Friday, 17 July 2015

reductionism and psychiatry: when prescribers become drug pushers; links with experimental ACING/NMD

I've been hearing recently, again in Dundee, how psychiatric patients, in the community, are being kept on drug cocktails, over the recommended maximum doses in some cases, even when a person is keen to taper and is managing their mental health responsibly.  Recovery isn't being promoted by psychiatrists, rather they are keeping people drugged up and disabled.

There has to be a link with biological psychiatry and reductionist thinking.  That all mental health issues are brain related and in the genes.  Rather than mental health issues are caused by problems in life, including trauma, abuse, bullying, inequality, pain and poverty.  Easier to reduce mental anguish to brain stuff so as to contain it with drugs.  Much more of a challenge to see the person holistically, mind and body, spirit and soul.  Taking time to listen and to help the person work through the issues, develop or rediscover resilience.

The Advanced Interventions Service is based at Ninewells Hospital, Dundee, where psychiatrists are experimenting with ACING/anterior cingulotomies (NMD or brain surgery for mental illness).  Irreversible surgery which doesn't cure, rather people are coming back for more because they are desperate and I think because of the attention they are getting.  Much more resource per head of person in DAIS than in ordinary mental health services.

To be a candidate for DAIS a person has to have had at least 2 courses of ECT and many courses of drug prescribing which were ineffective.  Diagnoses of OCD and depression are most common for referrals, also bipolar disorder. Is this why in Carseview Centre, Dundee, where there are two rooms set aside for ACING/anterior cingulotomies, there is a bias towards ECT and polypharmacy?  Prospective candidates for the Dundee Advanced Interventions Service?

Yesterday evening I sent a few tweets to Dr David Christmas, psychiatrist with DAIS, suggesting we work together on helping people taper their psychiatric drugs:

No response as yet from Dr Christmas.

I contend that if the drugs don't work then the drugs don't work.  No point in blaming the person for a failed paradigm.  Fiddling in brains does not get to the root of the problem.  Which is complex, to do with living and particular to each person.  Pushing drugs on vulnerable people is a criminal act if there is no prescription.  Drug prescribing in psychiatry therefore deserves more scrutiny, particularly where there are conflicts of interest.  Links with drug companies and/or to reductionist thinking.

We are more than guinea pigs or mice, to be experimented on, and it is way beyond time that we stopped scapegoating mentally ill people, consigning them to a dead-end road.  I got out of the cul-de-sac by not believing the lifelong prognosis of mental illness.  Nothing miraculous about it.  Rather it was a matter of scepticism, resistance and dogged determination.  Recovering from psychosis and coercive psychiatric drug treatment.


'Towards a hermeneutic shift in psychiatry' perspective by Dr Pat Bracken, World Psychiatry, Oct14

"I do not believe that we will ever be able to explain the meaningful world of human thought, emotion and behaviour reductively, using the “tools of clinical neuroscience”.  This world is simply not located inside the brain. Neuroscience offers us powerful insights, but it will never be able to ground a psychiatry that is focused on interpretation and meaning. Indeed, it is clear that there is a major hermeneutic dimension to neuroscience itself (17). A mature psychiatry will embrace neuroscience but it will also accept that “the neurobiological project in psychiatry finds its limit in the simple and often repeated fact: mental disorders are problems of persons, not of brains. Mental disorders are not problems of brains in labs, but of human beings in time, space, culture, and history.”

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