Trauma and Madness in Mental Health Services Quotes

“During the time of slavery, those who dared to seek freedom and run for their lives were diagnosed with the mental illness drapetomania , the cure for which was a master kind enough to provide “work” (e.g., Bynum, 2000). No one could understand why a slave would not wish to kneel before his master, so it made perfect sense that a disease must be causing him to run away. In later years, Black individuals were once again pathologized for daring to fight back against a racist society when schizophrenia became rebranded from a disorder mostly descriptive of middle-class White women to that of the angry, violent Black man (Metzl, 2010). One need only look at any advertisement during the 1960s for neuroleptic drugs, which almost exclusively featured an animalistic looking Black man clearly needing to be tranquilized like a feral dog.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Due to commercials and the “education” of prescribers directly by pharmaceutical representatives, the idea that people who were sad and depressed had chemical imbalances in their brains became common parlance. So how is this an example of manufacturing a disease? There is no such thing as a chemical imbalance that is known to cause some identifiable disease called depression. In fact, leaders within psychiatry have called the chemical imbalance theory an “urban legend” that was never taken seriously by “well-informed psychiatrists” (Pies, 2011). An entire society was led to believe in a disease known to be caused by neurochemical imbalances as a direct result of a genius marketing scheme, and nothing more (see also Schultz & Hunter, 2016 for a review).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Regardless of how any individual clinician may conceptualize a person’s distress, the current paradigm under which all mental health professionals operate is one that is conceived through a medical ideology with a medical classification system (Caplan, 1995; Frances, 2016). Terms such as “symptoms” are used to describe human behaviors and emotions (Hare-Mustin & Marecek, 1997), while many categories are associated with words like “neurological”, “genetic predisposition”, and “illness”, despite no known biological abnormality to be specifically associated with any DSM -defined category (e.g., Kupfer, 2013).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Although claiming to be neutral as to what supposedly causes madness, the DSM and its diagnoses are based upon a biomedical model (Erlandsson & Punzi, 2016). Essentially, by medicalizing human suffering, the problems in society, within families, and the general injustice of the world go ignored. Instead, the problems are placed inside individual brains. If context is considered, it becomes a mere trigger of an underlying disease rather than the problem in itself.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“It may be suggested by some that diagnoses are important because they aid in the process of determining appropriate drug treatment. Aside from the already discussed lack of predictive validity for DSM -defined categories, generally, psychotropic drugs actually do not have any such specificity to diagnoses (Moncrieff, 2008, 2013). For example, it has consistently been demonstrated that antidepressants essentially act as numbing agents and are rarely more effective than active placebo (e.g., Kirsch et al., 2008). Cocaine and other stimulants can enhance learning and help with focus and attention, whether one meets the criteria for ADHD or not (Lakhan & Kirchgessner, 2012; Moncrieff, 2013). Similarly, neuroleptics—euphemistically called “antipsychotics”—are tranquilizers that result in sedation and indifference, and are more useful for behavioral control rather than any specific effect to psychosis (De Fruyt & Demyttenaere, 2004; Dubin & Feld, 1989; Moncrieff, 2013).4 Similar to pain relievers, just because a drug “works” does not mean that there is some underlying, specific disease process that it is working upon.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“7 It is common in the United States, and other Westernized countries, to allow for forced treatment (i.e., involuntary hospitalization, involuntary ECT, involuntary drugging) if a person is deemed incompetent or a danger to themselves. While some may assert that this is necessary to save lives, this is based on emotion and ideology, not the evidence. For instance, people who are considered to be an imminent threat for completing suicide are often hospitalized against their will, yet, the more involvement with coercive psychiatry, the more likely one is to actually die from suicide (Hjorthoj, Madsen, Agerbo, & Nordentoft, 2014).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Further, increased adoption of the biomedical ideology is actually associated, overall, with worse outcomes (Firmin, Luther, Lysaker, Minor, & Salyers, 2016), decreased hope, and increased stigma and prejudice (Angermeyer & Matschinger, 2005; Read et al., 2006; Read & Harre, 2001).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“This is of particular concern when considering that non-Westernized cultures have demonstrated better outcomes and increased functioning for diagnoses such as “schizophrenia ” (Jablensky & Sartorius, 2008) than do the industrialized countries increasingly imposing their dominant ideologies.