psychiatric genocide in Nazi Germany and schizophrenia

Hartheim

There’s a free arti­cle in the Schiz­o­phre­nia Bul­letin (pdf) Psy­chi­atric Geno­cide: Nazi Attempts to Erad­i­cate Schiz­o­phre­nia by E. Fuller Tor­rey and Robert H. Yolken. You can see the abstract with­out down­load­ing the doc­u­ment here.

It’s esti­mated that 220,000 to 269,500 per­sons with schiz­o­phre­nia were mur­dered by the Nazis, which rep­re­sented between 73% to 100% of indi­vid­u­als with schiz­o­phre­nia liv­ing in Ger­many in 1939 – 1945. After the war, the rate of inci­dence of schiz­o­phre­nia was high; the sim­plis­tic genetic the­ory about schiz­o­phre­nia that the Nazis expected to be proven with ster­il­iza­tion and geno­cide was wrong.

Drs Ernst Rudin and Franz Kall­mann pro­moted the the­ory that schiz­o­phre­nia was a Mendelian inher­ited dis­ease that was passed down from gen­er­a­tion to gen­er­a­tion. Rudin thought that peo­ple with schiz­o­phre­nia should not have chil­dren— his research was sup­ported by the Rock­e­feller Foun­da­tion. The con­cept of “race hygiene” was pop­u­lar in Ger­many in the 1930s at the same time that the eugen­ics move­ment in the U.S. and Britain were peak­ing. States in the U.S. had been ster­il­iz­ing “lunatics” since 1907. Dr. Rudin, after mov­ing to New York, became the pres­i­dent of The Inter­na­tional Con­gress of Eugen­ics in 1932. From the article:

In 1916, New York patri­cian Madi­son Grant had pub­lished The Pass­ing of the Great Race, a jere­miad about the dan­gers of inter­ra­cial mar­riage that Sci­ence mag­a­zine called ‘‘a work of solid merit’’; it was sub­se­quently trans­lated into Ger­man and cited by Hitler in Mein Kampf.

Dr. Kall­man, who had been a stu­dent of Rudin stud­ied twins with schiz­o­phre­nia and also con­cluded that it was inher­ited. Kall­man advo­cated an exam­i­na­tion of rel­a­tives of peo­ple with schiz­o­phre­nia in an effort to iden­tify the ones who were not schiz­o­phrenic but that he believed were “car­ri­ers” of the reces­sive gene respon­si­ble for schiz­o­phre­nia and had them ster­il­ized. A year after that, he immi­grated to New York where he con­tin­ued twin studies.

While in Ger­many, about six months after Hitler had become chan­cel­lor, Rudin lob­bied for the “the law for the pre­ven­tion of prog­eny with hered­i­tary defects” to be passed. The first tar­gets were peo­ple who were diag­nosed with men­tal retar­da­tion, schiz­o­phre­nia, manic-​depressive dis­or­der, epilepsy, Hunt­ing­ton chorea, hered­i­tary blind­ness and deaf­ness, hered­i­tary alco­holism, and “grave bod­ily mal­for­ma­tion.“
Most of these peo­ple were in over­crowded men­tal hos­pi­tals. Patients with schiz­o­phre­nia who were being dis­charged from hos­pi­tals to make room for other patients, were the high­est pri­or­ity for ster­il­iza­tion. Over­crowd­ing in Ger­man psy­chi­atric hos­pi­tals was, at that time, a prob­lem that influ­enced the deci­sion to ster­il­ize and then mur­der psy­chi­atric patients.

The size of the pop­u­la­tion of patients in psy­chi­atric hos­pi­tals in Ger­many went from under 50,000 in 1800 to just under 240,00 in 1913; which was not pro­por­tion­ate to the increase in the total pop­u­la­tion of the coun­try. Also, over 140,000 asy­lum patients died from infec­tious dis­ease and hunger dur­ing World War I, yet the patient pop­u­la­tion was quickly replen­ished. The asy­lums were chron­i­cally over­crowded even after hos­pi­tals stays were reduced from 215 to 103 days. In one asy­lum, two-​thirds of the patients were diag­nosed with schiz­o­phre­nia, which was being diag­nosed more and more fre­quently. A mas­sive increase of schiz­o­phre­nia diag­no­sis was also occur­ring in Eng­land and the U.S. at that time.

