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.

Psychoimmunology, the Nocebo Effect and Psychiatry

©2018 Romesh Senewiratne-Alagaratnam (MD)

In the 5th century BC, the Athenian general and historian Thucydides wrote about how people who lost hope after contracting the plague were more likely to die from the deadly disease. His was the first description of what is now called psychoimmunology – the effect of the mind on the immune system. Another common manifestation of psychoimmunology is the well-known placebo effect, where belief in a treatment results in greater efficacy of the treatment, even if there is no active ingredient in the said treatment. The nocebo effect is the opposite of the placebo effect – when negative effects of an inert treatment occur due to expectations of harm.

The immune system is always subconsciously active, fighting off potential infections and cancers. It can also be over-active, as in allergic reactions, or become misdirected against the body’s own tissues, causing a wide range of autoimmune diseases. It is a common observation that mental stress can aggravate allergies and autoimmune diseases as well as cause depressed immunity.

The term ‘psychoimmunology’ was coined by George Solomon at UCLA in 1964. In 1975 Robert Ader and Nicholas Cohen coined the term ‘psychoneuroimmunology’ (PNI), emphasising the role of the brain and nervous system (neuro) in the processes by which the mind influences the immune system. This was initially viewed with scepticism since medical orthodoxy taught that the immune system was independent of the nervous system (despite knowledge of the placebo effect). There was less focus on how the immune system affects the brain and mind, although at times it obviously does (such as various types of inflammation of the brain). One of Ader’s interesting experiments was one where he conditioned rats to become immunosuppressed by pairing an immunosuppressive drug with saccharin. He found that he was able to stimulate immunosuppression by merely exposing the rats to saccharin after they had been conditioned to link saccharin with the immunosuppressive effects of the drug Cytoxan.

The placebo effect, and its converse, known as the ‘nocebo effect’ illustrate the effect of the mind on the immune system. How these effects arise and what neurological and physiological processes underpin them are partly unanswered questions, but are likely to involve many parts of the brain, especially those areas that affect emotional reactions (such as the amygdala and nucleus accumbens) and the hypothalamus, which affects the endocrine system via the pituitary and pineal glands as well as the autonomic nervous system. The role of the endocrine system in these effects is emphasised by the new term “psychoneuroendoimmunology” (PNEI).

An interesting thing about the placebo effect is that it operates even when the subject knows that it is a placebo. It has also been found that the colour and size of placebo tablets have a bearing on their effectiveness. Red tablets have been found to be more energising, while blue tablets are more calming. This indicates the role of the visual system on the placebo effect. Effective placebos are not just tablets, however. Injections of saline and ‘sham’ surgery have also been shown to be effective placebos. It has also been found that placebos are effective even when the subject knows that they are placebos and have no active ingredients in them. However, belief that an active drug is in the placebo makes the effect more powerful.

The converse effect, the nocebo effect, is the phenomenon by which a drug or treatment that is expected to cause disease does so. For example people become immunosuppressed, nauseated and lose hair if they think the placebo drug they have been given is a cancer chemotherapy drug (and they have been warned about possible side-effects). This indicates the possible negative, as well as possible positive effects, of suggestions.

Studies have shown that depressed mood is associated with impaired immunity and that a good mood promotes health of the immune system. The problem is that improved mood, especially if sudden and accompanied by insights and reduced need for sleep, is liable to be pathologised as hypomania or mania (and ‘elevated’, rather than improved, mood) and treated by dopamine-blocking drugs and lithium, often after locking the person up (which predictably causes the mood to come down). To complicate matters further, it has been reliably reported that people in a good mood (and those who are mentally relaxed) require less sleep. It is also known that meditation can lead to both insights and less need for sleep.

It is generally accepted that the amygdala, an almond-shaped nucleus located deep in the temporal lobes, plays an important role in the placebo and nocebo effects. The amygdala is activated by fear, alarm and anger responses. These emotions activate the hypothalamus and the sympathetic nervous system causing what the Harvard physiologist Walter Cannon termed the “fight or flight reflex”. Activation of the amygdala causes a cascade of hormonal changes via the hypothalamic-pituitary-adrenal (HPA) axis, causing stimulation of the heart, bronchodilation in the lungs, sweating and diversion of the blood flow away from the gut and towards the muscles (in preparation for fight or flight). Though the sympathetic nervous system is known to be involved in “flight and fight” (fear and anger) responses, this branch of the autonomic nervous system is also involved in positive excitement and healthy activation. As well as this, it innervates the pineal gland, where it regulates the synthesis of melatonin from serotonin (during the night).

The body’s response to stress, both physical and mental, is to secrete the hormone cortisol (from the adrenal glands) under influence of adrenocorticotrophic hormone (ACTH) from the pituitary. The ACTH is secreted in response to corticotrophin-releasing hormone from the hypothalamus, a structure at the base of the brain that is neurally connected with the amygdala and other emotion-related parts of the brain. In addition, neuropeptides such as Substance P, which have pro-inflammatory effects, are secreted by the brain and by immune cells such as macrophages and other white cells. The cortisol affects white cells in complex ways, including increasing some populations and decreasing others, causing apoptosis of some cells and chemotaxis of others. It has a generally suppressive effect on the immune system, for which it is often used therapeutically.

While this stress response is essential for escaping from danger, it is thought that in modern society there is often a chronic overstimulation of the stress pathways, leading to increased illness from a range of stress-related maladies (including heart disease, hypertension, autoimmune disease, headaches, peptic ulceration and irritable bowel syndrome).

The sympathetic nervous system is counterbalanced by the parasympathetic nervous system (associated with “rest and digest” physiology according to Cannon). This branch of the autonomic nervous system is associated with a range of physiological activities associated with healing and regeneration. Many stress-reduction techniques (including biofeedback and meditation) aim to increase parasympathetic activity over sympathetic activity in the autonomic nervous system, with the objective of increasing healing and regeneration.

The possible role of the pineal has not been discussed much, but the pineal’s main hormone, melatonin, is known to have effects on the secretion of pituitary hormones, and is thought to have effects on the immune system. In addition, melatonin is known to be a powerful antioxidant. Antioxidants counter oxidative stress and have positive effects on the immune system (and ageing) as well as beneficial effects on the cardiovascular system and nervous system. It is known that conversion of serotonin to melatonin in the pineal (which occurs mainly at night) occurs under the influence of sympathetic activation and the SNS neurotransmitter noradrenaline (norepinephrine).

There has been considerable study on the effects of neurotransmitters and neurohormones, cytokines and endorphins on the immune system. These studies illustrate the complexity of the brain’s effects on the immune system (especially the activity of white blood cells or leukocytes) and the effects of the immune system on the brain and mind (in such diseases as Multiple Sclerosis, AIDS, Parkinson’s Disease and Alzheimer’s Disease). Though complex and incompletely understood, it is clear that loss of hope and pessimism have negative effects on the immune system, as well as other physiological systems.

 

Implications for Psychiatry

 

The detrimental effect of loss of hope, written about by Thucydides 2500 years ago, has serious implications for doctors, especially psychiatrists. Psychiatry is a notoriously pessimistic area of medicine. Hundreds of “mental disorders” have been named, all incurable according to psychiatric orthodoxy. If the signs and symptoms of the “disorder” are no longer evident, the patient is said to have gone into remission, rather than cured. Labels of “personality disorder”, once applied, are never removed and all personality disorders are, according to psychiatric orthodoxy, permanent. This can be expected to depress the mood and the immune system. In addition there is an increasing tendency to regard the normal as abnormal. Excitement, for example, is seen as hypomania and normal sadness as “depression”, while a range of New Age beliefs and alternative science (and political) beliefs are regarded as signs of “schizophrenia”. This leads to self-fulfilling prophesies and partly explains the appalling life expectancy of people once they have been given a label of schizophrenia or bipolar disorder.

