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Talk with Tenney is a talk show hosted by Lauren Tenney, PhD, Psychiatric Survivor, was first involuntarily institutionalized at age 15. Her participatory research and activism calls for an abolition of state-sponsored human rights violations, including murder, torture, and slavery via forced compliance with psychiatric places, practices, procedures, and products. She exposes institutional corruption, which is a source of profit for organized psychiatry, and the retaliation people are subjected to when they speak out against State-Sponsored Organized Psychiatric Industries.

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A Belated Response to Dr. Jeffrey Lieberman’s Musings about “Anti-Psychiatry Prejudice” and Some Historical Notes Everyone Ought to Know.

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By Lauren Tenney, PhD, MPhil, MPA, Psychiatric Survivor

Author’s Note: Recently, on Facebook, I was tagged in the article written by Lieberman (2013) that was said to require a response. The blog post, “DSM-5: Caught between Mental Illness Stigma and Anti-Psychiatry Prejudice” was written by Dr. Jeffrey Lieberman (May 20, 2013), published on the MIND Guest Blog of Scientific American. It is such an inflammatory sentiment that is expressed by Dr. Lieberman, that it demands attention. The blog entry below is my initial response, which I hope generates much conversation.

At least as far back as May 20, 2013, Dr. Jeffrey Lieberman has wanted his readers to think he understands how anti-psychiatry came to hold its position against traditional psychiatry. It is interesting to note that he does not actually refer to any anti-psychiatry materials, many of which do show evidence of how and why psychiatry falsely profits from the lies in which the field presents as science. In my role as an adjunct assistant professor, I am ‘out’ both as someone who is anti-psychiatry and someone who is a psychiatric survivor. I often talk with students about how frustrating it is that a typical psychology textbook will address the importance of non-biased science, but when it comes to the actual science of psychiatry, it offers ‘maybe’ and ‘probably’ to address the etiology of psychiatric assignment via a biological model and that those potential futures are so strong that the lack of evidence is not only acceptable, but would be unethical not to pursue, because if the evidence ever came through, it would show that there was in fact a broken brain, a genetic link, or some kind of biological evidence, such as a chemical imbalance which “never panned out” (Whitaker, 2005, p. 25).

It’s all about the optics. A question I pose to students routinely is, “What would happen to your thinking if the textbook stated they have zero biological evidence of “mental illness” versus that ‘mental illness may be genetic, or probably is biological’?”. Of course, the response is generally that they would not accept psychiatry the way that they do, because of the optics in which psychiatric ‘science’ is presented. So, the twisted version of ‘science’ which psychology students are exposed to is problematic and the fact that Dr. Lieberman perpetuates it is irresponsible of him, and in my mind, a problem.

Dr. Lieberman (2013) himself described the field of psychiatry as having over the last half century “grown leaps and bounds . . . on a course for future growth and success” while he also downplayed the lack of actual evidence psychiatry had to offer, describing its evidence as leaving a sense of dissatisfaction, frustration, and yet a hope for future success. Readers of Mad in America will know that Whitaker (2010) pointed out that when one looks at “patient care episodes” (p. 24) one can find, “nearly a fourfold per capita increase in 50 years” (p. 24) and it seems that Dr. Lieberman is not willing to admit the growth is as much in allocates as it is in financial profits for individual practitioners and industries, respectively.

All of this, for a field whose practices, procedures, and products are able to be court-ordered on people kept in psychiatric places who do not want to comply and who subsequently are subjected to a host of human, constitutional, and civil rights violations (Chabasinski, 2013; Minkowitz, 2007, 2013; United Nations Drafting Committee, 1948; United Nations General Assembly, 1984; United Nations Human Rights Council, 2008, 2013; Weitz, 2002, 2004, 2008).

I suppose Dr. Lieberman (2013) taking a position of authority on the existence of anti-psychiatry by writing, “I do understand how anti-psychiatry ideas first developed and why they have been so difficult to combat” somehow how justifies why he feels he can categorically discount anti-psychiatry and disparage its proponents—and without naming one such person—Lieberman (2013) casts anyone identifying as anti-psychiatry off, by stating, “They are, to my mind, misguided and misleading ideologues and self-promoters who are spreading scientific anarchy” (Lieberman, 2013). Last I checked, it was the anarchistic spirit in scientists that has acted as the catalyst for the further development of science, (i.e. Galileo).

