OYM Robert Whitaker | Rethinking Psychiatry

 

It’s alarming to know that there’s a rising burden of mental illness globally, especially for those diagnosed with schizophrenia or bipolar. It’s time to rethink psychiatric care and focus on providing solutions for mentally ill patients. The author of Mad in America, Robert Whitaker, shares his knowledge on psychiatric care and what has been wrong for so long. He talks about his argument on modern treatments, medicine, and the human rights model. Robert is an American journalist covering medicine, science, and psychiatric research. In this episode, he joins Timothy J. Hayes, Psy.D., to discuss mental health issues, how society views psychiatric patients, and how our societal narrative has been the driving force for what we tolerate and allow. Tune into this conversation and learn what kind of outcomes that mindset would result in and the importance of creating non-traumatic environments today for people.

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Robert Whitaker On Rethinking Psychiatry To Address Mental Health Issues

Robert Whitaker is the author of four books and co-author of a fifth, three of which tell the history of psychiatry. In 2010, his book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America won the US Investigative Reporters and Editors book award for Best Investigative Journalism.

Robert, welcome. Thank you so much for joining us here.

It’s a real pleasure. Thanks for having me. I’m looking forward to it.

I was hoping you could start us off by telling us how you got into this work and what drives your passion for it.

My background is I worked for newspapers for a long time covering science and medicine. In 1998, I was doing a series for The Boston Globe, looking at abuses of patients in psychiatric research settings. At this time, I had a completely conventional understanding of psychiatry. My understanding was that researchers had discovered that depression and schizophrenia are caused by chemical imbalances. We had drugs that fix those chemical imbalances, which is a story of great progress. That’s what I had written about as a newspaper report.

While doing that series, I came upon two studies that belied that notion of progress. One was a study by the World Health Organization which twice compared the outcomes for schizophrenia patients in three developing countries, India, Columbia, Nigeria, with outcomes in the US and other developed countries. Each time they found that outcomes were much better in the developing countries, specifically India and Nigeria, I dug into that a little bit because that seemed surprising. The story that we had organized around was that story of great medical advance and then somehow it wasn’t coming out in the outcome.

We’ve got the miracle cure. How could they get better results?

That’s what the chemical imbalance story is. It’s a story of a miracle cure. I can’t tell you how many times I called up psychiatrists and they told me, “Schizophrenia is due to too much dopamine. The drugs block it and bring it back into balance.” That’s what I was told regularly. In the second study, the World Health Organization investigators hypothesized, “Maybe the reason for the better outcomes in the poor countries is they’re more medication-compliant. They take their antipsychotics regularly and adhere to that treatment.”

Create an environment that leaves people feeling safe, connected, a part of the community, and worthy.

That’s a valid hypothesis because if medications are so essential, which certainly we believe in this country related to schizophrenia and psychotic disorders, then adherence should lead to better outcomes. What they found was that in the developing countries with the best outcomes, they use the drugs acutely but not chronically. They only maintain about 11% of their patients regularly on the medications. This blew my mind because, in the series, which I was rewarded for The Boston Globe, one of the frameworks was, “You should never take away antipsychotics from schizophrenic people because it’s like insulin for diabetes,” but this made me wonder, “Have I got something wrong here?”

I found a study by Harvard researchers that looked at evolving schizophrenia outcomes over the past century. Part of the narrative of the progress is that in 1955, we get Thorazine and chlorpromazine. It’s introduced into asylum medicine and that makes this great advance forward. You can even read A History of Psychiatry, where they compared the introduction of Thorazine as similar in importance as the introduction of antibiotics and infectious medicine. That’s telling you have a great advance, but what did the Harvard researchers find? They found that schizophrenia outcomes, in fact, were in decline in the United States. They were now no better in other developing countries than they had been in the first third of the 20th century, long before the arrival of the antipsychotics.

