Psychiatry, Psychology, and the Law -- an online course with Jeffrey Schaler, May 2007

Psychiatry, Psychology, and the LawJLS-596 N01L
American University
Instructor: Jeffrey Schaler
May 14, 2007 to June 25, 2007

"This on-line course deconstructs concepts of mental illness, explanations for disease and behavior, and legal policies based on diverse explanations for both. It also investigates the insanity defense as legal fiction. In addition, it studies due process and involuntary commitment procedures and why and how society creates and welcomes the union of medicine and state, pharmacracy, and paternalistic practices based in psychiatric and psychological theories and practices."

The course is offered by American University in Washington, D.C. You can negotiate with your college or university for credit. If you are already a student at American University, check with your advisor or the appropriate person in charge about credit for this summer course. You must register through American University. Click http://www.american.edu/distanceed/courses.html to register.

This is an opportunity to study the ideas of Thomas Szasz, Jeff Schaler, and others concerning the myth and meaning of mental illness; the various explanations offered for mental illness--including theological, biological, psychological, and sociocultural explanations; and the various consequences of those explanations in diverse policy arenas including legal policy (involuntary commitment, the insanity defense, competency to stand trial, testamentary capacity, and general consequences for liberty and responsibility); clinical policy (including various biological "therapies," the meaning of psychotherapy, different types of psychotherapy, similarities between psychotherapy and religion, etc.); public policy (including various forms of formal social control, paternalism, how the state attempts to protect people from themselves in the name of public health and medicine; the consequences of drug prohibition, court-ordered treatment for addiction and First Amendment rights, problems facing doctors in terms of prescribing opiates for pain control, etc.); and various elements of social policy (the difference between formal and informal social control; conformity, compliance, and obedience to authority, etc.).

In the next week the full syllabus for this course will be available HERE. If you're interested in receiving a copy of the syllabus by email once it's ready, write to me at the following email address (written as is to avoid spam): schaler (at) american.edu. See past syllabi and evaluations by students of Schaler's teaching by clicking HERE

This is going to be an intense course with lots of reading, discussion, a mid-term examination, a final examination, and a paper. The course is taught through BlackBoard. You can only access the course by being registered as a student for it. For information on how to register, click at this url http://www.american.edu/distanceed/courses.html.

Researchers: Broken home linked to psychosis

People from broken homes may be more prone to psychotic illnesses such as schizophrenia, research suggests.

Researchers said their findings suggest the illnesses are not simply brain diseases, but linked to factors such as social adversity.

They found much higher rates among black people, who were also more likely to come from broken homes.

The study, by London's Institute of Psychiatry, will appear in the journal Psychological Medicine.

The researchers examined data on people in south east London, Bristol and Nottingham, including 780 who showed signs of a psychotic illness.

They found schizophrenia was nine times more common in people from African Caribbean origin, and six times more common in people from black African origin than in the white British population.

In a second paper, they found that separation from one or both parents for more than a year before the age of 16, as a consequence of family breakdown, was associated with a 2.5 fold increased risk of developing psychosis in adulthood.

Family breakdown of this type was found to be more common in the African-Caribbean community (31%) than the white community (18%).

Researcher Dr Craig Morgan said: "These findings provide evidence that early social adversity may increase the risk of later psychosis.

"Such early adversity may be one factor contributing to the high rate of psychosis in the African-Caribbean population."

More work needed

However, Dr Morgan said more work was needed to fully understand how specific types of early social adversity might interact with pyschological and biological factors to cause psychosis.

Professor Robin Murray, who also worked on the research, said: "For the last 30 years the traditional view has been that psychosis is largely a genetic brain disease, and most psychiatrists have thrown out the view that social factors can have a major impact.

"These findings suggest it is not just a brain disease, and that social factors can also contribute to the onset of illness."

Professor Murray dismissed the idea that drug taking might contribute to raised rates of psychosis among the black population.

He said evidence showed that drug taking was no higher among black people than the general population.

He said it was possible that the discrimination and disruption encountered by migrants to the UK might play a role in their increased vulnerability to psychosis.

Paul Corry, of the mental health charity Rethink, said there was evidence to suggest that although psychotic illness was linked to the genes, it often took an external trigger for symptoms to become apparent.

