Article Presents Interesting Critique of Psychotherapy and Humanistic Psychology

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Hans Eysenck was one of the most famous but also most controversial psychologists. In a paper from 1952, Eysenck reported that two-thirds of therapy patients improved significantly or recovered within two years, regardless if whether they actually received psychotherapy.

I found an article on the Internet called Critique of Humanistic Psychology by Daniel J. Castellano, at www.arcaneknowledge.org/science/psychotherapy.htm.

I do not agree with everything that the author says, and I think he is incorrect in implying that there is no clearcut or even scientific basis for mental health diagnosis and, to some extent, treatment. There are newer methods of studying the brain that are within the realm of science. He makes a distinction, however, between neurological versus psychological approaches, which echos the so-called mind/brain distinction. And at one point, he does sort of reverse himself and admit that there are some researchers in psychology and psychiatry who do base their work on scientific research. He says that people often seek psychotherapy not because they have serious problems in functioning with severe symptoms, but because they have a vague sense of being unhappy or lack a purpose or goal in life.

But some of his points on both psychotherapy and humanistic psychology I find relevant. He writes, "In the abscence of a strong theoretical foundation, most psychotherapists have de-intellectualized their practice to various extents. They eschew the technical analytic jargon that the Freudians so enjoyed, and instead employ a more conservational, patient-oriented therapy. This soft science tactic is good for business, as the therapist is more approachable and more customer-driven than the old school psychoanalyst. . . . It is little surprise, then, that the periphery of the counseling profession overlaps with the domain of self-help gurus and other charlatans promising pseudoscientific solutions to life's problems."

He summarizes what he considers to be the four main tenants of humanistic psychology, that humans are rational, socialized, and forward moving, have the potential to attain self-actualization, are constructive and trustworthy when free of defensiveness, and that humanistic counseling ". . . creates an environment in which congruence and the potential for self-actualization can be realized."

He makes the point that there are a certain number of disabled people who have cognitive limitations which make it extremely difficult for them to proceed with free will. But humanistic therapists claim that improving self-actualization or self-improvement is not just for the relatively few who have substantial mental impairments and cannot carry out their lives with autonomy, but is also for normal people who could use such improvement.

During the heyday of humanistic psychology in the 1970s, getting in touch with your feelings was emphasized. Castellano writes that there is a difference between understanding versus accepting reality. Mental health, he says, should not be defined simply in terms of "fitting in" to one's social environment. A metnally sound person might find dhis society to be fundamentaly flawed in its values or structure so that someone might ". . . willingly suffer ostracism rather than assimilate its values. The humanistic model leaves little place for such melancholy or choleric souls, for it defines social disengagement as 'unhealthy,' while egomaniacs might be found healthy if they are sufficiently sociable." Castellano claims that there is a bias aganist social confrontation in social discourse with an emphasis on "sensitivity and inoffensive language."

Politically, the above argument could work both ways. Liberals may feel as if they are being ignored in a conservative era. But conservatives, incluiding some conservative Christians, complain that no one respects their traditional values anymore. Conservatives fling wild accusations against Democratics, and some progressives use harsh and even somewhat offensive type of language to criticize anyone they disagree with. The observation has been made, not without merit, that there has been a breakdown in civility in our society. Yet, on college campuses and in many organizations, there is a strong norm in favor of inoffensive, so-called politically correct language. So the emphasis that Castellano finds in humanistic psychology on being sociable seems only true in certain places and circumstances.

Another criticism he makes is one that I have found certain other authors have also made about both our culture and psychotherapy. Castellano states that psychotherapy, rather than being based on science, is more a reflection of certain aspects of our culture, such as the emphasis on self-actualization through one's work and career. He says that this is more of a matter of the values of professional individuals such as therapists, who all have at least a master's degree and possibly a doctorate, than of what all people in society emphasize in their lives. He writes, "A strong belief in the power of the individual will help to rationalize the existing social and economic power structure. Since failure to achieve social or eocnomic success is only the result of defensiveness or fear toward realizing one's potential, ratehr than the product of an objectively unjust social order. Needless to say, thei 'can-do' philsophy is unrealistic, as it ignores the individual's total dependence upon the society in which he is enmeshed. . . ." He goes on to say that this individualism in humanistic psychology and psychotherapy also contradicts a religious world view, in which events may be somehow influenced by a supreme being. That argument I find specious. I think the problem is that not all therapists have much knowledge of trends in social inequality and upward mobility, which is more in the realm of sociologists and economists. If a person is low-income or poor, corporate power, a poor educational backgroud, and the high cost of higher education cannot be greatly impacted by talking to a counselor. In the mental health care, there are some mental health centers around the country which do provide housing to disabled clients, but they do not often follow the approach that was described in the book, The Soloist, by Steve Lopez of the Los Angeles Times. In that book, Mr. Ayres, the subject of the book, was offered housing by a mental health agency with no strings attached, as he was fearful of the possibility of being forced to be hospitalized as he had been previously. The agency understood the viewpoint of many people it might serve, and used the housing first approach. This same approach is being used to help the chronically homeless in Utah, where homelessness has been reduced by 91%.

As I said, I don't agree with everything Castellano says, and not all therapists are the same, as he acknowledges, but he raises some questions about the priorities, sincereity, and effectiveness of talk therapy. There is a lack of knowledge as to how the brain works and what goes wrong when someone cannot function due to a mental illness, but there is far too much evidence that treatment can help a subtantial number of people. In the case of others, social and political reforms rather than counseling would likely be a more fruitful solution. And some mentally ill people do not want treatment, but might need a place to live, and should not be denied having their need for shelter met by agencies who might be over-zealous.

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Robindell
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Comments

There are two news stories that both involve personal tragedies and abormal psychology. These tragedies likely could have been prevented if the proper professional help had been obtained.

The first involves a murder-suicide of a couple who continued to live in the same house, even though they were in the process of going through a divorce. They lived in a rural township on a quiet, country road. The police concluded that the man fatally shot the woman and then took his own life. The man had a criminal background but had not been in any trouble since he had been married. The woman graduated from college in only 3.5 years and was valedictorian of her class. She had gone on to graduate school in the field of criminal justice, and worked at the county juvenile dention center. The man had a bad temper, it was reported. It may have been unlikely that he would have sought out some form of mental health treatment, but if he had, his intentions and actions probably could have been altered, and two lives would have been saved.

The second story pertains to Virginia Democratic State Senator R. Creigh Deeds. According to the Washington Times, Deeds' attorney, Monica Mroz, said Thusday the Bath Democrat served notice on four local governments of a possible lawsuit aginst the Rockbridge Community Services Board that represents them. The notices were sent to Rockbridge and Bath countires and the cities of Lexington and Burena Vista, Virginia.

Austin "Gus" Deeds, the senator's late son, who had been suffering from bipolar disorder, was evaluated under an emergency custody order and released on Nov. 18 after no bed could be found for him. The next morning, he attacked his father with a knife before shooting himself.

The newspaper reports, "A recently released report from the office of the State Inspector General found no evidence that a local official contacted 10 facilities in pursuit of a bed for the younger Deeds, as the official claimed, after he weas released from a local service center last November."

I just want to clear that there is a need, in certain cases, to hospitalize people who present a threat to themselves or to others, at least for a period of observation. In this case, Deeds injured his father and committed suicide. The law varies from state-to-state on holding someone for observation in a psychiataric inpatient unit. I think it is common to allow for a 48 hour period. There are many families and officials who have to deal with distraught individuals who believe that it is too difficult to hospitalize people who are likely to be physically dangerous. The large number of mass shootings by people who have a history of mental illness but who did not undergo treatment demonstrates the seriousness of the issue. One problem is that dangerous people may not always reveal their intentions and plans to psychiatrists, whereas others will admit that they have contemplated suicide or wanted to hurt others. In this case, the young man was released not because he did not need hospitalization but because the mental health facility where he had been taken did not do what they claimed and did not look for an available bed at all of the area hospitals. There were at least two beds available, and had he been hospitalized, there would have been a good chance that his violent actions could have been prevented and his mental state stabilized. The new story is at www.washingtontimes.com/news/2014/may/15/deeds-files-notice-ahead-possib....

