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178. When Women's Physical Symptoms Are Dismissed as Mental Illness · Radically Genuine

• Roger K. McFillin, Psy.D, ABPP (00:02.046) Welcome to the Radically Genuine Podcast. I'm Dr. Roger McFillin. Behind every statistic is a story, and behind every diagnostic label is a life. And sometimes behind what we call mental illness is simply a body that medicine hasn't learned to hear or understand how to intervene. And some of these numbers are staggering. Women, for example, are diagnosed with depression and anxiety at twice the rate of men. Borderline Personality Disorder, three times more likely to appear in a woman's chart than a man's. So today we're gonna be asking a question that should unsettle us all. How many of these diagnoses represent a rush to label rather than a commitment to understand? And here's what I mean by this. When women report symptoms that are associated with many different medical conditions, whether that's fatigue, inexplicable pain, or symptoms that just don't fit neatly into clinical boxes, she's twice as likely to leave with a prescription for an SSRI than a referral for advanced testing. So what we dismiss as Just stress or anxiety in women often receives less investigation than in men. So yeah, a man is going to be treated differently. For example, it takes a woman with endometriosis an average of seven years to receive a proper diagnosis. Seven years of being told it's in their head. Women with heart disease, which presents much differently than men, are 50 % more likely to be misdiagnosed initially. And those with autoimmune disorders, they'll see an average of four doctors over three years before someone looks beyond their supposed emotional nature. These aren't just anecdotes or isolated incidents. There's a 2020 meta-analysis in the Lancet, which found that women were 30 % more likely than men to have a psychiatric diagnosis revised to a physical one after proper testing was finally done. This is about bias. Roger K. McFillin, Psy.D, ABPP (02:28.574) and this is about power. It often comes down to how is somebody believed and how are they understood? And that's a concern in psychiatry, one that we have to talk about. We have to understand that the manner in which a psychiatrist is trained and just the presence of a DSM diagnostic manual in itself. will influence the investigation into legitimate medical conditions. And we have how often are legitimate medical conditions being missed? And then you start them on a series of toxic psychiatric drugs, or even worse, you lose your freedom with a commitment. Today I'm joined by Dr. Casey Bills, who earned her PhD in social work from the University of Tennessee and is currently a professor at St. Mary's College of Notre Dame. At St. Mary's, she teaches courses on the DSM-5, human behavior in the social environment, social welfare policy. She's going to bring a unique perspective to our conversation today, not just as an academic, but I am interested in her, you know, academic findings and her areas of research. But as someone whose journey through the mental health system is both professional and deeply personal, these lived experiences are as informative in my opinion, as any scientific paper. perhaps more so. They reveal the gaps in our knowledge that controlled studies often miss and highlight the ethical dimensions that statistics alone don't capture. So personal narratives like this, they're not merely illustrative, they're essential to advancing both the science and ethics of mental health care. Dr. Casey Bills, I wanna welcome you to the radically genuine podcast. So Casey, you reached out to me. Dr. Kaycee Bills (04:21.646) Hey. Dr. Kaycee Bills (04:25.698) Yeah. Roger K. McFillin, Psy.D, ABPP (04:25.888) Initially to address some topics which I totally agree with you are are really important. I guess let's start with knowing you a little bit. I want to know you first as a professional in your professional background because it seems like these experiences like for so many drive some academic work as well as just a general calling in this field. Dr. Kaycee Bills (04:49.164) Yeah, so I started out getting my bachelor's degree in social work and I wanted to work with children who had disabilities. And I ended up actually working in community mental health and then I got my master's in social work. Wasn't really the route that I thought I was going to take, but I ended up working in community mental health and I did some volunteer disability work on the side. And I wasn't very happy in community mental health. I wasn't happy with the things I was seeing. To be completely honest, I saw a lot of things I didn't find completely ethical, but you know, here I am, just a little MSW, a little licensed social worker. You what am I gonna do at that point? And it just wasn't for me. And so then I started moving into disability work and then I got into research. And since I was working in research, they said, you know, you're doing the work of a PhD. Why don't you just... go get your PhD. So I ended up after, you know, doing some research work for Hawaii Pacific University, I went and got my PhD at the University of Tennessee. And most of my research has focused on disability related issues. But recently, things have kind of turned I became a foster mother who then adopted a child from foster care. And I've seen some of the things that I didn't really like before. I see them popping up in the foster care system as a foster mom and now an adoptive mom to a foster child. And then I had some personal experience where I went, well, I wasn't making this up. Now I'm on the other end of it. And so my research is really starting to turn. If you look at my publication list, it's mainly disabilities. But I'm certain I'm wanting to work on the other end of looking at, are we really diagnosing people correctly? Are these psychiatric holds even helpful? Are they helping people? Are they harming people? Because from just personal stories that I'm hearing in the very beginning of my research, I'm hearing a lot of people leave these hospitals very traumatized and I'm reading stories of people leaving very traumatized, feeling like they were like... Dr. Kaycee Bills (07:02.326) almost arrested, you know, so to speak. And so that's kind of where my research is headed in that direction. And I do teach classes on the DSM and I teach future social workers. So I want to inform, you know, the future of mental health so that these kind of stories don't happen to the clients that they happen to that I had in the past. They don't happen to foster children that I've had and they also, you know, don't happen to people like me or, you know, my students. And so that's kind of where I'm at right now. Roger K. McFillin, Psy.D, ABPP (07:32.138) So I am interested in your experience in community mental health for the audience. That's often how a lot of social workers, psychologists, counselors get trained in being able to assess and intervene with psychotherapy. And so we were exposed to this world. And the reason why it lends itself for the training of therapists is that it's often funded by Medicaid. And so you see a lot of low income, poverty stricken families. where they get government funded intervention. And if you're like me, you're horrified by the quality of the care and that often, I think for the most ethical and caring professionals, it drives a desire to either seek change, you know, in the system, similar to what I'm doing now, or at least it begins to inform you on what works and what. what doesn't work. So I am interested in to know your experience and maybe we can talk about what we, where those similarities are, the commonalities in what we experienced in community mental health. Dr. Kaycee Bills (08:39.744) Yeah, so when I was in community mental health, I saw actually a lot of children. So if you're not familiar with Medicaid, it's not just low income. It's also foster children automatically are put on Medicaid when they go into the system. So I had a lot of foster children and something too, if people aren't familiar with foster care is they're almost always court ordered therapy. And when I say almost always, I mean, 100 % of the time they're going to have court ordered therapy. And something I saw was they were getting therapy on top of like behavior coaching, you know, they call it different things all the time. And these were bachelor level people, you know, straight out of college with no training, doing these behavioral skills with kind of some deep issues that I, you know, lot of people, me included, I used to do that work, I was not qualified for. And then on the therapist side, we saw a lot of children who it was like, hey, I think we're overthinking. we're doing a little too much. I think we're traumatizing them because anyone who knows anything about therapy, there's a sweet spot. Too much is not good, too little is not great. There's a sweet spot in it. And I saw a lot of this person has Medicaid, this person's a foster child, this person can get this amount of services a week, let's maximize it and let's get these billable hours in. I hate to even say that, but that's what we would say. They'd say, these billable hours in. you know, let's maximize the services that are provided to them. And it felt more like profit over client, even though they