Mad in America: Rethinking Mental Health

Arthur Kleinman is a towering figure in psychiatry and medical anthropology. He has made substantial contributions to both fields over his illustrious career spanning more than five decades. As a Professor of Medical Anthropology at Harvard University's Department of Global Health and Social Medicine and a Professor of Psychiatry at Harvard Medical School, Kleinman has profoundly influenced how medical professionals understand the interplay between culture, illness, and healing. His extensive body of work includes seminal books and numerous articles that have become foundational texts in medical anthropology. These writings explore the crucial role of personal and cultural narratives in shaping medical practices and patient care. In recent years, Kleinman has increasingly focused on critiquing the prevailing practices within psychiatry, particularly the over-medicalization of mental health issues and the neglect of broader social and personal contexts that significantly impact patient care. His critiques advocate for a more nuanced and compassionate approach to psychiatry, one that recognizes the importance of individual patient stories and the socio-cultural dimensions of mental health. In this interview, Kleinman explores critical issues facing modern healthcare. He discusses the often-overlooked narrative of patient experiences, critiques the mechanistic approaches that dominate U.S. healthcare, and offers insightful reflections on the global mental health movement. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

On the MIA podcast this week we turn our attention to conflicts of interest (COIs) and new research from the British Medical Journal (BMJ). Mad in America has previously examined the problems with conflicts of interest in research but this time we extend that to look at the potential effect of COIs on diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). Joining me today are Lisa Cosgrove and Brian Piper, two of the authors of a paper which appeared in the BMJ. The paper is entitled “Undisclosed Financial Conflicts of Interest in the DSM-5 TR: Cross-Sectional Analysis,” and it was published in January 2024. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Swapnil Gupta is an Associate Professor and Medical Director of Ambulatory Psychiatry at Mount Sinai Morningside Hospital. She was trained as a psychiatrist in India and the United States, at SUNY Downstate Medical Center and Yale University, and PGI Chandigarh in India. She is known for her work on deprescribing from and discontinuation of psychiatric drugs. Dr. Gupta’s career began with research on the role of the endocannabinoid system in the pathophysiology of schizophrenia as an academic psychiatrist. Her subsequent scholarship has focused on applying deprescribing, the systematic reduction of unnecessary medications, to psychiatry by rooting it in the principles of recovery-oriented care. She has authored several peer-reviewed papers on deprescribing and co-authored a book with Rebecca Miller and John Cahill. She is an active member of two organizations that aim to enhance stakeholder engagement in psychiatric research. She is also a part of the editorial board of the Community Mental Health Journal. Currently, she is working on creating educational resources to help people discontinue psychiatric medications and gathering information on the knowledge and opinions of psychiatrists regarding the discontinuation of such drugs. In this interview, we discuss deprescribing from psychiatric drugs, the difficult decisions faced by patients, the importance of psychosocial support during withdrawal, and how deprescribing is central to recovery-oriented practices such as shared decision and patient choice. We will also tackle the complex issue of whether the recurrence of symptoms once a drug is tapered is a mark of relapse or withdrawal caused by the psychiatric medication. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Justin Garson is a Professor of Philosophy at Hunter College and The Graduate Center, City University of New York, and a contributor for Psychology Today and Aeon. He writes on the philosophy of madness, the evolution of the mind and purpose in nature. His most recent book is Madness: A Philosophical Exploration, published by Oxford University Press in 2022. He is also the author of the forthcoming The Madness Pill: The Quest to Create Insanity and One Doctor’s Discovery that Transformed Psychiatry, which will be published by St. Martin’s Press. In this interview, Justin joins us to talk about the ways in which society has attempted to explain or categorize madness over the years. We also discuss the value of looking at madness, not as disease or defect, but as a designed feature. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Deborah Kasdan is author of Roll Back The World: A Sister’s Memoir, in which she describes her extraordinary late sister Rachel–poet, musician, free spirit–and her decades-long journey through psychiatric treatment until, finally, she found a place of peace and community. Kasdan is a longtime business and technology writer who pivoted to memoir writing on a quest to tell her sister’s story, joining the Westport Writers’ Workshop. Her book, published in October by She Writes Press, is a moving and nuanced portrait filled with love and grief, candor, and complexity. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Hello and welcome to the Mad in America: Rethinking Mental Health podcast. If you are new here, hello. My name is James and I will be your host as we ask critical questions about the state of psychiatry and psychology in the 21st Century. In this podcast, we examine mental health with a critical eye by speaking with psychologists, psychiatrists, researchers, journalists and people with lived experience. When you hear such conversations, you realise that much of what is believed to be settled in mental health is actually up for debate. Is mental health a matter of faulty biology or is there more to it? Are the treatments used in psychiatry helpful or harmful in the long term? Are psychiatric diagnoses reliable? With the help of our guests, we examine these questions and so much more. I think you will find the podcast insightful, informative, and, most of all, thought-provoking. It’s available on all major podcast platforms like Spotify, Apple or Google podcasts and YouTube. Just search for Mad in America: Rethinking Mental Health. Please join us for these important conversations. *** Mad in America is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Mark Freeman is a renowned author and a pioneering voice in the emerging field of the psychological humanities. He serves as Distinguished Professor of Ethics and Society in the Department of Psychology at the College of the Holy Cross. His body of work, including the critically acclaimed Toward the Psychological Humanities: A Modest Manifesto for the Future of Psychology (Routledge, 2023), offers a profound reimagining of psychology, interweaving it with the arts and humanities to better understand the human condition. He is the author of numerous additional works, virtually all of which, in one way or another, speak to the emerging field of the psychological humanities. These include Rewriting the Self: History, Memory, Narrative (Routledge, 1993); Finding the Muse: A Sociopsychological Inquiry into the Conditions of Artistic Creativity (Cambridge, 1994); Hindsight: The Promise and Peril of Looking Backward (Oxford, 2010); The Priority of the Other: Thinking and Living Beyond the Self (Oxford, 2014); and Do I Look at You with Love? Reimagining the Story of Dementia (Brill | Sense). Along with David Goodman, he has also co-edited Psychology and the Other (Oxford, 2015) and, with Hanna Meretoja, has co-edited the recently published The Use and Abuse of Stories: New Directions in Narrative Hermeneutics (Oxford, 2023). He also serves as Editor for the Oxford University Press series “Explorations in Narrative Psychology.” In this interview, we'll explore his personal journey toward the psychological humanities, delve into his work in narrative psychology, and discuss his approach to the concepts of 'self' and the 'Other.' We'll also touch upon how his perspectives guided him as he navigated his mother's journey through dementia, a deeply personal narrative shared in his book. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

