Latest / Hardiness with Dr Paul Taylor / The Elephant in the Mental Health Room with Professor John Read

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The Elephant in the Mental Health Room with Professor John Read · Hardiness with Dr Paul Taylor

• 0:00
  Speaker 1: Most people understand, actually, the depression is caused by depressing
• 0:05
  Speaker 1: things happening. Okay, we know that, but psychiatry and the
• 0:10
  Speaker 1: drug companies try to tell us no, no, no, depression
• 0:14
  Speaker 1: is caused by something inside you called depressive disorder. Think
• 0:20
  Speaker 1: about it exactly, saying depression is caused by depression everyone.
• 0:35
  Speaker 2: Before we get into this week's podcast, we've got a
• 0:37
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• 1:09
  Speaker 3: Me anything episode.
• 1:11
  Speaker 2: So all you gotta do if you got a question
• 1:13
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• 1:42
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• 1:46
  Speaker 4: Now I home the podcast, Professor John Reid, Welcome to
• 1:50
  Speaker 4: the podcast.
• 1:51
  Speaker 1: Hi, thanks for having me. Hi's old Blighty at the minute, Well,
• 1:56
  Speaker 1: like the rest of the world, pretty damn depressed, quite honestly. Yes,
• 2:01
  Speaker 1: then what happened in America last week, I think the
• 2:04
  Speaker 1: world is standing I stand alone with it. So, since
• 2:06
  Speaker 1: you ask, it's incredibly, incredibly depressing and frightening.
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  Speaker 3: Yeah, and look the depressing bit.
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  Speaker 4: You have kind of made a career out of studying
• 2:20
  Speaker 4: in this area and publishing. You're at ridiculously prolific researcher
• 2:26
  Speaker 4: in this area. I think you've you've published well over
• 2:28
  Speaker 4: two hundred publications in the top two percent of cited
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  Speaker 4: scientists according to Stanford University and the chure of the
• 2:35
  Speaker 4: International Institute for Psychiatric Drug Withdrawal. So it is an
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  Speaker 4: honor for having you on this podcast because I think
• 2:44
  Speaker 4: I want to really bring your your research to the
• 2:48
  Speaker 4: attention of the general public, because I think what the
• 2:52
  Speaker 4: public think about depression and antidepressant medication often doesn't stack
• 2:59
  Speaker 4: up with the research are with what industry tells us.
• 3:03
  Speaker 4: So just give our listeners a bit of a sense
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  Speaker 4: of your career, how you got interested in this area,
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  Speaker 4: when it was and just some of some of the
• 3:12
  Speaker 4: highlights so far.
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  Speaker 1: Well, I think, if we're honest, a lot of people
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  Speaker 1: who get into mental health, whether it's researchers or clinicians,
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  Speaker 1: there are personal reasons. So a good day, my Adolessons
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  Speaker 1: was trying to figure out why the rest of the
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  Speaker 1: world was crazy, and a bad day was trying to
• 3:27
  Speaker 1: figure out why I was crazy. So that's why I
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  Speaker 1: went into psychology. I thought an undergraduate degree in psychology
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  Speaker 1: would give me some answer to that, but it didn't.
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  Speaker 1: So yeah, I mean, just personal interests growing up in
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  Speaker 1: an averagely dysfunctional British family, and then later when I
• 3:43
  Speaker 1: got a job as a psychiatric nursing aid my very
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  Speaker 1: first job in New York, I was always struck by
• 3:49
  Speaker 1: how if I could establish a relationship with people, and
• 3:52
  Speaker 1: that's the difficult bit. They would mostly not always, but
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  Speaker 1: mostly tell me awful things that had gone on in
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  Speaker 1: their lives, which was their understanding of why they had
• 4:02
  Speaker 1: gone crazy.
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  Speaker 3: Or suicidal or whatever.
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  Speaker 1: So I was struck by that. But I was also
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  Speaker 1: struck by how disinterested, uninterested most of the mental health
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  Speaker 1: staff were in their stories, and how when people tried
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  Speaker 1: to talk about, say abuse that experienced or trauma, it
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  Speaker 1: was either ignored or even worse, sort of dismissed as
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  Speaker 1: a delusion symptom of their illness. Early on, I found
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  Speaker 1: that quite fascinating and distressing, and so when many many
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  Speaker 1: years later I came back into academia, that was that
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  Speaker 1: was the area that I mostly wanted to focus on
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  Speaker 1: terms of research.
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  Speaker 4: That's interesting because my wife is currently doing a master's
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  Speaker 4: degree in counseling and the unit that she's on at
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  Speaker 4: the minute is about adverse childhood experiences how they actually
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  Speaker 4: fundamentally restructure or reshaped the brillan you know, impact on
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  Speaker 4: certain areas of prefront or corse X, the amig dealer,
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  Speaker 4: the hepocampus. And and since you just talk to our
• 5:03
  Speaker 4: listeners about these adverse childhood experiences and what are they
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  Speaker 4: doing to people's brains and how did they then contribute
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  Speaker 4: to mental health problems like depression and psychosis in later life.
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  Speaker 1: Well, I don't think you need to know too much
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  Speaker 1: about what's going on in the brain, although that is
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  Speaker 1: that is interesting, of course, but we can't understand quite
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  Speaker 1: easily what's going on for kids as they grow up
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  Speaker 1: if they've been through really bad experiences without worrying about
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  Speaker 1: what specifically to the brain is doing what Because what happens,
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  Speaker 1: of course is if enough bad things have happened to you,
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  Speaker 1: that affects your ability to establish relationships in the future.
• 5:43
  Speaker 1: So your attachment patterns are can be problematic, not for everybody,
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  Speaker 1: we don't know.
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  Speaker 3: Over Jackti Price, we'll.
• 5:49
  Speaker 1: Come back to that. So attachment patterns can be difficult
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  Speaker 1: to trust, to trust people, so you keep people at
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  Speaker 1: a distance, or sometimes you do the opposite, so you
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  Speaker 1: get very clingy to people, which kind of puts people off.
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  Speaker 1: So it can cause difficulty in relationships. Are worse than that,
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  Speaker 1: it can cause paranoia, of course, So if you've been
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  Speaker 1: done in enough times, it's really necessary and quite functional
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  Speaker 1: to scan for the next time something bad has happened.
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  Speaker 1: And you don't need you know, a lot of science
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  Speaker 1: to understand that, nor do you need to know which
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  Speaker 1: bit of the brain is operating. I'm black. People are
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  Speaker 1: looking into that, and so it's all quite in a way,
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  Speaker 1: quite common common sense that if you've been done in
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  Speaker 1: by other human beings, and your relationships with human beings
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  Speaker 1: in the future are going to be are going to
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  Speaker 1: be problematic, and you're also going to be Some people
• 6:38
  Speaker 1: end up sort of normalizing abuse, so they kind of
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  Speaker 1: in their adult relationships they kind of expect or what
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  Speaker 1: the very or even just tolerate really poor behavior from
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  Speaker 1: other people because that's all they've never own. So in
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  Speaker 1: all those different ways, it basically messes up our relationships
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  Speaker 1: in the future, and including our relationship with ourselves and
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  Speaker 1: whether we're lovable person because a lot of people, if
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  Speaker 1: you're abused early enough, of course, in what the little
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  Speaker 1: kids do when something bad happens or even something good
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  Speaker 1: at that age, we hold ourselves responsible. Anything good happens,
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  Speaker 1: I did it, Anything bad happens my fault. So people
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  Speaker 1: grow up blaming themselves for what happened and get into
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  Speaker 1: this pattern of any time something bad hamps so it
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  Speaker 1: must be me. I'm just a terrible person, so in
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  Speaker 1: all those different ways, and that shows up in across
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  Speaker 1: the diagnostic spectrum depression, anxiety, eating disorders so called personality
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  Speaker 1: sort of certainly my own area of psychosis, schizophrenia so
• 7:34
  Speaker 1: called across all those diagnostic categorist. Child abuses are massively
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  Speaker 1: power and neglect is a massive power powerful predictor.
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  Speaker 4: And does the ege at wish this occurs, this abuse
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  Speaker 4: or neglect the edge at which it starts. Does that
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  Speaker 4: have a big influence on whether or not are the
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  Speaker 4: severity liadter in life? Or is it is it very individually?
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  Speaker 1: Well, it is individualized, but we know and there are
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  Speaker 1: several variables that predict whether or not child abuse and
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  Speaker 1: neglect ends up the person ends up in bad shape
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  Speaker 1: later on, because not everybody does. And those predictors are
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  Speaker 1: the one you just named early age of abuse and
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  Speaker 1: there and the rest are quite obvious. So it's multiple
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  Speaker 1: abuses versus one, because then you generalize that the whole
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  Speaker 1: world is untrustable.
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  Speaker 3: Yeah, I could see that.
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  Speaker 1: And the third wipe this fourth and the third one
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  Speaker 1: is whether it happens inside the family or outside the family, surprise, surprise,
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  Speaker 1: And the fourth one is was anybody told at the time,
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  Speaker 1: and was the abuse or neglect interrupted did somebody do
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  Speaker 1: something about it? Because there's quite a difference between a
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  Speaker 1: singular event, however awful it is, and say, happening outside
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  Speaker 1: the family. The family becomes aware of it, there's an
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  Speaker 1: intervention legally or whatever, and the child is believed, supported
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  Speaker 1: and so forth. That's one end of the spectrum. At
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  Speaker 1: the other end of the spectrum, it's early inside the
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  Speaker 1: family the child tried to tell somebody and then slapped
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  Speaker 1: about perhaps for telling how dare you say such a
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  Speaker 1: thing about Uncle Jimmy And they're punished for that. That
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  Speaker 1: combination can lead to severe psychosism. So yeah, there's a
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  Speaker 1: range of variables there that predict whether someone ends up
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  Speaker 1: in bad shape or or not. And I could add
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  Speaker 1: just on that issue of that last fourth variable there,
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  Speaker 1: whether or not somebody is told and whether a person's belief.
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  Speaker 1: The average amount of time it takes somebody abused sexual abuse,
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  Speaker 1: now I'm just specifically talking about sexual abuse. The old
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  Speaker 1: amount of time takes them to tell another human being
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  Speaker 1: is fifteen to twenty years. What that's including people who
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  Speaker 1: tell at the time or are just oiled the abuses discovered,
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  Speaker 1: So that's when we get into how our mental health
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  Speaker 1: services are dealing with it. It becomes quite an important
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  Speaker 1: variable because very often sometimes I'm trying to tell a
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  Speaker 1: mental health professional and they're the first person that has
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  Speaker 1: been told, so even fifteen twenty years later. So it
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  Speaker 1: becomes very important how we respond in our mental health
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  Speaker 1: services when somebody tries to tell us about abuse and
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  Speaker 1: neglect and so how do you let's dive into that.
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  Speaker 4: How do the mental health services generally approach these problems?
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  Speaker 3: Wow?
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  Speaker 1: Sadly, with some exceptions, of course, not very well. We
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  Speaker 1: have published two or three reviews of the research literature
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  Speaker 1: on how often people are asked about abuse and then
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  Speaker 1: what the responses are when somebody does disclose. So the
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  Speaker 1: first answer the first question. The last time we published
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  Speaker 1: a review, I think we found about only about twenty
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  Speaker 1: studies altogether ever done on that, and the range of people,
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  Speaker 1: the range the percentage of people in different mental health
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  Speaker 1: services who had ever been asked about abuse and neglect
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  Speaker 1: in childhood ranged from twenty two percent to nought percent.