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“People increasingly can no longer reach out to a friend, change their life, talk to a trusted individual, change their diets, rebel against industrialized and oppressive society, or question those in authority. Just like religion, the people in charge know something no one else can and the evil within us must be quelled. Rather than exorcism, Prozac or Abilify can finally cast out our demons. In addition to these widely discussed problems, so, too, does the mental health field resort to claims of conspiracy and personal attacks against those in disagreement with the status quo and relies heavily on subjective measurement and tautological reasoning. Again, using the example of depression, this subjectivity and circular reasoning becomes evident. If a person seeks help for feeling sad, lethargic, unmotivated, and experiencing changes in sleep, this person might receive a diagnosis of MDD, a purported brain disease requiring life-long treatment. How does one know that this person “has” MDD? Because they feel sad, lethargic, unmotivated, and has changes in sleep. If the person wants to be really sure, a validated measurement might be given to said person which asks, essentially, if the person is sad, lethargic, unmotivated, and has had changes in sleep patterns. This process is akin to saying “I have a headache”, to which a doctor responds “Ah, yes, you have Major Headache Disorder”. If asked “How do you know I have Major Headache Disorder?” the answer is “Because you have a headache”.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“In general, a true science is open to change and counter-examples, is intent on discovering new ideas even if they contradict currently accepted ones, is open to and encourages criticism and alternative explanations, focuses on replication of results, is humble in its findings and generalizations, and utilizes objective measurement. Conversely, a pseudoscience or faith-based ideology relies on fixed ideas and marginalization of opposition, selectively attends to favorable “discoveries” while ignoring alternative explanations, suppresses criticism and relies on personal attacks and claims of conspiracy, amasses non-verifiable or replicable results, exaggerates claims, and relies on subjective measurements and tautological (circular) reasoning. The mental health field certainly has no shortage of problems concerning conflicts of interest, suppression of dissent, lack of replication, and exaggerated claims.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“A science becomes an ideology when dissent is suppressed, information is presented in confusing and overcomplicated ways, and when an attitude of omnipotence and authoritarianism is portrayed (Canestrari, 1999).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Mental health is an enormous business; in the United States, more money is spent on mental health conditions than any other medical specialty, with an estimated $201 billion spent in 2013 alone and an estimated increase to $280 billion by 2020 (Substance Abuse and Mental Health Services Administration, 2014). More than half of the budget for the American Psychiatric Association is income received directly from pharmaceutical companies, and drug-makers are the most frequent and largest donors of mental health advocacy groups (see, e.g., Harris, 2009). Speaking and consulting gigs for the pharmaceutical industry can earn psychiatrists up to $1 million or more in direct fees per year,4 and at least 70% of the professionals making up the task force for the DSM were tied to pharmaceutical companies (Cosgrove & Krimsky, 2012), raising concerns about corporate interests reflected in practice and policy and accusations of disease mongering (Moynihan, Heath, & Henry, 2002). The incentive for ensuring the medical and biological framework for conceptualizing problems in living is huge.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Although one might think that psychology would be the one field where unconscious biases might be acknowledged and considered, it rarely is. Inferential errors are common among clinicians, who tend to attribute client change for the better to intervention effectiveness (illusory causation; Lilienfeld et al., 2014) while change for the worse is attributed to client factors (attributional bias; Batson & Marz, 1979). Diagnoses are conceptual heuristics prone to the same errors inherent in all stereotypes,3 and their use is directly associated with prejudice and fear (Read, Haslam, Sayce, & Davies, 2006). Increased genetic determinism and “blaming the genes” can be considered as evidence of the ultimate attribution error (Pettigrew, 1979), wherein behaviors perceived as problematic by a person from a stereotyped group are considered to be genetically based; at the same time, any positive behaviors are suggested to be exceptions to the rule or due to situational context (i.e., “treatment”). Confirmation biases appear to be rampant, in that researchers and clinicians, unless actively seeking alternative explanations, are likely to observe and take note of behaviors and explanations that fit their preconceived ideas and beliefs (Croskerry, 2002; Garb, 1997; Nickerson, 1998). Another common bias that may arise is an overpathologizing bias that describes the tendency for women and minorities to be perceived as requiring more intense and intrusive interventions (Lopez, 2006; Ussher, 2010”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Others have written about losing their funding and jobs for documenting unfavorable findings to the prevailing ideology (e.g., Watson, Arcona, Antonuccio, & Healy, 2014)2 and being criticized and marginalized within educational programs for dissent (e.g., Hunter, 2015). There have even been instances where researchers were sued by their funding companies for publishing negative results (Bodenheimer & Collins, 2001). It is nearly impossible to get a degree and obtain licensure as a mental health professional without conforming to a strict way of thinking and expressing oneself. Those who question or dare to challenge the status quo are often removed from training, fired from programs, lose or never even receive funding, and/or are not given voice in academic forums (i.e., journals). This suppression of dissent and insistence on conformity is not how science progresses.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“The biases, career interests, and distortions of information spread to the public and professionals alike stand in the way for vulnerable individuals to find the help they need. There is no room for politics or careerism in helping people who have experienced some of the worst that life has to offer.”