In the case of bipolar disorder (manic depression) a single episode of mania or hypomania is taught in psychiatric texts to herald a life-long condition of “mood disorder” requiring long-term mood stabilizing drugs like lithium. These drugs have terrible side-effects and shorten the life, explaining why a diagnosis of bipolar disorder is accompanied by a ten to twenty year shorter lifespan, on average. A diagnosis of schizophrenia shortens the life by 15 to 20 years, on average, and again is treated with long-term antipsychotic drugs that are known to shorten the life and make people lethargic, obese and prone to diabetes and heart disease in addition to causing neurotoxicity in the form of Parkinson’s Syndrome and Tardive Dyskinesia (a permanent condition characterised by involuntary spasms, grimaces and writhing movements that is caused by antipsychotic drugs). Lithium is notorious for causing kidney and thyroid failure.

Though the suicide rate is much higher in people given these diagnoses, most of the morbidity and mortality is not due to suicide. Besides, self-harm and suicide can be partly attributed to the pessimistic diagnosis (resulting in loss of hope), and social stigmatization resulting in loneliness, poverty and other social problems. These commonly lead to loss of motivation and depression, with negative effects on the immune system. The main cause of the shortened life span when on antipsychotic drugs is due the long-term effect of blocking essential neurotransmitters, causing metabolic problems and heart disease. They can also cause irreversible brain damage in the form of cognitive decline, cerebral atrophy and tardive dyskinesia. Though they can be effective in treating hallucinations, they should not be used for behaviour control or as chemical restraints, as they frequently are, especially in the elderly. Delusions are better treated by debate than drugs. The diagnosis of delusions can also be problematic in that the belief system of the interviewer is pitted against, and assumed to be superior, to that of the patient.

To maximise the potential of the body’s own healing mechanisms, and those mediated by the mind, is imperative that people reject labels of incurable mental illness and realise that just because they have been mentally unhealthy in the past does not mean they need to be mentally unhealthy in the future. It is also imperative that doctors and other health workers realise that implanting pessimism in the minds of their patients is a recipe for inducing chronic illness.

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.

 

Public Image, Social and Professional Networking and Defying a ‘Schizophrenia’ Label

The PA Hospital psychiatrist Ghazala Watt has claimed, in a report for my upcoming Mental Health Review Tribunal hearing, that I have “paranoid schizophrenia” and that the only social support network I have is my 84-year-old mother. This essay proves her wrong.

The textbook characteristics of ‘schizophrenia’ include social awkwardness, social withdrawal and what was called, when I studied psychiatry in the 1980s, ‘downward social drift’. I have been labelled with schizophrenia, but I reject the diagnosis in myself for several reasons, including my social and professional networking ability and in others because it is a stigmatising misnomer. I do not satisfy diagnostic criteria for the label and the diagnostic criteria themselves are flawed. It is not scientific or rational to believe that people who have auditory hallucinations have the same incurable brain disease as people who are disorganised or socially withdrawn or who believe in telepathy or corporate and government conspiracies. I have never had hallucinations, of any sort, am well-organized in my thinking and actions, am sociable, and have never had telepathic experiences, but I admit to believing in certain conspiracies. These include my long-standing and well-founded conviction that my father conspired with others to have me silenced by getting me locked up and stigmatised me as a ‘mental patient’.

My father is blunt in his terminology when he speaks about me to my mother – “he’s bloody mad, he’s completely bananas” and other invectives. When he writes about me or phones people up he is more discreet, however, and says that I have a “serious psychotic disorder”, concealing his animosity towards me. He refuses to allow me to visit my mother at their house, though she wants me to do so, and he hangs up the phone on me if he answers it rather than my mother. Occasionally he abuses me first, but mostly he hangs up the phone silently or leaves it off the hook without answering my repeated “hellos?”

 

I have appealed to the Queensland Mental Health Review Tribunal (MHRT) for release from a “Treatment Authority” (T/A), previously called an Involuntary Treatment Order (ITO) prior to the change of terminology (but not practice) with the new Mental Health Act of 2017. The hearing is next week. I was put on an ITO a year ago by Dr Jumoke ‘Jumi’ Banjo of the Princess Alexandra Hospital. Dr Banjo, who had recently come to Australia from Nigeria, kept me locked up on three occasions over a few months in late 2016 and early 2017, following complaints to the hospital by my hostile father and next-door neighbour, Jeff Miller. She changed the diagnosis from ‘psychotic diagnosis – not otherwise specified (NOS)’ to ‘paranoid schizophrenia’ and dramatically increased the dose of the Paliperidone injection she ordered from 25 mg to 150 mg.

I contested this diagnosis at a MHRT hearing while I was still an inpatient, but, as I expected, I lost. Refusal to accept the disease label you have been given is routinely regarded as ‘lack of insight’ and further evidence of mental illness, necessitating involuntary treatment. This is despite Banjo writing, of my mental state:

“MSE [mental state examination]

Casually dressed, grey hair and beard, settled and polite with reasonable engagement, no psychomotor agitation.

Spontaneous speech, normal in rate, volume and tone.

Mood is euthymic and affect is reactive.

Thoughts are coherent, no disorder of thought form and does not currently appear preoccupied with previously described delusional content, no depressive cognitions, no suicidal or homicidal ideas.

No evidence of perceptual abnormality.”

This sounds like a normal, mentally healthy person. It is hard to explain, given this assessment, her statement that I have “limited insight into the nature and severity of [my] condition”, which she specified as “paranoid schizophrenia”. It is also hard to reconcile with her denying my liberty by keeping me locked up in the ward and her treatment plan to have me injected every month, indefinitely, with 150 mg of the antipsychotic drug Paliperidone. Her actions were illegal, according to the Mental Health Act, which states that patients can only be confined against their wills if they are and remain a risk to themselves or others. The legal loophole the psychiatric system in Australia uses, to get around these exclusion criteria, is to argue that the patients jeopardise their own health by refusal to take the prescribed drugs. It is also against the law to lock people up for their political or philosophical beliefs, but these laws are routinely violated too.

 

My 1995 theories

 

I had started theorising on the cause and management of schizophrenia before it was first suggested that I myself had the ‘disease’. This suggestion was made by my father, in a letter he wrote to the psychiatry registrar of the Junction Clinic in Melbourne, Noel Barrett, in March 1995:

“I’m not sure why, but I did remark to my wife that I thought his recent adventures into the unknown, the attempts to explain autism, the compulsive eating of obesity (which I’ve had an interest in), sleep, memory disturbances, Alzheimers, schizophrenia etc – was abnormal. I even said, ‘I don’t know whether this is the start of a schizophrenic illness.’ Why I said so (to my wife, of course, and not Romesh) I cannot quite remember but I did notice that the ego boundaries were no longer there.”

It is true that I was developing original ideas about the cause and management of autism, schizophrenia and memory disturbances and was also researching sleep. I was particularly interested in the role of the reticular activating system (RAS), the noradrenergic network of neurones connecting the brainstem with the midbrain and cortex that influences state of alertness and concentration as well as sleep. I hypothesised that the RAS is also involved with attention and mental focus, partly through its connections with the thalamus, which integrates and directs attention through the senses.

