Be Careful What You Say
How honesty leads to the trauma of unnecessary psychiatric hospitalization
By Dr. Roger McFillin | Radically Genuine | August 8, 2024
Picture a soul in turmoil, wrapped in the suffocating embrace of despair. In the sanctuary of a therapist’s office, they finally find the courage to voice the unspeakable:
“Sometimes, I think about not being here anymore.”
The words hang heavy in the air, a testament to the crushing weight of their pain, loneliness, and emptiness. This confession, born from a place of vulnerability and trust, should be the beginning of a deeper healing journey.
During these intense emotional struggles, it’s important to understand that thoughts of escape, including suicide, are a common human response to overwhelming pain. There’s a vast chasm between contemplating an end to suffering and actively planning to end one’s life.
Context is everything.
The mind, overwhelmed by anguish, may grasp at any perceived exit, including the idea of nonexistence. But voicing these thoughts doesn’t signal imminent danger. Rather, it’s often a cry for understanding, a desperate reach for connection in the depths of isolation.
Skilled and experienced therapists understand this.
The very act of sharing these dark musings with a trusted professional can be profoundly cathartic. It’s in these raw, unfiltered moments that true therapy has the potential to work its magic. A skilled therapist, one who can navigate these turbulent waters without succumbing to panic, becomes a lifeline. They offer not just a listening ear, but a steady hand to guide the patient through the storm, helping them to contextualize their pain and find hope in the midst of despair. This is the essence of healing – not in avoiding the darkness, but in facing it together, unafraid.
Fast forward to mental healthcare in 2024.
As the demand for mental health services skyrockets, we’re witnessing a disturbing trend: the proliferation of ill-equipped therapists flooding the market. What was once a skilled profession has, in many cases, devolved into little more than paid listening.
The rise of virtual therapy platforms, while increasing accessibility, has created a cohort of isolated practitioners. Lured by the promise of higher profits without the overhead of a physical office, many therapists now find themselves cut off from the vital support networks of supervisors and mentors. Without this crucial guidance, they’re left to navigate treacherous emotional waters alone, often defaulting to a “cover your ass” mentality when confronted with challenging situations.
Simultaneously, as large hospital networks muscle into the mental health arena, therapy is increasingly reduced to an appendage of psychiatry. The nuanced art of healing is replaced by a simplistic “take your pills and manage your mental illness” approach. This medicalization of human suffering is fundamentally dehumanizing, reducing complex emotional states to mere chemical imbalances.
The consequences of this shift are stark. Individuals brave enough to voice thoughts of death are no longer met with understanding, but with fear. Their pain is hastily labeled as emerging “mental illness,” triggering a rigid psychiatric protocol that leads to overmedicalization and unnecessary hospitalization.
“I want you to go to the emergency room”
The knee-jerk mantra of risk-averse therapists and doctors who’ve been brainwashed to treat every fleeting suicidal thought like a ticking time bomb.
They herd the emotionally vulnerable into sterile, overpriced hospital rooms, mistaking cold fluorescent lights and paper gowns for actual care. It’s a convenient way to abdicate responsibility, slap a band-aid on deep-seated pain, and pad the pockets of our broken healthcare system – all while patting themselves on the back for “saving lives.”
A Rise In Psychiatric Hospitalizations
The U.S. mental health care system is at a breaking point, buckling under the weight of an insatiable demand for inpatient care. Recent federal data, as reported by CBS News, reveals a system in crisis: hospitals and clinics are operating at a staggering 144% capacity for inpatient psychiatric beds. This alarming statistic, courtesy of the Substance Abuse and Mental Health Services Administration (SAMHSA), exposes the raw nerve of a long-festering problem – a dire shortage of psychiatric inpatient facilities.
Yet, this begs a crucial question: Is this surge in demand a genuine need, or merely a symptom of a more insidious systemic failure?
The COVID-19 pandemic has cast a long shadow over youth mental health, with alarming consequences. A recent study comparing mental health emergency admissions among young people before and after the outbreak reveals a disturbing trend. In the two years following March 2020, youth psychiatric emergencies surged by an astonishing 116.7% compared to the same period in 2018-2020. Even more concerning, this new wave of patients skewed younger and were less likely to have prior psychiatric histories.
