loss, the lost mental ability, the realization after awakening from the "therapy" that the essence of one's very self is being destroyed by the "treatment" that is terrifying. As was said by Lothar B. Kalinowsky, M.D., and Paul H. Hoch, M.D., in their book Shock Treatments, Psychosurgery, and Other Somatic Treatments in Psychiatry: Fear of ECT, however, is a greater problem than was originally realized. This refers to a fear which develops or increases only after a certain number of treatments. It is different than the fear which the patient, unacquainted with the treatment, has prior to the first application. ... "The agonizing experience of the shattered self" is the most convincing explanation for the late fear of the treatment. [Grune & Stratton 1952, p. 133]

Larry Tye in his book Shock: The Healing Power of Electroconvulsive Therapy, admits ECT can be "personality-obliterating" (p. ix).

One way ECT achieves its effects is the victims of this supposed therapy change their behavior, display of emotion, and expressed ideas for the purpose of dissuading psychiatrists from administering or continuing ECT in hopes of avoiding being (further) harmed by ECT. Refusing to take ECT often doesn't work, because psychiatrists can and do give ECT by force, over the so-called patient's objection. In The Powers of Psychiatry, Emory University Professor Jonas Robitscher, J.D., M.D., says "Organized psychiatry continues to oppose any restrictions by statute, regulation, or court case on its 'right' to give shock to involuntary and unwilling patients" (Houghton Mifflin 1980, p. 279). In Texas, it is illegal to give ECT to a person who is under 16 years of age, or to an unwilling person age 16 or older unless he or she has a court-appointed guardian, and the guardian consents, and not even then if the ward, when competent, indicated he or she would not want electroshock: See Texas Health & Safety Code §578.002 and Texas Civil Practice & Remedies Code §137.008 (c). For this reason, all persons (in Texas and elsewhere) should have an advance psychiatric directive (or "Declaration for Mental Health Treatment") refusing ECT (and all psychiatric drugs: See Psychiatric Drugs—Cure or Quackery?). In 2014 involuntary, court-ordered electroshock is still done in many if not most states of the U.S.A. I am aware of recent cases of courtordered ECT given to unwilling, objecting "patients" in New York and Minnesota. In 2013, Connecticut House Bill 5298 "To require the probate court to follow certain procedures before issuing an order for involuntary electroconvulsive therapy" was considered but not passed by the Connecticut Legislature, leaving Connecticut's involuntary electroshock law unchanged. The annual report for 2011-12 of the Mental Welfare Commission for Scotland indicates "there were 203 instances in Scotland last year (April 2011-March 2012) when ECT was authorized for non-consenting patients under the Mental Health Act. In 129 instances the patient was described as objecting to or resisting" the administration of ECT ("ECT Without Consent in Scotland 2011-12", accessed August 26, 2014). A September 2011 "Position

Statement on Electroconvulsive Therapy (ECT)" of The College of Psychiatry of Ireland (accessed August 26, 2014) says "patients may receive ECT without consent, under the rules of the [Ireland] Mental Health Act of 2001."

Even the thought of government-sanctioned, court-ordered violence such as forcibly administered electroshock (or psychiatric drugs or psychosurgery) should make any normal person shudder. As psychiatry professor Thomas S. Szasz once said, "violence is violence, regardless of whether it is called psychiatric illness or psychiatric treatment" ("Violence And The Psychiatrist", Freedom magazine, January 1986, p. 26).

This routine violence against people whose sadness or other thinking or behavior is labeled mental illness is often dishonestly denied. For example, the U.S. National Institute of Mental Health (in NIH Publication No. 11-3561, Revised 2011) falsely states that "patients always provide informed consent before receiving ECT".

Since the "patient's" fear of ECT is one reason ECT "works", psychiatrists get "cures" by merely threatening people with ECT. As psychiatrist Peter R. Breggin, M.D., says in his book Electroshock: It's Brain Disabling Effects: "For patients who witness these [brain disabling] effects without themselves undergoing ECT, the effect of ECT is nonetheless intimidating. They do everything in their power to cooperate in order to avoid a similar fate" (p. 173).

In his book How to Stop Your Doctor Killing You (European Medical Journal 2003) British physician Vernon Coleman, MB, ChB, DSc(hon) devotes 4½ pages of his chapter "Why Mental Health Care Isn't Always Worth Having" to a critique of ECT. He says in part: I've been vehemently critical of ECT for decades. It has always seemed to me to be a primitive, barbaric and crude form of 'therapy'. As a medical student I once had to watch it being administered. I remember feeling deeply ashamed of the profession I was preparing to enter. [p. 119] An important motive for administering ECT is profit: Each costs $2,000 to $3,000 ($36,000 for a typical series of 12), according to Larry Tye in his book Shock: The Healing Power of Electroconvulsive Therapy (p. 14). Psychiatrists and their co-workers who administer ECT are engaging in health care quackery, enriching themselves while harming and terrorizing their so-called patients.

Yet most psychiatrists have administered ECT. Psychiatrists usually are required to administer ECT to complete residency training in psychiatry, making it embarrassing and therefore difficult for them to later admit how harmful the "treatment" is: Thereafter it becomes imperative for them to deny, deny, deny the obvious truth about the brain damage they have inflicted on their so-called patients. Widespread understanding of what electroconvulsive brain damaging or "ECT" does might even lead to criminal prosecution of doctors and their co-workers who administer it. The trial and criminal conviction and four-year prison sentence of singer Michael Jackson's personal physician, Dr. Conrad Robert Murray, after his treatment caused Michael Jackson's death, is a precedent in this regard. (See "Trial of Conrad Murray", wikipedia.org, accessed February 5, 2014). __________________________________________________

WIDESPREAD UNDERSTANDING OF WHAT ECT DOES MIGHT LEAD TO CRIMINAL PROSECUTION OF DOCTORS WHO ADMINISTER IT __________________________________________________ When ECT is administered by force after being authorized by a judge, the judge is equally morally culpable despite being protected by judicial immunity. Legislators who vote for involuntary treatment laws are morally responsible for these crimes against humanity despite being protected by legislative immunity. The administration of ECT (or psychiatric "medication" or psychosurgery) by force or threat of force to an unwilling person that was authorized by law or court order may relieve the perpetrators of criminal liability, but it does not relieve them of moral responsibility. Such an assault is not morally justified merely because it was authorized by law or by a judge.

Unlike some countries, states in the U.S.A. have failed to fulfill their responsibility to protect people from cruel, irrational, and damaging "treatment" such as ECT. So if you live in the U.S.A. or another place where government does not protect you, it is left to you to, as best you can, protect yourself and your loved ones by keeping yourself and your loved ones away from psychiatrists who administer ECT. Recommended Reading

Linda Andre, Doctors of Deception—What They Don't Want You to Know About Shock Treatment (Rutgers University Press, New Brunswick, N.J. 2009) Peter R. Breggin, M.D., Electroshock: Its Brain Disabling Effects (Springer Publishing Co., New York, 1979) Peter R. Breggin, M.D., "Brain Damage From Nondominant ECT", American Journal of Psychiatry 143:10 (October 1986), p. 1320.

Peter R. Breggin, M.D., Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the New Psychiatry" (St. Martin's Press, New York, 1991) Peter R. Breggin, M.D., Brain-Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Psychopharmaceutical Complex, Second Edition (Springer Publishing Co., New York 2008), Chapter 9: "Electroconvulsive Therapy (ECT) for Depression", pages 217-251.

John Friedberg, M.D., "Electroshock Therapy: Let's Stop Blasting the Brain", Psychology Today magazine, August 1975, p. 18 John Friedberg, M.D., "Shock Treatment, Brain Damage, and Memory Loss: A Neurological Perspective", American Journal of Psychiatry, Vol. 134, No. 9 (September 1977), p. 1010; also available at PsychRights.org and ResearchGate.net Berton RouechĂŠ, "Annals of Medicine As Empty as Eve", New Yorker magazine, September 9, 1974, p. 84. This biographical article describes in horrifying detail the extent and permanence of memory loss caused by electroshock "therapy".

Don Weitz, "Electroshock Must Be Banned as Crime Against Humanity", thestreetspirit.org, August 2005

Recommended Videos

Peter R. Breggin, M.D., Simple Truth 10: Electroshock is Brain Trauma, YouTube.com. In this video, uploaded on April 8, 2015, Dr. Peter Breggin reveals the prevalence of electroshock in 2015 and the fact that this supposed therapy is brain damage and only brain damage.

"Patient pleads: please stop my shock treatment", uploaded Feb. 13, 2007, YouTube.com: "A Dunedin [New Zealand] woman who is being given electric shock treatment in a psychiatric hospital has made a public plea for her doctors to stop". This video is an opportunity to see how normal are people who are involuntarily electroshocked.

Web sites I recommended: ECT Resources Center, ect.org, The Coalition for the Abolition of Electroshock in Texas, MindFreedom, National Association for Rights Protection and Advocacy

copyright 2014 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "The Brain-Butchery Called Psychosurgery" ]

The Brain-Butchery Called

PSYCHOSURGERY Wayne Ramsay, J.D. Most people think psychosurgery is not done anymore. Unfortunately, this is not true. While psychosurgery was done less frequently in the last three or four decades of the 20th Century, it was never entirely abandoned, and now in the early 21st century psychosurgery is making a comeback.

What is psychosurgery? Elliot S. Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, defines psychosurgery as a "brain operation for the purpose of alleviating a severe psychiatric disorder in the absence of any direct evidence of neuropathology"

(Behavior Today, June 28, 1976, p. 5). The following definition appears in a psychiatric textbook: "Psychosurgery is the surgical intervention to sever fibers connecting one part of the brain with another or to remove, destroy, or stimulate brain tissue with the intent of modifying or altering disturbances of behavior, thought content, or mood for which no organic pathological cause can be demonstrated" (John Donnelly, M.D., Sc.D., in: Kaplan & Sadock, Comprehensive Textbook of Psychiatry/IV, 1985, p. 1563).

The term psychosurgery is as illogical as many of the other words used in psychiatry. What is illogical about the term psychosurgery is that the psyche is not a part of the body, and therefore it is completely impossible to do surgery on it. Saying a psychiatrist or a surgeon is going to do surgery on someone's psyche is as illogical as saying he is going to do surgery on the person's soul. Although psychosurgery is obviously done on the brain, there is good reason for not calling it brain surgery, since unlike psychosurgery, brain surgery deals with known abnormalities in the brain, such as benign or malignant brain tumor, infection, or intracranial hemorrhage. What is magical about the word "psychosurgery" is somehow it seems to justify psychiatrists or surgeons doing surgery on brains that as far as is known are biologically speaking perfectly healthy! (Thomas Szasz, M.D., The Myth of Psychotherapy, Anchor Press 1978, pp. 67) Psychosurgery goes by various names for variations on what most people call lobotomy. Because the term lobotomy has such stigma attached to it, and because late 20th Century and early 21st Century psychosurgery is at least allegedly less damaging than the psychosurgeries performed 50 years ago, those who perform or defend psychosurgery today usually use terms other than lobotomy to describe it.

Among these terms are subcaudate tractotomy, anterior cingulotomy, limbic leucotomy, anterior capsulotomy, and behavioral surgery. According to Dr. Benjamin Greenberg, professor of psychiatry at Brown University and chief of outpatient services at Butler Hospital in Providence, R.I., "We don't like to call it psychosurgery anymore ... It's neurosurgery for severe psychiatric illness" (quoted in Benedict Carey, "New surgery to control behavior", Los Angeles Times, August 4, 2003, & mindfully.org). In an editorial in 1990 in the Journal of Neuropsychiatry, Stuart Yudofsky, M.D. and Fred Ovsiew, M.D., wrote: "We propose unburdening so-called psychosurgery from the multifarious limitations of this appellation by advancing a new term: neurosurgical and related interventions (NRI) for psychiatric disorders" (Vol. 2, No. 3, Summer 1990, pp. 253-255, bold print in original). When lobotomy became a pejorative term, it became "psychosurgery". When the harm caused by psychosurgery became widely known, some sought to change the name to behavioral surgery, neurosurgery for psychiatric disorder, NRI, or other terms.

Some critics are unimpressed by the new names. For example, in a letter to the editors of The New York Times, "Lobotomy as Ancestor of Psychosurgery", published December 8, 1991, Graceann V. Inyard, a social worker, expressed her "outrage" about a November 3 article titled "Lingering Effects of Lobotomies of 40's and 50's". She says "The article gives the impression that lobotomies were not performed in this country after the advent of neuroleptic drugs. This is not true. They were just given different names under the umbrella term 'psychosurgery,' stereotaxis and cingulotomies among them." __________________________________________________

NOW IN THE EARLY 21st CENTURY PSYCHOSURGERY IS MAKING A COMEBACK _________________________________________________

The first I recall learning about psychosurgery was in an abnormal psychology class I took in college when our professor, a psychologist, described it in a class lecture. One type he described is drilling two holes in the "patient's" skull on each side of the forehead at about the hairline to allow access to the frontal lobes of the brain where intellectual mental functioning, thinking, and emotion are believed to take place. In one version, he said, a cylindrical shaped device that resembles an apple corer is inserted into each side of the brain, and a cylindrical shaped piece of each frontal lobe is removed. He said in other versions of the operation a scalpel is inserted to sever connections in the frontal lobes or between the frontal lobes and other parts of the brain. In one type of psychosurgery (transorbital lobotomy), instead of drilling holes in the skull, a scalpel or instrument similar to an ice-pick is poked or hammered through a thin part of the skull in each eye socket known as the orbit into the frontal lobes of the brain, and, our professor said, "the scalpel is moved like this", as he wiggled his finger from side-to-side. In his book Molecules of the Mind: The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin describes the same operation as "forcing a thin, ice pick-like instrument through the patient's eye socket and then waving the point around in the brain" (Dell Pub. Co. 1987, p. 64). In their textbook Synopsis of Psychiatry, published in 1988, psychiatry professors Harold I. Kaplan and Benjamin J. Sadock say the "surgical" instrument used in transorbital lobotomy or leukotomy not only is "like" an ice pick; they say it is an ice pick (p. 531). According to two supporters of psychosurgery, the inventor of this method of psychosurgery was Dr. Walter Freeman, and "His [Dr. Freeman's] initial operating instrument was in fact an icepick taken from his kitchen drawer" (Rael Jean Isaac & Virginia C. Armat, Madness in the Streets: How Psychiatry and the Law Abandoned the Mentally Ill, Free Press/Macmillan, Inc. 1990, p. 179). Although my psychology professor didn't use this specific analogy, he made it unmistakably clear that he thought such psychosurgeries are as unscientific and senseless as trying to repair a malfunctioning television set by drilling a hole in its cabinet, inserting a machete, and rattling it around inside the TV cabinet. In other words, these types of psychosurgery, generally known as prefrontal lobotomy, were indiscriminate infliction of damage in the frontal lobes of the brain. The Bantam Medical Dictionary says what it calls the "Modern" version of psychosurgery that is done today is more refined and involves making "selective lesions in smaller areas of the brain" ("leukotomy", Bantam Dell 1981, p. 405).

University of Iowa psychiatry professor Nancy Andreasen, M.D., Ph.D., describes modern psychosurgery as follows in her book The Broken Brain: The Biological Revolution in Psychiatry (Harper & Row 1984, p. 214, italics added): Whereas the older technique of "prefrontal lobotomy" involved cutting large amounts of whitematter tracts, the modern technique of psychosurgery emphasizes the selective cutting of very tiny and quite specific portions of the tracts connecting the cingulate gyrus to the remainder of the limbic system. This technique is assumed to break up the reverberating circuits of the limbic system and thereby stop the selfperpetuating cycle of emotional stimulation...

The use of the word assumed is an admission that psychosurgeons don't know for sure what they are doing from a biological perspective. In The Broken Brain, Dr. Andreasen also says that "While we know a great deal about the motor, sensory, and language systems, and quite a lot about the memory system, the frontal system is still a poorly understood frontier area" (Id., p. 118). She refers to this part of the brain as "the mysterious frontal lobe" (Id., p. 95). Yet, despite our ignorance of what the frontal lobes do

and how they work, it is in this very area of the brain that "psychosurgery" is done! In a book published in 2007, psychologist Bruce E. Levine, Ph.D., says G. Rees Cosgrove, M.D., formerly Associate Professor of Surgery at Harvard Medical School, and currently Professor of Neurosurgery and Chair of the Department of Neurosurgery at The Warren Alpert Medical School of Brown University, is "perhaps the most well-known psychosurgeon in the United States" (Surviving America's Depression Epidemic, Chelsea Green Publishing Co. 2007, p. 74). In his book The Noonday Demon—An Atlas of Depression, Andrew Solomon quotes Dr. Cosgrove making the following admission about psychosurgery: "We don't understand the pathophysiology; we have no understanding of the mechanisms of why this works" (Scribner 2001, p. 164). Dr. Cosgrove and Scott L. Rauch, M.D., Professor of Psychiatry at Harvard Medical School and Psychiatrist-in-Chief at McLean Hospital, in an article on a Massachusetts General Hospital and Harvard Medical School web page with a last modified date of March 2, 2005 (still on-line when I checked on September 22, 2014) say "The surgical treatment of psychiatric disease can be helpful in certain patients with severe, disabling and treatment refractory major affective disorders, obsessive compulsive disorder and chronic anxiety states." In that article they make the following admissions (italics added): Although the neuroanatomical and neurochemical basis of emotion in health and disease remains undefined, there is evidence that this system and its interconnections with the corticostriatothalamic circuits play a central role in the pathophysiology of major affective illness, obsessive-compulsive disorder and other anxiety disorders. ... Therefore, it is intuitively appealing, to believe that psychiatric disorders that are characterized by affective and cognitive manifestations (eg. depression, OCD, and other anxiety disorders) might reflect a final common pathway of limbic dysregulation. ... Neurochemical models suggest that the affective and anxiety disorders may be mediated via monoaminergic systems. ...

Although the exact neuroanatomical and neurochemical mechanisms underlying depression, OCD and other anxiety states remain unclear, it is believed that the basal ganglia, limbic system and frontal cortex play a principal role in the pathophysiology of these diseases. [http://neurosurgery.mgh.harvard.edu/functional/psysurg.htm]

It is on the basis of such merely suggestive evidence and conjecture that psychosurgeons cut, remove, or destroy fibers or tissue in human brains that as far as anybody can determine are perfectly normal.

What might be the effect of, to use Dr. Andreasen's words, "cutting of very tiny and quite specific portions of the tracts connecting the cingulate gyrus to the remainder of the limbic system"? According to neuroscientist and PET scan pioneer Marcus Raichle of Washington University in St. Louis, the cingulate gyrus is shown by positron emission tomography or PET scan studies of the brain to be a center for solving word problems. It also activates whenever "subjects are told to pay attention...It also shines with activity when researchers ask volunteers [whose brains are being studied by PET scans] to read words for colors—red, orange, yellow—written in the 'wrong' color ink, such as 'red' written in blue" (Newsweek, April 20, 1992, p. 70). In other words, the cingulate gyrus is responsible for some aspects of intelligence. _________________________________________________

"WE HAVE NO UNDERSTANDING OF THE MECHANISMS OF WHY THIS WORKS." _________________________________________________ The choice of the cingulate gyrus or other parts of the limbic system in the brain as the target of modern psychosurgery is based on the belief that the limbic system is responsible for emotions that are often considered the corpus or body or substance of mental "illness". However (overlooking the humanistic costs of damaging these parts of the brain), destroying a person's ability to experience emotions isn't necessarily that simple. An article published in 1988 points out the following: ...when it comes to fear, anger, love, sadness or any of the complicated mixtures of feeling and physical response we label emotions, a loose network of lower-brain structures and nerve pathways called the limbic system appears to be key. ... The most recent research, however, indicates that the experience of emotion has less to do with specific locations in the brain and more to do with the complicated circuitry that interconnects them and the patterns of nerve impulses that travel among them. "It's a little like your television set," says neuroscientist Dr. Floyd Bloom of the Scripps Clinic and Research Foundation. "There are individual tubes, and you can say what they do, but if you take even one tube out, the television doesn't work." [U.S. News & World Report, June 27, 1988, p. 53] This would seem to explain why victims of "psychosurgery" are often so incapacitated by the surgery they are not able to live outside a hospital or nursing home after psychosurgery even if they were able to do so prior to the surgery.

In her book Psychosurgery—Damaging the Brain to Save the Mind, published in 1992, Joann Ellison Rodgers, Director of Media Relations for The Johns Hopkins Medical Institutions, which she calls "the home of biological psychiatry", defends psychosurgery but acknowledges that "within the limbic system are the tangible roots of what make us essentially human." She says "everything that goes on in the limbic system to regulate mood, drive, and emotional reactions actually creates our conscious world, the 'real' world we must deal with every day." Yet she and other advocates of psychosurgery defend psychosurgeons destroying parts of this very same limbic system or its connections to other parts of the brain. Modern psychosurgery destroys less of the brain than prefrontal lobotomy but more specifically targets the parts of the brain that make us human. It is for this reason psychosurgery is sometimes said to be surgery that removes the soul of a human being. Ms. Rogers says "lobotomy's safer, less mutilating approximations, amygdalotomy and cingulotomy ... have consistently good outcomes" and that "Cingulotomies and related operations have helped hundreds of psychiatric patients". She quotes psychiatrist Michael Jenike of Harvard Medical School saying "the side effects" of psychosurgery "are very minimal." She quotes H. Thomas Ballantine, who she says was "one of the nation's most vocal psychosurgeons" saying "one thing we do know at least about cingulotomy is that it is safe, even if it is not always effective" (HarperCollins, pp. xi, 29, 31, 129, 184, 58, 192, 177, 181).

Similar false claims were made about prefrontal lobotomy, the original psychosurgery (unless you count trepanning by prehistoric man, which was chipping holes in the skull to allow evil spirits to escape). Prefrontal lobotomy is now thoroughly discredited. Even Joann Ellison Rodgers in her defense of psychosurgery, Psychosurgery—Damaging the Brain to Save the Mind, admits how bad prefrontal

lobotomies were: She says "Lobotomies and all of early psychosurgery were experiments that failed" (p.

219). Yet a highly esteemed medical reference and medical school textbook, Anatomy of the Human Body, also known as Gray's Anatomy (by Henry Gray, F.R.S., 28th edition edited by Charles May Goss, A.B., M.D., Lea & Febiger 1966, reprinted 1970, pp. 849-850, italics in original), a required text in my Legal Medicine class in law school, says this: The frontal area [of the brain]...contains extensive associations with other parts of the cortex and with the thalamus. The surgical operation of lobotomy, which isolates the area from the rest of the brain, especially the thalamus, has been used in the treatment of severe psychosis with generally favorable results (Freeman & Watts '48).

Obviously, the fact that a supposed therapy is endorsed in a standard, widely-used medical reference book or by our most highly esteemed specialists in human biology, health care, and medicine is not a reliable indication. Gray's Anatomy saying lobotomy has "generally favorable results" illustrates why I sometimes have more faith in common sense than in the supposed experts who write medical textbooks.

How bad the outcomes of modern psychosurgery can be and how safe modern psychosurgery isn't is illustrated by the case of Mary Lou Zimmerman, a 58 year old former bookkeeper who had a combined cingulotomy and capsulotomy in 1998 at the Cleveland Clinic in Ohio to relieve severe (so-called) obsessive compulsive disorder (washing her hands and taking showers frequently). This psychosurgery "left her without control of her limbs or bodily functions." In 2002 a jury awarded her and her husband a $7.5 million in damages (Peter Page, "7.5 Million—Jury slams Cleveland Clinic," The National Law Journal, June 24-July 1, 2002, p. A4; Benedict Carey, "New Surgery to Control Behavior", Los Angeles Times, August 4, 2003, ; "7.5 Million Psychosurgery Verdict", breggin.com).

Psychosurgery being brain damage and nothing but brain damage is even more obvious than in the cases of psychiatric drugs and electroshock. Each of these "therapies" achieve approximately the same end, albeit by different means. When I started my library research on psychosurgery I thought psychosurgery is worse, but the evidence indicates that isn't necessarily true: It depends on what drugs are used and for how long, how many electroshock "treatments" are given, the voltage and shock duration used, and on how much cutting (or burning) the psychosurgeon does.

According the Handbook of Clinical Psychopharmacology for Therapists, Sixth Edition (New Harbinger Publications 2010, by Preston et al., p. 5-6) "Psychosurgeries were carried out by the thousands in the 1940s, resulting in rather effective behavior control over agitated psychotic patients but at great human cost. Many, if not most, lobotomized patients were reduced to anergic, passive, and emotionally dead human beings." In his book The Brain, Richard M. Restak, M.D., clinical professor of neurology at George Washington University, says "psychosurgical operations turned out to have exacted an unacceptable cost. Many of the patients were changed so utterly that their friends and relatives experienced difficulty accepting them as the same individuals they knew before the operation." This contributed to what he calls "the decline of psychosurgery" (Bantam Books 1984, p. 151). That it is, or was, a decline rather than abolition is unfortunate. In his book, The Second Sin, psychiatry professor Thomas Szasz says "When a person eats too much, his intestines are shortcircuited: this is called a

'bypass operation for obesity.' When a person thinks too much, his brain is shortcircuited: this is called 'prefrontal lobotomy for schizophrenia.'" (Doubleday 1973, pp. 6162).

In his autobiography My Lobotomy—A Memoir, written with the help of former Newsweek correspondent Charles Fleming, Howard Dully describes being lobotomized in California in 1960 when he was 12 years old not only without his consent but without his knowledge. He refers to the hospital record: [Dr. Walter] Freeman [the psychosurgeon] had a warning for the [hospital] nurses: "Avoid escape. The patient is full of tricks. Nurse not to leave him alone at any time. Is not to know why he is in the hospital except for examinations."

Escape? Why would I try to escape? Where would I go? I was a twelve-year-old kid in a hospital gown. My father and stepmother and doctor had all told me I was in the hospital for tests. I had no reason to believe they were lying to me. They were treating me like the Birdman of Alcatraz, but I was just a kid who had been looking forward to Jell-O [for dinner]. ... I remember waking up the next day, which would have been Saturday [after the lobotomy]. I felt bad. My head hurt. ...

Freeman's notes tell the story: "Howard entered Doctors Hospital on the 15th and yesterday I performed transorbital lobotomy. ..." [Crown Publishers 2007, p. 96-97] Howard was lobotomized after his stepmother, with whom he had an unpleasant and adversarial relationship, contacted the lobotomist, Dr. Walter Freeman. Dully says "My father thought I was fine.

Lou [his stepmother] thought I was crazy" (My Lobotomy, p. 79). He recalls this incident (Id., p. 30): Lou was cutting all the boys' hair. I was last. I was sitting on a little stool, waiting for her to finish. She was cleaning up, using an old Electrolux vacuum cleaner to pick up the hair. For some reason, she took the metal end of the vacuum cleaner hose and hit me on the top of my head with it.

I flinched.

She said, "Oh, did that hurt?"

I said no. I wouldn't admit that anything hurt.

So she hit me again, but harder this time. I flinched again. She said, "How about that? Did that hurt?

I said no.

So she hit me again, real hard this time. I felt dizzy. She said, "How about that? Did that hurt?

I didn't answer. I figured if I said no again she'd hit me again. I thought she was going to knock me out.

Howard says of his stepmother, "she hated me" (Id., p. 31) and "I remember Lou being mad at me all the time" (Id., p. 81). Eventually Lou, his stepmother, came up with what she thought would be a solution: Lou met with six psychiatrists during the spring and summer of 1960. She wanted to know what was wrong with me and what she should do about it.

But all six of the psychiatrists, I found out later, said my behavior was normal. Four of them even said the problem in the house was with her. They said she was the one who could benefit from treatment. ...

That wasn't the answer she was looking for. ... So she kept looking for a doctor who would agree with her.

Sometime that fall, someone referred her to a doctor named Walter Freeman. [Id., p. 60] In Dr. Freeman, the cruel stepmother found a doctor who agreed with her that it was not her but her stepson who was the problem, and they decided to solve the problem by lobotomizing him. After initially opposing it, Howard's father consented to the operation, giving in to the wishes of his wife.

Lobotomizing anyone, particularly a 12 year old, because he was moody, messy, rambunctious, and defiant (or any other reason), is an example of why I call psychiatry evil.

Dr. Walter Freeman, who lobotomized Howard Dully, was the leading advocate and practitioner of psychosurgery in America. According to Howard and his co-author, it was Dr. Freeman who "proposed changing the name of the procedure from leucotomy to lobotomy" (Id., p. 65), and that became the name by which most people know psychosurgery. Howard and his co-author tell us in 1946 Dr. Freeman "conducted America's first transorbital lobotomy", also known as the ice-pick lobotomy, which is, or was, done without drilling or cutting into the skull but by punching through the thin bone at the back of the eye socket known as the orbit with an ice-pick and waving the ice-pick around in the brain (Id., p. 70), hence the term "transorbital" lobotomy. This type lobotomy is so simple Dr. Freeman "began doing lobotomies in his office" (Id.) He traveled around the U.S.A. in a specially equipped vehicle he called "The Lobotomobile" (Id., p. 71). A "Lobotomy PBS [Public Broadcasting System] documentary on Walter Freeman" available on YouTube.com says "By 1967, Dr. Freeman had personally performed more than twenty-nine hundred (2,900) lobotomies." A biography of Dr. Freeman says he did the first lobotomy in the United States and that "In the United States alone, the number of lobotomized patients would soar to about forty thousand over the next four decades, and Freeman would take part in nearly thirty-five hundred of these surgeries (Jack El-Hai, The Lobotomist—A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, John Wiley & Sons 2005, pp. 1, 14) It is reported that Dr. Freeman even lobotomized a patient against his will: Freeman was ready to do the surgery whenever, wherever. One of his surgical assistants—Jonathan Williams...later told a story about a patient who had been brought to Freeman for a lobotomy. The day before the surgery, though, he'd gotten cold feet and refused to go through with the operation. He locked himself in his hotel room. Freeman, contacted by the patient's family, drove to the hotel and convinced the patient to let him in. Using a portable electroshock machine he had designed and built for himself, he administered a few volts to the patient to calm him down. According to Williams, "The patient was . . . held down on the floor while Freeman administered the shock. It then occurred to him that since the patient was already unconscious, and he had a set of leucotomes in his pocket, he might as well do the transorbital lobotomy then and there, which he did." [My Lobotomy, pp. 72-73] Is lobotomizing a person against his will evil? Is it a more intimate kind of assault than a sexual assault? Is it more acceptable if the brain is damaged with electricity or neurotoxic and cytotoxic "medications" administered against the "patient's" will, as is commonplace today? Is it more acceptable if the patient consents to brain-damaging "therapy" after being falsely assured no harm will be done?

In her book Psychosurgery—Damaging the Brain to Save the Mind (pp. 54, 141) Joann Ellison Rodgers says "Oregon and California outlawed the practice of psychosurgery—Oregon in 1973 and California three years later ... Oregon and California passed laws establishing psychosurgery review committees, which resulted in making both voluntary and involuntary procedures virtually impossible to perform." (Should a psychosurgery review committee, or even a court, be empowered to authorize involuntary psychosurgery?) Oregon's physician licensing statute, §677.190 says this: The Oregon Medical Board may refuse to grant, or may suspend or revoke, a license to practice for any of the following reasons: 1(a) Unprofessional or dishonorable conduct. ... 22(a) Performing psychosurgery. ... "psychosurgery" means any operation designed to produce an irreversible lesion or destroy brain tissue for the primary purpose of altering the thoughts, emotions or behavior of a human being.

By its terms even if not intent, Oregon's above definition of psychosurgery includes electroconvulsive "therapy" (ECT).

An ABC news report dated March 3, 2011 says psychosurgery has been banned by law in the Australian state of New South Wales. The report includes an interview with Richard Bittar, a neurosurgeon from the Royal Melbourne Hospital, and Dennis Velakoulis of the Australian and New Zealand College of Psychiatrists, lamenting the psychosurgery ban in New South Wales and advocating psychosurgery for severely depressed persons.

A contrary trend exists in other parts of the world: A psychiatric textbook published in 2014 titled Psychosurgery: New Techniques for Brain Disorders, says "Psychosurgery, or the surgical treatment of mental disorders, has enjoyed a spectacular revival over the past 10 years" (Springer Int'l Publishing, back cover) and "Psychosurgery is a rapidly expanding field" (Id., p. xi). A March 4, 2010 article in Science Daily says "Psychosurgery is making a comeback." A Medical Xpress article in 2012 includes the results of a study of 63 adult patients at Massachusetts General Hospital who underwent a type of psychosurgery called stereotactic anterior cingulotomy as a treatment for obsessive compulsive disorder (OCD) between 1989 and 2010. The aforementioned psychiatric textbook about psychosurgery published in 2014 and four medical journal articles about psychosurgery published in 2012 verify the sad reality of psychosurgery's return to prominence:

• Psychosurgery: New Techniques for Brain Disorders by Marc Leveque (Springer International Publishing 2014) • "Strategies for the return of behavioral surgery", by Eljamel S., Surg Neurol Int. 2012:3(Suppl 1);S34-9. Epub 2012 Jan 14 • "The amygdala as a target for behavior surgery", by Langevin J.P., Surg Neurol Int. 2012:3(Suppl 1);S40-6. Epub 2012 Jan 14 • "Surgery of the mind, mood, and conscious state: an idea in evolution", by Robison R.A., et al, World Neurosurg. 2012 May-Jun;77(5-6);662-86. Epub 2012 Mar 21 • "Psychosurgery: Review of Latest Concepts and Applications", by Aydin S. & Abuzayed B., J Neurol Surg Cent Eur Neurosurg 2012 Oct 26. (Epub ahead of print)

Like most quack therapies, "psychosurgery" has supporters not only among its practitioners but also among at least a few of those who have received it—or perhaps I should say at least a few of those who have physically and psychologically survived it. I once met a woman who'd had a lobotomy, which was apparent at first glance because of the indentations on each side of her forehead at the hairline. She told me her husband left her when she needed what she called "brain surgery." When I asked what kind of brain surgery, she replied, "a lobotomy." She seemed surprisingly normal. Howard Dully retained enough mental capacity and memory after his lobotomy to write his autobiography, My Lobotomy—a Memoir, with the assistance of a coauthor. He has also made videos about his experience you'll find by doing a search for "Howard Dully" at YouTube.com. The amount of damage done by so-called psychosurgery varies widely.

The extent of damage depends on how much and what parts of the brain are severed or damaged. Psychosurgery kills some people. In The Noonday Demon—An Atlas of Depression, Andrew Solomon says "In the heyday of lobotomies, about five thousand were performed annually in the United States, causing between 250 and 500 deaths a year" (p. 163). That's a death rate of between 5% and 10%. Psychosurgery paralyzes some, causes seizure disorders in a few, and wipes out emotionality, personality, and mentality in many. However, if the psychosurgeon cuts or destroys very little of the brain it may affect the "patient" little or in no noticeable way except for power of suggestion or placebo effect. Much like those who believe their lives have been lengthened by coronary bypass surgery, contrary to scientific evidence showing no increased longevity from the operation for most people who undergo it (see Thomas J. Moore, Heart Failure: A Critical Inquiry Into American Medicine and the Revolution in Heart Care, Random House 1989, pp. 113-125), the survivors of "psychosurgery" sometimes emerge from the ordeal of the operation with a strong psychological need to believe they have benefited from the surgery and so may claim they have. But it is hard to believe they really have, for the same reason it would be hard to believe a computer programming error was corrected not by altering the programming but by disabling a part of the computer.

While brain damage from psychiatry's drugs or "medications" may not have been apparent from the start, it is or to any person with normal intelligence and common sense should have always been obvious that electroshock and psychosurgery are brain damaging. Electroshock and psychosurgery are therefore especially sad chapters in psychiatry's history of senselessly searching for physical causes of and physical treatments for problems that have not been shown to be the result of a physical or biological problem or abnormality. Just as bloodletting said something about incorrect theory and the state of ignorance in health care in the past, brain damaging "therapies" such as "psychosurgery", electroshock, and psychiatric drugs reveal much about incorrect theory and ignorance in psychiatry today. The shamefulness of the psychosurgical part of psychiatry's history—and in some quarters its present—is generally recognized, even by most psychiatrists.

Like psychiatric drugs and electroshock, "psychosurgery" may seem to some to be helpful if it eliminates the so-called symptoms of so-called mental illness. If a person is disabled enough, all of his or her "symptoms" of everything (including desirable personality traits) will be "cured". But changing or damaging a computer's hardware is not a logical or reasonable way to respond to the fact that the computer is running a program you dislike, and likewise, neither would be hiring a TV repairman to work on your TV set because there are too many annoying commercials on TV (paraphrasing Thomas Szasz in his book The Second Sin, Anchor Press 1973, p. 99). In a similar sort of way, changing a person's brain despite there being no evidence of biological abnormality is not a logical or reasonable way to respond to the fact that he is

thinking, feeling emotions, or performing behavior you dislike—whether you use drugs, electroshock, or "psychosurgery". copyright 2014 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "The Case Against Psychotherapy" ]

The Case Against Psychotherapy Wayne Ramsay, J.D.

"What we need are more kindly friends and fewer professionals."

-Jeffrey Masson, Ph.D., a psychoanalyst, in his book Against Therapy (Atheneum 1988, p. XV) The best person to talk with about your problems in life usually is a good friend. It has been said, "Therapists are expensive friends." Likewise, friends are inexpensive "therapists". Contrary to popular belief, and contrary to propaganda by mental health professionals, the training of psychiatrists, psychologists, and other mental health professionals does little or nothing to make them better equipped as counselors or "therapists". It might seem logical for formal credentials like a Ph.D. in psychology or a psychiatrist's M.D., D.O., M.B.B.S., or M.B.Ch.B. degree or a social worker's M.S.W. degree to suggest a certain amount of competence on his or her part. The truth, however, is more often the opposite: In general, the less a person who is offering his or her services as a counselor has in the way of formal credentials, the more likely he or she is to be a good counselor, since such a counselor has only competence (not credentials) to stand on.

Generally, the best person for you to talk with is a person who has worked himself or herself through the same problems you face in the nitty-gritty of life. You usually will benefit if you avoid the "professionals" who claim their value comes from their years of academic study or professional training. Peter Breggin, M.D., a psychiatrist who does only counselling or "psychotherapy" and never recommends psychiatric "medications" (except while withdrawing

from them) or electroshock or psychosurgery, put it this way in one of his books about how to do psychotherapy, The Heart of Being Helpful (Springer Publishing 1997, p. 69): One solution requires recognizing the real qualities required for becoming a good psychotherapist.

Advanced degrees, such as an M.D. or Ph.D., contribute little or nothing to a person's ability to do therapy. Instead, contemporary academic training and supervision can stifle intuitive skills and spontaneous caring. The competitiveness of the academic process winnows out more empathic people in favor of more obsessive and competitive ones. The arduous and largely irrelevant training required to obtain professional credentials encourages the graduates to demand higher prices for their services. The difficulty of getting the required degrees and the myth that the degrees confer an automatic level of expertise allow professionals to create licensure monopolies to enforce their higher prices.

Dr. Breggin makes a similar observation in his book Brain-Disabling Treatments in Psychiatry, Second Edition (Springer Publishing Co. 2008, p. 440): Being an effective therapist begins with being a person that other people can trust with their most vulnerable feelings. In this regard, by creating an authoritarian and manipulative attitude, most contemporary training programs in psychotherapy do more harm than good. They almost always teach a relativistic, self-protective ethic (doing what works; collaborating with psychiatrists; using drugs along with therapy; making cookie-cutter diagnoses; referring desperate or suicidal patients for drugs, electroshock, or incarceration).

When I asked a licensed social worker with a Master of Social Work (M.S.W.) degree who shortly before had been employed in a psychiatric hospital whether she thought the psychiatrists she worked with had any special insight into people or their problems her answer was a resounding no. I asked the same question of a judge who had extensive experience with psychiatrists in his courtroom, and he gave me the same answer and made the point just as emphatically. Similarly, I sought an opinion from a high school teacher who worked as a counselor helping young people overcome addiction or habituation to illicit pleasure drugs who both as a teacher and as a drug counselor had considerable experience with psychiatrists and people who consult them. I asked him if he felt psychiatrists have more understanding of human nature or human problems than himself or other people who are not mental health professionals.

He thought a few moments and then replied, "No, as a matter of fact, I don't."

In his book Against Therapy, a critique of psychotherapy published in 1988, psychoanalyst Jeffrey Masson, Ph.D., speaks of what he calls "The myth of training" of psychotherapists: Therapists usually boast of their "expertise," the "elaborate training" they have undergone. When discussing competence, one often hears phrases like "he has been well trained," or "he has had specialized training." People are rather vague about the nature of psychotherapy training, and therapists rarely encourage their patients to ask in any detail. They don't for a good reason: often their training is very modest. ... The most elaborate and lengthy training programs are the classic psychoanalytic ones, but this is not because of the amount of material that has to be covered. I spent eight years in my psychoanalytic training. In retrospect, I feel I could have learned the basic ideas in about eight hours of concentrated reading [Atheneum/Macmillan Co., p. 248].

In his lecture at the 2011 Empathic Therapy Conference in Syracuse, New York, Alaska psychiatrist Douglas C. Smith, M.D. (Doug Smith), said he personally had psychoanalytic training, which is a separate program unrelated to a typical psychiatrist's three or four years of residency training in psychiatry, but Dr. Smith said training in psychotherapy, or talk therapy, is not included in a typical psychiatrist's training.

Dr. Smith said "You don't get therapy training in psychiatry. No one does. You get just a smattering, but you don't even learn interpersonal skills, let alone therapy in psychiatric training." In his book The Death of Psychiatry (Penguin Books 1974, p. 65), psychiatrist E. Fuller Torrey, M.D., says "Psychiatrists, then, who turn out to be good 'psychotherapists' do so in spite of, not because of, their medical training."

Psychiatrist Peter Breggin, M.D., says the training psychiatrists get is actually counterproductive: We get trained out of our humanity even if we had a lot to begin with. And then what do we learn? Now as a psychiatrist we don't learn to do therapy. That's going to be done by the social worker, you see, because psychiatry went broke trying to compete doing therapy with social workers and psychologists: We charged twice as much and were not as good. So it got taken over by the social workers and psychologists and family therapists. We don't even get trained in it anymore. I was, but I'm 70 years old!

The young guys [young psychiatrists] don't get trained in therapy. So how are they going to change?

