Is psychosis a “gift?” Should we stop pathologizing human behavior and medicalizing mental illness ? Many anti-psychiatry advocates think so. Today we discuss the anti-psychiatry movement and debate this group’s grounds and end-game. Do they have a point or is this a dangerous pathway? Click on the player below to listen now!
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Computer Generated Transcript for “Mental Illness” Episode
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Lisa: You’re listening to Not Crazy, a psych central podcast hosted by my ex-husband, who has bipolar disorder. Together, we created the mental health podcast for people who hate mental health podcasts.
Gabe: Hello, everyone, and welcome to this episode of the Not Crazy Podcast. I’m your host, Gabe Howard, and with me, as always, is Lisa. Lisa, hey, what’s your quote today?
Lisa: Today’s quote is modern man has no more right to be a madman than medieval man had a right to be a heretic. And that is from the Encyclopedia of Theory and Practice in Psychotherapy and Counseling, the 2014 edition.
Gabe: I have a million questions, but what are you talking about?
Lisa: Ok. The quote goes on to say, because if once people agree that they have identified the one true God or good, it brings about that they have to guard members and nonmembers of the group from the temptation to worship false gods or goods.
Gabe: Listen, today we are talking about the anti psychiatry movement, the group of people that that seem to both recognize that mental illness is real. But they don’t believe that it’s a medical condition or that psychiatry should exist around it. I don’t like the anti psychiatry movement because psychiatry is literally the medical study of mental illness. Without psychiatry, Gabe would be dead. As everybody knows, you brought me to a hospital. You had me seen by a psychiatrist. I am on psychiatric medications. I go to a psychologist. All of this is psychiatry. I really struggle with the idea that anybody can be anti that. Because before I had psychiatry, I was this mess that needed you to save me. And now that I have psychiatry, I drive a Lexus. So I am not anti psychiatry in any way. Where I’m having trouble is, how does your quote tie into that?
Lisa: So the point is that medieval man, the heretic, was someone who thought differently or believed differently from the larger society around him. And people don’t like that. So the madman is thinking or believing differently from our larger society. And that makes us unhappy and uncomfortable.
Gabe: Ok. Am I the madman or am I the heretic?
Lisa: You’re both. That’s the point. Today’s madman is the 13th century’s heretic.
Gabe: But we don’t like heretics. Do we? What’s a heretic? Maybe I don’t understand the definition of heretic.
Lisa: A heretic is someone who spoke against the church.
Gabe: Oh. Well, but.
Lisa: It’s often used as a synonym for an atheist.
Gabe: Ok. But again, our society doesn’t like atheists. As we learned last week.
Gabe: But where does the anti psychiatry movement fit in?
Lisa: Because what they’re saying is that you’re making people who are different, bad and ill, rather than just being different.
Gabe: Ok. All right. So the general gist of the anti psychiatry movement and again, we’re not members of it. We did a bunch of research. We read a lot of the prominent books and bloggers and outspoken members of this movement. But the general belief of this particular movement is that if you have psychosis, that is a gift. If you have bipolar disorder, that is a gift. If you have major depression, that is a gift. And you should learn to harness those gifts. And doctors do not need to enter into this. These are just personality traits that, while different, are not inherently bad.
Lisa: With the gift thing, in general, no, it’s not saying that this is a good thing. The point is that this is part of the human condition and does not need to be medicalized, looked down upon or altered.
Gabe: I don’t think that it should be looked down upon. But part of the human condition is having high blood pressure. But we believe that you should take high blood pressure medication and live forever. Part of the human condition used to be dying by 30, but because of advancement in medical science, people are living to be 70, 80, 90, 100. There’s nothing that is illness based that doesn’t fit into this. I’m having trouble understanding how somebody suffering, literally suffering from mental illness, that can just be, hey, this is part of it, you’ve got to let that person go. Because people are dying from this.
Lisa: But who are you to decide? Why do you get to decide who’s suffering and who’s not? It is not a coincidence that many of the prominent members of the anti psychiatry movement, and I should point out for clarity here, that they usually don’t use that particular term. But most members of the anti psychiatry movement are themselves people who have been diagnosed with psychiatric illnesses and have had really bad experiences. These are people who have been wronged by psychiatry.
Gabe: Lisa, you made a good point. While they’re often referred to as anti psychiatry, that’s not what they call themselves. What name do they give to their movement?
Lisa: Well, they use a lot of different names, but the one that you hear a lot is psychiatric survivor, or they’ll call themselves advocates who are against the medical model of mental illness.
Gabe: I agree that we have some serious problems with the medical model. We have some serious problems with how medication is prescribed and how mental illness is diagnosed. But they go all the way to the extreme, right? All the way to the extreme. It’s all bullshit. All psychiatrists fired. That’s their general stance. Correct?
Lisa: Sometimes, but I don’t think it serves anyone to just dismiss them outright as being this fringe group. I was about to say lunatic group. Hah, irony. But I don’t think it serves us to just dismiss everything they’re saying outright. They have a lot of really valid points. I will agree that many take it too far, but I’m totally on board with a lot of what they’re saying.
Gabe: That’s very interesting to me. First and foremost, when we did our research, we did prominent groups, groups with hundreds of thousands of followers. Huge web sites that get millions of hits. People who have written New York Times best sellers on the subject of anti psychiatry. This is, we’re not doing some mean thing, where we found some weirdo that lives in his parents’ basement and tweets about how this is stupid. And we’re not trying to hold up any group as the spokesperson for it all. But whenever you see hundreds of thousands of people following a movement, you can’t ignore the movement. I am surprised that you seem to believe that they have more positives than negatives, because that seems to be what you’re saying. I’m just. Anybody can have a point. A stopped clock is right twice a day. But you seem to think it’s more even. You seem to think these people are running like fifty-fifty, whereas I see them as a dangerous fringe group that are convincing people who need care to not get the care. Which raises the rate of suicide. Why do you look at them so sympathetically instead of seeing them as dangerous?
