Hippocratic hypocrisy

caduceus-eyeWhen I graduated from Teachers College in ’07, I donned the goofy ceremonial robes and walked with my classmates at the university-wide commencement.  I distinctly remember my astonishment when I heard the medical graduates recite the Hippocratic oath, right there, for all of us to witness. I remember thinking to myself that other professionals should be required to recite oaths too, as lawyers, teachers, journalists, and others all have the power to do great harm, but I suppose that medicine still occupies a unique place, as the power to heal is synonymous with the power to kill.

I have arrived at a point in my dissertation research where I am now convinced that the psychiatric-pharmaceutical complex is in violation of the Hippocratic oath. I realize that this is a heavy accusation to make, but I now believe that the field has gone beyond simple, or even gross negligence, and has crossed the line into willful harm.

Apollo Physician and Asclepius and Hygieia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect… In purity and holiness I will guard my life and my art.

I make this claim based on a range of evidence – scientific, journalistic, anecdotal, end experiential.  Some of this evidence can be found in earlier posts on this blog, as well as in coverage in places like The Icarus Project, Madness Radio, and Mad in America.  But this post is less about demonstrating that the oath has been violated and trying to imagine a proportional karmic response.

For starters, consider that pharmaceutical companies don’t even take the Hippocratic oath – their charters don’t contain anything like Google’s “Don’t be evil“, and their employees aren’t required to take the Hippocratic oath upon hire. Their sole responsibility is to maximize shareholder value (and increasingly, that includes breaking the law as the calculated cost of running a profitable business). I’m under no delusion that adopting language like this would instantly reverse decades of malfeasance, but it might help generate a few more Edward Snowdens in the pharmaceutical industry.

It’s fascinating to me that we continue to invoke the Greeks with this oath. Now that it’s been violated, it is our duty to wake Zeus and Apollo and help them raise Olympus. I’m afraid that Jehovah, especially since Jesus, simply doesn’t have the wrath to deal with the crimes that psych-pharma is perpetrating.

For years I thought that a divine lightening bolt would strike psych-pharma over the harmful and abusive use of the toxic atypical anti-psychotics (Zyprexa, Seroquel, Risperdal, Abilify, Clozaril, Geodon, etc).  These drugs cause massive obesity, metabolic disorders, and diabetes(!), and are being prescribed liberally to kids, seniors, veterans, and prisoners. Despite billions of dollars in fines for over-marketing these drugs (last month Johnson and Johnson was fined $2.2 Billion for Risperdal, but they assured stockholders this fine would not have an adverse affect on their finances). I am learning how difficult it is to rally voices to defend the defenseless, and lately I have been rethinking approaches for slowing down psych-pharma’s relentless expansion.

As the anniversary of the tragic Newtown killings approaches we need to reiterate the call to redirect the journalistic inquiry following tragedies like these. Unfortunately, mass killings in the US continue at a horrific frequency, and the prevailing journalistic narratives have revolved around gun control and mental illness. The question that needs to be asked following these tragedies is – What psych drug was the perpetrator coming on (or off of) before the attack?

In 2004, the FDA issued a blanket Black Box warning on all antidepressants (updated in ’07) about the increased risk of suicidal thinking and behavior that antidepressants have been found to cause in some cases. The documentary film Prescription Suicide presents a gripping profile this disturbing trend . And, antidepressants may actually cause an increase in violence and aggression, which can be directed inward or outwards, leading to suicidal as well as homicidal thoughts/behavior. While the FDA’s 2007 black box warning only mentions the risk of suicide, the chorus of incidents connecting antidepressants with homicidal thoughts and actions continues to grow, and the FDA is tracking and documenting the violent side effects of psychiatric drugs. While the percentage of patients exhibiting these extreme side effects is low (< ~3%), these drugs are prescribed in such large numbers that even such small percentages add up to significant consequences.