― Noel Hunter, Trauma and Madness in Mental Health Services

“The mental health field also maintains authority through selectivity of its members and suppressed dissent. There is a pretense of certainty propagated by leaders in mental health, with oft repeated promises of supporting evidence to be discovered soon; it is taken for granted that their authoritative stance is merited. Despite this political posturing, several areas of concern actually leave much to question, for instance: it is rare for findings to be replicated (Open Science Collaboration, 2015), with only about 3% of journals even being willing to accept articles attempting to repeat previous studies to see if their findings were more than just a fluke (Martin & Clarke, 2017); the peer -review process of journals is biased toward recognizable names and against newcomers or detractors (Bravo, Farjam, Grimaldo Moreno, Birukou, & Squazzoni, 2018), setting up a sort of “good ol’ boys’ club” dynamic; the rates of authors retracting their studies due to problems or false findings are rapidly rising (Steen, Casadevall, & Fang, 2013); the subjects used in studies are consistently biased (Nielsen, Haun, Kartner, & Legare, 2017) and based on samples that are among the least representative of humans, in general (e.g., Arnett, 2008); spurious and meaningless correlations are frequently reported as exciting new discoveries (see Richardson, 2017); gold-standard “evidence-based treatments” are, on average and at best, only helpful for about 25% of people (Shedler, 2015); selective reporting, guild interests, and researcher allegiance heavily bias psychiatric research (Leichsenring et al., 2017; Whitaker & Cosgrove, 2015); and, perhaps most important, with all the purported advances in treatment, the prevalence and long-term outcomes of diagnosable mental disorders has not decreased in the last century (Jorm, Patten, Brugha, & Mojtabai, 2017; Margraf & Schneider, 2016), while disability rates continue to rise exponentially (see Whitaker, 2010 for an analysis on this trend).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Of course, for many others, mental health services may be viewed as life-saving (and for some it also may be both and everything in between!). Certainly, there are numerous individuals helped by traditional mental health interventions and the dedicated individuals who spend their lives assisting others. The subject matter of this book is not about criticizing individual clinicians or negating the beneficent intentions of many mental health professionals. Rather, it is an exploration of the system as a whole, the ideas and assumptions that support the oppressive nature of mental health services, how current treatment practices impact many, especially those who are already marginalized and/or who have experienced severe complex trauma, and what people have found to be helpful, both in and out of the system, when recovering from childhood adversity (Part II).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“When an emotional problem is conceptualized as internal, as a disease, as a faulty personality, or otherwise, a message is being implied that such a person is innately defective; the problems in the world, in the family, and in society are simply meaningless triggers of an individual deficit rather than the problems themselves. And, if one is a victim of such disease, then it is logical to assume they have no responsibility or control over their behaviors and must, therefore, be controlled by others. By dismissing the life circumstances underlying one’s distress and blaming them for having something internally wrong with them, society is, in effect, for many re-creating the traumatic dynamics that led to the distressing experiences in the first place. This is not hyperbole; evidence has demonstrated the traumatizing effects of mental health care for many, with some meeting full criteria for PTSD as a direct result of their treatment experiences (e.g., Mueser, Lu, Rosenberge, & Wolfe, 2010).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“Ongoing efforts to combat stigma by asserting that “mental illness is an illness like any other” are actually associated with increased stigma and increased efforts to distance oneself from those deemed mentally ill (Read, Haslam, Sayce, & Davies, 2006).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“One inadvertent consequence of labeling emotional distress as illness and categorizing different ways of reacting to life as disease is marginalizing people and setting up circumstances that lead to prejudice and discrimination (Chap. 4).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“The harm done by excluding certain disorders from those based in trauma is particularly evident for categories such as schizophrenia and bipolar disorders. In this, an apparent conceptual separation exists that deems experiences like hearing voices or paranoia as “psychotic-like” in those individuals (usually White women) whose trauma is easily recognized as being associated with such experiences, while others (usually Black men) are designated as having a brain disease (i.e., schizophrenia ) and truly psychotic for expressing these same internal experiences in a more confusing or symbolic manner (Chap. 3). Perhaps more troubling are those individuals whose trauma is recognized but whose responses to this trauma are dismissed as a personality defect, manipulative, fake, and/or representative of a multitude of different diseases (i.e., comorbidity; Chaps. 2 and 4).”
― Noel Hunter, Trauma and Madness in Mental Health Services

“There is also some evidence indicating specificity, wherein certain adverse experiences appear to be related to specific psychic phenomena. For instance, being bullied as a child is closely related to intense paranoia, while sexual abuse is more closely related to hearing voices (Bentall et al., 2012). Yet, most research and treatment continues to focus on individual internal defects (i.e., “illness”) that exist separate from one’s developmental context or life circumstances, and a search for the ever-elusive genetic basis for these purported defects.”
― Noel Hunter, Trauma and Madness in Mental Health Services