Latest / Hardiness with Dr Paul Taylor / The Deeply Entrenched Flaws of The Mental Health Industry, with professor John Read

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The Deeply Entrenched Flaws of The Mental Health Industry, with professor John Read · Hardiness with Dr Paul Taylor

0:11
Speaker 1: Professor John Reid. Welcome back to the podcast.
0:15
Speaker 2: Ah, well, good to be here.
0:18
Speaker 3: We had such a good conversation last time that I
0:21
Speaker 3: thought we should revisit it. Some people may have heard
0:25
Speaker 3: the previous conversation, but we've got lots of new listeners
0:28
Speaker 3: and I think there's new things that we'll talk about.
0:31
Speaker 3: We'll obviously go over a little bit of the old
0:34
Speaker 3: staff because it's really quite enlightening. But how long have
0:38
Speaker 3: you been studying mental health for in general?
0:42
Speaker 2: Oh? Probably about thirty years now. I mean I worked
0:45
Speaker 2: as a psychologist for some years before that, but probably
0:49
Speaker 2: researching twenty five thirty years.
0:50
Speaker 3: Yeah, And why did you go from working as a
0:54
Speaker 3: psychologist to being a researcher in the area.
0:58
Speaker 1: What tips did it well?
1:00
Speaker 2: Well? To be honest, I got pretty frustrated with trying
1:04
Speaker 2: to work within mental health systems that really were making
1:10
Speaker 2: at best, not helping people and at worst making them
1:14
Speaker 2: worse off. So I was getting more and more frustrating
1:18
Speaker 2: to try and it felt like I was sort of
1:21
Speaker 2: maybe able to rescue one or two people from the
1:24
Speaker 2: system from time to time, but trying to do this
1:27
Speaker 2: therapy with people that were sort of drugged up to
1:29
Speaker 2: the eyeballs trying to work against the sort of philosophy
1:33
Speaker 2: that people were being told there's something wrong with their brains,
1:36
Speaker 2: that they have an illness in them, and then wondering
1:39
Speaker 2: why people don't get better. And I just couldn't see
1:43
Speaker 2: spending the next thirty four years sort of working like that.
1:47
Speaker 2: It is hard enough to work anyway, trying to connect
1:49
Speaker 2: to people who are really distressed. I do, but that's
1:52
Speaker 2: all I ever wanted to do. That was my passion,
1:55
Speaker 2: That's what I wanted to do, but it was just
1:56
Speaker 2: too frustrating. So I thought I need to find some
1:58
Speaker 2: way to try and influence that system rather than just
2:02
Speaker 2: work with individual people, which I mix things about. I'm
2:05
Speaker 2: not missing.
2:08
Speaker 1: That. You've done pretty important work.
2:10
Speaker 3: Now you have said in you've gone on record saying
2:13
Speaker 3: that psychiatric diagnosis are scientifically meaningless.
2:18
Speaker 1: Can you walk us through what do you mean by that?
2:22
Speaker 2: Yeah, well, it gets it gets a bit technical because
2:24
Speaker 2: we have to start thinking about constructs like reliability and validity.
2:28
Speaker 2: So just very briefly and simply, reliability is the ability
2:33
Speaker 2: of two or more experts to agree on what's in
2:36
Speaker 2: front of them. So we're then studies where you have
2:41
Speaker 2: two or two or three psychiatrist, psychologists or whatever looking
2:45
Speaker 2: at an individual patient or video or whatever and seeing
2:48
Speaker 2: if they come up with the same diagnosis. And most
2:50
Speaker 2: of the time they've done. That's a very little reliability
2:55
Speaker 2: to the to the to the constructs. And even if
3:01
Speaker 2: they might have some agreement, there is obviously some level
3:05
Speaker 2: of agreement where it's not very high that people meet
3:08
Speaker 2: the criteria from more than one diagnosis almost all the time.
3:12
Speaker 2: So that's starting. I'll just give one example. In my
3:15
Speaker 2: own air of schizophrenia. You need there are five basic
3:19
Speaker 2: types of symptoms, doesn't really matter what they are, but
3:23
Speaker 2: you only need two of them to get the diagnosis.
3:26
Speaker 2: So you, Paul might have let's say, hallucinations and delusions
3:31
Speaker 2: and nothing else. I might have thought disorder and catatonia
3:36
Speaker 2: and nothing else. So we have nothing in common, but
3:39
Speaker 2: we get the same diagnosis. And that's called in scientific terms,
3:44
Speaker 2: that's called a disjunctive category. In any other, any other
3:50
Speaker 2: discipline other than psychiatry, I would suggest that would immediately
3:53
Speaker 2: be thrown out as non scientific. And there's an examples
3:57
Speaker 2: like that. So that's a reliability bit and Qruestionally, the
4:00
Speaker 2: validity part is, does does a construct relate to what
4:03
Speaker 2: it's supposed to relate to, So against famous schizophrenia, if
4:07
Speaker 2: there is such a construct, it's supposed to have a
4:09
Speaker 2: clearly identifiable biological cause, which it which it doesn't. It's
4:14
Speaker 2: good to have a consistent prognosis or outcome, which it doesn't.
4:18
Speaker 2: It has to have. It has to determine what as
4:21
Speaker 2: an effective treatment, which it doesn't. So they're just not
4:26
Speaker 2: scientific constructs. I have to emphasize this does not mean
4:30
Speaker 2: I don't think people have lots of symptom. You know, yeah,
4:35
Speaker 2: I'm not seeing people because the people are telling me, oh,
4:37
Speaker 2: you say schizophrenia doesn't exist, John, or don't you realize
4:40
Speaker 2: people have this? And of course I realize it that
4:43
Speaker 2: people have hallucinations and terrifying thoughts and everything. I'm just
4:47
Speaker 2: saying it doesn't help us understand them by calling them
4:50
Speaker 2: something and then saying this thing is what's causing it.
4:56
Speaker 2: And just to finish finish off the the well, let's
5:01
Speaker 2: take depression as a more common sort of diagnosis. We're
5:05
Speaker 2: told that people we diagnose people with this thing called depression,
5:09
Speaker 2: and then we say depression is caused by this thing
5:13
Speaker 2: they have called depression. So it's like the question it's
5:18
Speaker 2: causing the depression, it's it's meaningless. It's just it's just
5:22
Speaker 2: a word. Even if it was a scientifically reliable and
5:27
Speaker 2: valid construct. The idea that these words explain anything is
5:32
Speaker 2: it's just a bit but silly. They don't. They're just descriptors,
5:35
Speaker 2: and they're very bad descriptives at that.
5:38
Speaker 3: And look that gets it there because if we compare
5:41
Speaker 3: that to the rest of medicine, like if if I
5:46
Speaker 3: go to the doctor with an issue and he tests,
5:50
Speaker 3: say he tests my blood sugar and goes, you have diabetes,
5:54
Speaker 3: or test my blood pressure, goes you have hypertension, or
5:59
Speaker 3: you know, I get screen and it's like you have cancer.
6:01
Speaker 3: So there are clear biological signatures, repeatable ones where different people.
6:08
Speaker 1: Can look at it and go yes.
6:11
Speaker 3: How many of those psychiatric conditions in the DSM have
6:17
Speaker 3: a clear, consistent biological signature virtually none.
6:23
Speaker 2: I mean it depends whether you include things like dementia
6:26
Speaker 2: and as parts of psychiatricy. If you do, clearly that's
6:30
Speaker 2: a biological yes. But practically all the diagnosis in the
6:34
Speaker 2: DSM have no biological marker to them, which is astonishing
6:39
Speaker 2: because the basis of the medical model is that it's
6:42
Speaker 2: trying to tell us that our distress, whether it's depression
6:45
Speaker 2: or anxiety or worry or craziness or whatever, it's caused
6:48
Speaker 2: by biological phenomena, biogenetic etiologies. But there is just no
6:55
Speaker 2: evidence for that. And the DSM doesn't even claim to
6:59
Speaker 2: have any biological markers for anything in it.
7:02
Speaker 1: So this is this is going to be quite confusing
7:07
Speaker 1: for people.