The stories about mass killings in the in the mainstream media have revolved around gun control and mental illness, but crucially, they are missing an essential interstitial step – while the perpetrators may have been going through an emotional crisis, is the psychiatric intervention worse than the original condition? This account won’t explain (away) all of the gun violence in America, but it is only a matter of time before a national tragedy is linked to a popular, brand-name antidepressant.

What’s going to happen when this story finally breaks? Will patients rush to their physicians, demanding to switch to a competing brand (even though the side-effect profiles are quite similar across brands)? What will happen to the stock price of the pharma company whose unlucky number just came up? In the ensuing litigation, will documents emerge demonstrating that pharma has been aware for years of the violent, homicidal side-effects of their products?

There are scandals brewing in Big Pharma that will dwarf the scandals in Big Tobacco.

ZEUS_LIGHTINGIN

DSM-5 vs. NIMH: kill-shots and social constructs

Last month the DSM-5 finally launched at the American Psychiatric Association conference. After 13 years and multiple delays, you can now pre-order your copy at Amazon (list price: $150), or just leave a helpful comment.

The DSM-5 had been surrounded by controversy, and not just by the usual suspects. Allen Frances, the chairman of the DSM-IV task force, just published a scathing critique of the processes and outcomes of the DSM-5 efforts: Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life. Frances has been sounding the alarm about DSM-5 for over a year, raising concerns over the current committee’s secretive methods, conflicts of interest, expansive diagnostic inflation, and the reduction in reliability (the odds of two doctors agreeing on a diagnosis) that DSM-5.  Over 50 Mental Health organizations and almost 15k people signed a petition demanding reform of the DMS-5 drafts.

Although this scale of controversy would be scandalous in many fields, the APA barely flinched. The DSM-5 task force moved some of the most troubling diagnoses into the appendix, renamed a few others, skipped a round of efficacy trials to meet their deadline, and otherwise proceeded with business as usual.

I have to say my jaw dropped when I learned that the National Institute of Mental Health (NIMH), and it’s $1.5B/year of funding,  was “re-orienting its research away from DSM categories[!]”. The official NIMH announcement, Transforming Diagnosis, posted by their director Thomas Insel on April 29th, was picked up by a wide range of science media (NYTimes, Koplewicz @ The Huffington Post, Chris Lane @ Psychology Today, Psych Central) with headlines such as “NIMH Withdraws Support for DSM-5” and analysis that this was a “kill-shot” for DSM-5.

What struck me as most shocking was that the NIMH basically came out and said that the the Mental Illnesses defined in the DSM are social constructs – “the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.”  Ironically, the anti-psychiatrist’s arguments have prevailed, although for the wrong reasons. As I interpret this statement, NIMH isn’t denying the existence of mental illness, just our current ability to agree on its nature and manifestations. But, yes, the current definitions are social constructs and continue to defy attempts at validity. Ha!

But, before anyone gets too excited, what the NIMH proposes may turn out to be scarier than the system in place. This research is representative of the direction that the NIMH is heading: Suicidal behavior is a disease. Here, disorders will be sliced and diced into their constituent elements, which conform more readily to the instruments and models that scientists (neurobiologists and geneticists) already have at their disposal.

I’ve been convinced for a while that within the next 5-10 years the Pharma-Industrial complex was going to invest enough research money to find a definitive neuro-imaging/molecular/genetic/biochemical marker for mental illness (that is, once the marker cast a wide enough net).  However, I wasn’t expecting them to turn the tables and redefine mental illness according to what they could already test. Pretty sneaky.

The saddest part of this whole debacle is that instead of seizing this moment of crisis as an occasion to bring together disparate stakeholders – from patients, to consumers, to survivors, to advocates, to caregivers across a range of backgrounds – and work together to develop a new language and paradigm for understanding human suffering and emotional crisis, the NIMH has doubled down on scientific authority. Soon they will be short-circuiting all debate by pointing at pretty false-color pictures and lab results. There will always be a value judgement when evaluating the boundaries of normal experience/behavior, and no scientific instrument will ever be able to tell us when someone’s experience/behavior is deviant, without human interpretation. As the disability right’s movement says: Nothing about us, without us.