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Robindell
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Szasz on Freedom and Psychotherapy

by Randall C. Wyatt

The foremost psychiatric critic of our times, Thomas Szasz, engages in an in-depth dialogue of his life's work including freedom and liberty, the myth of mental illness, drug laws, the fragile state of psychotherapy, and his passion for humanistic values and social justice.

Sections in this Interview:

Myth of Mental Illness 101

Randall C. Wyatt:

I am going to ask you a wide variety of questions, given the diversity of your interests, and I want to make sure to also focus on your work as a psychotherapist. A little background first. You've been well-known for the phrase, "the myth of mental illness." In less than 1000 words, what does it mean?

Thomas Szasz:

The phrase "the myth of mental illness" means that mental illness qua illness does not exist. The scientific concept of illness refers to a bodily lesion, that is, to a material — structural or functional — abnormality of the body, as a machine. This is the classic, Virchowian, pathological definition of disease and it is still the definition of disease used by pathologists and physicians as scientific healers.

The brain is an organ — like the bones, liver, kidney, and so on — and of course can be diseased. That's the domain of neurology. Since a mind is not a bodily organ, it cannot be diseased, except in a metaphorical sense — in the sense in which we also say that a joke is sick or the economy is sick. Those are metaphorical ways of saying that some behavior or condition is bad, disapproved, causing unhappiness, etc.

In other words, talking about "sick minds" is analogous to talking about "sick jokes" or "sick economies."

In other words, talking about "sick minds" is analogous to talking about "sick jokes" or "sick economies." In the case of mental illness, we are dealing with a metaphorical way of expressing the view that the speaker thinks there is something wrong about the behavior of the person to whom he attributes the "illness."

In short, just as there were no witches, only women disapproved and called "witches," so there are no mental diseases, only behaviors of which psychiatrists disapprove and call them "mental illnesses." Let's say a person has a fear of going out into the open. Psychiatrists call that "agoraphobia" and claim it is an illness. Or if a person has odd ideas or perceptions, psychiatrists say he has "delusions" or "hallucinations." Or he uses illegal drugs or commits mass murder. These are all instances of behaviors, not diseases. Nearly everything I say about psychiatry follows from that.

... Continue Reading Interview >>

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LysanderSpooner
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Jul. 31, 2007 3:01 pm

Szaz is no longer alive. His ideas are outdated. You are too uneducated to know anything about scientific research in the field. You seem incapable of learning anything new and just parrot what someone said over and over. You are not licensed to practice medicine or anything else related to mental health. The idea that one guy knows more than anyone else is more like a dicatorship than a community of scientific scholarship. Szaz no doubt made money off of his books. It should be said, however, that he praticed psychiatry at SUNY. He wasn't so anti-psychiatric as he claimed. How do I know? I know someone who is a professional (a psychologist) who knew and worked under Szaz. I find suspicious that you could come up with such a long post almost instantly. You are not going to change anyone else's mind on this Web site. I just mentioned actual news stories about people who died from abnormal behavior. The man whose article I discussed was not even talking about mental illness as the main part of what he wrote, but was talking about counseling for people who were not psychotic. Many such people would have no need for or interest in going to see a therapist. One someone just repeats the same outmoded, irrelevant, material over and over, that might be considered to be an instance of obsessive-compulsive disorder.

On this overall topic, I don't believe the moderators or Mr. Hartmann should allow this repeated response.

There are people who seek counseling who do not have any serious problems. You would think that someone who claims to be in favor of liberty and freedom would say nothing, other than, if someone wants to go to a therapist and possibly spend money on it, that is his or her right. It's no one else's business. So why is this kind of response even necessary? It isn't. There is no point to nonsense.

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Robindell
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Quote Robindell:

Szaz is no longer alive. His ideas are outdated.

He died recently. Which of his ideas are outdated?

Quote Robindell:You are too uneducated to know anything about scientific research in the field.

Psychiatry and psychotherapy are religions, not science. I don't have anything against freedom of religion. If you want to see a pyschotherapist, fine. If it helps you to talk to another human being, fine. I ONLY oppose the use of force.

Quote Robindell:You seem incapable of learning anything new and just parrot what someone said over and over. You are not licensed to practice medicine or anything else related to mental health.

Perhaps, you haven't read what I said elsewhere, echoing Szasz. I reject the idea that "mental illness" is a medical illness. I don't agree with your premise. Only people with MD's or are licensed to practice psychotherapy are allowed to critique?

Quote Robindell:The idea that one guy knows more than anyone else is more like a dicatorship than a community of scientific scholarship. Szaz no doubt made money off of his books. It should be said, however, that he praticed psychiatry at SUNY. He wasn't so anti-psychiatric as he claimed. How do I know? I know someone who is a professional (a psychologist) who knew and worked under Szaz.

Szasz never used coercion in his whole career. He only saw people on a contractual voluntary basis. The title of Professor of Psychiatry doesn't mean you practice Psychiatry. Also, Szasz never identified as an anti-Psychiatrist. That was Laing.

Quote Robindell: I find suspicious that you could come up with such a long post almost instantly.

Why? I was on the site when your post caught my eye.

Quote Robindell:You are not going to change anyone else's mind on this Web site.

How do you know? What do you have to fear from open dialogue?

Quote Robindell:I just mentioned actual news stories about people who died from abnormal behavior. The man whose article I discussed was not even talking about mental illness as the main part of what he wrote, but was talking about counseling for people who were not psychotic. Many such people would have no need for or interest in going to see a therapist. One someone just repeats the same outmoded, irrelevant, material over and over, that might be considered to be an instance of obsessive-compulsive disorder.

What does died of abnormal behavior mean? I find it interesting that you have to stoop to saying I have OCD. Is this how you discuss serious matters? I thought liberal critics of Psychiatry were against this sort of stigmatization?

Quote Robindell:

On this overall topic, I don't believe the moderators or Mr. Hartmann should allow this repeated response.

I believe in individual liberty and property rights. Mr. Hartmann owns this forum. If he, or his subordinates, deem that I broke the rules, they can suspend my account or kick me off. That is their right.

Quote Robindell:

There are people who seek counseling who do not have any serious problems. You would think that someone who claims to be in favor of liberty and freedom would say nothing, other than, if someone wants to go to a therapist and possibly spend money on it, that is his or her right. It's no one else's business. So why is this kind of response even necessary? It isn't. There is no point to nonsense.

I agree as said above. I support contractual relationships. However, I also have the right to say that psychotherapy is not a medical intervention. It's just talking. People talk to priests. People talk to bartenders. But I don't call it medicine.

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LysanderSpooner
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Jul. 31, 2007 3:01 pm

Not knowing very much about a topic is grounds for criticism, which is freedom. I will not be forced to read the views a quack nor accept medical advice or treatment from an unqualified practioner when my intelligence is being insulted that this involves freedom, because doing harm to someone on the basis of severe politically motivated distortions is not freedom.

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Robindell
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Quote Robindell:

Not knowing very much about a topic is grounds for criticism, which is freedom. I will not be forced to read the views a quack nor accept medical advice or treatment from an unqualified practioner when my intelligence is being insulted that this involves freedom, because doing harm to someone on the basis of severe politically motivated distortions is not freedom.

Robindell,

I'm sorry but I don't understand your post. I won't respond to any more of your posts, however.

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LysanderSpooner
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LysanderSpooner,

While I believe that "mental illness" does exist, I acknowledge that some forms of mental illness are of a nature so mild that neither medication nor hospitalization is necessary in any way. I also acknowledge that mandatory hospitalization for a person with this phenomena should not be considered necessary unless they pose a threat of violence or even are actually violent towards other people.

micahjr34
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Feb. 7, 2011 3:57 pm

For what it's worth micah I think spooner is certifiable. Ninety percent of what he says is delusional and the other ten percent has obviously been said under the influence of heavy drugs.

rs allen
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Mar. 15, 2012 4:55 pm

I propose that there is a difference between being crazy and being insane, if you get my point.

micahjr34
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Feb. 7, 2011 3:57 pm

Hmmm, presumably one is temporary and the other is a permanent condition?