would say we're just maximizing what's available to them. When really sometimes I just felt that we were doing too much therapy. were making, we were putting in these children, these notions that there was something wrong with them because of the amount of therapy that they were having to see. And then, you know, they're having high turnover rates. you know, with these skills coaches as well. And that's never a happy or, you know, that's never a attachment, you know, issue going on there. And I saw a lot of children who I really believe left our facilities a lot worse and made it harder on these foster parents, trying to care for them. I'm going back to their biological parents in worse conditions than they went in. And I also saw it with adults too, where it gets, it didn't seem to be helping. I guess seemed to be. Dr. Kaycee Bills (10:57.674) stuck in the spot of I've got Medicaid, get two services a week, this is what I do. And so that was kind of something that just bothered me in community mental health. was always billable hours, billable hours. wasn't, maybe this person's done or maybe this person needs a break. Maybe this person doesn't need any of this at all. Maybe this child is way too young to be going through this kind of therapy. What seven year old or six year old can... know, benefit from CBT, you know, maybe some, but I don't know. And so that was kind of the perspective that I brought to it that gets really bothered me. Roger K. McFillin, Psy.D, ABPP (11:33.94) Let me share my experiences because not only did I see this, so we're talking about the incentive structures that exist. So if you're going to open up a, a treatment facility, for example, Medicaid is usually lower end funding. And, and so then you're also going to have the, the lowest level of professionals who are often inexperienced and young because you pay them less, for example. And that's why you also have trainees who will be there and do the work for free where you can still build Medicaid. You bring up an important point about the degree of therapy interventions that take place, but I want to also talk about the other side, which is that... those who are in these facilities were often what's called polypharm drugs. So polypharmacy is like three or more drugs. So if you listen to my podcast, you know the efficacy of just one drug is highly questionable on a poor scientific foundation with often fraud and misrepresentation of its efficacy and certainly lack of long-term safety. When you start combining these drugs for developing children, developing brains, younger people, it's more unsafe. And so you're actually kind of working from a model of trying to sedate for the lack of a better word, a pretty complex behavioral problem. So when you're speaking, certainly with like foster kids, maybe they came from environments that were neglectful or abusive even. And so we're over-intervening with children who are survivors of like very complex and traumatic experiences. And we're highlighting them as if they are the issue, like their behavior is the diagnosis that you're trying to intervene, often outside of the context of a greater system. And it's not often a very evidence-based kind of approach to treatment, because first of all, the people who are actually intervening, they're working outside their boundaries of competence. And so there's the incentives around money, but there's also the incentives around billing for medication. Roger K. McFillin, Psy.D, ABPP (13:38.74) Right now I'm working on obtaining data each state level about how many young children are on multiple psychiatric drugs. I never walked into a community mental health center where somebody wasn't on multiple drugs. That is the primary way of intervention. And it's really horrifying because even like working in adults in that system, you see where people had... very manageable conditions or situations that were stressful and they were struggling and they were drugged into chronic disability and then becoming attached with a diagnosis in that chronic disability. So what starts off with just a typical reaction to an adverse event, 10, 15, 20 years down the line, they're now identified as bipolar, which is without a doubt drug induced. And they're on like four or five drugs on disability, no longer working and their health is deteriorating. So those were my experiences. Anything similar on that end for you? Dr. Kaycee Bills (14:43.798) yeah, I honestly, I would go to say that I did not, when it came to the foster children, I did not have a single client who was not on at least three. They were automatically on an SSRI. That is just like the go-to. Like if they're not on SSRI, they're gonna be on one automatically, usually ADHD medicine. And then... usually a mood stabilizer of some sort. then, you know, sometimes, you know, you'd see some anti-psychotics that, you know, you'd look at these meds, like Abilify would be a really big one that I would see a lot. you know, some of that damage is irreversible when you do it to a child so young when you're playing. And the other thing too, that I saw was it wasn't like these were consistent medications. These were, last month we were this and now this month, it didn't work last month. So now we're throw in another one and they were meeting with the psychiatrist who wasn't working with that person one on one. They weren't working with their home and there was just a disconnect there. They were just hearing, you know, this foster parents, you know, report and then their bio parents report and then their case managers report school report. And they're just kind of looking at this and it's not very client centered. It's just, okay, we'll just try something new because this didn't work. And a lot of it, I feel like could have been coached. were children who were very multiple, but I truly believe that some of the children that I saw are irreversible at this point because of the amount of anti-psychotic medication they were on. And I fear they got to a point where what would happen to them if we took them off at this point? You know, and I've had my daughter, for an example, I'll just go ahead and self-disclose with that. When she came into my care, was on a ton of different medications and I don't think any of that damage can be irreversed. I really don't. We manage what we can, but it's to the point where I adopted her when she was 13. She had been in the system since she was four. She had been on all these medications because they're court ordered, they're everything. And I truly feel that there's a lot of irreversible damage in. Dr. Kaycee Bills (16:55.704) There's nothing that can be done about that. And she does come with an intellectual disability and fetal alcohol. it, you know, there's a lot of other issues with that, but it does scare me too, that a lot of these children come with fetal alcohol and you're mixing drugs with fetal alcohol, which the fetal alcohol is what caused a lot of these problems to begin with. And now we're just adding more drugs to what caused the problem to begin with. And it's just a mix of a mess. you know, sometimes with the children, I don't think it's irreversible with adults. Maybe it can be reversed at that point. But when the mind's developing and they've already gotten used to being on, you know, these anti-psychotic medications, these ADHD medicines, you know, I don't know what can be done after so many years of it. Roger K. McFillin, Psy.D, ABPP (17:37.256) Yeah, and listen, if we can treat our most vulnerable children in that way, you know, imagine then what, you know, can occur with and this is across, you know, all demographics, but I don't want to focus on children today. That's almost a podcast for another time. what Dr. Kaycee Bills (17:52.736) Yeah, that's a different, yeah, it's just my focus has been mainly children. I was young, so they put me with the children. So yeah. Roger K. McFillin, Psy.D, ABPP (17:59.296) I'm more interested in getting into your story because as in the opening, the very clear statistics about how real medical conditions can be misunderstood, mislabeled, and the gender bias that exists, I thought your story was an opportunity to deep dive into that. Do you want to start about your experience in the mental health system? Dr. Kaycee Bills (18:02.702) Yeah. Dr. Kaycee Bills (18:20.894) Yeah, so I actually ended up on the other side of what you would call either 5150 old or 72 hour hold, whatever terminology you want to call it for a completely physical condition that they knew that I had. That I knew that I had, was on medication for it. And to give some context to that, I have what's called neurocardiogenic syncope. It's a fancy way of saying I have extremely low blood pressure. There's a medication I take called midrin that raises blood pressure kind of strange most people take blood pressure medicine to lower it I take it to raise it and I was on my way. I was living in North Carolina at the time I was a professor at Fayetteville State It was Thanksgiving break and so I decided on Wednesday and after my Wednesday night class I was gonna pull an all-nighter drive all the way to Indiana, you know, so pretty long truck as a 12-hour drive nonstop, get there, have a nice, relaxable, you know, Wednesday and then Thursday, enjoy Thanksgiving. I'm on my way, I'm almost to, I'm in Indiana, I'm about an hour from my parents' house