He said: "These findings underline the need to approach the treatment of schizophrenia not just in purely medical, drug-based terms, but also by taking into account the wider social context that the patient is inhabiting at the time, and trying to ensure they are offered relevant support."

It is thought that around 1% of the population develop schizophrenia, or related conditions, such as manic psychosis, and depressive psychosis.

Up to 300,000 people have been diagnosed with schizophrenia in the UK.

All the conditions are associated with hallucinations, delusions and bizarre forms of behaviour.

Pyschotic illnesses have been linked to raised levels of the mood-altering chemical dopamine in the brain.

The Institute of Psychiatry is based at King's College London.

Judge rules against boy’s circumcision

This is a most interesting legal decision. According to the Chicago Tribune,

In a case that has been closely watched by anti-circumcision groups nationwide, a Cook County judge ruled Tuesday that the medical benefits of the procedure are not clear enough to compel a 9-year-old Northbrook boy to be circumcised against his will.

The boy's mother and her new husband had claimed the operation was necessary to prevent recurrent episodes of redness and discomfort. The boy's father sought a court order barring the circumcision, which he called an "unnecessary amputation."

The mother has sole custody, but their 2003 parenting agreement gave her ex-husband a say in non-emergency medical decisions. The Tribune is not naming the parents in order to protect the boy's privacy.

In a written opinion handed down Tuesday, Circuit Court Judge Jordan Kaplan said, "The evidence was conflicting and inconclusive as to any past infections or irritations that may have been suffered by the child.

"Moreover," he continued, "this court also finds that the medical evidence as provided by the testimony of the expert witnesses ... is inconclusive as to the medical benefits or non-benefits of circumcision as it relates to the 9-year-old child."

Kaplan said the boy, as a minor, cannot make his own medical decisions but had indicated in a written statement that he does not want to be circumcised...

Clearly the court would not have intervened had the biological father not objected, but should courts ban genital mutilation of all minor males? If not, then why should the mutilation of minor females not also be permitted?

What types of unnecessary mutilation should be legally acceptable, and whose opinion should prevail? Who defines "medical"? If mutilation should be banned due to the lack of medical justification, should there be a religious exemption? If circumcision is not medically justifiable, what about ear piercing? Should a father be able to prevent his ex-wife from piercing her 9-year-old daughter's ears, with or without the child's consent? What if the child objects to the piercing? At what age should a child's opinion be considered by a court on such a matter?

It should never be taken lightly when a court's judgement replaces that of a parent, but I think that circumcision, except when medically indicated, if such a case can really exist, can properly be banned by courts. When a person reaches the age of majority he can always decide to be mutilated. But how can I then justify the ear piercing of a minor?

Confronting the "Good Death": Nazi Euthanasia on Trial, 1945-1953

Has anyone read this book?

Confronting the "Good Death": Nazi Euthanasia on Trial, 1945-1953
by Michael S. Bryant

Book Description:
Years before Hitler unleashed the "Final Solution" to annihilate European Jews, he began a lesser-known campaign to eradicate the mentally ill, which facilitated the gassing and lethal injection of as many as 270,000 people and set a precedent for the Nazis' mass murder of civilians.

In Confronting the "Good Death," Michael Bryant tells the story of the U.S. government and West German judiciary's attempt to punish the euthanasia killers after the war. His fascinating work is the first to address the impact of geopolitics on the courts' representation of Nazi euthanasia, revealing how international power relationships played havoc with the prosecutions.

Drawing on primary sources and extensive research in archives in Germany and the U.S., Bryant offers a provocative investigation of the Nazi campaign against the mentally ill and the postwar quest for justice. His work will interest general readers and provide critical information for scholars of Holocaust studies, legal history, and human rights.

Obituary: Martin Roth

Excerpts from lengthy obit by Claude M. Wischik in The Independent (UK) for Hungarian-born psychiatrist Martin Roth:

His textbook was a sure, humane and safe pilot for the discipline of psychiatry in ideologically stormy times: the transition from the post-Freudian thinking to the age of Prozac. These were times that Roth and his co-authors inspired with a unique blend of clarity, critical thought, breadth of scholarship, charm, and humanity. It was in the German tradition of Emile Kraepelin, who in his day transformed psychiatry with his clear descriptions of the major psychiatric syndromes, only to be swept aside in late life by the rise of the Freudians.