Eh, should we diagnose spooner's particular affliction?

rs allen
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Quote rs allen:

For what it's worth micah I think spooner is certifiable. Ninety percent of what he says is delusional and the other ten percent has obviously been said under the influence of heavy drugs.

That's a nice way of debating. Name calling.

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LysanderSpooner
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Jul. 31, 2007 3:01 pm

I don't know about that. If LysanderSpooner has a genuine mental condition, he should be diagnosed by a doctor. Even then, I do not think that if he does have a problem it should be treated with medication and/or hospitalization. His beliefs are more in the realm of personality, not necessarily caused by a biological mechanism.

micahjr34
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Quote micahjr34:

LysanderSpooner,

While I believe that "mental illness" does exist, I acknowledge that some forms of mental illness are of a nature so mild that neither medication nor hospitalization is necessary in any way. I also acknowledge that mandatory hospitalization for a person with this phenomena should not be considered necessary unless they pose a threat of violence or even are actually violent towards other people.

If people are being violent or threatening violence, that is the province of the legal system, not the medical system. People should only be put in prison if they are convicted of a crime by a jury making sure that they received due process. Mandatory hospitalization is imprisonment without a trial.

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LysanderSpooner
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Jul. 31, 2007 3:01 pm

OK, let there be a trial. However, that does not change the fact that such a person is best to be in a hospital and not in a prison.

micahjr34
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Feb. 7, 2011 3:57 pm

LysanderSpooner,

You ake an excellent point about due process. Regardless of whether a person has mental problems or not, there need to mechanisms that give people a means to voice their grievances againt government actions regardless of what any person is said to have done.

micahjr34
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Feb. 7, 2011 3:57 pm

deleted.

rs allen
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Mar. 15, 2012 4:55 pm
Quote LysanderSpooner:
Quote rs allen:

For what it's worth micah I think spooner is certifiable. Ninety percent of what he says is delusional and the other ten percent has obviously been said under the influence of heavy drugs.

That's a nice way of debating. Name calling.

Don't flatter yourself spooner. There is no debating someone who is either insane or 14 years old and I don't do either one.

rs allen
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Mar. 15, 2012 4:55 pm

Mica, if you want a serious discussion I'd suggest you stay away (ignore) spooner completely. His time zone is in another dimension.

Sorry I was remiss in welcoming you back. Please allow me this time to say I'm glad things are better for you at present, it's good to see your name on the board again.

rs allen
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Mar. 15, 2012 4:55 pm

Rs Allen,

Thank you for the support!

I consider myself a philosopher. In fact I would like to someday earn a college degree in philosophy. Politics is just one of the many things in this world that contains lots of philosophical practices and notions. If I refused to discuss things with LysanderSpooner, it would be an act of cowardice on my part.

micahjr34
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Feb. 7, 2011 3:57 pm

Those who talk about liberty incessantly are interested in created a distraction from their dictatorial beliefs. You deny health care when you HATE YOUR FELLOW MAN AND WOMANKIND. Promoting the views of a doctor who is now deceased but, when he was alive, got together with a religious cult to form an organization against psychiatry, who was criticized by a faculty member at a institution where this doctor received his training as not being able to be a psychiatrist because he seemed to hate the whole idea of his chosen profession, who almost lost his job at the medical school in upstate New York where he worked, and who was sued for malpractice after a patient who followed his advice died all point to the nefarious motivation of someone who won't address the facts about someone the individual whose writings and views have already been promoted, here, to widespread disagreement and criticism. The organization Human Rights Watch on May 12, 2015 came out with a report that found that mentally ill people who are thought to be in over 5100 U.S. prisons are punished with force. Mentally ill people cannot always obey orders which they may not fully understand, and live under stress in confinement, and without treatment. The report documents some specific examples and talks in more general terms of how mentally ill prisoners are sometimes punished simply because they annoy guards. Tasers have been used, as has pepper spray and other chemical agents. One mentally ill prisoner in California was pepper sprayed over and over again, far more spray than was actually needed to subdue him. Read the report. Physical violence against them is something that an immoral, intellectual incompetent, childish, corrupt hypcrite would be in favor of. This doctor was such a person. His family left Hungary to escape the Nazis. Even though he was Jewish, he was raised in a secular family. My relative also left Nazi Germany. My relative hated libertarians for their utter comtempt for anyone except themselves and their precious money. The report from Human Rights Watch is important here because this is exactly what certain backward people have explicitly said that they are in favor of: jailing mentally ill people. They have no concern with freedom. A hospital would be better for these people, if only to keep them indefinitely (or as needed), because a hospital at least is set up to provide treatment. Well, there are only about 3500 people today in America in mental hospitals, whereas there are over 50,000 incarcerated mentally ill people. The idea is to lie about mental illness, for which a genetic basis has been found in a certain percentage of cases of some conditions, to justify force, when the rhetoric from these right-wing extremists is the exact opposite: respect for individual rights. This is not to say that dangerous people should be allowed to walk the streets, but notice how certain individuals do not provide any references -- or have any knowledge -- of the hundreds of books and professional articles written on mental health, or studies of abuse of prisoners. And there have been reports on abuse of mental patients in psychiatric hospital units. The University of Illinois at Chicago Department of Psychiatry, for example, has written reports about poor medication practices and patients attacking other patients in certain private psychiatric hospitals in the Chicago area. They were commissioned to write these reports by the Illinois Department of Child and Family Services, which deals with children with mental illness. The doctor whose views were promoted above had an advisor who wanted him to do an internship or residency in a psychiatric hospital, but he refused, saying that he didn't believe in mental hospitals. Right now, there are people who are hospitalized whose lives probably have been saved by virtue of their being placed in a hospital setting where, like with anyone who is hospitalized, their condition can be properly evaluated and monitored. Are their people who are committed to a hospital who don't need to be there? No doubt, psychiatry is imperfect. Are there physically ill people who need to be in a hospital, but who either cannot afford it, or simply refuse to be admitted? Both private psychiatric hospitals and state mental hospitals have undergone downsizing. That is one reason why there is such a continuing problem with homeless mentally ill people. In the case of the son of State Senator Creigh Deeds, the agency that was taking care of his son lied about having contacted all the possible area hospitals to see if a bed was available. They said they could find none, but it was since reported that at least two beds were free that could have accepted the son. When you combine hatred with ignorance, the results are predictable, but should be criticized nonetheless.

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Robindell
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Robert Okin, M.D., is a much, much better source of information when it comes to mental illness. Dr. Okin works in San Francisco where he has interviewed and photographed, with their permission, homeless mentally ill people. Dr. Okin is on the faculty of the University of California San Francisco. The name of his book is, Silent Voices.

Sen. Chris Murphy of Connecticut has sent me emails, even though I don't live in his state, expressing his interest in putting forth legislation that would improve access to mental health services. He has asked for input from advocates, patients, and mental health professionals. Most members of Congress today and many state legislators are not concerned with this area, because they believe it will not generate any votes or campaign cash for them.

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Robindell
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Jul. 31, 2007 3:01 pm

Yes, it can be disturbing when people with mental illness can't get the treatment they need, suited to what their specific condition is.

micahjr34
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Feb. 7, 2011 3:57 pm

My original post referred to an article that is critical of what the author refers to humanistic psychology. The part of his comments that intereted me were those that raised questions about psychotherapy, which has evolved into a different field than psychiatry, since most psychiatrists prescribe medication and don't spend very much time talking with patients, other than to determine their condition, other medical conditions they have or medications they are talking, and to see if the medication the psychiartrist prescribed are helping. These medications are not considered to be a cure for mental illnesses but only help to control the symptoms.

