The ethics of a profession which uses social conditioning

How fucked is that?

But when thinking about the latter part of the biopsychsocial model of mental illness these thoughts are necessary.

Think about it. I argue there are other forces than what medicine treats in mental illness. One of those is social conditioning. This can be two parts: conditioning individuals specifically or the greater whole.

But this shit is fucked up. As fucked up as psychiatry.

Psychiatry has no basic ethics to the profession other than that of doctors, which it breaches.

As I argue for the profession to change society I know what their mode of thought could bring. Normalisation even more.

So there needs to be a philosophical and ethical framework. This was lacking when psychiatry was incieved but for what came with being a doctor. A whole new set of shit needs to be sorted out.

And it has to be real ideals. Not the shit that was behind too much other social stuff. Fuck practical. This, too often, leads to harm.

What could technology do for mental health?

Moodscope or whatever is one idea. Mobile phones which can accurately detect mood or emotion are another.

But often technology isn't aimed at this. Spell checking, for example, was never developed to reduce the disability of dyslexia.

Technology in the minority has helped physical disabilities directly from the all terrain wheelchair to the crutch. The word dearth comes to mind when thinking about technology directed at goals of mental health.

Television and other media may make mental health worse.

At the moment I'm depressed and lack the high quality drugs which help me explore these ideas further.

Read this blog and answer the question yourself. Ideas are not the sole remit of bloggers or drunks.

Ask a better and much harder question: how does technology contribute to real human happiness?

Often it doesn't. Often it creates either unfulfilment, jealousy or satiation only when technology is purchased.

Understanding society's influence in the creation of mental illness

Comparisons of international epidemiological studies show surprising results. The poorer, developing world nations have less mental illness.

If mental illness was a real illness these results would be frightening. It would be like seeing several times the prevalence of heart disease in the Uk as there was in Nigeria.

Instead these and other pieces of evidnece are often forgotten in favour of using the evidence for medication and psychiatry working on the individual.

This I would call sociopathology except the word is already in use. Poorly. I mean a cause of illness in society. Perhaps aetiosociopathology might bewhat I mean.

We are, after all, products of our conditioning. What if there was some problem with all of our conditioning?

Here's what I mean in an example but probably explained badly.

Way back in the day when Kraeplin and Freud ruled the roost there was an epidemic of hysteria in the US and UK. And yet today there is no epidemic of conversion disorders or disorders related to sex which would be what hysteria is now called.

What happened? How was this healed?

Doctors used to bring their female patients to climax before the vibrator was invented as a medical treatment. So was it this?

Or was it the women's sexual liberation movement? Prudish Victorian society was replaced with more liberal and affirmative sexual mores.

Or was it acceptance of the symptoms of what used to be pathologised as hysteria? When people are hysterical now they're not called ill. They're just called hysterical. This is unlike unhappiness which is often named using the medicalisation.

This is a really heavy point which clever people could write a lot more about. The last paragraph about medicalisation of the human condition might be a phd or a book or something. Hopefully written by someone who can communicate better than I.

But do you get where I'm coming from? Do you get me?

Just think about the title.

Go on. You can finish this one off yourself.

Are chemical treatments against medical ethics?

When a doctor graduates as a doctor they take an oath to do no harm.

The GPs who prescribed and continue to prescribe antipsychotics to treat behavioural symptoms in the elderly broke that oath. The drugs reduce life expectancy in the very elderly by 50%.

The drugs were used as behavioural change agents to suppress the madness of the demented. Antipsychotics do not heal brain illness. They were prescribed for the effect which could also be achieved by a gag and a straitjacket. In fact the medication is often used knowingly in this role.

There were alternatives and only after the mass slaughter are they being considered. The primary one is acceptance and tolerance of behavioural symptoms by carers and society at large. Working in this vein doctors would be ethical but this mode of thinking is not in their frame of thought.

The drugs are dangerous chemicals. They cause illness and clearly cause death. There is limited evidence to support this in what doctors know and are taught however there is enough evidence to support the statement.

Perhaps one day there might be a magic chemical treatment which doesn't kill as it alters behaviour. But this is not a solution in my opinion.

Doctors work to subjugate and suppress madness. They call it an illness but it isn't. It is part of human behaviour and the condition we have all shared for generations.

Doctors have powerful tools available. But they lack the wisdom to see that madness may not need to be treated other than to be accepted.

Society has formed towards docility and peacefulness as a norm which I admit is a good thing. In the process though difference from this is seen as abhorrent and not tolerate. This is especially true in post-Industril Age developed world nations.

Doctors are guilty of enforcing social norms and an agenda beyond their primary remit. Many take this on gleefully ebcause it is more power to feed their power hungry complex.

But medicine is not about enforcing social order, not unless we live in the fictional reality of Orwell's 1984. It is about treating real illnesses.

There are more and more social problems which are entering the domain of medicine and psychiatry from obesity to freethinking. Sociopolitical desires are enforced using the paradigm of medicine.

Because it is dealt with by doctors there are few checks and balances. There is little oversight.

The result is many deaths and a society which is ill. Psychiatrists lack the insight to see the social problems can be resolved in other ways. They forget what they're dealing with because it isn't part of their education. They're dealing with the diverse human condition and they see extremes as illness. This is a foolishness that will be seen in the future, but in the mean time society is ill and the mad are being killed by professionals who breach their fundamental oath.

Do you care about human rights?

Then why don't you care about psychiatric rights, the rights of addicts or vagrants?

Aren't we human? Or is it just you who are human?

The human rights act strips rights from my kind. No one gives a shit. The bastion of idealism is as useful as used toilet paper, for true human rights at least.

Fucking cunts wrote it. Fuck 'em.

Behold. I am made death. Destroyer of worlds.

The quote is from Shiva. The Hindu god of destruction and one of the most important of the core triumvirate.

I don't know why I'm thinking of it. It is in such contrast to other Hindu ideals.

The reason the destroyer is so powerful? Birth and creation can not happen without it. The two other gods are for birth and preservation, but Shiva was vaulted because without him Vishnu ans Brahma could not work.

I suppose doctors are like Shiva. They destroyed 1,800 people a year in the UK when they used psychiatric drugs on the elderly unnecessarily. There was no rebirth for those old folk though.

Just death.

I loved an organisation

Someone astute helped me to come to this realisation.

I used to work for a mental health charity. I placed it on a pedestal. And then it broke my heart. I continued to be dligient but it ate me up inside.

I became a bad lover. I still love their vision. Even if I'm the only one who can see it.

Where have I been?

The last few days have been tough for lots of reasons.

Primarily it is the wreck which is my physical and mental health. That is all stuff I've faced alone for a long time.

I am taking antidepressant medication. I thought I could handle the side effects but taking them on an empty stomach washed down with alcohol is a way to intensify them. I hoped it would also accelerate the active effect.

I've been a mess for the past few days. The nausea has been difficult. They feel chemically too. This is hard to describe. I am usually ok with side effects but the mental place I was in meant they redoubled in impacting on me.

St johns wort is a much better option but for reasons I've explained in an earlier post I've had to take the strong stuff.

Indoingso I think I made things worse in the short term. I have given up when I contact a doctor and reach for psychiatric medication. So I've been doing less of the other things I should do to keep a good mental state. I just sat in my room playing facebook games. No fresh air. No exercise. No alcohol. No cannabis. All things which would make me worse. And I have been sleeping 12 hours or more for the past few days. No wonder I feel shit. And, of course, I am eating no better. Worse perhaps.

All that was easy enough but there's a new variable. I seem to care about someone else a lot and I had hoped to have a good weekend with her. I couldn't see her. Except perhaps for today. The whole weekend has been awful.

Today I felt good. I didn't eat nor take my medication yesterday. I slept a good 12hrs. Of course my beloved makes me feel better. But nothing else makes sense.

And so I have returned to the park. It is raining. I have a bottle of wine I'm working my way through.

I haven't thought about suicide much for the past few days either. This is strange, and scary.

The question of preservation of human types

We preserve books. We preserve the bones of animals long gone. We protect the diversity of animal and plant life on Earth. Organisations and institutions exist to serve this purpose.

But what of people and our individuality? Who fights to preserve us and the diversity of human being?

Few. And without those few there would be a terrible tragedy.

These few are those fighting against psychiatry, the engine which seeks to normalise the human race. This machine would flatten Everest for standing too tall and fill the Grand Canyon because all it can see is a hole in the ground.

The human types are a beautiful gamut but beautiful because of diversity, not their sameness. But the psychiatric model applied to this diversity works to make types extinct.

There are many campaign organisations in mental health but none of them give a shit. They use the propaganda of distress which, though relevant, is not really what psychiatry deals with purely. After all, when the APA demedicalise homosecxuality they didn't introduce a diagnosis for the distress of homosexual awakening.

Few truly apply diversity to mental illness. Theparadigm is used to destroy diversity of humans.

We are born with a right to be and a right to be an individual. These rights are circumvented when individuality is an illness.

Bipolar sucks

I can barely drag myself out of bed. I can barely write about how I feel right now.

Today of all fucking days. Bipolar is part of me. I suck.

How do we become: the -social bit

In the biopsychosocial model the bio- bit is well studied. The -psycho- part is less well understood but the -social part seems the real mystery.

The best example I can give is the different presentation of anorexia in Hong Kong which changed signifcantly towards a Westernised presentation after a media story which published the reference symptoms.

In this case the presentation of a mental illness changed in a culture. This is extraordinary.

Another case might be the introduction of tv to a tv-naive population. More eating and body image related beliefs were reported after the introduction of tv.

