Welcome to From Insults To Respect. Today’s topic–money.
The way we handle money can influence how much respect we have for ourselves and others have for us. 
A classic illustration comes from Charles Dickens’s A Christmas Carol where we find the unforgettable Ebenezer Scrooge transformed by ghostly experiences from a disrespected miser to a lovable, generous employer. As we delve into our topic, we will draw upon a couple of episodes of Bob Dylan’s Theme Time Radio Hour show, both of which happen to be on the theme of money.
Money, Part One
As Bob introduces the first of his two episodes on money, he tells us, with reggae music in the background,
…we’re gonna take our cue from a sign Harry S. Truman kept on his desk: The Buck Stops Here. And not just the buck, the yen, the shekel, the nickel and dime, and if you still subscribe to the barter system, maybe a bushel of corn. So break open your piggy banks and cash in your bonds. This week’s episode of Theme Time Radio Hour is most definitely cash and carry.
Then, Bob plays us a recording of a man who sounds like someone delivering a US service announcement;
Wherever we go we see money being used as a medium of exchange. Money is a convenient method of exchanging many kinds of goods among many persons. Money is also a standard of value. The value of goods is stated in terms of money.
The first song Bob plays for us is the bluesy “That’s What They Want.” Performed by Jerry McCain and His Upstarts, it tells about a guy grieving about the women he knows who are just interested in finding men who have a lot of money, and a Cadillac too.
They don’t want no man,
Who don’t got no cash.
They’ll tell you quite quick,
They don’t mess with trash.That’s what they want,
Oh yeah, money honey.They don’t want no lovin’
No 24 hours a day,
They just want to know
When you get your pay.That’s what they want,
Oh yeah, money honey.
There is some fine harmonica playing on that one. As I interpret the song, the singer appears to be upset with women who view a guy as trash because he doesn’t have money. He’s looking for a gal who would be satisfied with a loving guy who will always be there for her. It captures the tension between wanting a relationship in which all of your material desires are achieved, versus the willingness to give up some, or all of that for someone whom you truly love because of his or her more intrinsic values. Reflective of this tension, over the years, I observed on occasion a guy or gal pointing to someone’s spouse while saying with disdain, “She married for money,” or “He married for money.”
A little later in the show, Bob tells us that some people will do anything for money. And then, setting up the next song, he says:
I almost think we play too much Van Morrison, but then I play one of his records and I say, “No we don’t.” Here’s one that Van recorded back in 1970, from his album, His Band and the Street Choir–“Blue Money.”
Blue money, according to the Urban Dictionary, refers to 100 dollar bills, which got its name from a blue line that goes up and down the bill. But in some circles, it means money from making porn movies. Thus, according to this interpretation, the song is about the singer’s girlfriend making porn movies, which involves engaging in sexual activities for money.
For many, people who make porn movies are looked down upon. There are better ways to make money, they say.
Although I personally believe there are indeed better ways to make money, I have some mixed feelings about completely losing respect for those who do earn money by engaging in sex. It comes from a couple of unique personal experiences.
When I was an undergraduate at Brooklyn College, I drove a taxi in Manhattan to cover my expenses. From time to time, as I was driving past the Port Authority, where buses and trains would bring loads of out-of-towners to the city, a few women dressed in very scanty, sexy outfits would jump in my taxi and tell me to drive around the block. As they peeked out the window, I could tell they had spotted some police officers, and they had me keep circling the block until the men in blue were gone.
Prior to this, I did think of those involved in this type of business in a pretty negative light, but this experience, meeting them in this strange way, well, I got to see a more human side of them as they talked among themselves in the taxi. I still feel that for myself there are far better ways to earn money, but this experience softened my unkind attitude toward those in the “Blue Money” trade.
Later, while a graduate student at the University of Minnesota, I worked at a Juvenile Correctional Facility, where I honed my counseling skills. Several of the female teenagers were in the facility because they had been engaged in prostitution. Here, I got to know what led these young ladies into this path to earn money. All came from extremely stressful financial situations. All were first lured into becoming hooked on drugs, which initially relieved their financially strapped stress. The leaders of the industry provided, at first, the drugs for free, along with other enticing gifts. In time, desperate to feed their addictions, these teenagers found turning tricks were the only way they knew how to survive. Somehow, during the counseling sessions, their humanity came to light, and a more kind and understanding attitude was fostered.
As Bob’s show continues, Bob plays for us, Nic Jones’s “Farewell to the Gold.” It provides a touching story of a man who, with a friend, spends his life hoping to strike it rich by prospecting for gold. In the end, his dream never comes true, and a flood leads to his friend drowning. The story is a metaphor for the real possibility that seeking gold doesn’t always work out well, and it’s important to be aware of this if we are to wisely choose our life’s pursuits.
In another song, this one called “Your Cash Ain’t Nothin’ but Trash,” by the Clovers, we hear about a woman who, in contrast to the women earning money in the Blue Money industry, this woman refuses to lower herself to a guy flashing his roll of dollars:
I was walking down the main track
One night
I met a fine chick
She was built just rightShe stopped when I flashed my roll
I told her she could have all of my doughShe turned around and with a frown
She said this ain’t no circus
And I don’t need a clownYour cash ain’t nothin’ but trash
Your cash ain’t nothin’ but trash
Your cash ain’t nothin’ but trash
And there ain’t no need in your hangin’ around
As this episode winds down, Bob plays us, “You Can’t Take It With You” by Jessie Price. If you like piano, clarinet, and trumpet solos, this number is sure to put a smile on your face. And then, Bob concludes with the following words:That was, “You Can’t Take It with You,” and one reason you can’t take it with you is that it usually leaves before you do. You know, I’m looking at my bag of records, and I brought too many again–bad planning. There are just too many songs about money to fit into a single hour, and there is no reason to cut fiscal corners. Hell, we did two shows about birds last year so we could do two about money. So, next week, we’ll dig back into our pockets, and continue to look at the filthy lucre. Join us again in seven days as we present part two of the Almighty dollar. Two shows about money, it makes good cents. See you next week.