Both of these studies belied what I knew to be true. That led me to get a contract to write a book called Mad in America. The purpose of this book was to investigate why are outcomes from “The Mad” or people with schizophrenia are so important in the United States. What I found in the course of that investigation is we have this narrative of progress around antipsychotics and psychiatric drugs that they fix chemical imbalances, but you find that’s not true. You find that it was a hypothesis born of an understanding of how drugs acted on the brain. They hypothesized that drugs had the opposite effect, but they never found that a lesion in the dopamine sections of the brain is a primary cause of schizophrenia.

You take that same look through the scientific literature with antidepressants and find the same story. Depression is said to be caused by low serotonin. The drugs up the serotonin and fix it like insulin for diabetes. What you find in the scientific literature is that hypothesis was born in the 1960s based on what the first antidepressants did. They investigated in the ’70s and ’80s and as early as 1984, the NIMH was saying, “We’re not finding a lesion in the serotonin system.” In 1998, the American Psychiatric Association’s own textbook said, “This hypothesis hasn’t panned out.” Frankly, it wasn’t a very smart hypothesis because there’s no reason that the pathology of the disorder should be the opposite of some drug that treats symptoms.

What happened was AI thought, as I investigated this, “We, the American society and other developed societies, are organized in their thinking and care around a false narrative with the chemical imbalance narrative at the core of that.” Once you start digging into the narrative, the second part that you find over and over again is that psychiatric medications say antipsychotics or antidepressants may provide some benefits over placebo in knocking down symptoms over the short term. You see in both lines of research on schizophrenia and depression that worries developed pretty early on that the use of these medications is increasing the chronicity of these disorders, relapse rates and functional impairments over the long-term.

I explored that in this book, Anatomy of an Epidemic. Think about this. Mental health and thinking about ourselves are such a critical part of our lives, how a society responds to problems, how it treats its kids and how you think of yourself. I had been a science and medical reporter for a long time. For example, I was the Director of Communications at Harvard Medical School for a period of time. I had very solid scientific training. We have a situation here where we, as a society, have organized ourselves around what I call a false narrative of science and it’s doing great harm.

You can see the harm, rising burden and mental illness among our kids and adults. We have early death problems and more people on disability. That’s the reason I got into this and for my passion, because this storytelling of a false narrative had a great impact on our lives and a negative impact. To have good science and treatment, you have to organize your thinking around whatever science is telling you and what people with lived experience are telling you too. They need to be heard from as well.

OYM Robert Whitaker | Rethinking Psychiatry

Mad In America: Bad Science, Bad Medicine, And The Enduring Mistreatment Of The Mentally Ill

That’s one of the things that struck me in your book when you were talking about how our societal narrative has been the driving force for what we tolerate and allow. As you were talking about treating “The Mad” the people who are mad from the 1700s forward, as the narrative changes, the nature of treatment facilities that are made available is changing as well. I was shocked by the information you have about eugenics and how powerful that was here in the United States. Before, that misguided concept was adopted by the Germans in the concentration camps, but it’s the same thing. We had abandoned people who had mental health issues and chosen to view them as a burden on high society and then the money dried up.

In mental hospitals, psychiatric disorders are sometimes odd. People who were put in hospitals are a burden on the population. Those were the words they used. Under the eugenics ideas that took hold around the turn of the century around 1900, we got forced sterilization, but we also got the sense they need to be segregated in mental hospitals, so they don’t spread their bad genes. What you see is discharge rates for first-episode “psychotic” patients prior to the eugenics era weren’t bad. You can see 65% to 70% being discharged. Once you get eugenic ideas, the idea is to keep them there, at least through the breeding year. Discharge rates go down and then we start saying, “This is why these disorders are chronic,” but that was the policy.

We were the first country to adopt eugenic ideas into legislative policies. From 1945 to 1955, after eugenics became a discredited idea, look at discharge rates in America’s mental hospitals for that decade. After you leave this idea that we should segregate them, discharge rates for first-episode psychotics are 65% to 70%. We forget that because the part of the narrative is they couldn’t come out until the antipsychotics arrived in 1955. That’s not true. Discharge rates for first-episode patients were already 65% or 70% before the antipsychotics.

