ISEPP's 24th annual conference will be held October 29-30, 2022 between 12pm and 6pm U.S. Eastern time.

This year's title is: A Paradigm Shift: From Pathologizing to Valuing Emotions.  

Register now!

by Chuck Ruby, Ph.D.

ISEPP is launching a new blog entitled "Fact Checking Psychiatry." It is an attempt to change psychiatry and the allied mental health professions from within. Through the blog, ISEPP mental health practitioners and academics will share their criticism of the medical model of human distress and how that model can be misleading, a waste of time, and potentially dangerous. As much as is possible, we will focus essays on current events relative to ISEPP's mission.

The intent is to attract professionals from within the mental health industry and to encourage them to consider asking the hard questions about the foundation of their professions. We hope those professionals, as well as the many people who are at the receiving end of these dubious psychiatric services, follow this blog and submit comments in order to start an ongoing and serious discussion.

Perhaps the most important ISEPP criticism of the medical model is the very foundation of the construct of "mental illness" and "mental health." We see them as oxymoronic - if something is mental, it can't be about literal illness or health; if something is about literal illness or health, it must be physical.

The only way around this would be to invite the medical establishment - psychiatry and its allied professions - to rule over the experiences of emotions and thoughts and how we act in this world. This would, in effect, drastically alter the definition of "illness" to include any experience or behavior that is considered a problem. This would be a very dangerous idea since those mental health professionals have no expertise in determining the appropriate ways of living life.

Moral judgments are the only ways to identify those "illnesses," since there is no pathophysiological basis to detect. So, mental health professionals would be in the business of determining appropriate levels of emotional distress, problematic thoughts, and wayward conduct and of enforcing so-called proper ways. Who among us wants this?

This is exactly what happened centuries ago when the Church was given that role on a society-wide basis, and we all know how that turned out. We also know how that approach turned out in totalitarian governments during more recent times when the mental/moral/medical profession identified politically inconvenient people and targeted them for "treatment" to make them more easily handled by those in power. To the extent that the mental health industry has incorporated more and more human dilemmas and struggles into diagnostic categories, this very thing seems to be where we're now headed in the 21st century. ISEPP wants to change that.

The many, many problems that get lumped into the rubric of "mental illness" are serious and they can have devastating effects on people, both those directly suffering and those who suffer as witnesses. But, absent any evidence that the suffering is due to pathophysiology - something wrong in body functioning - those problems are hardly medical matters.

Instead, they are personal, spiritual, economic, political, interpersonal, and existential struggles. There are many methods to help people with those struggles outside a medical model, and those methods do not harm, they operate with full informed consent, and they respect the principles of self-determination.

Chuck Ruby, Ph.D., is a psychologist in private practice and the Executive Director of the International Society for Ethical Psychology and Psychiatry (ISEPP). He is the author of Smoke and Mirrors: How You Are Being Fooled About Mental Illness – An Insider’s Warning to Consumers. Dr. Ruby earned his doctorate at Florida State University in 1995. He is a 20-year U.S. Air Force veteran.

Click here to watch ISEPP's 2021 conference.

The Destructive Propaganda of the Mental Health Industry: 

How Did We Get Here?

Where Are We Going?

Convened: October 9-10, 2021

Dedicated to the life and memory of Paula J. Caplan, Ph.D.

Since the dawn of civilization, the human species has struggled with the "other," the foreign, the different, the unusual, the suffering, the mad, the crazy, the psychotic, and those deemed "less than," sometimes kindly, many times with great cruelty.

Last year's conference addressed the question: "How did we allow biological psychiatry take a strangle hold of the struggles and diversity of humanity?"

The presentations explored how the so-called "medical model" has insinuated itself through privilege and power into virtually all aspects of our culture, from defining what is "normal" to pushing a diseased brain model of all behavior. Our schools, our courts, our healthcare, our every day life have felt the impact of psychiatry's prejudices.

SPEAKER LINEUP

Introduction to the Power Threat Meaning Framework: A Non-Diagnostic Conceptual System - Lucy Johnstone, Ph.D., psychologist

Dr. Johnstone is a consultant clinical psychologist, author of Users and Abusers of Psychiatry (2nd edition, Routledge, 2000) and co-editor of Formulation in Psychology and Psychotherapy: Making Sense of People’s Problems (2nd edition, Routledge, 2013) and A Straight-Talking Guide to Psychiatric Diagnosis (PCCS Books, 2014), along with a number of other chapters and articles taking a critical perspective on mental health theory and practice.