Part Two
Bob begins part 2 by welcoming us back to the show. And then he says:
If you were listening last week, and if you weren’t, what the hell is wrong with you, but if you were listening last week, you know we started our look at cold hard cash. We had too many songs, so here we are back again.
Soon, Bob plays for us “I’ve Got Money,” sung by an incredibly energetic James Brown. It’s all about a guy who has money but still needs love. Some of the lyrics go like this:
I’ve got money
And now I need love
When I get my lovin’
I’ll be the happy one
The theme, it seems to me, is money without love, is simply not enough for a full life.
At one point, Bob answers his phone:
Bob: Hi caller, you’re on the air.
Caller: Hi Bob.
Bob: Where are you from?
Caller: Carbondale, Illinois.
Bob: What’s your name?
Caller: Carol.
Bob: Well, Carol, what can I do for ya?
Caller: I heard last week’s money show and I really enjoyed it.
Bob: Hey, thanks a lot. We worked hard on it.
Caller: It shows. I heard you were doing another one this week, and I was wondering if I could make a request?
Bob: What do you want to hear?
Caller: The Beatles’ song, “Money Can Buy Me Love.”
Bob: Carol, I think it’s, “Money Can’t Buy Me Love.”
Caller: No, No, it’s can buy me love. I have the record, so I know.
Bob: [insisting] Carol, It’s “Money Can’t Buy Me Love.”
Caller: I know you are Mr. Sixties, but I have the record. It’s can buy me love.
Bob: All right, Carol. We’ll look for it. Keep listening.
Caller: Thanks Bob.
Bob then hangs up, let’s out a long sigh, and says, “You can’t help some people. Carol, if you’re still listening, money can not buy you happiness, but it can buy you more places to look. Still looking for that song, but in the meantime, let’s listen to one by the Drifters.”
After some background remarks about the Drifters, Bob plays their song, “Money, Honey.” With the smooth voice of Clyde McPhatter, and some fine sax solos, the lyrics go,
You know, the landlord rang my front door bell
I let it ring for a long, long spell
I went to the window and peeked through the blind,
And asked him to tell me what was on his mindHe said, “Money, honey!
Yes, money, honey!
Mhm, money, honey,
If you want to stay with me.I was cleaned and skinned and so hard-pressed
I called the woman that I love the best
I finally reached my baby ’bout a half past three
She said, “I’d like to know what you want with me”I said, “Money, honey!
Money, honey!
Money, honey,
If you want to get along with me”She screamed and said, “What’s wrong with you?
From this day on, our romance is through.”
I said, “Tell me, baby, face to face
How could another man take my place?”She said, “Money, honey!
Money, honey!
Money, honey,
If you want to get along with me.Now I learned my lesson,
The wind may blow,
Before I pay I will love them so.
No doubt that in some situations, without money it is hard to get along. The solution, of course, is to find some respected ways to earn some, or find situations where money is not so essential.
We spent so much time talking about money, I want to leave you with someone who had an opposing opinion. He’s a smart guy about relativity, and he’s smart about this. We’re talking about Einstein, and he said, “I’m absolutely convinced that no wealth in the world can keep humanity from moving forward. Even in the hands of the most devoted worker the examples of great pure individuals is the only thing that can move us to noble thoughts and deeds. Money only appeals to selfishness and irresistibly invites abuse. Can anyone imagine Moses, Jesus, or Gandhi armed with the bags of money of Carnegie.” We’ll see you next week with all new themes, dreams, and schemes.
Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.
Welcome to From Insults To Respect. As several of my earlier blog posts have indicated, many professionals, mental health service users, involuntary patients, and the general public have little, to no respect, for the American Psychiatric Association’s most recent version of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
I developed the CSM approach while working with the Task Force on Diagnostic Alternatives of the American Psychological Association’s Division 32 (Society of Humanistic Psychology). That group has not officially supported, as of yet, any single alternative. Instead, it has wisely decided that its next step is to send out a new open letter hoping to garner support for starting a process that will involve all of the mental health stakeholders including former and current mental health service users, individuals who experienced involuntary treatment, their family members, and mental health professionals.
Today we once again take up the controversial topic of the usefulness of the group of drugs referred to by psychiatrists and the pharmaceutical industry as “antipsychotics.” In most of the articles that I have read that have been written by psychiatrists, “antipsychotic” drugs are the first line of treatment for schizophrenia. And yet, a growing number of mental health advocates have been fiercely critical of this. As someone who has given considerable thought to helping people resolve challenging conflicts, I set myself on trying to find out what is going on here. 
After a review of the scientific research and participating in several debates, I then wrote three blog posts that reported to my readers what I have found.
Upon publishing the first two posts, several defenders of the use of these drugs claimed these drugs are worth using because they reduce the risk of early mortality. I, therefore, published a third 
The cost for the drug approach is not just confined to the cost of the “antipsychotic” drugs which has been estimated to be in the range of several billions of dollars. Doctors often prescribe a whole cocktail of drugs for these patients, dramatically adding to the cost of the drug approach, while evidence indicates the combination of “antipsychotics” with these other drugs often leads to additional adverse effects. The cost of the doctors’ time for prescribing and monitoring the treatment must be added, as well, as the cost of the revolving door of placement in a hospital, releasing from the hospital, and readmitting to the hospital, which has been the frequent pattern with this drugging approach. Finally, we must add the cost of treating patients for all of the adverse effects of these drugs.
There are several very promising alternatives, but in most regions they are not yet available. Articles like mine are designed to expand the general population’s knowledge of just how ineffective, harmful, and financially wasteful the drug treatments are, and that there are safer alternatives. This increased awareness campaign has been a major reason for the slow rising tide of advocates demanding that these more healthy alternatives become readily accessible in every community.
