don't care what the scilons say, psychiatry now a sick joke

[justdrew]

At this point using scientology is like having no argument at all.

well, I want to know if something is coming from them, if something is one of their fronts, etc

but every such discussion shouldn't have to be dominated by ritual scientology denunciations either. so it's a balance I guess

[compared2what?]

I'm surprised at the fallacy here, leaving aside the question of whether it's more in response to rhetoric from bks or a strawman from c2w?.

"Villainy and other moral flaws" in "the characters of people you read about in newspapers" and their personal inner "motives," known or not, are often immaterial to the question of whether these same people are fulfilling a role we may choose to characterize as villainous -- or if you prefer, find morally wrong, even as we avoid the loaded label of "villain."

Granted.

I can have no certain idea and sometimes no evidence pertaining to the character (a potentially vague term) or motives (quite a bit clearer but often unknowable, even to the one who has them) of countless people I've never met.

Yet I know that many of these people I don't know hold roles in enterprises that I feel qualified to judge as wrong; roles that should be rejected when offered, and not just by students considering hypotheticals in an ethics class. Pentagon war planners, Mubarak thugs, police enforcing the drug war, middle managers and workers at arms factories, the legal and psy-war teams for Monsanto and Bank of America and, relevant here, Pfizer and United Health... these are just a few such roles.

I am with you one hundred percent so far.

The people usually aren't pulling triggers, or even pushing a button at Milgram's request. They're usually working at desks, like the friendly Mubarak thug-dispatchers at the Interior Ministry. They may be really nice to befriend, generous to charity, avid readers of Proust, gentle to children. They may greatly regret what they are doing, and yet do it because it's their job and so they are "powerless." They may have genuinely noble motives and persuade themselves that what they are doing is necessary.

Okay. Yes, I agree. And I certainly wouldn't maintain that Dr. Levin is, without qualification, powerless. Because that would be totally absurd.

However, I would (and, I had thought, did) maintain that there's nothing in the article (as well as nothing not in the article, afaik) that suggests that he's the power responsible for the sorry state of affairs depicted in the OP. I guess that I also thought that it went without saying that he was the party responsible for his own choices, actions and decisions, because (a) who else would be?; and (b) I wasn't trying to argue that point. It was and still my view that what I described as his not-admirable-but-not-despicable conduct is sadly but nevertheless decidedly unexceptional (and even characteristic) behavior for individual human beings who are repelled by a system that relies entirely on their compliance and would fall apart if they ceased cooperating with it en masse. That's why I called his response human and flawed, and also why I addressed the very issue you raise like so:

PhRMA is pulling the strings, yes. But how tightly do they bind, and who did the tying, and why? PhRMA is an institution, representing one of the biggest industries in the world. Psychiatry, on the other hand is a profession. There's a chasm of difference that must be maintained as much as possible between the two, if the profession is to survive. If a profession is simply going to do the bidding of its carrying institutions, then why bother with the profession at all? Isn't that in fact what is threatened by acquiescence like Levin's on a large scale?

On a large scale? Yes. I agree with you. In the same sense that I would had you written:

If the citizenry of a country is simply going to permit its government to institute illegal and atrocious policies that include torture, indefinite detention without charges or recourse to law, and unprovoked acts of military aggression that result in near-genocidal numbers of civilian casualties, then why bother with democracy at all? Isn't that in fact what is threatened by acquiescence like [YOUR NAME OR MY NAME]'s on a large scale?

IOW, have a heart, ffs. No one person can really be condemned for his or her failure to act as part of an organized, unified resistance that nobody knew how to organize and unite successfully.

Quite apart from which, I don't think it's accurate to say that Dr. Levin is doing the bidding of his carrying institutions. I think he got caught in a squeeze play between the carrying institution he relied on (the health insurance industry) and its preferred (to Dr. Levin) partner in profitable crime (the pharmaceutical industry).

I mean, hello, bks, are you there? All doctors together are a very small, weak and poorly organized force compared to either, let alone both. And all psychiatrists together are diminishingly so. One lone psychiatrist -- ie, Dr. Levin -- is barely any more powerful than you or I or any other lone individual is. They don't make that much money. Most of them are probably somewhere around the middle third of the upper middle class.

I understand that's not a perfect analogy. But I'm willing to stand by it. I mean, personally, and speaking only for myself, I definitely do feel (and have always felt) strongly confident that I would never, ever compromise my values to the point of actively participating in something I knew to be ultimately corrupt and destructive. Despite which, I'd just be fucking lying to myself if I didn't admit that there have been times in the past when my strong confidence in my own ability both to recognize that I was approaching that point and to steer clear of it has been totally and wildly unjustified. For all I know, I'm serenely engaged in not having the courage of my convictions in some way right this very moment, and simply haven't yet arrived at the day on which the scales fall from my eyes, enabling me to look back on my cowardice with scorn and regret.