However, Dr. Lieberman flat out left out people who identify as psychiatric survivors, or people who have survived psychiatric atrocities and our rallying cry against psychiatry. Perhaps, if Dr. Lieberman actively privileged the voices of those of us who have experienced psychiatric practices, procedures, and products and still experience pain from psychiatry, as a doctor, Dr. Lieberman would not be able to deny the evidence he had and therefore would not be able to disparage those of us who challenge and expose psychiatry. Instead of hearing and actively responding to the voices of people who have survived psychiatric atrocities, and immediately acting in a support role to ensure that others are not subject to such human rights violations via psychiatry, Dr. Lieberman does something that ought not ever, in my opinion, have ever been done. Dr. Lieberman assigns this act of being anti-psychiatry, akin to racism and other horrible displays of discrimination and hate:

“Like most prejudice, this one is largely based on ignorance or fear–no different than racism, or society’s initial reactions to illnesses from leprosy to AIDS. And many people made uncomfortable by mental illness and psychiatry, don’t recognize their feelings as prejudice. But that is what they are.” (Lieberman, 2013)

Please note, this special type of prejudice, as being discussed by Dr. Lieberman, is not only toward the people who have been psychiatrically assigned, but is also aimed at the psychiatric assignor or provider. Lieberman did state that in 2013 it might have been the “right time to grapple with the prejudice against mental illness and its caretakers.”

Everyone ought to be concerned that one of the most powerful psychiatrists in the world is using analogies of discrimination to what it is he experiences as a psychiatric provider.   Dr. Lieberman should not be able to get away with comparing those who are anti-psychiatry to exhibiting something similar to “racism, sexism, homophobia, and other prejudices” (Lieberman, 2013).

Dr. Lieberman, perhaps this can serve as a brief reminder to you about the history of institutional and structural racism in psychiatry and how it continues to repeat on us today. Most people now know that at least dating back to Cartwright’s 19th century alienist diagnoses such as Drapetomania: a slave running free, or wanting to run free (Cochrane, 2004; Jackson, 2001), and Dysaesthesia Aethiopica, or a slave who would break tools, or disobey one’s master (Cochrane, 2004; Jackson, 2001); or one hundred years later, Szasz’s (1977, 2002) clear comparisons between those who are psychiatrically assigned and chattel slavery; and decades after that, the current over-representation of people of color involuntarily involved with psychiatry (Swartz, et al, 2009; Tenney, 2008; The New York Lawyers for the Public Interest, Inc., 2005). Dr. Lieberman’s (2013) language concerning groups, who are oppressed and discriminated against, ought to be railed against. Particularly in light of the intersection of race and disability, it strikes me as a problem that someone with such a position of power could legitimately make such claims and maintain one’s seat at the helm.

Dr. Lieberman (2013) calls the anti-psychiatry movement “relatively small” but clearly we are large enough for him to feel he ought to address it. According to his Twitter page, Dr. Lieberman is the Chairman of the Department of Psychiatry, at Columbia University and the Director of the New York State Psychiatric Institute and the Psychiatrist-in Chief at CUMC-NYPH. Because of some of these roles, I would like to shine light on the work of Linda Andre (2009) and McLain and Christensen (1996) who have highlighted the places where Dr. Lieberman currently presides over.

“I do not overlook the checkered history of psychiatry itself,” wrote Lieberman (2013). The “crude instruments” Lieberman acknowledged included “strait jackets, cold packs, fever induction, insulin shock therapy, and psycho-surgery” (Lieberman, 2013). However, the place of which he is Director, the New York State’s Psychiatric Institute, has been thought to be a leading place responsible for the advancement of the biomedical model.

