Suicide Rate Rises in Rhode Island (Again) -- Rhode Island Department of Health Needs an Overhaul

When I talk about "shameful" and "pathetic" in the context of suicide, I am NOT shaming the victim of suicide in the least. They are a tragic and much overlooked loss to humanity and society. What's shameful and pathetic are those institutions entrusted to treat the mentally ill, who do so in ways that are substandard, careless, reckless, and even abusive.

From the Providence Journal (Jan. 31, 2020):

A federal report released Thursday on life expectancy and mortality documented progress in reducing deaths by drug overdose, but the news on suicide was disheartening, as it has been for years.Deaths by suicide continue to rise, with an increase nationally from 47,173 in 2017 to 48,344 in 2018, the latest year for which full data are finalized.
Those numbers documenting an unrelenting crisis, contained in the Centers for Disease Control and Prevention’s “Mortality in the United States: 2018” report, brought renewed attention in Rhode Island, where the suicide trend has also been upward for two decades.
Suicide also was brought into sharp focus locally with the Christmas Day deaths in Boston of Erin Pascal and her two young children. Pascal was a reporting intern at The Journal from 2001 to 2003.
“We need to get help to people with behavioral health issues quickly, and in a way that is affirming, compassionate, consistent, and effective, in the same way that we do for physical health conditions,” state Health Department director Dr. Nicole Alexander Scott told The Journal. “We must do everything we can to lift people up, and let them know that they matter, and that they are loved.”

Dr. Nicole Alexander-Scott, R.I. Department of Health Director

Now I'm not going to make hay of the Erin Pascal tragedy in Boston, which was a widely-publicized murder-suicide. But my sense is that someone as educated as she was -- a Brown graduate -- had been in mental health treatment. But what often happens?

Preventive care needs to be improved, Denise Panichas, executive director of The Samaritans of Rhode Island, said on Thursday. Too often, she told The Journal, people at risk don’t receive help — or have become frustrated by what she described as an inefficient and cumbersome health-care system.
“Whatever numbers you can come up with will not count those who have been in treatment before and refuse care because they don’t believe it works,” Panichas said. Nor do such numbers “count those people who give up because the bureaucracy is so huge, dauntingly difficult to navigate, and exhausting that continuity of care seems impossible. We must do better streamlining care and working together across the spectrum of all providers.”

The fact is this: I have sent Dr. Alexander-Scott's Department of Health detailed complaints about several inept, unethical, incompetent, and unstable mental health so-called professionals here in Rhode Island. She even personally wrote back in response to one complaint. What happened? What did she do about it? Other than appointing one of the relatives of the therapists I complained about to one of the licensing boards, NOTHING. Otherwise: These mental health advocates are way off base, speaking mostly about "bureaucracy" and the inaccessibility of care, and not the poor performance and unprofessionalism of too many mental health providers, who seem to be held beyond all question about their performance and criticism. When their judgements are prejudiced by stigma and too much subjectivity, they often blow it, either with the basic diagnosis, or simply relating to the patient.    

The article goes on:

Rhode Island Department of Health statistics confirm the overall upward — although not straight-line — trend here over the last two decades. The state saw 96 deaths by suicide in 1999, 75 the next year, 88 in 2001, and 71 in 2005. That rose to 129 deaths in 2010, dropped to 101 the following year, and then hit a high for the period of 132 in 2013. The latest available figure was for 2017, when the state recorded 129 deaths by suicide, up three form the prior year.
The statistics for 2018 will not be finalized until later this year, according to the Health Department.
Suicide affects certain age groups more severely than others. In 2017, according to the Health Department, suicide was the fourth-leading cause of death for people age 10 to 14; and the second-leading cause of death for people 15 to 24 and people 25 to 34. It is the third-leading case in the 45-to-54 age group, and eighth for the 55-to-64 age group.

 And a mental hospital official is quoted as stating:

"The Mental Health America 2020 report indicates that Rhode Island has higher rates of adults with serious thoughts of suicide than many other states,” with the state ranking 40th out of 51 states including the District of Columbia, Diane Block, director of quality and patient experience at Butler Hospital, told The Journal. “To reduce deaths from suicide we have to be willing to talk openly and honestly about thoughts of suicide and to take action to mitigate suicide risk when a person endorses these thoughts.”

