www.isps.org THE INTERNATIONAL SOCIETY FOR THE PSYCHOLOGICAL TREATMENTS OF THE SCHIZOPHRENIAS AND OTHER PSYCHOSES VOLUME 11, ISSUE 2, WINTER 2007 ISPS AND BIG PHARMA LETTER FROM THE CHAIR BY MANUEL GONZÁLEZ DE CHÁVEZ Saint Augustine stated that "it is bad to In my opinion, in the ISPS, we should financial societies and speculation or look at women, worse to speak to them defend good knowledge of psycho- political corruption, of which Big Pharma and even worse, to touch them." Some pharmacology. This may require us to is not devoid of. Although this industry mental health care professionals seem not only correctly prescribe the drugs has contributed greatly to the progress to have a similar attitude about the but also to know which ones are abused and health, they are, as Bertold Brecht pharmaceutical industry. drugs and their many limitations. would say, some obscure "merchants of pain" who finance and introduce their Although we do not like it, we live in Furthermore, we should know the bio- special interests into the political and a world where the biological models of logical models that are spread as arrogant health care institutions. This allows them mental disorders are the dominant ones dogmas. This is necessary in order to to charge high prices and have immense and where most of the patients who reveal their deficiencies and ignorances benefits, promotions without control suffer these disorders take psychoactive and to demonstrate the harm that is de- and clinical trials with shameless biases, medications. rived from such simplistic hypotheses doubtful evidence and regrettable that are far from the lives and persons concealing of information, and they have who suffer these problems. The domi- left a large part of the medical research nant biologicism is more an ideology and almost all of post-graduate teaching than a science. But we should strive to at the mercy of the pharmaceutical understand it in order to refute it and industry. offer other more extensive, global and integrating models as an alternative that Whether we want it or not, the psycho- would better explain the factors that active medications and biological models participate in the origin of these dis- are dominant in current psychiatric care orders and the other models that may and we, with more global approaches be of great help to these patients. and interventions and combined thera- pies, are a minority sector. Perhaps we Unfortunately for them, this is gene- However, if the understanding of and are the avant-garde, but we should be rally the only help they receive, that attention to our patients make it aware that this is not only a scientific which the medical professionals offer necessary for us to know well the psycho- debate. We fight against much passivity, them, that which the pharmaceutical pharmacology and dominant biologicism, simplicity, convenience and important industry continuously updates and the what should we do with the Big Pharma interests. If we want to change the only type of help that many financial industry which is the motor that moves functioning of the health care services, managers of the health care services this entire biological circle with its we should form an active part of them, consider to be profitable in terms of immense benefits? Can we ignore it to know the dynamics that shape them and cost-effectiveness. But, what should we, exalt our purity? Can we move away from influence more to qualitatively improve the members of the ISPS who defend it as the monks and hermits tried to the future of our patients. We cannot the use of psychotherapies in psychotic conquer the temptations of the devil in isolate ourselves, acting as the Amish or patients in our objectives, do? Should the flesh? the hermits of psychotherapies of we demonize the drugs and the drug psychosis. Nor should we hide behind industry as Saint Augustine demonized hether we want it or not, the phar- W the banner of a testimonial narcissism, women or should we look at them, speak maceutical industry is part of our world, that converts us - and not our patients - with them and touch them without para- as is the armament industry and wars, into our principal objective. noia or other defence mechanisms? chemical industry and contamination, newsletter Objectives of ISPS ISPS secretariat Editorial The ISPS secretariat is a link between our mem- BY BRIAN KOEHLER PHD Promote the appropriate use bers and the executive committee. Until recently, of psychotherapy and psycho- the secretariat was partly hosted by the Centre Emerging Neuroscience logical treatments for persons for Psychotherapy and Psychosocial Rehabili- with schizophrenias and other tation of Psychoses (SEPREP), a non-commercial Research in Schizophrenia psychoses Norwegian foundation