“It is impossible to chronicle every single accomplishment achieved over the past 100 years at PI,” McLain and Christensen (1996) wrote under a heading, “Milestones in PI’s History,” which included more than a dozen examples of “accomplishments” of human and animal medical research conducted at PI. Hailed for its contributions to the field of psychiatry, these accomplishments of PI included being the earliest institution to conduct genetic research, and ‘medical’ advances including the first to use electroshock. PI also was the first to use of phenothiazines and lithium carbonate. As it is the DSM-5 which is at the heart of Dr. Lieberman’s (2013) blog, it is important to note that McLain and Christensen (1996) pointed out that at least three times prior to 1986, the institution was the hub for the updating of the rulebook of psychiatry, the DSM.

Dr. Lieberman’s joint position as Chairperson of the Department of Psychiatry at Columbia and Director of the New York State Psychiatric Institute ought to have people concerned for multiple reasons, not least of which, the conspiring of state and private entities. This public-private partnership has a long history in New York State, which without challenge is a trendsetter state, so the issues discussed here are not specific to New York. McLain and Christensen (1996) also reported that in 1925, Dr. George H. Kirby was the director of the Psychiatric Institute and he solidified this goal of a joint venture of research, practice, and policy with “an agreement with the new Columbia entity [Columbia-Presbyterian Medical Center] to build a new hospital and an institute.” As part of this agreement, PI moved from Ward’s Island (where Meyer had established its offices in 1902) to Manhattan. Meyer:

“pledged to make the facilities available to staff and students of Columbia’s medical college. Thus, PI became the headquarters of Columbia University’s Department of Psychiatry.” (McLain and Christensen, 1996)

Of course, Dr. Lieberman was awarded the “Adolph Meyer Award” by the American Psychiatric Association. Adolph Meyer (Tenney, 2014), was assessed through an analysis of work done by Grob (1994) and Scull (2005) was one the most dangerous players in the organization of organized psychiatry in the early 20th century. Scull (2005) suggested, “Meyerian psychiatry turned out to be as intellectually empty as its author was ethically blind” (p. 288). The organizers of organized psychiatry knew they had to protect their institution (Tenney, 2014).

Linda Andre (2009) also addressed this relationship between Columbia University and PI, which above, we saw was initiated by Meyer, in 1906. Andre (2009) zooms in on the 1925 marker as a solidification and formalization of the arrangement, which I see as evidence of the organization of State-sponsored Organized Psychiatric Industries (SSOPI) in New York State:

“Nevertheless, as we shall see, P.I. has played a larger role in the selling of electroshock than any other institution in America. This is largely because it is a research facility that has aggressively and successfully sought state and federal funding. More funding equals more publications equals more influence. Although it is a state facility, P.I. has had, since 1925, a unique affiliation agreement with Columbia University’s College of Physicians and Surgeons, which adds immeasurably to its perceived prestige.” (p. 40)

This is crucial evidence of the deliberate organization of organized psychiatry in New York State due to its connections between research, practice, policy, power, and profit—and that these connections did not end in 1907 as PI is still considered a prominent research institution. PI is still a State-Sponsored research institution. McLain and Christensen (1996) report the massive public expenditures directed at PI:

“New York State Psychiatric Institute is among the top institutions in terms of total dollars received from the federal government for medical research and is a leading recipient of grant money from the National Institute of Mental Health.”

Most recently, Dr. Lieberman twittered a picture of himself and three other tuxedo-wearing men at what seems to be the “Crown Awards” with the tweet, “defining the future of #genomic #medicine @Columbia @ColumbiaPS @drjlieberman “ (@drjlieberman, 5 December 2014). Because of this reconnection to genetics through his hashtag, #genomic, it is interesting to note that in a listing of selected accomplishments of the New York State Psychiatric Institute list as the second major milestone in PI’s history:

“Recruitment of the first psychiatric geneticist (Dr. Franz Kallman) in the United States, who conducted the first genetic studies of schizophrenia.” (McLain and Christensen, 1996)

Torrey and Yolken (2010) wrote:

“The systemic sterilization and killing of individuals with schizophrenia in Nazi Germany from 1934 to 1945 was influenced by several factors. Perhaps of greatest importance was a belief that schizophrenia was a simple Mendelian inherited disease, passed down from generation to generation. In Germany, this theory was promoted by Drs. Ernst Rudin and Franz Kallman, among others.” (p. 26)

Torrey and Yolken reported that Kallman, who became known for his studies of twins to find genetic roots of schizophrenia, was “a student of Rudin” (p. 26). Torrey and Yolken suggested that:

“In a 1935 speech, Kallman advocated the examination of all relatives of individuals with schizophrenia to identify nonaffected carriers, which he believed could be done by noting ‘minor abnormalities,’ and then the compulsory sterilization of such individuals. A year later he emigrated to New York, where he continued his twin research and later became one of the founders of the American Society of Human Genetics.” (p. 26)

I can go on, and in fact, in (de)VOICED: Human Rights Now (2014) I do go on for more than 600 pages. For now, I will leave off that Dr. Lieberman and I do have something we share. We both, as he wrote, are “amazed by the debates surrounding the DSM-5” (Lieberman, 2013). It does amaze me that an entire profession, which still gears itself with the authority of those ordained as leaders, as did Adolf Meyer one hundred years ago (Tenney, 2014), can get away with continually proposing that they are operating with facts and science when at best they have a creative, highly lucrative fiction.

Brava, anti-psychiatry for holding light to the issue of requiring evidence.

References

Andre, L. (2009). Doctors of deception: What they don’t want you to know about shock treatment. New Brunswick, New Jersey and London: Rutgers University Press.

Chabasinski, T. (2013). Of course I’m anti-psychiatry. Aren’t you? Blog. Retrieved on February 14, 2014 from http://www.madinamerica.com/2013/10/course-im-anti- psychiatry-arent/.

Cochrane, S. (2004). SPN Paper 4: Where you stand affects your point of view. Social Perspectives Network. (Website.) Retrieved on January 27, 2007 from http://www.spn.org.uk/fileadmin/SPN_uploads/Documents/Papers/SPN_Papers/SPN_Paper_4.pd f.

Grob, G. N. (1994). The mad among us: A history of the care of America’s mentally ill. New York: The Free Press.

Lieberman, J. A. (20 May 2013). DSM-5: Caught between mental illness and anti-psychiatry prejudice. MIND Guest Blog. Scientific American. Retrieved on December 7, 2014 from http://blogs.scientificamerican.com/mind-guest-blog/2013/05/20/dsm-5-caught-between-mental-illness-stigma-and-anti-psychiatry-prejudice/.

McLain, S.R. and Christensen, L. (1996). 100 years of leadership in mental health. P and S Journal, 16(3). Retrieved on August 20, 2013 from http://www.cumc.columbia.edu/psjournal/archive/archives/jour_v16n3_0020.html.

Minkowitz, T. (2013). We name it torture. Mad In America. Blog. Website. Retrieved on July 26,

2013 from http://www.madinamerica.com/2013/06/we-name-it-torture/.

Minkowitz, T. (2007). The United Nations convention on the rights of persons with disabilities and the right to be free from nonconsensual psychiatric interventions, Syracuse Journal of International Law and Commerce, 34, 405-426. Retrieved on October 14, 2008, from http://psychrights.org/Countries/UN/TMinkowitzOnNonconsensualPsychInterventions.pdf.

Scull, A. (2005). Madhouse: A tragic tale of megalomania and modern medicine. New Haven, CT: Yale University Press.

Szasz, T. (1998/1977). Psychiatric slavery. New York: Syracuse University Press. Szasz, T. (2002). Liberation by oppression: a comparative study of slavery and psychiatry. New

Brunswick (USA): Transaction Publishers.

Tenney, L. J. (2014). (de)VOICED: Human rights now. Volumes I, II, and III. New York: Graduate Center, City University of New York.
The New York Lawyers for the Public Interest, Inc. (April 7, 2005) Implementation of ‘Kendra’s Law’ is severely biased. New York. Retrieved on July 30, 2008 from http://www.nylpi.org/pub/Kendras_Law_04-07-05.pdf.

