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Oliver James guest blog: drugs are not the answer to mental distress(113 Posts)
Last week, the British Psychological Society was profoundly critical of the 'medicalisation' of mental distress - the idea that psychiatric disorders are by and large treatable by doctors using drugs.
They said it was unhelpful to see mental health issues as illnesses with biological causes when "there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances - bereavement and loss, poverty and discrimination, trauma and abuse."
Here psychologist and author Oliver James argues that, while the reassessment of the 'medical model' might alarm some parents, it's actually good news for them, and their children.
Tell us what you think - and if you blog on this subject, don't forget to leave your URL here on the thread.
"If your child is unmanageable or hyperactive, it can be all too reassuring to hear from a doctor that she suffers from a genetically caused brain disorder which is best treated by a pill. That model makes it not your fault and if the pill works, hey, thank god for that.
If you are a parent in that position, its also all too understandable that you might not want to hear from me that: (1) The pills usually don't work and have unknown long-term toxic effects when used for years; (2) The Human Genome Project is proving that genes play very little part in causing any mental illnesses; (3) There is no reliable scientific evidence that the brains of the mentally ill are measurably different. But don't stop reading.
The fact that these latter assertions are all now pretty much confirmed by the British Psychological Society is actually incredibly good news for parents.
It means that your child is not fixed in its abilities and potential. Massive change can occur, if what she's like is not in your child's genes. Indeed, there is strong evidence that simply by convincing children that their maths ability is malleable, for example, increases their likelihood of doing well.
It also means that the way you parent can make a huge difference, even if there is a biological cause for a problem. Whilst genes are getting ruled out, prenatal, foetal factors look as if they may be crucial for problems like autism. But even autism is turning out to be very responsive to the right kind of early intervention.
It is true that the kind of care a child receives in the first six years sets its emotional thermostat. But it is a thermostat: the setting can be changed.
For example, children's brain electro-chemistry is very sensitive to parental disharmony. Levels of Cortisol, the fight-flight hormone, are raised or become blunted if parents row a lot. But that can be good news, not bad news, if you can find a way to row less or at the least, to not do so in front of the children.
It is further known that children who had unresponsive early care are that much more easily upset by parental disharmony. This is true at two and a half - care at 3 and 9 months predicts whether cortisol will be triggered. Early care also predicts vulnerabily at later ages. But even this is much, much better news than the genes and brain disorder story - because early deficits can be corrected.
Thousands of parents have used the Love Bombing technique to reset their childs emotional thermostat. If things went badly early on - nearly always through no fault of the parents, things like depression or debt-induced anxiety - it's quite possible to give the child a very brief experience of the feeling of love and control it may have missed out on. Astonishingly brief bursts can be all it takes.
Psychological distress should never have been medicalized in the first place. Now that science is proving that what we are like is not due to genetic brain disorders, a world of hope is opening up for parents. Go into that world and feel liberated from the pseudoscience which has dominated us for too long."
Oliver James is the author of Love Bombing - Reset Your Child's Emotional Thermostat, which he discusses in this previous guest blog.
IT'S NOT JUST OLIVER JAMES. IT'S THE WHOLE BRITISH PSYCHOLOGICAL ESTABLISHMENT AND ANYONE WHO KNOWS ANYTHING ABOUT MENTAL HEALTH. There is no contradiction. The argument states that drugging is not effective and can worsen. Nobody is pointing a finger of blame here. Neither is the argument even relevant to certain people. It is often a question of simply being aware that there must be an alternative solution, looking around for an alternative solution and being dedicated to finding it.
THE DRUGS DON'T WORK!
Message withdrawn at poster's request.
Snoopy, I don't think anyone here is talking about the medicalisation of psychiatric cases who would be better treated with talking or behavioural therapies. What people are objecting to is OJ's reference to neurodevelopmental disorders as if they were psychiatric and therefore curable with enough love and support. It's insulting to parents of children who have these conditions to even suggest such a thing, not to mention absolute twaddle (and that's putting it politely).
There was absolutely no reason for him to mention neurodevelopmental disorders/conditions, as - as you yourself state - his argument is not even relevant to them, nor they to it. Therefore it comes across as yet another opportunity for him to peddle and perpetuate the refrigerator mother theory, which is frankly beyond insulting and downright hurtful to parents like myself who would do anything for any of their children, regardless of whether or not they are neurotypical.
Also, having a child who has SNs is not mutually exclusive to 'knowing anything about mental health'. We are people, as well as parents and having a child with SNs does not preclude being educated and informed, or even - shock horror - being a mental health professional.
