instagram pinterest linkedin facebook twitter goodreads facebook circle twitter circle linkedin circle instagram circle goodreads circle pinterest circle

Paula Joan Caplan's Authors Guild Blog

The President’s Fitness: Can Professionals Help Decide?

First published May 8, 2020, at https://www.madinamerica.com/2020/05/presidents-fitness-can-professionals-help-decide/ [new material added here is in square brackets below]

 

Even before Donald Trump became President of the United States, speculations about whether he was fit to serve were rampant. Although it is beside the point, much time and heated debate consisted of questions such as, "Is he mentally ill?" and "Which kindof mental illness does he have?" In our psychiatrized nation, such discussions have widely been heard as meaning: "Trump is mentally ill, and that makes him unfit to serve as President."

 

Most readers of Mad in America know that both the overarching category of "mental illness" and the hundreds of alleged subcategories listed in psychiatric classification systems have no scientific basis and are not useful in helping people who are suffering or stopping those who make other people suffer. I addressed this in an article I wrote fairly early in the debate, called "The Truth about Trump and Psychiatric Diagnosis."

 

Most readers of Mad in America also have a healthy skepticism about what—or whether—professionals have anything to contribute to the benefitting of society. So the question is whether that skepticism applies to determining whether Trump or any President is fit to serve in that office. I think that, for once, it does not, but I have a very specific reason for saying this.

 

The 25th Amendment to the United States Constitution was supposed to provide for the removal of an unfit President. It was "proposed by Congress and ratified by the states in the aftermath of the assassination of President John F. Kennedy" and "provides the procedures for replacing the president or vice president in the event of death, removal, resignation, or incapacitation." However,  the devil is in the details, and the Amendment turns out to be woefully inadequate. Why? Because Section 4 provides that:

 

Whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President.

 

However, even if that happened in Trump's case, the Amendment provides that if the President just declares in writing that "no such inability exists," he continues in his office unless the Congress determines by two-thirds vote of both Houses that the President is unable to discharge the powers and duties of the office. It's not hard to imagine that with the current Senate, that would be unlikely to happen, given the Senate's utter failure to act after the House of Representatives impeached the President.


Congressman Jamin Raskin (D-MD), a brilliant Constitutional law scholar, has tried to draft legislation that would get around the highly political nature of the process as it is described in the Amendment. He aimed to create a mechanism for determining fitness to serve by creating a Commission for that purpose. In correspondence with me (Sept. 4, 2017), he explained the further wish to avoid making the process solely "psychiatric or medical," because then, "people will say the decision has been medicalized or psychologized when it is properly a public policy question."

 

His idea was to constitute a Commission with a mix of public policy, medical, and psychiatric professionals. Since fitness to serve can be affected by such physical impairments as those caused by strokes and comas, it makes sense to include medical personnel who are not psychiatrists. The legislation he proposed was HR 1987 from the 115th Congress, to which 70 members of the House of Representatives signed on, all Democrats.

 

I sent Congressman Raskin a proposal in which I strongly argued against including mental health professionals who would likely focus on psychiatric diagnosis. I pointed out not only that such diagnoses are unscientific but also that many people who have been given such labels have done great work and done no harm.  I then pointed out that some psychologists and educators can offer information and tools that are directly relevant to fitness to serve.

 

In fact, it strikes me as quite simple: Determination of fitness to serve should be based on whether the office-holder can carry out the crucial elements of the job. Professionals who are trained in developing and administering reliable, valid achievement tests and tests of memory and abstract thinking—primarily some psychologists and educators—could play crucial roles in such a Commission.

 

Here are excerpts from what I wrote to the Congressman on January 4, 2018, and which still applies. I have added slight clarifications in square brackets.

If you have [psychiatrists] on the Commission, whatever they say will not be scientific, not empirically demonstrable, and thus open to accusations that the process is improperly political. Where there is no science (there is none in psychiatric diagnosis), there is only opinion, and opinion is always highly susceptible to bias of many kinds.
The Commission ought to include a neuropsychologist, since they are trained to give standardized memory tests, and memory is of course an essential component of fitness to serve.  The Commission should arrange to have [chosen or] constructed the relevant tests of fitness, which are in many ways achievement tests — tests of knowledge about the Constitution ([a] book being published tomorrow includes…that someone tried to discuss the Constitution with Trump and got as far as the 4th Amendment before he changed the subject, so this is a timely way to point out the usefulness of the approach I suggest), how a bill becomes a law, geography, political systems globally, and tests of memory and of the understanding of abstract concepts including but not limited to cause-effect relationships.
The tests described in (2) have a parallel in the achievement tests a person applying for U.S. citizenship needs to take. As you said, the Constitution does not include requirements as in (2), but those become relevant once the question of fitness to serve is raised.
Various people throw around the term "mental" as in "mental impairment." It is essential to distinguish between two kinds of "mental impairment": There is emotional impairment [or difference] (e.g., absence of empathy and compassion, believing oneself to be Jesus Christ [if one is not]), and there is cognitive impairment (e.g., dementia, reading disability, math disability, inability to form or comprehend abstract concepts). Just a note: Trump may be suffering from both lifelong cognitive impairment (one of his professors from Wharton called him the dumbest student he ever had) and perhaps now, some dementia. [T]he way he slurred "United States" recently is not explained by dry mouth as was suggested. He could be having small strokes. That's why a neurologist as well as a neuropsychologist would be good to have on the Commission.
If you left out Trump's name and just told anyone some things he has said and done, they would assign labels such as "bully," "whopping sense of entitlement," "power-hungry," "stunning lack of empathy and compassion" [and "thug," "criminal," or "evildoer]. These are more than adequate to explain a huge amount of what we see in him. Ask people what they think calling him "mentally ill" would add. What does it explain that is relevant to fitness to serve as President? Saying he is unfit to serve because of being mentally ill is causing huge offense to people who have psychiatric labels, and that may well come close to 1/3 of the U.S. population. Abraham Lincoln would have been diagnosed as mentally ill. A psychiatric label is orthogonal to the matter of fitness to serve.
The kinds of tests described in (2) are exquisitely specific, jargon-free, and inarguably relevant to fitness to serve.


Congressman Raskin, in a May 6, 2020 email to me, said that if he were to rewrite the legislation today, he would include Governors and a neurologist. He noted: "All of the events we are living through reconfirm for me that the critical concept under Section 4 of the 25th Amendment is 'dangerous unfitness' to discharge the powers and duties of office."

 

Despite all of the above, many psychiatrists and psychologists have claimed that they have "special expertise" and extensive training that qualify them to judge Trump to be mentally unfit and dangerous to this nation's "public health." Their position is that they have a "duty to warn" that justifies their ignoring of the Goldwater Rule, https://www.madinamerica.com/2020/04/muzzled-psychiatry-time-crisis/ which prohibits the giving of professional opinions of anyone the therapist has not evaluated in person.

 

Of course, given that psychiatric diagnoses are not valid, the Goldwater Rule by all rights should specify that no one should ever give anyone a psychiatric diagnosis. But the rule refers to more than just diagnosis, so the professionals who claim special expertise—who tend to vary among themselves, and some of whom vacillate between saying he is mentally ill and saying diagnosis is beside the point [their leader, Yale psychiatrist Bandy Lee, has been quoted in a recent article in a publication that is opposed to psychiatric diagnosis https://www.madinamerica.com/2020/04/muzzled-psychiatry-time-crisis/ as saying that diagnosis is beside the point, when in fact she sometimes says that but has vigorously promoted a book she edited and a film about the book in which her chosen authors say that he is mentally ill, and some even claim to know he should be diagnosed with specific, but various, labels] —should stop claiming that they must speak out because of that alleged expertise.

 

For psychiatrists, psychologists, social workers, and other therapists to claim that they are essential for warning people that Trump is dangerous is to claim special expertise and insight to which they are not entitled, and it simultaneously demeans the judgment of nonprofessionals and helps strengthen the power of their guilds.

 

The fact is that, as longtime expert on dangerousness Dr. James Gilligan has said, the only good predictor of dangerous behavior is past commission of dangerous acts, and as Dr. Gilligan pointed out in a press conference at the National Press Club in February, 2018, Trump himself has acknowledged his own dangerous behavior, including but by no means limited to his sexual assaults.

My middle-school grandchildren observed this with no help from any professional or anyone older than they. There is, then, a role for some professionals in trying to remove unfit officials from office, but it is not the one that some would like us to believe.

Be the first to comment

Big Pharma meets Big Diagnosis, Big Courts, and Big Psychiatric Hospitals

First published January 31, 2020, at https://www.madinamerica.com/2020/01/zyprexa-papers/

 

If you think the truth can set us free, and you care about harm done to suffering souls who seek help from the traditional mental health system, only to discover too often and too late that that system exponentially adds to their burdens, Jim Gottstein's blockbuster new book, The Zyprexa Papers, is essential reading. It should be required reading for every well-meaning friend or family member of someone who suffers emotionally, as well as for legislators who genuinely want to weed out corruption and harm.

 

The book is focused on the neuroleptic drug Zyprexa and two cases related to it — one in which Gottstein represented a client and one in which he became the accused — but importantly, it exemplifies problems throughout the systems of not only Big Pharma but also what could be called Big Diagnosis, Big Psychiatric Hospitals, and Big Mental Health-related Courts. It's a book about how the tsunami fed by the profit motive and the vast systems involved in the politics of mental health, including the so-called justice system, swamps what ought to be primary: the alleviation of emotional pain.

 

Gottstein's book is The Pentagon Papers of the traditional mental health system, because he exposes a mind-blowing number and variety of cold-blooded, calculating actions on the part of Eli Lilly in trying to hide what it knew to be the devastating effects of its hugely profitable Zyprexa, from its lies of both omission and commission about relevant data to what can only be called its persecution of Gottstein himself for trying to sound the alarm. Gottstein, a courageous and brilliant lawyer and tireless activist trying through strategic litigation to prevent people from being harmed by psychiatric drugs and electroshock through his nonprofit Law Project for Psychiatric Rights (PsychRights), also takes us day by day through his attempts to prevent one particular client, Bill Bigley (to whom the book is dedicated), from being involuntarily committed to a psychiatric facility and forcibly drugged. In doing so, he exposes the staggering number of ways the court system that handles such cases amounts way too frequently to a kind of Kangaroo Court, where the odds are so stacked against the person labeled mentally ill that it's almost inevitable they will be deprived of their rights. The hurdles the client and lawyer have to jump are so numerous and various that this part of The Zyprexa Papers will be a revelation to those who have not themselves been through it.

