Posts Tagged ‘political’

DSM 5 in Distress—Seven Questions For Professor Patrick McGorry

Friday, August 19th, 2011

Psychology Today – August 18, 2011

by Allen Frances, M.D.

Psychiatry cannot promise more than it can deliver.

Whenever contradicted, Professor McGorry attacks the motives of the messenger rather than providing any reasoned rebuttal to the message.

The great news is that Professor McGorry has recently renounced the relevance of psychosis risk syndrome in the current practice of clinical psychiatry. He has done so in two separate and dramatic ways: 1) by withdrawing his support for the inclusion of psychosis risk in DSM 5; and 2) by promising not to include it as a target in Australia’s massive new experiment in early intervention. Psychosis risk syndrome is an extremely promising topic for ongoing research, but it is not nearly ready for current clinical application and if introduced prematurely could cause disastrous unintended consequences.

Professor McGorry’s sharp about face on both fronts could well be a wonderful double game changer. He is by far the most powerful psychiatrist in the world and an absolutely brilliant politician. Leveraging his unique stature as 2010 ‘Australian Of The Year,’ McGorry has succeeded in gaining the support of all the major Australian parties in the funding of a large and much needed investment in the country’s mental health. His new caution on psychosis risk will influence others to be less venturesome in prematurely promoting this potentially dangerous diagnostic proposal.

But a dark cloud surrounds the silver lining of having one psychiatrist in a position of almost unopposed influence. Professor McGorry has developed the messianic blind spot that is so common in visionary prophets. His zeal has made him an unreliable evaluator of scientific evidence, allowing him to defend absolutely indefensible positions with the convincing, but inaccurate, force of a true believer. A review of Professor McGorry’s public statements shows his willingness to ignore any evidence contrary to his belief, to change stated views back and forth when he regards this to be necessary or convenient, and to unfairly attack those who point out the fallacies and inconsistencies in his comments. His are the skills of a prophet and rainmaker, not those of a policy maker or a program developer or a sober reviewer of scientific evidence.

The most telling example of the McGorry blind spot was his ready dismissal of a recent Cochrane review that has discredited his extravagant claims for early intervention. This independent, systematic, comprehensive, and rigorous review of the scientific literature concluded there was insufficient scientific evidence to support McGorry’s grand assertions that early intervention programs promote enduring change and can reduce the lifelong burden and cost of illness. Early intervention does seem to be helpful temporarily while it is being provided, but does not seem to have any lasting impact on the course or cost of illness once it is stopped.

So, the Cochrane group lines up on one side and McGorry lines up on the other. Who to believe? The Cochrane group is widely credited for its impartiality and esteemed for its expertise in all aspects of scientific review. Its reports are considered a gold standard, exerting great influence on state of the art, evidence based medical practice throughout the world, particularly in Great Britain. One might expect that Cochrane’s stainless reputation would daunt a person even of Professor McGorry’s extraordinary power and blind conviction. But no. When the Cochrane report disappoints his expectations and fails to nourish his prejudices, McGorry feels no hesitation in attacking it, criticizing its methodology, and dismissing its discouraging conclusions. His rebuttal of the Cochrane group consists only of his personal endorsement of early intervention accompanied by the blithe (but empty) claim that it has strong supporting evidence. As far as McGorry is concerned, Cochrane be damned. Such idiosyncratic evaluation of scientific evidence cannot be trusted as a sensible foundation for mental health policy.

