Latest / Radically Genuine / 88. Myths of Mental Illness w/ Chuck Ruby PhD: Part 1

Transcript

88. Myths of Mental Illness w/ Chuck Ruby PhD: Part 1 · Radically Genuine

• Sean: Welcome to the radically genuine podcast. I am Dr. Roger McFillin. Sean, I really do believe that medical freedom is one of the defining issues of our time. And I don't think we're able to make informed health care decisions and consent unless accurate information is disseminated to the public. So I've started a sub stack. Dr. McFillin dot sub stack free newsletter. I am planning on releasing this June 6th. Every Tuesday, you will get a newsletter. Whether it's this podcast or my Twitter account, we're trying to highlight information that contradicts the narrative. The narrative being very industry driven for the purpose of often monetary manipulation of the people for various reasons that have influenced the American public and our health care system. If you're not armed with information to be able to ask your health care professionals or question some of their recommendations, I feel like we are at risk for entering into a treatment or a conceptualization of our difficulties that can ultimately create harm. And I've been looking forward to this podcast for quite some time. Today's guest, I find fascinating. I've heard him on other podcasts. I've read his book. And Sean, as I was mentioning to you driving in here, I believe I found somebody who has the same questions that I have had in my training as a clinical psychologist. Ones that I felt like I was really outside what is the norm in thinking. And every time I questioned it, you get some blank stares or it's almost ignoring the issue until there was a point where I couldn't just continue working in the same way anymore. But after reading his book, I realized, you know, he's years ahead of me in his thought process around this. And his book is absolutely fascinating and being able to reasonably prove various arguments that we're going to get into today. He's also a fascinating person as far as just a background perspective. And so wanting to get into how he turned into a psychologist that is working and promoting ideas that are outside the mainstream to prevent harm. I'd like to introduce Dr. Chuck Ruby to the Radically Genuine podcast. He is the executive director. of the International Society for Ethical Psychology and Psychiatry, a nonprofit organization of professionals and consumers of the psychiatric industry. I'm proud to be a member. And I just registered this morning. It was on my radar to do. And every time I think about it, I'm away from my computer. But this morning, I am a member. The focus of this outstanding organization is to challenge the traditional notion. of mental illness and mental health, and to call for alternative and humane ways to assess and help those who suffer from emotional distress. He is the author of an amazing book, Smoke and Mirrors, How You Are Being Fooled About Mental Illness and Insider's Warning to Consumers. He is also the current director and general manager of the Pinnacle Center, a large, private group practice in southern Maryland just outside the Washington DC metropolitan area. Dr. Ruby was trained at the Florida State University receiving his PhD in psychology in 1995. Psychology is interestingly enough a second career for Dr. Ruby. He is a retired US Air Force Lieutenant Colonel who spent 20 years in the fields of criminal investigations, counterintelligence. counter espionage and investigative psychology in a variety of assignments across the globe. Fascinating to get into some of that. Dr. Ruby, I want to welcome you to the radically genuine podcast. Chuck Ruby: Wow, what an introduction. Thank you so much and I'm so glad to be here. Sean: fascinated about you as the person. Obviously, I'm a psychologist. So I'm fascinated by people in general and it drives the love of what I do, the opportunity to sit down and meet somebody that is unique in this entire world. You never meet anyone twice. You know, it's everyone's so unique. How do you how do you go from military service and what you've done to where you are now as a psychologist? Chuck Ruby: I'd like to say that was all planned, but it wasn't quite serendipitous, I guess. I've always saw life as sort of a series of stepping stones. But the only problem is, is you can only see the stone that you're standing on in the next one. And when you step to that next one, three more pop up. And then you get to choose between the three. And then on and on it goes. So my entry into the military in the late 1970s, was because I couldn't find a job in Western Pennsylvania during the recession. And my father recommended I think about that. Another thing I knew about the military then was it was like Boy Scout, you went camping and had fun. So I joined, it was nothing like that, obviously. I ended up in the Air Force. And for most of my career, as you've mentioned, I worked in criminal investigations, counterintelligence, counterterrorism, counterespionage, those kinds of things. Basically, work that would help the Air Force secure its resources and to protect against any kind of foreign intrusion or attempts to learn about us. So we, our job basically was to thwart the people who were trying to find out about us. Fascinating, fascinating work. A 20-some-year-old person would never get this kind of work. I mean, I've gone from, you know, plantations in the downtown