Despite increased spending on mental health treatment, mental illness disability and suicide rates have skyrocketed. “Perhaps more disturbingly,” notes clinical psychologist Noël Hunter, “recent evidence has demonstrated that as contact with psychiatric intervention increases, so too does completed suicide, suggesting the possibility that the current mental health system may be creating the very problems it purports to aid.” In Hunter’s recently published Trauma and Madness in Mental Health Services (Palgrave Macmillan, 2018), she asks, “Are we continuing to funnel money into a fundamentally broken system?”
For many on the Left, it is obvious that the military-industrial complex is devoted only to its own preservation and expansion, thus routinely jeopardizing national security and freedom—this despite many men and women serving in the U.S. military who care about national security and freedom. Far fewer on the Left recognize that the psychiatric- industrial complex (which includes the American Psychiatric Association and its Big Pharma financial partners) is also devoted only to its own preservation and expansion, thus routinely exacerbating emotional suffering—this despite many individual practitioners who want to help their patients.
The majority of psychiatrists and psychologists, owing to both ignorance and cowardice, routinely comply with diagnostic and treatment notions that pretend to be scientific but which have been politically and financially forged. There are, however, a handful of anti-authoritarian professionals who have rebelled, and Noël Hunter is one of them.
Hunter is a rare psychologist. She not only has extensive knowledge of the empirical research, but she herself was once diagnosed with serious mental illness, and she takes very seriously the insights of “experts by experience”—recovered ex-patients—who Hunter quotes throughout her book. Both objective and subjective sources make clear to Hunter that the essential cause for what is called serious mental illness is not some kind of biochemical or genetic defect but some kind of trauma, and that the essential remedy is healing from trauma. For critical thinkers who are not mental health professionals, Hunter’s assertions in Trauma and Madness in Mental Health Services may sound like simple common sense, but it is sense that is not common in the mental health profession.
Wisdom has been derailed by politics and misinformation in the mental health profession (as is the case for many other aspects of U.S. society). Despite what the general public repeatedly hears from the mass media, there is no actual science behind proclamations that “schizophrenia” or other “serious mental illnesses” are caused by a biochemical imbalance, a genetic flaw, or any other innate defect. After many years and much money spent attempting to prove defect theories, even establishment mental health has rejected the widely popularized chemical-imbalance theory of mental illness (though word of this rejection hasn’t gotten out to much of the U.S. general public or to even many practitioners).
In contrast, there is a great deal of scientific evidence showing that people diagnosed with schizophrenia and other serious mental illnesses are far more likely to have been victims of societal and familial trauma. Citing the empirical research, Hunter reports:
“Adverse experiences, particularly in childhood (such as physical and sexual abuse, parental separation, bullying, parental death, foster care, neighborhood violence, poverty, racism, etc.), have been demonstrated to have a direct and dose-response relationship (meaning the more adversity, the greater the risk) with adult mental health issues like hearing voices, suicidality, drug abuse, experiencing altered states of consciousness, extreme and intense emotions, fragmented sense of self, obesity, depression, paranoia, beliefs in conflict with consensus reality, anxiety, and more.”
A great tragedy for people viewed as biochemically defective rather than as victims of trauma is that such individuals who are already suffering are then stigmatized and marginalized owing to their defect status. Hunter reports that “ongoing efforts to combat stigma by asserting that ‘mental illness is an illness like any other’ are actually associated with increased stigma and increased efforts to distance oneself from those deemed mentally ill.”
Politics has long dictated a trauma cover-up. The significance of trauma, Hunter recounts, was obvious over a century ago to Pierre Janet, and so too did Sigmund Freud recognize the importance of sexual abuse as a cause of his patients’ problems. However, Freud then shifted his focus onto unconscious conflicts. While it took some courage for Freud to talk about repressed sexuality, it would have likely been reputation suicide if he had continued to focus on societal and familial trauma—this would have challenged those in society who had far greater status and influence than he had.
To be clear, modern psychiatry does not completely reject trauma as a cause of emotional suffering, and with good luck a patient can get the kind of diagnosis in which trauma is taken seriously. Post-traumatic stress disorder (PTSD) was included in the American Psychiatric Association’s diagnostic bible, the DSM, in 1980. “This inclusion,” Hunter points out, “was largely the result of political efforts on the part of American veterans of war.”
Politics, not science, dictates not only the explanations for mental illnesses but their creation (as with the case of PTSD) and abolition, as was the case with homosexuality. By the 1970s, gay Americans, angry about their sexual preference being viewed as a disease and defect, finally had enough political power to compel the American Psychiatric Association to abolish homosexuality as a mental illness, and it was excluded from the APA’s 1980 DSM-III. Unfortunately, people diagnosed with schizophrenia and other serious mental illnesses lack the political power to change psychiatric dogma, and so they are seen as defective rather than as victims of trauma.
Phil Ochs sang: “There but for fortune may go you or I.” This is the reality when it comes to psychiatric diagnoses. You and I can exhibit the same behaviors, but whether you or I become a chronic psychiatric patient depends on our bad or good fortune. I’ve talked to many people who as teenagers and young adults innocently told their parents about voices that they were hearing and were then labeled by doctors as schizophrenic, resulting in long careers as mental patients. And I’ve talked with others who kept their voice hearing to themselves; these voices actually helped them have breakthroughs, and they have had no such careers as mental patients.
In a scientific sense, terms like “schizophrenia” are completely meaningless—wastebaskets to toss people who are behaving in ways that appear bizarre to doctors. Often what causes people acting in unusual ways to become chronically dysfunctional are their doctors’ problematic reactions and “treatments.” In other words, it is common for the source of chronic dysfunction to be physician-induced (iatrogenic) trauma.
In the real world of psychiatric diagnoses, probably the most important criteria for whether you are diagnosed with schizophrenia or dissociative identify disorder (DID) is how much your doctor likes you, and Hunter was likable enough to get a DID diagnosis. For reasons of dogma, not science, trauma is taken seriously for DID but not for schizophrenia (in which one is simply seen as defective). So, Hunter considers herself relatively lucky, and one senses her “survival guilt.”
Unlike many books critical of the psychiatric-industrial complex, Trauma and Madness in Mental Health Services offers a great deal of practical help for both practitioners and for those in emotional turmoil. In very concrete terms, Hunter offers chapters on what is helpful and what is not. The research, her own experience as a patient, and her discussions with other ex-patients inform her: “Relationships matter. Relaxation matters. Nutrition matters. Hope and purpose matter. Nature matters. Love matters.”
Professionals often waste their limited time obsessing over a diagnostic process that is scientifically invalid and unreliable. “Rather,” Hunter concludes, “what is more important is to take an individualized, collaborative, trauma-informed approach that is attuned to individual needs without making assumptions and considering the person’s subjective experiences as real and something to be respected.” It’s important, Hunter concludes, to help people find meaning and value in the adaptive nature of their atypical experiences.
In general, I have little hope for the mental health profession, but I have seen individual professionals rise above their desire for security and then revolt against the policies of institutions in the psychiatric-industrial complex. In academia, such rebellion can jeopardize one’s chances for tenure, yet a handful of educators are willing to take that risk. They care less about security than being remembered by their students for turning them on to a book in which they actually acquire knowledge about some very interesting human beings and that is of great value in helping them. Such a book is Noël Hunter’s Trauma and Madness in Mental Health Services.