My theories on autism included the theory that lack of eye contact was related to lack of trust and fear of adults, which can be addressed by a gentle approach to building trust through play, music and art, with a conscious attempt to encourage eye contact with the child. My theories on schizophrenia, which have changed since then, related to the neurochemistry of dopamine, development of the limbic system and analysis of mental associations. These were only a few of the theories I was working on at the time; others related to the development of aesthetic appreciation in sight and hearing, integrative neuroscience, holistic approaches to health and theories about instincts. I was particularly fond of my insight that communication, curiosity and play are instincts which can be used to develop public health and individual health promotion strategies.

My theories on dementia were related to the relatively uncontroversial theory that curiosity is an instinct. It was based on the assumption that keeping the brain actively learning would help ward off dementia, something I thought was self-evident. I was interested in identifying social factors such as the beliefs that you are “too old to learn” or “too old to change” in contributing to dementia, and thought that encouraging curiosity and ongoing experiential (not necessarily formal) learning could mitigate against it. I later found, when I tried to discuss my ideas with Professor Colin Masters, in charge of Alzheimer’s Disease research at the Mental Health Research Institute in Melbourne, that not everyone thinks that keeping the brain active helps prevent or slow down the progress of dementia.

 

My Father’s Insanity

 

When he wrote to Noel Barrett and his consultant Rajan Thomas in March 1995, my father was clear that he wanted me committed, raising the possibility that I had both schizophrenia and hypomania. He also made it clear that he wouldn’t like to be committed himself. He wrote, in brackets, at the end of the long, handwritten letter:

“(I hope that the above dissertation does not result in someone certifying me!!!)

The preceding sentence in the letter, which was faxed to the Junction Clinic in Melbourne, refers to his activities in drawing attention to what he called “Third World conditions” at the Princess Alexandra (PA) Hospital, where he had worked as a visiting consultant physician since we came to Australia in 1976 (note his use of capital letters);

“ I am having a hectic job here handling a very busy practice and also Consultant Physician at a major hospital to add to this. I’ve recently become the major (in fact, one and only) spokesperson for the Hospital to represent the chaos in the Brisbane hospitals to the government. So I’ve got my work cut out. However, if you feel that I can be of any use in Melbourne – if only to provide the necessary family support – I’ll be delighted to hop on the next plane and head off there”.

This is a self-serving lie. My father did not represent the hospitals to the Queensland government. That was the job of hospital administrators, with whom he was mostly not on good terms. What he did was to agitate the junior staff and non-medical staff that the old hospital was like a “Third World” country like Sri Lanka and approached all the commercial TV stations to give interviews to make this charge. He didn’t mention that his main political activity was lobbying for the Tamil Tigers (LTTE) and the separatist cause in the war in Sri Lanka.

My father has written several letters to psychiatrists about me, but never mentioned Sri Lanka or his political activities in support of the separatist war. However, a review of his own blog (called ‘Brian Senewiratne pages’) and YouTube clips from his own site and the network of LTTE-supporting sites indicates what a serious omission this is. My father’s LinkedIn site, which reveals only that he is an ‘onsultant [sic] physician’, has no photo and no details of his medical work or qualifications but includes a list of his skills, all of which have been endorsed by his network of professional Tamil friends. He has 258 contacts, one of whom he shares with me.

His LinkedIn site also fails to mention what he calls elsewhere his “human rights work” and also his role, since the end of the war (May 2009) as a ‘senator’ of the ‘Transnational Government of Tamil Eelam’ (TGTE). Despite not speaking or understanding Tamil, he was appointed (not elected) as a ‘senator’ by Visuvanathan Rudrakumaran, a Sri Lankan Tamil lawyer in New York who was the legal representative of the LTTE until their defeat in 2009, following which he established the TGTE with himself as “Prime Minister”. The TGTE flies the LTTE flags at its events and commemorates the “martyrdom” of the LTTE fighters including their leader Vellupillai Prabakaran, as well as the organizations many suicide bombers. My father has written recently (2017) that the Tamil people in Sri Lanka are missing the LTTE now that they are gone, and that what most people call a terrorist organization ran a “well functioning de-facto state”, selectively omitting the long list of crimes committed by LTTE against Tamil, Muslim and Singhalese citizens of Sri Lanka over the 30-year conflict.

His public profiles as a doctor and as a political agitator have been kept separate, though he uses his qualification as a doctor to win the respect of his pro-LTTE audiences. My father has defended the fact that he only “preaches to the converted”, responding to this criticism in a YouTube clip where he says that “you have to preach to the converted to keep them converted; otherwise they become unconverted”. What he is intent on “converting” the Tamils to is the belief that they have been subjected to genocide by the Sri Lankan government and that the only solution to this is a separate state for Tamils and division of the country. He also tries to convince his Tamil audiences to support a boycott of Sri Lankan goods and services, as well as sport (cricket) and tourism, which he declares will “bring the Colombo government to its knees”. Back in 2006 he gave an interview in Canada where he said that what is needed, and could be achieved by such a boycott, is “economic exsanguination” of the country. Exsanguination is the act of draining all the blood out – he thought the LTTE could win the war by destroying Sri Lanka’s economy, disregarding the cost to the ordinary people of Sri Lanka, especially the poor.

My father makes it clear that he is not Tamil and makes a point of stressing that he is of Singhalese ethnicity and a “Christian”, whose mother was a “devout Buddhist”. In the same 2006 interview he claimed that he is a “genetic half-Buddhist” as if religion is inherited in the genes. He uses this claim to justify his criticism of the Buddhist clergy, whom he accuses of “ethno-religious chauvinism” and trying to make multicultural Sri Lanka into a “Sinhala-Buddhist” nation. He then says that he has no objection to this, but by the same token the Tamils need their own state – Tamil Eelam. This gained him the support of the separatists, but was a distortion of the actual situation in Sri Lanka, where though Buddhism is protected the State, Hinduism, Islam and Christianity are also respected and celebrated with public holidays. He has claimed that the Tamils were denied their language in 1956, when his uncle SWRD Bandaranaike made Singhalese the only official language, ignoring the fact that for many years the official policy has been to promote trilingualism in Singhala, Tamil and English, and Tamil has been a national language (in addition to Singhala, which was also the official language) since 1958 with the introduction of the Tamil Language Special Provisions Act.

There are many videos of my father on YouTube and also videos made by him. The videos of him include recordings of speeches he has given, always to Tamil Tiger-supporting audiences (in the USA, Canada, UK and Australia) as well as a few interviews he gave for Tamil cable TV channels. These have been uploaded by various supporters of the LTTE. The videos made by him have been uploaded by LTTE supporters and also, relatively recently (2 years ago) he uploaded 3 videos of him talking to the camera while seated at his dining room table. Though the talk was intended as an address to the TGTE, he posted it publicly on his own YouTube channel. These latter videos have had a few hundred views, a few likes and several dislikes (including by myself). The videos of his speeches, in which he shouts his support for the LTTE and “the Tamil Eelam struggle” have also had mainly negative ratings, and up to a few thousand views.

The videos made by my father, available for free on YouTube, but which he had originally hoped to make money out of, include his home-made propaganda videos. These were recorded unprofessionally with my mother turning the video camera on and off. He started making these in 2006, after he was invited to address the expatriate Ilankai Tamil Sangam organization in the USA and offered to make a video to “correct the disinformation campaign by the Sri Lankan government”. My father does not have video editing skills and very few computer skills, but he had access to the expertise of some of his ex-students, now doctors, who supported the LTTE. These took still photos and short video clips from the LTTE propaganda collection and inserted them into the videos, which he subsequently boasted were “a dozen DVDs I have produced on the ethnic conflict in Sri Lanka”. These, he claimed, were a “major contribution” that had worried the Sri Lankan government.