Panama City prior to the invasion in late 1980s, work like that. So never could you find a place like that, I don't think in any other kind of career. The reason I think, before I get into how I became a psychologist, the reason I think I ended up the kind of psychologist I am is because that kind of work in the military was based on being empirical. It was, we were investigators at heart and their job was to ask the hard... questions, not just to assume things. And there are many things within the field of counterintelligence and intelligence that is assumed and never questioned. So with that as a background, I came toward the tail end of my career and I was offered an opportunity to go to Florida State University. Well, actually I had a choice of the three Florida, main Florida universities, University of Florida, Miami, and Florida State. I chose Florida State. through the Air Force Institute of Technology. It was a full ride program. I received my military pay while I was going to school and having everything except books paid for, which was a wonderful opportunity. So I think I took that kind of investigative mentality into my training as a, you know, doctorate level trainee in psychology and in particular clinical psychology areas. I did some work within social psychology too, but My degree was focused on the clinical program. So when I came out of the program, I was still in the military. And I worked as an investigative psychologist at our Washington DC headquarters for about four or five years, providing that kind of support to our agents around the world. And very quickly after doing that, that's when I started the question. I started to. But I mean, just like you did probably in your early training, I swallowed it hook line and sinker. There was never any doubt that mental disorder was a true illness issue, some kind of defect or dysfunction in the person in some way. And, and I actually tried to convince people of that at that time. But when I started to look within and ask those hard questions, well, why is it, where is the defect? What are we doing? when we try to help people, what is it we're trying to correct? And I couldn't find anything. As you know, there's nothing there to correct. So what in the world are we doing? And it just came to me that this is a system of moral control. It's really based on what kinds of experiences and behaviors that people have that are appropriate or inappropriate. How much of this, how little of that? If you look at the diagnostic criteria, as you know, that's how they're couched in more than five of these things and less than two of those things. And those are all arbitrary decisions based on sort of a loose professional morality and then individual morality comes into play also. So that's what started my journey. Once I retired from military in 1999, I had already joined the Pinnacle Center at that time. I wasn't. in charge of it at that time. I was just wanting a few days a week to do psychotherapy with people and go fishing the rest of the week. Well, that didn't work. I ended up doing this full time and even more. Sean: Your background in counterintelligence. So I would imagine that there's this piece of deductive reasoning that takes place where you're trying to empirically determine based on available evidence how people make decisions and how they can influence people. And I can only... begin to surmise that part of your journey to challenge the authority is your skill set in being able to, I'm just going to say like determine what's bullshit and what's not bullshit through this deductive reasoning process. So when I was in graduate school, I did accept certain things to be true because there was a trust. There was a trust that people And large institutions are doing the best that they can in order to protect people and be able to treat them in a way that respects their collect, the collective humanity in the most safe and ethical manner. So I, I bought into the ethics, the ethical code. And as you well know, and was highlighted in your book, is if we are going to adhere to an ethical code to protect the welfare of others, then we have the responsibility to question authority. Is there something unique to you that allows you to kind of see outside what is... presented to us or what is considered to be mainstream and then question authority through that deductive reasoning process. Chuck Ruby: Yeah, I just until you asked that question, I never thought of this, but similar to how my investigative training in the military has helped me really go through the weeds and pick apart claims and try to find evidence for claims and so forth. So as an investigator, it was trying to find the elements of proof for a crime, but we had enough evidence to prosecute and then obviously convict someone. The organization I worked for is called the Air Force Office of Special Investigations. And we were at that time sort of a separate and a part agency for a purpose. We were independent of all command influence within the military. We reported directly to the secretary of the Air Force. So if we were on a particular location, we were not beholden to the military commander at that location. So it gave us an independence to investigate those people without fear of reprisal. That has changed by the way, 9-11 changed a lot of things and that happened after I left, but our organization now is sort of part of the command structure more so than