It’s clear in your work and others have pointed out that when you put people on medications, it dramatically increases the probability that they’ll have numerous relapses, be chronic or need to be on those medications forever. They create physiological change patterns in the brain as the brain is trying to reach its homeostasis. Most of the studies that talk about withdrawal or taking people off medication drop them off cold turkey very quickly. They get the rebound effect and say, “That means they need to be on this to prevent psychosis.” Whereas people like Dr. Breggin and others pointed out, “That’s ridiculous. If you come off slowly with the aid of some other things and you haven’t been on it too long, you don’t have the chronic relapse, rebound and psychotic episodes.”

There are two things on this. This shows up shortly after the introduction of antipsychotics in the 1950s. All of a sudden, clinicians who had been used to discharge rates and people staying in well rates noticed people were coming back more frequently now. They called this the revolving door syndrome. That was a new description of what was happening with the use of antipsychotics. There was even a study done in Boston that showed relapse rates were higher. My frustration is what you said. Do you know that there has never been a good placebo-controlled trial of the efficacy of antipsychotics in medication of naive patients? We’ve never studied that, but what we hear in society is, “People who come off of antipsychotics relapse,” as if that’s the return of the disease.

You see in these studies that they take chronic patients. By chronic patients, I mean people who have been on these drugs for some time. It’s often 5 or 10 years. They withdraw everybody abruptly and then they immediately randomize half back to the drug that they’re used to and the other they keep off. Those who are now going through withdrawal relapse. We know that, but it’s not the return of the disease. It’s a medication withdrawal effect for the very reason you said. Their brains have been changed by being on the drug. The frustration is everybody knows. It’s a charade. They keep on doing this.

You talked about compassion and care in the Quakers. A lot of people might be tempted to toss that off. It was so long ago and there was no way to study it, but then you talked about Mosher and Soteria. Can you tell us a little bit about that study?

Soteria is coming back now. In Israel, it’s beginning to embrace this approach to treating psychosis. Under the Quakers, they started doing this in late 1796 and opened their first retreat in York, England. The Quakers had this thought. At that time, there were all these madhouses in the UK where the people who were thrown in there were chained up and mistreated. The Quakers said this, “We don’t know what causes madness, but we do know this. They’re brethren. They’re not the other. As brethren and children of God, they have a natural capacity to recover their sanity. That’s a possibility. If not, we have a moral obligation to provide good shelter, good food and a kind environment.” They opened their York Retreat. If you can read descriptions of it, they were not using medical treatments. They want to create a new environment. They think nature and kindness are healing.

They’re not using medical doctors.

Mental health is a critical part of our lives and how society responds to problems.

It’s not a medical approach. That’s part of their thing. They don’t want the mad doctors in there. They kept quite good records. You’ll find especially with the first-episode people, the people nearly coming, the overwhelming majority got better with time, exercise, good food and walks in nature. The idea is they would dine together, do art, write, read and have a glass of port in the afternoon. What you find was with first-episode people who hadn’t been a long time in madhouses, the overwhelming percentage got better and discharged and didn’t come back.

That so-called moral therapy then was adopted by Quakers in the United States. Some of the first asylums like McLean Hospital, were initially moral therapy asylum. There were ones in Philadelphia, Hartford, etc. They reported good results with first-episode patients. The best long-term study came out of Worcester Asylum. With first-episode patients, 65% were discharged and never came back within the course of 30 years. That’s much better outcomes than we get to nowadays. If you look at historians who have gone back and looked at their case descriptions, these people were seriously disturbed going into the hospitals at that time.

We could talk about what happened. That gets eventually discredited and the reason it gets discredited is because we build these big asylums and communities as public asylums. They start putting people with Alzheimer’s in there and stage syphilis. The discharge rates go down and then eugenics comes along. In the 1970s, Loren Mosher, who was then Head of Schizophrenia Studies at the NIH, said to himself, “We’re not getting good results with our new form of care. People are revolving going back into the hospitals. Let’s try and see if environmental care can produce better outcomes.”