Using his own terminology, my father is an egomaniac. He is also extremely manipulative, as is seen by the titles of his videos, one of the first being “The New Killing Fields of Asia”. He’d hoped to emulate and capitalise on the popularity of the successful and famous movie “The Killing Fields” about the genocide in Cambodia. He was trying to create a mental association to support his claim that the Sri Lankan Tamils were being subjected to a similar genocide. He is not a subtle man.

The ‘New Killing Fields of Asia’ made in 2007, was uploaded 3 years ago by a Tamil separatist and supporter of the Tamil Tigers. Since then it has had only 65 views, and rated 3 dislikes and no likes. Another of his videos, ‘SRI LANKA – THE ETHNIC CRISIS – WHAT THE WORLD MUST KNOW’ was uploaded 10 years ago by another separatist site. It has had 518 views since then (ratings not disclosed). Then there is ‘SRI LANKA GENOCIDE CRIMES AGAINST HUMANITY VIOLATION OF INTERNATIONAL LAW BY BRIAN SENEWIRATNE’. This video has had 215 views in 5 years (one like and 3 dislikes). Despite this obvious lack of interest in and effect from his videos, my father continues to boast to Tamil audiences and members of the Socialist Alliance and Greens Party about his “dozen DVDs” being a “major contribution” he is proud of.

On YouTube there is another bizarre video, also amateur and home-made, of my father professing to be an expert on ‘AFFECTIVE DISORDERS’. This video was uploaded by one of his patients, who had been given the DVD by him. In this video slides have been crudely inserted that cover part of his face, and he slowly reads what is on the slides to reinforce his points. These include that the diagnosis of affective disorder is frequently missed by doctors less perceptive than himself (including psychiatrists), that adult doses of antidepressants should be used in children (saying that the only alternative is shock treatment) and that depression is caused by the neurones in the limbic system “not talking to each other”. He gets these videos copied, in small runs, by his local printer (a Vietnamese gentleman who has also printed his LTTE-supporting propaganda over the years) and hands them out free to his patients. He tells them, though, that the DVDs are in high demand and sell for “50 pounds each in the UK”. (I have heard him say this, when I called him while he was seeing a patient and left the phone off the hook so I couldn’t call back).

 

Yet my father admits elsewhere (when it suits him), that he is not trained in psychiatry. Earlier in the letter 1995 letter to Noel Barrett he has written:

“I’m not sure whether it is even worth recording the opinions of someone such as myself who has no background in psychiatry. My concerns are that he has decided to suddenly throw in his practice without really good reason. I’m also concerned that the ego boundaries seem to have been breached to the extent they are.”

 

Google provides this explanation of ‘ego boundaries’, a term I have never heard psychiatrists use any more, and don’t use myself:

“When the inner boundary is critically weakened or lost, the return of repressed egostates falsifies reality and can result in delusions and hallucinations. When the cathexis of the outer boundary is weakened or lost, the sense of reality is disturbed, and external objects are discerned as unknown, strange, and unreal.”

This is psycho-babble. I like to keep it real and use ordinary language. On a point of fact, I did not decide to “throw in” my medical practice in 1995. I told my parents that I was thinking of selling it to concentrate on research, music and writing. It was a carefully considered decision and not impulsive or indicative of mental illness in any way. After I was locked up, my family got the practice closed down and I lost it without selling it.

 

Ghazala Watt’s claim about my lack of a ‘Social Network’

 

I decided, when confronted with a recent report for the MHRT ‘authored’ by the MSAHMS psychiatrist Ghazala Watt, to prove her wrong. She has claimed, in the section on “Social Networks and the Capacity to Support the Patient”, that:

“Romesh’s only positive relationship was with his mother who supported him and accommodated him in a property which belonged to her. Romesh has a long-term conflict with his father who also antagonises with him. Father often prevents mother from supporting Romesh.”

That’s all Ghazala Watt has written, and to make matters worse, she has repeated it, word for word (along with the grammatical error), from the previous report to the Mental Health Review Tribunal (MHRT) from 20.9.2016. This time the person who claimed to be the author was Jumoke Banjo, a graduate of Ibadan University in Nigeria, and recently employed by the PA Hospital as a consultant psychiatrist. I had been relieved at first to have an African woman to discuss my freedom with, but before long I realised my optimism was unfounded. Let me correct the record, and explain why, though my father and I do not get on, this is not a consequence of mental illness on my part, and most certainly not a sign of ‘schizophrenia’, the serious mental illness label that both Ghazala Watt and Jumi Banjo are trying to pin on me.

The psychiatrists know full well that sociability and good social (and professional) networking skills go against this ‘diagnosis’. Making out that I have no friends is part of the process of pathologising me and stigmatising me. It makes a mockery of the stated values of ‘Metro South Health’, which includes the Metro South Addiction and Mental Health Services (MSAMHS). These, their website proclaims, are “caring for people, leadership, respect, integrity, teamwork and courage”. I think I deserve to be treated with more respect, and so do other patients of the ‘service’. They also show little evidence of integrity, leadership or courage, and what they call a “team” is a hierarchical system where the psychiatrist’s word is law.

My Social Networks and their capacity to support me

 

I get all the support I need from my daughter, my friends and my social networks, especially from Facebook and the positive comments I get on my YouTube sites. Since I was told that Ghazala Watt was increasing the dose of the abusive injections she has ordered, I have also worked on my professional network on LinkedIn, increasing my list of contacts from 200 to over 800 in less than a week. Several of my new contacts are professors, including psychologists and psychiatrists, from many countries, but mainly in Australia, the USA and UK. I have found, over the years, that my scientific opinions are more likely to be accepted by psychologists than psychiatrists, especially the psychologists leaning towards holism, positive thinking, CBT, embracing change and promoting healthy motivation and activities, as well as mindfulness. I am looking out for progressive psychiatrists that will be prepared to countenance criticism of their doctrines without pathologising me. I have also had contact requests accepted by other medical doctors, by lawyers, journalists and authors, environmentalists, film-makers, musicians, engineers (especially sound engineers), art therapists, social workers, nurses, public servants and other professionals.

Unfortunately, increase in sociability and motivation are liable to be pathologised by the medical profession as signs of mental illness, namely ‘hypomania’ and ‘mania’. I was first locked up, in 1995 and again in 1996, following accusations by my father and my sister’s boyfriend Rob Purssey (then a psychiatry registrar) that I had mania.

Sudden change raises alarm bells in people looking out for mania and psychosis, so I have to be careful not to seem “over-sociable” or “overactive”. But I am a sociable man, which is why I have more than 2700 friends on Facebook. These include people living all over the world, and some whom I have known since my childhood in Sri Lanka. I can chat to them whenever I want, but most of the time I am busy working, not socialising.

It is true that not all my Facebook ‘friends’ are people that I know and like. I have accepted friend requests from people I don’t know, though I have refused others, if they were spam. I consciously set out to make friends with people of all the ethnic groups in Sri Lanka – traditionally classified as Singhalese, Tamil, Muslim, Burgher and Veddha. I have no Veddha friends, since they are forest-living people, but I have over a thousand Sri Lankan friends on Facebook, including Singhalese, Tamil, Muslim, Burgher and Chinese Sri Lankans. I went to school with some of these friends and have known them for more than 40 years. I have made a point of making friends with people of every major religion, though I no longer believe in the Anglican Christianity I was brought up with, and lean more towards Buddhism. I have friends who are both Protestant and Catholic Christians, but I have more friends who are Buddhist and Muslim, with a few who are Hindu or Jewish. I rarely ask people about their religion, unless they raise the subject themselves, but I am interested in finding common values in different religions and am interested in their different perspectives.