it was. And I think just out of national security interest, but back then we were... I mean, in a way, sometimes we were like gods running around. We had no one was controlling us, and we could ask those hard questions. And until you, again, until you just asked me this, I'm wondering if that perspective I had of feeling outside looking in and being able to comment on problems inside there without fear of reprisal, maybe that had a lot to do with this. Now, I'm in my current work, I'm constantly in fear of reprisal. I've been lucky that I haven't had anything lodged against me. But in the kind of work I do as an independent practitioner, I don't have any bosses, except for the people who I try to help. They're my boss and they have fired me from time to time because they don't like what I do. And that's fine, that's their job to do that. But I don't have to worry about towing the line, just like I did in the military. I didn't have to worry about pleasing my bosses at all. And I think that does give me a little bit of a different perspective of, you know, it's a possibility that isn't there for some other people in my job here. Sean: That makes sense because I was thinking the chain of command of the military, it Chuck Ruby: Yeah. Sean: almost, it trains you to respect authority to not question the orders from above, but to understand that everybody has a role in this and your role is to execute the plan or and not to question because questioning is when things could potentially go wrong. So now Chuck Ruby: Mm-hmm. Sean: that you explain that perspective of how your job almost guided you. towards where you are now and some of the conclusions you've come to about mental illness. It all totally makes sense. You just snapped into focus when you explained what your role was with the military. Chuck Ruby: Yeah, and they always, they, the military people on the host installation, they always considered us kind of rebels. And that's sort of what we are here, but Roger and I are now kind of rebels in the system. And there's a lot of, there was a lot of complaining about that, but we were untouchable at that time. And so, I mean, politics do enter into it. And there were a couple cases that we worked that were incredibly sensitive or high level and involved high level people. So The reality is politics does come into play we are prevented from doing certain things because of those pressures, but that was very rare. And most of the things we did was just outside, and I was in a weird position where I was of rank, I was below say the installation commander far below at times, but I was in a position to tell them, no, I'm not gonna do that. which was a weird feeling being trained as a military person, but recognizing that's my role is to tell them, no, we're not doing that. We're gonna do this over here. In my organization, we were all, most of us were military people, but we never wore uniforms or identified by our rank. We all identified by special agent until we reached a certain rank and say if we were at the headquarters unit, we did wear a uniform then. So people didn't know what our rank was, so they had a hard time intimidating us, but they tried. Sean: do want to use deductive reasoning to kind of deconstruct this idea conceptualization of mental illness. Psychiatry probably has more power and influence on culture now that any at any other point in history, and that's very concerning to me. I'll be honest, I'm just libertarian by nature. And what that means is just an overall respect for personal liberty and freedom, and to protect the individual from coercive control methods. And the idea of a mental illness is problematic from multiple perspectives. I think you've done a great job in being able to communicate that idea, but let's assume that somebody is a skeptic. Dr. Ruby, what are you talking about that mental illness does not exist. I will walk down a major street in a US city and I will observe somebody who is talking to themselves and homeless and clearly not being able to function. Are you telling me that is not an example of mental illness? Chuck Ruby: Yeah, what you just did, Roger, was you used the commonly used strawman argument. I've never said mental illness doesn't exist. And in fact, I do a lecture locally for a veterans group. And in it, I start out saying that because I have been accused of claiming mental illness does not exist. There's no such thing as mental illness. Of course it exists. You just showed us how we can prove that. mental illness does exist. Now, but here's the kicker. It's just not an illness. So the thing, the problem that has been designated mental illness clearly exists. And it can be very harmful damaging to the person and to others around that person, but it's not a problem of illness, at least not in the sense that most people understand the term of the... concept of an illness. I don't know if you saw recently Ronald Pies, well-known person within our field is a, I would call a defender of the mainstream industry, mental health industry. He recently suggested that we define illness, thus to be assessed and treated by medical professionals, but that we define illness as any kind of human suffering. Now, when I saw that, and it was in writing, it was on Alois Aftab's substack. But anyways, I thought, my gosh, think about that for a second. Who among us is not suffering? How often do we suffer? I mean, I had a recent incident here where I