How ‘Drop the Disorder!’ colludes with the neoliberalism it claims to oppose

15-CPN-JM-SW-PK

(Panel discussion at the 2015 Critical Psychiatry Network (CPN) Conference: (left to right) Dr Joanna Moncrieff MRCPsych, CPN co-chair; Dr Simon Wessely FRCPsych, President of the Royal College of Psychiatrists (RCPsych) 2014-7; (unknown); clinical psychologist Peter Kinderman; Dr Hugh Middleton MRCPsych, CPN co-chair. Most CPN conferences have been reported, with accounts of the presentations, but although the Powerpoint slides were posted on the CPN website, I have been unable to find any report of this one.)

(Dr Wessely is discussed from the 9th paragraph, below)

 

Funding for mental health services has fallen in real terms over the last six years, and possibly over a longer period. As the editor of Asylum magazine, Helen Spandler, pointed out in her 2016 article, ‘From Psychiatric Abuse to Psychiatric Neglect?’, over the last 2-3 decades we have moved towards ‘the perverse situation where people may have to exaggerate their madness (and emphasise their dangerousness) in order to access or retain services. This is very worrying.’

‘Neoliberalism’ may not have one fixed meaning, but most would agree that cutting state-provided services in order to reduce taxes is a key element. Also, that Margaret Thatcher, more than any other politician, established it at the centre of political discourse from the early 1980s onwards:

 Image result for thatcherand sons

The Middle East journalist Patrick Cockburn is an expert in spotting unlikely political alliances, and he wrote this about Thatcher’s 1980s underfunding of ‘Care in the Community’: ‘The psychiatric hospitals were caught in a pincer movement from right and left. The left saw the asylums as being like prisons, whose inhabitants were primarily the victims of an authoritarian system. Films like One Flew Over the Cuckoo’s Nest propagated this attitude. On the right, such views were welcome because they provided respectable reasons for spending less money on the mentally ill and reduced the role of public welfare.’

In my view, calls over the last decade to ‘Drop the Disorder!’ represent a new form of this alliance between the ideological left, for whom treating and even supporting people with mental health problems distracts them from turning to socialism, and the state-shrinking neoliberal right. The beliefs that many such problems are either fictions promulgated by psychiatrists and the pharmaceutical industry (left version) or akin to malingering (right version, more straightforward now that profits on patent-expired psychiatric drugs are lower) are less in opposition than they might at first appear.

The CPN contains a range of leftist views, ranging from simplistic, even avowedly Marxist, ‘anti-neoliberalism‘, to lively cultural critiques, and more subtle approaches in which anti-capitalism is often buried in obscure discussions of Michel Foucault’s later writings on ‘Power’. CPN psychiatrists have mostly taken their anti-diagnosis discourse from ‘Critical Psychologists’, and I will only discuss Peter Kinderman as an example of the latter as he presented at the 2015 CPN conference; but he is probably the most prominent, having recently been president (and vice-president) of the British Psychological Society.

Peter Kinderman recently posted a talk he gave to a local Labour Party, full of lofty aspirations to ‘reduce financial and social inequality’ and promote ‘human rights’. He even had a photograph of Martin Luther King, who he quoted: ‘There are some things in our society, some things in our world, to which we should never be adjusted’. To be clear, I agree with these aspirations too, and with the view that inequality, abuse and trauma are major causes of mental disorder. But I differ in believing that support and psychotherapy will lead to more effective political engagement, not less.

Although he once, in passing, mentions mental health services as ‘under-resourced’, that is contradicted by the rest of the talk in which he implies great improvements can be made at no cost, or even with financial savings: he constantly stresses the claimed need to ‘reject…a diagnostic account of human distress’ but also reject ‘more of the same’ kind of mental health services.

No doubt these calls of ‘more money NOT needed here’ are pleasing to politicians in Whitehall, but also to Peter Kinderman’s local NHS managers in Liverpool.

