Voluntary Madness

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I like the article. I think voluntarily checking oneself in to a mental hospital to write a book about it's patient's raises some privacy concerns.

I like how the author of the review raises the point that "madness and free-will can co-exist."

To add, I agree that we are "in an age of psychopharmacologic doubt." I actually think that doctors in general, and psychiatrists specifically, add to this doubt when they fail to admit to the modest utility of many medications. When we say "you have an illness like diabetes and this pill is like your insulin" it may help with compliance, but it's not entirely true. And so when the pill eventually doesn't work to "fix" the problem then people doubt psychopharm. Moreover, I think docs should say something like "you need to take this pill AND get some therapy". I think that'd be good for patients, and thereby good for patient's perceptions of psychopharm
 
I found the whole idea obnoxious. Basically you have an Axis II personality disorder in a person with their own agenda who is sensationalizing her treatment in a system which is not meant to treat her issues. If her first psychiatrist had had the guts to tell her she had a personality disorder, and treat her accordingly, she wouldn't have had cause to write the book.


Vincent is a voyeur, a self-professed con artist with "a serial killer's people skills" and "a Schopenhauerian outlook on life," as she wrote in "Self-Made Man." If she truly thought, at the outset, that note-taking prurience would carry her through the writing of this new book, she may have gambled too much on the demon without. She's a 10-year veteran of the modern psychiatric system, beginning in her late 20s with a diagnosis of depression — which covered up a deep well of anger, feminine or not. ....

At the unfortunate cost of narrative suspense, Vincent discloses her biases early: like a growing number of Americans, she's fairly certain that America's love affair with modern-day psychiatry is nothing less than a subprime crisis, with the F.D.A., the DSM, Big Pharma and your harried family doctor in on the scam. She'll even go so far as to describe depression as "bratty rebellion," many diagnoses as "a guess" and most psychiatric drugs as "of dubious or at best limited efficacy and usually unfathomed toxicity."

...It is astounding how little it takes for Vincent to begin to recover at her last stop, a cognitive-behavioralist facility advertised for patients in mental distress but in practice a drug and alcohol rehabilitation center — a little bit of sympathy, a movement class, a therapist who finally zeroes in on the anger and breaks down the emotions around it.
 
...And so when the pill eventually doesn't work to "fix" the problem then people doubt psychopharm. ...

If we believe that we are "fixing" the problem, and fail to diagnose and treat this false belief in our patients, then we deserve the doubt. We CAN and SHOULD inform patients that we are MANAGING SYMPTOMS, not "Fixing" their "chemical imbalance".
 
I haven't read the book yet, but I heard the author talk about it on NPR. I agree that there is a lot of Axis II going on (how much identity diffusion do you need to become a man and then someone who is "insane" in order to write some books?). Obviously, as psychiatrists, we are biased to think that this woman has done some great injustice to our field. However, I think she does a greater injustice to those who are truly mentally ill. How insulting to say that a woman who is having religious delusions just needs a little more familial love. Anyway, I think we would all do well to familiarize ourselves with this material, as I fear it will seep its way into the public consciousness quite readily, along the cracks made by the recent scandals about conflict of interest and the pharmaceutical industry.
 
like a growing number of Americans, she's fairly certain that America's love affair with modern-day psychiatry is nothing less than a subprime crisis, with the F.D.A., the DSM, Big Pharma and your harried family doctor in on the scam. She'll even go so far as to describe depression as "bratty rebellion," many diagnoses as "a guess" and most psychiatric drugs as "of dubious or at best limited efficacy and usually unfathomed toxicity."

I have to say that as I read the review, I was finding myself highly annoyed with this woman as I read about some of her opinions... (Bratty rebellion?!??!?) SHE sounds like a "brat" herself!

But I also thought it might be a good book to read, even if I did find her annoying, to get some insight on the mindset of this type of person - understanding their thought processes might come in handy in working with other, similar patients.

Anyway, I think we would all do well to familiarize ourselves with this material, as I fear it will seep its way into the public consciousness quite readily.

And, yes, she may have just done a big dis-service to the mentally with many of the ideas she is promoting.

However, I think she does a greater injustice to those who are truly mentally ill.
 
I haven't read the book yet, but I heard the author talk about it on NPR. I agree that there is a lot of Axis II going on (how much identity diffusion do you need to become a man and then someone who is "insane" in order to write some books?). Obviously, as psychiatrists, we are biased to think that this woman has done some great injustice to our field. However, I think she does a greater injustice to those who are truly mentally ill. How insulting to say that a woman who is having religious delusions just needs a little more familial love. Anyway, I think we would all do well to familiarize ourselves with this material, as I fear it will seep its way into the public consciousness quite readily, along the cracks made by the recent scandals about conflict of interest and the pharmaceutical industry.

To say nothing of her occupying a needed acute care bed and utilizing scare healthcare resources in service of her narcissistic goals.

I agree--I don't mind people publicly dissing psychopharmacolgy, but the implication that other patients' illness is as ephemeral as hers gets my bile churning.
 
If we believe that we are "fixing" the problem, and fail to diagnose and treat this false belief in our patients, then we deserve the doubt. We CAN and SHOULD inform patients that we are MANAGING SYMPTOMS, not "Fixing" their "chemical imbalance".

The problem being that many of the heavy-duty and high exposure psychiatrists do claim to be 'fixing' the 'chemical imbalance'.

I have often thought of writing an autobiographical diary of experiences on various psych meds. It would be a fun project I think. 'January 1, prozac...' 'April 1, adderall...' August 1, abilify'
 
I have often thought of writing an autobiographical diary of experiences on various psych meds.

I thought about doing something like this back in my paxil days, but it wound up being something like "day 1, weird chest tightness side effect. day 4, weird chest tightness goes away. day 15, don't feel like putting gun in my mouth anymore. day 35, dizzy because I missed a dose. day 74, got a puppy." And that was pretty much it. And I was a creative writing major!

I think when people talk about how strange they feel on antidepressants, it's usually because their depression has lightened and their personality disorders have been just waiting in the midst to really show themselves.

It's almost impossible to be a writer without letting some cluster B traits rear their ugly heads. The simple act of creative writing is such a profoundly narcissistic enterprise that all memoirs should really be read with at least a modicum of distrust.
 
lol your last couple of sentences had me mocking myself. I have thus far (6 uncompleted novels now) failed to create a protagonist that wasn't me 10lbs lighter.

As for people feeling weird on antidepressants, the impression I always got was that it was a lot like a psychological lortab. i.e. you can feel the things that made you depressed are still there but you just don't care about them.

Wouldn't know. Never taken a pain pill, never been on an SSRI.
 
Does this other one, a grade school teacher in the urban education system, really need Seroquel? Vincent tells her to palm it. “You don’t need medication,” she says. “You need to change your job.”

Vincent should be prosecuted for practicing medicine without a license.
 
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