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  Speaker 1: So we're not even asking most of the time. And
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  Speaker 1: these are these studies all over the world, some in America,
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  Speaker 1: some in Britain, some in Australia. So your average mental
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  Speaker 1: health service still hasn't got to the point where it
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  Speaker 1: thinks it's important to ask. Now, obviously there's exceptions to that,
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  Speaker 1: and that is getting better slowly over time, but that
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  Speaker 1: level of not asking I in one of our last
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  Speaker 1: papers we described that as collusion, collusion with abuse, because
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  Speaker 1: this is not the butcher's or the green grocers, or
• 11:35
  Speaker 1: a supermarket or the dentist. These are the services where
• 11:39
  Speaker 1: people go when they are distressed and experience in despair
• 11:44
  Speaker 1: and so forth, and for those services not to address
• 11:48
  Speaker 1: this issue that is that is collusion.
• 11:51
  Speaker 4: That really begs the question, why the hell is it
• 11:55
  Speaker 4: not a standard protocol to ask straight up, like straight
• 12:00
  Speaker 4: off the back, Like so you go to the doctor,
• 12:03
  Speaker 4: they will ask about family history. That's you know, the
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  Speaker 4: first one of the first things that they do when
• 12:09
  Speaker 4: they're investigating any physical illness is asking about family history
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  Speaker 4: and all them. So, why on earth is this not forefront,
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  Speaker 4: particularly when there's very strong evidence from multiple lines of research,
• 12:23
  Speaker 4: right including your stuff including Brien changes. Why is it
• 12:27
  Speaker 4: not first line?
• 12:29
  Speaker 1: The simple answers, because our mental health services are dominated
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  Speaker 1: by our model and the medical model, which is largely unsubstantiated.
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  Speaker 1: And the model basically says, if we become distressed or
• 12:41
  Speaker 1: suicidal or desperate or confused, there's something wrong with our
• 12:44
  Speaker 1: brains and our genes, and it's not really very much
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  Speaker 1: to do with the with the environment. And that's you know,
• 12:52
  Speaker 1: you've got the chemical imbalance nonsense, which is completely refuted,
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  Speaker 1: it's just nonsense. You've got genetic theories about all of
• 13:00
  Speaker 1: these different so called illnesses, there's very little evidence for that.
• 13:04
  Speaker 1: And you've got a dominance of one profession, psychiatry, and
• 13:08
  Speaker 1: those folk are wor't very well intentioned, but they are
• 13:10
  Speaker 1: medically trained. They are trained to think like real doctors.
• 13:16
  Speaker 1: They look for symptoms, they count symptoms, they come up
• 13:19
  Speaker 1: with a label, and they pick a drug. That's largely
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  Speaker 1: what they do. They're not trained in the psychosocial causes
• 13:25
  Speaker 1: of distress. They're certainly not trained in how to relate
• 13:30
  Speaker 1: to people who are in a lot of distress and
• 13:32
  Speaker 1: how to enable them to tell their story. And then
• 13:36
  Speaker 1: the power the second part of the explanation. The answer
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  Speaker 1: to your question is that that model is rigorously and
• 13:42
  Speaker 1: effectively backed by the pharmaceutical industry.
• 13:45
  Speaker 4: I'm sure, yeah, yeah, yeah, the number of a number
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  Speaker 4: of different forces.
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  Speaker 1: Yet and the professional psychiatry all over the world, but
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  Speaker 1: particularly in the United States, has completely sold its soul
• 13:58
  Speaker 1: to the drug company. It's about twenty twenty five years ago.
• 14:01
  Speaker 1: So this is why. Because of this dominance of this ideology,
• 14:05
  Speaker 1: and I think it is an ideology because there's very
• 14:07
  Speaker 1: little evidence to support it. We repeatedly have people who
• 14:11
  Speaker 1: have been done in in a hundred different ways. Can
• 14:13
  Speaker 1: be war, trauma, can be losses. There's losses losing their job,
• 14:19
  Speaker 1: a partner, or whatever, who need human support and human
• 14:23
  Speaker 1: understanding and a human solution to their difficulties. Who are
• 14:29
  Speaker 1: told there's something wrong with their brains, something wrong with
• 14:31
  Speaker 1: their genes, they need medication, or even worse, they need
• 14:33
  Speaker 1: to lecture, shot and a. It doesn't work, and be
• 14:36
  Speaker 1: it's just not based in reality. So that's the simple
• 14:40
  Speaker 1: answer to a question.
• 14:42
  Speaker 4: So let's let's talk about diagnosis. I do want to
• 14:45
  Speaker 4: come back to the effectiveness of interventions that particularly antidepressants
• 14:50
  Speaker 4: and anti psychotics, but let's just talk because you've mentioned psychiatry.
• 14:55
  Speaker 4: For me, it's it's really interesting. I'm currently doing a
• 14:57
  Speaker 4: PhD in psychology or a bit of a background in
• 15:00
  Speaker 4: neuroscience and physiology.
• 15:02
  Speaker 3: But what I find really.
• 15:04
  Speaker 4: Interesting is looking at the DSM and there.
• 15:07
  Speaker 3: Are now over a hundred.
• 15:10
  Speaker 4: Different conditions that people can be labeled, all these different labels,
• 15:17
  Speaker 4: none of which have a biological signature. Like when we
• 15:20
  Speaker 4: look at physical diseases. Every physical disease has a biological
• 15:26
  Speaker 4: signature that you can kneel down. And to my understanding,
• 15:31
  Speaker 4: not a single one of the psychiatric definitions or psycho
• 15:35
  Speaker 4: psychiatric conditions has a strong evidence based biological signature. So
• 15:41
  Speaker 4: I mean, how useful are these diagnoses and is there
• 15:45
  Speaker 4: a strong keys for having over a hundred different ways
• 15:50
  Speaker 4: that people are not functioning?
• 15:53
  Speaker 1: Okay, how useful are the diagnoses? Well, some people find
• 15:56
  Speaker 1: them useful because when when you are in a lot
• 16:01
  Speaker 1: of distress and you're struggling to figure out what's going on,
• 16:05
  Speaker 1: it can be reassuring with someone in authority in a
• 16:08
  Speaker 1: white coat perhaps to tell you that what's going on
• 16:12
  Speaker 1: is X disorder or WHY disorder. That can be reassuring
• 16:16
  Speaker 1: because it means the doctor knows what it is. The
• 16:20
  Speaker 1: last thing you want to hear when you go to
• 16:22
  Speaker 1: a doctor and you tell them your symptoms the last
• 16:24
  Speaker 1: thing you want to hear is oh, my god, I
• 16:25
  Speaker 1: don't know what that is.
• 16:27
  Speaker 4: Absolutely, it kind of validates how people feel.
• 16:29
  Speaker 3: Right.
• 16:30
  Speaker 1: Yes, well it's an illusionary validation. We'll come back to that,
• 16:33
  Speaker 1: but it does make right. It also makes you feel
• 16:36
  Speaker 1: that you're not alone because other people have got this
• 16:38
  Speaker 1: X wide disorder, and it creates the belief that the
• 16:42
  Speaker 1: doctor probably knows what to do. So diagnosis can be
• 16:45
  Speaker 1: quite reassuring in the short term. However, it is illusory
• 16:49
  Speaker 1: because these are not First of all, they're not scientific categories.
• 16:53
  Speaker 1: And as much as they don't have very much reliability
• 16:56
  Speaker 1: or validity, and reliability is the capacity for different experts
• 16:59
  Speaker 1: to a degree who's got what. So you can go
• 17:02
  Speaker 1: to see ten different psychiatrists, you might get between seven
• 17:05
  Speaker 1: and eight different diagnoses, for instance, so consistency there. And
• 17:10
  Speaker 1: then the validity part is does the diagnosis predict the future?
• 17:14
  Speaker 1: Does it give you a prognosis? Does it predicting you
• 17:17
  Speaker 1: know the outcome? No, it doesn't. So you get a diagnosis.
• 17:21
  Speaker 1: Ten people getting a diagnosis of depression, and you go
• 17:23
  Speaker 1: back three months later, there will be ten different outcomes
• 17:26
  Speaker 1: or trajectories. Send a psychostism schizophrenia or whatever. Does it
• 17:30
  Speaker 1: predict what's going to help, well, treatment is going to help. No,
• 17:32
  Speaker 1: it doesn't. It does predict what you're going to get,
• 17:36
  Speaker 1: but it doesn't predict what's going to help. So, and
• 17:38
  Speaker 1: there's some problems Apart from the lack of science, there's
• 17:41
  Speaker 1: problems with the message that it gives because it creates
• 17:45
  Speaker 1: the illusion that there is along with this reassuring thing
• 17:48
  Speaker 1: that you know, yes, the doctor knows what it is,
• 17:49
  Speaker 1: creates an illusion that there's something wrong with you inside you.
• 17:53
  Speaker 1: You have something wrong with your brain, or your genes
• 17:56
  Speaker 1: or something, or your hormones, or the problem is entirely
• 18:00
  Speaker 1: located in you. It's a fairly sort of If it's
• 18:03
  Speaker 1: something wrong with your brain, that suggests it's a fairly permanent,
• 18:06
  Speaker 1: ongoing problem. It's not the flu or something. It's something
• 18:10
  Speaker 1: different and malfunctioning about your brain. Which is a very
• 18:14
  Speaker 1: powerful message to tell somebody, although again some people can
• 18:18
  Speaker 1: find that reassured and think, oh, well, that explains all
• 18:20
  Speaker 1: the things I've ever Yeah, now I get it. But
• 18:23
  Speaker 1: the problem is, there isn't anything wrong with a person's brain.
• 18:25
  Speaker 1: There is no chemical imbalance behind depression or anything else.
• 18:29
  Speaker 1: So that's that's an illusion as well.
• 18:31
  Speaker 3: And this is.
• 18:32
  Speaker 1: Especially true of its children, but there's also true of us.
• 18:34
  Speaker 4: It does.
• 18:35
  Speaker 1: It means you don't you haven't got a look in
• 18:37
  Speaker 1: the environment. So when was particularly worrying when children get
• 18:41
  Speaker 1: a psychiatric diagnosis, because then the first thing you should
• 18:44
  Speaker 1: look for when a child is distressed is what's going
• 18:47
  Speaker 1: on at home, what's going on in the school, What
• 18:49
  Speaker 1: help does that family need with little Johnny or little
• 18:53
  Speaker 1: Jane or what else. But now instead you've got the
• 18:56
  Speaker 1: foot there's something wrong with little Johnny, which is why
• 18:59
  Speaker 1: he can't sisk still at school, or why he's getting
• 19:02
  Speaker 1: very angry and shouting at the teachers or whatever. So
• 19:05
  Speaker 1: it's individualizes, it pathologizes. It creates the impression that's something
• 19:09
  Speaker 1: permanently wrong with you, and then we worry why somebody
• 19:11
  Speaker 1: doesn't get better five years later, so that they're unscientific,
• 19:15
  Speaker 1: unhelpful overall, and they don't actually explain anything. I just
• 19:20
  Speaker 1: an example. Most people understand, actually the depression is caused
• 19:26
  Speaker 1: by depressing things happening. Okay, we know that, but psychiatry
• 19:32
  Speaker 1: and the drug companies try to tell us no, no, no,
• 19:35
  Speaker 1: depression is caused by something inside you called depressive disorder
• 19:41
  Speaker 1: and symptoms of this thing inside you. Depressive is depression.
• 19:48
  Speaker 1: That's what's causing your depression. So you have and it
• 19:50
  Speaker 1: sounds sensible until you think about it. It's actually saying
• 19:53
  Speaker 1: depression is caused by depression. It's like it's backward circular logic.
