Adverse effects of therapy

I needed more than 140 for my reply to Dr Fulli: 


I agree that talking therapy can be very harmful. My Norwegian blog has numerous links to narratives of psychological harm from different sources: old-fashioned psychoanalysis can mislead people into years of labyrinthine bullshit, for example, and practitioners of behavioral therapy and CBT can also cause harm … often with the best of intentions and a firm belief that they are doing the right thing.  

I hope for serious research in this field in the future. 

And, Dr Fulli, I don’t only mean voluntary clients spending their own money. I mean that talking therapists can be aware that their therapy is based on one of many therapeutic theories, and may be less likely to treat disagreement as anosognosia, lack of insight, lack of capacity, also when the client pays within the NHS system. 

Speaking only for myself here: I have disagreed with and rejected four talking therapists in my life, and that has not had adverse consequences in the health services. But disagreement with and rejection of psychiatric help caused insurmountable problems: 
Quoting from this post:

I am not anti-psychiatry, I am pro-choice. And there will only be actual choice when we have an Advance Medical Directive like this German one, that makes it possible to “… specify in a legally binding manner which medical diagnoses and treatments I wish to strictly exclude and which ones I wish to allow”.

“Lack of insight” confirmed that I was “a borderliner” in the 1980s. And this kind of thing is still going on:

Linking to Mental Health Cop’s post on “Capacity”.

And embedding this: 


Regarding medication, every single person I’ve worked with in the last year has been put on antipsychotics almost immediately (…) with or without their consent Either they agree to it or they’re coerced into taking it or they’re just practically forced. Regardless of the diagnosis it’s always anti-psychotics, normally the same drugs (…) Normally the first drug they try is risperadone then they’ll try alanzapine, if those drugs don’t work they’ll try the older antipsychotics like haloperidol and for the people who don’t respond to anything they’ll try clozapine which has lots of side-effects and the person has to be closely monitored. Everyone is given these drugs, regardless of diagnosis.


People have insight. They know that they had a breakdown because of a distressing experience or childhood trauma or from coming off psychiatric medication. They have insight, and they don’t agree that they are mentally ill.


One client was told she had a psychotic illness and needed anti-psychotic medication. She felt that what she was experiencing was more of a psychological issue and wanted support from a psychologist. She got a psychologist to come and visit and really enjoyed it and felt that she was getting somewhere. I saw her being told by a psychiatrist on the ward that because she believed that psychology could help her, this was evidence that she was ill and needed to be sectioned. I’m not making that up, I witnessed that being told. As soon as you question their very narrow and fixed way of looking at things, they won’t hesitate to force you.

In our part of the world, “blasphemy” does not justify force or persecution in a religious context. Yet in a context of mental help, “anosognosia” is in the ICD-10 and justifies manipulation, violence, forced medication and deprival of human dignity and civil rights. Here is a definition from the Treatment Advocacy Center:

Anosognosia – “lack of insight” or “lack of awareness” – is believed to be the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications. A result of anatomical damage to the brain, it affects approximately 50% of individuals with schizophrenia and 40% of individuals with bipolar disorder. When taking medications, awareness of illness improves in some patients.

In a frame where lack of insight is a “result of anatomical damage to the brain”, a kind and sincere wish to help justifies force, threats, humiliation or just plain ignoring the patient’s opinions because one already knows that they are talking nonsense because one knows that they have a mental illness that is caused by the brain. And when psychiatrists also know that they think of psychosis in psychological terms and respect social factors and do not deny trauma and meaning, we get an always-wrong situation:

So … Is an insightful patient with rational reasons to disagree with psychiatric opinions as unreal as a diving giraffe?

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