 

Where does Big Diagnosis come in? Without the hundreds of psychiatric categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM), none of this could have happened, because giving a person even one DSM label — even one that sounds relatively innocuous — is what enables therapists, drug companies, and judges (not to mention others) to make a wide array of recommendations and even impose courses of action that they can call "treatment." And when the "treatments," including drugs, cause harm or fail to help, the labeled person's reports are easily ignored, minimized, or used as further "proof" that they are "mentally ill." Equally appalling is that calling psychiatric drugging, electroshock, involuntary commitment, and other intrusions "treatment" allows those who suggest, impose, or enforce them to escape culpability. In a lawsuit in which I was an expert witness, three therapists who nearly destroyed someone's life were not held in the least negligent, on the grounds that they had just been following the mental health system's standard of care.

 

The Zyprexa Papers is a hard book to put down, and it's so worth reading, because we need to know what goes on largely in secret, and as we read, we see clearly the many points where changes for the better must be made… and how each of us can help to change them.

 

Gottstein had had personal experience in the mental health system. In 1982, at age 29, he had become terribly disoriented from lack of sleep and as a result had been locked up in the Alaska Psychiatric Institute (API) — the very entity that had repeatedly hospitalized and forcibly drugged Bill Bigley. At API, Gottstein reports:

 

"I was told I would have to take mind-numbing Thorazine-like drugs for the rest of my life. When I told them I had graduated from Harvard Law School (which I had), I was considered delusional. Those who believed I was a lawyer said I would never practice law again. However, my mother, who was the Executive Director of the Alaska Mental Health Association, steered me to a terrific psychiatrist, Robert Alberts, who said that anyone who doesn't get enough sleep will become psychotic, and I just needed to learn how to keep from getting into trouble. … was lucky not to have been made into a permanent mental patient by the mental illness system. These experiences started my advocacy for people diagnosed with serious mental illness."

 

Gottstein describes having been inspired by Robert Whitaker's classic investigative book, Mad in America, which he describes as both "a terrific read" and "a litigation roadmap for challenging forced psychiatric drugging on the basis that it isn't in the patient's best interest." He explains that drugs like Zyprexa "have been marketed as 'antipsychotic'" when in fact what they do is "suppress people's brain activity so much they can no longer be much trouble—at least temporarily." For this reason, he uses the term "neuroleptic," which means "seize the brain" — it was "one of the first names given to this class of drugs, and is the most accurate description." To call them "antipsychotic," he says, is "marketing hype."

 

Readers discover the ghastly lengths to which Lilly, aiming solely to maximize its profits, went from the outset to conceal the fact that Zyprexa caused, among many other serious problems, high rates of diabetes, rapid and enormous weight gain (in some cases, more than 100 pounds after a year on the drug), and even death. How much money was at stake? In 2005, the year before the book's saga begins, Zyprexa's reported sales were $4.2 billion, with about two million people across the world taking the drug.

 

Gottstein describes his triple efforts, starting in 2006, to help one person protect his right to refuse psychiatric drugs, to help in other strategic litigation, and to publicize widely the truth about Zyprexa's dangers. The incriminating evidence about those dangers had been discovered by an expert witness for a number of plaintiffs in the 8,000-person, multi-district litigation who charged they were harmed by the drug, and Gottstein obtained that evidence by subpoenaing the expert for the documents to be used for Bill Bigley's case against forced drugging. In the multi-district litigation, the large number of lawsuits had been consolidated, and the documentation about Zyprexa's concealed dangers became subject to an order that they be kept secret. Fortunately, however, the information could be produced if it was subpoenaed for another court action and if Lilly was first given "notice and a reasonable opportunity to object."

 

The amount of time that "reasonable opportunity to object" required was unspecified, so when Gottstein subpoenaed the documents from the expert witness, Dr. David Egilman, whom he describes as a man of conscience, Egilman sent them to Gottstein not immediately but before Lilly objected. Egilman had told Gottstein he hoped Gottstein would subpoena him and then, after receiving Egilman's documentation, would turn it over to New York Times writer Alex Berenson for his reporting about Zyprexa. However, to Gottstein's personal detriment, when Egilman only showed Gottstein part of the entire secrecy order, he acknowledges that he "motored past that red flag" and relied on Egilman to indicate when he thought a "reasonable" amount of time had passed since Egilman had notified Lilly of Gottstein's subpoena and thus Gottstein was free to send the documents to Berenson, as well as to many others who would help disseminate the truth.

 

The interpretation of "reasonable" became a major weapon in what can legitimately be called Lilly's persecution of Gottstein for making the information public. On December 6, 2006, Egilman notified Lilly's top attorney that Gottstein had subpoenaed him for a deposition by telephone for December 20. On December 11, Gottstein sent Egilman an amended subpoena, because the original one had included the order for the doctor to bring his documents with him, but since the deposition was going to be by telephone, Gottstein needed the documents sent to him before the deposition. He asked Egilman to notify Lilly of the amendment, but Egilman did not do so. Egilman said that five days had passed since his notification to Lilly, and he believed that that constituted "reasonable" notice, so on December 12, he went ahead and uploaded the material to an internet domain Gottstein had created for that purpose. Gottstein had received a voicemail message from a Lilly lawyer the night before and had left a voicemail for him the next morning. In the meantime, as he said, "feeling Lilly's breath on my neck," he proceeded to give the Times reporter access to the documents, and he sent them in various ways to many other people.

 

Gottstein's courage in doing this is stunning. He knew that he could end up going to prison, given Lilly's power and money, but "thousands upon thousands of people had already been killed by the drug, and we [he and Egilman] were hoping to keep that from happening to thousands upon thousands more."

 

What followed showed both Lilly and the courts at their worst. Lilly's ability to bring in judges to try to intimidate Gottstein was astonishing. Readers will be alarmed to learn in the pages of The Zyprexa Papers how vulnerable truthtellers can be, even when their aim is utterly selfless and when they try to prevent massive harm like that which had already come to huge numbers of people. Lilly demanded that Gottstein not reveal the documents to anyone and that he immediately retrieve them from everyone to whom he had sent them and take them down from anywhere he had posted them. By then, some of his recipients had sent them on to still other people, and in various ways they had been further publicized. In fact, in an article Berenson wrote around that time, the following appeared: "Mr. Gottstein said yesterday that the information in the documents should be available to patients and doctors, as well as judges who oversee the hearings that are required before people can be forced to take psychiatric drugs. 'The courts should have this information before they order this stuff injected into people's unwilling bodies,' Mr. Gottstein said."

 

As media coverage about the matter increased, Lilly, clearly incensed, threatened Gottstein that he would lose his law license and that it would "seek sanctions" against him for having violated the secrecy order from that case that had been settled with the 8,000 plaintiffs. A court order included the instruction to him to "Preserve all documents, voice mails, e-mails, material and information relating to Dr. Egilman or any other efforts to obtain documents produced by Lilly." I recall that around that time, I had called Jim's office about some other matter and was stunned to hear his outgoing message, in which he instructed callers not to leave a message of any kind on his answering machine. It felt Orwellian.

 

The ways that Lilly and the courts conspired against Gottstein must be read to be believed. And it is poignant to read Gottstein kicking himself for the very human mistakes he made when called to testify under circumstances of extreme sleep deprivation, but these errors should never have justified the outcomes. Gottstein had spent vast amounts of money trying to defend himself and was facing even more legal fees beyond the huge ones he had already incurred. In addition, threats of losing his law license and contempt of court charges were hanging over his head. The story of why and how the case ended for him makes one rail at the so-called justice system and the overwhelming power of Big Pharma, as well as how they work together.

 

Gottstein speculates that the judges' decisions were due to their view that Gottstein flouted their authority by sending out the material covered by the secrecy order, and it looks to this reader as though they jumped at the chance to interpret or misinterpret anything in Gottstein's favor so as to allow them to protect Lilly. This impression is strengthened by the fact that vast numbers of the documents covered by the secrecy order had always been public knowledge, including media reports, yet all were subsumed in that order.

 

Bending over backward to understand the court's alarm about exposure of the documents, one might ask what benefit comes to the plaintiffs in settlements like the one that included the secrecy order. Gottstein tells us that the Zyprexa settlement with 8,000 victims averaged a little less than $90,000 per victim and says:

 

"This doesn't seem like a lot for giving someone diabetes, but it is even worse when you consider that the lawyers took 40% and then Medicaid and Medicare were reimbursed another 30%. At that point, even the approximately $27,000 individual victims received, on average, put those who were on Medicaid and disability over the asset limit for eligibility. This meant they had to spend the money from the settlement to treat their diabetes and otherwise spend it over the course of a year or two to maintain or get back their Medicaid and disability payments"

.

Furthermore, Gottstein writes, "judges are supposed to allow the secrecy only if it is in the public interest, but in practice, they don't. The secrecy greases the wheels of settlement as well as litigation, and judges want to have cases resolved and off their docket. … Normally, no one is representing the public interest." He continues:

I think it is fair to say by issuing the secrecy order the … Court was complicit with Lilly in hiding the great harm being done to people as a result of Zyprexa. If this information had become public earlier, thousands of additional lives could have been saved, and hundreds of thousands of people would probably not have taken Zyprexa.

 

Gottstein describes where the Court erred in considering the subpoena he issued and his release of the Zyprexa Papers:

 

"It felt I had violated its secrecy order, and never gave serious consideration to the possibility I had not. Protecting its authority was really the court's only consideration. It did not give fair consideration to PsychRights' legitimate interest in the Zyprexa Papers. It did not give fair consideration to the fact that PsychRights followed the secrecy order's rules in obtaining the Zyprexa Papers. … I had my independent and proper reasons for subpoenaing them, including alerting the public to the great harm caused by Zyprexa. … I believed I received them under the secrecy order's rules and once I had them in that way, they lost their secrecy."

 

The second story in the book, interwoven throughout with the Lilly case, is about the way that Bill Bigley, whom Gottstein brings to life with warmth and respect, experienced tragic losses that understandably made him sad. His deeply human reaction was then pathologized: He was diagnosed with psychiatric labels that formed the foundation for starting him on a cycle of involuntary hospitalizations that grew to number around 70 and of forced drugging that caused him so many problems that he understandably resisted those chemicals. All of this predictably led to his deterioration in many ways, and he began sometimes to act in ways that annoyed some people, but he was never violent. Gottstein writes: "In reality, it wasn't about Bill's quality of life at all but about reducing other people's annoyance with him."