He set up an experiment where most newly diagnosed people with psychosis would need to be treated randomized to a hospital or a home in the San Francisco area where others would be with them. They would cook and socialize together. There was no intention of knocking out the crazy ideas. The idea was, in these environments, people who might be very afraid of others would learn to be with others and cook. That environment without doctors was part of Loren’s idea. The psychosis would begin to abate.

In the study, those treated with Soteria had the same diminishment of psychotic symptoms over the short term than those treated conventionally in the hospital. In terms of the use of antipsychotics, it went like this. They tried not to give it immediately because one of the ideas was, “In order to get through this crisis and respond to this crisis, they need to be able to mount emotional responses. That’s part of the resilience and healing process.” The drugs are very much blocking the emotional responses. This is one of the purposes of it.

If people weren’t getting better after a few weeks or three weeks, they might give them a low dose of an antipsychotic. After a time, they would see who could come up. At the end of two years, 40% had never been exposed to antipsychotics. Maybe another 40% had temporarily and around 20% were on the drugs long-term. Here’s the thing. This experiment ran for ten years. Two houses were replicated. Their outcomes were better at the end of two years. They were more likely to be working in school and out of the hospital. That was an experiment in modern times where it’s a different environmental approach. An approach that didn’t focus on just knocking down symptoms but helping people get well proved to be successful.

It was run by people who weren’t physicians that created a very threatening situation for the physicians who were supposed to be the experts.

Loren was a physician. He was educated at Harvard Medical School, but it earned him enemies for precisely this reason because, in essence, he said, “We can shift the treatment of psychotic patients out of the hospital,” which is a medical environment. “We don’t need doctors. We just need people who can be with others in this time of extreme states.” What happened is he was forced out of the NIMH for that very reason because it was such a threat. The interesting thing is there were two other studies done at the same time by the NIMH that were both found better outcomes for psychotic patients not treated with medications over a longer period of time.

OYM Robert Whitaker | Rethinking Psychiatry

Rethinking Psychiatry: For those who got stable off meds, almost no one relapsed over the rest of that study. So that completely belies the idea that the medications reduce the risk of relapse.

 

A psychiatrist named William Carpenter said, “We have to worry that these drugs, in fact, are making people more biologically vulnerable to psychosis.” That was in 1980. There was some research done out of Canada that came forth with a biological explanation of why that was so and they said, “Many patients are developing what we call tardive psychosis, a permanent psychosis. It was related to the brain’s compensatory reaction to the drugs,” but then this went against money and the medical personnel. It gets pushed away.

What’s frustrating and then we’ll go up to what’s happening with Soteria. The best long-term outcome study that has been done in modern times was done by Thomas Jobe and Martin Harrow at the University of Illinois. Starting in the late ’70s and early ’80s, they recruited 200 mostly young patients, either first or second-episode, from two hospitals. One private, one public. Everyone was treated conventionally in the hospital with drugs and then they’re discharged. It’s a naturally interesting thing. They’re just going to follow them up at 2, 4.5, 7.5, 10, 15 and 20 years. At each fault, they’re going to look at, “Are they symptomatic? Are they working? Are they socializing? Are they using medications?”

The hypothesis was that those who choose to stop taking their medications would do poorly. They found exactly the opposite and they’ve published 7 or 8 papers. They found that the long-term recovery rates for those who took themselves off medication were six times higher than for those who were medication-compliant and stayed on the drugs. They also found this. By year two, a number of people diagnosed with schizophrenia had taken themselves off medication, but they were still psychotic, as were the people on the drugs. What did they see over the next two and a half years? This is a longer course than what you see in a six-week trial. They saw that they became stable. By the end of four and a half years, only 10% were actively psychotic.

The interesting thing is these people that stopped taking drugs left care. What Harrow and Jobe did is they had the brilliance to follow them into the community and find out how they were doing. For those who got stable off-meds, almost no one relapsed over the rest of that study. That completely belies the idea that the medications reduced the risk of relapse. They’ve published 6 or 7 articles on this and looked at this data from every possible angle. There have been other studies from other countries that, in essence, have replicated the sense that, “On the whole, recovery rates are higher for medicated patients.” Finally, you have a form of care out of Northern Finland where they tried to be very environmentally focused. It’s called Open Dialogue. They started this in 1990.

