Mark Taylor Won’t Budge

I went to see Associate Professor Mark Taylor again today. I went prepared, but was disappointed in the result. Though not surprised.

It was I who made the appointment, on my last visit to the new Woolloongabba Community Health Service building, of which the second floor is fully occupied by the Metro South Addiction and Mental Health Services (MSAMHS), supposedly a “service” to the people of Brisbane. The 2nd floor operation is effectively an outpatient clinic of the Princess Alexandra (PA) Hospital, and most of the patients were previously inpatients in one of the locked wards in Building 19.

I have been locked up many times in Building 19, usually in ‘West Wing Ward’ but also in ‘East Wing Ward’ and the euphemistically-named ‘Acute Observation Area’ (AOA) also called the High Dependency Unit (HDU). This is a double-locked ward that holds about 10 patients and is a hellish place. I was locked up there for 2 weeks in 2011, which is when I met Raghavan ‘Raghy’ Raman, who has now been appointed my ‘Case Manager’, responsible for “monitoring” my mental state for MSAHMS and recording and reporting his observations. Raghy Raman sat in on my interview with Mark Taylor, though he wasn’t present when I was last injected. This was about two weeks ago and was done by a very nice student nurse, who was polite enough to offer her hand to be shaken at the end of our encounter.

The nurse was learning to give injections in what is called the “Treatment Room”. Music and art are not among the treatments, needless to say. It is a tiny room with a set of scales, two fridges and cupboards with boxes of pre-filled depot injections, each with the name of a reluctant “client”. They now call patients “clients” to their faces but patients are referred to in the PA Hospital literature as “consumers”.

A couple of years ago Nigel Lewin, the British case manager who has been replaced by Raghy, told me that he thought I would make a “great consumer advocate”. I told him my objections to this manifestation of the “consumer culture”. I am not a consumer of psychiatric “services” or drugs – they are being forced into me by injection against my will. I am a victim and a survivor and I am also an extremely patient patient. The term patient has a long history and the term describes the attitude necessary for those who sought “treatment”.

The student nurse was nervous, so I didn’t alarm her by telling her that it was an assault. I had already told Raghy Raman, Nigel Lewin and the other case managers that I was submitting myself to be what is a monthly assault because if I refuse I will be taken back to the hospital by police, held down by security guards and injected anyway. Then I would be locked up again. For this reason I have allowed them to assault me every month for the past two years.

When I checked in at the long desk at the MSAMHS to be injected I introduced myself by saying “I’m here to be assaulted again”. The guy at the desk laughed. I’ve known him for many years and he doesn’t think I’m mad (and has told me so). He told me that Raghy was away but I’d have my injection given by the “Injection Nurse”. This was a hideous, grim woman who spends her day injecting “client” after “client” with neurotoxic drugs ordered by the doctors. She does not believe in talking to the patients, doesn’t smile or tell you her full name. She wears rubber gloves and doesn’t shake people’s hands before injecting them. On the second visit – in front of the student nurse – she asked me a few questions about my mood, eating and sleeping and recorded down my complaint about side-effects.

The student nurse was completely different in her attitude. When I told them that I was writing a book about music and the brain she said “how exciting”. She asked me if it was OK if she gave the injection and that I could give her “tips”. I told her that it was important to let the alcohol dry after swabbing the skin. “That stops it stinging”. The older nurse said “I do that too”, but she lied – the last time, when it was she who injected me she said “I won’t keep you waiting, so let’s get on with it” and hurried through the injection. I pointedly told the student to inject slowly, because that caused less tissue damage. The student nurse thanked me for the tips and extended her hand when I was leaving. There is hope for the future of nursing. But better still if they were confident enough to publicly disagree with the doctors.

I prepared for the interview with Mark Taylor by bringing with me four folders of my work. I told him I had brought some of my work to show him and prove my sanity.

“Oh good,” he said, but carried on typing, while looking at the screen and not at the folders.

I put the first one on the desk. It was my work-in-progress on psychoimmunology which I said was my short-term project.

“There’s a lot of interest in that,” he said, but he didn’t look through the 40-pages I have written so far.

I then showed him my long-term project, a book titled “Music, Instincts and Health”, telling him that I had written 350 pages so far and also had folders of research from the Internet on the topic, as well as folders of original theoretical work. He glanced at the contents and returned to his typing.

I then showed him a folder for HUB Music, including promotions of my music on Soundcloud, YouTube and Facebook. He asked me what I meant by “my music”. I explained that I had been recording my musical compositions for 30 years and had posted it on the net over many years. I told him that, however, my most watched videos on YouTube were not my music but my documentaries on eugenics and AIDS.

“I didn’t know you had researched eugenics and AIDS” he said, to my surprise. Either he has a poor memory or a selective one. In 2001 he wrote in the notes of the Alfred Hospital that my beliefs about “the eugenics of AIDS” were delusional and indicative of psychosis. He also wrote, at this time, that before I became “psychotic” I had a “paranoid and narcissistic personality”. It was a thorough character-assassination. I reminded him of this the last time we met, which was about 6 weeks ago.

“I saw you only recently” he said “A month ago. Nothing has really changed”.

I showed my the fourth folder I had brought with me, which was my current networking on Linkedin, where I have almost 6000 professional contacts around the world, from a wide range of academic disciplines including medicine and mental health. He wasn’t interested. One of numerous Mark Taylors, his own Linkedin page has only 10 contacts and he is not active on it. He has not even updated his current employment or uploaded a photo of himself.

“How have you been in your mental health?” he asked. I told him again about the fact the the injection was sterilizing me, making me salivate and making me sleep in the day. “You told me that last time”. I objected that though I told him he hadn’t budged on lowering the drug.

