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A recent study, published in the Journal of Psychopharmacology, examined the relationship between MDMA use, empathy, and general social cognition. The results of the correlational research suggest a link between empathy and long-term MDMA use compared to users of other substances, with no harmful effects on social functioning. These findings add support for MDMA’s beneficial use in conjunction with psychotherapy.

“Investigative studies looking at the acute effects of MDMA on social cognition have reported heightened levels of compassion, trust, generosity, and empathy, mirroring the effects reported by recreational users,” write the team of researchers, led by Dr. Molly Carlyle of the Addiction Research Centre at the University of Exeter.

Photo Credit: Wikipedia Commons

A growing movement is suggesting that certain psychedelics and street drugs, such as ‘ecstasy’ or ‘molly,’ should be considered as pharmacological tools for psychological healing. Preliminary research suggests that MDMA-assisted psychotherapy may be an effective intervention for those who have PTSD, given its enhancing effects on trust, openness, and compassion. The researchers explain the proposed rationale:

“[…] the acute effects of MDMA on empathy and openness are thought to help the extinction of traumatic memories as well as overall engagement during psychotherapy, and it is hoped that this will promote long-term changes in reducing distress.”

The research organization MAPS, the Multidisciplinary Association for Psychedelic Studies, is currently sponsoring an effort to win FDA approval for MDMA’s status as a prescription medication by 2021. Similarly, psychiatrist Scott Shannon has argued that MDMA’s legalized prescription status could represent a significant shift in the medical model’s focus on chronic symptom management, in favor of personal transformation, given MDMA’s ability to catalyze therapeutic change.

Phase 2 trials for MDMA-assisted psychotherapy have indicated promising results. After only three sessions, 61% of the 107 participants no longer qualified for the PTSD diagnosis at the two-month follow-up, which rose to 68% at the one-year mark. All participants exhibited treatment-resistant PTSD beforehand, with an average of 17.8 years suffering from the condition.

Research is still in the early stages, but the FDA has granted the substance the Breakthrough Therapy Designation, which means that it shows early promise over existing modes of therapeutic intervention and that its medical status is receiving expedited consideration. Phase 3 trials are currently being conducted in locations across the U.S., as well as internationally.

The current study analyzed empathy and other social cognition factors across three different groups, totaling 67 participants. The groups consisted of poly-drug users, including MDMA, poly-drug users not including MDMA, and a group that only used alcohol. An independent-group, correlational design was used, and participants were measured for emotional empathy, cognitive empathy, and response to social exclusion.

Carlyle and associates targeted chronic users of MDMA and other substances: at least once per month in the past ten months and at least ten times across the lifespan. They hypothesized that chronic use of MDMA would result in reduced empathy and increased sensitivity to social pain, considering some previous research findings on MDMA abuse.

Contrary to expectations, however, the researchers found that the group that included MDMA use scored higher on subjective emotional empathy than the other poly-drug users, but not from alcohol users. The difference between the two drug groups was only noted with a subjective report questionnaire (the Interpersonal Reactivity Index or IRI), and not a computerized test (the Multifaceted Empathy Test or MET). They speculated that the difference might result from the IRI’s emphasis on trait empathy, as opposed to the MET’s focus on state empathy, which is more temporary and fluid.

Cognitive empathy, or mentally taking the perspective of others, did not differ on the IRI. On the MET, MDMA users were found to have increased cognitive empathy from non-MDMA drug users, but not from alcohol users.

All three groups exhibited emotional distress following a computer game-based social exclusion test, but there were no significant differences between them.

The study had several limitations. Reliance on subjective self-report measures can produce unreliable results, both in terms of reported drug use and answers on the questionnaire. Additionally, because of the correlational design, it is impossible to know whether MDMA use caused increased emotional empathy, or whether individuals with higher empathy were drawn to using MDMA.

“Based on this research it is not possible to identify whether differences in empathic processes precede or are a consequence of MDMA use, nonetheless these data strengthen the argument that MDMA may be used safely in a therapeutic setting without negative repercussions on empathy and sensitivity to social pain.”

This study adds limited and tentative support for the relationship between MDMA and prosocial personality factors such as empathy. The findings contradict previous research which identified an associated decrease in social functioning with long-term MDMA usage. These issues will become increasingly significant if MDMA is approved as a prescription medication by the FDA in the coming years.

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Carlyle, M., Stevens, T., Fawaz, L., Marsh, B., Kosmider, S., & Morgan, C. J. (2019). Greater empathy in MDMA users. Journal of Psychopharmacology, 33(3), 295-304. https://doi.org/10.1177/0269881119826594 (Link)

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From The Nation: “This surge in the suicide rate has taken place in years during which the working class has experienced greater economic hardship and psychological stress. Increased competition from abroad and outsourcing, the results of globalization, have contributed to job loss, particularly in economic sectors like manufacturing, steel, and mining that had long been mainstays of employment for such workers. The jobs still available often paid less and provided fewer benefits.

Technological change, including computerization, robotics, and the coming of artificial intelligence, has similarly begun to displace labor in significant ways, leaving Americans without college degrees, especially those 50 and older, in far more difficult straits when it comes to finding new jobs that pay well. The lack of anything resembling an industrial policy of a sort that exists in Europe has made these dislocations even more painful for American workers . . .