But what of Dr Simon Wessely FRCPsych, who had become ‘Sir Simon‘ two years earlier, and at the time of the 2015 CPN conference was in his first year as President of the Royal College of Psychiatrists? Like their 1980s predecessors, The CPN and ‘Critical Psychologists’ tend to promote themselves as anti-establishment, so was the 2015 conference a confrontation, an occasion of mutual criticsm? Well, I have I have talked with several professionals and non-professionals who attended, and have been told that it was not. My explanation of this ‘mutual non-criticism’ follows.

Dr Wessely had been recruited to save money by ‘son of Thatcher’ Tony Blair’s government as early as 2001 (interestingly, Peter Kinderman reported a visit to the Department of Work and Pensions (DWP) in the same year). At the ‘Malingering and Illness Deception‘ conference in Woodstock, Oxfordshire, clinicians met both senior DWP staff and private companies whose ‘profits were threatened’ by disabling long-term disorders such as ME/CFS, which Dr Wessely (p.44) had based his research on over the previous decade.

Dr Joanna Moncrieff had been Dr Wessely’s MD student, and she had been interested in welfare as a drain on public spending even earlier, in 2000, when she published a paper warning that mental disorder-based ‘sickness benefits increasingly represent disguised unemployment‘. In 2016, a crack in the CPN’s ‘Drop the Disorder!’ consensus appeared when Dr Phil Thomas MRCPsych criticised another Moncrieff paper, which suggested that ‘to reduce benefit levels‘ was a valid primary aim for mental health services. Dr Moncrieff’s defence (below the Thomas critique, linked above), which started by irrelevantly stating that ‘almost all the data is already in the public domain’ and went on to repeat anti-neoliberal platitudes, was unconvincing.

Over the last 2-3 months I have come to the view that the CPN’s critique of the pharmaceutical industry is usually secondary to their concern about the ‘overmedicalisation’ of mental health:

Dr Moncrieff failed to respond to my point in this tweet. Since then, she has been silent about antidepressant hyping from the Maudsley Hospital/Institute of Psychiatry (where she did her MD), and about the overpromotion of ’emerging evidence’ claims from a leading psychiatrist employed half-time by GlaxoSmithKline (GSK) since 2005, who is active on a key RCPsych committee with Dr Wesseley. So has Peter Kinderman.

The selective criticism of pharmaceutical company behaviour by the CPN and ‘critical psychologists’ appears to go back, at least, to 2012, when there was little protest at the knighthood given to Andrew Witty, GSK’s CEO, for ‘services to the economy and the UK pharmaceutical industry’ (not for health), despite a $3 billion fine for overmarketing which was later confirmed as substantially ‘criminal’ and as partly relating to two antidepressants.

The CPN/’critical psychology’ alliance tends to claim sympathy with people who have difficulty withdrawing from antidepressants and benzodiazepines, but does not point out that medical supervision and support of such withdrawal is under financial pressure from their state-shrinking influence. Some ‘drug harmed’ people, who have been abused and shamed by another RCPsych ex-president, Dinesh Bhugra, as inventing or exaggerating ‘bizarre’ symptoms, partly motivated by ‘the incentive of litigation’, have noted a parallel between their experience and that of people with ME/CFS. Dr Moncrieff appears never to have commented on her former supervisor’s clinical area of interest, ME/CFS, but she has criticised patients’ self-advocacy as media-driven: ‘having a mental health problem has almost become a badge of honour among some sections of the popular press and numerous celebrity memoirs’ (p.77).

The unreported 2015 meeting between the CPN, Peter Kinderman, and Dr Simon Wessely shows that the post-Thatcher neoliberal state has found it useful to support a small but influential group of ‘Drop the Disorder!’ mental health professionals. In future Blog pieces I will explore aspects of this collusion further, and show how mental health diagnosis can be distorted and misused, sometimes oppressively, but is not inherently flawed as claimed by the CPN/’critical psychology’ alliance.

photo (4) - SW-JM-DS

Dr Simon Wessely after his presentation. Dr Moncrieff in the centre. Peter Kinderman (partly hidden) in the front row.

