http://www.mindfully.org/Health/2003...ericaJun03.htm
Mad in America
Bad Science and Bad Medicine
TERRY MESSMAN / Street Spirit (San Francisco) Jun03
[Robert Whitaker interview below]

In Mad In America, one lone author bears moral witness to the suffering of hundreds of thousands of people, and names the names that deserve to live in infamy.

Robert Whitaker's book, Mad In America, is a towering achievement that stands shoulder to shoulder with the best investigative reporting in U.S. history. His book invites comparison with other momentous examples of muckraking journalism, such as Rachel Carson's prophetic environmental exposé, The Silent Spring, or William Lloyd Garrison's liberating reporting on the fight to abolish slavery.

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A STIRRING ACT OF RESISTANCE

The publication of Mad In America is a watershed in the history of human rights. I was not the same after I read it. It is a searing historical exposé that has an impact comparable to reading the stories of Holocaust survivors. It is a song of lamentation for the human beings we have lost. It is an act of compassion that reclaims the humanity of psychiatric survivors.

Finally, it is a stirring act of resistance in , which one lone author bears moral witness to the suffering of hundreds of thousands, and names the names that deserve to live in infamy: the inventors of lobotomy and electroshock and tardive dyskinesia.

For over 30 years, patients rights groups have been speaking out against psychiatric abuses—the torturous treatments, the loss of freedom and dignity, the misuse of seclusion and restraints, the neurological damage caused by "antipsychotic" drugs. But these groups have been condemned and dismissed by the psychiatric. establishment, and their truths censured and denied.

Perhaps it takes a book by an outside journalist who fully believed in the widely parroted story of "progress" being peddled by the giant pharmaceutical corporations that utterly dominate the practice of psychiatry today. Through. his historical and scientific research, Robert Whitaker has shattered that myth of progress and has shown that antipsychotic drugs are nothing more than the latest, most trendy form of "brain-damaging therapeutics."

Mad In America is an astonishing indictment of 250 years of psychiatric mistreatment, dehumanization, torture, and the deliberate infliction of brain damage. One only wishes that it could be prescribed as a form of "forced treatment" and made mandatory reading for every psychiatrist and corporate drug pusher in the land.




FORCED STERILIZATION IN THE U.S.

Whitaker unveils a truly frightening history of prominent psychiatrists joining with the eugenics movement to rid the gene pool of the "insanity gene" by classifying mental health clients as debased and subhuman. Eugenicists sought to cleanse America of the mentally ill by forcibly segregating them in asylums so they couldn't procreate, and then sterilizing tens of thousands of patients to prevent them from breeding.

The U.S. eugenics movement was a key inspiration for Nazi Germany's similar programs to segregate and sterilize mentally disabled people, and German scientists even traveled to California to study our program of forced sterilization.

American eugenics may have reached its apotheosis in 1935 when Alexis Carrel, a' . physician at Rockefeller Institute for Medical Research in New York, wrote that the mentally ill "should be humanely and economically disposed of in small euthanistic institutions supplied with proper gases."

The U.S. psychiatrists who embraced the program of compulsory sterilization directly influenced the doctors of the Third Reich, who would soon begin the "mercy killings" of mental patients.

As psychiatry advanced in the 1940s and 1950s, the scientific assault on the brains of patients became, if anything, more methodical and in some cases more terrifying. Insulin- coma, metrazol convulsion therapy, electroshock and lobotomies were used to cripple the frontal lobe and the higher brain functions that separate human beings from the lower primates.

This assault on the brain then came fully into the present with the widespread use of neuroleptic drugs such as Thorazine and Haldol, and the current use of the new "atypical" antipsychotic drugs Zyprexa, Clozaril and Risperdal.

Both the neuroleptics and the atypicals create brain pathology by blocking the flow of neurotransmitters, leaving patients dulled, lethargic and vegetative. The neuroleptics unleashed a devastating epidemic of "persistent Parkinson's" symptoms and the terribly disfiguring neurological dysfunction called tardive dyskinesia. The new atypicals have already been linked with immense weight gain, diabetes, and the dangerous depletion of white blood cells.

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this photo shows -

Psychosurgery Brutality

American psychiatrist Walter Freeman (center)
developed the frontal lobotomy, a barbarous act
which plunged an icepick-like instrument beneath
the eyelid and, using a surgical mallet, drove it
through the eye socket bone and into the brain.
Movement of the instrument severed the fibers of
the frontal brain lobes, causing irreversible brain
damage.

Mad in America:

Controversial Book Examines Psychiatric Treatment for Schizophrenia

NEW YORK CITYVOICES:
By Carl Blumenthal

Robert Whitaker is a medical writer for the Boston Globe newspaper; he was a Pulitzer Prize finalist in 1998. In Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, Mr. Whitaker attacks psychiatry and drug companies in defense of the most vulnerable population, people with schizophrenia. However, in his pursuit of those who have sometimes harmed the mentally ill, Mr. Whitaker neglects the many consumers who, while abused in the past, are now benefiting from medication and a host of other services. In 2002, Perseus Publishing of Cambridge, Massachusetts, produced Mad in America (ISBN 0738203858, hardcover price $27).

More than 200 years of Mistreatment

Mr. Whitaker writes: "One of the enduring staples in mad medicine has been the rise and fall of cures. Rarely has psychiatry been totally without a remedy advertised as effective."

"Whether it be whipping the mentally ill, bleeding them, making them vomit, feeding them sheep thyroids, putting them in continuous baths, stunning them with shock therapies, or severing their frontal lobes, [not to mention sterilization, insulin coma therapy, Metrazol convulsive therapy, drugs that caused crippling side effects, and experiments that worsened symptoms]-all such therapies "worked" at one time, and then, when a new therapy came along, they were suddenly seen in a new light, and their shortcomings revealed."