They don't have anything! The only tools my colleagues have is drugs and shock treatment and an occasional lobotomy. [Peter Breggin, M.D., Changing Our Minds—Clear Thoughts on Depression, Drugs, and Alternative Paths to a Healthy Mind, Living Life Films (DVD), 2004/2010, "Extras" interviews]

Psychiatrist Daniel Carlat, M.D., disagrees, but his description of psychotherapy training may make you question its value: In all psychiatric programs there is a large psychotherapy component, and what that typically means is that you are really thrown into the room—it's kind of like being thrown into a lion's den, is how it feels when you're first doing therapy, because you have no idea what to say—you get basically thrown into a room with a patient, you wallow around a bit, try to be as helpful as you can, and then you leave, and you talk to a supervisor, and you learn that way. ["Daniel Carlat-Unhinged: The Trouble With Psychiatry", YouTube.com, at 33:41, uploaded Sept. 11, 2012]

In the same lecture (at 6:45), and in his book Unhinged: The Trouble With Psychiatry (p. 189), Dr. Carlat says in a 2005 survey it was found that 29% of psychiatry visits entail psychotherapy and that only 11% of psychiatrists offer psychotherapy to all of their patients. The vast majority of what psychiatrists do now is prescribe counterproductive "medications".

A psychiatrist's perspective on whether psychotherapy is part of psychiatric training probably depends on whether it was part of his or her training.

In his book Warning: Psychiatry Can Be Hazardous to Your Mental Health (HarperCollins 2003, p. xviii), psychiatrist William Glasser, M.D., says "Many medical schools, such as the prestigious Johns Hopkins, no longer require their psychiatric trainees to study psychotherapy." In a Mood Disorders Symposium I attended at Johns Hopkins, called by Joann Ellison Rodgers, its Director of Media Relations,

"the home of biological psychiatry", I heard Johns Hopkins psychiatry professor Raymond DePaulo, M.D., say "medications" and ECT and little or no psychotherapy are how he treats patients.

Some of the admissions about psychiatrists and psychologists having no useful expertise I have heard were from people I have known as friends who happened to be practicing psychologists.

Illustrative are the remarks of one Ph.D. psychologist in the 1970s who told me how amazed members of his family were that people would pay him $50 an hour just to discuss their problems with him. He admitted it really didn't make any sense, since they could do the same thing with lots of other people for free. "Of course," he said, "I'm still going to go to my office tomorrow and collect $50 an hour for talking with people." Due to inflation, today the cost is usually much higher than $50 per hour.

In his book The Reign of Error, published in 1984, psychiatrist Lee Coleman, M.D., says "psychiatrists have no valid scientific tools or expertise" (Beacon Press, p. ix).

Garth Wood, M.D., a British psychiatrist, included the following statements in his book The Myth of Neurosis published in 1986: Popularly it is believed that psychiatrists have the ability to "see into our minds," to understand the workings of the psyche, and possibly even to predict our future behavior. In reality, of course, they possess no such skills. ... In truth there are very few illnesses in psychiatry, and even fewer successful treatments ... in the postulating of hypothetical psychological and biochemical causative processes, psychiatrists have tended to lay a smokescreen over the indubitable fact that in the real world it is not hard either to recognize or to treat the large majority of psychiatric illnesses. It would take the intelligent layman a long weekend to learn how to do it. [Harper & Row 1986, p. 2830; emphasis in original] A cover article in Time magazine in 1979 titled "Psychiatry's Depression" made this observation: "Psychiatrists themselves acknowledge that their profession often smacks of modern alchemy—full of jargon, obfuscation and mystification, but precious little real knowledge" ("Psychiatry on the Couch", Time magazine, April 2, 1979, p. 74).

I once asked a social worker employed as a counselor for troubled adolescents whose background included individual and family counselling if she felt the training and education she received as part of her M.S.W. degree made her more qualified to do her job than she would have been without it. She told me a part of her wanted to say yes, because after all, she had put a lot of time and effort into her education and training. She also mentioned a few minor benefits of having received the training. She concluded, however, "Most of the things I've done I think I could have done without the education."

Most mental health professionals however have an understandable emotional or mental block when it comes to admitting they have devoted, actually wasted, several years of their lives in graduate or professional education and are no more able to understand or help people than they were when they started. Many know it and won't, or will only rarely, admit it to others. Some cannot even admit it to themselves.

Hans J. Eysenck, Ph.D., a psychology professor at the University of London, is described in the December 1988 issue of Psychology Today magazine by the magazine's senior editor as "one of the world's best-known and most respected psychologists" (p. 27). This highly regarded psychologist states this conclusion about psychotherapy: "I have argued in the past and quoted numerous experiments in

support of these arguments, that there is little evidence for the practical efficacy of psychotherapy...the evidence on which these views are based is quite strong and is growing in strength every year" ("Learning Theory and Behavior Therapy", in Behavior Therapy and the Neuroses, Pergamon Press 1960, p. 4). Dr. Eysenck said that in 1960. In 1983 he said this: "The effectiveness of psychotherapy has always been the specter at the wedding feast, where thousands of psychiatrists, psychoanalysts, clinical psychologists, social workers, and others celebrate the happy event and pay no heed to the need for evidence for the premature crystallization of their spurious orthodoxies" ("The Effectiveness of Psychotherapy: The Specter at the Feast", The Behavioral and Brain Sciences 6, p. 290).

In The Emperor's New Clothes: The Naked Truth About the New Psychology, (Crossway Books 1985) William Kirk Kilpatrick, professor of educational psychology at Boston College, argues that we have attributed expertise to psychologists that they do not possess.

In 1983 three psychology professors at Wesleyan University in Connecticut, in an article published in The Behavioral and Brain Sciences, a professional journal, titled "An analysis of psychotherapy versus placebo studies" question the value of "psychotherapy". The abstract of the article ends with these words: "...there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment" (Leslie Prioleau, et al., Vol. 6, p. 275).

George R. Bach, Ph.D., a psychologist, and coauthor Ronald M. Deutsch, in their book Pairing, make this observation: "There are not enough therapists to listen even to a tiny fraction of these couples, and, besides, the therapy is not too successful. Popular impression to the contrary, when therapists, such as marriage counselors, hold meetings, one primary topic almost invariably is: why is their therapy effective in only a minority of cases?" (Peter H. Wyden, Inc. 1970, p. 9; emphasis in original).

In his book What's Wrong With the Mental Health Movement, K. Edward Renner, Ph.D., a professor in the Department of Psychology at the University of Illinois at Urbana, makes this observation in his chapter titled "Psychotherapy": "When control groups are included, those patients recover to the same extent as those patients receiving treatment. ...The enthusiastic belief expressed by therapists about their effectiveness, in spite of the negative results, illustrates the problem of the therapist who must make important human decisions many times each day. He is in a very awkward position unless he believes in what he is doing" (NelsonHall Publishers 1975, pp. 138139; emphasis in original).

An example of this occurred at the psychiatric clinic at the Kaiser Foundation Hospital in Oakland, California. Of 150 persons who sought psychotherapy, all were placed in psychotherapy except for 23 who were placed on a waiting list. After six months, doctors checked on those placed on the waiting list to see how much better the people receiving psychotherapy were doing than those receiving none.

Instead, the authors of the study found that "The therapy patients did not improve significantly more than did the waiting list controls" (Martin L. Gross, The Psychological Society, Random House 1978, p.

18).

In the second edition of his book Is Alcoholism Hereditary?, published in 1988, Donald W. Goodwin, M.D., says "There is hardly any scientific evidence that psychotherapy for alcoholism or any other condition helps anyone" (Ballantine Books 1988, p. 180).

Dr. Vernon Coleman, a British physician, criticizes psychotherapy in a chapter titled "Why Mental Health Care Isn't Always Worth Having" in his book How To Stop Your Doctor Killing You (European Medical Journal 2003, p. 115):

What do psychotherapists do? Good question. Basically, they listen to (and occasionally talk to) their patients.

Do they do any good? I don't think so.

I suspect that a chat to a hairdressser or to a barman will do a patient as much good as a chat to a psychotherapist and that patients who are treated with psychotherapy are slightly more likely to become mentally ill, become alcoholics or commit a major crime than are patients who get no psychotherapy.

British psychiatrist Garth Wood, M.D., criticizes modern day "psychotherapy" in his book The Myth of Neurosis (HarperCollins 1986, pp. 2-3): These misguided myth-makers have encouraged us to believe that the infinite mysteries of the mind are as amenable to their professed expertise as plumbing or an automobile engine. This is rubbish. In fact these talk therapists, practitioners of cosmetic psychiatry, have no relevant training or skills in the art of living life. It is remarkable that they have fooled us for so long. ... Cowed by their status as men of science, deferring to their academic titles, bewitched by the initials after their names, we, the gullible, lap up their pretentious nonsense as if it were the gospel truth. We must learn to recognize them for what they are—possessors of no special knowledge of the human psyche, who have, nonetheless, chosen to earn their living from the dissemination of the myth that they do indeed know how the mind works.

The superiority of conversation with friends over professional psychotherapy is illustrated in the remarks of a woman interviewed by Barbara Gordon in her book Jennifer Fever: For Francesca, psychotherapy was a mixed blessing. "It helps, but not nearly as much as a few intense, good friends," she said. "...I pay a therapist to listen to me, and at the end of forty-five minutes he says, "That's all the time we have; we'll continue next week." A friend, on the other hand, you can call any hour and say, "I need to talk to you." They're there, and they really love you and want to help." [Harper & Row 1988, p. 132]

In an interview with another woman on the same page of the same book, Ms. Gordon was told this, referring to pain from losing a husband: "Good shrinks can probably deal with it; the two I went to didn't help."

Martin L. Gross, a member of the faculty of The New School For Social Research and an Adjunct Assistant Professor of Social History at New York University, has argued that "the concept that a man who is trained in medicine or a Ph.D. in psychology has a special insight into human nature is false" (quoted in "And ACLU Chimes In: Psychiatric Treatment May Be Valueless", Behavior Today, June 12, 1978, p. 3).

The June 1986 issue of Science 86 magazine included an article by Bernie Zilbergeld, a psychologist, suggesting that "we're hooked on therapy when talking to a friend might do as well." He cites a Vanderbilt University study that compared professional "psychotherapy" with discussing one's problems

with interested but untrained persons: "Young men with garden variety neuroses were assigned to one of two groups of therapists. The first consisted of the best professional psychotherapists in the area, with an average 23 years of experience; the second group was made up of college professors with reputations of being good people to talk to but with no training in psychotherapy. Therapists and professors saw their clients for no more than 25 hours. The results: "Patients undergoing psychotherapy with college professors showed ... quantitatively as much improvement as patients treated by experienced professional psychotherapists" (p. 48). Zilbergeld pointed out that "the Vanderbilt study mentioned earlier is far from the only one debunking the claims of professional superiority" (Id, p. 50).

Similarly, in his book House of Cards—Psychology and Psychotherapy Built on Myth (Free Press 1994, pp. 8 & 101-102), psychology professor and former president of the Oregon Psychological Association Robyn M. Dawes, Ph.D., says this: Virtually all the research—and this book will reference more than three hundred empirical investigations and summaries of investigations—found that these professionals' claims to superior intuitive insight, understanding, and skill as therapists are simply invalid. ... Evaluating the efficacy of psychotherapy has led us to conclude that professional psychologists are no better psychotherapists than anyone else with minimal training—sometimes than those without any training at all; the professionals were merely more expensive.

In his defense of psychotherapy in a book published in 1986, psychiatrist E. Fuller Torrey makes this argument: "Saying that psychotherapy does not work is like saying that prostitution does not work; those enjoying the benefits of these personal transactions will continue doing so, regardless of what the experts and researchers have to say" (Witchdoctors and Psychiatrists: The Common Roots of Psychotherapy and Its Future, Jason Aronson, Inc., p. 198). If you really are desperate for someone to talk to, then "psychotherapy" may in fact be enjoyable. However, if you have a good network of friends or family who will talk to you confidentially and with your best interests at heart, there is no need for "psychotherapy". Just as a happily married man or a man with a good sexually intimate relationship with a steady girlfriend is unlikely to have reason to hire a prostitute, people with good friendships with other people are unlikely to need "psychotherapy".

What if you need information about how to solve a problem your family and friends can't help you with? In that case usually the best person for you to talk to is someone who has lived through or is living through the same problem you face. Sometimes a good way to find such people is attending meetings of a group organized to deal with the kind of problem you have. Examples (alphabetically) are Alcoholics Anonymous, Alzheimer's Support groups, Agoraphobia SelfHelp groups, AlAnon (for relatives of alcoholics), Amputee Support groups, Anorexia/Bulimia support groups, The Aphasia Group, Arthritics Caring Together, Children of Alcoholics, Coping With Cancer, Debtors Anonymous, divorce adjustment groups, father's rights associations (for divorced men), Gamblers Anonymous, herpes support and social groups such as HELP, Mothers Without Custody, NarAnon (for relatives of narcotics abusers), Narcotics Anonymous, Overeaters Anonymous, Parents Anonymous, Parents in Shared Custodies, Parents Without Partners, Potsmokers Anonymous, Resolve, Inc., (a support group that deals with the problems of infertility and miscarriage), Shopaholics Ltd., singles groups, Smokers Anonymous, The Stuttering

Support Group, women's groups, and unwed mothers assistance organizations. Local newspapers often have listings of meetings of such organizations. Someone who is a comrade with problems similar to yours and who has accordingly spent much of his or her life trying to find solutions for those problems is far more likely to know the best way for you to deal with your situation than a "professional" who supposedly is an expert at solving all kinds of problems for all kinds of people. The myth of professional psychotherapy training and skill is so widespread, however, that you may find people you meet in selfhelp groups will recommend or refer you to a particular psychiatrist, psychologist, or social worker. If you hear this, remember what you read (above) and disregard these recommendations and referrals and get whatever counselling you need from nonprofessional people in the group who have direct experience in their own lives with the kind of problem that troubles you. You will probably get better advice and— importantly—you will avoid psychiatric stigma.

In their book A New Guide To Rational Living, Albert Ellis, Ph.D., a New York City psychologist, and Robert A. Harper, Ph.D., say they follow "an educational rather than a psychodynamic or a medical model of psychotherapy" (Wilshire Book Co. 1975, p. 219). In his book Get Ready, Get Set...Prepare to Make Psychotherapy A Successful Experience For You, psychotherapist and psychology professor Harvey L. Saxton, Ph.D., says "What is psychotherapy? Psychotherapy is simply a matter of reeducation.

Reeducation implies letting go of the outmoded and learning the new and workable. Patients, in one sense, are like students; they need the capacity and willingness to engage in the process of relearning" (University Press of America 1993, p. 1). In their book When Talk Is Not Cheap, Or How To Find the Right Therapist When You Don't Know Where To Begin, psychotherapist Mandy Aftel, M.A., and Professor Robin Lakoff, Ph.D., say "Therapy...is a form of education" (Warner Books 1985, p. 29). Since so-called psychotherapy is a form of education, not therapy, you need not a doctor or therapist but a person who is qualified to educate in the area of living in which you are having difficulty. The place to look for someone to talk to is where you are likely to find someone who has this knowledge. Someone whose claim to expertise is a "professional" psychotherapy training program rarely if ever is the person who can best advise you.

Recommended Video

Peter R. Breggin, M.D., Empathic Therapy, a psychotherapy training film, available at breggin.com: In this film, Dr. Breggin shows how anyone, including a person without professional training, can be an effective "psychotherapist". Applying the principles in Dr. Breggin's 22 minute introduction will make you a better person to talk with than many if not most professional "psychotherapists".

copyright 2014 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Unjustified Psychiatric Commitment in the U.S.A." ]

Unjustified Psychiatric Commitment in the U.S.A. Wayne Ramsay, J.D. "Most commitments are just rubber-stamped by judges... we only want the same human and civil rights as everyone else. We don't want to be locked up when we have committed no crime, on the pretext that it is for our own good. It's not. Being deprived of liberty is inherently harmful, never helpful—except for the institutions, the professionals, the drug companies, and everyone else who profits from locking us up. ... There is no such thing as forced treatment; if it's forced, it is social control for the benefit of others."

Linda Andre in her book, Doctors of Deception—What They Don't Want You to Know About Shock Treatment (Rutgers University Press 2009, pp. 5, 16, 17) "It was abusive psychiatry in medieval times when doctors of the church exorcised the demons they presumed were causing mental illness through the diagnostic and treatment techniques of torture and drowning. In Soviet times, coercive psychiatry was used to suppress political dissenters by calling them crazy and parking them for long stretches in mental hospitals. China reputedly is running its own 'psychiatric gulags' to quiet the vociferous economic complaints of peasants cheated by greedy local party officials. ... Before heaping what would be completely appropriate condemnation on abusive Chinese practices, we should get our own house in order" in the U.S.A. Psychiatrist Allen Frances, M.D., former chairman of the Department of Psychiatry at Duke University, and chairperson of the Task Force that created the 4th edition American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV in 1994 & DSM-IV-TR in 2000), in his article "A Clinical Reality Check", August 12, 2012, Cato Unbound—A Journal of Debate "Justice for all is a fundamental principle upon which our country was founded." Harry M. Reasoner, Chair of the Texas Access to Justice Commission, in an e-mail to supporters on December 9, 2014

In 1992, U.S. Representative Patricia Schroeder, chairwoman of the U.S. House of Representatives Select Committee on Children, Youth, and Families, held hearings investigating the practices of psychiatric hospitals in the United States. Rep. Schroeder summarized her committee's findings as follows: Our investigation has found that thousands of adolescents, children, and adults have been hospitalized for psychiatric treatment they didn't need; that hospitals hire bounty hunters to kidnap patients with

mental health insurance; that patients are kept against their will until their insurance benefits run out; that psychiatrists are being pressured by the hospitals to increase profit; that hospitals "infiltrate" schools by paying kickbacks to school counselors who deliver students; that bonuses are paid to hospital employees, including psychiatrists, for keeping the hospital beds filled; and that military dependents are being targeted for their generous mental health benefits. I could go on, but you get the picture. [quoted in: Lynn Payer, Disease-Mongers: How Doctors, Drug Companies, and Insurers Are Making You Feel Sick, John Wiley & Sons, Inc. 1992, pp. 234-235]

A headline on the front page of the July 6, 1986 Oakland, California Tribune reads: "Adolescents are packing private mental hospitals But do most of them belong there?" According to the newspaper article: ...mental patients advocates say many adolescents in private hospitals are not seriously mentally ill, but merely rebellious. By holding the adolescents, who often dislike hospitalization, advocates say private hospitals reap profits and please parents. ... Some county mental health officials and psychiatrists at private hospitals acknowledge there are hospitalized adolescents who, ideally, shouldn't be there. ... "It distresses me to see kids in these facilities; it distresses me to see the profits going on," Jay Mahler, of Patients Rights Advocacy and Training, said two weeks ago at a Concord Public forum. "It's a hot business," Tim Goolsby, a Contra Costa County Probation Department adolescent placement supervisor, later agreed. "If your kids like sex, drugs, and rock' n'roll, that 's the place to put them. I'm not sure insurance companies know what's going on, but they're being ripped off." Goolsby estimated 80 percent of adolescents in Contra Costa private psychiatric hospitals are not mentally ill... University of Southern California sociologists Patricia Guttridge and Carol Warren say these adolescents have been transformed from delinquents to emotionally disturbed children. After studying 1,119 adolescents in four Los Angeles-area psychiatric hospitals, they found that less than a fifth were admitted for serious mental illnesses. [Susan Stern, The Tribune (Oakland, California), Sunday, July 6, 1986, p. A-1 & A-2].

Alison Bass relates this story in her book Side Effects—A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial (Algonquin Books of Chapel Hill 2008, p. 182): "...seventeen-year-old Tonya Brooks ... was admitted to Seton Shoal Creek, a mental hospital for children and adolescents in Austin [Texas, in 2004]. The doctor diagnosed her as bipolar; according to Tonya, he labeled everyone bipolar.

'Ninety percent of the kids I met there, there's nothing wrong with them,' she later told me."

Tonya's observation about a doctor diagnosing everyone as bipolar might seem unlikely. However, in his book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (HarperCollins 2013, p. 232), psychiatrist Allen Frances, M.D., former chairman of the Department of Psychiatry at Duke University School of Medicine, and head of the group that wrote two editions of the American Psychiatric Association's "diagnostic" (actually description) manual, says "My experience has been that some clinicians make the same diagnosis and offer the same treatment for almost every patient they see." In the question and answer period at the lecture by British psychiatrist Joanna Moncrieff at the University of New England on February 25, 2013, a psychiatric hospital employee offered this observation:

I spent the first 6 years of my career working in a private psychiatric hospital ... In the morning we have 'the morning report', and we hear about the admissions from the day before, and over time I became aware I could predict the diagnosis based not on the symptoms that were described but by the personality of the psychiatrist who had admitted the patient, and I mean, with great accuracy. ["Joanna Moncrieff—The Myth of the Chemical Cure: The Politics of Psychiatric Drug Treatment", YouTube.com at 1:02:51 & 1:05:32].

Such observations are further evidence of the invalidity of psychiatric "diagnosis" I document in The Myth of Psychiatric Diagnosis. These unreliable and unscientific psychiatric "diagnoses" serve as the justification for involuntary psychiatric "hospitalization", forced psychiatric drugging, and other supposed treatment.

In the February 1988 Stanford Law Journal Lois A. Weithorn, Ph.D., a former University of Virginia psychology professor, said " the rising rates of psychiatric admission of children and adolescents reflect an increasing use of hospitalization to manage a population for whom such intervention is typically inappropriate: 'troublesome' youth who do not suffer from severe mental disorders" (40 Stanford Law Review 773 at 774).

A magazine article published in 1992 criticizing the trend towards locking up troublesome teenagers alleged that teenagers are locked up in psychiatric hospitals today more than in the past because "busy parents are less willing to deal with their behavior and because inpatient psychiatric business represents a profitable market in the health-care field." The result was an increase in the number of psychiatric hospitals "from 220 in 1984 to 341 in 1988". This increase in the number of psychiatric hospitals resulted in keen competition between hospitals and psychiatrists for patients: Keeping all those psychiatric beds filled is critical, and administrators are aggressively ensuring that they will be. Hard-sell TV, radio, and magazine ads (up to tenfold in the past few years, according to Metz) are ubiquitous ... Some facilities even resort to paying employees and others bonuses of $500 to $1,000 per referral. ... Rebellious teenagers used to be grounded. New they're being committed. Increasingly, parents are locking up their unruly kids in the psychiatric wards of private hospitals for engaging in what many therapists call normal adolescent behavior. Adolescent psychiatric admissions have gone up 250 or 400 percent since 1980, reports Holly Metz in The Progressive (Dec. 1991), but it's not because teens are suddenly so much crazier than they were a decade ago. Indeed, the Children's Defense Fund suggests that at least 40 percent of these juvenile admissions are inappropriate, while a Family Therapy Networker (July/Aug. 1990) youth expert puts that figure at 75 percent." [Lynette Lamb, "Kids in the Cuckoo's Nest Why are we locking up America's troublesome teens?", Utne Reader, March/April 1992, pp. 38, 40]

In her book And They Call It Help—The Psychiatric Policing of Americas Children, published in 1993, Louise Armstrong laments "the 65 percent of kids in private, for-profit psych hospitals who simply do not need to be there but are given severe-sounding labels nonetheless" (Addison-Wesley Pub. Co., p. 167— italics in original).

In the 1980s and 1990s unjustified involuntary commitment to psychiatric hospitals become so blatant Readers Digest published an article in the July 1992 issue exposing the unethical practice:

Similar storm clouds are appearing over the mental-health field. Alarmed by exploding costs, insurance companies began scrutinizing payments more carefully—and ultimately trimmed the average patient's length of hospital stay. As a result, "private hospitals that once made a great deal of money are now desperate for patients," says Dr. Alan Stone, former president of the American Psychiatric Association.

That desperation has opened the door for fraud. Among the alleged abuses: patients abducted by "bounty hunters"; others hospitalized against their will until their insurance runs out; diagnoses and treatments tailored to maximize insurance reimbursement; kickbacks for recruiting patients; unnecessary treatments; gross overbilling.

The most infamous charges were leveled in Texas. On April 4, 1991, two private security agents showed up at the Harrell family home in Live Oak to pick up Jeramy Harrell, 14, and admit him on suspicion of drug abuse to Colonial Hills Hospital, a private psychiatric facility in San Antonio.

Family members believed the agents to be law-enforcement officers. If Jeramy didn't cooperate, the agents said, they could obtain a warrant and have him detained for 28 days. "They acted just like the Gestapo," the boy's grandmother-and legal guardian-later told a Texas state senate committee.

According to that testimony, Jeramy was denied any contact with his family for six days and released only after a state senator [Frank Tejeda, later elected to Congress] intervened. State officials discovered the boy had been ordered detained by a staff doctor after his disturbed younger brother lied about Jeramy's supposed drug use. The guards who brought him in worked for a private firm paid by Colonial Hills for each patient delivered. ...

Soon after the ordeal, the Harrells got a bill for Jeramy's six-day stay, a stunning $11,000. The hospital's owner denied any wrongdoing.

The Harrell case led to those Texas senate hearings, which in turn brought to light other allegations of fraud and abuse involving some 12 other Texas facilities and at least three other national hospital chains. Similar charges have been made against hospitals in New Jersey, Florida, Alabama and Louisiana; three federal agencies have opened investigations, and more than a dozen states have probes under way. [Gordon Witkin, "Beware These Health Scams", Readers Digest, July 1992, p. 142 at 144-146] Another example was reported in National Review magazine in 1996: John David Deaton was a normal 17-year-old when he walked into a National Medical Enterprises (NME) psychiatric hospital in Dallas. A physician had persuaded him to go to there for help with depression after his girlfriend jilted him. Deaton did not know that the physician was on the hospital's payroll, and that his pay depended on how well he did at filling hospital beds. ... After four days, when Deaton sought to leave, he was tied down with leather restraints. ... In fact, the most abnormal thing about John Deaton was that his father's employer provided extraordinarily rich insurance coverage for mental illness. ... It was only when Deaton's insurance coverage ran out that he was allowed out of his restraints. ... "I was held in bondage for insurance money," Deaton told a congressional hearing in 1994. "Health-care fraud cost my insurance company around $250,000. It cost me over a year of my life."

Now, thanks to a recent U.S. Senate vote, we may all become more vulnerable to this kind of

psychiatric buccaneering, if not as "patients," then as people who will have to pay higher insurance premiums to cover "therapy" for a host of illnesses, many of them imagined or bogus. [Eugene H. Methvin, "Cuckoo's Nest", July 15, 1996, p. 38]

In 1991 or 1992 an administrator at a psychiatric hospital told me competition between psychiatric hospitals is what she called "cut throat". That can create a motive to hospitalize people unnecessarily, including by force if the so-called "patient" refuses.

What is most needed is widespread recognition that "mental illness" is an invalid concept. A psychiatric "diagnosis" is nothing more than a value judgment about a person's thinking or behavior.

Psychiatric "diagnoses" have nothing to do with medicine except for the fact the people making the value judgments are physicians. These value judgments have nothing to do with health.

3280 S. Florida Avenue (Route 41) Inverness, Florida

No Jury, No Justice

On March 26, 2015, I asked a Pennsylvania public defender responsible for representation of defendants in involuntary civil commitment for mental illness if Pennsylvania judges ever release people in such cases. He replied, "On occasion, but it's rare."

In an article opposing all involuntary psychiatric treatment titled "The Double Standard of Forced Treatment" (psychcentral.com, 26 Nov. 2012), psychologist John M. Grohol, Psy.D., said this: Forced treatment for people with mental illness has had a long and abusive history, both here in the United States and throughout the world. ... reform laws in the 1970s and 1980s took the [psychiatric]

profession's right away from them to confine people against their will. Such forced treatment now requires a judge's signature. But over time, that judicial oversight—which is supposed to be the check in our checks-and-balance system—has largely become just a rubber stamp to whatever the doctor thinks is best. ... Judges simply don't work as check for forced treatment, because they don't have any reasonable basis on which to actually rest their judgment in the short time they're given to make a determination.

Actually, of course, judges could take all the time they want to hear and evaluate the evidence for and against forced treatment and to form their own opinion about whether forced treatment is justified in any particular case. The problem isn't that they can't but that in most cases they won't. There is simply no way to force judges to exercise their own independent judgment rather than routinely defer to the judgment of the committing psychiatrist, physician, or psychologist. In the words of one law journal commentator, "Despite statutory protections for commitment, research has found that procedures for involuntary commitment tend to be perfunctory and a legal charade, which merely 'rubber stamp' psychiatric recommendations" (Douglas S. Stransky, "Civil Commitment and the Right to Refuse Treatment", 50 University of Miami Law Review 413 at 417, note 29).

However, the presence of a lay jury empowered to decide whether or not a person should be involuntarily committed changes this. Trial by jury provides a real opportunity for the defendant to be released, or in the case of outpatient commitment, a real opportunity to avoid court-ordered outpatient psychiatric drugging or electroshock. This is why a New York Mental Hygiene Legal Service attorney, in a lecture I attended in 2013, said in his observations mental hospital personnel "go crazy" whenever one of their involuntary patients demands a jury trial.

Under state constitutional law or state statutes, the majority of Americans do currently have a right to trial by jury in civil commitment of law-abiding persons for supposed mental illness. However, the right to jury trial in civil commitment for mental illness is not currently recognized in many states of the U.S.A. despite the unanimous U.S. Supreme Court opinion in Humphrey v. Cady, 405 U.S. 504 at 508-510 (1972) saying jury trial is needed for a full and fair determination in such cases: In Baxstrom [383 U.S. 107], substantially the same argument was advanced by a convicted prisoner who was committed under New York law for compulsory treatment, without a jury trial, at the expiration of his penal sentence. This Court held that the State, having made a jury determination generally available to persons subjected to commitment for compulsory treatment, could not, consistent with the Equal Protection Clause, arbitrarily withhold it from a few. [citation omitted] The Court recognized that the prisoner's criminal record might be a relevant factor in evaluating his mental condition, and in determining the type of care and treatment most appropriate for his condition; it could not, however, justify depriving him of a jury determination on the basic question whether he was mentally ill and an appropriate subject for some kind of compulsory treatment.

Since 1880, Wisconsin has relied on a jury to decide whether to confine a person for compulsory psychiatric treatment. Like most, if not all, other States with similar legislation, Wisconsin conditions such confinement not solely on the medical judgment that the defendant is mentally ill and treatable, but also on the social and legal judgment that his potential for doing harm, to himself or to others, is

great enough to justify such a massive curtailment of liberty. In making this determination, the jury serves the critical function of introducing into the process a lay judgment, reflecting values generally held in the community, concerning the kinds of potential harm that justify the State in confining a person for compulsory treatment. [italics added] Commitment for compulsory treatment under the Wisconsin Sex Crimes Act appears to require precisely the same kind of determination, involving a mixture of medical and social or legal judgments. If that is so (and that is properly a subject for inquiry on remand), then it is proper to inquire what justification exists for depriving persons committed under the Sex Crimes Act of the jury determination afforded to persons under the Mental Health Act. The Supreme Court of California ruled a unanimous jury verdict in civil commitment of law-abiding but mentally ill persons is required by the due process clause of the California Constitution in Mabel Roulet, 590 P2d 1 (1979). The highest courts of other states have said the right to trial by jury in civil commitment for mental illness is protected by state constitution provisions preserving the right to jury trial as it existed under common law or at the time of the adoption of the State's constitution: Missouri in State v. Holtcamp, 138 SW 521; New York in Sporza v. German National Bank, 84 NE 406 as interpreted in Coates, 8 AD2d 444, Arnold v. Sanchez, 634 NYS2d 343, and Robert C. v. Wack, 635 NYS2d 677; Tennessee in Johnson v. Nelms, 100 SW2d 648; Texas in White v. White, 196 SW 508; and Washington in Ellern, 160 P2d 639 and Quesnell, 517 P2d 568. In Quesnell the Supreme Court of Washington put it this way: First, the right to trial by jury in Washington mental illness proceedings is guaranteed by constitution (Wash.Const. art. 1 ยง21) and statute (RCW 71.02.210). ... the jury plays an essential role in guarding against wrongful commitment. ... the right to trial by jury in civil commitment proceedings is clearly fundamental.

As Judge Spreecher said in Lessard v. Schmidt, 349 F.Supp. at 1100 (1972), "The right to jury trial has been shown to be critical, numerous studies indicating that the exercise of that right may well mean the difference between release and commitment."

There is no meaningful defense against unjustified involuntary civil commitment for supposed mental illness in states where there is no right to trial by jury because of the unwillingness of most judges to exercise their own independent judgment in such cases, and in states where judges are elected, the judge's fear a person he releases may become a campaign issue in the next election by committing a crime of violence after being released. Like mental health professionals who commit anyone whose future behavior they have the slightest doubt about because of the professional's liability for millions of dollars if a person he or she could have but does not commit later commits a crime, elected judges similarly must "play it safe" (for themselves) by committing anyone and everyone the judge even vaguely suspects may later do something that would jeopardize the judge's re-election prospects. Jurors do not face this risk, so trial by jury is usually a defendant's only realistic hope of retaining or regaining freedom when threatened with involuntary civil commitment.

In a column e-mailed to lawyers on March 2, 2015, State Bar of Texas president Trey Apffel wrote,

"the right to a trial by jury is the very foundation of our liberties and freedoms. ... To me, there is no higher ideal than the right to trial by jury. ... Alexander Hamilton once called the civil jury 'a valuable safeguard to liberty.' We must not allow that liberty to die." Unfortunately, in civil commitment for supposed mental illness, it has died in many states of the U.S.A.

"Assistance" of Counsel?

Another important and needed reform is making the hiring and firing of mental health public defenders and the appointment of lawyers who represent proposed patients or respondents in civil commitment for mental illness (both inpatient and outpatient, and in involuntary guardianship) someone other than the judges before whom they appear. My observation of lawyers in civil commitment proceedings makes it hard to avoid the impression that (1) judges appoint as defense counsel only those they know from experience will not provide genuine assistance to persons accused of mental illness in civil commitment, and (2) most judges making these appointments are unlikely to tolerate a lawyer doing all he should for his client in such cases. Full-time mental health public defenders usually do a better job than lawyers whose law practices are mostly in other areas of law. Mental health public defenders at least are familiar with the applicable laws and sometimes do their jobs competently. That is rarely the case with court-appointed lawyers. When representation is by court-appointed lawyers, and too often when representation is by mental health public defenders, "assistance of counsel" in civil commitment for mental illness has become a weapon used against the defendant rather than a right of the defendant. It has been said: It is better to have ten enemies than one fake friend. It is important to know who your enemies are. Appointed "defense" attorneys and mental health public defenders very often are one of the proposed patient's enemies, but in disguise, a wolf in sheep's clothing. Evidence for this can be seen by observing civil commitment hearings. A study of involuntary civil commitment for mental illness in Nebraska found "there were proportionately fewer commitments among respondents represented by private counsel than among those represented by appointed counsel or public defenders" (Virginia Aldige Hiday, "The Attorney's Rose in Civil Commitment", 60 North Carolina Law Review 1027 at 1031 (1982). In 2014, Alaska attorney James Gottstein, President/CEO of the Law Project for Psychiatric Rights, said "when I represent someone in a commitment hearing I tell them it will take me at least a day or two to get ready. I tell them if they don't want to wait that long for a hearing, they can use the public defender and almost certainly be committed, or they can use me, wait a day or so, and have a real shot at not being committed" ("Should PsychRights Ask the U.S. Supreme Court to Hear an Appeal of the Alaska Supreme Court's Decision?", madinamerica.com, February 15, 2014).

One way representation by counsel is used as a weapon against the defendant is refusing to allow the defendant to speak on his own behalf or ask questions of witnesses because he is represented by counsel: Assistance of counsel should not be an excuse to ban a person from speaking in his own defense nor asking questions of witnesses.

Another is giving a single lawyer too many clients to represent in a single day's hearing schedule, preventing him from having time to adequately prepare himself for representation of each client.

Another way representation by counsel has been made a weapon used against the defendant is paying defense counsel a fixed fee for each person represented whether the case is resolved in a 30

second pro forma hearing or a week long jury trial, making it financially disadvantageous for the lawyer to do anything on behalf of his client that would lengthen the proceedings and take more of the lawyer's time. This kind of compensation scheme encourages lawyers to do all they can to dissuade clients from exercising their rights such as the right to a jury trial.

In most cases, proposed patients or defendants in civil commitment for supposed mental illness would be better protected by having no lawyer appointed to represent them and instead given a pamphlet or booklet containing a copy of the statutes under which they are being committed, summaries of important court decisions about civil commitment law, statistics about outcomes in the prior year's civil commitment cases in the jurisdiction, including percentage committed and released by juries and by judges, and by appearing in court with no "assistance" of counsel. Because defense lawyers in this type of case typically know so little about the applicable statutes and judicial precedents, providing this kind of information to defendants should be required even if the defendant is represented by counsel.

Does this seem like it must be exaggeration? Could judges and lawyers really be that bad? No, this is not an exaggeration, and yes, in this area of law judges and lawyers usually are that bad. This is not just my opinion: Every study of civil commitment for mental illness I have found reaches similar conclusions: In their 903 page textbook, Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers (Guilford Press 2007, pp. 348, 350 & 352), a group of medical school and law school professors (Gary B. Melton, et al.) make these observations: [E]mpirical studies of these hearings reveal that they are often pro forma exercises in which little effort is expended on the respondent 's behalf. ... [T]he referees [acting as judge in the case] encouraged passivity on the part of defense attorneys. Some referees expressly discouraged cross-examination of witnesses... The result was that commitment hearings were little more than a stamp of approval for the attending physician's opinion. ... These types of findings are echoed in several other studies. Virtually all found that attorneys rarely act in an adversarial manner during commitment hearings and indeed often assist the state in its task of proving committability [that is, are one of the proposed patient's enemies, but in disguise]. ... many lawyers do not appreciate the legal-moral aspects of civil commitment, and they may be mystified by clinical phenomena presented to them. Even when attorneys are neither naive nor lackadaisical, they may find judicial resistance to their doing their job.

In a law journal article titled "Effective Counsel for Persons Facing Civil Commitment: A Survey, a Polemic, and a Proposal", a law professor and lawyer in private practice, Elliott Andalman & David L. Chambers (hereinafter "Andalman & Chambers"), 45 Mississippi Law Journal 43 at 54, 74 & 83 (1974) say this: There will also be judges who resent the industrious attorney's disruption of formerly peaceful commitment procedures and who will confound the attorney's efforts at ardent advocacy by subtlety conveying that if the attorney presses procedural arguments, or even substantive ones, she and her future clients will suffer. ... counsel's behavior—the ardor of her advocacy—is shaped in part by her perception of the degree of ardor the judge will tolerate. ... In most systems of court-appointed counsel

in criminal, juvenile, and mental health cases, the authority to appoint has resided with the judge before whom the attorneys appear. The power of appointment has been a source of much abuse, both in its use as patronage and as a method of securing attorneys "who will not make trouble." ... As minimum protection we believe that appointments should be removed from the control of the committing judges and placed under an agency or bar committee that is not beholden to the judge.

In 1986 in Rivers v. Katz, 67 NY2d 485, New York's highest court ruled that involuntarily committed mental patients may not be forcibly drugged until after a judicial determination they lack the capacity to decide for themselves and that taking the "medication" is in their best interests. A study titled "Mental Hygiene Law Court Monitoring Project...An Examination of Rivers Hearings in the Brooklyn Court" (New York), June through October 1997, found in addition to almost always granting requests by psychiatrists for involuntary "medication", undermining the rights created by New York's highest court in Rivers v.

Katz, judges usually do all within their power to prevent persons accused of mental illness from having conscientious representation by legal counsel: "Although people have the right to be represented by a private attorney, if they can hire one, we only saw a request for this once, and it was severely hampered by the court ... All the [defendants or respondents in] hearings covered in this report were represented by the MHLS", which stands for Mental Hygiene Legal Service, a public defender service. The court monitors made the following observations: Psychiatrists advocating forced medication [with one or more neurotoxins] are not closely questioned as to how they made the determination that a person lacks capacity. They are not made to specify in detail the numerous risks associated with neuroleptic drugs, nor are they usually required to detail the benefit sought or their weighing of risks versus benefits for this particular person. ... Most often, closing arguments are neither offered nor required. ... Respondents' resistance to psychotropic drugs as part of what they believe to be illegal incarceration is treated as evidence of their lack of capacity. ... MHLS does not appear to be well-versed in mainstream psychiatric literature documenting adverse effects as well as questioning alleged benefits. Nor do they appear to be well-versed in the PDR [Physician's Desk Reference, a book summarizing the uses and dangers of pharmaceuticals], and have not in our observations used the PDR or any scientific literature to challenge psychiatrists' assertions. ... MHLS cross-examination leaves a great deal to be desired. It does not appear to be developed as an adversarial examination of a hostile witness... At times the MHLS attorney appears to be making the opposite side's case. [That is, the "defense" attorney is often his supposed client's enemy while disguised as defense counsel] ... when attorneys do represent their clients' asserted position, they are usually stymied by the court [meaning, by the judge]. ... Contrary to Rivers, the decision which is "uniquely judicial" (determination of capacity) has been de facto returned to the "medical" profession by judges who refuse to exercise their independent fact-finding duty. ... [The judge who heard most involuntary psychiatric drugging petitions] told Daily News reporter Bob Liff that she "strictly follows the psychiatrists' findings." ... In all circumstances where the person is refusing, and there is only the "treating" psychiatrist testifying as an expert witness (in favor of forced drugging), the orders are granted. Such deference to psychiatrists neutralizes the effect of Rivers with regard to backing up the constitutional right to refuse recognized in the [Rivers] decision. ... Since almost everyone loses in court,

and administrative hearings rarely dislodge the original psychiatrist's opinion, this means very few people successfully refuse [to be drugged].

__________________________________________________

ASSISTANCE OF COUNSEL IN CIVIL COMMITMENT FOR MENTAL ILLNESS HAS BECOME A WEAPON USED AGAINST DEFENDANTS ________________________________________________________ My observation of involuntary civil commitment and forced psychiatric drugging hearings in Texas convince me the situation is the same in Texas now as it was in Brooklyn in 1997: Courts continue to authorize "involuntary medication" with psychiatric drugs that should be taken by no one. (See Psychiatric Drugs—Cure of Quackery?).