(My thanks to Dr Duncan Double MRCPsych (the only CPN psychiatrist who has criticised the RCPsych and Dr Ed Bullmore FRCPsych) for the photographs of the 2015 Critical Psychiatry Network Conference)

Added 20th January 2019: My earlier piece ‘Pillshaming is Real‘, is also relevant.

 

Twitter responses:

I am still waiting for Duncan Double (who seems to be a rare example of a politically centrist, or perhaps apolitical, diagnosis-sceptic) to back up his various responses:

DD links here to the 2014 Nutt & Bhugra Lancet article (I tweeted back that I didn’t agree I was ‘turning the tables’, and that I had deliberately avoided the ‘stigma’ issue):

In a later piece I will try and find some good evidence (although it seems obvious to me) that flat/reduced mental health funding leads to overmedication because that is cheaper than support and psychotherapy:

Added 5th June:

From the co-author of ‘The Dangerous Rise of Therapeutic Education‘ (2008), which argues that a wider ‘therapy culture’ is in itself harmful, and tends to distract from those who need specialist intervention. There is an update, including Mindfulness, in a 2015 Youtube video.

From @AkikoMHart (Mind in Camden, @HVN_England, @ISPSUK) who is currently looking at Dr Wessely’s MHA review. And also @RITB_

My response to @RITB_ was that ‘A Disorder for Everyone’ and ‘Power Threat Meaning Framework’ closely overlap in content and aims with ‘Drop the Disorder’.

Then a protest from the author of ‘The Psychological Complex‘ (1985) and ‘Governing the Soul‘ (1989), both of which influenced ‘Critical Psychiatry’:

From a Sheffield Humanities Professor who has written about the limitations of his own NHS psychotherapy. I would read (and agree with) his 2008 book chapter as arguing for less dominance of ‘scientistic’ CBT, and comment that Foucault and Heidegger (the latter un-named but present in the frequent use of ‘being/becoming’) are fine to explore in and out of therapy but in the wider context are useful for neoliberal state-shrinking.

CPN stalwart Duncan Double (see above) seems to be defending ‘Drop the Diagnosis!’ as being the only true path to Mental Health Utopia:

And finally, a response from the editor of Asylum Magazine, whose Twitter profile starts with ‘Politics of Mental Health’. Perhaps I misread her ‘From Psychiatric abuse to Psychiatric Neglect’ piece as calling for more Mental Health services funding?

About Dr Neil MacFarlane MRCPsych

Independent Psychiatrist providing culturally informed mental health opinion, advice, and a few new facts. Based near London, UK. Main qualifications: BA MBBS MA MRCPsych.

22 responses to “How ‘Drop the Disorder!’ colludes with the neoliberalism it claims to oppose”

  1. Anonymous says :

    Hi Neil, I’m a bit distressed by your article. Particularly this comment: “In my view, calls over the last decade to ‘Drop the Disorder!’ represent a new form of this alliance between the ideological left, for whom treating and even supporting people with mental health problems distracts them from turning to socialism, and the state-shrinking neoliberal right.”

    The call to drop the disorder over the past 40 or so years hasn’t been motivated politically, its been a very long slog by former, and sometimes current psychiatric patients who have suffered under the medical paradigm and want to have the opportunity to have their experiences understood as normal reactions, albeit sometimes complex and painful to trauma and difficult life situations. I’m one of these people. I’ve had 13 admissions to mental health wards over 20 years and each time, I go seeking and hoping for understanding and support and instead find myself (quite genuinely) in a prison environment where everything I say and do is misunderstood, I’m forced to take pills that only make me feel confused and foggy, and any complaints I make or anger I feel about the situation or even requests to have my legal rights respected (under laws that are very unjust to begin with) are all re-interpreted as “symptoms” of an illness. I’ve suffered from chemical restraint so severe that I couldn’t move a single muscle in my body, been dropped on my face because staff didn’t believe me when I tried to slur that I couldn’t move and picked me up where I fell like a rag doll onto the concrete floor. I’ve been forced to strip naked in front of staff and put in seclusion in a pink tunic, with a single blanket for warmth. And I’ve many times been covered in bruises by nurses who grabbed at me as I ran away from them in fear (understandably). Neither this or any other treatment I’ve ever received in a mental health ward, including the diagnosis and the medication has ever helped me understand and heal from my trauma or distress. Rather, it’s made it considerably worse. I have also lost a sister to suicide who wrote in her suicide note to thank her private psychologist for being the only person in the mental health system that ever listened to her, she received treatment in both public and private wards she simply couldn’t believe that the people who were supposed to be caring about her would treat her that way. I’ve had to bear the guilt of this for 5 years because I was the one who took her to hospital. It made things much, much worse. She was 23 years old. There are countless other stories like this.