A 
The central features of this treatment for this group of patients involve normalization and evaluation of the appraisals that people make, helping them to test such appraisals with use of behavioral experiments, and helping them to identify and modify unhelpful cognitive and behavioral responses. Additionally, it aimed to provide warm, empathic, and non-judgmental face-to-face contact, supportive listening, signposting to appropriate local services for unmet needs, and crisis management when needed.
Relationships developed naturally, and we all got to know one another to various degrees, no different than how we develop friendships. This was not a therapist-patient relationship but rather a sort of social relationship. As a staff member I had some responsibilities—going to the market and preparing dinner. Everyone was on their own for breakfast and lunch and could help themselves to whatever they might like. Grocery shopping was often an outing to the market. Usually, one or two residents would accompany me to the store. When we returned, I would ask for help prepping the meal. It was quite informal. The house was often a bit of a mess, but then, we’d all get together and decide it was time for a quick house cleaning and again, whoever wanted to join would do so.”
Another approach well described in the JHP special issue is written by Charles Knapp. The Windhorse therapeutic perspective has a Tibetan Buddhist orientation that offers meditation, and spiritual teachings, along with a supportive, empathetic staff. Unlike the Soteria House approach, which aims to support people through a recovery process over a few months, the Windhorse approach recognizes that individual recovery periods are highly variable, and it is not uncommon for people to stay in their programs for eighteen months and even longer.
There are several other approaches described in the JHP special issue, all worth while to think about. All have had their share of success in helping to provide support for people experiencing extreme states.
Supporting this notion that the incident was staged is that McSally quickly posted the video. Fox News host Sean Hannity instantly began to praise her conduct, and she got additional publicity by appearing on Laura Ingraham’s Fox News show. Meanwhile, President Trump’s 2020 campaign 
Here’s another difference between what typically happens during your interpersonal relationships and the intergroup interactions that involve politicians. When someone directly seeks to insult you, unless you are well trained in handling this in a peaceful manner, you are likely to take the insult personally. The emotions that arise in this situation are more likely to be stronger than typically experienced when groups of people see on TV or in a large arena a politician throwing insults at someone they don’t personally know.
ikes you as political correctness.
“Blowin’ In The Wind.” “With God On Our Side.” “Masters Of War.” These are songs Bob Dylan has written and performed expressing deep emotions about the wisdom of going to war. As I began to reflect on these songs, to my mind came the pounding of war drums, the cries of vicious insults emanating from a deadly divide, images of fear, pride, disgrace, bombs exploding, and thousands screaming in horror.
And then I found myself pulling up on the internet Bob Dylan’s Theme Time Radio Hour show, and clicking to hear his specific show on the theme of war. It’s available for free 
The show begins with a series of brief audio clips of the sounds of a country at war–bombs going off as Marine helicopters are approaching a battle field, a news reporter describing the scene of burning tanks, the voice of President Lyndon Johnson committing an additional 20,000 troops to Viet Nam as that war was escalating, etc. Then we hear Bob introducing the show’s theme:
Plato once said, “Only the dead has seen the end of war,” and sadly it is as true today as it was then. 
Today we are going to examine battles and beaches, skirmishes and embroglios, we are going to let loose the dogs of war, pay tribute to Mars in Aries, shed a tear for the widows and orphans. We’re mustering cadets, for Theme Time Radio Hour is going to war!
Why I crossed three thousand miles of rolling waves.
When I was a young man I carried me pack 
When the ship pulled away from the quay 
Some say war is a game that men play using boys as the tools. Truth to tell, you don’t see many men in battle, but you see a lot of boys. Wars used to be fought by men and I think that fairer. Men are the ones waging the war, they ought go out and fight it. 
I’m just a poor ex-soldier that’s broken down and blue,
One staple of songs about war is the letter. Sometimes it’s the letter that the guy writes from the battlefield. Other times it’s from home. But the worse kind of letter of all to receive was one written by a military chaplain. It usually had a line in it, something like, “You would be delighted to know that your son died a hero.” It’s a nice sentiment, but I doubt it was really any solace. 
I close my eyes every night
Is don’t they pray
Peace to the world
An American flag waving in the breeze along with stirring patriotic music; this can be a fitting end to a Hollywood movie, but before we go marching once again into war, there is far more to consider.
I hope all of you are having a fine holiday season. This, of course, is the time of year when the longing for peace on Earth and good will to all is beautifully expressed in songs and stories.
For example, during the American Civil War, Henry Wadsworth Longfellow wrote a poem titled “Christmas Bells,” that was later made into a song renamed “I Heard the Bells on Christmas Day.” It begins with pleasant aspects of the season, but then the reality of the war sets in:
In the earliest period that humans thrived, they were chiefly hunters and gatherers. At that time, it has been estimated that death came as a result of one person killing another about twenty percent of the time. Evidence for this was obtained by looking at the skeletons from that period. Quite often we find fractured skulls and arrowheads embedded in chest cavities.
Another dramatic decrease occurred around the Age of Reason and the European Enlightenment in the 17th and 18th centuries. The invention of the printing press had made pamphlets and books far more readily available, spreading humanistic values throughout the human population. That era saw the first organized movements to abolish slavery, dueling, judicial torture, superstitious killings, sadistic punishment, and cruelty to animals.
Actually, we find that the vast majority of Muslims who are living under similar sets of conditions as other religious groups in the developed countries are in no way more violent, nor are they more likely to violate what are now viewed by most as basic human rights. Also relevant to this question is the fact that people from religious groups other than Muslims, when raised under the conditions similar to the violent Muslim areas, are every bit as violent as groups like ISIS. Consider the murder rate in communities like South Chicago.
