Psychiatric Power Quotes

Our society tends to regard as a sickness any mode of thought or behavior that is inconvenient for the system and this is plausible because when an individual doesn't fit into the system it causes pain to the individual as well as problems for the system. Thus the manipulation of an individual to adjust him to the system is seen as a cure for a sickness and therefore as good.

Why do I take a blade and slash my arms? Why do I drink myself into a stupor? Why do I swallow bottles of pills and end up in A&E having my stomach pumped? Am I seeking attention? Showing off? The pain of the cuts releases the mental pain of the memories, but the pain of healing lasts weeks. After every self-harming or overdosing incident I run the risk of being sectioned and returned to a psychiatric institution, a harrowing prospect I would not recommend to anyone. So, why do I do it? I don't. If I had power over the alters, I'd stop them. I don't have that power. When they are out, they're out. I experience blank spells and lose time, consciousness, dignity. If I, Alice Jamieson, wanted attention, I would have completed my PhD and started to climb the academic career ladder. Flaunting the label 'doctor' is more attention-grabbing that lying drained of hope in hospital with steri-strips up your arms and the vile taste of liquid charcoal absorbing the chemicals in your stomach. In most things we do, we anticipate some reward or payment. We study for status and to get better jobs; we work for money; our children are little mirrors of our social standing; the charity donation and trip to Oxfam make us feel good. Every kindness carries the potential gift of a responding kindness: you reap what you sow. There is no advantage in my harming myself; no reason for me to invent delusional memories of incest and ritual abuse. There is nothing to be gained in an A&E department.

The power to label is the power to destroy.

The ethics of psychiatric therapy is the very negation of the ethics of political liberty. The former embraces absolute power, provided it is used to protect and promote the patient's mental health. The latter rejects absolute power, regardless of its aim or use.

There was a muchacha who lived near my house. La gente del pueblo talked about her being una de las otras, “of the Others.” They said that for six months she was a woman who had a vagina that bled once a month, and that for the other six months she was a man, had a penis and she peed standing up. they called her half and half, mita’ y mita‘, neither one nor the other but a strange doubling, a deviation of nature that horrified, a work of nature inverted. But there is a magic aspect in abnormality and so-called deformity. Maimed, mad, and sexually different people were believed to posess supernatural powers by primal cultures’ magico-religious thinking. For them, abnormality was the price a person had to pay for her or his inborn extraordinary gift. There is something compelling about being both male and female, about having an entry into both worlds. Contrary to some psychiatric tenets, half and halfs are not suffering from a confusion of sexual identity, or even from a confusion of gender. What we are suffering from is an absolute despot duality that says we are able to be only one or the other. It claims that human nature is limited and cannot evolve into something better. But I, like other queer people, am two in one body, both male and female. I am the embodiment of the heiros gamos: the coming together of opposite qualities within.

Conviction rates in the military are pathetic, with most offenders going free AND THERE IS NO RECOURSE FOR APPEAL! The military believes the Emperor has his clothes on, even when they are down around his ankles and he is coming in the woman's window with a knife! Military juries give low sentences or clear offender's altogether. Women can be heard to say “it's not just me” over and over. Men may get an Article 15, which is just a slap on the wrist, and doesn't even follow them in their career. This is hardly a deterrent. The perpetrator frequently stays in place to continue to intimidate their female victims, who are then treated like mental cases, who need to be discharged. Women find the tables turned, letters in their files, trumped up Women find the tables turned, letters in their files, trumped up charges; isolation and transfer are common, as are court ordered psychiatric referrals that label the women as lying or incompatible with military service because they are “Borderline Personality Disorders” or mentally unbalanced. I attended many of these women, after they were discharged, or were wives of abusers, from xxx Air Force Base, when I was a psychotherapist working in the private sector. That was always their diagnosis, yet retesting tended to show something different after stabilization, like PTSD.

Generally certain symptoms appear, among them a peculiar use of language: one wants to speak forcefully in order to impress one's opponent, so one employs a special, "bombastic" style full of neologisms which might be described as "power-words." This symptom is observable not only in the psychiatric clinic but also among certain modern philosophers, and, above all, whenever anything unworthy of belief has to be insisted on in the teeth of inner resistance: the language swells up, overreaches itself, sprouts grotesque words distinguished only by their needless complexity. The word is charged with the task of achieving what cannot be done by honest means.

I have always been troubled by that opinion, because it appears to me to have encouraged the intellectual and professional leaders of Germany to remain silent, even in the face of enormous and unprecedented danger. It does not seem to me that the German Psychiatric Association of the 1930s deserves any honor or credit for remaining silent during Hitler’s rise to power

There is no major psychiatric condition in which sleep is normal. This is true of depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, and bipolar disorder (once known as manic depression).

The anti-psychiatrists held various, sometimes conflicting views but one particular line of reasoning is attributable to all of them—they all pitched their arguments against the power of the psychiatric establishment. They argued that the psychiatric diagnosis is scientifically meaningless. It is a way of labeling undesirable behaviour, under the guise of medical intervention. Those who are diagnosed ill are subjected to treatment which is a violation of human rights and dignity. The situation amounts to psychiatry having a mandate to declare some citizens unfit to live in an ‘ordinary’ community. It claims to cure but the supposed beneficiaries of that cure are often held in hospitals against their will. Within a structure like this it is impossible to understand the real nature of mental suffering and it is just as impossible to develop a coherent system of help.

The data on organised abuse has been simplified or distorted in an attempt force it to conform to mechanical psychological models of dissociative obedience or else to the psychiatric framework of ‘paedophilia’. Psychopathology alone is an inadequate explanation for environments in which sexual abuse has a social and symbolic function for groups of adults. Abusive groups do not emerge in a vacuum but rather they are formed within pre-existing social arrangements such as families, churches and schools.