These findings suggest a troubling shift: the pandemic appears to have triggered new, earlier onset psychiatric manifestations in previously unaffected youth. Moreover, these emergencies lead to psychiatric drugs as a matter of course.
Which leads to worsening outcomes.
Primary Care Driving Hospitalizations
The mental health crisis among youth has been sensationalized to a dangerous degree, leading to misguided interventions that may do more harm than good. In pediatric offices across the country the use of quick, invalid screening measures that reduce complex emotional states to simple checkboxes is the primary assessment approach. These cursory assessments, administered by primary care doctors ill-equipped to handle nuanced mental health concerns, are causing undue panic.
A single checked box on these questionable screening measures can set off a chain reaction of fear-mongering, with parents being urgently directed to emergency rooms for what may be nothing more than typical teenage angst or temporary emotional struggles. This knee-jerk approach not only overwhelms emergency services unnecessarily but also risks pathologizing normal developmental experiences.
The media’s portrayal of primary care doctors drowning in a youth mental health crisis obscures a more insidious reality: these physicians, despite their best intentions, are conducting mental health evaluations in alarmingly short timeframes without the proper training to contextualize their findings.
The result is a perfect storm of misunderstanding, where the vulnerability and complex emotions inherent to adolescence are stripped of their context and hastily labeled as mental health emergencies. This approach not only fails to address the real needs of struggling youth but also potentially traumatizes families and clogs a healthcare system already stretched to its limits.
Even if these youth are not hospitalized they are going to placed on a drug that will at least double the risk of suicide, if not more. Lexapro is often prescribed despite the 6-fold increase in suicide risk!
The Trauma of Psychiatric Detention
When desperate parents drag a sullen teenager to the ER, or a vulnerable adult finds themselves cornered by an ER social worker, a grim dance begins. The fluorescent-lit stage is set for a performance of “crisis management theater,” where real human suffering collides with bureaucratic checklists and liability concerns.
Parents, gripped by fear that their child might take their own life, often feel coerced into consenting to psychiatric hospitalization and medication. This fear becomes a potent weapon wielded by hospital staff, despite the lack of evidence that such interventions actually prevent suicide.
Ironically, within academic circles, it’s widely acknowledged that these very interventions may increase the likelihood of suicide. This grim reality makes a perverse kind of sense: patients are prescribed powerful, mood-altering drugs and then discharged back into the very circumstances that initially drove them to contemplate suicide.
The experience of psychiatric detention is frequently described as traumatizing. Patients are stripped of their dignity – quite literally during invasive searches – and their autonomy, as their phones and personal belongings are confiscated. Many report being treated like cattle by burned-out, unprofessional staff.
Young women often feel unsafe, surrounded by men who are also experiencing mental health crises. For women struggling with the aftermath of sexual violence – a common precursor to psychiatric hospitalization – the hospital stay itself can be profoundly re-traumatizing.
This system, designed ostensibly to help, often inflicts further harm. It substitutes genuine care and understanding with a one-size-fits-all approach that prioritizes risk management over true healing. In our rush to “do something,” we’ve created a revolving door of trauma, where those seeking help often emerge more damaged than when they entered.
When parents, armed with knowledge and a desire to protect their children from potentially harmful interventions, attempt to resist the pressure to medicate, they’re often met with a dismissive and exasperated “What do you want us to do then?”
It exposes a mental health apparatus that has become reliant on the false promise of quick-fix pharmaceutical solutions, lacking the resources, training, or willingness to explore alternative approaches. This attitude effectively holds families hostage: either accept potentially harmful psychiatric drugs or be left with no support at all.
This false dichotomy – drugs or nothing – is a damning indictment of a system that has lost sight of its purpose. It reveals a profound lack of creativity and compassion in addressing mental health crises. Instead of working collaboratively with families to develop comprehensive, individualized care plans, hospital staff often default to a one-size-fits-all approach that prioritizes expediency over efficacy.