found a little family of birds in a bush at my house that I was going to have the landscaping people remove and I had to stop them because I wanted these birds to grow up and fly away, right? Well, one day I went out there and the nest was empty and I thought a snake got them or another bird got them or a cat got them. I'm not sure what happened to them, whether they flew away or whether they... got eaten because that happens where I live in the woods. So anyways, I was suffering because I didn't know what happened to these birds that I had sort of tended to for a few weeks. Is that an illness? And is that something that a medical professional can help me with? I don't think so. I mean, I don't know what a medical professional would do to help me. It helps me more to go talk to my wife about that, just to share that. thing that's a reality, at least in my world. So if we say illness equals any human suffering, the medical profession has complete political power over every person in the United States and the world. And do we want that? Although that's what's happened. That is what is happening, not just with mental illness, but even with true physical illnesses. There's a very paternalistic. element in the medical profession to tell us what we should do, how we should live a healthy life, even true health. So, you know, change your diet, exercise, don't do that, don't do this, do this. And I always say there's more to life than health. That's one thing. And that's just one thing. There's more considerations to life than health. If I want to live a life smoking cigarettes, I don't, value in that, what's the problem with for me? I get to decide what the problem is, along with your libertarian ideas. I'm the one who gets to decide this, but then you take that over to this so-called mental health field and it becomes even more problematic. Anything I do that is difficult or causes some suffering can then be controlled without my consent and that happens. You know that. Sean: It certainly does and that's where it becomes very dangerous and we'll have to really have that conversation with our listeners about how one's own rights can be removed based on a designation of an illness by a physician. And the more that this becomes a gray area of definition, that it is Chuck Ruby: Thank Sean: left Chuck Ruby: you. Sean: to an individual's opinion of your own behavior. Well, then we give up our own rights to that medical authority. Chuck Ruby: Mm-hmm. Sean: And this was the problem. And I think there's an awakening that's occurring post COVID because we saw the slippery slope about how you can give up your own medical freedom, uh, under the guys that, uh, you are protecting others or that you are somehow going to be a danger to, you know, your neighbors or society. And how is that determined? Not by sound. science, empirical investigation, and agreement among the people, but rather an authority figure. And that's some of the dangers here of the diagnostic expansion. We can inflate the amount of people who are quote unquote ill and to protect the normal. And it's a very, very slippery slope and a very dangerous path that I think we're walking on in society to throw out that term illness. Because there is the suggestion then... that there is some abnormality within that person. Chuck Ruby: Exactly. Right. And we saw this, we're seeing this now post pandemic, where the there's this surge in anxiety disorders, quote unquote, among especially children who have suffered during the COVID lockdown. And but it's being portrayed as this another pandemic of anxiety disorders to be treated and all children need to be screened and some of these actions that are gonna do nothing but harm kids. It's not surprising that given COVID, all of us were harmed with the difficulty of it, the whole thing, not just lockdown, those who are infected, those who have concerns about the reality of the virus and the vaccines, the whole thing. And I don't wanna get into that, but that kind of an experience in a culture is very difficult. And we are going to react with fear, and we are going to react with despair. And those are the things that end up getting diagnosed as anxiety disorders, depressive disorders, even some psychotic kinds of things. If the mental health professionals are looking for that, they're going to find it. And they're going to find it every day, despite whether we have a pandemic or not. because human living is difficult. That doesn't make it an illness, but it has been defined as that and that's the problem. Sean: That's such an important point. The idea that if you were looking for something, you will find it because to be human is to suffer, is to struggle, is to feel emotional distress. There's a part of your book where you were talking about the limitations of like screening measures. In my area, the Lehigh Valley, Pennsylvania, we're in Bethlehem, Lehigh Valley Health Network has made the decision to mandate for. all primary care centers that children and adolescents be screened for depression. And I don't know if you're aware of the PHQ-9, the PHQ-9 for adolescents, is that screening measure developed by Pfizer? What are the dangers of screening every single child and teenager in primary care as the Academy American Academy of Pediatrics is beginning to recommend Chuck Ruby: The main danger is really a statistical one. And I explain this in nauseating detail in the book. If anyone's interested, I