She is the former Programme Director of the Bristol Clinical Psychology Doctorate and was the lead author of Good Practice Guidelines on the Use of Psychological Formulation (Division of Clinical Psychology, 2011). She has worked in Adult Mental Health settings for many years, most recently in a service in South Wales. She was lead author, along with Professor Mary Boyle, for the Power Threat Meaning Framework (2018), a Division of Clinical Psychology-funded project to outline a conceptual alternative to psychiatric diagnosis.

Lucy is an experienced conference speaker and lecturer, and currently works as an independent trainer. Her particular interest and expertise is in the use of psychological formulation, in both its individual and team versions, and in promoting trauma-informed practice.

Eugenics and the History of Mental Mis-Treatments: The "Science of Racial Betterment," the Mentally Unfit, and Utopian Promises of Breeding the Super Race - Okasana Yakushko, Ph.D., psychologist

Dr. Yakushko is a licensed psychologist, practicing clinician, and a professor in the Clinical Psychology program at Pacifica Graduate Institute (Carpinteria, CA). Her initial scholarship focused on xenophobia and such global concerns as trafficking and gender violence. Her recent work seeks to examine the impact of historical forms of scientific ideologies, such as the eugenics movement, on past and contemporary discipline/practice of psychology and other mental health fields. In addition, she traces eugenics based sciences/scientism to such contemporary phenomena as "race realism" (dominant in promotion of White supremacy), "evolutionary psychology" (central to justifications in the "manosphere" and related online misogyny groups), and "positive psychology" (highly popularized psychology efforts to promote ahistorical, biologized and social/emotional control-based views of humanity). She is an author of over 60 peer reviewed articles and book chapters. Her recent books include Modern Day Xenophobia (Palgrave, 2018) and Scientific Pollyannaism (Palgrave, 2019). Her upcoming publication entitled "Shameful Sciences!": Eugenics and Its Evolution in American Psychology is scheduled to be released in 2022. She is a Fellow of the American Psychological Association, a Board Member of APA's Division 39 (Psychoanalysis), and the recipient of the Leadership Award of the Committee on Women in Psychology (APA) in 2021. 

Domination Code and Generational Carry in
Liberation Psychology - David Edward Walker, Ph.D., psychologist

Dr. Walker is a liberation psychologist, writer, and musician who traces his connections to Indian Country through consulting work with the Confederated Tribes & Bands of Yakama Nation in central Washington state as well as via his music and Missouri Cherokee heritage. His series of critiques of the U.S. mental health system’s checkered role with Native Americans for Indian Country Today (ICT) was well received and controversial. His new book, Coyote's Swing: A Memoir & Critique of Mental Hygiene in Native America, is currently pending
publication at Washington State University Press and slated for 2022. ICT praised Dr. Walker's Medicine Valley novels, Tessa’s Dance and Signal Peak, for dealing “with all the issues of tragedy, psychological healing, and cultural and language revitalization. . . necessary in the
wake of centuries of genocidal efforts to destroy our Nations and Peoples.” An established singer-songwriter, Music Hound’s Essential Guide to Folk Music calls David “a singer-songwriter with a special ability to reach listeners” via “rich metaphors, spiritual themes,
moving ballads, and ambitious fingerstyle guitar work.” You can learn more at www.davidedwardwalker.com.

Afrikan Origins of the Study of the Psyche: Disrupting Western Corruption of Mental Health - Kevin Washington (Mwata Kairi), Ph.D., psychologist

Dr. Washington is an African-Centered psychologist licensed in Florida and Washington, DC. He is a graduate of Grambling State University as well as Texas A&M University. He has taught/lectured at several colleges nationally and internationally. NBCUniversal/BEN, National Alliance to End Homelessness, Roland Martin, Essence and many other national and international organizations have sought his expertise on psychological matters. He is a Past President of the Association of Black Psychologists and is currently an Associate Professor and Head of the Sociology and Psychology at Grambling State University and he is the National Director of Black Marriage Day. As a Fulbright-Hays scholar Kevin (Mwata) researched the impact of socializing institutions on the healing or restructuring of post-apartheid South Africa (Azania). It was in South Africa where he researched Ubuntu and how it can inform mental health service delivery to people of African ancestry and others. Much of his work focuses on healing the psycho-spiritual wounds that are present within people as a result of Cultural and Historical Trauma.  Mwata continues to develop healing paradigms for persons of African ancestry who have been impacted by Persistent Enslavement Systemic Trauma (PEST). He is the founder of Ubuntu Psychotherapy which is a culturally sensitive modality for mental health counseling and Psychotherapy for Black men and boys as well as Black/African families. He advances culturally-relevant trauma informed care and interventions to be utilized by psychotherapists, that are culturally inclusive and particularized to the healing of Black and brown people. Through his research and writing he seeks to assist people to live life with power, purpose and passion.