There are those individuals who do not feel that they need any psychotropic drugs but only want to talk to someone. Psychotherapy is a very limited type of service. They usually spend less than an hour with clients per session. If the client has private insurance, they will probably have a deductible. Some non=-profit counseling centers will accept insurance as full payment, whereas others will bill you for the co-payment. I don't know what percentage of cases involve marriage counseling or family therapy as opposed to an individual who does not have family conflicts. Some people don't have a family and live alone. Going to a therapist is probably not a productive solution for those who are isolated, even though some therapists will claim to be able to help anyone, a claim which I believe to be false. We have so many social problems in America. Despite all of the school counselors, marriage and family counselors, drug addition and alchohol counselors, and psychotherapists, the problems still persist.

For people with a disabling condition, it might be of more help to them to talk to a peer counselor or consultant, someone who is not a professional counselor in terms of training, but who has had experience with mental illness and with dealing with the mental health system. Althiough some states have tried to incorporate peer services into the mental health system, and some communities have peer-run organizations, many facilities don't yet have peers that someone can talk to. This type of service does not generate a bill as a visit with a therapist might. Some of these peer counselors may be volunteers, and some are paid from some kind of outside funding, or through the general revenues of the mental health agency. Many professional therapists seem to be so impersonal as to not really have the kind of empathy for the client that Carl Rogers and others said was helpful.

These are some of the areas that prompted me to post comments on the article I read. That someone only is concerned with the issue of what to do with mentally ill people who have acted violently or may do so shows a narrow-minded view of a much larger area. Of course, people who run prisons and jails as well as researchers are well-aware that most people with mental illness are not at all violent. When people hear of the large percentage of mentally ill people who are incarcerated or the number of mentally ill people who are imprisoned, they may not know that most of their offenses were relatively minor, being caught with illegal drugs, causing a verbal disturbance in public, or perhaps shoplifting.

Cook County Sheriff Tom Dart recently announced that he has appointed a clinical psychologist as the new director of the Cook County Jail, an institution with some 9000 inmates. Sheriff Dart, who is a lawyer, said that on any given night, they have at least 2000 mentally ill people in the jail, making it the largest single mental health treatment center in Illinois. The jail has its own mental health clinic at the facility. Dart explained that his office is the only sheriff's office in the country to have established a mental health treatment clinic outside of the jail. It is located in a county courthouse annex building in Markham, a south suburb. When mentally ill inmates are released from the jail, they are given information on how to get to the mental health clinic in Markham, so that they can continue with the treatment that they had been receiving in jail. Dart said that with most mentally ill people who are released from prison, they do not have any way to continue receiving treatment on the outside. They end up doing the same thing they did to get arrested in the first place, and end up back in jail. Sheriff Dart said that the clinic is paid for entirely out of the budget of the Cook County sheriff's office. He discontinued some other programs which were not effective and found money that could be used to hire some psychiatrists and other staff members. Under Republican Governor Bruce Rauner, the governor has proposed steep funding cuts to social services, including mental health, in attempt to reign in spending in the state with the worst finances and deficit of any state. Dart said that Illiniois in the last four years has already made some rather massive cuts to mental health, and that cutting more will in the longrun only end up costing the state more than it otherwise would have to spend, as more and more mentally ill people end up in costly nursing homes, homeless or are arrested and then incarcerated. Dart said that the state has some mental health courts that specialize in defendants with psychiatric conditions, but they only see a very small number of cases. He said that the new director of the jail is already working with judges to try and identify people with a history of mental illness with minor offenses so that they can be considered for alternative sentencing, in which they would undergo treatment rather than be added to the jail population. He said that it is a national disgrace that we have so many mentally ill people who end up in jail on these minor offenses. The concern that mentally ill people who break the law are not being punished is a false concern, given the number of mentally ill people who are imprisoned.

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Robindell
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Jul. 31, 2007 3:01 pm

Robindell,

I am very honored to talk to someone who knows so much about what is going on in the world concerning this topic. It will take me some time to read and digest this information. Thank you.

micahjr34
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Feb. 7, 2011 3:57 pm

Robindell,

Yes it is very disturbing how many people with mental illness are in prisons instead of hospitals. The cuts of funding in some areas concerning issues related to mental health within prisons is also disturbing. You are right in noting how prison is not the place for these people. Even if a person with such a condition did commit a crime, it is imperative that they receive compassion for their problems.

Now, back on topic. I do not think that psychotherapy alone could have helped me much. When I first started taking medications, I recognized at once how they helped me, even though they had significant side effects. When I do not remember to take even one of my medications during the day, I definitely feel a difference. However, there are times I do receive counseling, and I look forward to them, short as they may be with my doctor. It's not much, but also just talking to people concerning issues can help me too.

micahjr34
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Feb. 7, 2011 3:57 pm

Sheriff Tom Dart, who I believe has law degree, I should acknowledge, was recently interviewed on WTTW, Channel 11, one of two public broadcasting (PBS) stations in Chicago. They have a one-hour nightly news and feature story program called Chicago Tonight. I don't have the time to look it up at the moment, but if a person were to go to the WTTW website and then to the section for Chicago Tonight, it is possible that they have the interview with Sheriff Dart available to watch. Like I say, I'm not sure.

I have have a disability that I was not told about until I was over 40, even though I had it all of my life. I was told by an counselor at a university about a certain kind of professional evaluation that someone would have to undergo to determine if they had this type of disability, involving a certain area of testing. I eventually found someone who could provide the evaluation, and he knew more about my problems than anyone else I had ever consulted with. There is no medicine or other treatment that applies to this situation, and so I was not able to progress in life as most people do. One problem that I am concerned about regarding the mental health system in my state is that a person is supposed to have Medicaid to pay for certain services which are otherwise not covered, and that you retire and no longer have income from a job and need the help of a local agency, they require that the person accept a certain level of services, but not everyone is eligible for Medicaid, at least not immediately.

The reason I brought up the connection between crime and mental illness is because the "interloper" who always brings up that one doctor, whose views are mostly rejected today and whose behavior, when he was alive, involved a malpractice lawsuit against him, seems to complain that mentally ill people are treated with too much compassion when they carry out a violent act. I was attempting to point out that with all of the mentally ill people we have in prison, I don't think going to easy on them is a legitimate issue. I am not a lawyer, but proving that you should not be sentenced to jail on the basis of being mentally ill is something that is not easy to prove. You have to have psychiatrists get to know you who then testify on your behalf. Also, as you pointed out, the vast majority of mentally ill people are not violent in any way, and even if they are, their violence may only take the form of suicide or attempted suicide, which would harm them. There are some people who object to the use of diagnostic labels and the so-called medicalization of mental illnesses, but I think it is important to understand that people are not acting and feeling in certain ways just because they want to, but that there is something more difficult and complicated that is going on. Thank you for comments.

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Robindell
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Jul. 31, 2007 3:01 pm
Quote LysanderSpooner:
Quote rs allen:

For what it's worth micah I think spooner is certifiable. Ninety percent of what he says is delusional and the other ten percent has obviously been said under the influence of heavy drugs.

That's a nice way of debating. Name calling.

Name calling? He was offering an opinion of a product, nothing more nothing less. I think most of what you produce is noise, or graffitti for noise in print form. Hip hop, rap, and graffitti have many celebrated artists. I haven't a clue what their names are because I can't stand that tripe. Some performance artists get followings, some don't. I won't be a follower of yours LS.

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douglaslee
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illusions-of-psychiatry/

The Emperor’s New Drugs: Exploding the Antidepressant Mythby Irving KirschBasic Books, 226 pp., $15.99 (paper)

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in Americaby Robert Whitaker Crown, 404 pp., $26.00
Unhinged: The Trouble with Psychiatry—A Doctor’s Revelations About a Profession in Crisisby Daniel CarlatFree Press, 256 pp., $25.00

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)by American Psychiatric AssociationAmerican Psychiatric Publishing, 992 pp., $135.00; $115.00 (paper)

The article reviewing them all is worth reading.

They Got A Pill For That

Micah, I second rs's words above.