 

In spite of this, the mental health system destroyed this man, whose suffering, like that of so many, led to diagnosis that was then used to justify depriving him of his rights on the utterly unsupported grounds that he must have an incurable chemical imbalance and needed "treatment." As Gottstein describes trying to help Bigley so many times, he shows point by point how the system in Alaska — typical of those across the U.S. — was used to order involuntary commitment and forced drugging was rigged against him.

 

The very fact that someone has been given any psychiatric label is used in a staggering variety of ways to deprive them of self-respect, dignity, self-confidence, employment, custody of their children, the right to make decisions about their medical and legal affairs, and even their lives. Just as Gottstein's accurate statement that he had graduated from Harvard Law School had been construed as evidence of his "mental illness," so when Bigley accurately stated that he had been quoted in the New York Times, that was construed as proof of his "psychiatric disorder." And as so often happens, Bigley's refusal of psychiatric drugs was alleged to be proof that he was too "ill" to know how to take care of himself.

 

Flagrantly ignoring proof of the harm caused by psychiatric drugs, the judge ordered that Bigley could be drugged against his will. The judge's "reasoning" belongs in Alice in Wonderland rather than a court order. Try to find the logic in what the judge held, as Gottstein cites it:

 

"The Court is willing to assume that past medications have damaged Bigley's brain. It is further willing to assume that additional brain damage will result if API is allowed to administer more psychotropics. But that does not end the analysis.

"The Court finds that the danger of additional (but uncertain) damage is outweighed by the positive benefits of the administration of medication and the emotional and behavioral problems that will escalate if Bigley is not medicated. Even if the medication shortens Bigley's lifespan, the Court would authorize the administration of the medication because Bigley is not well now and he is getting worse."

 

Given that Zyprexa and similar medications such as Risperdal have been shown to cause early death, Gottstein is reasonable in concluding: "I guess judges decide who shall live and who shall die all the time, although the death penalty is not even allowed against murderers in Alaska."

 

Bill Bigley's hearings were usually held in a room at the Alaska Psychiatric Institute rather than in a courtroom and were usually not open to the public, as most similar court proceedings are supposed to be in order to help ensure due process and protect the person's rights. When hearings are held within such hospitals, they tend to become Kafkaesque, throwing due process and legal procedures out the window, so that coercive orders are made in the absence of evidence that the criteria for coercion (danger to self or others, gravely disabled, least restrictive alternative) are met. Bill Bigley therefore wanted his hearings to take place in a real courtroom and to be public.

 

Anyone in danger of losing their human rights — or their life — through a court proceeding should have someone like Gottstein advocating for them, because he is a tireless advocate, knows the law inside out, and never loses sight of what is true, what is right, and what is humane in its respect for his clients' dignity. He uses a combination of legal principles and procedures with analysis of whether those principles hold water within legal traditions but also outside of those traditions. Not feeling constrained by precedent in court and practice in the mental health system, he is consistently creative and resourceful in trying to find solutions. For instance, pursuing the principle that the "least restrictive alternative" should be tried, and knowing that court orders in cases like Bigley's were usually based on consideration of only two alternatives — drug the person or don't drug them, period — he makes this commonsense, caring proposal that includes a third option:

 

"…when someone is having a meltdown, they can be approached and told, 'Listen, we can't have you doing these things, because of ______________ [e.g., you annoy people or you scare people], so if you don't calm down, we are going to have to inject you with Haldol or put you in restraints or seclusion (solitary confinement). Which would you prefer?' I think some people would prefer the restraints or seclusion over the drug, but I also think there is some chance simply giving them the choice would allow them to calm down."

 

Of course, since this proposal is based on respect for the person and the assumption that they can use reason, consider options, and have agency, it's not the kind of thing that judges tend to accept. Their dual concerns — that they will be blamed if they don't order hospitalization and/or drugs and "something happens," and their tendency to believe the claims of the powerful, well-funded entities like Big Pharma and Big Psychiatric Hospitals — get in the way.

 

As for the psychiatric hospital's representatives, as Gottstein writes, what their continual pushing for forced drugging "demonstrates clearly is API was incapable of treating people without using drugs. This was and remains basically true of psychiatric 'hospitals' around the country."

 

Gottstein wrote this book in part to try to prescribe a roadmap for approaching these kinds of cases, which, he said in an email message to me, includes the need "to treat these cases like the big-stakes litigation they are." His compelling descriptions of his clashes with Lilly and his advocacy for Bigley make clear how high are the stakes and how dangerous to the brave souls who engage in the struggles. But as he poignantly notes, Zyprexa "is still being used on hundreds of thousands of people, including being forced on many. The same is true of the other neuroleptics." Indeed, even many who advocate for victims of the traditional mental health system in their writings and films legitimize and even valorize former DSM-IV Task Force head Allen Frances, despite knowing that he and two colleagues earned just under a million dollars for creating the fraudulent foundation that allowed Johnson & Johnson subsidiary Janssen Pharmaceuticals to deceptively market the dangerous neuroleptic drug Risperdal for an astonishing variety of "conditions" in people from childhood to old age. (For more on this, see my articles "Diagnosisgate: Conflict of Interest at the Top of the Psychiatric Apparatus" and "Diagnosisgate: A Major Media Blackout Mystery.")

 

Gottstein believes, finally, that:

 

"inadequate legal representation is the lynch pin for the massive harm being done to people through psychiatry. If people were being represented adequately the current system would be unable to lock the legions of people up and drug them against their will and would have to find some other way to deal with people diagnosed with mental illness and being disturbing. If PsychRights had the resources to employ just two or three lawyers full time in Anchorage, Alaska for such representations and funds for expert witnesses, I believe PsychRights could break the system and force provision of different approaches that have been shown to work and help people get through the problems they are having."

 

The book's Kindle edition is available for order starting today, January 31. The paperback is now also available for ordering on Amazon.

 

Be the first to comment

A book review of "Acceptance: The Defining Voice of Validation"

First published March 13, 2020, at https://www.madinamerica.com/2020/03/acceptance-book-review/

 

Happily, above the flood of books about whatever the author decides to call—or accepts as defining—"mental illness," with traditional recommendations about what is helpful, usually these days amounting to psychiatric drugging, a humane, nonpathologizing, truly useful volume has appeared. It is psychologist Evelyn Sommers' book, Acceptance: The Defining Voice of Validation, whose writing is clear as a bell and whose voice is consistently of one who walks with the reader who wants to move past earlier, upsetting matters and become "unstuck" in order to get on with a more productive, forward-looking life.

 

As with her previous books—Voices from Within: Women Who Have Broken the Law and The Tyranny of Niceness: Unmasking the Need for Approval—the writing of Dr. Sommers, a Toronto-based clinical psychologist, is an easy pleasure to read and is deceptively simple. In her new book, she identifies a universal problem that at first glance might seem too minimal to warrant serious consideration but that in fact often causes emotional troubles ranging from transitory discomfort to an inchoate uneasiness that can last decades to major psychological paralysis and confusion about what is real.

 

This is no goody-goody book but one that compellingly draws our attention to what in our hurried, overburdened lives too easily gets lost, that is, the essential human need for acceptance and validation. Validation, she says, "is a joining with the distressed person to reflect or give voice to that person's feelings accurately."

 

Early in the book, Sommers writes that a great deal of necessary attention is being paid to the role of trauma in creating emotional suffering, but she makes a powerful case for also focusing on what may seem like minor events that in fact constitute powerful barriers to self-acceptance, self-confidence, and an ability to focus on the future and make choices rather than being stuck because of an event or a comment that the world hasn't recognized as hurtful.

 

Better yet, Sommers offers thoughtful solutions that are easy to understand and begin to practice. She makes us notice things we need to see, that we might have overlooked, and that, once seen, we can use to help ourselves and to avoid causing unnecessary harm to others.

 

Some of the examples in Sommers' book are about children, and one might be tempted at first to think that we cannot create perfect worlds in which no child ever has to navigate dealing with an incident of invalidation, but it is crucial to recognize that one of the few things that psychologists know for certain is that acceptance through validation is what helps developing human beings grow a core of strength and resilience.

 

Furthermore, surely few of us even as adults can say honestly that if, in a work meeting or family gathering, someone is dismissive or demeaning of our point of view, our reactions don't range from feeling unsettled and unsure of ourselves to feeling humiliated and inclined either to silence ourselves or to lash out.  And anyone who has lost a loved one or returned from a war zone can give examples of the devastating—though of course clueless—exhortations some people have offered them to "Move on with your life. You can't grieve forever." Or, as a well-meaning friend urged me about six weeks after my dear father died, when he saw that I was grief-stricken, "You're still so upset. Don't you think you should see someone professional about this (as though the grief were not normal and only a professional could help) and get a little something (psychiatric drugs, of course) to take the edge off?"

 

Precisely because people who speak the invalidating words are rarely aware of their harmful effects and often consider themselves to be doing something for the other person's benefit, it may never strike the person whose reality was upended that that is what has happened. The invalidated person often just feels somehow insecure, ashamed, confused, or frightened and cannot figure out why.

 

Sommers starts with an example from her own life that may at first strike the reader as too trivial to think about: At eight years of age, when spring had arrived but snow had fallen, she one morning resisted her mother's reminder that she put on her boots before heading to school. The child felt clumsy and confined by the galoshes and longed to don lighter shoes and run freely outdoors. When she said, "I hate the snow," her mother, whom she hastens to describe as loving and having good intentions, responded by saying, "No, the snow is pretty" and reciting a poem about it.

 

She doesn't take the easy and too-common way out of pathologizing or even blaming her mother, instead speculating that her mother was "trying to help me accept what couldn't be controlled." But the child not only was not comforted but felt angry at her mother, with the dual consequences of creating tension between them and doing nothing to help the child come to terms with her disappointment and go on to enjoy the day. Had her mother said, "I know you're sick of wearing those boots, but I'd hate for you to sit all day in school in wet sneakers and socks," the child would have had her feelings validated. It wouldn't have taken much to do that, but Sommers acknowledges that, as a parent and grandparent herself, she understands the various pressures of time (have to get the kid to school soon) and emotion (I don't want her to be upset) that can get in the way of stopping to think about how—quickly—to validate the child's feelings and then move on.