Today, the major parts of the world that are most violent prone are at the same psychological developmental level as the largely Christian southern states were just about when the American Civil War began. Let us compare, for example, the highly violent group known as ISIS with that bloody period of American history. The confederate southern states had, like ISIS has today, an ideology that slavery was essential to their way of life, and outsiders (the northern states) were actively interfering with what they believed is right. Moreover, the confederate states used quotations from their holy book to defend their beliefs and to justify going to war to protect their ideology in a way that is similar to how ISIS utilizes sections of their holy book.
After abolishing slavery, England continued for about a hundred years to use violent force to maintain its hold on colonial labor, but Mahatma Gandhi effectively used nonviolent resistance to put an end to colonial rule. Soon afterwards, colonialism began to end elsewhere.
There are some credible reasons for supporters of the most violent regions of the Earth to feel that there has been an ongoing effort to force them to do whatever is in the interest of the US and its allies. Years before the creation of ISIS, for example, meddling in Middle East affairs occurred by the US’s CIA. Then came the US invasion of the largely Muslim inhabited Afghanistan and Iraq countries.
With regards to responding to regions that continue to enslave people, the US would use nonviolent approaches such as boycotting any goods or services that might fund the violent group’s operations, along with boycotting any country or enterprise that does business with such violent groups, while offering a vision for engaging in peaceful commerce as described in step 4.
Therefore, the US would launch an all out peaceful advocacy effort to have the United Nations offer to fund a constitutional convention for all of the stakeholders in the regions where violent groups are operating. Those violent groups’ representatives would be invited to be central players, and incentives to participate would be provided. UN Peace Keepers would be employed throughout the convention period to help decrease the likelihood that some would seek to violently sabotage such efforts.
Professor Steven Pinker provides evidence in his book, 
And in fact, many believe that it is this set of challenges that is the main cause of the region’s violence problems. In mid-day much of these regions are often so hot it could make the Dalai Lama ignite in irritability. Large sections of these regions are as parched as the moon’s surface. But the regions do have some natural resources. For example, they tend to have plentiful sunshine. Nevertheless, they remain rather poor in contrast to the more developed countries.
Professor Pinker notes that prior to the invention of the printing press there were very few books available. Those people who lived in the upper classes rarely had much direct contact with the lower classes. A nobleman’s quick glance while passing by a downtrodden worker often merely left the impression of a filthy, smelly soul, hardly human at all. After novels became available, a nobleman might read of a poor young woman pressed into very sad circumstances by a cruel person of the upper classes, and discover tears running down his cheeks. Discovering that people all over the world, in all classes, and other religions have very similar desires, dreams, and feelings that we can all relate to, increases empathy and the desire to deal with a wider range of humanity in kind and respectful ways.
So, how would we get these kinds of stories before those who are in groups prone to violence? At the two types of conventions I mentioned above that would be funded by the United Nations (constitutional and commerce) short, readable, relatable books would be freely provided that convey these heartwarming stories. International funding for public libraries for regions too poor to provide for them on their own would be provided. Moreover, there are ways to make these types of stories particularly accessible on internet sites that violent groups tend to visit, not only in written form, but also in audio-visual forms as well. And instead of the steady dropping of bombs in regions occupied by violent groups, an international coalition could drop little parachuted packages that include a little tasty healthy treat, a little toy or stuffed animal as a gift to the children, an interesting puzzle that adults would enjoy doing, and the type of stories that I have just described.
What does this controversy look like? Well, let’s begin by looking at an 
“The effectiveness of timeouts has been proven through decades of research, including work in the field of “
And a number of smaller, focused studies have specifically tested timeout and found it to be 
Apparently, part of the controversy is due to the timeout technique being employed in different ways. Consider a parent who says she uses time out with her 5-year-old daughter. Then, when we watch her using the technique, we discover that whenever her daughter acts in any way that is annoying her, she begins to scream, shoves her into her room, while shouting, “You better shut-up you little brat!” She keeps her alone in her room for an hour.
Because she has a number of tools to teach her child to learn how to behave in effective ways, she only uses timeouts on rare occasions, lasting only 5 minutes, and targeting just one behavior during a period of a few weeks until her child has learned a new positive behavior pattern to replace the negative behavior pattern. Then, slowly, she incorporates the technique for teaching another behavior pattern. She never tells her child to stop doing the negative behavior pattern, but instead, she explains, as best that she can, what behavior pattern would be better, and explains why it would be better. 
When she sends her child to timeout, she does so in a calm, supportive voice, and remains in the same room with him. Prior to carrying out this approach, she has discussed with her child this technique, explaining that learning a new skill takes time, and timeout will help him to learn to act in a manner people will respect. She emphasizes throughout the process that she loves him, and expresses confidence that he will master the new skill soon.
So, here we see two parents believing they use timeouts with their child, but both use dramatically different approaches. I used timeouts with my two sons when they were very young in an even different way. I’ll describe this other approach shortly, but, for now, my main point in this section is that part of the controversy has to do with the fact that when people say they use timeouts, without finding out more details about how they use it, a great deal of misunderstanding can ensue.
Removing access to rewards is a type of punishment, and research on punishment indicates it leads to variable results, sometimes good, sometimes bad. Dadds and Tully appear to hope to mitigate any bad results by advocating that rather than using timeout as a stand alone strategy, its use “must be part of a broader behavior program that promotes a warm and rewarding relationship, and explicitly teaches alternative positive child behaviors to replace the problem behavior to improve the child’s self-efficacy in meeting their own needs.”
These authors, reviewing the research evidence, conclude that timeout, when used as they describe, can promote a child’s mental health and that there is an absence of evidence showing it is harmful after five decades of research. Meanwhile, inappropriate parental discipline strategies have been, and continue to be implemented in the name of “timeout,” and these are potentially harmful.