and I am feeling dizzy. Like, I mean, seeing tunnel vision, not feeling well, but I'm thinking, I'm just tired, I've been driving, it's all nighter, like, I'm good. And I'm just... not feeling well at all. And then it got to a point where I called one of my best friends. Her name is Rachel and she lived in the area and I said, Rachel, I'm not feeling, you know, the greatest. And it's a little hazy from there, but she could sense something was wrong. And she knew kind of my condition before from going to school with me and doing sports with me. And she was like, do you, she was like, do you have that blood pressure medicine on you? She was like, I, she was like, you sound like you're going to pass out. And I was like, yeah, I do somewhere on my first and she was like, how close are you to the mall? And I was like, I'm very close. She was pull over, go in there now. So I'm in my purse. I'm digging for this midadren and can't find it, can't find it. And also I'll disclose, I was on Adderall for ADHD and I had accidentally opened that one, wasn't it? And I'm fumbling around because I'm dizzy. I spill it all over the bottom of my car. Dr. Kaycee Bills (20:31.546) and eventually get to the mid-adren and I take it and I am like almost to the point of passing out. My friend Rachel had called 911 at that point, because she knew what was going on. She, she's seen it before she could hear it in my voice. and, you said, you know, I think she had, and she explained the condition that I had, and said, I think she might be passed out right now at the Glenbrook mall. her blood pressure is probably really low. She's been driving all night. I'm assuming she didn't eat. And I don't know if she got to her medication and she explained all that to them on the phone. And so my memory is kind of hazy of that. I'm just going off of what she told me. But I start kind of coming to when EMS gets there because I had found my midren and still not feeling amazing. And they say, it's best we just take you by ambulance. And they're like, your friend Rachel's on her way. She's going to get your car and it's all going to be fine. And I was like, I don't really need to go by EMS. And they really felt that I should. So I said, you know, why not? And so I went by EMS and, you know, police were there too, which I thought was kind of strange. I didn't know why police were there, but figured it was just the first responding thing. And they were going through my car, which again, don't really care because, you know, I had nothing to hide. I didn't really care. I just wanted the car taken care of. And so my friend Rachel came and took care of the car or whatever. But I noticed when I got to the hospital, I was not getting treated. like I normally had, because I had been to the emergency room before, you know, I had to get diagnosed with this condition somehow. I had been there before, but I was like, they were asking me strange questions. A history of drug abuse. No, you know, asking me asking me all these like nothing to do with and I kept saying I have neurocardiogenic syncope over and over and over again. And they're looking at me kind of like, you know, like, mm hmm. And my friend Rachel shows up and she goes, Casey, they're about put you in a psychiatric hold. And I'm like, what? And she was like, I overheard the nurses talking because she didn't come in her happy self. She came in upset and I was like, what are you talking about? I like, I haven't even done anything. And she was like, they think you overdosed on Adderall because the police saw that Adderall all over the bottom of your car. She was like, I have the bottle right here. And I was like, well, give them the bottle to show that like this is a prescription. Like I guess I was dizzy. I fumbled and I spilt it all over. Dr. Kaycee Bills (22:50.83) And it was just a series of it. It did look into the police's defense. That looks pretty bad. You know, it does look pretty bad. And you know, and she tried to, yeah, go ahead. Roger K. McFillin, Psy.D, ABPP (22:59.552) Casey, I just want to intervene here for a second. My first thought is wouldn't they be able to test that? Like would like a blood test reveal that you, if you overdosed on Adderall? Dr. Kaycee Bills (23:10.656) And they did test for it, but the results didn't come back till the next day. Cause you got to remember this was over a holiday weekend. And people weren't reading the test. So yeah, they did take blood tests. They did take everything. And that's kind of the end of the story. We get released and we find out I have no levels in there, which was even more irritating, but yeah, they found out I didn't like, but it was later on. And so they had taken blood, but the results hadn't come back. And I remember the, I don't know what she was a social worker. She was not a nurse of some sort. It was someone she comes in and she says, I need your phone right now. And I said, no, I'm not giving you my phone. I haven't called anybody. I'm not giving you my phone. And she got really nasty with me. Then security comes in and they say, you can't have your phone. And I know what's happening. I had worked with this hospital. I know what's happening. They're taking my phone so that they can transfer me to the psychiatric unit because you can't have your phone there. And I knew and so then I tried to reason with her and just say look I have this condition I was like, you know, if I'm completely honest with you, I worked with you guys I worked at the facility and I'm not gonna name the names of the only them suing me But I was like I worked at you know facility here and we partnered with you guys. I've transported patients here I've worked with patients here. I've been here a lot. I know what you guys are doing and the only reason I'm not here now is because I got my doctorate and I'm a professor and you know that's what I do. was like, I'm not crazy. didn't overdose. I'm not any of this and I'm trying to explain it to her and she's going, mm hmm. Mm She was like, you're a doctor here is what you're telling me. I'm like, no, it's not. Exalt what I said. And so they had made up their mind before I could even explain it. And and I knew what had happened. I had to, I guess, accept my fate. I was putting handcuffs. I was transported over to the psychiatric unit. My friend Rachel had to contact my parents and tell them what was going on because I had no phone. had no nothing. And then it dawns on me, this is a holiday weekend. This 72 hour hold is going to turn into a much longer hold because there's no psychiatrist who's going to come in on Thanksgiving to assess this. And I also knew because of my history of working, you know, with this hospital that if I cry, if I fight, Dr. Kaycee Bills (25:27.168) If I get combative, if I do anything, I am here longer. Because then they're going to label me as psychotic, manic, whatever it may be. So I have got to be as cool as a cucumber. I've got to be chill. And so I'm playing off even though inside of me, I'm just dying. And kind of some backstory too, my grandpa had passed away the previous year. And this was going to be our first Thanksgiving without him. And so now all I'm thinking about is I am missing the first Thanksgiving without him. over something so stupid because someone didn't listen to me. And it's all going to come back once Thanksgiving's over, but it's going to be too late at that point. And so I don't know what happened between then and there. I will tell you, I was at that facility for 24 hours. They gave me a bunch of sedatives and I just didn't combat it. I guess I just took it. I like, maybe I can just sleep this off and wake up in this whole nightmare will be over. Which also very dangerous by the way if they thought I overdosed on Adderall, why are they giving me sedatives? They gave me benzodiazepines. I got the bill I got the item I feel gave me benzodiazepines and they gave me trazodone which is a sleeping medication and I essentially for 24 hours was just knocked out in this room and they didn't know my prior medical condition Well, they did I tried to tell them they didn't know any of that You know, they just gave me all these drugs and essentially made me sleep. The next morning I woke up and I'm so blessed that my dad is an Indiana State trooper. So he's got some contacts with some county judges that the normal person doesn't have. And he contacted the county judge and said, I just got a call from my daughter's best friend. Something very alarming is happening. This is not her. This is not anything. And they were able to get a psychiatrist to come in and they were able to reverse it. And that psychiatrist came in. And said, do you want your dad in here? He's here. And I said, yeah, my dad came in and my dad like, and me like really talked through it. And he goes, yeah, I don't, I don't see any issue here. He was like, you've been very calm. You've been very alert the whole time you've been talking. I got your test back. You actually had no out at all in your system whatsoever. He had said you had nothing else in your system. And he was like, and your blood pressure was very, very low in the EMS. He was like, and I can see he was like, Dr. Kaycee Bills (27:44.758) I'm shocked you weren't passed out. And he was like, I can see the blood, you know, the blood pressure rates. And I also got your my chart back. I see the neurocardiogenic