Furthermore, in some states, Texas being an example, there is as a practical matter no right to appeal the judge's decision to authorize forced drugging: Texas Mental Health Code §574.108 (b) provides "An order authorizing the administration of medication regardless of the refusal of the patient is effective pending appeal of the order." So during the time required for a court of appeals to rule, which is typically measured in months or years rather than days or weeks, the socalled patient is being drugged against his will, as a practical matter making the county or probate court judge not only the court of first resort but also the court of last resort. (See "Torture as 'Therapy'" in Why Psychiatry is Evil.)

In "The Attorney's Rule in Involuntary Civil Commitment", 60 North Carolina Law Review 1027 at 1033 (1982), Virginia Aldige Hiday, Ph.D., a North Carolina State University sociology professor and Visiting Professor of Psychiatry at the University of North Carolina Medical School, cites answers to a questionnaire distributed to judges hearing civil commitment for mental illness: "Less than twenty percent of judges demonstrated approval of the adversarial model" or roll of defense counsel in civil commitment for mental illness (Id., p. 1037). She says "One public defender who vigorously advocated for his client's release was dismissed from his job for failing to share the paternalistic viewpoint of the judge and other public defenders" (Id. at 1033).

In 2011 I witnessed strong evidence of a full-time mental health public defender being intimidated by a judge before whom she regularly tried mental health civil commitments because she told me proposed patients like those she represents have a better chance of being released if tried by a jury than by a judge. She seemed appalled when I told her there is no right to trial by jury in civil commitment for mental illness in other states. She said there being no right to trial by jury in civil commitment for mental illness in states where it does not now exist is terrible or awful because so many people being committed against their will "aren't even sick." When I told her about my efforts to persuade state legislators to create a right to trial by jury in civil commitment in states where the right does not now exist, she thanked me, saying "I appreciate your work." Later, the judge before whom she usually appeared, learning of her opinion release is more likely if the decision is by a jury rather than by him, seemed offended by the implication anyone would need a jury to be treated fairly in his court. He called me on the telephone and told me she denied making that statement. When I talked with her again she seemed nervous and, unlike before, said she was hesitant to discuss questions about civil commitment with me lest what she said be "misconstrued." Then she stated the opposite of her previously stated

opinion, one the judge plainly would like better, namely, that proposed patients have a better chance of release if tried by a judge rather than by a jury, because, she now said, judges can tell if a person is really sick, but juries will commit anyone who is different from themselves.

I inquired about being a part-time, substitute mental health public defender in her office who would step in when one of the full-time defenders was out sick or on vacation. After being told the name of the chief or administrative judge who makes those appointments, I attended a continuing legal education class taught by that judge. After class I handed the judge my resume and requested the appointment. My request was ignored, even though I offered to do it for free, or pro bono. I couldn't help wondering if the reason was I made it clear I intended to provide genuine representation and vigorous advocacy for my clients.

I thought it likely the mental health public defenders, being hired by that same judge, a colleague of the judge who was offended by the mental health public defender's remark about the superiority of trial by jury, can also fire them. My effort to find out if the mental health public defenders must constrain their advocacy to protect their jobs because they can be fired by the same judge who hires them, and who before whom they sometimes appear, led me to that same chief or administrative court judge's office where I asked her secretary or office manager, who referred me to the office of the County Commissioners, where I was referred to a court administrator, who referred me to the office of a public defender. I never could get an answer.

Nevertheless, I suspect the mental health public defender changed her outwardly stated opinion about the value of trial by jury in civil commitment for mental illness because she was afraid of losing her job, as happened to the mental health public defender in Professor Hiday's above cited article. If so, she probably also dares not be as conscientious as she would like to be in her in her representation of clients. That's a problem, because as I and other observers have noted, many judges hearing civil commitments seem to want to get such cases disposed of in a matter of minutes—or even seconds—and would be very annoyed if a defense attorney got in the way of such assembly-line justice. I have seen many civil commitment for mental illness hearings that were one minute or less in duration, with only a few lasting even five minutes, permitting twenty or thirty defendants to be committed in less than an hour. In one case, the judge ignored a proposed patient's demand for trial by jury and was not challenged by the court-appointed defense attorney until I spoke with him after the hearing and said to him, "Are you going to let the judge get away with that?" I have no doubt my presence in the courtroom that day, only as an observer, not a lawyer in the case, was the main reason that defendant got the jury trial he demanded.

In Professor Hiday's article she reported that "In various studies in six states, respondents' lawyers were described in such terms as reticent, ineffective, ill-prepared, mostly silent, lacking interest, rarely extending any effort, giving only perfunctory representation, doing little or nothing to obtain a client's release and seldom challenging adverse statements by witnesses or adverse psychiatric testimony" (60 North Carolina Law Review 1027 at 1030 (1982). In Andalman's & Chambers' study of effectiveness of lawyers representing proposed patients they say "What we have found, to our chagrin and professional embarrassment, is that attorneys appointed by courts for nominal fees to represent allegedly ill persons rarely expend any effort on their client's behalf" (p. 44). In an article titled "The Right to Counsel, Waiver Thereof, and Effective Assistance of Counsel in Civil Commitment Procedures", 29 Southwestern Law Journal 684 at 709, 712, 713 (1975), Vermont Law School professor John J. Brunetti, J.D., LL.M., says this:

The abundance of articles on counsel's role in the commitment process impliedly questions the competence and professional integrity of the private practitioner. ... the real burden is on the legislatures to make the right to counsel truly meaningful in this area of practice where few attorneys are experts. ... Admittedly, the need for statutorily specifying such [defense counsel] duties is an affront to the competency and conscientiousness of the legal profession, but the results of research studies belie the contention that appointed attorneys are, on the whole, competently representing their clients in the civil commitment process.

The result, in Professor Brunetti's words (Id. at p. 707), is "the appointment of counsel may, or actually has, become a mere procedural ritual which helps to sanctify the judgment of commitment without providing any substantive protection." Andalman & Chambers say in their observation of civil commitment proceedings in several states, the lawyers representing defendants in civil commitment for mental illness "did virtually nothing except stand passively at a hearing and add a falsely reassuring patina of respectability to the proceedings. There is some reason to fear that the presence of counsel who does nothing is not merely of no use to her client but may in fact worsen the client's chances for release" (45 Miss.L.J. at 72).

I've made inquires but found no law schools that require students to take even one course in civil commitment for mental illness to graduate from law school. Many, perhaps most law schools do not even offer such courses as electives.

There were no questions about civil commitment on the Texas bar examination I took in 1974.

Currently, bar examinations are typically two days long and include both the Multistate Bar Examination (MBE) and essay questions by the particular state's board of law examiners. On July 5, 2013 I telephoned the associate executive director of Ameribar, a company providing bar examination preparation courses and materials. I asked him if there are any questions on the various state's bar examinations about civil commitment, whether for mental illness or of so-called sexually violent predators (see my discussion of supposedly "civil" commitment of so-called sexually violent predators in Is Involuntary Commitment for "Mental Illness" or "Dangerousness" a Violation of Substantive Due Process?) He said on the MBE the answer is "definitely no" and that regarding the essay questions, which vary from state to state, the answer is "potentially, but probably not." Also on July 5, 2013 I asked the same question of employees of the Texas Board of Law Examiners. The Texas bar exam director told me he could not recall any questions about civil commitment on the Texas bar examination. He referred me to the Board of Law Examiner's web site where, he said, I would find the essay questions on the last ten years of Texas bar examinations. Seeing one of the questions on the February 2013 Texas bar examination was "What is a 'Pugh' clause?" (in an oil and gas contract) I did an Advanced Google Search of the Board of Law Examiners web site, http://www.ble.state.tx.us, for the word "Pugh" to test Google's indexing of the Board of Law Examiner's web site. The bar exam question "What is a 'Pugh' clause?" appeared in my search results. Having verified Google's indexing of the Board of Law Examiner's web site I then did a search for the word "commitment", which would apply to civil commitment of so-called sexually violent predators as well as civil commitment of law-abiding but supposedly mentally ill people.

Along with questions about criminal convictions or being fired from jobs, my search results revealed questions on the Declaration of Intention to Study Law and General Application for Admission to the Bar

of Texas asking applicants if they have ever been the defendant in a commitment proceeding but no bar examination questions about civil commitment, whether for mental illness or of so-called sexually violent predators.

In most if not all states of the U.S.A., lawyers are required to complete a minimum number of hours of continuing legal education (CLE) to maintain licensure. On August 23, 2013 I wrote by e-mail to a company offering CLE courses, Lawline.com, saying "I'd be interested in continuing legal education on civil commitment (of mentally ill persons and sexually violent/sexually dangerous persons, including outpatient commitment) and involuntary guardianship/conservatorship of adults (including Massachusetts Rogers guardianships)." Later the same day I received a reply from a Lawline.com employee saying "Unfortunately it looks like we don't have any courses in those subject areas available for you in Texas right now." I wrote back asking "Does your company have any courses in civil commitment or guardianship outside Texas?" The Lawline.com representative wrote back: "The only course I could find has to do with guardianship specifically in Virginia." He could find no continuing legal education courses in civil commitment anywhere and no continuing legal education about the involuntary guardianship or conservatorship of adults in 49 of the 50 states.

Lawyers not being required to study civil commitment to graduate from law school, the lack of courses of instruction in civil commitment even as electives at many law schools, the entire subject being omitted from state bar examinations, and the nonexistence of continuing legal education courses in civil commitment, partly explain why Andalman & Chambers are correct when they say "most attorneys are unfamiliar with the commitment process" (45 Miss. L.J. at 50). They wrote that in a bar journal article published in 1974, but it remains true now, decades later.

Most lawyers appointed to represent defendants in civil commitment for mental illness also know very little about psychiatry, and most of what little they think they know about psychiatry is wrong.

There are exceptions, and as a lawyer who has represented mental hospital "patients" as privately retained counsel, read books and now written a book about psychiatry and mental health law, I think I am one of them. However, generally speaking, limiting assistance of counsel available to defendants in civil commitment for supposed mental illness to lawyers prevents those threatened with involuntary commitment from having competent and conscientious assistance of counsel. Yet only lawyers are permitted to serve as defense counsel in civil commitment proceedings. People who are not lawyers, and lawyers who are not licensed in the state where the proceedings are held (with exceptions called pro hac vice, or for this occasion) are not permitted to do so even if they know more about psychiatry and mental health law than most of the lawyers who now serve as defense counsel in civil commitment.

In my opinion, the right of defendants to assistance of counsel, being a constitutional right, should take precedence over unauthorized practice of law statutes that limit representation of proposed patients to lawyers licensed to practice in a particular state, or any state, because such laws prevent these defendants from having genuine assistance of counsel. My opinion about this receives support from Andalman & Chambers who say "Social workers with additional training in law and procedure or specially trained paralegal professionals could adequately perform many, even all, of the functions herein prescribed for attorneys [in civil commitment for mental illness]. Our real point is that what is needed is an informed advocate, regardless of title or formal education" (45 Miss.L.J. at 53).

The Role of Insurance Companies in Curtailing Unjustified Psychiatric Commitment

Far from anything idealistic like law or concern for human rights, the primary forces curtailing unjustified involuntary psychiatric "hospitalization" in the U.S.A. have been insurance companies motivated not by idealism but the need to stop or at least reduce insurance fraud. As Tim Goolsby remarked in 1986 (above), "they [the health insurance companies] [a]re being ripped off." Eventually the health insurance companies became aware of the needless (and harmful) psychiatric treatment they were paying for. According to a front-page article in the August 3, 1992 issue of Investors Business Daily: Last Thursday...eight major insurance companies sued NME [National Medical Enterprises] for alleged fraud involving hundreds of millions of dollars in psychiatric hospital claims. Their complaint, filed in federal court in Washington, accused the company of a "massive" scheme to admit and treat thousands of patients regardless of their need for care. ...some institutions were paying "bounty fees" for patient referrals or misdiagnosing patients to get maximum reimbursement. [Christine Shenot, "Bleeder at National Medical Insurers Cry Of ' Fraud' Reopened A Big Wound." Investors Business Daily, Monday, August 3, 1992, p. 1]

Time magazine later reported NME settled the case for a record $300 million (April 25, 1994, p. 24). An article about a similar suit filed in Dallas, Texas appeared in the September 15, 1992 issue of New York Newsday: Two of the country's largest insurance companies filed suit yesterday against a national chain of private psychiatric and substance abuse hospitals, charging it with illegally admitting patients who did not need treatment and then not releasing them until their insurance benefits ran out. [Michael Unger, "Hospitals Called Cheats—Insurers say health-care chain pulled off nationwide scam", Thursday, September 15, 1992, Business section, page 33]

Mental health industry advocates responded to these insurance company attempts to reduce mental health care insurance fraud by lobbying, successfully, for state and federal statutes, called "mental health parity" laws, requiring health insurance policies to cover psychiatric and other so-called mental health treatment on the same basis and on the same terms, such as length of hospital stay, as they do bona-fide treatment of real disease. The U.S.A.'s federal Patient Protection and Affordable Care Act ("Obamacare") requires all persons (except prison inmates and a few others) to purchase health insurance that is far more expensive because of the legally mandated inclusion of treatment for so-called mental illness and other supposed mental health problems such as addiction (which one critic wryly but truly said is a disease you can decide not to have). Laws requiring health care insurance companies to pay for so-called mental health care as well as real health care, and Obamacare requiring the purchase of health insurance, make money available to pay for involuntary psychiatric "treatment" that would not otherwise be available. This encourages health insurance fraud consisting of unnecessary, harmful, involuntary supposed mental health treatment.

Insurance fraud involving psychiatrists involuntarily "hospitalizing" and "treating" people who do not want or need treatment (as if psychiatry had bona-fide treatment) illustrates a serious underlying

problem that still has not been adequately addressed: Loss of liberty based on the opinions of psychiatrists rather than on unlawful conduct by the accused has no place in a nation that claims to be governed by rule of law or claims to respect the rights of each individual.

Recommended Reading

Louise Armstrong, And They Call It Help—The Psychiatric Policing of Americas Children (Addison-Wesley Pub. Co. 1993) Bruce Ennis, J.D., Prisoners of Psychiatry—Mental Patients, Psychiatrists, and the Law (Harcourt Brace Jovanovich 1972) C. Peter Erlinder, "Essay: Of Rights Lost and Rights Found: The Coming Restoration of the Right to a Jury Trial in Minnesota Civil Commitment Proceedings", 29 William Mitchell Law Review 1269 (2003) copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Is Involuntary Commitment for Mental Illness or Dangerousness a Violation of Substantive Due Process?" ]

Is Involuntary Commitment for "Mental Illness" or "Dangerousness" a Violation of Substantive Due Process?

Wayne Ramsay, J.D. "...as long as a person remains unentangled in the state's psychiatric control system and is not directly exposed to its actual functioning, he is unlikely to appreciate its threat to basic human rights." Psychiatry

professor Thomas Szasz, M.D., in his book Suicide Prohibition—The Shame of Medicine (Syracuse University Press 2011, p. 15) "Over the years I have broadened my criticism of institutional psychiatry as a form of political totalitarianism—the use of state power to control the individual. Seldom will the liberty and integrity of the individual be subjected to greater threat than when he comes under the scrutiny of psychiatric authorities. In the Western World today, psychiatry remains the greatest threat to the civil liberties and the mental integrity of individual citizens." Psychiatrist Peter R. Breggin, M.D., "Coercion of Voluntary Patients in an Open Hospital", Archives of General Psychiatry 10 (1964):173-181 (1982 note), available at breggin.com)

According to Lockhart, Kamisar & Choper's textbook, Constitutional Law, substantive due process guaranteed by the U.S. Constitution is "a limitation of the substance of legislative action by the state and federal governments" (West Pub. Co. 1970, p. 454, emphasis added). A majority opinion of the U.S. Supreme Court in 1887 written by Justice Harlan said this: Under our system that power is lodged with the legislative branch of the government. It belongs to that department to exert what are known as the police powers of the state, and to determine, primarily, what measures are appropriate or needful for the protection of the public morals, the public health, or the public safety. ... [But] It does not at all follow that every statute enacted ostensibly for the promotion of these ends is to be accepted as a legitimate exertion of the police powers of the state. There are, of necessity, limits beyond which legislation cannot rightfully go. While every possible presumption is to be indulged in favor of a statute, the courts must obey the constitution rather than the law-making department of government, and must, upon their own responsibility, determine whether, in any particular case, these limits have been passed. ... The courts...are under a solemn duty, to look at the substance of things, whenever they enter upon the inquiry whether the legislature has transcended the limits of its authority. If therefore, a statute purporting to have been enacted to protect the public health, the public morals, or the public safety, has no real or substantial relation to those objects, or is a palpable invasion of rights secured by the fundamental law [the constitution], it is the duty of the courts to so adjudge, and thereby to give effect to the constitution." [Mugler v. Kansas, 123 U.S. 623 at 661] I document the invalidity of the concept of mental illness, disease, disorder, or syndrome in my essays Does Mental Illness Exist?, Schizophrenia: A Nonexistent Disease, The Myth of Biological Depression, The Myth of Psychiatric Diagnosis, and Why the Myth of Mental Illness Lives On. In this essay I will expose as myth the belief it is possible to accurately predict (and therefore possibly prevent) future violent acts, and I will present an argument for establishing rule of law in America (and in every nation of the World). The myth that future human behavior can be predicted with sufficient accuracy to justify incarceration or other discrimination is the basis of laws in all 50 states of the U.S.A., the U.S.A.'s federal Adam Walsh Act, and similar laws in other countries.

"Mental Illness"

We'll first consider laws authorizing involuntary commitment of or other discrimination against people who supposedly have mental illness: If there is no such entity as mental illness, that is, if mental illness is a myth, can laws authorizing incarcerating people, or treating them differently in any way, not because they have performed unlawful acts but only because they have "mental illness" be constitutional? Suppose that instead of believing in mental illness, people today believed in evil spirit possession and attributed thinking or behavior they dislike to possession by evil spirits. Suppose some or all of the states of the U.S.A. enacted laws authorizing the incarceration of (or other discrimination against) people who are possessed by evil spirits (instead of people who supposedly are possessed by mental illnesses). Would this be a proper and constitutional exercise of legislative power? Evil spirit possession exists only in the imaginations of people who believe in evil spirits. Mental illness also exists only in the imaginations of people who believe in mental illness, even if they are the vast majority of people alive today. In the words of neurologist John Friedberg, M.D.— The brain can have a disease and it can be proved by testing. The mind cannot have a disease in anything but a metaphorical sense. "Schizophrenia, bipolar disorder, inadequate personality" and all the other nonsense syllables in the psychiatric lexicon exist only in the minds of believers. [http://www.idiom.com/~drjohn/ect.html, accessed July 9, 2012]

Civil commitment for mental illness of law-abiding people today is in this way similar to the Salem, Massachusetts witch trials of the 1690s: Witches and witchcraft, like mental illness today, were accepted by almost everyone as fact. Nevertheless, they existed only in the minds of believers. But ideas have consequences, and a consequence of belief in witchcraft was the trial and execution of supposed witches. Today a consequence of belief in mental illness is the imprisonment (involuntary "hospitalization") and involuntary "treatment" of people innocent of lawbreaking in prisons disguised as hospitals, and court orders compelling them to ingest or authorizing others to inject their bodies with neurotoxins and cytotoxins called "medication". This is done not only to those incarcerated in "hospitals" but to people who are living in their own homes, which is called outpatient commitment or conditional discharge. ("Conditional discharge" in almost every case is when a person is permitted to leave a psychiatric "hospital" where he was involuntarily held on the condition that he take neurotoxic, cytotoxic "medication" after leaving the "hospital".)

The witches of Salem in the 1690s got more in the way of procedural due process than people accused of mental illness today: According to University of Georgia research professor of history Peter Charles Hoffer in his book The Salem Witchcraft Trials—A Legal History (Univ. Press of Kansas 1997, p.

87), persons accused of witchcraft were indicted by grand juries and tried by trial juries, and "The verdict had to be unanimous". My state-by-state tabulation found trial by jury in civil commitment for supposed mental illness is not available to 46.8% of the U.S. population. Even where the right to trial by jury in civil commitment exists, counterproductive legal guidance and representation by lawyers assure this right is rarely exercised. Most involuntary psychiatric commitments in the U.S.A. are rubber stamped by judges who make no attempt to form their own opinion of the facts in any particular case but instead grant all requests for involuntary "hospitalization" or forced "medication" or other treatment they receive, deferring to the supposed expertise of the psychiatrist or psychologist making the request. Trial by jury is also unavailable to persons accused of mental illness and threatened with involuntary "hospitalization"

or other involuntary psychiatric "treatment" in many countries of the world.

Today laws in all states of the United States permit involuntary civil commitment of people for mental illness without requiring a showing the person has ever committed an illegal act. Using "mental illness" as the justification for incarceration (or other discrimination) is as illogical and unjustified as explaining behavior we dislike and don't understand as the product of evil spirit possession and having commitment laws for (or other discrimination against) people who are possessed by evil spirits.

Warren Burger, then a judge on the U.S. Court of Appeals for the District of Columbia Circuit, and later Chief Justice of the U.S. Supreme Court, said this in a concurring opinion in Blocker v. United States, 288 F.2d 853 (1961): As I see it, our...opinion...tends to treat unsupported and dubious psychiatric theory as scientific knowledge. ... We know also that psychiatrists are in disagreement on what is a "mental disease," and even whether there exists such a definable and classifiable condition. So distinguished an authority as Dr. Philip Q. Roche, author of The Criminal Mind, which received the Isaac Ray Award from the American Psychiatric Association, said as recently as 1958: "I will say there is neither such a thing as "insanity" nor such a thing as "mental disease." These terms do not identify entities having separate existence in themselves. ... The idea that mental illness causes one to commit a crime or that it produces a crime has an unmistakable lineage from demonology."

According to Willie Sutton in his autobiography Where the Money Was (Viking 1976, pp. 174-175), Philip Q. Roche, M.D., "was one of the leading psychiatrists in Philadelphia. He had an extensive private practice, was on a number of hospital staffs, and he also taught at the University of Pennsylvania." Mr. Sutton also says Dr. Roche was "the prison psychiatrist" at Eastern State Penitentiary in Philadelphia where Mr. Sutton was an inmate and worked as Dr. Roche's secretary. As the psychiatrist at a state prison, Dr. Roche probably had ample opportunity to learn first-hand about the validity, or not, of the belief people commit crimes because of "mental illness" or "insanity" and, even before the publication of Dr. Thomas Szasz's book The Myth of Mental Illness in 1961, reached a similar conclusion.

Judge Berger concluded: ...no rule of law can possibly be sound or workable which is dependent upon the terms of another discipline [psychiatry] whose members are in profound disagreement about what those terms mean...

These factors, I think, demonstrate that a term such as "disease" [in the context he means mental disease] which has no fixed, agreed or accepted definition in the discipline which is called upon to supply expert testimony and which, as we have seen is literally "subject to change without notice" is a tenuous and indeed dangerously vague term to be a critical part of a rule of law... [underline added] In 1963 Dr. Szasz said "Inasmuch as there is no clear or generally accepted criteria of mental illness, looking for evidence of such illness is like searching for evidence of heresy: once the investigator gets into the proper frame of mind, anything may seem to him to be a symptom of mental illness" (Thomas S. Szasz, M.D., Law, Liberty, and Psychiatry, Collier Books 1963, p. 225). Because of the vagueness of the concept of mental illness, involuntary commitment for mental illness cannot meet the void for

vagueness test of Papachristou v. City of Jacksonville, 405 U.S. 156 (1972, see Why the Myth of Mental Illness Lives On).

Contrary to the almost universal belief that mental illness is a valid concept, there actually is, and can be, no mental illness. Therefore, laws that use "mental illness" as justification for incarceration, court-ordered outpatient drugging, or statutory discrimination, are violations of substantive due process.

"Dangerousness"

Under criminal law, it must be proved that the accused did something illegal. A person may not be deprived of liberty under criminal law for merely having a tendency to do something illegal.

Suppose a state legislature enacted a law that allowed people to be imprisoned not for murder, but for "murderousness" (analogous with "dangerousness"). "Murderousness", we will assume, is defined by the statute as having a likelihood of committing murder, although the defendant admittedly has never committed a murder. It would be far easier to convict defendants of murderousness than murder, since to convict a person of murderousness the judge or jury would have to conclude only that the defendant might commit a murder in the future.

Current law has done something similar in involuntary "civil" psychiatric commitment: The defendant, or "proposed patient", is not deprived of liberty for having done anything wrong in the past but for "dangerousness", which is a prediction of future behavior. Incarcerating a person for "dangerousness" is as wrong as incarcerating someone for "murderousness". Under these laws, a person is involuntarily "hospitalized", essentially imprisoned, because it is believed he might do something violent or "dangerous" in the future. An example is New Hampshire RSA (Revised Statutes Annotated) 135-C:34: Involuntary Treatment Standard The standard to be used by a court, physician, or psychiatrist in determining whether a person should be admitted to a receiving facility for treatment on an involuntary basis shall be whether the person is in such mental condition as a result of mental illness as to create a potentially serious likelihood of danger to himself or to others.

Often the alleged "dangerousness" is a prediction the defendant or "proposed patient" is likely to commit suicide. According to Earl A. Grollman in his book Suicide (Beacon Press 1971, p. 5), "Almost everybody at one time or another contemplates suicide. ... Dr. Joost Meerloo, author of Suicide and Mass Suicide, declared, 'Eighty percent of people admit to having 'played' with suicidal ideas.'" But only about 1 in 100 people actually commit suicide. According to Wikipedia ("Suicide", accessed June 19, 2013), "Approximately 0.5% to 1.4% of people die by suicide." A Mayo Clinic study found the suicide rate for the general population is 1 percent, for outpatients treated for depression 2 percent, and for those who are "at the highest risk level" namely, those "hospitalized for suicide after a suicide attempt or with suicidal thoughts", 8.6 percent ("Suicide Rates Overstated in People with Depression", updated December 6, 2003). Despite the over 90% probability a person contemplating suicide will not actually commit suicide, and despite the fact that suicide should be respected as a human right, and despite the (in the U.S.A.) First Amendment right to freedom of thought that should apply to "suicidal ideation" as well as all other ideation, and despite the fact that involuntary psychiatric "treatment" makes a person

more likely to commit suicide, as I document or argue in Suicide: A Civil Right, admitting to "suicidal ideation" (that is, what could be called thought crime) often results in involuntary civil commitment to a mental hospital. There, a person is not only essentially imprisoned and deprived of his supposedly unalienable right to liberty and his pursuit of happiness (by working towards whatever goals he felt important), but is also routinely subjected to psychiatric assault in the form of "involuntary medication", torture from the effects of psychiatric drugs, often involuntary electroconvulsive brain damaging (called electroconvulsive "therapy"), and four or five point physical restraints, which is a form of "noninjurious torture", which people confined to mental hospitals seeking my advice as a lawyer tell me is done to them frequently and for trivial reasons.

When laws deprive people of liberty, or otherwise discriminate against them, because of predicted future behavior such as for "dangerousness", they place these people and the lawyers representing them in the impossible position of trying to prove they are not going to do something "dangerous" tomorrow, next week, next month, or next year. No matter how harmless a person may be, it is impossible to prove he is not going to do something in the future unless he is totally and permanently paralyzed from the neck down, or for some other reason it is physically impossible.

Why is "professional" opinion of a psychiatrist that someone is likely to be "dangerous" in the future is accepted as credible? Without any scientific or empirical basis for the belief, members of Congress, state legislators, the president of the United States, governors, judges, and jurors accept the idea that "professionals" in mental "health" can predict a person's future behavior. This is a wholly groundless belief, as mental health professionals themselves sometimes acknowledge. In Barefoot v.

Estelle, 463 U.S. 880 at 921, three dissenting U.S. Supreme Court justices said this: The APA's [American Psychiatric Association's] best estimate is that two out of three predictions of longterm future violence made by psychiatrists are wrong. ... The APA also concludes, see APA Brief 916, as do researchers that have studied the issue, [Footnote 3/3] that psychiatrists simply have no expertise in predicting longterm future dangerousness.

Robyn M. Dawes, Ph.D., former professor of psychology and former head of the psychology department at the University of Oregon, and former president of the Oregon Psychological Association, and professor in the Department of Social and Decision Sciences at Carnegie-Mellon University, says this in his book House of Cards—Psychology and Psychotherapy Built on Myth (Free Press 1994, p. viii): I am angered when I see my former colleagues make bald assertions based on their "years of clinical experience" in settings of crucial importance to other's lives—such as commitment hearings, or in court hearings about custody arrangements, or about suspected child sexual abuse. ... An expert in a court room setting is supposed to be competent to present an opinion with reasonable certainty. But a mental health expert who expresses a confident opinion about the probable future behavior of a single individual (for example, to engage in violent acts) is by definition incompetent, because the research has demonstrated that neither a mental health expert nor anyone else can make such a prediction with accuracy sufficient to warrant much confidence.

In an article published August 3, 2012, psychiatrist Allen Frances, M.D., chairperson of the Task Force that created two editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (1994) and DSM-IV-TR (2000), says this: Psychiatry has no way to predict mass murder and no way to prevent it. Many mass murders never see a mental health worker before going ballistic. Even those who do are as impossible to identify as needles in a large haystack. Violent thoughts are not uncommon among psychiatric patients, but vanishingly few will ever act on them. Future mass murders are far too rare to be selected out of the crowd before the deed is done. Psychiatry ... strikes out in predicting or preventing violence. ["Mass Murder Psychobabble Misses Gun Policy Point", HuffingtonPost.com, accessed December 20, 2014]

In his book Psychiatric Drugs: Hazards to the Brain (Springer Publishing 1983, p. 267. psychiatrist Peter Breggin says "there is a growing awareness in legal circles that psychiatrists are not able to predict dangerousness."

In a Psychology Today magazine article, Harvard Law School professor Alan M. Dershowitz says— ...our research suggests that for every correct psychiatric prediction of violence, there are numerous erroneous predictions. ["The Psychiatrist's Power in Civil Commitment: A Knife that Cuts Both Ways", Psychology Today, February 1969, p. 43 at 47]

Herbert Silverberg, Director of the Patients Advocacy Project of the Public Defender Service at St. Elizabeth's Hospital, a psychiatric hospital in Washington, D.C., says— Prediction of dangerousness is virtually impossible for psychiatrists ... what few studies there are seem to demonstrate the virtual inevitability of false-positive predictions. ["The Civil Commitment Process: Basic Considerations", in Legal Rights of the Mentally Handicapped, Practicing Law Institute 1973, p. 103 at pp. 105-106)]

A study of "risk assessment instruments to predict violence and antisocial behavior in 73 samples involving 24,827 people" published in the British Journal of Psychiatry in 2012 found that— ...risk assessment tools produce high rates of false positives (individuals wrongly identified as being at high risk of repeat offending) ... Our review would suggest that risk assessment tools, in their current form, can only be used to roughly classify individuals at the group level, not to safely determine criminal prognosis in an individual case." [quoted in "Concerns over accuracy of tools to predict risk of repeat offending", medicalxpress.com, accessed June 28, 2013)

A study by the Columbia Center for Occupational & Forensic Psychiatry found that— Psychiatrists cannot predict when or if a patient will actually commit suicide or homicide. Psychiatrists cannot predict future harmful acts." [columbiaforensic.com/violence.html, accessed December 20, 2014]

After a U.S. Army psychiatrist, Major Nidal Malik Hasan, on November 5, 2009 shot and killed 13 people and injured at least 30, targeting fellow soldiers in uniform, at Fort Hood, a U.S. Army base near Kileen, Texas, the U.S. Department of Defense chartered a Defense Science Board Task Force to investigate ways to predict and prevent similar future occurrences. The Task Force's 104 page final report published in August 2012, titled "Predicting Violent Behavior", under the heading "Overall Conclusions" says "There is no effective formula for predicting violent behavior with any degree of accuracy."

Emergency Room psychiatrist Paul R. Linde, M.D., makes the same point in his book On the Front Line With an ER Psychiatrist (University of California Press 2010, pp. 100-102): Psychiatrists were now charged with a duty to maintain public safety, a responsibility more consistent with police powers than with medical ones. The task of a psychiatrist, which previously involved evaluating a person's need for treatment, had shifted suddenly to that of establishing "dangerousness criteria" and attempting to predict who might constitute a danger to self or a danger to others. ... At the same time, evolving judicial precedents more or less announced that psychiatrists should be able to foresee "preventable" acts of suicide or violence. It became our job to somehow keep those dangerous people locked up, preventing self-harm and mayhem. I refer to this as the crystal ball standard. ... It's still nearly impossible to predict suicides, assaults, or homicides—legal opinions to the contrary notwithstanding.

Psychiatrists and psychologists can be and sometimes are held liable in court for the acts of their so-called patients whose violent behavior they supposedly could have and should have predicted and prevented but did not. In 2015, a Tampa, Florida psychiatrist told me in every psychiatric evaluation she does, she involuntarily commits the person she is evaluating if she has the "slightest doubt" about the person's future behavior because, she said, if she doesn't and the person later does something violent, "I'm liable." An example of what can happen to a psychiatrist or psychologist who evaluates and fails to commit a prospective patient is illustrated in the case of Mertz v. Temple University Hospital, 25 Pa. D. & C. 4th 541 (1995): "Phyllis Litostansky went to Temple University Hospital's psychiatric emergency room seeking to have her husband Richard Litostansky involuntarily committed. ... However, Dr. Levine chose to discharge Mr. Litostansky. ... 17 days after the examination at Temple, Mr. Litostansky committed suicide by filling his home with natural gas and igniting it", causing injuries to others. Dr. Levine and another physician and the Hospital were found liable for over $5 million for supposedly negligently failing to involuntary commit Mr. Litostansky.

A consequence of holding psychiatrists and psychologists liable for the acts of their so-called patients is these mental health professionals keeping people incarcerated unnecessarily because of fear of liability if someone they release later commits a crime. Mental health professionals are much less likely to be held liable for committing or holding a person unnecessarily. Therefore, committing or refusing to release people is the safe bet for psychiatrists, psychologists, or other evaluators. To protect themselves from legal liability, they predict violence or suicide in vast numbers of people who would not, if permitted to remain at liberty, do anything violent or suicidal. The result is the preventive incarceration of vast numbers of harmless individuals. The conclusion of Henry J. Steadman, Ph.D., acting director, and

Joseph J. Cocozzza, senior research scientist, at the Mental Health Research Unit of the New York State Department of Mental Hygiene, in 1975 was that "as many as 20 harmless persons are incarcerated for every one who will commit a violent act" ("We Can't Predict Who Is Dangerous", Psychology Today, January 1975, pp. 32 at 35).

Psychiatrists' and psychologists' liability for failing to involuntarily commit people has created an entirely new burden of proof previously unknown in American jurisprudence: As regards future behavior, judged by psychiatrists and psychologists in involuntary "civil" commitment, people are judged not by the beyond a reasonable doubt standard used in criminal cases, nor even the clear and convincing evidence standard approved for civil commitments by the U.S. Supreme Court in Addington v. Texas, 441 U.S. 418 (1979), nor even the preponderance of the evidence standard used in civil lawsuits. Now, people lose their liberty and endure a lifetime of psychiatric stigma because a psychiatrist or other physician or a psychologist had only the slightest doubt about his or her future behavior. We could call it the slightest doubt burden of proof standard.

This has been true for many years but has failed to protect us from violence, even mass-murder. In 2012, psychiatrist Fredric Neuman, M.D., Director of the Anxiety and Phobia Treatment Center in White Plains, New York, concluded: "There are no measures that can be taken to prevent future violent behavior" ("Is It Possible to Predict Violent Behavior?", psychologytoday.com).

A problem with all of this psychiatric testimony about people's future behavior is it is invalid. In his book The Good News About Depression (Bantam Books 1986, p. 34), psychiatrist Mark S. Gold, M.D., criticizes the courts because they— ...continue to listen [to psychiatric testimony even] as evidence piles up against psychiatric fortunetelling. A study published in 1984 suggests that nobody even knows what "dangerous" means.

Psychiatrists and nonpsychiatrists were asked to rate sixteen criminals for dangerousness. Hardly any of the 193 raters agreed with each other; only on four of the cases was there as much as 60 percent agreement. Psychiatrists reached no higher level of agreement than anyone else. ... Ironically, despite its poor performance as an expert witness, the courts won't let psychiatry step down. The American Psychiatric Association in 1984 declared that psychiatry did not belong in the courtroom. Despite attacks on the legitimacy of psychiatric testimony in several court decisions, the Supreme Court has determined that psychiatrists can and should testify, even if their opinions are hypothetical...

In his book Prisoners of Psychiatry, attorney Bruce Ennis says "Some psychiatrists believe that a person is 'dangerous to himself' if he eats too much (or too little), or smokes cigarettes. Others limit the label to persons who have attempted suicide" (Harcourt Brace Jovanovich 1972).

In the above-cited Psychology Today magazine article in 1975, two researchers said this: One would assume that with its widespread use [in state commitment statutes], the meaning of "dangerousness" would be clear and specific. Not so, unfortunately: There are almost as many opinions on what constitutes dangerous behavior as there are psychiatrists and judges pondering the problem.

[Henry J. Steadman, Ph.D., & Joseph J. Cocozza, "We Can't Predict Who Is Dangerous", Psychology Today, January 1975, p. 32 at 33.]

This problem of defining what we mean by "dangerous" has never been resolved. (See Alexander D. Brooks, "Notes on Defining the 'Dangerousness' of the Mentally Ill".) Therefore, commitment statutes that make a likelihood of danger or similar words a criteria for incarceration or other loss of rights fall short of the void for vagueness standard stated by the U.S. Supreme Court in Papachristou v. City of Jacksonville, 405 U.S. 156 (1972, quoted in Why the Myth of Mental Illness Lives On) and other cases.

However, the desire to predict and prevent violence is so strong the impossibility of predicting future human behavior doesn't seem to matter. Legislators, governors, judges, and jurors continue to demand mental health professionals do the impossible.

If you think there are other studies showing experts can predict future human behavior accurately, I suggest you do an Internet search for "psychiatrists can predict future behavior" or "psychiatrists can predict violence" and see what appears in your search results. If you read carefully what you find, you will not find even one study proving psychiatrists or anybody else can accurately predict a human being's future violent behavior such as homicide or suicide.

I found a study by Alan Teo, M.D., of the University of Michigan saying "veteran psychiatrists were 70 percent accurate" in predicting which patients on a psychiatric ward would be violent if "yelling" is considered violence: "Incidents of physical aggression" predicted with 70 percent accuracy by veteran psychiatrists "typically included punching, slapping, or throwing objects, as well as yelling, directed at staff members of the hospital" ("Simple tool may help inexperienced psychiatrists better predict violence risk in patients", medicalxpress.com, September 4, 2012). The flaw in this study is almost everybody gets angry enough to throw an object or yell at somebody at times in their lives, so if you wait long enough, your prediction of these sorts of behavior will eventually be correct for almost anyone— especially someone who is being held prisoner and being subjected to violence such as "involuntary medication".

You may find misleading statements such as psychiatrists "can identify a potentially violent patient roughly 70% of the time" (Melissa Healy, "Predicting violent behavior: not guesswork, but far from certain", December 17, 2012, articles.latimes.com). If you read that quickly you might think somebody said psychiatrists can identify about 70% of violent people or a psychiatrist's prediction a particular person will commit a future violent act will be correct about 70% of the time. What makes the quoted statement nonsense is the word "potentially": Everybody, except those seriously physically or mentally disabled, is potentially violent. Also, of course, being right 70% of the time doesn't meet a beyond a reasonable doubt standard nor, probably, a clear and convincing evidence standard.

What your Internet search will show you is predictions of future violent human behavior in the form of homicide, suicide, or inflicting serious bodily injury to oneself or others are usually wrong.

Since psychiatrists and psychologists are thought the best we have regarding prediction of future human behavior, how can incarceration, or involuntary outpatient treatment, or discrimination regarding firearm purchase or anything else, be justified by their predictions? If psychiatrists' predictions about "dangerousness" (future behavior) are wrong two-thirds of the time, as the American Psychiatric Association acknowledges, how can their predictions about who will commit future acts satisfy the constitutional requirement of reliability? Legislators who write laws predicated on the ability of supposed experts (usually psychiatrists or psychologists) to predict future violent human behavior are writing laws based on factually mistaken wishful thinking. Judges who uphold such laws as

constitutional are either uninformed or are abdicating their judicial responsibility. When the goal is not punishment for past conduct but prevention of future harm, the often-heard principle in criminal law that it is better for ten guilty persons to go free than for one innocent person to be convicted is reversed.

Instead, the attitude seems to be it is better to incarcerate two (or ten) innocent, nondangerous persons than to allow one truly dangerous person to do future harm. Does accurate prediction and prevention of "dangerousness" (usually left undefined as to severity) by one person justify the wrongful detention of two innocent, nondangerous persons? Those who say yes might say "Imagine yourself as the victim of that one truly dangerous person." Those who say no might say "Imagine yourself as one of the two innocent, nondangerous persons needlessly subjected to as much as a lifetime of preventive detention."

Laws permitting deprivation of liberty or loss other rights or which authorize involuntary "treatment" because a person is considered "dangerous" or because supposed experts think there is a "potentially serious likelihood" he will cause injury to himself or others if not incarcerated or forcibly "treated" or otherwise treated differently are unconstitutional deprivations of liberty because they are based on predictions of future behavior that are unavoidably unreliable. They are as unreasonable and unconstitutional as would be laws depriving people of liberty or other rights because of predictions of future behavior by astrologers or palm readers. An article in Boston College Law Review is titled in part "Why Expert Predictions of Future Dangerousness in Capital Cases Are Unconstitutional" (Eugenia T. La Fontaine, "A Dangerous Preoccupation with Future Danger: Why Expert Predictions of Future Dangerousness in Capital Cases Are Unconstitutional", 44 B.C.L.Rev. 2007 (2002). Could unreliable "expert" predictions of future behavior be unconstitutional in capital cases but constitutional other cases?

Nevertheless, every state of the U.S.A. and most if not all countries of the world allow involuntary commitment of law-abiding people who object to being psychiatric patients because of predictions by psychiatrists, or sometimes psychologists, of their future behavior. Sometimes it is "inpatient" commitment or involuntary "hospitalization" (incarceration). Other times it is "outpatient commitment", a court-order requiring a person to take psychiatric drugs on their own or appear at a community mental health center every week or ten days for psychiatric drug injections or supervised oral administration of psychiatric drugs to prevent the supposed patient from hiding the "medication" in his mouth and spitting it out later. Sometimes "assisted outpatient" teams show up at people's houses or apartments to give them injections in their own homes, enforced by threat of involuntary "hospitalization" if they refuse.