I also have many friends in the anti-psychiatry movement and the psychiatry reform movement, some of whom I have known for many years, though I have been actively making friends in these movements in recent weeks as well as joining some related groups.

Many of my Facebook friends are musicians, mainly in Australia and Sri Lanka. Some of my Australian friends are personal friends that I have played music with over the past 30 years and one is a guitarist who played with me in my first serious band, Strange Etiquette, back in 1986, who is now a well-connected psychiatric nurse educator and academic. I am also friends with other members of Strange Etiquette, as well as other Brisbane musicians, but I have musician friends all over Australia. This is not the situation of a person who is socially isolated.

I also have Google+ and Twitter accounts, and even an old MySpace site. I have uploaded about 40 documents, including several e-books to my Scribd site, which I have had for about 10 years. These include books I have written on eugenics, holistic health, schizophrenia and music, as well as books of my poetry. I have recently purchased a new WordPress site and am enjoying writing for it and watching the site grow. What I publish on my WordPress blog is automatically shared with my LinkedIn, Facebook and Twitter pages, and I am also able to make links to my YouTube and Scribd sites. My YouTube site has 304 subscribers, which is not a lot, but more than my father (who has only two). My most viewed video has had 20,000 views, this being a documentary I made some years ago on my research into eugenics, biological warfare and AIDS. Though it has the most views and likes (44) it has also had the most dislikes (10). Other popular videos include footage I shot of mimicry by a Pied Butcherbird (7,490 views with 29 likes and 2 inexplicable dislikes) and a clip of me playing the piano and singing “Living in a Bubble”, one of my original songs. I have uploaded 241 videos over 10 years, including my musical compositions, a documentary on the neuroscience of music, my art (and that of my mother) and more clips of birds in my garden.  I have also uploaded some videos about the militarisation of psychiatry, the pineal organ and my research into it, as well as a monologue called “The Pseudoscience of Schizophrenia”. I work long hours on the Internet, but enjoy my work.

With the help of LinkedIn I have been able to compare the professional careers and profiles of the psychiatrists and medical family members who have called me mad with my own work output, networking and public profile. From memory, I have been diagnosed as mentally ill (with various labels) by the following Brisbane psychiatrists, none of whose assistance I sought: Rob Purssey (who was my sister’s boyfriend and a psychiatry registrar) who has a LinkedIn (with more than 500 contacts) and YouTube site (with only 4 subscribers) but no Facebook page; Ghazala Watt (LinkedIn with 353 contacts and Facebook with 200 friends but no YouTube); Jumoke Banjo (no LinkedIn or Facebook); Justin O’Brien (LinkedIn with 250 contacts and Facebook with 1000 friends); Joanna Loftus (LinkedIn with only 36 contacts and no information about her qualifications, experience or background) Daniel Varghese (LinkedIn with only 7 contacts and no Facebook); Subramanian Purushothaman (LinkedIn with 2 contacts and not filled out other than ‘Australia’); Monica Des Arts (no LinkedIn or Facebook) and Paul Schneider (no LinkedIn or Facebook).

I have also been seen by Dr Jill Schilling who said I was not mentally ill after a single visit to my home in July 2015 and took me off the ITO the hospital had put me on; by Ken Arthur, a private psychiatrist who examined me at the request of the MHRT (LinkedIn with only 16 contacts, no details and no photo); by Joan Lawrence (in 1995) who agreed that I should remain locked up at the Prince Charles Hospital under Dr John Bowles and by Brett Emmerson, who certified me in 1995 and got me locked up at Prince Charles Hospital at my father’s request, based on information provided by my father as well as a heated debate I had with him when my father brought him to my parents’ house in 1995 to certify me.

Brett Emmerson and my father now have both LinkedIn pages, but Joan Lawrence has neither. My father has a Facebook page but he doesn’t know how to use it, and has no friends at all. John Bowles has a LinkedIn page that says he is now retired but is an advisor to the MHRT. He has 111 contacts including 10 shared with me. I have also been seen, initially for an examination ordered by the Medical Board of Queensland, and later on my own volition, by Dr Frank New, who I have not seen for a while, but wrote to the Medical Board in 2002 that he was confident that I did not have a mental illness (after a 3 hour interrogation). My father, angered by this, told my mother that Frank New “is not highly regarded”. Frank, who I have considerable respect for, is in private practice. He doesn’t have a LinkedIn or Facebook page.

Brett Emmerson has 274 contacts on LinkedIn, and also features in a single video on YouTube. This was uploaded in 2014 by the Metro North PHN (Primary Health Network) and is of a lecture he gave to junior employees in an auditorium. He is currently the Director of the Metro North Hospital and Health Service, which covers the Royal Brisbane Hospital and the Prince Charles Hospital. I have watched this lecture and found it very boring. It has only had 56 views in 3 years, and rated 3 dislikes and 1 like.

The directors of the PA Hospital and Metro South Health also have LinkedIn pages, namely Michael Cleary (Executive Director of the PA), David Crompton (Director of Metro South) and Balaji Motamarri (Director of the MSAHMS). Professor Crompton’s LinkedIn page says that he is “Professor and Director of the Australian Institute for Suicide Research and Prevention” at Griffith University (since March 2017), “Professor School of Human Services and Social Work” (Griffith University, since December 2013) and “Executive Director Addiction and Mental Health Services” (Metro South Health) from September 2008 to the present. He was a rural general practitioner before he became a psychiatrist and then a medical administrator. He too has 111 contacts including 10 shared with myself.

The website of Metro South Health has a photo of Professor Crompton (OAM) listing his position as ‘Executive Director’ of the ‘Metro South Addiction and Mental Health Services Executive Team’. Dr Balaji Motamarri (with the space for his photo unfilled) is named as ‘Clinical Director of Psychosis Academic Clinical Unit’. The ‘Chief Executive’, who I had not heard of until I checked the website today, is Dr Stephen Ayre, a graduate like me of the University of Queensland who did general practice before getting a Masters in Health Administration from the University of New South Wales. He was previously Executive Director of Medical Services at Prince Charles Hospital (2008-2014) before being appointed ‘Executive Director’ of Princess Alexandra Hospital and QEII Jubilee Hospital Health Network in May 2014. He was appointed Chief Executive of Metro South Health in July 2017. Stephen Ayre, like Robert Purssey and myself (but unlike all the others mentioned) has over 500 LinkedIn contacts.

The psychiatrist in charge of the MSAHMS “psychosis unit” and the man who is responsible for the hospital’s atrocious, negligent and disrespectful treatment of me is Balaji Motamarri, who has refused to speak to me, even on the phone, though I have been locked up several times under his authority. His LinkedIn and Facebook pages do not suggest a man with academic skills or computer literacy, which are essential for a man in his position in this day and age. He clearly does not know how to use Facebook, which 13-year-old kids can handle. Not knowing how to have a private chat with his friend Manju, he has written on his wall, for all to see:

“Hi Manju My apologies for not replying earlier. As you can understand we are “recovering” from our trip – the trip of “Telangana 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 of holidays’ – what a nightmare to the parents.”

This was posted in January 2010 and he hasn’t posted anything since.

Academia is competitive, business is competitive and medicine is competitive too. I have opted to compete with my detractors on an uneven playing field, in which I was at a disadvantage, with the stigma of having been, as my father puts it, “in and out of mental hospitals”. I think I have won the competition for social and professional networking, as well as work output and public response to that work. I have also disproved the allegation that I have schizophrenia.