syncope. And it does look very much like you just passed out. You know, you let your blood pressure get too low. And that was it. That was it. And they're like, you're free to go. And it didn't leave a lot of closure with that because it was just like, really? That's it? Like, No admission of like we really messed up. We're so sorry. No, like by the way We drugged you all night with things and I didn't even know the diagnosis that they had made Until later on because again, I worked for this. I know how this worked. I went and checked my my chart The next week and I get on there and I see I am now diagnosed with borderline personality disorder bipolar disorder and not only bipolar disorder bipolar one and bipolar two never seen that before I've never seen someone cope with a comorbid wanted to and I still couldn't even read the chart and I'm like could they not decide but regardless they made those three diagnosis maybe two I don't know what they were they made those diagnosis off of one encounter with me and if anybody knows borderline personality disorder if anyone knows bipolar disorder You can't figure that out off of one encounter. You can't figure that out off of that. And that's on my record forever. Trust me, I've tried to fight with them to get that off. I can't. there was, and I got a huge bill. got this, well, it was first about $6,000. And when I asked for it itemized, it got moved down to 4,000, which was amazing. But it really, it broke my heart because there's no getting that off my record now. There's no getting that diagnosis gone. And so now, you know, God forbid if I, if something happens to me, say I'm in a car accident and I need pain medicine, or I need to go into surgery, they're going to open that up and they're going to see drug user. They're going to see, you know, all this stuff. They're going to see confabulation claim to be a doctor at our facility, which is what they wrote, which is not at all what I said. They didn't listen to me. and so, yeah, that's kind of my story with that. Roger K. McFillin, Psy.D, ABPP (29:50.304) Mm. This is such a cautionary tale. So one of the things that I think maybe people are kind of thinking about right now, well, this is rare. This isn't typical behavior. know, this is just, you know, over a holiday weekend, low level staff, you know, treating you in this way. But I want to remind everybody she has a father who's a state trooper. She herself is educated with means. had a supportive friend show up, family was called, everyone comes in and intervenes. This is just a misrepresentation of just one medical condition. And even that, and the way that we share, electronically share records now, I see this all the time. These labels are haphazardly placed on someone based on brief interactions. And now these labels bias every medical professional that will evaluate this person in the future. So not just you, Casey, we're talking about clients of mine, people I've met, my own experience in the system. Now, you provided a little bit of a 24 hour experience of losing your freedom, even being placed in handcuffs, being forced drugged into sedation without your consent. Now, what has been your experience? From the academic side or from your previous work in the mental health system, what has been your experience with psychiatric hold, psychiatric hospitalizations and forced commitments? Dr. Kaycee Bills (31:28.36) Yeah, I can tell you from a professional side, you know, the research I have is a lot of preliminary, just kind of qualitative stories. And so I've got a lot of like personal stories I've heard, but I can tell you just from what I personally observed when I worked at in community mental health was patients would go in into these 72 hour holds. And I can tell you and usually what had happened that got them there was they were really angry at something. They're pissed off. And they said, I could just die right now. These were people who had maybe some impulse control, but they didn't actually want to die. They just needed someone that could kind of talk them down a little bit. And so what would happen was they get put in because they made the comment. They said, I just want to die right now or whatever that may be. Got them in and I can tell you that by day, they calmed down by day one. Day two, be a little agitated. Day three, they miss their friends. Day three, they want their family. Day three, they want out. Day three, they're worried about their job because they haven't had a chance to call their boss to say why they're missing for three days and they haven't been able to tell them, you know, I need three sick days because you don't get your phone. You don't get phone privileges there. And when you do, you better have that number memorized. How many people have their, I don't know my work number memorized. And so, you know, day three, they're worried. Now they're like, they're thinking. I don't think I want to live because when I get out of here, my job might be gone because I just went, you know, AWOL for three days straight. My family, I'm embarrassed that I'm in here just because I just got mad. You know, not everybody has a support system, you know, like I do. And I would see at that 72 hour mark, they actually were suicidal. What wasn't suicidal in the beginning. Now this is hopelessness. Now this is I've lost my job. I haven't seen my kids for three days. I haven't seen my spouse for three days. My spouse is mad at me because they had to take off work because they had to watch the kids. And now I've seen their life spiral. And guess what? When you're actually suicidal at that 72 hour mark, when they do that reassessment, you're gonna be in there even longer. And I'm lucky that I knew that knowledge to keep it cool so that that did not happen to me. Roger K. McFillin, Psy.D, ABPP (33:45.928) Yeah, you have the personality and the wisdom to be able to say, hey, if I resist, that gets misinterpreted as a mental illness. But if I was in your position, I'd fight like hell, right? I mean, I would be so reactive, I would because I don't have it within me to comply. And I've certainly met other personalities the same way that they're stripped of their rights and their dignity. They're called liars. They're treated as if they are less than human and they fight back. know, they fight back in with what I think is indignation and justified anger. And then they get slapped on those diagnoses. So which tends to be things like personality diagnosis or bipolar disorder. Now you just identified kind of the trifecta of the bipolar spectrum and borderline personality disorder, which we know is going to be placed on women who represent any form of emotion dysregulation. But it was interesting in this particular situation, none of that even existed. just viewed you as somebody who was abusing drugs and was lying. But I want to get your take on why, and this is pretty staggering, I think the data, why do you think, number one, women are more likely to be psychiatrically drugged? And then two, why do you think women are more likely to be provided a psychiatric diagnosis when there's a legitimate medical condition that has not been identified. Dr. Kaycee Bills (35:21.024) Yeah, and I think that has to do with a lot of, you know, people expect men to be the fighters. People expect that. They expect men to not be happy about that situation. If a guy is, you know, for a lack of a, if he's pissed off that he's going to be in there for 72 hours, they go, yeah, yeah, I'm pissed off too. You know, like they look at it that way. But if a woman is mad and is, they can see that as abnormal. They say she is a bitch. She is irrational. She is, you know, whatever. cause they expect, you know, us to just be compliant. And I will say too, kind of a little bit about me is I have a very calm demeanor, but I have a very witty personality at times where it's calm, but it's witty. And this is in my chart too, where I made a comment to my friend Rachel and I was like, I am so over this that I hope I find a lawyer that I sue this place so badly that maybe they can just name this to Casey Vills hospital after I get sued them so fucking badly. Like I was just so mad. And like I said it very calmly while someone overheard it. put in my medical records, you know, stated that she thinks she's going to own this hospital. She thinks she owns it and it's named after the Casey build. And it's like, that's not what I was saying. I was trying to make light of this horrific situation and I was just being, I was being a smart ass. That's all I was doing, you know? And you know, and people don't expect that out of women either. They expect that kind of language out of men. And so when a woman is kind of witty, they take it as like a mood swing and they take it as being, you know, defiant. Or as a man, just look at it as being a man. And that's kind of my personal experience of just being a woman in mental health, seeing clients being treated that way, and then also seeing me being treated that way. Because I think if it was you and you were fighting like hell, I don't think they'd really see it as fighting like hell. I think they could see it as like, he's a dude and he's mad. Like he's getting his power shipped from him. But when a woman does it, she's crazy. And so that's kind of how I interpreted it. And I don't know, does that answer your question? Roger