• 19:59
  Speaker 1: And it quite attractive at one level for those reasons
• 20:02
  Speaker 1: I said at the beginning, it's kind of oh, now
• 20:04
  Speaker 1: I know why I'm so depressed. I'm one of those
• 20:05
  Speaker 1: people with that thing. Yeah, but people who are depressed
• 20:09
  Speaker 1: nine times out of ten aren't going to get better
• 20:11
  Speaker 1: unless we help them deal with the things that are
• 20:14
  Speaker 1: depressing them. So it's a very powerful model. One of
• 20:17
  Speaker 1: it's attracted is it simplicity, because you haven't haven't got
• 20:20
  Speaker 1: to think anymore. Yeah, I'm going to try and figure
• 20:23
  Speaker 1: out what's going on in someone's life. And if you're
• 20:26
  Speaker 1: not very good at connecting to people's feelings when they're distressed,
• 20:29
  Speaker 1: it's quite attractive to professionals who want to keep people
• 20:32
  Speaker 1: at a distance, get the emotions away, because it is
• 20:36
  Speaker 1: quite hard sitting with someone who's upset. Oh well, I
• 20:39
  Speaker 1: don't have to talk to them about what's going on
• 20:40
  Speaker 1: in their lives. I don't have to sit and wait
• 20:43
  Speaker 1: five ten minutes while they've finished crying. I just give
• 20:46
  Speaker 1: them a label and a pill and off they got.
• 20:48
  Speaker 4: Two points on nine. I think that's a really good point.
• 20:50
  Speaker 4: And there's a couple of things I want to come
• 20:51
  Speaker 4: back to that you said there. But I know somebody
• 20:54
  Speaker 4: who had mental health issues and went to see a psychiatrist,
• 20:58
  Speaker 4: and they said the psychiatrist sat on the other side
• 21:01
  Speaker 4: of the room and no rapport building, no relationship building,
• 21:07
  Speaker 4: just suddenly the other side of the room with a
• 21:08
  Speaker 4: clipboard and fired off a bunch of questions.
• 21:12
  Speaker 3: And then when you have this disorder and you need to.
• 21:15
  Speaker 4: Take this medication, right, And what we know in lots
• 21:19
  Speaker 4: of things in medicine, the warmth of the relationship between
• 21:23
  Speaker 4: the medical professional and the individual has a huge influence
• 21:27
  Speaker 4: on the outcome, right, And that's that human connection piece.
• 21:31
  Speaker 4: But what I wanted to come but oh sorry, The
• 21:34
  Speaker 4: other thing around as well is that I guess what
• 21:37
  Speaker 4: you're saying is it makes it easier to deal with
• 21:41
  Speaker 4: for the clinician. So rather than having to dive into
• 21:46
  Speaker 4: this complex web of someone's past and then help them
• 21:50
  Speaker 4: to try to make sense of the world.
• 21:52
  Speaker 3: I just write a script and off they go.
• 21:54
  Speaker 1: Yes, so intellectually and emotionally, it's just far easier for
• 21:58
  Speaker 1: mental health professionals don't really want to get engaged with
• 22:01
  Speaker 1: people's emotions.
• 22:02
  Speaker 4: Yeah, there's a Harvard professor, Harvard psychiatrist. She's writ the
• 22:05
  Speaker 4: book called dopamin Nation. I forget her name, And she said,
• 22:09
  Speaker 4: did she realized that psychiatry was broken when she found
• 22:12
  Speaker 4: herself as soon as she started interacting with the patient
• 22:16
  Speaker 4: and the patient was talking in her head, she was going,
• 22:20
  Speaker 4: which box, am I going to put this person in
• 22:22
  Speaker 4: rather than actually listening to them, And that's when she
• 22:26
  Speaker 4: realized it was broken.
• 22:27
  Speaker 1: Yeah, I want to say something. I do want to
• 22:29
  Speaker 1: come back to you what you said about the human connection.
• 22:31
  Speaker 1: Then how we know that that's a major component. Just
• 22:34
  Speaker 1: just to reinforce what you said, Paul, because we have
• 22:37
  Speaker 1: conducted research big surveys of people on antidepressants and antipsychotics.
• 22:42
  Speaker 1: In those surveys, were asked them about the relationship they
• 22:45
  Speaker 1: had with the person who gave them the pill. Did
• 22:47
  Speaker 1: they feel understood? Did they And just rate the quality
• 22:51
  Speaker 1: of that relationship even if it was a ten minute
• 22:52
  Speaker 1: interaction and the quality, the perceived quality of the relationship
• 22:57
  Speaker 1: was a powerful predictor of whether the drugs work.
• 23:01
  Speaker 4: Yeah, yeah, yeah, Look, we know this from all the
• 23:04
  Speaker 4: placebo research that if there is a connection between medical
• 23:11
  Speaker 4: professional and the individual, the place effect goes through the roof.
• 23:15
  Speaker 1: Right, Absolutely true for a psychologists as well. It's not
• 23:18
  Speaker 1: just medical situation situations, and the Placibo effect or non
• 23:24
  Speaker 1: specific effects is huge.
• 23:26
  Speaker 4: I wanted to come back to you just mentioned some
• 23:29
  Speaker 4: statistics about the reliability and the validity and if you
• 23:34
  Speaker 4: could just go through this again through the lens of
• 23:37
  Speaker 4: would any other branch of science accept that level of
• 23:42
  Speaker 4: reliability and validity?
• 23:44
  Speaker 1: No, it does raise and charge.
• 23:46
  Speaker 3: Can you just put the for the listeners at home.
• 23:49
  Speaker 4: I think it's worthwhile double clipping because there's a lot
• 23:51
  Speaker 4: of lay people listening to this.
• 23:53
  Speaker 3: Just really dive into what that.
• 23:55
  Speaker 4: Reliability and validity actually means in the real world.
• 23:59
  Speaker 1: Okay, let me give you a very very specific example.
• 24:01
  Speaker 1: That field that I work in, nual psychosis. The major
• 24:05
  Speaker 1: diagnosis in that field, as everybody knows, is schizophrenia. So
• 24:09
  Speaker 1: the diagnostic and statistical manual says there are five types
• 24:12
  Speaker 1: of symptoms or schizophrenia. We don't really need things like hallucinations,
• 24:16
  Speaker 1: delusions and so forth. We don't need to go into
• 24:19
  Speaker 1: what they all are. And then it says you need
• 24:22
  Speaker 1: two of these five to get the diagnosis. All right, now,
• 24:26
  Speaker 1: most people can immediately figure out what's wrong with that.
• 24:30
  Speaker 1: It means that let's say say I've got hallucinations and
• 24:34
  Speaker 1: delusions and nothing else, and you, Paul, You've got let's say,
• 24:38
  Speaker 1: thought disorder and catatonia, two of the other symptoms, but
• 24:41
  Speaker 1: nothing else. So now you and I have nothing in common,
• 24:44
  Speaker 1: but we have the same diagnosis. Now, in science this
• 24:47
  Speaker 1: is called a disjunctive category, and in English it is
• 24:52
  Speaker 1: just utter bollocks. And the fact that our discipline claiming
• 24:59
  Speaker 1: to be science after one hundred years, this diagnosis has
• 25:03
  Speaker 1: been in the system for one hundred years. They have
• 25:05
  Speaker 1: redefined it and redefined it many many times, and the
• 25:08
  Speaker 1: best they can come up within the twenty first century
• 25:11
  Speaker 1: is a disjunctive category wherebio people can have the same
• 25:13
  Speaker 1: diagnosis with no symptoms in common. Is bizarre and it
• 25:17
  Speaker 1: speaks volumes about the scientific status of psychiatrists as a discipline.
• 25:22
  Speaker 1: Because you asked me, would this be tolerated in any
• 25:25
  Speaker 1: other discipline? And the answer is clearly no. But yet
• 25:28
  Speaker 1: you have psychiatrists, good people, intelligent people, who generally think
• 25:33
  Speaker 1: there is this thing called schizophrenia that causes hallucinations and delusions,
• 25:38
  Speaker 1: rather than it just being a word that describes people
• 25:41
  Speaker 1: who have those experiences. And despite the fact that people
• 25:45
  Speaker 1: can have that diagnosis without having anything in common, they
• 25:49
  Speaker 1: believe it exists, and they believe that they can tell
• 25:51
  Speaker 1: who's got it and who hasn't, and they can't. The
• 25:54
  Speaker 1: level of agreement between them is very, very low. And
• 25:57
  Speaker 1: this wouldn't matter except that this debilitating diagnosis marks people,
• 26:03
  Speaker 1: often for life, and it really is time we stopped
• 26:06
  Speaker 1: using these diagnosis. It's really it's unscientific, and it's unethical
• 26:10
  Speaker 1: and its stigmatizing. The only thing it does is perpetuate
• 26:13
  Speaker 1: the myth that psychiatry is operating in the scientistic way
• 26:16
  Speaker 1: and that these are medical problems. They're not medical. Their
• 26:20
  Speaker 1: reactions there understandable reactions to adverse life events.
• 26:24
  Speaker 3: Yeah, absolutely, I want to know.
• 26:26
  Speaker 4: I talk about what the research says about the interventions, right,
• 26:30
  Speaker 4: and I'm going to read out something for the listeners.
• 26:34
  Speaker 4: This is from a paper that you wrote with James
• 26:37
  Speaker 4: Williams in twenty eighteen, and what you did was you looked.
• 26:41
  Speaker 3: At a whole heap of people.
• 26:43
  Speaker 4: Who were taking It was fourteen hundred and thirty one
• 26:46
  Speaker 4: people who were on an antidepressant across thirty eight countries,
• 26:50
  Speaker 4: which I think is really important for listeners to understand.
• 26:52
  Speaker 4: So it's cross cultural, and you ask them about their experience,
• 26:57
  Speaker 4: which is different to what the drug companies tell the doctors. Right,
• 27:02
  Speaker 4: and we can get into this, but I'm just going
• 27:04
  Speaker 4: to read this out for people. So sixty one percent
• 27:07
  Speaker 4: of the responders reported at least ten of the twenty
• 27:10
  Speaker 4: adverse effects, most commonly feeling emotionally numb seventy one percent,
• 27:15
  Speaker 4: feeling foggy or detached, seventy percent, feeling not like myself
• 27:18
  Speaker 4: sixty six percent, sexual difficulties sixty six percent, drowsing the
• 27:23
  Speaker 4: sixty three percent, sixty percent had a reduction in positive feelings,
• 27:27
  Speaker 4: and a whopping fifty percent felt suicidal as a result
• 27:32
  Speaker 4: of the drugs. And then withdrawal effects were reported by
• 27:36
  Speaker 4: fifty nine percent and addiction by forty percent. And as
• 27:40
  Speaker 4: you mentioned earlier on the rear of adverse effects were
• 27:43
  Speaker 4: higher for those prescribed multiple antidepression and those who took antipsychotics,
• 27:47
  Speaker 4: younger age, and longer use of antidepressors were positive related
• 27:51
  Speaker 4: to total as verse effects.
• 27:52
  Speaker 3: But and something you mentioned earliers were as well.
• 27:55
  Speaker 4: Less than five percent were actually told about these things
• 28:00
  Speaker 4: by the clinician administering them. So when you did that research,
• 28:07
  Speaker 4: did that just blow you away? Or were you kind
• 28:10
  Speaker 4: of expecting that from stuff that you'd seen previously.
• 28:14
  Speaker 1: Some were expected some surprise. So things that were a
• 28:18
  Speaker 1: surprise was the extent of the suicidality and the extent
• 28:22
  Speaker 1: of withdrawal. We knew about most of the other effects,
• 28:26
  Speaker 1: maybe not that quite as high as we found, but
• 28:29
  Speaker 1: we weren't too surprise. But to find that fifty about
• 28:33
  Speaker 1: fifty percent of people taking a drug that is supposed
• 28:36
  Speaker 1: to lift your mood is making you more suicidal, it's
• 28:41
  Speaker 1: difficult to know what the right words are. I mean,
• 28:43
  Speaker 1: obviously bizarre comes to mind, but it's staggering. Now I
• 28:47
  Speaker 1: have to qualify it a bit because the increased suicidality
• 28:51
  Speaker 1: for most people last only for the first few weeks
• 28:55
  Speaker 1: of treatment and then dies down a bit. So if
• 28:58
  Speaker 1: you can, if you get through those first few weeks,
• 29:01
  Speaker 1: then the suicidality from the drugs goes away. However, that's
• 29:06
  Speaker 1: still quite alarming, especially if you're not told Some people
• 29:10
  Speaker 1: are told that, but a few, but most people are
• 29:13
  Speaker 1: not told that. So here you are depressed enough that
• 29:16
  Speaker 1: you're willing to take a pill, some pills to try
• 29:19
  Speaker 1: and fix that, and just at the point where you're hoping,
• 29:22
  Speaker 1: maybe I found a solution, maybe I'm going to feel better,
• 29:25
  Speaker 1: you start feeling more suicidal. That's kind of that's scary,
• 29:30
  Speaker 1: I think, And I think it's safe to say any
• 29:34
  Speaker 1: other drug in medicine that had opposite effect of what
• 29:39
  Speaker 1: it is intended to do would never have made it
• 29:42
  Speaker 1: to the market in the first place, and certainly would
• 29:45
  Speaker 1: be withdrawn as soon as soon as though that reality
• 29:48
  Speaker 1: became known what they have done. They have put some
• 29:51
  Speaker 1: warnings on antidepressants, so it does state that you read.