No one is saying that every psychiatric case should be medicalised, what we are objecting to is his attitude towards children with specific disorders/conditions and their parents, who have no place at all in his argument.
DS1's drugs work really well, Snoopy.
And outcomes for children with ADHD who take stimulant medication (which is not what DS1 takes) are far better than for those with no treatment or who receive therapies alone.
Snoopy seriously, you don't believe the drugs work? What about the children who could not function in school, or children who cannot even get into school, or the numerous adults who would not remain in employment without their medication? What about the people who don't kill themselves because they are on medication which makes them feel less anxious?
And for many conditions, if the medication works, surely the pharmaceutical and psychological researchers should concentrate on finding solutions for all those children and adults who cannot be helped by existing treatments?
Of course Big Pharma will push pharmaceutical solutions, but how exactly is that any different to psychologists pushing talking therapies! It's all about making money. It is for each individual parent, adult, practitioner to assess the evidence and make the best choice they can.
I suppose drugs don't work in that they don't CURE these conditions.
But who is asking anyone for a cure?
Can someone please show me where the BPS refers to Autism as a mental health issue?
Yes, lotta. He has two children. I gather his wife does the childcare. And I have a feeling he has ishoos with his mother rather similar to your own, so I suppose it makes sense that you agree with his viewpoint, in much the same way that those of those who work and parent sn children can't abide the man as he has no fricking clue.
His last foray involved blaming working mothers for their child's issues, and was stuffed full of pseudo science about cortisol.
He's welcome to his fan club, but I won't be joining. It's human nature that those with similar issues pal up. I hope you aren't allowing that projection to creep into your professional responsibilities.
reading that excerpt was like listening to the cod-psychologists in the playground, or at a coffee morning, almost 'well i heard that family row a lot, no wonder miniU-C wets herself and obsessively counts the different type of dogs'
i feel sick that this man thinks that autism is caused by 'bad' parenting.
MNHQ, why are you hanging parents of children with autism out to dry. again?
I'd argue that is is very hard to parent a child with autism well, when views like this are prevelant, as you spend more time firefighting, protecting and generally safeguarding than parenting.
and for the record, family U-C are probably the least likely to row out of many
wonders if MNHQ quoted Oliver Adams' in error
Just FTR, many parents who don't have SN or autistic DC also think OJ's views are backward, poorly-researched, unsubstantiated, misogynist, creepy, deeply offensive, screwed up and ignorant.
Snoopy - sweeping statements such as 'the drugs don't work' just aren't accurate.
Thanks for letting us have your comments and concerns. We are sorry this guest blog has upset some folk.
As we hope you all know, our guest bloggers offer an opinion - which is not necessarily shared, and certainly not endorsed, by MNHQ. And we'd always encourage anyone who doesn't share that opinion to challenge it on the thread - as many of your have very robustly and articulately here.
On a couple of specific points, we do have to say that, as we read it, Oliver's post is primarily about whether psychological difficulties are biologically determined, and whether they are therefore best managed with medication, or with other forms of treatment.
As far as we can see, autism is mentioned as an example of a condition which is biologically determined, but which nevertheless might also be responsive to 'the right kind of early intervention'. He doesn't suggest, we don't think, the reverse: that autism is caused by the lack of such intervention.
That said, we acknowledge that we probably have set slightly the wrong tone with our thread title which, by mentioning 'behavioural difficulties', skews things rather.
We're sorry about that, and we're going to make an edit to fix it.
Olivia - I didn't even get past the first 2 paragraphs before my blood boiled. My "unmanageable or hyperactive" child has ADHD which actually does respond to drugs, but he has poo-pooed that in a completely Daily Mail-esque manner and gone on to imply that it's a diagnosis purely intended to keep me happy and absolve me of the blame I should be shouldering for his condition. He then, rather incoherently, in his second paragraph, refers to the content of his first paragraph as describing mental illness.
'As far as we can see, autism is mentioned as an example of a condition which is biologically determined, but which nevertheless might also be responsive to 'the right kind of early intervention'. He doesn't suggest, we don't think, the reverse: that autism is caused by the lack of such intervention.'
This was how I read it too. Autism certainly does respond to early intervention (and I'm not talking about Love Bombing) but that doesn't automatically mean that autism is caused by lack of parental love or care. How parents respond to and interact with their children is a really crucial part of developing a child's communication skills and behaviour - that is not the same as saying that a child's problem in those areas is the parents' fault, just that they are a huge part of the solution. So I agree with OJ that this is good news for parents - your child's difficulties are not set in stone, they can continue to learn and develop and progress and thrive and you are a crucial part of that process.