The healing of the hysteria epidemic is another major example. I can't elucidate more than to say the epidemic reduced to a relatively small prevalence. Perhaps the vibrator, something invented for the treatment of hysteria, was an amazingly successful treatment. Or perhaps society changed in a way which is beyond our explanation but healed the behavioural disorder.

And then there's homosexuaity. Healed solely by a change in sociey, not by the treatments. This aspect to me is least important to the question.

The question is how do we become?

I wonder if people can understand?

A few days ago I explained to a doctor that thoughts of suicide are a constant in my life. Even when I am in a phase of positivity I still think and wish for the end of my life?

Why? It doesn't even matter any more. A shortened life is a better life, that's all.

But imagine what it feels like. Imagine what struggling onwards feels like. Imagine what it is like on the inside, forever hoping my next attempt is final.

Of course I have no immediate plans.

Stigma, disability and mental healthcare

Stigma is not the only cause of disability. Society itself must change. Stigma is a part but...I guess discrimination is the word for the other bit but perhaps there's a better word.

First of all though stigma in mental health is not only about diagnosis. It is individuals themselves. Theirin lies the roots as much as anything else, least of all biology.

Severe mental illness comes with significant disability. Just like having no legs. To rectify a small part of the disability it wasn't an antistigma change which made a difference. It was ramps and lifts.. technology to reduce disability but backed by laws.

Fuck it. This is easy shit to work out.

Mental health as a way of enforcing social laws

Homosexuality was a mental illness. But today so are the...think they're called paraphilias...but I don't defend paedophiles.

I probably should but it depends on the definition. I would find it hard to defend someone who had sex with someone without consent or capacity to make the decision.

Let me be precise as I dig myself into a hole of shit. I had a chat to a doctor about one of his patients. This patient knew a lot. He'd been having paedophile thoughts. He came to see his doctor because he was having trouble controlling them. He'd never done anything to a child but he feared doing it. He wanted therapy. The doctor was unsure whether to report him to the police.

He had done no harm, was not hiding his condition from his doctor and was seeking thought/behavioural modification.

In another country or another time paedophilia may not be unacceptable. I think it's a Polynesian country or somewhere round there where the king deflowers every virgin. It is a culturally accepted and, perhaps, enforced thing. I assume it is bound in the culture and the act itself isn't something out of a porn movie.

But in this culture there are social and criminal laws. This individual was aware and aware of his deviance. He went to a doctor iin confidence. He wanted to be 'fixed'.

This is about social laws, behavioural modification and choice. Let me tell another small story. I used to work at a mental health charity and someone came across a piece of recent research that showed 15% (or something like that) of therapists would try to change or adapt a clients sexuality if asked.

I was disgusted and so was he, but for different reasons. He was gay and he was surprised at the 15%. I'm not but I believe in gay rights but more importantly choice. I was disgusted at the 85% who'd not done what the client wanted.

These two stories are just the start of a thought process. What is mental illness? What is paedophilia? Other stuff too.

Let me be clear. I am not adocating paedophilia. I'm trying to explain how social laws and psychiatry are bedfellows, irrespective of a biological component however biological evidence may be used to support the social law and treatment may involve chemicals.

Equality of action

Since 1983 a legal instrument has empowered doctors to govern the lives of inpatients. In 2007 it became even more coercive and stretched outside the psychiatric ward with new legal powers.

The new powers catered for the incaceration of people who'd committed no serious crime but were at risk of committing a serious crime. New powers allowed this primarily because of the risk of homicide by a mentally ill person.

If forget the figures but it's something like 100 people a year are killed by people with a pre-existing condition.

There's always an unhealthy level of media coverage whenever someone with a pre-existing condition kills someone. It's so much rarer covered but happens more often that the person takes their own life, not someone elses.

When 1.800 people with an organic mental illness were unnecessarily killed what happened? Was the presonse anything like the thalidomide scandal?

What about clozapine? When originally introduced it slayed many schizophrenics. After it was reintroduced it continued to kill. One newspaper, the indepedent, had a story about the reduced life expectancy - even worse than for other antipsychotics.

What about ect? The treatment has killed many. For many it doesn't work after treatment either.

So many dead. So many of the mad dead. With no protections doctors can get away with whatever they want.

200 years ago the treatment know as waterboarding was used on psychiatric patients. Today, in civilised nations, it is deemed illegal torture even in war.

Doctors seem to be saved from the sort of proper oversight. The mentally ill aren't protected either. There is no equality.

A small number of tragic murders by the mentally ill are enough to coerce them enmasse. But when doctors kill them? Fuck. Give them more power.

Why do I have a beef with mental health charities?

One of the themes in my rants here is the divide between true illness and what is mental illness.

For a long time I've tried to work out what mental illness is. Perhaps I'm slow, or perhaps I need good answers. It's been years thinking about it and I have no reduction.

In fact there are many concepts for which mental health is used. Some of these need different thinking.

It's why I prefer the phrase the human condition. Illness immediately carries with it concepts which may not be suitable.

It is the bit where it is about behaviour, personality and emotion. It's the bit where the system governs how mad, bad or sad a person is. This is where I feel the practice of medicine is not suitable because it requires different thinking and techniques to 'treat' the human condition.

Making people docile is no solution. Evidence can be used to justify its use but this isn't science. The question of treatment of the other construct, society, is little considered too though there is enough evidence to point to an illness here.

The NHS drugs people to treat their behaviour. Doctord have killed many and tortured others all to treat their behaviour.

The system has little oversight. The laws...well there are few if any protections or bills of psychiatric rights. The legal system takes away rights but protects few and allows for barbaric, coercive treatments.

There are still barbaric things done to people in the name of mental health. While some cunts talk about distress and want more funding for behavioural modifcation there are people dying and being harmed.

The system may not even offer people what they expect. Yet the charities languish their time on fuck all useful.

Why do I have a beef?

Social contact theory

Social contact theory was a great hope of mine. A driver in the move for change in society.

My explanation for it is about knowledge and people. People are informed by personal experience. When there is none they build their framework of understanding by whatever else is about, which is often the mentality which leads to prejudice.

To defeat prejudice it takes social contact theory applied at a grassroots level. I hoped this was the way forward for mental illness.

It isn't. Not without the key element: coming out.

The reason is because of drugs. So many people do them but so few know. Those within social circles of drug users know other users. Those outside don't.

Drug users who cross the line from circles of users to circles of non-users make a choice and the choice relates to activating the power of social contact theory.

Though many do drugs they keep it hidden and are only open in their circle, where they feel safe. They never speak out in public for fear of career and reputation.

Such is the stigma.

Social contact theory takes signifcant personal change and, perhaps worse, sacrifice. It is always those forebearers of change who get the worst of it...be it suffragettes or gandhi.

The mental health system works to ensure this never happens. It takes courage and insanity, things their treatments remove and the diagnoses perjoratise.

Could love be defined as wanting a person to be in your life?

This is not a theorectical question per se. More a question to engage abstract thought.

Love means many things. Another nebulous concept... is the above statement concise enough or elegant?

I don't know. Just posing a question.

Saw a doctor and started taking antidepressants today

That's all I've got to say I think.

Oh. And I need some skunk.

Divided society

Exclusion. It is one of the great fundamental problems. We can crack the secrets of material reality and the universe but solving ourselves and our society. Fuck. That's a fools errand.

Thankfully I live in a time blessed with fools.

I'm just a drunk myself though I dabble in the art of foolishness.

I see society as the cause of this exclusion. But I see it simplistically and with a human cause. It is the reaction to difference which creates exclusion and ills.

Society is formed for those who are like machines. Those most like a robot thrive and those who are on the other side of the dividing line are dealt with through the mental health system.

On one side is normal. The other side is different. Studies use different models or measures for different.

The different, those not of robot-like nature, are apparently mentally healthy and the rest should be like them. This is the power of psychiatry. Without question change can happen at the whim of the psychiatrist.

The entire system places a divide upon the human condition. There is no good lifetime prevalence estimate but a guesstimate based on current studies and a US estimate of lifetime prevalence is around 50%.

About 50% of us should be more like the other 50%. That's the influence on the divide effected by psychiatry.

Details
1 in 4 in a year. Good academic standing for that figure in the uk. In fact 3 in 10 if you bother to read enough.

No lifetime prevalence estimate available for the uk. Only one sutdy I stumbled across gives an estimate for the us. 1 in 2 lifetime prevalence roughly.

My memory ain't great. I have other faculties. But if I remember right the incidence figure for the us is 1 in 5.

Now I know there's theorectical concerns about all of this journalist-level science explained here but it's enough to guesstimate that current definitions of mental illness (in practice purely) must be about half the population at some point in their lives.

But what does treatment mean? No real treatment. Just a chemically induced change of state as long as the drugs are used. Drugs which don't heal biological differences which are the justifications of illness paradigm applied.

Do I make sense?

Now that feels a little better

Wouldn't it be great if there was a charity campaigning for The Different?

Just sit with me here.

Inhale and think.

There are smaller movements and large movements which touch upon this mission. But no one who takes this as their crest.

Imagine an organisation which campaigned for The Different?

They wouldn't be popular. They'd fight for those that weren't popular. From fat kids to fucking psychos.

How weird would that organisation be? The voice and shield of The Different.

It would, of course, be aligned with mental health because, after all, what the fuck? A system to suppress and make ill those who are different using the paradigm of illness.

What the fuck. What the fuck? Fuck! Why is no one doing this already.

True treatment and mental illness

As anyone might gather I see mental illness as a biomedical concept. It isn't an illness though and the biopsychosocial model (possibly prefixed by spirituo-) is closer to a truth. This also applies to real illnesses.

But the question of real illnesses isn't primarily about who a person is, their individuality and behaviour.