Somehow, for all of the NIMH’s noble intentions, I have a bad feeling that the treatment side of mental health care is poised to become more oppressive. We’ll likely continue to see the growth of anti-psychotics for everyone, and the pre-cog, pathologizing of risk through predictive and preventative care that will explosively expand the diagnostic reach.

This conversation just took a sharp turn past the rhetoric of the last few decades. I hope the psychiatric resistance is following along closely, and updating their arguments accordingly.

RIP Aaron. You are not alone

The corner of the internet that I hang around in has been mourning all weekend with tributes, eulogies, and heartfelt sharing about the untimely death of Aaron Swartz.

I don’t remember meeting Aaron personally, but I have heard him speak, am friends with many of his friends, and was very aware of his work and activism.

I am furious and sad to hear that he took his own life. I have lost a few friends and relatives to suicide, and years ago wrestled with some of these demons myself. Honestly, I am not sure how I feel about politicizing this moment. There are strong arguments on both sides. Being persecuted by the state is horribly stressful and isolating, and I also feel strongly about many of issues that Aaron advocated for. But, I am concerned about responses that reduce and simplify Aaron’s complex decision. This post about suicide reporting on the internet raises the concern that sensational reporting causes an increase in suicides in the wake of the coverage.

What I want to contribute to this conversation is an important message to any geeks, hackers, or activists that are struggling with isolation, alienation, depression, or even suicidal thoughts. You are not alone. And, sometimes it takes alot of courage to decide to stay alive.

For the past 10 years, radical mental health groups like The Icarus Project have been developing support materials for activists that provide alternative ways of thinking and talking about mental health. Take a peek at their forums, publications, podcasts, documentaries, and more. They have really helped so many people rewrite their own narratives, and connect with others struggling with similar emotions.

In the past year or two especially, I have seen more and more geeks/hackers who are attempting to organize around these issues, eliminate stigma, and provide peer-support outside of the mainstream psychiatric paradigm. Geeks, hackers, and activists are especially suspicious of authority, and habitually question systems of power.  They are justifiably mistrustful of psychiatry, but need a place to turn to for support.

I don’t know the state of all of these projects, but they seem like a good place to pick up the conversation for how can we take better care of each other and provide kind of compassionate support we all need so horrible tragedies like Aaron’s, Ilya’s and countless others can be averted in the future.

  • Blue Hackers is a fledgling community of hackers dealing with depression
  • At HOPE#9 this past summer, there was a 3 hour (!) panel on Geeks and Depression. The notes and slides were posted here.
  • Just last month, at the Chaos Communications Conference (29c3), Violet Blue gave a talk on Hackers as a High-Risk population, and suggested a harm-reduction approach for thinking and talking about these issues.

It feels like there is an important conversation starting to happen here, and not just around free culture and prosecutorial abuse. How can we steer this conversation without reinforcing the stereotypes and stigmas around suicide?

Hide your kids

 

It’s back to school season, and if you’ve glanced up from your smartphone while walking the streets of New York City, you are sure to have noticed a new campaign that is sweeping the city’s billboards and phone booths.

 

Children’s Mental Health MATTERS

Where Science Meets Hope for Children’s Mental Health

 

Who could possibly object to children’s health and well being?

The Child Mind Institute, whose “Billboard is now at Penn Station!” is a recently founded non-profit “committed to finding more effective treatments for childhood psychiatric and learning disorders, building the science of healthy brain development, and empowering children and their families with help, hope, and answers.”.  According to their website, they don’t accept funding directly from pharmaceutical companies. Anyone want to help me start cross-checking Pharma’s ties to their staff and board?

In a gushing profile of the organization and its founder, Dr. Harold Koplewicz, the New York Times reported last summer that they are awash in millions of dollars of funding, have 14 clinicians on staff, and a former editor of the New York magazine is editing their website. Koplewicz is also the go-to doc for helping celebrities and the 1% “manage” their children. The story glosses over Koplewicz’s messy departure from NYU to start the Child Mind Institute.