The post-​war eco­nomic and polit­i­cal cri­sis in Ger­many, com­bined with a boom­ing psy­chi­atric pop­u­la­tion were fac­tors that led to the idea of killing patients which was pro­moted in a pub­li­ca­tion titled Per­mis­sion for the Destruc­tion of Life Unwor­thy of Life which asked

Is there human life which has so far for­feited the char­ac­ter of some­thing enti­tled to enjoy the protect-​ion of the law, that its pro­lon­ga­tion rep­re­sents a per­pet­ual loss of value, both for its bearer and for soci­ety as a whole?

which was answered in the affir­ma­tive. Then there was an arti­cle called The Erad­i­ca­tion of the Less Valu­able from Soci­ety, which claimed that men­tal patients were cost­ing Ger­man soci­ety 150 mil­lion Reichs­marks a year. This appealed to Hitler who

… was inter­ested in these ideas and is said to have cis­cussed a pro­gram to kill chronic men­tal patients in 1933, shortly after assum­ing the chan­cel­lor­ship. He said that ‘‘it is right that the worth­less lives of such crea­tures should be ended, and that this would result in cer­tain sav­ings in terms of hos­pi­tals, doc­tors and nurs­ing staff.’ Prophet­i­cally, he sug­gested that such a pro­gram would be eas­ier to imple­ment dur­ing wartime, when pub­lic oppo­si­tion would be less.

While plan­ning to invade Poland in 1939, Hitler asked offi­cials to draft a law per­mit­ting the killing of men­tal patients that used the term “euthana­sia” in order to por­tray it as a mercy killing, which he put in place on the day he invaded Poland.

Hitler granted legal immu­nity to every­one that par­tic­i­pated in the mur­ders. A com­mit­tee of psy­chi­a­trists sorted men­tal patients by their abil­ity to do work, but required peo­ple diag­nosed with schiz­o­phre­nia to be killed with­out exception.

The authors of this paper are call­ing for more infor­ma­tion on this Nazi pro­gram and feel that it should be stud­ied as much as any other Nazi geno­cide. It’s only seven pages long, is writ­ten for a wide audi­ence, is infor­ma­tive, and it’s FREE.

articles on communities, economies, and suicide

APPLE-FOXCONN: SHENZHEN, CHINA

On Sui­cide Sta­tis­tics by Echidne at Echidne of the Snakes

Human beings are herd ani­mals. We should all talk to the steer next to us, we should learn that ask­ing for help in dire sit­u­a­tions is a sign of strength, not a sign of weak­ness, that the help received that way can one day be returned (but not if you are no longer around), that men­tal health care pro­fes­sion­als are intended to serve us in our times of need, that all indi­vid­u­als have many aspects of value, that nobody should put all their dreams into one bas­ket and on and on. Com­mu­nity, in short. That’s one of its major functions.

Let’s return to the ini­tial news about the eco­nomic depres­sion and increased sui­cide rates among cer­tain groups of Amer­i­cans. We failed these indi­vid­u­als as a com­mu­nity. Econ­o­mists failed them. The gov­ern­ment failed them. The finan­cial and hous­ing mar­kets failed them. But their deaths should be counted in the over­all costs of the depres­sion and its aftermath.

Time for a New Under­stand­ing of Sui­ci­dal Feel­ings by Will Hall at Mad in America

Force­ful and intru­sive inter­ven­tions are not based on a sound cal­cu­la­tion of risk pre­ven­tion. Instead, they rou­tinely dam­age peo­ple, and dis­cour­age many more, who fear invol­un­tary treat­ment, from reach­ing out for help. (And peo­ple also some­times learn to use the lan­guage of “safety” and “sui­cide” to elicit the response of hos­pi­tal­iza­tion when no other treat­ment options are avail­able – rather than speak­ing in terms of the pain, fear, sad­ness, or help­less­ness they feel.) To be hon­est, forced inter­ven­tion can­not be shown to actu­ally pre­vent sui­cide, and what it really treats is fear of respon­si­bil­ity and lia­bil­ity held by pro­fes­sion­als. We need a new approach.