K. McFillin, Psy.D, ABPP (37:20.64) Yeah, and I think historically we can look, this is a field and how can we trust a field that once lobotomized women for what they call hysteria, right? To fairly diagnose them today. And so I think you're right. When women express emotion in an aggressive way, they're more likely to be labeled with a mental illness diagnosis, while men are more likely to be provided an understanding to the context and knowing that this could be a valid reaction. Dr. Kaycee Bills (37:28.749) Yeah. Roger K. McFillin, Psy.D, ABPP (37:50.366) to the restriction of freedom. And that's where these biases are. This is why I say that psychiatry is an illegitimate authority. When you don't have a sound science and investigative process and you rely so much on diagnostic labels that are heterogeneous, they overlap and the presentations can be related to so many other legitimate medical conditions when that physician in itself does not have adequate background or training to investigate those. really they become an illegitimate authority that has the ability to restrict your own freedom and your own rights, not based on anything. In my opinion, that is like a valid and reasonable way to limit someone's rights, but rather just a judgment and a fear. And that's what drives mental health care in America often is fear. It could be fear of liability, for example, or fear of a crisis, like, you can't really withhold somebody's rights, because you predict they may potentially do something right that that's you can't as your dad as a state trooper can't arrest somebody because they believe they may create a, you know, I commit a crime in the future. And we can somehow do this in psychiatry is limited viewpoint, as if they're good predictors of future events, which shocker, they're not. And that's one of the things you learn about scientifically. Like for me as a psychologist, and for God's sakes, let's just have a bit of humility, we're horrible at predicting suicide. So why do we have this right to take away a person's individual freedom based on this possibility that we think we can predict it, right? Um, and where have we gotten in this society that we can take away somebody's individual rights if they're going to do something to themselves. Like that's an interesting concept that we don't really explore enough. I mean, a person, guess, could have the right to take away their own lives if they want to. Why do we have to protect somebody from themselves if they're not in danger of anybody else? And we would know we would, we, know we would decrease the, uh, prevalence rate of suicide if we did a number of things. Roger K. McFillin, Psy.D, ABPP (40:03.442) If we validated someone's pain, we saw it as something that was temporary and we fostered hope. We didn't prescribe them drugs that would lobotomize them or blunt their emotions or increase the likelihood that they would have, you know, suicidal ideations. We don't take away their rights. We don't place them in a, a hold, a psychiatric hold, a hospital that represents a jail more than anything else, right? So you strip them of their phone. Dr. Kaycee Bills (40:30.158) Thank Roger K. McFillin, Psy.D, ABPP (40:31.882) There's no windows, there's no connection to nature. You're forced drugged and you're placed in an environment with other people in a crisis situation. There's nothing that's going to resemble jail more than psychiatric hospitalization. And somehow we have normalized all this and we believe that this is quote unquote mental health care. You said it best earlier, if anything is gonna make somebody wanna kill themselves, it is that. Dr. Kaycee Bills (40:59.38) Yeah, it's you know I would say you have more freedom in a jail than you do in a psychiatric facility because someone can bail you out of jail You can plead your case. you know in jail you You know get cellmates like, know, you get in a psychiatric facility. You do not it is grim I mean, no one can bail you out. Like you're there. I don't even know how my dad pulled the strings. did. I don't know. I'm very lucky because that's not a normal occurrence and that's not going to happen to the normal person. But yeah, it'll drive you. I mean, that's, you know, that's kind of a torture tactic that sometimes the military uses as they isolate people until they confess that, you know, it's not, it doesn't treat anything. I mean, I see the value of if someone is in the act of harming themselves or something where you're seeing it in real time where you've got to put them in that setting and you've got to detox obviously is one where you would see that. But I wouldn't isolate them still from their family or friends because here's the thing, you don't get visitors either. We always preach in mental health that we want to treat it just like physical illness. We want to eliminate the stigma. want to treat it just like physical illness. Well, I can tell you that if I have a heart attack tonight, my family and friends can visit me whenever they want. I can keep my cell phone. I can call whenever I want. I can order food whenever I want. I can get up and walk around whenever I want. And really I can refuse care if I want. Is it gonna be recommended? Probably not, but you know, no one's gonna fight me for it. And so it's just so weird how we contradict ourselves and we say, we got to... Eliminate the stigma treating just like physical illness. Well, I can tell you if I get cancer I get visiting hours. I get phone calls I get you know, whatever I want but mental health You're in a you're locked in you're not and you don't even get therapy in those settings either You don't get anything. You're just sedated until you're not a problem anymore Roger K. McFillin, Psy.D, ABPP (43:08.896) Exactly. think decreased stigma is code word for let's create more customers and it's a pharmaceutical marketing intervention. So they've really pushed that on the cultural lexicon. Like let's just normalize seeking out help for mental health, which is really going to see doctors and what do doctors do? They write prescriptions. So it really increases the customer base and it's so distorted the way we look at about mental health and wellbeing. Who in their Dr. Kaycee Bills (43:14.508) You Roger K. McFillin, Psy.D, ABPP (43:35.294) right mind would believe that locking somebody up in a cell in that nature is somehow restorative. At least in jail, you know, the one thing you didn't mention is at least you get an hour of outside time, right? Dr. Kaycee Bills (43:46.54) Yeah, there you go. You don't get that. Also, they strip you of your clothing too. I forgot to mention that too. You're stripped completely of your clothing and it goes off somewhere and sometimes you don't get it back. I didn't get a shirt back. So, you know, you're stripped of your clothing too and I forgot to mention that to anyone who's not familiar with that. I mean, you're stripped of your entire dignity. And at least in jail, I mean, you get a jumpsuit of some sort. You get a sheet. You know at a psychiatric facility. So that's another big part too that's gonna make anybody's mental health not great Especially if you're looking at a trauma victim, let's say a rape victim and you've stripped them of their clothing and you put them in there. I Don't know. I don't know if that's the best tactic Roger K. McFillin, Psy.D, ABPP (44:30.856) It's dehumanizing. It's absolutely dehumanizing. And in my work over the past few decades, I mean, I've had to, that's the aftermath of that trauma. Right. And I can't tell you how many people have said, you know, it's more traumatic what I just went through. Then, you know, describing maybe previous traumas in their life. And here are the consequences and implications of this. You have now created a culture where someone actually does need help, but they're so afraid. to say what they're really going through because they don't want their rights removed and they don't want to be forced into another hospital stay. And so therefore, you know, it's the opposite of what we're intending. If this is our policy, if this is our approach to decreasing crisis situations and protecting people in vulnerable states, my guess is that, you know, we're actually worsening it. by our response. And it doesn't make a lot of reasonable or logical sense at all. And it's unfortunate. So you're in a position as a professor in social work and you're actually teaching courses around this one on the DSM. I'm so curious to know how maybe you up you approach teaching courses like this and you know, what are you trying to what are you trying to influence how what are what's the ultimate goal for you to train social workers in the system that they're going to work in. Dr. Kaycee Bills (46:01.748) Yeah, so I'm really trying to and I mean, I'm really trying to deconstruct the way that people are trained and just show them something and activities that I really like to do with my students and I do it a lot is kind of give them a scenario. Is this you know, is this a crisis or a bad day? Is this a mental illness or a bad day? You know, and I try to like really humanize it and I give them different cases We'll watch videos of you know, someone and I say, you know Do you think this is mental illness or do you think this is a bad day? You know, put yourself in their shoes Yeah, you know if someone did this to them this morning they