    My experience has been, both in and out of wards (and many feel similar) that psychiatric diagnosis doesn’t understand human trauma or distress -rather it prevents the understanding of it, both in the psychiatrist and the patient. The patient is trained to think of their thoughts, feelings or any metaphorical aspects of their experience as “symptoms” of an illness that need to be gotten rid of, instead of understood as a normal part of the human experience that can be understood, integrated and grown from. The psychiatrist is trained to view their patient from the outside, paying attention to how they look through the diagnostic lens, instead of how to understand the patients own experience, and what it means for them from a place of empathetic attunement. It doesn’t do either the psychiatrist or the patient (or the community in general) any good. It’s a tradition that dates back to times when we didn’t have very much understanding of one another or of psychological trauma or distress. Often abuse (emotional or physical) or difficult childhood histories get overlooked because of the paradigm still having strong roots in the time when there wasn’t an understanding of the way in which minds, brains, people and their environment worked together. Pills are often seen as a necessary intervention. Sadly, quite often the only intervention, particularly when on the ward. This carries on into psychology and other disciplines who also look at a person in terms of their diagnosis, and the dominant theories around it – that are often very outdated views of a “chemical imbalance” or a “brain disease”.

    Since I found a psychiatrist who practices without a diagnosis my life has completely turned around, I get to be a human again. It is heartbreaking that this couldn’t have happened from the beginning. I lost 20 years of my life that I could have had. I lost a beautiful sister, my whole family lost an incredible, brilliant and caring woman.

    Psychiatry needs to move beyond the trappings of the past – when it was assumed that distress and metaphorical experiences were caused by a brain malfunction and it patiently waited for science to bear this theory out. There is too much at stake here.

    This has nothing to do with left versus right ideologies – though it does end up getting trapped in them because the people who care want to get patients out of the terrible conditions in psychiatric wards (I know of a 15 year old girl who has been locked in seclusion for 7 months as we speak, she has already suffered a cardiac arrest due to clozapine, has a neurological disease that is affected by stress and her life expectancy is dropping daily). These places are not just imagined to be prison like. They really are.

    Please put aside your qualms about political left or right positions, we really need a paradigm shift to drop the disorder

    • Dr Neil MacFarlane MRCPsych says :

      Hello Anonymous. My account of the history of all this was simplified for reasons of space. Of course you are right that ‘survivors’ with bad experiences such as you describe have always been an important part of reform movements in mental health.

      I agree with your statement that ‘Often abuse (emotional or physical) or difficult childhood histories get overlooked’. I also agree that an over-emphasis on the ‘diagnostic lens’ can lead to cutting corners on the seeing the whole person, and often contributes to over-/mis-diagnosis and overmedication.

      But I am not convinced it is possible to be a ‘psychiatrist [or any other mental health professional] who practices without a diagnosis’. You do not name any of the diagnoses you were given, but you now imply that you need ongoing help of some kind (perhaps even medication at times) which you regard as originally caused by trauma and/or abuse.

      In the UK most people would call this ‘Post Traumatic Stress Disorder’. Or drop the word ‘disorder’ altogether and call it ‘Complex Trauma’. Either way, that is still a diagnosis.