I have described my broader child rearing strategy in earlier posts (see 
As William James, the great psychologist and philosopher, described using this approach with children:
Note that in contrast to the American Psychologist article I discussed earlier, my use of this type of timeout was not intended to take away some valued reward. Rather, I would seek to do something pleasant with them. At some point, when all was calm, I would ask gently, “When you were making all that noise near Mom, had she asked you to quiet down?” I would then listen to their responses and gently ask what they could do better if a similar situation comes up in the future? When they were very young, sometimes they blamed someone other than themselves for what happened, and I would frown. Sometimes they responded in a manner that took responsibility for their actions, and I would say how much I appreciated what they had said.
As another example, when we were in a restaurant, if one of my boys began to make too much noise, I would take him outside, and explain that people who go to restaurants typically prefer to eat in a pleasantly quiet atmosphere. I would then explain that when he was ready to go back and speak softly we could enjoy a nice family meal together. Typically, in less than five minutes, we would be back at our table.
If they go to someone in the medical profession, they typically find that after a visit of somewhere between ten minutes to an hour they have been labeled as having a mental disorder and then are prescribed one of the psychiatric drugs, or even a whole cocktail of them. This pattern of dealing with such concerns leads, in some circles, to a conflict. Some involved in the conflict think that the pathologizing of these very human experiences and the encouraging of the use of drugs to manage them is the very opposite of a healthy approach. Meanwhile, other people feel that drug treatment for these types of concerns are enormously helpful, and anyone questioning this position is irresponsible. Insults have been known to fly back and forth from people on both sides of this conflict.
You can hear me, for free, being interviewed on this topic by the insightful Emily Whyte Rubin on a recently recorded Feeling Deeply podcast by clicking 
You see, when I look to see if someone has a conflict, I think of the word 
Being guilty, as I use the term, means the person would be deserving of some punishment, such as being insulted.
That’s not to say that I advocate that those people already taking these drugs should immediately stop taking them. There are some physiological withdrawal effects that occur if someone suddenly stops, which some experience as awful. If some of you who have been taking these drugs decide that you want to try to wean yourself off, a good resource to help can be accessed 
Although I don’t have a conflict with those who believe in the psychiatric medical approach, I do find that as I go about advocating for my own view on this issue, many with opposing views do end up having a conflict with me.
There are, however, other people who do support the psychiatric medical model, and yet, like me, treat people with opposing views respectfully. Today’s post comes out of one such respectful discussion. This person, without insulting me, defended his support of the psychiatric drugs by claiming that all of the research clearly indicates that the “antipsychotic” drugs, when used by people diagnosed as having schizophrenia, decrease the risk of dying. I then, very respectfully, asked that he supply me with the references that he is relying on to make his assertion, and within a very brief period, he did just that.
Prior to looking at the articles that the respectful criticizer of my position provided to defend his belief that the “antipsychotics” reduce mortality for people being treated for schizophrenia, let’s first look at some relevant research studies that he left out. You will note that each time I use the term “antipsychotics” I put it within quotation marks. This is to help remind readers that these drugs do not work like antibiotics, which are designed to kill bacteria that have infected an organism. Nor am I at all convinced that these drugs work to counter any of the causes that lead someone to be given a psychotic label.
Patients diagnosed as having schizophrenia have a 15-20 year shorter life expectancy than the general population, according to a 2014 study published in the Annual Review of Clinical Psychology titled “Excess Early Mortality in Schizophrenia.” Just in case there is any confusion of what “mortality” means, it means risk of death.
Adjusted for age and gender, people with schizophrenia taking either no “antipsychotic,” one, two and three or more antipsychotics had relative mortality risks of 1.29, 2.97, 3.21, and 6.83 respectively. Said in a simpler manner, individuals who were labelled as having schizophrenia who did not take any “antipsychotic” drugs had the least chance of dying during the 17-year follow-up period, compared to the other patients who were labeled as having schizophrenia but were taking “antipsychotics.” If the patients took just one of the “antipsychotic” drugs, they were more likely to die, and if they took more than one “antipsychotic” drug, they were even more likely to die. The association remained stable throughout the observation period.
The authors note that it has been claimed that the contemporary high natural mortality in schizophrenia results from a variety of lifestyle factors. Of these factors, the study that they did was able to consider several (smoking, exercise, body mass index, blood pressure, serum total and HDL cholesterol). After adjustment for these factors the excess mortality of people with schizophrenia persisted. The association with “antipsychotics” and mortality was, according to the authors, very clear.
Mental health services have advanced in many parts of the world during the past few decades. Apart from a different mix of community-based care, the introduction of the second-generation antipsychotic medications [also referred to as atypical antipsychotics] in the early 1990s was initially found to be associated with better quality of life and reduced risk of relapse.
During the 1970s through the 1990s, the authors note, mortality rates were improving for the general population. In contrast to this general trend, mortality of those classified as having schizophrenia was trending in the opposite direction. The median SMR for those diagnosed in the 1970s, 1980s, and 1990s were 1.84, 2.98, and 3.20, respectively. The higher the SMR, the higher the rate of mortality.
Adverse health outcomes associated with weight gain and/or metabolic syndrome (eg, myocardial infarction, cerebrovascular accidents, or cancer) may take decades to fully emerge. Thus, it seems likely that studies undertaken in the 1990s (ie, the most recent studies included in this review) would capture only a small fraction of the eventual burden of mortality associated with the adverse effect profile of the second-generation antipsychotic medications. In light of the rising secular trends in SMRs already identified by this review, the prospect of further increases in mortality risks for schizophrenia is alarming.
In 2009, another study looked at the relevant research, this one appearing in the journal Schizophrenia Research. Titled, “Influence of Antipsychotics On Mortality in Schizophrenia: Systematic Review,” it concluded, “There is some evidence that long-term exposure to antipsychotics increases mortality in schizophrenia. More rigorously designed, prospective studies are urgently needed.”