Though I doubt it. But in all honesty, I pretty much always do. The truth is still that when it comes to my own capacity for some good old-fashioned well-intentioned, good-hearted and 100 percent self-serving rationalization, my intel has been known to be unreliable.

Anyway. Seems to me like that's a pretty common failing, through which many, many people each do very little individual wrong on a daily basis. And it also seems to me that Dr. Levin is squarely among them. The guy's a doctor. He's presumably prescribing medications that are the standard as well as the best available treatment for what are, believe it or not, sometimes real ills, and presumably he's doing it within medically recognized guidelines. That's what doctors do. I personally don't think that it's tenable or acceptable for psychiatrists to do that as if it were good or even adequate treatment.

But the guy's sixty-eight years old. I just can't find it in me to judge him too harshly for doing what I can't say with any certainty I'm sure I would never do if I had the same orientation, education and experience he does. Especially since I don't think he's the power responsible for the sorry mess he's in, given which judging him harshly avails neither me nor anyone else anything worth having. So I judge him somewhat, with compassion.

Does anyone have a problem with that?

Many thousands of people who fit these examples are neither rich nor economically autonomous nor members of anything like an upper class. With so many Pentagon war planners planning so many current and potential wars, thousands of them are just replaceable office salary-grunts. The PR teams for the big corporations are also full of salary-grunts, and even the top "creative" is usually just a contractor who can be shown the door (at sometimes minimal severance, depending on the contract).

You may find that many of the things done by these groups -- or by the Dr. Levins on the 15-minute psychiatric session assembly line, prescribing pills that they know to be likely useless and sometimes harmful to recipients who have not even been diagnosed properly --

Hold your horses, there, cowboy. Pentagon war planners and psychiatrists are not engaged in acts of comparable destructiveness. Or of comparable scale.

Additionally, I know nothing whatsoever about how the recipients -- or, as I think of them, "patients" -- in Dr. Levin's care were diagnosed. Nor do I know what medications he's prescribing. But fwiw, none of the psychotropic medications that, all things being equal, I would expect a psychiatrist in an out-patient setting to be prescribing to patients he only sees for fifteen minutes every now and again are just so flat-out intrinsically useless that it would really be either fair or rational to assume that he or she "knows" they're likely to be useless.

In context, I'd say it's fair to assume that Dr. Levin knows they're insufficient at best and that it's totally possible that they'll be of very little or no real, lasting or substantial help. The odds that they'll do any harm -- by which I mean "harm" and not "transient bad experience that I damn well expect Dr. Levin to tell his patients may occur if it's a known risk" -- are vanishingly small, assuming that he is using known medical guidelines -- ie, not prescribing SSRIs to adolescents, etcetera.

regrettable, but not of their making. (There's the central debate here, more below.)

I may, but I do not. I find it frightening, reprehensible and intolerable. And not of Dr. Levin's own making in any way that's materially constructive to dwell on for any of the only purposes that concern me.

You may believe it outrageous to compare any given one of these activities to pushing a button the button-pusher believes delivers an electric shock to a victim who is screaming and, by all audible appearances, dies as a result. That may be true; I'd still argue a range of routine professional activities performed by members of the above groups are as bad as pushing that button, or worse.

Okay. Well, by all means, let's hear that argument then. The billing has me intrigued.

Notwithstanding... none of that changes the upshot of Milgram's experiment, which is that 62 percent of the randomly chosen white male Connecticut-dwelling experimental subjects kept pushing the electro-shock button to the very end when a man in a white coat identified as an authority calmly asked them to do so, although they were free to go and no personal incentives were offered to them to continue. And while we can argue whether and by how much that share in any other given group today would vary, I would at least go into that argument with the position that for cohorts drawn from most groups, something like the same majority would still respond in the same way in comparable situations today.

(Allowing that the experiment would have to be different, since a good number of them today would see through the rickety style of the Milgram study if repeated in identical fashion. Okay, my optimism says that the number would be a bit lower today, because both blind obedience and authority have eroded somewhat. Well, okay, the number would be zero today, thanks to the inevitable veto from the Human Subjects Research Committee. Unless we did it in Africa on a Gates grant. But I digress.)