I told him that I had been watching YouTube clips of psychiatrists who were much more critical of the overuse of psychiatric drugs than himself. “Oh good” he said again. I named Daniel Carlat (who he had not heard of). Pat McGorry (who he had), Sami Timimi (who he had heard of but dismissed as “radical” and mistakenly thought was a woman), and Robert Whitaker. He had heard of Robert Whitaker and I told him that he was one of my friends on Facebook. “He’s not a psychiatrist, though”, he said.

“I wanted to ask you that – how much time do you spend in front of your computer?”

I knew he was trying to pathologise my behaviour. I said I spend only a couple of hours a week on Facebook but more time on Linkedin and Youtube. He said he did not follow “social media” and asked me how well known I am.

“Are you say one of the five best known people in Brisbane?”

This was another trap. He was looking for grandiosity.

“Of course not”, I laughed. “Most people wouldn’t know me from a bar of soap”.

“Do you get the recognition you deserve?” he asked, looking for evidence of me being what psychiatrists call “entitled”.

“I’m not looking for recognition, but it is nice to be appreciated”.

Conveniently forgetting his character-assassination of me in 2001, and his role in having me falsely incarcerated, Taylor said “The doctors at CFOS say you have posted things that are defamatory about me”. He said he hadn’t seen them himself but that he had been told about it by CFOS – which he pronounced as “see-fos”. This is a new organization called the “Community Forensic Outreach Service” – which I have been told by Raghy Raman is part of the health department and not the court system, but that he couldn’t tell me more about it other than that I had been referred to CFOS because he felt obliged to “escalate the matter” of my posting material about the “Queensland Health staff” on what he calls “the social media”. He is furious that I posted footage of him assaulting me in my own home on YouTube.

It was Raghy who informed me, by email and phone, that I had been referred to CFOS. I wanted to know what powers this new body had over me, and asked him who they were. He said he didn’t know and the decision to “escalate the matter” of my refusing to take down the YouTube clips was made by the “team leader” a woman called Sharon Locke. I have spoken to Locke on the phone but never met her and have now been told that she is no longer the team leader. Mark Taylor said I had refused to meet CFOS when we had last met and I told him I was prepared to talk to them on the phone or communicate with them over the net but would not come in to be interviewed (and framed, though I didn’t use the term) in the Woolloongabba Community Health Centre.

I told Taylor that Professor Pat McGorry has said that the antipsychotic drugs used to be used at 10 times the necessary dose and now are used at 2 to 3 times the necessary dose. His retort was “did you know that Pat McGorry has accepted payments from many drug companies?” I said I did. “Do you think Ibuprofen (an anti-inlammatory and alalgesic drug that is available over the counter) is over-used?”

“I’m sure it is. Many drugs are over-prescribed. The drug companies’ primary motive is money. They bribe those doctors who are prepared to accept bribes.”

“You haven’t answered. Did you post defamatory things about me?” he persisted.

I answered that I had posted things about him on Facebook, Linkedin and YouTube and explained that I had discussed his links with the drug companies, pointing to a video of him presenting his conflict of interest at a lecture in Scotland some years ago. I called it “accepting bribes”. Some people might interpret that as defamatory.

“That was about 7 years ago, and I think it is a good thing to disclose information,” he said, then saying that it was a private lecture and should not have been posted (though he knew who it was). In this clip he says, in reference to a statement by one of his psychiatric colleagues that “when it comes to industry you are either abstinent or promiscuous – you can see on which side I fall”. He then showed a slide disclosing that he had accepted “fees and/or hospitality” from 5 different drug companies. His audience laughed, but it was posted on YouTube by an audience member who wasn’t amused.

Taylor asked me if I had ever accepted a sandwich from a drug company – “that’s included in hospitality”. He also challenged Pat McGorry’s assertion that Cognitive Behaviour Therapy (CBT) should be used ahead of drugs in the treatment of psychosis, saying that “the problem is that CBT doesn’t work in psychosis”. When I contested this he claimed that it has been proved by “Cochrane”, meaning the Cochrane Collaboration. I said that I had discussed this with Peter Gotszche, the Director of the Nordic Cochrane Collaboration, who had written books about the ineffectiveness and harmfulness of psychiatric drugs including dopamine blockers and SSRI antidepressants.

“What do you hope to achieve by blocking my dopamine receptors?” I asked.

“We want you to remain stable and not have mood fluctuations”. He raised the risk of suicide. I told him that I had never been suicidal, though I lied. I have entertained fleeting thoughts of suicide on two and only two occasions in my life. One was when I was 34 and locked up at the Royal Park Hospital in Melbourne and the other time was when I was 55 and locked up at the psychogeriatric Grevillea Ward of the Princess Alexandra Hospital. In both instances it was a response to being disbelieved, locked up and drugged.

Mark Taylor said he wanted me to be “stable” over time and that he would “think about” lowering the dose. He said he didn’t want to see me for 3 months and that our time had run out. In contrast, the private psychiatrist Frank New spent 3 hours with me before writing a 13-paged report stating that he was confident that I did not have a mental illness and why he formed this well-considered opinion. But that was many years ago and the PA Hospital has been reluctant to speak to any doctors who do not agree that I am mad.

Raghy Raman stayed silent throughout the interview until I raised the fact that it was he who reported that I had “elevated speech” to Ghazala Watt, resulting in Watt, who trained in Pakistan and Britain, to abusively increase the dose of Paliperidone (ironically called Invega) from 75 to 100 mg. Raghy flew into a rage. “Why do you keep going back to this, over and over?” he shouted. “I said you had elevated mood but I retracted it and apologised. But you keep on raising this over and over. I apologised! And what I said had nothing to do with you being injected. No! The doctors make their own decisions. It had nothing to do with me”.

I pointed out that Ghazala Watt had written to the Mental Health Review Tribunal that the injection was increased “because the treating team reported elevated speech” – and that the same report recorded the “treating team” as only Watt and Raghy Raman. I also pointed out that it was Raghy that was getting angry and not me and that I have a very stable mood. I told Taylor that I am not prone to depression but have been said to have an elevated mood at times.