And let's be willing to talk openly about the FAILURES of mental health providers and those who are supposed to hold them accountable. 

FOLLOW-UP NOTE: Many believe that unemployment is behind much of the suicide rate. While loss of a job is no doubt a major life stressor and driver behind too many suicides, something stands out in the statistics for Rhode Island. The years 1999, 2000, as well as 2005 were very strong economically, especially by Rhode Island standards -- and unemployment was low. Perhaps correspondingly, the numbers of suicides were relatively low. Then suicides began to rise precipitously by 2010, when the economy was poor (and the job market especially bad in R.I.). But the heightened suicide trend continued into 2017 -- 129 deaths, 58 more deaths compared to 2005. The economy by 2017 was considered strong, the unemployment rate dropping to a 30 year low. Does work stress combined with financial difficulties, all while steadily having a job, factor into the equation?

Bruce Levine: Psychologist and Author on How Mental Health Treatment Compels Patients to Conform to Anyone's Claims to Authority

Arguably, the MOST important priority for mental health professionals is to ensure that their patients or clientele suck up to and comply with every type of AUTHORITY they encounter. This authority can be legitimate, illegitimate, or abusive (which should de-legitimize those who hold that authority, perhaps even rendering THEM on the wrong side of the law).

Many simpletons believe that non-conformist "troublemakers" try to resist ALL rules and authority figures, just for the fun of it, in favor of making their own rules or otherwise cultivating anarchy. This is binary thinking, where it's all or nothing, black or white, all good or all evil, with nothing in between. As clinical psychologist Bruce Levine has discovered for close to 50 years, anti-authoritarians, or those who question authority, do so first and foremost because they perceive hypocrisy in the system or the individual that holds the authority. For instance, authority figures who write rules for their employees in violation of local ordinances, who then claim that they can enforce those rules at their "discretion" (read: as they fucking feel like) would absolutely classify as hypocritical abusers of authority.

It's worth underscoring that living in the United States is NOT nearly as oppressive, personally stifling, or restrictive as living in many, if not most of the other governed countries on earth: just consider communist China, totalitarian Russia, Thailand, Vietnam, the Philippines, Turkey, Saudi Arabia, Egypt, and so on. But as the original Land of Liberty and also the planet's longest-lasting democracy, the U.S. still incarcerates more of its citizens than any other country whose number of inmates are known. Even with the recent "criminal justice reform," our government (often at the state level) continually classifies more and more criminal offenses as felonies that used to be misdemeanors. But it's not just our penal code that's the problem. Workers' rights are far fewer than they are in almost all other modern, wealthy Western democracies, with American workers given far fewer breaks, sick days, vacations days, family leave, and recourse after being fired. Public schools have more "zero tolerance" policies than ever before, despite the perennial complaints many older folks have about the "loosening of discipline" in schools -- the same nonsense that I remember hearing self-righteous adults bitch about when I was a kid in the 1990s. And even with the horrors of police officers getting gunned down in the line of duty and the stepped-up media publicity about these tragedies, civilians are still MANY times more likely to be shot by a cop (very often, the civilian having been without a weapon of their own to prompt deadly use of force by law enforcement). The lethal use of force by police is far more common in the U.S. than it is in just about any other country worldwide, as is violent crime (save for the nations of Latin America that have the world's highest murder rates and endless drug gang violence).

For reasons that are becoming increasingly obvious, living in the U.S. these days is no bargain. The long quotes below are excerpts from "Why Anti-Authoritarians are Diagnosed as Mentally Ill, and How This Helps America’s Illegitimate Authorities Stay in Charge" (Feb. 23, 2012)

In my career as a psychologist, I have talked with hundreds of people previously diagnosed by other professionals with oppositional defiant disorder, attention deficit hyperactive disorder, anxiety disorder and other psychiatric illnesses, and I am struck by (1) how many of those diagnosed are essentially anti-authoritarians, and (2) how those professionals who have diagnosed them are not
...Anti-authoritarians question whether an authority is a legitimate one before taking that authority seriously. Evaluating the legitimacy of authorities includes assessing whether or not authorities actually know what they are talking about, are honest, and care about those people who are respecting their authority.
...Some activists lament how few anti-authoritarians there appear to be in the United States. One reason could be that many natural anti-authoritarians are now psychopathologized and medicated before they achieve political consciousness of society’s most oppressive authorities...