 

If that seems like a trivial example, consider that it's never pleasant to feel tension in a relationship that is the most important in one's life, and when one is a child, having the adored adult act as though one's feelings are just plain wrong can—especially if it happens more than once and perhaps even more when it is clear that the adult's intentions are good—make one start to doubt one's perceptions and consider one's emotions and thoughts to be weird or even bad… or invisible to those who matter most to them. Furthermore, children, Sommers writes, "are often unable to articulate what is happening to them, and so instead act out their suffering in ways that make no sense to adults who expect them to be rational." At worst, she says,

 

"Lacking validation of their basic feelings, children learn to view the world as a place dominated by denial of their reality, and they begin to see their worth as conditional on social acceptance. In reaction, they either over-comply with or resist adult demands and then grow into adults who cannot move out of those stuck ways of relating. As a result they may never feel free to make up their own minds about their lives. Still others unconsciously resign themselves to the belief that they can never have validation and give themselves over to the demands of others."

 

Being seen for who we are, especially by those closest to us, is essential to developing a core sense of ourselves at any age. Sommers writes that "Validation is an inferred sense of being seen." In fact, even when we feel joyful, if those around us seem not to share our joy, we can feel uneasy, "overly expressive," embarrassed about our legitimate feelings.

 

Importantly, Sommers broadens the view of sources of invalidation beyond parents, siblings, teachers, friends, and other individuals, writing:

"Governments that create programs and structures that fail to meet individuals' needs are guilty of invalidating people who require them. Similarly, corporations that create myths about people's needs in order to market their products effectively are also guilty of invalidating individuals. The media cannot be forgotten in this list because messages abound in "news," advertising and promotion that lead people to doubt themselves. The corporate source of invalidation is not accidental. Instead, although corporations or governments would not express it in these terms, the implicit intention is to create enough invalidation, self-loathing and insecurity to weaken people in order to then convince them that they will be better off (and validated) by following the advice, programs or pitches that each entity might propose."

 

Helping us to recognize the various, common forms invalidation can take, and reflecting how her approach ranges from the individual to the societal, Sommers names and discusses clichés (e.g., "She's in a better place"); trivializing of suffering ("Don't cry. You didn't fall that hard."); diminishing of the person; diversion from real problems (politicians who claim that gun violence is due to "mental illness"—my example); certain comments presented as "jokes"; established, unquestioned practices (doctors who implement "treatments" that have no proven usefulness and may even be dangerous, because that is the standard of care); and celebrating of diversity while perpetuating in-groups (dominant groups endorsing festivals to celebrate racial and ethnic diversity but being more likely to accept people who look like "the Caucasian ideal").

 

Because she cares about making the world a better place, Sommers packs her book with eminently do-able solutions, beginning by pointing out blind spots that make it hard for us to notice when we commit invalidation and roadblocks to validating another's experience. In that connection, she quotes a client who sent her this note about how she helped him identify his blind spots:

 

"One of the most striking recent discoveries I've made […] in the process of working with you, has been to realize the absolutely awesome power and responsibility a parent has to quietly validate the most microscopic of emotional wounds in their child, and to do this in real time. Critically, these wounds are healed by the child itself, not the parent—and the child possesses equally awesome power to heal itself […] All that's needed is one critical gift from the parent: to strengthen the child's emotional immune system by providing the recognition that the wound actually exists […] Wounds that are not validated by the parent […] accumulate, get infected, fester […] grow in proportion and severity, and can gather unfathomable destructive momentum as the child ages and becomes an adult. If only the parents realized that they, too, just like their children, inherently deserved to exist in a state of healing."

 

Once Sommers describes the common roadblocks to our validating others, it's much easier to catch ourselves committing invalidation. One roadblock is difficulty in staying present, "both physically and emotionally," and she makes useful suggestions for staying present under difficult circumstances, such as when the other person is crying or yelling.

Other roadblocks include but are by no means limited to the use of psychiatric diagnosis, which nearly always leads to the discounting of the experiences of people who are so labeled and even overlooking of their real physical problems such as terminal illnesses; sexism that leads to the dismissive treatment of women's and girls' reports of sexual harassment and assault; ageism that leads to the ignoring or minimizing of old people's suffering; and the unresolved presence of the invalidator's own "fears, preconceptions, and needs."

 

Throughout the book, Sommers reminds the reader that "validation, understood to be acceptance of feelings, is central to being able to progress emotionally by moving through distress," and lack of validation produces "stuckness." Her avoidance of jargon and obscuring verbiage is combined with her deep exploration of nuance and variation in how people can learn to recognize invalidating tendencies quickly and how to correct for them.

 

Should readers wonder whether validating someone means always agreeing with them and supporting them in their choices, she writes that "Validation is at once simple and complex, an acceptance of where someone is in the here and now" and explains that "If you believe someone is misguided you can simply and clearly express your disagreement" after you make clear that you see and understand how they feel. "If you believe someone is doing harm by acting from their beliefs you can still validate [their] being without endorsing or validating views and attitudes with which you don't agree or that cause harm," she says.

 

I cannot do justice here to the depth and subtlety of the insight and guidance Sommers provides, but I can say that after reading Acceptance, I have become more aware of how many times each day I notice that have many chances to validate, ignore, or invalidate the experiences of others—including people who do repairs in my building, cashiers at the grocery store who are often the butts of customers' frustration when the self checkout machines fail to work, family members and friends of all ages—and find that Sommers' suggestions about how provide validation add to my own enjoyment of life.

 

Near the end of her book, she writes:

"The mechanism for validating someone is rather straightforward, hinging on acceptance of the other's emotional state and allowing time for the distressed—or sometimes the happy person—to take in your words. The real challenge is to manage your own emotions and to tolerate others' beliefs or ways of seeing a situation and feelings that differ from your own."

Be the first to comment

Why Must People Pathologize Eating Problems?

First published February 15, 2020, at https://www.madinamerica.com/2020/02/pathologize-eating-problems/

 

by Paula J. Caplan, Ph.D., and Jo Watson

 

The latest issue of the Sunday New York Times (February 9, 2020) had a full-page essay in its "Modern Love" series, in which writer Lauren Covalucci, an intelligent, self-aware woman, describes having been shamed since age three in her ballet class because her tights dug into her waist. At age 13, she writes, "my body had stretched and thinned," and her teacher said to her, "You finally look like a dancer." You might think that would be enough to convince her that such intolerable pressures – which pervade not only the ballet studio but the wider societies of many countries across the globe – are unconscionable and that something is wrong with the perpetrators of those pressures, not with those who are made to feel horribly inadequate and even to hate themselves.

Sadly, Covalucci reports that, after she began feeling better about her body thanks to being in a relationship with a man who treated her well – "Another person's comfort with you can make you forget your discomfort with yourself," she says – her therapist announced that she had an "eating disorder." The result of that diagnosis was despair: "That's when I really plummeted…. I spent mornings on the floor in a corner…, wailing because I couldn't speak in complete sentences anymore and my brain, my beautiful, Harvard-trained brain wouldn't work right." As psychologist Michael Cornwall has written, assigning someone a psychiatric diagnosis is the "infliction of what amounts to a medical curse."

 

Covalucci writes that eventually, she got better, and although she started taking psychiatric drugs that she says helped her it was the ongoing love and respect of her partner that made a huge difference. (She later mentions Prozac, which often causes weight gain, and reports that she has become "fat" and is trying to have a positive attitude about that.) Even when at one point her partner mentions that she has gained weight, because of his loving attitude toward her, "The words lost their venom coming from him." What would have helped, she says, is if her therapist had not told her she had an eating disorder, thus making it seem like she was "mentally ill," that there was some kind of internal, individual difficulty she had rather than that she was responding to terrible pressures from her ballet teacher and society in general.

 

Given that the societal factors leading girls and women to panic about their weight are crystal clear, why didn't her therapist address that with her instead of doing the most harmful thing, classifying her as mentally ill? That, too, would have been helpful, as the work of Prof. Carla Rice, former director of the Body Image Project at Women's College Hospital in Toronto showed decades ago. Once girls and women come to understand that they have been acting out impossibly strict societal standards with regard to eating and that their often distorted images of how they look have resulted from those standards, it is easier for them to begin to challenge them, keeping them in acutely conscious view, and to find other ways to feel good about themselves.

 

Indeed, why is it that so many people, even some astute critics of the traditional mental health system who are happy to challenge the pathologizing of emotional distress generally, cling uncritically to the term and concept of "eating disorders"? We come across it all the time and are genuinely confused and frustrated.

 

A Critical Omission
Those who challenge psychiatric diagnoses overall usually do so because on the whole they lack scientific foundation and certainly lack scientific validity, and are in fact constructs invented by committees of people with vested interests!  Unlike physical illnesses such as diabetes and cancer, there are not, never have been, and are never likely to be objective tests for the so-called psychiatric illnesses. Critics of psychiatric diagnoses generally readily acknowledge that, for instance, "Borderline Personality Disorder," "Schizophrenia," and "Attention Deficit Hyperactivity Disorder" are constructs without biological basis and have been invented and promoted by a collective of powerful people with questionable objectives that are mainly concerned with increasing their profits, power, and territory.

 

It is alarming that too often, "eating disorders" diagnoses have been left out of the critical dialogue, leading to a bizarre situation in which almost every class of psychiatric "disorder" is challenged except this one. Why is it alarming? Why indeed would the pathologizing of emotional distress that involves food, eating, and body image be any more acceptable than the pathologizing of emotional distress that gives rise to obsessive thinking, dissociative experiences, or suicidal thoughts and actions? The concept of "eating disorders" is just as dubious as all of the other so-called "disorders."  It is just as much a construct, and it is no more justified to call it "pathological" than, for instance, good old "PTSD."

 

Traditional mental health professionals have capitalized in many ways on pathologizing socially created problems, and the "eating disorders" concept does this especially blatantly, given the well-documented ways that patriarchal society puts intolerable pressure on girls and women to believe they can never be too thin, persuading them that if they weigh "too much," they will be unattractive to and devalued by men specifically and by society generally. In the process, it has become unusual for girls and women to be comfortable with their bodies, even when they become dangerously thin.