He said he had observed that I was talkative and laughed a lot – he didn’t need to mention that these are “symptoms” of “hypomania”, mania and mood elevation. I explained that this was my personality – I have been like that since I was a child. Though I can be shy when I first meet people I enjoy conversations and laugh a lot in conversation.

Mark Taylor had to admit that Raghy was angry so he said “we’d better end the inteview now”. He stressed again that he didn’t want to see me for 3 months. In the meantime that’s 3 more injections, each at the cost of more that $400 to the taxpayer.

Taylor said I should consider what to say at the next Mental Health Review Tribunal (MHRT). I pointed out that claiming not to be ill is immediately interpeted as “lack of insight” and that the MHRT discharges less than 5% of patients and inevitably sides with the hospitals. Losing a MHRT hearing is just another trauma. Right now I can’t be bothered appealing.

High-handed treatment by the PA Hospital

I am angry. After giving him the benefit of the doubt, despite our history, Professor Mark Taylor has betrayed my trust in him and his considered judgement. I should have been more wary – in 2001 he wrote that I had a psychotic illness when I said (and wrote) that AIDS is man-made. At the time, he opined that before I became “ill” I had a paranoid, narcissistic personality disorder. This character assassination and drugging was at the Alfred Hospital in Melbourne and I had hoped that the last 17 years would have improved Mark Taylor’s judgement and medical practice. A competent psychiatrist can ascertain whether a person is mad or sane in a few minutes, and can do it over the phone.

Last week I received a note in the mail from Raghavan ‘Raghy’ Raman who has been appointed my “case manager” since the English nurse Nigel Lewin went on long-service leave a few months ago. Lewin had been injecting me on the orders of a succession of psychiatrists at the PA since 2012, when I was locked up for 2 months for maintaining that my father was a supporter of Tamil Tiger terrorism and had worked as a lobbyist of the organization. The hospital refused to look at the evidence that I provided of my claims and put me under the authority of an Indian Tamil psychiatrist many years my junior who is known to my father.

The note Raghy sent informed me that “my” injection will be due today but that he would be on leave for two weeks. I was asked to come in for the injection, to be given by one of the other 200 staff of the MSAMHS. I was given a number to ring – that of the “psychosis team”.

I rang the number and asked to speak to Balaji Motamarri, the long-time director of MSAMHS, who also qualified in India, before coming to Australia in 1998. “We don’t have a Dr Motamarri working here”. I said that he was the director of the organization and I was put through, instead to Sharon Locke, the “team leader”. I have spoken to this woman many times in the past, and expressed my objections to the PA Hospital’s negligent, high-handed treatment of its patients, including myself. She listens and notes things down, but says she can’t comment on matters that I need to “discuss with the doctor”, including my diagnosis and need for treatment.

When I met Mark Taylor after 17 years I had 24-hours notice to prepare. I had been phoned by Raghy Raman the day before to say that rather than Ghazala Watt, I would be seeing “Dr Taylor”. I told him that Mark Taylor had been responsible for locking me up in Melbourne in 2001, and was one of the psychiatrists I had named in the Statement of Claim I sent to the hospital, but was not accepted by the courts. The hospital psychiatrists referred to this as my being “litiginous” and further evidence that I was mentally ill.

In 2001 Mark Taylor wrote that I was deluded about “AIDS, eugenics etc” and misrepresented my statement to him that my father was a supporter of Tamil Tiger terrorism, and was trying to stop me from asking him what he knew about biological warfare. Taylor wrote that I believed that my father was spreading AIDS and that he is a “biological terrorist”. He wrote that these beliefs (about AIDS, eugenics and my father) were evidence of schizophrenia and recommended that I be injected with zuclopenthixol (Clopixol) against my will under a “Community Treatment Order” (CTO). I successfully appealed against the CTO was was released from forced treatment by the Alfred Hospital, but now Mark Taylor has turned up again, and has been given power over me.

I answered Mark Taylor’s questions about me honestly but did not get a chance to show him any of the evidence of my sanity that I had carefully packed in my briefcase to show him. The opportunity never arose, since he was sitting in front of the computer screen and typing my responses to his interrogation of me. He was particularly interested in my drug intake but also asked general questions about my health. I was relieved to speak to somebody who was fluent in English and encouraged by his assessment that I was “no longer” psychotic and his promise that would consider reducing the injections.

After I expressed my concerns to Sharon Locke last week, Mark Taylor phoned me back and asked how he could help me. This is a first from psychiatrists at the PA Hospital. I said he had said he would think about stopping or reducing the injection. He agreed he had done so, but wanted to be sure that I was “stable” fiirst. I assured them that I was, and the only problem I have is side-effects from the 100 mg of paliperidone that Ghazala Watt had insisted be injected into me when my father contacted the “service” complaining about me again.

Rather than assessing my mental state over the phone, Mark Taylor said he wanted to “check with your case manager Raghy”. This is ridiculous and negligent. I have already told Taylor how Raman, who is an Indian Tamil with poor English skills, thought that the Tamil Tigers were “activists” rather than terrorists, and was clearly sympathetic to the terrorist organzation I have long been opposed to and my father supported. Today I told Sharon Locke more disturbing facts about Raghy Raman that I had not shared before, since he asked me to keep his confidence. These related to his own medical problems, including the cause of his psoriasis and hypertension. He was blaming the antihypertensives he was on for worsening his psoriasis, but I suggested that maybe stress was a common factor in both. He agreed that he was stressed, but blamed his wife’s behaviour towards him as the cause of the stress, and that there was nothing he could do about it. He then told me he expected to commit suicide when he was forced by his age to retire. This man is not in a position to judge the sanity of me or anyone else.

The injections don’t need to be reduced, they need to be stopped. It is patently obvious that I don’t have schizophrenia, if the the term is to be understood by the contents of psychiatric texts.