Torrey, E. F. and Yolken, R. (2010). Psychiatric genocide: Nazi attempts to eradicate

schizophrenia. Schizophrenia Bulletin, 36(1), 26 – 32. Retrieved on February 16,

2014 from http://schizophreniabulletin.oxfordjournals.org/content/36/1/26.full.

United Nations Drafting Committee. (1948). The universal declaration of human rights.

Retrieved on February 23, 2014 from http://www.un.org/en/documents/udhr/index.shtml.

United Nations General Assembly. (1984). Convention against torture and other cruel, inhuman or degrading treatment or punishment: resolution/adopted by the General Assembly., 10 December 1984, A/RES/39/46, Retrieved on February 14, 2014 from http://www.refworld.org/docid/3b00f2224.html.

United Nations Human Rights Council. (2008). Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Manfred Nowak : mission to Sri Lanka, 26 February 2008, A/HRC/7/3/Add.6. Retrieved on February 14, 2014 from http://www.refworld.org/docid/47d683cf2.html.

United Nations Human Rights Council (2013) Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, 1 February 2013, A/HRC/22/53. Retrieved on February 14, 2014 from http://www.refworld.org/docid/51136ae62.html.

Weitz, D. (2008). Struggling against psychiatry’s human rights violations. Journal of Radical Psychology, 7. Retrieved on February 16, 2014 from http://www.radicalpsychology.org/vol7-1/weitz2008.html.

Weitz, D. (2004). “Insulin Shock — a survivor’s account of psychiatric torture.” Journal of Critical Psychology, Counseling and Psychotherapy, 4(3), 187-194; see also http://www.psychiatricsurvivorarchives.com.

Weitz, D. (2002). Call me antipsychiatry activist — not ‘consumer.’ Ethical Human Sciences and Services, 5 (1), 71-72.

Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. New York: Crown Publishers.

Whitaker, R. (2005). Anatomy of an epidemic: Psychiatric drugs and the astonishing rise of mental illness in America. Ethical Human Psychology and Psychiatry. 7(1), 23- 35. Retrieved on July 27, 2013 from http://freedom- center.org/pdf/anatomy_of_epidemic_whitaker_psych_drugs.pdf

Evidence for Use of Electroshock on Veterans

A FOIA request that I submitted to the United States Department of Veterans Affairs for various types of information on the use of electroshock on Veterans was referred to and responded to by the Veteran’s Health Administration.

Specifically, the FOIA request produced data from Fiscal Year 2009 in a 16 page “draft/pre-decisional” document entitled, “National and Regional Resource Report” and addresses “programs not mandated by the Uniform Services Handbook” (p. 1).

Included in these programs, were programs for women’s PTSD care and Military Sexual Trauma programs. Listed in Appendix 3 was “ECT Services”, in a table (clearly in draft) with two columns, one representing “ECT in FY09” and “pts with 2 or more visits”. This is then broken into three columns. The first was headed as “Parent facility” and consisted of 75 Veterans Affairs Medical Centers (VAMC). The second and third columns represent, “# of visits” and “# of patients” (p. 13) which repeats as headers on the next page (p. 14). By my computations, the numbers in Appendix 3 do not match the description of the data given on p. 4 of the document, “5009 ECT treatments were provided to 743 unique VHA patients ” (p. 4). Therefore, it is unclear whether the data provided in Appendix 3 (pp. 13-14) is additional usage of electroshock or if there was some mistake in the written description provided by the report.  I have added a jpg of Appendix 3 for you to come to your own conclusions. Here is the full excerpt on the “ECT below in its full context under the heading, “ECT Use in the Veterans Health Administration” (p. 4):