I would argue (sorry about the conditional, but the actual argument would require a book-length post I prefer not yet to write) that the conditions of our society and of the human world as a whole provide rich evidence that the Milgram findings are robust, indicative of the human condition, and still true. I would argue that much if not most of what is considered "gainful employment" in fact implicates people in varying degrees of Milgramian button pushing, and that everything Dr. Levin is quoted as saying and is described as doing in the Jayson BlairNew York Times article suggests he'd be among "the 62%" and not "the 38%."

Hell, let's just say Dr. Levin doesn't even exist, and think of him as a hypothetical stand-in for psychiatrists who do what he is reported as doing -- a large set of whom does, in fact, exist! Again, you'd have to come up with a different, not strictly comparable experiment to snag the Dr. Levins into the 62%, since a Dr. Levin of today no doubt knows about Milgram.

Wait, I got it! I have a proposed experimental design: We will ask a randomly selected group of American psychiatrists if, given recent developments in the insurance and pharma industries entirely beyond their control, they are willing, in exchange for their continued economic security, to hold 15-minute sessions to prescribe pills known possibly to be useless, or even harmful, to patients known not to have been adequately diagnosed?

You don't know what the pills are, or how adequate the diagnosis was or wasn't. Objectively speaking, it's not incorrect to describe those meds as "pills known possibly to be useless, or even harmful." But neither is it meaningful or informative, for chrissake. I mean, fucking ibuprofen is known possibly to be useless, or even harmful. All things are relative.

And forgive me, honey, but you don't really seem to have the faintest idea what you're talking about. Although maybe you're just too modest to show it. But whatever the case, may I ask you something? Good.

What, exactly, prompts you to say that commonly prescribed psychotropic medications are likely and/or known possibly to be useless or even harmful?

As opposed, let's say, to overprescribed and often of limited therapeutic utility that's further compromised in many cases by a wide range of empirically non-harmful but practically unbearable side effects?

Or, let's say, so inherently inimical to a respect for the integrity of the individual that should be sacrosanct to all human beings and doubly so to doctors that they should only be used with extreme caution, care and attention as a treatment of last resort for all cases in which life, limb and safety are not at risk?

Because, frankly, while I myself wouldn't be satisfied with making any of those statements and then just calling it a day, leaving 99 percent of the problems as they really exist on the ground completely unaddressed, the two alternates that I proposed have what is (to me) an enormous, huge and immeasurable advantage over the first. And it's this:

They formulate the problem in terms that emphasize the needs and experience of the patient. Which are, imo, not just the central consideration, but the one that has primacy over all others. In fact, I'd say that pretty much all discussion and debate regarding the relative evils of both psychiatrists and psychotropic medications that gets so carried away with itself that the experience and needs of the patient are of such casual and accessory value to the main event that it seems perfectly natural to just sketch in those little details -- such as the validity and manner of their diagnoses, or the potential therapeutic uses and drawbacks of the meds they're presumed to be taking, or, I don't know, maybe how they fucking feel about the pros and cons of their treatment options -- verges on completely pointless. At best. At worst, it's, you know, worse.

That's how I see it, anyway.

Meanwhile, I would expect people from "the 38%" of today (whatever that % really is) are far likelier to be found among Dr. Levin's patients, as a subset of those who come to him with general and persistent but vague symptoms of depression mixed with dread; a subset who sort-of know they wouldn't push the Milgram button but also know they have no idea what they should be doing in this mess of a world, hence the lining up to see if there is a dosage and combination of pills that makes it all better.

Finally, Dr. Levin. Yeah, it's unfair to over-villainize him, but to call him powerless? Please. Only in the sense that we are all mortal and bleed when cut. I think c2w?'s description of where he fits in class society (at the top of the middle) is truer than bks's (at the bottom of the top). Either way, that means he has room to give up a lot of things and still (likely) live by a material standard that 80 percent of Americans would consider better than their own. Not that there's no risk involved in that -- he could end up worse off than that -- but I do see some people take even greater risks in defense of what they believe is right, or in defense of their own dignity and integrity. (Even given some material self-interest invariably mixed in; right now I'm thinking of the Wisconsinites who choose to fight for pride and living wages at the risk of personal disaster, instead of sacrificing dignity for relatively higher job security.)

All of which doesn't mean I condemn or villainize him, or would act differently. (I would act very differently, actually, but for reasons not to be covered now and not necessarily noble or admirable.) Hell, I'm not coming to a moral judgement here, after all that. I can't even go on, after producing so much just in response to a paragraph from each of you. I'm merely seeking to clarify terms and perhaps dispense with a few misleading concepts of what is.* In the hope that this was the case,

I come always as friend to both of you,

"JR"

PS - Notwithstanding that we are all in an experiment right now, not Milgram's but Rohrschach's, since we're working with impressions from uncertain and sparse data. But hey, that's what discussion boards are at their best: get to play things out all serious like, in what remains a game-space.

