Peter Stastny and (Eds.)

Alternatives Beyond

PrefacebyRobertWhitaker

Contributionsby VolkmarAderhold,LaurieAhern,BirgittaAlakare, KarynBaker, UlrichBartmann,AgnesBeier,ReginaBellion, WilmaBoevink,PatBracken,StefanBräunling,LudgerBruckmann, GiuseppeBucalo,DorotheaS.Buck-Zerchin,SarahCarr, TinaColdham,BhargaviDavar,AnneMarieDiGiacomo, ConstanceDollwet,JeanneDumont,MerindaEpstein, SandraEscher,JamesB.Gottstein,ChrisHansen,GeoffHardy, PetraHartmann,AlfredHausotter,MichaelHerrick,GuyHolmes, AndrewHughes,TheodorItten,MathsJesperson,KristineJones, HanneloreKlafki,MiriamKrücke,PeterLehmann,BruceE.Levine, HaroldA.Maio,RufusMay,SheryMead,KateMillett, MaryseMitchell-Brody,DavidW.Oaks,PeterRippmann, MariusRomme,MarcRufer,GiselaSartori,ErichSchützendorf, JaakkoSeikkula,AndySmith,ZoranSolomun,PeterStastny, ChrisStevenson,DanTaylor,PhilipThomas,JanWallcraft, DavidWebb,UtaWehde,ScottWelsch,SalmaYasmeen, LauraZieglerandUrsulaZingler

Translations by Christine Holzhausen, Katy E. McNally and Mary Murphy

Peter Lehmann Publishing ·· Eugene · Shrewsbury ·2007 4

This book is simultaneously published in German by Peter Lehmann Publishing under the title Statt Psychiatrie 2 (ISBN 978-3-925931-38-3, ed. by P. Lehmann and P. Stastny). Please find information on the internet at www.peter-lehmann-publishing.com/books/without/german. The italic explanations in the brackets are written by the editors. © This collection Peter Lehmann Publishing. Individual chapters the authors. All rights reser - ved. No part of this book may be reproduced, stored in a retrieval system, transmitted or utilized in any form by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher and/or the authors. Published by Peter Lehmann Publishing Cover design by Reinhard Wojke, Berlin · Printed by Interpress, Budapest Peter Lehmann Publishing, Zabel-Krüger-Damm 183, 13469 Berlin, , Tel. +49 30 85963706 · Branch offices: Eugene, Oregon (USA) / Shrewsbury, Shropshire (U.K.). Please send all postal mail direct to our Berlin switchboard. [email protected] · www.peter-lehmann-publishing.com

British edition ISBN 978-0-9545428-1-8 British Library Cataloguing in Publication Data. A catalogue record for this book is available from the British Library. American edition Library of Congress Cataloging-in-Publication Data Alternatives beyond psychiatry / Peter Stastny and Peter Lehmann, eds. ; preface by ; contributions by Volkmar Aderhold ... [et al.] ; translations by Christine Holzhausen, Katy E. McNally and Mary Murphy. p. ; cm. Published also in German under the title: Statt Psychiatrie 2. Includes bibliographical references and index. Summary: “61 therapists, , social scientists, lawyers, relatives and psychiatric (ex-) patients from all continents report about their alternative work, their objectives and successes, their individual and collective experiences. The book highlights alternatives beyond psychiatry, possibilities of self-help for individuals experiencing madness, and strategies toward implementing humane treatment”—Provided by publisher. Includes English translations of the German contributions. ISBN-13: 978-0-9788399-1-8 (softcover) ISBN-13: 978-0-9545428-1-8 (softcover) 1. Mental illness—Alternative treatment. 2. patients—Abuse of. 3. Mentally ill—Abuse of. 4. Antipsychiatry. [DNLM: 1. Mental Disorders—therapy. 2. Dissent and Disputes. 3. Human Rights. 4. Psychiatry—methods. 5. Treatment Refusal. WM 100 A466 2007] I. Stastny, Peter. II. Lehmann, Peter, 1950- III. Aderhold, Volkmar, 1954- IV. Title: Statt Psychiatrie 2. RC480.5.A472 2007 616.89’14—dc22 2007029028 5

Contents

Preface .................................. 11 Robert Whitaker Note about Liability ............................ 13 Introduction ............................... 15

WhyPsychiatryHurtsMoreThanItHelps

Introduction ............................... 17 Seventy Years of Coercion in Psychiatric Institutions, Experienced and Witnessed ....................... 19 Dorothea S. Buck-Zerchin The Illusion of Mental Illness ...................... 29 Antipsychiatric Work by Relatives: Unrestrained Anger and Commitment to Alternatives ....................... 38 Uta Wehde