Dr. Tarantolo is a psychiatrist, psychoanalyst, group therapist for over 40 years on Capitol Hill. He specializes in helping patients come off psychotropic drugs.

He published  “Primum Nocere, First to Harm, a Critique Of Neuroleptics and Theory Why they Continue to Be Prescribed” and had a cameo appearance in the film, "Thank You For Your Service” concerning the moral damage of war to American combatants.

Panel: The Medicalization of War Trauma: Who Is Served by This Model? - Mary Neal Vieten, Ph.D., ABPP, psychologist, and Warfighter Advance alumni:

MSgt Troy Drasher (USAF, ret)
Aircraft Weapons Specialist, First Sergeant (“Shirt”)

HM1(FMF) Shannon Book (USN, ret)
Fleet Marine Force Corpsman

Sgt Meeka McWilliams (USA, ret)
Automated Logistics Specialist

SPC4 David Rose (USA)
Combat Trauma Medic, Dustoff Medic

LCpl Douglas Gresenz (USMC)
Infantry Assaultman

Jason Lott
Law Enforcement Dispatcher, Volunteer EMT

This panel includes combat veterans who have survived the medicalization of their emotional response to war. They discuss the impact of DSM-5 labels and psychiatric drugs on their reintegration, the difficulties of withdrawal, and the permanent physical injuries the drugs have caused.

Dr. Vieten is a board certified clinical psychologist and U.S. Navy Commander (retired). She served on active duty from 1998 to 2008, with tours at the Naval Medical Center Portsmouth, Roosevelt Roads (Puerto Rico), and Naval Air Station Patuxent River. In 2008, Dr. Vieten transferred to the Select Reserve, where she has held several positions, including the Officer-in-Charge of the Headquarters Detachment, and Regional Detachment Director for New England, Expeditionary Medical Facility, Bethesda. In 2014, she was recalled to active duty and assigned to the staff of the Navy Chief of Chaplains where she trained over 1,000 military chaplains worldwide in pastoral response to operational and military sexual trauma. She has completed two deployments in support of Operation Iraqi Freedom and Operation Enduring Freedom.

Our dear friend and colleague, Paula J. Caplan, Ph.D., died on July 21, 2021 at her home in Rockville, Maryland. Paula was a tireless advocate for those who have been harmed by the conventional mental health industry, especially women and veterans. She has touched the lives of countless people and we can still hear the echoes of her forceful message.

It is fitting that we dedicate this conference to her, given that she spoke for those who have been branded as defective with "mental illness" labels. For decades, Paula stood toe-to-toe with the powerful and entrenched orthodoxy. One of her most notable achievements was when she served on the DSM task force in an attempt to ensure its scientific foundation and to remove the long-standing biases against marginalized and minority groups. She eventually resigned from the task force over that orthodoxy's resistance to change. Still, her voice of justice reverberated throughout the mental health professions and the lay public.

In 2019, ISEPP presented Paula with the ISEPP Lifetime Achievement Award. It states:

Chuck Ruby, Ph.D., Psychologist

Earlier this month, Dainius Pūras, M.D., was interviewed by Awais Aftab, M.D., of the Psychiatric Times. Dr. Pūras was asked about his experiences as a United Nations Special Rapporteur from 2014 to 2020. In that role, he was charged with assessing the human rights aspects of mental health¹ systems across the globe and reporting his findings to the United Nations Human Rights Council.

A primary concern of Dr. Pūras' was his dissatisfaction with the traditional separation of physical health and mental health. He believes this separation causes stigma and discriminates against people who seek mental health services. He further thinks that combining them under the same rubric of health and medicine is the solution to achieving mental health parity, the end of stigma and discrimination, and the advancement of human rights for those seeking mental health services.