Moreover, this response subtly shifts blame onto the parents, implying that by refusing medication, they’re somehow obstructing their child’s care. It’s a manipulative tactic that exploits parental fear and guilt, further eroding trust between families and mental health providers.
Fear Based Therapy
The mental health industry has a dirty secret: it’s terrified of the patients it claims to help. Therapists, those supposed bastions of understanding and support, turn into protocol-driven robots at the mere whisper of suicide. Gone is the empathy, replaced by a checklist of CYA questions designed more to protect their licenses than to save lives.
This is how they are trained.
This fear-based charade masquerading as care has created a toxic environment where honesty is punished. Patients learn quickly: bare your soul at your own risk. Admit to dark thoughts, and watch your therapist’s eyes glaze over with panic as they mentally rehearse their mandatory reporting script.
In my years of specializing in treating chronically suicidal clients, I’ve witnessed firsthand the deep-seated trauma inflicted not just by their original experiences, but by the very system purporting to help them.
A disturbing pattern emerges, particularly among women survivors of sexual violence. Their acute trauma reactions are frequently misunderstood and hastily misdiagnosed as bipolar disorder or other psychiatric illnesses, leading to a cascade of inappropriate treatments and interventions. The psychiatric hospitalizations that often follow are not just ineffective; they’re actively traumatizing.
When these survivors finally find their way to my office, the damage is palpable. Trust, the very foundation of effective therapy, has been shattered by their previous encounters with mental health professionals. It can take months of patient, careful work to rebuild that trust, to convince them that it’s safe to be open and honest in therapy. This process is painstaking, requiring us to undo layers of iatrogenic harm – harm caused by the very institutions and individuals tasked with healing.
The tragedy here is twofold: not only are these women denied proper care for their actual traumas, but they’re also subjected to a secondary trauma at the hands of a mental health system that fails to recognize the complexities of their experiences. This cycle of misdiagnosis, inappropriate treatment, and subsequent re-traumatization doesn’t just delay healing – it actively impedes it, sometimes for years. Many never recover.
What Genuine Help Looks Like
True healing begins with the compassionate ear of a skilled, experienced therapist who can create a safe space for emotional expression and validation. This approach recognizes a fundamental truth: everything, including emotional pain and suicidal thinking, is temporary. By understanding struggles in their proper context, therapists can help clients navigate their darkest moments without resorting to extreme measures.
A competent therapist knows that most expressions of suicidal thoughts are not declarations of intent, but rather desperate attempts to communicate profound suffering. This nuance, while seemingly obvious, often eludes less experienced or inadequately trained professionals who are paralyzed by fear and uncertainty. Instead of reacting with panic, skilled therapists help clients explore their pain and envision a life worth living, even in the midst of emotional turmoil and trauma.
When someone is in emotional turmoil and suicidal risk is present, truly skilled therapists know that a gentle, personalized approach can make all the difference. Instead of rushing to hospitalization, these compassionate professionals take the time to really listen and understand. They work hand-in-hand with the person in crisis, crafting a safety plan that feels right and makes sense for their unique situation. It’s not about imposing rules, but about finding inner strength and support.
Effective therapy often involves teaching clients how to regulate intense emotions and tolerate distress. This might include techniques drawn from dialectical behavior therapy (DBT) or other evidence-based approaches. For many, additional support such as telephone coaching and family-based therapies can create a plan to weather crisis periods. These interventions recognize that suicidal crises tend to be episodic and often resolve when the underlying problems are addressed.
Primary care doctors should not be administering mental health screening measures or prescribing psychiatric drugs for complex emotional issues. Their well-intentioned but misguided interventions often exacerbate the situation, medicalizing normal human experiences and setting patients on a path of unnecessary and harmful treatments.
Working in “mental health” requires patience, understanding, and a willingness to sit with discomfort – both from the client and the therapist. By moving away from a fear-based, reactionary model of care towards one that embraces complexity and prioritizes genuine human connection, we can create a mental health system that truly serves those in need.