The precise relationship between economic inequality and suicide rates remains unclear, and suicide certainly can’t simply be reduced to wealth disparities or financial stress. Still, strikingly, in contrast to the United States, suicide rates are noticeably lower and have been declining in Western European countries where income inequalities are far less pronounced, publicly funded healthcare is regarded as a right (not demonized as a pathway to serfdom), social safety nets far more extensive, and apprenticeships and worker retraining programs more widespread.

Evidence from the United StatesBrazilJapan, and Sweden does indicate that, as income inequality increases, so does the suicide rate. If so, the good news is that progressive economic policies—should Democrats ever retake the White House and the Senate—could make a positive difference. A study based on state-by-state variations in the United States found that simply boosting the minimum wage and Earned Income Tax Credit by 10 percent appreciably reduces the suicide rate among people without college degrees.”

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From Goop: “The experience of early-childhood trauma is often defined by what you can’t consciously remember. But it’s stored in the body, which retains the memory and implicit feeling of the trauma, says therapist Marta Thorsheim. Like many other trauma therapies, her focus at the Institute for Traumawork in Norway is on finding a way to help people work through the experience of those events. Even—and especially—when its effects seem too diffuse, too far beneath the surface to actively resolve.

Developed by her colleague, German psychotherapist Franz Ruppert, the modality Thorsheim uses and teaches is called identity-oriented psychotrauma therapy. The sessions themselves are fascinating and difficult to imagine without experiencing firsthand, but they center around the idea of reclaiming your identity. ‘When people get the opportunity to express themselves and show exactly who they are, including their traumatized past—and be met with love and compassion—that in itself has a great effect,’ she says.

A Q&A with Marta Thorsheim
Q
How do you define trauma?
A

A psychological trauma, or psychotrauma, is the sum of the effects of an event that a person does not have the psychological capacity to deal with.

For example, stress reactions that normally function as a helpful warning system have to be blocked during a trauma situation to avoid further provoking an attacker. Figuratively speaking, that’s like having one foot on the gas pedal and one on the brake. The immediate solution to this dilemma is to relinquish the unity of body and psyche. Therefore, the main effect of trauma is disconnection from our self, which can inhibit our ability to handle stressful situations in a good way further on.

As adults, we have many triggers that result from our childhood traumas. These triggers can be opportunities to understand that we suffer from a trauma. However, those opportunities require a person to feel safe enough to look at the trauma, and someone to help guide them compassionately to help dissolve the pain behind the trauma layer by layer.

Q
Why does identity matter so much in your work?
A

A healthy identity is the sum of all our conscious and unconscious life experiences. Including our beautiful days and our traumatizing ones. We are not denying any part of ourselves. A healthy identity means we are integrated with our senses, our feelings, our thoughts, our memories, our will, and our behaviors. It also means that we don’t lose ourselves in relationships with others. We are not sacrificing any part of our identity to anyone else.

When we’re children, so many of our early experiences are formative. In extreme situations—and even not so extreme, because as small children, we are very vulnerable—we often have to give up parts of our identity to survive. Whether it’s violence, or rejection from a bonding person at a very early stage of development, we start to give up parts of our identity to endure. That can lead us to a trauma of identity: We start to overidentify with others, and in a way our identity can become enmeshed with the identity of, say, our mother. We end up in a state of survival identity and not in a place where we really know who we are.

Identity-oriented psychotrauma therapy (IoPT) is the modality we use to help people regain a healthy identity. The goal of it is to make a person’s trauma biography conscious, to make their surviving strategies conscious, and to empower them to integrate the split-off, traumatized parts of themselves into their healthy identity.”

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A new study suggests that the common practice of forced hospitalization for mental health concerns may be doing more harm than good. People who felt they were coerced into being hospitalized against their will were more likely to attempt suicide after being released from the hospital. This was true even after controlling for other factors that might influence suicidality.

The research was conducted by Joshua T. Jordan and Dale E. McNiel at the University of California, San Francisco, and published in the journal Suicide and Life-Threatening Behavior, the journal of the American Association of Suicidology.

Photo Credit: Flickr

Previous research has found similar results. A 2017 article in JAMA Psychiatry found that risk of suicide was 100 times greater than average immediately after being released from a hospital, and a 2016 report suggested that “adverse experiences associated with hospitalization” were responsible for the high number of post-discharge suicide attempts. Involuntary hospitalization was associated with increased risk of suicide both during the hospitalization itself and afterward.

Indeed, even the United Nations has denounced the practice of involuntary “treatment.” The UN explicitly warned member countries, including the US, that the practice of involuntary hospitalization is “prohibited” and should be “abolished” since it consists of the restraint and imprisonment of people who have neither been accused of nor convicted of a crime. The UN group clearly stated that this infringes on the rights of people with psychosocial disabilities:

“As long as mental health laws allow for the involuntary deprivation of liberty, forced treatment and forced medication of persons with disabilities, those laws are contrary to the Convention, including the right of persons with disabilities to legal capacity.”

However, this remains a common practice, especially in the US. Many mental health professionals and policymakers argue that it is necessary, if regrettable, to detain people against their will to prevent possible future harm to themselves or others.

In the current study, Jordan and McNiel looked at 905 people who were in a psychiatric hospital and followed them for a year after they were discharged. The data came from the MacArthur Violence Risk Assessment Study, which occurred between 1992 and 1995.

