Something which Dr Aine Tubridy feels strongly about is the evidence of misdiagnosis she has accumulated in her years as a psychotherapist treating panic and panic attack victims. People come to her on cocktails of toxic psychoactive medications they should never have been prescribed: diagnosed as suffering from depression, they had in actuality suffered panic attacks, terrifying episodes of breathlessness, racing heart, dizziness and other reactions which, for some, imparted the conviction that they were going to die, right there.
    The diagnosis was wrong, the prescription was therefore also wrong, and patients who could easily have been taught to control their panic reactions were instead afflicted with months of potentially dangerous medication. Tubridy felt so strongly about it that she wrote a book, When Panic Attacks, which explains the mystery and supplies a toolkit of methods to deal with them and finally cease having them.
    The wrong diagnoses and irresponsible prescribing in this case are symptomatic of the pop-a-pill approach that Tubridy believes is highly inappropriate for depressed people as well as panic victims, and indicative of how little training that doctors, whether GPs or psychiatrists, actually get in medical school in recognising the real nature of people’s psychological difficulties.
    “The level of discontent, disillusionment and anger among sufferers at the terrible inadequacy of their treatment is really reaching a pitch now,” she says, explaining her belief that psychiatry is at a unique turning point. “The drugs and the whole pharmaceutical approach are beginning to be seen widely as having far more problems than was thought when they began to be used. So it’s an unprecedented situation in which psychiatry and psychiatrists will have to decide whether to continue as they are, running a blatantly inadequate service, or if they want to go down a different road and provide a really good service, a healing service.”
    There’s precious little healing in psychiatry as it now is, she believes, and she also has views on why this is.
    “The training of doctors has stayed with the pharmaceutical approach for many years now. There was a point in psychiatry where people’s pain was seen to be relieved by certain drugs, and that took hold. I think that as a result most doctors sat back and thought ‘that’s it, now, all we need to do is develop better and better drugs’. But I think it’s now becoming apparent that this approach is no longer applicable, if it ever was. People’s problems are much more complex than can be sorted with a pill — there are many factors entwined in these problems which need to be changed.
    “Basically, the pharmaceutical approach has outworn its short shelf-life.”
    Leaving aside the clear and present dangers of medications such as SSRIs (the class of selective serotonin reuptake inhibitors which includes Seroxat, Prozac and Ireland’s fastest-growing pill, Cymbalta), Tubridy points out that they are no more effective than a placebo — a sugar pill.
    “As a therapist, I look at the placebo effect and I see a large part of it being made up of the hope that ‘something is going to change for me now’, and that’s not good enough because really there has to be more to treatment than the mere hope that things will change. Why? Because in a short while, when there is no change and the side effects begin to kick in and become apparent, disillusionment will follow. This is really unacceptable, or should be unacceptable, when there are methods of treatment for depression which can cure, which can bring healing.”
    Aine Tubridy finds a lot to like in the crooked stick metaphor: “When people seek help with these difficulties, it’s a vulnerable time in their lives and they need a stick of some sort to lean on. They don’t know which way to turn, so they go to professionals for help and advice.
    “They’re not to know that what’s been handed to them is a crooked stick” which gives no support.
    “The straight stick, on the other hand, is one which has a lot more integrity and honesty, because we are beginning to name things as what they really are — they’re not ‘diseases’, they’re emotional states. They’re not sick brain dysfunctionalities, they’re a reaction to life’s difficulties. They’re reflective of a person’s resources to deal with life’s knocks, they’re reflective of the support in one’s life, of their belief systems, and so on.
    “The straight stick can say that if someone is in a failing marriage or a dead-end job or the poverty trap, then that’s the cause of their problem. It’s also saying that any solution lies in that, too, rather than saying it’s a chemical imbalance or dysfunction their brain.”
Tubridy warms to this theme, obviously convinced that the sheer uniqueness of each person’s problems makes the bio-psychiatric answer of a universal pill no answer at all.
    “The crooked stick divorces their problem, their state, from any context, so it encourages the doctor and the person’s family to sit back and wait for the pill to work on their so-called sick brain and fix it. The straight stick has more potential for going into the future with lasting healing, deep healing.”
    As with the other speakers, I asked Tubridy if she has any sense that we are near a tipping point, a wholesale paradigm shift from the crooked to the straight stick.
    “I do,” she answers. “There’s never been such a high level of consciousness among the public on these issues. The more the pharmaceutical companies have got themselves into trouble, the more legal cases about the side effects, including the drug-generated suicides, the more label changes such as the [US] FDA’s Black Box warnings on the risk of suicide, first to children and later to adults, the more the evidence of toxic side effects, then the more nervous the public becomes, wondering if they should take them, if they should trust their doctor. Huge proportions of the population in virtually every developed country are turning away, turning to complementary and alternative medicine, and this reflects the distrust: it’s people voting with their feet.
    “Now, I’m not at all sure that the consciousness in mainstream psychiatry comes near matching this, or to understanding that we are near a tipping point, but definitely among the public this is so, and it’s reflected by the fact that the media devote so much space and time to mental health where previously there was little or nothing said. There is a move under way.”