went through this this and that And then they acted this way at the end of the day Is this a mental illness or is this a bad day? And so I really stress and I and I'm thinking of a PowerPoint I have right now versus duration of symptoms because I really stressed that word, duration. You cannot make a diagnosis off of one interaction. can't, my God, this is a total borderline person. You can't do that. It takes a while to really observe a borderline. It takes a really long time to observe a bipolar case. It takes a while. You can't just see something and go, yep, that's what that is. And so that's something I guess emphasize. probably on a million of my PowerPoints, you're probably tired of that word, duration. It's gotta be, and it's also consistency, not just like, again, was this a bad week? Was this a terrible week? Or was this, is this something that's been going on chronically for years that's keeping them from getting jobs? We talked about that. That's keeping them from tending to their family, taking care of their kids. Or is this just like, you know. they lost their mother and they're just freaking grieving. They got a terrible job and they're just trying to find another one. So like is this mental illness or is it low state? Because everybody goes through terrible things in life. That's the way it is. And I really try to bring it back on them. Think of a time where you were really, really, really down. Did you exhibit some of these symptoms? Because you probably did. But do you think that you're actually that? Dr. Kaycee Bills (48:19.97) Do you still do that every single day? know, and try to, sometimes it's easier to put yourself in that mindset than it is to look on the outside. And so that's kind of what I try to do and really put them in there, you know, in that person's shoes. And then I also really try to educate them on, you know, you're gonna be probably, if you work in mental health, you're gonna see a client in these holds. You're just gonna see it. And there's nothing you can do about it. And there's just. I mean, you can advocate, you can do what you want, but really you're a judge who isn't involved in this case. A psychiatrist who hasn't seen this client is making the calls. There's nothing you can do about it. So I also really preach to them, you know, when you see the situation and you couldn't prevent it, just have empathy and remember that on day 72, they have not seen their friends. They have not called work. They have not seen their children. You know, go, go isolate yourself in a room for 72 hours. Think back to the COVID days. How depressed, you know, that was, that's where they're at. And so when you're doing your assessment, put that in perspective and, you know, think of how you would feel if you just went through that and make sure that your, you know, your assessment is relative to that, because you're going to find cases that yes, they probably do need to be on a hold. But and those are very obvious when you see those. But more times than not, those cases are actually really rare that I saw. Roger K. McFillin, Psy.D, ABPP (49:42.176) Yeah. Dr. Kaycee Bills (49:43.37) More more times than not, you're going to see the person who just said had a bad day and they just expressed what was on their mind. We all say something. I was watching a basketball game last night and lost some money on a bet. I said something I was pretty mad. You know, is that a disorder? You know, no, it's just you got to really put it kind of in that human perspective. And that's kind of what I try to preach with them and hope that slowly I can maybe change this, you know, from a practitioner standpoint. But hopefully I can get some good data and you know, maybe get some good research out there on, you know, the trauma. I really want to write a paper on, you know, who is this helping? Is this helping the client or is it help in the system? You know, who are we helping here? Roger K. McFillin, Psy.D, ABPP (50:27.974) Yeah, I mean, we're referring also to the kind of perverse incentives, right? So the more people that they can place in their hospital, they're able to, you know, bill insurance for that. And hospitals, although they have nonprofit status, are for profit, large scale networks. And especially since the Affordable Care Act, you know, there's a system that's been created to maximize profit. And the doctors are really indoctrinated into that system and there's protocols and the things that they follow, where to me the intention is certain financial. You were talking about something regarding the ESM I thought was really interesting because you're emphasizing really how anything that is of meeting diagnostic criteria requires us to be able to understand it in context, to understand it in duration and severity. And I am really adamantly opposed to the DSM for multiple reasons. First, the diagnoses are not legitimate science-backed medical conditions. They're labels, they're heterogeneous, they all overlap. It's so easy just to slap it on anyone for any normal period of time. but there are at least ways to protect yourself from overextending. And the DSM does talk about such things, right? Like the DSM does kind of say, hey, listen, be aware, these are just labels. And they have some usefulness in our way of being able to communicate or to bill, to code. But understanding that... Dr. Kaycee Bills (52:01.837) Yeah. Roger K. McFillin, Psy.D, ABPP (52:20.712) And we for whatever reason, we've evolved to this way that that doctors can make these really quick assessments sometimes in 15 minutes, 30 minutes or 45 minutes without interviewing family members. Roger K. McFillin, Psy.D, ABPP (52:34.752) excuse me, without interviewing family members, without understanding the duration of the symptoms, without understanding context, which sometimes reactions are extremely valid based on context, like for example, a trauma victim, right? Someone is sexually assaulted the night before and the next day they're disassociating, in panic, shaking, sleep deprived, right? So, We throw a psychiatric label on that and they get treated as if they have a mental illness instead of understanding its reaction to that adverse event. All of this drives drug reactions, right? All of this is going to be as a frontline intervention, it's going to be, the doctors are gonna prescribe you something. You go into hospital, you're getting a drug. And now we know once you have that drug response, we have no idea how it's gonna affect the individual. and then they add another one or potentially another one. And so what starts as a reaction to an event, you say a bad day, I like that, you know, because you're getting somebody at just a discrete period of time. And if we look back at our lives at our worst moments, you know, we've all probably thrown tantrums or said things we shouldn't have said or acted ways that we wish we didn't act, but it's just understood in its context. It's not really who we are. It's a bad day. Dr. Kaycee Bills (53:37.186) Yeah. Roger K. McFillin, Psy.D, ABPP (53:55.498) but it's so easy to get mislabeled in this system. And the DSM is really clear about such things, but we've completely abandoned it. You the other things in there, and I've gotten this debate like on social media recently and even wrote an article about it, that if you have a medical condition, know, legitimate medical condition, let's call it a thyroid condition. And then you have fatigue and mood, depressed mood, maybe anxiety, maybe difficulty sleeping. That's a thyroid condition. That's not major depressive disorder, right? So people say, well, you know, people are depressed when they're metabolically ill, therefore depression is a metabolic illness. And it's like we've abandoned the idea that we have these symptoms that are related to legitimate medical causes. When you're sick, you don't feel well. That's not a psychiatric condition. You might label it as a like depression related to a medical condition, but now depression is lost. Dr. Kaycee Bills (54:25.507) Yes. Roger K. McFillin, Psy.D, ABPP (54:55.336) it's really become an umbrella term, it's lost its value. So now, anyone who is like overweight and sedentary, and not active, or might have a thyroid condition, or maybe a cardiac condition or something else that's impairing their life, we start throwing the label that they're depressed. And then you can kind of reverse engineer it and someone can say, Wow, well, depression is related to metabolic illness. And then you pull them off their drugs that might have been making them sick and you change their diet and you prove their Dr. Kaycee Bills (55:11.661) Yeah. Roger K. McFillin, Psy.D, ABPP (55:24.832) their exercise and their lifestyle habits, which are critically important. You say, well, I cured their depression. And we've just like lost this way of like communicating, like, have we are we no longer just using common sense, like sick people don't feel well? Like, why, why do we, why are we pushing psychiatric diagnoses? And why does the most illegitimate medical profession that exists still has the authority they do in United States culture? Right? So we're still operating from a DSM five, the fifth edition when it's very clear it lacks validity. It relax, lacks reliability, but it's got more power in our country than at any other time. Dr. Kaycee Bills (56:07.85) Yeah, and you know, and the