So why do some people who otherwise challenge "mental disorders" claim that the label "eating disorders" is legitimate and must be retained? One argument is that "It's a biological problem, fundamentally physiological!" But the fact that depriving oneself of or bingeing on food has physical consequences no more justifies calling such behavior psychiatrically disordered than it would justify creating the concept "sprained ankle disorder."

Like most people who take comfort in being psychiatrically labeled, some women and men may suppose that the therapist gave them a label because he or she believes they are suffering. But that validation could be achieved by the statement, "I believe you are suffering," which would not add to their burden by conveying the notion that they are also "sick."

Besides masking the powerful social factors causing eating problems, to diagnose someone with an eating "disorder" is to make it extremely likely that they will be told something is wrong with their brain and that they need psychiatric drugs. Also, because severe restriction of food can have, at worst, fatal effects, caring family members may understandably agree to have the diagnosed person hospitalized, and sometimes even ask for this. But once hospitalized, in far too many cases, the person is increasingly medicated and stripped of their sense of agency.

 

Case Study
Consider the not unusual case of a teenage girl who had starved herself in reaction to her parents' ignoring her pleas that they get a divorce because she could not bear their constant fighting and her father's demeaning of her mother. Her parents resisted, though both of them longed to be out of the marriage, instead of staying together "for the daughter's sake." Talk about turning her reality upside down! When she was hospitalized in a psychiatric ward, her therapist advised her parents to forbid her to participate in the extracurricular activities she adored, where her immersion in the arts and her warm friendships were important in giving her strength to endure her difficult home life.

 

Allowing her to go home on a brief visit, the therapist also told the parents, "If you put 15 grapes on her plate, you have to make her eat all 15 grapes." Thus, she was deprived of her sources of emotional sanctuary and infantilized, just as her parents' and the doctor's pathologizing of her as the source of the problem involved a stunning lack of respect and regard for the suffering caused by her home situation. And all the while, no one addressed the forces that led to her using starvation as a coping mechanism: her father's demeaning views of real women and society's message that the route to happiness and regard is through weight loss. Many unhappy women go on strict diets when they feel that important parts of their lives are beyond their control, but dieting is something they can control.

 

What would likely have helped that young woman would have been if first her parents and therapists had really listened to the pain that her parents' awful relationship and her father's demeaning view of women were causing her, and then had worked with her to find ways to reduce that pain. Both parents could have considered her needs rather than the abstract principle that even a terrible marriage should continue because it is better for the child than a divorce. The psychiatrist could also have helped the daughter to spend more time and energy in rewarding activities like her choir practice rather than forbidding them unless she ate what the therapist considered to be "enough." He could also have helped her find ways to gain a sense of agency, given how helpless she was feeling, living with parents who were miserable and a father who demeaned women. And he could have helped her find ways to earn friendship, love, and respect other than by trying to become impossibly thin.

 

A New Perspective
The Power Threat Meaning Framework for considering emotional suffering could offer an infinitely more hopeful and respectful way of responding to eating distress than the traditional illness narrative imposed by psychiatry.  Lucy Johnstone, lead author of the article "The Power Threat Meaning Framework: An Alternative Nondiagnostic Conceptual System" published in the Journal of Humanistic Psychology, includes this advice:

"The Power Threat Meaning Framework can be used as a way of helping people to create more hopeful narratives or stories about their lives and the difficulties they have faced or are still facing, instead of seeing themselves as blameworthy, weak, deficient or 'mentally ill'."


This framework is a way to understand that "what may be called psychiatric symptoms are understandable responses to often very adverse environments and that these responses, both evolved and socially influenced, serve protective functions and demonstrate the human capacity for meaning-making and agency." The adverse environments of the woman and the girl described above were clear and starving themselves was in both cases a way to try to take some control over how people evaluated and treated them. So helping them to understand that the adverse factors in their environment were unreasonable, inhumane, and harmful; to consider other ways to think about themselves; and to find different, life-enhancing, life-enriching, self-respecting, safe ways to feel a sense of belonging, being loved, and caring for themselves would have been natural outgrowths of a Power Threat Meaning approach to so-called eating disorders.

 

The Power Threat Meaning Framework would suggest that eating problems should be understood not as a symptom of an illness but as a reaction to difficult experiences, as a threat response, a way of surviving the intolerable, that will on every level make sense. The Framework is ultimately about the process of that sense being made, and surely few would disagree that there are always reasons, always stories behind every type of eating problem.

 

We both remember too many reasons and stories, just as we remember too many women who we've come across over the years who had internalized the belief that they had/have an "eating disorder."  Just like any other psychiatric diagnosis, it has all too often robbed them of their power, taken away their agency, stolen their hope. The diagnosis of "eating disorder" in all its forms is as much a curse of psychiatry as any of its numerous others. Isn't it time we called it that?

 

Be the first to comment

The Invisibles: Children in Foster Care

Initially published on December 30, 2019, at https://www.madinamerica.com/2019/12/invisible-children-foster-care/

 

For people who have recently lost a loved one, holidays that others seem to be happily celebrating are hard. For the uncountable thousands of children of refugees whom the United States government has taken from their parents and put in cages, isolation from their families must be excruciating. But what about the nearly half a million foster children in this country, who are even less visible than refugee children, rarely the subjects of media reports except in the case of a death or a lawsuit? How are the holidays for current and former foster children? To be sure, some foster parents are loving and supportive, but far too often, being a foster child means something terrifyingly different.

 

I learned this 40 years ago when I was working as a psychologist at the Toronto Family Court Clinic in Canada. Some of the people we were asked to evaluate were children or youth deemed neglected or abused by Children's Aid Society (CAS) workers. Each time one of us clinicians was asked to recommend whether to leave the person in their home or send them to foster care, it pained us to know that there might be pros and cons for each option. We couldn't be sure whether or not a child who was living in a home where there were difficulties had a strong love or need for their parent(s), and we knew that, while some foster parents were wonderful, others were cruel (and some that had seemed wonderful turned out to be terrible). In still other cases, the foster parents were just a bad match for a particular child.

 

We also knew that in order to acquire greater certainty, we would have had to do far more observation and information-gathering than we had time for, and that in some cases, only the passage of time would reveal what mattered most, but that might be too late for the child. When what is at stake is nothing less than the security and happiness of a human being, these uncertainties and practical barriers often leave the frontline workers and clinicians feeling all at sea, helpless to find the truth but given the task of making crucial recommendations.

 

Forty years ago, both the children and teenagers who were in the system and their birth or adoptive parents were likely to be labeled as incorrigible, resistant, unworkable, and "mentally ill" and to be much less able to resist the system's dictates if they were poor and/or belonged to racialized groups than if they were white and wealthier. Times have changed far too little. Two major changes in recent decades have been the explosions in the use of psychiatric labels and prescription of psychiatric drugs for children — not just by psychiatrists but also by other clinicians and frontline workers (many of whom are quick to recommend the drugs even if they themselves cannot prescribe them).

 

Being a Foster Child
Please join me in imagining trying to live through just one of the following kinds of trauma, keeping in mind that many foster children experience more than one and often all of them:

--Being moved often — dozens of times not being rare; never knowing when one will be moved yet again; being shifted from one school — and thus one teacher and set of classmates — to another
--Never feeling loved and secure
--Being abused by foster parents or siblings
--Being diagnosed as "mentally ill" even though one is feeling utterly understandable grief, terror, and/or rage at being separated from one's original family or at never having felt secure and loved even in that original family
--Feeling overwhelmed, bewildered, unseen, and unheard as the system moves one around, often with little or no attention to what is helpful
--Having little chance to learn social and other skills for coping with everyday problems, never mind those that plague foster children
--Being put on psychiatric drugs that are more likely to harm one's body and brain than to help in any way (see Robert Whitaker's Anatomy of an Epidemic)
--Turning to illegal drugs to dull the grief, abandonment, helplessness, and/or despair
--Sliding into the juvenile justice system and later the adult prison complex because of how one expresses painful feelings or because, once turning 18, one has no way to support oneself and begins stealing food or dealing drugs just to get by
--Imagine homelessness, literal homelessness after long years of emotional rootlessness.

 

Jana Kaplan, a former foster child now in her sixties, summed it up well when she told me that foster children are "bromeliads, sometimes called 'air plants.' We grow without roots, without soil."

 

What the Numbers Show
All of this is documented in a welcome (and unusual) six-part investigative series published this month in the Kansas City Star, to which Kaplan drew my attention recently. Based on a year's worth of research by reporters Laura Bauer, Judy L. Thomas, and Eric Adler, the series, titled "Throwaway Kids," shines a spotlight on the vulnerability of foster children and on a Senate initiative to address their needs and growing numbers. The series is one every American should read and never forget.

 

The reporting team found that 23,000 children go into foster care each year, and in 2017, 443,000 children in the United States were in such care, an increase of 12 percent from five years earlier. They then recount the kinds of problems that send children into foster homes, including poverty and the kinds of neglect that are fairly easy and inexpensive to fix.

 

Part Two of the Star series includes this stunning news: Despite U.S. Congressional action in 1980 that set family preservation as a higher priority than removing children from their families, only a small fraction of all monies spent in the child welfare system is used for that purpose: "Collectively, in child welfare budgets across America, more money is spent on investigating families than on trying to keep them together — 17 percent for child protective services versus 15 percent for in-home preventive services."

 

As a result, "Kids who could have stayed in their homes take up beds in good foster homes that are needed for severely abused and neglected children whose safety is in jeopardy. Because of that, kids from Oregon to Florida and states in between are forced to sleep in child welfare offices or homeless shelters."

 

According to the Star, the National Council for Adoption estimates that the yearly foster care cost per child is about $25,000, whereas the cost of preserving a family average only $5,000-10,000 per child. But even if the cost of family supports were higher, is it fair to compare the immeasurable value of keeping children where they may be otherwise secure and loved to the monetary cost of helping their parents stay or get out of poverty? These efforts could include providing comprehensive, low-cost or no-cost health insurance, so that a family member's illness doesn't send the household spiraling into poverty, or providing practical, community-based help and moral support to a parent who is ill or coping with someone else's illness to prevent their being deemed negligent of their child, who is placed into foster care as a result. A woman who stays with an abusive partner because of a realistic fear of not being able to feed her children without the abuser's financial support would also benefit from financial help, and one who stays because she fears the abuser will implement threats of more physical violence if she leaves could certainly benefit from both moral and practical supports to help her do so rather than having her children taken away.