Frosh (2002) has suggested that therapeutic spaces provide children and adults with the rare opportunity to articulate experiences that are otherwise excluded from the dominant symbolic order. However, since the 1990s, post-modern and post-structural theory has often been deployed in ways that attempt to ‘manage’ from; afar the perturbing disclosures of abuse and trauma that arise in therapeutic spaces (Frosh 2002). Nowhere is this clearer than in relation to organised abuse, where the testimony of girls and women has been deconstructed as symptoms of cultural hysteria (Showalter 1997) and the colonisation of women’s minds by therapeutic discourse (Hacking 1995). However, behind words and discourse, ‘a real world and real lives do exist, howsoever we interpret, construct and recycle accounts of these by a variety of symbolic means’ (Stanley 1993: 214). Summit (1994: 5) once described organised abuse as a ‘subject of smoke and mirrors’, observing the ways in which it has persistently defied conceptualisation or explanation. Explanations for serious or sadistic child sex offending have typically rested on psychiatric concepts of ‘paedophilia’ or particular psychological categories that have limited utility for the study of the cultures of sexual abuse that emerge in the families or institutions in which organised abuse takes pace. For those clinicians and researchers who take organised abuse seriously, their reliance upon individualistic rather than sociological explanations for child sexual abuse has left them unable to explain the emergence of coordinated, and often sadistic, multi—perpetrator sexual abuse in a range of contexts around the world.

Our brain scanning experiments in healthy individuals offered reflections on the relationship between sleep and psychiatric illnesses. There is no major psychiatric condition in which sleep is normal. This is true of depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, and bipolar disorder (once known as manic depression).

Maimed, mad and sexually different people were believed to possess supernatural powers by primal cultures' magico-religious thinking. For them, abnormality was the price a person had to pay for her or his inborn extraordinary gift. There is something compelling about being both male and female, about having an entry into both worlds. Contrary to some psychiatric tenets, half and halfs are not suffering from a confusion of sexual identity, or even from a confusion of gender. What we are suffering from is an absolute despot duality that says we are able to be only one or the other. It claims that human nature is limited and cannot evolve into something better. But I, like pother queer people, am two in one body, both male and female. I am the embodiment of the hieros gamos: the comig together of opposit qualities within.

Bryukhanov and Fomin, as the highest ranking men at the plant, were each sentenced to ten years in prison, Dyatlov received five, Kovalenko and Rogozhkin: three, and Laushkin: two. Bryukhanov and Dyatlov - who wrote a book telling his side of the story some years afterwards, in which he placed the blame almost squarely on the designers - were released from prison early due to poor health brought on by radiation exposure. Chief Engineer Nikolai Fomin was declared insane in 1990 and transferred to a psychiatric hospital. Astonishingly, after he recovered he was allowed to return to work at the Kalinin Nuclear Power Plant near Moscow.

We will revisit the effects of sleep loss on emotional stability and other brain functions in later chapters when we discuss the real-life consequences of sleep loss in society, education, and the workplace. The findings justify our questioning of whether or not sleep-deprived doctors can make emotionally rational decisions and judgments; under-slept military personnel should have their fingers on the triggers of weaponry; overworked bankers and stock traders can make rational, non-risky financial decisions when investing the public’s hard-earned retirement funds; and if teenagers should be battling against impossibly early start times during a developmental phase of life when they are most vulnerable to developing psychiatric disorders.

While all of us dread being blamed, we all would wish to be more responsible—that is, to have the ability to respond with awareness to the circumstances of our lives rather than just reacting. We want to be the authoritative person in our own lives: in charge, able to make the authentic decisions that affect us. There is no true responsibility without awareness. One of the weaknesses of the Western medical approach is that we have made the physician the only authority, with the patient too often a mere recipient of the treatment or cure. People are deprived of the opportunity to become truly responsible. None of us are to be blamed if we succumb to illness and death. Any one of us might succumb at any time, but the more we can learn about ourselves, the less prone we are to become passive victims. Mind and body links have to be seen not only for our understanding of illness but also for our understanding of health. Dr. Robert Maunder, on the psychiatric faculty of the University of Toronto, has written about the mindbody interface in disease. “Trying to identify and to answer the question of stress,” he said to me in an interview, “is more likely to lead to health than ignoring the question.” In healing, every bit of information, every piece of the truth, may be crucial. If a link exists between emotions and physiology, not to inform people of it will deprive them of a powerful tool. And here we confront the inadequacy of language. Even to speak about links between mind and body is to imply that two discrete entities are somehow connected to each other. Yet in life there is no such separation; there is no body that is not mind, no mind that is not body. The word mindbody has been suggested to convey the real state of things. Not even in the West is mind-body thinking completely new. In one of Plato’s dialogues, Socrates quotes a Thracian doctor’s criticism of his Greek colleagues: “This is the reason why the cure of so many diseases is unknown to the physicians of Hellas; they are ignorant of the whole. For this is the great error of our day in the treatment of the human body, that physicians separate the mind from the body.” You cannot split mind from body, said Socrates—nearly two and a half millennia before the advent of psychoneuroimmunoendocrinology!

Original Statement by Hunger Strikers to Psychiatric Association, National Alliance for the Mentally Ill and the U.S. Office of the Surgeon General 1. A Hunger Strike to Challenge International Domination by Biopsychiatry. This fast is about human rights in mental health. The psychiatric pharmaceutical complex is heedless of its oath to “first do no harm.” Psychiatrists are able with impunity to: Incarcerate citizens who have committed crimes against neither persons nor property. Impose diagnostic labels on people that stigmatize and defame them. Induce proven neurological damage by force and coercion with powerful psychotropic drugs. Stimulate violence and suicide with drugs promoted as able to control these activities. Destroy brain cells and memories with an increasing use of electroshock (also known as electro-convulsive therapy). Employ restraint and solitary confinement—which frequently cause severe emotional trauma, humiliation, physical harm, and even death—in preference to patience and understanding. Humiliate individuals already damaged by traumatizing assaults to their self-esteem. These human rights violations and crimes against human decency must end. While the history of psychiatry offers little hope that change will arrive quickly, initial steps can and must be taken. At the very least, the public has the right to know IMMEDIATELY the evidence upon which psychiatry bases its spurious claims and treatments, and upon which it has gained and betrayed the trust and confidence of the courts, the media, and the public.21

There is only one historical development that has real significance. Today, when we finally realise that the keys to happiness are in the hands of our biochemical system, we can stop wasting our time on politics and social reforms, putsches and ideologies, and focus instead on the only thing that can make us truly happy: manipulating our biochemistry. If we invest billions in understanding our brain chemistry and developing appropriate treatments, we can make people far happier than ever before, without any need of revolutions. Prozac, for example, does not change regimes, but by raising serotonin levels it lifts people out of their depression. Nothing captures the biological argument better than the famous New Age slogan: ‘Happiness begins within.’ Money, social status, plastic surgery, beautiful houses, powerful positions – none of these will bring you happiness. Lasting happiness comes only from serotonin, dopamine and oxytocin.1 In Aldous Huxley’s dystopian novel Brave New World, published in 1932 at the height of the Great Depression, happiness is the supreme value and psychiatric drugs replace the police and the ballot as the foundation of politics. Every day, each person takes a dose of ‘soma’, a synthetic drug which makes people happy without harming their productivity and efficiency. The World State that governs the entire globe is never threatened by wars, revolutions, strikes or demonstrations, because all people are supremely content with their current conditions, whatever they may be. Huxley’s vision of the future is far more troubling than George Orwell’s Nineteen Eighty-Four. Huxley’s world seems monstrous to most readers, but it is hard to explain why. Everybody is happy all the time – what could be wrong with that?