On the Mad in America podcast this week, we continue our reader Q&A with Mad in America founder Robert Whitaker. In Part 1, we discussed Mad in America, the biopsychosocial model and the history of psychiatry. For Part 2, we will be covering reader questions on pharmaceutical marketing and issues with psychiatric treatments including psychiatric drugs and electroconvulsive therapy. Thank you to all of you who took the time and trouble to send in your questions. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

On the Mad in America podcast this week we have Robert Whitaker with us to answer questions sent in by readers and listeners. Thank you to all of you who took the time and trouble to get in touch. You sent some great questions and on this and our next podcast, we will be talking with Bob about Mad in America, the biopsychosocial model, the history of psychiatry, pharmaceutical marketing, and issues with psychiatric treatments including psychiatric drugs and electroconvulsive therapy. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Audrey Clare Farley is a writer, editor, and scholar of 20th-century American culture with a special interest in science and religion. She earned a PhD in English literature at the University of Maryland, College Park. She now teaches a course on U.S. history at Mount St. Mary’s University. Her first book, The Unfit Heiress: The Tragic Life and Scandalous Sterilization of Ann Cooper Hewitt, tells the story of a 1930s millionairess whose mother secretly sterilized her to deprive her of the family fortune, sparking a sensational case and forcing a debate of eugenics. Her second book, which we will be discussing today, Girls and Their Monsters: The Genain Quadruplets and the Making of Madness in America, explores the lives of the four women behind the National Institute of Mental Health’s famous case study of schizophrenia. It was named a New York Times Editors’ Pick and will be the focus of our conversation today. Audrey’s essays have appeared in the Atlantic, New York Times, Washington Post, and many other outlets. She lives in Hanover, Pennsylvania. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

Like to know more about MIA, its mission or rethinking psychiatry more broadly? On our podcast, MIA founder Robert Whitaker will answer your questions. Email questions to askmia@madinamerica.com by November 10 and we will pick a selection. *** Our guest today is Diane Dimond, a longtime, award-winning investigative journalist specializing in crime and justice issues. As a freelance journalist, syndicated columnist, and former television correspondent, her reporting and commentary have been featured in newspapers, magazines, and TV news outlets across the country. She’s also the author of several books, including Be Careful Who You Love: Inside the Michael Jackson Case, which she wrote after years of groundbreaking reporting on the topic; and her most recent, We’re Here to Help: When Guardianship Goes Wrong, recently published by Brandeis University Press. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