Romesh Senewiratne-Alagaratnam

25.2.2018

Debating Ghazala Watt

Today, when I attended the appointment that was sent to me in the mail, the PA Hospital psychiatrist Ghazala Watt was prepared to lock me up again. She arranged for a man called Gordon, a middle-aged man with a shaven head and thuggish demeanour, who I recognised to have a Scottish accent, to come into the consulting room with us. I wasn’t told that Gordon was the ‘duty officer’ (I read it later in her report) but I noticed that he sat between me and the door. If Ghazala had decided to “admit” me, Gordon would have provided the muscle to subdue me, if needed. As it was, he sat there silent, unmoving and expressionless, while I debated with Ghazala Watt and tried, again, to correct her misconceptions.

I attended the appointment under duress. I have made it clear that I have no respect for Ghazala Watt and do not want her to be my doctor, or have anything to do with her. I am my own doctor, though I also have a GP, who studied with me at the University of Queensland and I used to consult a private psychiatrist, Frank New, who won my respect when he interviewed me for 3 hours and then wrote a 13-paged report explaining why he thought I was not mentally ill, and didn’t think I ever had been. This was back in 2002, when Dr New was asked to provide an independent psychiatric assessment for the Medical Board of Queensland, following my numerous incarcerations as a mental patient in Melbourne. Since then, he has rung the hospital on several occasions, saying that he does not think I have ‘schizophrenia’, the label Ghazala Watt is trying to pin on me again. The schizophrenia diagnosis (initially made in Melbourne) was discarded by other psychiatrists at the PA in favour of what they termed “psychotic disorder NOS”. NOS stands for ‘not otherwise specified’, meaning not otherwise specified in the DSM (the Diagnostic and Statistical Manual of Mental Disorders), published by the American Psychiatric Association (APA). It is a misconceived label, open to abuse, that has now been discarded in the current DSM V.

After our debate, I was asked to wait while Ghazala prepared a document that I was given by Gordon titled “CLINICAL REPORT – TREATMENT AUTHORITY REVIEW – MENTAL HEALTH REVIEW TRIBUNAL”, for “Romesh SENEWIRATNE”, supposedly “prepared” by Raghuvan (Raghy) Raman and Ghazala Watt. This is misleading. The ‘interim case manager’ Raghy had little to do with the preparation of the report – it is a repeat of the last one the hospital produced, and the ones before that, with a single paragraph by Ghazala following our debate today. The false claims in the report were initially based on a thorough character assassination of me by the inpatient psychiatric registrar David Nguyen in 2012, then modified and made slightly less offensive by the psychiatrist Daniel Varghese (under whom I was locked up in 2009, 2010 and 2011). It was later added to by subsequent psychiatrists, including Subramanian “Subu” Purushothaman, Justin O’Brien and the registrar Sagir Parkar but no efforts were made to correct the factual inaccuracies (or even the typographical errors) after the most glaring ones in Nguyen’s initial report were amended by Daniel Varghese 5 years ago.

Ghazala Watt’s own contribution is written in bad English and all in lower case without any capital letters except Sri Lanka (the first time, the second reading ‘srilanka’). It reads (under ‘current mental state assessment’):

“presented for the review on time, was seen in the presence of duty officer. remained focused on his father’s actions leading to him having medications and admissions to the hospital. presented with multiple writings about his father, political movements in Sri Lanka and anti psychiatric movements. remained focused on the cause of previous admissions in relation to complain about father and not in relation to medication noncompliance or treatment authority being revoked.

presented less irritable preoccupied with srilankan politics and mental health services being ‘sided’ with his father. insight remains limited with limited understanding on mental illness and the role of medications.”   

Watt and Raman have also changed the diagnosis from “Psychotic Disorder – Not Otherwise Specified’ to ‘Paranoid Schizophrenia’. Someone who uses capital letters correctly, but also with a poor understanding of psychiatric terminology and theory, has written the section on “current treatment”. This may be Raghy or Nigel Lewin, who is English and was my ‘case manager’ and monthly assaulter for several years, until he went on long service leave recently, when he was replaced by Raghy Raman, who is an Indian Tamil man of late middle-age who is sympathetic to the Tamil Tigers (LTTE), the terrorist organization that my father acted as a lobbyist and propagandist for during the war in Sri Lanka, and has praised in his writings and speeches since the military defeat of the Tigers in May 2009. His most recent book claims that the Tamil people in Sri Lanka are missing the Tigers now that they are not there and that the LTTE ran a “well-functioning de-facto state” that had a good police force and legal system with courts superior to parallel courts provided by the Sri Lankan government. This is nonsense. The LTTE “courts” killed, tortured and imprisoned people who stood up against them. They were run not by trained lawyers but by young LTTE thugs. The LTTE kidnapped Tamil children and gave them weapons to fight in a war they knew they were losing (after placing cyanide necklaces around their necks, which they boasted showed their dedication to the cause rather than the organization’s ruthlessness). They used Tamil civilians as human shields and shot civilians who tried to cross to the government side at the end of the war. They killed numerous Tamil leaders who were branded as “traitors” for siding with the government. My father was one of the people who publicly named these “Tamil traitors” who became assassination targets for the LTTE. And this is just what the LTTE criminals did to the Tamils, who they claimed to be fighting for the “liberation” of.

I had a discussion with Raghy about Prabakaran and the LTTE the last time he came to visit me. He was armed with an injection; I was armed with a video camera. I filmed the interview and uploaded it to my YouTube site a week later, after I was told that I would have to see Ghazala Watt despite my objections to her. This may be why Ghazala asked me, as soon as I entered the room, “Are you recording this? Because I don’t give you permission to record this”.

I answered that I don’t even have a mobile phone. She said “I heard that you sometimes record interviews”. I explained that when people come around to my house to inject me I am in the habit of filming them and the camera is visible for all to see. I reassured her that I wasn’t recording us. She, on the other hand, had a “witness” who would agree with everything she said (Gordon), and act as her bodyguard too. It is ironic that she called me “paranoid schizophrenic” when it was she who demonstrated the paranoia.

During our discussion, Raghy expressed conviction that AIDS is man-made (as I have long suspected) but also came out with some strange delusions, with a political twist. He said that the LTTE’s military leader Prabakaran was not a terrorist in his opinion, but an “activist”, who only killed the “other groups” (of Tamils) after he converted to Christianity and this killing was directed by the Church. He also accused the Catholic Church and Sonia Gandhi of killing her husband Rajiv Gandhi (the ex-PM of India) “to win the sympathy vote” so that Sonia could become Prime Minister of India. When I told him that the LTTE had admitted to killing Gandhi (by a female suicide bomber), he said that this was due to a deal made between Sonia Gandhi and Prabakaran and that the LTTE had been promised help by India to win the separatist war but that India had let them down.

I corrected Raghy, and told him some things he needed to know about the LTTE’s terrorism and other crimes against Tamil as well as Singhalese and Muslim Sri Lankans, but I didn’t confront his delusions as strongly as I could have. As it was, he evidently thought I had “elevated speech”!

It was Raghy who gave me the last injection and also gave me the bad news last week that if I didn’t attend the appointment I had been sent I might be “returned to the hospital” by force. Raghy also told me that rather than stopping the injections, Ghazala and the “team” had decided to increase the dose. The report I was given today claims that I have “elevated speech”, in the section on “Current treatment”:

“Assertive case management for ongoing review of mental state, risks and compliance with medication. Paliperidone IM medication increased to 100mg every 4 weeks in the context of possible relapse in mental state evidenced by elevated speech with the treating team. To have monthly reviews by case manager and psychiatry registrar, and regular reviews with a consultant psychiatrist.”