People are even court-ordered to submit to outpatient electroconvulsive brain-damaging (or "therapy").

American courts often order involuntary electroshock for people confined to mental hospitals. Yes, all this happens in the U.S.A., which ends its pledge of allegiance to the flag of the United States of America with the words, "with freedom and justice for all."

"Sexually Violent Predators"

The U.S. federal government and twenty (20) of the fifty (50) states of the U.S.A. now also have involuntary and for practical purposes lifetime "civil commitment" of convicts when they near the end of a prison sentence for a criminal conviction if they are thought likely to commit sex crimes such as rape or sexual child abuse in the future, after release from prison. The U.S.A.'s

federal Adam Walsh Act (18 U.S. Code §4247), signed into law by President George W. Bush in 2006, provides for supposedly civil (non-criminal) commitment of persons who are in the federal prison system for any type of criminal offense—not necessarily a sex offense—if they are "sexually dangerous persons" defined as "a person who has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others" due to mental illness. The U.S. Supreme Court upheld this law in United States v. Comstock, 560 U.S. 126 (2010). How broadly "sexually dangerous person" is defined is shown by the fact that, in the words of the Supreme Court in Comstock, "Three of the five" defendants being committed under the Adam Walsh Act "had previously pleaded guilty in federal court to possession of child pornography" and had been convicted of no other crimes. Apparently, possession of child pornography is considered "sexually violent conduct or child molestation" warranting what in practical application is a life sentence. According to "The Adam Walsh Act Study Guide" (oncefallen.com/adamwalshact.html, updated February 16, 2012) "in porn cases ... Expert must examine hard drive in computer case to see if images were purposely downloaded or were put there by someone else", as if an expert could really determine that. Computer operating systems typically keep copies of previously viewed images and previously viewed web pages on the hard drive for faster subsequent viewing without any command to do so from the computer user. It also is commonplace for web sites to appear without request, hidden behind a web page you were viewing until you close the program, page, or window you were using and find, to your surprise, somehow a web page or web site you did not request somehow appeared on your computer screen. That web site you did not request might be cached in your web browser's memory and stored on your computer's hard drive or included in the list of web sites you have visited kept by your Internet Service Provider. So with laws like this, clicking on the wrong hyperlink on a web page, perhaps without knowing what you're going to get, or a web site that appeared without your request, or allowing another person to use to your Internet-connected computer, could get you imprisoned (or "hospitalized") for life.

The twenty states of the U.S.A. with "sexually dangerous person" or "sexually violent predator" civil commitment laws are Arizona, California, Florida, Illinois, Iowa, Kansas, Massachusetts, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Pennsylvania, Texas, Virginia, South Carolina, Washington, and Wisconsin. In most of these states they are called "Sexually Violent Predator" commitment laws. Obviously, legislators calling these criminals "Sexually Violent Predators" chose the most inflammatory, incendiary language they could think of. Unlike the federal Adam Walsh Act, persons committed under these state laws must have been convicted of a sex-related crime, although states are apparently free to adopt an "any crime" prerequisite similar to the federal Adam Walsh Act or even start committing people as sexually dangerous persons despite the defendant never having committed any crime. This is actually already possible under civil commitment for mental illness laws, because they do not require a criminal conviction as a prerequisite for commitment.

Under the "sexually dangerous person" or "sexually violent predator" laws of these 20 states, convicts who are nearing the end of a sentence for a sex-related conviction may be subjected to a nominally "civil" (not criminal) commitment, which as a practical matter is lifetime incarceration, based on supposed mental illness and prediction that he (or she) is likely to commit another sex related offense if he (or she) is released from prison.

New Hampshire went so far as to enact a civil commitment law for Sexually Violent Predators who do not have mental illness. This is the exact language of New Hampshire's RSA 135-E:1 (effective January 1, 2007): "a small but extremely dangerous number of sexually

violent predators exist who do not have a mental disease or defect that renders them appropriate for involuntary treatment" but "have antisocial personality features which are unamenable to existing mental illness treatment modalities, and those features render them likely to engage in criminal, sexual violent behavior." The statute authorized their for practical purposes lifetime incarceration. An amendment effective July 13, 2010 deleted the language stating that persons committed under the law "do not have mental disease or defect", probably to prevent the law from being declared unconstitutional, since the U.S. Supreme Court has upheld civil commitment laws, including of sexually violent predators or sexually dangerous persons, only if such persons have "mental illness".

I saw an article in which a state legislator is quoted as saying over 90% of sex crime convicts will commit another sex offense if released from prison, which he stated or implied justifies these laws. An article on the Texas Department of State Health Services web site summarizes the relevant research: After 15 years, 73% of sex offenders had not been charged with, or convicted of another sexual offense (Hanson 2004). ... Hanson and Bourgon (2004) in a study of 31,216 sex offenders found that, on average, the observed sexual recidivism rate was 13%, the violent non-sexual recidivism was 14%, and the general recidivism was 36.9%. Research has shown that the recidivism rates for sex offenders are much lower than for the general criminal population. ["Council on Sex Offender Treatment-Treatment of Sex Offenders-Recidivism", dshs.state.tx.us/csot/csot_trecidivism.shtm, updated April 30, 2012]

Despite the fact that non-sex-crime convicts have higher recidivism rates than sex-crime convicts, states have not enacted "commitment" laws for criminals whose crimes were not sex related. If they did, perhaps it would be called "Criminally Dangerous Person" commitment and called "civil" and "therapeutic" and hence not subject to the rights the Constitution guarantees to "criminal" defendants.

In his review of civil commitment of sexually violent predators (SVPs) in 2012, psychiatrist Allen Frances, M.D., said this: Most disturbing was the randomness of the decisionmaking. ... My experience indicates that the SVP laws are being implemented in a highly arbitrary and idiosyncratic fashion with judges and juries easily confused by misleading expert testimony. ... The bad news is that much of the diagnostic work done by SVP evaluators is simply wrong and misleading to juries and judges—resulting in SVP decisions that are arbitrary and questionably constitutional. ["My Review of 28 Sexually Violent Predator Cases", psychiatrictimes.com, April 2, 2012]

In his book The Reign of Error—Psychiatry, Authority, and Law (Beacon Press 1984, p. 6) psychiatrist Lee Coleman, M.D., says— For decades it was assumed that a psychiatrist could predict dangerous behavior at least as well as other doctors could prognosticate about medical illness. Finally, in the 1960s and 1970s, research studies demonstrated conclusively that psychiatric predictions of dangerousness were no better than flipping a coin. In fact, they were worse... [emphasis added]

Similarly, in his book Incognito—The Secret Lives of the Brain (Pantheon Books 2011, p. 178), Baylor College of Medicine neuroscientist David Eagleman recalls— Several years ago, researchers began to ask psychiatrists and parole board members how likely it was that individual sex offenders would relapse when let out of prison. Both the psychiatrists and the parole board members had experience with the criminals in question, as well as with hundreds before them— so predicting who was going to go straight and who would be coming back [to prison] was not difficult.

Or wasn't it? The surprise outcome was that their guesses showed almost no correlation with the actual outcomes. The psychiatrists and parole board members had the predictive accuracy of coinflipping [emphasis added].

Courts making decisions based on psychiatrists' and psychologists' predictions of future human behavior was also compared with coin-flipping in a law journal article by attorney Bruce Ennis and psychology professor Thomas R. Litwack, "Psychiatry and the Presumption of Expertise: Flipping Coins in the Courtroom", California Law Review, Vol. 62, Issue 3 (May 1974).

So-called civil commitment of convicts reaching the end of their prison sentences is wrong because they have served their time for their crimes, because the "mental illness" criteria in these laws is based on an invalid concept (see Does Mental Illness Exist?), because the "commitments" (imprisonments) are based upon predictions of future behavior that are necessarily unreliable, and because recidivism rates suggest such predictions are wrong in the majority of cases.

Should "Civil" versus "Criminal" Matter?

So-far courts have been for the most part duped by the "civil" label attached by legislators to what are really criminal laws. Criminal laws are laws that punish people for prohibited behavior. As I point out in Why the Myth of Mental Illness Lives On, punishing people for prohibited behavior, or preventing anticipated future harmful behavior, is the real purpose of all civil commitment for mental illness laws. It shouldn't matter if legislators try to abrogate defendants' constitutional rights by calling the laws "civil", calling the offenses "illnesses", and calling the punishment "treatment" or "therapy". Anything causing incarceration, including when it is called involuntarily hospitalization, should be considered "criminal" for constitutional law purposes. Even quarantine of persons with contagious disease should be judged by criminal law standards if the conditions of confinement are as restrictive as imprisonment in a jail or mental institution.

According to "The Innocence List" published at deathpenaltyinfo.org (accessed July 29, 2015), between 1973 and mid-2015 there were exonerations of 155 death row convicts in the U.S.A. New or overlooked evidence, in 20 cases DNA evidence not available at the time of trial, showed they were actually innocent of the crimes for which they had been convicted and sentenced to death, or a witnesses recanted his or her testimony, or evidence later determined unreliable had been used against them, or they were acquitted when their original death sentences were overturned on appeal and acquitted in a subsequent re-trial. These erroneous death penalty convictions occurred in 25 states: Alabama, Arizona, California, Florida, Georgia,

Idaho, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Missouri, Nebraska, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia. These erroneous death penalty convictions prove U.S.A. criminal law standards are lax enough to allow conviction of the innocent. If 155 persons were released from death row after they were convicted, or were posthumously exonerated, there were probably dozens more who were innocent but wrongfully executed during the same period of time. Furthermore, it is unlikely wrongful convictions occurred only in death penalty cases: Because judges and juries tend to be especially careful in death penalty cases, these erroneous death penalty convictions suggest those wrongfully convicted and serving prison sentences in the U.S.A. probably number in the thousands. Because of the unreliability of America's (and no doubt other nations') criminal justice systems, pleading guilty even though you are innocent in exchange for a light sentence is often the wisest choice, since it can and does happen that defendants who refuse to plead guilty and go to trial are sentenced to many years or a lifetime after turning down a light sentence in exchange for a guilty plea. So in many cases defendants plead guilty even though they are innocent. According to an October 14, 2014 news report, "In 97 percent of federal criminal cases and 94 percent of state criminal cases there is no trial at all, case are resolved by plea bargain", or in other words, by guilty or "no contest" pleas. __________________________________________________

First they came for the "mentally ill", and I didn't speak out because I am not mentally ill.

Then they came for the "sexually violent predators", and I didn't speak out because I am not a sex offender. Then they came for the "terrorists", and I didn't speak out because I am not a terrorist. But then they came for me, and nobody spoke out.

No one's constitutional rights are safe if anyone's constitutional rights are violated. ________________________________________________________ Dispensing with the more stringent standards of criminal law because legislators choose to call the proceedings "civil" allows even more convictions or "commitments" of innocent people than would occur under criminal law.

Involuntary Commitment for Fictional Treatment Violates Due Process

In Wyatt v. Stickney, 325 F.Supp. 781 (M.D. Ala. 1971), Chief Judge Johnson wrote: The patients at Bryce Hospital, for the most part, were involuntarily committed through noncriminal procedures and without the constitutional protections that are afforded defendants in criminal proceedings. When patients are so committed for treatment purposes they unquestionably have a constitutional right to receive such individual treatment as will give them a realistic opportunity to be cured or to improve his or her mental condition. ... The purpose of involuntary hospitalization for treatment purposes is treatment and not mere custodial care or punishment. This is the only justification, from a constitutional standpoint, that allows civil commitment to mental institutions such as Bryce. ... To deprive any citizen of his or her liberty upon the altruistic theory that the confinement is for humane therapeutic reasons and then fail to provide adequate treatment violates the very

fundamentals of due process. [appearing in Michael L. Perlin, Mental Disability Law—Cases and Materials— Second Edition, Carolina Academic Press 2005, pp. 335-336]

Involuntary inpatient or outpatient commitment is unjustified and is a violation of America's (or any democracy's) promise of liberty, and by the Court's reasoning in Wyatt v. Stickney a violation of due process, if the purpose of the involuntary commitment is "treatment" and there is, in truth, no bona-fide and effective treatment available. As I document in my essays Psychiatric Drugs: Cure or Quackery?, Psychiatry's Electroconvulsive Shock Treatment: A Crime Against Humanity, The Brain Butchery Called Psychosurgery, and The Case Against Psychotherapy, this is indeed the case: Psychiatry has no bona-fide treatment for anything. In their book Therapy's Delusions, a critique of so-called psychotherapy, a sociology professor and journalist conclude "A clear and general understanding of therapy's effectiveness would indeed lead to a general collapse of therapeutic authority" (Ethan Watters & Richard Ofshe, Scribner 1999, p. 136). In a law journal article in 1988 by Mary L. Durham, Ph.D., Associate Professor in the School of Public Health and Community Medicine at the University of Washington, and John Q. La Fond, J.D., Professor of Law at the University of Puget Sound, titled "A Search for the Missing Premise of Involuntary Therapeutic Commitment: Effective Treatment of the Mentally Ill", 40 Rutgers Law Review 303 at 310 (1988), the authors reach this conclusion: This article examines the available empirical data evaluating the effectiveness of treatment for the mentally ill in a variety of contexts. It concludes that there is no reliable evidence establishing that psychiatry can effectively treat nondangerous mentally ill patients confined against their will in state facilities. To the contrary, there is evidence that coerced hospitalization may actually do more harm than good. Consequently, this Article argues that coercive commitment of the nondangerous mentally ill for a therapeutic purpose should be abolished.

At his 2012 Empathic Therapy Conference in Syracuse, New York, psychiatrist Peter Breggin asked this question of Dr. Rachel Bingham, a British physician who had just given a presentation about people voluntarily accepting psychiatric hospitalization only because they were threatened with involuntary psychiatric hospitalization if they refused: "Did you anywhere find even an attempt to show that involuntary treatment or even hospitalization ever helped anybody? Is there? I have never found a study." Dr. Bingham replied, "It's going to be a very short answer: No." Dr. Breggin then went on to say— Now, think about that: Science based medicine? There are no studies showing that locking up people reduces their suicide rate. That'd be a very easy thing to do. It'd be very easy to look at a hospital cohort, get some sort of an outpatient group, and look at their suicide rates, or at anything else. Not a hard study. If they're being done, they're not being published, because they don't show that there is any benefit to being in a [psychiatric] hospital or being involuntarily confined.

In her book Whores of the Court—The Fraud of Psychiatric Testimony and the Rape of American Justice

(Regan Books 1997, p. 312), Boston University psychology professor Margaret A. Hagen, Ph.D., says "A mental hospital provides nothing effective except employment for the staff." ___________________________________________________

PSYCHIATRY HAS NO BONA-FIDE TREATMENT FOR ANYTHING ___________________________________________________ All involuntary commitments for purposes of mental health treatment are unconstitutional because there is no valid treatment in the field of mental health.

America's Promise of Liberty

There are a few groups of people who, probably even more than sex-crime convicts, tend to be the target of America's involuntary psychiatric commitment laws. Included in these are the young, the old, and the homeless. Sometimes old people are placed in mental hospitals just to get them out of the way. In most cases, nursing homes would be more appropriate, but often nursing homes are not preferred by the family because they are more costly and must be paid for by the family. Involuntary psychiatric commitment laws are used to get homeless people off the streets and sidewalks. Adolescents are committed by parents as a way of shifting the balance of power towards parents in intra-family conflicts, parents usually being the ones who have the money to hire psychiatrists to incarcerate their family member adversaries and define their opposing views and disliked behaviors as illnesses. In some states parents have statutory power to commit their children who are under age 18 without judicial proceedings, in large part because of the decision by the U.S. Supreme Court in Parham v. J.R., 442 U.S. 584 (1979). This Supreme Court decision in 1979 is probably largely responsible for the fact that in the years immediately following it "adolescent admission rates to psychiatric units of private hospitals have jumped dramatically increasing four-fold between 1980 and 1984" (Lois A. Weithorn, Ph.D., "Mental Hospitalization of Troublesome Youth: An Analysis of Skyrocketing Admission Rates", 40 Stanford Law Review 773 (1988). According to another report, "private psychiatric hospital admissions for teenagers are the fastest-growing segment of the hospital industry. ... Between 1980 and 1987 the number of people between 10 and 19 discharged from psychiatric units increased 43 percent, from 126,000 to 180,000. One reason is the aggressive advertising used by for-profit psychiatric facilities" (Christina Kelly, "She's Not Crazy But 14-year-old Sara got committed anyway", Sassy magazine, March 1990, p. 44). According to another report, between 1971 and 1991 "the number of teenagers hospitalized for psychiatric care has increased from 16,000 to 263,000" (Time magazine, August 26, 1991, p. 12). According to University of Michigan professor Ira Schwartz, "psychiatric hospitals are turning into jails for kids" (Sassy magazine, March 1990, p.

44). One reason this is wrong is the stigma of a wrongful involuntary psychiatric "hospitalization" during childhood or adolescence does not disappear upon reaching the age of majority but follows a person, who eventually becomes an adult, throughout life (see Psychiatric Stigma Follows You Everywhere You Go for the Rest of Your Life).

Of course, mental "hospitals" are jails for all persons detained there against their will.

Furthermore, they are places where people may be incarcerated with no showing of prior illegal (or otherwise harmful) conduct-only "mental illness" and supposed need for treatment or predictions of "dangerousness". Yet statutes authorizing involuntary commitment for mental illness do not say which supposed mental illnesses justify commitment and which do not. As I

have shown in The Myth of Psychiatric Diagnosis and Why the Myth of Mental Illness Lives On, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders has so many disorders, defined so broadly, few if any living humans fall within none of the book's definitions of mental disorder. With the exception of civil commitment of so-called "sexually violent predators" or "sexually dangerous persons" whereby persons convicted of sex crimes (or under the federal Adam Walsh Act, any crime) are civilly committed when their criminal prison sentences expire, the statutory definitions of "mental illness" and other commitment criteria do not include violation of a law. If subjected to proper constitutional scrutiny, such laws would be found void for vagueness, as would a statute allowing imprisonment for something called "crime" but which failed to define crime—leaving potential "criminals" in doubt about whether marijuana or alcohol use is legal, whether driving 65 mph on the highway is legal, whether the age of consent for what in the presence of a statute would be called statutory rape is 16 or 18 or some other age, or whether one must brandish a deadly weapon such as a gun in plain view and retreat from an attacker before using the weapon to take the attacker's life in self-defense, and allowing each prosecuting attorney to determine after the fact whether a particular act is definable as "crime", much as psychiatrists often determine after the fact whether a particular act or expression of ideas constitutes a committable "mental illness".

Have we forgotten that America is supposed to be a nation where all law-abiding persons are guaranteed liberty? How can a person know what behavior is prohibited if the laws are not clearly written? People like myself who believe strongly in individual freedom argue that violation of the rights of others should be the only acts prohibited by law; others will defend victimless crime laws. In either case, violation of law should be the only basis for depriving a person of his or her liberty over his or her protest.

One 14 year old girl who had been involuntarily committed to a private psychiatric hospital after an argument with her parents said "My parents would always threaten me with the hospital" (Sassy magazine, March 1990, p. 82). But it isn't only adolescents and old people who are threatened with psychiatric incarceration in their conflicts with family members. In her autobiography, Will There Really Be a Morning?, actress Frances Farmer tells how even when she was 30 years old her mother in seemingly every dispute would threaten her with commitment to Western State Hospital near her home in Seattle, Washington: "I'm just about at the end of my rope with you," she warned. "I've just about had all I can take. I've put up with you for years and what do I get for it? Nothing! Absolutely nothing! But you're my daughter and you're going to do exactly as I say, or back [to the mental hospital] you go. Do you understand me?

Back you go! And this time for keeps! ... You're a disgusting brat!" she spat contemptuously.

"I'm a thirty-year-old woman," I answered bitterly. "And I know damn good and well that you'll send me back the first chance you get." ... I could not cope with another fight. "I'm going back to bed," I said flatly. "This whole thing is absurd."

I started up the stairs, but her reply stopped me short. "I'm sending you back, Frances." I was chilled by her sudden calm. "And this time," she went on, "I'll see you that you stay." ...

It was morning, and I heard my mother rise. It startled me when she knocked softly at my door.

"Frances," she said calmly. "I'd like you to get dressed and come down stairs. There are some people here who want to meet you." ...

My mother was in the living room with two uniformed men...and I knew! ... They straddled me, and I felt the rough canvas of the straitjacket wrap around me and buckle into place. [Dell Publishing Co. 1972, pp. 15-33]

According to the biography by William Arnold, Frances Farmer was "almost certainly" given a transorbital lobotomy, and without her consent, by Dr. Walter Freeman during her "hospitalization" (Shadowland, Berkley Books 1978, p. 168, see also pp. 8-9, 155, 161, 166). Dr. Freeman's biographer, Jack El-Hai, in The Lobotomist (Whiley 2007, pp. 241-242) disagrees but acknowledges the doctors at Western State Hospital did propose lobotomizing Frances Farmer. He quotes Frances Farmer's sister, Edith, saying the Western State Hospital doctors "contemplated giving [her sister Frances] a lobotomy." He also quotes Frances Farmer's father saying "I got there just in time to head them off from some danged experimental brain operation on her."

In America and other nations that claim to value freedom and defend human rights, legislators writing "mental health" laws and those making personal or judicial decisions about what to do with a socalled mentally ill person or persons should keep in mind that America's guarantees of personal freedom are the basis for American patriotism. As psychiatry professor Thomas Szasz wrote in 2011: "If there is a single word that captures the idea of the United States of America, that word is freedom" (Suicide Prohibition—The Shame of Medicine, Syracuse University Press 2011, p. 19, italics in original). Listen, for example, to the words of a patriotic song, "God Bless the U.S.A.": If tomorrow all the things were gone I'd worked for all my life, and I had to start again with just my children and my wife, I'd thank my lucky stars to be living here today. 'Cause the flag still stands for freedom, and they can't take that away! And I'm proud to be an American, where at least I know I'm free. And I won't forget the men who died who gave that right to me. And I'll gladly stand up next to you and defend her still today. 'Cause there is no doubt I love this Land. God bless the U.S.A.! [italics added] Similarly, a Russian immigrant to the United States said this in an article published in Reader's Digest in 1991: "I looked up at the [United States] flag, fluttering in the breeze. ... Suddenly, I understood ...

America isn't about school sweaters or Johnny Mathis records or shiny new cars. It's about freedom and opportunity—not just for the privileged or the native-born—but for everyone" (Constantin Galskoy, "How I Became an American", Reader's Digest, August 1991, p. 76). The Declaration of Independence of the United States of America of July 4, 1776 declares— WE hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness —That to secure these Rights, Governments are instituted among Men...

The U.S.A.'s official national anthem, "The Star Spangled Banner", refers to America as "the land of the free". The Pledge of Allegiance to the Flag of the United States of America ends with the words "...with liberty and justice for all." One of America's most popular and prominent symbols is the Statue of Liberty.

Another statue, this one sitting atop the dome of the U.S. Capitol Building in Washington, D.C., is called the Statue of Freedom. One of the best selling high school history textbooks in the U.S.A. from the 1950s to the 1980s is titled History of a Free People (by Henry W. Bragdon & Samuel P. McCutchen, Collier MacMillan Publishers ©1954, 1956, 1958, 1960, 1961, 1964, 1973, 1978, 1981). In 1987 in a law journal

article discussing constitutional due process, U.S. Supreme Court Justice William J. Brennan, Jr., says "every enactment of every state...may be challenged at the Bar of the Court on the ground that such action, such legislation, is a deprivation of liberty without due process of law...those ideals of human dignity—liberty and justice for all individuals—will continue to inspire and guide us because they are entrenched in our Constitution" (Case & Comment, September-October 1987, p. 21). _________________________________________________

LIBERTY FOR ALL LAW-ABIDING PERSONS SEEMS TO BE TOO MUCH TO ASK, EVEN IN AMERICA _________________________________________________ Imagine how empty and meaningless are the words of such patriotic articles and songs, the Pledge of Allegiance to the Flag, the national anthem, the Declaration of Independence, the U.S. Constitution, the names of America's national monuments, and the title of that high school history textbook calling the people of America free, to a law-abiding person who has been imprisoned (involuntarily "hospitalized") and forcibly "treated" for so-called mental illness, or court-ordered to take psychiatric "medication" or electroshock on an outpatient basis in the U.S.A. A reason involuntary psychiatric commitment of law-abiding people is a violation of constitutionally guaranteed substantive due process is it is contrary to the most important values America and other democracies claim to stand for. Legislation and court decisions that are inconsistent with these values undermine the justification for American patriotism. This is just as true for those under the arbitrarily defined age of majority as it is for adults. In his inaugural address on January 20, 1989, the first President George Bush said "Great nations, like great men, must keep their word. When America says something, America means it—whether a treaty or an agreement or a vow made on marble steps." One of the consequences of belief in the myth of mental illness and the myth of psychiatric diagnosis is America's failure to live up to one of its most fundamental promises: liberty for all law-abiding Americans.

Recommended Reading

Books Bruce Ennis, J.D., Prisoners of Psychiatry—Mental Patients, Psychiatrists, and the Law (Harcourt Brace Jovanovich 1972)

John Monahan, Ph.D., The Clinical Prediction of Violent Behavior (Jason Aronson 1995) Thomas S. Szasz, M.D., Law, Liberty, and Psychiatry (Collier Books 1963) Articles

C. Peter Erlinder, "Minnesota's Gulag: Involuntary Treatment for the 'Politically Ill'", 19 William Mitchell Law Review 99 (1993) Allen Frances, M.D., "California DMH Instructs SVP Evaluators on Proper DSM-IV-TR Diagnosis", January 4, 2012

Allen Frances, M.D., "My Review of 28 Sexually Violent Predator Cases", psychiatrictimes.com, April 2, 2012 Allen Frances, M.D., "Mass Murders, Madness, and Gun Control", psychiatrictimes.com, July 30, 2012 Allen Frances, M.D., "Mass Murder Psychobabble Misses Gun Policy Point", psychiatrictimes.com, August 3, 2012 Recommended Video

"Frances Farmer: This Is Your Life" (1958), YouTube.com. This is a television program broadcast in 1958 that allows you to see and hear actress Frances Farmer discuss her experience as, at one time, America's most well-known involuntarily committed mental patient. copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Why Psychiatry Should Be Abolished as a Medical Specialty" ]

Why Psychiatry Should Be Abolished as a Medical Specialty Wayne Ramsay, J.D.

"PSYCHIATRY is an emperor standing naked in his new clothes. It has striven for 70 years to become an emperor, a full brother with the other medical specialties. And now it stands there resplendent in its finery. But it does not have any clothes on, and even worse, nobody has told it so. To tell an emperor that he does not have any clothes on has never been advocated as the best way to win friends. The alternative, however, is equally painful, for you must then become part of the general delusion." — Psychiatrist E. Fuller Torrey, M.D., in the Preface to his book The Death of Psychiatry (Penguin Books 1974) "Psychiatry remains as reluctant as ever to recognize the devastating impact of its treatments upon the minds and brains of its patients." Psychiatrist Peter R. Breggin, M.D., "Coercion of Voluntary Patients in an Open Hospital", Archives of General Psychiatry 10 (1964):173-181 (1982 note), available at breggin.com)

Psychiatry should be abolished as a medical specialty because medical school education is not needed nor even helpful for doing counselling or so-called psychotherapy, because the perception of mental illness as a biological entity is mistaken, because psychiatry's "treatments" other than counselling or psychotherapy (drugs, electroshock, and psychosurgery) hurt rather than help people, because nonpsychiatric physicians are better able than psychiatrists to treat real brain disease, and because nonpsychiatric physicians' acceptance of psychiatry as a medical specialty is a poor reflection on the medical profession as a whole.

In the words of Sigmund Freud in his book The Question of Lay Analysis: The first consideration is that in his medical school a doctor receives a training which is more or less the opposite of what he would need as a preparation for psychoanalysis [Freud's method of psychotherapy]. ... Neurotics, indeed, are an undesired complication, an embarrassment as much to therapeutics as to jurisprudence and to military service. But they exist and are a particular concern of medicine. Medical education, however, does nothing, literally nothing, towards their understanding and treatment. ... It would be tolerable if medical education merely failed to give doctors any orientation in the field of the neuroses. But it does more: it given them a false and detrimental attitude. ...analytic instruction would include branches of knowledge which are remote from medicine and which the doctor does not come across in his practice: the history of civilization, mythology, the psychology of religion and the science of literature. Unless he is well at home in these subjects, an analyst can make nothing of a large amount of his material. By way of compensation, the great mass of what is taught in medical schools is of no use to him for his purposes. A knowledge of the anatomy of the tarsal bones, of the constitution of the carbohydrates, of the course of the cranial nerves, a grasp of all that medicine has brought to light on bacillary exciting causes of disease and the means of combating them, on serum reactions and on neoplasms—all of this knowledge, which is undoubtedly of the highest value in itself, is nevertheless of no consequence to him; it does not concern him; it neither helps him directly to understand a neurosis and to cure it nor does it contribute to a sharpening of those intellectual capacities on which his occupation makes the greatest demands. ... It is unjust and inexpedient to try to compel a person who wants to set someone else free from the torment of a phobia or an obsession to take the roundabout road of the medical curriculum. Nor will such an endeavor have any success...

[Anchor Books 1964, pp. 71, 72, 73, 93-94, 95].

In a postscript to this book in 1927 Dr. Freud wrote: "Some time ago I analyzed [psychoanalyzed] a colleague who had developed a particularly strong dislike of the idea of anyone being allowed to engage in a medical activity who was not himself a medical man. I was in a position to say to him: 'We have now been working for more than three months. At what point in our analysis have I had occasion to make use of my medical knowledge?' He admitted that I had had no such occasion" (pp. 107-108). While Dr. Freud made these remarks about his own method of psychotherapy, psychoanalysis, it is hard to see why it would be different for any other type of "psychotherapy" or counselling. In their book about how to shop for a psychotherapist, Mandy Aftel, M.A., and Robin Lakoff, Ph.D., make this observation: "Historically, all forms of 'talking' psychotherapy are derived from psychoanalysis, as developed by Sigmund Freud and his disciples ... More recent models diverge from psychoanalysis to a greater or lesser degree, but they all reflect that origin. Hence, they are all more alike than different" (When Talk Is Not Cheap, Or How To Find the Right Therapist When You Don't Know Where To Begin, Warner Books 1985, p. 27).

If you think the existence of psychiatry as a medical specialty is justified by the existence of biological causes of so-called mental or emotional illness, you've been misled. So-called mental or emotional "illnesses" are caused by unfortunate life experience窶馬ot biology. There is no biological basis for the concept of mental or emotional illness, despite speculative theories you may hear. The brain is an organ of the body, and there is no doubt it can have a disease, but nothing we think of today as mental illness has been traced to a brain disease. There is no valid biological test that tests for the presence of any so-called mental illness. What we think of today as mental illness is psychological, not biological. Much of the treatment that goes on in psychiatry today is biological, but other than listening and offering advice, modern day psychiatric treatment is as senseless as trying to solve a computer software problem by working on the hardware. As psychiatry professor Thomas Szasz, M.D., once said: Trying to eliminate a so-called mental illness by having a psychiatrist work on your brain is like trying to eliminate cigarette commercials from television by having a TV repairman work on your TV set (The Second Sin, Anchor Press 1973, p. 99). Since lack of health is not the cause of the problem, health care is not a solution.

There has been increasing recognition of the uselessness of psychiatric "therapy" by physicians outside psychiatry, by young physicians graduating from medical school, by informed lay people, and by psychiatrists themselves. This increasing recognition is described by a psychiatrist, Mark S. Gold, M.D., in a book he published in 1986 titled The Good News About Depression. He says "Psychiatry is sick and dying," that in 1980 "Less than half of all hospital psychiatric positions [could] be filled by graduates of U.S. medical schools." He says that in addition to there being too few physicians interested in becoming psychiatrists, "the talent has sunk to a new low." He calls it "The wholesale abandonment of psychiatry". He says recent medical school graduates "see that psychiatry is out of sync with the rest of medicine, that it has no credibility", and he says they accuse psychiatry of being "unscientific". He says "Psychiatrists have sunk bottomward on the earnings totem pole in medicine. They can expect to make some 30 percent less than the average physician". He says his medical school professors thought he was throwing away his career when he chose to become a psychiatrist (Bantam Books, pp. 15, 16, 19, 26). In another book published in 1989, Dr. Gold describes "how psychiatry got into the state it is today: in low regard, ignored by the best medical talent, often ineffective." He also calls it "the sad state in which

psychiatry finds itself today" (The Good News About Panic, Anxiety, & Phobias, Villard Books, pp. 24 & 48).

In the November/December 1993 Psychology Today magazine, psychiatrist M. Scott Peck, M.D., is quoted as saying psychiatry has experienced "five broad areas of failure" including "inadequate research and theory" and "an increasingly poor reputation" (p. 11). Similarly, a Wall Street Journal editorial in 1985 said "psychiatry remains the most threatened of all present medical specialties", citing the fact that "psychiatrists are among the poorest-paid American doctors", that "relatively few American medicalschool graduates are going into psychiatric residencies", and psychiatry's "loss of public esteem" (Harry Schwartz, "A Comeback for Psychiatrists?", The Wall Street Journal, July 15, 1985, p. 18).

In a Psychiatric Times article published June 11, 2012, H. Steven Moffic, M.D., says "There is concern because of the low number of medical students—especially US medical school graduates—who want to go into psychiatry; the psychiatric workforce is aging and there may not be enough replacements" ("How to End a Psychiatric Epidemic: The Redemption of Psychiatry", psychiatric times.com). He also noted "Criticism by consumer groups, besides that of the antipsychiatry of Scientology, seems to be increasing ... What clearly seems more like an epidemic, other than the epidemic number of administrators now in our field, is the criticism, often vitriolic, towards psychiatry and psychiatrists" (Id). In another article, Dr. Moffic says "the antipsychiatry movement of Scientologists seems to be expanding to former patients and their families who felt they were hurt by psychiatry.

While some anger and criticism is surely warranted, the vitriol and call for the end of psychiatrists seems to border on hate speech" ("Psychism: Defining discrimination of Psychiatry", June 4, 2012, psychiatrictimes.com) The low esteem of psychiatry in the eyes of physicians who practice bona-fide health care (that is, physicians in medical specialties other than psychiatry) is illustrated in The Making of a Psychiatrist, Dr. David Viscott's autobiographical book published in 1972 about what it was like to be a psychiatric resident (i.e., a physician in training to become a psychiatrist): "I found that no matter how friendly I got with the other residents, they tended to look on being a psychiatrist as a little like being a charlatan or magician." He quotes a physician doing a surgery residency saying "You guys [you psychiatrists] are really a poor excuse for the profession. They should take psychiatry out of medical school and put it in the department of archeology or anthropology with the other witchcraft.' 'I feel the same way,' said George Maslow, the obstetrical resident..." (pp. 84-87).

Psychiatrist Colin A. Ross, M.D., makes a similar observation in his autobiography, The Great Psychiatry Scam—One Shrink's Personal Journey about the opinion of medical students about psychiatry when he was in medical school in Canada: I was very careful not to tell anyone I was going into psychiatry. If you told anyone you were going into psychiatry, you would be ex-communicated immediately, and never taken seriously again by your classmates. The attitudes towards psychiatry were crystal clear. Psychiatry is Mickey Mouse. Psychiatry isn't scientific. Psychiatry isn't real medicine. The only people who go into psychiatry are people who need psychiatrists themselves. That's what the real medical students thought, the ones who were going to become real doctors. [Manitou Communications, Inc. 2008, p. 45]

Medical student Ross encountered the same negative attitude toward psychiatry from Dr. Fraser, a surgeon he met during his clinical rotation in surgery: "Dr. Fraser was deeply disappointed when he found out from an intern, near the end of my [surgery] rotation, that I was going into psychiatry. He considered it a complete waste of my talents."

After becoming a psychiatrist, Dr. Ross discovered these negative attitudes about psychiatry were justified. In the Introduction to his autobiography, The Great Psychiatry Scam—One Shrink's Personal Journey, he wrote "...the revelations within these pages are a tragic statement of the general state of affairs in patient care and the overall lack of quality in psychiatry" (p. x). On page xii in the same Introduction of this same book he says this: There are good individual people in psychiatry. ... But the field as a whole is a mess. The standards of thinking, research and scholarship in psychiatry are pathetic. ... The amount of science in day-to-day clinical psychiatry is nil. ... I will prove to you that over 90% of medication prescriptions for psychiatric inpatients have no scientific basis. ... The belief system and the propaganda of twenty-first century psychiatry are no more scientific than the beliefs and behavior of any other cult. Psychiatrists scoff at people who believe in alien abductions, but their own belief system is no more scientific or grounded in reality. Psychiatrists get brainwashed into a group delusional system that controls how they understand mental illness and treat patients. This delusional system is bad news for patients.

On page 127 Dr. Ross says "psychiatry is not based on science. Psychiatry is a belief system posing as a branch of medicine."

In 2012, Tufts University psychiatry professor Seyyed Nassir Ghaemi, M.D., M.P.H., said this in his "Letter to a Young Psychiatrist": I teach ignorance. Four years of medical school; and 4 more years of residency. ... I teach we don't know ... Knowledge is 2-edged: It illuminates a fact or a part of experience. Usually, in so doing, it shows that what previously seemed sunlit truth is now utter darkness. As you learn something, you realize that much of what you "knew" was actually false. ...Young psychiatrists need to learn, foremost, that they are ignorant. And they need to learn that their elders are even more ignorant ... Look for the dogma.

Whatever is believed by most, is likely to be untrue. The truth is not a matter of popular vote... [psychiatrictimes.com, June 28, 2012] Similarly, in his book Antipsychiatry: Quackery Squared, Syracuse University Press 2009, p. ix), psychiatry professor Thomas Szasz, M.D., says "psychiatry—an imitation of medicine—is a form of quackery."

Psychiatrist and psychoanalyst Douglas C. Smith, M.D., of Juneau, Alaska described the contrast between what he and his fellow psychiatric residents were taught and what they observed as a "twilight zone" in his remarks at the 2011 Empathic Therapy conference in Syracuse, N.Y.: I think all of us as psychiatric residents experienced kind of a, the, twilight zone, a bit, because we could see these medicines weren't working. And we would talk about it among each other, very openly as

residents. "Have you ever seen Prozac work?" "No, I don't think I have." But we wouldn't talk that way to our teachers.

E. Fuller Torrey, M.D., a psychiatrist, makes a similar admission in his book The Death of Psychiatry (Chilton Book Co. 1974). In that book, Dr. Torrey with unusual clarity of perception and expression pointed out "why psychiatry in its present form is destructive and why it must die." (This quote comes from the synopsis on the book's dust cover.) Dr. Torrey indicates that many psychiatrists have begun to realize this, that "Many psychiatrists have had, at least to some degree, the unsettling and bewildering feeling that what they have been doing has been largely worthless and that the premises on which they have based their professional lives were partly fraudulent" (p. 199, emphasis added). Presumably, most physicians want to do something that is constructive, but psychiatry isn't a field in which they can do that, at least not in their capacity as physicians—just as TV repairmen who want to improve the quality of television programming cannot do so in their capacity as TV repairmen. In The Death of Psychiatry, Dr. Torrey argued that "The death of psychiatry, then, is not a negative event" (p. 200), because the death of psychiatry will bring to an end a misguided, stupid, and counterproductive approach to trying to solve people's problems. Dr. Torrey argues that psychiatrists have only two scientifically legitimate and constructive choices: Either limit their practices to diagnosis and treatment of known brain diseases (which he says are "no more than 5 percent of the people we refer to as mentally 'ill'" (p. 176), thereby abandoning the practice of psychiatry in favor of bona-fide medical and surgical practice that treats real rather than presumed but unproven and probably nonexistent brain disease—or become what Dr. Torrey calls "tutors" (what I call counselors) in the art of living, thereby abandoning their role as physicians. Of course, psychiatrists, being physicians, can also return to real health care practice by becoming family physicians or qualifying in a bona-fide medical specialty.

In an American Health magazine article in 1991 about Dr. Torrey, he is quoted saying he continues to believe psychiatry should be abolished as a medical specialty: He calls psychiatrists witch doctors and Sigmund Freud a fraud. For almost 20 years Dr. E. (Edwin) Fuller Torrey has also called for the "death" of psychiatry. ...No wonder Torrey, 53, has been expelled from the American Psychiatric Association (APA) and twice removed from positions funded by the National Institute of Mental Health ... In The Death of Psychiatry, Torrey advanced the idea that most psychiatric and psychotherapeutic patients don't have medical problems. "...most of the people seen by psychotherapists are the "worried well." They have interpersonal and intrapersonal problems and they need counseling, but that isn't medicine—that's education. Now, if you give the people with brain diseases to neurology and the rest to education, there's really no need for psychiatry." [American Health magazine, October 1991, p. 26]

Richard P. Bentall is Professor of Clinical Psychology at the University of Bangor in Wales (UK). In the Preface of his book Doctoring the Mind—Is Our Current Treatment for Mental Illness Really Any Good? (New York University Press 2009, pp. xiv, xv), titled "Rational Antipsychiatry", he says this:

...there have never been any anti-oncologists, anti-cardiologists, anti-gastroenterologists or even antiobstetricians. Psychiatry has therefore been unique in the extent to which it has generated both fascination and mistrust amongst intelligent people. Perhaps this is because, alone among the medical specialities, it has the power to compel people to receive treatment, and because some of the treatments inflicted on the mentally ill have seemed more terrifying than madness itself. ... conventional psychiatry might be reasonably criticized, not on hard-to-define humanistic grounds (although these are important) but because it has been profoundly unscientific and at the same time unsuccessful.