 

While politicians and other talking heads in the media describe the economy as thriving, they ignore those at the low end of the income scale, and clearly, child welfare matters more than money. Sadly, though, as a nation, the U.S. generally harshly judges rather than genuinely helps poor people. Years ago, Barbara Ehrenreich commented on this judgmental attitude's creation of a barrier to change, making the tongue-in-cheek suggestion that the government give the poor enough money to live on decently… but subject them to public shaming on a regular basis.

 

Possible Solutions… and Barriers to Implementing Them
To be sure, some families are dangerously neglectful or abusive. For those parents whose drug or alcohol abuse leads them to mistreat their children, stricter government oversight of doctors who hand out drug prescriptions like candy and states paying for and directing parents into proven substance-abuse programs would be far better than removing their children from an otherwise loving home. The alternative is sending them into the black hole of foster care, playing Russian roulette with the children's need to feel cherished and secure.

 

Regardless of the justifications offered for taking children into foster care, classism and racism plague the system today, just as they did four decades ago. "Black children enter foster care at a significantly higher rate than white children," according to the Star, and poor families and families from racialized groups are more likely than wealthier and/or white families to be punished in this way for being "dysfunctional" or having a physically messy or dirty home. Too often, child welfare workers — whether because they are overworked or for other reasons — don't see, or consider, the love between parent and child in such situations.

 

Furthermore, once the child welfare system connects with a family, those who are poor or from racialized groups tend to lack "the money or power to push back against government intervention," according to attorney Ira Lustbader, an attorney who represents children in class action lawsuits.

 

Where is the legal system in all this? In the past 40 years, nearly three dozen states have faced lawsuits citing foster care abuses, a remarkable figure in light of the powerlessness of foster children. But even in Illinois, a state that had improved its foster care system, a recent lawsuit was necessary to get it to stop transporting foster children in handcuffs and leg shackles. Alarmingly, the Star's review revealed that some states are currently being sued "for the same issues that plagued other systems 15 to 20 years ago," and a recent Rhode Island lawsuit alleged that "children in Rhode Island are more likely to suffer abuse or neglect if they are in foster care than if they are not."

 

Outcomes
What happens to children who go through the foster system and then age out of it at just 18 years old? More than 4,000 of them become homeless each year, thus making them subject to sex and/or drug trafficking. Former foster children are about half as likely to graduate from high school as are their peers, the Star found.

 

The reporters also surveyed prison inmates and found that one in four had been in foster care, some of whom reported moving more times than they had birthdays. Compare that to the mere 3 percent who graduate from college. The journalists also quoted Gerald Marshall, a 37-year-old Texas death row inmate, who observed, "The state that neglected me as a kid and allowed me to age out of its support is the same state that wants to kill me."

 

And consider those foster kids who, even if they have not ended up in the prison system, have been slapped with psychiatric labels and put on psychiatric drugs. These young people can suffer for the rest of their lives from the woefully mistaken belief that, because they were so labeled, they are "mentally ill," defective, or twisted. As documented in Robert Whitaker's book Anatomy of an Epidemic and countless Mad in America articles and webinars, the negative consequences of taking these drugs even briefly, and the effects of withdrawing from them, can last for many years.

 

Uncounted millions of former foster children remain invisible — at holiday times and throughout the year — in the loneliness and rootlessness that they feel. This is true even for many of those who have stayed out of the prison system, graduated from college, raised children, and contributed in many ways to the good of society. They deserve our attention and our care.

 

 

What's to Be Done?

What can parents do when they see that the authorities plan to take their children from them? I would say they can hire a lawyer, but that means either having enough money to do that or finding attorneys or other entities that provide legal help pro bono. And it's not as though family courts are devoid of racism and classism, as well as rampant mother-blame, so even if parents get their day in court, there's no guarantee that even deserving ones will be able to keep their children. Such parents can also assert their rights under the Adoption Assistance and Child Welfare Act, the 1980 legislation mentioned above, which mandates a focus on keeping children in their original home and trying to help and preserve the family, by contacting local and state officials. But do I have faith that that will change the system? Not much.

 

One useful step that any of us can take is to contact the bipartisan Senate Caucus on Foster Youth, co-founded by Republican Sen. Charles Grassley and Democratic Sen. Mary Landrieu, now chaired by Sen. Grassley and Sen. Debbie Stabenow. Their goal, they say, is to break the silence about current and former foster children and they have listened to them, leading to the passing in 2018 of the Family First Prevention Services Act, aimed at keeping as many children as possible at home… and safe. We can express appreciation for the Caucus's work and ask how we can help.

 

We can also urge our legislators to support the Fostering Stable Housing Opportunities Act, now making its way through the 116th Congress, which would give foster youth access to affordable housing when they reach 18.

 

And no matter where we live, we can contact our representatives in the U.S. Congress and our state legislatures and governors to ask them to increase expenditures to help struggling families. And we can demand they ride herd on the vast array of abuses that plague the foster care system, crushing the souls of children who deserve so much better.

 

Be the first to comment

How Long Have the Children Been Gone? U.S. Government's Separation of Refugee Children from Parents

by Paula J. Caplan
 
It's easy to lose sight of major tragedies in a world filled with them. That makes it essential to personalize suffering, to connect it to our own experiences. Any parent who has dropped off their child for the first day of daycare or preschool and found the child's anguish and even fear painful to see can only begin to imagine how it is for both refugee parents and children whom the United States government has torn from each other and kept separate for months…or longer.
 
During the Iran hostage period, newscaster Walter Cronkite never let the nation forget what was happening: Each night, he announced the number of days that had passed since the start of the Iran hostage crisis. In contrast, while uncounted and even uncountable numbers of children of refugees are being held in isolation from their parents in the United States, warehoused as punishment for the parents' search for a better life or their desperate flight from dangers in their home countries, these tragedies go off media people's radar and out of the minds and hearts of the public except on rare occasions. We shouldn't have to wait for another refugee child to die to keep these horrors in front of us.
 
I couldn't get out of my head the images of these children and could not stop imagining them wondering, "Where are my parents? Don't they love me? Will I ever see them again? Who are these people who come in here and speak in a language I don't understand Why doesn't anyone hug me? Why is it freezing in here? Why do I have to sleep on this hard floor with only a thin cover? Why do they stick needles in me with medicine that makes me feel awful? [Some of the children have been injected with psychiatric drugs.] What did I do wrong?"
 
I began by contacting Veterans For Peace Former National President Mike Ferner and VFP Cofounder and current Maine VFP Chapter President Doug Rawlings, whose encouragement and assistance helped lead to the creation of a coalition aiming to keep the current horrors about the children constantly before the public.
 
On Human Rights Day, December 10, 2018, a dozen human rights and violence/trauma organizations and more than three dozen individuals working in these fields issued a press release called "Who's Keeping Track? A Call for Continuous Media Attention on the Separation of Children from Refugee Parents." The crux of the release was a call for major U.S. news media outlets to dramatize the growing number of days these separations have lasted by asking them to follow Cronkite's example, announcing every day how many days have passed since the first children (as far as can be determined) were taken from their refugee parents. Also included in the release was a link to a petition where all can endorse the call: https://www.thepetitionsite.com/takeaction/387/953/389/
 
Our coalition recognizes that this seems to be a small step, but every day that the public forgets these horrors is another day the children and parents suffer, another day the government gets away with continuing the nightmare and in fact increasing these separations. Furthermore, stories about Cronkite's daily announcements by Washington Post columnist Ellen Goodman and Public Radio International (at 11:58) show how powerful they were. 
 
When no media response was forthcoming, the coalition created the howlonghavethechildrenbeengone.com website, which displays a clock ticking the seconds away, with this message: 
"This clock shows the amount of time passed since the first child -- as far as can be confirmed -- was separated from their refugee parent(s) on April 6, 2018. Undoubtedly, these punitive separations had been going on even before then. Please watch the clock, and put yourself in the position of such a child -- and then of their parent -- and vividly picture what it is like, one second at a time, to be going through what they are experiencing." 
 
The coalition's members hope that viewers will imagine how profoundly it affects the children to wonder why this has happened, whether their parents allowed it to happen, whether their parents love them, why no one speaks to them in their language, why it is so cold where they are warehoused, why no one hugs them, and why – for some – they are injected with drugs that make them feel horrible and/or sexually abused.
 
The website will remain up until the practice ends.
 
Veterans for Peace was the first organization to sign on to the initiative, and the other original signatory entities were the Association for Women in Psychology; Foundation for Excellence in Mental Health Care; Institute on Violence, Abuse, and Trauma; International Museum of Human Rights at San Diego; National Association for Rights Protection and Advocacy; National Partnership to End Interpersonal Violence; National Latinx Psychological Association; Psychoanalysis for Social Responsibility, Section IX of Division 39, American Psychological Association; Psychologists for Social Responsibility; and Psychotherapy Action Network. Subsequent endorsers are Eve Ensler's V-Day Project, Robert Shetterly's Americans Who Tell the Truth, ChildUSA, and the Academy on Violence and Abuse.
 
The press release included our statement that in the past year, "to the best of our knowledge, 2,667 babies and children were separated from their refugee parents for an average of 83 days each, though recent news is that the number may well be twice that high. Of those, 140 are yet to be reunited and 30 will not be returned to their parents.  The trauma and emotional devastation and damage to these children, as well as to their parents, are unconscionable and in some cases will be irreparable. One lawsuit already filed even alleges children were injected with powerful, dangerous psychiatric drugs."  
 
Still worse, the actual number of separated children may never be known, due to a combination of the government's covering up of the facts and shockingly irresponsibly poor record-keeping. https://www.pbs.org/newshour/nation/why-we-may-never-know-the-true-number-of-family-separations?fbclid=IwAR109-vcygENzMlQqOPRfys66Nxs_WAjuM1Xgm94BpY90XJ11d7XE-7W__g
 
Recognizing the impossibility of learning when the practice actually began, the coalition's clock starts from April 6, 2018, when U.S. Attorney General Jeff Sessions initiated what was called a "zero tolerance" policy and directed U.S. Attorneys to prosecute for illegal entry all those apprehended along the Southwest border. Part of the policy of prosecution was to separate parents from their children, and it has emerged that government agencies failed even to record the movements and locations of some children and some parents, making their reunification virtually impossible.
-
Leaders of the National Disability Rights Network, whose Protection & Advocacy (P&A) members are among the few people allowed entrance to places where these children are being held, said in a December 18, 2018, press release that after visiting more than 25 facilities in eight states, they had "identified children with a wide variety of disabilities (Intellectual/Developmental, Psychiatric, and Deaf) and unmet needs." They warned that problems identified in these facilities included "drugging, lack of education and treatment." They reported that during some of their monitoring visits, staff at the facilities "have stated that there are no children with disabilities in the facility, yet [the P&As] could see children who appear to have disabilities during the visits."  They called the treatment in at least some facilities "in question" and noted that their distance from potential sponsors and/or family affects "both their bond with caring adults and also their family's ability to monitor their conditions of confinement."
 