Critical examination of the lives and beliefs of gurus demonstrates that our psychiatric labels and our conceptions of what is or is not mental illness are woefully inadequate. How for example does one distinguish an unorthodox or bizarre faith from delusion? Gurus are isolated people, dependent upon their disciples with no possibility of being disciplined by a church or criticised by contemporaries. They are above the law. The guru usurps the place of god. Whether gurus have suffered from manic depressive illness, schizophrenia or any other form of recognised diagnosable mental illness is interesting, but ultimately unimportant. What distinguishes gurus from more orthodox teachers is not their manic depressive mood swings, not their thought disorders, not their delusional beliefs, not their hallucinatory visions, not their mystical states of ecstasy. It is their narcissism.

The imprisoned population could not have grown to almost 2.5 million people in this country without our implicit assent. And we don’t even acknowledge the fact that psychiatric institutions are often an important part of the prison-industrial complex, nor do we acknowledge the intersection of the pharmaceutical-industrial complex and the prison-industrial complex. But the point I make is that if we had mounted a more powerful resistance in the 1980s and 1990s during the Reagan-Bush era and during the Clinton era, we would not be confronting such a behemoth today. We have had to unlearn a great deal over the course of the last few decades. We have had to try to unlearn racism, and I am speaking not only about white people. People of color have had to unlearn the assumption that racism is individual, that it is primarily a question of individual attitudes that can be dealt with through sensitivity training.

found myself constantly drawn to the subject of narcissistic personality disorder (NPD), which I have concluded is inextricably linked to psychopathy, although this link is rarely mentioned in medical papers or among the psychiatric profession generally. As with psychopathy, people with NPD make up approximately 1 per cent of the population with rates greater in men. Another direct comparison between those suffering with NPD and psychopathy/sociopathy is that both types are characterised by exaggerated feelings of self-importance. In its moderate to extreme forms these people are excessively preoccupied with personal adequacy, power, prestige and vanity; mentally unable to see the destructive damage they are causing themselves and others. Symptoms of the NPD disorder include seeking constant approval from others who are successful in positions of power in whatever form it may be. Many are selfish, grandiose pathological liars; their egos and sense of self-esteem over-inflated, while at once they are torn between exaggerated self-appraisal and the reality that they might never amount to much.

When we consider the major role intimidation plays in this ideology, which was still at the peak of its popularity at the turn of the century, it is not surprising that Sigmund Freud had to conceal his surprising discovery of adults' sexual abuse of their children, a discovery he was led to by the testimony of his patients. He disguised his insight with the aid of a theory that nullified this inadmissible knowledge. Children of his day were not allowed, under the severest of threats, to be aware of what adults were doing to them. and if Freud had persisted in his seduction theory, he not only would have had his introjected parents to fear but would no doubt have been discredited, and probably ostracized, by middle-class society. In order to protect himself, he had to devise a theory that would preserve appearances by attributing all “evil”, guilt and wrongdoing to the child's fantasies. in which the parents served only as the objects of projection. We can understand why this theory omitted the fact that it is the parents who not only project their sexual and aggressive fantasies onto the child but also are able to act out these fantasies because they wield the power. It is probably thanks to this omission that many professionals in the psychiatric field, themselves the products of "poisonous pedagogy" have been able to accept the Freudian theory of drives, because it did not force them to question their idealized image of their parents. With the aid of Freud's drive and structural theories, they have been able to continue obeying the commandment they internalized in early childhood: "Thou shalt not be aware of what your parents are doing to you.

Our patients predict the culture by living out consciously what the masses of people are able to keep unconscious for the time being. The neurotic is cast by destiny into a Cassandra role. In vain does Cassandra, sitting on the steps of the palace at Mycenae when Agamemnon brings her back from Troy, cry, “Oh for the nightingale’s pure song and a fate like hers!” She knows, in her ill-starred life, that “the pain flooding the song of sorrow is [hers] alone,” and that she must predict the doom she sees will occur there. The Mycenaeans speak of her as mad, but they also believe she does speak the truth, and that she has a special power to anticipate events. Today, the person with psychological problems bears the burdens of the conflicts of the times in his blood, and is fated to predict in his actions and struggles the issues which will later erupt on all sides in the society. The first and clearest demonstration of this thesis is seen in the sexual problems which Freud found in his Victorian patients in the two decades before World War I. These sexual topics‒even down to the words‒were entirely denied and repressed by the accepted society at the time. But the problems burst violently forth into endemic form two decades later after World War II. In the 1920's, everybody was preoccupied with sex and its functions. Not by the furthest stretch of the imagination can anyone argue that Freud "caused" this emergence. He rather reflected and interpreted, through the data revealed by his patients, the underlying conflicts of the society, which the “normal” members could and did succeed in repressing for the time being. Neurotic problems are the language of the unconscious emerging into social awareness. A second, more minor example is seen in the great amount of hostility which was found in patients in the 1930's. This was written about by Horney, among others, and it emerged more broadly and openly as a conscious phenomenon in our society a decade later. A third major example may be seen in the problem of anxiety. In the late 1930's and early 1940's, some therapists, including myself, were impressed by the fact that in many of our patients anxiety was appearing not merely as a symptom of repression or pathology, but as a generalized character state. My research on anxiety, and that of Hobart Mowrer and others, began in the early 1940's. In those days very little concern had been shown in this country for anxiety other than as a symptom of pathology. I recall arguing in the late 1940's, in my doctoral orals, for the concept of normal anxiety, and my professors heard me with respectful silence but with considerable frowning. Predictive as the artists are, the poet W. H. Auden published his Age of Anxiety in 1947, and just after that Bernstein wrote his symphony on that theme. Camus was then writing (1947) about this “century of fear,” and Kafka already had created powerful vignettes of the coming age of anxiety in his novels, most of them as yet untranslated. The formulations of the scientific establishment, as is normal, lagged behind what our patients were trying to tell us. Thus, at the annual convention of the American Psychopathological Association in 1949 on the theme “Anxiety,” the concept of normal anxiety, presented in a paper by me, was still denied by most of the psychiatrists and psychologists present. But in the 1950's a radical change became evident; everyone was talking about anxiety and there were conferences on the problem on every hand. Now the concept of "normal" anxiety gradually became accepted in the psychiatric literature. Everybody, normal as well as neurotic, seemed aware that he was living in the “age of anxiety.” What had been presented by the artists and had appeared in our patients in the late 30's and 40's was now endemic in the land.