Levine theorizes that this mindless conformity is anchored deep within the mental health establishment:

I have found that most psychologists, psychiatrists, and other mental health professionals are not only [themselves] extraordinarily compliant with authorities but also unaware of the magnitude of their obedience. And it also has become clear to me that the anti-authoritarianism of their patients creates enormous anxiety for these professionals, and their anxiety fuels diagnoses and treatments.

And it's all pretty basic psychology, according to Levine, who sees the crop of the mental health establishment imposing the need for compliance that's demanded of them in training, onto their clients and patients:

Gaining acceptance into graduate school or medical school and achieving a PhD or MD and becoming a psychologist or psychiatrist means jumping through many hoops, all of which require much behavioral and attentional compliance to authorities, even to those authorities that one lacks respect for. The selection and socialization of mental health professionals tends to breed out many anti-authoritarians. Having steered the higher-education terrain for a decade of my life, I know that degrees and credentials are primarily badges of compliance.

Note Levine's wording: "And it also has become clear to me that the anti-authoritarianism of their patients creates enormous anxiety for these professionals, and their anxiety fuels diagnoses and treatments." In other words, among these anxious professionals are many who'll lay aside the clinically viable criteria to make an accurate diagnosis or do what's truly helpful to the patient, all in the interest of promoting or pressuring the patients' conformance to some authority. And any resistance to this by the patient can indeed lead to the further pathologizing of that patient and in various (perhaps normal) areas of his life.

This epitomizes the ethical debasement of an entire profession.

Levine continues:

A 2009 Psychiatric Times article titled “ADHD & ODD: Confronting the Challenges of Disruptive Behavior” reports that “disruptive disorders,” which include attention deficit hyperactivity disorder (ADHD) and opposition defiant disorder (ODD), are the most common mental health problem of children and teenagers. ADHD is defined by poor attention and distractibility, poor self-control and impulsivity, and hyperactivity. ODD is defined as a “a pattern of negativistic, hostile, and defiant behavior without the more serious violations of the basic rights of others that are seen in conduct disorder”; and ODD symptoms include “often actively defies or refuses to comply with adult requests or rules” and “often argues with adults.”

Psychologist Russell Barkley, one of mainstream mental health’s leading authorities on ADHD, says that those afflicted with ADHD have deficits in what he calls “rule-governed behavior,” as they are less responsive to rules of established authorities and less sensitive to positive or negative consequences. ODD young people, according to mainstream mental health authorities, also have these so-called deficits in rule-governed behavior, and so it is extremely common for young people to have a “duel diagnosis” of AHDH and ODD

When they're not busy trying to sell themselves to the highest bidder on sugar baby dating web sites, many of today's younger female elementary and secondary public school teachers act out on their thinly-veiled anti-male biases by labeling energetic boys as "disruptive" and "uncooperative" in promoting what is nothing more than a dull, follow-directions-all-day-long curriculum. Parents will be notified of their kids' school troubles, then panic, then put their kids through grueling evaluations with psychologists. If the diagnosis comes back as ADHD or ODD, the psychiatrist is then introduced into the mix, and will then prescribe deeply mind-altering stimulants or sedatives, which can screw up cognition and become quite addictive.

If pathologizing authoritarian mental health professionals love to harp on any insecurity their patients have to get these patients to be more cookie cutter and kiss ass more, it's this one, as Levine describes:

Many people with severe anxiety and/or depression are also anti-authoritarians. Often a major pain of their lives that fuels their anxiety and/or depression is fear that their contempt for illegitimate authorities will cause them to be financially and socially marginalized; but they fear that compliance with such illegitimate authorities will cause them existential death.