This is a confusion of psychiatric jargon. There is such a thing as an elevated mood (often misdiagnosed), but I have Raghy on record saying that I did not have one and that I was euthymic – presenting with a normal mood. The other psychiatric term is “pressure of speech” which is described as a sign of mania, not schizophrenia. An elevated mood is a sign of hypomania and mania, according to the DSM; there is no such thing as “elevated speech” in psychiatric terminology, such as it is.

Ghazala Watt claims in her CV that she has expertise in writing medico-legal reports. Yet she has written a report to the Mental Health Review Tribunal with poor grammar, incomprehensible sentences and no capital letters as required according to the accepted rules of English grammar, which are insisted on in legal reports. My 8 year old daughter uses appropriate capitals at the beginning of a sentence. One might think that a Fellow of the RANZCP should too.

My fresh recollection of this morning’s debate and interview are rather at odds with the brief assessment by Ghazala. Let me take it sentence by sentence, correct and include what she omitted.

“presented for the review on time [I was 15 minutes early], was seen in the presence of the duty officer”

I did not want Gordon, who looked like a neo-Nazi thug, to come into the room with us, but Ghazala insisted. She said she wanted him there, but not why. I had never met him before, and didn’t want to discuss personal matters in his presence. The real reason is that she wanted “backup” if needed. I didn’t know and wasn’t told that he was the duty officer, responsible for admissions from the clinic to the hospital.

 

The report’s next sentences are:

“remained focused on his father’s actions leading to him having medications and admissions to the hospital.” and “presented with multiple writings about his father, political movements in Sri Lanka and anti psychiatric movements”.

She has omitted some important information and misinformed the tribunal about what I carried with me to show her when I “presented”. I didn’t have “multiple writings” about my father. I didn’t have any at all. What I did bring with me, was my diary (which I showed her) and a folder I had titled “Public Image and Personae – Me vs. the people who are calling me MAD”. I didn’t show her this folder, but I selected particular documents for her to keep and read, including one piece by my father and two pieces by myself – “Theorising About the Pineal Gland” and “Royal Park Admission (1995)” printed off from my new WordPress blog. She had never heard of WordPress, so I explained what it was, and that I was writing about my psychiatric experiences. I didn’t have any of my own writings on the anti-psychiatry movement, though I mentioned it in my books The Politics of Schizophrenia (2000) and The Pseudoscience of Schizophrenia (2011) which I have not shown her yet.

At the end of the interview I also gave her a document that I hoped would give her some insight into my father’s modus operandi. This is a long and highly defamatory piece that he had published in the Britain-based expatriate website Colombo Telegraph (CT) a few years ago that purports to be a “psychiatric analysis” of the highly respected Sri Lankan politician Gotabaya Rajapaksa, who is hated by the LTTE supporters for his role in defeating the Tigers in his role as Defence Secretary. I gave Ghazala the first 10 pages of the article so that she could compare the sanity of my father’s writing with my own. This is the only thing I had in my folder about “political movements in Sri Lanka”, and it was not written by me.

What I did have in the folder, apart from these, were documents printed off the internet, from Google, Linkedin, Facebook and Youtube, comparing the work and image of four people – myself, my father, Ghazala Watt and her boss Balaji Motamarri, an undistinguished Indian psychiatrist who heads the “service” she kept referring to – the Metro South Addiction and Mental Health Services (MSAHMS) of which the PA is one of several hospitals. I was ready to debate the fact that madness and sanity are relative terms, but Ghazala rejected all talk of madness or sanity.

“What’s madness?” she asked

“Insanity.”

“What’s insane?”

“Crazy.”

I would have explained my reasons for thinking that everyone has false beliefs or delusions, and that these are propagated by several means, including the media, religions, cults, political parties, schools, universities and families. But such a discussion requires the other person to be open-minded and receptive to new ideas. Ghazala was only interested in denying concepts of madness and sanity in order to try and convince me that she and the “service” were “helping me” with my “mental illness” and not taking sides in what the report admits is an “acrimonious relationship” with my father. I doubt that Ghazala knows what acrimonious means.

 

I didn’t have writings of my own about “political movements in Sri Lanka” or the “anti psychiatric movement”. I had asked her about what she knew about the anti-psychiatry movement and she said she’d never heard of it. I showed her a printout of the first page of the “Worldwide Protest of the American Psychiatric Association” Facebook page, with a posting by myself, saying:

“It seems to me that psychiatry is primarily a system of character assassination”

“Why are you showing me this?” she asked.

I pointed out that the posting had many likes, and that it was part of a world-wide movement against abuses by her profession.

 

It is a sad reflection of psychiatric education for specialists in Australia that Ghazala Watt became a consultant and member of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) without being aware of the anti-psychiatry movement and scientific, ethical and legal criticism of her profession. Raghy and Nigel, the case managers, both psychiatric nurses, had heard of it but that’s about all. Raghy said the movement had been active for at least a hundred years, and he thought it was active in Melbourne, but I never saw signs of this during the 20 years I spent in Melbourne, during which I was locked up and injected more than 40 times between 1995 and 2007, when I returned to Brisbane.

In our brief conversation after my debate with Ghazala,  I asked Gordon if the anti-psychiatry movement was active in Scotland.

“No!” he answered, emphatically.

I then asked if he thought I had schizophrenia.

“I’d have to go along with the doctor on that, I’ve never met you before.”

“Do you think I am elevated?”

“Maybe.”

I explained to Gordon that I wasn’t elevated, or irritable, I was justifiably angry that the hospital kept siding with my father, who used to work at the hospital, against me.

The next sentence is hard to comprehend, but I think she’s trying to say that I was (and am) blaming my father for getting me locked up, rather than my not taking medications. I’m not sure what she means by “previous admissions in relation to…treatment authority revoked”. I have not been locked up because I was taken off the ITOs (Involuntary Treatment Orders – there were no such things as “treatment authorities” until the new Queensland Mental Health Act of 2017):

“remained focused on the cause of previous admissions in relation to complain about father and not in relation to medication noncompliance or treatment authority being revoked.”

In fact, as I explained to Ghazala, a previous psychiatrist, newly employed at the PA Hospital in 2015 by the name of Dr Jill Schilling had visited my house with Nigel in July and came to the conclusion that I was not psychotic and could not be legally kept on an ITO. After a single visit she took me off the ITO. The report says only that “ITO was revoked on 28/07/2015” but not why, and the fact that Dr Schilling thought me sane.

I told her what happened after that: my father pressured my mother to ring up the hospital complaining that they should not have taken me off the ITO and I was “again” saying that my father was involved with the Tamil Tigers. The fact is that I had never stopped, and that this was not just the truth but it was demonstrably true from his writings and speeches which are freely available on the Internet. The PA responded, to my mother, that as I had been taken off the ITO the only way I could be forcibly “assessed” was if she went to court and took out a “Justice’s Examination Order” (JEO), which she had never heard of. My father was in charge. It was he who drove my mother to court, but “kept his hands clean”.

I was then visited by police who told me I had to go with them back to the hospital, where I was locked up for a few days and discharged. Unsatisfied, my father continued his efforts to get me locked up and evicted from my house, enlisting the help of my next-door neighbour Jeff Miller, with whom he had several phone conversations (while refusing to speak to me on the phone and ringing the case manager to allege that I was harassing him by ringing him all the time, which was untrue).

