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Oliver James guest blog: drugs are not the answer to mental distress

(113 Posts)
KateMumsnet (MNHQ) Tue 14-May-13 11:09:13

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.

daytoday Fri 17-May-13 22:39:20

Perhaps James need to define which areas of mental illness/distress he is actually talking about?

My brother is Schizophrenic. He is absolutely lovely. No amount of loving/listing/caring/love bombing can reduce or alter his psychosis - we couldn't 'love and listen' the schizophrenia away from him when he was a young teen (or now he is middle aged) - anymore than we could love and listen cancer away. God knows itd be great if we could. Without medication he would be dead. His condition might not be in his 'genes' but its in his body.

The way I see it is there is an actual problem finding the right diagnosis in the first place, it takes years - and the path to mental distress is not clearly signposted - its a journey - and the whole family go on the journey with the patient.

hazeyjane Fri 17-May-13 22:52:20

this article by Oliver James from the guardian, is about his views on schizophrenia wrt families(mothers in particular), genetics and drugs.

justaboutalittlefrazzled Sat 18-May-13 06:26:41

Message withdrawn at poster's request.

strawberry17 Sat 18-May-13 09:05:36

Snoopy the withdrawals are very confusing for most people and feel like the original depression/anxiety but worse, hence so many people struggling to come off them or thinking they "need" to be on them for life. It's very confusing, I'm going to be on a very low dose of Prozac probably for the rest of my life now, I don't want to be, but I don't see how I can untangle myself from the drug without making myself really ill. I have a very supportive husband and sons and friends.

Punkatheart Sat 18-May-13 10:31:52

Astonishing how this chap is a psychologist, not a 'doctor.' - but he speaks with arrogance as if he has it all sewn up. I can imagine his words will be hugely distressing for any parent of a child with mental issues. Just what parents need - more bloody guilt.

Also his 'buy my book' in his article is twattish.

Unimpressed and irritated.

Punkatheart Sat 18-May-13 10:32:49

Love Bombing. How particularly patronising.

SnoopyLovesYou Sat 18-May-13 22:07:41

Sorry punkatheart but in mental health issues my opinion is that psychologists know a lot more than doctors!

scottishmummy Sat 18-May-13 22:35:36

the correct administration and monitotng of medication aids recovery,saves lives
I really need to emphasise this.why is. it ok to suggest denial of medication in mh?
would one deny beta lookers for cardiac issues?mh has a biochemical and social basis.medication is appropriate treatment

joanofarchitrave Sat 18-May-13 22:45:14

("It's too distressing darling because whether you believe in environment or heredity, either way we are boiled, shut up here with this old subhuman of a father.")

I don't know, really. My husband has a diagnosis of schizoaffective disorder. I have certainly felt that I would not have made some of the decisions on his upbringing that his parents made, but the reasons I would not have chosen them include the fact that he had already demonstrated far greater than average levels of sensitivity and lower levels of resilience, long before those decisions were made. His upbringing, also, was very different from that of his sister, who has a diagnosis of schizophrenia. And from that of his brother, who has periods of depression. I have seen him off 'the drugs' and I have seen him shortly after he has started on something again. The drugs have an effect. It is pointless to say 'they don't work', life is not a pop song. dH has been told by a consultant psychologist that therapy is likely to make things worse for him, and my experience of living with him during a gruelling period of group therapy would rather suggest she is right. I don't know; maybe given about ten years, therapy would indeed help and that would be amazing, but what is supposed to happen during those ten years? How am I supposed to carry on working and earning the money to keep the show on the road? How is ds supposed to have a childhood?

I can't help feeling that optimum mental health, optimum functioning, is as much of an illusion as optimum parenting, or optimum anything in fact. So if drugs are being used as a way of achieving optimum mental health, yes, they won't work. But neither will therapy. Or love-bombing. As a way of getting out of the door and doing some of the things you would like to do with the one life you have, yes, both drugs and therapy can be incredibly useful.

SnoopyLovesYou Sun 19-May-13 08:16:46

I think therapy is very effective! And other people have also shared its effectiveness in CURING the mental health problem. I find counselling along with other therapies and group support to be fantastic FOR MY PARTICULAR ISSUES. Not for everyone but to say that therapy doesn't work is ridiculous!

Yeah the drugs help people 'function day to day' but maybe a bit of 'falling apart and slow painful piecing back together' is preferable in the long run. And if it sometimes means making huge sacrifices in order to do this, maybe it's worth it?

whosiwhatsit Sun 19-May-13 08:30:17

I used to work in a large public ally funded mental institution in the US before it was shut down in government cutbacks. Time and time again, schizophrenics would be picked up off the streets after causing a public disturbance of some sort. These people would be brought in, put on antipsychotic drugs and stabilised, told to keep taking their medications and released again. Then they would e feeling better, would reason they didn't need their medication anymore, stop taking it again, and be brought back in yet again, having done all manner of things to themselves and others because the voices told them to.

Snoopy, your talk of "a slow painful piecing back together" is naive in the extreme at best, and at worst highly offensive to those without the resources of the rich and middle classes. In a time of massive funding cutbacks, who is going to pay for this "piecing together" of the poor and vulnerable members of society? Please tell me who is going to make the "huge sacrifices" to help them because I really want to know.

I am so glad for you that therapy has helped you for your particular issues. You were very fortunate that it helped you and that you had the luxury of being able to go. But the fact that you then feel somehow knowledgeable enough to generalise your very limited experience with yourself and your neighbours children to being the solution to everyone's problems is laughable.