If asked why am I mentally ill a doctor would probably say brain deficit or problems with neurotransmitters. They might say life experiences.

If asked why am I how I am the closest truth is the same as the closest truth for why I am mentally ill.

This can also be true of physical illness.

But physical illness is treated biologically. Hearts are fixed and cancers expunged. The biological differences in mental health are rarely treated. Chemicals work on pathways as long as the chemicals are in the system but do no healing in the traditional sense. They affect behaviour and emotion. They do this biologically but don't really biologically heal. This may alter prognosis but that doesn't make it a biological treatment.

So its not an illness and treatment makes little attempt to rectify the biological, biomedical problem.

It is just what drugs can change...

Why is there a survivor movement?

Enusp is a psychiatric survivor network. There are other survivor organisations.

Why is this? Is it because of the 'illness' or perhaps because it isn't really an illness.

There is no movement to depathologise cancer. There is no movement I am aware of which considers cancer treatment abuse, even though it can be dangerous and harmful in itself.

The mad, of course, could perhaps be paranoid and this movement of survivors a collective symptom. They lack insight into their condition. Their illness. From a power-holding psychiatric perspective this argument could be used to suppress any movement or free thought which considers psychiatric treatment abusive.

So is it a pathology to think that a person can be a survivor rather than only the saved as a result of psychiatry in their life?

The question can only be answered by survivors. Few know of this movement, their experiences or perspective.

Equality

There is nothing more today which needs more pursuit with greater urgency.

What equipment does a live music photographer need?

Fast lenses and a fast sensor. That goes without saying. The canon 5d mk2 is the benchmark.

Adobe lightroom. The software is worth it, especially for sub-35mm sensors.

A 50mm f1.4 or f1.8. This lens is as fast as they get. The qualityis usually insanely good for the price point.

A monopod. Image stabilisation is good but there's nothing better than good technique. Learn to hand hold and use any object as a support. Drink at least one beer too.

The other lenses are a telephoto zoom. A 70-200mm f2.8 is suitable. A wide angle lens is useful too. It's not my area of expertise but an f2.8 wide angle is suitable for DJs. Faster optics are always better but these are rare or expensive when wide angle lenses.

That's the core equipment. Doing events photography is different. A fast standard zoom and good flash is required.

I currently use a canon 50d. The lens is an old sigma 70-200mm f2.8 which only works at f2.8. This is the widest aperture which offers the worst quality and smallest depth of field. The lens is old. It has a metal body which is scuffed and scarred. The lens optics are too. The motor is worn and the oil may have dried up so I have to use it manual focus.

I still get good shots because more than equipment there's being out there shooting. That's how photographers get good shots.

Bentall has already proposed a complaints-based system.

In his book Madness Explained he rips into the science of psychiatry, particulaly in schizophrenia, and alludes to its pseudoscienceness.

He saw a complaints based system as a way forward. At least that's what I was told. I got about halfway through the book.

What I reckon is this is pretty necessary.

Step 1 is understanding what patients want and expect. This is often least considered. It takes lobbying and campaigning. Listening is not a skill in psychiatry.

There isn't a definitive study of this as far as I am aware.

There is a small, scattered body of work though and this forms a starting point for progress.

Step 2 is making measures which are useful in practice and research.

The funky thing...and here's the really fucking funky thing is aligning this structure to successful treatment.

Let's take the assumption that many patients who accept treatment from psychiatrists have different ideas from theoretical psychiatry. For example their definition of psychopathology of schizophrenia is delusions and hallucinations. While psychiatrists may argue this is incorrect I am disinterested in their opinion.

I'm skipping the first step which is about truly understanding and delivering in what individual patients expect from treatment. It's to focus on the second bit. Getting the evidence to make clinical decisions based on this new system whereby the patient matters.

So the easy thing is a full systematic retrospective review of all modern trials of treatments for psychosis. I am sure clever people like dr Joanna Moncrieff or Prof Rich Bentall and their ilk could work out the details of a good paper. This is a relatively cheap research project I guess though there'll be a lot of contacting authors to get acess to all the original data.

The system creates a new diagnostic structure for the evidence. In fact it could be refined to delusions or hallucinations alone but differentiating between the two in clinical practice is probably beyond current medical expertise. Regardless, the patient request of "I want these delusions and hallucinations to cease" can allow a doctor to say "here is the best evidence based way to change that", thereby achieving what patients expect and creating an effective way to treat.

Of course this risks polypharmacy and all sorts of shit if it were a general system so I need to think more about this. Perhaps the best solution is..bugger...don't know the technical term...

Basically not all people will concurrently suffer all symptoms. There have also been other classification systems suggested for schizophrenia. Subtypings.

I have no idea if what I'm talking about is related to the dimensional model.

Basically in the large mass, often described as heterogeneous, of people with schizophrenia there may be subtypes which specifically relate to successful treatment which psychiatric science as yet doesn't see.

Let's take a basic measure like panss. What if a person score high on other measures than delusions and hallucinations. Someone must have already done this sort of pattern analysis. Its obvious. This is all about making types given a black box reverse engineering situation.

Statistically identifying types within the measured main category must already be the fundamental of psychiatric science. Assigning treatment basewd upon those mathemathically defined subtypes using practical clinical definitions. Well thatzls a good definition of psychiatry?

And so this little bit of research I'm talking about must already exist. Its obvious to do this small bit of research into what works based on patient and public expectation.

I mean...fuck...otherwise psychiatry would only be killing people with treatment to deal with their extenral behaviour and the effects of the cause. With antipsychotics I mean. If they're actually only major tranquilisers and that's the only efect psychiatry cares about..

Well...I think the entire profession should be struck off if that were true.

For about half my life since the age of 25 I accepted psychiatric treatment. I was never happy with it.

For the other half I've survived without psychiatric treatment. My internal experience of life has been better but my external reality is a wreck.

At the age of 25 I was a corporate tyke with all the ambition of people working for blue chip companies. For years is struggled with my new identity, the mad, and feared for my future because I of the madness.

Today I am become whaty my old me feared. I am sat here in tattered clothes with a bottle of wine sitting alone in a park writing to my blog on a cheap smartphone. My clothes match my life.

I have been tettering on the bring for months and perhaps years. Eventually I'm accepting my failure. I have changed so much since I was 25.

I tried to thrive but I failed. I'm bitter, empty, twisted and something of a wreck. So much so I can't even manage to see a doctor. I just escape to the park with the same bottle of wine and some herb.

I've suppressed or not felt the difference in me. It has hit me like a wave as others things in my psyche also topple.

I value sadness and madness and worry and all the other stuff. But there's only so much a human soul can take.

I don't even have the hope that in 4 years I can have a peaceful, civilised death. Dignitas exclude the mentally ill too.

The nhs are ready to capitalise on my sense of failure. I risk all manner of bad things but when I need help like this there is no where else to turn.

I need relief and the relief is a drug. I need to get back to work.

A banal idea

In the time we live we spend a lot of time at work.

These are like schoolyards. Employment in reality and employment law are two different things.

Why not change the yard rather than the law?

I need a drink to think.

I am tired of my own failure when there is really important shit going on

1.800 died every year in the UK when doctors chose to use antipsychotics on them.

I have failed to persuade you or anyone that this one piece of evidence shatters the medical paradigm.

Every doctor remembers their first words. The Hippocractic Oath. If they don't then they should quit the business.

I am a lay person. I know it only as "first do no harm" and implicitly the next line is "or suck on my choclate salty balls". The reason for the next line is because of my heartfelt belief in the ideals of healers. The first line is the ideal.

The drug was used as a behavioural agent in the community and it made life easier. The almost dead were docile and quickened to their death. This was sanctioned by doctors. Fucking ace. They'd never kill unnecessarily...right?

The royal college of psychiatry report where I quote the 1,800 a year figure from didn't do enough. Now doctors murder but are measured on how little they murder when they offer these drugs in the community.

It is, after all, murder when the option is to train carers to deal with the elderly since society seems to have forgotten that when the elderly get close to death they get cranky.

My own failure? I can't make people listen and hear and see.

Whatever I am I fail in my goals. My logic and shit is questionable. My evidence is hamstrung but persuasive. My argument is ropey yet at the same time it is hard to counter.

The treatment for dementia, as an illness, is regenrating brain matter. The treatment for the mental 'illness' is fucking with dopamine transmission to enable the same result as any other form of b ehavioural restraint or change agent. No treatment of illness was achieved by antipsychotics.

Oh shit. And did it kill everyone about 50% faster? No. Scientifically it killed some a shit lot quicker than others. 50% was the average. At leasted the one in the one study which promoted the royal college of psychiatrey report. The only one in modern times where life expectancy of a large number of people on antipsychotic medication is compared with a decent fucking control.

In really old people, where the effect is magnified, where there's use of antipsychotics, again because this is an observational thing and those people may be more close to death and further progressed and shit, there's a marked decrease in life expectancy.

Okay so their are criticisms but shit me...50%? It was enough for the royal college of psychiatry to admit manslaughter the likes of which the UK has never seen.

...

So I am clearly an extremist with poor communication skills. I fail day in and day out. People are already dead and many more are dying. I can't even fucking communicate that need.

2 fucking years?! What the fuck. That's all I have? This blog. I tried to do more but I got fucked on again by life and my own stupid hopefulness.

I drink while others die. I collapse inwards while others die. I make an informed choice about my death. When it comes. Others don't. They die because doctors don't do what they used to.

First....the reason that word is there is because it is important to remember what comes next...do no harm...those words are there because if something is going to hold stronger than a religion then no matter what time, no matter what world let the healers have one and only one dogma.