“[Koplewicz’s] main mission in life, he contended, is to remove any stigma from mental illness among children and teenagers, make it merely something to be managed and overcome as it was with dyslexia or attention deficit disorder before it.” In his critique of Marcia Angell’s two-part series in the New York Review of Books on the epidemic of mental illness Koplewicz stakes out his position clearly: “In the meantime, we have patients, in our case children and adolescents, who desperately need help. These children may be out of control, overwhelmed by anxiety, dangerously aggressive, disorganized in their communication, floundering in school. We need to help them. Medications, often along with behavioral therapy, can have a transformative effect.” These are the symptoms that Koplewicz wants concerned parents to be vigilant about patrolling: Child Mind Institute Symptom Checker.

To me, Koplewicz reads like a raving megalomaniac, and his devotion and conviction are more frightening than the fictitious evil masterminds he claims are posited by Psychiatry’s critics. I get the sense that he genuinely believes his own spin. He worships at the alter of “objectivity”—”We would like to see objective research catch up with the clinical realities but can’t wait until that happens. Furthermore, falling back on pure non-pharmacological treatment is not the better alternative, since these treatments have rarely undergone objective evaluation.”—and the Child Mind Institute is outfitted with “the latest in brain imaging technology”. Koplewicz wields a formidable rhetoric, but is almost a caricature of the scientific realists in the Science Wars.

This post raises more questions than it answers. Who is funding the Child Mind Institute? Why now? How can organizations developing compassionate languages to describe mental diversity and difference, like The Icarus Project, respond to these campaigns? What roles do “objectivity” and “risk aversion” have in shaping the dynamics of this controversy? Should anything be stigmatized?

UPDATE 4/22/2013: I  tweeted about this ages ago, but realized that the following tidbit never made it into this post.

If you visit the wonderful Drug Industry Document Archive and search for ‘Koplewicz’, you will find that he was one of the co-authors on the now infamous Paxil 329 study that cost Glaxo Smith Klein $3 BILLION in settlements in 2012.

The Paxil 329 study tried to cover up the finding that not only does Paxil not work in children, but that it makes them more suicidal than a sugar pill did. The Dept of Justice found the study to be misleading and fraudulent.  I am pretty sure that the study was ghost written, but I think that makes his credibility even worse.

See also:

Bossewitch, Jonah (2011). Pediatric Bipolar and the Media of Madness “Drugs and Media: New Perspectives On Communication Consumption and Consciousness”, eds. MacDougall, R. C., New York : Continuum: 2011

Special thanks to Dyan Neary for helping out on this post.

#OccupyAPA: Mad Power, Mad Pride, Mad Action

 

Last weekend I went down to Philly to Occupy the American Psychiatric Association’s yearly conference (#OccupyAPA). I joined the protests on Saturday, attended the APA on Sunday, and participated in the Radical Caucus, hosted by a group of psychiatrists attending the conference on Sunday night. The weekend was overflowing with information and emotion, and I when I finishing unpacking it all I might just have a dissertation (or, at least a fat chapter).

This year’s APA was especially controversial since the DSM5 is scheduled to be published in 2013. Over a decade in production, and already delayed more than once, the DSM5 is, in a word, disastrous. Many psychiatrists, including the lead author of DMS-IV, have spoken out vehemently against both the processes and outcomes of DSM5.

[CALL TO ACTION: The final round of public comments on DSM5 is now open, until June 15th, 2012.]

The controversies around DSM-5 coupled with the energy of Occupy Wall Street, brought activists and the media out in force. The Philadelphia Inquirer ran a front page story on the protests (Former patients protest psychiatric convention), New Scientist covered the protests alongside their DSM coverage (Label jars not people), The Grey Lady covered and opined the DSM disaster (though not the protests), the BBC was filming, NPR was recording, and at least 2 documentary film crews (Cause of Death: Unknown), and a multitude of citizen journalists captured and reported on the actions.

Saturday morning kicked off at Quaker Friend’s Center, with a powerful lineup of psychiatric survivors firing up the protesters with speeches, songs, and changes. Hundreds of protestors marched through the streets of Philly to the main convention center, many wearing psychopharmacomania t-shirts, and holding creatively maladjusted signs.