even gave an appendix to lay out all these stats. And they amazed me, but I know some people just want to hear the end result. So here's the problem. It's one of false positives. If you have any problem in life that is a relatively low base rate occurrence, so 5% of the population say. And this is, we're talking about things like the mental disorder categories. They are diagnosed and the end result is it's a low base rate occurrence out in the community where let's say 5% of children are, or have been diagnosed, depressed again, they don't have an illness. They just been labeled depressed because of the difficulties they're facing. If you have a situation like that and you develop a screening tool and you get a really accurate screening tool. 99% accurate. Most people, especially the lay public, but even professionals say, wow, that's amazing. Let's use it. No problem. Right. There is a huge problem. Even with a very high accuracy, you end up with a very high number of false positives. And I'm talking about a very high. So I think in the book, some of the examples, some of the hypothetical examples I gave, with a very highly accurate screening tool. 90% of the people who were identified as having that problem don't have that problem. Nine out of 10. And if they're children, so you get nine out of 10 children. Let's say, Roger, you're aware of the recent attempt to make a diagnosis, a tenduated psychosis syndrome, I think is what it's called. Basically for teenagers who are at risk of becoming schizophrenic. If you do a screening tool like that, and nine out of 10 of the people you identify as needing preventive treatment, don't have the problem, but you still put them into the pipeline for this so-called treatment and they're young people who haven't even applied for a job yet. That's going to ruin their lives. They don't have the problem and they've been, it's been decided they have the problem and if they say, well, I don't have the problem. That's seen as, you know, lack of insight into their problem. And it's even more evidence to the mainstream that they have a problem. And so they're forced fed treatment, perhaps, or even they are there. They come to believe they have the problem when they don't. Now they feel bad about themselves. And can you imagine what let's say the military would do if they apply for the military and in there, it says, I have attenuated psychosis syndrome. They're not going to get into the military. they're not gonna get a security clearance. They're not gonna get lots of things because of that, because mental disorder diagnoses are very much like criminal records in that sense. So that's the big problem with screening. The more you screen everyone for a very low base rate problem, by far most of the people you've identified don't even have the problem in the first place. That's criminal. Sean: It's like that movie Minority Report, where you're held guilty for a crime you haven't committed, and your whole life is just ruined Chuck Ruby: Mm-hmm. Sean: as a result of somebody saying, like, this is gonna happen to you. It's like you're walking around with a time bomb in your mind of what your future is inevitably Chuck Ruby: especially Sean: gonna happen when it's not real. Chuck Ruby: if you're impressionable too, which teenagers are and children are, you come to believe it. You take, it's a self-fulfilling prophecy. So everything that happens to you that might be consistent with that problem, you go, oh, there it is. They were right. I have this problem. I talk about the issue of autism in the book and the same screening problem with that. and how I think I would have been labeled autistic when I was a kid. And I wonder how that would have affected me. I wasn't, but I mean, I'd, you know, I'd piqued all the criteria. And so if we had that label back in the 1960s, would I have been labeled and would I have ever gotten into the military? Would I have ever be doing what I'm doing now? Or would I be somewhere dependent on, you know, social security benefits and all kinds of... possible things could have happened differently. Sean: I want to tap into your counterintelligence, counter espionage background. What do you think the overriding goal of all this is? What is the purpose of doing it? Chuck Ruby: of doing what? Counter espionage and intelligence or? Sean: No, no, I'm gonna ask you to make a comment maybe on the greater system here. To me, it's pretty clear that there is motivation to increase the number of people to be diagnosed with a mental illness. Chuck Ruby: Yeah, Sean: Why? Chuck Ruby: in essence. Well, my personal view on that is I think there are people who truly believe they're helping others. They truly believe those others have a real illness of some sort. You know, it's well, there's some kind of a defect in your brain. We just haven't found out what it is yet, but we're certain it's there. We'll find it soon. And they're there in all good faith. They're trying to help. They're not thinking in terms of let me keep my market up. Let me keep my clientele base up so I can make more and more money. And then there are others, I think, that on the other side of the spectrum that are doing it for that reason, they realize what's happening. They realize what they're doing is kind of a sham, but that's their livelihood. And so they're going to continue doing it and collect the money and keep going. And in that sense, there's kind of like this