When the storm of the mind rages, feel-good therapy buzzwords and empty reassurances are as useful as a paper umbrella in a hurricane. What’s needed isn’t another degree or certification, but something far rarer: the guts to stare unflinchingly into the abyss of another’s pain without flinching. In the end, perhaps the most radical act in modern mental health care is simply having the backbone to shut up, sit down, and bear witness to suffering without trying to sanitize it.
Debunking the debunkers on the “myths” of antidepressants
By Maryanne Demasi, PhD | August 5, 2024
Recently, The Conversation ran an article which claimed to “debunk” a range of myths about antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
Natalina Salmaso, a clinical psychologist at Carleton University in Canada, highlighted five common myths that make people hesitant to take antidepressants.
Salmaso said hesitancy is often “unfounded” and “may not be grounded in science” and that “debunking the myths surrounding antidepressants is critical to permitting educated treatment decisions for those who suffer.”
However, Salmaso’s article was full of omissions and falsehoods, so we decided to debunk the debunker.
Myth 1 – I am stronger if I do this without meds
Salmaso says that a person with depression is like an athlete with a broken leg.
An athlete cannot compete effectively with a broken leg, in the same way a person with depression cannot function effectively, because their brain “is no longer responding to everyday life.”
She adds that a person’s brain needs to “heal” before they can expect it to function like they did pre-depression and implied antidepressants can help.
This is grossly misguided. This feeds into the false narrative that depression is a brain disease that can be cured by antidepressants.
Antidepressants don’t cure people with depression and their symptomatic effects are so small that they lack clinical relevance.
Studies show that patients actually do better with psychotherapy, which has enduring effects. Further, psychotherapy halves the risk of suicide whereas antidepressants double this risk, in people of all ages.
Myth 2 – I will be dependent on antidepressants to be happy
Salmaso says that antidepressants won’t make people ‘happy’ per se, but they “allow people to experience all emotions in an appropriate and balanced way.”
However, this is not what patients report. SSRIs tend to make people feel “numb” and unable to experience emotions. Some describe it as an inability to feel love, attachment or sexual excitement.
Some experience sexual dysfunction, which can continue long after the drug is discontinued.
Salmaso says that antidepressants “are a long-term (typically at a minimum for a year) and (hopefully) curative treatment, much like chemotherapy for certain types of cancer.”
This is also misguided. Most people become depressed because they have stressful or depressing circumstances, which no drug can cure.
People have been misled to believe that antidepressants can “correct” a chemical imbalance in the brain. A systematic review in 2022 thoroughly debunked the hypothesis that depression is caused a serotonin imbalance.
Salmaso even says that “most studies show that if you take antidepressant medications for a year before coming off of them, the majority of people will not relapse.”
This is also incorrect. The majority of studies on relapse are flawed because they involve subjects already on antidepressants and when they suddenly stop them for the trial they experience withdrawals, which interferes with the assessment of relapse.
Also, the longer someone takes an antidepressant, the higher the probability of that person experiencing withdrawal effects.
Myth 3 – Meds will change who I am, I will be different or feel high
Salmaso says that antidepressants won’t change you, but rather “allow you to view things from a more balanced perspective.”
However, Danish psychiatrists have reported that half of the patients on antidepressants agreed that the treatment could alter their personality and that they had less control over their thoughts and feelings.
Far from rebalancing the brain, antidepressants alter the normal functioning of the brain and disrupt biological processes with potentially devastating consequences.
As far as “changing who you are,” there have been ample reports of out-of-body experiences (including akathisia) where people became suicidal or homicidal on antidepressants, even in people with no history of this behaviour.
A systematic review found that taking antidepressants increased aggression three times more than taking a placebo, in children and adolescents.
Myth 4: I will become addicted
Salmaso says that antidepressants “are generally not addictive and have a low potential for misuse.”
This is not correct. Antidepressants can lead to dependency. Many people experience withdrawal symptoms, which are very similar to those that people experience when they try to come off benzodiazepines.
Salmaso claims that some patients get headaches and other withdrawal symptoms when the stop taking antidepressants “suddenly” but says they are “generally short-lived and can be minimised by tapering off treatment slowly.”