...Authoritarians, by definition, demand unquestioning obedience, and so any resistance to their diagnosis and treatment created enormous anxiety for authoritarian mental health professionals; and professionals, feeling out of control, labeled them “noncompliant with treatment,” increased the severity of their diagnosis, and jacked up their medications. This was enraging for these anti-authoritarians, sometimes so much so that they reacted in ways that made them appear even more frightening to their families.(boldface emphasis mine)

Furthermore,

...Americans have been increasingly socialized to equate inattention, anger, anxiety, and immobilizing despair with a medical condition, and to seek medical treatment rather than political remedies. What better way to maintain the status quo than to view inattention, anger, anxiety, and depression as biochemical problems of those who are mentally ill rather than normal reactions to an increasingly authoritarian society.

...In an earlier dark age, authoritarian monarchies partnered with authoritarian religious institutions. When the world exited from this dark age and entered the Enlightenment, there was a burst of energy. Much of this revitalization had to do with risking skepticism about authoritarian and corrupt institutions and regaining confidence in one’s own mind. We are now in another dark age, only the institutions have changed. Americans desperately need anti-authoritarians to question, challenge, and resist new illegitimate authorities and regain confidence in their own common sense.

...While it is unusual in American history for anti-authoritarians to take the kind of effective action that inspires others to successfully revolt, every once in a while a Tom Paine, Crazy Horse, or Malcolm X come along. So authoritarians financially marginalize those who buck the system, they criminalize anti-authoritarianism, they psychopathologize anti-authoritarians, and they market drugs for their “cure.”

Does following the system, and those who lead it, pay off? If you want to be a physician, psychologist, lawyer, or accountant, it generally does. Generally. Unless you have someone who's corrupt operating above you, who'll think nothing of doing whatever it takes to get ahead, and think nothing of leaving you behind, even with you holding the bag for his misdeeds. For most who don't end up making their living after attending law school, med school, or a CPA program, it's easy to get roped in by fantasies about The American Dream -- that you can brownnose your way up some now-mythical ladder of opportunity the way grandpa did with even less education than you have. Show up, pay your dues, and that corner office has your name on it. Yet, too much of Generation Y has more total student debt than annual income. Most of them were never diagnosed with ADHD or ODD, either. They DID do what they were told.

As far as the last quote from Levine, how is this working out for American society today, and the taxpayers who funds these "remedies" for the antiauthoritarian?

This is Bruce Levine's 2018 book on the topic of authoritarianism:

Compliance Disorders (ADHD and ODD)

This is wonderful short video. This is a big part of business for corrupt shrinks. While there is such a thing as ADHD in a limited number of younger patients, most kids who get bored, don't sit still and piss off his anti-male teacher isn't pathological.


Please note: I believe that John Stossel is wrong about a number of things, especially when it comes to jobs and economics. The worst are his claims that dead-end jobs are all ladders of opportunity to "work your way up" (even while Stossel more or less opposes the minimum wage). But in other ways, he's been a strong advocate for individual rights and liberty, and the school he presents flies in the face of the typical politically correct public schools dominated by 20 to 40-something anti-male women teachers looking for any way they can find to clamp down on the natural boyish behavior of male students.

How to Know When Psychotherapy Is and Isn't Working

The mental health industry of America is one of the least accountable of any sector of healthcare. I would say that Veterinary medicine has higher standards for professional training, development, and the humane treatment of its patients (animals). Despite this big effort to combat stigma by the many ineffectual (and in one huge case, very unethical) mental health advocacy groups, mental health providers -- made up of prescribers (mainly psychiatrists, trained physicians who prescribe medications to most of their patients, along with a growing number of nurse practitioners and physician's assistants who do the same) and therapists (who can be mental health counselors, clinical social workers, and doctorate-level Ph.D. or Psy.D. clinical psychologists) -- are just as prone to stigma as the rest of the modern world. Prescribers generally meet with patients for 15-30 minute sessions, mostly to discuss symptoms and for the prescriber to monitor the patient's medication use. Therapists are those you see for "talk therapy" to "lie on the couch" for 50 to 60 minutes. Even with all of the controversies about the dreadful effects of drugs like Prozac, Zoloft, and atypical antipsychotics, badly executed talk therapy can screw up somebody's mind permanently.