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douglaslee
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/shame-of our-prisons-new-evidence/

The Shame of Our Prisons: New Evidence David Kaiser and Lovisa StannowOCTOBER 24, 2013 ISSUESexual Victimization in Prisons and Jails Reported by Inmates, 2011–12: National Inmate Survey, 2011–12by Allen J. Beck and othersBureau of Justice Statistics, 107 pp., available at www.bjs.gov

Sexual Victimization in Juvenile Facilities Reported by Youth, 2012: National Survey of Youth in Custody, 2012by Allen J. Beck and othersBureau of Justice Statistics, 64 pp., available at www.bjs.gov

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douglaslee
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Jul. 31, 2007 3:01 pm

Robindell, marcia-angell's NYBooks page has a compendium of an author's work on the topic of your op.

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douglaslee
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I am not especially interested in being bombarded with a whole bunch of articles which in this case repeat what has been already been studied and reported regarding abuse in prisons. Human Rights Watch just came out with a report which says that force is often used on mentally ill inmates, even if they simply annoy guards.

Psychotropic drugs help many people who cannot experience improvement in any other ways. Doctors have the training to prescribe medication when they think it will help.

Getting back to the problem that was brought up by the approach taken by a certain respondent, when someone bases one's entire database of information or opinion on one author, in a field where there there is an almost endless bibliography of books and articles, including research studies in professional journals, that singular approach is not only narrow-minded but is academically substandard. There is no university including medical schools which would base their entire curriculum on the views of one author.

Authors don't necessarily care about actual patients. They no doubt publish in many cases to sell books and make money.

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Robindell
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One person who gave a review on Amazon to one of the above-referenced books says that she was on two different anti-psychotic drugs which did not help and had side-effects, but then was switched to another medication which was very successful in eliminating her symptoms, including hearing voices. The person says that she has annual blood tests to make sure that the medication is not causing any health problems. Some people find that such medications help them. I knew of one situation where someone improved after taking an antidepressant, and there was a case where a private mental hospital did not treat a patient incapicitated with depression with antidepressant of any kind, and he did not improve. His family transfered him to another hospital where he was given this type of medicine, and within days he was up and about. Many mentally ill people chose not to take medicine, and antipsychotic medications all have possible side effects and possible long-term, permanent damage, especially neurologically. Mental illness is so difficult to live with for many that patients are willing to live with treatments that are imperfect. I have heard of people going off their medication after a while, and other instances where someone stopped taking psychotropic medicine, only to experience deterioration, and having to resume the treatment. Many in the mental health field will readily admit that support services are just as important, and perhaps even more so in some cases, than medication, but that the funding and availability for these services is limited so that they are not always readily accessible. There are those with lesser cases of depression who unncessarily take medication, but psychiatrists will claim that many who could benefit from drugs are not being prescribed treatment.

There are problems with antibiotics causing resistant strains of bacteria. Some pain relievers are addicting, as Rush Limbaugh found out, and some are in different over-the-counter cold and flu products and can result in kidney damage if an overdose is taken without realizing how much of the drug has been ingested. If someone doesn't want to take psychiatric drugs, then as long as they are not a threat to self or to others, they shouldn't have to. But in many cases, it seems as if treatment with medicine is the only way that someone can function and avoid a dehabilitating state of depression or psychosis.

Physical differences have been found in many people with schizophrenia, and although this is not definite proof of a physicological cause, it is suggestive of physical differences in the brains of those with schizophrenia. Enlarged ventricles have been found through brain MRIs in some schizophrenics. Less brain tissue, especially in the medial temporal lobe has been found. MRI scans and post mortems on patients show that schizophrenic patients often have a smaller than normal hippocampus. Also, patients may have a smaller than usual limbic system, the area of the brain invovled in emotional expression. Reduced bloodflow in the pre-frontal cortex, involved in higher levels of thinking and emotion, suggest decreased neuronal activity. Also, post mortems of schizophrenics have shown that certain groups of neurons are organized differently in how they are interconnected compared to those who do not have schizophrenia.

There is still much stimga and fear surrounding mental illness. Cutting the budget for income support, housing, and other services is harmful to the well-being of disabled people. Adults with autism are often rejected by states for needed services because the eligibility criteron that is used is too narrow and in some states is based entirely on an I.Q. score, when many autisic people have a higher score or even a normal I.Q. than the state cutoff for eligibility. These adults often live at home with aging parents. A PBS doumentary called Autism: Coming of Age discussed this overlooked and serious problem.

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Robindell
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I am not opposed to pharmaceuticals. I am invested in biotechs. BIB, BBH, and FBT specifcally among others. GILD individually and PJP as an ETF. BIB is a nasdaq biotech ETF.

I also think the FDA restricts too many successful drugs proven effective internationally. They might be seeking bribes or are protecting a previous briber.

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douglaslee
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The mental health system in the states too often only provides people with the conventional services, drugs prescribed by a psychiatrist, and/or psychotherapy from someone who doesn't have any way to help someone who is disabled and cannot function in the commercial world and job market. A service called Supported Employment, which is sometimes referred to as being evidence-based, is intended to help mentally ill, disabled people who are already employed to be able to stay employed. If properly implemented, the employment specialist could intervene on behalf of a client who is having difficulty by going to talk with the employer about making a reasonable accommodation on the job which is part of the ADA or at least explaining to the supervisor that there is some issue that could be handled in a different way, possibly. The concern that arises is that when someone steps in on behalf of a disabled client, their disability is being revealed to the employer. Under the ADA, if a worker requires and requests a reasonable accommodation, the person has to request that from the employer, and that may result in a querry as to the nature of the employee's disability. Customers of a business may not know that an employee has a mental illness, but they sometimes are abusive, America being a country that has a higher crime rate than other advanced, industrialized countries, worse inequality, and a problem with child abuse. I believe employers should be held accountable for discrimination if employees who can't accept or handle dishonest, abusive customers are forced to continue dealing with such people instead of being allowed to walk away. If the customer doesn't like it, they can take their business elsewhere.

Housing continues to be a substantial issue in many communities for mentally ill and other disabled people.

The stigma associated with mental illness in American society, which is not talked about or acted upon too often by so-called progressives, and other circumstances such as a lack of family and relatives, often results in social isolation, which tends to aggrevate the person's difficulties. If peer counselors are made available, this could serve as a contact for someone in such a situation. Peer counselers which in some places are called Certified Recovery Specialists don't bill for their services and are paid a salary through available funding. Inconsistencies among different counties and states mean that some facilities have such a person available, and others do not. That is something that I think many people don't understand and may or may not find to be of concern.

Reactionary Christians don't follow what Christ said. More people, whether they are religious or not, should be more concerned about the mentally as well as the physically disabled with the protections and help that they need, and should be more politically active to let politicians know that they are watching as to what decisions are made in this regard.

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Robindell
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Quote Robindell:

I find suspicious that you could come up with such a long post almost instantly. You are not going to change anyone else's mind on this Web site. I just mentioned actual news stories about people who died from abnormal behavior. The man whose article I discussed was not even talking about mental illness as the main part of what he wrote, but was talking about counseling for people who were not psychotic. Many such people would have no need for or interest in going to see a therapist. One someone just repeats the same outmoded, irrelevant, material over and over, that might be considered to be an instance of obsessive-compulsive disorder.

That's because LS has sprung the Szasz thesis numerous times before without counter arguing criticisms of Szasz's absurd claim that there is no mental illness. My last encounter with LS promoting Szasz is in this thread, Gun Nuts Hate Teachers, Minorites, Liberals: Time for Gun Stamps, post #38

So I will repeat my response to LS that reveals his ulterior motive for fronting Szasz in support of his political agenda which ultimately is to relieve the 1% of any responsibility of spending government funds on social problems and thereby reduce the tax burden on the super-rich. That's all there is to it for LS. LS fronts Szasz because his thesis is compatible with Libertarian tax policy! Now how is that for science! The "hook" is Szasz's libertarian meme of protecting the "Freedom and Liberty" of the mentally ill--they have the freedom to live under a bridge and die with their illness, and we become defenders of Liberty by ignoring them. This is LS's logic for opposing all social spending.