Other problems the P&As noted were "lack of reasonable accommodation for children with disabilities, …little evidence of treatment for children with disabilities of all sorts," poor and inconsistent provision of education, and isolation of children from the community.
 
When a source who requested anonymity was asked why some among the relatively small numbers professionals and activists who are allowed to enter the children's holding facilities have not videotaped the conditions and made them public, their response was that that would likely lead to still further restrictions on who would be allowed access.
 
 "The welfare of these children has too quickly passed largely out of view of the public. We urge the media to move quickly to ensure ongoing media coverage of this massive human tragedy," said Sandi Capuano Morrison, CEO of the Institute on Violence, Abuse, and Trauma.  
 
A Democracy Now! Interview with a coalition representative is at https://www.democracynow.org/2018/12/19/mental_health_experts_rights_groups_call

 
 

Be the first to comment

To Warn or No To Warn: A Critique of MIA's Use of Diagnostic Terminology

Initially published June 18, 2019 at https://www.madinamerica.com/2019/06/critique-diagnostic-terminology/ Please note that this was written about the publication MadInAmerica (MIA) and its policy about naming psychiatric diagnosis. Robert (Bob) Whitaker is the founder of the publication and the author of the extremely important book, Anatomy of an Epidemic, a scrupulously researched book about the truth about psychiatric drugs.

 


By Paula J. Caplan, PhD
June 18, 2019

I appreciate Bob Whitaker's encouraging me to write this essay after I had written to him several times over the years to express concern about how Mad In America deals with psychiatric diagnoses. Below, I will report his responses to my concerns and my replies to those.

 

I need to begin with some history, so that readers will understand why I feel so passionately about an MIA practice that might seem to some to be relatively trivial.

 

In 1985, I had been teaching the Diagnostic and Statistical Manual of Mental Disorders as an advocate, believing the advertising produced by its publisher, the American Psychiatric Association, and by its Task Force leader Robert Spitzer, to the effect that it was a scientifically-grounded document. Then, through a series of events described in They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal, in 1988 I accepted the invitation of DSM-IV Task Force head Allen Frances to serve on two DSM-IV committees. In that capacity, over two years I received internal communications, mostly but not solely with regard to the two DSM labels "Self-defeating Personality Disorder" and "Premenstrual Dysphoric Disorder," and through these I was shocked to learn that the ways that "abnormality" and its varieties were chosen and described within the manual were extremely far from scientific (this troubled me all the more because I am an author of a textbook about research methods) and that those heading the Task Force minimized and even denied harm that getting any of their labels could cause. When I utterly failed to persuade them to come clean with the public about the unscientific nature of the labels and their criteria and to warn of the harm they could cause, I felt I had no choice but to resign on moral, ethical, and professional grounds.

 

Since then, the more I have spoken and written publicly about these matters, the more I have learned two kinds of things. One is that there is a vast array of approaches to reducing human suffering that do not involve calling sufferers 'mentally ill' and that are proven to be effective. The other is that I have received letters, email messages, and in-person reports from thousands of people whose lives were variously harmed or ruined and from loved ones of labeled people whose lives were ended due to sequences of events that began with a psychiatric label.

 

I have called psychiatric diagnosis "the first cause of everything bad in the mental health system." https://www.youtube.com/watch?v=-qIQqRl94_Y&t=22s     If they don't diagnose you, they cannot "treat" you, whatever that means in various contexts. But once they give you even what sounds like the most innocuous label (often Adjustment Disorder is named as the least dangerous), there is almost no limit to what they can do to you in the name of "treatment"… and too often, they escape all accountability because the diagnosing and the kinds of treatment that tend to follow are considered "standard of care."

 

Since few laypeople (and even surprisingly few professionals) have any idea about these facts concerning psychiatric diagnosis, when they are suffering and seek help in the mental health system, they rarely even know to ask the therapist such questions as, "Do you have to give me a diagnosis? If so, which one will you be giving me? What steps are you taking to protect me from the many kinds of harm that can result from getting a psychiatric label? If you are going to recommend ways for me to feel or function better, how are you going to decide what to recommend, given that treatments based on assumptions about unscientific categories might help me but might be harmful and might not work?"

 

Furthermore, the mental health establishment that uses these labels and falsely claims that they are "scrupulously scientific" (in the words of DSM-IV head Allen Frances describing his edition), helpful, and not harmful has vast wealth and media access. Mad in America has reached huge audiences and successfully educated untold numbers of people about the truth, but even MIA and other publications that challenge traditional practices still have a long way to go to reach and persuade as many people as does the establishment.

 

As a result, when anyone in the few challenging publications uses any psychiatric diagnosis without signaling that they are constructs and unscientific, I feel alarmed for those who will be strengthened in their mistaken beliefs about the labels. An example would be an article about a researcher's study of "children who have ADHD." Some people have learned to challenge what the DSM and APA brass claim, but for those who trust that what they read on MIA is far more likely to be well thought out and true and thus not misleading, I am especially concerned about their vulnerability to the reification of the categories by MIA specifically.

 

There are simple ways to signal that these diagnoses are constructs and unscientific, and over the years, I have repeatedly expressed my concerns to MIA when they publish pieces in which psychiatric diagnostic terms are used without a single mention of the fact that they are NOT scientific, that it is NOT helpful to use these terms when trying to alleviate suffering or help people change their behavior IF THEY WANT TO, and that getting ANY psych label exposes one to a vast array of kinds of harm, and that there are MANY other approaches that do NOT involve pathologizing or drugging and that have few or no risks and are shown to be effective. I have begged MIA to stop this practice and instead, for instance, simply to put all such labels in quotation marks or to include a simple sentence such as, "This is a review of a research report about children who have been given the ADHD label, which is not a scientifically supported entity" or "Our study was of people who had been given the Bipolar Disorder label, so since it is known that this label does not represent a scientifically supported entity, we ensured that our participants all reported struggling with changes in mood they felt they could not control."

 

In the June 9, 2019 MIA weekly newsletter, an article is described as showing "how genetic models of 'schizophrenia' explain very little." This is a perfect and very simple and unobtrusive way to solve the problem. And in articles, the first time a psychiatric label is used, it can be put in quotation marks followed by a note that it is in quotation marks this first time it appears in the article because it has not been shown to be a scientifically valid category, but that the reader is urged to think of quotation marks going around the label each time it appears in the piece.

 

MIA reader and longtime advocate Amy Smith suggests a couple of other approaches: One is to run a succinct header or footer on every page of articles that include mention of psychiatric diagnoses, making MIA's positioning clear, and, in her words, "proudly wearing their ideology on their sleeve," since it is clear from most of the content of the publication's articles that they aim to publish the truth. Her other suggestion is that for specific articles that are glaring in their use of unscientific constructs, MIA could insert a "Note from the editor" in between the title of the article and the body of the text to make this kind of point as it relates to that article.

 

Bob Whitaker, who knows I have tremendous respect for his own many scrupulous pieces of research and writing, has replied to these suggestions by stating that he sets the editorial rules for MIA and does not plan to change in response to my concerns. He replied further that MIA has "many blogs published deconstructing [psychiatric diagnoses], and published reviews of articles published in journals with that theme." Given the overpowering and pervasive extent to which "psychiatric diagnosis as truth" has permeated Western culture and is fast spreading to other parts of the globe, and given that not every reader reads everything published on MIA, I don't think this is sufficient justification for failing sometimes or at all to implement the kinds of solutions suggested above.

 

Bob also wrote to me that MIA is using psychiatric diagnostic terms because they signal "societal speaking about this diagnosis that exists in our society, and not because we are saying it is valid." I find this frankly alarming. There are many terms that, for instance, are sexist, racist, ageist, etc., that either now or previously have been widely used, and the harm that goes with their use is perpetuated and can rub off on readers. In addition, how in the world is a reader supposed to know that in a particular MIA piece, a diagnostic term is not supposed to be thought to be valid if there is no disclaimer to make that clear?

 

Finally, Bob wrote that "To put quotes around [psychiatric labels] every time just becomes superfluous, and in reviews of science articles reporting on that diagnosis, would just put us in the position of wearing an ideology on our sleeves that would discredit our reviews." I have two responses to this:

(1) As a longtime editor myself, I am aware that one of the solutions suggested above allows for more editorial elegance than do the others. Fine. I don't care which solution is implemented when. Just please consistently convey the truth rather than helping perpetuate harmful untruths.

(2) I would think a greater concern about ensuring that MIA publishes credible assessments of scientific research would be not avoiding "wearing ideology on its sleeve" but rather omitting the extremely important information that the studies under review were based on the use of psychiatric categories that have been shown to be unscientific, unhelpful, and often harmful. Doing the latter means that such reviews would include the whole truth, not omitting the parts that someone is scared will make them look biased.

 

I hope that Bob will reconsider the MIA policy about this matter.

Be the first to comment

Hatred and Violence: The Pittsburgh Murders and Thoughts About Actions to Take

I have recently read about what happened in and around Vilna as the Nazis came to power, and it is uncanny and terrifying in that context to hear the tragic news of the shootings of Jews in the Pittsburgh synagogue both because of the deaths and injuries of those victims and because they took place in an increasingly hate-filled nation whose President and his supporters feed anti-Semitism, racism, misogyny, xenophobia, homophobia, and transphobia.

 

I find myself flailing around, wondering what we can do beyond what we are already doing. VOTE, of course.