Lisa: I just think they have a lot of really valid points that concern me and that I myself struggled with quite a lot when I first started taking antidepressants, when I first started getting psychiatric care. And they may take it too far, but the main base premise is correct. We have over pathologized mental illness, and it’s hurting people.
Gabe: But I don’t think that’s their base premise. I think that’s how they create trauma bonding and gaslighting. I think that what they’re saying is, OK, what we want you to do is steal this guy’s car. Now, if we walk up to you and say, hey, will you steal his car? You’re gonna say, no, I’m not a car thief. That’s not gonna happen. So we start out very reasonably. Hey, man, do you own a car? No, I can’t afford a car. You know that guy? He’s got a $100,000 car. Can you believe that? Oh, that is a lot of car. Yeah. You know, I heard him the other day talk about how he dislikes people like you. Just look how he walks. Look at that strut. Yeah. That does annoy me. And before you know it, we all hate Carol Baskin. And why do we hate Carol Baskin? Because Carol Baskin was portrayed as an unsympathetic, elitist character in Tiger King. But in actuality, she’s committed no crimes and she’s done nothing wrong. And we should all have no reason to dislike her. I know I jumped my analogy there, so maybe I should start over. But no, I’m not starting over. I’m owning it. I could not get you to steal my neighbor’s car with one question, but if I set it up that my neighbor hated you, was hurting you and was injuring you and was mean and I convinced you and stroked you and taught you and brainwashed you into hating my neighbor, I bet I could get you to steal his car then. And you wouldn’t know why you’re doing it. But my base premise isn’t that I have a point. My neighbor is an elitist asshole because, you know, hey, maybe my neighbor is an elitist asshole. That’s not my point. My mission is stealing rich people’s cars are OK. Their mission is that psychiatry is bad and should be removed. All of these points that you’re bringing up are just the way that they convince people to join their cause. It’s disingenuous at best.
Lisa: What points that I’m bringing up? So far, all you’ve said is that you don’t like this your idea of their theoretical end goal. You haven’t discussed their points at all.
Gabe: I know a lot about their movement that I forgot that the audience probably doesn’t know. Lisa, let’s start talking about their points.
Gabe: And I’ll tell you why they’re wrong. I guess we’re doing that thing where you know who the killer is at the beginning of the movie. And then it goes flashback seven days ago and it goes all the way through the movie until it catches up to real time. I am not a fan of the anti psychiatry movement. We have figured that out. Now, back one week.
Lisa: The base premise being that all psychiatric diagnoses and therefore all psychiatric treatment is based on a subjective judgment. There isn’t any objective test that we can do here, and therefore there’s just no way to not bring in bias. Cultural bias, personal bias, and that can be extremely harmful.
Gabe: I completely agree with that, but I would like to point out, what we need to do is come up with a definitive medical test. The only way that we can come up with a medical test is to continue researching it, meaning psychiatry needs to advance. Which means that psychiatry needs to exist. So their base premise of being anti psychiatry and wanting to end it all and just accept this as the natural progression will never allow us to remove that bias or have a definitive test because they want it to go away, which means whatever we have today is all we will have forever. They want all psychiatrists to lose their license, be defunded and all medical terminology to go away surrounding this. They want all psychiatric facilities closed. They want all psychiatric medications taken off the market. You know, this is in their charter. The groups that we are talking about, you know damn well that they are not moderate.
Lisa: Ok, slow your roll. I think you’re painting a very large group with much too broad of a brush. And you keep saying they want, they want, they want. We don’t know all the theys. I don’t think that’s fair. And again, how do you address the base point? This is about pathologizing normal human behaviors. How do you get around that? How do you get around the idea of subjective diagnoses, that are used to do stuff, turns out bad?
Gabe: Because I don’t consider hearing voices, seeing things, thinking that demons are under your bed, carving on your own body and essentially killing yourself as normal human behaviors. And those are all covered by psychiatry.
Lisa: Well, but so are a whole bunch of other behaviors. What about things like, you know, reactive attachment disorder or oppositional defiant disorder? You’re going to straight to the things that most people would not argue are a problem and saying, look, these aren’t a problem.
Gabe: But that’s my point. They are arguing it.
Lisa: Well, what about all the other things that are clearly a problem? Why don’t you say anything about that?
Gabe: Because that’s not what they’re focused on.
Lisa: Again, I’ve already acknowledged that many of these folks are going too far, right? I believe that psychiatric illnesses are real. I myself take psychiatric medication. I believe it has saved my life. I believe psychiatry is real. But there are a lot of abuses and a lot of the stuff psychiatrists say is not based on anything. These are all about social norms. This doesn’t have any biological basis. And there’s not any science, at least not yet, backing a lot of this stuff. So why aren’t you talking about that?