The drugs don't work perfectly. The drugs do help. Sometimes they help enormously. Sometimes they're the only hope people have for being able to function in society at all

SnoopyLovesYou Sun 19-May-13 10:21:03

Rich and middle classes? I and my friends are NOT rich or middle class. Just because I can spell doesn't mean I am rich and middle class.

SnoopyLovesYou Sun 19-May-13 10:22:39

Noone is going to help. That's why us poor and vulnerable people need to help ourselves.

SnoopyLovesYou Sun 19-May-13 10:24:50

I do not claim to have the solution to everyone's problems. In fact I said that it was not for everyone in my post so the fact that you are accusing me of claiming all-knowingness is laughable

whosiwhatsit Sun 19-May-13 10:36:47

It's not the fact that you can spell (where did that come from?), it's the fact that you can afford to fall apart completely and then go to therapy to slowly put yourself together again that makes me think you're more privileged than many with mental health issues.

Please tell me how that whole falling apart thing you advocate would work out for the homeless prostitute schizophrenics who are picked up turning tricks outside a cheap motel to get enough money to self-medicate using crack cocaine? Yes there were many clients in this and very similar situations at the mental hospital where I worked.

Your posts have been filled with the notion of people getting loads of support and therapy but then you turn around and say the poor need to just help themselves as no one else will do it. You are contradicting yourself all over the place and seem quite confused.

StarlightMcKenzie Sun 19-May-13 11:42:07

Who will pay for a nanny and housekeeper whilst I attend 'therapy' for years and whilst I fall apart and rebuild my life that was destroyed by supposed 'caring' professionals who are paid to be the experts on young families with disabilities but in fact shafted us in the most barbaric and cruel way imaginable?

Drugs have never done that to me.

scottishmummy Sun 19-May-13 11:53:57

psychiatrists don't just prescribe medication,they talk,do consultations,work with other staff
medication can maintain an individual and get them to a level were talking therapies initiated
the majority of mh is managed in community by gp,ot,mh nurse,sw.using a range of treatments

StarlightMcKenzie Sun 19-May-13 12:32:41

The Wooly Wafflers ruined my life and CAUSED any MH issues I now have. Give me the hard evidence-based stuff any day and keep bloody Nurse Ratched the hell away from me.

SnoopyLovesYou Sun 19-May-13 19:29:39

I get free therapy.

There is no contradiction 'Whosiwhatsit'

Where I live anyway there is excellent free counselling available. It's quite possible to 'fall apart' in ones free time when one isn't working/minding kids etc. Is it ideal- no but at least that way, you're working through things and not just 'papering over the cracks' as the earlier person who shared her blog described taking drugs.

SnoopyLovesYou Sun 19-May-13 19:33:58

I was referring to disadvantaged people helping themselves to support, therapy... All the free services on the NHS. When I said no one else is going to get us proper help (I am an economically disadvantaged person myself.)

hazeyjane Sun 19-May-13 19:52:50

It was me who said about the falling apart and long slow process of piecing back together. By that I didn't mean not having the time, I meant the emotional fallout.

I have 3 small children, one of whom has, as yet only ever been left with me or my dh. At the time of going on ads, ds was being tested for a degenerative condition that would have meant him not surviving into adulthood. He was suffering horrendous acid reflux, causing him to scream constantly. He was unable to sit or hold his own body weight, so I was carrying him around most of the time. Dh and I were averaging about 4 hours sleep a night.

I still had to keep life going, get ds to therapies and appointments, get my 4 and 5 year old girls to school, make tea, have their friends round, keep the house clean etc etc - all the little stuff of day to day life. In the middle of this I was having a crisis, huge anxiety, fear for ds, worry about what was happening to me, having grown up in a family living in the shadow of severe mental health issues. I know that if I had embarked on counselling at that time, a light would have been turned on in the murkier corners of my mind, and I just couldn't face that, not at that time. Frankly I also needed to get on with stuff, and at the time it was like being stuck in a patch of tar, I felt like I couldn't move. Drugs helped me get on with stuff that needed to be done, and (and this surprised me) helped me start enjoying being with my children and dh.

hazeyjane Sun 19-May-13 19:56:16

When I discussed counselling with my gp, there were 6 free sessions available. The private counsellor, she recommended was £60 an hour.

Sunnywithshowers Sun 19-May-13 20:12:29

Snoopy are you listening to what others say?

People who use medication are not just 'papering over the cracks'. Some of us have rather a lot of 'cracks' to deal with, and need the meds to get to the point where recovery is possible.

It's great that you have been able to recover using therapy, but it's rather irritating to hear you dismiss other ways of getting help.

Our local NHS offers telephone-based CBT. Thereafter, it's all about finding a private counsellor or pyschotherapist.

whosiwhatsit Sun 19-May-13 20:24:18

And when I had depression brought on by work stress my NHS doctor told me the waiting list for therapy was three years! So I went on antidepressants instead which helped me to the point where I was able to go for and get a promotion into another department at work which was much less stressful not to mention better paid. I then got off the antidepressants by tapering off them gradually with no ill effects.

On the other hand, therapy seems to have been available to you Snoopy and seems to have done you good. I'm glad for you BUT your experience does not in the least negate my experience either personally or with the schizophrenic clients I talked about in my earlier post for whom getting on and staying on antipsychotic drugs was their only realistic hope.

What is infuriating here and with Oliver James is the statement that "the drugs don't work" is so absolute it blames people for whom drugs are a reasonable option for not doing things the best way ie therapy. I would never say someone was unreasonable to go into therapy and I expect the same respect from others about other treatment choices.

whosiwhatsit Sun 19-May-13 20:26:41

And I don't mean to imply that therapy is "the best way", only that Oliver James and others state that it is. In fact the success rates of traditional therapies (with the possible exception of cbt) are actually statistically pretty woeful.

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