Putin critic tells of her mental hospital ordeal

From this Report

Larisa Arap has just emerged from a 46-day imprisonment in two Russian psychiatric hospitals. Pills were forced down her throat and she received injection after injection. She doesn't know what medications they were, or whether they will cause permanent damage.

"I don't feel very well, but I have a fighting spirit," Mrs Arap said yesterday, adding that sometimes she was so drugged she could barely walk or speak

She was forcibly interned, not for health reasons, but over her association with the opposition group led by former chess star Garry Kasparov, the United Civil Front. Her arrest stemmed from the publication of an article entitled "Madhouse," exposing the ghoulish practices of a Russian psychiatric hospital in the Murmansk edition of his organisation's newspaper, Dissenters' March.

She was interned in the very hospital she had written about. "We're ready to take this to court, although the medics have made it clear that we'll lose," she said.

Russian activists say her ordeal confirms what they've argued for years: punitive psychiatry did not end with the Soviet Union. Now, critics suggest, if someone has a grudge - a husband, a business partner, even a psychiatrist - it isn't difficult to get them confined to a padded room.

In recent years, Mrs Arap had been looking after the child of her daughter, Taisiya, in her home town of Murmansk, north of the Arctic Circle. Problems first arose in 2003, when she uncovered corruption in her local housing association, as she reported in "Madhouse." She was then attacked in her building, mystery callers threatened to murder her, and finally she was warned by the FSB, the KGB's successor, to keep quiet. She didn't.

Taken to a mental ward, Mrs Arap noted that many of its occupants seemed perfectly sane. "I was surprised that among them were lots of normal people," she wrote in "Madhouse". "But how they [staff] communicated with them: They shouted, they beat them up, they put them on drips, after which people became like zombies, they raped them, carried them off in the night and returned them in the morning, tormented."

One woman was threatened with the removal of organs, Mrs Arap said. Children were told that if they didn't give massages to medics they'd receive electro-shock therapy.

Mrs Arap was freed, but on 5 July, she was restrained at a clinic after stopping for documentation needed to obtain a drivers' license. Her doctor asked if she had written "Madhouse," and when she confirmed, police escorted her to a Murmansk mental hospital.

Taisiya said that when she was first arrested, Mrs Arap was beaten, and went on a 5-day hunger strike in protest, consuming nothing but water and smoking cigarettes.

It was only on 18 July that a court sanctioned her hospitalisation; until then, she had been detained illegally. Mrs Arap was moved to a hospital near Apatity, 180 miles from Murmansk, "without her agreement or the agreement of her relatives," Taisiya said.

It was "a closed hospital from which people rarely return. ... No positive feelings arise in this hospital. It's a psychological hospital for the difficult, the dangerous, the abandoned."

Mrs Arap was eventually released when a commission, initiated by Russia's human rights ombudsman, Vladimir Lukin, said there was no reason for her to be hospitalised.

She is due in court today to protest her treatment, and the United Civil Front plans to prosecute everyone involved, although a representative admitted the group has little chance of winning.

"We were never told anything concrete about why she was locked up," Taisiya said. "The most frightening thing of all is that the law gives a lot of power to psychiatrists and doctors to do what they want."

The Sorry State of APA Ethical Standards

An Opinion piece first seen here

The American Psychological Association now says that its members can’t take part in water-boarding, sleep deprivation or sexual humiliation, among other techniques that have become part and parcel of Bush tactics against alleged terrorists at Guantanamo. If they see such activities, they are now required to intervene to stop them, report them to superiors, and to report the names of participating psychologists to the APA.

What? You say you thought the premier professional society of psychologists would have long ago adopted such ethical strictures? After all, psychologists, those most politically liberal and emotionally empathic of healers, are supposed to be in the business of healing emotional pain, not causing it.

The Post described the move as a “rebuke” of Bush interrogation tactics. Yet the APA rejected an all-out ban on psychologists working at places like Guantanamo; the group says it’s fine for psychologists to serve in places where the American government practices torture because they can protect the prisoners and show the torturers how torture doesn’t work.

Right. That’s a self-serving proposition, and there’s a reason for such unethical, craven behavior not named in the Post article: the APA’s sordid history in confronting this issue.

It begins with the psychological profession’s intimate relationship with the military, extending at least as far back as World War I and helping devise interrogation techniques used during the Cold War and by the CIA to torture their Latin American captives during the Reagan years.

In this devastating critique of the APA by Washington Monthly contributing editor Arthur Levine, published earlier this year, psychologists are shown to have distinctly ambivalent attitudes towards torture and their participation in it. Levine notes that psychology has always been seen as a lesser science, abstract and subjective, and as a result psychologists have always sought the respect of their healing-profession peers. The military connection helped immeasurably, not least with job security. Psychologists also want things from the government, like research money and the authority to prescribe psychopharmacological drugs.

Another thing they want: to avoid prosecution for helping with torture. And so in 2004, the APA rejected a members’ demand that the group prohibit its members’ participation in the kinds of interrogation that had been exposed at Guantanamo and Abu Ghraib. Such a prohibition could open psychologists working with torturers to criminal charges.

In 2005, the APA convened a “blue ribbon” panel to come up with guidelines. Six of the panel’s 10 members were military. Let’s see now - one of the members wrote a lecture entitled Brainwashing: The Method of Forceful Interrogation; another was the chief psychologist at the Army’s Survival, Evasion, Resistance, Escape (SERE) program, which trained soldiers to resist many of the techniques later used at Guantanamo. One of the military shrinks said of sleep deprivation, “Maybe it’s useful to an interrogation to wake someone up early.” When a civilian panelist said the government should follow the Geneva Conventions, the panel’s leader, psychologist Gerald Koocher, said: “We’re not going to go there. International law doesn’t have any standing in U.S. courts.”

Well, you can imagine the panel’s findings. Its report said psychologists are ethically obligated to report torture, but it didn’t define torture, saying that “over the course of the recent United States military presence in locations such as Afghanistan, Iraq, and Cuba, … rules and regulations have been significantly developed and refined.”

Psychological understatement of the decade, courtesy of George Bush, Dick Cheney, and sock puppet Alberto Gonzales. Lancet magazine called the report a “disgrace.” If that kind of reception fazed the APA, it wasn’t evident when APA president Ronald Levant visited Guantanamo on the Pentagon’s dime. His press release gushed: “I saw the invitation as an important opportunity to continue to provide our expertise and guidance for how psychologists can play an appropriate and ethical role in national security investigations.”

The APA supported the McCain anti-torture amendment in 2005, but Koocher used it as a sleazy bit of self-congratulation:

Supporting an amendment in direct contradiction to the Administration’s wishes was decidedly not the politically expedient thing to do in order to advance APA’s financial interests. It was, however, the right thing to do, and APA did it, despite that doing so placed significant funding for psychology in jeopardy.

There you have it. You can see just how much that amendment (signing-statemented out of existence) meant to the APA: Even after its much-derided report, conferees at the group’s 2006 New Orleans gathering listened in thrall as Army Surgeon General Kevin Kiley reinforced a notion they’ve apparently bought into whole hog: “Psychology is an important weapons system.” And what’s the definition of torture anyway? “..is four hours of sleep deprivation? How loud does a scream have to be? How many angels can dance on the head of a pin?”

The group also continued to let its members obey military commands rather than the APA’s own ethics rules. Levine quotes psychoanalyst Stephen Soldz shredding that approach: “What sort of experts on ethics write the Nuremberg defense into their professional ethics code?”

Well, at the same conference where Kiley talked about psychology as a weapons system, Koocher said this: “The dictum of ‘do no harm’ has evolved to ‘do as little harm as possible.’”

Now, with this latest venture into the scary and unfamiliar world of professional ethics, the APA has at least defined torture and said its members cannot participate and must report those who do. Unlike the AMA and the American Psychiatric Association, however, it did not bar its members from serving at Guantanamo. Once again, the military got its way. As the Post article reports, an Army psychologist told the group, “If we lose psychologists from these facilities, people are going to die.”