Gabe: I am talking about that. I in Gabe Howard’s advocacy work and on this show, we talk about that a lot. I’ve been doing this for 15 years. I have testified in front of the General Assembly that the way that we diagnose, treat and give people access to care is wrong. And in none of those speeches, over one and a half decades, over 15 years, have you ever heard me advocate to end medical help for the treatment of mental illness? I have heard these groups do that. And I’m sorry, I can’t take their conclusions seriously. I just can’t. It’s like when you like an actor and you love the actor and you love their comedy or their movie, and then they do something that is racist or sexist or they commit a really bad crime. And you’re just like, I can’t like them anymore. And then somebody says to you, well, but you have to admit that he was a really good comedian. Look, I don’t have to admit that at all. What he did was so far gone and so bad, it spoiled the whole pot. That bad apple spoiled the whole barrel for me. Sure. Fine. Bill Cosby is hilarious. What do you want? He’s a great comedian, but I’m sorry, I can’t watch him anymore. And I don’t think that’s unreasonable.
Lisa: So you’re saying that you aren’t going to listen or pay attention to the valid abuses these people are pointing out because basically you just don’t like them? And you don’t like where they go?
Gabe: No, that’s not what I said at all.
Lisa: Then talk to me about those abuses and how you’re gonna go around on them.
Gabe: Those abuses are very real. And as I said, they are causes that I myself personally have drawn attention to and taken up. And I feel that I have extraordinarily good odds, in a mountain of a climb, of seeing actual progress because I’m advocating for change that people will actually do. They’re advocating for forget it. It’s all over. It doesn’t exist anymore. Fire all the doctors. There’s only so much listening that politicians are going to do. And when I say something reasonable and then I have a reasonable solution and then they say something reasonable and have an unreasonable solution, they have wasted the time that is available. They have sucked the air out of the room and for whatever reason, because they’re so extreme, the media pays more attention to them. Like you always say, nobody wants to hear reasonable stuff on the news. A man saw a problem, man fixed problem, problem gone. That never makes the news. Man saw problem. Man overreacted, punched neighbor, neighbor burnt down other neighbor’s house. Nobody knows what the problem is anymore. Neighborhood on fire. Great. That’s what’s gonna make the news every time.
Lisa: You seem to be very angry about this. Why are you focusing all your anger on these folks rather than on the abuses psychiatry has committed? These folks would not exist if not for the abuses they are discussing.
Gabe: You’re kind of doing that thing where you’re like, Gabe, why are you fighting this man? That other man was worse.
Lisa: Right. Yes.
Gabe: The show topic is anti psychiatry. Why do you want me to talk about people that aren’t on the topic? Would you like me to bring up other people I’m mad at?
Lisa: I think the topic is anti psychiatry has valid points. Some of the abuses of psychiatry are horrifying and we are part of that problem because we are normalizing this idea that you can pathologize human behavior. The diagnosis of mental illness is often a proxy for the designation of social dissidents. People we don’t like or behavior that we don’t like, we define as mental illness. And there’s a bazillion examples. The most obvious one being homosexuality was a mental illness until 1973 because nobody liked gay people. Rather than saying, hey, we don’t like this, we don’t like this behavior, those people are terrible, it was easy to say, oh, no, they’re sick. And then you were able to use that to justify imprisoning and often torturing these people.
Gabe: Yeah, this is where it gets really tough. I mean, you are right. I mean, think about the 50s when any husband could put their wife
Gabe: In a psychiatric hospital with just their signature. You didn’t need anything at all.
Lisa: Psychiatry allows us to bypass legal procedures to establish guilt or innocence and incarcerate people based on we don’t like them.
Lisa: So it’s very, very disturbing. We have a thousand examples of this is always done with people who have unconventional religious beliefs or have different sexual practices or it’s used for racial bigotry. It’s just on and on and on.
Gabe: You are correct, and as much as it pains me, because I just, in a way, I just want to win the argument. Right? I think that they have gone too far. And that’s my base premise. And I’m having trouble moving off that point. But if Gabe Howard was alive in 1950, I would be very inclined to start this group. I would be very inclined to say tear it all down because of things like crib beds and ECT and
Gabe: Lobotomies, there you go. There’s a big one. You and I did a thing once where we talked about what would happen to Gabe if he was diagnosed with bipolar disorder, manic depressive, in 1950? And the answer was, I would have been put in a salt ice water bath until I entered a coma and I probably never would have left the psychiatric hospital ever again. The abuses of the psychiatric system are well-documented.
Lisa: So what you’re saying is, oh, no, all these abuses are in the past. We don’t do stuff like that anymore. Everything is good and happiness and rainbows. We should not be so arrogant to think that there’s not abuses going on right now. You don’t think in a hundred years we’re gonna be looking back on this and saying, oh, my God. Can you believe they did this?
Gabe: I’m not saying that at all. I’m saying that their base premise of we should just end it all and just let nature take its course is ridiculous. And I cannot get behind it. And I just I think that I’d be dead. And you’re asking where my emotion comes from? Death. I would be dead. You would be doing a podcast with my mom and dad who would be talking about how they didn’t know and how they wish that there was something they could do. And these anti psychiatry groups would be like, well, it’s OK that he’s dead because after all, he just couldn’t handle his illness. And that means he had to die because of what? Natural selection?
Lisa: You’re doing that thing where like, well, we never wore seat belts and we were all fine. Yeah, but the kids who died didn’t come to school. So you forgot about them. So what about all the people who died from the ECT or the induced comas or the lobotomies? So whatever the equivalent of that is, right now, those people aren’t here to tell us about it.
Gabe: This is very fair, but is the way to honor their memory, honestly, to let people like me die as well? Is that what we have to do? They died because of the abuse and now I die because I can’t get care? And suddenly it’s fair?