7:08
Speaker 3: Right, So the DSM, there are there's been a number
7:12
Speaker 3: of iterations of the DSM, the Diagnosis Statistical Manuals. So
7:17
Speaker 3: tell people about, you know, how that's created and what
7:21
Speaker 3: the changes have been over time with each release.
7:25
Speaker 2: Okay, well we're not times through the old history, but
7:30
Speaker 2: will start from the thirteen fifty two was the first one,
7:34
Speaker 2: and it was about a tenth of the length of
7:36
Speaker 2: the latest one. There was only about I think I
7:40
Speaker 2: can't remember exactly, about eight or nine constructs there. And
7:44
Speaker 2: most importantly, they were called reactions. So you had depressive reaction,
7:50
Speaker 2: who had anxiety reaction, psychotic reaction. They weren't disorders or
7:55
Speaker 2: illnesses at that point. They were understood at that point
7:59
Speaker 2: in history to be reactions to life events, and they
8:02
Speaker 2: were called that. And at that point in history, the
8:06
Speaker 2: American Psychiatric Association was run by the more psychoanalytics psychodynamic psychiatrists.
8:12
Speaker 2: After that, quite quickly after that, with the introduction of
8:17
Speaker 2: the early psychiatric drugs, the antipsychotics in the in the
8:20
Speaker 2: nineteen fifties, biological psychiatry kind of took over the American
8:25
Speaker 2: Psychiatric Association, and by the time of the scent two
8:29
Speaker 2: and they were all disorders, and they've been disorders ever since.
8:34
Speaker 2: And the DSM just gets longer and longer and longer.
8:39
Speaker 2: Here it is, here, it is today, And I don't
8:43
Speaker 2: know if I can sort.
8:44
Speaker 1: Of yeah, that's a jumping Jesus.
8:48
Speaker 2: It is, I'll tell you exactly. It is nine hundred
8:51
Speaker 2: and forty seven pages long. And as I say to
8:56
Speaker 2: my students, if you can't find yourself in here at
8:59
Speaker 2: least three times times, then you really need to get
9:01
Speaker 2: a life. And yes, it's funny, thank you, But but
9:07
Speaker 2: also what I'm trying to get across is that it's
9:11
Speaker 2: just about everything is pathologized. Yea being not being upset,
9:16
Speaker 2: being not upset enough being to upset. There's a mathematics disorder,
9:21
Speaker 2: there's naughtiness is now conduct disorder.
9:26
Speaker 1: It's opposite oppositional defiance disorder.
9:29
Speaker 2: Well, that's well, that's a good one. The difference between
9:31
Speaker 2: conduct disorder and oppositional defined disorder. Conduct disorders being naughty,
9:35
Speaker 2: oppositional defined disorder, it's been naughty and telling your teacher
9:38
Speaker 2: to f off from nate and control you. My favorite
9:44
Speaker 2: one is intermittent explosive disorder to diagnose men who are
9:49
Speaker 2: not violent all the time, but just violent vacation. It's
9:53
Speaker 2: it's I mean, it is funny, but it isn't because
9:56
Speaker 2: it's it's doing a lot of disservice to people's pathologizing
9:59
Speaker 2: people and somehow communicating to them that there's something wrong
10:04
Speaker 2: with them.
10:05
Speaker 1: Yeah, now then.
10:06
Speaker 2: Having understandable reactions to their life circumstances.
10:10
Speaker 1: So you're not the only one who's in this camp.
10:12
Speaker 3: Professor Francis, who authored the DSM four I believe, come
10:20
Speaker 3: out recently and said that he thinks that we have
10:25
Speaker 3: an over diagnosis problem and that it's ever loosening our
10:29
Speaker 3: increasing definitions is problematic. I mean, how many people would
10:36
Speaker 3: you say are in that camp in terms of you know,
10:39
Speaker 3: you've get your finger on the hilts on this.
10:41
Speaker 2: It's very it's very hard to put a number on
10:43
Speaker 2: it or I mean Alan, Alan certainly did predict to
10:49
Speaker 2: one of the biggest expansions, which is adult ADHD, because
10:54
Speaker 2: the ADHD until the lasts used to be only for
10:57
Speaker 2: children and then suddenly they decided, oh no, it's an
11:01
Speaker 2: adult disorder as well. And we've all seen the massive
11:06
Speaker 2: expansion in people trying to get ADHD diagnosis, people diagnosing
11:09
Speaker 2: themselves on the internet. There's waiting lists now in Britain
11:14
Speaker 2: and it's probably the son elsewhere not to get treatment
11:17
Speaker 2: trade DHD. There's nobody can get near that, and waiting
11:21
Speaker 2: to get the diagnosis, waitingness and people paying private people
11:27
Speaker 2: to give them the diagnosis. And I think in a universities,
11:31
Speaker 2: for instance, we have thirty of our students. They're now
11:37
Speaker 2: believing that there is something wrong with them. There's a
11:39
Speaker 2: whole neurodivergence which is suddenly developed out of nowhere. And
11:46
Speaker 2: again I think we're it's the same because we're often
11:50
Speaker 2: pathologizing things where people actually need some help to fix
11:54
Speaker 2: some of the things that are going on for them,
11:55
Speaker 2: rather than have them apply this label to themselves and
11:58
Speaker 2: telling themselves, oh help, so I can't do anything about this.
12:02
Speaker 2: I've got this got this thing so the diagnosas media
12:06
Speaker 2: esterday is off the scale, and also autism and that
12:11
Speaker 2: that spectrum as well. I've been over massively over diagnosed
12:14
Speaker 2: and over medical lives.
12:15
Speaker 3: So I got I got that I was being interviewed
12:21
Speaker 3: on a podcast, and I'd say, it's something that caused
12:24
Speaker 3: a massive stirry, and I mean, this is clearly an
12:28
Speaker 3: emotive topic, the whole diagnosis thing. And I pointed out
12:33
Speaker 3: that if you're born in the youngest part of the year,
12:38
Speaker 3: the youngest twenty five percent of the year, you are
12:41
Speaker 3: thirty eight percent more likely to be diagnosed with ADHD
12:46
Speaker 3: than if you're born late in the year. And you know,
12:51
Speaker 3: some people were like, oh my god, and lots of
12:53
Speaker 3: people started attacking me and stuff like that on social media.
12:57
Speaker 3: But that is just scientific fact. And it's often that
13:02
Speaker 3: that little Johnny is just six months younger than his peers,
13:06
Speaker 3: and it's not a tentive a name. I think the
13:09
Speaker 3: issue with boys is getting young boys to sit down
13:13
Speaker 3: all day long and try and rope learn stuff. It's
13:16
Speaker 3: just it's counter intuitive to buy they're designed well.
13:21
Speaker 2: You could ask what's wrong with the little boys who
13:23
Speaker 2: do sit there passively true to their chairs, not not
13:27
Speaker 2: wanting to get up and run about and do this
13:29
Speaker 2: thing that children ought to be doing. I mean, I
13:31
Speaker 2: mean that's been a bit facetious and simplistic, but there
13:36
Speaker 2: is a major, major problem the other but the other
13:39
Speaker 2: thing that's sort of motivating perhaps teachers to go along
13:42
Speaker 2: this room. If you can get kids diagnosed with the ADHD,
13:45
Speaker 2: you get extra resources into the into the classroom.
13:48
Speaker 1: You do get extra resources.
13:51
Speaker 3: Sorry, the teachers get extra resources, and the individuals actually
13:57
Speaker 3: get some some extra breaks, time on exams, those sorts
14:01
Speaker 3: of things, and they get.
14:03
Speaker 2: Some people yeah, which some people need. Yes, yeah, absolutely,
14:06
Speaker 2: I'm not saying that, And I'll get a taxis I'm
14:08
Speaker 2: sure for saying this over diagnosis, because people the attraction is.