Freud, as Roth liked to say, was not a psychiatrist, but a neurologist. Freud has come to be loved more in departments of literature and the history of ideas than in departments of psychiatry. This is because he never really came to grips professionally with the stuff of mental illness. The times of vast psychiatric institutions housing populations in excess of 1,000 souls in varying degrees of torment and hopelessness are still etched in the collective social consciousness, and their residue lives on in the stigma which is still too often attached to mental illness...

He emerged from these battles with his characteristic intellectual fearlessness, tenacity and honesty. These qualities were particularly needed when it came to dealing with the anti-psychiatry movement. He eventually published as The Reality of Mental Illness (1986) the debate between himself and Thomas Szasz dealing with the question whether mental illness is merely a social construct. The proposition here was that there is no such thing as mental illness. Psychiatry merely provides a police and custodial service on behalf of the socio-political establishment to deal with deviancy.

According to Szasz and Scientology, the whole psychiatric enterprise is bogus. According to Ivan Illich, we have no business medicalising the rich brocade of human diversity. Roth's response to this came from his long experiences in the psychiatric hospitals, where one cannot escape from the reality and torment of mental illness, and where the post-modernist rhetoric becomes inaudible against the cries that echo along the corridors in the night. Mental illness is real illness: the problem is how to help.

Roth had a fine turn of phrase in these battles. I remember his advice when dealing with an opponent: "The rapier is better than the broadsword." Or when dealing with Jacques Derrida: "The tide of his rhetoric is unimpeded by the outcrops of fact lying in its path." Or on Illich: "a brooding presence in night, like a dysfunctional lighthouse, emitting shafts of darkness to confuse unwary travellers".

He had fierce battles also within psychiatry, the most renowned being with Robert Kendell on the difference between anxiety disorder and depression. Kendell argued that they form an undifferentiated spectrum of emotional disorder, too often seen together to be able to distinguish the two. Roth argued that they were distinct biological entities, with different clinical features, different genetics and different natural history. Who was right in the end? From the diagnostic point of view, and also now from the molecular genetics, Roth's concept has been enshrined in DSM and ICD. From a therapeutic point of view, there remains a large overlap in terms of treatment.,,

The enduring sadness of the biological revolution in psychiatry that Roth helped to inspire is that its early promise has not been fulfilled through new treatments. Kraepelin delineated the major disorders, schizophrenia and manic depressive disorder, in the 1890s. Although there are newer drugs that do much the same as the originals of the 1960s, no fundamentally new approaches have emerged. This is not for want of effort, as neuroscience research is now a vast worldwide enterprise. The problem is that these disorders have proved to be difficult to unravel, and the mechanism of these diseases, unlike that of Alzheimer's disease, leaves no discernible trace in the brain. Unravelling them may take several more generations of research...

Rothbard's attack on psychoanalysis

Psychoanalysis as a Weapon
By Murray N. Rothbard
(Excerpt)

Thomas Szasz is justly honored for his gallant and courageous battle against the compulsory commitment of the innocent in the name of "therapy" and humanitarianism.

But I would like to focus tonight on a lesser-known though corollary struggle of Szasz: against the use of psychoanalysis as a weapon to dismiss and dehumanize people, ideas, and groups that the analyst doesn't happen to like. Rather than criticize or grapple with the ideas or actions of people on their own terms, as correct or incorrect, right or wrong, good or bad, they are explained away by the analyst as caused by some form of neurosis. They are the ideas or actions of neurotic, or "sick," people: so if the people themselves are not to be incarcerated in institutions as "mentally ill," then their ideas or attitudes may be treated in the same manner.

The unspoken assumption, of course, is that ideas or actions congenial to the analyst don't need "explaining" by psychoanalytic or other psychodynamic theories. Since they don't need "explaining," the implication is that they are normal, correct, and good, though of course no analyst, in his role as the embodiment of "value-free science," would ever be caught dead using such terms. For if he did so, he would have to take the ideas or actions of his opponents seriously, and set forth an explicit moral theory in doing so. He would not be able to dismiss them as "sick" or as people who are uniquely in need of being "explained."
----
Murray N. Rothbard (1926–1995) was dean of the Austrian School.
This article was a keynote address given at a special conference sponsored by The Institute for Humanistic Studies in 1980.