inbuilt conflict of interest in our profession. Right. I see people in psychotherapy, hopefully for the purpose that they get to one day, they won't have to see me in psychotherapy. but that's against my financial interests. So there's that conflict there. I don't know what we do about that, but there are, I mean, I think there are two forces at work. Number one is a guild interest. So, you know, I'm a psychologist. I have some certain level of power because of that and privileges. I wanna maintain that. So that might encourage me to continue. perpetuating the charade. The far more impactful problem though is the money involved in the system, in particular funding by pharmaceutical companies. They fund mental health organizations, they fund grassroots organizations, they fund medical schools. So one is gonna wonder to what extent are those funded agencies going to try to think empirically about this problem? and lose all that funding possibly. And it prevents us from getting into the mainstream discussion. If we'd like to publish, and we've all tried to do this, I think, publish with New York Times or Washington Post, or even my book. I couldn't get any publishers interested in publishing my book. They kept saying it was harmful. And so I self-published it. So that financial interest, I think, and that... over-reliance on authorities' accuracy about what we're dealing with gets in the way of doing that, of being heard. Sean: think what you're touching on is the perception that a lot of people look at the ideas in your book as harmful. How do we start having this conversation in a way that people can make the connection and start understanding that these stressful moments or human suffering is can be enhancing to your life and not debilitating. It makes me think of that work of Ali crumb. on beliefs and mindset. I think she's a Stanford university professor. Um, and I think she touches on, on military training as well as the approach of maybe it was the Navy SEALs to look at stress as enhancing and how their body responds. And they basically become stronger as a result of it when it comes to resilience. If we're training people to immediately look at human suffering as debilitating. Then that, that gets ingrained in culture. So you have publications like. national newspapers and news networks that are refusing to share your perspective because it's harmful. How do we get that to change? Chuck Ruby: That's a $64 million question. I don't, I mean, we're trying within my organization. We're trying to get a discussion going at least, but we have to rely on Twitter and Facebook and social media platforms and, you know, having our conferences and we're having a conference this fall in the Los Angeles area, finally getting back into person conferences. I think the... Better. So I've spent some time going to Capitol Hill and talking to legislators about this and they're very polite and they listen but as soon as we leave some Pfizer rep walks in with a couple hundred thousand dollars and we just can't compete with that at that level going from the top down. And I come to realize that it's, it's better to do this from the bottom up, I think. So, and this was actually a, an idea. that a colleague of mine had, her name is Mary Neal Vieton, and she runs a program called Warfighter Advance, www.warfighteredvance.org, where she helps veterans outside of a clinical and medical model, and veterans who had been within a VA system that had nothing but harm through that system, usually a lot of psychiatric drugs thrown at them that have been. not useful and actually very harmful. And she presents a more of a humanistic way to help them. And it's been a very, very rewarding program and very helpful. Hundreds of people have gone through it, but it was her idea and through that program that let's ignore Congress, let's ignore the power of the pharmaceutical companies, let's talk to the people who are affected and try to explain this to them. And to them, it makes sense. And they'll buy into it because they have no other financial investment, no other financial interest. They just want help. And so I do that in my private practice. When I talk to people, I try to make it very clear to them what I'm doing, who I am, what I'm going to do for them, what I'm not going to do for them, what kind of problem they have based on what they've told me. And to explain this is not a medical matter. And that in itself, I think, is incredibly helpful. for people. When they hear that, doors open that they didn't know were there before. Sean: totally agree with you that has to be a grassroots effort. And there's so many people that have been harmed by the system and the system includes a number of things, including harmful ideas. I can't tell you over the course of my career, how many clients have come into me, even though they're not doing well on a drug that's been prescribed to them. They're making statements such as I have to be on this drug, because I have a genetic abnormality or chemical imbalance. Chuck Ruby: Mm-hmm. Sean: And maybe you can help me out because I do believe in an integrative care system and collaborating care. I've been doing this for a couple of decades. I've been requesting lab reports to identify the chemical imbalance that exists so we can measure it in the course of treatment. I have yet to receive one lab report that in any way corroborates the idea that somebody has a deficiency in a