The protest culminated in a label rip, staged outside of the main convention center (The Alchemist makes an appearance at 2:25, warning that psychiatry is a threat to itself and to others).:

The Icarus Project represented, and we were thrilled to distribute physical copies of the eagerly anticipated Mindful Occupation to protestors, psychiatrists, and the media.

The protests were a rush, but for me, the surprise thrill was gaining admission to the APA conference itself on Sunday. I attended a few talks and a poster session, irrefutably detailing and confirming my research and predictions. Then I hit paydirt. The vendor exhibition hall. HOLY FUCK. Highlights included:

Future Blockbuster? Anti-psychotic action in 3D:

A live psychiatrist, hired by AstraZeneka, delivering their powerpoint presentation (she only squirmed a little when I asked her if this was the drug that killed 3-year old Rebecca Reilly):

and devices that only psychiatry can dream up uses for:


 

 

 

 

 

 

The Radical Caucus deserves a follow-up post of of its own. For starters, Brad Lewis’ brilliant breakdown seamlessly applies the hard-fought lessons of academic theory to the trenches of emotionally-loaded, real-life conflict. I have much more to say about this meeting, but first I need to track down who swallowed the comment that I posted in response to Brad’s post ;-).

For now, I’ll leave you with a teaser for next year’s APA: “Pursuing Wellness Across the Lifespan” – I guess that covers kids, the elderly, vets, prisoners, pregnant women, and whoever else is ensnared by DSM-5’s diagnostic nets (including the appendix).

Last Call

Our Kickstarter campaign to fund the publication of Mindful Occupation: Rising up Without Burning Out is in full swing.  We have made our financial goal (w00t!), and all additional funds raised will go towards additional printings.  Thanks to everyone who contributed and helped spread the word.  Let’s finish this campaign with a bang. Please share widely:

http://kck.st/yAmbya

A guide for participants in the occupy movement to strengthen our psychic, soulful and heartfelt contributions. #mutualaid #peersupport

Promissory Notes

My friend Dr. Rasmus Nielson sends me the best leads. Or, the worst ones, considering they are irresistible calls to action.  He sent me this one days before it was due, and I scrambled to pull-off this abstract over the weekend. Below is the call for papers, and my response. Now all I need to do is deliver on the promissory note I just wrote sometime in the next 3 months. Thanks Rasmus. 😉

 

 


CFP: Online Disorders. Recomposing Mental Health on and with the Internet


You are Not Alone: Re-envisioning Radical Mental Health in a Networked Society

In the first decade of the 21st century radical mental health activists reinvented the psychiatric survivor movement through recompositions that deeply resonated with the emerging affordances of new media and communications technologies. This freshly reconstituted field of resistance to biopsychiatry and the pharmaceutical industry emerged at the intersection of networked identity, narrative advocacy, and authentic virtual communities. Organizations such as The Icarus Project and The Freedom Center developed hybrid models of peer-support, direct action, and alternative therapies that were suggested and enabled by these emerging communicative possibilities. These groups mobilized around Web 2.0 platforms and social networks that supported discovery, advocacy, transparency, engagement, and community building.

Self-identified as part of the “mad pride” movement, these groups advanced a subtler critique of mainstream perspectives on mental illness than earlier generations of anti-psychiatry activists. This critique had less to do with any particular dogmatic position around hospitalization, medication, or labels, and was rooted in challenges to authority and knowledge production. The disability rights movement’s radical epistemology, captured in their mantra “Nothing about us without us”, succinctly represents this transformative shift. Instead of formulating their resistance around human rights discourses while fighting forced drugging and electroshock therapy, the mad pride movement embraced a liberatory politics that attempted to reinvent the language and categories used to describe the mentally ill. The movement aspired to develop languages of compassion, celebrated their “dangerous gifts” through creative expression, and fostered safe spaces for people to share their experiences and subjective narratives. And, unlike earlier generations of activists who were staunchly anti-psychotropic medication, this movement stood for pro-choice and informed consent – though information was becoming more difficult evaluate as pharmaceutical advertising and marketing grew increasingly more sophisticated and aggressive.