This is part of a pattern, not one isolated and exceptional instance of blind spot. Whenever contradicted, Professor McGorry attacks the motives of the messenger rather than providing any reasoned rebuttal to the message. His skill in the parry/thrust of the political sound bite is matched by an unwillingness to subject his views to anything resembling fact based discussion. When I expressed doubts about Dr McGorry’s excessive claims for his prevention model, he twisted my concerns to suggest that somehow I was defending the traditional US model of care against his innovative Australian model. This silly and totally incorrect attempt at diversion had not the slightest relevance to my two real motivations. Primary is the fear that by ambitiously overselling itself, psychiatry does a disservice to its patients and harm to its core mission and credibility. I believe strongly that scarce mental health resources must be judiciously spent to provide care for those who clearly need them- with continuity that starts with the first episode and lasts until they have either become well enough to do without or are dead. I therefore object to squandering vast resources upfront on those who may not need them using what are premature and still unproven methods. My secondary motivation (now somewhat assuaged by McGorry’s recanting, if he sticks to it) is the fear that the recognition of psychosis risk syndrome as an official diagnosis in DSM 5 and/or as a target in EPPIC programs will result in unnecessary stigma for the misidentified and dangerous off label overprescription of antipsychotic drugs.

McGorry has also tried to stifle his Australian critics- consistently evading their well reasoned and empirically supported arguments with the false innuendo that their motivation is simply to protect turf. His distraction technique employs catchy phrases (“Merchants of doubt do no favours for people with mental illnesses”) and dismissive insults (critics are a ‘cadre’). This so called ‘cadre’ of ‘merchants of doubt’ happen to be highly respected colleagues who are doing precisely what needs to be done- challenging McGorry in an open discussion of his excessive claims and of his idiosyncratic take on the literature. They are trying to protect Australia from blindly making a risky public health bet promoted by a stubborn ‘true believer’ who refuses to engage in meaningful dialog and cannot be unconvinced even by clearest evidence contradicting his personal belief system. It is crucial that scientists and policy makers always be honest and skeptical ‘merchants of doubt’ -not joiners in a parade of the credulous marching blindly off a cliff. McGorry needs to meet opposition with facts and rational debate, not innuendo and insult.

This brings me to my immediate purpose here. Let’s all get off the personal and focus instead on the issues. Below are seven questions that beg for Dr McGorry’s immediate public response. No evasion or questioning of my motivation is called for- just straight answers to simple questions. It will be useful for Professor McGorry to respond for the record now, before Australia’s makes final the terms of its much needed and awaited investment in mental health.

Question 1) Please spell out on what scientific basis you have dismissed the findings of the Cochrane report and indicate why Australia should base policy decisions on your personal interpretation of these data rather than on Cochrane’s more objective and systematic approach?

Question 2) What will be your role in establishing the goals and in directing the implementation of Australia’s early intervention programs and what protections are in place to ensure that opposing voices and interpretations get a fair hearing? Who else will be involved in the governance of these programs and how will they be selected?’

Question 3) Can you now state with certainty that the newly
funded early psychosis intervention programs will be restricted exclusively to those who are already diagnosed with definite psychosis and will definitely not include individuals deemed to be only at some increased risk for future psychosis?

Question 4) Do you now agree that it is inappropriate to prescribe antipsychotic medication for psychosis risk except under the close supervision of an approved research protocol?

Question 5) What protections will be in place to avoid the premature and incorrect differential diagnosis of psychosis? The distinction between prepsychotic and psychotic is much clearer on paper than in practice and psychotic symptoms in teenagers are often transient, caused by substance abuse or mood disorder. Will strict diagnostic requirements, careful differential diagnosis, and quality control guard against incorrect, premature, and stigmatizing diagnoses and also against unnecessary and potentially harmful treatments?

Question 6) Why not roll out the EPPIC programs in gradual steps? This would ensure that the model translates well from the research environment to day to day practice and would provide an opportunity to demonstrate its efficacy and cost effectiveness before disproportionate investments are made in it.

Question 7) How do you justify the funding shortfalls for other necessary continuity of care programs that will likely be caused by the front ending of expenditures for EPPIC (especially given lack of convincing evidence that EPPIC confers enduring benefits or any reduction in future need for, or cost of, services)? Is it worth staking such a large proportion of the mental health budget on such an uncertain roll of the dice?