. If all social problems are seen as the result of individual responsibility then dysfunctional institutions become immune to criticism and change: the NeoLiberal corporate-state is free of accountability. To say, “I reject the concept of mental illness. I believe in free will,” has the same political effect in both cases of depoliticizing the public sphere and allow public institutions to writher from indifference. This is the hidden agenda behind all Libertarian talk about individual freedom.
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Antifascist
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Thank you, Antifascist, for your somewhat belated response to that previous discussion. You might look at my other thread, to which no one responded, also in this Open Lounge section, on a few questionable or negative aspects of Szasz's background. For one thing, a patient of his committed suicide after Szaz advised the man on how to get off of his meds. Szasz was sued for malpractice by the patient's widow. Szasz stated that he would never stand in the way of someone who wanted to commit suicide. Also, for a while, Szasz joined forces with the Church of Scientology to criticize psychiatry, his own profession. I am not sure that Szasz himself was so opposed to government health programs as he was to forced hospitalization and treatment with medication of mental patients. I know a psychologist who went to SUNY and as part of his training, got to meet and follow around Szasz on rounds at the medical center. Szasz prescribed medication just like any other doctor. His objection was not to voluntary treatment but to commitment ordered by a court. This issue continues to be controversial to this day, especially with a newer approach known as outpatient commitment. There are critics of psychiatry who think that psychotropic drugs are either ineffective or harmful. Such critics seem to prefer psychotherapy to medical treatment, or at least would like to see psychiatrists take the time to talk to their patients in more detail, but they do not push the idea that mental illness is non-existent. My understanding is that there are some genetic markers for mental illness. I have heard that someday, there will probably be a blood test for depression, which I don't completely agree with, because I think depression may sometimes involve life circumstances that would not show up in a biological indicator in the blood. Some differences have sometimes been found between the brains of normal people compared to those with schizophrenia, but these differences may not always be there and how they affect the person's functioning is not clear. People report to mental health providers what they are experiencing. The physical uncertainty and complexity of it is what Szasz took advantage of. He told his academic advisor that he didn't want to do an internship at a state mental hospital, because he didn't believe in psychiatric hospitalization. I read that one faculty member said at one point that Szasz should not be allowed to become a psychiatrist, because his stated belief that mental illness does exist was antithetical to the whole idea of psychiatric practice and treatment. But over the years, there has been a fair amount of neglect and abuse of institutionalized mental patients, and some would say that Szasz brought this to the attention of doctors and state mental health officials.

Another controversial psychiatrist, Dr. E. Fuller Torrey, has said that the closing of state mental hospitals over a period of decades was never followed up with -- and compensated for -- by providing adequate state and federal funding to help mentally ill people who previously would have permanently lived in the state hospitals. This resulted in both a lack of available treatment and a lack of housing, with steady increases in homelessness among the mentally ill that you mentioned above. The Amercians with Disability Act has not been as effective as its supporters had hoped. The 2008 financial collapse and recession, the rise of right-wing extremism within the Republican party, and the financial problems of government, have all created somewhat of a crisis in mental health treatment, in help for those with autism, and with homelessness and housing assistance. The media ignores mental illness unless there is a multiple shooting involving someone who has a background of having had mental problems.

The funding is inadequate because it has been easy for the politicians to ignore the mentally disabled and the homeless. The issues of long-term care, health care in general, and mental illness and human behavior are too difficult and strenuous for most Americans to care about. It is just like most of the responses I received when I brought up cuts in music education and how that creates a lack of knowledge and exposure to classical music. People right on this Web site said that fine art doesn't matter and that classical music is too strenuous for them to listen to. Many of these pop singers and musicians are millionaires many times over. What is one of the most common refrains of both Thom Hartmann himself and people on this site? That super rich people are harming everyone else through greed. By way of contrast, as Chris Hedges pointed out in an interview on RT, some American symphony orchestras have had financial struggles in recent years. A decline in music lovers of a certain genre of great music is a sign of culture deterioration, as are inner city shootings and a lack of funding for housing first and mental health centers.

Hedges has said that progressivism among academics and clergy has significantly failed in recent years. As for the tastes and attitudes of many middle class Americans, my observation is that they are so ghetto.

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Robindell
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Jul. 31, 2007 3:01 pm

I can say from personal experience that there a tremendous $$$ incenstive to diagnose pathology for monetary gains.

that is not to say that mental "illness" doesn't exist

infact quite a bit of what is diagnosed as pathilogical/pharmaceutical is the cognitive dissonance ,that many people feel when people are required, even at the lowest functions, even in their jobs, to behave with "cruelty" toward their fellow human beings, eg unlivable wages as though it's wonderful. everyone gets the lie. thus thus ilness.

working 40+ hours for less than a 1st-world standard of living, eg.

both the "human resoureces" professional, if he/she has a conscious encounters "cognitive disonance"

as well as the wage earner, cognitive dissonance, and the depression/anxiety/etc

must we all go back to Psch 101?

cognitive dissonance creates "crazy"

of course, here come the multi-national pharmaceutical industrial complex to save us with all their advertising

"feel like an a-hole" 'cause you had to convince someone that $9.50 an hour is an AWESOME wage, TEAMPLAYERS!!!!!!!!!!!!!

heroin, meth, alchohol, pot, etc. to drown out the realization thats at $9.50 an hour you're a societal/cultural piece of shyte...............

what a collassal brain-washing of the American Physicians, the American Psychiatrists..................by the PharmaIndustrialcomplex.........

hell yes, people are anxious, depressed, in mental pain because:

this culture/society requires all of us to engage in cruelty, abuse, neglect on our fellow humans beings, our brothers and sisters...forcing some poor sap to promote $9.50 an hour like it's a gift is cognitive dissonance. 2 people are now in need of "pharmaceutical relief"- the abuser and the abused

because it goes aginst our nature: compassion, cooporation, empathyy, kindness

this is truely antithetical to who we are as a species. we survive through cooporation, not denegration, devision, skin color, nationality, gender, ethnicity.

we are one.

bully to the bullies.

let's live and vow to live and usurp the elite frauds

sinao

mlk.silenceisnotanoption (not verified)

The article and author I cited at the beginning offers the criticism that therapists may have a bias toward conformity to the existing social order, and I had a professor who once raised that same concern. Some people in the mental health industry have admitted to me that all they can do is "patch people up" and send them back out to a society with flawed human relations, institutions, and economic policies and practices.

People who are treated in a dehumanizing way by corporate employers might not have any options but to tough it out. I don't know for sure how helpful supported employment services would be to people who are experiencing tension, stress, or depression from their jobs, and I am not sure that psychotherapy can ever completely overcome the emotions left over from past abuse or neglect.

America has a higher rate of violent crimes and murders than do other advanced Western societies. Obviously, anger and conflict are problems. Not all of it is caused by poverty, but much of it is associated with poor households. Middle class people also have domestic violence and commit crimes.

Nevertheless, there are people with serious forms of mental illness who cannot function normally, and can often be helped at least to some extent by doctors. They might have trouble seeking help on their own, and even if they did make an appointment at a mental health agency, they may not be given the type of assistance that they are in need of if those services are not readily available, or if the person lacks resources.

The problem I find is that while conservatives have been criticized as being anti-intellectual, progressives who go to far in criticizing pharameutical companies without acknowledging that despite their ethical failings, they do help many people in conjunction with physicians, are too anti-science to be taken seriously. There is a reason that doctors and scientists who conduct research go through years of training, which in the case of physicians includes internships and residencies. I'm not convinced that many of the participants here are actually progressive. It is easy to generalize about other people who seek help. It comes down to moderating one's opinions as to make sure that one is not advocating the throwing out of the baby with the bathwater.

If people wanted to get involved, they could write letters to not only elected officials but to academics in medical schools, psychology departments, schools of social work, and to local community mental health centers, pointing out that social class is not being addressed very effectively by mental health counseling or medical treatment. One study compared people who were treated for depression with various forms of treatment, both medical and psychotherapuetic, who were classified as being either working class or middle class. The effectiveness of the treatment on work functioning was examined, and the working class people had less improvement in work functioning after being treated than did the middle class patients.