Lisa: I think part of the goal is that this is about giving individual people more autonomy. This is about letting individuals decide for themselves how they feel about this diagnosis and whether or not they want to undergo treatment. The reason they call themselves psychiatric survivors is not because one day they went and got themselves treatment and were like, oh, it turned out this wasn’t a good idea. No. These are people who were forced to do things to their detriment. You go to psychiatric hospitals, there’s an awful lot of people in there who don’t want to be there and have been forced there by the courts.
Gabe: As you know, I’m a moderate in this movement, and if this is the first time you’ve ever come across Gabe Howard or listened to me, you’re probably having trouble believing it right now. But I really do edge way closer to the middle than the average mental health advocate. I try to see all sides. I give people forums on our show, in blogs, everywhere, whom I disagree with. All the time. Being a moderate means that both sides hate you. And there’s been some very high profile advocacy points that have really dropped me out of mainstream advocacy. Assisted outpatient treatment being one of them. This idea that you can just declare that somebody psychiatric care or be forced on medications, who has broken no laws or done anything wrong, because the families have decided that it’s in their best interest. Now, I’m not saying that there is never a case for forced treatment. I’m not saying that at all. I don’t want to open up that can of worms.
Gabe: But what I specifically disliked about assisted outpatient treatment is it was very clear how to get somebody into the treatment, but it wasn’t clear how to get somebody out. There was all of these rules about how you could force somebody to do things against their will. But there was like no safety net to protect them from this. And there was no clear way out. And finally, study after study after study on AOT shows that it just does not work. As soon as the courts drop out, these people go back to where they started. And we’ve wasted a whole bunch of money and time and resources. And this has made me very unpopular with a lot of national mainstream charities. So I would have thought that would have given me some cred over on the psychiatric survivor side. It didn’t. The very fact that I say that medication is necessary, this is a medical disease, kills all my credibility over there, which meant my only choice was to start a podcast with my ex wife. Lisa, you are my only friend.
Lisa: It has been surprising how much people do not like those who are in the middle. If you’re not with us, you’re against us and you have to be with us all the way. You are either at 100 or you’re at zero and there’s no room for anybody else. That has been very surprising. And it has made it difficult for you specifically to find your place in all this as a more moderate person with more moderate beliefs. When you say these people, when the court system drops out, they just go back, but they don’t just go back. This thing happened to them. So they’re not going back to even. They’re not going back to where they were before. They’re in a worse position than when they started. Thanks a lot.
Gabe: Yeah, it’s very traumatizing.
Lisa: And they call it assisted outpatient treatment. Why don’t they call it forced outpatient treatment? Because that’s what it really is.
Gabe: That’s very true.
Lisa: We have personally met people who’ve been forced into treatment. And like you said, there’s no way out. It’s remarkable that no one considered how incredibly problematic this was, because who do you think is going to be forced into treatment? Vulnerable people, poor people, racial minorities. Just basically everybody society doesn’t like. This is not something that happens to upper class white folk.
Gabe: Clearly, these groups have some points, but I’m still gonna go back to the a broken clock is right twice a day. And Lisa, I got to tell you, some of it is based on their blatant misinterpretation of facts. The things like when they talk about the suicide rates. Again, this is a prominent group with hundreds of thousands of followers led by a New York Times best seller. This is not a small group. I want to read a study that is posted on their Web site. I’m not going to read the whole thing. But what I am reading is directly from their Web site. And the headline is it Could psychiatric care be causing suicides? And they write from 2,429 suicides and 50,323 controls, the researchers found that taking psychiatric medications during the previous year made a person 5.8 times more likely to have killed themselves. If a person had made contact with a psychiatric outpatient clinic, they were 8.2 times more likely to have killed themselves. Visiting a psychiatric emergency room was linked to a 27.9 times greater likelihood of committing suicide. And if someone had actually been admitted to a psychiatric hospital, they were 44.3 times more likely to have committed suicide within the year. It’s important to pause on those numbers. In a world of suicide prevention statistics, they are truly staggering. What other risk factor is associated with people being 44 times more likely to kill themselves? And then they finish up by writing, so we are left to speculate what might be causing these striking numbers. End quote from their Web site. Lisa, I know you are a trained scientist. You are a trained physicist. I want you to explain to the audience how offensively awful this is and how them passing this off as a fact that should make people change the way we treat mental illness in America, and using this as the driver is dangerous.
Lisa: Ok, I’m going to have to give you that one. It is hard to ally myself with these folks and their conclusions when they say stuff like this, because that’s just crazy. Putting this out there as a reason for why you should avoid psychiatric care is dangerous, and it represents a fundamental lack of understanding of science and statistics. Correlation does not equal causation. OK, let’s change some of this. Let’s switch it around. Did you know that if you had a heart catheterization in the last year, you are 50 times more likely to die of a heart attack? If you had, if you visited a cardiologist in the last year, you are 10 times more likely to die of a heart attack. Conclusion, do not visit cardiologists. They will give you heart attacks. No, that’s ridiculous. It’s so mind blowing that anyone even said this, right? It’s just ugh. Obviously, people who are extremely sick and who are at risk of killing themselves get psychiatric care. No kidding. So, yeah, this is, in fact, very dangerous.
Gabe: The word bullshit is not big enough. This is the literal equivalent of me saying that I looked at fifty thousand people who went to the hospital in the last year. And you were much more likely to die if you had a hospital admission. Now, I’m talking physical health now. Because I don’t know, sick people go to hospitals. They don’t seem to understand this. And they’re offering this up as if it’s a fact or meaningful in some way. These are sick people who sought out psychiatric care. No shit that they’re at higher risk of dying from a disease they were diagnosed with. They wrote exactly this, we are left to speculate what might be causing these striking numbers. This tells me, as a reasonable person, that we cannot trust them for anything. Because they’re left to speculate?