On Balaji Motamarri’s Directions

©2018 Romesh Senewiratne-Alagartatnam (MD)

I am writing this to express my strongest condemnation of the thinking and actions of Dr Balaji Motamarri towards me at the Princess Alexandra (PA) Hospital and Metro South Addiction and Mental Health Services (MSAMHS) of which he is the director.

I have never met Dr Motamarri, and he has refused to speak to me, even on the phone, but I have been subjected to abusive diagnosis and treatment by a series of psychiatrists at the PA Hospital and its outpatient clinics since 2002, when I was locked up 5 times under the authority of Dr Paul Schneider, who continues to work as a senior psychiatrist at the hospital to this day. Schneider was acting on the wishes of my father, Dr Brian Senewiratne, who was a long-time consultant at the same hospital and a colleague of his. My father was also a long-time propagandist and lobbyist for the Tamil Tigers (LTTE) travelling the world campaigning for the Tamil Tigers to be de-banned. He claimed that the Tigers were “freedom fighters” rather than terrorists and argued, citing the example of the Irish Republican Army (IRA), that a “guerrilla army using guerrilla tactics on guerrilla soil” could never be defeated, though the fight may go on for hundreds of years.

My father began getting me locked up in 1995, when I first publicly criticised him. A man who holds grudges, he has had me locked up numerous times since then, prevented me from earning my living as doctor, and tried to discredit me by claiming that I was “in and out of mental hospitals” (which was true, but mainly because of his insistence that I had a “serious psychotic disorder” that required “assertive treatment”). To run salt into my wounds, my father presents himself as a champion of human rights and the rights of the oppressed.

Balaji Motamarri, my father and I all have Linkedin and Facebook accounts. What I know about Dr Motamarri comes from what he has made publicly available about himself and his qualifications, rather than personal discussions with him. I have seen him once, when he was pointed out by nursing staff one weekend, when I had been locked up again in 2016. It was a weekend and he was the on-call psychiatrist for the PA. I had been locked up for more than a week and wanted to go home. I wanted to see him so that he could see for himself that I was of sound mind. He didn’t even acknowledge my presence and ignored me completely. I have not seen him since, though the Nigerian psychiatrist who had got me locked up (again on the wishes of my father) kept me locked up for a few more days, and tried to convince me that I had “paranoid schizophrenia”. I pointed out that my long-standing claims that my father was a supporter and lobbyist for the LTTE was not paranoid, it was factual. She ordered that I be injected with the antipsychotic drug paliperidone and placed on an Involuntary Treatment Order (ITO) to enable easier return to the hospital if I become “unwell” again or refuse (the abusive) “treatment”.

Balaji Motamarri’s Linkedin page indicates that he speaks Hindi and Telugu and graduated in medicine at the Andhra Medical College in 1987. His Linkedin page says he has been a psychiatrist in Australia and “Clinical Director, Psychosis Academic Clinical Unit” for 19 years and 8 months (since Oct 1998). Below this it states that he has been ‘Clincal [sic] Director” of MSAMHS since 2012. Since he has been the clinical director of the “Psychosis Academic Clinical Unit” I have been locked up and injected on more than 20 occasions, always at the PA Hospital (one of several hospitals on Brisbane’s south-side that comes under the authority of the MSAMHS).

Despite graduating (in India) some years after I graduated at the University of Queensland, Balaji Motamarri’s Linkedin and Facebook pages do not suggest that he is computer literate. He also has an almost complete absence of academic publications to his name, yet he is supposedly the clinical director of the “Psychosis Academic Clinical Unit”.  As testament to his carelessness, even when confronted with the relatively simple task of listing his experience for Linkedin he made several typographical errors (in addition to ‘clincal’ instead of clinical): He says he is now (since October 2016) the Executive Director of “Clincial Services” of “Metrosouth Mental Health Services”. He hasn’t even got his own title right. This is the “Executive Director of the Metro South Addiction and Mental Health Services (MSAMHS)”.

Balaji Motamarri has 161 Linkedin contacts, including 14 mutual contacts with me. I have about 3500 contacts, including psychologists and psychiatrists from many countries, including India. I also have contacts relevant to my other areas of interest – neuroscience, medicine, meditation, music, human rights, law, Buddhism, journalism and politics. I have posted links to my music and publications on my Linkedin page, which are available to be read by my peers, including Balaji Motamarri. I have sent him a contact request but he hasn’t accepted it yet.

The University of Queensland lists one and only one publication co-authored by Balaji Motamarri. From 2012, and published in “Current Medical Research and Opinion” it is titled “Practical guidelines on the use of paliperidone palmitate on the treatment of schizophrenia”. PubMed lists 3 other papers for which he was a co-author, all published in Australian psychiatry newsletters and all promoting long-acting injectables, like paliperidone. Since I was locked up at the PA in 2012 I have been injected monthly with paliperidone on the orders of a series of psychiatrists answering to Balaji Motamarri. They started off by saying I had schizophrenia, then revised it to “psychotic disorder – not otherwise specified” before changing back to schizophrenia. My protestations that I have never had hallucinations, am motivated and sociable with a stable mood, am well-organized, rational and logical and am obviously of sound mind has fallen on deaf ears. The psychiatrists have consistently taken the side of my father against me and declared me to be “psychotic” and “delusional” to believe that he was maliciously motivated towards me, and that he was a propagandist and lobbyist for the LTTE.

Balaji Motamarri’s Facebook page provides a window into his social life in 2010. There are only 2 postings, from 26 December 2009 “Merry Christmas to all” and from 25 January 2010, when he has posted on his wall what he intended as a personal message to his friend Manju:

“Hi Manju. My apologies for not replying earlier. As you can understand we are ‘recovering’ from our trip – the trip of ‘Telengana Bandhs’. Hyderabad has become a city of uncertain nightmares. And to add to the issue, our daughter’s school is starting in 2 days time and you know the dramas associated with this – just imagine ‘school after 10 weeks on holidays’ – what a nightmare to the parents.”