They found that fully two-thirds (67%) of the participants felt that they were forced into hospitalization, and 19% went on to attempt suicide after being released from the hospital. This data alone calls into question the idea that forced hospitalization is an effective treatment in preventing suicidality.

Interestingly, those who were forced into treatment were more likely to be young white women. They were also less likely to have a violent history than those who saw their treatment as voluntary.

The researchers adjusted for various potential confounding factors, such as whether they had a history of self-injury or suicide attempts, and whether they received mental health “treatment” after discharge.  The finding remained significant. Even when all these other factors were considered, being forced into hospitalization was associated with an increased risk of suicide attempts after being released.

“Some patients may feel violated, disrespected, humiliated, or dehumanized by the experience of coercion,” they write.

Despite their results, Jordan and McNiel lend support in their article  “The results of this study do not question that psychiatric hospitalization can be necessary for the safety of individuals and to the public, even when patients perceive it as coercive.”

There exists an ongoing tension between a disability rights approach and the preference of mental health professionals to retain the use of forced treatment. The results of this study call into question the effectiveness of forced treatment and add further empirical support suggesting that violating service users’ human rights in this way increase suicidality.

****

Jordan, J. T., & McNiel, D. E. (2019). Perceived coercion during admission into psychiatric hospitalization increases risk of suicide attempts after discharge. Suicide and Life-Threatening Behavior. doi: 10.1111/sltb.12560 (Link)

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In July 2018, the British government issued an LGBT action plan. This came in response to the results of a nationwide survey of LGB and T people which indicated that, among many other things, 5% of LGB respondents had been offered conversion therapy and another 2% had received it. This prompted the government to include the outlawing of conversion therapy in Britain in their 75-point action plan for improving the lives of LGB and T people. There is overwhelming evidence that LGB and T people are at higher risk of experiencing mental distress, developing mental health and addiction problems and of self-harm and suicide than the general population. In Britain we are also likely to experience discrimination within mental health services. Given this situation, why have service user and survivor activists in Britain been relatively quiet about this form of psychiatric oppression in general and this specific campaign to ban conversion therapy?

LGBT organisations and mental health professional groups have been at the forefront of campaigns to outlaw conversion therapy and provide better mental health services for LGB and T people in Britain. In 2014, the Department of Health requested that the UK Council for Psychotherapy, along with a number of other mental health professional bodies, issue a consensus statement on ‘conversion’ or ‘reparative’ therapy. They were clear that it is unethical and wrong to offer “a treatment for which there is no illness.” This position originated from the mental health establishment and LGBT activists. So is there question about survivor activism on LGB and T mental health and treatment? To date there has been little engagement between the survivor and LGBT movements despite a shared interest in critiquing and resisting the normalization project of the psy disciplines — that is, psychiatry and psychology’s clinical categorization of what is ‘normal’ and ‘abnormal’ or ‘healthy’ and ‘sick’. A common and intersectional position is yet to be developed between the two movements and their organisations.

Why might this be? Myself and Helen Spandler have been conducting an archive study about the treatment of female homosexuality in UK mental health services from the 1950s. This builds on our previous work in this area and we hope it will make a contribution to the intersecting histories of LGBT and Mad oppression. Our research has prompted us to wonder, along with US historian Regina Kunzel, if the present situation may have been influenced by the tactics of 1960’s and 70’s lesbian and gay activists in their campaigns to declassify homosexuality as mental illness.

Campaigns to depathologise homosexuality involved, as Kunzel says, “efforts to distance homosexuality from the stigma of mental illness.” For example, during the 1960’s and 70’s lesbian and gay rights activists who campaigned for declassification presented themselves as ‘Gay, Proud and Healthy’, essentially arguing that ‘gay is normal and healthy’ as opposed to ‘gay is abnormal and sick’.  Whilst this strategy may be an understandable reaction to pathologisation, despite their best intentions, were these activists falling into a psychiatric binary trap in their campaigning arguments about who should be classified as ‘sick’ or as ‘well’? In 1965, leading American Gay Liberation campaigner Franklin Kameny wrote of this tension in the lesbian magazine The Ladder, saying:

“If we allow the label of sickness to stand, then we will have TWO battles to fight — that to combat prejudice against homosexuals per se, and that to combat prejudice against the mentally ill — we will be pariahs and outcasts twice over. One such battle is quite enough.”

Similarly, in Britain, to avoid psychiatric disqualification and advance political credibility, activists such as Jackie Forster from the Minorities Research Group also promoted homosexuals as mentally normal when she wrote, “we are not sick . . . our sexual orientation does not impel us to behave in such a way to injure or distress others.” Despite the momentously important outcome of this campaigning — the declassification of homosexuality as a mental illness — this tactic implied that people with mental health problems are abnormal or dangerous and that LGB people who experience mental distress should be strategically marginalised for the greater cause.

At the 1971 American Psychiatric Association convention, Kameny and other US gay liberation activists who were seeking to remove homosexuality as a mental illness from the Diagnostic and Statistical Manual (DSM) forced the organisers to let gay men and women speak for themselves on a panel called, ‘Lifestyles of the Non-Patient Homosexual’. Here, it is important to highlight the conceptualisation of the ‘non-patient’ homosexual. At the time much of the research on homosexuality was done on ‘patient populations’, which was seen as making gay people seem more ‘sick’, but in defining the ‘non-patient homosexual’ had gay liberation activists constructed a ‘sanist’ entity in their bargaining? Was the performance of psychological normalcy a condition of the liberation of LGB people from psychiatry?