We need to speak openly about our sui­ci­dal feel­ings with­out fear of insti­tu­tional reaction.

When we have these dis­cus­sions, which I have had over the past 12 years as a sup­port group orga­nizer, trainer, and now as a ther­a­pist, we learn that sui­ci­dal feel­ings are much more com­mon than we real­ize. Many peo­ple live with sui­ci­dal feel­ings, and being able to talk about the urge to die, like being able to talk about any extreme dis­tress, is the key to recovery.

Our new spin on the Fox­conn sui­cide epi­demic at The Secret Diary of Steve Jobs

Sure, peo­ple kill them­selves all the time. But the Fox­conn peo­ple all work for the same com­pany, in the same place, and they’re all doing it in the same way, and that way hap­pens to be a grue­some, pub­lic way that makes a spec­ta­cle of their death. They’re not pill-​takers or wrist-​slitters or hang­ers. They’re not Sylvia Plath wannabes, seal­ing off the kitchen and qui­etly stick­ing their head in the oven. They’re jumpers. And jumpers, my friends, are a dif­fer­ent breed. Ask any cop or shrink who deals with this stuff. Jumpers want to make a state­ment. Jumpers are try­ing to tell you something…

…France Tele­com [had] a sui­cide epi­demic last year. Guess what. Nobody went around say­ing that it was no big deal because it was still below the national aver­age in France — instead the offi­cial expla­na­tion was that the sui­cides were caused by bru­tal man­age­ment harass­ing work­ers. The Sarkozy admin­is­tra­tion took this seri­ously and got involved and at France Tele­com a top exec­u­tive actu­ally resigned because of the tragedy.

articles on “brainwashing” and thought reform

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What hap­pens when psy­chol­ogy pro­fes­sion­als use psy­cho­log­i­cal mind tricks on fam­ily mem­bers Accord­ing to this arti­cle, psy­chol­ogy pro­fes­sion­als rank high as abusers. The arti­cle describes kinds of mind games that can be used to make a per­son feel crazy, lose self-​esteem, and essen­tially what the author calls “being brain-​washed” into believ­ing things about them­selves that aren’t true. As is always true with preda­tory manip­u­la­tion, this can be read as a warn­ing or a man­ual, depend­ing on your per­spec­tive and intentions.

Brain­wash­ing and Depro­gram­ming

Depro­gram­mers appeared on the scene, pre­sent­ing them­selves as hired gun inter­ven­tion super­heros, some­times charg­ing tens of thou­sands of dol­lars. They promised to reverse-​engineer the brain­wash­ing and restore the for­mer iden­tity. The pio­neer was Ted Patrick, whose own son was (as he described it) “psy­cho­log­i­cally kid­napped” by a cult. He was a life­long activist who, when faced with this new threat, boldly cre­ated the whole sub­cul­ture of depro­gram­ming. He was hired hun­dreds of times by aggrieved par­ents. Patrick’s meth­ods began with a kid­nap­ping, fol­lowed by phys­i­cal restraint and forced counseling.

Like Patrick, many depro­gram­mers did not have any for­mal coun­sel­ing cre­den­tials, and so the process itself had much more in com­mon with the Chi­nese brain­wash­ing than it had with any legit­i­mate psy­chother­apy. They would begin not by break­ing down the subject’s iden­tity, but that of the cult leader, even­tu­ally get­ting the sub­ject to rec­og­nize the rea­sons the cult leader has been rejected by moral soci­ety. At last the sub­ject would see him­self as allied with the depro­gram­mers against the cult leader.

Depro­gram­ming was quite sticky from a legal stand­point. Obvi­ously, kid­nap­ping and false impris­on­ment are ille­gal, and many depro­gram­mers were con­victed, includ­ing Patrick him­self. The Amer­i­can Civil Lib­er­ties Union often took up the cases of depro­gram­ming sub­jects, point­ing out that they had joined the cults on their own free will, and it was the depro­gram­mers who were the only crim­i­nals involved.