His track record makes clear that Professor McGorry can not be relied upon as a neutral reviewer of scientific evidence or a neutral advisor on the question of which mental health investments will bring to Australians the highest and safest returns. His countrymen should be very grateful to Professor McGorry for having obtained desperately needed funding for mental health, but should also be cautious in following his lead in determining how to best to allocate it. The mental health situation in Australia is without historic precedent. Never before has the future direction of an entire country’s mental health program depended almost solely on the unopposed opinions and actions of one charismatic psychiatrist and his band of loyal followers. His inordinate power places a huge responsibility on Professor McGorry to exercise responsible and responsive leadership. Direct answers to the questions raised above are needed to ensure that public policy will follow the scientific evidence and not be unduly influenced by the blinkered zeal of one man, however well meaning and highly respected he may be.

http://www.psychologytoday.com/blog/dsm5-in-distress/201108/seven-questions-professor-patrick-mcgorry

 

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We’re All in China Now: New Initiative Launches Police State Under Guise of Mental Health

Friday, October 30th, 2009

by Beverly Eakman,
Author, Educator

Former Editor-In-Chief, NASA’s Newspaper (JSC)
October 30, 2009

Chinese flag

It’s zero hour in America. Do you know where your country went?

Now that America’s education system and parenting “experts” have brainwashed a generation of now-grown schoolchildren-cum-parents into believing that what we once called personality quirks, character flaws and moral issues are, in essence, mental disorders, politicians have taken the ball and run with it.  Law enforcement agencies and the judicial system are in the process of adopting Stalinist and Mao-inspired methods of controlling dissidents at home.

Only a few, short years ago, what was held up as independent thinking, speaking one’s mind, and robust dialogue is now decried as a prelude to terrorism.  Our nation’s leaders are pulling off communist-style thought-control by implying that any words uttered in print or out loud that run contrary to “accepted wisdom” (and that can change in a “New York Minute”) is the result of mental illness.

Don’t believe it?  Well, “google” this:

A recent report out of Missouri labeled “not-for-public-distribution” (circulated anonymously by a shocked and patriotic police officer) specifically describes supporters of the three presidential candidates as potential “militia”-influenced terrorists and instructs police to be on the lookout for bumper stickers and other paraphernalia associated with, of all things, the Constitution—such as “Campaign for Liberty.”  Even a few Members of Congress were implied to be security risks themselves (potential domestic terrorists).  The document, entitled “The Modern Militia Movement” (February 20, 2009), emanated from the Missouri Information Analysis Center (MIAC), one of several so-called “Fusion Centers” established by the federal government around the country.

Most people are probably not familiar with the term “Fusion Center.”  These were originally intended to allow local and state law-enforcement agents to work alongside federal officers after 9/11 so that terrorist-related activities could be identified, then pounced upon by all three entities at once.  “Fusion Center” offices, therefore, incorporate local, state and federal law-enforcement personnel, a strategy which, prior to the launching of the Department of Homeland Security (DHS), was deliberately avoided to maintain independence and preserve impartiality.  Predictably, these Centers got out of hand and fell into what is referred to as “mission creep.”

Mission creep is defined by Wikipedia as:

“the expansion of a project or mission beyond its original goals, often after initial successes…. [I]t is usually considered undesirable due to the dangerous path of each success breeding more ambitious attempts, only stopping when a final, often catastrophic, failure occurs. The term was originally applied exclusively to military operations, but has recently been applied to [other] fields, mainly the growth of bureaucracies.”

Ongoing improvements in tracking and monitoring of opinions via magazine subscriptions, charitable gifts, school and household surveys, and other computerized data collection has made political prediction on hot-button topics that much easier to secure.  “Predictive computer technology” (already a staple of school assessment testing) entails analysis by behavioral psychiatrists with concurrent degrees in statistics. This same capability has greatly accelerated mission creep among the nation’s Fusion Centers.