Question for the APA: If the government thinks that psychologists are going to report torture, does the APA think psychologists will be allowed to witness it? As Leonard S. Rubenstein, executive director of the group Physicians for Human Rights, said, “It is unfortunate the APA did not recognize you cannot practice ethical psychology in interrogation settings in the context of pervasive violation of human rights.”

What you’re seeing in this sorry state of affairs is an ethically challenged profession still trying to have it both ways: Keep the military jobs (and resulting APA dues) and the research money while denouncing torture. That denunciation, though, comes with a wink-wink nod-nod to the Bush government. George Bush and the psychologists understand each other perfectly.

How one woman deals with mental breakdowns

as seen in the Rayne's World Weblog . Admirable writing. More at the link. Here's a snippet:

Those are my three primary experiences and symptoms that have been diagnosed by psychiatrists since 1982. The actual diagnoses vary, depending on the psychiatrist, and some of them include Major Depression, Dissociative Identity Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, PTSD, and the list goes on. I've also been diagnosed with illnesses that have nothing to do with the symptoms I described.

You see, once I got into the system, I developed other behaviors simply from the side effects from the medications I was given or from trying to survive in a psychiatric hospital or day program. These added behaviors were diagnosed with things like Chronic Undifferentiated Schizophrenia, Borderline Personality Disorder, Schizo Affective Disorder, and the list goes on.

These are the reasons I do not believe in the existence of mental illness. The system simply can't get it right, most likely due to the fact that there are no scientific tests for any mental illness.

Psychiatrists -- and NAMI -- will tell you that brain scans show differences in the brain chemistry of people with these illnesses, but hey, they failed to stop the medications before scanning the brains. Those scans are of chemically-altered brains! Other explanations are possible, too, like childhood trauma, which is the most prevelant occurance in people who have been diagnosed with a mental illness. But this whole brain-chemistry topic is for another post. It gets pretty involved.

So what do I do when those symptoms occur that I described above?

I embrace them. I honor them for what they are and I feel them for all they are worth. If I am depressed, I feel the depression as if I were being paid to describe to someone what depression is like. I describe it as I am feeling it. I don't try to distract myself from it the way everyone advises me to do. I hear things like "Take a walk, call a friend, go out with friends, exercise, do anything except feel the depression, you are only dwelling on it and it will make things worse, and for godssake don't isolate!" I used to feel so guilty for not being able to follow their advice. Not anymore! I will dwell on my depression. I will isolate. I will remove myself from all of society and I will treat myself to whatever my heart desires. That usually means isolating and wallowing in depression and crying my heart out for no reason.

There is movement in crying! There is healing. I cry as deeply as my body will allow, and the exhaustion that follows is the most healing experience of all. And "healing" does not mean that the depression is over. It may be around for a while, and that is okay. It is not something that needs to be healed. Depression is simply another human experience, and by god, I am going to experience it!

So what happens when you stop trying to cure depression? The only thing constant is change, and that includes depression. It is always temporary, and you can count on it.

Allowing depression to run its natural course ultimately allowed me to become a more compassionate and empathetic human being than I ever was before. These traits are priceless and eternal. No SSRI could ever accomplish that. Not even close.

The Teapot Syndrome

Another bit of humor found on the web.

Dr. White, the head psychiatrist at the local mental hospital, is examining patients to see if they're cured and ready to re-enter society.

"So, Mr. Clark," the doctor says to one of this patients, "I see by your chart that you've been recommended for dismissal. Do you have any idea what you might do once you're released?"

The patient thinks for a moment, then replies, "Well, I went to school for mechanical engineering. That's still a good field, good money there. But on the other hand, I thought I might write a book about my experience here in the hospital, what it's like to be a patient here. People might be interested in reading a book like that. In addition, I thought I might go back to college and study art history, which I've grown interested in lately."

"And the best part is, in my spare time, I can go on being a teapot."

Dr. Matt Israel of the Rotenberg Center and his Electric Shock Program for Kids

Food deprivation. Isolation. Electric shocks. Inside the taxpayer-funded program that treats American kids like enemy combatants. The main feature in Mother Jones this week is an expose about Dr. Matt Israel of the Rotenberg Center in Massachusetts and his Electric Shock Program for Kids, running under the title of School of Shock They ask the question: Eight states are sending autistic, mentally retarded, and emotionally troubled kids to a facility that punishes them with painful electric shocks. How many times do you have to zap a child before it's torture?

The Rotenberg Center is the only facility in the country that disciplines students by shocking them, a form of punishment not inflicted on serial killers or child molesters or any of the 2.2 million inmates now incarcerated in U.S. jails and prisons. Over its 36-year history, six children have died in its care, prompting numerous lawsuits and government investigations. Last year, New York state investigators filed a blistering report that made the place sound like a high school version of Abu Ghraib. Yet the program continues to thrive—in large part because no one except desperate parents, and a few state legislators, seems to care about what happens to the hundreds of kids who pass through its gates.

Their sidebar articles include:

• Nagging? Zap. Swearing? Zap: New York's Investigations of the Rotenberg Center
  
• Why Can't Massachusetts Shut Matthew Israel Down?
  
• The Cult That Spawned the Tough-Love Teen Industry
  
• Experts on Self-Injurious Kids Challenge Dr. Israel's Methods
  
• What Works for Troubled Teens?
  
  
• Photo Essay on the Rotenberg Center
  
• Primary Sources

The main articles are too long to even begin to quote in full here, we will probably be featuring the sidebars over the next few days.

The most effective treatments used by the psych industry for troubled teenagers have these things in common: They use family-based therapies; they treat adolescents with empathy, dignity, and respect; and, except for very short periods of emergency stabilization, they keep teens at home. Things that should be common sense to begin with.

Iowa to pay subjects $925K for stuttering study - 1930s experiment tried to cause speech issues by baiting, belittling orphans

Via this report on MSNBC - Sadly, not nearly enough for ruined lives.

The state [of Iowa] has agreed to pay $925,000 to unwitting subjects of an infamous 1930s stuttering experiment — orphans who were badgered and belittled as children by University of Iowa researchers trying to induce speech impediments.

Johnson County District Court Judge Denver Dillard issued an order approving the settlement Friday morning; it still must be ratified by the State Appeal Board, which next meets Sept. 4.

The six plaintiffs, who said the experiment left lifelong psychological and emotional scars, had originally sought $13.5 million.

“We believe this is a fair and appropriate settlement,” Attorney General Tom Miller said in a statement. “For the plaintiffs, we hope and believe it will help provide closure relating to experiences from long ago and to memories going back almost 70 years.”

He said it was a prudent outcome for the state because of the high costs of litigation and the difficulty of finding witnesses to events so long ago. He noted that the settlement provides a resolution for plaintiffs who are now in their 70s and 80s.

‘The Monster Study’

The 1939 experiment has come to be known as “The Monster Study” because of its methods and the theory researchers set out to prove — that stuttering is a learned behavior that can be induced in children.

Over a six-month period, Dr. Wendell Johnson, a nationally renowned pioneer in the field of speech pathology, and his staff tested his theory on 22 children who were in the care of the state-run Iowa Soldiers’ Orphans’ Home. Some were subjected to steady harassment, badgering and other negative therapy in an attempt to get them to stutter; the rest served as a control group.

According to the study, none became stutterers, but some became reluctant to speak or self-conscious about their speech.

Hazel Potter Dornbush, 84, of Clinton, who was 15 when she was chosen for the study, said she is relieved the case is settled.

“It was awful stressful all these years. I’m just glad it’s over,” she said. “How would you like to have them turn over all your past for the last 80 years?”

Dornbush said she recalls 22 children being taken from the state-run Iowa Soldiers’ Orphans’ Home to be used in the research. She said many of the children were told they stuttered even if they didn’t, and the researchers said they were there to help them stop.