• 29:55
  Speaker 1: You know, people trouble to read the little pat leaf
• 29:59
  Speaker 1: in the packet. I don't know how many people actually
• 30:01
  Speaker 1: read that stuff, and I have to admit I probably
• 30:03
  Speaker 1: don't when I've given medication, But that's my fault. You
• 30:06
  Speaker 1: should read it. It does say for young people only.
• 30:09
  Speaker 1: In fact, the evidence is that it's pretty much the
• 30:11
  Speaker 1: same for older people as well. But yeah, it is,
• 30:14
  Speaker 1: but there seems to be a separate set of standards
• 30:18
  Speaker 1: ethically and scientifically for psychiatry compared to the rest of
• 30:21
  Speaker 1: medicine that would not be allowed in any other form
• 30:23
  Speaker 1: of medicine. And then we can come on to withdraw
• 30:25
  Speaker 1: in a minute.
• 30:26
  Speaker 4: Yeah, yeah, because I was going to say that that
• 30:28
  Speaker 4: would just not be allowed in anywhere else. It's not
• 30:31
  Speaker 4: just your group that when I read that research people,
• 30:34
  Speaker 4: then you know, you diving into pub made similar articles
• 30:38
  Speaker 4: and find other research groups have found similar things. So
• 30:42
  Speaker 4: this is not an anomaly. This is across the board,
• 30:45
  Speaker 4: and it's very different to what the lay person and
• 30:49
  Speaker 4: doctors believe, as in, these drugs are seaf and they're effective, right,
• 30:55
  Speaker 4: but withdrawal is a completely It's another thing, isn't it,
• 30:59
  Speaker 4: Because people are on those drugs and you know, one
• 31:02
  Speaker 4: in seven I think it is in the UK one
• 31:05
  Speaker 4: in seven or one in ether I think it's one
• 31:06
  Speaker 4: in eight in the UK, one.
• 31:07
  Speaker 3: In seven in Australia, one in eight in New Zealand.
• 31:10
  Speaker 4: Similar in the United States. People are on these medications,
• 31:14
  Speaker 4: are on antidepressants or antipsychotic medications.
• 31:18
  Speaker 1: Iron now one in six in all of those three countries.
• 31:21
  Speaker 1: And now on antidepressants, and if your female, it's one
• 31:25
  Speaker 1: in four, one and five.
• 31:27
  Speaker 4: I read about the females. I was going to say,
• 31:30
  Speaker 4: I thought that was just the United States, but it's.
• 31:32
  Speaker 3: One in four.
• 31:33
  Speaker 4: And then if people do try to get off them,
• 31:38
  Speaker 4: there are really significant impacts from a withdrawal perspective. So
• 31:43
  Speaker 4: I'm just going to ask you about in a second.
• 31:44
  Speaker 4: But the average I think time that people are taking
• 31:48
  Speaker 4: these drugs is more than two years. That's the dad
• 31:52
  Speaker 4: I saw in Australia.
• 31:53
  Speaker 3: You probably got your finger on the pults better than that.
• 31:56
  Speaker 4: So talk us like this sorts to become a circular
• 31:59
  Speaker 4: issue because I take the drugs because I'm feeling depressed.
• 32:04
  Speaker 3: If I get over the bump, you.
• 32:05
  Speaker 4: Know what what I I know a number of people
• 32:08
  Speaker 4: who are on there and they just say it makes
• 32:10
  Speaker 4: the really bad not so bad, right, So but it
• 32:13
  Speaker 4: grays everything night, right, And then when people do want
• 32:17
  Speaker 4: to get off them, they have really significant withdrawal effects
• 32:22
  Speaker 4: and they straight away go of fuck, this is the
• 32:25
  Speaker 4: depression coming back in through force. So I have to
• 32:28
  Speaker 4: stay on this stuff.
• 32:29
  Speaker 1: Let's do the numbers first, so it's about half of people,
• 32:33
  Speaker 1: so it's not everybody. It's about half of people when
• 32:35
  Speaker 1: they try and come off antidepressants will experience withdrawal effects,
• 32:38
  Speaker 1: which is a lot higher than the drug companies were
• 32:41
  Speaker 1: told anybody or anybody's ever told. And of those people,
• 32:45
  Speaker 1: about half will describe the withdrawal effects as severe. So
• 32:50
  Speaker 1: to get into specters, like one in four people will
• 32:53
  Speaker 1: experience severe withdrawal effects when they try to come off.
• 32:56
  Speaker 1: That's that's high one in force.
• 32:58
  Speaker 3: But it's not.
• 32:59
  Speaker 1: I'm just saying it's not.
• 32:59
  Speaker 3: Ever.
• 33:00
  Speaker 1: This has been denied for decades by the drug companies,
• 33:03
  Speaker 1: and that misinformation has been passed via doctors onto patients.
• 33:06
  Speaker 1: The standard view has been that there might be they
• 33:10
  Speaker 1: like to call it discontinuation symptoms, which is a drug
• 33:13
  Speaker 1: company term designed specifically to sort of minimize it and
• 33:16
  Speaker 1: make it sound like it isn't proper withdrawal. And the
• 33:18
  Speaker 1: message has been for decades, it's rare, it's mild, and
• 33:23
  Speaker 1: it lasts about two weeks. And that that was the
• 33:25
  Speaker 1: drug company line that was sort of developed in nineteen
• 33:28
  Speaker 1: nineties and regurgitated by the professional psychiatry and I have
• 33:31
  Speaker 1: to say many gps as well until Roy very recently.
• 33:35
  Speaker 1: The good news is that in Britain at least, we
• 33:37
  Speaker 1: are really making some heterodes into that. We've had a
• 33:42
  Speaker 1: lot of We've had a government investigation into it. Public
• 33:44
  Speaker 1: Health England has published a full report on these sorts
• 33:48
  Speaker 1: of things and it's making recommendations that the NAHS and
• 33:51
  Speaker 1: Ingdom must have withdraw support services for people trying to
• 33:54
  Speaker 1: get off antidepressants, and we're in the process of trying
• 33:57
  Speaker 1: to get those services off the ground. Are a bit
• 34:01
  Speaker 1: ahead of the rest of the world on this, so changes,
• 34:03
  Speaker 1: it's possible and it's coming. It's fought truth and nail
• 34:06
  Speaker 1: by has been fought by the warw College of Psychiatry here,
• 34:10
  Speaker 1: although they eventually got on board and our nice guidelines,
• 34:13
  Speaker 1: which National Institute of Clinical Excellence change their guidelines. So
• 34:16
  Speaker 1: we have a long nded way and say we are
• 34:18
  Speaker 1: making some progress on but I think still around the
• 34:21
  Speaker 1: rest of the world, I'm sure in America and particularly
• 34:23
  Speaker 1: it's the complete ignorance amongst the GPS who I mean,
• 34:26
  Speaker 1: the research is out there now, there's a lot of
• 34:28
  Speaker 1: studies showing that these figures that we're talking about, and
• 34:31
  Speaker 1: several reviews of the literature. It's out there and while
• 34:35
  Speaker 1: we're on it now, just for some practical advice people
• 34:37
  Speaker 1: who when they do try to come up anti depressants,
• 34:40
  Speaker 1: it needs to be done slowly, obviously, yeah, yeah, and
• 34:44
  Speaker 1: then most people will know that. But what the people
• 34:46
  Speaker 1: don't know is that towards the very end of coming
• 34:49
  Speaker 1: off you need to slow down even more. Just when
• 34:53
  Speaker 1: you think you can throw the last ones away, that's
• 34:56
  Speaker 1: when you need to cut it in half, cut it
• 34:57
  Speaker 1: in quart and really really do the last couple of
• 35:00
  Speaker 1: months or whatever, very very slowly. Indeed, and at every
• 35:04
  Speaker 1: stage of coming off, you come down a little bit
• 35:09
  Speaker 1: and see how it goes. If you get some withdrawal effects,
• 35:11
  Speaker 1: wait for them to subside them, come down a little
• 35:14
  Speaker 1: bit more. It's a very gradual, careful first people can
• 35:17
  Speaker 1: do it, of course, but as you absolutely pointed out, well,
• 35:21
  Speaker 1: the biggest problem is if you try to talk to
• 35:23
  Speaker 1: your doctor who has only drug company misinformation to go on,
• 35:27
  Speaker 1: and the doctor will say, ah, this is your this
• 35:30
  Speaker 1: is your illness coming back. Just at the point where
• 35:33
  Speaker 1: you need to support an informed medical professional to help
• 35:38
  Speaker 1: you come off very slowly, the exact opposite happens, and
• 35:41
  Speaker 1: so the medication is reinstated and people get trapped. And
• 35:45
  Speaker 1: that's why the average amount of time that people are
• 35:48
  Speaker 1: on this drudge is going up and up and up.
• 35:49
  Speaker 1: It's over three years now the average amount of time
• 35:52
  Speaker 1: people are and that's average and summer on for ten
• 35:56
  Speaker 1: twenty years. I think that I mean and podcast this
• 36:00
  Speaker 1: are helping to get the information out there. I think
• 36:02
  Speaker 1: changing will have to come because, unlike an to psychotics
• 36:05
  Speaker 1: would have taken by a relatively small number of people,
• 36:07
  Speaker 1: we're talking about millions and millions of people on presence. Yeah, buddy,
• 36:13
  Speaker 1: if you're not on anti presents yourselves, you know several
• 36:15
  Speaker 1: people who are absolutely so. This information will well, I think,
• 36:20
  Speaker 1: will permeate gradually and we will people will learn how
• 36:24
  Speaker 1: to come up very slurrious, and doctors will eventually get
• 36:29
  Speaker 1: evidence based information rather than drug company information, and then
• 36:32
  Speaker 1: we'll be able to help.
• 36:33
  Speaker 4: What really is banging around in my head very lively here,
• 36:37
  Speaker 4: John is given that the evidence is out there, you know,
• 36:41
  Speaker 4: written by people like you and others who we see
• 36:45
  Speaker 4: this over and over again, the evidence of the side
• 36:48
  Speaker 4: effects and the withdrawal symptoms being very different than what
• 36:52
  Speaker 4: the drug companies advertised, and teach the doctors neither. It's
• 36:56
  Speaker 4: out there and that people are doing something about it.
• 37:00
  Speaker 4: I mean, the words informed consent and duty of care
• 37:03
  Speaker 4: are just banging in my head. Here is that? Why
• 37:07
  Speaker 4: hasn't there been from whether it's the health minister or
• 37:11
  Speaker 4: somewhere very high or psychiatry to go. We need to
• 37:14
  Speaker 4: now re educate doctors urgently about the real effects of
• 37:20
  Speaker 4: these drugs and give people informed consent, where somebody would
• 37:24
  Speaker 4: sit down with the doctor who has depression and they go, Okay,
• 37:28
  Speaker 4: here's your options. You can go on a drug and
• 37:30
  Speaker 4: rattle off all of the side effects that we see
• 37:33
  Speaker 4: in the withdrawal symptoms, or we can do some alternative treatment,
• 37:37
  Speaker 4: which we'll talk about in a second, Like why has
• 37:39
  Speaker 4: that not happened with extreme urgency? Now that the data
• 37:44
  Speaker 4: is very clear?