However, it is well-documented that about half of patients on antidepressants cannot stop them without experiencing withdrawals symptoms, which for some, can persist for many years. These symptoms are very difficult to “minimise” even with slow tapering.
Myth 5: Meds should only be used as a last resort
Salmaso disagrees that antidepressants should be used as a last resort.
She says that reserving antidepressants only for extreme cases “doesn’t make sense” because depression can reduce “work productivity and has immense societal consequences.”
“The financial repercussions that can be attributed to depression in terms of the number of workdays missed, jobs lost, accidents caused, etc. are enormous,” she added.
However, studies examining the efficacy of antidepressants have not shown any meaningful effects, such as improvements in quality of life, and they make it more difficult for people to function.
In all countries where this relationship has been examined, the increased use of antidepressants has been accompanied by an increase in disability pensions for mental health reasons.
Salmaso argues that, “Depression significantly increases risk of cardiovascular disease, gastrointestinal disease, respiratory disease and Parkinson’s disease, to name a few. It also seems to worsen the outcomes for cancer.”
Antidepressants do not improve these conditions either. Overall, it is our view that Salmaso’s evidence and arguments are flawed and misguided.
Israel Has a History of Killing Hamas Leaders Who Are Trying To Secure Ceasefires
Benjamin Netanyahu’s reckless assassination of Ismail Haniyeh undermines the prospects for a peace deal and the release of the hostages
Ismail Haniyeh in Doha, Qatar, on March 26, 2024. Photo by AFP via Getty Images
By Mehdi Hasan – zeteo – July 31, 2024
“Israel’s leaders killed three birds with one stone,” wrote Reuven Pedatzur, a senior military affairs analyst for the Israeli newspaper Haaretz. “They assassinated the man who had the power to make a deal with Israel; they took revenge on someone who had caused more than a few Israeli casualties; and they signaled to Hamas that communications with it will be conducted only through military force.”
Was Pedatzur referring to the Israeli assassination of senior Hamas leader Ismail Haniyeh, the head of the group’s political bureau, in Tehran in the early hours of Wednesday morning?
No. Pedatzur died in a road traffic accident in 2014. His quote from Haaretz, above, was in response to the Israeli assassination of another senior Hamas commander, Ahmed Jabari, in November 2012, which kicked off the 2012 Gaza war.
As my former colleague at The Intercept, Jon Schwarz, documented in great detail last year, “Jabari had come to believe that it was in the best interest of Palestinians for Hamas to negotiate a long-term truce” and had been in communication with the respected Israeli peace activist Gershon Baskin. “Just before the assassination, [Baskin] gave Jabari a draft proposal for such a truce to review and approve. The draft was agreed to by Baskin and Hamas’s deputy foreign minister, and Baskin also said he had previously shown it to Ehud Barak, then the Israeli minister of defense.”
Would Jabari have signed off on a ‘hudna,’ or long-term truce, between Hamas and Israel? We’ll never know.
Israel, in fact, has a long and cynical history of killing Hamas leaders who are in the midst of ceasefire negotiations or, even, proposing long-term truces with the Jewish state.
Remember Sheikh Ahmed Yassin, the quadriplegic co-founder and spiritual leader of Hamas? He was assassinated less than three months after he proposed a long-term truce with Israel “if a Palestinian state is established in the West Bank and Gaza Strip.”
His successor, Abdel Aziz al-Rantisi, was assassinated less than three months after he made a similar truce offer to Israel.
Then there was the Netanyahu government’s 2012 assassination of Jabari, who, as mentioned, was reviewing a “long-term mutual cease-fire” deal just “hours before he was killed,” according to Baskin.
The parallels between 2012 and 2024, between the killings of Jabari and Haniyeh, are eery.
“He was in line to die, not an angel and not a righteous man of peace,” Baskin said of Jabari shortly after his killing, “but his assassination also killed the possibility of achieving a truce and also the Egyptian mediators’ ability to function.”