 

But people I talk to feel both powerless because there is so much of this hate and so much condoning of violence at the highest levels of power in government and in the NRA that it is hard not to despair about the difficulty of rooting all of this out. But there are entities fighting hate that we can support. My mother's father, Nate Karchmer, was an early supporter of the Anti-Defamation League, which has long fought anti-Semitism and also made common cause with the targets of racism. And in the wonderful book, World of Our Fathers (apologies for the sexism in the title), I learned for the first time about the HIAS (Hebrew Immigrant Aid Society), which well over a century ago helped and supported Jewish immigrants to the U.S. The Pittsburgh murderer apparently loathed the HIAS, accusing them, Trumplike, of bringing in immigrants who kill people. Tonight I heard someone from HIAS say movingly that HIAS was established to help certain immigrants because they needed help and were Jewish, but lately, HIAS has aimed to help all immigrants, because those in HIAS are Jewish...and consider it of fundamental importance to provide that service.

 

The more that members of all oppressed groups, all groups targeted for hate speech and violence (and someone from the ADL said on TV tonight that hate speech becomes hate action), band together, the more reason there is to hope.

Be the first to comment

Science Takes a Major Hit with Firing of Dr. Peter C. Gotzsche from Previously-respected Cochrane Collaboration

The public ought to be able to have confidence in scientists' claims, especially when those claims can have immediate impact on their lives. However, far too much research in medicine and psychology has been skewed, even sometimes purposefully faked, as a result of the influence of companies that manufacture drugs and medical devices and that fund that research. 

 

Until recently, the Cochrane Collaboration has been a stellar and rare example of an entity from which issued scrupulously careful, unbiased analyses of bodies of research were issued, allowing the scientific community and the general public to have justifiable confidence in their conclusions. They appeared uniquely unaffected by industry, so that consumers and practitioners would not be at the mercy of a medical or psychiatric journal article (usually written by someone whose research funding came from the company manufacturing the drug being studied) or of a popular publication's science writer's sometimes inaccurate portrayal of what the research truly showed.

 

On September 13 of this year, Cochrane Cofounder Dr. Peter C. Gotzsche, a Cochrane Board member and Director of the Nordic Cochrane Center, was abruptly expelled from the Board and from Cochrane altogether. The move was frightening for three reasons: (1)Because of the apparent reason behind it, (2)Because of the way it was done, and (3)Because it shatters confidence in Cochrane, when it's so hard to find other truthspeakers about medical and psychiatric/psychological research. http://www.deadlymedicines.dk

 

M. Arbyn, L. Xu, C. Simoens, and P.P. Martin-Hirsch from Cochrane had published a major review of vaccines like Gardasil, whose manufacturers and many well-meaning people have been strongly urging parents to have injected into their children as young as age 11 (the U.S. Center for Disease Control's reoccmmendation) in order to prevent human papillomaviruses (HPV). Arbyn et al. reported no evidence that such vaccines cause harm 
https://www.ncbi.nlm.nih.gov/pubmed/29740819?dopt=Abstract

 

Subsequently, Dr. Gotzsche and his colleagues Lars Jørgensen and Tom Jefferson published a perceptive, solidly argued and strongly-supported critique of the above review. In that review, titled "The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias,"
https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012
they showed that there is indeed compelling evidence of serious kinds of harm, including deaths. The negative effects of these vaccines therefore could not have more severe implications for the public -- and doctors who advise use of the vaccine -- to know about.

 

Jorgensen, Gotzsche, and Jefferson show that the unwarrantedly sunny Arbyn et al. review was characterized by incomplete reporting of data and its authors' ties to industry:  "The Cochrane review only has four authors; three of whom had such conflicts of interest a decade ago. The review's first author currently leads EMA's 'post-marketing surveillance of HPV vaccination effects in non-Nordic member states of the European Union, which is funded by Sanofi-Pasteur-MSD that was the co-manufacturer of Gardasil."

 

In what Dr. Gotzsche calls a show trial, his expulsion was implemented although Cochrane's hired counsel had found no evidence of his wrong-doing. http://www.deadlymedicines.dk Had Cochrane's Board tried harder to think of a way to render obvious their motives for getting rid of Dr. Gotzsche, it's difficult to think how that would have been possible.

 

As a specialist myself, for decades, in research methods, and as author with Jeremy B. Caplan of a textbook about research methods https://www.amazon.com/Thinking-Critically-about-Research-Gender/dp/0205579884/ref=sr_1_1?ie=UTF8&qid=1538332545&sr=8-1&keywords=thinking+critically+about+research+on+sex+and+gender&dpID=5150rJj8XTL&preST=_SY291_BO1,204,203,200_QL40_&dpSrc=srch, I have long been alarmed by the amount of sloppy science that is promoted by powerful entities -- drug companies, medical device manufacturers, the American Psychiatric Association, to name a few -- as truth. And for decades I have listened to those who have been victimized by the false advertising based on that sloppy science that holds out the promise to people that if they just take this pill, get this injection, use this medical device, their suffering will end, or they will avoid future suffering. 

 

Are there honest medical and psychiatric/psychological researchers who scrupulously design and carry out research and then responsibly describe their results? Of course. But they are too rare, which makes the firing of Dr. Gotzsche and the corruption of Cochrane tragic.

Be the first to comment

Points of View, Politics, and Ongoing Pain from the War in Vietnam

I hope that thoughtful people will read this essay and consider how different experiences and different perspectives bear on the sequence of events I shall describe.

 

I am not a military veteran, but my late father was, and I have spent more than a dozen years listening to veterans from all eras, advocating for them and their families, making films about them, and making a Public Service Announcement series called "Listen to a Veteran!" These experiences have taught me much about the too-frequent chasms between veterans and nonveterans, and it means a great deal to me to try to bridge those chasms. You can only begin to imagine, I suspect, how troubled -- no, devastated -- I was by a series of recent events involving veterans from America's war in Vietnam, a war whose legacy has been tremendous conflict among Americans, confusion, pain, and moral anguish. 

 

The events about which this essay is written began when I read an article in Smithsonian Magazine and wrote a letter to its editor in response. The article was called "The Ghosts of My Lai" and included the statement that Vietnam veterans were called baby killers. First I shall tell you the content of my letter to the editor as it was published in the March 2018 hard copy edition of the magazine. It was:

 

Contrary to your suggestion, Vietnam veterans returning from the war were not called "baby killers," according to scholars who have reviewed news media reports and other sources from that time. In fact, government officials, trying to garner support and shift the public focus away from the war's realities, promoted the myth that antiwar protestors aimed that epithet at veterans. It was LBJ who was called a baby killer.  The letter was signed Paula J. Caplan, founder, Listen to a Veteran, Rockville, Maryland.

 

After my letter was published, about a dozen veterans wrote to me, I replied to each one individually and privately, and then on March 13, 2018, I wrote this letter to them collectively:

 

Hello,

 

This letter is going (Bcc'd) to the veterans who contacted me to express concern about the extremely shortened version of my letter that Smithsonian Magazine's editors chose to publish.

 

I am grateful to each of you for taking the time and trouble to write to me and to describe what were painful experiences you had that contradicted what seemed to appear in my letter. Being an advocate for veterans from all eras for more than a decade, the last thing I ever want to do is cause further suffering to any veteran.

I am currently dealing with major medical problems in a close family member -- and am deeply touched by the very kind, compassionate responses that two of you sent to that statement -- so have limited time, but I have been in communication with the magazine's editor about how to rectify the consequences of their restricting my letter to 50 words while publishing three other letters, two of which were 2 1/2 times longer than that. Especially with regard to a matter as complex as what I was wanting to convey, this was unforgivable, and the combination of their singular restriction placed on me with the wording I ultimately chose has seemingly led to their Managing Editor's acknowledgement of their wrong.

 

The editor refuses to publish a longer letter from me in the hard copy of the magazine, which is what I requested, and only agreed to (1)remove the current letter from their online version and (2)publish a longer letter from ... but only online... once I have the time and space to write it. However, it is unfortunate that -- though the editor says she has no idea how many people read the magazine in hard copy vs. how many read the online version -- she admits that it is likely that far fewer people look at it online than in hard copy.

 

Nevertheless, I will be writing that longer letter for the online version.

 

In the meantime, I wanted to send you this link to an essay I wrote some time ago on the website I have for my work with veterans, in case you'd like to have a look at the alarm I have felt about the invisibility of veterans' suffering. I realize this may seem ironic to you, in light of the reason you contacted me, but I hope you might have a look at it.

 

https://whenjohnnyandjanecomemarching.weebly.com/blog [the link took them to my essay called "The Naked Emperor and the Vanishing Veteran," which is also published on this Authors Guild website on the blog page]

 

I will be in touch when I have written the longer letter for the magazine's website.

 

Warm wishes,

 

Paula
Paula J. Caplan, Ph.D.
Founder and Director, Listen to a Veteran! listentoaveteran.org
"Is Anybody Listening?" film isanybodylisteningmovie.org
"Is Anybody Listening?" song https://www.youtube.com/watch?v=ztJ5c0URQ6E

 

Subsequently, I received a few letters from more veterans. I then wrote as follows on March 23 to all of the veterans who had contacted me:

 

Hello,

 

This message is going to you wonderful veterans who wrote to me about my extremely brief letter in the hard copy of Smithsonian Magazine.

 

It took me awhile to write a more extensive letter, because there was a lot I wanted to say, and I was so grateful for what each of you wrote to me and wanted time to mull over the various pieces of the matter, but the longer letter was published online today at
https://www.smithsonianmag.com/magazine/mar18_discussion-180968085/?no-cache

 

I hope you will see right away my report of your messages to me and my belief in what you told me, as well as my gratitude for how gracious you were.

 

I hope you will also understand more of why I wanted to respond to that initial statement in the My Lai article. And of course, if you would like to write anything to me about the new letter, I would be very interested to hear from you.

 

Warmest wishes,

 

Paula
Paula J. Caplan, Ph.D.
Associate, Hutchins Center, Harvard University
paulajcaplan.net
&
Founder and Director, Listen to a Veteran! listentoaveteran.org
Producer, "Is Anybody Listening?" film isanybodylisteningmovie.org
"Is Anybody Listening?" song https://www.youtube.com/watch?v=ztJ5c0URQ6E
Producer, "Isaac Pope: The Spirit of an American Century" (film scheduled for completion in the next couple of months) isaacpopefilm.com

 

I hope that readers of this essay will be sure to read my longer letter in Smithsonian Magazine online at https://www.smithsonianmag.com/magazine/mar18_discussion-180968085/?no-cache and send me your thoughts if you wish.

 

Be the first to comment