How can this type of data be made to tell a reliable story? By subjecting it to the economist’s favorite trick: regression analysis. No, regression analysis is not some forgotten form of psychiatric treatment. It is a powerful—if limited—tool that uses statistical techniques to identify otherwise elusive correlations.

In 1973, the American Psychiatric Association, after years of internal debate, rewrote the definition of homosexuality so it was no longer a mental illness—paving the way for the passage of state laws that made it illegal to discriminate against people because of their sexual orientation.

This power God has for us as we Christians in the ministerial, theological, psychological, psychiatric, medical, therapeutic, and counseling fields regain, first of all, an incarnational understanding of Christian reality, and then come together in unity, learn from one another, and collaborate with the God who is with us. If and when we get our act together, the world will once again, in regard to the soul of man, have everything to learn from us.

At first, Ross couldn’t believe what he was seeing: “I thought the first ten or twenty people were plants—that they must be faking it. They were saying things like ‘I understand love is the most powerful force on the planet’ or ‘I had an encounter with my cancer, this black cloud of smoke.’ People were journeying to early parts of their lives and coming back with a profound new sense of things, new priorities. People who had been palpably scared of death—they lost their fear. The fact that a drug given once could have such an effect for so long is an unprecedented finding. We have never had anything like that in the psychiatric field.

Forced by the hand of early school start times, this state of chronic sleep deprivation is especially concerning considering that adolescence is the most susceptible phase of life for developing chronic mental illnesses, such as depression, anxiety, schizophrenia, and suicidality. Unnecessarily bankrupting the sleep of a teenager could make all the difference in the precarious tipping point between psychological wellness and lifelong psychiatric illness. This is a strong statement, and I do not write it flippantly or without evidence.

Our brain scanning experiments in healthy individuals offered reflections on the relationship between sleep and psychiatric illnesses. There is no major psychiatric condition in which sleep is normal. This is true of depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, and bipolar disorder (once known as manic depression

we neglect what are the best forms of prevention—i.e., promoting exercise, proper diet, moderation in alcohol use, abstention from tobacco and drugs. These extremely useful and remarkably cheap prevention measures aren’t profitable for the medical-industrial complex and therefore lack its powerful and well-financed sponsorship.

Sadly, however, I have met people who are better evangelists for Prozac than they are for the living God. Rather than viewing medication as simply one component of a full-orbed God-centered body-soul treatment approach, they view it almost as if it was their salvation. By definition, this is idolatry: attributing ultimate power and help to something other than our triune God. If a counselee believes that what ultimately matters is fine-tuning the dose of his Paxil, and finds discussion of spiritual things superfluous or irrelevant, that’s a problem. How a person responds when the medication works—or doesn’t work—reveals her basic posture before God. Thanksgiving and a more fervent seeking after God in the wake of medication success say one thing; a lack of gratitude and a comfort-driven forgetfulness of God say another. A commitment to trust God’s faithfulness and goodness in the wake of medication failure says one thing; a bitter, complaining distrust of his ways says another. So, receive the gift but look principally to the Giver. Whether a medication “works” or not, he is always working on your behalf.

Bill Wilson would never have another drink. For the next thirty-six years, until he died of emphysema in 1971, he would devote himself to founding, building, and spreading Alcoholics Anonymous, until it became the largest, most well-known and successful habit-changing organization in the world. An estimated 2.1 million people seek help from AA each year, and as many as 10 million alcoholics may have achieved sobriety through the group.3.12,3.13 AA doesn’t work for everyone—success rates are difficult to measure, because of participants’ anonymity—but millions credit the program with saving their lives. AA’s foundational credo, the famous twelve steps, have become cultural lodestones incorporated into treatment programs for overeating, gambling, debt, sex, drugs, hoarding, self-mutilation, smoking, video game addictions, emotional dependency, and dozens of other destructive behaviors. The group’s techniques offer, in many respects, one of the most powerful formulas for change. All of which is somewhat unexpected, because AA has almost no grounding in science or most accepted therapeutic methods. Alcoholism, of course, is more than a habit. It’s a physical addiction with psychological and perhaps genetic roots. What’s interesting about AA, however, is that the program doesn’t directly attack many of the psychiatric or biochemical issues that researchers say are often at the core of why alcoholics drink.3.14 In fact, AA’s methods seem to sidestep scientific and medical findings altogether, as well as the types of intervention many psychiatrists say alcoholics really need.1 What AA provides instead is a method for attacking the habits that surround alcohol use.3.15 AA, in essence, is a giant machine for changing habit loops. And though the habits associated with alcoholism are extreme, the lessons AA provides demonstrate how almost any habit—even the most obstinate—can be changed.

However, a prevailing view in psychiatry has been that mental disorders cause sleep disruption—a one-way street of influence. Instead, we have demonstrated that otherwise healthy people can experience a neurological pattern of brain activity similar to that observed in many of these psychiatric conditions simply by having their sleep disrupted or blocked. Indeed, many of the brain regions commonly impacted by psychiatric mood disorders are the same regions that are involved in sleep regulation and impacted by sleep loss. Further, many of the genes that show abnormalities in psychiatric illnesses are the same genes that help control sleep and our circadian rhythms.