Balaji Motamarri seems to be feeling sorry for himself because his daughter has to go back to school after 10 weeks of holiday (which he claims he needs to recover from) and this is a “nightmare to the parents”. I have never had nightmares about my daughters going to school, but I have had many nightmares about being locked up by Balaji Motamarri’s unit. In these nightmares I am trying to prove my sanity but am interminably kept waiting. Sometimes I am assaulted by men with needles. Sometimes I am looking for my bed but am faced with endless corridors. My most consistent nightmare is being kept waiting in the confines of the PA Hospital. I am also uncertain about what he meant my Hyderabad becoming a “city of uncertain nightmares”. I am certain about my nightmares. They are very vivid.

Balaji Motamarri has only 182 Facebook friends, and hasn’t made any new ones in recent years. However, when he first filled in the questionnaire for Facebook he enthusiastically listed the Indian educational establishments he studied at. His Intro lists:

Works at MSAMHS

Worked at CNAHS

Studied psychiatry at PGIMER Chandigarh

Studied MBBS at Andhra Medical College, Visakhapatman, India

He also includes three high schools, including one in Chennai, where he matriculated in 1979 (before starting medicine in 1981).

 

Everybody should be treated with respect, but seniority is an important concept in society and in the medical and academic hierarchies. One is expected to respect ones seniors, as one is expected to respect ones elders. This has a long tradition in the West as well as the East (including India). The MSAHMS boasts that it provides “respect” as ones of its core values. I matriculated in 1978, winning the Tyrwitt Cup for best academic student at the Church of England Grammar School in Brisbane. I was working as a young doctor looking after desperately sick children and at the Royal Children’s Hospital and Prince Charles Hospital when Balaji Motamarri was still a medical student in India. While Motamarri was studying to become a psychiatrist I was looking after a community of 1000 mainly elderly patients, including many with complex illnesses (including mental health problems) as a family doctor in Melbourne. I have researched and lectured on mind-body medicine at Swinburne University in Melbourne, and my lectures can be viewed on YouTube, if Balaji Motomarri and his staff are interested to see what my state of mind was like in 2001 (when I was first misdiagnosed as having schizophrenia). They can even see the interview I gave in 1998 when I discussed my research into the pineal gland with Micheal Adami and the documentaries I have made about eugenics, psychiatry and AIDS (the theories that were diagnosed as ‘delusional’ by the psychiatrists in Melbourne).

I think I am owed the respect of a phone call with him to explain how and why his hospital is misguided to force a disease label and anti-psychotic drugs on me. I am also owed an apology for being locked up for raising uncomfortable truths and being denied my freedom of speech and my physical freedom. I am owed an apology, too, for being poisoned with drugs that have harmed my health and brought me no benefit, as well as putting me at risk of a range of iatrogenic adverse effects. At least I don’t have the added trauma of believing that I have an incurable brain disease.

Old Wine in New Bottles – Remarketing ‘Depression’

Last year, I watched an interview on ABC News 24 informing us about a “new theory on the cause of depression”. This is that it is caused, not by a “chemical imbalance” but by inflammation in the nervous system (notably the brain). This is being presented as an alternative to the “serotonin theory of depression” that was used to justify the presciption of Selective Serotonin Reuptake Inhibitor (SSRI) drugs, beginning with Prozac in 1987.

I have been watching and analysing the changing hype for many years. When I worked as a family doctor, the drug companies were claiming that depression was caused by a chemical imbalance in the neurotransmitter noradrenaline, not the indole amine serotonin (5-hydroxytryptamine). This was because the market leaders in the “depression market” were the toxic and ineffective “tricyclic antidepressants” which were developed in the 1950s and were the mainstay of depression treatment till they were replaced by the SSRIs in the 1990s. Tricyclics were known to affect noradrenaline (norepinephrine) levels in the brain.

The psychiatrist interviewed by the Australian Broadcasting Corporation (ABC) defended the “chemical imbalance theory” that has been such a successful marketing catchphrase for the drug companies but admitted that the SSRI’s don’t work for everyone and that “we don’t know” why some people with depression have disordered serotonin metabolism and others don’t. As usual, she explained that they needed more money for research to get the answers.

Dr Liz Scott, for that was her name, also agreed that the new theory was plausible, pointing to the fact that stress affects the immune system. She didn’t explain how stress, which usually depresses the immune system, is responsible for this inflammation, or why there is no evidence of such inflammation in the brains of depressed people who commit suicide. At the same time it is known that chronic illness of many types causes unhappiness and “depression”, including viral, bacterial and fungal infections, kidney and heart disease, cancer and chronic arthritis. Forced psychiatric treatment (especially incarceration) is an important cause of stress that Dr Liz Scott did not mention, predictably. Many other things cause unhappiness, and unhappiness has long been termed “depression” by the medical treatment industry, rejecting the older term of melancholia (thought to be due to a preponderance of black bile, one of the four humours of Galenic medicine).

In the 1960s American “experimental psychologists” of the “Behaviorist School” did a series of cruel experiments on baby chimpanzees, which demonstrated, as if there was need for it, that primates (as well as cats, dogs and even rats) pine away and become morose and depressed when they are deliberately made lonely and deprived of social activity and the comfort of others. This was heralded as a “discovery”.

Prozac was released with much hype, including a flurry of books in the “popular science” press, especially by Rupert Murdoch’s Harper-Collins publishers. These promoted Prozac for a range of medical and psychiatric conditions beyond depression, and resulted in profits of 3 billion for Eli Lilly. The other major drug companies followed suit, releasing and marketing (including bribing doctors to prescribe) a growing range of alternative SSRIs.

