One of these progressive thinkers is Ty Colbert, author of this classic critique of American biopsychiatry. Beginning in the second half of this century, a few lone voices criticized the theory and practices of institutionalized (and State-supported) psychiatry. Those voices are now becoming a chorus with an outpouring of books promoting a holistic view of psychological distress and the emergence of the consumer/survivor/ex-patient movement.
Set against the backdrop of established biopsychiatry, Dr. Colbert shows us a different perspective on psychological distress. Dominant psychiatric theory is based on a reductionist, mechanistic, linear worldview of human distress. All mental symptoms (including personal and social) are believed to be the result of biological, neurochemical, or genetic abnormalities. Individuals with mental pathology labels are seen as biologically defective and immutably different from everyone else. In Part One, Dr. Colbert challenges the biomedical model, reviews current research, and clearly establishes that these conditions cannot be reduced to genetics, chemical "imbalances," or biological defects.
Most people are surprised to learn that diagnoses such as schizophrenia, compulsive behavior, anxiety, substance abuse, depression, and Attention Deficit Hyperactivity Disorder (ADHD) are not based on any identifiable biological problem. There is no known physical or neurological abnormality, and no blood test, urine test, brain scan, or genetic marker by which they can be discerned. This information comes as a surprise because we have all read or heard the headlines "Genetic marker discovered for alcoholism" or "Scans show the brains of hyperactive adults have decreased rates of glucose metabolism." What most people did not see is the paragraph on the last page of the newspaper retracting the gene finding eight months later. Nor did people hear that even though a slight statistical difference was concluded the first time, when the brain scan study was repeated, the findings did not support the original much-publicized one. They also did not hear that all of the scans in both studies were normal, and it is quite impossible to look at an individual scan and distinguish a hyperactive one from a normal one.
The presumed "biochemical imbalance" or "genetic flaw" is inferred by judgments of one person about the behavior of another person. The diagnoses described in the Diagnostic and Statistical Manual of Mental Disorders (DSM) are proposed and voted upon by committees of psychiatrists and consist of lists of behavioral classifications. An individual in question must be deemed to demonstrate, for example, six of nine behaviors on the list in order to qualify for the diseases. The political rather than scientific nature of this process leaves it vulnerable to bias and fads.
The controversial diagnosis of ADHD is an illustration of a current American fad. The nine symptoms on the DSM diagnostic criteria list include: often fidgets with hands or feet; often leaves seat in classroom when remaining seated is expected; often runs about or climbs excessively; often has difficulty playing quietly; fails to finish schoolwork or chores; avoids or dislikes tasks that require sustained mental effort (such as homework); often loses things necessary for tasks (e.g., school assignments, pencils, books, tools). As impossible as it sounds, these are the allegedly scientific criteria on which over 3 million children are being labeled as biologically defective and drugged with toxic stimulants, even though there is no solid evidence that ADHD is a disorder or disease and no incontrovertible proof of any physical abnormalities in these children's brains or bodies.
Since psychiatry, by its own admission, has no cure for any mental condition, current ideology maintains that no one can change or evolve out of their emotional pain. The most positive outcome anyone is expected to achieve is a lifetime state of disability: "the history and development of modern psychiatry is firmly founded upon the belief that curing mental illness involves administering some kind of outward cure without looking too closely at the pain and woundedness inside the patient" (p. 25).
Drugs are the "treatment" of choice in the biomedical model. Dr. Colbert shows that, in reality, these drugs blunt and subdue the individual by disabling the centers of higher brain function, rather than creating a specific therapeutic effect. The brain does not work in such simplistic terms as a lack of serotonin causing depression or too much dopamine causing schizophrenia, as was originally hypothesized in the 1950s when only three neurotransmitters had been discovered. Since we now know of more than one hundred neurotransmitters, each of which acts on up to fifteen known types of receptors, ``it is sheer nonsense to think that we can somehow take a pill and rebalance such a system — if indeed the system were imbalanced to begin with'' (p. 43). According to Professor E. S. Valenstein (University of Michigan) organized psychiatry and the pharmaceutical industry distort what is known about the chemical basis of mental disorders and the effectiveness of drugs in order to discredit alternative treatments and further their own financial and political interests.