Opiate Romance

Opiate Romance
by George Giles
LewRockwell.com

Theodore Dalrymple is a British Doctor who is also a gifted writer. He has written extensively on his experiences in medical practice in some of the world's worst places: the third world, the British prison system, and the slums of London. He is critical of socialism, especially the British variant. His latest book Romancing Opiates" with a subtitle of Pharmacological Lies and the Addiction Bureaucracy is an insightful look behind the scenes of heroin and methadone addicts and the addiction bureaucrats that service them.

Dalrymple prose is like reading Shakespeare where every moment is a pleasure. You find yourself reading and re-reading just to enjoy the beauty with which the English language can represent ideas with simple words strung together sequentially. The enjoyment is all the more ironic when we consider the subject of much of his writings, the failure of socialism, and his personal dealings with those that have failed under it...

Where the book really gets interesting is when he relates individual stories of the addicts and how mild addiction to heroin/opiates really is. The "illness" is minor, passes quickly and is not at all the hideous ritual as is popularly portrayed ad nauseum by the addiction bureaucracy and their sycophants. He also provides ample evidence, from first-hand experience as a medical expert, both observation and expert witness testimony, that the addiction is not easily acquired and is easily shed when circumstances mandate. Most addicts eventually tire of the lifestyle and prison as they grow older. This contravenes the conventional wisdom of the multi-billion-dollar pharmaceutical addiction bureaucracy that in many cases provides both the product and the treatment for the kind of exorbitant profit margins that only a government-mandated cartel can provide...

My criticism of this book is that he does not apply Thomas Szasz's logic of self-medication as an alternative to established therapeutic practices which are the product more of privileged elite thought leaders than scientific reality. He does not address the immense societal cost of drug criminality due to cartel-mandated exorbitant prices, enforcement, and interdiction costs or the costs that "drug wars" impart on the citizenry of most countries of the world. He also does not criticize the existence of the cartel of which he is a member. This is all forgivable if not excusable when you look at his extensive record of truly helping the downtrodden...

Plastic surgery: natural mood enhancer?

Plastic surgery: natural mood enhancer?
SAN FRANCISCO, Oct. 9 (UPI) -- It has been proven that plastic surgery can improve self-esteem but a U.S. scientist says it can also act as a natural mood enhancer.

"Plastic surgery patients are taking a proactive approach in making themselves happier by improving something that has truly bothered them," said the study's author, Dr. Bruce Freedman, medical director of Plastic Surgery Associates of Northern Virginia. "While we are not saying cosmetic plastic surgery alone is responsible for the drop in patients needing antidepressants, it surely is an important factor."

In the study, 362 patients had cosmetic plastic surgery and 17 percent, or 61 patients, were taking antidepressants. Six months after surgery, however, that number decreased 31 percent, down to 42 patients. In addition, Freedman said 98 percent of patients said cosmetic plastic surgery had markedly improved their self-esteem.

"We have just begun to uncover the various physical and psychological benefits of plastic surgery," said Freedman. "By helping our patients take control over something they were unhappy about, we helped remove a self-imposed barrier and ultimately improved their self-esteem."

The study was presented Monday in San Francisco during the American Society of Plastic Surgeons 2006 conference.

Va. Parents Trying to Unadopt Troubled Boy-- Mother Says Caseworkers Failed to Disclose Child's Stormy History

Va. Parents Trying to Unadopt Troubled Boy
Mother Says Caseworkers Failed to Disclose Child's Stormy History
By Brigid Schulte
Washington Post Staff Writer
Monday, October 9, 2006; A01

A talkative 9-year-old boy came to Helen Briggs on Valentine's Day 2000. She was a foster mother with years of tough love and scores of troubled kids behind her. But she grew to love this boy. Within the year, she'd talked her husband into adopting him.

Now, six years later, Briggs and her husband, James, a maintenance worker for the city of Alexandria, are taking the highly unusual step of trying to unadopt him.