Had psychiatry got the causal direction wrong, and it was sleep disruption instigating mental illness, not the other way around? No, I believe that is equally inaccurate and reductionist to suggest. Instead, I firmly believe that sleep loss and mental illness is best described as a two-way street of interaction, with the flow of traffic being stronger in one direction or the other, depending on the disorder. I am not suggesting that all psychiatric conditions are caused by absent sleep. However, I am suggesting that sleep disruption remains a neglected factor contributing to the instigation and/or maintenance of numerous psychiatric illnesses, and has powerful diagnostic and therapeutic potential that we are yet to fully understand or make use of.

Forced by the hand of early school start times, this state of chronic sleep deprivation is especially concerning considering that adolescence is the most susceptible phase of life for developing chronic mental illnesses, such as depression, anxiety, schizophrenia, and suicidality. Unnecessarily bankrupting the sleep of a teenager could make all the difference in the precarious tipping point between psychological wellness and lifelong psychiatric illness.

Elusive reality does not discourage Umpire Two. We don’t have to fully perceive or understand the underlying nature of our world to negotiate it well. Our senses and reasoning powers evolved as they did because they work just fine in the everyday, nonphilosophical business of survival. Mental constructs of reality are imperfect, but indispensable, ways to organize the otherwise bewildering phenomena of the world.

Unnecessarily bankrupting the sleep of a teenager could make all the difference in the precarious tipping point between psychological wellness and lifelong psychiatric illness.

biomedical view, for its part, increasingly recognizes the power of things like meditation and traditional talk therapy to render concrete structural changes in brain physiology that are every bit as “real” as the changes wrought by pills or electroshock therapy. A study published by researchers at Massachusetts General Hospital in 2011 found that subjects who practiced meditation for an average of just twenty-seven minutes a day over a period of eight weeks produced visible changes in brain structure. Meditation led to decreased density of the amygdala, a physical change that was correlated with subjects’ self-reported stress levels—as their amygdalae got less dense, the subjects felt less stressed. Other studies have found that Buddhist monks who are especially good at meditating show much greater activity in their frontal cortices, and much less in their amygdalae, than normal people.n Meditation and deep-breathing exercises work for similar reasons as psychiatric medications do, exerting their effects not just on some abstract concept of mind but concretely on our bodies, on the somatic correlates of our feelings. Recent research has shown that even old-fashioned talk therapy can have tangible, physical effects on the shape of our brains. Perhaps Kierkegaard was wrong to say that the man who has learned to be in anxiety has learned the most important, or the most existentially meaningful, thing—perhaps the man has only learned the right techniques for controlling his hyperactive amygdala.o

trial and error. Other experimenters recorded the visual fields of target subjects exposed to the color red. Trainees who learned, through feedback, to approximate that same neural activity reported seeing red in their mind’s eye. Since those days, the field had shifted from visual learning to emotional conditioning. The big grant money was going to desensitizing people with PTSD. DecNef and Connectivity Feedback were being touted as treatments to all kinds of psychiatric disorders. Marty Currier worked on clinical applications. But he was also pursuing a more exotic side-hustle. “Why not?” I told my wife. And so we volunteered in her friend’s experiment. IN THE RECEPTION AREA OF CURRIER’S LAB, Aly and I chuckled over the entrance questionnaire. We would be among the second wave of target subjects, but first we had to pass the screening. The questions disguised furtive motives. HOW OFTEN DO YOU THINK ABOUT THE PAST? WOULD YOU RATHER BE ON A CROWDED BEACH OR IN AN EMPTY MUSEUM? My wife shook her head at these crude inquiries and touched a hand to her smile. I read the expression as clearly as if we were wired up together: The investigators were welcome to anything they discovered inside her, so long as it didn’t lead to jail time. I’d given up on understanding my own hidden temperament a long time ago. Lots of monsters inhabited my sunless depths, but most of them were nonlethal. I did badly want to see my wife’s answers, but a lab tech prevented us from comparing questionnaires. DO YOU USE TOBACCO? Not for years. I didn’t mention that all my pencils were covered with bite marks. HOW MUCH ALCOHOL DO YOU DRINK A WEEK? Nothing for me, but my wife confessed to her nightly Happy Hour, while plying the dog with poetry. DO YOU SUFFER FROM ANY ALLERGIES? Not unless you counted cocktail parties. HAVE YOU EVER EXPERIENCED DEPRESSION? I didn’t know how to answer that one. DO YOU PLAY A MUSICAL INSTRUMENT? Science. I said I might be able to find middle C on a piano, if they needed it. Two postdocs took us into the fMRI room. These people had way more cash to throw around than any astrobiology team anywhere. Aly was having the same thoughts

in believing that anxiety disorders typically arise from failed efforts to resolve basic existential dilemmas, Dr. W. is, as we will see, running against the grain of modern psychopharmacology (which proffers the evidence of sixty years of drug studies to argue that anxiety and depression are based on “chemical imbalances”), neuroscience (whose emergence has demonstrated not only the brain activity associated with various emotional states but also, in some cases, the specific structural abnormalities associated with mental illness), and temperament studies and molecular genetics (which suggest, rather convincingly, a powerful role for heredity in the determination of one’s baseline level of anxiety and susceptibility to psychiatric illness). Dr. W. doesn’t dispute the findings from any of those modes of inquiry. He believes medication can be an effective treatment for the symptoms of anxiety. But his view, based on thirty years of clinical work with hundreds of anxious patients, is that at the root of almost all clinical anxiety is some kind of existential crisis about what he calls the “ontological givens”—that we will grow old, that we will die, that we will lose people we love, that we will likely endure identity-shaking professional failures and personal humiliations, that we must struggle to find meaning and purpose in our lives, and that we must make trade-offs between personal freedom and emotional security and between our desires and the constraints of our relationships and our communities. In this view, our phobias of rats or snakes or cheese or honey (yes, honey; the actor Richard Burton could not bear to be in a room with honey, even if it was sealed in a jar, even if the jar was closed in a drawer) are displacements of our deeper existential concerns projected onto outward things. Early

I found myself constantly drawn to the subject of narcissistic personality disorder (NPD), which I have concluded is inextricably linked to psychopathy, although this link is rarely mentioned in medical papers or among the psychiatric profession generally. As with psychopathy, people with NPD make up approximately 1 per cent of the population with rates greater in men. Another direct comparison between those suffering with NPD and psychopathy/sociopathy is that both types are characterised by exaggerated feelings of self-importance. In its moderate to extreme forms these people are excessively preoccupied with personal adequacy, power, prestige and vanity; mentally unable to see the destructive damage they are causing themselves and others. Symptoms of the NPD disorder include seeking constant approval from others who are successful in positions of power in whatever form it may be. Many are selfish, grandiose pathological liars; their egos and sense of self-esteem over-inflated, while at once they are torn between exaggerated self-appraisal and the reality that they might never amount to much.