The PBS News Hour (not known for its conservatism or, for that matter, for being “alarmist”) recently reported on how political dissidents in China are forced into to psychiatric hospitals Video: Chinese Dissidents Committed to Mental Hospitals.  In the segment, aired September 13, 2009, the manner in which complainants (called petitioners), whistleblowers and outright protesters are “managed” bears an eerie resemblance to a policy shift right here in America.  States’ rights (or the 10th Amendment) are among the first casualties of a top-down, federal effort to minimize, and eventually suppress, dissent.

Psychopolitics is as the art and science of asserting and maintaining dominion over the thoughts and loyalties of individuals, officers, bureaus, and “the masses,” via various techniques ranging from “group dynamics,” “cognitive dissonance,” “de-sensitization,” “super-imposing alternate value structures,” “artificial disruption of thought,” the Delphi Method, the Tavistock Technique, to negative or positive “reinforcement.”   If you don’t recognize any of these, don’t feel too badly, because they are not part of any school curriculum.  The people who created them are, for the most part, unknown in our own country, except among those groomed by extremist political organizations to become “change agents,” professional agitators or “provocateurs.”  The pioneers of psychopolitics, including attitude prediction, include individuals such as Wilhelm Reich, Kurt Lewin, Theodor Adorno and Erich Fromm (Germany); A. S. Neill, A. J. Oraje and John Rawlings Rees (Great Britain); Antonio Gramsci (Italy); Anatoly Lunacharsky and Georg Lukacs (Russia); G. Brock Chishom and Ewen Cameron (Canada); and the U.S.’s own Ralph Tyler and Ronald Havelock.

Although psychopolitics originated under Vladimir Lenin as “political literacy” and “polytechnical education” in the old Soviet Union, and was carried to the free world via Peter Sedgwick (1934–1983) a translator for Victor Serge, author of PsychoPolitics and a revolutionary socialist activist as well as a member of the Communist Party of Great Britain, the term psychopolitics found its way into the American lexicon via Isaac Asimov, a master of the sci-fi genre.  But psychopolitics is no science fiction adventure, and never was.

By the 1970s, a slew of enablers were establishing a system of numerical codes for so-called mental disorders that would accommodate computerization.  This lent legitimacy to what would otherwise have been considered “questionable illnesses.” The goal was to ensure that medical professionals, the media and government accepted these terms as they might “diabetes,” thereby ensuring that the mental illnesses so codified would remain indelible, beginning with the youngest and most vulnerable.

The long-term game plan of psychopolitics is the conquest, usually by proxy, of enemy nations through “mental healing,” better known as “re-education.”  This entails what we know as “encounter groups,” extensive self-disclosure surveys and peer pressure to conform.  If all that doesn’t work, if certain individuals are still not amenable, then the first step is marginalization as “mentally unbalanced.”

Example:  A study by the National Institute of Mental Health and the National Science Foundation, funded by U.S. taxpayers to the tune of $1.2 million, announced on 1 August, 2003, that adherents to conventional moral principles and limited government are mentally disturbed. NIMH-NSF scholars from the Universities of Maryland, California at Berkeley, and Stanford attribute notions about morality and individualism to “dogmatism” and “uncertainty avoidance.”  Social conservatives, in particular, were said to suffer from “mental rigidity,” a condition which, researchers assert, is probably hard-wired, condemning traditionalists to a lifelong, cognitive hell, with all the associated indicators for mental illness: “decreased cognitive function, lowered self-esteem, fear, anger, pessimism, disgust, and contempt” (Jost, J. T., J. Glaser, et al. (2003). “Political Conservatism as Motivated Social Cognition.” Psychological Bulletin 129(3): 339-375 online at http://terpconnect.umd.edu/~hannahk/conservatism.html).