To what extent has the mad pride movement been shaped by a new generation of media and communications technologies? How has this movement leveraged these technologies as a means to redefine personal identity and avoid stigmatization? How have they used these technologies to resist and subvert corporate messaging and the plodding advance of biopower? The Internet, and especially free and open source software, played an instrumental role in the formation and assembly of these groups. The cultural practices embodied in these tools, alongside the movement’s roots in anarchism, punk, DIY, permaculture, and queer pride helped inform the organizational models, governance structures, as well as giving rise to new forms of collective action.

Mindful Occupation: Part II

In a previous post, I described my initial involvement with #occupymentalhealth and birth of our forthcoming zine Mindful Occupation: Rising Up Without Burning Out.

I alluded to the heated debates that emerged around our work on this  zine and my direct participation in the local NYC ‘Support’ working group. It was through these deliberative processes and exchanges that I rediscovered the promise Occupy’s discursive ‘public space’.

As a researcher of the radical mental health movement, I recognized a unique opportunity in Liberty Park to explore the rhetoric around mental health, in context. I was hopeful that the activists involved in supporting the health and safety of the #OWS community would be critical of mainstream corporate medical models, and would be very receptive to alternative perspectives and language. The discussions that ensued were provocative and transformative, and  the experiences have helped me crystallize future directions in my research.

As the occupiers settled into Liberty Park the task of self-governance grew in scale, with complexity that rivaled running a small town. Dozens of working groups sprung up to meet the challenge of non-hierarchical, self-governance — many committed to modeling the kind of society they dreamt of living in, rather than replicating existing broken forms. The working groups took responsibility for the protester’s basic human needs – food, shelter, sanitation, safety, spirituality – as well as organizing, maintaining, and sustaining the occupation, over the short/medium/long term.

A number of working groups took up the challenge of maintaining the heath and well-being of the protesters, and in New York City these groups  organized themselves into the Safety Cluster. The Safety Cluster included people committed to mediation, non-violent communication, security and deescalation, as well as people committed to anti-oppression and reducing sexual harassment (the Safer Spaces working group). Additionally, there was a working group calling itself ‘Support’ that had been operating as a subgroup of the Medic working group. The Support group was comprised primarily of mental health professionals – social workers, chaplains, psychiatrists, and a few non-traditional emotional support practitioners. Together, the safety cluster developed protocols for handling interpersonal conflicts in the park, and organized nightly “community watch” shifts, where members of the community organized to support protesters, and identify and defuse conflict.

While some of my fellow collaborators on the Mindful Occupation zine felt more comfortable working with the Safer Spaces working group, I realized that the best education  happens outside of our comfort zones. Tension and conflict are inherent properties of activism, as activists attempt to question and dislodge accepted norms.

Initially, I thought that this particular group of mental health professionals would be very receptive to questioning psychiatry’s mainstream medical models. These individuals were volunteering  their time and energy at #OWS.  As it turned out, although I found many sympathizers and allies among the Support group, I was stunned by the systemic efforts to silence and marginalize voices from outside the mainstream. While many of the Support volunteers were fully engaged in critiquing social and economic injustice in the world at large, few seemed prepared to apply a self-reflective critique of their entrenched beliefs and professional norms.

Through countless interminable meetings and mailings, I witnessed efforts to exclude the voices of those without formal expertise and training. Voices outside of the mainstream had difficulty getting their issues on the meeting agenda and were actively excluded from some events and conversations. I remained committed to working with the Support group, although I did not always feel welcome.

Within the Support group, proposals were raised for the “community watch” volunteers to wear identifying badges which included their profession (e.g. social worker, chaplain, psychiatrist) and license number, and for an active recruitment of more psychiatrists to patrol Liberty park. Some of the medics insisted on “clearing” all of their patients medically, before turning them over to social and emotional support. Sounds reasonable until you begin to question what’s medical, and more importantly, what’s not? A head trauma might be medical, but what about a chemical imbalance? If all conditions are ‘medical’, then all authority around health and well being has been effectively ceded to a narrow range of medical specialists.