Gabe: There is no speculation here. You know how in court, if you perjure yourself in one area, it is reasonable for the judge and jury to assume that all of your testimony is false? It is reasonable to assume they are lying if they lie about another material fact. They have just said we are left to speculate what might be causing these striking numbers. They have zero understanding of science.
Lisa: Yes, yes.
Gabe: Why should I listen to anything they say?
Lisa: You have an extremely good point there. Yes. If this is the level of misunderstanding you’re putting out there. Yeah, I’m pretty sure you don’t really understand anything. So I don’t necessarily want to listen to anything you have to say. Yeah, it’s just ridiculously stupid. It’s painfully stupid. It’s sad. But it’s that, it’s sad. This represents a profound lack of understanding. And these people are using that to make their own decisions, possibly to their detriment. And there’s a lot of pain and trauma involved in this. So it really just, more than anything, just makes me so sad for them that no one has ever sat them down and explained it.
Gabe: I’ve sat them down and explained it. You don’t think that I’ve ever written a follow up article to something that they’ve written?
Lisa: Oh, ok.
Gabe: You don’t think that I’ve ever sent them an e-mail? We’re doing this podcast right now where I am now pointing this out. I am a prominent mental health advocate with over 15 years of experience. I am partnered with one of the largest mental health Web sites and psychology Web sites on the Internet that’s been doing this for 25 years. You don’t think it’s never been pointed out to them? They are unwilling to change.
Lisa: All right. Yeah, I’m going to have to give you that. Excellent point, Gabe. It does seem to be deliberate ignorance.
Gabe: We’ll be right back after these messages.
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Lisa: And we’re back, talking about the points raised by the anti psychiatry movement.
Gabe: Now, you know what sucks? We’ve been talking about this psychiatric survivor movement, the anti psychiatry movement, these prominent movements that are pointing out a lot of the abuses, the actual abuses that exist and the problems with the psychiatric system. And, of course, this is resting largely on people who in some way identify with having these mental illnesses. And these are the things that they would like to see. You realize that we have no choice but in a few weeks to do the same amount of research and the same amount of in-depth reporting on groups that are run by psychiatrists. I’m thinking of two national groups that advocate on the Senate floor for laws like forced treatment, assisted outpatient treatment, who are just as extreme on the other side. And I have the same amount of hostility towards them for basically strangling data and numbers to match their bullshit that. I just, I am so angry that there’s no place to turn for me.
Lisa: That’s an excellent point that you’ve just made. I think this might actually be influencing my own thinking about this. When you’re talking about these prominent groups that are run by psychiatrists, etc., these are people with privilege. These are people that society looks to. These are people with money. These are people that bad stuff hasn’t happened to. When you look at these folks on the other side, they are wrong. They are just as wrong. But it comes from a different place. I don’t know, like their souls are purer? They have come to this through trauma and abuse and sadness. So I guess I just have a lot more. I guess I just have a lot more sympathy for their position and I want to take them more seriously. But you’re right, that’s dumb. You’re wrong, you’re wrong.
Gabe: It’s so difficult in mental health advocacy, Lisa, because I am often up against mothers whose children have literally died by suicide. They’re gone. And as you know, in my family, I watched my grandmother bury two children. They were my aunts and I loved them so much. And the trauma that it caused my grandmother and my grandfather and my mother and my uncle and me. And I watch these parents testify, and I want to give them everything that they ask for to make their pain go away. But it’s not backed by any research, by any data, by any study. And it will not work. And time and time again, it has been proven not to work. But by the time I take the podium, nobody cares anymore because they are so emotionally connected to that mother’s story. To that father’s story.
Lisa: You’re right.
Lisa: You’re right. I’m falling down the same hole. You’re right.
Gabe: We can’t pass laws and we can’t make rules that affect just an entire nation of people living with mental illness based on the trauma of any group. Of any group, not family members, not doctors, not people living with mental illness, not mental health advocates, not anybody. We need to look at hard data and science. And neither group is doing it. One group trots out that they were abused by psychiatrists, which they absolutely were. And another group trots out that their loved ones died by suicide because they couldn’t get help. And they absolutely did. This is not the way to make public policy. And I’m the bad guy for pointing it out. And it’s so incredibly difficult. I want to hug them all. But facts matter. Facts matter. We only seem to think that emotion matters. As I am all emotional, and I want you to listen to my emotional plea. It’s ridiculous.
Lisa: I’m sorry. Are you OK?
Gabe: I don’t think that my life is going to get better when we just have a suffering contest to who has suffered more? Family members, society, the medical establishment, law enforcement or the people living with the illness? First off, I want to be unequivocally clear, the people who have suffered the most are the people with the illness. You think it’s hard to be around somebody with severe and persistent mental illness? Yeah, we don’t get a break. We don’t get a break ever. I guess at least doctors get to go home. Honestly, Lisa, I don’t know what I’m saying, but you asked why I am so angry at these groups? Because we didn’t pick poorly funded groups. We picked groups with resources and money and following. And these are large, large groups that should know better. And if they would get their shit together and advocate for something that would work, where would we be? In the meantime there’s no moderate group out there. They can’t get funding to save their life. You either get money from the people who hate pharmaceutical companies or you get money from the pharmaceutical companies. Nobody wants to fund the people that like both sides.
Lisa: Or that don’t like both sides.