"In the 1990's, this repeating theme in mad medicine occurred once again. New 'atypical' [Clozaril, Risperdal, Zyprexa, etc.] drugs for schizophrenia were brought to market amid much fanfare, hailed as 'breakthrough' treatments, while the old standard neuroleptics [Thorazine, Stelazine, Haldol, etc.] were suddenly seen as flawed drugs, indeed (pp. 253-4)."

Mr. Whitaker describes how the drug companies paid large sums of money to promote the atypicals whether with the biased research that won FDA approval or for the misleading advertising that gained consumer loyalty.

With its litany of abuses, Mad in America should make even the most blameless psychiatrists feel guilty, paranoid and suicidal. The profession can no longer deny the skeletons in its closet because in the last 30 years dozens of historians have discovered records from America's insane asylums and mental hospitals. They have concluded that the role of these early institutions was to control deviant behavior. No wonder the mentally ill were treated as third-class citizens.

Mr. Whitaker and Voices Discuss the Merits of Mad in America

In spite of this long, pernicious record, many consumers today gain relief with the help of atypical meds. Taking advantage of the new medications and innovative social programs, many consumers are recovering from disability. With this in mind, Voices invited Robert Whitaker to a discussion of Mad in America's merits.

On June 13, 2002, the following people met with Mr. Whitaker at the Voices office to discuss the book: Shirlee Cohen is a consumer and nurse practitioner who teaches nursing students about mental health. She moderated the debate. Daniel Frey, Editor-in-Chief of Voices, is also a consumer and self-help group leader. Miriam Wexler is a consumer, Project Coordinator for the Voter Empowerment Project and Secretary for the National Picnic for Parity, Inc. And psychiatrist Anand Pandya, MD, heads the trauma unit at Bellevue Hospital. Others present were Rachel Koch, Casey Capps and (more???) the author of this article. All the consumers testified that some drugs had damaged them and Dr. Pandya stated he had witnessed misuses of medication. They also cited the often dramatic benefits of other drugs and maintained that today's atypical meds are superior to the neuroleptics used in the 1950s-1980s. Dr. Pandya criticized Mr. Whitaker for only selecting studies that prove the harmfulness of drugs. Although willing to admit that drugs are helpful in some cases, Mr. Whitaker insisted that those outcomes did not change his case against doctors and drug companies.

World Health Studies Show Third World with Better Mental Health

As in Mad in America, Exhibit A for Mr. Whitaker was a series of World Health Organization (WHO) studies between 1969 and 1992. Even E. Fuller Torrey, in his classic 1987 book Surviving Schizophrenia, confirmed the WHO's findings that patients with a diagnosis of schizophrenia get better quicker and stay well longer in the Third World than in Western countries. These are extraordinary results given that Third World countries lag behind the West on virtually every measure of public health.

Both Fuller in his book and Pandya at the debate faulted the studies for differences in diagnosis among countries. However, in his book, Mr. Whitaker maintains that the researchers corrected for such differences by reanalyzing the patients' medical records. Thus, he draws the startling conclusion that Africans and Asians were better off because they lacked the very drugs on which we rely. Mr. Whitaker repeated the WHO findings often during the discussion as if they represented the bottom line for our system of care.

Seeking Alternatives to "Mad Medicine"

Voices representatives and our other guests agreed with Mr. Whitaker on "moral treatment" or "the importance of human connection" for healing mental illness. He traces this approach to the mid-19th century Quakers who created small, country "asylums" for treating the insane with dignity and respect. The Society of Friends did not subject patients to the physical "tortures" popular at the time. Instead, the group used education and recreation to rehabilitate them, including rewards to encourage discipline.

For Mr. Whitaker, moral treatment and a modern variant, the Soteria Project of Dr. Leonard Mosher, represent lost opportunities to transform the mental illness system. Much as with the Quakers, "The philosophy at Soteria was that staff [not mental-health professionals], rather than do things 'to' the residents, would "be with them (p. 221)." The labor-intensive method allowed treatment of two hundred patients over a decade. Those of us affiliated with Voices reminded Mr. Whitaker that moral treatment lives on in community care, independent living, self-help, peer support, and even psychotherapy. Members of our discussion group, including some diagnosed with schizophrenia, described psychotherapy as equally, if not more, important than medication for recovery. In Transforming Madness, Jay Neugeboren describes many such organizations run by consumers, with or without medication. Ironically, Mr. Whitaker's focus on two (pure) experiments resembles psychiatrists' search for magic bullets.

Consumer Voice Missing from History of Mental Illness

Everyone agreed that the consumer voice is missing from the history of mental illness. Except for those few profiles by Mr. Whitaker of ex-patients fighting the use of medication, the consumer viewpoint is also missing from his book. This cohort of consumers at Voices has struggled too long to be taken in by false claims. Patients aren't the only ones who should sign consent forms for drug trials and treatment. The burden of proof should be on doctors-to live up to the Hippocratic Oath so the mistakes of the past are not repeated. As Dr. Pandya said, most doctors are not aware of how social and economic factors affect science.

After all his dogged research and writing, it is a shame that Mr. Whitaker feels pessimistic about improving the mental health system. He should have learned more about perseverance from the psychiatric survivors who inspired him. Nevertheless, consumers have on their side an eloquent writer whose story should prod the conscience of mental health professionals for a long time. Maybe next time he will consult more of the victims he writes about.