Also in 2009, there was a relevant study published in the prestigious New England Journal of Medicine. Titled, “
In 2010, the British Journal of Psychiatry published a study titled “Twenty-five Year Mortality of a Community Cohort with Schizophrenia.” Here, data from 1981 to 2006 was examined. The authors concluded that:
But the research reveals that, over the long term, this benefit turns into a negative, and so, over the long-term, there are only negatives to be chalked up: the increased chronicity of psychotic symptoms, the impaired functional outcomes, the worse cognitive functioning, and, of course, a broad range of “side effects,” such as tardive dyskinesia, metabolic problems, sexual dysfunction, and so forth. Such is the bottom-line arithmetic that makes the case against antipsychotics.”
The first study on my critic’s list used 
Rather than supporting his position, this article supports the theory that given the evidence that the “antipsychotic” drugs have a number of serious side effects, and once started, physiological withdrawal effects can be awful, it is prudent to safely hold off on the use of these drugs for at least 13 weeks to see if some patients will begin to recover without them. Despite this evidence, I am under the impression from dialogues with many psychiatric patients that the standard practice is to prescribe these types of drugs within somewhere between 10 minutes to an hour after the patient is first brought to the attention of a prescribing doctor. 
Before moving on, I would like readers to note that this was the only randomized controlled study on my critic’s list of references that he said supports his position. The rest of the studies compared different groups of patients that were not randomly chosen to be in each of the groups. These studies compared a group of patients described as not taking “antipsychotics,” with others said to be either taking just one of them, more than one, different dosages of them, or another drug such as a benzodiazepine. Without random placement to each of the groups, these studies, from a scientific point of view, cannot speak to whether it was the prescribed drug that was the cause of the different rates of mortality, or other reasons. This is an essential point to keep in mind.
First, random assignment only increases the likelihood, but does not guarantee, that the different groups being compared will be so similar prior to any intervention that any difference found after the intervention is due solely to the different interventions each group does or does not receive. Thus, with random assignment the pre-intervention groups can end up quite different. When this happens, the researchers can end up attributing any difference between the groups after the intervention to the intervention when the difference might be due to the groups being poorly matched prior to the intervention. A second reason why random assignment studies are not perfect is, those who did the experiment may report the results incorrectly because of a mistake, subconscious biases, or monetary motivations that lead to bending the truth.
Now, I am not faulting researchers for trying to get some relevant evidence using the nonrandom assignment to groups methodology. Although random assignment to groups is considered the gold standard, carrying out long-term studies with psychiatric patients is almost impossible. Patients who are assigned to take the drugs often don’t take them, or don’t take them as prescribed, and the longer the study, the more likely this will happen. A significant number of patients wander off and can’t be found at various follow-up points. Many doctors refuse to participate in long-term studies that utilize a placebo group believing it is unethical to withhold a promising treatment for such a long period of time when they see their patients suffering; and over the decades newer, more promising interventions come along, so to continue to use the drugs that were popular at the start of the study would be considered unethical.
The most important finding from the set of nonrandom to groups studies my critic provided, from my perspective, came out of a 2009 study. There we find that patients that were on “antipsychotics” for less than 6 months had a lower rate of dying than those who were on the drug for longer periods. The authors note this in the results section of their article with a single sentence, stating,”Patients who used antipsychotics for less than 6 months had especially low mortality rates.” This is accompanied by a graph showing this. Then, in the discussion section, the authors again mention this in a single sentence.
If you read just the abstract of the article, as many practitioners do because time reading research studies is not billable, you would find no mention of this statistically significant finding, a finding that could have life saving implications. And this finding can easily get lost in the numerous paragraphs of the study which focused instead on the evidence that those on the drugs for longer periods had a lower mortality than those who were said to be in the “no antipsychotic group.” However, the vast majority of the patients said to be in the “no antipsychotic group,” and probably all of them, actually were on these drugs at various points throughout the study. While they were hospitalized, they were almost certainly on the drugs, according to one team of researchers who had engaged in a similar study using the same data set, and many were hospitalized multiple times. What the researchers actually meant by labelling the group the “no antipsychotic group” were patients who didn’t take them each time they were released from the hospital. Thus, each time they left the hospital, they were suffering from withdrawal reactions.
There are a number of other serious problems with the design of these types of studies that was chronicled in a peer reviewed article that came out shortly after the 2009 study, including incomplete reporting of data, questionable selection of drug groups and comparisons, important unmeasured risk factors, inadequate control for potentially confounding variables, exclusion of deaths occurring during hospitalization leading to exclusion of 64% of deaths on current “antipsychotics” from the analysis, and survivorship bias due to strong and systematic differences in illness duration across the treatment groups. The writers of this critique concluded:
Thus, it is very possible that although a relatively higher percentage of patients not taking “antipsychotics” during periods when they were not in the hospital died when compared to the other patients during the five to eleven year periods that were looked at during the course of these studies, we still don’t know what would have happened if we could have looked at what age all of these patients ended up dying. The added risk factors that come with ingesting these drugs, such as weight gain and metabolic syndrome, may not exert their influence on mortality rates until a longer period of time.
This presents the theory that when compared to those patients in the other comparison groups, the group of individuals who did not take “antipsychotics” when they were not hospitalized may have had a higher percentage of members who not only avoid “antipsychotic” treatment, they also avoid all medical treatment. With this theory, it is not taking the “antipsychotics” that protects the patients from dying, but rather it is the increased likelihood that more “antipsychotic” compliant patients are more likely to comply with all medical treatment. Said another way, with this theory, we have less of a reason to conclude “antipsychotics” provide some protection from dying from these conditions; rather, it is this non-compliance to all medical treatment characteristic of some in the “no antipsychotic” treatment group that is the real cause for the statistical increased rate of death for those in this group during the relatively short window of time that these researchers were able to peek into.