We don't have to fully perceive or understand the underlying nature of our world to negotiate it well. Our senses and reasoning powers evolved as they did because they work just fine in the everyday, nonphilosophical business of survival. Mental constructs of reality are imperfect, but indispensable, ways to organize the otherwise bewildering phenomena of the world.

Sitting on the couch in the trailer watching TV one late night, I saw an infomercial for a series of audiocassettes called Attacking Anxiety and Depression from the Midwest Center for Stress and Anxiety. Without a moment’s hesitation I reached for the phone, called the 800 number on the TV screen and purchased the tapes. When the tapes arrived a few days later, I popped in the first cassette in the sixteen-cassette self-help series—which was comprised of testimonials from people afflicted with panic attacks—and realized that I wasn’t going crazy, that this was indeed a legitimate psychiatric disorder. As I listened to the remainder of the series in our trailer, I began to grasp that my brain could tell me something so convincingly that I had almost no choice but to believe it. During anxiety attacks I actually believed that I was dying. The attacks were so severe that I would have rather known that I was going to have open heart surgery at 9:00 a.m. the next day than a panic attack. That was the power of the nervous system: we can think things that aren’t true and feel and see things that aren’t real. With the Attacking Anxiety and Depression tapes suddenly the subjective no longer held the power for me that it had once held. Indeed, what I was learning about the power of the mind just might explain some of the experiences I’d had in the past—like speaking with God or hearing his voice. It was neurologically possible to hear an audible voice when there was no voice there. I began to entertain the possibility that there was an objective way of looking at my experiences, and that this objective perspective might prove those experiences to be false. Up until that moment seeing truly was believing, but what did it say about my beliefs if I had not seen or heard anything at all?

What is a dream? According to Cinderella, 'A dream is a wish your heart makes.' It is instructive to note that our hero sings these words to a family of birds who wear kerchiefs and don't appear to have the power of language, revealing the first important thing you need to know about dreamers, which is, most of them need psychiatric evaluation.

The most visible feature of self-oriented perfectionism is this hypercompetitive streak fused to a sense of never being good enough. Hypercompetitiveness reflects a paradox because people high in self-oriented perfectionism can recoil from competition due to fear of failure and fear of losing other people's approval. Socially-prescribed perfectionism makes for a hugely pressured life, spent at the whim of everyone else's opinions, trying desperately to be somebody else, somebody perfect. Perfectionism lurks beneath the surface of mental distress. Someone who scores high on perfectionism also scores high on anxiety. The ill-effects of self-oriented perfectionism correlate with anxiety and it predicts increases in depression over time. There are links between other-oriented perfectionism and higher vindictiveness, a grandiose desire for admiration and hostility toward others, as well as lower altruism, compliance with social norms and trust. People with high levels of socially-prescribed perfectionism typically report elevated loneliness, worry about the future, need for approval, poor-quality relationships, rumination and brooding, fears of revealing imperfections to others, self-harm, worse physical health, lower life satisfaction and chronically low self-esteem. Perfectionism makes people extremely insecure, self-conscious and vulnerable to even the smallest hassles. Perfection is man's ultimate illusion. It simply doesn't exist in the universe. If you are a perfectionist, you are guaranteed to be a loser in whatever you do. Socially-prescribed perfectionism has an astonishingly strong link with burnout. What I don't have - or how perfectionism grows in the soil of our manufactured discontent. No matter what the advertisement says, you will go on with your imperfect existence whether you make that purchase or not. And that existence is - can only ever be - enough. Make a promise to be kind to yourself, taking ownership of your imperfections, recognizing your shared humanity and understanding that no matter how hard your culture works to teach you otherwise, no one is perfect and everyone has an imperfect life. Socially-prescribed perfectionism is the emblem of consumer culture. Research shows that roaming outside, especially in new places, contributes to enhanced well-being. Other benefits of getting out there in nature include improved attention, lower stress, better mood, reduced risk of psychiatric disorders and even upticks in empathy and cooperation. Perfection is not necessary to live an active and fulfilling life.

was exploring something called Decoded Neurofeedback. It resembled old-fashioned biofeedback, but with neural imaging for real-time, AI-mediated feedback. A first group of subjects—the “targets”—entered emotional states in response to external prompts, while researchers scanned relevant regions of their brains using fMRI. The researchers then scanned the same brain regions of a second group of subjects—the “trainees”—in real time. AI monitored the neural activity and sent auditory and visual cues to steer the trainees toward the targets’ prerecorded neural states. In this way, the trainees learned to approximate the patterns of excitation in the targets’ brains, and, remarkably, began to report having similar emotions. The technique dated back to 2011, and it claimed some impressive early results. Teams in Boston and Japan taught trainees to solve visual puzzles faster, simply by training them on the visual cortex patterns of targets who’d learned the puzzles by trial and error. Other experimenters recorded the visual fields of target subjects exposed to the color red. Trainees who learned, through feedback, to approximate that same neural activity reported seeing red in their mind’s eye. Since those days, the field had shifted from visual learning to emotional conditioning. The big grant money was going to desensitizing people with PTSD. DecNef and Connectivity Feedback were being touted as treatments to all kinds of psychiatric disorders. Marty Currier worked on clinical applications. But he was also pursuing

ITEM. It is conservatively estimated that 20 percent of all Vietnam veterans, and 60 percent of combat veterans, were psychiatric casualties.58