Like to know more about MIA, its mission or rethinking psychiatry more broadly? On our podcast, MIA founder Robert Whitaker will answer your questions. Email questions to askmia@madinamerica.com by November 10 and we will pick a selection. *** Brooke Siem is a writer, speaker, and advocate for the safe de-prescribing of psychiatric drugs. Her work on antidepressant withdrawal has appeared in The Washington Post, the New York Post, Psychology Today, and many more. She is also an award-winning chef and Food Network Chopped Champion. In this interview, we talk about her experiences of withdrawal from a cocktail of psychiatric drugs and her debut memoir, May Cause Side Effects, published in 2022 which is one of the first books on antidepressant withdrawal to make it to the mass market. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

Ray Moynihan is an accomplished health journalist and author who has won several awards for his work. He is also an academic at Bond University and a documentary filmmaker. Moynihan's research and writing focus on the healthcare industry, with an emphasis on how diseases are created, branded, and marketed to unsuspecting people. He is known for his use of sharp humor, which can be seen in his mock documentary about a fictional illness called 'Motivational Deficiency Disorder.' He is also a founding member of the international conference Preventing Overdiagnosis and hosts the podcast The Recommended Dose. Today, we will be discussing something that the speaker refers to as "an assault on being human" - the labeling of everyday life struggles as disorders and how patient advocacy groups, doctors, medical journalists, and respected academics are often manipulated by a powerful, corporatized healthcare system. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

Bradley Lewis works at the intersections of medicine, psychiatry, philosophy, the psychological humanities, mad studies, and disability studies, balancing roles as both a humanities professor and a practicing psychiatrist. Lewis earned degrees in psychiatry (MD) and Interdisciplinary Humanities (PhD) from George Washington University, and he currently holds an associate professorship at New York University's Gallatin School of Individualized Study. He also has affiliations with NYU’s Department of Social and Cultural Analysis, the Department of Psychiatry, and the Disability Studies Minor. Additionally, he serves on the editorial board of the Journal of Medical Humanities. His books include Moving Beyond Prozac, DSM, and the New Psychiatry: The Birth of Postpsychiatry, Narrative Psychiatry: How Stories Shape Clinical Practice, and Depression: Integrating Science, Culture, and Humanities. He has two books forthcoming: Experiencing Epiphanies in Literature and Cinema and a co-edited Mad Studies Reader. His writing offers unique insights into the hegemonic foundations of mental health and champions the role of narrative in therapy. His work also actively bridges the gap between academia and on-the-ground initiatives. A founding member of the Institute for the Development of Humane Arts (IDHA), Lewis champions a paradigm shift in mental health by facilitating collaboration between advocates, service users, and clinicians. His profound appreciation for the humanities guides his exploration of mental health, often through the lens of art and literature. By analyzing the lives of figures like Vincent Van Gogh or dissecting Chekhov’s narratives, Lewis encourages us to rethink and expand our understanding of psychological experiences. Join us as we explore the philosophical foundations, practical implications, and transformative potential of his work. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

On the Mad in America podcast today, we hear about the potential of lucid dreaming therapy to aid those struggling with post-traumatic stress. Our guest is Charlie Morley, a lucid dreaming teacher and bestselling author who helps people wake up in their dreams and harness the power of sleep for psychological growth. Charlie became a Buddhist at the age of 19 and has been lucid dreaming for over 20 years. In 2018, he was awarded a Winston Churchill Fellowship to research PTSD treatment in military veterans and continues to teach workshops for people with trauma-affected sleep. These teachings form the core of his latest book Wake Up to Sleep. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

This week we are sharing the audio from a recently held online discussion on supporting a child, teen or young adult in crisis. The host is Mad in America’s Family Editor, Amy Biancolli, and with her are guest speakers Ciara Fanlo, a recovered troubled teen, Morna Murray, a parent who supports her son through crisis, and Sami Timimi, a child and adolescent psychiatrist. It’s an honest and thought-provoking discussion and vital listening for anyone with an interest in parenting or the challenges facing our young people. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

We have two guests today. One is Susan Swim, executive director of the Now I See A Person Institute, which she created in 2007 to provide therapy and counseling to kids, teens, adults, families and others who haven’t found healing in the usual approaches to therapy and treatment. From its base in Los Angeles County, California, the Institute provides both in-person services, including equine therapy, and virtual sessions—and offers training as well. An expert in collaborative dialogical practices, Susan Swim is also a researcher whose topics include family reunification, helping people recover from trauma after previously unsuccessful treatments, and process ethics—which she’s described as “what is right and good for every client in therapy.” She’s also on the faculty of the Houston Galveston Institute, where she first started teaching in the early 1980s. In the past she worked for the Taos Institute and taught at Loma Linda University in Loma Linda, California. She’s written extensively on many topics and is the former editor of the Journal of Systemic Therapies. Our other guest today is the father of a daughter who was first hospitalized at age 13 and endured years of psychiatric treatment, diagnoses, drugs, and more hospitalizations before embarking on a path to healing at the Institute. The father will remain anonymous. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA and its mission to rethink psychiatry, please help us continue to survive and grow by making a donation. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here