In subtler ways, i believe that some of the work in this group contributed to an atmosphere of fear and control in the park. Support’s role-plays often focused on the most violent scenarios, invoking the stereotype of the knife-wielding psychotic, and priming those on community watch to bring this anxiety with them throughout their encounters in the park. While the violence and sexual harassment in the park were unfortunately very real, some of the efforts to prevent these behaviors may have exacerbated them.

I witnessed that the providers of mental health services, with rare exceptions, found it incredibly difficult to listen to the recipients of their services. To ask and solicit opinions and stories, and incorporate their experience and judgment into the congress of their decision making.

I developed fresh insights into radical mental health through these encounters, that opened my eyes to much of what I had grown to take for granted. I learned that radical mental health has less to do with any particular dogmatic position — around hospitalization, medication, coercion, or diagnoses — and everything to do with authority and knowledge production. I learned that it is hard to find a proposition more radical than the disability rights mantra – Nothing about us without us!

#OccupyAuthority

Mindful Occupation: Part I

On September 17th 2011, sleeping giants stirred as the perception of social and and economic injustice in the US finally crossed a critical threshold. And the people spoke.

During the first week or two of the Occupation of Zuccotti park I was following along closely, but not yet fully engaged or plugged in.  The movement erupted at the beginning of the semester, just as a good friend and I were embarking on a study of digital activism and collective action in the 21st Century. #Occupy quickly became both a primary source and case study as we scrambled to track the tools and tactics that were rapidly deployed.

Within days the movement launched multiple web platforms, was taking online donations, was  broadcasting a 24-hour streaming video, and started publishing a broadsheet newspaper. Protesters were sharing and exchanging citizen-generated-multimedia-speech using services distributed across the internet, and organizing themselves and their expressions around shared tags. The mainstream media disgraced itself as one of the first (genuine) networked-grassroots movement redefined activism by breeding wikis and folksonomies, with  Blue Stockings and Indymedia.

Public Space: The Final Frontier

The protester’s literal occupation of space quickly went metaphorical, as everything from yoga to religion were soon “occupied.” At one point I came across a call to #occupypsychiatry, although no one seemed to know exactly what that meant. By that point many activist groups had descended on the park, and were tabling, distributing pamphlets, and competing to get their messages out while the media’s spotlight was shining brightly in their vicinity.

In the early days of the occupation, while the weather was still mild, Zuccotti was a cross between a party and a seminar. Epic discussions around substantive issues sprung from every flagstone, and the best of Zuccotti suggested what a university could and should be. The occupiers rediscovered public space, and honest-to-goodness publics were formed.

It occurred to me that,  far more important than any message that #occupy might broadcast were the internal dialogues and communications between and among activists. Especially in these early, fragile stages,  teach-ins and skill shares helped forge the alliances and friendships that would propel the movement through the winter and beyond.

One of the nights in the park I found myself in a conversation with someone from the sanitation working group, and was struck by the humility of someone focusing their energy on sustaining the community instead of clamoring to be heard by the rest of the world. Through some of the mad pride networks I am connected to, I    started hearing stories about protester burnout and emotional crisis at the occupations.

Frayed Edges

Given the exacerbating conditions – lack of sleep, poor nutrition, exposure to the elements, and don’t forget the police brutality – it is unsurprising there were many frayed edges amongst the protesters.  Although the movement had scorned resolving conflicts by turning to the criminal justice system, it had not formed an analogous consensus about resolving emotional crises by turning to the psychiatric system. Around the country reports of forced hospitalization (and  medication) emerged, and people kept reaching out for materials that offered alternative perspectives towards handling emotional trauma and navigating crises.

Over the summer I had been been working towards setting up on-demand  publishing solutions for some of The Icarus Project’s publications. I had spent months trying to track down original indesign files, fonts, and assets, in order to recreate these publications according to the specifications the ondemand publishers mandated.