In his book Schizophrenia Breakthrough (Practical Psychology Press 2003, p. 163), psychologist Al Siebert, Ph.D., says "Psychiatry is the only medical specialty that must arrange for police protection against demonstrations by ex-patients when they hold national conferences." _________________________________________________ PSYCHIATRY IS UNIQUE IN THAT THERE IS AN ANTI-PSYCHIATRY MOVEMENT. THERE HAVE NEVER BEEN ANY ANTI-NEUROLOGISTS, ANTI-PEDIATRICIANS, ANTI-ONCOLOGISTS, ANTI-CARDIOLOGISTS, ANTI-GASTROENTEROLOGISTS OR ANTI-OBSTETRICIANS. _________________________________________________

The disadvantage to the whole of the medical profession of recognizing psychiatry as a legitimate medical specialty occurred to me when I consulted a dermatologist for diagnosis of a mole I thought looked suspiciously like malignant melanoma. The dermatologist told me my mole did indeed look suspicious and should be removed, and he told me almost no risk was involved. This occurred during a time I was doing research on electroshock (which I summarized in Psychiatry's Electroconvulsive Shock Treatment: A Crime Against Humanity). I found overwhelming evidence that psychiatry's electric shock treatment causes brain damage, diminished intelligence, and memory loss and doesn't reduce unhappiness or so-called depression as is claimed. About the same time my reading about psychiatric drugs reinforced my impression most if not all psychiatric drugs are ineffective for their intended purposes, and I learned many of the most widely used psychiatric drugs are not merely psychologically harmful but cause biological injury, including permanent brain damage if used at supposedly therapeutic levels long enough, as they are not only with the approval but the insistence of psychiatrists. I explain my reasons for these conclusions in Psychiatric Drugs: Cure or Quackery? Part of me tended to assume the dermatologist was an expert, be trusting, and let him do the minor skin surgery right then and there as he suggested. But then, an imaginary scene flashed through my mind: A person walks into the office of another type of recognized, board-certified medical specialist: a psychiatrist. The patient tells the psychiatrist he has been feeling depressed. The psychiatrist, who specializes in giving outpatient electroshock, responds saying: "No problem.

We can take care of that. We'll have you out of here within an hour or so feeling much better.

Just lie down on this electroshock table while I use this head strap and some electrode jelly to attach these electrodes to your head..." In fact, there is no reason such a scene couldn't actually take place in a psychiatrist's office today. Some psychiatrists do give electroshock in their offices on an outpatient basis. Realizing that physicians in the other, the bona-fide, medical and

surgical specialties accept biological psychiatry and all the quackery it represents as legitimate made (and makes) me wonder if physicians in the other specialties are undeserving of trust also.

I left the dermatologist's office without having the mole removed, although I returned and had him remove it later after I'd gotten opinions from other physicians and had done some reading on the subject. Physicians in the other, the real, health care specialties accepting biological psychiatry as legitimate, and their failure to recognize nonbiological psychiatry (psychotherapy or counselling) as something other than health care, calls into question the reasonableness and rationality not only of psychiatrists but of all physicians.

On November 30, 1990, the Geraldo television talk show featured a panel of former electroshock victims who told how they were harmed by electroshock and by psychiatric drugs.

Also appearing on the show was psychoanalyst Jeffrey Masson, Ph.D., who said this: "Now we know that there's no other medical specialty which has patients complaining bitterly about the treatment they're getting. You don't find diabetic patients on this kind of show saying 'You're torturing us. You're harming us. You're hurting us. Stop it!' And the psychiatrists don't want to hear that."

Harvard University law professor Alan M. Dershowitz has said psychiatry "is not a scientific discipline" ("Clash of Testimony in Hinkley Trial Has Psychiatrists Worried Over Image", The New York Times, May 24, 1982, p. 11). Such a supposed health care specialty should not be tolerated within the medical profession. _________________________________________________

PSYCHIATRY IS NOT A SCIENTIFIC DISCIPLINE _________________________________________________ There is no need for a supposed medical specialty such as psychiatry. When real brain diseases or other biological problems exit, physicians in real health care specialties such as neurology, internal medicine, endocrinology, and surgery are best equipped to treat them. People who have experience with similar kinds of personal problems are best equipped to give counselling about dealing with those problems.

Despite the assertion by Dr. Torrey that psychiatrists can choose to practice real health care by limiting themselves to the 5% or less of psychiatric patients he says do have real brain disease, as even Dr. Torrey himself points out, any time a physical cause is found for any condition that was previously thought to be psychiatric, the condition is taken away from psychiatry and treated instead by physicians in one of the real health care specialties: In fact, there are many known diseases of the brain, with changes in both structure and function.

Tumors, multiple sclerosis, meningitis, and neurosyphilis are some examples. But these diseases are considered to be in the province of neurology rather than psychiatry. And the demarcation between the two is sharp. ... one of the hallmarks of psychiatry has been that each time causes were found for mental "diseases," the conditions were taken away from psychiatry and reassigned to other specialties.

As the mental "diseases" were show to be true diseases, mongolism and phenylketonuria were assigned to pediatrics; epilepsy and neurosyphilis became the concerns of neurology; and delirium due to infectious diseases was handled by internists. ... One is left with the impression that psychiatry is the repository for all suspected brain "diseases" for which there is no known cause. And this is indeed the case. None of the conditions that we now call mental "diseases" have any known structural or functional

changes in the brain which have been verified as causal. ... This is, to say the least, a peculiar specialty of medicine." [The Death of Psychiatry, p. 38-39] Neurosurgeon Vernon H. Mark, M.D., makes a related observation in his book Brain Power (Houghton Mifflin Co. 1989, p. 130): Around the turn of the century, two common diseases caused many patients to be committed to mental hospitals: pellagra and syphilis of the brain. ... Now both of these diseases are completely treatable, and they are no longer in the province of psychiatry but are included in the category of general medicine.

The point is that if psychiatrists want to treat bona-fide brain disease, they must do so as neurologists, internists, endocrinologists, surgeons, or as specialists in one of the other, the real, health care specialties—not as psychiatrists. Treatment of real brain disease falls within the scope of the other specialties. Treatment of real brain disease is not within the usual scope of practice of psychiatrists. It's time to stop the pretense that psychiatry is a type of health care. In the words of Anna Law, M.D., an emergency room physician— It would be good if all the medical professionals who are really practicing medicine and really trying to help people, based on scientific fact and what they can best do to improve the lives of others, if they would recognize, just be able to look at this fact—it's hard to look at it, but look at this fact—and be ethical, and be honest, and clean up the profession by getting rid of this fraudulent part of it: psychiatry. ["The DSM: Psychiatry's Deadliest Scam", YouTube.com at the 1 hr, 15 minutes point, accessed August 15, 2012]

In his book Do Doctors and Nurses Kill More People Than Cancer? (European Medical Journal 2011, available at vernoncoleman.com), British physician Vernon Coleman devotes eight consecutive pages (pp. 28-36) to a devastating and outspoken critique of psychiatry. What follows are a few of his remarks.

Italics are Dr. Coleman's: The idea that anyone would describe psychiatry as a science is utterly absurd. Nothing that psychiatrists claim as "fact" can be proved by any means recognized by scientists... Psychiatry is black magic masquerading as science. ...psychiatry is the greatest con on earth. Officially, one in two people in Britain is incurably mentally ill. ... The bald truth is that psychiatry is no more a science than witchcraft.

It is a perfect example of pseudoscience running riot. ...there is no proof to show that any psychiatric disorders really exist. ... Many psychiatrists claim (apparently meaning it) that we are all mentally ill and that we all need treatment. ... The sad truth is psychiatry is a nonsensical specialty. And all its treatments are unproven rubbish.

Eighteen (18) years after I published, as a pamphlet, the first edition of this essay advocating the abolition of psychiatry as a medical specialty, I attended a lecture by psychologist Bruce E. Levine, Ph.D., on the subject "Can psychiatry as an institution be reformed or does it need to be abolished?" Dr.

Levine's conclusion is that while "in the 1970s psychiatry could have been reformed", today "psychiatry has become psychotic" because of psychiatrists' loss of touch with reality, that psychiatrists have become a "threat to others", and that psychiatry as a profession "needs to be abolished" (National Association for Rights Protection and Advocacy conference, Cincinnati, Ohio, September 8, 2012).

The American Board of Psychiatry and Neurology should be renamed the American Board of Neurology, and there should be no more specialty certifications in psychiatry. Organizations that formally represent physicians such as the American Medical Association and American Osteopathic Association and similar organizations in other countries should cease to recognize psychiatry as a part of the medical profession.

Recommended Reading Richard P. Bentall, Ph.D., Doctoring the Mind—Is Our Current Treatment for Mental Illness Really Any Good? (New York University Press 2009)

James Davies, Ph.D., Cracked—The Unhappy Truth About Psychiatry (Perseus 2013) Stuart A. Kirk, D.S.W., Tomi Gomory, Ph.D. & David Cohen, Ph.D, Mad Science—Psychiatric Coersion, Diagnosis, and Drugs (Transaction Publishers 2013) Colin A. Ross, M.D., The Great Psychiatry Scam—One Shrink's Personal Journey (Manitou Communications, Inc., Richardson Texas 2008) Colin A. Ross, M.D., and Alvin Pam, Ph.D., Pseudoscience in Biological Psychiatry (John Wiley & Sons, Inc. 1995) Thomas Szasz, Psychiatry: The Science of Lies (Syracuse University Press 2008) E. Fuller Torrey, M.D., The Death of Psychiatry (hardcover: Chilton Book Co./paperback: Penguin Books, Inc. 1974) copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents | Next Essay: "Suicide: A Civil Right" ]

Suicide: A Civil Right Wayne Ramsay, J.D. "The proper role of government is exactly what John Stuart Mill said in the middle of the 19th century in his essay, 'On Liberty': The proper role of government is to prevent other people from harming you.

Government, he said, never has any right to interfere with an individual for that individual's own good."

Milton Friedman, Ph.D., a world-renowned economist and winner of the 1976 Nobel Memorial Prize in Economic Sciences, "Milton Friedman — End The Drug War" (1991), YouTube.com at 7:48.

Thinking about suicide is commonplace. In his book Suicide, published in 1988, Earl A. Grollman says "Almost everybody at one time or another contemplates suicide" (Second Edition, Beacon Press, p. 2). In his book Suicide: The Forever Decision, published in 1987, psychologist Paul G. Quinnett, Ph.D., says "Research has shown that a substantial majority of people have considered suicide at one time in their lives, and I mean considered it seriously" (Continuum, p.

12). Nevertheless, thinking about suicide is generally speaking frowned upon and by itself is enough to result in involuntary "hospitalization" and so-called treatment in a psychiatric "hospital", particularly if the person in question thinks about suicide seriously and refuses (socalled) outpatient psychotherapy to get this thinking changed. The fact that people are incarcerated in America for thinking and talking about suicide implies that despite what the U.S. Constitution says about free speech, and despite claims Americans often make about America being a free country, many if not most Americans do not really believe in freedom of thought and speech—in addition to rejecting an individual's right to commit suicide.

In contrast, the assertion that people have a right to not only think about but to commit

suicide has been made by many people who believe in individual freedom. In his book Suicide in America (W. W. Norton & Co. 1982, p. 209), psychiatrist Herbert Hendin, M.D., says this: Partly as a response to the failure of suicide prevention, partly in reaction to commitment abuses, and perhaps mainly in the spirit of accepting anything that does not physically harm anyone else, we see suicide increasingly advocated as a fundamental human right. Many such advocates deplore all attempts to prevent suicide as an interference with that right. It is a position succinctly expressed by Nietzsche when he wrote, "There is a certain right by which we may deprive a man of life, but none by which we may deprive him of death." Taken from its social and psychological context, suicide is regarded by some purely as an issue of personal freedom.

In his book The Death of Psychiatry, published in 1974, psychiatrist E. Fuller Torrey, M.D., said this: "It should not be possible to confine people against their wills in mental 'hospitals.' ... This implies that people have the right to kill themselves if they wish. I believe this is so" (Chilton Book Co., p. 180). In 1968 in his book Why Suicide?, Dr. Eustace Chesser, a psychologist, asserted: "The right to choose one's time and manner of death seems to me unassailable. ... In my opinion the right to die is the last and greatest human freedom" (Arrow Books, London, pp. 123 & 125). In On Suicide, published in 1851, Arthur Schopenhauer said: "There is nothing in the world to which every man has a more unassailable title than to his own life and person" (H. L. Mencken, A New Dictionary of Quotations, Knopf 1942, p.

1161). In a books-on-tape audiocassette version of their book Life 101, published in 1990, John-Roger and Peter McWilliams tell us: "The consistency of descriptions from a broad range of individuals points to the possibility that death might not be so bad. ... Suicide is always an option. It is sometimes what makes life bearable. Knowing we don't absolutely have to be here can make being here a little easier."

Suzy Szasz (daughter of psychiatry professor Thomas S. Szasz), a victim of Systemic Lupus Erythematosus, confirms this view in her book Living With It: Why You Don't Have To Be Healthy To Be Happy after an acute flare-up of her disease during which she contemplated suicide: "As many an ancient philosopher has noted, I found the very freedom to commit suicide liberating" (Prometheus Books 1991, p. 226). In ancient times (circa 485-425 B.C.), Herodotus wrote: "When life is so burdensome death has become for man a sought after refuge." In his book The Untamed Tongue, published in 1990, psychiatrist Thomas Szasz asserts: "Suicide is a fundamental human right. ...society does not have the moral right to interfere, by force, with a person's decision to commit this act" (Open Court Publishing Co., p. 250-251).

To these statements of support for the right to commit suicide, I will add my own: In a truly free society, you own your life, and your only obligation is to respect the rights of others. I believe everyone is entitled to be treated as the sole owner of himself or herself and of his or her own life. Accordingly, I think a person who commits suicide is well within his or her rights in doing so provided he or she does so privately and without jeopardizing the physical safety of others. Family members, police officers, judges, and "therapists" who interfere with a person's decision to end his or her own life are violating that person's human rights. The often expressed view that the possibility of suicide justifies psychiatric treatment even if it must be imposed against the will of the potentially suicidal person is wrong.

Provided the person in question is not violating the rights of others, that person's autonomy is of more value than enforcement of what other people consider rational or of what other people think is in a person's best interests. In a free society where self-ownership is recognized, "dangerousness to oneself"

is irrelevant. In the words of the title of a movie starring Richard Dreyfuss: "Whose Life Is It, Anyway?"

The greatest human right is the right of self-ownership, one aspect of which is the right to life, but another aspect of which is the right to end one's own life. Whether or not a person supports the right to commit suicide is a litmus test of whether or not that person truly believes in self-ownership and the individual freedom that comes with it, the individual freedom that many of us have been taught is the reason-for-being of American democracy.

One reason some oppose the right to commit suicide is theological belief that is sometimes expressed this way: "God gave you life, and only God has the right to take life from you." Using this reasoning to justify interfering with a person's right to commit suicide is imposing religious beliefs on people who may not share those beliefs. In a country such as the United States of America where we supposedly have freedom of (and from) religion, this is wrong.

Another reason some people believe it is ethical to interfere with a person's right to think about or commit suicide is belief in mental illness. But a so-called diagnosis of "mental illness" is a value judgment about a person's thinking or behavior, not a diagnosis of bona fide brain disease. So-called mental illness does not deprive people of free will, but on the contrary is an expression of free will (which reaps the disapproval of others). Those who say mental illness destroys "meaningful" free will or who call the beliefs of others irrational (and therefore necessarily caused by mental illness) are accepting the idea of mental illness as brain disease without adequate evidence or are refusing to accept the beliefs of others only because they differ from their own.

Sometimes people oppose the right to commit suicide because of belief in a sort of entirely nonbiological mental illness. The error of this way of thinking is that without a biological abnormality the only possible defining characteristic of mental illness is disapproval of some aspect of a person's mentality or thinking. But in a free society, it shouldn't matter if the thinking of a person meets with the disapproval of others, provided the person's actions do not violate the rights of others.

Furthermore, there isn't any good evidence that mental illness by any generally accepted definition is usually involved in a person's decision to commit suicide. In her book about teenage suicide, Marion Crook, B.Sc.N., says "teens considering suicide are not necessarily mentally disturbed. In fact, they are rarely mentally disturbed" (Every Parent's Guide To Understanding Teenagers & Suicide, Int'l Self-Counsel Press Ltd., Vancouver, 1988, p. 10). Psychologist Paul G. Quinnett, Ph.D., makes this observation in his book Suicide: The Forever Decision (pp. 11-12): As we have already discussed, however, you do not have to be mentally ill to take your own life. In fact, most people who do commit suicide are not legally 'insane.' So it seems we have a very interesting problem. To prevent you from killing yourself, doctors like myself will stand up in court and say something to the effect that, by reason of a mental illness, you are a danger to yourself and need treatment. But—and this is the weird part—you may, in a matter of a few hours to a couple of days, get up one morning and say, "I've decided not to kill myself, after all." And if you can convince us you mean what you say, you can leave the hospital and go home. Question: Are you now completely cured of your so-called mental illness? Obviously not, since the chances are you were never 'mentally ill' in the first place. ... As I have said, I do not believe you have to be mentally ill to think about suicide.

Dr. Quinnett's statement is a clear admission that allegations of mental illness to justify incarcerating suicidal people often are conscious, deliberate dishonesty, even by the definition of mental illness that exists in the minds of the professionals who make the allegations of mental illness. They make these allegations of mental illness even though they know they are false because involuntary psychiatric commitment laws require a finding of "mental illness" before involuntary commitment may take place.

Making deliberately false accusations of "mental illness" under oath in a court of law to satisfy commitment laws for the purpose of discouraging suicidal thinking or preventing suicide is a way to avoid coming to terms with the fact that incarcerating people only because they happen to think their lives are not worth living or because they have attempted to end their own lives is a form of authoritarianism and despotism. In the case of people who have only thought about (not attempted) suicide, it is imprisonment for mere thought-crime similar to that illustrated by George Orwell in his novel 1984.

Even people who oppose the right to commit suicide because of their belief in mental illness sometimes can be made to understand the erroneousness of their biological theorizing or their belief in some kind of non-biological mental illness by asking them if they would see any point in living if they were suffering from a terminal disease involving excruciating, unrelievable physical pain or were completely paralyzed from the neck down with no chance of recovery. Once people admit there are any circumstances in which they would choose death, they often see suicide is the result of a person's personal judgment about his or her circumstances in life rather than a biological malfunction of the brain or some conception of non-biological mental illness.

Some may feel it is right to use force to prevent suicide because of their belief that the potentially suicidal person's desire to die is probably temporary and will probably go away or subside if he or she is forced to live a short time longer until the acute emotional reaction to a recent traumatic event has faded with time. Those advancing this argument sometimes acknowledge a person does have a right to commit suicide if he or she is not acting impulsively. But most evidence indicates few if any people who commit suicide do so impulsively. As Earl A. Grollman says in his book Suicide (in which he opposes the right to commit suicide): "Suicide does not occur suddenly, impulsively, unpredictably" (p. 63). In his book Suicide: The Forever Decision, psychologist Paul G. Quinnett, Ph.D., says: "I have talked to hundreds of suicidal people... If I can make another guess about what has been going on inside your head and heart, it is that you have had long and difficult discussions with yourself about whether to live or die" (pp. 18-19). In a July 6, 2011 Psychiatric Times article titled "Understanding and Overcoming the Myths of Suicide", Thomas Joiner, Ph.D., Distinguished Professor in the Department of Psychology at Florida State University, includes a section titled "Impulsivity myths" in which he says "Except in works of fiction, I have never encountered a death by suicide that was truly impulsive." Rather than being impulsive, suicide is something people do after long contemplation as part of their efforts to deal with what they consider intolerable life circumstances.

The usual justification for involuntary incarceration and so-called treatment of those considering or attempting suicide is alleged dangerousness to oneself. But even people who don't agree with the principle of self-ownership should ask themselves: dangerousness to oneself in the eyes of whom? To an onlooker, suicide may seem to always be harmful to the person ending his or her life. But that's not how the person committing suicide sees the situation. People commit suicide because they decide continued

living in their particular circumstances is a greater harm to themselves than death. This is made abundantly clear by Francis Lear, editor-in-chief of Lear's magazine, in her autobiographical book, The Second Seduction (HarperPerennial 1992, p. 26): I ALWAYS HAVE an 'exitline.' A stash of lithium. A building tall enough to kill, not maim, for godsake, not maim. One goes out in suicide, one simply goes out, gets out, wriggles, bolts, and does not some back merely smashed up or, as the first priority, left with the ability to feel. One does not go out in a halfassed manner. Suicide has many consequences. It will hurt people who love you, it can splatter the sidewalks; but its purpose, the reason for its magnetism, is that it is the only guaranteed, surefire way to end, blitz, detonate a critical mass of suffering. Suicide, reduced to its pure essence, is a delivery system that moves us from pain to the absence of pain. If the gods contrive against us and the planets are in disarray, if the earth cracks open beneath us, we must always have a way out.

As Dr. Eustace Chesser said, "Suicide is a deliberate refusal to accept the only conditions on which it is possible to go on living" (Why Suicide?, p. 122).

A person's reasons for choosing death may or may not make sense to other people. In a free society, however, that doesn't or at least shouldn't matter. It is a very personal and subjective determination, so how can anyone else reasonably claim to know that a person considering suicide is making the "wrong" decision in terms of "dangerousness to himself" or herself as experienced by that person? As William Glasser, a psychiatrist, says in his book Positive Addiction: "we should keep in mind that we can never feel another person's pain" (Harper & Row 1976, p. 8). In general, I agree with the often heard assertion that "Suicide is a permanent solution to a temporary problem." However, the determination of whether it is best to suffer through a miserable present in the hope of getting to a possibly better future is a value judgment. A person could legitimately decide a hopefully better future does not justify choosing to experience an unbearable present. Emotional pain can be so great refusing to end one's pain by ending one's life can seem like masochism. No one should claim the right to override, by force, a person's value judgments and decisions about something as personal as this.

Why "Suicide Prevention" Promotes Suicide

Another factor to consider is that mental health professionals who force a person considering suicide into "treatment" may be unwittingly promoting suicide, even though they call what they do "suicide prevention". In an article in the May-June 1974 New York University Law Review titled "Involuntary Psychiatric Commitments to Prevent Suicide", New York University sociology professor David F. Greenberg, Ph.D., says studies on psychiatric suicide prevention "have been either inconsistent or negative" and suggest "that institutionalization may not prevent suicide, but, in fact, may result in more suicides" (p. 256, emphasis in original). In his book The Suicidal Mind, psychologist Edwin S. Shneidman says "Neither psychology nor psychiatry can be counted as grand successes as far as suicide is concerned" (Oxford University Press 1996, p. vii). In an interview broadcast April 18, 2009, John Sadler, Professor of Psychiatry and Clinical Sciences and Medical Ethics at the University of Texas Southwestern Medical Center said this:

Well, what troubles me the most about involuntary treatment, other than the obvious humanistic costs, is the lack of any real science to suggest that commitment laws really make a difference in saving people's lives. You might say the sacred symbol of commitment laws is suicide prevention, and we really don't know whether commitment laws really prevent people taking their lives. That seems to me to be very problematic, and that's something that not just psychiatrists need to consider but societies in general, and the lawmakers that make these requirements. [Thomas Szasz: psychiatrists respond, accessed January 16, 2015]

In a study titled "Suicide Prevention: Prevention Effectiveness and Evaluation" supported by a grant from the Centers for Disease Control (CDC), published in 2001 (available at sprc.org), the researchers reached this conclusion: "At this point, most suicide prevention efforts currently in place assume efficacy, with little or no scientific evidence." The researchers warned: Do no harm is an ethical principle that should be at the forefront of concern when implementing any program. Some suicide prevention techniques are associated with potential hazards. Some hazards may result directly from prevention efforts. ... Without evaluation of programs, we do not know if the program benefits or harms the people we are trying to help. [pp. 16, 20, bold print and italics in original] A World Health Organization (WHO) study published in July 2004 titled "For which strategies of suicide prevention is there evidence of effectiveness?" reached this conclusion (p. 4): Findings About 30 types of suicide preventive interventions were evaluated in the published research, which covered the whole spectrum of primary and secondary prevention efforts. More than half of these interventions fall into the domain of treatment rather than prevention and maintenance. Limited evidence indicates that no single intervention appeared to be effective in reducing the suicide rate.

In Brain-Disabling Treatments in Psychiatry, Second Edition (p. 223) psychiatrist Peter Breggin says— ECT is frequently justified as treatment of last resort in cases at high risk for suicide. But research uniformly shows that ECT has no beneficial effect on the suicide rate. Indeed, the most thorough study available, published in the British Journal of Psychiatry in 2007, found an overall increased rate of suicide in patients previously given ECT (Munk-Olsen et al., 2007). In addition, "patients treated with ECT in the past week had a greatly increased risk of suicide compared with other patients (RR=4.82, 95% CI 2.2210.95)" [p. 437, emphasis added].

The study is titled "All cause mortality among recipients of electroconvulsive therapy", British Journal of Psychiatry, Vol. 190, pp. 435-439.

In her book Doctors of Deception—What They Don't Want You to Know About Shock Treatment (Rutgers University Press 2009, pp. 98, 99, 286), Linda Andre says this:

One such study in 1950 found that patients who had received ECT committed suicide at twice the rate of those who hadn't received it. ... Study after study from the 1970s to the present shows that if ECT indeed has any effect on suicide, it is that people who have had ECT may be more likely to die from suicide or other causes than persons who haven't had it ... and that some of those who did made it clear that ECT's effects or fear of further ECT was the reason they had chosen to end their lives.

In his book Suicide Prohibition—The Shame of Medicine, published in 2011, psychiatry professor Thomas Szasz concludes: "There is no evidence that suicide prevention prevents suicide" (p. 69).

At his 2012 Empathic Therapy Conference in Syracuse, New York, psychiatrist Peter Breggin said this: There are no studies showing that locking up people reduces their suicide rate. That'd be a very easy thing to do. It'd be very easy to look at a hospital cohort, get some sort of an outpatient group, and look at their suicide rates, or at anything else. Not a hard study. If they're being done, they're not being published, because they don't show that there is any benefit to being in a [psychiatric] hospital or being involuntarily confined. [Discussion following presentation by Dr. Rachel Bingham, MBBS] One reason so-called suicide prevention promotes suicide is the harmfulness of today's biological "treatments" in psychiatry. People subjected to involuntary "medication" often describe the experience as torture (see Why Psychiatry is Evil), and all or nearly all "hospitalized" psychiatric patients, including those thought suicidal, are forced (yes, forced) to take psychiatric drugs. In his book Suicide Prohibition— The Shame of Medicine, psychiatry professor Thomas Szasz warns: "When mental hospitals and psychiatrists use torture, they call it suicide prevention" (p. 98, italics in original). In the same book Dr. Szasz says involuntary treatment of a person considering suicide is "ostensibly to prevent his death, actually to punish him for disturbing the orderly functioning of his family and society" (p. 11). _________________________________________________ PSYCHIATRIC TREATMENT SUCH AS E.C.T. MAKES SUICIDE MORE LIKELY _________________________________________________

The dreariness and cruelty involved in forcing a person to live in a mental hospital may make death seem preferable. As ACLU Capital Punishment Director John Holdridge has observed, "A state hospital is as bad as a prison" (speech at New Hampshire Civil Liberties Union's Annual Meeting, archived at aclu.org). Lawrence Schwartz, staff attorney for the Mental Health Law Project of Washington, D.C., alleges incarceration in "mental institutions is often indistinguishable or even worse than criminal incarceration" ("The Civil Commitment Process: Established and Emerging Rights" in Legal Rights of the Mentally Handicapped, Practicing Law Institute 1973, p. 113 at 128). A woman in Pennsylvania who served time in both the Allegheny County Jail and a psychiatric ward of the University of Pittsburgh Medical Center, both in 2015, told me "I would rather be in jail than be in a mental hospital." In his book Brain-Disabling

Treatments in Psychiatry, Second Edition (Springer Publishing Co. 2008, p. 440), psychiatrist Peter Breggin says "Traditional mental hospitals are extremely controlling, authoritarian, humiliating, and physically dangerous places—exactly the opposite of what already overwhelmed people need." In his pseudopatient study, Stanford University psychology professor David Rosenhan found— Neither anecdotal nor "hard" data can convey the overwhelming sense of powerlessness which invades the individual as he is continually exposed to the depersonalization of the psychiatric hospital. ... The consequences to patients hospitalized in such an environment—the powerlessness, depersonalization, segregation, mortification, and self-labeling—seem undoubtedly counter-therapeutic. ["On Being Insane in Insane Places", Science, January 19, 1973, Vol. 179, p. 250 at 256-257]

Sometimes private, for-profit hospitals are even worse than a state hospital because of prolonged, unjustified, involuntary commitment and expensive, harmful, forced "treatment" such as involuntary electroconvulsive "therapy" (ECT) to enhance profit. According to a Houston Chronicle article— A [Texas State] Senate committee Wednesday recommended that the state take steps to clamp down on the use of "shock therapy" in private psychiatric hospitals. ... The Senate Interim Committee on Health and Human Services ... has been investigating abuses at private psychiatric hospitals ... Although the use of electroconvulsive therapy, known as ECT or "shock therapy" is tightly controlled in public hospitals, it remains virtually unregulated in private facilities, where its use reportedly is increasing. [Clay Robinson, "Panel suggests tighter rules on shock treatment", Sec. A, p. 17, 04/02/1992]

So-called suicide prevention also promotes rather than prevents suicide because of psychiatric stigma causing lowered self-esteem. In her autobiography, Too Much Anger, Too Many Tears—A Personal Triumph Over Psychiatry, Janet Gotkin calls her hospitalizations after suicide attempts "ten years of indoctrination into my fundamental worthlessness" (p. 383). What would being institutionalized for mental illness do to your self-esteem?

An associated and even more reliable effect of inpatient psychiatric "treatment" is diminished respect from others and anticipated or actual discrimination in education, employment, and important personal, including intimate, relationships.

For these reasons, increased rates of suicide among people considering suicide who get psychiatric "treatment" compared with a similar population of people considering suicide who do not get "treatment" should be expected. The value of recognizing the right to commit suicide is not only respecting individual freedom but preventing the harm and cruelty that typically go on in the name of suicide prevention and, ironically, preventing suicides precipitated in part by counterproductive suicide prevention efforts.

In addition to creating problems that are added to a person's already existing problems, coercive suicide prevention may cause people who are considering suicide to deliberately mislead others about the fact they are considering or planning to commit suicide, making it impossible for others to offer suggestions or ideas or do anything that is genuinely helpful that might make suicide a less appealing choice. As one mental health worker said: "...a person who wants to kill self will do so quietly and will

not go to ER [Emergency Room], doctor's office or family members and announce he/she will kill self. It does not make sense to announce it when one knows something will be done to prevent it" (Thimmappayya Hasanadka, a reply to "Can a Suicide Scale Predict the Unpredictable?" by Arline Kaplan, psychiatrictimes.com, May 23, 2011). Psychiatry professor Thomas Szasz was correct when he said "Suicide prohibitions have not succeeded in preventing suicides but have succeeded in preventing people from having an honest, private conversation about life and death. Those persons who trust mental health professionals with their innermost thoughts may quickly find themselves punished with a 'seventy-two-hour hold' or worse" (Suicide Prohibition—The Shame of Medicine, pp. 82-83).

An example is Michael Wechsler, who ended his life at age 26 with an intentional overdose of his psychiatric prescription "medication" the evening of May 15, 1969. According to his father's biographical and autobiographical book, In a Darkness, in which he refers to his son's successive therapists as "Dr. First", "Dr. Second", and so forth, "Dr. Eighth...had seen Michael for a long time during the late afternoon of his final day and detected nothing that inspired any fear. Until Michael's [suicide] note was found, she had convinced herself—and was attempting to persuade me—that his death must have been a pharmaceutical accident." According to Dr. Eighth, her psychotherapy session with Michael only several hours before his death "had been largely devoted to talking about his plans for going back to Harvard [University]" where he had been a student. The next day, after his death, in his bedroom his parents found a large bottle labeled "May 15", where he had apparently stashed the psychiatric "medications" with which he ended his life, as well as his suicide note. Michael Wechsler's true-life story, ending with his well-planned suicide after "therapy" with eight therapists, illustrates a number of truths: (1) Psychiatric and psychological "therapy" is of no or negative value. After Michael's death, his father concluded his son's "therapy, especially in the last months, was essentially worthless or even harmful."

(2) So-called suicide prevention actually promotes suicide, in part because of psychiatric stigma. In Michael's father's words: "We had observed during Michael's illness the discomfort he often suffered from being identified as a 'mental patient' and had sensed how being set apart this way had complicated his problems". (3) Mental health "professionals" cannot predict future human behavior, including suicide. (4) Psychiatry's "medications" are toxic (poisonous). In the "therapeutic" range they cause discomfort or disability. In larger doses they cause death. (5) People whose frustrations with life make their lives of more negative than positive value to themselves often know they cannot tell anyone they are considering suicide if they sincerely want to have the option of ending their pain by ending their lives. Reflecting on his son's intentional, lethal overdose, Michael's father wrote: "I remember thinking that, if Michael survived, he again faced hospital 'imprisonment.'" Michael probably knew that, too. He probably also knew he would again face "hospital imprisonment" if he admitted to "suicidal ideation". So he intentionally deceived everyone including his "therapist", Dr. Eighth, with his false plans for the future, giving her and everyone else who knew him not only no chance to subject him to the horrors of psychiatric assault that psychiatrists call "suicide prevention" ("hospital imprisonment", torturous involuntary "medication" and/or electroshock, and 4 or 5 point physical restraints, particularly if the "patient" resists this mistreatment) but also no chance to say or do anything genuinely helpful that might have changed his mind. (James A. Wechsler, In a Darkness, W.W. Norton & Co. 1972, pp. 14, 152, 153, 156, 157).

Suicidal Ideation as Constitutionally Protected Freedom of Thought

"Do you have suicidal ideation?" and "Have you been thinking about killing yourself?" frequently are questions in psychiatric evaluations and in civil commitment proceedings. Black's Law Dictionary says "Every confinement of the person is an 'imprisonment' whether it be in a common prison, or in a private house, or in the stocks, or even by forcibly detaining one in the public streets" (1968 edition, p. 890). Involuntary hospitalization is therefore a type of imprisonment. As psychiatry professor Thomas Szasz says in his book The Age of Madness: The History of Involuntary Mental Hospitalization (Anchor Books 1973, p. xi), "mental hospitals, for example—are medical in name only; actually, they are prisons disguised as hospitals." Even if it is called hospitalization, imprisoning a person because of what he is thinking is an obvious violation of the First Amendment to the U.S. Constitution if the First Amendment guarantees and protects the right to think as well as speak and write freely on all subjects. In Wooley v. Maynard, 430 U.S. 705 at 714 (1977), the U.S. Supreme Court said there is "a right of freedom of thought protected by the First Amendment." In Palko v. Connecticut, the U.S. Supreme Court said "freedom of thought...is the matrix, the indispensable condition, of nearly every other form of freedom. With rare aberrations, a pervasive recognition of that truth can be traced in our history, political and legal. So it has come about that the domain of liberty, withdrawn by the Fourteenth Amendment from encroachment by the states, has been enlarged by latter-day judgments to include freedom of the mind" (302 U.S. 319 at 326-327 (1937), overruled on another issue (double jeopardy in criminal cases) in Benton v. Maryland, 395 U.S. 784 (1969). Novelist George Orwell sought to warn against incarceration for what he called thought crime in his novel Nineteen Eighty-Four. His warning about this happening in the future, by the year 1984, was valid whether or not Orwell realized imprisonment called hospitalization merely because of what a person is thinking was a already a reality in 1949 when Orwell published the novel, and regardless of whether the disallowed thinking is called crime or illness. In his book Suicide Prohibition—The Shame of Medicine, psychiatry professor Thomas Szasz correctly points out that "thinking about suicide is simply thinking, a symptom of freedom of thought" (p. 9).

Depriving a person of liberty merely because of what he is thinking, with no evidence of biological abnormality needed to establish the existence of an illness or disease, is a violation of the First Amendment right to freedom of thought, whether or not the loss of liberty is disguised as or falsely said to be benevolence or for a supposedly therapeutic purpose.

Judicial Decisions

In his book Death With Dignity, published in 1989, attorney Robert L. Risley says in general "court cases clearly established the right to bodily integrity, confirming that the basic right of self-determination includes the right to die, and that it overrides the state's duty to preserve life" (Hemlock Society, Eugene, Oregon, 1989, p. viii).

The U.S. Supreme Court addressed the question of whether the U.S. Constitution protects the right to die in 1990 in the case of Cruzan v. Missouri, 497 U.S. 261. In the words of Time magazine, in this case the U.S. Supreme Court "declared for the first time that there is indeed a right to die" (July 9, 1990, p. 59). Of the nine justices, all except Justice Scalia acknowledged the right to die is a federal constitutional right. In his concurring opinion, Justice Scalia argued vigorously against the reasoning of the majority and dissenting opinions, both of which

acknowledged the right of self-determination is a constitutional right and that it includes the right to die. Justice Scalia opposed the view of the other eight justices, arguing vigorously against what he called the right to commit suicide. But in this respect he stood alone on the Court. _________________________________________________

FREEDOM OF THOUGHT IS ESSENTIAL TO EVERY OTHER FORM OF FREEDOM _________________________________________________ The Cruzan decision illustrates the fact that courts are more likely up uphold the right to die in cases involving physically ill or disabled people who choose to refuse treatment and allow a natural process to end their lives, particularly if they are conscious enough to express their desire to die or who when healthy enough to do so indicated death is what he or she would want in the circumstances. The sick or disabled person's supposed desire to die is probably in many cases a mere excuse or rationalization that conceals the real reason family members and courts allow them to die. If the sole reason for permitting death was the desire of the ill or disabled person, involuntary commitment of persons who admit they are thinking about committing suicide would not take place. A bona-fide but unacknowledged reason ill or disabled people are allowed to end their lives is they have become a burden to other people. Just as able-bodied people who consider suicide are incarcerated for their own supposed benefit (to supposedly prevent them from committing suicide) when the real reason is selfish concerns of others, people with severe, permanent disability or incurable disease are allowed to die for their own supposed benefit when a real but unacknowledged purpose is to relieve others ("society") of the burden of caring for them.

The U.S. Court of Appeals for the Second Circuit ruled in favor of a right to physicianassisted suicide in Quill v. Vacco, 80 F3rd 716 (1996). The following day a headline in The Wall Street Journal read "Court Rules Suicide is a Constitutional Right" (April 3, 1996, p. B1). The U.S. Supreme Court reversed the Second Circuit, saying there is no "right to hasten death".

However, the Supreme Court also said people have "well-established, traditional rights to bodily integrity and freedom from unwanted touching" and therefore may refuse life-saving treatment and deliberately allow a natural process to end their lives (Vacco v. Quill, 521 US 793 at 807, 1997).

Courts split two-to-two on the right to physician-assisted suicide in Compassion in Dying v. State of Washington. A federal district court judge ruled in favor of a right to physician-assisted suicide, only to be reversed by a three-judge panel of the U.S. Court of Appeals for the Ninth Circuit, which was in turn reversed by the Ninth Circuit sitting en banc (eleven judges), which was reversed by the U.S. Supreme Court in Washington v. Glucksberg, 521 US 702 (1997). The opinions of the U.S. Supreme Court in Cruzan, Vacco, and Compassion in Dying/Glucksberg do not support my opinion there is or should be a right to commit suicide, but the rulings in and reasoning of those same decisions create a right to refuse suicide prevention if suicide prevention is considered health care and if the decision to refuse it is made when mentally competent, such as in a psychiatric advance directive.

State courts may find there is a right to commit suicide under state law even if federal courts find there is no such right under the U.S. Constitution. For example, in Baxter v. Montana, a District Court judge found there is a right to physician-assisted suicide under the Montana Constitution, as did a concurring Supreme Court of Montana justice. The Supreme Court of Montana majority ruled in favor of the right to physician-assisted suicide on state statutory rather

than state constitution grounds (224 P3d 2011, 354 Mont 254 (2009).

Psychiatrist Allen Frances correctly says "suicide is the most personal of human decisions" (Saving Normal, HarperCollins 2013, p. 14). Other people have no more right to dictate this decision to an individual any more than they have the right to tell a person who to marry or what occupation or profession to enter. _________________________________________________

SUICIDE IS THE MOST PERSONAL OF ALL HUMAN DECISIONS _________________________________________________ According to a Jurist news report on May 14, 2013, the European Court of Human Rights (ECHR), interpreting Article 8 of the European Convention on Human Rights, ruled that Article 8— ... protects an individual's right to respect for private life, which was interpreted by the court in the 2011 case Hass v. Switzerland to include an individual's right to decide the way in which and at which point his or her life should end, so long as he was in a position to form his own judgment and act accordingly. In the present case of Gross v. Switzerland, applicant Alda Gross, an elderly Swiss woman, petitioned the ECHR after she could not find a doctor to prescribe her a lethal dosage because she suffered from no clinical illnesses.

The Court ruled in favor of Ms. Gross's right to end her life, saying "that Gross's right to respect for her private life was violated". The report says assisted suicide is permitted in Belgium, the Netherlands, Luxembourg, and Switzerland ("Europe rights court rules Switzerland laws on assisted suicide too vague", jurist.org). A February 2, 2007 news report says "The Swiss Supreme Court has issued a decision saying that chronically depressed and mentally ill people have a 'right' to assisted suicide. ... The suit claimed a right to suicide for the mentally ill under the European Convention of Human Rights." The court said "it is difficult to determine if the desire for death is a function of the illness calling for treatment, or the result of a 'self-determined, carefully considered and lasting decision of a lucid person ('balance suicide') which possibly needs to be respected'" ("Mentally Ill have a Right to Assisted Suicide—Swiss High Court", lifesitenews.com).

Another report, titled "Death on Demand | First Things", dated February 8, 2007, by Wesley J. Smith (http://www.firstthings.com) about the same or a similar decision, says "The Swiss Supreme Court has ruled that people with mental illnesses can be legally assisted in suicide. ... The Swiss high court ruled, 'It must be recognized that an incurable, permanent, serious mental disorder can cause similar suffering as a physical (disorder)'. ... The Dutch Supreme Court [found] that the law cannot distinguish between suffering caused by physical illness and that caused by mental anguish."

According to another report, "A Dutch Supreme Court ruled that a psychiatrist, who assisted the suicide of a woman in grief over her dead children, had not acted wrongly because suffering is suffering and it doesn't matter whether it is physical or emotional" ("Assisted Suicide and Euthanasia—Why the CBC [Center for Bioethics and Culture network] Opposes Assisted Suicide and Euthanasia", http://www.cbc-network.org, accessed July 27, 2013).

I have always had mixed feelings about veterinarians because they kill animals as well as try to heal

them. For similar reasons, I am opposed to physicians killing human beings. At the same time, a person's right to decide to end his life and do it by his own hand seems to me beyond question. I oppose the use of psychiatric "diagnosis" to justify force against a person only because he chooses to end his own life.