ActualAlternatives

Introduction ............................... 41

A. Individual Strategies with and without Professional Support

What Helps Me if I Go Mad? With Contributions by Ludger Bruckmann, Chris Hansen, Andy Smith, Sarah Carr, Alfred Hausotter, Merinda Epstein, Harold A. Maio, Agnes Beier, Peter Lehmann, Zoran Solomun, Ursula Zingler, David Webb, Tina Coldham and Constance Dollwet ................. 44 Peter Lehmann 6

How We Discovered the Soteria Principle ............... 75 Regina Bellion Depression and the Use of Natural Healing Methods .......... 83 Bhargavi Davar Running from the Crisis ......................... 90 Ulrich Bartmann Advance Directives: A Step towards Self-help ............. 97 Miriam Krücke

B. Organized Self-help

Survival, the Art of Living and Knowledge to Pass on: Recovery, Empowerment and Experiential Expertise of Persons with Severe Mental Health Problems ........................ 105 Wilma Boevink Reclaiming Mad Experience: Establishing Unusual Belief Groups and Evolving Minds Public Meetings ............. 117 The Voices Accompany My Life .................... 128 Hannelore Klafki INTERVOICE: Accepting and Making Sense of Hearing Voices ... 131 and Sandra Escher The : Dangerous Gifts, Iridescent Visions and Mad Community ............................... 137 Maryse Mitchell-Brody

C. Models of Professional Support

Soteria: An Alternative Mental Health Reform Movement ...... 146 Volkmar Aderhold, Peter Stastny and Peter Lehmann Hotel Magnus Stenbock: A User-controlled House in Helsingborg, Sweden ................................. 161 Maths Jesperson Contents 7

The Windhorse Project ......................... 168 Michael Herrick, Anne Marie DiGiacomo and Scott Welsch The Crisis Hostel: Findings from a Consumer/Survivor-defined Alternative to Psychiatric Hospitalization ............... 179 Jeanne Dumont and Kristine Jones Finding Common Strength Together: The Berlin Runaway House .. 188 Petra Hartmann and Stefan Bräunling Second Opinion Society: Without Psychiatry in the Yukon ...... 199 Gisela Sartori Trauma-informed Peer Run Crisis Alternatives ............ 210 Shery Mead A Sicilian Way to Antipsychiatry: La Cura .............. 217 Giuseppe Bucalo Open Dialogues ............................. 223 Jaakko Seikkula and Birgitta Alakare Psychotherapy Instead of Psychiatry? A No-brainer .......... 240 Theodor Itten

GeneralandSpecificBeneficiariesofAlternativeApproaches

Introduction ............................... 253 Families: A Help or Hindrance in Recovery? ............. 254 Karyn Baker Choice and Diversity: Developing Real Alternatives for People from Non-Western (and Western) Cultures .............. 260 Philip Thomas and Salma Yasmeen Troubled Children and Teens: Commonsense Solutions without Psychiatric Drugs or Manipulations .................. 271 Bruce E. Levine 8

When a Slice of Sausage Turns into a Lens-cleaning Cloth: To Respect and Support People with Dementia ............ 281 Erich Schützendorf The Shame of “Not Being a Man”: Experiences of Gay, Straight and Bisexual Men ............................ 288 Guy Holmes and Geoff Hardy

RealizingAlternativesandHumaneTreatment

Introduction ............................... 297 Personal Ombudsman in Skåne: A User-controlled Service with Personal Agents .......................... 299 Maths Jesperson PSYCHEX: A Swiss Experiment .................... 304 Peter Rippmann Money, Rights and Alternatives: Enforcing Legal Rights as a Mechanism for Creating Non- Alternatives ...... 308 James B. Gottstein Upholding Psychiatric Advance Directives: “The Rights of a Flea” .. 317 Laura Ziegler MindFreedom International: Activism for Human Rights as the Basis for a Nonviolent Revolution in the Mental Health System ... 328 David W. Oaks MindFreedom Ghana: Fighting for Basic Human Conditions of Psychiatric Patients ........................... 336 Dan Taylor User-led Research to Develop an Evidence Base for Alternative Approaches ......................... 342 Jan Wallcraft Preparing People for User Involvement Work in Health and Social Care ............................... 351 Andrew Hughes Contents 9

INTAR: The International Network Toward Alternatives and Recovery .............................. 359 Laurie Ahern, Peter Stastny and Chris Stevenson Self-help, Difference in Opinion and User Control in the Age of the Internet .............................. 366 Peter Lehmann and Maths Jesperson

WhyWeNeedAlternativestoPsychiatry

Introduction ............................... 381 Psychiatry: Its Diagnostic Methods, Its Therapies, Its Power ..... 382 Marc Rufer Beyond Models, Beyond Paradigms: The Radical Interpretation of Recovery ....................... 400 Pat Bracken Reforms or Alternatives? A Better Psychiatry or Better Alternatives? ........................... 402 Peter Lehmann and Peter Stastny

