On the mental health system

I spend a good deal of my adult life thinking about the mental system.  I’ve spent years working in it, criticizing it, making movies about it, visiting programs within it, giving lectures about it, trying to help people escape from it, interviewing people about it, trying to improve it, and often just thinking that it needs to be scrapped, melted down, and rebuilt.  Although the mental health system helps some people, it harms so many — so unnecessarily.  I have seen many lives destroyed by it. That sickens me.

Below I present a variety of essays on the subject.  Some are links to essays I’ve written for other websites.  I am a blogger on madinamerica.com, and have published essays there and elsewhere (such as on mindfreedom.org and beyondmeds.com).

Unfortunately I don’t always get notified of comments on the other websites, so if you read those essays feel free to share your comments about them here on this page.

6 thoughts on “On the mental health system

  1. Hi Daniel,

    I have just read your essay ‘Therapy without Force’. One bit that struck a chord was ‘When we trump a person’s right to make autonomous decisions we send him the message that he is incompetent. We teach him not to trust himself. We teach him that his experience is a pathology rather than an opportunity for self-study and growth. ‘ . This is something that I (and probably a lot of people suffering from mental health problems) have experienced both from people working in the mental health profession, and also from well meaning but not always well-understanding others who have tried to help me at different times.

    I wanted to ask if you know of anything written (or any videos) on the same question of non-coercive approaches to recovery, but more from the point of view of a person looking to find a way to deal with their difficulties, rather than from the point of view of a therapist. In particular, how somebody who has been hurt by these kind of coercive attitudes from people can reclaim their personal autonomy and ability to trust their own judgement about things.

    Another question I am interested in is, given that many of us including myself are still in a relationship with the mental health services, how practically to do this in a way where we get to keep our own personal boundaries and emotional integrity. One thing that is important to me is to remember that I always have the right to speak about my experiences in my own words.

    Also, I am interested in any writings or videos by you or anyone else on the question of what an autonomy respecting mental health system could look like, and also what the idea of recovery could mean if we believe that people have the right to decide for themselves what they think is good or bad for them, given that the wider society we live in is also quite coercive and at times abusive or oppressive in various ways.

    Another thing I’d like to say is I really liked and appreciated your video of the two people from iceland who had managed to get off their medication. I am still on meds but I have managed to reduce the dose to about a third of what I started on. I am glad of this, although I still find that they make me physically lethargic, often lacking in motivation and enthusiasm, and finding it hard to put my energy into creative projects that I like to do. Watching that video was one of the things that made me think it was possible to get free of the meds.

    Also, I wanted to pass on a link to my friend Bryony’s video ‘Beyond Closed Doors’, which is about recovery houses in the UK. https://www.youtube.com/watch?v=6vyumSeowPo&list=PLCqu6vqaMSbPO8lp8defXG27PNJQpqRH3&index=21

    Cheers, Andrew Baxter

    • This is what Judith Herman says on this question in ‘Trauma and recovery’. I really like that book.

      “The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections. Recovery can only take place within the context of relationships; it cannot occur in isolation. In her renewed connections with other people, the survivor re-creates the psychological faculties that were damaged or deformed by the traumatic experience. These faculties include the basic capacities for trust, autonomy, initiative, competence, identity, and intimacy. Just as these capabilities are originally formed in relationships with other people, they must be reformed in such relationships.

      The first principle of recovery is the empowerment of the survivor. She must be the author and arbiter of her own recovery. Others may offer advice, support, assistance, affection and care, but not cure. Many benevolent and well-intentioned attempts to assist the survivor founder because this fundamental principle of empowerment is not observed. No intervention that takes power away from the survivor can possibly foster her recovery, no matter how much it appears to be in her immediate best interest. In the words of an incest survivor “Good therapists were those who really validated my experience and helped me to control my behaviour rather than trying to control me”.

      Caregivers schooled in a medical model of treatment often have difficulty grasping this fundamental principle and putting it into practice. In exceptional circumstances, where the survivor has totally abdicated responsibility for her own self-care or threatens immediate harm to herself or others, rapid intervention is required with or without her consent. But even then, there is no need for unilateral action; the survivor should still be consulted about her wishes and offered as much choice as possible compatible with the preservation of safety”

  2. Hi Daniel,
    I’ve just read your essay “Reflections on Being a Therapist”. I write to you in tears because this piece truly spoke to me. Though I am still quite new in the field of psychotherapy as a counsellor (3 years to be exact, 10 years in the mental health field), I submitted my resignation about 3 weeks ago. Similarly to what you shared in your entry, I feel emotionally (and physically) drained. I am filled with self-doubt as a counsellor because though I know that I don’t have all the answers that my clients are looking for, the pressure to provide them with these can be overpowering. I will continue to work as a counsellor until the end of the month, but I truly have no idea what I want to do with my life afterwards. I feel pressured to pay off my student loans and become an independent adult, so I can’t help but feel as if I was taking a step backwards, but I ultimately know that this is the right decision for me. Like you, I also have a passion for mental health… I just don’t think counselling is what I want to be doing anymore. Any tips for somebody like me? I’m feeling pretty discouraged, lost, and scattered at the moment.

  3. The mental health system is burdened with a large amount of mentally ill patients, all of which are difficult to deal with. The amount of TMS therapies, psychotherapies and medication required for the vast numbers of victims of mental disorders is almost impossible to fulfill.

  4. I’ve read your “Therapy Without Force” paper, on a website I have growing respect for; but I’m worried by several parts of your paper: that a therapist can find a client’s emotional needs too much and to step away?! Surely that’s your issue, not the clients’? This feels really damaging to the client.

    • when i wrote that paper i was referring to extreme situations — and yes, that does become the therapist’s problems. for instance — if a client is threatening to beat up or kill the therapist, or is threatening to kill himself and not showing up to sessions, which can totally stress out a therapist. that’s what i was referring to. not just more “regular” stuff — in which cases i’d say the therapist has much less of a “right” to pull away from the client.

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