* - One of my unfortunate conclusions being that the Milgram findings more than not characterize the human condition. Which I can understand wanting to deny.

.

I'm just not feeling the Milgram stuff, sorry. To me, an understanding of those experiments is something that just has too much integrity on its own for tossing it around like a rhetorical football to be altogether seemly.

I come always as a friend to you, too. Please let me know if I skipped anything important. I have an uneasy feeling that there was something that I meant to go back to. But I can't for the life of me figure out what it was, if so.

[compared2what?]

At this point using scientology is like having no argument at all.

well, I want to know if something is coming from them, if something is one of their fronts, etc

but every such discussion shouldn't have to be dominated by ritual scientology denunciations either. so it's a balance I guess

I have yet to see any ritual scientology denunciations. I have made broad statements on the subject twice. And AD is running very true to form by continuing to assert otherwise while utterly failing to produce any evidence of it.

In fact, I challenge everyone on this fucking board to find a thread on psychiatry or psychotropics anywhere on RI from any point in time in which Scientology was raised "ritually" or as an all-purpose means of rebutting an otherwise impeccable argument. Even the two times that I've raised it in broad terms rather than (usually) given a specific head's-up about the specific Co$ associations of a specific citation or (afaik, just the once) remarked on it as a factor that didn't help the problems I already had and had just finished stating with the OP -- in a thread that I ended up leaving because I was too embarrassed for undead to point out that he was, well, lying about the weaponization of Prozac, although he was, btw -- I gave it more context than that.

By which I mean, it wasn't "ritual." It was and is, in fact, supportable. I just don't feel like doing the enormous amount of collating and writing it would take to support it.

In any event. That ritual?

Doesn't fucking happen. Seriously. Cites or it didn't happen. And if you can't find any, please have the grace to acknowledge it, won't you?

Because, loathe though I am to complain, I am sick and damn tired of being pilloried for a crime I've never committed while others dance freely around waving their ritually empty and insincere rhetorical sorrow over my failure to confess to the bad acts with which the Politburo has charged me.
_________________

eyeno, I believe that I have yet to see you offer a scintilla of fucking evidence in support of the views expressed in any of your posts in this general subject area. You might want to look into trying that out some time. Like right now, for instance. So why don't you go get some nice quotes from all the threads in which Scientology is used as "no argument at all" -- not including this one and one other on suicides in the military from months ago -- and bring them back here so that we can all see what you're talking about.

And if you can't do that, please have the courtesy otherwise to explain yourself. Thank you so very much.

CITES. I WANT TO SEE THEM.

[barracuda]

At this point using scientology is like having no argument at all.

If only that were so, eyeno. You may or may not recall that it was just four months ago that we had to institute a new posting guideline prohibiting scientology sources. Why? Because discussions here were being overrun by articles which were easily traced back to their CoS roots. The main problem was that almost no one seemed to be interested in examining the genesis of their material closely enough to figure this out, because the polemic found in the CoS sources nicely matched the preferred point of view of the some of the psych-critical posters. For example, the following CCHR information was blithely posted here on a discussion of this topic:

What had began with a psychiatric plan to eliminate undesireable humanity had now spread throughout the civilized world and was responsible for the murder of eleven million people. Never brought to justice, psychiatrists as you will see, continued to advance eugenics around the world, and today we see the results, in racism, human misery, and unending social conflict.

...along with links to scientology-run websites. So on this forum, generally it is best if you pre-qualify your source material before posting so that Jeff, or the mods, or a pretty meticulous researcher with extensive background on the cult such as compared2what?, or even a fairly rabid anti-CoS reseacher like Plutonia doesn't have to sniff it out for you.

[compared2what?]

At this point using scientology is like having no argument at all.

So true. I mean, the next thing you know, people will be saying that everything you thought you knew about Frances Farmer was just so much Academy-Award-nominated Co$ propaganda.

ON EDIT:

Highlights for the tl;dr crowd:

CONCLUSIONS

William Arnold [author of the book on which the movie from which we learned everything we know about Farmer was based -- c2w] was the first person to allege Frances Farmer was lobotomized. He provides absolutely no supporting evidence, either documentary or otherwise, in his book. Conversely, many people intimately connected with the case are on record, using their names, saying no lobotomy ever was performed on Farmer. The Farmer family has always insisted no operation took place. Nurses who were there at the time insisted no operation took place. Definitive archival records clearly show that Frances was not operated on. Western State was excited about their lobotomy program and certainly would not have kept an operation on Farmer secret for any reason; Keller and Freeman were both eagerly seeking press coverage of the lobotomies, and were in fact successful in garnering copious press for the program at Western State.