So I admit I also have some weird ideas but the rest of this shit. Well I just could have done better.

Who or what is the voice in your head?

The funny thing? This a question which deserves to be in the next census.

It is not a mental illness. The question is fucking important though. Too many hear it an never ask. Too many ask and have few answers for themselves.

No one has an answer because the question has not been asked properly. It is not a question of what I believe. I am, after all, an antitheist.

Ask the question. Then asked those people again in 2 years.

That would be pretty interesting? The 2 years might seem arbitary and pointless. Not when you know the journey though.

Just ask yourself. Who is debating or commenting or speaking within your stream of consciousness to you?

A hard concept

I may be a little slow. Or maybe not. I just need to slot things into holes and places rather than remember and rejurgutate. It may be a crystalising intelligence to compensate for deficiencies in memory, or deficiencies in memory which were masked by crystalising intelligence. Or something else. I don't know.

I have laboured upon the question of what is mental illness for far too long than any sane person might. It has been a hard and challenging concept. It took me a year but I got the reduced concept of this crazy technology thing. I've not yet reduced mental illness.

No one has either. They're all 'nebulous' which might as well be synonymous to bollocks in this vernacular but in the mode of science and philosophy and rights and medicine.

Medicine, by which I mean the professional faculty of healers rather than pills alone, is a speciality which is beautiful but made ugly with time. Most often in mental healthcare.

What is illness is an important thing. I think a cold is an illness and there are alternatives to treating it. I think obesity is not an illness and neither did many doctors until treatments proliferated. I think smoking is not an illness but it is treated by the NHS. I think homosexuality is not an illness.

But I have no suitable reduction of what mental illness is and is not.

Linking a lot of things

Patients want one thing. Doctors want another though some want what patients want.

Psychiatric research? It usually helps the psychiatric hegemony more than any of those two things.

So why not think about commissioning research ina different way. Of course experimental research and psychopathology stuff needs to be done but achieving what patients want and expect...isn't that what we expect of doctors?

Or do people with schizophrenia expect to be made docile? Do manic depressives understand their type is being suppressed from existence? Do people know what happens to the good things in their life when they accept psychiatry? Many can disappear.

Can people expect to use a health system that doesn't achieve what they want? Yes. If they use mental healthcare.

I still believe that someone, somewhere thought to do a retrospective analysis systematic review on delusions and hallucinations. When back at a pc I will have a look.

It must be there but doctors don't know it. Neither do the mental health charities I guess but, perhaps, I'm just being harsh on all of them.

Whatever. There must be a link between commissioned research and what patients want, and ultimately into what the NHS can actually offer.

I still think they should offer sex as a recommendation and perhaps on prescription...but that's an idea for another blog post.

They take rights but protect nothing

The human rights act lumps together criminals, vagrants, addicts and the mentally ill as people who can be punished by loss of liberty.

1 in 4 of those have committed serious crimes and developed society's worse punishment is imprisonment.

The other four are offered equal protection. Of course these people have committed no crimes so they can lose their liberty and it is not, in any way punishment. This last sentence should be said in a sarcastic tone but it is the truth of the psychiatric system.

There is not even the system of justice afforded to those who commit crimes. There is one judge and jury. The psychiatrist or responsible clinician.

No judicary and little oversight. This is what the human rights act gives the mentally ill and their members rampantly abuse it.

The amended Mental Health Act in the UK. The children with learning disabilities legally tethered to a wall. Forced electrocution. Forced chemical restraint. Forced use of the killer drug clozapine.

Are we so inhuman the human rights act doesn't protect us and the uk's lawmakers take advantage to subvert the tenets of law and liberty because a psychiatrist judges an individual as mentally ill.

We have no protections and because it is assumed malice can happen prisons have better oversight. Don't fucking leave it up to doctors to ensure psychiatric wards are always better than prisons.

I wonder if I could get Big Pharma to fund a research trial or two?

Perhaps their reps may be easier to persuade than the dogmatic psychiatrists who overlook these important research questions, chosing instead to inject people with cannabis constituents.

Let wisdom guide. Let the pharmaceutical companies come together to do this. The prize for them is the treatment which patients want, the treatment patients will ask their GPs and psychiatrists for. The one which genuinely reduces the delusions and hallucinations antipsychotics are suppose to treat.

It wouldn't cost that much. The important thing is the full systematic review of measures of effect on delusions and hallucinations only in all modern high quality trials is good enough to be published in a peer reviewed journal so it can influence commissioning.

I think I might see if I can sell the idea to them for the funding to do a second, more important piece of research. A census of people with psychotic illnesses to see what they want and expect from their treatment.

Anyone is welcome to use the market data from the second idea.

For everyone involved in treatment patients this second piece of research is the first step to a leap in mental healthcare: an evidence base to give people what they want and expect, rather than have to tolerate.

There's money in that. Loadsamoney. However my only hope is it is the sort of progress mental health science really needs. It is just the start and an example of an idea of what might be in forty or fifty years time: the evidence base to understand and assist people's needs, not what psychiatrists think they need or what society wants to do using the word illness.

I hope they'd be more willing to listen to this simple idea. Use the old data to answer patient expectations. The hegemony has to be willing to give up power.

This is the sort of principles which make democracy a good idea applied, poorly perhaps, to the problem of psychiatric practice and the tyranny of power which psychiatrists have empowered by a lack of evidence or attempt to seek evidence based on patient expectation of treatment.

The unwitting tyranny is incompetence or lack of wisdom, not malice. But a sequitor to hanlon's razor is what to do in the face of psychiatric incompetence?

Ask any psychiatrist to name of the top of their head the study of patient expectations of treatment they remember from their psychiatric education? Ask them to find the study which looks at the effect of antipsychotics purely on delusions and hallucinations? Ask they questions which, in my opinion, they will have no answer to and you will start to feel an ire.

At least if you are a person blessed or cursed with a psychotic disorder. As a teacher it is always a blessing.

That's it in a sense

The conclusion from the pain.

Get on with it. Keep fighting. Grow up.

No answer to my misery but...in the lack of answers it is hope that enough booze and solitude provide something other than total annihaltion.

I am imploding. My psyche is falling apart. I've had to work today. Or volunteer. I don't get fucking paid.

I am so tired and empty but...all I have is that. That's it.

That's more than most.

It's funny.

Inappropriate perhaps. But after a while inappropriate humour is all I have.

I am broken and broken down. A major cause is me. I work too hard. The other is my shitty job. The one I resigned from.

I'm still doing work for them even though I'm also in this pit because of them. They have a situation and they need me. When I'm depressed I'm straight. I say what I see.

It's funnt because why the fuck do I bother? I whored myself for someone elses dream. Cunt couldn't deliver for me.

People become

The biopsychosocial model of cause of mental illness is fascinating. Its a unifying theory with little practical application but being the closest to the truth.

The truth is people become. Perhaps genetic predispositions and psychological types and current society contribute together through numerous factors to create patterns of behaviour and experience.

People become. From saints to murders this is a truth. In fact in terms of types some of those so valued in history and people's hearts could become reveiled as the worst of the worst. Or vice versa.

People become. But there is another thing. Judgements and labels. Norms and constructs.

People become. But society places judgements upon them. In psychiatry it is sophisticated but it is magic, a trick and a sleight of hand. The purpose is this aspect of enforces temporary norms.

Kids with ADHD? No. Just kids. People with dementia killed through the use of antipsychotics it treat their supposed illness. No. Just a norm which changed when society, and doctors, had a useful tool which had no safeguards. Depression itself. Not an illness but a part of the human condition when psychiatrists are taught that normal is like a robot and the solution to a maladapted society is modification of the individual.

Let wisdom guide? Fucking motto of the royal college of psychiatry. What a joke.

People become. The human individual and our diversity is more precious than the unique and irreplaceable diversity of nature.

Even the venus fly trap is beautiful. We live in a time when the wisdom is here to promote this vision of the sanctity of other organisms and the recognition of the change in valuation.

Nature used to be a resource. Now the World Wildlife Federation and others seek for people to see the other inmates of planet earth as brothers and sisters, not food and fodder.

People value nature's diversity but too often don't value our own human diversity. This gold amongst gold is more precious.

Individuals. Amazing, strange, different, and oh so human humans.

People become. And in ways more diverse than through Darwin's evolution applied to the natural world.

But psychiatrists say the venus fly trap is bad and it should be a sunflower. Psychiatrsts want lions to be sheep and elephants to be mice. Or whatever average constitues their temporary version of normal.

People become. But psychiatry polices this. The secret power to make extinct human types and destroy human diversity in a way hunters of yore could only dream of.

Why is there no progress in the treatment of psychiatric crisis in the UK?

And by progress I mean bringing up the standard of psychiatric wards to be better than prisons.

What I mean is experimentation. What I mean is seeking new ways. Specifically it's things like Soteria. There's nothing like it in the UK. There's no buy in anywhere but in the fringe. And yet alternative strategies for psychosis show promising results in the small number of reviews available.

The NICE schizophrenia guidelines when revised showed little progress but recommended regular health checks. This was it. They still only recommend one thing for treatment resistant schizophrenia, the killer drug clozapine, even though it's been decades since the drug when initially intrroduced slaughtered many patients and was voluntarily withdrawn.

Few are papers but less is the problem. Less interest. It's as if the pseudoscience of psychiatry doesn't look for new or revolutionary ways of treatment. By revolutionary I mean the term as it is often bandied about in the technology industry.

Soteria and the other alternatives would be called game changing technologies if they were computer technology. While san fran's silicon valley exploded across the world the soteria project just survived and had little impact except on the lives of people they helped.

Currently a small group of grass roots camapigners in the north are campaigning for a Soteria facility. That's pretty much it. There's fuck all progress.