In early October I attended the provocative Mobility Shifts conferences on digital learning, and attended a workshop on the Booki  software that explained the practice of book sprints. Booki is essentially a wiki platform that was designed to support collaborative book authoring.  The application supports chapters, tables of contents, and pagination, and pumps-out ebooks and print-ready pdfs. [In the course of this project I have learned a lot about digital publishing and the future of open zines, but I’ll save those thoughts for another post.]

Another good friend of mine was also in the midst of working on an #Occupy  pamphlet, The 99%’s Guide to the Current Clusterf#*k, and that night something clicked. I imagined working together with radical mental health activist to remix a zine (aka pamphlet) that would present alternative perspectives on activism and mental health.  I got really excited about a concrete way to contribute to the occupation. I bounced the idea off of some friends and we were all really jazzed about the project. That night, Mindful Occupation: Rising up Without Burning Out was conceived.

[to be continued]

That way madness lies

Bossewitch, J. (2010). Pediatric Bipolar and the Media of Madness. Ethical Human Psychology and Psychiatry, 12(3), 254-268. doi: 10.1891/1559-4343.12.3.254

I am finally published in a peer-reviewed journal! Ethical Human Psychology and Psychiatry (available for purchase here – but my cut is exactly 0%). I wasn’t expecting much, and it’s mildly anti-climactic, but I have heard from a few people I never would have communicated with otherwise, and worked really hard to polish up this paper. Anyway, now its traditionally citable, which still means something (for the next few years, at least).

This paper is at least 2 years in the making.  It began when Rasmus Nielsen forwarded me a call for papers about drugs as a form of media for NCA ’09, and I participated in a panel  organised by Robert MacDougall (my slides). Around the same time as NCA, I also attended ICSPP and had the pleasure of meeting James Tucker and Peter Breggin. This meeting eventually led to my submission to EHPP – a journal that typically publishes articles by and for psychologists, psychiatrists, and social workers.  I was thrilled to help bring a dash of media and communications theory/research to that audience. Special thanks to Annie Robinson, Sascha Scatter, Bonfire Madigan, Brad Lewis, Biella Coleman, Philip Dawdy, Nicholas Mirzoeff, Julia Sonnevend, Ben Peters, and the Icarus Project for ideas, inspiration, and edits.

I have also reworked the main arguments in this essay into a chapter in the upcoming: Drugs & Media: New Perspectives on Communication, Consumption and Consciousness (edited by Robert C. MacDougall). I even worked on a McLuhanesque Tetrad around Prodromal diganoses (a.k.a. Psychotic Risk Syndrome).

Unfortunately, I was unable to convince Springer to go open access with my paper, but I tried and was able to deposit an open-access pre-print in the Columbia institutional repository, and also have a pre-print available here. If enough people make noise about open access, I hope the editors and publishers will eventually start to get the idea.

The issues raised in this paper are beginning to percolate into the mainstream. Last month Harpers published a (flawed) long  piece on predictive diagnoses: Which way madness lies: Can psychosis be prevented? Wired just ran a great piece on the backlash against DSM5, especially Psychotic Risk Syndrome, by one of the DSM IV contributors: Inside the Battle to Define Mental Illness. A good friend of mine from the Journalism school also just produced an investigative short-documentary on antipsychotics use among foster home children that just aired this weekend on PBS: The Watch List: The medication of foster children.

Finally, Crooked Beauty is coming to town next month for the 3rd  annual Reelabilities Film Fest – c’mon out to the launch party or one of the screenings:

Thursday 02/03/2011 1:00pm JCC of Mid-Westchester
Friday 02/04/2011 1:30pm Bellevue Hospital Center
Friday 02/04/2011 6:00pm New York City College of Technology
Saturday 02/05/2011 7:00pm The JCC in Manhattan
Monday 02/07/2011 6:30pm Solomon R. Guggenheim Museum
Tuesday 02/08/2011 7:00pm JCC of Staten Island

It’s going to be a great year.

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