In 2003, when the boy was 12, he sexually molested a 6-year-old boy and a 2-year-old girl still in diapers. She said it was only then, as she waited outside the courtroom for his sexual battery hearing and caseworkers handed her his psychological profile, that she found out just how damaged the boy had been when he came into her life.

The Washington Post generally does not name the subjects of juvenile court cases.

Briggs said she did not know he had lived in five foster homes since he was 16 months old. Nor that his alcohol- and drug-addicted biological parents had physically abused him, injuring his brain stem and impairing his ability to gauge the passage of time.

He'd been hospitalized seven times in psychiatric institutions and diagnosed as possibly psychotically bipolar. He'd thrown knives, kicked in walls, pulled out all his hair and threatened to kill himself. He'd heard voices telling him to do bad things. His confidential case file shows he most likely was sexually abused.

"I did not know any of that," Briggs said, though Virginia policy states that caseworkers should provide "full, factual information" about a child to adoptive parents. "They just told me he was hyperactive."
She said the state's failure to fully disclose the boy's background is tantamount to fraud.

State child welfare officials could not comment on the case because of confidentiality restrictions. But some caseworkers do not believe Briggs, records show. They think she wants to get out of paying child support.
Still, a Fairfax County court has granted Briggs's petition to relinquish custody. The boy, who has lived in institutions since his conviction, is now officially back in foster care. He asked to be put on suicide watch, records show, when the judge's decision came down.

Briggs hired an attorney to terminate her parental rights. But in Virginia, a child older than 14 must give consent. The boy, now nearing 16, wants Briggs to be his mother forever, according to the voluminous confidential case file and e-mail and phone records Briggs subpoenaed for her lawsuit and provided to The Post.

Briggs sought to file a "wrongful adoption" lawsuit. But under Virginia law, she needed to file within two years of discovering the boy's history. Instead, she wavered.

First, she wanted him home after he had completed his sex offender treatment. But then psychologists deemed him a "sexual predator." That meant Briggs could no longer be a foster parent, which she considers her job. Nor could she allow her three grandchildren in her house. Nor could she keep a little girl she had cared for since the day she was born.
She had to choose.

"You don't want to throw somebody away," she said. "But sometimes you have to."

Her choice has left her with none of the rights and many of the responsibilities of a parent. Caseworkers forbid her from contacting the child because he becomes so violent and angry when she does. Yet state law requires that she pay $427 a month in child support and cover court costs when he appears before judges who now decide what's best for him.
With no legal recourse, she is asking politicians to help her find a way out.
"At first blush, you think, 'What, you're trying to give up your kid? You're a jerk,' " said Virginia Del. David B. Albo (R-Fairfax). "Then you find this lady has received awards for all the foster work she's done. And that she never would have adopted the boy and put other children in danger if she had had the information that was withheld from her."

The technical term for what Briggs is trying to do is "dissolve" the adoption, as if all the bonds of love and hurt could simply vanish into thin air.

A Hopeful Start
When Briggs, 57, went to visit the boy for the first time, she said she saw a cute, happy child. She recalls caseworkers telling her that he was in a psychiatric hospital because he was too much of a handful for his great-aunt.

They were nearing desperation before they found Briggs, records show. Nobody wanted him.

A no-nonsense, old-school "professional parent," Briggs figured she could handle him. When the boy acted out, she gave him limits. When he began pulling his hair out, she had it shaved. And when he kept running away from school and her Lorton townhouse, she turned him over to her husband for a whupping, just like she got as a child -- until caseworkers called Child Protective Services.

Nonetheless, caseworkers noted that the boy thrived in her care. "The Briggs foster home is the most constructive and potentially successful placement option that this child has," they wrote.

Briggs hadn't planned on adopting anyone. There was just something special about this child. He was so thankful he had his own room, with the first bed he hadn't had to share in his whole life, she remembers him telling her.

If she got sick, he'd make her soup and rub her feet. At school, if he heard an ambulance, he'd be beside himself until school workers let him call home to make sure Briggs was okay. She understood, she said. So many people had abandoned the child.

As she was signing the adoption papers, she remembers nothing about a background briefing, as required by state policy. Only a caseworker asking skeptically, "Are you sure you want to do this?"