What were their outcomes? At the end of five years, 80% of their first-episode patients were working or back in school, asymptomatic and off-antipsychotics. That was the result from their first five-year study. That seems so high. In the decade before the arrival of antipsychotics, you would see cohort studies that said, “At the end of 3 to 5 years, anywhere from 65% to 80% would be living in the community and there was no social service. In other words, they had to be working.” It’s the reflection of some of the outcomes we were seeing before the arrival of antipsychotics. Finally, going back to Soteria, there is a revival of this approach a little bit in the United States. Particularly, in Israel, they have a number of Soteria houses opening up with the idea of being with people and they seem to be flourishing.

I was flipping through here as you were wrapping up there with your epilogue, which is looking at some lessons that can be learned from the masterful presentation you’ve done of the data of the history. One of the things that is so critical that you’ve mentioned a couple of times here is, “Talking to the people who received the services as though they’re human beings and they’ve got an experience that’s valid, and the feedback from that experience might inform care.”

If you’re into that model of eugenics and you’re thinking these are inferior beings, to begin with, then there’s no reason to ask them how they liked it or if they felt it was good. When you look at people who have been in psychiatric hospital care in the allopathic model, which is to medicate, restrain and ask them how they liked it, you get a very different picture from the people who were in the Quaker or Soteria houses.

This is such an important point. In medicine, we do know that, as a general rule, you need to listen to your patients and learn from them. In psychiatry, precisely because so often the patients didn’t like these aggressive medical treatments, which had the purpose of silencing and quieting them, they often reject the treatments, including antipsychotics. In fact, there was an introduction of antipsychotics that helped create a psychiatric survivor movement in the 1970s. How did psychiatry respond to people being released, saying, “We hate these drugs? They make us feel like zombies. We can’t have real lives.” They said, “These people lack insight into their illness. They don’t know they’re sick,” so they adopted, as a primary mode of care, not listening to their patients. That’s a prescription for bad outcomes and bad medicine.

To have good science and good treatment, you have to organize your thinking around science and what people with lived experience tell you.

I want to add one thing to what you said here. How do we conceive of people who are having a psychotic episode, manic episode or any of these extreme states? Are they like us or are they the other? Are they abnormal or are they just in the spectrum of what human beings are? In the alternative, starting with the Quakers, there’s no effort to say, “Here are the abnormal people and here are the normal people.” It’s like, “Our minds are a difficult place. They go to crazy places and we don’t know why these things happen, but they are brethren.” If you start with that, you get a whole different form of care as opposed to, “They’re the other. We need to be afraid of them. They’re violent.” This conception is so critical to everything that follows.

You say at the top of the wish list for things that could be different, honesty is at the top of that list. It’s the idea that, “Can we get the drug companies and/or the physicians that are prescribing these things to be honest with people about what they can expect, what they know and don’t know?” It’s an extraordinarily complex web of things. There are billions of dollars that are at stake that are funneled into marketing directly to the doctors or the abuse of letting drug companies market directly to patients.

Ask your doctor and what your doctor is going to tell you because your doctor has been trained in the system that was funded by the drug companies, to begin with. What can you tell us about the movements that are going? I know you’re somewhat connected to people and you have some connections. A person introduced me to you who works with the Survivor Network or Consumer Advocacy. What is your awareness of how it’s moving? You say it’s changing and the Soteria is coming back. Did you say in Israel and the US?

Israel and there are some Soteria houses in the US popping up. The Open Dialogue therapy that was promoted in Northern Finland is becoming quite popular in countries. There’s something called the Hearing Voices Network that’s growing here and elsewhere. Here’s what’s happening. That old narrative has collapsed even among those within that narrative. It’s openly admitted now the chemical imbalance there did not pan out. That’s number one within the biological psychiatry community.