and network of users, clinicians and researchers promoting psycho- Rescent neuroscience research in schizophrenia points to altered Promote the integration of logical treatment of the psychoses. Since the DNA methylation patterns in the reelin gene which codes for psychological treatments in end of 2006, and after the election of a new ISPS proteins that are important in synaptogenesis, axonal branching, treatment plans and com- board, SEPREP no longer provides secretarial etc. This is important because many neuroscientists view prehensive treatment for all schizophrenia as a disorder of neural connectivity. We do not usually services to the ISPS. We are very grateful for the persons with schizophrenias see actual cell loss (except perhaps in the mediodorsal thalamic and other psychoses secretarial help of Wenche Løyning over the nuclei), rather, a reduction in neuropil (axonal and dendritic past years. processes, arborization reduction), which, from my perspective, can Promote the appropriate use Antonia Svensson in Athens continues to work be explained by the impact of experience, pre-and postnatally, as part-time as ISPS Organiser. She continues to do well as throughout life, on the CNS. Neurogenesis (the conversion of psychological understanding most of the work of the secretariat that can be of stem cells into functional neurons or glial cells, i.e., the birth of and psychotherapeutic new cells) is suppressed by stress, as are neurotrophic factors, such approaches in all phases of done electronically, as well as maintaining the as brain-derived-neurotrophic factors (BDNF). the disorders including both website, assisting the Editor of the ISPS News- early in the onset and in letter, managing the databases and contact large number of methyl groups attached to the cytosine nucleo- A longer lasting disorders with ISPS members and local groups, as well tide of DNA can lead to gene suppression, whereas demethylation as answering any queries. or acetylation can result in gene expression. The former can be Promote research into detrimental for genes that express proteins which nourish neurons Antonia can be contacted on the [email protected] individual, family, group (e.g., BDNF), reelin, glucocorticoid receptors (which help regulate e-mail address. psychological therapies, stress reactivity through inhibitory influence on the hypothalamic- Website: www.isps.org pituitary-adrenal axis, leading to reduced cortisol expression), etc. preventive measures and Interestingly, methylation is also increased in socially defeated/ other psycho-social THE ISPS EXECUTIVE COMMITTEE OF 2006 - 2009 depressed mammals. Experiences such as early nuturance from programmes for those Manuel González de Chávez (Spain), Chair caregivers increase acetylation of histones (which allows for DNA with psychotic disorders Chris Burford (UK) to be transcribed, despite methylation, what we refer to as transcript- Lyn Chua (Singapore) ionally competent DNA), thereby unraveling the DNA and making Support treatments that Brian Koehler (USA) it accessible to the process of transcription and the encoding of include individual, family, Klaus Lehtinen (Finland) new proteins. group and network Ann-Louise Silver (USA), Treasurer approaches and treatment When we look at the diversity and non-specificity of the neuroscience John Read (New Zealand), Secretary methods that are derived research in 'schizophrenia,' rather than, seeing a ‘schizophrenic Bent Rosenbaum (Denmark) brain,’ we may very well be seeing a 'socially isolated/defeated from psychoanalysis, Co-opted Board Members: brain,' a chronically fearful/stressed/anxious/traumatized/ or de- cognitive-behavioural, pressed/hopeless brain. This has been my hypothesis first presented systemic and psycho- Ivan Urlic (Croatia) formally at our 1997 ISPS conference in London and elaborated on educational approaches David Kennard (United Kingdom) since then. ISPS HONORARY MEMBERS Advance education, training Brian Koehler PhD Yrjö Alanen, Finland and knowledge of mental New York University & Long Island Gaetano Benedetti, Switzerland health professionals in the University/[email protected] L. Bryce Boyer, USA psychological therapies Luc Ciompi, Switzerland Johan Cullberg, Sweden Stephen Fleck, Germany Do you subscribe to Murray Jackson, UK Jarl Jørstad, Norway the ISPS-INT information/discussion group? Julian Leff, UK Theodore Lidz, USA The international email group ISPS-INT, which was set up after ISPS Melbourne Christian Müller, Switzerland 2003, is available to all ISPS members. There are over 230 members from over 20 Barbro Sandin, Sweden different countries who share announcements and discuss current issues relevant Harold Searles, USA Helm Stierlin, Germany to our field. The group is well moderated