Gabe: I don’t have a problem with pharmaceutical companies, except for the list of things that I have a problem with, but I don’t think they’re all evil. The anti pharmaceutical lobbyists will not fund me because I don’t think the pharmaceutical companies are all bad. Pharmaceutical companies don’t want to fund me because I point out that they’ve done stuff wrong and that the way that they talk about people with mental illness is often sketchy. So they don’t want to give me a ton of money. I’m not 100% on their side. So in the meantime, we have two warring factions and neither side has a solution. They suck all the air out of the room and people like me suffer. That’s it. Mental health in America.
Lisa: Wow, that is so depressing.
Gabe: Am I wrong? Convince me that I’m wrong
Lisa: No, no.
Gabe: And then hug me. Like, hug me a lot.
Lisa: You’re right. I am being swayed by these emotional arguments and these incredibly heartbreaking stories. And, yeah, I’ve sat next to you. To the woman whose son died by suicide. And on the one hand, like you said, you want to hug her. But on the other hand, I want to strangle her because you’re not helping. You’re making it worse. This is not a good way to memorialize your lost loved one. So, yeah, you’re right. I have sat there. I’ve been annoyed. I’ve been angry. And I’m falling into that same trap just on the other side. I did not think of it that way. And now I am super depressed. Yeah.
Gabe: Every single member of the psychiatric survivor community or the anti psychiatry movement, they are welcome at my table. They are welcome in my house. They are welcome to email me at show@PsychCentral.com and tell me what I got wrong. I have not cut off ties. I want us to work together. I just want us to get focused on someplace where we can affect change, like real change. And I’m sorry, but completely tearing down the medical model and pretending that mental illness does not exist, is not it. One of the things that I think that we could work on is really deciphering what mental illness is because a severe psychosis and schizophrenia and bipolar disorder and is called mental illness. You know, in the exact same way that being nervous on Mondays is. We’ve taken this everything is mental health too far. It would be the literal example is if we called everything physical health. Oh, you have a headache? You have physical health. Oh, you have terminal cancer? You have physical health. And those are the same thing. They’re not. And we need more words for what’s going on. And I think that’s part of the problem. And that’s why I just think that the whole thing is just like baloney. And I just, I want to eat an elephant. The whole thing is just like, super sad, right?
Lisa: Oh, my gosh, it’s so incredibly sad. Ugh. But the fact that psychiatric illness is socially constructed, there’s no definitive test, there’s no biological basis that we’ve discovered. These are culturally constructed based on what we think, based on the cultural narrative that we have in the moment.
Gabe: I struggle when you say that mental illness is culturally constructed.
Lisa: It is.
Gabe: I don’t think that a bunch of people sat around and said, all right, let’s decide that everybody that wants to kill themselves is mentally ill. I think that people saw this behavior and were scared of it and terrified by it. And they saw that the people who were exhibiting this behavior did not look pleased or happy or, of course, they did not look alive. They were dead. And they thought that does not look normal. And then they studied it and found out that, you know, boom, boom, boom, boom, boom. And that’s why Gabe Howard is allowed to live a good life right now. But then other things like, for example, one of the things that they’re arguing about right now is whether or not gaming disorder is a mental illness.
Lisa: That’s a thing?
Gabe: That’s where you like to play video games too much. It’s being discussed right now. And, of course, the debates that we always hear about, like attention deficit hyperactivity disorder. When do you have a rambunctious child and when do you have a sick child? Actually, I’m going to use this example, Lisa. When is Gabe manic and when is Gabe loud?
Gabe: You and I talk about this all the time.
Lisa: And that is the problem on a much larger scale, on a societal scale that these people are talking about. When is this God, that guy’s annoying or that guy is different or that guy’s weird? And when is it that guy is psychiatrically ill? That guy is mentally ill and he needs to be in a hospital even if he doesn’t want to go. And these anti psychiatry people are saying, where are these lines? We have drawn the lines in the wrong place.
Gabe: And if that was their argument.
Lisa: I know.
Gabe: First off, we know where the lines are. Interferes with the activities of daily living for more than two weeks. That’s the line. Now, that’s vague and it has all kinds of problems. But just because you don’t like the line or you think that the line is incomplete. This is why these groups frustrate me. There’s no line, they just make it up. That’s not true. There’s literally a book. You want to know where the line is? Read the DSM five. It’s written in the book.
Lisa: Well, but you realize the obvious example. I don’t mean to drive it into the ground, but homosexuality. It’s the perfect example for all the abuses of psychiatry.
Gabe: It is. But it’s also an example that’s old, that’s very old and that has been corrected.
Lisa: But again, that’s arrogance to think that, oh, those mistakes are all in the past. We aren’t doing anything like that today. No, we’re doing stuff like that today. We just don’t know yet.
Gabe: But I would like to point out that it happened decades ago and it was absolutely, unequivocally corrected and it wasn’t even like a pansy correction. Oh, we, no, it was like that was wrong. We were completely wrong. The part where husbands were allowed to lock up their wives. That was wrong. It was completely wrong. The literal abuses are
Lisa: Ok. But now we have mothers allowed to lock up their children. How is that any different?
Gabe: And that would be a good point to fight against. That would be a good thing to fight against. This is why I struggle, Lisa. Because you’re right. That would be a good part. But they don’t want to fight against it. They’re saying that because there is a disagreement in how to handle a situation, one group is evil and one group is the hero. And I hate that. I hate that. Why does it always have to be heroes versus villains? The anti psychiatry, psychiatric survivor group, they believe that they are the heroes and that everything that they want to do is correct, even though they say incredibly stupid shit and refuse to use any sort of science. Oh, what could possibly explain these higher numbers? I can think of a million explanations that you’re refusing to consider.