This is the sort of unprovable, but nevertheless libelous condescension that is  heaped upon anyone from talk show hosts, to authors to patriots who dare to contradict “common wisdom” (a.k.a. “political correctness”).  If that doesn’t work, contempt may be followed up with “mandatory [psychiatric] counseling” (already a feature of the American judicial system), or even forcible psychiatric drugging (well on its way to legitimacy in this nation’s schools). Finally there is incarceration in a psychiatric hospital, which gratefully is not yet a fixture in American democracy for potential dissenters, but the handwriting is on the wall, as the expression goes.

Totalitarian states like Communist China and Russia may be more blatant in their affronts to human rights and personal property — inasmuch as they don’t need a “reason” — but the differences are narrowing precipitously.

As emphasized during interviews on the PBS segment, the Chinese system is set up in such a way as to pre-empt complaints.  The Chinese government doesn’t wait around for somebody to sound off; it pre-emptively seeks out individuals likely to become troublesome, by assigning a mental-health diagnosis to anyone at the first sign of a provocative or inflammatory remark.

This lies at the heart of what is going on here in America, and we absolutely must put a stop to it, if it isn’t already too late.  Data-mining (which actually pre-dates 9/11), along with longitudinal tracking (that’s tracking over long time periods) and, therefore, ongoing monitoring of individual perceptions, worldviews and beliefs is gaining momentum with every moment that computer technology evolves — which means constantly.  Combine this with the practice of assigning mental-illness labels to private opinions, based on snippets of various information — with anything that might be favorable to the individual conveniently left out!

This “diagnosis,” like the American school child’s, follows the person for life, often compromising his or her college and career prospects.  An why not, after all?  Computerization makes it impossible for anyone to prove that an erroneous or falsified accusation has been purged from the system with no backup copy.

Today’s Chinese authorities, like Josef Stalin, Adolf Hitler, and Mao Zedong (Tse-tung) before them, in order to avoid drawing attention to policies that may be morally or ethically distasteful abroad (e.g., the one-child policy and forced abortion) or invite protests that coincide with an event at which international media attention is expected (such as the Olympics), they employ spies, block careers and intimidate family members.

It may be shocking to hear from your college-age children that we going down the same road.  Several universities, like the University of Delaware, in which a lawsuit was filed, have planted paid opinion-monitors in university dormitories (called “resident assistants,” or RAs).

Adam Kissel, Director of the Individual Rights Defense Program, Foundation for Individual Rights in Education, explains in a 2008 speech:

The freshman arrived for her mandatory one-on-one session in her dormitory at 8 pm. Classes had been in session for about a week. Her resident assistant handed her a questionnaire. He told her it was “a little questionnaire to help [you] and all the other residents relate to the curriculum.” She “looked a little uncomfortable.”

“When did you discover your sexual identity?” the questionnaire asked.

She wrote in response: “That is none of your damn business.”

Another question: “When was a time you felt oppressed?”

Her response: “I am oppressed every day [because of my] feelings for the opera.  Regularly [people]…jeer me with cruel names.… But I will overcome!  Hear me, you rock-loving majority?”

The resident assistant felt appalled…. He wrote up an incident report and reported her to his superiors.

This one-on-one session was not a punishment…for a recalcitrant student who had committed an infraction. It was mandatory sensitivity training, indeed, but it was part of a program that was mandatory for all 7,000 students in the University of Delaware dorms. It was a thorough thought-reform curriculum that was designed by the school’s Residence Life staff in order to treat and correct the allegedly incorrect thoughts, attitudes, values, and beliefs of the students….

Many other features — the mandatory one-on-one and group sessions throughout the year; the “confrontation” training to help RAs challenge students who were not complying [with political correctness]; the posters with [politicized] messages spread throughout the dorms; the zero-tolerance policy against anything deemed “oppressive”; the individual files on students and their beliefs, in some cases called “portfolios,” which were to be archived after graduation; the RA reports on their “best” and “worst” one-on-one sessions; the scientific analysis of the questionnaires in order to measure improvement toward the “educational objective”; the “strong male RAs” who were hired to break the “resistance to educational efforts” among [especially] the young male students — all of this, according to the university’s own materials, was part of a cutting-edge educational model that had won awards from a professional association for university administrators, the American College Personnel Association.