In addition to merging physical and mental health, he proposed that both systems deemphasize the biomedical approach, asserting that psychiatry and mental health professions are in a position to remind the rest of the medical world that medicine is fundamentally a social science. In other words, health and illness are largely affected by social determinants, such as poverty and other social inequities, and the field of medicine should be addressing these social determinants and not just the defective biology of patients.

I agree that the discrimination and stigmatization of those seeking mental health services are due to separating it from the rest of medicine, and I am glad to see Dr. Pūras objecting to the excessive biomedicalization of human living. However, I disagree that the solution to this problem is to merge mental and physical health.

Doing so would strengthen the medical industry's domination over individual lives, and solidify its role of morally judging the appropriateness of distress and behavior. Notwithstanding the importance of addressing social factors that impact health and illness, the study of medicine is primarily a chemical, mechanical, and biological endeavor. It is not suited for providing expertise in making judgements about how we should respond to the emotional challenges of living.

So, instead of combining physical and mental health, I suggest keeping them separate, but in a fundamentally different way. The solution to stigma and discrimination, and the subsequent threats to human rights for those seeking mental health assistance, is to realize that the essence of mental health care is not literally about health and illness. It definitely isn't about using chemical, mechanical, and biological knowledge and skills to correct dysfunctional physiology.

Instead, the term "mental health" is a figurative description of social challenges, personal meaning, emotional distress, and one's responses to these things. Therefore, it is in a domain completely separate from the study of medicine and the literal idea of health and illness, not a different type to merge with the physical type.

Of course, as with all human activity, there is underlying biology at work. This fact, however, is not the same as claiming the biology involved is defective or malfunctioning. It doesn't even mean the biology causes those human actions any more than it could be said the actions cause the biology to occur.² For example, when we walk or talk, there is biology that allows for walking and talking. Does biology cause walking and talking? Or, does walking and talking cause the biology to occur.

The same goes for when we think, feel emotions, and take action of any kind. There is biology always at work. Yet this fact doesn't mean that biology causes those things, and it clearly doesn't mean those things are disorders or illnesses caused by defective biology. Even when those human actions are very problematic, it is not logical to conclude they equal illness and lack of them equals health. If I walk in front of a bus and get injured, the decision to walk and the act of walking are not illnesses. Instead, the subsequent injury is the illness.

Having said this, the field of medicine does have an important, but limited, role at the intersection of physical health and mental health matters. Specifically, medical intervention can serve three purposes: 1) it can alleviate the negative physiological correlates of personal actions and distress (e.g., gastric damage, injuries); 2) it can identify and treat physiological defects, the results of which mimic mental health problems (e.g., poor nutrition, urinary tract infections); and 3) it can offer chemicals to those who choose, with full informed consent, to subdue their experiences of distress (e.g., Valium, Zoloft) just like it does for people who want to numb arthritis or headache pain.

This limited role is inherent in the fact that mental health problems are based on a definition that is void of any physiological ailment that medical specialists can diagnose and treat. More importantly, in situations where there is a physiological affliction, psychiatry (or the other mental health professions) would not handle it; the appropriate medical specialty would step in. Psychiatrists and psychologists don't treat gastric damage, broken bones, vitamin deficiencies, or urinary tract infections.

So, Dr. Pūras has good reason to be concerned about the separation of physical and mental health and the stigmatization and discrimination that come from it. However, it must be remembered that the mental health system created this problem in the first place in its definition of mental disorder. The DSM-5 defines it as a disturbance in thinking, feeling, or acting that is caused by impairment in mental functioning. Setting aside the circular nature of this definition, it makes mental disorder sound like a matter of dysfunction in a person, just like with physical illnesses.

But the main problem with this definition, and the reason it necessitate the separation of physical and mental health matters, is that such impairment in mental functioning cannot be identified without using moral judgments. It is not identified with an examination of chemical, mechanical, or biological dysfunction.

This is why DSM diagnoses and their criteria are developed out of the wrangling and consensus of committee members and not evidence of impairment. They are based on an aggregate moral judgment: what should we be distressed about, how much distress should we feel, how long should we feel distressed, and what should we do about the distress. In stark contrast to this, physical health matters are defined as actual bodily defects that threaten a person's physiological viability. No moral judgment is involved in identifying or theorizing about physical illness.