neurochemical. Um, how do we get these lab reports? Chuck Ruby: Yeah, there are none, right? You know that. Yeah, this is the, this is the, I don't know what to even call it. It's the biggest myth that's out there and it just won't die. Even though it's admitted to be an error by the people who have, who perpetuate it, yet they just keep still perpetuating it. I like to think of it in terms of there was an original chemical imbalance theory that was version one. And it has publicly been debunked by the very people who perpetuated it. But now there's a version two or one point two, maybe. And it, it's little watered down. It's not, uh, you have depression because you have a chemical imbalance in your brain. It's not just serotonin, but the, the version two is it's thought that chemical reactions in the brain and brain circuitry malfunctions are involved in the thing called depression. It's that. And so it's now portrayed as just sort of a part of the overall thing called depression. But in actuality and in practice, it is used as the main thing and still attempts to target that chemical mechanical brain functioning alleged problem is the focus. You know that. I've seen, I don't know, thousands of people in my career in therapy and every one of them had a prescription for a drug, of all of them, none of them were told otherwise than that when they asked the question. Many of them didn't ask the question. There was just the assumption that, oh, my doctor knows I better take this thing. Not realizing what it does, what it doesn't do, the harms involved. There just isn't informed consent about that. Because to have informed consent, the prescriber would have to say something like, We know there's no chemical imbalance in your brain, and we know this drug isn't gonna correct anything that's dysfunctional in you, but we suggest you take this for life. Now, people wouldn't take it if that were the message, but that's the truth. Some people might know if I said that to someone and they said, well, I understand that, but I, you know, I want to take this drug because I just feel better when I'm taking a drug. I'm fine with that, but I would wonder why you spend all that money and time to go to a doctor to get it. You can just stop off at your bar and have a few drinks every day that would do the same thing in a way. Uh, but We just don't, we do, but the mainstream doesn't give that information out so people can make an informed choice. Sean: I'm a bit of a history buff, so I do like to consider things in historical context. Chuck Ruby: Uh-huh. Sean: One thing that's always clear about human nature is that people in power have always tried to institute control over those who are not in order to both maintain their power in a society, but also for their own. potential urges for control and so forth. I mean, that's one thing that no one can really deny. You speak to this concept systemically within the mental health field and with psychiatry from a paternalistic kind of perspective. And I'm concerned about that authority, the... the authoritarian kind of ideas that can be utilized within a mental health system. So you're speaking from the point of, hey, we're human, let's collaborate. Here is who I am. You have the freedom to choose or not choose. Here's what I can provide. Here's an alternative. Here's like, I can serve you. You can choose it. I respect your individual right to choose. But in the psychiatric system, although we do have a strong ethical code, I don't know if people truly understand the risks they are taking by entering in to that idea, the system that governs it. Can you speak more to that paternalistic notion? Chuck Ruby: Yeah, the paternalism of our industry, the authoritarianism of our industry, is based, I think, fully in the idea that, number one, mental illness is a medical problem. It's something that affects you, not something we label you with when you are having a particular problem. There's a big difference there. So, for instance, The label diabetes doesn't refer to the problem. Diabetes refers to the thing in the body that's not working right that causes the problem. That's how the convention sees mental disorder. There's something in the body that causes depression, for example. And that something affects one's reasoning, one's logic, it affects one's rationale for acting, it affects one's insight. And so there's this built in way to discount people. discount their desires, to discount their choices, and just to say, well, obviously, you don't have the ability to make a choice that's in your best interest. That's the big difference between the so-called mental illness and real illness. When we have diabetes, we have the right to refuse treatment. If we have cancer, we have the right to refuse treatment and die of cancer if we want. any physiological illness we have, we have the right to not do it and to live our life the way we want to. But when you get into this mental disorder area, we don't have that right because the disorder itself is said to jeopardize your ability to make sound decisions. And so we have it, we have it all covered. We just say, well, you don't know what's best for you. And we've seen this happen a lot. And we're going to dictate what you have to do to include incarcerating you, to include injecting you with drugs, to include forcibly giving you electro-compulsive treatment, to make you more in line with what we say is more appropriate. there's