Kunzel believes that one of the key problems lies with the campaigners’ use of a “single axis of oppression relying on the spoiled health of others” where “health is not just a desired state or self-evident good, but an ideology that mobilises a set of norms, prescriptions and hierarchies of worth.” Cat Fitzpatrick and Jijian Voronka writing on contemporary campaigns to depathologise trans identities and lives have urged trans activists to be careful not to “imitate gay activists in throwing mad people under the bus in the interests of respectability.” To paraphrase the lesbian feminist writer Adrienne Rich who wrote about the oppressive power of ‘compulsory heterosexuality’, do LGB people and communities also experience the oppressive power of ‘compulsory sanity’?

Given this legacy and context, it seems necessary to ask about the relationship of UK survivor movement’s to LGB survivor history and to the contemporary social and political struggles of LGB and T communities with psychiatry, therapy and mental health. The UK survivor movement has not had a prominent role in campaigning against the contemporary religious revival of therapeutic treatment for homosexuality, or in criticizing the homophobic treatment of LGB people in mental health services. There still isn’t an adequate critique of the oppressive power of heteronormativity as it relates to the ‘psy’ disciplines (as well as in society itself) from within the movement. Those who identify as lesbian, gay, bi or queer and mad inhabit an intersectional space between the two movements, and can be marginalised in both. However, we may now be entering into a new era of queer survivor activism and politics in Britain. There are an emerging number of survivor activists, many of them younger women, many of whom identify as queer and feminist, who are challenging the ‘borderline personality disorder’ and ‘emotionally unstable personality disorder’ labels. Activists are calling the labels misogynist ‘character slurs’. If you are non-heterosexual you may well be at higher risk of being given these labels. One of the diagnostic criteria is having ‘unstable’ self-image or sense of self, interpreted by some clinicians as being indicated by sexual orientation and gender identity. New and important questions about the psy establishment’s definitions of ‘normal and abnormal’ and ‘sick and well’ are being asked.

In 1965, Kameny said that gay liberation campaigners “must argue from a positive position of health.” There are now highly compelling reasons for collaborations to argue from a critical position on health, as conceptions of health rely on clinically, socially and culturally constructed normativities that continue to oppress and exclude. Regina Kunzel reminds us that “Disability and Mad Studies help us understand health not simply as an assertion of pride over stigma, but also as a project of normativity and exclusion.” Helen Spandler and Meg-John Barker have discussed some of the complexities and commonalities between the two radical disciplines of Queer and Mad Studies to explore potential shared visions between the two. Importantly, they explain that “both Queer and Mad Studies critique dominant and culturally-accepted ways of being ‘normal’ . . . they question dominant understandings and constructions of what it means to be psychologically or sexually normal . . . they both share the idea that ‘normativities’ are kept in place through binary oppositions, where one side is privileged over the other.” Given the contemporary and intersectional struggles that exist for LGBT people who experience mental distress or receive a diagnostic label, the survivor movement and LGBT communities in Britain can stand in open solidarity to construct and argue from critical positions on health to challenge the power of psychiatrists and psychologists in determining ‘normality’ and ‘sanity’.

With thanks to Helen Spandler, Professor in Mental Health, University of Central Lancashire, UK.

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From The Conversation: “Just a few decades ago, manufacturers packaged everyday appliances with instructions on how to repair them. Now they come with danger warnings and threats that doing so will void the warranty.

Repair is discouraged by unavailable replacement parts, glued assemblies and tamper-proof cases that are difficult to open. So we discard things rather than fix them.

Much research suggests this harms more than the natural environment. It also affects our mental environment. There’s a connection between the way society treats material objects and the way it treats people.

Returning to an economy of repair could help create a kinder, more inclusive society. By mending broken things we might also help mend what’s broken in ourselves . . .

As Europe starts banning the disposal of unsold and returned consumer products, a mounting body of research shows that repair economies can make people happier and more humane.

During research for my 2017 book Tinkering: Australians Reinvent DIY Culture, I learned how material repair generates a deep sense of care, pride, belonging and civic participation.

Even solitary acts of repair involve a community of influences. Through acts of repair we experience products as expressions of our collective knowledge. Repaired products become bearers and extensions of personhood: like genomes, they carry their pasts within their presence.

By contrast, product obsolescence ‘blocks our access to the past’, argues Francisco Martínez, an ethnographer at the University of Helsinki. His research found repair was ‘helping people overcome the negative logic that accompanies the abandonment of things and people’. Repair made ‘late modern societies more balanced, kind and stronger’. It was a form of care, of ‘healing wounds’, binding generations of humanity together.”

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Two summers ago, I watched as a good friend of mine in North Carolina was involuntarily committed to a psychiatric hospital. Though he posed zero risk to himself or others, he was handcuffed, forcibly drugged, and locked in a psychiatric hospital for weeks against his will. I had experienced four involuntary commitments in my life, but witnessing him go through this traumatic experience led to me researching resources that could help him in his situation. By the end of the summer, I’d traveled out to the west coast and met with members of MindFreedom International, and I began getting involved in what I came to learn was the consumer/survivor/ex-patient movement.