The same could be said of Haniyeh. Mainstream Western media outlets agree that the Hamas leader was – by Hamas standards – a “pragmatist”; a key figure in the ongoing negotiations to secure a ceasefire in Gaza and free the Israeli hostages.
From Reuters:
“For all the tough language in public, Arab diplomats and officials had viewed [Haniyeh] as relatively pragmatic compared with more hardline voices inside Gaza, where the military wing of Hamas planned the October 7 attack. While telling Israel’s military they would find themselves ‘drowning in the sands of Gaza,’ he and his predecessor as Hamas leader, Khaled Meshaal, had shuttled around the region for talks over a Qatari-brokered cease-fire deal with Israel that would include exchanging hostages for Palestinians in Israeli jails as well as more aid for Gaza.”
From Sky News:
“Haniyeh was the pragmatic face of Hamas. He was less hard-line and militaristic than Yahya Sinwar, who is the head of Hamas inside Gaza and is leading the battle. Haniyeh was the public face of Hamas’s diplomacy in Arab capitals. He was leading efforts to negotiate a ceasefire in Gaza.”
This was the person that the far-right Israeli government of Benjamin Netanyahu chose to assassinate on Iranian soil on Wednesday.
Why?
Put simply, Netanyahu and his coalition of fascists and bigots do not want a deal to release the hostages. They prefer to continue the war, no matter the cost to Gaza’s civilians or to their own citizens still held inside of the enclave. Despite Joe Biden’s ludicrous claims to the contrary, it is Netanyahu who has been the biggest obstacle to a deal to free Israel’s hostages in Gaza. The former spokesperson for the hostages’ families says Netanyahu rejected a deal. Benny Gantz, a former member of Israel’s war cabinet, says Netanyahu blocked a deal. Israeli defense officials tell Haaretz that “Netanyahu systematically foiled the negotiations to free the hostages.”
There is nothing new here. To misquote Winston Churchill, Israel has always preferred “war-war” over “jaw-jaw.” Israeli governments – especially those led by Netanyahu – have preferred having Hamas as the permanent enemy – or as an “asset,” to quote the current Israeli Finance Minister Bezalel Smotrich – rather than trying to do a permanent deal with Hamas.
As the late Israeli journalist Pedatzur wrote, in his analysis of the disastrous Jabari assassination in 2012:
“Our decision makers, including the defense minister and perhaps also Prime Minister Benjamin Netanyahu, knew about Jabari’s role in advancing a permanent cease-fire agreement. … Thus the decision to kill Jabari shows that our decision makers decided a cease-fire would be undesirable for Israel at this time, and that attacking Hamas would be preferable.”
Change the name ‘Jabari’ to ‘Haniyeh’ above, and those words could have been written today.
Plus ça change, plus c’est la même chose.
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From the Archives
Examples of hate speech by Israel against Palestine
1. “There is a huge gap between us (Jews) and our enemies, not just in ability but in morality, culture, sanctity of life, and conscience. They are our neighbors here, but it seems as if at a distance of a few hundred meters away, there are people who do not belong to our continent, to our world, but actually belong to a different galaxy.” Israeli president Moshe Katsav. The Jerusalem Post, May 10, 2001
2. “The Palestinians are like crocodiles, the more you give them meat, they want more”…. Ehud Barak, Prime Minister of Israel at the time – August 28, 2000. Reported in the Jerusalem Post, August 30, 2000
3. ” [The Palestinians are] beasts walking on two legs.” Menahim Begin, speech to the Knesset, quoted in Amnon Kapeliouk, “Begin and the Beasts”. New Statesman, 25 June 1982.
4. “The Palestinians” would be crushed like grasshoppers … heads smashed against the boulders and walls.” Isreali Prime Minister (at the time) in a speech to Jewish settlers New York Times April 1, 1988
5. “When we have settled the land, all the Arabs will be able to do about it will be to scurry around like drugged cockroaches in a bottle.” Raphael Eitan, Chief of Staff of the Israeli Defence Forces, New York Times, 14 April 1983.
6. “How can we return the occupied territories? There is nobody to return them to.” Golda Maier, March 8, 1969.
… Continue
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