14:17
Speaker 2: I actually say to my students right at the beginning
14:21
Speaker 2: of any lectures about mental health, so I suggest you
14:24
Speaker 2: all make your own diagnosis up now, don't care what
14:28
Speaker 2: it is, and then whenever you do anything self defeating
14:33
Speaker 2: or ridiculous or the rest of your life, you will
14:34
Speaker 2: have an explanation for it. And I tell them, minus
14:37
Speaker 2: squirkly Bob disorder. And how do I know I've got
14:40
Speaker 2: squirkly bob disorder? Well, I do the sorts of things
14:42
Speaker 2: that people with squirkly bob disorder do, and I list
14:46
Speaker 2: some of my failings, and I've got a perfect explanation
14:50
Speaker 2: for every every time. I don't have to do anything
14:52
Speaker 2: to try and change it, and nobody can give me
14:55
Speaker 2: a high time. It's it's a silly and cheap way
14:57
Speaker 2: of trying to make it make a point, but that
15:02
Speaker 2: the other problem with this overdiagnosed with radio is that
15:05
Speaker 2: people with real, real problems, yes and set as advice
15:09
Speaker 2: to autism. I mean, people with real autism really need
15:14
Speaker 2: a lot of help, and to have ten twenty percent
15:17
Speaker 2: of people what's the right word, but believing that they
15:21
Speaker 2: have autism Anita when they actually don't. They have something
15:25
Speaker 2: some very sort of weak, minor version of it, or
15:30
Speaker 2: some symptoms vaguely related to her and might need a
15:34
Speaker 2: better help. But it's not real autism, and it's so
15:36
Speaker 2: it's taking services away from people who really needia. But
15:40
Speaker 2: it's clearly an attractive thing. It's happening, you know, so
15:43
Speaker 2: many people find this a helpful solution or a helpful
15:48
Speaker 2: way to think about life's difficulties. It's attractive, isn't it.
15:52
Speaker 2: I mean it's like you've got an explanation, you've got
15:56
Speaker 2: a reason for not doing anything about it. Hopefully get
16:00
Speaker 2: a bit of sympathy and so but it's but it's
16:04
Speaker 2: in many cases it's just not real.
16:08
Speaker 3: And so you're talking about obviously that the continuum here,
16:11
Speaker 3: and and I think it's not just autism or adios D.
16:16
Speaker 1: It's also depression, it's anxiety.
16:18
Speaker 3: It's it's people who would be on the much milder
16:22
Speaker 3: end of the scale, were were people like you would go, well,
16:26
Speaker 3: actually you don't have a disorder, you're just having a
16:29
Speaker 3: reaction to to a life event. But but they are
16:34
Speaker 3: then taking up resources for people with severe depression, severe
16:40
Speaker 3: ADHD who can't actually get in to get the help
16:44
Speaker 3: that they need. I mean in Australia that the waiting
16:47
Speaker 3: list to see a psychiatry or psychologist is crazy. And
16:52
Speaker 3: so that there's there's that side of the problem as well,
16:55
Speaker 3: isn't it that then these mental health resources and help
16:59
Speaker 3: that's out are for people who really need it, that's
17:02
Speaker 3: just got spread so thin. Then the other point that
17:07
Speaker 3: you bring up is really important that getting a liable
17:12
Speaker 3: in some people can cause a lack of agency. And basically,
17:17
Speaker 3: I have this thing and you blame everything on this
17:20
Speaker 3: thing and actually don't go and do the thing. Do
17:23
Speaker 3: the things that you need to do. For instance, we
17:27
Speaker 3: know with depression exercises way more effective than SSRI medications.
17:36
Speaker 3: You know, there's a number of other things you could do.
17:38
Speaker 3: Getting your vinomin d up is actually quite effective. Creating
17:43
Speaker 3: and taking creating I don't know if you saw, but
17:45
Speaker 3: creating is quite effective as an antidepressant, and it enhances psychiatry.
17:52
Speaker 3: Our psychological interventions are therapy by over fifty percent, you know,
17:57
Speaker 3: having good sleep, all of those things. How big a
18:01
Speaker 3: problem do you think having a lebelase.
18:05
Speaker 2: For some people? I mean, numerically, it's getting it's it's
18:08
Speaker 2: getting really bizarre. I mean the figures in Australia the
18:11
Speaker 2: same as here. We have just take depression. We have
18:14
Speaker 2: now had one in six of our adult population on
18:18
Speaker 2: antidepressants for having depressive disorder, or even higher if you're
18:23
Speaker 2: a woman, or if you're a sixty or if you're
18:26
Speaker 2: living in a poor area, so where I am in
18:29
Speaker 2: New and one of the poorest borroughs in London, if
18:32
Speaker 2: you're a woman over sixty, probably got a fifty percent
18:35
Speaker 2: chance of being on antidepressants orbum major depressive disorder. So
18:41
Speaker 2: that's that's bizarre. So the numbers are getting quite quite
18:47
Speaker 2: ridiculous of the number, you know, the numbers of people
18:50
Speaker 2: with a supposed mental illness or psychiatric disorder.
18:56
Speaker 3: I saw Mark Horra Whiz you you know MARKR. Wentz
18:58
Speaker 3: very well in viewers. He's been on the podcast. He's
19:03
Speaker 3: a bit of a trial blazer like you. I saw
19:06
Speaker 3: him in an interview saying that with the latest edition
19:10
Speaker 3: of the DSM, about eighty five percent of adults qualify
19:15
Speaker 3: for having some sort of a disorder.
19:18
Speaker 2: Sounds about right. I'm not sure we've actually done that.
19:21
Speaker 2: Horry revived with that figure. I would have even put
19:23
Speaker 2: it slightly higher. But I mean literally, I defy anybody
19:29
Speaker 2: to read that from cover to cover and not find
19:31
Speaker 2: themselves seriously at least once I'm in there on four
19:35
Speaker 2: or five. I'm not telling you which pages.
19:37
Speaker 3: Someone, right, I probably on numerous I would have made.
19:42
Speaker 2: It's very hard to get through it with that farm.
19:48
Speaker 3: Sorry, it's probably, But I mean, I mean, whether the
19:52
Speaker 3: numbers eighty percent, eighty five, seventy, I mean, whatever that
19:55
Speaker 3: number is, it's hard to get away from the idea
20:01
Speaker 3: that the mental health industry is minting patients like central
20:07
Speaker 3: banks mint money.
20:09
Speaker 2: Well, I think if you do follow the money, you
20:13
Speaker 2: always come up with some interesting learning, don't you. So
20:18
Speaker 2: in this case, you follow the money and you follow
20:21
Speaker 2: drug company money, who are extraordinarily influential in the field
20:26
Speaker 2: of mental health, and they fund a lot of the research,
20:31
Speaker 2: and the majority of the research into psychiatric drugs certainly
20:35
Speaker 2: is funded by drug companies. They fund psychiatric associations, especially
20:41
Speaker 2: the American psychiatric associations, heavily enmeshed with the pharmaceutical industry.
20:48
Speaker 2: They provide people onto the DSM committees. The majority of
20:52
Speaker 2: people who sit on the DSM committees are drug company
20:54
Speaker 2: funded psychiatrists. Really, I mean, the influence cannot be exaggerated.
21:02
Speaker 2: And they are there to do their job in a
21:06
Speaker 2: way you can't blame them. Their job is to increase
21:09
Speaker 2: return to their shareholders. And how do you do that
21:11
Speaker 2: some more of your product. And how do you do
21:13
Speaker 2: that in this field is you convince the public and
21:16
Speaker 2: the psychiatrists and other doctors that human distress is not
21:22
Speaker 2: ordinarily human distress responding to distressing things. It is a
21:27
Speaker 2: symptom of a biological illness. And the fact that there's
21:30
Speaker 2: no evidence for biology based causation doesn't matter. They are
21:36
Speaker 2: extraordinarily effective marketers and they do their job very well,
21:41
Speaker 2: so yes, we should hold them to account. But the people,
21:45
Speaker 2: the real problem is the professional psychiatry, which has sold
21:49
Speaker 2: its soul to the pharmaceutical companies. It has forgotten what
21:53
Speaker 2: a proper boundary is between a medical scientific discipline and
21:58
Speaker 2: a profit base organization or set up companies. There has
22:03
Speaker 2: to be a very strong boundary there and that has
22:07
Speaker 2: collapsed about twenty twenty five years ago. So that's It's
22:13
Speaker 2: a simplistic explanation for all this over diagnosis, But we
22:18
Speaker 2: have to acknowledge on the other side, does us every
22:22
Speaker 2: human being many of us would prefer a quick fix. Yeah,
22:27
Speaker 2: plistic explanation. I mean, look, look, Paul, Yeah, I hear
22:31
Speaker 2: your difficulty, and the problem is you've got X disorder,
22:33
Speaker 2: and here's the pill that's going to fix it. Would
22:36
Speaker 2: you like to do that or would you like to
22:38
Speaker 2: sit and talk to me for hours and hours about
22:41
Speaker 2: lots of messy stuff in your life and then eventually
22:44
Speaker 2: figure out how you can make some changes in your life.