Thought Reform and the Psy­chol­ogy of Total­ism. An excerpt from Chap­ter 22 of a book by the Psy­chol­o­gist Robert Jay Lifton. In this chap­ter, he dis­cusses thought reform and the psy­chol­ogy of human zealotry. Aaaaand— BOOM:

At the level of the rela­tion­ship between indi­vid­ual and envi­ron­ment, the demand for purity cre­ates what we may term a guilty milieu and a sham­ing milieu. Since each man’s impu­ri­ties are deemed sin­ful and poten­tially harm­ful to him­self and to oth­ers, he is, so to speak, expected to expect pun­ish­ment — which results in a rela­tion­ship of guilt and his envi­ron­ment. Sim­i­larly, when he fails to meet the pre­vail­ing stan­dards in cast­ing out such impu­ri­ties, he is expected to expect humil­i­a­tion and ostracism — thus estab­lish­ing a rela­tion­ship of shame with his milieu. More­over, the sense of guilt and the sense of shame become highly-​valued: they are pre­ferred forms of com­mu­ni­ca­tion, objects of pub­lic com­pe­ti­tion, and the basis for even­tual bonds between the indi­vid­ual and his total­ist accusers. One may attempt to sim­u­late them for a while, but the sub­terfuge is likely to be detected, and it is safer to expe­ri­ence them genuinely.

Peo­ple vary greatly in their sus­cep­ti­bil­i­ties to guilt and shame, depend­ing upon pat­terns devel­oped early in life. But since guilt and shame are basic to human exis­tence, this vari­a­tion can be no more than a mat­ter of degree. Each per­son is made vul­ner­a­ble through his pro­found inner sen­si­tiv­i­ties to his own lim­i­ta­tions and to his unful­filled poten­tial; in other words, each is made vul­ner­a­ble through his exis­ten­tial guilt. Since ide­o­log­i­cal total­ists become the ulti­mate judges of good and evil within their world, they are able to use these uni­ver­sal ten­den­cies toward guilt and shame as emo­tional levers for their con­trol­ling and manip­u­la­tive influ­ences. They become the arbiters of exis­ten­tial guilt, author­i­ties with­out limit in deal­ing with oth­ers’ lim­i­ta­tions. And their power is nowhere more evi­dent than in their capac­ity to “forgive.”

The indi­vid­ual thus comes to apply the same total­ist polar­iza­tion of good and evil to his judg­ments of his own char­ac­ter: he tends to imbue cer­tain aspects of him­self with exces­sive virtue, and con­demn even more exces­sively other per­sonal qual­i­ties — all accord­ing to their ide­o­log­i­cal stand­ing. He must also look upon his impu­ri­ties as orig­i­nat­ing from out­side influ­ences — that is, from the ever-​threatening world beyond the closed, total­ist ken. There­fore, one of his best way to relieve him­self of some of his bur­den of guilt is to denounce, con­tin­u­ously and hos­tilely, these same out­side influ­ences. The more guilty he feels, the greater his hatred, and the more threat­en­ing they seem. In this man­ner, the uni­ver­sal psy­cho­log­i­cal ten­dency toward “pro­jec­tion” is nour­ished and insti­tu­tion­al­ized, lead­ing to mass hatreds, purges of heretics, and to polit­i­cal and reli­gious holy wars. More­over, once an indi­vid­ual per­son has expe­ri­enced the total­ist polar­iza­tion of good and evil, he has great dif­fi­culty in regain­ing a more bal­anced inner sen­si­tiv­ity to the com­plex­i­ties of human moral­ity. For these is no emo­tional bondage greater than that of the man whose entire guilt poten­tial — neu­rotic and exis­ten­tial — has become the prop­erty of ide­o­log­i­cal totalists.

This.

philosophy: quotes by Theodor W. Adorno, Judith Butler, and Lionel Trilling

pieter_bruegel-the-way-to-calvary-photographed-by-christian-vc3b6hringer
oil paint­ing by Pieter Brue­gal
The Way to Cal­vary
photo by christian-​vc3b6hringer

The universal…appears as some­thing vio­lent and extra­né­ous and has no sub­stan­tial real­ity for human beings.