"Yes," she recalled answering. "I love him."

When the boy came to her, he was taking medications for mental illness, depression, delusions, seizures and attention-deficit hyperactivity disorder. He was considered a "therapeutic" foster child, one that comes with extra emotional, medical or behavioral baggage and a heftier monthly subsidy.

Some case workers think she must have known, records show. One wrote that Briggs wasn't being "entirely honest." However, nothing in the case file indicates she was given an oral briefing or a written summary of the boy's background, or access to his records. In some reports, details such as his psychiatric hospitalizations and sexual abuse are left out.

There are also notations of alarm when Briggs began taking the child off his medications, that perhaps she did not understand the gravity of his condition.

Briggs said she thought the medications were for hyperactivity. When the child began complaining of headaches, she took him to a psychiatrist caseworkers recommended. She asked if the boy needed all the pills. The psychiatrist, records show, said no.

"When he told me he was hearing voices, I told him it was just his conscience talking," she said.

Records show that caseworkers are vehemently against Briggs terminating her parental rights. "At least, if his parents win the lottery and die, he will inherit," one wrote in an e-mail. Some think she has rejected the boy because she needs the money she gets from foster children.

"That's a lie," Briggs said angrily.

A religious woman and active in her Sword of Spirit Deliverance Ministry Pentecostal Church, Briggs said being a foster mother is a calling. She's on disability, she explained, so it's one of the few things she can do to supplement her husband's blue-collar wage.

"The system needs to be revised. That's why I'm doing this," she said. "I should have known about the child. Because people get hurt."

And then there is another reason, one that woke up late one recent morning and, yawning, shuffled downstairs in fluffy white slippers with bells on the toes and nestled onto Briggs's ample lap: a little girl of 5, the child of a former foster daughter and Briggs's legal ward.

"I can't take him back," Briggs said, stroking the hair of the child she chose to keep.

Wrongful Adoption
If it is true what Briggs says, that she really didn't know the full extent of the boy's difficult young life, it would not be the first time.

The first "wrongful adoption" lawsuit was won in Ohio in 1986. Parents were told the 16-month-old they adopted was a healthy infant born to a teenage mother. When the child later developed a fatal disease and exhibited mental disorders, the parents discovered he was born to two middle-age mental patients.

Since then, states have enacted a patchwork of laws and written disclosure policies. Some states, such as Texas and Ohio, give adoptive parents access to a child's entire case file. In Maryland, social workers are required to prepare a written background summary and ask adoptive parents to sign it. Virginia's disclosure policy has no written requirement.

"I have seen so many adoptive parents come back and feel so angry and cheated that we didn't tell them about a child. And we did tell them," said Judith Schagrin, a Maryland social worker. "It's just that at the time, they were so hopeful and looking through a lens of love that they couldn't hear what we were saying."

But sometimes, because of the high turnover of case workers, information gets lost, assumptions get made, mistakes happen -- especially if the child is older. Especially if they've bounced around foster care for years. And especially, Schagrin said, if their sad and broken histories might scare away potential foster or adoptive families.

That pressure has intensified since 1997 because of a federal law that rewards states as much as $6,000 for every foster child adopted.

"I have seen caseworkers. They think, 'Oh, the family won't adopt the child if they know everything," Schagrin said.

Most adoptions take, especially for infants. But for children over 12, as many of 25 percent of the adoptions don't. They simply dissolve.

Full

"Experts" say term schizophrenia should be abolished

Schizophrenia term use 'invalid'
BBC News
2006/10/09

The term schizophrenia should be abolished, experts have said.

They claim the category falsely groups a wide range of symptoms and encourages over-reliance on anti-psychotic drugs rather than psychological intervention.

The academics also said the label stigmatised people as being violent, dangerous and untreatable...

Richard Bentall, professor of experimental clinical psychology, from the University of Manchester, said: "We do not doubt there are people who have distressing experiences such as hearing voices or paranoid fears.

"But the concept of schizophrenia is scientifically meaningless. It groups together a whole range of different problems under one label - the assumption is that all of these people with all of these different problems have the same brain disease."