22:46
Speaker 2: To know I'm exaggerating the two extremes of course, no,
22:50
Speaker 2: I'm just how attract we it's attractive to us and
22:53
Speaker 2: we we fall for in our millions.
22:57
Speaker 1: Yeah, that is.
22:59
Speaker 3: Let me a quick comparison for people, you know, that
23:03
Speaker 3: immeshment of the drug industry with people on the DSM.
23:10
Speaker 3: You know, there's been a massive outcry in the United
23:13
Speaker 3: States because it was identified that I think there's around
23:19
Speaker 3: twenty nine people on the committee that creates the Dietary
23:23
Speaker 3: Guidelines and something like twenty three of them have strong
23:28
Speaker 3: ties to the food big food industry, right, which is
23:32
Speaker 3: clearly wrong, but exactly like what you talked about. And
23:36
Speaker 3: then in Australia a number of years ago, Dietitians Australia
23:41
Speaker 3: were outed by an investigative journalist, Marianne Demasi, for taking
23:46
Speaker 3: money from the Australian and Breakfast cereal manufacturers and to
23:51
Speaker 3: promote their product, and.
23:53
Speaker 1: They then had to change things. People went, this is.
23:56
Speaker 3: Just wrong, and they were called out and they had
23:59
Speaker 3: to change. But it's obviously ongoing. In psychiatry, now we've
24:06
Speaker 3: talked about you've talked about the issues with diagnosis. So
24:11
Speaker 3: if they're not going to diagnose people, if you're saying
24:15
Speaker 3: diagnosis or problematic, what should actually replace them? Should we
24:19
Speaker 3: be going back to the original DSM where it talked
24:23
Speaker 3: about reactions to life events or is there is there
24:27
Speaker 3: something else in addition to that, what's your thoughts on
24:30
Speaker 3: the way ahead?
24:33
Speaker 2: Well, I think I mean in a way it sounds simplistic,
24:37
Speaker 2: in a bit common sense, but it's the The alternative
24:42
Speaker 2: is to find out, to explore with the person in
24:45
Speaker 2: front of you, what's going on in their life and
24:48
Speaker 2: the connection between their difficulties and those events in their life.
24:53
Speaker 2: I have a current events or events from their childhood
24:55
Speaker 2: or whatever. I mean. As psychologists, you know, we like
24:59
Speaker 2: to have fun words for it, so we call it
25:01
Speaker 2: a psychological formulation. But all that is really is getting
25:05
Speaker 2: someone's life history and trying to make sense of their
25:08
Speaker 2: current problems in light of their current circumstances and past
25:11
Speaker 2: events in their life. It's not rocket science. It's almost
25:15
Speaker 2: the sort of thing you do when you meet a
25:17
Speaker 2: new friend and you want to get to know them.
25:19
Speaker 2: You ask the questions about their about their life, about
25:22
Speaker 2: what they like to do about any difficulties, et cetera,
25:25
Speaker 2: et cetera. It's a bit more structured than that, but
25:29
Speaker 2: and that's that's the that's the alternative, and it's not.
25:32
Speaker 2: It's not difficult, and it's what many mental health professionals do,
25:36
Speaker 2: so counsels and many psychologists. The problem with that is
25:42
Speaker 2: that if one of the problems with that is you
25:45
Speaker 2: don't have a labor or a diagnosis and you can't
25:47
Speaker 2: perhaps get the insurance coverage for it, you have to
25:51
Speaker 2: call it something to get to get payments. Sometimes that
25:56
Speaker 2: this this more obvious sense of approach doesn't always match
25:59
Speaker 2: up with funding streams. But that shouldn't that shouldn't mean
26:05
Speaker 2: that we don't that we don't do that. And the
26:08
Speaker 2: other thing we need to do is stop only looking
26:11
Speaker 2: at the individual in front of us, try and look
26:14
Speaker 2: at the system around whether it's their family or their workplace,
26:16
Speaker 2: or the school the kids attending, or whatever, trying to
26:19
Speaker 2: make sense of it in a social context, because you know,
26:23
Speaker 2: our difficulties don't arise from inside us their eyes, from
26:27
Speaker 2: our interactions with people around us.
26:29
Speaker 1: We all know that.
26:30
Speaker 2: We know, we know that we we get distressed when
26:33
Speaker 2: people do distressing things to us or we see distressing.
26:37
Speaker 2: We know it, so we just me it's really common sense,
26:41
Speaker 2: just get to know the person and together help them
26:43
Speaker 2: figure out a what the problem is, be what's causing
26:46
Speaker 2: the problem, and then the important thing, of course, see
26:49
Speaker 2: what changes might might help, whether that's exercise, dietary a
26:55
Speaker 2: couple doing some work on the way you think about things.
26:58
Speaker 2: There's a whole different many, many different approaches, and no
27:02
Speaker 2: one think works for everybody obviously, so let's as SIMPLI
27:07
Speaker 2: to you. But it's kind of it is.
27:09
Speaker 3: You know, it's simple, but not easy, right, It's about
27:15
Speaker 3: doing that work. And so so let's then do the
27:18
Speaker 3: comparison here and you know, you throw out those statistics.
27:22
Speaker 3: I think it's one in six in the UK Industryian
27:26
Speaker 3: New Zealand it's between one and six and only seven
27:28
Speaker 3: adults on an on an antidepressant. And you've done a
27:33
Speaker 3: lot of research in this area around the side effects
27:38
Speaker 3: of this. I think the average length of time that
27:42
Speaker 3: people are on them are is about two years something.
27:45
Speaker 3: Correct me if I'm wrong on that. But so, so
27:49
Speaker 3: what are some of the problems, Because you've actually researched
27:53
Speaker 3: real people who have been on these medications and asked
27:58
Speaker 3: them about their symptoms, either reactions the side effects to it.
28:04
Speaker 3: So what sort of things tend to pop up with
28:07
Speaker 3: what regularity?
28:09
Speaker 2: Okay, so the most common adverse effects of antidepressants. Probably
28:16
Speaker 2: the most common one is an emotional numbing so people say, yeah,
28:22
Speaker 2: I don't I don't feel as depressed as I used to,
28:27
Speaker 2: but I don't feel anything about anything, so that they
28:31
Speaker 2: replaced this feeling of sadness, grief, depression quarterback that that
28:36
Speaker 2: might have gone, but still has everything else. So they're
28:39
Speaker 2: live in a completely emotionless life, which for a few
28:44
Speaker 2: weeks might not be a bad idea if you're an
28:46
Speaker 2: extreme crisis, you know, three or four people have died
28:49
Speaker 2: or something. You know, I can imagine just yeah, close
28:52
Speaker 2: me down for a few weeks for that. The people
28:55
Speaker 2: are then left in this state for years and years,
28:58
Speaker 2: So that's that's that's one of them. An alarming one
29:03
Speaker 2: is a significant number of people feel more suicidal on them.
29:09
Speaker 2: Certainly for the first few weeks, that tends to go away.
29:13
Speaker 2: So if you get through that without killing yourself, then
29:17
Speaker 2: that goes away. But the idea that a significant proportion
29:21
Speaker 2: of people should be more suicidal from a treatment that
29:24
Speaker 2: I'm supposed to treat depression is odd.
29:27
Speaker 1: That's crazy.
29:29
Speaker 3: That's like having high blood pressure and starting to take
29:31
Speaker 3: a tablet the pitch of blood pressure.