Eli Lilly have a long history of research into psychedelic drugs and psychoactive drugs that affect the serotonin receptors and pathways in the brain. In the 1960s they bought the rights to LSD (or ‘acid’) from the Swiss company (Sandoz) that had developed it. It was known that LSD could cause “schizophrenia-like” psychotic episodes, according to the psychiatric terminology of the time. This terminology dates back to 1909, when the Swiss psychiatrist Eugen Bleuler coined the term “schizophrenia” and promoted its use for what his colleague Emil Kraepelin of the University of Heidelberg in Germany, known as the “Father of Psychiatric Classification”, had termed “dementia praecox” (adolescent dementia).

Bleuler argued that Kraepelin, in Germany was too pessimistic and that a third of his patients in the Swiss Burgholzli asylum recovered and were discharged from hospital. Kraepelin had taught, for many years, that any young person who “heard voices” was eventually destined to die of dementia (terminal mental degeneration) in a lunatic asylum.

German psychiatry became more brutal under the Nazis when patients with “schizophrenia”, “cyclical madness” (manic depression or bipolar disorder) and “personality disorder”, who had been populating the long-term mental asylum wards, were prescribed “euthanasia” – meaning “good” or “mercy killing”. Needless to say this included political enemies of the regime, since it has long been the case that enemies of the state or ruling regime get branded as mad. The same label of schizophrenia was also used in the Soviet Union to justify locking up and drugging, with chemical restraints, social and political dissidents.

In fact, chemicals do have a lot of effect on human thinking and behaviour, as the well-known effects of alcohol and drunkenness demonstates. To understand the hidden crime of “antipsychotic drugs”, and “antidepressants” one needs to know a few basics about catecholamine and indole amine neiurotransmitters and neurohormones.

Neurotransmitters are small molecules that bind to cell membranes of the nerve cells (neurones) in the brain and nervous system, stimulating or inhibiting “action potentials” or electrical impulses that pulse or vibrate in a constant, complex network through the nervous system. There are many different receptors for the same neurotransmitter – for example there are D1, D2, D3, D4 and D5 receptors in different parts of the brain. This results in the same chemical neurotransmitter having different effects depending on the type of receptor on the effector cell.

This science lies behind the efforts, over many decades, to find antipsychotic drugs that did not cause stiffness, dribbling and uncontrollable writhing movements of the face and limbs (Tardive Dyskinesia) which crippled so many of the long-term inmates of mental hospitals in the 1960s, 70s and 80s, when the main drugs that were used were Largactil (Thorazine), Haldol (haloperidol), Stelazine and Modecate. Thousands were crippled and still are, by these horrible drugs – both in the communist and the capitalist nations. The main “indications” were “schizophrenia”, “mania” and “schizoaffective disorder”, though they were also used as chemical restraints in elderly people diagnosed with dementia, a particularly cruel form of elder abuse that was prevalent in the more abusive nursing homes in Australia.

It is important to realise that the neurotransmitters in the brain are in constant dynamic flux. Every emotion or action results in chemical changes. When one listens to music the chemicals in the brain change. When one does for a walk, the chemicals change. When one gets excited, or relaxes, the chemical balance changes. Some neurotransmitters increase and some decrease in activity, made more complex by the fact that different cells have different neurotransmitter receptors, affecting how they respond to them. It been demonstrated that the successful completion of tasks results in measurable increase in serotonin levels.

Chemical imbalance theories make a lot of money for companies selling chemicals (drugs/medications). Millions of dollars are spent on promoting various chemical imbalance theories and the drugs that affect these chemicals. The dopamine theory of schizophrenia and the serotonin theory of depression were used to market dopamine-blocking “antipsychotic drugs” and SSRI “antidepressants” respectively. Despite numerous people demonstrating the fallacy of the different chemical imbalance theories, opponents are up against a multi-billion-dollar industry that is profit-driven and stands to profit from repeating the theories without mentioning the opposition to them.

Don’t believe the hype.

Debating Psychiatry with the PA Hospital

 

This is a debate from two years ago (February 2016) between me and Nigel Lewin, an English psychiatric nurse from the Princess Alexandra (PA) Hospital.

Nigel had been appointed my ‘case manager’ and I was being made a “medical case” and “mental case” by my medical colleagues at the hospital that empoyed my father from 1976, when my family migrated to Australia from Sri Lanka. I was 15 then and remember staying in a house on the grounds of the hospital when we first arrived. Later, I avoided the hospital where my father and sister worked, and had a poor opinion of it, reinforced by my father’s claims (for which he was eventually sacked) that the hospital was “in chaos”. This was in 2001 and he got me locked up at the “chaotic” hospital (in his own written opinion) in 2002. In fact, he got me locked up 5 times in 4 months, culminating in my rib and finger being broken by security guards and male “nurses” immobilising me so that I could be injected with a drug called Zuclopenthixol, a treatment for ‘schizophrenia’ and other ‘psychotic disorders’

I began my debate with Nigel by asking him what he thought about “Psychotic Disorder – Not Otherwise Specified”, the label the hospital was trying to pin on me at the time, after revising the diagnosis from one of schizophrenia. Now, under the treatment of Jumoke Banjo (from Nigeria) and Ghazala Watt (from Pakistan) the diagnosis has been changed back to “paranoid schizophrenia”. Nigel Lewin has now gone on long service leave and a new case manager, an Indian man by the name of Raghy Raman, has been appointed. Raghy has expressed the opinion that the leader of the Tamil Tigers, Vellupillai Prabakaran was an “activist” rather than a terrorist, and described me as having “elevated speech” when I debated with him about the Tamil Tigers. In response to this, the psychiatrist Ghazala Watt increased the dose of depot antipsychotic she has abusively ordered.