Therefore, it appears clear that the only way to eliminate the stigmatization and discrimination of those seeking mental health services is to eliminate this medical-moral model of mental health. Otherwise, those seeking services will continue to be seen as suffering from a mixture of medical and moral problems, which is why there is such popular fear and derision of those said to be mentally ill. It is also why they are stigmatized and discriminated against, and why their human rights are frequently violated.

By continuing to conflate physical health and mental distress, and anointing medical professionals as experts in the latter, the mental health system will always be prone to stigma and discrimination, opening the doors to involuntary and forced treatment. The resulting irony is that while we frequently see such coercion within the mental health system, we rarely see it with physical health. People who are diagnosed with physical health problems, such as diabetes, cancer, and heart disease are rarely treated involuntarily, against their will (unless, of course, they are judged mentally ill and, thus, not able to make "wise" choices).

In this way, the mental health professions have taken on a medical-moral role in identifying inappropriate (i.e., wrong, abnormal, bad, "sick") personal conduct and experiences, portraying them as the result of something impaired in the person, and seeking various ways to muzzle them. There is no way to medically correct the alleged impairment because there is no identifiable impairment to correct. All too often, the conventional methods of treatment are merely physical, chemical, and electrical restraint. Talk therapy, or psychotherapy, can also be a form of restraint in the form of scolding people for having these inappropriate experiences and persuading or coercing them to change their conduct. None of these are forms of medical treatment. They are forms of control.

Dr. Pūras' international efforts to ensure the right to mental health is a very worthy effort, but it means different things depending on the definition of “mental health” as explored above. If it is defined as in the DSM, then that right hardly applies to the person so affected. This is because, by definition, the affected person’s thoughts, emotions, and actions are the product of a dysfunction. Therefore, that person’s decisions and choices are not to be valued or honored because they are the tainted product of that dysfunction.

If, however, the right to mental health is defined as one’s right to decide how to resolve personal challenges, what to do about emotional distress, and what actions to take to resolve those challenges and distressing feelings, including which services of the conventional mental health system to take advantage of, then we’re really talking about respecting human rights.

In fact, Dr. Pūras was adamant that we should work toward eliminating all forms of coercive treatment and base our services on individuals' preferences and desires, even in cases where they are considered psychotic. But I don't see how this can possibly happen without abandoning the medical-moral model of human distress that defines mental health problems as something impaired in the person.

In his further emphasis on respecting individual choice, Dr. Pūras, pointed out the importance of democratic systems for the promotion of good mental health and adherence to human rights. But how can the right of mental health exist if the mental health system itself is not democratic, and instead mirrors the many totalitarian and authoritarian regimes that devalue the desires of its citizens? He lamented that mental health professionals and academics frequently block attempts to change the status quo, making the right to mental health impossible, since it prevents fully informed consent and it allows human rights to be routinely violated.

It appears clear to me that in order to arrive at a truly human rights based mental health system, we have to understand that the essence of mental health is not a matter of health and illness. Therefore, we need to find substitute terms for "mental illness" and "mental health" that accurately describe the very real problems that people endure and what can be done to help them. "Mental health" must not be seen as a different kind of hybrid health split off from physical health, and it must not be merged with physical health. It must be recognized as having to do with personal meaning, distress, and choice.

¹I use the term "mental health" only as a metaphor. I do not intend to imply that it is a literal matter of health and illness.

²See Chapter 12, The Difference Between Brain and Mind in my book Smoke and Mirrors: How You Are Being Fooled About Mental Illness - An Insider's Warning to Consumers. Welcome, MD: Clear Publishing for an elaboration of this conundrum.

CAMPP (ISEPP's action committee) just released "Prescripticide", a new 12-minute video about how psychiatric drugs increase the risk of violence and suicide. Please view this video and share it as widely as possible so it goes viral!

[embedyt] https://www.youtube.com/watch?v=6YRnewUXLvw[/embedyt]

Podcast interview of Gail Tasch, M.D. - One Female Doctor's Call to Arms When It Comes to Psych Drugs for Children: Part 1, Part 2, Part 3

Is COVID-19 Making Everybody Crazy? - Paula Caplan, Ph.D.   Paper Version: Is Covid-19 Making Everybody Crazy?

Effects of Children’s Screen Time During COVID—19 - Jeanne Stolzer, Ph.D.   Paper Version: Screen Time 

Chronic Pandemic Stress Disorder, CPSD, A Unique Challenge for Avoiding Massive Anxiety and Depression in Our New World - Brian Sheen, Ph.D.   Paper Version: CPSD