• 37:45
  Speaker 1: Well, it's a bit simplistic, but one I record it
• 37:49
  Speaker 1: a partial explanation is that when people in those sort
• 37:52
  Speaker 1: of positions of authority politicians for instance, have questions about
• 37:57
  Speaker 1: medical issues like this, who do they consult with?
• 38:00
  Speaker 4: They go to the psychiatrists, right the Royal.
• 38:03
  Speaker 1: College of Psychiatry or the American Psychiatric Association asks them
• 38:06
  Speaker 1: to their view, and their view is dictated by the
• 38:08
  Speaker 1: drug companies. And they won't say that they Obviously they
• 38:11
  Speaker 1: think they're being independent and scientific, but they're not. And
• 38:15
  Speaker 1: the line they will give to the politician is you
• 38:17
  Speaker 1: must not do anything that will scare people into stopping
• 38:22
  Speaker 1: taking their medication. People will die and it will be
• 38:25
  Speaker 1: your responsibility if you have promoted this information, this misdate,
• 38:31
  Speaker 1: which they see is misinformation that will make people stop
• 38:34
  Speaker 1: taking their medication. And that the drug company is incredibly
• 38:38
  Speaker 1: powerful lobbyists in America they have and this is out
• 38:41
  Speaker 1: of date now it's probably more. They have one full
• 38:45
  Speaker 1: time lobbyist for every member of the House of Representatives.
• 38:48
  Speaker 1: That's just bonkers. And the professional psychiatry bodies are not
• 38:54
  Speaker 1: as powerful as drug companies, but they don't have to
• 38:56
  Speaker 1: be as powerful because the politicians come to them. What
• 38:59
  Speaker 1: you we do about this? To be fair. In Britain
• 39:02
  Speaker 1: they have on antidepressants. They have finally kicking and screaming,
• 39:07
  Speaker 1: They have changed their guidelines here and they are now
• 39:10
  Speaker 1: saying that yes, antidepressant withdrawal is real and they are
• 39:13
  Speaker 1: supporting our efforts to try and get services. So credit
• 39:17
  Speaker 1: to them, my credits due. But for thirty years before that,
• 39:19
  Speaker 1: they just regurgitated the drug company misinformation. They've got there
• 39:24
  Speaker 1: now the American psychiatric source is another matter altogether. They
• 39:27
  Speaker 1: are so embedded with the drug companies over there. I'm
• 39:30
  Speaker 1: not hopeful.
• 39:31
  Speaker 4: There's really stunning parallels to big food, which is in
• 39:35
  Speaker 4: an area that I know a lot of and the
• 39:37
  Speaker 4: lobby groups that go and that is kind of expecting
• 39:39
  Speaker 4: that answer because of it's the sea and playbook of
• 39:42
  Speaker 4: big food, big tobacco, and me and you are both
• 39:45
  Speaker 4: scientists and probably as far away as from conspiracy theorists
• 39:49
  Speaker 4: as you could get, but when you look into this world,
• 39:52
  Speaker 4: it is a very very mulky world. I want you
• 39:55
  Speaker 4: to give people just a sense of how the formula
• 39:58
  Speaker 4: on pharmaceutical industry influence public opinion and research and clinical practice. Because,
• 40:03
  Speaker 4: for the example of the food, there's the International Life
• 40:06
  Speaker 4: Sciences Institute, which is funded by big food that then
• 40:10
  Speaker 4: sponsors research at universities that is deliberately designed to put
• 40:16
  Speaker 4: doubt in consumers' minds and cloud the judgment. Right, So
• 40:20
  Speaker 4: that's one tactic that big big food uses and a lobby.
• 40:24
  Speaker 4: So tell our listeners what sort of things that the
• 40:27
  Speaker 4: pharmaceutical industry does to influence public and practice research.
• 40:33
  Speaker 1: Well, as we've already alluded to, the big funders of research.
• 40:38
  Speaker 1: Most drug trials psychi actually drug drafts are funded by
• 40:41
  Speaker 1: drug companies.
• 40:42
  Speaker 4: With any sensible person, there's a red flag straight away,
• 40:46
  Speaker 4: you would think so.
• 40:47
  Speaker 1: But when sort of eighties to ninety percent of called
• 40:50
  Speaker 1: trials are drug companies studies, it becomes normalized and they
• 40:54
  Speaker 1: say it's not a problem, John, because we now declare
• 40:58
  Speaker 1: our conflicts of interest not a problem, which I think
• 41:02
  Speaker 1: is quite laughable. It's it's like saying somebody who committed
• 41:05
  Speaker 1: a theft saying, well, I have a biget to the theft,
• 41:07
  Speaker 1: so why are you still annoyed about? And it's right
• 41:10
  Speaker 1: that they should should declare their interests and sometimes a
• 41:13
  Speaker 1: list of interests. It's almost as low as the article itself.
• 41:16
  Speaker 1: But that's first first way they influence it. Another way,
• 41:20
  Speaker 1: in America they influenced things via direct consumer advertising. There's
• 41:25
  Speaker 1: only two countries in the world, and I think actually
• 41:27
  Speaker 1: in New Zealand that's been stopped.
• 41:28
  Speaker 3: It's New Zealand and America.
• 41:30
  Speaker 4: Isn't it that they can advertise drugs to people. Somebody
• 41:33
  Speaker 4: told me though I either tried to stop it or
• 41:35
  Speaker 4: had stopped it.
• 41:35
  Speaker 1: In New Zealand, it never had.
• 41:37
  Speaker 3: The winter in motion to stop it. In New Zealand,
• 41:39
  Speaker 3: I believe.
• 41:40
  Speaker 1: In any way they don't do it. I lived there
• 41:42
  Speaker 1: for twenty years. You do not see adver advertisements in
• 41:45
  Speaker 1: New Zealand television like you do in America. Whenever I
• 41:47
  Speaker 1: come over sitting in a hotel and switch to tally
• 41:50
  Speaker 1: on every third or fourth advertisement, people and people around
• 41:53
  Speaker 1: the rest of the world don't realize this. Every third
• 41:55
  Speaker 1: or fourth of billing is a blood company advertisement.
• 41:57
  Speaker 3: Absolutely.
• 41:58
  Speaker 4: I was in America to a couple of weeks ago,
• 42:00
  Speaker 4: and the amount of odds for drugs because saying go
• 42:04
  Speaker 4: and ask a doctor about this drug unbelievable.
• 42:08
  Speaker 1: Yes. The other way the influence is by funding supposedly
• 42:12
  Speaker 1: independent NGOs or charities. So in America, the biggest example
• 42:17
  Speaker 1: of this is ARMY, the National Association for Mental Illness
• 42:20
  Speaker 1: DNS itself as a pressure group for patients and relatives.
• 42:24
  Speaker 1: It's absolutely a front group for the drug companies they as.
• 42:28
  Speaker 1: The last time I looked about I think it was
• 42:30
  Speaker 1: fifteen different drug companies were funding ARMI, who unsurprisingly are
• 42:35
  Speaker 1: always pushing from more medication, more coercive legislation to lock
• 42:39
  Speaker 1: people away and get on the sort of injectable drugs
• 42:42
  Speaker 1: so that people can't stop taking them, so that they
• 42:44
  Speaker 1: do that, and they do that all over the over
• 42:46
  Speaker 1: the world. We're lucky again in Britain we are largest
• 42:49
  Speaker 1: mental health charity called Mind does not take any money
• 42:52
  Speaker 1: from drug companies. But that's another way they do it.
• 42:55
  Speaker 1: They and that's not just with psychiatry. That's probably in
• 42:58
  Speaker 1: your field as well, I don't know, but son in
• 43:00
  Speaker 1: all sorts of areas. And the other area, and surprisingly
• 43:04
  Speaker 1: is the Internet. And we've published studies where we've looked
• 43:07
  Speaker 1: at say the top fifty to Google schizophrenia, and you
• 43:10
  Speaker 1: look at the top fifty websites or whatever, more than
• 43:13
  Speaker 1: half are drug company funded. And they don't. They don't
• 43:15
  Speaker 1: always declare that. Some declare it, some are upfront, some
• 43:18
  Speaker 1: are not. And surprise, surprise, when you analyze their websites
• 43:22
  Speaker 1: that are drug company funded versus those that are independently funded,
• 43:26
  Speaker 1: the drug company wants push a biological explanation and they
• 43:29
  Speaker 1: push medications, and they in my field of schizophrenia, they
• 43:33
  Speaker 1: are much more likely to describe this as that not
• 43:36
  Speaker 1: only as an illness, but a debilitating, lifelong, chronic, dangerous illness.
• 43:42
  Speaker 1: You ask how they influence these they are very good researchers.
• 43:46
  Speaker 1: They don't spend a penny without that doesn't influence things,
• 43:50
  Speaker 1: And that's not true. Sometimes they spend money to make themselves.
• 43:52
  Speaker 3: Look like they're doing good.
• 43:54
  Speaker 1: Yes, so they will occasionally fund something on the other
• 43:57
  Speaker 1: side of the buying. And I actually don't blame in
• 44:00
  Speaker 1: them pull their job. Their job is to increase profit
• 44:05
  Speaker 1: for their shareholders. Absolutely, and it's the same with same
• 44:09
  Speaker 1: with big food.
• 44:10
  Speaker 3: That's the job.
• 44:11
  Speaker 1: Yes, they shouldn't lie, but we all know that advertising
• 44:13
  Speaker 1: is live, we don't. You know, when you buy washing powder,
• 44:16
  Speaker 1: you really don't think that it washes whiter than white?
• 44:18
  Speaker 3: Do you?
• 44:19
  Speaker 1: But well, annoy that.
• 44:21
  Speaker 3: But what I.
• 44:22
  Speaker 1: Find so upsetting is that the professional psychiatry does not
• 44:26
  Speaker 1: have a professional ethical boundary between itself and a profit
• 44:32
  Speaker 1: making industry. They have just given up on that, and
• 44:36
  Speaker 1: that is shameful. It's shameful, a little deta knowing all
• 44:41
  Speaker 1: of this stuff that you know, how do you stop
• 44:44
  Speaker 1: this frustration? Because I can, I can sense the frustration.
• 44:49
  Speaker 1: How do you personally stop this frustration from driving you
• 44:53
  Speaker 1: completely bonkers? Great Qris Well, first of all, knowing that
• 44:58
  Speaker 1: there are thousand of thousands of people around the world,
• 45:01
  Speaker 1: engaged in the same struggle. So it's a bit of
• 45:05
  Speaker 1: a cliche, but this is the last, in some ways,
• 45:07
  Speaker 1: the hardest and last human rights struggle. This is a
• 45:10
  Speaker 1: human rights issue that's interesting, and it is very, very
• 45:14
  Speaker 1: hard because we're up against the sort of monolithic power
• 45:17
  Speaker 1: base that we've been describing. But you meet the best
• 45:21
  Speaker 1: people on the way. Like just just on Friday, we
• 45:24
  Speaker 1: had five hundred people on the online launcher of a
• 45:28
  Speaker 1: book called Drop the Disorders. Doesn't matter the detail, but
• 45:31
  Speaker 1: the five hundred people around the world, all focused in
• 45:34
  Speaker 1: the same direction, sharing the frustration, and in all different ways,
• 45:39
  Speaker 1: from service users to very high powered researchers and professors
• 45:43
  Speaker 1: or politicians, all in their different ways, trying to shift
• 45:46
  Speaker 1: the paradigm towards an evidence based, humane approach. And it's
• 45:52
  Speaker 1: very hard, and it is frustrating. And you know, if
• 45:55
  Speaker 1: I've got a disorder, it's banging my head against the
• 45:57
  Speaker 1: brick wall. Disorder and well.