“I call that brainwashing. I don’t care what anybody else calls it, that’s my language. I was wise to it right away, but I cooperated. You know we weren’t in no position to argue with nobody. We had nobody to lean on to help us out.”

The university kept the experiment and its methods from the former subjects for decades. It was not until 2001 when the San Jose (Calif.) Mercury News published an investigative story about the study and its methods did the former subjects learn about the experiment’s true purpose. The newspaper based its story on statements made by Mary Tudor, one of Johnson’s former research assistants, who lived in California at the time the story was published.

The university apologized for the experiment in 2001; the plaintiffs sued in 2003.

The settlement pays $900,000 to five of the plaintiffs, Dornbush, Kathryn Meacham, the Betty Romp estate, the Clarence Fifer estate and the Phillip Spieker estate. The state also will pay $25,000 to the sixth plaintiff, Mary Nixon.

Xanax Found in More DUI Stops

Hillsborough sheriff's Deputy Larry Morrell pulled over the 26-year-old woman after she crashed into an apartment gate on Brandon's Regency Avenue.

He shined a light in her eyes and asked her to track its movement. She couldn't.

"It looked like a pingpong game going on with her eyes," Morrell said.

Typically, only an extremely inebriated driver would fail the test so badly, he said.

But the woman's breath test showed a blood alcohol content of just 0.09 percent, slightly above the 0.08 level at which the state presumes impairment.

So while processing her arrest, Morrell asked her whether she had taken any drugs.

Yes, she admitted. She'd been at a party at a hotel in Brandon and had taken some Xanax, a prescription antianxiety pill.

Law enforcement officers increasingly encounter drivers impaired by dangerous combinations of alcohol and Xanax.

In Pinellas County last year, it was the most commonly detected prescription drug among those arrested for impaired driving, according to the Pinellas-Pasco Medical Examiner's Office, which tracks the statistics. The drug was found in 177 drivers suspected of driving under the influence.

That's a sharp increase from 1998, when the drug turned up in just four cases. Then, experts say, doctors were writing prescriptions much less frequently.

The drug isn't as potent as methadone, and not as well known as painkillers like OxyContin. But it is widely prescribed and reacts so strongly with alcohol that people taking Xanax become incapacitated with fewer drinks.

The drug, known generically as alprazolam , exacerbates alcohol's intoxicating effect.

"One plus one may equal three or more," said Dr. Raphael Miguel, the program director of pain medicine at the University of South Florida College of Medicine.

A drug on the rise

Xanax, also used to treat panic disorders, gives users a feeling of euphoria, said Dr. Bruce Goldberger, a toxicologist and director of forensic medicine at the University of Florida College of Medicine.

"That's why it's abused," he said.

The pills can be bought from friends who have prescriptions or illegally from an online pharmacy advertising "Anxiety Drugs with Discounts this Week!!!" But the drug is widely available legally, too.

Alprazolam is the fifth-most-commonly prescribed drug in America, according to data from IMS Health, a health care information company. In 2006, 37.5 million presprescriptions for it were dispensed, up from 29.9 million in 2002.

"People aren't any more anxious," Goldberger said. "But patients are being prescribed more and more medication in the past decade."

Miguel prescribes Xanax infrequently, but when he does, he tells patients about the drug's anesthetic effect, which can cause fuzzy memories, and warns them that the pills may make them drowsy.

"I prefer to start them on a weekend when they don't have job responsibilities, so they get a good idea of how they're going to feel on the medication," he said.

Patients starting on the drug may take doses of 0.25 or 0.5 milligrams, Miguel said.

Those doses can seem far less potent than the 80- or 160-milligram doses of OxyContin, a frequently abused painkiller, making it easy for someone to take too much of it.

"Doctors prescribe it for three times a day, but for patients with true anxiety, that's not enough, so they end up popping it four or five times a day," Miguel said. "It's easy to spill over into the next effect of oversedation."

Last year, 456 people overdosed on alprazolam, according to a report by the Florida Medical Examiners Commission, making it the fourth-most common cause of overdose, after cocaine, methadone and oxycodone, the generic name for OxyContin.

Deaths in professional wrestling can be traced to ‘wrestling cocktail'

Steroids, alcohol, and the psychiatric drug Xanax can be a very deadly combination. As reported in the Charleston Post and Courier Part of a series, more at the link

The news Monday that yet another professional wrestler had died at a relatively young age made headlines across the country.

But to Marc Mero, who has led an effort to clean up the business, it was just another name on a morbid list of wrestlers who have failed to reach the age of 50.

That's not to say Mero wasn't saddened to hear about the passing of Brian 'Crush' Adams, who was found dead at his home in Tampa, not that far from Orlando where Mero runs a high-end gym. Mero had talked to Adams a couple of weeks earlier, and the 6-6, 300-pounder sounded in good spirits, asking to come down and see Mero's facility.

The cause of the 44-year-old wrestler's death remains a mystery, and further tests have been ordered following an autopsy.

Mero hastened that it would be too early to speculate, but he couldn't help but wonder if his friend had fallen victim to a disturbing trend in the wrestling profession.

'Who knows how he died, but it seems to be the typical MO of ‘a wrestler found dead.' And he was one of the guys I was closer to, and it's just like, here we go again,' says Mero.

Adams had a history of steroids, having been arrested in 1995 on charges of illegal possession of steroids and weapons while living in Hawaii, which led to his WWE release.

Mero, like many, believe a number of elements — not just steroids — were involved in the Chris Benoit double murder-suicide in June. Steroids, painkillers, depression all likely played a part. But, he says, they're all by-products of a business that has a high mortality rate.

'Welcome to the world of professional wrestling,' says Mero. 'It's not one particular thing. It's the wrestling cocktail.'

Mero, who retired from the business several years ago, spoke with a forensic psychologist and his wife, a toxicologist, who told him alcohol, which was found near Benoit's body, and Xanax, which was found in his system, can be a very unpredictable combination.

'Some people can go sleep, and some people can absolutely freak out. They don't even remember what they did. And obviously mixing this with steroids and pain medication ... your body is only wired a certain way, and it can short-circuit.'

Mero still struggles trying to comprehend how Benoit, who he wrestled many times in WCW, could have killed his wife and 7-year-old son.

'It is one of the most baffling things. We all know he loved his son. What caused him to go over the edge and snap like that? One thing we don't talk a lot about is depression. There are many wrestlers who are depressed. I remember once thinking, ‘Oh, my gosh, I've got all this money in the bank, everywhere I go people are going to recognize me,' and you try to find happiness through other means. It's a very, very strange life. There are guys who can do it, and those who can't.'

The media, he says, put an emphasis on steroids because it seemed to be the most sensational hook to the story.

'They jumped on the steroid bandwagon since it was a double murder-suicide,' says Mero, who adds that WWE's explanation of what constitutes steroids makes little sense. 'The testosterone they're talking about ... we would have loved to have gotten our hands on that. Now when you get it from your doctor, it's not called steroids, it's called ‘hormone replacement.' I only wish there had been doctors back then, although there were doctors doing it illegally.'

'I don't see these problems that much in baseball or football with doctors prescribing because they don't get to pass go and collect $200 like they do in WWE,' he adds. 'So if we really tighten up the drug program and change the testosterone level from 10/1 to 4/1 like in the other sports and you get to retake it, and if you produce a prescription from your doctor, you pass it. That's something I think will take care of itself.'

Benoit's personal physician, Dr. Phil Astin, was charged with providing more than a million doses of prescription drugs and steroids — in just two years — to patients other than Benoit. A federal agent's affidavit said Astin prescribed a 10-month supply of anabolic steroids to Benoit every three to four weeks between May 2006 and May 2007.

'We really have to get down to these doctors because that's bad,' says Mero. 'Some of them are writing scripts over the Internet. They need to give them some strict penalties. I think because of Dr. Astin coming to light, a lot of doctors are getting real worried, and I guarantee you that a lot of pictures of professional wrestlers on the walls of doctors' offices throughout the country have been taken down.'