Even NICE's recommendation of arts therapies admist recommendations against treatments like counselling for schizophrenia aren't actually happening. Arts therapists are losing their jobs. Only those who follow the dogma of cbt are protected and this solitary treatment is what those that are getting any alternative to a life on drugs, a life shortened because of them.

Many dead already but doctors continue to use drugs.

Minimum standard of care

What do we expect?

Fuck everything else when considering this question except what you, for yourself, when you ask for care from the nhs expect.

What's your minimum?

My process is slow

A dear friend of mine wanted rid of the aspect of her personal experience which she wanted removed. She wanted psychosis ended. She wanted a nornal experience of consciousness.

I won't divulge any more than this except about me.

Initially I provided her with a link to alternative treatments for psychosis. There's a great site I should link to when I'm at a pc.

Her psychiatrist wanted to help her. So he tried different meds and high levels. She's very sedated now. I don't know how she is.

What evidence does a doctor need to do better than switching meds and using high doses? Perhaps a systematic analysis which looks at the effect of a broad range of treatments for psychosis but only at the sub factors of delusions and hallucinations...but I'm just an addict.

What would I know? It took me months to realise this important bit of the evidence base was missing.

2 years...maybe more...looking for the argument which would change NICEs schizophrenia guidelines. The one thing I have, apart from the other stuff and perhaps more importantly than the other stuff, is this one important research question.

It is not my idea nor ever has been. It is my friend's idea because it was the thing which answered her need.

It takes me ages. Someone else must have thought about this. It is why I have to keep asking and searching. Half a century of psychiatry is stupid but not so stupid that this research question above all others which doctors asks hasn't been asked.

After all...they know what patients want from treatment and expect...right? Isn't this what a large proportion of the research which informs clinical practice all about - what patients want?

Of course it isn't about what patients want. That's clear. But there still must be a load of funding for what patients want? You know...to fund all that research into treatment outcomes which patients and the public expect?

So I'm slow and I admit my failings. It takes months of work to write a good rant!

Judging my circumstances and thinking about the different paradigms of mental illness

Psychological distress isn't perhaps the right word. I may be deadened to the distress. Self medicated and exhausted neural circuitary barely respond as other might and my tolerance levels are pretty fucking high. Doesn't mean it doesn't hurt.

Depression comes with other things than the simple medicalisation of misery. In fact the clinical concept is far different from a person's self report of subjective unwellness.

In a very, very small way this is a good thing. It encapsulates the seemingly paradoxical depression without low mood diagnosis. The cluster of symptoms approach includes it because low mood can be left out as a symptom and the clinical criteria still met.

It's because psychopathology relates to social disability and exclusion/isolation. I'm not sure self report of subjective unwellness is often consider in research however my desperate hope is there are still some good doctors left in the mental healthcare system who listen to patients and what they want.

Here it's perhaps useful to consider the already accepted dual continua model of mental health. Theirin lies 2 continua: psychopathology and psychological distress. This is an incredibly simplistic model.

My personal experience might help to refine additions - all theorectical. First there's the measure of patient report of subjective unwellness. In practice this is not the same as psychological distress unless it is a very broad term which, currently, the mental health system does not cover conceptually.

There's the problem of false report by patients too. This is why doctors and psychiatrists must give diagnoses, because their system makes it hard for people to fake it without knowing it. Once it is known it is easy to fake because the operational cluster of symptoms are designed to be simple.

With me there is also the problem of natural reaction to circumstances. I should be feeling like shit because in many ways to the old me I am someone I wouldn't want to be.

This aspect of self stigma or part of how poorer life outcomes relate to psychological distress is probably well studied if people with lived experience had any influence on the pursuit of research.

My recent failure in work is bad luck and bad timing but...fuck...the event hurts like shit. So it's natural to feel down.

The problem is I'm already down. While this natural reaction might be acceptable as an individual trait I have had a bad time already by my standards. There is the problem of the value of pain and the risk of excessive pain which can harm.

There's social disability and poorer clinical outcomes, two things which are perhaps facets of psychopathology or are distinct concepts.

I am alone. Isolated and isolating myself. I have little self care. I am making little social contact and destroy the ones I do have.

Accept me as an individual who is going through something but makes a choice to go through it and its an informed choice. But the compassion in people would want to change that. And they have evidence to back up that I will do worse in life and die earlier because of what I chose to experience.

And be.

...

This theory is irrelevant. There are times I need help and I feel like I'm falling. Falling quicker and faster than I can handle. Overcome with the world and circumstance.

I'm self sectioned. As much as possible. I have my freedom but I withdraw for safety and know I'm ill.

So how important is the measure of one thing? Self report of unwellness, by any name.

We failed

While I write this I am so very tired. I should be thinking of Rudyard Kipling's poem If but instead I wallow.

I am falling. Every day I creep towards an edge. It's not a dangerous suicidal edge. It's an implosion. It's a day by day slip into putting my head into the sand and drinking into oblivion.

I'm not at the moment. A bottle of wine a day is nothing by my standards. Not for where I am now. Not for how I feel.

I've not looked after myself properly. Again. My failure is the failure of anyone who carries the burden of self management.

Last year was shit. I should have been more mindful then the winter came and with it life became harder. Not least because of what I got paid to do and what I chose to continue to do.

For a few months I worked intensely. At the start it was very long days and without taking days off. The job was a challenge but the potential rewards were the carrot.

The body and the mind need rest and recuperation. In my spare time, as I am doing now, I write to this blog. I spend a lot of time reading and thinking to come up with these posts. Up until recently I ran a mental health and photography project on Facebook as well.

I left little time for rest or other people. I worked so hard so I could justify my high salary. I was going through...a difficult time too but I slogged through it.

I lived a basic and withdrawn life to achieve a goal then when it came to payment for my work my life and my plans broke down. There were many delays and it looked hopeless. It still does.

Exhausted in every way I had to deal with this. I started having a break down. My usual medication, skunk or herbal cannabis, also stopped being available.

The pressure of debts, students loans,taxes and my own longstanding unhappiness was eased by the prospect of my death but I'm used to it. I admit wanting to hasten proceedings but instead i'd slipped into this empty shell slipping a little bit closer to a pit of existence.

Finally I got a small amount of what I'm owed for my work. Not much changed. I can barely be arsed to do anything but go to the park, drink a bottle of wine then go home to eat and pass out asleep. I stay in bed as long as possible and try to reduce the amount of time I am awake.

This time last week I arranged to see my gp and spoke to a psychiatrist. The appointment with my gp was today but they fucked it up and I cancelled anyway. I might see them tomorrow morning.

I've failed because I need to seek help from services. I need psychiatric drugs. This is some severe shit I'm going through. I need antidepressants but the psych wants me on mood stabilisers too.

I am as worried as he of hypermania. This is aa true psychotic state which is an amazing experience but can damage lives and is a risk of madness I work to never re-experience even though it is a happiness beyond the comprehension of anyone who's never experienced it.

It's a risk I have avoided for the last few years. I've been unmedicated and unassisted by the NHS. Anyone who reads any trial data will know the consistent poor outcomes of no treatment.

The problem is I had no other option. Every contact with a doctor is one where I fear for my liberty and safety. I also had a small sense of pride which came from suriviving and...almost...thriving.

Instead I'm in tatters. It's not surprising I feel like this. Hindsight is fucking insightful but I've failed to acquire it in time...again. and perhaps that last word is the true failure.

Can people be killed for being?

No.

Schizophrenic is a behavioural type. It is an individual. Like a homsexual.

They are treated because of a biological brain difference. This is the fundamental reason their type is pathologised as an illness.

Their type is treated with prophylatic use of antipsychotics. Treatment resistance demands the use of the most power chemical cosh.

Psychiatry's beloved chemcial behavioural modification agent is clozapine. It kills quickly or slowly but it changes behaviour. It doesn't even treat the biological component.

Fuck. Ain't that inappropriately funny? The classic, protoype and, most importantly I reckon, the ostensive (linked to a Kraeplinian prototype) is not biologically healed by the treatment. The treatment may change the brain in a negative way and reduce life expectancy. It is known as chemical restraint or the chemical cosh.

What was my point? Oh yeah, to stop schizophrenics being society kills them...one more drink me thinks.

an idealists view of disability

It doesn't exist.

Society, technology and civilisation advance to create a beautiful world, a world of choice and identity, of valuation of difference and a living soul is free. And dying ones too.

We were born as human. It is our commonality. Death as well as birth a part of this and truths which are strong in a reasonable paradigm.

The rest is changeable. By that I mean society and civilisation. they can change. The will change.

It may take a million people to smash their heads against brick walls they can not, alone, break. No wall is built for that onslaught and I believe the wall of human inequality will break.

But the wall of disability doesn't exist. Being human does, or, perhaps, moreso than some temporary temporal construct.

The wall will break. Disability will cease and civilisation will heal. It's just a hard path for those who, for a brief moment called a lifetime, get to contribute.

Sociologist need to get their shit together

Psychiatry is a profession. Social psychiatry is little considered.

Society and the lack of influence or ability within psychiatry is the missing link in psychopathology and psychological distress...and perhaps even flourishing too.

People with biomedical training don't make good doctors though. They don't make good psychiatrists. The profession, independent of psychiatry, is yet brone, but it is necessary.

But society is ill. It is social anthropologists and people in the progressive mental health field who see this. Their needs to be a hegemony created and this comes not from medicine but from other paradigms.

I'm bored of criticising the paradigm of illness applied to the human condition as a way of actually making things better for individuals. Give me something else to fight!