What could William Arnold’s motives have been for so severely distorting the record of Frances’ unfortunate troubles? Edith Farmer Elliot, among others, maintained that Arnold was a Scientologist, intent on furthering Scientology’s late 70s push to have psychiatry discredited. (As recently as 2004, Scientologist Tom Cruise was on record as saying “Psychiatry is an utter waste of time and should be outlawed”). In his acknowledgements, Arnold himself thanks at least two Scientologists or Scientology groups, including the Citizens Commission on Human Rights (CCHR) and Heber Jentzsch [then Co$ President -- c2w]. Indeed, in the People magazine article referenced above, it is explicitly stated that Arnold and Yates met through the Scientologist publication Freedom, and to this day the CCHR's publications and website continue to quote liberally from Arnold and utilize Frances' supposed mistreatment and ultimate lobotomy as the prime example of what the "horrors of psychiatry" can do.

Why Arnold chose Frances to be his “poster child” is unknown, other than that she provided an obviously riveting “hook”; certainly his quite laudable thesis regarding psychiatric abuses could have been just as well served by the actual facts, without the “fictionalizing” Arnold added. As is sadly described in archival records, between July 23, 1942 and June 12, 1953, 252 pre-frontal and transorbital lobotomies were performed at Western State. These poor souls suffered no less by reason of the fact that Frances was not among their ranks.

Supporters of the belief that Frances never underwent a lobotomy have long labored under the burden of having to prove a negative. With the overwhelming weight of this clear documentary evidence, the burden of proof now shifts to those who insist the operation took place, yet who fail to provide documentary evidence of any kind

____________

Hear, hear. About the failing to provide documentary evidence of any kind, I mean.

Epically failing, you could say.

[justdrew]

At this point using scientology is like having no argument at all.

well, I want to know if something is coming from them, if something is one of their fronts, etc

but every such discussion shouldn't have to be dominated by ritual scientology denunciations either. so it's a balance I guess

I have yet to see any ritual scientology denunciations. I have made broad statements on the subject twice. And AD is running very true to form by continuing to assert otherwise while utterly failing to produce any evidence of it.

In fact, I challenge everyone on this fucking board to find a thread on psychiatry or psychotropics anywhere on RI from any point in time in which Scientology was raised "ritually" or as an all-purpose means of rebutting an otherwise impeccable argument. Even the two times that I've raised it in broad terms rather than (usually) given a specific head's-up about the specific Co$ associations of a specific citation or (afaik, just the once) remarked on it as a factor that didn't help the problems I already had and had just finished stating with the OP -- in a thread that I ended up leaving because I was too embarrassed for undead to point out that he was, well, lying about the weaponization of Prozac, although he was, btw -- I gave it more context than that.

By which I mean, it wasn't "ritual." It was and is, in fact, supportable. I just don't feel like doing the enormous amount of collating and writing it would take to support it.

In any event. That ritual?

Doesn't fucking happen. Seriously. Cites or it didn't happen. And if you can't find any, please have the grace to acknowledge it, won't you?

Because, loathe though I am to complain, I am sick and damn tired of being pilloried for a crime I've never committed while others dance freely around waving their ritually empty and insincere rhetorical sorrow over my failure to confess to the bad acts with which the Politburo has charged me.
_________________

eyeno, I believe that I have yet to see you offer a scintilla of fucking evidence in support of the views expressed in any of your posts in this general subject area. You might want to look into trying that out some time. Like right now, for instance. So why don't you go get some nice quotes from all the threads in which Scientology is used as "no argument at all" -- not including this one and one other on suicides in the military from months ago -- and bring them back here so that we can all see what you're talking about.

And if you can't do that, please have the courtesy otherwise to explain yourself. Thank you so very much.

CITES. I WANT TO SEE THEM.

hey, I'm not even particularly talking about you c2w or anyone else in particular.

by ritual-denunciations, i mean the way I felt compelled to add the phrase "I don't care what the scilons say" before even bring up the subject. because I half expected someone to discover that the article's author is an OT3 or something. It can get to a place all too similar to any complaint about Israeli policies having to be prefaced by "some of my best friends are jews but..." Just broaching the subject leads me to worry about being suspected of being secretly a scientology symp. but that's just ME. not accusing anyone of MAKING me feel that way.

and look there. I used an abrev, does that make me sound like a scientologist?