There was almost a decade between my first involuntary psychiatric commitment and my learning that this movement existed. Years were spent unnecessarily stumbling along on my own, seeking alternatives, trying to find allies, but always alone in this journey and being hindered by constant self-doubt. Much like when I started getting involved in alternative education and it took a couple years before I discovered the already-existing world of self-directed learning and unschooling, I saw there was a need for a focused effort to connect those in need to the existing movements and resources that were available to them.

It was this need in mind that the Voices for Choices video series was conceived.

Voices for Choices (1 of 13) - Fighting for human rights in mental health - YouTube

This video series, which consists of 13 videos, was a collaboration between many individuals including psychiatric survivors, alternative practitioners, artists, journalists, writers, and activists. I am grateful to have been given the opportunity to be a part of this project. I want to specifically thank a few people for their work.

First and foremost, a special thanks to Sherri Huang, the Editor and Associate Producer who poured endless hours into video editing and making critical editorial decisions that steered this project in a direction that would maximize its integrity and impact. Her journalistic approach, creative vision and detailed editing skills have no doubt transformed this video series from being an amateur home video project assembled by a novice learning to use a camera for the first time into a professional, first-rate journalistic production that will change countless lives. I am incredibly grateful for the sacrifices she made with her time to bring Voices for Choices to life.

I also want to thank the team at MindFreedom International, especially Sarah Smith, who was the champion of the grant which included the Voices for Choices series. While I was a part of the brainstorming session to plan the video, it was Sarah who took the lead in organizing all the documentation and drafting the grant proposal, securing the funding, and accommodating the regularly shifting deadlines that arose from my poor planning and execution. I’m incredibly thankful for her making this project possible and being understanding in all the delays and requests for time extensions that I begged for. The Steering Committee including Cindy Olejar, Mary Maddock, Jim Maddock, Celia Brown, Ron Bassman, David Oaks, and Sarah Smith was also invaluable in navigating this long process of creating these videos and I am thankful to have had their experience and guidance.

I also want to extend a sincere thanks to the Foundation for Excellence in Mental Health, whose financial support made this project possible. While I am often skeptical that receiving funding for creative projects can potentially limit their freedom to free speech, the Foundation was incredibly supportive of our work and I’m grateful that I never felt constrained or fearful in the creative process. Thank you for believing in this project.

I want to thank all of the interviewees involved in the project: Kumail Akbari, Frank Blankenship, Erik Bray, Celia Brown, Oryx Cohen, Emily McMurphy, Sera Davidow, Janet Foner, Al Galves, Chris Gordon, Jim Gottstein, Peter Gótzsche, Chris Hansen, Jill Kesti, Mary Maddock, Hilary Melton, Grace Nichols, David Oaks, Opeyemi Parham, Ron Unger, Robert Whitaker. I want to thank them not just for their time, but specifically for their trust. It is not easy to have someone point a camera at you and ask you questions about such challenging subject matter, knowing that they will be cutting and splicing your words into a larger story. I’m not sure I have that courage and am inspired by all those who did.

I want to thank my long-time friend Mark Sturgess and his partner Adam Carver for providing the music accompaniment. I’ve wanted to collaborate on a project with Mark for years and finally found the perfect opportunity. The music in this videos really captures the emotional tone in a way that I never could have imagined. Thank you for lending your talents to this project.

Lastly, I want to thank Sean Blackwell. I first discovered Sean’s YouTube series “Bipolar or Waking Up” in 2010, just a couple years after my involuntary commitment. It was the first glimpse I ever received into there being an alternative path to interpreting my experiences. I would say that his work directly inspired the strategy behind creating Voices for Choices series nearly a decade later.

Without further ado… please enjoy Voices for Choices and share them with everyone you know! We’ll be releasing one video every week for the next 13 weeks. I can’t wait to hear what you think!

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This week on MIA Radio, we continue our series of discussions with Doctor Lee Coleman. In previous podcasts, we have discussed Lee’s views as a critical psychiatrist and the role of psychiatry in the courtroom. This time, we turn our attention to the need for action to address the inherent power held by psychiatry and how society might respond.

In this episode we discuss:

  • How language has the power to trigger associations and can lead us to not question theories that are presented to us as facts.
  • How we have come to equate psychiatric ‘treatment’ with interventions in other areas of medicine.
  • The deception behind the names of the drugs used in psychiatry such as ‘antidepressants’ or ‘antipsychotics’.
  • That society may well be blinded by language to the critical issues of the use of force and the relationship between the law and psychiatry.
  • That, ultimately, society demands that psychiatry play the role that it does and therefore we need a societal and political response.
  • That any movement to address the dominance of the medical model needs to educate the public at large and so needs resources to be able to provide that challenge.
  • How the media often provides an amplified voice for mainstream messages leading to normalisation and lack of critical questioning of such messages.
  • That we can and should partner with sympathetic media channels who are open to challenging mainstream messaging.
  • That Lee will hopefully be leading a workshop at the 2019 NARPA (National Association for Rights Protection and Advocacy) Conference in Connecticut, USA.
Relevant Links

Article – Technology and Psychiatry

NARPA 2019 Conference

YouTube – Psychiatry’s “War of the Words”

YouTube – Dealing With Powerful Opponents: Psychiatry, Government and Pharma

To get in touch, email us at podcasts@madinamerica.com

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From openDemocracy: “All over the world we’re succumbing to polarisation, tribalism and sectarian thinking. The erosion of our sense of common ground is preventing us from responding to some of the toughest and most urgent challenges we’ve ever faced, like climate breakdown, hyper inequality and mass extinction.