 

 

 

 

 

 

 

Considering ‘Insight’

©2018 Romesh Senewiratne-Alagaratnam (MD)

Being insightful is considered a virtue. It is similar to being thoughtful, but insight implies intuitive knowledge and perception of truth. There has been much study of insight in psychology in recent years, mainly looking at the phenomenon from the perspective of problem solving. It has been found that insight is promoted by good mood and sleep, which help solve problems. An insight is described as an “aha moment”, “penny-drop moment”, “eureka moment” or epiphany.

However, ‘insight and judgment’ mean something quite different in psychiatry – in this medical specialty, insight specifically means willingness to accept that you are, and have been, mentally ill. This is problematic and constitutes a widely used circular argument – that refusal to agree you are mentally ill is itself evidence of mental illness. It means that mentally healthy people who are mistakenly admitted as psychiatric patients harm their chances of discharge if they maintain that they are not mentally ill.

 

The Positive and Negative Syndrome Scale (PANSS), widely used in evaluating antipsychotic drugs for schizophrenia, is explicit about this. Section G12, titled “Lack of Judgment and Insight” states that ‘extreme’ (grade 7) lack of insight is to be recorded due to:

“Emphatic denial of past and present psychiatric illness. Current hospitalization and treatment are given a delusional interpretation (e.g., as punishment for misdeeds, as persecution by tormentors etc.), and the patient may thus refuse to cooperate with the therapists, medication or other aspects of treatment.”

 

Good judgment involves the ability to make sound decisions, based on knowledge of what is true and what is false. It is insulting to accuse someone of poor judgment, and uncalled for if the accusation is based on reasonable refutation of an incurable mental illness label. People can make sound judgments about many things, but not be convinced that they are mentally ill, especially if the illness is claimed to be due to unmeasurable chemical imbalances in their brains that are of uncertain origin, the dominant paradigm in psychiatry.

 

This item in the PANSS is one of 16 items taken from the older Brief Psychiatric Rating Scale (BPRS), which was developed in the USA in the 1960s and used to evaluate “general psychopathology”, as well as to evaluate psychoactive drugs. The PANSS also includes 7 “positive symptoms” and 7 “negative symptoms” for a total of 30 items that are evaluated. This results in a score from 30 to 210. “Improving” scores on the PANSS constitute the main claims for efficacy of the newer antipsychotic drugs; the older drugs were evaluated by the BPRS and other scales, usually when compared to the “benchmark drugs” chlorpromazine and haloperidol, rather than placebo.

 

A glaring problem with the PANSS and BPRS is the fact that known side-effects of dopamine-blocking drugs, such as “flattened affect” are described as signs of schizophrenia, rather than the treatment of the condition. Other signs such as hostility and uncooperativeness can be explained as legitimate objection to being called mad (or insane), by whatever name.

Predictably, people with some mental illness diagnoses resist the label of “illness” more than others. People with phobias, anxiety and depression often come to see doctors for help and so do people with auditory hallucinations (usually diagnosed as schizophrenia or schizo-affective disorder). In these people the diagnosis of illness can be a relief, and they accept drug treatment without objection. In other cases, patients resist the label of illness vehemently, especially when they are said to have elevated mood (diagnosed as hypomania and mania) or delusions.

It is not surprising that many people accused of having an elevated mood resist the judgement. The BPRS grades “moderately severe” elevated mood (rating 5 on a scale from 1 to 7) as:

“Reports excessive or unrealistic feelings of well-being, confidence or optimism inappropriate to circumstances, much of the time. May describe feeling ‘on top of the world’, ‘like everything is falling into place’ or ‘better than ever before’. OR several instances of marked elevated mood with euphoria”.

Needless to say, people who feel on top of the world, better than ever before, or for whom everything is falling into place, are often not inclined to think they are mentally ill, and with good reason. Likewise people with an increase in goal-directed activities, increased zest for life those who see connections they didn’t see before and have insights. Ironically, the process of coming to conclusions through insight, especially if they are unique or ‘idiosyncratic’, is itself viewed as a sign of mental illness.

The Young Mania Rating Scale (YMRS) rates elevated mood on a scale from 1 to 5, with grade 3 being:

“Definite subjective elevation; optimistic, self-confident, cheerful, inappropriate to content.”

The key to the diagnosis is the subjective evaluation of what is “inappropriate to content” or “inappropriate to circumstances”. This is done by the interviewer, and depends on his or her own belief system, judgement and understanding of the patient’s circumstances.

Persecution by Tormentors and Punishment for Misdeeds

 

The belief that one is persecuted is not necessarily delusional. Many people, over the ages, have been persecuted, for various reasons including their race, their ‘caste’ and their beliefs. People are sometimes tormented by the families, or by their peers (for example victims of bullies at school or work). Siblings sometimes torment each other, and so do cousins and other relatives. Sometimes it is neighbours who do the tormenting. People often gang up against people who are stigmatised as strange, mad, crazy or odd and this can amount to persecution. Children are often punished for disobedience and it is not unreasonable for people to regard their imprisonment as mental patients a punishment. This is not helped by a punitive culture in the mental health systems of many nations.

 

There are many dysfunctional families, and family dysfunction comes in many forms. Some families are very competitive and sibling rivalry, as well as competition between parents and children, can be a problem. Some parents, especially fathers, are very authoritarian and demand obedience from their children. Disobedient children are labelled as “difficult” and taken to doctors for diagnosis and treatment. Here the power imbalance is obvious. The child has little power to resist being labelled as the “problem”, however much the doctors protest that they can’t help their behaviour because they have a chemical imbalance in their brains. When the children misbehave it is inevitable that the adults and siblings blame the “illness” and ask if they are complying with taking their their tablets.

The adults in this situation include parents and other family members as well as teachers. Some teachers are inclined to suspect their students of having “attention deficit disorder” when they are not interested in their lessons, and become visibly bored, restless and fidgety. Teachers provide a large number of the referrals for ADD and ADHD. It is rarely asked as to whether the teacher is to blame for being boring and failing to engage the student. This requires introspection, which is sometimes lacking in any profession, including teaching.