I'm only this kind of scientist

[Plutonia]

or even a fairly rabid anti-CoS reseacher like Plutonia doesn't have to sniff it out for you.

Moi?

It's the way they've made autism the bogeyman in their campaign to foment hysteria around vaccines that burns my butt. And their attacks on adult auties too. Gets me goin'. Grrrr...

[compared2what?]

Motives? I think I've limited my discussion of his motives to what can reasonably be inferred from what he says they are. He had kids in college, or else he probably wouldn't be assembly-lining, remember? He doesn't want to move backwards in terms of monetary compensation, remember? Those are expressions of what is motivating him.

Morality has nothing to do with it, if you want to get technical. We're talking about ethos. The spirit of what he's doing frankly sucks. Obscuring that does no one any good, and acknowledging it doesn't entail foreclosing on the man's humanity or anything.

I think it's a better idea in these matters to look at what people do, rather than what motivates them, anyway. Practice is the product of character, and character is the product of habituation, deliberation, trial and error, more deliberation and on and on and on. If you mean to do 'good' and consistently don't, it just doesn't amount to much in most cases, no matter what Kant might think.

I agree with all of that, as far as it goes.

But my objection to the depiction of Dr. Levin as a villain did not, in fact, arise from my having any very strong feeling about whether he was one or not. It is indeed an overstatement by my standards. But so the fuck what? I don't know the man and don't really care enough to quibble if others condemn him more harshly than I do simply for the sake of the thing.

Rather, as I believe I may have indicated, it arose solely and exclusively from the concern I felt upon seeing an article about a very real imminent threat -- roughly to the effect that all private-practice psychiatry other than fifteen-minute consultations for prescription-writing purposes was soon to vanish entirely from the landscape, due to the wholesale economic untenability of the enterprise created by Big Health Insurance -- being read but apparently not comprehended as anything other than a confirmation of the oft-expressed belief that psychiatrists are unilaterally evil and that psychotropic medications are unilaterally dangerous and ineffective.

Principally, feeling sorely troubled by how much dimmer the already dim prospect of, let's say, popular organized political resistance to the machinations of the health insurance industry was sure to grow should the unrelenting focus on the evil of psychiatrists and danger of psychotropic medications become so fixed and narrow that it started blinding people to all other concerns, I felt moved to point out that that was what was fucking happening. On this thread.

If you have any problems with that, please let me know what they are.

Care to explain this bolded section?

No. I know what I meant, but I'd rather concede the point than get sidetracked by the Milgram experiments, which I commented on only because you appeared to me to be raising them at absolute random simply for the sake of invoking something scary. But I guess I must have misunderstood you. Please accept my apologies for that as well as for declining to address the rest of the Milgram stuff on the grounds that if it has fuck-all to do with the topic, it's just beyond my grasp to comprehend how. But maybe some other time, okay?

I think I said "can easily do them harm". If you think there is "no reason at all" to believe that prescribing psychoactive mediation on the basis of a misdiagnosis can do harm, then please say so. Because that would seem to be at odds with what you said to drew here: [ETCETERA]

I most certainly do not think that there's no reason at all to believe that prescribing psychoactive medication on the basis of misdiagnosis can do no harm. In fact, I know in some detail that there are a number of circumstances in which there would be reasons to think that it not only could but would, for some medications.

However, I also know that as a general rule, no thoughtful, reputable psychiatrist who had a stake in keeping his license -- and Dr. Levin struck me as such a one -- who was making a living prescribing psychoactive medications could conceivably be ignorant of what those circumstances were for each and every one of the psychoactive medications he could reasonably be supposed to be prescribing on an outpatient basis to people with whom he only had contact at fifteen-minute check-up visits.

Because although there are a number of such circumstances, it isn't a very large number. And typically, when there is a risk of harm, practicing psychopharmacologists either don't prescribe the drug or -- if the risk is both low and preventable when detected early -- don't prescribe it without ensuring that it will be detected early. For example, there are a number of mood stabilizers that have been prescribed for Bipolar I and II for years that have a very small risk of compromising liver function. So no one ever prescribes them to patients without monitoring liver function via regular blood tests. Which is both a good practice and not a malpractice.

The whole question is, of course, purely speculative since neither you nor I has any idea at all how Dr. Levin's patients are diagnosed or by whom or with what or what meds they're taking. But please forgive me if I just disregard speculation about misdiagnosis on the grounds that it's completely irrelevant to the odds of psychoactive-medication-induced harm occurring. I mean, if they can do harm, they can do it to anyone, well or ill. And if they can't, they can't.

Basically, I guess that I prefer to deal with real problems as they arise, in context. I find it more constructive than just flailing around jousting with generally alarming hypotheticals.