Appendix

Index .................................. 413 About the Authors ........................... 418

11

Preface

The first question raised by a book titled Alternatives Beyond Psychiatry is this: Why do we need alternatives? What is wrong with the “care” that main - stream psychiatry provides? While there are many answers to that question, first and foremost we can look at one startling statistic, and that is the rise in the number of people disabled by “mental illness” over the past 50 years. The modern drug-based paradigm of psychiatric care dates back to 1954, when chlorpromazine was introduced as the first medication. This, or so psychiatry would like us to believe, kicked off a great leap for - ward in society’s care of the “mentally ill.” Psychiatric researchers are said to have made great strides in understanding the biological causes of mental dis - orders and that has led to the development of ever better drugs for treating them. Yet, here is what all this “progress” has wrought: in the United States, the rate of the “disabled mentally ill” has increased nearly six-fold in the past 50 years, from 3.38 people per 1,000 population in 1955 to 19.69 people per 1,000 population in 2003. Since the introduction of Prozac 1 in 1987—this was the first of the second-generation psychiatric drugs said to be so better than the first—the number of so-called disabled mentally ill in the United States has been increasing at the rate of 150,000 people per year, or 410 peo - ple newly disabled by “mental illness” every day. Other countries that have adopted a drug-based paradigm of care, such as the U.K. and Australia, have also reported a great surge in the number of peo - ple disabled by mental disorders in the past 50 years. This interesting fact leads to only one conclusion: mainstream psychiatry’s paradigm of care has failed. It has not proven to be an approach that helps people struggling with mental distress of some kind—depression, anxiety, mania, , etc.—

1 Antidepressant, active ingredient fluoxetine, marketed also as Auscap, Deprax, Eufor, Flexetor, Fluohexal, Fluox, Fluoxebell, Fluoxetine, FXT, Lovan, Movox, Oxactin, Plinzene, Psyquial, Sarafem, Veritina, Zactin, etc.; component of Cymbyax 12 recover and get on with their lives. Instead, it has proven to be an approach that increases the likelihood that such people will become chronically ill. We desperately need to think of alternatives to that failed paradigm of care. That is a big challenge, and yet the contributions in this timely and much needed book all ultimately point to a common starting point: if we want to help those struggling with their minds, we can start by thinking of them—as the Quakers did when they rebelled against mainstream psychiatry in the late 1700s and early 1800s—as “brethren.” Not as people with “broken brains,” but simply as people who are suffering. From that conception, a whole world of “care” follows. What does everyone need to stay well? Shelter, food, friendship, and something meaningful to do with his or her time. Any society that provides such care and support, along with a message of hope—that peo - ple can recover from whatever mental distress they may be suffering—makes a good start at providing an effective alternative to psychiatry. There are chapters in this book that tell of such programs. There are proven alternatives to psychiatry, programs that have a track record of helping peo - ple get better. And there are reports of ways of coping with madness on an in - dividual level. This book hopefully will encourage many, many other such efforts to take root and flourish.