Conclusion

The above cited European court decisions support my opinion that freedom to choose the time of one's own death, before death becomes inevitable, is a fundamental human right with which other people (acting through government) have no right to interfere. Additionally, the opinions of U.S. courts upholding the right to die, whether with a physician's help or by refusing life-saving treatment, emphasize personal autonomy and self-determination as the reason for the decision and therefore also provide some support for my opinion each person should be considered the sole owner of himself or herself, of his or her own body, and of his or her own life. A logical extension of this reasoning is each person's right to commit suicide provided he does so privately and does not physically jeopardize others, and for any reason that seems sufficient to him, whether or not it seems sufficient to others, and whether or not his decision seems rational to others: It is an individual prerogative. In the words of former congressman and Secretary of Defense Donald Rumsfeld, "free people are free to be wise and to be unwise. That's part of what freedom is" ("Secretary Rumsfeld Interview with Parade Magazine", October 12, 2001, available at http://www.defense.gov). If we are only free to be wise (as judged by others), we are not free but are, in a sense, slaves: To be a slave is to be a person who has no control over his life.

Reducing people to this kind of slavery is one aspect of involuntary psychiatric treatment. In the words of psychologist Jeffrey A. Schaler, Ph.D., "Involuntary commitment is a form of assault and battery. ... Normally, we call it slavery when people earn their living by depriving others of their liberty" ("Reply to Allen Frances", August 17, 2012, http://www.cato-unbound.org). The World Book Encyclopedia (1957, p. 7498) says "SLAVERY is a practice in which human beings are held captive, or owned, by other human beings." The essence of ownership is control. Black's Law Dictionary (West Publishing 1968, p. 1559) defines "SLAVERY" as "that civil relation in which one man has absolute power over the life, fortune, and liberty of another." That's the situation of people subjected to involuntary "hospitalization" (and those subjected to involuntary guardianship or conservatorship). Slavery also might be defined as being forced to live one's life for the benefit of other people rather than for one's own benefit. Involuntary mental patients qualify as slaves by this definition because coercive supposed suicide prevention or other psychiatric "therapy" benefits the so-called therapists who earn handsome incomes from their counter-productive suicide prevention efforts and other supposed therapy, not those who are subjected to imprisonment called involuntary hospitalization and assault called involuntary medication, involuntary electroconvulsive "therapy", or forcible and torturous application of physical restraints. As psychiatry professor Thomas Szasz says in his book, Suicide Prohibition —The Shame of Medicine, "Together with mental health, suicide prevention is a cornucopia of pseudotherapeutic 'programs' that deprive people of essential liberties and enrich quacks ...

Today, so-called suicide prevention is a quasi-medical specialty and a big business" (Syracuse University Press 2011, pp. 5-6, 11). Another of Dr. Szasz's books about involuntary civil commitment for mental illness is titled Psychiatric Slavery (Free Press 1977, Syracuse University Press 1998).

Considering the cruelty and harmfulness of modern psychiatric treatment, including so-

called suicide prevention, and the prevalence of unjustified involuntary psychiatric treatment in supposedly free countries such as the U.S.A., everyone would be well advised to have a psychiatric advance directive refusing treatment for "mental illness", particularly all biological treatment in psychiatry, as well as anything called suicide prevention.

If you are a state or federal legislator who believes in each person's right of selfownership, you should introduce legislation to delete references to "dangerousness to oneself" in state and federal involuntary psychiatric treatment laws. Judges should strike down as unconstitutional laws that imprison (involuntarily "hospitalize") or permit involuntary outpatient psychiatric treatment only because of a person's past or predicted future harm to himself or herself. Laws allowing imprisonment, preventive detention, or involuntary "hospitalization" for "dangerousness", whether to oneself or others, are unconstitutional because of the impossibility of predicting the future accurately enough to satisfy any burden of proof, as I document in Is Involuntary Commitment for "Mental Illness" or "Dangerousness" a Violation of Substantive Due Process? This being the case, state and federal legislators should repeal laws calling for involuntary hospitalization or outpatient treatment of people based on psychiatrists' (or other persons') predictions of future behavior, i.e., "dangerousness", and judges should strike down such laws as unconstitutional, just as they would repeal or strike down as unconstitutional laws authorizing incarceration or forced treatment based on predictions of future behavior or "dangerousness" by astrologers.

For both ethical and practical reasons, we should respect the freedom of people to do whatever they want with their lives if their past conduct has not unlawfully harmed others.

Recommended Reading

Thomas Szasz, M.D., Suicide Prohibition—The Shame of Medicine (Syracuse University Press 2011).

Thomas Szasz, M.D., "The Ethics of Suicide" in The Theology of Medicine (Syracuse University Press 1988), pp. 68-85 copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents | Next Essay: "Psychiatric Stigma" ]

Psychiatric Stigma Follows You Everywhere You Go for the Rest of Your Life Wayne Ramsay, J.D.

A problem you should think about before consulting a mental health professional, or encouraging or forcing someone else to do so, is the stigma of having received the so-called therapy. If you seek counseling or "therapy" from a psychiatrist or psychologist, how are you going to answer questions on applications for occupational or professional licenses, a driver's license, applications for health or life insurance, and school and college applications, such as "Have you ever had psychiatric or psychological therapy?" When you apply for a job or occupational license or a driver's license or apply for an insurance policy or admission to an educational program you will often be required to answer this or a similar question. When you answer such questions candidly and admit having received psychiatric or psychological "help", the result often will be loss of important opportunities: Answering "yes" to such questions often results in rejection for employment or licensure or admission to college or other educational program or denial of insurance coverage. Sometimes you will be forced to ask your "therapist" to breach the confidentiality of your communications with him or her by making a report on you in order for you to get a job, license, insurance coverage, or admission to school. If you conceal your experience of psychiatric or psychological "therapy" by answering "no", thereafter you will have to be careful to watch what you say and to whom, and you may with good reason worry about being found out-since you run the risk of being fired from a job or expelled from school or suffering revocation of licensure if your deception is ever discovered. You may eventually find the insurance policy you have been paying premiums on for many years is valueless because of what you concealed on the application for the policy several years earlier.

In his book The Powers of Psychiatry, Jonas Robitscher, J.D., M.D., Professor of Law and Behavioral Sciences at Emory University's Schools of Law and Medicine, pointed out that "Applicants for the state of Georgia bar examination, like applicants in many other states, are required to state ... whether they have ever received diagnosis of ... emotional disturbance, nervous or mental disorder, or received regular treatment for any of these conditions. Although there is no known instance of this information having been used to keep an applicant from taking the examination or being admitted to the Georgia bar, there are instances of denying applicants in other jurisdictions" (Houghton Mifflin Co. 1980, p. 234).

In the same book Dr. Robitscher described the case of a medical school applicant who had graduated from college magna cum laude, who was admitted to Phi Beta Kappa, and who scored in the upper ninety-ninth percentile in the Medical College Admission Test—but who was denied admission to medical school because she had sought psychiatric treatment (pp. 238-239). He said this is typical of "prejudicial policies of not admitting or readmitting students who have had or are undergoing psychotherapy" (p. 239).

An airline pilot told me he was grounded for seven months by the Federal Aviation Administration because he revealed he had been seeing a psychiatrist (for so-called outpatient psychotherapy) on the medical history questionnaire he was required to fill out as part of his routine periodic medical examinations required of airline pilots and which involved criminal penalties (a fine of up to $10,000 and/or up to five years imprisonment) for concealing the requested information. He told me he enjoyed seeing the psychiatrist but that the hassle which resulted from his doing so, because of the questions it created about his job qualifications, outweighed whatever benefit came from seeing the psychiatrist. He said that all factors considered, "It wasn't worth it." When taking physical examinations, pilots in the United States are required to "List all visits in the last three years to a physician, physician assistant, nurse practitioner, psychologist, clinical social worker, or substance abuse specialist for treatment,

evaluation, or counseling. Give date, name, address, and type of health professional consulted, and briefly state reason for consultation. ... Routine dental, eye, and FAA periodic medical examinations may be excluded" (FAA Form 8500-8, italics added). This suggests that, contrary to what some people think, anyone consulting a psychologist or clinical social worker is considered suspect. That is, stigma attaches to anyone consulting not only psychiatrists, but also psychologists or social workers. Routine dental or eye examinations involve no stigma or suspicion of disqualification and therefore are not required to be reported.

The 1988 Democratic Party Presidential nominee, Massachusetts Governor Michael Dukakis, in the words of Newsweek, "was accused of having received psychiatric treatment" ("The High Velocity Rumor Mill", Newsweek, August 15, 1988, p. 22. See also, Andrew Rosenthal, "Dukakis Releases Medical Details To Stop Rumors on Mental Health", The New York Times, August 4, 1988, p. 1). The accusations proved to be false, but the impression given by the news reports about this story is that Dukakis' presidential campaign would have been doomed by this one fact alone if the claim he had ever consulted a psychiatrist or psychologist had proven to be true. In 1972 U.S. Senator Thomas Eagleton was nominated for VicePresident of the United States at the Democratic National Convention but subsequently was removed from the ticket by the Democratic National Committee when it became known he had undergone psychiatric treatment, including hospitalization and electric shock treatment.

Bruce Ennis, an American Civil Liberties Union (ACLU) attorney who has represented people deprived of employment because of psychiatric stigma, argues that "In the job market, it is better to be an ex-convict than an ex-mental patient." He says "very few employers will knowingly hire an ex-mental patient." He points out that "Almost all public employers and most large companies ask job applicants if they have ever been hospitalized for mental illness" and that "If the answer is yes, the applicant will almost certainly not get the job". Mr. Ennis also points out that "if the applicant lies and says no, he runs the risk of eventual discovery". On this basis Mr. Ennis argues that "It is time for psychiatrists and judges to face the brutal facts. When they commit a person to a mental hospital, they are taking away not only his liberty, but also any chance he might have for a decent life in the future." On the basis of his experience as an attorney for people saddled with psychiatric stigma he observes that "Even voluntary hospitalization creates so many problems and closes so many doors that an old joke takes on new truth —a person has to be crazy to sign himself into a mental hospital" (Bruce J. Ennis, Prisoners of Psychiatry: Mental Patients, Psychiatrists, and the Law, Harcourt Brace Jovanovich 1972, pp. 143-144). Mr. Ennis wrote those remarks in 1972, but if anyone is inclined to think psychiatric stigma substantially diminished during the 1970s and 1980s, consider once again the reaction of the press and public in 1988 to the apparently false allegation that presidential candidate Governor Michael Dukakis had previously consulted a psychiatrist. That it should be such a headline grabbing issue shows how stigmatizing is any experience as a psychiatric "patient". This public reaction is particularly noteworthy in light of the fact that Governor Dukakis was accused only of consulting a psychiatrist in his office, not psychiatric hospitalization.

The presumption of unreliability, untrustworthiness, and emotional instability which flows from having ever sought psychiatric or psychological "therapy" doesn't haunt only people with responsibilities like doctors, lawyers, airline pilots, and Presidential or VicePresidential candidates: In his book, Prisoners of Psychiatry, ACLU attorney Bruce Ennis reports many cases of people who have been denied taxi driver licenses because of past psychiatric treatment even though "Most of them had never been hospitalized"

and had never done anything to suggest they were dangerous (p. 160).

In a book she wrote, Eileen Walkenstein, M.D., a psychiatrist, says "A psychiatric diagnosis is like a jail sentence, a permanent mark on your record that follows you wherever you go" (Don't Shrink To Fit! A Confrontation with Dehumanization in Psychiatry and Psychology, Grove Press 1975, p. 22). If you consult a mental health professional, you will probably get some kind of "diagnosis", particularly if health insurance is paying for the consultation or "therapy", since the psychiatrist or psychologist will probably be required to provide a "diagnosis" to the insurance company to get paid for whatever (supposed) service is provided. In at least some states, professional licensing laws require mental health professionals, including psychologists, to keep a written record of "diagnosis" and "treatment".

In 1992, Commenting on the Americans with Disabilities Act (ADA), Peter Manheimer, chairperson of the Commission for the Advancement of the Physically Handicapped, said "It is most appropriate that the ADA protects recovering drug addicts, alcoholics, persons with AIDS, and persons who have mental and psychological disabilities, as they form the most misunderstood and feared portion of the disability community. They suffer the greatest discrimination" (Peter Manheimer, "Reporting on persons with disabilities", letter to the editor, Miami Herald, July 24, 1992, p. 16A-italics added).

And "a study by the National Institute of Mental Health in 1993 found that even ex-convicts rank above former mental patients in social acceptance" (Chi Chi Sileo, "Rip-offs Depress Mental Health Care", Insight magazine, January 24, 1994, p. 14.) This article quotes a psychiatric hospital patient saying "The stigma is incredible ... Forget telling an employer! Sometimes they find out anyway, and all of a sudden you're unfit to work there" (Id). In his autobiography, Kenneth Donaldson said after he had been committed to a psychiatric hospital, people "accepted a psychiatric diagnosis which forever rent the fabric of my life. Thereafter, not only society at large but members of my family would not see Ken the son and father and friend, but Ken the mental patient. From this would flow unimagined misery, a fog which would envelop all our lives. And our situation would be, of course, representative of millions. The fog would seep into my employment, my relations with doctors, my access to lawyers and the courts.

Every enterprise in which I would engage would be poisoned by the label. It haunted me and frightened others" (Insanity Inside Out, Crown Pub. 1976, p. 321).

In an article published June 4, 2012, H. Steven Moffic, M.D., wrote "I don't think by today that there can be any question that there is significant discrimination and prejudice against those who are deemed to have some sort of significant mental problem. Many times, that has resulted in trying to keep such people out of mainstream society, whether that be hospitalization, not being able to live in certain neighborhoods, and not being hired for work. ... We have the continuing stigma against people who are called 'crazy'" ("Psychism: Defining Discrimination of Psychiatry", psychiatrictimes.com).

In his book The Powers of Psychiatry, Emory University professor Jonas Robitscher, J.D., M.D., said this: Psychiatrists have been so criticized for the errors or vagueness in their labeling procedures because the label produces a new disability, which often remains as a burden long after the symptoms that led to the label have departed. ... A study of the attitudes in a small town indicates that fellow townspeople reject other members of the community in a direct relationship to the professionalization and specialization of the source of help, with the least rejection when help is sought from a clergyman, increasing percentages of rejection for those seeking psychiatric help from physicians and psychiatrists, and the

most rejection for those who get mental hospital help. A study of work supervisors shows that the knowledge that an employee is seeing a psychiatrist would be likely to rule out a promotion even if the employee is doing good work...The harm and potential harm done to mental patients and former mental patients is not only confined to those who have had serious illnesses, those who have been hospitalized or who have had to interrupt careers or schooling. Psychiatrists know that many people who consult them as outpatients are much less 'sick' than many or most of the general population. If these people had decided not to be patients but instead to be clients or parishioners and had taken their problems to a social worker, a pastoral counselor, or a faith healer, they would have incurred no stigma. ... The ubiquitous questionnaires that ask, 'Have you ever consulted a physician for a physical or emotional or mental condition?' do not take account of those who should have and haven't, or those who are able to answer no because they have taken their problems to an encounter group, a sensitivity-training session, an est seminar, or a consciousness-raising group, and so have escaped the discriminatory effect of seeking help. [pp. 230, 232, 233] The difficulty of getting a health insurance policy after having sought psychiatric or psychological "therapy" or even marriage counselling was mentioned in the August 1990 issue of Consumer Reports in an article titled "The Crisis in Health Insurance": "Virtually no commercial carriers and only a handful of Blue Cross and Blue Shield plans will sell policies to anyone who has had heart disease, internal cancer, diabetes, strokes, adrenal disorders, epilepsy, or ulcerative colitis. Treatment for alcohol and substance abuse, depression, or even visits to a marriage counselor can also mean a rejection. If you have less serious conditions, you may get coverage, but on unfavorable terms" (p. 540, italics added). In the U.S.A., the Patient Protection and Affordable Care Act known as "Obamacare" contains a provision effective in 2014 prohibiting health insurance companies from rejecting applicants because of a pre-existing condition. Time will tell if repeal efforts that have passed the U.S. House of Representatives will ultimately succeed and whether insurance companies will limit their risk by finding ways to discriminate against people with pre-existing conditions including supposed mental illness.

The stigma involved in obtaining psychiatric "therapy" was discussed in an article by columnist Darrell Sifford titled "Should You Lie About Psychiatric Care?" appearing in The Charlotte Observer (Charlotte, N.C.) on June 10, 1990, page 4E. A mother wrote to Mr. Sifford asking whether her teenage son, who was about to apply for admission to college, should answer truthfully the questions about psychiatric treatment, which he had had at the age of 15. She wrote: "Many of these [college application] forms request information regarding any psychiatric treatment. And once he is out in the real world, most job application forms ask for the same information ... Have we [by insisting he get psychiatric care] doomed him to a future of lying on application forms for fear of losing the position or college being applied for? What should we do?" The newspaper columnist realized the woman's question is what he called "a serious question. Very Serious." He shared the woman's letter with Paul Fink, immediate past president of the American Psychiatric Association. This was Dr. Fink's advice: I would tell them to lie on the forms ... The stigma is there, and to deny it and sacrifice yourself by telling the truth makes no sense. ... With the public at large I work to decrease stigma, but with individual patients I impress on them how widespread and deeply rooted the stigma is. ... If two people who are

equal in credentials apply for a job and one has had psychiatric treatment, that person will be discriminated against, and he'll be the loser in the competition for the job. ... Even if the person with treatment had better credentials, he most likely still would lose out to the other person. That's how deeply rooted the stigma is. ... I will not encourage anybody to acknowledge that they had treatment.

Psychologist Paula Caplan, Ph.D., interviewed on February 11, 2012, said she maintains a web site called psychdiagnosis.net that includes true life stories showing "the whole huge array of the ways people's lives have been destroyed by getting a psychiatric label." In that same interview she said this ("MindFreedom (MF) Live Free Web Radio: Paul Caplan v. Psychiatric Labeling!", interviewed by David Oaks, archived at blogtalkradio.com): There was a wonderful article in the New York Times Magazine some months ago by Ethan Waters, and he looked at the research showing, and this sounds really weird, but it makes total sense once you think about it, he found, or he talks about the research showing that, when there are campaigns against stigma, guess what happens to the level of stigma?!: It rises! Now, why is that? It's because the nature of these campaigns goes like this: Well yes, they're different from us, but don't hold it against them. So anything that increases the sense of there are those of us who are not mentally ill, and then there are those 'other people'" increases the prevalence and intensity of psychiatric stigma.

Campaigns against psychiatric stigma enhance awareness of so-called mental illness, thereby increasing discrimination against the supposedly mentally ill.

Do you want to go through life with this kind of problem? How do you feel about lying on applications for the rest of your life? If it is your rebellious adolescent or troubled spouse for whom you're considering psychiatric "treatment", ask yourself: Are you really upset enough with your rebellious teenager or spouse to impose this kind of problem on him or her? Is it the right thing to do?

The problems motivating you to impose so-called therapy on a member of your family are probably short-term, but psychiatric stigma lasts a lifetime.

The U.S.A.'s Americans with Disabilities Act (ADA), enacted in 1990, prohibits questions about former psychiatric treatment on employment applications by employers with 15 or more employees.

However, a complete employment history may be required, gaps in which may bring up questions, and as Jonas Robitscher, J.D., M.D., said in his book The Powers of Psychiatry prior to the enactment of the ADA: "The disclosure that one is or has been mentally ill can lead to rejection, and other reasons for the rejection can always be found. ... Forcing private employers to hire the disabled would raise issues of invasion of privacy and problems of enforcement. Stigmatization will continue to be a problem, and discrimination will continue to exist" (p. 241-242). In areas covered by the ADA, availing oneself of its protection will probably require large amounts of time spent in litigation and a lot of money paid in lawyer's fees, with uncertain results.

There also are many areas of stigmatization and discrimination the ADA and other laws don't cover.

One example is the effect of psychiatric stigma on personal relationships: Keeping secrets conceals parts of who you are and prevents emotional intimacy of the sort most people want with friends and especially with one's spouse, but sharing this secret leaves you open to blackmail or similar kinds of

pressure. Concealing psychiatric "treatment" from an employer (which may be necessary to get a job) but revealing it to one's spouse or a friend gives the spouse or friend knowledge that can be used against you if your relationship turns sour. Should you be put in a position where you must lie to your spouse or a friend to keep secret your history of so-called psychiatric or psychological "therapy" (e.g., if he or she should ask), you introduce deception into a relationship that would be better if you could be honest and sincere. Even if you don't tell your spouse or someone you are thinking about marrying, divorce now occurs in close to half of marriages, and in a divorce—especially if you get into a dispute over child custody or even visitation rights—your spouse's attorney will probably ask you, under oath when you are subject to the penalties of perjury, if you have ever had psychiatric or psychotherapeutic "treatment"— perhaps confronting you with the choice of committing perjury or jeopardizing your employment by telling the truth. Whether you admit having had psychiatric or psychological "therapy" or it is discovered some other way, the resulting stigma may result in losing your children in a custody battle, and threats to reveal it to your employer may be used to pressure you to agree to property division or alimony (or lack of it) or an amount of child support that is not appropriate. You may have to consider these problems when contemplating the wisdom of getting married or divorced—problems you could have avoided by simply avoiding psychiatric or psychological "therapy". You are likely to face a similar dilemma if you are ever called for jury duty, since during the jury selection phase of the trial potential jurors are often asked, under oath, if they have ever had psychiatric "treatment". A Home Box Office (HBO) film, "Citizen U.S.A.: A 50 State Road Trip" says among the questions asked of persons seeking permanent residence in the U.S.A. are whether they have ever been convicted of a crime, been a prostitute, or confined in a mental institution.

If the socalled therapy helped enough, it might be worth the problems created by the stigma of having had psychiatric or psychological "help". However, the benefit assumed to come from psychiatric and psychological "therapy" (itself a questionable assumption) is outweighed by the stigma that comes from receiving it. The stigma that results from seeing psychiatrists, psychologists, or psychiatric social workers is a strong argument in favor of instead consulting friends, family, or nonprofessional counselors whose expertise comes from life rather than from "professional" training, or simply trying to solve your problems yourself.

copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "Why Psychiatry is Evil" ]

Why Psychiatry is Evil Wayne Ramsay, J.D. "I believe psychiatry epitomizes what's evil."

Psychiatrist Peter R. Breggin, M.D.,

at his Empathic Therapy Conference April 26, 2013, Syracuse, N.Y. "You have no idea how cruel psychiatry is. ... This is really a battle between good and evil."

Psychiatrist Peter R. Breggin, M.D. at his Empathic Therapy Conference April 17-19, 2015, at Michigan State University E. Lansing, Michigan To most human beings, killing another human being is the epitome of evil. Torturing a living human being may be even more cruel and even more evil. By either definition, psychiatry qualifies as evil.

Deaths Caused by Psychiatry's "Medications"

Most psychiatry deaths are caused by psychiatry's so-called medications. Psychiatry's most lethal drugs are the so-called antipsychotic, anti-schizophrenic, major tranquilizer or neuroleptic (nerve-seizing) drugs. All these terms are different names for the same group of drugs. Other types of psychiatric drugs also kill people, however.

Dr. Peter C. Gotzsche, a physician specializing in internal medicine at Denmark's Nordic Cochrane Centre, alleged in the May 12, 2015 British Medical Journal: Psychiatric drugs are responsible for the deaths of more than half a million people aged 65 and older each year in the Western world... Their benefits would need to be colossal to justify this, but they are minimal. ... Given their lack of benefit, I estimate we could stop almost all psychotropic drugs without causing harm ... This would lead to healthier and longer-lived populations.

If people under age 65 and those outside the Western world are included, perhaps psychiatric drugs kill more than one million people each year worldwide.

A study by Matti Joukamaa, M.D., Ph.D., et al., published in the British Journal of Psychiatry in 2006, "Schizophrenia, neuroleptic medication, and mortality" (bjp.rcpsych.org) found that "The number of neuroleptics used at the time of the baseline survey showed a graded relation to mortality. Adjusted for age, gender, somatic diseases and other potential risk factors for premature death, the relative risk was 2.50 (95% Cl1 46-4.30) per increment of one neuroleptic." The study found taking a neuroleptic "medication" more than doubles a person's risk of death.

American researchers using U.S.A. nationwide data reported in a February 2011 article in Pharmacoepidemiology and Drug Safety there were 14.3 million "Annual antipsychotic treatment visits" in 2008 in the U.S.A. alone (Caleb Alexander, M.D., Assistant Professor of Medicine at the University of Chicago, and Randall Stafford, M.D., Ph.D., Associate Professor of Medicine at Stanford Prevention Research Center, et al., "Increasing off-label use of antipsychotic medications in the United States, 19952008", Vol. 20, Issue 2, pp. 177-184, also available at ncbi.nlm.nih.gov). How many patients those 14.3 million antipsychotic treatment visits represent isn't clear. If we assume each patient sees his psychiatrist

once a month, that's 1,191,666 patients taking so-called antipsychotic or neuroleptic (nerve-seizing) drugs in the U.S.A. in 2008 (14.3 million divided by 12 = 1,191,666). Many of these deaths are caused by neuroleptic malignant syndrome, which is when the body succumbs to the toxicity of the so-called medication. In 2012, Eelco F.M. Wijdicks, M.D., Professor of Neurology at Mayo Medical School in Rochester, Minnesota reported— Incidence rates for neuroleptic malignant syndrome (NMS) range from 0.02 to 3 percent among patients taking neuroleptic agents... Mortality [death rate among those contracting NMS] has declined from the earliest reports in the 1960s of 76 percent and is more recently estimated between 10 and 20 percent. ...

NMS is most often seen with the "typical" high potency neuroleptic agents (eg, haloperidol, fluphenazine). However, every class of neuroleptic drug has been implicated, including the low potency (eg, chlorpromazine) and the newer "atypical" antipsychotic drugs (eg, clozapine, risperidone, olanzapine). ["Neuroleptic Malignant Syndrome", updated April 10, 2012, Wolters Kluwer Health | uptodate.com] Not all psychiatrists are convinced the so-called "atypical" neuroleptic drugs produce a lower death rate than the "typical" neuroleptics. Some evidence suggests the death rate with "atypical" neuroleptic/"antipsychotic" drugs is higher. In his book Brain-Disabling Treatments in Psychiatry, Second Edition, 2008, p. 25) psychiatrist Peter R. Breggin, M.D. says this: ...the newer antipsychotic drugs pose even greater risks of causing potentially life-threatening disorders, including marked obesity, elevated cholesterol, and potentially lethal diabetes, cardiovascular disease, and pancreatitis. Overall, the concept of atypical is a marketing ploy with little clinical reality. These drugs combine the risks associated with the older neuroleptics with the very serious new risks.

Nevertheless, health care providers, including sophisticated physicians, seem taken in by the claims.

Similarly, in his book Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, psychiatrist Allen Frances says experience has shown "the newer antipsychotics were no more effective than their predecessors and carried much worse long-term risks" (HarperCollins 2013, p. 92). Dr. Breggin's and Dr. Frances' opinion that the newer or "atypical" (so-called) antipsychotics have worse long-term effects than the older or "typical" (socalled) antipsychotics receives support from a report by the National Association of State Mental Health Program Directors, "Morbidity and Mortality in People with Serious Mental Illness", in October 2006, by which time atypicals had become the majority of neuroleptic prescriptions. The report states in bold italics, "People with serious mental illness (SMI) die, on average, 25 years earlier than the general population. State studies document recent increases in death rates over those previously reported."

Premature death among those considered seriously mentally ill began at the same time as the the advent of psychiatric drugs, suggesting psychiatric drugs are the reason, and an increase in deaths among supposedly seriously mentally ill persons corresponding with the shift from "typical" to "atypical" neuroleptic/"antipsychotic" drugs suggests there is a higher death rate with the newer, supposedly better "atypical" neuroleptics than with the older or "typical" neuroleptics.

Using Dr. Wijdick's smallest figures, 0.02 percent (0.0002) and my assumption the 14.3 million "Annual antipsychotic treatment visits" represent about 1,191,666 (1.19 million) Americans taking neuroleptic drugs, the resulting estimate of Americans contracting neuroleptic malignant syndrome (NMS) each year is 238, about 24 of whom die if the death or mortality rate is 10%, or 48 if it is 20%.

Using his upper incidence rate for NMS of 3% and his upper mortality or death rate of 20% yields an estimate of approximately 35,745 NMS victims, about 7,150 of whom die. The worldwide figure would be a multiple of those numbers.

According to psychiatrist Peter Breggin and clinical social work professor David Cohen in their book Your Drug May Be Your Problem—How and Why to Stop Taking Psychiatric Medications (De Capo/Perseus Books 2007, pp. 102-103), about 2.4 percent of persons treated (if that's the correct term) with neuroleptic drugs will contract NMS. They also cite the following estimate: Using a low-end rate of 1 percent, Maxmen and Ward [in Psychotropic Drugs Fast Facts, 2nd ed., W.W. Norton 1995, p. 33] estimate that 1,000 to 4,000 deaths occur in America each year as a result of neuroleptic malignant syndrome [NMS]. The actual number is probably much greater. [Id] Again, the worldwide "antipsychotic"/neuroleptic death toll is necessarily many times greater than in America alone.

The target of psychiatric drugs is the brain, but psychiatric drugs including neuroleptics reduce the function of nerves all over the body and hence may disable many other parts of the nervous system, resulting in many deleterious effects, some of which are life-threatening. A study of "individuals who had died because of choking" after taking neuroleptic/antipsychotic drugs in the November 2003 British Journal of Psychiatry titled "Choking deaths: the role of antipsychotic medication" found choking deaths in persons taking so-called antipsychotic drugs may result from "compromised neurological competence" and that those taking thioridazine (a particular so-called antipsychotic) were 92 times more likely to die.

It was also found that persons taking lithium were 30 times more likely to die (David Ruschena, et al., Vol. 183, pp. 446-50, ncbi.nlm.hih.gov).

One of the ways neuroleptic or nerve-seizing drugs kill people is slowing or deactivating nerve impulses to the heart, causing the heart to lose coordination, which is called arrhythmia, or causing the heart to stop beating, causing sudden death, which is when death is unexpected and without warning.

An article titled "Sudden cardiac death and antipsychotics" in the journal Advances in Psychiatric Treatment in 2006 (Vol. 12, pp. 35-44, by Nasser Abdelmawla, Ph.D. in psychopharmacology & Alex Mitchell) says "Sudden death refers to the unexpected death of a person who has no known acutely lifethreatening condition and yet dies of a fatal medical cause." In this article the authors say sudden death is "thought to result from fatal arrhythmias" of the heart and that "Prospective studies show that people with prolongation of the QT interval beyond 500 ms [milliseconds] are at increased risk of serious [heart] arrhythmias such as ventricular tachycardia [dangerously fast heartbeat] and torsade de pointes" (see below) and that "Most antipsychotics prolong the QTc interval in overdose but some prolong it even at therapeutic doses."

In an article in the American Journal of Psychiatry in 2001, Alexander H. Glassman, M.D. and J.

Thomas Bigger, M.D., titled "Antipsychotic Drugs: Prolonged QTc Interval, Torsade de Pointes, and Sudden Death" (Nov. 1, 2001, Vol. 158, No. 11, pp. 1774-1782) say this: The first report of sudden arrhythmic death with an antipsychotic drug appeared in 1963 ...sudden unexpected death occurs almost twice as often in populations treated with antipsychotics as in normal populations. ... Torsade de pointes is a malignant ventricular arrhythmia that is associated with syncope [loss of consciousness] and sudden death. ... Drugs blocking the I Kr channel can induce torsade de pointes and sudden death in apparently healthy adults. ... At this point in time, an atypical antipsychotic without concern does not exist.

Note they say an "atypical" (not typical) antipsychotic without concern does not exist, casting doubt on the claims the newer atypical antipsychotics are safer.

Bruce G. Charlton, M.D. of the School of Biology and Psychology, University of Newcastle upon Tyre, in an article titled "Why are doctors still prescribing neuroleptics?" (QJM 2006; 99, 417-20) says "the so-called 'atypical neuroleptics' which now take up 90 percent of the US market, and are increasingly being prescribed to children, seem to offer few advantages over traditional agents while being highly toxic and associated with significantly increased mortality from metabolic and a variety of other causes." He suggests the harm done by neuroleptic drugs including the newer so-called atypicals "represents an unprecedented disaster for the self-image and public representation—not just of psychiatry—but the whole medical profession."

Health science writer Ethan A. Huff cites a study published in the British Medical Journal by researchers from Harvard Medical School of more than 75,000 dementia patients given so-called antipsychotic drugs such as haloperidol (Haldol, a "typical" neuroleptic) and quetiapine (Seroquel, an "atypical" neuroleptic) showing "at least 1,800 additional deaths a year as a result of dementia patients taking antipsychotic drugs." He suggests "These 1,800 deaths, of course, are just the additional deaths caused by antipsychotic drugs when they are used for off-label purposes in those with dementia, which means there are tens of thousands—and perhaps even hundreds of thousands—of deaths every year in other patients taking antipsychotics for other purposes" ("BMJ [British Medical Journal] admits antipsychotic drugs kill far more people than terrorism", March 02, 2012, naturalnews.com, italics in original).

There is evidence SSRI "antidepressants" cause suicide, homicide, and other violence, perhaps by making people feel worse, contrary to their expectation, perhaps by reducing sleep quality, and perhaps by disabling parts of the brain responsible for people's normal inhibitions. (See Psychiatric Drugs: Cure or Quackery?) How this was discovered is described in Alison Bass' book Side Effects—A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial (Algonquin Books 2008). Because of these harmful effects, the U.S. Food and Drug Administration (FDA) now requires a "black box" warning on the package inserts for all supposedly antidepressant drugs about increased risk of suicide in adolescents and young adults (but not older adults) taking them (as if the drugs have different effects in a person of age 20 than they do in a person of age 30 or 40).

In his book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (HarperCollins 2013, p. xv), psychiatry professor Allen Frances, M.D., chairperson of the task force that created DSMIV, says this: Since 2005 there has been a remarkable eightfold increase in psychiatric prescriptions among our active duty troops. An incredible 110,000 soldiers are now taking at least one psychotropic drug, many are on more than one, and hundreds die every year from accidental overdoses.

Others die from intentional overdoses or other suicide methods. Increased suicidality is one of the effects psychiatric drugs for reasons discussed in my essay Psychiatric Drugs: Cure or Quackery?

According to an article in the May 28, 2012 Newsweek magazine, "About 18 veterans kill themselves each day. Thousands from the current wars have already done so. In fact, the number of U.S. soldiers who have died by their own hand is now estimated to be greater than the number (6,460) who have died in combat in Afghanistan and Iraq (Anthony Swofford, "We Pretend the Vets Don't Even Exist", p. 26 at 29). If the psychiatric drugs U.S. soldiers take make them suicidal when they would not be otherwise, psychiatry may be indirectly but truly causing the deaths of more American soldiers than the Nation's enemies on the battlefield.

Others die neither from accidental overdose nor suicide but because of other effects of psychiatric "medication". According to a report by neurologist Fred A. Baughman, Jr., M.D. published electronically December 29, 2011 in the European Heart Journal, many U.S. military veterans have died in their sleep with "no signs of suicide" or overdose while taking Seroquel (an antipsychotic), Paxil (an antidepressant), and Klonopin (a benzodiazepine). Dr. Baughman concluded "psychotropic drug polypharmacy is never safe, scientific, or medically justifiable." It is nevertheless commonplace if not routine in psychiatry.

Whatever the exact numbers are, there is plenty of evidence psychiatry's "medications" cost rather than save lives.

Furthermore, psychiatrists (and other physicians, physician assistants, nurse practitioners, and psychologists with prescribing authority) do this for the ostensible purpose of treating nonexistent illnesses and arbitrarily defined "disorders". In the words of Edward Shorter, professor of the history of medicine and psychiatry in the Faculty of Medicine of the University of Toronto, psychiatry today uses "drugs that don't work for diseases that don't exist" ("Why Psychiatry Needs Therapy", Wall Street Journal (Eastern Edition), Feb. 27, 2010, p. W3, proquest.umi.com).

Despite the harm psychiatric and particularly neuroleptic drugs do, psychiatrists continue to prescribe them, and American courts, acting on psychiatrists' recommendations, continue to order people to take them. In 2012 a 44 year old woman in Pennsylvania sought my advice about a judicial outpatient commitment order compelling her to appear for injections of Invega Sustenna (an "atypical" neuroleptic), sometimes by a treatment team who came to her home, with a threat of incarceration if she did not comply. Also in 2012 a New Hampshire man sought my advice about his elderly father, who was under the control of a court-appointed professional guardian and was being held in a geriatric psychiatric ward of a private hospital where he was being given food and beverage to which a psychiatric drug cocktail including a neuroleptic was added. In 2013 a 32 year old man in New Hampshire sought my advice about his being required to appear at a Community Mental Health Center every ten (10) days for injections of Prolixin (a "typical" neuroleptic) pursuant to a conditional discharge from New Hampshire Hospital, where he was also required to be supervised simultaneously taking lithium orally to be certain he actually swallowed the "medication". Due to the widespread ignorance or lack of concern about the harm done by psychiatric drugs and the lack of right to jury trial in civil commitment in these states, resulting in court hearings before a single judge who routinely grants (or "rubber stamps") psychiatrists' requests for involuntary inpatient or outpatient commitment orders, there is little legal protection for such persons.

Electroshock Deaths Most estimates of the number of people who are given electroconvulsive "therapy" (ECT) are 100,000 per year in the U.S.A. and one million to two million per year worldwide. In its model consent form for ECT, the American Psychiatric Association claims the death rate for ECT is approximately one death per 10,000 patients treated (Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging, American Psychiatric Association 1990, Appendix B p. 157; see also p. 59).

Other investigations show the ECT death rate is much higher.

The authors of an article in Psychiatric Services (Vol. 52, No. 8, August 1, 2001), titled "An Analysis of Reported Deaths Following Electroconvulsive Therapy in Texas" by Raj S. Shiwach, M.D., et al.

(available at ps.psychiatryonline.org) attempted to minimize the ECT death rate but nevertheless reported "Over the study period, 8,148 patients received a total of 49,048 ECT treatments" and that "Among more than 8,000 patients who received 49,048 ECT treatments between 1993 and 1998, a total of 30 deaths were reported to the mental health department..." 8,148 patients receiving ECT divided by 30 deaths is a death rate of 1 in 271.6 (8,148 divided by 30 = 271.6). If 100,000 Americans receive ECT each year as estimated by ECT advocates, and the death rate is 1 in 271.6 patients, the approximate number of Americans dying each year from electroconvulsive "therapy" or ECT is 368, slightly more than, on average, one American dying from ECT each day. Applying the 1 in 271.6 death rate to the worldwide estimates of one or two million persons per year given ECT is an ECT death toll of 3,681 or 7,363 persons per year. Dividing those figures by 365 days in a year yields an estimated worldwide death rate from ECT of, on average, 10 or 20 persons each day.

In The Myth of Biological Depression I show there is no evidence depression, for which ECT is most often used, is ever caused by biological abnormality (in the brain or elsewhere). In Psychiatry's Electroconvulsive Shock Treatment: A Crime Against Humanity, I show there is no credible theory to explain why inducing seizures by running electricity through a person's head would cure or treat anything and ample evidence it damages the brain.

Psychiatry Deaths Caused by Physical Restraint October 11-15, 1998 the Hartford Courant, a newspaper in Hartford, Connecticut, published a series of articles titled "Deadly Restraint: A Hartford Courant Investigative Report" about the killing of hundreds of people in America's facilities for the mentally ill and retarded because of the way they were physically restrained: A 50-state survey by The Courant, the first of its kind ever conducted, has confirmed 142 deaths during or shortly after restraint or seclusion in the past decade. The survey focused on mental health and mental retardation facilities and group homes nationwide. But because many of these cases go unreported, the actual number of deaths during or after restraint is many times higher. Between 50 and 150 such deaths occur every year across the country, according to a statistical estimate commissioned by The Courant and conducted by a research specialist at the Harvard for Risk Analysis. That's one to three deaths every week, 500 to 1,500 in the past decade, the study shows. "It's going on all around the country," said Dr. Jack Zusman, a psychiatrist and author of a book on restraint policy. The nationwide trail of death leads from a 6-year-old boy in California to a 45-year-old mother of four in Utah, from a private treatment center in the deserts of Arizona to a public psychiatric hospital in the pastures of Wisconsin. In some cases, patients died in ways and for reasons that defy common sense: a towel wrapped around the mouth of a 16-year-old boy; a 15-year-old girl wrestled to the ground after she wouldn't give up a family photograph. Many of the actions would land a parent in jail, yet staffers and facilities were rarely punished. [charlydmiller.com, accessed June 24, 2013] I recall seeing a videotaped interview with the mother of the 16 year old boy, or perhaps who I saw was the mother of another teenage young man who died in a similar way: She said a towel was wrapped around his nose and mouth while he was in 4-point restraints, supposedly to prevent him from biting

people (as if he could while restrained in that way even without the towel).

Probably the reason people are rarely punished for torturing or killing supposedly mentally ill or mentally retarded people is the perception of the victims as less than fully human. The human mind is the defining characteristic of a human being, and it is that part of the person that is considered defective or absent in these victims.

Torture as "Therapy"

"The very term psychiatry (Psychiatrie) was a German invention, coined in 1808 by Johann Christian Reil (1759-1813). ... In addition to coining the term 'psychiatry,' he also coined the term 'noninjurious torture,' to describe the methods of frightening mental patients that he considered effective and legitimate 'treatments'" (Thomas S. Szasz, M.D., "Mental Illness as Brain Disease: A Brief History Lesson", The Freeman, May 1, 2006, szasz.com). Dr. Benjamin Rush, often called the father of American psychiatry, whose face, in 2015, still appears on the official seal of the American Psychiatric Association, implying approval of Dr. Rush's methods, wrote in his book Medical Inquires and Observations upon the Diseases of the Mind in 1812 that "TERROR acts powerfully upon the body, through the medium of the mind, and should be employed in the cure of madness" (Kimber & Richardson, Philadelphia: 1812, reprinted by Hafner Publishing Co., New York: 1962, p. 211, emphasis (capitals) in original). Today, torture and terror remain among the primary modes of action of psychiatry's supposed therapies.

Much if not most psychiatry today consists of psychiatrists and their co-workers trying to persuade their patients to take, or forcing their (so-called) patients to take, "medication" and the so-called patients doing everything in their power to avoid being "medicated". The usual explanation is the supposed mental illness prevents those so afflicted from realizing they are sick and need "medication", but the real reason is the torturous effects of the drugs.