In general, psychiatric stigma (which takes many forms) amounts to providers treating their mental patients and clientele either like immature, undisciplined, irresponsible, misbehaving children -- but at the same time trying to hold them responsible as adults. Or, they view their patients sort of like convicts out of jail and on probation (and always a potential menace to society). In other words, you're always prone to doing something bad, in their minds, because of a diagnosed (and presumably treatable) mood and/or anxiety disorder diagnosis -- and especially if there's a history of any conflicts with family, friends, school, or at work. In light of all of this malfeasance, it's mostly been certain upstanding members of the mental health community that have boldly come forward and identified the sorts of personal prejudices and other bullshit that their colleagues routinely engage in and project onto their patients. In the near future, I'll be writing a list of the frequent, common, one-size-fits-all remedies and solutions that patients are so often told to do by providers "if you want to get better." These are often unnecessary, even damaging solutions where a patient is told to gratuitously rearrange some major element of their life so providers can get them to troop along with everybody else in society.

BELOW is an excerpt of a speech given by a clinical psychologist of good faith who knows some of her collogues all too well (FAIR USE laws apply. The passage below is edited for brevity.)

This is an EXCERPT FROM:

How to Know When Psychotherapy is Really Working
By Martha Heineman Pieper, Ph.D.

This was a brief portion of a long lecture given by Dr. Pieper over a dozen years ago. In my humble opinion, it applies to BOTH prescribers and therapists, though usually more to therapists. I have boldfaced some words and statements for the sake of clarity and emphasis.

For the entire lecture, see https://www.marthaheinemanpieperphd.com/wp-content/uploads/2017/04/How-to-know-if-psychotherapy-is-really-working_final.pdf

...The therapist offers advice. If the advice is coming from the therapist’s caregiving motives, it will feel truly helpful and respectful. An example is a client who knew...that her motives for conflict often led her to behave in ways that irritated [her boss]. She knew it was his birthday and had gone out and bought him a tie and then thought to ask the therapist if she thought she should give it to him. The therapist, who by that time had a good sense for the boss’s personality, said that she thought he would think the client had crossed a boundary and that he wouldn’t like it. The client was happy and relieved to have brought the problem to the [therapist] and to have been spared the pain of causing herself another negative experience at work.

When a therapist’s personal motives are in control, the client may experience the therapist’s advice as artificial and imposed, or as covering territory the client feels entirely competent to handle on her own (emphasis mine). An example is the client who liked to entertain and who mentioned in one session that she was having a dinner party that night. The therapist asked what she was serving and proceeded to give the client advice on how to cook the dishes, even though the client felt no need for this input. The client felt both depreciated and also as though her process had been hijacked by the therapist’s remarks.

Another moment when it is possible to assess whether the therapist is responding with personal or caregiving motives is when the client is feeling negatively about her life, her work, her relationships, or the therapist. If the therapist is able to respond with caregiving motives, she will remain available to hear the client’s dysphoria, even when she is the target of it, and to help the client mourn the loss it represents.
The client can be certain that the therapist is being regulated by her personal rather than by her caregiving motives if the therapist reacts to the client’s negativity by expressing disappointment or irritation when the client’s pain surfaces in an intense manner. An example is the therapist who responded to the client’s renewed feelings of despair about her ability to lose weight by saying, “I don’t understand why you feel that way when you were able to lose three pounds last week.” The client felt the rebuke keenly, and, as a result, felt she had to watch what she said in her therapy to avoid angering her therapist. In general, it is a bad sign when clients who did not enter treatment with these concerns feel they have to monitor their words for fear of disappointing their therapist and being criticized.