Whether we manage to find our way through depends primarily on what goes on inside our minds – on whether we’re able to manage our mental and emotional states at a time of extraordinary turbulence; whether we reach for the right stories to explain what’s happening at this moment in history; and above all, whether enough of us can see ourselves as part of a larger ‘Us’ instead of a ‘them-and-us,’ or just an atomised ‘I.’

Our future depends, in other words, on collective psychology . . .

We usually think of the problems we’re facing in the real world – climate breakdown, mass extinction, inequality, poverty – in a different category from our crises of mental health, like our epidemics of depression, anxiety, suicide, and self-harm, especially among the young.

But actually, our inner and outer crises aren’t separate. Take depression or anxiety. We used to think that they were caused by imbalances in brain chemistry, and that the way to treat them was simply to take drugs to redress the imbalance. Now though, we’re realising that they have deep roots in how our ways of living fail to meet the psychological needs of many – and maybe most – of us . . .

It turns out that ultimately, democracy depends on citizens who can manage their mental and emotional states, feel empathy for each other, and share a sense of common identity and purpose – things in which we’ve invested next to nothing.

So right now, our internal and external crises are reinforcing and amplifying each other, creating a situation full of risk. How do we interrupt this dynamic?”

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The 2018 movie Three Identical Strangers documented the story of identical triplets Robert Shafran, Eddy Galland, and David Kellman, who were born in 1961 and were adopted away into three separate homes at six months of age as part of a secret and unethical study of separated twins, conducted by New York psychiatrist Peter Neubauer and others in the 1960s and 70s. The results were never published, and the research materials are currently stored in an archive at Yale University with instructions to keep them sealed until the year 2066. (Over 10,000 pages of “heavily redacted” material from the archives were released to Shafran and Kellman after the completion of the filming.) The triplets grew up not knowing that they had genetically identical brothers, until they discovered each other in 1980. Tragically, Eddy Galland committed suicide in 1995.

The triplets’ story lands squarely in the middle of the long-running “nature-nurture debate,” which centers on the question of whether differences in human behavior and intelligence are mainly the result of genetic influences, or whether they are mainly (or entirely) the result of environmental influences.

Interpretations of Three Identical Strangers have been mixed, with some reviewers seeing it as showing the powerful influence of environmental factors on behavior, while others see it as showing that genetic influences play an important role. Many reviewers understandably have focused on the tragic human-interest and abuse-of-science aspects of the story. My focus here is on how the triplets’ stories relate to the nature-nurture debate, in the larger context of problems in reared-apart twin research in general.1 believing very strongly in nurture. I was shocked to discover just how influential DNA is. The idea that you could make decisions in your life for reasons that hinge on your ancestors—that you can’t fight and do unconsciously—it’s freaky.” It is not clear whether Wardle changed his views on the basis of reading the behavioral genetics literature on twin studies, or on how he interpreted (or misinterpreted) the triplets’ histories and behavior.]

Single Cases of Reared-Apart Monozygotic Twin Pairs (MZAs)

Studies of supposedly reared-apart (separated) identical (monozygotic) twins are often cited as providing powerful evidence in favor of the view that heredity plays a major role in determining human behavior, including especially intelligence as allegedly measured by IQ tests. These genetically identical twins are known as “MZA” pairs, or monozygotic (identical) twins reared apart. Critics, on the other hand, have argued that “twins reared apart” (TRA) studies, as well as single-case MZA pairs reported in the popular media, provide little if any evidence in favor of genetics.

My book The Trouble with Twin Studies: A Reassessment of Twin Research in the Social and Behavioral Sciences contains a detailed critique of TRA studies, which includes the famous “Minnesota Study of Twins Reared Apart” (MISTRA), performed by Thomas J. Bouchard, Jr., Matt McGue, Nancy Segal and others between 1979 and 2000. Although Bouchard and colleagues published some of their results, they have always denied access to potentially critical independent reviewers to inspect and possibly reanalyze the raw data and life history information on the twins they studied. (My 2018 full analysis of Bouchard’s Minnesota twin study can be found HERE.)

Single-case “cherry-picked” anecdotal stories of allegedly similarly behaving MISTRA MZA twins or triplets, such as the “Jim Twins,” the “Fireman Twins,” “Oskar Stöhr and Jack Yufe,” and the “Three Identical Strangers” have been reported ad nauseam in the media and by the researchers themselves since the late 1970s. According to Wikipedia, cherry picking is “the act of pointing to individual cases or data that seem to confirm a particular position, while ignoring a significant portion of related cases or data that may contradict that position.” These stories, which are often used to sell the false ideology of genetic (biological) determinism, have entered the public imagination in ways that academic research results never could. As science writer and MISTRA critic John Horgan put it, “These tales of separated twins serve as a powerful rhetorical device, much more so than the statistical analyses and heritability figures.”2 Behaviorally dissimilar MZA pairs usually are not discussed in media reports or in textbooks.