A program in Connecticut called Child First uses therapists to help reduce stress in poor families with children. Different suggestions are offered to help improve how the parents communicate with their children and other things that might be helpful. A research study done on the program found that the children who participated had less difficulty with language, which might include learning to read, and parents had a reduction in depression, and similar improvement. The degree of stress that many poor families have is described by Harvard's Center in the Developing Child and pediatrician Jack Shonkoff as being toxic stress, because it stifles brain development and results in learning and memory problems that otherwise would not exist. The program in Connecticut is somewhat expensive and there is a waiting list of children who are eligible for the program.

Recently, Diane Rehm on NPR did a hour segment on the Americans with Disabilities Act. There were several basic, important points that were mentioned which hardly ever get any coverage in the media. One is that nationally, about 70% of all disabled people are unemployed. Another is that whenever a disabled person find a job, they become ineligible to continue receiving benefits, especially Medicaid. Many disabled people have ongoing medical conditions and treatment. Medicaid often pays for certain services which private insurance or even Medicare may not cover. Most jobs have probationary periods before an employee can sign up for employer-sponsored health coverage. Since the ADA partly deals with employment, I thought Rehm and the panelists could have spent more time talking about employment discrimination against the disabled, although one participant gave the example of a deaf employee who was provided with a sign language interpreter instead of some other technical device that would have been easier to look at while the person was working, because it would not have required that the person look up to see the sign language person. I'm not sure from the description what kind of work the person was doing or what the sign language person was getting the words from, but the worker sued for the perferred accommodation, but the court ruled that the employer met the requirement of the law, and what they provided was good enough. A guest from the Chamber of Commerce seemed to question if some of the modifications being insisted upon by some disabled people were reasonable are absolutely necessary. They spent too much time talking about accessibility of online commercial Web sites, which might be of concern to some, but not to others. The inadequate funding for services such as job coaching or Supported Employment was not discussed in any detail other than someone who commented that providing assistance for disabled people which they need to help them keep a job would save money in the longrun instead of cutting such programs and preventing people from working. At least, however, the topic of disability and the ADA was discussed, when it is generally excluded from the media.

The media responds to popular opinion to some degree. There is no one on this site that has much concern with public policy or social inequality in areas that don't fit a pattern of mass consumption, such as the difficulty of disabled people to survive on what the government is willing to do to help them, including with Vocational Rehabilitation or Supported Employment and related programs for those who are employed and are in need of communication with someone with some training and concern.

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Robindell
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I found an article online that had been published in the New York Times written by a psychotherapist. This therapist writes that he has been receiving some negative reports about other therapists from some of his clients, who say that other therapists they have seen simply sit at their desks and only respond by nodding their heads, without saying anything. An example he gives is of a client who asked another therapist for some advice or counsel as to what to do about the problem the person had been telling the therapist about. All the therapist said was, "Same time next week." He ignored the client's question and demonstrated what the author of the article has been told over and over: that a lot of these therapists have nothing to say about the client's problem other than trying to get them to continue coming so they can keep the bills coming, fok nothing. The lack of adequate training of many people in clinical psychology, mental health counseling, clinical social work, and marriage and family counseling so that it would be made clear to them that they have to offer the client some type of suggestion as to how to improve their emotions or personal circumstances, and the lack of supervision by either a clinic supervisor or by state licensing boards to prevent them from not saying anything of any help other than nodding their heads shows that there is corruption within the counseling area. People in America are so often so socially isolated and individualistic that they don't even communicate very much with family members and relatives, let along with outsiders. Sociologists have written about the breakdown of community social organizations and activities in this society. Some people probably go to a therapist mainly because they are on their own and have no one to "run past" decisions, worries, and conflicts that they have. Some have called some of these therapy clients "the worried well" as opposed to seriously mentally ill people, such as the man who recently committed another mass shooting in another movie theater, this time in Lafayette, LA. He had a history of both right-wing extremist involve with various Web sites and with psychiatric treatment, having been hospitalized in a mental hospital by his parents. His treatment should not have just ended when he was released from his hospital stay.

Therapists sometimes are depicted in films as asking, "What do you think?", instead of anwering a client's question. People do have to make decisions, but the idea that there is something wrong with you just because you have to do it all on your own, with no human response from anyone else, seems abnormal, if it is accepted that humans are social animals. I have read that some therapists now say that they provide "life coaching," which implies that they give some kind of advice or feedback. The idea that some unconscious memory will be revealed if the person keeps on talking about his or her past seems fairly antiquated, especially in lieu of the controversy several years ago over "false memory syndrome" and therapists who plant suggestions into the minds of clients of some past abuse which really did not happen as the person seems to remember it. I am not convinced that therapists really know how having had a hard life of neglect or abuse would affect someone's emotions. People vary in their unique stories and how they deal with past difficulties. I'm sure many people simply forget about the past, but they may have enough activities and supports that they don't need to think about it or allow it to drag them down. Other people never completely "recover" from harsh childhoods or other such experiences. There are veterans who were damaged psycholgically from being at war who might have benefited from psychotherapy, but there are probably some vets who cannot overcome post-traumatic stress disorder, even if they try. Some events may just have a permanent impact. Reserching this in a comprehensive, accurate way seems very difficult, if not impossible, as there are so many variables that could be involved, and so many differences among individuals that cause a degree of unpredictability.

I am not convinced that talking to someone who simply listen's while nodding one's head could be considered to be actual treatment. This is also unfortunate considering the ignorance and disdain that many conservative politicians seem to have against those with mental disabilities. Not enough is being done to keep the poorly considered and wrongheaded opinions of lay people, such as political policymakers, out of the treatment room. Yet, having therapists who don't say anything of any substance and then charge for their time seems like a situation in need of some kind of oversight, new guidelines, and supervision. Community mental health centers should have better complaint and client rights procedures. In Michigan, all community mental health centers and public mental health hospitals are required to have a recipient rights officer right there, on the premises, to accept complaints from consumers and investigate and try and get a response that might resolve the matter for the client.

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Robindell
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Jul. 31, 2007 3:01 pm

A psychologist is a mirror...that allows the client to see in their own lives false beliefs, ideas and ways of being that don't work. When a client sees them, a psychologist can make suggestions...but he isn't a mechanic. He provides the tools...the client makes the repairs if he/she choses to.

It's my own view that a life not striving for "self actualization" is a life wasted. Self actualization and "adjustment" are two very different things.

"It is no measure of health to be well adjusted to a profoundly sick society." - Krishnamurti

Retired Monk - "Ideology is a disease"

polycarp2
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Jul. 31, 2007 3:01 pm

But the therapist who wrote this article from the Times was saying that people were telling him that some therapists said absolutely nothing, as if they had taken a vow of silence, for which they were and are charging money. I wrote elsewhere that a person could just as easily comment on one's own thoughts and emotions by talking into a microphone connected to a tape recorder or computer, and then play back one's own words.

I think there are many ways of finding self-actualization. Some people who can afford a boat could go sailing, or fishing. Some may enjoy going to the library to read. Some may paint, make pottery, or play an instrument. Meditation is something that monks may do, but moreso Buddist monks than Christians, I would hazard to guess. If a person wanted to go to a psychoanalyst for self-actualization, that might be worthwhile, although some would criticize it as being too self-absorbed instead of being engaged. My concern is when therapy is being sought out because of difficulty and personal distress and the practitioner doesn't have anything to say. One of the problems of socioeconomic inequality is that people cannot always find a way to experience improvement in their lot in life. Comparative statistics about upward mobility in this country compared to some other advanced, industrialized countries would suggest this. Also, some people may be content to have a relatively low income; wealth or middle class status would not interest them, but the pressure to conform is considerable.