      Regarding inhumane treatment, I don’t agree that diagnosis, when properly used as I have suggested above, is the primary cause. We either decide to allow people to harm themselves and/or others or we do not. My point about ‘state-shrinking neoliberalism’ is I think very relevant to how humane compulsory admission and treatment is, because it is much cheaper to over-restrain and over-drug people than to provide well-paid and well-trained staff who have the time and expertise to engage with people who have acute problems.

      • Steve McCrea says :

        I would submit that the requirement of a BILLING CODE is very real in order to provide “treatment.” However, that it an economic/social issue that has nothing whatsoever to do with the legitimacy of or the effect of subjective “diagnoses” on the individuals involved.

        There is excellent evidence showing that the very act of diagnosing someone with a “brain disorder” leads to others losing empathy with the “diagnosee” and seeing them as “other” and more dangerous. There are also impacts on the ability of the person so diagnosed to reclaim agency over their own circumstances, as yet another person is now telling them “what’s wrong with them.”

        Moreover, you yourself will have to acknowledge that these “diagnoses” are subjective heruistics that have little to no actual scientific support as physiological defects in the body. In fact, the diagnostic categories put forth by the DSM are admitted by the DSM itself not to differentiate people into meaningful groups – see the intro to the DSM IV where it clearly states that there is “no assumption” that people qualifying for the exact same “disorder” “are alike in all important ways.”

        So the DSM has essentially grouped people together based on symptoms without any consideration as to cause or underlying physiology, and admits that these groupings are most likely highly heterogeneous. That works fine for insurance billing, but how can anyone claim to do scientific research on such completely meaningless and heterogeneous groupings?

        No one is denying that people exposed to highly traumatic events tend to have flashbacks, or that people who are mistreated early in life tend to be untrusting and have unstable relationships. But calling these subjective and heterogeneous groupings “diagnoses” gives them an authority that they do not deserve. And it is easy to see that the effects of such groupings include increased discrimination and “othering” of those so diagnosed, a disconnection from causal factors such as trauma, poor quality parenting, and the stresses of our bizarre 21st century society, and a tendency to approach all “cases” with the same “diagnosis” from a viewpoint of mindless reductionism, leading to overdrugging for profit and an increasing tendency to completely ignore context in the pursuit of “symptom reduction.” As there is no scientific basis for these “diagnoses” to speak of, how can you dismiss objections to psychiatric diagnoses as a purely political aim?

        • Dr Neil MacFarlane MRCPsych says :

          Steve…many of the points you make about diagnosis have been made by others and there are a range of responses to them. I think one of the best responses is by psychologist Vaughan Bell: https://mindhacks.com/2017/09/19/why-we-need-to-get-better-at-critiquing-diagnosis/

          Diagnosis and stigma: I think this is quite complex. Yes, pharma-enmeshed psychiatrists often overstate the stigma-reducing effects of stressing possible biological causes. And yes, there is some evidence for the opposite, but I am not sure it is ‘excellent’. In any case, I think diagnosis should be defended on whether it is reasonably valid in itself, not on social consequences like this.

          Psychiatry is only partly a science, so although I believe the concept of diagnosis has some scientific validity, I find most people accept the uncertainties inherent in diagnoses being about people.

          Trauma and diagnosis: see my response to ‘anonymous’, above.

          Diagnosis and overdrugging: if we abolished diagnosis we would still have ‘symptoms’ or ‘problems’ or ‘difficulties’. Amphetamines, barbiturates and benzodiazepines were all overprescribed before DSM 3. I think what really changed from the 1970s is that pharmaceutical companies became even more adept at promoting overdiagnosis and, of course, the drugs themselves: https://drnmblog.wordpress.com/2018/10/23/prescribed-harm-from-psychiatric-drugs-a-manifesto/

          Diagnosis as ‘purely political’: no, I am saying that anti-diagnosis purism often colludes with contemporary neoliberalism, but does not necessarily include it.