I'm not qualified to comment on the use of drugs to treat early developmental difficulties so I won't. I do think however that some doctors are far too quick to prescribe antidepressants for adults who present with strong/upsetting/difficult emotions. I take ADs myself but will be coming off them soon as I feel that it's psychotherapy that is helping me to manage the root cause of my anxiety and depression - the ADs are just masking the symptoms and are not helping me long term. That is not a criticism of others who take ADs successfully - I know that some adults feel that ADs have saved their lives - but a concern that some doctors are medicalising issues which are possibly best dealt with in other ways, for some people.
We are to take away that good parenting will lead to better outcomes because our children's condition has no genetic component.
So if your kid has wonky genes no ammount of therapy or input will do much 'cos those ones have a destiny ? REALLY?
So all those questions asked about anyone even remotely related who was 'quirky' or 'odd' are just to entertain the myriad of professionals who assess non-nt children? REALLY?
This the kind of nonsense that suggests to language delayed/disordered children's Mothers that they should talk to them more.
Last week a highly lucrative document called DSM V was published. It is used predominantly in the states to validate who can access medical care under insurance. It isn't used in the UK. Medication is used far less liberally in the UK. To suggest that all MH conditions respond to "talking therapy" is inaccurate, and if the gentleman had the slightest understanding of atypical development or serious MH he would be ashamed of himself.
Sweeping generalisations like, 'the drugs don't work' are completely unhelpful.
I also don't understand how the influence of genes can be written off, when research into a genetic factors in behavioural conditions and mental health problems is still ongoing.
What annoys me most about this is the lost opportunity. It could so easily have been about "we need to stop over medicalising everything just so drug companies can make massive profits and instead we have to do more for the mentally ill than just throw drugs at them and then forget about them". But I suppose that approach isn't newsworthy or provocative enough to sell books.
This article on the controversy over the dsm-v and the face-off between psychiatrists (who are of course licensed to prescribe medication) and psychologists (who aren't): http://www.huffingtonpost.com/2013/05/15/dsm-5-mental-health-psychiatric-manual-_n_3281434.html
Thank you Jane Mumsnet for clarifying. It won't take the bees out of some people's bonnets though!
I did not put what I said earlier very diplomatically but in essence I am just saying that I agree with the research and what OJ says on the subject, in the same way as LottaPiano has expressed above. I am not pointing a finger at anybody at all. I have just seen so many cases of friends being convinced by psychiatrists that their distress/depression (caused by suicide of close one, rape to name a couple of instances) is caused by something genetic. 'Oh yes- an imbalance in the brain's chemicals and oh look! It's down to genes. Here you go love- these pills will set you back on track.' IT'S CLEARLY NOT DOWN TO GENES! IT'S DOWN TO STRESSFUL AND UPSETTING EVENTS IN A PERSON'S LIFE!
As for autism, I am not an expert however I have seen amazing turnarounds in autistic children's behaviour and development when adequate support is found. Amazing turnarounds. No drugs. That's all. Now please find another scapegoat for this thread ;-)
Do you mean KateMN ?
Please tell us more about the "amazing turnarounds" you have seen in children with autism you have seen once their inadequate support was improved. I am intrigued.
hazeyjane - ADHD has around 70% heredity. If you have ADHD, there's a 70% chance a child will be affected. That's pretty strong.
I got Kate's name wrong, too, zzzzz
And I'd love to see evidence of these amazing turnarounds, too. And not that it happened once, but that it's a reproducible result in any child this is tried with. Then maybe DS1 won't be so dstressed about what other people eat and DS2 will not only learn to talk and become continent, but use the intelligence he has buried in his ASD to find the cure for cancer.
Why is MN giving a platform to enable this tedious fart to flog his dubious books and his misogynist ideology? Why? he has no scientific respctability. Everyone I know who does serious work in the field of child development and developmental disoreders regards him (if they've heard of him) as a joke. His true profession is media whoring, not psychology.
'Autism is turning out to be very responsive to the right kind of early intervention'
Why the actual fuck does he think parents of children with autism spend half of their lives fighting for adequate early intervention? Or indeed, any early intervention at all?
I know not one single sn parent whose first thought is 'ooh, is there a drug for that?'
He is a patronising cock, and I am deeply offended by his attitude.
Almost as offended as I was by his suggestion that I was harming my child by raising her cortisol levels by placing her in nursery because I had the temerity to work, instead of lashing myself to my offspring 24/7 like he thinks all women should, whilst the men bring home the bacon and write tedious bollocks about why women are getting it wrong. Again.
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