Anatomy of an Epidemic (Part Five)


Many of the people on SSI or SSDI that I interviewed spoke about how they felt they were caught in the tangles of a business enterprise. “There is a reason we are called consumers” was a comment I heard several times. They are right of course that the pharmaceutical companies wasn’t to build a market for their products, and when we view the psychopharmacology “revolution through this prism, as a business enterprise first and a medical enterprise second, we can easily see why psychiatry and the pharmaceutical companies tell the stories they do, and why the studies detailing poor long-term outcomes have been kept from the public. That information would derail a business enterprise that brings profits to so many.

The marketing machinery has lured more and a more Americans into the psychiatric drugstore. As new drugs were brought to market, disease “awareness” campaign was conducted and diagnostic categories were expanded. Now, once a business gets a customer into its story, it wants to keep that customer and get that customer to buy multiple products, and that’s when the psychiatric “drug trap” kicks in.

The “broken brain” story helps with customer retention, of course, for it a person suffers a “chemical imbalance”, then it makes sense that he or she will have to take the medication to correct it indefinitely, like ”insulin for diabetes”. But more important, the drugs create chemical imbalances in the brain, and this helps turn a first-time customer into a long-term user, and often into a buyer of multiple drugs.

The patients’ brain adopts to the first drug and makes it difficult to go off the medication. The first drug triggers a need for a second, and so on.

Such is the story of the psychiatric drug business. The industry has excelled at expanding the market for its drugs, and this generates a great deal of wealth for many. However, the enterprise has depended on the telling of a false story to the American public, and the hiding of results that reveal the poor long-term outcomes with this paradigm of care. It also is exacting a horrible toll on our society. The number of people disabled by mental illness during the past 20 years has soared, and now the epidemic has spread to our children. Indeed, millions of children and adolescent are being groomed to be lifelong users of these drugs.

What patients say: “The meds isolate you. They interfere with your empathy. There is flatness to you, and so you are uncomfortable with people all the time. They make it hard for you to get along. The drugs may take care of aggression and anxiety and some paranoia, those sorts of symptoms, but they don’t help with the empathy that helps you get along with people.”

From a societal and moral point of view, this is a bottom line that cries out for change.

Loren Mosher believed that psychosis could arise in response to emotional and inner trauma and in its own way, could be a coping mechanism. As such he believed there was the possibility that people could grapple with their hallucinations and delusions, struggle through a schizophrenic break, and regain their sanity. And if that was so, he reasoned that if he provided newly psychotic patients with a safe house, one staffed by people who had an evident empathy for others and who wouldn’t be frightened by strange behaviors, many would get well, even though they were not treated with antipsychotics.

“I thought that sincere human involvement and understanding were critical to healing interactions. The idea was to treat people as people, as human beings, with dignity and respect.” It was a twelve room Victorian house in Santa Clara, CA. which opened in 1971, Soteria House.

Another interesting theory is Tony Stanton’s “attachment theory”, which is based on the importance of emotional relationships to a child’s well-being. In the late 70s, he (while in charge of a psychiatric ward for children at a county hospital in CA) assigned a “mentor” to every child. The children were not medicated, and he saw a number of them become attached to their mentors and “blossom”.

“You just can’t organize yourself without a connection to another human being, and you can’t make that connection if you embalm yourself with drugs”. When a child enters Seneca Center’s residential program, Stanton doesn’t ask “what is wrong” with the child, but rather “what happened to them”.

He gets the department of social services, schools and other agencies to send him all of the records they have on the child, and then he spends eight to ten hours constructing a “life chart”. As might be expected, the charts regularly tell of children who have been sexually abused, physically abused, and horribly neglected. But Stanton also tracks their medication history and how their behavior may have changed after they put on a particular drug, and given that they children who arrive at Seneca Center are seriously disturbed, these medical histories regularly tell of psychiatric care that has worsened their behavior. The children regularly arrive at the center on drug cocktails, and thus It can take a month or two to withdraws the medication. And often they do become more aggressive for a time.

“Most times when the kids come in, they can’t keep their heads up, they are lethargic, they are just a blank and there is minimal engagement. You just can’t get through to them. But when they come off their meds, you can engage them and you get to see who they are. You get a sense of their personality, their sense of humor, and what kinds of things they like to do. You may have to use psychical restraints for a time, but to me, it’s worth it”.

Once they are off meds, the children begin to think of themselves in a new way. They see that they can control their own behavior, and this gives them a sense of “agency”, Stanton said. The Seneca center uses behavior-modification techniques to promote this self-control, with the children constantly having to abide by a well-defined set of rules. They have to ask permission to go to the bathroom and enter bedrooms, and if they don’t’ comply with the rules, they may be sent to a “time-out” or lose a privilege.

But the staff tries to focus on reinforcing positive behaviors, offering words of praise and rewarding the kids in various ways. The children are required to keep their rooms clean and perform a daily chore, and at times they will help prepare the evening meal.

“The question of feeling in charge of yourself and being responsible for yourself is the central issue in their lives.” Stanton said. “They may only partially get there while they are with us, but when we are really successful, we see them develop this sense of “O, I can do this; I want to be in control of myself and my own life”. They see themselves as having that power”.

Even more important, once the children are off the medications they are better able to form emotional bonds with the staff, and the staff with them. They have known rejection all their lives, and they need to form relationships that nurture a belief that they are worthy of being loved, and when that happens, their “internal narrative” can switch from “I’m a bad kid” to “I’m a good kid”.

Please, read the rest of the book by Robert Whitaker “Anatomy of an Epidemic” for more thorough understanding of mental health situation in the United States.

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