A related instance in which the therapist responds with personal motives to the client’s negativity is the therapist who buys into the client’s feelings of self-deprecation, thereby endorsing and cementing them. Clients who are troubled by persistent bouts of self-rage, which occur in the therapy hour as elsewhere in their lives, hope deep down that the therapist will not view them as negatively as they see themselves. When the therapist seems convinced by the client’s self-critical opinions, the client is harmed considerably.
An example is the client who was very bright but had trouble believing in his academic abilities because he was tortured by an internal voice that constantly accused him of being “stupid.” He repeatedly told his therapist that he didn’t think he was going to make it through architecture school, to which he had just been accepted, because he was sure he wasn’t as capable as his fellow classmates would be. After the client reiterated this viewpoint in a number of sessions, the therapist replied, “Well, maybe it wouldn’t hurt to put in an application in a related field, like design.” The client agreed that this would be a good idea and that it was in keeping with his own desire to make the world beautiful, but deep down, he felt devastated.
Clients should not experience their therapist as accepting clients’ worst feelings about themselves as reality. Rather, when a therapist’s caregiving motives are in control, [s]he will retain a balanced view of the client’s capabilities no matter how negative the client’s self-evaluation.

Another indication of whether a therapist is being regulated by personal or caregiving motives is whether the therapist attempts to impose her own agenda on the client. As long as the client is not pursuing self-destructive motives (emphasis mine -ed.), the therapist should remain open to whatever life choices the client makes, and should focus on increasing the effectiveness of the client’s pursuit of these choices, whatever they are.
The client can regard it as a bad sign when her therapist has an agenda that is different from hers, for example in relation to: job change, divorce, dating, wanting children, choice of friends, political or social views, etc. An example is the client who was in a marriage that was making her utterly miserable and who concluded after much soul searching and many months of discussing the marriage in her treatment sessions that she wanted a divorce. When she conveyed this decision to her therapist, the therapist responded that she didn’t think the client had worked hard enough on saving her marriage to be able to reach that conclusion legitimately and that she should continue to work on this issue in her treatment.
Fortunately, the therapist had previously shared with the client that her own marriage had been rocky but that she had stuck it out. The client wisely decided to seek treatment elsewhere with a therapist who didn’t have an agenda in this area.

When a therapist’s caregiving motives are in control, she will not initiate displays of physical affection or make out of context statements about the client’s virtues – this restraint allows the client freedom to have and express any negative feelings she may have about the treatment or the therapist. Therapists who heap praise on clients or begin or end sessions with physical affection, such as hugs, are giving clients the message that therapists need clients to feel positively about them. While once in a while a client who has been through a very emotional positive or negative experience (has had a baby, has just heard that a parent died, etc.) may give the therapist a hug, these occurrences are rare and should always be initiated by the client. When therapists initiate hugs or make them a regular part of the therapy process, these physical displays of affection interfere with the therapeutic process by giving the client the message, “You should arrive (or leave) feeling good about me and our work together.” The client who knows that a hug will begin or end every session does not have the freedom to really explore and share negative feelings. So while, manifestly, hugs are a sign of closeness, in reality they can be coercive and distancing.

One sure way to distinguish a therapist’s personal motives from her caregiving motives is how she reacts to experiencing her own angry, irritated, bored or other negative feelings toward the client. There are schools of thought that recommend that the therapist share negative feelings with the client on the grounds that this sharing is justified by the client’s behavior, deepens the relationship, provides the client with reality testing in the relationship, and so on. blogger's note: or what the snowflake and/or self-absorbed conformance-promoting shrink deems upsetting and disrespectful TO THEM] However, this kind of therapist transparency always stems from personal rather than caregiving motives. In fact, any and all negative feelings about the client always originate in the therapist’s personal rather than caregiving motives and, therefore, should never be shared with the client. Rather, the therapist has some internal work to do to understand why her personal motives, which are causing the irritation, anger, dislike, disapproval, etc., are regulating her caregiving motives, when it should be the other way around.
I cannot overemphasize that when a therapist’s caregiving motives are in control, she will view the client’s criticisms, complaints, backsliding, missed appointments, failure to progress, etc. as expressions of problems the client brought to treatment that the therapist is trying to help her with, and not as behaviors that are personally aversive to the therapist When these behaviors are viewed through the perspective of the therapist’s caregiving motives, they will stimulate the therapist to reflect on the most helpful response to the client, rather than to think about her personal reactions, which ideally she will be aware of, but which she will have no need to act on. (blogger's note: unless she is a solipsistic head case, when any and all interactions are about her in her mind. This sort of nonsense shows how blameless they see themselves as, and the lack of empathy these therapists have -- the very sort of thing many tell clients that they're lacking and need to develop).
When therapists share negative feelings about the client with the client, they are in essence attempting to control the client in order to sooth their own inner disquiet – they are trying to get the client to “shape up” and stop making them feel uncomfortable. In other words, when the therapist tells the client that she is feeling angry, bored, irritated, etc., the client hears the therapist saying, “I don’t like you when you do this.” In order to be liked by the therapist, the client will try to change her behavior.