Noth­ing is more degen­er­ate than the kind of ethics or moral­ity that sur­vives in the shape of col­lec­tive ideas even after the World Spirit has ceased to inhabit them — to use the Hegelian expres­sion as a kind of short­hand. Once the state of human con­scious­ness and the state of social forces of pro­duc­tion have aban­doned these col­lec­tive ideas, these ideas acquire repres­sive and vio­lent qualities.

Because the col­lec­tive ethos is no longer shared — indeed, pre­cisely because the col­lec­tive ethos which must now be herded by quo­ta­tion marks, is not com­monly shared — it can impose its claim to com­mon­al­ity only through vio­lent means. In this sense, the col­lec­tive ethos instru­men­tal­izes vio­lence to main­tain the appear­ance of its col­lec­tiv­ity. More­over, this ethos becomes vio­lence only once it has become an anachro­nism. What is strange his­tor­i­cally — and tem­po­rally — about this form of eth­i­cal vio­lence is that although the col­lec­tive ethos has become anachro­nis­tic, it has not become past; it insists itself into the present as an anachronism.

~ Adorno

Pol­i­tics of “the who” …the expo­sure and vul­ner­a­bil­ity of the other makes a pri­mary eth­i­cal claim upon me.

The recog­ni­tion that one is, at every turn, not quite the same as how one presents one­self in the avail­able dis­course might imply, in turn, a cer­tain patience with oth­ers that would sus­pend the demand that they be self-​same at every moment.

It may be that only through an expe­ri­ence of the other under con­di­tions of sus­pended judg­ment do we finally become capa­ble of an eth­i­cal reflec­tion in the human­ity of the other, even when that other has thought to anni­hi­late humanity.

~ Judith But­ler from Giv­ing an Account of Oneself

Every neu­ro­sis is a prim­i­tive form of legal pro­ceed­ing in which the accused car­ries on the pros­e­cu­tion, imposes judg­ment and exe­cutes the sen­tence: all to the end that some­one else should not per­form the same process.

~ Lionel Trilling

anti-​abortion movement’s focus on minority women

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The Mis­sion­ary Move­ment to ‘Save’ Black Babies by Akiba Solomon at Col­or­lines

Care Net Urban cre­ates “cri­sis preg­nancy cen­ters” to dis­cour­age girls and women from get­ting abor­tions. Such cen­ters have tra­di­tion­ally been located in white, middle-​class neigh­bor­hoods near a clinic that pro­vides abor­tions. They get their fund­ing from such sources as golf ben­e­fits and dri­ves held in churches. Recently, Care Net has estab­lished a “cri­sis preg­nancy cen­ter” in a pre­dom­i­nately black neigh­bor­hood in Kansas City. Rely­ing on a debunked study claim­ing that the major­ity of abor­tion cen­ters are in areas of cities with a large minor­ity pop­u­la­tion, Care Net has made estab­lish­ing these cen­ters in minor­ity neigh­bor­hoods a priority.

Col­or­lines does in-​depth, inves­tiga­tive news sto­ries. If you’re inter­ested in how these evan­gel­i­cal Chris­t­ian groups are por­tray­ing abor­tion as a white, fem­i­nist tool to hurt minor­ity women, and lying about the effects of abor­tion, I sug­gest you read this arti­cle. To try to sum it up would be to lose the plot.

Iraqis suffering psychological distress benefit from counseling

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Spe­cial Report: Heal­ing Iraqis from Doc­tors With­out Borders/​Médecins Sans Frontières

Years of war and vio­lent con­flict leaves many Iraqis with high lev­els of emo­tional dis­tress that is mak­ing their lives mis­er­able and mak­ing it dif­fi­cult for them to rebuild their coun­try. Médecins Sans Fron­tières (MSF)/Doctors With­out Bor­ders has been col­lab­o­rat­ing with the Iraqi Min­istry of Health to make psy­cho­log­i­cal coun­sel­ing avail­able through the Iraqi health care sys­tem. Together they’ve devel­oped a pro­gram that focuses on non-​pharmaceutical approaches to psy­cho­log­i­cal coun­sel­ing for the kinds of anx­i­ety and depres­sion that com­monly result from trauma, vio­lence, and unre­quited stress. These ser­vices have been made avail­able in two Bagh­dad hos­pi­tals, and one in Fal­lu­jah. The plan is for these ser­vices to serve as mod­els of care that can be adopted by community-​based clin­ics through­out Iraq as an aspect of pri­mary care.