• 46:03
  Speaker 4: Work which unlikely antidepressants. It's great when it stops.
• 46:07
  Speaker 1: Indeed, indeed, so yes, it is. It is frustrating. But
• 46:13
  Speaker 1: as I say, there's so many people involved in the struggle,
• 46:16
  Speaker 1: and we see we see gains. There are pockets. In
• 46:18
  Speaker 1: every country, there are pockets of excellence, and there are alternatives,
• 46:21
  Speaker 1: which I know I think you've been asking me about.
• 46:23
  Speaker 1: In a second, Yes, the need nurturing and highlighting. And
• 46:27
  Speaker 1: within the mental health system there are some really really
• 46:30
  Speaker 1: good people, including psychiatrist. So I know I've made blankets
• 46:34
  Speaker 1: about the profession of psychiatry. Within that, there are some
• 46:38
  Speaker 1: excellent psychiatrists who despite their psychiatric training, are doing some
• 46:44
  Speaker 1: very very good good work. And I'm not scared of
• 46:46
  Speaker 1: people's emotions and I'm not scared of the complexity of
• 46:49
  Speaker 1: people's lives. And then there's the rest of the mental
• 46:51
  Speaker 1: health workforce, because you have to remember that psychiatry makes
• 46:55
  Speaker 1: up about one percent of the mental health workforce. Somehow
• 46:58
  Speaker 1: they grasped much percent of the power. Sounds familiar.
• 47:01
  Speaker 4: Wow, I mean you just kind of describe the Catholic
• 47:05
  Speaker 4: Church for me.
• 47:06
  Speaker 1: Or most economists for that matter.
• 47:08
  Speaker 4: Yeah. Well, yeah, yeah, well exactly. I mean that's the thing, right,
• 47:11
  Speaker 4: is that money talks. It really does. So let's know
• 47:15
  Speaker 4: that we have open people's eyes to what the data
• 47:20
  Speaker 4: is actually saying. What are some alternatives to antidepressant and
• 47:25
  Speaker 4: anti psychotic medications?
• 47:28
  Speaker 3: And then you know, at the end.
• 47:29
  Speaker 4: We're going then point to people in directions for resources
• 47:32
  Speaker 4: if they are on these drugs and do want to
• 47:34
  Speaker 4: get off, but alternative interventions and treatments.
• 47:38
  Speaker 1: Okay, Well, just before we do that, I need to
• 47:40
  Speaker 1: stress that for some people the diagnosis are helpful, and
• 47:44
  Speaker 1: for some people the medications are helpful. So and certainly
• 47:49
  Speaker 1: I should stress that do not stop taking your medication
• 47:53
  Speaker 1: on the basis of listening to one podcast.
• 47:56
  Speaker 4: Yes, and I think, particularly John, if they have serious
• 48:02
  Speaker 4: disease that you know, so not mild. If they have severe,
• 48:07
  Speaker 4: I think that's when the drugs tend to are seen
• 48:10
  Speaker 4: to be, from my reading of it, more helpful for
• 48:13
  Speaker 4: people who are really debility in it.
• 48:16
  Speaker 1: Well, let's just do with that quickly. Then alternatives to
• 48:20
  Speaker 1: A while ago, Irvin Cursews at Harvard Medical School got
• 48:23
  Speaker 1: hold of all of the drug trials for antidepressants that
• 48:27
  Speaker 1: have previously been buried. And by buried, I mean to
• 48:31
  Speaker 1: get a license. Get a drug license, you only need
• 48:33
  Speaker 1: to do two studies, submit to studies that share effectiveness
• 48:36
  Speaker 1: and safety. So the drug companies will do twenty twenty
• 48:39
  Speaker 1: five or however Manique takes until they get to that
• 48:42
  Speaker 1: US share efficacy, and this those two irving got whold.
• 48:46
  Speaker 1: Professor Kursh got hold of all the others analyze all
• 48:50
  Speaker 1: of those and he found that for about ninety five
• 48:55
  Speaker 1: percent of people on antidepressants, there is no difference between
• 48:58
  Speaker 1: antidepressants and placed.
• 49:00
  Speaker 4: Is that the Emperor's new drugs the paper that he wrote, Yeah,
• 49:03
  Speaker 4: I've got the paper. Yeah, that's stunning. I mean I
• 49:07
  Speaker 4: want that to sinking to people. For ninety five percent
• 49:12
  Speaker 4: of them, the antidepressors were no more effective than placebo,
• 49:16
  Speaker 4: which is not saying that placebo doesn't have an effect, right, Well.
• 49:18
  Speaker 1: One, that's important. Yes, that's absolutely important. So it's what
• 49:21
  Speaker 1: we were talking about before. People are getting feeling better
• 49:24
  Speaker 1: on anti press but not because of the pills, but
• 49:27
  Speaker 1: because somebody has listened to a little bit, listened at
• 49:29
  Speaker 1: least long enough to give them a pill. That's something
• 49:32
  Speaker 1: they've decided they've got a problem, and they've decided to
• 49:35
  Speaker 1: do something about it, and they are doing something about it.
• 49:38
  Speaker 1: And the pills sorttly make you feel different. So it's
• 49:41
  Speaker 1: really quite easy under those circumstances. Well I am, I'm
• 49:43
  Speaker 1: feeling better. Pacebo is Latin for I please.
• 49:46
  Speaker 3: Which is ah, there you go.
• 49:48
  Speaker 1: He yeah, really need to know, isn't it, And then
• 49:51
  Speaker 1: it was another five percent for whom there is a difference,
• 49:55
  Speaker 1: and that's the severe. There's mild, moderate, and severe. So
• 49:59
  Speaker 1: people but at the top end of the severe category
• 50:02
  Speaker 1: do get more some sort of effect that is not
• 50:04
  Speaker 1: a placebo effect, and Irving suggested that that's because they
• 50:08
  Speaker 1: are so depressed they cannot access the placebo effect right
• 50:14
  Speaker 1: so down that it doesn't matter that someone's listened to
• 50:17
  Speaker 1: them or they've done something so anyway, but I think
• 50:20
  Speaker 1: the important thing is that for ninety five percent of people,
• 50:22
  Speaker 1: there's nothing about these pills that are actually helping them.
• 50:25
  Speaker 1: So that's important. That's important to that. So when you
• 50:28
  Speaker 1: when you think about coming off them, and you worry
• 50:31
  Speaker 1: about am I going to get worse as a result
• 50:34
  Speaker 1: coming off, the answer almost invariably is no, You're not
• 50:38
  Speaker 1: going to be worse because of the absence of the pills.
• 50:41
  Speaker 1: You may feel worse because of the withdrawal.
• 50:43
  Speaker 3: Effects getting Yeah, once you get off though, then.
• 50:46
  Speaker 1: So you asked me about alternatives and I went off
• 50:48
  Speaker 1: for tangent.
• 50:49
  Speaker 3: No, No, that was but that's important.
• 50:51
  Speaker 1: I think this is where if I'm doing an undergraduate
• 50:54
  Speaker 1: lecture This is the part where I make the joke
• 50:55
  Speaker 1: about the definition of thought disorder is going off on
• 50:58
  Speaker 1: a tangent and not being able to come back. So
• 51:01
  Speaker 1: where were we, Paul? If I can't find my way
• 51:04
  Speaker 1: back there, that means I've got schizophrenia anyway, brad Ja.
• 51:07
  Speaker 1: So the corner. The third thing to say about the alternatives,
• 51:11
  Speaker 1: they are all all the variations are based on the
• 51:15
  Speaker 1: assumption of the core ingredient or an effective treatment, if
• 51:20
  Speaker 1: we must call it that for mental health problems, is
• 51:22
  Speaker 1: based on human relationships. So all of the things I'm
• 51:25
  Speaker 1: going to talk about now are centered around quality of
• 51:28
  Speaker 1: the relationship between the helper and the person being helped,
• 51:32
  Speaker 1: and an understanding that the problems have come from very
• 51:36
  Speaker 1: often faulty or dysfunctional relationships in the past. So it's all.
• 51:41
  Speaker 1: Some people call that trauma informed therapy because you focused
• 51:44
  Speaker 1: on the traumas in the past. Some people relational therapy
• 51:47
  Speaker 1: doesn't matter. It's about human beings. And the basic idea
• 51:50
  Speaker 1: here is some of my ideas are a bit simplistic,
• 51:53
  Speaker 1: you know, the idea that depression is caused by depressing things.
• 51:56
  Speaker 1: My idea about therapy, which is also one that everybody
• 52:00
  Speaker 1: knows already. If distress and despair and fear is based
• 52:05
  Speaker 1: on human beings having done not very nice things to
• 52:08
  Speaker 1: us in the past, the answer is human beings doing
• 52:12
  Speaker 1: nice things to us in the presence. It's not sophisticated,
• 52:16
  Speaker 1: is it, but the So there are some examples of
• 52:19
  Speaker 1: the alternatives. One that's catching on around the world is
• 52:22
  Speaker 1: called open dialogue. Have you heard of that one?
• 52:25
  Speaker 3: I haven't heard of that, Okay.
• 52:27
  Speaker 1: So this rage originated in Finland. It's based on the
• 52:30
  Speaker 1: idea and it's especially for psychosis. It's based on the
• 52:33
  Speaker 1: idea that when somebody has a psychotic episode or lose
• 52:36
  Speaker 1: his contact with reality or or whatever you want to
• 52:39
  Speaker 1: however you want to describe it, it's very important to
• 52:42
  Speaker 1: as quickly as possible gather together as the key people
• 52:45
  Speaker 1: in that person's life, whether that's family, friends, teaches, doesn't
• 52:48
  Speaker 1: matter who it is, get a group of people together,
• 52:51
  Speaker 1: including the person themselves, and together talk about what has
• 52:57
  Speaker 1: gone wrong and what might be helpful. And the role
• 53:00
  Speaker 1: of the professional is not to tell the person what's
• 53:03
  Speaker 1: going wrong, but to help these key people in the
• 53:06
  Speaker 1: person's life develop a plan together about how to help
• 53:10
  Speaker 1: that person. Is not rocket science, except that those very
• 53:13
  Speaker 1: good science behind it. This works surprise surprise, which is
• 53:17
  Speaker 1: completely different from taking the person away from their family,
• 53:20
  Speaker 1: locking them.
• 53:21
  Speaker 4: Up and giving them a leg and altered shocks.
• 53:23
  Speaker 1: Oh, don't start me there. That's a whole nother hour.
• 53:27
  Speaker 1: But I was in New Zealand for twenty years and
• 53:30
  Speaker 1: the Mari people in New Zealand cannot understand why us
• 53:34
  Speaker 1: white people, when somebody gets distressed, takes the person away
• 53:38
  Speaker 1: from their family, sits them privately in a room and
• 53:43
  Speaker 1: has a private one on one discussion which cannot be
• 53:46
  Speaker 1: shared with anybody else, which is our understanding confidentiality, isn't it?
• 53:51
  Speaker 1: So it makes sense to us, But they don't. Why
• 53:54
  Speaker 1: on earth would you do that with a pig? So
• 53:56
  Speaker 1: they have an open dialogue sort of approach. They will
• 53:59
  Speaker 1: literally get together the extended family, which in Marridom can
• 54:03
  Speaker 1: sometimes with twenty thirty people, and talk together about what
• 54:07
  Speaker 1: these voices the person has heard, what it means, and
• 54:11
  Speaker 1: they'll come up with understandings like it's dead grandmothers speaking
• 54:15
  Speaker 1: to them or whatever. It will be things that I
• 54:18
  Speaker 1: understand or agree with, because I don't think dead grandmothers
• 54:21
  Speaker 1: can speak to you. But who cares. What I think
• 54:23
  Speaker 1: that's a cultural understanding, shared understanding, and what those two
• 54:28
  Speaker 1: things have in common is that it does not pathologize
• 54:31
  Speaker 1: the individual. It's not like there's something wrong with this
• 54:34
  Speaker 1: person that we need to be frightened of them or
• 54:37
  Speaker 1: push them away or lock them up or treat them
• 54:39
  Speaker 1: as different. It means this is a group problem with
• 54:43
  Speaker 1: a group solution, and this completely different sort of approach.