Lisa: You’re right. They are making the same logical fallacy that the other side of the argument is making. And that they are criticizing them for.
Gabe: It reminds me of couples that get in a fight where they’re both yelling, you never listen to me. And they’re both right. But, and you’re watching it from a distance because I don’t know, maybe they’re your parents. You grew up in that household. I don’t know. But you’re looking at them and you’re like, wow, Mom is not listening to Dad. Dad is not listening to Mom. Mom is very upset that she is not being heard. Dad is very upset that he is not being heard. They don’t realize it, but they are both completely and entirely right. And doing to the other what they are so offended by having done to them. Listen, if these groups find an advocacy point, they stick to the advocacy point, they stick to the facts, and they want to work together to change these things, I am on their side. But they don’t want me. They don’t want me because my end advocacy goal is to fix it. Their end advocacy goal is to burn it to the ground. And I think that having the ability to burn something to the ground and pretend that there’s no problem once it goes away is extraordinarily privileged and it will kill a lot of people, I believe far more people than it will save.
Lisa: Well, but they’re saying the opposite, that it’s killing far.
Gabe: But I have proof.
Lisa: No, you don’t.
Gabe: Yes, I do.
Lisa: No, you don’t.
Gabe: Yes, I do.
Lisa: You don’t have that proof. And neither do they.
Gabe: I feel that more people are helped by medical intervention for mental illness than are hurt by it.
Lisa: How do you know that? On what do you base this? Do you have stats or data or studies? What? Why do you say this?
Gabe: I’m going to use the stats by the National Institute of Mental Health, which, of course, they’re going to say is bullshit and you can’t count because they’re the government. I’m going to use stats by the APA, the American Psychological Association. But they’re going to say we can’t use them.
Lisa: But they don’t have them. What are you talking about? I’m willing to accept information from both of those groups. Show me this information of which you speak. They don’t have that data.
Gabe: What specific? How do you think the data is going to read, Lisa?
Lisa: Because it’s impossible to get in the first place. How are you going to decide that people have been helped by psychiatric intervention versus hurt by it? How are you ever going to decide that?
Gabe: Let me ask you this. If you saw somebody who is suffering from the effects or symptoms of bipolar disorder, would you say put them in your car and take them to the emergency room and have them committed?
Lisa: I did not have you committed. But yes.
Gabe: Oh, so you agree with me? You agree that the odds are greater that people would be helped by psychiatry than hurt by psychiatry. Or you never would have taken me to the hospital.
Lisa: But just because it worked out for you doesn’t mean it’s going to work out for everybody. And you’re also a white man. Do you think it’s going to work out the same way for everybody? That’s ridiculous.
Gabe: I don’t believe that they can prove it. I believe that I can prove it. But of course, here’s a problem. I don’t have any money. All right. I did not start an organization where I claimed to have proof of all of these abuses without actually offering up any proof. I want them to prove to me that more people are being hurt by psychiatry than helped. I understand that you’re saying that I can’t prove that more people are being helped. But I would like to point out that I have personally seen more people be helped.
Lisa: Well, that doesn’t mean anything.
Gabe: It doesn’t, but let me tell you what else I’ve seen. You are an odds player, Lisa. You have a scientific mind and you would not hesitate to take anybody to a psychiatric hospital. When you found me, I was symptomatic out of my mind.
Gabe: You suspected that I was bipolar. You suspected that I was suicidal. Well, I. OK. You didn’t suspect, I told you that I was suicidal. And you did not hesitate to take me to the emergency room, by tricking me I might add. And then tricking me into signing myself in. It’s a semantic argument at this point whether or not I was committed against my will. You know damn well I didn’t know what I was signing.
Lisa: And I did it anyway.
Gabe: And you had no problem with that.
Lisa: That’s true. I had no problem with it, I still don’t.
Gabe: And you realize that the group that you’re defending thinks you’re the enemy. You literally tricked somebody into signing away their rights. They are no friend of yours. And you believe to this day that you did the right thing. And now be honest. Would you do it again?
Lisa: I absolutely would do it again. But you’re not considering that it isn’t just your situation out there.
Gabe: I am considering that. I’m considering there are abuses in everything. There is nothing in America, literally nothing that doesn’t. Everything’s the force. It has a light side and a dark side. So it does not surprise me that mental health and psychiatry would be the same way. You’re saying that it’s, that psychiatry in and of itself, the doctors, the system, the people working in it, are somehow malicious and evil and intentionally hurting people. So much so that they need to be stopped by outside forces. Whereas what I’m saying is that there are systemic issues that need to be worked on and advocated for. Because they’re underfunded, there’s not enough beds. We need more research. We need definitive testing.
Lisa: Where the hell do you get that that’s what I’m saying? That’s ridiculous. When did I ever say that? I personally get psychiatric care. Clearly, I believe it has value. I personally do it every day and pay money for it. But they do have some non-zero points. There are abuses out there. And just saying that, well, I’ve never had a problem, everybody I know is better off. That doesn’t mean anything. Everybody these people know isn’t better off. Plus, why did you go straight to people with bipolar disorder? Maybe everyone with bipolar disorder is better off? I don’t know. But maybe everybody with attention deficit disorder isn’t. Maybe they’re worse off. Maybe everybody with that gaming disorder thing you just talked about, maybe they’re worse off. We don’t know that.
Gabe: Because they specifically state anti psychiatry and mental illness, meaning they’re lumping everybody together.
Gabe: Their point is the suicide rate is so high because of psychiatry. And they’re trying to prove that and offer it up as a point.