In contrast, when the therapist’s responses remain regulated by caregiving motives, the client who is unhappy or critical will get the message that the therapist doesn’t change toward her when she is feeling negatively, but remains just as motivated to help her as when she is feeling happy and positive...

Another test of the therapist’s ability to put caregiving over personal motives occurs when the therapist makes the inevitable caregiving lapse (forgets a rescheduled appointment, makes an insensitive comment, etc.). The therapist whose caregiving motives are in command will respond to her own caregiving lapses with the willingness to take responsibility and listen to the client’s point of view, whereas the therapist whose personal motives are in the driver’s seat will handle her errors by blaming the client, denying the lapse, or by taking other evasive actions designed to keep herself from having to acknowledge her error...

Now reflect upon the providers you've seen, whether for only a few sessions or over the span of several years. All I can say is that MOST providers I've encountered in the last 25 years going back to when I was in high school leaned far more towards the personal (i.e., subjective and self-absorbed) than the caregiving (i.e., objective and patient-focused) motives -- similar to what's outlined above. This should be a primer of whether or not you retain the services of your mental health provider, or fire them and find someone else.

You can do a search for the entire piece by Dr. Pieper on Google. The purpose of therapy is not to hire someone to dictate to you, either outwardly or subtly, how to live your life, what to think, or how to feel. Many folks will complain that their therapists "don't give me enough advice." True, individuals approach therapists at the times in their lives that their problems have become hugely overwhelming, and deep down they're aware of the inevitability that changes will need to be made. But while showing personal concern, the therapist is there to guide the client through their personal morass, hopefully raising questions about how realistically the client sees their situation (without deriding how the client has approached every situation in their life before, and directing the client to seeing where he or she does and does not have control within their lives). The biggest problems arise, I believe, when therapists insist that clients always kiss the asses of others, as if these others always have a higher social or moral positions (which doesn't entitle them to be abusive) and are always right in any disagreement with the client (the one glaring exception to this would usually be when battered women are urged to leave their abusers by mental health professionals). But being cheated out of wages or a legitimately earned promotion by unethical bosses and saying nothing about it just to keep the peace at a dead-end job, or being deprived of care (or have care delayed) by a doctor on the basis of insurance and going back to that doctor anyway, or having your living arrangement unlawfully threatened by a landlord and keeping your mouth shut so as "not to cause problems" hardly lends any advantages to someone at the receiving end. This is because these therapists (and often prescribers as well) believe that their avoid-all-conflict band-aid will help solve your problems, or at least avoid any new ones, especially if some sort of conflict with someone else was the source of your mental angst when first entering mental health treatment. Even when shrinks decidedly approach their clients as if the clients are randomly conflict-prone, recalcitrant children (and the client MUST BE at fault for any dispute they have), who just stir shit for the fun of it, it is still not hard to see how the client LOSES BADLY without a higher wage, without proper care for a physical health problem, or without a secure place to live. Too many modern shrinks see it as their foremost duty to paternalistically (or even coercively) keep people "in line with" what's "socially acceptable," which doesn't simply mean not breaking the law and committing any major crimes. It's about learning to follow orders, and adhere to many of modern American (and other Western) society's "morals." Psychologist Bruce Levine is the expert in this area.