• 54:47
  Speaker 1: Another example is the Hearing Voices Network, which now has
• 54:52
  Speaker 1: Hearing Voices groups I think are in their twenty three
• 54:54
  Speaker 1: twenty four countries, and these are people who hear voices
• 54:58
  Speaker 1: coming together to support one and again, similar sort of
• 55:01
  Speaker 1: basis is about relationships. It's not nobody has the power
• 55:05
  Speaker 1: to diagnose one another or medicate one another or impose
• 55:09
  Speaker 1: an understanding. Nobody's going to be saying it's all biology
• 55:13
  Speaker 1: or it's all trauma. Everybody you know might be twelve
• 55:15
  Speaker 1: people in a room. They might have twelve different explanations
• 55:18
  Speaker 1: of their voice hearing, and they will share coping mechanisms
• 55:22
  Speaker 1: that no mental health professional will ever tell you. For instance,
• 55:25
  Speaker 1: they will share tricks like if you want to hear it,
• 55:28
  Speaker 1: stop the voices, immediately, turn the radio on.
• 55:30
  Speaker 3: Or read a book because your attention.
• 55:33
  Speaker 1: That's right, yes, which is simple and obvious. But no
• 55:35
  Speaker 1: mental health professionals still you that they might as ay
• 55:38
  Speaker 1: some of the hearing voices. People are beginning to educate
• 55:41
  Speaker 1: as professional so that's good, and that's going on all
• 55:43
  Speaker 1: around around the world. There's less research on that. We
• 55:47
  Speaker 1: can't do randomized control trials on that, but we have
• 55:50
  Speaker 1: around a few, quite a few now surveys of people
• 55:52
  Speaker 1: who attend those groups, and they talk very much about
• 55:55
  Speaker 1: it's helpful because of the non judgmental atmosphere in the
• 55:58
  Speaker 1: room and because it's it's people helping one another, and
• 56:01
  Speaker 1: that that works not for everybody, and some people can't
• 56:04
  Speaker 1: stand groups, you know, so nothing works for everybody. I'm
• 56:08
  Speaker 1: just giving you some examples of the fact that there
• 56:11
  Speaker 1: are alternatives. And another is the Power Threat Meaning Framework,
• 56:15
  Speaker 1: which isn't really a treatment model as a way of thinking,
• 56:18
  Speaker 1: it's an alternative in a way, or an addition to diagnosis,
• 56:20
  Speaker 1: which is something that's British psychologists put together, which is
• 56:24
  Speaker 1: out there on the internet for free. The power Threat
• 56:28
  Speaker 1: Meaning Framework, which basically express it simply, it means, instead
• 56:32
  Speaker 1: of asking what's wrong with somebody who asked what's happened
• 56:34
  Speaker 1: to them? And then how do they Again, none of
• 56:38
  Speaker 1: this stuff is complicated or rocket science, and I think
• 56:42
  Speaker 1: it's the right time to mention that when you do
• 56:44
  Speaker 1: surveys around the world asking people what causes mental health problems,
• 56:49
  Speaker 1: in every country except America, God bless America, they seem
• 56:53
  Speaker 1: to get everything wrong. But in twenty seven countries where
• 56:57
  Speaker 1: this has been done, you ask people what's wrong, what
• 57:00
  Speaker 1: causes mental outcome? They prioritize social things. They prioritize loneliness, loss, trauma, abuse,
• 57:07
  Speaker 1: being a refugee, unemployment. We know, we know why we
• 57:10
  Speaker 1: get upset, don't we Because upsetting things happen. And then
• 57:13
  Speaker 1: we'll ask them what sort of treatment should be given,
• 57:16
  Speaker 1: whether that's the depression or schizophrenia or anything. They prioritize
• 57:20
  Speaker 1: social solutions, and primarily talking therapies are much more in
• 57:25
  Speaker 1: demand around the world than medication or certainly an ect.
• 57:30
  Speaker 1: So I guess I'm stressing that because that sometimes those
• 57:33
  Speaker 1: of us calling for change positioned as sort of a
• 57:36
  Speaker 1: radical or a bit extreme, but the public almost everywhere
• 57:39
  Speaker 1: is already on that page, and now so is the
• 57:43
  Speaker 1: United Nations and the World Health Organization, who who are
• 57:46
  Speaker 1: putting out twenty twenty three. Just last year they put
• 57:49
  Speaker 1: out a joint document calling to an end to the
• 57:52
  Speaker 1: medical model.
• 57:53
  Speaker 4: Yeah, well, you're just describing the biopsychle social model versus
• 57:56
  Speaker 4: the medical model, right that tikes into a kind the
• 58:00
  Speaker 4: people's backgrounds, their social connections or But but you're talking
• 58:05
  Speaker 4: about it from an intervention perspective.
• 58:07
  Speaker 1: I'm talking more about the social than the bio. It's
• 58:10
  Speaker 1: a bit complicated.
• 58:11
  Speaker 4: The sorry, sorry, I should have said psycho social.
• 58:13
  Speaker 3: Should have taken a biote right.
• 58:15
  Speaker 1: Well, yes, except, of course the brain is important. But
• 58:18
  Speaker 1: let's just quickly, very quickly deal with that. The brain
• 58:21
  Speaker 1: is important, but not in the way that the drug
• 58:23
  Speaker 1: companies and psychiatry tells. If the best way to illustrate
• 58:27
  Speaker 1: this quickly, say I've lost two or three people in
• 58:31
  Speaker 1: the last three months, are very dear to me. My
• 58:33
  Speaker 1: thoughts will be different, my feelings will be different, and
• 58:35
  Speaker 1: my brain will be operating differently at that point in time,
• 58:39
  Speaker 1: so on, my metabolism and everything all be sort of
• 58:42
  Speaker 1: closed down. Along terms of research, you're looking for the
• 58:45
  Speaker 1: cause of my depression. They look at the scan my
• 58:47
  Speaker 1: brain and see what's going on in my brain. And
• 58:49
  Speaker 1: yes it is operating differently. Has that caused my or
• 58:54
  Speaker 1: have the losses causes And that's the fundament mental mistake
• 58:58
  Speaker 1: that biological psychiatry he keeps making. They keep finding these
• 59:02
  Speaker 1: brain differences and simplistically, and I have to say, stupidly
• 59:06
  Speaker 1: think that they're causal. They're not causal. They're the result
• 59:10
  Speaker 1: of what's going on in pertance. And the quickest way
• 59:13
  Speaker 1: to get that across with them is what use would
• 59:15
  Speaker 1: a brain bee that didn't respond to what's going on
• 59:19
  Speaker 1: in the environment.
• 59:20
  Speaker 4: That's a very good point, John, is that we are
• 59:24
  Speaker 4: brains are designed to respond to the environment. That there
• 59:29
  Speaker 4: is remodeling of our brains depending because of that neuroplasticity,
• 59:33
  Speaker 4: and that's what we do, is we respond to the environment.
• 59:35
  Speaker 4: I'm going to throw a couple of other things just
• 59:38
  Speaker 4: to get your opinion on them, and I think here
• 59:41
  Speaker 4: more is around some of the drivers of mind depression.
• 59:46
  Speaker 4: I'm not talking about the severe or even potentially the moderate.
• 59:50
  Speaker 4: I'm talking about the large percentage of worried well who
• 59:54
  Speaker 4: are out there and here on an antidepressant. So our
• 59:57
  Speaker 4: recent publication this year and i'm Uberella review of ultraprocessed
• 1:00:02
  Speaker 4: food find convincing class one evidence, which you very rarely
• 1:00:08
  Speaker 4: see in nutrition, that increasing ultraprocessed foods in the diet
• 1:00:12
  Speaker 4: increases the risk of anxiety by forty three percent and
• 1:00:15
  Speaker 4: forty eight percent sorry, and common mental health disorders by
• 1:00:18
  Speaker 4: fifty three percent.
• 1:00:20
  Speaker 3: Right.
• 1:00:20
  Speaker 4: And we know that in your country and my country,
• 1:00:23
  Speaker 4: more than fifty percent of all calories concerned are ultra
• 1:00:26
  Speaker 4: processed shit.
• 1:00:28
  Speaker 3: Right.
• 1:00:28
  Speaker 4: And if you're eating a shit diet, I say that people,
• 1:00:31
  Speaker 4: you're playing Russian Roulette with your mental health, especially when
• 1:00:35
  Speaker 4: you combine that with not exercising, because the human genome
• 1:00:40
  Speaker 4: is so dependent on physical exercise. I mean I could
• 1:00:43
  Speaker 4: wax lyrical for at least an hour of the impact
• 1:00:45
  Speaker 4: of mild kinds and particularly on the brain, on all
• 1:00:50
  Speaker 4: of these different neurotransmitters and feel good chemicals that basically
• 1:00:53
  Speaker 4: that if you're not exercising, eating well, and sleeping well,
• 1:00:58
  Speaker 4: you're actually.
• 1:01:00
  Speaker 3: Putting your brain in at.
• 1:01:01
  Speaker 4: A massively increase vulnerability, I believe. And then you have
• 1:01:06
  Speaker 4: these natural life events that cause us to be sad and.
• 1:01:10
  Speaker 3: Then bomb people. And then the answer is there's.
• 1:01:12
  Speaker 4: A pill for that, which is the easy way out
• 1:01:15
  Speaker 4: because it's a shit a load easier to take a pill,
• 1:01:17
  Speaker 4: then get off your ass and exercise and stop eating
• 1:01:20
  Speaker 4: shit food and get off Netflix and social media at nights, right,
• 1:01:25
  Speaker 4: And so I'd like your opinion on that. But then
• 1:01:27
  Speaker 4: also I think as an adjunctive therapy for treatment is
• 1:01:32
  Speaker 4: getting people in a wholesome diet and exercising and being
• 1:01:35
  Speaker 4: good around their sleep hygiene, so as they that it
• 1:01:38
  Speaker 4: works in with all of those really important social interventions
• 1:01:42
  Speaker 4: that you're talking about.
• 1:01:44
  Speaker 3: What's your thoughts on those things?
• 1:01:45
  Speaker 1: Absolutely agree with all of that. If not, they're they're
• 1:01:48
  Speaker 1: they're not my area of expertise. But then as that
• 1:01:50
  Speaker 1: surprises me, so it's crucially important. It's because some of
• 1:01:54
  Speaker 1: that is beginning to happen over here as social It's
• 1:01:58
  Speaker 1: called different things, but some people will go it's social prescribing.
• 1:02:01
  Speaker 1: So so some of our GP practices now have social
• 1:02:05
  Speaker 1: prescribing offices or whatever they're called, where somebody will be
• 1:02:09
  Speaker 1: encouraged to think of different ways that they can. I
• 1:02:13
  Speaker 1: guess the theme is do something get involved in. Whether
• 1:02:17
  Speaker 1: that's running exercise, it's swimming, or dramatic society or or
• 1:02:20
  Speaker 1: chess club or whatever. It doesn't sort of matter. And
• 1:02:24
  Speaker 1: I think a lot of the motivation for that is
• 1:02:25
  Speaker 1: around relationships.
• 1:02:27
  Speaker 4: Again, do something with other people ideally.
• 1:02:30
  Speaker 1: Yes, but it does address some of the issues you're raising,
• 1:02:33
  Speaker 1: like exercise and they will die. Diet will certainly be
• 1:02:36
  Speaker 1: in on the agenda when people use with the social prescriber,
• 1:02:39
  Speaker 1: that's a very exacting development I think. And they're locating
• 1:02:43
  Speaker 1: in GP's offices.