Two, for a long time, we heard that these are discrete illnesses of the brain. They’re biological disorders. Therefore, depression, ADHD and schizophrenia are discrete illnesses. What you see among experts in the diagnosis, they’re saying, “These are constructs. We haven’t validated any of these as real disorders.” For example, Steven Hyman talking about the DSM, the Diagnostic and Statistical Manual, said, “It’s a book of horror,” or something to that effect. The Anatomy of an Epidemic did help this. There is an increasing look at the long-term outcomes and no one has been able to say that they’re good.

That whole story of medical progress has collapsed within the scientific community. When you have one narrative collapse, it opens up the possibility for a paradigm shift to rethinking. That’s where we’re at. Here are two examples of how this is bubbling up. The UN Special Rapporteur for Health, Dainius Pūras, left and wrote a paper when he was done calling for a revolution in mental health. He said, “We need to pay attention to social factors, poverty, inequality, poor housing and poor diet. We need to put much less emphasis on drugs, which haven’t led us to the promised land. We need to rethink this whole thing.” When he put that out, he got a lot of pushback. Nevertheless, this was coming from someone, the UN Special Rapporteur for Health, calling for revolution.

I run something called the Mad in America website. We even had people from our staff that were contributing to his drafts because he appreciated how we were both deconstructing the existing science and pointing to other possibilities. Second, the World Health Organization put out a big study and analysis document calling for a paradigm shift as well in mental health along the same lines. They even quoted Dainius Pūras and said, “We’ve got to have more Soterias. We’ve got to have less emphasis on meds. We need to have considered social and human rights factors. We’ve got to stop forcing people into treatment and locking them up.” Here, you have two big bodies saying what has been told to us isn’t true, not working and we need something different. That is opening up possibilities.

OYM Robert Whitaker | Rethinking Psychiatry

Rethinking Psychiatry: You need to listen to your patients and learn from them because so often, the patients didn’t like these aggressive medical treatments, which had the purpose of silencing them.

 

Soteria is even being embraced by the Ministry of Health. How about in Norway? In Norway, the Minister of Health ordered all of its four health districts, it has a national health service, but there are four providers, to start providing medication-free treatment to psychiatric patients for those who want it. There’s a hospital that opened up near Oslo that calls itself the first medication-free hospital for psychiatric patients. It’s a place where people who usually go who have been in the care now want to get off the meds. My point is, we’re at an inflection point or a moment where we say, “What we’ve been doing in the past has failed. Disability rates have risen in every developed country. Our kids hit the age of eighteen now and 25% have a diagnosis.” We also know that the whole story was a corrupt story fueled by pharma money and, frankly, some gild interest.

We’re at the moment we can re-envision what we do and that’s happening. A lot of it is bubbling up from grassroots, but it’s getting traction. The Hearing Voices Network, Open Dialogue Network and Soteria-type houses are spreading. You’re seeing from the top like the World Health Organization and the UN Special Rapporteur for saying like, “Environments matter. If you have bad and traumatic environments, you’re going to have people suffer and struggle. We need to bring that into our thinking. If environments matter in causing problems, proper and better environments can also be pathways to recovery as well.”

Honestly, there are a lot of gild and financial interests that don’t want to hear any of this, but there is a growing movement for wholesale change. The public isn’t happy with that medication or disease model of care either. They want it different for their children, too, because that has been a disaster. That’s where I think we’re at. We’re at for a possible rethinking and reconceptualization away from these disease and medical models to what the World Health Organization said, “We need a human rights model.”

The other word you slipped in there in traumatic environments is trauma. Most of us in the Western culture want a simple cause-and-effect relationship. As human beings, the mind, emotions and connection energetically to the body is not just that simple. There are a lot of different factors in there, but more people are recognizing whether they’re trained in integrative medicine, functional medicine or holistic approaches that trauma is one of those strong complicating factors. Addressing the traumas and the resolution of the effects of past traumas is one of the best ways to get improved outcomes.