This pattern of hostile behaviour by my father has continued to the present day. Only last month he shouted to my mother, “He’s getting worse. He’s completely bananas. You’ll have to call Miller and get him to call the hospital”. When my mother demurred he got angry, “What about the other neighbours? We can jump up and down and they [the hospital] won’t take any notice of us”. This was because Nigel Lewin had recognised my father’s animosity towards me and took what he said with a pinch of salt. Nigel and Sagir Parkar had also spent some time looking into my father’s political activities on the Internet and concluded that what I had been saying about his involvement with the LTTE was, in fact, true.

I was locked up again on my 55th birthday, on 22nd September 2015, after my neighbour Miller and my father reported me together, one (my father) to the Mental Health Services and one (Miller) to the police. Miller said I was armed with a knife and he feared for his life lest I run across the road and stab him, because in his paranoid imagination I hated him that much. The truth, as I reported to the police who eventually dropped the case,  was that I had not even seen Miller and had walked across the road to cut some bark off a paperbark tree for my art. Ghazala Watt’s report contains the version of this event as recorded by Justin O’Brien who was the consultant at the hospital responsible for keeping me locked up for the next two months, while my father emptied my house of its contents and convinced my mother to put it up for sale (rendering me homeless). He also employed workmen to chop own all the trees and shrubs I had planted over the past 8 years, and got my mother to sign a curt, legalistic note informing me that if I attempted to return to my house she would take out an ‘Apprehended Violence Order’ (AVO), though again, she had no idea what an AVO is or its legally correct use. My mother signed the letter in three places as directed by my father, and copies were sent to Justin O’Brien and the case manager. She has no recollection of signing this cruel letter two years later, and eventually relented and let me return to my home (she owns the house, but the title deeds are in the hands of my hostile older sister’s lawyers).

After she told me she was increasing the injection I told Ghazala that I was disappointed that she and the hospital consistently took my father’s side against me.

“There are no sides” Ghazala tried to persuade me, “Not your side, or the hospital’s side or your father’s side. I can assure you that the hospital is quite independent of your father.”

In her “assessment” she continues:

“presented less irritable preoccupied with srilankan politics and mental health services being ‘sided’ with his father”

Less irritable than when? I have never been irritable. I am a very calm and forgiving person, but I get irritated (not irritable) when I am insulted by people calling me mentally ill or psychotic, especially  by people who are wilfully ignorant or prejudiced. I was justifiably angry because Ghazala Watt had just told me that she had decided to increase the dose of the ‘antipsychotic’ injection from 75 mg to 100 mg. This was despite my explaining at the beginning of the interview that I was suffering from deteriorating physical health because of these abusive injections. I told her that I have gained 10 kg of weight and my daughter has recently commented on my “pot belly”, which I didn’t have in the past. Ghazala is well aware that weight gain is a common side-effect of the drug she insists on ordering be given to me against my will, under threat of being locked up again. Today when I challenged the science behind her “clinical decision” to increase the dose (rather than stopping the drug, which would be the ethical and scientific thing to do) she asked me, threateningly, “do you want to be hospitalised again?”

It was Ghazala who raised the matter of my father with me. She said he had contacted “the service” several times and complained about me, which is why she was increasing the injection (she later said that there were other reasons too, when I accused her of siding with my father against me). She said she had not spoken to him herself, but asked me to explain why I had posted things about my father on the Internet. She then said that she’d heard that I’ve also posted things about “our service” in which I had named names. I couldn’t deny it and explained that I am naming them and shaming them.

Interestingly the new report has taken out the previous report’s naming of the Tamil Tigers (LTTE) as the terrorist organization I was accusing my father of supporting. Instead it says that I was, in October 2016, “preoccupied with delusional thoughts about his father’s involvement with a political group”. I have never heard the LTTE described as a “political group”, or as Raghy would have it “activists”. Most people know them as ruthless terrorists, which they were.

Finally, she ends her contribution to the character assassination with:

“insight remains limited with limited understanding on mental illness and the role of medications”

My understanding of mental illness and the correct use of medications is at least as good as Ghazala Watt’s. I worked for many years in family medicine, including psychiatry. I know the role of the drug companies in shaping the thinking of doctors, and that drugs are over-prescribed and over-consumed. I am also aware of the pseudoscience prevalent in psychiatry with its various “chemical imbalance theories”. I have also researched the Australian psychiatric system and the role of eugenics in shaping psychiatric doctrine in Australia, the USA and elsewhere. I had to admit to Ghazala Watt, though with a smile, that I thought she was heavily brainwashed.

I explained to Ghazala that I needed to defend myself when people called me mad.

“Who called you mad?”

“My father. He calls me a bloody madman, all the time.”

“You don’t like that?”

“Would you?”

“I don’t know. No-one has ever called me mad.”

I held my tongue, but I confess to the urge to be the first to do so. That was a wise decision that may have stopped me from being locked up again, something Ghazala and Gordon were ready for.

“Let’s get this clear, I am not involved with mad, crazy and insane, I am a doctor treating mental illness”, she said.

A label of ‘mental illness’ is worse than a label of mad. It’s cool to be mad. It’s good to be mad at bad things, evil actions, oppression, torture and abuse of power and position. I’m mad at my father, and mad at Ghazala Watt, but I am not mentally ill. I am angry, and my anger is justified and rational. They say that the pen is mightier than the sword. I’m hoping that the pen is also mightier that the needle.

 

The Pseudoscience of Schizophrenia

The Pseudoscience of Schizophrenia looks in detail at the theory that schizophrenia is primarily an iatrogenic problem which is worsened by the current disease model in psychiatry.

The term “schizophrenia” was coined by a Swiss psychiatry professor named Bleuler who declared that the young people whom his rival the German psychiatry professor Emil Kraepelin had classified as “suffering from dementia praecox” had, in fact, a “split mind”. This was later discussed ad nauseum – was there, in fact, a split between “thought” and “affect” as the Eugen Bleuler has postulated in 1911, or is it a misnomer but still a valid label?

When I studied medicine at the University of Queensland in the early 1980s we were taught that though the term “schizophrenia” is a misnomer, it is, in fact, a “real illness”. This was said to be a developmental disorder that was partly inherited and characterized by “chemical imbalances” in the brains of people, many young people, who heard voices, had hallucinations, and held delusional beliefs. These beliefs, we were told, included such things as belief in magic, UFOs and that thoughts can be put into ones head by remote means (with no mention of the TV’s potential to do so).

This book questions this and associated jargon and doctrines of the medical branch of the mind sciences – the doctors who profess to have expertise in “mind treatment” (psyche+iatros=psychiatry) rather than “mind knowledge” (psyche+logos=psychology).

Talk therapies and words that are used in therapy (and by the media and wider society) have profound effects on the health of individuals and nations. The use of pseudo-scientific terms that rapidly become terms of abuse has a long history in medicine – take the terms idiot, moron, cretin and mongol, for example.

Nowadays people are abused as “schizos” and “being mental”. Yet the entire focus for what passes as “mental health promotion” is centred on convincing more people that they are mentally unhealthy and need to consult their doctor. The doctors themselves are groomed to prescribe at the drop of a hat.

Though there is a growing market in “antipsychotic” drugs the biggest money-spinners are the “anti-depressants”, especially the SSRI drugs. Depression is also amenable to talk therapies and non-drug approaches such as music, creative activity, building interests and social activity. Strategies for promotion of mental health without the use of drugs (or ECT) are explored in later chapters of this book.

 

https://www.scribd.com/document/71008178/The-Pseudoscience-of-Schizophrenia-by-Dr-Romesh-Senewiratne-2011