Tuesday, April 28, 2009
A few days ago, Beyond Meds "reprinted" a 2000 tract by clinical psychologist and author Ty Colbert PhD, entitled, NAMI Parent’s False Hope: Blindly Disabling Children for Life.
Dr Colbert has participated in NAMI, where he has observed parents achieving at best mixed success with their kids on meds. According to Dr Colbert:
"Even though these members (parents) are dedicated to helping their children, because they have been falsely convinced that mental illness is a biological disorder, they are blindly helping to disable their children, many for life."
Clearly Dr Colbert struck a chord, judging by the post's numerous spirited comments, some virulently anti-NAMI, but many from individuals who feel that long-term meds treatment has ruined their lives.
Dr Colbert cites the case of Gary, the son of two NAMI parents who became depressed shortly after being turned down for an athletic scholarship. He was examined, then sent home (this would have been more than 30 years ago, so we are presuming no meds were involved). Then, when Gary's thinking grew disordered and delusional, he was diagnosed with schizophrenia and prescribed medication. Despite this, his condition deteriorated, and 25 years later he is still struggling to reclaim his life.
According to Dr Colbert: "His paranoid thoughts and hallucinations were his mind’s way of trying to deal with all this pain." An insightful therapist, Dr Colbert contends, "could have helped Gary deal with his strong feelings of failure. In this way, Gary could have successfully worked through his pain and not lost his life to the disabling effects of the drugs."
It is a long stretch to claim that Gary lost his life to meds rather than schizophrenia or that talking therapy could have helped, particularly in describing events that occurred a quarter century before Dr Colbert ever laid eyes on Gary, but we get the point.
Indeed, at this year's International Congress on Schizophrenia Research I learned that 4 percent of the US population experiences psychotic symptoms without having schizophrenia. Clearly, then, we can make a case for extreme caution before slapping a label on someone and telling them they will need to be on meds the rest of their lives.
So what is Dr Colbert's clinical track record? Curiously, the one unequivocal success he cites in his piece involves helping a kid through his "dark spot." No mention was made of any symptoms approaching schizophrenia. Dr Colbert does say he has helped young people through their "psychotic breaks," but the best he can show for his efforts is Jerry, age 28, who is only just beginning to put his life together after 10 years on meds.
Dr Colbert points out that psychosis doesn't just come out of nowhere, but this is hardly news. The "diathesis-stress" model has been in circulation in psychiatry for at least three decades, the DSM refers to psychosis linked to stress, and research across a wide array of disciplines strongly supports the notion that our brains mediate how we respond to our environment. Dr Colbert contends that "the mind is actually functioning very creatively to protect the soul or self," but in reality he is describing a physical and biological organ very hard at work.
But, yes, we badly need Dr Colbert's voice in the conversation. Over the course of two decades he has been speaking out against the blind faith patients and families have placed in very imperfect and frequently disabling meds, and the terrible things that can happen when frustrated patients inevitably go off them without other therapeutic supports in place.
Having said that, it is appropriate to end on this cautionary note:
Some time back, an individual I know fairly well entered a program inspired by (but hardly modeled on) Loren Mosher's Soteria House. He was taken off his meds and underwent talking therapies designed to get him in touch with his feelings. (Soteria House would never have taken this individual off his meds.) While still in the program, he experienced a psychotic break and entered a restaurant brandishing a BB gun. He was arrested, criminally prosecuted, and served two years in a locked psychiatric unit, along with murderers and other violent offenders.
This individual is now on meds and is working part-time in an academic setting. The doctors in charge of taking this individual off his meds refused to take responsibility.