In those early days at the VA, we labeled our veterans with all sorts of diagnoses—alcoholism, substance abuse, depression, mood disorder, even schizophrenia—and we tried every treatment in our textbooks. But for all our efforts it became clear that we were actually accomplishing very little. The powerful drugs we prescribed often left the men in such a fog that they could barely function. When we encouraged them to talk about the precise details of a traumatic event, we often inadvertently triggered a full-blown flashback, rather than helping them resolve the issue. Many of them dropped out of treatment because we were not only failing to help but also sometimes making things worse. A turning point arrived in 1980, when a group of Vietnam veterans, aided by the New York psychoanalysts Chaim Shatan and Robert J. Lifton, successfully lobbied the American Psychiatric Association to create a new diagnosis: posttraumatic stress disorder (PTSD), which described a cluster of symptoms that was common, to a greater or lesser extent, to all of our veterans. Systematically identifying the symptoms and grouping them together into a disorder finally gave a name to the suffering of people who were overwhelmed by horror and helplessness. With the conceptual framework of PTSD in place, the stage was set for a radical change in our understanding of our patients. This eventually led to an explosion of research and attempts at finding effective treatments

It is estimated that the financial burden of mental illness worldwide will reach $16 trillion by 2030. The World Health Organization reports that over 300 million people suffer from depression alone, making it the leading cause of disability worldwide. That projection is not only disturbing but emphasizes the need to seek disruptive, innovative approaches to psychiatric disease. Mobilehealth can help fill these needs for at least two reasons: given the number of available mental health professionals, it is virtually impossible for all those in need of those services to be cared for face-to-face, a dilemma that is especially acute in low and middle-income countries. And there is also some evidence to suggest that many patients are more willing to open up about their psychological concerns online during an anonymous consultation. 

research team in Italy examined bipolar patients during the time when they were in this stable, inter-episode phase. Next, under careful clinical supervision, they sleep-deprived these individuals for one night. Almost immediately, a large proportion of the individuals either spiraled into a manic episode or became seriously depressed. I find it to be an ethically difficult experiment to appreciate, but the scientists had importantly demonstrated that a lack of sleep is a causal trigger of a psychiatric episode of mania or depression.

Like the psychological model outlined above, the psychiatric understanding of ’organised paedophilia’ is a framework that is focused primarily on individual psychological factors and overlooks the role of violence in criminal groups and the contexts in which such groups emerge. The underlying assumption of literature on ‘organised paedophilia’ is that members of sexually abusive groups are motivated by a pathological sexual interest in children but this does not accord with evidence that suggests that abusive groups can simultaneously abuse children and women. It is increasingly recognised that sexual offenders may not specialise in one particular victim category, and a significant proportion of child sexual abusers have also offended against adults (Cann et al. 2007, Heil et al. 2003). Furthermore, many of the behaviours of abusive groups appear to be designed to elicit fear and pain from the victim rather than to generate sexual pleasure for the perpetrator per se., are not mutually exclusive, but there is a sadistic dimension to organised abuse that is not explicable as ‘paedophilic’. A survivor of organised abuse from Belgium, Regina Louf, made this point clearly when she said: I find the expression ‘paedophile network’ misleading. For me paedophiles are those men who go to playgrounds or swimming pools, priests…I certainly don't want to exonerate them, but I would rather have paedophiles than the types we were involved with. There were men who never touched the children. Whether you were five, ten, or fifteen didn’t matter. What mattered to them was sex, power, experience. To do things they would never have tried with their own wives. Among them were some real sadists. (Louf quoted in Bulte and de Conick 1998) A credible theoretical account of organised abuse must necessarily (a) account for the available empirical evidence of organised abuse, (b) address the complex patterns of abuse and violence evident in sexually abusive groups, and (c) explain the ways in which sexually abusive groups form in a range of contexts, including families and institutions.

Our immune system does not exist in isolation from daily experience. For example, the immune defences that normally function in healthy young people have been shown to be suppressed in medical students under the pressure of final examinations. Of even greater implication for their future health and well-being, the loneliest students suffered the greatest negative impact on their immune systems. Loneliness has been similarly associated with diminished immune activity in a group of psychiatric inpatients. Even if no further research evidence existed—though there is plenty—one would have to consider the long-term effects of chronic stress. The pressure of examinations is obvious and short term, but many people unwittingly spend their entire lives as if under the gaze of a powerful and judgmental examiner whom they must please at all costs. Many of us live, if not alone, then in emotionally inadequate relationships that do not recognize or honour our deepest needs. Isolation and stress affect many who may believe their lives are quite satisfactory. How may stress be transmuted into illness? Stress is a complicated cascade of physical and biochemical responses to powerful emotional stimuli. Physiologically, emotions are themselves electrical, chemical and hormonal discharges of the human nervous system. Emotions influence—and are influenced by—the functioning of our major organs, the integrity of our immune defences and the workings of the many circulating biological substances that help govern the body’s physical states. When emotions are repressed, this inhibition disarms the body’s defences against illness. Repression—dissociating emotions from awareness and relegating them to the unconscious realm—disorganizes and confuses our physiological defences so that in some people these defences go awry, becoming the destroyers of health rather than its protectors.

While all of us dread being blamed, we all would wish to be more responsible—that is, to have the ability to respond with awareness to the circumstances of our lives rather than just reacting. We want to be the authoritative person in our own lives: in charge, able to make the authentic decisions that affect us. There is no true responsibility without awareness. One of the weaknesses of the Western medical approach is that we have made the physician the only authority, with the patient too often a mere recipient of the treatment or cure. People are deprived of the opportunity to become truly responsible. None of us are to be blamed if we succumb to illness and death. Any one of us might succumb at any time, but the more we can learn about ourselves, the less prone we are to become passive victims. Mind and body links have to be seen not only for our understanding of illness but also for our understanding of health. Dr. Robert Maunder, on the psychiatric faculty of the University of Toronto, has written about the mindbody interface in disease. “Trying to identify and to answer the question of stress,” he said to me in an interview, “is more likely to lead to health than ignoring the question.” In healing, every bit of information, every piece of the truth, may be crucial. If a link exists between emotions and physiology, not to inform people of it will deprive them of a powerful tool. And here we confront the inadequacy of language. Even to speak about links between mind and body is to imply that two discrete entities are somehow connected to each other. Yet in life there is no such separation; there is no body that is not mind, no mind that is not body. The word mindbody has been suggested to convey the real state of things. Not even in the West is mind-body thinking completely new. In one of Plato’s dialogues, Socrates quotes a Thracian doctor’s criticism of his Greek colleagues: “This is the reason why the cure of so many diseases is unknown to the physicians of Hellas; they are ignorant of the whole. For this is the great error of our day in the treatment of the human body, that physicians separate the mind from the body.” You cannot split mind from body, said Socrates—nearly two and a half millennia before the advent of psychoneuroimmunoendocrinology!