Apart from scape-goating a particular family member, there are problems with looking for a chemical solution or “magic bullet” to life’s difficulties. This can form a pattern of behaviour in the child and in their carers and family. When they are down, rather than looking for activities and experiences that will bring them back up, the tendency is to take an antidepressant. When they are anxious, instead of listening to music or going for a walk, or any of a wide range of actions that can lessen anxiety, they look for a benzodiazepine.

It is also a problem when children are medicated for what is basically disobedience. The drugs that are used for ADHD are stimulants, related to amphetamines, known on the street as ‘speed’. Though they can improve concentration and keep you awake when you are tired, it has been known for over a century that amphetamines are addictive, and can also cause psychosis. Despite this they were widely used as weight loss drugs and “pep pills” in the 1960s and were again promoted in the 1990s for the newly-named “mental disorder” known as ADHD (Attention Deficit Hyperactivity Disorder). In the 1980s it was said that only 1 in 200 children had ADD; this rocketed up to 1 in 20 with the new label, with a corresponding explosion in prescriptions for stimulant drugs. This was in the 1990s, and was a precursor to the explosion in addiction to amphetamines a decade later. Many of the youth who are addicted to metamphetamine (‘ice’) were initially diagnosed as having ADHD and given stimulant drugs.

 

Family abuse occurs at all ages. Children and the elderly are especially vulnerable and can easily be pathologised for being “difficult”. Rebellious adolescents are also vulnerable to being given a disease label for their behaviour, as well as young people who reject the religious beliefs of their parents and embrace other philosophies and religions.

 

The concept of insight should be considered holistically. There is a difference between insight (introspection) and insights (epiphanies). One aspect of introspection is to be able to look critically at our own mistakes, flaws, vices and poor judgements in the past. It requires us to challenge our indoctrination from various sources as we grew up. The process of growing up and learning from our environment (including family and school) inevitably results in some false beliefs and delusions. Some of our beliefs are not congruous with reality, and it is a challenge, throughout life, to rid ourselves of such delusions. Sometimes, when one realises ones previous error, especially about long-held beliefs, it comes as an insight. Such insights are often pleasant, and can be exciting. They can elevate the mood.

Seeing connections you didn’t notice before and making new associations can also be exciting and elevate the mood. Elevating the mood itself has the effect of increasing insights and insightful thinking. How many potentially beneficial insights have been suppressed or destroyed by the practice of regarding “gaining insight” as a synonym for accepting that you are mentally ill?

 

 

Evidence against the PA Hospital

At 9.00 am this morning the Indian psychiatric nurse, Raghuvan ‘Raghy’ Raman, who thinks the Tamil Tigers were ‘activists’ rather than terrorists, rang me from the PA Hospital. He told me “your injection is due, what time can I come around?”. He didn’t ask me how I was; if he did I would have told him.

At 11.30 he turned up alone with a bag containing a 100 mg injection of Invega Sustenna (paliperidone) ordered by the Pakistan-trained psychiatrist Ghazala Watt for a cost to the taxpayer (at the Chempro chemists in Buranda, opposite the hospital) of $414.09. The script was written by a Dr A Neligan, who I have never heard of, and is probably Ghazala Watt’s registrar.

Paliperidone is a treatment for schizophrenia and other psychotic ‘disorders’, but I am not in the least bit psychotic or mentally disordered. Ghazala Watt, though, has repeated the diagnosis of a Nigerian psychiatrist named Jumoke ‘Jumi’ Banjo, who kept me locked up on three occasions in late 2016 and early 2017, following complaints to the hospital by my hostile father and next-door-neighbour.

Banjo is a graduate of Ibadan University in Nigeria, and had not been in Australia long. I graduated in medicine many years before either of these psychiatrists, and am senior to them in years as well as experience.

What I wanted to discuss with Raghy Raman on camera was the grossly negligent, inaccurate and defamatory report recently ‘written’ by Ghazala Watt. One of the two modifications she has made to the report claims that “elevated speech” was evidenced by the ‘treating team’, and hence she was increasing the dose of antipsychotic from 75 to 100 mg. After he had asked for the video camera to be turned off and I complied, we discussed this and he admitted it was he who said I had “elevated speech”.

My voice gets louder when I am angry or trying to make a point. I was both. There is also no such thing as “elevated speech” in psychiatric texts – only ‘elevated mood’ and ‘pressure of speech’. Pressure of speech and elevated mood are evidence of mania, rather than schizophrenia, and I do not display either. I am justifiably angry at being misdiagnosed as “mentally ill” and assaulted with injections that are making my physical health deteriorate and are the ONLY CAUSE of my mental distress.

But I am a tough guy, and these people have injected me with even bigger doses in the past, of even worse drugs. And I have survived, though according to the statistics, at 57 I am nearing the end of my expected life, as a mental patient in Australia.

The report of Ghazala Watt was more a character assassination than a legitimate medical report. The bulk of the report was already on the PA Hospital computer, and she changed only two paragraphs, retaining all the misinformation that previous psychiatrists and psychiatry registrars had written for previous MHRT tribunals. She has not even changed the opening statement of the report that I am a “52 yo male”. I am, in fact, a 57-year-old physician and graduate of the University of Queensland, who has four times as many LinkedIn contacts as her, and 10 times as many Facebook friends. Yet she has retained in the report, in the section on Social Networks (there is no section for professional networks) that I have no social support apart from my mother. This is presumably an effort to paint me as a socially withdrawn and inept “schizophrenic”. My appeal to the MHRT is to be heard in a week’s time. In the meantime I’ll try and continue working.

I have many forensic psychologists and forensic psychiatrists among my LinkedIn contacts. I would appreciate their assessments of Ghazala Watt and Raghy Raman from the evidence I have provided, My own assessment is that they are grossly incompetent and systematic violators of human rights in Australia, for which their superiors are also legally responsible.