          • Anonymous says :

            Can you please explain to me how psychiatry qualifies in any capacity as a science. Yes, they do “research,” but what contribution to medical knowledge has psychiatry made which has withstood repeated applications of the scientific method?

            Is there a single element of psychiatry capable of holding up under the scientific method?

  2. thomas leonard says :

    The author seems to me to have a vendetta against some of our more enlightened mental health professionals. However the key issues are (1) to seek holistic forms of treatment which actually work (2) to maintain the population in a tolerable socio-economic state in the meantime. I regard anti-stigma campaigns and willy nilly demands to ‘drop the disorder’ as tangential to these objectives and to at times work in political opposition to them. I believe that some recent campaigns have gone to excess by failing to recognise that people on the Spectrum, including those with ADD, should be diagnosed and treated in an appropriate, holistic manner,

    • Dr Neil MacFarlane MRCPsych says :

      Thomas thanks for your comment. Perhaps you are not convinced that Peter Kinderman and others support ‘Drop the Disorder’? I think I need to do another piece on this. For now, I would emphasise the paper ‘Time to Drop the Language of Disorder’ (link in ‘anti-diagnosis discourse’, paragraph five, above). Also, last time I saw the header photo for @dropthedisorder on Twitter, Peter was in the group as was John Read.

      I am also sceptical about anti-stigma campaigns but like ‘Pillshaming’ I think the idea of stigma should not be dismissed altogether. A piece on that in due course also.

  3. runagainstcastration says :

    Maybe you could do a review of the cross-party human rights activists The Alleged Lunatics’ Friend Society opposing being diagnosed and kidnapped for treatments and their motives since 1845?

    https://en.wikipedia.org/wiki/Alleged_Lunatics%27_Friend_Society

    • Dr Neil MacFarlane MRCPsych says :

      Hi Alan (I believe). Sorry I missed this back in June when I was unwell and have only just caught up. From what I know of the history (it has been a while since I read Andrew Scull and others) I strongly suspect you could read ‘state-shrinking’ into the 1840s. Maybe I will try to bring this into a future Blog piece.

  4. Planet Autism says :

    “I will explore aspects of this collusion further, and show how mental health diagnosis can be distorted and misused, sometimes oppressively”

    Look forward to reading this. One example of this, is parents going through the family courts being deliberately falsely diagnosed with personality disorders, FII and mental health disorders to justify taking their children.

    Another important issue, is autistic females being misdiagnosed or undiagnosed, a fairly common misdiagnosis is BPD, or anorexia being correctly diagnosed but the underlying ASD not. Or co-morbid anxiety diagnosed but the ASD not.

    Yet another issue, is those with the PDA subtype of ASD being misdiagnosed/partially diagnosed with ADHD (even though up to 80% of autistics also have ADHD). There is a postcode lottery and patchy acceptance (or lack thereof) of the PDA ASD subtype. Many are going undiagnosed or misdiagnosed and then parents are suffering false accusations of child abuse as a result.

    Withholding of ASD diagnosis is prevalent. Recently, several areas have attempted to prevent access to ASD diagnosis for children, including a London borough, in breach of the SEN Code of Practice 2014 and the Health & Social Care Act 2008/12.

    Many children with neurodevelopmental disorders are being misdiagnosed with attachment disorder, despite that at any one time only 30% of the population are securely attached.

    “The Overdiagnosis & Misdiagnosis of Attachment Disorder”
    http://docs.wixstatic.com/ugd/58c8f1_c414ab0452b94c4bb3a80a5dfd6e54f1.pdf?index=true

    https://www.rightpro.org.uk/s/article/Are-Thousands-of-Children-with-Autism-in-Care-for-Erroneous-Reasons-Quite-Probably

    “False accusations of fabricated and induced illness against parents”
    http://docs.wixstatic.com/ugd/58c8f1_34b64b05a6174aa2a91cdaa5ca99f2a2.pdf?index=true

    Then you get people like Sami Timimi saying ADHD and ASD don’t exist. Don’t know how he’s not embarrassed, considering there are multiple studies on the brain differences in both conditions and biological differences in ASD also. Yes, in the States perhaps there is overdiagnosis of ADHD, but it’s definitely not the case in the UK and any tiny amount of misdiagnoses of either condition are far outweighed by the underdiagnosis and misdiagnosis into psychiatric conditions.