A small idea about evolution and unhappiness which I'll probably spend months ruminating upon

So we're basically apes. They're our closest genetic relatives.

They are closer to our natural way to be. The basic things within them we retain except when society malfunctions. Like the invention of the atom bomb the advancement of society brought other weapons of harm.

The apes live in packs. There are structures within them. There are many things analogous to humans.

But there's that one thing. Of all the apes I know they all exist in groups. In tribes. They may have different social orders but the one quality of living in a group is seen as a basic thing.

Herds are common for mammals. It's older species and birds like the albatross which trigger my memory of the opposite of this need to exist in a group.

I am being simplistic here because I have a lack of knowledge. But I have a sense. I sense the research which shows human contact with a generally therapeutic aim has benefits for mental health. The research into the correlation between exclusion and isolating, disability and poorer outcomes shows how the opposite of group/social interaction is bad.

But most of all I know it from personal experience. Isolation. Not belonging. To some people that really sucks.

This may be a basic need not addressed well enough. Considering primate behaviour as a template for advanced human behaviour might seem stupid. Considering the problem of mental illness...it might not.

The animal had to adapt from a basic existence which millions of years of evolution designed it for to the needs of civilisation and society.

What if civilisation and society was never formed with considering how primates live and be? What happens if part or all of mental illness is a product of this maladaption, or illness, in society?

Cognitive psychology is run by lunatics

I assume this is what the posh name is for the art of talking bollocks. It's in relation to suicide and some of the "without lived experience" models of perjoratisation of thinking, being, personality or whatever else is often slandered by their version of science.

Edwin schneidman brought forth the great leap. He pioneered the research of suicide not through observation per se but through reading suicide notes.

Of course this method is limited because many don't leave suicide notes but many do. More can be taken from that which can help than the sort of bollocks that is passed about in psychology circles.

Suicide is something you just can't understand till you want to do it. Imagine what it's like with my experience? The university of life is a harsh teacher. It is also the best.

Research questions for psychiatry?

What do patients want?

What are patient measures?

What are patient expectations of treatment?

Where is this system and when the fuck if the people's mental health system going to exist?

The psychiatric hegemony's power should reign no longer. The start of the rebirth of psychiatry starts with asking the right research questions?

If the research evidence doesn't look for what people expect then what the fuck is the science of psychiatry doing?

I've made a poor attempt to find a systematic review of treatments for schizophrenia which only looks at measures of delusions and hallucinations, what most people think antipsychotics work on.

I've seen a paper which has a table showing how after a patient reports unwellness and more of the symptoms which cluster together to make a diagnosis of clinical depression are required fewer and fewer people meet the criteria for clinical depression and men are worse affected.

Research focuses on depression not as the statement of unwellness alone but also, are more usually in research, the definition requires the research criteria to be met. This criteria is psychopathology as such and often subjective wellness is little considered.

Mental health itself has many understandings and perspectives - far more than other fields of science. There is no good definition in scientific terms and lots of damning evidence that there's no science whatsoever.

Most dark of all is this idea that it is just an enforcement of cultural and social norms agreed upon by psychiatrists then used without judicary for whatever purpose is temporarily served by treating something as a mental illness.

There are several dead old people who were killed unnecessarily when behaviours associated and accepted as part of old age for generations were treated to subdue them with antipsychotics. Several thousand people died unnecessarily because of the use of mental illness as an idea to treat behaviour.

The fact that schizophrenics are medicated for life, the drug group is being prescribed for more mental illness and the age of use is getting younger...fuck....am I the only one who sees the dangers and the bullshit of treatment?

What of welfare? Who should benefit from benefits?

Society is malformed. The breadth of humanity and the full variance of the human condition was not what society and culture's advancement benefited with equal measure.

The maladaption created false disadvantages. These false disadvantages are sort of what disability is about.

The system which rectfied this illness in society which means certain types of people do less well or do not reach their full capability (flourishing)...bugger...benefits never sorted the latter.

Benefits keep people alive but they're a shit solution. Getting people off them enmasse during a recession is a shit solution too.

Benefits are a shit solution because they don't help an individual flourish. The system contributes to negative life course. It also contributes to the exclusion of the disabled.

I've been on state medical benefits for suicide and alcohol and drug abuse. The latter wasn't that bad. Just towards an extreme. I know people hate the idea of addicts getting support though their social disability is equivalent to other people with other mental illnesses.

I have worked fucking hard to stay off them. Its because work gives me more.

But good work. Not just any work. Work which brings job satisfaction.

There's a sizeable systematic review which shows job satisfaction kicks arse on physical and mental health. Though the authors didn't do a funnel plot to check for publication bias the effect sizes were so large that even with a third knocked off they're still bigger than seen in large reviews of lesser quality trials in psychological therapies.

The added benefit to physical health is obviously a bonus to other mental health treatment.

So if I was so bold as to question who should benefit from benefits then i'd turn the question around.

I'd say how dare you? Society's illness cost people's health and long life. It makes life shitter for them too.

The smallest bit more society can do for the less well off is a step forward in progress.

This is what we should be spending our time considering. Not how to divy up a small pot of money but how to come up with better solutions.

Why not a job creation program? Why not use psychometric testing and motivational interviewing to help people off benefits and back into society in a way which is healthy.

Instead smart people who ask questions like who should benefit come up with shitty answers to shitty questions. The current solution to the governments longstanding desire to get people of medical benefits is a shit one which will kill a few directly and make many more more ill.

Who should benefit from better jobs and better job satisfaction?

Everyone. But in this current crisis the experimental group is those who are worse off.

Help people on benefits into the right kind of work and the health economics argument makes this a total fucking bargain.

Dead people? Fuck it. Keep them employed

There are so many forms of death.

One is suicide. Another is death through treatment.

A therapist refuse my ask for help. She knew I asked because I didn't want to die. I would thank her but I should make sure she never does what she did to me to another person. Nor any other therapist. Fucking cunts.

The psychiatrist said stay working and if id listened I would. And he was right. For so long I've wanted to die and the pattern I was in would have ended up in my death. For a brief moment I wanted to live.

He is, of course, a dickhead. The therapist is evil.

Shit...what was I talking about? Iapt. The welfare reforms. Who cares?

The UK mental health charities don't care about the deaths of the mentally ill

It was found that 1,800 old people were killed unnecessarily by doctors. They used a treatment for dementia which they'd not used before. They used the 'antipsychotic' drug.

They slaughtered the elderly enmasse and they got away with it. It was a research paper showing the drugs reduced life expectancy by half which got the government to change the dementia strategy. SIGN now recommend training for carers of people with dementia.

NHS GPs can still prescribe these drugs knowing the risk of death. They offer a convenience for society very different to what the medical oath expects of the profession. They know they are not treating the illness and what they are offering kills their patient. They're murderers now.

And none of the mental health charities give a shit. None have demanded an investigation into the number of deaths caused by these drugs when they're used to cosh schizophrenics.

A recent review of high quality trials of ECT shows it doesn't work and the risks are significant. Sham ECT is currently the best treatment for depression.

This treatment has killed many. For decades people were electrocuted against their will. Even the very first subject had his wishes not to be treated ignored.

The mental health charities don't give a shit. Not one word has been spoken by them about this review.

The drug clozapine continues to kill and cause illness. It is still recommended as the only treatment for treatment resistant schizophrenia. Many have died already and many, many more have had their lives shortened by this most dangerous chemical cosh.

The mental health charities don't give a shit. Rethink in fact asked their campaigners to write to their MP to recommend the clinical guidelines be followed through.

Rare studies into alternative treatment paradigms for first episode psychosis have shown benefits to conventional drug treatments. These are the future because the treatments work better and don't slay the patient. There are none of these in the UK.

The mental health charities don't give a shit.

Lithium is a risky drug and can kill. The alternatives cause liver damage. If society could learn to accept bipolar people, like in Spain, then fewer would need to have their life shortened to treat their difference.

The mental health charities don't give a shit.

Their staff are well paid but often know little about mental illness. Their funders expect better but are forced to be satisfied with weak shit. Few truly mentally ill people work at them and few people who are truly passionate stay working or retain their jobs.

They'll let psychiatry continue to murder people because they don't understand and are too lazy to find out. They seek simple campaigns which still suck because they seek easy goals to fail at.

Fundamentally the evidence shows they don't give a flying fuck. Not really. The only exception, perhaps, is the A

Here's to the crazy ones

Calling it an illness is one of the dark tragedies of modern society.

In the main most human behaviour isn't an illness. Neither is suffering, personality or individuality. Experience of consciousness and reality are also not always biological illnesses.

Of course there are neurological differences between people. Life events and general condition can shape the brain. The modern brain has probably changed a lot since the human brains from a few centuries ago. Our intelligence levels surpass even the previous generation.

But difference does not mean illness. This is where psychiatry is a pseudoscience. Different races have much more variable biology and a social disability could be applied to why, for example, black people did worse off three centuries ago. But being black is not an illness and the disability is because they were slaves.

They were thought to be subhuman which is why black people were subjugated and enslaved. It's a very different model of slavery to the Romans who enslaved conquered people but made no bones about them being subhuman.

The mentally ill have seen history repeat itself. The darkest thing is the idea it is an illness though this construct is useful because in an uncompassionate society which believes normal behaviour is docile robotic banality this lie creates a reason to forgive.

Instead they call it an illness to be dealt with by doctors. This profession has the highest status of any. They are assumed to only do good things and never harm.

But they harm. Time and again. Over the course of two centuries terrible things have been done to the mentally ill by doctors. The harms were not malice but stupidity. They too were fooled into using the principles of illness when in fact they were medicalising the human condition.