Micha Frazer-Carroll is a writer, editor, and advocate whose work ventures into the radical politics of madness and mental health. Our exploration will excavate the connections between mental health, power structures, societal norms, liberation, and disability justice. A columnist at the Independent and previously an editor for publications such as the Guardian, gal-dem, and Blueprint, a mental health magazine that she founded, Micha has consistently used her voice to challenge mainstream, decontextualized, and depoliticized discourses in psychology and psychiatry. As a result, Micha has positioned herself at the forefront of redefining how we approach and understand madness in our society. Her book, "Mad World: The Politics of Mental Health," published by Pluto Press, is an insightful journey that unearths mental health as a political issue, extending beyond mere personal concern. It challenges our understanding of mental health by connecting it to capitalism, racism, disability justice, queer liberation, and other social frameworks. In Mad World, she is breaking barriers and creating new ways to understand care, empathy, and mental health itself. It’s been hailed as a “radical antidote” to how we usually think about these subjects, a guide for anyone who wants to challenge the status quo in our fields. As we discuss "The Radical Politics of Madness" today, we'll explore what it means to reframe mental health as an urgent political concern and how Micha's work serves as a testament to the transformative power of radical thinking in a world often confined by labels, diagnoses, and societal constraints. *** Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Today on the Mad in America podcast we share a conversation between Luis Gerardo Arroyo Lynn and Justin Karter. Luis conducted this conversation in his role as an editor of Mad in Mexico. Established in September 2021, Mad in Mexico is not just an extension but an essential limb of the international initiative of Mad In America. Its mission resonates with the core values of challenging conventional thinking around mental health, focusing on the Spanish-speaking communities of South and Central America as well as the United States. Luis graduated from Universidad La Salle and is now pursuing a master’s degree in Social Psychology of Groups and Institutions at UAM Xochimilco. He is currently conducting research on “Depsychiatrization of Mental Health,” with an interest in the fields of critical psychology, anti-psychiatry, and anti-speciesism. Luis is in conversation today with Mad in America’s own Justin M. Karter, whose multidisciplinary work stands at the intersection of psychology, philosophy, mad studies, and global mental health. As a counseling psychologist, an Instructor for the Center for Psychological Humanities & Ethics at Boston College, and the lead research news editor at Mad in America since 2015, Justin’s approach to mental health goes beyond clinical practice. In the spotlight is Justin’s research titled “Inclusion Toward Transformation: Psychosocial Disability Advocacy and Global Mental Health.” This study, completed in August 2021, addresses pressing concerns in modern mental health discourse. It critiques the prevailing Western notions that shape the Movement for Global Mental Health (MGMH) and champions a rights-based perspective, considering cultural, political, and economic conditions. This interview explores the crux of Justin’s research, examining the transformative potential of an integrated psychosocial disability framework. By interrogating and deconstructing mainstream discourses, this conversation promises to shed light on how we can better serve those with lived experiences of mental distress, transcending traditional boundaries and embracing a more rights-based, inclusive approach. This conversation aims to redefine the way we approach mental health, madness, psychiatry, and psychological suffering, in a world that desperately needs a compassionate, critical perspective. *** Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

This week on the Mad in America podcast, we are joined by Sarah Fay. Sarah is an author, an adjunct professor at Northwestern University, a freelance writer at The New York Times and elsewhere, a certified mental health peer recovery support specialist, and a mental health keynote speaker who’s spoken to audiences across the country about recovery from mental illness. We have previously spoken with Sarah about her book, Pathological: A True Story of Six Misdiagnoses, which told the story of her twenty-five years spent in the mental health system. For her follow-up work, Cured: A Memoir, Sarah writes about her recovery from mental illness. She says, “During the twenty-five years I spent in the mental health system, not one clinician mentioned the word recovery. I ended up one of those “hopeless” cases—diagnosed with bipolar disorder, chronically suicidal, and unable to live independently. Yet I recovered. Not remission. Full recovery.” In this interview, we discuss why "cured" is such a seldom-used word in psychiatry. We talk about the power of finding hope, the peer recovery movement, and much more. *** Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here