PRIMER #1: THE REALITY OF LIBEL LAW (A Personal Disclaimer)

Rather than beginning with a discussion of therapy, psychiatry, and mental illness, there's a pertinent legal concern on peoples' minds oftentimes when it comes to blogging. This post is not intended as legal advice. Nor is it written as an expert entry in a law review. Since I am a true believer in The First Amendment, I take my right to express my beliefs and relevant facts about any necessary topic, including the professional performance of others, with grave seriousness. Yet, there are many today who think that either by shouting or by making legal threats, they can automatically control what is said or published -- including silencing speech that's totally protected by the Constitution. What you will see on this blog are TRUE, good faith comments and opinions about the mental health field. And some of its actual providers, who may be identified. I may unveil my impressions about these individual clinicians over time, when I see fit. And once I do, there will be no apologies, and there will be no retractions or admissions of wrongdoing by me. As noted below, I acknowledge that libelous speech is not protected by the First Amendment, which is why I am truthful in fact and sincere in my opinions and true accounts. But anyone thinking of engaging the legal profession and court system as "remedies" to what anyone else states better think long and hard, and consider the following:

FROM http://www.alllaw.com/articles/nolo/civil-litigation/filing-civil-lawsuit-defamation-expect.html

Defamation is the publication of a false statement that causes you to be harmed in some way. Whether the statement is published in the paper, on the Internet, or is merely spoken to another, it has the power to harm you. You can take action by consulting with a lawyer. But what does that entail? And, if you decide to pursue a lawsuit, what will the process be like? (emphasis added)

First of all, just because somebody has something published about them that makes them look like shit, and makes them feel bad, doesn't mean it's defamation under the law. What it should say in the above quote is alleged defamation.

So what's the upshot?

Finally, it is important to consider the potential side effects of defamation litigation. While a lawsuit is definitely an option to redress a wrong, and you may succeed, media coverage of it may make the statement more widely publicized than it was before, compounding the harm. Even if the case settles, settlements are often confidential and the public may be left with the wrong impression about the outcome. These cases can also be costly. Unless your attorney takes the case on a contingent fee basis, gathering facts and finding experts can be very expensive.

Most attorneys want a retainer, which is at least $5,000 just to get started. Then, they'll bill $300 or more an hour. The aggrieved party can get a parade of character witnesses to say how swell they are (and find others to say what a douchebag the allegedly libeling defendant is). But the question always boils down to whether WHAT the defendant said or PUBLISHED is TRUE or not. And if it's in any way false, what could then be considered is whether the person who uttered the offending "libelous" claim (or published it) KNEW IT WAS FALSE (or if they should have known).


Of course, there are enough lawyers who are just as thin-skinned and hot-headed as their clients, who will "take this case all the way to court." Or, they'll file suit knowing that the aggrieved plaintiff will get maybe a $150 settlement and has zero chance of winning at trial, while the plaintiff will still owe THOUSANDS in legal fees to that attorney for filing the lawsuit to start with. In other words, these lawyers are scumbags. And if the plaintiff suing for libel or slander loses, then THEY and their lawyer can be sued by the defendant, essentially for violations of free speech (be forewarned here of my own inclinations). I'm not writing a mini legal thesis here, but look up "anti-S.L.A.P.P. lawsuit." Medical professionals, in particular, have had a very difficult time prosecuting libel cases when they've been trashed on sites like vitals.com or healthgrades.com.

And IF someone DOES win the judgement for the lawsuit, payment is NOT automatic. You're not the IRS that can garnish everything down to someone's childhood piggy bank. Receiving payment, anywhere near the full amount, for "damages" is far from guaranteed, and can require filing another suit just to collect.

SEE https://www.avvo.com/legal-answers/how-difficult-is-it-to-sue-for-libel--defamation-o-2431687.html

AND ALSO SEE http://www.quickanddirtytips.com/business-career/legal/judgment-collections

This blog is intended to serve the informational needs of the public on the topic of mental health treatment. The public needs to be aware from one's own personal experience, however "bitter" that moralists and others with a vested interest in keeping with the status quo may claim that I am. Mental health providers, psychiatrists, clinical psychologists, therapists, etc. should be held to a high standard of conduct and performance, and not simply expect to be admired and bowed down to, as heroes, simply on the basis of their degrees and professional licensure.