other thing too, I want to add to that, you know, if you go back to like the thyroid example, well, you know, it's going to happen to someone where you label them as depressed, when you use a DSM instead of what it actually is. Guess what? The other thing too, is the mind is powerful thing. You tell someone they're depressed enough. Guess what? They're going to become depressed. You tell someone they're, they've got generalized anxiety disorder enough. They're going to start doing that. You tell someone they have panic disorder enough. guess what, they're gonna start exhibiting those symptoms. And so that's another thing too, that you have to be really careful. Because once you label them and you tell them they're that, well, they're gonna start researching that. And we all know the power of, if you go in that DSM, you can diagnose yourself with really anything if you want to. And so when we're telling people, it looks like you have this, well, we live in an internet age, people go on there and they Google and they go, my God, I meet this, I meet this, I meet this. And then they start exhibiting. those behaviors and they very much become that and we created it. We put it in their head is what we did. Roger K. McFillin, Psy.D, ABPP (57:13.433) Casey, are you saying that human beings have a mind? Dr. Kaycee Bills (57:17.302) Yeah, actually they do. Yeah, and it's very powerful. You can really control a lot of symptoms, you know, with that, you know, it's a Roger K. McFillin, Psy.D, ABPP (57:25.14) I mean, I thought everything was just reduced to genetic determinism and that if anytime we're thinking, feeling or acting in a way that's outside the cultural norm that it's a brain illness. Dr. Kaycee Bills (57:39.03) Yeah, I mean, you know, it's a crazy thought. It's a crazy theory. But yeah, you know, and that's not to say that there aren't people who have a genetic condition like schizophrenia, very genetic. You know, there are people who have schizophrenia and that's a very severe mental illness. It's not to say that these don't exist, but not in the capacity that we're, you know, we're seeing. And it's interesting to see the trends that we go through waves of like, now this one's really diagnosed heavily. And it's just interesting. Roger K. McFillin, Psy.D, ABPP (58:09.598) Well, yeah, I see I'll challenge you on that. So yes, we have people who develop psychosis and when they do, along with some other symptoms, we'll label that as schizophrenia. But what's interesting is that it's not really clear that we can say there's a genetic link. That's very, very, very speculative. And I like to look at Dr. Kaycee Bills (58:15.276) Okay, channeling's Dr. Kaycee Bills (58:33.678) Interesting. Roger K. McFillin, Psy.D, ABPP (58:38.612) the work of other countries and other approaches. So our outcomes are horrible in the United States because we treat it that way. We say, well, this is just a genetic brain condition and all we can do is manage it with drugs. But other countries use other approaches and don't have the reliance on pharmaceuticals. They have much better outcomes. And so we don't really understand what schizophrenia is. We call things genetic, but it's possible that two people come from a same environment. in same family situations with same biology or genetic background, and it gets expressed in exposure to those situations. So let's say that, I don't know, we can probably, let's say there's a combination of two factors, malnutrition, metabolic illness, exposure to trauma. And those things converge where some people develop psychosis as a detachment from that reality, and they all converge together, right? It does, you know, if, if there's another environment where it's a similar family way of relating similar new, same nutritional deficiencies and same trauma that it expresses itself that way, then we can say, okay, well, there's an epigenetic kind of component to this. That's how that person's mind responds to, and maybe it's self protective in some evolutionary function that that's how their mind responds to that trifecta. But if you go to like Norway, for example, and like their open dialogue program where psychosis is viewed as a reaction in a stressful environment. And if you keep people in the safety and structure of their home and you provide meaning to that psychotic break, there's this like extremely high recovery rate that aren't always These aren't always like second episodes or third episodes. So how can we say something is genetic and chronic? when cross-culturally we see different responses to it, right? So we're so, we're just so conditioned in this medical world that we live in that the only way to do anything is through pharmaceuticals. And then we like use this word genetic. And what does that mean to people? Like I have no say. Dr. Kaycee Bills (01:00:49.23) Yes, that was interesting. Roger K. McFillin, Psy.D, ABPP (01:01:02.824) I have no control. I lost the genetic lottery. And so we've created that in consciousness. And what is the power of that? So if we have the power and consciousness of creating a DSM label, I am depressed. I am an anxious person. I am bipolar. Well, there's other things that are created in consciousness as well. I lost the genetic lottery. I'm doomed to this condition. Health is outside my control, recovery is outside my control. I must take my pills. Right? So I think like I'm very sensitive when we kind of limit the conversation by saying, I'm sorry, that's just genetic. And that's why that happens. And so there's real brain illnesses and real mental illness. And those things have to be taken care of, which I can say, yes, there are real, there are chronic conditions that are rare, thankfully. We understand risk factors and we do nothing to improve the. chronicity or severity of the condition. Nothing. In fact, good evidence would suggest, I think we worsen it. Dr. Kaycee Bills (01:02:03.054) Yeah, and you know, and that's an interesting point. And I have to look into that more cross culturally, because I was always trained, you know, with schizophrenia very specifically, that it was genetic, it usually, you know, sprang on around 2526. That's usually when it came on in a family history. That's really how I was trained. And so it's interesting. And I have to go and I really can't rebuttal what you say, because I don't know enough about that. have to look into that. But that's a really interesting perspective. But let's say, you know, It is genetic. Let's say it is purely genetic. There's a lot of physical conditions that are genetic that you can prevent. So I don't know why we wouldn't even if we did know it was genetic, know, like heart disease. You can prevent heart disease from happening even if everybody in your family had it, you know, like. Roger K. McFillin, Psy.D, ABPP (01:02:46.784) Yeah, it's such a it's, I guess everything's genetic, if we put it that way, like, I've got brown hair, and, you know, I've got this blue eyes or I have a gray beard right now. Like, okay, we can say that everything is genetic to an extent because I am the product of my two parents. But epigenetics suggests that we have all this coded in our DNA throughout our entire lineage. And that's actually there to protect us and Dr. Kaycee Bills (01:02:51.085) Yeah. Roger K. McFillin, Psy.D, ABPP (01:03:16.64) symptoms arise as indicators of exposure and our body is reacting to that. We're twisted in our idea to think about, genetic means I'm going, you know, I have a susceptibility to heart disease. I find that bullshit. My dad died of a heart attack at age 50, right? I don't look anything like him. I don't eat like him. I don't live like him. I don't have any of the risk factors like him. I never smoked. I exercise. I eat strong diet. I handle my stress very well. I'm about probably 40, 50 pounds less than him. Why would I believe I'm susceptible to having a heart attack because he did? Right? That doesn't make any sense to me. Dr. Kaycee Bills (01:04:00.056) Yeah, you know, that's an interesting perspective. And, know, there are family members to that, I guess, you know, maybe I won the genetic lottery, but yeah, a lot of these things are very preventable. And there are a lot of them are very environmentally caused, you know, and I guess, and I, and, know, we talk about how mental illness is on the rise, speaking of environment, you know, there's a mental health crisis in America, it's always on the rise. Well, sometimes I feel like it's on the rise because we constantly say it's on the rise, you know? And so it scares me. I don't know if this is a little off topic or not, but it does have to go with the DSM and it makes me fearful of a direction it might be going to. I recently went to a conference where someone gave a presentation on the new term CPTSD. And... it honestly just looked like another name for borderline. When I was like listening to the symptoms, it just looked like another name for borderline, only I just, stemmed it from a constant, you know, trauma. And for anyone who isn't familiar with CPTSD, it's basically like instead of PTSD, a single event, it's, you know, they got chronically bullied or they were chronically in poverty. They had all this stuff. And so I do get nervous because I feel like we're going to get to a point where every single little difficulty in life is going to become a mental illness. And we're seeing that