Cohort Influences on Twins’ and Triplets’ Behavior

Although rarely mentioned by journalists or textbook authors, MZA pairs, and identical triplets such as Shafran, Galland, and Kellman, share many non-familial environmental influences in common, and are subject to cohort effects. The cohort effect concept refers to similarities in age-matched people’s behavior, preferences, beliefs, physical condition, and other characteristics that are caused not by heredity, but by experiencing stages of life at the same time in the same historical period and cultural milieu. Twins (and triplets) are of course born at the same time, and therefore are similarly exposed to cohort influences at the same points of their lives. As behavioral geneticist Richard J. Rose pointed out in relation to the impact of cohort effects on MZA behavioral resemblance, “You’re comparing individuals who grew up in the same epoch, whether they’re related or not. If you asked strangers born on the same day about their political views, food preferences, athletic heroes, [and] clothing choices, you’d find lots of similarities. It has nothing to do with genetics.”3

Age- and sex-effects alone make it likely that genetically unrelated same-sex strangers born in the same year would think and behave much more similarly than would genetically unrelated opposite-sex strangers born decades apart from each other. Males and females, as common sense tells us, are socialized to behave and think differently, meaning that same-sex pairs—which MZAs always are—will behave and think more alike for this reason alone.

Even hypothetical MZA pairs or triplets that were separated during the first few months of life, who never met each other, and who spent their entire lives not knowing that they had a twin, share many of the following 31 prenatal and postnatal non-familial behavior-molding environmental influences:

  1. Prenatal (including common prenatal exposure to toxins and other influences)
  2. Postnatal healthcare
  3. Postnatal nutrition
  4. Postnatal exposure to environmental toxins
  5. Birth cohort (same age)
  6. Gender cohort (same sex)
  7. Developmental stage
  8. Striking physical resemblance, including facial appearance and height
  9. Adoptee status (with accompanying abandonment and attachment issues)
  10. National culture
  11. Regional culture
  12. Political culture
  13. Socioeconomic or class status
  14. Ethnic/racial
  15. Language
  16. Religious (defined in part as “a cause, principle, or system of beliefs held to with ardor and faith”)
  17. Oppression, racism, discrimination, or privilege on the basis of common racial or national background, gender, SES status, language, religious beliefs, disabilities, political beliefs, etc.
  18. Climate/Weather
  19. Shifting gender roles and increased career opportunities for women
  20. Age at puberty onset or menarche
  21. Diet/nutrition
  22. Advertising and marketing campaigns
  23. Exposure to the mass media, Internet, social media, etc.
  24. Legal status of abortion
  25. Birth control technology and availability
  26. Selective placement status (adoption)
  27. Teaching methods and technological advances in education
  28. Exposure to similar music and lyrics
  29. Advances in medical technology and medical treatments
  30. Advances in cosmetic surgery technology
  31. Advances in technology designed for people with disabilities

Psychologist Susan Farber noted in her 1981 book, Identical Twins Reared Apart: A Reanalysis, that MZA pairs are “not so much similar to each other as they are similar to people of their eras and SES.”4 Although she was referring to twins’ dental issues, this observation applies to IQ and behavioral similarity as well.

Although even perfectly separated twins and triplets grow up sharing many non-familial environmental influences in common, in the famous MISTRA study the researchers’ conclusions in favor of genetics were based on the crucial yet completely false assumption that “all [behavioral] resemblance between reared apart relatives is because of shared genetic factors,” and they encouraged the journalists reporting on the twins they supplied to accept this completely false assumption.5 As I wrote in a previous article, journalists’ and researchers’ presentation of individual cherry-picked MZA pairs and triplets in support of genetic theories of behavior has been one of the major “scientific” smoke-and-mirrors deceptions of the past half century.

Peter Neubauer and Colleagues’ “Secret Study”

The purpose of what journalist Lawrence Wright called Neubauer’s “secret study” was to investigate sets of genetically identical twins and triplets that were placed into homes of differing socioeconomic status (SES), and then to study and test them as they were growing up. It appears that these twins and triplets were separated for research purposes. (Neubauer, who died in 2008, denied that they were separated for this purpose.) Adoptions were made by Louise Wise Services, which arranged for the adoption of children into Jewish families in the New York City area. Neubauer believed that if the environment (nurture) is important, genetically identical pairs or triplets placed into separate homes of differing SES would behave and test differently. If heredity (nature) is important, their behavior and test scores would be similar. It is also likely that Neubauer was interested in investigating whether psychiatrically diagnosed birthmothers produced adopted-away offspring with the same condition.

The number of MZA pairs and triplets studied by Neubauer and colleagues is unknown to the public because the study was never published, but it is likely that five to eight sets were involved. Due to the rarity of such pairs, only a small handful of reared-apart twin studies have been performed, and this was the first to attempt to identify and study twins from the first months of life to adulthood.

False assumptions

In addition to its harmful and unethical aspects, the logic of the study was amazingly misguided because, as we have just seen, social class is only one of at least 31 potential non-familial environmental influences shared by MZA twins and triplets. As a Freudian psychoanalyst/researcher initiating the study in the heyday of psychoanalysis, Neubauer by training believed that mothering and the family environment were major factors determining human behavior. As he wrote in his 1990 book Nature’s Thumbprint: The New Genetics of Personality (co-authored by his son Alexander Neubauer), the purpose of the study was to assess “the influence of the environment on the child, and by environment we meant, primarily, the mother’s relationship with the infant.”6 Psychologist Lawrence Perlman, who was a research assistant in the study, stated in the movie that “we were interested in differences in parenting.” Strict Freudian analysts and psychiatrists believe that psychological problems and personality are mainly the result of how a child’s innate “drives” and “infantile sexuality” are frustrated or satisfied in the family environment, and they often overlook, and at times attribute to “fantasy,” the direct effects of abuse, trauma, poverty, social oppression, and neglect.