29:34
Speaker 2: Indeed, that that is what it's like. But again that
29:36
Speaker 2: the psychiatrist operates in sort of a different set of
29:39
Speaker 2: rules to the rest of medicine, or it almost operates
29:43
Speaker 2: without rules. So those are two of them, most concerning one,
29:49
Speaker 2: but the concerning adverse effects, some physiological ones, but the
29:55
Speaker 2: biggest one that's emerged in the last five to ten years,
29:57
Speaker 2: as you know, is the withdrawal effects antidepressants, which the
30:02
Speaker 2: public has been lied to for decades by the drug
30:05
Speaker 2: companies and I'm afraid, i have to say, by a
30:08
Speaker 2: psychiatric professional organization. It was only about six or seven
30:12
Speaker 2: years ago that our College of Psychiatry was insisting that
30:16
Speaker 2: antidepressant withdrawal effects are are rare and mild and only
30:20
Speaker 2: last one or two weeks, which is astonished. They took
30:25
Speaker 2: their credit as a result of our research, and people
30:27
Speaker 2: like Mark Horowitz and Joanna Moncrief, they have done a
30:30
Speaker 2: u turn and they have now put out proper guidance
30:33
Speaker 2: to say that can last for months or years and
30:36
Speaker 2: people must come off very very slowly. So that's just
30:40
Speaker 2: sort of the new part, the new learning from the
30:44
Speaker 2: last few years. It's a level of withdrawal effects. So
30:48
Speaker 2: our review of that literature shows that just over half
30:51
Speaker 2: of people, when they tried to come off antidepressants will
30:55
Speaker 2: have some sort of withdrawal effects, and of those about describe.
31:01
Speaker 1: The best severe twenty five percent.
31:04
Speaker 3: Until of all people who are trying to come off
31:06
Speaker 3: are saying that the withdrawal effects are severe.
31:10
Speaker 1: Is this then?
31:12
Speaker 3: This my recognition that the withdrawal effects can be severe
31:17
Speaker 3: and they're they're much more frequent than they used to
31:20
Speaker 3: be thought.
31:21
Speaker 1: Has that has that then influenced?
31:26
Speaker 3: Has that tightened who then gets put on it?
31:30
Speaker 1: Is it filtered down to that level?
31:31
Speaker 2: Yet? Yeah? No, not yet. Every year we look at
31:35
Speaker 2: the figures in Britain and around the world and I
31:37
Speaker 2: think this must be the first year in twenty five
31:40
Speaker 2: that it doesn't increase. But that hasn't happened yet. The
31:44
Speaker 2: last year's figures, as always, it's gone up two or
31:47
Speaker 2: three four percent on the previous year. It has to
31:51
Speaker 2: platter at some point, or it has to come it
31:53
Speaker 2: has to start coming down because it just kind of
31:55
Speaker 2: the numbers are ridiculous. So I think we're I think
32:01
Speaker 2: they will. I think I think they will. I think
32:03
Speaker 2: the message is getting getting out. I mean we've had
32:06
Speaker 2: things like in Britain with the mortly de prescribing Diadeline.
32:10
Speaker 1: Yeah, well they've come in in Australia now as well.
32:13
Speaker 2: Excellent, Well Mark is you know, Australia should be very
32:16
Speaker 2: proud of Mark Orwitz. It's kind a wonderful, wonderful job.
32:20
Speaker 2: And he's an Aussie and.
32:22
Speaker 3: To talk us, talk us through that, so so John,
32:25
Speaker 3: So for for anybody who's listening who might resonate with this,
32:31
Speaker 3: whether they're they're on an SSRI I for either depression
32:35
Speaker 3: or they can be on it for anxiety as well. Right,
32:38
Speaker 3: and and if they're deciding that they want to get
32:41
Speaker 3: off the drug, and then what should they be doing
32:45
Speaker 3: to do they go to their GP they say they
32:48
Speaker 3: say they're under GP car right or or a psychologists car.
32:51
Speaker 3: Does that change what they should do whether they're who's
32:55
Speaker 3: currying for them? And presumably presumably then they should talk
33:00
Speaker 3: to their doctor about these guidelines if the doctor's not
33:03
Speaker 3: aware of it.
33:04
Speaker 2: Yes, so that yes, we always advise to go to
33:07
Speaker 2: the prescriber, describe your the symptoms you're having and try
33:12
Speaker 2: and get the prescriber to make a plan with you
33:16
Speaker 2: about how to withdraw very very slowly, but realistically. At
33:22
Speaker 2: this point in history, the doctors have been misinformed and
33:27
Speaker 2: about with the withdrawal effects and are quite likely to
33:32
Speaker 2: misdiagnose the withdrawal effects as a return of the depression
33:36
Speaker 2: or the anxiety. Right, So we're just in britaintly just
33:40
Speaker 2: beginning to put training programs in place to try and
33:43
Speaker 2: reach because in this instance it's more GPS and psychiatrists
33:46
Speaker 2: than just numerically terms of antidepressants. So they're trying to
33:50
Speaker 2: reach the GPS the family doctors with training. It's taken
33:53
Speaker 2: a while to get that off the ground. So the
33:56
Speaker 2: most likely outcome when people at the moment when they
33:59
Speaker 2: go to prescribe but get some help is that they
34:01
Speaker 2: won't get any help because the doctors are poorly informed.
34:07
Speaker 2: So you're then kind of left by yourself and well,
34:12
Speaker 2: I say buying said meth. Tens of thousands of people
34:15
Speaker 2: are getting good support online Facebook groups, so a lot
34:19
Speaker 2: of the you know, thousands and thousands of done, couple
34:22
Speaker 2: of studies on it, actually thousands and thousands of people
34:24
Speaker 2: supporting one another. So there is support out there, but
34:28
Speaker 2: not from professionals, which is sad. But the basic there's
34:32
Speaker 2: two basic rules, well three one very very slowly whatever
34:36
Speaker 2: that means, and what that means is that has to
34:41
Speaker 2: be sort of individualized. Don't let anybody tell you the
34:45
Speaker 2: answer is reduced by ten gram or whatever, reduced once
34:49
Speaker 2: a month, or it's not the same for nature people.
34:52
Speaker 2: So you reduce a little bit, wait and see what happens,
34:58
Speaker 2: and if the if the with all effects are tolerable
35:01
Speaker 2: and begin to fade a little bit, then you can
35:03
Speaker 2: reduce a little bit more. Bearing in mind of course
35:06
Speaker 2: that while this is going on, life is still happening
35:10
Speaker 2: something really upsetting, right, how you might need to go
35:13
Speaker 2: back up for a little while. That that's okay, that
35:15
Speaker 2: doesn't mean you've failed. But the other bit of information
35:19
Speaker 2: is that people should reduced by a percentage of the
35:23
Speaker 2: previous dose, not by you know, ten ten milligrounds, ten
35:27
Speaker 2: milligans tonel percentage, so that at the very end you
35:33
Speaker 2: are you are really reducing tiny, tiny amounts. Because it's
35:37
Speaker 2: at the end this is where people go wrong. They
35:41
Speaker 2: get very close to finishing, throw the last one and
35:44
Speaker 2: then it comes back in it. So that's I mean,
35:47
Speaker 2: it's that's trying to condense the that's a whole book.
35:50
Speaker 2: But those are the three that slowly, slowly, at your
35:53
Speaker 2: own pace and be flexible and do it by a percentage.
35:58
Speaker 2: So it's very slow at the end. And I guess
35:59
Speaker 2: the fourth one it's get as much support as you
36:01
Speaker 2: can from from family and friends, because it's for some
36:05
Speaker 2: people it's a very very difficult journey. Not everybody. There
36:11
Speaker 2: are some people who managed to throw them away and
36:13
Speaker 2: it's fine.
36:14
Speaker 3: Yeah, And I suppose the key the key thing is
36:17
Speaker 3: doing you don't you don't know until you're starting to withdraw, right,
36:21
Speaker 3: that's right.
36:22
Speaker 2: And people and I have to say, people do come
36:24
Speaker 2: out the other end, and it's it's it's it's possible.
36:28
Speaker 2: It's just I don't want to paint too bleak a picture.
36:30
Speaker 2: But it's more likely if you're very careful and go slowly.
36:34
Speaker 2: And for basically I just lay that.