If, by some chance, you were using the word "harm" as a synonym for "no help," or maybe "unpleasant and possibly quality-of-life-impairing side-effects that go away when people stop taking the drug":

Oh, man. I am totally with you in agreeing very, very fully and strongly that those are serious and urgent concerns. I could not, in fact, agree with you more. It seems practically inevitable that there would be many more instances of both if talk therapy became a thing of the past and the only access anyone had to psychiatric treatment at all was fifteen minutes with a psychopharm every couple of months. On top of which, patients who were at high-risk for suicide -- we are talking about psychiatric patients, after all; and the suicide rate for Bipolar alone is 20 percent, across the board, irrespective of whether its being treated at all or not -- would be much more likely to slip through the cracks.

That's why I felt so very moved to point out that focusing on the unelaborated presumptive dangers of psychotropic medications in general and/or the evil of psychiatrists in general, while all well and good in its way, was not really an adequate or comprehensive response to the issues raised by the OP.

As a matter of fact.

More shortly.

[compared2what?]

Thanks, justdrew.

CONFIDENTIAL TO SOME OTHERS: SHOW ME THE CITES OR HAVE THE DECENCY TO ADMIT THAT YOU WERE WRONG. THANK YOU.

[compared2what?]

On a tangentially related note:

I highly recommend that posters who are worried about harm and misdiagnosis take twenty seconds to produce some numbers or other material indicating what harm and what misdiagnosis is worrying them and why.

And I mean something a little less anecdotal than your own experience not benefiting from a psychoactive medication. Because you know what? There are other people in the world. And they might have different problems than you do.

But you'll never know if you don't try to find out!

Give it a shot. You might like it. I find that it's good for the soul, personally.

[justdrew]

ok, so some solution space ideas...

1. anyone showing aptitude for medical service provision is given access to as much free education, training and experiential learning as they want. at whatever time works. train to be a doctor for free in your evenings, etc... Licensing still requires the same or (even greater/better) demonstration of competency as currently.
2. malpractice insurance is provided free, via a single entity who's risk-pool is all medical services provided in the country.
3. record-keeping is centralized, yet also distributed, so sometimes records of some services can be withheld from the central database.
4. custodial, facilities maintenance, capital equipment, administration, and all purchasing in bulk, done by a single National Medical Services Cooperative. This organization owns some and operates most medical service centers, both ambulatory clinics, small offices, hospitals, research and manufacturing facilities.
5. all staff wages are set in a similar fashion to bureaucratic methods employed by the federal government, but the providers and staff are all in a union as well, so incomes are not simply dictated. Supply and demand play a role in setting wages, also difficulty and amount of effort spent learning to do it. Performance and outcomes analysis can play a direct roll in compensating providers, allowing star performs to out-earn merely nominal providers.
6. no cost for services. all costs are paid by the federal government, funds coming to some extent from taxation. However - people who use a lot of services can be asked to pay a somewhat higher tax rate. So one aspect would be tax levels being a unique value for various individuals based on a variety of factors, such as lifetime health-care costs
7. guaranteed room, board, internet and a minimal living stipend for all humans in the US. and guaranteed optional access to some useful (if 'boring') work.

all of that could be phased in and could be done without unduly disrupting things, in fact, it would lead to a much more secure, sustainable and booming economy/country/world (because this system would be easy to export)

[compared2what?]

"Probably safe" meaning it probably won't cause them to commit suicide? Yeah, you're right. Or "probably safe" meaning it won't have any significant health effect (mental or otherwise) which could reasonably be called harm? Far less clear. Anyway, when did "probably safe" become the standard for acceptable practice? It's pretty shitty practice, as you acknowledge, and which is the bigger point. In a well-functioning system it would first be required to prove pharmaceuticals are a good treatment for any particular malady as compared to other kinds of treatment. Under certain circumstances that can be demonstrated, yes, as you've said. But it's a long distance to proving that SSRIs, for instance, are a good treatment option for severely depressed people to giving anyone who exhibits the slightest behavior that departs from some institutional norm a psychoactive drug.

If the reply is that i could be making the complaint about any branch of medicine, point taken, but I'd still argue that psychiatry is a special case given the irreducible reliance on translating feelings and other fleeting aspects of experience into something concrete.

Dude, the reply is nothing of the kind. Rather it is:

What exact part of my calling something reprehensible, horrifying and intolerable (or whatever words to that effect that I used) led you to believe that I thought it was acceptable practice? How could I have so epically failed to convey my views to you, I wonder.