the morality of the system. It's all based on what we say is appropriate. And we have incredible power to do that to people in the position that you and I are, we're licensed, we're credentialed, all that stuff. And the law gives us a lot of power to control people that way. And so you can imagine state authorities using this and psychiatrists and psychologists being willing to be used in that way to control people and to make them more manageable. I mean, I have no problem with managing people's behavior. I'm not an advocate of, you know, laissez-faire, anarchy or anything like that. We have rules in society and we want people to sort of abide by those rules to some degree. And those rules are brought about by legislative actions and elections and so forth, not medical science. But medical Sean: I got Chuck Ruby: scientists, Sean: some great. Chuck Ruby: they're not good at it. Sean: Got some great recent examples of this exact idea. So the listeners understand. And I mentioned this on a previous podcast. I had a client who was prescribed a drug for a migraine, developed horrible akathisia and was hearing voices kind of outside of herself to harm herself. But she was wise enough to say, this isn't me. This is an experience that I, um, I'm scared of. but it's not my intention. So I do everything that I think is legally and ethically within my bounds, which is to contact the prescribing's office, recommend medical observation given the nature of the drug reaction, and to make sure that this person is not treated as a psychiatric patient. She had a trauma history, a number of other things that I was concerned about. She goes into the hospital, what do they do? They treat her as a psychiatric patient. stripper of her phone. She has to strip her clothes off. She is treated as if she is a prisoner. I'm also dealing with a number of cases right now where I'm trying to provide some consultant direction where somebody is prescribed multiple psychiatric drugs, has an adverse drug reaction, and then the doctors are then making claims that that reaction is a sign of their underlying mental illness and they just now have to find the right drug and their freedom is Restricted because what they want is to go off the drugs that made them worse in the first place But now they're under this this idea, and I'm calling it, I guess I can only call it an ideology, because we can't, we don't have any medical science to support that there's an underlying illness that's driving it, that this is representative of their illness. And so now, because they are not trusted, they are deemed mentally ill, they lose their own freedom to make choices. The question always comes back to me is what do we do about this? Like, how can we... help. How can you help Dr. McPhil? Dr. Ruby, how can you help? And I always just come back to the statement where I understand what you're going through. Let's fight this, but let's bring attention to it and let's prevent it from ever happening in the first place. But it doesn't serve anyone who's already like in the middle of it. What recourse do people have who've gotten sucked into the system? Chuck Ruby: Now, this is a question that I sort of hate the question because I don't know the answer. And I don't like questions. I don't know the answer. And we we can you and I can do exactly what you said you did. Try to make people aware of this. But we have to rely really on the prescribing person's willingness to at least let go of the person and not see this as an attempt on your part to prevent medical treatment. and take over the process. Clearly, we can talk to our clients about this, and we can explain to them what might happen if they want to go off their drugs because of the effects like akathisia or the other numerous negative effects of psychiatric drugs. But because of the power that the industry has, we're going to lose in some cases. And that is unfortunate. is there. There's an organization called Psych Rights. I don't know if you're familiar with it. Jim Sean: Jim Chuck Ruby: Gotts, Sean: Gottstein. Chuck Ruby: a lawyer that he lives in Hawaii now, but I think he started in Alaska. He's tried to be involved in helping people like that, and he's had some successes. There's an organization called Mind Freedom. It's also a group mostly, I think, of survivors of the industry who stand up for others who are in difficult situations like that. They have a program right now called Shield Alert. If you are on their mailing list, you will get a notice that Jane Doe has been hospitalized against her will in Arkansas. Please contact your representative in Arkansas and contact the doctors at the hospital and complain. And they get enough people calling in and complaining. Sometimes it does change the. the doctor's mind and let my people go, right? Let them out of there with more helpful assistance than what you're getting inside of a hospital. I've never seen a hospital, an inpatient setting or a forced setting be helpful to anybody in my time. It's always been harmful and you're right. All the complaints that are made, all the understandable, reasonable complaints that are made are seen as symptoms of the underlying problem. When the person stops taking the drugs, the withdrawal effects of the drugs are seen as symptoms of the underlying problem. The decision to stop the drugs is seen as a symptom of the underlying problem. It's hard to break out of that way of reasoning.