In considering how dependable the evidence is from this entire set of studies, it is worthwhile to look how frequent they came up with contradictory findings. A few of the studies, for example, found a statistically significant decreased risk of suicide for those taking “antipsychotics” when compared to the so called “no antipsychotic” group, while another study that looked at the same data set found no significant difference. One study found a significant reduction in risk of dying when the patients used the “antipsychotic” clozapine, whereas another study did not find this, and found instead that clozapine was one of the drugs that appeared to slightly increase the risk of dying. A couple of studies found that even patients who took the highest doses of “antipsychotics” had a similar risk of dying when compared to a moderate dose, while another found the highest dosed patients were at an increased risk of dying. Thus, anyone making firm conclusions based on these types of studies is trying to build a house on shifting sands.
The first study that appears on his list was published in The Lancet in 2018, and titled “
These two studies were carried out by the same team of authors and applied a similar methodology using a data base from Finland. The first of these is titled, “Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of Patients in Community Care After First Hospitalisation Due to Schizophrenia and Schizoaffective Disorder: Observational Follow-up Study,” and was published in 2006 in the British Medical Journal. It looked at a nationwide cohort of 2230 consecutive adults hospitalized for the first time because of schizophrenia or schizoaffective disorder, from January 1995 to December 2001. All of the patients had been hospitalized at various points in time, and during their hospitalization, no record was kept to see if while they were there they had been placed on antipsychotics and/or other drugs. Those patients who chose not to fill their prescriptions whenever they left the hospital were said to be in the no antipsychotic group. However, it is very possible that many of the patients in this group had repeatedly gone into a hospital for various periods of time and while there were placed on an “antipsychotic,” or a cocktail of “antipsychotics” and other drugs, and each time they were discharged they went through drug induced withdrawal reactions.
Moving on to the other Finland study by this team of authors, it was published in 2009 in Lancet and titled “11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).” As I mentioned, it is very similar to the previous Finland study, but extends the follow-up period an extra few years. Both studies have very similar results. Those who are labeled as not using any “antipsychotics” but probably did use them when they were in the hospital, had relatively higher rates of death than most of the other comparison groups. However, the patients that had the lowest rate of deaths were those in the group labeled as using “antipsychotics” for less than 6 months. In the main body of the journal article the authors note this in a single sentence, stating,”Patients who used antipsychotics for less than 6 months had especially low mortality rates.” There is a graph that illustrates this. It does repeat this again in another single sentence in the “Discussion” section of the report. Nothing else in the write-up of the report bothers to discuss this, and it can easily get lost in the numerous paragraphs defending the evidence that those on the drugs for longer periods had a lower mortality than those who were in the “no antipsychotic group” even though all of those patients in that group had probably been on such drugs each time they were hospitalized, and were only not taking them each time they were released from the hospital.
The next study on my critic’s list is titled “Mortality and Cumulative Exposure to Antipsychotics, Antidepressants, and Benzodiazepines in Patients With Schizophrenia: An Observational Follow-Up Study” and was published in a 2016 edition of the American Journal of Psychiatry. The lead author is, once again, Dr. Jari Tiihonen, the same researcher of the last two studies that we looked at and who has numerous pharmaceutical industry conflicts of interest.
Using a very similar methodology as the Finland studies, it found that over a period of 5 years the prescription of moderate or high-dose “antipsychotics” for people labeled in Sweden as having schizophrenia was associated with lower overall mortality, compared to those said to be in a “no antipsychotic” group.” For those prescribed a benzodiazepine along with an “antipsychotic,” the results were quite different in that this group had the highest likelihood of dying when compared to the other groups. Thirty-eight percent of the patients were prescribed a benzodiazepine. Common benzodiazepines are Valium (diazepam) and Xanax (alprazolam).
This 2013 study, titled “Comorbidities and Mortality in Persons With Schizophrenia: A Swedish National Cohort Study,” was published in the American Journal of Psychiatry. It is pretty much the same type of study as the one’s carried out with Dr. Tiihonen and uses the same Swedish group of patients over a very similar time period as one of his studies, but here a different team of researchers looked at that data set. Again, lack of antipsychotic treatment was associated with elevated mortality. However, as hard as I looked in the article to see how the researchers defined “lack of antipsychotic treatment” I was not able to find it. As in other similar studies, most of those in the “lack of antipsychotic treatment group” were still alive, so we don’t know if they would, as a group, have begun to die at an earlier age if all were followed up until all in their group died.
This 2017 study, titled “Reduced All-Caused Mortality With Antipsychotics and Antidepressants Compared to Increased All-Cause Mortality with Benzodiazepines in Patients With Schizophrenia observed in Naturalistic Treatment Settings,” was published in Evidence-Based Mental Health. This study examined the same Sweden data set as our “Fourth Study,” but utilized a different set of researchers. The outcomes were largely the same. Five years were looked at. Compared to the “no antipsychotic” group, the prescription of “antipsychotics” for people labeled in Sweden as having schizophrenia was associated with lower overall mortality, unless they were also prescribed a benzodiazepine, in which case they had the highest likelihood of dying. As in the earlier Sweden study that I discussed, inferences from this study’s findings are limited due to lack of randomization to the various comparison groups which prevent differentiation of causal from non-causal associations. This study actually does not really compare patients who took no “antipsychotics” with those who did, because all of the patients took “antipsychotics” at various points in their lives. Despite statistical adjustment for some relevant baseline variables, highly relevant variables were unaccounted for, including direct measures of schizophrenia severity, unhealthy lifestyle behaviors, degree of substance use, medical comorbitities and treatment, health service use pattern, and treatment adherence. And, of course, the study just looked at what could be observed in a five year period at which point the vast majority of the patients studied were still alive. Such studies don’t reveal what the average age of death is for those who are labeled as having schizophrenia and are taking “antipsychotics” versus those who were also labeled as having schizophrenia but did not take “antipsychotics.” Like other studies that were done after the 2009 study, this one did not bother to find out if patients that were on “antipsychotics” for less than six months was the group least likely to die during the followup period.