ECT?
    “A barbaric procedure. Every time I say ECT to someone, they say ‘But that’s not used anymore, is it?’ and I have to correct them and say that in Ireland over 850 people are blasted with electric shocks every year.
“Then I see the jaw drop, because it does seem unbelievable that people are submitted to this practice in the 21st century."
    And it’s not just the inherent character of ECT that’s in question, it’s the cultural or sociological selection that visits it disproportionately on the vulnerable: “What’s worrying, too, is that certain categories of people end up having ECT, quite out of all proportion to their numbers, such as elderly women in particular, or people who don’t have families to look out for them.”
I was reminded of Thomas Szasz’s accusation that psychiatry likes to maintain ECT in its armoury because it’s all about exercising power, and the need to have power, rather than about the good of the patient. Dr Tubridy’s next point emphasised it.
    “Then, too, people who are on drug treatments get into a very confused state as an effect of the drugs. After a couple of months of being heavily medicated, let’s say they’re asked if they want ECT, well, they don’t know! They don’t know whether to say yes or no, and typically they would be reassured that there aren’t any side effects, or only mild or short-term ones, and that it’s a wonderful, effective treatment!
    “Experience in my practice tells me the opposite, and this is true for my colleagues too — people come in with loss of memory, completely confused, they’ve lost interest in just about everything in their lives. Really, they are wrecks.
    “Often, they don’t put this down to the ECT, but to their ‘condition’, but they’re wrong — their brains have in fact been damaged by the ECT.
    Again, I was reminded of the large animal studies in which experimental jolts of ECT similar to the doses given to humans have been administered to animals. Subsequent autopsies show brain haemorrhages and extensive cell damage.
    “So yes,” continued Tubridy, “I think it’s high time ECT is banned. It’s a case of the so-called cure being worse than the disease. It causes a closed-head injury, comparable to being knocked down by a car. Look: a bolt of electricity is passed through the brain from temple to temple. And the result? If you came into A&E after ECT, they’d ask what had banged you over the head? Did you fall from a height? What caused all these symptoms? They’d treat you as an emergency and maybe put you in intensive care.
    “But psychiatry just puts all this down to ‘post-ECT effects’ and simply does not take it seriously. What people should know is that if that strong a current of electricity was passed through the whole body, you’d have a heart attack, at the least.
    “It’s just a ferocious procedure to use on a human being. It has to be banned.”
    Given that the ‘Healing Depression’ conference will turn the spotlight on such practices, does she think it’s timely?
    “Very much so. I’ve been to many conferences with families, carers, patients, healthcare workers and so on present, and with all kinds of well-meaning resolutions for change and determination to work for it. The problem is that those down the pecking order in hospitals and the mental health services can talk until they’re blue — it’s those at the top, the psychiatrists in the system and the academic psychiatrists, who make the ultimate decision and it is always a decision, always, in favour of medication.
    “That’s why I think it’s important that the speakers on Saturday are all doctors, and all speaking in favour of the suffering public. It’s something I don’t normally see at a conference in this field — the public able to hear an alternative view articulated by practicing psychiatrists.
    And coming out of it?
    “I’d like to see sweeping change. For a start I’d like to see doctors questioning their own standpoint on these matters a lot more. I’d like to see them asking themselves if they have been fed a line all these years, and why the drugs are not working. After all, the drugs-based model is not standing up — it’s not evidence-based.
    “I’d also like to see the public putting to their doctors this exact argument, and putting it to them that they do not want medication, that they want a different treatment. In the end, if the public refuse the drugs approach and demand a different approach, the psychiatrists will have to change.”

— Basil Miller

“The terrifying thing about ECT is that it’s an extension of the medical model and the psychiatrists won’t let go of it,” says Dr Michael Corry. “What’s the difference between a psychiatrist and a Rottweiler? A psychiatrist just won’t let go.”
    It may be a little dramatic, but it underscores Michael Corry’s passion in defence of patients that he should have formed such a view of his fellow psychiatrists after 28 years in practice. ECT is a horror and it should be banned immediately, he believes. For him, it’s the antithesis of what psychiatric treatment should be, for Corry takes his lead from the literal meaning of the word, soul healing, from psyche, the soul, and iatrea, healing, and wants to see a methodology of treatment based on the uniqueness of every soul, every individual.
    To him, psychiatry is not just in crisis “it’s in chaos, but it doesn’t know this. Psychiatry may believe it’s serving people, but to the service users, the patients, it has nothing to offer them, only the biological approach, the drugs approach, the hospitalisation approach, the disease model approach”. And he foresees a deepening of this crisis as time goes on.
    “There will be in time an enormous drift away from psychiatry, as has happened with various institutions over the years. The fact that there are widespread anti-psychiatry movements all across the globe shows that people are turning against it, but psychiatry does not want to take cognisance of this fact — it goes on fiddling while Rome burns.”
    The failed model in psychiatry he, too, sees as having its origins in the introduction of the medical approach.     “This biological model came to have dominance because of medical doctors moving into the area of the psyche, the soul — because it wasn’t always like this — an area which is perhaps traditionally that of the shamans, the wise ones, monks or priests, teachers, and later counsellors and therapists.