Part of the chal­lenge of reduc­ing stigma and encour­ag­ing peo­ple to seek psy­cho­log­i­cal coun­sel­ing is let­ting peo­ple know that suf­fer­ing from trau­matic and unre­lent­ing stress is nor­mal— it doesn’t mean you’re crazy. Here are two Iraqis express­ing what they’ve been going through to a counselor:

I came here for the first time, to over­come the sit­u­a­tion I’m in. I always have neg­a­tive thoughts and when any­one starts talk­ing to me I sud­denly can’t stop cry­ing. I wit­nessed sev­eral explo­sions go off in front of my house and have had my homes searched by the police sev­eral times. These expe­ri­ences affected my life and my work so much. I tried to talk to my fam­ily, but they didn’t under­stand me and didn’t lis­ten to me. They say I’m crazy. That’s why I came here I want some­one to lis­ten to me. I left my work and now I’m a house wife, I don’t like social­iz­ing with the fam­ily at all.

and

I almost had a ner­vous break­down. I hit every­thing that I see in my way. I get angry and hit things. I’m wor­ried that my chil­dren will get sick. I wit­nessed an explo­sion four years ago and I still have shrap­nel in my head from the inci­dent. Six years ago I was impris­oned in Abu Ghraib for a year and a half. I became an angry per­son, I would get irri­tated so eas­ily and always felt mis­er­able. After the first ses­sion of coun­sel­ing I felt that I had been helped. The prob­lem is I’m always wor­ried about the cost of liv­ing since I don’t have enough money… and I’m always afraid and wor­ried that some­thing bad could hap­pen to my family.

Women are suf­fer­ing psy­cho­log­i­cal dis­tress dis­pro­por­tion­ately. My guess is that hav­ing gone from being equal to men in the eyes of the law, to being sub­ject to extreme Shia sanc­tions in pub­lic, and for some, pri­vate life has required many Iraqi women to adapt to more social con­trol and dan­gers that may seem arbi­trary and for­eign to them in the con­text of their lives and iden­ti­ties prior to the war. Also, women are pri­mar­ily respon­si­ble for main­tain­ing home life and tak­ing care of chil­dren, though many no longer have the social sup­port they used to have in this role. Many of these women also lost their hus­bands, fathers, and/​or broth­ers, sons in the war/​occupation/​continuing con­flict, and there­fore have inad­e­quate means in a soci­ety in which even pro­fes­sional women have lit­tle or no chance of find­ing a job. It’s also typ­i­cal for domes­tic vio­lence, gen­der vio­lence, and rape to esca­late in any soci­ety in a state of war— Iraq is not an exception.

Doc­tors With­out Borders/​Médecins Sans Fron­tières will com­plete their work in build­ing this model of psy­cho­log­i­cal coun­sel­ing inte­grated into the Iraqi health care sys­tem in June 2013. They are leav­ing the Iraqi Min­istry of Health with rec­om­men­da­tions to improve the sys­tem. As always, Doc­tors With­out Borders/​Médecins Sans Fron­tières has, out of human kind­ness and exper­tise in deal­ing with peo­ple in polit­i­cal cri­sis, done a great ser­vice to peo­ple in Iraq who want some­one they can talk to about the psy­cho­log­i­cal dis­tress and over­whelm­ing emo­tion they’re feel­ing, and aren’t being helped within a soci­ety in which nearly every­one is and has been stressed, for a decade or longer.