Hey, I have an idea! Let's just take a short look at the quote from me you're riffing on above:

It's my opinion that none of those hypothetical patients (or any others) should be taking SSRIs or any other psychopharmaceutical drug with absolutely no other treatment or monitoring or other medical oversight. It's probably safe, but that's a pretty fucking dubious advantage if it's not effective treatment.

Wait a minute, wait, wait....Eureka! I think I figured out the problem. It's not that I didn't say what my views were plainly. It's that you are persistently and repeatedly misrepresenting them in order to give the appearance that I am in fact the shill for corporate interests that I'm so widely purported to be. Despite the strange lack of documentary evidence attesting to it.

I come to this discussion from the standpoint that the more we're ready to medicalize behavior, the less we'll be willing to make accommodations for people who don't fit those norms, or who chafe under normal conditions (in schools, for instance, where a neighbor of ours apparently may get medicated because, while everyone acknowledges he's a delightful, smart kid, he gets up and walks around the kindergarten classroom at times he's "supposed to" be sitting down). We should be looking for environmental remedies for mental suffering/anguish before we resort to the label of mental illness, which carries with it a stigma and also suggests the existence of something that is entirely internal to the person and which gets carried around with them wherever they go, no matter what circumstances they find themselves in.

I don't really know that I care from what standpoint you come to this discussion. Because whatever it is, when you get here, you don't play fair. So I'm just going to wrap it up here.

Okay? But just to show a giving and forgiving spirit, here's a tip, and it's on the house:

Look into the background of the writers you name very, very carefully. And then evaluate their affiliations with an eye to any potential lack of transparency or bias yourself, without my help. Because that would really be a pretty informative thing to do. And in one case, it's more or less a model challenge. Of its kind.

Anyway. You'll never regret having acquired the research skills after you're done, I guarantee you. Or the mental exercise you'll get from making the judgment calls. Because they'll both just keep on paying dividends. You'll be amazed.

[82_28]

However, psychiatrists are not, in the present, "comfortably atop societal hierarchies."

Does the fact that the psychiatrist I was seeing held a "penthouse" office in a 32 storey building in downtown Seattle count and he still sees fit to obsessively hound me about $125?

And justdrew, that is a very fine idea. Training to be a doctor should, in fact, be free of charge! Jesus, that's brilliant. All willing humans should have the opportunity to train in open-source health care. I mean, in high school, they make you take the mandatory CPR and other emergency class in order to graduate.

Oh, why the fuck do dentists cost so goddamn much? Why is dental insurance always (for the most part) separate from the "health" insurance? Why is mental health always, unless it's a super-duper rich person's insurance policy, outside of coverage?

Shit's a scam from top to bottom. All sides are in collusion.

Psychiatry is a spray the shit at the wall and see what sticks profession. It's evidence based, sure. However, even though Reagan "turned the mentally ill onto the streets", the true reason was because, I surmise, the pharma corps had all manner of bullshit waiting in the wings to effectively dumb down society by making the mentally ill more noticeable(?) and thus nobody would never ever want to appear to others like that -- see Charlie Sheen! Well, now we have moved on a generation and society has internalized this "madness" as the blame of it laying on each and every one of them/us personally and falsely see it as a problem with the individual. It's quickly turning into a high tech Victorian Age 2.0. Remember, it takes a village.

Nordic, yes, most psych meds are prescribed by GPs. You might get your initial diagnosis from a psychiatrist, but your maintenance prescriptions normally just come from a GP after that. He just sends you on your way with like a year's worth of refills and you're all good.

[bks]

c2w? wrote:
Look into the background of the writers you name very, very carefully. And then evaluate their affiliations with an eye to any potential lack of transparency or bias yourself, without my help. Because that would really be a pretty informative thing to do. And in one case, it's more or less a model challenge. Of its kind.

Anyway. You'll never regret having acquired the research skills after you're done, I guarantee you. Or the mental exercise you'll get from making the judgment calls. Because they'll both just keep on paying dividends. You'll be amazed.

I accept this challenge, and given your superior knowledge in this area, frankly it's appropriate for you to ask it if we're to keep talking about this stuff at length.

I'm too busy for the next 24 hours or so to write a full reply to your last post, too, but I will as soon as time permits. In the meantime, I took the liberty of searching this site for comments on Peter Breggin and David Healy, and I found your, ah, assessment of Breggin. There was a bit more help there than I wanted for this 'challenge", and since I don't know your assessment of Healy, I'm going dig further into his background first. I look forward to our future discussions about him.

[compared2what?]

Do it for yourself, bks. I'm not interested in pursuing the point. So I won't be responding further.