He this can misinform treatment, and has encouraged the widespread use of "drastic biomedical interventions" as the first-line of treatment, rather than psychological help. He said although drugs were useful for some patients, too often they were given at extremely high doses and had some dangerous side-effects.

He said: "Overall, I think the concept is scientifically meaningless, clinically unhelpful and ultimately has been damaging to patients."

Paul Hammersley, also of the University of Manchester, who is involved with the Campaign to Abolish the Schizophrenia Label (Castle), wants the term dropped.

He said: "It is associated with violence, dangerousness, unpredictability, inability to recover, constant illness, constant need for medication and an inability to work. I cannot emphasise enough how stigmatising this label is."

But the academics could not give a definitive answer to what should replace the term schizophrenia if it was eliminated.

They pointed to Japan, where the category schizophrenia was replaced with "integrated disorder" in 2004, as a possible model.

And Professor Bentall suggested patients should be treated on the basis of individual symptoms, as opposed to an overarching category.

Robin Murray, professor of psychiatry at the Institute of Psychiatry, London, said most psychiatrists accepted term schizophrenia was imperfect but warned that were it discarded another method of classification must be devised.

He said: "If we don't have some way of distinguishing between patients, then those with bipolar disorder or obsessional disorder would be mixed up with those currently diagnosed as having schizophrenia and might receive treatments wholly inappropriate for them.

"Most psychiatrists would still agree that the term schizophrenia is a useful, if provisional, concept. My personal preference would be to replace the unpleasant term schizophrenia with dopamine dysregulation disorder which more accurately reflects what is happening in the brain when someone is psychotic. "

Til Wykes, professor of clinical psychology and rehabilitation at the Institute Of Psychiatry, said: "We should be careful not to throw the baby out with the bath water, as despite its limitations, a diagnosis can help people access much needed services.

"What all of us have to remember is that these are people with a diagnosis of schizophrenia, not 'the schizophrenic'."

Wikipedia: Szasz LSD trip "'one of the best experiences' he'd lived through"

How appropriate that this perplexing comment should appear in the Wikipedia entry, "Reality":

"Thomas Szasz called his LSD trip near the end of his life "one of the best experiences" he'd lived through..."

After posting this I raised a bit of a stink over it in the Wikipedia discussion about the "Reality" page, and someone has now removed it. Wikipedia is a farce worthy of its time.

LSD treatment for alcoholism gets new look

The Hindu
Sunday, October 8, 2006

Some participants still have not had a drink 40 years after the trials. For the past five years, Dr. Erika Dyck has been unearthing some intriguing facts related to a group of pioneering psychiatrists who worked in Saskatchewan, Canada in the '50s and '60s.

Among other things, the University of Alberta history of medicine professor has found records of the psychiatrists' research that indicate a single dose of the hallucinogenic drug LSD, provided in a clinical, nurturing environment, can be an effective treatment for alcoholism...

After perceiving similarities in the experiences of people on LSD and people going through delirium tremens, the psychiatrists undertook a series of experiments. They noted that delirium tremens, also know as DTs, often marked a "rock bottom" or turning point in the behavior of alcoholics, and they felt LSD may be able to trigger such a turnaround without engendering the painful physical effects associated with DTs.

"The LSD somehow gave these people experiences that psychologically took them outside of themselves and allowed them to see their own unhealthy behavior more objectively, and then determine to change it," said Dyck, who read the researchers' published and private papers and recently interviewed some of the patients involved in the original studies - many of whom had not had a sip of alcohol since their single LSD experience 40 years earlier...

"The LSD experience appeared to allow the patients to go through a spiritual journey that ultimately empowered them to heal themselves, and that's really quite an amazing therapy regimen," Dyck said...

In spite of the promise LSD showed as psychotherapy tool, its subsequent popularity as a street drug, and the perception of it as a threat to public safety, triggered a worldwide ban in the late 1960s - including its use in medical experiments. However, the ban on its use in medical experiments appears to be lifting, Dyck noted. A few groups of researchers in the U.S., including a team at Harvard, have recently been granted permission to conduct experiments with LSD.

"We accept all sorts of drugs, but I think LSD's 'street' popularity ultimately led to its demise," Dyck said.
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See also: LSD — The Problem-Solving Psychedelic