Pseudoscience is a word often used in the progressive movement on psychiatric research. The human condition is reduced to simplistic ideas of normal behaviour then new illnesses are created as the system shrinks the definition of normal.

The masses accept this. They accept the simplistic solutions and allow psychiatric dullards to come up with nothing new.

The masses hope for solutions their doctors can't offer. They hope for relief from distress from a system which is not grounded in the science of distress. It regulates behaviour and offers treatments to regulate behaviour. It hides social control and behavioural modification as treatment of illness...unless anyone bothers to independently research treatment.

Thankfully the human spirit will never die. Neither will independent thought and the crazy ones who obsess to find real answers outside the consensus thought.

These are the crazy ones too. Crazy enough to think for themselves. Though they suffer alone and strive against barrier after barrier they're the ones who'll create the next system, the one which I hope will no longer subjugate human difference and indivudality.

Guilt, depression, religion and being white

As I read dsm and depression, and laugh, I strike upon one of those cultural things white people forget.

When I mean white people I mean psychiatrists. Even the black and the brown ones. What an extraordinary focus on guilt. Those catholics born guilty of original sin....are their 'mental health system' have influence.

You dumb white fucks. Guilt is socialetal. Construct shit. Prevaling reigious shit...

Fuck...why do I bother...its just any excuse to enforce cultural norms.

No solution. No answer. Just quesions

The brain is capable of two consciousnesses. Alien hand syndrome is a proof. Some people who have their brain cut in half so the two hemispheres are separated experience a syndrome where one half of their body, the part controlled by one of the hemispheres, takes control and is independent of what the other half considers as themselves and their volition.

How amazing is that? Well children who've had an entire half of their brain removed, rather than separated, can function well and live fulfilling lives.

Has no one ever considered that what I'm talking about and what is the voice inside my head are related?

No. Most of those that do don't hold power. They're not psychiatrists. They learn not through constructs but through the university of life.

They're sheperds rather than sheep in a world where sheperds are, apparently, a disability.

Oh fuck I tire of these simple things I come up with. No fucking solution. No answers. Just more questions.

A sane person would have given up a long time ago. Thankfully I have a limited time. 4 years.

Show me a research psychologist and I'll show you someone who wouldn't know science if it slapped them in the face

Psychologists are idiots. At least rosenthal..or rosenbaum...forget who did the famous expectations experiment.

The study is a testament to psychologists unethical research practices. It is no surprise to anyone who's bother to read their shit.

People who believe in psychology don't believe in facts and science...oh....they will use science...but only to serve their ends. This is why psychological therapies show such high levels of publication bias. The search for truth has little meaning. The search to promote their truth - they're as guilty as psychiatrists.

The expectations experiment is a prime example of why psychologists are the shit I scrape off my soul. A group of kids were seqauested without knowledge. Their teachers were told, at random, some were late bloomers and expected to perform well. Everywhere you look you will see references to the result where the expectation of good performance shows good results in actual performance.

But thankfully I've learned enough about psychologists to know they're fucking cunts who would deny help to a suicidal person. They have no heart. They have no fucking idea about science.

It takes an unschooled individual - me - to see the crap. Read the data in the study and the effect doesn't happen in older children.

That sort of detail and science doesn't matter to psychologists. The journal which published the paper didn't give a shit about science. Psychologists are cunts.

And they are also specialising in behavioural modification and control. Like so much in mental health they use the whole distress thing to hide their actions.

Read far and wide enough you'll find the Journal of Behavioural Modification.

Cunts.

The syndrome of schizophrenia and the pathologisation

People have probably written books on this shit.

The syndrome or the thing which is schizophrenia is a hard concept to grasp and poorly explained in texts. I am afraid I can do little better.

The operational cluster of symptoms is an extraordinary leap in pseudoscience however it doesn't describe the 'disease'. It's the clinical instruments which do that and it's here where people can be more elucidated in what's actually being pathologised.

For a start, it's not just delusions and hallucinations.

Difference does not mean illness

This is the thing with the biomedical model. They first found different behaviour. Afterwards they applied the paradigm of illness.

The behaviours were different. They cause exclusion. This exclusion is why psychiatry exists. The mad were the outcast and compassion sought to house them in old leper colonies. I'm sure they hoped madness woud die out the same way the leprosy epidemic died out but madness is a different thing.

It was in these early days the biomedical paradigm was created. 200 years later there's lots of research into the biological differences between the types mad and and automoton.

The problem is a biological difference associated with behaviour is not a deficit. Even if in a certain country or time period the biological difference relates to a disability this does mean it is an illness. At least unless the paradigm of illness can shift to see ill societies. These are as much a cause of the 'illness' and the UK was only healed in a small way in 1992 when homosexuality was demedicalised.

Why does psychosis have to be bad?

This might seem like a naive or basic question. Anyone who adhere's to the illness paradigm might see it like asking why does cancer have to be bad.

Psychosis isn't an illness though. It's not one thing either. It doesn't have a shared definition as well I think. Psychiatrists, the arbiters, have a different definition to the public and patients.

It is a dumb question because the word means something bad. At least in the concensus definition. This is not just the mental illness stereotype. It's the psychopathology too. People kill other people and, more often, themselves when psychotic.

There is a movement battling against the perjoratisation of psychosis. They are a small movement will little impact yet but the change they bring is a necessary one. They would understand my question is not a dumb one.

There are also drug users who get high. They purposely induce what psychiatric measures see as psychosis but they enjoy pleasureable experiences. In fact the word enthogen is used to describe drugs which create experience, but the term is synonymous with induced experiences of altered reality.

And, of course, religion has its seed in psychosis. That's a huge thing in itself but I can't be arsed to explain it again.

These are little pithy examples which expand the mind of the uninitiated however they don't do much for the purpose of the question. The question is the start of a thought process whereby the psychosis pathologised by psychiatry could, perhaps, have better outcomes for the individual.

Just so the reader understands, I've been through psychosis. The bad kind. The kind not induced voluntarily nor 'treated' forcibly. I nearly killed myself and I have a forearm with scar upon scar to remind me of the period.

But I survived and though I will kill myself in 4 years the process was sort of worth it. I've changed. A lot. This is what some people have mentioned as one of the problems of psychosis.

People change. The thing is that's not a bad thing, just an unusual one to an automoton.

I met with a friend of mine yesterday and he spoke of his desire for a Lamborgini. He has worked hard to get qualifications which could get him a job in a bank so he could make loads of money and buy his dream.

I used to be like him. We've know each other for ten years and there's always been some rivalry as part of the friendship. When we left uni we were on similar paths. We had somewhat similar ambitions.

Today my equivalent of his dream supercar is beating the National Institute for Clinical Excellence. I'll be honest and say my motivations have strayed far from any laudable goals I once had. I feel like Rocky in the penultimate round. I just want to win. There will be no feeling of success to ride me through. Just a brief interlude before the next challenge.

I could turn my talents once again to the pursuit of wealth. I don't though. I live frugally and work without payment or recognition. I work obsessively most of the time. Always struggling with concepts and research. Still with this idea of striving to affect the greater good but with a lot of the idealism tarnished.

I could probably blag myself into another job in the commercial sector but I don't want to. What changed was pretty significant. I am still the same arsehole but my life is dedicated to more socially acceptable things than acquiring material wealth.

Making the concept of mental illness not nebulous

This is perhaps an excuse to use the word to do whatever. Mental illness is a hazy concept but is used in areas where precision is required. Many things are under the umbrella too and the original definition and the current consensus one are quite different.

Is strict biomedical thinking the only true mental illness for which the rest of the stuff is applied? Is the psychosocial paradigm one which warrants different language because the concept is different. We are all products of our learning and upbringing and experiences whereas the privilege (and inhumanity) of the biomedical paradigm is only available to the biomedically mentally ill.

The concept of social disability as a reason for treatment and outcomes based upon improvement by altering indivudals begs serious questions about the aim of treatment. It also means there's a different treatment target. Society is the cause of social disability as much as individual differences.

And homosexuality was a mental illness but isn't any more. How was it one in the first place.

Simply because there is no rigour in the concept and anything which the psychiatric hegemony decides is too different can be a mental illness.

This is why it shouldn't be allowed to be nebulous.

The removal of the treatability test is a violation of human rights but the problem is the mental health act

In 2007 the mental health act was simplified and many dangerous precedents set.

It is in breach of what I know about the tenets of UK justice. The punishment it can enable can be equal to punishment for crimes.

One of the big problems iis the removal of the treatability test. I'm not a lawyer but know enough to know that case law is more important than any amendments to an act but I would guess the act was changed because of case law.

The treatability test I don't fully understand. I think it means there should be treatment available. Removing it means disorders which have no treatment, specifically psychopathy, can be 'treated' by hospitalisation under section but no treatment offered nor available nor required to be provided or developed.

This is not that dfferent from the punishment of incaceration. The facilities in which people are detained are somewhat better sometimes.

Deprivation of liberty is society's worst punishment and only used on those who've actually committed a crime. The criminal justice system and forensic science are well funded because innocence of crime is the starting point and guilt has to be proven beyond reasonable doubt - or something like that. The innocent shouldn't be punished by incarceration.

Except if a psychiatrist says so. And the HRA allows them to. The MHA allows them to be incarcerated without treatment and without precision about the definition of mental illness.

Essentially it means a person can be incarcerated for being mentally ill and at risk of committing a crime. Both those assessments are the judgement of a psychiatrist alone. Their are few checks and little oversight. No treatment is a guaranteed right so it can be pure and indefinite incarceration.

However if the person is not mentally ill and at risk of committing a serious crime then they are allowed to be free. Anything less would be against human rights law.