In her book, The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment, Revised Edition (Palgrave Macmillan 2009, p. 14), British psychiatrist Joanna Moncrieff says "the effects produced by most psychiatric drugs are experienced as unpleasant."

Alan A. Stone, M.D., Touroff-Glueck Professor of Law and Psychiatry at Harvard Law School, has said high rates of suicide among hospitalized psychiatric patients "may be a consequence of tranquilizing drugs keeping patients in a state of agony for a long period of time" (quoted in David F. Greenberg, Ph.D., "Involuntary Psychiatric Commitments to Prevent Suicide", New York University Law Review, Vol. 49 (May-June 1974), p. 227 at 259, note 106).

Yes, you read that correctly: He said agony.

Alexander D. Brooks, Justice Joseph Weintraub Professor of Law at Rutgers School of Law—Newark, in "The Right to Refuse Antipsychotic Medications: Law and Policy", 39 Rutgers Law Review 339 at 350 (1987) says this: In sum, it must be acknowledged that side effects caused by antipsychotic medications are serious, although more so for some patients than for others. They generate a high order of physical, emotional, and cognitive distress. The fact that most side effects (though not tardive dyskinesia) recede when medication is discontinued provides little comfort for the chronically and severely mentally ill who are currently required to use medication at all times.

Calling the effects of antipsychotic medications "a high order of physical, emotional, and cognitive

distress" is another way of saying torture. Permanent neurological diseases such as tardive dyskinesia, akathisia, dystonia, and dementia caused by psychiatric drugs are another kind of torture.

In her book Own Our Own, Judi Chamberlin, says in psychiatric hospitals there is "heavy use of psychiatric drugs, which is often perceived by the patients as torture. But patients cannot object to treatment without bringing on more treatment. Only agreeing that one is indeed ill and in need of help brings the possibility of ending the treatment" (Hawthorn Books, Inc. 1978, p. 111).

Psychiatry professor and psychiatrist Allen Frances, M.D., quotes one of his patients describing the effects of Thorazine, one of the so-called typical tranquilizer/neuroleptic/antipsychotic drugs she was forced to take: Mindy was put through the horror show that passed for treatment in those days, and I was part of the team directing it. "Three times a day, we lined up for meds and I was given Thorazine, the standard drug for psychosis. If I tried hiding the pills in my cheek, the nurse would search my mouth and I'd be given a bitter-tasting liquid [version of Thorazine to compel swallowing]. Either way, the effect was the same: the drugs would nail you to the furniture, suck your life force, dry your mouth an fill your head with despair.

Each time I swallowed the pills I wished the doctors could feel for themselves the deadening effects."

[Saving Normal, Harper Collins 2013, p. 46] Dr. Frances says "in those days" as if people are not forced to swallow or be injected with psychiatry's torture drugs now in the 21st Century.

According to a Radio Free Asia report on October 31, 2012 (http://www.unhcr.org)— China's new mental health law does little to protect patients or end a longrunning practice that enables the government to silence dissidents by deeming them mentally ill, rights groups and former mental health detainees said. ... Wang Yonglan, a petitioner who tried to file a complaint against officials in her hometown of Chongshan in the eastern province of Jiangxi, had been locked up in the Hougang Psychiatric Hospital near Leshan city "numerous times" during the course of this year, according to her close friend Yu Ganlin. "While she was in the mental hospital, they forcefed her with drugs," Yu, a fellow petitioner from Hubei province, said in an interview on Wednesday. "If she refused to take the drugs, they would force her mouth open and pour them down her throat," Yu said. "This made her very sick, and she told me that it would be better to die than to live like that." [italics added] In Washington v. Harper, a U.S. Supreme Court decision about involuntary administration of neuroleptic/antipsychotic drugs to prison inmates, Justice Stevens' says in his dissenting opinion that "Inmate Harper stated he would rather die th[a]n take medication" 494 U.S. 210 at 239 (1990, footnote 2/5).

Better dead than drugged was also the conclusion of a patient of a Canadian psychiatrist quoted by Eric Fabris in his book Tranquil Prisons: Chemical Incarceration under Community Treatment Orders (University of Toronto Press 2011, p. 161). Community Treatment Orders, or CTOs, in Canada are similar to Outpatient Commitment and Conditional Discharge in the U.S.A. according to which people are courtordered to take psychiatric drugs while living in their own homes. The psychiatrist said her patient

"would rather die than be on a CTO." Tranquil Prisons is both an autobiographical account and a study of forced outpatient psychiatric drugging in which Eric Fabris says "My personal experience of psychiatric drugging (not so much the assault [by hospital employees in the administration of the drug] but the effects of the drug) was the most frightening aspect of my psychiatrization. ... drugging can be understood as torture, according to psychiatric survivor and lawyer Tina Minkowitz and the U.N." (Id., p. 193).

Juan E. MĂŠndez, the United Nations Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, in his statement to the 22nd session of the Human Rights Council in Geneva, Switzerland on March 4, 2013 said this: ...abusive practices in health-care settings meet the definition of torture ... Free and informed consent should be safeguarded on an equal basis for all individuals without any exception ... Any legal provisions to the contrary, such as provisions allowing confinement or compulsory treatment in mental health settings, including through guardianship or other substituted decision-making, must be repealed. ...

Despite the significant strides made in the development of norms for the abolition of forced psychiatric interventions on the basis of disability alone as a form of torture and ill-treatment and the authoritative guidance provided by the CRPD [Convention on the Rights of Persons with Disabilities], severe abuses continue to be committed in health-care settings where choices by people with disabilities are often overridden based on their supposed "best interests" ... medical treatments of an intrusive and irreversible nature, when lacking a therapeutic purpose or when aimed at correcting or alleviating a disability, may constitute torture or ill-treatment when enforced or administered without the free and formed consent of the person concerned. ... States should repeal any law allowing intrusive and irreversible treatments when enforced or administered without the free and informed consent of the person concerned. ... Such interventions always amount at least to inhuman and degrading treatment, often they arguably meet the criteria for torture, and they are always prohibited by international law.

In her autobiography, Too Much Anger, Too Many Tears—A Personal Triumph Over Psychiatry (Quadrangle/The New York Times Book Co. 1975, pp. 388-399), Janet Gotkin says this of her psychiatric hospitalizations and treatment with psychiatric drugs and ECT following suicide attempts: If all the years of being a psychiatric patient brought me nothing but pain and increasing torment, who, then benefited from my status? And the final question: Are these men evil? Did they lie when they said "We only want to help you?"

"We only want to help you" is a statement woven integrally into the pattern of lies, semantic farces, and mystification that is the fabric of American psychiatry. ... It is what every psychiatrist says to his patient when he plans to perpetrate another psychiatric torment and he doesn't want any resistance: "I only want to help you." For many years I believed the lie. Now I say, if that is help, we are not speaking the same language.

Someone is continuing to insist that these human garbage dumps called mental hospitals are, in reality, hospitals. Someone is saying that they are places where troubled people can get help. They are calling the guards doctors, the tortures treatments, and the humiliating experience of being a mental patient therapeutic. They are saying that the psychiatric labels that degrade and imprison people are

diagnoses. They are the Mental Health Professionals. ... But their help was imprisonment and torture and we allowed the semantic niceties of treatment and hospital to continue to fool us.

Four and five point physical restraints (wrists, ankles, and sometimes chest or head), are used frequently in psychiatric hospitals and psychiatric wards in the U.S.A. and are an obvious example of torture.

Imagine being tied down and unable to use a toilet, being unable scratch an itch on your face or back because of restraints holding your hands to your sides, having asthma and being unable to reach for the rescue inhaler in your pocket or purse or attached to your key chain, and preventing raising your inhaler to your mouth, or having chronic, severe nasal congestion and being unable to raise a hand to spray decongestant into your nose, and unable to position your head to use the decongestant as nose drops, choking on mucus from your chronic post nasal drip but being unable to get off your back and into a position gravity would help you dislodge the mucus caught in your throat and help you stop choking, being desperately thirsty but being unable to reach for a glass of water, feeling your lips getting dry and beginning to crack or tear but being unable to use your Chap-Stick or other lip moisturizer because your hands are bound, being cold but being unable to reach for a blanket, or being hot and sweating under a blanket but because your hands are bound you are unable to remove the blanket. Add to this a face mask such as is seen in the below photograph, forcing you to re-breath air you have exhaled, causing partial suffocation, especially if you already have difficulty breathing. When I offered a dust mask similar to this to a healthy 22 year old man spackling and sanding walls in a bedroom in my house, he refused and continued breathing paint-dust tainted air because, he said, the mask made him feel like he was suffocating. Imagine feeling like that but being unable to remove the mask because your hands are bound. Add to this the torturous and life-threatening effects of psychiatric drugs given over your objection while you are physically restrained. All this is a reality for people subjected to physical restraints and forced drugging, supposedly as psychiatric "therapy", in the supposedly human-rightsrespecting U.S.A.

In 2013 a man in Keene, New Hampshire left me an answering machine message saying "I'm currently incarcerated in an emergency room facility. I've been here a week now against my will.

Been in four-point restraints several times. Was brought in for no good reason whatsoever. I just want to get the hell out of here. ... Thank you very much, Mr. Ramsay." When we had a two-way telephone conversation he told me while at New Hampshire (State) Hospital he was held "spread eagle" in four-point restraints (wrists and ankles) for 24 hours, which he described as "hell".

The use of physical restraints against David Deaton, "a normal 17-year-old when he walked into a National Medical Enterprises (NME) psychiatric hospital in Dallas...for help with depression after his girlfriend jilted him" is described in a July 15, 1996 National Review article: After four days, when Deaton sought to leave, he was tied down with leather restraints. ... he was held for more than a year, including 333 days tied to a wheelchair or spreadeagled on a bed with leather restraints. He was required to use a bedpan and never allowed more than one arm free to take his meals. ... His muscles...atrophied so badly he could not walk. ... Deaton told a congressional committee hearing in 1994 [about the experience]. [Eugene H. Methvin, "Cuckoo's Nest", p. 38] According to Juan E. MĂŠndez, the U.N. Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment in his Statement to the 22nd session of the Human Rights Council in Geneva, Switzerland on March 4, 2013, "there can be no therapeutic justification for the use of solitary confinement and prolonged restraint of persons with disabilities in psychiatric institutions; both prolonged seclusion and restraint constitute torture and ill-treatment."

Involuntary electroconvulsive "therapy" is no longer a type of physical torture because of the use of anesthesia, but because of its harmful effects, forcing it on people is psychological torture. The lowered IQ and inability to remember or learn resulting from electroshock-induced brain damage may also be considered a type of torture. Listen to the words of the two below quoted women who were subjected to involuntary electroshock, and then imagine yourself in the situation in which they found themselves, and ask yourself if involuntary electroshock is a form of torture. The first is Janet Gotkin (maiden name Moss) in her autobiography Too Much Anger, Too Many Tears: A Personal Triumph Over Psychiatry (Quadrangle/The New York Times Book Co., New York: 1975, p. 148): "No breakfast for you, Moss," she said into the smoky light of my room. No breakfast. I repeated the words to myself; they were nonsense syllables; I wouldn't hear what they said. No breakfast. That meant shock. I was on the shock list.

"No!" I screamed, hurling the thin beige hospital blanket off my rubber-sheeted bed. In an instant I was by the door. "There must be some mistake. I'm not supposed to get treatments." How many times had I seen other people perform this same panicky charade? How many times had I heard the frantic terrorized cry? Not me, not me. There must be some mistake. Now it was me, in a frenzy of survival fear, crying the futile cry, clawing on the twelve-foot wall.

"No mistake," the little woman said calmly. "Here's your name, right near the top of the list."

"But my doctor said—" I started to explain. She interrupted.

"No breakfast," she said again. "I'll be back to get you in a few minutes." She turned, as smartly as a new private, and I heard her raspy voice with its message for the doomed, as she moved from room to room.

According to the New Zealand Book Counsel, Janet Frame (1924-2004) is "New Zealand's most distinguished writer". She wrote this about her experience as a mental hospital patient: Every morning I woke in dread, waiting for the day nurse to go on her rounds and announce from the list of names in her hand whether or not I was for shock treatment, the new and fashionable means of quieting people and of making them realize that orders are to be obeyed and floors are to be polished without anyone protesting and faces are made to be fixed into smiles and weeping is a crime. Waiting in the early morning, in the black-capped frosted hours, was like waiting for the pronouncement of a death sentence. ... If our name appeared on the fateful list we had to try with all our might, at times unsuccessfully, to subdue the rising panic. For there was no escape. ... the fear leads in some patients to more madness. [Janet Frame, "Faces in the Water", appearing in Thomas Szasz (editor), The Age of Madness: The History of Involuntary Mental Hospitalization Presented in Selected Texts, Anchor Books 1973), pp. 203, 204-205, 210]

Imagine yourself incarcerated in a psychiatric hospital, or psychiatric ward of a general hospital, talking with people, other patients, who seem normal when they first arrive at the hospital, but after a few electric shock treatments are so demented they can no longer talk with you. They are still breathing, but their minds are gone. Since the mind is the most essential part of a human being, it can seem, or even be, equivalent to murder. Imagine watching a fellow patient being hauled away by force for electric shock treatment while she resists physically as well as she can while she pleads with the psychiatrist and hospital attendants to stop. Imagine the terror of knowing you might be next, and your mind, your memories, your intelligence, might be the next to be erased, and there is nothing you can do stop it.

Joanna Moncrieff, M.B.B.S., M.Sc., FRCPsych., M.D., and Senior Lecturer in the Department of Mental Health Sciences at University College London, in her book The Myth of the Chemical Cure: A Critique of Psychiatric Drug Treatment (Palgrave MacMillan 2009, p. 2) says— We have only to look to the relatively recent past to see the proclivity of psychiatrists to subject their patients to invasive, degrading, harmful and not unusually fatal procedures in the name of therapy, and to blind themselves to the real nature of their activities.

A central theme of this series of essays is psychiatry's harmful, cruel, evil, and sometimes fatal "treatments" exist not only in psychiatry's relatively recent past but now in the early 21st century.

Sadly, the torture goes on, and for the most part, lawmakers do nothing.

Silencing Critics and Suppressing Free Speech

Psychiatry is evil because in addition to imprisoning (forcibly "hospitalizing"), torturing and killing law-abiding people, damaging brains and causing neurological disease with psychiatric drugs, and ruining people's lives with psychiatric stigma, and deceiving to the public and law makers about what psychiatry is and can do, psychiatrists retaliate against those who attempt to

reveal psychiatry as the quackery and violation of human rights it is. In his book Anatomy of an Epidemic (Crown Publishers 2010, pp. 304-312), Robert Whitaker puts it this way: American psychiatry has told the public a false story over the past thirty years. The field promoted the idea that its drugs fix chemical imbalances in the brain when they do no such thing ... In order to keep that tale of scientific progress afloat (and to protect its own belief in that tale), it has needed to squelch talk about the harm that the drugs can cause.

Whitaker gives examples of actions taken against those on what he calls "psychiatry's hit list". One of them is psychiatrist Peter Breggin, M.D., who for the last few decades has led the fight against biological psychiatry: Psychiatry's policing of its own ranks began in earnest in the late 1970s... [Dr. Peter] Breggin appeared in 1987 on Oprah Winfrey's television show, where he spoke about tardive dyskinesia and how that dysfunction was evidence that neuroleptics damaged the brain. His comments so infuriated the APA [American Psychiatric Association] that it sent a transcript of the show to NAMI [a drug-company financed pro-psychiatry advocacy group], which in turn filed a complaint with the Maryland State Commission on Medical Discipline, asking that it take away Breggin's medical license on the grounds that his statements had caused schizophrenia patients to stop taking their medications (and thus caused harm). Although the commission decided not to take any action, it did conduct an inquiry (rather than summarily dismissing NAMI's complaint), and the message to everyone in the field was, once again, quite clear. [Quoting Dr. Breggin:] "...what this showed is that...they were willing to destroy your career" [to discourage criticism of psychiatry]. [pp. 304-305] In a lecture at Tufts University, psychiatrist Daniel Carlat says after publication in 2010 of his book Unhinged: The Trouble With Psychiatry—A Doctor's Revelations About a Profession in Crisis, he "got a taste of just how angry it is possible to make some people that are in your field when your are critical. ...

When you are a psychiatrist and you become critical of your field, you're in for a special retribution" ("Daniel Carlat—Unhinged: The Trouble with Psychiatry", YouTube.com at 1:25).

An example of psychiatric retaliation against a physician because he tried to expose psychiatry's mythology about itself is what happened to neurologist John Friedberg (1942-2012). Dr. Friedberg describes what happened to him in his book Shock Treatment Is Not Good For Your Brain—A Neurologist Challenges the Psychiatric Myth (Glide Publications 1976, pp. 10-21), which is both an autobiography and a scientific book about the harm done by electric shock treatment. In 1974, after graduating from Yale University and the University of Rochester School of Medicine and beginning a residency in neurology at Pacific Medical Center in San Francisco, Dr. Friedberg became interested in the harm done by electroconvulsive "therapy". He placed an invitation for people who'd been subjected to electroshock to contact him in the April 7 Sunday San Francisco Examiner and Chronicle: "Electric shock therapy is not good for the brain. I would like to hear from anyone who has received these treatments here in San Francisco. Call 668-2085 evenings or 563-4321 noontime. John Friedberg, M.D." Three days later the chairman of the Pacific Medical Center Department of Psychiatry sent a memo to Dr. Friedberg's superior in the neurology department and to the dean of Pacific Medical Center with a photostatic copy of Dr.

Friedberg's newspaper notice saying "We believe that this study is inappropriate for a resident at Pacific Medical Center." Dr. Friedberg received word his superior was thinking of firing him. His superior gave him a choice: Either "go into psychotherapy with the chairman of the Department of Psychiatry as a patient, or be fired" (italics are Dr. Friedberg's). Dr. Friedberg refused and was fired. "Residents are rarely dismissed from their training programs," wrote Dr. Friedberg, "Dismissal from residency connotes gross negligence or incompetence. My career in neurology was at stake, my reputation as a doctor was at stake, and my freedom of speech was at stake." He reached the conclusion that "active opposition to ECT is simply not tolerated, even from within" the medical profession because "entire careers in psychiatry were built upon searing the brains of the gullible and the powerless and the unhappy." He appealed his dismissal without success and took a job as an emergency room physician but was later offered and accepted a position in the neurology program at the University of Oregon in Portland and became a board-certified neurologist who spent the remainder of his life writing and speaking against psychiatry's harmful "therapies". _________________________________________________

THE TORTURE GOES ON, AND LAWMAKERS DO NOTHING _________________________________________________ According to psychiatrist Ron Leifer, M.D., in "A Critique of Psychiatry and an Invitation to Dialogue" in the December 27, 2000 Ethical Human Science and Services, after the publication of The Myth of Mental Illness by Dr. Thomas Szasz in 1961, "Serious attempts were made to remove him [Dr. Szasz] from his tenured appointment as professor of psychiatry. His two main defenders at that time, Ernest Becker and myself, both of us untenured, were fired" (iaapa.de/zwang/leifer.htm & critpsynet.freeuk.com).

Psychiatry has also been used to retaliate against physicians who criticize their fellow physicians for medical practices unrelated to psychiatry.

Dr. Ignaz Semmelweis (1818-1865) was committed to an insane asylum where he was beaten and died of his injuries after accurately accusing his fellow physicians of causing the deaths of many maternity patients by giving patients infections with the doctors' own dirty hands.

Dr. Semmelweis recommended washing hands in chlorinated water before contact with patients.

According to psychology professor Robyn M. Dawes in his book House of Cards—Psychology and Psychotherapy Built on Myth (Free Press 1994, pp. 77-78), "Semmelweis ... lost his sanity, begun accosting people on the streets to warn them to stay away from doctors who didn't clean their hands, and died in a mental institution in 1865." Probably what actually happened is not that Dr. Semmelweis lost his sanity but that his warnings seemed crazy at a time people knew nothing about germs, and because his warnings were an affront to his fellow physicians. Only after Dr. Semmelweis' death did the germ theory of disease gain acceptance and vindicate his beliefs. Now, Semmelweis University in Budapest, Hungary, which has schools of medicine, dentistry, and pharmacy, is named after him.

Elaine Kennedy, M.D., is a 1974 honors graduate of Vanderbilt University School of Medicine in Nashville, Tennessee. In 1993 she was named Outstanding Physician of the Year by the Tennessee Medical Association. According to an Associated Press report, later that year, on December 17, 1993, she went to the office of Dr. Ferroll Sams III, an internal medicine specialist of Fayetteville, Georgia to review the medical records of her elderly aunt. Dr. Kennedy was reportedly "hostile, demanding, and interfering" regarding her aunt's medical care. Dr. Sams was

apparently displeased by another physician questioning the treatment provided and had Dr. Kennedy committed to a psychiatric facility after writing on the commitment form she was delusional, hyperactive and manic-depressive. Dr. Kennedy remained psychiatrically hospitalized for five (5) days and temporarily suffered loss of her medical licensure, confirmation of which appears on the the Tennessee Department of Health web site, which says Dr. Kennedy must undergo "evaluation by a psychiatrist of the board's choosing" for "an independent psychiatric evaluation of licensee", after which her license to practice medicine was reinstated. In a lawsuit that followed, Dr. Kennedy won a $3.4 million jury verdict against Dr. Sams for wrongful commitment. The jury said the commitment was "unlawful" and that Dr. Sams "did not act in good faith" when he had Dr. Kennedy involuntarily committed.

Both Dr. Semmelweis and Dr. Kennedy were involuntarily committed to an insane asylum or psychiatric facility because of their exercise of the right of free speech.

So was psychologist Al Siebert, Ph.D., during a post-doctoral fellowship in clinical psychology at the Menninger Foundation in Topeka, Kansas, because he questioned the concept of mental illness and the validity of psychiatry. He describes the experience in a chapter in Dr. William Glasser's book Warning: Psychiatry Can Be Hazardous to Your Mental Health (HarperCollins 2003, pp. 178-203) and in his book A Schizophrenia Breakthrough (Practical Psychology Press 2003), an autographed copy of which he gave me when we met at a conference in 2003. Dr. Siebert was accused of mental illness because he began to speculate "about why a suppressed need for esteem compels people to force unwanted help onto others ... I explained how the perception of mental illness in others is mostly a stress reaction in the mind of the beholder." Psychiatrists in his training program found these ideas unacceptable, ignored (or more likely never even thought about) Dr. Siebert's right of free speech, called him mentally ill, and demanded he go to a mental hospital as a patient. When threatened with involuntary commitment, Dr. Siebert entered a mental hospital "voluntarily" because he believed "a person who goes into a mental hospital voluntarily can get out much more easily than a person who is committed." His like many others was a case of coerced consent and so was essentially involuntary. Like virtually all psychiatric hospital patients, Dr. Siebert was forced to take at least one psychiatric drug, in his case Thorazine: "I saw that they would use force if necessary. Make me take shots maybe put me in an isolation room. I saw that my chances of successful resistance were zero. I reached out for the cup the nurse held out to me. The aides relaxed and stepped back." After his experience as a mental hospital patient Dr. Siebert concluded psychiatry is "a deluded profession" and that psychiatrists are "like members of a cult, their minds controlled by a delusional belief system."

American commentators point an accusing finger at dictatorial regimes in other nations, such as the former Soviet Union, where critics including authors of books who try to correct what's wrong with a society are imprisoned or involuntarily committed to mental institutions.

What happened to Drs. Kennedy and Siebert is reason to wonder if some of us in America are equally bad.

When I told Dr. Thomas Szasz about my efforts, as a lawyer, to stop kangaroo court commitment proceedings in the U.S.A., Dr. Szasz replied to me in an e-mail dated 3/19/2012 saying "Writing a book is a good idea. Otherwise, desist. Asking for justice for people against psychiatry is asking for trouble, as you are finding out."

We Americans should ask ourselves what kind of country we've become if critics who call attention to uncomfortable truths in an effort to correct what's wrong in our society are punished.

Was Dr. Szasz correct about America having become a nation where asking for justice is asking for trouble?

Institutionalizing Dishonesty

Psychiatry is evil because dishonesty is a routine part of what psychiatrists and those who work with them do.

For example, in my essay Suicide: A Civil Right, I quote Paul G. Quinnett, Ph.D., a psychologist, in his book about suicide saying "doctors like myself will stand up in court and say something to the effect that, by reason of a mental illness, you are a danger to yourself and need treatment" even when they do not believe the person so accused actually has a mental illness.

E. Fuller Torrey, M.D., a psychiatrist, is one of today's leading advocates of involuntary psychiatric treatment, contrary to the views he previously expressed in his book The Death of Psychiatry in 1974. In later books and through his Treatment Advocacy Center, Dr. Torrey urges legislators to make it easier to subject people to involuntary "hospitalization" for mental illness and outpatient psychiatric drugging court orders authorizing what is in reality a type of assault.

In his book Out of the Shadows: Confronting America's Mental Illness Crisis, Dr. Torrey says "It would probably be difficult to find any American psychiatrist working with the mentally ill who has not, at a minimum, exaggerated the dangerousness of a mentally ill person to obtain a judicial order of commitment" (John Wiley & Sons 1997, p. 152, italics added). He quotes Paul Applebaum, M.D., Professor of Psychiatry at Columbia University College of Physicians and Surgeons, saying mental health professionals regularly use "discretion to expand the scope of commitment statutes by admitting who might not qualify under strict [legal] criteria but are thought to be in need of [involuntary] care." Dr. Torrey continues: Families also exaggerate their family member's symptoms to get the person committed to a hospital. In a 1989 study of 83 families in Philadelphia, 18 percent said they had lied or exaggerated to officials in order to get a relative committed. ... In fact a number of local officials with the Alliance for the Mentally Ill (AMI), a nationwide support group for families, say they privately counsel families to lie, if necessary, to get acutely ill relatives hospitalized. . . . They say they were attacked when they weren't, they say their children tried to kill themselves when they didn't... Thus, ignoring the law, exaggerating symptoms, and outright lying to get care for those who need it are important reasons the mental illness system is not even worse than it is.

What Dr. Torrey means is laws should permit involuntary hospitalization and involuntary treatment without evidence the supposedly mentally ill person has ever done anything violent, making it unnecessary for others to make false accusations of violence to get somebody involuntarily "hospitalized" or involuntarily drugged.

Dr. Torrey's current position on forced psychiatric "hospitalization" and forced psychiatric "treatment" is 180째 opposite of his opinion in The Death of Psychiatry in 1974 wherein he said "It should not be possible to confine people against their wills in mental 'hospitals.' ... This implies that people have a right to kill themselves if they wish. I believe this is so" (Penguin Books, p. 180). In The Death of Psychiatry Dr. Torrey repeatedly puts the word disease, when referring to mental disease, in mocking quotation marks (as I often do). On pages 150 and 151 of The Death of Psychiatry he puts quotation

marks around the word disease six times to indicate he did not believe mental disease is real disease. In The Death of Psychiatry Dr. Torrey leaves no doubt he fully understands the erroneousness of the concept of mental illness, including schizophrenia. (See, for example, quotations from The Death of Psychiatry appearing on the first page of my essays Does Mental Illness Exist? and Schizophrenia: A Nonexistent Disease) In The Death of Psychiatry Dr. Torrey puts the word treatment in quotation marks (e.g., p. 149). He puts quotation marks around the words hospital and hospitals when referring to psychiatric or mental hospitals as a way of indicating they are really prisons (e.g., pp. 154-155).

It is impossible for me to believe someone who so eloquently and convincingly debunked the concept of mental illness, including schizophrenia, as Dr. Torrey did in The Death of Psychiatry, could be sincere now when he promotes these very ideas. In 1990 at the Thomas S. Szasz Tribute Dinner in New York City in a face-to-face conversation with Dr. Szasz, author of The Myth of Mental Illness, I asked Dr. Szasz, "Whatever happened to Fuller Torrey?!" Dr. Szasz answered with a single word, "Funding", and suggested I ask another psychiatrist who was with us that night, Dr. Ron Leifer, who gave me the same answer. Dr. Szasz wrote an article about Dr. Torrey's turnabout titled "Psychiatric Fraud and Force: A Critique of E. Fuller Torrey" in the Journal of Humanistic Psychology (Vol. 44, No. 4, Fall 2004, p. 416).

Although Dr. Torrey intended his above quoted words to be a critique of laws he says wrongfully protect the liberty of supposedly mentally ill people, the important lesson of what Dr. Torrey says in Out of the Shadows: Confronting America's Mental Illness Crisis is dishonesty is an integral and endemic part of involuntary psychiatric commitment of law-abiding but supposedly mentally ill people in the U.S.A. Human nature being the same everywhere, this habitual dishonesty is probably a reality all around the world. This dishonesty undermines rule of law and makes America's or any democracy's promise of liberty a broken promise.

Additional evidence of routine dishonesty in civil commitment of supposedly mentally ill and dangerous persons is found in The Clinical Prediction of Violent Behavior (Jason Aronson, Inc. 1995), by John Monahan, Ph.D., professor of law and psychology at the University of Virginia. The 1981 edition of this book was cited by the U.S. Supreme Court in Barefoot v. Estelle, 463 U.S. 880 at 899 (1983), where the Court says "one of the State's experts relied [on Dr. Monahan] as 'the leading thinker on'" the question of whether psychiatrists have the ability to predict future human behavior. In the 1995 edition of this book, Dr. Monahan points out that in Baxstrom v. Herold, 383 U.S. 107 (1966) and Dixon v.

Attorney General of the Commonwealth of Pennsylvania, 325 F.Supp 966 (1971) court decisions caused the release of prisoners detained because of predictions by psychiatrists or psychologists they would be violent if released from custody. If predictions of future human behavior by psychiatrists and psychologists were (1) honest and (2) anywhere close to accurate, a high percentage of these former prisoners would have committed violent crimes after they were released from prisons and mental hospitals. However, of the Baxstrom patients, all of whom were what are now usually called sexually violent predators, when followed by researchers for 2½ years after their release, only 8 percent were convicted of a crime, and "only one of those convictions was for a violent act" (p. 46). Additionally, "Only 14 percent of the [Dixon] patients were discovered to have engaged in behaviors injurious to other persons within 4 years after their release" (p. 47). Dr. Monahan continues: It is sometimes claimed regarding the Baxstrom and Dixon patients that no one really believed that they would be violent if released—that the predictions were merely a bureaucratic ploy to keep "chronic"

patients in the hospital—and so the finding that they were not violent upon release should not be surprising. ... It is difficult to respond to the criticism that mental health professionals were not telling the truth when they predicted violence so that they could facilitate their bureaucratic hold on patients. It may, unfortunately, be true that if the ticket to involuntary treatment is a prediction of violence, many psychiatrists and psychologists are willing to punch it, regardless of whether they actually believe the patient to be violence-prone. [pp. 50-51] I once told the Assistant Superintendent of a large state mental hospital in Texas it seemed to me doctors were routinely certifying "that the proposed patient is mentally ill and because of his mental illness is likely to cause injury to himself or others if not immediately restrained" when this was not true, and known by the doctor to be untrue, because the Texas Mental Health Code (Article 5547-66, later repealed) required the doctor to say this to get the "patient" forcibly "hospitalized" immediately. If the doctor said only that the proposed patient was mentally ill and needed hospitalization in a mental hospital but did not say the proposed patient was likely, because of mental illness, to cause injury to himself or others if not immediately restrained, the proposed patient remained at liberty until his commitment hearing (pursuant to Article 5547-35, titled Liberty Pending Hearing). In practice, patients were never permitted to remain at liberty until their commitment hearing. They were always certified as likely, because of mental illness, to cause injury to self or others if not immediately restrained and forcibly "hospitalized" (imprisoned) on the basis of an ex parte proceeding, meaning one about which they knew nothing prior to being taken into custody and incarcerated at the Hospital. I thought it noteworthy that the second physician, who was required to concur with the first prior to the commitment hearing regarding mental illness and need for treatment in a mental hospital, usually did not make the statement about imminent dangerousness on the fill-in-the-blank form where he made the required statements that the proposed patient was mentally ill and needed hospitalization. The space in the fill-in-the-blank statement about the proposed patient being likely because of mental illness to cause injury to self or others if not immediately restrained was usually left blank. (Why tell a lie when you don't have to?) Additionally, seeing and hearing the proposed patients at their hearings, and talking with them in the hallway outside the conference room where the commitment hearings were held, they never seemed dangerous. Many seemed old and senile and in need of nursing home care. Many seemed completely normal. I thought the Assistant Superintendent, a physician and probably a psychiatrist, would disagree with my observation that doctors were routinely lying on their Certificates of Medical Examination for Mental Illness regarding proposed patients' likelihood of causing injury to self or others due to mental illness if not immediately restrained. I thought he would insist that under no circumstances would a physician fill out a Certificate of Medical Examination for Mental Illness stating the proposed patient was likely because of mental illness to cause injury to himself or others if not immediately restrained when the doctor did not think so. However, to my surprise, the Assistant Superintendent agreed with me. He admitted psychiatrists and other physicians routinely certified people as likely, because of mental illness, to cause injury to self or others if not immediately restrained, even when the doctor knew this was not true, because this statement was required to prevent the proposed patient from remaining at liberty until his commitment hearing. I said to the Assistant Superintendent it was the intent of the Texas Legislature when drafting the Texas Mental Health Code to

allow persons with mental illness who need treatment in a mental hospital but are not imminently dangerous to remain at liberty until their commitment hearings. I asked him why doctors would tell lies to deliberately defeat the Legislature's intent. His answer was bold, candid, blunt and without the slightest trace of apology or embarrassment. He said, "Because that's the way you dumb lawyers wrote the law!" It was a candid admission psychiatrists and other committing physicians are willing to say whatever the law says they must to obtain an involuntary commitment even when they know what they are saying is false.

In his 1,104 page textbook, Mental Disability Law—Cases and Materials, Second Edition (Carolina Academic Press 2005, pp. 26-27), Michael L. Perlin, Professor of Law at New York Law School and for decades a leading scholar in mental health law, makes a similar observation: ...the legal system regularly accepts (either implicitly or explicitly) dishonest testimony in mental disability cases ... This pretextuality—along with sanism [analogous to racism]—drives the mental disability law system. ... the entire relationship between the legal process and mentally disabled litigants is often pretextual. This pretextualilty is poisonous. It infects all players, breeds cynicism and disrespect for the law, demeans participants, reinforces shoddy lawyering, invites blase judging, and at times, promotes perjurious and corrupt testifying. The reality is well known to frequent consumers of judicial services in this area: to mental health advocates and other public defender/legal aid/legal service lawyers assigned to represent patients ... In short, the mental disability law system often deprives individuals of liberty disingenuously and for reasons that have no relationship to case law or statutes.

In his book Psychiatry—The Science of Lies (Syracuse University Press 2008, p. 96), psychiatry professor Thomas Szasz says "Whether they talk about platelets or patients, diagnosis or treatment, law or liberty, psychiatrists remain stubbornly estranged from truth-telling."

Some years ago court decisions and statutes (in theory) limited civil commitment to occasions when incarceration is the "least restrictive alternative". In practice, this made and makes absolutely no difference other than requiring the committing physician, psychiatrist, or psychologist to take a few seconds to tell one more lie in his testimony: "Doctor, do you believe involuntary hospitalization is the least restrictive alternative?" "Yes." The same is true of legislators' attempts to restrict involuntary commitment without prior notice to the affected party and prior to his having any kind of day in court or opportunity to argue for his liberty to "emergencies". As I said in my conversation with the Assistant Superintendent, my observation has been that such "emergency" commitment provisions are used routinely in every commitment, including when there is no emergency. Such statutory limitations are not true limitations: They merely require mental health professionals (or family members) to tell one more lie.

Sadly, legislators refuse to repeal, and continue to write, laws that assume honesty on the part of psychiatrists, psychologists, family members, and other supporters and perpetrators of psychiatric oppression such as involuntary "hospitalization" and outpatient commitment and psychiatric assault such as involuntary psychiatric "medication" and involuntary electroconvulsive "therapy". They do not understand that any law that depends for its proper functioning on the honesty of mental health

professionals and others involved in civil commitment will not function in actual practice as legislators intended when enacting the law.

Punishing Violators of Our Unwritten Laws

In my essay Why the Myth of Mental Illness Lives On, I point out that we, as a society, employ psychiatry to impose what in reality are punishments for breaking society's unwritten rules of behavior. Psychiatry is evil because its "treatments" are often more cruel than the punishments we inflict on those who violate our written laws, such as against bank robbery. It is as if we had laws (actually, implicitly we do have laws) saying any person whose feelings of sadness are upsetting to other people may be involuntarily "hospitalized" and electroshocked against his will until his brain has been damaged sufficiently to lower his IQ by 30 points, or anyone who expresses ideas that seem irrational to other people may be given "antipsychotic" drugs against his will in sufficient dose and duration to cause permanent neurological injury and brain damage evidenced by abnormal body movements and dementia, or any teenager who annoys her parents may be forcibly administered "medications" that will shorten her life by twenty-five years. We do actually inflict these punishments (called "treatment" or "therapy") on people whose sadness or "depression" or other behavior bothers us or whose ideas seem strange or irrational, with court-ordered imprisonment ("hospitalization") and/or "involuntary medication" erroneously referred to as "antipsychotic" or involuntary electroshock. In The Antidepressant Fact Book, psychiatrist Peter Breggin, M.D., says "Damaging the brain to impair brain function lies at the heart of all the physical treatments in psychiatry" (Perseus 2001, p. 155; italics are Dr. Breggin's).

If administered as punishment, psychiatry's physical or biological therapies would be soon declared a violation of the U.S.A.'s Eighth Amendment prohibition against cruel or unusual punishment: Can you imagine a criminal law requiring or authorizing administration of braindamaging drugs or electroshock as punishment for a crime? Yet as "therapy" for supposed "mental illness", such "treatments" are inflicted on unwilling so-called patients. The legislators, judges, jurors, psychiatrists and other mental health professionals who impose these punishments on people, or permit them to continue, either fail to see the truth about involuntary psychiatric treatment being punishment, and inflicting injury, and constituting torture, or know it but are not honest enough to acknowledge it.

Undermining the Values of Democracy

Psychiatry is evil because it makes alienable, or voidable, human rights that the U.S.A.'s Declaration of Independence says are the God-given and unalienable rights of every human being: "WE hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness". Dictionary definitions of "unalienable" are cannot be taken away, surrendered, or given away; not transferable. When doing research for his biography of actress Frances Farmer, who was probably America's most famous involuntary mental patient before her death in 1970, William Arnold learned something most Americans never think about (Frances Farmer—Shadowland, Berkley Books 1978, p. 125):

Psychiatry gained the extraordinary power to arrest, detain, and sentence any citizen to an indefinite confinement without due process. The mere accusation of insanity was all it took for the suspension of every single human right guaranteed under the Constitution.

In the words a San Francisco, California emergency room (ER) psychiatrist— As time goes on, I become more and more aware of how awesome that power is. We're able to just grab people and say, "You have to be here for seventy-two hours," with no evidence other than our belief that it's the right thing to do; and we're empowered to do it. We don't have to prove it to anyone. That's a tremendously abusable power... [Paul R. Linde, M.D., Danger to Self: On the Front Line With an ER Psychiatrist, University of California Press 2010, p. 96]

It is also a power nobody should have in a country such as the United States of America that says in its founding document, the Declaration of Independence, that all men are endowed by their Creator with certain unalienable rights, one of which is liberty, and whose people and political leaders continue to claim is a nation of free people. _________________________________________________

IF ADMINISTERED AS PUNISHMENT, PSYCHIATRY'S BIOLOGICAL THERAPIES WOULD BE DECLARED IN VIOLATION OF THE U.S.A.'s EIGHTH AMENDMENT PROHIBITION AGAINST CRUEL OR UNUSUAL PUNISHMENT, BUT AS "THERAPY" THEY ARE PERMITTED TO CONTINUE _________________________________________________ In states with no right to trial by jury in civil commitment, psychiatrists actually have the power to hold people prisoner indefinitely, not only for 72 hours, because what happens after 72 hours is the formerly free citizen, now reduced to being a mental patient in hospital clothes and "medicated" against his will into a state of reduced mental functioning if not outright stupor, gets a hearing before a judge who routinely grants all requests by psychiatrists for continued confinement, with rare if any exceptions. I'm reminded of a justice of the peace in Kerrville, Texas in 2011 who in the conference room where hearings were held at the Crisis Stabilization Unit, a few minutes before hearing the first of four (4) cases, casually mentioned she was going to do whatever the doctor recommended, which is exactly what she did, committing all of the patients whose cases she heard. Hearings before judges who have this attitude, which is most of them, provide only a pretense of due process and do not protect against wrongful commitment.

(For reasons previously stated, all civil commitment of law-abiding and objecting persons is wrongful.) Even where the right to trial by jury exists, it is seldom exercised because lawyers supposedly representing patients don't tell them they must demand a jury to avoid a kangaroo court hearing in which commitment is a virtual certainty (see "'Assistance' of Counsel?" in Unjustified Psychiatric Commitment in the U.S.A.).

Few Americans know how tenuous and uncertain is their freedom in America. Few Americans know they can be arbitrarily imprisoned at any time in a place called a hospital merely because someone (often a family member) is willing to pay a mental health professional to question their "mental health". America advertises itself to itself and to the world as a free

country. In American public schools children are taught how lucky we are to be Americans because of the freedom we have in America. Almost all of us Americans believe the misleading platitudes about our freedom we hear in speeches by our political leaders, especially presidents, particularly on occasions such as the 4th of July and Memorial Day holidays. We sincerely believe the soldiers, sailors, and airmen who died for our freedom died for something real, but in fact the freedom for which Americans have died has been a myth throughout the Nation's history for many Americans, starting at the Nation's inception with Negro slavery and still today with what has been called psychiatric slavery. Because of psychiatric stigma, the victims dare not speak out, and the myths of mental illness and of psychiatric diagnosis go unchallenged, and America's promise of liberty continues to be false. Psychiatry is evil because it undermines America's most fundamental promise, which is freedom.

Recommended Reading

Louise Armstrong, And They Call It Help—The Psychiatric Policing of America's Children (Addison-Wesley Pub. Co. 1993). This book is out of print: Try bn.com; look for "marketplace sellers".