Psychologist guilty of fraud

from this report out of Corpus Christi

A 53-year-old psychologist with a professional office in Corpus Christi has been convicted of defrauding Medicare and Medicaid for millions of dollars, officials with the U.S. Attorney's Office and Texas Attorney General Greg Abbot said Friday.

A jury in a Corpus Christi federal courtroom found Joe Luis Lerma guilty Wednesday of nine counts of health care fraud. Lerma was accused of billing Medicare and Medicaid for services not performed by a licensed psychologist, not provided under the supervision of a licensed psychologist, or not provided at all, or for double billing for services over a 2 1/2-year period beginning in September 2002, officials with the U.S. Attorney's Office said.

Between January 2002 and June 2006, Lerma billed Medicare/Medicaid more than $1.7 million for two procedures, according to a press release by the U.S. Attorneys' Office.

An Oct. 24 sentencing hearing has been set by U.S. District Judge Hayden Head, who presided over the trial. Lerma faces as many as 10 years in prison for each of the nine counts. He also could face up to $250,000 in fines on each count, a spokeswoman for the U.S. Attorney's Office said.

"Texans will not tolerate the abuse of our Medicare system and those who depend on it for their health care," Abbot said in a press release.

According to evidence presented in the five-day trial, federal investigators found Lerma hired people with master's degrees in the psychological field to do psychological testing on a contract basis. Some were licensed by the Texas State Board of Psychologists and some were trainees, the press release states.

Under Medicaid regulations, psychologists cannot bill for services performed by others, officials with the U.S. Attorney's Office said.

Furthermore, Lerma used the subcontractors to perform testing, paying them $125 to $150 to perform examinations, the press release states. Medicaid was billed $750 for each test and $150 for the interview session.

Lerma is free on bond until his sentencing hearing, the release added. A phone call to his office went to a voice mailbox for the practice.

ADHD Misdiagnosis Checklist

A valuable resource from the website of Dr. Mary Ann Block. We remind people that we ourselves are not medical doctors, and do not offer any medical diagnosis. People with concerns about ADD/ADHD are encouraged to seek out competent medical care capable of checking out the issues presented below before making important decisions.

---

ADHD Misdiagnosis Checklist

A "Yes" answer to any of the following questions may indicate a health or learning problem that is causing ADHD-like symptoms.

Part 1

• Does your child eat a lot of sugary products, even at breakfast? Y or N
  
• Does your child drink a lot of caffeinated soft drinks? Y or N
  
• Does your child eat a lot of chocolate? Y or N
  
• Does your child wake up in the morning in a bad mood and then feels better after eating? Y or N
  
• Does your child have trouble waiting to eat? Y or N
  
• Does your child exhibit a "Jekyl and Hyde" personality where she/he is sweet one moment and then angry and hard to handle the next? Y or N
  

Part 2

• Does your child have airborne allergies? Y or N
  
• Does your child have allergies to animals such as dogs, cats, etc.? Y or N
  
• Does your child have chronic respiratory infections? Y or N
  
• Does your child complain of headaches? Y or N
  
• Does your child suddenly change from alert to sleepy even though she/he is rested? Y or N
  
• Does your child's behavior change radically when in certain stores such as grocery stores or linen stores that have fragrances? Y or N
  
• Do you or anyone in your household smoke? Y or N
  
• Do you use air fresheners, plug-ins or sprays or fragrant cleaners in your home? Y or N
  
• Do you have your carpets cleaned often? Y or N
  
• Do you use insecticide in your home or have an exterminator? Y or N
  
• Do your household cleaning products contain fragrances? Y or N
  

Part 3

• My child does not like to read. Y or N
  
• Does your child complain about how things feel, like clothing? "It feels scratchy." Y or N
  
• Does your child not listen well, but hearing tests are normal? Y or N
  
• Does your child seem disorganized but knows where things are? Y or N
  
• Does your child prefer to do projects and presentations over written reports? Y or N
  
• Does your child have difficulty remembering left from right? Y or N
  
• My child is not very coordinated or good at sports. Y or N
  
• My child has difficulty throwing a ball into an intended receptacle, such as a basketball into an intended receptacle or a paper wad into the garbage can? Y or N
  
• My child touches everything of interest. Y or N
  
• My child seems to get confused when asked to follow simple directions. Y or N
  
• My child has trouble with handwriting. Y or N
  
• My child has difficulty remembering more than one verbal request at a time. Y or N
  
• My child has difficulty understanding cause and effect - does not seem to understand simple consequences to specific actions. Y or N
  

Part 4

• Is your child a picky eater? Y or N
  
• Does your child limit his/her foods to only a few? Y or N
  
• Does your child refuse to eat fruits or vegetables? Y or N
  
• Is your child overweight? Y or N
  
• Does your child eat a lot of "fast foods"? Y or N
  
• Does your child eat a lot of processed foods such as cookies, cakes, white breat, potato chips, etc.? Y or N
  
• Does your child have difficulty sleeping or waking up in the morning feeling rested? Y or N
  
• Does your child bruise or bleed easily but your doctor does not consider it to be a medical problem? Y or N
  
• Are your child's nails cracked, brittle or discolored? Y or N
  
• Does your child take a lot of medications? Y or N
  

Part 5

• Has your child been prescribed a lot of antibiotics in the past ? Y or N
  
• Does your child eat a lot of sugar and processed carbohydrates such as white bread and pasta? Y or N
  
• Does your child eat a lot of the following foods:
  
  ______Mushrooms
  ______Dry Roasted Nuts
  ______Commercial Soups
  ______Bacon
  ______Apple Cider
  ______Barbecue Potato Chips
  ______White Flour
  ______Soy Sauce and Tofu
  ______Vinegar and all foods containing vinegar, including salad dressing, pickled vegetables, green olives, and sauerkraut
  ______Processed meats such as dried and smoked meat, sausage, hot dogs, luncheon meats
  
  

Part 6

• Does your child have allergies? Y or N
  If the answer is yes, please read the following:
  
  
  • Annals of Allergy, 1993 concluded that allergies by themselves may cause learning impairment.
    
  • Children with allergies performed less successfully, across the board, than children who did not have allergies.
    
  • These children should not have to take tests during their allergy season unless the allergies can be under control.
    
  • Allergies: WIth elimination of allergic foods, artificial colors, preservatives and caffeine, more than half exhibited improvement in behavior. Pediactrics, 1989
    

"Yes" answers in any or all of the sections are quite common in children misdiagnosed with ADHD.

A "Yes" answer in Part 1 may indicate a possible sugar level problem.
A "Yes" answer in Part 2 may indicate a sensitivity to household and everday chemicals.
A "Yes" answer in Part 3 may indicate a potential learning problem or a learning difference.
A "Yes" answer in Part 4 may indicate nutritional deficiencies.
A "Yes" answer in Part 5 may indicate a possible yeast problem.

When the underlying problems are identified and fixed, the attention and behavior problems usually resolve. No one should treat symptoms with psychiatric drugs, which carry a risk of serious side-effects, while ignoring the possible health and learning problems that may be causing the symptoms.

The menticide of Jose Padilla

An insightful commentary from the Majikthise Weblog. We are interested in what this also says about the quality of men who would do such a thing. The destruction of a human mind seems to be part and parcel a consequence of the psychiatric package of techniques.

Democracy Now! has a fascinating interview with a psychiatrist who interviewed suspected terrorist Jose Padilla for over 22 hours in an attempt to determine whether he was fit to stand trial after more than 3 years of solitary confinement.

In 1951, psychiatrist Joost Meerloo coined the term "menticide" to describe the kind of systematic psychological violence that the Chinese inflicted upon American POWs during the Korean War. The basic techniques haven't changed much since then. Over the years, these tactics have been embraced by a variety of cults and coercive "treatment" programs in the United States and abroad.

Today, the US government insists that mind-killing is an essential part of their endless war on terrorism. For details, see Jane Mayer's excellent New Yorker piece, The Black Sites.