Extension of compassion to addicts

Depressed people get compassion. They're not told to get on with it. Their suffering is understood and understanding is offered.

Not for addicts and drug users. Generally they're allowed to be treated with disrespect, stigmatised and never given an inch of compassion.

There have been few attempts to shift this mode of thinking. Mind's men and mental health policy report made a small reference to the suffering addicts are self-medicating. It is a rare example.

The mental health movement treat addicts differently. They rarely stand up for them or even stand by them. There are millions of addicts and drug users in the UK but there's no antistigma movement for them.

The mental health movement has often suppressed the potential of illegal drugs. Noteably the Harvard Psychobicilin Project at its spiritual faculty was shut down by the mental health faculty.

But they, like the rest of the mentally ill based on the current definition, deserve compassion. They suffer the same exclusions, clinical outcomes and social disability which define the prognosis of mental illness. I would guess that addiction has neurobiological differences which could fit the biomedical model.

I also know the suffering from the inside. I know the crazy and what happens to the crazy. I know how drug users and addicts are vilified. I know how no one campaigns for us.

Could compassion really be extended to this group which are often pariahs even in the mental health community?

Illness and crime

What happened with mental illness as a construct is it allowed compassion and leniency to be used for a certain group of people. This is the privilege of the invalid as Szasz termed it. Calling it an illness means compassion can be shown.

This is the problem of attacking the illness paradigm. With it comes the benefits. As well as all the terrible, horrible nasty stuff. In many ways the construct and the true concept have similarities.

In part it is about the loss of capacity. The problem is it can be faked and it can be misread or misrepresented. Punishments can be little different regardless of if it is prison or a psychiatric ward, though prisoners have more basic human rights and some prison facilities are better than some psychiatric ones.

The mentally ill who commit crimes are offered a different punishment, that of psychiatric care. Many prefer it and this is one of the benefits of the illness paradigm.

There are those who've committed no crime but are incarcerated in psychiatric wards. There are now people who can be hospitalised because they pose a risk of commiting a serious crime though have notcommitted one.

Crime has a huge and complex system to ensure justice. Psychiatry has the judgement of one person, little oversight and no concept of the wrong that is the punishment or medication of the innocent.

The chemical cosh is a punishment. Though patients are fooled into accepting treatment many through educating themselves independently can see through the fallacies which allow a punishment to be used as a health treatment.

Calling a behaviour an illness, then treating the behaviour rather than the illness but thereby inducing real illnesses...is also the job of psychiatry. The entire profession is a crime against the Hippocratic oath and the ideals we hold doctors by.

Several thousand old people with dementia would agree with me...but they're dead. They're dead because of their behaviour and the doctors who treated their behaviour with 'antipsychotics' which killed them quicker.

The importance is the difference between manslaughter and murder. These drugs have not been banned. The prescribers know the evidence as do the manufacturers and whatever body licenses them. They treat behaviour using drugs which reduce life expectancy. They know the research and they know 1,800 people a year were slaughtered when the mistake was made.

That, apparently isn't a crime in the UK. The doctors got away with a "doh!". Even national dementia charities didn't speak up against the slaughter. Nor the continued slaughter. The drugs are still used.

What is illness?

Again and again I seem to be stuck on this and related concepts.

Mental illness wasn't considered a biological illness really until the time of psychiatry's inception. I don't know enough about the history of psychiatry to comment any further.

There's the concept of Kraeplinan ostensiveness or ostensivity which is meant to mean real mental illnesses fit the prototype of Kraeplin's idea which is biology and prognosis.

People with severe mental illnesses die on average 20 years earlier so it is possible to say doctors can treat this as an illness. I'm not sure it is correct to do so but I don't quite understand why. I think it's because doctors are biological, I.e. they're taught and deal with biological problems. The life expectancy thing is primarily caused by things not directly related to suffering but to human behaviour and patterns as well as social factors.

The question of what is illness and what is behaviour is seen in obesity. This wasn't thought to be an illness but a problem of affluence and addictions. It is a problem in developed world nations, particularly the US. An obese person will die earlier and be more ill.

It could be seen as a mental illness but it is treated and accepted more as a physical illness. The change in acceptance grew as treatments grew. These were mainly biological treatments and as they developed doctors in general began to accept it was an illness. The point is as treatment becomes possible doctors are more ready to consider something which wasn't an illness as an illness.

This discussion relates to a long standing debate about personailty disorders and whether they are mental illnesses. I have to say I don't understand a lot of it but it is about the finesse of what is a mental illness.

Personality disorders weren't considered strictly as a mental illness. Mental illness was considered abnormal whereas PDs were considered extremes of normal human behaviour. Essentiallu everyone has a psychopath in them but in real psychopaths these tendencies present as an extreme. Bipolar and schizophrenia were considered totally abnormal.

PDs have high levels of disability and poor clinical outcomes. The prognosis exists. There's the issue of the biological differences. Here is another grey area for me. I thought that PDs weren't associated with biological differences but there are studies which show or seek to show biological differences in people with PDs. Not read a review or a systematic review on the subject though. (Btw - I'm talking about brain biology rather than the rest of the body)

There's a paper written by louis appelby, now the UK's mental health tzar, about how PDs shouldn't be mental illnesses published ten to fifteen years ago. He was the mental health head honcho when the Mental Health 1983 was amended and the legal definition of what the act covered was extended to personality disorders.

It is this area of neurobiology which is where I am weakest in my knowledge. I know studies have shown there are brain differeneces and significant ones they're not conclusive for me. But I hope they do show brain differences because it sort of helps with my hypothesis.

In short what I'm questioning is the difference between difference and deficit. What if, like races, the mentally ill are simply different rather than dysfunctional or sub human. This is a difficult question to answer.

What is more difficult is if I'm right. What if the phenotype mentally ill, a construct of modern society, is no smaller a mistake than the enslavement of black people because of their skin colour.

What if difference is not an illness?

Can it be possible to allow what happens to people who are called ill to continue

This is a crappy title.

I'm shit at all of this stuff. I can communicate but some stuff is really hard.

This idea if the priviliege of illness. This is what thomas szasz ranted about far more eroditely than I could in his seminal work.

But I take a different angle. I say what of the privilege given to doctors and the medical establishment as a whole? This is about what happens and is justified because its about illness (whereby all the privileges of doctors treating such as general absolvement from blame when bad things are done) but it isn't and it is terribly harmful.

What I'm talking about is the exposure of psychiatry as a form of social or cultural normalisation which exists unchecked because of the paradigm of the application of illness to social problems.

Look. Here's another way. Doctors swear an oath when they become doctors. First do no harm. Since then it has been weakened but the principle holds except in psychiatry.

A study came out showing when psychiatric drugs were used on the elderly with dementia to deal with a socially unacceptable symptom they reduced life expectancy in the very elderly prescribed these behavioural modification drugs by 50%.

The drugs became used because of social convenience. People decided that rather than do something inhumane like using a straitjacket or gag they used something far worse to cosh the elderly. They used a drug which ended up killing many unnecessarily. 1,800 a year in the UK while antipsychotics were used enmasse for patients in the community.

1,800. Unnecessarily. Deaths through the use of antipsychotic.

For what? Convenience. It was never treatment. Just convenience.

There's a big old ethical question here. But one thing superseeds it. The oath which makes a doctor a doctor. An oath which companies like google echo.

First, do no harm.

Something about a search for words

I was thinking about what would happen if the paradigm of illness was applied to society rather than individuals as it is in psychiatry.

I wondered what it would be called. Psychiatry is know as psychopathology. The study of illness of the mind. The study of wellness of the mind would be psychosanology however this term I've only seen used once before.

I thought the study of illness of society would be called sociopathology. That term is already taken in reference to something broadly aligned with psychopathy.

The paradigm of medicine could be applied to societies and cultures. There evidence that geography and culture change mental illness and prevalence. There are studies which could be used to show that there are errors, differences or causes of people doing less well in life because they are different. For example the study showing the influence of the introduction of television on children's body image in a TV-naive Fujian island. Prevalence studies for depression show poorer nations, not affluent post industrial age nations which expensive mental healthcare systems.

These and other data make me interested in this idea of ill societies rather than the mentally ill. After all the latter is as much of a construct as the former.

I see schizotypy

Schizotypy is a non-pathological version of schizophrenia. It is associated with positive or desireable states. There may be negative aspects too.

I feel I can sometimes see it in some people. There are small tells. Little unconscious things people do. Small externalisations.

The problem is this is dumb because schizotypy tells me nothing about the person, their individuality and their life. The other is I have no way to tell if I'm right or wrong.

How did the human condition become an illness?

Its sort of funny because a lot of people in the uk believe mental illnesses are real illnesses. They aren't. They're primarily about other things than biology but there may be biological differences.

Let's take gender identity disorder. Evidence shows people with this diagnosis often have a difference size of the corpus callosum. This sort of information would make the protopsychiatrist Emil Kraeplin jump for joy. He's the Freud of psychiatry.

What would baffle him was the treatment. A mental illness means the thinking or behaviour is modified to be normal. In this case the person would be made to think they had the same biological and mental gender.

This isn't what happens when there's funding available to allow the person to have a sex change. The mental illness part is about offering counselling for the distress. Some people are counselled on their decision to change their sex then counselled through the process.

Two things have happened. Medical technology makes a sex change possible. I know at least one transgender person who is very fit and indiscernable from a woman to the naked eye.

The other is society accepted that some people have a different mental gender to their born biological one.

I would guess there was a time when people who wanted a sex change would be treated as mentally ill in the traditional sense. Perhaps a century ago their individuality would be considered pathological and the healthcare system would work to make them the same as their biological gender.

These social judgements are all about what psychiatry is about.