Nature’s Thumbprint was not mentioned in Three Identical Strangers even though in it, Neubauer discussed his study and described how his results, and recent behavioral genetic research, had led him to the position that “genes…play a vital role in dimensions such a temperament, perception, emotion, and both physical and emotional illness.” He wrote that “much of what we call personality has an underlying genetic foundation” (italics in original), and that “we can now say that much of what becomes personality is intrinsic to the child from the start—in other words, predisposed by natural inclination.”7 In reaching this conclusion, Neubauer committed the colossal error of overlooking the numerous non-familial environmental influences on behavior that I listed above, and of assuming that MZA behavioral resemblance is caused by either (1) hereditary influences, (2) the influences of the maternal and the family environment, or (3) by a combination of both. The only behavioral genetic study that he cited in support of his conclusions was a 1988 MISTRA study of personality, which was based on a similar error.

A 1986 Publication about the Study

The movie mentioned, but did not discuss, a 1986 publication in The Psychoanalytic Study of the Child, an academic journal co-edited by Neubauer. The author was Neubauer’s colleague, the Freudian psychiatrist Samuel Abrams. Abrams began the article by reviewing the rationale for the study, and then presented a case-study of one of the pairs, “Beth and Amy.”8 No test results were provided in this article.

Abrams wrote that “several sets” of separated identical twins (MZAs) had been placed into different homes by an adoption agency. This presented “an extraordinary research opportunity” to the researchers because, for the “first time,” it would be possible to follow reared-apart identical (MZA) twins “as they grew up in different households.” Abrams believed that the study “cast a brighter light upon the nature-nurture issue: how much is owed to disposition, and how much to the environment?” He noted that previous studies of reared-apart twins had only been “retrospective” because twins were not examined until their adult years, and he briefly described other problems with these studies. This new investigation, headed by Neubauer, studied twins “within a clinical, psychoanalytic, and developmental framework,” and had produced “an extraordinary quantity of data.” This included “direct observations, films, psychological tests, parent interviews, integrated discussions, impressions, hypotheses, and findings,” which were “captured in the minutes of almost a thousand weekly conferences.” In these conferences his colleagues experienced “moments of distress when some long-cherished views about human development suddenly seemed quite vulnerable.”

Amy and Beth were placed together in a foster home at six weeks of age, and were separated and sent to different adoptive homes several weeks later. Abrams wrote that by age ten both twins had “equivalently pathological” serious mental disorders on the basis of vague behavioral patterns such as “inner-directedness,” “problems in effectively engaging persons and things,” and a “limitation in integrative capacity.” He combined these and other behaviors to highlight a supposedly new “disease entity” discovered by Neubauer, which Neubauer called “An impairment in the inherent impetus.” Among other things, this “disease” interfered with the girls’ ability to successfully resolve their “Oedipus complex.”

On the basis of studying Amy and Beth and a few other pairs, Abrams concluded that genetic factors played an important role in determining these girls’ supposedly similar behaviors and disorders. “Nature and nurture…are potentials to be realized,” he wrote, and “each exacts a continuing influence upon the other, transforming potential into shape and substance.” The behavior-shaping impact of age- and sex-effects, in addition to many other environmental influences shared by MZAs (see above), were not addressed or recognized in this article, nor was the fact that both twins shared a common prenatal and perinatal environment. As abandoned children (AKA “adoptees”), both girls experienced attachment rupture with their birthmother (which we now know has a negative impact on brain development), and both had difficulties in securely attaching to others. Although adopted children in the United States in general are at higher risk for developing psychiatric disorders than are children who grow up with their biological parents, Abrams attributed the girls’ similar symptoms in part to hereditary factors.9

Misleading Accounts

Three Identical Strangers featured an interview with Natasha Josefowitz, who in the early 1960s obtained information about what she called Neubauer’s “monumental study” in an admittedly “peripheral” way. Although she did not “do the research,” she “heard about” the findings because she was “in the office.” “I just do the hearsay,” she said. She believed that the study “would put to rest the dilemma of nature and nurture forever,” and claimed “what they found out was incredible…I did not believe that it [behavior] would be as much hereditary as it was. That was more than any of us thought.” However, this was merely her “hearsay” account based on unpublished data obtained from a tiny handful of twin pairs and triplets.

Undoubtedly, many viewers were impressed by statements from the charismatic Josefowitz that “we are moved to behaviors that we are totally unconscious about,” and that “we would prefer that we have some influence over our lives…so finding out never mind, it doesn’t matter what you do” is “disturbing” to people. The filmmakers seemed to support these claims by cutting to early 1980s clips of the triplets saying that their behavior was “ridiculously” similar, and to an MZA pair who claimed that their similar behavior “seemed to be inherited”—all accompanied by dramatic background music produced by a string quartet. Despite her “peripheral” status as someone not directly involved in the study, the film presented Josefowitz as a semi-authoritative figure with insider access to spectacular unpublished data. Whatever “hearsay” stories she may have been privy to, the results of twin studies, and the behavior of separated twins and triplets, prove absolutely nothing about genetics—the crucial question is how these results and behaviors should be interpreted.

Perhaps I should mention that when the filmmakers first contacted Josefowitz and asked her to participate in the project, according to her own 2019 account she told them that she..

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