All VISN mental health liaisons were surveyed regarding the presence of Electro-Convulsive (ECT) programs in their VISNs. Responses were received from 15 of the 21 VISNs, and all 15 of these VISNs reported ECT programs within their VISNs. Three VISNs reported limited contracts for ECT services and most ECT services are provided to patients coming from within VISN boundaries.
In addition, we examined administrative data regarding ECT use in fiscal year 2009. This was based on current procedural terminology (CPT) codes in the outpatient records (90870 and 90871) and ICD-9 codes from surgery and procedure records (94.26 and 94.27). This method has been found to have reasonable sensitivity and specificity for detecting ECT when compared to chart reviews. This method does not capture ECT provided to VA patients through contracting with a non-VA facility.
In FY09, a total of 5009 ECT treatments were provided to 743 unique VHA patients for an average 6.7 treatments per patient. All 21 VISNs provided some ECT in accordance with Uniform Mental Health Services provisions outlined in VHA HANDBOOK 1160.01. The mean number of patients treated in each VISN was 35.4 (SD 23.3). VISNs 4, 5, and 19 fell one standard deviation below the mean, whereas VISNs 1, 8, 12, and 23 were more than one standard deviation above the mean. ECT was provided in 75 VA Medical Centers for an average of 9.9 (SD 11.3) patients treated per VAMC that provided ECT, although 7 of these facilities had only one recorded treatment, which suggests that ECT may have been recorded in error at these facilities. The VAMCs with the most ECT treatments (≥ 30 patients treated) were San Juan, Omaha, North Chicago, Kansas City, and San Antonio.

(Office of Mental Health Services, Veteran’s Health Administration, May 28, 2010. Draft/Pre-decisional. National and Regional Resource Report  p. 4 )

In the other document I was sent, VHA Handbook 1004-01 — Informed Consent, electroshock is specifed in Appendix A “Treatments and Procedures Requiring Signature Consent” (pp. A1 – A2) and specifies prior to #9 “Electroconvulsive therapy” (p. A2), this note:

NOTE: It is not necessary to obtain a separate signature consent for sedation, anesthesia, or blood product transfusion if the combined consent form for the procedure already contains consent for sedation, anesthesia, or blood product transfusion . . . (p. A2).

Finally, the Information Officer responded affirmatively to a request I had in response to criteria mentioned in the Informed Consent handbook, namely, VHA Handbook 1160.01 (September 11, 2008)  which in relation to ECT states:

(4) Veterans must have access to electroconvulsive therapy (ECT) in the VISN in which they receive care.

(a) ECT must be provided when it is clinically indicated consistent with VA clinical practice guidelines found at:
http://vaww.oqp.med.va.gov/CPGintra/cpg/MDD/MDD_Base.htm, as well as those of the American Psychiatric Association.
NOTE: VA guidelines are located on an internal VA site that is not available to the public.
1. Staff needs to be knowledgeable about the current scientific literature.
2. Electroconvulsive therapy needs to be coordinated with other psychosocial, psychological, psychopharmacological, and medical care that patients may be receiving.
(b) Patients who respond to ECT require some form of continuation or maintenance treatment to prevent relapses or recurrences. (pp. 31-32)

It is time to talk about the evidence of the use of electroshock on Veterans. According to the data I have been given electroshock was routinely used on Veterans in the United States of America in 2009 and was widely available in the VAMC network. I am sure one can spend the rest of one’s life going through all of this information. This is but a step toward finding out what is happening to all Veterans in the United States of America in 2015 and beyond. I have been in communication with the VHA FOIA Officer concerning new questions this information has created including seeking clarification of informed consent procedures and forms used.

On July 24, 2015, I sent a follow-up FOIA request to the Veteran’s Health Administration.

I will continue to follow this information. Please feel free to make suggestions for analysis and other information I ought to put in FOIA requests to the Veterans Health Administration.

http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1762

Mad in America Blog Posts

For up-to-date access to my blog on Mad in America: “Psychiatry, State Power, and Capitalism” please visit:  http://www.madinamerica.com/author/ltenney/

Lauren Tenney, PhD, MPhil, MPA, is a psychiatric survivor and environmental psychologist. First institutionalized at 15 years old, her often activist-work uses video research and alternative media to shine light on institutional corruption which is a source of profit for organized psychiatry. She works to abolish state-sponsored human rights violations, such as murder, torture, and slavery, carried out via state-sponsored organized psychiatric industries.

Contact: laurentenney@aol.com, www.laurentenney.us, (718) 273-8708 (516) 319-4295 (cell)