36:38
Speaker 3: So let's let's start talk about what what good curR
36:43
Speaker 3: looks like. I mean, on the last interview that we did,
36:47
Speaker 3: you said something that just blew my mind, and it
36:52
Speaker 3: was that that when people are our first being, they
36:57
Speaker 3: go to a mental health professional. Think you said only
37:00
Speaker 3: about twenty five percent of the time are they asked
37:03
Speaker 3: about any trauma in their life.
37:06
Speaker 2: Did I remember that correctly? Yeah, Well that's not. Yeah,
37:09
Speaker 2: pretty much. I was talking about people who have been
37:11
Speaker 2: in mental health services finny period of time that's months
37:15
Speaker 2: or ferios. Less than twenty percent of people are ever
37:22
Speaker 2: asked and all that comes up with mental health is
37:24
Speaker 2: are ever asked about what's going on in that childhood
37:28
Speaker 2: or of adverse events? Yeah, were you staggering?
37:32
Speaker 1: No?
37:32
Speaker 3: No, I mean I'm not a mental health professional, but
37:35
Speaker 3: fuck me like that is just crazy. I mean, anybody,
37:43
Speaker 3: it's pretty clear to anybody that all of your experiences
37:48
Speaker 3: and ship how you view reality, and particularly you and
37:54
Speaker 3: we know with the developing brand, you're born with two
37:58
Speaker 3: hundred billion neurons by age of seven, probably less than that,
38:02
Speaker 3: you've lost one hundred billion in a process called synaptic pruning.
38:06
Speaker 3: I think the Jesure to say, give me a boy
38:08
Speaker 3: to the age of seven, it will give you back
38:10
Speaker 3: a man. You know, that's called the Great period of development,
38:15
Speaker 3: and that synaptic pruning is basically you're brain being shaped
38:20
Speaker 3: by experience and the environment. Like, how can how can
38:26
Speaker 3: that not be a major factor in talking to somebody
38:32
Speaker 3: about their issues? How can you not be asking about
38:36
Speaker 3: their freaking childhood?
38:37
Speaker 1: It's mad to.
38:38
Speaker 2: Me, Well, yes it is. I think I think the
38:42
Speaker 2: pruning happens a bit later, but in adolescence. But the
38:46
Speaker 2: basic point is it's right that the developing brain is
38:50
Speaker 2: of course shaped by some environment. How could it? How
38:52
Speaker 2: could it not be? But I think I mean to
38:55
Speaker 2: ask you a question, is this is the extent of
38:57
Speaker 2: the power of the dominance of that simplest medical model
39:02
Speaker 2: which permeates all Western mental health mental health systems. I
39:07
Speaker 2: think America is the worse. Australia is not far behind.
39:09
Speaker 2: I'm afraid it's my experience with is very biological. Britain's
39:14
Speaker 2: not a lot better, it's a little bit. But within
39:17
Speaker 2: each of those countries there are pockets of really of
39:20
Speaker 2: excellence where people do understand that if you want to
39:26
Speaker 2: understand someone's mental health problems, you need to understand what's
39:29
Speaker 2: going on in their life and what's going on in
39:30
Speaker 2: the past. But that's the power of the medical model
39:35
Speaker 2: at the moment. And there's other factors, of course, in
39:38
Speaker 2: terms of resources and time. It takes time to get
39:41
Speaker 2: to know somebody. It takes ten to fifteen minutes to
39:44
Speaker 2: diagnose somebody and hand out a pick what color pill
39:46
Speaker 2: you're going to.
39:47
Speaker 4: Give them, So there are resource issues as well, yeah,
39:51
Speaker 4: I mean this is this the crux of the issue,
39:54
Speaker 4: because you know, my wife Collie has just finished her
39:58
Speaker 4: Masters in counseling and a big chunk of that was
40:01
Speaker 4: about trauma informed.
40:03
Speaker 1: Care, which I know you talk about.
40:05
Speaker 3: And the fact that I think something crazy like eighty
40:08
Speaker 3: or really five percent of all psychiatric medication is prescribed
40:12
Speaker 3: by non psychiatric doctors.
40:15
Speaker 1: Is that a big part of the problem in that the.
40:21
Speaker 3: First time that they get to see somebody about their
40:24
Speaker 3: issue is that often they are not trained specifically in that.
40:30
Speaker 2: Well, I'm not sure that is a problem because I personally,
40:37
Speaker 2: and on my forty fifty years experience, I wouldn't have
40:40
Speaker 2: more faith in the psychiatrist than a GP to come
40:46
Speaker 2: up with a sensible understanding of what's going on and
40:48
Speaker 2: to pick achievement. So I don't think. I think not
40:56
Speaker 2: because of the individuals involved, but because of how they trained.
41:00
Speaker 2: Right they are they are trained to count symptoms, pick
41:05
Speaker 2: a page of the d s M and pick a
41:06
Speaker 2: color pill. That's I don't know how it takes six years.
41:09
Speaker 3: Are they not trained in trauma informed cur like council
41:13
Speaker 3: or sorry?
41:14
Speaker 2: Of course no, really, it might be there might be
41:18
Speaker 2: I don't know, maybe these days there's one lecture on
41:22
Speaker 2: it somewhere in their five or six years. I don't know,
41:25
Speaker 2: but they're certainly not trauma informed practitioners at all. Some
41:32
Speaker 2: individual psychiatrists will take themselves off and do a training,
41:38
Speaker 2: but but the average psychiatrist knows very little about about trauma.
41:43
Speaker 2: They might know how to diagnose PTSD maybe, but still
41:50
Speaker 2: they'll probably apply a pill to that. They certainly won't
41:53
Speaker 2: be training how to do trauma therapy, that is.
41:59
Speaker 1: I find that shocking. What about what about psychologists? So
42:03
Speaker 1: you were?
42:04
Speaker 3: I mean, I guess different courses of different universities teach
42:07
Speaker 3: different things. But are psychologists generally treated in trauma and
42:12
Speaker 3: formed car as part of their dealers?
42:14
Speaker 2: Yes, to different degrees. It's relatively you would say, trauma
42:18
Speaker 2: inform caa sort of ten fifteen years all now, well,
42:23
Speaker 2: the whole movement around Truman's form cave. But yes, most
42:26
Speaker 2: clinical psychology training brothers will have quite a lot about
42:28
Speaker 2: Tuman form on board nurses not so much. But it's
42:37
Speaker 2: it's coming. It's coming. So it is improving painfully, angfully slow.
42:44
Speaker 2: And yeah, I was gonna maybe have been too negative,
42:50
Speaker 2: but I don't think. I think the poem is psychiatry's
42:54
Speaker 2: power of psychiatry and it's position at the top of
42:57
Speaker 2: the hierarchy. They've they've nailed themselves to the medical model.
43:01
Speaker 2: So if if they were to admit, well, actually there's
43:03
Speaker 2: no biological causes to any of these things, they kind
43:05
Speaker 2: of lose that special right, their reason for being in
43:11
Speaker 2: charge of all the multi disciplined teams. There's actually no
43:13
Speaker 2: reason they should be in charge of at all. But
43:16
Speaker 2: they are. But they are, and they're not going to
43:20
Speaker 2: give up the biological stuff easily. I don't think it's
43:23
Speaker 2: what I do, what what it's what defines them unfortunately,
43:27
Speaker 2: and again it's certainly not as individuals. As individuals, they
43:31
Speaker 2: undoubtedly want to help and are good people. Yeah, they've
43:35
Speaker 2: been indoctrinated into this other way of thinking.
43:39
Speaker 3: So you're not criticizing the individual, criticizing the system. Right,
43:42
Speaker 3: that's correct.
43:43
Speaker 2: Yes, And so it's going to sound like a very
43:47
Speaker 2: bad joke, but some of my best friends are psychiatrists, right, Okay.
43:55
Speaker 3: Just as we puck it out and we need to,
43:57
Speaker 3: I talk about e c. T. Because it don't I know,
44:00
Speaker 3: you've done a lot of research in this area, and
44:05
Speaker 3: you've audited the use of electro convulsive therapy in England
44:09
Speaker 3: multiple times. So tell us about this, what are the
44:14
Speaker 3: problems with it? I think you talk about consent, you
44:18
Speaker 3: talk about autonomy, you talk about the impacts of it.