Dr. Angela Hagerty concluded that Padilla was not fit to stand trial. Amongst other things, she observed that the 36-year-old American was furious at his own lawyers for making the government's job harder:

Also he had developed, actually, a third thing. He had developed really a tremendous identification with the goals and interests of the government. I really considered a diagnosis of Stockholm syndrome. For example, at one point in the proceedings, his attorneys had, you know,done well at cross-examining an FBI agent, and instead of feeling happy about it like all the other defendants I’ve seen over the years, he was actually very angry with them. He was very angry that the civil proceedings were “unfair to the commander-in-chief,” quote/unquote. And in fact, one of the things that happened that disturbed me particularly was when he saw his mother. He wanted her to contact President Bush to help him, help him out of his dilemma. He expected that the government might help him, if he was “good,” quote/unquote. [Democracy Now!]

Talk about not being fit to participate in your own defense...

Padilla was charged with conspiring to murder people overseas and providing material support to terrorists abroad. The government publicly accused Padilla of participating in a "dirty bomb" plot, but that wasn't what they charged him with. After nearly four years of "enhanced" interrogation, they still didn't have enough evidence to lay charges in the bomb plot? What does that say about the effectiveness of their methods?

By destroying Padilla, the government cheated us all out of justice. If Padilla had gotten the speedy trial that he was entitled to as an American citizen, he might have been legitimately convicted. Instead, the government tortured an American citizen and undercut the legitimacy of their prosecution. 

Depression is 'over-diagnosed'

From the BBC

Too many people are being diagnosed with depression when all they are is unhappy, a leading psychiatrist says.

Professor Gordon Parker claims the threshold for clinical depression is too low and risks treating normal emotional states as illness.

Writing in the British Medical Journal, he calls depression a "catch-all" diagnosis driven by clever marketing.

But another psychiatrist writing in the journal contradicts his views, praising the increased diagnosis of depression.

Professor Ian Hickie writes that an increased diagnosis and treatment of depression has led to a reduction in suicides and removal of the old stigma surrounding mental illness.

Under the current diagnosis guidelines, around one in five adults is thought to suffer depression during their lifetime. This costs the UK economy billions in lost productivity and treatment.

Prof Parker, from the University of New South Wales, in Australia, said the "over-diagnosis" began around 25 years ago.

The professor, who carried out a 15-year study of 242 teachers, found that more than three-quarters of them met the current criteria for depression.

He writes in the BMJ that almost everyone had symptoms such as "feeling sad, blue or down in the dumps" at some point in their lives.

He said prescribing medication may raise false hopes and might not be effective as there was nothing biologically wrong with the patient.

The number of prescriptions for antidepressants in England hit a record high of more than 31 million prescriptions earlier this year.

In an odd example of journalistic bias, this article in Irish Health reports the exact same story, but headlines it with the phrase Depression underdiagnosed. Which is not the plain and obvious thrust of the original story. The headline is backwards in meaning.

Of course, some shrinks will scream if their drug schemes are exposed, because it means less easy money.

Intensive ADHD therapies offer 'little benefit'

From this report

Intensive therapies offer little benefit for children with ADHD, suggest US study findings.

Neither intensive medication nor behavioural intervention for ADHD led to sustained improvement of the condition, compared with more moderate care.

The latest findings, from the Multimodal Treatment Study of children with ADHD (MTA), go against earlier results that suggested the 14-month course of intensive medical management and behavioural therapy worked.

But three-year follow-up data from 485 of 579 children involved in the study showed this improvement does not persist.

[...]

He added: ‘It’s a sort of let-out for the NHS because they’re suggesting that there’s no benefit of an intensive regime.

‘There was no way that the NHS was going to be able to provide that level of intensive therapy in routine practice.’

If you diagnose the wrong problem, then the treatments you come up with don't work.

Guilty of sex with inmate, psychologist downs pills in courtroom suicide attempt

From the Arkansas Democrat

A former prison psychologist swallowed pills in an apparent courtroom suicide attempt Wednesday moments after a jury convicted her of having sex with an inmate she treated last year.

Anna Clark, 55, was found guilty of two counts of third-degree sexual assault for having sex with a severely depressed and suicidal inmate in the mental health barracks at the Cummins Unit at Grady. The jury of seven men and five women recommended sentencing her to three years in prison or possible probation.

The Department of Correction hired Clark in February 2006 knowing that allegations surfaced in 2001 that she had had sex with a patient under her care then.

Is It Time To Sue Doctors Who Prescribe Drugs Off-Label ?(Part I )

Part 1 of an article by Evelyn Pringle, via this website.

Critics say the tens of thousands of lawsuits filed against the drug giants have had little impact when it comes to dismantling the off-label drug marketing schemes and therefore, there needs to be an all out campaign of highly publicized lawsuits filed against the doctors serving as middle man pushers, one by one by one.

It is illegal for a drug company to promote a drug for uses not listed on the FDA-approved label for the simple reason that the drug maker has not successfully proven to the FDA that the drug is safe or effective for uses not listed on the label.

"However, because of a legal loophole wider than a barn door, doctors have the authority to prescribe a drug for an unapproved use if they believe a patient would benefit, which means all a drug maker has to do is find doctors willing to promote the off-label uses and deny the drug company's involvement in the scheme.

And recent studies on prescribing habits have shown that the drug companies have found thousands of doctors all across the US in every field of medicine more than willing to participate in drugging for profit schemes by writing prescriptions that result in fees paid for monthly office visits that require no more than a few minutes of the doctor's time.

Critics says the first round of lawsuits should be filed against the quacks involved in prescribing psychiatric drugs to millions of children who are now stigmatized for life by a label of mental illness and will face a life-time of discrimination in finding jobs and obtaining health insurance due to a trail of medical records showing a history of taking drugs used to treat the most severe mental illnesses of major depression, bipolar disorder and schizophrenia.

Critics point out that doctors in fields of medicine that have never before involved the diagnosing and treatment of mental illness would never have come up with the idea to prescribe psychiatric drugs off-label to children without the illegal prompting from the drug makers.

For example, on June 20, 2004, the Florida Sun-Sentinel reported that a review of Medicaid records in that state found doctors with specialties in dermatology, nutrition, anesthesiology, ophthalmology, allergy, radiology, plastic surgery, hematology, obstetrics, pathology, diabetes, rheumatology, and hand surgery wrote prescriptions for psychotropic drugs for children aged 12 and younger between September 2002 to September 2003.

In record numbers, children are being fed powerful psychiatric drugs, often in combination with each other, including selective serotonin reuptake inhibitor antidepressants like Paxil, Cymbalta, Lexapro, Celexa, Prozac, and Zoloft and the new generation of "atypical" antipsychotics, such as Zyprexa, Risperdal, Geodon, Seroquel, Clozaril, and Abilify.

Children are also receiving drugs for ADHD in record numbers including the stimulants Adderall, Dexedrine and Ritalin, often combined with drugs approved only to treat adults with epilepsy such as Depakote and Neurontin.

Experts say its not uncommon to see children on an SSRI, an antipsychotic, a stimulant drug, and a sleeping medication all at the same time. Neurologist, Dr Fred Baughman, author of, The ADHD Fraud, warns that multiple drugs are being prescribed together in combinations that are lacking of any scientific basis.

Most critics say the ever-expanding list of invented disorders is the driving force behind this mass-drugging for profit. "While the drug companies certainly are getting rich providing mind-altering drugs for psychiatry's made-up mental disorders, the fault for the fraud of psychiatric diagnosing lies with the psychiatric community," says investigative journalist, Kelly Patricia O'Meara, author of "PSYCHED OUT: How Psychiatry Sells Mental Illness and Pushes Pills That Kill".

Harvard Instructor Dr John Abramson, author of, "Overdosed America," calls it a "progressive medicalization" of undesirable behavior in children. "We have seen this in the enormous proliferation of stimulant medication use," he notes, "far out of proportion to use in other countries."