Janet & Paul Gotkin, Too Much Anger, Too Many Tears—A Personal Triumph Over Psychiatry (Quadrangle/The New York Times Book Co. 1975) Thomas Szasz, M.D., Psychiatric Slavery (Syracuse University Press 1998) Thomas Szasz, M.D., Psychiatry—The Science of Lies (Syracuse University Press 2008).

E. Fuller Torrey, M.D., The Death of Psychiatry (hardcover: Chilton Book Co./paperback: Penguin Books, Inc. 1974), especially Chapter 12, "People as Human Beings: Legal Implications" Recommended Video

"Without Consent" (a.k.a. Trapped and Deceived)(1994), available on YouTube.com. Seeing this movie shortly after reading Louise Armstrong's book And They Call It Help—The Psychiatric Policing of America's Children, the movie seemed to me a fictionalized version of Ms. Armstrong's nonfiction book. A movie reviewer at imdb.com calls it a movie about "the awful, evil people at the psych facility ... It's a sad yet realistic look at what truly goes on behind the closed, locked doors of these 'treatment centers, and psychiatric hospitals. ... It is just SICKENING how innocent people...are treated WORSE than convicted CRIMINALS' ... This movie is a chilling look at the pure injustice that occurs in today's psychiatric facilities." [capitalization in original] copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

[ Contents

| Next Essay: "The Future of Anti-Psychiatry Activism" ]

The Future of Antipsychiatry Activism Wayne Ramsay, J.D. "Many of us can never forget the injustice of being locked up against our will when we had committed no crime, often on the basis of nothing but a lie by a family member, and then forced to submit to terrifying and damaging "treatment"...typical of the practice of psychiatry today, which is increasingly biological, and yet not based on science. ... What do I do with this horrible knowledge? Should I try to put it behind me—and how would that be possible? If it were, did I even want to? What responsibility did I have to those who came after me, those being deceived into signing up for brain damage? Was I the kind of person who could walk away from that responsibility, or was I not? If I knew of such injustice and did nothing, how would I live with myself? ... Another accidental [antipsychiatry] activist was born." Linda Andre in her book Doctors of Deception—What They Don't Want You to Know About Shock Treatment (Rutgers University Press 2009, pp. 15 & 165)

Mark Twain once said "Truth is mighty and will prevail. There's nothing the matter with this, except that it ain't so." The continued existence of psychiatry is an example of how right Mark Twain was.

The Wikipedia article titled "Anti-psychiatry" (accessed October 11, 2012, since modified) said "Anti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s..."

Actually, antipsychiatry efforts date from at least 1774 with the publication of Samuel Bruckshaw's book One more proof of the iniquitous abuse of private madhouses. In 1838, John Thomas Perceval published his autobiographical book about his experience of being placed against his will in an insane asylum 1831 through 1832 in England, which he calls a "system of downright oppression" ("A Lunatic's Protest" in The Age of Madness, edited by Thomas Szasz, Anchor Books 1973, p. 29 at 32). In the 1860s Mrs. Elizabeth Packard was involuntarily committed to an insane asylum by her husband and later was successful in persuading Illinois state legislators to provide all persons with a right to a public hearing to determine the appropriateness of involuntary commitment to such an asylum, and today Illinois is one of the states where there is a right to trial by jury in civil commitment for supposed mental illness. In 1887 Nellie Bly published her exposé (see The Myth of Psychiatric Diagnosis).

The antipsychiatry movement got a boost in 1961 when psychiatry professor Thomas S. Szasz, M.D., published his book The Myth of Mental Illness questioning the central concept in psychiatry. In the half-century since Dr. Szasz has written many other books and many articles debunking the concept of mental illness and condemning the use of this concept to violate human rights. Among his books I have read are The Myth of Mental Illness (1961), Law, Liberty and Psychiatry (1963), The Manufacture of Madness (1970), Ideology and Insanity: Essays on the Psychiatric Dehumanization of Man (1970), The Second Sin (1973), Schizophrenia—The Sacred Symbol of Psychiatry (1976, republished in 1988), Psychiatric Slavery (1977), Psychiatry: The Science of Lies (2008), Antipsychiatry—Quackery Squared (2009), and Suicide Prohibition—The Shame of Medicine (2011).

In 1979, another psychiatrist, Peter R. Breggin, M.D., began a long career debunking claims of benefit of any of psychiatry's biological "therapies" in a series of books and articles. I've read ten (10) of Dr. Breggin's books: Electroshock—It's Brain Disabling Effects (1979), Psychiatric Drugs—Hazards to the Brain (1983), Toxic Psychiatry (1991), Talking Back to Prozac (1994), Your Drug May Be Your Problem (1999), Reclaiming Our Children (2000), The Antidepressant Fact Book (2001), The Heart of Being Helpful (2006), Brain Disabling Treatments in Psychiatry, Second Edition (2008), and Psychiatric Drug Withdrawal (2012).

In 1969, Ron Leifer, M.D., another psychiatrist, published his book In the Name of Mental Heath: The Social Functions of Psychiatry (Science House) in which he says the concept of mental illness is invalid and that involuntary psychiatric treatment violates the principle of rule of law.

In 1973, Stanford University psychology professor Daniel Rosenhan got widespread attention after publication of his article "On Being Sane in Insane Places" in Science magazine, showing psychiatrists cannot distinguish the sane from the insane and that what happens in psychiatric hospitals is harmful to patients, not therapeutic as psychiatry supporters claim ("On Being Sane in Insane Places", Science Vol. 179, January 19, 1973, p. 250).

Neurologist John Friedberg, M.D., published Shock Treatment Is Not Good For Your Brain—A Neurologist Challenges the Psychiatric Myth in 1976.

Lee Coleman, M.D., a psychiatrist, published The Reign of Error—Psychiatry, Authority, and Law (on

the dust cover: "A startling exposé of psychiatry's misrule in the courts, mental hospitals, and prisons"), published in 1984.

Sydney Walker III, M.D., published A Dose of Sanity—Mind, Medicine, and Misdiagnosis in 1996 in which he says psychiatry has substituted the science of diagnosis with the pseudoscience of labeling (describing) and challenges the use of psychiatric, especially neuroleptic, drugs. In 1998 he published The Hyperactivity Hoax debunking the concepts of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD/ADHD).

Boston University psychology professor Margaret A. Hagen, Ph.D., published Whores of the Court— The Fraud of Psychiatric Testimony and the Rape of American Justice in 1997.

Psychology and neuroscience professor Elliot Valenstein, Ph.D., published Blaming the Brain: The Truth About Drugs and Mental Health in 1998 showing the lack of evidence for chemical imbalances in the brain as a cause of mental illness and questioning the usefulness of psychiatric drugs.

Joseph Glenmullen, M.D., a clinical instructor in psychiatry at Harvard Medical School, published Prozac Backlash in 2000 showing the harm done by so-called selective serotonin reuptake inhibitors (SSRIs) such as Prozac.

Journalist Robert Whitaker published Mad in America—Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill in 2002 showing people considered to have mental illness were more likely to live successful lives before the advent of psychiatric drugs. In 2010 he published Anatomy of an Epidemic—Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America further documenting the fact that psychiatric drugs not only are not helpful but have caused an epidemic of disability.

Psychiatrist William Glasser, M.D., published his book Warning: Psychiatry Can Be Hazardous to Your Mental Health in 2003.

Neurologist Fred A. Baughman, M.D., published The ADHD Fraud: How Psychiatry Makes "Patients" of Normal Children in 2006, questioning ADHD as a true disease or disorder.

Richard P. Bentall, Professor of Clinical Psychology at the University of Bangor in Wales (UK), published Doctoring the Mind—Is Our Current Treatment for Mental Illness Really Any Good? in 2009 wherein he makes arguments supporting what he calls "rational antipsychiatry".

British psychiatrist Joanna Moncrieff, MBBS, MSc, MRCPsych, MD, Senior Lecturer, Department of Mental Health Services, University College London, published The Myth of the Chemical Cure, A Critique of Psychiatric Drug Treatment, Revised Edition in 2009. Also in 2009 she published A Straight Talking Introduction to Psychiatric Drugs. In 2013 she published The Bitterest Pills: The Troubling Story of Antipsychotic Drugs.

In 2013 three professors of social work or social welfare (Stuart A. Kirk, et al.) published Mad Science: Psychiatric Coercion, Diagnosis, and Drugs. British psychiatrist Joanna Moncrieff summarizes the book in a few words on the dust cover: "Mad Science...describes how the unfounded but repeatedly stated notion of madness as a brain disease helps to disguise the dark heart of coercive practices that remain at the centre of psychiatric care."

Many former psychiatric "patients" and their families and others have published books showing how psychiatry violates basic human (including constitutional) rights or how psychiatric treatment is ineffective and hurts rather than helps people. Among them are Francis Farmer, Will There Really Be A Morning? (1972), James A. Wechsler, In a Darkness (1972), Janet & Paul Gotkin, Too Much Anger, Too

Many Tears—A Personal Triumph Over Psychiatry (1975), Kenneth Donaldson, Insanity Inside Out (1976), Judi Chamberlin, Own Our Own: Patient Controlled Alternatives to the Mental Health System (1978), William Arnold, Frances Farmer—Shadowland, (Berkley Books 1978), Doug Cameron, How to Survive Being Committed to a Mental Hospital (1980), and Howard Dully and Charles Fleming, My Lobotomy (2007).

I've gone to meetings of anti-psychiatry, human rights groups as long ago as 1972. At many of them I heard the myths underlying modern psychiatry debunked by speakers better than myself.

Yet, when I talk with people who are directly responsible for or involved with psychiatric oppression, I find they know nothing of any of the above cited writings nor organizations opposing psychiatric quackery, oppression, and despotism.

For example, on October 14, 2010 at San Antonio State Hospital I observed involuntary commitment hearings of supposedly mental ill persons who were not charged with crime and asked one of the Mental Health Public Defenders if she had read anything by Dr. Thomas Szasz or Dr. Peter Breggin.

She said she had not in a way that gave me the impression she had never heard of either.

On September 2, 2011 in a face-to-face conversation an attorney in Portland, Oregon employed as a public defender whose practice was largely representing civilly committed persons said to be mentally ill and not charged with crime told me she had never heard of Drs. Szasz or Breggin.

On March 8, 2013, a mental health public defender in Austin, Texas told me he'd heard of Dr. Szasz and might have read an article about him decades ago but had never heard of Dr. Peter Breggin.

A mental health public defender who has never heard of Dr. Thomas Szasz or Dr. Peter Breggin is like an American history professor who has never heard of George Washington or Abraham Lincoln.

In 2011 I told a New Hampshire psychiatrist who was a member of the American Psychoanalytic (not Psychiatric) Association I was looking for a psychiatrist whose thinking is similar to Thomas Szasz, Peter Breggin, or Ronald Leifer. I was looking for a psychiatrist willing to certify to people's competence when executing psychiatric advance directives. He told me the only of those three names he'd heard of before was Thomas Szasz.

In November or December 2013 I asked a board-certified psychiatrist at Manhattan Psychiatric Center if she had read any critiques of psychiatric drugs by psychiatrists Peter Breggin or Joanna Moncrieff. She said she had not. She also could not name any critiques of psychiatric drugs she had read although she said she did know psychiatric drugs have "side effects."

On December 5, 2013 I asked another psychiatrist who I'd seen and heard testifying at an involuntary civil commitment hearing in the courtroom at Manhattan Psychiatric Center who later told me she'd completed residency training in psychiatry five (5) years before if she'd ever heard of Thomas Szasz or Peter Breggin. She said she had not heard of either.

The truth about psychiatry cannot prevail if people working in mental health such as psychiatrists, lawyers, judges, and the people who make our laws such as state legislators, governors, and members of Congress are unaware of it.

If truth were more powerful than widespread myths promoted by huge financial interests such as pharmaceutical companies that with costly advertising make huge profits by convincing professionals, lawmakers, and the public that mental illness is biological, to increase psychiatric drug sales, both the concept of mental illness and psychiatry (the pseudo-medical specialty based on the myth of mental illness) would have vanished decades ago. The ignorance of people responsible for the unscientific,

harmful, and morally objectionable activities about which the above mentioned authors have written illustrates the powerlessness of truth to prevail over highly promoted, well-established myths, selfish professional interests of psychiatrists and those who work with them, and the problems created by the inadequacy of rule of law I describe in my essay Why the Myth of Mental Illness Lives On. Someone, perhaps expanding on Mark Twain's remark, once said the truth is powerful and will prevail, but only if efforts are made to bring it to light. Obviously, hundreds of books and articles and videos (many of which are available on YouTube.com), and television and radio appearances by psychiatrists such as Thomas Szasz, Peter Breggin, Ron Leifer, Joanna Moncrieff, Grace Jackson, Colin Ross, Lee Coleman, neurologists such as Fred Baughman and John Friedberg, and psychologists such as John Breeding, Theodore Sarbin, and Jeffrey Schaler, are inadequate to overcome the propaganda causing most of us to accept the myth of mental illness as fact. Laws in every state of the U.S.A. and most if not all other countries provide for involuntary "treatment" with "hospitalization", drugs, and electroshock of persons who supposedly have mental illness. The situation is analogous to the late 1600s when everybody believed in witches and there were witch trials.

Since the commendable efforts of the above cited authors and others have proved to be inadequate to overcome well-established, widespread psychiatric myths, more is needed to reveal the truth to the people who make and administer our laws: legislators, governors, lawyers involved in civil commitment, judges, and potential jurors, meaning the whole population. Efforts to repeal involuntary treatment laws are commendable and must continue. Even if the myths on which psychiatry is based are so widespread and effectively promoted that it is impossible persuade legislators, governors, and judges to create a society in which mythological illnesses such as schizophrenia and bipolar and personality disorder and other supposed mental illnesses are no longer used to justify depriving law-abiding people of liberty, and to rationalize subjecting them to assault called involuntary psychiatric treatment, it is important for us to make the effort. In the words of Elie Wiesel, once a prisoner in Nazi Germany's Auschwitz, Buna, and Buchenwald concentration camps, and later a university professor, political activist and novelist, "There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest." We must at least try if we want to live in a truly free society and to pass a tradition of liberty rather than oppression and thought-control to future generations, and to protect people from brain-damaging quackery such as voluntarily or forcibly administered psychiatric drugs, electroshock, and psychosurgery.

Here are a few ideas: Buy a copy, or a few copies, of Dr. Breggin's Brain-Disabling Treatments in Psychiatry, Second (2008) Edition, or Robert Whitaker's Mad in America or Anatomy of an Epidemic and give them to judges who hear civil commitments. I've done that. Giving a copy of Dr. Breggin's book, or this book, The Case Against Psychiatry, to lawmakers, judges, and journalists may help overcome well established psychiatric myths. Giving them to mental health public defenders or lawyers appointed to represent "patients" may motivate them to provide real advocacy for their clients, although as observers have noted (see "Assistance' of Counsel?" in Unjustified Psychiatric Commitment in the U.S.A.), in many cases the judges before whom they appear will not tolerate them doing this. Dr. Breggin's BrainDisabling Treatments in Psychiatry, Second Edition is the most comprehensive writing I've seen showing how harmful are psychiatry's supposed medications and electroconvulsive "therapy". It is for sale in hardcover on Dr. Breggin's web site, breggin.com or at amazon.com. Dr. Breggin's book, or excerpts from this book, The Case Against Psychiatry, which I've made available free on the Internet, can be given to

judges, lawyers, and members of your state's state senate and house of representatives or assembly.

These books can also be given to members of Congress who might be persuaded to end federal government support for psychiatry in Medicare, Medicaid, and the Veterans Administration, and to abolish the National Institute of Mental Health (NIMH), and the Substance Abuse and Mental Health Services Administration (SAMHSA), and to repeal the federal mental health parity laws forcing health insurance companies to pay for psychiatric treatment as if it were bona-fide health care.

Writing letters can be part of this effort. When the U.S. Congress formed a Joint Select Committee on Deficit Reduction, composed of both U.S. Senators and U.S. Representatives, called the Supercommittee, to find ways to reduce the U.S. Government budget deficit, I wrote letters to all members of the Committee suggesting an end to federal government support for psychiatry, which I said would both reduce the budget deficit and improve the nation's health. With each letter I enclosed a compact disc of short YouTube.com videos, including the speech by Dr. Jeffrey A. Schaler in 2006, exposing psychiatry as quackery and as contrary to America's promise of liberty. Later, after doing research showing the Supercommittee could have met its deficit-reduction goal with the single measure of ending U.S. federal government support for psychiatry, I wrote a letter to U.S. Representative Paul Ryan, chairman of the House Budget Committee, making this suggestion.

It is especially important to educate members of your state's legislature. The scope of practice of licensed professionals is determined not by federal law, not by the U.S. Congress nor the Food and Drug Administration, but by state law created by state legislatures. It is state legislators who decide whether physicians may prescribe narcotics, or lethal drugs to assist a person who wishes to commit suicide, whether doctors of osteopathy (physicians with a D.O. rather than M.D. degree) will have the same scope of practice as doctors of medicine (M.D.; in all 50 states of the U.S.A. and many other nations, they do), whether psychologists can prescribe psychoactive drugs, whether optometrists (doctors of optometry-O.D.) can prescribe medicine for eyes, whether pharmacists can give injections (as they do in North Carolina), the scope of practice of podiatrists (doctors of podiatric medicine, D.P.M.), whether doctors of chiropractic (D.C.) or naturopathy (N.D. or N.M.D.) or naprapathy (D.N.) or midwives will be licensed and what their scope of practice will be, whether emergency medical technicians (E.M.T.), nurse practitioners (N.P.) or physician assistants (P.A.) can prescribe or administer medicines or do surgery and if so what classes of medicine they can prescribe or administer and what kinds of surgery they can do.

State legislators have it within their power to protect us from health care quackery such as biological psychiatry even if the FDA will not. State law can ban electroconvulsive brain damaging (electroconvulsive "therapy" or ECT) or define ECT or prescription of psychoactive drugs such as neuroleptics, SSRI antidepressants, and benzodiazepines, or psychosurgery, as outside the scope of practice of all physicians, including M.D.'s, within a particular state. State legislators have it within their power to repeal involuntary "medication" and electroshock laws and define any involuntary treatment with drugs, electroshock, or psychosurgery as assault or as another kind of act prohibited by the state's penal code. We, the public, cannot compete with drug companies who induce cooperation of the FDA by hiring FDA officials at enormous salaries, thereby encouraging those who remain at the FDA to do the same. We may not be able to equal the influence of big business such as drug companies that make huge campaign contributions to politicians. We can and should, however, try to influence our elected representatives, especially state representatives and state senators representing the district where we live.

Antipsychiatry activists don't have the advertising budgets of drug companies that make billions of dollars from selling psychiatric drugs (that are typically paid for by insurance companies and government programs) and therefore can and do buy television advertising and full-page advertisements in magazines. However, custom-made bumper stickers, buttons, and T-shirts can be bought inexpensively from local vendors. Copies of pamphlets and articles can be made at Office Max, Staples, and FedExOffice or Kinko's Copy shops and similar businesses and given to persons considering psychiatric care for themselves or persons in their families, and to governors, legislators, and judges.

3280 S. Florida Avenue (Route 41) Inverness, Florida

Goals The most important goals of the antipsychiatry movement are abolishing involuntary psychiatric treatment, establishing rule of law, and guaranteeing liberty to all law-abiding persons. Many people are gullible enough to be harmed by psychiatric treatment they accept voluntarily, and licensure laws exist to protect the public from health care quackery. Another goal of the antipsychiatry movement must therefore be prohibiting unscientific and harmful psychiatric treatment by licensed health care practitioners. This means enacting laws defining the scope of practice of all health care practitioners as excluding all of psychiatry's biological therapies—"medications", electroconvulsive brain damaging, and psychosurgery—with the exception of persons who are withdrawing from or who are permanently addicted to psychiatric drugs and cannot withdraw from them without terrible consequences. Success will be complete when psychiatry no longer exists as a supposed medical specialty, medical schools have abolished their departments of psychiatry, specialty or board-certification in psychiatry no longer exists, courts no longer accept psychiatric testimony as evidence, and people working as counsellors or advisors about dealing with life's problems are no longer called "therapists". Until rule of law is established and involuntary psychiatric "treatment" of law-abiding people is abolished, interim goals should be creating a right to refuse "medication" prior to a trial on the merits of a proposed civil commitment, trial by jury in civil commitment where it does not already exist, enactment of laws requiring government to abide by psychiatric advance directives (see next section), and suspending court-orders imposing involuntary

"medication" or electroshock during appeal of those orders.

However, because of widespread public ignorance, and selfish professional and financial interests of psychiatrists and others who promote psychiatric oppression, such as pharmaceutical companies that profit from laws requiring people to consume their products, and family members who want a rationale for suppressing and oppressing others in their families, and the ignorance or irresponsibility of legislators and judges who are personally responsible for authorizing psychiatric assault, and perpetuation of the myths that seem to justify psychiatric oppression by the news media and TV and movie fiction script writers, the only solution in our lifetimes—if there is a solution—is likely to be an individual solution. If and for so long as democracies (not to mention autocratic dictatorships) refuse to guarantee liberty to all law-abiding persons, and fail to protect citizens from health care quackery such as biological psychiatry, the strategies to protect ourselves and those we care about from arbitrary imprisonment called "hospitalization" and torture and brain damage caused by modern psychiatric "treatment", must be primarily about protecting ourselves and those we know and care about personally.

Psychiatric Advance Directives

In Vacco v. Quill, 521 U.S. 793 at 807 (1997), the U.S. Supreme Court said "[t]he principle that a competent person has a constitutionally protected liberty interest in refusing unwanted medical treatment may be inferred from our prior decisions ... our assumption of a right to refuse treatment was grounded ... on well-established, traditional rights to bodily integrity and freedom from unwanted touching." Unless the Court wishes to make an exception for psychiatric care (if "care" is the correct term), there is a federal constitutional right to refuse it. Furthermore, if this is a federal constitutional right, it prevails over state and federal laws authorizing involuntary psychiatric hospitalization or treatment.

A California Court of Appeals put it this way in Bartling v. Super Ct., 209 Cal.Rptr. 220 at 224-225 (Cal.App. 2 Dist. 1984): In California, "a person of adult years and in sound mind has the right, in the exercise of control over his own body, to determine whether or not to submit to lawful medical treatment." ... a competent adult patient has the legal right to refuse medical treatment. ... The right of a competent adult patient to refuse medical treatment has its origins in the constitutional right of privacy. This right is specifically guaranteed by the California Constitution (art. I, §1) and has been found to exist in the "penumbra" of rights guaranteed by the Fifth and Ninth Amendments to the United States Constitution. [citation omitted] "In short, the law recognizes the individual interest in preserving 'the inviolability of the person.'" [citation omitted] The constitutional right of privacy guarantees to the individual the freedom to choose to reject, or refuse to consent to, intrusions of his bodily integrity.

One antipsychiatry strategy is making a Psychiatric Advance Directive stating that if you in the future are determined to be "mentally ill" you wish to receive no treatment for your so-called mental illness, including hospitalization, "medications", ECT, or psychosurgery, including in "emergency" situations.

Involuntary psychiatric hospitalization and treatment is predicated on the assumption that mental illness is a valid concept, that psychiatry has bona-fide therapy for mental illness, that victims of mental illness

will benefit from psychiatric treatment, and that they would choose to have psychiatric treatment if they could make a rational decision. As I have shown in these essays, all these assumptions are wrong. By making a psychiatric advance directive refusing psychiatric treatment with a certification by a psychiatrist or psychologist, or both, of your mental competence at that time, this rationale for involuntary psychiatric treatment can be undermined. To prevent your psychiatric advance directive from being disregarded on the ground that you were not mentally competent when you made it, you need to have a psychiatrist or psychologist, or both, certify to your competence at the time of the making of your psychiatric advance directive. If you do not have a certification by a mental health professional of your competence when you made your psychiatric advance directive, it is likely to be disregarded. For example, in 2012 a woman in Minnesota provided me with a copy of her psychiatric advance directive, which had no such certification, just the signatures of witnesses who were not mental health professionals, and a copy of a Minnesota court order dismissing her psychiatric advance directive as a product of her mental illness and authorizing giving her electroconvulsive brain damaging (electroconvulsive "therapy") against her will.

I disagree with other lawyers I have discussed this with who are of the opinion psychiatric advance directives are not protection from involuntary "hospitalization", only from the kind of treatment a person can receive while involuntarily "hospitalized". These lawyers believe a psychiatric advance directive cannot stop a state from involuntarily "hospitalizing" a person because of the state's police powers or the states's right to protect the individuals and the public from (future) harm. I show why these justifications are invalid in The Myth of Psychiatric Diagnosis, Is Involuntary Commitment for "Mental Illness" or "Dangerousness" a Violation of Substantive Due Process?, and Suicide: A Civil Right. I believe the supposedly unalienable right to liberty theoretically enjoyed by all law-abiding Americans may not be abrogated because of predictions of future behavior until such time as it is possible to reliably predict the future. As I have shown, psychiatrists' and psychologists' predictions of future violence are wrong approximately 90% of the time. The justices constituting the majority in Barefoot v.

Estelle, 463 U.S. 880 (1983) may have, and I believe were, influenced by the fact that the State of Texas could have imposed a death penalty on a murderer without the prediction of future conduct required by Texas at that time. I think it unlikely a U.S. Supreme Court majority or a majority at most state or federal appellate courts would allow imprisonment, including when it is called involuntary "hospitalization", of persons who were always law-abiding because of a psychiatric "diagnosis" or predictions about his or her future behavior if he or she has a psychiatric advance directive declining such supposed care with his or her mental competence when making it certified to by a board-certified psychiatrist or other credible mental health professional. A psychiatric "diagnosis" is dehumanizing in terms of how other people see a person so "diagnosed" and makes it difficult for judges to think of such persons as citizens with constitutional rights. Nevertheless, I believe a psychiatric advance directive declining treatment including hospitalization for so-called mental illness with a certification to the maker's mental competence by a psychiatrist or psychologist, and a past that involves no lawbreaking, and evidence such as I've summarized in this book about the unreliability of predictions of future behavior, are likely to be a successful defense to unwanted psychiatric "treatment" including involuntary "hospitalization", but it may require the intervention of an appellate court, which can take months.

In Hargrave v. Vermont, 340 F3d 27 (2nd Cir 2003), a U.S. Court of Appeals ruled that refusal to

follow a person's psychiatric advance directive while recognizing and abiding by non-psychiatric health care advance directives is discrimination prohibited by the federal Americans With Disabilities Act.

Be leery of Scientology

Any discussion of the future of anti-psychiatry activism is incomplete without mention of the Church of Scientology (scientology.org) and an organization founded by the Church of Scientology named the Citizens Commission on Human Rights (CCHR, cchr.org). Scientology and CCHR are the best known antipsychiatry groups in the world, so much so people often wrongfully assume anyone who criticizes psychiatry must be a Scientologist.

How closely associated CCHR is with the Church of Scientology is difficult to discern. On October 4, 2009 when I met and talked with Dr. Thomas Szasz for over an hour and a half, knowing Dr. Szasz was one of the founders of CCHR, I asked him about the founding of CCHR and its connection with Scientology. Dr. Szasz told me the relationship between the Church of Scientology and CCHR was a "marriage of convenience" because the Church of Scientology was (and perhaps still is) the only group willing to fund CCHR. CCHR has created excellent films or videos shining the bright spotlight of truth on psychiatry. I recommend some of them in this book. The criticisms of psychiatry by the Church of Scientology and CCHR that I have seen have been basically accurate.

The association of Scientology with criticism of psychiatry has however been a handicap because Scientology is said by critics to be a for-profit business, not a religion (see "The Prophet and Profits of Scientology", originally published in the October 17, 1986 Forbes magazine) and because Scientology has been the target of other credible and frightening accusations.

In the 1980s or 1990s I saw a late-night television infomercial on a New York television station advertising a "Dianetics" program for $69.95 or $79.99 or whatever the price was. The infomercial said nothing about Scientology nor the founder of Scientology, L. Ron Hubbard, but I knew Mr. Hubbard had written a book titled Dianetics, The Modern Science of Mental Health and that he founded the Church of Scientology. The infomercial told viewers Dianetics would solve their psychological and emotional problems. The infomercial made me wonder if the people behind Scientology criticize psychiatry because they are in competition with it. During my aforementioned conversation with Dr. Thomas Szasz in 2009, Dr. Szasz told me being in competition with psychiatry is indeed why Scientologists criticize psychiatry. This same observation has been made by John Bush, executive director of the Texas Society of Psychiatric Physicians, who pointed out that "the Church of Scientology competes with psychiatry through it's Dianetics program, which it calls a 'modern science of mental health'" ("Opposition to shock therapy diverse...", Houston Chronicle, January 26, 1997, chron.com, accessed November 26, 2012). In accounts on YouTube.com by former Scientologists I've heard claims people recruited into Scientology spend tens of thousands or even hundreds of thousands of dollars on Scientology self-improvement courses or training leading to attaining various levels of improvement or recognition within Scientology. In her book Inside Scientology, Janet Reitman says Scientology has a "requirement that believers pay as much as hundreds of thousands of dollars to reach the highest levels of salvation." (This quote comes from the front flap of the book's dust cover.) Such allegations make it difficult to avoid the belief that whether it is psychiatry or Scientology, they're after your money (or in psychiatry's case, your insurance company's, Medicare's, or Medicaid's money). There are allegations of criminal activity by the

Church of Scientology: For example, a Huffington Post report is titled "Belgium To Prosecute Scientology As Criminal Organization; Church Faces Charges of Extortion, Fraud" (huffingtonpost.com, posted 12/28/2012). Before even talking with a Scientologist, do an Internet search so you'll be familiar with the allegations. I do not know which, if any, of the allegations of criminal or other wrongful activity by the Church of Scientology are true and which, if any, are a misleading counterattack by psychiatry supporters, because I have never been associated with Scientology nor CCHR and have not knowingly talked with nor otherwise communicated with a Scientologist or a CCHR member (other than Dr. Szasz, and more recently psychologist John Breeding of Austin, Texas) for many years, nor have I investigated the news reports about criticisms of Scientology. Whatever the truth or falseness of the allegations against Scientology may be, know that joining the Church of Scientology reduces your credibility in the eyes of many people, not only because of the allegations against it but also because its theology or cosmology seems so much like science fiction like you might expect from a religion founded by a science fiction writer, L. Ron Hubbard, which all agree Scientology is.

Don't have a family

I began this essay with a quote from Linda Andre's book Doctors of Deception: "... the injustice of being locked up against our will when we had committed no crime, often on the basis of nothing but a lie by a family member". The person most likely to start the process of forcing you into harmful psychiatric mistreatment, including incarceration in a so-called hospital, is someone in your family. The truth of this can be verified by asking almost anyone who has been subjected to involuntary psychiatric treatment or reading the background facts in court opinions about involuntary psychiatric commitments. As regards psychiatric oppression, your family is likely to be your enemy. If you have a family, and members of your family act in ways contrary to your best interest, such as trying to force you into so-called mental health care, your best option may be to divorce or separate yourself from and have no contact with nor communication with your family. In 2009 when I telephoned retired psychiatry professor Thomas S. Szasz and told him I intended to make a psychiatric advance directive, he asked me about my family. Learning I'm unmarried and without children and have only one elderly parent, my mother, he told me I probably don't need a psychiatric advance directive because, he said, "You don't have any family to screw you up."

Educate your family about psychiatry

However, for most of us not having a family is not an option. Also, for many people, family is one of their most important sources of happiness. Do what you can to make your closest family members, especially the one recognized by law as your "next of kin", aware of the truth about the complete lack of benefit of psychiatric "treatment" and harm from all of psychiatry's biological "therapies". One way to do that is loan them your copy of this book or give them books written

by Dr. Szasz, Dr. Breggin, Dr. Moncrieff, Robert Whitaker, and others listed in Recommended Reading in this book.

Don't expect public outrage

During the writing of this book I met with a long-time friend employed for many years as a hospital administrator. Speaking of health care in the U.S.A., she said, "We're killing a lot of people" due to "preventable medical errors." She said it's "amazing" there isn't "outrage" about of the number of deaths caused by what is supposed to be health care.

An article in The Economist in 2013 says "Every year nearly 100,000 people die in America alone from preventable infections acquired in hospitals" (Technology Quarterly innerfold, September 7, 2013, p. 8).

In their book 121 Ways to Live 121 Years and More: Prescriptions for Longevity (Basic Health Publications 2006, p. 3) Ronald Klatz, M.D., D.O., and Robert Goldman, M.D., Ph.D., D.O., warnThe U.S. Department of Health and Human Services reported that physicians cause 120,000 or more accidental deaths a year in the United States. Averaging that across the approximate number of physicians in the United States (700,000), the rate of accidental deaths per physician is 0.171. Comparing with a rate of accidental deaths per gun owner of 0.000188, doctors are statistically 9,000 times more dangerous than guns!* On the front cover of his book Malignant Medical Myths, Joel M. Kauffman, a Ph.D. in organic chemistry from M.I.T. and Professor of Chemistry at the University of Sciences in Philadelphia, who later "turned his attention to exposing fraud in medicine" says "medical treatment causes 200,000 deaths in the USA each year".

Some estimates go still higher. According to Gary Null, Ph.D., Martin Feldman, M.D., Debora Rasio, M.D., and Carolyn Dean, M.D., N.D., in their book Death by Medicine Praktikos Books 2011, p. 4-5)The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is nearly 800,000 per year. It is now evident that the American medical system is the leading cause of death and injury in the US. By contrast, the number of deaths attributable to heart disease in 2005, the most recent year for which final data is available, is 652,091, while the number of deaths attributable to cancer is 559,312.

If the immediately above estimates are even close to correct, mainstream health care in the U.S.A. kills more people than either heart disease or cancer. In his book Do Doctors And Nurses Kill More People Than Cancer? (European Medical Journal 2011, p. xxii), Dr. Vernon Coleman, a British physician, says "I firmly believe that doctors and nurses now kill more people than cancer." In "An Interview with Dr. Vernon Coleman", Dr. Coleman says "when doctors go on strike, patient morbidity and mortality levels invariably fall. What an indictment" (vernoncoleman.com, Š2006). Yet there has been no public outrage.

The exonerations of many persons sentenced to death for crimes they did not commit (see The Innocence List) should have sparked outrage about America's unreliable system of justice but has not.

News reports about the killing in 2011, with a drone strike, of American citizens Anwar al-Awlaki and Samir Khan, far from any battlefield, and without charges or trial, by order of President Barack Obama should have aroused public outrage, even if the victims had Arabic names different from those of most Americans and were in another country at the time, but did not. Attorney General Eric Holder has

said President Obama may likewise order the assassination of American citizens while they are within the U.S.A. Do an Internet search for "assassination of U.S. citizens by presidential order" and you'll find many news reports about this prior to the 2012 election. These news reports were in my opinion not as widely disseminated as they should have been. Rather than being outraged and spreading word of this far and wide, Americans re-elected the President who ordered the killings.

If none of the above caused widespread protest by the American people, it is unlikely a large number of Americans will be outraged by the arbitrary incarceration, torture, and killing of American "mental patients" who because of widespread belief in mental illness are not considered fully human.

Don't be a witness against yourself

In the words of psychiatrist Allen Frances, "There are no objective laboratory tests in psychiatry, and therefore there is no way for anyone to diagnose your problems [or accuse you of mental illness] without your help. ... The key to psychiatric diagnosis is self report" (Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life (HarperCollins 2013, p. 229-230). Because judges who rule on questions of constitutional law have for the most part been fooled by the "civil" label attached by legislators to involuntary psychiatric treatment laws and don't realize involuntary psychiatric treatment is punishment for violating society's unwritten laws, serving the same function as criminal law, most courts in the U.S.A. have ruled there is no right against self-incrimination in a psychiatric interview unless you are asked if you have violated a criminal statute. However, what can be done to you if you say, "I think I have a right of privacy that gives me a right to keep my thoughts to myself and that my constitutional right to freedom of speech includes the right to refrain from speaking, and I choose to exercise those rights"? You may be accused of "refusing to be examined", but (in the U.S.A.) your constitutional right of privacy and your First Amendment right to refrain from speaking are, or should be, superior to state or federal laws requiring you to be psychiatrically "examined".

Don't voluntarily make yourself a "patient"

You will see much encouragement to "ask for help". You'll be told it's the "healthy" and "smart" thing to do. Sometimes it is camouflaged as "counselling". Don't call attention to yourself by following this misleading advice. If you need someone to talk to, look for someone with experience in his or her own life with the kind of problem that troubles you as I suggest in The Case Against Psychotherapy. Make certain the person you talk with is someone who you can trust to do nothing you consider disloyal to you. Seeing a mental health professional is asking for trouble, because your "therapist" has vicarious liability for your actions should you ever do anything violent or criminal, and courts have ruled this duty of psychotherapists overrides the "therapist's" obligation to keep confidential what you say to him or her. This vicarious liability creates a strong incentive for the "therapist" to have you incarcerated or to report you to the police if he or she even vaguely suspects you might do anything that would make him or her liable for failure to predict and prevent your future behavior. The seminal case in this area of law is Tarasoff v. Regents of the University of California, 551 P2d 334 (Supreme Court of California 1976): "In our view, however, once a therapist does in fact determine or under applicable

professional standards reasonably should have determined, that a patient poses a serious danger of violence to others, he bears the duty to exercise reasonable care to protect the foreseeable victim of that danger." In that case the therapist was a psychologist, not a psychiatrist or other type of physician. The Court rejected the argument that psychologists and psychiatrists and other "psychotherapists" are unable to predict clients' or patients' future behavior. The Court also rejected the argument that psychotherapy is impossible when a person cannot rely on what he tells his psychotherapist remaining confidential. Confidential conversation or communication with mental health professionals has been essentially outlawed by American courts. An example of what can happen is a woman who consulted me because her "therapist" thought her children sleeping with her was abusive and reported this supposed child abuse to Child Protective Services.

Don't tell anyone you are thinking about committing suicide

The result of letting it be known you are considering ending your pain by ending your life usually will not be other people helping you achieve the goals dearest to your heart that will, in your opinion, make your life worth living. The result is more likely to be imprisonment (called hospitalization), and "involuntary medication", or in other words drug torture. If you resist swallowing or being injected with psychiatry's torture drugs, you risk being put in 4 or 5 point physical restraints, which may be the worst torture of all and has itself caused many deaths.

Electroconvulsive "therapy" is still touted as the best "treatment" for suicidal ideation, and in many if not most states of the U.S.A., the U.K., New Zealand, and probably many other countries, you may be electroshocked against your will by court order after psychiatrists testify it will "save your life", even though all it will really do is damage your brain while making money for psychiatrists and those who work with them. What psychiatry is likely to do to you because of your committing the "heinous crime" of freedom of thought (thinking about suicide) not unlikely will be worse than whatever originally caused you to think about ending your life.

Don't go to a hospital emergency room

Don't go to a hospital emergency room if you can possibly avoid doing so, especially when you are emotionally traumatized. Many if not most hospital emergency departments include either psychiatrists or masters degree level "mental health counsellors" or "consultants" whose job it is to have people forcibly removed from the emergency room to a psychiatric ward or state mental hospital, ensnaring people in the mental health system.

Don't call the police Don't call 911

Calling the police or an emergency telephone number, such as 911 (or in some countries 112) when you are emotionally traumatized is asking for trouble, for similar reasons as going to a hospital emergency room. Laws in probably every state permit police officers to, without a warrant, incarcerate people in psychiatric facilities. For example, Texas Health & Safety Code ยง573.001, says police officers may "take a person into custody if the officer: (1) has reason to believe and does believe that: (A) the person is mentally ill; and (B) because of that mental

illness there is a substantial risk of serious harm to the person or to others unless the person is immediately restrained; and (2) believes that there is not sufficient time to obtain a warrant before taking the person into custody."

Consider moving to a state with more favorable laws

Consider moving to a state where there is no outpatient commitment or where the right to jury trial in civil commitment is recognized.

According an article on the Connecticut General Assembly web site, "Involuntary Outpatient Mental Health Treatment Laws", dated December 21, 2011, "Connecticut is one of six states (also Maryland, Massachusetts, New Mexico, Nevada, and Tennessee) that do not have" involuntary outpatient treatment for supposed mental illness. A 2011 article at the Treatment Advocacy Center web site, "Assisted Outpatient Treatment Laws", that I accessed on May 15, 2015, says "The five states that do not have AOT [Assisted/Assaultive Outpatient Treatment] are Connecticut, Maryland, Massachusetts, New Mexico and Tennessee." However, when I contacted the Massachusetts Mental Health Legal Advisor's Committee (mhlac.org) in August 2013, a lawyer there told me about Massachusetts Rogers Guardianships, which is outpatient commitment by another name (appointing a "guardian" for the purpose of the "guardian" authorizing forced drugging or other treatment objected to by the proposed ward.) On February 7, 2014, a woman working for the Connecticut Legal Rights Project (clrp.org) told me outpatient commitment legislation has been proposed in Connecticut.

A list of states that do and do not permit trial by jury in civil commitment is found at the Antipsychiatry Coalition web site, "Do You Have a Right to Jury Trial in Psychiatric Commitment?" ________________________________________________

ALL BIOLOGICAL TREATMENT IN PSYCHIATRY IS HARMFUL TO YOUR HEALTH ________________________________________________ Because of the U.S. Court of Appeals for the Second Circuit decision in Hargrave v. Vermont, 340 F3d 27 (2003), the states of Connecticut, New York, and Vermont are required to abide by decisions you make in a psychiatric advance directive. I believe federal constitutional law requires all states of the U.S.A. to abide by health care decisions a person makes for himself when he is mentally competent, including (socalled) mental health care. To defeat the argument you were not mentally competent you made your psychiatric advance directive, it is important to get a certification of your mental competence from a mental health professional at the time you make it.

Consider leaving the country

It is regrettable people living in America, a nation that advertises itself as free, would need to leave America to escape psychiatric oppression such as involuntary "hospitalization", involuntary psychiatric drugging, or involuntary electroshock, but this kind of oppression is a reality for many Americans. When considering leaving the U.S.A. to escape psychiatric oppression and psychiatric assault such as forced drugging, keep in mind that without your health you have

nothing and that all biological treatment in psychiatry is harmful to your health. If you are courtordered to remain in the U.S.A. or in a particular state, you may be forced to decide whether it is more important to obey the law or protect your health. Remember also psychiatric oppression exists in most if not all nations, and to be safe you must avoid the mental health system wherever you go. copyright 2015 Permission to reproduce is granted provided the reproduction is accurate and proper credit is given

The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com

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