In my opin­ion, they could cut the Gor­dian Knot of stigma by using the term “psy­cho­log­i­cal dis­tress” instead of “men­tal ill­ness” which is inun­dated with the stink of bio­log­i­cal psy­chi­a­try, simple-​minded reduc­tion­ism, and the reifi­ca­tion of diag­nos­tic cat­e­gories. Most of the peo­ple who will ben­e­fit from these coun­sel­ing ser­vices are suf­fer­ing from psycho-​social prob­lems and trau­matic stress. There isn’t some­thing “wrong” with their brains or minds, they are hav­ing a nor­mal response to an abnor­mal and inhu­man situation.

articles on psychiatry

tumblr_mksn3hsM061r4vhsho1_1280Art of the ‘Men­tally ill’: #5 Micheal Del­gado ‘Observe your Choices’

Is Psy­chi­a­try Dis­hon­est? And if so, is it a noble lie? a review of Gary Greenberg’s book Book of Woe by Ben­jamin Nugent

Green­berg is a psy­chother­a­pist — as well as a widely pub­lished jour­nal­ist and author — and he believes psy­chi­a­trists must make clear to patients that such dis­or­ders are not dis­eases but “pro­vi­sional cat­e­gories.” This, he pre­dicts, will mean “fewer patients, more mod­est claims about what [psy­chi­a­try] treats, less clout with insur­ers, and reduced author­ity to turn our trou­bles into med­ical prob­lems sim­ply by adding the word dis­or­der to their description.”

He sees this hum­bling of the dis­ci­pline as the path to an “hon­est psy­chi­a­try.” A nim­ble rhetori­cian, Green­berg implies that in its cur­rent state psy­chi­a­try is like the tit­u­lar swindler of Melville’s The Confidence-​Man, from which that “heart of man” quo­ta­tion is drawn. Psy­chi­a­trists, he says, must learn restraint. They must say “I don’t know” more often. Because, from some angles, the pro­fes­sion looks like a con­fi­dence game. If it’s a sci­en­tific study of the mind, rather than sim­ply a mir­ror of our cul­tural val­ues, why was homo­sex­u­al­ity listed as a dis­or­der in the DSM until 1973? Go back even fur­ther in the annals of men­tal ill­ness, and you find drapeto­ma­nia, pro­posed by the New Orleans physi­cian Samuel Cartwright in 1850: “the dis­ease caus­ing negros to run away.”

Sui­cide rates increase dra­mat­i­cally among middle-​aged Amer­i­cans by Ryan Jaslow at CBS news

Sui­cide now kills more Amer­i­cans than car acci­dents, accord­ing to a new gov­ern­ment report.

In 2010, the last year of avail­able data included in the report, more than 38,000 peo­ple took their own lives. In the same year, less than 34,000 peo­ple died in motor vehi­cle crashes.

The Cen­ter for Dis­ease Con­trol and Prevention’s (CDC) analy­sis of U.S. sui­cide rates found sharp increases among cer­tain pop­u­la­tion groups, includ­ing middle-​aged adults.

For­mer cham­pion says pub­lic safety fears led to adop­tion of mea­sures that seri­ously cur­tailed patients’ freedoms

Con­tro­ver­sial pow­ers to treat men­tal health patients in the com­mu­nity while seri­ously cur­tail­ing their free­doms have been crit­i­cised by one of their strongest supporters.

Pop­u­larly known as “psy­chi­atric Asbos”, Com­mu­nity Treat­ment Orders (CTOs) were intro­duced five years ago after a series of high-​profile cases that involved men­tally ill peo­ple attack­ing mem­bers of the pub­lic. The dra­con­ian mea­sures have now been shown to make no clin­i­cal dif­fer­ence – and the psy­chi­a­trist who cham­pi­oned them is call­ing for their imme­di­ate suspension.

CTOs gave doc­tors legal author­ity to impose con­di­tions on their patients after they are released from hos­pi­tal such as where they must live, what drugs they must take and even how much alco­hol they could consume.

If they broke any of these stip­u­la­tions they could be imme­di­ately recalled and sec­tioned to a psy­chi­atric unit.

It was hoped that the orders would strengthen psy­chi­a­trists’ abil­ity to ensure patients stuck to their treat­ment pro­grammes after being discharged.