Now the diagnosis of bipolar disorder in children is rising in parallel, he says, and clearly it is the drug industry driving this medicalization to sell more products.

Other experts agree. On February 15, 2007, the New York Times reported comments by Dr Bessel van der Kolk, a professor of psychiatry at Boston University who also treats children at a trauma clinic. "Most of the patients I see who have been misdiagnosed," she said, "have been told they have bipolar disorder."

"The diagnosis is made with no understanding of the context of their life," she said. "Then they're put on these devastating medications and condemned to a life as a psychiatry patient."

Former Clinical Director of Kingsboro Psychiatric Center in Brooklyn, Dr Nathaniel Lehrman also says, "relying on medication as the definitive treatment of psychiatric complaints, rather than addressing their real causes in patients' lives, is responsible for the gross overuse of psychiatric medications, especially among children."

He is especially critical of the ADHD diagnosis. "Its "symptoms" acting impulsively; easy distractibility; interrupting others; constant fidgeting or moving; and difficulty in paying attention, waiting one's turn, planning ahead, following instructions, or meeting deadlines, can be found in any of us," Dr Lehrman points out.

A study in the August 3, 2004 Archives of Pediatric Adolescent Medicine reported that the rate of antipsychotics use by children covered by a public health care program in Tennessee had nearly doubled between 1996 and 2001, and had increased 61% with preschoolers.

A review of Medicaid records in Ohio for the month of July 2004, found 18 newborn to 3 year-old babies had been prescribed antipsychotics and 28 more in the same age group were on antidepressants, according to the April 25, 2005 Columbus Dispatch.

According to the December 2006 Special Report entitled, "Foster Children - Texas Health Care Claims Study," in 2004, psychotropic drugs accounted for more than 76% of the cost of all medications prescribed to foster children in Texas on Medicaid.

Of all drugs prescribed, the study found antidepressants, antipsychotics and stimulants were the most frequently prescribed and half of the children in a sample of 472, received 3 or more drugs from different classes at the same time and 27.5% received 4 or more, with antidepressants and antipsychotics being the two most commonly prescribed together.

The same year, Texas also spent nearly $4.8 million on nearly 43,000 anticonvulsants used as mood stabilizers for about 4,500 foster children, including 133 aged four and younger, as well as close to $4.5 million on 45,318 stimulant prescriptions for more than 6,500 foster children including nearly 200 who were aged 4 and under.

There were also nearly 2,500 prescriptions written for hypnotic/sedative drugs for about 1,000 foster children, including 232 four and younger to treat anxiety or sleep disorders.

In addition, more than 400 of the foster children were prescribed antidyskinetics drugs to control side effects caused by the antipsychotics which included tremors, tics, dystonia, dyskinesia and tardive dyskinesia.

Last year in Florida, Medicaid records show that more than 1,100 children 6 and under were prescribed antipsychotics at a cost to Medicaid of nearly $1,800 per child and most were prescribed to treat mood disorders, depression, anxiety or ADHD. In addition, 367 Florida toddlers 3 and under were prescribed ADHD drugs in 2006.

The debate about the over-drugging of children has been festering behind the scenes for a decade, but the all-out war between medical professionals recently exposed in the media is the result of the widespread outrage over the highly publicized overdose death of the 4-year-old toddler, Rebecca Riley in Hull, Massachusetts in December 2006.

The outrage began when the police investigation revealed that Rebecca was given the diagnoses of ADHD and bipolar disorder by Dr Kayoko Kifuji, at the Tufts-New England Medical Center, when she was only 2 and half-years-old and placed on a 3-drug cocktail of Clonidine, a drug approved to treat adults with high blood pressure, Depakote an antiseizure drug approved to treat adults with epilepsy, and Seroquel, approved to treat adults with schizophrenia or the mania of bipolar disorder.

Investigators also reported that Dr Kifuji had diagnosed Rebecca's 6-year-old sister and 11-year-old brother with the same disorders and kept them on the same 3-drug cocktail even longer than Rebecca. The mother and father were also diagnosed mentally ill and the whole family was covered by Medicaid, according to police reports.

In a June 17, 2007 report in the Boston Globe, reporter Scott Allen discussed Rebecca's death and the rising dissent within the medical profession. Under the headline, "Backlash on bipolar diagnoses in children," he noted that psychiatrist, Dr Joseph Biederman of Massachusetts General Hospital, "could be credited more than any other" for convincing Americans that even small children can develop bipolar disorder.

"From his perch as one of the world's most influential child psychiatrists," Mr Allen wrote, "Biederman has spread far and wide his conviction that the emotional roller coaster of bipolar disorder can start "from the moment the child opened his eyes" at birth."

Critics also identify Dr Janet Wozniak, director of the Pediatric Bipolar Disorder Research Program at Massachusetts General, as a researcher who has worked side by side with Dr Biederman to promote the bipolar diagnosis for children.

On June 19, 2007, pediatrician, Dr Lawrence Diller, author of "Should I Medicate My Child," publicly denounced their research and what he called "misguided standards of care" in an editorial in the Boston Globe and informed the world that he had recently done "the nearly unthinkable" at a medical conference on bipoloar disorder in children.

"I charged another doctor," he stated, "with moral responsibility in the death last December of Rebecca Riley, a 4-year-old girl from Hull."

He acknowledged that he understood the risks of naming names. "Yet I felt compelled," he said, "to name Joseph Biederman, head of the Massachusetts General Hospital's Pediatric Psychopharmacology clinic, as morally culpable in providing the "science" that allowed Rebecca to die."

According to Dr Diller, Dr Biederman shocked the child psychiatric world in 1996 by announcing that nearly a quarter of the kids he was treating for attention deficit disorder also met his criteria for bipolar disorder. "Up until then," he says, "bipolar disorder was rarely diagnosed in teenagers and unheard of in prepubertal children."

Dr Diller says there are thousands of potential Rebecca Rileys being treated with multiple psychiatric drugs because Dr Biederman has said it's OK and necessary.

Psychologists are the last of the medical professionals willing to support the interrogation of "high-value" detainees

In a rebuke of President Bush, the American Psychological Association has resolved to condemn brutal CIA and military interrogations. Psychologists are the last of the medical professionals willing to support the interrogation of "high-value" detainees, and so this is a definite change in course. But it might not be so simple as issuing an official statement. As seen in this Salon News Article:

The American Psychological Association, the world's largest professional organization of psychologists, is poised to issue a formal condemnation of a raft of notorious interrogation tactics employed by U.S. authorities against detainees during the so-called war on terror, from simulated drowning to sensory deprivation. The move is expected during the APA's annual convention in San Francisco this weekend.

The APA's anti-torture resolution follows a string of revelations in recent months of the key role played by psychologists in the development of brutal interrogation regimes for the CIA and the military. And it comes just weeks after news that the White House may be calling on psychologists once again: On July 20, President Bush signed an executive order restarting a coercive CIA interrogation program at the agency's "black sites." Director of National Intelligence Mike McConnell has indicated that psychological techniques will be part of the revamped program, but that the interrogations would be subject to careful medical oversight. That oversight is likely to be performed by psychologists.

In fact, given what promises to be the continuing involvement of psychologists in coercive interrogation, there is intense infighting within the organization about whether simply condemning abusive tactics is enough. Some of the APA's 148,000 members think the anti-torture resolution put forward by APA leadership is too weak, and they are putting intense pressure on the organization's leadership to go a step further and ban psychologists from participating in detainee interrogations altogether. They have introduced their own resolution proposing a moratorium. "I and others think that a moratorium is essential to try to tell the government that psychologists are not going to participate in the interrogation of enemy combatants," said Bernice Lott, a member of the Council of Representatives, the APA's policy-making body. Others oppose the moratorium because they think psychologists must be involved in the interrogations to prevent abuse -- and because the government may just choose to use non-APA members for its interrogations, as has already happened.