Robert Whitaker Cambridge, MA 13

Note about Liability

Psychiatric treatment is more dangerous than many (ex-) users and survivors of psychiatry and even physicians realize. Psychiatric drugs can cause seri - ous adverse effects. Electroshock may cause permanent brain damage. Psy - chiatric drugs can also produce powerful physical dependence. For example, their withdrawal can cause sleeplessness, rebound and withdrawal psycho - ses, withdrawal-emergent tardive syndromes, return of base line psychologi - cal and emotional problems and even life-threatening withdrawal reactions (see Peter Lehmann, Coming off Psychiatric Drugs , Berlin 2004, pp. 25-38). Especially when psychiatric drugs have been taken for prolonged periods of time, experienced clinical supervision may be advisable or even necessary during the withdrawal process. In referring to alternatives beyond psychiatry, we do not provide medical advice. Also this book is not intended as a substitute for professional help. Should you have any health care-related questions, please call or see your physician or other health care provider promptly. The publisher, editors, au - thors and suppliers are not responsible if you decide against this advice. Nor are they responsible for any damage you may experience from a medical and, in particular, psychiatric treatment. If you are thinking about withdrawing from prescribed psychiatric drugs, it is important to realize that the problems which led to their administration may return when you stop taking them. Decisions to withdraw from psycho - tropic drugs should be made in a critical and responsible way. It is important to have a safe and supportive environment in which to undertake withdrawal (see ibid., pp. 311-321) and to consider the possibility that you may experi - ence so-called relapse or worsening of your condition. Withdrawal may not work for everyone. Sometimes the difficulty of withdrawal or the base line psychological and emotional problems seem insurmountable, so people may decide to maintain on lower amounts of drugs or fewer drugs. Many psychia - trists do not support withdrawal and are convinced that people with psychiat - ric diagnoses like “schizophrenia,” “psychosis,” “manic depression” or “ma - 14 jor depression” need psychiatric drugs or maintenance electroshock “ther - apy” for the rest of their lives. If you choose to give weight to the various opinions expressed in this book, that is your choice, and is not based on any claims of special training or medi - cal expertise by the publisher (for professions and experiences of the authors see pp. 417-430). No alternative , holistic remedy, or self-help method referenced in this book is being recommended as a substitute for pro - fessional medical advice, diagnosis or treatment, and no comparisons are be - ing made between such alternative methods and treatment with electroshock or psychiatric drugs. Neither the publisher, editors, authors nor suppliers make any claimthat their information in this book will “cure” or heal disease. All contributors and especially all (ex-) users and survivors of psychiatry in this book report about essentially positive experiences with alternatives beyond psychiatry. This is no coincidence because the editors only asked for positive experiences. Since many individual factors (physical and psycho - logical condition, social circumstances, etc.) exert a remarkable influence on the way to cope with emotional problems, the authors’ individual statements should not be interpreted as transferable advice for all other readers. No responsibility is assumed by the publisher, editors, authors and suppli - ers for any injury and/or damage to persons or property from any use of any methods, products, instructions or ideas referenced in the material herein. Any therapy not initiated or completed as well as any use of a referral and/or subsequent treatment regimen sought as a result of buying and/or reading this book is the sole responsibility of the reader. The publisher, editors, authors and suppliers undertake no responsibility for any consequences of unwanted effects either when receiving or when not receiving electroshock or taking psychiatric drugs or when withdrawing from them. They do not accept any liability for readers who choose to deter - mine their own care and lives.

Peter Lehmann and Peter Stastny 15

Introduction

What helps me if I go mad? How can I find trustworthyhelp for a relative or a friend in need? How can I protect myself from coercive treatment? Where can I talk to like-minded people about my own experiences with psychiatry and about my life? As a family member or friend, how can I help? What should I do if I can no longer bear to work in the mental health field? What are the alternatives to psychiatry? How can I get involved in creating alternatives? Assuming psychiatry would be abolished, what do you propose instead? These are the main questions addressed by the 61 authors—(ex-) users and survivors of psychiatry, therapists, psychiatrists, lawyers, relatives, politi - cians and social scientists and relatives from all five continents.

Alternatives Beyond Psychiatry is a collection of reports and approaches from non-, anti- and post-psychiatric everyday life in different countries and provides an appraisal of individual and organized alternatives and measures that point to a need for structural change in the system. This is a book of prac - tice and ideas, more personal than generalized. It offers suggestions, high - lights contradictions and problems, and shows positive examples and models but does not provide easy answers. Our alternatives beyond psychiatry are far removed from the academic re - mains of the ’68 generation; nor are they a reform-oriented variant of Italian psychiatry, social psychiatry or community extensions of psychiatric institu - tions. Instead, alternatives beyond psychiatry are truly innovative, initiated and carried out by critical professionals and independent (ex-) users and sur - vivors of psychiatry, the real experts in the psychiatric domain, dedicated to the right of self-determination, physical inviolability and social support. Alternatives beyond psychiatry originate from an undogmatic and human - istic movement. Accordingly, the texts in this book are filled with a contrari - an spirit and the fundamental conviction that (1) psychiatry, as a scientific discipline, cannot do justice to the expectation of solving mental problems 16 that are largely of a social nature, (2) its propensity and practice to use force constitutes a threat, and (3) its diagnostic methods obstruct the view of the real problems of individuals. Furthermore, the texts in this volume describe a commitment to (1) devel - oping adequate and effective assistance for people in emotional difficulties, (2) safeguarding civil rights in treatment on a par with “normal” patients, (3) joining forces in cooperation with other human rights and self-help groups, (4) use of alternative and less toxic psychotropic substances and a ban of electroshock, (5) new ways of living with madness and being different—with as much independence from institutions as possible, and (6) tolerance, re - spect and appreciation of diversity at all levels of life.

This book has been published without any financial support from sponsors. We have no connection to the pharmaceutical industry and to organizations that are dependent on them, nor to Scientology or other sects and dogmatists of whatever color. Beyond health, nothing is more valuable than freedom and independence. We would like to express our heartfelt thanks to the many supporters who have provided valuable ideas, translated, corrected, and illustrated, in par - ticular Arno Hessling, Christine Holzhausen, Craig Newnes, Darby Penney, David W. Oaks, Katy E. McNally, Kerstin Kempker, Martin Urban, Mary Murphy, Paula Kempker, Pia Kempker, Reinhard Wojke and Tricia R. Owsley.

August 2007 Peter Stastny, Peter Lehmann

Translated from the German by Mary Murphy