When I was writing Anatomy of an Epidemic, I interviewed somewhere between 80 to 100 people, asking them their stories. Especially those who had a diagnosis of schizophrenia or bipolar, so many of them told their difficult childhoods. They talked about being bullied and not being safe at their home. They weren’t as a youth in places that felt safe. They weren’t afraid. There was stress and isolation even as children. If we start thinking of this, one of the solutions to trauma beyond whatever therapeutic things in terms of addressing that is, “How can you create non-traumatic environments now for people where they can be with others, socialize with others, find meaning and love?” That conception leads to a whole different understanding of what is possible.

What you’re talking about is so beautifully represented in Gabor Maté’s book, In the Realm of Hungry Ghosts. The harm reduction movement is getting exactly what you’re talking about. Maybe we can’t go back and undo old traumas, but we can help create environments in the present moment that leave people feeling safe, connected, a part of the community and having a sense of worth.

We all need meaning in life. Think about how different that is from a disease model that says to people, “You have an abnormal brain and you’re going to be abnormal for the rest of your life. Good luck. Take the drug.” Let’s say you’re struggling, depression, mania or whatever it may be. Which there do you want to be greeted with? Which one do you want to try to inhabit as you go forward with your life?

The one that has got some hope.

Bad environments cause problems and traumas, so proper and better environments can also be pathways to recovery.

It’s so simple in a way. We all know that hope is central to recovery from a lot of medical disorders, to be honest with you.

To me, it’s very heartening to continue to interview people like you and then other practitioners who are willing to go the extra mile and get trained in functional medicine after they get their regular Medical degree or integrative approaches. The hope is that we’ll get people as consumers that say, “I don’t want to go to somebody who isn’t willing to work with me and ask me how I like what we’re doing. If I’m going to go to somebody who is going to view me as defective and lesser than them, somebody who can’t make decisions about his or her own life, then I’m going to get a whole different outcome than if I find somebody who is willing to work with me.”

There is a rising tide of that approach among people who come as patients or come seeking help that they want to have agency and want to be listened to. If you talk to people who are frustrated or who have done poorly with the medical model, one of the things they always talk about is, “They didn’t care about me and listen to me. They never even asked me what my problem was.”

If they ask you, “Do you want this medication?” and then you say no, then they go and get a court order to be able to force it on you anyway.

As part of this change, there is a groundswell among ordinary people for something different.

Your books, both of them, have contributed to that. I have greatly appreciated your willingness to take the time to talk to us here. Is there something that we haven’t even touched on yet that you would want to put in here?

I do run this website called MadInAmerica.com that is devoted to rethinking psychiatry. One of the things that we do is try to feature stories of people with lived experiences. We cover the science and have resources. Regularly, every week, we have a story from someone with lived experience. The point is to bring that into the societal discussion. To your readers, if you have the experiences that you would like to share to make your story known, write to us. We’re looking for stories of people with lived experience. It’s always been an essential and almost a central part of what we do.

OYM Robert Whitaker | Rethinking Psychiatry

Rethinking Psychiatry: We need to have human rights factors. We’ve got to stop forcing people into treatment and locking them up. It’s not working.

 

I appreciate your time more than you’ll know. I look forward to the next book you might happen to write.

Thank you so much for having me. It has been a real pleasure.

Robert Whitaker is the author of four books and co-author of a fifth, three of which tell the history of psychiatry. In 2010, his book Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America won the US Investigative Reporters and Editors book award for Best Investigative Journalism. Prior to writing books, he worked as a science reporter at the Albany Times Union newspaper in New York for a number of years. He is the Founder of MadInAmerica.com, a website that features research, news and blogs by an international group of writers interested in rethinking psychiatry.

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About Robert Whitaker

OYM Robert Whitaker | Rethinking PsychiatryRobert Whitaker is the author of four books, and co-author of a fifth, three of which tell of the history of psychiatry. In 2010, his Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness won the U.S. Investigative Reporters and Editors book award for best investigative journalism.

Prior to writing books, he worked as a science reporter at the Albany Times Union newspaper in New York for a number of years. He is the founder of madinamerica.com, a website that features research news and blogs by an international group of writers interested in “rethinking psychiatry.”

 

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