As if this weren’t enough to prove that psychopolitics is alive and well in America, with the pervasive undercurrent of “mental illness” as justification, schools below the college level have thoroughly succeeded in exchanging academic testing for mental-health “assessment”; left out, rewritten, and altered history texts until virtually nothing is left of the Framers ideals of a constitutional republic; redefined and watered down morality into something called “situation ethics”; removed the physiology from health classes and replaced it with graphic sex education, beginning in kindergarten.

Already, we see the results:

Do you vocally promote the right to self-defense?  Do you voice support for the intact family; national sovereignty and strict interpretation of the U.S. Constitution? Do you criticize easy immigration (i.e., without a citizen-sponsor); unrestricted free trade; free condoms hanging on some college freshmen’s dormitory doors; formalization of same-sex unions; abortion on-demand; mandatory mental-health screening of all pregnant women and schoolchildren?  Do you have a problem with the policies of the Federal Reserve; with “traffic” cameras and other surreptitious surveillance devices; industry-wide bailouts; no-fault divorce and illegitimacy?  Then, my friend, you are not merely holding to a “divergent viewpoint,” to use the 1950s term; you are mentally ill and a potential terrorist.  You are a person who is ripe for radicalization and therefore suspect.  Did you volunteer for certain political candidates in the 2008 election?   Do you, by your choices of magazine literature and religious preference, show that you have “bought in to” theological tenets such as the Creation?

If any of these apply to you, good luck in ever securing a government grant or contract, or getting your child into a top university, when there are others who carry none of this psychological “baggage.”

Americans are supposed to view any opposition to all this as “paranoia.”  Of course, the term paranoia carries a chilling effect, because it screams “mentally unbalanced” to the world.

Once it becomes possible, via technology, to track and legislate private opinions — and even to classify those that don’t conform as “mentally ill” — then we have left the realm of politics and moved into coercion.  We have facilitated the stigmatization of political dissent and vocal objection using labels like “acute stress disorder” or “paranoid schizophrenia,” just as they do a right now, today, in China, according the aforementioned PBS segment.

As a former employee of the U.S. Justice Department, I personally saw several precursors to the MAIC document — “watch-out” reports (for lack of a better term), on a smaller scale, under Janet Reno’s tenure there.  These were distributed to employees following the first anniversary of the Oklahoma City bombing.  Obviously, such alerts have been greatly expanded, what with the network of government “Fusion Centers” in state after state.

With pharmaceutical company moguls and politicians sitting on each other’s boards (E. I. Lilly’s chief executive officer, Sidney Taurel, sat on the Homeland Security Council under George W. Bush’s administration); with nationwide mental health assessments like the New Freedom Initiative (funded by the House in 2002) sizing up the political “health” of schoolchildren (and curriculum being altered accordingly); and with “behavioral detection officers” (“BDOs”) looking for any signs of irritation among model citizens in airport security lines, while U.S. borders are left open for drug-runners, who then get to sue Border Patrol agents for shooting at them—all this points to an America in big trouble.

“Political dissent” is now in the eye of the bureaucratic beholder — or the surveillance camera, erected under the guise of traffic safety to pursue revenue and to intimidate through meaningless “gotchas.”

We’re all in China now.

Beverly K. Eakman is a CCHR Commissioner, a former educator and retired federal employee who served as speechwriter for the heads of three government agencies and as editor-in-chief of NASA’s newspaper at the Johnson Space Center.  Today, she is a Washington, DC-based freelance writer, the author of five books, and a frequent keynote speaker on the lecture circuit. Her most recent work is Walking Targets: How Our Psychologized Classrooms Are Producing a Nation of Sitting Ducks (Midnight Whistler Publishers).

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