A therapist once said that it was not her job to help clients find a new job or help them with employment-related issues or problems. The lack of concern for work and income on the part of therapists is especially hypocritical when you stop and consider that many and perhaps even most therapists are clinical social workers. As part of its mission statement, the National Association of Social Workers indicates that social workers are pledged to help the poor and to help those who are discriminated against. Wouldn't that include the unemployed, the underemployed, or those who have faced or are facing employment discrimination? One social worker advertises her practice as including Yoga instruction. Social workers mostly stopped being concerned with the poor as psychoanalysis became in vogue many years ago, and when they found out that they could make more billing insurance companies for therapy than being paid a salary by some government agency or private social service agency. The term that was adopted by social worker was a "psychodynamic" approach. This was even incorporated into social case work, in which social workers worked with low-income families who, in many cases, received Aid to Dependent Families as it was once called. Some studies were done of social case work services which found that this type of service did not help poor families to improve their income. I think there was one study that looked into whether social case work improved school performance of children from poor families, and the study did not find any improvement with children whose families received social case work compared to those who did not. Since that time, was about 50 years ago or more, newer approaches to helping kids from poor families to do better, other than actual preschool child development programs, have shown promise. Connecticut's Child First is one such program. An in-school mentoring program for black male students in Chicago reduced invovlement with gangs and violence. Pennsylvania State University has done research into improving educational outcomes in students who come from low-income families. The media, politicians, and the general public don't much care about academic research.

One therapist once asked me if I ever had tried going to a temporary employment agency. I have, but found that their jobs are mostly just that: temporary. Every assignment could be at a new company. Some of them were pretty awful or even confusing. Employment of lower-level hourly people sometimes involves treating people as if they are subhuman, like slaves. Vocational Rehabilitation uses non-profit agencies to help disabled people to find employment. Some of these agencies have sheltered workshops which pay disabled people sub-minimum wages. One such agency would only take on clients for job-search assistance who have a serious developmental disability/impairment. That leaves out many disabled people.

In Michigan, there is a training institute that is accredited by the North Central Association, just like college and universities are, that specializes in providing vocational training to disabled people. I don't know for sure, but it sounds like a state-owned school, like a state university. In Michigan (Thom's home state), there is some kind of committee that has recommendations for emphasizing employment instead of income assistance, or "welfare," which it is really not, for disabled people. In the first place, I seriously doubt that the people in this committee are physicians or other health care providers and therefore are more like political hacks than qualified people when it comes to diagnosing medical conditions. Second, they don't want to admit the sick nature of a certain number of business people, who believe in mistreating people or otherwise excluding them. Recent comments by one prominent business executive illustrate the point that just because someone owns a company does not mean that the individual is a decent human being. If disabled people have been unemployed for months or years due to disability, many employers would not even consider hiring them. If someone has a hidden disability that is not apparent, you are not required to mention the disability to an employer during a job interview. They may not know why the person has a gap in employment, because having a disability does not have to be mentioned and may not disqualify someone from being able to do a certain job. It all depends. This committee doesn't discuss problems faced by many disabled people of not being able to find an appropriate job where the job would not be degrading or overly repetitive and boring, but at the same time is something the person could do. The workforce is becoming more and more divided between low-level and more highly-skilled or professional jobs. An increase in employment does not seem to be the long-term direction in which the world is headed.

Counseling doesn't address educational limitations, the unwillingness of employers to hire someone, and a lack of adequate or any income. Social work has become profit-seeking as it largely became a psychotherapy field. These therapists may say things that the client has already thought of.

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Robindell
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Jul. 31, 2007 3:01 pm

When it comes to public policy concerning helpful or necessary government programs, there is not much serious discussion of this on this site or anywhere. The main purpose of many is to either express disdain for certain presidential candidates or groups of people. What mostly seems to be the case is tearing down of government. Pundits and many politicians, in connection with incidents of mass shootings, occasionally mention the inadequate nature of our mental health system. People with certain kinds of mental conditions have difficulty in retaining employment. A practice or program that is related to vocational rehabilitation called Supported Employment has been found to be effective in allowing employed individuals with mental illness to be able to continue working. The interpretation that apparently is used with some state governments is that since the research on Supporated Employment was done in coordination with psychiatric treatment, clients should be undergoing such treatment while receiving this form of help with employment. I disagree completely that only those consumers who are taking prescribed psychotropic drugs could benefit from supported employment. Another problem that might come up is for agencies to confuse job coaching with Supported Employment. There are not one and the same. Supported Employment is for people who are already employed, and is not a job search program, although the employment specialist might in some cases be able to assist someone in learning of how to receive a promotion or find a different and possibly better job. The main purpose of Supported Employment is to assist someone who is already employed continue with a job. Therefore, it only stands to reason that a person who has been working in a job for a certain length of time already knows how to do the job and does not need job coaching.

The primary problem with this service is its lack of accessibility. Private insurance does not cover support services of this type. Employment specialists are unlikely to be licensed therapists, nor do they need to be. They have to have as much knowledge and experience as possible with jobs and with business. They also have to have a good working knowledge of mental health and psychology. In some states, the only source of funding for Supported Employment is Medicaid. This program has strict eligbility requirements so that a certain number of people who need this kind of assistance are not eligible simply because they are not Medicaid eligible. Vocational rehabilitation agencies only pay for so-called follow-along services for a limited time. Someone who is working might need to talk to someone every so often about one's job over a period of months and years. Again, the service may not be accessible. Some people might be able to pay a small fee, but if the person is low-income, that is money that could otherwise be used for rent, food, or medicine.

A final issue would be the willingness and ability of an Employment Specialist to advise or assist a client in requesting a reasonable accommodation from an employer which would be necessary to make sure that the employee can function adequately on-the-job. This is part of the ADA. If an employer does not handle a situation in a way that is appropriate and reasonable for a mentally disabled person, whether there is overt employment discrimination or not, would the Employment Specialist after discussing it with the client be able to visit the workplace and raise the concern with the person's supervisor? Unless more is done that is currently being done, many mentally ill people will not be able to sustain employment. More does need to be done. There have to be enough personnel in the Supported Employment program so that they can have the flexibility to address the clients' concerns adequately, and so that they could spend enough time talking with the person, observing the person at work, or going to the employer to discuss an issue so that there would be an effective result that does what it needs to to help someone.

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Robindell
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Jul. 31, 2007 3:01 pm

A mental health center has a branch office in the same county where their main headquarters is located. The branch is located in the most populous city in the county. An admissions counselor there was rather rude and said that they don't have anyone in the clinic who knows anything or can help someone with housing. Under the Americans with Disabilities Act, states are required to help disabled people who cannot afford housing so that they can live in the community in the least restrictive environment. That this mental health center has an office that only has doctors and therapists shows that both agency and the state, which licensing these community mental health centers, are not doing their job. Psychiatrists have stated that housing is often an integral part of mental health services. A psychiatrist with the National Institute of Mental Health recently was interviewed on the PBS Newshour. He said that medication is useful in treating people with schizophrenia because it reduces or eliminates the most severe and troublesome symptoms, but support services such as those I discussed above are also necesary. These are lacking in many communities do to public and political apathy.

James Holmes who committed the worst mass shooting massacre in American history at a movie theater in Aurora, CO was seen by a psychiatrist at the University of Colorado's Aurora medical campus in the student mental health clinic. She noted that he was dangerous, but did not commit him for a 72-hour inpatient observation. In too many instances, the mental health system is dismissive and ignores the need for inpatient evaluation or to help clients with important areas such as housing or employment.

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Robindell
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Jul. 31, 2007 3:01 pm

Why are you so filled with hate?

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stwo
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Jul. 31, 2007 3:01 pm

Forest Gump: "Stupid is as stupid does."

Therapist and author Joycee Kennedy stated, ". . . I am very disappointed in the mental health system. . . ." (Quoted by Singular and Singular in The Spiral Notebook.)

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Robindell
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Jul. 31, 2007 3:01 pm

Part 1 - Is Economic Disaster About to Hit & Are You Prepared?

Thom plus logo Right now the United States and the world are facing four massive trends that, in combination, we haven't faced since the 1920s. We are seeing the rise of a new and brutal form of governance with extraordinary industrial capacity and power in China, much as Nazi Germany rose in Europe.
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