• 1:02:45
  Speaker 4: Ah.
• 1:02:45
  Speaker 1: Nice, but that's part of the problem because the GP,
• 1:02:48
  Speaker 1: who has no time at all, has to try and
• 1:02:50
  Speaker 1: refer people to somewhere else and very often we don't
• 1:02:53
  Speaker 1: bother going or whatever. They're actually right there in the
• 1:02:57
  Speaker 1: in the GP practice Live will be addressing to those
• 1:03:00
  Speaker 1: points that you raise, which it might as are incredibly important.
• 1:03:03
  Speaker 4: John, I am aware of your time. You've been very
• 1:03:05
  Speaker 4: generous with it. But there is a question I think
• 1:03:07
  Speaker 4: we have to address. And so what is helpful and
• 1:03:11
  Speaker 4: what is helpful for people who are trying to withdraw
• 1:03:15
  Speaker 4: from anti psychotic medications, antidepressants, antipsychotics, and are there any
• 1:03:20
  Speaker 4: resources that you can point them to as well?
• 1:03:23
  Speaker 1: Okay, so general guidelines around what's helpful on what's unhelpful.
• 1:03:28
  Speaker 1: So what's helpful is ideally, and I know this is difficult,
• 1:03:31
  Speaker 1: ideally get the support of the person who prescribed the
• 1:03:34
  Speaker 1: drugs that's currently that's quite difficult to do in many circumstances,
• 1:03:39
  Speaker 1: but at least try. You might you might just be surprised,
• 1:03:44
  Speaker 1: especially if you take some research with you or whatever.
• 1:03:48
  Speaker 1: But be prepared for that person to say no. Especially
• 1:03:50
  Speaker 1: with ant psychotics, they'll say no, it's not safety to
• 1:03:52
  Speaker 1: come off, you'll go crazy, blah blah. But try, because
• 1:03:55
  Speaker 1: that is the ideal situation. Other than that, there's a
• 1:03:59
  Speaker 1: lot of support out there on Facebook groups and online
• 1:04:03
  Speaker 1: and we shouldn't need to use online groups for things
• 1:04:07
  Speaker 1: to provide things that professionals should be providing. But I
• 1:04:09
  Speaker 1: think for the next five ten years, until we educate
• 1:04:12
  Speaker 1: the professionals, these groups are going to be still very important.
• 1:04:16
  Speaker 1: One for instance, is that there's an ORGI in a compass.
• 1:04:20
  Speaker 1: I can email you. I don't know if you can
• 1:04:21
  Speaker 1: put them up on that'd be great.
• 1:04:23
  Speaker 3: Yeah, no, I'll stick these links on for people for sure. Yeah.
• 1:04:26
  Speaker 1: All right, So in a compasses one, because there's lots
• 1:04:28
  Speaker 1: around the world. There's a lot of resources at an
• 1:04:30
  Speaker 1: organization that I'm chair of that you mentioned before, the
• 1:04:33
  Speaker 1: International Institute of Psychiatric Drug Withdrawal, and there's a new
• 1:04:37
  Speaker 1: one also called psychotropic I think it's called a Psychotropic
• 1:04:41
  Speaker 1: Prescribing Council, which has just started a similar organization. There's
• 1:04:45
  Speaker 1: lots out there on the internet, and some of them
• 1:04:48
  Speaker 1: are people supporting one another like in a compass, and
• 1:04:52
  Speaker 1: this one called Surviving Antidepressants. There's lots, and then others
• 1:04:56
  Speaker 1: are like these institutes and organizations are trying to provide
• 1:04:59
  Speaker 1: resources and research from people. So that's another way to
• 1:05:01
  Speaker 1: get Getting support from family and friends is key if
• 1:05:05
  Speaker 1: you can. It can be very hard for partners or
• 1:05:10
  Speaker 1: children or whoever. When you are going through withdrawal. There
• 1:05:14
  Speaker 1: will be times when you will be a pain in
• 1:05:16
  Speaker 1: the ass because you also to stress. You're very stressed,
• 1:05:19
  Speaker 1: and so people need to sort of know what's going
• 1:05:21
  Speaker 1: on and try and get support from from family and
• 1:05:24
  Speaker 1: then and then what I was mentioning before is that
• 1:05:26
  Speaker 1: the importance of not going too fast, and the problem
• 1:05:30
  Speaker 1: is that's different for each individual. So by and large,
• 1:05:34
  Speaker 1: rather than reducing, so the mistake in the past has
• 1:05:38
  Speaker 1: been reduce ten grams or milligrants, ten milligrams or whatever
• 1:05:42
  Speaker 1: per time. Don't do that reduced by a percentage. So
• 1:05:45
  Speaker 1: if you're reduced by ten percent every time, then the
• 1:05:48
  Speaker 1: actual amount you're reducing each time is getting smaller as
• 1:05:52
  Speaker 1: time goes on. That it's called parabolic. It sounds a
• 1:05:56
  Speaker 1: bit classical, but it's really important. It really can make
• 1:05:59
  Speaker 1: the differ diference for some good research now thirty days.
• 1:06:02
  Speaker 1: But we are fairly convinced that that is a safer
• 1:06:06
  Speaker 1: way to go, so, especially at the end, very very
• 1:06:09
  Speaker 1: very slowly, and it's to do with the way that
• 1:06:12
  Speaker 1: the brain has adapted without going into technicalitism. So those
• 1:06:15
  Speaker 1: are the key things. So the unhelpful get I guess
• 1:06:18
  Speaker 1: is the opposite of all of those. Trying to do
• 1:06:20
  Speaker 1: it completely by yourself with no support and going to
• 1:06:25
  Speaker 1: quickly go to the nose can be done. And having
• 1:06:28
  Speaker 1: said all of that, inexplicably some people are able to
• 1:06:32
  Speaker 1: just go completely cold turkey. So I can, and people
• 1:06:35
  Speaker 1: sometimes John I did, I don't. I didn't need all that.
• 1:06:39
  Speaker 1: I just I just I'm strong willed and I just
• 1:06:41
  Speaker 1: stopped and it was horrible, but I got through it
• 1:06:43
  Speaker 1: well done. But not the recommended mechanism not recommended. And
• 1:06:48
  Speaker 1: it doesn't mean you're not strong world if you cut.
• 1:06:50
  Speaker 1: If you can't do that, I'm just acknowledging that everybody
• 1:06:53
  Speaker 1: is different.
• 1:06:53
  Speaker 4: What's your hope for the future in all of this,
• 1:06:56
  Speaker 4: I think we do need a complete paradigm shift.
• 1:07:00
  Speaker 1: We have to let go of this simplistic and actually
• 1:07:03
  Speaker 1: pessimistic idea that when we are distressed and feel hopeless
• 1:07:08
  Speaker 1: or confused or desperate, that means there's something wrong with
• 1:07:11
  Speaker 1: our brains or our genes. It doesn't. It means that
• 1:07:15
  Speaker 1: we are human beings. And when awful things happen in
• 1:07:18
  Speaker 1: personal worlds or as the sort of things you're talking
• 1:07:21
  Speaker 1: about terms of our nutrition, we will feel terrible and
• 1:07:24
  Speaker 1: we need solutions that address that. And we have to
• 1:07:28
  Speaker 1: free our mental health services from the influence of drug companies.
• 1:07:31
  Speaker 1: And until we've done that, this paradigm change won't happen.
• 1:07:35
  Speaker 1: And that isn't going to be easy because they're not
• 1:07:37
  Speaker 1: going to go with their power. One of the most
• 1:07:39
  Speaker 1: hopeful things for me recently is being involved in some
• 1:07:43
  Speaker 1: legal cases around ECT, which I won't i'll go into
• 1:07:46
  Speaker 1: because we're running out of time. But I said for
• 1:07:48
  Speaker 1: a long time, change is more likely to come when
• 1:07:51
  Speaker 1: we earn get people into court than when we publish
• 1:07:54
  Speaker 1: research papers.
• 1:07:55
  Speaker 4: You know, I was thinking earlier on John when the
• 1:07:57
  Speaker 4: day that somebody starts to take doctors and characterists to
• 1:08:00
  Speaker 4: court for not giving them proper informed consent, that's when
• 1:08:04
  Speaker 4: we might see a bit of a change.
• 1:08:05
  Speaker 3: Right, Sorry but I interrupted.
• 1:08:07
  Speaker 4: Just so, just for for our list of ECT is
• 1:08:10
  Speaker 4: an electoral convulsive shock therapy, right, that's correct.
• 1:08:13
  Speaker 1: Yes, So several cases in America and two in Canada
• 1:08:17
  Speaker 1: and one in the UK currently working their way through.
• 1:08:20
  Speaker 1: One last year is in a jury trial in Florida
• 1:08:23
  Speaker 1: where was the expert witness there? And we want a
• 1:08:25
  Speaker 1: jury trial case wherever we found the manufactures of the
• 1:08:29
  Speaker 1: ECT machine who happened to be two psychiatrists guilty of
• 1:08:33
  Speaker 1: misinforming of not informing psychiatrists of the risks. And that
• 1:08:37
  Speaker 1: was a major breakthrough. So that's the first one one,
• 1:08:39
  Speaker 1: and once you won one with the tends to be
• 1:08:41
  Speaker 1: a domino effect. I personally think ECT will be gone
• 1:08:44
  Speaker 1: within the next five to ton. Yes, the problem is
• 1:08:46
  Speaker 1: then out there developing new things to replace it already.
• 1:08:50
  Speaker 1: I mean it's endless. We've got ketamine, we've got locinogenic works,
• 1:08:55
  Speaker 1: we've got magnetic stimulation of the brain, so that the
• 1:08:58
  Speaker 1: biological fix is will always be attractive. I think because
• 1:09:03
  Speaker 1: there's money it's easy to make money out of them,
• 1:09:05
  Speaker 1: especially in the American system based on insurance and so forth,
• 1:09:09
  Speaker 1: and be as three of the reasons we discussed before,
• 1:09:11
  Speaker 1: it's simplistic, and we don't have to address the messier
• 1:09:16
  Speaker 1: sides of our lives, things that sometimes we just don't
• 1:09:19
  Speaker 1: want to talk about. So but I am fortunate as
• 1:09:22
  Speaker 1: much as I get invited around the world increasingly online
• 1:09:26
  Speaker 1: these days, obviously, and so I meet, I see the
• 1:09:29
  Speaker 1: struggles going on in many, many different countries or focus
• 1:09:32
  Speaker 1: in this direction of getting a paradigm shift towards an
• 1:09:35
  Speaker 1: evidence based social relationship based its humane alternatives to this
• 1:09:42
  Speaker 1: pessimistic and unscientific approach that we currently have. And I'm
• 1:09:45
  Speaker 1: optimistic that we will get there, but I'm not stupid
• 1:09:48
  Speaker 1: enough to think it's going to happen quickly.
• 1:09:50
  Speaker 4: John, This is being friggin' awesome. I really do tip
• 1:09:55
  Speaker 4: my hat to you, because you and many others are
• 1:09:59
  Speaker 4: like you, are are out there really moving the needle
• 1:10:03
  Speaker 4: on something that is causing a lot of humans suffering.
• 1:10:06
  Speaker 3: Around the world.
• 1:10:07
  Speaker 4: So well done, Matte, and just keep up your great work,
• 1:10:10
  Speaker 4: which I'm sure you absolutely will, because clearly you're a
• 1:10:13
  Speaker 4: very passionate trail blazer in this place. So thank you
• 1:10:17
  Speaker 4: for your time, and thank you for your years of
• 1:10:20
  Speaker 4: really hard research and getting a message out there.
• 1:10:23
  Speaker 1: Thanks for having me on, and thanks for the work
• 1:10:25
  Speaker 1: you do in your field as well as a real
• 1:10:26
  Speaker 1: parallel effort.
• 1:10:27
  Speaker 3: I think absolutely