This 2017 study, titled “Mortality and Antipsychotic Drug Use in Elderly Patients With Parkinson’s Disease in Nursing Homes,” was published in the Journal of the American Medical Directors Association. It looked at some data over a period of 18 months and does not directly address the issue under discussion. That is, these patients were elderly and had Parkinson’s Disease, rather than being labeled as having schizophrenia. For this group, prescribed antipsychotics for an 18 month period was not associated with the risk of death.
This 2015 study, titled “Antipsychotic Treatment and Mortality in Schizophrenia,” was published in Schizophrenia Bulletin. It looked at the same Sweden data set as our “Fourth Study” and “Eighth Study.” Each had looked at the follow-up that began on January 1, 2006 and ended on December 31, 2010.
Consequently, some of my readers showered me with praise for having the courage to stand up to the powerful pharmaceutical-psychiatric institutions, while others showered me with the most disrespectful insults known to the human race. 
And then there were those who disagreed with me but did so in a respectful manner. I believe it is my responsibility to now provide them a respectful response.
Any pill prescribed by a doctor will lead many to experience a placebo effect, which can be, for a period of time, helpful. I hasten to point out that a person can get a placebo effect with non-drug treatment approaches as well, and this would avoid the various harms associated with this type of drug.
These drugs are not only known as “antipsychotics,” but also “major tranquilizers,” because they sometimes do appear to calm someone in distress.
Unfortunately, once someone begins to take these drugs to help with agitation, when they try to come off of the drug, they are left with drug withdrawal experiences that have been described as awful. I hasten to point out that there are other ways to help someone to calm down that need not rely on these types of drugs. I have worked on many occasions with people who are agitated, and without the aid of a drug prescription I listened in a caring way, and in time the person eventually calmed down. If, however, you give someone a drug that calms the person down, it is sometimes much easier, and less time consuming. For people who witness someone they care about in high distress drift into a calmer state upon taking an “antipsychotic,” this can seem enormously helpful.
Some of them would have recovered in a fairly short period without the drug, but because they recovered while taking the drug, they, and their loved ones, attribute the improvement to the effectiveness of the drug. If the person tries to see whether the improvement was due to the drug or the natural recovery process, he or she may try to stop ingesting the drug.
However, the withdrawal from the drug, as I mentioned above, often causes a nasty physiological reaction which, in some ways, is similar to someone who is a coffee drinker who suddenly decides to stop, cold turkey. However, the “antipsychotic” physiological withdrawal reaction can be experienced as much worse. When people who care about this person see the downward spiral that occurs from the physiological withdrawal reactions, they may come to attribute it to the person’s “mental illness” returning, and thus, the illusion of long term effectiveness is now deeply entrenched.
Another way in which the illusion of the long term effectiveness of the drugs can occur has to do with the fact that even when the “diagnosed” person is not functioning well on a drug treatment regimen, human beings can always imagine that the patient would be doing even worse without taking the drug. And of course, when the patient does try to go off the drug, the raging physiological withdrawal process occurs. So, in this way, the combination of the belief that the patient could be doing worse, and upon becoming worse when trying to do without the drug, it convinces people that the drug treatment is helpful.
Once they take that position, and tell others what they had done, information that comes their way in the form of the distressed person having bad side-effects, or hearing from people who take the position that the drugs may be more harmful than helpful, a psychological phenomenon known as cognitive dissonance occurs. The principle of cognitive dissonance states that human beings strive for internal psychological consistency. When they experience internal inconsistency they become psychologically uncomfortable and a major way that they try to reduce the discomfort is by avoiding circumstances and contradictory information likely to increase the magnitude of the cognitive dissonance.
I have publicly supported the argument that these drugs cause more harm than good. Therefore it can be argued, it is I who suffer from cognitive dissonance whenever evidence comes my way that might support the idea that these drugs are helpful in the long run.
By the late 1990s, investigators had reported that antipsychotics caused basal ganglion structures and the thalamus to swell, and the frontal lobes to shrink, with these changes in brain volumes “dose related.” Then, in 1998, Raquel Gur, from the University of Pennsylvania, reported that the swelling of the basal ganglia and thalamus was “associated with greater severity of symptoms.”
The MRI studies provide objective evidence that antipsychotics cause changes in brain volumes that are associated with a worsening of symptoms, and a worsening of functional impairment.
And so, parents start getting phone calls from these frustrated teachers, urging them to consider having their son or daughter evaluated for ADHD. “There are medications available for children that help these kinds of problems,” the teachers explain.
To do my best to offer balance to the pharmaceutical industry’s point of view, in earlier posts I review the research pertaining to how effective and ineffective these drugs are (see 
That is, many of these children have no problem paying attention to many types of tasks, such as art projects, singing songs, and playing sports, but find academic school lessons boring. 
Others are the youngest student in the class and are actually acting in a manner typical for their age.
Nevertheless, it does sadden me when I hear about this decision, for I become concerned about the child’s stomach, kidney, nerves, hormones, developing brain, and bone structure. Drugs that physicians have said are safe and effective have, in the past, proven to be far more toxic than anyone ever dreamed. The latest such case involves the use of pain killers that fall in the class of Oxycontin, which many physicians cooperated in creating a situation now declared a national emergency. I for one have been deeply grieving over the suffering of the tens of thousands of family members caught up in this horrible deadly mess.
I grieve as well over the social misery that goes along with being singled out as a child that must take a pill to fix the problem said to be in his or her brain. More than a few kids have told me that this process, for them, became a dreaded experience.
I prefer to put forth a view that encourages us to teach our kids about the value of keeping our bodies in lifelong possession of its full youthful state by avoiding the use of stimulants and narcotics. I wish to teach our kids it is possible that the morning sun and air are far better and healthier intoxicants. Doing something that puts a smile on the lips of a loved one, accomplishing a valued challenging task, providing assistance to another human being–these are the directions I wish we would point to when we guide a child toward a fulfilling life.