44:21
Speaker 2: Give us the Yeah, Well, the audits we did with
44:24
Speaker 2: I'm not sure they came up with anything new. I
44:27
Speaker 2: mean we found that about forty percent are giving it
44:29
Speaker 2: against their will under under mental health legislation, which we
44:33
Speaker 2: believe is a human rights violation.
44:38
Speaker 1: Often does this happen in medicine?
44:42
Speaker 2: Medicine, there's no other branch of medicine where you can't
44:45
Speaker 2: force people to take the cancer treatment if they don't
44:48
Speaker 2: want it, even if you know it will save their life.
44:50
Speaker 2: You cannot strap someone to a bed and force them
44:52
Speaker 2: to have cancer treatment, but you can easy to or
44:56
Speaker 2: antipsychotics for that matter, you can force people under the
45:01
Speaker 2: law to have an injection of antipsychotic medications.
45:04
Speaker 3: But is this Is this still going on because it's
45:07
Speaker 3: just like one of one flew over the fucking Cuckoosons territory.
45:11
Speaker 2: Yeah, I mean all countries have mental health acts which
45:15
Speaker 2: gives psychiatrists the right to forcibly admit people and lock
45:19
Speaker 2: them up and forcibly treat them with electricity or antipsychotic medication.
45:24
Speaker 2: And I believe in thirty forty years time, we will
45:27
Speaker 2: look back on this period and wonder what were we
45:31
Speaker 2: what were we thinking? I mean, the World Health Organization
45:35
Speaker 2: and the United Nations have both named coercive psychiatric treatment
45:39
Speaker 2: as an abuse of human rights, and it's I mean,
45:42
Speaker 2: you don't you don't need organizations like that too to
45:48
Speaker 2: point that out. It's it's so obviously there is no
45:50
Speaker 2: other group of people that can have this done to them.
45:52
Speaker 2: So that's that's a major And then as the effect
45:55
Speaker 2: of this, of the treatment itself, we were just publishing
45:58
Speaker 2: now several papers out of the largest survey ever done
46:02
Speaker 2: of ECT patients, over a thousand and their families, family members,
46:09
Speaker 2: and over half are talking about memory loss. And of
46:14
Speaker 2: those who talk about memory loss, the majority to say
46:17
Speaker 2: it lasts at least three years, which means it's permanent.
46:20
Speaker 1: Fuck.
46:21
Speaker 2: But what they're told is that, oh, yes, you might
46:24
Speaker 2: get some temporary mile memory loss for the period just
46:28
Speaker 2: around the uct. But what we're publishing is many, many
46:33
Speaker 2: accounts of people not being able to remember their childhood
46:36
Speaker 2: or the childhood of their own kids. I can't remember
46:39
Speaker 2: getting married, and these are you know, these are at
46:42
Speaker 2: the extreme end to be fair, but the majority of
46:46
Speaker 2: people are describing memory loss, and the majority of those
46:49
Speaker 2: are saying it lasted. It's lasted at least three years.
46:53
Speaker 2: That's that's really significant. There's no treatment in medicine. I
46:57
Speaker 2: don't think that could possibly be permitted once that level
47:01
Speaker 2: of adverse effect is yes, and then yeah, I mean
47:04
Speaker 2: there's other that's kind of of rescular risks. There's the
47:06
Speaker 2: risk of I mean not you're having eight to ten
47:10
Speaker 2: general anesthetics, never mind the electricity, the oh you have
47:14
Speaker 2: to have an anesthetic to general anisthetic every time. Yes,
47:18
Speaker 2: so this anesthetic has a little risk to it. But
47:21
Speaker 2: you're having ten within three weeks, within three weeks, yes,
47:28
Speaker 2: the average courses between eight and twelve. And they're space
47:33
Speaker 2: spaced up two or three times a week. So yeah,
47:35
Speaker 2: on average about ten over three three weeks. So you've
47:38
Speaker 2: got a general anesthetic, then you've got the equivalent of
47:41
Speaker 2: one hundred and fifty vaults of electricity, and then you
47:45
Speaker 2: have a grand mouse seizure ten times. And I mean,
47:52
Speaker 2: in a way you don't need research to know that
47:54
Speaker 2: this is not a good way.
47:56
Speaker 1: I'm my jaw is almost on the floor here.
47:58
Speaker 3: This is this is shocking be here, I mean, fuck it, hell,
48:02
Speaker 3: this isn't far away from when they used to have
48:05
Speaker 3: people in beds and get that little pick axe and
48:09
Speaker 3: you know, get whack into their temporal lobes and cut
48:12
Speaker 3: out a bit of their frigging temporal lobes.
48:14
Speaker 1: This is barbar I mean, how successful? Is easy?
48:19
Speaker 3: I mean there must be a reason why they're doing it, right.
48:23
Speaker 2: Yeah, Well, the reason they do it they believe it
48:26
Speaker 2: helps people. Obviously, these again, these are good people. They mean, well,
48:33
Speaker 2: how successful? Well, first of all, there hasn't been a
48:36
Speaker 2: randomized control placebo studied since nineteen eighty five. They refuse
48:43
Speaker 2: to do any randomized control trust because they say it
48:46
Speaker 2: would be unethical to withhold a treatment that they know.
48:53
Speaker 1: That's crazy a lot of minute.
48:55
Speaker 3: So the argument goes, and we don't want to test
49:01
Speaker 3: this treatment that clearly has all of these side effects
49:04
Speaker 3: because we believe it's the best treatment, and having a
49:10
Speaker 3: randomized of our control group with not having this treatment
49:14
Speaker 3: is bad for the pertient.
49:16
Speaker 2: It's correct. And I explained to them that that positions
49:20
Speaker 2: you entirely outside of science. Altogether. The whole point of
49:26
Speaker 2: siple control, as you just said, that whole point is
49:28
Speaker 2: to find out because we all believe what we do works. Yes,
49:32
Speaker 2: I believe all the psychotherapy I did well, not all
49:35
Speaker 2: of it, most of it works, but I can't prove
49:38
Speaker 2: that unless there's some sort of study. But they refuse
49:42
Speaker 2: to do this. There's only ever been ten before before
49:46
Speaker 2: nineteen eighty five, tiny studies, very flawed. Four of them
49:50
Speaker 2: found and there was a slight benefit to act at
49:54
Speaker 2: the end of treatment, and the other six found no difference,
49:58
Speaker 2: and none of them found any different and a week out,
50:02
Speaker 2: a week from the end of the last DCT. So
50:05
Speaker 2: and on this basis they continue to sell it's safe.
50:10
Speaker 2: And they they do studies, you know, they compare that
50:14
Speaker 2: to to antidepressants and ketamine and all sorts, and and
50:19
Speaker 2: that's all those results very are very mixed. There's no
50:22
Speaker 2: doubt some people get a temporary lift in mood, Paul,
50:25
Speaker 2: There's no doubt about it. And that's partly very powerful place.
50:29
Speaker 2: But you think about it, you're very, very depressed. Yeah,
50:33
Speaker 2: you've tried other things and they haven't worked. And the
50:36
Speaker 2: doctors tell here's something that we know works, and you
50:39
Speaker 2: have people in white coats, you have nurses, you have anesthetists. Yeah,
50:44
Speaker 2: ten times when you come around, your head is very
50:48
Speaker 2: fuzzy and made your headache for the first hour or so.
50:51
Speaker 2: With that fades away, then you feel fuzzy. You have
50:54
Speaker 2: the sort of euphoria that is described for most minor
50:58
Speaker 2: brain trauma and think, oh, I'm wise, fels different, and
51:04
Speaker 2: the fact that goes away a few days later. But
51:09
Speaker 2: the people, what I'm saying is people do in our
51:12
Speaker 2: in our survey we have a minority. People definitely say
51:15
Speaker 2: it help me, and some saying it saved my life.
51:19
Speaker 3: That It's interesting what you say about the placebo there
51:23
Speaker 3: are because I know from the placebo research that big
51:28
Speaker 3: pills are more effective than little pills. The capsules are
51:32
Speaker 3: more effective than pills. That the frequency that you take it,
51:36
Speaker 3: if you're told to take one once a day versus
51:39
Speaker 3: once a week, the once a day one is more effective.