Whether or not the APA imposes a moratorium at this weekend's convention, its Council of Representatives is likely to approve the resolution condemning specific interrogation techniques. A draft of the resolution obtained by Salon includes "an absolute prohibition" on psychologists directly or indirectly participating in interrogations that involve a list of coercive measures, including, but not limited to, mock executions; water-boarding; sensory deprivation; "hooding"; forced nudity; sexual humiliation; rape; cultural or religious humiliation; exploitation of phobias or psychopathology; stress positions; dogs; physical assault; slapping and shaking; exposure to extreme heat or cold; induced hypothermia; psychotropic drugs or mind-altering substances; isolation and sleep deprivation; threats of harm or death, or threats to members of an individual's family.

And even without a moratorium, adopting a resolution condemning specific interrogation techniques -- including some allegedly used by the CIA -- could be interpreted as a rebuke of the agency and the White House. Stephen Soldz, a faculty member at the Boston Graduate School of Psychoanalysis, supports a moratorium. But he said the new condemnation of specific harsh tactics would in itself be "an advance because it would be a blow to the CIA." (The military last September disavowed the tactics and embraced a new interrogation field manual that expressly prohibits the coercive methods, but the CIA, under Bush's new executive order, seems to be going ahead full steam.)

But how much of a rebuke it would be is debatable. "It is somewhat of a rebuke, because it does name some interrogation techniques that have been used or advocated by the White House and the CIA," said Neil Altman, a former member of the APA's council. "But it still allows psychologists to continue to be part of a process which overall is cruel, inhuman and degrading," he added. "There is no due process. It is indefinite detention without being charged. The entire setting is cruel, inhuman and degrading."

[...]

But it is unclear whether an APA resolution will have any effect on real-world interrogations conducted by the CIA. Salon reported in June that two CIA-employed psychologists, James Mitchell and Bruce Jessen, were in the cross hairs of Senate investigators looking into the genesis of the brutal, and very similar, post 9/11 interrogation regimes developed by the CIA and the military.

Mitchell and Jessen are part of a cabal of psychologists associated with the military's secretive Survival, Evasion, Resistance and Escape program. The program trains soldiers to resist torture if captured by exposing them to brutal techniques employed by Cold War adversaries who would violate the Geneva Conventions to provoke confessions: water-boarding; forced nudity; stress positions; lengthy isolation; sleep deprivation; sexual humiliation. The plan was to reverse-engineer those techniques for use on real detainees.

The military employed the same game plan at the same time, suggesting high-level government coordination. A previously classified Department of Defense inspector general report released in May detailed efforts in 2002 by the Army Special Operations Command's Psychological Directorate to reverse-engineer SERE training for use at Guantánamo, including a September 2002 "SERE psychologist conference" at Fort Bragg to brief staff from Guantánamo on the use of SERE tactics.

But Mitchell and Jessen, the psychologists who helped the agency, are not APA members. So a resolution might not matter much to men like them.

[...]

Why Psychiatry is Outdated

Psychiatry’s roots in paternalism: why the field has not kept up with contemporary thinking, an article by Juli Lawrence of ect.org:

At its core, the field of medicine has always been paternalistic: doctor knows best. Even the Hippocratic Oath included a line that encouraged physicians to perpetuate the imbalance of power between doctor and patient: “I will prescribe regimen for the good of my patients according to my ability and my judgment.”

But while patients’ rights activists have provoked change in this power struggle, the field of psychiatry maintains roots deeply planted in paternalism and patriarchy. This imbalance of power is evident in the privacy of the doctor’s office, among colleagues, in hospitals, and even in the courtroom.

The very nature of psychiatry seeks to modify emotions and behavior, whether through therapy, medications, electroshock and other methods, and the doctor-
patient relationship revolves around a paternalistic imbalance of power. Psychiatrists label their patients as compliant or noncompliant to characterize whether or not the psychiatrist’s power has been accepted.

The doctrine of informed consent theoretically gives a patient information about a treatment, and the right to refuse treatment for any reason. But the doctrine hinges on the patient’s competence, and in psychiatry, the concept of competence is often used to reassert the psychiatrist’s power.

In many states, a person’s competence can be decided by the views of one psychiatrist. Some states require a second opinion, though it’s rare that in a simple competency hearing one doctor will disagree with another. In the court system, psychiatrists are given even more power and it would take a unique judge to listen to a patient - particularly a psychiatric patient - over a doctor.

Consider a case of forced electroshock involving an elderly woman in St. Louis, Missouri in August, 2000.

Kathleen Garrett was a woman in her 60s, recently widowed and undergoing treatment for breast cancer, as well as enduring a recent estrangement from one of her sons. Most women in such circumstances would find themselves with feelings of grief, if not downright depressed. Mrs. Garrett, with a lifelong history of episodic depression, did become depressed. Her psychiatrist adjusted her medications, but the depression remained. He then told her she needed to have electroconvulsive therapy, or electroshock. Mrs. Garrett refused, and immediately transformed into a “noncompliant patient.”

Instead of spending time discussing other options or why she didn’t want electroshock, her psychiatrist rushed into court, told the judge that he knew best, and that Mrs. Garrett was not competent to make such a decision. He didn’t mention that until the moment she said no, he considered her competent to make the decision.

Mrs. Garrett had very little time to put together a legal defense, and her Social Security income limited her access to an experienced attorney. The judge quickly ruled against her, ordering the doctor to begin electroshock treatments against her will. Mrs. Garrett would have been just another silent victim of the abuse of psychiatric power, but a loud and angry e-mail campaign against the doctor and hospital focused negative attention on her plight, and she was released from the hospital before completing the full series of treatments against her will.

Psychiatric patients often find themselves labeled noncompliant if they dare to speak back to their doctors, challenge his authority, or even ask questions. If a prescribed treatment, such as medication, is unsuccessful, the patient is again labeled noncompliant, with the psychiatrist just assuming that the patient has not followed directions. Psychiatric patients are at a distinct disadvantage because of the psychiatrists’ ability to use force to maintain the power structure.

Certainly “noncompliance” is a term used in other medical specialties, and doctors complain that patients with high blood pressure, diabetes, and other diseases sometimes do not take medications as directed. However, despite a potential life-threatening outcome, a person with high blood pressure won’t find herself plunged into a courtroom drama to force compliance. A woman with diabetes who skips an insulin injection, or decides she’s tired of the routine, will not open her door to a nurse with a hypodermic in hand.

Psychiatric patients often face scenarios like this once they threaten a psychiatrist’s power, and states are enacting laws making it easier to force “compliance,” such as Illinois SB0198, currently undergoing Senate review. As it went through the Rules Committee, the proposed bill has had its language changed from “cause serious harm to self or others” to “engage in dangerous conduct.” Past experience has shown that dangerous conduct could be anything from eating unhealthy foods to disagreeing with a psychiatrists’ order to take medications despite having caused dangerous side effects in the patient’s past. Or dangerous conduct, more often, would simply be a “noncompliant patient.”

A mental health rights activist once said that if someone prepares a buffet of delicious, healthy food, people will come. But if that buffet serves food that makes people feel sick, they won’t return. It is an excellent analogy, and one that needs attention in the world of psychiatry. Too often, patients who tell their psychiatrists that the medications make them feel worse than their original symptoms made them feel are quickly tossed into the basket of “noncompliant patients.” The atmosphere quickly shifts from the psychiatrist’s comfortable balance of “Doctor says, patient obeys,” to one of “I am the expert, you must do as I say.” It can easily disintegrate into the psychiatrist labeling the patient incompetent, because she did not submit to his power and authority.

Experienced patients quickly learn they have a choice: they can submit and follow orders, or they can play “the game.” Most psychiatric patients fully understand that the game involves pretending to do exactly as ordered, and to put on an air of gratefulness. Unfortunately, this also means that the patient no longer confides in the psychiatrist with regard to symptoms, and their emotional disorders may grow worse. Alternately, the symptoms may abate on their own, as is common with psychiatric disorders. In the end, the doctor proclaims his methods are successful, he asserts his superiority, and the power game goes on. But under the surface of cooperative relationship, the truth reveals a relationship based on distrust and deception.