Rorschach’s dissertation, which he finished in 1912, set out to define the physiological pathways that make empathy in Vischer’s sense possible. “On ‘Reflex Hallucinations’ and Related Phenomena” may be a brain-numbing title in English, but the subject was nothing less than the connection between what we see and how we feel. Reflexhalluzination was a technical psychiatric

It does not seem to me that the German Psychiatric Association of the 1930s deserves any honor or credit for remaining silent during Hitler’s rise to power. On the contrary, it appears from our perspective today to have been a passive enabler of the worst atrocities he committed

Sylvia Plath's achingly powerful The Bell Jar weaves her personal battle with depression into the tapestry of fiction. Ned Vizzini's best-selling It's Kind of a Funny Story was inspired by his own psychiatric hospitalization. The House on Mango Street, by Sandra Cisneros, contains

This was the first study ever to show that cognitive-behavior therapy—or, indeed, any psychiatric treatment that did not rely on drugs—has the power to change faulty brain chemistry in a well-identified brain circuit. What’s more, the therapy had been self-directed, something that was and to a great extent remains anathema to psychology and psychiatry. The changes we detected on PET scans were the kind that neuropsychiatrists might see in patients being treated with powerful mind-altering drugs. We had demonstrated such changes in patients who had, not to put too fine a point on it, changed the way they thought about their thoughts. Self-directed therapy had dramatically and significantly altered brain function. There are now a wealth of brain imaging data supporting the notion that the sort of willful cognitive shift achieved during Refocusing through mindful awareness brings about important changes in brain circuitry as we will see in later chapters.

GANDHI WOULD LEARN, however, that empathy had its limits, an insight previously reached by the psychiatrist/philosopher Karl Jaspers, famous for making empathy central to his thinking. Jaspers boldly resisted Nazism and was one of the few prominent anti-Nazi philosophers who stayed in Germany after Hitler took power. In both his psychiatric and political experience, Jaspers discovered the limits of empathy. In psychiatry, he found that the inability to empathize was a sign of psychosis, the loss of touch with reality that characterizes bizarre delusions or hallucinations. The psychotic’s inability to empathize with others is mirrored by our inability to empathize with his delusions. If you firmly believe that your entrails are being invaded by Martians, no matter how much I try to understand your life and feelings and thoughts, I cannot make sense of—or empathize with—your delusion. Just as Jaspers argued that there are limits to empathy in psychiatry, he found that he could not empathize with the Nazi evil; it was the political equivalent of a delusion—a pure falsehood with which he could not conceivably empathize. His discovery would be repeated by Gandhi’s experience during the last decade of his life, and, initially, with the same challenge: Adolf Hitler.

Since we are talking about autistic children, let’s start there, and then we will circle back and focus on treating people with PTSD. Dr. Porges: We can cluster both PTSD and autism together, because from a Polyvagal perspective, the pivotal point is whether we can help another human feel safe. Safety is a powerful construct that involves features from several processes and domains, including context, behavior, mental processes, and physiological state. If we feel safe, we have access to the neural regulation of the facial muscles. We have access to a myelinated vagal circuit that is capable of down-regulating the commonly observed fight/flight and stress responses. And, when we down-regulate our defense, we have an opportunity to play and to enjoy our social interactions. I wanted to introduce into this discussion the concept of play. An inability to play is a characteristic of many individuals with a psychiatric diagnosis. Yet, we do not find an inability to play with others or to spontaneously and reciprocally express humor in any diagnostic criteria.

One drug, Levaquin, a powerful antibiotic, is in the top three of all drugs that cause adverse psychiatric effects. It is the focus of multiple lawsuits.

plays a role in his capture. Sociopaths like Francois who do not feel guilt exhibit a rare psychiatric disorder. Such individuals are not listed in the DSM. While sociopathy is acknowledged among psychiatrists as a legitimate mental condition, such individuals come under the “Antisocial Behavior” diagnosis in the DSM. According to the DSM, the essential feature of Antisocial Personality Disorder is violating the rights of others. It is a condition that begins in childhood or early in adolescence and progresses into adulthood. The DSM does point out that this pattern of behavior is often referred to by other names, including “psychopathy” and “sociopathy.” Deceit and manipulation are considered characteristics of this diagnosis. People who exhibit this kind of behavior do not conform to social norms; far from it. They may exhibit unlawful behavior. Repeatedly, they may perform illegal acts, including property destruction. Harassment of individuals, robbery and illegal occupations are also characteristic. Frequently, they lie and cheat to get what they want, especially sex or power. They may act impulsively and fail to plan ahead. Thus, when Francois killed the women in his house, he may

It does not seem to me that the German Psychiatric Association of the 1930s deserves any honor or credit for remaining silent during Hitler’s rise to power. On the contrary, it appears from our perspective today to have been a passive enabler of the worst atrocities he committed—as were most German clergymen, professors, lawyers, judges, physicians, journalists, and other professionals and intellectuals who could have, but did not, speak out when they saw a blatantly obvious psychopath gaining the power to lead their country into the worst disaster in its history. Our current president does not have to be a literal reincarnation of Hitler—and I am not suggesting that he is—in order for the same principles to apply to us today.

Most people suffer from megalomania an excessive enjoyment in having power over other people, and a craving for more of it a psychiatric disorder with delusions of power, a psychiatric disorder in which the patient experiences delusions of great power and importance

We are not alone. But we desperately need one another. We need to share our stories. We need comradery and a unified movement. As many of us have found out the hard way, none of us can fix these diseases alone. None of us, rich or poor, can insulate and protect our family members from psychiatric disorders. I’ve met billionaires who are helpless to get their ill children out of jail. I’ve met the most powerful public health officials who have helplessly watched their siblings die on the streets. The richest among us can’t buy medicines that don’t exist; the cleverest person can’t find a bed in a hospital that lies in ruins; the smartest doctor can’t unravel the riddle of these poorly understood brain diseases. We can only solve this together, as an outspoken, unified, undeterred, and unashamed community.