51:43
Speaker 3: We know that injections are more effective, sticking needles in
51:48
Speaker 3: and is more effective. So the I guess what I'm
51:51
Speaker 3: getting at is is the the size are they are.
51:56
Speaker 3: The perceived size of the treatment affects the placebo effect.
52:03
Speaker 3: And you've just described something that is way beyond capsules
52:07
Speaker 3: and pills.
52:09
Speaker 2: It's a boat as intrusive as you can get. And
52:11
Speaker 2: as you said, the more intrusive or the larger, whichever
52:14
Speaker 2: you want to put in the treatment, they're stronger than placebo.
52:17
Speaker 2: There's nothing wrong with placebo. Placebo. It's the expectation of
52:22
Speaker 2: ho yep. And a lot of what our psychologists do
52:25
Speaker 2: is pacebo. And I'm not bothered by that. It's and
52:29
Speaker 2: as soon as you decided to do something. You know,
52:32
Speaker 2: if you've been struggling with something and you go and
52:33
Speaker 2: ask for help, you feel better immediately. Yeah, yeah, and
52:37
Speaker 2: you and you ascribe that to whatever the whatever the
52:39
Speaker 2: doctor or psychologist did. You ascribe it to that treatment,
52:43
Speaker 2: versus the fact that I've got my assa doing something
52:47
Speaker 2: and I went to see somebody and they listened long
52:49
Speaker 2: enough to decide to give me something, and I feel
52:52
Speaker 2: better now, and that's great. I mean, placebo is Latin
52:55
Speaker 2: for I please. Yeah.
52:57
Speaker 3: And I used to be I used to be critical
52:59
Speaker 3: of things and and and and that that had a
53:03
Speaker 3: you know, potentially large placebo thing, and now I might
53:06
Speaker 3: I've changed and I've gone Actually that's okay, And we
53:09
Speaker 3: should probably harness it.
53:11
Speaker 1: You know, we should probably harness it.
53:13
Speaker 3: I mean, jeez, we could talk all day about the
53:15
Speaker 3: research on placebo and but and look, look we need
53:19
Speaker 3: to start to wind up. I would imagine John that
53:23
Speaker 3: you know, you produce a lot of research, your your
53:25
Speaker 3: your your a big voice in this area. I would
53:28
Speaker 3: imagine that a lot of psychiatrists are not very happy
53:32
Speaker 3: with you, and that you're probably attacked left, right and center.
53:37
Speaker 3: And number one does that happen? And and number two
53:40
Speaker 3: what gives you the courage to keep pushing back against
53:45
Speaker 3: this system?
53:47
Speaker 2: Well, yeah, it does does happen so social media, But
53:51
Speaker 2: it happens a lot, gets quite ugly there. But some
53:55
Speaker 2: of the responses in the scientific journals, some of the
54:00
Speaker 2: attempts to discredit our research, our interestingly literally misrepresent what
54:06
Speaker 2: we said and a blah blah blah. Soh yes, it
54:08
Speaker 2: does happen. But we get a range of responses. I mean,
54:11
Speaker 2: in Britain we have a very strong critical psychiatry movement,
54:15
Speaker 2: as as a large group of psychiatrists who are as
54:20
Speaker 2: critical as I am of psychiatry. So there's a range
54:22
Speaker 2: of responses.
54:25
Speaker 1: But yes, it does.
54:27
Speaker 2: Some of our work does represent a bit of a
54:29
Speaker 2: threat to the core identity of biological psychiatry. Certainly, what
54:34
Speaker 2: gives me the courage, well, I don't feel well. I
54:38
Speaker 2: guess what keeps me going is seeing people who have
54:41
Speaker 2: been through the system themselves and who are campaigning and
54:47
Speaker 2: trying to create a better, a better mental health system.
54:49
Speaker 2: Our ECT research group of six of us, three of
54:54
Speaker 2: the team have had ECT themselves. Three women who have
54:57
Speaker 2: been through ECT. Wow, ruggle in many ways, but are
55:03
Speaker 2: determined to do what they can to reduce a number
55:07
Speaker 2: of people who go through the same thing as then
55:10
Speaker 2: and to increase the number of people that get some
55:12
Speaker 2: sort of rehabilitation, because the most shocking thing about ECT
55:17
Speaker 2: is that nobody ever gets any rehab or help for
55:21
Speaker 2: the memory loss or brain damage because you can't get
55:24
Speaker 2: that because they won't admit that it exists. And these
55:30
Speaker 2: three women are so determined that's been a joy to
55:34
Speaker 2: a joy to work with them. So they keep me going,
55:37
Speaker 2: I guess, And we are having some effects. So I mean,
55:42
Speaker 2: I think I'm on a behavior's called a partial reinforcement schedule.
55:50
Speaker 3: Yeah, look, I mean it must be very rewarding when
55:55
Speaker 3: you start to make a difference, when you see the
55:58
Speaker 3: needles start to move and you know, yeah, what what's
56:04
Speaker 3: your what's your hope for the whole mental health industry?
56:09
Speaker 1: Well, I mean, what what does good look like in
56:12
Speaker 1: your view?
56:13
Speaker 2: Well, and i know it's going to be incremental because
56:18
Speaker 2: I've been at this far too long to know that
56:22
Speaker 2: big change is not going to happen quickly. So the
56:24
Speaker 2: incremental changes towards a yeah, towards the trauma informed approach
56:32
Speaker 2: the things and really having I think the goal is
56:37
Speaker 2: for to have the biological folk have much less influence
56:43
Speaker 2: and and and for society and to understand that these
56:46
Speaker 2: are not really medical problems. That's I think that's the goal.
56:49
Speaker 2: When when we're upset by something that is not a
56:52
Speaker 2: medical problem, we don't need to go to a medical professional.
56:56
Speaker 2: We need to support one another. We need to as
56:58
Speaker 2: you say, eat better, get more exercise. And one of
57:02
Speaker 2: the most promising things happening in Britain is the is
57:04
Speaker 2: the social prescribing. So a lot of GP preposes now
57:08
Speaker 2: have a social prescribing person in the office.
57:12
Speaker 1: That's cool.
57:14
Speaker 2: Yeah, And it's not just exercises. You know, might join
57:17
Speaker 2: the chess club, do what I've done recently and joined
57:20
Speaker 2: a choir which is really makes me happy on a
57:23
Speaker 2: Tuesday evening. Just just do something, do something. So that's
57:29
Speaker 2: that's it's almost in returns of common sense. And we've
57:32
Speaker 2: got to just rid ourselves with this crippling ideology that
57:37
Speaker 2: there's something wrong with our brains if we get upset.
57:40
Speaker 2: So that's that's the goal. And we're moving very slowly,
57:44
Speaker 2: very slowly in the right direction. I think.
57:46
Speaker 1: Yeah, I think that And interesting you talked about joining acquired.
57:49
Speaker 3: I read some research recently that when when a group
57:52
Speaker 3: of humans are doing the same thing at the same time,
57:57
Speaker 3: they get that whole connection and that and they feel
58:02
Speaker 3: they feel better connected as individuals.
58:05
Speaker 1: So that you know, the obvious one is singing, there's dancing.
58:08
Speaker 3: But it reminded me of my time in the military
58:10
Speaker 3: and marching and that when when people march together in time,
58:14
Speaker 3: they feel a level of deep connectedness. And I think
58:17
Speaker 3: that's why the military do it right. So yeah, yeah, no,
58:22
Speaker 3: that's just an interesting little aside. So John, look, look,
58:27
Speaker 3: thanks thank you for you're telling you being very generous
58:28
Speaker 3: with your time.
58:32
Speaker 1: We need more. We need more John Reads in the world.
58:36
Speaker 1: We need more Juan one a Monk Crease. We need more.
58:38
Speaker 3: Mark Horowitz is in the world, and so that everybody
58:43
Speaker 3: can get the proper treatment that they that they actually
58:47
Speaker 3: need and actually have proper informed consent when whenever they
58:52
Speaker 3: go into it.
58:53
Speaker 1: So I do.
58:55
Speaker 3: I I tip my hat to you because you're doing
58:58
Speaker 3: very important work.
58:59
Speaker 1: So thank you for stam, Thank you keep cracking on.
59:03
Speaker 2: Thank you for having me appreciate pleasure