    “Medicine moved into the psychological area and brought with it its technologies, the technologies of physical medicine. Psychiatrists are doctors, and they are using physical methods to treat the non-physical, taking the same approach as is applied to pain and disease and applying it to the soul. Well, this has backfired — it can’t work, it’s a misfit.
    “When we look at the psyche, what are we looking at? We’re looking at ‘software’, at consciousness. But psychiatry is looking at hardware, at the structure of the brain, seeing the equation ‘mental problems = sick brain’, just as a doctor looks at an X-ray and sees a pneumonia or at an angiogram and sees a strictured artery.
    “Instead of seeing a mental state, they’re seeing a broken brain. But this is what has led to the crisis we are experiencing, because the problem is in the software, not in the hardware.
    “Look, if you don’t like the programmes on TV, what do you do? Do you call the TV repairman? No, you change the channel, because the TV repairman is not appropriate. Fixing the brain is not the answer to mental difficulties, which are life’s difficulties, caused by stresses and experience and the problems we all face.”
By now, the metaphor of the crooked and straight sticks has been around the houses, so I’m not expecting what comes next.
    “We are trying to create and introduce an alternative model to the biological model, one based on consciousness, emotion, behaviour, soul, spirit, the heart. What I see as the central issue here is human sustainability, because humanity is in distress, at all levels of society. But to have the most wounded in society treated in a maladapted way is a real tragedy, a tragedy of consciousness. That’s definitely the crooked stick.
    “What sustains us? What does not? The straight stick, for me, is a matter of subtracting the psychological distress from the disease model and putting it back where it belongs, in consciousness, in emotion, in the very business of life. With it, we put the actual individual, who is unique, at the centre of treatment. We’re fighting for the psychiatric services genuinely to treat each individual as unique, to see each as unique, and so to provide a tailor-made response to each patient’s needs.”
    And did Corry believe we might near a tipping point which would bring this radical change?
    “Yes, definitely. I think so, because I see a huge movement out there, looking at mental health education, at the need for it. Once we get involved in education, we have to look at the potential of each individual kid, in schools and colleges, and at the huge need for prevention of many psychological problems. This brings us again into the field of consciousness, and so we need to consider teaching our children skills — coping skills, emotional and psychological skills, so that they will be able to deal with the problems of living, without buckling, without killing or harming themselves.
    “That’s why I see a tipping point coming, because the demand for such approaches can only be satisfied by a methodology which starts from consciousness, not from biology.
    “I’m not the only one to think this. One of the prime movers in the HSE (Health Services Executive) told me he feels that we have a moment of opportunity — he compared this to the melting of an ice field — and that we should make the most of it, move on it now, because he would be worrying about the chance of a re-freeze.
“To me, though, it’s a bigger opening and I’m less fearful of a re-freeze. Once we move away from the biomedical model and into a focus on consciousness, it will be for good, it will be exponential.”
    This is no minor matter, either, for Corry: “It’s going from the flat earth concept to the round earth; it really is that profound a paradigm shift. I’ve been practicing as a psychiatrist since 1978, and I can feel in my bones that this shift is coming. I’ve been pushing the striaght stick all these years within this matrix, and now I can suddenly feel the old model dismantling. Atomising.”
Which is the point at which we got to ECT. Says Corry:     “If I was to hear that there was a group of people, somewhere in the world, being given electric shocks to change their thoughts or their moods, I would immediately think of death camps, of the horrors of concentration camps, of the way the Americans treat detainees at Guantanamo. But when I reflect that this is actually happening in medicine — about 850 people each year are given ECT in hospitals in Ireland — it’s hard to express. It’s just wrong, morally and ethically wrong, because it causes brain damage. It only ‘works’ because it causes brain damage, because it erases memory, destroys cells. It’s a form of concussion, a closed head injury.”
    This is where he tells the bitter Rottweiler joke. We don’t laugh. “Problem is,” he says, “that if a patient will not or does not respond to the drugs, the pills, they give them electroshock. It’s the logical endpoint of the medical model, and I must say I foresee legal cases, I foresee tribunals, looking at ECT and its effects and the people who carry it out. Ban it, ban it immediately.”
Corry, along with many others, has put a lot of effort and time into organising the October conference. So what does he in particular want to see coming out of it?
    “It’s going to be an exciting day, a day of learning and debate and fresh experience. I’d like to see therapy providers, the stakeholders, the funding providers, the policy-makers and the administrators attending, as well as sufferers and their families and the public, and I’d like to see them coming from physical medicine as well as psychological, because this conference is about consciousness, it’s about mind. It’s about mind science, and we don’t actually have a science of mind even though we direly need one. So it’s a great opportunity for all of those people, to be introduced to and to experience a new vocabulary, a new language.
    “So what I’d like to see as a result is this new language and vocabulary being introduced into psychiatric medicine, which would in turn make it easier to bring about the kind of change we want to see happening. We need that new language, that new way of looking at psychological difficulties. And I’d like to see policy-makers and administrators in this area going away from it afterwards enthused about what can be done.”