Ritalin, for example, often prescribed for ADHD, does not improve academic performance or social relationships. What it does do, according to Dr. Peter Breggin (Talking Back to Ritalin, Common Courage Press, Maine, 1998) is "suppress creative, spontaneous, and autonomous activity in children, making them more docile and obedient'' at the risk of permanent neurological tics, drug-induced behavioral disorders, psychosis, mania, growth retardation, drug abuse and addiction. Neuroleptics such as thorazine and haldol are prescribed for individuals labeled schizophrenic, 20% of nursing home residents and those with developmental disabilities. These drugs reduce unwanted symptoms and behaviors by disrupting most of the person's ability to think and act, rendering them quieter and more compliant. Among many serious problems, neuroleptic use carries a 5% plus per year risk of neurologic damage, called tardive dyskinesia, producing a variety of uncontrollable movements, tremors, spasms and lip-smacking movements. The resulting epidemic of impairment has been called ``one of the worst medically induced disasters in history.''
In Part Two, Dr. Colbert introduces the emotional pain model. With this new paradigm, the difference between those who have been labeled mentally ill and those who have not is not the fact of their distress but the degree of it. We have all felt pain as a consequence of the human condition, we all have at times lost the ability to act in productive ways. ``Our vulnerability to pain has its origin in human consciousness. Because we have the ability to be consciously aware and to invest our hearts into whatever we choose to focus upon, we have the potential to open ourselves up to becoming deeply hurt" (Colbert, p. 120).
It is the set of choices we make, not genetics or biochemistry, that form each person's self-awareness. We may feel violated by the death of a loved one, abuse, etc., and the choice is not necessarily conscious, but some element of choice is always involved. A forced choice may be made to protect the woundedness of the person, such as a child learning not to look at a verbally abusive parent and developing poor eye contact. "Later, as an adult, he may realize that his communication skills greatly suffer because of the way he was forced to choose to deal with his pain as a child" (p. 125). With new awareness, he can begin to take charge of his fear and make different choices about eye contact.
Mental symptoms arise as coping mechanisms to deal with wounds and violations of trust. However, the emotional pain model is not about placing blame, but about admitting our humanness: "It is to admit that there is nothing wrong with the mind, outside of the fact that our hearts have been broken and we are all hurting" (p. 132).
In Part Three, Dr. Colbert discusses how psychiatry has failed to solve the problem of psychological distress by denying emotional pain and its relationship to "symptoms," as well as by relying on drugs which do not address the underlying cause. The biomedical model leaves the hurting person out of the formula and denies their ability to acquire the necessary tools and the necessary healing that could lead to a full recovery. Dr. Colbert proposes a three-phase approach of (1) teaching individuals to identify feelings and resolve conflict, (2) seeing symptoms as indicators of an overload of emotional pain, and (3) developing non-medical, non-abusive healing environments (p. 220). Individuals are empowered to take charge of their own choices, reducing dependency on medication as well as welfare and mental health systems.
To see mental illness as a disease is both to fail to see the pain in our society, and fail to learn how to move forward in a more cooperative, non-violating way. To see the pain behind the behavior of people diagnosed as schizophrenic, and to make the commitment to help such individuals is to heal a potential healer.
. . . To call an emotionally troubled person "diseased" and to block his pain with drugs is to lose the gift of seeing our own pain and being touched by the love of others. — pp. 283-4
For those who believe our lives, suffering, and symptoms represent important messages about what is needed to heal ourselves, Dr. Colbert's emotional pain model provides relief from mechanistic ideology. As a registered nurse and spokesperson for Mental Health Employees for Ethical Treatment, I have seen how unproven biological explanations lead to artificial barriers between people, barriers such as us the well ones and them the sick ones; us the mental health experts and them the patients who lack "insight" into their "disease"; and even us the survivors and them the agents of force and coercion who lock us up, tie us down, and damage our brains with toxic drugs and electroshock.
As said by the Dalai Lama, "We are human beings, consisting of the human body and the human mind. Our physical structure is the same, and our mind and our emotional nature also the same."
(From Sunrise magazine, June/July 1999. Copyright © 1999 by Theosophical University Press)
Common sense is instinct, and enough of it is genius. — Josh Billings