    The proof of corruption is out there.

  5. johnthejack says :

    There are I think two other key people involved in this: Mansel Aylward (1) and Frank Furedi (2).

    Aylward was the Chief Medical Officer at the DWP whose work formed the base for the Work Capability Assessment.

    The ‘diagnostic account of human distress’ is an echo of Furedi’s medicalization of normal human experience. The increasing amount of this medicalization is a social issue, best explained by… a sociologist like Furedi.

    Furedi has a bizarre group of acolytes who include Fiona Fox (Science Media Centre) and Tracey Brown (Sense About Science). Anyone who challenges their pseudoscience faces a full onslaught in the media attacking them.

    1. See:
    Problems in the assessment of psychosomatic conditions in social security benefits and related commercial schemes ManselAylward John J.Locascio Journal of Psychosomatic Research Volume 39, Issue 6, August 1995, Pages 755-765
    https://doi.org/10.1016/0022-3999(95)00037-J

    A Biopsychosocial Model of Sickness and Disability Waddell, Gordon, Burton, A. Kim and Aylward, M. (2008) The Guides Newsletter. pp. 1-13.

    Blaming the victim, all over again: Waddell and Aylward’s Biopsychosocial (BPS) model of disability Tom Shakespeare, Nicholas Watson, Ola Abu Alghaib Critical Social Policy Volume: 37 issue: 1, page(s): 22-41
    https://doi.org/10.1177/0261018316649120

    Memorandum on disability insurance
    http://www.whywaitforever.com/dwpatosmemodisins.html

    Companies House
    https://beta.companieshouse.gov.uk/officers/B3vXXsuIcfmpUkkt5aXK3QUizwE/appointments

    CV
    https://prabook.com/web/mansel.aylward/164087

    Job for wife
    https://www.independent.co.uk/news/top-doctor-in-job-for-wife-row-1153041.html

    2. For example:
    http://www.frankfuredi.com/site/article/the_seven_deadly_personality_disorders/

    3. https://www.theguardian.com/education/2003/dec/09/highereducation.uk2

    4. Hatchet job on ME patients for challenging St Simon, written by Michael Hanlon who had previously co-authored a work with Tracey Brown.
    https://www.thetimes.co.uk/article/this-man-faced-death-threats-and-abuse-his-crime-he-suggested-that-me-was-a-mental-illness-t250dr25xg5

    The SMC has recently stopped all pretence to be impartial on ME and tried in vain to scupper the release of the a reanalysis of PACE by publishing the day before the embargo was lifted on the press release: a response to the trial, a ‘before the headlines analysis’ and a factsheet. They later had to delete their accusation the US CDC had in some way been nobbled by patients.
    See also: https://johnthejack.com/2017/10/20/a-response-to-fiona-fox/

    • Dr Neil MacFarlane MRCPsych says :

      Thanks John…first off as a psychiatrist I don’t really follow the medical aspects of MECFS. My interest is more generally to do with disability, but also with those people who have ‘co-morbid’ depression & other mental health problems, as recognised by the medical advisor to the ME Association, Charles Shepherd.

      I have looked at some of the links you provide but others are less familiar. With regard to the issue of disability benefit (they keep changing the name) assessments, at least we seem to be heading in the right direction with the chair of the Commons DWP committee, Frank Field, calling for recorded interviews. Not the whole answer, of course.

  6. gaiusvincent says :

    I’ve only heard anyone suggest psychiatric help might distract someone from seeking (presumably revolutionary) socialism in a “Play for Today” on the BBC back in about 1970. Such thinking faded out with the collapse of the Stalinist Parties after 1956 Hungary

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