with that CPTSD that's going to, I think, eventually creep its way into that DSM. Roger K. McFillin, Psy.D, ABPP (01:05:28.672) Well, there's a label for everything. And when you create a label for something, then you can create an entire industry around it. But you, I think, spoke so eloquently about the what we create in our consciousness becomes like attached to our identity. Listen, our attention is a commodity where we focus our attention matters. If you want to focus your attention on every aspect of your being and what is wrong with you and the things that have happened to you in your life, I guarantee that's going to drive mental suffering and misery. and that will get commoditized, commodified in this culture. So the commodification of all of this is that, you know, the person who wants to develop a career around CPTSD, they want to maybe research it, they want to develop protocols, they want to develop awareness, they want to speak at conferences about it. It generates this momentum of an idea. And it's not that there's not validity to this. Like, for example, the fact that yes, people chronically exposed to stressful conditions can present with symptoms of PTSD, but we already have PTSD as a label. Why don't we just leave it the way it is? And each person is a unique individual with their own experiences, that if they choose to get help in some areas, then let them go choose help. Why create more, more labels? How has that benefited any of us? Like I had a conversation with a psychiatrist once we were in agreement on this. We said we could just break this down to like six categories. Dr. Kaycee Bills (01:06:31.246) Thank Roger K. McFillin, Psy.D, ABPP (01:06:56.542) Why like why all these why 300 plus diagnoses? Why not just break down the like, you know, six categories? Yes, there are going to be more severe conditions of people who are psychotic or delusional and put that in a separate category. And then there's like anxiety and obsessiveness that can create, you know, problem reactions and behaviors. There could be really low mood, you know, severity of like a depressed episode that can drive a desire to want to end one's life because the pain is so strong, then there's certain then there's like eating problems like eating disorders, bulimia, anorexia, these are like legitimate conditions. And there's there's mania. You know, and then of course, people abuse substances and other things. But why all these categories? Why not just say, hey, it's under that umbrella, someone seeking out help with them. And then we don't have to mislead people. by saying, you have ADHD, you have bipolar disorder, you have major depressive disorder, which leads people to believe that they have something genetic, that they have obtained something, there's something broken within them that needs the fixing of the medical system. So it's that misleading lie that has pushed people to get biological interventions and quick fixes, like I can take this pill or I can get this, I don't know, electric treatment. Bectric shock therapy, is now promoted and. Dr. Kaycee Bills (01:08:28.302) Sadly coming back, we used to talk about how like this was the worst thing we ever did in humanity. you can go down a whole rabbit hole of how like that used to just be cruel treatment that we just abandoned because we didn't know what we were doing. No, it's creepy. It's creeping its way back, which just shocked me when I found out that they're doing it just in a nicer looking way, I guess. Roger K. McFillin, Psy.D, ABPP (01:08:41.896) Yeah, we repackaged these things. Roger K. McFillin, Psy.D, ABPP (01:08:49.566) Yeah, nothing shocks me anymore. It's just about being open and honest with people because I think we look at post COVID, for example, boy, the benefits of that is the veil is kind of lifted and it just kind of reveals, whoa, behind the scenes, we have this machine of pharmaceutical companies, academics in the medical systems, insurance companies and government officials and this machine is working at a way to kind of control the population. And really, what it does is like we have been acting under false pretenses. We've been approaching our lives and our health, not with sound science, but rather a really a very sophisticated way of creating more disease, more sickness, and measures of treating it. And so you become aware of that. Please be awakened to when it's going to continue to happen again in other manners. Like it hasn't stopped that we're becoming more awake. The Maha movement hasn't stopped it. You know, it's just we're bringing awareness to this. And let's remember what our rights are. Our rights are around informed consent and we have freedom. And when your freedom is removed or taken away based on an illegitimate medical authority or scientific foundation, it is the right of the people for to resist this and there needs to be a revolution around it, right? So conversations like this, my entire podcast is around this revolution, right? Be aware of your rights, be aware of illegitimate medical authorities, be able to ask questions, don't have anyone force anything onto you and make sure you protect your mind and protect your body because what is clear is that we can be influenced so much by propaganda and that propaganda is powerful. that propaganda is going to be taught in our academic institutions. And it requires professors like you to be able to think independently and get your social work students to be able to develop critical thinking skills and empathy and to be able to stand and resist against the medical authority when it oversteps its boundaries. Because let's face it, the bystanders in this, which like on a hospital center are going to be the nurses or the social workers. Roger K. McFillin, Psy.D, ABPP (01:11:12.116) the bystanders allow this to happen. If they did not allow it to happen and they resisted the authority and they protected the rights of the individual, things would actually change in American healthcare. That's kind of my final statement on that. I'll let you have the last word. Dr. Kaycee Bills (01:11:29.758) Yeah, and you gave kind of the psychologist perspective, I'll give the social work perspective. We really emphasize our code of ethics, the NASW code of ethics. And in the social work code of ethics, self determination is one of the biggest ones self determination of services. And I am so big on that with the students, if that client doesn't want the services and they don't need it, not for them, you know, self determination is so key. You can't You can't force anything on anyone. And we are a field that is breaking kind of our own code of ethics because we're not allowing a lot of clients to self-determine. then we changed their self-determination into, we persuaded them that they are self-determining by thinking they are kind of a certain way. And so that's something I guess really, you know. preach on my students that self-determination and then the one last thing that I always preach on my students that I kind of want to just put out here too. If someone does seek out therapy, it's not meant to be a forever thing either. If someone seeks therapy, it's not supposed to be a lifelong thing. Freud has been debunked on the whole thing on, you know, we got to have therapy for the rest of our lives. And so that's the last thing I would probably put out there too is There's nothing wrong with therapy, but it was never meant to be a long-term solution, and we've turned it into a long-term solution. And this is not meant to work that way. Roger K. McFillin, Psy.D, ABPP (01:12:57.5) Incentives, financial incentives, money, money, money, you know, creating customers for life, creating patients for life at the expense though of our wellbeing, the health of our nation and potentially our own sovereignty. a nation that's too sick, a nation that is too coerced and controlled to resist is not really much of a nation. And so you're never going to be able to resist tyranny and you're never going to be able to resist oppressive actions. And we have to be careful what we normalize. Dr. Kaycee Bills (01:12:59.756) Yeah. Roger K. McFillin, Psy.D, ABPP (01:13:26.336) And I think today's conversation was a representation of this. have to be careful what we have accepted and these forced psychiatric hospitalizations, these labels, the misrepresentation and misunderstanding of the range of emotional symptoms that exists across the human spectrum of experience and with disease. Psychiatric labels are just a false scientific base, and it can lead you to lose your rights. not only that, you know, from just talking about the statistics I mentioned earlier, it does influence, it biases the medical professional on diagnosing real conditions, whether that's thyroid, endometriosis, number of like endocrine disorders. because of the mislabeling of them. And only through education can we make changes here and having these conversations, it's really, really important. And I'm so grateful for you reaching out and I really enjoyed meeting you. I really enjoyed the conversation today. Dr. Kaycee Bills (01:14:36.226) Yeah, absolutely. And thanks. These are thoughts I've been wanting to have for a while, so it's nice to kind of get them out there. So I appreciate that. Roger K. McFillin, Psy.D, ABPP (01:14:45.396) Dr. Casey Bills, I want to thank you for a radically genuine conversation.