Psychiatrist Sally Satel, author of “PC, M.D.: How Political Correctness Is Corrupting Medicine,” has written extensively about the need to maintain the status quo of doctor over patient. Her writings reveal her anger that women are trying to take control of their healthcare, particularly with regard to mental healthcare.

“But it is wrongheaded to confuse the need to know more - an imperative that will always be with us - with the unwarranted and poisonous notion that women are somehow second-class subjects in the world of medicine,” she writes.

She chastises health activists for interfering with “effective diagnosis and doctoring.”

Psychiatric patients are fighting back, however.

A growing movement of patients and ex-patients is demanding change in the system, and asking that patients be given a long-overdue voice and control of their healthcare choices. Not surprisingly, activists are not generally well-
received by psychiatrists. But psychiatrists still have their secret weapon, and it’s a weapon that the general public accepts without question: the issue of competence. To discredit an activist’s words, simply declare she is suffering from mental illness, and doesn’t know what’s best. Reassert psychiatry’s authority, and you have an effective method of discrediting just about anything.

The courts buy into it, because psychiatry has been given special status in the court system. The public buys into it, because they don’t have the experience to understand how paternalistic psychiatry is. And of course the medical industry buys into it because paternalism fits in with their views to “help” anyone who needs help, even when the help is intrusive, inappropriate and unwanted. The doctor knows best.

Psychiatry has a long way to go in moving into modern times. Psychiatrists want so badly to be taken seriously as medical doctors and legitimate scientists, but until they confront a history that is full of abuses, and a method that continues today to abuse authority, psychiatry will remain mired in an atmosphere of paternalism, controversy and resentment.

"It's a well known fact Lexapro makes your symptoms worse for seven days"

From the Irish Independent

A man who suffered from polio shot himself with a home-made gun eight days after starting a course of medication for depression, an inquest heard yesterday.

Patrick Fitzpatrick (58), of 9 Shanid Road, Harold's Cross, died in a downstairs room at his home after shooting himself with a brass pistol he had made himself, Dublin City Coroner's Court heard.

The retired watch-repairer was discovered in his home by his brother, Anthony Fitzpatrick and a locum doctor, Dr Ronan Donohoe on September 28, 2006. He had attached a note to the door on the downstairs room which read: "Do not open. Call the guards. I have shot myself."

A subsequent post mortem by Deputy State Pathologist, Dr Michael Curtis revealed that Mr Fitzpatrick died from a gunshot wound to the head. There were no suspicious circumstances.

The inquest heard that Mr Fitzpatrick, who suffered from polio since the age of two or three and spent many years in hospital when he was young, attended his local GP, Dr Robert Hickey on September 19, where he was prescribed the anti-depression medication, Lexapro.

He returned to the practice three days later on September 22, and told Dr Hickey that he was still feeling very down. The doctor told him that "it takes 10 days to kick in".

Anthony Kelly told the court that the family are concerned that Dr Hickey failed to stress to Patrick that "it's a well known fact Lexapro makes your symptoms worse for seven days".

Coroner, Dr Brian Farrell, adjourned the inquest to a date in September to give Dr Hickey to answer the issues raised.

The Wackness

Psychiatrists have complained that they aren't portrayed fairly in movies. It's sort of like the Harry Truman quote, people tell the truth about them, and they feel it's hell. There is more than a grain of truth in the satires. And it's time to add one more satire to the pile.

According to Variety, a new movie entitled The Wackness is going into production. It centers on a troubled teenage drug dealer and a drug-addled psychiatrist -- after the former trades pot for therapy sessions, then falls for the doctor's daughter.

It has attracted some slightly controversial attention because of reports that two stars in the film Ben Kingsley and Mary-Kate Olsen will have an extended kiss/make-out scene, despite the obvious age differences. Kingsley plays the corrupt shrink, and Olsen plays one of his patients.

It's billed as a comedy, this mess between a psychiatrist and his drug dealer. It's early in the production, so who knows what changes will take place in the script, etc. between now and the premier.

But it's nice to see something taking advantage of all of the weird press the shrinks get. We wish them luck.

Psychiatric Center for Teenagers Is Mired in Patient Accusations of Rape

From the August 7th NY Times

A widely respected residential psychiatric treatment center for teenagers in Manhattan acknowledged yesterday that it was cooperating with law-enforcement authorities who have charged three former employees with sexually assaulting girls at the center in recent years.

The suspects, all child-care workers for the August Aichhorn Center for Adolescent Residential Care at 23 West 106th Street, were fired in May and early June after being indicted on multiple counts of rape, sexual abuse and sexual misconduct involving at least four girls younger than 17. The allegations were reported yesterday by The New York Post.

“The August Aichhorn Center is deeply concerned by the allegations of illegal conduct made by current and former residents against members of our staff,” Dr. Michael A. Pawel, a psychiatrist who is the center’s executive director, wrote in a statement posted on the center’s Web site.

The statement added: “Aichhorn has been fully cooperative with the New York County district attorney’s office in its investigation and we will continue to cooperate with all relevant investigations so that it can be determined whether these allegations are true or false.”

Court records listed the suspects as Milton Venable, 46, Phree Noel, 32, and Edward R. Tapia, 26, all Manhattan residents who had worked for years at the treatment center and have families and roots in the community. All pleaded not guilty at their arraignments in Manhattan Criminal Court and at the request of their lawyers were released without bail for court appearances later this month and in September.

According to the court records, most of the sexual assaults occurred during the last two years, although one occurred in 2002. Mr. Venable was charged with two counts of rape and two of sexual misconduct, Mr. Noel was charged with numerous counts of rape, and Mr. Tapia was charged with multiple counts of rape, criminal sexual acts, sexual abuse and other misconduct.

Dr. Pawel’s statement did not name the accused men or detail any of the allegations, but it noted that the center’s patients were among “the most severely troubled teenagers in the New York area,” and that the center had strict rules for handling allegations of misconduct.

“The center follows stringent, documented procedures for the protection of both residents and our staff, as a healthy and safe environment is necessary for the successful treatment and rehabilitation of the adolescents in our care,” Dr. Pawel wrote. “All allegations of mistreatment which are brought to our attention are taken seriously, internally investigated and always reported to the proper authorities for an outside, independent review. We have followed these procedures in this matter.”

Efforts to reach the accused men and their lawyers were unsuccessful yesterday, although Mr. Venable’s father, Frank, said in a brief telephone interview that the charges against his son were false. Dr. Pawel did not respond to calls, and Carmen Torres, an administrative aide, referred a reporter to his Web site statement.

The Aichhorn center, a co-educational residential facility for 32 patients who range from 12 to 16 years old when they are admitted for treatment, takes in some of the city’s most troubled teenagers: boys and girls with records for assault, robbery, arson and other criminal activity, who have been shuttled among foster homes, state hospitals, juvenile detention facilities and mental health centers. Treatments take an average of 30 months.

“We get the youngsters nobody else can handle,” Dr. Pawel, who founded the center in 1991, told New York magazine in 1999. The magazine described the center as “part hospital, part jail,” and said the living quarters had the feel of a college dormitory, with rooms decorated with movie posters and the covers of hip-hop magazines.

The center, in a six-story brownstone, has four living units — three with eight single rooms and one with four double rooms — and has its own school, a clinic and recreational facilities. The full-time staff of 86 includes therapists, teachers and 46 child-care workers, all of them screened and trained. Rules of the center prohibit staff members from being alone with a patient.

The work of the center, which receives more than $5 million in public funding, has drawn wide praise from state and city mental health officials and others in the juvenile-justice field. In 2001, Gov. George E. Pataki hailed the center in a letter to Dr. Pawel. “Through the committed work of community-based organizations like yours, we will continue to advance the well-being of young adults in your community and the entire state.”