Lisa: Yeah, that’s dumb. There is no defense for that.
Gabe: This is not a point, and then you say to me, well, can you prove they’re wrong? I don’t have to prove a negative. It doesn’t work that way. They need to prove their point. They have not proven their point.
Lisa: They have definitely proven their point to me.
Gabe: No, they haven’t.
Lisa: Yeah, they have.
Gabe: They have not proven that more people are hurt by psychiatry than helped. They have not proven that.
Lisa: I don’t know that that’s their point.
Gabe: That is their point. That’s why they want to end it.
Lisa: They have multiple points. Why don’t we go with they have successfully proven to me that psychiatry has abuses and it’s very disturbing and it hurts vulnerable people.
Gabe: Yes, agreed.
Lisa: And it has the potential to hurt us, too.
Lisa: And we as a society should really work on that, ’cause it’s creepy.
Gabe: I completely agree.
Lisa: And awful and horrible and depressing.
Gabe: I agree 100%.
Lisa: Ok. So there we go. So we’re agreeing.
Gabe: Well, yes, we are, and that’s part of their gaslighting until they get to the point where they asked me to steal the neighbor’s car and join the cult. Because they take it too far. They take reasonable points and they come up with unreasonable expectations and conclusions. You’re right, they do have reasonable points. Lisa, of course, they have reasonable points, but their solutions to those reasonable problems are so unreasonable that I have trouble looking them in the eyes when they talk. Once they came out and started promoting these conclusions and discouraging people from getting help when they are sick, I’m sorry. I don’t care that they made some good points. I feel that it’s kind of like a cult. You know, you’re walking by and a cult is like, hey, are you lonely? Do you lack purpose? You want volunteer gigs? All those things are very reasonable. I don’t want people to be lonely. I want people to have purpose. I think volunteerism is great. And that’s how the cult gets you in the door. And before you know it, they shave your head and they take all your money. And you’re just like, what? I just wanted to volunteer. They have some good points. Volunteerism is good. No, the cult is bad.
Lisa: You realize that comes back around to your point about the middle, because the other side isn’t offering anything either.
Gabe: I didn’t say they were, and I’m not on their side either. But you’re asking me why I’m not on the anti psychiatry side.
Lisa: But that’s the point. You’re in the middle. That’s how we tie it together. There is no middle. Where’s the middle? These people have good points. These people over here have good points also. Let’s all come to the middle.
Gabe: Do you feel that either side is making any attempt to come toward the middle?
Lisa: No, well. No, not really, no.
Gabe: I think the only way the sides are gonna come to the middle is if they stop looking at each other as the enemy. Both sides need to look at each other and say, you are not my enemy. We just have a disagreement. And both sides need to understand that disagreement does not equal disrespect. And then they need to start working together on the advocacy points that we all have in common, like actual abuses, specific examples, not examples from the 1950s. Not a book that was written wrong in 1980. Stuff that’s happening today. Not enough beds. The mental health safety net just being just ripped apart. Actual access to care where the person who is sick, one can participate in their own care and have reasonable guidelines for when they need to be treated against their will and how to escape that life.
Lisa: That’s a fair point.
Gabe: Lisa, I appreciate you saying that you were taken in by emotion. I and any listener of, well, hell, this episode knows I’m an emotional guy and it’s easy to get sucked in. It’s just it’s incredibly easy to get sucked in. But this is not how we make national policy. And of course, they are very emotional about what has happened to them because of the abuses and mistakes of psychiatry. And they want to now make public policy based on that emotion. They don’t like that psychiatry isn’t using facts in their estimation, but they’re not using facts either. They’re just like we feel bad and we don’t want this done anymore. Two wrongs don’t make a right. And it is a shame, Lisa, because you’re right. Individual points here and there, I agree with. But I have to look at an organization based on their stated mission, their stated goals, and what they are encouraging people to do with their resources and their platform. I respect what they’ve gone through and I really do respect them as people. And, they are welcome to email us at show@PsychCentral.com and tell us why we’re wrong. But I’m sorry, as a platform, not only are they wrong, but I believe that their conclusions are ultimately dangerous and misguided. And that’s where I am.
Lisa: So, Gabe, do you think any of them will listen and send us that e-mail?
Gabe: I don’t know. They haven’t up until now, and I really have tried.
Lisa: Fair point. Good point.
Gabe: I do think that groups need to be diverse and they need to get people who disagree with them to join. I love to be surrounded by people who disagree with me. That is why I do a podcast with my ex-wife.
Gabe: I mean, we don’t agree on nothing.
Lisa: Oh, you’re so sweet.
Gabe: I love how we don’t agree on nothing is like a term of endearment for us.
Lisa: Yeah. Aww. That’s why we’re divorced, dear.
Gabe: Listen up, everybody, I hope you enjoyed listening to the show. I hope that we made some good points and I hope that Lisa and I bickered just enough to be interesting. Check us out on PsychCentral.com‘s Facebook page. You can get over there by going to Facebook.com/PsychCentral. And of course, you can find Gabe and Lisa everywhere. The official Web site for the show, PsychCentral.com/NotCrazy. Subscribe on your favorite podcast player.
Lisa: And we’ll see everybody next Tuesday.
Announcer: You’ve been listening to the Not Crazy Podcast from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. Want to see Gabe and me in person? Not Crazy travels well. Have us record an episode live at your next event. E-mail firstname.lastname@example.org for details.
Howdy, Traci PedersenThis article originally appeared on Psych Central as Podcast: Debating ‘Anti-Psychiatry’ Advocacy.